MindMap Gallery Don’t study medicine in the next life - blood and lymph
Summary of blood and lymph knowledge points, including blood. Summary of the content points of the three modules of lymphatic, hematopoietic stem cells and hematopoietic stem cell transplantation. Hope this helps you all!
Edited at 2023-02-10 10:17:38El cáncer de pulmón es un tumor maligno que se origina en la mucosa bronquial o las glándulas de los pulmones. Es uno de los tumores malignos con mayor morbilidad y mortalidad y mayor amenaza para la salud y la vida humana.
La diabetes es una enfermedad crónica con hiperglucemia como signo principal. Es causada principalmente por una disminución en la secreción de insulina causada por una disfunción de las células de los islotes pancreáticos, o porque el cuerpo es insensible a la acción de la insulina (es decir, resistencia a la insulina), o ambas cosas. la glucosa en la sangre es ineficaz para ser utilizada y almacenada.
El sistema digestivo es uno de los nueve sistemas principales del cuerpo humano y es el principal responsable de la ingesta, digestión, absorción y excreción de los alimentos. Consta de dos partes principales: el tracto digestivo y las glándulas digestivas.
El cáncer de pulmón es un tumor maligno que se origina en la mucosa bronquial o las glándulas de los pulmones. Es uno de los tumores malignos con mayor morbilidad y mortalidad y mayor amenaza para la salud y la vida humana.
La diabetes es una enfermedad crónica con hiperglucemia como signo principal. Es causada principalmente por una disminución en la secreción de insulina causada por una disfunción de las células de los islotes pancreáticos, o porque el cuerpo es insensible a la acción de la insulina (es decir, resistencia a la insulina), o ambas cosas. la glucosa en la sangre es ineficaz para ser utilizada y almacenada.
El sistema digestivo es uno de los nueve sistemas principales del cuerpo humano y es el principal responsable de la ingesta, digestión, absorción y excreción de los alimentos. Consta de dos partes principales: el tracto digestivo y las glándulas digestivas.
blood and lymph
blood
Circulating blood volume is 5L, accounting for approximately 7% of body weight
Anticoagulants (heparin or sodium citrate)
Plasma (55% volume)
light yellow
Volume 55%, ph7.3~7.4
Ingredients
Water (90%)
plasma proteins
albumin
globulin
fibrinogen
No anticoagulant is added. After standing outside the body, fibrinogen is converted into fibrin in a fiber-interwoven state, which wraps the blood cells and causes the blood to coagulate into a blood clot.
enzyme
lipoprotein
hormone
vitamins
Inorganic salt
Function
Circulating fluid that carries blood cells, nutrients, and metabolites throughout the body
Participate in the body's immune response, body fluid and body temperature regulation, water and electrolyte balance and osmotic pressure maintenance
blood cells
White blood cells and platelets
off-white
leukocyte
Colorless nucleated spherical cells
Are there any special particles?
granulocytic leukocytes
neutrophils
Most (50~70%)
It is spherical in shape, with darkly stained nuclei, curved rod-shaped or lobulated, and the lobed nucleus is irregular oval. There are filaments connecting the leaves. It can be divided into 2 to 5 lobes, and normal people usually have 2 to 3 lobes.
The number of leaves is proportional to the residence time
Leftward shift of the nucleus (increase of rods or 2 lobes)
severe bacterial infection
Nucleus shifted to the right (4th to 5th lobe)
Bone marrow hematopoiesis disorder
The cytoplasm is light red and contains many granules.
Larger in size, lavender
azurophilic granules
20%
Round or oval membrane covered particles
High electron density
for lysosomes
acid phosphatase
myeloperoxidase
Multiple acid hydrolases
Digestion of swallowed bacteria and foreign matter
Small, reddish
special particles
80%
dumbbell oval
medium electron density
secretory granules
Phagocin
Lysozyme
Can kill bacteria and dissolve glycoproteins on the surface of bacteria
There are a large number of actin filaments at the periphery of the cytoplasm, and there are also a small number of mitochondria, endoplasmic reticulum and ribosomes in the cytoplasm.
logo
myeloperoxidase
CD15
Chemotaxis
Metamorphosis (swimming out)
phagocytic secretion activity
Neutrophils that phagocytose bacteria
Macrophage phagocytosis
turn into pus cells
Eosinophils (0.5~5)
Spherical
Larger than neutrophils
Rod-shaped or lobed, mostly with two leaves, arranged in a figure of eight
eosinophilic granules
Thick, evenly distributed, consistent size, orange-red, refractive
Round or oval, membrane-coated, containing fine granular matrix and square or rectangular dense crystals
lysosome
cationic protein
arylsulfatase
Break down leukotrienes
histamine
Function
Chemotaxis and deformation motility
phagocytic secretion activity
Phagocytosis of antigen-antibody complexes is the main manifestation
suppress allergic reactions
Kill parasites
cationic protein
Basophils 0 to 1
The smallest number and spherical shape
The nucleus is lobulated or S-shaped, with light coloring and unclear outline.
basophilic granules
Different sizes, uneven distribution, different shades
Blue-violet (metachromatic toluidine blue-violet)
often covering the core
Filled with fine, evenly distributed particles, some of which may be lamellar or filamentous.
secretory granules
Contains heparin, histamine, neutrophil chemotactic factor, eosinophil chemotactic factor
Can be quickly released
Contains leukotrienes, released very slowly
Also involved in allergic reactions
agranulocytosis
Monocytes 3 to 8
The largest in size and spherical in shape. The nucleus is kidney-shaped, horseshoe-shaped or irregular in shape
Fine lavender azurophilic particles
The cytoplasm is rich, weakly basophilic, and appears gray-blue.
The cell surface has wrinkles and microvilli, and the cytoplasm contains many coated granules and phagocytic vacuoles.
Differentiate between lymphatic system and lymph node
Contains catalase, acid phosphatase, non-specific esterase and lysozyme
Differentiate into different types of macrophages
a
Osteoclasts
Mononuclear phagocyte system (mononuclear plus macrophages)
Swallow pathogenic microorganisms and foreign bodies that invade the body
Remove senescent cells from the body
Participate in immune response
Secretes a variety of cytokines to participate in the regulation of hematopoiesis in the body
Lymphocytes (20~40)
Spherical, various sizes
Small lymphocytes (6~8um)
The chromatin is dense, thick, and deeply stained
There is little cytoplasm, forming only a thin layer around the nucleus
Medium lymphocytes (9~12um)
The nuclear chromatin of large and medium lymphocytes is slightly sparse, the staining is slightly lighter, and nucleoli are visible in some cases.
Large and medium-sized lymphocytes have more cytoplasm and a small amount of azurophilic granules can be seen.
Large lymphocytes (13~20um)
The nucleus is round or oval, with a small groove on one side.
Basophilic, blue
Abundant free ribosomes, a small amount of mitochondria, lysosomes, rough endoplasmic reticulum and Golgi complex
thymus-dependent lymphocytes
T cells are small in size, contain a small amount of lysosomes, and account for 75% of peripheral blood lymphocytes.
bone marrow dependent lymphocytes
B cells are slightly larger in size, generally do not contain lysosomes, and have a small amount of rough endoplasmic reticulum, accounting for 10 to 15%.
natural killer cells
NK cells are medium lymphocytes, accounting for 10 to 15%
Platelets (100-300*10^9)
A small piece of cytoplasm shed by bone marrow megakaryocytes, in the shape of a biconcave flat disk
When subjected to mechanical or chemical stimulation, platelets can protrude into irregular shapes.
No nucleus, cytoplasm is light purple blue
Granular area (middle)
blue-purple platelet granules
special particles
alpha particles
Large size, medium electron density
Contains
platelet factor IV
Against the anticoagulant effect of heparin
platelet-derived growth factor
Stimulates endothelial cell proliferation and vascular repair
thrombospondin
Promote platelet aggregation and catalyze fibrin into filamentous fibrin
Dense particles
delta particles
Small size, high electron density
membrane particles
5-hydroxytryptamine
Promote vasoconstriction
ADP
ATP
Calcium ions
Adrenaline
few lysosomes
transparent area
Surrounding light blue
Contains microfilaments and microtubules, involved in the maintenance and deformation of platelet morphology
canalicular system
open duct system
Facilitates uptake of plasma substances and release of granular contents
dense vascular system
Equivalent to the smooth endoplasmic reticulum, which collects calcium ions and synthesizes prostaglandins
Hemostasis and coagulation
Lifespan 7 to 14 days
red blood cells
Biconcave disc shape
The surface area of a sphere with the same volume increases by one-fourth.
The distance between any point in the cell and the cell surface is no more than 0.85um, which is conducive to rapid gas exchange.
Light staining in the center and dark staining around
mature red blood cells
No nucleus or organelles
full of hemoglobin
porphyria-containing proteins
Accounting for 33% of the weight of red blood cells, it easily combines with acid dyes and dyes them light red.
Oxyhemoglobin
carbamic acid hemoglobin
Red blood cell thread
Single red blood cells are light yellow-green when fresh, and a large number of red blood cells make the blood red. Multiple red blood cells are often stacked together to form a string of money
red blood cell skeleton
The red blood cell membrane is fixed on a deformable disk-shaped grid structure
spectrin
actin
Morphological variability
Can change shape when passing through capillaries smaller than its own diameter
Lack of ATP energy supply, the shape changes from disc-shaped to echinococcus-shaped
Hemolysis
Blood ghost (residual red blood cell membrane vesicle)
ABO blood group system
RBC membranes contain mosaic proteins
Blood group antigen A or B
A
A
anti-B
B
B
Anti-A
AB
AB
O
Anti-A Anti-B
Average lifespan 120 days
After being engulfed by macrophages in the liver and spleen, the iron in hemoglobin can be reused
Reticulocytes
Bright tar blue staining shows blue-stained fine mesh or granules in the cytoplasm.
remnant ribosomes
Still has the function of synthesizing hemoglobin
0.5~1.5% (3%~6% newborns)
Male hemoglobin 120~160; female 110~150
7.0~8.5um
Boys 4~5.5*10∧12; girls 3.5~5*10∧12
Usually use wright/giemsa
Blood
Blood cell morphology and quantity ratio hemoglobin content
generation of blood cells
The evolution of hematopoietic organs
Yolk sac hematopoietic stage
blood island
In the 3rd week of human embryo, extraembryonic cells densely form in the yolk sac, body pedicle and chorion.
Cells surrounding blood islands differentiate into vascular cells
Induced by vascular endothelial growth factor VEGF secreted by surrounding mesoderm
flat skin endothelial cells
The cells in the middle become round, separate from the surrounding cells, and differentiate into primitive hematoblasts (the earliest hematopoietic stem cells).
primitive hematopoiesis
Hematopoietic differentiation toward erythroid lineage
embryonic hematopoiesis
Hematopoietic stage of liver, spleen, thymus and lymph nodes
In the 6th week of embryonic life, hematopoietic stem cells in the yolk sac begin to enter the liver with blood circulation and colonize in the extrahepatic hepatocyte cords of the liver blood.
9-24, the liver is the main hematopoietic organ of the embryo
12. The spleen begins to form hematopoietic cells, and its hematopoietic stem cells may come from the liver.
Steady hematopoiesis (adult hematopoiesis)
Hematopoietic stem cell pluripotency
composition
red blood cells
Myelomonocytic cells
Megakaryocytes
Primitive erythroblasts disappear in the erythroid system and are replaced by stereotyped erythroblasts
Committed erythroblasts produce proliferation and differentiation responses to the stimulation of erythropoietin EPO
Thymus and lymph nodes (lymphocytes)
In 3 months, lymphatic stem cells enter the thymus, proliferate and differentiate to form thymocytes, and cultivate T cells.
At 4 months, mature T cells and mature B cells enter the lymph nodes and grow and develop into more cells.
The ability of the thymus and lymph nodes to produce lymphocytes lasts a lifetime
Bone marrow hematopoietic stage
Appears at 20 weeks, or 12 to 15 weeks, and lasts a lifetime
stereotyped hematopoiesis
red blood cells
Granulocytes
monocytes
subtopic
Macrophages-platelets
bone marrow structure
located within the medullary cavity
Hematopoiesis-inducing microenvironment HIM
neural component of bone marrow
The nerves in hematopoietic tissue are mainly unmyelinated nerve fibers, and their terminals terminate in the middle of arterial smooth muscle fibers, sinusoidal endothelium and hematopoietic cells.
microvasculature
fiber
extracellular matrix
bone marrow stromal cells
core ingredients
Macrophages
Fibroblasts
blood endothelial cells
reticular cells
fat cells
osteoblast
bone marrow stromal stem cells
Red blood cells at different stages of development are often located near blood sinusoids, forming islands of immature red blood cells centered on macrophages.
Immature granulocytes mostly stay away from the blood sinusoids, and macrophages or fibroblasts can also form cell islands. When the late myelocytes have the ability to move, they approach and pass through the blood sinusoids through deformation movement.
Megakaryocytes are close to the sinusoidal endothelial space, extend their cytoplasmic protrusions into the sinusoidal cavity, and break away to form platelets that directly enter the sinusoidal cavity.
divided into
red bone marrow
composition
hematopoietic tissue
composition
reticular tissue
reticular cells
mesh fiber
The mesh is filled with various blood cells in different stages as well as a small amount of macrophages, fibroblasts, adipocytes, bone marrow stromal stem cells
hematopoietic cells
stromal cells
blood bandits
Arterial capillaries branch into the bone marrow and form
The lumen is large, irregular in shape, the wall is lined with porous endothelium, the gaps between endothelial cells are large, and the basement membrane is incomplete.
Blood endothelial cells can secrete adhesion molecules to adhere and fix hematopoietic stem cells, and can also secrete a variety of hematopoietic growth factors to participate in the regulation of blood cell development.
Bone marrow-blood barrier MBB
blood endothelial cells
There are bundles of microfilaments under the plasma membrane, and cell contraction can adjust the area covered by endothelial cells.
adventitial cells
branched fibroblasts
The surface of endothelial cells covered by adventitial cells reflects the functional status of MBB
pericytes
nearby macrophages
Screening mature blood cells into the bloodstream plays an important role in regulating the release of blood cells.
Blood cells cross endothelial cells
Directly crosses the cytoplasm and enters the bloodstream
The bone marrow blood endothelium has no fixed pores. When blood cells pass through the endothelium, the cells first press the outer surface of the endothelial cells and fuse with the inner surface to form temporary pores.
Granulocytes
nucleated red blood cells
When passing through the wall, the nucleus remains in the hematopoietic tissue and is engulfed by macrophages, and its cytoplasmic reticulocytes enter the blood circulation.
The bone marrow in fetuses and infants is red bone marrow.
In adults, it is mainly distributed in flat bones, irregular bones and cancellous bones at the epiphysis of long bones.
yellow bone marrow
Adipose tissue
Around the age of five, fat cells begin to appear in the marrow cavity of long bones, gradually changing from red marrow to yellow marrow.
Yellow bone marrow still has a small amount of hematopoietic stem cells
Hematopoietic stem cells and hematopoietic progenitor cells
hematopoietic stem cells
After birth, it is mainly located in the red bone marrow, accounting for 0.5% of the number of nucleated cells in the bone marrow.
Distributed in very small amounts in peripheral blood, fetal umbilical cord blood, spleen, liver and lymph nodes
Mouse spleen colony formation experiment confirms the existence of hematopoietic stem cells
Each spleen colony is a clone, called a spleen colony-forming unit CFU-S, which represents a hematopoietic stem cell.
indirect proof
Chronic myelogenous leukemia patients have PhI aberrant chromosomes in the erythrocyte, granulocyte, and macrophage lines
Mixed cell colonies appear when bone marrow cells are cultured in vitro
characteristic
Strong proliferation potential
Mostly in G0 resting state
Multidirectional differentiation ability
hematopoietic progenitor cells
non-hematopoietic cells
Dendritic Cells
Langerhans cells
Endothelial cells
Ability to self-renew or replicate
asymmetric mitosis
One maintains hematopoietic stem cells
A differentiated hematopoietic progenitor cell
Heterogeneity
Hematopoietic stem cells from different sources at different developmental stages have different functional biophysical properties and surface markers.
hematopoietic progenitor cells
Hematopoietic growth factor receptors have appeared on the surface
EPO
colony stimulating factor CSF
Myeloid multilineage hematopoietic progenitor cells
Can differentiate into erythrocytes, granulocytes, monocytes and megakaryocytes
Can differentiate into monolineage or bilineage hematopoietic progenitor cells
Erythroid hematopoietic progenitor cells (proliferate induced by IL-3, stem cell stimulating factor SCF and EPO)
Explosive red blood cell colony-generating unit
shaped like an explosion
Differentiated from early differentiated erythroid hematopoietic progenitor cells
red blood cell collection unit
Derived from rapidly developing, late-differentiating hematopoietic progenitor cells
Granulocyte-monocyte lineage hematopoietic progenitor cells (granulocyte colony-stimulating factor GM-CSF, IL-3)
Megakaryocyte lineage progenitor cells (thrombopoietin TPO, megakaryocyte colony-stimulating factor Meg-CSF)
lymphoid hematopoietic stem cells
Blood cell genesis and morphological evolution
developmental stage
primitive stage
Infantile stage (early, middle, late)
mature stage
common law
The cell body gradually becomes smaller from large to large, but the macrophage cell body gradually becomes larger from small to large.
The nucleus changes from large to small
Red blood cells disappear immediately
Granulocytes gradually change from round to rod-shaped, and finally form a lobulated shape.
Macrophage nuclei change from small to large and appear lobed.
The cytoplasm changes from less to more, and the basophilia gradually becomes weaker.
However, monocytes and lymphocytes remain basophilic
Special structures or protein components in the cytoplasm gradually increase from scratch (special particles of granulocyte island, hemoglobin of red blood cells)
Cell division ability has gone from being present to non-existent, and lymphocytes still have a strong potential to divide.
red blood cells
proerythrocytes
promyelocytes
Mesoblasts
late erythrocytes
Reticulocytes
red blood cells
Coarse granular (chromatin)
Coarse granular
Coarse granular
Dense
2 to 3 pieces (kernels)
meet occasionally
none
none
>3/4 (nuclear to cytoplasmic ratio)
>1/2
Approximately equal to 1/2
smaller
Strong (basophilic)
Stronger
weaken
weak
micro
disappear
Ink blue
Ink blue
Polychromophilia
red
red
red
Yes (split ability)
have
weak
none
None (hemoglobin)
Start to appear
increase
A lot
It takes 3 to 4 days for proerythrocytes to develop into immature erythrocytes.
granulocyte cell line
myelocytes
promyelocytes
Mesomyelocytes
promyelocytes
rod-shaped granulocytes
lobulated granulocytes
fine mesh (chromatin)
Coarse mesh
net block
net block
Coarse block
Coarse block
sky blue
light blue
light blue
light red
None (Azurophilic granules)
A lot
few
None (special particles)
A small amount
increase
obvious
A lot
Monocyte line
Megakaryocyte-platelet lineage
Young megakaryocytes undergo numerous divisions and form 8 to 32 ploidy, but the nuclei do not divide, forming polyploid megakaryocytes.
The smooth endoplasmic reticulum forms reticular tubules and is divided into several cytoplasmic compartments.
lymphocyte line
Mainly manifested as changes in cell membrane proteins and functional status
lymph
fluid within the lymphatic system
Lymphatic components in different parts of lymphatic vessels are different
Lymph of limbs is bright and transparent, protein 0.5%
The lymph in the lymphatic vessels of the small intestine contains fat droplets and is milky white.
Liver lymph protein 6%
Hematopoietic stem cells and hematopoietic stem cell transplantation
It has extensive migration and specific homing characteristics, can be preferentially located in the corresponding hematopoietic microenvironment, and exists in a non-reproductive state and lacks relevant antigens.
Surface markers and isolation passivation of hematopoietic stem cells
HSC are in the stationary phase of metabolism and division. Monoclonal antibody-labeled cell immunoisolation methods can be used for isolation, including flow cytometry cell sorting, auxin-avidin immunoaffinity column chromatography, and immunomagnetic beads.
Surface marker Lin-Scal KIT (LSK cells)
Some cells of CD34-Flt3-CD150 have long-term ability to reconstruct hematopoiesis
CD34 Flt3-Only short-term hematopoietic reconstitution
HSC purification mark
CD34-, CD38-, CD133, CD45RO, HLA-DR-, Thy-1, Hoechst33343low, Rhodamine123low
Biological properties of hematopoietic stem cells
HSC mitotic asymmetry can be established across cell populations
high proliferative potential
multidirectional differentiation
Long-term reconstruction of hematopoietic stem cells
Short-term reconstruction of hematopoietic stem cells
Regulation of quiescence and self-renewal of hematopoietic stem cells
niche
endosteal osteoblast niche
Maintain HSC quiescence
endothelial vascular niche
Site of actively dividing HSCs and hematopoietic progenitor cells
The increase or decrease in osteoblast function determines the number of HSCs, especially LT-HSCs.
Bone marrow stromal cells multiple cytokines
interact with receptors
Activated bone marrow extracellular matrix ECM adhesion molecule
Upregulates cyclin-dependent enzyme inhibitory factors such as p21 and p57
wnt, notch signal transduction pathway
endogenous factors
Self-renewal capability is not unlimited
Hematopoietic stem cell transplantation
Stem cell donors come from different sources
autologous stem cell transplant
No GVHD and few complications
May be infected by tumor cells
No graft-versus-tumor effect
Delayed hematopoietic reconstitution
syngeneic stem cell transplant
Hematopoietic disorders and congenital immune deficiencies can only choose isogenic or allogeneic transplantation
allogeneic stem cell transplant
Peripheral blood stem cell transplantation PBSCT
Hematopoietic reconstruction is rapid
Does not increase the incidence of acute GVHD, although it may increase chronic GVHD and also increases the graft-versus-leukemia effect GVL