In vitro and in vivo measurements of human RBCs frozen with glycerol and subjected to various storage temperatures before deglycerolization and storage at 4 degrees C for 3 days

BACKGROUND: This study was designed to assess the effects of changes in storage temperature of frozen RBCs such as might occur during a malfunction of the -80 degrees C mechanical freezer or during shipment. STUDY DESIGN AND METHODS: Fifteen participants donated blood for autologous transfusion of RBCs; all RBCs were frozen with 40-percent (wt/vol) glycerol. Five subjects received RBCs that were stored at -80 degrees C alone before transfusion. Five subjects received RBCs that were stored initially at -80 degrees C, then at -40 degrees C for 4 weeks, and finally at -80 degrees C before transfusion. Five subjects received RBCs that were stored at -80 degrees C, then at -20 degrees C for 2 weeks, and finally at -80 degrees C before transfusion. After deglycerolization, the RBCs were stored at 4 degrees C in a sodium chloride-glucose solution for 3 days before transfusion. RESULTS: No significant differences were observed in freeze-thaw recovery, freeze-thaw-wash recovery, 24-hour posttransfusion survival, index of therapeutic effectiveness, or RBC ATP levels. Greater hemolysis and reduced RBC K+ levels were observed in the units stored at -80 degrees C/-40 degrees C/-80 degrees C and in those stored at -80 degrees C/ -20 degrees C/-80 degrees C compared with the units stored at -80 degrees C alone, but these differences did not affect the 24-hour posttransfusion survival. CONCLUSIONS: The results of this study indicated that RBCs frozen with 40-percent (wt/vol) glycerol can be stored at -40 degrees C for 4 weeks or at -20 degrees C for 2 weeks between periods of frozen storage at -80 degrees C with satisfactory results.     

狂犬病暴露后预防处置进展

本文介绍了WHO推荐的狂犬病暴露后预防处置三方面的进展,主要包括狂犬病疫苗的种类、免疫程序、被动免疫制剂的国内外发展和使用情况,论述了其效果以及在中国应用的可能性,并初步探讨如何促进中国的狂犬病暴露后预防处置.     

苦碟子注射液联合瑞舒伐他汀治疗急性脑梗死临床研究

目的 评价苦碟子注射液联合瑞舒伐他汀治疗急性脑梗死(acute cerebral infarction,ACI)的疗效.方法 将符合入选标准的90例ACI患者按随机数字表法将患者分为3组,每组30例.对照组口服阿托伐他汀,治疗I组口服瑞舒伐他汀,治疗Ⅱ组在治疗I组基础上联用苦碟子注射液.3组均治疗2周.采用生化分析仪检测血清TC、TG、LDL-C含量,采用全自动血凝分析仪检测纤维蛋白原、血小板计数和凝血酶原时间,采用Barthel指数评价患者日常生活能力,采用美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)评价患者神经功能,比较临床疗效.结果 治疗Ⅱ组总有效率为96.7%(29/30)、治疗I组为76.7%(23/30)、对照组为73.3%(22/30),3组比较差异有统计学意义(χ2=6.537,P=0.018).治疗后,治疗Ⅱ组血清TC[(4.03±0.83)mmol/L比(4.61±0.89)mmol/L、(5.42±0.75)mmol/L,F=21.538]、TG[(1.68±0.46)mmol/L比(2.02±0.81)mmol/L、(2.38±0.67)mmol/L,F=8.585]、LDL-C[(2.37±0.48)mmol/L比(2.74±0.68)mmol/L、(3.11±0.81)mmol/L,F=9.092]水平低于治疗I组和对照组(P<0.01);治疗Ⅱ组纤维蛋白原[(2.48±0.37)g/L比(2.81±0.46)g/L、(2.95±0.51)g/L,F=8.592]、血小板[(125.27±11.88)×109比(132.13±13.55)×109、(133.83±13.91)×109,F=3.571]低于治疗I组和对照组(P<0.05),凝血酶原时间[(17.52±1.94)s比(16.14±1.62)s、(15.34±1.18)s,F=14.139]高于治疗I组和对照组(P<0.05).治疗II组Barthel指数[(85.63±4.10)分比(81.83±3.92)分、(79.23±4.81)分,F=16.873]高于治疗Ⅰ组和对照组(P<0.01)、NIHSS评分[(3.57±1.17)分比(4.63±1.22)分、(5.57±1.33)分,F=19.550]低于治疗I组和对照组(P<0.01).结论 苦碟子注射液联合瑞舒伐他汀可有效降低ACI患者血脂水平,改善凝血功能,提高生活质量,促进神经功能恢复.     

肌内效贴联合艾灸疗法改善骨科术后患者功能性便秘的效果评价

目的 探讨肌内效贴联合艾灸疗法对骨科术后功能性便秘的疗效。方法 选取2019年1—12月在上海市浦东医院康复医学科住院的骨科术后患者40例,入选患者符合功能性便秘的诊断标准。采用电脑生成随机数字法将患者平均随机分成观察组和对照组,观察组同时接受肌内效贴和艾灸治疗,对照组只接受艾灸治疗。采用首次自主排便时间、便秘患者临床评分量表以及便秘诊治效果分级作为疗效评价指标。结果 所有入组的40例患者均完成了为期10天的干预。观察组患者8 h内首次排便率为40%,高于对照组,差异有统计学意义（P<0.001）;干预前两组患者的便秘患者临床评分量表差异无统计学意义（P=0.29）,干预后观察组评分显著优于对照组（P<0.001）;干预后观察组便秘临床痊愈率（50%）高于对照组（5%）,整体便秘诊治效果分级也显著优于对照组（P<0.001）。结论 肌内效贴联合择时艾灸疗法可以明显改善骨科术后功能性便秘,值得开展进一步研究以明确其临床疗效。     

Optimal control for the spread of infectious disease: The role of awareness programs by media and antiviral treatment

This paper presents a detailed mathematical analysis of the role of awareness programs by media and antiviral treatment on the control of infectious diseases. A nonlinear model is proposed in order to control the infectious diseases, and the model is examined under various scenarios of control measures using variety of mathematical techniques including stability, sensitivity, optimal control, and cost‐effectiveness analysis. Considering the constant control parameters, the basic reproduction number is derived and investigated by the existence and stability of equilibria, then the relative impact of each of the constant control parameters are assessed by calculating the sensitivity index of the basic reproduction number. Under the time‐dependent controls, the necessary conditions for the optimal control of the disease are derived using the Pontryagin's maximum principle in order to determine optimal strategies for controlling the spread of the disease. In order to investigate the most cost‐effective control strategy among all the possible strategies, cost‐effectiveness analysis is carried out using numerical simulations and the result reveals that the strategy combination of 3 control measures (the successful campaign of awareness programs by media, controlling effort that alters infectious cases receiving treatment, and strengthening effort made on awareness campaign programs) is the most cost‐effective control strategy and this indicates that implementation of all the 3 control measures is necessary in order to control the disease outbreak.     

Genomic Markers in Prostate Cancer Decision Making

Context

Although the widespread use of prostate-specific antigen (PSA) has led to an early detection of prostate cancer (PCa) and a reduction of metastatic disease at diagnosis, PSA remains one of the most controversial biomarkers due to its limited specificity. As part of emerging efforts to improve both detection and management decision making, a number of new genomic tools have recently been developed.

Secondary data sources for health services research in urologic oncology

Background

Though secondary data analyses of large datasets may reduce logistical and financial barriers required to perform significant and innovative work, such research requires specialized skills in data handling and statistical techniques as well as thorough and detailed knowledge of the data sources being used.

EAACI guidelines on allergen immunotherapy: Hymenoptera venom allergy

Hymenoptera venom allergy is a potentially life‐threatening allergic reaction following a honeybee, vespid, or ant sting. Systemic‐allergic sting reactions have been reported in up to 7.5% of adults and up to 3.4% of children. They can be mild and restricted to the skin or moderate to severe with a risk of life‐threatening anaphylaxis. Patients should carry an emergency kit containing an adrenaline autoinjector, H₁‐antihistamines, and corticosteroids depending on the severity of their previous sting reaction(s). The only treatment to prevent further systemic sting reactions is venom immunotherapy. This guideline has been prepared by the European Academy of Allergy and Clinical Immunology's (EAACI) Taskforce on Venom Immunotherapy as part of the EAACI Guidelines on Allergen Immunotherapy initiative. The guideline aims to provide evidence‐based recommendations for the use of venom immunotherapy, has been informed by a formal systematic review and meta‐analysis and produced using the Appraisal of Guidelines for Research and Evaluation (AGREE II) approach. The process included representation from a range of stakeholders. Venom immunotherapy is indicated in venom‐allergic children and adults to prevent further moderate‐to‐severe systemic sting reactions. Venom immunotherapy is also recommended in adults with only generalized skin reactions as it results in significant improvements in quality of life compared to carrying an adrenaline autoinjector. This guideline aims to give practical advice on performing venom immunotherapy. Key sections cover general considerations before initiating venom immunotherapy, evidence‐based clinical recommendations, risk factors for adverse events and for relapse of systemic sting reaction, and a summary of gaps in the evidence.