Factors which can influence the quality related to cell viability of the umbilical cord blood units

Cell viability is an important indicator for the quality of umbilical cord blood (UCB) units that can influence the transplant final outcome. Thus, it is particularly important to identify the factors that may affect the cell quality during the banking process. The present study is a first attempt to correlate the impact of exogenous factors (time from collection to processing, collected UCB volume) and endogenous factors (TNCC – total nucleated cell count, CD34⁺cell count) on cell viability assessed before UCB units cryopreservation within a banking standardized process. Three thousand UCB units collected in 35 ml CPDA containing bags were processed by HES sedimentation within 48 h. TNCC, CD34⁺ cell counts and total cell viability were determined after processing. Cell viability of 94.37 ± 4.67%, TNCC of 73.17 ± 36.73 × 10⁷ and CD34⁺cell count of 2.61 ± 2.29 × 10⁶ was obtained after processing of units with UCB collected volume of 80.23 ± 28.52 ml. A significant negative correlation was found between cell viability and the time from collection to processing (r = –0.7228; P < 0.0001). The cell viability decreasing rate of 20.54%, 15.18% and 3–10% were achieved for units with collected UCB volume <40 ml, (40–80 ml) and >80 ml, to 48 h versus 12 h. There were no differences considering cell viability for the UCB units with similar collected UCB volume that had various CD34⁺cell count or TNCC (P > 0.05). The extension of the time from collection to processing of UCB units can reduce the quality by decreasing cell viability. The cell viability decreasing rate owing to the time influence is determined by the collected UCB volume being inversely proportional to it. Endogenous factors do not affect the cell viability.     

Factors which influence how nurses communicate with cancer patients

Communication is one of the most important aspects of cancer nursing. Evidence suggests nurses experience communication difficulties and frequently block patients from divulging their worries or concerns. This paper focuses on a study which aimed to determine: (a) the extent to which nurses facilitate or block patients and awareness of their verbal behaviours; (b) whether there is a relationship between nurses' verbal behaviours and levels of anxiety, social support, work support and attitude to death; and (c) nurses' difficulties in caring for cancer patients. The study was conducted in a specialist and non-specialist hospital. Fifty-four registered nurses completed three audio-taped histories (one with a new cancer patient, a patient with a recurrence and a patient for pallative care), a self-administered questionnaire and a semi-structured audio-taped interview. The data were analysed using SPSSX. The findings indicate an overall poor level of facilitative communication, with a patient's recurrence causing most difficulties. There is evidence to suggest the way nurses communicate may depend on the environment created by the ward sister, the nurses' religious beliefs and attitude to death rather than specific education in communication skills.     

降钙素原与血小板指标影响急诊脓毒症患者预后

目的：探讨脓毒症患者降钙素原及血小板指标变化与病死率等相关性,以期指导临床。方法：选择符合入选条件的脓毒症患者78例,入院即刻查血常规、降钙素原及行血培养,入院第4天复查血常规,血培养结果依据细菌染色分为革兰氏染色阴性（G-）和革兰氏染色阳性（G＋）。①依据降钙素原值分组,A组（〉100μg/L）、B组（10~100μg/L）、C组（1.5~10μg/L）、D组（〈1.5μg/L）,比较各组入院30d病死率、血培养细菌G-和G＋菌例数及病因差异;②依据入院时血小板数值将所有脓毒症患者分为血小板减少1组与血小板正常1组,后组依据入院第4天血小板数值分为血小板减少2组与血小板正常2组,比较组间病死率等。结果：所有脓毒症患者,随降钙素原增加,病死率增加,同时G-细菌所占比例增加,肺部感染增多。脓毒症患者入院3d后血小板减少,增加病死率。结论：脓毒症患者入院降钙素原数值在一定程度上可指导临床选择抗菌素及指导预后。脓毒症患者入院3d后血小板减少增加病死率。     

Gray platelet syndrome: alpha-granule deficiency. Its influence on platelet function

The ultrastructure, cytochemistry, biochemistry, and functions of platelets from two patients with the familial gray platelet syndrome are described. Ultrastructural studies showed a lack of alpha-granules in the megakaryocytes in the vicinity of a marrow myelofibrosis and/or in platelets. A normal number of mitochondria and a slight increase of dense bodies was confirmed by labeling the whole patient with mepacrine. Platelet peroxidase (in the dense tubular system) and catalase-positive granules (revealed by the cytochemistry) were present. Platelets from both patients had severe deficiency of beta TG either after tritonization (less than 4% of normal) or thrombin treatment (less than 15% of normal), and the plasma beta TG levels were slightly increased. Functional studies of these platelets showed an uptake of [14C]5HT inhibited by reserpine similar to that in the control platelets. Thromboxane formation was within normal limits in the presence of arachidonic acid, ADP, collagen, or ionophore A23187, indicating that (1) the cyclooxygenase/thromboxane synthetase systems were not altered and (2) the phospholipase activities were not impaired. Although the platelet adhesion to prepolymerized fibrillar type III collagen and the ADP-, arachidonic acid-, and ionophore A23187-mediated aggregations were apparently normal, in every case the release of [14C]5HT was either at the low side of the normal range or decreased. This abnormality was increased when collagen or thrombin was added to either PRP or washed platelets from both patients, where at the same time, the aggregation and the release were markedly reduced. The results suggest that alpha-granules or their content has an influence on not only the platelet aggregation but also the dense bodies involved in the [14C]5HT release reaction.     

老年人血脂水平对血小板活化释放状态影响的研究

目的：研究老年人血脂水平对血小板活化释放功能的影响。方法：采用SLTSPECTRA酶标仪以ELISA法测定血浆β－血小板球蛋白（β－TG）和血小板第4因子（PF4）、血栓烷B2（TXB2）;采用放免法测定血小板P－选择素（GMP－140）;采用BayerRA－50型半自动生化分析仪测定总胆固醇、三酰甘油、低密度脂蛋白胆固醇。结果：与青年对照组、健康老年前期组比较,健康老年人组β-TG、PF4、TXB2、GMP-140等指标显著增高（P＜0．01）;高LDL－C组、高TC、TG、LDL－C组各项指标均显著高于青年对照组、健康老年前期组、健康老年人组（P＜0．01）。结论：血脂水平的增高对老年人血小板的功能亢进具有明显影响。     

Factors which influence coping: home-based family caregiving of persons with advanced cancer

The findings from a qualitative study of how caregivers coped while they cared for a dying family member at home are presented. Fifteen family caregivers were interviewed twice following the death of their family member. Although it was not one of the original objectives of the research, coping emerged as a category needing further analysis. There were factors that either facilitated or interfered with caregiver coping. Those factors that facilitated their coping included characteristics of the caregivers themselves; contributions made by the dying person; and supportive networks, both formal and informal, available to the caregivers. Interfering factors related to caregiver experiences with informal and formal systems. From the more distant perspective of post-death reflections, the caregivers provided insight into how their coping was grounded in the meaning associated with their experiences.     

影响血液标本取材质量因素的调查分析

目的了解影响血液标本取材质量的因素,探讨解决与克服的措施.方法由质量控制小组随机对护理人员静脉血标本采集全过程进行逐项调查,各项结果主要采用统计描述和对影响血标本取材质量的因素进行分析.结果13%的护理人员对静脉血标本取材质量影响检验结果的前因后果不甚了懈,9%的护理人员静脉血标本采集操作不规范.影响血液标本取材质量的主要因素:取材试管有水雾占2.88%,注射器漏气占2.93%,机械性损伤占4.05%,血标本延长送检时间占5.04%,抗凝剂标本凝固占1.17%,药物因素占0.32%,采血部位不当占1.94%,住院部血标本取材存在问题较普遍.结论加强护理人员血标本取材技术知识培训考核,有利于提高血标本取材质量.     

临床护理教师有效教学行为的调查研究

护理临床实习是护理教育的重要组成部分，不仅是护生理论联系实际、护理技能进一步提高和形成护理专业态度的过程。更是护生确立人生信念、强化职业道德、适应护士角色、获得全面发展的社会化的关键时期，对护生的职业发展是一段非常重要的经历。本研究通过调查了解教师教学行为缺陷的构成及分布特点，为建立教师目标发展体系、师资水平宏观建设决策、临床教师师资培训、充实教师评价体系、完善教学管理方式提供依据，并为教师在理想角色的自我发展完善与行为修正方面提供指引方向。     

Factors that influence platelet recovery after transfusion: resolving donor quality from ABO compatibility

BACKGROUND: A system was established to examine the extent to which the apheresis donor determines platelet recovery after transfusion, to measure the impact of ABO identity, and to predict outcome by evaluating the donor. STUDY DESIGN AND METHODS: The percentage of platelet recovery was measured after prophylactic transfusion of apheresis units divided from single donors to paired recipients with uncomplicated thrombocytopenia secondary to leukemia chemotherapy. Platelet microaggregation induced by citrate was measured at the time of apheresis. RESULTS: Platelet recoveries in paired recipients correlated strongly when both transfusions were ABO- identical. When one recipient was ABO-identical and the other was ABO-nonidentical, nonidentical transfusions yielded one-third the recovery of ABO-identical transfusions. In ABO-identical transfusions, platelet recovery in donors having microaggregates in the before-apheresis ACD sample was one-third that in donors without microaggregates. This difference was observed at 1 and 24 hours. Expression of P-selectin in the apheresis units at the time of transfusion correlated well with ACD microaggregates in the before-apheresis sample. CONCLUSION: When transfusions of platelets are ABO-identical, donor quality dominates recovery in circulation. Donor quality is predicted by a rapid and simple assay of citrate-induced microaggregation performed at the time of apheresis. When donor quality is factored out, ABO identity prevails.     

Factors that influence therapeutic anticoagulation control.

A wide range of variables can influence warfarin anticoagulation control. This report summarizes the effects of medication, alcohol, diet, and other factors on prothrombin times. Useful summary tables are included.     

老年人血脂水平对血小板活化释放状态影响的研究

目的研究老年人血脂水平对血小板活化释放功能的影响。方法采用SLTSPECTRA酶标仪以ELISA法测定血浆β-血小板球蛋白(β-TG)和血小板第4因子(PF4)、血栓烷B2(TXB2);采用放免法测定血小板P-选择素(GMP-140);采用BayerRA-50型半自动生化分析仪测定总胆固醇、三酰甘油、低密度脂蛋白胆固醇。结果与青年对照组、健康老年前期组比较,健康老年人组β-TG、PF4、TXB2、GMP-140等指标显著增高(P＜0.01);高LDL-C组、高TC、TG、LDL-C组各项指标均显著高于青年对照组、健康老年前期组、健康老年人组(P＜0.01)。结论血脂水平的增高对老年人血小板的功能亢进具有明显影响。     

Mycobacterium paratuberculosis. Factors that influence mycobactin dependence.

Mycobacterium paratuberculosis does not produce any detectable mycobactin, an iron-binding compound that is synthesized by most Mycobacterium spp. and necessary for the growth of all mycobacteria. This study examined the influence of various culture conditions on mycobactin dependence in M. paratuberculosis. Using a radiometric growth assay, we found the minimal concentration of mycobactin J necessary for growth of M. paratuberculosis to be 0.006 microM, whereas 1.2 microM (1 microgram/ml) was required for optimal growth. In media without mycobactin at iron concentrations less than or equal to 100 microM, growth of M. paratuberculosis occurred at pH 5.0, but not pH 6.8. Iron concentrations greater than 100 microM did not significantly increase growth at pH 5.0, but at pH 6.8 the growth rate increased with increasing amounts of iron reaching a rate equal to control cultures containing mycobactin. Mycobacterium paratuberculosis appeared to lose mycobactin dependence when subcultured; however, this was subsequently shown to be a result of mycobactin carried over from primary medium. Removal of this contaminating cell-wall-associated mycobactin reestablished mycobactin dependence. We conclude that mycobactin dependence must be carefully determined because it is a key test used in identification of M. paratuberculosis and may be easily influenced by media pH, iron concentration, and mycobactin carryover from primary media.