96例临床输血不良反应分析

目的：通过对临床发生的输血不良反应资料回顾分析,探讨有效降低输血不良反应的措施。方法：按《临床输血技术规范》要求,对绵阳市第三人民医院2008—2009年各类输血不良反应回报单进行统计分析。结果：在19865人次输血中,发生输血不良反应96人次,输血不良反应发生率为0.48%,主要表现为过敏及发热反应,其中过敏反应57人次,占59.38%,以输注血浆引起为主,发热反应34人次,占35.4%,以输注红细胞引起为主,负荷过重1人次,占1.04%,其他反应4人次,占4.17%。结论：提高科学合理用血水平及输血新技术、新方法的应用有助于降低输血不良反应发生。     

283例临床输血反应的分析

目的：回顾性分析我院近年来发生的输血反应。方法：对2006年1月-2009年9月期间输注各种血液成分的住院病例进行调查。结果：该期间共有41545人次的住院患者输注了111462U的各种血液成分,主要是去白红细胞悬液、新鲜冰冻血浆和冷沉淀;观察到283例发生了输血反应,反应发生率为0．25％,其中非溶血性发热性输血反应和过敏性输血反应占98．59％;不同的血液成分中,输注去白红细胞悬液、新鲜冰冻血浆和冷沉淀的输血反应发生率分别为0．16％、0．42％和0．30％。结论：急性输血反应主要是非溶血性发热性输血反应和过敏性输血反应,以输注新鲜冰冻血浆的反应发生率最高。     

海南地区208例输血不良反应调查报告

<正>输血治疗是临床治疗甚至抢救患者不可或缺的重要手段,但输血也会发生不良反应。随着输血相容性检测技术的发展和输血相关工作人员安全意识的不断增强,急性溶血和细菌污染等人为因素引起的重大输血反应已极大降低,但过敏反应和发热反应等仍时有发生。通过总结分析我院近4年输血不良反应发生情况,希望有效降低输血不良反应发生,保障临床用血安全。1资料与方法1.1资料来源我院2010-01-01-2013-12-31进行输血治疗     

Prevalence and characteristics of disinhibition during bronchoscopy with midazolam

BackgroundDisinhibition is sometimes experienced during bronchoscopy with sedation. However, data on disinhibition during bronchoscopy are scarce. We examined the prevalence and characteristics of disinhibition during bronchoscopy with midazolam.MethodsThis retrospective study analyzed consecutive patients who underwent bronchoscopy between November 2019 and December 2020. The severity of disinhibition was defined as follows: mild, disinhibition sometimes requiring restraints by assistants; moderate, disinhibition always requiring restraints by assistants; and severe, disinhibition requiring antagonization of sedation by flumazenil to continue bronchoscopy.ResultsAmong 251 eligible patients who were sedated using midazolam, 36 (14.3%; 95% confidence interval [CI], 10.5%–19.2%), 42 (16.7%; 95% CI, 12.6%–21.8%), and 7 (2.8%; 95% CI, 1.4%–5.6%) experienced mild, moderate, and severe disinhibition, respectively. Depression (odds ratio [OR] 2.77; 95% CI, 1.20–6.41), endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) (OR 10.23; 95% CI, 1.02–103.01, referred to brushing/bronchial washing/observation), and increased administration of midazolam (OR 1.20; 95% CI, 1.02–1.42, per 1-mg increase) were independently associated with moderate-to-severe disinhibition. Patients experiencing moderate disinhibition reported significantly better scores for discomfort during bronchoscopy. Besides the maximum systolic and diastolic blood pressures during bronchoscopy, the changes in hemodynamic and respiratory statuses during bronchoscopy or complications did not significantly differ between patients experiencing moderate-to-severe disinhibition and those experiencing none-to-mild disinhibition.ConclusionsModerate-to-severe disinhibition occurred in 19.5% of patients during bronchoscopy with midazolam. We should focus on disinhibition when patients have depression or are planning to undergo EBUS-TBNA, and sparing the administration of midazolam might reduce the occurrence of disinhibition.Clinical trial registrationUMIN000038571     

Combined prophylactic suppression of graft-versus-host and host-versus-graft reactions following treatment of prospective bone marrow recipients with rat IgG2b anti-mouse T cell antibodies

Summary A new approach to avoid typical complications from bone marrow transplantation into MHC different mice was studied. Rat monoclonal anti-Thy-1 antibodies of the IgG2b isotype were identified, which inhibit T lymphocytes in vivo so that transplanted donor T cells as well as residual T cells of the conditioned marrow recipient were suppressed.A single injection of these antibodies after irradiation and before marrow transplantation did not only prevent graft-versus-host mortality but suppressed also host-versus-graft reactivity so that the radiation dose necessary for engraftment of donor cells differing in H-2, IA (both haplotypes) major histocompatibility antigens could be reduced to 6.0 Gy. In addition an anti-T leukemic cell effect from the injected monoclonal T cell antibodies was observed.Supported by SFB 1187     

Formation of benzene in the interstellar medium

Polycyclic aromatic hydrocarbons and related species have been suggested to play a key role in the astrochemical evolution of the interstellar medium, but the formation mechanism of even their simplest building block--the aromatic benzene molecule--has remained elusive for decades. Here we demonstrate in crossed molecular beam experiments combined with electronic structure and statistical calculations that benzene (C(6)H(6)) can be synthesized via the barrierless, exoergic reaction of the ethynyl radical and 1,3-butadiene, C(2)H + H(2)CCHCHCH(2) → C(6)H(6) + H, under single collision conditions. This reaction portrays the simplest representative of a reaction class in which aromatic molecules with a benzene core can be formed from acyclic precursors via barrierless reactions of ethynyl radicals with substituted 1,3-butadiene molecules. Unique gas-grain astrochemical models imply that this low-temperature route controls the synthesis of the very first aromatic ring from acyclic precursors in cold molecular clouds, such as in the Taurus Molecular Cloud. Rapid, subsequent barrierless reactions of benzene with ethynyl radicals can lead to naphthalene-like structures thus effectively propagating the ethynyl-radical mediated formation of aromatic molecules in the interstellar medium.     

探讨以抑制致敏小鼠哮喘气道炎症为主的治疗新途径

目的 以Ｔｈ１反应拮抗Ｔｈ２反应，抑制哮气道以淋巴细胞和嗜酸细胞浸润为主的炎症，探索治疗哮喘的新途径。方法Ｇ５７Ｂ１／６小鼠６０只，腹腔注射０．５μｇＰＰＤ２次，间隔２周，第１７、２４天腹腔注射卵清蛋白２次。将小鼠随机分成４组，每组１５只。Ａ组小鼠吸入卵清蛋白；Ｂ组小鼠雾化吸入ＰＰＤ后，雾化吸入卵清蛋白；Ｃ组小鼠吸入卵清蛋白后，雾化吸入ＰＰＤ；Ｄ组小鼠吸入ＰＰＤ，作为对照组。用免疫组化－原位杂交检     

Reaction following treatment of murine borreliosis and Shwartzman type reaction with borrelial sonicates*

Summary Treatment of experimental murine borreliosis induced an acute transient fall in temperature, leucopenia and thrombocytopenia with appearance of circulating ‘endotoxin-like’ material. This reaction to treatment could be reproduced by the inoculation of borrelial sonicates into infected mice or by two injections of the same sonicate given 24 hours apart, into normal mice. Sensitization or precipitation of the reaction could not be induced by E. coli lipopolysaccharide, although a reaction indistinguishable from the reaction to treatment could be provoked in mice by two successive injections of lipopolysaccharide given 24 hours apart. The nature of this reaction in mice was investigated and the relation of both reactions to the Shwartzman reaction, Endotoxin.     

Organocatalytic asymmetric assembly reactions for the syntheses of carbohydrate derivatives by intermolecular Michael-Henry reactions

Given the significance of carbohydrates in life, medicine, and industry, the development of simple and efficient de novo methods to synthesize carbohydrates are highly desirable. Organocatalytic asymmetric assembly reactions are powerful tools to rapidly construct molecules with stereochemical complexity from simple precursors. Here, we present a simple and robust methodology for the asymmetric synthesis of pyranose derivatives with talo- and manno- configurations from simple achiral precursors through organocatalytic asymmetric intermolecular Michael–Henry reaction sequences. In this process, (tert-butyldimethylsilyloxy)acetaldehyde 1 was successfully utilized in two ways: as a donor in a highly selective anti-Michael reaction and as an acceptor in a consecutive Henry reaction. Varied nitroolefins served as Michael acceptors and varied aldehydes substituted for 1 as Henry acceptors providing for the construction of a wide range of carbohydrates with up to 5 stereocenters. In these reactions, a catalyst-controlled Michael reaction followed by a substrate-controlled Henry reaction provided 3,4-dideoxytalose derivatives 6 in a highly stereoselective manner. The Henry reaction was affected by addition of a simple base such as triethylamine: A complex chiral base was not necessary. 3,4-Dideoxymannose derivatives 7 were produced by simply changing the base from triethylamine to 1,8-diazabicyclo[5.4.0]undec-7-ene. Extension of this methodology to a syn-Michael initiated sequence was also successful. A mechanistic discussion is provided to explain the unusual substrate-induced stereoselectivity of the Henry reaction.     

Leukocytosis due to adrenal metastases from malignant melanoma: reversal after bilateral adrenalectomy with long-term survival

Leukocytosis has been noted in association with many non-hematologic malignancies in the absence of concurrent infection or metastatic involvement of bone marrow. We report a case of sustained, neutrophilic leukocytosis in a patient with disseminated malignant melanoma which reversed after bilateral adrenalectomy for adrenal metastases.     

Redox potentials of primary electron acceptor quinone molecule (QA)- and conserved energetics of photosystem II in cyanobacteria with chlorophyll a and chlorophyll d

In a previous study, we measured the redox potential of the primary electron acceptor pheophytin (Phe) a of photosystem (PS) II in the chlorophyll d-dominated cyanobacterium Acaryochloris marina and a chlorophyll a-containing cyanobacterium, Synechocystis. We obtained the midpoint redox potential (E(m)) values of -478 mV for A. marina and -536 mV for Synechocystis. In this study, we measured the redox potentials of the primary electron acceptor quinone molecule (Q(A)), i.e., E(m)(Q(A)/Q(A)(-)), of PS II and the energy difference between [P680·Phe a(-)·Q(A)] and [P680·Phe a·Q(A)(-)], i.e., ΔG(PhQ). The E(m)(Q(A)/Q(A)(-)) of A. marina was determined to be +64 mV without the Mn cluster and was estimated to be -66 to -86 mV with a Mn-depletion shift (130-150 mV), as observed with other organisms. The E(m)(Phe a/Phe a(-)) in Synechocystis was measured to be -525 mV with the Mn cluster, which is consistent with our previous report. The Mn-depleted downshift of the potential was measured to be approximately -77 mV in Synechocystis, and this value was applied to A. marina (-478 mV); the E(m)(Phe a/Phe a(-)) was estimated to be approximately -401 mV. These values gave rise to a ΔG(PhQ) of -325 mV for A. marina and -383 mV for Synechocystis. In the two cyanobacteria, the energetics in PS II were conserved, even though the potentials of Q(A)(-) and Phe a(-) were relatively shifted depending on the special pair, indicating a common strategy for electron transfer in oxygenic photosynthetic organisms.     

Studies on the mechanisms of adverse reactions produced by diethylcarbamazine in patients with onchocerciasis—Mazzotti reaction

Summary The treatment of patients with onchocerciasis with diethylcarbamazine (DEC) can produce local or systemic reactions within a few hours—the Mazzotti reaction. In order to study the immunological mechanisms which could underly this reaction, three patients were studied who were undergoing treatment, and two normal subjects who had been treated successfully previously were controls. Blood eosinophils were vacuolated and a higher proportion than normal had Fc receptors. After taking 50 mg DEC orally, in parallel with the development of symptoms in the three patients, localised in two and generalized in one, there was a fall in blood eosinophil counts which were lowest at 12 h. Serum IgG levels fell slightly in all three patients, and the serum IgE level fell in one, but there were no changes in the titres of antimicrofilarial antibodies. Levels of circulating immune complexes were not elevated at any time, and complement levels did not alter during the reaction. From these findings and a review of previous work on the mechanisms of the Mazzotti reaction it is suggested that when microfilarae are damaged by DEC, an inflammatory reaction is produced which may be localised or generalized. The reaction does not appear to require the generation of circulating immune complexes, or systemic complement activation, even when the reaction is generalized. It is suggested that the clinical features of the reaction may be due to the effects of mediators secreted from inflammatory cells including eosinophils, in sites where microfilarae are being destroyed.     

Ammonia synthons for the multicomponent assembly of complex gamma-lactams

The synthesis of γ-lactams that are unsubstituted at the 1-position (nitrogen) as well as their subsequent N-functionalization is reported. A recently discovered four-component reaction (4CR) is employed with either an ammonia precursor or a protected form of ammonia that can be deprotected in a subsequent synthetic step. These methods represent the first multicomponent assembly of complex lactam structures that are unsubstituted at nitrogen. In addition, two methods for the introduction of nitrogen substituents that are not possible through the original 4CR are reported. X-ray crystallographic analysis of representative structures reveals conformational changes in the core structure that will enable future deployment of this chemistry in the design and synthesis of diverse collections of lactams suitable for the discovery of new biological probes.     

Influence of Accelerating Admixtures on the Reactivity of Synthetic Aluminosilicate Glasses

This research aims at gaining a further understanding of the impact of accelerating admixtures on the reactivity of supplementary cementitious materials (SCMs), which are widely used as a clinker replacement in blended cements. This was done on synthetic glasses with controlled composition and structure that mimic two types of real SCMs (slag and calcium-rich fly ash). The effects of DEIPA, TIPA, NaSCN and Na₂S₂O₃ on the glass dissolution, hydration kinetics and reaction products were investigated. The obtained results concluded that the pH of the NaOH solution and the composition of the synthetic glass play a key role on the effect of the admixtures. In 0.1 M NaOH (pH = 13.0), all the studied admixtures inhibited the dissolution of slag-like glasses while they enhanced the dissolution of Ca-rich fly ash-like glasses, being Na₂S₂O₃ the admixture that led to the highest increase of the dissolution rate of the Ca-rich fly ash-type glasses. In 1 M NaOH solutions (pH = 13.8), only the alkali admixtures (NaSCN and Na₂S₂O₃) enhanced the degree of reaction of both glasses. In slag-type glasses pastes mixed with 1 M NaOH, the addition of 2% Na₂S₂O₃ induced the highest increase of their reactivity as inferred by the total heat release and the amount of bound water. This is related to the formation of a high amount of S(II)-AFm, in addition to C-A-S-H, that would increase the aluminium undersaturation of the pore solution and consequently the further dissolution of the glass.     

Comparative quantification of human intestinal bacteria based on cPCR and LDR/LCR

AIM: To establish a multiple detection method based on comparative polymerase chain reaction (cPCR) and ligase detection reaction (LDR)/ligase chain reaction (LCR) to quantify the intestinal bacterial components.METHODS: Comparative quantification of 16S rDNAs from different intestinal bacterial components was used to quantify multiple intestinal bacteria. The 16S rDNAs of different bacteria were amplified simultaneously by cPCR. The LDR/LCR was examined to actualize the genotyping and quantification. Two beneficial (Bifidobacterium, Lactobacillus) and three conditionally pathogenic bacteria (Enterococcus, Enterobacterium and Eubacterium) were used in this detection. With cloned standard bacterial 16S rDNAs, standard curves were prepared to validate the quantitative relations between the ratio of original concentrations of two templates and the ratio of the fluorescence signals of their final ligation products. The internal controls were added to monitor the whole detection flow. The quantity ratio between two bacteria was tested.RESULTS: cPCR and LDR revealed obvious linear correlations with standard DNAs, but cPCR and LCR did not. In the sample test, the distributions of the quantity ratio between each two bacterial species were obtained. There were significant differences among these distributions in the total samples. But these distributions of quantity ratio of each two bacteria remained stable among groups divided by age or sex.CONCLUSION: The detection method in this study can be used to conduct multiple intestinal bacteria genotyping and quantification, and to monitor the human intestinal health status as well.     

Probing the resonance potential in the F atom reaction with hydrogen deuteride with spectroscopic accuracy

Reaction resonances are transiently trapped quantum states along the reaction coordinate in the transition state region of a chemical reaction that could have profound effects on the dynamics of the reaction. Obtaining an accurate reaction potential that holds these reaction resonance states and eventually modeling quantitatively the reaction resonance dynamics is still a great challenge. Up to now, the only viable way to obtain a resonance potential is through high-level ab initio calculations. Through highly accurate crossed-beam reactive scattering studies on isotope-substituted reactions, the accuracy of the resonance potential could be rigorously tested. Here we report a combined experimental and theoretical study on the resonance-mediated F + HD → HF + D reaction at the full quantum state resolved level, to probe the resonance potential in this benchmark system. The experimental result shows that isotope substitution has a dramatic effect on the resonance picture of this important system. Theoretical analyses suggest that the full-dimensional FH₂ ground potential surface, which was believed to be accurate in describing the resonance picture of the F + H₂ reaction, is found to be insufficiently accurate in predicting quantitatively the resonance picture for the F + HD → HF + D reaction. We constructed a global potential energy surface by using the CCSD(T) method that could predict the correct resonance peak positions as well as the dynamics for both F + H₂ → HF + H and F + HD → HF + D, providing an accurate resonance potential for this benchmark system with spectroscopic accuracy.