Preparation of packed red blood cell units in the blood bank: Alteration in red blood cell deformability

BackgroundDonated blood is stored in the blood bank as packed red blood cell units. In the process of packed cells preparation, the red blood cells (RBCs) are subjectedto high level of shear stress, which can induce alterations in their properties.In the present study, we examined the effect of packed RBCs preparation (which included leuko-filtration) on red cell deformability.MethodsBlood samples were collected from 25 healthy donors and from corresponding units of packed RBCs. The portion of undeformable cells (%UDFC) was determined for each sample.ResultsThe median value of %UDFC was equal to 6.75 ± 0.70 %, for freshly-donated RBCs, and to 6.36 ± 0.51 %, for packed cells. Wherein, %UDFC may increase or decrease following packed cells preparation, depending upon the initial portion of undeformable cells.ConclusionLikely, exposure of RBCs to high shear stress, during packed cells preparation, induces opposing effects: (a) removal/destruction of rigid (undeformable) cells, thereby reducing their total amount (i.e., decreasing the %UDFC) on the one hand, and (b) mechanical damage to the cell membrane and subsequent reduction of the cell deformability (thereby increasing the %UDFC) on the other. As a consequence, the final impact of packed cells preparation is primarily determined by the initial state of erythrocytes in the blood of the donor.     

Selective isolation of allergens. I. Reaction of house dust mite extracts with tridacnin and concanavalin A and examination of the allergenicity of the isolated components

Tridacnin, a lectin from the clam Tridacna maxima was found to precipitate with crude extracts from the house dust mites Dermatophagoides farinae and Dermatophagoides pteronyssinus. Using tridacnin in direct precipitation and affinity chromatography studies, a carbohydrate-rich preparation of high molecular weight was isolated from D. farinae extracts. The isolated preparation gave one precipitin line when used with tridacnin in gel diffusion and immunoelectrophoresis experiments but two bands were seen on polyacrylamide disc gels after electrophoresis at pH 8.9. Radioallergosorbent test (RAST) studies demonstrated that the isolated material reacted strongly with sera from human subjects allergic to house dust mites and accounted for a significant proportion of the IgE binding capacity of the crude D. farinae extracts. Only one out of fifteen mite-allergic subjects gave a positive response when prick tested with the isolated preparation at a concentration of 0.2 mg/ml. A possible explanation for the discrepancy observed between RAST and skin test results is discussed. Concanavalin A also precipitated with D. farinae extracts but the material isolated with this lectin did not react with tridacnin and reacted weakly in the RAST with sera from mite-allergic subjects. We suggest that the high molecular weight component(s) which react with tridacnin may be useful for immunotherapy of house dust mite allergy.     

浆膜腔积液细胞块对提高细胞学诊断及开展基因检测的价值

目的：探讨低温冷藏（4℃）过夜离心法制作浆膜腔积液细胞块的可行性,并评估细胞块免疫组化对提高浆膜腔积液细胞学诊断的价值及其作为基因检测新标本来源的可行性。方法收集2011年至2013年间有组织学确诊的积液152例,均采用直接离心和低温冷藏过夜离心制作细胞块,同时均行传统涂片、细胞块HE染色、免疫组化及检测50例非小细胞肺癌积液细胞块EGFR基因突变情况。结果低温冷藏过夜离心法制作细胞块的成功率（100.0%）显著高于直接离心法（75.0%）（χ2=43.43,P＜0.001）;细胞块免疫组化的诊断准确率（92.1%）明显高于传统涂片（67.1%）和细胞块HE染色（72.4%）（χ2=29.99, P＜0.001）;EMA对癌性积液中的癌细胞诊断具有较高敏感性和特异性,TTF-1、CDX-2、CA125、GCDFP-15、P63和CgA分别对肺腺癌、胃肠腺癌、卵巢癌、乳腺癌、鳞癌和小细胞癌具有较高的敏感性和特异性;非小细胞肺癌积液细胞块EGFR基因突变检出率为44.0%。结论低温冷藏过夜离心法制作细胞块成功率高,操作简单,易于推广;细胞块免疫组化极大地提高了浆膜腔积液细胞学的诊断准确性,同时也可为个体化治疗基因检测提供一种新的标本来源。     

青薄退热汤治疗小儿高热的临床观察

目的对比观察青薄退热汤擦浴与酒精擦浴治疗小儿高热的疗效,探讨中药治疗小儿高热的对策.方法将62例高热患儿随机分成青薄退热汤擦浴和酒精擦浴2组,每组各31例.2组病例均在擦浴30min后作疗效评定,记录有关数据进行统计分析.结果青薄退热汤擦浴与酒精擦浴2组的退热降温疗效相近,p>0.05.但在退热降温维持时间,出现过敏性皮疹、肌颤、寒战等副反应方面,青薄退热汤擦浴优于酒精擦浴,p<0.05.结论青薄退热汤擦浴治疗小儿高热,具有对皮肤刺激性小、疗效确切、费用低廉、患儿易于接受等优点.     

Interaction of angiotensin with exogenous and neurally released norepinephrine on the cat nictitating membrane in vitro.

We have studied the effect of high (1-2.9 X 10(-5) M) and low 1.9 X 10(-9) M) concentrations of angiotensin on the retention and release of 3H-norepinephrine by the cat isolated nicititating membrane preparation in vitro in conjunction with their effect on the contractile responsiveness of the preparation to exogenous norepinephrine and transmural electrical stimulation. Both concentrations of angiotensin made the preparation contract, but only the high concentration affected the retention and spontaneous efflux of 3-H-norepinephrine. Retention was inhibited about 25% only when the preparation was preincubated with the angiotensin for 30 minutes (i.e., before adding 3H-norepinephrine). Under similar conditions cocaine, 2.9 X 10(-5) M, inhibited retention more than 90%. Spontaneous efflux was increased for as long as the high concentration of angiotensin was in contact with the preparation. Under similar conditions, tyramine, 5.7 X 10(-6) M, caused a much greater sustained increase in spontaneous efflux. Transmural stimulation of the preparation caused release of 3H-norepinephrine and frequency-dependent contractions. The contractions were selectively inhibited by phentolamine, 2.7 X 10(-6) M, or bretylium, 2.4 X 10(-5) M. Angiotensin had no effect on this neurally mediated 3H-norepinephrine release and contractile response or on contractions produced by exogenous norepinephrine. Since, as reported previously, angiotensin in vivo strongly inhibits contractile responses of the cat nicitating membrane to both neurally released and exogenous norepinephrine, the present results make it unlikely that such inhibition derives from angiotensin's relatively modest capacity for affecting the disposition of norepinephrine by this effector organ.     

上消化道内镜诊疗黏膜准备的现状及争议问题

我国是食管癌和胃癌的高发国家,但上消化道早期肿瘤的检出率较低。实现上消化道肿瘤早诊早治的关键,是高质量的上消化道内镜诊疗。但在内镜诊疗过程中,常因黏膜准备不充分导致疾病漏诊和误诊。目前,关于肠道准备方法,国内外已有多项指南进行规范,但上消化道黏膜准备方法尚无权威性指南规范。临床实践中,不同医疗机构采用的准备方法差别较大,黏膜准备效果有一定差异,在某些方面还存在较多争议。该文对国内外上消化道黏膜准备的现况和争议问题进行归纳总结,期望为临床规范的制订提供参考,同时,也有助于为后续相关课题研究提供思路。     

Release of calcitonin gene-related peptide (CGRP) from guinea pig dura mater in vitro is inhibited by sumatriptan but unaffected by nitric oxide

Migraine attacks can be provoked by administration of nitroglycerin, suggesting a role for nitric oxide (NO). The fact that release of the neuropeptide CGRP from trigeminal sensory nerves occurs during the pain phase of migraine and that NO can augment transmitter release prompted us to study CGRP release from the in situ dura mater in guinea pig skulls. Release of CGRP by capsaicin or by high potassium concentration was concentration-dependent and counteracted in calcium-free medium. The anti-migraine compound, sumatriptan, inhibited CGRP release via the 5-HT1-receptor. The NO donors, nitroglycerin, sodium nitroprusside and S-nitroso-N-acetylpenicillamine did not influence CGRP release, alone or together with the stimulants. We concluded that the skull preparation is well suited for scrutinizing CGRP release from dura mater. The fact that sumatriptan inhibits CGRP release as in migraine patients suggests a use for the present preparation in headache research.     

Novel, improved sample preparation for rapid, direct identification from positive blood cultures using matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry

Matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) is widely used for rapid and reliable identification of bacteria and yeast grown on agar plates. Moreover, MALDI-TOF MS also holds promise for bacterial identification from blood culture (BC) broths in hospital laboratories. The most important technical step for the identification of bacteria from positive BCs by MALDI-TOF MS is sample preparation to remove blood cells and host proteins. We present a method for novel, rapid sample preparation using differential lysis of blood cells. We demonstrate the efficacy and ease of use of this sample preparation and subsequent MALDI-TOF MS identification, applying it to a total of 500 aerobic and anaerobic BCs reported to be positive by a Bactec 9240 system. In 86.5% of all BCs, the microorganism species were correctly identified. Moreover, in 18/27 mixed cultures at least one isolate was correctly identified. A novel method that adjusts the score value for MALDI-TOF MS results is proposed, further improving the proportion of correctly identified samples. The results of the present study show that the MALDI-TOF MS-based method allows rapid (<20 minutes) bacterial identification directly from positive BCs and with high accuracy.     

Humoral response in rabbits immunized with calcium phosphate adjuvanted HIV-1 gp160 antigen

Rabbits were immunized with either calcium phosphate adjuvanted purified HIV-1 gp160 or a fluid preparation. Circulating antibodies were detected by ELISA, RIPA and Western Blot tests. Sera of rabbits immunized with the adjuvanted preparation contained high levels of anti-gp160 antibodies, as well as antibodies recognizing p55, p25 and p18. On the contrary, rabbits immunized with the fluid preparation contained only anti-p18 antibodies. Neutralizing antibodies were also detected. It is concluded that the calcium phosphate adjuvant could be used for preparation of candidate anti-HIV vaccines, since it permits one to induce high levels of circulating antibodies, in the absence of untoward reactions as observed when aluminium adjuvants or water in oil emulsions are used.     

Choice and predictability in the preparation for barium enemas: a person-by-situation approach

The effects of choice and predictability information regarding preparation for a barium enema procedure was investigated for patients differing in desire for control (DFC) and in experience with the barium enema exam. One-third of the patients, randomly assigned to the choice condition, were selected from three equally effective preparations. For these patients, choice and predictability information are confounded. Patients in the instruction only and information conditions were yoked to choice patients to control for type of preparation. Patients in the information condition were given the same sensation information about their specific preparation as those in choice. Instruction only was effective for low DFC patients, but contrary to prediction the choice was problematic for high DFC patients. It was suggested that the limited choice created reactance for these patients. The differential effectiveness of health care interventions in relation to patient predispositions was stressed.     

富血小板血浆临床应用及其生物材料性能

背景:富血小板血浆的制备方法、设备及应用手段等方面有了长足发展,但是相对于国内临床工作者而言富血小板血浆技术仍是一项相对较新的生物技术。目的:对富血小板血浆分类等相关概念和存在问题加以说明和论述,使其制备和应用技术等更加清晰和明确。方法:以"platelet rich plasma,preparation,富血小板血浆,制备"为检索词,检索PubMed数据库及维普数据库1995-09/2010-09相关文章。结果与结论:根据所含白细胞的多少可以将富血小板血浆分为贫白细胞的富血小板血浆和富白细胞的富血小板血浆;根据应用形式又可以分为未激活富血小板血浆和激活的富血小板血浆,后者又可以分为富血小板血浆凝胶和富血小板血浆释放物。被视为第二代血小板浓缩物的富血小板纤维蛋白与富血小板血浆都含有高浓度的血小板,但两者在制备方法,凝胶形成方式等方面有根本的区别。由于其安全性和易于制备,富血小板血浆在医学领域的应用将会越来越多,但临床应用还要保持谨慎,因为富血小板血浆在多个方面还缺乏相关研究。     

富血小板血浆临床应用及其生物材料性能

背景：富血小板血浆的制备方法、设备及应用手段等方面有了长足发展,但是相对于国内临床工作者而言富血小板血浆技术仍是一项相对较新的生物技术。目的：对富血小板血浆分类等相关概念和存在问题加以说明和论述,使其制备和应用技术等更加清晰和明确。方法：以＂platelet rich plasma,preparation,富血小板血浆,制备＂为检索词,检索PubMed数据库及维普数据库1995-09/2010-09相关文章。结果与结论：根据所含白细胞的多少可以将富血小板血浆分为贫白细胞的富血小板血浆和富白细胞的富血小板血浆;根据应用形式又可以分为未激活富血小板血浆和激活的富血小板血浆,后者又可以分为富血小板血浆凝胶和富血小板血浆释放物。被视为第二代血小板浓缩物的富血小板纤维蛋白与富血小板血浆都含有高浓度的血小板,但两者在制备方法,凝胶形成方式等方面有根本的区别。由于其安全性和易于制备,富血小板血浆在医学领域的应用将会越来越多,但临床应用还要保持谨慎,因为富血小板血浆在多个方面还缺乏相关研究。     

Judgement of the quality of bowel preparation at screening flexible sigmoidoscopy is associated with variability in adenoma detection rates

BACKGROUND AND STUDY AIMS: Adenoma detection rates (ADRs) at screening flexible sigmoidoscopy are known to vary between endoscopists. Variability in the technique used and in the quality of bowel preparation may explain this. The aim of this study was to establish whether there is a relationship between the grading of bowel preparation and the ADR. MATERIALS AND METHODS: The relationship between the ADR and assessment of bowel preparation was examined using the full United Kingdom Flexible Sigmoidoscopy Screening Trial data set (n = 38 601). The consistency of the bowel preparation classification was then investigated by six experienced endoscopists (video scorers), who examined 260 flexible sigmoidoscopy cases - 20 from each of the 13 trial endoscopists. RESULTS: Overall, the ADR was significantly higher in flexible sigmoidoscopy examinations with excellent or good bowel preparation ( P = 0.02). However, endoscopists with a higher ADR coded a smaller proportion of their examinations as having excellent/good preparation ( P = 0.002). Video scorers agreed with the trial endoscopists' definition of bowel preparation in 48.9 % of the readings, but they scored the quality of preparation as poorer than the trial endoscopists in 36.4 % and 40.6 %, respectively, in the intermediate-performance group (10 % < ADR < 14 %) and lower-performance group (ADR or =14 %). There was a significant linear trend between the proportion scored as having poor bowel preparation and the ADR ( P < 0.001), varying from 2.7 % in the higher-performance ADR group to 13.4 % in the lower-performance group. CONCLUSIONS: Endoscopists with a higher ADR are more likely to be critical of the quality of bowel preparation. Training in judgement processes such as non-acceptance of suboptimal bowel preparation is required in order to ensure universally high standards in screening procedures.     

Preparing for international medical service

In many ways, preparation for medical service outside the United States is not greatly different from preparation for a self-guided vacation tour of another country. The major differences are in the rigor that one should apply to being sure all details are set, particularly if one is planning to go to a site away from a capital city. Additionally, the mental preparation is required in terms of the understanding of global health issues in a holistic sense and the personal mental preparation for working under what may be austere conditions. With solid preparation, anyone interested in IH experiences should be able to have a rewarding, trouble-free experience.     

Rechtliche Grundlagen zur Hygiene

To summarise, it can be stated that the joint recommendation of the Robert Koch Institute and the Federal Institute for Pharmaceutics and Medical Products is just as helpful for the operator as other technical standard norms, official statements, guidelines or other similar recommendations from professional societies. But this does not release the user from the main task, which is that he is duty bound to perform the preparation using a procedure which has been validated by him with respect to suitability. This is carried out using a reproducible procedure which has been adequately documented by him and where the objective parameters must be documented in writing for each individual batch. These documents then serve as proof that the preparation has been duly carried out. Care must be taken with the transfer of technical parameters for preparation from the development and manufacture of medical devices to the actual preparation in public health organisations. These technical standards are not directly relevant for the actual preparation for a procedure by the user, but are the technical specifications for the equipment which establish the conditions for preparation according to the current state-of-the-art of technology for the manufacturer. It does not follow from this that the preparation in health organisations must always be carried out with the newest equipment. However, the technical data do allow details for the regulation-conform preparation to be derived, which the user should consider in the validation of the preparation procedure. If, for example, new pathogens or problem situations with respect to infections or similar events can be recognised which must be considered in the preparation due to modified technical data, these new parameters must also be taken into consideration during the next validation of the preparation procedure. The preparation of single use products is not legally prohibited in Germany, yet. They can, therefore, also be prepared with a suitable and validated procedure which in addition to the hygiene aspects also guarantees technical and functional safety after the preparation procedure. However, this is the problem.     

内科护理学PBL教学模式下集体备课的实践

目的:总结护理本科生内科护理学PBL教学模式中集体备课的实践,为PBL指导教师作好充分的教学准备提供借鉴。方法:在哈尔滨医科大学2006级护理本科生内科护理学PBL教学实践中,为更好地做好教师引导工作,实施了集体备课制度。结果:集体备课取得了良好效果,教师能有效指导学生自学和引导学生课堂讨论,学生对内科护理学PBL教学的总体满意度和对指导教师的满意度均较高,教学效果好。结论:内科护理学PBL教学中,集体备课是促进教学相长的有效措施。     

Partial preparation computed tomographic colonography: a feasibility study

We retrospectively evaluated computed tomographic colonography examinations of patients who have had a partial bowel preparation and compared the quality of their preparation with patients who have had a full bowel preparation. In total, 27 patients undergoing computed tomographic colonography examination (10 patients with partial bowel preparation and 17 with full bowel preparation) had their examinations retrospectively reviewed by three independent radiologists in a blinded manner, with evaluation of residual stool, distention, residual fluid, and overall bowel preparation quality. Six colon segments were evaluated individually and independently for these four variables (a total of 161 segments tested). Comparisons were made with the Mann–Whitney test between the partial preparation group and the full preparation group. Partial preparation included stool and fluid tagging plus 20 mg of bisacodyl orally; full preparation included stool and fluid tagging plus 2 L of polyethylene glycol solution. No significant clinical difference was found in colon preparation between the partial and full bowel preparation groups—when evaluated with individual colon segments or by independent readers. Interreader correlation was high. This pilot study indicates that full bowel preparation is not required for diagnostic-quality computed tomographic colonography examination. Further evaluation of this partial bowel preparation regimen is warranted.     

Preanalytical mRNA stabilization of whole bone marrow samples

BACKGROUND: Gene expression profiling is a useful tool for cancer diagnosis and basic research. A major limitation is that, even during short-term storage of native specimens of peripheral blood or bone marrow (BM) and/or RNA isolation, significant changes of gene expression pattern can occur because of gene induction, repression, and RNA degradation. METHODS: We investigated the effectiveness of a newly developed RNA stabilization and preparation system for BM specimens (PAXgene Bone Marrow RNA System) over time. We analyzed 256 RNA samples, processed from 64 BM specimens. RESULTS: Although the overall RNA yield (normalized to 1 x 10(7) leukocytes) was not different, the RNA preparation using unstabilized reference samples had an approximately 3 times higher failure rate. With the PAXgene system, we observed significantly higher RNA integrity compared with the reference RNA preparation system (P <0.01). In the stabilized samples, we found very high pairwise correlation in gene expression (DeltaDeltaC(T) 0.16-0.53) for the analyzed genes (GATA1, RUNX1, NCAM1, and SPI1) after 48-h storage compared with immediate preparation of RNA (2 h after BM collection). However, we found major differences in half of the analyzed genes using the reference RNA isolation procedure (DeltaDeltaC(T) 1.07 and 1.32). CONCLUSIONS: The PAXgene system is able to stabilize RNA from clinical BM samples and is suitable to isolate high-quality and -quantity RNA.     

Community Dwelling Elderly Women and Meal Preparation

ABSTRACT

Maintaining instrumental activities of daily living independence is an important component of successful aging in place. Meal preparation is an essential occupation and aspect of self-identity for many women. The aim of this study was to learn which meal preparation occupations are perceived to have high activity demands, the source of these activity demands, and the coping strategies developed to mitigate the press of these activity demands. Eight community dwelling American women, 73 years old or more, participated in this study. Using the Canadian Occupational Performance Measure, each woman identified meal preparation occupations that were important to her but which she felt were performed unsatisfactorily. The author completed an activity analysis based on the Person-Environment-Occupation Model to validate each participant's identified source of high activity demands. The results suggest that the activity demands are not solely due to a decline in functional capacity but also due to environmental barriers.     

Kininogen deficiency in Fitzgerald trait: role of high molecular weight kininogen in clotting and fibrinolysis.

Plasma from an asymptomatic person with defects in blood coagulation, release of kinin, and evolution of fibrinolytic activity upon contact with a foreign surface was deficient in kininogen. The coagulation defect was identified as "Fitzgerald trait." A preparation of high molecular weight kininogen repaired the defects in clotting, kinin release and fibrinolysis, but a preparation of low molecular weight kininogen did not. Therefore, Fitzgerald factor appears to be a high molecular weight kininogen. The site of action of the kininogen appears to be after that of activated Hageman factor and kallikrein in the generation of clot-promoting activity through activation of plasma thromboplastin antecedent (PTA).