Postfiltration factor VIII and fibrinogen levels in cryoprecipitate stored at room temperature and at 1 to 6 degrees C

The 13th edition of the standards of the American Association of Blood Banks specified storage at 1 to 6 degrees C for cryoprecipitated anti-hemophilic factor (Cryo) administered up to 6 hours after thawing if the Cryo is used for factor VIII (FVIII) content (Standard J4.210). Previous editions specified room-temperature (RT) storage for up to 6 hours. Currently, the temperature specification has been deleted. There are few data addressing the optimal storage temperature and maximum storage time for FVIII and fibrinogen in thawed Cryo. Thirty bags of Cryo were assayed for FVIII and fibrinogen. Each bag was divided into two aliquots; one was stored at RT and the other at 1 to 6 degrees C. Assays were performed immediately after thawing (Base) and 6 and 24 hours after thawing, respectively. All samples were filtered through 200-mu blood component infusion sets before assay. Three hundred analyses were performed, 150 each for FVIII and fibrinogen by conventional clotting technique. Data were analyzed by using a paired t test. Cryo stored at 1 to 6 degrees C for 6 and 24 hours showed an FVIII loss of 35 percent (p less than 0.0001) and 63 percent (p less than 0.0001), respectively. Cryo stored at RT for 6 and 24 hours had an FVIII loss of 8 percent (p greater than 0.05) and 20 percent (p less than 0.0001). Cryo stored at 1 to 6 degrees C for 6 and 24 hours had a fibrinogen loss of 20 percent (p less than 0.0001) and 43 percent (p less than 0.0001). Cryo stored at RT for 6 hours had no fibrinogen loss and a 2 percent loss at 24 hours (p greater than 0.05). These preliminary data show a significant loss of FVIII and fibrinogen activity in Cryo stored at 1 to 6 degrees C and filtered before assay. The FVIII and fibrinogen activity at RT is clearly maintained up to 6 hours after thawing.     

那屈肝素钙治疗不同发病时间的急性脑梗死

目的 :研究那屈肝素钙治疗不同发病时间脑梗死的疗效。方法 :5 0例发病 12h以内的脑梗死病人 ,随机分为治疗A组和对照A组各 2 5例 ;6 0例发病 12～ 4 8h ,随机分为治疗B组和对照B组各 30例。以上各组均予以丹参注射液 2 0mL +氯化钠注射液 2 5 0mL ,ivdrip ,qd。治疗组加用那屈肝素钙4 10 0IU ,sc ,q 12h。 4组疗程均 10d。治疗前、治疗后 1mo和 3mo测定病人神经功能缺损程度评分(NFDS)和日常生活活动能力评分 (ADL)。结果 :1mo和 3mo后 ,治疗A组和B组NFDS为 10± 4 ,5± 4和 13± 6 ,8± 3;与对照A组 (13± 5 ,10± 5 )和B组 (14± 7,12± 4 )比较 ,P <0 .0 5或P <0 .0 1。ADL评分和血液流变学指标各组均有改善 ,但以治疗A组尤为明显 ,P <0 .0 5或P <0 .0 1。结论 :那屈肝素钙能有效治疗急性脑梗死 ,早期应用效果更佳     

Pediatric peripheral blood progenitor cell collection: haemonetics MCS 3P versus COBE Spectra versus Fresenius AS104

BACKGROUND: An increasing number of apheresis machines are becoming available for peripheral blood progenitor cell (PBPC) collection in children. STUDY DESIGN AND METHODS: At the Children's Hospital of Florence (Italy), three apheresis machines were evaluated: MCS 3P (Haemonetics) (10 procedures in 4 patients, aged 10–12 years, weight 23.5-64 kg), Spectra, (COBE) (8 procedures in 3 patients, aged 4–17 years, weight 19–59 kg), and AS104 (Fresenius) (24 procedures in 9 patients, aged 2–16 years, weight 13.6-60 kg). For PBPC quantitative analysis, CD34 cytofluorimetry was employed. Relevant variables analyzed included efficiency of CD34+ cell extraction and enrichment, mononuclear cell purity and red cell contamination of the apheresis components, and platelet count decreases after leukapheresis. RESULTS: No significant differences in CD34+ cell-extraction abilities were found. However, the AS104 provided consistently purer leukapheresis components in terms of mononuclear cell and CD34+ cell enrichment (441 +/− 59%, vs. 240 +/− 35% and 290 +/− 42% for MCS 3P and Spectra, respectively). Postapheresis platelet counts dropped the least with the AS104. The smallest patient who underwent apheresis with MCS 3P (the only machine working on discontinuous flow and hence with greater volume shifts) weighed 23.5 kg and tolerated the procedure well, with no signs of hemodynamic instability. No significant complications were observed. CONCLUSION: All machines seem to have comparable PBPC extraction efficiency, but the AS104 seems to give the component with the greatest PBPC enrichment. This feature might be relevant for further ex vivo cell processing (CD34+ cell selection, expansion, and so on).     

Mobilization of early hematopoietic progenitor cells with BB-10010: a genetically engineered variant of human macrophage inflammatory protein- 1 alpha

BB-10010 is a genetically engineered variant of human macrophage inflammatory protein-1 alpha with improved solution properties. We show here that it mobilizes stem cells into the peripheral blood. We investigated the mobilizing effects of BB-10010 on the numbers of circulating 8-day spleen colony-forming units (CFU-S8), CFU-S12, and progenitors with marrow repopulating ability (MRA). A single subcutaneous dose of BB-10010 caused a twofold increase in circulating numbers of CFU-S8, CFU-S12, and MRA 30 minutes after dosing. We also investigated the effects of granulocyte colony-stimulating factor (G- CSF) and the combination of G-CSF with BB-10010 on progenitor mobilization. Two days of G-CSF treatment increased circulating CFU-S8, CFU-S12, and MRA progenitors by 25.7-, 19.8-, and 27.7-fold. A single administration of BB-10010 after 2 days of G-CSF treatment increased circulating CFU-S8, CFU-S12, and MRA even further to 38-, 33-, and 100- fold. Splenectomy resulted in increased circulating progenitor numbers but did not change the pattern of mobilization. Two days of treatment with G-CSF then increased circulating CFU-S8, CFU-S12, and MRA by 64-, 69-, and 32-fold. A single BB-10010 administration after G-CSF treatment further increased them to 85-, 117-, and 140-fold, respectively, compared with control. We conclude that BB-10010 causes a rapid increase in the number of circulating hematopoietic progenitors and further enhances the numbers induced by pretreatment with G-CSF. BB- 10010 preferentially mobilized the more primitive progenitors with marrow repopulating activity, releasing four times the number achieved with G-CSF alone. Translated into a clinical setting, this improvement in progenitor cell mobilization may enhance the efficiency of harvest and the quality of grafts for peripheral blood stem cell transplantation.     

细胞核仁形成区酸性非组蛋白在胆囊癌诊断与监测中的价值

目的探讨检测细胞核仁形成区酸性非组蛋白在胆囊癌诊断与监测中的价值。方法应用细胞银染技术对体外激活的外周血和胆汁淋巴细胞染色 ,并对胆囊组织作核仁形成区嗜银蛋白银染 ,计算外周血和胆汁中硝酸银染色酸性非组蛋白 (Ag) NORs面积与核面积的比值 (IS % )和组织切片中AgNOR颗粒面积。结果正常人 (2 0例 )、慢性胆囊炎 (90例 )与胆囊癌之间 (2 1例 )外周血、胆汁T细胞Ag NORs面积与核面积的比值和组织切片中AgNOR面积差异均有显著性意义 ,血清、胆汁中T细胞Ag NORs面积与核面积的比值 (IS % )逐级降低 ,组织切片中AgNOR面积逐级升高 ,且血清、胆汁中T细胞Ag NORs面积与核面积的比值 (IS % )、组织中AgNOR面积三者相互间有良好的直线相关性 (P均 <0 0 1)。结论监测胆囊病变过程中患者外周血、胆汁中T细胞Ag NORs面积与核面积的比值 (IS % )和组织切片中AgNOR面积的变化 ,有助于胆囊癌的诊断     

合欢皮中新皂甙的结构鉴定

从合欢皮(Albizziae cortex)的95%乙醇提取物的正丁醇萃取部分中分离得到3个新的三萜皂甙,用化学方法及¹H-和¹³C-NMR,DEPT,COSY,TOCSY,HMQC-COSY,HMQC-TOCSY,HMBC,NOESY等波谱方法鉴定其结构为:I(1个三萜,9个糖,2个单萜),命名为合欢皂甙(julibroside)J₁;II(1个三萜,8个糖,2个单萜),命名为合欢皂甙J_{2;II(1个三萜,9个糖,2个单萜),命名为合欢皂甙J3。}     

柴胡皂甙q及其甙元的结构鉴定

从小叶黑柴胡(Bupleurum smithii Wolffvar;parvifolium ShanetY.Li)的根中得到3个化合物,柴胡皂甙元A和Q及柴胡皂甙q。柴胡皂甙元Q和柴胡皂甙q为新化合物,根据理化性质和波谱分析,确定其结构分别为齐墩果烷-11,13(18)-二烯-3β,16β,23,28,30-五醇和3β,16β,23,28,3O-五羟基齐墩果烷-11,13(18)-二烯-3-O-β-D-吡喃葡萄糖基(1→6)-[α-L-吡喃鼠李糖基(1→4)]-β-D-吡喃葡萄糖甙。     

The economics of primary prevention of cardiovascular disease – a systematic review of economic evaluations

Background

Global resource needs estimation is a critical part of addressing the HIV/AIDS epidemic. To generate these estimates knowledge of costs and cost structures is required. The evidence base for costs of HIV prevention programmes is limited. Even less is known about the existence of economies scale and whether, as economic theory suggests, average costs form a 'u'-shaped curve as scale increases. Using an econometric analysis, this paper addresses this question by estimating marginal costs and economies of scale for HIV prevention programmes for vulnerable groups in Southern India with different levels of coverage.

Methods

Two hybrid translog-cost functions were estimated. First, expenditure data from 78 state-funded HIV prevention projects in Andhra Pradesh were used to explore the impact of scale, institutional history and price on costs; second, economic cost data from 16 commercial sex worker projects across Tamil Nadu and Andhra Pradesh were analysed to additionally assess the impact of the value of inputs not reported in expenditure data and location. Coefficient estimates were used to calculate marginal costs and economies of scale.

Results

The econometric model yielded a good fit (R² = 0.46, p < 0.001 and R² = 0.79, p < 0.001, for the expenditure and economic cost datasets, respectively). The economies of scale index was greater than 1 for both datasets and fell as coverage increased. Analysis of the expenditure data found economies of scale were not exhausted, with a 0.002% change in total cost for each extra person reached and an 11% difference in total cost between target group categories. Estimation using the economic cost data suggests a point of minimum efficient scale at around 1750–2000 people reached, a 0.03% change in total cost for each extra person reached, and 28% lower costs in Tamil Nadu than Andhra Pradesh.

Conclusion

Econometric analysis of these standardized datasets provides insights into how costs change with coverage, the impact of project location and nature of the project target group. The results demonstrate the importance of understanding the nature of the cost function when designing, budgeting and estimating resource requirements for scaling up coverage of HIV prevention projects.     

Endothelial cell seeding of polytetrafluoroethylene vascular prostheses coated with a fibroblastic matrix

One of the most serious problems with endothelial cell (EC) seeding of prosthetic materials is the poor adhesion and stability of the cells. Although several substrates that improve the initial adhesion have been assayed, the EC are lost within a limited period of time. In this study we attempted to modify the hydrophobic conditions of expanded polytetrafluoroethylene (ePTFE) by treating it with ethanol prior to seeding. In addition, we created a fibroblastic matrix that was also fixed by ethanol to the prosthetic material. In vitro studies were carried out at intervals of 24 hours and 15 days after seeding. EC from umbilical cord vein and fibroblasts from skin were seeded onto disks of PTFE with a porosity of 30 µm. The results obtained show that treatment of ePTFE with ethanol prior to EC seeding modifies its permeability, preventing cellular adhesion. The seeding of fibroblasts onto ePTFE allows a coating to form at 24 hours. The EC seeded onto this matrix adhere to it, forming a monolayer that persisted throughout the entire study period. The fibroblastic matrix allows the long-term survival of the EC on ePTFE.Supported by a grant from the CICYT SAF 92-0875.