The in vitro evaluation of two filters (Erypur and Imugard IG 500) for white cell-poor platelet concentrates

White cell-poor blood components are useful in patients with white cell antibodies. White cells are efficiently removed by two different filters, Imugard and Erypur, which have used saline as the filter solution. This study evaluated these filters as to their production of white cell-poor platelets. Pools of random-donor platelet concentrates were filtered. Prefiltration and postfiltration samples were evaluated for percentages of platelet recovery, white cell (WBC) removal, and platelet function. The two filter solutions tested were normal-strength saline (NSS) and fresh-frozen plasma (FFP). Postfiltration samples using NSS showed no measurable platelet aggregation with ADP, epinephrine, or collagen. However, with FFP, both filters showed 100 percent platelet aggregation with ADP, epinephrine, and collagen. The FFP filter solution provided excellent white cell removal in both filters (Imugard: 100% WBC removal or less than 1.0 X 10(6) residual WBC; Erypur: 99.5% removal or greater than 1.0 X 10(7) residual WBC); however, platelet recovery was better with Imugard (95%) than with Erypur (55%). The filtration procedure is an excellent method for the preparation of white cell-poor platelets; however, the quantity of the saline solution recommended for the filtering of red cells must be minimized for platelets.     

Heparin therapy in the Chinese--lower doses are required

Warfarin requirements are lower in the Chinese, but it is not known if this applies to heparin. We investigated the optimal dose for heparin therapy in Chinese patients, and to assess relationship between i.v. heparin dosage and anticoagulation efficacy. One hundred Chinese patients requiring intravenous heparin therapy were given an initial bolus followed by continuous intravenous infusion. The main outcome measures were: (i) Efficacy of anticoagulation assessed by blood coagulation studies (APTT) compared to heparin dosage, (ii) Determinants of dosage variation-age, gender, body weight, height, indication for heparin therapy and number of medications, other disease, and serum albumin level. It was found that the mean therapeutic infusion dose requirement of heparin was 848.7 +/- 274.7 units/h, 79% required a dose of 1000 units/h or less. Heparin dose correlated negatively with age (r = -0.40; p < 0.001) and positively with weight (r = 0.44 p < 0.001) and height (r = 0.49; p < 0.001). Chinese subjects require lower heparin doses (about 800 units/h) than usually recommended for Caucasians (usual dose 1000-1500 units/h). This can be partly explained by the lower body weight in Chinese patients.      

Detection of human herpesvirus-8 DNA in oral ulcer tissues of HIV-infected individuals

OBJECTIVE: To determine the frequency of detection of human herpesvirus-8 (HHV-8) in HIV-related oral ulcers. DESIGN: Analysis of archived biopsy material. METHODS: Nested polymerase chain reaction of DNA extracts. RESULTS: HHV-8 DNA was detected in six of 10 oral ulcers of HIV-positive patients without oral Kaposi's sarcoma (KS) lesions and five of 11 oral KS lesions. The positive non-KS samples were derived from various oral sites. CONCLUSIONS: In HIV-positive people, HHV-8 can infect oral tissues that are not affected by KS.     

半月板纤维软骨细胞与小肠黏膜下层的组织相容性

目的:观察小肠黏膜下层与半月板纤维软骨细胞的组织相容性,评价其作为组织工程半月板支架材料的可行性及应用价值。方法:实验于2005-06/12在华中科技大学同济医学院附属协和医院骨科实验室完成。①物理和化学方法处理猪小肠黏膜下层支架材料。②体外复合培养兔半月板纤维软骨细胞与小肠黏膜下层。③通过苏木精-伊红染色观察小肠黏膜下层的组织学结构表现;倒置相差显微镜观察细胞生长及与生物材料附着的情况;扫描电镜观察半月板纤维软骨细胞与小肠黏膜下层复合情况。结果:①小肠黏膜下层组织学检查:经物理方法处理后的小肠黏膜下层表面有大量残留的细胞碎屑;化学方法处理后的小肠黏膜下层表面没有残留的细胞碎屑,胶原纤维未受损。②细胞生长及附着情况:相差显微镜观察,复合培养第1～4天时细胞增殖不明显,第5天有较多细胞直接贴附于材料边缘,第7天有大量细胞向材料边缘聚集,细胞形态多为梭形或多角形,连成一片。③细胞与支架复合情况:扫描电镜观察,单纯小肠黏膜下层支架材料可见黏膜表面较粗糙,孔隙较多,大小不一。半月板纤维软骨细胞与小肠黏膜下层复合培养7d可见细胞间通过突起相互连接附着在材料表面,细胞在小肠黏膜下层支架材料上生长、黏附、增殖良好,并分泌大量的细胞外基质成分。结论:小肠黏膜下层具有良好的组织相容性,可以用作组织工程半月板的支架材料。     

应用简明健康测量量表评估美沙酮维持治疗患者生活质量

目的:对比接受与未接近美沙酮维持治疗的海洛因依赖者健康相关生活质量。方法:①选择2004-04/05在云南省个旧市美沙酮维持治疗门诊接受美沙酮维持治疗的海洛因依赖者作为治疗组(95例)。纳入标准:符合美国精神障碍诊断与统计手册第4版中海洛因依赖诊断标准;至2004-11时尚未脱失;采用滚雪球方法,于2004-11在该市社区内寻找从未接受过美沙酮维持治疗的海洛因依赖者作为对照组(37例),均符合美国精神障碍诊断与统计手册第4版中海洛因依赖诊断标准。纳入对象均对调查项目知情同意。②根据患者的日常海洛因使用量、使用方式、末次使用量决定美沙酮首次剂量,一般<40mg;导入期则根据患者的戒断症状控制情况逐渐加量。维持期的剂量差异较大,5～160mg/d,多超过60mg/d。同时根据治疗组患者的需求,每月定期开展心理干预小组活动。对照组患者未接受美沙酮维持治疗或任何戒毒措施、干预活动,评估期间时仍然在使用海洛因。③治疗组于治疗刚开始及治疗8个月后,对照组于治疗组治疗8个月后同期采用简明健康测量量表对两组对象进行健康相关生活质量评估。该量表包括躯体功能、躯体角色、肌体疼痛、总健康状况、生命力、社会功能、情绪角色及心理健康8个维度,评分越高表明生活质量越好。④计量和计数资料差异比较分别采用t检验和χ2检验。结果:治疗组95例和对照组37例均进入结果分析。参加美沙酮维持治疗8个月后,治疗组简明健康测量量表中6个维度躯体角色、总健康状况、生命力、社会功能、情绪角色及心理健康的评分分别为(6.59±1.48),(15.54±3.97),(16.20±3.91),(8.39±2.29),(4.72±1.17),(20.19±2.68)分,高于治疗刚开始时和对照组[(5.54±1.51),(13.37±3.58),(13.19±3.81),(7.17±2.21),(3.94±1.11),(17.05±4.24)分;(5.43±1.29),(11.83±3.84),(12.89±3.79),(6.71±2.12),(4.06±1.08),(15.77±4.45)分,t=3.02～7.03,P<0.01];躯体功能得分也较治疗前有了明显提高[(27.16±3.24),(26.48±3.34)分,t=1.96,P<0.05],但与对照组比较,差异不明显[(26.31±2.78)分,P>0.05]。治疗组肌体疼痛评分与治疗刚开始时和对照组相近(P>0.05)。结论:美沙酮维持治疗可有效提高海洛因依赖者的健康相关生活质量,但短期的维持治疗对肌体疼痛改善不明显。     

脂肪组织与骨骼肌信号之间的分子代谢关系

学术背景:最近研究发现脂肪组织与骨骼肌之间有着某种联系。脂肪组织能分泌许多细胞因子,对体质量调节起着重要作用。然而骨骼肌在代谢调节方面可能与脂肪组织有相似的作用。目的:探讨骨骼肌与脂肪组织之间的关系,说明骨骼肌在控制体质量方面的作用。检索策略:应用计算机检索CMBI、NCBI据库1994-01/2005-12相关骨骼肌、脂肪组织、肥胖等方面的文献,检索词"Skeletal muscle,Adipose tissue",限定文献语言种类为English。对资料进行初审,选取包括骨骼肌、脂肪组织、瘦素与细胞因子的文献,开始查找全文。纳入标准:①具有原创性,论点论据可靠的实验文章。②观点明确,分析全面的文章。③文献主体内容与此课题联系紧密的文章。排除标准:实验设计不合理的文章及观点模糊的综述。文献评价:共检索到109篇关于骨骼肌、脂肪组织与细胞因子的文献,最终纳入47篇符合标准的文献。资料综合:脂肪组织在能量稳态中起重要作用,能分泌一些细胞因子。这些细胞因子的表达或活性的改变对肥胖和胰岛素抵抗等病理状态有着重要作用。然而骨骼肌在代谢调节方面可能与脂肪组织有相似的作用。有研究证明在骨骼肌中表达的一些细胞因子确实可以调节脂肪代谢。本文综述了脂肪组织和骨骼肌信号之间的代谢关系。这两种组织的细胞因子在维持脂肪组织和骨骼肌足够比率方面有重要作用,因而在体质量控制方面亦有重要作用。白细胞介素15(在骨骼肌中高度表达)、肿瘤坏死因子α和瘦素在脂肪组织与骨骼肌之间联系中起着重要作用。结论:脂肪组织与骨骼肌之间可能存在联系,而且与体质量控制有关,包括脂肪储存和肌肉质量的控制。     

人类项韧带的精细解剖结构

目的:观察人类项韧带的精细解剖结构及形态。方法:实验于2004-09/2005-04在大连医科大学解剖教研室及大连医大生物塑化有限公司科研部完成。观察对象为4具成人尸体的颈部,均有完整的颈部(椎)全段,包括颅骨后枕外隆突。其中1具尸体进行肉眼大体解剖;3具尸体取寰椎到C7水平,制作成P45(聚酯树脂)生物塑化薄片。所有标本及材料均由大连医大生物塑化有限公司及大连医科大学解剖教研室提供。观察大体标本及P45断层塑化薄片标本,记录各种新发现。最后将两部分的观察及影像结果合并,利用断层解剖知识,标注项韧带组织名称并进行分析。结果:在颈椎的不同平面,项韧带的浅层、背侧部和腹侧部分别由斜方肌、头夹肌、小(大)菱形肌和上后锯肌的腱膜纤维组成的一个整体,且绝大部分纤维走向为横行。结论:①项韧带的结缔组织纤维不是全部纵向走行的,是以横向走行为主的肌腱腱膜组织纤维。②P45生物塑化薄片技术的应用使项韧带精细解剖结构的全貌更直观。     

Development of the Capacity Necessary to Perform and Promote Knowledge Translation Research in Emergency Medicine

Knowledge translation (KT) research in emergency medicine (EM) is in its infancy, and few EM investigators have the skills needed to perform KT research. Furthermore, the capacity to perform such KT research is underdeveloped in the field of EM. This consensus group used an iterative process to set forth initial recommendations and suggest methods for the development of EM KT research capacity. We have emphasized the need to form sustainable linkages, particularly between EM researchers and KT scientists, and to educate EM researchers in KT research methods to help create and sustain a culture of KT in our field. EM KT researchers must also engage local and national organizations and stakeholders to fund and promote KT research. Finally, we see the need to further develop and support EM research networks, as these networks will be both the clinical laboratories in which to perform the KT research and the incubators for the development of EM KT research experts.     

"I am pregnant and my husband has diabetes. Is there a risk for my child?" A qualitative study of questions asked by email about the role of genetic susceptibility to diabetes

Background  

Diabetes Mellitus is a global health problem. Scientific knowledge on the genetics of diabetes is expanding and is more and more utilised in clinical practice and primary prevention strategies. Health consumers have become increasingly interested in genetic information. In the Netherlands, the National Genetic Research and Information Center provides online information about the genetics of diabetes and thereby offers website visitors the opportunity to ask a question per email. The current study aims at exploring people's need of (additional) information about the role of inheritance in diabetes. Results may help to tailor existing clinical and public (online) genetic information to the needs of an increasing population at risk for diabetes.