A one-step Du test in microplates

A one-step Du test, developed for use in automated microplate systems, uses anti-D with 0.6 percent dextran to potentiate the reaction. Because the washing and reagent-adding steps of the antiglobulin test are not required, the Du test can be performed in the same microplate as the ABO/Rh test. A set of reactions prepared with this technique was visually interpreted and also classified by an automated microplate ABO/Rh system. Visual interpretation of reactions resulted in a sensitivity and specificity close to those of the antiglobulin test, although the sensitivity of the test was reagent-dependent. When the automated microplate blood grouping system was used, the test was not as sensitive or as specific as the antiglobulin test, although it may be sufficient for many applications.     

Inhibition of cytokine accumulation and bacterial growth during storage of platelet concentrates at 4 degrees C with retention of in vitro functional activity

BACKGROUND : The potential for bacterial contamination limits the storage of platelet concentrates (PCs) at 22° C to 5 days. In addition, storage of platelets under conventional protocols for longer times (> 3 days), in the absence of white cell filtration, has been correlated with incidents of cytokine-associated febrile reaction in recipients. It has been demonstrated that the addition of a reagent mixture of second-messenger effectors allows platelets stored at 4°C to maintain significant in vitro functional activity. Thus, the effects of 4°C storage on the growth of bacteria and the accumulation of cytokines by the white cell fraction of PCs were analyzed to demonstrate the benefits of this refrigerated storage system. STUDY DESIGN AND METHODS : The platelet storage solution was added directly to PCs obtained from the blood bank, and these treated PCs were stored at 4° C without agitation. In parallel, control PCs were stored according to standard blood-banking procedures. On Days 1, 3, 5, and 9, the PCs were measured for the plasma concentrations of cytokines. Treated and control PCs stored at 4°C and 22°C were inoculated with low-titer Staphylococcus aureus, and bacterial growth was measured over a 5-day period. RESULTS : Control PCs displayed a time-dependent increase in the plasma concentration of interleukin 6, interleukin 1β, and tumor necrosis factor α. These conventionally stored PCs also displayed a time-dependent increase in the bacteria titer. In contrast, the treated PCs stored at 4°C displayed no accumulation of the above cytokines in the plasma fraction and no increase in bacteria titer above the initial inoculation. CONCLUSION : The storage of PCs at refrigerated temperatures inhibits the accumulation of white cell-produced cytokines in the PCs, an effect that could alleviate cytokine-associated febrile transfusion reactions The 4°C storage was also bacteriostatic, which indicates that the storage of PCs at that temperature increases safety by decreasing the potential for sepsis. Thus, the ability to store PCs at 4°C may allow extension of the storage limit beyond 5 days.     

肝移植术后患者血清胆汁酸代谢的检测及临床意义

目的:评价肝移植术后患者血清总胆汁酸水平、胆酸/鹅脱氧胆酸比值在肝移植术后发生排斥反应及肝功能延迟恢复时的变化规律。方法:选择2004-01/2004-12在大连医科大学器官移植中心进行肝移植手术的患者28例,同时收集大连医科大学附属二院门诊健康体检者和肝硬化患者血清学标本各12例作为对照,所有观察对象均知情同意。采用高效液相色谱检测肝移植术后患者血清中不同种类胆汁酸及总胆汁酸水平,也与常规肝功能监测指标谷草转氨酶和总胆红素加以比较,对肝移植术后患者血清指标与肝功能恢复之间的关系进行综合评价。结果:所有观察对象均进入结果分析,无脱落。①肝硬化组、肝移植组术前患者的血清总胆汁酸水平显著高于正常对照组(P<0.05)。②肝移植患者术后发生排斥反应或肝功能延迟恢复时,血清总胆汁酸水平较术前明显升高(P<0.05),胆酸/鹅脱氧胆酸比值明显降低(P<0.05),且比谷草转氨酶、总胆红素的变化提前发生,随着供肝功能的恢复它们将逐渐恢复正常。结论:总胆汁酸及胆酸/鹅脱氧胆酸比率可以作为肝移植术后发生排斥反应及肝功能延迟恢复的早期诊断指标,其对于肝移植术后急性排斥反应的早期诊断、早期治疗有重大意义。     

Low risk of viral infection after administration of vapor-heated factor VIII concentrate. International Investigator Group

A multicenter prospective study was carried out to evaluate whether a vapor-heated factor VIII concentrate transmitted blood-borne viral infections over a surveillance period of 15 months. Thirty-five patients with hemophilia and von Willebrand disease who had never received any blood components were treated. Twenty-eight were analyzed and found not to have non-A, non-B hepatitis. Sera from 20 of these 28 patients were also tested for the antibody to the hepatitis C virus. None had sero-converted during the follow-up period. None of the patients analyzed developed markers of the hepatitis B virus (n = 17) or the human immunodeficiency virus (n = 31). This vapor-heated factor VIII concentrate carries a low risk of transmitting hepatitis and human immunodeficiency virus infection.     

Migraine in childhood and adolescence. A critical study of the diagnostic criteria and of the influence of age on clinical findings

We studied 253 children aged <15 years. Phase 1 included 193 children with migraine (1.1 and 1.2) divided into two groups (<10 and ≥ 10 years). We studied the relationship between age and migraine type, headache characteristics, and associated symptoms of the International Headache Society (IHS) definition. A higher frequency of migraine with aura, pulsatile quality, and unilateral location was observed in older children. In phase 2 we studied 176 children with headache (excluding migraine with aura), comparing diagnostic criteria, definition items, sensitivity, and specificity. The results showed that item B of the definition was the most frequent cause of exclusion in the 1.7 diagnostic group. Compared with Vahlquist and the IHS, the Prensky criteria were the most sensitive. Sensitivity was >70% for pain of moderate/severe intensity, duration between 2 and 48 h, isolated photophobia, isolated phonophobia, and aggravation with physical activity. Specificity was >70%, for nausea, vomiting, phonophobia and photophobia, isolated photophobia, aggravation with physical activity, and isolated phonophobia. Based on three alternative definitions, each modifying one item of the IHS definition, the sensitivity and specificity of these alternative definitions were compared with the "extended" criteria (children with migraine without aura and migrainous disturbance, according to the IHS criteria, grouped together). Exclusion of headache duration increased sensitivity by 10%, compared to restrictive IHS criteria, without decreasing specificity.     

Bacterial meningitis in patients with nasopharyngeal carcinoma

Bacterial meningitis was found in 12 patients with nasopharyngeal carcinoma, accounting for 0.65% of the 1850 patients with the tumour diagnosed between 1981 and 1994 in our hospital. In 11 patients, the time-lag between diagnosis of cancer and the appearance of infection ranged from 9 months to 11 years (mean 57 months) whereas in one patient it was only 5 days. Three patients developed mixed bacterial meningitis. Cerebrospinal fluid culture for bacteria was positive in six patients. Three patients (25%) were bacteraemic. Gram-negative bacilli, especially Pseudomonas aeruginosa, were the most common pathogens. Age, sex and histopathology were not risk factors for infection. Conditions predisposing to meningitis included intracranial invasion of the tumor, neutropenia, otitis media, and neurosurgical procedures. All but two patients had intracranial tumour invasion and erosion of the base of the skull. Local spread of micro-organism to the meninges was more important than haematogenous spread. The overall mortality in our patients was 66.7%, much higher than in patients without cancer.      

抗癌药物的研究:4-氯苯氧乙酰胺衍生物的合成

Since compounds Ⅲ and Ⅳ possess retinoid-like action and analogues of Ⅰ inhibit some cancer cells ,seventeen derivatives of chlorophenoxy acetamide were synthesized.Of the seven compounds screened ,two exhibit cytostatic activity(1 and　2).Mass spectra showeda　special expulsion of SO2 and CO from the sulfonamide compounds,Nuclear magnetic resonancesplitting patterns of these compounds also showed interesting features.     

Beyond “patient-provider race matching.” Black midwives clarify a vision for race-concordant care to achieve equity in Black perinatal health: A commentary on “Do Black birthing persons prefer a Black health care provider during birth? Race concordance in birth”

Racial concordance has been identified as a potential strategy to improve the perinatal health of Black women and birthing people by mitigating implicit bias and improving mutual trust, healthy communication, and satisfaction. In a recent article published in BIRTH: Issues in Perinatal Care, Bogdan-Lovis et al. surveyed 200 Black women to determine whether they possessed a race and gender practitioner preference for their birth practitioner and examined whether race and gender concordance was associated with greater birth satisfaction and perceived respect, trust, practitioner competence, empathy, and use of inclusive communication. In this commentary, written by a group of Black midwives, we respond to the study and offer a vision for race-concordant care that encompasses cultural safety provided in a community-based setting.