Effects of prestorage white cell-reduction of apheresis platelets on platelet glycoprotein Ib and von Willebrand factor

Twenty plateletpheresis components were harvested from 11 healthy donors and stored in polyolefin bags on a horizontal flatbed agitator at 22 degrees C. After 24 hours, white cells were reduced in one aliquot by centrifugation while the other aliquot was stored unaltered. Samples were obtained aseptically from each of these platelets at intervals for up to 10 days, and measurements were made of platelet glycoprotein Ib (GPIb) by both flow cytometry and polyacrylamide gel electrophoresis, of ristocetin-induced platelet aggregation by impedance aggregometry, and of plasma and platelet von Willebrand factor (vWF) by enzyme-linked immunosorbent assay. Storage of platelets under these conditions was associated with only minor decreases in surface GPIb, intraplatelet vWF, and ristocetin-induced platelet aggregation, and no differences were observed between the white cell-reduced and nonreduced aliquots. No benefit of white cell reduction in such components before prolonged storage is evident in the vWF-platelet interaction.     

隐神经-大隐静脉营养血管远端蒂复合瓣移植修复小腿、踝足部创伤

目的:在显微解剖学基础上,观察隐神经-大隐静脉营养血管远端蒂复合瓣移植修复小腿、踝足部创伤的临床效果。方法:选择2004-05/2007-04由解放军南京军区福州总医院骨科、解放军第97医院骨科、解放军第107医院骨科采用隐神经-大隐静脉营养血管远端蒂复合瓣移植修复小腿、踝足部组织缺损48例,患者对治疗均知情同意。其中皮瓣修复小腿、踝周及足部的创面感染、缺损23例;肌皮瓣修复小腿上段、下段的溃疡、骨髓炎和骨钢板外露12例,跟骨内侧骨髓炎5例;骨皮瓣修复伴有胫骨缺损和跟骨骨不连的创面8例。术后定期随访,观察隐神经-大隐静脉营养血管远端蒂皮瓣移植修复术后的存活情况及骨皮瓣的骨愈合、功能情况。结果:48例患者术后均有程度不同的皮瓣肿胀,其中3例皮瓣远侧边缘少量坏死,经换药愈合;皮瓣部分坏死植皮1例。伤口Ⅰ期愈合44例,Ⅱ期愈合4例。所有病例经5￣15个月随访,创面及骨不连修复,外形满意。结论:隐神经-大隐静脉营养血管远端蒂皮瓣、复合瓣用于外伤造成的小腿远端骨缺损、骨不连、大的死腔以及踝足部的缺损创面修复,具有快捷方便,抗感染力强,成活率高和愈合快的优点。     

The association of biologically active lipids with the development of transfusion-related acute lung injury: a retrospective study

BACKGROUND: Transfusion-related acute lung injury (TRALI) is clinically similar to the adult respiratory distress syndrome (ARDS) and has been linked to the transfusion of leukocyte antibodies in blood components. Animal model have implicated neutrophil (PMN)-priming agents in ARDS; however, two agents were required. Previous studies showed the generation of PMN-priming agents during blood storage. Thus the association of PMN-priming agents with TRALI was examined. STUDY DESIGN AND METHODS: Ten patients with TRALI and 10 with febrile or urticarial reactions (control group) were evaluated. The presence of PMN-priming activity was tested in the patients' pretransfusion and posttransfusion blood samples by incubating PMNs with these samples followed by activation of the respiratory burst. Plasma lipids were separated by normal-phase high-performance liquid chromatography (HPLC), and the priming activity was evaluated. The presence of leukocyte antibodies was determined in the blood donors and patients with TRALI. RESULTS: Significantly more PMN-priming activity was present in the posttransfusion sera (11.4 +/? 1.8 nmol superoxide anion/min, mean +/? SEM; n=10) and plasma of patients with TRALI than in their pretransfusion sera (6.5 +/? 1.5: n=10) or in the pretransfusion and posttransfusion sera (5.1 +/? 1.3, n=10; and 4.5 +/? 1.4, n=10, respectively) and from the controls (p < 0.05). HPLC separation of lipids demonstrated that three active species were present in the posttransfusion plasma samples of TRALI patients. All the patients with TRALI had underlying clinical factors, such as infection, cytokine administration, recent surgery, or massive transfusion, while only 2 of 10 control patients had these clinical conditions. None of the donors had significant titers of HLA or HLA-DR antibodies; however, 50 percent had weak positivity for granulocyte antibodies. CONCLUSION: TRALI is the result of two clinical events, the first being a predisposing clinical condition and the second being the transfusion of biologically active lipids in stored blood.     

Treatment of acute lymphoblastic leukemia in adults with intensive induction, consolidation, and maintenance chemotherapy

The Southwest Oncology Group conducted a study of acute lymphoblastic leukemia (ALL) in adults over a 5-year period, testing the utility of the L-10M regimen initially described by the group from Memorial Sloan- Kettering Cancer Center. One hundred sixty-eight eligible patients were treated with this intensive combination chemotherapy regimen. One hundred fifteen (68%) achieved complete remission. With the current median follow-up time of 34.5 months, the median durations of remission, relapse-free survival, and overall survival were 22.9, 20.9, and 17.7 months, respectively. Only 35% of the patients over 50 years of age achieved a complete remission. Age was a significant prognostic factor for complete response, survival, relapse-free survival, and remission duration. In addition, a low initial WBC count was found to have a statistically significant association with longer remission duration. Responders between the ages of 20 and 49 years with WBC counts of less than 15,000 appear to have an exceptionally good prognosis.     

藏药独一味根化学成分的研究

继前报从藏药独一味(Lamiophlomisrotatakudo)根的正丁醇提取物中分离得到两个甙类成分。经化学和光谱分析,两个化合物的结构分别鉴定为3-羟基-4-甲氧基苯乙基-O-[α-L-吡喃鼠李糖(1→3)]-O-[β-D-呋喃芹菜糖(1→6)]-4-O-阿魏酰基-β-D-吡喃葡萄糖甙(1)和3-甲氧基-4-羟基苯乙基-O-[α-L-吡喃鼠李糖(1→3)]-O-[β-D-呋喃芹菜糖(1→6)]-4-O-阿魏酰基-β-D-吡喃葡萄糖甙(2),后者为一新化合物,命名为独一味甙A(lamiophlomiosideA)。     

Pancreatic necrosis: CT manifestations

Pancreatic necrosis is a potential sequela of acute pancreatitis, which pathologically represents a collection of devitalized tissue. Appropriate therapeutic planning requires definition of this irreversibly damaged gland, the presence of which is not consistently diagnosed on the basis of clinical and laboratory data. Over an 18-month period, 22 patients with pancreatic necrosis were studied by one or more computed tomographic (CT) examinations. Retrospective analysis showed the findings to vary with the developmental stage of the necrotizing process. During the acute phase, there was considerable morphologic overlap of necrosis and pancreatic phlegmon. Typical findings were seen in the subacute and chronic stages and included diffuse enlargement of the gland with largely decreased central density. A thick, smooth surrounding rim produced a characteristic saclike configuration. CT-guided aspiration for culture material was performed in four patients with suspected superinfection. Negative gram stain and culture results in two patients allowed surgery to be performed on a more elective basis.     

Diffusion and Perfusion MRI in Acute Cerebral Ischemia

Ｃｅｒｅｂｒａｌｉｓｃｈｅｍｉａｉｓａｌｅａｄｉｎｇｃａｕｓｅｏｆｄｅａｔｈａｎｄｌｏｎｇ ｔｅｒｍｄｉｓａｂｉｌｉｔｙ .Ｔｈｅｄｉｒｅｃｔａｎｄｉｎｄｉｒｅｃｔｃｏｓｔｓｔｏｓｏｃｉｅｔｙａｒｅｅｘｐｅｃｔｅｄｔｏｒｉｓｅｉｎａｎａｇｅｉｎｇｐｏｐｕｌａｔｉｏｎ .Ｈｏｗｅｖｅｒ ,ｒｅｃｅｎｔａｄｖａｎｃｅｓｉｎｓｔｒｏｋｅｃａｒｅ ,ｓｕｃｈａｓｄｅｓｉｇｎａｔｅｄｓｔｒｏｋｅｔｅａｍｓａｎｄｔｈｒｏｍｂｏｌｙｓｉｓ ,ｈａｖｅｓｈｏｗｎｓｉｇｎｉｆｉｃａｎｔｉｍｐｒｏｖｅｍｅｎｔｓｉｎｔｈｅｃｌ…     

Risk factors of recurrent choledocholithiasis following therapeutic endoscopic retrograde cholangiopancreatography

Background: The risk factors for the recurrent choledocholithiasis after endoscopic retrograde cholangiopancreatography(ERCP) have not been well studied. The aim of this study was to explore the risk factors of recurrent choledocholithiasis. Methods: We carried out a retrospective analysis of data collected between January 1, 2010 and January 1, 2020. Univariate analysis and multivariate analysis were used to explore the independent risk factors of recurrent choledocholithiasis following therape...