The detection of platelet alloantibodies by flow cytometry

A flow cytometric procedure was investigated for its ability to detect antibodies directed against blood group A, HLA, and PlA1 (HPA-1a) antigens. When type O sera were tested against platelets from blood group A donors, only 9 of 14 positive reactions were observed. Furthermore, the expression of blood group A varied more than 100-fold on platelets derived from individual donors. When anti-HLA-A2 and -B7 were evaluated, 11 of 11 individuals with HLA-A2 and -B7 antigens reacted. In contrast, when platelets from donors whose HLA antigens included HLA-B8 or -B12 were tested with anti-HLA-B8 or -HLA-B12, respectively, positive reactions were observed in only 3 of 7 instances, despite the fact that the lymphocytes reacted strongly. Platelets from 10 HLA-A2-positive donors, which had been stored for up to 20 months at -70 degrees C, were studied. In all cases, frozen-stored platelets reacted well with an anti-HLA-A2. Limited testing with an anti-PlA1 (anti-HPA-1a) showed equal reactivity with fresh and frozen platelets. Finally, the method was compared to a visual immunofluorescence assay using sera from patients who were refractory to platelet transfusions. The results agreed in 30 of 37 comparisons, and most discrepancies were resolved in favor of flow cytometry. It is concluded that flow cytometry is useful for detecting platelet alloantibodies and possibly for prospective platelet crossmatching, as HLA- and platelet-specific antibodies can be identified by using platelets stored frozen for several months.     

Generating Evidence for Program Planning: Rapid Assessment of Avoidable Blindness in Bangladesh

Purpose: There is a lack of data on the prevalence and causes of blindness in Bangladesh, which is important to plan effective eye health programs and advocate support services to achieve the goals of Vision 2020.

Methods: We conducted a rapid assessment of avoidable blindness (RAAB) in 8 districts of Bangladesh (January 2010 – December 2012) to establish the prevalence and causes of blindness. People aged ≥50 years were selected, and eligible participants had visual acuity (VA) measured. Ocular examinations were performed in those with VA<6/18. Additional information was collected for those who had or had not undergone cataract surgery to understand service barriers and quality of service.

Results: In total, 21,596 people were examined, of which 471 (2.2%, 95% confidence interval, CI, 2.0–2.4%) were blind. The primary cause of blindness was cataract (75.8%). The majority of blindness (86.2%) was avoidable. Cataract and refractive error were the primary causes of severe visual impairment (73.6%) and moderate visual impairment (63.6%), respectively. Cataract surgical coverage for blind persons was 69.3% (males 76.6%, females 64.3%, P<0.001). The magnitude of blindness among people aged ≥50 years was estimated to be 563,200 people (95% CI 512,000–614,400), of whom 426,342 had un-operated cataract.

Conclusions: In Bangladesh, the majority of blindness (86.2%) among people aged ≥50 years was avoidable, and cataract was the most important cause of avoidable blindness. Improving cataract surgical services and refraction services would be the most important step towards the elimination of avoidable blindness in Bangladesh.     

ABC and VED Analysis in Medical Stores Inventory Control

Background

The basic principle of inventory control is ABC based on cost criteria and VED on criticality.

Methods

Based on ABC-VED matrix, economic analysis of drug expenditure of priced vocabulary of medical stores (PVMS) section 01 for the year 2003 of a 190 bedded service hospital was under taken.

Result

Out of 493 drugs in PVMS section 01, only 325 drugs were being used in the reference hospital. The total cost of drugs used was Rupees 55,23,503. Of these 325 drugs, 47(14.4%) drugs were Category A, consuming 70% of total expenditure, 73 (22.46 %) drugs Category B consuming 20% and rest 205 drugs (63.7 %) Category C drugs cost only 10% of expenditure. VED categorization done by consensus opinion of medical officers, found 24 (7.3%) drugs vital, 160 (49.3%) essential and rest 141 (43.3 %) desirable.

Conclusion

On coupling the two techniques ABC-VED matrix was made and drugs were classified in to Category I (AV+BV+CV+AE+AD) comprising 68 drugs, Category II (BE + CE +BD) 159 and Category III (CD) 98 drugs. The management of Category I drugs was monitored by top management resulting in better control on the annual expenses and at the same time making available the vital Category II by middle and Category III at lower mangerial level.Key Words: Inventory control, Medical stores     

A SHORT HISTORY OF OCCUPATIONAL DISEASE: 2. ASBESTOS,CHEMICALS, RADIUM AND BEYOND

Historically, the weighing out and manipulation of dangerous chemicals frequently occurred without adequate protection from inhalation or accidental ingestion. The use of gloves, eye protection using goggles, masks or visors was scant. From Canary Girls and chimney sweeps to miners, stone cutters and silo fillers, these are classic exemplars of the subtle (and in some cases not so subtle) effects that substances, environments and practices can have on individual health.     

中国病毒性乙型肝炎的研究

我国是病毒性乙型肝炎(HB)高发病国家,人群感染HBV约有6.5亿,而HBsAg慢性携带者则为1.2亿,每年死于HB及相关性疾病者在16万人以上,HB已成为我国危害最大的社会公共卫生问题。现就目前我国HB研究的状况,提出一些思考,希望能对HB的研究有所助益。 1 病毒性乙型肝炎的分类我国现行的病毒性肝炎分类方案(以下称分类方案)与国际上基本一致,将其分为急性、慢性和肝炎肝硬变三大类,又根据HB不同的临床体征及组织病理学表现,而分成若干亚型。     

近红外光谱技术在元胡止痛散定量分析中的初步应用研究

目的为元胡止痛散建立一种快速有效的定量分析方法,并为将近红外光谱分析技术应用于中药的定量分析提供指导。方法按处方配制25个模拟样本,随机挑选18个组成训练集,另外7个组成预示集,采集各样本的近红外光谱数据,用BP神经网络和PIS法对数据进行处理,并实际分析了三批样品。结果模拟样本中,对于元胡,采用BP网络和PLS法,平均相对预示误差分别为1．5％,2．5％,对于白芷,平均相对预示误差分另为2．9％,4．4％,对于实际样本,各组分标示量的百分含量都在95％～105％之间。结论近红外光谱结合BP神经网络或PLS应用于元胡止痛散的定量分析是可行和有效的。     

Increased catabolism and decreased unsaturation of ganglioside in patients with inflammatory bowel disease

AIM: To investigate whether accelerated catabolism of ganglioside and decreased ganglioside content contribute to the etiology of pro-inflammatory intestinal disease. METHODS: Intestinal mucosa from terminal ileum or colon was obtained from patients with ulcerative colitis or inflammatory Crohn's disease(n = 11) undergoing bowel resection and compared to control samples of normal intestine from patients with benign colon polyps(n = 6) and colorectal cancer(n = 12) in this observational case-control study. Gangliosides and phospholipids of intestinal mucosa were characterized by class and ceramide or fatty acid composition using liquid chromatography triple-quad mass spectrometry. Content and composition of ganglioside classes GM1, GM3, GD3, GD1 a, GT1 and GT3 were compared among subject groups. Content and composition of phospholipid classes phosphatidylcholine(PC) and phosphatidylethanolamine were compared among subject groups. Unsaturation index of individual ganglioside and phospholipid classes was computed and compared among subject groups. Ganglioside catabolism enzymes beta-hexosaminidase A(HEXA) and sialidase-3(NEU3) were measured in intestinal mucosa using western blot and compared among subject groups. RESULTS: Relative GM3 ganglioside content was 2-fold higher(P 0.05) in intestine from patients with inflammatory bowel disease(IBD) compared to control intestine. The quantity of GM3 and ratio of GM3/GD3 was also higher in IBD intestine than control tissue(P 0.05). Control intestine exhibited 3-fold higher(P 0.01) relative GD1 a ganglioside content than IBD intestine. GD3 and GD1 a species of ganglioside containing three unsaturated bonds were present in control intestine, but were not detected in IBD intestine. The relative content of PC containing more than two unsaturated bonds was 30% lower in IBD intestine than control intestine(P 0.05). The relative content of HEXA in IBD intestine was increased 1.7-fold(P 0.05) and NEU3 was increased 8.3-fold(P 0.01) compared to normal intestine. Intestinal mucosa in IBD is characterized by increased GM3 content, decreased GD1 a, and a reduction in polyunsaturated fatty acid constituents in GD3, GD1 a and PC.CONCLUSION: This study suggests a new paradigm by proposing that IBD occurs as a consequence of increased metabolism of specific gangliosides.     

腹主动脉瘤术后血小板变化的临床意义

目的探讨腹主动脉瘤腔内修复术后血小板变化的特点及其临床意义.方法121例腹主动脉瘤切除术中81例行主髂动脉单臂腔内修复术(endovascular