脂膜微泡结合凝血酶原复合物的制备

目的:制备结合凝血酶原复合物(PCC)的阴离子脂膜微泡,评价微泡的理化性质。材料和方法:采用机械振荡直接连接法,分两组(于机械振荡之前或之后加入),制备结合PCC的阴离子脂膜微泡,观察并检测洗涤前后微泡的理化性质。结果:微泡与PCC的结合率及Ⅸ因子活性:两组间比较无明显差异(P>0.05),但洗涤后结合率由洗涤前的95%降为80%,活性由90%降为19%。结论:直接连接法可制备结合PCC的阴离子脂膜微泡,微泡与PCC结合率较高,且洗涤前能保持Ⅸ因子较高的活性。     

Safety of virus inactivated antithrombin III concentrate ANTITHROMBIN III IMMUNO (AT III)

In a prospective clinical trial the risk of infection after application of virus inactivated antithrombin III concentrate ANTITHROMBIN III IMMUNO (AT III) was investigated in patients undergoing cardiovascular surgery. The study was conducted according to the recommendations of the International Committee on Thrombosis and Hemostasis (ICTH), with the exception that most patients required additional blood products as well as AT III.

Twenty-seven patients were eligible to test for the risk of acquiring hepatitis B. Twenty-six patients could be evaluated in terms of hepatitis NANB transmission considering ALT-levels whereas 20 patients could be tested for anti-HCV one year after surgery. Samples from 78 patients could be monitored for anti-HIV-1. None of these patients showed any signs of infection. AT III IMMUNO seems to be an antithrombin III concentrate with low or absent infectivity.     

A European consensus statement on the use of four-factor prothrombin complex concentrate for cardiac and non-cardiac surgical patients

Modern four-factor prothrombin complex concentrate was designed originally for rapid targeted replacement of the coagulation factors II, VII, IX and X. Dosing strategies for the approved indication of vitamin K antagonist-related bleeding vary greatly. They include INR and bodyweight-related protocols as well as fixed dose regimens. Particularly in the massively bleeding trauma and cardiac surgery patient, four-factor prothrombin complex concentrate is used increasingly for haemostatic resuscitation. Members of the Transfusion and Haemostasis Subcommittee of the European Association of Cardiothoracic Anaesthesiology performed a systematic literature review on four-factor prothrombin complex concentrate. The available evidence has been summarised for dosing, efficacy, drug safety and monitoring strategies in different scenarios. Whereas there is evidence for the efficacy of four-factor prothrombin concentrate for a variety of bleeding scenarios, convincing safety data are clearly missing. In the massively bleeding patient with coagulopathy, our group recommends the administration of an initial bolus of 25 IU.kg^-1. This applies for: the acute reversal of vitamin K antagonist therapy; haemostatic resuscitation, particularly in trauma; and the reversal of direct oral anticoagulants when no specific antidote is available. In patients with a high risk for thromboembolic complications, e.g. cardiac surgery, the administration of an initial half-dose bolus (12.5 IU.kg^-1) should be considered. A second bolus may be indicated if coagulopathy and microvascular bleeding persists and other reasons for bleeding are largely ruled out. Tissue-factor-activated, factor VII-dependent and heparin insensitive point-of-care tests may be used for peri-operative monitoring and guiding of prothrombin complex concentrate therapy.     

丘陵地区氯硝柳胺悬浮剂灭螺费用及效果分析

[目的]了解25%氯硝柳胺悬浮剂(SCN)在丘陵山区果园内灭螺效果,并进行成本-效果评价。[方法]选择宜兴市山丘地区2处有螺果园为试验现场,采用灭螺机喷洒的方法,实验组用SCN按2.0g/m2、对照组用50%氯硝柳胺乙醇胺盐可湿性粉剂(WPN)按4.0g/m2喷洒灭螺,比较两组有螺面积下降率和活螺密度下降率;以有螺面积下降率和活螺密度下降率作为评价指标进行成本-效果分析。[结果]实验组用SCN喷洒4次,灭螺后30d有螺面积下降率和活螺密度下降率均为100.0%,有螺面积和活螺密度每下降1个百分点的费用均为56.00元,分别优于对照组WPN的99.00%、92.25%和92.93元、99.73元。[结论]用SCN山区灭螺,操作方便,成本低,灭螺效果好,具有良好应用前景。     

Exploring Body Art Trends

‘Best of the Literature’ presents summaries of sports medicine-related articles culled from more than 30 medical journals. Experts comment on what the new findings add to current medical thinking and on the implications for practice.     

Three‐Stream,Bicarbonate‐Based Hemodialysis Solution Delivery System Revisited: With an Emphasis on Some Aspects of Acid‐Base Principles

Hemodialysis patients can acquire buffer base (i.e., bicarbonate and buffer base equivalents of certain organic anions) from the acid and base concentrates of a three‐stream, dual‐concentrate, bicarbonate‐based, dialysis solution delivery machine. The differences between dialysis fluid concentrate systems containing acetic acid versus sodium diacetate in the amount of potential buffering power were reviewed. Any organic anion such as acetate, citrate, or lactate (unless when combined with hydrogen) delivered to the body has the potential of being converted to bicarbonate. The prescribing physician aware of the role that organic anions in the concentrates can play in providing buffering power to the final dialysis fluid, will have a better knowledge of the amount of bicarbonate and bicarbonate precursors delivered to the patient.