简介：AbstractObjective:Platelet-rich plasma (PRP) releases growth factors upon activation, which in turn accelerates healing and regeneration of the target tissue. However, PRP composition may vary according to the patient’s demographics, and wider applications of PRP warrant product standardization. The current study aimed to examine variables influencing the platelet-derived growth factor BB (PDGF-BB) concentration in PRP.Methods:This observational study was conducted in the Department of Pathology and Dentistry at Swami Rama Himalayan University, a tertiary care hospital in northern India from December 2016 to November 2017. PRP was prepared from 40 mL of whole blood from 35 individuals (22 women, 13 men). Platelet counts, platelet indices (platelet distribution width, mean platelet volume) and PDGF-BB levels were measured, and platelet yield, platelet dose, and growth factor dose in PRP were also calculated. All parameters were analyzed using Pearson’s correlation coefficient. The association between PDGF-BB and PRP platelet count was evaluated using logistic regression. This study was approved by the Ethics Committee of Swami Rama Himalayan University (SRHU/HIMS/ETHICS/2016/103) on September 7, 2016.Results:The mean platelet count, PDGF-BB concentration, platelet yield, platelet dose, and growth factor dose in PRP were 1317×109/L, 30±9.89ng/mL, 71.62±28.34%, 6.5±3.5×109, and 159.62±52.39ng/mL, respectively. Linear regression analysis indicated that PRP platelet counts were a good predictor for PGDF-BB (P<0.05; adjusted R2=0.96. PRP platelet count was significantly positively correlated with PDGF-BB concentration (r=0.74, P<0.001), platelet yield (r=0.80, P<0.001), platelet dose (r=1, P<0.001), and growth factor dose (r=0.74, P<0.001).Conclusions:PRP has wide clinical applications associated with its healing and regenerative properties, and both the quality and quantity of PRP thus need to be standardized as per the requirements. Evaluating variables affecting PRP will thus aid pathologists and clinical practitioners.

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简介：AbstractThe aim of this study was to evaluate the performance of an assay using dried plasma spot (DPS) and dried blood spot (DBS) samples for the serological detection of anti-hepatitis C virus (HCV) antibodies. Between January and July 2019, plasma, DPS and DBS specimens were collected from individuals at high-risk for HCV infection. Samples were tested for anti-HCV by ELISA, and the performance of DPS and DBS specimens was examined using results from the plasma testing, as the standard. Blood samples were collected from 329 persons, including 129 men who have sex with men and 200 intravenous drug users. Results from the plasma testing indicated that 118 samples (59.0%) were HCV positive. Data from the DPS sample testing showed sensitivity as 99.2% (95% confidence interval [CI]: 0.95-1.00) and specificity as 100% (95% CI: 0.98-1.00) for HCV detection, with Kappa of 99.3% (95% CI: 0.98-1.00) while in DBS sample testing the sensitivity as 98.3% (95% CI: 0.93-1.00) and specificity as 100% (95% CI: 0.98-1.00), with Kappa of 98.7% (95% CI: 0.97-1.00), respectively. Spearman’s correlation coefficients for the comparisons between plasma and DPS specimen, plasma and DBS specimens, DPS and DBS specimens were 0.857, 0.750, and 0.739, respectively. Compared with the results in plasma, 1 sample was not detected using the DPS specimens, and 2 samples were failed for the positive detection, using the DBS specimens. Both DPS and DBS samples were promising alternatives to plasma, for the detection of anti-HCV antibodies.

简介：AbstractImportance:Acute necrotizing encephalopathy (ANE) is a rare disease with high mortality. Plasma exchange (PLEX) has recently been reported to treat ANE of childhood (ANEC), but its efficacy is uncertain.Objective:This study aimed to investigate the effectiveness of PLEX on ANEC.Methods:A retrospective study was conducted in four pediatric intensive care units from December 2014 to December 2020. All patients who were diagnosed with ANEC were included; however, these patients were excluded if their length of stay was less than 24 h. Participants were classified into PLEX and non-PLEX groups.Results:Twenty-nine patients with ANEC were identified, 10 in the PLEX group and 19 in the non-PLEX group. In the PLEX group, C-reactive protein, procalcitonin, alanine aminotransferase, and aspartate aminotransaminase levels were significantly lower after 3 days of treatment than before treatment (13.1 vs. 8.0, P = 0.043; 9.8 vs. 1.5, P = 0.028; 133.4 vs. 31.9, P = 0.028; 282.4 vs. 50.5, P = 0.046, respectively). Nine patients (31.0%, 9/29) died at discharge, and a significantly difference was found between the PLEX group and non-PLEX group [0 vs. 47.4% (9/19), P = 0.011]. The median follow-up period was 27 months, and three patients were lost to follow-up. Thirteen patients (50.0%, 13/26) died at the last follow-up, comprising three (33.3%, 3/9) in the PLEX group and ten (58.8%, 10/17) in the non-PLEX group, but there was no significant difference between the two groups (P = 0.411). Three patients (10.3%, 3/29) fully recovered.Interpretation:PLEX may reduce serum C-reactive protein and procalcitonin levels and improve liver function in the short term. PLEX may improve the prognosis of ANEC, and further studies are needed.

简介：AbstractBackground:Chemotherapy plus granulocyte colony-stimulating factor (GCSF) regimen is one of the available approaches to mobilize peripheral blood progenitor cells (PBPCs). It causes thrombocytopenia and delays leukapheresis. This study aimed to evaluate the role of recombinant human thrombopoietin (rhTPO) before mobilization chemotherapy in facilitating leukapheresis in patients with lymphoma.Methods:In this randomized open-label phase 2 trial, patients were randomly assigned in a 1:2 ratio to receive mobilization with rhTPO plus GCSF in combination with chemotherapy (the rhTPO plus GCSF arm) or GCSF alone in combination with chemotherapy (the GCSF alone arm). The recovery of neutrophils and platelets and the amount of platelet transfusion were monitored.Results:Thirty patients were enrolled in this study between March 2016 and August 2018. Patients in the rhTPO plus GCSF arm (n = 10) had similar platelet nadir after mobilization chemotherapy (P=0.878) and similar amount of platelet transfusion (median 0 vs. 1 unit, P=0.735) when compared with the GCSF alone arm (n = 20). On the day of leukapheresis, the median platelet count was 86 × 109/L (range 18-219) among patients who received rhTPO and 73 × 109/L (range 42-197) among those who received GCSF alone (P=0.982). After the use of rhTPO, the incidence of platelet count <75 × 109/L on the day of leukapheresis did not decrease significantly (30.0% vs. 50.0%, P=0.297). Platelet recovery after PBPC transfusion was more rapid in the rhTPO plus GCSF arm (median 8.0 days [95% confidence interval 2.9-13.1] to platelets ≥50 × 109/L vs. 11.0 days [95% confidence interval 8.6-13.4], P=0.011). The estimated total cost of the mobilization and reconstitution phases per patient was similar between the two treatmtent groups (P=0.362 and P=0.067, respectively).Conclusions:Our findings indicate that there was no significant clinical benefit of rhTPO use in facilitating mobilization of progenitor cells, but it may promote platelet recovery in the reconstitution phase after high-dose therapy.Trial registration:This trial has been registered in Clinicaltrials.gov as NCT03014102.

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简介：AbstractObjective:Pulmonary Mycobacterium tuberculosis infection can trigger cellular and humoral innate immune responses, which may cause death of the pathogen and or host cells/tissue. We aimed to determine the cytotoxic response of phagocytes in patients with pulmonary Mycobacterium tuberculosis infection based on plasma tumor necrosis factor-alpha (TNF-α), malondialdehyde (MDA), and superoxide dismutase (SOD) levels.Methods:In this observational study, patients newly infected with pulmonary Mycobacterium tuberculosis (n=31; age 37-62 years) and age-matched uninfected volunteers (n=50) were recruited as test and control volunteers, respectively in Owo, Nigeria. The study protocol was reviewed and approved by the Research and Ethics Committee of the Department of Medical Laboratory Science, Achievers University, Owo, Nigeria (AUO/MLS/VII/2009/212). Anti-hepatitis C virus, human immunodeficiency virus antigen/antibody, hepatitis B virus surface antigen, and plasma TNF-α were determined by enzyme-linked immunosorbent assay, SOD, and MDA were determined by colorimetry, Plasmodium by Giemsa thick blood film staining, and acid-fast bacilli in sputum were detected by Ziehl-Neelsen staining.Results:All participants had normal blood glucose levels and tested negative for human immunodeficiency virus antigen/antibody, anti-hepatitis C virus, hepatitis B virus surface antigen, and Plasmodium spp., and had no medical history of cancer. Infected patients had significantly higher plasma MDA and TNF-α levels and significantly lower SOD levels compared with control subjects (all P<0.05).Conclusion:Mycobacterium tuberculosis infection elicited a cytotoxic response by phagocytes, evidenced by significant increases in MDA and TNF-α and a significant decrease in SOD levels.