Development and Application of Permanent Magnet Motor and Its Control in the Field of Artificial Blood Pump / 中国医疗器械杂志

Permanent magnet motor has been widely used in the field of artificial heart pump due to its high power density, high stability and easy control. In this paper, the development history and research progress of permanent magnet motor for blood pump were described. Firstly, the motors were classified according to their structures and application scenarios. And then, the measures taken by different types of motors to meet the corresponding performance requirements were introduced, and the specific application cases were given. After that, commonly used control algorithms of these motors were enumerated. What's more, the advantages and disadvantages of the control algorithms and their application emphasis were carefully explained. Finally, the paper was summarized in short.

Red blood cell concentrate transfusion strategies utilised at a tertiary-level paediatric intensive care unit: A descriptive study on impact and cost

Background. Optimal haemoglobin threshold for red blood cell (RBC) transfusions in critically ill anaemic children in a paediatric intensive care unit (PICU) is uncertain.Objective. To describe outcomes and costs associated with different RBC transfusion strategies in anaemic patients admitted to a tertiary PICU in Durban, South Africa.Methods. Transfusion data gathered over a 1-year period were analysed retrospectively. RBC transfusion strategies were classified as restrictive, 'modified liberal' or mixed. The 'modified liberal' group was subdivided into haemodynamically stable or unstable clusters.Transfusion-related effects, comorbidities and mortality were described. Costs associated with RBC transfusions in the various strategy groups were analysed.Results. Over the 118 transfusion records analysed, a restrictive strategy was adopted in 27 cases (22.9%) and a modified liberal strategy was used in 68 cases (57.6%). A mixed strategy was followed in 23 (19.5%) cases. Although mortality was higher in the modified liberal group than in the restrictive group (27.9% v. 11.1%), the difference was not statistically different (p=0.09). There were no differences in the duration of intermittent positive pressure ventilation, length of PICU stay or post-transfusion effects between the restrictive and modified liberal transfusion strategies. A saving of R155 280.15 could have been realised if a restrictive transfusion strategy had been used for haemodynamically stable patients assigned to the modified liberal group. A further R28 988.67 was spent on avoidable after-hours transfusions levies.Conclusion. Adopting a restrictive daytime strategy for RBC transfusions at a PICU could introduceconsiderable cost savings without affecting outcomes

Venous Blood Derivatives as FBS-Substitutes for Mesenchymal Stem Cells: A Systematic Scoping Review

Abstract Although the biological properties of mesenchymal stem cells (MSC) are well-characterized in vitro, MSC clinical application is still far away to be achieved, mainly due to the need of xenogeneic substances for cell expansion, such as fetal bovine serum (FBS). FBS presents risks regarding pathogens transmissions and internalization of animal's proteins, which can unleash antigenic responses in patients after MSC implantation. A wide range of venous blood derivatives (VBD) has been reported as FBS substitutes showing promising results. Thus, the aim of this study was to conduct a systematic scoping review to analyze whether VBD are effective FBS substitutes for MSC ex vivo expansion. The search was performed in SciVerse ScopusTM, PubMed, Web of ScienceTM, BIREME, Cochrane library up to January 2016. The keywords were selected using MeSH and entry terms. Two independent reviewers scrutinized the records obtained considering specific inclusion criteria. The included studies were evaluated in accordance with a modified Arksey and O' Malley's framework. From 184 found studies, 90 were included. Bone marrow mesenchymal stem cells (BMMSC) were presented in most of these studies. Overall, VBD allowed for either, maintenance of MCS's fibroblast-like morphology, high proliferation, high colony-formation ability and maintenance of multipotency. Besides. MSC expanded in VBD supplements presented higher mitogen activity than FBS. VBD seems to be excellent xeno-free serum for ex vivo expansion of mesenchymal stem cells. However, an accentuated heterogeneity was observed between the carried out protocols for VBD isolation did not allowing for direct comparisons between the included studies.

Resumo Embora as propriedades biológicas das células-tronco mesenquimais (MSC) sejam bem caracterizadas in vitro, a aplicação clínica das MSC ainda está longe de ser alcançada, principalmente devido à necessidade de substâncias xenogênicas para expansão celular, como o soro fetal bovino (FBS). O FBS apresenta riscos quanto às transmissões de patógenos e à internalização de proteínas animais, o que pode desencadear respostas antigênicas em pacientes após a implantação das MSC. Uma vasta gama de derivados do sangue venoso (VBD) têm sido relatada como substitutos do FBS mostrando resultados promissores. Assim, o objetivo deste estudo foi conduzir uma revisão de escopo sistemática para analisar se VBD poderiam ser substitutos do FBS eficazes para expansão das MSC em condições ex vivo. A pesquisa foi realizada no SciVerse Scopus, PubMed, Web of Science, BIREME e biblioteca Cochrane até janeiro de 2016. As palavras-chave foram selecionadas usando MeSH e entre termos. Dois revisores independentes examinaram os registros obtidos considerando critérios de inclusão específicos. Os estudos incluídos foram avaliados de acordo com uma estrutura modificada de Arksey e O 'Malley. Dos 184 estudos encontrados, 90 foram incluídos. As células-tronco da medula óssea (BMMSC) foram utilizadas na maior parte destes estudos. Em geral, o VBD permitiu tanto a manutenção da morfologia semelhante a fibroblastos das MCS, alta proliferação, alta capacidade de formação de colônias e manutenção de multipotêncialidade. Além disso, as MSC expandidas em suplementos derivados do sangue venoso apresentaram uma maior atividade mitogênica do que as expandidas em FBS. Os VBD parecem ser excelentes soro livres de agentes xenogênicos para expansão ex vivo de MSC. Entretanto, observou-se uma heterogeneidade acentuada entre os protocolos realizados para o isolamento VBD, não permitindo assim comparações diretas entre os estudos incluídos.

Nueva metodología geométrica para evaluar la morfología del eritrocito normal / New physical and mathematical methodology to evaluate the morphology of normal erythrocyte

Resumen Objetivo. Desarrollar una nueva metodología para caracterizar la estructura del eritrocito normal mediante el espacio ocupado por el anillo del eritrocito normal caracterizado con el método de Box Counting. Método. Se analizaron las imágenes de 20 extendidos de sangre periférica, cuyos eritrocitos fueron evaluados por un experto como normales. Se superpusieron dos rejillas Kp de 5 x 5 pixeles y Kg de 10 x 10 pixeles, para calcular el espacio ocupado por dos regiones del eritrocito estos son, el disco y centro de este, visto de manera frontal mediante el método de Box Counting. Resultados. Los espacios ocupados por la región del disco con la rejilla Kp variaron entre 47 y 56, la región del centro del eritrocito, varió entre 9 y 14. La dimensión fractal de estas dos regiones varió entre 0,941 y 1,115 para el disco, entre 0,652 y 1,222 para el centro. Conclusiones. La estructura del eritrocito normal puede ser caracterizada mediante el espacio ocupado por cada una de las regiones del eritrocito a partir de la geometría fractal.

Abstract Objective. Develop a new methodology to characterize the structure of the normal erythrocyte through the space occupied by the ring of the normal erythrocyte characterized by the method of Box Counting. Method. Images of10 peripheral blood smears were analysed, whose erythrocytes were evaluated by an expert as normal. There were superimposed two Kp grids of 5 x 5 pixels and Kg of 10 x 10 pixels, to calculate the space occupied by two regions of the erythrocyte which are, disc and centre of this, seen of way frontal by the method of Box Counting. Results. The spaces occupied by the disc region with grid Kp varied between 47 and 56, the central region of the erythrocyte, varied between 9 and 14. The fractal dimension of these two regions varied between 0,941 and 1,115 for the disc, between 0.652 and 1,222 for the centre. Conclusions. The normal erythrocyte structure can be characterized by the space occupied by the regions erythrocyte from fractal geometry.

comparative analysis of serum albumin from different species to determine a natural source of albumin that might be useful for human therapy

Objectives: Serum albumin [SA] is one of the most abundant proteins in human plasma and performs functions for protein transport, scavenges for free radicals, and regulates osmotic pressure. SA has been used for therapy in humans with several diseases including hypovolemia, hypoalbuminemia, and chronic liver disease. However, the most appropriate source of albumin for medical applications remains unclear, especially in the case of viral infections, which complicates finding viable donors. Substitution of human serum albumin [HSA] with albumin from other natural sources is a viable alternative. Therefore, we elucidated the similarity in character, structure and evolutionary relationship among serum albumin isolated from seven different species

Methods: We compared the sequence, structure, and properties of SA from different species using an in-silico approach

Results: These data suggested that SA has sequence polymorphism that clusters based on closely relatedspecies. However, these polymorphisms do not change the three-dimensional structure of the protein; this may serve to maintain its function as a transporter. The Gallus gallus albumin has the lowest number of the epitopes that closely resemble HSA

Conclusion: This study is crucial in providing explicit information about the structural similarity of albumin isolated from other species compared to HSA. The Gallus gallus SA might be used as a primary natural source of albumin where warranted for human therapy

Hemodynamic Analysis in Patients Who Underwent Lumbar Spine Fusion Surgery without Blood Transfusion / 대한정형외과학회잡지

PURPOSE: Lumbar fusion surgery was performed on transfusion-free patients and hemodynamic changes were analyzed. MATERIALS AND METHODS: A total of 36 transfusion-free patients who had undergone lumbar fusion surgery using recombinant human erythropoietin (rHuEPO) before surgery from April 2007 to March 2014 were included in the study. Hemoglobin and hematocrit levels were measured before surgery, immediately after surgery, 12 hours after surgery, on day 1, day 2, day 3, and day 7. Changes in levels were investigated and the factors affecting the changes in hemoglobin levels were analyzed. RESULTS: Changes in hemoglobin and hematocrit were -18.11% before surgery and -22.92% on day 7, respectively, and they tended to recover from day 2 after surgery. Depending on the patient's age, gender, body mass index, blood loss, and surgery method (presence of lumbar interbody fusion), the changes in hemoglobin level did not show statistically significant differences; however, significant differences were observed in the surgical time and extent of the operation. CONCLUSION: Transfusion alternatives during lumbar spinal fusion are deemed safe methods, leading to good, postoperative hemodynamic outcomes. However, the surgical time and extent of the operation must be determined before surgery.

Production of Transfusable Red Blood Cells from Stem Cells / 대한수혈학회지

Blood transfusion is a well-established cell therapy. However, blood available for transfusion is a limited resource and is available only through donations by healthy volunteers. Moreover, the perpetual and widespread shortage of blood products, problems related to transfusion transmitted infections, and new emerging pathogens have elicited an increase in demand for artificial blood. Therefore, research for alternative RBC substitutes has begun in the 1960s. Hemoglobin-based oxygen carriers (HBOC) and perfluorocarbon-based oxygen carrier (PBOC) were two popular study subjects; however, research on these substitute candidates was halted due to unsatisfactory results and safety issues, including death, in the 1990s. Since then, worldwide efforts to produce RBC have shifted over to stem cell-derived RBC production using cord blood and G-CSF-mobilized peripheral blood stem cells, and some progress has been made. In terms of practical usefulness, however, large-scale production and cost effectiveness are still problematic. Recently, human embryonic stem cells (hESC) and human-induced pluripotent stem cells (hiPSC) have shown the potential to produce RBCs as unlimited cell sources. These two methods using hESCs and hiPSCs are also cost-effective since autologous and O, D negative blood RBCs will be used for alloimmunized patients with multiple alloantibodies or rare blood types (high incidence antigens) as well as universal blood production. We will review the current research on in vitro RBC production from hematopoietic stem cells and pluripotent stem cells and assess future directions in this field.

Glucosa 6 fosfato deshidrogenasa: características bioquímicas y moleculares. Prevalencia de la deficiencia / Glucose-6-phosphate dehydrogenase: biochemical and molecular characteristics. Prevalence of deficiency

La glucosa-6-fosfato deshidrogenasa (G6PD) es una enzima citoplasmática que se encuentra distribuida en todas las células del organismo y que cataliza el primer paso de la vía de las pentosas en el cual la glucosa 6 fosfato (G6P) es convertida a 6-fosfogluconato(6FG) y el NADP reducido a NADPH, proceso indispensable para proteger a los eritrocitos del daño oxidativo. La deficiencia de la enzima G6PD es la eritroenzimopatía más común, es recesiva y ligada al cromosoma X, con amplia distribución mundial y elevada heterogeneidad genética y bioquímica. Se realizó una revisión sobre aspectos bioquímicos, estructura, genética, bases moleculares, defecto enzimático, prevalencia de la deficiencia en el mundo y en Venezuela, y el papel de la deficiencia de G6PD en el tratamiento de la malaria por el incremento en el riesgo de hemolisis que lleva consigo la tendencia de aumentar la dosis total de Primaquina en sujetos paludismo,particularmente en las regiones donde predomina la infección por Plasmodium vivax.

In-Vitro Stem Cell Derived Red Blood Cells for Transfusion: Are We There Yet?

To date, the use of red blood cells (RBCs) produced from stem cells in vitro has not proved practical for routine transfusion. However, the perpetual and widespread shortage of blood products, problems related to transfusion-transmitted infections, and new emerging pathogens elicit an increasing demand for artificial blood. Worldwide efforts to achieve the goal of RBC production through stem cell research have received vast attention; however, problems with large-scale production and cost effectiveness have yet to prove practical usefulness. Some progress has been made, though, as cord blood stem cells and embryonic stem cells have shown an ability to differentiate and proliferate, and induced pluripotent stem cells have been shown to be an unlimited source for RBC production. However, transfusion of stem cell-derived RBCs still presents a number of challenges to overcome. This paper will summarize an up to date account of research and advances in stem cell-derived RBCs, delineate our laboratory protocol in producing RBCs from cord blood, and introduce the technological developments and limitations to current RBC production practices.

Holstein-Friesian RBC as human blood substitute / 中国实验血液学杂志

α-Gal, the main xenotransplantation antigen, can lead to hyperacute rejection (HAR) in xenotransplantation. This study was purposed to investigate the effect of recombinant α-galactosidase (α-Gal antigen) on the Holstein-Friesian(H-F) red blood cells (RBC). The enzymelysis method was used to digest the α-Gal antigen on H-F RBC; the saline and anti-human globulin methods were used to perform the agglutination test of H-F RBC and human plasma; the flow cytometry was used to detect the α-Gal antigen on surface of H-F RBC, fluorescence intensity of FITC-IB4 and FITC-IgG labeled RBC. The results indicated that the saline and anti-human globulin method showed α-galactosidase-treated H-F RBC fail to agglutinate with human pooled plasma; the flow cytometry showed the fluorescence intensity of FITC-IB4 and FITC-IgG labeled RBC decrease 99.0% and 87.8%, respectively. It is concluded that the novel α-galactosidase can be used to cleared the α-Gal antigen on the surface of H-F RBC and α-galactosidase-treated H-F RBC may be considered as human blood substitute.

Effects of freeze-drying process on polymerized human placenta hemoglobin / 生物医学工程学杂志

The present study was aimed to investigate the influence of freeze-drying on the quality of polymerized human placenta hemoglobin (PolyPHb). The PolyPHb solution was freeze-drying under suitable conditions. Hemoglobin concentration, methemoglobin (MetHb) content, UV spectrum, Fe3 content, oxygen-carrying capacity, pH, the average molecular weight and its distribution, circular dichroism, oxygen equilibrium curve and other indicators were measured before and after freeze-drying. The appearance, residual water content, rehydration time of the lyophilized product were also evaluated. The results showed that there was no significant difference on all the indicators measured above, which indicated that freeze-drying process had no effect on the physical and chemical properties of PolyPHb, as well as on its biological activity. Therefore, the properties of PolyPHb were stable during this freeze-drying process and could be preserved after such freeze-drying process.

[Haemovigilance]

Haemovigilance is defined as a set of surveillance procedures from the collection of blood and its components to the follow-up of recipients, denoted to collect and assess information on unexpected or undesirable effects resulting from the therapeutic use of labile blood products, and to prevent their occurrence or recurrence. In this system the complications of blood transfusion are systematically collected and reported and data of adverse effects of blood transfusion are analyzed and a series of corrective measures are performed to prevent the recurrence of them. Another goal of haemovigilance is documentary collections of blood transfusion cases which eventually leads to conducting and promoting blood transfusion in hospitals. Haemovigilance only works if complications of blood transfusion are early detected and reported

Effect of temperature on the partition coefficient of isoflurane and sevoflurane in perflurocarbon emulsion (Oxygent(TM)) / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effect of temperature on the partition coefficient of isoflurane and sevoflurane in perflurocarbonate emulsion (Oxygent(TM)).</p><p><b>METHODS</b>The partition coefficients of isoflurane and sevoflurane in perflurocarbonate emulsion (Oxygent(TM)) were measured at different temperatures (4, 22, 27, 32 and 37 degrees celsius;) using syringe-flask double headspace equilibration technique with gas chromatography, and the relationship between the partition coefficients and the temperature was analyzed.</p><p><b>RESULTS</b>At 4, 22, 27, 32 and 37 degrees celsius;, the partition coefficients of isoflurane in Oxygent(TM) were 85.30∓5.60, 40.48∓1.09, 37.14∓3.64, 27.38∓2.28 and 24.66∓1.03, and those of sevoflurane were 91.54∓5.40, 42.50∓0.91, 37.21∓2.76, 25.43∓1.03 and 28.05∓1.74, respectively. The partition coefficients of sevoflurane at 4, 22 and 37 degrees celsius; were significantly higher than those of isoflurane (P<0.05). The regression equations between the partition coefficient and temperature for isoflurane and sevoflurane were Y=-1.893X+89.20 (R(2)=0.942) and Y=-2.075X+95.58 (R(2)=0.951), respectively. An inverse linear relationship was found between temperature and the partition coefficient.</p><p><b>CONCLUSION</b>Within a specified range of temperatures, the partition coefficients isoflurane and sevoflurane decrease as the temperature increases. Sevoflurane shows a high solubility in Oxygent(TM) as compared to isoflurane.</p>

Cardiocirculatory changes in hemorrhagic shock induced in pigs submitted to three distinct therapeutic methods / Alterações cardiocirculatórias no choque hemorrágico induzido em suínos submetidos a três terapias distintas

PURPOSE: To evaluate and compare the response of pigs submitted to hemorrhagic shock and treated using three different strategies. METHODS: Thirty-five Dalland pigs were divided into four groups: Control; Bleeding; Saline and Saline + Red Cell Concentrate. Parameters evaluated: heart rate (HR), mean arterial blood pressure (MAP) and central vein pressure (CVP).Hemorrhagic shock was induced by removing (624.25±64.55), (619.30±44.94) and (664.23±39.96) ml of blood respectively, with the following treatment: Bleeding Group - zero volume replacement; Saline Group - replacement with 676 ml of 0.9 percent saline solution; Saline + Red Cell Concentrate Group - replacement with 440 ml of 0.9 percent saline solution + 291 ml of red cell concentrate. The treatment was evaluated after 10 (T3), 30 (T4), 45 (T5) and 60 (T6) minutes. RESULTS: HR: No statistically significant difference was found between the Bleeding and Saline [p=1.000], Bleeding and Saline + Red Cell Concentrate [p=1.000], and Saline and Saline + Red Cell Concentrate [p=0.721] groups. MAP; Significant differences were found between all the groups studied. CVP: No significant difference was found between the groups. CONCLUSION: Non-replacement and euvolemic resuscitation maintained a satisfactory hemodynamic pattern in controlled severe hemorrhagic shock in swine. The euvolemic replacement strategies exceeded the limit values of MAP for rebleeding.

OBJETIVO: Avaliar e comparar as respostas cardiocirculatórias em suínos tratados por três terapias diferentes após choque hemorrágico. MÉTODOS: Trinta e cinco suínos Dalland foram divididos em quatro grupos: Controle; Sangria; Salina; Salina + Concentrado de hemácias. Parâmetros cardiocirculatórios avaliados: Frequência cardíaca (FC), pressão arterial média (PAM) e pressão venosa central (PVC). O choque hemorrágico foi induzido retirando (624,25±64,55) (619,30±44,94) e (664,23±39,96) ml do volume sanguíneo. Terapias: Grupo Sangria - Sem reposição volêmica; Grupo Salina - reposição com 676 ml de solução salina 0.9 por cento; Grupo Salina + Concentrado de hemácias - reposição com 440 ml de solução salina 0,9 por cento + 291 ml de concentrado de hemácias. A avaliação do tratamento foi realizada aos 10 (T3), 30 (T4), 45 (T5) e 60 minutos (T6). RESULTADOS: FC; Não houve diferença significativa entre os grupos Sangria e Salina [p=1,000]; Sangria e Salina + Concentrado de hemácias [p=1,000]; Salina e Salina + Concentrado de hemácias [p=0,721]. PAM; Houve diferença entre todos os grupos. PVC; Não houve diferença entre os grupos estudados. CONCLUSÃO: Os procedimentos sem reposição e com reposição euvolêmica mantiveram padrão hemodinâmico satisfatório no choque hemorrágico grave controlado em suínos. As estratégias de reposição euvolêmica ultrapassaram os valores de PAM considerados limites para o resangramento.

Dedifferentiated Liposarcoma of the Retroperitoneum / Journal of the Korean Cancer Association, 대한암학회지

A dedifferentiated liposarcoma of the retroperitoneum is an extremely rare tumor. A 51-year old man was admitted to our department because a retroperitoneal mass was seen on abdominal computed tomography at another hospital. Computed tomography of the abdomen and magnetic resonance imaging showed a large pelvic mass located in the right hemipelvis, and it was pushing the right ureter and invading the right kidney, duodenum, colon and inferior vena cava. The patient underwent right radical nephrectomy, pylorus preserving pancreatoduodenectomy, right hemicolectomy and artificial blood vessel replacement for the inferior vena cava. The histopathological diagnosis was dedifferentiated liposarcoma and the patient was free from recurrence on the computed tomography that was done 6 months after the operation.

Research progress of blood substitutes for the treatment of hemorrhagic shock / 生物医学工程学杂志

Hemorrhagic shock is a medical complication caused by the reduction of circulation blood in body. The routine treatment of hemorrhagic shock is to infuse blood or substitute. However, the duration of blood storage is short,the procedures for matching of blood are necessary, and there is the risk of spreading some hematogenous diseases. All these have limited the use of blood-transfusion in the emergent situations such as disaster and war. Thus, the research of blood substitutes is promoted. Considering the scarcity of domestic research report on the use of blood substitutes for the treatment of hemorrhagic shock, we present an overview in this paper.

Initial observation of oxygen carriers with acute myocardial infarction in rats / 生物医学工程学杂志

The purpose of this study was to test whether oxygen carriers could decrease tissue injury in a rat model of acute myocardial infarct. The study included 3 groups: SD rats in group II and group III were subjected to permanent occlusion of their left anterior descending coronary arteries; SD rats in group I were subjected to sham-operation. The success of modeling was assartained by ECG. Then the rats were given drug via caudal veins for 2 days. A quantitative evaluation was made with an automatic device for interpretation of cardiac troponin T (cTnT); heart staining was made for the calculation of myocardial infarction size (MIS); and myocardial tissue was taken and subjected to routine pathological hematoxylin-eosin (HE) staining for showing myocardial cell injury. cTnT in the sham-operation group was significantly lower by comparison with that in the model group (P < 0.01), and it was slightly lower in the oxygen carriers group than that in the model group, but there was no statistically significant difference (P = 0.18); MIS was significantly smaller in the sham-operation group than that in the model group (P < 0.01), and it was greater in the model rats than that in the oxygen carriers rats (P < 0.05). HE staining of myocardicum in the oxygen carriers group was significantly better than that in the model group (P < 0.01). The evidence suggested that oxygen carriers increased oxygen supply to ischemic myocardium, reduced the myocardial injury, and thus might offer a novel treatment of myocardial infarction.