Evaluation of the resulting quality level index for interregional passenger automobile transport

In order to improve transport services for the population, it is necessary to study and analyze the information on the quality of transport services on the basis of gained experience and wishes of the passengers. This paper, basing on the normative and technical documentation and expert assessments, provides the rationale for the selection of quality indicators for interregional passenger automobile transport. Quality evaluation indexes are supposed to be simple for calculation and use; quality indexes are supposed to be formed in the way to judge the participation of carriers in the improvement of the quality of the transport process, i. e. to separate the qualities, which depend and do not depend on their activities. Indexes, developed on the basis of the standards' requirements are used in this paper. Such approach in the management of interregional passenger transport can contribute to the quality improvement of interregional automobile transport services provided to the population. The results of statistical data processing of passengers' questionnaires are also given here. The transport quality indexes were quantified through the passengers' answers ranking, the evaluation of the interregional passenger automobile transport quality was carried out on the example of the Ulyanovsk State Technical University. © Published under licence by IOP Publishing Ltd

Characteristics of erythropoietin antibodies in patients treated with recombinant human erythropoietin

Our aim was to characterize anti-EPO antibodies in serum samples of the patients treated with erythropoietin. 106 serum samples from the patients treated with erythropoietin (EPO) were collected and assayed. 134 serum samples of patients who did not receive EPO were taken for comparative analysis. The anti-EPO antibody detection was performed in ELISA test with rhEPO, by passive capture on ELISA plates, using steptavidin-biotin immunochemical system. Mouse monoclonal antibodies to human IgG, IgG1, IgG2, IgG3 and IgG4 conjugated to horseradish peroxidase were used to detect anti-EPO antibodies, and protein-A peroxidase conjugate was used for quantitative assays. Rabbit anti-human EPO polyclonal antibodies at known concentrations were used as a calibration standard. Six calibration samples at the concentration range of 16-1000 ng/ml were used to plot calibration curves. The lower detection limit was 12 ng/mL, and the quantitative detection limit was 31 ng/ml. Immunochemical capturing led to increasing of total IgG antibody detection by 3.2 times, IgG1 – by 1.1 times IgG2 – by 1.25 times, IgG3 – by 1.5 times, IgG4 – by 1.7 times. Antibodies of mixed isotype were found in most patients. IgG1 or IgG4 antibodies to EPO were determined only in 3 samples. Specific IgM was not detectable among 106 sera samples, whereas total IgG antibodies were detected in 36.8 % of cases. In 34% of sera, their presence was confirmed by detection of at least one of the subclasses. IgG1 antibody was detected in 83.3%; IgG4, in 80.6% of the samples positive for total IgG antibodies. In all cases, IgG2 and/or IgG3 were detected in presence of IgG1 or IgG4 antibodies. The antibody concentration was 3.2 to 35.5 µg/mL in sera from 28 patients, in 8 cases the level of antibodies was > 50 µg/ml, however, being below the limit of quantitative detection in 3 patients. Only 6 samples contained antibodies with avidity index of > 50%. Immunochemical capturing of the antigen led to increased sensitivity for detecting all subclasses of specific antibodies. The specific IgG antibodies to EPO were found in more than 1/3 of serum samples from the patients treated with erythropoietin. Low-avidity antibodies of IgG1 and IgG4 subclasses were determined in most cases

Трансплантация почки с применением комплемент-блокирующей терапии у пациентки, страдающей атипичным гемолитико-уремическим синдромом, ассоциированным с антителами к фактору H: успешное предотвращение рецидива основного заболевания

Atypical hemolytic-uremic syndrome (aHUS) is an extremely rare complement-mediated disease that belongs to the group of thrombotic microangiopathies (TMA). It often reoccurs after kidney transplantation (KT). Previously, KT was considered contraindicated in both children and adults with aHUS due to high (up to 50% and above) incidence of early graft loss associated with post-transplant recurrent TMA. Introduction of specific complement inhibitor therapy into clinical practice has improved outcomes in patients with aHUS and has significantly reduced the risk of post-transplant recurrence of underlying disease. We describe the clinical observation of a 20-year-old female patient with aHUS associated with antibodies to factor H, a major regulator of complement activation. The patient underwent KT and eculizumab was used for prophylactic purposes. In the postoperative period, the patient developed ureteral necrosis that required reconstructive surgery, followed by graft pyelonephritis. Despite postoperative complications, which were highly likely to trigger uncontrolled complement activation, TMA recurrence was avoided due to early treatment of the complications and prophylactic use of complement inhibitor therapy.Атипичный гемолитико-уремический синдром (аГУС) – орфанное комплемент-опосредованное заболевание, относящееся к группе тромботических микроангиопатий (ТМА), нередко рецидивирующее после трансплантации почки (ТП). Ранее ТП считалась противопоказанной и у детей, и у взрослых пациентов с аГУС из-за высокой (до 50% и выше) частоты ранних потерь трансплантатов, связанных с рецидивами ТМА после трансплантации. Введение в клиническую практику специфической комплемент-блокирующей терапии улучшило исходы у пациентов с аГУС и позволило существенно снизить риск посттрансплантационных рецидивов основного заболевания. В статье приводится описание клинического наблюдения 20-летней пациентки с аГУС, ассоциированным с антителами к основному регулятору активности комплемента – фактору H, которой была выполнена ТП с профилактическим использованием экулизумаба. В послеоперационном периоде у больной развился некроз мочеточника трансплантированной почки, потребовавший выполнения реконструктивной операции, а затем пиелонефрит трансплантата. Несмотря на послеоперационные осложнения, которые с высокой вероятностью были способны вызвать неконтролируемую активацию комплемента, рецидива ТМА удалось избежать благодаря своевременному их лечению и профилактическому применению комплемент-блокирующей терапии