Comparison of the conventional tube and erythrocyte-magnetized technology in titration of red blood cell alloantibodies

BACKGROUND Erythrocyte alloantibodies are mainly produced after immune stimulation,such as blood transfusion,pregnancy,and transplantation,and are the leading causes of severe hemolytic transfusion reactions and difficulty in blood grouping and matching.Therefore,antibody screening is critical to prevent and improve red cell alloantibodies.Routine tube assay is the primary detection method of antibody screening.Recently,erythrocyte-magnetized technology(EMT)has been increasingly used in clinical practice.This study intends to probe the application and efficacy of the conventional tube and EMT in red blood cell alloantibody titration to provide a reference for clinical blood transfusion.AIM To investigate the application value of conventional tube and EMT in red blood cell alloantibody titration and enhance the safety of blood transfusion practice.METHODS A total of 1298 blood samples were harvested from blood donors at the Department of Blood Transfusion of our hospital from March 2021 to December 2022.A 5 mL blood sample was collected in tubing,which was then cut,and the whole blood was put into a test tube for centrifugation to separate the serum.Different red blood cell blood group antibody titers were simultaneously detected using the tube polybrene test,tube antiglobulin test(AGT),and EMT screening irregular antibody methods to determine the best test method.RESULTS Simultaneous detection was performed through the tube polybrene test,tube AGT and EMT screening irregular antibodies.It was discovered that the EMT screening irregular antibody method could detect all immunoglobulin G(IgG)and immunoglobulin M(IgM)irregular antibodies,and the results of manual tube AGT were satisfactory,but the operation time was lengthy,and the equipment had a large footprint.The EMT screening irregular antibody assay was also conducted to determine its activity against type O Rh(D)red blood cells,and the outcomes were satisfactory.Furthermore,compared to the conventional tube method,the EMT screening irregular antibody method was more cost-effective and had significantly higher detection efficiency.CONCLUSION With a higher detection rate,the EMT screening irregular antibody method can detect both IgG and IgM irregular antibodies faster and more effectively than the conventional tube method.

Effect of Point-of-care Hemoglobin/Hematocrit Devices and Autologous Blood Salvage on Reduction of Perioperative Allogeneic Blood Transfusion

Objective To evaluate the effect of point-of-care hemoglobin/hematocrit(POC HGB/HCT) devices and intraoperative blood salvage on the amount of perioperative allogeneic blood transfusion and blood conservation in clinical practice. Methods A total of 46 378 medical records of 22 selected hospitals were reviewed. The volume of allogeneic red blood cell and plasma, number of patients transfused, number of intraoperative autologous blood salvage, total volume of autologous blood transfusion, and amount of surgery in the year of 2011 and 2013 were tracked. Paired t-test was used in intra-group comparison, while t-test of two isolated samples carried out in inter-group comparison. P<0.05 was defined as statistically significant difference. Results In the hospitals where POC HGB/HCT device was used(n=9), the average allogeneic blood transfusion volume per 100 surgical cases in 2013 was significantly lower than that in 2011(39.86±20.20 vs. 30.49±17.50 Units, t=3.522, P=0.008). In the hospitals without POC HGB/HCT meter, the index was not significantly different between 2013 and 2011. The average allogeneic blood transfusion volume was significantly reduced in 2013 than in 2011 in the hospitals where intraoperative autologous blood salvage ratio [autologous transfusion volume/(autologous transfusion volume+allogeneic transfusion volume)] was increased(n=12, t=2.290, P=0.042). No significant difference of the above index was found in the hospitals whose autologous transfusion ratio did not grow. Conclusion Intraoperative usage of POC HGB/HCT devices and increasing autologous transfusion ratio could reduce perioperative allogeneic blood transfusion.

Packed red blood cell transfusions as a risk factor for parenteral nutrition associated liver disease in premature infants

AIM To determine if packed red blood cell transfusions contribute to the development of parenteral nutrition associated liver disease. METHODS A retrospective chart review of 49 premature infants on parenteral nutrition for > 30 d who received packed red blood cell(PRBC) transfusions was performed. Parenteral nutrition associated liver disease was primarily defined by direct bilirubin(db) > 2.0 mg/dL. A high transfusion cohort was defined as receiving > 75 mL packed red blood cells(the median value). KaplanMeier plots estimated the median volume of packedred blood cells received in order to develop parenteral nutrition associated liver disease.RESULTS Parenteral nutritional associated liver disease(PNALD) was noted in 21(43%) infants based on db. Among the 27 high transfusion infants, PNALD was present in 17(64%) based on elevated direct bilirubin which was significantly greater than the low transfusion recipients. About 50% of the infants, who were transfused 101-125 mL packed red blood cells, developed PNALD based on elevation of direct bilirubin. All infants who were transfused more than 200 mL of packed red blood cells developed PNALD. Similar results were seen when using elevation of aspartate transaminase or alanine transaminase to define PNALD.CONCLUSION In this retrospective, pilot study there was a statistically significant correlation between the volume of PRBC transfusions received by premature infants and the development of PNALD.

Red Blood Cell Transfusion in a Neonatal Tertiary Care Center: A Moroccan Study

Background: Red Blood Cell (RBC) transfusion is a common therapy in neonatal practice and data from different international neonatal centers are available, however, there is paucity of Moroccan data regarding blood components usage. We aim to study trends and outcomes of RBC transfusions in our department and emphasize the need for transfusion guidelines. Material and method: This retrospective study was performed in a Moroccan tertiary neonatal intensive care center. The records of all neonates admitted from January 2015 to March 2016 were screened for RBC usage and indications. The data were statistically analyzed by using Microsoft ExcelTM software. Results: A total of 60 neonates received 77 RBC transfusions. Postnatal age at transfusion ranged from 1 to 30 days with an average of 13 days, and 30% of our patients were aged ≥21 days. RBC Transfusion was given once in 48 patients (80%), twice in 8 patients (13.3%) and ≥ thrice in 4 patients (6.7%). More than one type of blood components was needed in 23 (38%) neonates. 70% of patients were critically ill, 60% were born before 37 weeks’ gestation and 57% were small for gestational age. Mean hemoglobin at the time of transfusion of RBC was 8.59 g/dl (2 - 11.6 g/dl). Sepsis and anemia with mechanical ventilation for severe respiratory illness were the commonest indications. All gestational ages were considered, and mortality was noted in 66% of our cases and worsening in 13%;21% of the infants showed improvement. Conclusion: Judicious implementation of guidelines for RBC transfusions would decrease their inappropriate use.

Risk factors for blood transfusion and its prognostic implications in curative gastrectomy for gastric cancer

BACKGROUND Gastric cancer(GC)is still a prevalent neoplasm around the world and its main treatment modality is surgical resection.The need for perioperative blood transfusions is frequent,and there is a long-lasting debate regarding its impact on survival.AIM To evaluate the factors related to the risk of receiving red blood cell(RBC)transfusion and its influence on surgical and survival outcomes of patients with GC.METHODS Patients who underwent curative resection for primary gastric adenocarcinoma at our Institute between 2009 and 2021 were retrospectively evaluated.Clinicopathological and surgical characteristics data were collected.The patients were divided into transfusion and non-transfusion groups for analysis.RESULTS A total of 718 patients were included,and 189(26.3%)patients received perioperative RBC transfusion(23 intraoperatively,133 postoperatively,and 33 in both periods).Patients in the RBC transfusions group were older(P<0.001),and had morecomorbidities(P=0.014),American Society of Anesthesiologists classification III/IV(P<0.001),and lower preoperative hemoglobin(P<0.001)and albumin levels(P<0.001).Larger tumors(P<0.001)and advanced tumor node metastasis stage(P<0.001)were also associated with the RBCtransfusion group.The rates of postoperative complications(POC)and 30-d and 90-d mortalitywere significantly higher in the RBC transfusion group than in the non-transfusion group.Lowerhemoglobin and albumin levels,total gastrectomy,open surgery,and the occurrence of POC werefactors associated with the RBC transfusion.Survival analysis demonstrated that the RBCtransfusions group had worse disease-free survival(DFS)and overall survival(OS)compared withpatients who did not receive transfusion(P<0.001 for both).In multivariate analysis,RBCtransfusion,major POC,pT3/T4 category,pN+,D1 lymphadenectomy,and total gastrectomywere independent risk factors related to worse DFS and OS.CONCLUSIONPerioperative RBC transfusion is associated with worse clinical conditions and more advancedtumors.Further,it is an independent factor related to worse survival in the curative intentgastrectomy setting.

Red blood cell level is increased in obese but not in non-obese patients with coronary heart disease

Objective To examine the changes of red blood cell levels in the obese and non-obese patients with coronary heart disease （CHD） and its clinical significance. Methods 230 cases of coronary heart disease were selected and divided into the obese group and the non- obese group. Obesity and non-obesity were defined based on the body mass index （BMI if 28.0kg/m2）, or waist-hip ratio （men〉 0.9, women〉 0.85）. In addition, 130 healthy subjects were recruited as controls. The pathological status of coronary lesions was quantita- tively analyzed according to the Coronary Vascular Image Segmentation Evaluation Criteria （American Heart Association 1984） and the Gensini scoring system. Results of the changes of both the hemoglobin levels and the red blood cell count in the obese group, the non- obese group with CHD and the control group were compared. Besides, Multivariant Logistic Regression Analysis was applied to assess the correlation between the red blood cells and the coronary artery disease. Results The red blood cell count and the level of hemoglobin in the obese group with CHD was higher than that in the non-obese group with CHD [（4.35 ± 0,55） and （4.13 ± 0.56） 10^9/L; （136.71± 15.87） and （129.96 ±16.23） g/L, P 〈 0.05 in both]; the proportion of acute coronary syndrome in the obese group with CHD was higher in the obese group with CI-/D than that in the non-obese group with CHD （P〈0.05）; Multivariant logistic regression analysis also showed that the red blood cell count was positively correlated with obesity with CHD.Conclusion The red blood cell count and the level of hemoglobin in the obese group were higher than those in the non-obese group; the increase of red blood cell count and hemoglobin level is one of the independent risk factors for the obese patients with CHD.

Correlation between GEM Premier 3000 and Vitros5.1+5600, SYSMEX XN-9000 in Detecting Electrolytes and Red Blood Cell Volume

Objective: To explore the consistency and relevance of the results of the bedside rapid blood gas analyzer GEM premier 3000, the Vitros5.1+5600 biochemical immunoassay analyzer and the SYSMEX XN-9000 automatic blood cell analyzer in the central laboratory detecting serum potassium (K+), serumsodium (Na+), blood glucose (Glu), hemoglobin (Hb) and red blood cell volume (Hct). And to provide a reference for the accurate interpretation of the bedside blood gas analysis report. Method: Usually, ICU patients will be taken arterial blood gas, biochemical and blood samples through the arterial indwelling needle;at the same time patients’ potassium, serum sodium, blood glucose, hemoglobin and red blood cell volume will be detected. This study implemented paired t-test and correlation regression analysis on each group of data, and used the analysis quality requirements (allowable total error) of CLIA’88 proficiency testing program as the criteria for clinical acceptance. Results: The paired t-test showed that the serum potassium, serum sodium and blood glucose detected by GEM premier 3000 and Vitros5.1+5600 were significantly different;and the hemoglobin and red blood cell volume detected by GEM premier 3000 and SYSMEX XN-9000 were significantly different (P < 0.05). The Pearson correlation coefficients (r) of hemoglobin, red blood cell volume and red blood cell volume were 0.860, 0.886, 0.924, 0.841 and 0.856, respectively, and the above test items all had good correlations (P < 0.05). The average (SE) of the paired differences of K+, Na+, Glu, Hb and Hct detected by the two sets of instruments is less than the allowable error of CLIA’88, and the SE of blood Na+ and Hb is less than half of the allowable error of CLIA’88. Conclusion: The test results of GEM premier 3000, the central laboratory Vitros5.1+5600 and SYSMEX XN-9000 have good correlation, but the consistency is not good. The test results of GEM premier 3000 cannot replace the central laboratory.

Analysis of Factors Influencing the Effect of Red Blood Cell Suspension Infusion in Children

Objective: The related factors of no improvement of hypoxia and ineffective infusion were analyzed to provide new ideas, clinical observation and evaluation pathway for RBC transfusion in clinical children. Methods: Retrospective analysis from January 2020 to December 2020, Guangzhou women and children’s medical center hospital in the emergency observation room of 249 children under 1 month to 18 years of blood cell suspension infusion, analyze the clinical effect of red blood cell infusion and children gender, age, fever after transfusion, disease type, delay transfusion. The possible influencing factors were analyzed by logistic regression. Results: Invalid transfusion was associated with the type of transfusion product (P = 0.032), logistic regression analysis showed that patients infused with washed RBC suspension were 3.231 times more likely to not achieve the expected effect than those infused with RBC suspension (P = 0.025). Failure transfusion was associated with the type of transfusion products. In ineffective transfusion was closely related to post-transfusion fever (P P P = 0.031). Logistic regression analysis showed that fever after transfusion was a risk factor for no improvement of hypoxia (OR = 5.809, P = 0.001), and the improvement of hypoxia in adolescent children was 10.744 times higher than that of infants (0 - 3 years old). Late transfusion hypoxia improvement was 4.212 times more likely to achieve no effect than timely transfusion. If ineffective infusion of red blood cells is considered and hypoxia after transfusion is not improved, univariate suggests a close correlation with fever after transfusion (P = 0.002), logistic regression analysis showed that fever after transfusion was an independent risk factor (OR = 7.258, P = 0.002). Conclusion: There was no correlation between the ineffective transfusion of red blood cells and the type of disease affected in the child. Infusion of red cell suspension has an advantage over the wash red cell infusion. Ineffective RBC transfusion and no improvement in hypoxia after transfusion were closely related to post-transfusion fever, with no difference between children in all age groups. Red blood cell infusion in pediatric clinical treatment activities should pay attention to adolescent children, especially female children to give more attention, and give timely red blood cell infusion as much as possible.

Severe hyperkalemia following blood transfusions:Is there a link?

Patients with gastrointestinal bleeding often require large volume blood transfusion. Among the various side effects of blood transfusion,the increase of potassium levels is a serious one which is often overlooked. We report a case of severe hyperkalemia in a patient with gastric bleeding after large volume transfusion of packed red blood cells. The patient had hyperkalemia at baseline associated with his receiving medication as well as acute renal failure following hypovolemia. The baseline hyperkalemia was further aggravated after massive transfusions of packed red blood cells in a short period of time. The associated pathogenetic mechanisms resulting in the increase of potassium levels are presented. A number of risk factors which increase the risk of hyperkalemia after blood transfusion are discussed. Moreover,appropriate management strategies for the prevention of blood transfusion associated hyperkalemia are also presented. Physicians should always keep in mind the possibility of hyperkalemia in cases of blood transfusion.

Cost of allogeneic blood transfusion

Blood is a scarce and costly resource to society. Therefore, it is important to understand the costs associated with blood, blood components, and blood transfusions. Previous studies have attempted to account for the cost of blood but, because of different objectives, perspectives, and methodologies, they may have underestimated the true(direct and indirect) costs associated with transfusions. Recognizing these limitations, a panel of experts in blood banking and transfusion medicine gathered at the Cost of Blood Consensus Conference to identify a set of key elements associated with whole blood collection, transfusion processes, follow-up, and to establish a standard methodology in estimating costs. Activity-based costing(ABC), the proposed allinclusive reference methodology, is expected to produce standard and generalizable estimates of the costof blood transfusion, and it should prove useful to payers, buyers, and society(all of whom bear the cost of blood). In this article, we argue that the ABC approach should be adopted in future cost-of-transfusion studies. In particular, we address the supply and demand dilemma associated with blood and blood components; evaluate the economic impact of transfusion-related adverse outcomes on overall blood utilization; discuss hemovigilance as it contributes not to the expense, but also the safety of transfusion; review previous cost-oftransfusion studies; and summarize the ABC approach and its utility as a methodology for estimating transfusion costs.

Effect of packed red blood cell transfusion on the prognosis of patients with upper gastrointestinal bleeding:a retrospective analysis of eICU-CRD v2.0 multicenter critically ill patients database

Background:The effects of packed red blood cell(PRBC)transfusion on the prognosis of patients with upper gastrointestinal bleeding(UGIB),particularly on the 30-day mortality rate,are unclear.This study aimed to determine the prognostic influence of PRBC transfusion in patients with UGIB with different hemoglobin(Hb)levels.Methods:The subjects in this study were selected from the Philips Electronic ICU Collaborative Research Database Version 2.0 multi-center critically ill patient database from January 2014 to December 2015.A total of 4689 patients were included in this study.The Hb levels were divided into 3 groups:Hb<6 g/dL(Group 1),6 g/dL≤Hb<8 g/dL(Group 2),and Hb≥8 g/dL(Group 3).Based on the ad-ministration of PRBC transfusion,each group was subdivided into PRBC and non-PRBC groups.Results:A total of 4689 patients were enrolled in the study,including 825,2195,and 1669 patients in Groups 1,2,and 3,respectively.Furthermore,the PRBC and non-PRBC groups consisted of 1847 and 2842 patients,respectively.There was no significant difference in the 30-day mortality rate between Group 1 and Group 2 or between the PRBC and non-PRBC subgroups.In Group 3,the 30-day mor-tality rate of patients who received transfusion was higher than that of patients who did not(13.29%vs 9.14%,P=0.029).For the PRBC group,the difference in 30-day mortality rate was not statistically significant among the 3 groups,whereas for the non-PRBC group,the 30-day mortality rate in Group 3 was the lowest,and there was a significant difference among the 3 groups(P=0.003).There was no significant difference in the subgroup analysis of bleeding at different sites and etiologies.Conclusion:Packed red blood cell transfusion does not improve prognosis or reduce mortality in patients with UGIB but may increase mortality in patients with Hb levels greater than 8 g/dL.

血红蛋白、白蛋白水平及红细胞分布宽度与心力衰竭预后的相关性研究

[目的]探讨血红蛋白和白蛋白水平及红细胞分布宽度(RDW)与心力衰竭预后的相关性.[方法]收集自2020年1月至2023年6月间洛阳市中心医院收治的86例心力衰竭患者的临床资料列入观察组,另收集同时期49例非心力衰竭者临床资料列入对照组;比较两组一般资料及血红蛋白、白蛋白水平及RDW.将观察组患者中在出院后3个月内出现全因死亡/心力衰竭再入院的23例纳入预后不良组,其余63例纳入预后良好组;比较两组血红蛋白、白蛋白水平及RDW.进一步分析血红蛋白、白蛋白水平及RDW与心力衰竭预后的相关性及对心力衰竭预后不良的预测价值.[结果]两组患者年龄、性别、体质量指数、是否患有高血压、糖尿病、高血脂间差异均无统计学意义(P>0.05).与对照组比较,观察组血红蛋白、白蛋白水平均明显降低,RDW明显升高,差异均具有统计学意义(P<0.05).与预后不良组比较,预后良好组血红蛋白、白蛋白水平均明显升高,RDW明显降低,差异均具有统计学意义(P<0.05).血红蛋白、白蛋白及RDW的预测阈值分别为131.35、38.22 g/L及0.155 g/dL,三者单一指标及联合预测心力衰竭预后不良的曲线下面积分别为0.627、0.717、0.702及0.809,三者联合预测的曲线下面积最大,灵敏度、特异度亦较高.[结论]血红蛋白、白蛋白水平的明显降低及RDW的明显升高与心力衰竭预后不良有关系,三者联合检查对心力衰竭预后不良的预测有一定的应用价值.

红细胞分布宽度、糖化血红蛋白水平与不稳定型心绞痛患者冠状动脉病变程度及狭窄程度的相关性分析

目的分析红细胞分布宽度、糖化血红蛋白水平与不稳定型心绞痛患者冠状动脉病变程度及狭窄程度的相关性。方法120例不稳定型心绞痛患者,根据冠状动脉病变支数的不同分为单支病变组(60例)、双支病变组(40例)、多支病变组(20例),根据冠状动脉狭窄程度的不同分为轻度狭窄组(50例)、中度狭窄组(40例)、重度狭窄组(20例)、完全闭塞组(10例)。对比不同冠状动脉病变支数组和狭窄程度组的红细胞分布宽度、糖化血红蛋白水平;使用Pearson法分析红细胞分布宽度、糖化血红蛋白水平与不稳定型心绞痛患者冠状动脉病变支数、冠状动脉狭窄程度的相关性。结果单支病变组、双支病变组、多支病变组的红细胞分布宽度分别为(9.27±0.71)%、(12.59±1.36)%、(17.87±2.68)%,糖化血红蛋白分别为(6.57±1.12)%、(8.89±2.06)%、(12.65±3.18)%。单支病变组、双支病变组、多支病变组的红细胞分布宽度、糖化血红蛋白水平对比,差异均有统计学意义(P<0.05);且红细胞分布宽度、糖化血红蛋白水平从高到低分别均为:多支病变组>双支病变组>单支病变组,差异均有统计学意义(P<0.05)。轻度狭窄组、中度狭窄组、重度狭窄组、完全闭塞组的红细胞分布宽度分别为(8.71±0.63)%、(11.86±0.92)%、(15.76±1.78)%、(20.36±3.04)%,糖化血红蛋白分别为(5.47±1.15)%、(6.97±1.83)%、(9.22±2.68)%、(14.86±3.89)%。轻度狭窄组、中度狭窄组、重度狭窄组、完全闭塞组的红细胞分布宽度、糖化血红蛋白水平对比,差异均有统计学意义(P<0.05);且红细胞分布宽度、糖化血红蛋白水平从高到低分别均为:完全闭塞组>重度狭窄组>中度狭窄组>轻度狭窄组,差异均有统计学意义(P<0.05)。Pearson分析法显示,不稳定型心绞痛患者冠状动脉病变支数的多少与红细胞分布宽度、糖化血红蛋白水平之间呈正相关(r=0.25、0.15,P<0.05);不稳定型心绞痛患者冠状动脉狭窄程度的轻重与红细胞分布宽度、糖化血红蛋白水平之间呈正相关(r=0.49、0.65,P<0.05)。结论临床可以通过红细胞分布宽度、糖化血红蛋白水平的血清学检测来评估不稳定型心绞痛患者冠状动脉病变支数和狭窄程度,进而根据患者病情的轻重来指导临床治疗,从而使患者获得更好的预后。

西藏自治区阿里地区健康新生儿出生后血氧饱和度特点与红细胞形态及功能的研究

目的通过比较西藏自治区阿里地区人民医院与陕西省两所医院健康新生儿出生后血氧饱和度(SpO_(2))水平和血常规水平,探索西藏自治区阿里地区新生儿出生后SpO_(2)水平与红细胞形态、功能的特点。方法本研究为盲法回顾性研究。选取阿里地区人民医院、泾阳县人民医院和耀州区人民医院新生儿科2020年1月至2020年7月正常出生的167例足月新生儿,阿里地区人民医院出生新生儿(74例)为高原组,陕西省两所医院出生新生儿(93例)为平原组。监测正常足月新生儿断脐后10 min右上肢SpO_(2)及心率水平,同时采集废弃脐血进行血细胞分析。比较高原组与平原组足月正常新生儿出生后10 min SpO_(2)水平特点,与《新生儿复苏指南(2021年)》(后文统一简称《指南》)中SpO_(2)目标值进行比较,同时比较两组血细胞分析结果的差异。结果高原组出生新生儿出生1~10 min SpO_(2)水平低于平原组,差异有统计学意义(P<0.05)。高原组出生新生儿脐血白细胞计数、血小板计数低于平原组,差异有统计学意义(P<0.05);红细胞计数、血红蛋白高于平原组,差异有统计学意义(P<0.05);红细胞平均体积小于平原组,差异有统计学意义(P<0.05),平均血红蛋白量、平均血红蛋白浓度、红细胞分布宽度标准偏差及红细胞分布宽度变异系数高于平原组,差异有统计学意义(P<0.05)。高原组出生新生儿1~8 min SpO_(2)水平与《指南》目标值符合率明显低于平原组,差异有统计学意义(P<0.05)。高原组出生新生儿出生后第9 min、出生后第10 min,SpO_(2)水平与《指南》目标值符合率为100%,与平原组比较差异无统计学意义(P>0.05)。结论《指南》中出生后10 min SpO_(2)预期值适用于西藏自治区阿里地区新生儿,脐血红细胞特有形态及高血红蛋白含量和浓度可能是常驻藏族新生儿适应高原的原因之一。

体外生产红细胞:进展与挑战

目前临床用血供不应求,尽管自体输血等血液保护技术可部分缓解此类情况,但红细胞作为主要的血液成分需求量巨大,而体外生产安全的红细胞则可解决这一难题。目前研究显示,可从胚胎干细胞、人诱导多能干细胞、脐带血、外周血和永生化红系祖细胞系几种来源分化出成熟红细胞。本文就体外生产红细胞的来源及应用进行综述,并分析目前所面临的挑战,以期为输血治疗提供新思路。

外周血红蛋白红细胞分布宽度比值与性别的交互作用对非小细胞肺癌预后的影响

目的分析外周血红蛋白/红细胞分布宽度比值(hemoglobin-to-red cell distribution width ratio,HRR)与非小细胞肺癌(non-small cell lung cancer,NSCLC)患者预后的关系,并探究HRR与性别的交互作用对NSCLC患者预后的影响。方法回顾性收集2020年1月至2021年1月在我院就诊的NSCLC患者的临床资料,包括患者人口学资料、疾病特征资料以及实验室检查资料等。根据外周血红蛋白与红细胞分布宽度计算患者的HRR水平,并以中位数为分界线,将患者分为高水平HRR组与低水平HRR组。采用单因素分析探究HRR变化与NSCLC患者不同特征之间的关系。采用Cox相乘交互作用分析HRR与性别的交互作用对NSCLC患者生存情况的影响,并绘制相应的生存曲线。结果NSCLC患者的HRR水平与其性别之间存在交互作用,且此交互作用显著影响患者的预后。在男性患者中,HRR呈低水平者的疾病进展风险是高水平者的3.171倍(95%CI:1.924~6.015,P=0.002)。在女性患者中,不同HRR水平的患者的疾病进展情况无显著差异(P>0.05)。结论HRR与性别的交互作用对NSCLC患者的预后有显著影响。男性NSCLC患者的预后受到HRR影响程度高于女性,在使用HRR作为预后预测因子时应考虑性别差异。

洗涤红细胞和去白悬浮红细胞输注治疗自身免疫性溶血性贫血的效果

目的:探讨洗涤红细胞和去白悬浮红细胞输注治疗自身免疫性溶血性贫血(AIHA)的效果。方法:回顾性选取2020年3月—2023年3月蚌埠医学院第一附属医院收治的64例AIHA患者作为研究对象。根据治疗方法的不同将其分为试验组和对照组,各32例。对照组输注去白悬浮红细胞,试验组输注洗涤红细胞。比较两组输血后24 h临床疗效,输血前、输血后24 h相关指标,输血反应。结果:试验组总有效率高于对照组,差异有统计学意义(P<0.05)。输血后24 h,两组血红蛋白(Hb)、红细胞计数(RBC)升高,网织红细胞百分比(Ret)、总胆红素(TBIL)水平降低,试验组Hb、RBC高于对照组,差异有统计学意义(P<0.05)。两组输血反应发生率比较,差异无统计学意义(χ^(2)=1.016,P>0.05)。结论:对AIHA患者而言,在输血治疗中输注洗涤红细胞的总体有效率高于输注去白悬浮红细胞,并且Hb和RBC的提升效果更加明显。

人源化基因修饰猪红细胞与人血清免疫相容性的体外研究

目的 探讨野生型(WT)、四基因修饰(TKO/hCD55)和六基因修饰(TKO/hCD55/hCD46/hTBM)猪红细胞与人血清的免疫相容性和免疫差异。方法 收集20名不同血型志愿者的血液,将WT、TKO/hCD55和TKO/hCD55/hCD46/hTBM猪红细胞、ABO-相容(ABO-C)及ABO-不相容(ABO-I)人红细胞分别暴露于不同血型人血清中,检测血凝集、抗原抗体结合(IgG、IgM)水平和补体依赖细胞毒性,评估2种基因修饰猪红细胞与人血清的免疫相容性。结果 ABO-C组未出现明显凝集;WT组和ABO-I组凝集水平高于TKO/hCD55组和TKO/hCD55/hCD46/hTBM组(均为P<0.001)。WT组猪红细胞裂解水平高于ABO-C组、TKO/hCD55组和TKO/hCD55/hCD46/hTBM组;ABO-I组猪红细胞裂解水平高于TKO/hCD55组、TKO/hCD55/hCD46/hTBM组(均为P<0.01)。TKO/hCD55组猪红细胞IgM和IgG结合水平均低于WT组和ABO-I组;TKO/hCD55/hCD46/hTBM组猪红细胞IgG和IgM结合水平低于WT组,IgG低于ABO-I组(均为P<0.05)。结论基因修饰猪红细胞的免疫相容性优于野生型猪,并接近于ABO-C,人源化猪红细胞在血资源奇缺时可考虑作为血液来源。

体外模拟加压输血对悬浮红细胞质量影响的研究

目的探讨不同压力对悬浮红细胞质量的影响,为研制加压输血装置提供数据支撑。方法将25袋悬浮红细胞随机等分成5组,分别施加10、20、30、40和50 Kpa压力,实时记录血流速度;施压前后分别留取部分血样测定红细胞相关指标(RBC、HGB、HCT、MCV、MCH、MCHC)变化情况,测定血浆中钾离子、间接胆红素、乳酸脱氢酶、游离血红蛋白含量;检测红细胞渗透脆性并用电镜观察红细胞形态变化,从而评价不同压力对血液质量的影响。结果加压可显著提高输血速度。在不同压力下红细胞相关指标变化与K+、IBIL、LDH变化无统计学意义,游离血红蛋白与溶血率均符合国家有关规定。电镜下观察随着压力升高出现少量异形红细胞,胞膜电子密度有差异,网状结构破坏,网眼不均匀。结论在50 Kpa范围内加压对红细胞损伤影响不大,血液质量符合我国相关标准要求。