ABSTRACT
【Objective】 To retrospectively analyze the effect of AB platelet secondary compatible transfusion on the efficacy of matched platelet transfusion. 【Methods】 A total of 2 276 cases of platelet transfusion in our hospital were selected from November 2020 to September 2021, including 2 068 ABO matched platelet transfusions and 206 AB platelet secondary compatible transfusions. 117 cases were selected for the first occasion of AB platelet secondary compatible transfusion. The controls were matched transfusion receipts before given AB platelet secondary compatible transfusion, and the experimental group was given matched transfusion after AB platelet secondary compatible transfusion (take the first, second and third transfusion as group 1, 2 and 3, respectively). The platelet count(Plt), platelet elevation (△Plt) and 24 h Plt correction increase index (CCI) of patients before and after platelet transfusion were used as observation indexes to analyze the effect of AB type mis-matched platelet transfusion on the efficacy of matched platelet preventive transfusion by gender, blood type and disease type. 【Results】 Among the 2 276 platelet transfusions, and the △Plt of matched platelet transfusions was significantly higher than that of AB type secondary compatible transfusions, with the mean values at (14±15)×109/L and (11±14)×109/L(P<0.05). The △Plt of female patients was higher than that of male patients (15±16)×109/L vs (13±14)×109/L(P < 0.05). The △Plt values of MDS, NHL and MM were (9±14) ×109/L, (10±12) ×109/L and (8±11) ×109/L, respectively, which were significantly lower than the average value (P < 0.05). For 117 cases of AB platelet secondary compatible transfusion: the Δ Plt was significantly lower than that of the control group and the experimental group, respectively at (9±12) ×109/L, (13±13) ×109/L and (13±12) ×109/L(P<0.05). The effective rate of 24 h CCI was 52.14%, significantly lower than the control group and experimental group (71.59% vs 71.83%), P<0.05; no significant difference was noticed in △ Plt value and 24 h CCI between the experimental group and the control group(P>0.05). The △Plt of the experimental group 3 was significantly lower compared with the experimental group 1, (10±13) ×109/L vs (14±12) ×109/L, P<0.05, and the effective rate decreased from 73.12%(68/93)to 58.70%(27/46), P>0.05. No significant difference in △Plt and the number of effective 24 h CCI cases was found between the experimental group and the control group in terms of gender, blood type and disease type (P>0.05). 【Conclusion】 The △Plt and the effective rate of AB platelet secondary compatible transfusion were lower than those of matched platelet transfusions, and has no significant effect on short term(less than 10 days) matched platelet transfusion.
ABSTRACT
【Objective】 To retrospectively analyze the safety and product quality of NGL XCF 3000 blood cell separator for collecting platelet-rich plasma (PRP) in 256 cases, so as to provide reference for safe collection and product quality control of PRP. 【Methods】 The data of 256 patients receiving PRP treatment in our hospital from June 2021 to June 2022 were statistically analyzed, and the differences in the collection time, circulating blood volume and the occurrence of adverse reactions to blood donation were analyzed when NGL XCF 3000 was used to collect autologous PRP among patients of different genders, ages and platelet counts. The differences in platelet content, red blood cell(RBC) contamination and white blood cell(WBC) residues in PRP products were analized. 【Results】 1) There were no significant differences in collection time, circulating blood volume and collection volume among patients of different genders, ages and platelet counts (P<0.05). 2) The contents of WBC, RBC and platelet were not significantly different between male and female patients after collection (P<0.05); 3) The WBC contents increased with the increase of age, and the WBC residue in the elder group[ 56 to78 years old, (0.64±0.41) ×109/L] was significantly higher than that in the younger group[group 1,18 to 40 years old, (0.50±0.35)×109/L], with significant difference was Statistically significant (P<0.05). 4) The residues of WBCs and RBCs in in low platelet group [group 1, (100-150)×109/L] were higher than those in other platelet count groups, and the difference was Statistically significant (P<0.05), and the platelet count in this product was significantly lower than that in other platelet count groups (P<0.05). Conclusion The NGL XCF 3000 blood cell separator is safe and stable for PRP collection in patients with different genders, ages and platelet counts of (100-450)×109/L, and the PRP products collected can meet clinical therapeutic needs.
ABSTRACT
【Objective】 To retrospectively analyze the efficacy of low dose apheresis platelet prophylactic infusion and explore its feasibility. 【Methods】 A total of 392 inpatients with platelet transfusion in our hospital from November 2020 to September 2021 were selected. The conventional dose (1 therapeutic dose) of apheresis platelet transfusion was set as the control group, and the low dose (0.5 therapeutic dose) as the experimental group. Platelet count before and after infusion, platelet elevation value (△PLT) and 24 h platelet count correction increase index (CCI) were observed, and the efficacy of low-dose platelet infusion was analyzed by disease type and gender. 【Results】 The △PLT value and 24h CCI effective infusion rate in control group were higher than those in experimental group: (16±16) ×109 vs (7±10) ×109, 71.94% vs 60.46%, P<0.05. The △PLT value of the control group was about 1.2-3.5 times that of the experimental group, and the effective rate was about 1-1.4 times. In control group, the △PLT (×109) was AML (20±14) >AA (14±14) >ALL (13±12) >NHL (9±8) >MDS (7±6). In the experimental group, the △PLT (×109) was AA (11±18) >AML (8±8) >ALL (5±7) >NHL (5±7) >MDS (6±16). The 24h CCI was AML(163/188, 86.70%)>AA(23/32, 71.88%)>ALL(65/98, 66.33%)>MDS(9/17, 52.94%)>NHL(12/22, 51.55%) in the control group, and AML(133/188, 70.74%)>AA(19/32, 59.38%)>NHL(12/22, 51.55%)>ALL(47/98, 47.96%)>MDS(8/17, 47.06%) in the experimental group. The effective infusion rates of AML and ALL2 in the experimental groups were 70.74% (133/188) and 47.96% (47/98), respectively, significantly lower than 86.7% (163/188) and 66.33% (65/98) in the control group(P<0.05). No significant difference was noticed in the effective infusion rate between the experimental group and the control group for other diseases (P>0.05). 【Conclusion】 Low-dose apheresis platelet prophylactic infusion can alleviate the between supply shortage, with an effective infusion rate of 60.46% (236/392), which has certain clinical application value. Patients with AML, AA or ALL were recommended with low dose platelets, while patients with MDS and NHL were not recommended.
ABSTRACT
Objective:To explore the risk factors for urinary tract infection (UTI) among type 2 diabetics after an ischemic stroke.Methods:A total of 459 survivors of a first ischemic stroke who had type 2 diabetes were studied retrospectively. The 149 who had contracted a urinary tract infection (32.5%) formed the infections group; the other 310 were the no-infections group. Univariate analysis was applied to the subjects′ ages, sex, type of ischemic stroke, body mass index (BMI), history of coronary heart disease, glycosylated hemoglobin (HbAlc) levels, serum albumin (ALB) levels and serum glucose (GLU) levels. The risk factors for urinary tract infection for such patients were analyzed using binary logistic regression.Results:The univariate analysis showed that gender, age, smoking, drinking, type of ischemic stroke, coronary heart disease, as well as BMI, HbAlc and ALB levels were correlated with UTI. In the binary logistic regression analysis the significant predictors were being female, HbAlc≥6.5%, serum albumin<40g/L, obesity (BMI≥28.0kg/m 2) and the type of ischemic stroke. Conclusions:Ischemic stroke survivors with type 2 diabetes mellitus are at high risk of UTI. Being female and/or obese, a high HbAlc level, a low ALB level, and certain types of ischemic stroke are all risk factors. These findings should provide a basis for the prevention and treatment of UTIs after a stroke.
ABSTRACT
【Objective】 To explore the corresponding strategies of blood preparation for placenta previa operation in our hospital according to the situation of blood transfusion during and after operation. 【Methods】 Ninety pregnant women with placenta previa (complete, partial or marginal) undergoing the caesarean operation and blood transfusion in our hospital from January 2011 to September 2020 were selected as the research objects. The corresponding data about intraoperative/postoperative blood loss, blood transfusion and blood preparation were collected, analyzed and compared. 【Results】 There was no significant differences in age between complete and marginal placenta previa(P>0.05), but significant differences in intraoperative/postoperative blood loss and the units of blood transfusion (P1 000 mL). The difference between ordering and transfusion units of complete and marginal placenta previa were 0.4 and 0, respectively. When the complete placenta previa was accompanied by placenta increta or placenta percreta, the blood loss was larger (>1 000 mL) and the units of blood transfusion ranged from 4.5 U to 6 U, while the blood loss was generally low (≤1 000 mL) and the units of blood transfusion was concentrated at 3 (2, 4) U without placenta accreta nor implantation.The difference between ordering and transfusion units of complete placenta previa with non-implantation, placenta accreta, placenta increta and placenta percreta were 0.165, 0.33, 0.5 and 1, respectively. 【Conclusion】 For marginal placenta previa, 3U blood is recommended for routine preparation, 3U blood for complete placenta previa with non-implantation or placenta accrete, and 4.5-6U for complete placenta previa with placenta increta or placenta percreta.
ABSTRACT
【Objective】 To explore the clinical application of a universal platelet product for emergency, which was prepared by suspending O-type apheresis platelet concentrate in AB-type fresh frozen plasma, so as to improve the platelet support ability in emergency and special treatment. 【Methods】 A retrospective analysis of 21 hematological patients, which was divided into 3 groups of platelet transfusion schemes: universal type, AB type and the same type, was performed to analyze the differences in PLT, dose, 24 h PPR, 24 h CCI, follow-up platelet transfusion units and interval, and adverse reactions to transfusion. 【Results】 1)There was no significant difference in PLT, MPV, PDW, K, MA and pH between the initial O-type apheresis platelets and the finished universal platelets (P>0.05). The titers of both anti-A and anti-B in the universal platelets were less than 2. 2) Twenty-one patients were transfused with universal platelet for 27 occasions[1~5 occasions per person; 1 (0.4, 1.0) dose per time]. No adverse reactions to transfusion occurred. 3)There was no significant difference in the effective rate of 24 h CCI and 24 h PPR between the three groups after transfusion(P>0.05). The time interval of the first subsequent platelet transfusion between the compatible group and the universal group was longer than that in the AB-type transfusion group, with significant difference(P0.05) among three groups. 【Conclusion】 In emergency, the application of this universal platelet product can make hematological patients get timely and effective treatment. Its accessibility and effectiveness can be elevated and the infusion interval can be prolonged by improving the preparation method and storage conditions. This product is not only expected to improve the platelet support capacity for patients with emergency and also those undergoing hematopoietic stem cell transplantation during the blood type conversion period, but also may be a practical method to alleviate the contradiction between platelet supply and demand.
ABSTRACT
【Objective】 To establish the maximum surgical blood order schedule(MSBOS) for orthopedic surgery, as to guide the clinical blood application and reasonable blood preparation for this type of surgery. 【Methods】 The ordered and actual amount of transfused blood of orthopedic elective operations in our hospital from 2014 to 2018 were collected by the hospital information(HIS) and blood collection information software of Department of Blood Transfusion.The surgeries were classified and indices, including blood transfusion rate and per capita transfused RBC volume, were calculated, then orthopedic MSBOS was established by combining the surgical transfusion rate, per capita red blood cell infusion volume, the algorithm of MSBOS, the risk of massive hemorrhage and the actual situation of our hospital. 【Results】 A total of 3 730 cases of elective orthopedic surgery were included, and the ordered blood volume was 10 183.8 U. 1084 cases received intraoperative blood transfusion, with the total blood transfusion volume of 3 498.8 U and the blood transfusion rate at 29.1%(1 084/3 730). The blood transfusion volume of surgical patients was [1~17.5(3.21±1.89)] U/patient. MSBOS for orthopedic surgeries had been established in our hospital. According to the blood transfusion data of each surgical procedures, surgical blood ordering was divide into 2 categories: Type/Screen, Type/Screen/Crossmatch (2~8 U). 【Conclusion】 The establishment of MSBOS in Department of Blood Transfusion according to the daily blood use in orthopedic surgery is not only beneficial to guide the blood preparation for orthopedics surgery more scientifically and reasonably, but also can optimize the management of blood inventory and provide reference for the establishment of MSBOS in other blood use departments.
ABSTRACT
【Objective】 To explore the factors affecting the collection and product quality of platelet-rich plasma (PRP), and to provide reference for ensuring the safety of PRP collection and the quality of PRP products. 【Methods】 A total of 108 patients receiving PRP treatment in our hospital from February 20 to April 20, 2016 were investigated by analyzing the time of PRP collection, the amount of circulating blood, the amount of anticoagulant and the use of calcium from four factors including gender, age, Plt before collection and collection equipment. The effects of PRP product volume, platelet content, RBC and WBC contamination, and the occurrence of adverse reactions were statistically analyzed. 【Results】 The type of equipment had little influence on the collection parameters and product quality(P>0.05). RBC residues in female patients were (0.07±0.03) ×1012/L, higher than that in male patients (0.04±0.02)×1012/L (P<0.05). Significant differences in collection time, circulating blood volume, anticoagulant dosage and collection volume were noticed by age(18~40 vs 56~77 years old, P<0.05) and platelet count(×109/L) (201~450 vs 100~150, P<0.05). In patients with low Plt count (100~150)×109/L before collection, the Plt content in PRP product was relatively low(771±218)×109/L, and WBC(0.45±0.25)×109/L and RBC(0.07±0.03)×1012/L residual amount was rather high(P<0.05), but also satisfied the quality criteria. 【Conclusion】 The MCS+ and NGL XCF 3000 blood cell separators are safe and stable in PRP collection, even in patients with low platelet count(100~150)×109/L or old age (>55 years old).
ABSTRACT
Objective: To demonstrate that expression of the CCRSDelta32 protein in PBMCs able to down-regulate surface expression of the HIV-1 coreceptor CCR5 and CXCR4.Methods:CCR5Delta32 gene was amplified from human peripheral blood mononuclear cells(PBMCs)genomic DNA by using PCR, and then cloned into lentiviral vector pLenti6/V5-D-TOPO.Recombinant lentiviral particles were produced by packaging using 293T cells.Human PBMCs were transfected with the constructed recombinant lentiviral particles and the expression of CCR5Delta32 was detected by Western blot.The level of CCR5 and CXCR4 expression on transfected PBMCs was detected by FACS analysis.Results: The recombinant lentiviral vector pLenti-CCR5Delta32 was constructed successfully, and the target protein was expressed in PBMCs.FACS analysis showed that CCR5Delta32 protein expressed in PBMCs was able to down-regulate cell surface expression of CCR5 and CXCR4.Conclusion: This study is expected to be used for the gene therapy on AIDS, which deserves further study.
ABSTRACT
Objective To statistically analyze data of blood transfusion from General Hospital of Chengdu Military Command,Mianyang field blood station,Deyang field blood station and other military medical institutions from May 12 to June 30,2008 so as to provided certain references for reasonable blood supportability in wartime and disaster.Methods A statistical analysis was done on data of blood collection and supply including self-taken blood and assembled blood,total amount of blood supply as well as the transfusion information of inpatients injured by earthquake in our hospital.Results The amount of self-taken blood was 5 111 U,the amount of assembled blood 3 380 U and the total amount of blood supply 1 0405.5 U.But blood transfusion was 4 090.6 U in 132 patients admitted into General Hospital of Chengdu Military Command.In addition,the crest-time of transfusion appeared at 96 hours after earthquake.Moreover,patients with fractures received the highest rate of blood transfusion and crush syndrome patients received the most blood transfusion and the highest per capita transfusion.Conclusions Blood supportability in earthquake is different from that in wartime and other disasters in aspects of transfusion time,blood types and blood transfusion volume.It is important to analyze the characteristics of transfusion in patients injured by earthquake for national strategy of blood supportability in disasters and for blood supportability in the wartime.