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【Objective】 To investigate the effects and mechanisms of different doses of fingolimod (FTY720) on non-antibody-mediated transfusion-related acute lung injury (TRALI). 【Methods】 A TRALI mouse model was constructed using lipopolysaccharide (LPS) pre-stimulation and platelets (Plt) of different storage days for second strike. The success of the modeling was determined by protein concentration in lung tissue homogenates, myeloperoxidase (MPo) activity, lung wet/dry weight ratio (W/D ratio), lung tissue damage score and pathological sections. Ceramide and sphingosine-1-phosphate (S1P) contents in platelets of different storage days were detected. FTY720 was administered 1 h after LPS injection to investigate the role of FTY720 in TRALI. The expression levels of vascular endothelial cadherin (VE-cadherin) and zonula occludens-1 (ZO-1) were analyzed by WB. 【Results】 Mice infused with stored 5-day Plt (d5Plt group) exhibited typical signs of TRALI, and the differences in lung tissue homogenate protein concentration (6 546.38±409.50) μg/mL, MPO activity (49.38±4.43) U/L, W/D ratio 4.79±0.21, and lung tissue damage score 7.24±0.38 from the rest of the groups were statistically significant (P<0.05). With the increase of platelet storage time, the ceramide content gradually increased and S1P content gradually decreased, and the ratio of the two was imbalanced. d5Plt showed statistically significant differences (P<0.01) in ceramide content (58.37±5.69) μmol/L and S1P content (149.81±4.86) nmol/L from the rest of the groups. After preventive administration of FTY720, 1 mg/kg FTY720 had no significant effect on TRALI mice, whose lung tissue homogenate protein concentration (6 170.26±545.50) μg/mL, MPO activity (45.97±4.79) U/L, W/D ratio 4.88±0.25, and lung tissue damage score 7.92±0.65 were significantly higher than those of the normal and LPS control groups (P<0.01). The low-dose (0.5, 0.2, and 0.1 mg/kg) FTY720 group alleviated lung injury, and its protein concentration, MPO activity, W/D ratio, and lung tissue injury score were significantly lower than those of the d5Plt group (P<0.05). Pathological sections also showed similar results. In terms of endothelial intercellular junction protein expression, the VE-cadherin expression levels in the 1 mg/kg FTY720 group were significantly lower than those in the normal and LPS control groups (P<0.05), and the VE-cadherin and ZO-1 expression levels in the low-dose (0.5, 0.2, and 0.1 mg/kg) FTY720 group were significantly higher than those in the d5Plt group (P<0.05), which tended to be normalized. 【Conclusion】 In this study, a TRALI mouse model was successfully established by one strike of LPS and two strikes of d5Plt. Low doses of FTY720 (0.5, 0.2, 0.1 mg/kg) were protective against TRALI, while high doses of FTY720 (1 mg/kg) may aggravate the symptoms of TRALI. This protective effect may be somewhat dependent on the expression of VE-cadherin and ZO-1.
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【Objective】 To explore the research status, hotspots, development trend and frontier of RBC storage lesion. 【Methods】 The Web of Science core collection database (http: //webofscience.com) was used to retrieve the documents related to " red blood cell storage lesion" from 2005 to 2021. After the exclusion of unrelated documents, CiteSpace (CiteSpace.5.7.R2) was used for bibliometric analysis, including author (all signatories of the article), institution and country (to which the article is affiliated), journal, key words and cited literatures. 【Results】 A total of 508 literatures were included, accounting for 91.86% (508/553) of all publication concerning " RBC storage lesion" in this period. The annual growth rate of publications was 14.38%. There were 1 868 authors totally, and 39.76% (202/508) of them published more than 3 papers. D ′Alessandro A from the United States ranked first [7.68% (39/508)], Univ Colorado System and Univ Pittsburgh were the top two institutions [7.28% (37/508) and 7.09% (36/508), respectively]. The United States [53.35% (271/508)], Canada [13.19% (67/508)], the United Kingdom [6.50% (33/508)] and Switzerland [6.10% (31/508)] were the top 4 countries. Keywords co-occurrence network, emergent atlas and literature co-citation cluster atlas mainly focused on mechanism research, clinical trials, improvement of RBC storage conditions and reduction of RBC storage lesion. 【Conclusion】 The most important researchers and institutions in the field of RBC storage lesion in the past 17 years were mainly from the United States and Europe. The application of metabolomics and other technologies, the mechanism of RBC storage lesion, the selection of donor diversity, and the research and development of new preservation solutions or additives are the hotspots and frontiers in this field.
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【Objective】 To investigate the risk factors of vasovagal reactions(VVR) related to plasma donation, so as to put forward clinical suggestions for early identification and accurate intervention of high-risk groups to ensure the safety of plasma donation. 【Methods】 The demographic characteristics(i.e. gender, age, weight) and records of plasma donors(donation history, pulse before plasma donation, duration of collection, etc.) were collected from July to December 2019 in a region of Sichuan. Based on logistic regression analysis, the correlation between these factors and the risk of VVR was explored. 【Results】 The information of 69 172 donors was collected, and the incidence of VVR was 7.04‰. The risk of VVR was reduced by 99% in the group with plasma collection duration less than 30 minutes compared with the group with plasma collection duration more than 50 minutes(OR, 0.01; 95% CI, 0.00~0.01; P<0.001). The risk of male group was 94 % lower than that of female group(OR, 0.06; 95% CI, 0.04~0.10; P<0.001). Compared with the 45~50 kg group, the risk of weight greater than 80 kg group decreased by 80%(OR, 0.20; 95% CI, 0.09~0.42; P<0.001). The risk of repeated donation group was 34 % lower than that of the first time donation group(OR, 0.66; 95% CI, 0.47~0.91; P<0.001). The risk of VVR in the group with pulse greater than 90 bpm before plasma donation was 2.43 times that in the 60~69 bmp group(OR, 2.43; 95% CI, 1.75~3.36; P<0.001). 【Conclusion】 Duration of plasma collection, gender, weight, frequency of plasma donation, pulse before plasma donation and donor status are independent risk factors for plasma donation-related VVR. Among them, plasma collection duration, gender and weight were the main independent risk factors for plasma donation-related VVR. For donors with plasma collection duration more than 50 minutes, female and low weight, higher risk of VVR was presented and more preventive intervention should be given.
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Neonatal illness severity score is a scoring system for assessing severity of illness,predicting mortality and guiding clinical work in neonatal intensive care units.It plays an important role in the progressive development of neonatology.This article introduces and compares several illness severity scores commonly used in the world.Compared with score for neonatal acute physiology ( SNAP),score for neonatal acute physiology perinatal extension(SNAPPE) and our country's neonatal illness severity score,cinical risk index for Babies ( CRIB ),score for neonatal acute physiology version Ⅱ ( SNAP-Ⅱ),simplified version of the score for neonatal acute physiology (SNAPPE-Ⅱ) and clinical risk index for babies-revised (CRIB-Ⅱ) simplify the variables,weight the items scientifically,cost less time and predict the motality risk reliably.In conclusion,CRIB,SNAP-Ⅱ,SNAPPE-Ⅱ and CRIB-Ⅱ have better practicability and need to be promoted.
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Objective:To find out the clinic characteristics of congenital syphilis(CS),to reduce the possibility of misdiagnosis.Methods:Fifty-five(aged at hedyanhour to three years)cases were analyzed the clinic manifestation retrospectively during 1999 to 2008.Results:There were 33 male and 22 female.of 55 cases,only 5 were diagnosed as CS at the beginning of entry hospital and the rest were misdiagnosed.The main complain showed 27 cases with mucocutaneous lesion(papula,papulopustule,bleb,desquamation),26 with jaundice,32 with hepatomegaly,14 with splenomegaly,12 with tachypnea,6 with osteomyolitis,20 with nose problem(rhinocleisis, epistaxis,rhinorrhea),7 with congenital deformity,5 with hemorrhage,4 with abdominal distension,1 with abdominal pain,2 with vomiting,2 with edema,1 with tic,1 with bad cry.Conclusion:In most newborns and infants,the onset of CP is heralded by nonspecific signs which involved multi-system.The rate of misdiagnosed for CP could be beyond 90%.