Analysis of reactive HCV results detected by current blood screening strategy / 中国输血杂志

【Objective】 To assess the status of HCV infection by analyzing the results of anti-HCV reactive blood samples detected by the current blood testing strategy, and discuss the viability of classified management of reactive blood donors. 【Methods】 The anti-HCV reactive samples (dual ELISA and once NAT), from May 2017 to October 2018, were divided into three groups: samples both anti-HCV and HCV RNA reactive, sole HCV RNA reactive, and sole anti-HCV reactive, and all of them were confirmed by recombinant immunoblot assay (RIBA). The positive predictive value (PPV) between groups were compared. The sensitivity, specificity and PPV for each reagent under different screening threshold (screening threshold for routine detection, optimal screening threshold, and corresponding screening threshold of the highest PPV) were analyzed. The group with low PPV were stratified by ELISA S/CO values, and PPV by different screening threshold was compared. 【Results】 There were 939 reactive samples (0.49%, 937/191 627). Confirmed by RIBA, the positive rate of anti-HCV reactive samples was 10.67%(100/937). Two samples were sole HCV RNA reactive (0.001%). Both anti-HCV+ HCV RNA reactive samples were 6.71%(63/939), with the PPV of 96.83%(61/63). Sole anti-HCV reactive samples were 93.08(874/939), with the PPV of 4.46%(39/874), among which PPV by dual and one ELISA reagent were 18.72% and 0.15%, respectively, showing statistically significant difference (P<0.05). The PPV between different S/CO values was statistically significant (P<0.05). The optimal screening thresholds of anti-HCV reagent were 9.29 and 3.97, according to the ROC curve, with significant difference noticed in PPV by different screening threshold (P<0.05). PPV in the sole anti-HCV reactive group increased from 4.46% (the routine screening threshold) to 49.35%(the optimal screening threshold), and the difference was statistically significant (P<0.05). 【Conclusion】 The blood donors with both anti-HCV and HCV RNA reactive can be determined as HCV infection and need to be permanently deferred. The S/CO value of sole anti-HCV reactive samples was positively correlated with RIBA confirmation results, and the higher the S/CO value, the greater the chances of positive confirmation are. With the current blood screening strategy, the HCV infection status of sole anti-HCV reactive blood donors can be determined by establishing a screening threshold with high PPV or adding confirmatory test.

Detection of occult HBV infection and probably window period infection among single NAT reactive blood donors / 国际检验医学杂志

Objective To analyze hepatitis B virus(HBV) infection stage in single nucleic acid test(NAT)reactive blood donors.Methods Blood donor samples were screened routinely for HBV DNA by using transcription-mediated amplification(TMA) NAT and quantitative polymerase chain reaction(PCR).Then serum markers of HBV were also detected.The HBV infection stage was analyzed.Results Among the 225 single NAT reactive samples,78(34.67%) were identified to be reactive for HBV DNA by TMA NAT discrimination test and/or PCR test,of which 63(82.89%) were occult HBV infection(OBI),13(17.11%) were probably window period infection(pWP),and 2 cases could not be classified for infection stage.Among the OBI samples,49 samples(77.78%) were with HBV DNA concentration less than 20 IU/mL,whereas,there were only 4 samples(30.77%) in pWP samples.The 225 samples were classified into three groups according to the S/CO of NAT, including 1-<6 group,6-<10 group and 10-17 group, the confirmed HBV DNA positive rates of which were 13.11%,13.64% and 47.18%,and the positive rate of 10-17 group was higher than 1-<6 group and 6-<10 group(P<0.05).In all 63 OBI samples,there were 8(12.70%),3(4.76%) and 52(82.54%) samples were classified into S/CO 1-<6,6-<10 and 10-17,respectively.All of the 13 pWP samples were with NAT S/CO of 10-17.Conclusion Part of single NAT reactive blood donors could be with HBV infection,of which OBI might be popular than pWP, with very low concentration of HBV DNA.Deferral of single NAT reactive blood donors could reduce transfusion-transmitted HBV infection.

Surgical treatment of talar neck fractures / 中国骨伤

<p><b>OBJECTIVE</b>To explore the clinical effect of talar neck fractures treated by open reduction and internal fixation with screws.</p><p><b>METHODS</b>Among 28 cases in the study, 20 cases were males and 8 cases were female. The age ranged from 22 to 72 years with an average of 38 years. Based on the Hawkins classification,there were 6 cases of type I,18 of type I and 4 of type II. They were treated by open reduction and internal fixation with screws.</p><p><b>RESULTS</b>Twenty-eight cases were followed up for 1 to 7 years(mean 2.8 years). The evaluation of the results by Hawkins functional rating scale revealed excellent in 14 cases,good in 9 cases, fair in 3 cases and poor in 2 cases. The excellent and good rate were 83.2%. Osteonecrosis occurred in 5 cases with 3 of type II and 2 of type III fractures. Two of 3 cases with talar displacement were found with osteonecrosis or painful arthritis. The subtalar arthritis occurred in 6 cases, 3 of which were associated with ankle arthritis. Two cases underwent arthrodesis because of painful arthritis of the subtalar joint or osteonecrosis of the talar body. Wound infection and anteromedial skin necrosis of the ankle were not found.</p><p><b>CONCLUSION</b>Treatment of talar neck fractures could obtain satisfactory clinical results through open reduction and internal fixation with screws. Protection of the residual blood supply, anatomically reduction and stable fixation are essential for successful treatment of talar neck fractures.</p>

Animal trials for mPEG-modified red blood cells / 中国实验血液学杂志

This study was aimed to investigate the survival rate and difference of transfused modified and unmodified RBC at 24 hours. The modified and unmodified RBC from mice, monkey, pig and human were labeled by using FITC, then these blood RBCs were transfused to homogeneous and heterogeneous animals. The result showed that 24 hour survival rate of unmodified mice RBC transfused to mice was 74%, while survival rate of 2.0 mmol/L mPEG-SPA modified mice RBC transfused to mice was 45%, difference between them was significant. The 24 hour survived rate of unmodified human RBC transfused to mice was 8%, while 24 hours survival rate of 2.0 mmol/L mPEG-SPA modified human RBC transfused to mice was 5% without statistical difference. The 24 hour survived rate of homogeneous transfusion of modified monkey RBC was 90%, while survival rate of modified human and pig RBC was zero on 24 hours after transfusion to monkey. It is concluded that RBC labeling methods and mice species are unrelated to 24 hours survival rate, but mPEG variety and concentration are related to mouse RBC life-span. It is incredible to use mouse RBC homogeneous transfusion result instead of human RBC to evaluate longevity and safety of modified human RBC. But modified human RBC transfused to mice can be a model to evaluate longevity of modified human RBC. It is very difficult to get the result about modified RBC life span by RBC transfusion among great heterogeneous mammal animals. So evaluation in large mammal animal models needs to be further studied.

Rh antigen stability of mPEG modified red blood cells / 中国实验血液学杂志

The objective of study was to investigate the Rh antigen stability of mPEG-modified RBC. RBC membrane protein SDS-PAGE technology was used to analyze the combination of the mPEG modified RBC membrane protein with mPEG molecules; the RBC ghost coagulation test and 4 degrees C CPD-preserved modified RBC mixed with matched blood were used to observe the stability of RBC Rh antigen camouflaged by mPEG. The results showed that the blood groups of stored mPEG-modified RBC were kept consistency before or after simulating transfusion, i.e. mixture of modified RBC with matched bloods, while the plasma hemoglobin after simulating transfusion was not only within the normal range during the storage, but also less than that before simulating transfusion even after incubation at 37 degrees C. The electrophoresis pattern stained with iodine and Coomassie blue displayed the bands of mPEG combined with RBC membrane protein and the slow mobility of membrane protein. The hemagglutination of PEGylation RBC ghosts did not take place and mPEG still covered the antigen. In conclusion, mPEG-SPA can bind the erythrocyte with its extracted membrane protein in both ghosts and living erythrocytes.

Effect of human plasma on preservation of red blood cells / 中国实验血液学杂志

In order to study whether plasma can affect the structure and function of red blood cells during their storage period, the differences of pH value, concentration of K(+), Na(+), osmotic fragility, plasma hemoglobin, AchE, ATP, 2.3-DPG, P50 in suspended RBC, washed RBC, and RBC with various plasma volume at different storage times were compared. The results showed that plasma helped the blood to keep the RBC at high pH value, low K(+), high Na(+) and maintain RBC-ATP, oxygen carry capacity and deformability, but no effect on maintenance of osmotic fragility, and levels of plasma hemoglobin, AchE, ATP and 2.3-DPG was found in preservated blood. In conclusion, human plasma may be in favour of the preservation of red blood cells.