Platelet Transfusion Strategies for MASPAT-Matched Platelet Transfusion Failed Patient with Allogeneic Hematopoietic Stem Cell Transplantation / 中国实验血液学杂志

OBJECTIVE@#To investigate the causes of ineffectiveness of platelet transfusion with monoclonal antibody solid phase platelet antibody test (MASPAT) matching in patients with allogeneic hematopoietic stem cell transplantation and explore the strategies of platelet transfusion.@*METHODS@#A case of donor-specific HLA antibodies (DSA) induced by transfusion which ultimately resulted in transplantation failure and ineffective platelet transfusion with MASPAT matching was selected, and the causes of ineffective platelet transfusion and platelet transfusion strategy were retrospectively analyzed.@*RESULTS@#The 32-year-old female patient was diagnosed as acute myeloid leukemia (high risk) in another hospital with the main symptoms of fever and leukopenia, who should be admitted for hematopoietic stem cell transplantation after remission by chemotherapy. In the course of chemotherapy, DSA was generated due to platelet transfusion, and had HLA gene loci incompatible with the donor of the first transplant, leading to the failure of the first transplant. The patient received platelet transfusion for several times before and after transplantation, and the results showed that the effective rate of MASPAT matched platelet transfusion was only 35.3%. Further analysis showed that the reason for the ineffective platelet transfusion was due to the missed detection of antibodies by MASPAT method. During the second hematopoietic stem cell transplantation, the DSA-negative donor was selected, and the matching platelets but ineffective transfusion during the primary transplantation were avoided. Finally, the patient was successfully transplanted and discharged from hospital.@*CONCLUSIONS@#DSA can cause graft failure or render the graft ineffective. For the platelet transfusion of patients with DSA, the platelet transfusion strategy with matching type only using MASPAT method will miss the detection of antibodies, resulting in invalid platelet transfusion.

Correlation Analysis of Hemolytic Transfusion Reaction Induced by Low Titer Antibody / 中国实验血液学杂志

OBJECTIVE@#To establish the diagnostic process of low titer blood group antibody in the occurrence of adverse reactions of hemolytic transfusion.@*METHODS@#Acid elusion test, enzyme method and PEG method were used for antibody identification. Combined with the patient's clinical symptoms and relevant inspection indexes, the irregular antibodies leading to hemolysis were detected.@*RESULTS@#The patient's irregular antibody screening was positive, and it was determined that there was anti-Lea antibody in the serum. After the transfusion reaction, the low titer anti-E antibody was detected by enhanced test. The patient's Rh typing was Ccee, while the transfused red blood cells were ccEE. The new and old samples of the patient were matched with the transfused red blood cells by PEG method, and the major were incompatible. The evidence of hemolytic transfusion reaction was found.@*CONCLUSION@#Antibodies with low titer in serum are not easy to be detected, which often lead to severe hemolytic transfusion reaction.

Sequencing and Proteomic Analysis of Exosomes from Apheresis Platelets in Different Storage Periods / 中国实验血液学杂志

OBJECTIVE@#To investigate the changes of gene sequencing and proteomics of apheresis platelet (AP) exosomes in different storage periods and predict the function of AP exosomes in different storage periods.@*METHODS@#Platelets at different storage periods of 0 day (D0), 3 day (D3) and 5 day (D5) were collected, exosomes were extracted with Gradient centrifugation; gene sequencing and proteomic analysis were used to analyze the exosomes, and biological functions of platelet exosomes were analyzed and predicted by bioinformatics. Liquid mass spectrometry (LMS) was used to detect the changes and function prediction of exosomes proteins. The small RNA sequencing library was prepared, and the constructed library was sequenced and bioinformatics technology was used for data analysis.@*RESULTS@#AP exosome iTRAQ protein analysis showed that AP exosomes stored in D3 with 55 up-regulated proteins and 94 down-regulated proteins (P<0.05, FC<0.83 or FC>1.2), while AP exosomes stored in D5 with 292 up-regulated proteins and 53 down-regulated proteins (P<0.05, FC<0.83 or FC>1.2) as compared with D0. KEGG pathway analysis showed that the proteins were mainly involved in transport and metabolism, immune system, cancer, membrane transport and other processes. There were statistically significant differences between AP exosome miRNAs in different storage days (P<0.01). The number of miRNA up-regulated and down-regulated was 374 and 255 as compared with the number of platelet exosomes miRNA stored in D3 and D0, while that was 297 and 242 in D5 and D0, and 252 and 327 in D5 and D3, respectively. The target genes of differential platelet exosome miRNAs were analyzed by GO enrichment. Target genes of differential miRNA were mainly involved in membrane composition, mainly played molecular functions binding to proteins, and participated in biological processes of transcriptional regulation.@*CONCLUSION@#The exosome differential proteins and miRNAs in D5 are significantly different from those in the D0 of APs, and they are involved in various biological processes.

Preliminary Study on Screening and Identification of Lewis a Antigen Mimic Epitope in Alpaca Phage Display Nanobody Library / 中国实验血液学杂志

OBJECTIVE@#To establish a new method for synthesizing Lewis blood group antigens, that is, the mimotopes of Lewis blood group antigens were screened by using an alpaca phage display nanobody library.@*METHODS@#We selected mimotopes of the Lewis a (lea) antigen by affinity panning of an alpaca phage display nanobody library using a monoclonal anti-lea antibody. Enzyme-linked immunosorbent assay (ELISA) was used to test the affinity of the positive clones for the monoclonal anti-lea antibody, and the high-affinity positive clones were selected for sequencing and synthesis. Finally, the sensitivity, specificity and reactivity of the synthesized lea mimotope in clinical samples were verified by ELISA.@*RESULTS@#A total of 96 phage clones were randomly selected, and 24 were positive. Fourteen positive clones with the highest affinity were selected for sequencing. The result showed that there were 5 different sequences, among which 3 sequences with the highest frequency, largest difference and highest affinity were selected for expression and synthesis. The sensitivity and specificity of lea mimic antigen by ELISA showed that, the minimum detection limit of gel microcolumn assay (GMA) and ELISA method were 25 times different, and the lea mimic antigen had no cross reacted with the other five unrelated monoclonal antibodies(P<0.001). Finally, 30 clinical plasma samples were analyzed. The mean absorbance of the 15 positive plasma samples was significantly higher than that of the 15 negative plasma samples (P=0.02). However, the positive signal values of the clinical samples were much lower than those of the monoclonal antibodies.@*CONCLUSION@#A new method of screening lea mimic antigen by using alpaca phage nanoantibody library has been established, which is expected to realize the screening of lea mimotopes, thus realizing the application of high-sensitivity detection methods such as ELISA and chemiluminescence in blood group antibody identification.

A Novel Lyophilized PRP-Loaded Gel Based on Chitosan and PEG with Hemostatic and Antibacterial Properties / 中国实验血液学杂志

OBJECTIVE@#A dynamic gel loaded with lyophilized platelet-rich plasma-chitosan/difunctionalized polyethylene glycol (LPRP-CP) was prepared to investigate its hemostatic antibacterial and promoting wound healing of scald wounds through in vitro and in vivo experiments.@*METHODS@#In this study, normal gauze/blank tablet (Ctrl), LPRP-CP, Chitosan HUCHUANG Powder(Chito P)and ChitoGauze XP PRO group (Chito G group) were set. The hemostatic effect and promoting healing effect of the four groups of materials were evaluated by establishing rabbit ear artery hemorrhage model and superficial Ⅱ° scalded model of skin on the back. The hemostatic time and bleeding amount were calculated and the gross and histological results of scald healing were observed. The antibacterial effect of the four groups of materials was evaluated by antibacterial test in vitro.@*RESULTS@#In the rabbit ear arterial hemorrhage model, the hemostasis of all materials was successful. The hemostatic time of Ctrl, Chito P, LPRP-CP and Chito G groups was 213.33±38.30, 118.33±24.01, 115.00±8.37 and 111.67±11.69 s, respectively. The blood loss was 1233.83±992.27, 346.67±176.00, 193.33±121.47 and 147.50±80.66 mg, respectively. Compared with Ctrl, the hemostasis time of LPRP-CP, Chito P and Chito G group was significantly shorter (P<0.001), and the amount of blood loss of LPRP-CP and Chito G group was decreased (P<0.05). Compared with LPRP-CP, there were no significant differences in hemostatic time and blood loss between Chito P and Chito G group (P>0.05). In the model of superficial Ⅱ° scalded on the back of rabbit, the wound healing rate of LPRP-CP was faster than that of the other three groups at the same time, and the healing effect was perfect. In the antibacterial test in vitro, only LPRP-CP had better anti-S. aureus effect, and all groups had no anti-E. coli effect.@*CONCLUSION@#LPRP-CP is an excellent hemostatic material for superficial wounds, and has certain antibacterial and wound healing effects, which has a wide academic value and research prospects.

Retrospective Analysis of Serological Characteristics and Distribution of Patients with Mimicking Antibodies / 中国实验血液学杂志

OBJECTIVE@#To understand the characteristics of patients with mimicking specificity autoantibodies through the analysis of the causes of autoantibodies, specificity of antibodies, strategy of blood transfusion, effect of transfusion and distribution of antibodies in China and abroad.@*METHODS@#A total of 23 patients who applied for blood in our hospital from January 2017 to June 2019 were identified as mimicking specificity autoantibodies by antibody identification or absorption-elution test. The causes of mimicking specificity autoantibodies, antibody specificity, blood transfusion strategy and blood transfusion effect were analyzed. The relevant articles on antibodies published in China and abroad were summarized and sorted out, and the distribution of antibodies was analyzed.@*RESULTS@#All the 23 patients with mimicking specificity autoantibodies were Rh blood group system antibodies, of which mimicking anti-Ce autoantibodies were the most common (34.8%), followed by mimicking anti-e autoantibodies (26.1%), mimicking anti-D autoantibodies (21.7%), mimicking anti-C autoantibodies (8.7%) and mimicking anti-E autoantibodies (8.7%). Except for 2 cases with suspected history of blood transfusion, the other 21 cases had a history of blood transfusion / pregnancy. The most common cause of mimicking autoantibodies was drug, followed by infection and autoimmune diseases. The hemoglobin (Hb) of pretransfusion in the blood transfusion group was (48.4±23.9) g/L, which was significantly lower than (86.0±38.9) g/L in the non-transfusion group (P<0.01). Except for 2 cases who could not evaluate the effect of blood transfusion, the effective rate of transfusion was 100%. According to the retrospective statistics of 32 related articles published in China and abroad, the most type of mimicking antibodies were in Rh blood group system, accounting for 79.28%, among which anti-E was the main part of all mimicking autoantibodies, accounting for 21.95%. The following ones were in Kidd system MNSs system, and Kell system.@*CONCLUSION@#Combined with the clinical symptoms and the degree of difficulty of blood matching, the best strategy of blood transfusion should be selected to ensure the safety of blood transfusion.

Research Progress of in Vitro Experiment of Allergic Transfusion Reaction for Plasma Transfusion and Its Relative Mechanism---Review / 中国实验血液学杂志

Allergic transfusion reaction (ATR) caused by plasma transfusion is one of the main adverse transfusion reactions, and severe allergic reactions may even endanger the patient's life. Currently, ATR is mainly prevented and controlled by drug prevention and symptomatic treatment, and there still lack of preventive measures such as in vitro experiments. It has been shown that mast cells and basophils are the main effector cells of allergic reactions, and histamine is one of the main mediators of IgE-mediated allergic reactions. Some experiments can be used to identify patients with allergies or plasma components containing allergens, such as detection of serum-specific IgE, IgA, anti-IgA antibody, tryptase and histamine, mast cell degranulation test, basophil activation test, and so on. The basophil activation test can also be used for functional matching of plasma in vitro. Research of in vitro experiment of ATR is good for directing the precise infusion of plasma, reducing waste of resources, and avoiding the risk of blood transfusion. As a pre-transfusion laboratory test for clinical use, in vitro experiment of functional matching provides a new way to prevent ATR.

Research Advance on Preparation Technology and Application of Virus-inactivated Lyophilized Plasma---Review / 中国实验血液学杂志

Lyophilized plasma has a certain advantage in emergency situation, such as war wound treatment. However, lyophilized plasma has two major problems, plasma pathogen pollution and mass loss after lyophilized. Studies have shown that plasma pathogen inactivation technology targeting pathogen envelope or nucleic acid can ensure its safety, and adding citric acid and glycine to plasma can effectively maintain pH and protein activity of plasma after reconstitution. At present, there are three kinds of lyophilized plasma products on the market abroad, but none for China. Therefore, understanding the research progress of lyophilized plasma may contribute to the development of similar products in China.

Detection of Autoimmune Hemolytic Anemia Induced by Salvianolate and Evaluation of Blood Transfusion Efficacy / 中国实验血液学杂志

OBJECTIVE@#To evaluate the characteristics of autoimmune hemolytic anemia caused by salvianolate by antibody detection and clinical index monitoring.@*METHODS@#Micro-column gel anti-human globulin method was used for irregular antibody screening and antibody identification. Salvianolate, sodium creatine phosphate and levocarnitine were used to sensitize red blood cells that were compatible with the patient's plasma, and the RBCs were used to test drug antibody in patient plasma respectively. The patient's clinical examination of hemolysis index and blood transfusion effect were analyed retrospectively.@*RESULTS@#The patients were positive for irregular antibody screening, and there were antoanti-Ce antibodies in serum. The erythrocytes sensitized with salvianolate in the patient's serum were positive, while those sensitized with sodium creatine phosphate and levocarnitine were negative.@*CONCLUSION@#Salvianolate causes drug-induced autoimmune hemolytic anemia in this patient.

Analysis on Factors Influencing Posttransfusion Effectiveness in Plasma Transfusion of 4423 Cases-Times / 中国实验血液学杂志

OBJECTIVE@#To investigate the related factors influencing plasma transfusion efficacy so as to improve the plasma transfusion efficiency.@*METHODS@#According to the clinical symptoms and the laboratorial results, the patients were divided into transfusion efficient and inefficient groups. A total of13090.8 units of plasma were transfused to 4423 patients. The clinical symptoms and the hemorrhage related index per- and pro-transfusion, plasma components sorts, storage time, and the dose of plasma (kg/ml) transfusion were analyzed.@*RESULTS@#The largest transfusion volume of plasma were in intensive care unit (ICU) accounted for 30.36%, the largest blood plasma per patient transfusion was in cardiac surgery (3.96 U). The analysis of transfusion efficiency showed that in terms of patient age, there were difference in transfusion efficiency among the patients with different ages (P＜0.001). The effective transfusion rate in the group of age ＜18 was 53%, which was higher than that in group of age 18-60(41%) and group of age ＞60 (30%); in terms of sex, the effective transfusion rate in female group was higher than that in male group (42% vs 37%) (P＜0.001); in terms of transfusion plasma volume/body weight, there were differences in transfusion efficiency (P＞0.05). The multi-factor logistic regression analysis showed that there was no significant correlation among the plasma sorts, storage time of the plasma pre-transfusion and transfusion efficiency(P＞0.05). The analysis of the non-hemolytic fever reaction caused by plasma transfusion revealed that there was no statistical difference between the plasma and the leukocyte-depleted plasma groups (P＞0.05).@*CONCLUSION@#The plasma transfusion effectiveness relates with age and sex, but not relates with the transfusion plasma voume/body weight, plasma sorts, and the duration of storage.

Evaluation and Comparison of Thromboelastography and Conventional Coagulation Tests for Blood Coagulation Function in Children with Henoch-Schönlein Purpura / 中国实验血液学杂志

OBJECTIVE@#To evaluate the coagulation function of children with Henoch-Schönlein purpura (HSP) by thromboelastography (TEG) and conventional coagulation tests (CCTs), and to explore the correlation and consistency of the 2 test methods.@*METHODS@#A total of 468 children with HSP were selected from January 2017 to December 2017 in Beijing Children's Hospital, Capital Medical University. The TEG and CCTs data were analyzed to evaluate coagulation function of children with HSP, meanwhile, the coagulation results were analysed the superiority of the 2 test methods was compared by Pearson correlation and Kappa consistency analysis.@*RESULTS@#There were no clinically significant abnormalities practically in HSP children by TEG and CCTs analysis, except for D-dimer level was elevated (t=9.15, P＜0.001). There were no significant changes for coagulation data from, sex comparison of HSP children (P＞0.05 all), but the coagulation reaction time (R), blood clot formation time (K), α-Angle, CI value, fibrinogen, D-dimer and anti-thrombin III in HSP children with different age groups showed difference (P＜0.05 all), and the blood in children aged 0-2 years old tended to be hypercoagulable. The TEG indexes demonstrated no significant difference in coagulation function of children with HSP each other (P＞0.05). However, CCTs data showed that the blood in children with severe kidney involvement were hypercoagulable. Comparision results of the correlation and consistency of TEG and CCTs in detecting coagulation function of HSP children showed that R was weakly correlated with prothrombin time (PT), International Normalized Ratio (INR) and activated partial thromboplastin time (APTT). There were weak correlation between K, α-Angle and Fib (0.1＜|r|＜0.4 all). There was no obvious consistency between them each other (kappa＜0.4 all).@*CONCLUSION@#The overall changes in coagulation function in children with HSP are not obvious, but the hyperfibrinolysis in hypercoagulable state may exists. Furthermore, younger age and severe kidney involvement may cause hypercoagulation in HSP children. The weakly correlation and consistency of TEG and CCTs in detecting coagulation function of HSP children are furtherly confirmation, and the 2 test methods may be irreplaceable.

Effect of Storage Time on Cumulation of Platelet-related Growth Factors in the Supernatant of Leukoreduced Packed Red Cells and Tumor Cell Proliferation In Vitro / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the effect of storage time on accumulation of platelet-related growth factors in the supernatant of leukoreduced packed red blood cells (LR-pRBC) and on tumor cell proliferation in vitro.</p><p><b>METHODS</b>LR-pRBC were quartered and stored at 2 °C-6 °C. The supernatant of pRBC was obtained by centrifugation with 1 006 × g for 10 min at day 0, 14, 21 and 35 d. The enzyme-linked immunosorbent assay (ELISA) was used to detect the expression of platelet-derived growth factor(PDGF) and vascular endothelial growth factor (VEGF). After HepG2 cells was cultured with the supernatant of LR pRBC at day 0 and day 35 together for 48 hours, methylthiazoliltetracolium (MTT) method was used to measure the proliferation of tumor cells in vitro.</p><p><b>RESULTS</b>The concentrations of 2 cytokines were still increased with the storage time prolonging. As compared to LR-pRBC at day 0 [611.84 (95%CI, 356.45-867.23) pg/ml], the level of VEGF reached 900.16 (95% CI, 552.26-1248.07) pg/ml (P<0.05). There was a similar tendency in PDGF level with less increment in the supernatant of LR pRBC at day 35 [2.23 (95% CI, 0-5.37) ng/L vs 5.66 (95% CI, 0-12.48), P=0.073], but there was no significant statistical difference. Likewise, in vitro study of HepG2 cell proliferation showed that the LR-pRBC at day 35 promoted more proliferation of tumor cells with OD value 0.40 (95% CI, 0.38-0.42) (P<0.05).</p><p><b>CONCLUSION</b>The residual platelets in LR-pRBC were activated, disintegrated and released the dense granules and α-granules which induce the accumulation of VEGF and PDGF. It seemed that the supernatant of LR-pRBC promoted the proliferation of tumor cells in vitro.</p>

Analysis of Factors Influencing Posttransfusion Effectiveness in 26045 Cases of Platelet Transfusion / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To investigate the factors influencing platelet transfusion results so as to improve the platelet transfusion efficiency.</p><p><b>METHODS</b>According to the clinical symptoms (bleeding condition is stopped or improved)and the corrected count of increment (CCI), the patients were divided into efficient transfusion and inefficient transfusion groups. A total of 20 671 patients' clinical data and main platelet transfusion parameters in 26 045 tranfusions including platelet count of per- and post- transfusion, platelet component sorts, storage time and transfusion number were analysed.</p><p><b>RESULTS</b>The comparison of platelet transfusion efficiency in age and sex between two groups did not showed statistical difference (P > 0.05), the platelet count before transfusion between two groups showed statistical difference (t = -5.59, P < 0.001) after converting to log, a significant linear correlation did not exist between storage time of the platelet and CCI (corrected count of increment), but there was statistical difference in transfusion efficiency of patients with different diseases. The patients with hematologic diseases showed lower efficiency of platelet transfusion. According to the results of Wilcocon test detection, there was difference between different times of transfusion and transfusion efficiency, that is to say, the transfusion frequency was higher, the transfusion efficency was lower. The Fisher test indicated that the transfusion efficiency of single platelet transfusion was lower than that of transfussed platelet with other blood components (P < 0.01).</p><p><b>CONCLUSION</b>Platelet transfusion efficiency associates with many factors, including different diseases, whether being transfused with other blood components, the platelet count before transfusion, transfusion frequency, but the time of storage does not relate to the transfusion efficacy.</p>

Effect of 25 Gy (60)Co Irradiation on the Physico-chemical Property and Functions of the Platelets During Storage / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To evaluate the effects of the 25 Gy ⁶⁰Co irradiation on the physiological and biochemical properties and the functions of the platelets during storage.</p><p><b>METHODS</b>A total of 15 bags of platelets were apheresis-collected from 15 healthy donors, and each bag of platelets were divided into 2 parts, then the platelets were divided into the control group (without 25 Gy ⁶⁰Co irradiation) and the irradiated group (with 25 Gy ⁶⁰Co irradiation) groups. The two groups of platelets were kept under the condition of (22 ± 2) °C and shaken. The Platelet count and pH value were detected on the d 1, d 2, d 3, d 4 and d 5. The variables such as R, K values, α angle and maximal amplitude (MA) were measured by thrombelastography on the same days. Hypotonic shock response (HSR), morphological score were devised.</p><p><b>RESULTS</b>There were no statistically significant difference in Plt counts, mean platelet volume (MPV), platelet distribute width (PDW) and pH between the two groups (P > 0.05), and Plt count decreased on the end of storage. There were no marked changes in HSR level and morphological score between the two groups during storage, and there were no significant difference between the two groups (P > 0.05). In the TEG analysis there were no significant difference of the R, K, α angle and MA values between the two groups (P > 0.05). R value showed upward trend increased along with prolongation of preserved time (P < 0.01), no significant changes in α angle (P > 0.05), K value was slightly higher and MA value was lower in the last day of storage than the days 1-4 (P < 0.01), respectively.</p><p><b>CONCLUSION</b>25 Gy ⁶⁰Co gamma-ray irradiation can not damage the physiological, biochemical properties and the functions of the platelets during storage. In order to ensure the best curative effect, it is suggested that no matter the platelets were irradiated or not, the platelets should be used as soon as possible.</p>

Prevalence and Specificity of Red Blood Cell Alloantibodies in Patients from China During 1994-2013 / 中国实验血液学杂志

<p><b>OBJECTIVE</b>To analyze the data about red blood cell alloantibodies in patients from mainland China and to provide evidence for formulating a management guideline.</p><p><b>METHODS</b>The Chinese and English literatures about Chinese patients in mainland China published in periodicals were retrieved by CHKD, CNKI, CMJD and PubMed using the key words as unexpected antibody, irregular antibody, blood group antibody, hemolytic transfusion reaction (HTR), hemolytic disease of the newborn (HDN), hemolytic disease of the fetus and newborn (HDFN).</p><p><b>RESULTS</b>A total of 5582 red blood cell alloantibodies were retrieved from 4800 patients. The average prevalence of alloantibody in 89 retrospective analysis reports was 0.34 %. Among all study patients, the 10 most common antibodies were anti-E (33.9%), anti-D (18.3%), anti-c (10.9%), anti-M (9.9%), anti-C (8.1%), anti-e (4.8%), anti-Le(a) (3.4%), anti-P1 (2.0%), anti-Mur (1.6%), and anti-Jk(a) (1.2%). Out of all 136 patients with HTR, the most frequentl alloantibodies were Rhesus antibodies (71.7%), and other antibodies included anti-Jk(b) (5.9%), anti-Le(a) (5.1%), anti-Jk(a) (3.7%), anti-M (1.5%), and anti-Mur (1.5%). A total of 644 alloantibodies contributing to HDFN come primarily from the Rhesus (93.1%) and MNS (6.0%) blood group systems.</p><p><b>CONCLUSION</b>The postnatal Rh prophylaxis should become a routine procedure in mainland China. The use of blood matched for C, E, c, e, Jk(a) and Jk(b) should be recommended for Chinese patients with a history of multiple transfusions. Patients with MNS alloantibodies should be given sufficient attention, and Mur+ red blood cells should be included in antibody screening panels.</p>

Research achievements on biological activities of calycosin / 中国中药杂志

Calycosin, which is a kind of typical phytoestrogen, can bind with estrogen receptor and produce estrogen-like effects. Calycosin were reported to have antioxidant, anti-osteoporosis, anti-tumor and immunomodulating activities. This review covers biological activities and its mechanism of calycosin. It will provide a useful reference for clinical research and rational utilization of monomericompound.

Effect of leukoreduction on tumor-associated cytokine accumutation in supernatant of stored packed red cells and its effect on tumor cell proliferation in vitro / 中国实验血液学杂志

<p><b>OBJECTIVE</b>This study was to investigate whether prestorage leukoreduction could decrease the accumulative concentration of tumor-associated cytokines in supernatant of stored packed red blood cells (pRBC) and to study the effect of prestorage leukoreduction on proliferation of HepG2 tumor cells by in vitro. The leukoreduced (LR) and non-leukoreduced (NLR) pRBC were equally obtained from one donation and were stored under 2 °C-6°C. The supernatants of pRBC in these two group were performed by centrifugation with 1 006×g for 10 min at day 0 and 35 d. The enzyme-linked immunosorbent assay (ELISA) was used to detect the expression of normal T cells and secretory factor (RANTES/CCL5), as well as the accumulative concentrations of tumor-necrosis factor (TNF-α), platelet derived growth factor (PDGF), vascular endothelial growth factor (VEGF) and monocyte chemotactic protein-1 (MCP-1) in pRBC supernantant of above-mentioned two groups. After HepG2 cells was cultured with the supernatant of NLR-pRBC and LR-pRBC at the end of day 35 together for 48 hours, the methyl thiazolil tetracolium (MTT) method was used to measure the proliferation of tumor cells in vitro.</p><p><b>RESULTS</b>The accumulative concentration of 5 cytokines in supernatants of above menthioned two groups increased in different degrees along with the prolongation of storage time,that is, the accumulative concentrations of 5 cytokines at 35 d were higher than that at day 0, in which the change of VEGF accumu-lative concentration showed statistical significance, its accumulative concentration in NLR group at day 35 elevated to 549.61 ± 299.43 pg/ml, and was higher than that in LR group (95.46 ± 110.87 pg/ml) (P < 0.05). The experiment of HepG2 cell proliferation indicated that the supernatant of LR pRBC group produced less proliferation of tumor cells with OD value 0.40 (95% CI, 0.38-0.42) than that of NLR pRBC group with OD value 0.49 (95% CI, 0.43-0.55) (P < 0.05).</p><p><b>CONCLUSION</b>The prestorage leukoreduction has been confirmed to decrease the accumulative level of cytokines, particalarly decrease the accumulative level of VEGF, moreover, it may be a factor for inhibiting the proliferation of tumor cells in vitro.</p>

Influence of "dosage effect" on unexpected antibody identification / 中国实验血液学杂志

<p><b>OBJECTIVE</b>This study was to investigate the influence of "dosage effect" on unexpected antibody identification and explore its condition, scope and regularity.</p><p><b>METHODS</b>A total of 40 blood recipient samples containing definite unexpected antibodies were selected by column agglutination technology, then AB fresh plasma was used to dilute the samples to obtain different concentrate liquid. After selecting panel cells which show positive with corresponding unexpected antibody in the serum, "single dosage" antigens were distinguished from "double dosage" ones, and then the antigen-antibody reactions were observed between "single dosage" panel cells and respective diluted recipient samples (by column agglutination technology). It's believable that the highest concentration which retains a negative result was choose to evaluate the agglutination strength between "double dosage" panel cells and diluted unexpected antibody, and to observe the difference happened at different "dosage" antigens with unexpressed antibody.</p><p><b>RESULTS</b>Among 40 diluted recipient samples detected by column agglutination technology, the "dosage effect" appeared in 31 diluted samples. There were 30 samples in which the unexpected antibody agglutinated "double dosage" antigens ≤ 2+, while "single dosage" antigens negative. It appeared in another 1 diluted sample, in which the unexpected antibody agglutinated "double dosage" antigens 3+. There were 9 diluted samples in which the unexpected antibody agglutinated panel cells showing negative results (strength was between 1+-3+ before dilution).</p><p><b>CONCLUSIONS</b>When the unexpected antibodies in Rh, MNS, Kidd, Duffy agglutinated "double dosage" antigens ≤ 2+ (by column agglutination technology) , "single dosage" antibody reaction maybe weaken, even be negative, and it may cause the "dosage effect" to interfere the unexpected antibody identification. The "dosage effect" appears in Rh, MNS, Kidd, Duffy blood system usually.</p>

Investigation and analysis of blood transfusion in 1 766 hospitalized trauma patients / 中国实验血液学杂志

<p><b>OBJECTIVE</b>The study was to understand the incidence of traumatic coagulopathy and the clinical blood transfusion in hospitalized trauma patients so as to provide a reference for guiding scientific component transfusion in trauma or surgical patients.</p><p><b>METHODS</b>By using a software "clinical transfusion database" developed by our department, 1 766 trauma cases who suffered traumatic injury and required hospital admission between 2001 and 2012 were retrieved, and out of them 1 211 patients were given transfusion, and the transfusion-related indicators of the patients such as coagulation, hemoglobin levels before transfusion, trauma situation, massive blood transfusion and total blood transfusion were retrospectively analyzed. According total volume of blood usage during hospitalization,1 211 cases with transfusion were divided into three groups: low volume transfusion group ( ≤ 5 U, n = 471), moderate volume transfusion group (5-10 U, n = 449) and high volume transfusion group (>10 U, n = 291), then the difference of indicators among the 3 groups was compared, and the risk factors of high volume transfusion were analyzed.</p><p><b>RESULTS</b>There were 33 cases of coagulopathy and 52 cases of massive transfusion in trauma patients with transfusion. The transfusion rate of trauma patients was about 68.6%. There was no association between the total amount of blood transfusion and surgical grade or whether surgery. The most patients were transfused using two components (plasma and red blood cell), the ratio of plasma to RBC transfused in patients with coagulopathy was approximately 1.0. In high volume transfusion group, there were more younger and male patients with more serious injury, their infection and death were significantly higher than that in other two groups (P < 0.01).</p><p><b>CONCLUSION</b>There were approximately 69% of hospitalized trauma patients require transfusion, the patients in high volume transfusion group have two populations such as middle-aged and young men who was vulnerable to severe trauma mainly caused by accident injury or fall injury and older women who was vulnerable to osteoporotic hip fractures mainly caused by fall injuries. The coagulation disorders in the patients with trauma coagulopathy should be corrected by transfusion with high ratios of plasma to RBC. Massive transfusion (OR = 95.22), hemorrhagic shock (OR = 17.2), trauma coagulopathy (OR = 4.52) are risk factors of high volume transfusion > 10 U, and massive transfusion also is a risk factor of trauma coagulopathy (OR = 16.257). The routine dynamic monitoring of coagulation should be performed for trauma or surgical patients to guide the clinical transfusion scientifically.</p>

Preparation of tranexamic acid-loaded porous starch and evaluation of its hemostatic ability / 中国实验血液学杂志

This study was aimed to develop a new generation of ideal hemostatic powder which can be safely, effectively and easily used mainly to first aid anterior to hospital by the synergistic effect of physical and chemical hemostatic mechanisms. The tranexamic acid(TA)-loaded porous starch(PS) (TAPS) was prepared by using PS as carrier and TA as loaded drug component. The absorption property of TAPS was evaluated by water absorption; the hemostatic ability of TAPS was evaluated by test in vitro and in vivo, the blood coagulation time of TAPS was detected by using Lee-white method. The experiment was divided into 3 groups: blank control group, Yunnan Baiyao group and TAPS group, each group with 10 blood samples in vitro test; the 27 SD rats were used to test in vivo, and randomly were divided into 3 groups: PS,Yunnan Baiyao and TAPS, each group consisted of 9 rats for establishing the animal model of liver trauma and detecting the complete hemostasis time. The results showed that the water absorption of PS did not be affected by TA when dose of TA loaded in PS was <0.02 g/g PS. There was no statistic difference in blood coagulation time between TAPS and PS groups(P > 0.05). The complete hemostatic time of TAPS for trauma of left lobe liver was 236.67 ± 55.00 seconds, which was shorter than that of Yunnan Baiyao (340.00 ± 73.48 seconds) and PS (396.67 ± 68.37 seconds) (P < 0.05 and P < 0.01, respectively). It is concluded that PS can load TA and play the hemostatic effect through releasing TA; the TA loading <0.02 g/g PS did not affect the water absorption and pro-coagulation properties. The TA can enhance the hemostatic efficacy of PS, the hemostatic property of TAPS is derived from synergism of physical and chemical hemostatic mechanisms.