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【Objective】 To investigate the effect of phenotypes of Duffy blood group on chemokine storage and chemokine scavenging function of erythrocytes. 【Methods】 Twenty-four erythrocyte samples were collected and tested Duffy blood phenotype using the anti-human globulin method, and erythrocyte CCL2, CCL5, CXCL8, and CCL11 content and their chemokine scavenging function using ELISA. The expression of Duffy antigens on erythrocytes was detected using a flow analyzer. 【Results】 The difference in CCL2 content(41.1±14.7 pg/mL vs 63.1±20.8 pg/mL)of erythrocyte lysate between Fy(a+b-) and Fy(a+b+) phenotype was statistically significant (P0.05).The difference in the scavenging function of CCL2(1471±202.1 pg/mL vs 1860±267.5 pg/mL)and CCL5 (848.5±461.7 pg/mL vs 1797±546.1pg/mL) between Fy(a+b-) and Fy(a+b+) phenotype were statistically significant (P0.05).The difference in Duffy antigen expression (mean fluorescent intensity:105.3±20.45 vs 111.9±18.30)on erythrocytes between Fy(a+b-) and Fy(a+b+) phenotype was not statistically significant (P>0.05). 【Conclusion】 The Fy(a+b+) and Fy(a+b-) phenotypes of the Duffy blood group can affect the chemokine storage and scavenging function of erythrocytes. Fy(a+b+) phenotypes are able to store more chemokines and have a stronger chemokine scavenging function than Fy(a+b-) phenotypes.
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【Objective】 To validate the performance of a nucleic acid testing(NAT) system for blood screening in the high-altitude Nagqu region of Tibet, in order to assess the capability of NAT in high-altitude areas and further enhance blood safety. 【Methods】 Various methods were employed to evaluate the analytical sensitivity, reproducibility, ability to prevent cross-contamination, and comparison between different NAT systems. 【Results】 The NAT system in the Nagqu region of Tibet achieved a 100% detection rate for high-concentration HBV DNA and HIV-1 RNA samples, and over 90% for medium-concentration samples. PROBIT analysis revealed the lower limits of detection (LOD) for HBV DNA and HIV-1 RNA to be 8.29 IU/mL (95% CI, 5.88~20.55 IU/mL) and 40.52 IU/mL (95% CI, 30.26~85.92 IU/mL), respectively. For HCV RNA genotype 2a, the LOD was 97.14 IU/mL (95% CI, 71.00~182.67 IU/mL), all of which were lower than the declared minimum detectable concentrations in the instructions. Reproducibility analysis demonstrated a 100% level of consistency within the system. Cross-contamination performance verification showed a strong ability to resist cross-contamination. Comparative analysis of repeated testing of low-concentration HBV DNA samples and multi-system testing in plain areas revealed consistency rates of 77.78%(14/18) and 77.27%(17/22), respectively, indicating certain differences between the NAT system in Nagqu region and other systems. 【Conclusion】 The NAT system exhibited excellent performance in blood screening at high altitudes. The results of performance validation in high-altitude blood screening NAT systems were largely consistent with those in plain areas, providing a reliable basis for enhancing blood safety in high-altitude regions.
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【Objective】 To investigate the expression characteristics of ABO gene mRNA in peripheral blood of patients with acute myeloid leukemia. 【Methods】 The RNA-seq data of acute myeloid leukemia in TCGA database and the whole blood RNA-seq data in GTEx database were downloaded. The difference of ABO gene mRNA expression between acute myeloid leukemia and GTEx whole blood samples was analyzed by R software, and the relationship between ABO gene mRNA expression and DNA methylation, immune infiltration and prognosis was analyzed. 【Results】 The expression level of ABO gene mRNA in acute myeloid leukemia(median: 1.333, P25: 3.654, P75: 0.401)was significantly lower than that in the control group(median: 3.576, P25: 3.747, P75: 3.470)(P<0.001). The expression level of ABO gene mRNA in acute myeloid leukemia was negatively correlated with the methylation of + 82(r=-0.249, P<0.001), + 618(r=-0.268, P<0.001), + 1 080(r=-0.105, P<0.001) and + 1 409(r=-0.210, P<0.001) at downstream of transcription start site, and positively correlated with the immune infiltration of nine types of immune cells (B cells, CD8 T cells, Cytotoxic cells, pDC, T cells, T helper cells, Tcm, Tfh and Treg) (P<0.001). There was no significant difference in overall survival between patients with high (median survival time: 366 days, confidence interval: 304-731 days) and low (median survival time: 731 days, confidence interval: 335-1 402 days) expression of ABO gene mRNA in acute myeloid leukemia (P>0.05). 【Conclusion】 The mRNA expression of ABO gene in peripheral blood of patients with acute myeloid leukemia is decreased, which is associated with DNA methylation of the first intron of ABO gene and immune infiltration, but not with the prognosis.
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【Objective】 To investigate the voluntary blood donation status across China under COVID-19 epidemic in 2020 and the corresponding countermeasures, so as to provide reference for blood center staff. 【Methods】 A questionnaire of Survey of Blood Collection and Supply under COVID-19 Epidemic in 2020 was issued by Blood Donor Mobilization Committee of Chinese Blood Transfusion Association to conduct the data survey on blood collection and supply institutions nationwide. 【Results】 The valid data of 115 cities were collected, and detailed data of whole blood and platelet collection, clinical blood consumption, and measures taken to ensure clinical blood use under COVID-19 epidemic from 2019 to 2020 were obtained. The total volume of whole blood collection in the 115 blood supply institutions in 2020 (13 262 724.36 U)decreased by 4.83% compared with the same period in 2019(13 935 131.5 U), and the total units of platelet collection(1 582 494.5 U)was basically the same as that in 2019(1 581 139.5 U). The total clinical consumption of RBCs from the 115 blood banks in 2020(14 257 441.67 U)decreased by 3.68% compared with that in 2019(1 4801 404.19 U), and the total clinical consumption of platelets(1 738 546.42 U)was basically the same as that in 2019(1 731 037.70 U). With the support of governments at all levels, blood banks have basically guaranteed the clinical blood supply under the epidemic by organizing group blood donation for emergency, making appointments for blood donation, recruiting regular blood donors by phone and text messages, strengthening media publicity and launching haemovigilance. 【Conclusion】 The government attaches great importance to blood safety in public emergencies and plays a leading role. Making appointments for blood donation, recruiting regular blood donors through telephone and text messages and strengthening media publicity play an important role in emergency blood donation. Blood banks should cooperate closely with hospitals to coordinate emergency management of clinical blood, and took various measures to broaden sources and reduce transfusions, so as to effectively guarantee clinical blood supply during the epidemic.
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【Objective】 To establish a reasonable and effective blood screening strategy for Hepatitis C virus (HCV), so as to reduce the risk of blood transfusion transmission, ensure blood safety and improve the quality of blood screening. 【Methods】 In order to evaluate HCV screening strategies comprehensively, the unqualified blood donations due to anti-HCV alone positivity in Dalian from 2017 to 2021 was tracked, with combined detection methods of electro-chemiluminescence immunoassay (ECLIA) and HCV-RNA nucleic acid test (NAT). 【Results】 A total of 851 (0.20%) unqualified donations due to anti-HCV alone positivity were screened from 2017 to 2021, with a decreasing trend in both numbers and rate. Among them, the unqualified rate of samples with anti-HCV reactivity in both dural-ELISA-reagent and NAT decreased significantly (P<0.05). A total of 117(0.028%) samples were anti-HCV reactive in dural-ELISA-reagent but nonreactive in NAT; 664 reactive in one-ELISA-reagent, with 70(10.54%) in Reagent Ⅰ and 594(89.46%) in Reagent Ⅱ; 122 (35.88%) out of 340 donations were reactive in ECLIA. Among the 28 participants in the follow-up test, 15 still were reactive in ELISA and 2 reactive in ECLIA. 【Conclusion】 Although the unqualified rate of HCV is decreasing, serological screening of anti-HCV is still an important method for ensuring blood safety, and its complementarity with HCV-RNA NAT should be evaluated. As a new serological assay, ECLIA has high sensitivity and specificity. Miss detection may occur if only one ELISA reagent is adopted for anti-HCV detection. Appropriate ELISA and NAT system for HCV screening should be reasonably chosen, and HCV screening strategy should be developed and adjusted according to the local conditions.
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【Objective】 To analyze the related factors affecting perioperative blood transfusionin patients undergoing totalhysterectomy, explorethe effective measures to reduce allogeneic blood transfusion and provide data for the establishment of clinical blood transfusion single-disease evaluation index of total hysterectomy. 【Methods】 747 cases of total hysterectomy from three grade-A tertiary general hospitals and onematernal and child health care hospitalin Dalian wereselected, and divided into transfusion group(n=69)and non-transfusion(n=678). Detailed information was collected and analyzed, including patient demographics, operation information, blood routine before operation, postoperative recovery and transfusion volume. 【Results】 9.2%(69/747)of total hysterectomy patients received blood transfusion, with per capita red blood usageof(0.4±2.1)U. The age, operative time, volume of intra-operationbleeding, pre-operationhemoglobin(Hb) level, length ofhospital stay, types and days of antibiotics use between transfusion group and non-transfusion groupwere (49.7±9.1)vs(53±9.5)years old, (182.7±83.5)vs(119.5±64.8)min, (603±650)vs(160±173)mL, (96±26)vs(124±18)g/L, (9.3±4.8)vs(7.3±3.9)days, (2.2±1.1)vs(1.6±0.7)kinds, (6.0±3.9)vs (4.4±2.2)days, respectively, showing significant differences(P<0.05). Transfusion volumewas associated with volume of intra-operation bleeding (r=0.004), operative time (r=0.002) and Hb level of pre-operation(r=-0.022). 【Conclusion】 Blood management of patients undergoingtotal hysterectomy should be strengthened to reduce the incidence of allogeneic blood transfusion and improve patient outcomes by raising the pre-operation Hb level, shortening the operative time and reducing the volume of intra-operation bleeding.
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Objective By studying the different blood volume blood donors machine adopt platelet product aggregation,platelet content,the machine adopt circulating volume,etc,analysis of different blood volume machine adopt donors on appropriate conditions.Methods The base material of randomly selected 307 blood donors,through blood related index in the study of circulating volume,blood volume,gender,platelets,Hct,Pct count before collection,machine adopt of platelet aggregation and the relationship between the acquisition time;different blood volume,blood platelet count grouping machine adopt the different of platelet aggregation rate,different amount of platelets collect blood volume group,the comparison of blood circulation.The use of statistical software SPSS 17.0,data analysis,analysis including multiple regression analysis,chi-square test,t test,etc.Results 1)The lower count of platelets,Hct,Pct count before collection,the longer the acquisition time,and gender and Pct has nothing to do with the acquisition time the longer the acquisition time,the higher the machine adopt the possibility of platelet aggregation.2)Low blood volume and low platelet count group,machine mining platelet aggregation rate is higher.3)Machine adopt donors of blood volume is higher,the machine adopt the platelet collection amount,the more and the less blood circulation.Conclusion According to the different blood volume blood donors check-up indicators,further carries on the reasonable analysis,optimized machine mining scheme,especially to reasonable arrangement of low blood volume blood donors,so as to improve the quality of platelet collection.
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Objective To investigate the expression and significance of Th9, Th17 and CD4+CD25+Foxp3+regulatory T (Treg) cells as well as the related cytokines (IL-9, IL-17, TGF-β) in peripheral blood of patients with adult primary immune thrombocytopenia ( ITP) . Methods Peripheral blood samples were collected from 47 patients with ITP and 39 age-and sex-matched healthy subjects. The percentages of Th9, Th17 and CD4+CD25+Foxp3+Treg cells in peripheral blood samples were detected with flow cytometry. The levels of IL-9, IL-17 and TGF-βin serum samples were detected by enzyme linked immunosorbent assay ( ELISA) . Results Compared with healthy subjects, the percentages of Th9 and Thl7 cells and the concen-trations of IL-9 and IL-17 in patients with ITP were significantly increased [(1. 27±0. 31)% vs (0. 71± 0. 26)%, P<0. 05;(2. 01±0. 42)% vs (0. 97±0. 32)%, P<0. 05. (26. 52±7. 48) ng/L vs (16. 16± 5. 27) ng/L, P<0. 05;(10. 97±3. 94) ng/L vs (7. 14±2. 73) ng/L, P<0. 05]. The percentages of CD4+CD25+Foxp3+ Treg cells and the concentrations of TGF-β in patients with ITP were lower than those in healthy subjects [(4. 69±0. 85)% vs (7. 16±1. 92)%, P<0. 05. (3. 76±1. 28) μg/L vs (6. 41±1. 83)μg/L, P<0. 05]. Moreover, the blood platelet counts in patients with ITP were negatively correlated with the percentages of Th9 and Th17 cells and the concentrations of IL-9 and IL-17 (γs=-0. 349, P=0. 037;γs=-0. 392, P=0. 031;γs=-0. 436, P=0. 014;γs=-0. 401, P=0. 027), but were positively correlated with the percentages of CD4+CD25+Foxp3+ Treg cells and the concentrations of TGF-β (γs=0. 411, P=0. 024;γs=0. 407, P=0. 026). Conclusion The imbalanced distribution of Th9, Th17 and Treg cells and the abnormal expression of related cytokines (IL-9, IL-17 and TGF-β) in patients with ITP might be the possible immunological pathogenesis of ITP.
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Objective To evaluate the efficacy and safety of therapeutic drug monitoring (TDM ) based vancomycin dose adjustment in patients with gram‐positive infections .Methods A cohort study was designed with 128 inpatients undergoing TDM in Huashan Hospital from January 2005 to September 2014 .The clinical data of these patients were used to analyze the efficacy and safety of vancomycin therapy by Cox model and survival analysis .Results The patients undergoing TDM‐based dose adjustment had a higher daily dose and blood trough concentration ,which may lead to better bacteriological efficacy and overall efficacy .Cox proportional hazards model analysis showed that TDM‐based dose adjustment is a protective factor .No safety‐related risk factor was found .Conclusions TDM‐based vancomycin dose adjustment is important for patients to achieve better outcomes in fighting gram‐positive infections .
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Objective To analyze the relationship between plasma concentration and efficacy , adverse drug reactions by monitoring vancomycin serum concentrations for appropriately treating the infections caused by methicillin‐resistant Staphylococcus aureus or other gram‐positive cocci .Methods Vancomycin concentration was monitored in the patients with indications for vancomycin therapy .Blood sample was taken after vancomycin was administered for at least 4 doses .The blood sample collected within 30 minutes before dosing was used to determine the trough blood concentration .The samples were taken within 30 minutes to 1 hour after infusion of vancomycin were used to estimate the peak concentration by fluorescence polarization immunoassay .The clinical data were collected at the same time to analyze clinical efficacy and safety .Results Vancomycin trough concentration ranged from 3 .22 mg/L to 50 .79 mg/L in 25 patients ,specifically ,< 5 mg/L in 3 cases ,5‐<10 mg/L in 11 cases ,10‐15 mg/L in 3 cases ,and > 15 mg/L in 8 csaes .Peak concentration ranged from 13 .57 mg/L to 60 .47 mg/L ,specifically ,< 25 mg/L in 14 cases ,25‐40 mg/L in 7 cases ,and > 40 mg/L in 4 cases .The infection was cured in 80 .0% (20/25) of the patients .The gram‐positive cocci were eradicated in 87 .5% (21/24) of the patients .The dosage of vancomycin was adjusted in 13 patients according to the results of blood concentration monitoring .Majority of these patients (12/13 ,92 .3% ) were cured .Renal impairment was observed in 4 patients .Conclusions Vancomycin is safe and effective in treatment of methicillin‐resistant Staphylococcus aureus and other gram‐positive bacterial infections . Vacomycin concentration varies from person to person . Serum concentration monitoring is required to achieve best outcomes and the goal of individualized treatment of vancomycin.
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Objective To investigate the percentages of Th17 and CD4+CD25+FoxP3+ regulatory T(Tr) cells and the levels of related cytokines IL-6,IL-23,IL-17 and TGF-β in serum of patients with anlylosing spondylitis(AS).Methods Forty patients with AS and 37 age-matched healthy donors were studied.Flow cytometry Was used to analyze the percentages of blood Th17 and CD4+CD25+FoxP3+Tr cells.The levels of serum IL-6,IL-23,IL-17 and TGF-β were assayed by enzyme-linked immunosorbent assay ( ELISA).Results The proportion of Th17 cells in AS group was significantly higher than those in normal group [ (1.02±0.34)% vs (0.68±0.29)%,P<0.05) ],and the proportion of CD4+CD25+FoxP3+ cells was lower in AS group comparing with normal group [(3.77±0.81)% vs (4.69±1.23)%,P<0.05)].Meanwhile,serum levels of IL-6,IL-23 and IL-17 were significantly higher in AS group than those in normal group [ (6,15±2.71) ng/L vs (3.31±1.65) ng/L; (9.44±3.12) ng/ml vs (5.82±2.61) ng/ml;(10.53±4.97) ng/L vs (6.78±3.26) ng/L,all P<0.01 ].In contrast,TGF-β level was decreased in AS group compares with the normal group [ ( 4.76±2.15) ng/ml vs (5.16±2.02) ng/ml,P>0.05 ],but the difference was not significant.No associations of serum eytokine levels with clinical and laboratory parameters were found in AS.Conclusion The abnormality Th17 cells and Tr cells and their related cytokines IL-6,IL-23,IL-17 and TGF-β changes in patients with AS,which may be involved in immunological pathogenesis of AS.
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A new type of killer cells, named PHA-?CD3LAK, was induced by means of costimulating the peripheral blood mononuclear cells (PBMC) with anti-CD3McAb (?CD3) and rIL-2 after PHA-priming for 48 hours. Some biological characteristics of PHA-?CD3LAK, PHA-LAK and CD3AK were compared. The results showed that PHA-?CD3LAK exhibited some advantages over CD3AK and PHA-LAK in proliferation, cytotoxicity, the expression level of mIL-2R, as well as the utilizing of IL-2, suggesting the synergistic enhancing role of PHA, ?CD3 and IL-2. All three groups of effector cells were heterogeneous populations, predominantly CD3 + CD8 + T cells. The CD8 ~(+) cell percentage of PHA-?CD3LAK was higher than that of the other two groups. The application of PHA-?CD3LAK might open a new prospect to clinical therapeutic approach.