Measurement of Free Hemoglobin Percentage in Stored Packed Red Blood Cells Units by Colorimetric Method

Aims:To measure free hemoglobin percentage in stored packed red blood cells units by colorimetric method.Study Design:This is a descriptive, hospital based case study.Place and Duration of Study:Khartoum central blood bank during the period from June to September 2021.Methodology:A total of thirty-six packed red blood cells blood bags with Citrate-Phosphate-Dextrose-Adenine-one (CPDA-1) stored at 2-6°C for 35 days were withdrawn aseptically on days one; 14, and day 35. Free hemoglobin concentration was measured with Drabkin's method through digital photoelectric colorimeter in which the percentage of hemolysis was calculated, and PH values were measured by a PH meter (ADWA). Mean and standard deviation ofeach day were calculated by statistical package for social science (SPSS)computer program version 22.0.Results:The results showed statistically significant elevation in percentages of free plasma hemoglobin with prolongation of storage duration periods; day one compared with day 14 (P= 0.001), day one compared with day 35(P= 0.001) and day 14 compared with day 35 (P= 0.001). No significant correlation was observed between the degree of hemolysis in day 35 with PH values (P= 0.9).Conclusion:This study concluded that prolonged storage is associated with elevation of free plasma hemoglobin level indicative of progressive hemolysis.

Efectos del consumo de alimentos en la concentración de hemoglobina y el riesgo de anemia infantil en el Perú - 2018 / Effects of Food Consumption on Hemoglobin Concentration and the risk of Childhood Anemia in Peru - 2018

RESUMEN Objetivo: Caracterizar y medir el efecto del consumo de alimentos sobre la concentración de hemoglobina y el riesgo de amenia en niños menores de tres años en el Perú. Materiales y métodos: Se empleó datos de corte transversal de la Encuesta Nacional de Hogares (ENAHO) y la Encuesta Demográfica y de Salud Familiar (ENDES) de 2018. En la estimación del efecto del consumo de alimentos sobre la concentración de hemoglobina se empleó el modelo de regresión lineal múltiple; mientras que para medir el efecto de consumo de alimentos sobre el riego de anemia se empleó el modelo de regresión probit. Resultados: Se encontró que el consumo de lechuga, apio y beterrega (verduras), hígado (carne roja), papaya (fruta) contribuyen positivamente sobre la concentración de hemoglobina y la reducción del riesgo de anemia. La papa (tubérculo) contribuye positivamente en el incremento de la hemoglobina y la reducción del riesgo de anemia para niveles de consumo por debajo de 50 kilogramos por año. Entre las variables de control resultaron altanamente significativos las características biológicas de la madre y el niño, las características socioeconómicas del hogar y las características de la vivienda y del hogar. Conclusión: El mayor consumo de hígado de res, lechuga y beterraga produce mayores niveles de hemoglobina, mientras el consumo de papa por debajo de 50 kg en promedio anual contribuye a la reducción del riesgo de anemia, y mayor consumo de apio y papaya genera una menor probabilidad de riesgo de contraer anemia.

ABSTRACT Objective: To characterize and measure the effect of food consumption on the concentration of hemoglobin and the risk of anemia in children under three years of age, in Peru. Materials and Methods: Cross-sectional data from the National Household Survey ENAHO and the Demographic and Family Health Survey ENDES of 2018 were used. In estimating the efect of food consumption on hemoglobin concentration, the linear multiple regression model was used; while the probit regression model was used to measure the effect of food consumption on the risk of anemia. Results. The consumption of lettuce, celery, and beet (vegetables), liver (red meat), papaya (fruit) was found to positively contribute to the concentration of hemoglobin and the reduction of the risk of anemia. Potatoes (tuber) contribute positively to increasing hemoglobin and reducing the risk of anemia, for consumption levels below 50 kilograms per year. Among the control variables, the biological characteristics of the mother and child, the socioeconomic characteristics of the household, and the characteristics of the region and community were highly significant. Conclusion: Higher consumption of beef liver, lettuce, and beets produces higher levels of hemoglobin, while the consumption of potatoes, below 50 kg on a yearly average, contributes to the reduction of the risk of anemia, and higher consumption of celery and papaya generates a lower probability risk of anemia.

Rouleaux formation of white blood cells and platelets in leukemia / Formação de rouleaux de glóbulos brancos e plaquetas em leucemia

The objective of this study was to measure the effects of glucose and salt level on white blood cells, red blood cells and platelets (PLTs) in the blood of a leukemic patient by using a white light microscope. Different concentrations of glucose and salt in the range of 0 mM to 500 mM were admixed in the blood sample to prepare blood smear. We revealed that shape of erythrocytes, leukocytes and platelets changes and form aggregates. Increasing concentrations of glucose cause to increases aggregation process of white blood cells, red blood cells and platelets. And the increasing concentration of sodium chloride causes to increase rouleaux formation and aggregation of platelets but dehydration due to increased sodium chloride concentration causes to break the aggregation of white blood cells. Comparison of CBC reports of these samples with and without analytes shows that total leukocyte count (TLC) decreases gradually towards normal ranges of leukocytes which is favorable in the treatment of leukemia but at the same time decreasing level of hemoglobin HGB, mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC) and increasing level of red blood cell (RBCs) causes to reduce oxygen supply which is in favor of cancer growth and anemia. This work provides us the base for translation this in vitro study towards the in vivo case of blood microvasculature as a non-invasive methodology.

O objetivo deste estudo foi medir os efeitos da glicose e do nível de sal nos glóbulos brancos, glóbulos vermelhos e plaquetas (PLTs) no sangue de um paciente leucêmico usando um microscópio de luz branca. Foram misturadas diferentes concentrações de glicose e sal na gama de 0 mM a 500 mM na amostra de sangue para preparar esfregaço de sangue. Descrevemos que a forma dos eritrócitos, leucócitos e plaquetas muda e forma agregados. O aumento das concentrações de glicose aumenta o processo de agregação de glóbulos brancos, glóbulos vermelhos e plaquetas. E a crescente concentração de cloreto de sódio causa o aumento da formação de rouleaux e a agregação de plaquetas, mas a desidratação devido ao aumento da concentração de cloreto de sódio causa a quebra da agregação de glóbulos brancos. A comparação dos relatórios de CBC dessas amostras com e sem analitos mostra que a contagem total de leucócitos (TLC) diminui gradualmente para os intervalos normais de leucócitos, o que é favorável no tratamento da leucemia, mas ao mesmo tempo diminui o nível de hemoglobina HGB, hemoglobina corpuscular média (MCH ), a concentração média de hemoglobina corpuscular (MCHC) e o aumento do nível de glóbulos vermelhos (RBCs) reduz o suprimento de oxigênio, o que é a favor do crescimento do câncer e da anemia. Este trabalho fornece a base para a tradução deste estudo in vitro para o caso in vivo de microvasculatura de sangue como uma metodologia não-invasiva.

The research of hemoglobin mass on athletic biological passport for blood doping detection / 中国应用生理学杂志

OBJECTIVE@#To research the changes of blood parameters on different time points after micro-rHuEPO injection on young men and hope to provide evidences for Athletic Biological Passport (ABP) using in the detection of blood doping.@*METHODS@#Fourteen health young men were injected with micro-rHuEPO for 7 weeks, twice per one week.The subjects were treated with ferralia 105 mg every day during the injections.The control group was administrated with the same volume of saline solution injection and placebo 105 mg.The blood parameters (red blood cell, hemoglobin, reticulocyte, total hemoglobin, plasma volume, etc) were tested 11 times (7 days before the first injection, 3, 10, 17, 24, 31, 38 and 45 days after the first injection, 1, 2 and 3 weeks post the seventh week of last injection).By analyzed these total and concentration parameters, hope to know the effective of two kinds of parameters on ABP.@*RESULTS@#The levels of RBC and[Hb] were increased sharply after two weeks of injection and reached the peak in 5-6 weeks (9-10%, <0.01).It sustained till 3 weeks after the last injection.Total hemoglobin was increased significantly during the whole procedure of injections and reached the peak in week 5 (10%, <0.01) till 1 week after the last injection.Red blood cell volume was increased with the EPO injection and reached the peak in week 5 (<0.01), but blood volume wasn't increased significantly.Plasma volume was decreased with EPO injection and it was hemoconcentration.@*CONCLUSIONS@#It can enhance the total and concentration parameters through 7-week micro-rHuEPO injections and the total haemoglobin is more sensitive.So tHb can be used to detect blood doping in ABP.At the end of the last injection, the total blood parameters, such as the total hemoglobin, returned to normal, while the concentration index remained highly, possibly as a result of blood concentration.

Comparison of ultrasonography and ultrasound-guided diffuse optical tomography in assessing treatment response of breast cancer to neoadjuvant chemotherapy / 中华超声影像学杂志

Objective To investigate the clinical value of conventional ultrasonographic ( US),US-guided diffuse optical tomography ( US-guided DOT ) and both combined to assess treatment response of breast cancer to neoadjuvant chemotherapy( NAC). Methods Eighty-eight breast cancer patients,totally 93 lesions were included in the study. Pre-and post-last chemotherapy,size,and total hemoglobin concentration ( THC) of each lesion were measured by conventional US and US-guided DOT before biopsy,the change of lesion Size( ΔSize) and the change of THC( ΔTHC) were calculated respectively.Based on the guidelines to evaluate the response to treatment in solid tumors,the responses to NAC were classified into complete response, partial response, static disease, progressive disease groups. The histological response to chemotherapy were categorised as partial pathological response and complete pathological response using Miller and Payne system. Results Of 93 breast cancers,the overall response rate was 81.7%,the cPR rate was 24.7%. According to ROC curve analysis,when ΔSize 42.6% and ΔTHC 23.9% as cutoff values to evaluate the complete response and partial response,the area under the curve ( AUC ) were 0.666 and 0.751,respectively,the AUC of US and US-guided DOT combined in parallel and in series were 0.680 and 0.737 respectively.When ΔSize 64.5% and ΔTHC 27.2% as cutoff values to evaluate complete pathologial response,the AUC were 0.690 and 0.728 respectively,the AUC of US and US-guided DOT combined in parallel and in series were 0.693 and 0.726 respectively. Conclusions US-guided DOT and US can be used to predict breast cancers response to NAC,US and US-guided DOT combined in parallel and in series can not improve response prediction comparing with US or US-guided DOT alone.

Evaluation of ultrasound-diffuse optical tomography on the early efficacy of neoadjuvant chemotherapy for breast cancer / 中华超声影像学杂志

Objective To discuss the value of early prediction and evaluation using ultrasound-guided diffuse optical tomography (US-guided DOT) of neoadjuvant chemotherapy (NCT) for breast cancer.Methods Sixty-two primary breast cancer patients were included.Before every neoadjuvant chemotherapy and surgery,the total hemoglobin concentration(Hb) was measured by US-guided DOT.According to the RECIST 1.1 standard,62 patients were divided into partial response (PR) group,complete response (CR) group,progressive disease(PD) group and stable disease(SD) group.According to the Miller and Payne (MP) grading system,the patients were divided into poor efficacy group(MP grade 1-3) and the effect of excellent group (MP grade 4-5).According to the postoperative pathological results,patients were divided into pathologic complete response(pCR) group and non pCR group.Hb with imaging and postoperative pathological results were analyzed.Results All of the 62 patients finished the NCT.After first cycle of chemotherapy and all chemotherapy,the value of Hb in the above groups had different degrees of decline,and the difference among the groups was statistically significant(P ＜0.001).When the descending value of Hb was 44.5 as the threshold for early prediction of NCT efficiency,the area under the curve of ROC (Az) was 0.745,and the sensitivity was 75.0％,specificity was 73.1％,positive predictive value was 79.4％,negative predictive value was 67.9％,and accuracy was 74.2％,respectively.Conclusions In the process of neoadjuvant chemotherapy of breast cancer,the decrease of Hb value is positively related to the therapeutic effect of chemotherapy.The change of Hb value can predict and evaluate the efficacy of neoadjuvant chemotherapy in the early time.

Ultrasound-guided diffuse optical tomography(DOT) differences and clinical characteristics of T1-T3 breast carcinoma / 中华超声影像学杂志

Objective To explore the ultrasound-guided diffuse optical tomography (DOT) distribution difference and clinical characteristics of T 1-T3 breast carcinoma. Methods Four hundred and forty-seven breast cancer patients with 455 breast lesions were enrolled.The lesion maximal diameter and total hemoglobin concentration(THC) were obtained by ultrasound-guided DOT before breast surgery biopsy.The patients age,body mass index(BMI),and the distances from lesion to skin and nipple were measured,lymph node status were also assessed.According to the 7th Edition of the AJCC Cancer Staging, all tumors were divided into T1( ≤ 2 cm),T2(2 cm < lesion ≤ 5 cm),and T3( > 5 cm) three groups according to maximum diameter on ultrasound.Results Out of 455 breast cancer lesions,148 lesions were stage T1,251 lesions were stage T2,56 lesions were T3.The age,lesion size,lesion THC and the distances between lesions and nipples of breast cancer patients were found that there were significant differences among T1,T2 and T3(all P = 0.000). With T stages increasing,the age of breast cancers patients decreased,the distance between lesions and nipples decreased,the THC increased.THC of breast cancer T 2 [(221.0 ± 56.0)μmol/L] and T3[(233.1 ± 54.0)μmol/L] were significant higher than that of T1 [(181.6 ± 70.4)μmol/L](all P = 0.000).There were all no significant difference for BMI and the distancefrom lesion to skin among different stages T( P > 0.05).With T stages increasing,the ratio of lymph node metastasis increased(T1 26.4%,T2 49.8%,T3 55.4%; P =0.000).Conclusions With breast cancer T stages increasing,T HC increases,the age of the patients decreases,lymph node metastasis rate increases.

Effects of delayed umbilical cord clamping on maternal and neonatal outcomes / 中华护理杂志

Objective To determine the effects of delayed umbilical cord clamping on the postpartum hemorrhage,instant and long-term newborn anemia,newborn jaundice.Methods In total,303 infants were selected during October 2016 to June 2017 in three hospitals in Beijing.They were randomly allocated into two groups receiving instant clamping of umbilical cord (less than 60s after delivery,n=158) and delayed clamping of umbilical cord(after cord pulsation ceased,n=145).Relevant indicators of maternal and neonatal outcomes are compared.Results There were significant differences between two groups in instant hemoglobin concentration and in 5～7 days (P＜0.05).There were no differences between two groups in transcutaneous bilirubin,the risk of anemia in three months,the risk of jaundice in 5～7 days and the need of blue-light therapy (P＞0.05).There were no differences between two groups of women in postpartum hemorrhage,the length of third stage of labor and the rate of breast feeding (P＞0.05).Conclusion Clamping the umbilical cord when cord pulsation has ceased does not have negative effects on delivery process and postpartum hemorrhage,but it increases the instant hemoglobin concentration and hemoglobin concentration after delivery in 5～7 days.Still it is unclear whether it will affect the risk of jaundice.

The relationship between preoperative hemoglobin concentration and use of hospital resources in cardiac surgery / 临床外科杂志

Objective To explore the relationship of preoperative hemoglobin concentration and use of hospital resources.Methods 108 patients receiving cardiac surgery in the central hospital of wuhan were included.The relationship of preoperative hemoglobin concentration was explored on blood transfusion rates,return to the operating room for bleeding and/or cardiac tamponade,postoperative intensive care unit(ICU)and in-hospital length of stay,and mortality.Results For every 10-unit increase in hemoglobin(g/L),blood transfusion requirements were reduced by 8.0%,6.0%,and 3.0% for red blood cell units,platelet pools,and fresh frozen plasma units,respectively.For each 10-unit decrease in hemoglobin(g/L),the probability(over time)of discharge from the ICU and hospital increased 7.0%,16.0% respectively.Conclusion A lower preoperative hemoglobin concentration resulted in increased use of hospital resources after cardiac surgery.Therefore,the correction of decreasing preoperative hemoglobin concentration could improve the use of hospital resources after cardiac surgery.

Optical tomography image ultrasonography system in the diagnosis of breast cancer / 医学研究生学报

Objective The incidence of breast cancer in China obviously keeps rising in recent years. The optical tomo?graphy image ultrasonography system ( OPTIMUS) is gradually applied in clinic as a new imaging diagnostic technique, but few system?atic studies are reported on its application to the diagnosis of breast tumors. The aim of this study was to assess the value of OPTIMUS in differentiating benign and malignant breast masses by measuring the maximum hemoglobin concentration ( MHC) in the lesions using OPTIMUS with the help of the results of controlled pathological study. Methods This prospective study included 380 cases of breast tumor ( 210 benign and 170 malignant ) treated from April 2009 to April 2014. We measured the MHC using OPTIMUS, detected the expressions of VEGF and PECAM?1/CD31 by immunohistochemistry, calculated the optimal threshold valve of MHC in predicting breast malignancy with the ROC curve, and analyzed the correlation of the MHC value with benign and malignant lesions, lymph node metasta?sis, and the expressions of VEGF and PECAM?1/CD31. Results The mean MHC was significantly higher in the malignant than in the benign lesions ([215.33±69.31] vs [116.50±55.31] μmol/L, P<0.01). The area under the ROC curve (AUC) was 0.836 (95%CI 0.684-0.989). The optimal threshold valve in the diagnosis of malignant breast lesions was 135.00 μmol/L, with a sensitivity of 84.7% and a specificity of 89%. When the tumor was≤2 cm, the MHC was significantly higher in the patients with lymph node metas?tasis than in those without ([207.73±66.43] vs [184.36±62.13] μmol/L, P<0.05). However, the MHC was markedly lower in the benign masses with VEGF and PECAM?1/CD31 negative than in the malignant lesions with VEGF and PECAM?1/CD31 positive ([116.50±55.31] vs [205.73±72.46] μmol/L, P<0.05) and strongly positive ([244.21±63.56] μmol/L, P<0.05). Strongly posi?tive expressions of VEGF and PECAM?1/CD31 were positively correlated with MHC ( P<0.05) . Conclusion Measurement of MHC by OPTIMUS contributes to the differential diagnosis of benign and malignant breast lesions and has a potential value for preoperative assessment of the prognosis of breast cancer.

Investigation on reference intervals of MCV,MCH and MCHC levels determined by Mindray BC-6800 hematology analyzer / 重庆医学

Objective To investigate the reference intervals of mean corpuscular volume (MCV) ,mean corpuscular hemoglo‐bin(MCH) and mean corpuscular hemoglobin concentration (MCHC) examined by the MindrayBC‐6800 hematological analyzer to establish the reference intervals suitable for our laboratory .Methods According to the method recommended by the NCCLS C28‐A3 ,600 healthy adult individuals were selected as the reference individuals .MCV ,MCH and MCHC levels were determined by the MindrayBC‐6800 hematological analyzer for constructing the reference intervals ;other 150 healthy persons undergoing the physical examination were selected and their MCH ,MCV and MCHC detection results were collected for verifying the established reference intervals .Results The detection results of MCV ,MCH and MCHC in healthy adults showed a normal distribution ,MCV had sta‐tistical difference among different age periods (P<0 .05);the reference intervals :82 .278 -94 .242 fL for young adults ,83 .032-94 .608 fL for the middle‐aged persons and 83 .137-96 .343 fL for the elderly .MCH had statistical differences between different se‐xes and among different age periods ;the reference intervals :27 .785-32 .415 pg for male young adults ,28 .324-32 .456 pg for male middle‐aged persons and 28 .274-32 .966 pg for male elderly ;27 .367-31 .973 pg for female young adults ,27 .445-32 .215 pg for female middle‐aged persons and 27 .532 -32 .468 pg for female elderly .MCHC had statistical difference between different sexes (P<0 .05) ;the reference intervals :328 .611-352 .810 g/L for male and 323 .771-348 .750 g/L for female .In 150 individuals un‐dergoing the physical examination ,the proportion of individuals locating at the outside of reference interval was less than 10 .0% , therefore the newly established intervals were suitable for this laboratory .Conclusion The sex difference or/and age differences of MCV ,MCH and MCHC exist among adult populations .So the reference intervals are respectively established according to the prac‐tical situation ,which are suitable for this laboratory by verification .

Evaluación de la concentración de hemoglobina en donantes regulares de plasma / Assessment of haemoglobin concentration in regular plasma donors

INTRODUCCIÓN: está demostrado que la donación de sangre total repetitiva conduce a una deficiencia de hierro, dependiendo fundamentalmente de la frecuencia de donaciones. Sin embargo, el posible efecto que pudiera inducir la plasmaféresis regular sobre la concentración de hemoglobina es un aspecto poco reportado. OBJETIVO: determinar el comportamiento de esta variable y estimar las pérdidas de masa de eritrocitos en donantes de plasmaféresis intensiva nivel 2. MÉTODOS: se realizó un estudio descriptivo longitudinal a través de la revisión de 100 historias clínicas de donantes seleccionados aleatoriamente, para recoger resultados de la determinación de hemoglobina y del hematocrito durante un ciclo de 24 donaciones. Las pérdidas de masa de eritrocito fueron estimadas a través de la medición del volumen y del hematocrito de la sangre total contenida en set de plasmaféresis al finalizar la donación de plasma, sumando a ello la cantidad de sangre total extraída para los estudios de laboratorio. RESULTADOS: se encontró que la concentración promedio de hemoglobina no presentó modificaciones estadísticamente significativas para ambos sexos ni para el grupo total. La pérdida de eritrocitos en un proceso de plasmaféresis fue de aproximadamente 18 mL (9.25 mL remanentes en el set de plasmaféresis y 8.86 mL para muestras de laboratorio), muy cercanos a los 25 mL reglamentados por el Centro para el Control Estatal de la Calidad de los Medicamentos en Cuba (CECMED). CONCLUSIONES: aunque la concentración de hemoglobina y el hematocrito son fácilmente estimadas, su sensibilidad no es buena para la evaluación de la deficiencia de hierro en etapas en que solo sus reservas están disminuidas. La incorporación de otros exámenes de laboratorio más sensibles contribuiría a mejorar la vigilancia de los niveles de hemoglobina en este grupo de individuos(AU)

INTRODUCTION: A close relation between repetitive whole blood donation and iron deficiency has been demonstrated, mainly depending on the frequency of donations. However, the possible effect on hemoglobin concentration that regular plasmapheresis could induce has been scarcely reported. AIM: Determine the behavior of this variant and to estimate red blood cell mass loss in intensive plasmapheresis donor level 2. METHODS: A longitudinal descriptive study was carried out reviewing medical records of 100 randomly selected donors to collect results of the determination of hemoglobin and hematocrit during a cycle of 24 donations. Red cell mass loss was estimated by measuring of volume and hematocrit of whole blood contained in the plasmapheresis set at the end of plasma donation and adding the total amount of blood collected for laboratory tests. RESULTS: Average concentration of hemoglobin showed no statistically significant changes for both, female or male donors. The loss of red blood cell mass in a process of plasma was approximately 18 mL (9.25 mL remaining on the plasma set and 8.86 mL for laboratory tests) which was very close to the limit of 25 mL according to Centro para el Control Estatal de la Calidad de los Medicamentos en Cuba (CECMED) regulations. CONCLUSIONS: Even when hemoglobin and hematocrit concentration are easily estimated, sensitivity is not good for the evaluation of iron deficiency in periods in which only stores are diminished. The inclusion of other more precise laboratory tests will contribute to a better surveillance of haemoglobin levels in this group of individuals(AU)

A study of relationship between blood parameters with myocardial infractions.

Background: The aim of this study was to find out the changes in blood parameters in a group of myocardial infarction patients in Jamnagar, Gujarat. Methods: In this cross sectional study conducted at the medicine clinic in GGH general hospital, Jamnagar between May 2012 and April 2013, a total of 100 subjects were included. Parameters like hemoglobin, RBC count, WBC count, platelet count, hematocrit, ESR, Mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, packed cell volume, differential WBC count used. Results: The results of present study revealed that WBC count, ESR, the differential leukocyte count (e.g. neutrophil cells) in patients increased significantly (P <0.01) comparison to controls. While, the differential leukocyte count of lymphocyte & platelet count revealed to decrease significantly (P <0.01) in patients. Conclusion: Abnormal blood parameters are more common among diabetes patients. Elevated WBC count, ESR, neutrophils are present in patients as compared to control. While decreased in lymphocytes & platelets are seen in patients as compared to control.

Rapid Identification of Thrombocytopenia-Associated Multiple Organ Failure Using Red Blood Cell Parameters and a Volume/Hemoglobin Concentration Cytogram

Thrombocytopenia-associated multiple organ failure (TAMOF) has a high mortality rate when not treated, and early detection of TAMOF is very important diagnostically and therapeutically. We describe herein our experience of early detection of TAMOF, using an automated hematology analyzer. From 498,390 inpatients, we selected 12 patients suspected of having peripheral schistocytosis, based on the results of red blood cell (RBC) parameters and a volume/hemoglobin concentration (V/HC) cytogram. We promptly evaluated whether the individual patients had clinical manifestations and laboratory findings were consistent with TAMOF. Plasma exchanges were then performed for each patient. All 12 patients had TAMOF. The mean values of RBC parameters were significantly higher in all of the patients than with the reference range, however, 3 patients had % RBC fragments within the reference range. The mean value of ADAMTS-13 activity was slightly lower in patients compared with the reference range. Of the 12 patients, remission was obtained in 9 patients (75%) within 4 to 5 weeks using plasma exchanges. Three patients died. An increased percentage of microcytic hyperchromic cells with anisocytosis and anisochromia indicated the presence of schistocytes, making it an excellent screening marker for TAMOF. Identification of TAMOF with RBC parameters and a V/HC cytogram is a facile and rapid method along with an automated hematology analyzer already in use for routine complete blood cell counting test.

Critical evaluation of peripheral smear in cases of anemia with high mean corpuscular hemoglobin concentration in children: A series of four cases.

Mean corpuscular hemoglobin concentration (MCHC), a parameter that is reported as a part of a standard complete blood count by automated analyzer, is a measure of the concentration of hemoglobin in a given volume of packed red blood cell. Values of MCHC significantly above reference range are not physiologically possible due to limitations on solubility of hemoglobin. The high MCHC can give us a clue to certain type of hemolytic anemia and necessitate critical evaluation of peripheral smear to reach a definitive diagnosis. Here we are presenting a series of four cases with raised MCHC, emphasizing the importance of systematic and meticulous examination of the peripheral smear to render a definitive diagnosis.

Correlation on hemoglobin concentration and the development of cognition among pre-school children / 中华流行病学杂志

Objective Our purpose was to evaluate the association between hemoglobin concentration (Hb) and cognitive ability of children at 4-6 years of age in 21 counties/cities in China.Methods A total number of 7331 children born during 1993-1996 were randomly selected from 21 counties or cities in Hebei,Jiangsu and Zbejiang provinces,Hb concentration of children were measured followed by three tests including full-scale,verbal and performance intelligence quotient (IQ) test performed by Chinese-Wechsler Intelligence Scale for Children,one year later.Results There were a 0.7 point difference in mean verbal scale IQ(P=0.144) and a 0.9 point difference in both mean performance and full-scale IQ (P=0.055 and 0.079,respectively) between anemia and non-anemia groups.Compared with children with non-anemia,children with anemia were 1.3-fold more likely to score poorly in verbal IQ and operational IQ (95%CI:1.1-1.6,1.1-1.5,respectively) and 1 A-fold more likely to have had poor scores in full-scale IQ(95%CI:1.2-1.6) after controlled for children's gender,age at intelligence test,region,parity and mother's IQ,education level,occupation.Participants were divided into 5 sub-groups according to Hb concentration of every 20 percentile.Verbal IQ scores of the lowest(Hb＜110 g/L),moderate (117 g/L≤Hb＜122 g/L) and the highest Hb concentration groups (Hb≥130 g/L) were 90.6±18.1,94.0±17.6 and 91.0±16.4,respectively.Performance IQ scores were 102.2±15.7,104.6±14.8 and 100.5±14.9,respectively.Full-scale IQ scores were 95.94±17.3,99.0±16.4 and 95.2±15.6,respectively.Children with both low and high hemoglobin levels did poorly in all intelligence tests than children with moderate Hb concentration (P＜0.001).After controlling for confounding factors,children with the lowest concentration were 1.4-fold more likely to have had poor verbal and performance scores than children with moderate Hb concentration (95% CI:1.1-1.7,1.1-1.8,respectively) and 1.5-fold (95% CI:1.2-1.8) more likely to have had poor full-scale scores than those with moderate Hb concentration.The association between high Hb concentration and low IQ scores disappeared in the multivariate model.Conclusion Low Hb concentration might have adversely affected children' s cognitive development.

Relationship between hemoglobin concentration, cytokine and cardiac function in anemic patients with ischemic cardiomyopathy / 中国基层医药

Objective To study the relationships between hemoglobin concentration,cytokine and cardiac function in patients with ischemic cardiomyopathy.Methods Hemoglobin concentration,sernm TNF-α,IL-6 in 121 patients with ischemic cardiomyopathy were measured,left ventricular ejection fraction(LVEF)by echocardiography,according to hemoglobin concentration,these patients were distributed to the anemic group and the non-anemic group,contrasting to 27 healthy persons.Results The levels of serum TNF-α,IL-6 in the anemic patients group were higher than those in the non-anemic group subjects,but LVEF Wag lower.With the increase of anemia severity,the levels of serum TNF-α,IL-6 significantly increased;there was a positive correlation between LVEF and the levels of serum TNF-α,IL-6(P＜0.01),and a negative correlation between LVEF and Hb concentration.Conclusion The levels of cytokine promote the pathophysiological procedure between cardiac failure and anemic in ICM.

Plasma hemoglobin concentration was related to estimated glomerular filtration rate in elderly patients with ischemic Cardiomyopatny / 老年心脏病学杂志（英文版）

Objectlves To stuaythe relationship between plasma hemoglobin concentration and estimated glomerular filtration rate (eGFR)in elderly patients with ischemic cardiomyopathy (ICM).Methods Clinical data of patients with coronary heart disease who weredischarged from The First Affiliated Hospital,Chongqing Medicai University between 2005 and 2007 were analyzed retrospectively.Echocardiography resuIts.plasma hemoglobin and creatinine concentration were abstracted from the medical records.The study included235 Chinese Han patients with age 60 years and older with angiography confwmed coronary heart disease.silent myocardial ischemia orangina pectoris,of whom 154 had ICM defined as left ventricular end-diastolic diameter(LVDd),male≥56mm,female≥51 mm(63.51±7.70 mm)measured by M-mode echocardiography.The differences in plasma hemoglobin concentration were analyzed retrospec-were no significant changes in plasma hemoglobin concentration and eGFR;however,plasma hernoglobin concentration was related toeGFR significantly positively in elderly patients with ICM due to coronary heart disease.

Evaluating the Appropriateness of a Single Unit Transfusion / 대한수혈학회지

BACKGROUND: The domestic quantity of blood components consumed has been decreasing since 2002, but the rate of a single unit RBC transfusion (SUT) has been on the increase. In the past, a SUT was regarded as an uncesssary procedure, but currently is considered as an effective method to maintain a minimal hemoglobin concentration for physiological needs. We investigated the actual conditions of a SUT. METHODS: We analyzed 800 cases of SUTs performed at a tertiary care university hospital between March 2006 March and February 2007. The subjects of the study were divided into a surgical group (n=561) and medical group (n=239) for the purpose of RBC unit usage and were analyzed by groups and ordering departments, with an analysis of the pre and post-transfusion hemoglobin concentration and hematocrit values. The distribution according to the pre and post-transfusion hemoglobin ranges were calculated. RESULTS: The mean hemoglobin concentration increment of the surgical group was significantly lower than that of the medical group (P<0.0001) and the mean pre and post-transfusion hemoglobin concentrations of the medical group were lower than that of the surgical group (P<0.0001). Approximately 26% cases of the SUTs performed in the surgical group were appropriate, based on a post-transfusion hemoglobin concentration below 10 g/dL. In the medical group, about 75% of the SUTs were appropriate based on a pre-transfusion hemoglobin concentration below 9 g/dL. CONCLUSION: Most transfusions are decided based on various clinical situations and opinions of the clinicians. Therefore, continuous evaluation of the appropriateness of transfusion is necessary. In our study, the appropriateness of a SUT was estimated indirectly based on the pre and post-transfusion hemoglobin concentration. Consequently, policies and strategies for performing asingle unit RBC transfusion are required.

Difference of Hypoxia Tolerance with Reference to Sex

BACKGROUND: Time of useful consciousness is related with various factors including smoking, age, sex, drug, and temperature. It is still unclear whether acute hypoxia tolerance is different between male and female. METHOD: We included 32 healthy students (male, n=16; female, n=16) volunteered to participate in this study. The blood hemoglobin concentration was measured at a day before flight. With high altitude rapid decompression flight training chamber, flight to simulated altitude of 25,000 ft was performed after nitrogen extraction breath. At 25,000 ft, heart rate and arterial O2 saturation (SaO2) were measured by using pulse oximeter after taking off oxygen mask. We compared the duration from mask-off to the time at 60% SaO2 between male and female and correlated the time at 60% SaO2 with hemoglobin concentration. RESULTS: The duration from mask-off to SaO2 reaching 60% were significantly longer in the male group. There was a linear relationship between hemoglobin concentration and time at 60% SaO2. CONCLUSION: Acute hypoxia tolerance differs from the two sexes and the difference of hemoglobin concentration is one of possible causative factors of this difference.