Evaluation of Cytotoxic effect of Moringa peregrina seeds on Oral Cancer, CAL 27, Cell Line and Red Blood Cells Hemolysis / Evaluación del efecto citotóxico de las semillas de Moringa peregrina en el cáncer oral, CAL 27, líneas celulares y hemólisis de glóbulos rojos

Background: Moringa peregrina Forssk is a well-known plant in ethnomedicine due to its widespread uses in various diseases like cough, wound healing, rhinitis, fever, and detoxification. The plant seeds contain compounds that are cytotoxic to many cancer cells. During the therapeutic use of plants via the oral route, some compounds present in the plants may be cytotoxic to normal cell lines and red blood cells. Objective: This study was the first report of investigation of the cytotoxic profile on oral cancer, CAL 27, cell line, and hemolytic activities on human erythrocytes of Moringa peregrina seeds ethanolic extract (MPSE). Methods: MPSE was screened for its cytotoxic effect against oral cancer, CAL 27, cell line using 3-(4, 5-dimethylthiazol-2-yl)-2, 5,-diphenyltetrazolium bromide (MTT) assay. The toxicity of MPSE on human erythrocytes was determined by in vitro hemolytic assay. Results: MPSE showed significant anti-proliferative activity against oral cancer, CAL 27 cell line at lower concentrations with half maximal inhibitory concentration (IC50) value of 21.03 µg/mL. At 1,000 µg/ml of MPSE, the maximum hemolysis was found to be 14.3% which is within safer limit. Conclusions: This study revealed a potential anti-oral cancer of MPSE and provided a baseline for its potential use in oral cancer treatment with minimum hemolytic effect on human RBCs.

La Moringa peregrina Forssk es una planta muy conocida en etnomedicina debido a sus usos generalizados en diversas enfermedades como la tos, la cicatrización de heridas, la rinitis, la fiebre y la desintoxicación. Las semillas de la planta contienen compuestos citotóxicos para muchas células cancerosas. Durante el uso terapéutico de las plantas por vía oral, algunos compuestos presentes en ellas pueden ser citotóxicos para las líneas celulares normales y los glóbulos rojos. Objetivo: Este estudio fue el primer informe de investigación del perfil citotóxico sobre el cáncer oral, CAL 27, línea celular, y las actividades hemolíticas en eritrocitos humanos del extracto etanólico de semillas de Moringa peregrina (MPSE). Métodos: Se examinó el efecto citotóxico del MPSE contra la línea celular de cáncer oral CAL 27 mediante el ensayo con bromuro de 3-(4, 5-dimetiltiazol-2-il)-2, 5,-difeniltetrazolio (MTT). La toxicidad del MPSE sobre los eritrocitos humanos se determinó mediante un ensayo hemolítico in vitro. Resultados: MPSE mostró una actividad antiproliferativa significativa contra el cáncer oral, línea celular CAL 27 a concentraciones más bajas con un valor de concentración inhibitoria media máxima (IC50) de 21,03 µg/mL. A 1.000 µg/ml de MPSE, la hemólisis máxima fue del 14,3%, lo que está dentro del límite de seguridad. Conclusiones: Este estudio reveló un potencial anticancerígeno oral de MPSE y proporcionó una base para su uso potencial en el tratamiento del cáncer oral con un efecto hemolítico mínimo en los glóbulos rojos humanos.

Metahemoglobinemia y hemólisis intravascular aguda después de una intoxicación por naftaleno en un paciente pediátrico / Methemoglobinemia and acute intravascular hemolysis after naphthalene poisoning in a pediatric patient

La intoxicación por naftaleno es poco frecuente en los niños. Es causada por la ingesta, la inhalación o el contacto con la piel de sustancias que contienen naftaleno. Los pacientes suelen tener orina de color marrón oscuro, diarrea acuosa y vómito bilioso. Los signos incluyen fiebre, taquicardia, hipotensión y valores bajos en la oximetría de pulso, incluso con oxigenoterapia. Los análisis de sangre detectan anemia hemolítica, metahemoglobinemia, insuficiencia renal e hiperbilirrubinemia. Además del tratamiento sintomático, se hacen transfusiones de eritrocitos y se les administran ácido ascórbico, azul de metileno y N-acetilcisteína. En este artículo, presentamos el caso de un paciente masculino de 23 meses de edad con metahemoglobinemia y hemólisis intravascular aguda que recibió atención en la unidad de cuidados intensivos durante cinco días por intoxicación por naftaleno. Si bien la intoxicación por naftaleno es muy poco frecuente, tiene consecuencias mortales y se debe ejercer precaución con su uso y venta.

Poisoning by naphthalene is uncommon in children. It is a type of poisoning brought on by ingesting, inhaling, or coming into touch with naphthalene-containing substances on the skin. Patients typically present with an initial onset of dark brown urine, watery diarrhea, and bile vomit. The signs include fever, tachycardia, hypotension, and low pulse oximetry readings even with oxygen support. Hemolytic anemia, methemoglobinemia, renal failure, and hyperbilirubinemia are all detected in blood tests. Erythrocyte transfusion, ascorbic acid, methylene blue, and N-acetylcysteine (NAC) therapies are provided to inpatients in addition to symptomatic treatment. We present a 23-month-old male patient who developed methemoglobinemia and acute intravascular hemolysis, who was followed up in the intensive care unit for five days due to naphthalene intoxication. Although naphthalene poisoning is very rare, it should be known that it has fatal consequences, and more care should be taken in its use and sale.

Passenger lymphocyte syndrome after liver transplantation in a blood group AB recipient with a blood group A donor: a case report / 中国输血杂志

【Objective】 To explore the laboratory monitoring procedure and its clinical significance in patients with passenger lymphocyte syndrome after liver transplantation. 【Methods】 The Hb and bilirubin levels were monitored in one AB blood type patient post-liver transplantation. The ABO blood group type, unexpected antibody screening test, direct anti-globulin test and acid elution test were performed respectively in blood samples of the patient to identify the serum antibodies and erythrocyte membrane sensitized antibodies. 【Results】 The patent’s Hb level showed a decreasing trend on the day 11 post-operation, reaching the lowest level of 62 g/L on day 17, and his serum bilirubin increased. The patient’s ABO blood type was determined as AB while anti-B antibody was detected in the patient’s serum. The direct anti-globulin test was weakly positive, while the unexpected antibody screening test was negative. Anti-B antibody was detected in the elution and the patient’s serum. The patient′s serum was incompatible with type AB and type B erythrocytes in the cross-matching test, while it was compatible with type A and type O erythrocytes. 【Conclusion】 Through monitoring serum anti-A, anti-B and direct anti-human globulin test, the patients with passenger lymphocyte syndrome after liver transplantation can be early diagnosed and the prognosis can be improved.

Analysis of chylemia and its impact on blood product quality / 中国输血杂志

【Objective】 To analyze the causes of chylemia, explore the effects of varying degrees of chylemia on subsequent blood products and the countermeasures. 【Methods】 The information of blood donors in the Central Blood Station of Xinjiang Production and Construction Corps from January 2018 to July 2022 were analyzed retrospectively, and the causes of fatty blood discarding was analyzed in terms of gender, age and times of donation. The effects of chylemia of control group, mild group, moderate group and severe group and corresponding gender and age on the hemolysis rate of suspended red blood cells(RBCs) at the end of storage and residual amount of methylene blue in the inactivated plasma were discussed. 【Results】 The incidence of chylemia in males(0.93%,84/9 047) was much higher than that in females(0.24%,9/3 781) (P<0. 05). The hemolysis rates of WBC-free suspended RBCs of mild, moderate and severe chylemia group at the end of storage(0. 19±0.08,0.28±0.06,0.66±0.25) were higher than that in control group(0.08±0.03), in males significantly higher than those in females(0.08±0.03 vs 0.06±0.02,0.21±0.09 vs 0.15±0.04,0.30±0.05 vs 0.24±0.07), in the age group of 18-30 years significantly lower than those in 31-41 years(0.07±0.02 vs 0.09±0.03) and ≥41 years(0.07±0.02 vs 0.09±0.03), P <0.05. The residual methylene blue in plasma with viral inactivation prepared from mild and moderate chylemia was significantly higher than that in control group(0.12±0.02,0.18±0.06 vs 0.06±0.02) (P<0.05). 【Conclusion】 Chylemia shall be monitored during the whole process of blood collection, and coutermeasures shall be taken to decrease the effects of chylemia on blood quality.

Study of glycine solution in preparation of frozen thawed deglycerolized erythrocytes / 中国输血杂志

【Objective】 To study the protective effect of glycine solution on frozen red blood cell thawing process. 【Methods】 A total of 20 bags of 1 U of leukocytes reduced suspended red blood cells within 6 days were selected for the study. After mixing, each 2 bags of suspended red blood cells were divided into 2 bags and into two groups with 10 bags of 1 U in each group, and were frozen for storage. One group was deglycerolized with sodium chloride solution (control group), and one group was deglycerolized with glycine solution (experimental group). The hemoglobin, free hemoglobin, residual glycerol, total glycerol in red blood cells, adenosine triphosphate (ATP) and 2,3-diphosphoglycerate (2,3-DPG) were detected in the two groups. 【Results】 Compared with the free hemoglobin content (0.90±0.05)g/L and residual glycerol content (1.17± 0.08)g/L in the control group, the final product red blood cell supernatant free hemoglobin content (0.77±0.15)g/L and residual glycerol content (0.79±0.33)g/L in the experimental group were decreased, and the difference was statistically significant (P<0.05). Compared with the ATP content (4.03±0.38)µmol/gHb and 2,3-DPG content (485.65±78.08)µg/L in the control group, the ATP content (4.41±0.35)µmol/gHb and 2,3-DPG content (656.28±116.68)µ g/L in the experimental group were significantly increased, with statistical significance (P<0.05). 【Conclusion】 Using glycine solution instead of sodium chloride solution to prepare frozen thawed deglycerolized erythrocytes achieved the effect of protecting erythrocytes, reduced the hemolysis rate of erythrocytes and glycerin residue, and increased the recovery rate of erythrocytes.

Value of three hemolysis tests and carboxyhemoglobin in the diagnosis of hemolytic disease of the fetus and newborn / 中国输血杂志

【Objective】 To investigate the value of three hemolysis tests and carboxyhemoglobin (COHb) level in the diagnosis of hemolytic disease of the fetus and newborn (HDFN). 【Methods】 From January 1, 2019 to December 31, 2022, the neonates hospitalized in the Department of Neonatology of Hebei Provincial Children's Hospital with suspected hemolytic disease who had serological testing were retrospectively enrolled in the study. They were distributed into HDFN group and non-HDFN group according to the final diagnosis. Their clinical and laboratory data were collected and analyzed, and the COHb level was detected by blood gas analyzer. 【Results】 A total of 378 neonates with HDFN and 217 neonates without HDFN were included in the study. Most of the neonates in HDFN group were full-term infants (348/378, 92.1%), with median gestational age of 39.1 (38.3, 40.0) weeks. Three hundred and fifty-four cases (354/378, 93.7%) were ABO-HDFN and the rest were Rh HDFN. There were significant differences in the level of serum total bilirubin, hemoglobin, COHb and reticulocyte percentage at admission between the two groups(P<0.05). The positive rate of three hemolysis tests in HDFN group decreased with the increase of the days after birth. The highest positive rate (more than 80%) was observed within 2 days after birth. Correlation analysis showed a negative relationship between the COHb level and the age (rs = -0.434, P<0.001) . Among the three hemolysis tests in HDFN group, the positive rate of antibody release test was the highest (69.0%), followed by the free antibody test (55.6%) and the direct antiglobulin test (DAT) (36.0%). Receiver operating characteristic (ROC) curve analysis showed that the optimal cut-off value of COHb was 1.15%.The sensitivity of COHb ≥ 1.15% was 51.8%, higher than single DAT (36.0%) . The diagnosis effectiveness of three hemolysis tests couldn't be improved when combined with COHb detection(Z = -0.727, P>0.05) . 【Conclusion】 The three hemolysis tests are important in the diagnosis of HDFN, among which the antibody release test has the highest sensitivity. COHb has certain value for the diagnosis of HDFN, but joint testing cannot improve the diagnosis effectiveness of three hemolysis tests. Hemolysis tests and/or COHb detection should be conducted for neonates at risk of hemolysis as early as possible after birth.

Diagnosis and treatment of passenger lymphocyte syndrome following secondary ABO-incompatible allogeneic hematopoietic stem cell transplantation / 中国输血杂志

【Objective】 To investigate the clinical characteristics and diagnosis and treatment of passenger lymphocyte syndrome (PLS) in patients following allogeneic hematopoietic stem cell transplantation (allo-HSCT). 【Methods】 A total of 489 patients who underwent allo-HSCT in Suzhou Hongci Hematology Hospital were retrospectively enrolled. The clinical process, diagnosis and treatment measures and prognosis of four patients complicated with PLS after transplantation were analyzed. 【Results】 Among the 489 patients, 4 were diagnosed with PLS. The blood types of donor/recipient ABO were all secondary incompatible (The blood type of donors were O and the recipients were A or B). The overall incidence of PLS in allo-HSCT was 0.82%(4/489)and 2.2%(4/179)in transplants with donor/recipient secondary incompatible ABO-blood types. PLS occured in 6-13 days after donor stem cell infusion. Clinical manifestations were dizziness and fatigue, low back pain, jaundice, deepening urine, rapid decrease in hemoglobin on laboratory tests, elevated indirect bilirubin and lactate dehydrogenase, positive urobilinogen, positive direct anti-human globulin test (DAT), and anti-A or anti-B antibodies against recipient red blood cells were detected in plasma. After the treatment of O-type washed red blood cells, methylprednisolone, gamma globulin, rituximab and other treatments, the hemolysis was improved. All patients achieved engraftment of neutrophil and platelet. Red blood cell transfusion was halted in 3 weeks. 【Conclusion】 PLS is a rare complication of allo-HSCT, which mainly occurs in allo-HSCT patients with secondary incompatibility of ABO blood group of donor/recipient. The clinical prognosis is good after properly treatment.

Factors influencing hemolysis rate of leukocyte-reduced red blood cells at the end of preservation period in blood donors / 中国输血杂志

【Objective】 To compare the current standards and explore the influencing factors for hemolysis rate of leukocyte-reduced red blood cells at the end of the preservation period, in order to formulate reasonable internal control indicators. 【Methods】 A retrospective analysis was performed on hemolysis rate of 427 samples of leukocyte-reduced red blood cells at the end of the preservation period in Nanning Blood Center from 2015 to 2022. Compared with the current standard for hemolysis rate at the end of the preservation period (GB 18469-2012 Quality Requirements for Whole Blood and Component Blood), the differences were analyzed, and the factors influncing the hemolysis rate were analyzed in terms of different blood donor groups. 【Results】 1) Among the 427 samples, the hemolysis rate of 418 (97.89%) did not exceed 0.4%, all lower than 0.8%; 2)the hemolysis rate of the male group was higher than that of the female group; 3) the hemolysis rate of the 18-29 years old group was lower than that of the 30-39 year old group and the 40-60 year old group, with statistically significant difference; 4) in terms of occupation, the hemolysis rate of students was the lowest, and the differences between groups were statistically significant; 5) no statistical significance was found in ethnicity and blood type. 【Conclusion】 Statistics indicated that gender, age, blood donation volume and occupation of blood donors were the influencing factors of hemolysis rate. The current standard is obviously higher in the qualified range of blood quality control in Nanning. It is advisable to formulate a reasonable quality control strategy with internal control index of hemolysis rate set <0.4%, which is conducive to making accurate evaluation of internal quality control and ensuring blood safety.

Caracterización fisiopatológica de las anemias hemolíticas autoinmunes / Pathophysiological characterization of autoimmune hemolytic anemia

Introducción: La anemia hemolítica autoinmune se define como el aumento de la destrucción de los eritrocitos en presencia de autoanticuerpos dirigidos contra antígenos de grupos sanguíneos eritrocitarios. Objetivo: Caracterizar las anemias hemolíticas autoinmunes teniendo en cuenta las características fisiopatológicas, manifestaciones clínicas y el diagnóstico de laboratorio. Métodos: Se realizó una revisión de la literatura en inglés y español de artículos publicados en los últimos 10 años sobre anemia hemolítica autoinmune. Conclusiones: La anemia hemolítica autoinmune es una enfermedad muy heterogénea. El diagnóstico suele ser fácil, pero los casos difíciles pueden ser un desafío. La definición de cada tipo es fundamental ya que la terapia es diferente y se enfoca más con la comprensión de los mecanismos patogénicos(AU)

Introduction: Autoimmune hemolytic anemia is defined as increased destruction of red blood cells in the presence of autoantibodies directed against red cell blood group antigens. Objective: To characterize autoimmune hemolytic anemias, taking into account immunohematological, clinical, diagnostic and pathogenic mechanisms. Methods: A review of the literature, in English and Spanish, of articles published in the last 10 years on autoimmune hemolytic anemia was carried out. Conclusions: Autoimmune hemolytic anemia is a very heterogeneous disease. Diagnosis is usually easy, but difficult cases can be challenging. The definition of each type is fundamental since the therapy is different and focuses more on understanding the pathogenic mechanisms(AU)

Validation of blood components transport through a pneumatic tube system

ABSTRACT Introduction: Urgent blood component transfusions may be life-saving for patients in hemorrhagic shock. Measures to reduce the time taken to provide these transfusions, such as uncrossmatched transfusion or abbreviated testing, are available. However, transport time is still an additional delay and the use of a pneumatic tube system (PTS) may be an alternative to shorten the transport time of blood components. Objectives: To assess pneumatic tube system transportation of blood components based on a validation protocol. Methods: Pre- and post-transport quality control laboratory parameters, visual appearance, transport time and temperature of the packed red blood cells (RBCs), thawed fresh plasma (TFP), cryoprecipitate (CR), and platelet concentrate (PC) were evaluated. Parameters were compared between transport via pneumatic tube and courier. Results: A total of 23 units of RBCs, 50 units of TFP, 30 units of CR and ten units of PC were evaluated. No statistically significant differences were found between pre- and post-transport laboratory results. There was also no difference in laboratory parameters between transport modalities (PTS versus courier). All blood components transported matched regulatory requirements for quality criteria. The temperature during transport remained stable and the transport time via PTS was significantly shorter than the courier's transport time (p < 0.05). Conclusion: The PTS was considered a fast, safe and reliable means of transportation for blood components, also securing quality prerequisites.

Lesión renal aguda y anemia hemolítica autoinmune inducida por rifampicina, una complicación poco frecuente y potencialmente mortal

La rifampicina es un medicamento ampliamente utilizado para el tratamiento de diversas infecciones bacterianas con un amplio espectro de efectos adversos que varían desde reacciones leves hasta potencialmente fatales; la anemia hemolítica es un efecto adverso escasamente reportado en la literatura pero que puede tener un desenlace potencialmente fatal, reportamos así un caso de anemia hemolítica autoinmune asociada a lesión renal aguda en una paciente joven en segunda fase de tratamiento para tuberculosis pulmonar.

Summary Rifampicin is a widely used drug for the treatment of various infectious diseases with a broad spectrum of adverse reaction ranging from mild to life-threatening manifestations; hemolytic anemia is an adverse effect rarely reported in the literature, but it can have a potentially fatal outcome. Thus, we report a case of autoimmune hemolytic anemia associated with acute kidney injury in a young patient in the second phase of treatment for pulmonary tuberculosis.

COVID-19 Positive Cohort Undergoing Cardiac Surgery: A Possible Un(3H)oly Trinity of Hypoxia-Hemolysis-Hyperinflammation

Abstract While the fraternity continues to ponder on the mechanisms by which coronavirus disease (COVID-19) positivity affects the outcome of cardiac surgical subset, we put forth a 3H (Hypoxia-Hemolysis-Hyperinflammation) trilogy aimed at elucidating the liaison between cardiopulmonary bypass (commonly employed for cardiac surgical conduct) and COVID-19 infection. A sound comprehension of the same can doubtlessly assist the perioperative team in staging a well-directed pathophysiology-driven management approach.

Association of hemolysismarkers and cortisol level with different severity of sickle cell disease among Sudanese patients

Background:Sickle cell anemia (SCA) is an inherited disorder of hemoglobin. Several biomarkers have been identified, which is essential in the different clinical presentations of the disease. This study aimed to determine the association between hemolysis markers andcortisol level with varying severity groups of Sudanese patients with SCA.Methods:This descriptive cross-sectional study included 100 patients with sickle cell disease between February 2016 and April 2017. According to Hedo et al scoring, medical history was obtained to conduct disease severity. A total of 3ml of venous blood was collected from each patient. A complete hemogram was performed using an automated hematology analyzer (Sysmix®-KX-21N). Bilirubin and lactate dehydrogenase (LDH) were estimated using a spectrophotometer, while cortisol was measured using the Elecsys® system 2010 E170. The reticulocyte count was performed manually. Data were analyzed using statistical package for the social sciences (SPSS)version 21 computer software program.Results:Disease severity was variable and was categorized into; eighteen (18%) patients had mild symptoms, while 70 (70%) patients had moderate disease, and 12 (12%) patients had severe disease. The analysis of variance (ANOVA)test showed that hemoglobin, reticulocyte count, LDH, and direct bilirubin were positively correlated with disease severity,p value: 0.001, 0.04, 0.00, and 0.02, respectively. While indirect bilirubin, total bilirubin, and cortisol did not correlate withdisease severity, the pvalue was (0.248, 0.083, and 0.868, respectively).Conclusions:This study confirmed that the hemolysis markers (Hb, reticulocyte count, direct bilirubin and LDH) were positively associated with disease severity. In contrast, indirect bilirubin, total bilirubin, and cortisol levels were not associated with the disease severity.

Testes Ergométricos em Pacientes com Anemia Falciforme: Segurança, Viabilidade e Possíveis Implicações no Prognóstico / Exercise Testing In Patients with Sickle Cell Disease: Safety, Feasibility and Potential Prognostic Implication

Resumo Fundamento Pacientes com anemia falciforme (AF) têm risco aumentado de complicações cardiovasculares. O teste ergométrico é usado como marcador de prognóstico em uma série de doenças cardiovasculares. Entretanto, há uma escassez de evidências sobre exercícios em pacientes com AF, especialmente em relação à sua segurança, viabilidade e possível função prognóstica. Objetivos Usamos o teste em esteira máximo para determinar a segurança e a viabilidade do teste ergométrico em pacientes com AF. Além disso, os fatores associados à duração do exercício, bem como o impacto das alterações causadas pelo exercício em resultados clínicos, também foram avaliados. Métodos 113 pacientes com AF que passaram pelo teste ergométrico e por uma avaliação cardiovascular abrangente incluindo um ecocardiograma e os níveis do peptídeo natriurético do tipo B (BNP). O desfecho de longo prazo foi uma combinação de eventos incluindo morte, crises álgicas graves, síndrome torácica aguda ou internações hospitalares por outras complicações associadas â doença falciforme. A análise de regressão de Cox foi realizada para identificar as variáveis associadas ao resultado. Um p valor <0,05 foi considerado estatisticamente significativo. Resultados A média de idade foi de 36 ± 12 anos (intervalo, 18-65 anos), e 62 pacientes eram do sexo feminino (52%). A presença de alterações isquêmicas ao esforço e resposta pressórica anormal ao exercício foram detectadas em 17% e 9 % da´população estudada respectivamente. Dois pacientes apresentaram crise álgica com necessidade de internação hospitalar no período de 48 horas da realização do exame. Fatores associados à duração do exercício foram idade, sexo, velocidade máxima de regurgitação tricúspide (RT), e relação E/e', após a padronização quanto aos marcadores da gravidade da doença. Durante o período médio de acompanhamento de 10,1 meses (variando de 1,2 a 26), 27 pacientes (23%) apresentaram desfechos clínicos adversos. Preditores independentes de eventos adversos foram a concentração de hemoglobina, velocidade do fluxo transmitral tardio (onda A), e a resposta da PA ao exercício. Conclusões A realização de testes ergométricos em pacientes com AF, clinicamente estáveis, é viável. A duração do exercício estava associada à função diastólica e a pressão arterial pulmonar. A resposta anormal da PA foi um preditor independente de eventos adversos.

Abstract Background Patients with sickle cell disease (SCD) are at increased risk for cardiovascular complications. Exercise testing is used as a prognostic marker in a variety of cardiovascular diseases. However, there is a lack of evidence on exercise in SCD patients, particularly regarding its safety, feasibility, and possible prognostic role. Objectives We used the maximal treadmill test to determine safety and feasibility of the exercise testing in SCD patients. Additionally, the factors associated with exercise duration, as well as the impact of exercise-induced changes on clinical outcome, were also assessed. Methods One-hundred thirteen patients with SCD, who underwent exercise testing, were prospectively enrolled. A comprehensive cardiovascular evaluation, including echocardiography and B-type natriuretic peptide (BNP) levels, were obtained. The long-term outcome was a composite endpoint of death, severe acute painful episodes, acute chest syndrome, or hospitalization for other SCD-related complications. Cox regression analysis was performed to identify the variables associated with the outcome. A p-value<0.05 was considered to be statistically significant. Results The mean age was 36 ± 12 years (range, 18-65 years), and 62 patients were women (52%). Ischemic electrocardiogram and abnormal blood pressure (BP) response to exercise were detected in 17% and 9%, respectively. Two patients experienced pain crises within 48 hours that required hospitalization. Factors associated with exercise duration were age, sex, tricuspid regurgitation (TR) maximal velocity, and E/e' ratio, after adjustment for markers of disease severity. During the mean follow-up of 10.1 months (ranging from 1.2 to 26), the endpoint was reached in 27 patients (23%). Independent predictors of adverse events were hemoglobin concentration, late transmitral flow velocity (A wave), and BP response to exercise. Conclusions Exercise testing in SCD patients who were clinically stable is feasible. Exercise duration was associated with diastolic function and pulmonary artery pressure. Abnormal BP response was an independent predictor of adverse events.

Efficacy of pentamidine-loaded chitosan nanoparticles as a novel drug delivery system for Leishmania tropica

@#The present study compares the in vitro effects of nanoparticles loaded pentamidine drug and conventional pentamidine on Leishmania tropica. Herein, pentamidine-loaded chitosan nanoparticles (PTN-CNPs) have been synthesized through an ionic gelation method with sodium tripolyphosphate (TPP). Next, the physical characteristics of PTN-CNPs were determined through the surface texture, zeta potential, in vitro drug release, drug loading content (DLC), and encapsulation efficacy (EE) and compared its efficacy with free pentamidine (PTN) drug against promastigotes and axenic amastigotes forms of L. tropica in vitro. The PTN-CNPs displayed a spherical shape having a size of 88 nm, an almost negative surface charge (-3.09 mV), EE for PTN entrapment of 86%, and in vitro drug release of 92% after 36 h. In vitro antileishmanial activity of PTN-CNPs and free PTN was performed against Leishmania tropica KWH23 promastigote and axenic amastigote using 3-(4, 5- dimethylthiazol-2-yl)-2, 5-diphenyletetrazolium bromide (MTT) assay. It was observed that the effect of PTN-CNPs and free PTN on both forms of the parasite was dose and time dependent. Free PTN presented low efficacy even at higher dose (40 µg/ml) with 25.6 ± 1.3 and 26.5 ±1.4 mean viability rate of the promastigotes and axenic amastigotes, respectively after 72 hrs incubation. While PTN-CNPs showed strong antileishmanial effects on both forms of parasite with 16 ± 0.4 and 19 ± 0.7 mean viability rate at the same higher concentration (40 µg/ml) after 72 hrs incubation. Half maximal inhibitory concentration (IC50) values of PTN-CNPs toward promastigotes and amastigotes were obtained as 0.1375 µg/ml and 0.1910 µg/ml, respectively. In conclusion, PTN-CNPs effectively inhibited both forms of the L. tropica; however, its effect was more salient on promastigotes. This data indicates that the PTN-CNPs act as a target drug delivery system. However, further research is needed to support its efficacy in animal and human CL.

Effects of Postmortem Hemolysis and Ultrafiltration on Creatinine Detection Results / 法医学杂志

OBJECTIVES@#To investigate the interference of postmortem hemolysis on the detection of creatinine and whether ultrafiltration can reduce the interference.@*METHODS@#A total of 33 non-hemolyzed whole blood samples from the left heart were collected. Hemolyzed samples with 4 hemoglobin mass concentration gradients H1-H4 were artificially prepared. Ultrafiltration was performed on each hemolyzed sample. Creatinine concentrations in non-hemolyzed serum (baseline serum), hemolyzed samples and ultrafiltrate were detected. Bias (B), Pearson correlation and receiver operator characteristic (ROC) of baseline creatinine concentration between before and after ultrafiltration were analyzed.@*RESULTS@#As the hemoglobin mass concentration increased, B of the hemolyzed samples in the H1-H4 groups gradually increased, the |B| was 2.41(0.82, 8.25)-51.31(41.79, 188.25), reaching a maximum of 589.06%, and there was no statistically significant between the creatinine concentration and the baseline creatinine concentration (P=0.472 7, r=0.129 5). After ultrafiltration of hemolyzed samples, the interference of creatinine concentration in ultrafiltrate was significantly reduced, the |B| was 5.32(2.26, 9.22)-21.74(20.06, 25.58), reaching a maximum of 32.14%, and there was a positive correlation with baseline creatinine concentration (P<0.05, r=0.918 2). In the hemolyzed samples of H3 and H4 groups, there were 7 false-positive samples and 1 false-negative sample; in the ultrafiltrate samples, there were no false-positive sample and 1 false-negative sample. ROC analysis results showed the hemolyzed samples were lack of diagnostic value (P=0.117 5).@*CONCLUSIONS@#The postmortem hemolysis significantly interferes creatinine detection results of blood samples, ultrafiltration can reduce hemolysis-induced interference in postmortem creatinine detection.

Hemolysis caused by autologous blood transfusion in ectopic pregnancy patient with hemorrhagic shock: a case report / 中国综合临床

Ectopic pregnancy is a common gynecological acute abdomen disease. Once the pregnant tissue is ruptured, it will rapidly develop into hemorrhagic shock or even death. In recent years, blood transfusion from the body is widely used in the rescue of intra-abdominal hemorrhage of ectopic pregnancy, which can reduce the time of cross matching and blood collection, reduce the risk of allogeneic blood transfusion, and enable patients with hemorrhagic shock to receive timely and effective treatment. Hemolysis caused by autologous blood transfusion is rarely reported. Once hemolysis occurs, if it is not handled in time, severe cases can occur acute renal injury, hyperkalemia, or cardiac arrest or even sudden death. We retrospectively analyzed the diagnosis and treatment of a patient with hemolysis after autologous blood transfusion, suggesting that the adverse reactions of blood transfusion occur not only in allogeneic blood transfusion, but also in autologous blood transfusion. It should be handled reasonably in clinical work to reduce the occurrence of similar complications.

A case of hemolytic disease of the newborn caused by IgG anti-E / 中华检验医学杂志

A case of hemolytic disease of the newborn (HDFN) caused by immunoglobulin (Ig) G anti-E was analyzed in this study. The ABO and Rh blood group of the newborn was O and CcDEe, respectively. The ABO and Rh blood group of her mother was A and CCDee, respectively. Thus, the reason of ABO and RhD hemolysis were impossible. The incompatible antibodies were found in the newborn serum by three serological tests. The antibody screening and identification test using the plasma and the red blood cell eluate from the newborn and the plasma from her mother showed that the HDFN was caused by the IgG anti-E antibodies. The case was caused by failing to prenatal screening for irregular antibodies. Therefore, the prenatal screening for irregular antibodies seems necessary for pregnant women to prevent, diagnose or manage the HDFN at an early time, reducing the occurrence of perinatal complications.

Evaluación de la sangre ovina como suplemento nutritivo en medios de cultivo: citratada y desfibrinada / Evaluation of sheep blood as nutritive suplement in culture media: citratated and defibrinated

Introducción: La sangre ovina constituye un suplemento esencial en la elaboración de medios de cultivo, dado que aporta factores nutricionales indispensables para el crecimiento y la recuperación de diversos microorganismos. Objetivo: Evaluar comparativamente el efecto de la sangre ovina, tanto citratada como desfibrinada, en medios de cultivo de base agar en cuanto al crecimiento bacteriano y la producción de hemólisis de cepas de referencia de diferentes bacterias patógenas, así como la recuperación o el aislamiento de microorganismos de muestras clínicas. Métodos: Se realizó un estudio observacional, descriptivo y transversal en 6 laboratorios de microbiología de la ciudad de Santiago de Cuba durante el año 2017, en los cuales se empleó sangre de ovinos de la raza pelibuey, para la elaboración de medios de cultivo. A cada laboratorio se le suministró tanto sangre citratada como desfibrinada y se le entregó una encuesta para valorar los resultados. Resultados: Existió un mejor crecimiento y aislamiento bacteriano en el medio suplementado con sangre desfibrinada, a pesar de que el rendimiento o los resultados en el caso de la sangre citratada resultaron satisfactorios. Conclusiones: Se confirmó la pertinencia del uso de la sangre desfibrinada como suplemento de enriquecimiento nutritivo en medios de cultivo; no obstante, quedó demostrada la utilidad de la sangre citratada en la labor de rutina del laboratorio de microbiología clínica.

Introduction: Sheep blood is an essential supplement in the elaboration of culture media, as it provides important nutritional factors for the growth and recovery of different organisms. Objective: To evaluate comparatively the effect of sheep citrated and defibrinated sheep blood in culture media with agar base as for the bacterial growth and the production of hemolysis in reference strains from different pathogen bacteria, as well as the recovery or isolation of microorganisms from clinical samples. Method: An observational, descriptive and cross-sectional was carried out in 6 microbiology laboratories in Santiago de Cuba city during 2017, in which male sheeps blood from the pelibuey breed for elaborating culture media. Each laboratory received either citrated blood or defibrinated and a survey was delivered to evaluate the results. Results: There was a better growing and bacterial isolation in the media supplemented with defibrinated blood, although yielding or results were favorable with citrated blood. Conclusions: The pertinence of the use of defibrinated blood as a supplement of nutritive enrichment in culture media was confirmed; however, the use of citrated blood was demonstrated in the routine work of the clinical microbiology laboratory.

Stability of IgE in Postmortem Plasma and Hemolyzed Samples / 法医学杂志

Objective To investigate the stability of IgE in postmortem plasma and hemolyzed samples under different storage conditions and freezing-thawing. Methods Thirty nine cardiac blood samples were collected from non-frozen corpses with the postmortem interval of less than 48 hours, including 20 plasma samples and 19 hemolyzed samples taken from whole blood. The samples were stored at -20 ℃, 4 ℃ and 25 ℃ for 28 d and at -80 ℃ for 1 year to evaluate the stability of IgE under different storage conditions. Repeated freezing-thawing treatment was conducted for 5 times to explore the stability of IgE in postmortem plasma and hemolyzed samples. IgE concentration in plasma and hemolyzed samples was detected by electroluminescence before and after treatment. Results The degradation rates of IgE in plasma samples under the three storage conditions, -20 ℃, 4 ℃ and 25 ℃ were close. After 28 d, the mean value was about 15%, the degradation speed of IgE in hemolyzed samples was faster than that of plasma under the same condition （P<0.05） and the degradation rate was faster than other two conditions under 25 ℃ （P<0.05）. The differences in the concentration of plasma samples after freezing at -80 ℃ for 1 year and that before freezing had no statistical significance （ P>0.05）, while the concentration of hemolyzed samples was degraded after freezing at -80 ℃ for 1 year （P<0.05）. The differences between the detection results of plasma and hemolyzed samples after repeated freezing-thawing for 5 times and that before freezing-thawing showed no statistical significance （ P>0.05）. Conclusion IgE has good freezing-thawing stability in postmortem plasma and hemolyzed samples. Stability of IgE is better in postmortem plasma samples than hemolyzed samples, thus it is recommended to separate plasma from postmortem blood samples as soon as possible in forensic practice.