Systematic evaluation and classification of adverse reactions to incompatible blood component transfusion in patients undergoing ABO-incompatible allogeneic hematopoietic stem cell transplantation / 中国输血杂志

【Objective】 To analyze and evaluate the occurrence of adverse reactions to incompatible blood component transfusion in patients undergoing ABO-incompatible allogeneic hematopoietic stem cell transplantation (ABO-incompatible allo-HSCT) in our hospital, and provide a basis for clinical safety management of incompatible blood component transfusion. 【Methods】 The case data of 467 ABO-incompatible allo-HSCT patients with incompatible blood components transfused in our hospital from June 2021 to December 2021 were retrospectively analyzed, and the adverse reactions to blood transfusion that occurred were diagnosed according to the clinical manifestations and changes before and after blood transfusion as well as the results of related laboratory tests. The evaluation was based on three aspects as the degree of certainty of the type of reaction, the severity of it, and its probablity associated with blood transfusion. 【Results】 The overall incidence of adverse reactions to transfusion of incompatible blood components was 30.19% (141/467). The incidence occurred in suspended red blood cells were 42.86%(15/35), apheresis platelets 39.25%(73/186), frozen plasma 28.26%(26/92), cryoprecipitated coagulation factors 19.05%(8/42) and washed red blood cells 16.96%(19/112). The incidence of adverse reactions of washed red blood cells and suspended red blood cells was statistically different(P<0.05). The types of adverse reactions were mainly allergic reactions (67.37%, 95/141), followed by non-hemolytic febrile reactions (22.69%, 32/141), transfusion-related graft-versus-host disease(2.84%, 4/141), acute hemolytic transfusion reactions(2.84%, 4/141), transfusion-related hypotension(2.84%, 4/141) and 2 cases (1.42%, 2/141) of other adverse reactions. A total of 141 adverse reactions were graded: 113 cases (80.14%, 113/141) were " sure" , 20 cases (14.19%, 20/141) were " basically sure" , 8 cases were " suspected" (5.67%, 8/141); 130 cases (92.20%, 130/141) were " mild" , and 10 cases (7.09%, 10/141) were" moderate" , 1 case was " severe" (0.71%, 1/141). As to the occurrence associated with blood transfusion: 117 cases (82.98%, 117/141) were " highly correlated" , 17 cases (12.06%, 17/141) were " likely correlated" , and 7 cases (4.96%, 7/141) were " less correlated" . 【Conclusion】 Evaluating and grading the adverse reactions to transfusion of incompatible blood components can deepen the cognition of clinical medical staff, increase the accuracy and rigor of their judgment of adverse reactions, and avoid the missed and false reports of adverse reactions to a certain extent, which laid the foundation for the establishment of a unified standard for adverse reactions to incompatible blood transfusion.

The Local Alternative Ti-6Al-4V Alloy Coating of Surgery Steel Instruments for Laser Deposition Forming / 中国医疗器械杂志

Aiming at the medical practice problems of the surgical steel medical instruments, such as the crevice corrosion, the poor mechanical compatibility and the Ni, Cr plasma exudation, the laser deposition of Ti-6Al-4V alloy cladding layer at the local functional area as alternative coating was proposed and realized as a new process method. The accurate element content and good formability Ti-6Al-4V cladding powder was chosen, the low power and high duty cycle optimized laser process was adopt, the alternative coating of good fusion and low dilution was prepared. Through the elemental line scanning, the interface microstructure analysis and the experiments of basic mechanical properties, the basic properties of the cladding were characterized and verified. The experiments results showed that, the Ti, Al and V contents of the top coating were respectively about 88%, 4.9% and 3.9%, no sensitizing ions such as Cr and Ni were detected. Initial equiaxed α phase, flake β phase dist were distributed in the coating and interface, the α' martensite was precipitated at the boundary of the flake β phase, some refined granular β phase dispersion pinned to the grain boundary of basket structure. The microhardness of cladding layer was 352.08~312.76 HV0.1. The friction coefficient of the cladding layer was about 0.22~0.65. A new technology and method reference for improving and upgrading the performance of surgical medical devices is provided by this research.

Drug eruption in children / 中国小儿急救医学

The epidemiology, clinical manifestations and appropriate diagnostic methods of drug eruption in children are still poorly understood.On the one hand, children′s adverse reactions to drugs are different from adults because of their weight and age characteristics.On the other hand, they can mimic many other skin diseases, especially viral exanthems, frequently appearing as a maculopapular or morbilliform rash sometimes indistinguishable from a cutaneous adverse drug reaction.Meanwhile, the tools used for drug eruption management in adults are applied also for children.Whereas this appears generally acceptable, some aspects of drug eruption and management differ with age.The pathogenesis of drug eruption in children is related to virus infection, immune state, drug and metabolic enzyme effect.Most reactions in children are still attributed to betalactams.The practicability and validity of skin test and other diagnostic procedures need further assessment in children.The key to treatment is early diagnosis, discontinuation of suspect drugs, assessment of prognosis, and specialist support.

Drug eruption in children / 中国小儿急救医学

The epidemiology, clinical manifestations and appropriate diagnostic methods of drug eruption in children are still poorly understood. On the one hand,children′s adverse reactions to drugs are dif-ferent from adults because of their weight and age characteristics. On the other hand,they can mimic many other skin diseases,especially viral exanthems,frequently appearing as a maculopapular or morbilliform rash sometimes indistinguishable from a cutaneous adverse drug reaction. Meanwhile,the tools used for drug erup-tion management in adults are applied also for children. Whereas this appears generally acceptable, some aspects of drug eruption and management differ with age. The pathogenesis of drug eruption in children is related to virus infection,immune state,drug and metabolic enzyme effect. Most reactions in children are still attributed to betalactams. The practicability and validity of skin test and other diagnostic procedures need further assessment in children. The key to treatment is early diagnosis, discontinuation of suspect drugs, assessment of prognosis,and specialist support.

Analysis of Pathogens and Drug Resistance in 380 Children with Vulvovaginitis / 中国药房

OBJECTIVE:To explore the characteristics of pathogens distribution of pediatric vulvovaginitis and drug resis-tance,and to provide reference for clinical drug use. METHODS:409 strains of positive routine bacteria and fungus culture were collected from 380 children with vulvovaginitis in 2014. The pathogens culture and drug sensitivity were recorded. RESULTS:The top 5 bacteria were Escherichia coli [36.67%(150/409)],Haemophilus influenzae [20.29%(83/409)],Streptococcus hemolyticus group A [13.20%(54/409)],Klebsiella pneumonia [8.80%(36/409)] and Staphylococcus aureus [5.37%(22/409)]. CONCLU-SIONS:The main pathogenic bacteria of pediatric vulvovaginitis is Gram negative bacilli,so that drug resistance should be paid at-tention to improve therapeutic efficacy when antibiotics are used in the clinic. The result of sensitivity test should be taken as basis for rational application of antibiotics in the treatment.