Prevalence and trends of transfusion-transmittable infections among blood donors in Southwest China.

BACKGROUND: The high prevalence of transfusion-transmitted infections (TTIs) is causing serious harm to human health worldwide. The aim of this research was to assess the prevalence and influencing factors of TTIs in Southwest China. METHODS: A retrospective study of blood donor records from January 2008 to December 2015 was conducted. All samples were screened for HBV, HCV, HIV and syphilis. The donor's data was recorded and analyzed statistically using SPSS software. RESULTS: We revealed that the prevalence of TTIs showed a decreasing trend from 2.39 to 1.98%, and this was slightly lower than that in other regions of China. Syphilis infection was the most serious issue among blood donors in Southwest China, which demonstrated a significantly higher rate than that in other areas of China. The high infection rate of the female and farmer groups in rural regions is worth noting. The logistic regression model showed that age, occupation and donor category was the influential factors for TTIs. CONCLUSIONS: The overall prevalence of TTIs demonstrated a decreasing trend from 2008 to 2015 in Southwest China, but there is still a sufficient threat to blood safety, and more efforts are needed to further guarantee blood safety in China.

Quantitative and multiplexed detection for blood typing based on quantum dot-magnetic bead assay.

BACKGROUND: Accurate and reliable blood grouping is essential for safe blood transfusion. However, conventional methods are qualitative and use only single-antigen detection. We overcame these limitations by developing a simple, quantitative, and multiplexed detection method for blood grouping using quantum dots (QDs) and magnetic beads. METHODS: In the QD fluorescence assay (QFA), blood group A and B antigens were quantified using QD labeling and magnetic beads, and the blood groups were identified according to the R value (the value was calculated with the fluorescence intensity from dual QD labeling) of A and B antigens. The optimized performance of QFA was established by blood typing 791 clinical samples. RESULTS: Quantitative and multiplexed detection for blood group antigens can be completed within 35 min with more than 105 red blood cells. When conditions are optimized, the assay performance is satisfactory for weak samples. The coefficients of variation between and within days were less than 10% and the reproducibility was good. The ABO blood groups of 791 clinical samples were identified by QFA, and the accuracy obtained was 100% compared with the tube test. Receiver-operating characteristic curves revealed that the QFA has high sensitivity and specificity toward clinical samples, and the cutoff points of the R value of A and B antigens were 1.483 and 1.576, respectively. CONCLUSION: In this study, we reported a novel quantitative and multiplexed method for the identification of ABO blood groups and presented an effective alternative for quantitative blood typing. This method can be used as an effective tool to improve blood typing and further guarantee clinical transfusion safety.

[Purine and carboline alkaloids from ascidian Symplegma oceania].

Five purine and carboline alkaloids were isolated from the methanol extract of the ascidian Symplegma oceania. Classic chromatographies including preparative HPLC were used for isolation and purification of the compounds. The structures were established as 6-methoxy-7-methyl-8-oxoguanine (1), 2-methylimino-3-methyl-6-methylamino- 9H-purine (2), 1,2,3,4-tetrahydro-betacarboline (3), 1,2,3,4-tetrahydro-1-methyl-beta-carboline (4) and 1,2,3,4-tetrahydro-beta-carboline-3-carboxylic acid (5) by comparison the spectroscopic data (MS, 1H, 13C-NMR) with those reported in the literatures. Compounds 2-5 were reported from the the genus Symplegma for the first time. The purine and carboline were the major alkaloid types of S. oceania.

[Morphology and function of platelets stored in modified platelet additive solution at low temperature].

The aim of study was to evaluate the function of modified platelet additive solution (PAS-IIIM) with trehalose as a substitute of plasma for the storage of platelet concentrates at low temperature (10 degrees C). Apheresis platelets from 6 donors were divided and added with different media (group A: 100% plasma; group B: 70% PAS-IIIM/30% plasma; group C: 100% plasma/trehalose). Groups A, B, C were stored at 10 degrees C, 22 degrees C and -85 degrees C separately. In addition, group D (platelet concentrates stored with 100% plasma at 4 degrees C) was set up as control group for scan electronmicroscopy. The samples of each platelets were collected on day 0, 1, 5, 7 and 9 after storage respectively, while samples of platelets stored at -85 degrees C (group C) were collected on day 20 after storage. CD62p, hypotonic shock response (HSR), platelet aggregation, lactic dehydrogenase (LDH) and morphology of platelets were evaluated. The results showed that the expressions of CD62p in groups A and B increased in a time-dependent manner, but HSR and platelet aggregations decreased. The expression of CD62p, LDH release, and platelet aggregation in group A were significant higher than that in group B (p < 0.05). HSR in group A was significant lower than that in group B (p < 0.05). LDH release was significant high in samples of group C and the expression of CD62p was lower than that in other two groups (p < 0.05). It is concluded that the protective effects of 70% PAS-IIIM/30% plasma (10 degrees C) and plasma platelets (22 degrees C) on morphology of platelets are similar, but better than those of plasma platelets (4 degrees C) and plasma/trehalose (-85 degrees C). In short, PAS-IIIM serves as a good substitute of plasma for platelet storage, and protects the chilled platelets.

HCV infection in voluntary donors and its influence on recruitment of donors in Chongqing area.

Blood donor recruitment models have changed from paid donors to employer-organized donors and to voluntary donors in China. Reports on the hepatitis C virus (HCV) infection among voluntary blood donors in China have been rarely found at present. The prevalence of anti-HCV and genotypes among the first-time voluntary blood donors was investigated in Chongqing area of China. A total of 13,620 serum samples were collected from the first-time voluntary blood donors in Chongqing, China. Anti-HCV antibody was tested by ELISA. The Core/E2 region of HCV RNA from HCV seropositive samples was amplified by RT-PCR for genotyping. The results indicated that the prevalence of anti-HCV averaged 0.49% (67/13,620), and the highest rate (0.86%) was obtained in the group aged 40 to 49. A higher prevalence was observed among the more educated donors, and metropolitan donors. The ratios of following genotypes 1b, 2a, 3a and 3b were 4 (18%), 5 (23%), 9 (41%) and 4 (18%) in all the 22 samples respectively. Genotype 3 (3a and 3b) was the predominant genotype. In conclusion, the prevalence of anti-HCV was low among the population of voluntary blood donors in Chonqing area. The genotyping results showed the possibility of presence of druggies among the voluntary blood donors. Therefore, more attention should be paid to exclude those high-risk persons from the volunteers.

Hexaaqua-hexa-kis(µ(2)-3,5-diamino-4H-1,2,4-triazole)trinickel(II) tris-(hexa-fluoridosilicate) icosa-hydrate.

The trinuclear cation of the title compound, [Ni(3)(C(2)H(5)N(5))(6)(H(2)O)(6)][SiF(6)](3)·20H(2)O, has the six 3,5-diamino-1,2,4-triazole ligands each bridging two metal atoms; the metal atom in the middle, which lies on a special position (of 32 site symmetry), is connected to six N atoms in an octa-hedral geometry. The other metal atom, which lies on a special position (of 3 site symmetry), is connected to three N atoms and three O atoms. One hexa-fluroridosilicate anion lies on a site of 3 symmetry and the other lies on a site of symmetry. The hexa-cation, dianions and uncoordinated water mol-ecules inter-act through hydrogen bonds to form a three-dimensional network. One uncoordinated water molecule is disordered, with site occupancy 0.3.

[Change of free hemoglobin content after mixing type B whole blood with different amounts of type O whole blood].

To investigate the changes of free hemoglobin (FHb) content after mixing type B whole blood with different amounts of type O whole blood at room temperature and at 37 degrees C, two lots of type B whole blood stored at 4 degrees C for 24 hours were randomly taken as recipient blood, and were packed as 60 ml respectively. Type O blood was taken as donor blood. 60 ml type B whole bloods were mixed with different amounts of type O whole blood, i.e. with 9, 12, 15 and 18 ml. The mixed blood was packed into 100 ml plastic blood bags and stored at 37 degrees C or room temperature, shaken once every 15 minutes. Free hemoglobin content was determined for the harvested samples at 1, 2, 4, 8 and 12 hours after store. The results showed that there was no significant elevation of FHb within 12 hours after mixing B whole blood with different amounts of type O whole blood. In another lot, there was obvious difference in FHb after 1 hour store along with the prolongation of store at either room temperature or 37 degrees C. In one lot, there was no difference of FHb (P > 0.05) during 1 - 8 hours of store at room temperature or 37 degrees C, but significant difference at 12 hours of store (P < 0.001). In another lot, there was no difference of FHb (P > 0.05) within 1 hour of store at room temperature and at 37 degrees C, but significant difference during 2 approximately 8 hours of store (P < 0.001). It is concluded that the FHb would not change significantly within 12 hours after type B blood was mixed with 1 200 ml of type O whole blood, but when the mixed blood was placed at room temperature or at 37 degrees C for 8 hours, the FHb content approaches, even exceeds 170.4 mg/L which was observed in the blood stored for 2 days. It suggests that freshly collected blood must be put into refrigerator of 2 approximately 4 degrees C for storing as soon as possible, so as to decrease the catabolism of erythrocyte and the releasing of FHb and other metabolites which are deleterious to the recipients.

[Report on difficulty in blood group identification due to anti-H antibody in three cases].

Anti-H antibody belongs to IgM type cold antibody, which often induces the unconformity of positive and reverse typing and leads to the difficulty in clinical blood typing. Anti-H antibody was found during identification of the counter blood group in 3 cases. The antibody was found to be active at 37 degrees C, room temperature and 4 degrees C when determined by blood group serology, and was finally analyzed to be IgM. It is suggested that not to give erythrocytes of O group unreasoningly to blood recipient of AB group during emergent moment, but instead, to give same type of blood. If there was no same type of blood during urgent events, O type erythrocytes could be employed after being matched by saline centrifuging with host side coincidence and screened by incomplete method. In this case, anti-H antibody leading to adverse-reaction in blood transfusion should be prevented.

[Effects of taurine on rabbit cardiomyocyte apoptosis during ischemia/reperfusion injury].

AIM: To study the effect of taurine (Tau) on rabbit cardiomyocyte apoptosis during ischemia/reperfusion (I/R) injury. METHODS: Rabbit heart I/R injury was induced by occluding the left anterior descending coronary artery for 45 min and reperfusion for 180 min. taurine (200 mg/kg) was intravenously injected 5 min before heart ischemia. Cardiomyocyte apoptosis was measured by using terminal deoxynucleotidyl transferase--mediated dUTP nick end labeling method (TUNEL), flow cytometry (FCM) and DNA agarose gel electrophoresis. RESULTS: DNA ladder pattern of DNA in myocardium was revealed by agarose gel electrophoresis in I/R group while was not found in Tau + I/R group. Apoptotic cardiomyocytes were sparse within ischemic myocardium at risk in Tau + I/ R group as compared with that in I/R group (TUNEL stain). Apoptosis rate in ischemic myocardium from I/R and Tau + I/R groups detected by flow cytometry was 17.66% +/- 1.54% and 4.86% +/- 1.23%, respectively. Fas and Bax protein expressions in ischemic myocardium of I/R group were higher than that in nonischemic myocardium group (P < 0.01), Bcl-2/Bax ratio in I/R group was lower than that in nonischemic myocardium (P < 0.01); while in Tau + I/R group, Fas and Bax protein expressions were lower than that in I/R group (P < 0.01), the Bcl-2/Bax ratio was higher than that in I/R group (P < 0.01). CONCLUSION: Taurine reduced apoptosis of myocytes in I/R rabbit heart; its mechanism may involve Fas, Bax and Bcl-2 proteins expression.

[Experimental hemorheology study on group a whole blood added with group O whole blood].

The study was to investigate the hemorheologyic changes of group A blood recipient transfused with large amounts of group O whole blood, by erythrocyte count, sympexis index, erythrocyte deformation index, erythrocyte rigid index and whole blood reduced viscosity, 60 ml of group A whole blood were added with 9, 12, 15 and 18 ml of group O whole blood (which corresponds to the 4 000 ml whole blood added with 600, 800, 1 000 and 1 200 ml whole blood). The mixed blood was incubated at 37 degrees C with mixing at 80 times per minute. Samples were taken from the mixed blood at 30 minutes, 2, 4, 8, 12 and 24 hours after culture, and the hemorheology of the mixed whole blood was determined by FASCO-series type 3020B automatic rheograph apparatus. The results showed that there were no differences of erythrocyte count, sympexis index, erythrocyte deformation index, erythrocyte rigid index and whole blood reduced viscosity among all different kinds of mixed whole blood, and there was no difference of sympexis index at different times, but there were obvious differences of erythrocyte count, erythrocyte deformation index, erythrocyte rigid index and whole blood reduced viscosity. It is concluded that blood transfusion of 1,200 ml group O whole blood to a recipient with 50 kg of body weight but with different blood type in emergent situation may exert no harm to the erythrocytes of recipient in a short term.

[Effect of erythrocyte preserved for different lengths of time on anti-D antibody identification with three blood matching tests].

The specificity of the antigens and length of preservation time of erythrocytes are the interfering factors in blood group serological tests. In order to clarify the influence of preservation time of erythrocytes on the blood matching test, the titers of anti-D antibody were detected with papain method, BioVue cross matching card and DianaGel cross matching card in 7 series of panel red blood cells preserved for various length of time (0 to 9 months). The results showed that the titer of micro-column gel test (DianaGel card) was one tube higher than that of column agglutinating test (BioVue card). The titer of erythrocytes preserved for 9 months was as high as 256 tested by DianaGel card, but it was only 2 by papain method in the same anti-serum. It is suggested that there was no obvious difference between the results of micro-column gel test and column agglutinating test, and titer of papain method was the lowest.

Clinical assessment of preventing febrile nonhemolytic transfusion reaction by leukocyte-depleted blood transfusion.

The objective was designed to assess the clinical efficiency of preventing febrile nonhemolytic transfusion reactions (FNHTR) with transfusion of leukocyte-depleted RBC and platelet concentrates. One hundred patients with cirrhosis of liver, gastric ulcer and cancer were selected to receive RBC concentrates with leukocyte filtration. Another group of 50 patients with liver necrosis, gastric ulcer and cancer were selected to receive non-filtered RBC concentrates. Two hundred and forty patients with acute or chronic leukemia, aplastic anemia, multiple myeloma, thrombocytopenia purpura, diabetes mellitus, cirrhosis of liver, upper gastrointestinal hemorrhage, severe hepatitis, burn and cancer post radioactive or chemical treatment were divided into two group with 120 patients in each one and selected randomly to receive platelet concentrates. The incidence rates of FNHTR in all patients were investigated. Results showed that there was no FNHTR in 100 transfusions with leukocyte-depleted RBC concentrates. Eight out of 50 patients with non-filtrated RBC concentrates showed FNHTR. The incidence of FNHTR was sixteen (16%) in non-filtrated transfusion. Twenty-five and 7 patients manifested FNHTR respectively in non-filtrated or filtrated platelets transfusions. The incidence of FNHTR was 20.83% and 5.83% respectively in non-filtrated or filtrated platelet transfusion. It is concluded that leukocyte-depleted RBC and platelet concentrates reduces FNH TR in blood transfusion.

[Leucocyte removal and its clinical application].

Blood transfusion leads to leucocyte-mediated adverse reactions related to the transfusion of leucocytes in allogeneic blood and blood products. The leucocytes are also capable of transmitting virus infection. Leucocyte depletion of homologous blood products can effectively reduce the immunosuppressive effect as well as minimize the likelihood of transmitting virus. Blood component transfusion is generally "buffy-coat-poor", which removes about two thirds of the leucocytes present in whole blood. Using special filters, blood component can be filtrated 99.9% of the leucocytes. Leucocyte-depletion using filter should significantly lessen the leucocyte-mediated transfusion adverse reactions, such as febrile non-hemolytic transfusion reactions and graft versus host disease. At the same time, leucocyte filtration can decrease the risk of transmitting virus. Otherwise, leucocyte-depletion plays very important role in the treatment of cardiac surgical patients to attenuate leukocyte-mediated inflammation and organ reperfusion injury, the treatment of ulcerative colitis, and the treatment intractable diseases such as autoimmune and neurologic diseases.

High Prevalence of HBV in Tibet, China.

Hepatitis B virus (HBV), distributed throughout the world, is classified into seven geographically separated genotypes designated A to G. Since the prevalence of HBV infection in isolated ethnic Tibetan populations in China, and the HBV genotypes involved have been hither to remained unclear, we collected 262 blood samples from four isolated villages in the east and west regions of Tibet. The prevalence of HBV infection was estimated by EIA for HBV Ag and HBV Ab. The HBV genotypes were determined by a PCR-microwell plate hybridization method using plasma DNA. The prevalence of HBV Ag and HBV Ab positives was 19.1% (50/262 cases) and 29.0% (76/262 cases), respectively. We detected only the C genotype (20/20 cases), this being known as a predominant type of HBV among Mongoloid populations in Asia. The results revealed, for the first time, that Tibetan villagers have a high rate of infection with HBV of C genotype, in line with the available data for chronic hepatitis and liver cancer.