ObjectiveTo study the preoperative factors of perioperative red blood cells suspension (CRCs) consumption in cardiopulmonary bypass (CPB) valve surgery. MethodsClinical data from 71 adult patients of selective CPB valve surgery during December 2012 to November 2014 were collected and analyzed. By binary logistic regression to find out risk factors of perioperative CRCs large consumption (≥8 U) in 5 variables (including age, body mass index (BMI), left ventricular ejection fraction (LVEF), preoperative creatinine (Cr), alanine aminotransferase (ALT), peripheral vascular disease history, atrial fibrillation and flutter in 2 weeks before surgery, cardiac function). ResultsIn single variable logistic regression, 5 variables were in the equation (age, BMI, LVEF, preoperative Cr and peripheral vascular disease history, P <0.10, respectively.). In multivariable logistic regression, 3 variables were in the equation (age, preoperative Cr and BMI, P<0. 10, OR = 2.128, 4.244 and 0. 264, respectively). ConclusionMore blood should be prepared for patients of elder, higher preoperative Cr and less BMI due to the possibility of the patients with perioperative CRCs in needs of large consumption(≥8 U).

ObjectiveTo guide the clinical rational use of blood by retrospective analysis of red blood cell transfusion in orthopedic patients. MethodsRandom checked 98 medical documents with transfusion record in a third-grade class-A hospital from 2013 to 2014. Restrictive transfusion group was adopted in 41 patients whose concentration of hemoglobin (Hb) was less than 70 g/L before transfusion. Liberal transfusion group was adopted in 57 patients whose Hb was less than 100 g/L. The outcomes were compared afterwards. ResultsAsignificant differences was seen between the two groups with respect to the initial Hb (P <0.01). No significant difference was observed in the volume of blood transfused,the blood lost,and the length of hospital stay. ConclusionRestrictive transfusion strategy could be advocated in orthopedic patients .

ObjectiveTo investigate the clinical application of predeposit autotransfusion in gynecological patients. MethodMaking analyses of 259 cases of patients with gynecological diseases who were applied with predeposit autotransfusion in our hospital from January 2013 to November 2014. Result259 cases of patients, except for 9 cases who were mild nausea, muscle cramps, and subcutaneous hematoma after blood collection, the rest had no adverse reactions (incidence of adverse reactions 3.47%), 200 ml~400 ml blood were collected each time and totally 98 600 ml. Thirteen patients failed to receive the autologous blood transfusion (3 600 ml wasted), the rest were successfully transfused, with a transfusion rate of 94.98%(246/259). No adverse events happened, and 95000 ml of allogeneic blood were saved. Compared with that before blood collection, Hb and Hct values of the blood after collection fell into the acceptable range (P> 0.05). ConclusionPredeposit autotransfusion is easy to carry out and is effective in saving precious blood resources, reducing the use of allogeneic blood to improve transfusion safety, ease the pressure of blood supplement and other issues. The gynecological patients are as well relatively safe. This method shows its clinical value.

ObjectiveTo explore the distribution of ALT(alanine aminotransfease) disqualified blood donors and influential factors for the disqualification so as to find evidence for lowering the incidence of unqualified ALT, and additionally, to evaluate the meaning of ALT test in volunteer donors. MethodsBy applying retrospective analysis, gathering information about volunteer donors from Anyang city, making analysis on the reasons of ALT disqualification and the population distribution. ResultsAmong the volunteer donors from Anyang city, the ALT disqualification rate is 1.20%, which can be mostly seen in donors who are male, aging from 26~35 who are self-employed. What is more, the positive rate tends to be higher in August and September. ConclusionA fixed donor group should be actively organized, and consultation before blood donation and ALT primary screening test should be regulated to lower ALT disqualification rate.

ObjectiveTo explore the clinical significance of KDIGO standards in the patients with MODS combined with AKI for the time selection of blood purification therapy. Method150 patients with MODS/AKI were selected in our hospital who needed blood purification, and then were divided into three groups of KDIGO 1,2,3 according to the KDIGO criteria and three groups of APACHEⅡ scored <15,15 to 25,> 25 according to the APACHEⅡ criteria. The survival rate of patients in each group and the renal function improvement, average length of being hospitalized, cost of treatment and the total amount of CBP ultrafiltration treatment were respectively compared. ResultThe survival rates, renal function improvement, the average length of being hospitalized, the total cost of treatment and ultrafiltration of CBP treatment of the KDIGO1,2 patients were significantly better than patients whose APACHEⅡscore≤25 points, the difference was statistically significant(P<0.05). KDIGO3 patients’ survival rates, renal function improved survival rates, average length of stay, treatment costs and CBP treatment’s total ultrafiltration had no significant difference with patients in group of APACHEⅡscore>25(P>0.05). ConclusionThe blood purification treatment on the patients in the period of KDIGO1 and 2 can significantly improve the therapeutic effect.

ObjectiveThis study was to investigate the expression and significance of miR-125a-3p in peripheral blood of Acute myeloid leukemia patients. MethodsReal-time fluorescent quantitative PCR was performed to detect the expression levels of miR-125a-3p in peripheral blood specimens of 119 AML patients, including 53 newly diagnosed, 12 relapsed and 54 treated patients. In addition, 12 healthy persons were selected as normal controls. Moreover, 7 persons were selected randomly from newly diagnosed patients for dynamic monitoring of miR-125a-3p levels in peripheral blood. ResultsCompared with normal controls, the expression levels of miR-125a-3p were decreased significantly in newly diagnosed and relapsed patients (P<0.05). However, miR-125a-3p expression in treated patients were increased (P> 0.05). The researchers compared respectively the expression levels of miR-125a-3p in different FAB subtypes of newly diagnosed and treated patients and found that there were no significant differences among various subtypes in newly diagnosed patients (P>0.05). In treated patients, the expression of miR-125a-3p in M4 patients was significantly higher than it in M0 (P<0.05), however, the differences between other subtype patients were not significant (P>0.05). Dynamic monitoring of miR-125a-3p levels of 7 patients showed that miR-25a-3p expression maintained a higher level in the process of the treatment; when one patient with remission relapsed after 4~5 courses of treatment, miR-125a-3p expression reduced again. ConclusionThe expression of miR-125a-3p is obviously decreased in patients with newly diagnosed and relapsed AML, and chemotherapy arises the expression level, which may be related with the occurrence and development of AML. Thus miR-125a-3p is expected to become a biological marker of AMLin evaluating for therapy efficacy and monitoring.

ObjectiveThe study was to investigate the diagnostic values of FDP and D-dimer in patient with acute cerebral infarction(ACI) and deep vein thrombosis(DVT). MethodsThe plasma concentrations of FDP and D-dimer were retrospectively statistically analysed, which included 295 cases of ACI, 84 cases of DVT,and 300 cases without the above- mentioned diseases were set up as control. ResultsFDP and D-dimerin varied in ACI,DVT and the control(P<0.01). Patients with DVT, compared to those with ACI showed a significant increase(P<0.01).Diagnostic sensitivity of FDP and D-dimer was 21.5% and 36.2% in ACI, and 44.1% and 64.2% in DVT,while negative predictive value was 48.8% and 53.8% in ACI,and 86.1% and 90.4% in DVT. ROC curve analysis suggested that FDP and D-dimer had certain diagnostic value in patients with ACI and DVT. ConclusionPlasma markers of FDP and D-dimer can be used as diagnostic marker of acute vascular thromboembolic diseases, particularly in showing higher negative exclusion value in deep venous thrombosis disease.

ObjectiveTo investigate the expression and significance of inhibition of cell differentiation factor -1 (inhibitor of differentiation or inhibitor of DNA binding, id-1), vascular endothelial growth factor (vascular endothelial growth factor, VEGF) and matrix metalloproteinase-9 (matrix metalloproteinase-9, MMP-9) in normal cervical tissue, cervical carcinoma in situ and cervical squamous cell carcinoma. MethodsThe expression levels of Id-1, VEGF and MMP-9 proteins in normal tissues (n=20), cervical carcinoma in situ (n =16) and cervical squamous cell carcinoma(n =74)were examined by immunohistochemistry. ResultThe positive expression rates of Id-1, VEGF and MMP-9 in cervical squamous cell carcinora was gradually increased (P<0.05) than normal tissues, cervical carcinoma in situ, cervical carcinoma.The positive expression of Id-1, VEGF and MMP-9 was related to that of FIGO stage, histological stage(P<0.05), but it was not related to the age (P >0.05). Id-1 protein was positively related to that of VEGF (rs=0.809, P <0.05) and MMP-9 (rs=0.837, P <0.05). ConclusionThis study reveals that Id-1, VEGF and MMP-9 takes part in development and progression of cervical carcinoma. Both VEGF and MMP-9 ,and Id-1 are important biomarkers in the of diagnosis and prognosis of cervical carcinoma.

ObjectiveThe study was aimed to analyze the changing expression levels of Th22 Cells and its cytokines in patients with acute lymphoblastic leukemia and its clinical significance. MethodsClinical data of patients with acute lymphoblastic leukemia received treatment at our hospital from 2008 to 2014 was analyzed as Group A. The healthy controls were enrolled as Group B. ResultsA total of 78 patients were analyzed, Group A consisted of 43 cases and Group B 35 cases. Group A had lower level of Th22 cells, TNF-α, IL-6 and IL-22 than these of Group B (P<0.001), and had a higher levels of TGF-β than that of Group B (P<0.001). After treatment, Group A patients had a significant improvement in Th22 cells, TNF-α, IL-6 and IL-22 (P<0.001), and a great decrease in TGF-β (P<0.001). The correlation analysis indicated the level of IL-22 Group A had a significant positive correlation with the level of TNF-α (r =0.699,P<0 .001), and a significant negative correlation with the level of TGF-β (r =-0.731,P<0.001). Group A patients were divided into two groups by the levels of Th22 cells as Group A1 (≥0.71) and Group A2 (<0.71). Group A1 patients had lower recurrence rate than that of Group A2 (9.09%,2/22 vs 38.10%,8/21;Log-rank χ2 =3.963,P =0.047). ConclusionThe decrease of Th22 cells and down-regulation of IL-22 expression level may be related with pathogenesis of acute lymphocytic leukemia, and can be used in evaluating treatment effects.

ObjectiveTo explore the effects on biological activity of coagulation factor in cryoprecipitate by using dry plasma and waterbath plasma melting instrument to melt cryoprecipitate and the length of melting time. Guiding transfusion department to protect the activity of coagulation factor better in cryoprecipitate and choose the right melting instrument as well as the opportune time. Providing a theoretical basis to achieve the best effect of melt. MethodChoosing 140 bags cryoprecipitate (specifications 1.0 U / bag) provided by Kunming Blood Center of Yunnan and the acquisition time is similar (not more than five days). Choosing 80 bags cryoprecipitate as test group 1 and using water-soluble plasma melting instrument to melt. Choosing the remaining 60 bags cryoprecipitate as test group 2 and using dry plasma melting instrument to melt. Using CA-1500 automatic coagulation analyzer to test FⅧ, VWF antigen, PT, TT, APTT and Fib of 140 copies cryoprecipitate samples of which are melted 10 minutes, 20 minutes, 30 minutes in different plasma melting instruments of 37 ℃. ResultThe effects of dry and water bath plasma melting instruments and various detection index compared with no significant difference, P> 0.05. But with the extension of melting time will lead to the APTT, FⅧ, VWF antigen activity decreased, P<0.05, the difference is significant. ConclusionProlonged the time of melting plasma will cause a decrease in coagulation factor FⅧ , VWF antigen activity and the effectiveness of APTT prolonged. There is a significant difference. In order to ensure the clinical blood transfusion is safe and effective, we recommend the best melting time of cryoprecipitate as 10 minutes.

ObjectiveTo explore the feasibility of improving the recovery ratio of red blood cells in frozen-thawed red blood cells by adding an appropriate amount of xylitol during the washing process. Methods20 packs of 400mL red blood cells which were leukocyte-reduced and prepared within 6 days were selected. The plasma was removed after centrifuge and each pack was divided into 2 bags (100 ml each) as experimental group and control group. In the experimental group, xylitol with final concentration of 1.2%,0.2% was added into first washing solution (80 ml 9% NaCl) and second washing solution (200 ml 0.9% NaCl).The recovery ratio of red blood cells, residue level of glycerin and osmotic fragility in two groups were statisticaly analyzed. The key step of improving recovery ratio of red blood cells was sought by detecting the concentrate of free hemoglobin in washing process. ResultsThe recovery ratio of red blood cells was significantly higher in experimental group than that in control group（t=-10.222,P<0 .05） while the concentration of free hemoglobin after first washing was significantly lowered（t=24.496,P<0 .05）. No significant difference was seen in the residue of glycerin,osmotic fragility and free hemoglobin after additional washing（P> 0.05）. ConclusionThe key step of improving recovery ratio of frozen-thawed red blood cells was the first washing process.

ObjectiveTo evaluate the detection methodology of urinary retinol binding protein(RBP) by latex immune-nephelometry. MethodsTyhe Precision, linear range, accuracy, sensitivity, and specificity of the examination methodology that is currently used were evaluated according to the standard protocol of National Committee for Clinical Laboratory Standards (CLSI) documents. ResultsThe lowest detection limit in this methodology was 0.037 8 mg/L and the linear range was 0~10 mg/L. Repeatability precision was 1.121%, inter-assay precision was 5.536% and reproducibility precision was 6.657%. The average recovery rate was 101.83% and there was no interference to RBP detection under the existence of <100 mg/L total bilirubin or <10 mg/L hemoglobin. There was a positive correlation between the present methodology and the control reagent of urinary RBP detection (r2 =0.974 0), which was based on the platform of automatic biochemical analyzer, and there was no significance comparing with the results of urinary RBP of 40 clinical samples using these two methodology. ConclusionThe present method of urinary RBP detection, with high sensitivity, precision, accuracy and strong anti-interference, is suitable for clinical laboratory point-of-care testing (POCT).

ObjectiveTo analyze the quality of the washed red blood cells and the factors which affect the cells quality. MethodsAccording to the G18469-2012 Quality Requirements for Whole Blood and Blood Components and Technical Operation Regulation of the Blood Station (2012), we tested 96 bags of the washed red blood cells which were spot tested randomly in two years by the quality control department. They were detected with the levels of the blood capacity, hemoglobin contents, serum protein contents and hemolysis rate. Then the detected results were analyzed. Results

ObjectiveTo implement the comprehensive process management by establishing and improving the quality management system of blood transfusion. MethodsAdopt effective measures to guarantee the normal operation and continuous improvement of the system, according to the quality management system standards home and abroad, basing on the practice of our laboratory. ResultsCompared with the same period of time, the usage of suspension red cell, plasma and whole blood in year 2011 to 2013 decreased more than 12% on average. Compared with the first season of 2013, the third season showed a reasonable improvement in pre-blood-transfusion composite assignment (9.5%) and after-blood-transfusion effectiveness assignment (10.4%). During the whole process of blood transfusion, not a case of unqualified blood supplement occurred and all kinds of untoward effects happened at a rate of less than 5% in the year 2011 to 2013. All nodes in the process is under control. ConclusionThe quality management of blood transfusion process can be implemented through establishing the operable quality management system which is suitable for one’s own practical situation,and is of great importance to the quality management of the scientific and rational use of blood.