Objective To explore the safe blood transfusion strategy of Ael/Bel subtypes, sequence analysis of ABO genes in 10 samples for which the reason for serological phenotype or suspected elution subtype was conducted. Methods ABO phenotypes of ten samples were identified by serological methods. The exons 1~7,the upstream CBF/NF-Y enhancer region,promoter and the +5.8 kb erythroid cell-specific regulatory elements in ABO intron 1 genes were amplified, sequenced and analyzed. Results The serological phenotypes were identified or suspected of elution subtypes ABO gene sequences analysis showed that the genotypes of five AEL cases were ABO*AEL.02/O.01.01（2 cases）,ABO*AEL.08/O.01.01（1 case）and ABO*AEL.02/O.01.02（2 cases）,respectively; all five BEL cases were ABO*BEL.03/O.01.02. Conclusion Elution subgroup is difficult to be detected by routine serological methods. It can be accurately identified by molecular biology techniques. It is helpful to guide safe and effective blood transfusion strategies.

Objective To identify genotype of ABO subtype and to analyze the heredity of ABO allelic enhancement. Methods ABO blood grouping were identified by serological methods. The full coding regions of the ABO gene, the upstream CBF/NF-Y enhancer region, promoter, and the erythroid cell-specific regulatory elements in intron 1 were nucleotide sequenced. Exons 6 and 7 of the ABO gene were clone sequenced. Results Serological result showed A_subB. Gene sequencing showed A/B heterozygous genotype. The haplotype sequencing analysis revealed that one allele was ABO*A1.02 with a c.955C>G variation, and the other allele was ABO*B.01. Conclusion Allelic enhancement occurs when A allele carries the c.955C>G （p.Leu319Val） variation and both A and B allele were inherited simultaneously.

Objective We collected and analyzed the coagulation test results of hospitalized newborns with blood transfusion to improve the reference values of coagulation indexes and to provide data support for precise treatment of newborns. Methods Data were collected about the coagulation indexes of 5 669 hospitalized newborns from 46 hospitals in China, and the changes of coagulation indexes in newborns with different gestational ages and different days-old were compared. Results (1) The PT value of newborns in different gestational age groups decreased gradually with the increase of days-old. Compared with the same days-old group, the PT value gradually decreased with the increase of gestational age, the PT value of full-term infants being the lowest. The days-old of 0~4 days, 5~6 days and ≥16 days were statistically significant, but no difference was observed among other age groups. (2) The INR values of newborns in different gestational age groups declined with the increase of days-old. Compared with the same days-old groups, the days-old of 0~4 days, 5~6 days, 7~9 days, 11~13 days and ≥16 days were statistically significant. (3) The APTT value was found to fall with the increased newborn days-old in the three groups. Compared with the same days-old groups, the APTT value of full-term neonates was the lowest, while that of <32 weeks neonates was the highest. There was statistical significance in the 0~6 days, 10~12 days and ≥16 days. (4) With the newborn days-old in the three groups increased, the TT value had a downward trend, and there was statistical significance in the group. Compared with the same days-old, there were differences in TT values among the three groups with 1~2 days, 3~4 days and ≥16 days. (5) With the increase of days-old, the FIB value of newborns in each gestational age group fluctuated. FIB at the same days-old increased with the increase of gestational age, and had statistical significance at 1~4 days, 5~6 days, 11~12 days, 13~14 days and ≥16 days. Conclusion The coagulation function related indexes of newborns at different gestational ages and different days-old seem to have remarkable changes, which can guide the clinical diagnosis and treatment of neonatal coagulation disorders and help formulate the reference range of neonatal coagulation indexes based on gestational ages and days.

Objective To explore the blood routine index reference value of hospitalized newborns with blood transfusion throughout the country and to provide data support for blood routine reference range of newborns in different gestational ages. Methods The basic information of 5 669 hospitalized newborns with blood transfusion were collected and divided into three groups according to their gestational age：<32 w group,32~36 w group and ≥ 37 w group. The data of blood routine indexes of newborns in different gestational ages before blood transfusion were collected and analyzed. Results The erythrocyte count,the hematocrit and the hemoglobin of newborns in different gestational age groups decreased with the increase of postnatal days. There were statistical differences in the erythrocyte count of newborns on the day 0,1~2,6~7 and 9~10,but there were no differences among other time groups. The hematocrit and the hemoglobin of newborns in different gestational age groups decreased with the increase of postnatal days. There were statistical differences in hematocrit and hemoglobin among groups on the day 0~1, 1~2 and 3~4, but there were no differences among other groups. The white blood cell count of newborns in different gestational age groups decreased with the increase of postal days, and there were statistical differences among groups on day 0~1, 1~2, 2~3, 3~4, 6~7, 8~9 and ≥16 d, but no differences among other groups. The platelet count of newborns in different gestational age groups increased obviously from day 0~1 to ≥16 after birth. There were statistical differences in platelet count among groups on day 0~1, 1~2 , 7~9, 11~14 and ≥16 after birth,but there were no differences among other groups. Conclusion The changes of blood routine indexes in newborns with blood transfusion are significant,and it is helpful to guide clinical diagnosis and precise treatment to formulate the reference range of blood routine according to gestational age and postnatal days.

Objective To analyze the reference intervals of liver function index before blood transfusion in hospitalized newborns with different gestational ages and days-old,and complete the "reference value of liver function indexes" of hospitalized newborns. Methods This study adopted a multi-center retrospective survey method,taking 5 669 newborns admitted to 46 hospitals in China from January 1,2017 to June 30, 2018 as the research objects. According to a unified data collection table,the diagnosis and treatment data of hospitalized newborns were collected. The data were divided into three groups according to gestational age：<32 w group,32~36 w group,and ≥37 w group,and the liver function indicators of different days-old and gestational ages were analyzed. Results （1）The results of ALT showed that the median ALT of 0~28 days in the two groups of preterm infants was 5~8 and 8~11 U/L,respectively. The higher ALT of term infants was 11~22 U/L, which was statistically significant among different gestational age groups. ALT increased gradually with gestational age among the same days-old groups,and the ALT value of full-term infants was the highest. There were significant differences among all groups except 13~14 days of age. （2）TBIL and DBIL of newborns with different gestational age increased at first and then decreased with the increase of days-old. TBIL and DBIL were higher with the increase of gestational age in the same days-old group. （3）TP value of the three groups decreased 1~2 days after birth and then showed a gradual upward trend, and there were statistical significance in comparison with different days-old. TP increased with the increase of gestational age in the days-old. （4）ALB increased with the increase of gestational age in the same days-old group. Conclusion The reference range of liver function index is related to neonatal gestational age and days-old. Studying the range of liver function index of neonates with different gestational age and days-old is helpful to improve the accurate treatment of neonatal diseases.

Objective To investigate the blood gas indexes of hospitalized neonates with blood transfusion nationwide,and provide data support for in-depth research on the reference range of blood gas in newborns at different stages. Methods We conducted a multi-center retrospective study of 5 669 newborns with blood transfusion admitted to 46 hospitals in China between January 1, 2017 and June 30, 2018 as the research objects. According to a unified data collection table, the diagnosis and treatment data of hospitalized newborns were collected. Based on the gestational age, these newborns were categorized into three groups：<32 w group, 32~36 w group, and ≥37 w group. The blood gas values were statistically analyzed. Results The pH value of newborns fluctuated slightly with the increase of gestational age and age, but the overall trend generally increased. PO₂ showed that the <32 w group showed a decreasing trend with increasing age, and the ≥37 w group increased from 0~1 day （61.80 mmHg） to 4~5 days （72.50 mmHg） and then stabilized. Comparison of PO₂ among the three groups at the same age, PO₂ in preterm infants was greater than that of full-term infants at 0~3 days. PCO₂ showed that PCO₂ gradually decreased with the increase of gestational age among the three groups at the same day. The HCT value showed a gradual decrease trend with the increase of day and gestational age. SaO₂ showed that the ≥37 w group increased from 0~1 day （93%） to 2~3 days （96.40%） and then stabilized. Conclusion Changes in blood gas related indexes of newborns with different gestational ages and days of ages were significant. The reference ranges of neonatal blood gas indexes based on gestational age can help guide the clinical accurate diagnosis and treatment of neonatal diseases.

Objective To analyze the expression of miRNAs in stored apheresis platelets and their effects on protein levels associated with platelet aggregation. Methods Healthy male donor platelets were collected and stored at（22±2）℃. The expression profile and changes of miRNA in these platelets were detected by human miRNA array and qRT-PCR. Flow cytometry（FCM）was used to test P2Y12,VASP,GPⅡb/Ⅲa and apoptosis rate in stored platelets. Results Compared the microarray of microRNA expression in platelets stored on the 2nd with 5th days,47 miRNAs expression increased and 120 decreased. Compared the 8th storage day with 2nd day,28 miRNAs increased and 202 miRNAs decreased. Differentially expressed miRNAs were found to be associated with platelet activation,degranulation,PDGF receptor signaling pathway differentiation. As for miRNAs related to platelet aggregation,miR-155,miR-21-5p and miR-21-3p decreased on the 5th day of storage（P<0.05）,while let-7b,miR-223 and miR-3162 increased（P<0.05）. The apoptotic rate of apheresis platelets increased continuously with the increase of storage days. Proteins related to aggregation were also assayed, P2Y12 was activated and then induced the dephosphorylation of VASP. PLT GPⅡb/Ⅲa stayed relatively stable during storage. Conclusion miRNA expressions were found in banked platelets and the expressions changed over time. The changes of miRNA are associated with the corresponding protein level,and eventually lead to the change of platelet aggregation function. Some miRNA expression shows the potential role as biomarkers for platelet lesion during storage in blood bank condition.

Objective To establish biotin labeling for in vitro erythrocyte technology platform to investigate the correlation between the 24-hour post-transfusion recovery （PTR_24h） of leukocyte-reduced suspended red blood cells （RBCs）stored at 4℃ for different times and the in vitro quality indexes such as apoptosis, membrane surface molecules and energy metabolism. Methods We set different NHS-biotin concentrations 0,1,2.5,5,7.5,10,12.5 μg/mL to label mouse red blood cells（about 1×10⁹/mL）,and determined the optimal labeling conditions by flow cytometry. Based on the optimal conditions,the mice RBCs stored at 4 ℃ for different storage times（0,2,4,6,8,10,12,14 d）were biotinylated and then infused into mice. After 24 hours,blood was collected and PTR_24h was calculated by flow cytometry. The changes of CD47 molecule,phosphatidylserine（PS）on the surface of erythrocyte membrane and intracellular ATP content at different storage time were also determined and analyzed. The correlation between PTR_24h in vivo and quality indexes of RBCs in vitro was analyzed by SPSS. Results The optimal concentration of biotin labeling was 7.5 μg/mL in 1×10⁹ RBCs/mL with positive labeling rate as high as 99%. Taking hemolysis rate and erythrocyte apoptosis rate as quality control,biotin labeling did not cause many RBCs rupture（hemolysis rate <1.5%） and obvious apoptosis. Compared to the mean fluorescence intensity（MFI） on fresh RBCs group,CD47 expression significantly declined from day 10（80.4%）（P<0.05）. External exposure of membrane PS increased to （0.7±0.0） % from day 8（P<0.05）. ATP decreased significantly from day 2,and the difference was statistically significant （P<0.05）. The PTR_24h in vivo showed a decreasing trend with extended storage time. PTR_24h values on day 10 （65.8±2.9）% were significantly lower than that of fresh RBCs（94.0± 0.6）%（P<0.05）,and less than 75%. The Pearson product-moment correlation coefficient showed that there was a strong positive correlation between CD47,ATP and PTR_24h,with r=0.954 （P<0.01） and r=0.938 （P<0.01）,respectively. And PS was negatively correlated with PTR_24h （r = -0.777, P<0.05）. Conclusion The expression levels of CD47,PS and ATP content of RBCs stored at 4℃ with different times were strongly correlated with PTR_24h. It can provide a reference for clinical evaluation of blood transfusion effectiveness.

Objective To develop a new method for RhD blood group typing. Methods In the quantum dots fluorescence detection, blood group D antigen was seperated by quantum dots-antibody complexes and magnetic beads, and identified according to the ratio of fluorescence intensity before and after the reaction （Ratio value）. The detection performance of this method was validated by blood typing of 160 clinical specimens. Results When the RBC concentration is at 1×10¹⁰~1×10¹¹/L the detection of RhD blood group antigen could be completed within 35 minutes. The intra- and inter-group variation coefficients of the detection system were 3.86% and 5.06%, respectively. Compared with the tube test method, the accuracy of the quantum dots fluorescence detection was 100% by the RhD blood group results of 160 clinical samples. ROC curve analysis showed that when the Cut-off value was 1.610, the quantum dot fluorescence detection method had the highest sensitivity and specificity. Conclusion Quantum dot fluorescent RhD blood group detection can be used as an effective supplement to conventional RhD antigen detection methods.

Objective To compare the feasibility and validity of TRALI rat models induced by human plasma and rat homo/heterologous plasma respectively. Method After intraperitoneal injection of lipopolysaccharide in SD rats, SD rats, BN rats and human plasma were intravenously infused, and clinical symptoms, wet-dry ratio of lung tissue, and lung histopathological data were collected. Result All rats in the human plasma infusion group showed obvious TRALI-related clinical symptoms. Only 60% of the rats in the BN plasma infusion group showed different degrees of TRALI-related clinical symptoms. Almost none of the rats in the SD plasma infusion group showed TRALI-related clinical symptoms（P<0.05）. In addition, the wet-dry ratio of lung tissue and the pathological scores of lung injury in SD plasma group were significantly different from those in human plasma group（P<0.05）. There was significant difference in pathological scores of lung injury between BN plasma group and SD plasma group（P<0.05）. Conclusion Infusion of human plasma can effectively induce TRALI-SD-rat model with repeatability and stability.

Objective To discuss blood component usage during extracorporeal membrane oxygenation（ECMO） in neonates. Method Medical records of neonates who underwent ECMO respiratory support between January 2015 and March 2020 were retrospectively analyzed in three ECMO centers, namely Bayi hildren's Hospital,Seventh Medical Center of PLA General Hospital, Children's Hospital affiliated to Zhengzhou University, and Children's Hospital Affiliated to Chongqing University. Patients received suspended red blood cells（SRBCs）, frozen plasma, cryoprecipitate and platelet during ECMO support. This study explores the relationship between the transfusion of blood components and hospital mortality. Result A total of 41 patients were included in the study. Based on discharge outcome, they were divided into survival group （n=30）and death group（n=11）, with a hospital mortality rate of 26.8%. Overall, the daily hematocrit was maintained at （34.1±3.59）% close to the normal level. The transfusion volume of SRBCs and platelet was higher. Logistic regression analysis showed that the increased transfusion of SRBCs and platelet during neonatal ECMO was an independent risk factor for hospital mortality, and OR values were both 7.264 （95%CI 1.266~41.674）. Conclusion The usage of blood components during ECMO in death group increased significantly, of which the increased amount of SRBCs and platelet transfusion was associated with higher in-hospital mortality.

Objective To explore the related factors of very low birth weight infant （VLBWI） anemia, and establish a nomogram prediction model. Methods We retrospectively selected VLBWI admitted to the neonatology department and NICU of our hospital from January 2016 to July 2021 as the research objects,and recorded their general data,prenatal data,postnatal data,and complications during hospitalization. The subjects were divided into anemia group（73 cases）and non-anemia group （81 cases）according to whether they are anemia. Logistic regression analysis was used to screen the related factors of anemia of VLBWI. The nomogram prediction model was established,and the ROC curve was used to evaluate the predictive ability of the nomogram model for VLBWI anemia. Results Multivariate logistic regression results showed birth weight,gestational age at birth,hemoglobin（Hb）at birth,hematocrit（Hct）at birth,and reticulocyte hemoglobin content（RET-He）at birth were independent protective factors for anemia of VLBWI, cesarean section and pregnancy anemia were independent risk factors for anemia of VLBWI. The constructed nomogram model fits well, and the AUC value of the nomogram model predicting anemia of VLBWI was 0.921 （0.907~0.935）. Conclusion Birth weight,gestational age at birth,Hb at birth,Hct at birth,RET-He at birth,cesarean section,and anemia during pregnancy are closely related to VLBWI anemia. Clinicians and pregnant women must pay attention to health care during pregnancy control high-risk factors, and improve prognosis of delivery.

Objective To explore whether the effect of autologous platelet separation and transfusion on patients with different platelet counts is similar to each other and to find the best application range of that in aortic dissection. Methods 300 patients with aortic dissection who accepted cardiac surgery in 2014 to 2019, with age arranged from 22 to 79 years and with weight from 50 to 85 kg, were divided into four grades according to preoperative platelet count：（100~ 150）×10⁹/L,（150~200）×10⁹/L, （200~250）×10⁹/L,（250~300）×10⁹/L. And each grade was randomly divided into two groups：control group and aPRP group（the patients received autologous PRP）.The whole plateletpheresis process was completed before heperinization. Analyze the transfusion volume of allogeneic platelet,suspended red cells, plasma and cryoprecipitate of two groups during perioperative stage. Results There were no significant differences between control group and aPRP group in ages, weights, heights and PLT count before operation（P>0.05）in 300 patients. The amounts of allogeneic platelet and cryoprecipitate transfuesd was less in aPRP group than that in control group through four grades（P<0.05）. The amounts of suspended red cells（PLT count<200×10⁹/L）and plasma（PLT count<250×10⁹/L）in aPRP groups were decreased significantly comparing with control groups（P<0.05）. However,there was no significant differences in the transfusion volume of suspended red cells（PLT count≥200×10⁹/L）and plasma（PLT count≥250×10⁹/L）between aPRP and control groups（P>0.05）. Conclusions In order to reduce the use of allogeneic platelets,autologous platelet separation and transfusion technology can be applied to patients with normal platelet count. For patients with platelets count in the range of（100~200）×10⁹/L,autologous platelet separation and transfusion technology should be strongly recommended. It can significantly save blood products.

Objective To compare the effects of liberal transfusion strategy and restrictive transfusion strategy on death and neurodevelopmental impairment of extremely low birth weight（ELBW）infants. Methods We included randomized controlled trials（RCTs） comparing the effects of two blood transfusion strategies on the prognosis of ELBW infants,and conducted systematic review and Meta-analysis. The primary outcomes,measured at 18~26 months（corrected age）,was death or a composite of neurodevelopmental impairment（cognitive delay,cerebral palsy, hearing loss,vision loss）. We searched following English databases,PubMed,Cochrane Central Register of controlled Trials,EMBASE,Clinicaltrials until February 1,2021. In the Chinese databases,we searched CNKI,Wanfang Database,VIP and CBM. The retrieval deadline was August 11,2021. For binary variables,we calculated risk ration（RR）. Results A total of 3 288 infants from 3 RCTs were analyzed. 1 657 infants were randomly assigned to the restrictive transfusion group and 1 631 infants to the liberal transfusion group. There was no significant difference in the primary outcomes between the two groups （RR=1.01, 95%CI=0.93~1.09,I²=7%,P>0.05）. Statistical heterogeneity was observed only in the synthesized results of cognitive delay（I²=60%,P=0.08）. Conclusions For ELBW infants,restrictive transfusion strategy did not increase the likelihood of death or neurodevelopmental impairment at 18~26 months of corrected age.

Objective To evaluate the efficacy and safety of different dose of platelets in pediatric patients with acute lymphoblastic leukemia. Methods It was a retrospective analysis of 483 platelet transfusions in 56 pediatric patients with acute lymphoblastic leukemia. All cases were divided into three groups according to the actual infusion dose per unit body surface area. Low dose group：<2.2×10¹¹/m²,middle dose group：2.2~4.4×10¹¹/m²,high dose group：>4.4×10¹¹/m². The 24-h platelet count increase index（CCI）was calculated and adverse reaction events were recorded during transfusion. We compared the efficacy between different transfusion doses,and analyzed the CCI values in the effective infusion cases. Results There were no significant differences for the effective rate of platelet transfusion and adverse reaction rate among the three groups. In the effective transfusion cases,there was no statistical difference in CCI values between the groups,but in PPI values,there was statistical difference. Conclusion In children with acute lymphocytic leukemia,the platelet infusion dose is not a major influencing factor of the efficacy. And the high-dose platelet infusion does not improve the platelet count increase index. The 0.5 therapeutic dose of platelets are feasible in pediatric application.

Objective To investigate the effect of SENEX on the proliferation and apoptosis of Acute Myeloid Leukemia (AML) cells. Methods 20 adult patients with newly diagnosed AML, 5 relapsed AML, 17 complete remission of AML, and 7 control bone marrow samples were selected. The expression level of SENEX was detected by qPCR, apoptosis was detected by flow cytometry, and cell proliferation was detected by CCK8. Results (1) The expression level of SENEX increased in newly diagnosed and relapsed AML, and was related to the disease status; (2) After sliencing with SENEX, the cell proliferation efficiency of NB4 cells decreased and the proportion of apoptosis increased; (3) IL-35 can attenuate the apoptotic proportion of NB4 cell and the upward trend of SENEX gene induced by cytarabine . Conclusions enex might participate in the occurrence and development of AML by directly promoting the proliferation of AML cells and inhibiting the apoptosis of AML cells.

Objective To investigate and analyze the relationship between GCK gene polymorphism and steroid diabetes (SD) in patients with primary nephrotic syndrome treated with glucocorticoid. Methods From January 2015 to December 2019, 148 patients with primary urinary nephrotic syndrome were continuously recruited, and they received glucocorticoid-induced immunotherapy. DNA was extracted from the subjects' blood samples, and the association between rs13306388, rs2971672 and rs1799884 in the GCK gene region and SD was analyzed. Results The total incidence of SD in all subjects was 35.1% (52/148). The subjects in the SD group were older than those in the non-SD group (P<0.001), and the glucocorticoid concentration/dose was higher (P<0.05). The genotype distribution of all SNPs was Hardy-Weinberg equilibrium (P>0.05). Among the allele frequencies of GCK polymorphism, only the rs2971672*C allele was significantly correlated with the occurrence of SD (OR=0.37; 95%CI=0.16 to 0.80; P=0.012). After adjusting for age in multiple logistic regression analysis, the SNP of GCK genotype rs1799884 (codominant 2 model: OR=3.63, 95% CI=1.19~12.06, P=0.027; recessive model: OR=3.78, 95% CI=1.22~11.94, P=0.035) and SNP rs2971672 (commonly dominant 1 model: OR=0.32, 95%CI=0.13~0.75, P=0.009; dominant model: OR=0.29, 95%CI= 0.12~0.68 , P=0.002) is significantly related to the occurrence of SD. Conclusion The mutations at rs2971672 and rs1799884 in the GCK gene region may affect the occurrence of SD events in primary nephrotic syndrome receiving glucocorticoid immunosuppressive therapy.

Objective To investigate the effect of prognostic nutritional index （PNI） on postoperative complications and 3-year survival rates for patients with advanced gastric （AGC） cancer. Methods The data of 106 AGC patients were extracted and analyzed between October 2015 and September 2017 in our hospital. The PNI value was calculated based on the peripheral blood lymphocyte count and albumin value,and the optimal cut-off value of PNI was calculated by a receiver operating characteristic（ROC）curve. The mean PNI of all patients was calculated. Patients were divided into high PNI group and low PNI group according to the mean PNI. The clinicopathological characteristics and overall survival rate（OS）were compared between two groups. Logistic regression analysis and Cox proportional hazard model were used to analyze the relationship between PNI and postoperative complications and long-term survival rate. Results The optimal cut-off value of PNI was 46.The mean PNI was 45.6. Sixty-nine cases were classified in high PNI group and 37 cases were in low PNI group. There were significant differences in age（χ²=4.049,P=0.044）,BMI（χ²=4.381,P=0.036）,lymph node metastasis（χ²=5.110,P=0.024）,serosal invasion（χ²=20.856,P<0.001）and postoperative complications（χ²=5.384, P=0.020） between two groups. There was significant difference in OS between two groups（χ²=15.232,P<0.001）. Unconditional binary logistic regression analysis showed that PNI<46（OR=2.256,P<0.001）and serosal invasion（OR=2.038,P<0.001） were independent risk factors for postoperative complications. In multivariate analysis,age≥60 years（HR=2.963,P=0.012）,PNI<46（HR=10.430,P<0.001）,lymph node metastasis（HR=3.600,P=0.025） and postoperative complications（HR=4.056,P=0.039）were independent predictors of overall survival. Conclusion Many factors affect postoperative complications and survival rate of AGC patients. PNI can be used not only to assess the increased risk for postoperative complications, but also to predict short-term survival rate after surgery. It should be included in a routine evaluation and strengthen the perioperative management of gastric cancer patients.

Objective To explore the clinical characteristics of small cell lung cancer（SCLC）patients with negative pro-gastrin-releasing peptide precursor（ProGRP）. Methods The clinical data of hospitalized patients with SCLC between December 2016 and May 2021 were retrospectively analyzed. There were 25 negative ProGRP patients and 75 positive ProGRP patients. The clinicopathological characteristics and survival differences between the two groups were compared,and changes in ProGRP levels were observed during monitoring the effects in ProGRP-negative SCLC patients. Results ProGRP-negative SCLC patients accounted for 25%. ProGRP-negative SCLC patients and ProGRP-positive SCLC patients had no significant differences in gender, age, smoking history, clinical stage, and NSE positive rate. Of which, 92% were in extensive stage disease（ED）, and the positive reate of NSE was 84%. The progression-free survival（PFS）of ProGRP-negative SCLC patients was significantly lower than that of the ProGRP-positive patients. For ProGRP-negative SCLC patients,the serum level of ProGRP maintained at a relatively low level in different periods of efficacy monitoring of tumor therapy,even disease progression. Conclusions ProGRP-negative SCLC patients have a poor prognosis. It may be a special type of SCLC.

Objective We investigated the relevant indexes of routine umbilical cord blood and the mass percentage of various types of hemoglobin（HbA%,HbF%,and HbA₂%）of full~term newborns in Zhejiang Province to determine their reference value ranges,and therefore provide a reference for the screening of neonatal hemoglobinopathy and other diseases. Methods Blood routine and hemoglobin capillary electrophoresis were used to detect 1 788 cord blood donated by full~term healthy newborns. The percentile method was used to define the normal reference value ranges of bilateral 95% confidence intervals of WBC,RBC,Hb concentration,MCV,MCH,MCHC,HbA%,HbF and HbA₂%,and T~test or analysis of variance was used to judge the effects of gestational weeks and Hb concentration on HbA%,HbF% and HbA₂%. Results The reference values of WBC,RBC,Hb,MCV,MCH and MCHC in cord blood of full~term healthy newborns in Zhejiang Province were as follows：（9.7~23.4）×10⁹pieces/L,（3.5~5.0）×10¹²PCS/L,124~178 g/L,111~131 fl,33~39 pg/cell,and 280~315 g/L. The reference value range was 11.1%~32.1% in hemoglobin HbA%,67.5%~88.9% in HbF%,and 0~0.4% in HbA₂%. Gestational age and Hb concentration had effects on HbA%,HbF% and HbA₂%,but neonatal MCV,MCH,maternal age,neonatal gender and weight not. Conclusion The reference value ranges of related indexes of routine umbilical cord blood and hemoglobin capillary electrophoresis in newborns in Zhejiang Province can provide a basis for the diagnosis of diseases. Gestational weeks and Hb concentration may affect the mass percentage of HbA%,HbF% and HbA₂% of newborns.