Objective To investigate whether free heme released in hemolysis could directly damage hepatocytes and disrupt liver function. Methods The mice model of hemolytic transfusion reaction was established, and ALT, AST and other biochemical indexes were detected to analyze the liver function. In vitro, the LO2 cells were stimulated with different concentrations of lysed supernatant of red blood cells and heme respectively. Then the levels of ALT and AST were detected to analyze the liver function. Cell viability was observed by flow cytometry, and cell morphology and skeleton structure were observed by immunofluorescence. Results Abnormal liver function was observed on the mice model of hemolytic transfusion reaction. The results of in vitro experiments showed that LO2 cell viability decreased and the proportion of dead cells increased along with the incremental concentration of free heme. The biochemical indexes such as ALT and AST were aggravated significantly. And free heme could directly destroy the cytoskeleton of LO2 cells. Conclusion Free heme can directly destroy the cell structure of hepatocytes, inhibit cell vitality, induce cell death and abnormal liver function. The degree of damage is positively correlated with the concentration of free heme.
Objective To investigate the changes in the expression profile of growth factors in platelet-rich plasma (PRP) under different preparation conditions, providing experimental evidence for selecting different types of PRP for different clinical treatment purposes. Methods Seven portions of PRP (30 mL each) were obtained using a blood component separator. Ten milliliters of the same PRP were randomly divided into platelet-poor plasma (PPP) control group, PRP gel supernatant group, and PRP frozen lysate group. The PRP gel group utilized bovine thrombin and 10% calcium gluconate to create a premix solution, which was then added to PRP in a 1∶9 ratio to obtain PRP supernatant. The PRP frozen lysate group went through five cycles of freezing and thawing at temperatures ranging from -20℃ to 37℃ to obtain platelet lysate. Changes in the growth factor profile in the samples were detected using Quantibody® growth factor protein chips, and differential growth factors were validated using ELISA. Results Compared to PPP, five growth factors showed increased expression in the PRP supernatant group: brain-derived neurotrophic factor (BDNF, 14.64 times), platelet-derived growth factor-AA (PDGF-AA, 4.53 times), epidermal growth factor (EGF, 4.52 times), vascular endothelial growth factor (VEGF, 3.45 times), and hepatocyte growth factor (HGF, 2.16 times). GO and KEGG analyses indicated that these factors were mainly enriched in cell migration, Ras, and PI3K-Akt signaling pathways, participating in tissue repair. In the PRP lysate group, the increased growth factors were BDNF (20.74 times), EGF (11.12 times), transforming growth factor-β1 (TGF-β1, 5.76 times), while the decreased growth factor was insulin-like growth factor-binding protein-6 (IGFBP-6, 1.46 times). These factors were primarily enriched in the MAPK signaling pathway and FoxO signaling pathway, playing anti-inflammatory roles. Conclusion Both PRP supernatant and PRP lysate can release a variety of growth factors. Growth factors produced in PRP supernatant mainly participate in wound repair and healing, while those in PRP lysate mainly contribute to tissue repair and anti-inflammatory effects. Therefore, for different clinical treatment purposes, PRP products prepared in different ways should be selected to achieve the best therapeutic outcome.
Objective To investigate the effects of platelets with different storage days and quantities on the proliferation of liver cancer cells. Methods Twelve type O platelet braids were collected from Nanning Central Blood Station and sent to the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine. According to the storage days, they were divided into fresh PLT group and old PLT group, of which the fresh PLT group was platelets stored for 1 day. In the old PLT group, platelets stored for 4 days were used. The two groups of platelets were co-cultured with human liver cancer cell Huh-7. The confluence degree of Huh-7 cells in each group within 48 hours was observed by scratch test, and the invasion ability of Huh-7 cells in each group within 24 hours was observed by transwell test. Results The results of scratch test showed that the proliferation ability of Huh-7 cells was significantly enhanced after co-culture with platelets. When the same amount of PLT was added, old PLT could promote the proliferation of Huh-7 cells more strongly. When PLT with the same storage days was added, PLT with a higher number generally showed a relatively stronger ability to stimulate cell proliferation. The results of transwell experiment were similar to the results of scratch. When the number of PLT was the same, the number of Huh-7 cells invaded by old PLT group was more than that of fresh PLT group, and the difference was statistically significant (P<0.05). The more PLT was added into Huh-7 cells, the more invasive cells occurred in the fresh PLT group and the old PLT group, and the difference was statistically significant (P<0.05). Conclusion The ability of platelets to promote cell proliferation and invasion is positively correlated with the storage time of platelets and the number of platelets. The application rules of platelet products need to be analyzed according to the specific clinical conditions. In the treatment of patients with neoplastic diseases, the application of old platelets should be avoided as far as possible, and the transfusion of platelets should be minimized when platelets have to be used, so as to achieve the purpose of slowing down the proliferation and metastasis of tumor cells.
Objective To analyze the risk factors of massive blood transfusion in adolescent scoliosis surgery, establish a nomogram early warning model, and verify the predictive effect of the model. Method The clinical data of 292 adolescent scoliosis patients treated in our hospital from March 2015 to February 2020 were retrospectively analyzed and used as a modeling set. The patients were divided into a massive blood transfusion group and a non-massive blood transfusion group according to the occurrence of massive intraoperative blood transfusion (Within 4 hours, the infusion volume of allogeneic red blood cells is ≥ 1 time the total circulating blood volume, which is 40 mL/kg), and the independent risk factors of intraoperative massive blood transfusion were screened out by Logistic regression. An early nomogram warning model for predicting massive intraoperative bleeding was established based on independent risk factors, the Bootstrap method was used for internal validation of the model, and the receiver operating curve (ROC) and calibration curve were used to evaluate the discrimination and calibration of the model. In addition, 68 cases of adolescent scoliosis orthopedics treated in our hospital from March 2020 to February 2023 were selected as the validation set for external validation. Results The incidence of massive intraoperative blood transfusion in 292 adolescent scoliosis patients was 20.89% (61/292). Multivariate logistic regression analysis showed that BMI≤18kg/m2 (OR=2.584, 95%CI: 1.314~5.081), preoperative Cobb angle>48° (OR=3.680, 95%CI: 1.808~7.491), number of vertebral fusion segments>10 (OR=4.543, 95%CI: 2.210~9.340) and intraoperative blood loss >960 mL (OR=3.817, 95%CI: 1.805~8.070) were independent risk factors for massive intraoperative blood transfusion (P<0.05), and cyclic acid (OR=0.393, 95%CI: 0.193~0.803) was a protective factor (P<0.05). Based on this result, a nomogram prediction model was established. The area under the receiver operating characteristic of the modeling set was 0.841 (95%CI: 0.784~0.899), the sensitivity was 82.68%, the specificity was 75.41%, the risk threshold corresponding to the maximum Youden's J statistic 0.58 was 25%, and the predictive critical value score was 220 points, that is, those with predicted nomogram scores ≥ 220 points were high-risk groups for massive blood transfusion during surgery. The area under the Receiver operating characteristic of the validation set is 0.790 (95%CI: 0.720~0.850); The slope of the correction curve approximates the ideal curve; The probability of predicting the risk of massive intraoperative blood transfusion using the column chart warning model is consistent with the actual probability of occurrence. The Pt ranges were 0.38~0.9 and 0.42~0.9, respectively, and the patients could obtain positive net income. Conclusion The column chart warning model established based on the risk factors of massive blood transfusion during adolescent scoliosis correction surgery has good fitting and predictive effect. Those with a column chart score of ≥ 220 are high-risk groups for massive blood transfusion during surgery. Medical staff should prepare for large-scale blood transfusion plans in advance and provide timely blood transfusion treatment.
Objective To observe the effect of mixed red blood cells with different ratios of A/O on blood type identification, and select the appropriate method to accurately determine the blood type after type A-supply to O hematopoietic stem cell transplantation. Methods Red blood cells mixed in different proportions of A/O were accurately prepared, and the blood type was identified by the test tube method of saline medium, the microcolumn gel carding method of low-ion liquid medium and flow cytometry. Results When the ratio of A cell/A cell+O red blood cell was 0.1%, small agglutination could be observed by tube method; When the proportion was 3%, type A red blood cells appeared in gel cards; At 3%~15%, the blood type card presents a double group of AB type, and the flow cytometry results can identify the positive of B type as false positive. Conclusion The test tube method combined with microscopic examination is the most accurate and sensitive method for identifying blood type; Flow cytometry can identify the false positive results of micro column gel blood type cards.
Objective To analyze a phenomenon in 3 cases of HDN, the false negative of D antigen due to D antigen masking. Methods Blood type and antibody titers of maternal and newborn specimens were detected by blood group serology, and antibody screening and identification were carried out. DAT, free antibody and released antibody tests were performed on the samples of the children, and genotyping was carried out. Results DAT, free antibody and released antibody were positive in 3 neonates. The results of maternal and neonatal antibody screening and identification were anti-D antibody, and the titers were all greater than 512. The blood type test of the child was negative for RhD, and the red blood cells of the child were weakly positive after heat release at 56℃. The gene result of the 3 cases was positive for RhD antigen, and the effect of blood exchange treatment was good. Conclusion The high titer of maternal anti-D antibody can lead to D antigen masking phenomenon, which makes the newborn RhD antigen false negative and further increases HDN. It is necessary to give newborn treatment as soon as possible and accurately detect the newborn blood type.
Objective To study the value of serum IgG anti-A/B titer score of pregnant women with blood type O for predicting the hemolytic disease of newborn (HDN). Methods 45 blood type O pregnant women with high IgG antibody titer were selected as the research object. The IgG titer of the mother was measured by anti-human globulin test carried out by traditional tubing test. At the same time, the score of each tube were measured according to the intensity of agglutination. To obtain the antibody titer scores of the tested samples, add up the scores of the tubes. The correlations between the IgG antibody titer score of pregnant women and the possibility of HDN of newborns were analyzed. Results Of the 45 newborns, 27 were diagnosed as HDN. With the serum antibody titer of pregnant women increasing, the prevalence of HDN shows an upward trend, but the difference between different antibody titer groups was not statistically significant. There was a statistically significant correlation between the titer score and the incidence of HDN, and the correlation coefficient was -0.665. Conclusion Compared to antibody titer, the titer score of pregnant mothers is more closely related to the incidence rate of HDN of newborn. The IgG antibody titer score of pregnant women has more clinical significance in predicting the HDN of hemolytic disease.
Objective This study is to investigatethe relationship between erythrocyte storage duration and acute kidney injury (AKI) after pediatric cardiac surgery with cardiopulmonary bypass (CPB). Methods A total of 346 consecutive pediatric patients from January 2019 to December 2022 who received cardiac surgery by CPB in Beijing Children's Hospital were retrospectively analysed. They were divided into fresher blood group (≤14 d, n=163) and older blood group (15~35 d, n=183) according to the erythrocyte storage duration. The incidence and severity of postoperative AKI were compared between two groups. Results A total of 346 subjects were included in the study. Among them, 93 cases developed AKI after surgery, and the incidence rate was 26.88%. There were 163 children in the newer blood group, and 47 (28.83%) had AKI after surgery, including 28 cases (59.57%) in AKI stage 1, 15 cases (31.92%) in AKI stage 2, and 4 cases (8.51%) in AKI stage 3. There were 183 childrenin the older blood group, and 46 cases (25.14%) developed AKI after surgery, including 28 cases (60.87%) in AKI stage 1, 16 cases (34.78%) in AKI stage 2, and 2 cases (4.35%) in AKI stage 3. The results showed that there was no significant difference in the incidence and severity of AKI between the two groups (incidence rate χ2=0.600, P=0.439; severity χ2=0.699, P=0.797). Conclusion AKI is a common complication following cardiac surgery with CPB in children, the incidence rate was 26.88%. But the duration of blood storage had no effect on the incidence of acute kidney injury after pediatric cardiac surgery with CPB.
Objective To discuss the identification method of polyagglutination of red blood cells by T-antigen exposure in children with necrotizing enterocolitis (NEC) to formulate transfusion strategies to provide reference for clinical guidance and scientific and rational use of blood in children. Methods ABO and Rh blood group identification, direct antiglobulin test (DAT), antibody screening test and cross-matching test were performed in 2 NEC children with difficult cross-matching difficulty in our center. Erythrocyte polyagglutination was found in 3 ABO donor plasma, 3 AB donor plasma and 3 umbilical cord blood plasma. The polyagglutination was further identified by Peanut Agglutinin, MN Blood Group Reagent and Polybrene test. Results The erythrocyte antibody screening test, DAT and major cross-matching test were negative in 2 cases. The minor cross-matching test using saline and anti-human globulin test were positive. The red blood cells of the children were positive with plasma from donor of the same blood type and AB plasma, and negative with cord blood plasma of the same blood type. MN blood group antigen was negative in children who were positive with Peanut Agglutinin. No expected agglutination was observed with Polybrene test. Conclusion NEC children with polyagglutinated erythrocytes showed negative DAT tests and positive minor cross-matching tests. At this time, multiple methods should be used to identify the phenomenon of erythrocyte polyagglutination to choose appropriate blood products to avoid delayed transfusion.
Objective The sodium chloride (NaCl) solution used for the preparation of frozen thawed glycerolized red blood cells (RBCs) was replaced by sodium citrate and glycine solutions. The quality of washed RBCs was analyzed. Methods Ten bags of suspended leukocyte-depleted RBCs collected within 7 days were selected, glycerolized and prepared into frozen RBCs, and stored at -80℃±5℃ for 6 months. They were divided into control group and experimental group, each group 10 bags. In the control group, the original preparation method was used. In the experimental group, the 9% NaCl in the first washing was replaced by 18.75% glycine solution, and the 0.9% NaCl in the second and subsequent washing solution was replaced by 2.58% sodium citrate solution. The preparation time of the two groups was recorded, and the quality indexes were compared and analyzed. Results The preparation time of glycerol removal from frozen thawed RBCs was shortened by improved methods. Compared with the control group, there was no significant difference in the recovery rate of RBCs (P >0.05). The contents of free hemoglobin and residual glycerin in supernatant decreased, with statistical significance (P< 0.05). The levels of ATP and 2, 3-DPG were significantly increased, with statistical significance (P<0.05). Conclusion By improved preparation method of frozen deglycerolized RBCs, the quality of RBCs can be stable and optimized. This method can further improve the safety, effectiveness and timeliness of blood transfusion for patients.
Objective To investigate the effects of plasmapheresis on donor serum proteins and electrolytes to provide scientific basis for the health and safety of plasma donors. Methods A total of 223 new plasma donors were recruited from two plasmapheresis stations in Sichuan Province from February to May 2022, of which 118 donors were enrolled. The demographic information of donors was collected and followed up for one year. The plasma proteins and electrolytes levels were detected before each plasma donation. The change trend of plasma proteins and electrolytes levels was analyzed, and the covariance analysis was used to eliminate the interference of the baseline level of each relevant index before donation. The influence of donation times on the change of relevant indicators after donation was analyzed, and multiple linear regression was used to explore the influencing factors of relevant indicators. Results The levels of serum ferritin (SF) in male donors decreased with the increase of donation times, while the levels of other components did not fluctuate significantly. After controlling for confounding factors by covariance analysis, there was no statistical significance in the influence of donor times on SF. The results of multiple linear regression showed that the effect of donation times on SF level was not statistically significant after controlling the baseline level. Conclusion Low frequency plasma donation over a period of one year did not have statistically significant effects on plasma proteins and electrolyte levels in donors.
Objective This study is to investigate the residual risk of HIV transmission among blood donors in Changsha city from 2014 to 2022. Methods The blood screening results of unpaid blood donors from January 1, 2014 to December 31, 2022 in Changsha Blood Center and the confirmed results fed back by the Center for Disease Control and Prevention (CDC) were retrospectively analyzed through the blood station information management system, and the residual risk of HIV screening of unpaid blood donors was assessed using the incidence rate window mathematical model. Results During the study period, the HIV positive rate in the Changsha area was 0.199 5 ‰ (273/1 368 333), among first-time blood donors was 757 455 accounting for 55.36%, the HIV positive rate was 0.249 5 ‰ (189/757 455) and the repeat blood donors was 610878 accounting for 44.64%, the HIV positive rate was 0.1375 ‰ (84/610 878). There was a statistical difference in the positive rates between the first and repeat blood donors (χ2=21.270, P<0.001). The residual risk of HIV among first-time blood donors was 1/204 081.63, which is higher than that of repeat blood donors by 1/370 370.37. The residual risk of HIV is 1/85 470 in the two-time enzyme-linked immunosorbent assay (ELISA). After HIV Nucleic acid test (NAT) blood screening, the residual risk was reduced to 1/250 000. NAT screening can reduce the residual risk by 65.81%. Conclusion The assessment of residual risks may help to evaluate the impact of different testing strategies on blood safety and ensure blood quality
Objective To analyze the quality control indexes of national clinical blood use in 2020 and provide reference for the management of clinical blood use. Methods A retrospective investigation was carried out to collect and analyze the data of blood quality control indexes of medical institutions in 2020. Results We collected 438 clinical blood quality control data, 1 673 (68.62%) of which were from tertiary hospitals, 594 (24.37%) from secondary hospital, and 171 (7.01%) from the hospitals below secondary or other ungraded ones. There were significant differences in clinical blood quality control indexes such as the number of professional and technical personnel for blood transfusion per thousand units, reported cases of adverse transfusion reactions per thousand transfusion times, average blood consumption of third and fourth level operating tables, and average blood consumption of discharged patients among hospitals at all levels (P<0.05). Except for the indoor quality control rate of transfusion compatibility test items and the autotransfusion rate of surgical patients, the other quality control index data had significant differences between regions (P<0.05). Conclusion The quality control indexes of blood for clinical use vary in different grades of hospitals and in different regions, suggesting that there is still room for improvement in the management of blood for clinical use.
Objective To investigate the serological and molecular genetic characteristics of individuals with p blood type of Lahu and their family members. Methods Blood samples from family members of 6 cases with p blood type previously found in Lahu population were collected, and ABO, Rh, P1PK blood group system serological identification was performed by test tube method, and the coding region sequences of A4GALT gene were analyzed by PCR sequencing. Results Among 39 family members from 5 families, 12 cases p blood type individuals (including 6 previously identified probands) were detected, all of them were p blood type, including 7 cases of type B, 2 cases of type O, 1 case of type A, 1 case of type AB, and 1 case of undetected ABO blood group. Anti-PP1Pk antibodies were detected in the plasma of 11 individuals with p blood type, 1 case collected by finger blood and no antibodies were detected. Sequencing of A4GALT gene coding region was performed on 23 of the family members whose venous blood was collected. The sequencing results of 11 cases showed homozygous mutations of G>C at position 559 of exon 3 of A4GALT (including 6 previously identified probands), were p blood type, and 5 cases showed heterozygous mutations of 559G/C. Sequencing of 7 cases was consistent with the reference series. Conclusion The mutation of A4GALT gene C.559G >C may be the molecular basis for the formation of p blood group in Lahu population.
Objective To explore the effect of regularly donating platelets from male multiple platelet donors aged 56 to 60 on their blood routine and coagulation function for a better guide to the elderly blood donation. Methods A total of 61 healthy male blood donors were selected from our center from November 2021 to August 2022, including 51 single platelet donors and 10 healthy whole blood donors who had not donated single platelet. The single platelet donors were all multiple donors (>10 times in the past year), among whom 12 donors aged 56 to 60 were assigned in Group A, and 39 donors aged 18 to 55 in Group B; healthy whole blood donors wihtout donation of single collected platelets were all aged 56 to 60 years old, with a total of 10 cases in Group C. Before collecting platelets, samples were taken and their blood routine, thromboelastogram (TEG), thrombin time (TT), Prothrombin time (PT), activated partial thromboplastin time (APTT) and fibrinogen (Fg) were tested. SPSS26.0 statistical analysis software was used for one way ANOVA analysis to compare its differences. Results Some differences were observed in Hb, Hct, PLT, MPV, and PCT (P<0.05), but not in other blood routine indicators (P>0.05) between groups A, B and C. There was no significant difference in blood routine indicators related to red blood cells, white blood cells, and platelets between Group A and Group B (P>0.05); compared with Group C, Hb, Hct in Group A showed a significant decrease, while PLT and PCT were increased. The difference between the two indicators was statistically significant (P<0.05), while other blood routine indicators did not differ (P>0.05). The R, K, Angle, and MA values of TEG (thromboelastography) in the three groups were within the normal reference range, with no significant difference in TEG indicators among Groups A, B, C, between Group A and Group B, or between Group A and Group C (P>0.05). TT, PT, and APTT in Group A and Group B were all within the normal reference range, but FIB showed a slight increase, and TT in Group C had a certain degree of increase while the other three indicators were normal; a significant difference was noted in TT and PT between groups A, B and C (P<0.05), but not in APTT and Fg.There was no significant difference in coagulation related indicators between Group A and Group B (P>0.05); TT and PT in Group A were lower than those in Group C, with a significant difference between the two groups (P<0.05); however, APTT and FIB showed no significant difference (P>0.05). Conclusion Regular donation of single platelet donors aged 56 to 60 does not have a pronounced impact on their blood routine and coagulation function. Considering paucity of single platelet resources, we should encourage multiple single platelet donors aged 56 to 60 to regularly donate single platelet. Meanwhile, however, it is also necessary to monitor the health of single collectors during the collection process.
Clinical transfusion is one of the important treatment of severe hemorrhage patients. Timeliness is a key factor of curative effect in transfusion therapy. Many complicated process and many departments are involved. Therefore, it is imperative to build a standard, reasonable and effective paperless process of clinical transfusion. The paperless process transforms the traditional paper-based documents into seamless connections between programs. It is mainly composed of three modules, information interaction, compatibility test and transfusion closed-loop. This process improves the work efficiency, reduces the error rate, saves energy and storage space. It also has realized the safety management of standardization, informationization and paperless transfusion closed-loop.
Objective To analyze the effectiveness of the R-CHOP regimen in the treatment of double-expression diffuse large B-cell lymphoma (DEL). Methods A retrospective analysis of the clinical data of the DEL patients admitted to the Second Affiliated Hospital of Anhui Medical University from December 2017 to December 2022. The clinical characteristics, survival and prognostic factors were analyzed, and non-DEL patients admitted in the same period were selected as the control group. Results A total of 243 DLBCL patients were collected, including 63 cases of DEL patients (25.9%). There were no differences in the clinical characteristics between DEL patients and non-DEL patients. The complete remission (CR) rate of DEL patients was significantly lower than that of non-DEL patients (P=0.033).The non-DEL and DEL groups had a progression-free (PFS) rate of 74.5% and 41.7% respectively at 3 years, with median PFS was 38.6 (95％CI:33.3~43.9)month and 30.2 (95％CI:22.3~38.2) month (P=0.003). The overall survival (OS) rate at 3 years was 80.3% in the non-DEL group and 60.4% in the DEL group, with median OS of 49.2(95％CI:44.6~53.8) month and 34.2 (95％CI:28.1~40.4) month respectively (P=0.031), the difference were statistically significant. Multivariate COX regression analysis of DEL patients showed that only the IPI score affected the PFS (HR=51.695, P=0.001) and OS (HR=6.513, P=0.001). Conclusion There is no significant difference between DEL and non-DEL patients in clinical characteristics. DEL patients undergoing first-line treatment with R-CHOP regimen have poor prognosis.
Objective This study aimed to explore the early clinical efficacy and safety of cladribine combined with venetoclax and low-dose cytarabine in elderly patients with acute myeloid leukemia (AML) by small sample analysis. Methods From September 2022 to March 2023, 12 newly diagnosed and refractory elderly AML patients in our center were selected as the study subjects. All patients were treated with cladribine combined with venetoclax+low-dose cytarabine for the first induction chemotherapy. The clinical efficacy was evaluated after 1~2 cycles of chemotherapy; the safety data was collected and analyzed during the first induction chemotherapy process, and the bone marrow suppression and non hematological toxicity of this protocol were evaluated in elderly AML patients undergoing induction therapy. Results After 1~2 cycles of treatment, 12 patients achieved complete clinical remission (CR+CRi 83.3%,10/12), except for 2 patients who did not follow up with bone marrow due to the epidemic and personal reasons after the first course of treatment. No deaths occurred during the induction chemotherapy period; During that period, the patient had good tolerance and was hospitalized for an average of 27.8 days. During the hospitalization period, the main manifestations were hematological toxicity and bone marrow suppression. The average days of neutrophil ratio below 0.5×109/L, platelet count below 20×109/L, and hemoglobin below 60 g/L were 12.7 days, 10.6 days, and 10.8 days, respectively. Among them, 2 patients had severe pulmonary infections before induction chemotherapy, and after actively and stably controlling the infection, this regimen was administered for induction chemotherapy, During chemotherapy, the infection did not worsen on the basis of continuous treatment. Conclusion This protocol has a better therapeutic effect in the induction therapy of elderly AML, and has a significant improvement compared to the current demethylation combined with Vineclavone protocol in elderly AML patients. The efficacy is basically consistent with recent reports abroad, with a high early clinical remission rate and tolerability. There are no deaths during the initial induction chemotherapy period, and all patients have controllable hematological and non hematological toxicity, which is worthy of further clinical promotion and application.
Anemia leads to increased perioperative blood transfusion rate and blood transfusion volume, prolonged hospital stay in coronary artery bypass grafting patients, and is also an independent risk factor for postoperative complications and mortality.Patient blood management is a patient-centered, systematic, evidence-based approach to improve patient outcomes through the diagnosis and treatment of perioperative anemia and the protection of autologous blood.This paper reviews the research progress in the prevention and treatment of perioperative anemia in patients with coronary artery bypass grafting, which hopely improves the treatment plan and clinical outcome of patients with anemia after coronary artery bypass grafting.
More recently, novel monoclonal antibodies targeting immune checkpoints related signaling pathways have shown promise in the field of cancer immunotherapy. Hu5F9-G4, IBI188, and Daratumumab, designed specifically to target CD47 and CD38, have demonstrated clinical efficacy in patients with lymphoma, multiple myeloma, and other malignancies. Because CD38 and CD47 molecules are expressed not only on tumor cells, but also on red blood cells, anti-CD38 or anti-CD47 antibodies are specifically bound to red blood cells in the blood of patients treated with anti-CD38 and anti-CD47 monoclonal drugs. This leads to false positives in compatibility testing, such as blood typing, cross-matching and irregular antibody screening etc., which poses a risk to transfusion safety. In this paper, the interference problems of anti-CD38 and anti-CD47 on blood transfusion compatibility testing and the existing elimination strategies are described to provide reference for minimizing the impact of anti-CD38 and anti-CD47 on blood transfusion safety.
The treatment of chronic non-healing wounds remain challenging in terms of complexity. Although platelet rich plasma (PRP) therapy has been widely proven effective, the traditional method of in vitro activation of PRP leads to the rapid release of all growth factors. Due to the separation of colloid and supernatant after activation, the factor-rich supernatant is easy to flow and lose, and it is difficult to form a stable structure, which affects its therapeutic effect. To overcome this problem, researchers in recent years have explored hydrogels as carriers for PRP to improve the shortcomings of traditional PRP treatment. This article reviews the latest research on hydrogel-loaded PRP for the treatment of chronic non-healing wounds and provides a reference for optimal treatment.
