Objective To investigate the effects of different formulas of red blood cell (RBC) preservation solutions on RBC storage lesions in vitro to provide optimal storage solution for RBC in patients with type 2 diabetes mellitus (T2DM). Methods A total of 20 diabetic patients and 20 non-diabetic patients who underwent elective surgery from June 2021 to January 2022 were collected. RBCs were stored in different preservation solutions (preservation solution a, preservation solution b and preservation solution c) to select out the appropriate preservation solution (DO-o). Morphologic and metabolic changes in RBCs were observed in the conventional preservation solution of non-diabetic patient group (NC group), the conventional preservation solution and the new preservation solution of diabetic patient group (DO-c group and DO-o group). Results At T0 (immediately after red blood cell separation), T1 (storage for 7 days), T2 (storage for 14 days), T3 (storage for 21 days) and T4 (storage for 28 days),RBC count, hemoglobin, Na⁺ concentration and pH value in each group gradually decreased (P<0.05), while K⁺ concentration gradually increased (P<0.05). The RBC count in preservation solution group b was significantly higher than that in group a and c (P<0.05). At T2, T3 and T4, the levels of hemoglobin in group a and b were higher than that in group c (P<0.05). At T3 and T4, Na⁺ in group b was higher than that in the other two groups (P<0.05). At T2, T3 and T4, K⁺ in group a and c was lower than that in group b (P<0.05). At each time, there were statistically significant differences in hemolysis rate, Free Hemoglobin (FHb), Lactic Acid (LA) and Lactate Dehydrogenases (LDH) within and between groups (P<0.05); the hemolysis rate, FHb, LA and LDH were significantly lower than those in the DO-c group (P<0.05). Adenosine Triphosphate(ATP) in all groups gradually decreased, and the difference was statistically significant (P<0.05); at T1, T2 and T4, ATP in DO-o group was higher than that in DO-c group (P<0.05). Conclusion The new preservation solution can significantly improve RBC storage lesions in diabetic patients.

Objective Long-term use of large-dose caffeine sodium benzoate, a psychotropic drug, has a great impact on the physical and mental health of users, leading to not only addiction but also varieties of diseases. This study was to investigate the mechanism of endothelial cell dysfunction mediated by caffe natrium causing coagulation dysfunction. Methods Based on clinical data, the effects of sodium ampoule on coagulation function and related diseases were examined. β-galactosidase staining was done to observe the stimulation of human umbilical vein endothelial cells (HUVECs) using 25% sodium cafe patient serum +75% normal human serum, 50% sodium cafe patient serum +50% normal human serum, 75% sodium cafe patient serum +25% normal human serum, sodium cafe patient serum and lipopolysaccharide, and the effects of sodium ampoule serum on HUVECs were analyzed via the HUVEC cell tube experiment to test the ability of cells to form blood vessels. Results Long-term consumption of caffeine sodium benzoate seriously affected the coagulation function of patients, and the proportion of positive cells increased with higher coffee with sodium ampna serum (P<0.05), i.e. senescent cells were elevated, and cell tube experiments showed that HUVECs blood vessel formation rate decreased after serum stimulation in patients with caffeine sodium benzoate (P<0.05). Conclusion Long-term consumption of caffeine sodium benzoate can lead to abnormal function of vascular endothelial cells in patients and hence coagulation dysfunction.

Objective To evaluate an improved massive transfusion protocol (MTP) to reduce transfusion and complications in orthotopic liver transplantation (OLT) at a single institution. Methods We retrospectively studied the massive ransfusion patients who underwent OLT at the Second Xiangya Hospital of Central South University from January 2016 to December 2022, enrolled 146 baseline data-matched cases (73 in improved MTP group and 73 in initial MTP group) by propensity-matched analysis, and compared the intraoperative transfusion profiles, laboratory and clinical outcomes and prognosis. Results Improved MTP decreased the intraoperative erythrocyte transfusion, increased apheresis platelet and cryoprecipitate transfusion, and plasma/platelet to red blood cell (RBC) transfusion ratios (P<0.05), but there was no statistically significant difference in plasma transfusion between the two groups (P>0.05). In improved MTP group, the level of Hb, PLT, FIB and TT were significantly increased (P<0.05), PT was significantly decreased (P<0.05), the renal markers (CREA and UREA) elevated values and in-hospital mortality rate were significantly lower (P<0.05). Conclusion In OLT, the improved MTP can reduce unnecessary blood transfusion and improve transfusion efficacy.

Objective To compare the efficiency of autologous plateletpheresis (APP) transfusion and allogeneic apheresis platelet transfusion on the blood protection and the short-term outcome of type A aortic dissection (TAAD). Methods A retrospective review was performed of 78 patients who underwent TAAD operation in our hospital between June 2019 and December 2021. Of which 40 patients received APP transfusion and 38 patients in the control group received 1U of allogeneic apheresis platelet transfusion. The preoperative waiting time, intraoperative blood loss, output from postoperative chest tube, perioperative blood transfusion, ventilation time, length of stay (LOS) in the intensive care unit (ICU), hospital stay, and the incidence of perioperative complications and in-hospital mortality between the two groups were analyzed. Results The preoperative waiting time in APP group was significantly shorter than that in the control group (Z=-2.48,P< 0.05). The ventilation time was shorter, too. (Z =-2.20, P<0.05). Postoperative pulmonary infection rate was 17.5%, significantly lower than that in the control group (χ²=4.65, P<0.05). The intraoperative and perioperative transfusion of red blood, plasma and cryoprecipitate were significantly lower than those in the control group (P<0.05). There were no significant differences between the two groups in intraoperative blood loss, ICU LOS, hospital stay and in-hospital mortality. Conclusion Compared with allogeneic platelet transfusion, APP transfusion can effectively reduce the preoperative waiting time, mechanical ventilation time, postoperative pulmonary infection rate and perioperative allogeneic blood transfusion use, so as to better blood protection effect, but it has no significant improvement on the short-term outcome of patients.

Objective In this study, we built a blood transfusion prediction model for perioperative patients with esophageal cancer to provide reference for patient blood management. Methods We retrospectively collected the data of patients esophageal cancer resection at Fujian Cancer Hospital from January 2008 to December 2020. The data was divided into a modeling set and a validation set in a 7∶3 ratio. Univariable and multivariable logistic regression analysis were performed to screen variables, and a nomogram prediction model was constructed. Receiver operating characteristic (ROC) and calibration curve were used to evaluate the performance of the model. Finally, the clinical utility of the model was confirmed through the decision curve. Results A total of 980 patients were enrolled in the study. Multivariable logistic regression analysis showed that preoperative albumin, hemoglobin, surgical method, and the amount of pleural drainage fluid were independent risk factors for perioperative blood transfusion in patients with esophageal cancer. The nomogram model is established based on risk factors. The area under the ROC of the modeling set and the validation set is 0.712 and 0.706, respectively. The calibration curves of both groups fit well with the standard curve, and the model has good predictive accuracy. Finally, decision curve analysis confirms that the model has good clinical utility. Conclusion We constructed a nomogram prediction model by screening risk factors. It can effectively predict the high-risk population for perioperative blood transfusion in patients with esophageal cancer, provided reference for patient blood management, and improved the rationality, safety, and accuracy of clinical blood use.

Objective To study the effect of intravenous immunoglobulin（IVIG）on cross-match in non-hemolytic anemia in children to discuss the best-practice transfusion strategy. Methods A total of 12 non-ABO hemolytic patients with negative antibody screening and cross-match incompatibility from January 2020 to December 2022 were included. Blood type identification was performed by tube test method. Antibody screening, cross-match, direct antiglobulin test (DAT), and anti-A and anti-B detection in free plasma and elution test were performed by microcolumn gel card method. Results After receiving IVIG, anti-A was detected in 6 type A and 2 type AB, anti-B in 3 type B, and anti-A and anti-B in 1 type AB. All patients were DAT positive, and appeared different degrees of hemolysis. Those were cross-match incompatible with same blood type suspended red blood cells, but cross-match compatible with type O washed red blood cells. Conclusion After administration of IVIG, some non-ABO hemolysis children have cross-match incompatibility and mild hemolytic symptoms, so it is advisable to choose O-type washed red blood cell.

Objective To study the detection and distribution characteristics of IgG antibody titers and subtypes in newborns with ABO hemolytic disease (ABO-HDN), and provide laboratory diagnostic evidence for clinical diagnosis and treatment of ABO-HDN. Methods 222 newborns were selected as research subjects. Clinical basic data of newborns, hemolysis related testing parameters (TBiL, IBiL, Hb), and data of blue-ray therapy were collected. Three hemolysis tests, IgG antibodies titer and subtype detection were performed using microcolumn gel method. The distribution characteristics of IgG antibody titer and subtype were analyzed, as well as their relationship with the severity of hemolysis in newborns. Results A total of 142 cases were positive and 80 cases were negative. The levels of TBiL and IBiL in the positive group were higher than those in the negative group, and the incidence rate of newborns with type A is higher than that of type B, the difference was statistically significant (P<0.05). In the detection of IgG antibody titers in newborns, the highest titer of free antibody was 16, and the highest titer of release antibody was 32. With the increase of the titer of free or release antibody in newborns, the level of TBiL, IBiL, and Blu-ray treatment duration tended to increase, while Hb levels tended to decrease. IgG1 and IgG1/G3 subtypes were detected in the newborns, and IgG1 and/or IgG3 antibodies were mainly distributed in the high titer group (≥8). Compared with the low titer group (<8), each hemolytic parameter showed statistically significant differences (P<0.05). Conclusion High titer IgG antibodies and IgG1/G3 subtypes are associated with the severity of hemolysis. It can provide important laboratory data support and helpful for clinical diagnosis, prevention and treatment of ABO-HDN.

Objective To investigate the influence factors of blood transfusion and transfusion amount and the construction of prediction model in very low birth weight infants (VLBWIs). Methods A total of 102 VLBWIs admitted to our hospital from February 2017 to January 2021 were selected and divided into the training set (76 cases) and the test set (26 cases) with a ratio of 3∶1 by using computer-generated random number method. The medical data, diseases and treatments were compared between the transfusion and non-transfusion groups. The risk factors for transfusion in VLBWIs were analyzed by Logistic regression. Four machine learning methods, including Logistic regression, CatBoost, XGBoost and LightGBM, were used to construct transfusion prediction models to compare the prediction effects. Multiple linear stepwise regression was used to analyze the independent factors affecting the blood transfusion volume to fit the prediction model in VLBWIs. Results Low birth weight, small for gestational age infant, large volume blood collection within two weeks after birth, long-term parenteral nutrition and cesarean section were independent risk factors for blood transfusion (P<0.05). The AUC of Logistic regression, XGBoost, CatBoost and LightGBM models were 0.836 (95%CI: 0.745~0.889), 0.801 (95%CI: 0.734~0.862), 0.738 (95%CI: 0.658~0.800), 0.700 (95%CI: 0.609~0.785), respectively. There were no statistically significant differences compared with the test set (P>0.05). Stepwise multiple linear regression analysis was used to determine that birth weight, gestational age, Hb value at birth and Hct at birth were the independent influencing factors for transfusion. The prediction model for VLBWIs blood transfusion volume was: Y= 24.175-0.731×birth weight-0.538×gestational age- 0.431 × Hb value at birth- 0.569 × Hct, F=33.321, P<0.001, D-W (Durbin-Watson) = 1.725, R²=0.671. Conclusion Birth weight, gestational age, blood collection volume within two weeks after birth, long-term parenteral nutrition and cesarean section were independent risk factors for blood transfusion in VLBWIs. Birth weight, gestational age, Hb value at birth and Hct at birth were independent factors affecting transfusion. The prediction effect of Logistic curve is more accurate by using four machine learning methods of Logistic regression, CatBoost, XGBoost and LightGBM.

Objective By retrospectively analyzing the transfusion threshold used in the clinical transfusion practice for acute upper gastrointestinal bleeding (AUGIB) patients admitted to our hospital, we evaluated the prevalence and utility of restrictive transfusion strategies for such patients. Methods Patients diagnosed with AUGIB and transfused with red blood cells in our hospital from July 2020 to June 2022 were selected as research subjects. The frequency of the hemoglobin (Hb) threshold used in the transfusion patients was investigated. According to the Hb threshold of blood transfusion, the patients were divided into a restrictive transfusion group (the hemoglobin threshold for transfusion was 70 g/L, and 80 g/L in the patients with coronary heart disease) and a non-restrictive transfusion group. Then, the differences in clinical outcomes between the two groups were compared. Results Among the 384 transfusion patients, Hb 70g/L transfusion threshold was used in 62.0%, 70~80 g/L threshold in 32.8%, 80~90 g/L threshold in 3.6%, and the liberal transfusion strategy of Hb≥90g/L in only 1.6%. The main transfusion strategy for 384 patients was restrictive transfusion, accounting for 73.4%, and the ratio was up to 88.5% in the subgroup of patients with coronary heart disease; the non-restrictive transfusion strategy was taken only in 26.6% of 384 patients. The rate of re-bleeding during hospitalization was 4.6% in the restrictive transfusion group, and 10.8% in the non-restrictive transfusion group, with the difference between the two groups being statistically significant (P=0.027). All-cause mortality during hospitalization was 5.3% in the restrictive transfusion group, and 5.9% in the non-restrictive transfusion group; there was no significant difference in mortality between the two groups (P=0.830). Totally 54 of 384 (14.3%) patients failed to reach the target Hb value after transfusion and were at risk of undertransfusion, all of whom were in the restrictive transfusion group. 12.5% of patients had Hb concentrations below the target Hb value before discharge, and 45 of the 48 undertransfusion patients were in the restrictive transfusion group. Conclusion The restrictive transfusion strategy widely used in the clinical transfusion practice for AUGIB patients is safe and practicable. While avoiding over-transfusion, we should also be alert on the risk of undertransfusion stemming from the restrictive transfusion strategy.

Objective To explore the causes and analyze the molecular biology of ABO typing discrepancy in patients of Tujia and Miao nationalities in Enshi. Methods Totally 59 cases of ABO typing discrepancy samples taken in our hospital from October 2018 to October 2022 were retrospectively investigated. The absorption and release tests, accidental antibody detection, and molecular biology testing were performed on the samples to examine the reasons for ABO typing discrepancy, and the serological and molecular biological testing results were compared. Results Among the 59 samples, there were 8 (13.56%) cases of positive stereotype abnormalities, 47 (79.66%) negative, and 4 (6.78%) both positive and negative. The proportion of males (62.71%, 37/59) was higher than that of females (37.29%, 22/59) (P<0.05). The proportion of the ≥61-year-old group (42.37%, 25/59) was higher than that of the 41-50-year-old group (32.20%, 19/59) and that of the 51-60-year-old group (25.42%, 15/59) (P<0.05). Twelve (70.6%) of the 17 ABO subtype samples were of Turkish origin. Among the 59 cases of ABO typing discrepancy, 29 (49.16%) were unexpected antibodies, 17 (28.81%) ABO subtypes, and 13 (22.03%) serum antibodies weakened. Among the 17 ABO subtypes, there were 6 cases of subtype A (1 case of A2 type, 4 cases of A3 type, 1 case of Ael type), 4 cases of subtype B (3 cases of B3 type, 1 case of Bel type), 2 cases of AB3 type, 3 cases of subtype B (A type), and 2 cases of cisAB type. Among the 17 ABO subtypes, 8 serological results were consistent with genotyping results, with a concordance rate of 47.1% (8/17). The A307/O02 genotype was dominant in subtype A, and the B303/O02 genotype in subtype B. Conclusion After excluding the physiological, pathological and experimental factors, the ABO subtype is the main cause of ABO typing discrepancy in the Tujia and Miao populations of Enshi. Among the subtypes, the A307/O02 genotype is the main type in subtype A, and the B303/O02 genotype is the main type in subtype B.

Objective To investigate the accuracy, sensitivity and specificity of the microfluidic gel method in ABO blood group normalisation and Rh blood group antigen detection. Methods Samples from 1 005 patients with clinical blood use were tested for positive ABO typing and Rh blood grouping by microfluidic gel technology versus column agglutination technology,and the positive, negative and total compliance rates of the two methods were compared, as well as the compliance situation in patients with different diseases and ages. Results Compared with the column agglutination method, the compliance rate of microfluidic gel technology in ABO positive typing and Rh blood typing was 99.70% and 98.61%, respectively. There were 17 cases of incompatible identification results, including 5 cases of haematological diseases, 3 cases of tumours, 4 cases of infectious diseases and 5 cases of other diseases; including 6 cases of history of blood transfusion and 7 cases of history of pregnancy and childbirth; there was no significant difference between the results of the two detection methods with statistical analysis (P>0.05, Kappa value>0.75). Conclusion The microfluidic gel method has the advantages of low sample and reagent consumption, small test card size and convenient operation, and is expected to be popularised in clinical testing due to its high sensitivity, good specificity and accurate results in detecting ABO positive blood group typing and Rh blood group antigen.

Objective To analyze the clinical significance and economic analysis of RhD, C, c, E, e antigen compatible blood transfusion in our hospital, and provide scientific basis for the comprehensive promotion and popularization of Rh compatible blood transfusion and the decision-making of health administrative departments in the future. Methods We screened and identified the production of unexpected antibodies between Rh compatible transfusion group and control group. The length of hospital stay (LOS) and the cost of transfusion-related testing were analyzed in the two years before and after Rh phenotyping. Results The Rh antigen compatibility between donors' red blood cells and patients was high enough to transfuse Rh matched red blood cells for 92.43% of patients. The total ratio of unexpected antibodies was 1.72% (186/10,786), the antibody frequency of Rh system was 43.30%, anti-Mi^a was 20.98%. There is no new development of Rh system antibodies after Rh compatible transfusion. After Rh phenotyping, the mean LOS and the cost of red blood cells were slightly decreased. Conclusion Rh compatible transfusion can significantly diminish new unexpected antibodies. The increased cost of transfusion-related testing due to Rh compatible transfusion did not significantly increase medical costs. Rh compatible blood transfusion is worth promoting and popularizing.

Objective miRNA mainly participates in the post transcriptional regulation of gene expression through gene silencing. The present study speculates that miRNAs contained in red blood cell (RBC) at different storage times during clinical transfusion might play a potential role in tumor progression and prognosis through target genes and their mediated molecular signaling pathways based on bioinformatics analysis. Methods Differential expression miRNAs (DEmiRNAs) and mRNAs (DEmRNAs) were screened out using the Gene Expression Omnibus (GEO) and Cancer Genome Atlas (TCGA) databases. By conducting pathway enrichment analysis on miRNA target genes and integrating with DEmRNAs, candidate genes were selected out, and a risk factor prediction model was established. The reliability of the model was evaluated through survival analysis and ROC curve. Results Compared with the GSE114990 data set on day 1, totally 27 and 22 DemiRNAs were identified on day 7 and 28, respectively. After screening, prediction, and integration analysis, miR-381 and candidate 18 target genes were selected to construct risk factors prediction model, which revealing significant differences in survival rates among different risk groups, and speculating a potential molecular signaling pathways of miR-381-target genes (NR3C1, TSHZ3, LIPG, and DLC1)-tumors. Conclusion The results of our study indicate that the potential molecular mechanism based on the "miR-381 target gene-tumor" signal axis may affect disease progression and prognosis in endometrial cancer patients receiving RBC of different storage times.

Objective To explore the effects of three conditions of not taking calcium, taking calcium gluconate orally, and taking calcium lactate granules orally on blood Ca²⁺, PTH and adverse reactions of blood donors with fixed platelets donors, and to compare which calcium is better. Methods From July to September 2020, 35 volunteers (20 males and 15 females) were recruited from the fixed blood donor population at our center to participate in three sets of trials:The first group of experiments was a control group, which did not supplement calcium before platelet collection;The second group was supplemented with 10% Calcium gluconate oral liquid 20 minutes before collection (after sampling);The third group supplemented calcium lactate granules 20 minutes before harvest (after sampling).In each of the three experiments, 5ml of whole blood samples were collected for the detection of blood Ca²⁺ and PTH at sampling time (20 minutes before collection), needle insertion time (0 minutes after collection), middle school stage (20 minutes after collection), and later stage of collection (40 minutes after collection).Compare the trend of changes in blood Ca²⁺ and serum PTH values among three groups, and explore the effect of calcium agents. Results The change in blood Ca²⁺ of donors over time was significant（F=101.979,P<0.001）,the inter group effect was not significant（F=0.059,P=0.943>0.05）; The change in serum PTH over time was significant（F=495.834,P<0.001）,the inter group effect was not significant（F=1.241,P=0.294>0.05）;There was a negative correlation between blood Ca²⁺ and PTH values with changes in blood collection time.Both calcium agents reduce the probability of citric acid reaction.（P<0.05）Conclusion Regardless of whether preventive calcium supplementation was used or what type of calcium supplementation was used, the blood Ca²⁺ in blood donors could remain stable under the action of PTH.Preventive calcium supplements could reduce the risk of citric acid.

Objective The aim of this study is to explore the efficiency of freezing point cooling inverted centrifugation on plasma chylemia reduction. Methods 46 bags of frozen plasma (200 mL/bag) were collected from blood composition preparation process. The freezing point cooling inverted centrifugation was employed for removal of chylemia from plasma, and the absorbance, lipid levers, total plasma protein (TP) and chylemia were analyzed before or after the centrifugation to evaluate the effect of chylemia reduction. Results After the treatment of freezing point cooling inverted centrifugation, the OD value, TG content and chylous index of were significantly decreased in moderate chylous plasma (P<0.01). While, the levels of TC, HDL, LDL and TP were not significantly different from those without treatment (P>0.05). The OD value, TG content and chylous index were significantly decreased in severe chylous plasma after treatment of freezing point cooling inverted centrifugation (P<0.01). The appearance of plasma was significant improved, and the compliance rate of comprehensive standards was 75%. However, the levels of TC, HDL, LDL and TP were not significantly different from those without treatment (P>0.05). Conclusion Freezing point cooling inverted centrifugation method can effectively reduce plasma chyle degree, improve the compliance rate of plasma quality control, reduce the scrap rate of blood and minimize the waste of blood resources as much as possible.

Objective To investigate whether the SNP of cytochrome P450 gene is associated with a risk of liver cirrhosis induced by hepatitis B virus (HBV). Methods We screened 10 loci on cytochrome P450 genes from bioinformatics database after literature research, and then collected 255 samples in HBV-related cirrhosis group and 160 samples in healthy group for genotyping by sequencing. Logistic regression and other statistical analyses were used to analyze the relationship between SNP and susceptibility to HBV-related cirrhosis. Results The genotype distribution of all SNP loci was in Hardy-Weinberg equilibrium. The chi-square test showed that only rs3758581 genotype and allele distribution at 10 loci were significantly different between HBV-related cirrhosis group and healthy group. Logistic regression analysis showed that the codominant, additive, dominant and overdominance models at rs3758581 suggested patients with GA genotype had an increased risk of HBV-related cirrhosis. Conclusion The GA genotype heterozygous mutation at rs3758581 on cytochrome P450 gene may increase the risk of HBV-related cirrhosis.

Objective To analyze the correlation between serum endothelial cell-specific molecule-1 (Endocan), soluble interleukin-2 receptor (sIL-2R) and inflammatory markers,and their predictive value for clinical outcomes in patients with peritoneal dialysis-associated peritonitis (PDAP). Methods A total of 121 patients with PDAP (PDAP group) and 121 patients with normal peritoneal dialysis (control group) admitted to Linyi Central Hospital from February 2019 to January 2022 were selected. The serum Endocan, sIL-2R and inflammatory markers were compared between the two groups, and the correlations were analyzed by Pearson method. The PDAP patients were divided into the cure and treatment failure groups based on clinical outcomes. Baseline data were collected, and factors influencing treatment failure in PDAP patients were analyzed using multivariate Logistic regression model. The predictive value of serum Endocan and sIL-2R in treatment failure group were analyzed using receiver operating characteristic (ROC) curves. Results The levels of serum Endocan, sIL-2R, interleukin (IL)-1β, IL-6 and hs-CRP in the PDAP group were higher than those in the control group (P<0.05). Pearson correlation analysis showed that serum Endocan, sIL-2R were positively correlated with IL-1β, IL-6 and hs-CRP in the PDAP group (P<0.05). Of 121 patients, 82 (67.77%) were cured, and 39 (32.23%) were failed treatment. The dialysis age, time from symptom onset to treatment, white blood cell (WBC) count, IL-1β, IL-6, hs-CRP, endocan and sIL-2R in the treatment failure group were higher than those in the cure group, while the serum albumin, potassium and dialysate white blood cells were lower (P<0.05). Multivariate logistic regression analysis showed that long duration from symptom onset to treatment, elevated serum endocan and sIL-2R levels were independent risk factors for treatment failure in PADP patients, and elevated serum albumin was an independent protective factor (P<0.05). ROC curve analysis showed that the area under the curve (AUC) of serum IL-1β, IL-6, hs-CRP, endocan and sIL-2R in predicting treatment failure in PDAP patients were 0.694 (95% CI, 0.604-0.775), 0.654 (95% CI, 0.562-0.738) and 0.685 (95% CI, 0.5955-0.767), 0.779 (95% CI, 0.694~0.849) and 0.720 (95% CI, 0.631~0.797), respectively. The predictive efficacy of serum endocan and sIL-2R was higher than that of IL-1β, IL-6 and hs-CRP. The combinations of serum endocan and sIL-2R (LogP mode) predicted an AUC of 0.849 (95% CI, 0.773~0.908) for treatment failure in PDAP patients. Conclusion Elevated serum endocan and sIL-2R levels were higher risk factors for treatment failure, and combinations of the two tests can predict the clinical outcomes for PADP patients.

Objective To investigate the relationship between blood lead levels（BLLs） and hematological parameters in children with severe lead poisoning,so as to explore the effect of high blood lead level on hematological parameters at high altitudes. Methods A total of 591 patients with lead poisoning in a hospital in Sichuan from July 2021 to May 2022 were selected. 475 children with healthy physical examination were selected as the control group. The leukocyte count（WBC）,red blood cell count（RBC）,hemoglobin（HGB）,hematocrit（HCT）,mean corpuscular volume（MCV）,mean corpuscular hemoglobin（MCH）,mean corpuscular hemoglobin concentration（MCHC）,width of red blood cell distribution（RDW）,platelet count（PLT）and blood lead levels（BLLs）were collected.The correlation between blood lead level and hematological parameters was analyzed,to assess the effect of high blood lead levels on hematological parameters. Results The RBC,HGB,HCT,MCV and MCH of the lead poisoning group were significantly lower than those of the control group,while the RDW of the lead poisoning group was significantly higher than that of the control group（P<0.05）. The BLLs of the lead poisoning group was negatively correlated with RBC（r_s=-0.10,P=0.012）,HGB（r_s=-0.24,P<0.001）,HCT（r_s=-0.22,P<0.001）,MCV（r_s=-0.20,P=0.002）,MCHC（r_s=-0.18,P<0.001）and MCH（r_s=-0.23,P<0.001）,and positively correlated with RDW（r_s=0.28,P<0.001）. Logistic regression analyses showed that BLLs were significantly associated with decreased HGB,HCT,MCV,MCH,MCHC and increased RDW after adjusting for potential confounders. The children with BLLs ≥700 μg/L were 1.34,0.91,0.87,1.61 and 1.25 times more likely to achieve decreased HGB,HCT,MCV,MCH and MCHC,respectively,compared to those with BLLs < 700 μg/L. Compared with children with BLLs<700 μg/L,those with BLLs≥700 μg/L were 1.47 times more likely to show increased RDW. The individuals with BLLs of the highest quartile were 2.16,1.03,and 1.81 times more likely to exhibit decreased HGB,HCT and MCH,respectively,than the children with BLLs of the lowest quartile. Compared with children with BLLs of the lowest quartile,those with BLLs of the highest quartile were 1.47 times more likely to show increased RDW. Conclusions High blood lead levels in children with severe lead poisoning at high altitudes have affected the hematopoietic function of the blood system,resulted in a decrease in the oxygen-carrying capacity of red blood cells,which in turn affected children's growth and development and quality of life.

Objective We analyzed the anti-D alloimmunization induced by transfusion of "Asia type" DEL red blood cells (RBCs) in an RhD negative individual to develop a strategy of such transfusion. Methods ABO and Rh system blood group antigens were examined, and irregular antibodies were screened and identified by the serological method. RHD genotyping of DEL type was detected by high-resolution melting (HRM) and gene sequencing analyses. Results The recipient was found to be type O and RhD negative. The donors had “Asia type” DEL with the RHD1227G>A mutation and the Rh phenotype was Ccee. The routine pre-transfusion alloantibody screening test was positive after the last blood transfusion. Anti-D (titer, 512-fold) and Anti-C (titer, 128-fold) were identified by further alloantibody identification. Conclusion Transfusion of "Asia type" DEL RBCs in RhD-negative patients could induce anti-D alloimmunization, therefore making it crucial to enhance DEL type screening for RhD-negative blood donors, and, if necessary, add RHD gene testing to guarantee transfusion safety.

ABO blood group is an independent risk factor for venous thromboembolism （VTE）in cancer patients. However, the specific mechanism and risk factors of ABO blood group on VTE in tumor patients are still unclear, which brings challenges to the prevention and treatment of the disease. This article deeply reviews the influence of ABO blood type on VTE in cancer patients based on the latest literature, so as to further optimize the management of VTE in cancer patients.