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  • 中国科学论文统计源期刊
  • 中国科技核心期刊
  • 美国化学文摘(CA)来源期刊
  • 日本科学技术振兴机构数据库(JST)

Responsible Institution:

Anhui Commission of Health

Sponsor:

The First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital) Anhui Provincial Association of Transfusion

Editor-in-Chief:XU Ge-liang

Publication Frequency:Bimonthly

CSSN:

ISSN 1671-2587

CN 34-1239/R

Current Issue

2024, Vol.26, No.3 Date of publication:20 June 2024
Chinese Expert Consensus on Red Blood Cell Antigen Extended Matching Range
Expert consensus drafting group of red blood cell antigen extended matching range
JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE. 2024 (3):  289-298.  DOI: 10.3969/j.issn.1671-2587.2024.03.001
Abstract ( 1179 )   HTML ( 32)   PDF(1386KB) ( 928 )  
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Exploration of the Mechanism of Sema7a Promoting Adhesion of Umbilical Vein Endothelial Cells to Megakaryocytes
LAI Dongdi, DONG Han, WEI Yaming, YUAN Zhaohu
JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE. 2024 (3):  299-308.  DOI: 10.3969/j.issn.1671-2587.2024.03.002
Abstract ( 855 )   HTML ( 17)   PDF(2503KB) ( 172 )  
Objective The purpose of this study was to explore the mechanism of Sema7a protein promoting the adhesion between endothelial cells and megakaryocytes. Methods Human umbilical vascular endothelial cells (HUVECs) and megakaryocyte line MEG01 were used to simulate the adhesion of pulmonary vessels and megakaryocytes in vitro. Immunofluorescence, flow cytometry, 4D Label free and other biological techniques were used to detect the adhesion between endothelial cells and megakaryocytes, the amount of Sema7a binding to HUVECs, and the changes of protein expression and biological information in HUVECs. Immunofluorescence was used to detect the expression of intercellular cell adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) in HUVECs. Results The adhesion between MEG01 and HUVECs was promoted after Sema7a binding to HUVECs, with the MAPK signal pathway been activated, and molecules ICAM-1 and VCMA-1 of HUVECs been up-regulated. Conclusion Sema7a promoted the adhesion between megakaryocytes MEG01 and endothelial cells HUVECs by up-regulating the expression of molecules ICAM-1 and VCMA-1 in HUVECs.
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The Impact of Reduced Bisphosphoglycerate Mutase(BPGM)Enzyme Activity in Sensitized Red Blood Cells on Oxygen Carrying/Releasing Capacity
MENG Weicheng, CHEN Yaozhen, WANG Yafen, AN Ning, LIU Zhixin, WU Xiaoshuang, WANG Fei, HU Xingbin
JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE. 2024 (3):  308-314.  DOI: 10.3969/j.issn.1671-2587.2024.03.003
Abstract ( 781 )   HTML ( 15)   PDF(1719KB) ( 150 )  
Objective To explore the underlying causes for the observed anomalies, the oxygen-carrying/releasing capacity of sensitized red blood cells (RBCs) was analyzed . Methods The sensitized red blood cells were detected through microcolumn gel cards, and an oxygen-carrying/releasing assessment device was employed to evaluate the oxygen-carrying/releasing capacity of sensitized RBCs in patients with autoimmune hemolytic anemia (AIHA) and hemolytic disease of the newborn (HDN). We constructed a transfusion-induced hemolytic reaction mouse model using plasma from healthy adults, while the control group received PBS. Record the time until exhaustion during weight-loaded swimming in mice and analyze the oxygen-carrying/releasing capacity of isolated mouse RBCs. Perform GO and KEGG enrichment analysis on differentially expressed proteins related to hemolysis and the control group using proteomics. Measure BPGM enzyme activity and 2,3-DPG levels in sensitized RBCs using ELISA. Results Compared to the corresponding control groups, the oxygen dissociation curves in AIHA, HDN, and transfusion-induced hemolytic reaction model mice exhibited a left shift and decreased P50. The weight-loaded swimming time in hemolytic model mice was significantly shortened. Proteomic screening revealed abnormalities in BPGM, with decreased BPGM enzyme activity and a decline in intracellular 2,3-DPG content. Conclusion The reduced activity of BPGM in sensitized RBCs led to a decline in their oxygen-releasing capacity.
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Proteomic Analysis of Plasma Exosomes from Young Versus Middle-aged People
XIAO Pan, LIU Yulin, XUE Xiaonan, XUE Yingna, LIU Yi, SUN Liping, YU Yang
JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE. 2024 (3):  315-325.  DOI: 10.3969/j.issn.1671-2587.2024.03.004
Abstract ( 796 )   HTML ( 12)   PDF(1624KB) ( 214 )  
Objective Exosomes, as cellular messengers circulating in bodily fluid, carry diverse bioactive chemicals. This study aimed to analyze the characteristics and variations in plasma exosomal proteins between young and middle-aged individuals, offering theoretical insights into their role in influencing bodily functions. Methods Peripheral blood samples were collected from young (age:19.33±1.16) and middle-aged (age:50.33±2.52) adults. Plasma exosomes were isolated by differential ultracentrifugation, and characterized via transmission electron microscopy, particle size analysis, and Western blot. Liquid-phase mass spectrometry analysis technology was used to detect and analyze the types and functional differences of plasma exosome proteins between the two age groups. Results The average diameter and protein concentration of plasma exosomes in young men were similar to those in middle-aged men, but the average concentration of exosomes was slightly lower in young men. Plasma exosomes from young men exhibited low CD9 levels, contrary to high CD9 levels observed in middle-aged men. A total of 110 differential proteins were identified in the plasma exosomes of both groups, with 36 proteins upregulated and 74 downregulated in young males compared to middle-aged males. GO functional analysis revealed differences in biological processes, particularly translation elongation, cellular macromolecule biosynthesis, and organic nitrogen compound biosynthesis. Molecular functions focused on translation elongation factors, copper ion binding, and nucleic acid binding. KEGG pathway analysis indicated enrichment in 13 pathways, including antigen processing, presentation, and endocytosis. Among the 21 proteins specific to young men's plasma exosomes, Drebrin-like protein (DBNL) displayed functions related to both the nervous system and the immune system. Conclusion No differences have been noted in the morphology, size, and concentration of plasma exosomes between young and middle-aged men, but there are significant differences in their surface markers and intronic proteins.
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Effect of Double Filtration Plasmapheresis and Plasma Exchange on Blood Type Antibody Removal in ABO-incompatible Kidney Transplantation Recipients: A Single Center Comparative Analysis
YANG Hao, DONG Shuling, YANG Qiankun, HAN Yue, WANG Shuya, JIN Huifang, ZHENG Lu, TANG Yue
JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE. 2024 (3):  325-331.  DOI: 10.3969/j.issn.1671-2587.2024.03.005
Abstract ( 831 )   HTML ( 9)   PDF(1105KB) ( 180 )  
Objective To compare the effect of double filtration plasmapheresis (DFPP) and plasma exchange (PE) on blood type antibody removal before ABO-incompatible kidney transplantation (ABOi-KT). Method Clinical data and antibody titers before and after each treatment of 36 recipients treated with DFPP and 27 recipients treated with PE before ABOi-KT from February 2021 to December 2023 in the First Affiliated Hospital of Zhengzhou University were collected and analysed. Results 98 and 82 times of treatment were performed in DFPP and PE group, respectively. The titers of blood type antibodies after DFPP and PE treatment were significantly lower than those before treatment (P<0.05). Both DFPP and PE showed good removal effect on high titer antibodies, and the removal effect of DFPP on IgG anti-A, IgG anti-B and IgM anti-B antibodies in group of titer ≥32 was better than that in group of titer ≤16 (P<0.05). The removal effect of PE on IgM anti-A and IgM anti-B antibodies in group of titer ≥32 was better than that in group of titer ≤16 (P<0.05). Overall, DFPP and PE showed no significant difference in the removal effect on different types of antibodies. However, both DFPP and PE showed a better removal effect on IgM antibodies in group of titer ≥32 compared with group of titer ≤16 (P<0.05), and the effect of PE was more obvious. The removal effect on anti-A antibodies in PE group was better than that in DFPP group. This advantage was mainly manifested as follows: PE had a better removal effect on IgG anti-A antibody than DFPP in group of titer ≤16 (P<0.05); PE had a better removal effect on IgM anti-A antibody than DFPP in group of titer ≥32 (P<0.05). There was no significant difference between the two methods in the removal effect on the other blood group antibodies (P>0.05). Conclusion Both DFPP and PE can significantly reduce the titer of blood type antibodies, and the two methods have a better removal effect on high titer antibodies. There was no significant difference between the two methods in the removal of antibodies of other blood groups, except that the removal efficiency of low titer IgG anti-A and high titer IgM anti-A antibodies by PE was better than that by DFPP.
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Comprehensive Effect of Autologous Plateletpheresis and Transfusion Technology in Patients with ATAAD
ZHAO Nan, LU Jiangtao, HE Ling, CHEN Xiaoling, ZHANG Wenjie, ZHANG Dafa, TANG Zongsheng
JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE. 2024 (3):  332-337.  DOI: 10.3969/j.issn.1671-2587.2024.03.006
Abstract ( 194 )   HTML ( 7)   PDF(1427KB) ( 155 )  
Objective To investigate the clinical effect of autologous plateletpheresis (APP) transfusion in patients with acute type A aortic dissection (ATAAD). Methods The clinical data of 125 ATAAD patients admitted to our hospital from January 2020 to April 2023 were retrospectively analyzed. The patients were divided into APP group (n=59) and non-APP group (n=66) based on whether APP and transfusion performed. The levels of coagulation indexes and liver and kidney indexes were recorded at preoperative (T0), 24 h postoperative (T1), 48 h postoperative (T2), and 72 h postoperative (T3). Platelet count, the amount of allogeneic blood transfusion, duration of surgery, duration of mechanical ventilation, volume of mediastinal drainage in the postoperative period, length of stay in the ICU, hospitalization cost, and rate of postoperative complications were recorded. Results At T1-T3, PT and APTT in the APP group were significantly shorter than those in the non-APP group (P<0.05), and the level of FIB was higher than that in the non-APP group (P<0.05). The liver function parameters after operation were observed. Compared with the non-APP group, the levels of ALT and AST in the APP group were relatively lower at T1 and T2 (P<0.05); LDH was maintained at lower levels at T1, T2, and T3 (P<0.05); the levels of DBil and TBil were lower than those in the APP group at T1 (P<0.05). Postoperative renal function parameters were observed. SCr and BUN levels in the APP group were significantly lower than those in the non-APP group at T1, T2, and T3 (P<0.05). From blood protection, compared with the non-APP group, PLT in the APP group maintained a high level at T1 (P<0.05), and the amount of perioperative allogeneic red blood cells, platelets, plasma and cryoprecipitate transfusion in the APP group was relatively lower (P<0.05). The postoperative outcomes were observed. Compared with the non-APP group, duration of mechanical ventilation and length of stay in the ICU in the APP group were shorter; total hospitalization cost was lower; the volume of mediastinal drainage at 24 h after surgery was lower (P<0.05). The postoperative complications were observed. The incidence of acute kidney injury in the APP group was significantly lower than that in the non-APP group (P<0.05). Conclusion Autologous plateletpheresis and transfusion technology can effectively improve the coagulation function of ATAAD patients and have obvious effects on postoperative liver and kidney function protection and blood protection, and accelerate postoperative recovery and regression. The application of this technology is helpful to reduce the economic burden of patients and achieve good social and economic effects.
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Analysis of Correlation and Influencing Factors between RhD Negative Pregnant Women and the Occurrence of HDFN
CHEN Tingting, HUANG Rong, LING Yu, HU Wenjing
JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE. 2024 (3):  338-345.  DOI: 10.3969/j.issn.1671-2587.2024.03.007
Abstract ( 283 )   HTML ( 20)   PDF(1492KB) ( 203 )  
Objective By comparing and analyzing the related indexes of hemolytic disease of the fetuses and newborn (HDFN) in fetuses and newborns delivered by RhD-negative pregnant women, we can provide reference and guidance for the prevention and treatment of HDFN. Method A total of 737 RhD-negative pregnant women who gave birth in our hospital from January 2018 to December 2022 were collected. The relative factors of HDFN caused by RhD blood group incompatibility and ABO blood group incompatibility, RhD-HDFN and ABO-HDFN were compared. Moreover, the differences of laboratory indexes between RhD-HDFN and ABO-HDFN and RhD-HDFN in newborns with IgG anti-D titer ≤16 and ≥32 were analyzed. Results Among 737 RhD-negative pregnant women, 88.89% (40/45) had the same or compatible ABO blood type between mother and infant, which was significantly higher than 11.11% (5/45) in mother-infant ABO blood type incompatibility. Maternal second pregnancy and above births had a 93.33% (42/45) RhD-HDFN rate which was significantly higher than the 60.66% (37/61) ABO-HDFN rate. In addition, the lowest hemoglobin value in newborns born to mothers with IgG anti-D titers ≥32 was significantly lower than that of mothers with IgG anti-D titers ≤ 16 (χ2=5.61, P<0.05). As expected, the peak value of serum total bilirubin in newborns born to mothers with IgG anti-D titers ≥32 was higher than those with IgG anti-D titers ≤ 16 (χ2=4.471, P<0.05). Conclusion Among RhD-negative pregnant women, those with the same or compatible ABO blood type and gravidity and parity history ≥2 are more likely to develop RhD-HDFN in their corresponding newborns and the severity of neonatal hemolysis is significantly higher in those with maternal IgG anti-D titer ≥ 32 than in those with anti-D titer ≤ 16.
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Risk Factors for Death during Plasma Exchange Therapy for Subacute and Acute Liver Failure: Based on PSM Method
LI Peihua, SU Huanzheng, SHA Xiajun, LUO Wenying
JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE. 2024 (3):  345-352.  DOI: 10.3969/j.issn.1671-2587.2024.03.008
Abstract ( 165 )   HTML ( 3)   PDF(1338KB) ( 76 )  
Objective To explore the risk factors for death during plasma exchange therapy for subacute and acute liver failure (ACLF) based on propensity score matching method (PSM). Methods The clinical data of 196 patients with ACLF admitted to our hospital from January 2019 to January 2023 were analyzed. According to the death situation during plasma exchange therapy, they were divided into death group (n=68) and survival group (n=128). A 1:1 PSM method was used to match general demographic variables between the two groups; after matching, Cox regression model was applied to analyze the factors influencing mortality during ACLF plasma exchange treatment. Kaplan-Meier curve was drawn to analyze the relationship between influencing factors and death during ACLF plasma exchange. Results The mortality rate during ACLF plasma exchange treatment was 34.69%. Before matching, there were no statistically significant differences between the two groups in terms of gender, BMI, smoking history, hypertension, hyperlipidemia, diabetes, and chronic kidney disease (P>0.05). There were significant differences in age and drinking history (P<0.05). After PSM, 64 pairs were successfully matched, and there were no significant differences in all matched factors between the two groups (P>0.05), indicating good balance and effective matching. After matching, the ratio of the death group with hepatorenal syndrome, the model of end-stage liver disease (MELD) score system combined with serum sodium (MELD-NA) score, red blood cell volume distribution width (RDW), total bilirubin (TBil), blood creatinine (Scr) and international standardized ratio (INR) were higher than those of the survival group (P<0.05). The levels of serum sodium and prothrombin activity (PTA) and the proportion of treatment compliance were lower than those of survival group (P<0.05). Cox regression analysis revealed that MELD-Na scores (HR=2.450, 95% CI:1.483~4.046), concurrent hepatorenal syndrome (HR=2.223, 95% CI:1.496~3.303), RDW (HR=2.912, 95% CI:1.416~5.991), PTA (HR=0.373, 95% CI:0.225~0.620), and treatment compliance (HR=0.284, 95% CI:0.141~0.571) were significant factors affecting mortality during ACLF plasma exchange treatment (P<0.05). Cox regression model after adjusting for confounders showed that MELD-Na score (HR=2.889, 95% CI:1.431~5.836), hepatorenal syndrome (HR=3.048, 95% CI:1.332~6.975), RDW (HR=2.166, 95% CI:1.340~3.502) were the influential factors of death during ACLF plasma exchange (P<0.05). Log-rank test showed that the mortality of patients with high MELD-Na score, hepatorenal syndrome and high RDW were higher than those of patients with low MELD-Na score, no hepatorenal syndrome and low RDW (P<0.05). Conclusion Based on PSM, MELD-Na score, hepatorenal syndrome, RDW are found to be influential factors for death during ACLF plasma exchange treatment.
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Analysis of HLA/HPA Antibody Specificity and Its Impact on Platelet Transfusion Outcomes in Patients with Immune Platelet Transfusion Refractoriness
FAN Chengyan, WEN Yujie, ZHANG Dan, LIAN Xue, LIU Na, SUN Tiecheng, WANG Dongmei, JIA Yanjun, LI Dongmei
JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE. 2024 (3):  353-358.  DOI: 10.3969/j.issn.1671-2587.2024.03.009
Abstract ( 215 )   HTML ( 9)   PDF(1099KB) ( 363 )  
Objective To analyze the distribution of HLA/HPA antibody specificity and its influence on the efficacy of platelet transfusion in patients with immune platelet transfusion refractoriness(PTR). Methods In this study, 86 patients with immune PTR were recruited, and clinical data were collected, including gender, age, height, weight, times of platelet cross-matching, diseases, as well as platelet count before and after platelet transfusion. HLA antibody specificity was determined using the microbead assay. Results Among 86 PTR patients, 72 (83.72%) had HLA antibodies alone, 8 (9.30%) had HPA antibodies alone, and 6 (6.98%) had both HLA and HPA antibodies. The most prevalent HLA alleles corresponding to HLA antibodies in different loci were A*25:01, B*15:12, C*02:02 (and C*17:01), with the positive rates of 81.48%, 87.04%, and 48.15%, while the top antigenic epitopes were 163LG, 97V, and 71ATD, with the positive rates of 87.04%, 77.78%, and 74.07%, respectively. In patients with HLA antibodies alone, cross-matched platelet transfusions showed significantly higher 24 h corrected count increment(CCI)and transfusion efficiency than randomized transfusions (P<0.01). In patients with negative cross-matching results, the intensity of HLA antibodies inversely correlated with both the 24 h CCI and the effective rate of platelet transfusion in patients receiving cross-matched platelets. Specifically, a higher the level of HLA antibodies corresponded to a lower 24 h CCI and reduced transfusion efficiency (P<0.01). Conversely, in patients with a lower level of HLA antibodies, the efficiency of platelet transfusion and 24 h CCI of cross-matched platelets were significantly higher than those of randomized platelets (P<0.05). Conclusion Our findings reveal the specificity of HLA/HPA antibodies in patients with immune PTR and their effect on platelet transfusion efficacy, which would provide guidance for donor selection in the establishment of platelet banks. Furthermore, this study could also provide a reference for selecting appropriate treatment strategies for patients with immune PTR.
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Application of Single Molecule Real-time Sequencing in HLA Genotyping
CHU Yushuang, XIAO Yanlin, WANG Zhe, FENG Qinging, LI Tingting, BIAN Maohong
JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE. 2024 (3):  359-365.  DOI: 10.3969/j.issn.1671-2587.2024.03.010
Abstract ( 169 )   HTML ( 3)   PDF(1256KB) ( 147 )  
Objective To explore the accuracy and the feasibility of this method in clinical application, single molecule real-time (SMRT) sequencing technology was employed to determine HLA genotyping, haploid type. Methods Blood samples were collected from 19 patients who needed kidney transplantation, genomic DNA was extracted respectively, and the sequences of all samples were obtained by SMRT sequencing technology, and then detected by PCR-SBT to verify the accuracy of the result. Results The genotypes and haplotypes of 19 samples could be assigned by SMRT technique, which were consistent with those of the PCR-SBT method. The results of HLA-C locus showed ambiguous combination on samples 1 and 14 using SBT method, with HLA-C*03:02,03:03 and -C*03:04,03:132; while the unique result of them is HLA-C*03:02:02, 03:03:01 using SMRT technology. In addition, a new HLA-B allele of sample 1 was identified using SMRT method. Conclusion SMRT sequencing technology has high accuracy when applied to HLA high-resolution typing, and has unique advantages of accurately locating multiple long-distance mutation in HLA haploid typing.
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Application of ONT in Ambiguous Results of the HLA-DPB1 Genotyping
LIAN Xue, ZHANG Dan, WEN Yujie, FAN Chengyan, WANG Dongmei, LIU Na, ZHANG Rongfang, JIA Yanjun
JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE. 2024 (3):  365-370.  DOI: 10.3969/j.issn.1671-2587.2024.03.011
Abstract ( 202 )   HTML ( 3)   PDF(1113KB) ( 159 )  
Objective This study aims to analyze the efficiency, advantages and mechanisms of the ONT platform, a TGS method in ambiguous results of the HLA-DPB1 genotyping in comparison to PCR-SBT and NGS. Methods 48 samples were tested for HLA-DPB1 genotyping by PCR-SBT, NGS(Illumina platform)and TGS (ONT platform). HLA-DPB1 allele was assigned to the third field for NGS and TGS, and the second field for PCR-SBT. Results TGS had no ambiguity with a single allele combination of HLA-DPB1 alleles. Ambiguous results were given in 45 out of 48 samples by PCR-SBT, accounting for 93% (45/48), and 5 out of 48 samples by NGS, accounting for 10% (5/48). Conclusion Compared with NGS and PCR-SBT, TGS can resolve most of the ambiguous combinations and improve the efficiency and accuracy in HLA-DPB1.
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Research on the Problems and Countermeasures of Dual Track Employment in Blood Collection and Supply Institutions in China
HU Xiaoyu, LIU Tingting, LI Kesong, YIN Kun, LIU Weifeng, ZHOU Donggen
JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE. 2024 (3):  371-376.  DOI: 10.3969/j.issn.1671-2587.2024.03.012
Abstract ( 289 )   HTML ( 6)   PDF(1275KB) ( 167 )  
Objective To explore the problem of dual track employment in blood collection and supply institutions, and provide countermeasures and suggestions for optimizing human resource management. Methods A specialized survey questionnaire was used to conduct a survey on 229 blood collection and supply institutions nationwide, to collect information on the number and turnover of staffing and non staffing personnel, then conduct a t-test for differential analysis. Results Blood collection and supply institutions across the country generally face problems such as delayed changes in staffing ratios, differences in the number of new personnel, significant differences in the turnover of self caused personnel, and complex or diverse salary management systems. Conclusion Strengthen the understanding of the management complexity brought by dual track employment, plan the dynamic mechanism of personnel staffing standards, innovate personnel management inside and outside the staffing, and optimize personnel allocation structure.
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Observation on the Disinfection Effect of Hydrogen Peroxide Mist Disinfection Machine on Bloodmobile
QIU Yingjie, ZHANG Shunwei, MA Qing, FU Jianmin, XU Yuyang, NIE Xiaoxun
JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE. 2024 (3):  376-380.  DOI: 10.3969/j.issn.1671-2587.2024.03.013
Abstract ( 187 )   HTML ( 8)   PDF(1082KB) ( 101 )  
Objective To evaluate the disinfection effect of bloodmobile carriage (hereinafter referred to as "carriage") by hydrogen peroxide mist disinfection machine. Methods After using a hydrogen peroxide mist disinfection machine to disinfect the interior of the carriage, we evaluated the disinfection effect by testing the natural environmental air microbial counts inside the carriage, the Bacillus stearothermophilus (ATCC12980) tablets, as well as the number of surface colonies on the left and right sides of the carriage, near the interior wall of the driver's cabin, the handle positions, and around and in the center of the built-in refrigeration unit. Results After disinfection, the air colonies and surface colonies inside the carriage were qualified and the logarithmic value of extermination was >1.00, and the killing rate of Bacillus sphaericus (ATCC12980) was 100%, only the bacteria were detected in the inner door handle and the built-in refrigeration unit close to the cab (front)with the median colony counts 4.21 CFU/cm2 (range: 0 CFU/cm2~6.84 CFU/cm2) and 6.84 CFU/cm2 (range: 0 CFU/cm2~8.42 CFU/cm2), respectively, and the rest of the detected locations were free of bacterial growth. The median manual operation time of hydrogen peroxide mist disinfection machine was 45 s (range: 40 s~51 s), and the median of manual operation time required by conventional disinfection spray was 610 s (range: 605 s~613 s). Conclusion The use of a hydrogen peroxide mist disinfection machine can meet the disinfection requirements for air colonies and the surface of objects inside the carriage, improve work efficiency and increase safety.
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Efficacy and Safety of CAR-T Cell Therapy in Treatment of Elderly Patients with B-cell Acute Lymphoblastic Leukemia: A Clinical Study
WANG Meiyan, CAI Mengjie, ZHU Mingqing, QIU Huiying
JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE. 2024 (3):  381-386.  DOI: 10.3969/j.issn.1671-2587.2024.03.014
Abstract ( 184 )   HTML ( 5)   PDF(1250KB) ( 143 )  
Objective To investigate the efficacy and safety of CAR-T cell therapy in treating elderly patients with B-cell acute lymphoblastic leukemia(B-ALL). Methods Follow-up data were retrospectively analyzed for 21 B-ALL patients who underwent CAR-T cell therapy from May 2020 to December 2022 at The First Affiliated Hospital of Soochow University. We evaluated the therapy's outcomes and safety profile. Results Among the 21 elderly B-ALL patients treated with CAR-T treatment,the incidence rates of cytokine release syndrome(grade 1-2),neutropenia,and neutropenia were 38.1%(8/21),42.9%(9/21),and 28.6%(6/21),respectively. One week after CAR-T transfusion,there was no significant difference in absolute white blood cell count compared with pre-infusion levels,but a remarkable increase was observed one month later(P<0.001). Neutrophil counts remained unchanged at one week and one month post the treatment(P>0.05). C-reactive protein significantly increased 7 days after CAR-T and decreased after 30 days(-3 d vs 7 d,P=0.007; 30 d vs 7 d,P=0.000 6); After one year following CAR-T-cell transfusion,85.7%(18 of 21)patients achieved complete remission,with a median follow-up duration of 17 months. The progression free survival rate(PFS)after CAR-T was 81.0%,uncorrelated with the gender,CAR-T cell type,Philadelphia chromosome status,high tumor burden,history of hematopoietic stem cell transplantation, treatment times, LDH concentration and platelet count(P>0.05). The median PFS of elderly B-ALL patients with CAR-T was 13 months. For patients with relapsed or refractory(R/R)B-ALL,the CR rate and PFS rate were 75% and 67.5%,the median PFS was 12 months. The average relapse time was 10.5 months after infusion of CAR-T. Conclusion CAR-T cell therapy demonstrates a promising response rate in the treatment of elderly B-ALL patients,which provides a potential therapeutic avenue for this population with a poor prognosis.
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Analysis of the Impact of Serum Albumin Level on the Infections and Prognosis in Childhood Acute Lymphoblastic Leukemia
CHENG Jie, CHEN Tianping, GAO Shan, WANG Jian, QV Lijun, LIU Hongjun
JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE. 2024 (3):  387-393.  DOI: 10.3969/j.issn.1671-2587.2024.03.015
Abstract ( 152 )   HTML ( 3)   PDF(1150KB) ( 110 )  
Objective This study aims to investigate the impact of albumin level on the incidence of severe infections and the long prognosis in childhood acute lymphoblastic leukemia (ALL). Method A retrospective analysis was conducted on 202 ALL patients diagnosed and treated at the Anhui Provincial Children's Hospital from January 2018 to October 2021. Baseline data, changes in body composition and albumin levels during chemotherapy, the occurrence of infections, and overall survival (OS) were collected. SPSS 26.0 software was used for the analysis of the related factors, with P<0.05 considered statistically significant. Results Out of the 202 children, 51 cases (25.24%) developed severe infections. Multivariate analysis indicated that the albumin level on the 15th day (D15) and WBC ≥50×109/L at the time of diagnosis were independent risk factor for severe infection (P<0.05). Albumin levels on D15, in combination with other factors, predicted a high probability of developing severe infections, 55.55% of the death cases died of severe infection in the first induction period,failure to achieve negative results for minimal residual disease (MRD) on day 33 were independent risk factors affecting the overall survival(P<0.05). Conclusion Children with acute lymphoblastic leukemia are susceptible to severe infections during the initial induction period, and the decrease of albumin on day 15 is a risk and predictive factor for severe infections, which is an important cause of early chemotherapy-related death. and the MRD on day33 remain positive affecting the OS. Clinical practice should focus on enhanced support, particularly albumin supplementation, to achieve better treatment outcomes.
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Research Advances in Blood Transfusion Medicine in the Year of 2023
HE Minwei, ZHOU Qianqian, ZHANG Ke, ZHAN Linsheng
JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE. 2024 (3):  399-403.  DOI: 10.3969/j.issn.1671-2587.2024.03.017
Abstract ( 371 )   HTML ( 16)   PDF(1091KB) ( 723 )  
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Research Progress on Erythrocyte-based Vaccine Carriers
GAN Li, YI Ping, ZHAO Qinjian, ZHANG Xinyuan
JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE. 2024 (3):  404-411.  DOI: 10.3969/j.issn.1671-2587.2024.03.018
Abstract ( 687 )   HTML ( 10)   PDF(1281KB) ( 130 )  
Erythrocytes are abundant within the body and are predominantly responsible for oxygen delivery. Mature mammalian erythrocytes have no nucleus and organelles, and they possess a high surface area-to-volume ratio, making them easy to conduct modification. These characteristics make erythrocytes suitable as delivery system, and erythrocytes have been used for drug delivery. Erythrocytes also possess immune regulatory capabilities. Erythrocytes can bind to pathogens and interact with chemokines, participating in innate immunity. Senescent erythrocytes modulate the expression of surface molecules and interact with phagocytic cells in the spleen, thereby regulating the adaptive immune response, facilitating the clearance of senescent erythrocytes through non-inflammatory pathways. The advantages in delivery and immunomodulation have led to the use of erythrocyte-based carriers in novel vaccines, replacing traditional vaccine adjuvants. There are diverse methods for synthesis of erythrocyte-based carriers. These carriers have great biocompatibility and are amenable to modification, accommodating the needs of different vaccines. By design, carriers based on erythrocytes in different stages can exert different immunomodulatory functions. Carriers based on normal erythrocytes can induce immune activation, while those based on senescent erythrocytes can be used to induce immune tolerance, showing promising results in the prevention and treatment of cancer, infectious diseases and autoimmune diseases. This article reviews the biological advantages of erythrocyte as vaccine carriers, antigen-loading strategies, the immunological effects of erythrocyte-based vaccine carriers and optimization strategies, providing insights for the development of novel vaccines.
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Advancements in Research on the Impact of Smoking on Red Blood Cells
WU Changrui, HUANG Yuanshuai, WANG Jie
JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE. 2024 (3):  411-419.  DOI: 10.3969/j.issn.1671-2587.2024.03.019
Abstract ( 240 )   HTML ( 11)   PDF(1249KB) ( 271 )  
Smoking constitutes a significant public health concern, recognized as a leading preventable cause of mortality worldwide. Tobacco smoke carries biologically active substances and toxic compounds that affect human health, leading to shortened lifespans. Oxidative stress induced by smoking exerts negative effects on the quality of red blood cells (RBCs), primarily through membrane damage and increased levels of abnormal hemoglobin. Prolonged smoking leads to abnormalities in various RBC parameters, thereby facilitating the onset and progression of diseases. This paper provides a summary of recent research on the adverse effects of smoking on red blood cells, aiming to furnish additional theoretical groundwork for enhancing tobacco control efforts.
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The Prospect of Combined Application of Platelet-rich Plasma and Mesenchymal Stem Cells in Regenerative Medicine
ZHAO Ziyue, HUANG Weihua, CHA Zhanshan
JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE. 2024 (3):  420-426.  DOI: 10.3969/j.issn.1671-2587.2024.03.020
Abstract ( 767 )   HTML ( 7)   PDF(1192KB) ( 192 )  
The combined application of platelet-rich plasma (PRP) and mesenchymal stem cells (MSCs) has shown great potential in regenerative medicine, providing new therapeutic strategies and powerful tools for the treatment of various diseases and tissue regeneration. This combined application combines the abundant growth factors in PRP and the multidirectional differentiation potential of MSCs to produce a synergistic effect that accelerate tissue regeneration and repair processes. The combined application of PRP and MSCs in different medical fields, such as orthopedics, orthopedics, cardiovascular and infertility treatment, has shown a wide range of application potential. In addition, personalized medicine has been made possible to adjust the treatment plan according to the specific situation of the patient and improve the treatment effect. However, there are some risks and limitations in the process. Among them, the risks of uncontrolled differentiation, bleeding and thrombosis require to be payed specialattention. In addition, the long-term safety, persistence of effects, and standardization of treatment protocols remain uncertain and need to be verified by more large-scale studies. In summary, the combined application of PRP and MSCs brings new hope and prospects for the field of regenerative medicine, but the advantages and risks need to be carefully weighed to ensure the safety and effectiveness of treatment options.
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Advances in the Detection of Fetalmaternal Transfusion Syndrome and Related Disorders
WANG Guomei, YANG Jijun, LIU Tiemei
JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE. 2024 (3):  426-432.  DOI: 10.3969/j.issn.1671-2587.2024.03.021
Abstract ( 178 )   HTML ( 9)   PDF(1149KB) ( 165 )  
Fetomaternal hemorrhage (FMH) is a series of reactions in which fetal red blood cells enter the maternal circulation before or during delivery, and the mother produces antibodies against fetal red blood cells, which in combination with red blood cell surface antigens cause fetal red blood cells to undergo varying degrees of hemolysis. Accurate quantification of fetalmaternal hemorrhage is crucial for the prevention of neonatal birth defects including neonatal hemolytic disease. Based on the latest relevant literature at home and abroad, this article analyzes the new and traditional detection methods for FMH, elucidates the advantages and shortcomings of various detection methods, and briefly outlines the correlation between FMH and various perinatal fetal clinical disorders, in order to provide a basis for standardization of testing techniques for fetalmaternal hemorrhage and further prevention and treatment of related diseases.
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