成都地区健康人群血常规各参数参考值范围的调查

目的了解成都地区健康人群血常规各参数的正常参考值范围。方法 2007.10-2008.07在我院体检的不同年龄(儿童和成人)、不同性别(男女)、不同采血方式(全血和末梢血)的健康人群共22178人,于清晨空腹抽取静脉血2mL或手指末梢血40μL(儿童),应用深圳迈瑞公司BC-5500型全自动血液分析仪进行检测,检测项目包括:红细胞(RBC)、白细胞(WBC)、血红蛋白(Hb)、红细胞比容(HCT)、红细胞平均体积(MCV)、红细胞平均血红蛋白含量(MCH)、红细胞平均血红蛋白浓度(MCHC)、血小板(PLT)、红细胞体积分布宽度(RDW)、血小板体积分布宽度(PDW)、血小板平均体积(MPV)、血小板压积(PCT)、中性粒细胞百分率(NEU%)、淋巴细胞百分率(LYM%)、单核细胞百分率(MON%)、嗜酸性粒细胞百分率(EOS%)、嗜碱性粒细胞百分率(BAS%)等23项指标,剔除离群点后,采用SPSSl1.5软件进行统计分析。结果本调查的血常规各参数呈非正态分布,男性和女性参考值间有显著性差别(P<0.01),成人和儿童之间有显著性差别(P<0.01),儿童全血和末梢血之间有显著性差别(P<0.01),成都地...     

The blood donation experience: self-reported motives and obstacles for donating blood

Background and Objectives The aim of the study was to investigate motives for donating blood as well as difficulties and obstacles associated with blood donation as perceived by the donors themselves. Materials and Methods Six hundred consecutive blood donors (i.e. all blood donors with a history of at least one previous whole blood donation attending, during nine working days, the Blood Centre of Umeå University Hospital) received a self‐administered questionnaire that contained questions aimed at elucidating motives for donating blood (general motives for donating blood, specific motives for the first donation and motives for continuing to be an active blood donor). Questions concerning difficulties and obstacles that had to be overcome in order to continue being a blood donor were also included in the questionnaire. Results Altogether 531 whole blood donors filled in the questionnaire (88·5%; 322 men and 209 women). No statistically significant differences were found between male and female blood donors concerning general reasons and motives related to donating blood. The most frequently reported reasons for giving blood the first time were ‘influence from a friend’ (47·2% of donors) and ‘request via media’ (23·5% of donors). Among general reasons/motives with highest ranking of importance, the most commonly reported motive for donating blood were ‘general altruism’ (40·3%), ‘social responsibility/obligation’ (19·7%) and ‘influence from friends’ (17·9%). General altruism’ and ‘social responsibility/obligation’ were also the most frequent reasons for continuing to donate blood (68·4 and 16·0%, respectively). The most commonly reported obstacle to becoming a regular blood donor was ‘laziness’ (19·1%) followed by ‘fear of needles’ (10·5%). Conclusions Altruism was the most common general motive for donating blood and also for continuing to be an active blood donor. Yet, for the first blood donation, direct ‘influence from friends/relatives’, ‘media appeal’ and other types of recruitment were more commonly reported as reasons or motives for donating blood than altruism. The findings support the notion that different strategies should be used/adopted to get people to donate blood the first time (e.g. recruitment through other blood donors using, for example, the ‘bring a friend along’ method) and to retain these subjects as active blood donors (e.g. by information and by strengthening their sense of being a blood donor or their self‐efficacy etc.).     

天津地区某教学医院职工ABO、Rh血型分布调查

目的:调查天津地区某教学医院职工的血型分布特征,建立血型档案,为日后职工安全供输血提供理论依据。方法:通过应用血清学正反定型、ABO基因分型试验等方法检测该院1 287位职工的ABO血型、使用单克隆IgM抗D血清鉴定Rh(D)血型。结果:ABO血型中A型占28.7%,B型占31.5%,O型占28.6%,AB型占11.2%,血型分布特征为BAOAB。Rh(D)阴性血型11人,阴性率0.85%。3例ABO正反定型不符,其中2例基因分型检测鉴定结果为B(A)型;另外1例为B型,NN,有抗M抗体存在。结论:根据本研究,建立健全了职工血型档案,了解了该院职工的血型分布特征,明确检测ABO正反定型的重要性,防止亚型及有意义不规则抗体对血型鉴定的影响,确保ABO、Rh血型定型结果的准确。     

Overview of blood pressure measurement by Brazilian health professionals

Although automated monitors for blood pressure (BP) measurement are used increasingly worldwide, understanding of how such devices are used in Brazil is low. This study analyzed the status of BP measurement by Brazilian health professionals. A questionnaire regarding experience with BP measurement was sent electronically to Brazilian nurses, nursing assistants, and doctors. It had 2004 responses. Previous experience with use of automated monitors was most frequent in men (71.2%), nursing technicians (65.5%), specialists (61.1%), secondary care (71.9%), emergency care (70.6%), or the private sector (66.3%). The least complied aspects of the standardized measurement protocol were availability of various cuff sizes (53.9% and 72.9% for auscultatory and oscillometric methods, respectively) and proper calibration checks (21.5% and 46.8% for auscultatory and oscillometric methods, respectively). Brazilian health professionals report not adequately performing all the necessary aspects to measure BP in accordance with the standardized protocol in both methods, but mainly regarding the oscillometric.     

2007—2012年我院临床用血分析

输血是临床治疗和抢救生命的重要手段之一,在临床治疗中是其他治疗方法和药物无法替代的。近年来,我国的输血事业取得了突飞猛进的发展,但仍存在着一些不足。随着用血量的增加,采供血矛盾也日益加深,尤其个别地区还出现了“血荒”,因此,充分发挥输血科的职能,科学合理用血显得尤为重要。现对我院2007—2012年临床用血情况进行分析,报告如下。     

The use of cord blood for transfusion purposes: current status

Although the use of umbilical cord blood (UCB) for transfusion purposes has been proposed decades ago, the employ is still limited. In this article we review studies evaluating UCB collection efficiency and sterility, examine processing and storage of UCB-derived red blood cells (RBC) and discuss clinical studies in which UCB was used for transfusion purposes.
Efforts to provide preterm newborns with autologous RBC derived from UCB have not been very successful. UCB collected after full-term deliveries can however easily be processed into RBC products and could be used autologous in case surgery of the neonate is indicated early after birth, or for allogeneic small volume paediatric transfusions. To harvest enough UCB volume, immediate clamping of the umbilical cord is commonly used as standard practice. Although delayed cord clamping has shown to improve the iron status in full-term infants; for small-for-gestational-age infants this has not been demonstrated. In addition, an increased need for phototherapy after delayed clamping exists. Altogether, we could find no disencouraging evidence to collect UCB, which could be processed into an easily available RBC product for paediatric transfusion in resource-restricted countries.     

襄阳地区无偿献血后免费用血情况调查分析

目的:回顾性调查襄阳市2006-2013年无偿献血者用血返还情况,预测未来免费用血发展趋势。方法:对8年以来无偿献血者用血返还情况进行收集、整理、统计。结果:无偿献血者用血返还金额在未来可能呈快速增长趋势。结论:建议加大财政对无偿献血工作的经济投入,减轻血站的用血返还压力,进一步促进无偿献血事业的健康持续发展。     

Haemophilia therapy: assessing the cumulative risk of HIV exposure by cryoprecipitate

Most of the world's haemophilia population live in countries with developing or emerging economies. As such, they do not have access to viral inactivated clotting product. Many are treated with cryoprecipitate made from locally supplied blood. The rationale for using cryoprecipitate instead of viral inactivated products is based on an implicit belief that because blood banks can provide reasonably safe products by using modern testing procedures, transmission of HIV and other blood-borne viruses is rare. However, the risk of acquiring a blood-borne infection is cumulative, and haemophilia patients treated with cryoprecipitate or fresh-frozen plasma are exposed to hundreds or thousands of donors during their lifetime. The risk that an HIV-infected person will be a donor during the 'window period' is directly related to the incidence of HIV in the country where the donation occurs. To illustrate the extent of this problem, we devise a model for estimating the risk that a person with haemophilia will encounter HIV-contaminated cryoprecipitate as a function of years of treatment and the underlying incidence rate of HIV among blood donors. We apply the model to two countries with different incidence rates of HIV, Venezuela and the USA. Over a lifetime of treatment (60 years), the cumulative risk of HIV exposure for a person with haemophilia receiving monthly infusion of cryoprecipitate prepared from plasma of 15 donors is significant, 2% in the USA and 40% in Venezuela. Considering the cumulative risk for transmitting HIV to patients with haemophilia through cryoprecipitate treatment, medical care providers should carefully evaluate the use of cryoprecipitate in any but emergency conditions or when no virally inactivated products are available.     

Evaluation of the analytical performances of a portable, 18‐parameter hemometric system using capillary blood samples for blood donor enrolment

Background and Objectives Blood donor enrolment process is frequently based on the sole capillary haemoglobin (Hb) evaluation while platelet donors by apheresis also requires platelet (Plt) count. The ‘sole Hb’ approach prevents a complete donor evaluation and does not allow Plt donor enrolment. To extend blood counts before donations, we evaluated the performances of a multiparametric counter using capillary blood. Materials and Methods The ABX Micros 60 (Micros 60) blood analyzer was employed on capillary blood and compared with venous counts by a reference counter (Coulter AcT 5diff) in a first series of 416 donors and in a second series of 136, after a 3‐month period of routine use of this study counter. An average of 50 μl of capillary blood was collected whose 10 μl had been aspirated by Micros 60. Results High correlations were found between capillary counts using Micros 60 and venous counts using the reference counter. Mean Plt counts differed of 37 × 10⁹/l less for capillary approach in the first series of comparisons, but decreased to 10 × 10⁹/l less in the second series due to a greater expertise of operators in capillary sampling. All other parameters were accurate and never reached clinical relevance albeit they showed statistically significant differences. Conclusion Data on Micros 60 demonstrated that capillary predonation counts may represent a feasible and effective approach to realize an accurate enrolment process of blood and Plt donors.     

Impact of obstetric factors on cord blood donation for transplantation

Recent reports have shown that low nucleated cell dose significantly decreases survival after cord blood transplantation. Prior to starting clinical cord blood banking we investigated the impact of obstetric factors on cell dose and volume of cord blood donations. Cord blood was obtained from 114 normal full-term deliveries. Mean volume collected was 93.5 ml, mean total nucleated cell count (TNC) was 13.1 x 108. Statistical analysis was by backwards stepwise regression. Significant factors affecting nucleated cell yield were volume of blood collected (P < 0.001), length of gestation (P < 0. 0001), time from delivery of the infant to cord clamping (P = 0.018) and total length of labour (P = 0.002). In clinical cord blood banking we have successfully used these findings for pre-collection assessment of placentae. Out of 476 cord blood donations subsequently collected for banking, only 29 (6.1%) have been discarded due to low volume. The mean TNC of the 409 banked units following volume reduction was 10.1 x 108. Despite careful optimization of collection, processing and storage techniques, cell dose still limits cord blood transplantation to smaller recipients.     

200例正常中老年人24小时动态血压特征

目的 :动态血压测定值常因地区、种族、时节不同而异。方法 :我们于 1996年～ 1998年对成都地区 2 0 0例中老年人进行了 2 4小时动态血压监测。结果 :平均年龄 5 8.15± 8.19岁 ,昼夜均值 93～ 146 / 5 2～ 93mm Hg,日间均值10 0～ 135 / 5 9～ 92 m m Hg,夜间均值 10 0～ 132 / 5 5～ 83mm Hg,昼夜平均压均值 93± 10 .19mm Hg,血压负荷值 12～ 30 /10～ 15 %。结论 :本组结果可作为成都地区动态血压的参考正常值     

Barriers and motivators to blood and cord blood donations in young African-American women

The primary aim of this study was to assess potential barriers and motivators to blood and cord blood donation among African-American women. A telephone survey of African-American women, ages 18-30 years, in the St. Louis metropolitan area was performed. The survey was administered by trained telemarketing personnel using a Computer-Assisted Direct Interview (CADI) system. One hundred sixty-two women were surveyed. Common barriers to blood donation were inconvenience of donor sites (19%), fear of needles (16%), and too much time required to donate (15%). Potential motivators were increasing awareness of need for blood (43%), increasing the number of convenient donor locations (19%), and encouragement by spiritual leaders to have blood drives at their church (17%). Lack of awareness was the only identified barrier to cord blood donation. Most women surveyed (88%) indicated that they definitely or probably would donate cord blood. Strategies to increase the proportion of African-American blood and cord blood donations may include educating potential donors about the process and benefits of donation to particular patient populations and engaging church leadership in supporting blood and cord blood donations.     

胃病患者血浆内皮素水平的变化

目的研究消化性溃疡、慢性胃炎（急性活动期）、胃癌患者血浆内皮素－１水平的变化意义．方法采用放射免疫分析法测定了胃溃疡１４例，十二指肠溃疡９例治疗前后及胃炎１５例（急性活动期），胃癌１５例空腹血浆内皮素－１水平，并与１６例健康人作对照．结果胃溃疡（６２９６±２００１ｎｇ／Ｌ），十二指肠溃疡（４５５８±１６５７ｎｇ／Ｌ），慢性胃炎（４５７６±１８７４ｎｇ／Ｌ）及胃癌（４９８２±１３６８ｎｇ／Ｌ）患者血浆内皮素－１水平较对照组（２９７０±９２７ｎｇ／Ｌ）显著升高（Ｐ＜００１）．胃溃疡组（活动期）血浆内皮素＿１水平又明显高于十二指肠溃疡（活动期）胃炎组（Ｐ＜００５）．治疗后胃溃疡组血浆内皮素＿１水平显著下降（Ｐ＜００５）．结论血浆内皮素＿１可能参于胃病的病理生理过程     

Proteomic applications in blood transfusion: working the jigsaw puzzle

The application of proteomic technologies to transfusion medicine has opened new avenues to our understanding of the products we prepare for patients and the processes that impact the quality of those products. The development of the field of proteomics has paralleled that of transfusion medicine with over a century of key scientific accomplishments required to bring us to our modern systems. We review the technology of proteomics and its application to transfusion medicine with specific reference to the analysis of blood products, both fractionated and fresh. Although the use of proteomic tools to address transfusion medicine questions is really just beginning, it is clear that this method of analysis provides different insights into unaddressed issues in the area of blood product research. Proteomics also offers the promise of improving our approach to the control of blood product quality and even the assessment of blood donors, but these are efforts for the near future.     

Nocturnal blood pressure surge in seconds is associated with arterial stiffness independently of conventional nocturnal blood pressure variability in suspected obstructive sleep apnea patients

Nocturnal blood pressure (BP) surge in seconds (sec-surge), which is characterized as acute transient BP elevation over several tens of seconds is induced by obstructive sleep apnea (OSA) and OSA-related sympathetic hyperactivity. The authors assessed the relationship between sec-surge and arterial stiffness in 34 nocturnal hypertensive patients with suspected OSA (mean age 63.9 ± 12.6 years, 32.4% female). During the night, they had beat-by-beat (BbB) BP and cuff-oscillometric BP measurements, and brachial-ankle pulse wave velocity (baPWV) was assessed as an arterial stiffness index. Multiple linear regression analysis revealed that the upward duration (UD) of sec-surge was significantly associated with baPWV independently of nocturnal oscillometric systolic BP variability (β = .365, p = .046). This study suggests that the UD of sec-surge, which can only be measured using a BbB BP monitoring device, may be worth monitoring in addition to nocturnal BP level.     

Donating umbilical cord blood to a public bank or storing it in a private bank: knowledge and preference of blood donors and of pregnant women

Background.

Umbilical cord blood (UCB) is a source of stem cells for allogeneic haematopoietic transplantation in paediatric and adult patients with haematological malignancies and other indications. Voluntary donation is the basis for the success of unrelated UCB transplantation programmes. In the last few years a growing number of private banks offer their services to expectant parents, to store UCB for future use. The debate concerning UCB donation and private preservation has been ongoing for several years. The aims of this single centre study were to explore knowledge about UCB stem cells and attitudes towards voluntary UCB donation or private UCB preservation among both blood donors and pregnant women.

Materials and methods.

This study was conducted at the “Sapienza” University of Rome. Two types of anonymous questionnaires were prepared: one type was administered to 1,000 blood donors while the other type was distributed to 300 pregnant women.

Results.

Most blood donors as well as the majority of pregnant women had some general knowledge about UCB (89% and 93%, respectively) and were aware of the possibility of donating it (82% and 95%). However, the level of knowledge regarding current therapeutic use resulted generally low, only 91 (10%) among informed blood donors and 69 (31%) among informed pregnant women gave a correct answer. The survey revealed a preference for voluntary donation both among blood donors (76%) and among pregnant woman (55%). Indeed, a minority of blood donors (6.5%) and of pregnant women (9%) would opt to store UCB for private use.

Discussion.

The study raises the following considerations: (i) the large support for UCB donation expressed by blood donors and by pregnant women suggests that UCB preservation does not represent an obstacle to the expansion of UCB donation and to development of unrelated transplantation programmes; (ii) information about UCB donation and preservation should be carefully given by professionals and institutions.     

Use of a Combined Blood-Glucose- and ?-Ketone-Measuring Device Improves Glycemic Control in Insulin-Treated Patients With Diabetes: The Gold Plus Study

Background:Using self-measurements of blood glucose (SMBG) is daily routine for patients with insulin-treated diabetes, however measuring ß-ketones in blood is not widespread. How the use of a combined device, which can measure both, is accepted in daily routine by patients and will lead to better glycemic control is not well studied.Methods:This multicenter, prospective, noninterventional study assessed the impact of routine use of the GlucoMen® LX Plus on patient acceptance, usage and glycemic control among insulin-treated patients with diabetes mellitus type 1 and type 2. A1c and self-reported frequency of SMBG were evaluated at baseline and also postprandial SMBG, ß-ketone measurements, and use of reminders after 3 and 6 months of use. A total of 631 patients, 254 type 1/350 type 2 (27 no type specified), with mean (SD) baseline A1c 8.5% (1.5), age 54.6 (15.6) years, and 47.3% female were studied.Results:Frequent use of SMBG at baseline led to a higher decrease in A1c at 6 month (V3): –0.3% if SMBG measured up to 1/day versus −0.9% in 4-6/day. Increase of SMBG frequency during the study showed also a negative correlation to A1c, 9.2% at V1 versus 7.6% at V3. Postprandial SMBG was done by 77.7% and ß-ketone measurements by 45.5% of all patients; the reminders were used by 33.4% and led to an increased frequency of SMBG at 6 months.Conclusions:A combined device for SMBG and ß-ketone measurements is well accepted by patients with insulin-treated diabetes and can lead through the avoidance or detection of ketoacidosis/increased frequency of SMBG and increased awareness of the patients to an improved glycemic outcome.     

Ambulatory blood pressure phenotypes and isolated elevation of office central or brachial blood pressure

Disagreements in office brachial and central blood pressure (BP) have resulted in the identification of novel hypertension phenotypes, namely isolated central hypertension (ICH) and isolated brachial hypertension (IBH). This study investigated the relationship of ICH and IBH with ambulatory BP phenotypes among 753 individuals (mean age = 47.6 ± 15.2 years, 48% males) who underwent office and 24‐hours brachial and central BP measures using a Mobil‐O‐Graph PWA monitor. Thresholds for elevated office central and brachial BP were 130/90 and 140/90 mm Hg. Results of multivariable analysis adjusted for potential confounders showed that ICH (n = 25) had 3.71‐fold (95% CI 1.48‐9.32; P = .005) greater risk of masked hypertension than normal brachial/central BP (n = 362), while IBH (n = 20) had 4.65‐fold (95% CI 1.76‐12.25; P = .002) greater risk of white coat hypertension compared with combined brachial/central hypertension (n = 346). These findings suggest that the diagnosis of ICH and IBH might be useful in identifying individuals at higher risk of presenting discordant office and ambulatory BP phenotypes.