Preoperative anemia and extensive transfusion during stay-in-hospital are critical for patient`s mortality: A retrospective multicenter cohort study of oncological patients undergoing radical cystectomy

Background

Preoperative anemia and allogeneic blood transfusions (ABTs) may affect outcomes in cancer surgery. The prevalence of anemia, the use of ABTs, the risks of transfusions, lengths of stay and mortality of oncological patients undergoing radical cystectomy were investigated in three University Hospitals in Germany.

Toxicology of 3-epi-deoxynivalenol,a deoxynivalenol-transformation product by Devosia mutans 17-2-E-8

Microbial detoxification of deoxynivalenol (DON) represents a new approach to treating DON-contaminated grains. A bacterium Devosia mutans 17-2-E-8 was capable of completely transforming DON into a major product 3-epi-DON and a minor product 3-keto-DON. Evaluation of toxicities of these DON-transformation products is an important part of hazard characterization prior to commercialization of the biotransformation application. Cytotoxicities of the products were demonstrated by two assays: a MTT bioassay assessing cell viability and a BrdU assay assessing DNA synthesis. Compared with DON, the IC₅₀ values of 3-epi-DON and 3-keto-DON were respectively 357 and 3.03 times higher in the MTT bioassay, and were respectively 1181 and 4.54 times higher in the BrdU bioassay. Toxicological effects of 14-day oral exposure of the B6C3F₁ mouse to DON and 3-epi-DON were also investigated. Overall, there were no differences between the control (free of toxin) and the 25 mg/kg bw/day or 100 mg/kg bw/day 3-epi-DON treatments in body and organ weights, hematology and organ histopathology. However, in mice exposed to DON (2 mg/kg bw/day), white blood cell numbers and serum immunoglobulin levels were altered relative to controls, and lesions were observed in adrenals, thymus, stomach, spleen and colon. Taken together, in vitro and in vivo studies indicate that 3-epi-DON is substantially less toxic than DON.     

狼疮性肾病患者与红细胞补体受体Ⅰ型分子基因型相关性研究

采用 PCR和 Hind 酶切技术以及酶联法定量测定狼疮性肾炎 (L N)患者、非 L N患者及正常人的红细胞补体受体一型分子 (CR1 )数量。结果示 L N患者红细胞 CR1 分子密度相关基因型高表达较非 L N患者及正常人明显下降 ,中、低表达明显升高 (P<0 .0 5～ 0 .0 1) ;L N患者 CR1 分子的数量表达全部低于非 L N患者及正常人平均水平 (P<0 .0 0 1) ,并且 CR1 分子数量表达的变化与病情活动度呈明显相关。认为 :对 L N患者进行红细胞CR1 分子定量测定 ,对临床诊断和病情判定具有重要参考价值 ,对探讨 L N病因也有很大的启示。     

Reduced volume of red blood cell priming is safe for pediatric patients undergoing therapeutic plasma exchange

RationalTherapeutic Plasma Exchange (TPE) procedures in pediatric patients are challenging due to the large extracorporeal volume of the cell separators, which were designed for adults. Red blood cell (RBC) priming is an alternative for overpassing the risks of hypovolemia, but data referring to the volume of packed RBCs to be infused are yet incomplete. Restricting the volume of RBC priming may potentially be associated with less transfusion reactions.GoalTo determine the safety of administering a reduced volume of RBC priming for pediatric patients undergoing TPE, in comparison to the standard volume recommended by the cell separators’ manufacturers.MethodsThis was a case-control study which enrolled 15 pediatric patients undergoing TPE and weighting more than 10Kg. The TPE procedures (n = 406) were divided in two groups: 1) Group1: TPE with ≤150 mL of packed RBC priming and 2) Group2: TPE with 150-250 mL of RBC priming. Groups were compared in terms of hemoglobin / hematocrit and occurrence of adverse reactions.ResultsGroup1 and Group2 did not differ significantly in relation to pre- and post-TPE hemoglobin (Hb) levels (p = 0.19 and p = 0.18, respectively). The Δ Hb (Hb pre-TPE – Hb post-TPE) was also not statistically different between the groups. The number of adverse reactions was significantly higher in Group 2 in relation to Group 1 (p = 0.01). The number of allergic reactions was also higher in Group 2 (p = 0.06).ConclusionsRestricting the volume of RBC priming to less than 150 mL is safe for pediatric patients weighting more than 10Kg and associated with lower rates of transfusion-related adverse reactions.     

Duffy、Diego等4种血型系统基因频率及多态性研究

目的了解岳阳汉族人群Kidd(Jk^a/Jk^b)、Duffy(Fy^a/Fy^b)、Diego(Di^a/Di^b)、Dombrock(Do^a/Do^b)4种红细胞血型系统的基因频率和多态性特点,为建立该地区稀有血型库提供数据支持。方法采用聚合酶链式反应-序列特异性引物法(PCR-SSP法)对303名岳阳汉族RhD(+)固定献血者进行4种血型系统基因分型。结果岳阳汉族人群Duffy血型的基因频率为Fy^a=0.9472,Fy^b=0.0528;Dombrock血型基因频率为Do^a=0.0842,Do^b=0.9158;Diego血型基因频率为Di^a=0.0247,Di^b=0.9752;Kidd血型基因频率为Jk^a=0.4802,Jk^b=0.5198。结论岳阳汉族人群Duffy、Diego、Kidd和Dombrock血型系统基因呈多态性分布。     

2单位冰冻红细胞自动化洗涤程序研究

目的：对透析式冰冻红细胞（ RBC）洗涤机的处理程序进行改进,使之适用于2 U冰冻RBC的洗涤处理。方法深低温保存2 U冰冻RBC解冻复温后,采用透析式冰冻RBC洗涤机进行洗涤处理,对洗涤程序进行了提高泵速和加液速度、调整溶液渗透压等方面的改进,大幅缩短2 U冰冻RBC洗涤处理时间。对洗涤后的RBC进行血红蛋白（ Hb）含量、Hb回收率、甘油残留量（上清渗透压）、游离Hb含量、变形性以及凋亡率等指标的检测,并据此判断洗涤效果。结果改进前后的透析式洗涤程序处理得到的RBC的Hb含量分别为（35．03±4．20）和（53．82±2．08）g;Hb回收率分别为（61．10±8．46）％和（80．22±3．73）％;上清渗透压分别为（307．00±14．50）和（322．00± 29．00）mOsm;游离Hb分别为（0．74±0．04）和（0．80±0．08）g／L;程序改进前后的洗涤时间分别为（1．64±0．31）和（1．04±0．16）h;改进前后的洗涤程序处理得到的RBC在Hb含量、Hb回收率、RBC变形性、洗涤时间等指标上有明显改善。而在甘油残留量、游离Hb含量、细胞凋亡等方面无显著变化。结论经过程序改进,2 U冰冻RBC洗涤时间缩短、洗涤后RBC和Hb含量显著升高,提高了洗涤效率及冰冻RBC的利用效率。     

冻存前滤除白细胞对解冻红细胞质量影响的研究分析

目的探讨冻存前滤除白细胞对冰冻解冻去甘油红细胞的血液质量和生化指标的影响。方法随机采集20名无偿健康献血者全血400mL×20袋,常规分离血浆制备成悬浮红细胞2μ×20袋。根据配对设计方法,将血液等量分成两份1μ×20袋,其中20袋在2~4℃静置2~4h后用一次性白细胞滤器滤除白细胞为滤白组,另20袋不做其他处理为非滤白组。两组红细胞经40%甘油化后冻结,保存在低于-65℃的超低温冰箱至少30d,解冻后红细胞复悬于MAP红细胞保存液中,4℃保存。分别在0、7、14、21d检测解冻红细胞的血液学和生化学指标。结果滤白组冰冻解冻去甘油红细胞较非滤白组冰冻解冻去甘油红细胞的溶血率低、氨浓度低及ATP浓度高,两组比较差异有统计学意义(P0.05)。滤白组可见LDH水平明显抑制,钾浓度增加速度相对较缓。结论滤白组解冻红细胞长期生存能力较非滤白组解冻红细胞强。     

Protective effect of flavonoids against red blood cell hemolysis by free radicals

BACKGROUND:

Flavonoids are polyphenolic substances with antioxidant properties, and they are found in different vegetables and fruits. Epidemiological studies have shown that the consumption of flavonoids reduces the prevalence of cardiovascular diseases. The use of synthetic antioxidants, however, has been limited because of their toxicity. Therefore, medical researchers have intensified their quest to find natural antioxidants.

OBJECTIVES:

To investigate the effect of several pure flavonoids, such as kaempferol, quercetin, morin and rutin, on red blood cell hemolysis and evaluate their -SH capacity as an indicator of membrane protection.

METHODS:

The rate of hemolysis and cell membrane -SH capacity were determined by spectrophotometry. Red blood cell peroxidation was induced using 2,2′-azo-bis-(2-amidinopropane) dihydrochloride. The effect of each flavonoid on hemolysis was examined at three concentrations (0.5 μg/mL, 5 μg/mL and 10 μg/mL), however, only the greatest concentration (10 μg/mL) of each flavonoid was used to study the effect on -SH groups.

RESULTS:

In all cases, the antioxidant activity was dose-dependent. Rutin showed the highest inhibitory effect on hemolysis among flavonoids (42.5%). The protective effect of kaempferol, rutin and morin against -SH group oxidation measured 7.7%, 23.3% and 26.4%, respectively.

CONCLUSIONS:

Results showed that flavonoids and flavonoid-containing plants can be used as natural antioxidants for the treatment and prevention of disease conditions, the pathogenesis of which is mediated by lipid peroxidation.