Objective To analysis the related influencing factors and explore the approach of improving the effect of platelet transfusion through compared the posttransfusion effect of matched-type with random platelet transfusion.Methods Analysis the results of platelet antibody screening test and matched-type test in our hospital′s inpatients during July 2013 to June 2014,who applied for platelet transfusion.The influence of sex,blood transfusion history,pregnant history on the antibody were analyzed.The factors of sex,times of blood transfusion,pregnant times,platelet component sorts,storage time,combined with other components,platelet antibody (positive or negative) and transfusion matched-type platelet on the effect of platelet transfusion were analyzed.Application in our clinical blood transfusion intelligent management and evaluation system to evaluate the effect of platelet transfusion.Results Totally 812 patients′ platelet antibody were screened.Then we randomly selected 87 antibody positive inpatients were selected and 1 247 U plateletswere transfused,which including matched-type platelet transfusion for antibody screening positive patients,random platelet transfusion for antibody screening positive patients,random platelet transfusion for antibody screening negative patients,there were statistical difference (P<0.05).With Logistics regresion analysis,the history of blood transfusion was an independent risk factor for platelet antibody production (P<0.05,OR=13.104,95%CI:7.784-22.061).Sex (P<0.05,OR=1.629,95%CI:1.236-2.148),transfusion times,different platelet component sorts (leukocyte-reduced platelets aphaeresis and irradiation leukocyte-reduced platelets aphaeresis),different storage time,transfusion combined with other components (RBC)(P<0.05,OR=2.464,95%CI:1.053-5.765),transfusion matched-type platelet(P<0.05,OR=0.576,95%CI:0.389-0.854) were the risk factors for platelet transfusion.Conclusion Matched-type test should be done to improve efficiency when the platelet antibody screening were positive.Sex,times of blood transfusion,platelet component sorts,storage time,combine with other components,transfusion matched-type platelet couldinfluence the effect of platelet transfusion.

Objective To investigate the value of anti-HI antibody screening and identification in clinical blood transfusion . Methods 4 cases of anti-HI antibody positive in our hospital from February 2016 to November were selected as the research subjects .The irregular antibodies screening and identification were performed by adopting the anti-human globulin and saline test tube method ,then the blood transfusion effect was evaluated .Results Four cases were ABO blood group ,in which 2 cases were group A RhD positive and 2 cases were group AB RhD positive .The screening results of anti-human globulin method were weak positive , while which of saline test tube method were positive .Under the saline medium condition ,the reaction results of serum with 16 spectrum cellular reaction in 4 cases were positive ,while which with autoerythrocytes were negative ;under the anti-human globulin medium condition ,the reaction results of serum with 16 spectrum cellular reaction in 4 cases were negative except 1 case of weak positive ,while which with autoerythrocytes were negative .After blood transfusion in 2 cases of treatment blood use ,Hb increase reached the expected effect without blood transfusion adverse reactions occurrence .Conclusion In blood transfusion for the patients with anti-HI antibody positive ,the blood of same type ABO and compatible results in both saline test tube method and anti-human globulin tests should be selected .

OBJECTIVE: To study the serological, molecular and genetic characteristics of an individual with para-Bombay blood group. METHODS: Serological method was used to detect the presence of A, B, H antigens in red blood cells and saliva, and Sanger sequencing was used to analyze the FUT1 gene of the proband and her family members. Genetic mechanism of the blood group was analyzed by pedigree analysis. RESULTS: Forward and reverse typing of the ABO blood group were inconsistent for the proband. A, B and H antigens were not found on erythrocytes, while B and H antigens were found in saliva, in addition with unexpected antibodies. The proband was found to have a genotype of ABO*B.01/ABO*O.01.04 caused by homozygous variant of c.948C>A (p.Tyr316Ter) of the FUT1 gene. CONCLUSION A novel para-Bombay blood group was identified, which was due to the missense variant of c.948C>A in the coding region of the FUT1 gene, which has probably resulted in inability to synthesis active H antigen transferase.
ABO Blood-Group System/genetics* ; Alleles ; Female ; Fucosyltransferases/genetics* ; Genotype ; Homozygote ; Humans ; Phenotype

Objective:To study the correlation between the acute-phase characteristics of motor evoked potential (MEP) and severities of spinal cord injury in patients with acute cervical hyperextension injury and central cord syndrome (CCS).Methods:Retrospectively analyzed were the data of 45 patients with acute cervical hyperextension injury and CCS (observation group) who had been admitted to Department of Orthopedics, Tongji Hospital Affiliated to Tongji University from December 2018 to July 2021 and 20 healthy controls. Examination of transcranial magnetic stimulation-induced MEP was performed in patients with CCS and healthy controls using a magpro x100 magnetic stimulator, and recording was conducted in bilateral abductor pollicis brevis (APB). The characteristics of MEP waveform latency, amplitude and motor threshold were described and compared between the healthy control and observation groups; the correlations were analyzed between the MEP latency and the severity of spinal cord injury [American Spinal Injury Association (ASIA) total score and motor function of Upper Extremity Motor Subscores (UEMS)] in the observation group. According to different MEP-induced states, the patients in the observation group were divided into a resting group ( n=19), a facilitation group ( n=18), and a no-waveform group ( n=8). The severity of spinal cord injury (ASIA total score) and the functional independence of the spinal cord (SCIM-Ⅲ score) were compared among the 3 groups to analyze the correlation between the MEP-induced state and the severity of spinal cord injury (ASIA total score). Results:The observation group had a significantly longer MEP latency [(30.16±6.32) ms], a significantly smaller amplitude [(0.54±0.30) mV] and a significantly higher motor threshold [(65%±11%)] than the healthy control group (all P<0.05). The MEP latency in the observation group was significantly correlated with ASIA total score ( r=-0.730, P<0.001) and UEMS ( r=-0.740, P<0.001). The ASIA total score and SCIM-Ⅲ score were significantly different among the 3 groups ( P<0.05), and the MEP-induced state was significantly correlated with the severity of spinal cord injury (ASIA total score) ( r=0.668, P<0.001). Conclusions:In patients with acute cervical hyperextension injury and CCS, the MEP latency is prolonged, the amplitude lowered, and the motor threshold enhanced. The MEP latency is strongly correlated with the severity of spinal cord injury and upper limb motor function. The MEP-induced state is also closely related to the severity of spinal cord injury.

【Objective】 To investigate the impact of ABO blood group compatibility and incompatibility(major /minor/bidirectional incompatibility) on the outcomes of patients underwent allogeneic hematopoietic stem cell transplantation(allo-HSCT), and to provide evidences for optimizing the transplantation program. 【Methods】 From January 2014 to June 2018, we retrospectively reviewed the clinical courses of 18 recipients of allo-HSCT from ABO-compatible donors and 52 from ABO-incompatible donors at our hospital. The implantation time of granulocyte/erythrocyte/megakaryoblast, RBC/platelet transfusions within 3 months posttransplantation, the initiating and completion time of ABO blood group conversion(for ABO-compatible donors only) were analyzed and compared among the ABO-incompatible and ABO-compatible donors as such variables including demographic data, donor and patient relationship, diagnosis of disease, bone marrow hematopoietic function prior to transplantation, HLA matching were not significant different. 【Results】 For 18 recipients of allo-HSCT from ABO-compatible donors, the implantation time of granulocyte, erythrocyte, megakaryoblast was 12.0(11.0~16.3), 41.5 (35.0~49.0) and 19.0(16.0~22.5)days, respectively. For 52 recipients of allo-HSCT from ABO-incompatible donors, the ABO blood group conversion was initiated at 28.0(22.5~44.0)days posttransplantation and completed at 105.5(85.0~141.8)days. In the ABO-compatible group, the time of erythrocyte implantation was shortened(P<0.05), and less RBC /platelet transfusions were required as compared with the ABO major and bidirectional incompatible group, except for the time of granulocyte and megakaryoblast implantation(P>0.05), no significant difference was observed between these two variables. The blood group conversion time, implantation time of granulocyte/erythrocyte/megakaryoblast, and RBC /platelet transfusions among ABO major, minor and bidirectional incompatible groups were not significant different (P>0.05). 【Conclusion】 ABO-compatiblity enjoys priority in allo-HSCT. ABO-incompatiblity can be chosen in the order of minor, major and bidirectional incompatibility in the absence of ABO-compatiblity.

【Objective】 To study the RHD genotyping of primary screening RhD negative population in Beijing, and analyze the serological characteristics of different genotypes and the distribution of Rh phenotypes. 【Methods】 From August 2022 to January 2024, 204 RhD negative samples in our hospital were initially screened by microplate or microcolumn agglutination method. RhD antigen phenotype was identified by saline tube method, and RhD negative confirmation test was performed by microcolumn gel-indirect antiglobulin technology.RHD genotyping was performed by polymerasing chain reaction-sequence specific primmer (PCR-SSP) method and sequencing technology, and the phenotypic frequency and gene frequency were calculated. 【Results】 The distribution of Rh serologic phenotypes in 204 RhD negative samples were 112 cases of ccee (54.90%) > 73 cases of Ccee (35.78%) > 9 cases of CCee (4.41%) > 6 cases of ccEe (2.94%) > 4 cases of CcEe (1.96%). A total of 7 RHD genotypes were detected in this study, including 129 cases of RHD^* 01N.01 (63.24%), 44 cases of RHD^* 01EL.01 (21.57%), 26 cases of RHD^* 01N.03 (12.75%), 2 cases of RHD^* 01N.16 (0.98%), 1 case of RHD^* 06.03.01 (0.49%), 1 case of weak RHD^* 15 (0.49%) and 1 case of RHD^* 13.01/RHD^* 01N.01 (0.49%). The frequency and phenotype distribution of Rh blood group antigen gene were consistent with Hardy-Weinberg equilibrium (P>0.05). 【Conclusion】 The RHD gene is polymorphic in the primary screening RhD negative population in Beijing, and the most common RhD negative genotype is RHD^* 01N.01, and the RHD variant is RHD^* 01EL.01.This study may provide data to support the clinical implementation of genotype-matched blood transfusions.

【Objective】 To study the serological and genetic characteristics of a case of B(A) blood group. 【Methods】 Serological and genetic ABO blood group typing were used to analyze the ABO subtype and family inheritance of the probands and her 8 family members. The B(A) blood type sample was used as the blood recipient, and the B-type and O-type donors were selected for cross-matching using microcolumn gel anti-human globulin method to evaluate the blood transfusion strategy. 【Results】 5 out of 9 family blood samples were B(A) phenotype, carrying B(A)04 allele. Among them, 1 was B(A)04/O1 type, and 4 were B(A)04/B type. The primary blood matching of B(A) blood type samples with type B and O recipients were all negative. 【Conclusion】 A total of 5 cases of B(A)04 blood type were found in this family investigation, and there were differences in serological manifestations. Washed RBCs with B and O type can be used for B(A) blood type transfusion, and type B suspended RBCs can be considered in case of emergency.

【Objective】 To explore the prognostic impact and clinical application value of therapeutic plasma exchange(TPE) intervention timing and liver injury periodization in patients with exertional heat stroke(EHS). 【Methods】 Data of 127 EHS patients from the First Medical Center of the General Hospital of the People′s Liberation Army from January 2011 to December 2023 were collected, then divided into the death group and the survival group based on therapeutic outcomes and into 5 stages according to the dynamic changes of ALT, AST, TBIL and DBIL. According to propensity score matching analysis, 11 patients in the survival group and 12 patients in the death group were included in the statistical analysis, and 20 of them were treated with TPE. The changes in indicators and clinical outcomes before and after TPE were observed, in order to evaluate the impact of intervention timing on prognosis. 【Results】 Among the 23 patients, 14 had no liver injury or could progress to the repair phase, resulting in 3 deaths(with the mortality rate of 21.43%), while 9 patients failed to progress to the repair phase, resulting in 9 deaths(with the mortality rate of 100%), with significant differences(P<0.05). The mortality rate of the first TPE intervention before the third stage of liver injury was 23.08%(3/13), while that of intervention after reaching or exceeding the third stage was 85.71%(6/7), and the difference was statistically significant(P<0.05). 【Conclusion】 TPE should be executed actively in EHS patients combined with liver injury before the third phase to lock its pathological and physiological processes, thereby improving prognosis and reducing mortality.