1.Clinical application of microcolumn gel immunoassay in transfusion-related experiments
International Journal of Laboratory Medicine 2009;30(9):848-849,851
Objective To explore the applicable value of microcolumn gel immunoassay(MGIA) in transfusion-related experiments(blood typing, cross matching, antibody titration), and carry out its methodical evaluation. Methods Fifteen anti-Rh D positive samples from 55 Rh D negative patients, twenty-one cases of discrepant blood typing and twenty-nine cross matching positive samples were studied by applying MGIA and routine tube test simultaneously. Antibody titer data from 853 pregnant women with type O were brought into statistics. Results In 55 Rh D negative samples, the positive rate of Rh D antibody tested by MGIA and tube test was 27.27%(15/55) and 21.82 % (12/55) respec-tively,and the samples with titer 1:4 above got the coincident results by the two methods. For twen-ty-one discrepant blood typing samples, 11 cases with weak reaction showed discrepant results by MGIA;however, all samples showed weak reaction by tube test. In 29 samples with cross matching positive by MGIA,2 cases were confirmed to be negative by tube test. For the pregnant women with type O,IgG antibody titer abnormal ratio was 33.18%(144/434) if their respective husbands was with type A,33.17%(139/419) if their respective husbands was with type B.Conclusion MGIA is charac-teristic of convenience, fastness and reliability of test results, but its false-positive or false-negative should be paid attention to. When abnormal results occur, traditional tube test as well asmicroscopic examination should be performed in parallel.
2.The therapeutic efficacy of cryoprecipitate in the treatment of DIC
International Journal of Laboratory Medicine 2008;29(8):687-688,690
Objective To study the therapeutic efficacy of cryoprecipitate in the treatment of disseminated intravascular coagulation(DIC).Methods 28 healed cases of DIC from 2006 to 2007 were enrolled in the study.The changes of thrombin time(TT),prothrombin time(PT),activated partial thromboplastin time(APTT)and fibrinogen(Fbg)were compared and analyzed before and after cryoprecipitate infusion.Results The therapeutic efficacy of 28 cases was satisfactory after cryoprecipitate treatment,and the findings of TT,PT,APTT and Fb were improved.Conclusion The cryoprecipitate plays an important role in the treatment of DIC.Cryoprecipitate offers various kinds of blood coagulation factors for control of DIC,provides the opportunity of successful remedy,and improves the treatment achievement ratio.
3.Comparison of efficacy between extended pelvic lymph node dissection and standard pelvic lymph node dissection in laparoscopic radical cystectomy
Lingquan MENG ; Qingbao HE ; Mingshuai WANG ; Nianzeng XING
Chinese Journal of Urology 2017;38(5):342-346
Objective To investigate the difference of surgical efficacy between extended lymph node dissection and standard lymph node dissection in laparoscopic radical cystectomy.Methods We retrospectively analyzed 62 bladder cancer cases,icluding 52 males and 10 females patients in our hospital from January 2011 to October 2016,who underwent laparoscopic radical cystectomy and pelvic lymph node dissection.Their mean age was (62.5 ± 9.6) years,ranged from 42 to 83 years.27 cases were underwent extended lymph node dissection and 35 cases were underwent standard lymph node dissection respectively.The basic characters,operative time,intraoperative blood loss,intraoperative and postoperative complications,postoperative eating time,postoperative activity time,postoperative hospital stay,lymph nodes positive rate,lymph node density,and cancer-free survival were evaluated.Results All patients were underwent successful operation.There was no significant difference in operation time [(326.2 ± 77.5) min vs.(345.5 ± 66.8) min,P =0.297],blood loss [(198.2 ± 77.5) ml vs.(213.7 ± 160.0) ml,P =0.590],intraoperative complications (0/27 vs.5/35,F =0.063),postoperative complications (8/27 and 9/35,P =0.732),postoperative eating time[(4.8 ±2.2)d vs.(4.6 ± 1.9)d,P =0.817],postoperative activity time[(1.9 ± 0.8) d vs.(1.9 ± 0.9) d,P =0.838] and postoperative hospital stay[(15.6 ± 7.5) d vs.(16.0 ± 5.9)d,P =0.483].In this study,994 lymph nodes and 100 positive lymph nodes were dissected.There were significant differences in the number of lymph nodes dissected in the two groups (23.2 ±6.6 vs.10.5 ±3.6,P <0.01).40.74% (11/27) of cases in ePLND were lymph node positive and the lymph node density was 11.7% (73/626),which was higher than that of the sPLND group (28.57% vs.7.34%,respectively).In regard to prognosis,the cancer-free survival rate (DFS) of ePLND group was 96%,91%,80% and 71% at 3,6,12 and 24 months follow-up respectively.The other group was 97% 94%,84%,80% correspondingly.And no significant difference was detected (P =0.546).Although there was no significant difference (P > 0.05),DFS of ePLND group tended to be higher than that of sPLND group in lymph node positive subgroups.Conclusions Extended lymph node dissection and standard lymph node dissection have similar surgical safety and prognosis,and appropriate surgical procedures should be selected according to the patient's condition.
4.Genotyping of ABO blood group and its application
Jiongcai LAN ; Qingbao MENG ; Yinze ZHANG ; Al ET
Chinese Journal of Immunology 1985;0(06):-
Objective:To study on significance of ABO genotyping.Methods:To use the methods of polymerase chain reaction sequence specific primers(PCR SSP) for genotyping of ABO blood group and observation ABO gene polymorphism as well as identification of doubt sample.Results:The reliability of the genotyping for ABO blood group was proved by testing DNA samples previously known genotypes.The results of genotyping for 104 healthy and unrelated HAN individuals were correspond with serological phenotypes.The method of ABO genotyping was applied for clinical pre transfusion ABO typing,pre delivery fetal ABO typing,parenting test and subgrouptyping.Conclusion:The method of ABO genotyping may correct typing for doubt sample of ABO serological typing.
5.Rh blood system classification and compatible blood transfusion
Yachun SUN ; Hailan LI ; Zhonghui GUO ; Ping ZHANG ; Qingbao MENG
Chinese Journal of Blood Transfusion 2022;35(3):272-274
【Objective】 To investigate the profiles of RhC, c, E, and e antigens and phenotypes in 4 704 inpatients from multiple regions, i. e. Nanning, Guangzhou and Shenzhen, and provide data information for compatibility blood transfusion of Rh blood group. 【Methods】 The Rh blood group antigens were detected by microcolumn gel cards from three manufactures. If the test and the control results are inconsistent, a third-party reagent would be used, and traditional tube method for confirmation if needed. The Chi-square test and Fisher's exact test were used to analyze antigen frequency and Rh phenotypes in each region. 【Results】 Among the 4 704 inpatients, the frequency of C, c, E, and e antigen was e(91.77%)>C(85.64%)>c(49.62%)>E(41.60%), and Rh phenotypes distribution was CCee(49.40%)>CcEe(27.53%)>Ccee(8.16%)>ccEE(7.74%)>ccEe(4.89%)>CCEe(0.96%)>ccee(0.83%)>CcEE(0.47%)>CCEE(0.02%). There were significant differences in Rh blood type distribution among Nanning, Guangzhou and Shenzhen(P<0.05). Differences in Rh phenotype distribution between male and female were noticed in Shenzhen(P< 0.05), but not in Nanning or Guangzhou. 【Conclusion】 The distribution of Rh blood group in Shenzhen, Nanning and Guangzhou were significantly different from each other, therefore regional characteristics should be considered when carrying out Rh-compatible blood transfusion, so as to guarantee the security of transfusion and reduce the incidence of unexpected antibodies.
6.Progress in immune hemolytic anemia caused by drugs
Xinyan LONG ; Leiping WANG ; Yinze ZHANG ; Qingbao MENG
Chinese Journal of Blood Transfusion 2023;36(6):553-556
Drug-induced immune hemolytic anemia (DIIHA) is a rare cytopenia caused by damage to RBCs by drug-induced antibodies or non-immune protein adsorption (NIPA). The drugs associated with DIIHA and the mechanistic hypotheses that are thought to be involved have been controversial, with complex serological tests often required by specialized Immune Hematology laboratories for diagnosis. It is necessary to know the clinical manifestation and laboratory diagnosis of DIIHA in order to distinguish the immuno-hematological abnormality caused by drugs from other causes. How to improve the diagnostic ability of DIIHA and establish a scientific and reasonable idea of DIIHA serological examination is urgent to help clinical diagnosis and correct treatment.
7.Transfusion adverse events in a tertiary hospital from 2016 to 2022: a retrospective analysis
Yachun SUN ; Leiping WANG ; Guihua DENG ; Xinyan LONG ; Shunling YUAN ; Qingbao MENG
Chinese Journal of Blood Transfusion 2023;36(7):601-604
【Objective】 To strengthen the management of transfusion adverse events, so as to reduce the occurrence of medical damage and accidents, and guarantee the safety of blood transfusion. 【Methods】 The adverse events of blood transfusion reported in our hospital from July 2016 to December 2022 were collected, the reasons were tracked, and continuous improvements were made. 【Results】 From 2016 to 2022, a total of 315 transfusion adverse events were reported, including 233(73.97%, 233/315) cases of transfusion reactions and 82(26.03%, 82/315) transfusion adverse events. There were 271 328 transfusion cases in the same period, and the incidence of transfusion reactions was 0.858 7‰(233/271 328). The number of transfusion application was 129 887, and the incidence of transfusion adverse event is 0.631 3‰(82/129 887). Sixty-eigtht(82.93%, 68/82) cases of transfusion adverse events were caused by human factors, while the other 14(17.07%, 14/82) cases were non-human factors. According to the linear regression analysis, we have concluded that the year is a significant indicator for transfusion reaction rates (P<0.05), but not for transfusion adverse event rates (P>0.05). 【Conclusion】 Strengthening the management of reporting adverse events in clinical blood transfusion, monitoring the incidence, analyzing and improving different types of adverse events by management tools can reduce the medical risks of blood transfusion and help to guarantee the safety of clinical blood transfusion.
8.Factors influencing the length of hospital stays of the AFLP patients and the establishment of prediction model
Guihua DENG ; Yachun SUN ; Leiping WANG ; Xinyan LONG ; Shunling YUAN ; Xiaopeng YUAN ; Qingbao MENG
Chinese Journal of Blood Transfusion 2024;37(4):431-438
【Objective】 To investigate the factors influencing the length of hospital stays of the acute fatty liver of pregnancy (AFLP) patients, so as to establish the prediction model. 【Methods】 A total of 49 patients diagnosed as AFLP)in ShenZhen People’s Hospital between January 2008 and January 2023 were retrospectively analyzed. According to the median length of hospital stays, the patients were divided into two groups: Group A(n=21)and Group B(n=28). Preoperative general laboratory data, clinical features and postpartum adverse outcomes in both groups were analyzed. Multivariate binary logistic regression was used to analyze the independent factors affecting the length of hospital stays for AFLP, and a prediction model for hospitalization time was established. 【Results】 Comparison between Group B and Group A were as follows: hospital stays(d)(15.5 vs 8), preoperative icterus(%)[16(57.1%)vs 3(14.3%)], thrombin time(TT)(s)(24.2 vs 21.3), prothrombin time(PT)(s)(16.8 vs 15.3), activated partial thromboplastin time(APTT)(s)(52.3 vs 40.7), total bilirubin(TBIL)(μmol/L)(77.2 vs 45.2), indirect bilirubin(IBIL)(μmol/L)(21.2 vs 10), creatinine(Cre)(μmol/L)[(171.97±53.34) vs (131.81±45.06]), TT extension(%)[24(85.7%)vs 11(52.4%)], APTT extension(%)[27(96.4%)vs 7(33.3%)], IBIL elevation(%)[19(67.9%)vs 4(19%)], Cre concentration rise(%)[21(75%)vs 8(38%)], number of postpartum plasma exchange sessions(%)[23(82.1%)vs 5(23.8%)], postpregnancy co-infection phenomenon(%)[21(75%)vs 4(19%)], with Group B significantly higher than Group A. The preoperative platelet count(×109/L)(128 vs 221)and the concentration of fibrinogen(g/L)[0.9 vs 1.6] in Group B were significantly lower than those in Group A. Univariate logistic regression analysis showed that preoperative icterus, postpregnancy co-infection phenomenon, number of postpartum plasma exchange sessions, preoperative TT extension, preoperative APTT extension, Cre concentration rise were influencing factors for the hospital stays of AFLP patients. According to the minimum result of Akaike information criterion, the multivariate binary logistic regression analysis (step-wise selection) showed that the number of postpartum plasma exchange sessions, icterus, preoperative APTT extension were the independent risk factor influencing the hospital stays of AFLP patients, and the logistic regression prediction model was established by incorporating the above three factors. Regularization techniques were further employed in linear regression to address and assess overfitting issues. Additionally, the confidence interval for the estimated effect sizes in each model have been acquired by bootstrapping techniques. 【Conclusion】 Preoperative icterus, preoperative APTT extension(APTT>43s)and the number of postpartum plasma exchange sessions were the independent risk factor influencing the hospital stays of AFLP patients and the logistic regression prediction model with high predictive effectiveness was established successfully.