Objective To study the molecular mechanisms of Rh deletion D--individuals.Methods Several exons and introns of RHD and RHCE gene were amplified by PCR-SSP.The abnormally amplified segments,which were inconsistent with serologic phenotyping,were cloned and sequenced.Results Fragments of D,e gene were amplified in two RhD--individuals.After sequencing,deletion at nucleotide 22 in exon 5,and point mutations at codon 48 and 90 were found in one individual.Mutation at codon 48 in exon 5 were found in another.Conclusion Exon deletion of Rh gene,along with deletion and mutation of single nucleotide may cause Rh deletion D--.

Objective To investigate the clinical significance of direct antiglobulin test(DAT) in patients with chronic hepatitis B.Methods Column agglutination technique(CAT) and conventional tube technique(CTT) were used to detect red blood cell(RBC) antibodies in a total of 162 samples,including 50 cases of asymptomatic carriers,42 cases of active phases of chronic hepatitis B(CHB) patients,52 cases of severe hepatitis and 18 healthy individuals.Results The RBC count and hemoglobin(Hb) in patients with severe hepatitis were significantly lower than those in asymptomatic carriers,CHB patients and healthy individuals(P

Objective To observe the therapeutic effect of lymphoplasmapheresis (LPE) in treatment of Guillain-Barre syndrome (GBS). Methods The initial recovery time of muscle strength, muscle strength score difference, clinical therapeutic effect and the security after treatment with LPE were observed in 34 GBS patients. Meanwhile, 17 GBS patients applied with therapeutic plasma exchange (TPE) named TPE group were served as control group. Results LPE group was treated with LPE 51 times in all, and the mean times was 1.5. TPE group received TPE 33 times in all, and the mean times were 1.9. In LPE group, the average initial recovery time [(12.74?7.18)d] was significantly shorter than that in TPE group [(24.35?14.22)d] (P0.05).Conclusions The therapeutic effect of LPE is distinguished for treatment with GBS and the side effect is rare. It is worth to apply in clinic.

Objective To evaluate the clinical efficacy of lymphoplasma exchange (LPE) for the treatment of severe refractory immune-related skin diseases.Methods From May 2013 to October 2015,8 patients with toxic epidermal necrolysis,drug-induced hypersensitivity syndrome (DIHS),pemphigus vulgaris,pemphigoid or paraneoplastic pemphigus were enrolled from Department of Dermatology,Xiangya Hospital,Central South University,who showed no response to conventional therapy or presented with multiple organ dysfunction.After the treatment with LPE,the efficacy was evaluated,and adverse reactions were observed.Results After one session of LPE therapy,6 patients received marked improvement,and were cured at last.In 1 patient with pemphigus vulgaris who was resistant to the treatment with high doses of glucocorticoids and immunosuppressive agents,the rashes regressed during the treatment with LPE,but recurred after the end of treatment.One patient with bullous pemphigoid presented with eruptive blisters on the next day after the treatment with LPE,which were considered as allergic reactions to allogeneic plasma.There were no obvious differences in white blood cell count,lymphocyte count,neutrophil count and blood platelet count in the peripheral blood of 8 patients before and after the treatment with LPE.During the follow-up of 3-5 years,all of the patients were recovered without recurrence,except 1 patient with bullous pemphigoid who died of disseminated tuberculosis after 1 year.Conclusion LPE is effective for the treatment of severe immune-related skin diseases,but attention should be paid to potential transfusion reaction and allergic reactions.

【Objective】 To investigate treatments of discrepancy presented in blood typing and cross-matching test caused by anti-I antibody and the difference between autoanti-I antibody and alloanti-I antibody. 【Methods】 38 cases of I-positive antibody in our hospital from January 2016 to July 2019 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, and the blood transfusion effect was evaluated. 【Results】 37 cases of autoanti-I antibody and 1 case of alloanti-I antibody, with specificity produced by an individual with a rare i blood group, were identified. 34 cases contained I-positive antibody and 4 contained I-positive antibody combined with alloantibodies. At 4 ℃, most of the anti-I titers were between 32 and 512, 2 cases were more than 1 024. After the RBCs were washed with 37℃ normal saline and cold absorbed at 4℃, the cross-matching tests were matched and 37 cases of blood transfusion were all effective except for one case. After performing the same treatment on i adult red blood cells and adding I antigen-negative cord blood cells, the result was correct to be B type. The titer of IgM alloanti-I antibody in this adult was 256, and autotransfusion was preferred. 【Conclusion】 Patients with anti-I antibody, reactive at low temperature, should be treated with warm and slow transfusion under close monitoring. Autotransfusion is, in principle, beneficial to adult i blood group patients producing alloanti-I antibody. If i blood patients suffered from massive blood loss without suitable blood resource available, the elderly i blood donors were preferred, and plasmapheresis may also be an alternative to remove anti-I temporarily.