To guide transfusion practice in critically ill children who often need plasma and platelet transfusions, the Transfusion and Anemia Expertise Initiative-Control/Avoidance of Bleeding (TAXI-CAB) developed Recommendations and Expert Consensus for Plasma and Platelet Transfusion Practice in Critically Ill Children. This guideline addresses 53 recommendations related to plasma and platelet transfusion in critically ill children with 8 kinds of diseases, laboratory testing, selection/treatment of plasma and platelet components, and research priorities. This paper introduces the specific methods and results of the recommendation formation of the guideline.

Based on systematic review and consensus meetings of international multidisciplinary experts, the Transfusion and Anemia Expert Initiative—Control/Avoidance of Bleeding (TAXI-CAB) project team developed management strategies for platelet and plasma transfusion in critically ill children. This consensus presents five expert consensus statements and two recommendations addressing two key questions: 1) What Laboratory Tests and Physiologic Triggers Should Guide the Decision to Administer a Platelet or Plasma Transfusion in Critically ill Children? 2) What Product Attributes Are Optimal to Guide Specific Product Selection? This consensus provides guidance for decision-making regarding plasma and platelet transfusion in critically ill children in two aspects: relevant laboratory testing indicators and additional special properties of blood components. This article explains the rationale behind the recommendations in this part of the guideline, aiming to emphasize the need for clinicians to develop transfusion strategies based on multidimensional assessment, while calling for enhanced interdisciplinary collaboration and evidence-based research to optimize blood management in critically ill children, reducing the risk of over-transfusion and improving treatment outcomes. Furthermore, there remains an urgent need for further research to explore laboratory indicators associated with bleeding risk to guide transfusion therapy.

In the development of oxidative stress-relevant diseases, reactive oxygen species (ROS) removal obstacle or excess production results in the damage of the body tissues and organs. Recent studies have demonstrated that nuclear factor E2-related factor 2/heme oxygenase-1 (Nrf2/HO-1) axis played a significant role in anti-oxidative stress. The Nrf2/HO-1 axis counteracts oxidative stress injury by its resistance to inflammation, oxidation, mitochondrial damage and calcium influx, apoptosis, pyroptosis, ferroptosis and autophagy, which provides a theoretical basis for its therapeutic effect on various oxidative stress-relevant diseases in multiple organs (respiratory, cardiovascular, nervous, digestive, urinary and blood systems). Therefore, effective regulation of the Nrf2/HO-1 signal axis can be an important strategy for treatment of oxidative stress-relevant diseases.
Heme Oxygenase-1 ; NF-E2-Related Factor 2 ; Oxidative Stress ; Reactive Oxygen Species ; Signal Transduction

Objective: To observe the effect of poloxamer 188 (P188) on megakaryocyte cultivation and induction from cord blood mononuclear cells in order to obtain more megakaryocyte progenitor cells (MPC). Methods: The cord blood mononuclear cells were isolated and inoculated in cell culture bag or cell culture flask respectively. The WIGGENS shaker and cell culture bags were used to mimick WAVE Bioreactor for three-dimensional (3D) cell culture, and the P188 was added to induction medium, The cells were detected for morphology, surface marker, viability, and number on day 14. Results: In the two-dimensional (2D) culture, CD41⁺, CD41⁺/CD61⁺, CD61⁺ megakaryocytic numbers increased significantly after adding P188 (all P<0.01). And in the 3D culture of adding P188, the cell volume became larger and the nuclear shape was irregular, the cytoplasm appeared magenta granules, and the megakaryocyte cells became more mature. By 3D culture, the expression of CD41/CD61 was (36.30±1.27)% vs (23.95±1.34)%, hence the differentiation for MPC was significantly higher than that in the 2D group (P<0.01). Furthermore, adding P188 in 3D culture resulted in highest differentiation efficiency for MPC [(59.45±1.20)%]. There were no significantly differences in terms of cell viability and cell number among 3D culture containing P188, 2D and 3D culture groups (all P>0.05). Conclusion 3D culture was beneficial for the differentiation of MPC, but the cell viability was lower than 2D group; However, the satisfied cell growth and better induction efficiency were obtained by adding of P188, which might provide a new method of megakaryocytes production for clinical application.

Objective: To explore an optimal method for granulocyte cell production from umbilical cord blood mononuclear cells. Methods: Erythrocytes were precipitated by hydroxyethyl starch. Mononuclear cells were isolated through Ficoll density gradient centrifugation. Different media, additives and cultivation model were chosen for granulocyte induction. Cell morphology was observed by microscopy, and cell phenotype was detected by flow cytometry. The CD18 expression of granulocytes was tested by immunofluorescence assay, and phagocytosis test was executed as well. Results: Compared to fetal bovine serum (FBS) treatment group, cell viability, counts and differentiation rate of granulocytes induced by X-VIVO^TM 15 combined with TPO, SCF, G-CSF but without FBS were superior. And X-VIVO^TM15 medium was better than SCGM medium at effectiveness and cost. Using two-stage mode of hematopoietic stem cell expansion followed by granulocyte induction with X-VIVO^TM15 combining TPO, SCF and G-CSF, cell proliferation was nearly 132 times at day 21. Flow cytometry showed that the differentiation was lagged in 2-stage mode than in direct induction mode, CD15 expression was (69.60± 1.06) % vs (97.73±0.39) %; Wright-Giemsa staining demonstrated mature granulocytes; immunofluorescence showed the expression of lysosomal proteins CD18. A strong phagocytic function of mature granulocytes was demonstrated by phagotrophic efficiency of (51.43±0.05) %. And granulocyte had chemotaxis ability under the role of chemotactic factor IL-8. Conclusion Optimized culture media and cultivation mode are achieved for functional granulocytes induction in vitro.

Objective To investigate the mechanism of hypedipidemia on pancreas of rats by comparative proteomic analysis.Methods Ten male SD rats were randomly divided into two groups,the experimental group Was fed with high lipid forage and the control group Was fed with normal food.Pancreatic samples from the two groups were harvested six weeks later.Differential protein analysis Was performed using differential in-gel electrophoresis(DIGE),and characterizing the protein biomarkers using tandem mass spectrometry.Western blot Was used to confirm the expression of significantly changed proteins.Results Compared to the normal pancreas tissue,a total of 3 protein spot-features were found to be significantly increased and 11 significantly decreased in pancreatic samples with hyperlipidemia.Significantly increased proteins in hyperlipidemia pancreatic samples were arginaseⅡ,ribonuclease inhibitor and glyeine amidinotransferase,which increased by 2.19,1.82 and 1.12 fold,respectively.Significantly decreased proteins in hyperlipidemia group were tyrosyl-tRNA synthetase,alpha-amylase,triacylglycerol lipase,DJ-1protein,Cu,Zn superoxide dismutase,which dicreased by 2.48,2.37,1.85,1.73 and 1.65 folds,respectively.Western blot analysis revealed increased arginase Ⅱ levels and decreased alpha-amylase in pancreatic samples with hyperlipidemia.Conclusions Pancreas wag possibly injured by hyperlipidemia via increase of arginase Ⅱ.Decreased amylase and lipase may be the protection mechanism of pancreas.

OBJECTIVE: To strengthen drug management in hospital.METHODS: Hospital Information System(HIS)-based drug management was supplemented and consummated with the help of Microsoft Excel worksheet's functions such as ranking,computing and advanced screening etc.RESULTS: Using the Microsoft Excel worksheet to help monitor inventory control,warehousing,and shortage of drug supply,unsalable drugs and expiration date in HIS-based drug management has facilitated the effective management on both the quality and the quantity of drugs in our hospital.CONCLUSIONS: Microsoft Excel worksheet can be utilized to consummate HIS-based electronic management of drugs in hospital.