1.Impact of intraoperative platelet and cryoprecipitate transfusion strategies on perioperative transfusion and outcomes in orthotopic heart transplant patients
Rui ZHANG ; Xiaoqin LUO ; Mei ZHOU ; Fengxiu YU ; Baohua QIAN ; Haihui GU
Chinese Journal of Blood Transfusion 2025;38(10):1313-1319
Objective: To retrospectively compare the impact of different intraoperative transfusion strategies for platelets and cryoprecipitate on perioperative blood usage and clinical outcomes in patients undergoing orthotopic heart transplant (OHT), thereby providing a reference for perioperative patient blood management. Methods: The clinical data of 65 patients who had undergone OHT at our hospital between 2020 and 2025 were retrospective collected. Patient demographics, underlying chronic conditions, and perioperative (preoperative, intraoperative, and postoperative) laboratory blood test results were analyzed. The transfusion volumes of intraoperative red blood cells, plasma, platelets, and cryoprecipitate were examined. Univariate and multivariate logistic regression models were employed to identify factors associated with perioperative outcomes. Results: A total of 65 patients received allogeneic blood transfusion during the perioperative period. The ultilization of intraoperative platelets and cryoprecipitate was as follows: simultaneous transfusion of both platelets and cryoprecipitate (at a 1∶1 ratio) was administered in 42 patients (64.62%), platelets alone in 12 patients (18.46%), and cryoprecipitate alone in 11 patients (16.92%). Patients who received simultaneous transfusion of platelets and cryoprecipitate (1∶1) (n=42) had a shorter ICU length of stay (32.45±10.18 d), while those who received either platelets or cryoprecipitate alone (n=23) had a significantly longer ICU length of stay (68±15.97 d). Patients receiving simultaneous intraoperative transfusion of platelets and cryoprecipitate also required fewer units of allogeneic red blood cells intraoperatively (median=4 units) and had a lower mortality rate (16.7%) than those receiving either product alone (26.1%), with a statistically significant difference (P=0.023). Multivariate logistic regression analysis indicated that the volume of cryoprecipitate transfused was an independent protective factor against postoperative allogeneic red blood cell transfusion (OR=0.344, 95% CI [0.177, 0.829], P=0.0159). Multivariate logistic regression also identified cryoprecipitate transfusion volume as an independent protective factor for ICU length of stay (OR=0.877, 95% CI [0.719, 0.986], P=0.0008), which was in line with the multivariate Cox regression results. Conclusion: In patients undergoing OHT, the intraoperative transfusion strategy for platelets and cryoprecipitate influences the volume of perioperative allogeneic red blood cell transfusion and patient mortality. Intraoperative cryoprecipitate transfusion volume is an independent protective factor against both postoperative allogeneic red blood cell transfusion and prolonged ICU length of stay. The establishment of a multidisciplinary collaborative blood management model, combined with the modification of perioperative blood utilization practices and the implementation of a comprehensive patient blood management strategy, can holistically ensure perioperative patient safety.
2.Urine sample collection methods for measuring urinary concentrations of phenolic endocrine disrupting chemicals and their comparison in pregnant women
Ning TANG ; Xia WANG ; Xu WANG ; Shasha ZHAO ; Xiaogang YU ; Fengxiu OUYANG
Journal of Shanghai Jiaotong University(Medical Science) 2017;37(6):816-821
Objective · To compare urine sample collection methods for measuring urinary concentrations of phenolic endocrine disrupting chemicals including bisphenol A (BPA),triclosan (TCS),and 4-n-nonylphenol (4-n-NP) in pregnant women.Methods· Urine samples were collected from women at late pregnancy by two methods:urine catheter and collection bag (n=176),urine collecting containers made of polypropylene (PP) (n=642).Urinary concentrations of BPA,TCS and 4-n-NP were measured with high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS)method.Confirmation experiment used PP containers,urine catheter and collection bags,as well as low-density polyethylene (LDPE) tubes and glass containers as both negative controls to collect urine samples from each of the 5 women.Results · Geometric mean (GM) of urinary BPA concentration collected by urine catheter and collection bags was 82.5 ng/mL (95% CI 71.4-95.4 ng/mL),which was 63 times higher than that from PP containers (GM 1.3 ng/mL;95% CI 1.3-1.5 ng/mL).Concentrations of urinary 4-n-NP and creatinine were similar between two collection methods.Confirmation experiment showed that urinary BPA concentration collected by urine catheter and collection bags was much higher than those collected by other three methods.Conclusion· In collection of urine samples for measuring phenolic chemicals,PP urine collection container as well as LDPE containers are adequate for use in epidemiologic studies,but urine catheter and collection bag is not.
3.Results of different interventions applied to 118 cases with impaired fasting glucose for 3 years
Yaxin BI ; Guoxi JIN ; Lei YU ; Jing ZHOU ; Shirong ZHANG ; Fengxiu JIANG ; Zhiyi SONG ; Jianhua SHI
Chinese Journal of Endocrinology and Metabolism 2010;26(7):586-587
The results of different interventions administered in 118 cases with impaired fasting glucose (IFG) for 3 years were investigated. The rates of transformation of IFG to diabetes mellitus in metformin treatment groups and rosiglitazone treatment groups were significantly lower than that in life style intervention group. This study suggested that metformin or rosiglitazone treatment could effectively reduce transformation of IFG to diabetes as compared with life style intervention.
4.Ameliorative effect of water extract of propolis preconditioning on mesenteric microcirculation of rats subjected to small intestinal ischemia reperfusion
Shutong YAO ; Hui SANG ; Jiafu WANG ; Zhanping SHANG ; Weihong LI ; Fengxiu YU
Chinese Journal of Pathophysiology 2010;26(1):23-27
AIM: To investigate the ameliorative effect of water extract of propolis (WEP) preconditioning on mesenteric microcirculation of rats subjected to small intestinal ischemia reperfusion (I/R). METHODS: Thirty-two male Wistar rats were randomly divided into sham, I/R and WEP (100, 200 mg/kg) preconditioning groups. Model of small intestinal I/R injury was made by clamping super mesenteric artery for 45 min followed by 120 min of reperfusion in rats. Mesenteric microcirculation was detected at the end of reperfusion. The degree of small intestinal injury was The content of soluble intercellular adhesion molecule-1 (sICAM-1) in plasma and myeloperoxidase (MPO) activity in intestinal tissue were detected using enzyme linked-immuno-sorbent assay (ELISA) and spectrophotometer, respectively. RESULTS: (1) WEP preconditioning alleviated significantly the pathologic lesion in small intestine, and wet/dry ratio, compared to those in I/R group (P<0.01). (2) The disturbance of the blood flow in microvessel induced by I/R was improved significantly by WEP. In addition, WEP preconditioning alleviated significantly the decrease in diameters of microvessels and microcirculatory blood velocity (P<0.05 vs I/R group) and inhibited the adherence of leukocytes to venule (P<0.01 vs I/R group) in a dose-dependent manner. SICAM-1 content in plasma and MPO activity in intestinal tissue were decreased in WEP preconditioning group, compared to those in I/R group (P<0.05 or P<0.01). CONCLUSION: WEP preconditioning ameliorates mesenteric microcirculation of rats subjected to small intestinal I/R through suppressing the activation of polymorphonuclear neutrophils mediated by ICAM-1.

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