Objective: To investigate the effects of blood component transfusion on the prognosis of patients with varying severity of traumatic brain injury (TBI). Methods: A retrospective analysis was conducted on clinical data from 621 TBI patients admitted between January 2012 and December 2022. The patients in the blood transfusion group were categorized into three groups based on Glasgow Coma Scale (GCS) scores: severe impairment (GCS 3-8, n=302), moderate impairment (GCS 9-12, n=186), and mild impairment (GCS 13-14, n=133). General clinical data and laboratory test indexes were analyzed. Patients were further divided into two subgroups based on in-hospital mortality: death group (n=72) vs survival group (n=549). Univariate and multivariate logistic regression analysis was used to analyze the effects of different blood component transfusion volumes on the prognosis of TBI patients. ROC curve was used to evaluate the prognostic value of red blood cell transfusion volume. Results: Patients with GCS scores 3-8 had significantly longer hospital stays (21.73±15.89 vs 20.83±11.54 vs 15.5±7.76) and higher RBC transfusion volumes (6.16±6.79 vs 4.67±2.81 vs 3.67±3.20) than the other two groups (P<0.05). NLR, PCT, CRP, PT, Fib, FDP and DDI after the last transfusion showed significant differences from pre-transfusion values (P<0.05). The death group exhibited higher transfusion volumes of RBCs, plasma, platelets, and cryoprecipitate compared with the survival group (P<0.05). Univariate (OR: 1.541, 95%CI: 1.412-1.682) and multivariate (OR: 1.522, 95%CI: 1.362-1.700) logistic regression analyses showed that the RBC transfusion volume was a risk factor affecting the prognostic factors of TBI patients after infusion of blood components. ROC curve analysis showed that RBC transfusion volume could serve as a prognostic marker (sensitivity: 0.708, specificity: 0.812). Conclusion: Blood component transfusion alters inflammatory and coagulation markers in patients with different degrees of TBI, and RBC transfusion volume is a viable prognostic indicator for TBI outcomes.

【Objective】 To analyze the effect of blood component transfusion when the results of direct antiglobulin test (DAT) changed from negative to positive after blood transfusion. 【Methods】 The data of 215 surgical blood recipients, who were admitted in our hospital from January to October 2019 and presented negative results for both DAT and irregular antibody screening (Anti-screening), were collected via Ruimei Laboratory Management System. DAT and Anti-screening were performed again after blood transfusion, and DAT positive patients(re-test positive group) were then subject to antibody classification and polybrene cross-matching (referred to as cross-matching), and Anti-screening positive patients were tested for irregular antibodies. Patients were stratified by perioperative RBCs transfusion volume as ≤4 U (150 ± 10% mL/U), >4 to 8 U and > 8 U, and DAT-negative patients after blood transfusion were set as the controls, and the transfusion effect of DAT-positive patients after blood transfusion was compared with them. 【Results】 8.84% (19/215) of DAT-negative patients turned positive after RBCs transfusion, among which IgG type accounted for 84.21% (16/19) and IgG+ C3 15.79% ( 3/19); two patients(anti-E and-M, 10.53%) were positive in anti-screening re-test and the rest were negative (89.47%, 17/19). As for cross matching, incompatibility of both primary and secondary side, primary side and secondary side accounted for 5.26% (1/19), 5.26% (1/19) and 10.52 (2/19), respectively, while 78.95% (15/19) showed compatibility of both primary and secondary side. The Hb, RBC and Hct values of the re-test positive group, received RBC transfusion volume (U)≤4 and >4~8, were effectively elevated compared with the controls (P<0.05), while no significant changes of the parameters were noticed when blood transfusion volume >8 U(P>0.05). 【Conclusion】 The conversion of DAT negative results to positive after RBC transfusion indicates the patient has developed antibodies or the incidence of blood transfusion reaction, which can provide references for the clinical choice of appropriate blood components to ensure the safety and effectiveness of blood transfusion.

OBJECTIVETo study whether the abilities of hepatitis C virus (HCV) E2 gene immunization to induce humoral and cellular immune responses to E2 protein were affected by hepatitis B virus (HBV) preS gene when they fused in DNA-immunized mice.

METHODSMice were immunized with E2, preS-E2 (preS gene was upstream of E2 gene), and E2-preS (preS gene was downstream of E2 gene) gene by their eukaryotic expression vectors, respectively. The anti-E2 or anti-preS antibodies were detected using the E2 and preS antigens. The cellular immune response to E2 protein in immunized mice was presented by its survival time after injecting SP2/O myeloma cells expressing HCV E2 protein into the abdominal cavity.

RESULTSChimeric E2 and preS gene immunization can induce mice to develop anti-preS and anti-E2 antibodies. The number of the mice developing anti-E2 antibody and the antibody titers in preS-E2 gene-injected group were higher than those in E2-preS gene-immunized group. However, the mice injected with E2 gene did not develop the detectable anti-E2 antibodies until 12 weeks after DNA immunization. After the mice was injected with target cells, the average survival time of the mice in the group immunized with E2 gene alone was longer than that of the group injected with E2 gene fused with HBV preS and was significantly longer than that of the control (P < 0.05).

CONCLUSIONHBV preS might be a humoral enhancer that can affect the abilities of HCV E2 protein to induce immune responses in DNA-immunized mice.

Animals ; Antibody Formation ; drug effects ; Hepacivirus ; chemistry ; Hepatitis B Surface Antigens ; genetics ; pharmacology ; Hepatitis B virus ; chemistry ; genetics ; Immunity, Cellular ; drug effects ; Male ; Mice ; Mice, Inbred BALB C ; Protein Precursors ; genetics ; pharmacology ; Recombinant Fusion Proteins ; immunology ; Viral Envelope Proteins ; genetics ; pharmacology