Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

【Objective】 To investigate whether the psychological counseling nursing could alleviate psychological stress and reduce the incidence of adverse events in patients receiving advanced autologous apheresis (AAA) treatment. 【Methods】 A total of 253 patients who underwent AAA treatment in our department from September 2019 to February 2020 were studied and randomly divided into the observation group (n=127) and the control group (n=126). Other than the routine nursing, the patients in the observation group also received psychological counseling nursing. The scores of self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to compare the psychological stress state and the incidence of adverse events between two groups, and the nursing satisfaction was evaluated by NSNS scores. 【Results】 The SAS and SDS scores in the observation group( after receiving counseling nursing as the psychological intervention) were 30.03±5.06 and 33.59±4.49, respectively, significantly lower than those in the control group (43.55±3.68 and 42.18±4.22, respectively) (P<0.05). The incidences of adverse events (convulsions not included) in the observation group and the control group were 11.8%(15/127) vs 26.2%(33/126) (palpitation and shortness of breath), 6.3%(8/127) vs 16.7%(21/126) (sweating), 8.7%(11/127) vs 23.8%(30/126) (dizziness and numbness in mouth), and 5.5%(7/127) vs 19.8%(30/126) (nausea), respectively (P<0.05). The total nursing satisfaction rate of the observation group was 98.4% (125/127), which was significantly higher than that of the control group (92.9%, 117/126) (P<0.05). 【Conclusion】 The psychological counseling nursing can effectively relieve the psychological stress of patients receiving AAA treatment and reduce the incidence of adverse events.

Objective To determine the optimal procedure for preparation of the SPIO nanoparticles modified by dextran polylysine,and to evaluate the quality of this product.Methods The optimal preparation procedure of four factors (solution pH value,dextran concentration,reaction temperature and stirring rate) affecting SPIO hydrodynamic size were obtained through orthogonal experiments (3 levels).SPIO nanoparticles were synthesized under an optimum procedure.The shape and hydrodynamic size were detected by transmission electron microscope (TEM) and Malvern Zetasizer respectively.The content of Fe was detected by atomic absorption spectrophotometer,while chemical structures of SPIO nanoparticles were characterized and analyzed by infrared spectroscopy (IR) method.X-ray powder diffraction method was used to identify the ingredients,and the magnetic parameters were measured by vibrating sample magnetometer.Furthermore,experiments with ovarian cancer cells were performed to primarily validate the magnetic property of SPIO nanoparticles.Results The results of the orthogonal experiments showed that the optimum preparation procedure was as follows:dextran concentration of 10 mg/ml,pH 10,reaction temperature of 80 ℃ and stirring rate of 600 r/min.The TEM results showed the SPIO nanoparticles were in spherical shape,homogeneously distributed and uniform in size,and the mean diameter was 7.0 nm.The content of Fe was (12.36±0.08) g/L.The IR results clearly showed that the Fe3O4 was coated by dextran successfully.The Xray powder diffraction method showed that the sample contained Fe3O4 and the magnetism parameters indicated that the sample had superparamagnetism.The experiments with ovarian cancer cells demonstrated that SPIO nanoparticles could enter into the cells and then the cells had certain magnetic properties.Conclusions The SPIO nanoparticles synthesized under the optimal procedure are stable,small in size,with good dispersion and are feasible to enter into cells for rendering certain magnetic properties.This study has provided a good foundation and potential for further research.

Objective To investigate the effect of predeposit autotransfusion in operation of the patients with lumbar disc protrusion.Methods Fifty patients of transfusion with lumbar disc protrusion were assigned into two groups by stratified sampling randomly,30 patients whose blood were predeposited before operation in experimental group,and the other 20 patients whose blood were not predeposited before operation in control group.The blood loss,the blood requirements during operations,the hemotological routine indexes and the complications related to blood transfusion were compared respectively.Results The blood loss of experimental group [ (720 ± 665 ) ml ] perioperative period was lower than that of control group [ ( 1060 ± 558 ) ml ],but there was no significant difference between two groups (P ＞ 0.05 ).All the patients in experimental group went through perioperative period safely without allogenic blood transfusion.Hemoglobin,red blood cell and white blood cell were not significantly different between two groups before and after operation for 3,7 days (P＞ 0.05 ),the platelet count after operation for 7 days was significantly different between two groups (P ＜ 0.05).No complication was observed in experimental group but 1 case with complication was observed in control group.Conclusions Predeposit autotransfusion is an effective to avoid homologous blood transfusion and its complications for the patients with lumbar disc protrusion.Furthermore,the clinical effect is not significantly different between the predeposit autotransfusion patients and the allogenic blood transfusion patients.

Objective To compare the specificity, sensitivity, titers, and rapidity of four methods including papain technique, anti-globulin technique, polybrene test, and micro-column gel test for determination of IgG red blood cell antibodies. Methods Twelve kinds of IgG red blood cell antibodies such as anti-D, anti-E, anti-C, anti-c, anti-e, anti-Jk a, anti-Jk b, anti-Fy a, anti-Fy b, anti-k, anti-S, and anti-s were checked by the four methods. Results Seven kinds of IgG red blood cell antibodies including anti-D, anti-E, anti-C, anti-c, anti-e, anti-Jk a, and anti-Jk b were detected using papain technique (7/12). All of the 12 kinds of IgG antibodies were detected by anti-globulin technique (12/12). Eleven kinds of IgG red blood cell antibodies except anti-k were examined with polybrene test (11/12) and all the antibodies were also determinated by micro-column gel test (12/12). The titers of the antibodies determination suggested that papain technique was less sensitive than other three methods, while the micro-column gel test was more sensitive than other three methods in examination of all the antibodies. The lasting time of four techniques were: papain technique 45 min, anti-human globulin technique 60 min, polybrene test 5 min, and micro-column gel test 30 min. Conclusion Papain technique has some limitation in determination of IgG antibodies and anti-globulin technique is complicated because of long period incubation and multiple wash of red blood cells. Polybrene test is the most simple and convenient technique for determination of IgG antibodies. Micro-column gel test is the most sensitive method in determination of IgG antibodies.

Objective To study the preservative indices of stored platelet and verify the effect of a new platelet incubator made in China. Methods 12 bags of fresh platelet rich plasma (PRP) were collected. Each bag was equally divided into 2.One bag was stored for 5 days in XHZ-IA platelet incubator which was made in China, and the other bag stored in FORMA-3606 platelet incubator made in USA. Some preservative indices of stored platelet e.g. aggregation rate, recovery rate after response to hypotonic shock, CD62p expression rate etc. were tested daily. Results There were no significant differences in these preservative indices between platelets stored in two platelet incubatorshas. Conclusion XHZ-IA platelet incubator has the same effect on PRP preservation as FORMA-3606 platelet incubator.

0.05).⑵ With the increase of titers of anti-A(B) antibodies of IgG type, both the incidence and severity of HDN elevated (P

Objective To explore the quality control method of leucodepleted red cell concentrate (LDRC) preparation ,to choice an optimal processing , in order to raise the quality of LDRC,so as to ensure the efficiency and safty for the preparation application.Methods 62 bag red cells concentrates suspensin(each 150ml,preparation from 200ml whole blood) were investigated.By linear regression multianalyzed the effects of some factors on efficiency for removal of leukocytes from red cell concentrates.Free hemoglobin value(n=8) was detected before and after leukodepleted filtration.1% samples were tested and bacterial cultured,and observed the clinical adverse effects after LDRC tranfusion.Results ⑴The plasma and platelet in red cell contentrate before filtration,the time of filtration had influence significantly on the result of leukocyte depletion.⑵The percentage of leukodepleted red cell in which residual leukocyte less than 5?10 6/unit and 1?10 6/unit were 100% and 46.9%. The percentage of leukodepleted red cell in which the leukocyte removal efficiency more than 2log(99%)and 3log(99.9%) were 100% and 56.1% .After controlling the time of filtration,the percentage of leukodepleted red cell in which residual leukocyte less than 1?10 6/unit was up from 46.9% to 90.91% and the percentage of leukodepleted red cell in which the leukocyte removal efficiency more than 3log(99.9%)/bag was up from 56.1% to 78.1%.⑶Red blood cell recovery rate was (90.48?4.73)%. There was no significant change of free hemoglublin before and after filtration.⑷No bacteria were detected by germiculture.⑸Evident side effects was no seen after transfusion.Conclusions During the course of removal of leukocytes from red cell concentrates by filtration, the sustained quality control is necessary for improving the quality of leukodepleted red cell.So enforcing aseptic manipulation rigorously and controlling the components of blood,the time of blood storage and filtration appropriately are quite important.

To study the formation and change of platelet leucocyte aggregation (PLA) in red blood cell concentrations(CRCs) stored at 4℃ and the preventive effectiveness of filtration, 8 units of CRCs were each divided into two equal parts in two integrative bags and two paired groups were formed: control group and filtration group. The following items of control group and filtration group were detected weekly. Platelet and leukocyte counts, concentration and percentage of platelet lympocyte (P lym), platelet monocyte (P mon), platelet neutrophil (P neu) aggregatoins, and concentration of total PLA. The results showed that rate and concentration of PLA in the control group were significanly higher than those in the circulating blood. The rates of P lym and P mon in CRCs stored at 4 ℃ were two to five times of those before storage, and the rate of P neu in CRCs stored at 4 ℃ was ten to twenty times of that before storage. PLA in the CRCs separated from plasma rose to a high level at the first day of preparation. The concentration of PLA in CRCs reached the highest level at one week after stored at 4 ℃ and then decreased, but a high concentration was retained all the while. P neu is the major part (about 80%～90%) of whole PLA in CRCs. PLA was not detectable by flow cytometry during the whole storage course. The results suggested that high concentrated PLA was detected in CRCs stored at 4 ℃, which could be prevented by leucocyte depleting filtration.

Objective To explore the changes in plasma fibronectin level in patients with SARS in the acute stage, and the feasibility of the use of plasma fibronectin in acute stage of SARS. Methods Plasma fibronectin contents were assayed with ELISA in patients with SARS in acute stage and 24 healthy donors. Results The plasma fibronectin level of control group was 476.2?221.0mg/L, while that of four SARS patients was 42.2?23.0 mg/L(P