RESUMO
Red blood cells (RBCs) of Asian-type DEL phenotype express few RhD proteins and are typed as serologic RhD-negative (D-) phenotype in routine testing. RhD-positive (D+) RBC transfusion for patients with Asian-type DEL has been proposed but has not been generally adopted because of a lack of direct evidence regarding its safety and the underlying mechanism. We performed a single-arm multicenter clinical trial to document the outcome of D+ RBC transfusion in patients with Asian-type DEL; none of the recipients (0/42; 95% confidence interval, 0-8.40) developed alloanti-D after a median follow-up of 226 days. We conducted a large retrospective study to detect alloanti-D immunization in 4045 serologic D- pregnant women throughout China; alloanti-D was found only in individuals with true D- (2.63%, 79/3009), but not in those with Asian-type DEL (0/1032). We further retrospectively examined 127 serologic D- pregnant women who had developed alloanti-D and found none with Asian-type DEL (0/127). Finally, we analyzed RHD transcripts from Asian-type DEL erythroblasts and examined antigen epitopes expressed by various RHD transcripts in vitro, finding a low abundance of full-length RHD transcripts (0.18% of the total) expressing RhD antigens carrying the entire repertoire of epitopes, which could explain the immune tolerance against D+ RBCs. Our results provide multiple lines of evidence that individuals with Asian-type DEL cannot produce alloanti-D when exposed to D+ RBCs after transfusion or pregnancy. Therefore, we recommend considering D+ RBC transfusion and discontinuing anti-D prophylaxis in patients with Asian-type DEL, including pregnant women. This clinical trial is registered at www.clinicaltrials.gov as #NCT03727230.
Assuntos
Antígenos de Grupos Sanguíneos , Sistema do Grupo Sanguíneo Rh-Hr , Humanos , Feminino , Gravidez , Estudos Retrospectivos , Sistema do Grupo Sanguíneo Rh-Hr/genética , Transfusão de Sangue , Eritrócitos , Fenótipo , Epitopos , AlelosRESUMO
OBJECTIVE: To evaluate the effect of silicon and latex urinary catheters on urinary mucosa. METHODS: A randomized, controlled prospective clinical trial was carried out in 60 patients admitted in the Department of Neurosurgery, who required long-term use of an indwelling urinary catheter. The patients were divided into 2 equal groups with placement of silicon or latex urinary catheter, and routine laboratory urine test was performed on a regular basis and the patients feelings during catheter retention were recorded. RESULTS: Patients with placement of indwelling silicone catheters reported no obvious discomfort in relation to the catheter placement and had significantly lower incidence of hematuria identified microscopically than those with common latex catheters. CONCLUSION: Compared with latex catheters, silicone catheters cause less injuries and reduce substantially irritation of the urinary mucosa, and we suggest the use of silicone catheter in patients requiring long-term indwelling urinary catheters.
Assuntos
Cateteres de Demora , Látex , Silício , Cateterismo Urinário/instrumentação , Adulto , Cateteres de Demora/efeitos adversos , Feminino , Humanos , Látex/efeitos adversos , Masculino , Estudos Prospectivos , Silício/efeitos adversos , Cateterismo Urinário/efeitos adversosRESUMO
OBJECTIVE: To assess the value of Halena SAS-3 full automatic hemoglobin agarose electrophoresis in the diagnosis of thalassemia. METHODS: Hemoglobin A and A2 was detected by agarose electrophoresis in 200 blood samples collected from 170 healthy subjects, 2 patients with beta-thalassemia, 12 with acute lymphoblastic leukemia, 12 acute myelocytic leukemia and with 4 non-Hodgkin lymphoma. RESULTS: The Mean+/-SD of hemoglobin A in the healthy subjects and patients with beta-thalassemia, acute lymphoblastic leukemia, acute myelocytic leukemia and non-Hodgkin lymphoma was 97.55+/-0.51, 97.01+/-0.329, 97.42+/-0.57, 97.44+/-0.55, and that of A2 was 2.44+/-0.51, 2.99+/-0.32, 2.84+/-0.28, 2.55+/-0.55, respectively. The values of electrophoresed hemoglobin F of the 2 patients with beta-thalassemia were higher than those of the normal adults. The within-run coefficient of variation (CV) and between-run CV was 0.17 and 7.76 for hemoglobin A, and 0.16 and 7.14 for hemoglobin A2, respectively. CONCLUSIONS: Halena SAS-3 full automatic agarose electrophoresis system possesses strong resolving power in detecting trace abnormal hemoglobin and accurately identifies unusual evaluation of hemoglobin A2 and F to facilitate the diagnosis of thalassemia.
Assuntos
Eletroforese em Gel de Ágar/métodos , Hemoglobinas/análise , Talassemia beta/sangue , Pré-Escolar , Feminino , Hemoglobina Fetal/análise , Hemoglobina A/análise , Humanos , MasculinoRESUMO
OBJECTIVE: To evaluate the effect of polyethylene glycol/montmorillonite (PEG/MMT) nanocomposite material in adsorption of triglyceride (TG), cholesterin and low-density lipoprotein-cholesterol (LDL-C). METHODS: The structure of PEG/MMT nanocomposite was analyzed by means of X ray diffraction and its effect of blood lipid and albumin adsorption was evaluated in comparison with Na-MMT. RESULTS: The interval distance was larger when the PEG of greater molecular weight was used for preparing the nanocomposite, and PEG/MMT nanocomposite had greater adsorption rate of TG, cholesterin and LDL-C in serum than that of serum albumin. MMT material had poor adsorption effect. CONCLUSION: PEG/MMT nanocomposite possesses the potential as a novel adsorbent of blood lipid for clinical use.
Assuntos
Bentonita/química , Hiperlipidemias/sangue , Lipídeos/química , Nanopartículas/química , Polietilenoglicóis/química , Adsorção , HumanosRESUMO
OBJECTIVE: To observe the efficacy of heparin-induced extracorporeal low-density lipoprotein-lipoprotein alpha- fibrinogen precipitation (HELP) in clearing blood lipids. METHODS: Thirty-six patients were subjected to extracorporeal plasma lipid separation procedures that utilized heparin to induce the formation of the complex consisted of heparin, low-density lipoprotein cholesterol (LDL-C), lipoprotein and fibrinogen which was precipitated and consequently separated from the plasma. Blood samples were obtained from the patients both before and after the procedures to assay serum total cholesterol (CH), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), LDL-C, apoliprotein A (ApoA) and apoliprotein B (ApoB). RESULT: Significant differences were observed between the pre- and postoperative levels of lipoprotein (P<0.001). CONCLUSION: Plasma lipoprotein can be partly cleared by way of HELP.
Assuntos
Anticoagulantes/farmacologia , Circulação Extracorpórea , Fibrinogênio/metabolismo , Heparina/farmacologia , Lipoproteínas LDL/sangue , Adulto , Idoso , Apolipoproteínas A/sangue , Apolipoproteínas B/sangue , Remoção de Componentes Sanguíneos/métodos , Precipitação Química , Colesterol/sangue , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Feminino , Fibrinogênio/efeitos dos fármacos , Humanos , Lipoproteínas LDL/efeitos dos fármacos , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Triglicerídeos/sangueAssuntos
Síndrome Respiratória Aguda Grave , Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto JovemRESUMO
In this work, the electrophoretic mobility (EPM) measurement of individual cells was investigated by a simple on-chip electrophoresis system with LIF multipoint detection. The system enabled the characterization of cell electrophoresis behavior as well as the fluorescence signal from individual cells simultaneously. The measurement yielded the electropherograms of a large number of cells labeled with dye, in which the migration time and migration distance could be obtained easily. The EPM has been demonstrated to be different between the K562 cells and K562 cells treated with anticancer drug arsenic trioxide (As2O3). The K562 cells were found to exhibit a lower EPM compared to the cells after drug addition with different concentration. In this preliminary study, over 300 cells could be analyzed within 2 h, demonstrated a much higher analysis throughput compared with traditional methods. The established system is simple and fast, which is expected to be a promising method for evaluating cell surface properties and to be useful in clinical and pharmaceutical applications.