Blood Components Research Articles

Blood component-associated acute transfusion reactions in pediatric patients: experience of a tertiary care hospital.

The transfusion of blood products is a life-saving clinical practice in patients with bleeding, hemoglobinopathy, and cancer. It was aimed herein to analyze the frequency and types of blood component-related acute transfusion reactions (ATRs) in pediatric patients. This retrospective study was conducted at a tertiary care academic pediatric hospital. During the study period, 30,811 transfusions were administered to 25,448 patients. There were 103 ATRs detected in 81 patients (0.33%; 3.34 reactions per 1000 transfusions, mean age 8.3 ± 5.98 years, 36 females and 45 males). All the reactions were observed within an average of 4 h after the transfusion began. The most common ATRs were allergic reactions (79; 76.6%) and febrile nonhemolytic transfusion reactions (12; 11.6%). All the allergic transfusion reactions occurred within the first hour after the start of the transfusion. Granulocyte concentrates were the blood component associated with the highest ATR rate (2.1%). Within our hospital, pediatric hematology-oncology wards and the stem cell transplantation unit had the most frequent ATR reports; therefore, when transfusions are carried out, increased attention should be given to these units. Educating health staff about the adverse effects of transfusion therapy should increase the awareness and reporting of ATRs in children.

Swertia cincta and its main active ingredients regulate the PPAR-α pathway in anti-cholestatic liver injury

Ethnopharmacological relevanceSwertia cincta is a traditional remedy for cholestasis commonly utilised in Yunnan, China. Despite its widespread use, the specific active components and underlying mechanisms of action remain poorly understood. Aim of this studyThis study aimed to investigate the therapeutic properties, mechanisms, and active compounds of Swertia cincta in an animal model of cholestasis induced by alpha-naphthylisothiocyanate (ANIT). Materials and methodsUHPLC/Q-TOF-MS and high-performance liquid chromatography (HPLC) were utilised to analyse the blood components of Swertia cincta. An ANIT-induced cholestatic liver injury animal model was established, and metabolomics was employed to explore the potential mechanisms of Swertia cincta in treating cholestatic liver injury. Hepatocellular injury induced by taurochenodeoxycholic acid was evaluated in vitro, and key bioactive components of Swertia cincta for cholestatic liver injury treatment were identified and confirmed using the ANIT-induced mouse model. ResultsThe established HPLC method demonstrates good specificity and reproducibility, enabling the simultaneous determination of six components in Swertia cincta. Results from serum biochemical indicators and liver pathology analysis indicated that Swertia cincta exhibits promising anti-cholestasis liver injury effects. Specifically, gentiopicroside, loganic acid, and isoorientin were identified as key active ingredients in treating cholestatic liver injury. Their mechanism of action primarily involves regulating PPAR-α, FXR, CYP3A4, NTCP, CAR, and CPT2. By modulating PPAR-α and bile acid metabolism-related proteins, reducing pro-inflammatory factors, enhancing bile acid transport, and promoting fatty acid oxidation to reduce lipid accumulation, Swertia cincta exerts protective and therapeutic effects against cholestatic liver injury. Notably, gentian bitter glycosides appear to be the most critical components for this effect. ConclusionSwertia cincta may improve cholestatic liver injury by activating the peroxisome proliferator-activated receptor alpha pathway, and the key active compounds were gentiopicroside, loganic acid, and isoorientin.

Resonant Acoustic Rheometry for Real Time Assessment of Plasma Coagulation in Bleeding Patients.

Disordered hemostasis associated with life-threatening hemorrhage commonly afflicts patients in the emergency room, critical care unit, and perioperative settings. Rapid and sensitive hemostasis phenotyping is needed to guide administration of blood components and hemostatic adjuncts to reverse aberrant coagulofibrinolysis. Here, resonant acoustic rheometry (RAR), a technique that quantifies the viscoelastic properties of soft biomaterials, was applied to assess plasma coagulation in a cohort of bleeding patients with concomitant clinical coagulation assays and whole blood thromboelastography (TEG) as part of their routine care. RAR captured the dynamic characteristics of plasma coagulation that were coagulation activators-dependent. RAR coagulation parameters correlated with TEG reaction time and TEG functional fibrinogen, especially when stratified by comorbidities. A quadratic classifier trained on RAR parameters predicted transfusion of fresh frozen plasma and cryoprecipitate with high overall accuracy. These results demonstrate the potential of RAR as a bedside hemostasis assessment to guide transfusion in bleeding patients.

An audit to assess the clinical use of blood and blood components at a tertiary care hospital

An understanding of trends in blood and its product usage profile and current usage can help predict future trends in demand and help to put efforts to reduce use in particular areas. Present study aimed to assess the use of blood and blood components issued by blood bank and indication for selection of specific blood products. The present cross sectional observational time bound study was conducted at Father Muller Medical College & Hospital, which included all the patients to whom the whole or blood component are issued from blood between Jan 2016 to Jan 2020. All the units of blood and blood components issued to outside hospitals and institutions were excluded. A total of 20000 components were dispatched to 5002 patients request for the blood components from the blood bank, 2968 were males and 2032 were female patients (male to female ratio of 1.46:1). Highest request for blood components for transfusion was received from Medicine department and allied with 6063 units, followed with various Intensive care units (4477 units), oncology department (5729 units), OBG (1841 units), orthopaedics (1248 units) and surgery (453 units). The most common diagnosis for patients requiring blood components was haematological causes or Bleeding followed by elective surgery. Auditing the use of blood, its components and indications for their use by the various departments of the hospital has helped to finding the trend of number of blood.

Quality Improvement Assessment of Massive Transfusion Protocol (MTP) Utilization and Blood Component Return to Blood Bank in a Level 1 Trauma Center

Abstract Introduction/Objective The goal of MTP in management of patients with hemorrhage is to restore coagulation factors, oxygen carrying capacity, and platelets by transfusing equal amount of plasma, RBC, and platelets. Upon activation of MTP, blood components are released in rounds until deactivation. This quality improvement study was initiated to assess blood products transfused versus returned during MTP activation at our Level1 Trauma Medical Center. Methods/Case Report Upon MTP activation, the Blood Bank (BB) prepares first round of cooler with components at 5:5:1 ratio of plasma, RBC, apheresis platelets. We reviewed retrospective MTP data of eleven-month, from 10/2022- 08/2023. We analyzed patterns of blood component usage by service line, number of MTP rounds issued, and number of units transfused versus returned. Results (if a Case Study enter NA) MTP data was reviewed for 195 patients. MTP activation by service line included emergency department 58.5%, medical ICU (MICU) 14.4%, and surgical ICU (SICU) 11.8%. In many MTP activations, only one round of components was released. Overall, an average of 1.5 rounds were issued. Data of units transfused and returned by component type showed more RBC (43.1%) units were transfused than plasma (39.4%) suggesting MTP transfusion did not follow 1:1:1 ratio. Out of all issued blood units 58% were returned. The high fraction of returned blood components suggests MTP activation may not always truly indicate massive hemorrhage. This finding, and the notable frequency of MTP activation for MICU and SICU patients suggests that individual component order on an emergency-release basis may have been the appropriate option. Conclusion In general, the data suggests implementation of a quality improvement initiative focused on increasing awareness of criteria for MTP activation, and training of staff surrounding MTP is essential. We recently implemented an electronic emergency transfusion order set that allows providers to order individual components for non-massively bleeding patients.

Transfusion reaction patterns by blood component

Abstract Introduction/Objective Blood transfusion is becoming safer by continuous improvement of donor screening, patient identification, blood management, and infectious disease screening. This study was conducted to examine the rate and characteristics of transfusion reactions in the setting of universal leukoreduction of cellular products as well as pathogen reduction and/or irradiation of apheresis platelets. Methods/Case Report Data from the blood bank database for a 5-year period from 1/1/2019 to 12/31/2023 was collected. Transfusion reaction data as reported to National Healthcare Safety Network (NHSN) was analyzed. Results (if a Case Study enter NA) A total of 134,552 transfusions and 491 transfusion reactions were reported over the study period, resulting in the overall transfusion reaction rate of 0.36%. Allergic reaction was the most common reaction (38%), followed by febrile non-hemolytic transfusion reaction (FNHTR, 30%), delayed serologic transfusion reaction (DSTR, 14%), transfusion-associated circulatory overload (TACO, 10%), and transfusion-associated dyspnea (TAD, 4%). Platelets had the highest rate of transfusion reaction at 0.61% (n=167 of 27,180), red blood cells (RBC) at 0.35% (n=289 of 82,963), plasma at 0.13% (n=24 of 19,114), and cryoprecipitate at 0.06% (n=3 of 5295). The most common reaction associated with platelet transfusion was allergic reaction (64%, n=107), while FNHTR was the most common reaction associated with RBC transfusion (37%, n=106). By severity, 9 (2%) reactions were life-threatening, 21 (4%) were severe, 374 (75%) were non-severe, and 87 (18%) were not determined. Of life-threatening reactions, allergic reactions were the most common (5 of 9), while TACO was the most common severe reaction (9 of 21). Platelets were the most commonly implicated component in life- threatening reactions (4 allergic and 2 TACO), and RBCs were more commonly implicated in severe reactions. Conclusion Platelet transfusions were associated with a higher rate of transfusion reactions and life-threatening allergic reactions compared to other blood components.

CaF2/TiO2 nanophotonic biosensor based on a one-dimensional photonic crystal for Chikungunya virus detection

An optical sensor based on a defective photonic crystal is proposed to identify the Chikungunya virus in blood components, including plasma, platelets, red blood cells (RBCs), and uric acid. Under healthy conditions, each blood component has a unique refractive index; this value is altered if the person is infected with the Chikungunya virus. The infected blood sample results in a deviation in the refractive index of the sample as compared to a normal sample due to the presence of the infection in the human blood. With the help of our suggested structure, this alteration can be detected, and the normal cell can be distinguished from the infected one. To simulate the results, the transfer matrix method (TMM) is applied. The sensitivity of the suggested structures loaded separately with the sample containing plasma, platelets, red blood cells, and uric acid is found to be 1411, 1352, 1335, and 795 nm/RIU, respectively. These results are enough to support our claim that the present design can be used as an ultra-sensitive nanophotonic biosensor for the detection of the Chikungunya virus.

Tracking Blood Product Wastage over a 6-year Period in Virginia Commonwealth University Medical Center

Abstract Introduction/Objective Blood transfusions are a necessary practice for hospital emergency and surgical department. In emergent situations, blood components are in unmonitored settings during transit of critically ill patients. Any unused blood products are returned to the blood banks outside of a controlled temperature environment and are no longer viable to use. This study seeks to collect the average amount of blood products wasted in the Emergency and Surgery Department at Virginia Commonwealth University’s (VCU) Main Hospital. In addition, the study intends to highlight the budget that is impacted by these wasted blood units. Methods/Case Report Emergency Stock Records of VCU’s Hospital Emergency Department, Operating Room, Children’s Hospital of Richmond’s (CHoR) Emergency Department, and the CHoR’s Operating Room were collected and accumulated by the Transfusion Service’s Quality Assurance Coordinator. VCU’s Main Hospital Emergency Department monitors blood unit viability with a sensitive temperature indicator on each unit of blood stored in unmonitored refrigerators. Blood units above 10 degrees Celsius trigger the indicator and are required to be discarded. Our study collected a tally of these discarded units due to a triggered temperature indicator from 2018 to 2023. Acquisition cost per blood unit was estimated to be approximately $250 and overhead cost per unit was estimated to be $760. Results (if a Case Study enter NA) From 2018 to 2023, VCU’s health system wasted an average of 89.16 blood units per year due to the triggered temperature indicators, with a total of 535 units wasted over six years. The average annual cost of the wasted units totaled $90,058.33 per year ($22,291.67 and $67,766.67 in acquisition and overhead costs, respectively); cumulative cost over the 6 years amounted to $540,350 ($133,750 and $406,600 in acquisition and overhead costs, respectively). Conclusion With a notable number of resources and funding lost in the process due to blood unit wastage, an administrative discussion should focus on the use of high-level remote- controlled automated refrigerators in lieu of manual temperature indicator to reduce the expenditure and wastage of blood products.

Low-dose carbon monoxide inhalation to increase total hemoglobin mass and endurance performance: scientific evidence and implications.

Recently, chronic intermittent inhalation of low-dose carbon monoxide (CO) has been postulated as a practice to increase total hemoglobin mass with potential beneficial effects on endurance performance. In this perspective article, we discuss the potential performance enhancing capabilities as well as the safety concerns, which include individual variability in CO response, and acute and chronic health effects. It is also important to note that according to the World-Anti-Doping-Agency (WADA), CO inhalation could fall under "M1. Manipulation of Blood and Blood Components" and therefore could be considered a prohibited method if used as a non-diagnostic tool.

Nanoplatelets modified with RVG for targeted delivery of miR-375 and temozolomide to enhance gliomas therapy

Gliomas are one of the most frequent primary brain tumors and pose a serious threat to people’s lives and health. Platelets, a crucial component of blood, have been applied as drug delivery carriers for disease diagnosis and treatment. In this study, we designed engineered nanoplatelets for targeted delivery of therapeutic miR-375 and temozolomide (TMZ, a first-line glioma treatment agent) to enhance glioma therapy. Nanoplatelets were prepared through mild ultrasound, TMZ and miR-375 were co-loaded through ultrasound and electrostatic interactions, respectively, to combine chemotherapy with gene therapy against glioma. To improve the blood brain barrier (BBB) crossing efficiency and glioma targeting ability, the nanoplatelets were modified with central nervous system-specific rabies viral glycoprotein peptide (RVG) through thiol-maleimide click reaction. The RVG modified nanoplatelets co-loaded TMZ and miR-375 (NR/TMZ/miR-375) not only inherited the good stability and remarkable biocompatibility of platelets, but also promoted the cellular uptake and penetration of glioma tissues, and effectively induced cell apoptosis to enhance the therapeutic effect of drugs. In vivo studies showed that NR/TMZ/miR-375 significantly increased the circulation time of TMZ, and exhibited superior combined antitumor effects. In summary, this multifunctional ‘natural’ nanodrug delivery system provides a potent, scalable, and safety approach for platelet-based combined cancer chemotherapy and gene therapy.

Death Due to Embolic Renal Cell Carcinoma

Abstract Introduction/Objective While most pulmonary embolisms are composed of blood clot resulting from venous stasis, tumor embolism is rarely encountered. We describe an autopsy patient with an unexpected renal cell carcinoma (RCC) who expired after a massive tumor embolism to the pulmonary artery. Methods/Case Report A 56-year-old male presented with complaints of shortness of breath and was found to have a large right-sided pulmonary embolism with an incidental finding of a 9.0 cm right kidney mass on imaging. He was subsequently admitted for further management consisting of thrombo-aspiration. The procedure was largely unsuccessful and the patient’s respiratory status continued to decline and he subsequently expired. On autopsy, a 9.3 x 6.2 x 6.0 cm, yellow-tan, well-defined mass was discovered primarily in the lower pole of the right kidney with invasion into the hilar structures. The mass grossly appeared to be invading into the renal vein. Two large yellow-tan emboli were found to be causing significant obstruction of the inferior vena cava at the level of the right renal vein and in the right pulmonary artery. Microscopic evaluation revealed the kidney tumor to be consistent with renal cell carcinoma morphologically and immunohistochemically. Interestingly, all emboli discovered at autopsy are primarily composed of sheets of cells identical to the patient’s renal mass. It is therefore concluded that the patient’s kidney cancer invaded into the renal vein and embolized to the pulmonary artery, ultimately resulting in death. Results (if a Case Study enter NA) NA Conclusion Tumor embolism is a rare cause of death. Renal cell carcinoma is a relatively common neoplasm that has been described to present as a tumor thrombus in 13.3% of patients. Of these patients with RCC tumor thrombus, 1% embolize to the right atrium. Our case represents this rare phenomenon and demonstrates why it is crucial to confirm the contents of a pulmonary embolism, as not all are composed of blood components alone.

Role of Modified Blood Components in Patient with History of Allergic Reactions Undergoing Liver Transplantation

Role of Modified Blood Components in Patient with History of Allergic Reactions Undergoing Liver Transplantation

Pyridine functionalized nickel(II) N–heterocyclic carbene complexes as highly sensitive molecular sensors for the electrochemical sensing of date rape drugs

Molecular electrocatalysts featuring a nickel atom within a tailored N–heterocyclic carbene ligand environment are valuable for various electrocatalytic applications. This study presents the synthesis and characterisation of nickel organometallic electrocatalysts based on 1,2,4–triazol–5–ylidene with different steric profiles for the sensitive detection of date rape drugs (DRDs). Bis– N–heterocyclic carbene coordinated nickel(II) complexes were compared, and square wave voltammetry (SWV) showed that these catalysts detected xylazine in the concentration range of 1–100 µM with a limit of detection (LOD) of 0.621 nM. The developed electrocatalyst was also utilized for detecting scopolamine over a concentration range of 1–150 µM, with a LOD of 1.40 nM, as well as γ–butyrolactone in the range of 1–100 µM, with a LOD of 0.638 nM. The selectivity for these DRDs was analysed in the presence of other blood and urine components. The electrodes remained stable over 30 days with minimal performance variation, demonstrating the potential of these electrocatalysts for developing reliable on–site molecular sensors for DRD detection.

Multidisciplinary care to optimise pregnancy outcomes among Jehovah’s Witness: Case series over fifteen years in a tertiary teaching hospital

ObjectiveTo assess the obstetric and neonatal outcomes of Jehovah’s Witness (JW) mothers and the willingness to accept blood products after multidisciplinary management. Study DesignA retrospective case-control study was conducted at Queen Mary Hospital from 2005 to 2020. Delivery records of pregnant women who identified themselves as JW were reviewed. The immediate next age-matched non-JW patient in the booking register was assigned as control. ResultsA total of 96 subjects were identified within the study period (48 JW and 48 non-JW age-matched patients). The haemoglobin levels of JW and non-JW were similar at booking, 28 weeks of gestation, pre-delivery and postnatal day 2. JW mothers were more likely to receive iron supplements in the antenatal period than the control group (27.1 % vs. 6.3 %, p = 0.01) despite the similar rate of antenatal anemia in both groups (4.2 % vs. 4.2 %, p = 1.00). There were no differences in mode of delivery, total blood loss at delivery, rate of primary postpartum haemorrhage, gestational age at delivery, birth weight, and Apgar score at 1 and 5 min between JW and non-JW. There were no maternal deaths, hysterectomy or admissions to the adult intensive care unit in either group. Six JW women accepted packed cell transfusion at the initial consultation and did not receive multidisciplinary care. The remaining 42 JW women had consultant obstetric and anesthesiologist review before delivery. After multidisciplinary consultation, two (4.8 %, 2/42) accepted blood transmission and 11 (26.2 %, 11/42) accepted some components of blood. The remaining 29 (69 %, 29/42) women refused all blood products. ConclusionJW patients who received multidisciplinary care achieved comparable pregnancy and neonatal outcomes to the normal population. Antenatal iron supplement was more common among pregnant JW despite the similar rate of antenatal anemia compared with the non-JW women. 12.5% of JW women agreed packed cell transfusion at the initial consultation and a further 27.1% of JW women agreed to some forms of blood products after multidisciplinary counseling.

MODERN PARAMETERS OF LABORATORY EXPRESS DIAGNOSTICS IN INTENSIVE NEUROLOGY AND NEUROSURGICAL PRACTICE IN PATIENTS WITH CRANIOCEREBRAL INJURIES

The parameters listed in the article show the huge path that laboratory express diagnosis of emergency conditions in neurology has taken over the past 50 years. And this is not the limit - new unique technologies appear. The range of measured and calculated parameters continues to expand, which makes it possible to more fully and adequately assess the condition of a critically ill patient. Thus, a timely and qualitative study of the gaseous composition of blood is important for carrying out differential diagnosis, prescribing adequate treatment and monitoring the therapy effectiveness. The aim of the study was to highlight the current parameters of laboratory rapid diagnostics in intensive neurology and neurosurgical practice in patients with traumatic brain injury. There are two situations that necessitate the development of rapid methods for monitoring hemostasis in the neurological intensive care unit and neurosurgical operating room: the need to immediately determine the concentration or biological effect of anticoagulants. Some areas of surgical intervention are associated with increased blood loss due to coagulopathy, which requires timely replacement therapy. A long process of determining hemostatic parameters by routine methods in a general laboratory leads to a delay in diagnosis and, as a result, untimely treatment. Quite a few express methods designed to obtain specific information about the hemostasis process are currently available in the operating room. If these monitoring methods are used correctly, the research results are reliable, so some researchers use them to develop algorithms for determining the need for transfusion of blood components. However, the development of new monitoring methods requires close collaboration with scientists specialized in hemostasis, plus quality control must be established. It is necessary to prove the positive effect of rapid diagnostic methods on the result to ensure the possibility of their wide application in various operations.

Impact of Intraoperative Blood Transfusion on Cerebral Injury in Pediatric Patients Undergoing Congenital Septal Heart Defect Surgery

Background: The components of donor blood themselves have the potential to initiate a systemic inflammatory response and exacerbate neuroinflammation, resulting in subsequent cerebral injury. The aim of this study was to establish the role of transfusion in the development of cerebral injury during the correction of congenital heart defects in children. Material and Methods: A total of 78 patients aged from 1 to 78 months, with body weights ranging from 3.3 to 21.5 kg, were investigated. Biomarkers of cerebral injury and systemic inflammatory response were studied at three time points. First: prior to the surgical intervention. Second: after the completion of cardiopulmonary bypass. Third: 16 h after the conclusion of the surgery. Results: The strongest correlation was found for S-100-β protein with the volume of transfusion at the second (Rho = 0.48, p = 0.00065) and third time points (Rho = 0.36, p = 0.01330). Neuron-specific enolase demonstrated a similar trend: Rho = 0.41 and p = 0.00421 after the completion of cardiopulmonary bypass. Conclusions: The use of red blood cell suspension and its dosage per kilogram of body weight correlated with the biomarkers of cerebral injury and systemic inflammatory response with moderate to significant strength.

Construction and biocompatibility evaluation of CS-FA/VA composite coating on the surface of ZE21B vascular stent

Magnesium alloys have become the focus of attention as a new generation of vascular stent materials due to their excellent mechanical properties and degradability. However, their rapid degradation rate and poor surface endothelialization performance have become key factors limiting their clinical application. In this study, the Mg-Zn-Y-Nd (ZE21B) surface was modified with the magnesium fluoride (MgF2) corrosion-resistant layer, and the polydopamine (PDA) layer was used to immobilize the chitosan (CS)-ferulic acid (FA)/vanillic acid (VA) bioactive composite coating. The results of the electrochemical and hydrogen evolution experiments showed that the corrosion current density and hydrogen release of the modified ZE21B alloy significantly decreased, and its corrosion resistance was enhanced; the results of the hemolysis rate and whole blood experiments showed that the adhesion of blood components such as white blood cells and platelets on the surface of the modified ZE21B alloy significantly decreased, improving the blood compatibility of the magnesium alloy; the results of in vitro cell experiments showed that the modified ZE21B alloy effectively promoted endothelial cell (ECs) adhesion and proliferation, and inhibited smooth muscle cell (SMCs) pathological proliferation. These enhancements suggest that the CS-FA/VA coating significantly improves both the corrosion resistance and biological compatibility of the ZE21B alloy.

Yiqi Yangxue formula inhibits cartilage degeneration in knee osteoarthritis by regulating LncRNA-UFC1/miR-34a/MMP-13 axis

Ethnopharmacological relevanceKnee osteoarthritis (KOA) is a prevalent and disabling clinical condition affecting joint structures worldwide. The Yiqi Yangxue formula (YQYXF) is frequently prescribed in clinical settings for the treatment of KOA. Existing research has primarily focused on alterations in drug metabolism, with limited investigation into the epigenetic effects of YQYXF, particularly in relation to non-coding RNA. Aim of the studyExploring the effects of YQYXF on critical factors of long chain non-coding RNA UFC1/miR-34a/matrix metalloproteinase-13 (MMP-13) axis and their interrelationships. MethodsUHPLC-QE-MS technology was used to identify the YQYXF ingredients in rat serum. KEGG and GO analysis were performed on the targets of blood components acting on KOA using a database. Simultaneously, a protein interaction network was constructed using target proteins and metabolites to identify the core components and key pathways of YQYXF. The KOA rat model was established using an improved Hulth method. SPF SD rats were randomly divided into normal group, sham surgery group, model group, celecoxib capsules group (18 mg/kg), YQYXF low, medium and high dose groups (4.6 g/kg, 9.2 g/kg, 18.4 g/kg). Observe the synovial and cartilage tissues of rats using pathological methods. RT-PCR was used to detect the levels of UFC1, miR-34a, and MMP-13 in cartilage. Immunohistochemistry was used to detect the levels of MMP-13 and ADAMTS-5 in cartilage. ELISA method was used to detect the levels of MMP-13 and ADAMTS-5 in serum. In addition, we further validated the regulation of crucial factor expression levels of UFC1/miR-34a/MMP-13 axis in rat chondrocytes and degenerative chondrocytes of KOA patients by YQYXF, providing a basis for its treatment of KOA. ResultsThe compounds that YQYXF enters the bloodstream mainly contain flavonoids and phenylpropanoid compounds. The core components that act on OA include quercetin, fisetin, and demethylweldelolactone. The main target pathways are the IL-17 signaling pathway, lipid and atherosclerosis, cellular sensitivity, inflammatory mediator regulation of TRP channels, TNF signaling pathway, relaxin signaling pathway and C-type lectin receptor signaling pathway. YQYXF inhibited the expression of miR-34a and MMP-13 mRNA, and reduced the protein levels of MMP-13 and ADAMTS-5. In vitro studies have confirmed that 20% YQYXF serum promoted UFC1 and reduce miR-34a levels. In addition, miR-34a in sh-UFC1+10% YQYXF serum and sh-UFC1+20% YQYXF serum groups significantly decreased compared to the sh-UFC1 group. ConclusionThe anti-KOA cartilage degeneration effect of YQYXF might be related to inhibiting cell apoptosis and promoting cell proliferation, which regulated the lncRNA-UFC1/miR-34a/MMP-13 axis.

Perioperative selection of blood and components for substitution: Immunohaematological assessment of immunization risk and methods for selection of optimally compatible blood

The aim of this study is to assess the risk for immune and hematologic adverse events in perioperative transfusion of blood components. Our second goal is to propose methods for the selection of an optimally compatible donor in order to limit the negative impact of complications following blood component transfusion on the hospital outcome of patients admitted to clinics of general, gastrointestinal, thoracic, and vascular surgery. The largest group of patients included in this study were patients with gastrointestinal disorders (614 patients; 31%) and patients with diseases of the organs of the blood and lymphatic system (589 patients; 30%). This was followed by patients with diseases of the skin and subcutaneous tissue (368 patients; 18%) and patients with benign and malignant neoplasms (365 patients; 18%). The remaining 65 patients (3%) were diagnosed with diseases of the endocrine system, trauma patients, and patients with genitourinary disorders. The methods used for optimal selection of compatible blood components in this study are enzyme tests, Coombs tests, and tests in agglutinating medium. The study shows that clinically significant antibodies, which could provoke a post-transfusion hemolytic reaction, were detected in 4.3% of the screened patients. In the majority of patients, the specificity of antierythrocyte antibodies cannot be established. For those patients where the specificity of anti-erythrocyte antibodies could be established, the type of antibody and the antigen system to which it belonged were as follows (in descending order): 1. Anti-erythrocyte antibodies belonging to the Rh system: 37% (n = 17) of all screened patients (1.6% of all patients), including anti-E type (5 patients), anti-D (8 patients), anti-C-1, anti-C (2 patients), and anti-Cw (1 patient). 2. In 3 (6% or anti-erythrocyte antibodies belonging to other erythrocyte antigen systems—Kidd-1 patients, Lewis-2 patients—6% of the screened patients (0.3% of all patients). 3. In 57% (n = 26) of those screened (2.4% of all patients), alloantibodies without any known specificity were identified. The largest number of identified antibodies were directed against the D antigen belonging to the Rh system. Most of the anti-D alloantibodies found in Rhesus D (-) negative patients with no history of prior transfusion of D (+) positive red blood cell (RBC) concentrate possibly have resulted from prior Rh isoimmunization during pregnancy, provided that anti-D antibodies persist for a long time after birth—in some of the studied patients, 15–20 or more years. A greater number of alloimmunizations were found in women—28 (61%), compared to men—18 (39%), due to previous sensitization with different blood group antigens during pregnancy. This study shows that timely diagnosis is essential for the selection of appropriate RBC concentrate, for the avoidance of adverse reactions, and for the improvement of hematological parameters after transfusion of blood components. Graphical abstract:

Associations of age and sex with characteristics of extracellular vesicles and protein-enriched fractions of blood plasma.

Extracellular vesicles (EVs) are nanosized particles that are released by various cell types and play vital roles in intercellular communication. They carry biological molecules reflecting the physiological and pathological states of their source cells and tissues, showing potential as biomarkers. However, the impact of demographic factors like age and sex on the properties of blood plasma EVs remains underexplored. This study aims to fill this gap by evaluating how these factors influence the particle count and proteomic profiles of plasma EV preparations and corresponding protein fractions. Plasma samples from 120 healthy volunteers were collected and pooled into six groups: young males (age: 27.6 ± 4.0), young females (27.4 ± 3.8), middle-aged males (48.8 ± 3.8), middle-aged females (48.9 ± 3.9), old males (69.3 ± 3.9), and old females (69.4 ± 4.3). EV- and protein-enriched fractions were separated by size-exclusion chromatography (SEC). Fractions were characterized for particle number concentration and protein composition to identify characteristics affected by age and biological sex. Plasma EVs and corresponding protein fractions exhibited distinct characteristics, with differential enrichment of markers related to EVs and other blood components, including lipoproteins. Proteomic profiles of both EVs and protein fractions displayed sex- and age-dependent differences. Differentially abundant proteins displayed functions previously identified in the context of aging and sex differences, highlighting their utility as biomarkers. Age and sex significantly affect the characteristics of plasma EVs and proteins, potentially influencing their efficacy and interpretation as biomarkers in clinical applications. This study lays the groundwork for detailed mechanistic research to understand how EVs mediate age- and sex-related effects in health.