Hemoglobin Concentration In Peripheral Blood Research Articles

Incidence of postpartum hemorrhage based on the improved combined method in evaluating blood loss: A retrospective cohort study.

In view of the current clinical inaccuracies and underestimations of postpartum hemorrhage amount, this study aims to investigate the incidence, etiology, clinical characteristics of postpartum hemorrhage in different modes of delivery based on the combination of volumetric method, gravimetric method and area method in evaluating blood loss. This retrospective cohort study was conducted in Hangzhou Women's Hospital from January 2020 to June 2021, including 725 cases of postpartum hemorrhage among 18,977 parturients. Based on different modes of delivery, the participants were divided into three groups: vaginal delivery, forceps delivery, and cesarean section, for comparison. Using an improved combined assessment method for blood loss, we retrospectively analyzed a cohort of parturients with postpartum hemorrhage who underwent vaginal delivery, forceps delivery, or cesarean section and were hospitalized in Hangzhou Women's Hospital from January 2020 to June 2021. (1) Among the 18,977 parturients, 725 cases of postpartum hemorrhage occurred, with an incidence rate of 3.8%, and severe postpartum hemorrhage accounted for 0.4% of the cases. (2) The incidence of postpartum hemorrhage was significantly higher in the forceps delivery group than in the vaginal delivery group (χ2 = 19.27, P<0.001), while the incidence of severe postpartum hemorrhage was significantly higher in the cesarean section group than in the vaginal delivery group (χ2 = 8.71, P = 0.003). (3) The causes of postpartum hemorrhage were statistically different among the different delivery modes, with varying underlying factors (P<0.001). (4) Patients with postpartum hemorrhage in different delivery modes showed statistically significant differences in age, body mass index (BMI), birth weight, gestational age, gravidity, parity, the decline of postpartum peripheral blood hemoglobin concentration, and estimated blood loss (P<0.05). (5) The proportion of blood transfusion was significantly higher in the cesarean section group than in the vaginal delivery and forceps delivery groups (χ2 = 231.03, P<0.001). This study is a single-center retrospective study, which may have led to selection bias in case selection. Additionally, the implementation of the combined three blood loss assessment methods may not have been strictly followed in all cases. Moreover, due to the mixing of bleeding with amniotic and irrigation fluids, the accuracy of evaluation may have been affected, leading to the possibility of inaccuracy of blood loss. Forceps delivery and cesarean section increase the risk of postpartum hemorrhage, but forceps delivery does not significantly increase the incidence of severe postpartum hemorrhage. Uterine atony remains the leading cause of postpartum hemorrhage, while birth canal laceration and placental factors are the second most common causes of postpartum hemorrhage in forceps delivery and cesarean section, respectively. In this study, the volumetric method, gravimetric method and area method were combined to quantitatively assess postpartum hemorrhage amount. The combined method has strong clinical practicability and is less affected by subjective factors, although it also has limitations. In the future, we still need to focus on the early prediction and identification of postpartum hemorrhage, and further improve the quantitative assessment of postpartum blood loss.

Relation of ASXL2 Gene Mutation with Clinical Characteristics, Prognosis and C-KIT Gene Mutation in AML Patients with AML1- ETO Fusion Gene

To analyze relation of ASXL2 gene mutation with the clinical characteristics, prognosis and C-KIT gene mutation in acute myeloid leukemia (AML) patients with AML1-ETO fusion gene. The clinical data of 63 primary AML patients with AML1-ETO fusion gene were collected and retrospectively analyzed. The mutation of ASXL2 gene was directly sequenced by PCR. The clinical characteristics, C-KIT mutation rate and prognosis were compared between the patients with ASXL2 gene mutation (group A) and non-mutation (group B). Among 63 patients, 8 (12.70%) cases of ASXL2 mutation gene was detected. Hemoglobin level in peripheral blood of patients in group A was significantly lower than that in group B (P＜0.01). There was no significant difference in sex, ages proportion of bone marrow blasts, lymph node enlargement, peripheral blood leukocytes count and platelets between the two groups (P＞0.05). The infiltration of central nervous system, liver and spleen was not found in both groups. The expression of CD33 in group A was significantly lower than that in group B (P＜0.05), but the results of other immunophenotype analysis were not significantly different between the two groups (P＞0.05). The remission rate and median survival time were not significantly different between two groups (P＞0.05). The detection rate of C-KIT gene mutation were not significantly different between group A and group B (P＞0.05). Among AML patients with AML1-ETO fusion gene, ASXL2 gene mutation accounts for a certain ratio, and the peripheral blood hemoglobin concentration and CD33 expression in these patients are often low. At the same time, ASXL2 gene mutation may not be closely related with C-KIT gene mutation.

Relation of ASXL2 Gene Mutation with Clinical Characteristics, Prognosis and C-KIT Gene Mutation in AML Patients with AML1- ETO Fusion Gene

To analyze relation of ASXL2 gene mutation with the clinical characteristics, prognosis and C-KIT gene mutation in acute myeloid leukemia (AML) patients with AML1-ETO fusion gene. The clinical data of 63 primary AML patients with AML1-ETO fusion gene were collected and retrospectively analyzed. The mutation of ASXL2 gene was directly sequenced by PCR. The clinical characteristics, C-KIT mutation rate and prognosis were compared between the patients with ASXL2 gene mutation (group A) and non-mutation (group B). Among 63 patients, 8 (12.70%) cases of ASXL2 mutation gene was detected. Hemoglobin level in peripheral blood of patients in group A was significantly lower than that in group B (P＜0.01). There was no significant difference in sex, ages proportion of bone marrow blasts, lymph node enlargement, peripheral blood leukocytes count and platelets between the two groups (P＞0.05). The infiltration of central nervous system, liver and spleen was not found in both groups. The expression of CD33 in group A was significantly lower than that in group B (P＜0.05), but the results of other immunophenotype analysis were not significantly different between the two groups (P＞0.05). The remission rate and median survival time were not significantly different between two groups (P＞0.05). The detection rate of C-KIT gene mutation were not significantly different between group A and group B (P＞0.05). Among AML patients with AML1-ETO fusion gene, ASXL2 gene mutation accounts for a certain ratio, and the peripheral blood hemoglobin concentration and CD33 expression in these patients are often low. At the same time, ASXL2 gene mutation may not be closely related with C-KIT gene mutation.

The effects of co-transplantation of bone marrow hematopoietic stem cell and thymic multipotent stromal cells on the immune system of mice during its regeneration after cyclophosphamide treatment

The multipotent stromal cells (MSCs) are considered as one of the most promising agents for regenerating the immune system due to its powerful secretion of reparative factors and immunomodulatory properties.The purpose of the study is to investigate the effect of co-transplantation of bone marrow hematopoietic stem cells (HSCs) and thymic multipotent stromal cells (MSCs) on regeneration of murine immune system damaged by cyclophosphamide.Materials and methods. MSCs were obtained from thymuses of C57BL mice using explant technique. Bone marrow cells (BMCs) were obtained by flushing out the femur with nutrient medium. The immune deficiency of mice was modelled by the treatment with cyclophosphamide. After that, the cells were co-transplanted and the parameters of the immune system was evaluated. We determined the total number of erythrocytes, hematocrit, and hemoglobin concentration in peripheral blood; phases of the cell cycle and apoptosis of the cells of the mesenteric lymph nodes; the number of antibody-producing cells in the spleen; delayed type hypersensitivity (DTH); proliferative and cytotoxic activity of natural killer lymphocytes; phagocytic activity, level of spontaneous and induced bactericidal activity of peritoneal macrophages.Results. It was shown that in contrast to BMCs, the use of MSCs alone or co-transplantation of these cells increased the spontaneous proliferative activity of lymphocytes with a significant decrease in the number of lymph node cells in G0/G1 phase by 9.2 % and an increase in the number of lymphocytes in G2-M+S phase by 35 %, as well as restoring cellularity of bone marrow, thymus and lymph nodes in mice treated with cyclophosphamide. Regeneration of erythropoiesis was stimulated by BMCs, which was manifested by the normalization of hematocrit and hemoglobin, and an increase in the number of reticulocytes in the blood by 2.2 times compared with the group of mice receiving cyclophosphamide. Co-transplantation had less pronounced, but similar effect. Transplantation of thymic MSCs stimulated the natural cytotoxicity of splenocytes by 2.7 times and substantially increased the number of antibody-producing cells in the spleen by 1.7 times compared with the group of mice receiving cyclophosphamide. Co-transplantation had a pronounced suppressive effect on the blast transformation reaction induced by phytohemagglutinin by 1.7 times, but showed a stimulating effect on DTH response by 1.46 times. Transplantation of BMCs did not affect the functional activity of the immune system.Conclusion. The effects of co-transplantation of BMCs and thymic MSCs are realized in the several parts: stimulation of hematological parameters recovery (like under the effect of BMCs separately), normalization of cell number of lymphoid organs (as under the impact of thymic MSCs); inhibition of blast transformation activity and stimulation of DTH are the effects of co-transplantation.

The influence of sex and age upon response of white rats to hypoxic hypoxia

Periodic 3-hour daily exposition of white rats to hypoxic hypoxia (standard altitude 8250 m) for 10 days have revealed males and females of both very young and extremely old age groups (“young” - 0,5 months old and “old” - 26 months old) to be more sensitive to chronic hypoxic hypoxia than mature middle-aged animals (“mature” - 3 months old). Their increased sensitivity was apparent in body mass dynamic changes, oxygen consumption, peripheral blood hemoglobin concentration, and red blood cells’ count and peroxidase activity. Parallel to these parameters hypophysis-adrenal system functional activity was assessed according to blood eosynophils’ amount, ascorbic acid adrenals’ concentration, hypophysis and adrenals relative masses changes and “resistance index”. Both male and female rats of “young” and “old” age groups demonstrated variability of different parameters however those characteristic of hypophysis-adrenals system functional activity were practically always involved. Granted non-specific universal adaptation reactions like general adaptation syndrome are of special importance during exposure to any chronic influence, the “young” and “old” animals demonstrated insufficient capacity of hypophysis-adrenals system. However “old” female rats were much more resistant to chronic hypoxic impact revealing the lowest level of hypophysis-adrenals system functional activity.

Are haematocrit and haemoglobin concentration reliable indicators of body condition in adult Welcome Swallows?

Parent birds often have substantial fat reserves that are critical in successful breeding. Erythrocyte variables, particularly haematocrit and haemoglobin concentration in peripheral blood, are increasingly being used as avian body-condition indices (BCIs) but problems can arise if such variables are used and interpreted uncritically. We investigated whether there were significant relationships between three size-adjusted BCIs thought to reflect the magnitude of fuel reserves, and four erythrocyte variables in free-living, adult Welcome Swallows (Hirundo neoxena) in south-eastern Australia over two breeding seasons. Haematocrit was not correlated with body-mass and condition. Whole-blood haemoglobin concentration, mean cell haemoglobin concentration and haematocrit-haemoglobin residuals were significantly related to body-mass and all the BCIs but the correlations were modest and negative (r ≤—0.39). Thus none of the erythrocyte variables was convincing as a reliable indicator of estimated fuel reserves in breeding adults. Currently the utility of haematocrit and haemoglobin concentration as reliable BCIs in adult birds cannot be assumed and needs to be validated for each population or species being investigated.

Improving pre-operative bowel preparation in colorectal cancer patients

Objective To study the feasibility of improving pre-operative bowel preparation in colorectal cancer patients. Methods Sixty cases were randomly divided into two groups with thirty cases in each group. The experimental group was performed oral magnesium sulfate combination with glucose normal saline the day before surgery while the control group was conducted the ordinary pre-operative bowel preparation.All of the cases were tested for peripheral blood hemoglobin concentration, hematocrit and part of the serum ion levels before and after bowel preparation. Weight was measured and intestinal flora was analyzed before and after surgery preparation. The number of diarrhea was counted in the process of bowel preparation and intestinal cleanliness was observed during operation. Patients' general condition and complications were observed before and after surgery. Results Compared with the control group, the experimental group outperformed in terms of bowel preparation tolerance and the number of preoperative diarrhea(P＜0.05). Blood tests indicated that there was no significant difference in intestinal cleanliness between the two groups (P＞0.05). The incidence of postoperative complications in the control group was higher than that in the experimental group, which, however,was not significant (P＞0.05). In the experimental group, no significant change of intestinal flora was observed, whereas intestinal flora changed significantly in the control group. Conclusions The revised bowel preparation for colorectal cancer patients is simple. It can shorten the process of bowel preparation, increase patients' tolerance, and prevent postoperative flora disorder. Key words: Colorectal cancer; Surgery; Bowel preparation; Magnesium sulfate

Association of G6PD −202/−376 with Lower Hemoglobin Concentration but Not Increased Hemolysis in Patients with Sickle Cell Anemia.

Abstract 1511Poster Board I-534 BackgroundWhat determines the degree of hemolysis and of anemia in patients with hemoglobin SS is not fully known. The rate of hemolysis and severity of anemia are ameliorated by the presence of alpha thalassemia and by higher hemoglobin F percentage. Mild G6PD deficiency in the form of G6PD-202/-376 may be associated with episodic hemolysis in individuals of African descent, but past studies indicated little influence of G6PD-202/-376 on the degree of hemolysis and anemia in sickle cell disease patients (1,2). In this study we examined the roles of single and double α-globin deletions and G6PD-202/-376 on the degree of hemolysis and the hemoglobin concentration in hemoglobin SS patients. MethodsTwo hundred sixty two children and adolescents with hemoglobin SS were recruited at three tertiary medical centers and studied at steady state. Principal component analysis was used to develop a hemolytic component from concentrations of lactate dehydrogenase, aspartate aminotransferase and bilirubin. PCR was used to determine the presence of α-thalassemia and G6PD-202/-376. Multivariate models were employed to determine the independent effects of these genotypes on hemoglobin concentration and degree of hemolysis. ResultsSingle a-globin deletion was associated with an estimated 0.4 g/dL increase in steady-state hemoglobin concentration and double α-globin gene deletion with a 0.8 g/dL increase (P = 0.005 for trend) due to, progressively lower degrees of hemolysis (P = 0.004). G6PD-202/-376 was associated with an estimated 0.7 g/dL decrease in the hemoglobin concentration (P = 0.003) (Figure 1a), but this observation could not be explained by increased hemolysis. Rather, the reticulocyte count was an estimated 22% lower with G6PD-202/-376 (P = 0.032) (Figure 1b). DiscussionG6PD-202/-376 may be associated with lower hemoglobin concentration in sickle cell anemia and the mechanism is probably impaired erythropoiesis rather than hemolysis. A recent study (3) indicates that G6PD is needed for definitive erythropoiesis as well as for normal survival of red blood cells in the periphery. Our present findings raise the possibility that, in the setting of the markedly increased erythropoiesis of sickle cell anemia, G6PD-202/-376 may result in impairment in erythropoiesis that is discernible in the peripheral blood hemoglobin concentration. [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

Hypoxia-induced megaloblastosis in vitamin B12-deficient rats.

In rats, in contrast with human subjects who develop megaloblastic anaemia due to vitamin B12 deficiency, haematological abnormalities with anaemia were not observed under normoxic conditions even though plasma vitamin B12 concentration was reduced to <15 % of a normal concentration by depleting dietary vitamin B12. To elucidate whether erythropoiesis was affected by vitamin B12 deficiency in rats, these vitamin B12-deficient rats were exposed to hypoxia (10.5 % O2) to stimulate erythropoiesis. In the vitamin B12-sufficient control rats, erythrocyte count was significantly (P<0.05) increased 1 week after starting the hypoxic exposure. However, the hypoxia-induced erythropoiesis was affected by vitamin B12 deficiency, and no significant increase in the erythrocyte count was observed even after 6-week exposure to hypoxia in the vitamin B12-deficient rats. In the vitamin B12-deficient rats in hypoxia, erythrocytes became abnormally enlarged, and haemoglobin concentration in peripheral blood was increased in proportion to the increase of mean corpuscular volume. However, the level of the increase in the haemoglobin concentration was significantly (P<0.05) lower in the vitamin B12-deficient rats compared with that in the -sufficient controls. In addition, in the vitamin B12-deficient rats, in contrast to the -sufficient rats, serum erythropoietin concentration was not normalized even after 6-week exposure to hypoxia. These results indicate that a megaloblastic anaemia-like symptom is induced when the vitamin B12-deficient rats are exposed to hypoxia.

Megaloblastic anaemia in vitamin B12 deficiency.

In rats, in contrast with human subjects who develop megaloblastic anaemia due to vitamin B 12 deficiency, haematological abnormalities with anaemia were not observed under normoxic conditions even though plasma vitamin B 12 concentration was reduced to < 15 % of a normal concentration by depleting dietary vitamin B 12 . To elucidate whether erythropoiesis was affected by vitamin B 12 deficiency in rats, these vitamin B 12 -deficient rats were exposed to hypoxia (10.5% O 2 ) to stimulate erythropoiesis. In the vitamin B 12 -sufficient control rats, erythrocyte count was significantly (P<0.05) increased 1 week after starting the hypoxic exposure. However, the hypoxia-induced erythropoiesis was affected by vitamin B 12 deficiency, and no significant increase in the erythrocyte count was observed even after 6-week exposure to hypoxia in the vitamin B 12 -deficient rats. In the vitamin B 12 -deficient rats in hypoxia, erythrocytes became abnormally enlarged, and haemoglobin concentration in peripheral blood was increased in proportion to the increase of mean corpuscular volume. However, the level of the increase in the haemoglobin concentration was significantly (P<0.05) lower in the vitamin B 12 -deficient rats compared with that in the -sufficient controls. In addition, in the vitamin B 12 -deficient rats, in contrast to the -sufficient rats, serum erythropoietin concentration was not normalized even after 6-week exposure to hypoxia. These results indicate that a megaloblastic anaemia-like symptom is induced when the vitamin B 12 -deficient rats are exposed to hypoxia.

A CASE OF LEIOMYOSARCOMA OF THE ASCENDING COLON PRESENTING WITH ANEMIA

A 67-year-old man was admitted to the hospital because of anxiety of the breast lasting for one week and was anemia which was pointed out at another hospital. No tumor nor superificial lymph node was palpated, and hemoglobin concentration in peripheral blood was 7.3 g/dl. Stool was positive for occult blood. Abdominal ultrasonography revealed a stone in the gallbladder. Abdominal CT visualized a deviated tumor 5 cm in diameter in the ascending colon, and a submucosal tumor was suspected. Barium enema study revealed a demarcated tumor shadow about 5 cm in diameter in the ascending colon, and colonoscopy showed a hemispherical elevated lesion 5 cm in diameter with shallow and irregular ulcer. Biopsy of the lesion showed Group 1. From these findings, a malignant submucosal tumor of the ascending colon was suspected. A right hemicolectomy with lymph node dissection (D-2) was performed. Microscopically, the tumor was leiomyosarcoma arising the proper muscule, and eight mitoses were seen per 10 high power fields, indicating high malignancy. A case of leiomyosarcoma of the ascending colon was reported, together with a review of the literature.

Oxygen tension and vascular density in human cervix carcinoma.

Hypoxia-induced radiation resistance has been proposed to be a consequence of low vascular density in tumours. The purpose of the study reported here was to investigate possible relationships between pretreatment oxygen tension (pO2) and vascular density in patients with cervix carcinoma. Tumour pO2 was measured by the use of polarographic needle electrodes. Biopsies were taken from the electrode tracks and vascular density and tissue composition, i.e. volume fraction of carcinoma tissue, stroma and necrosis, were determined by stereological analysis. The vascular density of individual biopsies was related to the median pO2 of the corresponding electrode track. Tumour regions with vascular density below 24 mm mm(-3) always showed low pO2, whereas tumour areas with vascular density above 24 mm mm(-3) could show a high or a low pO2. This indicates the existence of a threshold value of about 24 mm mm(-3) for vascular density in cervix carcinoma; a vascular density above this value is probably needed before high pO2 can occur. Low vascular density might, therefore, be a useful predictor of hypoxia-induced radiation resistance in cervix carcinoma. High vascular density, on the other hand, can probably not be used to exclude radiation resistance. The differences in pO2 among tumour regions with high vascular density were not a consequence of differences in the amount of necrosis or stroma or in the haemoglobin concentration in peripheral blood of the patients. Model calculations indicated that these differences in pO2 could be explained by differences in the oxygen delivery alone and by differences in the oxygen consumption rate alone.

Correlation of splenic function with the splenic uptake rate of Tc-colloids

The splenic uptake rate of Tc-sulphur colloid or Tc-tin colloid was measured and found to correlate well with splenic function. The normal tracer uptake rate was 0.0002/s-0.0006/s (measured uptake rate divided by measured injected activity). Lower values indicated hyposplenism (sensitivity = 0.97, specificity = 0.95), and values over 0.0006/s indicated hypersplenism (sensitivity = 0.96, specificity = 0.97). Higher values of splenic uptake were associated with proportional reductions in the white blood cell and platelet counts, and to a lesser extent the haemoglobin concentration in peripheral blood. Patients with rheumatoid arthritis had increased tracer uptake, but still below the criteria for hypersplenism, whereas patients with Felty's syndrome had tracer uptake rates in the 'hypersplenic' range.

Magnetic Resonance Imaging of the Bone Marrow following Treatment with Recombinant Human Erythropoietin in Patients with End-Stage Renal Disease

We used magnetic resonance imaging (MRI) to study vertebral bone marrow in hemodialysis patients during treatment with recombinant human erythropoietin (rHuEPO). We found changes in T1 relaxation times and image contrast within 14 days after starting treatment, before any response was seen in the hemoglobin concentration in peripheral blood. The increase in T1 relaxation times, together with earlier reported changes observed with localized magnetic resonance spectroscopy, indicate an alteration in cellular composition of the hemopoietic bone marrow with an increase in the amount of hemopoietic active tissue. MRI may be a useful, non-invasive way of evaluating bone marrow response to different modes of rHuEPO administration and dosage.