ObjectiveTo study the NF-κB p65 and STAT-1 expression in Sprague Dawley rats with transfusion-related acute lung injury or acute pancreatitis associated lung injury. MethodSixty SD rats were randomly divided into TRALI group, APALI group, control group, rapamycin treated TRALI group, rapamycin treated APALI group, and rapamycin treated control group, with 10 animals in each. Gene expression of NF-κB p65 and STAT-1 was detected by qRT-PCR. The method of 2-△△Ct was used to calculate the relative qualification of target genes. ResultThe expression of NF-κB p65 and STAT-1 in TRALI and APALI groups was found to be down-regulated（P<0.05）, and APALI group decreased more than TRALI group（P<0.01）. The gene expression of NF-κB p65 and STAT-1 in rapamycin traeted TRALI group decreased more than in TRALI group（P<0.01）, while rapamycin intervention APALI group did not decrease significantly compared to APALI group（P>0.05）. ConclusionRapamycin might deteriorate pathological process of the lung injury in TRALI, but have limited effects on APALI.

ObjectiveTo investigate the influences caused by blood storage temperatures and time which affect the leukocytes reduced of red blood cells in additive solution leukocytes. We also aimed at selecting and establishing proper operation methods of leukocytes reducing which will further improve the effects of leukocytes reduced in blood. Methods

ObjectiveTo analysis the regular pattern of using RBC class dosage for clinical use in Handan area, trying to set up the optimal mathematical model and make predictions. Then provide guidance for blood agencies’ work related business. MethodsCreating a dataset of the amount of clinical supplying red blood cells from January 2002 to December 2013 in Handan City with the support of Epidata3.0 double-lines input data system and then import it to IBM SPSS Statistics 21. Setting up a mathematical model for clinical using blood volume with curvilinear regression and expert modelers from which the optimal one is selected. Finally, reusing the model to predict clinical blood volume, and verify it. ResultsThe highest R2 of curve regression equation as the cubic polynomial function. R2=0.947, P<0.05, fitting equation =2 413.906+83.189X-0.602 X2+0.004X3. Expert modelers advised the model of ARIMA (0,1,1) (0,1,1). The five models of residual white noise test results have shown the P>0.05, instructions residuals all was white noise sequence, all models were extracted from the original sequence data information and passed the model diagnosis. With the two models respectively predict clinical using blood volume from January to June,2014, the relative error of ARIMA (0,1,1) (0,1,1) model prediction is within 5%; the one of cubic equation model, predicting the deflection, went up to 14.68%. ARIMA model is superior to the cubic equation model. ConclusionThrough the establishment of mathematical model, adding the follow-up data, blood agencies can scientifically predict the trend of using blood volume and reasonably guide the corresponding business work.

Objective To select matching red blood cells and promote hemoglobin level for anemia patient with autoantibody caused by G6PD deficiency. Methods Blood group typing, antibody screening and cross matching were tested by micro column gel method. Results Autoantibody was identified in the patient, which caused interference with main side in cross-match. Two units of RBC, whose main side agglutination intensity was lower than or similar to self-control, were selected after cross-matching multiple donors, and transfused to the patient. Conclusions Main side agglutination due to autoantibody is not an absolute contraindication for transfusion, and the hemoglobin of patient is effectively improved after transfusion of 1.5 U RBC.

ObjectiveTo evaluate the necessity of apheresis platelet specimens tested by NAT as well as its feasibility of synchronous ELISA and NAT. MethodsBlood screening adopts mode of twice ELISA and once NAT. Both Anti-HCV and anti-HIV1/2 were screened by ELISA kits produced by Wantai and Xinchuang, and HBsAg by Kehua and Xinchuang. In addition to ELISA, minipools of 6 NAT was performed to apheresis platelet specimens. Confirmatory tests were done to those positive ELISA but negative NAT specimens. Both confirmatory tests and follow up were complished to negative ELISA but positive NAT specimens and their donors. ResultsSixty-four of 37 496 tested apheresis platelet specimens were positive, among them 12 were both double-ELISA and NAT positive;5 were double-ELISA positive but NAT negative;4 were both single ELISA and NAT positive;20 were single ELISA positive but NAT negative;23 were ELISA negative but NAT positive. Six samples with positive ELISA and negative NAT were confirmed to be positive, out of which 4 were double-ELISA positive and 2 were singleELISA positive. In 23 donors of negative ELISA but positive NAT, 22 were confirmed to have latent HBV infection and one was in HBV window period. ConclusionsELISA and NAT are complementary and may effectively reduce the risk of transfusion infection. The simultaneous tests of ELISA and NAT are feasible and may minimize the detection time.

ObjectiveTo implement the classification management system of application for clinical blood transfusion and evaluate its effects on audit supervision. MethodsProcessing qualification verification on the 5476 pieces of application for clinical blood transfusion which were audited during July, 2013 to June, 2014. Then revising and implementing the classification management system of the application for clinical blood transfusion according to the PDCA circulation principle. The HIS’s automatic authorization to the titles of attending physicians or above was used for prescribing electronic applications of blood transfusion. The institution of comprehensive quality audit and real-time records were established in blood transfusion rooms. There were regular statistical analysis, reporting and announcement of the results of the audit supervision. The comprehensive quality control to the classification management system of the application for clinical blood transfusion was carried out in the hospital. ResultsThe average qualification rate of the application that needs to be examined and be signed by the senior doctors surpassed 96.97%. The average qualification rate of the application submitted to the director increased from 22.97% to 95%(P < 0.01) and by staff of Medical Department from 88% to 95% simultaneously. ConclusionThe implementation of classification management system of application for clinical blood transfusion obviously improved the quality of application, promoting the appropriate clinical use of blood products.

Objective To re-evaluate the importance of alanine aminotransferase (ALT) testing for blood safety improvement after nuclear acid testing performed in Chinese BTSs. Method 498,085 blood donors were collected in Shanghai between November 2011 and July 2013, the donors were divided into two groups,sole ALT disqualified donors and qualified donors with blood donation interval of less than 365 days ．The second-time blood screening results of the donors in the two groups and the results of HBV/HCV confirmation testing among sole ALT disqualified donors group were analyzed. Results ALT disqualification rate among the sole ALT disqualified donors was 20.32%, significantly higher than that of qualified group(P< 0.01). The positive rates of HBV, HCV, HIV and syphilis were 0.13%,0.20%,0%, and 0.07%, respectively, and had no significant difference between the qualified group (P> 0.05). All HBV/HCV confirmation tests among sole ALT disqualified donors group were negative. Among all ALT disqualified donors within the two groups, no donors of negative HBV or HCV enzyme immunoassay were found to be nucleotide testing positive simultaneously. Conclusion ALT testing, due to the popular implementation of NAT testing, seems to be of no significance in ruling out of HBV and HCV window phase infection as well as HBV latent infection.

ObjectiveTo analysis the loss of blood donors, find out the reasons backward and to provide a basis for the development of recruiting strategies for this population. MethodsAn investigation was carried out on those who did not participate in blood donation in the past two years, which using the blood information management system for selection and excluded those who failed the infective diseases detection tests. Then the return visit by phones was conducted among who have participated in non-remunerated blood donation while have been quitted for merely 2 years. ResultIn a total of 3611 people who have been quitted from non-remunerated blood donation, 2918 were successfully interviewed. Among the reasons they gave, the top three were as follows: 37.11% reported inconvenience because of time and traffic, 26.29% reported to have forgotten to donate blood, 12.61% reported to have blood donation reactions in the past. In the investigation of who hold the willingness to donate blood again, students, soldiers and free professionals accounted for 69.54%, 71.05% and 50.57% respectively. Considering education levels, people with at least university degree or junior middle school education and below are 71.49% and 60.42%. Considering age, the 18-30 and 31-40 age groups comprised 68.47% and 62.17%. ConclusionTo reduce the loss of blood donors in Tianjin, our blood collection should focus on the donors under 40 years old and the free professionals with low education.

ObjectiveTo evaluate the specificity of chemiluminescence assay (CLIA) in anti-HIV test, and to analyze HIV infection in the patients before blood transfusion. MethodsCLIA was used to detect the anti-HIV in 73727 cases from pre-transfusion patients. The sera with initially positive anti-HIV was then confirmed by Western blotting (WB). ResultsOne hundred and forty f serum samples were anti-HIV positive by CLIA. Among them, 110 were confirmed to be positive by WB assay. Anti-HIV was more prevalent in those aged 20-60 years, and the HIV infection rate of male is much higher than that of female (χ2=15.01,P<0.005). In the samples with S／CO value between 1 and 10, the seroprevalence of anti-HIV was 0%, while in the sample with S／CO value more than 50, the seroprevalence of anti-HIV was 100% tested with WB assay. The anti-HIV positive rate of WB assay showed significant difference among 1<S／CO≤10, 10<S／CO≤50 and S／CO>50 three groups (P<0.005). ConclusionsPart of blood recipients before transfusion have HIV infection. Low S／CO value indicates relatively high false positive HIV infection although CLIA shows high sensitivity.

ObjectiveTo observe the incidence and the influential factors of clopidogrel resistance (CPGR) in patients who received percutaneous coronary interventions(PCI). MethodsEighty six patients with PCI were subjected to the study. Light transmittance aggregometry was used to measure platelet aggregation (PA) induced by adenosine diphosphate (ADP) before and 5-7 days after clopidogrel intake. The △P measurements were based on the standard of △P ≤ 10% CPGR (negative values included) . The patients were divided into CPGR group and none CPGR group according to the △P. The relation between CPGR and the patients’ relevant clinical biochemical indexes was observed. Results

ObjectiveTo reveal the change of vaginal microbe flora after vaginal delivery or cesarean delivery. MethodThree hundreds and seventy two women who labored in hospital were selected for the study, among them 220 women were given cesarean delivery and 152 underwent vaginal delivery. The vaginal secretions were collected for detection of PH value, BV, and bacterial culture. Besides, The time of lochia disappearance in puerperium was recorded. ResultsThere was no significant difference between the two groups in comparison of vaginal PH value and the time of lochia disappearance in puerperium (P>0.05). Compared with the subjects of cesarean delivery, the levels of E2, T, P and PRL in those whoc had vaginal delivery were statistically increased (P<0.05), while no significant difference was seen in LH and FSH (P>0.05). Compared with the women with abnormal vaginal PH value , the time of lochia disappearance in puerperium in the women with normal vaginal PH value was significantly decreased (P<0.05), and the positive rate of BV in women with normal vaginal PH value was also decreased (P<0.05). Conclusionthe vaginal microbe flora seems to be unbalanced following vaginal or cesarean delivery and vaginal PH value is abnormal. Additionally, Lactobacillus spp may be significantly depressed , with a high incidence of BV in both ways of delivery.

ObjectiveTo establish a fluorescence-based quantitative real-time PCR (qPCR) for detection of barcode DNA that is applied to the novel bio-barcode assay of human viruses. MethodThe barcode DNA, primers and TaqMan probes were designed and synthesized for the novel bio-barcode assay. After being amplified by PCR, the barcode DNA were cloned into pMD18-T vector to construct the recombinant plasmids. The reaction conditions of qPCR were optimized, and recombinant plasmids were ten-fold serially diluted as quantitative standard to perform the calibration curves. Finally,the sensitivity and reproducibility of the qPCR for detection of barcode DNA were assessed．ResultThe specific barcode DNA was obtained to construct recombinant plasmids. The qPCR for detection of barcode DNA was established with wide linear range of 102~109copies/μl and high sensitivity (100 copies/μl). The intra-group CVs were less than 10%, and inter -group CVs were between 4.42 % and 39.05%. ConclusionThe qPCR for detection of barcode DNA is established with high sensitivity and good reproducibility, which can be used for the further study of novel bio-barcode assay.

ObjectiveTo investigate the cognitive status about blood donation of soldiery in Beijing, in order to provide suggestions for blood donation promotion and social participation enhancement. MethodsAccording to the self-designed Soldiery Blood Donation Knowledge Questionnaire, we randomly selected 2000 soldiery in Beijing from different units of administering and made the research anonymous. Finally sorting out 1 207 copies of questionnaire with integrate content. ResultsSoldiery has a higher degree of participating in blood donation, blood donors accounted for 72.5% (875/1 207). The number of soldiers supporting blood donation reached 90%. 57.3% soldiers chose to participate actively when receiving an urgent need of blood information. In the knowledge of blood donation, it was more comprehensive that donors shall use blood for free, blood donation would contribute to the society and would not hazard health as well as other aspects (the awareness rate is higher (P<0.05)); but 53.9% (651/1 207) in the staff did not understand that blood donation will not be disease-contagious. The main access of blood donation related knowledge receiving is television, newspapers, publicity activities and hospital. Network knowledge accounted for only 6.2%.ConclusionThe soldiery cognitive of blood donation is unbalanced. There is a demand for different subdivision publicity ways to improve the recruitment strategy. Efforts to establish a long-term mechanism of voluntary blood donation is also critical.

ObjectiveTo evaluate the rationality of plasma transfusion by analyzing plasma use in Class 3 comprehensive medical institutions in Anhui Province from 2013 to 2014. MethodPlasma use was retrospectively analyzed in Class 3 comprehensive medical institutions in Anhui Province from 2013 to 2014. According to the evaluation criteria, Plasma transfusion records were evaluated basing on reasonableness. Then the records were used to analyze the rationality and diversities of plasma use in various clinical departments. ResultPlasma reasonable transfusion in Class 3 comprehensive medical institutions in Anhui Province in 2014 was better than that in 2013. The rationality of plasma use in every clinical departments have differences. The reasonableness in internal medicine is higher than that in surgical. The most unreasonable utilization is that plasma was transfused for protein supplement. ConclusionPublicity and implementation of blood transfusion technical specifications and supervision of blood transfusion by health authorities can improve the rationality of plasma transfusion.

Objcective To investigate the positive impact of nuclear acid testing on reducing the risk of regional infectious transfusion through systematic retrospective analysis on nucleic acid screening data of blood in Shanghai after centralized detections. Method Nucleic acid testing（NAT） results of 1,276,206 blood samples with no reactive to the Enzyme-Linked ImmunoSorbent Assay (ELISA) (HBsAg、Anti-HCV、HIV Ag-Ab) from various blood services in Shanghai region after centralized screening are analyzed. Results The ratio of “ negative in ELISA (HBsAg,Anti-HCV, and HIV Ag-Ab) but positive in nucleic acid testing (NAT)” ((ELISA NR/NAT R ) in Shanghai was found to be 0.63‰. The overall ELISA NR/NAT R ratios from the year 2012 to 2015 gradually declined . The highest ELISA NR/NAT R ratio was in 2012 (0.76‰), apparently higher than those of the next 3 years（P<0.01）, and the second highest ELISA NR/NAT R ratio appeared in 2013 and 2014 (0.62‰). The lowest ELISA NR/NAT R ratio (0.50‰) was observed in 2015. There was no significant differenceduring the last 3 years (P>0.05). Among the total 800 cases of reactive “NAT” (0.63‰), 464 (0.36‰) cases were positive for HBV DNA, with the highest ratio of HBV DNA positive cases in 2012 (0.49‰), which was notably higher than those of the next 3 years (P<0.01). The overall ratios of HBV DNA positive cases from 2013 to 2015 were ranged from 0.31‰ to 0.34‰, with no significant difference (P>0.05). For other cases of reactive “NAT”, 7 (0.005‰) were positive for HCV RNA, 14 (0.01‰) were positive for HIV RNA, and 315 (0.25‰) were negative for the three viruses. Conclosion Despite the exist of certain false reactivity in NAT, the full implementation of nuclear acid testing for blood in Shanghai region after centralized detections has effectively reduced the risk in blood transfusion and ensure the blood safety citywide.

ObjectiveTo study the application of six-sigma (6-sigma) measurement tool in the evaluation of the quality level to promote detections of 9 clinical laboratory tumor markers (TMs). MethodsThe data from internal quality control and external quality assessment in clinical laboratory were collected for the 9 TMs (β-HCG, CEA, beta CA125、CA153、 CA199、 AFP、 t-PSA、f-PSA and FERR ) in 2014 and 2015. Using the total allowable error (TEa) as the standard by Ministry of Health Examination Center TMs EQA, the 6-σ value and quality target index (Quality Goal, Index, QGI) of each item were calculated according to the formula (TEa = Bias / CV%). The Sigma value is divided into world class (σ≥6), excellent (5≤σ<6), good 4≤σ<5) critical (3≤σ<4), bad (2≤σ<3) and unacceptable (σ<2) . The quality improvement plan was designed according to QGI and improvement measures were implemented of TM whose σ did not reach the world-class. The rectification of TMs levels improvement of quality evaluation was compared. ResultThe sigma average quality level increased from 4.93(2014) to 6.34(2015), the world class item consists of 2 (11.1%) to 8 (44.4%), excellent level item was 6 (33.3%), good grade increased from 4 (22.2%) to 7 (38.9%), bu the critical item and non acceptance item decreased from 2 (22.2%) and and 1 (5.6%) to zero, respectively. ConclusionThe 6- sigma can evaluate the level of clinical of TMs quality detection precision, show the defects, provide clear direction for quality improvement, and improve the quality level of TMs test. It is an effective laboratory quality management tool.