Practice Comparison is an effective way of improving management level continuously. It can identify the best practice through collection of information and comparison with other service systems. We summarized and explored the experiences of practice comparison from APBN. This paper introduced the working content and management experience of practice comparison in mainland China,and provided the basis for the feasibility and exploration of blood transfusion service for practice comparison work.

Asia Pacific Blood Network(APBN) comparison of practice program is a comparison program in blood collection,separation,preparation,test and supply among all member countries. This article focuses on the scope and indicator of the APBN comparison of practice program from 2008 to 2015 in order to provide experience for the Chinese comparison of practice program. This may help to improve persistently the managements of quality,operation and costsin transfusion medicine of China.

To explore the practice comparison and implement benchmarking in China. The development of practice comparison is challenged by huge data volume,therefore it is particularly necessary to establish a professional information management system. Here we reported the construction,system structure and functional implementation of information management system for practice comparison in blood transfusion service. Index data collection and analysis platform for blood transfusion service were performed with the aid of a series of security measures,which provides scientific and visual data support for blood transfusion service to improve management in practical work.

Comparison of practice is an implementation of benchmarking within blood transfusion service. It has shown a significance by Asia Pacific Blood Network.The article introduced the comparison of practice to the blood transfusion service in Chinese Mainland via summarizing the definition and significance of benchmarking in the country to give the suggestions to improve the management level by this effective application of the practice comparison.

Objective To investigatethe safety and clinical efficacyduring platelet transfusion for emergency use.Method sTwo hundred and ninety-five cases of patients on emergency use were retrospectively analyzed,according to the ABO blood group compatibility. The patients were divided into the experimental and control groups,and reversehemostatic effects after cross matching for platelet transfusion were observed.Results The incidence of reverse reactions following transfusion ofABO group incompatibility were 2.27% in experimental group and 2.45% in control group,and effective blood transfusions were 63.63% and 68.10%,respectively. No statistical significance was noted (P>0.05).Conclusion Platelets with ABO blood incompatibility may be used for transfusion for emergency cases.

Objective To improve standardized clinical blood use management by three level of united control and stratified advancement through medical administrative sectors,center of city blood quality and control and various medical institutes. Methods Clinical blood use was intensively monitored and transfusion records were self-checked by department of medical service and transfusion from January 2013 to December 2014. Criteria of medical record evaluation were implemented by organization of blood quality management and control and 2865 medical records were checked and reported monthly using the criteria. The construction of transfusion department and clinical blood use management from hospitals were inspected twice annually by the municipal commission of health and family planning. Results The quality of medical records has been improved and the pass rate for medical records increased from 47.33% in January 2013 to 92.94% in December 2014. The amount of red cell and blood plasma used has dropped by 6.2% and 35.9% respectively,while the amount of platelet and cryocepitate coagulation factors use increased by 12.1% and 15.7% respectively,within a reasonable range. The clinical blood use has become reasonable. Conclusions Through clinical blood use management by three levels,the ability of standardized clinical blood use by medical staff has been improved. Transfusion procedure and clinical blood has been utilized scientifically. Therefore the safety of clinical transfusion was ensured and clinical disputes related to transfusion have been reduced.

Objective To investigate the population structure characteristic and its influencing on the repeated donations in Binhai New Area,in order to improve blood donor recruitment strategy,service quality and service level.Method sBlood donors were selected in 2015,and the donors' feelings were evaluated regarding the reliability,response,tangibles,assurance and empathy in the process of blood donation that may affect the repeated donations. Results The donators were aged from 20 to 35 years,accounting for 64.24% （14637/22786）; workers accounted for 45.15% （10 288/22 786） and freelancers accounted for 35.24% （8 030/22 786）; persons with junior middle school education accounted for 49.09% （11 185/22 786）. The purpose of 30.67% blood donation was "devote love". Blood donation awareness was mainly from street propaganda （22.94%） and media （34.51%）,The main negative factor （24.24%） influencing repeated donations was fearfulness of the health effects. Clean donation environment and the understandable promotional materials were active factors that affect their subsequent donation whereas insufficient problem-resolving ability in donation process and unsatisfied attitude constituted adverse factorss. Conclusion Well-trained staff and qualified service,together with efficient advertisements,are crucial for improvement of enthusiasm of blood donation in order to ensure the clinical blood supply.

Objective To understand the situation of HIV infection among voluntary blood donors in Nanjing from 2013 to 2015,and to provide the decision-making basis for strengthening the management of blood safety. Method The data of blood donation in Nanjing from 2013 to 2015 were collected and analyzed. Results From 2013 to 2015,240890 cases of blood samples from blood donors were tested. 233 cases had a reaction to HIV antibody screening test,including 36 cases of confirmed HIV positive samples. The positive detection rate was 0.0149%. Among these confirmed HIV positive donors,male citizens accounted for 91.97%,people born in the 1990s accounted for 66.67%,and unmarried people accounted for 75%. Conclusions In Nanjing,the main group of the HIV positive people were unmarried young men. They are advised to be the target group of strengthened AIDS prevention and control policy.

Objective Explore the relative factors and effective resolution for adverse transfusion reaction through the investigation in our hospital. Method sThe relationship of blood transfusion adverse reaction and age,sex,history of blood transfusion,disease,transfusion of blood components,non use of white blood cell filter and the reaction types were studied in 15594 patients. Results In 15 594 blood recipients there were 35 cases of adverse transfusion reaction （0.22%）. There was a significant correlation between the occurrence of adverse transfusion reactions and the factors of age,gender （female）,history of blood transfusion,internal medicine,Gynecology and Obstetrics,and the disuse of white blood cell filter（0.001<P<0.05）; Infusion of different blood products and reaction type shows no statistical difference （P>0.05）. The reaction types were mainly non hemolytic febrile reaction,and the incidence rate was 65.72%. Conclusion Factors like age,gender,history of blood transfusion,disease type and disuse of white blood cell filter were associated with the occurrence of adverse transfusion reactions. Strict control of blood transfusion testify,prevention and monitoring are ways ensuring the safety of blood using.

Objective To Analyze the change of Syphilis antibodies in patients with hematopathy before or after use of human Immunoglobulintreatment,and provide a reference for clinical diagnosis. Method Fifty-two cases of Syphilis antibody absorbance signal of sample cutoff value（S/CO）>0.5 in patients with hematological diseases were detected by chemiluminescence immunoassay （CLIA）,42 of them were injected with human immunoglobulin. Two ELISA reagents were used for verication. Syphilis haemagglutination assay（TPHA） was performed for confirmation. Nine cases were followed up for detection of Syphilis antibody after withdraw of human Immunoglobulin administration. To compare the Results of human Immunoglobulin in vivo and in vitro,times dilution the Harbin Paisi ficco Human Immunoglobulin with saline and AB type plasma to detect Syphilis antibody,simultaneous test the Results of Chengdu rongsen Human Immunoglobulin（PH4）. Result 10 patients showed positive TPHA,42 patients who had received human Immunoglobulin injection presented positive rates of 78.6%,88.1% and 66.7% in Syphilis antibody detection when tested by different reagents purchased from Johnson,Wan Tai and Sorin,TPHA,however,was found to be negative in all patients. Nine patients revealed positive Syphilis antibody after withdraw of human Immunoglobulin. Conclusion Human Immunoglobulin administration may cause a false positive detection of Syphilis antibody in patients with hematological diseases. The patients with the experience of human Immunoglobulin treatment together with low Syphilis antibody reaction should be re-checked for Syphilis antibody after three months.

Objective To improve blood donor arm disinfection adherence time,ensure the sterilization effect. Method Considering characteristics of the nature of work in center blood stations,it is a reasonable arrangement with Critical path Method that blood donors communication,the labeling process were integrated into the waiting time of blood donor arm disinfection,with layouting reasonably each part of the operations. Results Randomly selected 60 blood donors,with left/right arm was divided into experimental/control group respectively,the new and old Method were used respectively with a stopwatch to calculate two disinfection time,the difference was statistically significant （P<0.01） by t test. Conclusion New Method has an irreplaceable advantage which can improve blood donor arm disinfection time adherence,ensure the disinfection effect,and reduce blood donation reaction as well as labeling mistake.

Objective To analyze the confirmation test Results of anti-HCV screening-positive samples of the blood donors. Method The 284 anti-HCV screening-positive donor samples were collected randomly. Western blotting（WB） test was used to confirm the Results. The Results were evaluated based on the data of WB test and personal information of the blood donors. Result 49.82 percent of 284 cases of anti-HCV screening-positive donor samples were confirmed to be positvie. Compared with the confirmation Results of positive samples screened by two round ELISA and positive samples screened by single round ELISA ,significant statistical differences were noted in positive rates. The confirmed positive rates between initial and repeated blood donations,genders and ages revealed significant statistical differences. Conclusion Confirmation or additional tests should be carried out for screening-positive donors,particularly in those screened by single round ELISA and repeated blood donors.

Objective To analyze the situation of rapid test of anti-TP on voluntary blood donors in Changsha,and to formulate the corresponding measures for the recruitment and retention of blood donors. Method sHBsAg/TP colloidal gold test strip was used to do rapid test before blood donation as the initial screening,the data of rapid test of anti-TP positive donors was analyzed．Resluts There were 146 753 blood donors from May 2014 to April 2015,701 donors were found positive after rapid test of anti-TP. Among them,there were 424 males （60.49%）,429 donors with 26~45 years（61.2%）,397 donors with career unknown （56.63%）,488 donors with high school diploma and below （69.61%）,651 donors with Han nationality （92.87%） and 569 local donors（81.17% ）. Conclusion In Changsha area,there are different distributions in gender,age,occupation,education level and so on for rapid test of anti-TP positive donors ,which can be a guide for the recruitment of low risk blood donors.

Objective To track the voluntary blood donors who showed positive hepatitis B virus DNAs to ensure blood transfusion safety. Methods 22 518 cases of blood donors were subjected to repeated ELISA testing and NAT detection. The NAT-positive samples that showed negative HBsAg by repeated ELISA but positive HBsAg by single ELISA were checked by both DNA detections and routine profile tests for HBV infection. The individuals with negative repeated ELISA but positive DNA detection were followed-up after 6 months of primary examinations. Results 0.12 % cases presented positive NAT although they were negative when tested by repeated ELISA. Among them,22 cases were OBI infections and 4 fell in window phase of HBV infection. All of the OBI donors were characterized by positive HBcAb（100%）,followed by HBeAg （63.6%）.All of the 31 samples exhibited single or combined positivity of routine profile tests for HBsAg,HBsAb,HBeAb,or HbcAb. Conclusion DNA detection may cover the shortage of ELISA,shorten the window phase,and avoid misdiagnosis so as to reduce the risk at transmission of infectious diseases.

Objective The HPA genotyping of platelet donors in xingtai area was performed,and the HPA genotype of the platelet donors was established. Method PCR-SSP Method was used to randomly select 150 platelet donors who carry out a total of 14 antigens of HPA-1-6 and HPA-15 . Result The gene frequencies were found to be 0.953 and 0.010 for HPA-1a and -1b：0.951 and 0.086 for HPA-2a and -2b：0.596 and 0.394 for HPA-3a and -3b：1.000 and 0.000 for HPA-4a and -4b：0.967 and 0.015 for HPA-5a and -5b：0.986 and 0.010 for HPA-6a and -6b：0.475 and 0.506 for HPA-15a and -15b. Conclusion The gene frequencies of HPA-1-6 and HPA-15 antigens in xingtai area of Hebei province coincide with the Hardy-Weinberg genetic law,which shows difference among nationalities and regions.This is the first establishment of HPA genotype database in xingtai.

Objective The dual antiplatelet drug for the treatment of percutaneous coronary intervention after operation of acute coronary syndrome patients,the by optical than Light Transmission Aggregometry （LTA） and Method of thromboelastography（TEG） detection of clopidogrel resistance（CPGR） consistency analysis,and compare the correlation with the levels of CYP2C19 enzyme activity. Methods A total of 425 patients with acute coronary syndrome treated with dual antiplatelet therapy and PCI in the Department of Cardiology during the period of January 2015 to November were collected. Consistency and correlation analysis of CPGR induced platelet aggregation rate （LTAADP） and ADP induced platelet inhibition rate （TEGADP） as well as the relationship between the two Methods to detect CPGR and CYP2C19 gene expression level were done. Results The platelet aggregation rate measured by the LTA Method was used to detect the CPGR as 12%. The platelet inhibition rate measured by the TEG Method was used to detect the CPGR as 11.8%. There is a negative correlation between LTAADP and TEGADP （r=-0.351,P<0.01）; There was a certain degree of correlation between the activity of CYP2C19 gene and the detection of CPGR by LTA Method （r=0.239,P=0.00）. No correlation between the degree of activity of CYP2C19 gene and the detection of CPGR by TEG Method （r=-0.088,P=0.70）. And no significant difference between the two Methods in the detection of CPGR was found. Conclusion TGE Method and LTA Method to monitor the efficacy of clopidogrel has well consistency,There was no significant difference between the two Methods for the detection of CPGR with the degree of CYP2C19 gene activity.

Objective To investigate the diagnostic value of IL-22,IL-27,VEGF,TF and TFPI inhibitor value in the benign and malignant pleural effusions. Method Selected ninety pleural patients were subdivided into two groups according to the Results of pathology and iconography diagnosis,ie the benign pleural effusions （benign） group with 43 cases and malignant pleural effusions （malignant） group with 47 cases. To test the diagnostic ability of several indicators used alone and in combination,the concentrations of IL-22,IL-27,VEFG,TF and TFPI were determined by ELISA Method,and the concentrations of these five biomarkers in pleural effusion were compared,then receiver operating curve （ROC） analysis was performed. Results A significant difference of IL-22,IL-27,VEGF,TF and TFPI levels were observed in patients with malignant and benign pleural effusion （P<0.05）. Receiver operating curve analysis indicated that several indicators used alone showed a less potent diagnostic ability of benign and malignant pleural effusion,the area under the ROC curve of less than 0.8; while these biomarkers used in combination showed an obvious improvement in sensitivity,specificity and accuracy. Conclusion The combination of several biomarkers can provide a reference for the differential diagnosis of benign and malignant pleural effusion. Because of the high accuracy,efficiency and simplicity,this Method is worthy promotion.

Objective To investigate the damage of the hepatitis E to liver function in the elderly patients. Method sA total of 208 patients with hepatitis E were recruited and grouped according to age and gender. Indexes of liver function,including AST,ALT,GGT,TBA,PA,ALB,TBIL and DBIL were tested and then compared with those of 131 patients with chronic hepatitis B and 100 healthy control subjects. Results Compared with 131 patients with chronic hepatitis B and 100healthy control subjects,the levels of AST,ALT,GGT,TBA,TBIL,DBIL were higher in the patients with hepatitis E,while the levels of PA and ALB were lower in hepatitis E patients. The levels ofAST,ALT,PA and ALB in the patients over 50 years old （62.8±6.9） were lower than patients under 50 years old （62.8±6.9）,and the levels of TBIL and DBIL in the patients over 50 years old （62.8±6.9） were higher than patients under 50 years old （62.8±6.9）. There was no significantly statistical difference in the levels of GGT and TBA. The levels of AST,ALT,GGT,PA,TBIL and DBIL in male were higher than female,while the levels of TBA,and ALB were not significantly different. Conclusion The damage of hepatitis E to liver function is serious,especially for older patients and male patients. In addition,older patients had more serious jaundice and were prone to cholestasis.

Objective To explore early clinical diagnostic value of serum heart type fatty acid binding protein （h-FABP）,troponin（cTnI）,myoglobin（Mb） and creatine kinase isoenzyme Mb （CK-Mb） detection in children's hand,foot and mouth disease （HFMD） combined with myocardial damage,for clinical provides the basis for early diagnosis of myocardial damage. Method sfor March to December 2015 in our hospital of pediatrics door and inhospital see a doctor and a diagnosis of 276 cases of children with hand,foot and mouth disease,eventually diagnosed with myocarditis 57 cases,at the same time,choose the same 40 healthy children as control group. Collection and different time after admission in patients with venous blood were determined in serum in children with h-FABP,cTnI,Mb and CK-Mb content,the differences of the index level compared with the control group,and analysis the dynamic change of its content in different time. Results 276 cases diagnosed with myocarditis in children with HFMD,57 cases of myocarditis concurrent rate was 20.65% （57/276）,detection within 0~3 h,276 cases of children with HFMD h-FABP in serum cTnI,Mb and CK-Mb abnormal rate was 20.29% （56/276）,1.81% （6/276）,14.86% （41/276） and 2.90% （8/276）,and abnormal rate of h-FABP and Mb was obviously higher than that of cTnI and CK-Mb,the difference was statistically significant between the Results （χ²= 35.132~37.063,P<0.01）,h-FABP abnormal rate is higher than that of CK-Mb,difference was statistically significant （χ²= 3.175,P<0.05）; HFDM combined serum h-FABP children suspicious viral myocarditis,cTnI,Mb and CK-Mb concentrations were significantly higher than that of control group,difference between index concentration were statistically significant （t=17.261~37.625,P<0.01）; After the occurrence of HFMD combined myocarditis 0~3h h-FABP and Mb concentration started to rise,4~9h peak,began to decline after 12,20~36h basic dropped to normal; CTnI and CK-MB concentration in HFDM combined myocarditis began to rise after 4~9h,10~12h peak,12~72h has been in a higher level,began to decline after 72h,7d basic drop to normal. Conclusion Children with HFMD myocarditis had a higher incidence of a disease,h-FABP is the most sensitive indicators for early diagnosis,can be used as ideal markers for early diagnosis of children with HFMD myocarditis followed by Mb;CTnI and CK-MB is children with HFMD myocarditis middle-late diagnostic sensitivity index. h-FABP joint detection cTnI,Mb and CK-Mb has important clinical value in early diagnosis ofchildren with HFMD myocarditis ,improvement of the diagnostic rate and lessening of the misdiagnosis rate,et al.

Objective To investigate the drug-resistance of common pathogenic bacteria from a hospital in 2014 and to provide evidences for rational use of antibiotics in the clinic. Method s1 221 strains of bacteria were isolated from clinical specimens in 2014. The pathogens were identified and retrospectively analyzed statistically by Zhuhai Dl Medical Biotech L-96 automated microbial identification system. Results Among all the 1 221 isolates,36.04% （n=440） were Gram-positive bacteria; 63.96% （n=781） were Gram-negative bacteria. The three major Gram-positive bacteria were Staphylococcus aureus （12.20%,n=149）,Coagulase - negative Staphylococcus sp. （10.07%,n=123）,and Enterococcus sp. （10.16%,n=124）; The top two Gram-negative bacteria were Escherichia coli （20.06%,n=245）,and Klebsiella pneumoiae（13.27%）. The most common non-fermentative bacteria included Pseudomonas aeruginosa（11.71%,n=143） and Acinetobacter baumanii（9.99%,n=122）. In Staphylococcus,MRSA and MRCNS detection rates were 76.71% of S.aureus and 81.4% of Coagulase- negative Staphylococcus,respectively. No vancomycin and Teicoplanin resistant Staphylococcus had been found. In Gram-negative bacteria,detection rates of ESBLs were 77.2% of E. coli and 26.0% of K.pneumoiae,both were equally sensitive to carbapenems. Conclusion Hospital’s bacterial drug resistance is increased ,among them the Gram-negative bacteria dominate. The constant surveillance and control of bacterial antibiotics resistance are crucial to the rational application of antibiotics and prevention of nosocomial infection.

Objective To investigate application value of bone marrow biopsy detection of acute leukemia minimal residual disease. Method s78 cases of adult acute leukemia patients in our hospital during the period January 2013 - January 2014 were treated as the research object,using bone marrow biopsy after chemotherapy,12,24 ,36 and 48 months in patients with bone marrow smear and biopsy of implementation,comparison of bone marrow cytology and bone marrow biopsy Results,statistical processing. Results A total of 78 patients with bone marrow biopsy were performed 290 times in this group. The positive aspects of minimal residual lesions were 12 months and 24 months,36 months and 48 months,and the difference was significant （P<0.05）.In minimal residual lesions and recurrence： there were minimal residual lesions in 12 and 24 months,and 2 patients relapsed after chemotherapy,there were no minimal residual lesions in 1 cases,and 1 patients with minimal residual disease. Minimal residual lesions were positive in the continuous remission group. Conclusion Bone marrow biopsy is safe and convenient,and it has a certain reference value for the detection of minimal residual disease in adult patients with acute myeloid leukemia.

Objective To explore the significance of sodium levels in evaluation of prognosis of patients with severe stroke combined with acute kidney injury （AKI）. Method Electrolytes and renal function of different periods after hospitalization were detected in 300 patients with severe strokefrom Jan.2012.1 to Dec.2014. with,The patients were scored with APACHEⅡ,followed by administration of the symptomatic treatments. Results Sixty of 300 patients were found to present high hyponatremia ,accounting for 20.0%; 44 （14.67%）cases had AKI,Eighteen of 60 high hyponatremia patients revealed acute cerebral infarction,32 had acute cerebral hemorrhage,and 10 possessed subarachnoid hemorrhage. The average measurement score of APACHEⅡ was （24.5 ± 6.4）; AKI was noted in 17 cases（28.33%）,The high serum sodium concentration was in parallel with the high frequencies of AKI occurrence. Conclusion In patients with severe stroke combined with acute renal injury,hypernatremia usually happens 3-7 days after the disease. A high sodium level which occurs 7 days after disease may indicate a poor consequence of treatment and a high mortality