Objective To study the molecular mechanisms of acute myelogenous leukemia stem cell apoptosis induced by triptolide. Methods Proliferation inhibition of triptolide to KG-1 cell was determined by MTT, IC50 concentration was calculated. According to the concentration gradient of triptolide, KG-1cells were collected to detect cell apoptosis via flow cytometry 48h after treatment. Bcl-2, beta-catenin, p-AKT and AKT proteins were detected by Western blot. Results Triptolide to KG-1 cell proliferation inhibition is in dose dependent manner and IC50 is about 4 nmmol/L, it can also induce apoptosis of KG-1 cell. Bcl-2, beta-catenin, p-AKT proteins can be down-regulated by triptolide. Conclusions Molecular mechanism of triptolide induced KG - 1 cell may be related to the Bcl-2, beta-catenin and p-AKT.

Objective To explore the effect of MDSCs on the number and function of CD8+T cells,tumor growth in vivo and survival in Lewis lung cancer mice. Methods LLC tumor cells were inoculated into the flank of C57 LB/6 mice. MDSC were depleted by intravenous administration of Gr-1 blocking antibody. Tail blood was collected and CD8+T cells,MDSCs and splenocyte cytotoxicity of LLC were detected by flow cytometry. Tumor growth and survival of tumor bearing mice were recorded. Results On day 7 after tumor inoculation,the percentages of MDSCs from tumor bearing mice were significantly higher than the control （23.87±1.35% vs 7.600±0.677%,P<0.001） and CD8+T cells were declined compared with the control （7.906±0.428%） vs （11.22±0.606%,P<0.001）. Gr-1 blocking antibody was administered to deplete MDSCs. On day 3 after administration,the percentages of MDSCs were rapidly decreased（1.578±0.299% vs 38.34±3.214%,P<0.001） and CD8+T cells were significantly higher than control mice（9.464±0.820 vs 4.024±0.488,P<0.001）. On day 10 after administration,MDSCs percentages were increased,but decreased when compared to control mice（1.578±0.299%） vs（38.34±3.214%,P=0.0016） and CD8+T cells were deceased but elevated compared with control mice（9.464±0.820%）vs（ 4.024±0.488%,P=0.0019）. Tumor growth in mice with MDSCs depletion was markedly inhibited compared with control group（P<0.05）. The survival of mice with MDSCs depletion was notably longer than control mice（P=0.036,median survival 46 vs 53）. Conclusion MDSCs depletion in LLC tumor bearing mice eliminated the inhibition of CD8+T cells by MDSCs Leading to a restriction of tumor growth and prolonged survival.

Objective To investigate and define the main departments of blood irrational use,blood product types and reasons of unreasonable use,provide theoretical basis for promoting standardized and rational use of blood products.Methods Make the specifications of blood transfusion according to the "clinical blood transfusion technical specifications" and other rational transfusion standards,analyze reasons of irrational use of blood products,observe all blood transfusion record of a hospital from February 2015 to March 2016,determine the rationality of each transfusion,classify the reasons for the irrational transfusion,and analyze the collected data. Results The reasonable using ratios of erythrocytes and platelets （94.36% and 94.48%,respectively）were higher than that of plasma and cold precipitates （54.52% and 64.66%,respectively）. The use of erythrocytes in internal medicine （hematology 95.71%,other internal medicine 95.80%）was more reasonable than the surgical one （90.38%）,and the surgical use of plasma （55.04%）and cold precipitation （71.53%）was more reasonable than hematology （plasma：33.33%,cold precipitate：39.13%）and other internal medicine （plasma 50.86%,cold precipitation 53.66%）. The overall rate of blood rational use in medicine （93.56% in hematology and 85.42% in other internal medicine）was higher than that in surgery （77.24%）. The main unreasonable reason of red blood cells and platelet transfusion was a transfusion management with no indication and loose specification; the unreasonable reasons of plasma and cold precipitate were transfusion with no indication,match sample and low dose transfusion.Conclusion The rational use of erythrocytes and platelets is relatively good while the rational use of plasma and cold precipitates is generally poor and requires improvement. Overall,the medical use of blood is better than surgery.

Objective Analysis of effect of intraoperative autologous transfusion on coagulation function in patients with scoliosis. Methods According to transfusion volume accounted for the proportion of circulating blood volume,198 cases scoliosis with autologous blood transfusion technology were divided into 3 groups：group A transfusion volume is less than 10% of the circulating blood volume,group B transfusion volume of circulating blood volume accounted for 10%-50%,group C transfusion volume greater than the circulating blood volume 50%,hemoglobin （Hb）,hematocrit （HCT）,platelet （PLT）,prothrombin time （PT）,partial thromboplastin time （APTT）,fibrin original （FIB） were detected before and after transfusion. Results In group A Hb and HCT were increased after reinfusionthan （P<0.05）,but PLT and coagulation function without significant difference（P>0.05）.In group B,compared to before reinfusion,Hb and HCT were increased（P<0.05）,PT,APTT were prolonged,FIB was decreased after reinfusion（P<0.05）.In group C,transfusion after reinfusion,PLT and coagulation function significantly were decreased,（P< 0.05）,while Hb,HCT significantly improved （P<0.05）.Conclusion Autologous blood transfusion in children's scoliosis surgery is beneficial to reduce blood loss and allogeneic blood transfusion. For a large amount of blood loss,it is required for intraoperative monitoring of coagulation function,timely replenishment of fresh plasma,platelets or other coagulation factors.

Objective To Analyze the causes of abnormal color of plasma,so as to reduce waste of blood and ensure transfusion safety. Method Blood donors information was analyzed and the total bilirubin content of the plasma with abnormal color was detected from 2011 to 2014. Results The total bilirubin of the green anomaly plasma was found to be lower than that of normal plasma. Most plasma abnormalities were temporary,which was frequently seen in the fall and winter seasons.Repeatedly noted plasma color abnormalities accounted for 5.77%. Conclusion Edible pigment is most likely the reason in most of the green plasma. Some repeated abnormalities may be associated with liver metabolism and should not be used in blood donation.

Objective To investigate the clinical significance of massive transfusion protocol（MTP） in patients with postpartum hemorrhage,and to provide a clinical basis for the establishment of a more reasonable blood transfusion program. Methods Analysis of 1 cases of postpartum hemorrhage patient,use of drug treatment,vital signs monitoring,start massive transfusion protocol,and then analyzed the indicators of patient. Results The patient's vital signs were steadily through timely and actively treatment. Conclusion MTP developed a fusion of multi-disciplinary advantages,that MTP can be effective and safe for patients with postpartum hemorrhage,the hospital or clinical departments should formulate their own MTP protocol as soon as possible.

Objective To analyze the clinical characteristics of adverse transfusion reactions,and investigate the effect of preventive medication on transfusion adverse reactions. Methods Adverse reactions of transfusion were analyzed in the hospital from April 2014 to November 2015. The patients were divided into group 1（ dexamethasone before blood transfusions）,group 2 （preventive use of promethazine） and control group （patients without any medications）. The adverse reactions of three groups were compared,and the results were statistically analyzed. Results There were 36 cases of adverse transfusion reactions among 17 466 blood transfusion cases,with an incidence of 0.21%. Allergic reactions mostly occurred,accounting for 80.56%. Additionally,the incidence of adverse reactions in apheresis platelets transfusion was the highest （0.58%）. No significant difference was noted in the incidence of adverse transfusion reactions between group1,group 2,and control group（P> 0.05）. Conclusion Preventive medication before blood transfusion has no significant effect on the occurrence of adverse reactions.

Objective To investigate the clinical utilization of the Emergency Rescue Transfusion Recommendations under Special Cases （ERTRSs ）and its significance in suspicious blood typing,cross-matching and antibody screening.Methods Patients in a critical condition and with suspicious blood cross-matching were given rescuing according to ERTRSs and adverse reactions following blood transfusion were closely monitored. Indicators of HB,Hct,TBIL,DBIL,and IBIL were analyzed 1d and 7 d before and after transfusion so as to evaluate its therapeutic effect. Results All of the patients presented an effective treatments following the ERTRSs and no significant side effects were seen. Conclusion It is necessary to implement ERTRSs timely for rescuing the patients with difficult blood cross-matching and interpretation of antibody screening and for avoiding medical risk.

Objective To analyze the gene frequency of killer cell immunoglobulin-like receptor （KIR） in Hebei Han population．Methods The blood samples of288unrelated Hebei Han individuals were genotyped by PCR-SSP method, gene frequency was analyzed. Results Among the Hebei Han population, framework gene KIR2DL4, 3DL2, 3DL3, 3DP1was found in all samples, 2DL1, 2DL3, 3DL1, 2DS4, 2DP1presented very high frequencies, genes2DL2, 2DS2, 2DS3, 2DS5presented low frequencies．A total of51KIR genotypes were identified, in which the genotype2DL4+3DP1+3DL2+3DL3+2DL1+2DL3+2DP1+3DL1+2DS4were predominant, with frequencies of43.75％. Conclusion The gene frequencies of KIR in Hebei Han population were similar to other Asian countries but significant differences with other national minority. The genotype2DL4+3DP1+3DL2+3DL3+2DL1+2DL3+2DP1+3DL1+2DS4was predominant．

Objective To analyze the serological characteristics and HBV DNA levels of HBsAg-negative blood donors with occult HBV infection and their correlation. Methods The blood donors were screened for HBsAg by two different ELISA reagants and the qualified samples were tested for HBV DNA by nucleic acid amplification （NAT）. The positive blood donors were further tested by HBV marker detection and Quantitative Real-time PCR for HBV DNA. Results A total of 29890 samples were detected HBsAg negative by twice ELISA test. Of the 29890 HBsAg-negative samples,31 were detected positive for HBV DNA by NAT. Among the 31 donations screened non-reactive in both rounds of HBsAg testing by ELISA,3 cases were reactive for HBsAg by the means of chemiluminescence. Among the 28 HBsAg - HBV DNA + donations,2 cases （7.1%）were identified as window period infection and 26 cases （92.9%）were identified as occult HBV infection （OBI）. NAT lowered the residual risk of HBV by 9.37/10⁴. On the basis of the serological profile,OBI can be mainly distinguished into two seropositive patterns （HBsAb and HBcAb positive or isolated HBcAb positive）. Of the 28 OBI donations,the HBV DNA levels with HBsAb negative was higher than that with HBsAb positive （P<0.05）. Conclusion HBV remains a risk of transfusion-transmitted infection through ELISA detection in HBsAg-negative blood donors,and OBI is frequent. The application of NAT in blood screening is very important for assuring the safety of blood. The OBI blood donors with HBsAg-negative have certain serological patterns,in which HBsAb-negative donors may have a higher residual risk of transfusion-transmitted HBV infection.

Objective To study the application value of examining coagulation indicator and platelet indicators in research for hepatic cirrhosis,and to discuss the clinical significance,so as to provide theory evidence for the diagnosis and treatment of hepatic cirrhosis. Method 80 cases of patients with hepatic cirrhosis treated in our hospital since January 2014 to January 2015 and 80 cases of normal people were selected as the object of study. Patients with hepatic cirrhosis were set as observation group,while normal people were set as control group. Patients in observation group were divided into level A,level B and level C in accordance with hepatic cirrhosis Child-Pugh classification standard. People in groups mentioned above were detected for platelet indicators and coagulation indicator via hematology analyzer and coagulometer. Platelet indicators includes platelet distribution width （PDW）,platelet count （PLT）,mean platelet volume （MPV） and plateletcrit （PCT）,while coagulation indicator includes Fibrinogen （FIB）,prothrombin time （PT）,thrombin time （TT） and activated partial thromboplastin time （APTT）. Results There was a significant difference in Platelet PDW,PLT,MPV and PCT between observation group and control group,and a significant difference in coagulation indicator FIB,PT,TT and APTT between observation group and control group,having statistical significance （P<0.05）. In comparison among hepatic cirrhosis Child-Pugh classification,the platelet indicator gradually decreased from level A,level B to level C. There was a distinct difference between group B &C and group A,and there was a significant difference between level B and level C in MPV,PLT and PCT,having statistical significance （P<0.05）. PDW had no statistical significance （P>0.05）. As for coagulation indicator in level A,level B and level C,TT,APTT and PT gradually increased,while FIB gradually decreased. There was a significant difference between group B&C and group A,and there was no significant difference in APTT and FIB between level B and level C （P>0.05）. PT and TT differ distinctly,having statistical significance （P<0.05）.Conclusion Compared with normal people,various coagulation indicators and platelet indicators of patients with hepatic cirrhosis were abnormal,and indicators vary in accordance with the severity of hepatic cirrhosis. Coagulation indicator and platelet indicator can reflect the severity of hepatic cirrhosis of patients,significantly for the diagnosis and treatment of hepatic cirrhosis.

Objective To study HBsAg and HBV-DNA in the patients with chronic hepatitis B （CHB）,cirrhosis and hepatocellular carcinoma. Methods Of 200 CHB patients enrolled in the study within four years,116 cases of CHB,74 cases of liver cirrhosis,and 10 cases of primary liver cancer were detected for HBV makers with chemiluminescence and for HBV-DNA with PCR. Results In HBsAg and HBV DNA quantification of the three groups,a significant difference was seen in HBV makers that presented positive HBsAg,HBeAg,and anti-HBc（P<0.05）. Conclusion Patients with CHB may exhibit the shifted level of HBV makers and the decreased levels of HBsAg and HBV-DNA with the disease progressed,which may indicate a trend of the development of hepatic cirrhosis or liver carcinogenesis.

Objective To investigate the genotype distribution of the methylenetetrahydrofolate reductase （MTHFR） C677T essential for the folic acid biosynthetic pathway among Chinese Han pregnant women in Anhui province, so as to provide pregnant women with guidance of supplementing folic acid. Methods By mean of PCR- chip hybridization method, 484 samples collected from Anhui province were detected the genotype distributions and allele frequencies of MTHFR C677T, then, the results were compared with published data in other 9 provinces of China. Results In Anhui Han pregnant women population,the CC,TC,and TT genotypic frequencies of SNP C677T were 25.2 % ,49.2 % and 25.6 %,respectively．Significant different of genotypic frequencies have been observed between Anhui women population and Shandong, Sichuan, Yunnan and Hainan women population （P<0.05）. Conclusion The distributions of C677T in the MTHFR gene showed geographical variations. The polymorphisms of MTHFR may play a role in birth defects risk, thus, periconceptional folic acid supplementation and healthcare following gene polymorphism investigation may be a powerful measure to decrease congenital malformations.

Objective To investigate the current epidemic situation of hospital infection of Acinetobacter baumannii and its resistance to antibiotics in order to provide reference for clinical treatments．Methods The retrospective analyses were performed based on the sample isolations and bacterial cultures from inpatients in the hospital from 2012 to 2016．Results A total of 2168 bacterial strains were collected. The positive rate was found to annually increase from 2012 to 2014 but it showed a gradual decrease from 2014 to 2016. Clinical isolates of A. baumannii were mainly from sputum samples. The majority of isolates came from the critical care medicine,neurosurgery,pulmonary infections,orthopedics,and geriatrics. The resistance rate of A. baumannii to antibiotics that are currently used was as high as 70 percent. The bacterial resistance to Cefoperazone was the lowest of all isolates. Conclusion The frequency of multiple drug resistance seems to be rising in spite of the decreased A.baumannii isolation in the hospital surveyed,indicating an urgent need of clinician use of antibiotics based on sensitivity test.

Objective Analysis of pertussis infection in Shandong area. Methods From January 2015 to December 2016 in Shangdong Provincial Hospital affiliated to Shandong University,BP-DNA analysis was used to detect Bordetella pertussis nucleic acid in 1989 patients. SPSS21.0 software was used to retrospectively analyse Bordetella pertussis infection in population. Results In 1989 throat swab specimens,the positive rate of nucleic acid detection of Bordetella pertussis was 23.06%,the positive rate of pertussis nucleic acid is 30.78% in male,slightly lower than the 34.75% of women,but there was not statistically significant difference between two groups （P>0.05）; the positive rate of nucleic acid of Bordetella pertussis in the age group of 0-1 year old is the highest,accounting for 38.72%,the positive rate decreased gradually with the age increasing,and the positive rate is the lowest in above 30 years old group with 14%; there was significant difference between seasons of Bordetella pertussis nucleic acid detection positive rate （P<0.05）. Among them,the highest positive rate was 40.35% in summer,which was significantly higher than that in autumn with 33.11% （P<0.05）,the positive rate in autumn was significantly higher than that in spring with 24.8% （P<0.05）,and it was slightly higher in spring than in winter with 19.56% （P>0.05）. Conclusions There was no significant difference in the positive rate of detection of Bordetella pertussis among population in Shandong area,but there were differences in age and season. We should strengthen the detection of Bordetella pertussis nucleic acid in suspected patients.

Objective To investigate the clinical efficacy of anisodamine injection combined with azithromycin sequential therapy for the treatment of Mycoplasma pneumonia and its effect on serum inflammatory and immunological markers.Methods Eighty children infected with M. pneumonia in the hospital were randomly divided into two groups from February 2015 to February 2017. The control group was only given azithromycin,the observation group was given anisodamine injection combined with azithromycin sequential therapy. The effective rate of clinical treatment,serum cytokines and immunological indexes,the disappearance of clinical symptoms and signs,and the duration of hospitalization were compared and analyzed. Results The total effective rate of the observation group was higher than that of the control group （P<0.05）. The levels of IgA,IgM and IgG in the observation group were significantly higher than those in the control group （P<0.05）. MCP-4,MDC,CysLTs,sICAM-1,and IL-17A were found to be decreased significantly in the observation group than those in the control group （P<0.05）. The time of cough appearance in the observation group was earlier than that in the control group. The duration of fever,wheezing,lung rales and the hospitalization was shorter than that of the control group （P<0.05）. Conclusion The anisodamine injection combined with azithromycin sequential therapy in the treatment of Mycoplasma pneumonia infection may improve the clinical curative effect ,decrease the serum inflammatory cytokines and increase immunological markers,resulting in a prompt reduction of the clinical manifestations.

Objective To detect the serum level of IL-37 in patients with rheumatoid arthritis （RA） to uncover the correlation of IL-37 with rheumatoid arthritis. Methods Fifty-nine patients diagnosed as rheumatoid arthritis were enrolled in the study. Disease activity was evaluated by calculating the 28-joint Disease Activity （DAS28） Score based on the clinical information． RA patients were divided into active and inactive groups according to the DAS28 score．The serum levels of IL-37,TNF-α,IL-17,IL-10 were measured by enzyme linked immunosorbent assay （ELISA） and C-reaction protein （CRP） by nephelometry. Results The serum levels of IL-37 was higher in RA group compared with the other two groups （P<0.01）. In addition,IL-37 levels in the active group were elevated markedly compared with those in the inactive group. More importantly,IL-37 showed a significantly positive correlation with DAS28,CRP,TNF-α and IL-17 concentrations in RA patients,but not with IL-10 by Spearman's test. Conclusion These findings show that IL-37 indicates the disease activity of RA and might be a valuable biomarker for auxiliary diagnosis of RA.

Objective To explore the levels of serum total cholesterol （TC） and hemoglobin （Hb） in different stages of chronic lymphatic thyroiditis（CLT） in female patients and its clinical significance. Methods 119 female patients with CLT were divided into 3 groups according to serum TSH levels. Group A （patients with transient hyperthyroidism,TSH<0.27 IU/ml）; Group B （patients with normal serum TSH,TSH0.27-4.2 IU/ml）; and Group C （patients with hypothyroidism,TSH>4.2 IU/ml）. Another 36 persons,who showed normal condition after health examinations swere selected as controls. The serum levels of TSH,TC and Hb were detected and compared in the four groups. Correlations of TSH with TC and Hb were evaluated in patients with CLT. Results The serum TC level was significantly higher in Group B and Group C than in normal controls. The level of TC was notably lower in Group A than in the other 3 groups （P<0.05）. The serum level of Hb was significantly lower in Group A and Group C than in normal controls（P<0.05）. In patients with Hashimoto′s thyroiditis,TSH was positively correlated with TC（r=0.572,P<0.001）,but not with Hb（r=0.256,P>0.05）.Conclusions There exists alteration of TC and Hb in different stages of chronic lymphatic thyroiditis in female patients,and timely laboratory survelliance would be necessary.

Objective To investigate the clinical value of anti-HCV-IgG antibody and serum HCV-RNA in the diagnosis of hepatitis C. Methods The serum samples of 114 patients with hepatitis C were collected from October 2014 to October 2016,the anti-HCV-RNA antibody was detected by enzyme-linked immunosorbent assay （ELISA）,and the HCV-RNA load was detected by fluorescence quantitative polymerase chain reaction （PCR）.Statistics of all specimens of anti-HCV-RNA antibody,HCV-RNA data. Results The positive rate of anti-HCV-IgG was 25.44% （29/114）by ELISA. The positive rate of HCV-RNA was 27.19% （31/114）by fluorescence quantitative PCR. anti-HCV-IgG positive specimens of 26 cases were detected from 31 cases of HCV-RNA positive specimens,the coincidence rate of 83.87% （26/31）. There was no significant difference in detection positive rate between anti-HCV-IgG antibody by ELISA and HCV-RNA by fluorescence quantitative PCR （P> 0.05）. With the increase of HCV-RNA viral load,the detection rate of anti-HCV-IgG positive antibody was significantly increased. There was no significant difference in the detection rate of anti-HCV-IgG antibody positive in the adjacent region of different HCV-RNA viral load （P> 0.05）.Conclusion ELISA to detect anti-HCV-RNA antibody and fluorescence quantitative PCR detection of HCV-RNA in the diagnosis of hepatitis C have a certain clinical value,serum HCV-RNA viral load is an important basis for judging the infection of hepatitis C virus,which can But a single anti-HCV-RNA antibody,HCV-RNA detection is still limited,prone to misdiagnosis phenomenon,the combination of the two can significantly improve the detection rate of hepatitis C virus infection,Do early diagnosis,early treatment,to provide value for improving clinical efficacy.

Objective To investigate the clinical value of serum 5'-NT, TBA combined with MAO in the diagnosis of liver tumors. Methods 250 patients with liver disease treated in our hospital from May 2014 to May 2016 were selected as the observation group. The patients were divided into three groups according to the type of disease：liver tumor group, chronic hepatitis group, cirrhosis group, severe hepatitis group, acute hepatitis group and type Hepatitis group; and then select the same period to our hospital for physical examination of 100 cases as a control group. Serum levels of 5'-NT, TBA, MAO, AST, ALT and GGT were detected in each group and compared with each other.Results The levels of TBA, AST, ALT and GGT in 250 patients were significantly higher than those in the control group （P<0.05）.The levels of serum 5'-NT in liver tumor group, chronic hepatitis group, cirrhosis group, acute hepatitis group and hepatitis C group were higher than those in control group, the difference was statistically significant （P<0.05）.There was no significant difference in serum 5'-NT level between the severe hepatitis group and the control group （P>0.05）.The levels of MAO in liver tumor group and cirrhosis group were significantly higher than those in control group （P<0.05）.There was no significant difference in MAO level between the other groups and the control group （P>0.05）.The levels of serum 5'-NT in chronic hepatitis group, cirrhosis group, severe hepatitis group, acute hepatitis group and hepatitis C group were lower than those in liver tumor group （P<0.05）.The level of TBA in severe hepatitis group was higher than that in liver tumor group, acute hepatitis group and hepatitis C group, the difference was statistically significant （P<0.05）.The levels of MAO in chronic hepatitis group, severe hepatitis group, acute hepatitis group and hepatitis C group were lower than those in liver tumor group （P<0.05）.The levels of ALT in chronic hepatitis group, severe hepatitis group and acute hepatitis group were higher than those in liver tumor group （P<0.05）.The levels of GGT in liver cirrhosis group, severe hepatitis group, acute hepatitis group and hepatitis C group were lower than those in liver tumor group, the difference was statistically significant （P <0.05）.Conclusions erum 5'-NT, TBA combined with MAO detection in the diagnosis of liver tumors in patients with liver secretion, synthesis and metabolic function has a high sensitivity, serum 5'-NT, TBA, MAO, AST, ALT and GGT levels can be effective Response to the degree of liver function damage, for the differential diagnosis of liver disease to provide a reliable basis.

Objective To investigate the drug resistance of Carbapenem-intermediate Enterobacteriaceae （CIE）,and whether carrying carbapenemases gene. Methods 26 CIE isolates were collected from March 2015 to January 2017 in the North District of Affiliated Suzhou Hospital,Nanjing Medical University,drug resistance of these isolates were investigated by antibiotic susceptibility testing. Carbapenemase genes KPC,NDM,IMP,VIM and OXA48 were detected by polymerase chain reaction （PCR）. Results More than 80% of 26 CIE clinical isolates were resistance to ampicillin,cefazolin,ceftazidime. PCR detected 6 isolates carrying carbapenemase genes,including 4 isolates of KPC,1 isolate of NDM and 1 isolate was IMP positive. Conclusion The multidrug resistance rate in carbapenems-intermediate Enterobacteriaceae was high,and the carbapenemases gene positive isolates were also account for a certain proportion,which suggests that the clinical monitoring of multiple drug-resistant bacteria needs to be further strengthen.

Objective To built an effective method for RhD genotyping. Methods RhD phenotyping,weak D testing and RhCE phenotyping were performed in 30 samples from members of the RhD-negative club in Nanjing Red Cross Blood Center. The RhD promoter,intron 4,and exons 7 and 10 were analysed by real-time PCR. Results Of 30 RhD-negative persons,21 showed complete deletion of the RhD gene,2 showed the results consistent with RhD-CE-D hybrid,and 7 showed amplification of RhD promoter,intron 4,and exons 7 and 10. Of the latter group,5 were in the DEL blood group,1 were weak D,1 was partial D. The RhD-negative phenotype samples consisted of 20 C-E-c+e+,6 C+E-c+e-,2 C+E-c+e+ and 1 C-E+c+e-. The C-E-c+e+ phenotype showed 100% positive predictive value for detecting D-negative cases.Conclusion RhCE phenotyping is efficient to distinguish D-variants in RhD（-）screening test.

Objective To analyze the allele frequencies and the polymorphisms of Human platlet antigen 1 to 17 system in Heilongjiang Han population for determination of their clinical significance. Method PCR-SSP was used for HPA1-17 genotyping among 123 unrelated Han nationality volunteer donors. The genotypes and gene frequencies of the each HPA gene system were calculated,and the difference with other populations were compared. Result The gene frequencies of HPA-1a,2a,3a,5a,6a,15a were 0.9878,0.9594 ,0.6828,0.9715,0.9837,and 0.4796,respectively,and the gene frequencies for all of HPA-4a,7a~14a,16a,17a were found to be 1.0. The gene frequencies of HPA-1b,2b,3b,5b,6b,15b were 0.0122,0.0407,0.3171,0.0285,0.0163,and 0.5204,respectively. HPA-4b and 7b to 14b and 16b to 17b were undetactabl. The study is the first time to investigate the assortment of HPA genes and their frequencies. The 24 assortment systems were found in Heilongjiang Han population,and only 3 of HPA gene frequencies more than 10%,and 21 less than 7.5% were noted. Conclusion Distribution of the allele polymorphisms of HPA 1-17 in Heilongjiang Han population was featured compared with other regions and countries. The system of HPA-3,15 in Han population with high polymorphism in that the incompatibility rates of donor recipient HPA-3,15 were 33.93％ and 37.46％ in random platelets infusion.

Objective To explore the relations between times of delivery and anti-E antibody frequencies in RhE- negative pregnancies. Methods Micro-column gel test was used to detect RhE antigens, irregular antibodies and ABO blood groups in 2012 pregnant women, and spectral cell identification was performed to detect anti-E antibodies in the samples with positive irregular antibodies. Results Fifty percent pregnant women were found to be RhE antigen-negative. No significant difference of positive rates of anti-E antibodies was noted between the women with first pregnancy and those with over one time of pregnancy（P>0.05）. Additionally, no obvious difference of ABO blood group distribution was seen between RhE-negative and –positive pragnancies （P>0.05）. Conclusions Over half of pregnant women present negative RhE antigen and the positive anti-E antibodies are frequently detectable in multipara women, which is significantly meaningful to the women with a second child.

Objective To evaluate the performance of the body fluid （BF）mode on Sysmex XT-4000i for counting blood cells in cerebrospinal fluid （CSF）. Methods One hundred and forty -two CSF specimens were collected from the inpatients in Shandong Provincial Hospital from June to December,2015. Blood cells of all the specimens were counted for method comparison between Sysmex XT-4000i and manual microscope （counting chamber and stained cytospin slides）.Results Excellent correlations were found for counting white blood cells （y=1.17x+3.21,n=118,r²=0.98）,mononuclear cells （y=0.81x+13.61,n=101,r²=0.88）,polynuclear cells （y=0.82x+5.15,n=101,r²=0.88）and red blood cells （y = 1.01x+146.40,n = 62,r²= 0.99）. Good agreement was found between levels of high fluorescent （HF）cells detected by XT-4000i and large cells （macrophages or malignant cells）found under the microscope （y = 0.54x+3.31,n= 101,r²= 0.27,P <0.000 1）. The true positive rate of HF cells was 13.9% and their true negative rate was 96.9%. However,no correlation was found between eosnophils detected by XT-4000i and under the microscope （P >0.05）. The true positive rate of eosnophils was 9.8% and their true negative rate was 80.0%. Good precision （CV≤30%）was got in white blood cells,mononuclear cells,polynuclear cells and red blood cells counted by XT-4000i. Both carry-over （≤0.3%）and linearity （r²=0.99）were also excellent for white blood cells and red blood cells. Conclusion The BF mode on XT-4000i may be routinely used for CSF cells count because of its excellent accuracy and precision. HF cells may have some predictive value in large cells in CSF.

The laboratory of blood station is an important place to ensure the quality of blood for clinical use,standardization and normalization of management in the laboratory can improve the working environment,increase efficiency and quality of work,improve the image of blood station. According to the 5S management mode,we use 7S field management method and continuously enhance the management of laboratory,which not only create a clean,orderly and smooth space environment in the laboratory,but also improve work efficiency,ensure the quality of blood testing and save resources. Through the discussion of implementation of 7S management about specific methods,process and effect,we aim at providing the reference for the construction and development of laboratory in national blood station.