Objective To detect the serumantibodies against oncotherapy agentsand provide clinical datafor safety of transfusion and chemotherapy. Methods A total of 309 serum samples were randomly selected from patients with chemotherapy and antibodies were detected. Antibodies tocapecitabine and trastuzumab were detected in 157 and 152 patients,respectively. The patient's seraweremixed with O-type erythrocytes coated with the corresponding drugs,andthe micro-column gel indirect anti-human globulin method wasperformed to detect the antibodies against the two agents. Results Among 309 serum samples,eight were found to bepositive,with ageneral positive rate of2.5%,including 3 (1.9%) of Trastuzumab and 5 (3%) of capecitabin. Conclusion Detection of the antibodies against anti-tumor chemicals would be necessary toprevent from immune hemolysis and other adverse reactions post-transfusion.
Objective To report one case of hemolytic anemiainducedby cefoperazone-sulbactam sodium, with theestablishment of diagnostic procedure for the patient. Methods The anti-human globulin test and DAT typing of erythrocytes were performed in the patient. The antibodies against the drugs weredetected by drug-sensitized erythrocytes and the hemolytic and coagulation index were analyzed. Results DAT was positive and DAT typingshowed IgG+C3, and antibodies against cephalosporins was present in theserumof the patient, the Hb decreased from 122g / L to 80g / L after treatment and the PLT from 90×109/ L to 17×109/L. Inversely, LDH increased from 189.5 μmol / L to 347.2 μmol / L and AST increased from 25.7 U / L to 63.5 U / L. PT prolonged from 13.4 s to 20.9 s and APTT from 35.8 s to 56.6 s, with the INR extending from 1.19 to 1.8. Conclusion Hemolytic anemiamay occurin the patient following cefoperazone-sulbactam sodium administration.
Objective Comparison of platelet quality between machine preparation of platelet and manual preparation.Method 400 ml of blood extracted from 60 donors. Platelet concentrates were obtained by Methods of Machine preparation and manual preparation. Platelet recovery,platelet count,platelet capacity,red blood cell residue were detected. Results The Buffer-coat-derived platelet recovery rate by Machine were higher than by manual separation preparation （P<0.05）. There is no difference of The account of Red blood cell residue by Machine and by manual（P>0.05）.CV of platelet capacity by mannual was higher than that of machine（P<0.05）.Conclusion Machine preparation of collected concentrated platelet has higher platelet recovery and capacity than manual preparation of platelets.
Objective To detect and analyze the human parvovirus B19 antigens and antibodies in methylene blue inactivated virus-free plasma to evaluate the safety of blood transfusion. Method 1 056 bags of plasma inactivated with methylene blue were randomly selected and prepared from February to April,2016,for detection of the human parvovirus B19 antigens and antibodies using ELISA. Samples of the positive HPV B19 antibodies were grouped for statistical analyses according to gender,age,and blood groups. Results Parvovirus B19 virus antigens were negative in all 1056 bags of methylene blue inactivated virus-free plasma,whereas IgG and IgM antibodies were positive with the overall prevalence of 20.5%（216/1056）,with 19.5%（206/1056）IgG positive rate being,and 4.9%（52/1056）IgM positive rate. The HPV B19 antibody positive rate were found to be different among different blood donors：B19 positive rate increased with age,antibodies to B19 in blood group A and AB was higher than in groups B and O.No statistically significant difference was noted in gender. Conclusion Although the risk of Yichang residents at human parvovirus B19 infection from blood transfusion is not high,detection of HPV B19 before blood transfusion is significant for some recipients such as immunocompromised patients.
Objective This study aimed at investigating the recalling of blood donors in Dalian who had been identified aspositiveanti-HCVcarriers by routine screening Methods.Methods Anti-HCV positive samples that had been preliminarily screened by routine screening were re-examined with ELISA,NAT and electro-chemiluminescence assay in Dalian Blood Center from January 2013 to July 2015. The time and intervalof recalling was evaluated. Results A total of 192 065 blood donorswere screened and 679（0.35%） cases wereprimarily identified to beanti-HCV positive. Among them77 cases were followed upby repeated combinative detections stated above. No significant difference of ELISA positive rate between various recalling times and intervals （P=0.106,P=0.353,respectively） was seen in the blood donors whoshowed both negative electro-chemiluminescence assay and NAT.Thus twotimes of recalling and longer than 3 monthsof interval weredeterminedas the appropriate recalling strategy. Conclusion The screen Methods routinely usedis insufficient to avoid the occurrence of false positivitiesthat might be related tounqualified regents and/or uncaliberated instruments. A deep approach is needed to optimize thestrategy of laboratory examinations for rejectionof the anti-HCV positive cases or rejoin of qualified blood donors in order toensure the safety of resource.
Objective To understand the blood groups and suspicious blood group testing. Methods 342 145 blood samples were retrospectively analysed in the routine tests of ABO blood type and RhD blood type in the blood center from 2014 to 2015. The ABO blood type discrepancy,O type cell agglutination,and RhD negative samples were identified. Results ABO blood typing in donors revealed B（34.78%）> O（30.59%）>A（25.00%）>AB（9.62%）. 2 025 case of RhD negative samples were screened out,among them 1 888 cases（93.23%） were identified as negative RhD type and 137 cases（6.77%）of D type variants 127 cases of suspicious blood type included 67 cases of weakly positive/negative antibodies,8 cases of low antigenicity,31 cases of subtypes,16 cases of irregular antibodies,4 cases of cold agglutination,and one case of autoantibodies. Conclusion It is significant for appropriate planning of donors recruitments and specified blood typing to analyze blood type detections.
Objective Statistical analysis the antibody specificity and transfusion of patients due to blood transfusion of red blood cells of irregular antibodies,explore the measures to promote the saftey and effectiveness of blood transfusion. Methods 22 306 cases of blood transfusion patient was collected from January 2013 to December 2015,to statistics analysis the red blood cells of irregular antibodies screening evaluation test Results and the red blood cells of irregular antibody specificity. Results There were 22 215 cases which were negative for irregular antibody in 22 306 cases of blood transfusion samples,and 41 cases were positive after blood transfusion,at a rate of 0.18% （41/22 215）. Specific antibodies were found in 36 cases,Rh system antibodies were detected in 29 cases,accounting for 80.56% （29/36）; Lewis system antibodies were found in 5 cases,accounting for 13.88% （5/36）; Kidd system antibodies were found in 2 cases,accounting for 5.56% （2/36）. Among 36 patients,14 patients produce irregular antibody with transfusion of red blood cell,there are 4 cases of frozen plasma infusion alone or platelets,18 cases of infusion contains a variety of blood composition. Conclusion Irregular antibody screening and identification of the Rh system antigen in blood donors and recipients before blood transfusion,and transfusion of the suitable blood which can significantly reduce the produce of irregular antibodies,was an important means to ensure the safety of clinical blood transfusion.
Objective To analyze the distribution pattern and changing trend on gender,age and background（organizations or individuals）among voluntary blood donors from 2011 to 2015,evolve and improve reference basis for donor recruitment measures.Methods Collected data of blood donors in Dalian from 2011 to 2015 including gender,age and background（organizations or individuals）.Then analyzed the distribution varied trend of donators employing Tangshan Qiao Analyzing System．Results The number of blood donors in Dalian has been increasing every year.Male blood donors always exceed females in scale.The gender gap has further widened beyond proportion（63.2%VS36.8%）and the difference was statistically significant （P<0.01）; the mean age of blood donors has increased by 2.5 years（P<0.01）.From 2011 to 2015,the donation proportion of aged 18~25 decreased gradually（49.2%VS38.7%,P<0.01）,and no significant differences was observed in the age group of >25~35 （26.1%VS25.9%,P>0.05）,but>35~45 and over>45 gradually increased（17.2%VS21.6%,P<0.01;7.5%VS13.8%,P<0.01）．From 2011 to 2015,the ratio of individual blood donation decreased from 82.4% to 72.8%（P<0.01）while that of organization donors increased from 17.6% to 27.2%（P<0.01）.Conclusion The distribution of voluntary blood donors in Dalian,including gender,age and background（organizations or individuals）,has its own characteristics．The donation proportion of voluntary blood donors from different population shows great volatility,so we should strengthen publicity toward blood donors from different age and education levels,establish reasonable blood donor recruitment measures and ensure enough blood supply．
Objective Infection status one case of low concentrations of HIV RNA window period blood donor was confirmed by combined serological and molecular biological Methods. Methods On serological ELISA Results qualified blood specimens for nucleic acid detection,1 case of low concentration of HIV window period were found via the method of qualitative and quantitative detection of nucleic acids （NAT）,the donor's samples in different periods of blood specimens of HIV viral load were detected. Results The first time blood donor samples tested negative by ELISA serology,nucleic acid reactive qualitative test,followed by quantitative nucleic acid testing is less than 20 copies / mL; for follow-up samples collected serological and nucleic acid testing,final confirmation serum turn positive. Conclution The blood donor is a very low viral load of 1 HIV window period of blood donors,NAT detection technology and ELISA detection combined to further protect the safety of clinical use of blood.
Objective To analyze and compare the detective ability of nucleic acid testing Kehua and Daan．Methods Kehua and Daan nucleic acidscreeningsystems were used to detect 56 703 specimens after routine examination qualified and 10 copies of NCCL specimens which had passed the ELISA test beforehand. Statistical analysis was conducted on the effective split ratio and positive ratio of nucleic acid．Results Kehua nucleic acid screening system screened 31,497 specimens and 35 mixed specimens were determined to be positive,among which 23 pools were determined reactive by split testing．The number of reactive samples was 26. The effective split ratio was 65.71%. The positive ratio of specimens was 0.083%. 25 206 specimens were detected by Daan system and 58 mixed specimens were determined to be positive,among which 30 were reactive by split testing,and the number of reactive samples was 34. The effective split ratio was 51.72%. The positive ratio of specimens was 0.135%. 10 cases of NCCL specimens were correctly detected. Conclusion Kehua and Daan screening system shows their own advantages in detecting positive samples from ELISA negative. Both are well fit for routine nucleic acid testing．
Objective To study significance of combined detection of serum retinol binding protein （RBP） and urine alpha 1 microglobulin （alpha 1-MG）,albumin （mALB） in assessment of renal function and prognosis in patients with chronic glomerulonephritis. Methods The 50 cases were randomly selected from patients with chronic glomerulonephritis undergoing implementation method of treatment as the research object in our hospital in December 2013 -2014 year in December,as the observation group,and randomly 50 cases of healthy persons were selected as control group at the same period. RBP,1-MG and mALB alpha were detected in two groups,the correlation between above indicators and the damage of kidney function or prognosis of patients were analyzed. Results Compared with the control group,there was higher level of RBP,a 1-MG and mALB in patients from the observation group with significantlydifference （t=8.6225,9.3614,11.2416,P<0.05）; RBP,mALB and alpha 1-MG levels were significantly higher in patients with chronic renal failure than in those slow or no progress （t=7.9854,8.6354,10.5241,P<0.05）,the change of RBP,alpha 1-MG and mALB level is proportional to the prognosis effect ; and compared to separate evaluation,sensitivity and specificity are significantly higher in ROC of RBP,a 1-MG and mALB curve of joint detection area. Conclusion Three indexes of RBP,1-MG and mALB alpha has important application value in the evaluation of renal function in patients with chronic glomerulonephritis damage effect and prognosis,and three indicators combined detection is helpful to improve the accuracy of clinical assessment,it is worthy of popularization and application.
Objective To explore clinical distribution and drug resistance of carbapenem-resistant Enterobacteriaceae and provide basis for clinical rational use of antibiotics．Methods Carbapenemase phenotypes were detected in identified 46 CRE by modified Hodge test．The strains and their drug sensitivity tests were performed by VITEK-2 automatic bacteria identification system . The antimicrobial susceptibility Results were evaluated according to CLSI 2012 standard and analyzed with WHONET 5.6 software．Results 82.61% of 46 CRE isolates were identified to be Klebsiella pneumoniae． Those infected patients were mainly from intensive care units（ICU）,accounting for 50.0%, and infection site located at the lower respiratory tract（69.57%）. A total of 38 stains from 46 isolated stains were positive in modified Hodge test. Analysis of the 46 CRE during last two years,we found that 9 of them were pan drug-resistant（19.6%）,but the resistance rates of CRE isolates to other antimicrobial agents were all in 70%-100%,and all appear in this recent year. The resistant rates of the CRE in the year from September 2014 to September 2015 to aminoglycoside drug amikacin,tobramycin and gentamicin were dramatically increased to which from September 2015 to September 2016（from 19.0%,19.0% and 23.8% to 96.0% and 88.0%,96.0% respectively）,and resistant rates to the Compound sulfamethoxazole and nitrofurantoin were slightly decreased（from 85.7% and 100% to 65.8% and 80% respectively）. Conclusion The CRE isolates were mainly isolated from specimen of sputum in ICU and there was multiple drug resistance trend. The Drug resistance surveillance should be strengthened to guide the clinical medication and to reduce the emergence of drug resistant strains.
Objective This study aim to explore the correlation between adverse pregnancy outcome and TORCH infection.Methods 1 892 pregnant women were enrolled in our hospital from October 2013 to October 2015,and the clinical data of all pregnant women were retrospectively analyzed. All pregnant women were divided into normal pregnancy group according to pregnancy outcome group 1 788 cases,104 cases of adverse pregnancy group. TORCH infection in pregnant women from two group were detected and compared. Results TORCH-IgM was positive in all the pregnant women,accounting for 1.85% （35/1 892）. The positive rate of TORCH-IgM in the adverse pregnant group was higher than that in the normal pregnancy group （P<0.05）.The positive rate of TORCH-IgG in all pregnant women was 1.16% （22/1 892）,but the difference was statistically significant （P<0.05）.In all pregnant women,293 cases were diagnosed with umbilical cord blood,9 cases of TORCH-IgM positive,accounting for 3.07% （9/293）; and adverse pregnancy group TORCH-IgM positive rate was higher than the normal pregnancy group,the difference was statistically significant （P<0.05）.The positive rate of TORCH-IgG was 1.71% （5/293）,while the positive rate of TORCH-IgG in the adverse pregnant group was higher than that in the normal pregnancy group （P<0.05）,and the difference was statistically significant （P<0.05）. Conclusion There is a significant correlation between the adverse outcome of pregnant women and TORCH infection,and the possibility of TORCH infection in both pregnant women and newborns. TORCH should be used as routine prenatal examination,early diagnosis,early treatment and improvement of pregnancy ending.
Objective To investigate the clinical application of homocysteine in the interventional treatment of myocardial infarction. Method 156 patients cured in our hospital treated by percutaneous coronary intervention with acute myocardial infarction from 2014 June to 2016 January were chosen as the treatment group,before and after treatment hyperlipidemia,homocysteine and other indicators were detected and compared with 60 healthy persons （the control group）. Results The levels of blood pressure、BMI、TG、TC、LDL-C、HDL-C、GLU and Hcy in the treatment group before the operation were higher than the control group,the difference was statistically significant （P<0.05）; The levels of Hcy in the treatment group after the operation were lower than before the operation,but higher than the control group,the difference was statistically significant（P<0.05）; multivariate Logistic regression analysis showed that Hcy was an independent risk factor for AMI. Conclusion The Hcy level decreased after acute myocardial infarction PCI,is related to the severity of coronary heart disease,it is helpful to understand the condition and prognosis of myocardial infarction.
Objective To investigate the current status of Staphylococcus aureus and streptococcus pneumoniae infection in our hospital from 2012 to 2016 and their drug resistance in order to provide reference for clinical medication．Methods The retrospective analysis was performed on the separation condition and the drug resistance of Staphylococcus aureus and streptococcus pneumoniae from the bacterial culture among the inpatients of our hospital from 2012 to 2016. Results A total of 18 966 strains of pathogenic bacteria were isolated from all kinds of specimens,and 1 697 strains of Staphylococcus aureus were isolated. Among them,623 strains were methicillin resistant Staphylococcus aureus （MRSA）,accounting for 36.71%,Streptococcus pneumoniae 353,and the isolation rate was 1.86%.The main sources of the samples were sputum,secretion and blood;the departments with Staphylococcus aureus infection were mainly the ICU,neurosurgery,orthopedics and geriatric ward。The isolation rate of SA in 5 years and the antimicrobial resistance rate showed a continuous slow downward trend,but the detection rate of MRSA had no obvious change。The Results of SP showed that no vancomycin or linezolid resistant strains were found,The resistance rates of erythromycin,clindamycin,tetracycline and sulfamethoxazole were higher,There was a certain fluctuation of drug sensitivity in 2012-2016 year.Conclusion Our hospital SA hospital infection control is better,but the drug resistance of SP isolated from our hospital was not optimistic. clinicians should still pay more attention to the clinical rational use of antibiotics according to drug susceptibility test Results.
Objective To analyze the expression and significance of troponin（cTnI）,creatine kinase isoenzyme（CK-MB） and plasma fibrinogen（Fib） in patients with acute coronary syndromes （ACS）. Methods One hundred and twenty patients with ACS and 30 cases of healthy persons were examined for cTnI,CK - MB and Fib from Jan to December 2016. Simultaneously,patients with ACS were subsequently divided into the group of unstable angina （UA,71 cases） and group of acute myocardial infarction （AMI,49 cases）,and the Results were compared and correlation of the concentrations of the markers with the severity of disease was analyzed.Results Patients of ACS group presented a higher level of cTnI,CK-MB and Fib compared with the healthy persons（P<0.05）. Patients with AMI showed an elevated level of cTnI,CK-MB and Fib when compared with the group UA（P<0.05）. Additionally,the serum concentrations of cTnI,CK-MB and Fib are positively correlated to the scores of Gensini in coronary heart disease（P<0.05）. Conclusion The level of cTnI,CK-MB and Fib is obviously increased in sera following ACS onset and linearly correlated with the severity of ACS.
Objective To establish normal reference range of LHD（low hemoglobin density） and MAF （Microcytic Anemia Factor） in the healthy crowds from Jiangning hospital,and to study clinical values in the two parameters' joint detection in the diagnosis of iron deficiency Anemia. Methods To select randomly 180 cases of healthy exam crowds,among which 90 cases were male,and the other 90 cases were female,54 cases of iron-deficiency anemia IDA and 50 patients with non iron deficiency anemia. Routine blood tests were operated by UniCe®DxH 800,and the hematology analyzer calculates the LHD and MAF,based on the analysis of parameters of MCHC （mean corpuscular hemoglobin concentration）,MCV（erythrocyte mean corpuscular volume）,and Hb（hemoglobin,Hb）.Results the average value of LHD in the healthy control was 2.11%,95% confidence interval of which was 0.65% ~ 3.79%. The LHD value of males was higher than that of females. The difference was statistically significant （t=4.45,P<0.01）. The average value of MAF was 130,95% confidence interval of which was 111.35 ~ 146.19. The MAF value of males was higher than that of females,the difference was statistically significant（t=9.14,P<0.01）. LHD in the IDA group was obviously higher,average of which was 26.19%,compared with the healthy control group,and the difference was statistically significant （t=10.93,P<0.01）;There were significant differences in the group of anemia patients with non iron deficiency anemia（t=4.68,P<0.01）.There was a significant decline in MAF,the average of which was 78.88,compared with the healthy control group,and the difference was statistically significant（t=26.10,P<0.01）.There were significant differences in the group of anemia patients with non iron deficiency anemia （t=7.6,P<0.01）. Receiveroperating characteristic（ROC） curve analysis for LHD and MAF in the diagnosis of IDA：cut-off 4.09% and 109.9.The sensitivity and specificity of diagnosis for IDA were higher than MCHC. The sensitivity and specificity of MAF were optimal. Conclusion To establish the reference rang of LHD and MAF in the area of jiangning.LHD and MAF for early diagnosis of IDA has certain clinical significance.
Objective To study clinical significance of NLR,PLR and RDW in the diagnosis,dynamic monitoring and prognosis of septic shock. Methods One hundred and fifty-five cases of septic shock（group death：76 deaths,cured group：79 cases）and 155 cases of healthy control were subjected to NLR,PLR and RDW blood testing. A comparison was made in PCT,WBC,RDW,PLR and NLR for their efficiency in diagnosis of septic shock. Results PCT,WBC,RDW,PLR and NLR tests in cases group revealed a statistical significance. The diagnostic sensitivity and specificity were 96.1% and 95.5%,respectively when 4.68 was taken as NLR diagnosis threshold,and 72.3% and 66.4%,respectively when 14.62 was used as PLR threshold. PCT had significantly positive correlation with NLR and PLR（r=0.884,0.599）. The mortality of septic shock was 49.03%. A difference was seen between PCT and RDW in deaths and cured individuals. Patient outcome had positive correlation with PCT and RDW（r=-0.165,-0.449）.Conclusion NLR and PLR had positive correlation with PCT,that can be used to for diagnosis and dynamic monitoring in septic shock patients due to their convenience,economy,and easy application.
Objective To understand the pathogenic bacteria distribution characteristics in children with lower respiratory infection,and guide the rational use of antimicrobial agents pediatricians,we studied sputum bacterial culture Results from children’s sample taken from nasal cavity.Methods Retrospective analysis the bacterial culture Results of 5795 cases of our hospital pediatric ward take sputum sample through nose during July 2013 - June 2016,the statistics of drug susceptibility Results with WHONET 5.6 software.Results 5795 cases of sputum specimens detected 2535 strains of pathogenic bacteria,class A,class B and class C specimen positive detection rate of 51.29%,36.75% and 18.32% respectively,Moraxella catarrhalis,Streptococcus pneumoniae,Staphylococcus aureus,Haemophilus influenzae and Escherichia coli were the top five species of pathogens isolated from;The non sensitive rate of Moraxella catarrhalis to erythrocin and azithromycin was the highest（40.93%）,the positive rate of β-lactamases was 96.22%; Did not check out the drug resistance of streptococcus pneumoniae to penicillin;Methicillin-resistant staphylococcus aureus （MRSA） detection rate of 9.49%;The drug resistance rate of Haemophilus influenzae to compound sulfamethoxazole was the highest（36.02%）,the positive rate of β-lactamases was 30.65%; The drug resistance of Escherichia coli to imipenem was not found.Conclusion Sputum taken through the nose for bacterial culture is not not impededed by oral bacteria,its Results are accurate,high positive rate; Clinical should be more choose antimicrobial agents according to antimicrobial susceptibility test Results,delay the produce of drug-resistant bacteria.
Objective A method for rapid detection of GBS bacteria is chosen,then it is evaluated. Methods The bacterial culture as the standard method,752 cases of vaginal swabs were cultured and identified,while the double antibody sandwich method for group B streptococcus immune chromatography was tested,Kappa value from SPSS19.0 software analysis of sensitivity and specificity of immunochromatography was used to compare the two Methods of consistency in the detection. Results The sensitivity of the immunochromatography was 98.21%,a specificity of 93.75%,diagnosis rate of 94.4%,Kappa=0.807. Conclusion The immune chromatography detection of GBS has high sensitivity,specificity,and high compliance rate with standard method in the detection of group B streptococcus,and is easy to operate,suitable for primary health care institutions GBS bacteria screening.
