Objective To explore the application of new transfusion paradigm，patient blood management，in transfusion practice. Methods To investigate 232 blood transfusion patients'age，gender，admission departments，hospitalization days，discharge diagnosis，blood routine before and after blood transfusion，intervention measures before and after operation from January 2016 to January 2017. Results 10 of 11 operation departments （90.91%） take more than one kind of intervention measures. Intervention group has shorter hospitalization days and higher hemoglobin change after operation than the control group. Conclusion Nowadays the application of PBM in clinic transfusion practice is limited. It is worth extending as well because it can reduce blood transfusion and improve patients'prognosis .

Objective To provide the basis for management and deployment of blood resources through retrospective analysis of clinical blood transfusion in the hospital. Methods Shanghai Kingstar blood transfusion management software was used to collect data of the clinical blood usage in clinical departments in 2015-2016，including component transfusion rate，component transfusion ratio and quarterly volume of blood consumption. Results The component transfusion frequenciesa were 99.72% and 99.80% respectively，and the blood transfusion mostly occurred in the fourth quarter of the year. The surgical ICU had the most consumption whereas the departments of gastroenterology and heptology used the large portion of RBCs and plasma. The RBCs transfusion decreased by a maximum of 40.63% in orthopedics due to the autologous blood transfusion. Conclusion Regular retrospective analysis of clinical transfusion is conducive to monitoring clinical blood uses and drawing up blood storage plan . Autologous blood transfusion is of great significance in saving blood resources.

Objective To observe the manual and automatic separation machine and the use of ACP-215 automatic red blood cell processing system in the preparation of washed red blood cell quality control indicators，compare the three . Methods on the quality of red blood cell differences. Method 120 cases of 2 U washed red blood cell products prepared by ACP-215 erythrocyte washing machine and 30 cases of similar products prepared by hand washing and 30 cases of automatic blood component separation were prepared. Results The hemoglobin content，supernatant protein content and hemolysis rate were 48.85±6.44，0.15±0.07 and 0.16±0.05，respectively，when the quality of washed red blood cell was determined by using ACP-215 erythrocyte washing machine. The other two . Methods of preparation data are good，are in line with national standards. Conclusion The use of ACP-215 erythrocyte washing machine to prepare washed red blood cell product quality is more superior，can further ensure the safe and effective clinical infusion.

Objective This study is to explore whether the parameter modification can improve the platelet erythrocyte overflow while the erythrocyte overflow occurs during the operation of the MCS+ Blood cell collector. Method ology：When the erythrocyte overflows or peak of platelet falls during the platelet collection process，the parameters of MCS+ blood cell collector would be modified and the collection of platelets thereafter would be noted. Results 18 of the 26 cases of collection with potential risk of erythrocyte overflow were then collected successfully after the parameters were modified，achieving a success rate of 69.2%; but erythrocyte overflow still occurred in the other 8 cases.Conclusion This study shows that parameter modification can partially reduce risk of erythrocyte overflow then increase the success rate of platelet collection，which can also lower the cost of platelet collection in terms of both labor and supplies.

Objective To provide evidence for recruiting blood donors in low-risk population and ensure the safety of blood transfusion，we analyzed the status of human immunodeficiency virus （ HIV ） infection among unpaid blood donors in Bozhou area. Methods A total of 200 463 blood donors were selected from 2010 to 2017 in Bozhou area. According to the results of the confirmatory test conducted by Bozhou center for disease control and prevention，the blood donors with positive results of HIV confirmatory test were divided into groups according to the year，sex，educational background，age，blood donation types and blood donation frequency. Results 35 cases of HIV infection were found in 200 463 blood donors，the infection rate was 17.46/100 000. The infection rate of male blood donors was 28.16/100 000 （82.86%），and that of female blood donors was 6.15/100 000（17.14%）. The infection rate of blood donors with associate degree or above was 9.22/100 000（8.57%），and that of blood donors with high school degree or below was 19.06/100 000 （91.43%）.The infection rate of blood donors aged 18 - 35 years was 21.56/100 000 （60%），that of blood donors aged 36-45 years was 15.53 / 100 000（31.43%），and that of blood donors aged 46-60 years was 9.32/100 000（8.57%）. The infection rate of whole blood donors was 17.92/100 000（100%）. The infection rate of primary blood donors was 36.98/100，000 （60%），that of repeated blood donors was 14.20/100 000，and that of fixed blood donors was 3.38/100 000. Conclusion Voluntary blood donors infected with HIV in Bozhou area have certain characteristics of gender，educational background and age distribution. It is necessary to strengthen the publicity and popularization of voluntary blood donation knowledge，adhere to the principle of recruiting blood donors from low-risk population，select more sensitive reagents and choose more sensitive virus nucleic acid amplification detection （NAT） method，to further ensure the safety of blood transfusion.

Objective To analyze the sources of volunteer donators and testing results of their blood in recent five years in order to provide a reference for developing the effective recruitment strategy of blood donation. Methods A total of 158 027 donators were collected，including local residents，soldiers，and the relatives of patients. Preliminary examinations and retests of whole blood samples were performed for serum alanine aminotransferase （ALT），hepatitis B virus （HBV），hepatitis C virus （HCV），human immunodeficiency virus （HIV）and Treponema pallidum （TP）. The sources of the donors and testing results were statistically analyzed. Results Among 158027 voluntary blood donators，the proportion of the local residents （in the street），soldiers，and the relatives of patients was 1∶2.7∶4.4，the total failure rate was 4.1%. The failure rate of donations in the residents and soldiers was lower than those in the relatives and friends of patients（χ2=22.329，P＜0.05）. The difference of total unqualified rate in different years was noted（χ2= 519.222，P＜0.05）. The unqualified rate was found to be HBsAg>ALT>TP>HCV>HIV. The difference of unqualified rate in all tested markers （except for HCV）in different years was statistically significant（χ2=2 298.798、41.849、23.547、34.582，P＜0.05）. Nine cases showed positive HIV and HBV，29 cases had positive HIV and TP，and 1 case exhibited positive HIV，TP and HCV，which is statistically different in the three populations of blood donation（χ2=52.707，P＜0.05）. Conclusion Continuous attention should be paid to the blood detections and blood-borne infectious diseases for ensuring the safety of blood sources.

Objective To investigate the changes of serum calcium concentration（iCa） before and after massive transfusion，and discuss the influencing factors of the occurrence of hypocalcemia. Methods 75 cases of patients receiving massive blood transfusion in Xiangya Hospital from May 1，2015 to Apr 30，2016 were selected，collected serum calcium concentration of patients before and after massive transfusion，and analyzed changes of serum AG during massive transfusion，researched on the factors affecting the incidence of hypocalcemia. Results Student t test between groups showed that the serum calcium concentration（iCa） was significantly lower than that before the blood transfusion （P<0.05），iCa after the blood transfusion 24 hours rise again，but it was still lower than that before blood transfusion （P<0.05）. Logistic regression analysis showed that the amount of blood product input and AG after blood transfusion （blood acidity after transfusion） are important factors leading to the occurrence of hypocalcemia after massive transfusion，AG after blood transfusion is main influencing factor of the severity of hypocalcemia（P< 0.05）. Conclusion Hypocalcemia has direct relationships with the amount of blood products input （P＜0.05），while patients receiving massive transfusion have higher probability to suffer from hypocalcemia. Monitoring the change of iCa and blood pH closely during treatment can reduce the occurrence of hypocalcemia and other complications after massive transfusion.

Objective To know the changes of hemogram and coagulation index after blood transfusion in medical patients. To provide clinical evidence for improving the transfusion efficacy in medical patients. Methods 116 patients received blood transfusion were screened from December 1st，2016 to May 31st，2017. Blood indicators before and after transfusion were analyzed．116 patients were divided into continuous blood transfusion and discontinuous blood transfusion groups，then we computed the average changes of red blood cells（）and hemoglobin（）in 24 hours after blood transfusion respectively. SPSS 23.0 software was applied for statistical treatment. Results A total of 116 patients received transfusion．The median red blood cells was 2.23 units. Each unit blood could increase red blood cell 0.21×1012/L and hemoglobin 6.30 g/L. The basic diseases played no significant role in the effect of blood transfusion in 24 hours. Compared with the discontinuous blood transfusion and the first time of the continuous blood transfusion groups，there existed significant differences in the average changes of red blood cells and hemoglobin after second time of the continuous blood transfusion group（P<0.05）. Conclusion Medical patients were recommended to be transfused with blood continuously in 24 hours. The effect of blood transfusion would be improved obviously.

Objective To provide evidence for effective use of platelet through analyzing the efficiency of platelets transfusion and its influencing factors. Methods Statistical analysis was carried out for 276 times of platelet transfusion in 136 patients based on gender，age，blood groups，transfusion frequency，and splenomegaly. Peripheral blood PLT count and clinical symptoms of hemorrhage were evaluated for platelet transfusion efficiency. Results One hundred and ninety-four transfusions were found to be effective in 276 transfusions （70.29%）. Both sex and age showed no significant impact on platelet transfusion efficiency （P>0.05）. The frequency of platelet transfusion negatively correlated with transfusion efficiency （P<0.05）. The patients with splenomegaly presented a significant impact on platelet transfusion efficiency （P<0.01）. Conclusions The transfusion frequency and splenomegaly are influencing factors of the transfusion efficiency. Attention should be paid to the indications of the patients in PLT transfusion so as to reduce or avoid the occurrence of invalid transfusion and improve the efficiency of PLT transfusion and clinical efficacy.

Objective To analyze the correlative risk factors and prognosis of transfusion-related acute lung injury （TRALI）in the patients who had received blood transfusion. Methods Thirty seven patients with TRALI from 2008 to 2014 were compared with the control of 58 cases for gender，age and clinical index，and possible independent risk factors that might influence TRALI were discussed. Results Compared with the control without TRALI，risk factors for TRALI included HLA antibodies II，transfusion，shock，smoking and hepatic disorders. Patients with TRALI had a higher mortality when compared with the control （χ2=49.056，P<0.05）. Conclusion The risk factors correlated to TRALI comprised of antibodies against HLA II，blood transfusion，shock，and history of smoking and hepatic diseases. Patients with TRALI had bad prognoses. Post-operative intensive cure is the critical for avoidance of TRALI.

Objective To improvethe traditional frozen red blood cell technology，we have established a rapid，simple，high recovery rate of red blood cell freezing method. Methods The glycerol protective agent was divided into three parts，from low to high concentration and the total volume was constant. Three parts were added according to the sequence from low to high concentration. The recovery rate of red blood cells，free hemoglobin，and glycerol residue were compared between the traditional method and the improved method. Results Red blood cell recovery rate was （87.44 + 3.4）%，free hemoglobin was （0.65+0.31）g/L，glycerin residue was （4.2+0.75）g/L in improved method. The control group for the corresponding results was （81.77±3.2）%，（0.58±0.23）g/L and （2.5±0.34）g/L. The red cell recovery rate of the two .Methods was statistically different（P<0.05）. Conclusion The indexes of red blood cells prepared by the improved method were in line with the national standard. And the red blood cell recovery rate was higher than the traditional method. The quality of red blood cells was improved，which was vital for ensuring the safety of blood transfusion and improving the effect of blood transfusion.

Objective To evaluate the function of coagulation and changes of coagulation markers in the preterm infants following fresh frozen plasma transfusion. Methods Prothrombin time （PT），international normalized ratio （INR），activated partial thrombin time （APTT），fibrinogen （Fbg），thrombin time （TT），and d-dimer （DD） were examined in 71 preterm newborns and the coagulation markers were detected in 36 preterm infants who received treatments of fresh frozen plasma transfusions. Results The range of coagulation parameters were PT （16.34±3.49） s，INR 1.46±0.31，APTT （78.20±20.56） s，Fbg （1.78±0.91） g/L，TT （20.24±3.06） s，and DD （5.79±10.28） mg/L，respectively，in 71 preterm infants. The PT，INR，APTT，Fbg and DD were found to be statistically different in 36 cases of plasma transfusions （P<0.05），characterized by shortened PT and APTT，decreased INR and DD，and increased Fbg. Conclusion The reference ranges of coagulation-associated markers may differ between the preterm newborns and adults. Transfusion of fresh frozen plasma may help improve the coagulation function of the preterm infants.

Objective To explore hemoglobin critical value for pediatric patients and patients with neonatal transfusion of red blood cell，and used it in clinical transfusion management of critical value. Methods Respectively threshold for starting the transfusion of red blood cells were collected in children hospitalized with leukemia，cancer，tissue cells and bone marrow transplantation before and after the children，pediatric intensive care unit，neonatal medical children，children with other children with medical and emergency medicine，and statistically analysed，based on on the study，children with partial internal medicine and neonatal infusion of red blood cells critical value was established，and used in hospital transfusion management. Results Eight medical group average Hb was 76.39 g/L for transfusion of red blood cells，transfusion of red blood cells of newborn group average Hb was 101.30 g/L. Through discussion by the hospital transfusion management committee，hemoglobin critical value is set as 75 g/L for pediatric medical transfusion of red blood cell，the newborn transfusion of red blood cell hemoglobin critical value as 100 g/L，new critical value will be released to the floor of each department. Release of new critical value before and after transfusion of red blood cells per patient fell by 0.2 U，neonatal infusion of red blood cells per patient fell 0.1 U. Conclusion Through the formulation of red blood cells infusion critical value，and on the floor，can effectively reduce the amount of red blood cell transfusion in children，save blood resources，improve children blood transfusion safety.

Objective To studythe pre-storedautologous whole bloodin stead of allogeneic blood transfusionapplied in complex spine surgery and observethe dynamic changes of postoperative inflammatory factors. Methods Fortypatients with complex spine surgeryunder general anesthesia were randomLy divided into autologous group （auto-G） and allogeneic group （allo-G） （n=20）. Patients in allo-G only received allogeneic transfusion whereas patients in auto-G pre-deposited400mLof theirwhole bloodbefore oneweek of operation and received transfusion of intraoperative salvage of shed blood. Serum IL-6，TNF-α，IL-4，and IL-10 were measured immediately after anesthesia（T1），before transfusion（T2），after transfusion（T3），on 1d（T4），4d（T5）and 7d（T6）after operation by ELISA.Blood routine tests were recorded on the days of 1，4，and 7 after operation. Results Postoperative Hb level decreased obviously（P＜0.05）while WBC notably increased in all patients of the two groups（P＜0.05）but no difference was seen between the two groups. On 4 d after operation，IL-6 were significantly higher than that in immediately after anesthesia in two groups（P＜0.05）Serum level of TNF-αand IL-10 on 1d and 4d after operation were significantly higher than thoseon the dayofanesthesia in two groups（P＜0.05）.On 1d and 4 d after operation，TNF-αandIL-10 production in auto-G was lower than that inallo-G（P＜0.05）. On 1d after operation，IL-6 in auto-G was lower than that inallo-G（P＜0.05）whileIL-4 in auo-G was lower than that in allo-G when tested on 4 d and 7 d after operation（P＜0.05）. Conclusion Pre-stored autologous whole bloodcombined with intraoperative autologous blood can reduce the amount of allogeneic blood use to save blood resource，and may help prevent adverse reaction following transfusion.

Objective To analyze the related factors of adverse reactions of blood transfusion so as to provide evidence for clinical prevention and reduction of the side effect of transfusion in children. Methods Data were collected and analyzed in pediatric blood transfusions from 2009 to 2014. Results A total of 30 518 transfusions were performed during six consecutive years in the children's hospital，among them 166 transfusion reactions were recorded，the incidence was 0.54% and the frequency of allergic reaction was 80.73%（134/166）. The most common reactions included fever （12.65%，21/166）and platelets-associated disorders（1.92%，P<0.05）.Incidence of reactions in children was not related to gender. Patients over one year of age had a higher occurrence rate of reactions following transfusion than those aged 0-1 year （P<0.05）. The incidence was significantly higher in children with more than 3 times of transfusion than others （P<0.05）. Children with leukemia，renal or rheumatic disorders were susceptible to adverse reactions（P＜0.05）. Conclusions Junior patients present a higher incidence of adverse effect after transfusion and thus unnecessary transfusion should be avoided. Children with leukemia，kidney disease or rheumatism，particularly with the age over one year and with the history of 3 times of transfusion，should be strictly monitored for the risk of transfusion reactions.

Objective To improve the rational use of blood transfusion by investigating the clinical blood transfusion data. Methods Medical records of patients received blood transfusion from 2010 to 2015 in a grade A class 3 hospital were investigated and analyzed，including total quantity of clinic blood transfusion，situation of component blood transfusion and blood transfusions in main departments. Results The number of hospitalized cases has remarkably increased during the last 6 years in this hospital. However，the total quantity of blood transfusion，per capita transfusion volume and the ratio of patients received blood transfusion reduced in a downtrend. Only the cases received blood transfusion remained basically unchanged. The highest rate of transfusion was found in the use of red blood cell （43.21%），and the others were plasma （36.76%），platelet （17.46%），and cryoprecipitate （2.57%）. Conclusion Thanks to the safety of blood transfusion management system implementation，the clinical use of blood becoming rational and the ratio of component blood transfusion was improved，yet the reasonable use of plasma still expects for enhancement.

Objective To order to provide reference for clinical rational use of antibacterial agents，we investigated the distribution and drug resistance of Psedomonas aeruginosain in our hospital. Methods A retrospective study by the software WHONET 5 .6 and SPSS16 .0 was conducted on 474 strains of P . aeruginosa isolated from the clinical specimens collected from inpatients 2014 and 2016.The BioMerieux VITEK‐2 compact system was used to identify bacterial and sensitivity test . Results Totally 2407 strains of gram-negative bacteria were detected from the clinical specimens，including 474 strains of P .aeruginosa with the detection rate of 19.7%. The common types of specimens were sputum（76.4%），secretions（7.6%）. P .aeruginosa causing hospital-acquired infections were found frequently in intensive care unit（21.5%）and the department of respiration medicine（18.3%）;During the past three years，the isolation rate of Pseudomonas aeruginosa was always in the second place，the drug resistance rates to Trimethoprim/sulfamethoxazole，amikacin，tobramycin were significantly increased（P<0.05）. Conclusions Hospital-acquired infections with P .aeruginosa distributed in the departments of multi-invasive operations，widely use of antibiotics and long periods of hospitalization .Respiratory tract infection was prevalent，during the past three years，drug resistance of Psedomonas aeruginosa without significant descending trend. Therefore，bacterial resistance surveillance should be enhanced in order to provide the reference for clinical rational application.

Objective To evaluate the laboratory-made reference materials for detection of erythrocyte sedimentation rate （ESR） in internal quality control （IQC）. Methods Red blood cells separated from fresh animal blood were washed and fixed. Six batches of the reference materials with different ESR values （Lot：ESR01-ESR06） were prepared by mixing with laboratory-made simulated plasma. The homogeneity and stability of the reference materials and the commercial reference materials （Lot：QC01-QC02） were compared following ISO Guide 35 and CNAS-GL03. And three levels of the reference materials with similar ESR value of commercial reference materials were selected for internal quality control in different measuring systems. Results Homogeneity evaluation showed that both reference materials were homogeneous and no difference among bottles was noted （P>0.05）. The bottle-to-bottle homogeneity uncertainty of laboratory-made and commercial reference materials，which were of similar ESR values （e.g. ESR01 Vs QC01，ESR04 Vs QC02），was 0.2 mm/h-1.0 mm/h and 0.8 mm/h-1.5 mm/h，respectively. The results of short-term stability showed no trend change after repeated testing within 4 weeks （P> 0.05） when stored at room temperature or refrigerated condition. However，when stored at refrigerator，the reference reagents （ESR02，ESR03，ESR04 and QC02） gave rise to the fluctuation beyond the evaluation criteria. No trend change （P>0.05） of stability after long-term （25 weeks） storage at refrigerated condition was noted for laboratory-made reference materials. The long-term stability uncertainty of laboratory-made and commercial reference materials （e.g. ESR01 Vs QC01，ESR04 Vs QC02），which were of similar ESR value，was 0.1 mm/h-3.0 mm/h and 1.0 mm/h-2.9 mm/h，respectively. The difference of the ESR value over time was in the range of evaluation criteria. Additionally，the CV of laboratory-made reference materials was found to be close to that of the commercial reference with the similar ESR value in internal quality control. Conclusion The laboratory-made reference materials are of high homogeneity and stability and can be used in internal quality control of clinical laboratory diagnosis.

Objective To explore the correlation and its diagnostic value between urine kidney injury molecule-1（KIM-1） levels and acute kidney injury （AKI） in the patients with postpartum hemorrhage. Methods Clinical data of 185 cases of postpartum hemorrhage were retrospectively analysed，according to AKI diagnostic criteria. The patients were divided into 46 cases of AKI group and 139 cases of non-AKI group. The urine occult blood and protein were detected by urine paper test，serum creatinine level was detected by alkaline picric acid method，urine KIM-1 level was determined by ELISA. The AKI risk factors was analysed by logistic regression. The diagnostic value of urine KIM-1 and other indicators for AKI were evaluated by receiver operating curve （ROC）. Results The SCr，urine KIM-1，postpartum hemorrhage volume and the rates of gestational diabetes，gestational hypertension，placental abruption，preeclampsia，positive urinary protein，positive urine occult blood in AKI group were significantly higher than those in non-AKI group （all P＜0.05）. The urine KIM-1 level was positively correlated with urine protein，urine occult blood and SCr in AKI patients （r=0.798，0.630，0.600，0.887，P＜0.05），and no correlation of other indexes were found. Logistic multivariate regression analysis showed that urine KIM-1，protein，occult blood，and SCr were risk factors for AKI （all P＜0.05）. The optimal cut-off value of urine KIM-1 as an indicator for AKI diagnosis was projected to be 5.21 ng/mL，which yielded a sensitivity of 78.4% and a specificity of 82.9% with an area under the curve （AUC） of 0.811 （95%CI：0.649～0.929，P＜0.05）. The AUC of urine KIM-1 for KAI diagnosis was higher than urine protein （AUC：0.732，95%CI：0.600～0.864，P＜0.05），urine occult blood （AUC：0.758，95%CI：0.634～0.882，P＜0.05），and SCr （AUC：0.676，95%CI：0.539～0.813，P＜0.05）. Conclusion Urinary KIM-1 is a risk factor for AKI and detection of KIM-1 may provide a reference for the diagnosis of AKI.

Objective The aim of this study was to investigate red blood cell parameters and prevalence of anemia among children aged 2-＜7 years in Lvyuan District of Changchun.. Methods From January to September in 2017，a total of 7 626 Children from 2 to 7 years old was selected from Changchun Lvyuan Maternal and Child Health Hospital. The blood samples were detected by Sysmex XE-1800 automatic blood cell analyzer. Differences between sex and age for Red blood cell （RBC） count，hemoglobin （HGB），Hematocrit （HCT），Mean Corpuscular Volume （MCV），Mean Corpuscular Hemoglobin （MCH），Mean Corpuscular Hemoglobin Concentration （MCHC），and Red Cell Distribution Width （RDW） were evaluated. Results The total prevalence rate of boys and girls aged 2~＜7 years in Lvyuan District of Changchun was 2.6% （102/3 902），2.3% （85/3 724），respectively. There was sex difference for RBC，HCT，MCV，MCH，MCHC，and RDW.The value of RBC and MCHC was higher in boys than in girls. However，the value of MCV and MCH was higher in girls than in boys. RBC，HGB，HCT，MCV，and MCH showed upward trend with the age growth in boys and girls. Conclusions The prevalence rate of anemia among children aged 2~＜7 years in Lvyuan District of Changchun was low. There are sex and age differences for Red blood cell parameters.

Objective To investigate the effect of deproteinized calf serum injection （DCSI） combined with hyperbaric oxygen on neurological function and serum levels of vascular endothelial growth factor （VEGF），matrix metalloproteinases （MMP-9） and basic fibroblast growth factor （BDNF） in patients with acute cerebral infarction （ACI）. Methods Ninety two patients with ACI in the hospital were selected in the last two years and divided into 2 groups，46 cases in each. The control group was given DCSI only whereas the experimental group was treated with both DCSI and hyperbaric oxygen. The treatment efficacy and adverse reactions were recorded. The neurological function score，serum levels of VEGF，MMP-9，BDNF and quality of life were compared between the two groups pre- and post-treatment. Results The total effective rate of the experimental group was 93.48% （43/46），which was higher than that of the control group （78.26%，36/46）（P＜0.05）. The scores of NIHSS in the experimental group were lower while physiological function，energy，mental state and health status were higher than those in the control（P＜0.05）. The levels of serum VEGF and BDNF in the experimental group were elevated whereas MMP-9 was decreased（P＜0.05）. No significant difference of the adverse reactions was seen between in the experimental （19.57%，9/46） and control groups （15.22%，7/46）（P＞0.05）. Conclusion Deproteinized calf serum injection combined with hyperbaric oxygen in the treatment of acute cerebral infarction can obviously decrease the levels of MMP-9 and VEGF，effectively elevate the level of BDNF，and improve the neurological functions and the quality of life of patients with acute cerebral infarction.

Objective To explore the effectof phosphorylated AMPK and adiponectinresistance on valvular heart disease（VHD） complicated with cardiac insufficiency. Methods A total of 47 VHD inpatients were selected as VHD group，33 cases of cardiac trauma as experimental control，and 50 healthy personsas normal group. ELISA was used to detect the serum adiponectin（APN），tumor necrosis factor-α （TNF-α） and brain natriuretic peptide（BNP）. A small amount of myocardial tissue specimenswas collected bybiopsy in the patients and control group，respectively. APN mRNA expression in cardiac tissue was detected by real time quantitative PCRand APN，AMPK and phosphorylated AMPK （pAMPK） expressions in cardiac muscle tissuesweredetected by Western blotting. Results The serum levels of APN，TNF-α，BNP in VHD group were significantly higher than those in the control and normal group （P<0.05）; serum APN，TNF-α，BNP in control group were obviouslyhigher than thosein normal group （P<0.05）. The myocardial fibers in the tissues of VHDgroup were found to beirregular，with a high expression of APN mRNA and protein （P<0.05）.The expression of pAMPK in VHD group was notablylower than that in the control （P<0.05）. No significant difference of AMPK expressionbetween the VHDpatients and the control （P>0.05）. Conclusion Patients with VHD combined with cardiac insufficiencyshowed increasedserumAPN，TNF-α and BNP but decreasedphosphorylated AMPK，and the APN resistance of myocardial tissuesmay occur，leading to the failure of APN-mediated myocardial protection.

Objective To analyze the changes of five blood coagulation indexes and exploretheir clinical significance inpatients with acute promyelocytic leukemia （APL）. Methods Prothrombin time （PT），activated partial thromboplatin time （APTT），fibrinogen，thrombin time （TT） and D-dimer were tested by CA-7000 coagulation analyzer in 203 acute leukemia cases including 46 APL （18 with high-risk and 28 with low/intermedia-riskfollowed byDIC complications），157 non-APL cases and 30 normal controls. Results Compared with the control，PT and D-dimer level were elevated in APL and non-APL groups （P＜0.05）.Fibrinogen was found to be decreased in APL group than in the control and non-APL group （P＜0.05）.No significant difference of APTT and TT was noted in the three groups （P＞0.05）. PT level was high in the high-risk group than in the low/intermedia-risk group （P＜0.05） although APTT，TT，FIB and D-dimer did not show any significant difference inthe two groups （P＞0.05）. APL with subsequent DIC complications exhibited a high level of PT and D-dimer and lower level of FIB （all P＜0.05）. Moreover，PT was negatively correlated with FIB （r=–0.43，P＜0.05） and positively with WBC （r=0.46，P＜0.05）. Conclusion The elevated PT is related to the severity of APL patients，an abnormally high level of PT and/or D-dimer and low level of fibrinogen might be valuable for early diagnosing APL with DIC.

Objective To investigate the application value of Golgi glycoprotein 73（GP73）in the diagnosis of chronic liver diseases. Methods The peripheral serum samples were collected from patients with hepatocellular carcinoma （HCC）（n=91），hepatocirrhosis（n=217），hepatitis（n=230），and healthy control group（n=62），and the serum GP73 and AFP were determined by Elisa and electrochemiluminescence . Methods respectively. Then the specificity and sensitivity were statistically analyzed. Results The level of serum GP73 was the highest in patients with HCC，followed by hepatocirrhosis group，hepatitis group and healthy control group（P<0.05）. In the diagnosis of HCC，the sensitivity and specificity of GP73 was 65.9% and 79.5%，respectively，and the sensitivity and specificity of AFP for HCC were 61.5% and 74.6%，respectively. While combined measurement of AFP and GP73 increased the sensitivity and specificity to 84.6% and 90.1% respectively. Moreover，in patients with HCC，the level of AFP was correlated with serum DBIL and AST，while GP73 level was associated with TBIL，DBIL，TBA，ALT and AST. Conclusion The sensitivity and specificity of GP73 were high enough for liver cancer screening，while combination measurement of GP73 and AFP would further improve clinical application value in diagnosis of hepatocellular carcinoma.

Objective To evaluate the value of plasma brain natriuretic peptide （BNP） in evaluating the severity of burn patients. Methods Samples were collected from 72 cases of burn patients in our hospital from February 2015 to March 2016，according to common burn method to divided into mild injury group （n=28，II degree burn area<9%），moderate burn group （n=25，II degree burn area of 10-29%，or III degree burn area<10%） and severe burn group （n=19，total burn area of 30-50%，or III degree burn area of 10% to 20%），about 3 mL of venous blood samples were drawn from the patients with injury after 24 h，48 h，72 h，96 h，respectively，immunefluorescence detection method was used to detect the blood BNP concentration，the expression level. venous blood samples from 20 cases of healthy volunteer （fetch medical examination） in our hospital were drawn as a reference. Results BNP level in 72 cases of burn patients after 24 h，compared with the normal control group，had no significant difference （P>0.05），but injury after 48 h，72 h，96 h blood BNP value were significantly increased，the difference has statistical significance （P<0.05）; BNP value differences in minor burns，moderate burn group and severe burn group after injury in 24 h blood had no statistical significance （P>0.05），but at 48 h，72 h，96 h BNP value，compared to the 24 h，were significantly increased （P<0.05）; correlation analysis showed that the burn severity and plasma levels of BNP were highly positive correlation （r=3.057，P<0.05）. Conclusion The blood BNP of burn patients reflects the characteristics of change with abnormal elevation，and is positively correlated with the degree of burn，which provides an important reference for dynamic assessment of the patient's condition，guiding clinical treatment and so on.

Objective To analyze the results of laboratory examination in cerebrospinal fluids of the patients with syphilis and explore the significance of laboratory detection for the diagnosis of neurosyphilis. Methods The data of cerebrospinal fluids (CSF) examinations of 41 inpatients were retrospectively analyzed for TRUST, TPPA, CSF, biochemical markers and IgG from 2015 to 2016. Results Thirteen cases of neurosyphilis were definitely diagnosed, 4 cases were suspected of neurosyphilis, and 24 were excluded. Positive TRUST of CSF were found in 9 cases and positive TPPA were noted in 17 cases. The number of CSF leukocytes increased (>10×106/L) in 3 cases (3/13) and the level of abnormal proteins elevated (>0.6g/L ) in 7 cases (7/13). Eleven cases（11/13） had increased level of IgG (>34mg/L). No significant changes of glucose and chloride were found compared with the non-neurosyphilis group. Conclusion Early neurosyphilis is asymptomatic and easy to be misdiagnosed. Early CSF examination is recommended for timely treatments of neurosyphilis in suspected cases.

Objective To ensure the proper application of internal quality control（IQC） and external quality assessment（EQA） in laboratory，we established the quality control .Methods of blood test in blood bank.Methods The IQC of laboratory routine test in blood bank was standardized to analyze the IQC curve periodically; We actively participated in national clinical laboratory quality assessment of National Center for clinical laboratory，verification of testing ability of blood collection and blood supply system in Anhui，and the EQA of Anhui clinical laboratory center and China International Centre for transfusion infection prevention and control（CITIC）. Results In 2016，the quality control results of the laboratory blood test room were all within the control range; The results of EQA of Anhui clinical laboratory center were qualified twice. The results of qualitative tests of verification of testing ability of blood collection and blood supply system in Anhui got the full scores. The EQA of clinical laboratory center of the Ministry of public health were totally satisfied or 100% three times. The EQA of CITIC for three times were all qualified. Conclusions Establishment of an effective quality control system can ensure the accuracy and reliability of the inspection results. At the same time，according to the result of the feedback from the EQA，it can effectively evaluate the existence of systematic errors in the laboratory，which is of great importance to improve the level of blood test，to ensure the scientific and effective results and to ensure the safety of clinical blood.

Objective To investigate the effect of information system application in nursing safety transfusion practice and experience in nursing management. Methods The hospital quality control team members used information query system to monitor the implementation of blood transfusion. The blood transfusion system used as an evaluation criterion，and to find the problems in the transfusion process. Results Before and after the quality control，the blood transfusion standard execution time，the infusion time，and the patrol time was statistically significant different. Conclusion The information system applied to blood transfusion nursing safety management can improve the quality of nursing，and was convenient to the nursing quality control.