Objective To provide a platform for clinical research of transfusion medicine,we established a national multi-center clinical preoperative anemia database. Methods Based on the Hospital Information System（HIS）of mutle-general hospitals, the data acquisition website was used to collect preoperative anemia related information of surgical patients, and the data was desensitized, aggregated and cleaned with PYTHON 3.6.1 and STATA 15.0. Results A preoperative anemia data collection system and a multi-center clinical preoperative anemia database were established, including massive high-quality data such as demographic information, laboratory examination information, diagnostic information and surgical information. Conclusion Based on data collection system, the multi-center clinical preoperative anemia database with resourceful information, high-quality data and strong operability can be used for clinical research of preoperative anemia.

Objective To analyze the influencing factors of red blood cell transfusion in patients with hematopoietic stem cell transplantation so as to improve the efficacy of blood transfusion. Methods The fundamental information before and after transfusion in patients who had underwent hematopoietic stem cell transplantation were retrospectively analyzed from January 2016 to December 2016. The changes in hemoglobin were used as the dependent variables whereas other indicators, as independent variables. The model of multi-factor linear regression analysis was used to calculate the influencing factors of transfusion. Results A total of 409 person-times of transfusions were performed in 89 patients with hematopoietic stem cell transplantation. The heart rate, height, weight, volume of single transfusion, and days of blood preservation were considered as influencing factors. Conclusion Patients with hematopoietic stem cell transplantation benefit from the blood with fresh preservation. For patients in the blood group transition stage, individual strategy should include the blood according to specific serological patterns.

Objective To analyze the characteristic of RhD negative blood type and anti-D antibodies and their association with hemolytic diseases of newborns (HDNs) in Nanning, Guigang and Baise regions of Guangxi province. Methods A total of 96 471 samples from pregnant women with no blood transfusion were tested with blood type cards and tube testing. Results 304 samples (0.32%) of RhD-negative blood were found in the pregnant woman and 7 of them had co-test with anti-D antibodies（2.30﹪）, among them, 5 newborns（71.43%） suffered from HDNs. Conclusion The distribution frequency of RhD negative blood type varied in regions of Guangxi, with different frequencies of positive anti-D antibodies that may be associated with hemolytic diseases of infants.

Objective To study the polymorphism of RHD in the pregnant women with RhD（-）who were detected by serological method so as to improve the prenatal screening and prevent hemolytic disorders of the newborns in Panyu district of Guangzhou. Methods Eighteen cases of RhD (-) pregnant women were collected. The RhD (-) recognition test was carried out with indirect anti-human globulin method, and the RhD (-) samples were verified by absorption and release test for identification of DeL phenotype. RHD genotyping was performed with PCR-SSP. Results Serological tests revealed 18 cases of RhD (-) and 4 cases of DeL phenotype (22.2%). Genotyping results showed 10 cases of 1~10 exons (55.6%), 4 cases of RHD1227A DEL (22.2%), 3 cases of RHD-CE (2-9)-D (16.7%), and one case of positive RHD. Conclusions The RHD1227A DEL variation of RHD gene dominates, suggesting that a combination of RHD genotyping with anti-D antibody detection might help guide prophylactic use of Rh immunoglobulin to prevent hemolytic diseases in newborn infants.

Objective To study the immune function and inflammatory factors after the blood transfusions following leukocyte filtration in the patients with severe trauma. Methods One hundred and forty-seven patients were randomLy divided into three groups,49 patients of the first group received transfusions with white blood cells removed and 49 patients of second group were given conventional plasma products with white blood cells. The patients in the third group untreated with transfusion were taken as control. Concentrations of CD3+,CD4+,CD8+,CD4+/CD8+,TNF-α,and IL-6 were determined in all of the subjects investigated before and after transfusion on 1d and 7d . Results No difference was noted of CD3+,CD4+,CD8+,and CD4+／CD8+ in those who received WBC-removed blood transfusion（P>0.05）on day 7 while the indicators obviously decreased in those with whole blood transfusions（P<0.05）. All the patients with transfusion showed a significant increase in serum TNF-αand IL-6 （P<0.01）on 1d and gradually decreased on 7d after transfusion（P<0.01）. The level of TNF-αand IL-6 was elevated in the patients with WBC- removed transfusion on 7d after transfusion（P<0.01）.The patients of second group presented an increased level of TNF-αafter transfusion（P<0.05）but no change was seen for IL-6（P>0.05）. Conclusion Leukocytes-free transfusion may delay the decrease of serum TNF-αand IL-6,which is helpful for rehabilitation of the patients with blood transfusion.

Objective To retrospectively analyze the distribution of antibodies and results of treatments in 8 cases of intrauterine transfusions for positive irregular antibodies and to provide a reference for the clinic treatments. Methods Irregular antibodies and their titers were detected in 8 maternal blood samples and fetal hemoglobin contents and hematocrit were measured with Sysmex xs-800i (five categories) . Results Four of 8 cases of Rh blood group antibodies were found, including one case of anti-CcEe, two cases of anti-D, and one case of anti-DC antibodies. There were 4 pregnant women who showed anti-M antibodies. Eight cases received 27 times of intrauterine blood transfusion, resulting in a notable improvement of fetal hemoglobin content or hematokrit. Correspondingly, the maternal irregular antibody titers were decreased in different degree. Six of the 8 fetuses survived. Conclusion Antibody screening and titer monitoring are required in those who have the history of transfusion, pregnancy, and/or habitual abortions. Ultrasound examination and implement of standardized intrauterine transfusion may improve the environment of the fetal growth .

Objective To assess the relationship between the initial inferior vena cava diameter and massive transfusion requirements in patients with blunt trauma. Methods We retrospectively analyzed all patients hospitalized for blunt trauma (ISS severity≥16) from 2014 to 2017. Univariate and multivariate analyses were performed to determine independent predictors of massive transfusions (defined as ≥10 units of red cell concentrate transfusions within 24 h of admission). The subject's working curve and area under the curve (AUC) were calculated. Results Two hundred and twenty-two patients were collected, including 50 patients in the massive transfusion group and 172 patients in the non-bulk transfusion group. The incidence of massive transfusion was 22.5%. Multiple regression analysis, diameter of the inferior vena cava [odds ratio (OR): 0.88; 95% confidence interval (CI), 0.80-0.96; P<0.01], fibrin degradation product (FDP; OR: 1.01; 95% CI: 1.00 -1.01;P<0.01) and fibrinogen levels (OR: 0.99; 95% CI: 0.98-1.00; P<0.01) are strong predictors of massive transfusions. Inferior vena cava diameter showed moderate accuracy (AUC: 0.74; cut-off value: 13 mm; sensitivity: 67%; specificity: 73%). The FDP value of 80.5 μg/ml, the fibrinogen concentration of 165 mg/dL, and the combined cut-off point of the inferior vena cava diameter greater than 13 mm can determine the accuracy of unnecessary large blood transfusions to be 100%. Conclusion The initial inferior vena cava diameter is a predictor of massive blood transfusion in patients with blunt trauma.

Objective This is to explore from the hospital transfusion physicians involved in transfusion-related cases of consultation to the use of blood transfusion expertise in the development of clinical transfusion therapy adjustment program, which more directly involved in the clinicalservice. Methods A retrospective analysis was made on the inpatients of Wuhan First Hospital who participated in in-hospital consultation from June 2016 to October 2018. The basic situation of patients, the distribution of departments, the purpose of consultation, consultation opinions, the adoption of doctors' suggestions and the evaluation of patients' efficacy were analyzed. Results 290 patients were consulted 304 times, covering 22 clinical departments such as orthopaedics, neurosurgery and oncology. The purpose of the consultation was mainly related to 9 aspects, such as red blood cell transfusion, DIC or hyperfibrinolysis transfusion, blood transfusion therapy guidance, etc. The rate of adoption of consultation advice was 88.8%, of which 69.7% were effective after adoption, and the blood treatment and coagulation indexes of the effective treatment patients were significantly improved. Conclusion Blood transfusion physicians play an important role in guiding clinical blood transfusion, coagulation management and transfusion therapy, and play an active role in participating in clinical consultation. It has greatly improved in the effectiveness and rationality of transfusion related treatment. At the same time, as a clinical transformation department, blood transfusion department is gradually recognized by clinical practice.

Objective To investigate the effect of dexamethasone (DX) combinated with caffeic acid tablet (CAT) on PAIg G and GPⅡb/Ⅲa levels in patients with primary immune thrombocytopenia (ITP). Methods Eighty patients with ITP in the hospital were selected from August 2014 to March 2017 and randomly divided into two groups, with 40 cases in each. The control group only received CAT, while the observation group was given DX and CAT. Clinical efficacy and PAIg G and GPⅡb/Ⅲa levels were compared between the two groups. Results The CR, R and NR rates did not reveal any significant difference on d14, d28 and w12 after treatments. Similarly, the bleeding score, PAIg G and GPⅡb/Ⅲa levels showed no remarkable differences before treatments（P>0.05）but obviously decreased after treatments in the observation group compared with the control （P<0.05）. Conclusion Compared with dexamethasone treatment, dexamethasone combined with caffeic acid tablet did not improve the therapeutic outcomes in the treatment of ITP patients in terms of laboratory tests. However, the combination therapy can effectively ameliorate the bleeding symptoms and reduce the antibody levels of PAIg G and GPⅡb /Ⅲa.

Objective To study the amount and therapeutic effects of blood transfusion and formulate the storage and scheme optimization for blood use in emergency medicine in the hospital. Methods Clinical data of 219 patients with urgent blood transfusion were retrospectively analyzed from 2013 to 2015. The variety of diseases,blood types, consumption of red blood cells,plasma,apheresis platelets and cryoprecipitate were statistically analyzed,respectively. Results Blood of group A was more frequently used than other blood types in emergency treatments,and only less than 10% of total blood was used for transfusion on emergency.The average usage of red blood cells in trauma was （8.27±4.77） U,significantly higher than that in obstetrics and gastrointestinal and other unexpected hemorrhages．The frequencies of plasma,apheresis platelets and cryoprecipitate consumption in obstetric bleedings were（852.27±185.45）mL,（6.82±8.94）U,and （6.18±8.94）U,respectively, which was remarkably higher than in other diseases．Patients with blood transfusion on emergency still showed various degrees of anemia while the coagulation index generally recovered. Conclusion The inventory of the group A blood for first-aid use in the hospital should be increased. The secure amount of blood in storage should be ensured based on the consumption of blood and blood products for emergency treatments．

Objective To explore the effect of the blood donation interval adjustment of plateletpheresis donor released by Whole Blood and Component Donor Selection Requirements (GB18467-2011) on the peripheral platelet count level. Methods The linear mixed effect model in the longitudinal data analysis method was selected to model the plateletpheresis donors who donated plateletpheresis more than 10 times from September 30, 2016 to September 30, 2018, using R 3.5.1 statistical software. Periphery platelet count level and possible confounding factors within 23 plateletpheresis donations were selected for modeling analysis. Mixed effect model with a random intercept (model1) and with both a random intercept and a random slope for interval (model2) was established. Results AIC, BIC and the significance of distributions of the log (restricted) likelihood difference showed that model 2 was superior to model 1. In model 2, the parameter estimates of covariate intercept, periphery platelet baseline count, blood donation interval, collection volume, age, gender, blood donation times and the interaction effect of blood donation interval and blood donation times were 59.708, 0.795, -0.023, 3.798, -0.234, 7.173, 0.385 and -0.004, respectively. All of the above parameters were of statistical significance. Conclusion The current minimum interval rule does not cause a large fluctuation of periphery platelet count for plateletpheresis donors with a few blood donations. Long-term blood donation in a shorter interval may cause a certain fluctuation in periphery platelet count, but the fluctuation magnitude is still small. For frequently repeated blood donors with short intervals, less platelet volume or extended interval properly should be considered to reduce the fluctuation of periphery platelet count.

Objective To investigate the genetic characteristics of human leukocyte antigen-DQB1 (HLA-DQB1) genotype in Hebei Han nationality population. Methods HLA-DQB1 high-resolution genotyping was performed by polymerase chain reaction- sequencing based typing (PCR-SBT) in 1 914 Hebei Han nationality population. The frequency of allele was calculated directly and compared with other Regions of Han nationality populations in China. Results 21 HLA-DQB1 alleles were detected from 1 914 Han nationality blood donors in Hebei, among which 6 were common alleles with frequency greater than 0.050 0, which were DQB1^*03∶01、DQB1^*03∶03、DQB1^*06∶02、DQB1^*02∶02、DQB1^*06∶01、DQB1^*05∶01. Conclusion DQB1 in Hebei Han nationality population is rich in polymorphism, and the distribution of genes has obvious regional characteristics. The knowledge of the distribution of HLA-DQB1 in Hebei Han nationality population will help to find the HLA-matched unrelated Hematopoietic stem cell donors and provide valuable basic information for population genetics research in China.

Objective To analyze the consistency of results for detection of hepatitis B virus surface antigen (HBsAg) in blood donors between electrical chemiluminescence immunoassay (ECLIA) and enzymelinked immunosorbent aasay (ELISA) and to explore the effect of ECLIA application routinely in the detection of blood donors. Methods Blood samples from blood donors were collected from December 2016 to November 2017. HBsAg was detected by ECLIA and two ELISA reagents (Reagent A and Reagent B) from different manufacturers. ECLIA were also performed for some samples which were non-reactivity in HBsAg but were reactivity in nucleic acid detection (NAT) HBV DNA. According to the 0≤S/CO<0.3, 0.3≤S/CO<0.9and S/CO≥0.9 in the ELISA, the ECLIA positive samples were grouped and counted to analyze the consistency of results between ECLIA and ELISA. ECLIA was used as a reference method to analyze the sensitivity and specificity of the two ELISA reagents. Results A total of 11 127 HBsAg were detected. The positive rates of reagent A,reagent B and ECLIA were 2.642%, 3.020, and 2.894%, respectively, the differences among them were not statistically significant (P>0.05).ECLIA showed excellent consistency with the two ELISA reagents (К_{reagent A}=0.927, К_{reagent B}=0.900). With ECLIA as the reference method, in the non-reactive samples in the ELISA detection, the ECLIA positive rate of group in “0.3≤S/CO<0.9” was0.35% higher than that of group in “0≤S/CO<0.3”0.11% (P<0.05). The sensitivity of reagent A was 88.82% lower than that of reagent B 92.24%, the specificity of reagent A was 99.93% slightly higher than 99.64% of reagent B. 16 cases were positive in ECLIA from 78 cases of HBsAg which were non-reactive in ELISA but reactive in NAT, with a positive rate of 15.5%. Conclusion The detection of HBsAg samples by twice of ELISA still has the possibility of missed detection. ECLIA can shorten the "window period" of ELISA detection, and has a high consistency with the ELISA results. The existing blood detection method can add once of ECLIA to improve blood safety.

Objective To investigate blood donor samples of positive minipool-HBV NAT （MP-HBV）but negative resolution HBV NAT （resolution-HBV）whether contain trace HBV DNA. Methods Samples of positive MP-HBV but negative resolution-HBV,and positive resolution-HBV but negative quantitative HBV,and normal samples,were measured by electrochemiluminescence assay （ECLIA）for HBsAg,anti-HBs,HBeAg,anti-HBe and anti-HBc. The resolution NAT was executed once more when resolution NAT was negative. Results Among 693 samples of positive MP-HBV with negative resolution-HBV,239 showed only anti-HBs,134 demonstrated anti-HBs/anti-HBc,111 with anti-HBs/anti-HBe/anti-HBc,25 with only anti-HBc and 9 with anti-HBe/anti-HBc. No significant difference of the seroprevalence was noted between these samples （74.75%）and normal samples （71.00%）. There were 119 of 275 resolution-HBV positive samples that presented quantitatively HBV negative. Among them,38 showed positive anti-HBe/anti-HBc,30 were anti-HBs/anti-HBc,22 anti-HBs/anti-HBe/anti-HBc,18 were only anti-HBc,3 only anti-HBs and 4 were HBsAg/ anti-HBe/anti-HBc. The HBV seroprevalence was 96.64%,which was higher than positive MP-HBV but negative resolution-HBV samples. Six of 29 secondary resolution NAT revealed positive HBV DNA. Conclusion There may exist HBV infection in positive MP-HBV but negative resolution-HBV samples with anti-HBs/anti-HBc.

Objective To compare the colloidal gold method with nucleic acid test （NAT） using ELISA positive HCV samples so as to observe the practical significance of the three methods in the safety ensurance of clinical blood transfusion. Methods The samples of blood donors were found to be positive for HCV by two ELISA methods and the results were analyzed by means of NAT and colloidal gold method. Results The NAT positive rate was 37% in 45 cases of anti- HCV positive sera,and the rate of colloid gold test was 77.8%%. No NAT positive samples were found in those with average value of S/CO below 10.0 when examined by two ELISA reagents whereas the frequencies of positive NAT was 70.8% and 62.9% in those with the average value of S/CO over 10.0.The Colloidal gold method revealed the positive rates of 46.1% and 40% respectively in those whith the value of S/CO between 1.0 and 5.0. The positive rates of colloidal gold method reached 75% in the samples of S/CO values between 5.0 and 10.0 and 95.8% in those of S/CO over 10.0. Conclusion The positive rates of NAT and Colloidal gold method are elevated with increase of S/CO value tested by ELISAs. The NAT is irreplaceable for conventional ELISAs but combination of ELISAs with NAT might improve the detection of HCV RNAs.

Objective To compare the time duration of blood centrifugation and its impact on the quality of red blood cells in leukocytes-reduced suspension. Methods Sixty samples with leukocytes reduced from 400 mL whole blood were randomly divided into 3 groups, centrifuged at 4 669 gx 4℃ for 10 min, 15 min and 20 min, respectively. Hemoglobin concentration, HCT and leukocyte residues were detected and storage terminal hemolysis rate was analyzed. Results No difference was seen in all of the indicators observed with different durations of centrifugation stated above (P>0.05). Conclusion Duration of blood centrifugation for removing leukocytes has no distinct influence on the quality of red blood cells.

Objective To analyze the influencing factors of reluctant donation of apheresis platelets, so as to provide evidence for improving the blood donation and its coping strategies. Methods The data of apheresis platelet donors were collected at the blood center, and the willingness of re-donations was randomly followed-up. Results A total of 1 160 donators with experience of apheresis platelet donation within one year received telephone follow-ups. Among them 17.52% (89/508) were at age below 25, followed by 26-35 (45.87%, 233/508), 36-45 (28.15%, 143/508), 46-55 (8.07%, 41/508) and 56-60 (0.39%, 2/508). There were 508 (43.79%) of the donors who expressed reluctance to re-donation, and among them, 388（76.38%）were males and 120（23.62%）were females. The main reasons for unwillingness to re-donation included lost touch with blood donors (59.84%, 304/508), no time (16.73%, 85/508), physical conditions ( 8.07%, 41/508) , long distance work or study (8.07%, 41/508), missed calls (6.89%, 35/508), and bad experience (0.39%, 2/508). Conclusion The common reasons for the loss of apheresis platelets donors were the failure to keep in contact with them. Therefore, it is necessary to improve the documentation, updating the information and communications with the donors for re-donation of apheresis platelets.

Objective To investigate the satisfaction of blood donors in FoShan for better understanding of the service quality of blood stations and its influencing factors. Methods With self-made questionnaire, 520 individual and group unpaid blood donors were collected by convenient sampling from blood donation stations. The effects of different demographic characteristics and blood donation conditions on the satisfaction of blood donors were analyzed by rank sum test. Results A total of 520 questionnaires were distributed, 502 valid questionnaires were recovered, with a recovery rate of 96.53%. The total rate of satisfaction of blood donors was 98.25%, and the satisfactory rate on five dimensions was over 97.5%. Total loyalty was 84.86% and the reputation was 83.47%. A high rate of satisfaction from individuals was noted compared with the group donors. Conclusion Blood donors are highly satisfied with the overall service of blood stations. Individual blood donors, however, express less satisfaction than group donors, indicating the necessity of the service quality improvement of blood station.

Objective To explore the distribution and drug resistance of pathogens causing blood stream infection in patients with hematologic disease, to provide the evidence for rational antimicrobial therapy. Method The bioMerieux BACT/ALERT 3D system was used for blood culture. VITEK2 Compact system was uesed to indentify bacteria and antibiotic susceptibility. WHONET 5.6 software was uesed to analyze the distribution and drug resistance of pathogens. Results A total of 101 strains of pathogens were isolated from blood culture from October 2017 to September 2018, of which gram negative organisms accounted for 76.24% , gram positive cocci 22.77% and fungi 0.99%. The distribution of pathogens causing blood stream infection in patients with hematologic stem cell transplantation (HSCT) were different from patients without HSCT. The prevalence of ESBLs in E.coli and Klebsiella pneumoniae were 42.9 % and 55.0 %, respectively. P. aeruginosa strains were susceptible to commonly used antibiotics. 1 strains of E.coli and 3 strains of Klebsiella pneumoniae were resistant to imipenem.The prevalence of methicillin-resistant strains was 33.3% in S. aureus (MRSA) and 66.7% in coagulase negative Staphylococcus (MRCNS). All Gram-positive bacilli were susceptible to vancomycin, linezolid, tegacycline and quinupristin-dalfopristin. Conclusion The pathogens isolated from patients with hematologic malignancies were mainly gram negative organisms. Moreover, the pathogens are highly resistant to multiple antibiotics. It is necessary to strengthen surveillance of bacterial resistance. Antimicrobial therapy should be decided cautiously base on local pathogen distribution and bacterial resistance.

Objective To study the relationship between coagulation parameters and carcinoembryonic antigen （CEA） expression in patients with small cell lung cancer （SCLC）. Methods From January 2009 to June 2012,120 patients with small cell lung cancer （SCLC） who were admitted to our hospital during that period were selected as the study object and set up as the lung cancer group and 100 healthy volunteers who underwent the physical examination in our hospital at the same time as the control group. We collected blood samples of all the subjects to determine the expression level of carcinoembryonic antigen,coagulation function index,and compared the expression level of carcinoembryonic antigen between lung cancer group and control group. Coagulation function index. The patients with small cell lung cancer were followed up for 5 years. According to their 5-year survival,the patients were divided into survival group and death group. The expression level of carcinoembryonic antigen （CEA） and coagulation function were measured and compared during 5 years follow-up. The expression level of carcinoembryonic antigen （CEA） was analyzed. Results The expression levels of carcinoembryonic antigen and fibrinogen in lung cancer group were higher than those in control group （P<0.05）. The prothrombin time and activated partial thromboplastin time were shorter than those in the control group （P<0.05）. The expression levels of carcinoembryonic antigen and fibrinogen in the dead group were higher than those in the survival group （P<0.05）,and the prothrombin time was higher than that in the survival group. The activated partial thromboplastin time was shorter than that of survival group （P<0.05）. The expression of carcinoembryonic antigen （CEA） and fibrinogen levels were negatively correlated with the long-term survival of patients with small cell lung cancer （SCLC） and prothrombin time （prothrombin time）. The activated partial thromboplastin time was positively correlated with the long-term survival of patients with small cell lung cancer. Conclusion The blood status of patients with small cell lung cancer is generally in hypercoagulability and coagulation function index. The expression level of carcinoembryonic antigen is closely related to its long-term survival. The coagulation function index and carcinoembryonic antigen expression level can be used as a reference index to predict the prognosis of patients with small cell lung cancer.

Objective To investigate the clinical and laboratory characteristics of brucellosis for improving diagnosis of the disease in the non-epidemic areas. Methods A retrospective analysis of the clinical data was performed in 10 cases of brucellosis in the hospital from 2015 to 2018. Results Brucellosis mainly occurred between March and August of the year, commonly noted in middle-aged men. Seventy percent of the patients had the history of exposure to infected animals. The white blood cell(WBC) counts were normal or reduced. High C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR)were the most common laboratory findings (accounting for 80%). Final diagnosis was made by identifying bacteria Brucella sp. With VITEK2 Compact, the average time of positive reports in blood culture was 3.8 days. Conclusion Patients with brucellosis showed different clinical and laboratory features. Attention should be paid to brucellosis in non-epidemic areas, particularly in those who presented failed treatment for unexplained long-term fever or joint muscle pain. Blood culture examination of the suspected patients is recommended so as to avoid missing diagnosis.

Objective To investigate the changes of plasma procalcitonin and C-reactive protein (CRP) in patients with Pneumocystis pneumonia(PCP) following renal transplantation and to study the value of differential diagnosis of Pneumocystis and bacterial pneumonia. Methods Fifty-five patients with PCP after renal transplantation in the hospital were examined for procalcitonin and CRP by prospective clinical observation. The patients were divided into two groups according to the diagnosis methods, and the patients with PCP after transplantation were divided into two groups: group of definitive diagnosis (group A) and group of clinically suspected diagnosis(group B). The patients of group B were described and compared with the data collected by appropriate statistical methods. Results The serum procalcitonin concentration in 55 patients with PCP remained unchanged. The CRP concentration in 47 of the 55(87.5%) patients showed a slight increase. The serum levels of procalcitonin and CRP in group B were found to be slightly higher than those in group A but no significant difference was noted (P>0 05). Conclusion Procalcitonin and CRP concentrations remains unchanged significantly in PCP patients after renal transplantation, both can not be used for differential diagnosis of Pneumocystis or bacteria pneumonia.

Objective To analyze the genotypes and mutation sites of hepatitis B virus (HBV) associated with drug resistance. Methods A retrospective analysis was conducted in HBV genotypes, nucleoside drugs (NAs) resistance including lamivudine (LAM), telbivudine (LdT), adefovir dipivoxil (ADV) and entecavir (ETV). Drug resistance mutations, HBV DNA, HBeAg, alanine aminotransferase (ALT) and platelet (PLT) were detected in 114 patients with hepatitis B between 2014 and 2016. Results Sixty-one of 114 patients were found to carrywith HBV genotype C, 45 with genotype B, 3 with genotype D, one with recombinant B/C, one with recombinant B/D and 5 with other genotypes. Type C had a high frequency (P<0.05). Thirty-nine(34.21%) cases carried NAs resistance mutations. No significant difference of NAs resistance mutations was seen between types C and B. The patients with type C had significantly decreased HBeAg (P<0.05) and low PLT(P<0.05) compared with type B.The most common drug resistance mutation was found in rt204I. Multilocus mutation of type C was more commonly detectable than that of type B (P<0.05). The combinated resistance of HBV to LAM and LdT, and two or more multiple drug resistance weremost common (P<0.01). Conclusion The genotype C of HBV dominated in this study, followed by genotype B. Patients with genotype C are prone to hepatic fibrosis and multiple site mutations, and the HBV resistance was frequently noted to LAM and LdT. The results indicated that HBV genotyping and drug resistance mutation detectionmay help evaluatethe clinical efficacy of antiviral therapy.

Objective To explore serum levels of Ang Ⅱ, BNP and neutrophil-to-lymphocyte ratio（NLR） in patients with chronic heart failure （CHF） before and after treatment and the clinical value of combination detection for CHF patients. Methods 120 cases of patients with CHF in our hospital from January 2016 to December 2018 were selected as CHF group. The patients were divided into different cardiac function groups according to NYHA method including grade Ⅱ with 48 cases, grade Ⅲ with 39 cases and grade Ⅳ with 33 cases. 95 cases healthy volunteers were selected as control group. The serum AngⅡ, BNP and NLR of all the subjects were detected, and the results were analyzed statistically. Results The levels of serum AngⅡ, BNP and NLR in CHF group before treatment were higher than those of control group, and the differences were statistical significance(P<0.05).The levels of serum AngⅡ, BNP and NLR in CHF patients were all increased along with the severity of the disease, and there were statistically significant difference in AngⅡ, BNP and NLR levels between each two groups(P<0.05). After treatment, the levels of serum AngⅡ, BNP and NLR in CHF were significantly decreased (P<0.05). The areas under the curve (ROC) of AngⅡ, BNP and NLR for distinguishing CHF from all control individuals were 0.83、0.84、0.75 respectively. Pearson correlation analysis showed that NLR and Ang Ⅱ closely related (r=0.483, P< 0.05); NLR was positively correlated with BNP (r=0.527, P<0.05). Conclusions The levels of AngⅡ, BNP and NLR in CHE were changed significantly before and after treatment and may be help for cardiac function grading and diagnosis,and the combined detection of those parameters could improve the accuracy of CHF diagnosis.

Objective To explore the diagnostic value of WBC, N%, CRP, PCT, together with IL-6, IL-27, IL-10, and TNF-α for early diagnosis of neonatal sepsis. Methods Flow cytometry was used to detect WBC and N%. The CRP and PCT were detected with both immune turbidity and the immunochromatography in the sera of patients. The levels of IL-6, IL-27, IL-10 and TNF-α were measured with enzyme linked immunosorbent assay. Results The levels of WBC, N%, CRP and PCT on days 1 and 3 were higher than those on day 7 (P<0.05). Concentration of CRP on day 3 and PCT on day 1 was elevated compared to the other groups. The levels of IL-6, IL-10 and TNF-α on days 1 and 3 were obviously higher than those on day 7 (P<0.05) whereas IL-6 and IL-27 were found to be increased on day 3 in the neonatal patients with sepsis (P>0.05). Conclusion The levels of cytokines IL-6, IL-27, IL-10 and TNF-αvaried with the courses of neonatal sepsis. Combined detection of WBC, N%, PCT as well as the cytokines may be helpful for the early diagnosis of neonatal sepsis.

Objective Identification of a rare blood type of Di(a+b-) with anti-Dib antibody by serological and molecular biology technique. Methods The patient's blood type, direct anti-globulin test, and irregular antibody screening and identification were performed by serology means. DNA sequencing was used to identify the Diego blood type. Results The patient has irregular antibodies against highly prevalent antigens. DNA sequencing confirmed the rare Di(a+b-) blood type. Conclusion Blood typing by DNA sequencing is pivotal for identification of antibodies against highly prevalent antigens.