Objective To explore the value of serum Kerbs von den Lungren 6（KL-6）in diagnosis of transfusion-related acute lung injury（TRALI）.Methods Before transfusion,at the time of 6h after that in 95 patients with mechanical ventilation,at the time of clinical diagnosis of TRALI when TRALI occurred,the observations including such as plasma BNP levels,arterial blood gas analysis,bedside chest X-ray examination,ventilator parameters,Murray lung injury score,serum KL-6 levels detected by ELISA method were collected. 95 patients with mechanical ventilation were divided into TRALI group and non-TRALI group according to the criteria of transfusion-related acute lung injury. Compared to before transfusion,the changes of serum KL-6 levels were analyzed between the TRALI group and non-TRALI group. The relationship between serum KL-6 and Murray lung injury score,oxygenation index was analyzed. In addition,the diagnostic significance of serum KL-6 was evaluated using ROC curve for diagnosing TRALI.Results Before transfusion,there were no statistically significant differences in Murray lung injury score,plat pressure （Pplat）,peak pressure （Ppeak）,oxygenation index,serum KL-6 levels,and BNP levels between the TRALI group and the non-TRALI group,P>0.05. In non-TRALI group,serum KL-6,BNP,lung injury score,oxygenation index,Ppeak and Pplat before transfusion were not significantly different than that at the time of 6h after transfusion,P>0.05. In TRALI group,compared to before transfusion,serum KL-6 levels were significantly higher,Murray lung injury score were significantly higher,Ppeak and Pplat were significantly higher,oxygenation index is significantly lower,at the time of clinical diagnosis of TRALI and at the time of 6h after transfusion,P<0.05. Compared with non-TRALI group,at the time 6h after transfusion,Serum KL-6 levels was significantly higher,lung injury score was significantly higher,oxygen combination index was significantly lower,Ppeak and Ppat were significantly higher in TRALI group,P<0.05. Serum KL-6 level was positively correlated with lung injury score,the correlation coefficient was 0.811,P<0.001. Serum KL-6 level was negatively correlated with the oxygenation index,and the correlation coefficient was -0.680,P<0.001. ROC curve analysis showed that serumKL-6 level can be used for diagnosis of TRALI,and the area under the curve （AUC） was 0.966,P<0.001. The sensitivity and specificity were 85.0% and 97.4% respectively when the level of serum KL-6 was higher than 369U·mL-1.Conclusion Serum KL-6 is a serological marker for acute lung injury,which is helpful for the laboratory diagnosis and evaluation of severity in TRALI patient with mechanical ventilation.

Objective To improve microcolumn agglutination test,then discuss the effects on early detection of HDN.Methods The microcolumn agglutination test was improved from the aspects of reaction time（15min,30min）,cell concentration（0.5%,1%）,treatment of cell reagent（low ionic strength salt solution,papain） and serum cell ratio（2∶1,4∶1）,respectively. Second,The simulation experiment was carried out by using IgG anti -D reagent,and the best scheme was found by the range analysis method. Three hemolysis experiment were carried out for the 90 cases of suspected HDN send from obstetric. Tossing in test was using thermal radiation method. Classic antiglobulin test （control group） and improved microcolumn agglutination test （experimental group） were used respectively for free trials and radiation test. Finally,statistical methods were used to compare the two methods.Results ①The optimal detection scheme of improved microcolumn agglutination test was the reaction time of 30 min,the cell concentration 1.0 %,the treatment of cell reagent papain,and the proportion of serum and cell 2∶1,among them cell reagents had the greatest impact on detection results. ②In the 90 suspected HDN cases,36 cases were diagnosed as HDN,21 cases of type A,15 cases of type B. There was no statistically significant difference in different type of HDN（χ²=0.008,P=0.931）. ③The positive rates of improved microcolumn agglutination test were higher than classical antiglobulin test（χ²=3.988,P=0.046; χ²=4.261,P=0.039）. It showed that improved microcolumn agglutination test was better than classical antiglobulin test for the early detection of HDN.Conclusion sThe best experimental scheme of improved microcolumn agglutination test was reaction time 30 min,cell concentration 1.0 %,treatment of cell reagent papain,and the proportion of serum and cell 2∶1. The improved microcolumn agglutination test was better than classical antiglobulin test for the detection of HDN,which could provide more reliable test basis for early diagnosis.

Objective Research the application value of deep autologous blood in orthopedic joint replacement.Methods A retrospective analysis of 283 cases of orthopedic joint replacement patients transfusion cases,according to whether the depth of self-storage of blood into allogeneic transfusion group and autologous transfusion group. comparative analysis of two groups of patients preoperative parameters,intraoperative bleeding,Intraoperative autologous / allogeneic blood transfusion,postoperative drainage,hidden blood loss,postoperative recovery and other parameters.Results Two groups of patients recovered well after surgery,There were no complications after operation. The total amount of blood transfusion in both groups was basically the same; Two groups of patients in different replacement of dominant bleeding,there was no difference in the P values in occult blood loss,preoperative hemoglobin levels and postoperative hospital stay were greater than 0.05. When two groups of patients with double hip and knee replacement were discharged from the hospital,the P values in hemoglobin levels were less than 0.05,the P values in autologous group was significantly higher than allogeneic group.Conclusion Depth of autologous blood can reduce allogeneic blood transfusion,there is no effect on patient surgery and postoperative recovery. It is especially suitable for unilateral arthroplasty.

Objective To detect the genotype and analysis the clinical features of deletional Chinese ^Gγ⁺（^Aγδβ）⁰-thalassemia.Methods According to the data of hematology parameters,hemoglobin electrophoresis analysis and conventional α-thalassemia gene and β-thalassemia gene detection results,126 suspected Chinese^Gγ⁺（^Aγδβ）⁰-thalassemia carriers were found,and Gap PCR was used to detect the globin gene mutations. Result20 cases were identified to be heterozygote of deletional Chinese ^Gγ⁺（^Aγδβ）⁰-thalassemia. The value of HbF was 7.31%~19.31%, Hb was 94 g/L~141 g/L,MCV was 58 fL~77.6 fL,and MCH was 18.2 pg~25.7 pg . The other 2 cases were Chinese ^Gγ⁺（^Aγδβ）⁰-thalassemia accompanied by the common βthalassemia, hemoglobin analysis showed medium or severe anemia .Conclusion Among the high Hb F population,the proportion of Chinese ^Gγ⁺（^Aγδβ）⁰-thalassemia was not low,and the Chinese ^Gγ⁺（^Aγδβ）⁰-thalassemia heterozygotes showed normal or mild anemia,but when Chinese ^Gγ⁺（^Aγδβ）⁰-thalassemia combined with other common β-thalassemia,it showed medium or severe anaemia.

Objective To explore the clinical significance of irregular antibody screening of pregnant women in diagnosis of hemolytic disease of newborns.Methods Antibody screening was performed in 3719 pregnant women by microcolumn gel anti-human globulin card method,and antibody specific identification was carried out in those with positive antibodies. Blood type serological examination and antibody specific identification of neonatal hemolytic disease were simultaneously performed.Results Twenty four cases （0.64%） of irregular antibodies were found,including 13 cases of anti-D,3 cases of anti-M,2 cases of anti-E,1 case of anti-Ce,1 case of anti-DC,1 case of anti-Lea and 3 cases of cold autoantibodies. Among the 24 pregnant women with positive antibody screening,pathological jaundice occurred and 11 cases （45.8%） were diagnosed as neonatal hemolytic disease （HDN） by serology of blood grouping.Conclusion Screening of maternal irregular antibodies is of great significance in diagnosis,prevention and treatment of neonatal hemolytic disease.

Objective To predict the trend of future development,and to provide reference for the preparation of blood components and the rational use of blood in clinical practice,we studied the current situation of blood use in Xiang yang medical institutions in the past 5 years.Methods Collecting data of blood supply and blood transfusion data from 10 hospitals on the annual report,we performed statistics on the proportion of blood and total blood,the trend of monthly consumption and the distribution of departments in hospital yearly.Results In the past five years,the total amount of clinical blood used has increased by 20.7%. The proportion of component blood transfusion has risen from 94.32% to 99.71%. Cold precipitate increased by 19.18% is first and Platelet by 17.38% is secondary. The monthly fluctuation of red blood cell used was more stable than that of plasma. It is a low valley period in February each year. The largest amount of blood was used in internal medicine,accounting for 43.28%.Conclusion How to ensure blood quality and services,at the same time,blood supply will be a long-term and serious task in the future.

Objective To study the changes and related factors of some test indexes after massive blood transfusion in Tibetan Plateau.Methods From May 2017 to April 2018,72 patients undergoing massive blood transfusion in our hospital were divided into two groups. 72 patients who received massive blood transfusion in plain area in the same period weretaken as the control group. The seven routine blood transfusion indexes of the two groups were compared,and the changes of the detection values and the related factors were analyzed.Results Platelet （PLT） level and serum calcium（Ca²⁺）were measured in the observation group after blood transfusion therapy,the level of serum potassium （K） and serum sodium（Na⁺） were significantly different between the two groups （P<0.05）,the level of prothrombin time （PT）,activated partial thromboplastin time （APTT） was significantly higher than that of the control group （P<0.05）. There was no significant difference in plasma fibrinogen （FIB） （P>0.05）.Conclusion In the course of massive blood transfusion treatment in the plateau area,it is easy to appear adverse diseases. Therefore,the factors of the change of the detection value should be analyzed when the patients are treated with massive blood transfusion in the Tibetan Plateau area. Effective measures can be taken to prevent them in advance,thereby reducing the incidence of complications. to improve the therapeutic effect of patients.

Objective This paper reviews the present situation of application of storage auto-transfusion of Preoperative Autologous Blood Donation（PABD） in our hospital,analyzes its clinical effect in elderly patients,and probes into the feasibility and difficulties of popularizing PABD in elderly patients.Methods Data from285 patients with PABD undergoing elective operation in our hospital from January,2016 to December,2017 was retrospectively analyzed. Among them,127 elderly patients over 55 years old were selected as the observation group and the elderly patients without PABD under the same conditions as the control group. The blood transfusion rate,the blood transfusion volume and the intraoperative bleeding volume,hemoglobin （HB） level and adverse reaction after operation were compared between the two groups.Results The intraoperative blood transfusion volume and blood transfusion rate in the elderly patients with or without PABD were significantly higher than those in the non-elderly patients （P<0.05）. There were no adverse reactions in the elderly patients in the observation group,but 2 cases in the control group,both showing allergic or febrile reactions,and the incidence of adverse reactions was 1. 5%. Compared with the control group,the intraoperative blood loss,blood transfusion rate and blood transfusion volume decreased significantly in the observation group,but the hemoglobin level was lower after operation （P< 0.05）.Conclusion PABD also has good effect in elderly patients and is worth popularizing. At the same time,the hospital should establish a scientific and reasonable blood transfusion system to improve conditions for the promotion of PABD.

Objective To research and analyze the serological characterization of occult hepatitis B virus infection in volunteer blood donors in Handan.Methods From March 1,2017 to December 31,2017,75,984 samples were screened by two ELISA reagents. The normal HBsAg single reagent positive specimens and negative specimens were used to undergo qualitative nucleic acid test. Then HBV DNA positive specimen were further determined by quatitative nucleic acid test and Chemical luminescence "double half" test,the correlation between combined two-method DNAtest resultsand blood donor statistics information was analysed.Results 26 OBI samples were obtained for HBsAg^-/ HBV DNA⁺ / HBcAb⁺,Among them,HBsAg^-/HBsAb⁺/HBcAb⁺ and HBsAg^-/HBsAb^-/HBcAb⁺ are the main serotypes of OBI,Each of these serotypes accounted for 30.8 % and 50.0 % respectively. The number of HBsAb>100IU/L samples accounted for 11.5 % of the total number of cases（3/26）,and the number of HBsAb （20-160） IU/L was 6 cases,accounting for 23.1 % of the total number of cases（6/26）. The concentration of the gradient dilution HBV DNA standard（3.15 IU/mL,4.2 IU/mL IU/mL,6.3 IU/mL,8.4 IU/mL） corresponds to the CT values of 41.14,37.45,36.23,and 35.04,respectively. There was no statistically significant difference between men and women in the rate of OBI infection. In terms of age distribution,there was an increasing trend with age.ConclusionAdoption of nucleic acid detection would reduce the risk of blood transfusion infection caused by the double ELISA method,especially for the detection of OBI,and improve the safety of blood transfusion. Encouragement of healthy blood donors with low anti-HBs titration to timely injection of hepatitis B vaccine would reduce the risk of blood transfusion infection of hepatitis B.

Objective To analyze the significance of Neopterin detection for screening blood donors by tested the serum Neopterin levels in virus negative and positive serum samples.Methods The virus markers（HBsAg,anti-HCV,anti-HIV and syphilis） were screened using different ELISA kits for dual hole detection. According to the results,the serum samples were divided into normal,single-positive and double-positive groups（50 cases in each group randomly）.Totally 150 samples were used to detect the Neopterin levels via ELISA kits.Results Compared with the normal group,the Neopterin levels in single-positive and double-positive groups were significantly elevated,meanwhile,the differences between groups also had statistical significance（P<0.01）.ConclusionSerum Neopterin concentration was significantly increased in different condition of viral infection samples,which was feasible for screening blood donors.

Objective To investigate the difference of IL-4,IL-10 and IFN-γ levels in blood samples between TPPA positive donors and negative controls.Methods The blood donors in the unqualified results of anti-TP antibody screening were confirmed by TPPA. The IL-4,IL-10 and IFN-γ were detected by quantitative enzyme-linked immunosorbent assay （ELISA） .Results The means of IL-4,IL-10 and IFN-γ in TPPA positive donors were 3.9 pg/mL,3.6 pg/mL,1.5pg/mL respectively. The means of IL-4,IL-10 and IFN-γ in TPPA negative control group were 5.0pg/mL,2.0pg/mL and 2.32pg/mLrespectively. There was no significant difference in the levels of IL-4,IL-10 and IFN-γ between the two groups.Conclusion There was no significant difference in Th1/Th2 cytokine levels between TPPA positive donors and negative controls. It wasn’t yet confirmed that there was a Th1/Th2 imbalance in TPPA positive donors.

Objective To provide theoretical support for recruitment of blood donors,occupational protection of our staffers as well as blood test we did study on the band patterns of HIV antibody positive.Methods Whole blood samples of the blood donors’were tested by ELISA screening test in our laboratory and those HIV antibody reactive samples were sent to Ji Nan CDC for confirmatory test using Western blotting technology. Collect the positive information feedback and take a pooled analysis of band patterns by analyzing the rate of the band appearance as well as band patterns.Results Totally 54 positive cases were collected. Reactivity with all the bands was the most commonly observed WB pattern,which occurred 38.9％in HIV antibody positive blood donors. The bands of gp160/120 and p24 were observed in all the patients. The next is p66 （92.6%） and gp41（90.7%）. The positive rate of p31,p17,p51 were 83.3%,87.0%,87.0% respectively. The bands of p39 and p55 showed low positive rates （59.2% and 42.6%,respectively）.Conclusion The band patterns indicate that HIV infection is in the early stage in most of the HIV antibody positive blood donors. Measures should be taken to avoid blood donation from those high risk population.

Objective To analyze the influencing factor of vasovagal reaction in whole blood donors.Methods Blood donors who had experienced vasovagal reactions were collected in 2017. The correlation of extents and types of the reactions with gender,age and frequency of donations were analyzed.Results Among 118 370 blood donors,850 person-times （0.72%） were found to have vasovagal reactions,which varied significantly in gender （male：0.54%; female：1.2%）,age （0.84% in those below 30y and 0.53% in those over or equal to30 y） and frequency of donations （0.78% in first donation and 0.52% in second donation） （P<0.01）. The reactions mostly occurred lightly（94.37%） in the donors,showing pale,perspiration and dizziness after blood collection（P<0.05）.Conclusion The young females have a predisposition to vasovagal reaction on the first donation. Preventive measures should be taken to maintain a stable pool of blood donors.

Objective To analyze HbA₂ level and indexes of red blood cells （RBCs） in patients with iron deficiency anemia （IDA） and alpha thalassemia （α-THAL） so as to provide a reference for the differential diagnosis of anemia.Methods A total of 4 156 pregnant women for routine prenatal examinations were screened in the hospital from 2016 to 2017,among them 120 cases of normal control,240 cases of IDA group and 80 cases of α-THAL group were collected. HbA₂and RBCs of the pregnant women of the three groups were compared.Results Compared with the normal group,seven RBCs indexes in IDA group significantly changed,and the level of HbA₂ decreases. The RBCs indexes in α-THAL group,except for RDW,were notably altered and HbA₂ level was decreased. A significant difference of RBCs,MCV,RDW,and HbA₂ contents was noted between IDA and α-THAL groups. The RDW detection gave rise to 77.5% of specificity and 95.0% of sensitivity whereas the detections of MCV,RBC,and HbA2 resulted in 81.3%,77.5%,and 83.8% of specificity and 93.3%,86.7%,and 87.5% of sensitivity,respectively.Conclusion sThe HbA₂ and indexes of RBCs may help differenciate iron deficiency anemia from α-thalassemia. The RDW is highly specific and sensitive in identification of iron deficiency anemia. HbA₂ combined with SF is quite useful for diagnosis of patients with α-thalassemia.

Objective To explore the production of calreticulin (CRT) and apoptosis of acute myeloid leukemia cells induced by bortezimib combinated with idarubicin, so as to improve the strategy of leukemia treatments.Methods Peripheral mononucleated cells were isolated by lymphocyte separation and density gradient centrifugation in 20 patients with newly diagnosed AML. The CD34⁺CD38⁺ cells and CD34⁺CD38^- cells were detected by flow cytometry. Under optimal time and concentration, the leukemia cells were treated with bortezimib or idarubicin alone or in combination of the both, and the apoptosis and CRT expression on CD34⁺CD38⁺ and CD34⁺CD38^- cells were analyzed.Results No significant difference of the apoptotic rate of the cells and expression level of CRT was observed between the bortezimib and idarubicin treatments but combination of the both agents significantly ameliorated the cell injuries. Additionally, the apoptosis were more deteriorated in CD34⁺CD38⁺ cells compared with CD34⁺CD38^- cells in idarubicin (P=0.007),bortezimib (P=0.01) and idarubicin+Bortezimib treatments (P=0.009）. Similar results were seen in CRT expression (P=0.000, P=0.01, and P=0.006).ConclusionIdarubicin and proteasome inhibitors may induce apoptosis and increase the expression of calreticulin on leukemic cells, particularly of CD34⁺CD38⁺ cells, and combination therapy is synergistically effective.

Objective To analyze the statusofserologicprenatal screening and prenatal diagnosis duringthe second trimester pregnancy in Anhui Maternity and Child Health Hospital from 2016 to 2017,compare the efficiency of double and triple screening,and evaluate the significance of uE3 （estratriol）.Methods A total of 28,900 pregnant women who agreed to make prenatal screening were screened.The concentrations of AFP,Free β-hCG and uE3 were determined by time-resolved fluorescence. Risk calculation was performed using Lifecycle risk assessment software. The efficiency of screening for double test （AFP,Free β-hCG） and tripletest （AFP,Free β-hCG,uE3）,The chromosome condition disgnosed by amnioticfluid puncture and the pregnancy outcome were followed up.Results Among the 28,900 pregnant women,when the cut-off value was 1/270,the detection rate of the 21-trisomy was the same by double and triple screening,both of which were 76.92%,but the false positive rate of triple screening was greatly reduced,only 4.27%,the false positive rate of double screening is 6.23%,with statistically significant （P<0.05）.Conclusion For the screening of Down's syndrome,the screening efficiency of triple serum screening is better than double screening during the second trimester pregnancy.

Objective To investigate the effects of high-flux hemodialysis on inflammatory factors and immune function in patients with diabetic nephropathy.Methods Fifty patients with diabetic nephropathy were enrolled in this study. Patients were divided into two groups： conventional dialysis group （control group） and high-throughput dialysis group （25 cases）. The treatment time was 12 weeks. The changes of T lymphocyte subsets （CD3⁺,CD4⁺,CD4⁺ / CD8⁺）,immunoglobulin （IgA,IgG,IgM） and the levels of IL-6 and TNF-α.ResultsThere was no significant difference in T lymphocyte subsets,immunoglobulin （IgA,IgG,IgM）,serum IL-6 and TNF-α in peripheral blood after dialysis treatment in the control group（P>0.05）; There was no significant difference in the level of IgA,IgG,IgM between the two groups after dialysis （P>0.05）. The number of T lymphocyte subsets was significantly higher than that before treatment,and the levels of IL-6 and TNF-αlevels were significantly lower than before treatment（P>0.05）,and compared with the control group after treatment,the difference was statistically significant（P>0.05）.Conclusion High-throughput hemodialysis can reduce the levels of inflammatory cytokines and immune function in patients with diabetic nephropathy.

Objective This study is to explore the relationship between folate metabolism related enzyme gene polymorphism and adverse pregnancy outcomes.Methods 56 unhealthy pregnant and lying-in women received in our hospital from January 2018 to August 2018 were selected as study group and 56 normal pregnant and lying-in women in the same period were selected as control group. PCR was used to detect gene polymorphism in both groups. The genotype distribution characteristics of the two groups were compared and the correlation between the two groups was analyzed.Results The frequencies of CC homozygous mutation,TT homozygous mutation at C677T locus and GG homozygous mutation at A66G locus of MTRR gene in the study group were higher than those in the control group （P<0.05）,while the frequencies of AA wild homozygous at A1298C locus of MTHFR gene,CC wild homozygous at C677T locus and AA at A66G locus of MTRR gene in the study group were higher than those in the control group （ The frequency of wild homozygous genes was lower than that of the control group （P<0.05）.Conclusion There is a close correlation between adverse pregnancy outcomes and folate metabolism related enzyme gene polymorphism.

Objective To investigate the clinical effect of patients with Luminal A breast cancer treated with chemotherapy and endocrine therapy.Methods A total of 84 patients with Luminal A type breast cancer were observed in 2015 and 2017. The patients were randomly divided into control group （n=42） and observation group （n=42）. The control patients were treated with chemotherapy alone whereas those for observation were treated in combination with tamoxifen endocrine therapy. CD3⁺,CD4⁺,CD8⁺,and CD4⁺/CD8⁺cells were measured by flow cytometry pre- and post- treatment. Simultaneously,IFN-γ,TNF-α,IL-4,and IL-10 cytokines were detected. The survival time at different time points after treatments was compared for the clinical efficacy in the two groups.Results No significant difference was noted in the efficacy rate between the treatment group （64.29%） and the control （47.62%） （P>0.05）. The number of CD3⁺/CD4⁺CD8⁺ and CD4⁺/CD8⁺cells in the group of combination treatments was increased when compared with the control （P<0.05）. But the CD3⁺/CD8⁺cell counts as well as IL-10 in the combination group were lower than in the control （ P<0.05）. No significant difference,however,was found in survival rates of 1yr,3yr,and 5yr between the two groups （P>0.05）.Conclusion The combination of chemotherapy and tamoxifen endocrinotherapy in patients with Luminal A type breast cancer may help improve the immunity,inhibit inflammatory factors and prolong the survival of patients.

Objective To evaluate the prognostic value of TSGF,SCC-Ag and CA125 in peripheral blood of patients with cervical cancer before chemotherapy.Methods 70 patients with cervical cancer diagnosed with I-II were enrolled in our hospital from January 2013 to January 2014 and were followed up for 3 years after the end of treatment. The recurrence of tumor was recorded and the patients were treated with different prognosis. The expression levels of TSGF,SCC-Ag and CA125 in peripheral blood were detected before and after treatment. The prognostic value of these indexes was analyzed.Results The expression levels of TSGF,SCC-Ag and CA125 in peripheral blood of patients without recurrence（54.63±12.35 U/mL、2.42±0.60 μg/L、27.28±12.28 U/mL） were significantly lower than those in patients with relapse after three years（78.29±18.29 U/mL、3.89±1.25 μg/L、36.43±13.05 U/mL）（P<0.05）.The expression of TSGF,SCC-Ag and CA125 in peripheral blood was positively correlated with the risk of recurrence within three years after treatment （r=0.535,r=0.329,r= 0.744,P<0.05） by Spearman correlation analysis. Further ROC analysis showed that the sensitivity,specificity and accuracy of TSGF,SCC-Ag and CA125 expression in cervical cancer were significantly higher than those in cervical cancer before and after chemotherapy.Conclusion The level of TSGF,SCC-Ag and CA125 in peripheral blood of patients with early cervical cancer before chemotherapy can be used as one of the indicators of prognosis evaluation.

Objective To understand the carbohydrate antigen 153 （carbohydrate antigen 153,CA153） and placental growth factor（placental growth factor,PLGF） level in placental abruption maternal serum,and to explore its clinical significance.Methods Collected in March 2014 to August 2017 to shenzhen baoan district people's hospital obstetric delivery of 107 cases of placental abruption maternal as study group,120 cases of normal pregnant women as control group,DXI800 full automatic immune luminescence analysis and enzyme-linked immunosorbent assay （enzyme linked immunosorbent assay,ELISA） maternal prenatal and postnatal three months was detected in concentration of serum CA153 and PLGF,and analyze whether there is a difference between the two sets of results.Results Study group antenatal concentration of serum CA153 was（119.32±37.25）U/mL,significantly higher than the control group of（41.86±19.07）U/mL,difference was statistically significant （t=8.152,P<0.05）,while PLGF concentration was（79.06±15.85）pg/mL,significantly lower than the control group of（132.37±45.26）pg/mL,difference was statistically significant（t=6.974,P<0.05）; In the three months after delivery,the concentrations of CA153 andPLGF in the maternal serum of the study group were（43.92±21.35）U/mL and（121.52±42.67）pg/mL,There was no statistically significant difference between the control group and the control group （t=1.038~1.203,P>0.05）.Conclusion Concentration of CA153 in the prenatal serum of placental abruption was significantly higher,and concentration of PLGF decreased significantly,and thepostpartum recovery was normal. Therefore,the prenatal process of CA153 and PLGF detection has a certain prediction value for the diagnosis of placental abruption,which is worth extending the application.

Objective To investigate the effect of levocarnitine and hemoperfusion combined with hemodialysis on cardiac function and bone metabolism in patients with uremia.Methods 60 patients with uremia admitted into our hospital from January 2015 to December 2017 were divided into two groups by draw lots,with 30 cases in each group. Control group was given hemodialysis,while research group was treated with levocarnitine and hemoperfusion based on control group. The indexes of cardiac function [left ventricular ejection fraction （LVEF）,stroke volume （SV）,fractional shortening （FS）,E/A],indexes of bone metabolism [bone alkaline phosphatase （BALP）,intact parathyroid hormone （iPTH）],indexes of renal function [blood urea nitrogen （BUN）,serum creatinine （Scr）] and adverse reactions were compared between the two groups.Results After treatment,the indexes of cardiac function （LVEF,SV,FS,E/A） in research group were higher than those in control group （P<0.05）; After treatment,the indexes of bone metabolism （BALP,iPTH） and renal function （BUN,Scr） in research group were lower than those in control group （P<0.05）; The incidence of adverse reactions in research group was 6.67%（2/30）,which was lower than 26.67%（8/30） in control group （P<0.05）.Conclusion Levocarnitine and hemoperfusion combined with hemodialysis in treatment of uremia is effective,it can improve cardiac function and renal function,reduce bone metabolism disorder,and not increase adverse reactions,which is worthy of promotion.

Objective To analyze the value of anti-Mullerian hormone （AMH） in sera and follicular fluids on the day of oocyte retrieval to predict the outcome of superovulation in vitro fertilization in those with polycystic ovary syndrome （PCOS）. MethodForty eight patients with IVF-ET were selected as group PCOS and 52 with oviduct infertility treated with IVF-ET as the control. The general condition,AMH in sera and the follicle fluids of the pregnant and non-pregnant patients,and clinical features of the IVF-ET treatment cycle were compared.Results The levels of AMH in the sera and follicle fluids of group PCOS were （7.4±4.1） ng/mL and （3.9±2.1） ng/mL,respectively,which was higher than those of the control [（3.5±1.9） ng/mL and （1.7±1.1） ng/mL （t=6.180,P<0.05; t=5.500,P<0.05]. A total of 998 ovarian follicles and 570 eggs were obtained in group POCS,while 687 follicles and 476 eggs were obtained in the control. There was no significant difference in the rates of normal fertilization,high quality embryo,clinical pregnancy,early abortion as well as continuing pregnancy between the two groups [64.1% vs 69.4%,（39.3±26.5）% vs （38.8±23.4）%,45.8% vs 46.2%,18.2% vs 12.5%,and 37.5% vs 40.4%,P>0.05]. However,the rates of obtained eggs and egg maturation varied （57.1% vs 69.3%,77.9% vs 88.2%,P<0.05）. The difference existed in the AMH levels of follicle fluids and sera between pregnant and non-pregnant patients in POCS patients [（10.7±4.1）% vs （4.5±1.7）%,（5.2±2.0）% vs （3.0±1.5）%,P<0.05]. A significant difference was seen in the ratio of high quality embryos,AMH of follicular fluids and sera between pregnancy and non-pregnancy patients in the control group （50.7±18.4）% vs （27.2±21.2）%,（4.7±2.1）% vs （2.2±1.1）%,（1.9±1.0）% vs （1.2±0.6）%,and P<0.05].Conclusion The AMH value in follicular fluids and sera may reflect the clinical features of PCOS during IVF-ET process and help to predict the superovulation outcomes of IVF cycle in PCOS patients but not the outcomes of pregnancy after IVF-ET.

Objective To investigate the correlation between the serum levels of AFP-L3%,CA125,CA199 and IL-6 and HBV induced liver cirrhosis and hepatocellular carcinoma.Methods Forty-five patients with chronic hepatitis B,41 patients with post-hepatitis B cirrhosis and 24 patients with hepatitis B-related liver cancer were selected as the study group,and 30 healthy persons were selected as the control group. Serum levels of AFP-L3%,CA125,CA199 and IL-6 were detected and compared.Results Compared with the control group,the levels of AFP-L3%,CA125,CA199 and IL-6 in chronic hepatitis B group,liver cirrhosis group and liver cancer group were significantly increased （P<0.05）. With the development of the disease,AFP-L3% and IL-6 levels in chronic hepatitis B group,liver cirrhosis group and liver cancer group increased gradually. IL-6 （91.67%） was the most sensitive and AFP-L3% （89.66%） was the most specific. The sensitivity,specificity and accuracy of the four combined tests were higher than those of single test.Conclusion sSerum AFP-L3%,CA125,CA199 and IL-6 levels were correlated with liver cirrhosis and canceration caused by hepatitis B,and the combined detection of four serum indicators could improve the diagnostic efficiency of liver cancer B and make up for the defect of single detection.

Objective To analyze the association of the maximal amplitude (MA) of thromboelastography (TEG) and clot index (CI) with delayed traumatic intracranial hematoma (DTICH) in patients with craniocerebral trauma.Methods One hundred and fifty patients with craniocerebral trauma in the hospital were collected between 2014 to 2018. The Patients were divided into DTICH group (n=36) and non-DTICH group (n=114) by presence or absence of delayed traumatic intracranial hematoma. General clinical data, MA of TEG and CI in the two groups were collected and analyzed for their relations with DTICH.Results The rates of pupillary changes, Babinski sign, skull fracture, cerebral palsy, basal cistern compression and the level of diastolic blood pressure in the DTICH group were significantly higher than those in the non-DTICH group (both P<0.05). The rates of MA greater than 70 mm, CI greater than or equal to 3 and △MA_5-1, △MA_10-1, △MA_15-1, △CI_5-1, △CI_10-1, △CI_15-1 on days 5, 10 and 15 after trauma in the DTICH group were remarkably elevated compared to those in the non-DTICH group (P<0.05). Multivariate logistic regression analysis showed that combined Babinski sign, skull fracture and △MA_5-1at admission were risk factors for DTICH in patients with craniocerebral trauma while the timing of surgery was a protective factor.The area under the ROC curve with △MA_5-1 predicting DTICH was 0.640, the optimal sensitivity threshold was 3.047, with the sensitivity of 71.40% and the specificity of 60.41%. Taking△MA_5-1 over 3.047 as the grouping cut-off value, we found a lower cumulative survival rate on day 15 than that of △MA_5-1 below 3.047 group (χ²=5.143, P=0.023).Conclusions The △MA_5-1, combined Babinski sign at admission and skull fracture are risk factors for DTICH in patients with craniocerebral trauma. Clinical coagulation monitoring is needed. The △MA_5-1 more than 3.047 would indicate a high risk of DTICH and poor prognosis.

Objective To improve the quality of blood transfusion science and education, and to train blood transfusion professionals,we have established the teaching system based on education status of blood transfusion medicine in southwest China.Methods 2016-2017 interns as the research object, the interns were divided into 2016 group and 2017 group, 2016 group, in accordance with the school internship teaching outline is complete, in 2017 group according to build the teaching system of teaching, according to the assessment results and the questionnaire result evaluation of effect of the teaching system.Results The assessment results of interns in 2017 group were higher than those in 2016 group. The assessment result at the end of the internship in 2017 was higher than that at the begining of the intership（P<0.05）, with statistically significant differences. The students' knowledge of blood transfusion was improved significantly, and their ability of expression, practical operation and problem analysis were improved.Conclusion The above results show that the students in 2017 group have achieved satisfactory teaching effect. The implementation of this teaching program can make up for the deficiency of blood transfusion education in colleges and universities at present, which has a certain positive effect on promoting the cultivation of blood transfusion professionals.

Objective To explore the effect of normalized management of blood transfusion in nursing care of patients with hematological diseases,and to analyze its significance in prognosis and quality of lives of patients.Methods One hundred and six patients who had received transfusions were randomly divided into the observation group and the control group,with 53 case in each. The control were subjected to routine transfusion nursing whereas the observation group were given standardized management of blood transfusion nursing for 4 weeks. Before and after intervention,the SF-36 Health Survey Questionnaire and Blood Transfusion Satisfaction Questionnaire were given to patients for survey,and the quality of life and blood transfusion satisfaction were evaluated and the prognosis was recorded.Results No significant difference was noted between the two groups in various dimensions of the SF-36 scale before nursing （P>0.05）. The scores of each dimension of the two groups were remarkably increased after standardized nursing （P<0.05）. The physiological functions,vitality of lives and health scores in the observation group were higher than those in the control （P<0.05）. The satisfaction rates of disinfection health,blood transfusion management process,work efficiency and blood transfusion risk control were 94.34%,94.34%,96.23%,and 98.11%,respectively,which was elevated （P<0.05） when compared with the control. A low incidence （3.77%） of adverse events was found in the observation group compared with the control group （16.98%） （P<0.05）.Conclusion Standardized management of blood transfusion nursing may improve the quality of life of patients with blood transfusions,increase transfusion satisfaction and reduce the incidence of adverse occasions.