Objective In this article, we discussed the effect of preoperative anemia on perioperative blood transfusion and clinical outcomes in patients undergoing orthopedic surgery. Methods 33 379 hospitalized patients who underwent orthopedic surgery from January 2014 to January 2019 were selected as the survey subjects, and preoperative anemia was used as an independent variable to compare the effect of different degrees of anemia on perioperative blood transfusion and clinical outcomes by propensity score matching (PSM).Results After PSM, 34.5% of patients with mild anemia and 41.75% of patients with moderate to severe anemia had longer hospital stay (LOS≥12 d), and their perioperative red blood cell infusion rates were 58.24% and 73.34%, respectively. The ICU occupancy rates of the two groups were 2.84% and 4.97%, and the median hospitalzation expenses were ¥74 035.26 and ¥74 589.56 respectively, which were significantly higher than those of non-anemia group (P<0.001). The incidence of complications in patients with mild and moderate to severe anemia was 5.18% and 5.98%, respectively, which were significantly higher than those in non-anemia patients (P<0.05).Conclusions The preoperative anemia in patients undergoing orthopedic surgery could prolong their hospital stay, increase the perioperative blood transfusion rate and blood transfusion volume, and at the same time which could lead to a rise in ICU admission rate, hospitalization costs and postoperative complications.

Objective To investigate relationships between perioperative blood transfusion and postoperative inflammatory complications in patients with colorectal cancer. Methods The patients who underwent colorectal cancer surgery and were pathologically diagnosed with malignant tumors between February 2019 and June 2021 were collected. The perioperative blood transfusion, hematological parameters, modified Glasgow Prognostic Score (mGPS), operation mode, operation time, tumor size, tumor location, TNM staging, hospital length of stay and postoperative inflammation were statistically analyzed.Results A total of 643 patients met the inclusion and exclusion criteria, including 201 cases of preoperative anemia (31.3%), 442 cases of non-anemia (68.7%), and 156 cases of perioperative blood transfusion (24.3%), 487 cases (75.7%) without blood transfusion, and inflammatory complications occurred in 115 cases (17.9%). After propensity score matching, the perioperative transfusion group (81 cases) and non-transfusion group (81 cases) were compared and analyzed. The results showed that the incidence of inflammatory complications in the perioperative transfusion group was significantly higher than that in the non-transfusion group (32.1% and 17.3%, respectively, P=0.029), The median hospital length of stay was longer (23 and 20.5 days, respectively, P=0.008). Univariate logistic regression analysis showed that perioperative blood transfusion was an independent risk factor for postoperative inflammatory complications (OR 2.262, 95% CI 1.078~4.747, P=0.031).Conclusion Perioperative blood transfusion is associated with postoperative inflammatory complications in patients undergoing colorectal cancer surgery.

Objective To study Ael subgroup gene polymorphism and correspondingly mutation mechanism. Methods 9 cases of suspected Ael/AelB subgroups detected by tube method were further identified by absorption-elution test, Real time PCR and gene sequencing for accurate ABO blood type results.Results There were 4 kinds of alleles (Ael02, Ael04, Ael05 and Ael10) detected through the nucleotide sequences analysis and alignment, which were generated by corresponding mutation mechanisms (gene recombination, splicing error, point-mutation and frameshift mutation).Conclusion The conformation of Ael subgroup show high genetic diversity and different mutation mechanisms leading to the affected activity of A glycosyltransferase.

Objective To establish a prediction model of fetomaternal hemorrhage syndrome on machine learning algorithm, so as to assist clinicians in early detection,diagnosis and intervention of FMH. Methods This study was based on the data of pregnant women at 6~42 weeks of gestation who have received antenatal examinations in the Second Xiangya Hospital between June 2019 and December 2020. The recursive feature elimination algorithm was used to select key variables and developed eight kinds of machine learning algorithms and traditional regression model,and the model with the best performance was selected. Besides,the ten-fold cross-validation method was used to verify the model.Results The AUC of XGBoost model is 0.827,the AUC of test set is 0.808,and the accuracy is 0.76. The performance of XGBoost model is significantly better than that of traditional logistic regression model with AUC of 0.681 and other seven machine learning models.Conclusion In this study,a prediction model of FMH based on XGBoost algorithm was successfully constructed and its prediction performance is good.

Objective 1）To explore the serological characteristics of cells with different Rh phenotypes bound to the anti-CD47 IgG4 monoclonal antibody TJC4;2）To clarify the treatment strategy of TJC4 to eliminate the interference of blood transfusion compatibility test. Method 5 mL of venous blood from patients with EDTA-K₂ anticoagulation, non-tumor and no acute or chronic underlying diseases with Rh phenotypes of CCDee, CcDEe, CcDee, ccDEE, ccDEe, ccdee, Ccdee, and CCdee were collected, using microcolumn gel method, saline Blood transfusion compatibility tests such as DAT (direct antiglobulin test), IAT (indirect antiglobulin test), and cross-matching blood were respectively performed by the method and polybrene method to detect TJC4 in vitro sensitization and idiotype antibody ID-ab neutralization. , Immucor AHG interference removal.Results 1)All Rh phenotype cells sensitized by TJC4 showed positive reaction of DAT, IAT and cross-matching with varying intensity of agglutination. The interference can be eliminated by using the Immucor AHG LISS method. 2)In order to remove the interference of CD47 McAb to ccDEe and ccdee phenotypes, higher doses should be used in idiotypic antibody ID-ab neutralization test.Conclusion 1)In this study, various blood transfusion compatibility test methods with different Rh phenotypes combined with TJC4 were used and showed notable serological differences. 2)The idiotypic antibody ID-ab neutralization test and the Immucor AHG LISS enhancer assay lacking IgG4 subtype detection can eliminate the serological interference caused by CD47 McAb. However, there were dose differences among the different Rh phenotypes.

Objective To investigate the clinical characteristics and prognosis of regression in children with congenital non-hemolytic unconjugated hyperbilirubinemia starting in the neonatal period in Zhangjiajie, Hunan Province. Methods Clinical data of 19 full-term congenital non-hemolytic unconjugated hyperbilirubinemiac children admitted to the neonatal unit of Zhangjiajie People's Hospital were collected during their hospitalization, and their clinical manifestations, peripheral blood test characteristics, genetic diagnosis, prognosis of primary disease and follow-up results were summarized and analyzed.Results Nineteen children with congenital nonhemolytic unconjugated hyperbilirubinemia were finally diagnosed by whole-exome sequencing, and six mutation loci encoding bilirubin-uridine diphosphate glucuronosyltransferase (UGT1A1) were identified, and all mutation types were missense mutations, including 10 pure mutations alone (52.6%), 5 pure heterozygous mutations (26.3%) and 4 compound heterozygous mutations (21.1%), with 2 and 17 cases in Han and Tu families, respectively. The most common clinical manifestation was severe skin jaundice, and 14 children had severe or higher hyperbilirubinemia (>342 μmol/L) 7 children received simultaneous peripheral arteriovenous blood exchange and intermittent double-sided blue light therapy, and the median time of receiving blood exchange therapy was 7.2 d postnatally (Interquartile spacing： 5.9, 7.3 d), and the average time of receiving light therapy was (34.7±17.0) h. 12 children received intermittent double-sided blue light therapy. After treatment, the serum indirect bilirubin level decreased compared to the previous level. At follow-up, the basic growth and development of all 19 children were found to be fair, with one case of typical bilirubin encephalopathy in the short term, with gradual improvement of symptoms after 2 months of age.Conclusion In our group, the majority of congenital non-hemolytic unconjugated hyperbilirubinemia cases had serum bilirubin values exceeding the level of severe hyperbilirubinemia, and the pathogenesis was mainly associated with c.211G>A, c.1091C>T, c.1318A>G, c.1348C>T, c.686C>A, and c.1456T>G mutations, with c.211G>A simple pure mutations the most common; the primary symptoms of congenital non-hemolytic unconjugated hyperbilirubinemia were relieved by simultaneous peripheral arteriovenous blood exchange and two-sided blue light therapy. Simultaneous peripheral arteriovenous blood exchange and intermittent two-sided blue light therapy can alleviate the primary symptoms in children with congenital non-hemolytic unconjugated hyperbilirubinemia, but it is still necessary to be alert for complications such as neonatal bilirubin encephalopathy and cholestatic hepatitis during treatment and follow-up.

Objective Analyze the influencing factors on Rh（CcEe）alloimmunization in patients with liver cirrhosis after ABO,Rh（D）isotype random matched blood transfusion. Method A total of 301 liver cirrhosis patients who received blood transfusion in the hepatobiliary regions of our hospital from January 1,2019 to June 30,2021 were included,including 206 males and 95 females. Patients with incomplete clinical data and Rh（CcEe） alloantibody detected in the first admission were excluded. Univariate and multivariate Logistic regression were carried out to analyze the influencing factors on Rh（CcEe）alloimmunization in patients with liver cirrhosis after ABO, Rh（D） isotype random matched blood transfusion. Result （1）Within the 301 patients,the positive rate of Rh（CcEe）alloantibody was 6.6%（20 / 301）. The percentage of anti-E antibody, anti-Ec composite antibody,anti-Ec mixed antibody,anti-C antibody,anti-Ce composite antibody were 70.0% （14 /20）,5.0%（1 / 20）,10.0%（2 / 20）,10.0%（2 / 20）,5.0% （1 / 20）,respectively.（2）There were statistical differences in the alloimmunization of Rh（CcEe）in patients with liver cirrhosis after ABO, Rh（D）isotype random matched blood transfusion with different causes,different red blood cell transfusion times and different blood types（P<0.05）.（3）Univariate Logistic regression analysis showed that liver cirrhosis after autoimmune hepatitis, red blood cell transfusion 5~9 times,red blood cell transfusion times more than or equal to 10 and type O blood were the risk factors of the Rh（CcEe）alloimmunization in patients with liver cirrhosis. The OR values were 6.888（95%CI：2.022~23.461）、14.444（95%CI：2.980~70.024）、30.469（95%CI：6.380~145.508）、12.444（95%CI：1.597~97.001） respectively. （4）Multivariate Logistic regression analysis indicated that liver cirrhosis after autoimmune hepatitis, red blood cell transfusion 5~9 times, red blood cell transfusion times greater than or equal to 10 and type O blood were the risk factors of the Rh（CcEe）alloimmunization in patients with liver cirrhosis. The OR values were16.909（95%CI：2.402~119.021）、22.311（95%CI：3.496~142.387）、36.527（95%CI：5.758~231.718）、10.160（95%CI：1.061~97.281）respectively.Conclusion The risk of Rh（CcEe） alloantibody is higher in patients with liver cirrhosis after ABO,Rh（D） isotype random matched blood transfusion.Liver cirrhosis after autoimmune hepatitis,red blood cell transfusion times,and type O blood were the risk factors of the Rh（CcEe）alloimmunization in patients with liver cirrhosis,especially those with 5~9 times of blood transfusion and greater than or equal to 10 times of red blood cell transfusion.It is recommended to adopt ABO,Rh（DCcEe）isotype blood transfusion for patients with liver cirrhosis.

Objective To investigate the core performance of the self-developed heating and pressurizing blood transfusion apparatus （transfusion speed/temperature controllable）. Methods We compared the flow rate between normal saline（NS）and suspended red blood cells（sRBCs）at room temperature by using the IBP Medical,detected the output temperatures of NS（initial temperatures of（10±0.5）℃ and（20±0.5）℃）under the heating conditions of 36℃,38℃,40℃ and 42℃ and flow rates of 50 mL/min,100 mL/min,150 mL/min and 200 mL/min by a digital thermometer. We also detected the output temperature of sRBCs refrigerated at 2~6℃ under the heating condition of 42℃ and the flow rate of 50 mL/min,100 mL/min,150 mL/min and 200 mL/min,and compare the differences before and after heating and pressurizing of free hemoglobin （FHb）,potassium ion concentration and blood routine.Results There was no significant difference between the actual flow rate of NS and sRBCs（P>0.05）. The output temperature of NS with initial temperature of（10±0.5）℃ and（20±0.5）℃ could reach 31~34 ℃ by heating and pressurizing blood transfusion apparatus. Under the conditions of different flow rates at 42℃, the output temperatures of refrigerated sRBCs at 4 ℃ were（40.8±0.3）℃,（36.4±0.2）℃,（34.7±0.9）℃and（32.8±0.4）℃,which were higher than the initial temperature（P<0.05）. After heating and pressurization, the FHb content in the supernatant of sRBCs increased significantly（P<0.05）,but still met the national standard（≤0.72 g/L）; There was no statistical difference in potassium ion concentration,HGB,HCT,MCV and MCH indexes before and after heating and pressurization.Conclusion The apparatus showed a good heating and pressurizing effect and little influence on hemolysis of sRBCs.

Objective To evaluate the characteristics and changes of microbial distribution on the surface before and after disinfection of different donor populations with the existing blood donor arm skin disinfection methodand to provide a basis for the development of appropriate disinfection methods or standards. Methods The skin surface specimens of 200 blood donors before and after disinfection were collected by contact dish sampling, cultured and purified by matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS).Results The results of skin disinfection monitoring of 200 donors met the criteria; A total of 49 bacterial species were detected in the pre-disinfection samples, of which Gram-positive and Gram-negative bacteria accounted for 75.51% (37/49) and 24.49% (12/49), respectively, and 19 bacterial species were detected in the post-disinfection samples, of which Gram-positive and Gram-negative bacteria accounted for 84.21% (16/19) and 15.79% (3/19), respectively; the indoor group The residual rate of bacteria after disinfection was significantly lower than that of the outdoor group, P<0.05. The highest residual rates after disinfection in the indoor group were Acinetobacter baumannii, Acinetobacter loftii, Staphylococcus saprophyticus, Bacillus subtilis, Campylobacter and Propionibacterium spp. The highest residual rates after disinfection in the outdoor group were Bacillus cereus, Staphylococcus cephalosus and Staphylococcus haemolyticus. Comparison between groups showed that the residual rates of Cephalococcus and Staphylococcus epidermidis after skin disinfection in the outdoor group were significantly higher than those in the indoor group, and the P values were <0.05.Conclusion Although the current arm skin disinfection method can achieve the standard disinfection effect, there are still bacterial residues after disinfection, and the bacterial residue rate and residual microbial species may be related to the working environment of donors, this study can also provide a reference basis for the development of relevant standards or protocols.

Objective To study the effect of A20 on the signaling pathway of interleukin-2 （IL-2） in regulatory T cells （Treg）. Methods A20^flox/flox mice were hybridized with CD4^-cre mice to get CD4^-cre A20^flox/flox mice, which, with A20 gene conditionally knocked-out in CD4⁺ T cells, were assigned into the experimental group, and A20^flox/flox mice into the control group. Spleen cells and lymph node cells of the experimental and control groups were then isolated. The proliferation and activity of Treg were detected by flow cytometry and in vivo experimentation. The source of Treg proliferation was traced by BrdU. The expressions of STAT5, ERK1/2 and Akt were identified by staining with anti-pStat5, pERK1/2 and pAKT markers respectively.Results In mice with conditional knockout of A20 gene, T cell development was not significantly defective. The proportion and number of regulatory T cells in the thymus and peripheral lymphoid tissues of A20 cKO mice increased significantly and showed a normal inhibitory effect in vivo. Additionally, Stat5 expression in IL-2 signaling pathway was markedly enhanced.Conclusion A20 could boost the activity of Treg cells by enhancing STAT5 and IL-2 signaling pathway.

Objective To compare the anticoagulant effect of different concentrations of sodium citrate staged anticoagulation in hemodialysis patients. Methods 150 patients who received hemodialysis in the hospital from January 2019 to January 2021 were selected as the research subjects, and a random number table method was used to divide them into 5 groups with 30 cases in each group. In the 2.5% sodium citrate one-stage anticoagulation group and 4% sodium citrate one-stage anticoagulation group, 2.5% and 4% sodium citrate was pumped at the dialyzer; in the 2.5% sodium citrate staged anticoagulation group and 4% sodium citrate staged anticoagulation group, 2.5% and 4% sodium citrate was pumped at the dialyzer and venous kettle. At the end of treatment, the anticoagulant effect among the five groups was compared. The coagulation function indexes [thrombin time (TT), prothrombin time (PT), fibrinogen (FIB), activated partial thromboplastin time (APTT)], electrolyte indexes [bicarbonate (HCO₃^-), calcium ion (Ca²⁺), potassium ion (K⁺), pH] and free calcium ion [arterial end (A), after filter (V)] were measured and compared before treatment (T₀), on the 1^st h (T₁), 2^nd h (T₂), 3^rd h (T₃) and 4^th h (T₄) after treatment (iCa²⁺). The dialysis adequacy (urea nitrogen clearance rate, urea clearance/volume) of patients among the five groups were compared. During treatment, the adverse reactions among the five groups were counted.Results The anticoagulation effect of 4% sodium citrate staged anticoagulation group was better than that of non heparin group, 2.5% sodium citrate one-stage anticoagulation group and 4% sodium citrate one-stage anticoagulation group, and the total effective rate of anticoagulation was higher than that of non heparin group, 2.5% sodium citrate one-stage anticoagulation group and 4% sodium citrate one-stage anticoagulation group, there were statistical significant differences (P<0.05); there was no statistical significant difference in the total effective rate of anticoagulation between 2.5% sodium citrate segmented anticoagulation group and 4% sodium citrate segmented anticoagulation group (P>0.05); there was no statistical difference in PT, TT, APTT and FIB at T₀, T₁, T₂, T₃ and T₄ among the five groups (P>0.05); compared PT, TT, APTT and FIB among the five groups at T₀ with those at T₁, T₂, T₃ and T₄, there were statistical significant differences (P<0.05); there was no statistical difference in K⁺ and HCO₃^- at T₀ among the five groups (P>0.05); compared K⁺, HCO₃^-, Ca²⁺, pH among the five groups at T₀ with those at T₁, T₂, T₃ and T₄, there were statistical significant differences (P<0.05), 2.5% sodium citrate staged anticoagulation group was lower than non heparin group, 2.5% sodium citrate one-stage anticoagulation group, 4% sodium citrate one-stage anticoagulation group and 4% sodium citrate staged anticoagulation group (P<0.05); compared K⁺, HCO₃^- among the five groups at T₀ with those at T₁, T₂, T₃ and T₄ (P<0.05); there was no significant difference in Ca²⁺ and pH among the five groups at T₀, T₁, T₂, T₃ and T₄ (P>0.05); there was no significant difference in A iCa²⁺ and ViCa²⁺ at T₀, T₁, T₂, T₃ and T₄ among the five groups (P>0.05); compared A iCa²⁺ and ViCa²⁺ among 5 groups at T₀ with those at T₁, T₂, T₃ and T₄, there were statistical significant differences (P<0.05); there was no statistical significant difference in dialysis adequacy (urea nitrogen clearance rate, urea clearance/volume) of patients among the five groups (P>0.05); there was no statistical significant difference in the incidence of adverse reactions among the five groups (P>0.05).Conclusion Pumping 2.5% and 4% sodium citrate in front of dialyzer and venous kettle has high anticoagulant effect in hemodialysis patients, of which pumping 2.5% sodium citrate at the dialyzer and venous kettle can effectively adjust the electrolyte level of patients, and has certain safety.

Objective To explore the predictive effect of early pregnancy placental growth factor （PlGF） combined with pregnancy associated protein A（PAPP-A）, mean arterial pressure（MAP）and uterine artery pulsatility index（UtPI）on preeclampsia,and to analyze the positive rate,incidence rate and efficiency of screening, so as to provide some data basis for the clinical application of preeclampsia screening in Anhui Province. Methods From 2019 to 2021, six hospitals in Anhui Province were organized to carry out a multi center research project to collect the clinical information of pregnant women who met the enrollment criteria within 11~13⁺⁶ gestational weeks. PlGF and PAPP-A were detected by time-resolved fluoroimmunoassay. The eclampsia risk assessment software was used to calculate the combined risk of multiple indicators in combination with maternal factors,PlGF,PAPP-A,MAP and UtPI,and to track the pregnancy development and pregnancy outcome of pregnant women. The clinical application effect of this screening model was analyzed by data statistics.Results A total of 9 400 pregnant cases were collected. There were 243 pregnant women with pregnancy related hypertension,including 128 cases of preeclampsia,6 cases of chronic hypertension with preeclampsia,101 cases of gestational hypertension,and 8 cases of pregnancy with chronic hypertension. The incidence rate of preeclampsia was about 1.43%. The cases of chronic hypertension with preeclampsia,gestational hypertension and pregnancy with chronic hypertension were excluded,and the remaining 9 285 pregnant women were included in this study. 128 cases of preeclampsia were taken as the study group,and the other 9 157 cases were taken as the control group. The results showed that PAPP-A and PlGF in the study group were lower than those in the control group （P<0.05）,and MAP and UtPI were higher than those in the control group（P<0.05）. A total of 6 139 samples with complete quadruple indicators （PlGF+PAPP-A+MAP+UtPI） were collected for separate statistical analysis. When the cut-off value was 1/137,the false positive rate of PlGF+PAPP-A+MAP+UtPI quadruple screening scheme was 15%,and the positive rates of PE<32 weeks, PE<34 weeks and PE<37 weeks were 1.16%,3.31% and 15.08% respectively,and the detection rates were 90%,80% and 63.64% respectively.Conclusion PlGF combined with PAPP-A,MAP and UtPI in early pregnancy is of high value in predicting early-onset preeclampsia.

Objective We studied the biological function of NFKBIZ in breast cancer and analyzed its clinical significance in combination with clinical data to discuss its potential value of diagnosis. Methods Quantitative real-time PCR（qPCR） was used to identify the expression of NFKBIZ in cells and in tissues. Western blot assay and immunohistochemistry were used to detect the IκBζ expression in tissues. siRNA was constructed and transfected into breast cancer cells for colony formation and transwell migration assay to detect the effect of NFKBIZ expression on the proliferation and migration; ROC curve was performed to analyze the diagnostic efficacy of NFKBIZ in breast cancer; Statistical analysis was determined the correlation between NFKBIZ expression level and pathological parameters of breast cancer.Results qPCR showed that the expression of NFKBIZ on MDA-MB-231 cells was significantly higher than that on MCF-7 cells （P<0.05）,and its expression in breast cancer tissues was significantly higher than that in para-cancerous tissues（P<0.05）. The expression level of IκBζ protein in breast cancer was significantly higher than that in benign breast disease tissues. The area under the ROC curve （AUC） of NFKBIZ was 0.810, with a cutoff value of 1.418,showing a sensitivity of 81.8%, and a specificity of 90.9%. The expression level of NFKBIZ was significantly correlated with tumor size and patient age （P<0.05）,but it had no significant correlation with TNM stage,pathological type,and lymph node metastasis （P>0.05）.Conclusion NFKBIZ plays an important role in the development of breast cancer and may become a novel biomarker for clinical diagnosis.

Objective To analyze the value of interferon-gamma release assay（IGRA）combined with FadD9 recombinant protein in the diagnosis and prognosis of severe pulmonary tuberculosis（SPT）. Methods 127 and 74 patients treated in our hospital from January 2018 to February 2021 were included in the SPT and non-SPT groups. Besides,36 patients with more than one year of close contact with tuberculosis patients were assigned into the close contact group, and 92 healthy subjects into the control group during the same period in our hospital. The fadD9 gene sequence（gene ID：888574）was obtained from the website of the National Biotechnology Information Center of the United States,and the recombinant FadD9 protein was prepared,with its immunogenicity,specific antibody level and cellular immunity in clinical plasma samples evaluated. Based on the prognosis of SPT patients we recorded and counted,the patients were divided into the survival group（n=93） and the death group（n=34）,and the general clinical data of the two groups were compared. The risk factors affecting the death of patients with SPT were screened by Cox proportional hazard regression,the Nomogram prediction model was established, and the consistency index（C-index）was calculated. The ROC,calibration curve and clinical decision curve were used to evaluate the differentiation,calibration and clinical effectiveness of the Nomogram prediction model.Results Similar to the positive reference antigen Ag85A protein,the A value of FadD9 recombinant protein was higher than that of the negative control group. The serum antibody titer of the recombinant FadD9 protein was 1∶12 800. The levels of IL-2,TNF- α and IFN- γ in FadD9 immunized group were 126.95,225.87 and 395.92 pg/mL,respectively. The level of anti-FadD9 antibody in the SPT group was significantly higher than that in the close group and control group,the difference being statistically significant（P<0.001）. BMI,APACHE Ⅱ,COPD,pulmonary infection,respiratory failure,cor pulmonale,organ damage,multidrug resistant tuberculosis,hypoalbuminemia,IGRA and FadD9 recombinant protein antibody levels were independent risk factors for death in SPT patients（P<0.05）. The C-index of the constructed Nomogram model was 0.742（95% CI：0.684~0.845）,the AUC of the Nomogram model was 0.802（95% CI：0.764~0.840）,and the sensitivity,specificity and Yoden index were 85.42%,74.05% and 0.595. On the whole,the accuracy and effectiveness of Nomogram model in predicting the death of SPT patients were found to be satisfactory. The area under the curve of FadD9 recombinant protein for the diagnosis of severe pulmonary tuberculosis was 0.748, the best critical value was 0.352,the sensitivity was 97.33%, and the specificity was 72.51%.Conclusion IGRA seems to be effective in the diagnosis of SPT,with FadD9 recombinant protein serving as a candidate component of a new antigen combination of IGRA,which has high sensitivity in the diagnosis of SPT. To some extent,the Nomogram model constructed in this study could be used as an auxiliary tool for predicting the prognosis of death in SPT patients.

Objective To investigate the correction performance of platelet optical detection technology of Mindray BC6800 blood analyzer for EDTA-dependent pseudothrombocytopenia（EDTA-PTCP）. Methods Totally 53 patients with EDTA-PTCP were assigned into the experimental group and 25 without platelet aggregation into the control group. Within 20 minutes after the specimens were collected,the blood of EDTA-K₂ anticoagulant was detected by CDR mode with Mindray BC6800,and the count values of PLT-I and PLT-O were obtained. Meanwhile,non anticoagulated venous blood was counted by artificial microscope and recorded as PLT-M. The three groups of data were compared and analyzed. In addition, according to the number of platelet aggregation particles under microscope,the experimental group was divided into 5 groups：PLT<6,PLT 6~10,PLT 11~15,PLT 16~20 and PLT>20. Taking PLT-M as the target value and CV≤12.5% as the judgment standard, we counted the qualification rate of PLT-O correction counting in each group and analyzed the unqualified specimens. Additionally,10 specimens with successful correction were randomly selected and placed for 40 minutes and 60 minutes respectively,and then the number of qualified correction of the instrument was counted, with the smear simultaneously examined by microscope.Results There was significant difference between PLT-I and PLT-M in the experimental group（P<0.05）,while PLT-O and PLT-M did not differ significantly（P=0.317）. No significant difference was observed between PLT-M and PLT-O or PLT-I in the control group. The qualification rates of PLT-O correction counting in 5 groups of specimens with different aggregate particle numbers were 88.7%,88.7%,81.8%,80% and 22.2%, respectively. Compared with the blood smears of corrected and qualified specimens,the aggregation of platelets in corrected but failed specimens was more dense and clumpy,and the boundary of platelets was blurred. After being placed for 40 and 60 minutes, the qualification rate of correction was 70% and 50%. The number of platelet aggregation particles in the newly added specimens with unqualified correction was >20.Conclusion The optical detection technology of BC6800 blood analyzer can be used to correct the specimen counting in patients with EDTA-PTCP, but the accuracy of corrected counting results should be determined by combining the approximate particle number of platelet aggregation under blood smear and the density of adhesion between platelets.