Abstract:Objective To explore the relationship between serum growth differentiation factor 15(GDF-15)and homocysteine(HCY)levels and the degree of neurological deficit and infarct size in patients with acute ischemic stroke(AIS).Methods Serum samples were collected from patients diagnosed with AIS in Shipai Hospital of Dongguan City from March 2023 to June 2024,who were included in AIS group.In addition,serum samples from 60 healthy subjects undergoing physical examination during the same period were selected and included in control group.The serum levels of GDF-15 and HCY were compared between two groups.The AIS patients were divided into mild group(80 cases),moderate group(29 cases)and severe group(11 cases)according to National Institutes of Health Stroke Scale(NIHSS)score,and into large infarction group(14 cases),medium infarction group(35 cases)and lacunar infarction group(71 cases)according to infarct size.The serum levels of GDF-15 and HCY were compared among AIS patients with different disease severity and different infarct sizes.Results The serum levels of GDF-15 and HCY in AIS group were significantly higher than those in control group[GDF-15(ng/L):1 390.46±278.10 vs.793.55±184.37;HCY(μmol/L):24.35±2.96 vs.11.78±2.56;both P<0.05].The serum level of GDF-15 in severe group was significantly higher than those in moderate group and mild group(ng/L:1 737.89±152.41 vs.1 437.98±139.62,1 325.49±125.15,both P<0.05),and the level of HCY in moderate group was significantly higher than those in severe group and mild group(μmol/L:30.49±6.387 vs.17.26±4.34,23.10±5.21,both P<0.05).The serum level of GDF-15 in large infarction group was significantly higher than those in medium infarction group and lacunar infarction group(ng/L:1 858.98±249.87 vs.1 444.28±190.22,1 271.55±141.69,both P<0.05),and the level of HCY in medium infarction group was significantly higher than those in large infarction group and lacunar infarction group(μmol/L:29.97±8.02 vs.24.31±7.45,21.59±7.45,both P<0.05).Conclusions GDF-15 and HCY are highly expressed in serum of AIS patients,and their levels are related to the degree of neurological deficit.High serum HCY level suggests that the patient mostly has medium infarction,which has certain reference value for the early diagnosis of the patient's condition.

Abstract:Invasive arterial pressure monitoring has been widely used in perioperative management of general anesthesia and intensive care unit(ICU)as an invasive monitoring method for direct blood pressure measurement.However,the issue of complications at the puncture site associated with this method is becoming increasingly prominent,mainly including bleeding,subcutaneous hematoma,radial artery occlusion,etc.The complications are not only related to the patients'own conditions,but also closely related to the hemostasis method at the puncture site.Traditionally,clinical staff rely on manual compression combined with gauze bandage or radial artery hemostat for hemostasis,but these methods have exposed many shortcomings and limitations in practice.Based on the anatomical and physical principles of radial artery and dorsal foot artery,the medical team of cardiovascular medicine department in Jiading District Central Hospital of Shanghai designed and invented a passive pulsor,and obtained National Utility Model Patent(ZL 2023 2 0892378.1).The pulser is constructed from core components such as a coating containing a highly efficient adhesive release layer,a pressure plate and a hemostatic sponge,which could quickly and effectively achieve hemostatic while providing a comfortable experience.It could effectively avoid the common complications in the process of invasive arterial pressure hemostasis,and significantly improve the comfort of patients,so it has high practical value.

Abstract:Objective To explore the application effect of"three-step hand-washing method"in process of blood collection in department of clinical laboratory.Methods Forty medical staff from department of clinical laboratory of a tertiary hospital in Longyan from September 2023 to April 2024 were selected as research subjects.Taking the implementation time of"three-step hand-washing method"(January 2024)as time node,"six-step hand-washing method"was implemented in medical staff before implementation(September to December 2023),and"three-step hand-washing method"was adopted after implementation(January to April 2024).The disinfection effect,compliance and accuracy of hand hygiene methods in medical staff before and after implementation of"three-step hand-washing method"were compared.Results There was no significant difference in the disinfection pass rate before and after implementation(87.50%vs.92.50%,P>0.05).At four hand hygiene moments such as before contacting patients,before cleaning/aseptic operations,after contacting patients and after contacting patient environments,the hand hygiene compliance after implementation was significantly higher than that before implementation(before contacting patients:62.79%vs.43.19%;before cleaning/aseptic operations:60.74%vs.39.38%;after contacting patients:70.07%vs.60.09%;after contacting patient environments:73.70%vs.27.74%;all P<0.05).However,there was no significant difference in hand hygiene compliance after liquid contact before and after implementation(81.48%vs.66.67%,P>0.05).The hand hygiene accuracy after implementation was significantly higher than that before implementation(95.20%vs.79.66%,P<0.05).Conclusion Compared with"six-step hand-washing method","three-step hand-washing method"could improve hand hygiene compliance and accuracy in the blood collection process while ensuring disinfection effectiveness.

Abstract:Objective To investigate the relationship between mycoplasma and chlamydia infection and distribution of vaginal flora in patients with chronic pelvic inflammatory disease(CPID).Methods A total of 158 patients with CPID who visited Longyan Second Hospital from January 2022 to December 2024 were selected as research subjects and included in observation group.In addition,158 healthy women who underwent physical examinations during the same period were selected as control group.The infection rates of mycoplasma and chlamydia were detected using PCR technique for all research subjects,the infection rates of mycoplasma and chlamydia were compared between two groups,and the differences in vaginal microbiota distribution between infected and uninfected CPID patients were compared.Results The infection rates of mycoplasma and chlamydia in observation group were higher than those in control group,with statistically significant difference(mycoplasma infection rate:38.61%vs.8.86%;chlamydia infection rate:28.48%vs.6.33%;both P<0.05).Among CPID patients,the proportions of mycoplasma infection patients with gradeⅠ+Ⅳmicrobiota density,gradeⅠ+Ⅳmicrobiota diversity and microecological abnormalities were higher than those of uninfected patients,with statistically significant differences(gradeⅠ+Ⅳmicrobiota density:81.97%vs.51.55%;gradeⅠ+Ⅳmicrobiota diversity:77.05%vs.53.61%;microecological abnormalities:83.61%vs.63.92%;all P<0.05).The proportions of gradeⅠ+Ⅳmicrobiota density,gradeⅠ+Ⅳmicrobiota diversity and microecological abnormalities in patients with chlamydia infection were significantly higher than those in uninfected patients,with statistically significant differences(gradeⅠ+Ⅳmicrobiota density:88.89%vs.53.10%;grade Ⅰ+Ⅳmicrobiota diversity:84.44%vs.53.98%;microecological abnormalities:86.67%vs.65.49%;all P<0.05).Conclusions Patients with CPID have a relatively high risk of mycoplasma and chlamydia infection,and infection with such pathogens could affect the distribution of vaginal flora.Great attention should be paid and anti-infection treatment should be carried out in a timely manner.

Abstract:Objective To retrospectively analyze the distribution characteristics of antinuclear antibody spectrum(ANAs)in 231 cases of pediatric systemic lupus erythematosus(pSLE).Methods The basic information and clinical data of 231 cases of pSLE diagnosed in Hunan Children's Hospital from January 2022 to December 2024 were collected.There were 38 males and 193 females.According to age,the children were divided into 0-6 years old group(27 cases),7-11 years old group(76 cases)and 12-18 years old group(128 cases).Indirect immunofluorescence(IIF)was used to screen antinuclear antibodies(ANA),and Western blotting was used to detect ANAs and analyze the distribution characteristics in children of different gender and age groups.Results Among the 231 cases of pSLE,the highest detection rate of ANAs was anti-SSA(48.92%),while the lowest was anti-Jo-1(0.43%).The distribution of major ANAs varied between genders.In males,the top three antibodies with the highest detection rates were anti-nRNP/Sm(39.47%),anti-dsDNA and anti-SSA(both 34.21%).In females,the top three were anti-SSA(51.81%),anti-nRNP/Sm(43.52%)and anti-Ro52(41.97%).The detection rate of anti-CENP-B was significantly higher in males than that in females(10.53%vs.0.52%,P<0.05).Among single ANA-positive tests,the most common patterns were the detection of two or three antibodies simultaneously(both 53 cases,accounting for 22.94%).Among the 231 cases of pSLE,the distribution of major ANAs differed across age groups.Conclusion The distribution of ANAs in 231 cases of pSLE mainly featured anti-SSA,anti-nRNP/Sm and anti-Ro52,showing variations by gender and age.

Abstract:Objective To review and analyze the results of joint detection of six kinds of common respiratory viruses in a hospital,discuss the prevalence and distribution of respiratory infections,and provide diagnostic and treatment basis for clinical practice.Methods The 11 531 samples of throat swab for joint detection of six kinds of common respiratory viruses in Lijiang People's Hospital from November 2023 to March 2025 were collected,and PCR-fluorescent probe method was used to qualitatively detect six kinds of viruses,such as influenza A virus(INFA),influenza B virus(INFB),respiratory syncytial virus(RSV),adenovirus(ADV),human rhinovirus(HRV)and Mycoplasma pneumoniae(MP).The detection rates of different viruses,as well as the detection rates in different quarters and age groups were compared.Results Out of samples of 11 531 respiratory and pharyngeal swab submitted for testing,4 685 samples were positive,with a positive rate of 42.74%.Among them,3 805 cases of single virus infection were detected,accounting for 81.22%of positive samples;781 cases were co-infected with two kinds of viruses,accounting for 16.67%of positive samples;97 samples were infected with a mixture of three kinds of viruses,accounting for 2.07%of positive samples;two samples were infected with a mixture of four kinds of viruses,accounting for 0.04%of positive samples.There were 1 233 cases of INFA,518 cases of IFNB,1 390 cases of RSV,830 cases of ADV,1 628 cases of HRV and 1 275 cases of MP detected in 11 531 samples sent for testing.RSV,HRV and MP had the highest detection rates in the fourth quarter,which were 20.59%,20.66%and 18.44%,respectively.The detection rates of INFA and INFB were the highest in the first quarter,which were 9.99%and 18.08%,respectively.RSV and HRV had the highest detection rates in infants and young children under 1 year old,which were 22.45%and 19.33%,respectively.The detection rate of INFA was the highest among elderly people over 60 years old,which was 21.31%.MP had the highest detection rate among adolescents aged 7-18 years old,which was 21.08%.Conclusion Pathogen testing should be conducted as early as possible for patients with respiratory infections,which could provide effective reference for clinical diagnosis and treatment of respiratory diseases and is worth further promotion and application.

Abstract:Objective To analyze the distribution and antimicrobial resistance of pathogens in postoperative infection among elderly diabetic patients.Methods A total of 100 elderly diabetic patients who developed postoperative infection after abdominal surgery in Zhangping General Hospital between December 2023 and December 2024 were selected as research objects.All patients underwent infection site sampling,microbial culture,standardized pathogen identification and antibiotic susceptibility testing upon hospital admission.The detection of pathogens in elderly diabetic patients with infection after abdominal surgery was counted,and the drug resistance of different types of pathogens was analyzed.Results Clinical specimens from 100 patients were examined,yielding 168 isolates including 109 strains of Gram negative(G-)bacteria(accouting for 64.88%)and 59 strains of Gram positive(G+)bacteria(accouting for 35.12%).G-pathogens predominantly consisted of Escherichia coli and Klebsiella pneumoniae,while G+pathogens were mainly Staphylococcus aureus and Enterococcus species.For primary G-bacterial species,the sensitive drugs were imipenem and amikacin.Escherichia coli and Klebsiella pneumoniae showed resistance rate of 0.00%to imipenem,while levofloxacin,cefotaxime and ciprofloxacin were the primary resistant drugs.Notably,both Escherichia coli and Klebsiella pneumoniae exhibited the highest resistance rates to levofloxacin at 58.33%and 64.29%,respectively.For primary G+bacterial species,vancomycin and linezolid were the primary sensitive drugs.Staphylococcus aureus and Enterococcus species showed resistance rate of 0.00%to vancomycin,linezolid and ticarcillin,while penicillin and tetracycline were the primary resistant drugs.Staphylococcus aureus and Enterococcus species demonstrated the highest resistance rates to penicillin at 84.00%and 85.71%,respectively.Conclusions In elderly diabetic patients undergoing abdominal surgery,G-bacteria are the main pathogens causing postoperative infections.Various common pathogens exhibit resistance to frequently used antimicrobials.Clinicians should select appropriate antimicrobials based on microbial susceptibility profiles to enhance surgical outcomes and promote favorable prognoses.

Abstract:Objective To investigate changes in serum alpha fetoprotein(AFP),neutrophil to lymphocyte ratio(NLR),platelet count(PLT)and coagulation parameters in patients with hepatitis B virus(HBV)-related hepatocellular carcinoma(HCC)after treatment.Methods The clinical data from 60 patients with HBV-related HCC admitted to interventional department of the Third Affiliated Hospital of Qiqihar Medical College from January 2022 to December 2023 were retrospectively analyzed.All patients underwent transcatheter arterial chemoembolization(TACE).The serum AFP was measured using chemiluminescence immunoassay.The parameters including white blood cells and PLT were detected using fluorescent flow cytometry,and NLR was calculated.The coagulation indicators[including fibrinogen(FIB),thrombin time(TT),prothrombin time(PT)and activated partial thromboplastin time(APTT)]were detected using automated coagulation analyzer.The changes in serum AFP,NLR,PLT and coagulation indicators before and after treatment were compared.The short-term efficacy was evaluated on day 30 post-treatment,and the patients were divided into disease controlled(DC)group(44 cases)and disease uncontrolled(non-DC)group(16 cases)based on the efficacy assessment results.The levels of serum AFP,NLR,PLT and coagulation indicators between two groups were compared.Spearman correlation analysis was used to investigate the correlation between serum AFP,NLR,PLT,coagulation indicators and short-term efficacy in patients with HBV-related HCC.Results On day 3 and day 30 post-treatment,the serum levels of AFP,NLR and FIB in patients with HBV-related HCC were significantly lower than those before treatment[AFP(μg/L):516.27±47.92,385.60±49.83 vs.582.71±56.19;NLR:3.57±0.62,2.49±0.58 vs.4.10±0.54;FIB(g/L):1.59±0.40,1.03±0.32 vs.3.10±0.72;all P<0.05].On day 3 post-treatment,the level of PLT was significantly lower than that before treatment,while the levels of TT,PT and APTT were significantly higher than those before treatment[PLT(×109/L):123.88±11.04 vs.137.75±11.27;TT(s):25.69±2.78 vs 22.75±3.14;PT(s):18.41±2.30 vs 15.08±2.16;APTT(s):45.19±5.65 vs 39.26±5.48;all P<0.05].On day 30 post-treatment,the level of PLT was higher than those before treatment and on day 3 post-treatment,while the levels of TT,PT and APTT were lower than those before treatment and on day 3 post-treatment[PLT(×109/L):148.97±10.05 vs.137.75±11.27,123.88±11.04;TT(s):15.08±2.59 vs.22.75±3.14,25.69±2.78;PT(s):10.61±1.85 vs.15.08±2.16,18.41±2.30;APTT(s):28.07±4.29 vs.39.26±5.48,45.19±5.65;all P<0.05].The DC group had significantly lower serum AFP,NLR,FIB,TT,PT and APTT levels,and significantly higher PLT level compared to non-DC group[AFP(μg/L):357.92±34.57 vs.410.58±32.15;NLR:2.31±0.30 vs.2.70±0.33;FIB(g/L):2.73±0.49 vs.3.42±0.51;TT(s):13.97±1.76 vs.16.24±1.85;PT(s):9.70±1.43 vs.11.59±1.36;APTT(s):26.02±3.10 vs.30.15±2.98;PLT(×109/L):126.79±5.47 vs 119.52±6.10;all P<0.05].Serum AFP,NLR,FIB,TT,PT and APTT showed negative correlations with short-term efficacy,while PLT showed a positive correlation(r values were-0.814,-0.839,-0.780,-0.841,-0.803,-0.785,0.769,P values were 0.004,0.003,0.005,0.003,0.004,0.005,0.006,respectively).Conclusions After TACE treatment in patients with HBV-related HCC,serum levels of AFP,NLR and FIB significantly decreased,the levels of TT,PT and APTT initially increased and then decreased,while the level of PLT initially decreased and then sincreased.Serum AFP,NLR,PLT and coagulation sparameters are closely associated with the short-term efficacy of TACE treatment and could assist in evaluating patients'prognosis.

Abstract:Objective To analyze the etiological examination of children with acute respiratory tract infection in Chifeng area of Inner Mongolia Autonomous Region,and to provide reference for clinical treatment.Methods The clinical data of 1 096 children with acute respiratory tract infection(including 639 males and 457 females)in Chifeng Songshan Hospital from July 2024 to March 2025 were reviewed and analyzed,including age,gender and detection rates of influenza A virus(INFA),influenza B virus(INFB),Mycoplasma pneumoniae(MP),adenovirus(ADV),respiratory syncytial virus(RSV)and human rhinovirus(HRV)in throat swabs.They were divided into bronchitis group(376 cases),pneumonia group(306 cases),upper respiratory tract infection group(139 cases)and bronchial asthma group(75 cases)according to type of infectious disease.According to age,the children were divided into 1-3 years old group(328 cases),4-6 years old group(374 cases)and 7-13 years old group(394 cases).They were divided into winter and spring group(829 cases)and summer and autumn group(267 cases)according to the onset season.The detection rates of different pathogens in each group were analyzed and compared.Results The detection rate of INFA in children with upper respiratory tract infection was the highest(58.27%),and that of MP in children with pneumonia was the highest(75.16%).The detection rate of ADV in males was significantly higher than that in females(7.51%vs.3.50%,P<0.05).The detection rates of INFA,INFB,MP,RSV and ADV in different age groups were significantly different.The detection rates of MP and RSV in winter and spring were significantly higher than those in summer and autumn,and that of INFB in winter and spring was significantly lower than that in summer and autumn(MP:39.32%vs.37.51%;RSV:6.51%vs.4.38%;INFB:2.41%vs.5.24%;all P<0.05).Conclusion MP and INFA are the main pathogens of respiratory tract infection in Chifeng area,and MP is mainly found in children aged 7-13 years old and detected in winter and spring.

Abstract:Objective To establish a normal reference range for alkaline phosphatase(ALP)applicable to children in Cenxi area,Guangxi Zhuang Autonomous Region based on the evaluation system of standard reference interval.Methods The clinical data of 6 083 apparently healthy children(0-14 years old)who underwent physical examinations at Cenxi Maternal and Child Health Hospital from January 1,2021 to December 30,2023 were collected.The participants were categorized into the following age groups:<1 month group(283 cases),1-12 months group(284 cases),1-3 years old group(4 457 cases),4-6 years old group(715 cases),7-12 years old group(157 cases)and 13-14 years old group(187 cases).The serum level of ALP was measured using standardized colorimetric method,the reference interval[M(P2.5,P97.5)]for each group was calculated using non parametric method,and the 90%confidence interval(90%CI)was estimated.The distribution characteristics of serum ALP in children of different age groups were analyzed,differential analysis was performed on the ALP levels of adjacent groups and the grouping and reference interval were re-established.The detection range of 6 083 children and the established normal reference range were compared,and the conformity rate was calculated.Results The reference ranges for ALP in<1 month group,1-12 months group,1-3 years old group,4-6 years old group,7-12 years old group and 13-14 years old group were 172.00(99.60,400.70)U/L,310.00(175.13,550.25)U/L,220.00(142.00,357.00)U/L,213.00(137.00,329.90)U/L,214.00(119.40,418.20)U/L and 178.00(69.70,414.20)U/L,respectively.The serum ALP distribution data of 6 083 healthy children showed a non normal distribution,with the median ALP level being the highest in children aged 1-12 months.The differences in ALP levels between adjacent age groups were compard,the final grouping was determined as<1 month group,1-12 months group,1-3 years old group,4-6 years old group,7-12 years old group and 13-14 years old group.The detection value range was compared with the established normal reference value range,and the conformity rates were≥90%.Conclusions The established normal reference range is applicable to healthy children aged 0-14 years old in Cenxi area.The establishment of the normal reference range for ALP in children helps to solve the lack of normal reference range for routine biochemical indicators in clinical laboratories,providing reference for pediatricians in clinical disease diagnosis,efficacy observation,prognosis judgment and health assessment,and protecting children's physical health.

Abstract:Objective To explore the value and application effect of continuous quality improvement management mode in microbiological testing at Center for Disease Control and Prevention.Methods The period for sample selection was from January to December 2024,with a sample size of 200 test samples collected in Linqu County Center for Disease Control and Prevention.The samples were grouped according to time interval,among which 100 samples during the period of implementing conventional management mode from January to June 2024 were included in control group,and 100 samples during the period of implementing continuous quality improvement management mode from July to December 2024 were included in observation group.The scores of management quality(including management methods,management content and system compliance effectiveness),staff response to public health emergencies ability(including personal protective equipment use,emergency project item preparation,correct use of inspection standards and skill improvement),and inspection operation qualification rates(including sample collection qualification rate,hospital supplies surface microbiological compliance rate and staff hand hygiene inspection compliance rate)of two groups were compared.Results The scores of management methods,management content and system compliance effectiveness in observation group were significantly higher than those in control group(management methods score:9.23±0.30 vs.8.96±0.24;management content score:9.20±0.38 vs.8.87±0.21;system compliance effectiveness score:9.25±0.37 vs.8.91±0.22;all P<0.05).The scores of personal protective equipment use,preparation of emergency items,correct use of inspection standards and skill improvement in observation group were significantly higher than those in control group(personal protective equipment use score:9.22±0.32 vs.8.91±0.26;emergency item preparation score:9.23±0.30 vs.8.85±0.28;correct use of inspection standards score:9.25±0.31 vs.8.87±0.27;skill improvement score:9.24±0.33 vs.8.90±0.25;all P<0.05).The qualified rate of sample collection,compliance rate of surface microorganisms on hospital supplies and compliance rate of staff hand hygiene inspection in observation group were significantly higher than those in control group(qualified rate of sample collection:100.00%vs.96.00%;compliance rate of surface microorganisms on hospital supplies:99.00%vs.93.00%;compliance rate of staff hand hygiene inspection:99.00%vs.92.00%;all P<0.05].Conclusion Actively introducing the continuous quality improvement management mode into the microbiological testing of Center for Disease Control and Prevention could significantly improve management quality,staff's ability to respond to public health emergencies and qualified rate of testing operations.

Abstract:Objective To explore the application effect of autologous blood transfusion in cardiovascular surgery,compare it with acute normovolemic hemodilution combined with intraoperative cell salvage technique,and evaluate the advantages of autologous blood transfusion in reducing postoperative bleeding,transfusion volume and adverse reactions.Methods The clinical data of 185 patients undergoing cardiovascular surgery in Affiliated Cardiovascular Disease Hospital of Xiamen University from January 2023 to December 2024 were retrospectively analyzed.According to different methods of blood transfusion,they were divided into autologous blood transfusion group(58 cases;acute normovolemic hemodilution combined with intraoperative recycled autologous blood transfusion),allogeneic blood transfusion group(60 cases;allogeneic blood transfusion according to the amount and composition of blood loss)and autologous+allogeneic blood transfusion group(67 cases;autologous blood transfusion combined with allogeneic blood transfusion).The blood routine indexes[hemoglobin(Hb)and hematocrit(Hct)],coagulation function indexes[activated partial thromboplastin time(APTT),prothrombin time(PT)and thrombin time(TT)]before and 24 hours after operation,as well as thoracic drainage volume and blood transfusion volume 24 hours after operation,postoperative adverse reactions and prognosis were compared.Results The levels of Hb and Hct in autologous blood transfusion group and autologous+allogeneic blood transfusion group were significantly higher than those in allogeneic blood transfusion group[Hb(g/L):128.41±13.74,102.28±14.72 vs.96.44±18.20;Hct:(38.74±3.73)%,(35.67±5.94)%vs.(30.50±4.77)%;all P<0.05].The PT,APTT and TT in autologous blood transfusion group were significantly shorter than those in allogeneic blood transfusion group[PT(s):12.76±1.27 vs.14.30±3.10;APTT(s):28.50±3.66 vs.36.96±11.87;TT(s):19.16±2.43 vs.24.45±19.84;all P<0.05].The thoracic drainage volume and blood transfusion volume 24 hours after operation in autologous blood transfusion group were significantly lower than those in allogeneic blood transfusion group[thoracic drainage volume 24 hours after operation(mL):220.0(150.0,322.5)vs.240.0(62.5,502.5);blood transfusion volume 24 hours after operation(mL):0(0,0)vs.0(0,273.5);both P<0.05].The incidence of adverse reactions and mortality in autologous blood transfusion group and autologous+allogeneic blood transfusion group were significantly lower than those in allogeneic blood transfusion group(incidence of adverse reactions:1.72%,1.49%vs.11.67%;mortality:1.72%,1.49%vs.3.33%;all P<0.05).Conclusions Autologous blood transfusion has significant clinical advantages in cardiovascular surgery,and could effectively reduce the incidence of postoperative anemia and promote the recovery of coagulation function.It also demonstrates notable benefits in reducing postoperative bleeding,volume of allogeneic blood transfusion,adverse reactions and improving overall patient outcomes.

Abstract:Objective To investigate the diagnostic value of urinary retinol binding protein(RBP),microalbumin(MA),creatinine(Cr)and microalbumin to creatinine ratio(MA/Cr)in early diabetic nephropathy.Methods Fifty patients with early diabetic nephropathy admitted to the First People's Hospital of Zhaoqing City from February 2022 to February 2024 were selected as research subjects and included in observation group.In addition,50 patients with simple diabetes mellitus during the same period were selected as control group.After admission,the levels of urine RBP,MA and Cr in all patients were detected using automatic specific protein analyzer,MA/Cr was calculated,and the differences of above indicators between two groups were compared.The receiver operator characteristic curve(ROC curve)was drawn to evaluate the diagnostic value of RBP,MA,Cr,MA/Cr alone and in combination for early diabetic nephropathy.Results The levels of MA and MA/Cr in observation group were significantly higher than those in control group[MA(mg/L):376.42±79.39 vs.10.95±2.20;MA/Cr(g/mol):79.55±19.38 vs.1.58±0.30;both P<0.05],while no significant differences were observed in RBP or Cr levels between two groups[RBP(mg/L):3.97±0.96 vs.2.51±0.96;Cr(mmol/L):8.41±0.94 vs.7.88±0.78;both P>0.05].The area under ROC curve(AUC)of combined detection of urine RBP,MA,Cr and MA/Cr in diagnosis of early diabetic nephropathy was 0.960,and the sensitivity and specificity were 90.00%and 98.00%,respectively.The diagnostic value of combined detection was better than those of RBP and Cr alone.Conclusions The levels of urine MA and MA/Cr in patients with early diabetic nephropathy were significantly higher than those in patients with simple diabetes mellitus,but the levels of RBP and Cr do not change significantly.The combined detection of urine RBP,MA,Cr and MA/Cr has high specificity in the diagnosis of early diabetic nephropathy,but has little overall advantage compared with detection of MA and MA/Cr alone.

Abstract:Objective To investigate the effect of plateletpheresis on platelet function in multiple blood donors.Methods A total of 50 voluntary blood donors who underwent plateletpheresis at Weifang Central Blood Station from January to December 2023 were selected as study subjects.The blood samples of study subjects were collected,the levels of platelet count(PLT),mean platelet volume(MPV)and platelet volume distribution width(PDW)were detected using fully automated blood analyzer,and the levels of prothrombin time(PT),thrombin time(TT),activated partial thromboplastin time(APTT)and fibrinogen(FIB)were detected using fully automated coagulation analyzer.The changes in platelet function indicators and coagulation function indicators of study subjects before the first plateletpheresis,after 6 months plateletpheresis and after 1 year the last plateletpheresis were compared.Results The levels of PLT,MPV and PDW before the first plateletpheresis were significantly lower than those after 6 months of plateletpheresis and after 1 year the last plateletpheresis,with statistically significant differences[PLT(×109/L):210.65±24.64 vs.232.48±30.92,259.42±38.71;MPV(fL):8.34±0.52 vs.9.45±0.64,10.17±0.80;PDW(fL):11.33±1.09 vs.13.28±1.40,15.31±1.56;all P<0.05],and the levels of PLT,MPV and PDW after 6 months plateletpheresis were significantly lower than those after 1 year the last plateletpheresis,with statistically significant differences(all P<0.05).There was no statistically significant difference in the levels of PT,TT,APTT and FIB among blood donors before the first lateletpheresis and after the last lateletpheresis[PT(s):12.65±0.44 vs.12.43±0.35;TT(s):16.70±1.31 vs.17.06±1.42;APTT(s):28.59±2.45 vs.29.03±2.55;FIB(g/L):3.22±0.31 vs.3.31±0.36;all P>0.05].Conclusion Although multiple plateletpheresis may lead to increase in platelet function indicators in blood donors,the levels of indicators are still within the normal reference range and will not have a significant impact on the platelet function and coagulation function of blood donors.

Abstract:Objective To investigate the predictive value of white blood cell classification count,coagulation indicators and hypersensitive C-reactive protein(hs-CRP)for adverse reactions of blood transfusion.Methods The clinical data of 60 patients who received blood transfusion in Fuzhou Changle District People's Hospital from January 1,2022 to December 31,2023 were reviewed and analyzed.Among them,30 patients with adverse reactions were included in study group,and 30 patients without adverse reactions were included in control group.The levels of white blood cell classification count[neutrophil count(NEU),eosinophil count(EOS)and basophil count(BAS)],hs-CRP and coagulation indicators[thrombin time(TT),activated partial thromboplastin time(APTT),fibrinogen(FIB)and prothrombin time(PT)]were compared between two groups before and after blood transfusion.Logistic multivariate regression analysis was used to evaluate the predictive value of above indicators for adverse reactions of blood transfusion.Results There were no significant differences in the levels of EOS,BAS,NEU,hs-CRP,FIB,TT,APTT and PT between two groups before blood transfusion.The levels of EOS,BAS,NEU,hs-CRP and FIB in two groups after blood transfusion were significantly higher than those before blood transfusion,and those in study group were significantly higher than those in control group[EOS(×109/L):0.36±0.13 vs.0.25±0.09;BAS(×109/L):0.31±0.10 vs.0.18±0.06;NEU(×109/L):7.20±1.90 vs.6.12±1.69;hs-CRP(mg/L):17.74±3.70 vs.9.64±2.73;FIB(g/L):4.02±0.68 vs.2.09±0.51;all P<0.05].The levels of TT,APTT and PT in two groups after blood transfusion decreased significantly,and those in study group were significantly lower than those in control group[TT(s):17.26±1.42 vs.19.13±1.69;APTT(s):28.38±3.69 vs.34.45±4.04;PT(s):11.85±2.70 vs.13.28±2.74;all P<0.05].Logistic regression analysis showed that the increase of NEU,hs-CRP and FIB levels and decrease of TT,APTT and PT levels were independent risk factors for adverse reactions[odds ratios(OR)were 1.517,1.237,2.846,1.465,1.340 and 1.397,respectively,and P values were 0.043,0.030,0.007,0.039,0.034 and 0.003].Conclusions The increase in NEU,hs-CRP and FIB levels,as well as decrease in TT,APTT and PT levels,are independent risk factors for adverse reactions of blood transfusion.White blood cell classification count,coagulation indicators and hs-CRP have important values in predicting transfusion adverse reactions.

Abstract:The quality control of microbiological testing in Center for Disease Control and Prevention is the key link to ensure public health safety.This article systematically analyzed the main factors affecting the quality of microbiological testing,including professional quality of personnel,equipment and reagent management,implementation of standardized procedures and perfection of quality control system,and put forward optimization strategies.In terms of personnel management,it is suggested to emphasize the construction of a systematic training system,and improve the post responsibility system and performance appraisal mechanism.In terms of equipment and reagent management,it is suggested to establish a full life cycle archive and strengthen supplier evaluation and quality verification.In terms of standardized procedures,it is proposed to improve the standard operation procedure(SOP)system and strengthen the implementation supervision.In terms of quality control,it emphasized the combination of internal quality control and external quality assessment,and established a scientific quality evaluation system.In addition,the study also discussed the effective ways to strengthen external support and share quality control resources,so as to promote the continuous improvement of laboratory quality management.The implementation of these strategies could significantly improve the accuracy and reliability of microbiological testing,and provide more reliable technical support for prevention and control of infectious disease and decision-making of public health.

Abstract:Objective To analyze the application effect of CYP2C19 gene polymorphism detection as an auxiliary clinical tool in precision treatment of ischemic stroke(CIS).Methods The 76 patients with CIS who received precise antiplatelet therapy at Langxi County People's Hospital from January 2024 to April 2025 were selected as study subjects and included in observation group.In addition,80 patients with CIS who received conventional antiplatelet therapy were included in control group.The clinical treatment efficacy was evaluated using modified Rankin Scale(mRS),Activity of Daily Living Scale(ADL)and incidence of adverse drug reactions.Results After 3 months of treatment,the mRS score in observation group was significantly lower than that in control group,and the ADL score was significantly higher than that in control group,with statistically significant differences(mRS score:1.26±0.51 vs.1.78±0.62;ADL score:68.36±8.12 vs.52.67±7.63;both P<0.05).The survival analysis results showed that the observation group had a significantly higher probability of non recurrence survival than the control group,and the difference was statistically significant(χ2=4.219,P=0.040).The incidence of adverse reactions in observation group was significantly higher than that in control group,and the difference was statistically significant(11.8%vs.1.3%,P<0.05).Conclusions Precise antiplatelet therapy could effectively improve the neurological function and self-care ability of CIS patients,but at the same time,it may increase the incidence of adverse drug reactions such as bleeding events and respiratory distress.Clinical practice needs to strengthen multidisciplinary consultation,develop personalized drug treatment plans,and reduce the occurrence of adverse drug events.

Abstract:Objective To investigate the efficiency and coincidence rate of cartridge microcolumn gel test in clinical blood transfusion test.Methods The 617 patients undergoing blood transfusion test in Penglai People's Hospital of Yantai City during January to July 2024 were selected as research objects.The venous blood samples of all subjects were collected,and the cross matching was carried out using low ion condensed amine technology and cartridge microcolumn gel test,respectively.The test efficiencies,success rates of one-time blood matching,incidence of adverse reactions and coincidence rates between two methods were compared.Results The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of cartridge microcolumn gel test were higher than those of low ion condensed amine technology(sensitivity:96.06%vs.85.10%;specificity:87.88%vs.63.64%;accuracy:95.62%vs.83.95%;positive predictive value:99.29%vs.97.64%;negative predictive value:55.77%vs.19.44%;all P<0.05),the success rate of one-time blood matching was higher than that of low ion condensed amine technology(91.57%vs.82.50%,P<0.05),the total incidence of adverse reactions was lower than that of low ion condensed amine technology(0.81%vs.2.43%,P<0.05),and the coincidence rates of primary and secondary sides were higher than those of low ion condensed amine technology(coincidence rate of primary side:91.90%vs.82.49%;coincidence rate of secondary side:90.60%vs.82.82%;P<0.05).Conclusion In the clinical blood transfusion test,cartridge microcolumn gel test has higher efficiency and coincidence rate,which could promote the safety of blood transfusion treatment.

Abstract:Tuberculosis infection may harm any organ in the body,but the risk of lung damage is the highest,accounting for about 80%,which is pulmonary tuberculosis.In the past,the tuberculin skin test was used to diagnose tuberculosis infection,but the method gradually exposed many defects during the application process.Therefore,in order to further optimize the diagnostic effect of tuberculosis infection,the article explores the application of T cell spot test(T-SPOT.TB)diagnostic method.If tuberculosis infection exists,the immune system will produce targeted memory T cells and release interferon-γ.According to the analysis of research results obtained by domestic scholars,the sensitivity and specificity of T-SPOT.TB in diagnosing different types of tuberculosis infections vary among different scholars,but they are generally not less than 70%.The purpose of the article is to analyze the application progress of T-SPOT.TB diagnostic method,elucidate the response methods of human immune barrier after tuberculosis infection,explain the principle of T-SPOT.TB,and point out that T-SPOT.TB experiment is effective when the number of spots in the blank and positive control wells reaches 10 or less and 20 or more,respectively.When the number of spots in the blank control well does not exceed 6,subtracting the number of spots in any experimental well,and the result is greater than 6,it is considered positive.When the number of spots in the blank control well is greater than 6,and the ratio of the number of spots in any experimental well to it is greater than 2,it is considered positive.The application progress of T-SPOT.TB in active and latent tuberculosis,as well as extrapulmonary tuberculosis,was analyzed in detail.

Abstract:Objective To investigate the application of combined detection of immunological indicators in diagnosis of rheumatoid arthritis(RA).Methods The 120 cases of RA patients admitted to Beijing Jishuitan Hospital Guizhou Hospital from July 2023 to July 2024 were selected as research objects and included in RA group,and 60 healthy objects with physical examination were selected as control group.The level of rheumatoid factor(RF)was detected by immunoturbidimetry in all subjects,enzyme linked immunosorbent assay(ELISA)was used to detect anti-cyclic citrullinated peptide antibody(anti-CCP)and anti-rheumatoid arthritis 33 antibody(anti-RA33),and flow cytometry combined with laser scattering technique was used to detect neutrophil to lymphocyte ratio(NLR).The differences of the above immunological indexes between two groups were analyzed.The receiver operator characteristic curve(ROC curve)was drawn and the area under ROC curve(AUC)was calculated.The diagnostic efficacy of each index for RA was analyzed.Results The levels of RF,anti-CCP,NLR and anti-RA33 in RA group were significantly higher than those in control group[RF(U/L):25.50±3.30 vs.20.34±2.24;anti-CCP(kU/L):9.41±5.50 vs.6.41±4.27;NLR:4.61±1.40 vs.1.84±0.63;anti-RA33(kU/L):8.41±6.63 vs.7.68±6.40;all P<0.05].The AUC of combined detection of RF,anti-CCP,NLR and anti-RA33 in diagnosis of RA was significantly higher than those of single detection(0.973 vs.0.611,0.819,0.875,0.832,all P<0.05).The sensitivity of combined detection was significantly higher than those of RF and anti-CCP alone(93.33%vs.70.00%,76.67%,both P<0.05),but there was no significant difference compared with NLR and anti-RA33(93.33%vs.90.00%,95.83%,both P>0.05).The diagnostic specificity and accuracy of combined detection were significantly higher than those of indicators detected alone(specificity:95.00%vs.73.33%,83.33%,80.00%,61.67%;accuracy:93.89%vs.71.11%,78.89%,86.67%,84.44%;all P<0.05).Conclusion The combined detection of RF,anti-CCP,NLR and anti-RA33 could significantly improve the diagnostic sensitivity and specificity of RA,optimize the early diagnosis process of RA,and provide more accurate basis for clinical decision-making.