滨州市无偿献血血液检测指标不合格率下降原因统计分析

目的探讨滨州市无偿献血者血液检测不合格原因及其相应的解决策略。方法收集2006~2010年无偿献血者血液初、复检结果的各项实验室数据。结果献血者检验样本158479份,ALT、HBsAg、抗-HCV阳性率比较,均逐年下降,差异有统计学意义（分别为χ2=586.3、χ2=10935.05、χ2=79.24,均P〈0.01）。年度总不合格率呈下降趋势,差异有统计学意义（χ2=31.69P〈0.01）。结论增加初筛项目,建立固定献血者队伍,严格执行各项操作程序,能够降低血液检测的不合格率。     

东莞市2008-2012年无偿献血者HIV感染状况分析

目的了解东莞市无偿献血HIV感染流行趋势及人群特征,为安全输血和献血招募提供依据。方法分析2008-2012年东莞市无偿献血者121例HIV抗体阳性情况,利用SPSS16.0软件进行统计分析。结果2008-2012年东莞市无偿献血者中HIV感染率分别为15/10万、21/10万、32/10万、45/10万和51/10万,平均感染率为34/10万,各年间比较差异有统计学意义(χ2=19.89,P0.05)。男性感染率为44/10万,女性感染率为9/10万,男性高于女性(χ2=27.31,P0.05)。36~岁组感染率为49/10万,为各年龄组最高(χ2=12.94,P0.05)。初中以下学历感染率为43/10万,与高中/中专组比较差异有统计学意义(χ2=4.47,P0.05)。再次献血者感染率低于首次献血者(χ2=17.47,P0.05)。集体组织献血与个人献血差异无统计学意义(χ2=2.84,P0.05)。结论东莞市无偿献血者HIV感染率呈逐年上升趋势,HIV感染已从高危人群向一般人群扩散。采供血机构在严格进行抗-HIV筛查时,还应加强献血者特别是低学历青壮年男性的献血前健康征询。     

无偿献血者5项传染性标志物检测结果与分析

目的掌握无偿献血者5项传染性标志物的阳性率,加强实验室检测质量管理,确保输血安全。方法对13617份无偿献血者血样5项传染标志物检测结果进行汇总分析。结果抗-H IV、抗-梅毒的阳性率有逐年上升趋势,HBsAg和抗-HCV阳性率有逐年下降的趋势;ALT不合格比例最高占1.65%,其次是梅毒抗体阳性占1.04%。结论为了保证血液质量,防止通过输血传播疾病。应加强对献血者的询问,排除高危人群,发展固定的无偿献血队伍;对血液检测应使用高灵敏度、特异性强的试剂。     

2016至2020年杭州地区无偿献血人群HIV感染状况分析

目的 了解杭州地区无偿献血人群HIV感染状况,为本地区降低HIV经输血传播风险,制定有效献血者招募及艾滋病防控策略提供数据支持。方法 采用酶联免疫吸附试验(enzyme-linked immunosorbent assay,ELISA)和病原体核酸检测技术(nucleic acid testing,NAT)对2016年1月至2020年12月杭州地区902 847例无偿献血者标本进行抗HIV-Ⅰ/Ⅱ抗体/抗原和HIV RNA检测。抗-HIV抗体/抗原或HIV RNA 反应性标本送杭州市疾病控制中心进一步采用Western blot法和NAT进行确认。结果 2016年1月至2020年12月杭州地区共检测HIV确证阳性103例,阳性检出率为0.01%,其中101例ELISA和NAT筛查均为阳性反应,2例ELISA筛查为阴性反应,NAT为阳性反应。103例感染者中,以男性（91.26%,94/103）、18~35岁（69.90%,72/103）、初次献血者（68.93%,71/103）为主。2016至2020年献血者HIV阳性率呈逐年下降趋势（χ2= 7.181,P=0.007）。男女献血者HIV阳性率各年的差异无统计学意义（χ2= 10.336,P=0.350;χ2= 0.653,P=0.957）。各年龄组献血者HIV阳性率各年的差异无统计学意义（χ2= 6.378,P=0.173;χ2=2.318,P=0.678;χ2= 5.284,P=0.259;χ2= 9.183,P=0.057）。结论 近5年HIV感染在杭州市无偿献血人群中呈低流行水平,但仍存在感染风险,应加强在低危人群中招募献血者并且应采用先进的检测技术,选择合适的检测策略,保证血液安全。     

益阳市无偿献血五项检测结果分析

目的 了解益阳市无偿献血者健康状况并分析血液不合格原因.方法 分析2005～2007年益阳市无偿献血者ALT、HBsAg、抗-HCV、抗-HIV和梅毒抗体(抗-TP)等五项血清学检测指标.结果 献血者五项血检总阳性率为2.95%;2005～2007年度无偿献血人数逐年大幅度增加,而血液检测不合格率明显下降,差异有统计学意义,均P＜0.01(x2=44.545,138.160,25.343);不同年龄段无偿献血者五项血检不合格率差异有统计学意义,P＜0.01(x2=328.459),献血者中18～25岁年轻人占的比例较大.五项指标检测结果不合格率依次为HBsAg(32.77%)、ALT(28.07%)、抗-HCV(18.80%)、抗-TP(11.36%)、抗-HIV(9.01%);男性献血者人数多于女性献血者人数,两者血液检测阳性率差异有统计学意义,P＜0.01(x2=12.562).结论 应加大宣传力度,建立和发展适龄健康的固定无偿献血者队伍,以确保本地区充分、安全的血液供应.     

邯郸地区无偿献血者丙型肝炎病毒流行状况调查分析

目的分析邯郸地区无偿献血者抗丙型肝炎病毒抗体(抗-HCV)血液检测情况,确定该地区低危献血者,为临床提供安全可靠血液。方法选取2012-2014年邯郸地区无偿献血者222 417人,使用抗-HCV酶免法进行检测,检测结果采用χ2检验进行统计学分析。结果 2012-2014年邯郸地区无偿献血者抗-HCV阳性率为0.31%,各年阳性率分别为0.31%、0.37%、0.24%,差异有统计学意义(χ2=22.24,P0.01)。其中男性和女性阳性率分别为0.29%和0.33%(χ2=2.66,P0.05);多次献血者阳性率(0.54%)高于初次献血者(0.28%)(χ2=40.96,P0.01);18~、30~、40~岁不同年龄段阳性率分别为0.33%、0.26%、0.31%(χ2=4.45,P0.05);不同学历间(大专以上、高中及中专、初中以下)阳性率分别为0.19%、0.29%、0.34%,差异有统计学意义(χ2=15.57,P0.01);不同职业献血者阳性率分别为0.34%、0.35%、0.29%、0.23%和0.31%(χ2=6.11,P0.05)。结论邯郸地区应选择初次献血者或大专以上学历的献血员作为该地区无偿献血的低危献血者,并逐步从初次献血者队伍中发展固定献血者。     

2012～2016年衡阳市无偿献血者血液检测情况调查分析

目的 了解本地区不同人群无偿献血者血液检测情况，为制定招募安全血源、减少血液浪费的策略提供依据。方法 收集无偿献血者197588份标本的检测结果，并对其进行统计分析。结果 血液检测总不合格率呈逐年下降趋势，各项目检测不合格率从高到低排序为ALT＞HBsAg＞抗-HCV=抗-TP＞抗-HIV，不合格率在献血人群的年龄、性别、职业、学历分布差异上均有统计学意义（P＜0.05），其中男性高于女性，25～44岁献血人群高于其他年龄组，农民最高，学生最低。学历越低，检测不合格率越高。结论 重点招募低危献血者，加强献血前征询和快筛，加强ALT和HBsAg献血前初筛质量管理以减低血液检测的不合格率，并保证血液安全。     

银川市无偿献血者血液传染性标志物检测结果分析

目的 为探索银川市无偿献血者传染性标志物的流行趋势,研究进一步做好血液质量监控,减少血液资源的浪费,提高供输血管理工作质量.方法 对银川市2002-2008年无偿献血者血液检测结果进行分析.结果 ALT异常为血液报废的主要因为,HBsAg、抗-HCV、抗-HIV、梅毒抗体阳性率总体呈逐年下降趋势.结论 应不断加大无偿献血知识的宣传力度,做好献血前的健康征询和宣传教育工作,尽量采集低危人群相对安全的血液,保障临床用血安全.     

清远市无偿献血者抗-HCV阳性结果

目的了解清远市无偿献血人群丙型肝炎病毒(HCV)感染的分布及流行趋势。方法对清远市2012-2016年在本血站献血的77 677份无偿献血者血液标本采用ELISA法进行双试剂检测,对抗-HCV检测结果不合格的献血者进行调查分析。结果清远市无偿献血者抗-HCV总阳性率为0.34%(266/77 677),不同年份抗-HCV阳性率差异无统计学意义(P0.05);男性献血者阳性率0.36%(209/57 847)稍高于女性献血者0.29%(57/19 830),但差异无统计学意义(P0.05);不同年龄段、不同学历、不同献血次数无偿献血者抗-HCV阳性率差异无统计学意义(P0.05)。266例抗-HCV阳性献血者中86.84%为单一抗-HCV项不合格,献血者合并其他阳性的情况少。结论加大无偿献血宣传工作力度,做好献血者筛选,建立一支固定的低危献血者队伍,减少输血感染HCV风险,保障血液安全。     

2004年-2008年海南州无偿献血者血液检测结果分析

目的：分析海南州近五年来无偿献血人群血液不合格情况,为制定安全的献血者招募策略提供科学依据。方法：收集2004年—2008年海南州无偿献血者7 376人的血液检测结果。运用统计学方法对献血人群传染性指标进行比较、分析。结果：海南州自愿无偿献血人群中,血液检测不合格率2004年为8.8%,2008年为6.02%,呈逐年下降趋势,差异有统计学意义。梅毒阳性率占首位,为2.47%,HBsAg为1.8%。结论：加大无偿献血宣传力度,加强卫生科普知识宣传,从低危人群中招募献血者,建立一支固定的自愿献血者队伍可有效保障血液安全。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.