温州市无偿献血者ABO、Rh血型分布特征的调查分析

自1998年以来，温州市中心血站通过积极开展无偿献血工作，现已实现发往温州市各临床用血单位的血液制品100％来自自愿无偿献血者。本文对近4年来温州市献血者的ABO、Rh血型分布情况进行调查分析，全面掌握了ABO、Rh血型在温州市的分布特征，为临床用血提供参考，现将统计结果分析如下：     

我院输血科面向基层医院临床申请用血规范的体会

随着《血液制品管理条例》法律法规颁布实施，临床用血在许多地区蔚然兴起，不规范的临床用血很快得以扼制，为了解基层医院、促进基层医院临床用血规范化发展，现将我院输血科面对21个基层医疗机构的农牧团场医院临床用血现状调查分析报告如下。     

合理用血 科学用血

输血是治疗病人的特殊手段 ,血液和血液制品是临床治疗中的一种重要的、其它治疗方法不可替代的手段。为了能合理、科学用血 ,保证无偿献血制度的实施 ,我院在各级领导与临床医护人员的重视下 ,制订了严格的用血制度并已全面开展科学用血、节约用血、并取得良好的效果。1　努力推广成分用血 ,发展临床科学用血和合理用血　　我院是全省最大的三级甲等医院 ,病人多、手术多、急救多 ,病人的文化背景复杂 (少数民族多 ,经济落后 )。临床用血量已是全区医院用量最多之一。1995年前 ,月用血量达30万毫升左右 ,有时竟多达 40万毫升。各临床科室没…     

碧血丹心铸关爱 披肝沥胆写春秋——广西血液中心四十年发展历程掠影

历史变迁 广西血液中心前身是“柳州战备血库”．创建干1965年9月．历经几十年的风雨变迁，几经易名，1991年经自治区编委批准．正式定为广西壮族自治区血液中心，广西血液中心位于广西柳州市羊角山路6号．与风景如画的柳州大龙潭景区毗邻，1999年以前．广西血液中心除了为医疗机构提供临床用血服务以外．还从事血液制品的生产和经营1999年血液制品生产与采供血业务彻底脱钩后．工作重点转移到临床采供血和无偿献血，主要担负柳州市300多万人口临床用血的采集与供给任务．同时还负有对全区采供血机构进行业务指导、技术人员培训和科技成果推广的职责。     

突发事件时乌鲁木齐市无偿献血人群分布特征调查

0引言“7·5”事件发生后，医疗机构伤员增多，乌鲁木齐市各大医院临床用血普遍紧张，急救用血上升，血库告急，应急用血需求进一步凸显．为了解突发事件下无偿献血人群的分布情况，我们对乌鲁木齐市2009-07-05前、后各1mo的无偿献血人群的性别、年龄、民族、文化程度等特征及血型分布情况进行了调查分析．     

公示制度推动无偿献血

卫生部2月24日公示2005年全年及2005年第四季度全国及各省、自治区、直辖市无偿献血占采集临床用血比例。与2004年相比，2005年全国各地无偿献血继续稳步增长，全国无偿献血占采集临床用血比例由88%上升到95%，其中自愿无偿献血比例由61%上升到84%。     

新型农村合作医疗住院患者输血情况分析

目的调查新型农村合作医疗住院患者的输血情况。方法对2012年1月-12月3家县级医院住院患者的输血情况进行调查分析。结果各医院成分输血率、用血指征符合率和输血不良反应率以及病历合格率检查各项指标基本符合要求。结论加强血液制品管理,保证临床合理用血和用血安全,仍是今后工作的重点。     

2004～2007年牡丹江地区无偿献血者血液检测结果分析

随着《献血法》的实施，无偿献血的宣传动员工作不断深入和公民无偿献血意识的不断提高，临床用血已全部来自无偿献血，为了进一步提高血液质量，有针对性的开展工作，笔者对2004～2007年来我站的无偿献血者ALT、HBsAg、抗-HCV、抗-HIV和梅毒抗体的检验结果进行了回顾性的统计分析，现报告如下。     

淮安市无偿献血免费用血情况分析与探讨

目的:进一步完善办理免费用血程序,不断改进工作方法,使无偿献血者享受到应有的权利后,能继续支持、参与无偿献血工作。方法:通过对1999年以来无偿献血返还资料的收集、整理、进行分析与探讨。结果:通过免费用血服务,不断扩大和固定无偿献血队伍。结论:在免费用血比例不断上升的同时,不断推动无偿献血事业的发展。     

六省市36所医院血浆临床使用合理性评价

近几年全国各地不断出现血浆及其血液制品如人血白蛋白等在临床上严重短缺,直接影响了医疗救治工作,也引起了有关行政管理部门的关注。本研究受卫生部委托,对2007年1月至2008年6月期间我国临床用血浆使用情况进行了调查、分析和评价。渊查发现目前临床血浆及其血液制品供应不足的状况普遍存在,与诸多的因素有关,临床上血浆及血液制品的使用虽然较普遍存在着相对不合理性,但不存在绝对不合理。医疗特色技术的应用、血液制品供应不足导致临床血浆替代治疗、血液制品流通领域不规范、医疗机构临床输血管理机制不完善等是影响临床用血浆量激增的原因。建议：国家完善血浆及血液制品相关管理制度,推进输血学科建设和发展。     

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.