南京地区无偿献血者RH阴性血液复检不合格情况分析

目的：分析南京地区无偿献血者中RH阴性血的检出结果和复检不合格情况,寻求减少稀有血型血液浪费的对策。方法：对2006-2011年间南京地区无偿献血者的血液标本进行检测,并对结果进行统计分析。结果：近年来RH阴性血比例有逐年下降的趋势,2011年有所回升。同时,其复检不合格率却呈现出逐年上升的趋势,由2006年的0．28％上升至2011年的1．92％。其中以HBsAg和ALT不合格为主要报废原因。在不合格人群中,报废血量为200ml的人数逐年上升,但总体仍以捐献300ml、400ml为主,其中非固定与固定献血者比例为19：7。不合格群体分布以来自南京郊县的青壮年已婚男性为主,但近年来呈现出高学历以及南京地区外来人群报废情况增加的趋势。结论：减少RH阴性血液报废,不仅需要提高检测试剂质量,规范人员操作;同时需要加强宣传招募工作,尤其加强对于重复献血者的招募,及时招募暂时淘汰成员归队,促进稀有血型献血工作的可持续发展。     

2713名重复献血者献血情况分析

目的：了觧和掌握重复献血者的献血动态情况,评价现行无偿献血宣传、招募工作的效果,制订和调整新形势下的招募策略,为建立一支固定自愿无偿献血者队伍提供科学决策参考。方法：2008年8月—2010年1月调查在本中心流动采血车献血3次以上2713名自愿无偿献血者的献血情况及检测结果,调查内容包括献血品种、献血量、献血次数及血液感染性指标检测结果等。结果：2713名重复献血者中,首次献全血200ml、400ml人次的比例分别为51.42%和48.58%;随着献血次数的增加,400ml全血采集人次的比例逐渐递增,差异有统计学意义（P〈0.01）;占献血总人次的66.37%;血小板捐献的人次也相应增加,但只占调查总人次的1.97%。血液感染性指标检测结果明显优于其他类型献血者（P〈0.01）。结论：重复献血者对无偿献血持有积极的动机;无偿献血知识认知度较高,反复献血行为积极;多次定期献血,血液的质量与安全得到保证。     

初次献血者与重复献血者血液检测结果分析

目的:了解初次献血者与重复献血者输血相关传染病指标的情况,为建立一支健康、固定的无偿献血队伍提供科学依据.方法:对2005年1月～2005年12月盐城市无偿献血者的血液检测结果进行统计分析.结果:血液检测的阳性率,随着献血次数的增加而逐步下降,初次献血者为5.45%,2次献血者为3.39%,3次及以上献血者为2.77%,除谷丙转氨酶(ALT)差异不大外,其余4项差异有统计学意义.结论:重复献血者处于"窗口期"的危险性较低.     

临床微生物培养不合格标本的分析与对策

目的探讨临床微生物培养不合格标本的特点、产生原因及应对措施。方法统计2009年门诊和住院患者的血、痰、尿、胸水、腹水、大便、各种分泌物等微生物培养不合格标本的数量及发生部门,分析其产生原因。结果全年31 414份微生物培养标本中,691份为不合格标本,不合格率为2.20%。不合格的原因,标本留取污染占71.36%,不合格标本中内科系统占59.04%。结论应重视微生物检验分析前的质量控制,注重与各相关职能部门的联系与合作,加强检验、医护及运送人员相关专业知识培训,促进微生物实验室检验质量的不断提高。     

丙氨酸氨基转移酶不合格报废血液的原因分析

丙氨酸氨基转移酶(ALT)是临床评价肝功能的常用指标,也是卫生部对采供血机构颁布的《献血者健康检查标准》中规定的强制检验项目之一.随着《中华人民共和国献血法》的实施,流动采血车、献血屋采血成为血站血液来源的主要途径.由于受流动采血的设备条件和无偿献血的流动性及时间等因素的限制,本站对献血者不进行ALT初筛.根据对血液不合格项目的统计,ALT不合格的比例最高,已超出报废血液的50%.因此,通过对ALT不合格报废血液的原因分析,有针对性的采取一些措施,降低因ALT不合格的血液报废显得尤为重要[1].现将我站自2003年以来的ALT不合格的原因进行分析,并就相应措施进行探讨.     

脉动真空压力蒸汽灭菌器生物监测不合格原因分析及对策

目的 分析脉动真空压力蒸汽灭菌器生物监测不合格的原因,探讨其处理和预防的措施.方法 对脉动真空压力蒸汽灭菌效果进行生物监测,分析灭菌不合格的原因.结果 脉动真空压力蒸汽灭菌器故障引起的生物监测不合格.结论 加强灭菌工作中环节质量的管理,操作人员需严格遵守机器操作流程,建立完善机器维护和保养机制,才能保证灭菌器的正常运行并提供合格的灭菌物品.     

洛阳市无偿献血者ALT不合格人群分布特征

目的：了解洛阳地区无偿献血者中丙氨酸氨基转移酶（ALT）不合格人群的分布特征以及相关影响因素,为制定无偿献血招募策略提供依据。方法：收集2006年1月—2008年12月洛阳地区无偿献血者（献成分血者除外）的资料,运用统计学方法分析ALT不合格与性别、职业、文化程度、献血次数的关系。结果：男性ALT不合格率明显高于女性,文化程度为大专及以上人群ALT不合格率最低,学生及军人ALT不合格率较低,干部ALT不合格率最高,献血次数超过1次的人群ALT不合格率低于第一次献血的人群。结论：相对稳定的低危献血者队伍是保证血液安全的基础,应将高学历人群、学生、军人及多次献血人群作为目标人群,制定科学的招募计划,积极动员其投身于无偿献血队伍中来。降低血液报废率,保证本地区血液安全及临床供应。     

随州市2010-2012年献血者不合格原因分析

<正>在人类还没有能力制造出血液的今天,没有一种药物可以代替血液去挽救患者的生命,只能靠健康人捐献,所以血液是一种宝贵的医疗资源。但在采集血液的过程中,血液如工厂中加工的其他产品一样,也是需要消耗成本的。如何最大限度的降低成本,减少血液的报废,除制定科学的无偿献血策略,采集低危健康无偿献血者的血液外,还应及时总结无偿献血的工作经验。为此笔者对我市2010-2012年献血者ALT及HBsAg、抗-HCV、梅毒、抗-HIV等传染病指标的检测结果进行了统计分析,报     

2016-2020年武汉市隐性梅毒病例重复报告情况分析

<正>梅毒报告病例数历年在我国甲乙类传染病报告中居第三名^[1],且隐性梅毒报告数和构成比呈逐年上升趋势^[2]。梅毒作为术前和住院筛查的实验室必查项目,患者在多次就医时,会导致病例被重复报告,从而影响梅毒疫情数据的准确性。“中国疾病预防控制信息系统传染病监测系统”可通过身份证号码进行自动查重,     

2016-2019年江西省梅毒病例重复报告情况分析

目的 了解江西省梅毒病例重复报告情况及相关影响因素,为质量管理提供基础数据.方法 通过中国疾病预防控制信息系统收集2014-2019年报告现住址为江西省的所有梅毒病例资料,根据本次拟定的重报判定标准,将每年报告卡片在本年和前两年卡片中进行个案查重,获得2016-2019年重复报告率.结果 2016-2019年报告现住址...     

Restenosis and its determinants in first and repeat coronary angioplasty

Restenosis is the main problem limiting long-term success ofpercutaneous transluminal coronary angioplasty (PTCA) and ismost accurately evaluated by follow-up angiography. We comparedthe primary and long-term results of angioplasty in 268 consecutivepatients (293 segments) with first PTCA (PTCA 1, angiographicfollow-up 98%) and in 66 patients (76 segments) with repeatPTCA after restenosis (PTCA 2, angiographic follow-up 92%).Forty clinical, angiographic and procedural factors were assessedin relation to outcome. Primary success rate was higher in PTCA2 (91% vs 67.5%) and major complications were fewer (4.5% vs16%).Higher inflation pressure (7.9 ± 2.3 vs 6.8 ±1.8 atm, P<0.005) and larger balloons (3.5 ± 0.5 vs3.2 ± 0.5mm, P< 0.005) were used for PTCA 2, resultingin lesser residual stenosis (33 ± 16± vs 40 ±18%, P <0.05). Restenosis rate (>70%) after PTCA 1 andafter PTC A 2 (27% vs 36%, P = NS) and the mean time to recurrence(4.7 vs 5.3 months, P = NS) were similar. Procedural factorswere the main determinants of long-term success in primary PTCA.The restenosis risk was independently related to residual stenosis>45% (P<0.001), variant angina (P<0.05) and multivesseldisease (P<0.05) after PTCA 1 and to male sex (P<0.001)and higher inflation pressure (P<0.05) after PTCA 2. Mildto moderate intimal tearing was associated with less restenosisafter PTC A 1, but not after PTCA 2. Including 9 patients (10segments) with a third PTCA, 70% of the 66 patients with repeatPTCA had a successful long-term outcome. Repeat angioplastyshould therefore be considered as an integral part of PTCA therapy.Restenosis however remains a major concern. An optimal primaryresult with a minimal residual stenosis is decisive for firstPTCA, whereas avoidance of a dissection by using lower inflationpressure on a restenosis might improve the long-term outcomeof repeat PTCA.     

细菌性肺炎的C-反应蛋白恢复正常时间与治愈时间的比较研究

目的 选取3种常见细菌性肺炎的临床类型,监测其C-反应蛋白(CRP)恢复正常的时间以及肺炎治愈的时间,评判CRP恢复正常的时间能否作为停用抗生素的指标.方法 回顾性统计分析146例细菌性肺炎病例,其中社区获得性肺炎组86例,重症肺炎组38例,呼吸机相关性肺炎组22例,分别记录各组CRP恢复正常的时间以及治愈的时间,并对结果进行统计分析.结果 社区获得性肺炎组的CRP恢复正常时间与治愈时间分别为(8.00±1.12)d、(11.66±1.79)d;重症肺炎组的CRP恢复正常时间与治愈时间分别为(9.82±1.69)d、(16.08±2.52)d;呼吸机相关性肺炎组的CRP恢复正常时间与治愈时间分别为(10.73±1.45)d、(16.95±3.68)d;三组中每组的CRP恢复正常时间与治愈时间相比差异均有统计学意义(P值均＜0.01).结论 在细菌性肺炎的治疗中,CRP恢复正常的时间先于治愈时间,CRP恢复正常不能作为停用抗生素的指标.     

LPA gene: interaction between the apolipoprotein(a) size ('kringle IV' repeat) polymorphism and a pentanucleotide repeat polymorphism influences Lp(a) lipoprotein level

OBJECTIVES: In order to search for factors influencing the Lp(a) lipoprotein level, we have examined the apolipoprotein(a) (apo(a)) size polymorphism as well as a pentanucleotide (TTTTA) repeat polymorphism in the 5' control region of the LPA gene. DESIGN: Lp(a) lipoprotein levels were compared between individuals with different genotypes as defined by pulsed field gel electrophoresis of DNA plugs, and PCR of DNA samples followed by polyacrylamide gel electrophoresis. DNA plugs and DNA were prepared from blood samples collected from blood donors. RESULTS: Twenty-seven different K IV repeat alleles were observed in the 71 women and 92 men from which apo(a) size polymorphism results were obtained. Alleles encoding 26-32 Kringle IV repeats were the most frequent. Alleles encoding seven to 11 TTTTA repeats were detected in the 84 women and 122 men included in the pentanucleotide polymorphism study, and homozygosity for eight TTTTA repeats was the most common genotype. The eight TTTTA repeat allele occurred with almost any apo(a) allele. An inverse relationship between number of K IV repeats and Lp(a) concentration was confirmed. The contributions of the apo(a) size polymorphism and the pentanucleotide repeat polymorphism to the interindividual variance of Lp(a) lipoprotein concentrations were 9.7 and 3.5%, respectively (type IV sum of squares). Nineteen per cent of the variance in Lp(a) lipoprotein level appeared to be the result of the multiplication product (interaction) between the apo(a) size polymorphism and the pentanucleotide repeat polymorphism. CONCLUSIONS: The contribution of the apo(a) size polymorphism alone to the variation in Lp(a) lipoprotein level was lower than previously reported. However, the multiplicative interaction effect between the K IV repeat polymorphism and the pentanucleotide repeat polymorphism may be an important factor explaining the variation in Lp(a) lipoprotein levels among the populations.     

Eliciting repeat blood donations: tell early career donors why their blood type is special and more will give again

BACKGROUND AND OBJECTIVES: This study was designed to investigate whether sending a personalized and informative letter to early career donors would increase the number returning to donate again, as the literature suggests that it is at around the third donation that people become career donors. MATERIALS AND METHODS: Experimental participants were sent a recruitment letter that included information about their own blood type and the percentage of the general population with the same blood type who donated. Control participants received a recruitment letter with some general information. The aim of the study was to determine whether more participants in the experimental group, compared with the control group, would donate blood within a 4-week period after receiving their personalized recruitment letter. RESULTS: Donors in the experimental group were 43% more likely to return to donate than those in the control group [chi(2) (1) = 5.79, P < 0.016]. CONCLUSIONS: Sending out personalized, informative letters appears to be a potentially powerful donor-retention tool.     

Non-myeloablative allografting from human leucocyte antigen-identical sibling donors for treatment of acute myeloid leukaemia in first complete remission

Many patients with acute myeloid leukaemia (AML) in first complete remission (CR1) are ineligible for allogeneic transplantation as a result of age or medical problems other than leukaemia. Eighteen patients (median age 59 years, range 36-73 years) with de novo (n = 13) and secondary (n = 5) AML in morphological CR1, who were not candidates for conventional allografting, received non-myeloablative peripheral blood stem cell transplants from human leucocyte antigen identical sibling donors after conditioning with 2 Gy total body irradiation (TBI; n = 10) or 2 Gy TBI and 90 mg/m2 of fludarabine (n = 8). Postgrafting immunosuppression was with cyclosporine and mycophenolate mofetil. Two rejections were observed in patients not given fludarabine and one died with relapse. Overall, 10 patients died between 77 and 841 d, seven from relapse and three from non-relapse mortality (NRM). Day +100 NRM was 0% with a 1-year estimated NRM of 17%[95% confidence interval (CI) 0-35%]. The median follow-up among the eight survivors was 766 d (range, 188-1141 d). Seven of these eight survivors remain in complete remission (CR). One-year estimates of overall and progression-free survivals were 54% (95% CI 31-78%) and 42% (95% CI 19-66%) respectively. While follow-up is short, this analysis demonstrates that the procedure is sufficiently safe to be studied in a wider group of patients.