Objective To reduce the risk of blood transfusion ,and discuss the serological characteristic and cross‐match test of those patients who got positive both in autoantibody test and direct coombs test .Methods With absorption‐elution testing ,antibody screening cells and panel cells belong to different manufactures and batch numbers were applied to distinguish autoantibody from al‐loantibody within serum and reagent red cells for absorption test .Appropriate donors were selected to do cross matching test ;the specificity of autoantibody and alloantibody and the relationship between ABO blood type ,diseases ,anemic and the efficacy of blood transfusion were analysed .Results Among the 139 study subjects ,all of them were identified positive both in autoantibody and di‐rect antibody test ,including 20 cases just have autoantibody ,59 cases accompanied with Rh system or MNs system or Kidd system antibody ,47 with autoantibody except for alloantibody ,13 with drug resistant or other system antibody .Within the 221 cases of blood transfusion ,none of them has hemolytic transfusion reaction .We found a positive correlation(P<0 .05)between the intensity of agglutination of autoantibody and direct antibody and anima ,while a negative correlation(P<0 .05)with the efficacy of transfu‐sion .Similarly ,there is a positive correlation(P<0 .05)between the intensity of autoantibody and the sensitization of autologous e‐rythrocyte ,most of which are immunologic diseases ,while has no correlation with ABO blood type(P>0 .05) .Conclusion To those cases which were identified positive both in autoantibody and direct antibody test ,the degree of anaemia ,the numbers of transfusion and the efficacy of transfusion were associated with the intensity of agglutination of autoantibody and direct antibody .In order to de‐crease the risk of blood transfusion and make it highly efficient ,we should affirmed it if there is any autoantibody .In this process , an appropriate procedure and assay must be adopted .Besides ,relative antigen‐negative donors or high frequency local autoantibody need to be matched with corresponding the donors who have the same type of antigen .

Objective To investigate the effect of Xinmailong injection on patients with heart failure after emergency PCI and its effect on cardiac function. Methods 80 patients with heart failure after PCI in our hospital from December2015 to December 2016 were enrolled. All patients were divided into Xinmailong treatment group and conventional treatment group according to the random number table method, with 40 cases in each group. After emergency PCI, both groups were given conventional anti-platelet aggregation therapy, oral statin lipid-lowering drugs, ACEI, β-receptor antagonists, nitrates, etc. The Xinmailong treatment group was given 0.9％ sodium chloride injection 100 mL+Xinmailong injection 6 m L (ivgtt, 2 times/d). And the conventional treatment group was given 0.9％ sodium chloride injection 100 mL (ivgtt, 2 times/day). The two groups were treated continuously for 4 weeks. The clinical efficacy after treatment, as well as the changes of serum NT-proBNP levels before and after 1 week and 1 month of treatment, the LVEF and LVEDd before and after treatment of the two groups. Results The total effective rate of the patients in Xinmailong treatment group was 95.00％, which was significantly higher than that of the conventional treatment group, and the difference was significant (P<0.05). After treatment, serum NT-proBNP levels in the Xinmailong treatment group were significantly lower than those in the conventional treatment group at 1 week and 1 month after treatment, respectively, and the difference was significant (P<0.05). After treatment, the LVEF of the Xinmailong treatment group was significantly higher than that of the conventional treatment group, and the LVEDd of the Xinmailong treatment group was significantly lower than that of the conventional treatment group, and the difference was significant (P<0.05). Conclusion Xinmailong injection on the basis of routine treatment has exact curative effect on patients with heart failure after emergency PCI, which can significantly improve the heart function and improve the prognosis of patients. It is worthy of clinical promotion and application.

Objective:To develop a recombinant protein vaccine based on KPC-2, a drug resistance target in Klebsiella pneumoniae, and evaluate its immunogenicity, protective efficacy and mechanism in a mouse model of pneumonia. Methods:KPC-2 was expressed in Escherichia coli and purified using GST affinity chromatography. A recombinant protein vaccine was prepared with KPC-2 and used to immunize New Zealand rabbits through subcutaneous injection. Serum samples were isolated from cardiac blood and Protein G chromatography was used to purify polyclonal antibodies against KPC-2. Opsonophagocytic killing assay was used to assess the bactericidal activity of the polyclonal antibodies in vitro. Female BALB/c mice were immunized three times with the recombinant protein vaccine, and the titers of specific IgG antibodies in serum were measured by indirect ELISA. One week after the last vaccination, the mice were infected with Klebsiella pneumoniae strain SRT through tracheal intubation, and received a single intravenous dose of meropenem (0.1 mg) 1 h later. The protective efficacy of the KPC-2 recombinant protein vaccine was evaluated by comparing the survival rates, bacterial colonization and histopathological changes between vaccine group and adjuvant group as well as the survival rates between meropenem group and normal saline group. Moreover, the protective efficacy of polyclonal antibodies against KPC-2 was evaluated through passive immunization. Results:The level of specific IgG antibodies in serum was significantly higher in the vaccine group than in the adjuvant group ( t=4.325, P<0.05). The survival rate in the vaccine group was also higher than that of the adjuvant group [70% (7/10) vs 10% (1/10), P<0.05]. Furthermore, lung inflammation was less severe and bacterial burden was reduced in the vaccine group as compared with those of the control group ( t=3.127, P<0.05). Both active and passive vaccination strategies demonstrated strong protective efficacy against Klebsiella pneumoniae infection, and had a synergistic effect when used in combination with antibiotic therapy. The polyclonal antibodies against KPC-2 had bactericidal activity in vitro ( t=5.427, P<0.05). Conclusions:The prepared KPC-2 vaccine has better immunogenicity and protective efficacy. It can induce strong humoral immune responses. This study suggest that drug resistance target may be used as a candidate antigen for future vaccine development.