By analyzing the present defects in the management of medical consumables which include lagged management model,nonstandard storage names of medical consumables and bad traceability of the implanted medical products,this paper puts forward some corresponding improvement measures,such as changing the management model of medical consumables,standardizing the storage names of medical consumables and establishing information management system for tracing the implanted medical products,so as to realize scientific and appropriate management of medical consumables.

Objective To evaluate the specificity,sensitivity and clinical significances of direct antiglobulin test of bone marrow monouclear cells (BMMNC-Coombs test) and Flow Cytometry (FACS).Methods Autoantibodies on bone marrow mononuclear cells of 270 patients with immune and 471cases with primary or secondary anaemia and 19 normal controls were measured by BMMNC-Coombs test,and a part of IRP patients with negative BMMNC-Coombs test were retested by FACS.Results In 270 immune hemocytopenia patients,there were 163 (60.37%) with positive BMMNC -Coombs test.The positive rate of patients with immunorelated pancytopenia (IRP) was upmost and accounted for 67.2%.AIHA 63.6%,ITP 57.1%,Evans syndrome 43.2%.Both 471 patients with primary or secondary anaemia and 19 normal persons were all negative.In BMMNC-Coombs positive cases,there were mainly three types including IgG,IgG+C_3,IgG+IgM+IgA+C_3,they accounted for 30.4%,26.4%,20.8%.61 1RP with negative BMMNC-Coombs test were teased again for their BMMNC autoantibodies by FACS.83.6% of them were found to be positive with autoantibodies on BMMNC.The positive rate of autoantibodies on hematopoietic stem cells of IRP patients was 94.1%.it was higher than positive rate on any other types of bone marrow hematopoietic cells.Conclusion the sensitivity and specificity of BMMNC-Coombs test for diagnosis of autoimmune hemocytopenia was high,but the sensi- tivity of FACS assay was higher than that of BMMNC-Coombs test for detecting autoantibodies.Also had IRP,AIHA, ITP and Evans syndrome patients autoantibodies on bone marrow hematopoietic cells,The difference between IRP and other immune hemocytopenias was that IRP patients did have autoantibodies only on BMMNC.

Objective: To explore the causal link of cumulative ecological risk and future orientation with health risk behaviors among higher vocational college students, so as to provide reference for reducing and preventing health risk behaviors among higher vocational college students. Methods: A longitudinal follow up study was conducted on 612 students using convenience sampling from 2 vocational colleges in Hunan Province. The Cumulative Ecological Risk Scale, Future Orientation Scale, and Health Risk Behavior Scale were used during three follow up visits (T1: September 2022, T2: June 2023, T3: March 2024), and a cross lagged panel model was constructed to examine the longitudinal causal relationship of cumulative ecological risk, future orientation and health risk behaviors. Analysis of longitudinal intermediary effect between variables by Bootstrap. Results: The cumulative ecological risk scores of T1, T2 and T3 among higher vocational college students were (2.94±1.44,2.99±1.63,3.02±1.54), future orientation scores (40.49±4.71,41.51±5.72,41.06±4.35) and health risk behavior scores (3.73±2.01,3.49±2.00,3.23±2.00). The results of repeated measures ANOVA showed that the future orientation score of T2 was higher than that of T1, and the main effect of measurement time was statistically significant ( F=5.09，P＜0.01,η 2=0.02). The health risk behavior score of T1 was higher than that of T2, and the health risk behavior score of T2 was higher than that of T3, and the main effect of measurement time was statistically significant ( F=10.12，P＜0.01,η 2=0.03).The cross lagged model showed good adaptability, with χ 2/df =7.20 ( P <0.01), relative fitting indicators GFI=0.98, CFI=0.99, TLI=0.96, IFI=0.99, NFI =0.99, and absolute fitting indicator RMSEA =0.06. Among them, the T1, T2 cumulative ecological risk showed negatively predictive effects on T2, T3 future orientation ( β =-0.24, -0.47 ), and T1, T2 cumulative ecological risk positively predicted T2, T3 health risk behavior ( β =0.20, 0.24), while T1, T2 future orientation negatively predicted T2, T3 health risk behavior ( β =-0.25, -0.18) ( P ＜0.01). Bootstrap test analysis found that T2 future orientation had a longitudinal mediating effect ( β=0.04, P ＜0.01) on the T1 cumulative ecological risk and T3 health risk behavior. Conclusions The accumulation of ecological risk among higher vocational college students can positively predict health risk behaviors, while future orientation can negatively predict healthrisk behaviors. Moreover, future orientation plays a longitudinal mediating role between accumulated ecological risks and health risk behaviors.