Objective To discuss the necessity and feasibility of nucleic acid test(NAT)in clinical blood transfusion by the im-plementation of the nucleic acid testing after the ELISA screening of Zhengzhou blood donors.Methods HBV DNA,HCV RNA, HIV RNA were detected by Roche Cobas S201 system and Shanghai kehua screening system,the samples were mixed by 6×166.7μL and 8×180 μL(as one pool)separately.If the mix pool was negative,the result can be issued directly;if the pool was positive, than secondary single sample dectection must be taken and the secondary report was the final result.Results A total of 115 227 blood samples were screened by Roche Cobas S201 system and 130 mix pools were positive,among which 80 pools were reactive by secondary split testing,and the reactive samples were 86,the split ratio was 61.5%,The positive ratio of specimens was 0.75‰.90 359 samples were screened by kehua system,and the mixed pools were 93,among which 31 pools were reactive by secondary split testing,and the reactive samples were 31,the split ratio was 33.4%,The positive ratio of specimens was 0.34‰.So the total num-ber screened by the two systems was 205 586,among which 117 cases were reactive,the total positive ratio of specimens was 0.57‰.And one case was HIV window phase infection.Conclusion NAT could effectively decrease the risk of blood transfusion caused by omission of ELISA and ensure the safety of blood transfusion.

Objective To evaluate the reliability, validity and feasibility of the Chinese version of SF-36 health survey questionaire in long-term survivors of nasopharyngeal carcinoma (NPC). Methods A total of 85 long-term NPC survivors completed the Chinese version of SF-36 by either telephone or mail survey. Correlation analysis, reliability analysis and factor analysis were performed to evaluate the reliability and validity of the scale. Results The Chinese version of SF-36 was easy to complete. The split-half reliability was 0. 92 and the Cronbach's α coefficient among domains were all above 0. 70, which showed good reliability and discrimination capacity among domains. All the correlation coefficients between each item and its domain achieved or approached 0. 5, which were greater than those between the item and other domains. These results demonstrated that the Chinese version of SF-36 had good content validity and discriminatory validity. Six principal components were extracted from the scale, which could basically represent eight domains. The cumulative variance was 71.4%. Two common factors were extracted from the eight domains, which accounted for 73.3% of the variance. The Chinese version of SF-36 was able to detect differences in the quality of life between NPC patients and healthy populations. Conclusions The Chinese version of SF-36 has good feasibility, reliability and validity in evaluating the quality of life in long-term NPC survivors.

Objective To analyze the effect of quality of life (QOL) on the prognosis of long-term survivors with nasopharyngeal carcinoma (NPC). Methods A total of 192 NPC patients treated between 1999 and 2000 and with tumor-free survival before July 2003 were enrolled in this study. All patients received QOL measurement between July and August in 2003. Measurement scales included Chinese SF-36 questionnaire and a checklist consisting of fourteen items about self-rating symptoms. The median follow-up time was 7.9S years (range 2.67-9.55 years). The effects of QOL, social demographic and clinical factors on prognosis were analyzed. Results Univariate analysis showed that QOL affected the tumor-free survival and overall survival. Multivariate analysis showed that hypomnesia was an independent prognostic factor of tumor-free survival, while trismus, headache and age were independent prognostic factors of overall survival. The younger and the better QOL had better prognosis. The other sociodemographic and clinical factors had no prognostic value. Conclusion QOL is an important factor affecting the prognosis of long-term survivors with NPC, and it should be routinely evaluated during the follow-up.

BACKGROUNDTo evaluate three new chemotherapeutic regimens for non-small cell lung cancer (NSCLC) by pharmacoeconomic analysis in guiding rational use of drugs.

METHODSOne hundred and one cases of NSCLC in clinic stage III or IV were treated by one of the three chemotherapeutic schemes-PC: paclitaxel (135mg/m²,d1)+DDP; TC: docetetaxel (75mg/m²,d1)+DDP; VC: vinorelbine (25mg/m²,d1 and d8)+DDP, DDP were given at 80mg/m² in 3 groups. Pharmacoeconomic cost-effectiveness analysis was used to compare the efficacy of the three regimens.

RESULTSThe response rate was 46.9%, 48.6% and 47.1% and median survival duration was 7.8, 7.5 and 7.6 months for PC, TC and VC regimen respectively, with 1-year survival rate of 37.5%, 37.1% and 38.2% respectively. There was remarkable difference in the response rate and median survival duration between PC and TC, but no statistical difference was observed between PC and VC. There was no statistical difference in 1-year survival rate among the three regimens. The average cost of one patient for one therapeutic cycle was RMB 15840.5, 15831.1 and 9401.8 Yuan respectively. Escalation of 1% of response rate costed RMB 337.75, 325.74 and 199.61 Yuan respectively. Prolongation of 1 month of median survival duration costed RMB 2030.83, 2110.97 and 1237.08 Yuan respectively. Escalation of 1% of one year survival rate costed RMB 422.41 , 426.71 and 246.12 Yuan respectively.

CONCLUSIONSAmong these three new chemotherapeutic regimens for the advanced patients with NSCLC, the expenditure of VC is much cheaper than PC and TC. The cost effectiveness of VC is the lowest among the three regimens.

Objective:To investigate the factors affecting postoperative short-term improvement of consciousness level in patients with prolonged disorders of consciousness after severe traumatic brain injury (sTBI).Methods:A case-control study was conducted to analyze the clinical data of 55 patients with prolonged disorders of consciousness after sTBI admitted to Beijing Tiantan Hospital Affiliated to Capital Medical University and Seventh Medical Center of PLA General Hospital from September 2021 to September 2022. There were 33 males and 22 females, with the age range of 13-68 years [(43.0±15.5)years]. All patients were assessed for the consciousness level using the coma recovery scale-revision (CRS-R) preoperatively and within 48 hours postoperatively. A total of 33 patients were observed in vegetative state and 22 in minimally conscious state preoperatively. The consciousness level was found to be improved in 26 patients (consciousness- improved group), but not improved in the remaining 29 patients (consciousness-unimproved group). Indicators were documented including gender, age, cause of injury, Glasgow coma score (GCS) on admission, course of injury, preoperative consciousness level, operation mode, operation time, intraoperative fluid replenishment, intraoperative urine volume, intraoperative bleeding volume, American Society of Anesthesiologists grade, analgesic regimen and sedation maintenance drugs. A univariate analysis was conducted first to assess those indicators′ correlation with postoperative short-term improvement of consciousness level in patients with prolonged disorders of consciousness after sTBI. Multivariate Logistic regression analysis was then used to determine the independent risk factors for their postoperative short-term improvement of consciousness level.Results:Univariate analysis showed that GCS on admission, course of injury, preoperative consciousness level and analgesic regimen were correlated with short-term improvement of postoperative consciousness level in patients with prolonged disorders of consciousness after sTBI (all P<0.05), whereas gender, age, cause of injury, operation mode, operation time, intraoperative fluid replenishment, intraoperative urine volume, intraoperative bleeding volume, American Society of Anesthesiologists grade and sedation maintenance drugs showed no relation to the improvement of postoperative consciousness level (all P>0.05). Multivariate Logistic regression analysis showed that the GCS &ge;7 points on admission ( OR=0.06, 95% CI 0.01, 0.36, P<0.01), preoperative minimally conscious state ( OR=0.09, 95% CI 0.02, 0.40, P<0.01) and intraoperative use of Sufentanil combined with Remifentanil ( OR=0.07, 95% CI 0.01, 0.43, P<0.01) were significantly correlated with postoperative improvement of consciousness level. Conclusion:The GCS on admission (&ge;7 points), preoperative minimally conscious state and intraoperative use of Sufentanil combined with Remifentanil are independent risk factors affecting short-term postoperative improvement of consciousness level in patients with prolonged disorders of consciousness after sTBI.

【Objective】 To evaluate the residual risk of hepatitis C virus (HCV) in blood screening among voluntary blood donors in Zhengzhou. 【Methods】 The ELISA and NAT screening results of 497 171 voluntary blood donors in Zhengzhou from January 2019 to December 2020 were collected through the information management system of our blood center.The residual risk of HCV was assessed using the Prevalence-Window Period Residual Risk Model. 【Results】 The residual risk among repeated and first-time blood donors was 1∶132 280 (95% CI: 1∶95 520~1∶188 820) and 1∶44 090 (95% CI: 1∶31 840~1∶62 940), respectively. The overall residual risk of blood donors screening was 1∶68 540 (95% CI: 1∶65 910~1∶130 290). The reactive rate of HCV screening in first-time blood donors (0.144%, 334/231 168) was significantly higher than that in repeated blood donors (0.014%, 36/266 003) (P<0.05), and the reactive rate of repeated blood donors in 2019 (0.019%, 26/135 267) was significantly higher than that in repeat blood donors in 2020 (0.008%, 10/130 736) (P<0.05). 【Conclusion】 The residual risk of HCV among voluntary blood donors in Zhengzhou is low.The publicity and recruitment should be further strengthened to establish a stable team of voluntary blood donation, and health consultation and physical examination should also be strengthened to further reduce the residual risk of blood transfusion.

【Objective】 To investigate the characteristics of NAT reactive(R) population among voluntary blood donors in Zhengzhou, and analyze the residual risk of NAT and the infection in different ages, educational levels, and occupations. 【Methods】 The samples of voluntary blood donors in Zhengzhou from 2018 to 2019 were comprehensively screened (samples reactive by duplicate ELISA reagents excluded), and the occupation, gender, education level and marital status of voluntary blood donors were analyzed. 【Results】 A total of 488 365 samples were detected, 323 were NAT R samples (0.66‰), including 318 HBV R samples (0.65‰) and 5 HIV R samples (0.01‰), but no HCV R was detected. Statistical analysis showed that NAT R rate in male voluntary blood donors was 0.78‰ (252/321 196), higher than 0.42‰ (71/167 439) in female (P<0.05); the NAT R rates of 18~25, 26~35, 36~45, 46~55, and over 55 years old group were, 0.21‰ (39/187 816), 0.56‰ (61/108 481), 1.03‰ (101/97 872), 1.27‰ (112/87 943), and 1.53‰ (10/6 523), respectively, showing an upward trend with age(P<0.05). The NAT R rate of donors of junior middle school education and below, high school education, secondary vocational education, college education, undergraduate education and above were 1.00‰(27/26 921), 0.99‰(62/62 375), 0.97‰(28/28 908), 0.37‰(43/117 643)and 0.43‰(55/126 992), respectively, showing a downward trend (P<0.05). Among different occupations, the NAT R rate of farmers was the highest as 1.10‰ (49/44 430), and those of medical personnel and students were rather low as 0.32‰ (4/12 666) and 0.21‰ (31/145 563), respectively (P<0.05). The NAT R rate in repeated blood donors was 0.75‰ (192/257 077), which was higher than 0.57‰ (131/231 558) in first-time blood donors (P<0.05), but no significant difference was noticed in blood group and ALT (P>0.05). 【Conclusion】 Some blood samples were negative by ELISA but reactive by NAT. Therefore, NAT is an effective supplement to missed detection of ELISA and can reduce the risk of transfusion transmitted infection diseases. The characteristics of NAT R population in Zhengzhou are worth studying, which can provide reference for health consultation and further improve blood safety.

【Objective】 To investigate the variation of ferric metabolism indexes in male regular platetpheresis donors (MRPDs) with the low iron storage (plasma ferritin <30 μg/L). 【Methods】 The ferric metabolism indexes of 137 MRPDs with ferritin <30 μg/Lwere detected, including serum free iron (sFI), hemoglobin (Hb), unsaturated iron binding capacity (UIBC), total iron binding capacity (TIBC), transferrin (TRF) and prealbumin (PALB). The correlation between these indexes and the level of ferritin, the total number of platelet donation and the number of platelet donations in the previous year were analyzed. 【Results】 The UIBC of MRPDs with ferritin <30 μg/L showed a significant upward trendin comparison with the normal reference value, with the median level of UIBC at 55.1 μmol / L. The level of serum iron decreased significantly, with the median level at 10.9 μg / L. The level of ferritin was correlated with UIBC and Hb, and the indexes of iron metabolism were generally correlated to each other. The number of platelet donation in the previous year was correlated with TIBC, UIBC and TRF. The total number of platelet donation was correlated with TIBC and TRF. 【Conclusion】 MRPDs with ferritin <30 μg/L showed abnormalferric metabolism. It is necessary to detect both ferritin and ferric metabolism indexes to evaluate the iron deficiency in MRPDs.

【Objective】 To verify the results of HBV DNA and HCV RNA screening under different brands of vacuum collection tubes for blood samples, storage temperature and storage time. 【Methods】 Experiment 1 was conducted as follows: blood samples were collected simultaneously from 52 voluntary blood donors using two brands(divided into group A and group B) of vacuum collection tubes for blood samples. The plasma separation of group A and group B were compared, and the effects of storage time on the NAT yield of HBV DNA and HCV RNA were statistically analyzed. Experiment 2 was conducted as follows: the effects of different storage temperature, time and tubes on the NAT yield of HBV DNA and HCV RNA samples with low viral load in group A and B were verified and compared in the simulated phlebotomy condition. 【Results】 In Experiment 1: After centrifugation, blood plasma layer and cells layer were separated completely in group A(100%, 52/52), but one sample was not well separated in group B(1/52, 1.92%). After 4 to 10 h after collection, blood samples of two groups were centrifuged and screened for HBV DNA, HCV RNA within 24 h. No positive samples were yielded and the Ct values of internal control(IC-DNA and IC-RNA) were uniform. In Experiment 2: Whole blood samples, stored for either 4 h or 6~10 h at 4 ℃ or 25℃ before centrifugation, showed no difference on the NAT-yield of HBV DNA nor HCV RNA samples with low viral load(P>0.05). Ct values of HBV DNA and HCV RNA of group A was similar to those of group B as centrifuged samples were stored for 24 h or 72~104 h at 4℃(P>0.05), but all increased as the storage time prolonged. Ct values of HBV DNA in group A increased from 33.45±0.29(24 h) to 33.82±0.08(72~104 h) and HCV RNA from 35.21±0.20 to 36.12±0.43; HBV DNA from 33.46±0.25 to 34.30±0.60 and HCV RNA from 35.47±0.24 to 36.49±0.51 in group B. 【Conclusion】 Under certain laboratory condition, different storage time, storage temperature and tubes shed few effect on the NAT-yield of HBV DNA and HCV RNA samples with low virus loads. However, it is suggested that the blood sample be detected within 72 h after centrifugation at 4 ℃ storage.

【Objective】 To study and compare the effects of different storage temperature and time on coagulation factor after cryoprecipitated antihemophilic factor(CAF) melting, and to provide reference for the establishment of industry standards. 【Methods】 From June 2021 to May 2023, a total of 96 bags of CAF were sampled in 4 bags per month, and timely detected in the same month. After the CAF was melted in a 37℃ water bath, the mild to moderate lipemic blood was labeled. Each bag of CAF and two 50 mL transfer bags were divided into two bags and two groups of 20 mL each using a sterile adapter. One group was placed in a 4℃ refrigerator and the other in a 22℃ water bath for 0 h, 4 h, 8 h, 12 h, 24 h and 48 h. Then 2 mL of aseptic sample was taken separately and put into the test tube, and 1mL of sample and 3 mL of buffer were added into the other test tube with the sampling gun and mixed on the machine for testing. The experimental data of 60 bags without mild to moderate lipemic blood cryoprecipitation and coagulation factor were randomly selected and statistically analyzed by SPSS21.0. 【Results】 After melting, CAF was stored for 0 h, 4 h, 8 h, 12 h, 24 h and 48 h to detect the average content and growth rate of coagulation factor in the two groups: 1) Storage at 4℃, factor Ⅷ content was 118.62, 111.57(-5.95%), 105.51(-11.05%), 103.30(-12.92%), 94.35(-20.46%) and 83.25(-29.82%) IU/ bag, respectively; Storage at 22℃, the factor Ⅷ content was 118.62, 112.69(-5.00%), 111.41(-6.08%), 109.01(-8.10%), 101.55(-14.39%) and 92.75(-21.81%) IU/ bag, and the storage results of the two groups were compared. At 24 h at 4℃ and 48 h at 22℃, the content of factor Ⅷ had significant statistical significance(P<0.01), and when stored at 22℃, the decay rate of factor Ⅷ was slower; 2) When stored at 4℃, the content of factor V was 41.19, 41.31(0.29%), 40.52(-1.64%), 40.27(-2.23%), 39.05(-5.19%) and 36.99(-10.21%) IU/ bag, respectively; Stored at 22℃, the factor V content was 41.19, 41.71(1.25%), 42.54(3.28%), 41.94(1.80%), 39.21(-4.80%) and 35.64(-13.48%) IU/ bag, respectively. Comparison of storage results between the two groups showed that the content of factor V was statistically significant(P<0.05) and significantly significant(P<0.01) at 4℃48 h and 22℃48 h, respectively, and the decay rate of factor V was faster when stored at 22℃; 3) When stored at 4℃, the Fbg content was 268.86, 268.17(-0.26%), 262.46(-2.38%), 270.50(0.61%), 267.52(-0.50%) and 261.92(-2.58%) mg/ bag, respectively; Stored at 22℃, the Fbg content was 268.86, 265.86(-1.12%), 264.12(-1.77%), 265.89(-1.11%), 266.04(-1.05%) and 261.04(-2.91%) mg/ bag, respectively. There was no statistical significance between the 2 groups and the original 0 h content in each time period(P>0.05). 【Conclusion】 After CAF melting, coagulation factor decreased with the extension of storage time, especially the decrease of factor Ⅷ, followed by factor V, while Fbg basically unchanged. Comparison between the two groups showed that, factor Ⅷ decay rate is slower, factor V decay rate is faster of storage at 22℃. CAF should be transfused as soon as possible after melting. If the delay is unavoidable, for the delay time less than 12 h, storage at 4℃ is recommended, fot the delay time more than 12 h and less than 24 h, storage at 22℃ is recommended.