Objective To investigate the residual risks of transfusion-transmitted HBV/HCV/HIV in current donor screening system of Qingdao area.Methods After the ELISA tests(HbsAg,anti-HCV,anti-HIV) were performed,NAT tests of HBV-DNA,HCV-RNA,and HIV-RNA on plasma samples were conducted.Such specimens as have discrepant ELISA and NAT results(N+/E-,or N-/E+) were subject to further follow-up confirmation tests.Results Among 12000 donor samples,no sample with anti-HCV(-)/HCV-RNA(+) or with anti-HIV(-)/HIV-RNA(+) was detected.However,2 individuals were detected as HBsAg(-)/HBV-DNA(+).One donor had negative ELISA test results in HBsAb,HBeAg,HBeAb,and HBcAb at the first screening.But the HBsAg,HBeAg and HBcAb were confirmed positive along with HBV-DNA after 11 weeks.The other donor was negative for HBsAb,HBeAg,and HBeAb but positive for HBcAb.Follow up tests after 3 weeks indicated the same serological results,with a similar low viralload at about 1000 IU/mL.Conclusion Due to the window period and occult HBV infection,current blood donor screening system has some residual risks of transfusion-transmitted HBV.NAT and HBcAb tests should be implemented to reduce the residual risks of transfusion-transmitted HBV.

Objective To investigate the clinical characteristics of skin lesions of tsutsugamushi disease.Methods The skin lesions and clinical characteristics of 17 hospitalized patients with tsutsugamushi disease were analyzed. Results Of the patients, 88.2% (15/17) developed eschar and skin ulcer, 64.7% (11/17) had skin rashes. The patients often developed solitary, painless and nonpruritic eschar 4 to 10 days after the occurrence of fever, with indefinite locations and average diameter of 1.2 cm (range: 0.5 - 3.0 cm). The eschar was covered with a black and dry surface and surrounded by a ring-shaped erythematous halo, and usually shedded 5 to 9 days after the appearance with the formation of shallow ulcer. Superficial lymphadenectasis was observed near the eschar in 80% of the patients with eschar, and no eschar was observed at the first visit in 66.7% of the patients. Skin rashes mainly included nonpruritic congestive papules (45.5%) and maculopapular rashes (54.5%), and often subsided 2 to 5 days after emergence. Conclusions The skin lesions of tsutsugamushi disease include eschar and skin rashes. Eschar is an important characteristic and highly suggestive of this entity.

OBJECTIVE:To investigate the distribution of common bacterial pathogens and their drug resistance in our hospi-tal,and to provide guidance for clinical treatment and promote rational drug use. METHODS:The results of microorganism cul-ture,isolation and identification,and drug sensitivity test were collected from our hospital during Aug. 2010-Sept. 2014. The isolat-ed pathogens and drug sensitivity were analyzed statistically. RESULTS:14 687 strains of bacterial pathogens were isolated or cul-tured in 4 years,among which 1 790 strains of Pseudomonas aeruginosas were most common Gram-negative bacterium,followed by 1 313 strains of Escherichia coli and 770 strains of Klebsiella pneumoniae,670 strains of Bauman acinetobacter;915 strains of Staphylococcus aureus were most common Gram-positive bacterium,followed by 223 strains of Enterococcus faecalis,98 strains of Staphylococcus haemolyticus;1 446 strains of Mycoplasma urealytium were the most common microorganism,followed by 769 strains of Candida albicans,187 strain of Mycoplasma hominis. CONCLUSIONS:Regular detection of bacteria distribution and bacterial resistance monitoring are conducive to understand the bacterial resistance of the medical institutions so as to provide guid-ance for clinical treatment and promote reasonable application of antibacterial drugs.

Objective To analyze the blood screening results after adjustment of critical value 40 to 50 U/L and to observe the effect of reducing blood scrap rate and to discuss the correlation between ALT and HBV,HCV infection.Methods We screened 2656 blood donors (ALT >40 U/L)by serological and nucleic acid amplification testing(NAT)in Qingdao blood center from 2013 to 2014,and conducted the correlation analysis by chi square test.Results 1 771 cases (66.68%)were ALT 40-50 U/L,including 6 cases of HBsAg ELISA (+),2 cases NAT (+),4 cases NAT(-).In the 8 cases of anti-HCV ELISA (+)samples,4 cases NAT (+),3 cases NAT (-),1 case with positive TP without NAT result.In 885 blood donors with ALT>50 U/L,5 cases were HBsAg-reactive,7 cases were anti-HCV-reactive,and 873 cases were negative.Related statistics showed that there was no signifi-cant difference between ALT and HBV infection (P <0.05),but significant difference was found between ALT and HCV infection (P >0.05).Conclusion The proportion of blood donors with ALT 40-50 U/L is much higher than that with ALT >50 U/L do-nors.Adjustment of the critical value greatly reduces blood scrap rate.Elevated ALT is associated with the infection of HBV but not with HCV.

Objective To investigate the apearance and characteristics of skin rashes in patients suffering from dengue fever.Methods Clinical data were retrospectively analyzed for 126 hospitalized patients with dengue fever collected from August to October,2007.Results Out of 126 patients with dengue fever,69.0% (87/126)had skin rashes,which usually developed from day 1 and 11 after fever.About 59.7%(52/87)of these patients developed skin rashes from day 3 to 7 after fever.No eruption order was evidenced in 59(67.8%)patients.Skin rashes were located in both the trunk and limbs in 38(43.7%)patients,and only in the limbs in 30 (34.5%)patients.The incidence rates of maculae,maculopapules,papules.hemorrhagic rash and mixed eruptions were 14.9%(13/87),14.9%(13/87),18.4%(16/87),26.4%(23/87)and 21.8%(19/87),respectively.Conclusions Most patients with dengue fever developed skin rashes from day 3 to 7 after fever.Limbs and trunk are predilection sites of skin rashes in dengue fever.Skin rashes in dengue fever is complex,including maculae,papules,hemorrhagic rashes,vesicles and mixed rashes.

There has been a growing amount of evidence that a balanced blood component transfusion with roughly equal ratio of units of packed red blood cells,fresh frozen plasma,and platelets leads to better outcomes in massive transfusion re-suscitation of trauma victims.Therefore,the great interest of massive transfusion protocol(MTP)with whole blood was a-roused.Low titer group O whole blood(LTOWB)is implemented in routine use for civilian prehospital ambulance services in large trauma centers of most European and American countries nowadays.There is a growing body of evidence to date to support that early use of LTOWB in patients with life-threatening bleeding improve their survival.In view of the current situ-ation of whole blood supply in our country,most trauma resuscitation guidelines still recommend balanced component trans-fusion for MTPs in the early stage of resuscitation.The research and application of LTOWB abroad will be introduced in this article.

HIV infection and transmission is a serious threat to people's health and public health security.Antiretroviral therapy(ART),including pre-exposure prophylaxis(PrEP)and post-exposure prophylaxis(PEP),has played a huge role in controlling AIDS and curbing HIV transmission.However,the production and detection of HIV screening test markers may be affected because of the decrease of plasma viral loads and antigen levels in HIV-infected individuals after ART.It has been found that blood donors are receiving ART,and there is an increasing trend of it amongst blood donor population at home and abroad.Therefore,the uncertainty and risk of HIV screening of blood donors are increasing.In this case,blood collection and supply institutions should attach great importance to it,and take relevant studies and explore scientific and reasonable countermeasures actively.

【Objective】 To compare the detection performance of Cobas s201, a minipool(MP) nucleic acid test(NAT) system, and Panther, a individual donation(ID) NAT system, in blood donor screening. 【Methods】 NAT was conducted on 126 359 blood samples, and initially reactive (IR) samples were either discriminated or resolved by ID testing.The non-discriminated reactive (NDR) samples implicated in Panther sysytem were subjected to ID-NAT by Cobas s201. Some non-repeatable reactivet(NRR) and repeatable reactive (RR) samples implicated in Cobas s201 system were subjected to ID-NAT by Panther. 【Results】 61 MP-IR cases were implicated in a total of 85 128 samples that detected by Cobas 201, and 29(0.34‰) were RR after resolved by ID testing. 74(1.79‰)IR samples were implicated in 41 231 samples that detected by Panther, and 22 (29.73%) were DR-HBV after discriminatory test. Among the NDR 28 samples detected by Panther multiplex system, 7 were positive by Cobas s201 single sample (PP1) whereas non-reactive in simulated MPs of six by Cobas 201.In 28 RR samples resolved by Cobas 201, 24 positive and 4 negative samples were retested by Panther. Among the 11 samples presenting inconsistent retest results by Panther and Cobas 201, 10 were anti-HBc positive, carrying low viral load HBV. 【Conclusion】 The NAT-yield by Panther was significantly higher than that by Cobas s201. Some samples with negative discriminatory results were OBI, and it is necessary to further track and verify the unidentified samples. Cobas s201 is more suitable for a wide array of MP-NAT testing while Panther sample loading, which is flexible and easy to operate, is more suitable for ID-NAT with medium sample size.

【Objective】 To study and analyze the serological and viral charactereristics of hepatitis B virus(HBV) infection in voluntary blood donors in Qingdao. 【Methods】 315 520 blood samples of voluntary blood donors were screened by ELISA combined with nucleic acid testing (NAT). All HBsAg-/HBV DNA+ samples were subjected to high-precision viral load detection and five serological markers of HBV. The sequence of HBV S gene was detected by PCR direct sequencing, and virus genotypes and amino acid mutations were analyzed. 【Results】 A total of 604(0.20%)HBV ELISA or NAT reactive samples were detected: HBsAg+ /HBV DNA- in 307(0.10%) cases, HBsAg-/HBV DNA+ in 138(0.04%) and HBsAg+ /HBV DNA+ in 157(0.05%). Among the 138 HBsAg-/HBV DNA+ donors, 118(85.5%) carried anti-HBc, and 45 (32.61%) carried sole anti-HBc and 5 (3.62%) carried both HBsAg and anti-HBc. In viral load detection, 64 were quantitatively negative and 74 were quantitatively positive, of which 42 were HBV DNA <20 IU/mL and 32 > 20 IU/mL. 13 HBsAg-/HBV DNA+ samples were successfully amplified and sequenced, and 5 were genotype B, presenting a total of 17 amino acid mutations without any deletion or insertion, and 8 were genotype C, presenting a total of 41 amino acid mutations and 2 amino acid deletions. 【Conclusion】 NAT, in combination of ELISA, provides additional safety in detecting potentially infectious HBV during the window period and occult HBV infection (OBI). The viral load was low in OBI infected donors, and anti-HBc+ was the main manifestation.The dominating HBV genotypes are genotype B and C, suggesting HBsAg amino acid mutations may be related to the formation of OBI.

Objective:To investigate the unqualified hepatitis C virus (HCV) detection result of blood donors from the served area of blood institutions.Methods:The data related to HCV markers detected of the first and repeat blood donors were collected from the system of practice comparison for the Chinese mainland blood institutions from 2017 to 2021. The anti-HCV reactive rate and the rates of anti-HCV negative but HCV-RNA reaction and all the relationship between rates and the annual, regional and different blood donors were statistically analyzed.Results:During 2017-2021, the number of anti-HCV reactive per 100 000 blood donors decreased from 444.3 to 250.44 in the served area of 22 blood institutions ( χ2=49.677, P<0.05). The number of HCV RNA detected positive per 100 000 anti-HCV negative increased from 0.69 to 2.05 year by year, but there was no statistical significance ( χ2=0.643, P>0.05). The anti-HCV unqualified rate was significantly different among regions ( χ2=3 260.283, P<0.05). The anti-HCV unqualified rate of the first blood donors was significantly higher than that of the repeated blood donors ( F=130.993, P < 0.05). The annual number of HCV RNA detected positive per 100 000 anti-HCV negative blood samples from donors ranged from 0 to 17.28. Conclusions:The anti-HCV unqualified rate of blood donors in the served area of 22 blood institutions decreased year by year. Compared with repeated blood donors, HCV infection should be emphasized in first-time blood donors. The implementation of HCV RNA test can detect out much more HCV infections and reduce the risk of transfusion transmitted infectious HCV.