1.Evaluation of clinical blood transfusion management using DRGs
Jiwu GONG ; Yanming LIU ; Peiwei YANG
Chinese Journal of Hospital Administration 2011;27(11):866-870
ObjectiveBy analyzing the transfusion-related data using DRGs data to establish a credible evaluation system for clinical use,thereby enhancing the safe and effective clinical transfusion management.Methods Use the transfusion-related data of DRG-s,and statistical methods of EXCEL database to categorize and analyze the number of blood transfusion,hospital name,hospital type,hospital level,DRGs code and name,times of blood transfusion,volume of transfusion,etc.Results Output the statistics of the city's ratio of institutional use of blood,per capita consumption in patients,distribution and ordering of hospital based blood tranfusion,distribution and ordering of DRGs based blood transfusion,distribution and ordering of single DRGs between hospitals,annual consumption growth in different hospitals and major disease groups of blood tranfusion.ConclusionThe use of DRGs can efficiently control clinical indicators for blood transfusion and evaluate the performance of blood transfusion.it can provide a credible management tool for the health administrative departments and hospitals while offering data support for policy making of management objectives at the same time.
2.Analysis of safety on blood transfusion in the elderly patients
Yanming LIU ; Wenjing GUO ; Jiwu GONG
Chinese Journal of Geriatrics 2012;31(8):694-696
Objective To analyze the safety of blood transfusion in hospitalized senile patients,and to prevent or reduce adverse transfusion reactions. Methods The blood transfusion information of patients over the age of 60 years in our hospital from January 2009 to December 2011 were retrospective analyzed. The data of pre-storage type of autologous blood transfusion for elective surgery were also discussed. Results Among 3549 cases of elderly patients,there were totally 23877 times of allogeneic transfusion and 84 cases with blood transfusion adverse reactions of heating or allergic reactions.The adverse reaction rates occured most in the infusion of fresh frozen plasma (0.55%).There was no hemolytic reaction,and transfusion adverse reactions occarred during stored blood autotransfusion. Conclusions Medical institutions should set the scientific and rational principle of blood use and select the appropriate blood components to reduce transfusion adverse events in the elderly patients. The autologous blood transfusion in the elderly patients should be actively pursued.
3.Research and Analysis Result of Recheck Blood Type in Part of Beijing Blood Bank
Xiaoyang ZHAO ; Dong LIN ; Jiwu GONG
Chinese Journal of Nosocomiology 1994;0(04):-
OBJECTIVE To investigate the degree of risk of viral prevalence of HBV,HCV and HIV through blood transfusion in Beijing Hospital in China,and to assess the need of a national Haemovigilance System. METHODS Retrospectively,7883 blood bank specimens (collected from 2004 to 2007) were re-examined using 8 indicators (including 5-item Hepatitis B,anti-HCV,anti-HIV and Syphilis) for the prevalence of most common viral infection. RESULTS From the blood bank specimens,the prevalence of HBsAg was 0.88% (69),the anti-HBc positive blood,only the anti-HBc was found in 2.65% of the specimens,while both the anti-HBc and the anti-HBe were found in 2.09% of the specimens. The prevalence of anti-HCV was 0.09% (7). CONCLUSIONS We need to establish the national Haemovigilance System to strengthen the monitoring of the above HbsAg,HBcAb and HCV indicators to prevent the transfusion-transmitted infection. Only in this way can the public confidence in blood safety be improved.
4.Exploration of teaching for orthopedic postgraduates
Xiaohua PAN ; Weidong SONG ; Jingshan GONG ; Zhongshi XU ; Jiwu CHENG
Chinese Journal of Medical Education Research 2013;(5):463-466
To improve higher training quality and capacity of orthopedic postgraduates,early contact education,problem-base learning combined with co-supervisor with radiologists were engaged for orthopedic postgraduates since 2008.Effect of the practice was assessed by postgraduates one year later.Investigation revealed that practice aroused learning enthusiasm and initiative,promoted comprehensive understanding of orthopedic knowledge,set up social responsibility,and constructed innovative thinking.
5.Investigation of blood transfusion in elderly patients in third-level general hospitals
Yanming LIU ; Wenjing GUO ; Jiwu GONG ; Peng ZHANG ; Junhua HU
Chinese Journal of Geriatrics 2014;33(12):1330-1333
Objective To investigate the blood transfusion paths in elderly patients in order to ensure the blood transfusion safety in the elderly.Methods Clinical data of elderly patients (aged 60 and over) receiving blood transfusion were selected from January 2008 to December 2013.Data of blood transfusion in different clinical department were analyzed.Results From 2008 to 2013,the number of elderly patients receiving blood transfusion and transfusion volume showed the rising trends.Patients in Department of Cardiothoracic Surgery had the most blood transfusion volume among all surgical departments (9.3U/person),and plasma transfusion accounted for the most with plasma and red blood cells in a 3 ∶ 1 ratio.Patients in Department of Internal Medicine had the most blood transfusion volume among all non surgical departments (15.9U/person),and platelets transfusion accounted for the most with platelets and red blood cells in a 3 ∶ 1 ratio.The oldest patients on average receiving blood transfusion in the top 10 was from Department of Emergency (aged 77 years),and the most common cause was gastrointestinal hemorrhage.The youngest patients receiving blood transfusion in the top 10 was from Department of Cardiothoracic Surgery and Department of Gynecology (aged 69 years),and the most common cause was huge pleural mass and ovarian cancer.Conclusions Blood transfusion for elderly patients should be restrict the indications for transfusion strictly,choose the reasonable transfusion time,blood components and volume.Physiological and functional changes and clinical features of elderly patients should be paid attention to at the same time in order to reduce unnecessary transfusions,particularly the dependence on plasma transfusion and unnecessary collocated blood transfusion,to avoid the overload and adverse transfusion reactions.
6.Survey and analysis of testing capabilities of clinical transfusion laboratories in medical institutions in Beijing
Jiwu GONG ; Dandan JIA ; Yanming LIU ; Dong LIN ; Zhiyang NIE
Chinese Journal of Hospital Administration 2012;28(3):176-178
Objective To investigate the testing capabilities of clinical transfusion laboratories in medical institutions in Beijing for the regulatory authorities to formulate administrative policies in this regard.Methods Experts assigned by Beijing Clinical Transfusion Quality Control Center made on-site inspections at the transfusion laboratories in medical institutions using quality control products.They recorded the complete testing process of the operators as well as the instruments,detection reagents in use and the testing results,with statistics and analysis made to the data so collected.Results The pass rate of these on-site inspections was lower than that of the external quality assessment.Some laboratories failed to complete the testing of the quality control products in time and the actual operations in some laboratories were inconsistent to the guidelines.55.9% of level Ⅰ hospitals and 25.6% of level Ⅱ hospitals were found with insufficient and inadequate instruments and process layout to meet the needs of clinical blood transfusion.Some of the technicians were found without sufficient trainings in their professional knowledge and basic skills,resulting in their poor competence against emergency cases and weakness in independent problem solving.In addition,the records of detection process and results were found to be substandard.Conclusions Transfusion laboratories in Beijing need to improve their testing capabilities in general.
7.Construction and primary identification of a naive Fab fragment phage library
Qian GONG ; Changying LI ; Jiwu CHANG ; Tiehong ZHU
Chinese Journal of Immunology 2001;0(07):-
Objective:To construct a human Fab fragment phage display library and provide a platform for human antibody preparation.Methods:Peripheral blood lymphocytes were collected from healthy donor.The heavy chain Fd fragment and light chain of human immunoglobulin's genes were amplified by RT-PCR,and then cloned into phagemid pComb3XSS to generate human phage antibody library.Cutting with endonucleases such as SacⅠ,XbaⅠ,XhoⅠand SpeⅠto identify the insertion of the light chain or heavy chain Fd genes.IL-2 and digoxin as the antigen was used to scan the phage antibody library.Results:A phage antibody library of Fab had 8.4?107 members and it's recombinant rate was 70%.Through DNA sequencing of one positive clone,it was showed that its heavy chain belonged to IgG subvariety and its light chain to ? family.Conclusion:The success of constructing a nave human phage antibody library proves the useful of phage display system in human antibody preparation,and it can be used to select,purify and express of amylin Fab antibody.
8.Discussion on the clinical non-transfusion application of platelet concentrates
Chinese Journal of Blood Transfusion 2021;34(7):683-684
Platelets concentrates play a vital role in the maintenance of normal hemostatic activity and the integrity of blood vessel wall. Accordingly, for patients with low platelet counts (thrombocytopenia) or dysfunction, platelet transfusion can be of significant value in preventing and treating hemorrhage. In recent years, various studies have proved that platelets also play a very important role on anti-inflammation and improvement of cell and tissue growth and repair in regeneration processes. Platelets with the natural source of various growth factors can help in wound healing and proliferation. At present, autologous platelet-rich plasma and platelet gel are also widely used in the treatment of clinical patients. Therefore, the non-transfusion therapy of allogeneic platelet concentrate and alternatives such as platelet rich plasma, platelet gel and dry platelet (freeze-dried platelet) should be applied on patients in the near future.
9.Expression of MMP-2 mRNA and MMP-9 mRNA in pulmonary arterioles of rats with pulmonary hypertension induced by chronic hypoxia hypercapnia
Jiwu LI ; Yongsheng GONG ; Xiaofang FAN ; Lianggang HU ; Luzhen ZHENG ; Zhongsun JIANG
Chinese Journal of Pathophysiology 1989;0(05):-
AIM: To investigate the expression of matrix metalloproteinases(MMPs) in pulmonary arterioles of rats with chronic hypoxia and hypercapnia-induced pulmonary hypertension. METHODS: MMP-2, MMP-9 and MMP-2 mRNA, MMP-9 mRNA were observed in pulmonary arterioles by the techniques of immunohistochemistry and in situ hybridization. RESULTS: ①The mean pulmonary artery pressure (mPAP) and weight ratio of right ventricle to left ventricle and septum (RV/LV+S) of hypoxia-hypercapnia groups were higher than those of normal control group ( P
10.Effect of puerarin on pulmonary arterioles wall collagen metabolism of chronic hypoxia hypercapnia rats
Yongsheng GONG ; Jiwu LI ; Penglin YANG ; Xiaofang FAN ; Lianggang HU ; Lzhen ZHENG ; Zhongsun JIANG
Chinese Journal of Pathophysiology 1999;0(09):-
AIM:To investigate the effect of puerarin on pulmonary vessel collagen metabolism in pulmonary hypertension rats induced by chronic hypoxia and hypercapnia. METHODS: Collagen Ⅰ,Ⅲ and their mRNA were observed in pulmonary arterioles by the technique of immunohistochemistry and in situ hybridization. RESULTS: ① Light microscopy showed media thickness of pulmonary arterioles was much higher in HH(hypoxic-hypercapnia) group than that of NC(normal control) group, and, vessel cavity turned more straiter in HH group than that of NC group.However, the damage of pulmonary arterioles in HP(hypoxic-pueratin) group was much slighter than that of HH group. ② The levels of plasma ET-1 and lung homogenates Hyr were much higher in HH group than those of NC group( P 0.05). CONCLUSION: Puerarin inhibited the deposition of collagen and improved pulmonary vessel remodeling.