OBJECTIVE To discuss the application of tachypleus amebocyte lysate test in transfusion reaction. METHODS Based on agglutination when tachypleus amebocyte lysate test encountered bacterial endotoxin, the quantity of the bacterial endotoxin was tested. RESULTS Twenty-three cases were analyzed with tachypleus amebocyte lysate test, the main reasons were excessive pyrogen, improper combined drug compatibility, excessive agents or unqualified pyrogen of the agent added, pollutions on transfusion devices and air in the treatment room, disobeying axenic operation rules, overlong drug dispensing, too fast transfusion speed, etc. CONCLUSIONS On prevention of transfusion reaction, all the axenic operation rules should be strictly followed, single dose transfusion, to reduce transfusion reaction.

BACKGROUND: Studies have shown that umbilical cord mesenchymal stem cells are ideal seed cells for tissueengineering research.OBJECTIVE: To isolate, culture and identify tree shrew umbilical cord mesenchymal stem cells, in order toestablish a standardized tree shrew umbilical cord mesenchymal stem cell lines.METHODS: Caesarean-isolated tree shrew umbilical cord samples were used to isolate and culture umbilical cordmesenchymal stem cells using tissue explant adherent method. Flow cytometry assay was used to detect cellsurface markers. Osteogenic and adipogenic induction media were used to induce umbilical cord mesenchymalstem cells to differentiate into osteoblasts and adipocytes.RESULTS AND CONCLUSION: The cultured umbilical cord mesenchymal stem cells expressed CD90 and CD105 with the positive rate of 99.9% and 99.8% respectively. Hematopoietic stem cell marker CD34 expression ratewas 0.0% and the endothelial cell marker CD31 expression rate was 0.7%, in line with the characteristics of umbilicalcord mesenchymal stem cell surface markers. Calcium nodules by alizarin red staining and lipid droplets by oil red Ostaining were observed in the induced cells. These experimental findings indicated that umbilical cord mesenchymalstem cells from tree shrews capable of osteogenic and adipogenic differentiation were successfully isolated and cultured.

Objective To explore the extensively drug resistant mechanism and clinical treatment strategy of Klebsiella pneu-moniae .Methods The isolate was identified by Vitek2 Compact System.Antimicrobial susceptibility testing was conducted by Kirby-Bauer method.KPC-2 carbapenemase was detected by modified Hodge test.The gene encoding KPC-2 carbapenemase was amplified by polymerase chain reaction (PCR)and then sequenced.Results The strain was resistant to all antibiotics used in routine antimicrobial susceptibility testing except amikacin.Modified Hodge test showed positive result.KPC-2 gene was detected by PCR.The sequence was consistent with that of 11844849 in GenBank.After treatment for one month,no exten-sively drug resistant K.pneumoniae strain was detected from the patient.Conclusions It is necessary to strengthen the monito-ring and improve the awareness of extensively drug resistant K.pneumoniae for better control of such infections.

Objective To evaluate reference range for fasting venous blood cells in the healthy 51 584 elderly people from Shuyang,China.Methods Totally 1000 non-old people and 51 584 elderly people were involved in this study.Fasting venous blood cells were collected from each group of subjects using standard procedures.The collected aliquots were processed according to standard operating procedures to determine participants' complete blood counts.Non-parametric methods were employed to calculate the reference intervals and 95 ％ confidence intervals for complete blood counts by Sysmex XE-2100 blood cell analyzer.Results The reference ranges of fasting venous blood cells in elderly subjects (male,female) were [(3.25-9.45) × 109/L and (3.35-9.39) × 109/L,WBC];[(3.87-5.55) × 1012/L and (3.71-5.19) × 1012/L,RBC] ; [(116.2-169.5)g/L and(107.4-153.6)g/L,Hb] ; [(37.2-52.4) ％ and(35.2-48.6) ％,HCT] ; [(86.3-104.8)fl and (85.2-103.5) fl,MCV] ; [(27.0-33.4) pgand(26.4-32.5)pg,MCH]; [(297.1-335.4)g/L and(293.3-330.5)g/L,MCHC];[[(38.4-54.2) and (38.6-52.9),RDW-SD]; [(11.3-15.4)％ and(11.4-15.3)％,RDW-CV];[(98.8-303.8) × 109/L and (109.9-334.8) × 109/L,PLT] ; [(1.10-3.42) and (1.20-3.78) ml/L,PCT];[(11.2-15.6) fl and(11.3-15.5)fl,MPV]; [[(8.89-16.7)％ and(9.48 17.1)％,PDW];[(20.3-49.1) ％ and (20.5-48.6) ％,PLCR],respectively.13 parameters of fasting venous blood samples in elderly people had statistically significant differences compared with non-old people (all P ＜0.05).Conclusions The reference range of fasting venous blood samples in elderly people are significantly different from non-old people.It is necessary to scientifically and reasonably establish the reference ranges for fasting venous blood cells in local elderly people.

Objective To explore the effects of music therapy combined with acupuncture and auricular acupoint pressing in childbirth of primipara. Methods From June to December 2017,this study selected 90 primiparas with childbirth in Obstetrics Department at Zhejiang University Zhoushan Hospital as subjects by convenience sampling. All of primiparas were divided into intervention group and control group with the method of random number table,45 cases in each group. Control group adopted music therapy in which patients listened to their favorite music. On the basis of that in control group,intervention group carried out the acupuncture and auricular acupoint pressing. This study compared the Numerical Rating Scale(NRS),the time when the orifice of uterus ranged from 3 to 10 cm,neonatal Apgar score and blood loss two hours after childbirth of delivery women. Results There was no statistical difference in the score of NRS of primiparas between two groups when the orifice of uterus ≥3 cm(P>0.05). The scores of NRS of intervention group were lower than those of control group with statistical differences 30 min after analgesia and when uterus opened to the full(P<0.05). The time when the orifice of uterus ranged from 3 to 10 cm in intervention group was shorter than that in control group with a statistical difference(P< 0.05). There were no statistical differences in the neonatal Apgar score and blood loss two hours after childbirth of patients between two groups(P> 0.05). Conclusions Music therapy combined with acupuncture and auricular acupoint pressing can ease the labor pain,shorten the time when uterus opens to the full,and is safe for mother and baby and has better effects compared with simply music therapy which is worthy of being popularized and applied.

Objective To investigate the impact of SARS-CoV-2 infection on male semen quality through meta-analysis and retrospec-tive study.Methods Literature retrieval was conducted in PubMed,CNKI,Wanfang Database and CBM database.Meta-analysis was performed using Stata 15.0.The male patients meeting the inclusion criteria from our hospital were enrolled as study subjects.General demographic data and semen parameters were collected.Single factor analysis of variance and graphing of semen parameters were con-ducted using GraphPad Prism 9.5.1.The test level was set at 0.05.Results A total of 9 studies involving 267 patients were included in the meta-analysis.There were no significant differences in sperm concentration and survival rate before and after SARS-CoV-2 infec-tion(P＞0.05).Semen volume and percentage of normal morphology significantly increased during 1-3 months after infection(P=0.005,P=0.010),with semen volume recovering to pre-infection level＞3 months later(P＞0.05).Sperm motility and progressive mo-tility increased＞3 months after infection(P=0.046,P=0.045),recovering to pre-infection levels(P=0.099,P=0.098).Sperm DNA fragmentation index may be temporarily elevated within 3 months after infection but gradually decreased＞3 months later.In the retrospective study of 8 cases,there were no statistical differences in semen parameters at different stages compared with pre-infection(P＞0.05),but semen parameters showed a negative trend during＜1 month after infection and recovered to pre-infection levels＞3 months later.Conclusion The results of this laboratory study are basically consistent with the meta-analysis.SARS-CoV-2 infection in males only caused short-term negative effects on sperm morphology,vitality and DNA integrity,but generally recovered to pre-infection levels＞3 months after infection.Due to the limitations of study subjects and sample size,the impact of SARS-CoV-2 infection on male semen quality needs to be further confirmed by long-term large-scale prospective studies.