[Objective] To evaluate the risk of bacterial contamination of platelets apheresis and improve the clinical diagnosis rate of transfusion-transmitted bacterial infections. [Methods] A retrospective analysis was conducted on 11 cases involving bacterial contamination detected in apheresis platelets during quality inspections at our center from 2021 to 2023, as well as cases of transfusion-transmitted bacterial infection (TTBI) caused by platelet transfusion. The return of positive platelet bacteria test results and clinical transfusion adverse reactions were statistically analyzed. [Results] There were 9 donors with bacteria-contaminated platelets, of which 3 were reported as clinical transfusion reaction, 4 were detected by quality sampling, and 2 were identified by appearance detection before transfusion. The bacterial contamination rate of platelets was about 0.08% (9/10 762). The contaminated platelets were involved in 11 cases of TTBI, with an incidence of TTBI of approximately 0.05% (11/21 916). Only 3 cases of transfusion reactions were clinically reported, while the rest were case tracking with positive results of platelet bacterial test from quality sampling. The clinical return rate of TTBI was 27.27% (3/11), with an average reporting time of 8.12 hours after the occurrence of transfusion reactions. The majority of the contaminated platelets were detected at the end stage of storage, with 55.56% (5/9) of platelets collected on the 4th day after collection. Partial contaminated platelets were identified through quality sampling, with a positive rate of 2.78% (4/144). [Conclusion] The platelet bacterial contamination rate is high, but with low clinical return rate. It is recommended to conduct routine platelet bacterial monitoring and improve clinical diagnostic level.

[Objective] To compare the efficacy and safety of deglycerolized red blood cells (DRBC) and suspended red blood cells (SRBC) based on the propensity score matching (PSM) method, so as to provide evidence for the rational use of DRBC resources in clinical practice. [Methods] A total of 89 patients who received DRBC transfusion and 2 916 patients who received SRBC transfusion in our hospital from January 2023 to September 2024 were included. A 1∶1 nearest neighbor PSM was used to balance covariates such as gender, age, and body mass index (BMI). The changes of hemoglobin (Hb), red blood cell (RBC) count, hematocrit (HCT), and inflammatory markers such as white blood cell (WBC) count, neutrophil (NE) count, C-reactive protein (CRP), and Interleukin-6(IL-6) in the last 72 hours after transfusion were analyzed by SPSS 26.0 and R software to evaluate clinical efficacy and transfusion safety. [Results] The baseline of the two groups was balanced after PSM (P>0.05). There was no significant difference in the total effective rate between the DRBC group (80.9%) and the SRBC group (86.5%) (P>0.05). In the SRBC group, WBC (×10 /L) increased from 9.634±6.742 to 10.147±6.835, CRP (mg/dL) increased from 5.468±4.647 to 6.174±6.114, and IL-6(pg/mL) decreased from 213.733±587.191 to 157.255±552.626. In the DRBC group, WBC (×10 /L) decreased from 11.123±7.880 to 11.011±8.549, CRP (mg/dL) decreased from 5.729±4.761 to 5.326±4.466, and IL-6(pg/mL) decreased from 238.806±639.060 to 152.255±266.558. Compared with the before treatment, the differences between the SRBC group and DRBC group were not statistically significant (P>0.05). Among all patients included in the statistics, the overall incidence of transfusion adverse reactions was 0.205% (6/2 916) in the SRBC group, and no adverse reactions occurred in the DRBC group. The incidence in the SRBC group was higher than that in the DRBC group. [Conclusion] Based on PSM analysis, there was no significant difference in the efficacy and safety of DRBC transfusion compared with SRBC transfusion, which can provide evidence-based support for routine application.

[Abstract] [Objective] To compare and analyze the efficacy of platelet transfusion in patients with different doses, and to analyze the risk factors for platelet transfusion refractoriness. [Methods] A total of 5 827 patients who received platelet transfusion in the PLA General Hospital from May 2023 to May 2024 were selected as the research subjects, among which 4 780 patients were transfused with 1 therapeutic dose of platelets, and 1 047 patients were transfused with 0.5 therapeutic dose of platelets, and the efficacy of platelet transfusion was compared between the two groups. The effects of gender, disease type, white blood cell count before transfusion, fever, number of platelet transfusions, and platelet antibodies on platelet transfusion refractoriness were analyzed using univariate analysis, and the independent risk factors affecting platelet transfusion refractoriness were further analyzed by multivariate logistic regression. [Results] Among 4 780 patients, 3553 (74.3%) were effective and 1 227 (25.7%) were ineffective. Among 1 047 patients, 0.5 platelet infusion was effective in 755 cases (72.1%) and ineffective in 292 cases (27.9%). There was no significant difference in the effective rate of platelet transfusion between the two groups (P>0.05). Univariate analysis showed that the therapeutic effect of platelet transfusion was related to age, the number of platelet transfusion, disease type, platelet antibodies and white blood cell count before transfusion (P<0.05), while age, gender, fever and blood type were not related to the therapeutic effect of platelet transfusion (P>0.05). The results of multi-factor analysis showed that age, white blood cell count >50×10⁹/L, platelet transfusion times, disease type and platelet antibody were independent risk factors for ineffective transfusion (P<0.05). [Conclusion] There is no significant difference in the efficacy of platelet infusion with 0.5 therapeutic dose or 1 therapeutic dose. In addition, age, white blood cell count >50×10⁹/L, the number of platelet transfusion, disease type and platelet antibodies were the factors affecting the ineffective platelet transfusion in group 2.

[Abstract] [Objective] To analyze the detection ability of one imported and three domestic microcolumn agglutination anti-human globulin cards in unexpected antibody screening test. [Methods] A total of 104 positive samples from antibody screening test conducted at our hospital from July to September 2022 were selected. Microcolumn agglutination antiglobulin tests were performed in parallel with antibody screening tests using one imported card (A Card) and three domestic cards (B, C and D Cards ) to analyze the differences in the sensitivity, specificity and agglutination intensity scores. [Results] The sensitivity of the four anti-human globulin cards was as follows: D card 88.51% (131/148) > C card 83.22% (124/149) > B card 81.63% (120/147) > A card 80.54% (120/149); the specificity was A card 97.79% (133/136) > B card 95.65% (132/138) > D card 95.62% (131/137) > C card 93.38% (127/136); and the average agglutination intensity score (points) was D card 214.57 > C card 191.90 > A Card 179.69 > B Card 175.83, and the H value of Kruskal-Wallis test was 7.221, with no statistically significant difference (P > 0.05). Among them, C card was prone to false positives, accounting for 3.16% (9/285), and A card was prone to false negatives, accounting for 10.18% (29/285). [Conclusion] There were differences in the detection ability of anti-human globulin cards of different manufacturers, and some domestic cards have higher detection performance than imported cards. It is recommended to use anti-human globulin cards of two manufacturers routinely in clinical practice, that is, to use cards with high detection sensitivity for antibody screening tests to avoid antibody missed detection as much as possible, and to use cards with high specificity for cross-matching blood tests to avoid delays in transfusion due to false positives, which could hinder transfusion treatment.

Objective To investigate the effect of a three-tier delirium care management process in patients with acute stroke in neurology intensive care unit(NICU).Methods A total of 50 patients with acute stroke admitted to the NICU of the Fourth Hospital of Changsha from May to September 2021 were assigned to the control group.The patients in the control group received routine NICU nursing care to prevent delirium.Another 50 patients with acute stroke admitted to the NICU from December 2021 to April 2022 were assigned to the trial group.They were managed with the three-tier delirium nursing management process on top of the routine NICU nursing care for the control group.The incidence of ICU delirium(DICU),duration of DICU,length of stay in NICU and the incidence of delirium-related adverse events were compared between the two groups.The degree of delirium and cognitive function before and after the intervention were compared between the two groups as well.Results The trial group had significantly shorter duration of DICU and NICU stay(both P<0.05)and lower incidence rate of delirium-related adverse events(P<0.05)compared to the control group.After the intervention,the trial group showed significantly lower scores on the intensive care delirium screening checklist(ICDSC)and significantly higher scores of cognitive function compared to those of the control group(both P<0.05).Conclusion The three-tier delirium nursing management process can lower the occurrence of delirium in NICU patients with acute stroke,shorten the NICU stay,reduce the safety risk in nursing,and improve the cognitive function.

To introduce a strategy for a case of severe pneumonia complicated with lung abscess caused by Fusobacterium necrotum.The pathogen was not identified,but the patient was still coughing up feverish bloody sputum after being treated with meropenem,linezolid and ornidazole.The results of detection of pathogen metagenomes in bronchoalveolar lavage fluid by posterior bronchoscopy suggested that the pathogen was Fusobacterium necrophorum,according to the characteristics of bacteria,the dynamic changes of clinical symptoms,liver and kidney function,body temperature and blood picture infection index,combined with the results of bacterial culture/drug sensitivity test,bronchoalveolar lavage fluid NGS and the pharmacokinetic/pharmacodynamic characteristics of antimicrobial agents,to propose an anti-infective regimen that is strategically adjusted to imipenem cilastatin(1.0 g,ivd,q8h)plus ornidazole(0.5 g,ivd,q12h)for the implementation of pharmaceutical care after adoption by physicians.After 21 days,the patient's severe infection and lung abscess was controlled and patient was discharged.In this case,clinical pharmacists study the bacterial characteristics of Fusobacterium necrotum,review a large number of domestic and foreign literature to track the frontier knowledge of antimicrobial agents,and use their own expertise to provide effective pharmaceutical support for the clinical team,to assist clinical team in the diagnosis and treatment of rare infections,to achieve professional value.

Objective:To study the correlation between hearing loss and cognitive decline in community-dwelling older adults and to analyze the influencing factors.Methods:Using Pure-tone audiometry, the Hearing Handicap Inventory for the Elderly (HHIE), Mini-Mental State Examination (MMSE), Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder, a survey was conducted with 492 community-dwelling older adults aged 60 years and above in Beijing. Age, gender, education level, hearing loss, levels of anxiety and depression, and other factors were used as independent variables, and the MMSE scores were used as dependent variables. Analysis of variance and multiple linear regression were performed.Results:Among the 492 subjects, based on the better ears, 418 (85.0%) had hearing loss and 160 (32.5%) had disabled hearing loss. Factors such as age (β=-0.33, P<0.01), gender (β=0.09, P=0.04), education level (β=0.31, P<0.01), hearing loss (β=-0.11, P=0.02) and marital status (β=0.56, P=0.02) were significantly related to cognitive decline. Gender (β=-0.17, P<0.01) and hearing loss (β=0.08, P=0.02) correlated with anxiety indicators; gender (β=-0.84, P=0.02) and hearing loss (β=0.04, P=0.01) also correlated with depression indicators. Conclusion:Results indicated a correlation between hearing loss and cognitive decline, and between hearing loss and anxiety and depression among community-dwelling older adults in Beijing.

Objective:To investigate the normal range of fetal ventricles and posterior cranial fossa development in the second and third trimesters and their variations with gestational age using quantitative MRI analysis.Methods:This retrospective study enrolled 675 pregnant women who underwent prenatal MRI examination with an average gestational week of 29.0±8.5 in the Third Affiliated Hospital of Guangzhou Medical University from January 2016 to January 2020. MRI data of all the subjects were collected and analyzed, including left lateral ventricle trigonometric width (LLVTW) and right lateral ventricle trigonometric width (RLVTW), third ventricle width (TVW), fourth ventricle width (FVW), the anterior-posterior diameter of the fourth ventricle (APDFV), cavum septum pellucidum width (CSPW), cisterna magna width (CMW), etc. Spearman, Pearson correlation analysis, and t-test were used for the statistical analysis. Results:(1) Totally 675 fetuses were recruited, including 392 female and 283 male fetuses. No statistical difference of gestational weeks at MRI was found between male and female fetuses. (2)The mean value of TVW and CMW of the female fetuses were significantly higher than those of male fetuses [(0.60±0.05) vs (0.63±0.04) cm, t=－5.059; (0.57±0.14) vs (0.67±0.15) cm, t=－7.445; both P<0.001]. Spearman correlation analysis showed that TVW and CMW were negatively correlated with fetal gender ( r=－0.179 and－0.312, both P<0.001). (3)Pearson correlation analysis showed that LLVTW, RLVTW, TVW, FVW, APDFV, CSPW, and CMW were all positively correlated with gestational weeks ( r=0.310, 0.267, 0.205, 0.801, 0.829, 0.216 and 0.284, all P<0.001). FVW and APDFV were significantly linearly correlated with gestational weeks (r=0.801 and 0.829, both P<0.001). (4) There was no significant change in LLVTW and RLVTW in the second trimester, but a slight increase was found in the third trimester. TVW showed a scattered distribution in the second and third trimesters and increased slightly with the gestational week at 26 to 27 +6 gestational weeks. FVW and APDFV increased linearly while. CSPW increased slowly with gestational weeks in the second and third trimesters. CMW increased slightly with gestational weeks in the second and third trimesters but showed little change in the third trimester. Conclusions:The development of fetal ventricles and posterior cranial fossa in the second and third trimesters show a growth trend of varying degrees with the increase of gestational weeks. TVW and CMW are significantly negatively correlated with the fetal gender.

【Objective】 To study the serological and genetic characteristics of a case of B(A) blood group. 【Methods】 Serological and genetic ABO blood group typing were used to analyze the ABO subtype and family inheritance of the probands and her 8 family members. The B(A) blood type sample was used as the blood recipient, and the B-type and O-type donors were selected for cross-matching using microcolumn gel anti-human globulin method to evaluate the blood transfusion strategy. 【Results】 5 out of 9 family blood samples were B(A) phenotype, carrying B(A)04 allele. Among them, 1 was B(A)04/O1 type, and 4 were B(A)04/B type. The primary blood matching of B(A) blood type samples with type B and O recipients were all negative. 【Conclusion】 A total of 5 cases of B(A)04 blood type were found in this family investigation, and there were differences in serological manifestations. Washed RBCs with B and O type can be used for B(A) blood type transfusion, and type B suspended RBCs can be considered in case of emergency.

Objective To evaluate the value of 3.0 T dynamic contrast-enhanced magnetic resonance imaging(MRI) in the diagnosis of hip joint lesions in patients with ankylosing spondylitis (AS).Methods Fifty-two AS patients with hip involvement were diagnosed in Department of Rheumatology in our hospital from January 2013 to December 2016.All patients underwent AS disease activity ankylosing spondylitis disease activity score (ASDAS)-C-reactive protein (CRP) score evaluation of hip joint acti-vity and hip joint disease activity was evaluated by doctors.According to ASDAS-CRP score,patients were divided into active disease 34 cases and remission for 18 cases.All patients underwent double hip MRI plain scan,dynamic enhanced scan and post-processing analysis after the diagnosis.Six regions of interest were selected in the abnormal synovial area around the hip joint.The time signal TIC curve was generated automatically,the shape of the curve was described and the early intensification rate of the third,fourth phase was measured.The early intensification rates of the active disease group and the remission group were analyzed statistically.Two independent samples t test was used for analysis,and P＜0.05 was regarded as statistically significant.The early intensification rate of the third,fourth phase were compared with the ASDAS-CRP score,the evaluation of hip joint activity in patients and the evaluation of hip joint activity were carried out by doctors taking care of the patients.Results The TIC curve of the active group was rising fast,followed by platform or fast rising.The curve of the remission group was slow rising.The inten-sification rate of the third,fourth phase [(116±9)％,(146±12)％ respectively] in the active phase group was higher than that of the remission group [(23±5)％,(43±14)％],and the difference was statistically significant (t=2.447,3.054;P＜0.05).The rate of synovial enhancement of the third,fourth phases was positively correlated with the ASDAS-CRP score (r=0.802,0.836,P=0.01),and the correlation was poor with evaluation of hip joint activity by patients (r=0.352,0.458;the P=0.02,0.01respectively),and the correlation was goodwith the evaluation of hip joint activity by doctors (r=0.652,0.717;P=0.01).Conclusion The shape and early enhancement rate of magnetic reson-ance dynamic enhanced TIC curve is valuable in assessing the disease activity of hip joint lesions in AS patients.