Objective To improve the protocols of red blood cells ( RBCs) processing devices ( automatic medical RBC centrifuge, type:BBS926).Methods RBCs separated from 400 ml of whole blood collected from healthy donors were frozen at -80℃.After thawing , the cells were processed by the washing device .Based on the original protocol ( protocol 1), a modified protocol (protocol 2) was established and used to evaluate the quality of the frozen RBCs .In the test group (protocol 2), the amount of washing buffers and the washing steps were revised to form the optimized protocol .RBCs processed with the two protocols were evaluated by different assays .Results The indexes from the standards for frozen-thawed RBCs: the amount of hemoglobin ( Hb) of RBCs from protocol 1 and protocol 2 was 37.55 ±3.58 and 42.18 ±3.35 g(P<0.05),respectively;the amount of free hemoglobin(FHb) was 0.51 ±0.08 g/L and 0.53 ±0.07 g/L (P>0.05);the residual amount of white blood cells (WBCs) was (1.90 ±0.99) ×107 and (1.92 ±1.04) ×107(P>0.05);The osmolarities were 334 ±8.03 mOsm and 327 ±9.06 mOsm(P>0.05);both the bacteria and fungi tests were negative for the RBCs processed with the two protocols .Among other indexes ,the hemolysis rate for RBCs from protocol 1 and protocol 2 was (12.44 ±8.24)%and (12.02 ±5.78)%(P>0.05), the deformation index was 21.40 ±1.41 and 21.42 ±1.45 (P>0.05), the RBC recovery was(72.02 ±3.70)%and (77.18 ±5.58)%(P<0.05),the cell apopto-sis rate was(1.12 ±0.54)%and (1.10 ±0.61)%(P>0.05),and the processing time was (79.00 ±0.71)min and (79.60 ±0.55)min (P>0.05).Conclusion The RBCs processed by the two protocols meet the national standards for frozen-thaw RBCs.Hb amounts and cell recoveries of the RBCs are enhanced by treatment with protocol 2.Protocol 2 proves to be better than protocol 1.

ObjectiveTo analyze drug resistance status and risk factors in elderly tuberculosis patients in Ninghai County of Zhejiang Province， and to provide basis for prevention and control of drug-resistant tuberculosis. MethodsClinical data were collected from 142 elderly tuberculosis patients （with positive sputum culture） who were diagnosed and treated in medical institutions in Ninghai from 2016 to 2020. The risk factors of drug resistance were analyzed by Chi-square test and logistic regression model. ResultsThe overall drug resistance rate was 33.80%， and the drug resistance rate in patients with recurrent pulmonary tuberculosis was significantly higher than that in patients with initial pulmonary tuberculosis， and the difference was statistically significant. Multivariate unconditional logisitic regression analysis showed that irregular medication and disease recurrence were independent risk factors for multidrug resistance in the elderly patients. ConclusionThe drug resistance rate in elderly tuberculosis patients in Ninghai is high. It is necessary to strengthen the management and supervision of tuberculosis in the community， and to carry out effective health education and visit for elderly patients， especially for newly treated patients， and to avoid treatment failure caused by irregular medication and interruption of treatment.

Objective:To study the distribution and antibiotics resistance of the main pathogens of neonatal purulent meningitis in different regions of China.Methods:A retrospective descriptive clinical epidemiological study was conducted in children with neonatal purulent meningitis which admitted to 18 tertiary hospitals in different regions of China between January 2015 to December 2019. The test results of blood and cerebrospinal fluid, and drug sensitivity test results of the main pathogens were collected. The distributions of pathogenic bacteria in children with neonatal purulent meningitis in preterm and term infants, early and late onset infants, in Zhejiang Province and other regions outside Zhejiang Province, and in Wenzhou region and other regions of Zhejiang Province were analyzed. The chi-square test was used for statistical analysis.Results:A total of 210 neonatal purulent meningitis cases were collected. The common pathogens were Escherichia coli ( E. coli)(41.4%(87/210)) and Streptococcus agalactiae ( S. agalactiae)(27.1%(57/210)). The proportion of Gram-negative bacteria in preterm infants (77.6%(45/58)) with neonatal purulent meningitis was higher than that in term infants (47.4%(72/152)), and the difference was statistically significant ( χ2=15.54, P=0.001). There were no significant differences in the constituent ratios of E. coli (36.5%(31/85) vs 44.8%(56/125)) and S. agalactiae (24.7%(21/85) vs 28.8%(36/125)) between early onset and late onset cases (both P>0.05). The most common pathogen was E. coli in different regions, with 46.7%(64/137) in Zhejiang Province and 31.5%(23/73) in other regions outside Zhejiang Province. In Zhejiang Province, S. agalactiae was detected in 49 out of 137 cases (35.8%), which was significantly higher than other regions outside Zhejiang Province (11.0%(8/73)). The proportions of Klebsiella pneumoniae, and coagulase-negative Staphylococcus in other regions outside Zhejiang Province (17.8%(13/73) and 16.4%(12/73)) were both higher than those in Zhejiang Province (2.9%(4/137) and 5.1%(7/137)). The differences were all statistically significant ( χ2=14.82, 12.26 and 7.43, respectively, all P<0.05). The proportion of Gram-positive bacteria in Wenzhou City (60.8%(31/51)) was higher than that in other regions in Zhejiang Province (38.4%(33/86)), and the difference was statistically significant ( χ2=6.46, P=0.011). E. coli was sensitive to meropenem (0/45), and 74.4%(32/43) of them were resistant to ampicillin. E. coli had different degrees of resistance to other common cephalosporins, among which, cefotaxime had the highest resistance rate of 41.8%(23/55), followed by ceftriaxone (32.4%(23/71)). S. agalactiae was sensitive to penicillin, vancomycin and linezolid. Conclusions:The composition ratios of pathogenic bacteria of neonatal purulent meningitis are different in different regions of China. The most common pathogen is E. coli, which is sensitive to meropenem, while it has different degrees of resistance to other common cephalosporins, especially to cefotaxime.