Objective: To analyze characteristics of hepatitis B infection in HBsAg-/HBV DNA+ blood donors in Taiyuan, so as to provide evidence for adjusting blood screening strategies. Methods: Blood samples of HBsAg-/HBV DNA+ donors were tested using enzyme-linked immunosorbent assay (ELISA), chemiluminescence assay, nucleic acid qualitative test, and nucleic acid quantitative test. Data on HBsAg-/HBV DNA+ donors in Taiyuan region from January 1, 2016 to December 31, 2024 were statistically analyzed to evaluate the detection rate, demographic characteristics, influencing factors of detection rate, nucleic acid quantitative results, and serological patterns of HBsAg-/HBV DNA+ donors. Results: From January 1, 2016 to December 31, 2024, 991 565 donor samples underwent nucleic acid testing in Taiyuan. A total of 309 HBsAg-/HBV DNA+ samples were detected, resulting in an HBsAg-/HBV DNA+ detection rate of 3.12 per 10 000. The detection rate varied significantly across different years (P<0.05). Males had a significantly higher HBsAg-/HBV DNA+ detection rate than females, first-time donors had a higher rate than repeat donors, and whole blood donors had a higher rate than apheresis donors (P<0.05). The detection rate also differed significantly among age groups (P<0.05). Logistic regression analysis showed that gender, age, donation frequency, and donation type were all influencing factors for HBsAg-/HBV DNA+ detection (all P<0.05). The predominant serological patterns among HBsAg-/HBV DNA+ donors were HBsAb+/HBcAb+ (43.69%, 135/309) or HBcAb+ alone (24.27%, 75/309). Viral load was detectable in 53.40% (165/309) of the HBsAg-/HBV DNA+ donors. Among these, 61.21% (101/165) donors had a viral load<20 IU/mL, and 94.55% (156/165) had a viral load<200 IU/mL. Donors with viral load<200 IU/mL primarily exhibited HBsAb+/HBcAb+ (41.67%, 65/156) or HBcAb+alone (36.54%, 57/156) serological patterns. Conclusion: The prevalence of HBsAg-/HBV DNA+ is low among blood donors in Taiyuan. Higher detection rates were observed in the 46-55 years age group, males, first-time donors, and whole blood donors. HBsAg-/HBV DNA+ donors exhibit specific serological patterns and generally have low viral loads, indicating a potential residual transfusion risk. It is recommended to add HBcAb testing, together with high-sensitivity nucleic acid testing technologies and donor follow-up, to ensure blood safety and guide donor reentry.

Objective: To evaluate the effect of repeated testing combined with cross-validation using different principles of NAT systems on improving the detection rate of occult HBV infection (OBI) in HBsAg-negative/NDR samples. Methods: A total of 89 NDR samples from the Taiyuan Blood Center between August 2024 and May 2025 were enrolled. All samples were tested for HBsAg by ELISA and subjected to NAT screening using the Roche system (PCR method). For all HBsAgnegative, MPNAT+/IDNAT (NDR) samples, further crossvalidation was performed using repeat IDNAT with the Roche system and the Grifols system (TMAbased) dHBV discriminatory assay; in addition, HBV serological markers were detected, and the results were confirmed by realtime quantitative PCR and nested PCR with sequencing genotyping. The NAT yield/window period ratio model was used to estimate the residual risk of HBV transfusion for the Roche single system in actual use, and the theoretical residual risk was calculated by assuming that the Grifols system was applied to individual screening of all blood donors. Results: The detection rate of HBsAg-negative/NDR was 0.99‰ (89/90 115), consistent with the national average. Among the 89 NDR samples, 4 were confirmed as HBV DNA-positive by nested PCR (viral load 15 - 20 IU/mL), including 3 of genotype C1 and 1 of genotype B2. Serological analysis showed that the anti-HBc positivity rate in NDR samples was 24.7% (22/89); all 4 OBI samples were antiHBcpositive (18.2%) and none were antiHB-spositive. In the single-NAT system, the residual risk for first-time donors (RR_FD) was 48.98/10 person-years for the Roche system and 21.01/10 person-years for the Grifols system, both higher than the corresponding residual risk for repeat donors (RR_RD: 15.23/10 and 9.80/10 person-years, respectively), but the differences showed no statistical significance (P>0.05). Conclusion: Implementing repeated testing combined with cross-validation using different principles of NAT systems can effectively increase the detection rate of low-viral-load OBI and reduce the risk of missed detection.

【Objective】 To analyze the epidemic of hepatitis C virus (HCV) in voluntary blood donors , and to assess the residual risk of HCV transmission by blood transfusion in Taiyuan. 【Methods】 The HCV screening results of voluntary blood donors in Taiyuan from 2016 to 2021 were collected by blood center information system, and the epidemiologic feature of first-time and repeated donors were analyzed. The incidence-window period model was used to assess the residual risk of HCV transmission by transfusion in first-time/repeated donors as well as that in repeated donors under different blood screening modes. 【Results】 Of the 662 705 samples in Taiyuan from 2016 to 2021, the HCV positive rate of the first-time donors was 1.83‰(595/325 009) and the residual risk of HCV transmission was 14.91/100 000. The HCV positive rate of the repeated donors was 0.04‰ (13/337 696) and the residual risk was 0.31/1 000 000. The total residual risk of HCV transmission was 7.47/1 000 000. A total of 337 696 blood samples of repeated blood donors were tested, the repeated blood donors’ residual risk of transfusion-transmitted HCV was 0.31/100 000 after dual ELISA tests , and 0.06/100 000 after dual ELISA and once NAT, which reduce by 80.65% since NAT were adopted. 【Conclusion】 The residual risk of HCV transmission from repeated donors was less than that from first-time donors. The blood screening mode of HCV by dual ELISA and once NAT can effectively reduce the residual risk of transfusion-transmitted HCV and improve blood safety. The rate of repeat blood donation needs to be increased by continuously optimizing the recruitment strategy of blood donors.

Objective:To construct the scheme of palliative care for nursing undergraduates based on competency outcomes and performance assessment (COPA) model, and to provide reference for palliative care course.Methods:The research period is from March to December in 2020. Based on Lenburg's COPA model, the first draft of the curriculum scheme was constructed through literature research and focus group interview, and 23 experts were invited to modify the content to determine the final versions of curriculum scheme.Results:The response rate of the two rounds of questionnaires were 100.0% and 91.3% respectively, and the expert authority coefficient were 0.80 and 0.82 respectively. After two rounds of Delphi procedure, the opinion of the experts was nearly consistent. The curriculum scheme contains 49 curriculum objectives, 70 theoretical contents, 5 practical contents and 9 teaching methods.Conclusions:The curriculum scheme of palliative care for nursing undergraduates based on COPA model is scientific and practical, which can provide guidance for undergraduate nursing.