Objective: To establish an accurate and rapid typing method for Rh typing of samples from patients who have received recent blood transfusions by utilizing the difference in osmotic fragility between fresh and old red blood cells. Methods: A lysing solution suitable for destroying old RBCs was prepared. Sixty-one samples collected in our hospital in 2024 with Rh typing of double groups were treated with the lysing solution to remove the old allogeneic red blood cells while preserving the patient's own fresh red blood cells, followed by repeat Rh typing tests. Results: For 61 samples with Rh typing in double groups, 41 were accurately detected identified through the red blood cell lysis method, yielding an identification rate of 67.21%. No significant difference was observed compared to the detection rate of the commonly used capillary centrifugation modified method (χ =0.103, P>0.05). Conclusion: The red blood cell lysis method provides a novel and rapid experimental approach for clinical use in processing Rh-typed samples that are of double groups, thereby offering a basis for Rh compatibility blood transfusion.

Objective To develop a high throughput sequencing method for pathogenic microbial metagenomics and verify its detection performance.Methods First,the library construction conditions with different input levels of nucleic acid were studied.Three differ-ent input levels of nucleic acid such as 5 ng,50 ng,and 100 ng,three fragmentation times such as 20 min,25 min,and 30 min,and three amplification cycles such as 7,5,and 3 cycles were tested.The optimal library construction conditions were determined by the li-brary concentration and fragment size.The representative bacteria covering fungi and gram-positive/negative bacteria,including Candi-da albicans,Staphylococcus aureus,Staphylococcus epidermidis,Escherichia coli and Cryptococcus Gattii,were selected.Three different concentrations of mixed bacterial suspensions were prepared at a 1∶1 ratio.Then,106/mL of T-cell suspensions were added to prepare reference samples.The performance of the self-established method(Method 1)was verified by the reference samples,and its consis-tency with Method 2(DNA sample library construction kit combined with probe anchored polymerase chain reaction sequencing method)was compared.Results The optimal library construction conditions of the sequencing method for pathogenic microbial metagenomics were determined as follows:a nucleic acid input of 50 ng,a nucleic acid fragmentation time of 20 min,and 5 amplification cycles for PCR.The positive coincidence rate(accuracy)and negative coincidence rate(specificity)of Method 1 were 100%,and its detection limit was 500 CFU/mL.The correlation coefficients(r)of the reads per million(RPM)in linear samples of various microorganisms were greater than 0.9.The CV of bacterial detection were less than 10%,while those of fungal detection were around 20%.The consis-tency between Method 1 and Method 2 was 100%.Conclusion A sequencing method for pathogenic microbial metagenomics is estab-lished successfully,which can acquire accurate,stable,and reliable results and is suitable for the pathogen detection of alveolar lavage fluid samples.

Objective To observe the clinical efficacy of electroacupuncture manipulation combined with massage therapy in the treatment of knee osteoarthritis,and to analyze the efficacy-value.Methods A total of 118 patients with knee osteoarthritis admitted to Kuitun Traditional Chinese Medicine Hospital of Xinjiang Production and Construction Corps from January 2023 to January 2024 were selected as research subjects and divided into electroacupuncture manipulation and massage group(n=60)and sodium hyaluronate group(n=58)by random number table methood.Electroacupuncture manipulation and massage group was treated 3 times a week for 3 weeks.Sodium hyaluronate group was injected with sodium hyaluronate injection in the joint cavity once a week for 3 weeks.Knee function scores and effective rate of two groups before and after treatment were observed,and the differences between two treatments were compared by using the health economics evaluation method.Results After comparing the patients before and after treatment,the knee function scores improved.There was significant difference of knee function scores after treatment between two groups(P＜0.05).There were significant difference of response rate and the incidence of adverse effects between two groups(P＜0.05).Sodium hyaluronate group had a better clinical efficacy-value than electroacupuncture manipulation and massage group.Conclusion Electroacupuncture manipulation and massage and sodium hyaluronate intra-articular injection can effectively improve joint pain and joint function in patients,and intra-articular injection of sodium hyaluronate has a higher incidence of adverse reactions.

Objective To observe the clinical efficacy of electroacupuncture manipulation combined with massage therapy in the treatment of knee osteoarthritis,and to analyze the efficacy-value.Methods A total of 118 patients with knee osteoarthritis admitted to Kuitun Traditional Chinese Medicine Hospital of Xinjiang Production and Construction Corps from January 2023 to January 2024 were selected as research subjects and divided into electroacupuncture manipulation and massage group(n=60)and sodium hyaluronate group(n=58)by random number table methood.Electroacupuncture manipulation and massage group was treated 3 times a week for 3 weeks.Sodium hyaluronate group was injected with sodium hyaluronate injection in the joint cavity once a week for 3 weeks.Knee function scores and effective rate of two groups before and after treatment were observed,and the differences between two treatments were compared by using the health economics evaluation method.Results After comparing the patients before and after treatment,the knee function scores improved.There was significant difference of knee function scores after treatment between two groups(P＜0.05).There were significant difference of response rate and the incidence of adverse effects between two groups(P＜0.05).Sodium hyaluronate group had a better clinical efficacy-value than electroacupuncture manipulation and massage group.Conclusion Electroacupuncture manipulation and massage and sodium hyaluronate intra-articular injection can effectively improve joint pain and joint function in patients,and intra-articular injection of sodium hyaluronate has a higher incidence of adverse reactions.

Objective To develop a high throughput sequencing method for pathogenic microbial metagenomics and verify its detection performance.Methods First,the library construction conditions with different input levels of nucleic acid were studied.Three differ-ent input levels of nucleic acid such as 5 ng,50 ng,and 100 ng,three fragmentation times such as 20 min,25 min,and 30 min,and three amplification cycles such as 7,5,and 3 cycles were tested.The optimal library construction conditions were determined by the li-brary concentration and fragment size.The representative bacteria covering fungi and gram-positive/negative bacteria,including Candi-da albicans,Staphylococcus aureus,Staphylococcus epidermidis,Escherichia coli and Cryptococcus Gattii,were selected.Three different concentrations of mixed bacterial suspensions were prepared at a 1∶1 ratio.Then,106/mL of T-cell suspensions were added to prepare reference samples.The performance of the self-established method(Method 1)was verified by the reference samples,and its consis-tency with Method 2(DNA sample library construction kit combined with probe anchored polymerase chain reaction sequencing method)was compared.Results The optimal library construction conditions of the sequencing method for pathogenic microbial metagenomics were determined as follows:a nucleic acid input of 50 ng,a nucleic acid fragmentation time of 20 min,and 5 amplification cycles for PCR.The positive coincidence rate(accuracy)and negative coincidence rate(specificity)of Method 1 were 100%,and its detection limit was 500 CFU/mL.The correlation coefficients(r)of the reads per million(RPM)in linear samples of various microorganisms were greater than 0.9.The CV of bacterial detection were less than 10%,while those of fungal detection were around 20%.The consis-tency between Method 1 and Method 2 was 100%.Conclusion A sequencing method for pathogenic microbial metagenomics is estab-lished successfully,which can acquire accurate,stable,and reliable results and is suitable for the pathogen detection of alveolar lavage fluid samples.

【Objective】 To monitor the effectiveness and accuracy of the blood transfusion compatibility test system by self-made weakly positive internal quality control products. 【Methods】 Red blood cells from DAT(-) healthy subjects were selected, and B/RhD(-)E(-) red blood cells were selected as tube 1. A/RhD(+ )E(+ ) was selected as tube 2 to prepare blood group quality control products according to the principle of blood group antigen compatibility, and red blood cell preservation solution and corresponding ABO blood group reagent antibody were added to make the agglutination intensity of microcolumn gel method in reverse blood typing reach a low positive value (1+ ). Tube 3 and tube 4 were prepared with five different preservation media: plasma, serum, antibody diluent, mixture of equal plasma and antibody diluent, and mixture of equal serum and antibody diluent, respectively. IgM anti-E antibody was added to tube 3, and IgG anti-D antibody was added to tube 4, so that the agglutination intensity of microcolumn gel method reached a low positive value (1+ ). 【Results】 Comparison between the 5 different preservation media showed that the preservation medium of antibody diluent was the most stable for weakly positive antibody (F=11.35, P<0.05), Agglutination intensity 1+ is assigned 5 points by AABB Technical Manual, and its score was 5.25±1.75 points. 【Conclusion】 The use of self-made weakly positive quality control products can improve the effectiveness, accuracy and sensitivity of the monitoring system, thus achieving internal quality control and ensuring the safety of clinical blood use.

Objective:To construct a competency evaluation indicator system for infection prevention and control nurses in Operating Rooms (hereinafter referred to as "IPC") and provide an objective basis for the management of IPC nurses.Methods:From June to November 2022, an initial competency evaluation indicator system for IPC nurses was developed through literature review and semi-structured interviews. The Delphi method was employed to consult 20 experts from 11 provinces and municipalities across the country. Analytical Hierarchy Process (AHP) and mean distribution method were applied to quantify and determine the weight of each level of indicators within the system.Results:Nineteen experts were finally included, with two rounds of questionnaire recovery rates of 95.00% (19/20) and 100.00% (19/19), respectively. The authority coefficients of the experts were 0.858 and 0.861, familiarity coefficients were 0.850 and 0.853, and coefficients of judgment basis were 0.865 and 0.868, respectively. The Kendall's W coefficient of concordance for the two rounds of inquiries were 0.139 and 0.202 ( P<0.05), respectively. The final IPC nurse competency evaluation indicator system included six primary indicators, 22 secondary indicators, and 66 tertiary indicators. Conclusions:The constructed IPC nurse competency evaluation indicator system is scientific, reasonable, objective, and comprehensive, providing a valuable reference for the capability training, assessment, entry standards, and qualification certification of IPC nurses.

Objective To determine the reference red blood cells with weak agglutination intensity of low positive quali-ty control products by comparing RhD antigen expression intensity difference according to the serological results.Methods The RhD(+)red blood cells were detected by microcolumn gel method with 1 500 times diluted anti-D typing reagent.The samples with weak and strong RhD antigen expression intensity were selected as the reference red blood cells for weak agglu-tination intensity of low positive quality control products,and verification was performed.Results Ten RhD(+)red blood cells were detected with diluted anti-D typing reagent,of which 8 were 1+and 2 were±.Red blood cells with agglutination intensity of 1+were used as the benchmark to determine the maximum dilution ratio of anti-D typing reagent when their ag-glutination intensity was 1+.As the preparation standard of low positive quality control products,the agglutination intensity of red blood cells with low RhD antigen expression intensity was extremely weak±,which was difficult to ensure the stability of its control limit properties.Based on red blood cells with agglutination intensity of±,the maximum dilution ratio of anti-D typing reagent with agglutination intensity of 1+was re-determined as the preparation standard of low positive quality con-trol products,and the results met the requirements of quality control product setting.Conclusion Using red blood cells with low RhD antigen expression intensity as the benchmark to set the weak agglutination intensity of the low positive quality control products can avoid the loss of control due to the low target value.

Objective:To identify the risk factors for postoperative cognitive dysfunction (POCD) and develop the prediction model in elderly patients undergoing lumbar surgery under general anesthesia.Methods:The elderly patients undergoing elective lumbar surgery under general anesthesia in our hospital from July 2021 to July 2022 were enrolled. Cognitive function was assessed at 7 days after surgery using Mini-Mental State Examination and Montreal Cognitive Assessment. When the decrease in both scales≥ 1 standard deviation, the patients were considered as having POCD. The patients were divided into POCD group and non-POCD group according to whether POCD developed. The propensity score matching was used to balance the confounding bias between two groups. The multivariate logistic regression analysis was used to identify the risk factors for POCD. The prediction model was constructed, and a nomogram was drawn for visualization of the model. The receiver operating characteristic curve, calibration plot and decision curve analysis (DCA) were drawn to evaluate the differentiation, consistency and clinical validity of the model, respectively.Results:A total of 159 patients were enrolled in this study, and the incidence of POCD was 31.4%. There were statistically significant differences in the ratio of intraoperative blood transfusion, cumulative time of hypotension, total infusion volume and operation time between two groups ( n=32 each) after propensity score matching ( P<0.05). The results of multivariate logistic regression showed that age, educational levels, diabetes mellitus, previous two or more operations under general anesthesia, APTT and cumulative time of hypotension were independent risk factors for POCD in elderly patients undergoing lumbar surgery under general anesthesia ( P<0.05). A model was developed based on the risk factors mentioned above: LogitP=-15.878+ 0.263 × Age (years) - 0.122 × Educational Level (years)+ 1.601 × Diabetes Mellitus+ 1.468 × History of General Anesthesia for 2 or more times+ 0.608 × Cumulative Time of Hypotension(min) - 0.140 × APTT (s). The area under the receiver operating characteristic curve was 0.930 (95% CI 0.887-0.973), the sensitivity was 0.920, specificity was 0.798 and Youden index was 0.718. After visualizing the model via nomogram, the model was verified by Hosmer-Lemeshow test, P=0.403, C index was 0.930, and corrected C index was 0.914. Conclusions:Age, educational levels, diabetes mellitus, previous multiple operations under general anesthesia, APTT and cumulative time of hypotension are independent risk factors for POCD in elderly patients undergoing lumbar surgery under general anesthesia, and the established risk prediction model can effectively predict the occurrence of POCD in elderly patients undergoing lumbar surgery under general anesthesia.

Objective:To prepare and preliminary verify dezocine polylactic acid-glycolic acid block copolymer (PLGA) microspheres.Methods:Preparation of dezocine PLGA microspheres Dezocine 120 mg, PLGA 0.1 g and the solubilizing additive poloxamer 0.1 g were dispersed in tetrahydrofuran solvent to form an organic phase solution. Sodium chloride and polyethylene glycol were dissolved in water for injection to form an inner aqueous phase solution and an outer aqueous phase solution. After the organic phase solution 20 ml was mixed with the inner aqueous phase solution 20 ml to form a water/oil colostrum, the water/oil colostrum was added to the outer aqueous phase solution to form a water/oil/water multiple emulsion, which was fully mixed with lyophilized powder protective agent and freeze-dried to prepare dezocine PLGA microspheres. Verification Eighteen clean-grade healthy male Sprague-Dawley rats, aged 10-12 weeks, weighing 220-260 g, were divided into 3 groups ( n=6 each) by a random number table method: control group (group C), dezocine ordinary preparation group (group D 1) and dezocine PLGA microspheres group (group D 2). Normal saline, dezocine injectio (dose 1 mg) and dezocine PLGA microsphere injectio (dose 0.2 μg) 0.2 ml were intramuscularly injected in C, D 1 and D 2 groups, respectively. The concentrations of dezocine in plasma were measured at 30 min and 1, 2, 3, 4, 5, 6, 7 and 8 h after administration, and thermal paw withdrawal latency was measured at T 1-T 3, T 5 and T 9. Tissues from the injection site were obtained on day 7 after intramuscular injection, and the inflammatory response was observed after HE staining. Results:Compared with group C, the thermal paw withdrawal latency was significantly prolonged at T 1-T 3 in group D 1 and at T 1-T 3, T 5 and T 9 in group D 2 ( P<0.05). Compared with group D 1, the thermal paw withdrawal latency was significantly prolonged at T 5 and T 9, and the plasma concentrations of dezocine were increased at T 6-T 9 in group D 2 ( P<0.05). Compared with the values at T 2, the plasma concentrations of dezocine were significantly decreased at T 4-T 9 in group D 1 ( P<0.05), and no significant change was found in the plasma concentrations of dezocine at T 3-T 9 in group D 2 ( P>0.05). On 7 days after injection, no inflammation was found in the local tissues in C, D 1 and D 2 groups, and no significant difference was found among the three groups. Conclusions:The sustained-release formulation of dezocine PLGA microspheres is successfully prepared, and it can maintain stable blood concentrations, effectively prolongs the action time of the drug and has significant sustained-release effect in rats.