Objective: To assess the current status of bacterial detection capabilities in various blood collection and supply and related laboratories across China, and to identify key factors affecting the consistency of test results. Methods: A pooled analysis was conducted on data from 21 external quality assessment (EQA) rounds for blood bacterial detection carried out by the China International Transfusion Infection Prevention and Control (CITIC) project from 2019 to 2025. The study covered three types of laboratories-blood centers, central blood stations, and commercial laboratories—across 23 provincial-level administrative regions in China. Statistics were compiled on the number of participating laboratories, and the concordance rates were calculated for different institution types, different automated blood culture systems, different bacterial concentrations, and different strains. Non-standard reporting issues were also reviewed, and statistical methods were applied for analysis. Results: Over the seven-year period, the number of participating laboratories increased from 161 to 236, with an average annual growth rate of 6.58%, and the annual concordance rates ranged from 82.61% to 94.92%. The overall laboratory concordance rates for the three types of participating laboratories were all>89.0% (P>0.05), while commercial laboratories showed a significant year-by-year increase (70.97%-100%, P<0.05). The concordance rates of automated blood culture systems from eight manufacturers showed no significant differences (97.98%-100%, P>0.05), indicating stable performance across all devices. The overall sample concordance rate was 98.88%, with negative samples showing a lower rate than positive samples (97.97% vs 99.14%); positive sample rates increased with higher concentrations; and low-concentration Gram-negative bacterial samples had a lower concordance rate than Gram-positive ones (93.15% vs 100%). A total of 50 instances of non-standard result reporting were identified, with incorrect time units accounting for the highest proportion (52.0%). Conclusion The participation scale and overall testing proficiency of blood collection and supply and related laboratories nationwide have improved year by year, and all types of automated blood culture devices can meet the requirements for blood bacterial screening. Detection of negative and low-concentration positive samples remains a weak link in current bacterial EQA, and the standardization of laboratory data reporting requires further strengthening. Continuous: external quality assessment, targeted training, and standardized reporting procedures can effectively enhance the homogenization level of blood bacterial testing across the country and ensure the safety of clinical transfusion.

Yi He Rehabilitation,which is based on traditional Chinese rehabilitation treatments and rehabilitation principles from modern medicine,is effective in staging treatment of post-stroke hemiplegia.This paper systematically discusses the origin and annotation of Yi and He from the perspectives of traditional Chinese medicine and modern medicine.The medicinal connection between Yi and the body and its function is related to unobstructed attunement.Based on the connotation of Yi and He,we believe that the pathogenesis of post-stroke hemiplegia is the comprehensive result of abnormal effects of Yi on the organism at the microscopic level and abnormal effects of He on function at the macroscopic level,featured as tense muscle movement and a pathological process of abnormal motion,including the disturbance of yang qi with body dysfunction,the disorder of spirit with sinews and vessels with diversion,and the variation of brain collateral with physical and mental inconsistency.By inducing relaxation and calmness,Yi He rehabilitation takes effect in staging treatment of post-stroke hemiplegia with characteristic mechanisms.First,by calming ascending yang and relaxing the disordered body in periods of relaxation,it can achieve the maintenance function of the kinematic chain peripherally with passive rehabilitation.Second,by calming the disordered spirit and relaxing the inhibited meridian sinews in spasmodic periods,it can reconstruct the neural plasticity of motor function centrally with assistive rehabilitation.Third,by calming damaged brain collateral and relaxing the impassable zang organs in the recovery period,it can close the central-peripheral-central loop of rehabilitation with active rehabilitation.

Objective:To explore the predictive value of the prognostic nutritional index (PNI) in concurrently infected patients with acute-on-chronic liver failure (ACLF).Methods:220 cases with ACLF diagnosed and treated at the First Affiliated Hospital of Xi'an Jiaotong University from January 2011 to December 2016 were selected. Patients were divided into an infection and non-infection group according to whether they had co-infections during the course of the disease. Clinical data differences were compared between the two groups of patients. Binary logistic regression analysis was used to screen out influencing factors related to co-infection. The receiver operating characteristic curve was used to evaluate the predictive value of PNI for ACLF co-infection. The measurement data between groups were compared using the independent sample t-test and the Mann-Whitney U rank sum test. The enumeration data were analyzed using the Fisher exact probability test or the Pearson χ2 test. The Pearson method was performed for correlation analysis. The independent risk factors for liver failure associated with co-infection were analyzed by multivariate logistic analysis. Results:There were statistically significant differences in ascites, hepatorenal syndrome, PNI score, and albumin between the infection and the non-infection group ( P ?

Abstract Allergic diseases can occur in all systems of the body, covering the whole life cycle, from children to adults and to old age, can be lifelong onset and even fatal in severe cases. Children account for the largest proportion of the victims of allergic disease, Children s allergies start from scratch, ranging from mild to severe, from less to more, from single to multiple systems and systemic performance, so the prevention and treatment of allergic diseases in children is of great importance, which can not only prevent high risk allergic conditions from developing into allergic diseases, but also further block the process of allergy. At present, there is no consensus on the management system of allergic children in kindergartens and primary schools. The "Consensus on Allergy Management and Prevention in Kindergartens and Primary Schools", which includes the organizational structure, system construction and management of allergic children, provides evidence informed recommendations for the long term comprehensive management of allergic children in kindergartens and primary schools, and provides a basis for the establishment of the prevention system for allergic children.

In recent years, modeling and simulation technology based on pharmacometrics has received increasing attention in the development of innovation drugs. In August of 2021, FDA issued a guidance named Pharmacokinetic-Based Criteria for Supporting Alternative Dosing Regimens of Programmed Cell Death Receptor-1 (PD-1) or Programmed Cell Death-Ligand 1 (PD-L1) Blocking Antibodies for Treatment of Patients with Cancer Guidance for Industry, claiming the necessity of using population PK-based simulation method for the optimization of dosing regimens, and the corresponding implementation standards. This article first summarized the existing therapeutic regimens of PD-1/PD-L1 blocking antibodies in clinic as well as the main content of the guidance, and then cited some actual examples where population PK-based simulation method did contribute to the approval of the alternative dosing regimens. Besides, some critical considerations for the dosing regimen optimization of PD-1/PD-L1 blocking antibodies were also analyzed. In our view, this guidance would have positive impacts on the development of PD-1/PD-L1 blocking antibodies in the future. We hope that this article may provide some references for the colleagues in China.

【Objective】 To investigate the environmental pollution of blood collection and supply institutions by using matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) and evaluate its application value. 【Methods】 Colonies of air from blood donation sites, skin puncture sites of blood donors, platelet storage boxes, platelet collection equipment, object surfaces of related experimental consumables and cuff surfaces of staff after disinfection were collected, and typical colonies after cultivation were selected for microbial identification by microbial mass spectrometry and then compared with bacteria results detected in blood components from May 2017 to May 2021. 【Results】 Aseptic growth, the number of colonies ≤4.0 CFU/ dish, and the number of colonies > 4.0 CFU/dish accounted for 21.20%, 62.20% and 16.60%, respectively. The qualified rate from high to low was platelet storage box, bacteria settling in the air of blood donation room after disinfection, platelet collection equipment, skin puncture site of blood donors after disinfection, the surface of platelet consumables and the surface of medical staff's overalls. After disinfection, the blood donors' skin puncture sites were compared with other collection sites, and the t values were 2.0371, 1.508, 2.109, 1.961 and 1.778, respectively, with no significant difference (P>0.05). Thirty cases of bacterial contamination of blood components were detected from May 2017 to May 2021, among which the detection rate of apheresis platelets was the highest, and the t values were 1.731 and 2.272, relative to the contamination frequency of erythrocytes and plasma bacteria (P>0.05), while the t value was 2.875, relative to concentrated platelets, with significant difference (P<0.05). 【Conclusion】 Bacterial contamination of blood components mostly come from air bacteria settling, blood donors' arms and skin after disinfection, and surfaces of related equipment and materials. Therefore, it is of clinical significance to conduct strict disinfection of working sites, establish disinfection monitoring methods and formulate disinfection hygiene standards in blood stations.

Model informed precision dosing (MIPD) is a new concept to guide precision dosing for individual patient by modeling and simulation based on the available information about the individual patient, medications and the disease. Compared to the empirical dosing, MIPD could improve the efficacy, safety, economics and adherence of the pharmacotherapy according to the individual's pathophysiology, genotyping and disease progression. This consensus report provides a brief account of the concept, methodology and implementation of MIPD as well as clinical decision supporting systems for MIPD. The status and future advancing of MIPD was also discussed to facilitate the appropriate application and development of MIPD in China.

【Objective】 To observe the effect of hydrogen peroxide atomization sterilizer using low concentration hydrogen peroxide disinfectant on the environment and object surface of physical examination area (hereinafter referred to as " physical examination area" ) in blood centers, so as to provide a simple method which is safe, efficient, easy to operate, harmless to human body and has no corrosive effect on equipment. 【Methods】 The physical examination area was disinfected with atomized hydrogen peroxide sterilizer, and the difference of colony number between air and surface before and after disinfection was compared to evaluate the disinfection effect. 【Results】 After disinfection, the hydrogen peroxide residue was detected for 25 times at 5 points, and the results were (0.7~1)ppm, with no statistical difference (P>0.05). 25 tests were carried out at 5 points, and the quartile of the test results was (0~2)CFU/ dish, and the qualified rate was 100%. The test results of bacteria before and after disinfection were statistically significant (P<0.05), which met the requirements of Class Ⅱ environment in Hygienic Standard for Hospital Disinfection(GB15982-2012). After disinfection, the quartile of surface colony detection results of workbench, blood donor seat, screen and door handle were (0~24.1)CFU/cm^2, (1.6~55.4)CFU/cm^2, (0~7.2)CFU/cm² and (0~4.8)CFU/cm^2, with the qualified rate at 80%, 48%, 100% and 100%, respectively, which were in accordance with the requirements of Class Ⅲenvironment in GB15982-2012. The number of colonies after disinfection at the above detection sites decreased significantly compared with that before disinfection (P<0.05). The surface contact plate pressing method and cotton swab smearing method were used to detect the number of colonies on the surface of sterilized work tables and blood donor seats, and the detection rate of the former was higher than that of the latter, with statistical significance (P<0.05). 【Conclusion】 After disinfection by hydrogen peroxide atomization sterilizer, the hydrogen peroxide residue met the requirements specified in the manual. The terminal disinfection effect of air in the physical examination area environment can meet the Class Ⅱ environmental requirements of GB15982-2012. However, the number of microorganisms on object surface after terminal disinfection was significantly lower than that before disinfection.

【Objective】 To analyze the clinical characteristics of patients with coronavirus disease 2019 (COVID-19) in Xi’an so as to investigate the relationship between the dynamic changes of lymphocytes and the disease progression. 【Methods】 We retrospectively analyzed the clinical data of 15 patients with COVID-19 in The First Affiliated Hospital of Xi’an Jiaotong University from January 22 to February 16, 2020. 【Results】 Among the 15 patients with COVID-19, 8 were males and 7 were females, aged from 22 to 89 years. There were 12 ordinary cases (80%), 1 severe case (6.67%), and 2 critical cases(13.33%). There were 6 groups of family clusters.Most of the patients (14/15, 93.3%) had fever of different degrees. The average time from illness onset to admission was 2.80±1.66 days, and the average time from illness onset to diagnosis was 2.83±2.29 days. The main accompanying symptoms were dry cough (8/15, 53.33%) and shortness of breath (4/15, 26.67%). Nine patients (60%) who had low lymphocyte counts at admission, including of all of the critically ill patients (1 severe case and 2 critical cases) and 6 (6/12, 50%) ordinary patients. Lymphocyte counts in the ordinary cases increased gradually, but fluctuated in the severely ill patients. They were always at low level, or even decreased overall in critical cases. 【Conclusion】 In Xi’an City, COVID-19 mostly occurred in family clusters. Lymphocyte counts were reduced in most patients, especially in critically ill (severe and critical) ones. The lymphocyte count at admission and its kinetics during therapy may be an important predictor for the severity and prognosis of the disease.