Objective: To analyze the results of national external quality assessment (EQA) for transfusion compatibility test from 2018 to 2023, with the aim of providing references for improving laboratory testing quality and ensuring the safety of clinical blood transfusion. Methods: Three EQA programs were conducted annually, each distributing 22 quality assessment samples. Participating transfusion laboratories were required to complete testing within specified deadlines and to submit results along with documentation of testing methodologies, reagents, and equipment used. National Center for Clinical Laboratories (NCCL) conducted statistical analysis of laboratory results, evaluated testing outcomes and related circumstances, and provided feedback to participating laboratories. EQA data from transfusion laboratories across China from 2018 to 2023 were collected and systematically analyzed. Results: From 2018 to 2023, the qualification rates for all five items (ABO forward typing, ABO reverse typing, Rh blood group typing, antibody screening, and cross-matching) were 67.59%, 77.11%, 77.38%, 72.78%, 79.96%, and 85.16%, respectively. The mean qualification rates for ABO forward typing, ABO reverse typing, RhD blood group typing, antibody screening, and cross-matching over the past six years were 96.25%±0.59%, 90.45%±4.52%, 96.05%±0.71%, 90.88%±2.86%, and 88.34%±3.48%, respectively. The qualification rates in 2019, 2020, 2022, and 2023 all showed a stable trend of "blood stations>tertiary hospitals>secondary hospitals". The mean qualification rate of laboratories in secondary hospitals from 2018 to 2023 was significantly lower than those of laboratories in tertiary hospitals and blood stations (P<0.05), while no significant difference was observed between laboratories in tertiary hospitals and blood stations (P>0.05). The micro column agglutination method was the most widely used in all five tests. In the four test items, namely ABO forward typing, ABO reverse typing, antibody screening, and cross-matching, there was a statistically significant difference in the qualification rate of micro column agglutination method compared to other methods (P<0.05). There was a statistical difference in the qualification rate between manual and automated detection using micro column agglutination method in the cross-matching tests (P<0.05), whereas no significant difference was noted for the other test items (P>0.05). Conclusion: From 2018 to 2023, the number of laboratories participating in EQA activities has been increasing year by year, and the qualification rate has shown an overall upward trend. The type of laboratory is a key factor affecting the qualification rate, and the testing capabilities of some laboratories still need to be improved. The micro column agglutination method is widely used in transfusion compatibility tests. The established EQA program effectively monitors quality issues in laboratories, drives continuous improvement, and ensures sustained enhancement of testing standards to safeguard clinical blood safety.

Ischemic stroke （IS） is a serious cerebrovascular disease common in clinical practice. Targeting the pathogenesis of IS， intravenous thrombolysis for restoring blood flow is still the most effective therapy. However， intravenous thrombolysis has shortcomings such as increased bleeding risk， narrow therapeutic window， and contraindications， which limited its clinical application. Protection of the ischemic brain tissue before full recovery of blood flow is associated with the prognosis of IS. Studies have identified multiple pathways in the alleviation of the brain injury caused by IS， such as the mammalian target of rapamycin （mTOR） signaling pathway. Traditional Chinese medicine （TCM） has abundant therapies and unique advantages in the treatment of IS， especially in alleviating symptoms and improving the quality of life of patients. After the onset of IS， TCM can be integrated with Western medicine to play a role in the whole process of treatment， rehabilitation， and recurrence prevention as soon as possible， thus maximizing patient benefits. TCM has clinical significance for the recovery of neurological and motor functions after IS. Studies have shown that TCM can reduce the cerebral injury caused by IS by regulating and activating the mTOR signaling pathway， thereby regulating autophagy， inhibiting apoptosis of nerve cells， and reducing oxidative stress and inflammation. TCM exerts a positive effect for achieving cerebral protection and improving the prognosis of IS and provides new ideas for the prevention and treatment of IS. This article introduces the role of the mTOR signaling pathway in the pathogenesis of IS and reviews the research progress in the TCM regulation of this pathway in the treatment of IS， aiming to provide new therapeutic ideas and systematic scientific reference for the treatment of IS with TCM.

Objective:To explore the influence of laparoscopic radical gastrectomy on patients′immune functions, coagulation functions and prognoses.Methods:Fifty-eight patients with gastric cancer who underwent laparoscopic radical gastrectomy (laparoscopic group) and 40 patients with gastric cancer who underwent traditional open surgery (traditional group) in Henan People′s Hospital from May 2016 to May 2018 were selected as the subjects. The immune function and coagulation function were compared between the two groups before and after operation. The prognoses of patients underwent laparoscopic radical gastrectomy and the influencing factors were analyzed.Results:Three days after operation, the CD4 + level and CD4 + /CD8 + ratio in laparoscopic group were (29.78±3.58)% and (1.01±0.18), higher than (27.23±3.47)% and (0.93±0.14) in control group ( P<0.05). Three days after operation, the activated partial thromboplastin time (APTT) in laparoscopic group was (26.55±2.56) seconds, shorter than (27.86±2.73) seconds in traditional group, while the levels of fibrinogen (FIB) and D-dimer were (4.24±0.84) g/L and (377.91±47.19) μg/L, higher than (3.88±0.75) g/L and (330.28±45.11) μg/L in traditional group ( P<0.05). The 5-year survival rate was 77.5% in traditional group and 72.4% in laparoscopic group, without significant difference ( P>0.05). Multivariate analysis showed that lymph node metastasis was the independent risk factor for prognosis of laparoscopic radical gastrectomy ( P<0.05). Conclusions:Laparoscopic radical gastrectomy can effectively reduce postoperative immunosuppression, but affect postoperative coagulation function. Lymph node metastasis is closely related to the prognosis of patient with gastric cancer. The patient′s condition should be comprehensively evaluated before and after operation to determine whether the laparoscopic operation is suitable, for reducing postoperative complications and improving the prognosis.

Objective:To explore the influence of laparoscopic radical gastrectomy on patients′immune functions, coagulation functions and prognoses.Methods:Fifty-eight patients with gastric cancer who underwent laparoscopic radical gastrectomy (laparoscopic group) and 40 patients with gastric cancer who underwent traditional open surgery (traditional group) in Henan People′s Hospital from May 2016 to May 2018 were selected as the subjects. The immune function and coagulation function were compared between the two groups before and after operation. The prognoses of patients underwent laparoscopic radical gastrectomy and the influencing factors were analyzed.Results:Three days after operation, the CD4 + level and CD4 + /CD8 + ratio in laparoscopic group were (29.78±3.58)% and (1.01±0.18), higher than (27.23±3.47)% and (0.93±0.14) in control group ( P<0.05). Three days after operation, the activated partial thromboplastin time (APTT) in laparoscopic group was (26.55±2.56) seconds, shorter than (27.86±2.73) seconds in traditional group, while the levels of fibrinogen (FIB) and D-dimer were (4.24±0.84) g/L and (377.91±47.19) μg/L, higher than (3.88±0.75) g/L and (330.28±45.11) μg/L in traditional group ( P<0.05). The 5-year survival rate was 77.5% in traditional group and 72.4% in laparoscopic group, without significant difference ( P>0.05). Multivariate analysis showed that lymph node metastasis was the independent risk factor for prognosis of laparoscopic radical gastrectomy ( P<0.05). Conclusions:Laparoscopic radical gastrectomy can effectively reduce postoperative immunosuppression, but affect postoperative coagulation function. Lymph node metastasis is closely related to the prognosis of patient with gastric cancer. The patient′s condition should be comprehensively evaluated before and after operation to determine whether the laparoscopic operation is suitable, for reducing postoperative complications and improving the prognosis.

Objective To study the relationship between heparin-binding protein(HBP) and β2 integrin on the surface of neutrophil in acute lung injury.Methods A total of 30 mice from animal center of Tongji University were divided into control group,CLP group and antibody-treatment group by random number method.Acute lung injury animal model was established by cecal Ligation and puncture in the mice of CLP group and antibody-treatment group.Sham operations were performed on the mice in control group.Mice in antibody-treatment group received anti-CD18 antibody injected via tail vein 30 min before establishing acute lung injury animal model.Twenty-four hours after operation,mice were sacrificed and lung tissue was taken.After HE staining,lung injury were evaluated by Smith score.Lung tissue wet/dry weight ratio,BALF protein level,plasma HBP level and β2 integrin on neutrophil were measured.T test were used to compare the difference among groups.Pearson correlation was used to study the correlation between HBP,integrin and lung injury index.Results Compared with control group,mice in CLP group had higher Smith score(t=10.607,P＜0.01),lung wet/dry ratio(t=3.968,P=0.001),BALF protein level(t=4.331,P＜0.01) and as well as higher plasma HBP(t=3.515,P=0.002) and β2 integrin(t=4.816,P＜0.01) level.After CD18 antibody treatment,anti-treat group mice had lower Smith score (t=2.307,P=0.033),lung wet/dry ratio(t=3.080,P=0.006),BALF protein level(t=2.484,P=0.023) and as well as higher plasma HBP level(t=2.218,P=0.046) than mice in CLP group.Pearson correlation analysis showed HBP had obvious correlation with wet/dry ratio(r=0.527,P=0.017),BALF protein(r=0.508,P=0.022) and as well as β2 integrin(r=0.674,P=0.001).Conclusions Both HBP and β2 integrin involved in the lung injury pathogenesis.HBP level is interrelated with the severity of lung injury.The β2 integrin is associated with the release of HBP by neutrophil.Inhabiting the function of integrin could decrease HBP level and alleviate the severity of lung injury.

Objective To evaluate the efficacy of facial acupoint injection combined with nerve block in treating hemifacial spasm. Methods Fifty?four patients of both sexes, aged 26-73 yr, with the course of disease 6 months-17 yr from February 2015 to January 2016, were included in this study accord?ing to diagnostic criteria for hemifacial spasm based on expert consensus in 2014. Patients were divided into 2 groups(n=27 each)using a random number table: facial acupoint injection combined with nerve block group(group A)and nerve block group(group B). In group A, the mixed injection 2 ml(2% lidocaine hydrochloride 5 ml, compound betamethasone 1 ml, mecobalamin 1 mg, diluted to 18 ml in normal sa?line)was given at facial Sibai, Jiachengjiang, Xiaguan and Yifeng acupoints once every 5 days, 3 times in total;facial nerve block was performed via the stylomastoid foramen with the mixed injection(5 ml) previously described once every 5 days, 3 times in total;stellate ganglion block was performed on the right and left side alternately once a day, 5 times on each side. In group B, patients received facial nerve block and stellate ganglion block, and no facial acupoint injection was applied. The Cohen rating and Shorr out?come were recorded before treatment and at 10th day, 3rd month and 1 yr after treatment, and the recur?rence was recorded at 3 months and 1 yr after treatment. Results Compared with group B, Cohen classifi?cation was significantly decreased, and the effective rate was increased at 10th day, 3rd month and 1 yr af?ter treatment, and the recurrence rate was decreased at 3 months and 1 yr after treatment in group A(P<0.05). Conclusion The facial acupoint injection combined with nerve block produces better long?term ef?ficacy in treating hemifacial spasm than nerve block alone.

Objective To evaluate endoscopy for the diagnosis of primary gastrointestinal mucosaassociated lymphoid tissue lymphoma (MALT lymphoma) and diffuse large B-cell lymphoma (DLBCL).Methods The clinical pathology,hematological/biochemical studies,and endoscopic data of 98 primary gastrointestinal MALT lymphoma and DLBCL patients from Aug 2010 to May 2017 were analyzed retrospectively.Results 17 patients had higher than normal LDH blood level (＞270 U/L).47 patients were Helicobacter pylori (Hp) positive;Gastrointestinal endoscopic study,including endoscopic mucosal resection (EMR)/endoscopic submucosal dissection (ESD) and endoscopic ultrasonography established diagnosis of MALT lymphoma and DLBCL in 96 out of 98 cases (98％).The endoscopic manifestations of MALT lymphoma and DLBCL were ulcerative,uplift,diffuse and infiltrative,and erosive,with ulcerative type as the dominant one.The follow-up examination showed that the survival ratio (88％) of MALT patients was higher than that of DLBCL(68％),and more patients with lower Ann Arbor stage survived (92％) than those with higher Ann Arbor stage (64％).Conclusion Endoscopic biopsy together with endoscopic ultrasonography makes definite diagnosis of MALT and DLBCL.

OBJECTIVE:To investigate the influence of CYP3A5*3 (rs776746) genetic polymorphism on blood concentration of tacmlimus (TAC) and renal function in renal transplant recipients during the stable period.METHODS:A total of 98 renal transplant recipients during the stable period receiving TAC-based triple anti-rejection scheme (TAC + sodium mycophenol +predrnisone acetate) after surgery and regular follow-up were selected from our hospital during Jan.1995-Dec.2014.The follow-up information during Jan.-Dec.2016 was also collected.Trough concentration of TAC in renal transplant recipients was determined by chemiluminescence microparticle immuno assay.Standard blood concentration (C/D) was calculated after corrected with body weight and daily dose.Scr level was detected with dry chemistry method.CYP3A5*3 genotype was detected by PCR-RFLP and direct sequencing.The relationship of CYP3A5*3 genetic polymorphism with TAC C/D value and Scr level was determined by Kruskal Wallis H or Mann-Whitney U assay.RESULTS:Among 98 renal transplant recipients,there were 9 cases of CYP3A5*3 *1/*1(AA) genotype,37 cases of *1/*3 (AG) genotype and 52 cases of *3/*3 (GG)genotype.The gene frequencies were 9.18％,37.76％,53.06％,which were all in line with Hardy-Weinberg equilibrium (P＞0.05).There was no statistical significance in trough concentration of TAC among different genotypes (P＞0.05).There was statistical significance in TAC dose and C/D value among different genotypes (P＞0.05).TAC dose of CYP3A5*3 *3/*3 genotype recipients was significantly lower than those of *1/*3 and *1/*1 genotype recipients;that of *1/*3 genotype recipients was significantly lower than that of *1/*1 genotype recipients.C/D value of *3/*3 genotype recipients was significantly higher than those of *1/*3 and *1/*1 genotype recipients;that of *1/*3 genotype recipients was significantly higher than that of *1/*1 genotype recipients,with statistical significance (P＜0.05).There was no statistical significance in Scr levels among different genotypes (P＞0.05).CONCLUSIONS:CYP3A5*3 genetic polymorphism significantly influences blood concentration of TAC in renal transplant recipients during the stable period,and *3 allele carriers have higher C/D values and need smaller TAC daily dose.CYP3AS*3 genetic polymorphism may be not associated with Scr level.

Objective To compare the clinical values of impedance method,optical method and microscopy when used to detect platelet abnormal results.Methods Platelet re-examinations by optical method and microscopy were carried out in case of low confidence degree in platelet test with impedance method by XE-2100 automatic hematology analyzer,and then the results by the three methods were compared.Results Most of the low-confidence-degree results by impedance method could be corrected by re-examination by optical method,and the remained had to turn to microscopy due to unsatisfied requirements of the instrument.Conclusion Optical method has to be involved to correct the platelet abnormal results by XE2100 automatic hematology analyzer,and microscopy should be applied in case optical method doesn't work.The three methods gains advantages and disadvantages of themselves,and can be supplementaries for one another.

Objective To study the relationship between the washout speed in the contrast-enhanced ultrasound (CEUS) and the differentiation grading in pathology in patients with hypervascular hepatocellular carcinoma (HCC).Methods Totally 271 patients who underwent complete resection for hypervascular HCC from April 2009 to December 2014 at Nanchong Central Hospital were included in this study.CEUS examinations were perfomred in all patients 2-3 days before liver resection.A timer on the ultrasound screen displayed the time elapsed since the saline flush was used to determine time to washout.The washout rate were categorized into four levels based on enhancement in portal venous phase and delayed phase.The differentiation grade and the washout speed were compared using Kruskal-Wallis test.Results All 271 (100％) lesions were arterially enhanced with different washout rate.Washout speed 1 was found in 19 patients (7.0％),while speed 2 in 157 patients (57.9％),speed 3 in 65 (24.0％),and speed 4 in 30,respectively.The washout speed had a significant correlation with the differentiation (x2=179.8238,P ＜ 0.001).The faster washout speed,the higher differentiated.Washout speed 1 could distinghuish well-differentiated from the poor and moderately differentiated tumor.The sensitivity and specificity of preoperative washout speed 1 to identify well histologic grade were 98.0％ and 77.8％,the positive predictive value and negative predictive value were 96.0％ and 48.8％,and the positive likelihood ratio and negative likelihood ratiowere were 1.9 and 0.01.Washout speed 4 could distinghuish poor differentiated from well and moderately differentiated tumor The sensitivity and specificity of preoperative washout speed 4 to identify poor histologic grade were 24.3％ and 97.0％,the positive predictive value and the negative predictive value were 65.3％ and 61.3％,and the positive likelihood ratio and negative likelihood ratiowere were 3.2 and 0.7.Conculsions Washout speed can reflect the degree of differentiation roughly.Washout speed can effectively diagnose the well-differentiated HCC,but it is difficult for moderate and poor differentiated HCC.