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【Objective】 To analyze the cause of single-ELISA reactive of four blood screening items in 18 blood stations in Henan, so as to provide the basis for improving the quality of blood screening. 【Methods】 The single-ELISA reactive rate of HBsAg, anti-HCV, HIV Ag/Ab and anti-TP of 18 blood station laboratories in Henan throughout 2019 was calculated, and the causes were analyzed according to different ELISA reagent combinations and gray area settings in each laboratory. 【Results】 The overall single-ELISA reactive rates of HBsAg, anti-HCV, HIV Ag/Ab and anti-TP were 1.740(2 154/1 237 789), 0.564‰(698/1 237 789), 1.421‰(1 759/1 237 789) and 1.561‰(1 932/1 237 789), respectively, showing significant differences by detection items (P <0.05). Person correlation analysis showed that the single-ELISA reactive rate was independent of the gray area settings.but dependent on laboratories and reagent combinations. The single-ELISA reactive rate of HBsAg, anti-HCV, HIV Ag/Ab and anti-TP in D laboratory was the highest and higher than that in other labs using the same reagent.The laboratories with high HBsAg single-ELISA reactive rate were mostly those using a combination of imported reagents and domestic reagents, including the top 6 laboratories. The laboratories with high anti-HCV single-ELISA reactive rate were mostly those using certain domestic reagents. No obvious rules was noticed by single-ELISA reactive for anti-HIV. Laboratories with high anti-TP single-ELISA reactive rate were mostly those using combination 4. 【Conclusion】 The HBsAg single-ELISA reactive rate was the highest in the four blood screening items of blood station laboratories in Henan. The single-ELISA reactive rate is related to the laboratory itself and the reagent manufacturer, suggesting that laboratory quality control should be strengthened and proper reagent combination should be selected to reduce the waste of blood.
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【Objective】 To analyze the HIV-, HCV- and HBV- NAT yield rate in different areas of Henan province, so as to provide the basis for disease prevention and control as well as the establishment of a unified quality control standard for nucleic acid testing(NAT) in the Henan province. 【Methods】 The number and prevalence of NAT yielding samples with isolated infectious virus, namely HIV, HCV and HBV, in 18 blood stations in Henan province from 2017~2019, as well as the trends were analyzed. The NAT quality of each laboratory and each testing system was analyzed according to the ratio of reactive individual donation(ID) results to reactive minipools(MP). 【Results】 The HBV, HCV and HIV ID-NAT yield numbers in 3 501 251 blood donations were HBV 2 606(74/100 000), HCV 21 (0.63/100 000), and HIV 34(1.00/100 000). The HBV ID-NAT yield rate showed an upward trend in the whole province from 2017 to 2019, while the prevalence of HIV and HCV ID-NAT yield didn′t differ significantly during three years. 5 kinds of NAT detection systems were applied in 18 blood centers. among which Ⅰ, Ⅱ, Ⅳ and Ⅴ were triplex detection systems. 2661 ID-reactive samples were implicated in 5 595 MP-reactive samples, with a resolution rate of 47.56%. The resolution rate of triplex NAT system Ⅰ, Ⅱ, Ⅳ and Ⅳ was 39.63%~47.95%, 40.43%~54.36%, 51.61% and 70.00%~45.45%, respectively. An upward trend in triplex NAT resolution rate was observed in 8 laboratories, i. e.B, D, E, F, I, K, L and Q, and an descending trend in A and C. The NAT system Ⅲ, a ID-NAT system, was used only by laboratory C, presenting a NAT-yield rate of 0.19% (282/145 474) and resolution rate of 46.45% (131/282). 【Conclusion】 The majority of NAT-yield of one infectious virus in Henan province is HBV, presenting annual increasing trend. The quality management of NAT laboratories should be strengthened as the divergence was seen in the performance of different NAT laboratories.
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Objective To study the effect of combined laparoscopic and percutaneous nephroscopic necrosectomy in the treatment of peripancreatic abscesses.Methods The clinical data of 8 patients with peripancreatic abscesses treated by combined laparoscopic and percutaneous nephroscopic necrosectomy in our hospital from June 2015 to June 2017 were retrospectively analyzed.Results 8 patients were treated with percutaneous puncture and drainage under Ultrasonic / Computed Tomography guidance.Combined laparoscopic and percutaneous nephroscopic necrosectomy was then carried out.Two patients underwent percutaneous nephroscopic surgery twice and laparoscopic surgery once,and 3 patients underwent percutaneous nephroscopic surgery thrice,and 3 patients underwent percutaneous nephroscopic surgery 4 times and laparoscopic surgery once.One patient after percutaneous nephroscopic necrosectomy was complicated with sinus tract hemorrhage,which was treated by haemostasis through a small incision.Two patients who developed postoperative colonic fistula were treated successfully by conservative treatment.The average length of hospital stay was 80 d (60 ～ 153 d),and there was no death.Conclusion Combined laparoscopic and percutaneous nephroscopic necrosectomy was a minimally invasive and efficacious method to treat peripancreatic abscesses.
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Objective To evaluate the practical value of the method of contrast enhanced ultrasoundguided reduced-fine needle aspiration (CEUS-FNA) in decreasing the complications of prostate nodule puncture.Methods Nine hundred patients with suspected prostate cancer(PCa) who underwent traditional 10-point blind transperineal prostate nodule puncture(n =548) or CEUS-FNA(n =352) were collected retrospectively and classfied into normal group or CEUS group,respectively.The ratio of prostate cancer diagnosis,number of punctur and compliations were observed in both groups.Results Altogether 362 PCa were diagnosed from 900 patients.Among these cases the diagnosis ratio of normal group was 38.0％ (208/548) and that of CEUS group was 43.8 ％ (154/352).There was no significant difference in diagnosis ratio between two groups (x2 =2.992,P =0.084).The puncture number of normal group were more than that of CEUS group(P ＜0.01).There were 134 cases occurred infection and other complications in tradition group and 56 cases in CEUS group.The complication rate in normal group was higher than that in CEUS group (24.5 ％ vs 15.9 ％),with significant differences between the two groups (x2 =9.393,P =0.002).Conclusions CEUS-FNA could reduce puncture number,but not decrease the PCa diagnsis rate.And also that could reduce the complication rate of prostate puncture.
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Objective To discuss the necessity and feasibility of nucleic acid test(NAT)in clinical blood transfusion by the im-plementation of the nucleic acid testing after the ELISA screening of Zhengzhou blood donors.Methods HBV DNA,HCV RNA, HIV RNA were detected by Roche Cobas S201 system and Shanghai kehua screening system,the samples were mixed by 6×166.7μL and 8×180 μL(as one pool)separately.If the mix pool was negative,the result can be issued directly;if the pool was positive, than secondary single sample dectection must be taken and the secondary report was the final result.Results A total of 115 227 blood samples were screened by Roche Cobas S201 system and 130 mix pools were positive,among which 80 pools were reactive by secondary split testing,and the reactive samples were 86,the split ratio was 61.5%,The positive ratio of specimens was 0.75‰.90 359 samples were screened by kehua system,and the mixed pools were 93,among which 31 pools were reactive by secondary split testing,and the reactive samples were 31,the split ratio was 33.4%,The positive ratio of specimens was 0.34‰.So the total num-ber screened by the two systems was 205 586,among which 117 cases were reactive,the total positive ratio of specimens was 0.57‰.And one case was HIV window phase infection.Conclusion NAT could effectively decrease the risk of blood transfusion caused by omission of ELISA and ensure the safety of blood transfusion.
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Objective To evaluate the clinical significance of rearrangements during transfection of papillary thyroid cancer (RET/PTC) 1,3 in fine needle aspiration (FNA) specimen from regional thyroid nodules by FQ-PCR.Methods Two hundred and eighty-five FNA samples were collected from patients with thyroid nodules during January 2012 to January 2013.RET/PTC1,3 rearrangements were detected with FQ-PCR.Results The frequencies of the RET/PTC1 and RET/PTC3 rearrangements in 285 FNA samples were 17.2％ (49/285) and 1.4％ (4/285),respectively.During 21.7 months of follow-up,19 (40.4％,19/47) RET/PTC1 positive patients were confirmed to have papillary thyroid carcinoma(PTC) after operation.In the patients with RET/PTC1 rearrangement PTC was found in Thy5 and Thy4 groups.In Thy 2 group,22.6％ cases with RET/PTC1 rearrangements developed PTC as compared with 3.2％ cases without it(x2 =6.667,P＜0.01).In addition,8.5％ (4/47) RET/PTC1 rearrangements emerged in benign lesions.Conclusions It is convenient and reliable to detect RET/PTC1,3 rearrangements by FQ-PCR using FNA samples.RET/PTC1 rearrangement frequently occurs in PTC,however it would be detected in benign lesions occasionally.
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Objective To investigate the effect of endoscopic sphincterotomy (EST) on function of gall bladder motility.Methods Sixty patients with common bile duct stones and intact gallbladder were recruited from January 2010 to June 2012 and divided to two groups according to with or without cholecystolithiasis.All patients underwent real-time ultrasound examination to assess bladder motility at fasting and after fat meal,and were followed up to observe the incidence of cholecystitis after EST.Results Compared with those before EST,there was a significant reduction in mean fasting volume and mean residual volume of gallbladder,and an increase in gall bladder emptying after EST.Within the mean follow-up period of 18.7 months,the incidence of cholecystitis in patients with cholecystolithiasis was similar with that of patients without cholecystolithiasis,but the recurrent rate of common duct stone was higher (26.7％ vs.6.7％,P =0.032).Conclusion After EST,contractility of the gall bladder is enhanced,although the rate of cholecystitis is similar to patients without cholecystolithiasis,the incidence of secondary common bile duct stone in patients with cholecystolithiasis increases.