Background Blood transfusion therapy is extremely important for certain neonatal diseases, but the threshold for neonatal blood transfusion is not the same in different countries. Until now, clinical studies to determine the suitable threshold for newborns in China are lacking. Therefore, it is of high importance to establish a multi-center cohort study to explore appropriate transfusion thresholds for newborns in China. Methods This retrospective cohort study investigated neonatal blood transfusion therapy administered from January 1, 2017 to June 30, 2018, with the aim of evaluating the effect of restricted and nonrestricted blood transfusion on neonatal health. The subjects were enrolled in 46 hospitals in China. A total of 5669 neonatal cases were included in the study. Clinical diagnosis and transfusion treatment of these neonates were collected and the data were retrospectively analyzed. The neonates were followed up 1 week and 1 month after leaving the hospital. The newborns’ and their mothers’ data were collected containing 280 variables in the database. The primary outcome of the study was mortality, and the secondary outcomes were complications, hospital stays, NICU hospital stays and hospital costs. Results Results from the < 1500 g group showed that there was a higher mortality rate in the restricted transfusion group (11.41%) when compared with the non-restricted transfusion group (5.12%) ( P = 0.000). Among the secondary outcomes, the restricted transfusion group had fewer costs. Results from the 1500-2500 g group showed that the mortality rates of the restricted and non-restricted transfusion groups were 3.53% and 4.71%, respectively, however there was no statistical significance between the two groups ( P = 0.345). Among the secondary outcomes, the restricted transfusion group had fewer hospital stays, NICU hospital stays and hospital costs. The incidence of necrotizing enterocolitis was lower in the restricted transfusion group (OR, 2.626; 95% confidence interval [CI], 1.445 to 4.773; P = 0.003). The results from the ≥ 2500 g restricted transfusion group suggested that the mortality rate of (3.02%) was significantly lower than that of non-restricted transfusion group (9.55%) ( P = 0.000). Among the secondary outcomes, the restricted transfusion group had fewer hospital stays and hospital costs. The incidence of retinopathy of prematurity was lower in the restricted transfusion group (OR, 4.624; 95% confidence interval [CI], 2.32 to 9.216; P = 0.000). Conclusions Current transfusion protocols for newborns weighing less than 1500 g may be inappropriate and lead to higher mortality. The current transfusion threshold performed better for the other two weight groups.

目的 调查分析全国住院输血新生儿血常规检测指标,为深入研究不同胎龄新生儿血常规参考范围提供数据支持.方法 收集全国5669例住院输血新生儿基本信息,并按照出生胎龄分为<32 w组、32～36 w组、≥37 w组,采集输血前三组不同胎龄新生儿血常规指标数据,对检测结果进行汇总分析.结果 不同胎龄组内新生儿红细胞计数、红细胞比容及血红蛋白随着日龄增加而降低,红细胞计数在出生第0天、1～2天、6～7天、9～10天组间比较差异有统计学意义,其他日龄组间差异无统计学意义.红细胞比容和血红蛋白在出生第0～1天、1～2天、3～4天组间比较差异有统计学意义,其他日龄组间差异无统计学意义.不同胎龄组内新生儿白细胞计数随着日龄增加而降低,在出生第0～1天、1～2天、2～3天、3～4天、6～7天、8～9天、≥16天组间差异有统计学意义,其他日龄组间差异无统计学意义.不同胎龄组内新生儿血小板计数从出生后0～1天到≥16天均有明显的升高,在出生第0～1天、1～2天、7～9天、11～14天、≥16天组间比较差异有统计学意义,其他日龄组间差异无统计学意义.结论 住院输血新生儿血常规指标变化明显,依据不同胎龄日龄制定新生儿血常规参考范围对新生儿精准诊疗意义重大.

目的:根据历年临床输血不良反应情况,制定输血不良反应监测机制,保证患者输血安全.方法:采集2010 ～2016年全院输血不良反应病例,分析输血不良反应的种类及原因.结果:2010 ～2016年发生输血不良反应的病例共658例,每年的发生率在3.0％ ～4.2％之间,平均3.9％,涉及临床用血科室有11个,输血反应种类中发热反应10例,过敏反应28例,发热反应加过敏反应1例,溶血反应1例,血小板输注无效618例.发生输血不良反应的血液成份情况:红细胞类13例,血浆6例,机采血小板639例,冷沉淀3例.结论:根据不同的输血不良反应,制定相应的预防措施,减少输血不良反应的发生,保证患者输血安全.

为将分析测试结果误差控制在允许限度内,实验室必须采取质量控制措施.室内质量控制是对测试过程进行自我控制的过程,目的在于判断检验结果的质量,结果是否可接受.对于定量检测项目,《临床实验室定量测定室内质量控制指南》(以下简称指南)从质控规则、质控品频次、失控判定规则、标准差、变异系数到质控图的绘制等都做了详细说明,然而对于定性实验,目前尚无可遵循的质控指南.

目的：根据 Rh（D）阴性的孕妇血型及不规则抗体检测结果，做好产前准备，保证孕妇安全生产。方法：用微柱凝胶法检测孕妇血型及不规则抗体，并据此准备合适的血液。结果：为血型 Rh（D）阴性及不规则抗体检测阳性的孕妇及时准备了异体或自体血液，全部孕妇均安全生产。结论：根据孕妇的血型，制订相应的备血策略，对保证孕妇生产和生命安全有重要意义。

目的：研究血液病输注血小板的疗效，评价血小板输注的效果，保证患儿得到有效治疗。方法：用 CCI和 PPR 或血小板计数增加与否判断血小板输注效果并分析患儿血小板输注无效的原因。结果：729例血液病患儿共计输注890治疗量血小板，输注前后血小板比较差异具有统计学意义（P <0．05）；在890例次中，总的有效输注696例次，其有效率为78．2%，不同类型血液病患儿血小板输注有效率间有显著性差异（P <0．05）。结论：非免疫因素输注血小板效果好，免疫性的如血小板减少性紫癜输注效果不好，要严格掌握输血适应症，做到输注血小板前的病情评估与输血后的疗效评价，科学合理使用血小板制品。

目的:鉴定1例急性早幼粒白血病血型正、反不符的血型.方法:采用盐水法、凝聚胺法、微注凝胶法、吸收与放散试验鉴定红细胞上抗原及血浆中抗体.结果:综合分析各种实验结果判定患者血型为A型.结论:急性白血病致血型鉴定困难,对临床输血安全很关键.

目的了解患儿在感染乙型肝炎病毒(HBV)过程中HBV血清学标志物的变化。方法用ELISA法检测血清学标志物。结果HBsAg阳性率为9.33%。HBV感染患儿血清学标志物模式有18种,以“小三阳”和“大三阳”模式为主。结论大、小三阳是儿童HBV感染的主要血清学标志,HBV感染患儿应加强随访和干预治疗。

佝偻病是我国小儿常见病,它不仅使患儿骨发育迟缓,骨骼变形,而且还可引起神经、肌肉、造血、免疫等组织器官的功能异常.因此,早期诊断尤其重要,为了了解太原地区婴幼儿佝偻病发病情况,现将我院2002年1月至12月0～3岁婴幼儿骨碱性磷酸酶(NBAP)检测结果报告如下.

院内感染是指住院病人在医院内获得的感染.当患者进行各种手术和产妇分娩时,都会接触到各种手术器械和暴露的危险,都有出血的可能,而输血是临床上治疗和抢救病人常用的医疗措施.由于病毒感染途径多样,是输血和医源性感染所致,还是患者接受治疗或入院前就已被感染,这就需要获得患者手术前、输血前及产前的资料来区别.因此,进行手术前、输血前及产前院内感染(院感)5项即抗甲型肝炎病毒抗体(抗-HAV-IgM);乙型肝炎病毒表面抗原(HBsAg);抗丙型肝炎病毒抗体(抗-HCV);抗艾滋病1+2抗体(抗-HIV1/2);抗梅毒螺旋体抗体(抗-L-P)检查,对避免和预防患者院内感染、医务人员的职业感染及防止出现医疗纠纷均具有重要的临床意义.

目的:为了做好婴幼儿缺铁性贫血与佝偻病的防治工作,降低其发病率,了解患儿骨源性碱性磷酸酶含量情况及与贫血之间的相关关系,为防治探索更多、更有效的途径.方法:采用美国贝克曼-库尔特公司生产的JT-IR全自动血细胞计数仪测定血系列;采用北京中生生物工程高技术公司生产的小儿骨源性碱性磷酸酶试剂盒进行骨源性碱性磷酸酶测定.结果:对照组350例,＞250 U/L者29例,占8.3%;贫血组104例,＞250 U/L者30例,占28.8%.缺铁性贫血患儿血红蛋白与骨源性碱性磷酸酶含量有直线关系且成负相关.讨论:结果显示,缺铁性贫血患儿骨源性碱性磷酸酶(NBAP)＞250 U/L者明显高于正常对照组(x2=29.97,P＜0.001).并且缺铁性贫血患儿血红蛋白与骨源性碱性磷酸酶含量成负相关(r=-0.315 9,t=3.363,P＜0.001).探讨缺铁性贫血与佝偻病之间的内在关系.

目的分析肥胖症与血糖(GLU)和三酰甘油(TG)之间的关系.方法从976例健康体检人员中,以肥胖指数r=w(kg)/h2(cm2)≥24作为肥胖标准.筛选出肥胖指数＞25者584例,并对肥胖者进行了TG和GLU测定及肝脏超声检查的分析.结果控制肥胖是预防高血脂、脂肪肝和糖尿病的最好措施.结论肥胖症可以引起GLU和TG的升高.

Objective To observe the anticoagulant effect of heparin on childhood nephritic syndrome. Methods Seventy-six cases of nephritic syndrome were randomly divided into two groups;the treatment group and the control group.The plasma-fibrinogen was measured before and after the treatment respectively,and the results were statistically analysed.Results There was no significant difference in plasma-fibrinogen content between the two groups before the treatment,whereas significant difference was found after the treatment( t =1 56, P 0 05);significantly different plasma-fibrinogen contents were seen in the treatment group before and after the treatment( t =11.47 and t =5.786 respectively; P 0.001).Conclusion The anticoagulant effect of heparin can reinforce the therapeutic effect,alleviate the inflammatory reaction in kidney,slow down fibrosis of glomerulus,and prevent renal failure.