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1.
Nurs Stand ; 39(3): 40-43, 2024 03 06.
Artigo em Inglês | MEDLINE | ID: mdl-38312004

RESUMO

Arterial blood gas (ABG) analysis is a fundamental skill in healthcare practice, particularly when caring for acutely unwell or deteriorating patients. It can be useful in the assessment of patients' acid-base balance and gas exchange, thereby informing appropriate care and management. However, many nurses find interpreting ABG results challenging. This article outlines a simplified approach to ABG analysis using three main values - pH, partial pressure of carbon dioxide and bicarbonate - and applying the RoMe ('Respiratory opposite, Metabolic equal') technique. It also provides brief descriptions of selected acid-base imbalances and explains how to identify whether these are uncompensated, partially compensated or fully compensated.


Assuntos
Bicarbonatos , Dióxido de Carbono , Humanos , Cidade de Roma , Gasometria/métodos
2.
Children (Basel) ; 10(9)2023 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-37761528

RESUMO

To learn what mothers know about newborn bloodspot screening (NBS), the procedure, and the sources used, a pilot study was performed. An online questionnaire was developed, with the first part focused on characteristics and the NBS procedure, and the second on knowledge, information sources, and health care providers (HCPs). This questionnaire was accessible until 200 answers were received. The characteristics of respondents were representative for the population. Mothers gave verbal consent in 69.5% of cases, 12.5% did not, and 18% stated that no consent was requested. The 'knowledge' part contained 12 closed questions, five multiple-choice questions on sources, and assessments (5-point Likert scores) of the information transfer. The mean knowledge level was 7.2/12. Screening concepts (consequences, likelihood, sensitivity, carrier) and absence of notification of normal findings were well known. The fact that NBS is not compulsory was poorly known, and post-analysis sample handling procedures were poorly understood. Key HCPs were midwifes (80.5%) and nurses (38.5%). When the leaflet (44%) was provided, the majority read it. Mean Likert scores were 3.36, 3.38, 3.11 and 3.35 for clarity, timing appropriateness, sufficiency, and usefulness. The knowledge level and consent practices were reasonably good. Key HCP were midwives and nurses, the leaflets were supporting. This should enable a quality improvement program to a sustainable NBS program in Flanders.

3.
Transfusion ; 63(8): 1563-1570, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-37177851

RESUMO

BACKGROUND: Blood typing and antibody screening are key elements of transfusion safety. However, available single platform, flexible, and affordable technologies are limited, especially for extended phenotyping. Microarray-based technology allows for this extended phenotyping with the flexibility of piecemeal analysis. STUDY DESIGN AND METHODS: This study was conducted in three blood donor laboratories to determine the performance of a high-throughput microarray-based system for ABO, RH1-RH5, and KEL1 typing, ABS and extended phenotyping (RH8, KEL2&3, FY1&2, JK1, MNS3). Specimens were tested simultaneously on local platforms and on the microarray-based system. When discrepancies were identified, resolver testing were performed. RESULTS: In total, 4862 blood samples were tested for standard phenotype, 4257 for antibody screening and 2194 for extended phenotype. Results were available for 92.12% of the samples. The overall percent agreements were: 100% for ABO, 99.8% for RH1, 99.24% for RH2-5 and 99.86% for KEL1, 93.16% for antibody screening, and 99.68% for extended phenotype. CONCLUSIONS: This microarray-based system provides highly comparable results to current CE marked assays. The ability to continuously test 3000 microarrays in 1 day, providing simultaneously both extended RBC phenotyping and antibody detection drives laboratory efficiencies. The results of our study validate the performance of this new technology; however, the percentage of samples without results must be reduced and further analysis is required to interpret the ABS screening performances. This could constitute a real breakthrough in transfusion, making it possible in the long term, on a single platform, to carry out all the analyses necessary for the qualification of donations.


Assuntos
Transfusão de Sangue , Eritrócitos , Humanos , Tipagem e Reações Cruzadas Sanguíneas , Laboratórios , Doadores de Sangue
4.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-1005122

RESUMO

【Objective】 To investigate the effectiveness of current indicators in initial screening and retest before donation and access the optimal testing strategies. 【Methods】 Data of initial screening (rate method for ALT, colloidal gold method for HBsAg) and retest (rate method for ALT, ELISA for HBsAg) of 18 510 platelet donors in our center from January 2019 to December 2021 were collected, and the results were retrospectively analyzed and compared in terms of different years and number of donations. 【Results】 From 2019 to 2021, data of initial screening and retest of platelet donors were as follows: 1) the deferral rate of ALT and HBsAg was 12.98% (2 403/18 510) vs 0.26%(40/15 412); 2) the deferral rate of ALT was 13.19% (712/5 398) vs 0.20%(9/4 410)in 2019, 13.33% (873/6 549) vs 0.06%(3/5 387)in 2020 and 11.05% (725/6 563) vs 0.07%(4/5 615)in 2021; for initial screening, significant difference was noticed in ALT reactivity in 2021 as in comparison to other two years(P<0.05); 3) the reactive rate of HBsAg was 0.43% (23/5 398) vs 0.18%(8/4 410)in 2019, 0.66% (43/6 549) vs 0.20%(11/5 387)in 2020 and 0.41% (27/6 563) vs 0.09%(5/5, 615) in 2021. For initial screening, HBsAg deferral in 2021 was significantly different from 2019, while similar with 2020. 4) Among ALT deferral samples in the retest, 68.75% (11/16) were ALT≥45 U/L. Among HBsAg reactive samples, 91.67% (22/24) were reactive by single reagent. 【Conclusion】 Setting the threshold value of ALT for platelet donors in initial screening as less than 45 U/L can effectively reduce the reactive rate in the retest. HBsAg screening only for first-time platelet donors can reduce the detection cost. Adding pre-donation detection indicators according to local prevalence of transfusion transmitted diseases is conductive to reduce the discarding rate of platelets.

5.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-1004724

RESUMO

【Objective】 To evaluate the effectiveness of rapid initial screening using HBsAg and syphilis reagents of immunochromatography technology before blood donation, and explore the influencing factors. 【Methods】 The pre-donation screening of HBsAg and anti-TP and post-donation blood test results of blood donors in Yangzhou region from January 2020 to June 2023 were retrospectively analyzed. The HBsAg and anti-TP reactive samples by ELISA from January to June 2023 were, retested using colloidal gold immunochromatographic reagents, and the results were compared and analyzed. 【Results】 A total of 200 414 blood donors were screened, among which 781 were HBsAg and anti-TP positive, accounting for 0.39%. A total of 191 717 blood donors successfully donated blood, and 986 were HBsAg and anti-TP positive by ELISA, accounting for 0.51%. 62 HBsAg and 61 anti-TP reactive samples were retested using the initial screening reagent, with 24 HBsAg reactive samples and 26 anti-TP reactive samples, accounting for 38.71% and 42.62% respectively. 14 HBsAg and 6 anti-TP gray area samples were retested, but no reactivity was found.The reactivity rates of 9 samples with HBsAg detection S/CO values greater than 25.0 and 10 samples with anti-TP detection S/CO values greater than 15.0 were all 100%.There was a negative correlation between the reaction intensity (S/CO value) of reactive samples and interpretation time of initial screening reaction. 【Conclusion】 The rapid primary screening of hepatitis B and syphilis with immunochromatography technology among blood donors can effectively improve the quality of blood and the qualification rate of blood after collection. Through targeted training of primary screening staff, the quality of primary screening can be further improved, the rate of missed detection can be reduced, and costs can be saved, thus reducing the risk of transfusion transmitted infection and ensuring the health of blood donors.

6.
Nurs Stand ; 2022 Jul 28.
Artigo em Inglês | MEDLINE | ID: mdl-35899593

RESUMO

Arterial blood gas analysis is designed to measure the levels of oxygen and carbon dioxide in the blood, as well as the acid-base (pH) balance. Arterial blood gas analysis can assist healthcare professionals to evaluate respiration, circulation and metabolic processes in deteriorating patients. Arterial blood gas analysis is usually undertaken by a trained healthcare professional where patients are acutely unwell or deteriorating. REFLECTIVE ACTIVITY: 'How to' articles can help to update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of.

7.
Nurs Child Young People ; 34(4): 33-42, 2022 Jul 07.
Artigo em Inglês | MEDLINE | ID: mdl-35527710

RESUMO

This article, the 15th and last in a series on the biological basis of child health, focuses on the renal system, in particular the kidneys. It provides an overview of their role, function, anatomy and physiology, and embryological development. The renal system has a crucial role in homeostasis, so renal function impairment can have wide-ranging and potentially serious consequences for a child's overall health. The article describes some of the common renal conditions seen in children and how these are managed. It explains how to interpret the results of renal function tests and urine sampling conducted to assess renal function and to investigate acute and chronic disease.


Assuntos
Saúde da Criança , Rim , Criança , Humanos , Rim/fisiologia , Testes de Função Renal
8.
BMC Infect Dis ; 22(1): 279, 2022 Mar 23.
Artigo em Inglês | MEDLINE | ID: mdl-35321684

RESUMO

BACKGROUND: Since 2010, the Blood Center of Zhejiang province, China, has conducted a pilot nucleic acid amplification testing (NAT) screening of blood donors for Hepatitis B virus (HBV), Hepatitis C virus (HCV), and Human immunodeficiency virus (HIV). This study aims to assess the results of NAT testing over 10 years to establish the effects and factors influencing NAT yields of HBV, HCV, and HIV. METHODS: Blood donations from seven different blood services were screened for HBV DNA, HCV RNA, and HIV RNA using 6 mini pools (6MP) or individual donation (ID)-NAT method between August 1, 2010, and December 31, 2019, at the NAT centralized screening center. We compared 3 transcription-mediated amplification (TMA) assays and 2 polymerase chain reaction (PCR) assays. Further, HBV, HCV, and HIV NAT yields were calculated and donor characteristics and prevalence of HBV NAT yields analyzed. Donors with HCV and HIV NAT yield were also followed up. RESULTS: 1916.31 per million donations were NAT screening positive overall. The NAT yields for HBV, HCV, HIV and non-discriminating reactive were 1062.90 per million, 0.97 per million, 1.45 per million, and 850.99 per million, respectively, which varied in the seven blood services and different years. HBV NAT yields were higher than those of HCV and HIV and varied across demographic groups. Risk factors included being male, old age, low education level, and first-time donors. We found no differences in NAT yields of HBV, HCV, and HIV between the 3 TMA and 2 PCR assays; nonetheless, statistically, significant differences were noted between the five assays. CONCLUSION: In summary, NAT screening in blood donations reduces the risk of transfusion-transmitted infections and shortens the window period for serological marker screening. Therefore, a sensitive NAT screening method, ID-NAT workflow, and recruitment of regular low-risk donors are critical for blood safety.


Assuntos
Infecções por HIV , Hepatite B , Hepatite C , Ácidos Nucleicos , Doadores de Sangue , Feminino , HIV , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Hepacivirus/genética , Hepatite B/diagnóstico , Hepatite B/epidemiologia , Vírus da Hepatite B/genética , Hepatite C/diagnóstico , Hepatite C/epidemiologia , Humanos , Masculino
9.
Artigo em Alemão | MEDLINE | ID: mdl-35024894

RESUMO

Infections with hepatitis B, C, and E virus (HBV, HCV, and HEV) can be transmitted via blood and cause severe acute or chronic liver infections. To ensure the safety of blood donations and protect recipients from virus transmissions, blood donations in Germany are tested for viral genomes using nucleic acid amplification techniques (NATs) as well as for viral antigens and antibodies by serological testing. This article describes the relevant regulations on the safety of blood and blood products in Germany and the various screening methods. The safety of blood products is assessed.Currently used NAT methods for detection of hepatitis viruses are based either on polymerase chain reaction (PCR) or isothermal methods such as transcription-mediated amplification (TMA), which enable a highly sensitive detection of viral infections and thereby contribute to the reduction of the diagnostic window. Antigen tests for the detection of viral surface protein of hepatitis B virus in blood donations were introduced in the 1970s in order to prevent potential transmissions. Since the introduction of mandatory testing for HCV-specific antibodies in 1992, HCV NAT testing in 1999, anti-HBc antibody testing in 2006, and the non-mandatory HBV NAT, which is voluntarily performed by most of the blood establishments, blood safety has increased tremendously. Only a few isolated cases of transfusion-transmitted infections in the early window period have been reported since. The success of the recent introduction of mandatory HEV NAT testing in 2020 will have to be assessed in the upcoming years. Besides blood donor screening, the system for blood safety in Germany is supplemented by additional measures for donor selection and pathogen inactivation.


Assuntos
Antígenos de Superfície da Hepatite B , Hepatite B , Doadores de Sangue , Segurança do Sangue , DNA Viral , Alemanha , Hepatite B/diagnóstico , Hepatite B/prevenção & controle , Humanos , Programas de Rastreamento
10.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-1004377

RESUMO

【Objective】 To establish a routine screening method for unexpected antibodies of blood donors, analyze the results of centralized screening for unexpected antibody of blood donors in the blood center, and compare the cost of centralized and decentralized screening modes. 【Methods】 A total of 35 591 blood donors were screened for unexpected antibodies from March 31, 2021 to July 31, 2021, using microcolumn gel method. Unexpected antibody screening reactive samples were further confirmed by the Transfusion Research Institute of Shenzhen Blood Center, and the demographic characteristics were further determined through the analysis of unexpected antibody positive population. The direct cost and indirect cost of centralized and decentralized unexpected antibody screening mode were compared. 【Results】 Forty unexpected antibody positive samples were confirmed in Shenzhen, with the positive rate at 0.11%(40/35 591), among which MNS, Rh and Lewis system accounted for 35% (14/40), 32.5% (13/40) and 17.5% (7/40), respectively. Males and females accounted for 45% (18/40) and 55% (22/40), respectively (P0.05). Unexpected antibody screening in a centralized way saved about 1.16 million yuan per year. 【Conclusion】 It is necessary to carry out unexpected antibody screening for all blood donors, and centralized screening is more economical than decentralized screening.

11.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-1004375

RESUMO

【Objective】 To establish scrap indicators for key equipment in blood screening laboratory of blood centers and quantitatively assess the running status of key equipment, so as to provide a scientific method for equipment scrap. 【Methods】 Through the literature review and Delphi method, the scrap indicators of key equipment in blood screening laboratories were established in terms of applicability, economy and advancement of the equipment. The weights of relevant indicators were calculated by analysis hierarchy process (AHP), and the quantitative assessment model of equipment scrap priority was established according to the indicators and its weight. The equipment running data from January 2020 to December 2020 of Laboratory Department were collected and analyzed using the model, and its accuracy was verified based on experience. 【Results】 Thirteen second-level scrap indicators were established, and the weights of the three first-level indexes of applicability, economy and advancement were 0.582, 0.114 and 0.306, respectively. Among the total 30 key equipment, the model score of 4 equipment was less than 0.5, and the running status after manually checking met the scrap standard. 【Conclusion】 The model can accurately assess the scrap priority of key equipment and facilitate the procurement budget and scrapping identification in advance, which can avoid the waste of resources and ensure safe, efficient and orderly laboratory work.

12.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-1004289

RESUMO

【Objective】 To verify the detection performance of a newly introduced individual donation(ID) nucleic acid detection(NAT) system, and to confirm whether its main test parameters meet the expected requirements of blood screening. 【Methods】 Standard serum and plasma negative for HBV DNA, HCV RNA, and HIV RNA were diluted to different multiples samples (0.5~3 times) of the detection system′s limit of detection (LoD). These samples were conducted NAT test for HBV DNA, HCV RNA and HIV-1 RNA, to verify the testing sensitivity, stability, accuracy and anti-interference ability. 【Results】 The sensitivity of 3× LoD concentration of HBV DNA, HCV RNA and HIV-1 RNA was tested by the system, and the yielding rates were all 100%, with 1 ×LoD at 95.0%~100% and 0.5×LoD at 70.0%~90.0%. The intra-assay and inter-assay precision variation coefficient was 2.07%~2.62% and 2.33%~2.88%, respectively. The accuracy of 10 external quality assessment samples of National Center for Clinical Laboratories was 100%. Severe hemolysis and fatty blood had no effect on the detection of samples with 3×LoD concentration of HBV DNA, HCV RNA and HIV-1 RNA. Any combinations by samples with 2 × LoD concentration of HBV DNA, HCV RNA, and HIV-1 RNA were not inhibited by high concentrations of other viruses. Among 2 041 sero-negative samples from blood donor, the NAT yield of this system was 1.67% (34/2 041), which was a little bit higher than that of a imported minipool system (1.66%, 33/2 041) (P>0.05). 【Conclusion】 The ID-NAT system can meet the requirements in terms of sensitivity, stability, accuracy and anti-interference ability, and can be used for blood screening of blood donors.

13.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-1004251

RESUMO

【Objective】 To evaluate the residual risk of hepatitis C virus (HCV) in blood screening among voluntary blood donors in Zhengzhou. 【Methods】 The ELISA and NAT screening results of 497 171 voluntary blood donors in Zhengzhou from January 2019 to December 2020 were collected through the information management system of our blood center.The residual risk of HCV was assessed using the Prevalence-Window Period Residual Risk Model. 【Results】 The residual risk among repeated and first-time blood donors was 1∶132 280 (95% CI: 1∶95 520~1∶188 820) and 1∶44 090 (95% CI: 1∶31 840~1∶62 940), respectively. The overall residual risk of blood donors screening was 1∶68 540 (95% CI: 1∶65 910~1∶130 290). The reactive rate of HCV screening in first-time blood donors (0.144%, 334/231 168) was significantly higher than that in repeated blood donors (0.014%, 36/266 003) (P<0.05), and the reactive rate of repeated blood donors in 2019 (0.019%, 26/135 267) was significantly higher than that in repeat blood donors in 2020 (0.008%, 10/130 736) (P<0.05). 【Conclusion】 The residual risk of HCV among voluntary blood donors in Zhengzhou is low.The publicity and recruitment should be further strengthened to establish a stable team of voluntary blood donation, and health consultation and physical examination should also be strengthened to further reduce the residual risk of blood transfusion.

14.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-1004226

RESUMO

【Objective】 To investigate the situation of hepatitis E virus(HEV) infection among voluntary blood donors in Wuhan area and provide evidences for enhancing blood screening strategies. 【Methods】 HEV nucleic acid detection(NAT) was performed on blood samples from eligible blood donors in Wuhan from November to December 2020. The testing results were analyzed, and the blood donors with repeated reactive results were followed up to clarify the status of infection. 【Results】 Routine screening was performed on 17 409 blood samples from November to December 2020. A total of 17 322 blood samples of eligible blood donors were tested for HEV NAT, and one case of HEV RNA reactivity was detected. The results from the follow-ups showed that the blood donor should be in the window period of HEV seroconversion. The current HEV infection rate of voluntary blood donors in Wuhan arewas 0.058‰(1/17 322), which was lower than other domestic areas. 【Conclusion】 The current HEV infection rate of voluntary blood donors was at a relatively low prevalence level in Wuhan area. Selective blood screening strategies can be taken to further reduce potential risk of blood transfusion infection with hepatitis E virus.

15.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-1004216

RESUMO

【Objective】 To evaluate the performance of electrochemiluminescence immunoassay (ECLIA) in detecting HIV antigen/antibody in blood screening. 【Methods】 A total of 128 donors, reactive to anti-HIV(ELISA)testing, from September 2016 to September 2020 were enrolled, and seven samples were reactive to double anti-HIV reagents, among which 6 were confirmed by WB, 1 confirmed by NAT as negative.Two group of donors, reactive to solo anti-HIV reagent but being confirmed negative by WB(n=121) vs.randomly selected donors non-reactive to ELISA + NAT(June to September 2020, n=1360), were subjected to HIV antigen/antibody testing using ECLIA to compare the testing results, including concordance rate, sensitivity and specificity. 【Results】 The ECLIA results remained non-reactive for 1360 samples initially non-reactive to both ELISA and NAT.The concordance rate of anti-HIV reactivity by ECLIA and ELISA+ WB were 100%(6/6). For 122 samples, reactive to ELISA anti-HIV testing but nonreactive to confirmatory testing, 4(3.28%)of them were reactive to HIV antigen/antibody testing and 118(96.72%) nonreactive, with the concordance rate of ECLIA and ELISA at 96.88%(124/128). The sensitivity, specificity and false positive rate of ECLIA and ELISA were 100% vs 100%, 99.73% vs 91.77%, and 0.27% vs 8.23%, respectively. 【Conclusion】 ECLIA for HIV antigen/antibody detection has good sensitivity and specificity, which can meet the requirements of blood screening, and the false positive rate is lower than that of ELISA, adopted commonly in blood bank at present.

16.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-1004210

RESUMO

【Objective】 To analyze the cost-effectiveness of ELISA grey area strategy through establishing the health economics model. 【Methods】 The serological grey area strategy evaluation model was composed of screening strategy subdecision tree, pathogen infection subdecision tree and pathogen detection subdecision tree. The key parameters in the model were obtained from literatures and research data. The cost-effectiveness of setting ELISA grey area strategy was compared by software, and multifactor sensitivity analysis was conducted. 【Results】 After setting the ELISA grey area, extra samples(5.86 cases/100 000) with serological false negativity could be detected, including HBV samples at 4.93/100 000, HCV samples at 0.27/100 000, HIV samples at 0/100 000, syphilis samples at 0.66/100 000. To yield an additional seropositive sample out of every 100 000 blood donors, blood center will afford extra 1 million yuan about. 【Conclusion】 Through this study, a cost-effectiveness evaluation model of serological detection strategy was established. Although the ELISA grey area setting can yield a small number of seropositive samples, the cost is much higher than the current affordability.

17.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-1004181

RESUMO

【Objective】 To retrospectively analyze the unqualified blood screening results of voluntary blood donors in Guangzhou area during 2016~2020, and analyze various factors that affect the blood screening results, for the purpose of providing a scientific basis for recruitment and retention of blood donors, improving blood safety, and avoiding waste of blood resources. 【Methods】 A total of 1 548 204 voluntary blood donors in Guangzhou from 2016 to 2020 were selected as the research objects, and the blood samples were screened by dual ELISA and once NAT. The unqualified rate of different years and populations were counted and the analysis of risks of unqualified blood testing was performed by conditional Logistics regression. 【Results】 An overall unqualified rate of blood screening was 2.52% in Guangzhou from 2016 to 2020, the unqualified rate of every year showed a downward trend first and then an upward trend. HBsAg and ALT were the two primary deferral causes, the positive rate was 0.65%(10 129/1 548 204) and 1.22%(18 824/1 548 204), respectively; the unqualified rate in male blood donors3.10%(31 091/1 004 079) was significantly higher than that in female(P<0.05), and that in blood donors aged 18~25 was 1.84%(12 781/694 374), which was lower than the other three age groups (P<0.05). Fewer students(1.33%, 4 024/302 007) and bachelor degree donors(1.57%, 5 379/341 662) were deferred. Compared with individual blood donors, group blood donors’ deferral rate(2.62%, 21 307/813 664) was higher. The deferral rate of first-time blood donors(4.57%, 24 469/535 551) were higher than the repeated blood donors (P<0.05) , meanwhile, whole blood donors(2.84%, 38 111/1 340 678) higher than those apheresis donors (P<0.05). Gender, age, occupation, education, frequency and blood components donated were risk factors for unqualified blood screening. 【Conclusion】 The deferral rates of voluntary blood donors in Guangzhou showed an overall upward trend, from 2016 to 2022. HBsAg and ALT were the primary deferral causes, and there were differences in demographics and blood donation characteristics. To formulate targeted recruitment strategies according to the test results of voluntary blood donors, and strengthen the publicity of low-risk groups and the consultation and screening before blood donation, will be a great benefit for reducing the blood scrap and guaranteeing the blood safety.

18.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-1004149

RESUMO

【Objective】 To investigate the serological and molecular characteristics of HBsAg+ /HBV DNA non-reactive (NR) infections. 【Methods】 Samples tested as HBsAg+ and HBV DNA NR were confirmed by individual NAT repeat testing, viral particle concentration by PEG precipitation combined with in-house nested PCR and real-time quantitative PCR, anti-HBc testing, and HBsAg quantification. HBV sequences were compared with those from donors with chronic and occult infection as controls. 【Results】 A total of 792 195 samples were screened between January 2011 and December 2020, of which 53 (1: 14 947) were confirmed HBsAg+ /HBV DNA NR. HBV DNA was detected further in five (9.4%) samples; three S sequences and four Pre Core/Core sequences were obtained. Unique amino acid substitutions (P130T, P135Q/S, R151Q, G153S and S155F) were found in the Core protein that may affect virus packaging and replication. 【Conclusion】 Extremely low HBV DNA level was detected in plasmas of HBsAg+ /HBV DNA NR donors. Barely detectable HBV DNA might be associated with unusual mutations in the Pre Core/Core protein affecting viral replication. More sensitive HBV DNA and/or HBsAg assays may be considered to further reduce the potential HBV transfusion-transmission residual risk.

19.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-1004048

RESUMO

【Objective】 To investigate the confirmatory status of HIV-1 antibody detection and Western blot (WB) test among voluntary blood donors in Wuhu, and to explore the strategies and methods to further ensure blood quality and safety. 【Methods】 Blood samples were preliminarily screened by ELISA and NAT, and the reactive samples were sent to Wuhu CDC for further WB test of HIV-1 antibody. The confirmation results of HIV-1 antibodies of voluntary blood donors in Wuhu in the past 10 years were retrospectively collected. The characteristics of WB bands of positive samples were analyzed, and the demographic characteristics of HIV-infected voluntary blood donors were sorted out. 【Results】 A total of 354 864 blood samples from voluntary blood donors in Wuhu during January 2011 to May 2021 were investigated, among which 42 were confirmed HIV positive (HIV-1 antibody positive in 41, and solo HIV-RNA reactive in 1), with a total HIV positive rate of 11.8/100 000(42/354 864). Statistical differences were found in gender [males 97.6% (41/42) vs females 2.4% (1/42)], marital status [unmarried 17.3/100 000 vs married 8.0/100 000] and occupation [staff/workers 37.5/100 000 vs students11.4/100 000 vs others 7.7/100 000]. Among the positive samples, the yield rate of WB bands gp160 was 100% (41/41), both gp41 and p24 were 97.6% (40/41),, and p55 was the lowest 46.3% (19/41). P51 and P66 presented the highest yield consistency (Kappa=1.000, P5 000 cps/mL by viral load (VL) testing, indicating HIV window period infection. 【Conclusion】 HIV infection statistically affected male donors more than females in Wuhu area, and most were early infection that revealed by WB band analysis. NAT plays an important role in the detection and confirmation of HIV infection during the window period, and is essential for blood safety.

20.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wpr-1004047

RESUMO

【Objective】 To retrospectively analyze the quality status and annual trend of provincial-level centralized blood screening across Ningxia, and discuss the effect and advantages of the application of centralized blood screening. 【Methods】 The centralized detection, with the combination of enzyme linked immunosorbent assay (ELISA) and nucleic acid test(NAT), in Ningxia from 2016 to 2020 was statistically analyzed, and the sample size, overall unqualified rate and unqualified rate of each item were compared among different regions. 【Results】 There were about 70 000 samples in Ningxia annually, 65% were in Yinchuan city, and 35% in Shizuishan, Wuzhong, Guyuan and Zhongwei city. The unqualified rates of blood screening in above five cities were 1.09% (2 438/223 852), 1.48% (401/27 024), 1.50% (425/28 364), 1.01% (351/34 772) and 1.45% (435/30 002) respectively. Significant differences were noticed in the unqualified rates of HBsAg, anti-HCV, anti-TP, HIV Ab/Ag, ALT and HBV DNA (P0.05) among the five cities. 【Conclusion】 Centralized blood screening at provincial-level in Ningxia can optimize the allocation of laboratory resources and better ensure blood safety, which is of great significance to the construction of urban public health system in Ningxia.

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