2007-2011年湘西州艾滋病确证实验室HIV阳性检测结果分析

目的分析湘西土家族苗族自治州2007-2011年艾滋病病毒（HIV）筛查及确证试验的检测数据,以了解该州艾滋病的流行特点和HIV感染的人群特征,以及不同人群的感染率,为制订防控策略提供科学依据。方法依照《全国艾滋病检测技术规范》（2004年版、2009年版）对送检样品进行检验,对实验室确证数据进行统计分析。结果 2007-2011年全州HIV初筛标本305 255份,初筛阳性748份,经确证实验室确诊为阳性的442份,阴性279份,不确定27份;监测人群HIV平均阳性率为0.14%,以2008年的阳性率最高,为0.18%（95/54 113）,各年度筛查确证阳性率差异有统计学意义。442份HIV阳性标本中,男性289例（65.38%）,女性153例（34.62%）,男女性别比例为1.89∶1。年龄主要集中在31～55岁（占44.1%,195/442）和55岁以上（占37.8%,167/442）。结论湘西州HIV感染者男性多于女性,主要以大年龄组居多。自愿咨询检测是发现HIV感染的最重要方式。     

南昌地区无偿献血人群HIV-1感染状况及特征分析

目的调查近5年南昌地区无偿献血人群1型艾滋病病毒(HIV-1)感染状况,描述感染者特点,为本地区降低HIV经输血传播风险,制定有效献血者招募及艾滋病防控策略提供数据支持。方法无偿献血者血液标本采用酶联免疫吸附试验(ELISA)方法进行抗-HIV初复检筛查,ELISA初筛阴性标本用核酸检测(NAT)方法检测艾滋病病毒核糖核酸(HIV RNA),抗-HIV或HIV RNA反应性标本用蛋白印迹试验(WB)方法进行确证。统计2014-2018年南昌地区献血者HIV抗体检出率,整理分析HIV-1感染者人口学特征及流行病学资料。结果 2014-2018年南昌地区无偿献血者HIV-1型抗体确证阳性57例,HIV抗体不确定30例,抗体检出率0.018%。ELISA-/NAT+1例,WB鉴定为HIV抗体不确定。57例感染者中,男性占98.25%;21～30岁青年人占40.35%;未婚占64.91%;本科文化占33.33%;本市(县区)户籍占43.86%;高校学生占40.35%;初次献血占75.44%,捐献全血占96.49%;男男同性性传播占52.63%,异性性传播占43.86%;合并梅毒感染占14.04%。HIV-1型抗体阳性标本出现WB特异性条带gp160、gp120、p24均占100%,p66占96.49%,gp41占91.23%,HIV抗体不确定标本出现条带p24占66.67%,gp160占36.67%。结论近5年南昌地区无偿献血人群中HIV-1感染者以初次捐献全血的高校青年男男性行为者(MSM)为主。应采用先进的检测方法和试剂开展HIV筛查,保证血液安全。     

庆阳市无偿献血人群HIV感染状况分析

目的分析甘肃省庆阳市无偿献血者HIV感染状况,为规范采供血管理制度、确保临床用血安全提供科学依据。方法依据《庆阳市中心血站无偿献血者健康状况征询表》和庆阳市疾病预防控制中心对HIV确证阳性者的建档资料,回顾性分析2011—2018年庆阳市无偿献血者HIV感染趋势及流行病学特征。结果 2011—2018年庆阳市无偿献血检测样本144 205份,HIV确证阳性15例,阳性率10.40/10万,其中男性占93.33%,40岁～组占40.00%,本地区户籍占86.67%,高中及以下学历占73.33%,首次献血者占93.33%,已婚占93.33%,合并感染占30.07%;不同户籍(χ2=30.784 6)、性别(χ2=4.272 2)、婚姻状况(χ2=9.537 0)和献血次数(χ2=9.376 0)无偿献血者HIV抗体阳性率差异有统计学意义(P0.05)。结论庆阳地区无偿献血人群HIV抗体阳性率低于全国大部分城市;应加大人群艾滋病防治知识的宣传教育,完善献血招募政策,提高HIV检测水平,努力建立一支低危、稳定的无偿献血队伍。     

兰州地区输血传播HIV残余风险评估

目的调查兰州地区无偿献血者HIV的感染情况,评估ELISA和核酸(NAT)筛查后经血传播HIV的残余风险。方法收集2013-2018年兰州地区无偿献血者HIV检测结果,统计HIV确证阳性人数,分析初次献血者和重复献血者阳性人群特征,用发病率-窗口期模型对输血传播HIV的残余风险进行评估。结果兰州地区无偿献血者HIV确证阳性率为0.033%,确证阳性人群以中青年男性为主。兰州地区输血传播HIV的总残余风险为6.54×10~(-6),初次献血者HIV残余风险是6.97×10~(-6),重复献血者HIV残余风险是4.22×10~(-6)。结论兰州地区输血传播HIV的残余风险略高于全国整体水平,重复献血者残余风险小于初次献血者,需进一步采取有效措施,提高重复献血率,降低无偿献血者HIV确证阳性率,保障血液质量,降低兰州地区输血传播HIV的残余风险。     

2010-2013年宁夏灵武市艾滋病检测结果分析

目的了解宁夏灵武市HIV抗体在人群分布情况,为制定防治策略提供科学依据。方法 2010-2013年HIV抗体初筛实验室选择酶联免疫吸附试验(ELISA);初筛点选择快速检测试验(RT)。结果 2010-2013年HIV抗体检测累计59 328人次,发现艾滋病感染者和患者13例,医疗机构检测阳性率1.64/万,重点人群检测阳性率2.56/万,羁押人群检测阳性率19.90/万,性传播途径占发现阳性总数的84.6%,崇兴镇、郝家桥镇、白土岗乡占阳性总数的69.23%。结论灵武市HIV抗体阳性率较低,重点人群及羁押人群为重点检测对象,加强崇兴镇、郝家桥镇、白土岗乡等地区性传播途径预防干预措施。     

甘肃省天水市HIV抗体确证阳性结果分析

目的了解甘肃省天水市艾滋病患病人群中HIV初筛阳性样本的确证阳性情况,为艾滋病的预防和干预提供依据。方法对2010─2016年天水市所有初筛阳性样本进行复检和确证,确证实验采用免疫印迹法(WB)。结果2010─2016年对天水市送检的726份初筛阳性标本进行确证,确证阳性标本569份,其中术前及门诊病例265例、MSM(男男同性恋者)108例、自愿咨询检测(VCT)92例;阳性率由2010年的0.35‰上升至2016年的0.57‰,差异有统计学意义(趋势χ~2=10.902,P0.05);确证病例中男性473例、占83.13%,女性96例、占16.87%,差异有统计学意义(χ~2=18.180,P0.05)。结论天水市HIV初筛阳性样本确证阳性率逐年升高,确证阳性病例以男性、术前及门诊和MSM为主,应针对重点人群,采取综合性干预措施。     

东莞市无偿献血人群HIV感染者流行病学特征分析

目的:了解东莞市无偿献血者人类免疫缺陷病毒(HIV)感染的特征及途径,为低危献血者招募服务。方法:对2012-2013年东莞市无偿献血者标本HIV传染性标志物进行检测,对有反应性标本送疾病预防控制中心进行确证,统计HIV确证阳性数;对确证HIV感染者进行告知和首次随访,分析HIV感染者流行病学特征,包括性别、年龄、学历、职业、感染途径。结果:2012-2013年HIV的感染率分别为0.049%和0.056%;感染者绝大部分为男性,占94.0%,女性感染者占6.0%,男女性别比为15.6∶1.0;感染者中年龄以21~30岁阶段为主,占45.8%,31~40岁,占33.7%,18~20岁和41~50岁分别占6.0%和14.5%,51~60岁阶段无感染者;感染者中初中及初中以下学历者比例最高,占43.3%,高中及中专学历者占41.0%,大专及大专以上学历者占15.6%;感染者职业主要为普通务工者,占68.7%,商业、服务行业者占16.9%,学生占1.2%,医务工作者占3.6%,其他职业占9.6%;感染途径全部为性传播,其中以异性性传播为主,占55.4%,男男同性性传播占31.3%,同时有异性性行为和男男同性性行为者占13.3%,未出现女女同性性传播案例。结论:东莞市无偿献血人群HIV感染者呈多年龄段、多职业人群分布状态,感染途径为性传播,特别是男男同性性传播形势严峻,应针对性的加强献血前问询和对高危献血人群的排查,以减少经输血传播HIV的风险。     

街头献血人群与集体献血人群HIV感染状况分析

目的探析街头献血人群与集体献血人群HIV感染状况,为更好地开展无偿献血招募工作和确保血液安全提供科学、合理的依据。方法选择我市2012年1月至2015年1月期间经ELISA法筛查的无偿献血者标本80289份作为研究标本,其中HIV Ag/Ab阳性标本26份,26份样本均经免疫印迹法(WB)确证,收集上述阳性患者的资料,探讨分析HIV感染情况和感染的人群特征。结果街头献血人群中2013年HIV感染率显著高于2012年与2014年,比较均有统计学意义(P0.05);2012年与2014年HIV感染率比较无统计学意义(P0.05)。集体献血人群中2014年度HIV感染率显著高于2012年与2013年,比较均有统计学意义(P0.05);2012年与2013年HIV感染率比较无统计学意义(P0.05)。2组间HIV总感染率比较有统计学意义(P0.05)。街头献血人群中的重复献血的HIV感染率高于首次献血,有可比性(P0.05);集体献血人群中的重复献血的HIV感染率高于首次献血,有可比性(P0.05)。说明重复献血感染HIV的可能性更高,因此应加强对重复献血者HIV相关知识的宣传教育。结论近年来,我市HIV感染率与往年相比呈明显上升趋势,应普及无偿献血和预防艾滋等传染性疾病的相关知识的宣传教育,加强接头流动献血的健康询问工作,减少经输血传播HIV的风险,确保血液安全。     

南昌地区青年学生献血人群输血相关传染病标志物检测结果分析北大核心CSCD

目的 了解南昌地区青年学生无偿献血人群经血传播病原体感染（TTI）状况及血液质量，为开展学生健康宣教、疾病防控及优化低危献血者招募策略提供数据支持。方法 采用速率法检测无偿献血血液标本ALT，采用ELISA双试剂检测HBsAg、抗-HCV、人类免疫缺陷病毒1型/2型抗体和p24抗原（抗-HIV/HIV Ag）、梅毒螺旋体特异性抗体（抗-TP）。HBsAg、抗-HCV、抗-HIV/HIV Ag、抗-TP筛查阴性标本采用核酸检测HBV DNA、HCV RNA及HIV RNA。以相同时期社会其他献血人群作为对照组，通过启奥血站管理信息系统统计南昌地区2019-2022年青年学生献血人群、社会其他献血人群输血相关传染病标志物检测不合格数据。通过中国疾病预防控制信息系统收集2019-2022年江西省血液中心报告的青年学生献血者HIV感染病例资料。结果 南昌地区2019-2022年大中专院校学生无偿献血者177 232人次。青年学生献血人群输血相关传染病标志物筛查总不合格率（1.53%）低于社会其他献血人群（1.92%）（χ2=74.33,P<0.01）；学生献血人群输血相关传染病标志物不合格率由高到低依次为ALT(1.02%)、抗-TP(0.16%)、HBsAg/HBV DNA(0.15%)、抗-HCV/HCV RNA(0.13%)、抗-HIV/HIV Ag/HIV RNA(0.08%)；男性学生总不合格率（1.98%）高于女性学生（0.84%）（χ2=365.13,P<0.01）；不同学历学生总不合格率由高到低依次为大学专科（1.72%）、中职（1.66%）、研究生（1.44%）、本科（1.38%）（χ2=33.08,P<0.01）;HIV确证学生感染者12例，其中10例感染途径为男男同性性传播。结论 南昌地区青年学生人群血液安全性高于社会其他人群。艾滋病、梅毒在学生人群中流行情况需引起高度重视。加强大中专院校学生献血知识普及和健康宣教，促进学生团体献血事业持续向好发展。     

2008-2012年太原市无偿献血者梅毒及HIV感染状况分析

目的分析太原市无偿献血者梅毒及HIV感染状况,为招募低危献血者提供科学依据。方法采用酶联免疫吸附试验（E1．ISA）检测太原市2008-2012年无偿献血者血浆标本梅毒抗体和HIV抗体,分析梅毒及HIV感染年度、性别、年龄、文化程度及职业分布。结果太原市2008～2012年无偿献血者血液标本共389796份,梅毒抗体阳性2277例,阳性率为0．584％,年度阳性率差异有统计学意义（χ2=22．63,P〈0．01）,但变化无规律;女性阳性率为0．661％,男性阳性率为0．549％,差异有统计学意义（χ2=18．28,P〈0．01）,男性41～50岁和女性31～40岁抗体阳性率最高;职业分布以农民和工人阳性率较高,分别为1．028％和0．645％,不同职业人群差异有统计学意义（χ2=248．84,P〈0．01）;初中及其以下学历者梅毒阳性率最高,为0．877％,不同文化程度人群阳性率差异有统计学意义（χ2=213．57,P〈0．01）。2008～2012年无偿献血者HIV抗体阳性80例,阳性率为0．021％,呈逐年上升趋势;男性阳性率为0．029％,女性为0．015％,差异有统计学意义（χ2=28．82,P％0．01）,且男性阳性率随年龄增长而降低;不同职业及文化程度人群HIV阳性率差异无统计学意义（P〉O．05）。无偿献血者5年平均梅毒一HIV合并阳性率为0．005％,全部为男性,占男性梅毒抗体阳性者的1．29％。结论太原市无偿献血者HIV抗体阳性率较低但有增高趋势,梅毒5年阳性率较高但无变化规律。梅毒、HIV对血液安全仍造成威胁,应加强对农民、工人及文化程度较低等高危人群献血前的征询。     

成都地区健康人群血常规各参数参考值范围的调查

目的了解成都地区健康人群血常规各参数的正常参考值范围。方法 2007.10-2008.07在我院体检的不同年龄(儿童和成人)、不同性别(男女)、不同采血方式(全血和末梢血)的健康人群共22178人,于清晨空腹抽取静脉血2mL或手指末梢血40μL(儿童),应用深圳迈瑞公司BC-5500型全自动血液分析仪进行检测,检测项目包括:红细胞(RBC)、白细胞(WBC)、血红蛋白(Hb)、红细胞比容(HCT)、红细胞平均体积(MCV)、红细胞平均血红蛋白含量(MCH)、红细胞平均血红蛋白浓度(MCHC)、血小板(PLT)、红细胞体积分布宽度(RDW)、血小板体积分布宽度(PDW)、血小板平均体积(MPV)、血小板压积(PCT)、中性粒细胞百分率(NEU%)、淋巴细胞百分率(LYM%)、单核细胞百分率(MON%)、嗜酸性粒细胞百分率(EOS%)、嗜碱性粒细胞百分率(BAS%)等23项指标,剔除离群点后,采用SPSSl1.5软件进行统计分析。结果本调查的血常规各参数呈非正态分布,男性和女性参考值间有显著性差别(P<0.01),成人和儿童之间有显著性差别(P<0.01),儿童全血和末梢血之间有显著性差别(P<0.01),成都地...     

The blood donation experience: self-reported motives and obstacles for donating blood

Background and Objectives The aim of the study was to investigate motives for donating blood as well as difficulties and obstacles associated with blood donation as perceived by the donors themselves. Materials and Methods Six hundred consecutive blood donors (i.e. all blood donors with a history of at least one previous whole blood donation attending, during nine working days, the Blood Centre of Umeå University Hospital) received a self‐administered questionnaire that contained questions aimed at elucidating motives for donating blood (general motives for donating blood, specific motives for the first donation and motives for continuing to be an active blood donor). Questions concerning difficulties and obstacles that had to be overcome in order to continue being a blood donor were also included in the questionnaire. Results Altogether 531 whole blood donors filled in the questionnaire (88·5%; 322 men and 209 women). No statistically significant differences were found between male and female blood donors concerning general reasons and motives related to donating blood. The most frequently reported reasons for giving blood the first time were ‘influence from a friend’ (47·2% of donors) and ‘request via media’ (23·5% of donors). Among general reasons/motives with highest ranking of importance, the most commonly reported motive for donating blood were ‘general altruism’ (40·3%), ‘social responsibility/obligation’ (19·7%) and ‘influence from friends’ (17·9%). General altruism’ and ‘social responsibility/obligation’ were also the most frequent reasons for continuing to donate blood (68·4 and 16·0%, respectively). The most commonly reported obstacle to becoming a regular blood donor was ‘laziness’ (19·1%) followed by ‘fear of needles’ (10·5%). Conclusions Altruism was the most common general motive for donating blood and also for continuing to be an active blood donor. Yet, for the first blood donation, direct ‘influence from friends/relatives’, ‘media appeal’ and other types of recruitment were more commonly reported as reasons or motives for donating blood than altruism. The findings support the notion that different strategies should be used/adopted to get people to donate blood the first time (e.g. recruitment through other blood donors using, for example, the ‘bring a friend along’ method) and to retain these subjects as active blood donors (e.g. by information and by strengthening their sense of being a blood donor or their self‐efficacy etc.).     

Overview of blood pressure measurement by Brazilian health professionals

Although automated monitors for blood pressure (BP) measurement are used increasingly worldwide, understanding of how such devices are used in Brazil is low. This study analyzed the status of BP measurement by Brazilian health professionals. A questionnaire regarding experience with BP measurement was sent electronically to Brazilian nurses, nursing assistants, and doctors. It had 2004 responses. Previous experience with use of automated monitors was most frequent in men (71.2%), nursing technicians (65.5%), specialists (61.1%), secondary care (71.9%), emergency care (70.6%), or the private sector (66.3%). The least complied aspects of the standardized measurement protocol were availability of various cuff sizes (53.9% and 72.9% for auscultatory and oscillometric methods, respectively) and proper calibration checks (21.5% and 46.8% for auscultatory and oscillometric methods, respectively). Brazilian health professionals report not adequately performing all the necessary aspects to measure BP in accordance with the standardized protocol in both methods, but mainly regarding the oscillometric.     

天津地区某教学医院职工ABO、Rh血型分布调查

目的:调查天津地区某教学医院职工的血型分布特征,建立血型档案,为日后职工安全供输血提供理论依据。方法:通过应用血清学正反定型、ABO基因分型试验等方法检测该院1 287位职工的ABO血型、使用单克隆IgM抗D血清鉴定Rh(D)血型。结果:ABO血型中A型占28.7%,B型占31.5%,O型占28.6%,AB型占11.2%,血型分布特征为BAOAB。Rh(D)阴性血型11人,阴性率0.85%。3例ABO正反定型不符,其中2例基因分型检测鉴定结果为B(A)型;另外1例为B型,NN,有抗M抗体存在。结论:根据本研究,建立健全了职工血型档案,了解了该院职工的血型分布特征,明确检测ABO正反定型的重要性,防止亚型及有意义不规则抗体对血型鉴定的影响,确保ABO、Rh血型定型结果的准确。     

2007—2012年我院临床用血分析

输血是临床治疗和抢救生命的重要手段之一,在临床治疗中是其他治疗方法和药物无法替代的。近年来,我国的输血事业取得了突飞猛进的发展,但仍存在着一些不足。随着用血量的增加,采供血矛盾也日益加深,尤其个别地区还出现了“血荒”,因此,充分发挥输血科的职能,科学合理用血显得尤为重要。现对我院2007—2012年临床用血情况进行分析,报告如下。     

襄阳地区无偿献血后免费用血情况调查分析

目的:回顾性调查襄阳市2006-2013年无偿献血者用血返还情况,预测未来免费用血发展趋势。方法:对8年以来无偿献血者用血返还情况进行收集、整理、统计。结果:无偿献血者用血返还金额在未来可能呈快速增长趋势。结论:建议加大财政对无偿献血工作的经济投入,减轻血站的用血返还压力,进一步促进无偿献血事业的健康持续发展。     

The use of cord blood for transfusion purposes: current status

Although the use of umbilical cord blood (UCB) for transfusion purposes has been proposed decades ago, the employ is still limited. In this article we review studies evaluating UCB collection efficiency and sterility, examine processing and storage of UCB-derived red blood cells (RBC) and discuss clinical studies in which UCB was used for transfusion purposes.
Efforts to provide preterm newborns with autologous RBC derived from UCB have not been very successful. UCB collected after full-term deliveries can however easily be processed into RBC products and could be used autologous in case surgery of the neonate is indicated early after birth, or for allogeneic small volume paediatric transfusions. To harvest enough UCB volume, immediate clamping of the umbilical cord is commonly used as standard practice. Although delayed cord clamping has shown to improve the iron status in full-term infants; for small-for-gestational-age infants this has not been demonstrated. In addition, an increased need for phototherapy after delayed clamping exists. Altogether, we could find no disencouraging evidence to collect UCB, which could be processed into an easily available RBC product for paediatric transfusion in resource-restricted countries.     

Haemophilia therapy: assessing the cumulative risk of HIV exposure by cryoprecipitate

Most of the world's haemophilia population live in countries with developing or emerging economies. As such, they do not have access to viral inactivated clotting product. Many are treated with cryoprecipitate made from locally supplied blood. The rationale for using cryoprecipitate instead of viral inactivated products is based on an implicit belief that because blood banks can provide reasonably safe products by using modern testing procedures, transmission of HIV and other blood-borne viruses is rare. However, the risk of acquiring a blood-borne infection is cumulative, and haemophilia patients treated with cryoprecipitate or fresh-frozen plasma are exposed to hundreds or thousands of donors during their lifetime. The risk that an HIV-infected person will be a donor during the 'window period' is directly related to the incidence of HIV in the country where the donation occurs. To illustrate the extent of this problem, we devise a model for estimating the risk that a person with haemophilia will encounter HIV-contaminated cryoprecipitate as a function of years of treatment and the underlying incidence rate of HIV among blood donors. We apply the model to two countries with different incidence rates of HIV, Venezuela and the USA. Over a lifetime of treatment (60 years), the cumulative risk of HIV exposure for a person with haemophilia receiving monthly infusion of cryoprecipitate prepared from plasma of 15 donors is significant, 2% in the USA and 40% in Venezuela. Considering the cumulative risk for transmitting HIV to patients with haemophilia through cryoprecipitate treatment, medical care providers should carefully evaluate the use of cryoprecipitate in any but emergency conditions or when no virally inactivated products are available.