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【Objective】 To establish a magnetic bead enrichment strategy for the detection of human immunodeficiency virus deoxyribonucleic acid (HIV DNA) in peripheral blood, and to verify the improvement of the sensitivity of this method for the detection of HIV DNA in HIV infected patients after early antiretrovital treatment (ART). 【Methods】 Peripheral whole blood was collected at 4 timepoints in one ART HIV window period (WP) patient. Peripheral blood mononuclear cells (PBMCs) were isolated on a Ficoll gradient. CD4+ T lymphocytes were enriched from total PBMCs by negative sorting. HIV DNA concentration in magnetic beads enriched group and whole blood group was detected by HIV DNA detection kit. 【Results】 CD4+ T cells were isolated by magnetic beads and identified by FCM for purity at (96.4 ± 2.6)%. The viability was (95.9 ± 2.9)%, as demonstrated by trypan blue staining. The person on continued ART treatment in this study had significantly greater reduction in HIV viral load and undetectable HIV plasma RNA at follow up timepoint 4. No HIV DNA was detected in the whole blood group at all 4 timepoints. The quantitative results of HIV DNA in the CD4+ T lymphocyte group of the magnetic bead enrichment group were 73.4, 429.3, 137.1, 449.9 copies/106 CD4+ T cell′s respectively. 【Conclusion】 The magnetic bead enrichment method can be more sensitive in detecting the limit low copy HIV DNA in blood samples, and provide early confirmatory data for HIV WP infection and breakthrough infection after ART treatment.
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【Objective】 To analyze the SARS-CoV-2 detection results among blood donors in different periods of COVID-19 pandemic control in Shenzhen and assess the antibody levels and infection status of blood donors in different periods, so as to provide reference for subsequent blood testing strategies. 【Methods】 A total of 4 768 plasma samples of blood donors were subjected to pooled testing by nucleic acid testing(NAT) with 8 samples per pool. Additionally, these samples were subjected to a 1000-fold dilution, and the detection of SARS-CoV-2 total antibody was performed by enzyme-linked immunosorbent assay (ELISA). The 4 768 plasma samples were collected from blood donors at different time points in Shenzhen, with inquiries made to determine whether donors during the COVID-19 pandemic were in the convalescence. The antibody positive rates in blood screening samples during different periods of the pandemic and samples from individuals in the convalescence of COVID-19 infection were analyzed. Furthermore, the antibody levels were examined for differences based on gender, age, and blood type. 【Results】 All 4 768 plasma samples from blood donors were negative by NAT, while 2 342 samples were detected positive by the SARS-CoV-2 total antibody detection, with a positive rate of 49.1%. These samples from four periods (September 30 to October 3, 2022; November 3 to 6, 2022; December 27 to 31, 2022; January 6 to 18, 2023) were subjected to a 1 000-fold dilution for COVID-19 antibody detection, and the positive rates were 21.3%, 15.8%, 65.9%, and 93.9%, respectively. 【Conclusion】 The prevalence of COVID-19 antibodies among blood donors in Shenzhen during different periods of the pandemic varied significantly. There was no difference in antibody prevalence among different genders and blood types, while younger individuals exhibited a higher prevalence of antibodies. The risk of COVID-19 transmission through blood transfusion was found to be extremely low.
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【Objective】 To analyze the results of different methods for reactive samples screened by the enzyme linked immunosorbent assay (ELISA) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in blood donors. 【Methods】 From March to April 2020, a total of 8 632 blood samples in Shenzhen were screened for SARS-CoV-2 total antibodies (TAb, including IgG, IgM, IgA) in plasma using ELISA(PC group), the antibody reactivity samples and their follow up plasma samples (FC group), and samples of disease control group(DC group) from January to April 2020 were detected using the following methods: 1) ELISA method for detecting IgG, IgM, and (or without detection) TAb; 2) pseudovirus neutralizing antibody test(pVNT); 3) western blot (WB) of SARS-CoV-2 antibody. The negative control group(NC group) from February to April 2020 performed ELISA and WB testing. 【Results】 Among the 34 total antibody positive samples, 2 were positive for pVNT test, and the total antibody, IgG and WB in the initial screening and tracking testing were positive. Thereafter, it was determined to be confirmed positive. The other 2 cases were positive for pVNT test, while the samples with positive WB results were in the follow-up stage. The TAb, IgG, and pVNT results did not conform to the dynamic evolution of antibodies, and cannot be determined as confirmed positive. 【Conclusion】 The infection status of antibody reactivity samples screened by SARS-CoV-2 ELISA can be judged by the logic of pVNT, WB and the dynamic change of antibody.
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Objective:To investigate the level change of serum total n-terminal propeptide of type Ⅰ precollagen (t-PINP) /type Ⅰ collagen carboxy-terminal peptide (beta-CTX) ratio, 25-hydroxyvitamin D (25-hydroxyvitamin D, 25 (OH) ) ratio, and 25-hydroxyvitamin D in elderly women with differentiated thyroid cancer (DTC) after surgery and its value in the prevention and treatment of osteoporosis (OP) .Methods:From Jan. 2020 to May. 2021, 112 elderly female postoperative DTC patients treated with thyroid stimulating hormone (TSH) suppression in Department of Endocrinology of Wenzhou Hospital of Integrative Medicine were collected for a prospective study, and the incidence of OP after 1 year of treatment was counted, and according to the incidence of OP, they were divided into incidence group ( n=78) and non-incidence group ( n=34). The general information, thyroid parameters [TSH, free triiodothyronine (FT3), free thyroxine (FT4) ], bone mineral density (BMD), and serum t-titrosine (BMD) were compared between the two groups. SPSS22.0 software was used, and the counting data was described by examples χ2 test. Grade data was expressed in u, Ridit test was used, measurement data was described in mean±standard deviation ( ±s), t test was used, Pearson correlation coefficient model was used to analyze postoperative thyroid index and serum t-PINP/β- Correlation between CTX ratio and 25 (OH) D level, and serum t-PINP after 1 year of treatment was analyzed through interaction/β- The role of CTX ratio and 25 (OH) D level in OP occurrence. Results:The incidence of OP after 1 year of TSH suppression treatment in 112 elderly female post-DTC patients in this study was 69.64% (78/112) ; serum TSH levels (0.63±0.19) mIU/ml after 1 year of treatment in patients who developed OP were lower than those in patients who did not develop OP (0.81±0.22) mIU/ml, and serum FT3 (6.15±1.71) pmol/ml and FT4 levels (24.63±4.28) pmol/ml were higher than those of patients without OP (4.32±1.29) pmol/ml and (20.36±3.70) pmol/ml ( t1=4.391, t2=5.581, t3=5.050,all P<0.05) .Serum t-PINP/β-CTX ratio (130.27±18.09) and 25 (OH) D level (20.18±4.15) ng/ml after 1 year of treatment in patients with OP were lower than those in patients without OP (148.56±20.37) and (23.36±4.36) ng/ml ( t1=4.733, t2=3.672, both P<0.05) ; serum TSH levels were positively correlated with serum t-PINP/β-CTX ratio and 25 (OH) D levels, and serum FT3 and FT4 levels were negatively correlated with serum t-PINP/β-CTX ratio and 25 (OH) D levels after 1 year of treatment in patients with OP ( P<0.05) ; low serum t-PINP/β-CTX ratio after 1 year of treatment expression, and low 25 (OH) D levels showed a positive interaction in OP occurrence in a superphase multiplicative model ( P<0.05) . Conclusion:Serum t-PINP/β-CTX ratio and 25 (OH) D level are closely associated with the occurrence of OP after DTC in elderly women, and postoperative monitoring can help prevent and treat OP.
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【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.
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【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.
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【Objective】 To study the molecular mechanism of 9 samples with rare RhD variants and their RhD epitopes and protein structure. 【Methods】 The 9 blood samples with rare RhD variants were collected from 210 644 blood donors of Shenzhen Blood Center. Regular serological assaying was used for determination of Rh type for the 9 samples. Indirect anti-human globulin test (IAT) was used to confirm the RhD antigen and to screen the antibodies. D-screen reagent was sued to analyze the RhD epitopes of the samples. RHD zygosity testing of the samples was detected by PCR-SSP. The nucleotide sequences of all 9 exons and adjacent flanking intron regions of RHD gene were sequenced. The prediction of the effects of mutations on RhD protein function were analyzed using PROVEAN, SIFT, PolyPhen-2 and MutationTaster software. Robetta and Swiss-PdbViewer 4.1.0 were used for modeling the tertiary structures of RhD. 【Results】 A total of 9 individuals with rare RhD variants were identified as follows: RHD*weak D type 25, RHD*weak D type 50, RHD*weak D type 95, RHD*weak D type 12, RHD*weak D type 128 and four novel RHD alleles. The prediction of the tertiary structures showed that the RhD protein conformation was disrupted in the 9 rare RhD variants samples. 【Conclusion】 Five rare and four novel RHD alleles have been identified. Their phenotypic and genotypic descriptions enrich the database of reported RHD alleles. Bioinformatics analysis provided evidences for further study of the structure and functions of RhD protein.
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【Objective】 To evaluate the performance and clinical application of a high-throughput nucleic acid blood screening detection system for SARS-CoV-2, so as to provide basis and technical means for its application in detection of plasma from recovered COVID-19 patients. 【Methods】 The SARS-CoV-2 nucleic acid was detected by real-time fluorescence quantitative PCR, and the sensitivity, precision, anti-interference and other parameters were evaluated. Blood donor samples collected during COVID-19 epidemic period were screened using the detection system to evaluate its applicability. 【Results】 The detection limits of gene N and ORF 1ab were 3.98 copies/mL and 9.38 copies/mL, respectively. The CV of high and low concentration samples were both less than 5%. Hemoglobin at 500 mg/dL and triglyceride at 3g/dL had little effect on the results. The detection system can effectively prevent carryover, thus avoiding false positive results. The SARS-CoV-2 nucleic acid blood screening was carried out in a total of 39 306 blood samples, and all samples were negative. 【Conclusion】 The established method can meet the needs of SARS-CoV-2 nucleic acid screening therefore ensure the safe application of plasma from recovered COVID-19 patients.
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【Objective】 To assess three severe acute respiratorysyndrome coronavirus 2 (SARS-CoV-2) enzyme linked immunosorbent assays (ELISA) and one pseudotype lentivirus-based neutralization test (ppNAT) in detecting the convalescent plasma antibody levles from COVID-19. 【Methods】 30 COVID-19 convalescent plasma samples were screened for antibodies against SARS-CoV-2 using three kinds of SARS-CoV-2 ELISA reagents and one ppNAT test in Shenzhen. The controls consisted of plasma samples from 32 healthy blood donors in February 2019. The diagnostic efficacy analysis of various SARS-CoV-2 ELISA reagents was performed using real-time fluorescent Polymerase Chain Reaction (RT-PCR). We also analyzed correlation between different immunological reagents and the age, gender, hospitalization, and severity of illness. 【Results】 The positive yielding rate of ppNAT and three kinds of IgG ELISA was higher than that of IgM ELISA. The positive yielding rates of three kinds of IgG ELISA were 100%(30/30), 93.33%(28/30), and 96.67%(29/30) respectively, while the yielding rates in control group were all 0. The positive yielding rate of three IgM ELISAs were 93.33%(28/30), 70%(21/30)and 46.67% (14/30). All the cases from negative control group were negative for IgG and IgM. Pearson correlation coefficient was calculated; there was a strong correlation between ELISA reagent 2 IgG and ELISA reagent 3 IgG (r=0.765, P0.05). 【Conclusion】 In the convalescent plasma with nucleic acid confirmed covid-19, the yielding rates of different IgM antibodies varied greatly. Antibody levels were influenced by age to some extent.
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【Objective】 To analyze the viability of 2 different blood screening strategies against SARS-CoV-2 in low risk populations, so as to provide references for the formulation of blood screening strategy. 【Methods】 Two screening strategies for antibodies against SARS-CoV-2 were adopted: 1) the total antibody were initially screened for all samples, and the antibody IgG and IgM were retested in those primary positive samples; 2) only antibody test of IgG and IgM for all samples. And SARS-CoV-2 nucleic acid was detected in parallel. Reactive samples was confirmed by neutralization test. The sensitivity, specificity and true positive rate of two strategies were calculated. 【Results】 None was positive for SARS-CoV-2 nucleic acid among 880 samples. Four truly positive samples were implicated in 9 (1.02%, 9/880) initially reactive samples in total antibody test; 3 in 26 (2.95%, 26/880) initially IgG or IgM reactive samples. 【Conclusion】 The first strategy is superior to the second strategy in the sensitivity and specificity, and is recommended for the detection of SARS-CoV-2 antibody in low risk populations.
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【Objective】 To validate the performance of enzyme-linked immunosorbent assay (ELISA) for the detection of antigens and antibodies for blood-borne diseases, so as to meet the requirements of blood screening laboratories. 【Methods】 The reproducibility, precision, sensitivity, specificity, conformance and detection limit of ELISA reagents under different detection procedures were verified according to relevant standards and reagent instructions. 【Results】 The performance verification results of the test procedures were in line with the relevant standards and laboratory requirements. 【Conclusion】 The performance of ELISA method can meet the relevant standards and requirements, as well as the application requirements of the laboratory. Through the analysis and comparison of the performance verification data, the blood screening laboratory can better understand the performance indicators of the detection system, continuously improve the performance of the detection system, and ensure the safety of clinical blood use.
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【Objective】 To track and evaluate the clinical diagnostic efficacy of an enzyme linked immunosorbent assay (ELISA) kit for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). 【Methods】 Total antibody (TAb) specific to SARS-CoV-2 in blood donors were determined using ELISA reagent. TAb positive donors were followed up 1 month after blood donation. SARS-CoV-2 specific IgG, IgM and pseudotype lentivirus based neutralization test (ppNAT) were conducted for TAb positive blood donors and follow-up samples. ppNAT and IgG antibodies simultaneously positive in ppNAT positive samples and its follow-up samples was used as the standard for antibodies validation. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy and Youden index of SARS-CoV-2 TAb ELISA were analyzed. 【Results】 Among 16 016 blood donors from January 31 to April 28, 2020, 61 donors were diagnosed as TAb positive, 6 cases were positive for ppNAT, in which 2 were positive for both ppNAT and IgG; 4 of 46 TAb positive follow-up samples were positive for ppNAT, in which 2 were positive for IgG simultaneously. The sensitivity, specificity, PPV, NPV, accuracy, Youden index, false positive rate and false negative rate of SARS-CoV-2 TAb reagent were 100.00%, 99.60%, 3.28%, 100.00%, 99.60%, 99.60%, 0.40% and 0.00%, respectively. 【Conclusion】 SARS-CoV-2 TAb ELISA has high sensitivity and good clinical diagnostic efficacy, but the false positive rate is relatively high in low-risk blood donors. Therefore, ppNAT, IgG and follow-up results should be fully considered in clinical in order to analyze the positive results and determine the infection status more accurately.
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Objective:To investigate the efficacy and safety of anlotinib in the treatment of advanced gastric cancer.Methods:Eighty patients with advanced gastric cancer in Longhua District Central Hospital of Shenzhen City from February 2015 to May 2016 were selected. The patients were randomly divided into anlotinib group (anlotinib 12 mg) and placebo group by random number table method. The anlotinib or placebo was given once a day for two weeks and discontinued for one week, and three weeks were a course of treatment. The relief situation, total survival time as well as adverse reactions after treatment of all patients were compared between the two groups.Results:The remission rate in the anlotinib group was higher than that in the placebo group [61.6% (37/60) vs. 5.0% (1/20)], and the difference was statistically significant ( χ2 = 19.315, P < 0.05). The overall survival time of the anlotinib group was longer than that of the placebo group [(22.8±1.0) months vs. (10.3±0.9) months], and the difference was statistically significant ( P < 0.01). The adverse reactions mainly included hypertension, diarrhea, nausea and vomiting, liver damage, etc. The adverse reactions were mild, and no drug-related deaths occurred. There was no statistically significant difference in the incidence of adverse reactions between the two groups (all P > 0.05). Conclusion:Anlotinib is effective and safe in the treatment of advanced gastric cancer.
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Objective:To study the effect of ultrasonic guidance in radial artery catheterization.Methods:From January 2017 to January 2018, 100 patients who received surgical treatment in Taizhou Central Hospital of Zhejiang Province and needed puncture and catheterization anesthesia during operation were randomly divided into control group ( n=50) and observation group ( n=50) according to digital table method.The control group adopted the traditional touch pulse method, while the observation group was guided by ultrasound.The first puncture success rate, the second puncture success rate, puncture time, puncture times, the vital sign index, incidence of adverse events, pain score, comfort score were compared between the two groups. Results:The first puncture success rate (80%) and the second puncture success rate (100%) of the observation group were higher than 62% and 88% of the control group (χ 2=3.934, 6.383, all P<0.05). The single puncture time [(59.85±8.31)s] and total puncture time [(107.14±35.37)s] of the observation group were shorter than those of the control group ( t=5.766, 6.398, all P<0.05), and the puncture times [(1.27±0.54) times] of the observation group was less than that of the control group ( t=5.689, P<0.05). After puncture, the heart rate [(73.79±2.46)times/min] and average arterial pressure [(96.75±6.76)mmHg] of the observation group were all lower than those of the control group ( t=5.058, 4.635, all P<0.05). The total incidence of adverse events such as subcutaneous hematoma and arterial wall penetration in the observation group (4%) was lower than that in the control group (18%) (χ 2=5.005, P<0.05). The pain scores at puncture and after puncture of the observation group [(1.53±0.71)points, (1.28±0.60)points] were lower than those of the control group ( t=5.545, 6.233, all P<0.05). The comfort scores at puncture and after puncture of the observation group [(91.25±9.64)points, (97.31±11.37)points] were higher than those of the control group ( t=6.147, 6.226, all P<0.05). Conclusion:Ultrasonic guidance can effectively improve the puncture efficiency, reduce the fluctuation of vital signs, pain, reduce the adverse events during puncture, and make the patients feel more comfortable.
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Objective@#To study the effect of ultrasonic guidance in radial artery catheterization.@*Methods@#From January 2017 to January 2018, 100 patients who received surgical treatment in Taizhou Central Hospital of Zhejiang Province and needed puncture and catheterization anesthesia during operation were randomly divided into control group (n=50) and observation group (n=50) according to digital table method.The control group adopted the traditional touch pulse method, while the observation group was guided by ultrasound.The first puncture success rate, the second puncture success rate, puncture time, puncture times, the vital sign index, incidence of adverse events, pain score, comfort score were compared between the two groups.@*Results@#The first puncture success rate (80%) and the second puncture success rate (100%) of the observation group were higher than 62% and 88% of the control group (χ2=3.934, 6.383, all P<0.05). The single puncture time [(59.85±8.31)s] and total puncture time [(107.14±35.37)s] of the observation group were shorter than those of the control group (t=5.766, 6.398, all P<0.05), and the puncture times [(1.27±0.54) times] of the observation group was less than that of the control group (t=5.689, P<0.05). After puncture, the heart rate [(73.79±2.46)times/min] and average arterial pressure [(96.75±6.76)mmHg] of the observation group were all lower than those of the control group (t=5.058, 4.635, all P<0.05). The total incidence of adverse events such as subcutaneous hematoma and arterial wall penetration in the observation group (4%) was lower than that in the control group (18%) (χ2=5.005, P<0.05). The pain scores at puncture and after puncture of the observation group [(1.53±0.71)points, (1.28±0.60)points] were lower than those of the control group (t=5.545, 6.233, all P<0.05). The comfort scores at puncture and after puncture of the observation group [(91.25±9.64)points, (97.31±11.37)points] were higher than those of the control group (t=6.147, 6.226, all P<0.05).@*Conclusion@#Ultrasonic guidance can effectively improve the puncture efficiency, reduce the fluctuation of vital signs, pain, reduce the adverse events during puncture, and make the patients feel more comfortable.
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Objective@#To summarize the experience of treatment for blunt pancreatic trauma.@*Methods@#The clinical data of 52 patients with blunt pancreatic trauma admitted to the Department of Pancreatic and Biliary Surgery of the First Affiliated Hospital of Harbin Medical University from January 2013 to June 2018 were analyzed retrospectively.There were 40 male and 12 female patients, aging from 12 to 112 years with a median age of 35.5 years.According to the organ injury scale by American Association for the Surgery of Trauma(AAST) for pancreatic injury severity, 15 cases were in grade Ⅰ(28.8%), 20 cases were in grade Ⅱ(38.5%), 10 cases were in grade Ⅲ(19.2%),5 cases were in grade Ⅳ(9.6%) and 2 cases were in grade Ⅴ(3.8%). Isolated blunt pancreatic trauma occurred in 11(21.2%) patients including 5 cases of grade Ⅰ,5 cases of grade Ⅱ and 1 case of grade Ⅲ, and associated injuries existed in 41 patients(78.8%).@*Results@#Among 52 patients, 36 patients(69.2%) were transferred from other hospitals and 16(30.8%) patients were admitted through the emergency department. Finally, 49 patients(94.2%) were cured and 3 patients (5.8%) died.For the 15 cases of grade Ⅰ,9 patients were managed non-operatively, 5 cases underwent peritoneal lavage and drainage after surgery for the other injured abdominal organs, and 1 patient received percutaneous catheter drainage(PCD) with non-operative treatment. For the 20 cases of grade Ⅱ,4 cases only received non-operative treatment and 2 cases also received PCD. Besides, 2 cases underwent debridement and drainage for peripancreatic necrotic tissue and external drainage for pancreatic pseudocyst retrospectively after about 25 days of getting injured. As for patients who received exploratory laparotomy, 5 patients underwent suture repair associated with external drainage, and 7 patients were managed only with external drainage. For the 10 cases of grade Ⅲ,6 patients were cured through distal pancreatectomy and splenectomy with external drainage, while 2 patients underwent endoscopic retrograde cholangiopancreatography and ductal stenting, and the other 2 patients just received debridement and drainage for peripancreatic necrotic tissue.For the 5 cases of grade Ⅳ,2 patients underwent jejunostomy and abdominal cavity drainage, 1 patient had a pancreaticoduodenectomy with drainage,1 patient received suture repair of the pancreas and pancreaticojejunostomy, and 1 patient was managed with suture repair of the head of pancreas and external drainage.For the 2 patients of grade Ⅴ,1 patient received exploratory laparotomy and gauze compression packing hemostasis, and the other patient underwent pancreaticoduodenal repair, gastrointestinal anastomosis, duodenal exclusion surgery and external drainage.@*Conclusion@#According to the AAST classifications, associated injuries, physiological status and intraoperative situation, it could be better to make a comprehensive judgment, achieve early diagnosis and take appropriate individualized treatment strategy, and to improve the overall therapeutic effect for blunt pancreatic trauma.
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Objective@#To study the prognostic factors of delayed gastric emptying(DGE) after pancreaticoduodenectomy(PD) and construct a prognostic predictive model for clinical application.@*Methods@#Clinic data of 401 consecutive patients who underwent PD between January 2012 and July 2016 in the First Affiliated Hospital of Harbin Medical University were retrospectively collected and analyzed. The patients were randomly selected to modeling group(n=299) and validation group(n=102) at a ratio of 3∶1. The data of modeling group were subjected to univariate and multivariate analysis for prognostic factors and to construct a prognostic predictive model of DGE after PD. The data of validation group were applied to test the prognostic predictive model.@*Results@#DGE after PD occurred in 35 of 299 patients(11.7%) in the modeling group. The multivariate analysis of the modeling group showed that upper abdominal operation history(χ2=6.533, P=0.011), diabetes mellitus(χ2=17.872, P=0.000), preoperative hemoglobin <90 g/L(χ2=14.608, P=0.000) and pylorus-preserving pancreaticoduodenectomy(PPPD)(χ2=8.811, P=0.003) were associated with DGE after PD independently. A prognostic predictive model of DGE after PD was constructed based on these factors and successfully tested. The area under the receiver operating characteristic(ROC) curve was 0.761(95%CI: 0.666-0.856) of the modeling group and 0.750(95% CI: 0.577-0.923) of the validation group.@*Conclusions@#Upper abdominal operation history, diabetes mellitus, preoperative hemoglobin<90 g/L and PPPD are associated with DGE after PD independently. The preoperative assessment of a patient′s prognostic for DGE after PD is feasible. The model is a valid tool to take precautions against DGE after PD.
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Objective To evaluate the reliability and validity of the Chinese version of the Newest Vital Sign(NVS). Methods The NVS was translated and back-translated. Cultural adaption of scale was performed by Delphi expert consultation and pilot study. The reliability and validity of the Chinese version of the NVS was tested in 451 Chinese residents. Results Chinese version of the NVS consisted of 6 items with Pearson correlation between item and total score of scale ranging from 0.50 to 0.71. Two factors were abstracted by exploratory factor analysis and explained 61.51% of total variance. Confirmatory factor analysis showed that the fitness of the model was acceptable:comparative fit index was 0.96, Tuker-Lewis index was 0.92, standardized root mean square residual was 0.04, root mean square error of approximation was 0.077. Cronbach α coefficient was 0.71, retest reliability was 0.92. Conclusions Chinese version of the NVS has good reliability and validity, which can be used to test the health literacy of residents in China.
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Objective To study the delayed gastric emptying for patients underwent pylorus-preserving pancreaticoduodenectomy and standard Whipple procedure.Methods Clinical data of 401 consecutive patients who underwent standard Whipple procedure/pylorus-preserving pancreaticoduodenectomy between January 2012 and July 2016 in the First Affiliated Hospital of Harbin Medical University were retrospectively collected and analyzed.Using the independent-samples t test,x2 test or Fisher's exact test,Mann-Whitney test and other statistical methods to compare the postoperative complications between pylorus-preserving pancreaticoduodenectomy and standard Whipple procedure group.Results Compare with standard Whipple procedure group,delayed gastric emptying after pylorus-preserving pancreaticoduodenectomy occurred in 8 of 35 patients (22.9％),obviously higher than it after standard Whipple procedure occurred in 40 of 366 patients (10.9％) (P =0.038).Other postoperative complications were not significantly different (P ≥ 0.05).Each level of delayed gastric emptying after pyloruspreserving pancreaticoduodenectomy and standard Whipple procedure were not significantly different (P ≥ 0.05),but the average recovery time of delayed gastric emptying after pylorus-preserving pancreaticoduodenectomy (12.13 ± 3.09) d was obviously shorter than it after standard Whipple procedure (17.28 ± 9.63) d (P =0.009).Conclusions Pylorus-preserving pancreaticoduodenectomy increases the risk of delayed gastric emptying,but it does not increase severity delayed gastric emnptying by each level.The recovery time of delayed gastric after pyloruspreserving pancreaticoduodenectomy is shorter.
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Objective To detect the reactive samples of enzyme-linked immunosorbent assay (ELISA1) by chemiluminescence microparticle immunoassay (CMIA),and to analyze the application value of CMIA in HCV infection validation of blood donors.Methods Nucleic acid 3-item combined testing (NAT),another ELISA2,HCV antibody supplementary test(Western Blot test,WB) and CMIA test supplemented in blood samples of 102 ELISA1 anti-HCV reactive blood donors were retrospectively analysed.Results Among 102 blood donors of anti-HCV positive,32 cases (31.37%,32/102) were HCV RNA reactive samples,50 cases (49.02%,50/102) were ELISA2/WB reactive simultaneously.With CMIA NAT results as the reference standard,CMIA was poorly correlated with HCV RNA (Spearman correlation coefficient rs=0.395,P<0.01),and the consistency between them was weak by Kappa test (Kappa=0.270,P<0.01).With ELISA2/WB detection results as the reference standard,CMIA was highly correlated with the results(Spearman correlation coefficient rs=0.713,P<0.01),and which showed high consistency by Kappa test (Kappa=0.674,P<0.01).Conclusion CMIA as a detection method of protein label after HCV infection has great value in the HCV infection confirmation in low-risk population.