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Objective:To establish a blood consumption prediction model for emergency trauma patients based on machine learning algorithm, so as to guide blood collection and blood supply institutions to prepare for the early blood demand of mass casualties in public emergencies.Methods:A retrospective analysis was conducted on trauma patients in the emergency system database of 12 hospitals in Zhejiang Province from January 2018 to December 2020. Patients with chronic medical history such as hematological diseases and tumors, and transferred from other hospitals after external treatment were excluded. The patients were divided into the transfusion group and non-transfusion group according to whether they received blood transfusion. The differences in demographic and clinical characteristics between the two groups were compared, and the computer learning algorithm (XGBoost) was used to build the blood consumption prediction model and blood consumption volume prediction model of emergency trauma patients.Results:Totally 2025 patients were included in this study, including 1146 patients in the transfusion group and 879 patients in the non-transfusion group. The blood demand of emergency trauma patients mainly occurred within 3 days of admission (60%). The main variables affecting the blood consumption prediction model of emergency trauma patients were shock index, hematocrit, systolic blood pressure, abdominal injury, pelvic injury, ascites and hemoglobin. Compared with the traditional prediction model, XGBoost model had the highest hit rate of 59.0%. The accuracy of blood consumption prediction model was the highest when seven levels of blood volume were adopted, and the deviation fluctuated between [0~1] U. According to the prediction model, the blood consumption prediction formula was∑ nw× c. Conclusions:The preliminarily constructed prediction model of blood transfusion and blood consumption for emergency trauma patients has better performance than the traditional prediction model of blood transfusion, which provides reference for optimizing the decision-making ability of blood demand assessment of hospitals and blood supply institutions under public emergencies.
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Objective:To investigate the value of fibroblast growth factor 2 (FGF-2) and microRNA-206 (miR-206) in predicting postoperative delayed union of closed tibial shaft fractures.Methods:The clinical data of 136 patients who underwent closed tibial shaft fracture surgery in Hospital of the 80 th Group Army of Chinese People's Liberation Army Ground Forces from May 2018 to May 2021 were retrospectively analyzed. Eighty-six patients who had delayed union of closed tibial shaft fractures were included in the observation group, and fifty patients who had normal union of closed tibial shaft fractures were included in the control group. Serum FGF-2 level was measured using the enzyme-linked immunosorbent assay, and serum miR-206 expression was detected using the real-time fluorescence polymerase chain reaction. The relationship between FGF-2 expression and miR-206 expression and closed tibial shaft fractures was analyzed. Results:At 1 day, 1, and 4 weeks after surgery, serum FGF-2 level was significantly lower in the observation group than the control group [(14.24 ± 2.15) ng/L vs. (20.36 ± 3.42) ng/L, (21.38 ± 3.27) ng/L vs. (30.45 ± 4.29) ng/L, (23.59 ± 4.36) ng/L vs. (36.67 ± 4.51) ng/L, t = 7.42, 8.42, 16.66, all P < 0.001]. Serum FGF-2 level gradually increased with time in each group. At 1 day after surgery, serum miR-206 expression was significantly lower in the observation group than the control group ( t = 7.50, P < 0.001). At 4 weeks after surgery, serum miR-206 expression was significantly higher in the observation group than the control group ( t = 17.24, P < 0.001). At 1 week after surgery, there was no significant difference in serum miR-206 expression between the two groups ( P > 0.05). Univariate analysis results showed that postoperative infection, FGF-2, and miR-206 were closely related to the delayed union of closed tibial shaft fractures after surgery (all P < 0.05). Multivariate logistic regression analysis results showed that postoperative infection ( OR = 1.93, 95% CI: 1.20-3.07), FGF-2 ( OR = 2.10, 95% CI: 1.31-3.36), miR-206 ( OR = 2.30, 95% CI: 1.35-3.89) were independent risk factors for delayed union of closed tibial shaft fractures after surgery (all P < 0.05). The receiver operating characteristic (ROC) curves plotting serum FGF-2 level and serum miR-206 expression after closed tibial shaft fractures showed that at 4 weeks after surgery, the optimal cut-off value of FGF-2 for predicting delayed union of closed tibial shaft fractures was 29.83 ng/L, with the area under the curve, sensitivity, and specificity of 0.76 (95% CI: 1.23-3.25), 79.34%, and 68.82%, respectively; at 4 weeks after surgery, the optimal cut-off value of miR-206 for predicting delayed union of closed tibial shaft fractures was 0.63, with the area under the curve, sensitivity and specificity of 0.72 (95% CI: 1.10-2.45), 75.33%, and 67.25%, respectively. The area under the curve, the sensitivity, and specificity of combined use of FGF-2 and miR-206 in predicting delayed union of closed tibial shaft fractures were 0.81 (95% CI: 1.35-3.26), sensitivity and specificity were 83.45% and 67.36% respectively. Conclusion:The decrease in serum FGF-2 level and the increase in serum miR-206 expression at 4 weeks after surgery are independent risk factors for delayed union of closed tibial shaft fractures. Combined use of FGF-2 and miR-206 can better predict the delayed union of closed tibial shaft fractures.
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【Objective】 To explore the influence of blood donors′ demographic characteristics and blood donation service experience on voluntary blood donation motivation. 【Methods】 Using self-made questionnaire, stratified sampling method was used to select blood donors from three urban areas in Zhejiang province for investigation. Independent sample t-test, variance analysis and chi-square test were used to compare the differences of blood donation motivation and blood donation service experience of different blood donors. Spearman correlation analysis and linear regression were used to analyze the correlation between blood donation motivation and blood donation service and the influencing factors of blood donation motivation. 【Results】 There were 705 valid samples. The motivation level of blood donation is higher in married people than that in unmarried people, in those over 27 years old than in those under 26 years old, and in those who donated for ≥3 times than those 1-2 times (P<0.05). The experience of blood donors in blood station staff service, blood donation process and blood donation environment was stronger than that of blood donation sites (P<0.05). Both voluntary motivation and controlled motivation were positively correlated with blood donation service experience (P<0.05). Good experience of blood donors on the distribution of blood donation sites, service of blood station staff and blood donation process was conducive to the improvement of blood donation motivation. 【Conclusion】 Blood donation service experience can influence the autonomous motivation and controlled motivation of blood donors to donate blood again. It is suggested that blood centers should take the test during conducting blood donation publicity and blood donation services.
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【Objective】 To evaluate the application of computer-aided personal interviewing (CAPI) and computer-assisted telephone interview (CATI) in the satisfaction survey among blood donors. 【Methods】 Voluntary blood donors from stationary and mobile blood collecting sites of Zhejiang Blood Center from Jan 2018 to Dec 2020 were surveyed according to the principle of random sampling. The satisfactory degree of totally 21 items involving pre-donation, in-donation, and post-donation were surveyed. The outcomes were categorized and subsequently analyzed by SPSS23.0, and the differences in demography and blood types between different years were analyzed. 【Results】 5 534 voluntary blood donors were investigated via CAPI and CATI, which contributed to the reflection of real needs of blood donors. The results showed that the comprehensive satisfactory degree of blood donors increased from 95.4% in 2018 to 95.8% in 2020. Significant difference has been found in the eight indexes in Zhejiang (P<0.05) as blood donation publicity, environment of blood donation, service and professional skills of healthcare physicians, skills of phlebotomist before donation, service of pre-donation testing physicians, service and skills of phlebotomist during donation. 【Conclusion】 The combination of CAPI and CATI methods used in the survey of blood donor satisfactory degree, which has presented credible results, is more objective, convenient and time saving, therefore worth popularizing.
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Objective ToinvestigatethevalueoftheoptimalCNR monoenergeticimagesofportalveininpredictingesophagealGgastric varicealbleeding(EVB).Methods FortypatientswithlivercirrhosisandportalhypertensionunderwentcontrastGenhancedspectral CTscan.TheoptimalCNR monoenergeticimagesand70keV monoenergeticimagesoftheportalveinphasewereselectedtocompare theimagingquality.TheconsistencyoftheoptimalCNR monoenergeticimageswithendoscopyforesophagealGgastricvaricealwas analyzed by Kappa test.A ccording to the E V B history ,the patients w ere divided into bleeding group and nonGbleeding group.T he ROCcurveswerecalculatedtoassessthevaluesofthemainportalvein(MPV)anditstributariesdiameterstopredictingEVB.Results TheCNRandobjectivescoreoftheoptimalCNR monoenergeticimagesweresignificantlyhigherthanthoseofthe70keVimages(P＜0.05).TheoptimalCNR monoenergeticimageshadgoodconsistency withgastroscopeintheclassificationofesophagealGgastric variceal(k＝0.769).ThereweresignificantdifferencesofthediametersofMPV,intrahepaticleftbranchofportalvein(LPV),splenic vein(SV)andleftgastricvein (LGV)betweenthebleedinggroupandnonGbleedinggroup (P＜0.05).ROCcurveanalysisshowed thattheincidenceofEVBwashighestwithasensitivityof76.92%andaspecificityof85.71%,whentheLGVwasgreaterthan6.1mm. Conclusion TheoptimalCNR monoenergeticimagesofportalveincouldimprovetheimagingquality,andLGVdiametershouldbe ariskindicatorforpredictingEVBinlivercirrhosis.
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@# Objective To explore the application of 64-slice spiral CT angiography (CTA) in the evaluation of cerebral vascular disease. Methods 160 cases with suspected cerebral vascular disease underwent CTA with 64-slice spiral CT. Two dimensional and three dimensional reformation were performed in all cases including multiplanar reconstruction (MPR), maximum intensity projection (MIP), volume rendering (VR). Both axial and reformatted images were analyzed by two radiologists. Results 94 cases of 160 were diagnosed as abnormal, including 50 stenosis or obstructive disease, 21 aneurysm, 1 post-intravascular stent, 4 cliped aneurysm, 3 arteriovenous malformation, 4 moyamoya disease, 4 carotid-cavernous fistula, 4 venous sinus thrombus, 1 straight sinus occlusion with perpetual falcial sinus, 1 great cerebral venous aneurysm, 1 perpetual sublingual artery. Conclusion 64-slice spiral CTA is a valuable diagnostic method for various cerebral vascular disease.