Value of resting state electroencephalogram in the diagnosis of Alzheimer's disease / 四川精神卫生

BackgroundThe diagnosis of Alzheimer's disease （AD） still faces great challenges， and the advantage of electroencephalogram （EEG） diagnosis lies in its portable and non-invasive nature， so the EEG diagnosis of AD has occupied an important place in clinical research. ObjectiveTo evaluate the value of resting state EEG for AD diagnosis， and to provide references for early recognition of AD in clinical practice. MethodsClinical data of AD patients （n=59） in an Inpatient Geriatric Psychiatry Unit of Shenzhen Kangning Hospital from May 2019 to May 2022 were retrospectively analyzed， and healthy elderly individuals attending outpatient clinics at the hospital during the same period were enrolled as control group （n=54）. Eight-channel resting state EEG data were acquired， and the absolute power values in the α， β， θ and δ frequency bands and the α/θ ratio were obtained and calculated using Fast Fourier Transform （FFT）. Cognitive function assessments of patients were done by Mini-Mental State Examination （MMSE） and Montreal Cognitive Assessment （MoCA）. Spearman correlation analysis was used to examine the correlation between EEG findings and MMSE and MoCA scores of AD patienrs. Logistic regression prediction model for AD was built using currently available EEG and clinical variables， and the model performance was assessed using the receiver operating characteristic （ROC） curve and the area under curve （AUC）. ResultsThe θ-band absolute powers in the right mid-frontal （F4） and mid-lateral （F7， F8） regions were higher in AD patients than those in healthy controls， with statistically significant difference （t=-2.844， -2.825， -3.014， P<0.05 or 0.01）. The absolute powers of α/θ ratio in prefrontal （Fp1， Fp2）， mid-frontal （F3， F4） and mid-lateral （F7， F8） regions showed a notable reduction in AD patients compared with healthy controls， with statistical difference （t=2.081， 2.327， 3.423， 2.358， 3.272， 2.445， P<0.05 or 0.01）. Spearman correlation analysis denoted that MMSE score was positively correlated with the absolute powers of α-band， β-band and α/θ ratio （r=0.206， 0.288， 0.372， P<0.05 or 0.01）. MoCA score was positively correlated with β absolute powers and α/θ ratio （r=0.201， 0.315， P<0.05 or 0.01）， and negatively correlated with θ absolute power （r=-0.218， P<0.05）. ROC curve revealed an AUC of 0.882 （95% CI： 0.820~0.943）， a sensitivity of 0.966 and a specificity of 0.673 for the AD prediction model based on EEG variables， while the prediction model for AD using comprehensive variables achieved better predictive efficacy， reaching an AUC， sensitivity and specificity of 0.946 （95% CI： 0.905~0.986）， 0.948 and 0.873， respectively. ConclusionResting state EEG of AD patients is correlated with cognitive function， and are of great value in the diagnosis of AD， with θ absolute power and α/θ ratio in EEG being the most strongly correlated with AD.

Preliminary exploration on operation process for autologous ozonized blood transfusion / 中国输血杂志

Autologous ozonized blood transfusion(AOBT) is a therapy of re-transfusion of 100-200 mL of autologous blood after shaking and agitation with appropriate amount of oxygen-ozone in vitro. The oxidation of blood through the strong oxidation of ozone can enhance the non-specific immune response of the body, regulate the internal environment and promote health. This therapy has been increasingly applied in clinical practice, while no unified standard for the operation process in terms of ozone concentration, treatment frequency and treatment course had been established. This operation process of AOBT is primarily explored in order to standardize the operation process and ensure its safety and efficacy.

Analysis on the characteristics of rural blood donation population in Dali Bai Autonomous Prefecture / 中国输血杂志

【Objective】 To explore the status and characteristics of voluntary blood donors in rural areas of Dali Bai Autonomous Prefecture (referred as Dali), and to provide basis for scientific and effective voluntary blood donation in rural population in regions inhabited by ethnic groups. 【Methods】 The data of rural blood donors who donated blood in Dali from 2010 to 2019 were collected, including demographic data as nationality, gender, age, educational background, as well as the blood donation frequency and blood infection screening (index) results. The above data of urban blood donors who donated blood in Dali during the same period were selected to investigate the increasing trend of blood donation rate. SPSS26.0 was used for statistical analysis of the collected data of rural and urban blood donation population. 【Results】 From 2010 to 2019,the number of blood donors in Dali increased from 13 949 to 19 479,with an increasing rate of 39.64%. The number of rural blood donors increased from 2 623 to 8 727,among which the number of ethnic minority groups increased from 1 779 to 5 059.The ratio of male to female blood donors was 70.30% (1 844/2 623) vs 29.70% (779/2 623) in 2010,56.37% (4 919/8 727) vs 43.63%(3 808/8 727) in 2019. Those with educational level of junior middle school or below were the most, accounted for 43.97%(38 443/85 836),with ethnic donors of 24.47%(23 583/85 836). The proportion of donors aged between 36 and 45 was the highest[40.73% (30 477/74 827) ], with ethnic donors of [28.56% (21 374/74 827), and the proportion of repeated blood donors was 54.87%(35 279/64 299),with ethnic donors of 49.89%(18 080/36 240) [the proportion of repeated blood donors in urban donors in the same period was 48.13% (55 677/115 675) ] (P0.05). 【Conclusion】 It is of great significance to explore the characteristics of blood donors in rural areas (especially regions inhabited by ethnic groups) and the reasons for disqualification, in order to scientifically carry out the recruitment of voluntary blood donors and further promote blood donation for rural residents

Constructing a Syndrome Differentiation Model by Combining Latent Structure Analysis of Association Rules： An Example of Kidney Yang Deficiency Syndrome in Primary Osteoporosis / 中医杂志

ObjectiveTo construct a quantitative differentiation model of traditional Chinese medicine （TCM） syndromes by taking primary osteoporosis （POP） with kidney yang deficiency syndrome as an example， and to provide methodological reference for the standardization of syndrome differentiation. MethodsHigh-frequency clinical features of POP were screened by descriptive statistical analysis， and strong association features of POP were obtained by association rule algorithm. On this basis， a latent structure （latent tree） model was established through latent structure analysis， and the implicit and explicit variables （features） related to POP with kidney yang deficiency syndrome were comprehensively clustered， and the clustering results were interpreted by the indexes of mutual information and cumulative information coverage， to explore the primary and secondary symptoms， and to deduce the categories of POP with kidney yang deficiency syndrome based on the probability of the features appearing in the various latent categories. Based on the categories， the clinical feature scores and identification thresholds were calculated， and the syndrome differentiation model of POP with kidney yang deficiency was initially constructed by combining the comprehensive judgment rules. Finally， the results of TCM professionals' judgment were used as the gold standard to further evaluate the effectiveness of the model in assisting the syndrome differentiation. ResultsThe 32 features strongly associated with POP were obtained， and the Bayes information critedon score of the further constructed latent tree model was -15291.93. Based on the mutual information and the cumulative information coverage， the main symptoms of POP with kidney yang deficiency syndrome were bone weakness， fatigue， pale tongue， clear urine， frequent nocturnal urination， cold limbs， thin pulse， white coating， and secondary symptoms were weakness， loss of libido， loose stool， frequent urination， lumbar and knee weakness， and fear of cold. From the probability of the occurrence of each clinical feature in different latent categories of POP with kidney yang deficiency syndrome， the state was introduced as S0 category （none/mild kidney yang syndrome）/ S1 category （moderate kidney yang syndrome）/ S2 category （severe kidney yang syndrome）. Optimizing the preliminary rules of state identification and refining the state of S1 category， the results showed that among 970 patients with POP， there were 520 patients having no/mild kidney yang deficiency syndrome， 224 patients with moderate to mild kidney yang deficiency syndrome， 81 patients with moderate to severe kidney yang deficiency syndrome， and 145 patients with severe kidney yang deficiency syndrome. During the evaluation and validation process， the correct rate of the model assessment index was 0.8835， while the sensitivity was 0.7181， and the specificity was 0.9437. ConclusionCombined with the latent structure analysis of the association rule， the syndrome differentiation model for POP with kidney yang deficiency could be constructed， and the model shows a good quantitative identification effect， which can provide methodological supports for clinicians to improve the efficiency and accuracy of TCM diagnosis.

Identification of Kidney-Yang Deficiency Syndrome in Osteoporosis Patients Based on Rule Ensemble Method of Bagging Combining LASSO Regression / 中国实验方剂学杂志

ObjectiveTo investigate the identification of kidney Yang deficiency syndrome of patients with osteoporosis（OP）， and to form the clinical syndrome identification rules of traditional Chinese medicine（TCM）. MethodBasic information， etiology， clinical symptoms and other characteristics of 982 OP patients were included， and statistical tests were used to screen the variables associated with kidney Yang deficiency syndrome. Taking the decision tree as the base model， bootstrap aggregation algorithm（Bagging algorithm） was utilized to establish the classification model of kidney Yang deficiency syndrome in OP， generating numerous rules and removing redundancy. Combining least absolute shrinkage and selection operator（LASSO） regression to screen key rules and integrate them to construct an identification model， achieving the identification of kidney Yang deficiency syndrome in OP patients. ResultEighteen key identification rules were screened out， and of these， where 11 rules with regression coefficients>0 correlated positively with the kidney Yang deficiency syndrome， the rule with the highest coefficient was chilliness（present）&feverish sensation over the palm and sole（absent）. The other 7 rules with regression coefficients<0 correlated negatively with the syndrome， the rule with the lowest coefficient was reddish tongue（present）&diarrhea（absent）&deficiency of endowment（absent）. According to the regression coefficients of each key rule， variables with importance>0.2 were ranked as chilliness， reddish tongue， feverish sensation over the palm and sole， cold limbs， clear urine， diarrhea， deficiency of endowment， prolonged illness. The results of the partial dependence analysis of the identification model showed that compared to OP patients without chilliness， those with chilliness（present） had a 0.266 8 higher probability of being identified as having kidney Yang deficiency syndrome， indicating that this variable had the highest impact on identification of the syndrome. Similarly， compared to OP patients without reddish tongue， those with reddish tongue had a 0.141 9 lower probability of being identified as having kidney Yang deficiency syndrome， indicating that this variable had the highest impact on identifying non-kidney Yang deficiency syndrome. The accuracy， sensitivity， specificity and area under receiver operating characteristic curve（AUC） of the established kidney Yang deficiency syndrome identification model in the test set were 0.865 9， 0.853 7， 0.872 0 and 0.931 5， respectively. ConclusionA precise identification model of OP kidney Yang deficiency syndrome is conducted basing on the rule ensemble method of Bagging combining LASSO regression， and the screened key rules can explain the identification process of kidney Yang deficiency syndrome. In this research， according to the regression coefficients of rules， the importance and partial dependence of variables， combined with the thinking of TCM， the influence of patient characteristics on the identification of syndromes is described， so as to reveal the primary and secondary syndromes of identification and assist the clinical identification of kidney Yang deficiency syndrome.

Clinicopathological characteristics and endoscopic treatment efficacy of de novo early colorectal cancer / 中华消化内镜杂志

Objective:To analyze the clinicopathological features of de novo early colorectal cancer and to evaluate the efficacy of endoscopic treatment.Methods:Patients with de novo early colorectal cancer who underwent endoscopic resection in Beijing Friendship Hospital, Capital Medical University from June 2020 to May 2022 were enrolled. The baseline data, endoscopic manifestations, treatment methods, postoperative pathological results and prognosis of the patients were collected retrospectively.Results:A total of 33 patients with de novo early colorectal cancer were enrolled with the age of 62.67 ± 8.62 years, and the male to female ratio was 7.25∶1. The long diameter of lesions was 0.96 ± 0.36 cm. The lesion morphology was mainly superficial phenotype (type 0-Ⅱ), accounting for 72.7% (24/33). Endoscopic submucosal dissection (ESD) was performed in 29 cases and endoscopic mucosal resection (EMR) was performed in 4 cases. Postoperative pathology showed that 11 cases (33.3%) were well differentiated tubular adenocarcinoma, of which the superficial submucosal layer was invaded in 2 cases. Twenty cases (60.6%) were moderately differentiated tubular adenocarcinoma, of which the superficial submucosa layer was invaded in 5 cases and the deep submucosa layer in 15 cases. Two cases (6.1%) were moderately-poorly differentiated tubular adenocarcinoma, where the deep submucosa layer was invaded in both. There was significant correlation between the depth of invasion and the degree of differentiation ( P<0.001), and moderately and moderately-poorly differentiated lesions were more likely to invade the deep submucosa layer. The en bloc resection rate was 100.0% (33/33), the complete resection rate was 97.0% (32/33), and the curative resection rate was 42.4% (14/33). Among the 19 patients who did not achieve curative resection, 13 patients received supplementary surgical treatment. No tumor residue or lymph node metastasis was found in the postoperative pathology. All patients were followed up for 3-25 months, and no signs of local recurrence or metastasis were found. Conclusion:Most de novo early colorectal cancers are superficial phenotype under endoscopy. The pathology is mainly moderately differentiated tubular adenocarcinoma. Endoscopic resection of de novo early colorectal cancer shows encouraging short-term efficacy.

Research progress in preventing delayed bleeding after gastric endoscopic submucosal dissection / 中国综合临床

Endoscopic submucosal dissection (ESD) is the common method for treatment of early gastric cancer. Compared with endoscopic mucosal resection (EMR), ESD can completely remove large lesions while ensuring negative margins as much as possible, which enables a more accurate pathological staging of tissue and reduces the risk of postoperative cancer recurrence. On the other hand, ESD generally results in larger ulcerations than EMR, which increases the likelihood of complications such as bleeding and perforation. Delayed bleeding is one of the main complications after gastric ESD. Delayed bleeding after ESD can cause hemorrhagic shock and even death, so we should take effective management strategies to prevent the occurrence of delayed bleeding after gastric ESD, such as the use of acid suppressive drugs, enough intraoperative hemostasis, lesion closure, and the use of lesion covering materials.

Complications and management of pregnancy with portal hypertension / 中国综合临床

Infertility in women with cirrhosis is overcome with the help of modern assisted conception techniques and systemic liver disease treatment. Hemodynamic changes during pregnancy are necessary to meet fetal growth needs, but can exacerbate portal hypertension, which can lead to life-threatening complications, such as esophagogastric varices bleeding and liver failure. Therefore, the complex clinical dilemma of pregnancy with portal hypertension presents us with a special challenge. Complications of portal hypertension during pregnancy mainly include esophagogastric varices bleeding and liver failure. Prepregnancy counseling and risk prediction scores can reduce the incidence of complications. At the same time, endoscopic treatment is currently recognized as the first-line treatment for esophageal and gastric variceal bleeding.

Relationship between metabolic syndrome and 1-year prognosis of elderly patients with acute cerebral infarction / 中国医师进修杂志

Objective:To investigate the relationship between metabolic syndrome and 1-year poor outcome in elderly patients with acute cerebral infarction (ACI).Methods:The clinical data of elderly patients with ACI admitted to Renqiu Kangjixintu Hospital from January 2014 to November 2018 were selected and divided into metabolic syndrome group (931 cases) and non-metabolic syndrome group (1 851 cases). The clinical data of the two groups of elderly patients with ACI were compared, and the effect of metabolic syndrome on poor outcome (modified Rankin scale>2 scores) of elderly patients with ACI in 1 year was analyzed by multivariate Logistic regression.Results:The proportion of female, hypertension, diabetes, hyperlipidemia, coronary heart disease, smoking, excessive alcohol consumption and antiplatelet drug use in the metabolic syndrome group were higher than those in the non-metabolic syndrome group: 52.74%(491/931) vs. 32.58%(603/1 851), 79.16%(737/931) vs. 64.29% (1 190/1 851), 42.32% (394/931) vs. 6.43% (119/1 851), 17.19% (160/931) vs. 11.62% (215/1 851), 18.90% (176/931) vs. 14.10% (261/1 851), 62.73% (584/931) vs. 50.89% (942/1 851), 3.73% (69/931) vs. 1.61% (15/1 851), 19.23% (179/931) vs. 15.51% (287/1 851), the levels of body mass index, systolic blood pressure, diastolic blood pressure, fasting plasma glucose (FPG), fasting plasma glucose (TG), total cholesterol (TC), platelet (PLT), fibrinogen (FIB), fall score were higher than those in non-metabolic syndrome group: 26.67 (25.31, 28.60) kg/m 2 vs. 23.30 (21.48, 24.91) kg/m 2, (167.17 ± 22.96) mmHg (1 mmHg = 0.133 kPa) vs. (164.21 ± 24.90) mmHg, (87.06 ± 13.10) mmHg vs. (85.76 ± 12.99) mmHg, (7.33 ± 2.64) mmol/L vs. (5.35 ± 1.38) mmol/L, (2.12 ± 1.51) mmol/L vs. (1.13 ± 0.78) mmol/L, (4.97 ± 1.31) mmol/L vs. (4.65 ± 0.99) mmol/L, 213.00 (179.00, 256.00) × 10 9/L vs. 203.00 (172.00, 241.00) × 10 9/L, 3.07 (2.63, 3.52) g/L vs. 2.94 (2.55, 3.37) g/L, (6.12 ± 1.70) scores vs. (5.93±1.74) scores, the levels of age, high density lipoprotein cholesterol (HDL-C), homocysteine (Hcy) and pressure ulcer score were lower than those of non-metabolic syndrome group: (69.29 ± 6.96) years vs. (71.28 ± 7.66) years, (0.98 ± 0.34) mmol/L vs. (1.31 ± 0.88) mmol/L, (18.93 ± 13.07) mmol/L vs. (21.66 ± 16.39) mmol/L, (18.55 ± 2.42) vs. (19.02 ± 2.43), with statistical significance ( P<0.05). After 1-year follow-up, the proportion of poor outcomes in the metabolic syndrome group was higher than that in the non-metabolic syndrome group: 21.70%(202/931) vs. 18.69% (346/1 851), with statistical significance ( P<0.05). Multivariate Logistic regression analysis showed that age, stroke, national institutes of health stroke scale (NIHSS) score at admission, systolic blood pressure, Hcy, pressure ulcer score, fall score, metabolic syndrome were independent risk factors for poor outcome of ACI in 1 year ( OR = 1.056, 1.309, 1.138, 1.005, 1.006, 0.882, 1.076 and 1.285; 95% CI 1.040 to 1.072, 1.037 to 1.652, 1.097 to 1.180, 1.000 to 1.010, 1.000 to 1.013, 0.834 to 0.933, 1.004 to 1.152 and 1.001 to 1.657; P<0.05). Conclusions:Multiple risk factors for stroke are closely related to poor outcome of ACI in the elderly. And metabolic syndrome is an independent risk factor for poor outcome of ACI in the elderly in 1 year.

Preliminary observation on endoscopic treatment for polyps in appendix cavity / 中华消化内镜杂志

From January 2016 to December 2020, 6 cases of polyps in the appendix cavity with a diameter of 0.3-1.3 cm were treated by endoscopy in the Department of Gastroenterology of Beijing Friendship Hospital, Capital Medical University. All 6 cases underwent endoscopic treatment successfully, including 3 cases of en bloc endoscopic mucosal resection (EMR), 1 case of piecemeal EMR, 1 case of endoscopic submucosal dissection (ESD), and 1 case of removed by cold forceps. No complications such as bleeding, perforation, infection or acute appendicitis occurred.The wound healed well with no recurrence after re-examination in 3 cases, and 3 others were not re-examined by colonoscopy yet. The results preliminarily confirmed that endoscopic treatment of intraluminal polyps in the appendix cavity is safe and effective.

Efficacy of endoscopy for early nonampullary duodenal cancer / 中华消化内镜杂志

Objective:To evaluate the clinical efficacy of endoscopic treatment for early nonampullary duodenal cancer.Methods:Data of patients with early nonampullary duodenal cancer, who underwent endoscopic treatment from January 2015 to January 2021 at Beijing Friendship Hospital were retrospectively analyzed. Baseline data, endoscopic treatment methods, wound closure, pathology, the occurrence and outcome of complications of patients were studied.Results:A total of 47 patients who successfully went through endoscopic treatment were enrolled. Seventeen cases received endoscopic mucosal resection (EMR), 5 cases received endoscopic submucosal dissection (ESD), and 7 cases received ESD+EMR (hybrid ESD). Six cases were converted to hybrid ESD due to difficulty in ESD. Four cases received full-thickness resection with over-the-scope clip system (OTSC), and 8 cases received endoscopic piecemeal mucosal resection (EPMR). Among the 47 cases of early cancer, the en bloc resection rate was 83.0% (39/47), and the complete resection rate was 85.1% (40/47). Four patients (8.5%) had perforation which occurred at the duodenal descending part during the perioperative period, among whom, 2 patients (4.3%) recovered after endoscopic treatment, 2 others (4.3%) recovered after surgical intervention. There were no complications such as postoperative bleeding or infection during the perioperative period.Conclusion:Endoscopic treatment for early nonampullary duodenal cancer is safe and effective. A specific treatment plan can be selected according to the location, size and specific conditions of the lesion. For the operation of the descending part, it is necessary to be more vigilant to against the occurrence of perforation complications.

Therapeutic effect of endoscopy on early cancer of duodenal papilla / 中华消化内镜杂志

Objective:To evaluate the clinical efficacy of endoscopy for early cancer of duodenal papilla.Methods:A retrospective analysis was performed on data collected from 23 consecutive patients with early cancer of duodenal papilla, who underwent endoscopic treatment from January 2015 to January 2021 in Beijing Friendship Hospital. Baseline data, endoscopic and pathological data, occurrence and outcome of complications were studied.Results:Twenty-three patients successfully received endoscopic treatment. The maximal diameter of lesions evaluated under endoscopy was 1.90±0.83 cm. Among the 23 cases, 20 underwent endoscopic mucosal resection and 3 underwent endoscopic piecemeal mucosal resection. Delayed bleeding occurred in 5 cases (21.7%), 3 patients (13.0%) developed postoperative hyperamylasemia, 6 patients (26.1%) developed mild acute pancreatitis, and 1 patient (4.3%) had pancreatic duct stent displacement after the operation, which improved after medical or endoscopic treatment. No perforation occurred during the perioperative period. In terms of final pathology, the en bloc resection rate was 82.6% (19/23), and the complete resection rate was 78.3% (18/23). Preoperative endoscopic ultrasonography showed that 19 lesions were confined to the mucosal layer, which were all demonstrated by postoperative pathology. Four other cases were suspected to be involved in the submucosa or the end of the pancreaticobiliary duct under endoscopic ultrasonography, two of which were confined to the mucosal layer, and the other 2 cases involved the submucosal layer, so additional surgery was performed. A total of 18 patients were followed up, among whom 14 achieved complete resection of postoperative pathology, and 2 patients (14.3%, 2/14) were found to have recurrence at 12 and 51 months respectively after the treatment and did not relapse after surgical treatment and endoscopic treatment respectively. Among 4 other patients of follow-up whose pathology did not achieve complete resection, 1 had no recurrence, and the other 3 received additional surgical treatment without recurrence.Conclusion:Endoscopic treatment for early cancer of duodenal papilla is safe and effective. It is necessary to improve preoperative evaluation, stay alert to perioperative complications, and pay attention to regular postoperative endoscopic follow-up.

Application of electronic bronchoscope in 65 children with congential tracheoesophageal fistula during perioperative period / 中国小儿急救医学

Objective:To explore the value and risk of electronic bronchoscope applied in perioperative management of children with congential tracheoesophageal fistula.Methods:Sixty-five children with congential tracheoesophageal fistula performed electronic bronchoscope examination from September 2014 to November 2020 were enrolled in this study.The results of examination and complications were analyzed.Results:Sixty-three children with congenital tracheoesophageal fistula were diagnosed by electronic bronchoscopy.The diagnosis rate was 96.92%.Fifty-four children with congenital tracheoesophageal fistula were diagnosed by esophagography.The diagnosis rate was 91.53%.Sixty-one children with congenital tracheoesophageal fistula were diagnosed by multislice spiral computed tomography.The diagnosis rate was 93.85%.Airway anatomic abnormity was found in 27 children, including three cases of nasopharyngeal soft tissue collapse, 14 cases of laryngomalacia, five cases of tracheal stenosis, nine cases of tracheobronchomalacia, and nine cases of tracheobronchial and abnormal opening of the bronchus.The incidence was 41.54%.Three children with difficult ventilator weaning were related to tracheobronchial stenosis or tracheobronchomalacia.They were gradually weaning from ventilator after a long period of mechanical ventilation and treatment.Two children with transient decrease in oxygen saturation were noticed as complication.Conclusion:Electronic bronchoscopy is a safe and effective method for the diagnosis of congenital tracheoesophageal fistula and recurrence after operation.It is of great value to the airway management after operation by early detection of respiratory anatomic abnormity.

Collateral Flow in Magnetic Resonance Angiography:Prognostic Value for Vertebrobasilar Stenosis With Stroke Recurrence

Background@#and Purpose Intracranial vertebrobasilar atherosclerotic stenosis (IVBAS) is a major cause of posterior circulation stroke. Some patients suffer from stroke recurrence despite receiving medical treatment. This study aimed to determine the prognostic value of a new score for the posterior communicating artery and the P1 segment of the posterior cerebral artery (PCoA-P1) for predicting stroke recurrence in IVBAS. @*Methods@#We retrospectively enrolled patients with severe IVBAS (70%–99%). According to the number of stroke recurrences, patients were divided into no-recurrence, single-recurrence, and multiple-recurrences groups. We developed a new 5-point grading scale, with the PCoA-P1 score ranging from 0 to 4 based on magnetic resonance angiography, in which primary collaterals were dichotomized into good (2–4 points) and poor (0 or 1 point). Stroke recurrences after the index stroke were recorded. Patients who did not experience stroke recurrence were compared with those who experienced single or multiple stroke recurrences. @*Results@#From January 2012 to December 2019, 176 patients were enrolled, of which 116 (65.9%) had no stroke recurrence, 35 (19.9%) had a single stroke recurrence, and 25 (14.2%) had multiple stroke recurrences. Patients with single stroke recurrence (odds ratio [OR]= 4.134, 95% confidence interval [CI]=1.822–9.380, p=0.001) and multiple stroke recurrences (OR=6.894, 95% CI=2.489–19.092, p<0.001) were more likely to have poor primary collaterals than those with no stroke recurrence. @*Conclusions@#The new PCoA-P1 score appears to provide improve predictions of stroke recurrence in patients with IVBAS.

Establishment and application of management information system for plasma collection stations in Zhejiang province / 中国输血杂志

【Objective】 To establish a management information system (referred to as the system) for plasma collection stations in Zhejiang province, so as to explore the current situation of plasma donors and implement effective supervision in Zhejiang. 【Methods】 The system was developed and connected to four plasma collection stations that were officially operating in Zhejiang in terms of plasma station setting and approval, as well as the publicity, recruitment and management of plasma donors, information management of the whole process of plasma collection, management of deferral plasma donors, plasma quality management and administrative supervision etc. Relevant plasma donor information was uploaded to the system by each plasma station, and information before (January 2016 to December 2020) and after (January 8, 2021 to June 2021) the system was collected. Information included the number of plasma donors/donations, demographic information of eligible plasma donors in the past 5 years, the type of plasma donors, and the deferral donors after the system was activated. The online approval of Plasma Donation Certificate and the intelligent supervision of key points of plasma apheresis stations in Zhejiang were also conducted. The frequency and composition ratio were described, and chi-square test was used for statistical analysis. 【Results】 The system (V1.0) was established and was officially launched on January 8, 2021, realizing the interconnection of blood donation and plasma donation information as well as the unified management of 24 quality indicators. Since the system was applied (January 8, 2021-June 2021), the proportion of donors both donated blood and plasma over the province was 3.56 (832/23 389), and 352 deferred donors were masked by the system. And 30.11% (106/352) , who intended to donate plasma, were deferred due to insufficient interval after blood donation; 11.65% (41/352) due to permanent masking in blood donations; 23.86% (23.86%) , who intended to donate blood, were deferred due to insufficient interval after plasma donation ( 84/352); 34.38% (121/352) due to permanent masking in plasma donations. The median approval rate of four plasma stations applying for Plasma Donation Certificate before the system (January 1, 2016 to January 7, 2021) and after the system (January 8 to June 2021) were 93.38% (10 609/11 361) vs 99.50% (2 602/2 615). Before the system was put into launch, the ratio of male to female donors and the proportion of regular donors showed an overall upward trend, while the age decreased slightly. The median proportion of women in the past 5 years was 61.52 %, significantly higher than that in last 6 months after the launch(58.86%). 【Conclusion】 The application of the system can realize information interconnection between blood centers and plasma collection stations in Zhejiang as well as the real-time supervision of plasma collection process, which is helpful to overcome the shortcomings in plasma donor management.

Investigation and analysis of HbA1c among voluntary blood donors in Hunan Province / 中国输血杂志

【Objective】 To understand the abnormalities of HbA1c in the blood donor population in order to improve blood quality and blood donor safety. 【Methods】 The qualified voluntary blood donors, from April 2021 to March 2022, were recruited from Yueyang Central Blood Station, Loudi Central Blood Station and Chenzhou Central Blood Station. The baseline data and HbA1c screening results of blood donors were collected for cross-sectional analysis. 【Results】 Among 1 397 eligible blood donors, 30.0% (419/1397) was in the prediabetes range (HbA1c 5.7%~6.4%) and 5.3% (74/1397) was in the diabetes range (HbA1c≥6.5%). Logistic regression analysis showed that age (OR=1.073, 95%CI: 1.058~1.088, P<0.05, BMI (OR=1.096, 95%CI: 1.060~1.133, P<0.05), gender (OR=2.392, 95%CI: 1.482~3.303, P<0.05, smoking (OR=2.216, 95%CI: 1.818~3.743, P<0.05), drinking (OR=3.615, 95%CI: 2.240~4.990, P<0.05), and education level (OR=0.077, 95%CI: 0.022~0.278, P<0.05) were the influencing factors of HbA1c in blood donors. 【Conclusion】 Among the blood donors in Hunan, 35.3% had abnormal HbA1c (diabetes and prediabetes). HbA1c screening of blood donors is helpful to improve the health management of blood donors, and may also help to improve the storage quality of red blood cells and reduce the occurrence of adverse reactions to blood transfusion in patients.

Investigation on the incidence and risk factors of fetomaternal hemorrhage syndrome in pregnant women in Changsha / 中国输血杂志

【Objective】 To investigate the incidence and possible risk factors of FMH among pregnant women in Changsha. 【Methods】 A total of pregnant women (6~42 weeks of gestation) who underwent prenatal examinations in our hospital from June 2019 to December 2020 were enrolled as subjects. In this study, the modified Kleihauer-Betke (K-B) test was used for preliminary screening and flow cytometry was applied to confirme initially positive samples to evaluate the incidence of FMH and estimate fetal blood loss. The logistic regression analysis was used to study the risk factors of FMH. 【Results】 The incidence of FMH in pregnant women was 10.45% (183/1 752), the average volume of fetal blood loss was (2.50±3.87)mL, and 0.11% (2/1 752) of the fetal losed blood > 30 mL. Univariate analysis showed that age, twin pregnancy, pregnancy complicated with uterine fibroids, in vitro fertilization, fetal growth restriction, preeclampsia, and number of pregnancies may be risk factors for FMH. Multivariate analysis showed that twin pregnancy (OR 2.274, 95%CI: 1.135-4.458, P<0.05) and preeclampsia (OR 2.341, 95%CI: 1.082-4.837, P<0.05) were independent risk factors for FMH. 【Conclusion】 Maternal age and various physiological and pathological factors during pregnancy may be associated with the risk of FMH, especially twin pregnancy and pre-eclampsia are independent risk factors for FMH.

Diagnostic value of endoscopic ultrasound-guided fine-needle aspiration for pancreatic lesions with liver lesions / 中华消化内镜杂志

Clinical data of 5 patients with pancreatic and liver lesions who underwent endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) in the Department of Gastroenterology of Beijing Friendship Hospital from February to May 2020 were analyzed retrospectively. Pancreatic lesions were located in the head of pancreas in 3 cases, the neck of pancreas in 1 case and the body of pancreas in 1 case, with the maximum diameter of 3.2-4.6 cm. The histological and cytologic results of pancreas were all positive in 5 patients after 2-4 needles of aspiration. Three patients had single lesion in left lobe of liver, 1 had multiple lesions in left lobe of liver, and 1 had multiple lesions in left and right lobe of liver. The maximum diameter of liver lesions were 0.4-1.2 cm. After 1-3 needles of aspiration, the histological and (or) cytologic results of liver were positive in 4 of 5 patients, only 1 patient's cytologic result was negative. No associated complications were recorded. EUS-FNA for pancreatic and liver lesions is safe and effective.

Application of single cell sequencing technology in atherosclerosis research / 中华神经科杂志

Atherosclerosis is one of the most common cardiovascular and cerebrovascular diseases, and it is also an important cause of stroke. However, the research on the pathogenesis of atherosclerosis is still incomplete. Single cell technology, as an emerging technology in the study of differences in cell biology, has become a new tool and provides a new way of exploring the etiology of atherosclerosis. This article reviewed the research progress of single cell sequencing technology in atherosclerosis in recent years.

New evidence, new guidelines, and new criteria for secondary prevention of ischemic stroke / 中华神经科杂志

Ischemic stroke and transient ischemic attack (TIA) are the most common subtypes of cerebrovascular diseases. Effective secondary prevention is an important approach to reduce the risk of stroke recurrence, disability, and mortality. With the development of international and domestic clinical research on the secondary prevention of ischemic stroke and TIA, new evidence-based medical evidence has been present, especially evidence in risk factor control, antithrombotic therapy, and other treatments. Based on these findings, the guidelines were updated in a timely and systematic manner to provide new standard of secondary prevention for stroke patients.