Clinical blood dispatching between hospitals in Shijiazhuang / 中国输血杂志

【Objective】 To analyze the blood dispatching of hospitals in Shijiazhuang area, in order to provide reference for blood dispatching policy of hospitals and ensure clinical blood supply. 【Methods】 The hospital blood dispatching data from 2018 to 2021 were queried through the blood center information management system (SHINOW9.5) and TMIS system, and the blood dispatching volume, frequency, variety and blood type distribution of hospitals at all levels were analyzed by SPSS statistical software. 【Results】 From 2018 to 2021, there were 1 196 times of blood dispatching in hospitals with a total volume of 4 648.5 U, showing a downward and then upward trend two years before and after the outbreak of COVID-19. As the main blood dispatching product, erythrocyte dispatching was 3 988 U, accounting for 85.79% of the total dispatching volume, with a dispatching rate of 2.99‰. The dispatching volume of red blood cells in secondary hospitals accounted for 86.13%.The dispatching rate of erythrocyte in secondary and tertiary hospitals was 1.03% and 0.06%, respectively, with significant difference(P<0.05). The dispatching rates of type A and AB red blood cells were 3.08‰ and 4.97‰, which were significantly different from those of type B and O red blood cells. 【Conclusion】 Blood dispatching has become an effective way to avoid blood waste and ensure emergency blood use in secondary and tertiary hospitals. In the actual operation, health administration department should strengthen supervision and hospitals should improve the blood dispatching process to ensure blood safety.

Mechanism of microRNA-223-3p inhibiting hepatic stellate cell activation by targeting microtubule-associated protein 1B / 临床肝胆病杂志

ObjectiveTo investigate the effect of microRNA-223-3p （miR-223-3p） on hepatic stellate cell （HSC） activation and its mechanism. MethodsHuman HSC LX2 cells were selected for the study， and LX2 cells were stimulated by TGF-β to establish a model of HSC activation； quantitative real-time PCR was used to measure the change in the expression level of miR-223-3p during HSC activation. After LX2 cells were transfected with miR-223-3p mimic， quantitative real-time PCR， Western blot， and immunofluorescence assay were used to clarify the regulatory effect of miR-223-3p on HSC activation， and dual-luciferase reporter assay was used to verify the association between miR-223-3p and the target gene MAP1B. After LX2 cells were transfected with MAP1B siRNA， Western blot was used to clarify the influence of inhibiting MAP1B expression on HSC activation； after LX2 cells were transfected with miR-223-3p， quantitative real-time PCR and Western blot were used to verify the regulatory effect of miR-223-3p on MAP1B. The independent-samples t test was used for comparison of continuous data between two groups. ResultsHSC in the activated state had a significant reduction in the expression level of miR-223-3p compared with those in the resting state （t=9.12， P<0.001）. Overexpression of miR-223-3p inhibited the mRNA and protein expression levels of the markers for HSC activation alpha-smooth muscle actin and collagen type Ⅰ （mRNA expression： t=8.35 and 12.23， both P<0.01； protein expression： t=16.24 and 20.90， both P<0.001）. The dual-luciferase reporter assay confirmed that MAP1B was a potential target gene of miR-223-3p. Compared with the control group， LX2 cells with miR-223-3p overexpression had significant reductions in the mRNA and protein expression levels of MAP1B （mRNA expression： t=5.95， P<0.01； protein expression： t=11.12， P<0.001）. ConclusionThis study shows that miR-223-3p can inhibit HSC activation by targeting MAP1B.

Methods for quantitative measurement in the computed tomography images of Tusanqi related hepatic sinusoidal obstruction syndrome / 中华消化杂志

Objective To explore the feasibility of applying threshold and region-growing based algorithm in computed tomography (CT) images for the estimation of hepatic lesion volumes in patients with Tusanqi related hepatic sinusoidal obstruction syndrome (SOS).Methods From July 2012 to January 2015,at the First Affiliated Hospital of Anhui Medical University,20 patients who were diagnosed with SOS and had complete CT images were enrolled.Stereology and threshold and regiongrowing based algorithm were performed to estimate volumes of the low-density region in the liver,respectively,and then the measured volumes of hepatic lesion and operation time were compared.Paired samples t test and the Bland-Altman statistical test were performed for statistical analysis.Results The hepatic lesion volumes measured by stereology and threshold and region-growing based algorithm were (1.001±0.327) dm3 and (1.045±0.363) dm3,respectively,and the difference was not statistically significant (P＞0.05).The consistency between the two methods was good.The operation time of threshold and region-growing based algorithm was (597.55±52.86) s (minimum 500 s),which was less than that of stereology (1 251.60 ± 105.88) s (minimum 1 075 s),and the difference was statistically significant (t =32.808,P＜ 0.01).Conclusion There is no statistically significant difference in the measured hepatic lesion volume of patients with SOS between stereology and the threshold and regiongrowing based algorithm,but the operation time of threshold and region-growing based algorithm is shorter.

Clinical significance and outcomes of pleural effusion in patients with type B aortic dissection treated by endovascular repair / 中华普通外科杂志

Objective To explore clinical implications of pleural effusion in thoracic endovascular aorta repair (TEVAR) of type B aortic dissection.Methods Clinical data of 28 patients (23 males,5 females) hospitalized from Jan 2015 to Dec 2016 were analyzed retrospectively.There were ruptured aortic dissection (RAD) (n =7) and the contained aortic dissection (CAD) (n =21).26 patients underwent TEVAR,and two patients received conservative treatment.Results 26 patients received TEVAR and operations were successful.2 patients treated conservatively died.Six patients had bilateral pleural effusion,while 20 had left pleural effusion and two had right pleural effusion.The distribution of pleural effusion was significantly different between CAD and RAD group (x2 =10.4,P ＜ 0.05),and the rupture risk was the highest in right sided pleural effusion.The median volume of pleural effusion on right side in RAD group are higher than that in CAD group (Z =-3.293,P =0.001).One patient died of sudden death on post-op 9th day.Pleural effusion disappeared in all 24 patients who were followed-up for more than 3 months.There were no ensuing pleural thickening,pulmonary atelectasis,and lung consolidation.Conclusious Pleural effusion on left side are common in type B aortic dissection,while bulk right pleural effusion may indicate impending rupture.Endovascular therapy is a feasible,safe and effective therapy for aortic dissection with pleural effusion.

The prevalence of varicocele in male patients with primary varicose vein of the lower extremity / 中华普通外科杂志

Objective To study the correlation between male primary varicose vein of the lower extremity and varicocele.Methods 100 male patients with varicose vein of the lower extremity were compared with 100 male adults without varicose vein of the lower extremity for the prevalence of varicocele by using ultrasonography.Results There is no difference of demographic data between the two groups (t =1.78,P ＞ 0.05).There were 49 (49.0％) patients found with varicoele in study group compared with 19 (19.0％) patients with varicoele in control group (x2 =20.05,P ＜ 0.01).We compared the rate of varicoele and the mean diameter of spermatic vein between the patients having reflux in the saphenofemoral junction or not,and found there was no statistical difference between themn (rate of varicose P ＞ 0.05,diameter P ＞ 0.05).In patients with both lower extremity varicose vein and varicocele there was a linear correlation between spermatic vein diameter and that of varicose vein (rs =0.407 2,P ＜ 0.01).When patients in study group were classified into six grades by Clinical-Etiology-Anatomy-Pathophysiology (CEAP) trend chi-square found no difference in the incidence of varicoele (x2 =0.879 8,P ＞ 0.05),nor the mean diameter of spermatic vein in different grades (F =1.59,P ＞ 0.05).Conclusion There is a correlation between varicose vein of the lower extremity and the pathogcnesis of varicocele.

The placement of inferior vena cava filters for the treatment of deep venous thrombosis / 中华普通外科杂志

Objective To explore the effect and technical consideration of placement of inferior vena cava filter (IVCF) in the treatment of low extremity deep venous thrombosis (DVT).Methods From Jun 2011 to Jun 2013,73 consecutive DVT cases were for IVCF placement.There were 47 males and 26 females with a mean age of (51 ± 23) years (ranging from 36 to 80 years).Results Procedures were successful in 70 out of 73 cases.There were 18 permanent and 52 temporary IVCFs deployed.The indications for filter insertion were pulmonary embolism (PE) (25 cases,34％),perioperative prophylactic implantation (18 cases,24％),contraindication to anticoagulation therapy (15 cases,20％) and iliofemoral vein thrombosis(10 cases,13％).17 filters were successfully removed with a successful rate of 33％.After the follow-up of mean 24 months (4 to 36 months) of 68 patients,no pulmonary embolism occurred,but symptomatic DVT recurred in 5 patients,and the conditions were improved after anticoagulation treatment.No serious complication of post thrombotic syndrome occurred.Conclusions IVCF placement is effective for prevention of PE,when the therapeutic indications and contraindications are properly controlled.

Seasonal variability of acute deep vein thrombosis onset / 中华普通外科杂志

Objective To investigate the seasonal variability of the onset of acute deep vein thrombosis(DVT).Methods The clinical manifestations in 774 DVT patients during January 2008 to December 2012 were collected and circular distribution statistics was used to identify seasonal variability.Results The total sample had the significant seasonal variability (P ＜ 0.01):DVT was most frequent in winter while less frequent in summer and the peak day was January 1.Female subgroup has significant seasonal variability (P ＜0.01):on peak in winter and at trough in summer while male subgroup has no significant seasonal variability (P ＜ 0.01).Different age subgroups (＜ 40 years,40-69 years,＜70 years)have significant seasonal variability(P ＜ 0.05,P ＜ 0.01,P ＜ 0.01).DVT was most common in December and less frequent in August.Left lower limb subgroup and both lower limb subgroup has significant seasonal variability (P ＜ 0.01,P ＜ 0.01),on peak in December-January.Immobilization subgroup also has significant seasonal variability (P ＜ 0.001):frequent in winter,January 1 is on the peak.Conclusions DVT has significant seasonal variability in onset:it is most frequently seen in winter while less frequent in summer.Some subgroups (female,＜70 years and immobilization) have the most significant seasonal variability in onset.

The clinical efficacy of catheter directed thrombolysis,thrombectomy and systematic anticoagulant in acute iliofemoral deep vein thrombosis:A Meta analysis / 重庆医学

Objective To compare the clinical efficacy of catheter directed thrombolysis(CDT ) ,thrombectomy(ST ) and system‐atic anticoagulant(SA) in treating acute iliofemoral deep vein thrombosis(AIFDVT ) of lower limb using Meta analysis method . Methods The systematic review was initialted by electronic literature searches (PUBMED ,MEDLINE ,ELSEVIER ,etc .) for stud‐ies comparing catheter directed thrombolysis ,thrombectomy and systematic anticoagulant clinical effects published from January 1984 to January 2014 based on the keyword such as iliofemoral deep vein thrombosis;thrombolysis;anticoagulant therapy ;throm‐bectomy ;RCTs;Meta analysis.A Meta analysis was conducted to estimate early vein patency ,post thrombotic syndrome(PTS) , venous reflux(VR) rate ,venous obstruction(VO) rate ,etc .Results Ten RCTs were included in this analysis ,including 626 pa‐tients .The early vein patency rate was higher in the CDT group and the difference was statistically significant(OR=4 .61 ,95% CI 1 .93-10 .98 ,P0 .05) .The post thrombotic syndrome rate was less both in the CDT group(OR=0 .18 ,95% CI 0 .07 -0 .43 ,P0 .05) .Conclusion For acute iliofemoral deep vein thrombosis(AIFDVT) , short term (6 m) outcomes ,the post thrombotic syndrome rate was less both in the thrombolysis group and the thrombectomy ,and catheter directed thrombolysis could diminish the vein obstruction rate .

Correlation of the pathogenesis of male primary varicose vein of lower extremity and varicocele / 国际外科学杂志

Varicose vein of lower extremity and varicocele show tortuosity,dilatation in different parts of venous.They are linked in venous anatomy structure.Their pathogenesis are not clear,but have certain similarity in venous wall structures,venous pressure,venous valvular incompetence,venous insufficiency,level of serum sex homone and apoptosis.We review the related literature to investigate the correlation between pathogenesis of them,in order to provide reference for the etiology,diagnosis and treatment.