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【Objective】 To analyze the basic characteristics of whole blood donors from blood stations before and after the outbreak of COVID-19. 【Methods】 After excluding invalid data, data related to the basic characteristics of whole blood donors collected from 26 blood stations in China during 2018 to 2021 were statistically analyzed, including the trend of total whole blood donors, the number of repeated blood donors, the frequency of blood donation, the average age of donors and the recruitment of first-time blood donors. 【Results】 Affected by the epidemic, 8 out of 14 indicators were with large variations, accounting for 57%. The overall growth rate of total whole blood donors during the epidemic was higher than before the epidemic (P<0.05).The number of repeated blood donors has shown an increased trend, with a higher number during the epidemic than before (P<0.05). The frequency of blood donation was lower during the epidemic than before(P<0.05).Average ages of blood donors and female blood donors fluctuated widely during the epidemic, both higher than those before the epidemic(P<0.05).The donation rate of first-time blood donors <25 years old and ≥25 years old varied widely and irregularly during the epidemic (both P<0.05). The percentage of first-time blood donors fluctuated irregularly during the epidemic, with overall percentage lower than that before the epidemic(P<0.05). 【Conclusion】 Whole blood donors from 26 blood stations increased after the outbreak of COVID-19, and some indicators in certain areas showed significant fluctuations during the epidemic.
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Objective:To explore the effects of different blood glucose management modes on self-management ability and glucose and lipid metabolism in patients with type 2 diabetes mellitus (T2DM) based on the WeChat platform.Methods:240 patients with T2DM were selected in Taiyuan Central Hospital from January to June 2020 for the study. They were randomly divided into general management groups, medical care management groups, peer management groups, and medical care and peer co-management groups using random number table, with 60 cases in each group. The general management group received routine outpatient follow-up. The medical care management group, peer management group, and medical care and peer management group established WeChat groups for management, respectively. Each group′s self-management ability and glucose and lipid metabolism indexes were compared before and after six months of intervention. t-test or nonparametric tests were used to compare. Results:After the intervention, self-management abilities such as diet, exercise, blood glucose monitoring, medication compliance, foot care, smoking and fasting blood glucose (FBG), and glycosylated hemoglobin (HbA 1c) were improved in the four groups (all P<0.05). The medical care management, peer management, and medical care and peer co-management groups were further improved than the general group (all P<0.05). Except for smoking, the above medical care and peer co-management group indicators were statistically different from those of the separate medical care management and peer management group (all P<0.05). Triacylglycerol (TG) of the four groups were improved compared with the previous [1.9(1.2, 2.7) compared with 2.3(1.6, 3.5)mmol/L, 1.4(1.2, 2.1) compared with 2.2(1.6, 3.2)mmol/L, 1.6(1.1, 2.0) compared with 2.2(1.4, 3.2)mmol/L, 1.5(1.0, 2.1) compared with 2.4(1.3, 3.1)mmol/L] (all P<0.05), and after the intervention, the total cholesterol (TC) of the four groups was also improved compared with that before the intervention [(4.7±0.9) compared with (5.1±1.2)mmol/L, (4.2±1.1) compared with (5.2±1.2)mmol/L, (4.3±1.1) compared with (5.4±1.3)mmol/L, (4.2±1.1) compared with (5.0±1.4)mmol/L] (all P<0.05), and TG and TC of the medical care management, peer management, and medical care and peer co-management groups were lower than those of the general group (all P<0.05). Conclusion:Based on the WeChat platform, the management mode of medical care and peer co-management is conducive to T2DM patients′ better self-management and blood glucose control.
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Purpose@#Lymphoblastic lymphoma (LBL) is an invasive neoplasm of precursor T-cell or B-cell lineage.A broadly accepted standard treatment for adult LBL has not yet been defined. @*Materials and Methods@#To address this issue, we compared two chemotherapy regimens: a modified non-Hodgkinlymphoma Berlin–Frankfurt–Mu!nster-95 (NHL-BFM-95) regimen and HyperCVAD/MA. Thisretrospective study consecutively enrolled 207 adult LBL patients at two hospitals from2000 to 2018. Univariate and multivariate analysis were used to assess prognostic factors. @*Results@#In the present study, most clinical characteristics were similar between the two treatmentgroups except for age and lactate dehydrogenase (LDH) level. Patients treated with modifiedNHL-BFM-95 regimen tended to be younger and with elevated LDH level. The modified NHLBFM-95 regimen produced better treatment outcomes than those with HyperCVAD/MA inpatients with T-LBL or patients < 40 years. Treatment with HyperCVAD/MA, high EasternCooperative Oncology Group scores, and bone marrow involvement were independent riskfactors in T-LBL. No patients interrupted treatment for severe adverse events. @*Conclusion@#The results suggested that the modified regimen is well-tolerated and can produce the promisingoutcomes in patients with T-LBL or patients < 40 years.
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Objective:To investigate the safety and feasibility of endoscopic cholecystolithotomy after endoscopic ultrasonography (EUS)-guided lumen-apposing metal stent (LAMS) implantation in animals.Methods:Six miniature pigs of 30-35 kg were selected to laparotomy under intravenous anesthesia. Two to four sterile human stones with diameter of 0.8-2.0 cm were implanted in their gallbladder. After successful modeling, LAMS was implanted between the stomach and gallbladder under the guidance of EUS. Ultrafine endoscope was used to search and remove stones after passing the gastric stent into the gallbladder. Endoscopic sphincterotomy (EST) and endoscopic retrograde biliary drainage (ERBD) was performed to prevent bile leakage. And then ordinary endoscope was used to remove LAMS and close the wound. The success rate, operation time, and incidence of complications were analyzed.Results:Five pigs were successfully implanted with LAMS, and the ultrafine endoscope entered the gallbladder smoothly. Small stones were removed from the stone basket, and large stones were completely removed after laser lithotripsy. The total operation time was 87-128 min. No postoperative complications such as bleeding, perforation, infection, or biliary fistula were observed. Failure in 1 pig was due to the first EST plus ERBD, resulting in rapid reduction of gallbladder volume and away from the gastric cavity leading to puncture difficulties.Conclusion:Endoscopic cholecystolithotomy after EUS-guided LAMS implantation is safe and feasible, and may provide animal experimental evidence for potential therapeutic approach for patients with difficulty in cholecystectomy.
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Objective To investigate the predictive value of early measurement of serum inflammatory mediators for infectious pancreatic necrosis secondary to severe acute pancreatitis (SAP).Methods A retrospective analysis was performed for the clinical data of 166 patients who were admitted to our hospital from January 2012 to January 2017.According to the presence or absence of secondary infectious pancreatic necrosis,the patients were divided into infection group with 58 patients and non-infection group with 108 patients.The serum levels of inflammatory factors were compared between the two groups.The receiver operating characteristic (ROC) curve was used for the analysis of indices with statistical significance.The independent samples t-test was used for comparison of continuous data between groups,and the chi -square test was used for comparison of categorical data between groups.Results Of all 166 SAP patients,58 experienced secondary infectious pancreatic necrosis,resulting in an incidence rate of 34.9％.Compared with the non-infection group,the infection group had significantly higher serum lipase,procalcitonin (PCT),C-reactive protein (CRP),and APACHE Ⅱ score (t =8.679,20.416,18.429,and 8.563,all P ＜0.05).The ROC curve analysis showed that serum lipase,PCT,CRP,and APACHE Ⅱ score had areas under the ROC curve of 0.647,0.877,0.823,and 0.655,respectively,with cut-off values of 612.5 U/L,7.5 ng/ml,226.5 mg/L,and 16.5 points,sensitivities of 68.5％,91.2％,86.8％,and 60.5％,and specificities of 59.3％,83.6％,80.1％,and 68.7％,respectively.Conclusion The abnormally elevated serum levels of CRP and PCT have a certain predictive value for infectious pancreatic necrosis secondary to SAP with convenient and fast operation,and therefore,it holds promise for clinical application.
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Objective Preoperative autologous blood donation(PABD) can reduce the demand of allogeneic blood transfusion and its safety in obstetrical application has been proved.The article aimed to explore the effects of PABD on reducing allogeneic blood transfusion in pregnant women with placenta previa and the optimal PABD volume for implanted placenta.Methods Retrospective analysis were made on 156 cases with placenta previa hospitalized in our hospital from January 2015 to April 2016, including 78 cases with placenta implantation.According to the volume of PABD, the cases were classified into no PABD group, 300~400mL PABD group, and 600ml PABD group.Data of postpartum hemorrhage volume and allogeneic blood transfusion after delivery were collected to analyze the effectiveness of PABD in reducing the need for allogeneic blood transfusion during pregnancy.Results The hemorrhage volume during the delivery of all 156 patients with placenta previa was 230-5670mL (median 985ml), the rate of severe postpartum hemorrhage (PPH) was 49.4% (77/156), and the rate of allogeneic blood transfusion was 33.3% (52/156).In patients who had no PABD, the rate of allogeneic blood transfusion was 48.2% (40/83).However, this rate dropped down to 16.4% in PABD patients (12/73)(χ2=17.624,P<0.001).The rate of allogeneic blood transfusion in patients was different according to the situation of placenta planting, 43.3% in patients with no placenta plantingand 53.8% in patients with placenta planting.600ml autologous blood could meet all the needs for blood transfusion if there was no placenta implantation.300-400mL PABD could meet the needs of more than 80% patients.11.2%-13.3% of ABD patients might need allogeneic blood transfusion in addition to autologous blood.However, the amount of allogeneic RBC and FFP per capita reduced.Conclusion Patients with placenta previa is in high risk of PPH and PABD can improve their medical safety by reducing the rate and volume of the allogeneic blood transfusion.The strategy of 300-400mL PABD during pregnancy are recommended if there is no contraindication.
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Cervical cancer is one of the most common gynecologic malignancy,ranking fourth in new cases and deaths in 2012.High-risk early stage cervical cancer after operative need adjuvant treatment.Compared with postoperative radiotherapy alone,CCRT can reduce the pelvic recurrence rates and improve survival rates. And CCRT can extend median survival time and survival rates than sequential CRT after operative. CCRT plus consolidation chemotherapy may play a potential role in further improving survival outcomes for high-risk early stage cervical cancer patients compared with CCRT alone. Retrospective studies show that CCRT had equivalent effects with postoperative chemotherapy alone,but further research is needed. Factors influencing the efficacy of postoperative CCRT include chemotherapy regimens,radiotherapy technology,the interval time between surgery and CCRT,multiple pelvic lymph node metastasis and number of pelvic lymph node dissection. Toxicities mainly include hematologic and gastrointestinal toxicity. Hematologic toxicity is the most common. The incidence of toxicity can be reduced by improving radiotherapy techniques.
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Background The use of adaptive optics (AO) system in ophthalmic clinic and basic studies has increased in recent years.However,there are few reports on the stability of ocular aberrations after correction.Objective This study was to analyze the stability of aberration after correction by observing the repeatability of ocular aberration measurements.Methods Forty-one postgraduate school students and volunteers who meet the conditions were included from February to April 2014.The Zernike aberration coefficients including astigmatism (Z2-2,Z22),defocus (Z02),trefoil (Z33,Z3-3),coma (Z3-1,Z13),spherical aberration (Z40) and the value of root mean square (RMS) including 3rd-order to 7th-order aberrations,total higher-order aberrations (HOAs) and total ocular aberrations (TOAs) were measured by using AO system.The repeatability and stability of these data after corrected with AO system were analyzed.The repeatability was evaluated by ANOVA,within-subject standard deviation (Sw),repeatability (r) and intra-class correlation coefficients (ICC).The stability was evaluated by the nonparametric Friedman's rank test.Results AO system showed excellent repeatability on Z2-2,Z22,Z20 and TOA RMS (ICC＞ 0.9),good repeatability on Z13,Z33,Z3-3,Z40,3rd-order RMS,4th-order RMS,HOA RMS (ICC ＞ 0.75),poor repeatability on Z3-1,5th-order RMS,6th-order RMS,7th-order RMS (ICC ＜ 0.75).Repeatability (2.77 Sw) values ranged from 0.009 mm (7th-order RMS) to 0.163 mm (Z31).After low-order ocular aberrations were corrected,It was founded that Z2-2,Z22 reached stable state at the 4th second;Z02 was stable at the 6th second;Z3-3 and Z33 reached stable state at the 4th second and third second,separately;Z13 was stable from 3rd-second to 9th-second,Z3-1 was stable at the 4th-second.Z40 and HOA RMS were stable at the third second and fifth second,respectively.The Z2-2,Z02,Z22,Z3-3,Z3-1,Z33,Z40 and HOA RMS were significantly different among different time points before and after low-order aberrations correction (all at P ＜ 0.05).Z2-2,Z22,Z20 reached stable state at the 4th-second,3rd-second and 5th-second,respectively;Z3-3,Z33 reached stable state at the 2nd-second and 3rd-second,respectively;Z3-1and Z40 reached stable state at the 2nd-second;HOA RMS reached stable state at the 5th-second.Conclusions After correcting the human ocular aberration,different aberrations can reach stable state at different time.The time of Z02,Z22,Z3-3,Z3-1,Z40reaching stable state after 2nd-order to 5th-order ocular aberrations correction was earlier than those of lower-order aberrations correction.
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Background Small incision lenticule extraction (SMILE) is lack of eye-tracking system and there is controversy in the treatment of astigmatism.It is very important to understand its correction effctiveness for myopic astigmatism.Objective This study was to evaluate the clinical outcomes in the correction of myopic astigmatism between SMILE and femtosecond laser assisted laser in situ keratomileusis (FS-LASIK).Methods In this retrospective study,95 eyes of 51 patients and 69 eyes of 40 patients with myopic astigmatism underwent the SMILE surgery and FS-LASIK surgery respectively in Tianjin Eye Hospital from December 2013 to July 2014 under the informed consent.No significant differences were found in spherical power,astigmatic power and spherical equivalent (SE) between the SMILE group and FS-LASIK group before surgery (all at P＞0.05).The uncorrected visual acuity (UCVA),best corrected visual acuity (BCVA),manifest refraction,slit-lamp microscopy,intraocular pressure and corneal topography were measured before surgery and 1 day,1 week,1 month,3 months after surgery.Vector analysis was used to calculate the components of astigmatism before and after surgery.Correction index (CI),index of success (IOS),angle of error (AofE) and flattening index (FI) were used to evaluate the correction effectiveness of astigmatism.Safety index and efficacy index were used to evaluate the recovery status of visual acuity.The corrected effectiveness was compared between the two groups,and the correlations of kappa angle with measured parameter were assessed by Spearman rank correlation analysis.Results The mean spherical power,astigmatic power and SE were (0.003±0.106),(-0.063 ± 0.126) and (-0.029 ± 0.101) D in the SMILE group,which were significantly lower than (0.112 ± 0.212),(-0.091 ± 0.142) and (0.067 ± 0.198)D in the FS-LASIK group (Z =-4.328,-3.197,both at P＜0.05).Vector analysis showed the postoperative with-the-rule astigmatism in the SMILE group and oblique astigmatism in the FS-LASIK group respectively,and the CI and F1 in the SMILE group were significantly lower than those in the FS-LASIK group (Z =-3.051,-3.126,both at P ＜ 0.05).The insignificant reduce in IOS and AofE were seen in the SMILE group compared with the FS-LASIK group (Z=-1.557,P=0.119;Z =-1.923,P =0.054).In addition,the safety index and efficacy index were not significantly different between the two groups (both at P ＞ 0.05).Negative correlations were found between safety index or efficacy index and preoperative kappa angle in the SMILE group (r =-0.258,-0.257,both at P＜0.05).Conclusions Both SMILE and FS-LASIK surgeries are effective and safe in correcting myopic astigmatism with good postoperative visual acuity.SMILE surgery shows less axis rotation and higher accuracy than FS-LASIK because of small incision and flapless procedure.The correction of cylinder can adjust based on experience of surgeon.
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Objective To prepare an attenuated Listeria vaccine Lmdd-LMP2A expressing the Ep-stein-Barr virus latent membrane protein 2A ( EBV-LMP2A) and evaluate its specific anti-tumor effects on nasopharyngeal carcinoma.Methods The gene fragment encoding EBV-LMP2A was amplified by PCR analysis and then subcloned into the shuttle vector p1565.PCR restriction enzyme digestion and DNA se-quencing were performed to identify the recombinant shuttle vector p1565-LMP2A.The p1565-LMP2A vector was then transformed into competent strains of the attenuated Listeria monocytogenes ( Lmdd) .The recombi-nant attenuated Listeria vaccine strain Lmdd-LMP2A was verified by Western blot assay.The histological sections of spleen and liver tissues were stained by Haematoxylin and eosin ( H&E) for analysis of inflamma-tion.A tumor-bearing HLA-A2 transgenic mouse model was established by subcutaneous injection of CNE-1/HLA-A2/LMP2A nasopharyngeal carcinoma cell line.The prepared Lmdd-LMP2A vaccine was inoculated into the mice via tail intravenous injection for the evaluation of specific CTL induction and the in vivo anti-tumor effects.Results The shuttle vector p1565-LMP2A and the recombinant attenuated Listeria vaccine strain Lmdd-LMP2A with stable expression of LMP2A protein were successfully constructed.The immunized mice showed mild inflammations with no structural damage and necrosis as indicated by H&E staining.The growth of tumors in tumor-bearing HLA-A2 transgenic mice was significantly inhibited by the immunization of Lmdd-LMP2A vaccine as compared with mice without inoculation.The survival time of mice was prolonged with the immunization of Lmdd-LMP2A vaccine.Conclusion The prepared attenuated Listeria vaccine Lm-dd-LMP2A showed specific anti-tumor effects with the safety advantage, suggesting the possibility of using it for anti-tumor therapy in clinic.
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Objective To explore the relationship between childhood asthma and pregnant and neonatal risk factors, thus provide evidence for early prevention of childhood asthma. Methods 162 children diagnosed asthma and 213 healthy children in pediatric outpatient and the inpatient services of our hospital who was born and living in Baotou city were retrospectively analyzed. The pregnancy related factors (parity, fever during pregnancy, pregnancy-induced hypertension syndrome, gestational diabetes mellitus, history of overdose in early-pregnancy) and the neonatal period related factors (surface defects, asphyxia, rough placenta, birth weight, number of fetus during this pregnancy, gestational age, premature birth, cesarean section) were investigated. The sex and age showed no signiifcance between childhood asthma and control group. Results Eight pregnant and neonatal factors (fever during pregnancy, pregnancy-induced hypertension syndrome, history of overdose in early-pregnancy, surface defects, asphyxia, rough placenta, birth weight, premature birth, cesarean section) showed signiifcant difference between the two groups (P<0.05). Multifactor regression analysis found fever during pregnancy (OR=9.43, 95%CI:3.08~28.82), rough placenta (OR=2.15, 95%CI:1.29~3.59), premature birth (OR=5.16, 95%CI:1.53~17.39) and cesarean section (OR=4.05, 95%CI:2.40~6.86)are independent risk factors for childhood asthma. Conclusions Fever during pregnancy, abnormal placenta;premature birth and cesarean section are likely risk factors of childhood asthma.
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Objective To assess the relationship between serum vitamin D and autoimmune thyroid disease.Methods Subjects included total 520 persons receiving regular health examination,and serum calcium,phosphorus,parathyroid hormone (PTH),thyroid peroxidase autoantibody (TPOAb) and 25-dihydroxy vitamin Ds was measured.The incidence of 25-dihydroxy vitamin D3 deficiency (≤30 μ g/L)was observed.The relationship between 25-dihydroxy vitamin D3 deficiency and autoimmune thyroid disease was analyzed.Results The serum 25-dihydroxy vitamin D3 of all the subjects was (24.47 ± 7.21) μ g/L,and the incidence of 25-dihydroxy vitamin D3 deficiency (≤30 μg/L) was 61.15％ (318/520),and the positive rate of TPOAb was 21.54％ (112/520).The proportion of TPOAb ＞ 50 kU/L or ＞ 100 kU/L in subjects with 25-dihydroxy vitamin D3≤30 μ g/L was higher than that in subjects with 25-dihydroxy vitamin D3 ＞ 30 μg/L [25.79％(82/318) vs.19.80％(40/202) and 9.43％(30/318) vs.4.46％(9/202)],and there was significant difference (P ＜ 0.05).The relationship between 25-dihydroxy vitamin D3 and TPOAb was assessed and showed significant inverse correlation (r =-0.13,P ＜0.05).Conclusions Vitamin D deficiency is very common in the population,and autoimmune thyroid disease is related with vitamin D deficiency,which may has impact on the body's immune regulation.Specific mechanism and whether vitamin D supplementation can intervene and treat autoimmune thyroid disease need further study.
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Standerdized patiets oan serve as patients, teachers and evaluators. Establishment of standardized patients' teacher-identity is helpful to improving their teaching passion, and it also makes sure all teaching steps may develop successfully and promote accuracy and fairness of evaluation in Standerdized patiets examinations.
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[Objective] To establish an effective and stable method to induce hematopoietic cells from embryonic stem(ES) cells,the phenotype and function of ES-derived hematopoietic cells induced by stromal cell conditioned medium (SCCM) of yolk sac (YS),fetal liver (FL) or bone marrow (BM) were analyzed and compared.[Methods] 10% of YS-SCCM,FL-SCCM or BM-SCCM was added to culture system for differentiation of ES cells.Flow cytometric analysis was used to identify expression of Flk1,Integrin α4,Sca-1,and CD34.Colony analysis was used to identify the quantity of high proliferative potential colony-forming cells (HPP-CFC) in differentiated ES cells.The yield of CFU-S (colony-forming unit-spleen) was also analyzed by transplanting ES cell derivatives into lethally irradiated mice.[Results] Expression of Flk1,Integrin α4,Sca-1,and CD34 could be tested on induced EB cells.The percentage of Flk-1+,Integrin α4+ and Sca-1+ cells induced by were 3.03%,2.9%,and 13.74%,respectively,which are greater than other groups.The percentage of CD34+ cells induced by BMSC-CM was 1.07% which was greater than other groups.The yields of HPP-CFC from hematopoietic cells induced by FLSC-CM or BMSC-CM were 7.4 /105 cells (P ＜ 0.01) and 5.8 /105 cells (P ＜ 0.05) which were greater than the yields of control group.The yields of CFU-S from hematopoietic cells induced by FLSC-CM or BMSC-CM were 8.5/5 × 105 cells and 6.75/5 × 105 cells which were also greater than the yields of control group (P ＜ 0.001).[Conclusion] Both YS-SCCM,FL-SCCM,and BM-SCCM could promote hematopoietic differentiation of ESE14.1 cells.Hematopoietic differentiation induced by FL-SCCM or BM-SCCM is more effective,which generates hematopoietic progenitor cells with normal function.Application of FL-SCCM generates more primitive hematopoietic progenitor cells than that of BM-SCCM.
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Objective To observe the efficacy and adverse effects of MRC UKALL Ⅻ/ECOG E2993 regimen in inducing remission of Chinese adults with acute iymphoblastic leukemia(ALL). Methods 11 cases of previously untreated ALL patients were treated with MRC UKALL Ⅻ/ECOG E2993 regimen, then observe the efficacy and adverse effects. Results All of the 11 patients achieved complete rcmission(CR), the CR rate was 100 %. Among the 11 patients,8 patients achieved CR after the first course of chemotherapy. In the 8 patients which could be followed up, 5 patients achieved durative CR, among that the longest survival time was 30 months, and 3 patients had relapses. This regimen has a severe myelosuppression. There was an effect on liver function, mostly in the increase of glutamic-pyruvic transaminase and glutamic-oxaloacetic transaminase.After the symptomatic treatment, liver function could return to normal. No treatment-related deaths occurred. Conclusion MRC UKALL Ⅻ/ECOG E2993 regimen can be used as inducing remission therapy for Chinese adults with acute lymphoblastic leukemia.
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The effect of myocardium subjected to 60 min ischemia and 60 min reperfusion on the level of lipid peroxides (LPO) and function of myocardial mitochondria and activity of superoxide dismutase (SOD) was studied in cat cardiopulmonary bypass. Myocardial mitochondrial function was slightly depressed after 60 min ischemia but significantly depressed after 60 min reperfusion. Increased lipid peroxides content and decreased SOD activity were observed at 60 min ischemia. After reperfusion, the SOD activity continued decreasing, but LPO elevated apparently. These results support a hypothesis that the free radicals may contribute to the myocardial mitochondrial reperfusion injury.