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【Objective】 To investigate the risk factors of vasovagal reactions(VVR) related to plasma donation, so as to put forward clinical suggestions for early identification and accurate intervention of high-risk groups to ensure the safety of plasma donation. 【Methods】 The demographic characteristics(i.e. gender, age, weight) and records of plasma donors(donation history, pulse before plasma donation, duration of collection, etc.) were collected from July to December 2019 in a region of Sichuan. Based on logistic regression analysis, the correlation between these factors and the risk of VVR was explored. 【Results】 The information of 69 172 donors was collected, and the incidence of VVR was 7.04‰. The risk of VVR was reduced by 99% in the group with plasma collection duration less than 30 minutes compared with the group with plasma collection duration more than 50 minutes(OR, 0.01; 95% CI, 0.00~0.01; P<0.001). The risk of male group was 94 % lower than that of female group(OR, 0.06; 95% CI, 0.04~0.10; P<0.001). Compared with the 45~50 kg group, the risk of weight greater than 80 kg group decreased by 80%(OR, 0.20; 95% CI, 0.09~0.42; P<0.001). The risk of repeated donation group was 34 % lower than that of the first time donation group(OR, 0.66; 95% CI, 0.47~0.91; P<0.001). The risk of VVR in the group with pulse greater than 90 bpm before plasma donation was 2.43 times that in the 60~69 bmp group(OR, 2.43; 95% CI, 1.75~3.36; P<0.001). 【Conclusion】 Duration of plasma collection, gender, weight, frequency of plasma donation, pulse before plasma donation and donor status are independent risk factors for plasma donation-related VVR. Among them, plasma collection duration, gender and weight were the main independent risk factors for plasma donation-related VVR. For donors with plasma collection duration more than 50 minutes, female and low weight, higher risk of VVR was presented and more preventive intervention should be given.
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【Objective】 To evaluate the suitability of current quality standard for end-stage hemolytic rate required by Quality Requirements for Whole Blood and Blood Components in Taiyuan through a 5- year retrospective analysis of leukocyte-reduced RBCs in additive solution in Taiyuan Blood Center. 【Methods】 A total of 240 packs of leukocyte-reduced RBCs in additive solution were collected from January 2007 to December 2021. Hb concentration, hematocrit(Hct) and free Hb in supernatant at end-stage were detected to measure the hemolytic rate. And the hemolytic rate was then compared with the current standard(0.8%) to analyze whether statistical differences existed. 【Results】 The hemolytic rate of leukocyte-reduced RBCs in additive solution were 0.109±0.123 in 2017, 0.113±0.085 in 2018, 0.121±0.076 in 2019, 0.101±0.057 in 2020, and 0.128±0.089 in 2021, with no significant difference among each other (P>0.05). And 97.5% of the products showed an end-stage hemolytic rate below 0.4%, 0.83% among 0.6%~0.7%, and none over the standard of 0.8%. 【Conclusion】 The current national standard for end-stage hemolytic rate of leukocyte-reduced RBCs in additive solution might not be suitable for blood quality control in Taiyuan, and a much stricter criteria should be considered.
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Objective:To compare the efficacy between intramedullary nailing (IMN) and minimally invasive percutaneous pate oteosynthesis (MIPPO) in the treatment of distal tibial fractures.Methods:China National Knowledge Infrastructure (CNKI), Wanfang Database, Chinese Biomedical Literature Database, Pubmed, Embase, Cochrane, and Web of Science databases were searched by computer for publications on IMN and MIPPO in the treatment of distal tibial fractures published in official journals at home and abroad from January 2010 to August 2020. The studies included were evaluated by 2 authors using the Cochrane collaboration’s tool for assessing risk of bias. The main extraction indexes were operation time, union time, superficial infection, deep infection, malunion, delayed union or nonunion, and soft tissue irritation. Review Manager 5.3 software was used for data analysis.Results:A total of 7 studies with 653 patients were included, with 325 in the IMN group and 328 in the MIPPO group. Meta analysis showed the following: operation time in the IMN group was significantly shorter than that in the MIPPO group ( MD=-10.75, 95% CI:-19.92~-1.58, P=0.02); superficial infection rate in the IMN group was significantly lower than that in the MIPPO group ( RR=0.58, 95% CI: 0.39~0.88, P=0.01); fracture malunion rate in the IMN group was significantly higher than that in the MIPPO group ( RR=1.87, 95% CI: 1.15~3.04, P=0.01). Concerning soft tissue irritation, incidence of anterior knee pain in the IMN group was significantly higher than that in the MIPPO group ( RR=16.98, 95% CI: 3.30~87.34, P=0.0007) while incidence of soft tissue irritation at the fracture site in the IMN group was significantly lower than that in the MIPPO group ( RR=0.13, 95% CI: 0.04~0.40, P=0.0004). There were no significant differences between the 2 groups in fracture healing time, deep infection rate, delayed union rate or nonunion rate ( P>0.05). Conclusions:Although both IMN and MIPPO are fine treatments of distal tibial fractures, IMN may be superior in prevention of superficial tissue infection but prone to anterior knee pain while MIPPO may be superior in prevention of malunion but prone to soft tissue irritation at the fracture site. Therefore, MIPPO is suggested in cases with fine pretibial soft tissues while IMN is used to reduce soft tissue infection otherwise.
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Objective:To establish a predictive model of lateral lymph node metastasis in patients with papillary thyroid carcinoma(PTC), and further to compare the diagnostic efficiency of this model with the suspected abnormal lymph node thyroglobulin in fine-needle aspirate fluid (FNA-Tg) for lateral lymph node metastasis.Methods:The preoperative clinical and ultrasonographic data of 110 patients (257 lymph nodes) who underwent PTC cervical lymph node dissection were retrospectively analyzed. According to the postoperative pathological results, they were divided into lateral lymph node metastasis and non-metastasis group. Regression analysis was used to screen out independent risk factors affecting lateral lymph node metastasis and establish a predictive model. The ROC curve was used to evaluate the diagnostic efficacy and the best diagnostic cut-off point.Results:Prediction model: Logit( P)=-2.987+ 2.189(S/L ratio of lymph nodes)+ 1.748(hilum absent)+ 2.030(hyperechoic)+ 1.849(vascular abnormalities). The sensitivity, specificity, accuracy and AUC of the prediction model in the diagnosis of lateral lymph node metastasis were 92.1%, 83.9%, 87.9% and 0.929, respectively. The Homser-Lemeshow goodness of fit test showed that the Logistic model has a good fitting effect. The sensitivity, specificity, accuracy, and AUC of FNA-Tg in the diagnosis of lateral lymph node metastasis were 87.4%, 95.4%, 90.3% and 0.968, respectively. The sensitivity, specificity, accuracy, and AUC of the combined diagnosis of the predictive model and FNA-Tg were 92.9%, 96.9%, 94.2% and 0.989, respectively. Conclusions:The model has a good predictive value for PTC cervical lymph node metastasis. Combined with FNA-Tg, it can improve its diagnostic efficiency and provide more valuable information for the decision-making of clinical surgical procedures.
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Objective@#To evaluate the correlation between ultrasound features of papillary thyroid carcinoma (PTC) and lymph node metastasis by preoperative ultrasound elemental observation of thyroid nodules.@*Methods@#Three hundred and seventy-six patients who underwent primary thyroid surgery and confirmed by ultrasound and pathological data as single-focal PTC from Jannary to December 2017 in Sir Run Run Shaw Hospital of Zhejiang Univbersity College of Medicine were retrospectively analyzed. According to the presence or absence of lymph node metastasis, they were divided into central and lateral lymph node metastasis group and non-metastasis group. Independent risk factors for central lymph node metastasis (CLNM) and lateral lymph node metastasis (LLNM) were analyzed by χ2 test and multivariate Logistic regression.@*Results@#Multivariate analysis showed that the posterior margin of the cancer was <0.25 cm from the posterior wall of the thyroid gland as an independent risk factor for CLNM (P=0.025). Compared with the tumor volume ≤0.38 cm3, the cancer volume >0.38 cm3 (P=0.000), was more prone to CLNM. And multivariate analysis showed that the anterior margin of the cancer was <0.17 cm (P=0.006) from the anterior thyroid capsule and the inner wall of the foci was <0.26 cm (P=0.014) as independent risk factors for LLNM. Compared with the maximum diameter of the tumor lesion ≤1 cm, the maximum diameter >2 cm (P=0.001) group was more prone to LLNM. Compared with the tumor volume ≤0.38 cm3, the tumor volume >0.38 cm3 (P=0.000) was more prone to LLNM.@*Conclusions@#The larger volume of single focal PTC carcinoma and the closer to the posterior thyroid capsule are independent risk factors for CLNM. The larger volume and diameter of single focal PTC, and the closer to the anterior and medial wall capsule are independent risk factors for LLNM.
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Objective To evaluate the correlation between ultrasound features of papillary thyroid carcinoma(PTC)and lymph node metastasis by preoperative ultrasound elemental observation of thyroid nodules.Methods Three hundred and seventy-six patients who underwent primary thyroid surgery and confirmed by ultrasound and pathological data as single-focal PTC from Jannary to December 2017 in Sir Run Run Shaw Hospital of Zhejiang Univbersity College of Medicine were retrospectively analyzed. According to the presence or absence of lymph node metastasis,they were divided into central and lateral lymph node metastasis group and non-metastasis group.Independent risk factors for central lymph node metastasis (CLNM) and lateral lymph node metastasis (LLNM) were analyzed byχ2 test and multivariate Logistic regression.Results Multivariate analysis showed that the posterior margin of the cancer was <0.25 cm from the posterior wall of the thyroid gland as an independent risk factor for CLNM(P=0.025). Compared with the tumor volume ≤0.38 cm3 ,the cancer volume >0.38 cm3(P=0.000),was more prone to CLNM.And multivariate analysis showed that the anterior margin of the cancer was <0.17 cm(P =0.006)from the anterior thyroid capsule and the inner wall of the foci was <0.26 cm (P =0.014) as independent risk factors for LLNM.Compared with the maximum diameter of the tumor lesion ≤1 cm,the maximum diameter >2 cm (P =0.001) group was more prone to LLNM.Compared with the tumor volume ≤0.38 cm3 ,the tumor volume >0.38 cm3(P =0.000)was more prone to LLNM.ConclusionsThe larger volume of single focal PTC carcinoma and the closer to the posterior thyroid capsule are independent risk factors for CLNM.The larger volume and diameter of single focal PTC,and the closer to the anterior and medial wall capsule are independent risk factors for LLNM.
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Objective To evaluate the diagnostic value of high resolution diffusion weighted imaging (RESOLVE-DWI) in adolescent primary osteosarcoma,and to compare the difference of image quality and apparent diffusion coefficient (ADC) value with conventional DWI echo planar imaging (EPI)-DWI.Methods Siemens Skyra 3.0T superconducting magnetic resonance imaging (MRI) scanner was used to collect MRI images of 30 patients suspected to be adolescent primary osteosarcoma.RESOLVE-DWI EPIDWI was performed.Meanwhile,the signal-to-noise (SNR) and ADC values of osteosarcoma tissues were measured and compared with the final pathological examination results.The image quality scores,SNR and ADC values of different diffusion weighted imaging sequences were tested by two independent samples t test.Results The overall quality of RESOLVE-DWI sequence images was significantly better than that of EPIDWI diffusion images,including 23 patients with RESOLVE-DWI scores ≥ 4 scored and 1 patients with EPI-DWI scores≥ 4,with significant difference(P ＜ 0.01).The mean ADC values of osteosarcoma tissues in RESOLVE-DWI sequence group and EPIDW sequence group were(856.16 ± 21.06) × 10-3 mm2 and (824.49 ±33.45) × 10-3 mm2,with no significant difference (P ＞0.05).The average SNR of RESOLVEDW1 group was significantly higher than that of EPI-DW1 sequence group (3.77 ± 0.51 vs 1.97 ± 0.23,P ＜ 0.01).Conclusions RESOLVE-DWI can improve the image quality and the SNR,and the ADC value of osteosarcoma tissue is not affected.It can provide more valuable diagnostic efficacy for the diagnosis of primary osteosarcoma in adolescents,and can be routinely used in the scanning of primary osteosarcoma in adolescents.
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Objective@#To analyze the VP1 genetic sequences of Enterovirus A group 71 (EV-A71) strains and Coxsackievirus A group 16 (CV-A16) strains from suspected hand, foot, and mouth disease(HFMD) cases in Dongcheng District, Beijing in 2017, in order to provide basic data for the prevention and control of HFMD.@*Methods@#By RT-PCR, the VP1 sequences of EV-A71 and CV-A16 VP1 were amplified, and those sequences were compared and analyzed with DNAstar 5.0, while the phylogenetic tree was constructed with MEGA 6.0 software.@*Results@#Totally 95 throat swabs of suspected HFMD cases were detected in Dongcheng District, 2017. Forty-six (48.42%) specimens were positive for enterovirus, 4 (4.21%) specimens were positive for EV-A71 and 4 (4.21%) specimens were positive for CV-A16, 38 (40.00%) specimens were positive for non-EV-A71, non-CV-A16 enterovirus. The nucleotide and amino acid sequence homology of the four EV-A71 strains were respectively 92.89%-99.15% and 97.32%-98.66%. The nucleotide and amino acid sequence homology of the three CV-A16 strains were respectively 93.90%-98.76% and 98.32%-100.00%. The phylogenetic tree indicated that EV-A71 strains belonged to C4a subtype and CV-A16 strains belonged to B1b subtype.@*Conclusions@#The main pathogens causing HFMD were non-EV-A71 and non-CV-A16 enteroviruses in Dongcheng District of Beijing in 2017, but EV-A71 and CV-A16 still account for a certain proportion. The EV-A71 strains belong to C4a genetic subtype; the CV-A16 strains belong to B1b genetic subtype. The subtypes of gene matched with the dominant strains in most areas of China in recent years and no new subtypes were detected.
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Objective To explore the value of diffused optical tomography(DOT)with ultrasonography (US)in differential diagnosis of breast benign from malignant neoplasms.Methods One hundred ard twenty-three breast neoplasms from 113 patients were checked use the optical tomography image ultrasonography(OPTIMUS).The diagnosis results of the system were compared with pathological study.Two-dimensional ultrasound features in breast neoplasms were digitalizated,and HBT and SO_2 were detected by DOT.At last,synthesis diagnostic index(SDI)was obtained by both US and DOT.Statistic process was carried out in sensitivity,specificity,and the rate of accuracy respectively by US,DOT and OPTIMUS system.Results Among breast neoplasms of 123 mass studied pathologically,78 of them were benign and the rest were malignant.HBT in benign lesions(153.02±105.78)was significantly less than malignant lesions(232.95±78.22),SO_2 in benign lesions(1.0332±0.1641)was significantly elevated compared with malignant lesions(0.8794±0.1814),SDI in benign lesions(147.26±53.76)was significantly less than malignant lesions(243.98±57.27),significant differences were found between the two groups(P＜0.05).The sensitivity of differential diagnosis of breast neoplasms by the OPTIMUS system was 93.33%,the specificity was 83.33%,and the rate of accuracy was 86.99%.Conclusions OPTIMUS can improve the specificity and the rate of early diagnosis.
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Objective To explore the change of function of adrenal cortex in patients with hyperthyroidism to provide theoretical evidence for clinical practice. Methods The reaction of adrenal cortex to small dosage of ACTH was detected and compared with each other in normal controls,in patients with mild hyperthyroidism,and patients with severe hyperthyroidism. Results The reaction to small dosage of ACTH was statistically different among the three groups \[F=278.3(15 min), 274.2(30 min), 469.8 (60 min), 273.3(min),866.2(AUC),P
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The CT features of 50 cases of primary bronchogenic carcinoma of different histologic types, including 34 cases of squamous carcinoma (SC) of which 26 of the central trpe, 8 of peripheral; 4 cases of undiffcrentiated small cell carcionma(USCC)which were all of the central type, and 12 cases of adeno-carcionma of the peripheral type, were reviewed in the attempt to find out the relationship between the histologicatypes and clinical behaviors of the carcinomas. The central squamous carcinomas usually show a transbronchial growth to form masses in the lung parenchmas; when it extends along the bronchial wall, a branching mass in the pattern similar to the bronchial branches can be seen; when it extends along the vascular sheath, there will be accentuation of the vascular markings around the mass; and it can also spread via the lymphatics to the mediastinum or to the pleura retrogradely. The primary lesion of USCC usually is relatively small in size, but its metastatic lesions can fuse together to form a huge mediastihal mass. Consequently its diagnosis ran only be made on the findings of bronchial stenosis or obstruction. Bronchogenic carcinoma of the peripheral type usually arises from the wall of small air passages to form a solid mass in the parenchyma. Lobulations or protuberances of the mass with brushy margin and pleural indentation suggest the diagnosis. Deep lobulations with long brushy projections of the mass and bronchovascular convergence are characteristic features of an adenocarcinoma.
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The dynamic changes of 64 cases of primary bronchogenic carcinoma were reviewed with their serial chest films.Obstructive pneumonitis was found in 26 cases,of which 17 showed a dense and/or enlarged hilar shadow on the first chest film.Inflammation could be minimized after treatment but the hilar shadow remained dense and/or enlarged.Hilar masses could appear after total absorption of inflammation.Thus increased density and/or enlargement of the hilar shadow could be considered as an important sign of obstructive pneumonitis.Solitary pulmonary nodule(SPN)was found in 36 cases.The nodules with a diameter smaller than 2 cm on the first chest film usually showed a high incidence of vacuolization and could be taken as an early sign of lung carcinoma.The nodules with a diameter larger than 2 cm usually suggested the malignant nature of the lesion if they exhibited an increased tendency to have spicule sign.tabulation sign,or linear shadows in lung parenchyma which might be clearly or blurrily demarcated and connected the nodule with the pleura.No vacuolization was seen in those nodules larger than 3 cm in diameter.The appearance of pleural indentation showed no relation to the size of the nodule.The dynamic changes of the nodulessmaller than 2 cm in diameter were emphatically observed and they usually appeared as a small piece of thin cloudiness,a small nodule,or a reticu-lonodular shadow on the first chest film.The measures to increase the detection of the nodular lesion smaller than 2 cm in diagmeter on a chest film were discussed.In addition,a rare early feature of lung adenocarcinoma,which showed a large piece of interstitial changes,was presented.
