Objective To comprehensively grasp the grassroots medical institutions blood transfusion(blood) management present situation,put forward improvement strategy for the universality of existence weak link,the stand-ardized management of clinical blood transfusion to strengthen grass -roots medical institutions to provide necessary theoretical support.Methods 62 grassroots medical institutions blood transfusion(blood)in Yantai district were selected as the research subjects,to set the planning,layout,basic construction standards,related technology and equipment application aspects of quantitative evaluation,preliminary conclusions.Results By examination of 62 grassroots medical institutions transfusion quality management level both in terms of hardware and software facilities, emergency plan formulation,system file support informatization construction,staff education training,etc,found many problems,there was a certain gap between the existing department of blood transfusion standards.Conclusion The current grassroots medical institutions transfusion management is conditioned by the objective conditions,there are many problems,such as not improved,will cause a certain hidden trouble on the safety of clinical blood transfusion. Therefore,should combine their own reality,strengthen the quality of blood transfusion management system construc-tion,and give full play to the supervision and management of the hospital transfusion quality management committee. At the same time,the local administrative department of health also should formulate corresponding policies,ensure transfusion management level significantly increased.

Objective To investigate the value of serological screening combined with fetal aneuploidy prenatal noninvasive DNA test ( NIPT) in prenatal diagnosis ,and provide guidance for reducing the birth of children with genetic defects in the future .Methods A retrospective analysis was conducted in 15282 pregnant women with prenatal counseling who performed serological screening and NIPT test .The high risk and critical TANG recommended NIPT test and severe abnormal karyotype children recommend termination of pregnancy .Results Down syndrome screening results showed that 804 cases of 15,282 cases of serological screening samples were detected in high risk , the high risk rate was 5.26％.A total of 804 patients with high risk of Don screen were further tested with noninvasive DNA,which was positive in 10 cases.Among them,8 cases were confirmed by amniocentesis ,including 5 cases of trisomy 21,1 case of trisomy 18 and 2 cases of sex chromosome abnormality (45,XO in one case and 47,XYY in one case),the consistency was 100.00％.Conclusion Noninvasive gene detection of fetal aneuploidy has the advantages of noninvasive ,safe and accurate .It has a wide range of clinical value in the diagnosis of fetal chromosomal abnormalities .

The biomimetic strategy of using the cell membrane-coated nanoparticles can retain the physical and chemical properties of the nanoparticles and show the biological characteristics of the source cell membrane, which can further enhance the role of the nanodrug in tumor treatment. A hybrid cell membrane is the fusion of two or more different types of cell membranes. A hybrid cell membrane can endow nanoparticles with multiple biofunctions derived from the source cells compared with a single cell membrane. Hybrid cell membranes provide a foundation to stimulate extensive research into multifunctional biomimetic nano-drug delivery system (NDDS), which is expected to broaden the application of biomimetic nanotechnology in drug delivery systems. In this review paper, the types of hybrid cell membrane used to construct nano-drug delivery systems, the preparation and characterization methods, and cancer treatment research progress in recent years were reviewed.

Objective:To explore the value of 99Tc m-diethylene triamine pentaacetic acid (DTPA) renal dynamic imaging combined with double plasma glomerular filtration rate (GFR) in the evaluation of split renal function in adult patients undergoing interventional therapy for unilateral hydronephrosis. Methods:Retrospective analysis of 79 patients (39 males, 40 females, age (41.4±16.3) years) with unilateral hydronephrosis in First Hospital of Shanxi Medical University from January 2015 to December 2019 were performed. All patients underwent surgery to relive obstruction. 99Tc m-DTPA renal dynamic imaging was performed before and after surgery to obtain bilateral renogram and GFR was measured by Gates method (marked as gGFR). Meanwhile, the corrected double plasma method was used to measure the GFR of both kidneys (marked as dGFR all). Double plasma GFR of the affected kidney (marked as dGFR) was obtained according to the ratio of renogram and dGFR all. Patients were divided into mild to moderate group (dGFR≥20 and <40 ml·min -1·1.73 m -2 ), severe group (dGFR≥10 and <20 ml·min -1·1.73 m -2) and extremely severe group (dGFR<10 ml·min -1·1.73 m -2) according to dGFR before surgery. Postoperative renal dynamic imaging and dGFR were reexamined to analyze the GFR recovery values (ΔgGFR, ΔdGFR). Data were analyzed by χ2 test, paired t test, one-way analysis of variance, Pearson correlation analysis and Bland-Altman consistency test. Results:There were 34 patients in mild to moderate group, 24 patients in severe group, 21 patients in extremely severe group. Significant differences were found in both gGFR and dGFR before and after surgery in mild to moderate group, as well as those in the extremely severe group ( t values: 2.42-3.34, all P<0.05 ), but there was no significant difference in severe group ( t values: 1.24, 1.27, both P>0.05). The ΔgGFR and ΔdGFR were not significantly different among three groups ( F values: 0.45, 0.34, both P>0.05). GFR mesured by the 2 methods (gGFR, dGFR) before and after operation correlated well in each group (before surgery, r values: 0.68-0.82; after surgery, r values: 0.80-0.91, all P<0.001). GFR measured by the two methods showed poor consistency in the mild to moderate and severe groups (>5%(5.88%, 2/34; 8.33%, 2/24) values before and after surgery exceeding 95% consistency limit), while good consistency was demonstrated in the extremely severe group (<5%(4.76%, 1/21) values before and after surgery exceeding 95% consistency limit). Conclusions:Preoperative GFR in patients with unilateral hydronephrosis cannot predict the recovery of renal function after interventional treatment. For the evaluation of split renal GFR in patients with unilateral upper urinary tract obstructive hydronephrosis, corrected dual plasma method combined with kidney ratio of renogram is more appropriate for the determination of GFR. Gates method has some limitations, however, it can be recommended for the evaluation of GFR in patients with extremely severe renal impairment before and after interventional surgery.

Objective:To evaluate the application of metagenomic next-generation sequencing (mNGS) in the diagnosis of osteoarticular infection.Methods:The clinical data of 37 inpatients aged 32-90 year with osteoarticular infection admitted in the Department of Spine Surgery of Qingdao Chest Hospital from January to December 2019 were retrospectively analyzed. There were 31 cases of spine infection and 6 cases of other joint infection. The tissue samples were obtained from the infected sites through puncture or surgical approach in all patients. The tissue samples were subjected to routine culture of mycobacteria, aerobic bacteria and anaerobic bacteria, respectively. The gene amplification and mNGS were performed for detection of mycobacterium tuberculosis DNA (MTB-DNA). The chi-square test or Fisher’s exact test were used to compare the detection rates of pathogen and simple bacterial infection between mNGS and conventional culture. The conventional culture, mNGS and MTB-DNA amplification detection were performed for all samples; with clinical diagnosis as the gold standard, the diagnostic values of 3 methods were evaluated with receiver operating characteristic curve (ROC). Paired sample t test was used to compare white blood cell(WBC) count, erythrocyte sedimentation rate, C-reactive protein of patients before and after treatment. P<0.05 was considered statistically significant. Results:The pathogens were detected by mNGS for 42 times: bacteria for 39 times (92.8%), fungi for twice (4.8%) and Kirks body for once (2.4%). Among 37 patients there were 29 cases of pure bacterial infection (78.4%), 2 cases of pure fungi infection (5.4%), 1 case of pure Kirks body infection (2.7%), and 5 cases of mixed infection of two or more pathogens (13.5%). The detection rates of mNGS and conventional culture were 100.0% (37/37) and 67.6% (25/37), respectively ( χ2=13.987, P<0.05). The detection rates of mNGS and conventional culture in 29 patients with pure bacterial infection were 100.0% (29/29) and 69.0% (20/29), respectively ( χ2=16.913, P<0.05). The area under the ROC curve (AUC) of conventional culture, mNGS, and MTB-DNA in the diagnosis of osteoarticular tuberculosis infection was 0.958 (95% CI: 0.866-1.000, P<0.05), 1.000 (95% CI: 1.000-1.000, P<0.05) and 0.958 (95% CI: 0.866-1.000, P<0.05). All the 37 patients were treated with anti-infective drugs according to the results of mNGS and conventional culture. Among them, 28 patients received surgical intervention. The patients were followed up until April 30, 2020, 1 patient died. After 3 months of follow-up, the WBC count, erythrocyte sedimentation rate and C-reactive protein were (5.5±1.5)×10 9/L, (41±38)mm/h and (5.0±4.6) mg/L, respectively, which were lower than those before anti-infection treatment [(8.0±2.9)×10 9/L, (79±42)mm/h and(63±52)mg/L] ( t=6.536, 8.302 and 6.373, all P<0.05). Conclusion:The metagenomic next-generation sequencing may have important clinical value in the differential diagnosis of osteoarticular infection.

Objective Network Meta-analysis was conducted to evaluate the differences in the efficacy of different traditional Chinese medicine injections(TCMI)in patients with cancer-related fatigue.Methods The database was systematically searched and included in Cochrane Library,PubMed,Web of Science,CNKI,Wan Fang,China Biomedical Literature Database and Database of Chinese sci-tech periodicals until September,2022.These relevant randomized controlled trial literatures were evaluated the methodological quality by using of Cochrane risk of bias assessment tool.Results 18 articles involving 1404 patients and 6 traditional Chinese medicine injections(TCMI)were included.The results showed that Kangai injection[MD=-2.30,95％CI(-3.09,-1.52)]and Aidi injection[MD=-1.31,95％CI(-1.99,-0.62)]combined with chemotherapy were better than chemotherapy alone in improving CRF in cancer patients during chemotherapy,among which Kangai injection is more effective[MD=-1.05,95％CI(-1.89,-0.21)];Shenmai injection[MD=-1.24,95％CI(-1.91,-0.57)],Kangai injection[MD=-1.02,95％CI(-1.65,-0.39)],and Shenqifuzheng injection[MD=-0.54,95％CI(-0.90,-0.19)]were superior to palliative care alone in improving CRF in palliative care of cancer patients,among which Shenmai injection[MD=-1.26,95％CI(-2.15,-0.37)]is more effective.Conclusions The results demonstrated that TCMI can improve the degree of cancer-related fatigue in tumor patients at different stages.When combined with chemotherapy,Kangai injection was superior to other TCMI,while when combined with palliative treatment,Shenmai injection was superior to other TCMI.

Studies have shown that spatial attention remarkably affects the trial-to-trial response variability shared between neurons. Difficulty in the attentional task adjusts how much concentration we maintain on what is currently important and what is filtered as irrelevant sensory information. However, how task difficulty mediates the interactions between neurons with separated receptive fields (RFs) that are attended to or attended away is still not clear. We examined spike count correlations between single-unit activities recorded simultaneously in the primary visual cortex (V1) while monkeys performed a spatial attention task with two levels of difficulty. Moreover, the RFs of the two neurons recorded were non-overlapping to allow us to study fluctuations in the correlated responses between competing visual inputs when the focus of attention was allocated to the RF of one neuron. While increasing difficulty in the spatial attention task, spike count correlations were either decreased to become negative between neuronal pairs, implying competition among them, with one neuron (or none) exhibiting attentional enhancement of firing rate, or increased to become positive, suggesting inter-neuronal cooperation, with one of the pair showing attentional suppression of spiking responses. Besides, the modulation of spike count correlations by task difficulty was independent of the attended locations. These findings provide evidence that task difficulty affects the functional interactions between different neuronal pools in V1 when selective attention resolves the spatial competition.
Animals ; Attention/physiology* ; Macaca mulatta ; Neurons/physiology* ; Photic Stimulation ; Primary Visual Cortex ; Visual Cortex/physiology*