【Objective】 To explore the causes of occupational exposure, so as to prevent occupational exposure that endangering the physical and mental health of staff in blood centers. 【Methods】 Occupational exposure cases reported from May 1, 2014 to April 30, 2020 by Taizhou Blood Center were classified and analyzed in terms of the exposure mode, body parts, post distribution, seniority of operators and whether the operation was carried out as required. 【Results】 From May 1, 2014 to December 31, 2020, 23 cases of occupational exposure (6.66/100000) occurred in Taizhou Blood Center, and the incidence rate was roughly the same in each year. Among the occupational exposure modes, sharp device puncture, wound exposure and mucosal exposure accounted for 65.2% (15/23), 17.4% (4/23) and 17.4% (4/23), respectively. The exposed sites of body were mainly fingers, followed by eyes and mouth. The incidence of occupational exposure of phlebotomist post accounted for 65.2% (15/23), followed by apheresis platelet collection, component preparation and preliminary screening post [21.7% (5/23), 8.7% (2/23) and 4.3% (1/23), respectively, P<0.05]. The incidence of occupational exposure of new staff rotated within one year was 43.5% (10/23), followed by fixed-point staff within 1-5 years and over 5 years [34.8% (8/23) and 21.7% (5/23), respectively], P<0.05. 56.5% (13/23) of occupational exposure was due to employees′ failure to obey the operate as required. 【Conclusion】 Where there is needle contact there is exposure risk. the newer staff are more likely to suffer occupational exposure, and most exposure are caused by non-compliance with the regulations. The establishment of various preventive measures can effectively reduce the incidence of occupational exposure in blood banks and ensure occupational safety.

【Objective】 To observe the changes of coagulation factor activity and protein content of the thawed fresh frozen plasma (FFP) and fresh liquid plasma (FLP) during storage at 2-6℃, and to provide reference for exploring the appropriate storage time of FFP at 2-6℃ after thawing. 【Methods】 The small-thaw group and the large-thaw group were respectively detected for the activity of coagulation factor FⅤ (FⅤ∶C) and FⅧ(FⅧ∶C), and the levels of fibrinogen (Fib), total protein (TP) and albumin (Alb) in TTP at 1, 2, 3, 4, 5, 6 and 7 days after thawing. And the FLP was detected for FⅤ∶C, FⅧ∶C, Fib, TP and Alb at 1, 2, 3, 4, 5, 6, 7 days and 1, 6, 11, 16, 21, 26 and 31 days after preparation, respectively. 【Results】 In FFP group, FⅧ∶C decreased gradually with the prolongation of storage time after melting (P<0.05), and decreased by 37.4% and 47.6% respectively in the two groups on the 7th day. There was no statistical difference in FⅤ∶C, Fib, TP and Alb (P>0.05). In FLP group, FⅧ∶C decreased gradually with the prolongation of storage time after melting (P<0.05). There was no statistical difference in FⅤ∶C in 7-day storage group (P>0.05), but it decreased gradually in 31-day storage group (P<0.05). There was no statistical difference in Fib, TP and Alb (P>0.05). 【Conclusion】 Although FⅧ∶C is decreased in thawed FFP stored at 2-6℃ for 7 days, it is still about 52.4%, which should be able to play a normal role in clinical practice.

【Objective】 To evaluate the value of Six Sigma quality management method in improving the efficacy of red blood cell transfusion. 【Methods】 The five steps of definition, measurement, analysis, improvement and control in Six Sigma quality management were used to analyze the existing process capability and influencing factors, so as to formulate corresponding optimized measures and control plans for continuous improvement. The transfusion effect of RBCs in hemodynamically stable patients in our hospital from January to November in 2019 were assessed in three phases: January to March(prior to the application of Six Sigma), April to August (tracking the application of Six Sigma), and September to November(determining the effect of Six Sigma). The efficacy and process ability of RBC transfusion in patients with stable hemodynamics before and after the improvement were analyzed and compared. 【Results】 After the improvement, the effective rate of RBC transfusion for hemodynamically stable patients in our hospital increased from 76.9% to 90.5%(P<0.05). The Z value of process capacity increased from 0.408 0 to 1.330 8, with a significant improvement. 【Conclusion】 Application of Six Sigma quality management method can effectively improve the effect of red blood cell transfusion in patients with stable hemodynamics.

Taking nephrotic syndrome as an example, this paper analyzed the autonomy of patients with chronic diseases in medical decision-making, and recognized that patients have autonomy in five dimensions: information, expression, function, decision-making and implementation. Respecting patient autonomy can enable patients to make decisions in their best interests, which is the basis for relevant medical decision-making. However, respecting patient autonomy in medical decision-making of chronic diseases also faces some problems such as limited autonomy of some patients with chronic diseases, poor communication of medical information or lack of resources weakens the autonomy of medical decision-making of patients with chronic diseases, and the difference in health literacy and health management ability affects the play of patient autonomy. Taking the patients with nephrotic syndrome as an example, this paper proposed to recognize the limitations of the autonomy of patients with chronic diseases and flexibly use different ways to respect the autonomy of patients; improve the communication ability and joint decision-making experience of clinical medical staff to fully respect patients’ autonomy; enhance patients’ health literacy and health management ability to realize clinical practice strategy of respect for patients’ autonomy.

Chinese materia medica (CMM) is the product of clinical practice of traditional Chinese medicine. Due to the complexity of the chemical composition of CMM and human body, the functional material base and its mechanism researches were facing a dilemma. In this paper, the chemical composition, antitumor material base, and related mechanism of Pinellia Rhizoma and Magnolia Officinalis Cortex were summarized and analyzed, and the existing problems were found. In order to better elucidate the functional material base and mechanism of the antitumor effects of Pinellia Rhizoma-Mangnolia Officinalis Cortex couplet medicines and reveal the scientific connotation of couplet medicines compatibility, the research thoughts of metabonomics combined with network pharmacology were proposed. With a view to providing theoretical basis and suggestion for the further research on the compound compatibility law.

Objective To find the effect of leonurine on LPS-induced macrophages activation and its potential mechanism. Methods Mouse primary peritoneal macrophages were isolated and pretreated for 24 h with LPS and leonurine. MTT assay was used to detect the cell viability of macrophages. The production of IL-1β, IL-6, TNF-α and IL-18 in culture medium were tested by ELISA, and the production of NO was detected by Griess reagent. The mRNA expression of NLRP3, ASC, caspase-1, TNF-α, iNOS, Arg-1 and CD206 were detected by RT-PCR, and the protein expression of NLRP3, ASC and caspase-1 were detected by Western blotting. Results LPS can significantly increase the releases of NO、IL-1β、IL-6、TNF-α and IL-18 from macrophages. Leonurine can suppress the expression of pro-inflammatory factor levels, such as IL-1β (P<0.05), IL-18 (P<0.05), NO(P<0.05), IL-6(P<0.05) and TNF-α (P<0.05). Leonurine can decrease the activation of macrophage as well as the expression of NLRP3 Inflammasome.Protein expressions of NLRP3、ASC、caspase-1 were mitigated. Conclution Leonurine exerts beneficial effects through M1/M2 phenotypic differentiation of peritoneal macrophage via inhibiting overactivation of NLRP3 inflammasome. These findings suggest that leonurine might have a therapeutic potential for pelvic inflammatory disease.

To summarize the clinical and imaging features of ipsilateral limb weakness caused by cerebral infarction，and to explore the possible physiological mechanism of the disease. Methods The clinical data of patients with ipside-limb weakness caused by acute cerebral infarction hospitalized in our department from January 1，2016 to December 30，2016 were collected，and the neurological symptoms and signs，magnetic resonance imaging （MRI） and other examination results of the patients were analyzed descriptively. Results 8 cases of ipsilateral hemiparesis （0.18%） were found in 4495 patients with acute cerebral infarction，all 8 patients were lacunar cerebral infarction，4 cases with previous medical history of cerebral infarction，3 cases have old infarcts in Contralateral cerebral hemisphere，DTI of 1 case showed pyramidal tract was not cross，the lesions of 2 cases were in the brain stem，2 cases in centrum semiovale，3 cases in capsule，One was in the putamen and one in the frontal cortex. Conclusion Most of the patients with ipside hemiparesis caused by cerebral infarction had a history of previous pyramidal tract injury，which was mostly lacunar lesions，mostly located in the configuration area of ipside-pyramidal tract.

AIM: To observe the effect of sub-bowman keratomileusis(SBK)on the posterior corneal curvature, posterior corneal elevation and anterior chamber parameters.

METHODS: Prospective self controlled study. Totally 49 patients(97 eyes)with myopia who had planned for SBK were included in this study, mean posterior corneal curvature, central posterior corneal elevation(PCE), anterior chamber volume(ACV), central and peripheral anterior chamber depth(ACD)were measured by Oculyzer before and 1wk, 1y, 3y after surgery. Repeated measure analysis of variance was adopted for data analysis.

RESULTS: There were no significant differences in mean posterior corneal curvature at any time point postoperatively compared with that preoperatively(P>0.05). However, central PCE, ACV and central ACD at 1wk, 1y and 3y postoperatively were all decreased(P<0.01). Except for the anterior peripheral ACD at 3y after SBK, other peripheral ACD at any time point postoperatively were all decreased(P<0.05).

CONCLUSION: The posterior corneal curvature remained stable after SBK, while the central PCE shifted slightly backward and the entire anterior chamber became shallow.

Studies have demonstrated the detrimental effects of overt hyperthyroidism on sexual functioning.Here,we comprehensively reviewed the studies that focused on the association between overt hyperthyroidism and erectile dysfunction (ED).After the systematic searching for relevant studies,we find that overt hyperthyroidism is significantly associated with the high risk of ED.The prevalence of ED in patients with hyperthyroidism ranges from 3.05% to 85%,while that in general population is 2.16% to 33.8%.A study reported that the erectile functioning of the hyperthyroidism patients was improved (International Index of Erectile Function:22.1±6.9 vs. 25.2±5.1) after the achievement of euthyroidism.The underlying mechanism of the increase in the risk of ED by overt hyperthyroidism might be correlated to the dysfunction of hypothalamus-pituitary-thyroid axis,dysregulation of sex hormones,abnormal expression of thyroid hormone receptors,and psychiatric or psychological disturbances (e.g.,depression,anxiety,and irritability).Since limited clinical trials have been conducted,additional well-designed cohorts with sizable samples are warranted to elucidate the evidence and mechanism of hyperthyroidism predisposing to ED.The present review indicates that overt hyperthyroidism and the risk of ED are associated,which reminds the clinicians should assess the thyroid stimulating hormone in hyperthyroidism patients presenting with ED,especially in those without positive conventional laboratory findings for causing ED.
Male ; Humans ; Erectile Dysfunction/etiology* ; Anxiety ; Hyperthyroidism/complications* ; Thyrotropin

OBJECTIVE: To compare the clinical efficacy of total hip arthroplasty with conventional instrument OCM approach and posterolateral approach in supine position. METHODS: From February 2017 to January 2019, 67 patients underwent hip arthroplasty due to hip diseases, including 21 patients in the minimally invasive group, 12 males and 9 females;there were 10 cases of femoral neck fracture, 5 cases of aseptic necrosis of femoral head and 6 cases of hip osteoarthritis. In the traditional group, 46 cases were treated by traditional posterolateral approach, including 28 males and 18 females;there were 24 cases of femoral neck fracture, 12 cases of aseptic necrosis of femoral head and 10 cases of hip osteoarthritis. All patientsused biological ceramic artificial joint prosthesis. The operation time, intraoperative bleeding, incision length, preoperative and postoperative creatine kinase (CK-NAC), underground activity time, hospital stay, abduction angle and anteversion angle of prosthesis were observed and compared between two groups. Harris scores before operation and 12 months after operation were compared between two groups. RESULTS: All cases were followed up for 14 to 26(18.4±3.6) months. There was no significant difference in intraoperative bleeding, postoperative anteversion and abduction angle between two groups ( CONCLUSION The two approaches of total hip arthroplasty can obtain satisfactory results.OCM approach has less damage and rapid postoperative recovery. It is a reliable surgical approach and can be popularized and used.
Arthroplasty, Replacement, Hip ; Female ; Femoral Neck Fractures/surgery* ; Femur Head ; Hip Prosthesis ; Humans ; Male ; Operative Time ; Retrospective Studies ; Supine Position ; Treatment Outcome