Objective:To study the detection value of platelet activation indexes and platelet parameters in patients with hepatitis B-induced cirrhosis.Methods:40 patients with hepatitis B-induced cirrhosis in our hospital from November 2015 to August 2016 were selected as the observation group.40 healthy subjects went through physical examination during the same period were chosen as the control group.The platelet activation indexes and platelet parameters of subjects with same age in two groups were detected and compared.The detection results of the two items in patients with different stages of hepatitis B-induced cirrhosis were compared,too.Results:The PLT of observation group was lower than that of control group,while the other platelet parameters and platelet activation indexes were all higher than those of control group.The detection results of two items in patients with different stages of hepatitis B-induced cirrhosis were with significant differences,all P＜0.05.Conclusion:The platelet activation indexes and platelet parameters in patients with hepatitis B-induced cirrhosis are obviously abnormally expressed.There are significant differences among the detection results in patients with different stages.Therefore,surveillance of those indexes in patients with hepatitis B-induced cirrhosis should be strengthened.

A sensitive and reliable liquid chromatography-electrospray ionisation-tandem mass spectrometry (LC-ESI-MS/MS) method was established to simultaneously quantitate four categories of compounds (isoflavonoids, flavonoids, alkaloids and saponins) in Gegen-Qinlian decoction (GQD). These compounds were separated by a Shiseido CAPCELL PAK C18 column with a linear gradient consisting of 0.1% (v/v) formic acid in water (A) and 0.1% (v/v) formic acid in acetonitrile (B), and delivered at a flow rate of 0.3 mL/min. All the analytes were determined by electrospray positive ionization tandem mass spectrometry in a multiple reaction monitoring (MRM) mode. Linearity, accuracy, precision, recovery and stability of the method were evaluated with the validation over the range of 4.0-538 5 ng/mL. The proposed method was applied to the analysis of a Chinese herbal preparation GQD successfully.

Objective To evaluate the correlation between plasma high sensitivity C reactive protein (hs-CRP) level and global registry of acute coronary events (GRACE) scores,and its predictive value for long-term (5 years) cardiovascular events in middle-aged and elderly patients with acute coronary syndrome (ACS).Methods 138 middle aged and elderly patients with ACS were divided into three groups according to GRACE scores:low risk group,middle risk group,high risk group.And based on quartiles of hs-CRP levels,subjects were segregated into 4 groups (Q1 to Q4).All subjects were followed up for about 5 years and adverse cardiovascular disease events were recorded.Results The hs-CRP level was gradually increased along with increasing risk according to GRACE risk stratification (hs-CRP low risk group,0.09 ± 0.22 ; middle risk group,0.21 ± 0.04 ;high risk group,0.43±0.23,P＜0.001).Meantime,GRACE risk scores were gradually increased along with increasing hs-CRP levels from Q1 to Q4 (Q1:133.0 ± 43.6; Q2:161.9 ± 60.2; Q3:169.3±52.6; Q4:188.4±47.5; all P＜0.001).Regression analysis showed that hs-CRP level was positively correlated with GRACE risk scores (r=0.576,P＜0.001).During a follow-up period of about 5 years,96 cardiovascular events were recorded.Receiver operating characteristic(ROC) curve analysis showed that area under the ROC curve (AUC) of hs-CRP was 0.821 (95 ％CI:0.749-0.892,P＜0.001) and AUC of GRACE risk score was 0.869 (95％CI:0.801 0.938,P＜0.001) in the evaluation of the long-term risk of incident cardiovascular events.The differences in prediction of long-term cardiovascular events in middle-aged and elderly patients with ACS were not significant (P =0.237) between GRACE risk score and hs CRP level.Conclusions Plasma hs-CRP level is positively associated with GRACE score.Both of them can predict long-term adverse cardiovascular events in middle-aged and elderly patients with acute coronary syndrome.

Objective To investigate the influence factors of birth defects. Methods The congenital malformational fetuses born from 13 week of gestation to 7 days after birth were selected as the study group between April 1st, 2009 and March 31st, 2010. The health born fetuses were set as control in the same period. Case-control and the three-level of monitor network of birth defects were used in the study in the participating 75 hospitals (Qingdao Women and Children's Medical Center, Affiliated Hospital of Medical College Qingdao University, Qingdao Municipal Hospital, etc.) . The study and control group's parents were interviewed by an uniformed questionnaire which was designed specially with influence factors of birth defects. Results (1) There are 466 congenital malformational fetuses in the total of 77 231 fetuses collected in 75 hospitals. The congenital malformational rate accounts for about 6. 034‰. The top six defect diseases were congenital heart disease (112 cases) , total harelip (cleft lip; cleft lip with palate; 85 cases) ,polydactyly (53 cases) , neural tube defects (38 cases) , congenital hydrocephalus (37 cases) and limb reduction defect (27 cases) in turn, which amounts to 353 cases (54.48% , 353/648). (2) Their mother education level in the birth-defect group (25. 6%) were significantly lower than that in control group (30. 0% , P < 0. 05). (3) The rate of passive smoking, drinking, raising pets of the parents in birth-defect group were significantly higher than that in control group (P < 0. 05). (4) The rate of exposure to harmful chemical and physical factors of mothers in birth defects group (13.9% and 20. 5% , respectively) was higher than that in control group (1.1% and 11.7% , respectively) , the difference between which were significant (P < 0. 01) . The rate of disease (34. 3%) , fever (13. 1%) , taking drugs (33. 8%) in pregnancy period in birth defect group were higher than that in control group (13. 5% , 1.5% and 9. 9% ,respectively) , the difference between which were significant (P <0. 01). The rate of bad moral irritation to the mother in pregnancy in birth defect group (11. 3%) was significantly higher than that in control group (1.4% , P<0.01). (5) There were 19 cases (2.9% , 19/648) with family heredity medical history in birth defect group, but there were none in the control group, the difference between which were significant (P<0. 01). There were 89 cases (13.7% , 89/648) with unusual birth history of their mothers in birth defect group, but there were 31 cases (4. 8% , 31/650) in control group, the difference between which were significant (P<0. 01). (6) Conditional Logistic Regression model was used for univalent and multivariate analysis. The results showed that main influence factors were identified as having important effect on birth defects, including mothers' exposure to harmful chemical factors (OR=13. 46) , disease (OR=3. 37) ,taking drugs (OR=2. 20) , exposure to bad moral irritation (OR=5. 44) , food-choosy (OR=1. 90) ,anemia (OR=1. 52) in gestational period, polyembryony (OR=4. 40) , father drinking (OR=1. 55) .While it was protective factors to supplement microelements such as the calcium iron and nutrient, etc. in pregnancy period (OR=0. 45). Conclusions First, the main birth defects were congenital heart disease, total harelip (cleft lip; cleft lip with palate) , polydactyly, neural tube defects, congenital hydrocephalus and limb reduction defect in turn. Second, the main influence factors identified as having important effect on birth defects were mothers' exposure to harmful chemical factors, ill, taking drugs, exposure to bad moral irritation, food-choosy, anemia in gestational period, polyembryony, father drinking. But it is protective factors to supplement microelements such as the calcium iron and nutrient, etc. in pregnancy period. Finally, it is the important part to prevent the birth defects by reducing and controlling dangerous factors in pregnancy period.

To analyse and compare the characteristics of the intestinal absorption of puerarin, baicalin, berberine and liquiritin in different combinations of Gegenqinlian decoction based on pharmacokinetic parameters, a sensitive liquid chromatography-tandem mass spectrometric (LC-MS/MS) method was applied for the quantification of four components in rat's plasma. And pharmacokinetic parameters were determined from the plasma concentration-time data with the DAS software package. The influence of different combinations on pharmacokinetics of four components was studied to analyse and compare the absorption difference of four components, together with the results of the in vitro everted gut model and the rat single pass intestinal perfusion model. The results showed that compared with other combinations, the AUC values of puerarin, baicalin and berberine were increased significantly in Gegenqinlian decoction group, while the AUC value of liquiritin was reduced. Moreover, the absorption of four components was increased significantly supported by the results from the in vitro everted gut model and the rat single pass intestinal perfusion model, which indicated that the Gegenqinlian decoction may promote the absorption of four components and accelerate the metabolism of liquiritin by the cytochrome P450.

Objective To establish the reference ranges of the spatial angles among cardiac chambers and great vessels in second and third trimester fetuses measured by spatiotemporal image correlation (STIC).Methods Volume images of 352 normal fetuses from 20 to 38 weeks of gestation were recruited in the study.An off-line analysis of acquired volume datasets was carried out with multiplanar mode.Parameters measured included angles between:(1) the 4-chamber view and the left ventricular long axis view; (2) the left ventricular long axis view and main pulmonary artery; and (3) the ductal arch and aortic arch.The relationships between above-mentioned angles and gestational age were assessed by correlation and regression analysis.Results The angle between the 4-chamber view and the left ventricular long axis view (range:55.7° - 35.7°,mean:45.7° ± 5.12°) was uncorrelated with gestational age (r = 0.03,P = 0.51).In contrast,the angle between the left ventricular long axis view and main pulmonary artery,and the angle between the ductal arch and aortic arch were correlated with gestational age (P ＜ 0.001),and the correlation coefficient was - 0.53 and 0.57 respectively.The best-fit exponential curve regression equations of the angle between the left ventricular long axis view and main pulmonary artery was:Y = 154- 4.24X +0.05X2 ,and the angle between the ductal arch and aortic arch was:Y = - 20.8 + 2.65X - 0.37X2.Conclusions The angles among cardiac chambers and great arteries of fetuses from 20 to 38 weeks of gestation can be quantitatively measured by STIC.The reference ranges provide a reliable quantitative standard to estimate the spatial relationships of the cardiac large arteries of fetuses,which may be clinically useful in prenatal screening congenital heart disease.

Objective To explore the clinical outcome of HLA haploidentical vs HLA-matcbed peripheral blood hematopoietic stem cell transplantation (PBSCT) without in vitro T-cell depletion for malignant hematological diseases. Methods 111 patients with malignant hematological diseases underwent PBSCT without in vitro T-cell depletion between May 2004 and February 2009, including 51 patients with HLA-haploidentical and 60 patients with HLA-matched. All patients have received myeloablative conditioning regimen. A two-agent based graft-versus-host disease (GVHD) prophylaxis was used as cyclosporine A and a short course of methotrexate. Mycophenolate mofetile was added for the patients with one locus mismatch. Mycophenolate mofetile, antithymocyte globulin and CD25 monoclonal antibody were added for the patients with 2-3 loci mismatch. The grafts were granulocyte colony-stimulating factor-mobilized peripheral blood stem cells without in vitro T-cell depletion. Results 111 patients achieved sustained and full donor-type engraftment. The median time to reach an absolute neutrophil count above 0.5×10~9/L was 14 days and that to a platelet count exceeding 20×10~9/L was 15 days in 51 HLA-haploidentical patients, and that was 12 days and 13 days in 60 HLA-matched patients, respectively. In 51 HLA-haploidentical patients, 25 patients developed aGVHD, including 20 cases of grade Ⅰ aGVHD, and 5 cases of grade Ⅱ. Thirty-three patients developed cGVHD with limited in 30 and extensive in 3. The 4-year cumulative incidence of cGVHD was 70.4 %. The 3-year probabilities of leukemia-free survival (LFS) were 74.5% (77.3 % for standard risk patients and 68.2 % for high risk patients respectively). Seven patients had recurrence. In 60 HLA-matched patients, 14 patients developed aGVHD, including 10 cases of grade Ⅰ, 2 cases of grade Ⅱ and 2 cases of grade Ⅲ. Thirty-seven patients developed cGVHD with limited in 32 and extensive in 5. The 4-year cumulative incidence of cGVHD was 58.1%. The 3-year probabilities of LFS were 72.1% (77.6 % for standard risk patients and 52.7 % for high risk patients respectively). Ten patients had recurrence. The incidence of aGVHD in HLA-haploidentical cohort was significantly higher than in HLA-matched cohort (P<0.05). There was no significant difference in incidence of cGVHD, incidence of relapse and LFS between HLA-haploidentical and HLA-matched cohorts (P>0.05). Conclusion Haploidentical PBSCT is feasible and safe for malignant hematological diseases to use myeloablative conditioning regimen in combination with intensive immunosuppressants without in vitro T cell depletion.

Objective:To construct a risk model of liver injury related to parenteral nutrition (PNALD) in patients with severe acute pancreatitis (SAP).Methods:The clinical data of 176 SAP patients admitted to the 971 Hospital of Navy from January 2019 to August 2021 were retrospectively collected. According to whether PNALD occurred or not, the patients were divided into liver injury group ( n=33) and non-liver injury group ( n=143). Multivariate logistic regression was used to analyze the influencing factors of PNALD in SAP patients. Then decision tree model and multivariate logistic regression model were established based on the screened risk factors. Hosmer and Lemeshow Test calibration curves were used to calibrate the two models, and receiver operating characteristic curve (ROC) was drawn and area under the curve (AUC) was calculated to compare the prediction efficiency of the two models. Results:Drinking history (history of alcohol intake), serum albumin / globulin ratio ≤1.45, prothrombin time (PT)≥18.52 s, PT activity ≤48.96, activated partial thromboplastin time (APTT) ≥45.91 s were all risk factors for PNALD. The ROC curve of the multivariate logistic regression model and the decision tree model was drawn, and calculated AUC of the two models was 0.851 and 0.906, respectively; the sensitivity was 79.6% and 80.8%, respectively; the specificity was 80.5% and 79.6%, respectively; and the Youden index was 0.601 and 0.604, respectively, with good consistency.Conclusions:Low serum albumin/globulin ratio and PT activity, high PT and APTT are all risk factors for PNALD. The PNALD prediction model based on the above risk factors has high specificity and sensitivity.

Objective To study the type and corresponding clinical characteristics of primary hemophagocytic lymphohistocytosis (HLH) associated immune gene mutations in the refractory virus infection or HLH of unknown causes. Methods From December 2009 to July 2010, the patients with refractory virus infection or HLH of unknown causes were screened for the primary HLH associated immune genes mutations by DNA sequence analysis, including PRF1, UNC13D, STX11, STXBP2, SH2D1A and XIAP. The clinical characteristics and outcomes were followed up. Results Totally 25 patients with refractory virus infection or HLH of unknown causes were investigated for the 6 genes and 13 cases were found carrying gene mutations, composing of 6 of PRF1 mutation, 3 of UNC13D, and each one of STX11,XIAP, SH2D1A and STXBP2, respectively. Among the 13 cases with gene mutations, 5 suffered from Epstein-Barr virus associated HLH( EBV-HLH), 1 human herpes virus 7 associated HLH (HHV7-HLH),1 HLH without causes, 4 chronic activated EB virus infection (CAEBV) with 1 progressing to Hodgkin's lymphoma carrying abnormal chromosome of t ( 15; 17 ) (q22; q25 ) and hyperdiploid, 2 EBV associated lymphoma. Among the other 12 patients without gene mutation, 4 suffered from EBV-HLH with 1 progressing to peripheral T lymphoma, 8 suffered from CAEBV. Conclusions Primary HLH associated immune gene mutations are critical causes of refractory virus infection of unknown causes, most patients manifest as HLH,some cases appear in CAEBV and EBV associated lymphoma. DNA sequence analysis is helpful to early diagnosis and correct decision-making for treatment.

Objective To observe the value of shear wave viscoelastography(SWV)for differentiating lung peripheral inflammatory masses and malignant tumors.Methods Conventional gray-scale ultrasound and SWV were prospectively performed in 70 patients with lung peripheral inflammatory mass or malignant tumor.The patients were divided into malignant group(n=42)and inflammatory group(n=28)according to pathological results.Clinical and ultrasonic data,including the maximum diameter of lesions,the mean Young's modulus(Emean),mean viscosity(Vmean),and mean dispersion slope(Dmean)were compared between groups.Receiver operating characteristic curves of ultrasonic parameters being significantly different between groups were drawn,and area under the curves(AUCs)were calculated to evaluate the efficacy of each parameter for differentiating lung peripheral inflammatory mass or malignant tumor.Results In malignant group,the maximum diameter and Emean of lesions were both higher,while Vmean and Dmean of lesions were both lower than those in inflammatory group(all P＜0.05).Vmean and Dmean of lesions had moderately/good efficacy for differentiating lung peripheral inflammatory mass or malignant tumor(AUC=0.843,0.866),both better than that of conventional ultrasound and Emean(AUC=0.673,0.685)(all P＜0.05).The combination of Emean,Vmean and Dmean had good efficacy for differentiating lung peripheral inflammatory masses and malignant tumors,with AUC of 0.874.Conclusion The viscous parameters of SWV could effectively differentiating lung peripheral inflammatory masses and malignant tumors.