Objective To study the quality control of previous process of apheresis platelets detection .Methods Single and double apheresis platelets each of 100 samples were collected and were diluted 1∶1 ,1∶3 and 1∶7 .Aautomatic Blood Cell Count-er was employed to detect the platelet count .Another 100 samples of apheresis platelets were collected and stand at room tempera-ture for 0 ,30 ,60 ,90 ,120 min ,After 1∶3 dilution ,the platelet counts were detected .Results Differences of platelet counts be-tween 1∶1 and 1∶3 dilution ,1∶3 and 1∶7 dilution of single or double apheresis platelets showed statistically significant differ-ences(P<0 .05) .Differences of platelet counts between standing for 0 ,30 min and standing for 60 ,90 ,120 min were found statis-tically significant(P<0 .05) .Conclusion Quality control of previous process of apheresis platelets detection is very important for platelet count after collection .

Objective To observe the clinical efficacy of long-time needle retaining at scalp acupoints plus body acupuncture in treating motor dysfunction in the sub-acute stage of cerebral stroke.Method A hundred patients in sub-acute stage of cerebral infarction or hemorrhage scored 4-24 by the National Institute of Health Stroke Scale (NIHSS) were randomized into a treatment group and a control group, 50 cases in each group. The control group was intervened by dry rehabilitation training, while the treatment group was additionally intervened by long-time needle retaining at scalp acupoints (6-8 h) plus body acupuncture. The neural functional deficit, motor function, and activities of daily life were estimated and compared respectively by using NIHSS, Fugl-Meyer Assessment Scale (FMA), and Barthel Index (BI).Result The NIHSS score was significantly changed in the treatment group after 1 treatment course (P<0.05). After 2 treatment courses, the NIHSS scores were significantly changed in both groups compared to that before treatment (P<0.05). The FMA and BI scores were remarkably changed in both groups respectively after 1 and 2 treatment courses compared to that before treatment (P<0.05). After 2 treatment courses, there were significant differences in comparing the NIHSS score and BI score between the two groups.Conclusion Long-time needle retaining at Scalp acupoints plus body acupuncture can improve the neural function deficit, motor function, and activities of daily life in sub-acute stage of cerebral stroke.

Objective To observe the effect of acupuncture on walk ability and motor function of lower limbs in subacute stage of cerebral stroke.Method A hundred patients in subacute stage of cerebral infarction or hemorrhage and scored 4-24 according to the National Institute of Health Stroke Scale (NIHSS) were randomized into a treatment group and a control group, 50 cases in each group. The control group was intervened by rehabilitation training, while the treatment group was additionally intervened by acupuncture. The neural deficit degree (NIHSS score), motor function of lower limbs [Fugl-Meyer Assessment (FMA)], activities of daily life [Barthel Index(BI)], and ambulation ability [Functional Ambulation Category (FAC)] were evaluated before and after intervention.Result After 1 treatment course, the NIHSS score was significantly changed in the treatment group compared to that before intervention (P<0.05). The NIHSS scores after 2 treatment courses were significantly different from that before intervention and that after 1 treatment course in both groups (P<0.05). In both groups, the FMA score, BI, and FAC score after 1 treatment course and 2 treatment courses were significantly different from that before intervention (P<0.05). The FMA and FAC scores after 2 treatment courses were significantly different from that after 1 treatment course in both groups (P<0.05). After 2 treatment courses, there were significant differences in comparing the NIHSS score, FMA, BI, and FAC scores between the two groups (P<0.05). Conclusion Acupuncture can improve the ambulation ability, neural deficit, motor function of lower limbs, and activities of daily life of hemiplegia patients in subacute stage of cerebral stroke.

OBJECTIVETo verify the clinical efficacy of acupuncture for mild cognitive impairment of stroke at subacute stage.

METHODSOne hundred patients at subacute stage of cerebral infarction or cerebral hemorrhage with scores of Montreal cognitive assessment (MoCA) less than 26 were randomly divided into an observation group and a control group,50 cases in each one. Based on the regulation of blood pressure and blood sugar and anticoagulation,cognitive rehabilitation training was adopted in the control group. On the basis of treatment in the control group,acupuncture was applied in the observation group. The acupoints were Baihui(GV 20), Sishencong (EX-HN 1), Shenting (GV 24), Yintang(GV 29), Hegu (LI 4) and Taichong(LR 3). Sishencong(EX-HN 1), Shenting (GV 24) and Yintang (GV 29) were connected to electroacupuncture apparatus. The treatment was given once a day,5 times a week, and 8-week treatment was acquired in the two groups. In the 4th week and the 8th week,limbs motor function, daily life ability and cognitive function were evaluated by Fugl-Meyer assessment (FMA) scale,Bathel index and MoCA scale.

RESULTSIn 4 weeks and 8 weeks, the scores of FMA, Bathel index and MoCA in the two groups were improved compared with those before treatment (all P < 0.05). After 8-week treatment, the scores of Bathel index and MoCA in the observation group were better than those in the control group (both P < 0.05).

CONCLUSIONBased on the cognitive rehabilitation training and the conventional treatment, acupuncture can improve the cognitive function and daily life ability of stroke patients at subacute stage with mild cognitive impairment.

Acupuncture Points ; Acupuncture Therapy ; Adult ; Aged ; Aged, 80 and over ; Cognition ; Cognitive Dysfunction ; psychology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Stroke ; psychology ; therapy

Objective; To clone, sequence and analyze the coding sequences of the Mr 15000 and Mr 9000 active segments of natural granulysin derived from human CTLs activated by allogenic antigen ,in order to establish the basis for further purifying and investigating the immune - impairing mechanism of granulysin. Methods; The coding sequences of the Mr 15000 and Mr 9000 granulysin gene were amplified from the total RNA of activated CTLs of healthy person after reverse transcription by Nested - PCR, inserted into pET32a ( + ) vectors and then transformed into E. Coli TOP10, respectively. The recons were identified by PCR, endonuclease digestion and sequencing. Results: The whole coding sequences of the Mr 15000 and Mr 9000 active segments were successfully cloned as expected. The accurate pET32a - Mr 15000 and pET32a - Mr 9000 recons were obtained through Colony - PCR, endonuclease digestion and sequencing. There lied polymorphism on the 119 th amino acid of the product encoded by GLS gene. Conclusion; The coding sequences of the Mr 15000 and Mr 9000 active segments of human granulysin can be obtained and cloned by the methods mentioned above and can be used for subsequent research.

Background and purpose:Although bortezomib has become one of the major therapeutic agents against newly diagnosed or relapsed multiple myeloma (MM), there are some patients who become resistant to bor-tezomib and then relapse, emerging as a major obstacle to long-term survival of MM patients. It has been found that elevation of intracellular cyclic adenosine monophosphate (cAMP) levels could induce cell cycle arrest and apoptosis in MM cells,which has become an interesting approach to MM therapy. This study aimed to investigate possible effects of forskolin combined with bortezomib on bortezomib-resistant myeloma cells and further explore its mechanisms. Methods:The bortezomib-resistant MM cell lines H929-R and primary cells from patients who do not respond to bortezomib were used asin vitro models. The inlfuences of bortezomib and/or forskolin on MM cells were evaluated through cellular morphology, changes of cell distribution and apoptotic rate. Meanwhile, lfow cytometry analysis was used to detect mitochondrial transmembrane potential (ΔΨm) and the expression levels of apoptosis regulators in these cells before and after the treatment were detected by Western blot.Results:Bortezomib (20 nmol/L) synergized with forskolin (50nmol/L) to induce apoptosis of H929-R cells and bortezomib-resistant primary cells. In addition, borte-zomib synergized with forskolin to induce collapse of mitochondrial transmembrane and facilitate the degradation of anti-apoptosis proteins including Bcl-2 and Mcl-1.Conclusion:Bortezomib could synergize with forskolin to induce apoptosis in bortezomib-resistant MM cells.

Objective To observe the formation of the biofilm in endotracheal tubes,the characteris-tics of etiology, drug resistance and relationship between the biofilm and ventilator-associated pneumonia ( VAP) . Methods A total of 60 cases of ventilated children patients whose mechanical ventilation time were≥48 h in the ICU from September 2010 to September 2012,according to the mechanical ventilation time,all cases were divided into 2 to 6 d group,7 to 14 d group and ≥15 d group. The incidence of VAP, biofilm structure under the electron microscope,etiology culture positive rate of the lower airway secretions and bio-film,etiological characteristics and drug resistance were prospectively studied. Results ( 1 ) A total of 19 cases occurred VAP in 60 cases of mechanical ventilation,the incidence of VAP was 31. 7%. (2) Observed by electron microscope,biofilm had formed in the endotracheal tube inner wall in early period of mechanical ventilation. With prolonged mechanical ventilation,biofilm structure had improved,as well as VAP incidence rate from 9. 1%(2 to 6 d group ) increased to 44. 4%(7 to 14 d group) and 88. 9%(≥15 d group). (3) A large number of pathogenic bacteria colonized in the biofilm. Gram-negative bacilli were dominate and drug resistance was high. (4) With prolonged mechanical ventilation,the cultured pathogens from the lower airway secretions and biofilm converged. Conclusion Biofilm could form in the endotracheal tube with mechanical ventilation patients,and is associated with the occurrence of VAP and refractory infections.

Background and purpose: Radiofrequency ablation (RFA) is one of the effective treatment methods for primary liver cancer and metastatic liver cancer. The purpose of this study was to investigate the risk factors of residual tumor after RFA for hepatic malignancies. Methods:A total number of 302 hepatic malignancies cases with 691 tumors after ultrasound-guided RFA from Jan. 2010 to Mar. 2013 were retrospectively analyzed. Single factor and multi-factor Logistic regression model were used to analyze the risk factors of residual tumor after RFA. Results:Complete ablation cases were 90.07%(272/302) for patients and 91.46%(632/691) for tumors, and the ablation residual rate was 8.54%. Ablation residual rates for tumor ≤3 cm, 3-5 cm and >5 cm in diameter were 6.30%, 9.57% and 28.57%, for tumor close to the intrahepatic vascular and gallbladder were 17.14%and 18.52%, for with and without combination with other local treatments were 7.02%and 13.41%, respectively. Multivariate analysis showed that tumor size>5 cm (P=0.044), proximity to large vessel (P=0.039) and without combination with other local treatments (P=0.001) were independent risk factors for ablation residual. Multivariate analysis showed that tumor near the intrahepatic vascular (P=0.014), single needle RFA (P=0.047) and without combination with other local treatments (P=0.023) were independent ablation residua risk factors for tumors between 3-5 cm in maximum diameter. Conclusion:Ultrasound-guided RFA can achieve satisfactory ablation effect. Tumor close to the intrahepatic vascular, tumor diameter>5 cm and without combination with other local treatment act as the independent risk factors for ablation residual. For tumors between 3-5 cm in diameter, in addition to close to intrahepatic blood vessels and without combination with other local treatment, single needle RFA is also another independent risk factor for ablation residual, and double-needle or multi-needle treatment can improve the ablation efifciency and reduce residual rate.

Objective:To observe the application effect of standard management-flexible teaching-pay attention to comprehensive quality improvement-correct evaluation (SFPC) teaching on the internship teaching of nursing students in department of obstetrics and gynecology.Methods:Forty-five nursing students who interned in the department of obstetrics and gynecology from July to December 2019 were classified as the control group, and the traditional teaching was adopted. Another 47 nursing students who interned from January to June 2020 were taken as research group, and SFPC was applied. The rotation assessment scores, clinical communication ability and comprehensive ability before and after the internship, and satisfaction with teaching of these nursing students were compared between the two groups. SPSS 23.0 was used for t test, chi-square test and rank sum test. Results:The results of theoretical and operational assessment of obstetrics and gynecology in the research group were significantly higher than those in the control group[(94.28±5.77) vs. (83.91±5.19); (91.85±5.27) vs. (81.07±5.24)]. The scores of building harmonious relationship, identifying patients' problems, keen listening, passing effective information, joint participation and verification of feelings after the teaching were significantly higher than those before teaching ( P<0.05). The scores of ideological quality, teaching activities, ability evaluation and other activities in the comprehensive ability assessment were significantly higher than those before teaching ( P<0.05), and those of research group were significantly higher than those of the control group ( P<0.05). The were significant differences in the grade distribution of teaching satisfaction between the two groups ( P<0.05), and the total satisfaction rate of nursing students in the study group was higher than that in the control group (95.74% vs. 80.00%). Conclusion:The application of SFPC teaching in the clinical teaching of nursing students in department of obstetrics and gynecology can significantly improve the performances of nursing students, clinical communication ability, comprehensive ability and nursing students' satisfaction with teaching.

Objective:In general, patients with seropositive rheumatoid arthritis (RA) are considered to show an aggressive disease course. However, the relationship between the two subgroups in disease severity is controversial. Our study is aimed to compare the clinical characteristics and prognosis of double-seropositive and seronegative RA in China through a real-world large scale study.Methods:RA patients who met the 1987 American College of Rheumatology (ACR) classification criteria or the 2010 ACR/European Anti-Rheumatism Alliance RA classification criteria, and who attended the 10 hospitals across the country from September 2015 to January 2020, were enrolled. According to the serological status, patients were divided into 4 subgroups [rheumatoid factor (RF)(-) anti-cyclic citrullinated peptide (CCP) antibody (-), RF(+), RF(+) anti-CCP antibody(+), anti-CCP antibody(+)] and compared the disease characteristics and treatment response. One-way analysis of variance was used for measurement data that conformed to normal distribution, Kruskal-Wallis H test was used for measurement data that did not conform to normal distribution; paired t test was used for comparison before and after treatment within the group if the data was normally distributed else paired rank sum test was used; χ2 test was used for count data. Results:① A total of 2 461 patients were included, including 1 813 RF(+) anti-CCP antibody(+) patients (73.67%), 129 RF(+) patients (5.24%), 245 RF(-) anti-CCP antibody(-) patients (9.96%), 74 anti-CCP antibody(+) patients (11.13%). ② Regardless of the CCP status, RF(+) patients had an early age of onset [RF(-) anti-CCP antibody(-) (51±14) years old, anti-CCP antibody(+) (50±15) years old, RF(+) anti-CCP antibody(+) (48±14) years old, RF(+)(48±13) years old, F=3.003, P=0.029], longer disease duration [RF(-) anti-CCP antibody(-) 50 (20, 126) months, anti-CCP antibody(+) 60(24, 150) months, RF(+) anti-CCP antibody(+) 89(35, 179) months, RF(+) 83(25, 160) months, H=22.001, P<0.01], more joint swelling counts (SJC) [RF(-) anti-CCP antibody(-) 2(0, 6), Anti-CCP antibody(+) 2(0, 5), RF(+) anti-CCP antibody(+) 2(0, 7), RF(+) 2(0, 6), H=8.939, P=0.03] and tender joint counts (TJC) [RF(-) anti-CCP antibody(-) 3(0, 8), anti-CCP antibody(+) 2(0, 6), RF(+) anti-CCP antibody(+) 3(1, 9), RF(+) 2(0, 8), H=11.341, P=0.01] and the morning stiff time was longer [RF(-) anti-CCP antibody(-) 30(0, 60) min, anti-CCP antibody(+) 20(0, 60) min, RF(+) anti-CCP antibody(+) 30(10, 60) min, RF(+) 30(10, 60) min, H=13.32, P<0.01]; ESR [RF(-) anti-CCP antibody(-) 17(9, 38) mm/1 h, anti-CCP antibody(+) 20(10, 35) mm/1 h, RF(+) anti-CCP antibody(+) 26(14, 45) mm/1 h, RF(+) 28(14, 50) mm/1 h, H=37.084, P<0.01] and CRP [RF(-) anti-CCP antibody(-) 2.3 (0.8, 15.9) mm/L, Anti-CCP antibody(+) 2.7(0.7, 12.1) mm/L, RF(+) anti-CCP antibody(+) 5.2(1.3, 17.2) mm/L, RF (+) 5.2(0.9, 16.2) mm/L, H=22.141, P<0.01] of the RF(+)patients were significantly higher than RF(-) patients, and RF(+) patients had higher disease severity(DAS28-ESR) [RF(-) anti-CCP antibody(-) (4.0±1.8), anti-CCP antibody(+) (3.8±1.6), RF(+) anti-CCP antibody(+) (4.3±1.8), RF(+) (4.1±1.7), F=7.269, P<0.01]. ③ The RF(+) anti-CCP antibody(+) patients were divided into 4 subgroups, and it was found that RF-H anti-CCP antibody-L patients had higher disease severity [RF-H anti-CCP antibody-H 4.3(2.9, 5.6), RF-L anti-CCP antibody-L 4.5(3.0, 5.7), RF-H anti-CCP antibody-L 4.9(3.1, 6.2), RF-L anti-CCP antibody-H 2.8(1.8, 3.9), H=20.374, P<0.01]. ④ After 3-month follow up, the clinical characteristics of the four groups were improved, but there was no significant difference in the improvement of the four groups, indicating that the RF and anti-CCP antibody status did not affect the remission within 3 months. Conclusion:Among RA patients, the disease activity of RA patients is closely related to RF and the RF(+) patients have more severe disease than RF(-) patients. Patients with higher RF titer also have more severe disease than that of patients with low RF titer. After 3 months of medication treatment, the antibody status does not affect the disease remission rate.