Objective To investigate the situation of ALT-single-unqualified blood donors and the ALT test when they donated again.Methods There were 3 784 cases of ALT-single-unqualified blood donors from March 2009 to February 2010 enrolled in the study.Investigations were carried out to know the previous situation of blood donation.A 3-year tracking survey on those people was carried out,and the data was recorded and analyzed.Results The ALT-single-unqualified blood donors who participated in blood donation for the first time accounted for 58.14% (2 201/3 748).The 3-year follow-up showed that the returned blood donors accounted for 33.62% (1 272/3 784);1-year return accounted for 46.62%(593/1 272)which was the most;ALT-qualified donors accounted for 65.72%(836/1 272)of the retured donors.with the increase of the times of blood donation,the qualified rate of blood ALT increased.Conclusion More than half of the ALT-single-unqualified blood donors returned.There was a large proportion of returning donors participated in blood donation more than onece,and the qualification rate of ALT increased with the increase of do-nation times.In order to reduce the unqualified rate of ALT test,we should strengthen the propaganda and fixed blood donation team construction.

Background Current researches of choroidal structure changes primarily focus on macular choroidal thickness in adolescents and children,but there are few studies on peripapillary choroidal thickness in children with enhanced depth imaging (EDI)-OCT.In addition,the reliability of manual measurements to peripapillary choroidal thickness is an important factor for the estimation of EDI-OCT.Objective This study was to determine the repeatability and reproducibility of manual measurements of peripapillary choroidal thickness in children by EDI-OCT.Methods A reliability evaluation of diagnosis test was performed.EDI-OCT technology was used to image the peripapillary choroidal thickness in 49 children aged 7-14 years in Eye Hospital of Wenzhou Medical University from February to March 2015 under the informed consent of their custodians.An annular scanning was carried out surrounding optical disc by the same ophthalmologist with Spectralis OCT,and the peripapillary choroidal thickness was manually measured at global,temporal,superotemporal,superonasal,nasal,inferonasal and inferotemporal zones.The intraclass and interclass repeatability and reducibility of measuring values from intraobserver,inter-observer and intra-session were evaluated with intraclass correlation coefficients (ICC),and BlandAltman agreement analysis was used to assess the consistency of repeated measurements.Results The average age in the subjects was (9.9 ± 1.3) years.No significant difference was found in the mean difference of reduplicative measured peripapillary choroidal thickness at each zone (all at P＞0.05).The ICCs of intra-observer,inter-observer and intra-session were 0.971-0.993,0.827-0.952 and 0.974-0.991,respectively,and the 95％ limit of agreement of global peripapillary choroidal thickness were-12.4-9.7 μm,-15.2-11.6 μm and-16.3-19.1 μm,respectively.Conclusions The repeatability,reproducibility and consistency are favorable in manually measured values of peripapillary choroidal thickness from EDI-OCT image.EDI-OCT appears a good application in the assessment of peripapillary choroidal thickness in children.

Objective To research the Annexin V-nanoscale ultrasound contrast agents'preparation, ultrasound imaging and the ability to binding apoptosis cells of tumor in vitro.Methods The nanoscale bubble (Nanobubbles,NBs ) packaged the octaflouropropane (C3 F8 ) gas was prepared by thin film hydration.The Annexin V-Nanobubbles (AVNBs ) solutions was acquired through conjugating the biotinylated-Annexin V to the surface of the NBs by biotin-streptavidin bridging chemistry.The size and zeta potential of AVNBs were measured by NanoPlus-3 zeta/nano particle analyzer.The shift in size distribution of AVNBs bubbles was analyzed for the stability,after it was stored at 4 ℃ for different time. AVNB's shape were measured by scanning electron microscopy.The AVNBs bubble was measured using an ultrasound system for echogenicity in vitro,and SonoVue was for control.Finally,the ability of AVNBs binding with apoptosis cells of tumor in vitro was determine via the fluorescence microscope.Results AVNBs has a size distribution of (640.2±32.1 )nm,and a mean zeta potential of (-23.30 ±5.71 )mV.Its size remained relatively constant and appeared to show less size variation within the 24 h analysis period. AVNBs solutions were visible milky white and slightly suspension liquid with the naked eye.Under scanning electron microscopy,AVNBs were uniform hollow sperical cavitation bubble with small size and larger dispersibility in solution.The AVNBs and SonoVue solution had the same higher grayscale signal intensity by ultrasonic imaging.The AVNBs binded well with apoptosis cells of tumor in vitro,and the rate of binding was (97.55 ± 1 .30 )%.Conclusions The AVNBs particles prepared by method of thin film hydration have a nanoscale size,good stability and echogenicity.It can be targeted binding with the apoptosis cells of tumor in vitro.

Drug Resistance, Bacterial ; Gram-Positive Bacteria ; isolation & purification ; Humans ; Infant, Newborn ; Microbial Sensitivity Tests ; Sepsis ; diagnosis ; drug therapy ; microbiology

OBJECTIVEVentilator-associated pneumonia (VAP) is a common nosocomial infection and is responsible for a very high mortality in neonatal intensive care unit (NICU) patients. This study was designed to investigate the etiology and high risk factors of neonatal VAP.

METHODSThe clinical data of 106 critical neonates who were treated with mechanical ventilator between 2003 and 2005 were studied retrospectively.

RESULTSOf the 106 neonates, 84 received mechanical ventilation for > or = 48 hrs. Thirty-five (41.7%) out of the 84 patients developed VAP. Univariate analysis showed that gestational age, duration of mechanical ventilation, reintubation, birth weights, primary lung disease and gamma globulin administration were associated with the development of VAP (P < 0.05). Multivariate stepwise logistic regression analysis showed that primary lung disease (OR=3.671, 95% CI=1.0-13.45, P < 0.05), duration of mechanical ventilation (OR=4.945, CI=1.51-16.21, P < 0.01), reintubation (OR=7.721, 95% CI=2.31-25.85, P < 0.01) and high-dose gamma globulin administration (OR=5.520, 95%CI=2.08-16.26, P < 0.01) were predicted factors for the development of VAP. The detection rate of gram negative bacilli (76.9%) was the highest, followed by gram positive coccus (17.9%) in VAP patients.

CONCLUSIONSOpportunistic drug-resistant bacteria are common pathogens for neonatal VAP. The risk of VAP is multifactorial, including external medical environments and patients' internal agents.

Anti-Bacterial Agents ; therapeutic use ; Female ; Humans ; Infant, Newborn ; Logistic Models ; Male ; Microbial Sensitivity Tests ; Pneumonia, Ventilator-Associated ; drug therapy ; etiology ; Retrospective Studies ; Risk Factors

Objective:To explore the correlation between middle cerebral artery (MCA) pulsatility index (PI) and total magnetic resonance imaging (MRI) burden in elderly patients with cerebral small vessel diseases (CSVD).Methods:A total of 203 CSVD inpatients aged 60 years and above who were hospitalized in the Department of Neurology of Hebei General Hospital from March 2017 to December 2020 were enrolled. The clinical data, transcranial Doppler ultrasound parameters and brain MRI data were collected. According to the total burden score, the patients were divided into low burden group (0-1 point) and high burden group (2-4 points). Univariate and multivariate Logistic regression analysis was used to analyze the correlation between MCA PI and total MRI burden in the elderly patients with CSVD. Subsequently, the receiver operating characteristic curve was used to evaluate the value of MCA PI for predicting the high MRI burden of CSVD in the elderly.Results:Hypertension ( OR=2.569, 95% CI 1.068-6.182, P=0.035), systolic blood pressure ( OR=1.033, 95% CI 1.006-1.061, P=0.016), creatinine ( OR=1.044, 95% CI 1.009-1.079, P=0.013) and MCA PI ( OR=1.125, 95% CI 1.087-1.166, P<0.001) were independently correlated with the increasing total MRI burden in the elderly patients with CSVD. Spearman rank correlation analysis revealed that there was strong and positive correlation between MCA PI and high MRI burden in the elderly patients with CSVD ( r=0.65, P<0.001). The analysis showed that when the cut-off for MCA PI was 1.11, it could identify high MRI burden of CSVD in the elderly. The area under the curve was 0.908 (95% CI 0.864-0.953, P<0.001). The sensitivity and specificity were 0.852 and 0.880, respectively. The positive predictive value was 92.38%, and the negative predictive value was 77.70%. Conclusion:The MCA PI is positively correlated with total MRI burden in the elderly patients with CSVD, and has a higher value in predicting the total MRI burden in the elderly CSVD patients, which probably bring brighter prospects for its clinical application.

Objective:To investigate the effect of self-made phase-change nanodroplets IR780/FA-Nds-DTX as molecular targeted ultrasound contrast agents for accurate diagnosis and combined targeted therapy of pancreatic cancer.Methods:Pancreatic cancer cell lines were cultured in vitro and 50 tumor bearing nude mouse models were established. The experimental group (IR780/ FA-NdS-DTX) and four control groups[ normal saline, Nds(FITC), FA-Nds (FITC) and IR-780] were divided to verify dual-mode targeted imaging. The imaging using the IVIS Imaging System verified the high-efficiency targeted detection ability and near-infrared fluorescence imaging of IR780/FA-Nds-DTX for tumors in vivo, phase transformation induced by low-intensity focused ultrasound and further contrast-enhanced ultrasound imaging verified the high-efficiency aggregation of IR780/FA-Nds-DTX in local tumors and accurate evaluation of tumor contour. The therapeutic effect was observed in the experimental group (IR780/FA-Nds-DTX) and four control groups (FA-Nds-IR780, FA-Nds-DTX, FA-Nds and normal saline). After low-intensity focused ultrasound irradiation for 30s induced microbubble blasting after phase transformation in each group, 808nm photothermal therapy apparatus was used to irradiate tumor area in each group. Two-dimensional ultrasound was used to monitor the changes in tumor volume in each group before and at 3 d, 9 d, 15 d after treatment, and the changes in tumor volume rate and inhibition in each group were statistically analyzed and compared.Results:The amount of IR780/ FA-Nds-DTX locally targeted aggregation was the largest, and the average fluorescence intensity of tumor in the experimental group was significantly higher than that of the control groups: IR780/ FA-Nds-DTX group compared with Nds(FITC) group[(5.12±0.69)×10 7 vs (1.06±0.23)×10 7, P<0.05], IR780/FA-Nds-DTX group compared with FA-Nds (FITC) group [(5.12±0.69)×10 7 vs (2.98±0.34)×10 7, P<0.05], IR780/FA-Nds-DTX group compared with IR-780 group [(5.12±0.69)×10 7 vs (1.54±0.42)×10 7, P<0.05], and there was no fluorescence in tumor area in saline group. Further contrast-enhanced ultrasound imaging after nanodroplet phase transformation could more accurately locate the tumor boundary. After 15 days of photothermal ablation combined with chemotherapy, the growth rate of tumor volume in the IR780/ FA-Nds-DTX treatment group was significantly lower than that in the control groups: IR780/FA-Nds-DTX group compared with FA-Nds-IR780 group[(0.105±0.075) vs (0.405±0.175), P<0.05], IR780/ FA-Nds-DTX group compared with FA-Nds-DTX group [(0.105±0.075) vs (1.385±0.035), P<0.05], IR780/ FA-Nds-DTX group compared with FA-Nds group [(0.105±0.075) vs (2.255±0.105), P<0.05], IR780/ FA-Nds-DTX group compared with normal saline group [(0.105±0.075) vs (2.185±0.155), P<0.05]. And the tumor inhibition rate increased significantly: IR780/ FA-Nds-DTX group compared with FA-Nds-IR780 group [(0.93±0.06) vs (0.48±0.17), P<0.05], IR780/ FA-Nds-DTX group compared with FA-Nds-DTX group [(0.93±0.06) vs (-0.51±0.105), P<0.05], IR780/ FA-Nds-DTX group compared with FA-Nds group [(0.93±0.06) vs (-1.63±0.115), P<0.05], IR780/ FA-Nds-DTX group compared with normal saline[(0.93±0.06) vs (-1.35±0.245), P<0.05]. Conclusions:The self-made phase-change ultrasound contrast agents IR780/FA-Nds-DTX have good potential clinical value in targeted detection and combined therapy of pancreatic cancer with small lesions or even metastases.

【Objective】 To identify and analyze a case of ABO discrepancy between forward and reverse blood grouping, and to provide reference for the identification of ambiguous blood group in clinical. 【Methods】 ABO and Rh blood group typing, absorption and elution test, and gene sequencing were performed to confirm the ambiguous blood group. 【Results】 The sample was identified by absorption and elution test and molecular biological method to be Ael subtype, and was named ABO^*AEL.05/ABO^*O.01.01 by ISBT. After family investigation, the proband and her second son share the same characteristic mutation site, and was named ABO^*AEL.05/ABO^*B.01.01 by ISBT. 【Conclusion】 Multiple blood group serological tests and molecular biology tests help to identify ABO subtypes, thus assuring the safety, scientificity and rationality of clinical blood transfusion.

Objective:To explore the therapeutic characteristics of population with gout achieving treat-to-target (T2T) indicators through real-world research and evaluate their safety.Methods:A total of 3 287 patients diagnosed with gout by rheumatologists in 21 first-class tertiary hospitals in 10 provinces, municipalities, and autonomous regions in China from January 2015 to December 2021 were included in this polycentric cross-sectional study. The database included patients′ general information, disease characteristics, and clinical application of traditional Chinese and Western medicine treatment measures. SPSS and Excel software were used for data analysis. Frequency analysis, cluster analysis, and factor analysis were used to summarize the characteristics and rules of treatment measures for patients with gout who achieved the target after treatment. The occurrence of adverse events (AE) was recorded during treatment.Results:After treatment, 691 visits (7%) achieved the serum urate (SUA) target, and the most frequent use of urate-lowering therapy (ULT) was febuxostat, followed by benzbromarone. The most common treatment options were following: GroupⅠ: traditional Chinese medicine (TCM) decoction-TCM external treatment-physical exercise-proprietary Chinese medicine; GroupⅡ: ferulic acid-nonsteroidal anti-inflammatory drugs (NSAIDs); Group Ⅲ: allopurinol-sodium bicarbonate-benzbromarone; Group Ⅳ: glucocorticoid-colchicine; Group Ⅴ: febuxostat. A total of 5 898 visits (60%) chieved manifestations of joint pain VAS scores target, and the most frequently used drug to control joint symptoms was NSAIDs. The frequency of use of drugs to control joint symptoms were 2 118 times (usage rate reached 35.9%), while the frequency of ULT were 2 504 times (usage rate reached 42.5%), which was higher than the joint symptom control drug. The most common treatment options were following: Group Ⅰ: proprietary Chinese medicine-TCM decoction-TCM external treatment-physical exercise; Group Ⅱ: NSAIDs-colchicine hormones; Group Ⅲ: allopurinol, Group Ⅳ: benzbromarone; Group Ⅴ: febuxostat. A total of 59 adverse events occurred during treatment.Conclusion:The proportions of gout patients who reach target serum urate level & good control of joint symptoms are both very low, and ULT and anti-inflammatory prescription patterns are very different from international guidelines, so it is necessary to strengthen the standardized management of gout patients. At the same time, life intervention measures account for a certain proportion of the treatment plans for the T2T population, and further exploration is needed.

The condition of patients with severe traumatic brain injury (sTBI) complicated by corona virus 2019 disease (COVID-19) is complex. sTBI can significantly increase the probability of COVID-19 developing into severe or critical stage, while COVID-19 can also increase the surgical risk of sTBI and the severity of postoperative lung lesions. There are many contradictions in the treatment process, which brings difficulties to the clinical treatment of such patients. Up to now, there are few clinical studies and therapeutic norms relevant to sTBI complicated by COVID-19. In order to standardize the clinical treatment of such patients, Critical Care Medicine Branch of China International Exchange and Promotive Association for Medical and Healthcare and Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Chinese expert consensus on clinical treatment of adult patients with severe traumatic brain injury complicated by corona virus infection 2019 ( version 2023) based on the joint prevention and control mechanism scheme of the State Council and domestic and foreign literatures on sTBI and COVID-19 in the past 3 years of the international epidemic. Fifteen recommendations focused on emergency treatment, emergency surgery and comprehensive management were put forward to provide a guidance for the diagnosis and treatment of sTBI complicated by COVID-19.