Objective To solve the clinical blood transfusion problem of the major cross-match compatibility and the minor cross-match incompatibility by using the microcolumn agglutination technique in the cross matching of the patients with non-auto-immune hemolytic anemia(non-AIHA).Methods The process was set up to analyze the reasons of the minor cross-match incom-patibility by reviewing the sample information from the patient and the blood donor,re-detection of ABO and Rh blood group,direct anti-globulin test (DAT),comparison of the agglutination intensity between DAT and minor cross-match,and antibody screening tests,etc.,and the corresponding laboratory treatment was carried out.Results The problem of minor cross-matching incompatibil-ity in 3 014 cases of non-AIHA were treated by this process,the result showed that the main reason leading to minor cross-match incompatibility was the DAT positive(98.6%).Those patients were infused with the RBC suspension with minor cross-match in-compatibility,comparing the occurrence rate(0.52%)of blood transfusion adverse reaction and the blood transfusion effectiveness (87.4%)had no statistical differences compared with the occurrence rate(0.48%)of blood transfusion adverse reaction and the blood transfusion effectiveness(85.4%)in the transfused RBC suspension with major and minor cross-matching compatibility,the differences had no statistical significance(P >0.05);other causes leading to the minor-cross-matching incompatibility were the sam-ple or blood group errors(0.8%),irregular antibody from the donor(0.6%),in such situation,the blood could be exchanged and the blood cross-matching could be performed again,the RBC suspension with major and minor compatibility was transfused.Conclusion This process can quickly and safely solve the clinical blood transfusion problem of minor cross-match incompatibility in the non-AIHA patients and is suitable for the laboratory adopting the microcolumn agglutination technique for conducting the cross-matc-hing test.

Objective To evaluate the role of contrast enhanced ultrasound in treatment of ultrasound guided high intensity fo‐cused ultrasound ablation for uterine fibroids .Methods Forty eight women with uterine fibroids were allocated into contrast en‐hanced group(25cases ,42fibroids) and non contrast enhanced group(23 cases ,35 fibroids) .The average volume of fibroids and the non perfused volume and the fractional ablation and adverse effects between the tow groups were compared .Results Non perfused volume was observed in all fibroids of the two groups after high intensity focused ultrasound ablation through sulphur hexafluoride micro bubbles .The average non perfused volume was 19 .5(18 .2)cm3 and 22 .5(14 .5)cm3 ,fractional ablation was (78 ± 18)% and (87 ± 13)% of the uterus immediately after HIFU respectively .The average non perfused volume was 18 .6(18 .2)cm3 and 19 .5 (18 .7)cm3 ,fractional ablation was (85 .7 ± 15 .2)% and (87 .6 ± 8 .0)% of the uterus two days after HIFU .There was no signifi‐cant difference was observed in average non perfused volume and the fractional ablation between the two groups(P>0 .05) .During HIFU procedure ,more patients in non contrast enhanced group complained sacral pain than those in contrast enhanced group(P<0 .05) .Conclusion Contrast enhanced ultrasound is an accurate method in assessing the treatment effect of HIFU and could be safely used during HIFU treatment for uterine fibroids ,shorten therapy time ,and decrease side reaction .

In this study, the adsorption behavior of epirubicin hydrochloride (EPI) on carboxylated single-walled carbon nanotubes (c-SWNTs) obtained by mixture acid treatment was investigated. The results indicated that the dispersion of c-SWNTs in water was obviously improved. The absorption of EPI on c-SWNTs came to equilibrium after 240 min and could be explained by pseudo-second-order model. Moreover, there were heterogeneous distribution of active sites onto c-SWNTs surface and the Freundlich isotherm model was better fit to describe the absorption precess of EPI on c-SWNTs. The absorption capacity of EPI on c-SWNTs increased obviously with the increasing pH and decreasing temperature. Compared with multi-walled carbon nanotubes, carboxylated multi-walled carbon nanotubes, SWNTs, c-SWNTs possessed higher absorption capacity for EPI. The controlled, targeted and sustained release of EPI from c-SWNTs-EPI could be instructive for the development of nano-carrier.

Objective To investigate the calculi composition of patients with urinary calculi in Henan area and the clinical significance of preventing calculi recurrence with individualized method.Methods From August 2009 to July 2010,1050 patients in our hospital underwent extracorporeal shock wave lithotripsy (ESWL) and ureteroscopy and percutaneous nephrolithotomy were set as the experimental group,all stone specimens were detected with the BRUKER TENSOR27 infrared spectroscopy for analysis of stone composition,and nurse on duty gave instructions according to the stone composition to prevent recurrence.From July 2008 to July 2009 1010 patients in our hospital underwent extracorporeal shock wave lithotripsy,ureteroscope and percutaneous nephrolithotomy were set as the control group,patients in the control group were not given calculi component analysis and these patients received general prevention guidance.The calculi recurrence was compared between two groups.Results Among 1050 cases in the experimental group,urinary calculi with single component accounted for 46.29％,of which calcium oxalate stones accounted for 44.95％.Calculi with mixed components accounted for 53.71％,mainly were calcium oxalate and carbonate apatite mixture components (30.48％).57 cases (5.43％) occurred urinary stone recurrence in the experimental group,while 177 cases(17.52％) in the control group.The difference had statistical significance.Conclusions Urinary calculi analysis has important clinical significance for understanding the causes and treatment of calculi as well as prevention of recurrence of calculi.

Dutch medical humanities education curriculum framework covers many disciplines which satisfies the professional requirements. The design and materials for teaching are based on re-search and practice driven; teachers' cooperation is full of experts from transnational, trans-regional, interdisciplinary, theory and practice. the Dutch university medical humanities provide a reference for China's medical humanities education curriculum reform as follows:the goal of medical humanities ed-ucation is for the medical practice but not intriguing sideline; the whole process of the students' par-ticipation mechanism should be full of support, supervision and examination;and the source of teachers should be multi-interdisciplinary and also from practice.

Objective:To observe the protective effects of Clostridium butyricum and butyrate on pancreas, liver and intestinal mucosa in rats with acute necrotizing pancreatitis (ANP), and to explore the possible mechanism.Methods:Forty Sprage-dawley rats were randomly divided into control group, ANP group，Clostridium butyricum treated group(CB group) and butyrate treated group(SB group), with 10 rats in each group by random number method. The ANP rat models were prepared by retrograde injection of sodium taurocholate into the biliopancreatic duct. Rats in CB and SB group were given intragastic administration of Clostridium butyricum 1×10 9 CFU or sodium butyrate (100 mg/kg) in 10 days once a day before modeling. Serum amylase (SAMY), lypase, ALT, AST, TBil, tumor necrosis factor alpha(TNF-α), IL-6 and HMGB1were measured after 24 h. Protein from intestinal mucosa was extracted and Western Blotting was used to measure expression of tight-junction proteins ZO-1, claudin-1 and occludin. Pancreas and liver tissues were stained with hematoxylin-eosin and scored by pathology. Results:The levels of amylase [(9365.1±716.5), (5947.3±512.0), (6517.7±269.6)U/L], lipase[(8343.7±1041.4), (6600.4±899.7), (6754.4±1046.4)U/L], AST[(560.5±72.7), (432.0±76.2), (429.8±40.5)U/L], ALT[(499.9±65.2), (385.7±46.0), (395.8±45.8)U/L], TBil[(134.2±56.2), (74.3±65.2), (81.3±35.3)U/L], TNF-α[(162.0±14.4), (100.4±6.3), (119.2±12.5)ng/L], IL-6[(161.4±26.0), (104.8±15.2), (105.5±12.7)ng/L], HMGB1[(100.1±6.7), (58.0±7.7), (63.4±7.2)ng/L] in ANP group, CB group and SB group were detected; and the pathological scores of pancreas[(11.2±1.08)，(9.45±1.06), (9.04±0.89)] and liver[(2.89±0.73), (2.09±0.49), (2.12±0.52)] in ANP group，CB group and SB group were higher than those in control group[(100.6±5.20)U/L, (966.5±301.9)U/L，(30.2±6.3)U/L, (27.6±5.9)U/L, (2.4±0.6)U/L, (29.5±4.8)ng/L，(36.9±7.6)ng/L，(35.5±5.7)ng/L，(1.18±0.05)，(0.56±0.09)]. However, those indexes in CB group and SB group were lower than those in ANP group, and the difference was statistically significant (all P<0.05). The expression of ZO-1 in control group, ANP group, CB group and SB group was 1.83, 0.79, 1.25 and 1.16. The expression of claudin-1 in control group, ANP group, CB group and SB group was 0.58, 0.13, 0.43 and 0.37. The expression of occludin in control group, ANP group, CB group and SB group was 1.06, 0.38, 0.82 and 0.79. The expression of TJ proteins in ANP group was significantly lower than that in other groups and the difference was statistically significant (all P<0.05). Conclusions:Clostridium butyricum and metabolites butyrate can alleviate the inflammatory response in ANP rats with liver injury, maintain the function of intestinal mucosal barrier and prevent the liver injury.

Objective: To learn the epidemiological characteristics of infectious disease related public health emergencies in Zhejiang Province from 2010 to 2018 for the prevention and control. Methods: The surveillance data was extracted from National Public Health Emergency Management Information System. Descriptive epidemiology method was used to analyze main diseases as well as distribution characteristics of time and places. Results: A total of 445 events were reported, which caused 14362 cases and 34 deaths, with a attack rate of 0.69% and mortality rate of 0.24%. There were 298 events with less than 30 cases, accounting for 66.97%. The event classification was dominated by general events ( 242 events, 54.38% ) and ungraded events ( 201 events, 45.17% ). The main diseases were chickenpox ( 134 events, 30.11% ), hand foot mouth disease ( 59 events, 13.26% ) and other infectious diarrhea ( 51 events, 11.46% ). The incidence peaked from April to June ( 129 events, 28.99% ) and from November to December ( 131 events, 29.44% ). Ningbo ranked the top in the number of reported events ( 141 events, 31.69% ). Most events ( 322 events, 72.36% ) occurred in schools. Conclusions The infectious disease related public health emergencies in Zhejiang Province from 2010 to 2018 were mainly caused by chickenpox, hand-foot-mouth disease and other infectious diarrhea. The two peaks of the emergencies occurred from April to June and from November to December. Ningbo was the main area reporting infectious diseases, and schools were the main places.

Objective To explore the relationship between corticospinal tract (CST) repairment and motor function recovery after rehabilitation in stroke patients by diffusion tensor imaging (DTI). Methods 15 stroke patients with internal capsule lesions and injured CST, 4-8 weeks after onset were included. They were scanned with DTI and assessed with the simple Fugl-Meyer Assessment (FMA) before and after 3-month rehabilitation. The fractional anisotropy (FA), FA ratio (rFA) and FA asymmetry (FAasy) in cerebral peduncle, posterior limb of internal capsule (PLIC) and corona radiate were obtained. The correlation of differences of FA, rFA and FAasy of CST with FMA was analyzed. Results The scores of FMA increased after treatment (P<0.01). The FA of the ipsilesional CST were significantly less than that of contralesional ones before and after rehabilitation. There was statistical differences in FA, rFA and FAasy in the corona radiate section of CST after treatment (P<0.05), but was not in the cerebral peduncle and PLIC section. However, there was no significant correlation of FA, rFA and FAasy of corona radiate section to scores of FMA. Conclusion DTI can respond to the repairment of corticospinal tract after stroke, especially in the corona radiate section.

Objective To explore brain plasticity of upper extremities motor function recovery after stroke with diffusion tensor imaging (DTI). Methods 25 stroke patients with internal capsule lesions and affected corticospinal tract (CST), 4-8 weeks after onset, were divided randomly into rehabilitation group (n=13) and control group (n=12). Both groups received routine medication and the rehabilitation group also received rehabilitation. All the patients were scanned with DTI and assessed with upper extremity Fugl-Myer Assessment (UE-FMA) before and 3 months after treatment. The fractional anisotropy (FA), FA ratio (rFA) and FA asymmetry (FAasy) in cerebral peduncle, posterior limb of internal capsule (PLIC) and corona radiate were obtained. The bilateral corticospinal tracts were reconstructed with diffusion tensor tractography. Results The scores of UE-FMA increased in both groups after treatment (P<0.05), and increased more in the rehabilitation group than in the control group (P<0.05). There was significant difference in FA, rFA and FAasy in the corona radiate section of CST after treatment in the rehabilitation group (P<0.05), but was not in the cerebral peduncle and PLIC section. However, there was no significant differences in FA, rFA and FAasy in the control group. The ipsilesional CST fibers were more compact after treatment in the rehabilitation group. Conclusion Rehabilitation can improve the upper extremities function recovery after stroke, which may associated with the repairment of CST in the corona radiate section.

Objective: To learn the characteristics of adolescent pregnancy in Wenzhou from 2015 to 2019, so as to provide basis for protecting adolescent physical and mental health. Methods: Data of demographic characteristics, pregnancy and delivery outcomes of the women aged under 19 years ( adolescent pregnant ) and 20 to 34 years ( right-age pregnant ) who delivered in Wenzhou from 2015 to 2019 were collected from Wenzhou Maternal and Child Health Information Management System. The incidence of pregnancy complication, comorbidity and adverse delivery outcomes of adolescent pregnant women was compared with that of right-age pregnant women. Results: Among 536 753 parturients reported in Wenzhou from 2015 to 2019, there were 22 419 ( 4.18% ) of adolescent pregnancy and 430 163 ( 80.14% ) of right-age pregnancy. The average age of adolescent pregnant women was (18.11±0.82) years ( range, 10-19 years ). The majority of adolescent pregnant women were migrant population (19 437 cases, 86.70%), had an education level of junior high school and below ( 18 594 cases, 82.94% ), and had no occupation (19 192 cases, 85.61%). The incidence rates of anemia, gestational diabetes, postpartum hemorrhage, perineal laceration and premature delivery in adolescent pregnant women increased from 2015 to 2019 ( all P<0.05 ). The incidence rates of gestational diabetes, anemia, gestational hypertension, placental abruption, postpartum hemorrhage, perineal laceration, premature delivery, low birth weight, fetal death and stillbirth were 1.65%, 11.76%, 0.19%, 0.26%, 3.19%, 24.52%, 6.03%, 5.53%, 0.50% and 0.04% in adolescent pregnant women, which were significant different from 5.49%, 8.94%, 0.13%, 0.01%, 0.17%, 23.46%, 4.66%, 3.08%, 0.26% and 0.01% in the right-age pregnant women, respectively ( all P<0.05 ). Conclusions The adolescent pregnant population in Wenzhou are mainly migrant population with lower education level and no occupation. The incidence rates of pregnancy complication, comorbidity and adverse birth outcomes in adolescent pregnant population are higher than those in right-age pregnant population, and are increasing year by year.