Health Policy ; Humans ; Italy ; Occupational Health Services ; organization & administration ; Safety Management

Finland ; Health Policy ; Humans ; Occupational Health Services ; organization & administration ; Safety Management

Objective Comparative evaluation of flow cytometric immunophenotyping in the diagnosis and differentiation of lymphadenopathy,lymphoma and reactive lymphoid hyperplasia. Methods Ninty-nine fine-needle aspiration specimens from patients with tentative clinical lymphoprofierative disorders were consecutively analyzed by both cytology and flow cytometry with histology results as the gold standard. The three color antibodies including CD3,CD3,CD4,CD5,CD10,CD19,CD20,CD23,CD45,K,λ,FMC7 and CD34 were used for cell composition evaluation and cells with abnormal phenotype. Lymphoma cases were classified according to new WHO classification and subtypes were categorized by immunophenotypic analysis. The results from flow cytometry and cytology were compared. Results By cytological study, 40 of 99 cases were diagnosed with lymphoma, 29 cases were diagnosed with metastatic carcinoma, and 30 cases were diagnosed with reactive lymphoid hyperplasia, necrosis or tuberculosis. Among them, 2 non-Hodgkin lymphoma(NHL) cases were misdiagnosed as reactive lymphoid hyperplasia by cytology. Biopsy was performed in 18 cases of NHL including 16 B-NHL and 2 T-NHL By flow cytometry study, 35 of 99 eases were diagnosed with lymphoma, including 4 cases of lymphoblast lymphoma, 1 case of T-cell lymphoma, and 30 eases of other B-NHL For those 30 cases of B-NHL, 28 cases showed monoclonal light chain expression, and k: λ orλ: k atios exceed 3: 1, and B-cell proportion was (73. 2±27. 2)%. Twenty-six cases could be sub-classified by immunophenotyped. Among 16 histologically confirmed B-NHL cases, only 2 cases diagnosed with follicular lymphoma showed discrepancy with flow cytometry results. In all cases diagnosed with reactive lymphoid hyperplasia and metastasis carcinoma , no abnormal lymphocytes can be found, and k: λ or k: λ ratios were less than 3: 1. Conclusions Fine-needle aspiration analysis with flow eytometrie immunophenotyping can be helpful in diagnosis and differential diagnosis as well as sub-classification of NHL

Abstract: Objective　This article summarizes the clinical characteristics and diagnosis and treatment experience of an elderly patient infected with Omicron variant BA.5.1.3 of COVID-19 in Hainan Province. Methods　The clinical data and treatment of an elderly patient infected with Omicron variant BA.5.1.3 of COVID-19 admitted to Haikou designated hospital on August 15, 2022 were retrospectively analyzed. Results　A 107-year-old female patient was admitted to the hospital with "fever and cough for 1 day". Two of her family members have infected with COVID-19. The patient initially developed fever, accompanied by cough, expectoration, a little white sticky sputum, accompanied by sore throat, muscle pain, fatigue. Nucleic acid test was positive in throat swab, indicating Omicron variant BA.5.1.3 infection. The patient was diagnosed as mild COVID-19 and treated with antiviral therapy, Chinese medicine conditioning, anticoagulation, electrolyte disorder regulation and symptomatic treatment for 9 days. The patient's clinical symptoms were relieved, and she was cured and discharged after two negative nucleic acid tests. One week later, the patient recovered well. Conclusions　Omicron variant BA.5.1.3 is highly infectious, and comprehensive treatment such as antiviral treatment and traditional Chinese medicine treatment has achieved good efficacy. For elderly patients, attention should be paid to maintaining the stability of organ function and internal environment, which is helpful to improve the prognosis of patients.

Objective To develop Community Home Mutual Pension Demand Scale and test its validity and reliability.Methods Firstly,the theoretical dimension of Community Home Mutual Pension Demand Scale was constructed by means of literature analysis and resident interview.Secondly,the scale with five dimensions containing 29 items was formed after small range of questionnaire survey.Finally,the data from 384 elderly people in 4 communities of Hengyang city were analyzed by using SPSS17.0 and AMOS17.0 to test its validity and reliability.Results The model consisted of 4 dimensions and 21 items,which explained 69.911％ of the total variance.x2/df=2.097,Tac ker Lewis index (TLI)=0.959,non normed fit index (NNFI)=0.959,relative fit index (RFI)=0.924,goodness-of-fit index(GFI)=0.921,comparative fit index (CFI)=0.966,normed fit index (NFI)=0.938,incremental fit index (IFI)=0.967,root-mean square error of approximation(RMSEA)=0.054;Cronbach α of the total scale was 0.932,Cronbach α of each dimension was 0.801-0.954.The correlation coefficient between dimensions was 0.241-0.592,P＜0.01.Conclusions The scale has good reliability and validity in the measurement of the mutual pension demand of elderly.

OBJECTIVETo observe the suppressive effect on the expression of pro-inflammatory cytokines in liver from brain dead (BD) rats through inhibition of p38 mitogen-activated protein kinase (MAPK) signaling pathway by SB203580.

METHODSA total of 30 male Wistar rats weighing from 180 to 200 g were randomly divided into 3 experimental groups: (1) BD group (n = 10): brain death was induced in rats; (2) BD+SB203580 group (n = 10): brain death was successfully induced and SB203580 (10 mg/kg) was given through dorsal vein of penis. After brain death artificial ventilation was maintained for 6 hours and only those with mean arterial blood pressure more than 80 mm Hg (1 mm Hg = 0.133 kPa) were accepted as BD donors. (3) Control group (n = 10): living healthy rats. The expressions of TNFalpha and IL-1beta mRNA in liver tissues were analyzed by RT-PCR and the protein expressions of TNFalpha, IL-1beta and phosphorylated p38MAPK were detected by Western blot.

RESULTSThe phosphorylated p38MAPK detected in the liver in BD group was significantly increased compared with the control group (q = 172.53, P < 0.01), and the expressions of TNFalpha and IL-1beta mRNA and proteins in liver were also significantly increased in BD group compared with the control group (q = 123.99, 135.35, 243.09 and 192.23, respectively, P < 0.01). The phosphorylated p38MAPK was decreased in BD+SB203580 group and significantly decreased compared with the BD group (q = 63.90, P is less than 0.05), but higher than that in control group (q = 108.63, P < 0.01). The expressions of TNFalpha and IL-1beta mRNA and proteins in liver were significantly decreased in BD+SB203580 group compared with the BD group (q = 55.11, 98.13, 61.03 and 50.85, respectively, P < 0.01), but higher than that in control group (q = 68.89, 37.22, 182.06 and 141.38, respectively, P < 0.01). SB203580 can suppress the expression of pro-inflammatory cytokines in the liver of brain dead rats through the inhibition of p38MAPK signaling pathway which may reduce the immunogenicity of donor livers.

Animals ; Brain Death ; metabolism ; Imidazoles ; pharmacology ; Inflammation ; Interleukin-1beta ; metabolism ; Liver ; drug effects ; metabolism ; pathology ; Male ; Pyridines ; pharmacology ; Rats ; Rats, Wistar ; Signal Transduction ; Tumor Necrosis Factor-alpha ; metabolism ; p38 Mitogen-Activated Protein Kinases ; antagonists & inhibitors ; metabolism

Objective To establish and evaluate criteria applied to review of complete blood counts (CBC)and differential results from automated hematology analyzers.Methods Temporary criteria were established by using alarm system of XE-2100 automated hematology analyzer and by consulting the 41 suggested rides of international consensus group.2 795 out-and in-patient samples were run as clinical samples.Stained blood films were prepared and manual differential with smear review were performed on all samples.Statistical analysis was done for each temporary rule and instrument flag which indicated abnormal cell quantity and morphology.Results Of all rules,instrument flags of ‘Immature Gran/Left Shift?’, ‘ Atypical Lympho?’and‘NRBC(nucleated red blood cell)?’showed most frequent false positive and false negative instrument flag.Evaluation on rnles about cell quantity change showed false positive and false negative rates were both low.Results of morphology evaluation showed that true positive rate was 17.44%, false positive rate was 15.82%,true negative rate was 63.49%,false negative rate was 3.25%.‘ Atypical Lymphocyte?’,‘Immature Gran?’and‘blast?’were the most frequent false positive flags.According to those results and clinicians opinions,our hematology review criteria for action following automated CBC and leukocytes differential was established.Conclusions The hematology review criteria have high true positive rate and low false negative rate.To clinical hematology laboratory using automated hematology analyzer,new criteria can reduce work load,bring lower false negative rate and higher work efficiency.

The purpose of this study was to investigate the influence of immunosuppressive therapy on the expression of TNF-α/IFN-γ in cytoplasm of peripheral blood lymphocytes of patients with aplastic anemia (AA). The expression of TNF-α and IFN-γ in cytoplasm of peripheral CD3(+) lymphocytes were measured by flow cytometry in 25 cases of de novo AA patients and 20 cases of AA after immunosuppressive therapy. The results showed that the positive rates of CD3(+)/TNF-α(+) and CD3(+)/IFN-γ(+) in de novo AA patients were (5.97 ± 6.78)% and (15.20 ± 11.28)% respectively, and (1.56 ± 0.87)% and (1.76 ± 0.87)% in normal controls respectively. There was significant difference between de novo AA patients and normal controls (p < 0.05). The positive rates of CD3(+)/TNF-α(+) and CD3(+)/IFN-γ(+) in immunosuppressive therapy group were (1.67 ± 1.26)% and (4.35 ± 4.33)% respectively. The difference between immunosuppressive therapy group and de novo AA group was statistically significant (p < 0.05). It is concluded that the levels of intracellular TNF-α and IFN-γ in AA patients are higher than those in normal controls. Immunosuppressive therapy significantly reduces the expression of intracellular TNF-α and IFN-γ. Its relationship with the clinical treatment is worth further observing.
Adolescent ; Adult ; Anemia, Aplastic ; blood ; metabolism ; therapy ; Female ; Humans ; Immunosuppression ; Interferon-gamma ; metabolism ; Lymphocytes ; metabolism ; Middle Aged ; Tumor Necrosis Factor-alpha ; metabolism ; Young Adult

OBJECTIVETo study the predictive factors that are associated with intraoperative identification of the sentinel lymph node (SLN).

METHODSLymphatic mapping using blue dye was performed in 108 patients with stage I and II operable primary breast cancer. Subsequently the patients received operations of breast cancer including axillary dissection. Clinical and histological factors were assessed to determine those that were associated with intraoperative identification of the SLN.

RESULTSThe sentinel node was identified at the time of surgery in 84 patients (77.78%). Of the clinical factors assessed, age(y) < 50 (chi(2) = 7.447, P < 0.01), tumour in the upper quadrant (chi(2) = 6.330, P < 0.05), diagnosis by preoperative biopsy (chi(2) = 5.509, P < 0.05), successful mapping of the lymphatic duct (chi(2) = 13.125, P < 0.01) were significant in identifying the sentinel node at operation. No histological factor was associated with intraoperative identification of the sentinel node.

CONCLUSIONThere are the possibility of failure of SLN identification at sentinel lymph node biopsy. Our results suggest that the best predictor of intraoperative sentinel node identification is the visualization of the lymphatic duct on mapping by blue dye. Other factors such as age, tumour site as well as diagnostic method are also important in determining the success of the procedure.

Breast Neoplasms ; pathology ; Female ; Humans ; Intraoperative Care ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Middle Aged ; Neoplasm Staging ; Sentinel Lymph Node Biopsy

Objective:To evaluate the effectiveness and safety of transepithelial photorefractive keratectomy (TransPRK) assisted by smart pluse technology (SPT) for the correction of high myopia.Methods:An observational case series study was conducted.Sixty high myopic patients (107 eyes) with spherical equivalent (SE)≥-6.0 D who received TransPRK assisted by SPT from January to December 2016 in Eye Hospital of Wenzhou Medical University were enrolled.Uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA) of the patients were examined and recorded in logarithm of the minimum angle of resolution (LogMAR) units, and refraction was examined with a subjective refractometer.The healing of corneal epithelium and corneal haze was observed with a slit lamp.Intraocular pressure (IOP) was measured with the non-contact tonometer.Safety index (SI) and efficacy index (EI) were analyzed.The follow-up time was 12 months.This study protocol adhered to the Declaration of Helsinki and was approved by an Ethics Committee of Eye Hospital of Wenzhou Medical University (No.2019-197-k-177). Written informed consent was obtained from each patient prior to any medical examination.Results:The mean epithelial healing time was (3.77±1.02) days.There were statistically significant differences in UCVA and BCVA between before and after surgery ( Z=380.812, 267.313; both at P<0.001). And the 7-day, 6-month, and 12-month postoperative BCVA were better than preoperative BCVA, showing statistically significant differences (all at P<0.05). Mean SI was 1.10±0.12, and mean EI was 1.05±0.17 at 12 months after surgery.There was no significant difference between the attempted SE before surgery (-8.02±1.36)D and the achieved SE at 12 months after surgery (-8.04±1.51)D ( P=0.523). SE in the predictive range within ±0.50 D accounted for 79% (85/107) and that within ±1.0 D accounted for 92% (98/107). The IOP was slightly increased in 3 eyes at 7 days and 7 eyes at 1 month after surgery, respectively, which returned to normal after the use of ophthalmic solution for lowing IOP.The incidence of haze severer than grade 1 was less than 1% (1 eye), and haze gradually disappeared after application of drugs. Conclusions:TransPRK assisted by SPT for high myopia shows good safety, effectiveness and predictability.It is an ideal corneal surface surgery to correct high myopia.