BACKGROUND:Buffy-coat-derived platelet concentrates and plasma-rich platelet concentrates have a high incidence of invalid infusion and adverse reactions.
OBJECTIVE:To observe the improved preparation of buffy-coat-derived platelet concentrates and to analyze the influential factors relevant to platelet recovery.
METHODS:400 mL of blood sample extracted from 126 cases were randomly divided into improved buffy-coat group, buffer-coat group and platelet-rich plasma after 4-6 hours. The 3-step centrifugal method was used for improved preparation of buffy-coat-derived platelet concentrates:step 1, centrifugation at 2 300 r/min for 12 minutes at (22±2)℃ with a deceleration of 5;step 2, centrifugation at 910 r/min for 10 minutes at (22±2)℃;step 3, centrifugation at 2 800 r/min for 12 minutes at (22±2)℃. After centrifugation, the upper layer containing few platelets was removed, and the rest 30 mL platelet suspension was platelet concentrates. Factors affecting platelet recovery were analyzed through literature retrieval.
RESULTS AND CONCLUSION:There was no difference in platelet number among the three groups before preparation of platelet concentrates (P>0.05). A higher rate of platelet recovery was found in the platelet-rich plasma group and improved buffy-coat group compared with the buffy-coat group (P<0.05), but there was no difference between the former two groups (P>0.05). There were less residual red blood cells and white blood cells in the two buffy-coat groups than the platelet-rich plasma group (P<0.05), but there was no difference between the two buffy-coat groups (P>0.05). The recovery rate of prepared platelet concentrates was affected by the whole blood amount, centrifugal speed, centrifugation time and methods. Improved buffy-coat method for preparation of platelet concentrates can be generalized in blood centers or blood stations, because it can reduce residual red blood cells and white blood cells and increase rate of platelet recovery.

Medical quality and safety are essential safeguards for the harmonious society in China, directly affecting people's sense of security and happiness. Continuously improving medical quality and ensuring medical safety are fundamental and essential to implementing the strategies of the Party Central Committee and the State Council, and promoting the construction of a healthy China. In recent years, with the rapid development of China's economy and the people's increasing emphasis on their own health and safety, China's plastic surgery industry has achieved significant progress and yielded outstanding results. However, along with the rapid growth of the industry, medical quality issues and safety accidents have occurred frequently, attracting widespread attention from all sectors of society. This article briefly outlines the history of quality management and quality control for medical quality and safety in China's plastic surgery specialty. It explores the development of quality management from its origin to medical quality management, as well as the responsibilities and contributions of the National Plastic Surgery Quality Control Center in improving industry standards and ensuring patient safety. It aims to provide support for the standardized management of the plastic surgery industry in the future, so as to promote its healthy and sustainable development.

To compare and understand the trends in quality control data changes in public and private medical institutions specializing in plastic and aesthetic major in China over the past three years.

To construct a quality control indicators system for Chinese plastic and aesthetic major and lay foundation for medical quality control.

Objective To explore the effects and mechanism of implantation of umbilical blood mesenchymal stem cells(MSCs)on rats with cerebral infarction. Methods Umbilical blood MSCs were cultured in vivo,flow cytometry was ap-plied to test cytometric immunophenotype, and model of rat cerebral infarction was made by suture method; 120 rats were randomly assigned to MSCs implantation group and control group; rats' neurological function was evaluated;western-blot was applied to test the expression of GFAP protein. Fluorescence microscope was applied to observe changes of hippocampal formation in rats as well as the distribution of MSCs in rats' brain. Results According to the test of neurological function, the score of neurological function in the experiment group was reduced, and the score in the control group was improved. The difference was statistically significant(P<0.05). Expression of GFAP in MSCs im-plantation group was increased with a peak in the 7th day,while no significant changes in the control group(P<0.05). According to the observation of immunofluorescence microscopy, the distribution of MSCs in rats' brain was good in MSCs implantation group, and the hippocampal formation showed clear layers in the experiment group. Hippocampal structures in the control group were chaotic, and synapses and organelles were dissolved and compromised. Conclu-sion MSCs are able to promote the repair of hippocampal structures after cerebral infarction in rats, strengthen neuro-plasticity and promote the recovery of neurological functions.

Objective To explore the influence of transcutaneous oximetry on septic shock-associated acute kidney injury (AKI) in intensive care unit (ICU).Methods Forty-nine patients with septic shock admitted in the ICU of Wuxi People's Hospital Affiliated to Nanjing Medical University were enrolled from January 2013 to December 2015.The 10 min oxygen challenge test was conducted using transcutaneous oximetry just before (0 h) and 6 h after initiation of fluid resuscitation,and 10 min oxygen challenge test data (10 min OCT) at 0 h and 6 h were then calculated,respectively.The enrolled patients were divided into low 10 min OCT group (10 min OCT ＜ 66 mmHg,L group) or high 10 min OCT group (10 min OCT ≥66 mmHg,H group) according to the 10 min OCT value at 6 h.The hemodynamic variables [mean arterial pressure (MAP),central venous pressure (CVP)],oxygen metabolism indexes [central venous oxygen saturation (ScvO2),arterial lactate (Lac)],dose of vasoactive agents,10 min OCT at 0 h and 6 h were recorded.APACHE Ⅱ score,incidence and severity of septic shock-associated AKI,frequency of CRRT,ICU mortality and 28 d mortality were compared between groups using SPSS 22.0 software,risk factors associated with prognosis were analyzed using COX regression model.Results There were 27 cases in L group and 22 cases in H group.The MAP,CVP,ScvO2,lactate level and dose of vasoactive agents were comparable between groups at 0 h or 6 h (P ＞ 0.05),while 10 min OCT at 6 h was higher in H group than that inLgroup [(77.6±18.5) mmHgvs.(51.3 ±21.6) mmHg,P＜0.05].The incidence of septic shock-associated AKI (77.8％ vs.50.0％,P ＜ 0.05),proportion of phase 3 AKI (44.4％vs.22.7％,P ＜0.05) and frequency of CRRT (48.1％ vs.22.7％,P ＜0.05) was higher in L group than those in H group,and similarly were the ICU mortality (51.8％ vs.22.7％,P ＜0.05) and 28 d mortality (63.0％ vs.31.8％,P ＜ 0.05).Therefore,the 6 h 10 min OCT ≥66 mmHg was a protective factor to improve the ICU mortality (RR =0.01,95％ CI:0.001-0.39,P ＜ 0.05) and 28 d mortality (RR =0.01,95％CI:0.001-0.27,P＜0.05) in patients with septic shock-associated AKI.Conclusions 10 min OCT imposes substantial influence on the incidence,severity and prognosis of patients with septic shockassociated AKI,oxygen challenge test could improve the treatment of septic shock-associated AKI.

Objective To determine the association between plasma concentrations of brain derived neurotrophic factor (BDNF), neuron-specific enolase (NSE), and S100β, and the occurrence of delirium in critically ill patients. Methods Totally 65 patients in Intensive Care Unit (ICU) of Wuxi People's Hospital of Nanjing Medical University between June 2015 and February 2016 were included in the present study. Delirium diagnosis was used by confusion assessment method for the ICU (CAM-ICU). Plasma BDNF, NSE, and S100β concentrations were determined on day 1(T1), 3(T3), and 10(T10) after ICU admission. The day of ICU admission was defined as T0. Results Compared with the plasma BDNF level on T1 (0.23±0.22) μg/L, the plasma BDNF level on T3 (0.59±0.34) μg/L and T10 (0.24±0.21) μg/L were higher, especially for that on T3 with a significant difference (F=21.58, P=0.018). Plasma NSE level on T3 (1.68±0.25) μg/L was significantly higher than that on T1 (1.22±0.32) μg/L (F=10.24, P=0.042). Compared with those without delirium, the delirious patients had lower BDNF, higher NSE and S100β on T1, T3 and T10, of which the difference of BDNF [T1: (0.23±0.22) μg/L vs. (1.02±0.24) μg/L, F=116.25,P<0.01; T3: (0.59±0.34) μg/L vs. (1.55±0.36) μg/L, F=82.39, P<0.01; T10: (0.24±0.21) μg/L vs. (1.09±0.55)μg/L, F=50.93, P=0.003, and NSE (T1: (1.22±0.32) μg/L vs. (0.47±0.23) μg/L, F=94.30, P<0.01;T3:(1.68±0.25) μg/L vs. (0.79±0.28) μg/L, F=78.63, P=0.017; T10: (0.98±0.37) μg/L vs. (0.51±0.22) μg/L, F=70.95, P=0.026) reached significant differences. Conclusions Plasma BDNF and NSE are closely related to the occurrence of delirium in critically ill patients, especially for BDNF. Clinical monitoring of plasma levels of BDNF can help to predict the outcome of brain function in critically ill patients.

Objective To investigate the feasibility of leucocyte-reduced pooled platelet concentrates from whole blood stored at 4℃,and provide theoretical basis for the components preparation.Methods The collected 400 mL ACD-B antico-agulant whole blood was randomly divided into two groups,stored at 4℃and room temperature.The buffy coat was prepared within 6 hours and store at 22℃until next day to prepare leucocyte-reduced pooled platelet concentrates.Platelet samples on day 1,3,5 and 7 were taken for the blood cell count and related parameter detection.The pH,glucose and lactic acid con-tent were determined to reflect the metabolic status,and the thromboelastography,platelet aggregation rate and PAC-1 and CD62P expression were determined to reflect the function and activation of platelets.The difference in platelets between two groups were analyzed.Results With the extension of storage time,the count of leucocyte-reduced pooled platelet concen-trates decreased gradually,but the platelets distribution width(PDW),mean platelet volume(MPV)and platelet-larger cell ratio(P-LCR)increased gradually in two groups,with no statistical significance(P＞0.05).The pH and glucose con-tents in two groups gradually decreased,but the lactic acid content gradually increased,with no significant difference(P＞0.05).The thrombelastogram showed MA value that reflecting platelet function has no significant change during the storage,and there was no significant difference between the two groups(P＞0.05).The aggregation rates decreased while the expres-sion of PAC-1 and CD62P increased gradually with the prolongation of preservation time,with no significant difference be-tween the two groups(P＞0.05).Conclusion There is no significant difference in platelet count,function and activation between whole blood stored at 4℃and at room temperature within 6 hours.Whole blood stored at 4℃within 6 hours can be considered as the raw material for leucocyte-reduced pooled platelet concentrates.

Medical quality and safety are essential safeguards for the harmonious society in China, directly affecting people's sense of security and happiness. Continuously improving medical quality and ensuring medical safety are fundamental and essential to implementing the strategies of the Party Central Committee and the State Council, and promoting the construction of a healthy China. In recent years, with the rapid development of China's economy and the people's increasing emphasis on their own health and safety, China's plastic surgery industry has achieved significant progress and yielded outstanding results. However, along with the rapid growth of the industry, medical quality issues and safety accidents have occurred frequently, attracting widespread attention from all sectors of society. This article briefly outlines the history of quality management and quality control for medical quality and safety in China's plastic surgery specialty. It explores the development of quality management from its origin to medical quality management, as well as the responsibilities and contributions of the National Plastic Surgery Quality Control Center in improving industry standards and ensuring patient safety. It aims to provide support for the standardized management of the plastic surgery industry in the future, so as to promote its healthy and sustainable development.

To compare and understand the trends in quality control data changes in public and private medical institutions specializing in plastic and aesthetic major in China over the past three years.