Allogeneic hematopoietic stem cell transplantation(allo-HSCT) represents a potentially curative treatment modality in a range of hematologic malignancies and autoimmune disease. Immune reconstitution is a major factor to evaluate the outcome of transplantation.As markers for recent thymic output function,T cell receptor excision circles (TRECs) have been widely applied to evaluate thymie output function in normal individuals or in patients with hematopoietic stem cell transplantation, hematologic malignancies,HIV infection or autoinunune disease.

Objective To analyze the expression level of CD44v6 in small cell lung cancer and the concentration of vascular endothelial growth factor(VEGF) in serum,to explore the clinical significance of them in small cell lung cancer.Methods The expression level of CD44v6 was detected by immunohistochemical methods in 80 cases of small cell lung cancer as patients group,who were treat in People''s Hospital of Jiangyin from January 2014 to January 2016.Another 80 cases of healthy subjects as control group.Used ELISA method to detect the concentration of VEGF of the two groups of patients in the blood.Analyzed the relationship between VEGF,CD44v6 with the survival time of patients.Results The CD44v6 expression in small cell lung cancer was positive in 6 cases,the total positive expression rate was 7.5%.The serum levels of VEGF in patients group((490.9±342.7) ng/L) was significantly different from that in the control group((180.8±67.5) ng/L),and the difference was statistically significant(P=0.024).There was no correlation between the survival time and the expression of CD44v6 in small cell lung cancer(P=0.723).The survival time of small cell lung cancer was negatively correlated with the concentration of VEGF in serum.Conclusion There is a significant correlation between serum VEGF concentration and survival time in patients with small cell lung cancer,which is one of the prognostic factors in patients with small cell lung cancer.

Objective To detect the expression levels of metallothionein1 H(MT1 H)in children and adoles-cents osteosarcoma serums,and to analyze its relationship with clinicopathological features,and to explore the effect of MT1 H on cell proliferation of osteosarcoma cells and its mechanism.Methods Enzyme -linked immuno sorbent assay (ELISA)was performed to detect the expression of MT1 H in children and adolescents osteosarcoma serums and non-neoplastic disease serums.MT1 H vector was transfected into the osteosarcoma U2OS cells.Reverse transcription -poly-merase chain reaction(RT -PCR)and Western blot were used to detect the expression of the mRNA and protein of MT1 H,respectively.Methylthiazolyldiphenyl -tetrazolium bromide(MTT)was used to detect the cell growth.Western blot was performed to detect the expression of nuclear factor(NF)-κB,and inhibitor of κB (IκB)-αprotein. Results The expressions of MT1 H in osteosarcoma serums and nonneoplastic disease serums was (0.51 ± 0.52)μg/L and (2.17 ±0.78)μg/L,respectively,with a significant difference between the 2 groups(t =-8.966, P <0.05).The expression of MT1 H in stage Ⅰ -ⅡA andⅡB -Ⅲ was (1 .98 ±0.69)μg/L and (2.45 ±0.82)μg/L,respectively,showing a gradual increase depending on clinical staging(t =-2.343,P <0.05).The expressions of MT1 H mRNA and protein were elevated in osteosarcoma U2OS cells after MT1 H vector transfection(all P <0.05). MTT assay showed that,the A value in blank control group,blank vector group,MT1 H vector group were 0.38 ±0.03, 0.36 ±0.03,0.42 ±0.03,respectively,the cell proliferation in the MT1 H vector group was significantly promoted when compared with these in the blank vector group and blank control group(F =4.213,P <0.05)from the third day.West-ern blot showed that,the relative expression of NF -κB in blank control group,blank vector group,MT1 H vector group were 0.56 ±0.05,0.53 ±0.05,0.92 ±0.07,respectively,the relative expression of IκB -αprotein were 0.64 ± 0.06,0.62 ±0.09,0.34 ±0.08,respectively,the expression of NF -κB protein was up -regulated and the expression of IκB -αprotein was down -regulated in the MT1 H vector group when compared with those in the blank vector group and blank control group(F =44.581 ,14.927,all P <0.05).Conclusions The expression of MT1 H is increased in children and adolescents osteosarcoma serums compared with that in nonneoplastic disease serums.The clinical stage is later,the expression of MT1 H is higher.MT1 H promotes cell proliferation through regulating the NF -κB pathway.

Objective To explore the effect of nursing safety management in drawing blood in outpatient department. Methods A total of 152 cases of patients who had blood taken in outpatient department of Affiliated Hospital of Guangdong Medical University from May 2016 to November 2016 were selected by purposive sampling method, and were divided into control and observation group with 76 cases in each according to the random number table. The control group was given routine outpatient transfusion nursing care. On the basis of that, the observation group strengthened nursing safety management. Patients' satisfaction and the incidence of adverse nursing events were compared between the two groups. Results Patients' satisfaction of observation group was 96.1%, significantly higher than that of the control group (85.5%) with statistical difference (χ2=5.035, P<0.05). There was no occurrence of adverse nursing events in the observation group and 5 cases in the control group, the difference was statistical significant (χ2=62.23, P< 0.05). Conclusions Nursing safety management can effectively improve the outpatient blood drawing patients' nursing satisfaction, and reduce the incidence ofadverse nursing events.

Objective To explore the clinical features,treatment and prognosis of malignant solid tumors in the digestive tract in children and adolescents. Methods Sixty-five children and adolescents with malignant solid tumors in the digestive tract from January 1997 to June 2017 were selected,who were treated at the Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital. The tumor site,gender,age,clinical presentations,treatment, follow-up time and their life status by deadline follow-up in 65 children and adolescents were collected respectively, and the clinical features,treatment methods and prognosis were retrospectively analyzed. The follow-up deadline was on December 31,2017. Results The most frequent sites of tumors were liver tumor(36 cases,55. 38%),followed by rectum tumor(11/65 cases,16. 92%),colon tumor(6/65 cases,9. 23%),pancreas tumor(5/65 cases,7. 69%),gas-tric(3/65 cases,4. 62%),esophagus (1/65 cases,1. 54%),gallbladder tumor (1/65 cases,1. 54%),ileum tumor (1/65 cases,1. 54%),and appendix tumor (1/65 cases,1. 54%). The prevalence rate in males and females was 1. 32:1. 00. The age of embryo tumor incidence was smaller,and the age of epithelium cancer incidence was older. The main symptoms included abdominal distension and pain (66. 15%,43/65 cases). Twenty-seven patients (41. 5%, 27/65 cases)was in stageⅣ. Radical and palliative surgery were the main treatment in 50 cases (76. 92%). The 1-year,3-year,5-year overall survival rates were 60. 7%,31. 0%,18. 8%,respectively. The overall survival rate of co-lon and rectal cancer was higher than that of hepatocellular cancer,and the differences were all statistically significant (χ2＝6. 268,P＝0. 012;χ2＝11. 772,P＝0. 001). The overall survival rate of patients who received surgery combined with chemoradiotherapy was the longest and those undergoing chemotherapy only was the shortest,but the differences had no statistical significance among 4 groups of sheer surgery,chemotherapy alone,surgery combined with chemothera-py and surgery combined with chemoradiotherapy(all P＞0. 05). Conclusion The malignant solid tumors in the di-gestive tract in children and adolescents have a poor prognosis. The unspecific presentation makes the diagnosis diffi-cult. It is very important to diagnose early and treat as soon as possible by the combination of surgery,chemotherapy and radiotherapy to improve the overall survival rate.

【Objective】 To establish the reference interval of Thromboelastography(TEG)of healthy adult in Hainan, compare with the interval provided by the manufacturers, and analyze the influencing factors. 【Methods】 A total of 308 healthy adult volunteers were included according to the inclusion and exclusion criteria. The TEG was analyzed based on adequate quality control, and the reference interval of each parameter was calculated with 95% CI. 【Results】 The reference interval of these volunteers were R 4.27~9.20 min, K 1.60~3.83 min, Angle 44.22°~67.78°, MA 47.82~64.17 mm, CI -5.63~1.12 and G 4.58~9.03. 14.94% (46/308) of these volunteers had at least one index exceeded the reference interval provided by manufacturers. A total of 74 healthy volunteers were diagnosed with coagulation disorder, with the specificity at 79.22%. Significant differences of R, K, Angle, MA, CI, G were observed between males and females (P<0.05). Hypercoagulability was not associated with the age. 【Conclusion】 This study established a reference interval of TEG of healthy adults in Hainan, which provided reference for related clinical and basic science study.

【Objective】 To investigate the correlation between preoperative thromboelastography (TEG) parameters and routine coagulation tests of malignant tumor patients. 【Methods】 A total of 79 patients with malignant tumors, receiving preoperative TEG tests and routine coagulation tests between January 2019 and June 2020, were included. The correlation and regression between coagulation indexes and TEG parameters were analyzed. 【Results】 In patients with malignant tumors, the coagulation time(K) was negatively correlated with Plt and fibrinogen (FIB), while Angle, Ma, and G were respectively positively correlated with Plt and FIB. 【Conclusion】 There is a correlation between preoperative TEG parameters and routine coagulation tests in patients with malignant tumors. There is complementarity but not reciprocal substitutability between these two tests.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.