Objective To explore the application effect of the wechat public platform in follow-up management of patients with moderate or severe craniocerebral injury.Methods 98 patients admitted in the craniocerebral department of our hospital from February to November 2014 were selected and divided into two groups by random number table method,with 48 cases in the control group and 50 cases in the observation group;the traditional follow-up management mode using telephone was adopted to patients in the control group,while the follow-up management mode using the wechat public platform was adopted to those in the observation group,with a follow-up period of 3 months;for patients in both groups,their activities of daily living (ADL) and exercise of self-care agency (ESCA) abilities before and after intervention,occurrence of adverse events and complications within the follow-up period,and their degree of satisfaction towards the follow-up management were collected.Results After intervention,ADL score,total scores of ESCA and total scores of satisfaction towards the follow-up management among patients in the observation group were 87.34±15.26,24.36±17.24 and 86.07±14.82,which were significantly higher than that among patients in the control group were 66.72±14.62,99.37±15.29 and 61.14±13.19 (t=7.941,7.982,6.962,all P ＜0.01);within intervention,the observation group had significantly lower total occurrence rate of adverse events and complications which was16.00％ (8/50) compared to the control group 39.58％ (19/48) (x2=6.824,P ＜ 0.01).Conclusions By establishing the follow-up management mode for patients with craniocrerbral injury through the wechat public platform,effect of the follow-up management can be effectively promoted,prognosis of patients can be improved and patients' degree of satisfaction can be enhanced;it is worth of being further promoted clinically.

Objective To investigate the effect of rosiglitazone on renal interstitial fibrosis in chronic cyclosporine nephropathy (CCN) rats.Methods Twenty-eight rats were randomly assigned to control group,rosiglitazone (RGZ,5 mg·kg-1·d-1) group,cyclosporine A(CsA,15 mg·kg-1·d-1) group,rosiglitazone (5 mg·kg-1·d-1) +CsA group.Real-time PCR and RT-PCR methods were used to investigate the expressions of OPN,RANTES on the 14th day and MMP-9,TIMP-1 on the 35th day in kidney of CCN respectively.Results In comparison with control group,the expressions of OPN,RANTES,MMP-9,TIMP-1 in CsA and RGZ+CsA groups were increased (P＜0.05).In comparison with the CsA group,the expressions of OPN,RANTES,MMP-9,TIMP-1 in CsA+RGZ group significantly decreased (P＜0.05).Conclusion Rosiglitazone may protect renal tissue after CCN by decreasing expressions of OPN,RANTES,MMP-9,TIPM-1.

With the rapid development of augmented reality, the surgical navigation based on augmented reality technology improved gradually, especially in the field of maxillofacial surgery, where real-time and accurate positioning is required. This article reviewed the structures of augmented reality surgical navigation system, its clinical applications in the field of maxillofacial surgery and its deficiencies, in order to provide benefits to the further research of augmented reality surgical navigation.

With the rapid development of augmented reality, the surgical navigation based on augmented reality technology improved gradually, especially in the field of maxillofacial surgery, where real-time and accurate positioning is required. This article reviewed the structures of augmented reality surgical navigation system, its clinical applications in the field of maxillofacial surgery and its deficiencies, in order to provide benefits to the further research of augmented reality surgical navigation.

【Objective】 To establish an intelligent management system of surgery blood (IMSSB) and explore its effectiveness in promoting rational and timely blood transfusion in surgical patients. 【Methods】 IMSSB was constructed based on the hospital closed-loop blood transfusion information management system, clinical transfusion mobile nursing APP system, and the Internet of Things blood bank forward management system to dynamically guide, supervise and evaluate the whole process of perioperative blood transfusion management. Blood management data of 100 patients undergoing cardiac vascular surgery before( from May to October, 2018) and after (from November 2018 to April 2019) the application of IMSSB were selected and compared to evaluate the role of the system in the management of surgical blood. 【Results】 Time, from blood application to transfusion, during surgery was shortened(30 minutes before vs less than 2 minutes after). The proportion of patients with Hb over 110g/L after intraoperative blood transfusion decreased significantly from 30.5%(25/82) to 8.5%(4/47)(P<0.01). The incidence of surgical blood transfusion decreased from 82.0%(82/100) to 47.0%(47/100)(P<0.01). 【Conclusion】 IMSSB, as an innovation of clinical blood management mode for surgical patients, can promote timely and rational blood transfusion during operation, which is of great significance to improve operation safety.

Objective: To investigate the clinical symptoms, laboratory tests, and treatment strategies of a case of fetal/neonatal alloimmune thrombocytopenia (FNAIT) complicated with piperacillin drug antibody. Methods: The platelet antibodies in the mother were screened and identified by ELISA. The HLA antigens of the newborn were genotyped through PCR-SSO, while the specificity of HLA antibodies in the mother was determined using a Single Antigen kit. The drug antibody was detected by a piperacillin kit. Results: Maternal antibodies against paternally-derived platelet antigens were detected. The HLA genotypes of the newborn were identified as HLA A 33∶03 and HLA B 58∶01. The mother exhibited strong positive antibodies against the specific platelet antigens of the newborn, namely anti-HLA-A33 and anti-HLA-B58 antibodies. The piperacillin antibody was detected in the newborn. Following treatment of continuous intravenous immunoglobulin (IVIG), platelet transfusions, red blood cell transfusions and discontinuation of piperacillin treatment, the platelet count and hemoglobin levels increased in the newborn. Conclusion: The newborn in this case was diagnosed with FNAIT complicated by the presence of anti-HLA-A33 and anti-HLA-B58 antibodies, as well as drug-induced hemolytic anemia caused by piperacillin drug antibody. The condition is more complicated under the influence of dual immune antibodies. Laboratory detection techniques such as platelet antibody and drug antibody tests can assist in early clinical diagnosis. At the same time, more active drug and blood transfusion treatments should be given in clinical practice to improve the prognosis.

Objective: To investigate the clinical symptoms, laboratory tests, and treatment strategies of a case of fetal/neonatal alloimmune thrombocytopenia (FNAIT) complicated with piperacillin drug antibody. Methods: The platelet antibodies in the mother were screened and identified by ELISA. The HLA antigens of the newborn were genotyped through PCR-SSO, while the specificity of HLA antibodies in the mother was determined using a Single Antigen kit. The drug antibody was detected by a piperacillin kit. Results: Maternal antibodies against paternally-derived platelet antigens were detected. The HLA genotypes of the newborn were identified as HLA A 33∶03 and HLA B 58∶01. The mother exhibited strong positive antibodies against the specific platelet antigens of the newborn, namely anti-HLA-A33 and anti-HLA-B58 antibodies. The piperacillin antibody was detected in the newborn. Following treatment of continuous intravenous immunoglobulin (IVIG), platelet transfusions, red blood cell transfusions and discontinuation of piperacillin treatment, the platelet count and hemoglobin levels increased in the newborn. Conclusion: The newborn in this case was diagnosed with FNAIT complicated by the presence of anti-HLA-A33 and anti-HLA-B58 antibodies, as well as drug-induced hemolytic anemia caused by piperacillin drug antibody. The condition is more complicated under the influence of dual immune antibodies. Laboratory detection techniques such as platelet antibody and drug antibody tests can assist in early clinical diagnosis. At the same time, more active drug and blood transfusion treatments should be given in clinical practice to improve the prognosis.

【Objective】 To explore the application of capillary ultracentrifugation technology in accurate identification of Rh phenotype and clinical blood transfusion. 【Methods】 132 samples, presenting mixed field agglutination during Rh phenotyping in our laboratory from May 2019 to February 2020, were separated using capillary ultracentrifugation technology, and the proximal and distal red blood cells were taken for Rh phenotype test, and then blood donors with the same Rh phenotype as the proximal cells were selected for cross matching. 【Results】 132 samples were subjected to capillary ultracentrifugation, and new red blood cells were successfully isolated from the proximal side in 128 (96.97%)cases, and the Rh phenotype was accurately identified, i.e. CcDEe in 47 cases (36.72%), CcDee in 12(9.38%). ), ccDEEin 11 (8.59%), CCDee in 52(40.63%), ccDEe in 5 (3.91%), and ccDee in 1(0.78%). 4 cases of mixed field reaction remained after centrifugation, and all of them had a history of blood transfusion within 2 days. For the 128 patients whose Rh phenotype was accurately identified, blood donors with the same type of Rh phenotype were selected, and 4 patients whose Rh phenotype could not be determined, donors with CCDee phenotype were selected based on the frequency of phenotype distribution and the principle of reducing antigen exposure. The cross-matched blood of all patients were consistent. 【Conclusion】 Capillary ultracentrifugation technology can effectively separate the new red blood cells, improve the accurate identification of Rh phenotype, and provide safety guarantee for clinical targeted blood transfusion.

Objective:To explore the efficacy and safety of daratumumab in late antibody-mediated rejection (late AMR) after kidney transplantation (KT).Methods:From December 2020 to December 2021, the relevant clinical data were reviewed for 8 patients with late AMR after receiving daratumumab at Affiliated Tongji Hospital. In intensive phase, the combination of plasma exchange (PP)/intravenous immunoglobulin (IVIG) and daratumumab were dosed once a week; in maintenance phase, once every 2 to 4 weeks. The levels of donor-specific antibody (DSA) and renal function were compared pre-treatment and Month 3/12 post-treatment. The treatment-related toxicities were observed. Independent sample T test was utilized for inter-group comparison.Results:The median treatment course during intensive period was 9(4-17) sessions. Maintenance treatment lasted for 5 to 19 months and 2 cases withdrew after 5 to 6 treatments for achieving antibody clearance. A total of 11 DSAs were detected in 8 recipients. At Month 3/12, mean fluorescent intensity (MFI) of DSA was 6 016±4 775 and 6 438±3 668. Both were significantly lower than 11 944±5 237 pre-treatment and the difference was statistically significant ( P=0.012, 0.004). Seven recipients achieved stable renal function during treatment and one recipient resumed hemodialysis at Month 18 due to acute rejection. Glomerular filtration rate of 7 recipients was (40.6±20.1), (53.6±20.9) and (49.0±17.2) ml·min -1· (1.73 m 2) -1 pre-treatment and Month 3/12 and no significant differences existed among different timepoints. During follow-ups, 2 cases developed mild nasal congestion during an early stage of daratumumab infusion while the remainders had no obvious discomfort during infusion and tolerance was decent. Conclusion:Early combination of daratumumab with PP/IVIG, followed by a course of daratumumab has demonstrated an excellent antibody reduction effect on late AMR. During treatment, renal function remains generally stable.