Objective To investigate the clinical status of massive transfusion in elderly patients in general hospital in order to improve the clinical use of blood and ensure the security of blood transfusion in elderly patients.Methods 100 patients who required massive transfusion were divided into 2 groups:elderly group (patients aged 60 years and over,n=32) and non-elderly group (patients aged under 60 years,n=68).Clinical blood transfusion indications in all patients met the Technical Criterion of Clinical Blood Transfusion issued by Ministry of Health of the People's Republic of China in 2000.Clinical data were analyzed and compared between the two groups.Results Elderly patients with massive transfusion were mainly in department of surgery,including department of orthopedics,general surgery,hepatobiliary surgery,cardiac surgery and urology surgery and gastroenterology,and the mean age of patients in these departments was 71.5 years,69.9 years,72.0 years,66.0 years,65.5 years,70.8 years respectively,accounting for 50.0％,70.0％,20.0％,75.0％,20.0％ and 66.7％ in all patients who required massive blood transfusion respectively.The mean blood transfusion volumes were higher in patients in department of gastroenterology,general surgery,hepatobiliary surgery and orthopedic,in which the mean units of red blood cell components transfusion were 14.0 U,7.0 U,5.2 U and 4.1U respectively,the mean units of plasma components transfusion were 23.3 U,8.4 U,8.0 U,0.5 U respectively,and the mean uint of platelet components transfusion was 1.6 U in hepatobiliary surgery.Conclusions The risk of blood transfusion is higher in the elderly than in the non elderly.We should select the effective blood components reasonablely,reduce the unnecessary blood transfusion and decrease the dependence on plasma transfusion to avoid the transfusion overload and adverse reactions.

The paper analyzed the necessity of the testing items for blood transfusion compatibility.By means of a comprehensive evaluation of the testing requirements of blood transfusion labs,and a basis on characteristics of blood transfusion profession and technical specifications in clinical transfusion,the paper probed into building appropriate lab examination techniques in terms of ABO blood type testing item,RhD blood type testing item and screening test,and cross-matching testing items,for the purpose of achieving the safety and effectiveness of clinical blood use.

Objective To investigate the association between red blood cell distribution width (RDW) level and the change of cardiac function in patients with chronic heart failure (CHF) and explore its possible mechanism by studying the correlation between RDW and left ventricular ejection fraction (LVEF),left ventricular end-diastolic dimension (LVEDD),and high-sensitivity C-reactive protein (hsCRP),and uric acid(UA) in patients with chronic heart failure.Methods Two hundred and eighty patients were included in our study.Each patient received the examinations of echocardiography,electrocar diogram (ECG),blood routine,and blood biochemistry.According to the different LVEF,LVEDD and RDW,the patients were divided into groups A,B,C,and D,respectively.The groups were compared with each other.Results According to the different LVEF,from group A to group D,with a progressive decrease in LVEF,RDW level were increased gradually [(13.48 ± 0.85) ％,(14.10 ± 1.46) ％,(14.59 ±1.59)％,(14.75±1.42)％,F =12.698,P ＜0.01].There was significant difference among the four groups (P ＜0.01).RDW level correlated inversely with LVEF(r =-0.538,P ＜0.01).According to the different LVEDD,from group A to group D,with a progressive increase in LVEDD,RDW level increased gradually [(13.53 ±0.91)％,(14.12±1.42)％,(14.60±1.68)％,(14.76±1.39)％,F =12.276,P ＜0.01].There was significant difference among the four groups (P ＜0.01).RDW level correlated positively with LVEDD (r =0.343,P ＜0.01).In chronic heart failure patients,there were significant linear correlation between RDW and hs-CRP,LgUA (r =0.486,0.513,P ＜0.05).Conclusions RDW correlated with the change of cardiac function in patients with chronic heart failure.With a progressive decrease in LVEF and a progressive increase in LVEDD,RDW level increased gradually.RDW had a strong correlation with hs-CRP,LgUA.This indicates that RDW level increase may be related to the inflammation and oxidative reaction in patients with chronic heart failure.

Objective To analyze the safety of blood transfusion in hospitalized senile patients,and to prevent or reduce adverse transfusion reactions. Methods The blood transfusion information of patients over the age of 60 years in our hospital from January 2009 to December 2011 were retrospective analyzed. The data of pre-storage type of autologous blood transfusion for elective surgery were also discussed. Results Among 3549 cases of elderly patients,there were totally 23877 times of allogeneic transfusion and 84 cases with blood transfusion adverse reactions of heating or allergic reactions.The adverse reaction rates occured most in the infusion of fresh frozen plasma (0.55％).There was no hemolytic reaction,and transfusion adverse reactions occarred during stored blood autotransfusion. Conclusions Medical institutions should set the scientific and rational principle of blood use and select the appropriate blood components to reduce transfusion adverse events in the elderly patients. The autologous blood transfusion in the elderly patients should be actively pursued.

Objective To study the granulocyte colony stimulating factor ( G-CSF ) and granulocyte macro-phage colony stimulating factor ( GM-CSF) in complete remission of acute myeloid leukemia ( AML) patients with den-dritic cells(DC)changes in the function and its subsets .Methods 36 cases of complete remission according to AML patients were randomly divided into 3 groups,G group was given G-CSF 200g/d,subcutaneous injection ,GM group were given GM-CSF 200g/d,subcutaneous injection ,the control group were injected with normal saline .The curative effects were compared.Results The expression of G in group DC,CD83 and CD86 on surface of CD80 were lower than that in GM group and C group (t=4.34,5.43,4.54,4.54,5.25,3.54,all P<0.05),GM group,DC expression of CD11c was higher than that of G group and C group (t=4.54,4.27,all P<0.05).G group and GM group DC in promoting lymphocyte proliferation were higher than those in C group (t=4.54,5.64,all P<0.05);group GM DC to promote the ability of CD4 +T lymphocyte proliferation was higher than that of G group (t=3.54,P<0.05).ELISA assay,GM group DC secretion of IL-12 than that of group G and C group;group G DC secretion of IL-10 was higher than that of GM group and C group (t=3.54.4.23,4.32,3.87,all P<0.05).Conclusion G-CSF and GM-CSF can make the complete remission in patients with AML subgroup DC shift ,the bias of G-CSF DC2 and certain immuno-suppressive effect ,while GM-CSF DC subsets of DC 1 and promotes cell immune deviation .

Objective To evaluate the influence of preoperative MRI on tumor-positive rate of resection margins in breast cancer patients eligible for breast-conserving surgery.Methods Study group consisted of 64 consecutive patients with breast cancer eligible for breast-conserving surgery,while 73 cases as history control group.For the two groups,a first plan for breast-conserving surgery was made on the basis of conventional imaging and clinical evaluation.Study group underwent preoperative breast MRI and re-evalu-ated before final surgical plan was made.Rates of tumor-positive resection margins were compared between the 2 groups.Surgical plan alteration was recorded in the study group.Results Study group had lower rate of tumor-positive resection margin compared with control group (9.6% vs 24.7%,P =0.04).Furthermore,18.8% of study group altered the finial surgical plan to mastectomy after breast MRI.Conclusion Preoperative breast MRI can more acurately evaluate the extent of breast cancer,therefore decrease rate of tumor-positive resection margin in breast cancer patients eligible for breast-conserving surgery.

Objective:To compare the fit of Co-Cr basal crowns fabricated by three kinds of technology. Methods:18 laser cured resin dies were divided into A, B and C groups(n=6) randomly. Co-Cr basal crowns of group A, B and C were made by traditional casting technology, CAD/CAM cutting metal technology and direct metal laser sintering technology( DMLS) respectively. The crowns were cemented to the corresponding dies and the basal crowns and dies were embedded in methyl acrylic. The thickness of the cement layer of the samples was measured under a stero microscope. Data were analyzed with SPSS13. 0 statistical software. Results:Marginal gap of group A, B and C was (66.08 ±3.90) μm, (29.21 ±3.31) μm and (24.96 ±2.99) μm respectively(P<0.01). Internal gap of group A, B and C was (114. 10 ± 27. 66) μm, (73. 69 ± 31. 31) μm and (79. 89 ± 33. 63) μm respectively(A vs B or C, P<0. 01, B vs C, P>0. 05). Conclusion:DMLS technology may make the best marginal fit, CAD/CAM and DMLS technology may pro-duce better internal fit. The marginal fit and the internal fit of the crowns prepared by the 3 methods can meet the clinical requirements.

OBJECTIVE:To establish a method for content and dissolution determination of berberine hydrochloride in Fengshi qutong capsule. METHODS:HPLC was conducted to determine the content of berberine hydrochloride in the preparation:the column was Waters Xbridge C18 with mobile phase of acetonitrile-0.05 mol/L sodium hydrogen(45:55,V/V)at a flow rate of 0.5 ml/min,de-tection wavelength was 345 nm,column temperature was 30 ℃,and the injection volume was 10 μl. Rotating basket method was used to determine the dissolution of berberine hydrochloride. RESULTS:The linear range of berberine hydrochloride was 1.06-74.2 μg/ml(r=0.9999);RSDs of precision, stability and reproducibility tests were lower than 1%;recovery was 96.8%-100.6%(RSD=1.6%,n=9). The dissolution of samples in 30 min was higher than 80%. CONCLUSIONS:The method is simple and stable with good reproducibility,and can be used for content and dissolution determination of berberine hydrochloride in Fengshi qutong capsule.

Objective To investigate the blood transfusion paths in elderly patients in order to ensure the blood transfusion safety in the elderly.Methods Clinical data of elderly patients (aged 60 and over) receiving blood transfusion were selected from January 2008 to December 2013.Data of blood transfusion in different clinical department were analyzed.Results From 2008 to 2013,the number of elderly patients receiving blood transfusion and transfusion volume showed the rising trends.Patients in Department of Cardiothoracic Surgery had the most blood transfusion volume among all surgical departments (9.3U/person),and plasma transfusion accounted for the most with plasma and red blood cells in a 3 ∶ 1 ratio.Patients in Department of Internal Medicine had the most blood transfusion volume among all non surgical departments (15.9U/person),and platelets transfusion accounted for the most with platelets and red blood cells in a 3 ∶ 1 ratio.The oldest patients on average receiving blood transfusion in the top 10 was from Department of Emergency (aged 77 years),and the most common cause was gastrointestinal hemorrhage.The youngest patients receiving blood transfusion in the top 10 was from Department of Cardiothoracic Surgery and Department of Gynecology (aged 69 years),and the most common cause was huge pleural mass and ovarian cancer.Conclusions Blood transfusion for elderly patients should be restrict the indications for transfusion strictly,choose the reasonable transfusion time,blood components and volume.Physiological and functional changes and clinical features of elderly patients should be paid attention to at the same time in order to reduce unnecessary transfusions,particularly the dependence on plasma transfusion and unnecessary collocated blood transfusion,to avoid the overload and adverse transfusion reactions.

Objective To study the effect of p38 mitogen activated protein kinase (MAPK) pathway inhibitors SB203580 on cell cycle of K562 cell lines and its mechanisms. Methods The expression of mRNA and protein of p38,Cyclin D2,Cyelin E and P27 in K562 cell lines treated with SB203580 were detected by retrotranscription polymerase chain reaction (RT-PCR) and Western blotting, respectively. Cell cycle was determined by flow eytometry (FCM). Results The expressions of mRNA and protein of p38, Cyclin D2 and Cyclin E in K562 cell lines treated with SB203580 were decreased and the expression of p27 was increased.The percentage of cells in G0/G1 phase was increased and was decreased in S phase. There was a significant difference as compared with K562 cell lines before treated with SB203580. Conclusion SB203580 can affect cell cycle regulatory proteins by p38 pathway and eventually inhibit proliferation of K562 cells.