Objective Single voxel proton spectroscopy technique (1H-MRS)was performed in the healthy newborn brain tissue to investigate the metabolic ratio in the right basal ganglia and the right frontal lobe changes with gestational age, and to improve the understanding of the neonatal brain development. Methods In this study, 69 newborns were selected, including twenty-five premature and forty-four term neonates. By using the Gesell developmental scale to evaluate brain development , they all had normal neurologic outcomes at 12-months corrected age. A point-resolved spectroscopy sequence was used to study the metabolic data obtained from each region of interest. Results N-acetylaspartate: creatine and N-acetylaspartate:choline were positively correlated with gestational age (the right basal ganglia r = 0.27, 0.63, the right frontal lobe r = 0.44, 0.64 respectively, P < 0.05) and choline:creatine was negative (the right basal ganglia r = -0.51,the right frontal lobe r = -0.41, P < 0.05), with a linear regression relationship among variables. In the same gestational age group , the N-acetylaspartate: choline of the right basal ganglia was higher than that of the right frontal lobe , and the metabolic ratios among the anatomic locations were significantly different (P < 0.05). Conclusion Neonatal brain metabolite levels are associated with gestational age , and MRS can monitor newborn brain maturation quantitatively.

To cultivate high-quality professionals of transfusion medicine and construct a new mode of undergraduate practice of transfusion medicine. Since 2013, orientation interns in blood transfusion medicine were recruited from the undergraduate program of laboratory medicine, and a new teaching mode of orientation practice of blood transfusion medicine was established from the aspects of teaching staff, rotation of posts, practice content and comprehensive quality. Through the new training mode of orientation practice, excellent transfusion medical professionals with solid basic knowledge, strong operational skills and high comprehensive quality were cultivated. The establishment of the oriented practice mode of blood transfusion medicine is beneficial to the cultivation and output of high-quality transfusion talents and plays a positive role in promoting the development of transfusion medicine education.

Objective:To investigate the role and mechanism of human umbilical cord mesenchymal stem cell exosomes (hUCMSC-ex) in wounds with escharectomy and skin grafting in scalded rats.Methods:The study was an experimental study. Twelve male Sprague-Dawley (SD) rats aged 6-8 weeks were divided into combined treatment group, fixed+allogeneic skin group, autologous skin+allogeneic skin group, and allogeneic skin group by random number table method (the same grouping method hereinafter), with 3 rats in each group. The four groups of rats were inflicted with scalded wounds on the back and performed with escharectomy, and then the wounds of rats in combined treatment group were fixed with a metal ring (the same fixing method hereinafter) and transplanted with autologous skin grafts and allogeneic skin grafts, and the other three groups of rats were fixed and/or transplanted with skin grafts corresponding to the group name. At 14, 21, and 28 d after surgery, the wound healing area in the four groups of rats was measured. Another 15 male SD rats aged 6-8 weeks were divided into normal group with no treatment, high exosome group, low exosome group, supernatant group, and phosphate buffer solution (PBS) group, with 3 rats in each group. The last 4 groups of rats were treated as that in the above-mentioned combined treatment group, and then were injected around the wounds with 200 μL of PBS containing 100 μg of hUCMSC-ex, 200 μL of PBS containing 50 μg of hUCMSC-ex, 200 μL of supernatant with no hUCMSC-ex, and 200 μL of PBS at 0 (immediately), 7, 14, and 21 d after surgery, respectively. At 14, 21, and 28 d after surgery, the wound healing area in the four groups of rats was measured. The wound neo-epithelial tissue of rats in high exosome group and PBS group at 28 d after surgery and the normal skin tissue of rats in normal group at the same time point were taken, and the differentially expressed proteins were screened by label-free quantitative proteomics method; the two up-regulated and differentially expressed proteins, the immunoglobulin G1 heavy chain constant region (IGHG1) and cystatin A (CSTA) with the largest and second largest fold changes in comparison between high exosome group and PBS group were selected, and their protein expressions were detected by Western blotting. The number of samples in all experiments was 3.Results:At 14, 21, and 28 d after surgery, the wound healing area in combined treatment group, autologous skin+allogeneic skin group, and allogeneic skin group of rats was significantly larger than that in fixed+allogeneic skin group ( P<0.05), the wound healing area in autologous skin+allogeneic skin group of rats at 21 d after surgery and that in allogeneic skin group of rats at 14 and 21 d after surgery was significantly larger than that in combined treatment group ( P<0.05), and the wound healing area in allogeneic skin group of rats at 14 d after surgery was significantly larger than that in autologous skin+allogeneic skin group ( P<0.05). The wound healing area of rats in high exosome group and low exosome group at 14, 21, and 28 d after surgery and in supernatant group at 14 and 28 d after surgery was significantly larger than that in PBS group ( P<0.05); the wound healing area in high exosome group of rats at 14 and 21 d after surgery was significantly larger than that in supernatant group ( P<0.05), and the wound healing area at 14 d after surgery was significantly larger than that in low exosome group ( P<0.05); the wound healing area in low exosome group of rats at 14 d after surgery was significantly larger than that in supernatant group ( P<0.05). Compared with that in PBS group, 332 proteins were differentially expressed in the neo-epithelial tissue of the wounds in high exosome group of rats at 28 d after surgery ( P<0.05), among which the protein expressions of IGHG1 and CSTA were significantly up-regulated (with fold change of 12.60 and 2.27, respectively, P<0.05). Compared with those of normal skin tissue in normal group, 1 400 and 1 057 proteins were differentially expressed in the neo-epithelial tissue of the wounds in high exosome group and PBS group of rats at 28 d after surgery, respectively. The protein expressions of IGHG1 and CSTA in the wound neo-epithelial tissue in high exosome group of rats at 28 d after surgery were significantly larger than those in normal skin tissue of rats in normal group ( P<0.05) and those in PBS group ( P<0.05). Conclusions:hUCMSC-ex may accelerate the repair process of wounds with escharectomy and skin grafting and improve the quality of wound healing in scalded rats by regulating the protein expressions of IGHG1 and CSTA.

【Objective】 To compare the efficacy and safety of transfusion of suspended RBCs and washed RBCs in patients with positive direct Coombs testing results. 【Methods】 A retrospective analysis was conducted on 98 patients with positive direct Coombs testing results as 2+ or less in the First Affiliated Hospital of Chongqing Medical University from January 2015 to December 2020. Among them, 31 patients, from January 2015 to December 2016, were transfused with washed RBCs and set as the control group; the other 67 patients, from January 2017 to December 2020, transfused with suspended RBCs, were enrolled as the experimental group. The changes of main laboratory indexes and the incidence of transfusion adverse reactions before and after transfusion of 2 U and 4 U RBCs were compared between the two groups to evaluate the efficacy and safety of transfusion. 【Results】 After 2 U and 4 U transfusion, Hb increased by 12±4.967 (g/L) and 23.78±12.736 (g/L) in the control group, while 12.85±7.109 (g/L) and 22.68±9.832 (g/L) in the experimental group, All transfusions of the two groups were effective, and no significant differences in Hb, TBIL, IBIL and LDH were noticed by groups (P>0.05). No significant difference in the incidence of adverse reactions to blood transfusion between the 2 groups was observed (P>0.05). 【Conclusion】 The transfusion of suspended RBCs is safe and effective in patients with positive direct Coombs testing results as 2+ or less, and the transfusion of washed RBCs was unnecessary.

OBJECTIVE：To inv estigate the tonifying blood effects of different extract parts of Embelia parviflora on blood deficiency model mice ，and to explore its mechanism. METHOD S：Totally 70 mice were randomly divided into blank control group（water），model control group （water），positive control group （Danggui buxue oral liquid ，324 g/kg），petroleum ether ， ethyl acetate ，n-butanol and water parts of E. parviflora groups（4.2，10.64，22.07，5.0 g/kg respectively ，calculated by the extractum），with 10 mice in each group. The mice were given medicine intragastrically ，once a day ，for consecutive 14 d. Except for blank control group ，other groups were given intraperitoneal injection of cyclophosphamide （80 mg/kg）on 12th and 13th day of starting administration to induce blood deficiency model. 30 min after last administration ，automatic hematology analyzer was used to detect the levels of peripheral hemogram indexes （WBC，RBC，HCT，PLT，HGB）；the levels of IL- 2，IL-3，IL-6，EPO， G-CSF，M-CSF and VCAM- 1 were determined by ELISA ；thymus and spleen indexes were calculated. RESULTS ：Compared with blank control group ，peripheral hemogram indexes levels ，serum levels of IL- 2，IL-3，IL-6，EPO，G-CSF，M-CSF，VCAM-1 and thymus index were decreased significantly ，while spleen index was increased significantly （P＜0.01）. Compared with model control group，there was no statistical significance in above indexes of mice in petroleum ether part of E. parviflora group（P＞0.05）. The levels of RBC ，HGB，PLT，the serum levels of IL- 2，IL-6，G-CSF，M-CSF，VCAM-1 and thymus index in ethyl acetate part of E. parviflora group were significantly increased （P＜0.05 or P＜0.01），while there was no statistical significance in other indexes （P＞0.05）. Except for no significant increase of WBC in water part of E. parviflora group，above peripheral hemogram indexes ， serum indexes and thymus index of n-butanol group and water part of E. parviflora group were increased significantly while spleen index was decreased significantly （P＜0.05 or P＜0.01）. CONCLUSIONS：The ethyl acetate ，n-butanol and water parts of E. parviflora can improve immunological function and the expression of hematopoietic factors in blood deficiency model mice ，and shows certain blood tonifying effects.

【Objective】 To analyze the root causes of adverse events to insufficient plasma transfusion, so as to explore improvement measures, optimize the transfusion strategy and avoid such adverse events. 【Methods】 The root causes of insufficient plasma transfusion were analyzed by health care failure mode and effect analysis, the targeted improvement measures were formulated and the effect was evaluated. 【Results】 After the improvement, the incidence of adverse events to insufficient plasma transfusion decreased significantly.The risk priority value affecting the safety of blood transfusion decreased from 70 to 8, and the proportion of coagulation function test after blood transfusion increased from 44.61%(1 309/2 934)in 2012 to 80.55% (2 187/2 715)in 2019, and plasma transfusion volume per capital increased from 300 mL to 528 mL. PT and APTT values after plasma transfusion in 2019 significantly increased compared with those in 2012. Meanwhile, the proportion of plasma transfusion in hospitalized patients decreased from 3.16% (2 934/92 838)to 2.12%(2 715/128 352). 【Conclusion】 Risk management of quality and safety of blood transfusion by combing healthcare failure mode, effect analysis and root cause analysis(RCA) can improve the risk awareness of clinical blood transfusion, optimize the proportion of plasma transfusion, and is essential to ensure the safety and effectiveness of blood transfusion and improve the prognosis of transfused patients.