Objective:To explore the application value and complications of two blood transfusion methods used for cesarean delivery.Methods:Sixty parturients undergoing cesarean delivery in Yiwu Central Hospital from January 2013 to December 2019 were included in this study. They were divided into autogenic blood transfusion and allogeneic blood transfusion groups ( n = 30/group) according to different blood transfusion methods used. In the autogenic blood transfusion group, self-storage blood transfusion scheme was used, while in the allogeneic blood transfusion group, allogeneic blood transfusion scheme was used. The amount of postpartum blood loss, amount of autogenic blood transfused, amount of allogeneic blood transfused, hemoglobin, hematocrit and coagulation index before and 3 days after surgery, complications were compared between autogenic blood transfusion and allogeneic blood transfusion groups. Results:Postoperative blood loss in the autogenic blood transfusion group was significantly less than that in the allogeneic blood transfusion group [(9 897.42 ± 215.37) mL vs. (23 081.87 ± 546.23) mL, t = 122.990, P < 0.05]. The amount of autogenic blood transfused in the autogenic blood transfusion group was less than that in the allogenic blood transfusion group [(954.32 ± 143.42) mL vs. (10 474.18 ± 376.87) mL, t = 129.310, P < 0.05). Hemoglobin level and hematocrit at 3 days after surgery in the autogenic blood transfusion group were (106.32 ± 12.19) g/L and (0.39 ± 0.19), which were significantly higher than those in the allogenic blood transfusion group [(86.18 ± 3.25) g/L, 0.34 ± 0.14, t = 8.744, 11.633, both P < 0.05]. D-Dimer and fibrin degradation product levels in the autogenic blood transfusion group were (5.45 ± 1.29) mg/L and (13.42 ± 2.41) mg/L, respectively, which were significantly lower than those in the allogenic blood transfusion group [(8.56 ± 1.47) mg/L, (21.30 ± 3.64) mg/L, t = 8.710, 9.887, P < 0.05]. The incidence of complications in the autogenic blood transfusion group was significantly lower than that in the allogenic blood transfusion group [6.67% (2/30) vs. 36.67% (11/30), χ2 = 7.954, P < 0.05]. Conclusion:Autogenic blood transfusion is highly effective for cesarean delivery of dangerous placenta previa, and it has few complications.

Hepatitis B virus (HBV) infection is a major global public health problem. Persistent HBV infection is prone to develop chronic hepatitis B (CHB), and CHB is closely related to the development of liver fibrosis and hepatocellular carcinoma. High-affinity specific anti-HBs are essential for the control of HBV infection, while the antibody production is closely related to follicular helper T (Tfh) cells. Tfh cells can help B cells differentiate into plasma cells to produce specific antibodies to control virus infection. This article reviews the latest research progress of Tfh cells in HBV infection to provide information of new strategies for the prevention and treatment of HBV.

Objective We aim to evaluate and discuss the feasibility of Hyaline imaging of three-dimension sonography in observation of paravaginal support structure in normal nonporous women.Methods Total of 45 normal infertile women were chosen.Three-dimensional volume datasets were collected at rest by transperineal ultrasound.The three-dimensional Hyaline images were acquired off-line.We observed the morphologic features of paravaginal support structure on the axial plane in middle vagina and measured the anteroposterior and lateral horizontal distances between bilateral paravaginal support structure and ureter.The consistency between two sonographers were analyzed by intraclass correlation coefficient (ICC).Results In three-dimensional Hyaline imaging sonogram,paravaginal support structure was appeared as typically tenting-like shaped.The anteroposterior distances between paravaginal support structure and center of ureter were listed as followed:left (-0.31 ± 1.29) mm,right (0.47 ± O.99) mm.While the lateral horizontal distances were left (12.67 ± 6.70) mm,right (13.01 ± 5.75) mm.There were no statistical differences between bilateral both anteroposterior and lateral horizontal distances.The consistency between two sonographers for distinguishing paravaginal support structure on the middle-vaginal plane and measuring distances between paravaginal support structure and center of ureter was remarkably high (ICC is 0.87 and 0.82).Conclusions Hyaline imaging technology of three-dimensional pelvic floor sonography could be used to observe paravaginal support structure in women.The normal paravaginal support structure is typically showed as bilateral symmetrical tenting-like structure,which is on the same level as the center of ureter.It provides normal anatomic radiological evidence and helps study defect of paravaginal support structure caused by pregnancy or delivery.

Objective: To investigate the effect of local autologous dermal fibroblasts transplantation on hypertrophic scar formation and wound healing quality in early scar formation. To explore the feasibility of fibroblasts for prevention and treatment of hypertrophic scar. Methods: Dermal fibroblasts were isolated from the dorsal skin tissue of New Zealand white rabbits by mechanical method combined with enzyme digestion. Passage 3 cells were induced to differentiate into osteoblasts and adipocytes. The complete epithelialization time and hypertrophic scar formation after full-thickness skin defect were confirmed by pre-experiment study. In the experiment, 6 rabbits were used, left ear as experimental group and right ear as control group. In the experimental group, the passage 4 dermal fibroblasts labeled with 5-bromodeoxyuridine (5-BrdU) were injected subcutaneously around the wound and hypertrophic scar on 20 d (day 2 after epithelialization) and 30 d (most obvious scar hyperplasia) after surgery. As a control group, physiological saline was injected following the same protocol. On 37 days after surgery, the hypertrophic scar tissue were harvested and assessed by gross view and histological examination. The transplanted cells were detected by immunofluorescence staining, transforming growth factor beta 1 (TGF-β1) and decorin(DCN) mRNA expression were assayed by real-time fluorescence polymerase chain reaction (RT-PCR), and the protein expression of TGF-β1、DCN、Collagen type Ⅰ and type Ⅲ were tested by enzyme linked immunosorbent assay(ELISA). Results: Compared with the control group, the scar in the experimental group was flatter and softer, the color was slightly lighter, and the volume was reduced. The histological results showed that compared with the control group, the number of fibroblasts and inflammatory cells in the superficial dermis was reduced, the proliferation of connective tissue and collagen deposition were reduced, and the basal cells and collagen fibers were arranged in order in the experimental group. The results of RT-PCR showed that TGF-β1 mRNA expression level in the hypertrophic scar tissue reduced significantly and DCN increased significantly in the experimental group, compared with the control group (P<0.01). ELISA results showed that TGF-β1, type Ⅰ and Ⅲ collagen contents in hypertrophic scar tissue were significantly lower than that in the control group, while the DCN expression was significantly increased (P<0.01). Conclusions The rabbit dorsal dermal fibroblasts significantly inhibited the hypertrophic scar in rabbit ears. The mechanism may be related to the up-regulation of DCN expression and down-regulation of TGF-β1 expression, reduction of type Ⅰ and Ⅲ collagen synthesis and extracellular matrix deposition, in the hypertrophic scar tissue.

【Objective】 To share the technical key points and experience of transvesical robot-assisted radical prostatectomy (TvRARP). 【Methods】 The clinical data of 13 patients with prostate cancer (PCa) receiving TvRARP during Nov.2021 and May 2022 were collected. The operation time, estimated blood loss, blood transfusion rate, catheter removal time, postoperative length of hospital stay, immediate urinary continence rate, postoperative IIEF-5 score and perioperative complications were evaluated. 【Results】 The operation time was (142±39) min, estimated intraoperative blood loss was (76±40) mL, and no transfusion was needed. The median postoperative IIEF-5 score was 16 (12-22), hospital stay 3 (2-5)days, and catheter removal time 7(5-14)days. Of all 13 patients, 12(92.3%) achieved immediate urinary continence at the removal of catheter. There were no postoperative complications of Clavien Ⅲ and above. Clavien Ⅰ-Ⅱ complications were observed in 4 patients (30.8%). 【Conclusion】 TvRARP is feasible and safe for selected patients with clinically localized PCa, which can ensure promising postoperative urinary continence and preserve erectile functional.