Objective To investigate the clinical effects of vitrectomy combined with cataract surgery in the treatment of proliferative diabetic retinopathy (PDR V-VI stage).Methods A total of 80 patients with proliferative diabetic retinopathy from January 2012 to January 2014 were divided into the single group and the combined group according to the surgical method.Patients of the single group were treated by vitrectomy while patients of the combined group were treated by vitrectomy combined with cataract surgery.The incidence of retinal reattachment,postoperative vision and surgical complications between the two groups were compared.Results Compared with the single group,the incidence of retinal reattachment was higher in combined group (P ＜ 0.05).The postoperative vision improvement was better than that in single group,the difference was significant (P ＜ 0.05).And the surgical complications in combined group was less than that in single group,the difference was significant (P ＜ 0.05).Conclusion Vitrectomy combined with cataract surgery in the treatment of proliferative diabetic retinopathy has a better clinical effect which is safe and reliable,and it can improve the rate of retinal reattachment and reduce surgical complications.

Objective: To reveal the molecular epidemiologic characteristics of glucose-6-phosphate dehydrogenase (G6PD) gene and to evaluate based on the genetic analysis the newborn screening program performance and enzymatic diagnosis of G6PD deficiency in Guangzhou. Methods: G6PD enzyme activities were measured by quantitative fluorescence assay in dry blood spots of 16 319 newborns(8 725 males, 7 594 females) 3-7 days after birth in Guangzhou Newborn Center. They were born in Guangzhou form Oct. 1 to 20, 2016. The cutoff value of G6PD was less than 2.6 U/g Hb in dry blood spots. G6PD deficiency was diagnosed when G6PD<1 700 U/L or G6PD/6PGD<1 in red blood cells. Genetic analysis of G6PD gene was performed on the dry blood spot samples of 823 newborns (including positive 346, negative 477)with various levels of G6PD enzyme activities through fluorescence PCR melting curve analysis(FMCA) to detect 15 kinds of mutations reported to be common among Chinese.G6PD gene Sanger sequency was performed in seven highly suspicious patients with negative results by FMCA. Results: (1) Using the cutoff value of G6PD< 2.6 U/g Hb , a total of 687(4.2%) newborns showed positive screening results, including 560 (6.4%) males and 127(1.7%) females. (2) Among the newborns with positive screening results, 214 males and 122 females were randomly chosen for G6PD gene analysis. The results showed that 197 (92.1%) males were hemizygote and 108(88.6%) females were mutation carriers with one to four alleles. Among the newborns with negative screening results, 41 males with G6PD 2.6-2.8 U/g Hb and 436 females with G6PD 2.6-4.5 U/g Hb were chosen for genetic analysis.Mutations were detected in 5(12.2%)boys, and 226(51.8%) girls were carriers.G6PD gene Sanger sequency of seven highly suspicious patients showed that c.406C>T, c.551C>T, c.835A>T hemizygote were found in 3 male's samples, respectively. (3) The estimated prevalence of harboring mutation was 6.0% in males and 13.5% in females according to rates of mutation in samples with various levels of G6PD enzyme activities. Six common mutations were c.1388G>A、c.1376G>T, c.95A> G, c.871G>A, c.1024C>T, c.392G>T, accounting for 95.5% of detected alleles .(4) based on results of G6PD gene analysis, the newborn scereening of G6PD deficiency with cutoff value G6PD<2.6 U/g Hb yielded a positive predict value(PPV) of 93.5%, a false-positive rate of 0.5%, and a sensitivity of 99.0% for males. A PPV of 88.5%, a false-positive rate of 0.2% . The prevalence of severe type G6PD deficiency in females was about 1.5%. Compared with to genetic analysis, the sensitivity and PPV of G6PD activity assay in red blood cells were 95.5%, 97.2%, respectively. Conclusions The prevalence of G6PD deficiency in males was 6.0% in Guangzhou. Six mutations c.1388G>A, c.1376G>T, c.95A>G, c.871G>A, c.1024C>T, c.392G>T accounted for 95.5%. The cutoff value of G6PD<2.6 U/g Hb innewborn screening program and the criteria of biochemical diagnosis could accurately identify G6PD deficiency . Combined with biochemical and molecular analysis will improve the accuracy of diagnosis of G6PD deficiency and detect more heterozygous females.

Objective To analyze the pathological types of colorectal flat polyps after endoscopic mucosal resection (EMR),and explore the risk factors of high-risk fiat adenomatous polyps.Methods The retrospective case-control study was conducted.The clinicopathological data of 245 patients with colorectal fiat polyps who were admitted to the People's Hospital of Xinjiang Uygur Autonomous Region between February 2010 and April 2016 were collected.All the patients underwent EMR,and incision tissues were diagnosed by pathological examination.Observation indicators:(1) clinical features and results of pathological examination of flat polyps;(2) risk factors analysis of high-risk flat adenomatous polyps.Measurement data with normal distribution were represented as (x)±s.The univariate analysis and multivariate analysis were respectively done using the chi-square test and Logistic regression model.Results (1) Clinical features and results of pathological examination of flat polyps:flat polyps located in the cecum,ascending colon,transverse colon,descending colon,sigmoid colon and rectum were detected in 12,26,55,35,73 and 44 patients,respectively.Of 245 patients,153 were combined with multiple polyps.The diameter of fiat polyps was (0.9±0.8)cm.Results of pathological examination of 245 patients:108,40,18,25,14,3,12,12 and 13 patients were diagnosed with as tubular adenomas with low-grade intraepithelial neoplasias (LGINs),tubulovillous adenomas with LGINs,tubulovillous adenomas with high-grade intraepithelial neoplasias (HGINs),tubular adenomas with HGINs,adenocarcinomas (T1 stage),neuroendocrine tumors,serrated polyps,mucosal chronic inflammation and hyperplastic polyps,respectively.(2) Risk factors analysis of high-risk fiat adenomatous polyps:the results of univariate analysis showed that age,number and diameter of polyps were the related factors related factors affecting the occurrence of high-risk fiat adenomatous polyps (x2 =8.920,5.455,36.901,P＜0.05).The results of multivariate analysis showed that age ＞ 60 years old and diameter of polyps ＞ 1 cm were the independent risk factors affecting occurrence of high-risk fiat adenomatous polyps (Odds ratio =2.681,8.162,95％ confidence interval:1.481-4.856,3.786-17.597,P＜0.05).Conclusion The main colorectal fiat polyps are adenomatus polyps,and age ＞ 60 years old and diameter of polyps ＞1 cm are the independent risk factors affecting occurrence of high-risk fiat adenomatous polyps.

Objective To systematically evaluate the real experience of frailty in elderly patients to provide a reference for formulating targeted intervention strategies.Methods The Cochrane Library,PubMed,Embase,Web of Science,CINAHL,Proquest,CNKI,Wanfang,VIP,and CBM were searched by computer for qualitative studies on the experience of frailty in elderly patients,and the search period was from the establishment of the databases to February 25,2023.Results A total of 14 papers were included,and 56 primary research findings were extracted and grouped into 12 categories,resulting in 4 integrated findings:the negative impacts in daily lives of frailty in elderly patients;the negative impact on the psychological state of frailty in elderly patients;elderly patients with frailty positively deal with the multidimensional effects of frailty;the unmet needs of elderly patients with frailty.Conclusion Healthcare professionals should pay attention to the multidimensional impact of frailty,focus on the real needs of elderly patients with frailty,explore forms of patient participation in frailty management,and continuously optimize the frailty management program,and improve the accessibility and continuity of healthcare services.

【Objective】 To learn the production efficient of platelet components among prefecture-level blood stations in China, to provide supporting data for those blood stations to optimize the production mode of platelet components and continuously improve production efficiency and supply capacity. 【Methods】 The data from 2017 to 2020 was obtained from 24 prefecture-level blood stations who were the members of the practice comparison network for blood institutes in China. The collection units of apheresis platelets, the number of dual-collections of apheresis platelets and plasma, the average apheresis units of one platelet apheresis procedure, the discarded rate of apheresis platelets, the amount of expired apheresis platelets and the amount of apheresis platelets issued were collected. For concentrated platelets, the prepared amount of platelet concentrates and the amount of expired platelet concentrates were collected; both the quantity of qualified and issued concentrated platelets were submitted for statistical analysis.The total output and efficiency of platelet components were calculated based on the collected data. 【Results】 The average annual growth rate of apheresis platelets collection in 24 prefecture-level blood stations was 12.23%, accounting for 99.80% of the total platelet output; the average collection unit of one platelets apheresis procedure was 1.75; from 2019 to 2020, only 5 blood stations performed dual-collection of platelet and plasma during one apheresis procedure; the discarded rate of apheresis platelets was 0.28%, of which 0.007% was due to expiration. A total of 1 621.2 therapeutic units of concentrated platelets were prepared, and 13.03% of them was discarded due to the expiration. The production efficiency of platelet components was 97.56%, of which the production efficiency of apheresis platelets was 97.61% and the production efficiency of concentrated platelets was 74.43%. 【Conclusion】 There are large regional differences in the supply capacity of platelet components in prefecture-level blood stations. Apheresis platelets are the main resource of platelet components product, and the collection capacity is increasing over the years with the characteristics of high production efficiency and low expiration scrapping rate. However, the preparation of concentrated platelets are still limited with relatively low production and high expiration discarded rate.

【Objective】 To analyze the basic characteristics of whole blood donors from blood stations before and after the outbreak of COVID-19. 【Methods】 After excluding invalid data, data related to the basic characteristics of whole blood donors collected from 26 blood stations in China during 2018 to 2021 were statistically analyzed, including the trend of total whole blood donors, the number of repeated blood donors, the frequency of blood donation, the average age of donors and the recruitment of first-time blood donors. 【Results】 Affected by the epidemic, 8 out of 14 indicators were with large variations, accounting for 57%. The overall growth rate of total whole blood donors during the epidemic was higher than before the epidemic (P<0.05).The number of repeated blood donors has shown an increased trend, with a higher number during the epidemic than before (P<0.05). The frequency of blood donation was lower during the epidemic than before(P<0.05).Average ages of blood donors and female blood donors fluctuated widely during the epidemic, both higher than those before the epidemic(P<0.05).The donation rate of first-time blood donors <25 years old and ≥25 years old varied widely and irregularly during the epidemic (both P<0.05). The percentage of first-time blood donors fluctuated irregularly during the epidemic, with overall percentage lower than that before the epidemic(P<0.05). 【Conclusion】 Whole blood donors from 26 blood stations increased after the outbreak of COVID-19, and some indicators in certain areas showed significant fluctuations during the epidemic.