Objective To study the middle ear mucosa of guinea pigs with tympanosclerosis by electron microscope and try to obtain some insights into the feature and pathogenesis of tympanosclerosis.Methods Eight healthy variegated guinea pigs were devided into 2 groups.Six(8 ears) guinea pigs were subjected to inoculation of 1×10~8/L of staphylococcus aureus solution 100 μl into the middle ear cavities under the microscope.All the guinea pigs were observed for more than 6 months with no farther treatment.For electron-microscopic studies,the mucosa tissues were taken from the tympanic mucosa in 6 guinea pigs (8 ears) with tympanosclerosis from various sites,while the middle ear mucosa of two healthy guinea pigs (4 ears) were taken as a control.Results Uhrastructural examination of the normal middle ear mucosa revealed a few collagen fibers,normal morphous of fibrocyte,rough endoplasmic reticulum and mitochondria,and there was no lysosome.However,the tympanosclerosis specimens showed that irregular deformation,elongation,and degeneration of fibrocytes and oval nucleus were darkly stained,lots of mitochondria and lysosomes gathered into the cytoplasm around the nuclear and cystic expansion of the endoplasmic reticulum.In the submucosa extracellular matrix,there were a large number of collagen fibers containing lots of amorphous high-density electron-rich body.Conclusion Electron-microscopic studies of the middle ear mucosa of guinea pigs with tympanosclerosis revealed evident proliferation of collagen fibers,and calcifications were seen in the structures such as extracellular matrix vesicle,lysosomes,myelin structures within lipid granules,which mainly in extracellular matrix vesicles.

Objective: To evaluate the impact of anemia on prognosis of elder patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI).
Methods: A total of 908 consecutive ACS patients elder than 60 years of age with PCI in our hospital from 2010-06 to 2012-06 were studied. According to WHO deifnition of anemia (HB<12.0 g/dL in female and HB<13.0 g/dL in male), the patients were classiifed as Anemia group, n=283 and Non-anemia group, n=625. The patients were followed-up for 1 year. The basic clinical characteristics, incidences of mortality and major adverse cardiovascular and cerebravascular events (MACCE) were compared between 2 groups by cardiac death, myocardial re-infarction, worsening of cardiac function, target vessel revascularization, cerebral hemorrhage and cerebral infarction.
Results: There were 31%of patients suffering from anemia. Anemia group had more patients with the elder age, female gender, diabetes, hypertension, chronic kidney disease, decreased LVEF, more patients with 3 vessel-disease, and higher mortality at 1 year after PCI, higher rate of MACCE than those in Non-anemia group, all P<0.05. Multiple regression analysis indicated that anemia is the independent predictor for mortality in elder ACS patients at 1 year after PCI, P<0.05.
Conclusion: Anemia may increase the incidences of mortality and MACCE in elder ACS patients after PCI for a long-term.

Objective To understand AIDS related knowledge,and to prevent and national control strategy among leaders from grass roots, and provide evidences for improving strategic support for HIV/AIDS prevention and control. Methods A total of 575 leaders from grass roots of Taishan district were chosen with cluster sampling. Health education methods included: giving special subject lecture about AIDS and handing out the beoklets,a questionnaire were conducted after Health education. Results A total of 401 leaders were investigated. The overall rate of correct answer about AIDS related knowledge was 86.30%, 83.79% of them know the national HIV/AIDS prevention and controlling policies "Four free and one care". Conclusion There are high level about AIDS related knowledge and the national HIV/AIDS prevention and controlling policies among leaders from grass roots of Taishan district after health education. AIDS health education needs to be strengthened so that prevention and control strategy could be implemented in an active manner.

Objective To identify the risk factors of major bleeding in patients undergoing off-pump coronary artery by-pass grafting( OPCAB) .Methods Data on coronary artery disease patients who underwent off-pump CABG between December 2009 and December 2014 were reviewed.Baseline characteristics were compared between patients with clopidogrel discontinua-tion ≥5 days and <5 days.Univariate and multivariate logistic regression analyses were performed to investigate the risk fac-tors of perioperative major bleeding.Major bleeding was defined as the Universal Definition of Perioperative Bleeding(UDPB) class 3 -4.Results A total of 3988 patients who underwent OPCAB were included in this study.Major bleeding rate was 9.23%(n=368).Multivariable regression analysis showed that female sex(OR=1.99, 95%CI:1.57-2.52), age(OR=1. 02, 95%CI:1.00-1.03), lower BMI(BMI≤25 kg/m2)(OR=1.40,95%CI:1.12-1.75), decreased GRF(GFR<60 ml/min)(OR=1.43,95%CI:1.01-2.02), decreased preoperative Hct(Hct <0.40)(OR =1.57, 95%CI: 1.23-1.99) and clopidogrel discontinuation <5 days(OR=1.97, 95%CI:1.58-2.44) conferred a higher risk of perioperative major bleeding during OPCABG.Conclusion Female, advanced age, lower BMI, decreased GRF, decreased preoperative Hct and clopi-dogrel discontinuation<5 days are independent risk factors of perioperatice major bleeding in patients undergoing OPCAB .Pre-dicting risk of major bleeding can help sugeons to optimize perioperative management .

【Objective】 To investigate the gene frequency and polymorphism of RBC blood group systems in RhD negtive population in Hunan, so as to lay a foundation for clinical blood transfusion and construction of multiple rare blood group database. 【Methods】 Blood samples were taken from 300 RhD negative blood donors, confirmed by serological method, from June 2019 to June 2020,. RHD genotyping was performed by SSP-PCR. For blood donors with typing results as RhD negative plus RHD gene deletion, antigens genotyping of MNS, Duffy, Kell, Domrock, Diego, Kidd, Sciawnna, Colton, Lutheran and Yt RBC blood group systems were performed by SSP-PCR and analyzed by the chi square test of SPSS 20 statistical software. 【Results】 RHD gene deletions accounted for 58.67% (176 / 300) of serological D negative blood donors. The gene frequencies were as follows: MNS: GYPB^*S=0.045 5(8/176), GYPB^*s=0.954 5(168/176), GYP^*Dane=0.039 8(7/176); Duffy: FY^*A =0.965 6(170/176), FY^*B=0.034 1(6/176); Dombrock: DO^*A=0.082 4(14.5/176), DO^*B=0.917 6(161.5/176); Diego: DI^*A=0.025 6(4.5/176), DI^*B =0.974 4(171.5/176); Kidd: JK^*A=0.485 8(85.5/176), JK^*B=0.514 2(90.5/176); Kell: KP^*A=0.005 7(1/176), KP^*B=0.994 3(175/176); Lutheran: LU^*A=0.005 7(1/176), LU^*B=0.994 3(175/176); Yt: YT^*A=0.002 8(0.5/176), YT^*B=0.997 2(175.5/176). The genotypes of Kell(K+ /k+ ), Scianna and Colton blood groups were KEL^*02 /KEL^*02, SC^*01 /SC^*01 and CO^*A /CO^*B, respectively. The expected frequencies of the combination of type O, RhD negative and other blood group systems were between 1/100 000 to 1/10 000. 【Conclusion】 Among RhD negative blood donors in Hunan, the gene profiles of MNS, Duffy, Domrock, Diego, Kidd, Kell and Lutheran blood group system were polymorphic, and Kell (K+ /k+ ), Colton and Scianna were homozygous. The data of other RBC blood group systems from RhD negative blood donors is of great significance to establish local database of rare blood groups.

Objective:To explore the role and molecular mechanism of DNAJB6 in liver regeneration during partial liver transplantation(PLT).Methods:Dark agouti(DA, donor)and Lewis(recipient)rats were prepared for liver regeneration model of PLT.Rats were divided into before perfusion, after split liver perfusion, after portal vein opening, before abdominal closure and Day 3/7 after surgery groups(n=6 each)for timepoints of PLT.C57 mice were performed for residual liver regeneration model of partial hepatectomy and divided into control, Day 1/2/3/4/5 groups(n=6 each)for timepoints of hepatectomy.Gene Expression Omnibus liver regeneration data were utilized for locating DNAJB6 in liver regeneration.DNAJB6 low-expression human hepatocytes were constructed by DNAJB6-Si transfection.The relationship between DNAJB6 and liver regeneration was examined by Western blot detection of cell proliferation markers PCNA and CCK8 cell proliferation experiments.And the possible molecular mechanism of DNAJB6 regulating liver regeneration in PLT was studied by Western blot detection of nuclear protein and protein in cell proliferation signal pathway.Results:The result of residual liver regeneration of partial hepatectomy showed that DNAJ family genes were differentially expressed on regenerated liver gene chip and DNAJB6 was lowly expressed on regenerated liver gene chip.Meanwhile, DNAJB6 was lowly expressed in regenerated liver tissues of PLT and partial liver resection.After silencing DNAJB6 by transfecting DNAJB6-Si, the cellular expression level of PCNA and proliferation rate increased.However, nuclear extraction failed to detect the nuclear/plasma changes of β-catenin and the level of Wnt4 protein had no obvious change.Although the activation levels of p38 and JNK2 downstream of Ras/MAPK showed no change, there was a higher activation level of ERK.Conclusions:In regenerating liver tissue, hepatocytes may suppress the Ras/MEK/ERK signaling pathway by lowering the expression level of DNAJB6 to promote liver regeneration.

【Objective】 To investigate the effect of serological methods for eliminating the interference of warm autoantibodies with the compatibility test before blood transfusion. 【Methods】 The blood samples (whole blood and serum, 3 mL/each) of 10 cases of warm autoantibodies interfering with antibody screening and identification were collected. Autogenous or allogeneic red blood cells(RBCs) were treated with microthermal(45 ℃), chloroquine, or ZZAP (dithiothreitol and papain) reagents, and then were used to absorb the autoantibodies in patients′ plasma. The plasma after absorption and RBC elution were used for antibody identification by anti-human globulin method or Polybrene method to determine the specificity of the autoantibody/alloantibody. Blood transfusion with ABO/Rh homotypic RBCs without corresponding antigens was performed in patients with alloantibodies or specific autoantibodies, and the efficacy of blood transfusion was evaluated. 【Results】 The interferenc of warm autoantibodies with antibody screening and identification due to primary or secondary autoimmune diseases were eliminated after absorption, and IgG isospecific antibodies (anti-E, anti-Jk^a, anti-Wr^a) in 3 cases and specific autoantibodies (anti-Ce) in 1 case were yielded. 6 of the 10 patients received blood transfusion, and 4 with specific antibodies avoided exposure to corresponding antigens. After transfusion of 2U suspended RBCs, the increase of hemoglobin at 24h in all 6 patients was greater than 10 g/L, and no hemolytic transfusion reaction occurred. Anemia symptoms were improved after transfusion. 【Conclusion】 Appropriate elution methods and autologous/allogeneic absorption methods can eliminate the interference of warm autoantibodies with the identification of alloantibodies, therefore can accurately identify the types and properties of antibodies, thus providing targeted and effective blood transfusion.

Objective: A retrospective analysis of the predictive value of acoustic radiation force impulse (ARFI) elastography for esophageal varices in post-hepatitis B cirrhosis patients. Methods: 124 patients with post-hepatitis B cirrhosis who were admitted to Tianjin Second People’s Hospital from August 2016 to August 2017 were selected. According to the shape of esophageal varices under gastroscopy and the risk of bleeding, patients were divided into 4 groups, none, mild, moderate and severe. In ARFI mode, the VTQ function was used to detect the VTQ values of the liver and spleen. The receiver operating characteristic curve and area under the curve (AUC) were used to evaluate the diagnosis of esophageal varices by VTQ values of the liver and spleen. Analysis of variance was performed on the data between the groups, and χ ² test was performed for categorical data. Results: The difference in liver VTQ values between groups were statistically significant (F = 12.623, P < 0.01). There was a statistically significant difference in VTQ values between spleens (F = 9.022, P < 0.01). The liver VTQ predicts that the AUC value of mild esophageal varices in patients with cirrhosis was 0.701 (0.575-0.827); moderate varices was 0.802 (0.701-0.902); severe varices was 0.885 (0.784-0.986). The best cutoff value was 2.235, the specificity was 97.37%, the negative predictive value was 88.10%, and the accuracy was 90.16%. The VTQ value of spleen predicts the AUC value of mild esophageal varices in patients with liver cirrhosis was 0.688 (0.539-0.798); moderate varices were 0.762 (0.651-0.873); severe varices were 0.800 (0.671-0.928). The best cutoff value was 2.885, the specificity was 84.21%, and the negative predictive value was 82.05%. Conclusion The application of ARFI elastography in the determination of VTQ values of liver and spleen has certain predictive value for esophageal varices and it might be useful for primary screening of esophageal varices in post-hepatitis B cirrhosis patients.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.