Objective To investigate the associations between the polymorphisms in CD40‐1C/T polymorphism(rs1883832) and Graves′disease by Meta‐analysis .Methods We searched Pubmed ,CBM ,VIP ,CNKI ,Cochrane library and Wanfang ,covering and selecting literatures according to criterions .Statistical analysis was performed by using Revman5 .2 and Stata12 .0 .Results A total of 18 eligible literatures were included(5 198 cases and 4 417 controls) ,The pooling results suggested that significant differ‐ence in allele C/T frequency and genotype frequency were observed between patients with and control subjects (P<0 .05);the indi‐viduals of genotype CC and(or) CT have significantly increased Graves′disease risk(CC vs .TT :OR=1 .60 ,95% CI=1 .28-2 .00 , P<0 .01;CC vs .CT :OR=1 .25 ,95% CI=1 .14 -1 .37 ,P<0 .01 ;CC vs .CT+ TT :OR=1 .34 ,95% CI=1 .17 -1 .52 ,P<0 .01 ;CC+CT vs .TT :OR= 1 .36 ,95% CI= 1 .13 -1 .64 ,P< 0 .01) .From subgroup analysis ,we identified that the research subjects difference showed between thyroid anti‐body(Ab ± ) and thyroid anti‐body (Ab -) in control group ,which might be the cause of heterogeneity ,but the pooling results in sensitivity analysis were stable and no significant publication bias were found .No significant difference in allele and genotype frequency of CD40 SNP were observed between Graves′disease with ophthalmopathy group and Graves′disease without ophthalmopathy group ,Graves′disease with family history group and Graves′disease without family histo‐ry group(all P>0 .05) .Conclusion This Meta analysis indicated that the polymorphisms in the CD40 gene(rs1883832) was related with Graves′disease ,but had nothing to do with family history and Graves′disease with ophthalmopathy .

Objective: To analyze the efficacy of recombinant activated factor Ⅶ a (rF Ⅶ a) on hematonosis with moderate or severe bleeding signs. Methods: Of total 16 cases with rF Ⅶ a treatment from May 2013 to May 2016, 8 cases received allogeneic hematopoietic stem cells transplantation (allo-HSCT) and the other were non-transplantation patients. In two groups, there was no significant difference on rF Ⅶ a usage and dosage. 15 patients with acute graft-versus-host disease (aGVHD) after allo-HSCT were control group (without rF Ⅶ a) . Results: ①The total response rate was 75.0% (6/8) in non-transplantation group and 37.5% (3/8) in transplantation group, respectively. Median interval for hemorrhage stop was 38.5 hours in non-transplantation group and 63.0 hours in transplantation group. The median overall survival (OS) was 201.0 and 29.0 days for non-transplantation group and transplantation group, respectively, and the OS rate was 50.0% (4/8) and 25.0% (2/8) , respectively. The bleeding-related mortality rate was 50.0% (2/4) and 83.3% (5/6) , respectively. ②Of the 16 cases, 9 showed response to rF Ⅶ a treatment and the other 7 cases’bleeding signs did not alleviate. The median OS was 268.0 in 9 cases with response and 24.0 days in 7 cases without response, respectively. ③In patients with intestinal aGVHD complicated with intestinal hemorrhage, the median OS of observation group (n=6) and control group (n=15) were 25.5 days and 20.0 days, respectively. Conclusion Patients with hematological diseases, especially patients after allo-HSCT, had high bleeding-related mortality, and rFⅦa therapy had a obvious hemostatic efficacy. The survival rate of patients with response was higher than that of cases without response. The causes of poor hemostasis efficacy of rF Ⅶ a therapy were associated with unsatisfactory control of complications in patients with intestinal bleeding after allo-HSCT.

Research integrity is the foundation for ensuring the sound and orderly development of scientific and technological innovation. As the main battlefield of clinical medical research, hospitals should effectively fulfill their main responsibilities and do a good job in research integrity management. The China Hospital Research Integrity Alliance, consisting of the first batch of 43 hospitals, was established in November 2021. With the aim of " complementary advantages, resource sharing, and collaborative development", the alliance has carried out construction practices from seven aspects: construction mode, cultural system construction, organizational management, institutional construction, publicity and education, early warning and supervision, and technological empowerment. It has achieved the overall improvement of the research integrity construction ability of member units of the alliance, organic linkage between government and medical institutions, and efficient combination of internal and external resources, which can provide reference for the research integrity construction of medical institutions in China.