Objective To analyse the effect of specimen storage time on platelet count in apheresis Donors,in order to choose the appropriate testing time.Methods We choose fifty healthy Unpaid Blood Donors of Platelets to test platelet count in 0,0.5,1,3,6h respectively by the blood counting instrument.Results At room temperature,the count of platelets from blood samples is relatively lower at 0 hour and the difference is significant (P ＜ 0.05).After 0.5-6 hours,the count of platelets become stabilized and not has significantly different(P＞0.05).Conclusion The count of platelets of blood samples is lower at 0 hour than 0.5-6 hours,this work suggest that the count of platelets of blood samples should be done at 0.5-6 h in order to protect platelets quality.

AIM: To prepare a nanodrug MMC-ATS-@PLGA using polylactic acid hydroxyacetic acid copolymer(PLGA)as a carrier and mitomycin C(MMC)loaded on PLGA, and to analyse the biological safety and treatment effect of this nanodrug on inhibiting the proliferation of filtering bleb scarring after glaucoma surgery in vivo.METHODS: The thin-film dispersion hydration ultrasonic method was used to prepare the MMC-ATS-@PLGA, and its physical and chemical properties were detected. The effect of MMC-ATS@PLGA on rabbit corneas was analysed through corneal fluorescence staining and HE staining, and tear film rupture time(BUT), Schirmer test and intraocular pressure data were collected to analyse ocular surface biosafety. A slit lamp was used to observe and calculate the filtration bubble size, and the tissue morphological changes were analysed by conjunctival HE staining. In addition, immunohistochemistry and Elisa were used to compare the anti-inflammatory effects of Flumiolone Eye Drops(FML), MMC, and MMC-ATS-@PLGA nanoparticles on inhibiting the formation of filtering bleb scarring after glaucoma surgery from multiple perspectives via comparative proteomic analysis.RESULTS: The average particle size and zeta potential of MMC-ATS-@PLGA were 128.78±2.54 nm and 36.49±4.25 mV, respectively, with an encapsulation efficiency and a drug loading rate of(78.49±2.75)% and(30.86±1.84)%, respectively. At 33°C(the ocular surface temperature), the cumulative release rate of the MMC-ATS-@PLGA nanoparticles reached(76.58±2.68)% after 600 min. Moreover, corneal fluorescence staining, HE, BUT, Schirmer, and intraocular pressure results showed that MMC-ATS-@PLGA had good biocompatibility with the ocular surface of rabbits. At 3 wk after surgery, the area of filtering blebs in the MMC-ATS-@PLGA group was significantly larger than that in the FML group and MMC group, and the filtering blebs in the control group had basically disappeared. Pathological tissue analysis of the conjunctiva in the filtering blebs area of the eyes of the rabbits revealed that compared with that in the normal group, the morphology of the collagen fibres in the MMC-ATS-@PLGA group was relatively regular, the fibres were arranged neatly, and the tissue morphology was similar to that of the normal group. Immunohistochemistry and Elisa confirmed that compared with those in the normal group, the expression levels of α-SMA, CTGF, and type Ⅲ collagen fibre antibodies were significantly increased in the control group. After FML, MMC, or MMC-ATS-@PLGA treatment for 3 wk, the expression of inflammatory factors gradually decreased. Among the groups, the MMC-ATS-@PLGA group showed the most significant decrease(P<0.05).CONCLUSION: This study successfully synthesized a nanomedicine(MMC-ATS-@PLGA)that inhibits scar proliferation after glaucoma filtration surgery. The drug had stable physicochemical properties, good biocompatibility, and better anti-inflammatory effects by inhibiting the expression of α-SMA, CTGF, and type Ⅲ collagen fibres, which can prevent the formation of scarring in the filtering blebs area, thereby improving the success rate of glaucoma filtering surgery.

Objective To investigate the status of blood donation in Shanghai streets,understanding the motivation of the donors for blood donation and how many times they had donate their blood.Here,we intend to improve work efficiency in order to better serve the blood donators and to provide a theoretical basis.Methods To gain insight into the understanding and attitude of citizens for blood donation,we analyzed the volunteer blood donors in 387 vehicles and 436 outdoor pre mobilization object by six months,questionnaire in blood collection vehicle or at scene etc.Results The survey specifically reflected the understanding,attitude and motivation of citizens and foreign workers for blood donation in Shanghai.Conclusion There existed many problems such as wrong recognition,diversified motivation among many citizens for blood donation.More publicity and education for the knowledge of blood donation are needed and it plays significant and longlasting role for blood donation.

Objective: To evaluate the outcome of modified rotary-propulsion facial artery perforator flaps for infraorbital defects repair, after facial tumorresection. Methods: Between January 2014 and June 2017, 21 patients with midface tumor were treated, including basal cell carcinoma (n=17) and squamous cell carcinoma (n=4). The size of the tumor ranged from 0.8 cm × 2.0 cm to 2.0 cm× 3.5 cm. The extended resection of the tumor tissue was performed, based on the tumor type. Intraoperative frozen specimen was used to make sure no tumor residual at margin or wound base. According to the location and size, anarterial perforator flap was designed to cover the defect.The donor site was closeddirectly. The flap size ranged from 1.5 cm × 3.0 cm to 3.0 cm × 5.0 cm. The length of flap pedicle was 1.0 cm to 2.5 cm. Results: All flaps completely survived, with satisfying blood flow.The incisions healed well. After 12 to 36 months follow-up, most scars in the donor site were hidden in nasal buccal sulcus and nasolabial folds. There was no lower eyelid ectropion, eyelid and eyeball separation, oral commissural and nasal distortion. The texture and color of the flap was similar to surrounding skin.The overall appearance is satisfactory. Conclusions The modified rotary-propulsion facial artery perforator flaps, to repair soft tissue defects in infraorbital area, is reasonable and useful. It is characterized by limited tissue damage indonor site, flexible rotation of flaps, and hidden incision scars. More importantly, it can reduce the occurrence of lower eyelid ectropion

Objective: To summarize the individual design of the perforator flap based on the descending branch of the lateral circumflex femoral artery and ecological protection of the flap. Methods: From June 2013 to June 2017, 33 cases of extremities wound defects were repaired with the descending branch perforator flap of the lateral circumflex femoral artery. According to the chracteristics of extremity wound and the anatomy of the descending branch perforator of the lateral circum flex artery, a medial incision of the flap according to the demarcation line was performed. Through meticulous dissection, two perforator branches were found and traced on the surface of facia lata. The size of the kiss flap was adjusted according to the perforator caliber. The chimeric muscular flap was incised according to muscular penetration point of the perforator and the course of lateral fermoral nerve with cautious protection of muscular branch of femoral nerve. During the incision, fascia lata, nerves and muscles on donor site were protected to reduce the damage to donor site. Meanwhile, ecological structure on donor site was reconstructed. Our series include 22 males, 11 females. The average age ranged from 13 to 71 years (mean: 47years). There were 21 cases of wounds on dorsum manus and wrists and 12 cases of wounds on the dorsum pedis and lower limbs. The wound dimension ranged from 7 cm×8 cm to 13 cm×24 cm. The flap dimension ranged from 6 cm×7 cm to 8 cm×15 cm.There were 22 cases of KISS flaps and 11 cases of chimeric flaps. Wounds on all donor sites were primarily sutured. Course of the disease ranged from 1 week to 2 months. Results: All flaps were harvested uneventfully and survived well. No vascular crisis occurred. Wounds on all donor sites were primarily sutured. Three to 24 (mean 18) months of follow-up was made on 28 cases. The color and texture of flaps was good. Appearance of the flaps was good. Protective sensation recovered. Only linear scar can be seen on donor sites. No muscular hernia and cinesipathy was noticed on donor sites. Conclusions The size of KISS flaps depends on the caliber of perforator branch estimated intraoperatively. Muscular part of the chimeric flaps was harvested according to the muscular entry points of perforators and the demand of recipient sites. The wound defects were reconstructed individually according to the peculiarity of the defects. Fascialate, nervus cutaneus and muscle was cautiously protected in the course of flap harvest. Ecological structure was reestablished after flap harvest to reduce complications.

Objective: To evaluate the clinical effect of the modified nasolabial flap with facial subcutaneous pedicle advanced flap in repairing the defects after midcheek tumor resection. Methods: From June 2012 to June 2017, 27 patients with facial tumors were treated, and according to the nature of the tumor, the tumor tissue was enlarged, frozen pathological examination was performed during the surgery. Once the edge and the base were reported to be negative, the nasolabial flap with facial subcutaneous pedicle advanced flap with a maximum 1 cm wider than the defect width was designed according to the position and size of the wound. The proximal border of the flap was designed at the cured edge of the circular wound. The curved bottom edge of the circular wound was the proximal end of the flap. The defects ranged from 2.0 cm×3.0 cm to 2.5 cm×4.0 cm. The donor site was directly sutured after subcutaneously loosening. Results: The operation was smooth, and the flaps were about 3.0 cm×6.0 cm to 3.5 cm×7.0 cm. The flaps were well transported after surgery, and there was no bruising at the tip. The suture was removed 1 week after surgery. After 6-36 months of follow-up, postoperative scar was not obvious, which were most hidden in the nasolabial folds. There was no ectropion and mouth deformity. The flaps were not swollen, and the color and texture were close to that of normal skin. The appearance was satisfactory. Sensation of skin were well recovered. Conclusions The modified nasolabial flap with facial subcutaneous pedicle advanced flap is suitable for repairing the facial defects with satisfactory skin sensation and good appearance.

OBJECTIVE To systematically evaluate the efficacy and safety of transcatheter arterial chemoembolization （TACE） combined with local ablation in the treatment of unresectable primary liver cancer （PLC）， and to provide evidence-based reference for rational clinical treatment. METHODS Retrieved from CNKI， Wanfang Data， VIP， PubMed， Embase， Cochrane Library， ClinicalTrials， Web of Science， Ovid and SinoMed， randomized controlled trial （RCT） about TACE combined with local ablation （trial group） versus TACE （control group） were collected. After screening the literature and extracting the data， the bias risk assessment tool recommended by the Cochrane System Evaluator Manual 5.1.0 was used to evaluate the quality of the included literature； Stata14.0 software was used for meta-analysis. RESULTS A total of 39 RCTs were included， including 2 294 patients， involving 6 interventions， i.e. TACE， TACE + radiofrequency ablation （RFA）， TACE + microwave ablation （MWA）， TACE + absolute ethanol injection （PEI）， TACE + cryoablation （CRA）， TACE + high-intensity ultrasound focused ablation （HIFU）， and 4 chemotherapeutic drugs， i.e. platinum， anthracycline， pyrimidine analogues， and polypeptides. The results of meta-analysis showed that in terms of objective remission rate， TACE+RFA， TACE+HIFU and TACE+MWA were higher； in terms of 1-year survival rate， TACE+PEI， TACE+HIFU and TACE+MWA were higher； in terms of 2-year survival rate， TACE+HIFU， TACE+MWA and TACE+PEI were higher； in terms of 3-year survival rate， TACE+HIFU， TACE+PEI and TACE+RFA were higher； in terms of security， TACE+MWA， TACE+RFA and TACE were 643295494@qq.com higher； there was no significant difference in the efficacy of 4 chemotherapeutic drugs in TACE+MWA （P＞0.05）. CONCLUSIONS For patients with unresectable PLC， TACE+ MWA has good efficacy and safety， which is the best combination； the 4 chemotherapeutic drugs in TACE+MWA are all effective， and suitable chemotherapeutic drugs can be selected individually.

Objective:To evaluate the clinical outcomes and complications of second sacral alar-iliac (S 2AI) technique utilized in adult patients with neuromuscular scoliosis, and to evaluate the impact on patients' quality of life. Methods:All of 11 patients (6 males and 5 females) applying S 2AI technique from January 2014 to December 2016 were retrospectively reviewed. The average age of the patients was 39.6±12.7 years. Among them, 8 cases were poliomyelitis, 2 cases were spinal muscular atrophy and 1 case was muscular dystrophy. All of 11 patients underwent posterior spinal fusion and utilized S 2AI screws for pelvic fixation. All patients were taken anteroposterior and lateral radiographs of the entire spine. Cobb's angle, spinal pelvic obliquity (SPO), regional kyphosis (RK), sagittal vertical axis (SVA) were recorded at pre-operation, post-operation and last follow-up. The Scoliosis Research Society (SRS)-22 questionnaires and Oswestry disability index (ODI) were utilized to evaluate the patient-reported outcomes. All complications were also recorded. Repeated measurement analysis of variance, t-test or non-parametric test was used to analyzed the data, respectively. Results:The average follow-up period was 62.4±10.8 months. The pre-operative Cobb angle was 98.0°±24.0°, and the post-operative Cobb angle was 60.7°±20.8°, of which difference was significant ( Z=3.015, P=0.003). The correction rate of Cobb angles was 57.2%±17.7%. 1-year after operation, the Cobb angle was 62.8°±23.6°, no loss of correction was found ( Z=0.294, P=0.797). And at last follow-up, the Cobb angle was 61.6°±21.7°, the correction maintained well ( Z=0.603, P=0.594). The pre-operative, post-operative, 1-year post-operative and last follow-up spinal pelvic obliquity were 37.0°±11.8°, 21.5°±11.6°, 23.2°±10.1° and 21.1°±8.6°. The significant improvement was obtained ( Z=2.934, P=0.003) and no loss of correction was found ( Z=0.690, P=0.519; Z=0.000, P=1.000). The pre-operative, post-operative, 1-year post-operative and last follow-up regional kyphosis were 46.8°±23.6°, 18.6°±10.6°, 18.9°±11.4° and 19.5°±9.8°. The significant improvement was obtained postoperatively ( Z=4.364, P<0.001) and remained stable at the last follow-up ( Z=0.074, P=0.945; Z=0.271, P=0.838). When compared the pre- and post-operative sagittal vertical axis, no significant difference was detected. In these patients, one patient had rod breakage and underwent revision, one patient suffered deep infection, and recovered by debridement surgery, one patient suffered from severe pain in the lower back and relieved with conservative treatment. Conclusion:The S 2AI technique utilized in patients with neuromuscular scoliosis could obtain satisfying clinical outcomes and provides safe, durable fixation with low rates of complications.

Objectives:To investigate the feasibility of second sacral alar-iliac (S 2AI) screw placement and trajectories index in patients with neuromuscular scoliosis with severe pelvic obliquity; and to explore the accuracy of S 2AI screw placement by O-arm three-dimensional (3D) CT navigation (Medtronic, Minneapolis, MN, USA). Methods:All of 28 patients with neuromuscular scoliosis who underwent posterior long fusion with S 2AI between January 2017 and August 2020 were reviewed, with an average age of 22.2 years old (ranged from 10 to 51 years), and the pelvic obliquity angle was 27.54±9.90° (ranged from 16.2° to 53.6°). Based on 3D CT reconstruction of these specimens, virtual S 2AI screw channels were identified and measured. Entry point was determined by 1 mm inferior and 1 mm lateral to the S 1 dorsal foramen, and virtual S 2AI screw trajectories with maximum length and width were explored by rotating 3D pelvis. The parameters of the determined channels were measured including caudal angulation on the sagittal plane (sagittal angle, SA), lateral angulation on the transverse plane (transverse angle, TA) and the maximal length of the channel (maximal length, ML). The accuracy of screw placement was evaluated by postoperative pelvic CT scan. Results:All of the virtual S 2AI screw trajectories can be reconstructed. The screw trajectory parameters were shown as follows: SA was 30.20°±21.94° and 50.94°±16.02° on the high and low sides of pelvis, respectively, and the difference was statistically significant ( t=3.990 , P<0.001). SA was 30.14°±21.93° on the anterior side of the pelvis and 51.00°±15.96° on the posterior side, respectively, with statistical significance ( t=4.027, P<0.001). TA was 43.67°±12.86° on the high side of pelvic tilt and 31.95°±13.80° on the low side, with statistical significance ( t=2.834, P=0.009). TA was 42.56°±12.52° on the anterior side of the pelvis and 33.05°±14.94° on the posterior side, respectively, and the differences were statistically significant ( t=2.192, P=0.037). ML was 97.12±12.44 mm and 92.28±11.04 mm on the high and low side of pelvis, and there was no significant difference ( t=0.963 , P=0.060). ML was 97.72±12.41 mm on the anterior sides of the pelvis and 91.68±10.57 mm on the posterior side, and the difference was statistically significant ( t=2.556 , P=0.017). SA tended to be smaller on the high side of pelvic tilt ( r=0.474, P<0.01) and TA tended to be higher on the anterior side of pelvis ( r=-0.419, P<0.01) . Only 2 screws (3.6%) showed screw breaches after surgery, with no clinically notable neurovascular or visceral complications. Conclusion:In patients of neuromuscular scoliosis with severe pelvic obliquity, the virtual S 2AI screw trajectory can be found in 3D CT reconstruction of the pelvis. But the parameters are very discrete at SA and TA. In these patients, the O-arm 3D CT navigation can be used to make sure the direction and length of the S 2AI screw, greatly improving the accuracy of screw placement and effectively descending the ratio of poor screw.

Objective:To explore the effect of high-flow airway humidification on aspiration and residues in cases of dysphagia after a tracheotomy.Methods:Seventeen persons with dysphagia after a tracheotomy were asked to swallow 5ml of a thick liquid when their tracheal cannula was either connected to a high-flow airway humidification system or blocked, or the cuff was empty or full. Endoscopic evaluation was then used to grade the residue and aspiration in the different conditions.Results:There were significant differences in the residuals grading and aspiration among the four conditions. The average penetration-aspiration scale grade was significantly lower when the subject was connected to high-flow airway humidification than in the other three conditions. The grade of residuals was also significantly lower.Conclusion:High-flow airway humidification can effectively improve the swallowing of persons with dysphagia after a tracheotomy.