Objective To analyze the application of in-use laparoscopes in clincal departments to enhance the laparoscope's effectiveness.Methods The effective utilization data of 29 laparoscopes from January 2024 to June 2024 were acquired with an hospital intelligent medical device management platform.Comparisons were carried out in terms of average daily workload,average daily hours of use and average daily efficiency between the laparoscopes from different departments and brands with non-parametric Kruskal-Wallis test and between the conventional and 3D laparoscopes with non-parametric Mann-Whitney U test.Pearson's correlation coefficient was used to analyze the correlation between the number of years of laparoscope use and the average daily workload,the average daily hours of use,and the average daily efficiency and the chi-square test was applied to investigating the relationship between the surgery grade and the type of equipment selected.Results Thoracic sugery department had the highest average daily workload(3.82 person-time),while the general medical department had the highest average daily hours of use(443.76 min)and the highest daily efficiency(92.45％).There were significant differences between the laparoscopes from different departments in average daily workload,average daily hours of use and average daily efficiency(P＜0.05).Brand D laparoscope behaved the best among brands of laparoscopes with the highest average daily workload(3.72 person-time),average daily hours of use(394.41 min)and average daily efficiency(82.17％).There were sig-nificant differences between the brands of laparoscopesin average daily workload,average daily hours of use and average daily efficiency(P＜0.05).3D laparoscopes obviously gained advantages over the conventional ones in average daily workload,average daily hours of use and average daily efficiency(P＜0.05).The number of years of use correlated negatively with average daily workload,average daily hours of use and average daily efficiency,with Pearson correlation coefficients being-0.095,-0.039 and-0.039 respectively.Grade Three and Four surgeries had significant differences in types of selected equipment(P＜0.001),and 3D laparoscopes were preferred for Grade Four surgery.Conclusion Utilization analysis of laparoscopes provides data support for optimized application and setup of laparoscopes.[Chinese Medical Equipment Journal,2025,46(2):87-91]

Background and purpose:Next generation sequencing-identified genetic alterations of diffuse large B cell lymphoma(DLBCL)and baseline SUVmax detected by 18F-FDG PET/CT were correlated with patients'prognosis.However,their relationship and the associations with R-CHOP response of DLBCL are still unclear.This study aimed to analyze the association bewteen genetic alterations and 18F-FDG PET/CT SUVmax and their correlations with clinicopathological characteristics and R-CHOP response of DLBCL.Methods:A total of 225 cases of primary DLBCL detected by next generation sequencing using 481 lymphoma gene panel and examined by 18F-FDG PET/CT before treatment between 2022 and 2023 were collected.This study was approved by the Ethics Committee of Fudan University Shanghai Cancer Center(Ethical No.:050432-4-2307E)and acquired the informed consent of the patients.The translocations of BCL2,BCL6 and MYC were identified by fluorescence in situ hybridization.The clinicopathological characteristics and the PET/CT scan after R-CHOP chemotherapy were collected.Results:Finally,191 patients were enrolled in this study.The frequency of MYD88 mutation,TP53 mutation,copy number variations of CDKN2A/2B,CD79B mutation in the 191 DLBCL patients were 24.6%,27.2%,32.5%and 16.8%,respectively.The range of baseline SUVmax was 5.10-63.10(24.44±10.70,median 22.80).The baseline SUVmax of MYD88L265P DLBCL was significantly higher than that of MYD88 wild type(P=0.039).There were no significant associations of SUVmax with other gene alterations including TP53 mutation,CDKN2A/B loss,CD79B mutation,KMT2D mutation,TNFAIP3 mutation,B2M mutation,EZH2 mutation,BTG1/2 mutation,CREBBP mutation,gene translocations of MYC,BCL2 and BCL6.The higher SUVmax before treatment was correlated with higher serum lactate dehydrogenase(LDH)level(P=0.012)and non-germinal center B-cell-like(non-GCB)DLBCL(P=0.040).However,there was no significant association of SUVmax with R-CHOP response(P=0.714).TP53 mutation was significantly associated with the poor response of R-CHOP(P=0.001)and was an independent predictor of non-complete metabolic response(non-CMR).TP53 mutation combined with Ann Arbor stage,International Prognostic Index(IPI)score and serum LDH level could better predict R-CHOP response than each factor alone.Conclusion:MYD88L265P DLBCL had higher baseline 18F-FDG PET/CT SUVmax.The baseline SUVmax was not associated with R-CHOP response.However,TP53 mutation was significantly correlated with poor response of R-CHOP in DLBCL patients.TP53 mutation combined with clinicopathological characteristics could better predict R-CHOP response.The associations of gene alterations and SUVmax with prognosis of DLBCL patients needed to be explored in the future.

Objective: To evaluate the safety and efficacy of the emergency infusion protocol for universal red blood cells by analyzing its clinical application in patients treated at our hospital's war trauma and emergency center. Methods: Data were collected from 133 patients who received universal red blood cell transfusion in the war trauma center of our hospital from January 2016 to December 2024. The basic information, universal red blood cell transfusion volume, compatible blood components, transfusion volume, blood routine (Hb, Hct), liver and kidney function (ALT, AST, TBil, DBil, creatinine, etc.) and coagulation function (PT, APTT, Fib, etc.) before and after transfusion were retrospectively analyzed. Results: Among the 133 patients who received a total of 374 units of universal red blood cells, the 24-hour survival rate was 62.4% (83/133). Spearman correlation analysis showed a positive correlation between shock index and universal red blood cell transfusion volume (r=0.283, P<0.05). Patients were stratified by universal red blood cell transfusion volume (≤ 3 U vs ≥ 4 U). The low volume group had less homotypic red blood cell transfusion volume and total transfusion volume at different time points, and the difference was statistically significant: within 2 h [2(2, 4)vs 4(3, 7), P=0.033<0.05], 0~24 h [6(4, 9) vs 8(6, 14), P=0.028<0.05], total transfusion volume [13(8, 20)vs 19(12, 35), P=0.021<0.05]. No acute hemolytic transfusion reaction occurred within 24 hours after transfusion of universal red blood cell. Conclusion: Universal red blood cells are safe for use in emergency treatment. Furthermore, the shock index combined with the volume of universal red blood cells transfused can predict subsequent transfusion requirements and enables the early reservation of compatible blood, thereby preventing delayed resuscitation.

Objective:To investigate the clinical and pathological significance of the DICER1 mutation in follicular thyroid carcinoma (FTC).Methods:Sixty-eight cases of primary FTC resected between 2009 and 2023 were retrieved from The Affiliated Hospital of Qingdao University, Qingdao, China. Sanger sequencing was performed to identify DICER1 and TERT promoter mutations in all cases. Cases with DICER1 or TERT promoter mutations were subject to additional examination of potential mutations in KRAS, HRAS, and NRAS. The clinical and pathological features of DICER1-mutant FTCs were then analyzed. The relationship between DICER1 mutations and TERT-promoter/RAS mutations was also assessed.Results:DICER1 mutations were detected in 16 of the 68 FTC cases (23.5%), with 11 near E1813 at exon 25, 6 near D1709 at exon 24, and 1 in the splice region of exon 25. Two cases harbored two (distinct) mutations. All patients with DICER1-mutant FTC were female. Compared with patients with DICER1-wild-type FTC, those with DICER1-mutant were much younger, and had a higher proportion of minimally invasive subtype. Nine FTCs with DICER1 mutations were subject to further sequencing on adjacent non-cancerous tissues or lymph node tissues, but no mutations were detected. TERT-promoter or RAS hotspot mutations were not identified in any of the DICER1-mutant cases. However, TERT-promoter mutation was found in 6 DICER1-wild-type cases (8.8%, 6/68), with 3 cases also having RAS hotspot mutations and exhibiting highly aggressive biological behaviors.Conclusion:DICER1 mutations may occur in FTCs and appear mutually exclusive with RAS and TERT-promoter mutations, warranting further study as RAS-like mutations.

Objective:To explore the application of contrast-enhanced ultrasound in the preoperative evaluation of carotid body tumor (CBT).Methods:The clinical data of 13 CBT patients undergoing contrast enhanced ultrasound test and surgical treatment at Peking Union Medical College Hospital from Nov 2017 to Aug 2021 was retrospectively analyzed.Results:Among the 13 patients, 7 patients had bilateral lesions. 18 tumors were identified by contrast enhanced ultrasound, which showed rich blood supply, with marked enhancement in 13 tumors and moderate enhancement in 5 tumors. The origins of the arterial supply for tumors were identified by contrast enhanced ultrasound. Time-intensity curve analysis showed that the tumors had enhancement characteristics of fast wash in and slow wash out. The mean contrast wash in time was (3.33±1.40) s, the mean peak intensity was (10.41±1.74) dB, and the mean wash out time was (56.47±22.28) s. A total of 13 cases underwent successful surgical removal. Five cases of external carotid artery ligation and 2 cases of internal carotid artery reconstruction were performed during surgery. Postoperative transient neurological injury occurred in 5 cases. There were no cases of cerebral infarction or death in the perioperative period. Mean postoperative follow-up was 14.31 months. Five cases of neurological injury had satisfactory recovery and no other adverse events occurred.Conclusions:Contrast enhanced ultrasound is an effective method of preoperative imaging assessment for CBT, which helps the surgical planning and preoperative preparation.

Objective To investigate the relationship between the serum red blood cell distribution width(RDW)to albumin(ALB)ratio,the expression of family with sequence similarity 19 member A5(FAM19A5)and leukocyte cell-derived chemotaxin 2(LECT2)with the glucose and lipid metabolism indexes in type 2 diabetes mellitus(T2DM)patients with metabolic syndrome(MS).Methods A total of 119 patients with T2DM were selected as the study group,and patients were divided into the MS group(67 cases)and the non-MS group(52 cases)based on whether they were complicated with MS.Meanwhile,93 healthy individuals who underwent physical examinations in our hospital during the same period were selected as the control group.RDW was detected by an automatic blood cell analyzer,and ALB was detected by an automatic biochemical analyzer.The ratio of RDW to ALB(RAR)was calculated.The serum levels of FAM19A5 and LECT2 were detected by enzyme-linked immunosorbent assay(ELISA).The correlation between serum and glycolipid metabolism indicators was analyzed by Pearson's method.The diagnostic value of serum RAR,FAM19A5 and LECT2 for MS in T2DM patients was analyzed by receiver operating characteristic(ROC)curve.Results Compared with the control group,the study group exhibited significantly higher levels of total cholesterol(TC),triacylglycerol(TG),low-density lipoprotein cholesterol(LDL-C),fasting blood glucose(FBG),serum RAR,FAM19A5 and LECT2,while high-density lipoprotein cholesterol(HDL-C)was significantly lower(P＜0.05).Compared to the non-MS group,body mass index(BMI),duration of T2DM,history of hypertension,blood pressure,waist circumference,TG,fasting insulin(FINS),FBG,glycated hemoglobin(HbA1c),homeostasis model assessment-insulin resistance(HOMA-IR),serum RAR,FAM19A5 and LECT2 were significantly increased,and HDL-C was decreased in the MS group(P＜0.05).Serum RAR,FAM19A5 and LECT2 were positively correlated with TG,FINS,FBG,HbA1c and HOMA-IR,and which was negatively correlated with HDL-C(P＜0.05).The area under the curve(AUC)for the diagnosis of T2DM patients with MS using RAR,FAM19A5 and LECT2 individually were 0.821,0.807 and 0.793,respectively,and the combined AUC was 0.952,indicating that the combined diagnostic efficacy of RAR,FAM19A5 and LECT2 was superior to their individual efficacies(P＜0.05).Conclusion Serum levels of RAR,FAM19A5 and LECT2 are elevated in T2DM patients with MS.These biomarkers exhibit a strong association with indices of glucose and lipid metabolism.The combination of these three markers has significant clinical diagnostic value for T2DM patients with MS.

OBJECTIVE: This study aimed to investigate the impact of glycemic control and diabetes duration on subsequent myocardial infarction (MI) in patients with both coronary heart disease (CHD) and type 2 diabetes (T2D). METHODS: We conducted a retrospective cohort study of 33,238 patients with both CHD and T2D in Shenzhen, China. Patients were categorized into 6 groups based on baseline fasting plasma glucose (FPG) levels and diabetes duration (from the date of diabetes diagnosis to the baseline date) to examine their combined effects on subsequent MI. Cox proportional hazards regression models were used, with further stratification by age, sex, and comorbidities to assess potential interactions. RESULTS: Over a median follow-up of 2.4 years, 2,110 patients experienced MI. Compared to those with optimal glycemic control (FPG < 6.1 mmol/L) and shorter diabetes duration (< 10 years), the fully-adjusted hazard ratio ( HR) (95% Confidence Interval [95% CI]) for those with a diabetes duration of ≥ 10 years and FPG > 8.0 mmol/L was 1.93 (95% CI: 1.59, 2.36). The combined effects of FPG and diabetes duration on MI were largely similar across different age, sex, and comorbidity groups, although the excess risk of MI associated with long-term diabetes appeared to be more pronounced among those with atrial fibrillation. CONCLUSION Our study indicates that glycemic control and diabetes duration significant influence the subsequent occurrence of MI in patients with both CHD and T2D. Tailored management strategies emphasizing strict glycemic control may be particularly beneficial for patients with longer diabetes duration and atrial fibrillation.
Humans ; Diabetes Mellitus, Type 2/blood* ; Male ; Female ; Middle Aged ; Aged ; Coronary Disease/complications* ; Myocardial Infarction/etiology* ; Retrospective Studies ; China/epidemiology* ; Glycemic Control ; Blood Glucose ; Adult ; Risk Factors ; Time Factors

OBJECTIVE: To explore the expression and clinical significance of XPO1 in newly diagnosed adult diffuse large B-cell lymphoma (DLBCL), and further investigate its functional mechanism. METHODS: Immunohistochemical testing was conducted for XPO1 expression in 93 cases of DLBCL and 30 cases of reactive lymphoid hyperplasia. A risk model was construed to find survival related genes in DLBCL patients. Cell proliferation, apoptosis, and cell cycle assays were performed to explore the effect of XPO1 inhibitor (KPT-8602) and XPO1 knockdown. Differential expression gene (DEG) was examined based on the transcriptomes. RESULTS The expression of XPO1 in DLBCL patients was higher than that of the controls. Compared with XPO1 low-expression group, XPO1 high-expression group had a worse prognosis. The constructed risk model indicated that XPO1 and 14 genes in nucleocytoplasmic transport pathway (NTP) might be potential prediction marker of adverse outcome in DLBCL. Moreover, KPT-8602 as well as the XPO1 knockdown could inhibit cell proliferation, promote apoptosis, and induce cell cycle arrest in two DLBCL cell lines, Farage and SU-DHL-4. Based on the gene expression profiling in the datasets of DLBCL, patients were classified into XPO1 high and XPO1 low expression groups, and the MYBL1 was identified as the down-stream effector of XPO1. Inhibiting the function of XPO1 or reducing its expression can significantly decrease the expression of MYBL1 Conclusion: XPO1 is highly expressed in DLBCL, which is associated with poor prognosis. The oncogenic roles of the new XPO1/MYBL1 signaling are identified in DLBCL and XPO1 inhibitor may be a potential option for newly-diagnosed DLBCL patients.
Humans ; Lymphoma, Large B-Cell, Diffuse/pathology* ; Exportin 1 Protein ; Karyopherins/metabolism* ; Receptors, Cytoplasmic and Nuclear/metabolism* ; Cell Proliferation ; Apoptosis ; Prognosis ; Cell Line, Tumor ; Clinical Relevance

Objective To investigate the effects of auricular point seed-pressing and earpoint scraping on sleep quality,sleep structure index and neurotransmitter in patients with sleep disorders in neurology department.Methods A total of 110 patients with sleep disorders treated in the Department of Neurology at Nanjing Hospital Affiliated to Nanjing Medical University from June 2022 to June 2024 were selected as the study subjects.The patients were randomly divided into an observation group and a control group using a random number table,with 55 cases in each group.The control group was treated with Estazolam Tablets,while the observation group received auricular point seed-pressing therapy combined with ear scraping therapy.The treatment course lasted for 4 weeks.After treatment,the clinical efficacy of the two groups was evaluated.Changes in the Pittsburgh Sleep Quality Index(PSQI)scores were observed before and after treatment,as well as sleep structure indicators,including total sleep time(TST),sleep latency(SL),arousal index(AI),non-rapid eye movement sleep time(NREM)[light sleep stage(S1),light to moderate sleep stage(S2),moderate sleep stage(S3),deep sleep stage(S4)],actual sleep time(AST),sleep efficiency(SE),and rapid eye movement sleep time(REM).The serum levels of norepinephrine(NE),5-hydroxytryptamine(5-HT),and gamma-aminobutyric acid(GABA)were compared before and after treatment,as well as changes in the Quality of Life Scale(SF-36)scores.The safety and incidence of adverse reactions in the two groups were also evaluated.Results(1)The total effective rate in the observation group was 96.61%(53/55),while it was 81.82%(45/55)in the control group.The efficacy of the observation group was superior to that of the control group,with a statistically significant difference(P＜0.05).(2)After treatment,the PSQI scores of both groups were significantly improved(P＜0.05),and the observation group showed significantly better improvement in PSQI scores compared to the control group,with a statistically significant difference(P＜0.05).(3)After treatment,the sleep structure indicators in the observation group,including TST,SL,AI,S1,S2,S3,S4,AST,SE,and REM,were significantly improved,and the differences were statistically significant compared to the control group(P＜0.05).(4)After treatment,the serum levels of NE,5-HT,and GABA in both groups were significantly improved,and the observation group showed significantly better improvement in these levels compared to the control group,with a statistically significant difference(P＜0.05).(5)After treatment,the SF-36 scores of both groups were significantly improved,and the observation group showed significantly better improvement in SF-36 scores compared to the control group,with a statistically significant difference(P＜0.05).(6)The total incidence of adverse reactions in the observation group was 0.00%(0/55),while it was 10.91%(6/55)in the control group.The incidence of adverse reactions in the observation group was significantly lower than that in the control group,with a statistically significant difference(P＜0.05).Conclusion Auricular point seed-pressing therapy combined with ear scraping therapy for the treatment of sleep disorders at the Department of Neurology can significantly improve patients'sleep quality,enhance sleep structure-related indicators,regulate neurotransmitter levels,thereby improving patients'quality of life with high safety and efficacy.

Objective To carry out quality control testing of anesthesia ventilators to ensure the reliability and safety during their clinical use.Methods Totally 88 anesthesia ventilators used in some hospital underwent quality control testing in terms of tidal volume,peak airway pressure and positive end-expiratory pressure by using a gas flow analyzer according to JJF(E)61-2020 Calibration Specification of Anesthetic Machines,which included 31 ones,36 ones,12 ones and 9 ones respectively from brand A,B,C and D.The Kruskal-Wallis test was used to analyze the variability of the measured values and errors of the performance indicators between different brands of anesthesia ventilators,the chi-square test was applied to discussing the variability of the accuracy class of the performance indicators between different brands of anesthesia ventilators,and the Pearson correlation coefficient was adopted to investigate the correlation between the years of use and the absolute values of the relative errors of the performance indicators.Results The 88 anesthesia ventilators had the overall pass rate for quality control testing being 42.05%,of which,brand B had the highest pass rate(52.78%)and brand C had the lowest pass rate(8.33%).Brand B gained advantages in tidal volume when compared with brand A,C and D,with the differences being significant(P<0.05);brand A behaved the best in peak airway pressure and positive end-expiratory pressure when compared with brand B,C and D,with the differences being significant(P<0.05).Brand A had the highest proportion(63.08%)of distinction and credit in terms of the three performance indicators.The absolute value of the relative error in tidal volume was positively correlated with the years of use at the 3 measurement points for setting values of 400,600,and 800 mL respectively(P<0.05),and there was a significant correlation between the absolute value of the relative error and the years of use at a peak airway pressure setting of 10 cmH2O(1 cmH2O=98.07 Pa)(P<0.05).Conclusion Quality control testing of anesthesia ventilators contributes to finding the risks during their application,which can be an effective tool to ensure the safety of anesthesia ventilators used in medical institutions.[Chinese Medical Equipment Journal,2025,46(9):75-80]