Objective: To analyze the serological characteristics of anti-Mur antibodies and investigate the distribution frequency of the Mur antigen among voluntary blood donors in Shiyan, thereby providing a basis for guiding clinical transfusion and establishing a Mur blood type database. Methods: ABO blood grouping of donors and patients was performed using an automated blood typing analyzer and the gel card method, respectively. Unexpected antibody screening and identification were performed using the saline, tube anti-human globulin, and polybrene methods. The specificity of anti-Mur antibodies was confirmed using Fisher's exact probability test. Plasma treated with 2-mercaptoethanol was used to distinguish IgM and IgG antibodies. IgM and IgG anti-Mur titers were determined by the saline tube method and the anti-human globulin tube method, respectively, at 4℃, room temperature, and 37℃. A total of 1 659 donor red blood cell samples were initially screened for the Mur antigen phenotype using three samples of human-derived anti-Mur plasma by the micro-tube method. Donors who tested positive for Mur antigen were further tested by the direct antiglobulin test (DAT); those with negative results were confirmed for Mur antigen by the gel card and polybrene methods. Results: Three blood samples were identified to contain mixed IgG and IgM anti-Mur antibodies. The titers of both IgM and IgG anti-Mur antibodies were highest at 4℃, intermediate at room temperature, and lowest at 37℃. The positive frequency of the Mur antigen among voluntary blood donors in Shiyan was 1.99% (33/1 659). Conclusion: anti-Mur antibodies were detected in both blood donors and patients in our region. The Mur antigen shows a certain distribution frequency among voluntary blood donors in Shiyan. Screening for the Mur blood type and establishing a corresponding database could enhance transfusion safety.

Objective:To optimize the smart follow-up workflow for day-case breast surgery patients using an action research approach and evaluate its effectiveness.Methods:A total of 648 post-discharge patients who underwent day-case breast surgery at the Day Surgery Unit of Peking Union Medical College Hospital, Chinese Academy of Medical Sciences between February and May 2024 were selected by convenience sampling. Patients who received routine smart follow-up (automated+telephone) from February to March 2024 served as the baseline group. Patients enrolled in April 2024 ( n=218) and May 2024 ( n=202) formed the first and second cycle groups, respectively, in which the smart follow-up workflow was optimized iteratively using action research. Outcome indicators included automated recovery rate and total recovery rate of follow-up forms, as well as the incidence of postoperative discomfort symptoms. Results:The automated and total recovery rates of follow-up forms in the first and second cycle groups were significantly higher than those in the baseline group, with statistically significant differences observed ( P<0.01). The proportion of patients experiencing persistent chest distress was significantly lower in the first and second cycle groups compared to the baseline group, and further reduced in the second cycle group compared to the first, with statistically significant differences observed ( P<0.01). Pain levels in the first and second cycle groups were also significantly lower than those in the baseline group, with statistically significant differences observed ( P<0.01) . Conclusions:Optimizing the smart follow-up workflow for day-case breast surgery patients based on an action research approach can significantly improve the automated and overall recovery rates of follow-up forms, reduce postoperative discomfort, and enhance both the efficiency and quality of follow-up care.

Objective:To optimize the smart follow-up workflow for day-case breast surgery patients using an action research approach and evaluate its effectiveness.Methods:A total of 648 post-discharge patients who underwent day-case breast surgery at the Day Surgery Unit of Peking Union Medical College Hospital, Chinese Academy of Medical Sciences between February and May 2024 were selected by convenience sampling. Patients who received routine smart follow-up (automated+telephone) from February to March 2024 served as the baseline group. Patients enrolled in April 2024 ( n=218) and May 2024 ( n=202) formed the first and second cycle groups, respectively, in which the smart follow-up workflow was optimized iteratively using action research. Outcome indicators included automated recovery rate and total recovery rate of follow-up forms, as well as the incidence of postoperative discomfort symptoms. Results:The automated and total recovery rates of follow-up forms in the first and second cycle groups were significantly higher than those in the baseline group, with statistically significant differences observed ( P<0.01). The proportion of patients experiencing persistent chest distress was significantly lower in the first and second cycle groups compared to the baseline group, and further reduced in the second cycle group compared to the first, with statistically significant differences observed ( P<0.01). Pain levels in the first and second cycle groups were also significantly lower than those in the baseline group, with statistically significant differences observed ( P<0.01) . Conclusions:Optimizing the smart follow-up workflow for day-case breast surgery patients based on an action research approach can significantly improve the automated and overall recovery rates of follow-up forms, reduce postoperative discomfort, and enhance both the efficiency and quality of follow-up care.

Objective To explore and analyze the therapeutic effect of cryotherapy in the removal of granulation tissue under electronic bronchoscope,and find an efficient and safe auxiliary treatment technique for patients undergoing granulation tissue removal surgery.Method A clinical practice study was conducted on 41 patients who underwent granulation tissue removal surgery from June 2021 to June 2022.Patients were divided into groups using single and double numbers,with 21 patients assigned to single numbers included in the control group and 20 patients assigned to double numbers included in the observation group.Both groups underwent electronic bronchoscope granulation tissue removal surgery.During the surgery,the control group received argon-plasma coagulation(APC),while the observation group received cryotherapy.The levels of immune function indicators(including CD4+,CD8+and CD4+/CD8+),postoperative recovery related indicators,and effective rate of the two groups of patients were compared before and after treatment.Result Before treatment,there was no statistically significant difference in CD4+and CD4+/CD8+between the two groups of patients(P>0.05).After treatment,CD4+and CD4+/CD8+in the observation group were significantly higher than those in the control group,and the differences were statistically significant(P<0.05);Before treatment,there was no statistically significant difference in CD8+between the two groups of patients(P>0.05).After treatment,the observation group was significantly lower than the control group,and the difference was statistically significant(P<0.05);The effective rate of the observation group was 95.00%,higher than 80.95%of the control group.The postoperative pain visual analogue scale(VAS)of the observation group was(2.14±0.18)points,significantly lower than the control group's(6.09±0.95)points,and the differences were statistically significant(P<0.05);The first postoperative feeding time of the observation group was(6.08±0.76)hours,and the hospital stay was(5.12±0.68)days,which were shorter than the control group's(15.39±2.97)hours and(7.08±0.93)days;The treatment cost of the observation group was(10 500.60±80.70)yuan,which was lower than the control group's(19 800.00±126.00)yuan,and the differences were statistically significant(P<0.05);The incidence of postoperative complications in the observation group was 5.00%,lower than the control group's 23.81%,and the difference was statistically significant(P<0.05).Conclusion The application of cryotherapy in the removal of granulation tissue under electronic bronchoscope has a significant therapeutic effect.It can not only improve the surgical treatment effect of patients,improve their immune index levels,but also alleviate their postoperative pain,reduce the incidence of postoperative complications,and shorten their postoperative pre-and post cycle.Moreover,the treatment cost is low,and it is worthy of clinical application and promotion.

Objective:To detect the levels of cytokines in peripheral blood of patients with chronic immune thrombocytopenia (ITP) and analyze their significance in the clinical prognosis of children with chronic ITP.Methods:Thirty patients with chronic ITP who were treated in the Department of Pediatrics, the First Affiliated Hospital of Xinxiang Medical Univercity from October 2015 to October 2018 were followed and enrolled in the experimental group and 40 healthy children in the same hospital were enrolled in the healthy control group.The levels of interleukin-2(IL-2), interferon-γ(IFN-γ), tumor necrosis factor(TNF), interleukin-4(IL-4), interleukin-6(IL-6), interleukin-10(IL-10) and interleukin-17A(IL-17A) in the experimental group and the healthy control group were detected by flow cytometry (CBA). The relationship between cytokines and prognosis of children with chronic ITP were analyzed.Results:Thirty patients with ITP were enrolled. The expressions of IL-2 and IL-17A in the experimental group before treatment were (7.86±3.90) ng/L and (10.45±12.35) ng/L, while those of IL-2 and IL-17A in the healthy control group were (3.11±2.41) ng/L and (2.97±7.04) ng/L. The levels of IL-2 and IL-17A in the experimental group were significantly higher than those in the healthy control group, and the differences were statistically significant ( t=-7.123, -5.582, all P<0.01). The expressions of IL-4 and IL-10 in the experimental group before treatment were (0.38±0.25) ng/L and (1.80±1.25) ng/L, while those of IL-4 and IL-10 in the healthy control group were (3.08±0.26) ng/L and (4.55±3.44) ng/L. The levels of IL-4 and IL-10 in the experimental group were significantly lower than those in the healthy control group, and the differences were statistically significant ( t=8.400, 5.653, all P<0.01). The expressions of IL-6, TNF and IFN-γ in the experimental group before treatment were (7.30±9.16) ng/L, (4.85±7.60) ng/L and (7.68±20.41) ng/L, while those of IL-6, TNF and IFN-γ in the healthy control group were (5.44±4.18) ng/L, (1.97±0.37) ng/L, (4.81±17.71) ng/L. There was no significant difference between the two groups ( P>0.05), and no significant difference in the levels of cytokines between the patients with chronic ITP before and 12 months after treatment ( P>0.05). Conclusions:The changes of T lymphocyte related cytokines are closely related to the pathogenesis and development of chronic ITP in children. There may be persistent immune dysfunction in children with chronic ITP. Dynamic monitoring of cytokines IL-2, IL-4, IL-10, IL-17A, especially IL-17A, is helpful to judge the prognosis of ITP in children, and may be of guiding significance in evaluating clinical prognosis.

Ocular opsoclonus is a rare disorder of the saccadic system, in which fixation is continuously interrupted by involuntary, chaotic, rapid and multi-directional saccadic eye movements, interrupting the gaze-holding function, leading to“dancing eyes”. Ocular opsoclonus has rarely been reported in China. A case of ocular opsoclonus associated with anti-N-methyl-D-aspartate receptor encephalitis is reported to improve awareness about the ocular sign. The patient′s condition reached the peak at the 5th week. He developed ocular opsoclonus on the basis of nonconvulsive status epilepticus, accompanied by frequent involuntary movements of the mouth and limbs. The ocular opsoclonus gradually relieved on the 7th week with the active treatment.

Objective: To learn the epidemiological characteristics of fall mortality among the elderly people in Taizhou，and to provide basis for intervention strategies of fall in the elderly. Methods: Data of fall mortality among residents aged 60 years or over in Taizhou from 2016 to 2018，collected from Zhejiang Chronic Disease Surveillance Information Management System，was used for analysis of time，population and geographical characteristics of fall deaths. The epidemic trend of fall mortality in the elderly was described by annual percentage change（APC）. Results: From 2016 to 2018，3 699 cases of fall death in Taizhou were reported，the crude and standardized mortality were 116.90/100 000 and 97.88/100 000. The standardized mortality of fall in women was 106.11/100 000，which was higher than 90.13/100 000 in men（P<0.05）. The standardized mortality of fall in rural residents was 131.20/100 000，which was higher than 28.15/100 000 in urban residents（P<0.05）. The mortality of fall in residents aged 65-69 years from 2016 to 2018 showed an upward trend（APC=4.20%，P<0.05），while the mortality trend of fall in other age groups was not statistically significant（P>0.05）. Conclusion Fall was the first cause of injury death in the elderly aged 60 years or over in Taizhou. Females and rural residents have relatively higher fall mortality.

Objective To explore the potential predictive value of plasma exosomal miR-422a in different time after ischaemic stroke (1, 2, 3, 4 day) .Methods Retrospective study.Forty patients diagnosed with ischaemic stroke ( IS ) and ten age and sex matched people who underwent a standard physical examination were recruited from the First Affiliated Hospital of Guangxi Medical University between May 2016 and December 2016.Plasma exosomes were extracted by use of related kit and the expression level of plasma exosomal miR-422a in both IS patients (1, 2, 3, 4 day) and healthy controls were examined via quantitative real-time polymerase chain reaction ( qRT-PCR ) .The areas under the curve ( AUC ) of the receiver operating characteristic curve were constructed to evaluate the diagnostic accuracy of the miR -422a in IS, and one-way analysis of variance followed by the Games-Howell post hoc test was used for difference analysis.Results The exosomes isolated from human plasma showed round or oval vesicles , the average particle size was 128.2 nm and with maximum peak distribution of 186.9 nm.Moreover , all of the isolated exosomes were positive for a marker , with the CD63-positive rate at 80.6％ and the CD81-positive rate at 91.7％.qRT-PCR confirmed that miR-422a was expressed in human plasma exosomes , and the expression levels of plasma exosomal miR-422a [median relative values, 1.221 (95％CI:0.640-1.802) for healthy group, 4.418 (95％CI:2.642-6.193) for group of 1 dayafter IS, 2.912 (95％CI:2.262-3.562) for 2 day, 2.744 (95％CI:2.000-3.487) for 3 day and 0.449 (95％CI:0.170-0.727) for 4 day] were significantly increased in the time after IS 1, 2, 3 day ( F=13.57, P<0.05, P<0.01, P<0.05, respectively;and the AUC values were 0.920, 0.945, 0.870, respectively ) .The expression of plasma exosomal miR-422a on the 4th day after IS were lower than those in other IS groups ( F=13.57,P<0.005, P<0.001, P<0.001, respectively), and no statistical significance was found between the expression of plasma exosomal miR-422a on the 4th day after IS than that in the control group [0.449 (95％CI:0.170-0.727)].Conclusion Plasma exosomal miR-422a showed high diagnostic value as blood-based biomarker for diagnosing IS in the early phase (1-3 d).

Objective To analyze the effects of curcumin combined with cisplatin on the growth and lymphatic metastasis of cervical cancer xenografts in nude mice.Methods The human cervical carcinoma Caski cells xenotransplanted tumor models were established.Inoculated mice were randomly divided into 4 groups according to random number table:control (normal saline 10 ml/kg),Cur (curcumin 100 mg/kg),Cis (cisplatin 3 mg/kg) and Cur + Cis group (100 mg/kg curcumin +3 mg/kg cisplatin).The tumor volume and anti-tumor rate were calculated.The mRNA levels of macrophage migration inhibitory factor (MIF) and vascular endothelial growth factor-C (VEGF-C) were analyzed by real-time fluorescent quantitative polymerase chain reaction (PCR).Results The inhibitory rates of Cur group,Cis group and Cur + Cis group were 40.8％,53.3％ and 60.0％.After 15 days treatment,the tumor volumes of the control group,Cur group,Cis group and Cur + Cis group were (123.44 ± 35.62),(71.72 ± 28.36),(65.47 ± 18.32),(53.44 ± 10.79) mm3.The growth rates of tumor volume in Cur group,Cis group and Cur + Cis group were slower,Cur + Cis group could more effectively inhibit tumor volume growth.The difference among the four groups had statistically significance (F =16.890,P =0.000).Real-time fluorescent quantitative PCR detection showed that compared with the control group (1.000),the MIF mRNA expressions in Cur group,Cis group and Cur + Cis group were 0.322 ±0.094,0.154 ± 0.006 and 0.136 ± 0.007,VEGF-C mRNA expressions in the three groups were 0.312 ± 0.068,0.263 ± 0.072 and 0.221 ± 0.041.The differences among groups had statistically significance (F =220.279,P =0.000;F =143.250,P =0.000).MIF mRNA was positively related with VEGF-C mRNA (r =0.815,P =0.001).Conclusion Curcumin combined with cisplatin can inhibit the growth of Carski cell xenografts in nude mice.Through the down-regulating expression of MIF mRNA and VEGF-C mRNA,cisplatin and curcumin can inhibit the lymphatic metastasis of cervical cancer,and it may be one of the important mechanisms of its anti-tumor effects.

Objective To investigate the effect of time from myocardial infarction (MI) onset to percutaneous coronary intervention (PCI) on plasma matrix metalloproteinases (MMPs) level and left ventricle (LV) remodeling in patients with acute ST-segment elevation myocardial infarction of anterior wall,and the relationship between MMPs and left ventricular remodeling.Methods All patients with anterior wall STEMI undergoing PCI were divided into early PCI group (PCI within 18 h after MI onset) and delayed PCI group (PCI between 2 and 3 weeks after MI onset).Plasma MMP-2 and MMP-9 activities were assayed on admission,and at 2 days,1 week after admission.One-year follow-up was finished after PCI.Left ventricular end-diastolic volume (LVEDV),left ventricular end-systolic volume (LVESV) and left ventricle ejection fraction (LVEF) were measured by echocardiography at baseline and one year later to elucidate the effects of time from onset to PCI on LV remodeling and the relationship between MMP-2,-9 levels and LV remodeling.Results The MMP -9 activity at 2 days after myocardial infarction was lower in early PCI group than in delayed PCI group [(46±26)μg/L vs.(66±40) μg/L,P=0.000].The changes in LVEDV and LVESV (△LVEDV and △LVESV) were lower and the change in LVEF (△LVEF) was higher in early PCI group than in delayed PCI group [(10.9±6.2) ml vs.(15.0±6.0)ml,(-1.1±5.7) ml vs.(2.9±4.6) ml,(5.5 ±4.0) ％ vs.(3.8±3.4) ％,P=0.000,0.000 and 0.015].MMP-9 had positive correlations with △LVEDV and △LVESV,and a negative correlation with △LVEF at admission and after 1-year follow-up (r=0.32,0.36 and-0.29,respectively,P=0.000,0.000 and 0.001).Conclusions MMP-9 activity at admission is correlated with LV remodeling and LV function.Early PCI can reduce MMP-9 activity and improve LV remodeling after myocardial infarction.