Objective: To evaluate the suitability of the existing hemolysis rate standards for locally processed red blood cell components by retrospectively analyzing 5-year hemolysis rate data at the end of storage. Methods: A total of 720 blood samples of three types of red blood cell components from our blood station from January 2019 to December 2023 were collected. Parameters included hemoglobin concentration (Hb), hematocrit (Hct), and free hemoglobin concentration (fHb). Hemolysis rate were taken as the control standard of 0.8% in accordance with the national standard. The hemolysis rates were compared against the national standard threshold of 0.8% (GB18469-2012), and annual trends of the detection parameters were observed. Results: The hemolysis rates (x-+s,%) of leukocyte-depleted whole blood at the end of storage were (0.038±0.023 8) in 2019, (0.049±0.039 5) in 2020, (0.043±0.040 7) in 2021, (0.049±0.030 7) in 2022, and (0.058±0.054 8) in 2023, respectively; The hemolysis rates (x-+s" />,%) of leukocyte-depleted suspended red blood cells at the end of storage were (0.093±0.050 2) in 2019, (0.086±0.049 5) in 2020, (0.123±0.072 3) in 2021, (0.122±0.052 1) in 2022, and (0.106±0.058 6) in 2023, respectively; The hemolysis rates (x-+s,%) of washed red blood cells at the end of storage were (0.127±0.038 2) in 2019, (0.150±0.066 5) in 2020, (0.121±0.052 2) in 2021, (0.124±0.038 9) in 2022, and (0.128±0.044 3) in 2023, respectively. Conclusion: Hemolysis rates at the end of blood storage of three red blood cell components were significantly lower than the limits specified in Quality Requirements for Whole Blood and Components (GB18469-2012), as well as standards from the EU, AABB and the United States. The results demonstrate excellent product quality control. A regional internal control standard of <0.2% is proposed for hemolysis rates at the end of storage.

OBJECTIVE: To observe the effect of transcutaneous electrical acupoint stimulation (TEAS) on postoperative pain in patients undergoing modified radical mastectomy for breast cancer. METHODS: A total of 140 female patients scheduled for unilateral modified radical mastectomy for breast cancer undergoing general anesthesia were randomized into a TEAS group (70 cases) and a sham TEAS group (70 cases, 2 cases dropped out). Patients in both groups received TEAS or sham TEAS at bilateral Neiguan (PC6), Zusanli (ST36), and Danzhong (CV17), respectively, from 30 min before anesthesia induction until the end of surgery, and on 1st, 2nd, and 3rd days after surgery for 30 min a time, once a day. On 1st, 2nd, and 3rd days after surgery, the pain visual analogue scale (VAS) score was observed; on 3, 6, 12 months after surgery, the incidence rate of chronic pain was observed; before surgery, and on 1st, 3rd, and 7th days after surgery, the serum levels of tumor necrosis factor (TNF)-α, interleukin (IL)-6 and IL-10 were detected; the number of analgesia pump press, rescue analgesia, and the occurrence of adverse reaction after surgery were recorded in the two groups. RESULTS: In the TEAS group, the VAS scores on 1st and 2nd days after surgery, and the incidence rates of chronic pain on 3 and 6 months after surgery were lower than those in the sham TEAS group (P<0.05). On 1st, 3rd, and 7th days after surgery, the serum levels of TNF-α, IL-6, and IL-10 were increased compared with those before surgery in both groups (P<0.05, P<0.01); the above indexes in the TEAS group were lower than those in the sham TEAS group (P<0.05). The number of analgesia pump press and the incidence rate of rescue analgesia after surgery in the TEAS group were lower than those in the sham TEAS group (P<0.05). There was no statistically significant difference in the incidence of adverse reactions after surgery between the two groups (P>0.05). CONCLUSION TEAS can effectively improve both the postoperative acute pain and chronic pain in patients undergoing modified radical mastectomy for breast cancer, the mechanism may relate to inhibiting the inflammatory reaction.
Humans ; Female ; Acupuncture Points ; Pain, Postoperative/blood* ; Middle Aged ; Breast Neoplasms/surgery* ; Adult ; Transcutaneous Electric Nerve Stimulation ; Mastectomy, Modified Radical/adverse effects* ; Interleukin-6/blood* ; Tumor Necrosis Factor-alpha/blood* ; Interleukin-10/blood* ; Aged

Hepatic encephalopathy （HE） is a common severe liver disease syndrome in clinical practice and is one of the critical and severe diseases in internal medicine， and more than half of liver failure patients diagnosed with overt HE have a survival time of less than 1 year. A comprehensive analysis of the complex pathogenesis of HE and the development of diagnosis and treatment regimens based on evidence-based medicine are of great importance for alleviating high medical resource consumption， high medical expenses， and high incidence and mortality rates in clinical practice. The latest studies have shown that the intestinal tract and the central nervous system can perform bidirectional continuous interaction and signal transmission and regulate the function of inflammation signals， molecules， cells， and organs， which is known as neuroimmune communication and is highly consistent with the main pathological features of HE. With a focus on the mechanism of neuroimmune communication in HE， this article reviews the association between inflammation signal transduction via the gut-brain axis and neurotransmitter regulation and its role in neuroimmune communication in HE， which provides new ideas for the clinical diagnosis and treatment of HE and the research and development of related drugs.

Objective To observe the effect of acupoint sticking therapy along meridians on gastrointestinal function recovery in patients after lumbar internal fixation surgery.Methods From January 2020 to March 2022,125 patients with lumbar degenerative diseases were admitted to our hospital's Department of Orthopaedics and divided into two groups:control(n = 62)and acupoint sticking therapy(n = 63).The control group received standard postoperative care for lumbar internal fixation,while the experimental group received routine care based on acupoint sticking therapy along meridians.The NVAS scores for postoperative nausea and vomiting,abdominal distension and pain,bowel sound,initial exhaust,and defecation time were compared between the two groups.Results Both groups experienced gastrointestinal problems to varied degrees following surgery.The experimental group had signifi-cantly lower rates of nausea,NVAS score,vomiting grade,abdominal distension,return to normal bowel sounds,and time of first exhaust and bowel movement compared to the control group(P<0.05).However,there were no significant differences in abdominal pain and abdominal circumference(P>0.05).There were no adverse reactions in either group.The incidence of postoperative abdominal distension,nausea and vomiting in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion Acupoint sticking therapy along meridians could accelerate the recovery of gastrointestinal function of patients after lumbar internal fixation,promote rapid recovery after surgery,and improve quality of life.

Objective:To investugate the unique electrocardiogram (ECG) characteristics of fulminant myocarditis (FM) patients and provide important clues for the diagnosis of FM.Methods:This was a retrospective study. Patients diagnosed with acute myocarditis at Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from February 2017 to April 2022 were enrolled and divided into fulminant myocarditis group (FM) and non-fulminant myocarditis group (NFM) according to clinical diagnosis. A total of 246 healthy people who underwent physical examination in the Health examination Center of Tongji Hospital at the same period were selected as the control group. The clinical data and ECG characteristics of the above 3 groups were analyzed and compared. Logistic regression model was used to analyze the influence of ECG parameters on left ventricular ejection fraction in FM patients. Receiver operating curves were constructed to evaluate the predictive value of different ECG parameters for FM.Results:A total of 180 patients were included in this study (FM group: n=123; NFM group: n=57), with an age of (35.0±16.2) years and 106 males (58.89%). Compared with NFM group, ECG was significantly abnormal in FM group, with a higher incidence of sinus tachycardia, ventricular tachycardia or ventricular fibrillation, escape rhythm, right bundle branch block, third degree atrioventricular block, ST-segment elevation, low voltage, prolonged QTc interval, and widened QRS wave in the FM group (all P<0.05). The ECG parameters showed that the amplitude of the full lead QRS wave in FM group was lower than that in NFM group ( P<0.01). The average heart rate and QTc interval of FM group were significantly higher than those of NFM and control groups (all P<0.05). Although ST-segment elevation had a higher incidence in the FM group, ECG parameters showed that except for leads Ⅲ and aVF, the ST segment levels in all leads in the FM group were lower than those in the control group (all P<0.05). There was a statistically significant difference in some ST segment changes between FM and NFM groups, while there was no statistical difference between the NFM and control groups. Multivariate regression analysis showed that widened QRS wave and increased heart rate were the influencing factors for left ventricular systolic dysfunction in FM patients ( OR=16.914, 95% CI: 1.367-209.224, P=0.028; OR=1.026, 95% CI: 1.010-1.042, P=0.001). Receiver operating curve analysis showed that heart rate>86.90 beat/min, QTc>431.50 ms, and RV5+SV1<1.72 mV had certain predictive value for FM diagnosis. Conclusions:FM patients displayed marked and severe ECG abnormalities, and characteristic changes in ECG can provide important first clues for the diagnosis of FM.

Objective:To explore the prognosis efficacy of psycho-cardiological therapy and management on patients with coronary atherosclerosis disease (CAD).Methods:This was a clinical randomized controlled study. This study included inpatients with CAD at the cardiology department in Beijing Anzhen Hospital, Capital Medical University from August 2021 to January 2024. The patients enrolled in this study were asked for basic information, and received measurements for depression, anxiety, sleep quality and living quality by the scales of Patient Health Questionnaire-9 (PHQ-9), General Anxiety Disorder scale-7 (GAD-7), Athens Insomnia Scale (AIS), EuroQol 5-dimension 5-level (EQ-5D-5L) respectively. The patients were randomly grouped into a regular treatment group and a psycho-cardiological treatment group which included WeChat management or antidepressant/antianxiety medical therapy according to the situation. After the patients discharging from hospital for 2, 4, 12, 24, 48, 72, and 96 weeks, professional cardiovascular doctors would follow up by telephone, WeChat, and outpatient department, including scales (2-48 weeks), and cardiac events (2-96 weeks). Kaplan-Meier survival curve and multivariate Cox proportional hazards model were used for analyzing the association between psycho-cardiological treatment and cardiac events.Results:This study recruited a total of 552 patients with CAD, aged 61.0(54.0, 67.0) years, and 379 (68.7%) were male. There were 279(50.5%) in the regular treatment group and 273(49.5%) in the psycho-cardiological treatment group. After treatment for 4, 12 and 48 weeks, the PHQ-9 score in psycho-cardiological was significantly lower than the regular treatment group; After treatment for 12 weeks, the EQ-5D-5L effective value in psycho-cardiological group was higher than the regular treatment group; After treatment for 2, 4, 12, 24 and 48 weeks, the EQ-5D-5L VAS score in psycho-cardiological group was higher than the regular therapy group (all P<0.05). The Kaplan-Meier survival curve showed that, during the different follow-up periods, the rate of cardiac events in psycho-cardiological treatment group was lower than regular treatment group (log-rank P<0.001). The multivariate Cox proportional hazards model adjusted the factor of age, the psycho-cardiological treatment contributed to reducing the cardiac events rate by 80.3% ( HR=0.197, 95% CI: 0.067-0.582, P=0.003). Conclusion:Psycho-cardiological treatment is beneficial for improving psychological stress, living quality, and reducing cardiac events, and helps to improve prognosis and psycho-cardiological rehabilitation in CAD patients.

Objective To explore the clinical efficacy and safety of azithromycin sequential therapy combined with risk management in the treatment of mycoplasmal pneumonia pneumonia(MPP)in children.Methods MPP children admitted to the Department of Pediatrics of Quzhou People's Hospital from March 2023 to November 2023 were retrospectively selected,and divided into a study group(azithromycin sequential therapy combined with risk management)and a control group(azithromycin sequential therapy combined with routine care)according to different intervention methods.The clinical efficacy,inflammatory cytokines[interleukin-6(IL-6),interleukin-17(IL-17),and tumor necrosis factor-α(TNF-α)],incidence of MPP-related complications,and incidence of drug-related adverse reactions(DRAR)in the two groups after treatment were observed and compared.Results A total of 119 children with MPP were included in the study,with 57 in the study group and 62 in the control group.The clinical efficacy of children with MPP in the study group was significantly higher than that in the control group(P＜0.05).There was no significant difference in IL-6,IL-17,and TNF-α between the two groups before treatment(P＞0.05);after treatment,both groups showed significant decreases in IL-6,IL-17,and TNF-α compared with before treatment,and these indicators of the study group were lower than thsoe of the control group(P＜0.05).The incidence of MPP-related complications in children in the study group was lower than that in the control group(P＜0.05),and there was no significant difference in the incidence of adverse drug reactions between the two groups(P＞0.05).In addition,the satisfaction of MPP children's family members in the study group with nursing care was significantly higher than that in the control group(P＜0.05).Conclusion The clinical efficacy of azithromycin sequential therapy combined with risk management in the treatment of pediatric MPP is significant,which can regulate the expression of inflammatory cytokines,reduce MPP-related complications,and improve clinical efficacy and family satisfaction with nursing care.

Objective To evaluate the effect of parasternal intercostal plane block(PIB)on postopera-tive fatigue in elderly patients undergoing off-pump coronary artery bypass grafting(CABG).Methods A to-tal of 111 elderly patients undergoing elective off-pump CABG in Xuzhou Municipal Central Hospital from May 2021 to January 2023 were selected as the study subjects.The patients were divided into the control group(group C,n=55)and PIB group(group P,n=56)by adopting the random number table method.After induction of anesthesia,the patients in the group P received the ultrasound-guided bilateral PIB,and the group C received the equal volume of normal saline at the same site.The incidence rate of postoperative fatigue syn-drome(POFS)on postoperative 1,3,5,7 d and postoperative 8 weeks,NRS scores immediately after extuba-tion and at postoperative 12,24,48 h,postoperative opioid drugs consumption,ICU stay duration,hospitaliza-tion duration and adverse events occurrence were compared between the two groups.Results Compared with the group C,the incidence rates of POFS on postoperative 1,3,5,7 d and postoperative 8 weeks in the group P were significantly decreased,the NRS scores immediately after extubation and at postoperative 12,24 h in the group P were lower,the postoperative opioid drugs consumption were smaller,the ICU stay duration was shorter,and the differences were statistically significant(P＜0.05).The NRS score at postoperative 48 h and hospitalization duration had no statistical differences between the two groups(P＞0.05).No nerve block re-lated adverse events in the patients appeared during the study period.Conclusion The ultrasound guided PIB could effectively reduce the incidence rate of POFS in elderly patients undergoing off-pump CABG,promote the patients'prognosis and improve the recovery quality of the patients.

Objective To study the properties and antimicrobial activity of the novel self-assembled antimicrobial peptide(AMP)CR-16,and to provide experimental evidence for the treatment of bacterial infections.Methods CR-16 was designed and synthesized based on the structure of antimicrobial peptides Buforin Ⅱ and LfcinB.Dynamic light scattering(DLS),transmission electron microscopy(TEM),and X-ray diffraction(XRD)were used to characterize CR-16.Based on the results of critical micelle concentration(CMC),the self-assembled properties of CR-16 were investigated using atomic force microscopy(AFM)and circular dichroism(CD).The minimum inhibitory concentration(MIC)was used to study the inhibitory effect of CR-16 while transmission electron microscopy(TEM)was adopted to observe the interactions between CR-16 and the outer membrane of bacteria.Results AMP CR-16 was prepared as self-assemblies,which were regularly spherical in shape and stable in activity.CR-16 could inhibit both the growth of Escherichia coli and,more importantly,the growth of NDM-1-producing carbapenem-resistant Escherichia coli,promising good prospects in treating infections caused by antibiotic-resistant bacteria.Conclusion CR-16 can be self-assembled and deliver antibacterial effects against Escherichia coli.

Objective To enhance the photostability of colchicine(COL)for sustained-release COL pellets.Methods The degradation was investigated by studying the photochemical degradation kinetics of COL.The impact of such physical properties of the photostabilizers as the type,color,dosage,and position on the photostability of COL in sustained-release pellets was also evaluated.Results The contents of photochemical degradation products did not increase after 10 days of light exposure to sustained-release COL pellets with red iron oxide of 4％(w/w)as the protective layer.Conclusion The findings of this study indicate that use of iron oxide as a photostabilizer in sustained-release COL pellets can significantly reduce the photochemical degradation of COL in the pellets.