In order to solve the difficulties and challenges in the implementation of the original blood distribution and collection regulations caused by the expansion of hospital area, the extension of blood transfer time, the changeability of blood transfer environment, and the strain of personnel due to the increase of workload, as well as to ensure the accuracy of the information throughout blood remote verification and distribution and the safety of clinical blood transfusion, , Shanghai experts related to clinical transfusion and blood management had made a systematic study on the applicable scope and management rules of remote verification of blood distribution and collection, and formulated this Expert Consensus combined with the development status of digital, intelligent and remote communication technologies, so as to provide corresponding guidance for clinical medical institutions in line with the changes in reality.

Purpose: The aim of this meta-analysis was to evaluate the efficacy and safety of imidafenacin for overactive bladder (OAB) induced by benign prostatic hyperplasia (BPH) in men receiving alpha-blocker monotherapy. Methods: We performed a systematic research of the PubMed, Embase, and Cochrane Library databases, and searched for studies about alpha-blocker with or without imidafenacin treatment for OAB in patients with BPH. We also investigated the original references of the included texts. Results: Four randomized controlled trials including 779 participants with BPH (389 in the alpha-blocker+imidafenacin group and 390 in the alpha-blocker only group) were studied. The main efficacy endpoint was the Overactive Bladder Symptom Score, which showed a mean difference of -1.88 (95% confidence interval, -2.32 to -1.44; P<0.00001), suggesting that alpha-blocker and imidafenacin treatment was effective in treating men with OAB. As other primary efficacy end points, the International Prostate Symptom Score (IPSS) total score (P=0.47), the IPSS storage symptom score (P=0.07), the IPSS voiding symptom score (P=0.60), and the IPSS quality of life score (P=0.18) indicated that 2 methods had no significant differences in treating men with OAB. In terms of safety, which was assessed using postvoid residual volume (P=0.05) and maximum flow rate (P=0.53), the analysis suggested that combination treatment was very well tolerated. Conclusions This study suggested that imidafenacin plus alpha-blocker was an efficacious and safe treatment for OAB symptoms in BPH patients.

Objective To investigate whether the amount of blood transfusion affects the lengths of stay (LOS),costs,and outcomes of hospital patients or not,and to prepare for the execution of patient blood management.Methods The data of hospital patients,who had been administrated with blood in our hospital during 2016,were collected.And the influence of blood transfusion volume on LOS,costs and outcomes of patients was analyzed retrospectively.Results LOS,costs and outcomes of patients vary significantly with the amount of blood transfusion (P＜0.01).There were positive correlations between the total amount of blood transfusion and LOS,costs,and outcomes of patients.The Spearman correlation coefficient was 0.317,0.497,0.290,respectively (P＜0.01).Plasma preparation transfusion volume has a great influence on LOS,costs,and outcomes than red blood cell (P＜0.05).The transfusion volume of death patients was significantly higher than that of the survival (P＜0.01).In particular,the amount of transfused plasma and precipitation was distinctly higher than that in death patients(P＜0.01).Conclusion Blood transfusion volume affects LOS,costs and outcomes of hospital patients.The administration of plasma preparations should deserve more attention.

Objective To investigate the best experimental scheme of Mycoplasma solid culture combined with liquid culture.Methods A total of 961 samples of urogenital tract excretion were collected from March 2016 to June 2016.Both solid culture and liquid culture were performed for detection of Mycoplasma,false positive broths were picked out after 48 h,20 μl of each one was transformed to solid media for subculture,final results were read after 48 h.The experimental data was analyzed to find an optimal combination culture scheme.Results The positive rate of solid culture was 38.7％ (372/961) for UU and 7.8％ (75/961) for MH.The positive rate of liquid culture was 45.27％ (435/961) for UU and 7.08％ (68/961) for MH.The different rate between both methods was 9.47％ (91/961) for UU (x2 =43.61,P＜0.005),and 3.02％ (29/ 961) for MH (x2 =1.24,P＞ 0.05).The different rate was 53.5 ％ (46/86) between primary solid culture and subculture.The positive rate of total (primary solid culture and subculture) solid culture was 41.9％ (403/961) for UU and 8.6％ (83/961) for M H,which produced higher sensitivity than single (primary solid culture or subculture) solid culture.The different rate between the total solid culture and the liquid method was 6.24 ％ (60/961) for UU (x2 =17.067,P＜0.05),and 3.43 ％ (33/961) for MH (x2=5.94,P＜0.05).Conclusion Perform both solid culture and liquid culture for Mycoplasma,pick out those false positive broths for subculture.Total solid culture could be more reliable as final result,for which could combine specificity of solid culture with sensitivity of liquid culture.

Objective ToestimatetheprevalenceofPanton-Valentineleukocidin (PVL)genes and antimicrobial resistance in methicillin-sensitive Staphylococcus aureus (MSSA)isolateds from outpatients with skin and soft-tissue infections (SSTIs)in Wuhan city. Methods A total of 182 MSSA isolates were collected from outpatients with SSTIs in 5 different hospitals in Wuhan city between 2011 and 2013. The Kirby-Bauer′s disk diffusion method was used to evaluate antimicrobial susceptibility of the MSSA isolates, and multiplex PCR was performed to detect mecA and PVL genes in these isolates. Results Of the 182 MSSA isolates, 65 (35.71%)carried PVL genes. The positive rate of PVL genes was significantly different among patients with different diseases (χ2 = 49.76, P = 0.00), and relatively higher in patients with furuncles/carbuncles(7/7), folliculitis(3/3), abscesses(55.53%, 30/57)or impetigo(2/4). The age of patients with PVL-positive MSSA infection was significantly younger than that with PVL-negative MSSA infection (35.40 ± 19.31 years vs. 43.21 ± 20.75 years,t = 2.50, P = 0.01). Among 65 PVL-positive MSSA isolates, the rate of resistance to clindamycin was highest (87.69%), followed by that to penicillin(53.85%)and erythromycin(41.54%). The frequency of resistance to clindamycin was highest in 117 PVL-negative MSSA isolates, followed by that to penicillin (20.51%)and ampicillin (12.82%). Furthermore, there was a significant increase in the rate of resistance to penicillin(χ2 = 21.19), ampicillin(χ2 = 97.97), doxycycline(χ2 =11.61), ciprofloxacin(χ 2 = 8.07), erythromycin(χ 2 = 25.04)and gentamicin(χ 2 = 10.86)in PVL-positive MSSA isolates compared with PVL-negative MSSA isolates (all P < 0.05). Conclusions MSSA isolates from outpatients with SSTIs in Wuhan city are resistant to most β-lactam antibiotics. Flucloxacillin, compound sulfamethoxazole tablets or doxycycline is recommended for empirical treatment of PVL-positive MSSA infections.

ObjectiveTo observe the effect ofZuogui Jiangtang Jieyu Formula on the expressions of glutamate, NR2A and NR2B in hippocampus of diabetic rats with depression;To explore the mechanism of protective effect. Methods Diabetes with depression rat models were established and then were randomly divided into the model group, positive medicine group, high-, medium- and low-doseZuogui Jiangtang Jieyu Formula groups. Normal rats acted as normal group, 16 rats per group. After 28 days of administration, Open-field test was used to detect the behavior of the rats;glutamate content of hippocampus was detected by ELISA;the expressions of NR2A and NR2B in rat hippocampus were detected by immunofluorescence.Results Compared with normal group, automatic activity times of rats in model group decreased significantly (P<0.01);both glutamate content (P<0.01) and expressions of NR2A, NR2B (P<0.01) increased significantly. Compared with the model group, automatic activity times of rats in positive medicine group and high-doseZuogui Jiangtang Jieyu Formula group significantly increased (P<0.01);glutamate content dropped (P<0.01);expressions of NR2A and NR2B decreased (P<0.05).ConclusionZuogui Jiangtang Jieyu Formula can improve depressive behavior of diabetic rats with depression, which may be related to the regulation of glutamate content and expressions of NR2A and NR2B in hippocampus.

Objective To investigate effects of Baishile Capsules on cAMP-CREB-BDNF signal pathway about hippocampal neurogenesis in model rats with chronic unpredicted stress depression. Methods SD rats were randomly divided into blank group, model group, fluoxetine hydrochloride group, and Baishile Capsules high, medium, and low dose groups. Chronic stress depression rat model was established by chronic and mild unpredictable stressors. All groups were given relevant medicine for 21 days. The open-field test, sugar consumption experiment, place navigation test, and space searching experiment were used to detect behavior changes of the rats. ELISA was used to detect content of corticosterone in plasma. The protein expressions of PKA, BDNF, and CREB were detected by immunohistochemical method. Results Compared with model group, Baishile Capsules high dose and medium dose groups could remarkably increase the number of vertical and horizontal activities and 1% sucrose partial eclipse. Platform latency and target quadrant searching time decreased significantly in Baishile Capsules high dose group (P<0.05), and content of corticosterone in plasma increased obviously (P<0.05) in Baishile Capsules all dose groups. Protein expressions of PKA, CREB, and BDNF in hippocampal DG and CA3 area increased significantly (P<0.05) in Baishile Capsules high dose group. Conclusion Baishile Capsules can promote hippocampal neurogenesis through the cAMP-CREB-BDNF signal pathway and realize anti-depression effect.

Objective To evaluate the efficacy and safety of silodosin in the treatment of benign prostatic hyperplasia (BPH).Methods Randomized controlled trials (RCT) on the efficacy and safety of silodosin for the treatment of BPH were retrieved from Medline (1966-2012),Embase (1988-2012),Cochrane liberary,CMCC (1979-2012),CNK1 (1979-2012) and the quality of the included RCTs were evaluated using Cochrane systematic evaluation to analyze the data statistically using Rev Man 5.1.0 software.Results Six RCTs involving 2543 participants were included for the meta-analysis.Results of analysis showed that silodosin was effective in the treatment of BPH in term of total international prostate symptom score (IPSS) (standard mean difference (SMD) =2.92,95 ％ CI =2.19-3.65,P ＜ 0.05),voiding symptom score (SMD =1.92,95％ CI =1.44-2.39,P ＜0.05),storage symptom score (SMD =0.92,95％ CI=0.60-1.24,P ＜0.05),and maximum flow rate (Qmax) score (SMD =1.56,95％ CI=1.38-1.75,P ＜ 0.05),compared with the placebo.Silodosin 8 mg was more effective than tamsulosin 0.2 mg in term of IPSS-related parameters and Qmax (P ＜ 0.05).Silodosin 8mg and tamsulosin 0.4 mg were similarly effective in all the efficacy analyses.Abnormal ejaculation was less common with tamsulosin 0.2 mg and 0.4mg (P＜0.05); overall adverse events were similar with tamsulosin 0.2 and 0.4 mg (P ＜0.05).Conclusions Silodosin was significantly more effective than placebo and tamsulosin 0.2 mg in improving symptoms and as effective as tamsulosin 0.4 mg.For adverse events,abnormal ejaculation was more common with silodosin.

This study was aimed to investigate Baishile Capsule on behavior, memory and expression of SYN I and SYNA in hippocampal CA3 region of depression model rats. SD rats were randomly divided into six groups, which were the control group, depression model group, fluoxetine hydrochloride group, and the Baishile Capsule group (2.88 g·kg-1, 1.44 g·kg-1, 0.72 g·kg-1). The chronic stress depression model rats were established by chronic and mild unpredictable stressors as described in the literature. In the model group, medicine was intragastricly administered once per day and continued for 21 days. In the control group and model group, same volume of distilled water was intragastricly administered. The open-field test, preference for 1% sucrose solution, Morris water maze, and rate of weight were carried out and observed. Immunohistochemistry and in situ hybridization were used in the observation of the expression of SYN I and SYNA in each group of model rats. The results showed that high-dosage Baishile Capsule can significantly increase the horizontal and vertical activities of score after two-week treatment (P< 0.01). The middle-dosage Baishile Capsule can significantly increase the horizontal activity of score after three-week treatment (P< 0.05). The rat's preference for sucrose solution was obviously increased in the high-dosage group after one-week treatment and in the middle-dosage group after three-week treatment (P< 0.01, or P< 0.05). The rate of weight of rats was obviously increased in the high-dosage group after two-week treatment and in the middle-dosage group after three-week treatment (P< 0.01, or P< 0.05). The high-dosage and middle-dosage Baishile Capsule can shorten EL, and significantly increase the number of target quadrant. The high-dosage Baishile Capsule can obviously shorten the target quadrant latency (P< 0.05). Compared with the model group, the immunohistochemistry and in situ hybridization showed high-dosage Baishile can significantly promote the expression of SYN I and SYNA in hippocampal CA3 region; and the middle-dosage group can enhance the expression of SYNA (P < 0.05, or P <0.01). It was concluded that Baishile Capsule can obviously improve the behavior and the expression of SYN I and SYNA in hippocampal CA3 region of depression model rats.

Objective To approach the efficiency of second-trimester prenatal screening using two serum markers for Down's syndrome (DS).Methods Retrospective analysis was conducted on the results of prenatal screening using two serum markers,alpha fetoprotein (AFP) and free beta subunit of human chorionic gonadotropin(free-β-hCG),in 50 cases of DS pregnancy identified among 60 931 pregnant women received prenatal screening from November 1997 to April 2008 in Nanjing Maternal and Child Health Hospital.Results Among the 50 DS cases,the detection rate of DS was 50% (25/50) when taking free-β-hCG≥2.5 MoM as the cut-off,with the positive rate of screening was 6.6%.And the detection rate of DS would be 18.0%(9/25) when taking AFP≤0.5 MoM as the cut-off,with the positive rate of screening was 4.6%.When the risk cut-off value of DS was set at 1/270,the detection rate changed to 52.0%,and the positive rate of screening was 4.7%;and the two figures changed to 62.0% and 5.5%,respectively,when the risk cut-off was set to 1/300.Thirteen DS cases showed the risk value between 1/1000 and 1/300,among which two were monomarker abnormality.Thirteen (26.0%) of the 50 DS fetus were found to have one or two abnormality markers by ultrasound scan,among which one was DS low risk,and the other 12 were DS high risk in serum screening.Conclusions The second-trimester prenatal screening using AFP or free β-hCG for Down's syndrome is effective in identifying DS pregnancy with limited specificity and sensitivity.But the detection rate can be elevated by the combination of these two markers.The second trimester systemic ultrasound scan is not ideal for DS identification,but it can increase the specificity and sensitivity of serum prenatal screening.