[Objective] To investigate the factors influencing the detection of HLA-C expression by flow cytometry. [Methods] A total of 12 hematopoietic stem cell suspension samples from peripheral hematopoietic stem cell volunteer donors were randomly collected after CD34⁺ cell counting detection. The influence of detecting different number of nucleated cell (500 000, 50 000 and 5 000), sequential order of red blood cell lysis and antibody incubation, and the HLA-C antibody with varied remaining time from the expiration date on the detection results of HLA-C expression by flow cytometry were investigated, respectively. The significance of differences between different groups was analyzed through Student t test. [Results] There was no significant difference in the proportion of HLA-C positive cells and mean fluorescence intensity (MFI) among the three groups with different nucleated cell numbers detected (500 000, 50 000 and 5 000) (P>0.05). The sequential order of red blood cell lysis and antibody incubation had no influence on the proportion of HLA-C positive cells (P>0.05), but HLA-C MFI value was significantly lower when antibody incubation was performed after red blood cell lysis than that when antibody incubation was performed before red blood cell lysis (P<0.05). The proportion of HLA-C positive cells and MFI value detected by HLA-C antibody remaining 24 months from the expiration date were significantly higher than those detected by HLA-C antibody remaining only 5 months from the expiration date (P<0.05). [Conclusion] The present study has investigated the factors of influencing HLA-C expression level by flow cytometry, the results have important reference and application value for standardizing the experimental operation of HLA-C expression and improving the accuracy and comparability of detection results.

A 50-year-old male patient diagnosed with extensive stage small cell lung cancer was treated with pamiparib in combination with temozolomide.Five days later,the patient developed fever with fatigue.After 10 days,the patient stopped taking the drug due to worsening symptoms and was diagnosed with chemotherapy-induced myelosuppression(grade 4).The clinicist evaluated the patient's condition and assessed the association of adverse reactions using the Naranjo's evaluation scale,and concluded that myelosuppression may be induced by the combination of pamiparib and temozolomide.After symptomatic treatment,the patient's myelosuppression recovered completely.This article discusses the correlation between myelosuppression and the combination of the two drugs,provides treatment measures for this situation,briefly describes the risk factors of myelosuppression,treatment and prevention,and guides medical personnel to adjust the treatment plan in time according to different individuals in the process of using similar programs,and strengthens the monitoring and education of adverse drug reactions,so as to provide references for safe drug use.

Objective To analyze the clinical characteristics of thyroid dysfunction induced by camrelizumab in the treatment of classical Hodgkin lymphoma(cHL)and explore the influencing factors.Methods The medical records of cHL patients treated with camrelizumab from January 1st,2017 to December 31st,2020,were collected.The clinical characteristics of thyroid dysfunction induced by camrelizumab were analyzed,and the influencing factors of adverse drug reactions(ADRs)were discussed.Results A total of 47 patients were included,12 patients(25.53%)experiencing thyroid dysfunction after receiv-ing camrelizumab.Among them,3 patients had hypothyroidism,7 had subclinical hypothyroidism,and 2 had subclinical hyperthy-roidism.The severity of ADRs was between grade 1 and 2(mild to moderate).None of the patients with thyroid dysfunction dis-continued camrelizumab.Thyroid dysfunction occurred between 1 and 22 months after camrelizumab treatment,with a median time of 6 months.2 patients with hypothyroidism treated with levothyroxine,the thyroid function returned to normal in 1 patient and was improved in the other.1 patient with subclinical hypothyroidism was treated with levothyroxine with the thyroid function continued to be abnormal.The rest of the 9 patients with thyroid dysfunction received no intervention,and 4 of them returned to normal,and others remained with no obvious change or loss in follow-up.Thyroid dysfunction was associated with baseline thyroid stimulating hormone level(P=0.03).The level of thyroglobulin antibodies and thyroid peroxidase antibodies was increased in 2 patients a-mong 3 patients with moderate thyroid dysfunction.Conclusion The incidence of thyroid dysfunction induced by camrelizum-ab in cHL was high.Camrelizumab-induced thyroid dysfunction was related to TSH baseline level(P=0.03).The severity was between grade 1 and 2,which was related to the level of TgAb and TPOAb.The subtype of thyroid dysfunction was mainly sub-clinical hypothyroidism with a long period.Patients could continue camrelizumab treatment,and the thyroid function of patients with grade 2 hypothyroidism was improved after the treatment with levothyroxine.

Objective To investigate the sleep structure of Parkinson's disease (PD) patients with rapid eye movement sleep behavior disorder (RBD) and its correlations with cognitive function, depressive state and motor function. Methods A total of 120 PD patients were enrolled in this study, and divided into PD+RBD group (n=45) and PD group (n=75) based on the presence or absence of RBD. Sleep structure was recorded for both groups. The scores of the Montreal Cognitive Assessment (MoCA), Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), Unified Parkinson's Disease Rating Scale Part Ⅲ (UPDRS-Ⅲ) and Scales for Outcomes in Parkinson's Disease-Autonomic (SCOPA-AUT) were compared between the two groups. The correlations of MoCA, HAMA, HAMD, UPDRS-Ⅲ and SCOPA-AUT scores with sleep structure in the PD+RBD group were analyzed. Results The PD+RBD group showed significantly higher percentage of non-rapideye movement (NREM) at stage 1, arousal index, periodic limb movements during sleep (PLMS) and apnea-hypopnea index (AHI) compared to the PD group, while the percentages of NREM at stage 3, rapid eye movement (REM) sleep, sleep efficiency and lowest oxygen saturation were significantly lower (P < 0.05). The PD+RBD group also had significantly higher HAMA, HAMD, UPDRS-Ⅲ and SCOPA-AUT scores, and significantly lower MoCA scores compared to the PD group (P < 0.05). In the PD+RBD group, the percentages of NREM at stage 1, arousal index, PLMS and AHI were positively correlated with HAMA, HAMD, UPDRS-Ⅲ and SCOPA-AUT scores, and negatively correlated with MoCA scores (P < 0.05). Conversely, the percentages of NREM at stage 3, REM sleep, sleep efficiency and lowest oxygen saturation were negatively correlated with HAMA, HAMD, UPDRS-Ⅲ and SCOPA-AUT scores, and positively correlated with MoCA scores (P < 0.05). Conclusion PD patients with RBD exhibit disrupted sleep structure, which is closely associated with cognitive function, depressive state, motor function, and autonomic nervous system function.

OBJECTIVES: To evaluate the feasibility and safety of bipolar-plasmakinetic transurethral enucleation and resection of the prostate (B-TUERP) in day surgery. METHODS: From January 2021 to August 2022, 34 patients with benign prostatic hyperplasia (BPH) underwent B-TUERP in day surgery in the First Affiliated Hospital of Anhui Medical University. Patients completed the screening and anesthesia evaluation before admission and received the standard surgery which implements "anatomical enucleation of the prostate" and "absolute bleeding control" on the same day of admission, and by the same doctor. Bladder irrigation was stopped, catheter was removed and the discharge evaluation was performed on the first day after operation. The baseline data, perioperative conditions, time of recovery, treatment outcomes, hospitalization costs, and postoperative complications were analyzed. RESULTS: All operations were successfully conducted. The average age of the patients was (62.2±7.8) years, average prostate volume was (50.2±29.3) mL. The average operation time was (36.5±19.1) min, the average hemoglobin and blood sodium were decreased by (16.2±7.1) g/L and (2.2±2.0) mmol/L, respectively. The average postoperative length of hospital stay, and total length of hospital stay were (17.7±2.2) and (20.8±2.1) h, respectively, and the average hospitalization cost was (13 558±2320) CNY. All patients were discharged on the day after surgery except for one patient who was transferred to a general ward. Three patients received indwelling catheterization after catheter removal. The 3-month follow-up results showed a substantial improvement in the International Prostate Symptom Score, quality of life score and maximum urinary flow rate (all P<0.01). Three patients experienced temporary urinary incontinence, 1 patient experienced urinary tract infection, 4 patients were diagnosed with urethral stricture and 2 patients experienced bladder neck contracture. No complications above Clavien grade Ⅱ occurred. CONCLUSIONS The preliminary results showed that B-TUERP ambulatory surgery is a safe, feasible, economical and effective treatment for appropriately selected patients with BPH.
Male ; Humans ; Middle Aged ; Aged ; Prostate/surgery* ; Prostatic Hyperplasia/surgery* ; Ambulatory Surgical Procedures ; Quality of Life ; Feasibility Studies ; Retrospective Studies ; Treatment Outcome

Objective:To explore the team construction and treatment strategy of the Diabetic Foot-Multidisciplinary Team.Methods:The clinical data of 19 patients with severe ischemic diabetic foot treated by our Diabetic Foot-Multidisciplinary Team Center from Apr 2021 to Mar 2022 were collected, and the overall amputation rate, above-ankle major amputation rate, minor amputation rate and mortality, Diabetic Foot-Multidisciplinary Team consultation discipline participation rate and treatment participation degree were retrospectively analyzed.Results:Nineteen patients (15 males and 4 females) were enrolled, aged 26 to 94 (68.6±14.2). All were with severe ischemic diabetic foot ulcer:Rutherford grade 5 or up and dysfunction in 2 or more organs. Complications included arteriosclerosis obliterans of the lower extremities in 18 cases, heart diseases in 18, hypertension in 15, and renal insufficiencies in 10. The overall amputation rate was 36.8%, major amputation rate in 21.1%, minor amputation rate in 15.8%, and mortality rate was 15.8%. A total of 16 disciplines participated in Diabetic Foot-Multidisciplinary Team; the main participating disciplines were vascular surgery (19 times), endocrinology (12 times), and cardiology (11 times). The main treatment disciplines were vascular surgery (14 times), plastic surgery (3 times), and cardiology (2 times).Conclusion:For the diagnosis and treatment of diabetic foot, it is necessary to set up a multidisciplinary team as early as possible to control the causes of diabetic foot ulcer, prevent the recurrence of diabetic foot ulcer, reduce the mortality and amputation rate, and improve the quality of life of patients.

AIM: To evaluate the clinical efficacy of amoxicillin from volume-based procurement (VBP) and potassium amoxicillin clavulanate in the eradication of helicobacter pylori (Hp) infection, providing basis for the selection of treatment programs. METHODS: Data from the patients who received Hp eradication therapy from May 2021 to May 2022 were recruited from the rational drug use management system. The data from the patients treated by amoxicillin (amoxicillin 1.0 g bid + bismuth potassium citrate 220 mg bid + esomeprazole 20 mg bid + clarithromycin 0.5 g bid, for 14 days) and potassium amoxicillin clavulanate (potassium amoxicillin clavulanate 0.914 g bid + bismuth potassium citrate 220 mg bid + esomeprazole 20 mg bid + clarithromycin 0.5 g bid, for 14 days) were selected and compared. RESULTS: A total of 171 cases were collected in the group treated by Amoxicillin program, and the eradication rate was 87.8% (150/171). A total of 69 cases were collected in the group of potassium amoxicillin clavulanate, and the eradication rate was 76.8% (53/69). There was no significant difference in baseline data between the two groups (P>0.05). There was a significant difference in clinical efficacy between the two groups (P< 0.05). In addition, the cost-effectiveness ratio (C/E) of the Amoxicillin treatment program was lower than that of the potassium amoxicillin clavulanate program CONCLUSION: The clinical efficacy of VBP Amoxicillin program in eradicating Hp infection is better than that of the potassium amoxicillin clavulanate program, which is worthy of clinical recommendation.

Pancreatic cancer is a kind of digestive system tumor with insidious clinical manifestations,rapid development and very poor prognosis,and its early diagnosis and surgical treatment can significantly improve the survival rate and prognosis of patients.So far,no tumor marker with sufficient sensitivity and specificity for early pancreatic cancer has been found for tumor screening.In recent years,more and more pancreatic canc-er-related tumor markers have been discovered and studied.Liquid biopsy has shown potential utility in a range of applications,with the advantages of non-invasive,non-destructive,real-time,multiple,and has broad prospects in many aspects of tumor diagnosis and treatment.This article discusses and summarizes the screen-ing and early diagnosis of circulating tumor cells and circulating tumor DNA in liquid biopsy,so as to provide reference for early detection and early treatment of pancreatic cancer.

Objective:To evaluate the safety and efficacy of bipolar plasmakinetic endoscopic enucleation of the prostate (BEEP) in the treatment of benign prostatic hyperplasia (BPH) in a day surgery mode.Methods:The clinical data of 162 BPH patients admitted to the First Affiliated Hospital of Anhui Medical University from January 2021 to June 2022 were analyzed retrospectively. The patients were divided into day group(80 cases) and conventional group(82 cases) according to hospitalization mode. In the day group, preoperative screening and anesthesia evaluation was completed during the pre-hospitalization period, and the patient was discharged within 24 hours. The two groups were treated with BEEP, the urethral mucosa was cut at a " Ω" 5 mm proximal to the external sphincter ring in front of the verumontanum. Following the standard of anatomical enucleation of the prostate, the gland tissue was cut out after enucleation. There were no significant differences in age [(63.6±8.9) years vs. (67.5±7.1) years], body mass index [(24.3 ±2.6) kg/m 2vs. (23.0±3.2) kg/m 2], prostate volume [(55.8±16.9) ml vs. (53.7±20.7) ml], preoperative prostate-specific antigen [3.8(1.2, 5.3)ng/ml vs. 3.5(2.1, 5.6)ng/ml], the international prostate symptom score (IPSS) [(25.9±5.2) vs. (26.3±5.9)], the quality of life score (QOL) [(5.0±0.7) vs.(5.0±0.6)], the maximum urine flow rate (Q max) [(8.2±4.5) ml/s vs. (7.9±4.1) ml/s] and residual urine volume (PVR) [49(0, 131) ml vs. 45(11, 106) ml] between the two groups ( P>0.05). The waiting time before admission was [(2.6±1.2) d vs. (5.3±1.5) d], and the difference between the two groups was statistically significant ( P<0.05). The perioperative efficacy indicators, total hospitalization expenses and short-term postoperative complications were compared between the two groups. Results:In this study, all patients successfully completed the operation. There were no statistical significances in the perioperative indicators between the day group and the conventional group including the operation time [(38.4±15.2) min vs. (40.4±13.9) min], enucleated tissue weight [(34.6±9.6) g vs. (35.4±10.8) g], the decrease value of hemoglobin [(13.0±2.5) g/L vs. (12.0±3.7) g/L] and the decrease value of blood sodium [(2.2±0.9) mmol/L vs. (2.4±1.3) mmol/L]( P>0.05). The significant differences were observed in bladder irrigation time [(16.9±2.1)h vs. (22.7±12.1)h], catheterization time [(18.8±5.1) h vs.(65.6±13.0)h], postoperative hospital stay [(16.8±2.4)h vs. (64.8±6.3)h] and the total hospitalization expenses [(13 282.2±2 236.3) yuan vs. (15 969.3±2 420.6) yuan] between the day group and the conventional group ( P < 0.01). In the day group, 1 case was transferred to the general ward for observation for 1 day. There were no significant differences in the incidence of complications as urinary retention [6.3% (5/80) vs. 3.7% (3/82)], temporary incontinence [2.5% (2/80) vs. 2.4%(2/82)], urethra stricture [7.5% (6/80) vs. 6.1% (5/82)], and hematuria for intervention [1.3% (1/80) vs. 1.2% (1/82)]between the day group and the conventional group ( P > 0.05). After 6 months of follow-up, there were no significant differences in IPSS[(6.7±2.8) vs. (6.1±2.5)], QOL[(1.8±0.9) vs. (2.0±0.8)], Q max [(26.4±5.5)ml/s vs. (25.8±4.6)ml/s] and PVR [7(2, 11)ml vs. 5(4, 8)ml] between the two groups at 6 months after operation ( P > 0.05), but there were significant improvements when compared with those items of preoperation ( P < 0.01). Conclusions:The treatment of BPH with BEEP in the day surgery mode is as safe and effective as that in the conventional surgery mode, with little bleeding, high resection efficiency, definite therapeutic effect and low incidence of complications. BEEP can shorten the length of hospital stay and reduce medical expenses in the day surgery mode, and can be carried out in hospitals with conditions.

Objective:To understand the correlation between urinary iodine, salt iodine and thyroid nodules in children aged 8 - 10 years and pregnant women in different regions of Fujian Province, and to explore the influencing factors of thyroid diseases.Methods:A cross-sectional study was conducted in Dongshan County and Pingtan County of Fujian Province from September to November 2019. According to the inclusion criteria, 140 pregnant women and 270 children aged 8 - 10 years were selected in Dongshan County, and 189 pregnant women and 368 children aged 8 - 10 years were selected in Pingtan County. Random urine and edible salt samples were collected to determine iodine content, and iodine nutrition was evaluated in each population. Thyroid was examined by B ultrasound and questionnaire survey of thyroid diseases was carried out. The correlation between urinary iodine, salt iodine and thyroid nodules in children aged 8 - 10 years and pregnant women in different regions was analyzed.Results:There were statistically significant differences in the median urinary iodine among children in different genders (male: 151.30 μg/L, female: 130.30 μg/L) and regions (Dongshan County: 160.30 μg/L, Pingtan County: 129.70 μg/L, P < 0.05); there was no significant difference in the median urinary iodine among children of different ages (8, 9, 10 years old: 141.60, 128.05, 150.30 μg/L, P > 0.05). The median urinary iodine among pregnant women was 119.30 μg/L, and there was no significant difference in median urinary iodine among pregnant women in different stages and regions ( P > 0.05). The medians of salt iodine from children and pregnant women were 20.30 and 23.65 mg/kg, respectively. Urinary iodine in children was positively correlated with salt iodine ( r = 0.13, P < 0.05). However, there was no correlation between urinary iodine and salt iodine in pregnant women ( P > 0.05). The detection rate of thyroid nodules in children was 21.79% (139/638). There was significant difference in the detection rate of thyroid nodules in children of different ages ( P < 0.05). The detection rate of thyroid nodules in pregnant women was 4.26% (14/329). There was no correlation between detection rate of thyroid nodules and urinary iodine or salt iodine in children and pregnant women ( P > 0.05). Thyroid volume of children in the two counties was within the normal range, and there was no correlation between thyroid volume and urinary iodine or salt iodine ( P > 0.05). Conclusions:The iodine nutrition of children in Dongshan County and Pingtan County is suitable (100 - 199 μg/L), while iodine deficiency (< 150 μg/L) exists in pregnant women. Urinary iodine in children is related to salt iodine, and urinary iodine increased with increase of salt iodine. The prevalence of thyroid nodules in children of different ages is different, which requires further study. The detection rate of thyroid nodules in children and pregnant women is not correlated with urinary iodine and salt iodine.