[Objective] To retrospectively analyze the detection results of alanine aminotransferase (ALT) unqualified repeat blood donors in Guangzhou, so as to provide evidence for further expanding the repeat blood donor pool, reducing the rate of blood discarding and improving the qualified rate of blood test. [Methods] Blood donors with unqualified ALT in Guangzhou Blood Center from January 2018 to April 2024 were selected as the research objects. The past blood donation and population characteristics were analyzed according to the number of blood donations and ALT unqualified times. [Results] Among repeat blood donors with previous ALT disqualification, 99.5% to 99.7% did not have reactive markers for transfusion-transmitted diseases (TTD), which was higher than the rate among first-time blood donors with unqualified ALT (95.8%) (P<0.05). The rate of single-item ALT disqualification in repeat blood donors was higher in males than in females (P<0.05); it also varied by age (18-25 years > 26-35 years > 36-45 years > over 45 years) (P<0.05); and by quarter (third and fourth quarters > first and second quarters) (P<0.05). The ALT unqualified rate was significantly higher whole blood donors than that of platelet donors and returning blood donors (P<0.05). The overall ALT level (51.0 U/L), individual ALT level (56.0 U/L) and individual ALT unqualified rate (66.7%) of repeat blood donors with multiple ALT disqualifications were higher than those of repeat blood donors with single-item ALT disqualifications (26.0 U/L, 38.5 U/L, and 33.3%, respectively) (P<0.05). Moreover, as the number of ALT disqualifications increased, the overall level of ALT in repeat blood donors also increased (P<0.05), and the average level of individual ALT and individual ALT unqualified ratio tended to increase. Repeat blood donors with frequent ALT disqualifications had higher ALT levels (69.0 U/L). [Conclusion] The ALT unqualified rates of repeat blood donors were mostly non-specific elevation without TTD. Repeat blood donors with multiple ALT disqualifications tend to have continuous high ALT. Moreover, and with the increase of ALT disqualifications times, the overall ALT levels the average individual ALT levels and individual ALT unqualified rates showed an increasing trend.

Objective: To investigate the urban and rural differences in adverse outcomes of pulmonary tuberculosis (PTB) in patients with pulmonary tuberculosis-diabetes mellitus comorbidity (PTB-DM), so as to provide insights into improving the prevention and treatment measures for PTB-DM. Methods: Patients with PTB-DM who were admitted and discharged from 14 designated tuberculosis hospitals in Hangzhou City from 2018 to 2022 were selected. Basic information, and history of diagnosis and treatment were collected through hospital information systems. The adverse outcomes of PTB were defined as endpoints, and the proportions of adverse outcomes of PTB in urban and rural patients with PTB-DM were analyzed. Factors affecting the adverse outcomes of PTB were identified using a multivariable Cox proportional hazards regression model. Results: A total of 823 patients with PTB-DM were enrolled, including 354 (43.01%) urban and 469 (56.99%) rural patients. There were 112 (13.61%) patients with adverse outcomes of PTB. The proportions of adverse outcomes of PTB in urban and rural patients were 14.41% and 13.01%, respectively, with no statistically significant difference (P>0.05). Multivariable Cox proportional hazards regression analysis identified first diagnosed in county-level hospitals or above (HR=2.107, 95%CI: 1.181-3.758) and drug resistance (HR=3.303, 95%CI: 1.653-6.600) as the risk factors for adverse outcomes of PTB in urban patients with PTB-DM, while the treatment/observed management throughout the process (HR=0.470, 95%CI: 0.274-0.803) and fixed-dose combinations throughout the process (HR=0.331, 95%CI: 0.151-0.729) as the protective factors for adverse outcomes in rural patients with PTB-DM. Conclusions There are differences in influencing factors for adverse outcomes of PTB in urban and rural patients with PTB-DM. The adverse outcomes of PTB are associated with first diagnosed hospitals and drug resistance in urban patients, and are associated with the treatment/observed management and fixed-dose combinations throughout the process in rural patients.

Purpose To analyze CT and MRI manifestations of rare primary malignant liver tumors in adults to improve the diagnostic accuracy.Materials and Methods This retrospective study analyzed imaging,clinical and pathological data from 28 patients with pathologically confirmed rare primary malignant liver tumors at the Affiliated Hospital of Zunyi Medical University(April 2011 to July 2024).Clinical presentations,laboratory findings,and CT/MRI characteristics of different tumor types were evaluated.Results The cohort included eight cases of hepatic sarcomatoid carcinoma,eight of primary hepatic lymphoma,six of primary hepatic gastrointestinal stromal tumor,three of intrahepatic biliary cystadenocarcinoma,and three of hepatic adenosquamous carcinoma.Distinct imaging features were observed:all eight sarcomatoid carcinomas presented as solitary,large cystic-solid masses;three showed progressive or persistent enhancement of solid components/septae,with four demonstrating portal vein tumor thrombus.Seven cases of primary hepatic lymphomas appeared as homogeneous,round/oval lesions,with one case restricted diffusion on diffusion weighted imaging,and seven cases exhibited mild homogeneous enhancement;two exhibited the vessel penetration sign;all six primary hepatic gastrointestinal stromal tumors manifested as cystic-solid masses with extensive central necrosis;two showed peripheral pseudocapsules while four had tortuous feeding vessels,with mild-to-moderate persistent enhancement of solid components;all three intrahepatic biliary cystadenocarcinomas occurred in the left lobe,presenting as multilocular cystic lesions with papillary mural nodules showing variable enhancement of walls,septations and nodules;two adenosquamous carcinomas demonstrated irregular morphology with distal biliary dilation and predominant delayed enhancement.Conclusion Imaging diagnosis of rare primary malignant liver tumors remains challenging.While some lesions demonstrate characteristic features,pathological confirmation remains essential for definitive diagnosis.

Purpose To analyze CT and MRI manifestations of rare primary malignant liver tumors in adults to improve the diagnostic accuracy.Materials and Methods This retrospective study analyzed imaging,clinical and pathological data from 28 patients with pathologically confirmed rare primary malignant liver tumors at the Affiliated Hospital of Zunyi Medical University(April 2011 to July 2024).Clinical presentations,laboratory findings,and CT/MRI characteristics of different tumor types were evaluated.Results The cohort included eight cases of hepatic sarcomatoid carcinoma,eight of primary hepatic lymphoma,six of primary hepatic gastrointestinal stromal tumor,three of intrahepatic biliary cystadenocarcinoma,and three of hepatic adenosquamous carcinoma.Distinct imaging features were observed:all eight sarcomatoid carcinomas presented as solitary,large cystic-solid masses;three showed progressive or persistent enhancement of solid components/septae,with four demonstrating portal vein tumor thrombus.Seven cases of primary hepatic lymphomas appeared as homogeneous,round/oval lesions,with one case restricted diffusion on diffusion weighted imaging,and seven cases exhibited mild homogeneous enhancement;two exhibited the vessel penetration sign;all six primary hepatic gastrointestinal stromal tumors manifested as cystic-solid masses with extensive central necrosis;two showed peripheral pseudocapsules while four had tortuous feeding vessels,with mild-to-moderate persistent enhancement of solid components;all three intrahepatic biliary cystadenocarcinomas occurred in the left lobe,presenting as multilocular cystic lesions with papillary mural nodules showing variable enhancement of walls,septations and nodules;two adenosquamous carcinomas demonstrated irregular morphology with distal biliary dilation and predominant delayed enhancement.Conclusion Imaging diagnosis of rare primary malignant liver tumors remains challenging.While some lesions demonstrate characteristic features,pathological confirmation remains essential for definitive diagnosis.

Objective:To construct a simple, precise and personalized comprehensive nomogram for prediction the risk of multidrug-resistant tuberculosis (MDR-TB) and to evaluate its prediction value among individuals with previous tuberculosis history (PTBH).Methods:A matched case-control study (1∶2 ratios) was performed in 1 881 patients with PTBH treated in 12 designated tuberculosis hospitals in Hangzhou City between January 1, 2005 and December 31, 2019, and there were 1 719 patients in training set, and 162 in validation set. A multivariable Cox regression analysis was used to evaluate independent predictors for the incident of MDR-TB in individuals with PTBH. A comprehensive nomogram was developed based on the multivariable Cox model. The accuracy of the prediction was assessed using concordance index (C-index), calibration curve and area under the receiver operator characteristic (ROC) curve.Results:The nomogram constructed based on the multivariable Cox regression model incorporated 10 independent predictors of the risk of MDR-TB. A history of direct contact (grade 1, 0-100.0 points) ranked on the top of all risk factors, followed by duration of positive sputum culture (grade 2, 0-84.5 points), unfavorable treatment outcome (grade 3, 0-52.0 points), human immunodeficiency virus infection (grade 4, 0-48.5 points), retreated tuberculosis history (grade 5, 0-40.0 points), non-standardized treatment regimens of retreated tuberculosis (grade 6, 0-32.5 points), duration of pulmonary cavities (grade 7, 0-31.0 points), passive mode of tuberculosis case finding (grade 8, 0-25.0 points), age<60 years (grade 9, 0-17.5 points), and standard frequencies of chest X-ray examination (grade 10, 0-14.0 points). The C-indexes of this nomogram for the training and validation sets were 0.833 (95% confidence interval ( CI) 0.807-0.859) and 0.871 (95% CI 0.773-0.969), respectively, indicating that the nomogram had good fitting effect. The calibration curves for the risk of incident MDR-TB showed an optimal agreement between nomogram prediction and actual observation in the training and validation sets, respectively.The areas under ROC curve of the 1-year, 5-year, and 10-year MDR-TB risk probability of the training set were 0.904, 0.921, and 0.908, respectively, and those of the validation set were 0.954, 0.970, and 0.919, respectively. Conclusion:Through this nomogram model, clinicians could precisely predict the risk of incident MDR-TB among individuals with PTBH in the clinical practice.

Nine compounds were isolated from the aerial part of Callicarpa kwangtungensis chun by various column chromatographic methods. Their structures were identified as pinnatifidanoid A(1), blumenol C(2), megastigman-5- ene-3β, 9R-diol(3), 3β-hydroxyurs-12-en-28-oic acid(4), kaji-ichigoside F1(5), 1, 4-terephthalic acid(6), syringic acid(7), vanillic acid(8), and 3, 5-dimethoxy-4-methylbenzyl alcohol(9)on the basis of spectral analysis. C13 nor-isoprenoids of 1-3, and compounds 5, 6 and 9, were isolated from the genus Callicarpa for the first time.

Objective To analyze the causes of failed transcatheter closure for ventricular septal defects (VSD)in children. Methods One thousand two hundred and eighty children aged 13 to 141 months who underwent transcatheter closure from June 2009 to September 2013 in Guangdong General Hospital were selected. There were 43 failures(3. 36% ). The clinical data including transthoracic echocardiograph( TTE),radiography,interventional ap-proach and surgical findings were analyzed. Results Forty - three patients included 25 male and 18 female. The pa-tients' ages ranged from 13 to 141(43. 0 ± 31. 9)months and their weight ranged from 10 to 35(16. 3 ± 5. 59)kg. The causes of failure including doubly committed subarterial VSD misdiagnosed as perimembranous VSD(PMVSD)or intracristal VSD were in 6 patients. The size of occluder was too small in 13 cases,and there were statistical differences between three measurements of size of VSD(F = 19. 134,P = 0. 001). The size of VSD measured by left ventricular an-giography was significantly smaller than that measured by TTE,and there was statistical difference[(4. 78 ± 1. 11) mm vs(6. 48 ± 1. 43)mm,t = 4. 50,P = 0. 001]. The dimension of VSD measured by left ventricular angiography was significantly smaller than that measured by surgical findings,and there was statistical difference[(4. 78 ± 1. 11) mm vs(7. 02 ± 1. 08)mm,t = 5. 92,P = 0. 001]. But,the size of VSD measured by TTE had no significant difference compared with that measured by surgical findings(t = 1. 42,P = 0. 168). Aortic regurgitation occurred in 14 cases;atrioventricular block or left bundle branch block in 3 patients;tricuspid stenosis in 2 cases and residual shunt in 5 pa-tients. Conclusions Doubly committed subarterial VSD may be misdiagnosed as PMVSD or intracristal VSD. In the ca-ses of VSD concomitant with aortic valve prolapse,size of the occluders should be referred to VSD dimensions measured by TTE. In the cases of VSD adjacent to aortic valve,suitable occluders should be selected and operation technique should be improved to avoid aortic regurgitation.

We received a patient who repeated unconsciousness due to excrescence locking bicuspid aortic valve. He experienced unconsciousness and treatments with anti infection, surgical operation, valve replacement and recovery. It was a rare case, which made us realize that the heart color Doppler ultrasound should be regularly performed in patients with aortic valve abnormalities. Once patients were found to have infective endocarditis combined with the valve vegetations, they should be formally treated as soon as possible.
Aortic Valve ; abnormalities ; physiopathology ; Echocardiography, Doppler, Color ; Endocarditis, Bacterial ; diagnosis ; Heart Valve Diseases ; physiopathology ; Humans ; Male ; Unconsciousness ; etiology

Objective To analyze the prevalence and risk factors of thyroid nodules in military pilots,to provide basis for prevention and cure of the thyroid nodules on military pilots.Methods Retrospective analysis was on 629 pilots who were in the health examination or transition physical examination in the 456th hospital of PLA.They were grouped by age,body mass index and fasting plasma glucose (FPG) level to compare the difference of detection rate of thyroid nodules among groups.The relationship between suspicious factors and detection rate of thyroid disease was analyzed by Logistic regression analysis.Results The detection rate of thyroid nodules in the 629 pilots was 19.24％.The thyroid nodules were mainly with the diameter smaller than 1 cm (61.16％) and solitary nodule (63.64 ％).The prevalence of nodule was increased with the age and showed statistical significance among age groups (x2 =44.188,P＜0.01).The pilots who had higher body mass index and fasting plasma glucose level showed the higher prevalence than those with the normal,and the difference had statistical significance (x2 =10.980,7.159,P＜0.01).The pilots who were with negative events showed higher prevalence of nodule than those without,and the difference had statistical significance (x2=5.862,P＜0.05).The smoking history,drinking history,aircraft type and flight time were insignificantly influence the prevalence of nodule (P＞0.05).The multiple factor Logistic regression analysis showed that age,fasting plasma glucose level,negative event influence,and body mass index were the influence factors of thyroid nodules (B=0.565-0.723,P＜0.05).Conclusions The prevalence of thyroid nodules is high in pilots,and the small solitary nodule is the main representation.Age,fasting plasma glucose level,negative event influence,and body mass index are the influence factors of thyroid nodules.

Objective To analyze the prevalence and risk factors of thyroid nodules in military pilots,to provide basis for prevention and cure of the thyroid nodules on military pilots.Methods Retrospective analysis was on 629 pilots who were in the health examination or transition physical examination in the 456th hospital of PLA.They were grouped by age,body mass index and fasting plasma glucose (FPG) level to compare the difference of detection rate of thyroid nodules among groups.The relationship between suspicious factors and detection rate of thyroid disease was analyzed by Logistic regression analysis.Results The detection rate of thyroid nodules in the 629 pilots was 19.24％.The thyroid nodules were mainly with the diameter smaller than 1 cm (61.16％) and solitary nodule (63.64 ％).The prevalence of nodule was increased with the age and showed statistical significance among age groups (x2 =44.188,P＜0.01).The pilots who had higher body mass index and fasting plasma glucose level showed the higher prevalence than those with the normal,and the difference had statistical significance (x2 =10.980,7.159,P＜0.01).The pilots who were with negative events showed higher prevalence of nodule than those without,and the difference had statistical significance (x2=5.862,P＜0.05).The smoking history,drinking history,aircraft type and flight time were insignificantly influence the prevalence of nodule (P＞0.05).The multiple factor Logistic regression analysis showed that age,fasting plasma glucose level,negative event influence,and body mass index were the influence factors of thyroid nodules (B=0.565-0.723,P＜0.05).Conclusions The prevalence of thyroid nodules is high in pilots,and the small solitary nodule is the main representation.Age,fasting plasma glucose level,negative event influence,and body mass index are the influence factors of thyroid nodules.