Objective To analyze the distribution of platelet antibodies in hospitalized patients and explore the clinical significance of platelet antibody detection. Methods A total of 95 987 hospitalized patient cases from a tertiary hospital in Xi'an from April 1, 2021 to December 31, 2023 were collected. Platelet antibodies were detected by solid-phase agglutination method. Statistical analysis was performed on variables including gender, age, blood type, department, history of blood transfusion, pregnancy history, and disease type. Results Among 95 987 hospitalized patients, the positive rate of platelet antibody detection reached 4.35%. The positive rate of platelet antibodies in female hospitalized patients (5.29%) was higher than that in male patients (3.31%), and the difference was statistically significant (x²=224.124). The positive rate of platelet antibodies in those with pregnancy history (7.92%) was higher than that in those without pregnancy history (4.19%), and the difference was significant (x²=292.773). Similarly, the positive rate of platelet antibodies in those with transfusion history (7.79%) was higher than that in those without transfusion history (3.97%), and the difference was significant (x²=300.209). There was a significant correlation between the positive rate of platelet antibodies and the number of pregnancies (x²=91.061). Conclusion The positive rate of platelet antibodies in 95 987 inpatient cases was 4.35%. The positive rate of platelet antibodies had a close relationship with a history of blood transfusions and pregnancies, and it increased with the number of pregnancies. For patients with multiple transfusion histories and pregnancy histories, screening for platelet antibodies holds significant diagnostic value.
Humans ; Female ; Male ; Adult ; Middle Aged ; Blood Platelets/immunology* ; Inpatients ; Aged ; Pregnancy ; Young Adult ; Adolescent ; Aged, 80 and over ; Autoantibodies/blood*

This study reports the diagnosis and treatment of a 26-year-old pregnant woman with severe malnutrition combined with acute pyelonephritis causing sepsis, refractory septic shock and multiple organ failure. A female patient, 26 years old, was admitted to hospital mainly due to "menelipsis for more than 19 weeks, nausea and vomiting for 20 days, fever with fatigue for 3 days". At the end of 19 weeks of intrauterine pregnancy, the patient presented with fever accompanied by urinary tract irritation. Laboratory tests showed elevated inflammatory indicators, and ultrasonography showed bilateral pelvicalyceal dilation. She was diagnosed with acute pyelonephritis, sepsis, acute kidney injury (AKI) and severe malnutrition. After a whole-hospital consultation, the patient was treated with meropenem and vancomycin as antimicrobial therapy, and bilateral nephrostomy drainage was performed simultaneously. After that, the patient suffered a sudden decrease in blood pressure, blood oxygen saturation, and rapid heart rate. Septic shock with multiple organ dysfunction was considered, and she was transferred to intensive care unit (ICU) immediately. After the patient was transferred to ICU, emergency tracheal intubation and ventilator-assisted ventilation were performed. Rapid fluid resuscitation was administered for the patient. While pulse indicator continuous cardiac output (PICCO) monitoring was performed, norepinephrine, terlipressin, and methylene blue were administered to maintain peripheral vascular resistance. Since the patient developed septic cardiomyopathy and cardiogenic shock later, levosimendan and epinephrine were admi-nistered to improve cardiac function. While etiological specimens were delivered, meropenem, teicoplanin and caspofungin were given as initial empiric antimicrobial therapy. Unfortunately, the intrauterine fetal death occurred on the night of admission to ICU. On the 3rd day of ICU admission, a still-born child was delivered vaginally with 1/5 defect of the fetal membrane. On the 6th day of ICU admission, the patient had fever again with elevated inflammatory indicators. After excluding infection in other parts, intrau-terine infection caused by incomplete delivery of fetal membrane was considered. Then emergency uterine curettage was performed and the infection gradually improved. Later the laboratory results showed that the nephrostomy drainage was cultured for Escherichia coli and uterine, cervical and vaginal secretions were cultured for Candida albicans. Due to severe infection and intrauterine incomplete abortion, the patient developed disseminated intravascular coagulation (DIC). Active antimicrobial therapy and blood product supplement were given. However, the patient was critically ill with significant decrease in hemoglobin and platelets combined with multiple organ failure. Thrombotic microangiopathy (TMA) was not excluded yet, so plasma exchange was performed for the patient in order not to delay treatment. The patient underwent bedside continuous renal replacement therapy (CRRT) for AKI. The patient was complicated with acute liver injury, and the liver function gradually returned to normal after liver protection, antimicrobial therapy and other treatments. Due to the application of large doses of vasoactive drugs, the extremities of the patient gradually developed cyanosis and ischemic necrosis. Local dry gangrene of the bilateral toes remained at the time of discharge. In general, the patient suffered from septic shock, cardiogenic shock, combined with DIC and multiple organ dysfunction. After infection source control, antimicrobial therapy, uterine curettage, blood purification treatment, nutritional and metabolic support, the patient was discharged with a better health condition.
Humans ; Female ; Pyelonephritis/complications* ; Pregnancy ; Adult ; Multiple Organ Failure/etiology* ; Shock, Septic/etiology* ; Sepsis/etiology* ; Pregnancy Complications ; Pregnancy Complications, Infectious ; Malnutrition/complications*

Objective:To understand the current situation of spiritual nursing needs in elderly patients with primary glaucoma and its influencing factors, and to analyze its relationship with self-perceived burden and perceived social support, so as to provide a theoretical basis for reducing their spiritual distress and pain and meeting their spiritual nursing needs.Methods:A total of 218 elderly patients with primary glaucoma who were hospitalized in the department of ophthalmology of the First Hospital of Jilin University from March to September, 2022 were selected by convenience sampling. They were investigated by using general information questionnaire, the Nurse Spiritual Therapeutics Scale, the Self-Perceived Burden Scale, and the Perceived Social Support Scale. And multiple linear regression was used to analyze the influencing factors of spiritual nursing needs among elderly patients with primary glaucoma.Results:The total score of spiritual nursing needs of elderly patients with primary glaucoma was (30.73 ± 4.85). The highest dimension of item average score was "building a good atmosphere" (3.02 ± 0.59), and the lowest dimension was "helping religious practice" (1.95 ± 0.63). The total scores of spiritual nursing needs and self-perceived burden were negatively correlated ( r=-0.423, P<0.01), and positively correlated with the total scores of perceived social support ( r=0.515, P<0.01). Multivariate linear regression analysis showed that age, religious belief, educational level, treatment duration, residence, self-perceived burden, and perceived social support were the main influencing factors of spiritual care needs of elderly patients with primary glaucoma, ( t values were -5.23-7.04, all P<0.01), which could explain 44.5% of the total variation. Conclusions:The spiritual nursing needs of elderly patients with primary glaucoma were at a medium level. Therefore, it is recommended that nurses should carry out targeted spiritual nursing for them according to the differences and characteristics of different patients, to reduce their self-perceived burden, and to improve perceived social support level, in order to meet their spiritual nursing needs.

Objective:To understand the evaluation of 90 pharmaceutical service posts by pharmacists in hospitals, so as to provide basis for rational allocation of pharmaceutical personnel in hospitals.Methods:A questionnaire survey was conducted among 2 582 hospital pharmacists in 31 provinces from August 2019 to April 2020. The survey contents included post classification, staffing qualification and scores related to drug safety.Results:Among the 90 pharmaceutical posts investigated, there were 39 posts with a safety correlation score of 5(the highest score), 36 with 4 and 15 with 3. There were 41 posts in advanced pharmaceutical care and 49 posts in basic pharmaceutical care. The minimum qualifications required was 21 posts with pharmacy related college degree or assistant pharmacist, 61 posts with pharmacy related or clinical pharmacy bachelor degree or pharmacist title, and 8 posts with higher qualification. Advanced pharmaceutical care posts had high drug safety relevance scores and high personnel qualification requirements, mainly involving drug treatment, scientific research and comprehensive management posts.Conclusions:Pharmacists with different qualifications should be allocated according to different levels of pharmaceutical care projects, which can reasonably allocate limited human resources and make the best of their talents.

【Objective】 To explore the effects of nerve growth factor （NGF） on bladder function and axon injury repair in rats with traumatic spinal cord injury （t-SCI） so as to explore its molecular mechanism. 【Methods】 Traumatic spinal cord injury model was constructed in 30 male SD rats by modified Allen’s beating method. The rats were randomly divided into sham-operation group， injury group and NGF group， with 10 rats in each group. We used the BBB score to observe the motor function of the rats’ hind limbs before and after the operation. The BL-420 biometer experimental system detected the urodynamics. Six anterior roots of the left lumbar taken from the distal end of the anastomosis were stained with toluidine blue， and the number of myelinated axons was counted. We used HE to stain rat bladder tissue， TUNEL to stain the rats’ severely injured spinal cord， and observed the spinal cord apoptosis rate. Western blotting was used to detect the protein expressions of Raf-1， p-MEK-2， MEK-2， ERK1/2， and p-ERK1/2 in spinal cord tissue. 【Results】 The BBB score results showed that there was no difference in the scores of the sham-operation group， the injury group and the NGF group before the operation. After the operation， the scores of the injury group and the NGF group were significantly lower than those in the sham-operation group （P<0.05）. The maximum detrusive pressure and the number of axons were significantly lower in the injury group than in the sham-operation group and the NGF group （P<0.05）， but the residual urine volume and bladder cell apoptosis rate in the injury group were notablely higher than those in the other two groups （P<0.05）. HE staining results showed that bladder edema in the injury group was severe and the detrusor muscle structure was loose， while the NGF group had reduced bladder injury. Western blot results showed that the protein ratio of p-ERK1/2/ERK1/2 and p-MEK-2/MEK-2 and the expression of Raf-1 in the injury group were significantly higher than those in the sham operation group and NGF group （P<0.05）. However， there was no significant difference between the sham operation group and the NGF group in maximum detrusive pressure， the number of myelin axons， residual urine volume， bladder cell apoptosis rate， or protein （P>0.05）. 【Conclusion】 NGF may hinder the conduction of MAPK/ERK pathway， thereby affecting the repair of axon damage and improving the bladder function of t-SCI rats.

OBJECTIVE: To investigate the feasibility of using 8-hydroxy-2'deoxyguanosine(8-OHdG) in blood and urine samples as biomarkers for the evaluation of human DNA oxidative damage caused by diesel exhaust(DE). METHODS: A convenient sampling method was used to select 56 male workers exposed to DE in a car manufacturing factory as exposure group, and 52 male workers without exposure to DE were selected as the control group.Urine samples and blood samples were collected from workers in the 2 groups 8 hours after work, and the levels of 8-OHdG in urine and plasma were measured by ultra-high performance liquid chromatography tandem mass spectrometer. RESULTS: The median level of urinary 8-OHdG in the exposure group was higher than that of control group(2.54 vs 2.03 μg/g Cr, P<0.05). The median levels of plasma 8-OHdG in the exposure group and control group showed no statistical significance(32.20 vs 31.40 ng/L, P>0.05). CONCLUSION: The urinary 8-OHdG can be used as a biomarker for evaluating the oxidative damage induced by DE exposure.

Objective: To analyze the current status of anticoagulant therapy for in-hospital patients with acute coronary syndromes (ACS) at county hospitals of China and to explore the relationship between anticoagulant therapy and clinical outcomes in real medical environment. Methods: 99 county hospitals from15 provinces of China were selected for this prospective registry study and 12373 eligible ACS patients without interventional therapy admitted from 2011-09 to 2014-06 were enrolled. The basic condition, previous history, initial assessment, anticoagulants (unfractionated heparin/low molecular weight heparin) application, severe bleeding events and in-hospital mortality were collected in all patients. Multiple logistic regression analysis was conducted to explore the relationship between anticoagulant therapy and clinical outcomes including in-hospital mortality, severe bleeding events and combined endpoints; meanwhile, possible confounders were adjusted. Results: A total of 9985/12373 ACS patients received anticoagulant therapy and 2388 did not. Anticoagulant therapy was conducted in 92.7% (4237/4570) patients with ST-segment elevation myocardial infarction (STEMI), 90.8% (1639/1805) with non-ST-segment elevation myocardial infarction (NSTEMI) and 68.5% (4109/5998) with unstable angina (UA); there were differences by regions and genders,P<0.01and no difference by age. Multivariable analysis indicated that anticoagulant therapy decreased the risk of in-hospital mortality in ACS patients at 53% (OR= 0.47, 95% CI 0.36-0.62), such reduction in STEMI patients was at 55% (OR=0.45, 95% CI 0.32-0.64), in NSTEMI patients was at 58% (OR=0.42, 95% CI 0.24-0.75); while it had no real effect in UA patients,P>0.05. Meanwhile, it did not increase the risk of severe bleeding events in ACS patients,P>0.05. Conclusion: Anticoagulant therapy has been widely used in STEMI and NSTEMI patients at county hospitals of China and obviously decreased the in-hospital mortality; while the application rate was relatively low in UA patients. The general safety of anticoagulant therapy has been good in ACS patients.

Objective To investigate the effect of Erhuang decoction on TGF-β1 expression of lung tiusses and the concentrations of IL-33 in asthmatic rats. Methods Fifty Sprague-Dawley rats were randomly divided into five groups equally:Control group, Asthmatic group, Budesonide aerosol group, High-dose Erhuang decoction group ( 68 g/kg)and Low-dose Erhuang decoction group(17 g/kg). The model of asthma was established by ovalbumin (OVA) sensitizing and challeng-ing. Then Erhuang decoction and budesonide aerosol was used respectively for intervention therapy. Histologic HE staining were used to observe the general pathologic alteration and to analyze the total bronchial wall area (Wat) and the muscle wall area(Wam). The protein expressions of TGF-β1 in the lung tissues were detected by immunohistochemistry. The concentra-tions serum IL-33 and BALF were tested by sandwich ELISA. Results There was significant reduction in the infiltrated inflammatory cells in all drug intervention groups compared with asthma group;The Wat and Wam in asthmatic group was significantly higher in than those in Budesonide aerosol group,High-dose Erhuang decoction group and Low-dose Erhuang decoction group ( Watμm2/μm:54.99±8.82, 52.28±7.61, 58.53±7.63 vs 79.50±5.64, P＜0.05;Wamμm2/μm:22.74±2.73, 20.63±1.72, 21.20±4.50 vs 30.16±1.68, P＜0.05);Compared with control group, BALF and serum IL-33 concentration were significantly higher in asthmatic group. Compared with asthmatic group, all the indicators were significantly decrease in the treatment groups after drug intervention (P＜0.05). Andthere was no significant difference between the treatment groups in all the indicators. TGF-β1 expression in lung tissues in asthmatic group were significantly higher than that in control group (12.60 ± 2.25 vs 1.67 ± 0.17). Compared with asthmatic group, there was significantly reduction of TGF-β1 expression in the Budesonide aerosol group (5.51±2.48), High-dose Erhuang decoction group (5.22±2.52) and Low-dose Erhuang decoction group (6.92 ±2.18) (P＜0.05). There were no significant difference between the treatment groups. TGF-β1 expression and se-rum IL-33 concentration in asthmatic rats were positively correlated with Wat and Wam. Conclusion The effects of Er-huang decotion on ameliorating the progression of airway remodeling about asthmatic rats may be partially by regulating TGF-β1 and IL-33.