[Objective] To explore the strategy of blood management in patients with massive transfusion in the frigid plateau region. [Methods] The treatment process of a patient with liver rupture in the frigid plateau region was analyzed, and the blood management strategy of the frigid plateau region was discussed in combination with the difficulties of blood transfusion and literature review. [Results] The preoperative complete blood count (CBC) test results of the patient were as follows: RBC 3.14×10¹²/L, Hb 10⁶ g/L, HCT 30.40%, PLT 115.00×10⁹/L; coagulation function: PT 18.9 s, FiB 1.31 g/L, DD > 6 μg/mL, FDP 25.86 μg/mL; ultrasound examination and imaging manifestations suggested liver contusion and laceration / intraparenchymal hematoma, splenic contusion and laceration, and massive blood accumulation in the abdominal cavity; it was estimated that the patient's blood loss was ≥ 2 000 mL, and massive blood transfusion was required during the operation; red blood cell components were timely transfused during the operation, and the blood component transfusion was guided according to the patient's CBC and coagulation function test results, providing strong support and guarantee for the successful treatment of the patient. The patient recovered well after the operation, and the CBC test results were as follows: RBC 4.32×10¹²/L, Hb 144 g/L, HCT 39.50%, PLT 329.00×10⁹/L; coagulation function: APTT 29.3 s, PT 12.1 s, FiB 2.728 g/L, DD>6 μg/mL, FDP 25.86 μg/mL. The patient was discharged after 20 days, and regular follow-up reexamination showed no abnormal results. [Conclusion] Individualized blood management strategy should comprehensively consider the patient’s clinical symptoms, the degree of hemoglobin decline, dynamic coagulation test results and existing treatment conditions. Efficient and reasonable patient blood management strategies can effectively improve the clinical outcomes of massive transfusion patients in the frigid plateau region.

Objective:To evaluate the effect of urethral stent tube irrigation in preventing postoperative complications in adolescents with hypospadias.Methods:A retrospective analysis was conducted using the clinical data of adolescents with hypospadias treated at the Department of Urology, Children’s Hospital of Chongqing Medical University, from April 2016 to July 2023. Patients were divided into control group and study group according to whether urethral stent tube was inserted in urethra during operation. All surgeries were performed by the same surgeon. For two days before surgery, patients were instructed to cleanse the surgical site daily with body wash and a 5% povidone-iodine solution. In the control group, patients received postoperative care with an indwelling urinary catheter. In the study group, in addition to the urinary catheter, a urethral stent tube was placed in the posterior urethra, and postoperative urethral irrigation with saline was performed. Postoperative complications, including wound infection, urethral fistula, urethral stricture, and urethral diverticulum, were monitored. Categorical data were expressed as frequencies and percentages and were analyzed using the χ2 test or Monte Carlo-based χ2 test. Continuous data with normal distribution are presented as Mean±SD and were analyzed using the t-test. Non-normally distributed continuous data were expressed as M ( Q1, Q3) and were analyzed using the Wilcoxon rank-sum test. P<0.05 was considered statistically significant. Results:A total of 76 patients were enrolled in the study, with 43 patients in the control group [median age 12.9(12.2, 13.7) years, reconstructed urethral length (3.88±1.86) cm] and 33 patients in the study group [median age 12.5(11.3, 14.1) years, reconstructed urethral length (3.30±1.45)cm]. Postoperatively, 32 patients (74.4%) in the control group experienced complications, including 24 cases (55.8%) of wound infection, 16 cases (37.2%) of urethral fistula, 6 cases (14.0%) of urethral stricture, and 2 cases (4.7%) of diverticulum. In the study group, only 1 patient (3.0%) developed both wound infection and urethral fistula. The incidence of wound infection, urethral fistula, and overall complications was significantly lower in the study group than in the control group (all P<0.01). Conclusion:Postoperative urethral stent irrigation in adolescents with hypospadias significantly reduces the incidence of wound infection and urethral fistula.

To address the shortcomings of traditional hydrogels in terms of mechanical performance and environmental stability,a new conductive organogel based on polyvinyl alcohol(PVA)and polypyrrole(PPy)was prepared in this study.By introducing dimethyl sulfoxide(DMSO)as a solvent,the mechanical strength and durability of the gel were significantly improved.Various characterization techniques,including infrared spectroscopy,thermogravimetric analysis,and scanning electron microscopy were used to characterize this conductive organogel.The experimental results showed that the prepared organogel exhibited optimal performance at PVA concentration level of 8%(m/m),with an average pore size of 5.2 μm and a conductivity of 0.65 S/cm.As a wearable strain sensor,the PVA/PPy organogel demonstrated excellent sensitivity and responsiveness,capable of precisely detecting joint and muscle movements as well as subtle physiological signals such as pulse and vocal cord vibrations.Notably,the gel maintained stable sensing performance even after 48 h at room temperature,showing outstanding environmental adaptability and long-term use potential.This innovative material design provided robust technical support for smart healthcare,health monitoring,and human-machine interaction,showing broad application prospects.

Objective:To evaluate the effect of urethral stent tube irrigation in preventing postoperative complications in adolescents with hypospadias.Methods:A retrospective analysis was conducted using the clinical data of adolescents with hypospadias treated at the Department of Urology, Children’s Hospital of Chongqing Medical University, from April 2016 to July 2023. Patients were divided into control group and study group according to whether urethral stent tube was inserted in urethra during operation. All surgeries were performed by the same surgeon. For two days before surgery, patients were instructed to cleanse the surgical site daily with body wash and a 5% povidone-iodine solution. In the control group, patients received postoperative care with an indwelling urinary catheter. In the study group, in addition to the urinary catheter, a urethral stent tube was placed in the posterior urethra, and postoperative urethral irrigation with saline was performed. Postoperative complications, including wound infection, urethral fistula, urethral stricture, and urethral diverticulum, were monitored. Categorical data were expressed as frequencies and percentages and were analyzed using the χ2 test or Monte Carlo-based χ2 test. Continuous data with normal distribution are presented as Mean±SD and were analyzed using the t-test. Non-normally distributed continuous data were expressed as M ( Q1, Q3) and were analyzed using the Wilcoxon rank-sum test. P<0.05 was considered statistically significant. Results:A total of 76 patients were enrolled in the study, with 43 patients in the control group [median age 12.9(12.2, 13.7) years, reconstructed urethral length (3.88±1.86) cm] and 33 patients in the study group [median age 12.5(11.3, 14.1) years, reconstructed urethral length (3.30±1.45)cm]. Postoperatively, 32 patients (74.4%) in the control group experienced complications, including 24 cases (55.8%) of wound infection, 16 cases (37.2%) of urethral fistula, 6 cases (14.0%) of urethral stricture, and 2 cases (4.7%) of diverticulum. In the study group, only 1 patient (3.0%) developed both wound infection and urethral fistula. The incidence of wound infection, urethral fistula, and overall complications was significantly lower in the study group than in the control group (all P<0.01). Conclusion:Postoperative urethral stent irrigation in adolescents with hypospadias significantly reduces the incidence of wound infection and urethral fistula.

Objective:To explore the difference of lymphocyte subsets in peripheral blood(PB)between aplastic anemia(AA)and hypoplastic myelodysplastic syndrome(hypo-MDS)patients,meanwhile to compare the clinical parameters obtained from PB and bone marrow(BM).Methods:The lymphocyte subsets in hypo-MDS(n=25)and AA(n=33)patients were investigated by flow cytometry.Meanwhile,the differences in PB cell counts,biochemical indicators,BM cell counts and abnormal chromosomes between the two groups were analyzed.Results:The percentage of CD8+T cells in A A group was significantly higher than that in hypo-MDS group(P=0.001),while the percentage of CD4+T cells and the CD4+/CD8+ratio in AA group were obviously lower than those in hypo-MDS group(P=0.015 and0.001,respectively).Furthermore,the proportion of CD4+andCD8+activated T(TA)cells,and memory Tregs in AA group was distinctly lower than those in hypo-MDS group(P=0.043,0.015 and 0.024,respectively).Nevertheless,the percentage of CD8+naive T(TN)cells in AA patients was remarkably higher(P=0.044).And hypo-MDS patients had declined lymphocyte counts(P=0.025),increased levels of total bilirubin(TBil),lactate dehydrogenase(LDH),vitamin B12 and proportion of BM blasts than AA patients(P=0.019,0.023,0.027 and 0.045,respectively).Conclusion:In this study it was confirmed that the percentages of CD4+and CD8+TA cells,memory Tregs and CD8+TN cells were significantly different between AA and hypo-MDS patients,which provide an essential basis for the identification of these two diseases.

Humans ; Diabetes Mellitus, Type 2/epidemiology* ; Air Pollution/adverse effects* ; Air Pollutants/toxicity* ; Risk Assessment ; Particulate Matter ; Environmental Exposure

OBJECTIVE: To explore the clinical characteristics and prognosis of multiple myeloma(MM) patients with secondary primary malignancies. METHODS: The clinical data of newly diagnosed MM patients admitted to the First Affiliated Hospital of Zhengzhou University from January 2011 to December 2019 were retrospectively analyzed. The patients with secondary primary malignancies were retrieved, and their clinical features and prognosis were evaluated. RESULTS: A total of 1 935 patients with newly diagnosed MM were admitted in this period, with a median age of 62 (18-94) years old, of which 1 049 cases were hospitalized twice or more. There were eleven cases with secondary primary malignancies (the incidence rate was 1.05%), including three cases of hematological malignancies (2 cases of acute myelomonocytic leukemia and 1 case of acute promyelocytic leukemia) and eight cases of solid tumors (2 cases of lung adenocarcinoma, and 1 case each of endometrial cancer, esophageal squamous cell carcinoma, primary liver cancer, bladder cancer, cervical squamous cell carcinoma, and meningioma). The median age of onset was 57 years old. The median time between diagnosis of secondary primary malignancies and diagnosis of MM was 39.4 months. There were seven cases with primary or secondary plasma cell leukemia, the incidence rate was 0.67%, and the median age of onset was 52 years old. Compared with the randomized control group, the β2-microglobulin level in the secondary primary malignancies group was lower (P=0.028), and more patients were in stage I/II of ISS (P=0.029). Among the 11 patients with secondary primary malignancies, one survived, ten died, and the median survival time was 40 months. The median survival time of MM patients after the secondary primary malignancies was only seven months. All seven patients with primary or secondary plasma cell leukemia died, with a median survival time of 14 months. The median overall survival time of MM patients with secondary primary malignancies was longer than that of the patients with plasma cell leukemia (P=0.027). CONCLUSION The incidence rate of MM with secondary primary malignancies is 1.05%. MM patients with secondary primary malignancies have poor prognosis and short median survival time, but the median survival time is longer than that of patients with plasma cell leukemia.
Humans ; Middle Aged ; Aged ; Aged, 80 and over ; Multiple Myeloma/complications* ; Leukemia, Plasma Cell ; Retrospective Studies ; Esophageal Neoplasms/complications* ; Esophageal Squamous Cell Carcinoma/complications* ; Prognosis ; Neoplasms, Second Primary

OBJECTIVE: To evaluate the feasibility and tolerability of metoprolol standard dosing pathway (MSDP) in Chinese patients with acute coronary syndrome (ACS). METHODS: In this multicenter, prospective, open label, single-arm and interventional study that was conducted from February 2018 to April 2019 in fifteen Chinese hospitals. A total of 998 hospitalized patients aged ≥ 18 years and diagnosed with ACS were included. The MSDP was applied to all eligible ACS patients based on the standard treatment recommended by international guidelines. The primary endpoint was the percentage of patients achieving the target dose at discharge (V2). The secondary endpoints included the heart rate and blood pressure at V2 and four weeks after discharge (V4), and percentage of patients experiencing bradycardia (heart rate < 50 beats/min), hypotension (blood pressure < 90/60 mmHg) and transient cardiac dysfunction at V2 and V4. RESULTS: Of the 998 patients, 29.46% of patients achieved the target dose (≥ 95 mg/d) at V2. The total population was divided into two groups: target group (patients achieving the target dose at V2) and non-target group (patients not achieving the target dose at V2). There was significant difference in the reduction of heart rate from baseline to discharge in the two groups (-4.97 ± 11.90 beats/min vs. -2.70 ± 9.47 beats/min, P = 0.034). There was no significant difference in the proportion of bradycardia that occurred in the two groups at V2 (0 vs. 0, P = 1.000) and V4 (0.81% vs. 0.33%, P = 0.715). There was no significant difference in the proportion of hypotension between the two groups at V2 (0.004% vs. 0.004%, P = 1.000) and V4 (0 vs. 0.005%, P = 0.560). No transient cardiac dysfunction occurred in two groups during the study. A total of five adverse events (1.70%) and one serious adverse event (0.34%) were related to the pathway in target group. CONCLUSIONS In Chinese ACS patients, the feasibility and tolerability of the MSDP have been proved to be acceptable.

Oxidative Phosphorylation ; Acetylglucosamine ; Uridine Diphosphate N-Acetylglucosamine/metabolism*