Tesla blood pumps demonstrate a reduced propensity for hemolysis and thrombosis compared with vane blood pumps. Considering the restricted driving force within the secondary flow channel of vane blood pumps, along with the low hydraulic efficiency of conventional Tesla blood pumps and their internal flow characteristics that significantly contribute to hemolysis and thrombosis, this study introduces a set of vanes atop the rotor of the Tesla blood pump. This forms a dual-fluid domain rotor, and an axial dual-outlet volute shell structure is adopted to realize the separation of the fluid domains. Through numerical simulations of the new structure, a comparative analysis was conducted in this study on the internal flow characteristics of double-outlet and single-outlet volute shells, and symmetric and asymmetric cross-sections of the same rotor. The results indicate that the flow field distribution is more uniform under the double-outlet volute shell structure, and overall energy dissipation is decreased. After implementing the double-outlet design, in the asymmetric cross-section, compared with the symmetric cross-section, the fluid velocity gradient and turbulent kinetic energy at the tongue of the septum are reduced, and the fluid velocity gradient at the convergence of the diffuser tube outlets are also decreased. The maximum scalar stress is lower, and the decline in head and efficiency is mitigated. Moreover, compared with the single-outlet volute shell, the hemolysis index in the asymmetric cross-section is reduced. In summary, this paper proposes a novel dual-outlet centrifugal disk blood pumps, which can provide a reference for the structural design and performance optimization of magnetically levitated centrifugal blood pumps.
Heart-Assist Devices ; Humans ; Equipment Design ; Hemolysis ; Computer Simulation

The impeller, as a key component of artificial heart pumps, experiences high shear stress due to its rapid rotation, which may lead to hemolysis. To enhance the hemolytic performance of artificial heart pumps and identify the optimal combination of blade parameters, an optimization design for existing pump blades is conducted. The number of blades, outlet angle, and blade thickness were selected as design variables, with the maximum shear stress within the pump serving as the optimization objective. A back propagation (BP) neural network prediction model was established using existing simulation data, and a grey wolf optimization algorithm was employed to optimize the blade parameters. The results indicated that the optimized blade parameters consisted of 7 impeller blades, an outlet angle of 25 °, and a blade thickness of 1.2 mm; this configuration achieved a maximum shear stress value of 377 Pa-representing a reduction of 16% compared to the original model. Simulation analysis revealed that in comparison to the original model, regions with high shear stress at locations such as the outer edge, root, and base significantly decreased following optimization efforts, thus leading to marked improvements in hemolytic performance. The coupling algorithm employed in this study has significantly reduced the workload associated with modeling and simulation, while also enhancing the performance of optimization objectives. Compared to traditional optimization algorithms, it demonstrates distinct advantages, thereby providing a novel approach for investigating parameter optimization issues related to centrifugal artificial heart pumps.
Neural Networks, Computer ; Algorithms ; Heart-Assist Devices ; Hemolysis ; Humans ; Equipment Design ; Stress, Mechanical ; Computer Simulation

Objective:To study the clinical characteristics of patients with brucella bloodstream infection in different age groups, and provide a basis for clinicians to take targeted diagnosis and treatment measures. Methods:Demographic data and general condition (age, sex, occupation, location, onset season, source of infection, clinical stage), clinical characteristics (main clinical symptoms and complications), and laboratory test results (routine and pathogenic tests) of adult patients with brucella bloodstream infection admitted to the Affiliated Hospital of Chengde Medical College from January 2015 to January 2020 were collected. According to the age stratification standards recommended by the World Health Organization, the patients were divided into a young group (18 - 44 years old), a middle-aged group (45 - 59 years old), and an elderly group (≥60 years old), and various indicators among different age groups were compared and analyzed. Results:A total of 75 patients were included, including 15 cases (20.00%) in the young group, 37 cases (49.33%) in the middle-aged group, and 23 cases (30.67%) in the elderly group. Among them, 61 cases (81.33%) were males and 14 cases (18.67%) were females, with statistically significant differences in gender ratios among different age groups (χ 2 = 7.28, P = 0.021). The majority of patients were farmers (64 cases, 85.33%), and 92.00% (69/75) of the patients came from rural areas. The main sources of infection were infected cattle and sheep, and contaminated food (39 cases, 52.00%). The main season of onset was spring and summer (45 cases, 60.00%). The clinical staging was mainly in the acute phase (66 cases, 88.00%). In terms of clinical symptoms, the young group of patients had no symptoms of low back pain, while the incidence rates of low back pain in the middle-aged and elderly groups were 35.14% (13/37) and 30.43% (7/23), respectively. There was a statistically significant difference between the three groups (χ 2 = 6.98, P = 0.031). In terms of complications, there were no cases of concurrent spondylitis in the young group of patients. The incidence rates of spondylitis in the middle-aged and elderly groups were 32.43% (12/37) and 34.78% (8/23), respectively. There was a statistically significant difference among the three groups (χ 2 = 6.86, P = 0.032). In terms of routine laboratory examinations, there were statistically significant differences in the proportion of blood lymphocytes and albumin levels among patients of different age groups ( F = 3.41, 3.27, P = 0.038, 0.044). In terms of pathogenic examination, there was a statistically significant difference in the median alarm time for positive blood culture among patients of different age groups ( H = 9.54, P = 0.008), with the middle-aged group having the longest (66.24 h) and the elderly group having the shortest (58.80 h). Conclusions:The clinical characteristics of patients with brucella bloodstream infection vary among different age groups, middle-aged and elderly patients are prone to low back pain symptoms, accompanied by spondylitis. Clinicians should pay attention to the patient's own characteristics and provide targeted diagnosis and treatment.

OBJECTIVE: To develop a cell-based system for the diagnosis of vitamin K-dependent coagulation factor deficiency 1 (VKCFD1). METHODS: In HEK293 cells stably expressing the reporter gene FIX-Gla-PC, the gamma-glutamyl carboxylase (GGCX) gene was knocked out by using CRISPR/Cas9 technology. Enzyme-linked immunosorbent assay (ELISA), DNA sequencing and Western blotting were used to identify the GGCX gene knockout cells. A quickchange point variant method was used to construct the GGCX variant. ELISA was used to assess the influence of GGCX variant on the activity of reporter gene. RESULTS: Two monoclonal cell lines with no reporter activity by ELISA was identified. Edition and knockout of the GGCX gene was confirmed by DNA sequencing and Western blotting. The activity of the reporter gene was recovered by transfection of the wild-type GGCX gene. Thereby two monoclonal cells with GGCX knockout were obtained. By comparing the wild-type and pathogenic GGCX variants, the reporter activity was decreased in the pathogenic variants significantly. CONCLUSION A cell-based system for the detection of GGCX activity was successfully developed, which can be used for the diagnosis of VKCFD1 caused by GGCX variants.

ObjectiveTo investigate the value of peripheral blood long non-coding RNA-LET (lncRNA-LET) in the diagnosis of chronic hepatitis B (CHB) cirrhosis, and to provide a basis for early clinical diagnosis and treatment of liver cirrhosis. MethodsA total of 175 CHB patients who attended The Affiliated Hospital of Chengde Medical University from March 2017 to May 2019 were enrolled, among whom 52 patients with hepatitis B cirrhosis were enrolled as cirrhosis group and 123 patients without the pathological changes of liver cirrhosis were enrolled as non-cirrhosis group. A total of 40 healthy individuals who underwent physical examination in our hospital during the same period of time were enrolled as normal control group. Liver function parameters and the level of lncRNA-LET in peripheral blood were measured for all subjects. The t-test was used for comparison of continuous data between two groups; an analysis of variance was used for comparison between multiple groups, and the least significant difference t-test was used for further comparison between two groups. The chi-square test was used for comparison of categorical data between groups, and the Kruskal-Wallis H test was used for comparison of ranked data. A Pearson correlation analysis was performed to investigate correlation. The receiver operating characteristic (ROC) curve was used to investigate the value of peripheral blood lncRNA-LET in predicting liver cirrhosis. Results Compared with the normal control group, the cirrhosis group and the non-cirrhosis group had significantly higher serum levels of the liver function parameters total bilirubin (TBil), total bile acid (TBA), albumin (Alb), and alanine aminotransferase (ALT) (all P＜0.05) and a significantly lower serum level of cholinesterase (ChE) (P＜0.05); compared with the non-cirrhosis group, the cirrhosis group had significantly higher serum levels of TBil, TBA, Alb, and ALT (all P＜0.05) and a significantly lower serum level of ChE (P＜0.05). Compared with the normal control group, the cirrhosis group and the non-cirrhosis group had significantly lower relative expression of lncRNA-LET in peripheral blood (P＜0.05), and the cirrhosis group had significantly lower relative expression of lncRNA-LET in peripheral blood than the non-cirrhosis group (P＜0.05). The relative expression of lncRNA-LET decreased significantly with the increase in liver fibrosis stage (P＜0.05). In the patients with CHB, the relative expression of lncRNA-LET in peripheral blood was negatively correlated with liver fibrosis stage, TBil, TBA, Alb, and ALT (r=-0.352,-0.372,-0.364, and -0.410, all P＜0.001) and was positively correlated with ChE (r=0.340, P＜0.001). The ROC curve was used to analyze the value of peripheral blood lncRNA-LET in predicting liver cirrhosis, and the area under the ROC curve was 0934, with an optimal cut-off value of 0.833, a sensitivity of 84.57%, and a specificity of 80.57%. ConclusionThe expression level of lncRNA-LET in peripheral blood decreases with the progression of liver fibrosis and has a good value in the diagnosis of CHB cirrhosis, and therefore, it can be used as a potential biological indicator for the diagnosis of liver cirrhosis.

Objective: To analyze the epidemiological characteristics of hepatitis E Virus antibody (anti-HEV) in people aged 1-29 years in China in 2014. Methods: Based on database of the national serologic survey of hepatitis B in people aged 1-29 years in China, in 2014, the sample size was estimated. The serum samples of the people surveyed were randomly selected to detect anti-HEV IgG by using enzyme- linked immunosorbent assay (ELISA). Statistical software SAS 9.1.3 was used to calculate the positive rate of anti-HEV and 95% confidence interval (CI) in different age, gender groups, urban and rural areas and geographic areas by using the Taylor series linear method with sampling weight. The difference was determined by comparing 95%CI. Results: A total of 14 106 serum samples were detected from people aged 1-29 years, including 6 996 males (49.60%), 7 013 urban residents (49.72%). The positive rate of anti-HEV was 8.12%(95%CI: 7.19-9.15) in people aged 1-29 years. There was no statistical difference between the men and women, between urban area and rural area. The positive rates of anti-HEV in western area(11.36%, 95%CI: 9.45-13.62) was higher than those in eastern and central areas. The positive rates of anti-HEV were 2.46%, 2.24%, 4.50%, 7.58%, 11.89% and 17.27% in people aged 1-, 5-, 10-, 15-, 20- and 25-29 years, respectively. As the age increased, the positive rate of anti-HEV gradually increased. In different ethnic groups, the positive rate of anti-HEV was higher in Tibetan (18.32%, 95%CI: 12.02-26.90), Zhuang (9.54%, 95%CI: 4.33-19.73) ethnic groups. Conclusion The positive rate of anti-HEV declined slightly in China in 2014. It is still necessary to pay close attention to the HEV infection, morbidity of hepatitis E and risk factors in people aged 1-29 years.

Objective To understand the characteristics of acute hepatitis B inpatients reported by the hepatitis B surveillance pilot points and to estimate the consistency between the diagnosed and reported types of hepatitis B by the clinicians involved.Methods Data related to acute hepatitis B was from the NNDRS and the characteristics of acute hepatitis B were classified by querying Hospital Information System.We recorded the results based on clinical diagnosis and analyzed the consistency between the reported and diagnosed types that the clinicians made,on hepatitis B.Resulis A total of 179 patients were included in this study with all of them as acute hepatitis B reported through NNDRS in 2015-2016.In terms of the durations of disease,among the 179 cases who were HBsAg positive,32.40％ (58/179) of them exceeding 6 months,2.79％ (5/179) within 6 months and 64.80％ (116/179) tested the first time or never.Among the 179 cases who claimed having the history of hepatitis,33.52％ (60/179) of them identified as having hepatitis B,1.12％ (2/179) were hepatitis A,C or E,41.34％ (74/179) did not have the signs on hepatitis,while the rest 24.02％ (43/179) did not know the situation.Only 79.89％(143/179) of the patients showed the symptoms or signs of hepatitis,but the rest 20.11％(36/179) did not.Among the 179 reported acute hepatitis patients,67 of them were diagnosed as acute hepatitis B while 112 cases were as non-acute hepatitis B.The consistent rate of acute hepatitis B was 37.43％ (67/179).Among the 112 cases that were diagnosed as non-acute hepatitis B,proportions of chronic hepatitis B and cirrhosis were 49.11％(55/112) and 16.07％(18/112) respectively.Conclusion Consistency between the reported type of acute hepatitis B inpatients and the types diagnosed by clinicians was poor.Our results suggested that clinicians should make the accurate diagnosis at first place and then report to the Network in accordance with the clinical diagnosis classification criterfia,set by the government.

Objective To analyze the sero-epidemiological features of hepatitis B among children aged 1-14 years old who were born to HBsAg positive mothers.Methods Based on the results from the hepatitis B national sero-survey in 2014,children aged 1-14 years old born to HBsAg positive mother were involved in this study.Positive rates on HBsAg,anti-HBs,anti-HBc by gender,age,nationality,birth place,residency (urban/rural),region (eastern/central/western) and related factors of HBsAg and anti-HBs for children under research,were analyzed by SPSS 18.0 statistical software.Results A total of 645 children aged 1-14 years old that born to HBsAg positive mothers were analyzed in the study.Positive rates on HBsAg,anti-HBs,anti-HBc among these children were 3.41％ (22/645),71.94％ (464/645) and 7.60％ (49/645),respectively.HBsAg positive rates for children aged 1-2 years,3-4 years,5-9 years,10-14 years appeared 1.27％ (3/236),3.23％ (6/186),5.71％ (8/140) and 6.02％ (5/83),respectively.The anti-HBs positive rates were 85.17％ (201/236),69.35％ (129/186),56.43％ (79/140),66.27％ (55/83) while the anti-HBc positive rates were 4.66％ (11/236),5.38％ (10/186),11.43％ (16/140) and 14.46％ (12/83),respectively.Results from the multifactor logistic analysis showed that birth place,time of the first dose of HepB inoculation were major influencing factors on the positive rates among children with HBsAg.HBsAg positive rate for the children born outside the hospital was higher than those born in the hospital (OR=7.47,95％ CI:1.50-37.25).HBsAg positive rate for children with the first dose of HepB inoculation＞24 h after birth,was higher than that inoculation within 24 h after birth (OR=6.21,95％ CI:2.15-17.99).Conclusions Some achievements in preventing mother-to-child transmission of hepatitis B had been seen in China.Hospital delivery for pregnant women and timely HepB vaccination with birth-dose for the neonates,remained the key strategy on prevention of HBV vertical transmission.

Objective To compare the antibody persistence 5 years after primary immunization with 5 μg and 10 μg recombinant hepatitis B vaccine (HepB) among newborns with normal and high response.Methods Newborns who completed three doses of 5 μ g HepB made by recombinant dexyribonucleic acid technique in Saccharomyces (HepB-SC) or 10 μg HepB made by recombinant dexyribonucleic acid technique in Hansenula polymorpha (HepB-HP) were recruited.Standardized questionnaire was used and blood samples were collected 1-6 months (T0) and five years (T1) after the third dose respectively.The titer of anti-HBs was detected by chemiluminescence microparticle imunoassay (CMIA).Those who achieved normal or high antibody response (anti-HBs titer ≥100 mIU/ml) were included in the study and the positive rate (≥ 10 mIU/ml) and titer of anti-HBs at T1 were compared between 5 μg HepB group and 10 μg HepB group.Multivariable analysis was conducted to identify the independent factors associated with the antibody persistence.Results The positive rate of anti-HBs at T1 was 49.92％ (943/1 883) and 75.92％ (1 135/1 495) respectively in 5 μg HepB group and 10 μg HepB group,the difference was significant (x2=237.75,P＜0.001).The anti-IBs geometric mean concentrations at T1 were 10.23 mIU/ml (95％CI:9.38-11.16) and 28.91 mIU/ml (95％CI:26.65-31.35) in the two groups respectively,the difference was also significant (F=280.36,P＜0.001).Among those whose anti-HBs titer was ＜ 10 mIU/ml at T1,the distributions of anti-HBs titer were significantly different between 5 μg HepB group and 10 μg HepB group (x2=39.75,P＜ 0.001).The multivariable analysis showed that dosage of HepB was independently associated with both positive rate and titer of anti-HBs at T1 after excluding the other factors [P＜0.001,OR=1.44(95％ CI:1.20-1.73);P＜0.001,β =0.27 (95％ CI:0.14-0.40)].Conclusion Five year anti-HBs persistence after primary immunization with 10 μg HepB might be better than that after primary immunization with 5 μg HepB among infants who achieved normal or high anti-HBs response after primary HepB immunization.

Objective: To analyze the sero-epidemiological characteristics of hepatitis B virus among people born during 1994-2001, conducted by the national hepatitis B sero-epidemiological surveys in 2006 and 2014. Methods: Based on the data of the two national hepatitis B sero-epidemiological surveys in 2006 and 2014, people born during 1994-2001 were included into our analysis as this study subjects. The two surveys were conducted in 160 disease surveillance points of 31 provinces (not including Hong Kong, Macao and Taiwan) in China. Face-to-face interviews with the subject by door to door or on the investigation site were conducted by trained staff using standard questionnaires to obtain basic information including birth date, sex, ethnicity, resident place and so on. And then 5 ml venous blood was collected. Enzyme-linked immunosorbent assay (ELISA) reagents were used for HBsAg, anti-HBs and anti-HBc measurements and Abbott micro-particle enzyme immunoassay (MEIA) reagents was used to confirm test. We analyzed HBsAg, anti-HBs and anti-HBc positive rate by gender, ethnicity, urban/rural, eastern/central/western region, birth years and compared the distribution of serum epidemiological characteristics in 2006 and 2014. Results: 19 821 and 4 712 people born during 1994-2001 were involved in 2006 and 2014 national serosurveys of China, respectively. For the people born during 1994-2001, HBsAg positive rate were 2.02% (95% CI: 1.82%-2.21%) in 2014 and 1.95% (95% CI: 1.56%-2.35%) in 2006. Anti-HBc positive rate were 7.94% (95%CI: 7.17%-8.71%) in 2014 and higher than that in 2006 (6.49%, 95%CI: 6.15%-6.83%), especially for the female (8.31%, 95% CI: 7.20%-9.43%), urban (7.45%, 95% CI: 6.38%-8.52%), western region (11.25%, 95%CI: 9.79%-12.71%), minority people (16.02%, 95%CI: 13.47%-18.57%) in 2014 were higher than that of the female (6.29%, 95% CI: 5.81%-6.78%), urban (4.82%, 95% CI: 4.40%-5.24%), western region (7.97%, 95% CI: 7.31%-8.63%), minority people (11.88%, 95% CI: 10.66%-13.00%) in 2006 respectively. Anti-HBs positive rate were 57.80% (95%CI: 57.11%-58.48%) in 2014 and 59.13% (95%CI: 57.72%-60.53%) in 2006. Anti-HBs positive rate of rural (58.80%, 95% CI: 56.83%-60.78%),western region (58.50%, 95% CI: 56.23%-60.78%), minority people (57.20%, 95% CI: 53.76%-60.63%) in 2014 was higher than of rural (52.62%, 95% CI: 51.64%-53.61%),western region (51.73%, 95% CI: 50.54%-52.96%),minority people (41.14%, 95%CI: 39.28%-43.00%) in 2006. Conclusion Anti-HBc positive rate among people born during 1994-2001 in 2014 survey showed a rising tendency than in 2006. The risk of HBV infection was existed. Hepatitis B vaccine catch-up in childhood was necessary.