1.Practical research on the reform of diagnostics experiment teaching for intelligent medical engineering assisted by outcome-based education
Yanfeng WANG ; Yin LIU ; Quanle GUO ; Guoxing ZHAO
Chinese Journal of Medical Education Research 2025;24(7):933-939
In response to issues in diagnostics experiment teaching for intelligent medical engineering in medical colleges and universities, such as the disconnection between theory and practice, the teaching content emphasizing "medicine" rather than "engineering", the lack of interaction between teachers and students, and the single teaching evaluation method, this study introduced the outcome-based education concept. According to the graduation requirements supported by the course, the experiment teaching reform ideas were adjusted from three aspects: setting curriculum objectives based on learning outcomes, reforming teaching strategies to achieve learning outcomes, and assessing learning outcomes to promote continuous improvement. The results of the reform show that students' satisfaction with the content, methods, and assessment of experiment teaching all exceeded 86.66%. The reform successfully integrated medicine and engineering, virtual and practical training, and teaching and ideological and political education. The reform also significantly improved the teaching effectiveness and talent cultivation level of experimental courses from the three dimensions of knowledge learning, ability improvement, and value shaping.
2.Evaluation of research trends and hotspots in biosecurity based on bibliometrics
Menglin LIU ; Xinlou LI ; Guoxing HUANG ; Zhenghao YU ; Heze YOU
Chinese Journal of Nosocomiology 2025;35(12):1887-1891
OBJECTIVE To analyze the current research status and development trends in the field of biosecurity both domestically and internationally,and to provide references for biosecurity-related research and evaluation.METHODS Using CiteSpace software,bibliometrics was employed to collect thematic research on bios-ecurity published in the Science Citation Index database from 2004 to 2024.Research trends,keyword clustering and emergence research were investigated,with visual analysis conducted on the number of publications,contribu-ting countries and keywords.RESULTS A total of 13 108 articles were included in this study.Research on biosecu-rity both domestically and internationally was in a phase of rapid growth,with related fields exhibiting an"expo-nential"growth trend.China ranked first in terms of the number of publications(35.62%),followed by the Unit-ed States(19.33%)and Australia(10.38%).Analysis of keyword clustering revealed 20 clusters,including risk assessment,antibacterial drug resistance,green synthesis,gene therapy,one health,drug delivery,invasive spe-cies,bovines,emergency animal diseases and highly pathogenic avian influenza.Regarding antibacterial drug re-sistance,the focus was primarily on the transmission mechanisms of drug-resistant pathogens in poultry farming,while exploring novel antibacterial technologies such as biomaterials and probiotic alternatives to address the chal-lenge of drug-resistant bacteria.In terms of strategies,research was primarily conducted on the development,ap-plication and safety of agricultural biotechnology and genetically modified crops.Keywords burst analysis indicated that different research topics had certain temporal research popularity,with carbon nanotubes,Anopheles ste-phensi,coronaviruses and one health being recent emerging themes.CONCLUSION China achieves certain pro-gress in the field of biosecurity research,and conducts certain exploratory research on prevention,diagnosis,treatment and intervention of biosecurity.Biosecurity risk assessment,as a research hotspot,deserves close attention.
3.Evaluation of research trends and hotspots in biosecurity based on bibliometrics
Menglin LIU ; Xinlou LI ; Guoxing HUANG ; Zhenghao YU ; Heze YOU
Chinese Journal of Nosocomiology 2025;35(12):1887-1891
OBJECTIVE To analyze the current research status and development trends in the field of biosecurity both domestically and internationally,and to provide references for biosecurity-related research and evaluation.METHODS Using CiteSpace software,bibliometrics was employed to collect thematic research on bios-ecurity published in the Science Citation Index database from 2004 to 2024.Research trends,keyword clustering and emergence research were investigated,with visual analysis conducted on the number of publications,contribu-ting countries and keywords.RESULTS A total of 13 108 articles were included in this study.Research on biosecu-rity both domestically and internationally was in a phase of rapid growth,with related fields exhibiting an"expo-nential"growth trend.China ranked first in terms of the number of publications(35.62%),followed by the Unit-ed States(19.33%)and Australia(10.38%).Analysis of keyword clustering revealed 20 clusters,including risk assessment,antibacterial drug resistance,green synthesis,gene therapy,one health,drug delivery,invasive spe-cies,bovines,emergency animal diseases and highly pathogenic avian influenza.Regarding antibacterial drug re-sistance,the focus was primarily on the transmission mechanisms of drug-resistant pathogens in poultry farming,while exploring novel antibacterial technologies such as biomaterials and probiotic alternatives to address the chal-lenge of drug-resistant bacteria.In terms of strategies,research was primarily conducted on the development,ap-plication and safety of agricultural biotechnology and genetically modified crops.Keywords burst analysis indicated that different research topics had certain temporal research popularity,with carbon nanotubes,Anopheles ste-phensi,coronaviruses and one health being recent emerging themes.CONCLUSION China achieves certain pro-gress in the field of biosecurity research,and conducts certain exploratory research on prevention,diagnosis,treatment and intervention of biosecurity.Biosecurity risk assessment,as a research hotspot,deserves close attention.
4.Practical research on the reform of diagnostics experiment teaching for intelligent medical engineering assisted by outcome-based education
Yanfeng WANG ; Yin LIU ; Quanle GUO ; Guoxing ZHAO
Chinese Journal of Medical Education Research 2025;24(7):933-939
In response to issues in diagnostics experiment teaching for intelligent medical engineering in medical colleges and universities, such as the disconnection between theory and practice, the teaching content emphasizing "medicine" rather than "engineering", the lack of interaction between teachers and students, and the single teaching evaluation method, this study introduced the outcome-based education concept. According to the graduation requirements supported by the course, the experiment teaching reform ideas were adjusted from three aspects: setting curriculum objectives based on learning outcomes, reforming teaching strategies to achieve learning outcomes, and assessing learning outcomes to promote continuous improvement. The results of the reform show that students' satisfaction with the content, methods, and assessment of experiment teaching all exceeded 86.66%. The reform successfully integrated medicine and engineering, virtual and practical training, and teaching and ideological and political education. The reform also significantly improved the teaching effectiveness and talent cultivation level of experimental courses from the three dimensions of knowledge learning, ability improvement, and value shaping.
5.Effect of urolithin C on proliferation,apoptosis and autophagy of human acute myeloid leukemia HL-60 cells and its mechanism
Guoxing YU ; Xin ZHANG ; Hengwei DU ; Bingjie CUI ; Na GAO ; Cuilan LIU ; Jing DU
Journal of Jilin University(Medicine Edition) 2024;50(4):908-916
Objective:To discuss the effect of urolithin C(UC)on the proliferation,apoptosis,and autophagy of the acute myeloid leukemia(AML)HL-60 cells,and to clarify its mechanism.Methods:The HL-60 cells were divided into different concentrations(20,40,60,80,and 100 μmol·L-1)of urolithin A(UA)groups,urolithin B(UB)groups,and UC groups.CCK-8 assay was used to detect the proliferation activity of the cells in various groups;the morphology of the cells in different concentrations of UC groups was observed under optical microscope.The HL-60 cells were divided into different concentrations(0,20,40,and 80 μmol·L-1)of UC groups and 3-methyladenine(3-MA)combined with different concentrations(0,20,40,and 80 μmol·L-1)of UC groups.CCK-8 assay was used to detect the proliferation activities of the cells in various groups.The HL-60 cells were divided into control group(0 μmol·L-1)and different concentrations(20,40,and 80 μmol·L-1)of UC groups.The live/dead cell staining method was used to detect the dead rates of the cells in various groups;flow cytometry was used to detect the apoptotic rates of the cells in various groups;the autophagy of the cells was detected by autophagy staining kit(monodansylcadaverine,MDC)method;real-time fluorescence quantitative PCR(RT-qPCR)method was used to detect the expression levels of Beclin 1,autophagy related gene 9(ATG9),and autophagy related gene 7(ATG7)mRNA in the cells in various groups;Western blotting method was used to detect the expression levels of cysteinyl aspartate specific proteinase-3(Caspase-3),cleaved cysteinyl aspartate specific proteinase-3(Cleaved Caspase-3),microtubule-associated protein 1 light 3(LC-3),extracellular regulated protein kinases(ERK),phosphorylated ERK(p-ERK),AMP-activated protein kinase(AMPK),and phosphorylated AMPK(p-AMPK)in the cells in various groups.Results:The CCK-8 assay results showed that after cultured for 24,48,and 72 h,compared with 0 μmol·L-1 UA,UB,and UC groups,the proliferation activities of the cells in different concentrations of UA,UB,and UC groups were decreased(P<0.01)with a concentration-and time-dependent manner;at 48 h,compared with UA and UB,the half-maximal inhibitory concentration(IC50)of UC was the lowest.The cell morphology observation results showed that compared with control group,the intercellular connection and the number of the cells were decreased with the increasing of UC concentration,and the cell fragment was increased.The CCK-8 assay results showed that compared with 40 and 80 μmol·L-1 UC groups,the proliferation activities of the cells in 3-MA combined with 40 and 80 μmol·L-1 UC groups were increased(P<0.05 or P<0.01).The live/dead cell staining results showed that compared with control group,the dead rates of the cells in 40 and 80 μmol·L-1 UC groups were increased(P<0.01).The flow cytometry results showed that compared with control group,the apoptotic rate of the cells in 80 μmol·L-1 UC group was increased(P<0.01).The MDC method results showed that with the increasing of UC concentration,the green fluorescence in the cells in different concentrations of UC groups was gradually intensified.The RT-qPCR results showed that compared with control group,the expression levels of Beclin 1,ATG9,and ATG7 mRNA in the cells in 80 μmol·L-1 UC group were increased(P<0.01).The Western blotting results showed that compared with control group,the expression levels of Cleaved Caspase-3 protein in the cells in 20,40,and 80 μmol·L-1 UC groups were increased(P<0.01),the ratio of membrane LC3/cytoplasmic LC3(LC3-Ⅱ/LC3-Ⅰ)in the cells in 80 μmol·L-1 UC group was increased(P<0.05),and the ratios of p-AMPK/AMPK and p-ERK/ERK in the cells in 40 and 80 μmol·L-1 UC groups were increased(P<0.01).Conclusion:UC can inhibit the proliferation of the AML HL-60 cells,induce the apoptosis and autophagy,and increase the phosphorylation levels of ERK and AMPK proteins in the cells.
6.Effects of CYP3A5 gene polymorphism and Wuzhi capsule on early postoperative tacrolimus exposure and adverse reactions in renal transplant patients
Qiulin XIANG ; Ling LIU ; Yi YANG ; Guoxing LI ; Song CHEN ; Yingying YANG ; Xian YU
China Pharmacy 2024;35(14):1765-1769
OBJECTIVE To investigate the effects of CYP3A5 gene polymorphism and Wuzhi capsule (WZ) on early postoperative tacrolimus exposure and adverse reactions in renal transplant patients. METHODS A total of 132 patients who underwent renal transplantation and received tacrolimus + mycophenolic acids + prednisone after operation in our hospital from September 2021 to September 2023 were selected and divided into four groups according to genotypes (CYP3A5*1 or CYP3A5*3/*3) and with or without WZ (“ +WZ” meant drug combination, “ +NO WZ” meant without combination). The blood trough concentration/daily dose (c0/D) values of the four groups were analyzed on the 14th day, 1 month and 3 months after renal transplantation. The incidence of acute rejection and the incidence of tacrolimus-related adverse reactions within 3 months after transplantation were compared among 4 groups. RESULTS On the 14th day, 1 month and 3 months after surgery (except for the CYP3A5*1+WZ group), c0/D values of CYP3A5*1 genotype patients were significantly lower than those of CYP3A5*3/*3 genotype patients regardless of whether they were treated with WZ additionally (P<0.05). Within 3 months after surgery, although there was no significant difference in the incidence of acute rejection and tacrolimus-related adverse reactions among the four groups (P> 0.05), the incidence of hyperglycemia in patients with CYP3A5*3/*3 was higher (41.67%). CONCLUSIONS CYP3A5 gene polymorphism is significantly related to tacrolimus c0/D in kidney transplant patients. Under the premise of c0 monitoring of tacrolimus, patients with CYP3A5*1 genotype should be given WZ as soon as possible after surgery to accelerate tacrolimus to reach the therapeutic concentration range, while CYP3A5*3/*3 genotype is not recommended to be given WZ because of the higher risk of hyperglycemia.
7.Safety of double and a half layered esophagojejunal anastomosis in radical gastrectomy: A prospective, multi-center, single arm trial
Pengfei MA ; Sen LI ; Gengze WANG ; Xiaosong JING ; Dayong LIU ; Hao ZHENG ; Chaohui LI ; Yunshuai WANG ; Yinzhong WANG ; Yue WU ; Pengyuan ZHAN ; Wenfei DUAN ; Qingquan LIU ; Tao YANG ; Zuomin LIU ; Qiongyou JING ; Zhanwei DING ; Guangfei CUI ; Zhiqiang LIU ; Ganshu XIA ; Guoxing WANG ; Panpan WANG ; Lei GAO ; Desheng HU ; Junli ZHANG ; Yanghui CAO ; Chenyu LIU ; Zhenyu LI ; Jiachen ZHANG ; Changzheng LI ; Zhi LI ; Yuzhou ZHAO
Chinese Journal of Gastrointestinal Surgery 2023;26(10):977-985
Objective:To evaluate the safety of double and a half layered esophagojejunal anastomosis in radical gastrectomy.Methods:This prospective, multi-center, single-arm study was initiated by the Affiliated Cancer Hospital of Zhengzhou University in June 2021 (CRAFT Study, NCT05282563). Participating institutions included Nanyang Central Hospital, Zhumadian Central Hospital, Luoyang Central Hospital, First Affiliated Hospital of Henan Polytechnic University, First Affiliated Hospital of Henan University, Luohe Central Hospital, the People's Hospital of Hebi, First People's Hospital of Shangqiu, Anyang Tumor Hospital, First People's Hospital of Pingdingshan, and Zhengzhou Central Hospital Affiliated to Zhengzhou University. Inclusion criteria were as follows: (1) gastric adenocarcinoma confirmed by preoperative gastroscopy;(2) preoperative imaging assessment indicated that R0 resection was feasible; (3) preoperative assessment showed no contraindications to surgery;(4) esophagojejunostomy planned during the procedure; (5) patients volunteered to participate in this study and gave their written informed consent; (6) ECOG score 0–1; and (7) ASA score I–III. Exclusion criteria were as follows: (1) history of upper abdominal surgery (except laparoscopic cholecystectomy);(2) history of gastric surgery (except endoscopic submucosal dissection and endoscopic mucosal resection); (3) pregnancy or lactation;(4) emergency surgery for gastric cancer-related complications (perforation, hemorrhage, obstruction); (5) other malignant tumors within 5 years or coexisting malignant tumors;(6) arterial embolism within 6 months, such as angina pectoris, myocardial infarction, and cerebrovascular accident; and (7) comorbidities or mental health abnormalities that could affect patients' participation in the study. Patients were eliminated from the study if: (1) radical gastrectomy could not be completed; (2) end-to-side esophagojejunal anastomosis was not performed during the procedure; or (3) esophagojejunal anastomosis reinforcement was not possible. Double and a half layered esophagojejunal anastomosis was performed as follows: (1) Open surgery: the full thickness of the anastomosis is continuously sutured, followed by embedding the seromuscular layer with barbed or 3-0 absorbable sutures. The anastomosis is sutured with an average of six to eight stitches. (2) Laparoscopic surgery: the anastomosis is strengthened by counterclockwise full-layer sutures. Once the anastomosis has been sutured to the right posterior aspect of the anastomosis, the jejunum stump is pulled to the right and the anastomosis turned over to continue to complete reinforcement of the posterior wall. The suture interval is approximately 5 mm. After completing the full-thickness suture, the anastomosis is embedded in the seromuscular layer. Relevant data of patients who had undergone radical gastrectomy in the above 12 centers from June 2021 were collected and analyzed. The primary outcome was safety (e.g., postoperative complications, and treatment). Other studied variables included details of surgery (e.g., surgery time, intraoperative bleeding), postoperative recovery (postoperative time to passing flatus and oral intake, length of hospital stay), and follow-up conditions (quality of life as assessed by Visick scores).Result:[1] From June 2021 to September 2022,457 patients were enrolled, including 355 men and 102 women of median age 60.8±10.1 years and BMI 23.7±3.2 kg/m2. The tumors were located in the upper stomach in 294 patients, mid stomach in 139; and lower stomach in 24. The surgical procedures comprised 48 proximal gastrectomies and 409 total gastrectomies. Neoadjuvant chemotherapy was administered to 85 patients. Other organs were resected in 85 patients. The maximum tumor diameter was 4.3±2.2 cm, number of excised lymph nodes 28.3±15.2, and number of positive lymph nodes five (range one to four. As to pathological stage,83 patients had Stage I disease, 128 Stage II, 237 Stage III, and nine Stage IV. [2] The studied surgery-related variables were as follows: The operation was successfully completed in all patients, 352 via a transabdominal approach, 25 via a transhiatus approach, and 80 via a transthoracoabdominal approach. The whole procedure was performed laparoscopically in 53 patients (11.6%), 189 (41.4%) underwent laparoscopic-assisted surgery, and 215 (47.0%) underwent open surgery. The median intraoperative blood loss was 200 (range, 10–1 350) mL, and the operating time 215.6±66.7 minutes. The anastomotic reinforcement time was 2 (7.3±3.9) minutes for laparoscopic-assisted surgery, 17.6±1.7 minutes for total laparoscopy, and 6.0±1.2 minutes for open surgery. [3] The studied postoperative variables were as follows: The median time to postoperative passage of flatus was 3.1±1.1 days and the postoperative gastrointestinal angiography time 6 (range, 4–13) days. The median time to postoperative oral intake was 7 (range, 2–14) days, and the postoperative hospitalization time 15.8±6.7 days. [4] The safety-related variables were as follows: In total, there were 184 (40.3%) postoperative complications. These comprised esophagojejunal anastomosis complications in 10 patients (2.2%), four (0.9%) being anastomotic leakage (including two cases of subclinical leakage and two of clinical leakage; all resolved with conservative treatment); and six patients (1.3%) with anastomotic stenosis (two who underwent endoscopic balloon dilation 21 and 46 days after surgery, the others improved after a change in diet). There was no anastomotic bleeding. Non-anastomotic complications occurred in 174 patients (38.1%). All patients attended for follow-up at least once, the median follow-up time being 10 (3–18) months. Visick grades were as follows: Class I, 89.1% (407/457); Class II, 7.9% (36/457); Class III, 2.6% (12/457); and Class IV 0.4% (2/457).Conclusion:Double and a half layered esophagojejunal anastomosis in radical gastrectomy is safe and feasible.
8.Mechanism of "Sanyang" combined therapy of traditional Chinese medicine in alleviating colonic injury in mice induced by influenza virus based on transcriptome sequencing technique
Yanan ZHANG ; Jun YAN ; Liqiong SONG ; Yuanming HUANG ; Chang LIU ; Guoxing LIU ; Jintong LI ; Yue ZHANG ; Mingzhe WANG ; Zhiguang ZHAI ; Chengxiang WANG ; Lishan ZHANG ; Chengjun BAN ; Wenbo XU ; Miao CHENG
Chinese Journal of Experimental and Clinical Virology 2023;37(2):159-167
Objective:To explore the mechanism of Ma-Xing Shi-Gan decoction combined with Xiao-Chai-Hu decoction (hereinafter referred to as " Sanyang combined treatment" ) in alleviating colon injury in mice infected with influenza virus by transcriptome sequencing technique.Methods:The mouse model of colonic injury caused by influenza virus was induced by intranasal drip of influenza A virus H1N1 suspension. The mice were divided into Control group, Model group, and Sanyang combined treatment (SCT) group. Model group and SCT group were fed with PBS and Ma-Xing Shi-Gan decoction combined with Xiao-Chai-Hu decoction respectively. Seven days later, the colon tissues of each group were taken, the colon length and pathological damage were observed, and the transcriptome was sequenced to screen the significantly different genes between the SCT group and model group for Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) and Gene Set Enrichment Analysis(GSEA).Results:After the therapy with SCT, the length of the colon of mice was significantly improved and the pathological injury of the colon was reduced. There are 92 differentially expressed genes between the SCT group and the model group. GO analysis indicated that the differential genes were enriched in biological processes such as regulation of cytokine and chemokine production, inflammatory response, defense response, immune response, regulation of NF-κB inducing kinase(NIK)/Nuclear factor-κB(NF-κB) signal and Mitogen-activated protein kinase(MAPK) cascade, as well as cell components related to intestinal barrier such as brush border membrane, brush border and microvilli. KEGG analysis indicated that the differential genes were enriched in Toll-like receptor signaling pathway, intestinal immune network for IgA production, complement and coagulation cascade, and Peroxisome proliferator-activated receptor(PPAR) signaling pathway. GSEA indicated that the intestinal immune network for IgA production, PPAR signaling pathway, propionic acid metabolism and butyrate metabolism were significantly up-regulated after the intervention with SCT, while apoptosis and MAPK signaling pathway were significantly down-regulated.Conclusions:Sanyang combined therapy can protect the intestinal tract of mice infected with influenza virus mainly through immunity, inflammation and metabolism pathways.
9.Safety of double and a half layered esophagojejunal anastomosis in radical gastrectomy: A prospective, multi-center, single arm trial
Pengfei MA ; Sen LI ; Gengze WANG ; Xiaosong JING ; Dayong LIU ; Hao ZHENG ; Chaohui LI ; Yunshuai WANG ; Yinzhong WANG ; Yue WU ; Pengyuan ZHAN ; Wenfei DUAN ; Qingquan LIU ; Tao YANG ; Zuomin LIU ; Qiongyou JING ; Zhanwei DING ; Guangfei CUI ; Zhiqiang LIU ; Ganshu XIA ; Guoxing WANG ; Panpan WANG ; Lei GAO ; Desheng HU ; Junli ZHANG ; Yanghui CAO ; Chenyu LIU ; Zhenyu LI ; Jiachen ZHANG ; Changzheng LI ; Zhi LI ; Yuzhou ZHAO
Chinese Journal of Gastrointestinal Surgery 2023;26(10):977-985
Objective:To evaluate the safety of double and a half layered esophagojejunal anastomosis in radical gastrectomy.Methods:This prospective, multi-center, single-arm study was initiated by the Affiliated Cancer Hospital of Zhengzhou University in June 2021 (CRAFT Study, NCT05282563). Participating institutions included Nanyang Central Hospital, Zhumadian Central Hospital, Luoyang Central Hospital, First Affiliated Hospital of Henan Polytechnic University, First Affiliated Hospital of Henan University, Luohe Central Hospital, the People's Hospital of Hebi, First People's Hospital of Shangqiu, Anyang Tumor Hospital, First People's Hospital of Pingdingshan, and Zhengzhou Central Hospital Affiliated to Zhengzhou University. Inclusion criteria were as follows: (1) gastric adenocarcinoma confirmed by preoperative gastroscopy;(2) preoperative imaging assessment indicated that R0 resection was feasible; (3) preoperative assessment showed no contraindications to surgery;(4) esophagojejunostomy planned during the procedure; (5) patients volunteered to participate in this study and gave their written informed consent; (6) ECOG score 0–1; and (7) ASA score I–III. Exclusion criteria were as follows: (1) history of upper abdominal surgery (except laparoscopic cholecystectomy);(2) history of gastric surgery (except endoscopic submucosal dissection and endoscopic mucosal resection); (3) pregnancy or lactation;(4) emergency surgery for gastric cancer-related complications (perforation, hemorrhage, obstruction); (5) other malignant tumors within 5 years or coexisting malignant tumors;(6) arterial embolism within 6 months, such as angina pectoris, myocardial infarction, and cerebrovascular accident; and (7) comorbidities or mental health abnormalities that could affect patients' participation in the study. Patients were eliminated from the study if: (1) radical gastrectomy could not be completed; (2) end-to-side esophagojejunal anastomosis was not performed during the procedure; or (3) esophagojejunal anastomosis reinforcement was not possible. Double and a half layered esophagojejunal anastomosis was performed as follows: (1) Open surgery: the full thickness of the anastomosis is continuously sutured, followed by embedding the seromuscular layer with barbed or 3-0 absorbable sutures. The anastomosis is sutured with an average of six to eight stitches. (2) Laparoscopic surgery: the anastomosis is strengthened by counterclockwise full-layer sutures. Once the anastomosis has been sutured to the right posterior aspect of the anastomosis, the jejunum stump is pulled to the right and the anastomosis turned over to continue to complete reinforcement of the posterior wall. The suture interval is approximately 5 mm. After completing the full-thickness suture, the anastomosis is embedded in the seromuscular layer. Relevant data of patients who had undergone radical gastrectomy in the above 12 centers from June 2021 were collected and analyzed. The primary outcome was safety (e.g., postoperative complications, and treatment). Other studied variables included details of surgery (e.g., surgery time, intraoperative bleeding), postoperative recovery (postoperative time to passing flatus and oral intake, length of hospital stay), and follow-up conditions (quality of life as assessed by Visick scores).Result:[1] From June 2021 to September 2022,457 patients were enrolled, including 355 men and 102 women of median age 60.8±10.1 years and BMI 23.7±3.2 kg/m2. The tumors were located in the upper stomach in 294 patients, mid stomach in 139; and lower stomach in 24. The surgical procedures comprised 48 proximal gastrectomies and 409 total gastrectomies. Neoadjuvant chemotherapy was administered to 85 patients. Other organs were resected in 85 patients. The maximum tumor diameter was 4.3±2.2 cm, number of excised lymph nodes 28.3±15.2, and number of positive lymph nodes five (range one to four. As to pathological stage,83 patients had Stage I disease, 128 Stage II, 237 Stage III, and nine Stage IV. [2] The studied surgery-related variables were as follows: The operation was successfully completed in all patients, 352 via a transabdominal approach, 25 via a transhiatus approach, and 80 via a transthoracoabdominal approach. The whole procedure was performed laparoscopically in 53 patients (11.6%), 189 (41.4%) underwent laparoscopic-assisted surgery, and 215 (47.0%) underwent open surgery. The median intraoperative blood loss was 200 (range, 10–1 350) mL, and the operating time 215.6±66.7 minutes. The anastomotic reinforcement time was 2 (7.3±3.9) minutes for laparoscopic-assisted surgery, 17.6±1.7 minutes for total laparoscopy, and 6.0±1.2 minutes for open surgery. [3] The studied postoperative variables were as follows: The median time to postoperative passage of flatus was 3.1±1.1 days and the postoperative gastrointestinal angiography time 6 (range, 4–13) days. The median time to postoperative oral intake was 7 (range, 2–14) days, and the postoperative hospitalization time 15.8±6.7 days. [4] The safety-related variables were as follows: In total, there were 184 (40.3%) postoperative complications. These comprised esophagojejunal anastomosis complications in 10 patients (2.2%), four (0.9%) being anastomotic leakage (including two cases of subclinical leakage and two of clinical leakage; all resolved with conservative treatment); and six patients (1.3%) with anastomotic stenosis (two who underwent endoscopic balloon dilation 21 and 46 days after surgery, the others improved after a change in diet). There was no anastomotic bleeding. Non-anastomotic complications occurred in 174 patients (38.1%). All patients attended for follow-up at least once, the median follow-up time being 10 (3–18) months. Visick grades were as follows: Class I, 89.1% (407/457); Class II, 7.9% (36/457); Class III, 2.6% (12/457); and Class IV 0.4% (2/457).Conclusion:Double and a half layered esophagojejunal anastomosis in radical gastrectomy is safe and feasible.
10.Characteristics and countermeasures of blood donors with adverse reactions to apheresis platelet donation
Yanyan LIU ; Jun LIU ; Guoxing XU ; Jinjing XU
Chinese Journal of Blood Transfusion 2022;35(3):311-314
【Objective】 To compare and study the characteristics of blood donors with and without adverse reactions to apheresis platelet donation(ARAPD), and to study the influencing factors of blood donors participating in blood donation again, so as to provide basis for putting forward scientific and reasonable countermeasures and retaining blood donors to the greatest extent. 【Methods】 157 679 platelet donors from Tianjin Blood Center from December 26, 2015 to December 25, 2020 were selected and divided into ARAPD group(n=168) and non-ARAPD group (n=157 511). Such characteristics as sex, age, height, weight, blood type, educational background, first-time donation or not, platelet count, hematocrit, phlebotomy time, circulating blood volume and anticoagulant dosage of the two groups were analyzed. Chi-square test was used to identify the high-risk population with poor blood donation response. Multivariate binary logistic regression was used to study the influencing factors of blood donors returning. 【Results】 The age, height and weight of ARAPD group were lower than those of the non-ARAPD group, and the proportion of first-time blood donors, the proportion of women and phlebotomy time were higher than those of non-ARAPD group. There was little difference between the two groups in circulating blood volume, anticoagulant dosage, pre- and post-donation platelet count and hematocrit. Logistic regression analysis showed that the influencing factors of ARAPD were age, educational background, first-time donation or not and phlebotomy time, among which age and first-time donation or not were positively correlated, education and phlebotomy time were negatively correlated (P<0.05). 【Conclusion】 Female, low age, low height and weight, and less blood donation are the basic characteristics of high-risk people with ARAPD. Low age, high education, first-time blood donation and long phlebotomy time are the influencing factors that lead to donor lapsing. Therefore, countermeasures are put forward based on the above results.

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