Objective: Blood safety surveillance is a critical measure for the objective assessment of blood quality and enhancing transfusion safety. This study aims to comprehensively understand the current status of blood safety surveillance and management in blood collection and supply institutions in Sichuan Province, systematically analyze existing problems and vulnerabilities, and provide a basis for optimizing management strategies and improving capabilities to ensure blood safety. Methods: The Blood Safety Surveillance questionnaire was designed, covering adverse donor reaction reporting, management of adverse events, and transfusion adverse reaction feedback. An online survey was conducted via Questionnaire Star platform among 21 blood collection and supply institutions in the province, gathering information on management systems, process implementation, and utilization of monitoring data. The collected data were organized and statistically analyzed using Excel. Results: The questionnaire response rate and validity rate were both 100%. Blood collection and supply institutions in Sichuan Province have generally established a blood safety surveillance system and achieved positive outcomes. Regarding adverse events in blood collection and supply, 95.24% (20 institutions) have established reporting procedures, and 66.67% (14) collect information through multiple channels such as internal reports, external reports, and statistical trend feedback. A total of 90.48% (19) institutions regularly summarize and analyze adverse event data, and 85.71% (18) produce reports with improvement recommendations based on this analysis.71.43% (15) institutions implement reward and penalty measures, and 71.43% (15) report underreporting or omission due to accountability or performance concerns. In terms of monitoring adverse blood donation reactions, all blood collection and supply institutions have established full-process management systems.76.19% (16) collect data through multiple approaches, including on-site donation records, voluntary donor reports, and donor follow-ups. Adverse reactions were followed up in 95.24% (20) of institutions with 65% (13) completing follow-ups within 24 hours.80.95% (17) have established investigation procedures, while 66.67% (14) believe underreporting or omission still occurs. All blood collection and supply institutions regularly compile statistics on adverse donation reactions. Of these, 85.71% (18) institutions providing feedback to management departments and 90.48% (19) analyzing the data and making recommendations.76.19% (16) institutions use monitoring data for return donor management and targeted care, and 71.43% (15 stations) incorporate it into management reviews. Regarding adverse transfusion reactions, 95.24% (20) institutions have established and implemented procedures for isolating, recalling, and tracing of problematic blood units. However, only 42.86% (9) have established feedback mechanisms of adverse transfusion reaction with hospitals, and only 19.05% (4) support direct reporting via information systems.47.62% (10) institutions regularly analyze adverse transfusion reaction data, and 19.05% (4) provide feedback and recommendations to relevant hospitals. All blood collection and supply institutions reported challenges in collecting hospital feedback, citing complexities in data collection and reporting processes. Conclusion: Blood safety surveillance systems have been preliminarily established in Sichuan Province. However, further strengthening is still required, including conducting in-depth data analysis and utilization, standardizing the configuration of emergency medications and equipment, and improving feedback mechanisms for adverse transfusion reactions. To improve the overall level of blood safety management, it is recommended to strengthen closed-loop data management, improve feedback mechanisms between blood collection and supply institutions and hospitals, foster a non-punitive reporting culture, and systematically advance the regionalization and standardization of the monitoring system. These efforts will contribute to sustainably improving the overall effectiveness and sustainability of blood safety management.

Objective To investigate the protective effect of cerebrospinal fluid(CSF)on the spinal cord in patients with scoliosis and evaluate its buffering effect during gravitational traction surgery and in daily life,so as to provide a theoretical guidance for surgical planning and postoperative rehabilitation of scoliosis.Methods A three-dimensional coupled spinal cord-CSF finite element model was established to simulate the biomechanical responses of the spine under two scenarios:gravitational traction surgery and daily life.Comparative analyses were conducted for conditions with and without CSF,and the buffering effect of CSF was quantitatively assessed.Results During simulated gravitational traction surgery,CSF significantly reduced the stress and deformation of the spinal cord,with the stress in spinal cord white and gray matter decreasing by 65％-90％and deformation decreasing by 70％-95％.In the daily life scenario,CSF provided greater protective effects in lateral flexion and anterior-posterior flexion directions,with stress reductions of 60％-85％.However,in torsion,the buffering effect of CSF was relatively weaker,with stress reductions of only 10％-25％.Conclusions CSF significantly reduces spinal cord stress and deformation during gravitational traction surgery and in daily life,reducing the risk of injury.

Objective To investigate the protective effect of cerebrospinal fluid(CSF)on the spinal cord in patients with scoliosis and evaluate its buffering effect during gravitational traction surgery and in daily life,so as to provide a theoretical guidance for surgical planning and postoperative rehabilitation of scoliosis.Methods A three-dimensional coupled spinal cord-CSF finite element model was established to simulate the biomechanical responses of the spine under two scenarios:gravitational traction surgery and daily life.Comparative analyses were conducted for conditions with and without CSF,and the buffering effect of CSF was quantitatively assessed.Results During simulated gravitational traction surgery,CSF significantly reduced the stress and deformation of the spinal cord,with the stress in spinal cord white and gray matter decreasing by 65％-90％and deformation decreasing by 70％-95％.In the daily life scenario,CSF provided greater protective effects in lateral flexion and anterior-posterior flexion directions,with stress reductions of 60％-85％.However,in torsion,the buffering effect of CSF was relatively weaker,with stress reductions of only 10％-25％.Conclusions CSF significantly reduces spinal cord stress and deformation during gravitational traction surgery and in daily life,reducing the risk of injury.

Compared with the previous automatic segmentation neural network for the target area which considered the target area as an independent area, a stacked neural network which uses the position and shape information of the organs around the target area to regulate the shape and position of the target area through the superposition of multiple networks and fusion of spatial position information to improve the segmentation accuracy on medical images was proposed in this paper. Taking the Graves' ophthalmopathy disease as an example, the left and right radiotherapy target areas were segmented by the stacked neural network based on the fully convolutional neural network. The volume Dice similarity coefficient (DSC) and bidirectional Hausdorff distance (HD) were calculated based on the target area manually drawn by the doctor. Compared with the full convolutional neural network, the stacked neural network segmentation results can increase the volume DSC on the left and right sides by 1.7% and 3.4% respectively, while the two-way HD on the left and right sides decrease by 0.6. The results show that the stacked neural network improves the degree of coincidence between the automatic segmentation result and the doctor's delineation of the target area, while reducing the segmentation error of small areas. The stacked neural network can effectively improve the accuracy of the automatic delineation of the radiotherapy target area of Graves' ophthalmopathy.
Algorithms ; Image Processing, Computer-Assisted ; Neural Networks, Computer ; Tomography, X-Ray Computed

Although high-efficiency targeted delivery is investigated for years, the efficiency of tumor targeting seems still a hard core to smash. To overcome this problem, we design a three-step delivery strategy based on streptavidin-biotin interaction with the help of c(RGDfK), magnetic fields and lasers. The ultrasmall superparamagnetic iron oxide nanoparticles (USIONPs) modified with c(RGDfK) and biotin are delivered at step 1, followed by streptavidin and the doxorubicin (Dox) loaded nanosystems conjugated with biotin at steps 2 and 3, respectively. The delivery systems were proved to be efficient on A549 cells. The co-localization of signal for each step revealed the targeting mechanism. The external magnetic field could further amplify the endocytosis of USPIONs based on c(RGDfK), and magnify the uptake distinctions among different test groups. Based on photoacoustic imaging, laser-heating treatment could enhance the permeability of tumor venous blood vessels and change the insufficient blood flow in cancer. Then, it was noticed that only three-step delivery with laser-heating and magnetic fields realized the highest tumor distribution of nanosystem. Finally, the magnetism/laser-auxiliary cascaded delivery exhibited the best antitumor efficacy. Generally, this study demonstrated the necessity of combining physical, biological and chemical means of targeting.

Objective:To measure and analyze the distribution characteristics of the micro-hardness of the middle-upper thoracic vertebrae (T 1-T 10) in the human body. Methods:T 1-T 10 vertebrae from three fresh cadavers were divided into vertebral body area and attachment area. 3 mm specimens were cut by a high-precision slow saw and 11 regions were selected and measured on each vertebrae by a Vickers microhardness tester (cortical bone: 1-9, cancellous bone: 10-11). The micro-hardness distribution of T 1-T 10 vertebrae was recorded and analyzed. Results:A total of 330 measurement areas from 30 vertebrae were measured, and 1 650 hardness values were collected. The average hardness values of the overall cortical bone of the middle-upper thoracic vertebrae of the 3 cadavers were 30.55±5.44 HV, 29.94±4.86 HV, and 29.55±4.36 HV, respectively. The difference among the groups was statistically significant ( F=4.680, P=0.009). The average hardness values of the overall cancellous bone were 27.93±5.61 HV, 28.21±4.96 HV, 27.98±3.94 HV, respectively. There was no significant difference among the groups ( F=0.091, P=0.913). There were statistically significant differences between the hardness values in the attachment area and vertebral body area of each cadaver ( t=7.467, 4.750, 6.621, P<0.001); the hardness of the cancellous bone in the attachment area of each cadaver was higher than that of the cancellous bone in the vertebral body ( t=1.785, 3.159, 3.103, P=0.077, 0.002, 0.003). The distribution of microhardness in 11 measurement areas of 3 cadavers were similar: the hardness of the cortical bone of pedicle, lamina and inferior endplate cortex (1, 2, 7) were higher; the hardness of the cortical bone of upper endplate and peripheral cortex (6, 8, 9) were lower. The distribution patterns of the microhardness in different vertebral segments of the 3 cadavers were similar: The hardness values gradually increased from T 1 to T 10. The vertebra with the largest hardness of the cortical bone was T 8; and the vertebra with the largest hardness of the cancellous bone were T 7, T 7 and T 6, respectively. Conclusion:The hardness of the upper endplate and peripheral cortex was low, which could disperse the load to protect the fragile cancellous bone. The hardness of the pedicle was the highest. The hardness of the cortical bone was higher than that of the cancellous bone, and the values of different segments gradually increased from top to bottom, which may be related to the physiological and anatomical morphology, and the gradual increase of the load of muscle force and body weight.

Multiple sclerosis (MS) is a disease characterized as inflammatory demyelinating of the central nervous system,which is the main cause of non-traumatic neurological disability in young and middle-age adults.The main manifestations of MS are memory and information processing speed,executive function and other cognitive impairments.MS associated with memory impairment (MSMI) is often overlooked because of the occult onset,which seriously affecting patients' life quality.In recent years,with the rapid development of neuro-functional imaging,MRI has become an important method to observe and diagnose MS,providing imaging evidence for diagnosis of MSMI.The clinical and MRI research progresses of MEMI were reviewed in this article.

Objective To explore the influencing factors on short -term efficacy of intravenous thrombolysis with rt -PA.Methods The clinical data of the 95 acute ischemic stroke(AIS)patients who received thrombolytic therapy were analyze.Multivariate logistic regression analysis was used to determine the possible influencing factors. Results Fifty -six(58.95%)patients had favourable outcomes after thrombolytic therapy for 24 hours.Multivariate logistic regression analysis indicated that diabetes(OR =3.933,95% CI 1.199 ~12.897)and TOAST classification (OR =1.448,95% CI 1.032 ~2.032 )were the independent predictors of short -term outcome.Conclusion Diabetes and TOAST classification are the major influencing factors of short -term efficacy after intravenous thrombolysis with rt -PA.It should pay attention screening patients for intravenous thrombolysis therapy and predicting the efficacy of thrombolysis.

Objective To assess the factors associated with occurrence of stroke in Xuzhou region on the basis of stroke registry database using data mining methods Relief F algorithm.Methods Five hundred and forty-six patients with acute cerebral infarction from June 2013 to June 2014 in Stroke Registry database and 546 healthy people at the same period in the region were chosen;their clinical data were collected and retrospectively analyzed.And the related data were collected,arranged and put into epidata database.Firstly,the data were normalized and converted to the number between 1 and 10.Relief F algorithm was used to analyze the weight of past histories and hematology index between healthy control group and stroke group.Matlab software was used to program and calculate,and the main program runs for 20 times.And then,the obtained results for each weighted average were summarized.Finally,the weight of past medical history and blood parameters in healthy control group and stroke group were obtained.Results Relief F algorithm was applied for data analysis:as compared with healthy controls,stoke group had higher weight of infarction (0.0353125) and history of drinking (0.01175),while not higher weight of history of hypertension,diabetes mellitus or transient ischemic attack;as compared with healthy controls,stoke group had higher weight of uric acid nitrogen level (0.0072),blood uric acid level (0.0071),cholesterol level (0.0067) and homocysteine level (0.0064),followed by high-density lipoprotein (0.0062),low density lipoprotein (0.0041) and triglyceride (0.0039).Conclusion Application of Relief F algorithm can excavate the closely related potential risk factors for stroke in stroke registration database.

Objective To study the value of transcranial Doppler (TCD) combined with digital subtraction angiography (DSA) in the evaluation of intracranial vessels in patients with cerebral watershed infarction.Methods The clinical and imaging data of 97 patients with cerebral watershed infarction,admitted to our hospital from June 2008 to June 2011,were retrospectively analyzed.All patients underwent TCD and DSA examination.Comparative analysis of TCD and DSA for intracranial stenosis diagnosis and compensatory collateral circulation in these patients was performed,and the advantages and disadvantages of TCD and DSA in these cases were compared.Results Eight hundred and seventy-three intracranial vessels of the 97 patients were analyzed.TCD and DSA showed no significant differences in evaluation of vascular stenosis or occlusion (P=0.503).As to the collateral circulation,no significant differences between TCD and DSA were shown in the evaluation of anterior communicating artery compensatory (P=0.754),while TCD was more sensitive than DSA in the evaluation of ophthalmic artery compensatory (P=0.039),and DSA was more sensitive in evaluating the posterior communicating artery and pial artery compensatory (P=0.035 and P=0.000).The internal watershed infarction and cortical watershed infarction had significant differences in intracranial vascular stenosis or occlusion and collateral circulation (x2=9.762,P=0.002; x2=24.708,P=0.000).Conclusion Combining TCD and DSA can contribute to judge the intracranial vascular lesions and collateral circulation correctly.