[Objective] To analyze the loss rate of platelet donors and evaluate the strategies for establishing a platelet donor bank. [Methods] A total of 1 443 donors who joined the HLA and HPA gene donor bank for platelets in Henan Province from 2018 to 2020 were included in this study. Data on the total number of apheresis platelet donations, annual donation frequency, age at enrollment, donation habits (including the number of platelets donated per session and whether they had previously donated whole blood), and enrollment location were collected from the platelet donor information management system. Donor loss was determined based on the date of their last donation. The loss rates of different groups under various conditions were compared to assess the enrollment strategies. [Results] By the time the platelet bank was officially operational in 2022, 421 donors had been lost, resulting in an loss rate of 29% (421/1 443). By the end of 2023, the overall cumulative loss rate reached 52% (746/1 443). The loss rate was lower than the overall level in groups meeting any of the following conditions: total apheresis platelet donations exceeding 50, annual donation frequency of 10 or more, age at enrollment of 40 years or older, donation of more than a single therapeutic dose per session, or a history of whole blood donation two or more times. Additionally, loss rates varied across different enrollment locations, with higher enrollment numbers generally associated with higher loss rates. [Conclusion] Through a comprehensive analysis of donor loss, our center has adjusted its strategies for establishing the donor pool. These findings also provide valuable insights for other blood collection and supply institutions in building platelet donor banks.

Cholelithiasis is one of the most common diseases of the digestive system,and the accurate preoperative diagnosis of cholelithiasis is important to guiding treatment and improving prognosis.Dual-energy CT based on material decomposition and post-processing techniques can generate virtual monoenergetic images,virtual noncontrast images,calcium-and fat-based material decomposition images and Rho/Z images which are helpful for detecting isoattenuating gallstones,and offer objective evidence for diagnosing gallstone disease and its complications.This article reviews the principle of dual-energy CT and its progress in cholelithiasis.

Cholelithiasis is one of the most common diseases of the digestive system,and the accurate preoperative diagnosis of cholelithiasis is important to guiding treatment and improving prognosis.Dual-energy CT based on material decomposition and post-processing techniques can generate virtual monoenergetic images,virtual noncontrast images,calcium-and fat-based material decomposition images and Rho/Z images which are helpful for detecting isoattenuating gallstones,and offer objective evidence for diagnosing gallstone disease and its complications.This article reviews the principle of dual-energy CT and its progress in cholelithiasis.

Objective:To explore the relationship between the degree of devascularization and clinical outcomes after interventional embolization and sclerotherapy for peripheral arteriovenous malformations.Method:A retrospective analysis was conducted on the data of 37 patients with peripheral arteriovenous malformations admitted at Department of Cardiovascular Surgery, China-Japan Friendship Hospital from July 2021 to June 2023. All patients received the treatment of "nidus" and/or outflow veins embolization combined with sclerotherapy injection. Two experienced physicians evaluated the degree of devascularization before and after treatment, and conducted a correlation study with clinical outcomes after follow-up.Result:All 37 patients were symptomatic. Swelling and pain accounted for 75.7% of all the cases. Twenty-six patients received only one procedure, 3 patients received re-interventional treatments. The average follow-up time was（13.3±5.0）months. Clinical symptoms were completely relieved in 14 patients, and partial relief in 22 patients. The overall effective rate was 97%. There were 6 patients with degree of de vascularization<50% during procedure, 16 patients with degree of 50%-75%, and 5 patients with degree of 75%-90%, 10 cases with degree over 90%. Patients with devascularization degrees less than 60% can not achieve clinical symptom relief.Conclusions:There is a positive correlation between the degree of devascularization and clinical outcomes in the interventional embolization and sclerotherapy of peripheral arteriovenous malformations, and 60% of the degree of devascularization can serve as the "threshold" for effectiveness of treatment.

Objective:To investigate the effect of carotid endarterectomy(CEA) in the treatment of symptomatic carotid artery near-occlusion(CNO).Methods:Clinical symptoms, imaging examination, treatment and prognosis of 122 symptomatic CNO patients admitted to China-Japan Friendship Hospital from Jan 2014 to Jan 2020 undergoing CEA were retrospectively analyzed. Patients were divided into two groups based on the collapse condition,full collapse group(54 cases) and non-full collapse group(68 cases).Results:The difference was insignificant between the two groups at the 30-day and 12-month occurrence rate of primary endpoints(1.85% vs. 4.41%, P=0.629;7.41% vs. 4.41%, P=0.698).Postoperative re-stenosis occurred in one case in the non-full collapse group 8 months after CEA. Conclusions:CEA can achieve good curative effect for patients with CNO with recurrent symptoms, irrelevant to the existence of distal full collapse. The shunt can prevent intraoperative hypoperfusion and postoperative hyperperfusion.

Objective:To evaluate the efficacy of different carotid artery revascularization strategy in sychronous carotid and coronary artery revascularization.Methods:The clinical data of 53 patients receiving simultaneous carotid and coronary artery revascularization in China-Japan Friendship Hospital from Jan 2014 to Dec 2019 was retrospectively analyzed. The clinical characteristics, imaging examination, treatment and prognosis were collected and reviewed. Patients were divided into CEA group (42 cases) and CAS group (11 cases) according to the carotid artery revascularization method.Results:The mean operative time and blood loss of CEA group were (288.81±43.28) min and (419.05±127.33) ml, respectively. The mean operative time and blood loss of CAS group were (251.82±23.16) min and (318.18±98.16) ml, respectively. The difference of operative time and blood loss between the 2 groups were not significant (all P>0.05). Four minor strokes, 4 transient ischemic attacks (TIA), 2 pulmonary infections and 4 recurrent laryngeal nerve injury were observed in CEA group. Two TIA and 1 re-thoracotomy for hemostasis occurred in CAS group. Conclusions:Both carotid endarterectomy and carotid stenting can achieve good clinical result in synchronous carotid and coronary artery revascularization procedure. The selection of proper carotid artery revascularization method should base on the lesion characteristic and surgeon's experience.

Objective:To analyze the correlation between simple thyroid nodule and blood lipid and glucose metabolism and iodine nutrition level.Methods:A cross-sectional study was conducted by collecting data of the population undergoing epidemiological investigation in Jinshan District, Shanghai from July to December 2015, to calculate the prevalence of thyroid nodules and analyze relevant functional indicators.Results:Simple thyroid nodules were detected in 603 subjects, with a prevalence of 22.6% (603/2 669). There were 358 female patients with simple thyroid nodules, with a prevalence rate of 26.9%, and 245 male patients with simple thyroid nodules, with a prevalence rate of 18.3%. The prevalence of simple thyroid nodule in female was higher than that in male, and the difference was statistically significant (χ 2=27.686, P<0.001). In addition, the prevalence of simple thyroid nodules increased with age (13.1% (92/704) and 20.2% (104/514) and 25.1% (145/578) and 24.4% (107/439) and 36.3% (98/270) and 34.8% (57/164), χ 2=83.872,P<0.001). In the ≤30 years group (8.0% (30/704) vs. 18.8% (62/331), χ 2=35.716, P<0.001), >30 to ≤40 years old group (14.1% (37/263) vs. 26.7% (67/251), χ 2=12.683, P<0.001), >60 to ≤70 years old group (26.2% (33/126) vs. 45.1% (65/144), χ 2=10.435, P<0.001), and the 70-year-old group (24.4% (21/86) vs. 46.2% (36/78), χ 2=8.521, P<0.001). The prevalence of simple thyroid nodules in males was lower than that in females. In the simple positive thyroid nodule group, Fasting blood glucose (5.12 (4.80, 5.69) and 5.02 (4.72, 5.48)), total cholesterol (1.24 (0.85, 1.86) and 1.13 (0.77, 1.76)), triglyceride (4.77 (4.09, 5.48) and 4.49 (3.92, 5.16)), low density lipoprotein((2.79 (2.26, 3.36) and 2.63 (2.19, 3.16)), and high density lipoprotein cholesterol (1.41 (1.18, 1.66) and 1.35 (1.13, 1.61)) were higher than those in the negative group ( U values were 554 818, 578 468, 535 622, 556 067 and 567 960, respectively, all P<0.01). The BMI index grade distribution of thyroid nodule positive group was higher than that of negative group, and the difference was statistically significant (3.7% (77/2 066), 50.1% (1 034/2 066), 32.4% (669/2 066), 13.8% (286/2 066), 3.2% (19/603), 43.6% (263/603), 38.1% (230/603), 15.1% (91/603), χ2=9.5201, P=0.023). The prevalence of simple thyroid nodules was significantly lower in the iodized salt group than in the non-iodized salt group (20.7% (436/2 102) vs. 29.5% (167/567), χ 2=19.376, P<0.001). The urinary iodine level in the positive thyroid nodule group was significantly lower than that in the negative group (148.4(100.2, 213.7) vs. 169.5(115.4, 241.75), U=545 129.5, P<0.001). After Logistic regression screening, age ( OR=1.57, 95% CI: 1.292-1.908, P<0.001), gender ( OR=1.278, 95% CI: 1.193-1.368, P<0.001), BMI grade ( OR=1.166, 95% CI: 1.022-1.330, P=0.022), total cholesterol ( OR=1.105, 95% CI: 1.005-1.214, P=0.040), iodized salt ( OR=0.689, 95% CI: 0.556-0.854, P=0.001) were independent influencing factors of thyroid nodule. Conclusion:The prevalence of simple thyroid nodules in Shanghai is relatively low. Age, sex, BMI level, total cholesterol and iodized salt are independent factors causing thyroid nodules. In addition, blood glucose level may also be related to the prevalence of thyroid nodules.

Objective To construct an intelligent analysis system based on visual attention for diabetic retinopathy ( DR) assistant diagnosis and to realize the automatic screening and grading of fundus images of DR. Methods Total of 35126 DR fundus images were downloaded from the Diabetic Retinopathy Detection competition in the Data Modeling and Data Analysis Competition Platform (Kaggle),and 1200 fundus images were downloaded from the Messidor website. Firstly,according to the characteristics of DR fundus images,a series of preprocessing was carried out for retina images. Then,on the basis of VGG16 network,visual attention SENet module was introduced to improve the saliency of lesion features,and a deep convolution neural network SEVGG with complex network structure was generated. The network basically inherited some structural parameters of VGG16,and the parameters of SENet module were adjusted according to the basic network and training data set. Finally, the SEVGG network model was used to screen the DR fundus image,and the fundus image was divided into different levels according to the degree of lesions of DR in different periods. Configure the training platform and environment and perform algorithm performance verification experiments. Results The method proposed in this study was tested on different open standard datasets,and finally achieved high accuracy in image-based classification. The accuracy of 5 classification in Kaggle dataset was 83％,the sensitivity of lesion detection was 99. 86％ and the specificity was 99. 63％. The accuracy rate of the 4 classification in the Messidor data set was up to 88％,the sensitivity of the lesion detection was 98. 17％,and the specificity was 96. 39％. The introduction of visual attention was more significant for the focus of the lesion,which helped the accurate detection of DR. Conclusions This method effectively avoids some shortcomings of traditional artificial feature extraction and fundus image classification,and is more accurate for lesion recognition. It is not only superior to the previous method,but also shows better robustness and generalization.

To determine the value of radiomics in identifying lymph node (LN) metastasis in patients with rectal nonmucinous adenocarcinoma.
 Methods: Imaging data of 91 patients were retrospectively analyzed (61 in the training set and 30 in the test set). A total of 1 301 radiomics features were extracted from high-resolution T2-weighted images of the whole primary tumor. The least absolute shrinkage and selection operator (LASSO) logistic regression was performed to choose the optimal features and construct a radiomics classifier in the training set. Its discrimination performance was compared with that of morphological criteria by receiver operating characteristic (ROC) curve analysis, which was validated in the test set.
 Results: The radiomics classifier combined with five key features was significantly associated with LN metastasis, which distinguished LN metastasis with an area under curve (AUC) at 0.874 (95% CI 0.787 to 0.960) in the training set, and the performance was similar in the test set (AUC 0.878, 95% CI 0.727 to 1.000). The AUCs according to the morphological criteria in the training set and test set were 0.619 (95% CI 0.487 to 0.752) and 0.556 (95% CI 0.355 to 0.756), respectively. Discrimination of the radiomics classifier was superior to that of morphological criteria in both the two datasets (both P <0.05).
 Conclusion: The radiomics classifier provides individualized risk estimation for LN metastasis in rectal nonmucinous adenocarcinoma patients and it has the advantage over the morphological criteria.
Adenocarcinoma ; Humans ; Lymph Nodes ; Lymphatic Metastasis ; Rectal Neoplasms ; Retrospective Studies

Objective To evaluate diagnostic method and treatment strategy for free floating thrombus in carotid artery.Methods From Ju12016 to Oct 2017,7 patients with free floating thrombus in carotid artery was diagnosed at our department.The medical history,symptoms,diagnosis,treatment strategy and prognosis of those patients were analyzed retrospectively.Results Among 7 patients,4 were symptomatic;4 patients were concomitant with severe carotid artery stenosis and 3 with mild to moderate stenosis.3 received carotid endarterectomy and patch angioplasty.4 received carotid artery stenting with distal cerebral protection divice.There was no perioperative and 30-day stroke,myocardial infarction,death or hyperperfusion syndrome occurred.The 12-month follow up showed no restenosis,no free floating thrombus recurrence and no ischemic cerebrovascular event.Conclusion Free floating filling defect in carotid artery is a typical sign for unstable plaque.Both carotid endarterectomy and carotid artery stenting can be used for the treatment of free floating thrombus.