To provide in-service medical technicians and nurses with convenient access to continuing education resources in transfusion medicine, reduce transfusion-related adverse events, and ensure the safety, rationalization, and effectiveness of clinical transfusion, we designed and developed an online transfusion continuing education platform. The platform was based on the new managed code programming model.NET Core and the powerful functions of hypertext preprocessor PHP 7.4, addressing current issues in transfusion online continuing education. Through in-depth analysis of student attributes, learning behaviors, and teaching behaviors, a comprehensive online continuous teaching quality evaluation index system was established. This system not only facilitates the quantitative assessment of teaching quality but also successfully integrates the two core functions of teaching and management, thereby achieving unified online teaching.

To provide in-service medical technicians and nurses with convenient access to continuing education resources in transfusion medicine, reduce transfusion-related adverse events, and ensure the safety, rationalization, and effectiveness of clinical transfusion, we designed and developed an online transfusion continuing education platform. The platform was based on the new managed code programming model.NET Core and the powerful functions of hypertext preprocessor PHP 7.4, addressing current issues in transfusion online continuing education. Through in-depth analysis of student attributes, learning behaviors, and teaching behaviors, a comprehensive online continuous teaching quality evaluation index system was established. This system not only facilitates the quantitative assessment of teaching quality but also successfully integrates the two core functions of teaching and management, thereby achieving unified online teaching.

Objective To evaluate the clinical value of neutrophil CD64(nCD64)index as a novel biomark-er in the differential diagnosis of acute and chronic brucellosis.Methods A total of 38 patients with acute bru-cellosis and 48 patients with chronic brucellosis diagnosed in the People's Hospital of Xinjiang Uygur Autono-mous Region from February 2021 to July 2023 were included.Peripheral blood of the patients was collected and nCD64 index was detected by flow cytometry,and the correlation between nCD64 index and disease severi-ty was analyzed.Receiver operating characteristic(ROC)curve was used to analyze the sensitivity and the specificity of nCD64 index in differentially diagnosing acute and chronic brucellosis.Meanwhile,Rose-Bengal Plate Test(RBPT)and Standard Tube Agglutination Test(SAT)were used as controls to evaluate the clini-cal diagnostic value of the three.Results The nCD64 index of acute brucellosis patients was higher than that of chronic brucellosis patients(U=216.00,P<0.001),and the index was positively correlated with the sever-ity of the disease(r=0.670,P<0.001).The ROC curve analysis results showed that the area under the curve of nCD64 index in the differential diagnosis of acute and chronic brucellosis was 0.882(95%CI:0.811-0.952,P<0.001),the cut-off value was 2.81,and sensitivity,specificity,positive predictive value,negative predictive value and accuracy were 83.3%,81.6%,80.4%,81.9%and 82.6%,respectively.The efficacy of nCD64 index in differential diagnosis of nCD64 index was significantly better than those of the qualitative tests of RBPT and SAT.Conclusion nCD64 index has favourable sensitivity and specificity in the differential diag-nosis of acute and chronic brucellosis,and tends to reflect the severity of the disease.It has clinical value in the differential diagnosis of acute brucellosis and chronic brucellosis,and plays an important role in the early diag-nosis and treatment effect monitoring of brucellosis.

The Choledochal cyst is an extremely rare congenital anomaly of the bile duct. Early cyst resection and Roux-en-Y hepatojejunostomy are the primary surgical methods for treating choledochal cyst. With the emergence of enhanced recovery after surgery, laparoscopic surgery has effectively reduced the incidence of biliary complications and wound infections, but it still does not meet people's requirements for minimally invasive surgery. Robotic surgery system has the potential to enhance surgical precision and the maneuverability of surgeons due to clear surgical visualization and flexible mechanical arms. The authors review the relevant literatures and conduct a Meta-analysis to evaluate the efficacy of robot-assisted surgery and laparoscopic surgery for choledochal cyst.

Humans ; Aripiprazole/therapeutic use* ; Schizophrenia/drug therapy* ; Antipsychotic Agents/therapeutic use* ; Risperidone ; China ; Treatment Outcome

Objective:To analyze the association between NUDT15 gene polymorphism and adverse reactions induced by azathioprine (AZA) myelosuppression in patients with inflammatory bowel disease (IBD) , and to provide reference for clinical treatment of IBD. Methods:Literatures of randomized controlled trials of NUDT15 gene mutation and AZA in the treatment of IBD were searched with computer from China Knowledge Network, Wanfang database, VIP database, PubMed, Cochrane Library and Web of Science. The quality evaluation and data of studies meeting the inclusion criteria were screened and retrieved to perform meta analysis. Results:Ten literatures were enrolled including 3095 patients. Meta analysis showed that the mutation rate of NUDT15 gene in Asian IBD population was significantly higher than that of TPMT gene (21.5% vs. 2.8%, OR = 0.10, 95% CI: 0.07-0.15, P<0.001) with significant difference. NUDT15 gene mutation was significantly associated with AZA-related leukopenia ( OR = 0.40, 95% CI: 0.34-0.47, P<0.001) . IBD patients with NUDT15 mutation were more likely to develop leukopenia in the early stage of AZA application ( OR = 2.69, 95% CI: 1.67-4.33, P<0.001) . Besides, homozygous mutants of NUDT15 gene (TT type) were more likely to have grade Ⅲ-Ⅳ bone marrow suppression ( OR = 0.09, 95% CI: 0.04-0.18, P<0.001) . Conclusions:In Asian IBD population, bone marrow suppression caused by AZA is significantly associated with NUDT15 gene mutation, which is more closely associated than TPMT gene mutation and usually occurs within 8 weeks of AZA application. At the same time, homozygous mutations of NUDT15 gene (TT) increase the risk of severe myelosuppression.

Objective:To analyze the association between NUDT15 gene polymorphism and adverse reactions induced by azathioprine (AZA) myelosuppression in patients with inflammatory bowel disease (IBD) , and to provide reference for clinical treatment of IBD. Methods:Literatures of randomized controlled trials of NUDT15 gene mutation and AZA in the treatment of IBD were searched with computer from China Knowledge Network, Wanfang database, VIP database, PubMed, Cochrane Library and Web of Science. The quality evaluation and data of studies meeting the inclusion criteria were screened and retrieved to perform meta analysis. Results:Ten literatures were enrolled including 3095 patients. Meta analysis showed that the mutation rate of NUDT15 gene in Asian IBD population was significantly higher than that of TPMT gene (21.5% vs. 2.8%, OR = 0.10, 95% CI: 0.07-0.15, P<0.001) with significant difference. NUDT15 gene mutation was significantly associated with AZA-related leukopenia ( OR = 0.40, 95% CI: 0.34-0.47, P<0.001) . IBD patients with NUDT15 mutation were more likely to develop leukopenia in the early stage of AZA application ( OR = 2.69, 95% CI: 1.67-4.33, P<0.001) . Besides, homozygous mutants of NUDT15 gene (TT type) were more likely to have grade Ⅲ-Ⅳ bone marrow suppression ( OR = 0.09, 95% CI: 0.04-0.18, P<0.001) . Conclusions:In Asian IBD population, bone marrow suppression caused by AZA is significantly associated with NUDT15 gene mutation, which is more closely associated than TPMT gene mutation and usually occurs within 8 weeks of AZA application. At the same time, homozygous mutations of NUDT15 gene (TT) increase the risk of severe myelosuppression.

Objective To study the clinical features and risk factors of acute pulmonary reperfusion injury after operation in neonates with severe pulmonary stenosis or pulmonary atresia.Method From February 2014 to February 2018,a retrospective analysis was performed in patients with critical pulmonary stenosis or pulmonary atresia who received percutaneous balloon pulmonary valvuloplasty (PBPV) in the neonatal intensive care unit of our hospital.Clinical characteristics,perioperative cardiac structure,hemodynamic data and biochemical results were collected.The neonates were assigned into injury group if they had acute lung reperfusion injury,and non-injury group if not.The risk factors of acute lung reperfusion injury were analyzed using multi-variate Logistic regression model.Result A total of 32 patients (24 prenatal diagnosis and 8 postnatal diagnosis) with severe pulmonary stenosis or pulmonary atresia with intact ventricular septum were enrolled.The main manifestations were dyspnea and cyanosis.Intravenous prostaglandin E was administered to keep the ductus arteriosus open.The age of operation ranged from 1 to 52 days and the median age was 7.5 days.Postoperative acute lung reperfusion injury occurred in 7 cases (21.9％).Preoperative and intraoperative pulmonary valve annulus diameter,balloon diameter,preoperative hemoglobin,hematocrit and blood albumin were significantly lower in the injury group.The operation duration,total length of hospital stay and postoperative duration were longer than in the non-injury group,the differences were statistically significant (P ＜ 0.05).Multi-variate Logistic regression analysis showed that the diameter of pulmonary valve annulus (OR =5.814,95％CI 1.106 ～30.568),preoperative blood albumin (OR =1.361,95％ CI 1.063 ～ 1.742),and hematocrit (OR =1.173,95％ CI 1.010 ～ 1.363) were risk factors of acute lung reperfusion injury,with statistically significant differences (P ＜ 0.05).Conclusion Acute lung reperfusion injury is one of the common complications after the operation of severe pulmonary stenosis or pulmonary atresia.The severity of pulmonary valve annulus stenosis,preoperative hematocrit and blood albumin level may be the risk factors of postoperative acute lung reperfusion injury.

Objective To investigate the potential dose-response relationship between PCDD/Fs inhalational exposure and oxidative damage to DNA and lipid in foundry workers.Methods The participants were divided into three groups,including exposure group,administrator group and control group.The concentrations of polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) in air environment were determined by isotope dilution high resolution capillary column gas chromatography/high resolution mass spectrometry (HRGC-HRMS).The inhalational dose of PCDD/Fs were evaluated by Houmen's model.Urinary 8OHdG was analyzed by high performance liquid chromatography-electrochemical detector (HPLC-ECD).Urinary 8-iso-PGF2a were determined by ELISA.Results The PCDD/Fs environmental concentrations of three groups (pg· TEQ/m) were 0.21 +0.08,0.03 ±0.01,0.0012 ±0.0007 (P＜0.05),respectively.The inhalational dose of exposure group (92.54 (32.90～264.49) fg· TEQ/kg· d) was 5.4 folds higher than the administrator group,and was 201 times more than control group.The levels of urinary 8-OHdG(nmol/L crea) of three groups were 3.25 (1.07～15.36),2.72(0.75～16.07),2.17(0.38～17.07) (P＜0.05) and the levels of urinary 8-iso-PGF2n (nmol/L crea)were 19.11(9.33～76.50),20.95(8.40～79.31),11.48(4.85～37.80)(P＜0.05),respectively.The multiple linear regression analysis revealed that there were significantly increased trend for levels of urinary 8-OHdG and 8-iso-PGF2a as PCDD/Fs exposure levels increased,after adjustment for age,sex,smoking statue,alcohol use and BMI (P＜0.01).Conclusion There was a dose-response relationship between PCDD/Fs inhalational exposure and oxidative damage in foundry workers.

Objective To investigate the potential dose-response relationship between PCDD/Fs inhalational exposure and oxidative damage to DNA and lipid in foundry workers.Methods The participants were divided into three groups,including exposure group,administrator group and control group.The concentrations of polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) in air environment were determined by isotope dilution high resolution capillary column gas chromatography/high resolution mass spectrometry (HRGC-HRMS).The inhalational dose of PCDD/Fs were evaluated by Houmen's model.Urinary 8OHdG was analyzed by high performance liquid chromatography-electrochemical detector (HPLC-ECD).Urinary 8-iso-PGF2a were determined by ELISA.Results The PCDD/Fs environmental concentrations of three groups (pg· TEQ/m) were 0.21 +0.08,0.03 ±0.01,0.0012 ±0.0007 (P＜0.05),respectively.The inhalational dose of exposure group (92.54 (32.90～264.49) fg· TEQ/kg· d) was 5.4 folds higher than the administrator group,and was 201 times more than control group.The levels of urinary 8-OHdG(nmol/L crea) of three groups were 3.25 (1.07～15.36),2.72(0.75～16.07),2.17(0.38～17.07) (P＜0.05) and the levels of urinary 8-iso-PGF2n (nmol/L crea)were 19.11(9.33～76.50),20.95(8.40～79.31),11.48(4.85～37.80)(P＜0.05),respectively.The multiple linear regression analysis revealed that there were significantly increased trend for levels of urinary 8-OHdG and 8-iso-PGF2a as PCDD/Fs exposure levels increased,after adjustment for age,sex,smoking statue,alcohol use and BMI (P＜0.01).Conclusion There was a dose-response relationship between PCDD/Fs inhalational exposure and oxidative damage in foundry workers.