[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.

Objective:To explore the therapeutic effect of micro-flaps carrying sensory nerve in treatment of high-pressure injection injuries of the digit (HPIID).Methods:From January 2022 to June 2024, retrospective analysis of 7 patients who had HPIID were admitted to the Department of Hand Surgery Division 1, Norinco General Hospital. The patients were 5 males and 2 females with ages from 25 to 59 years. The digital injuries were: 3 index fingers, 2 middle fingers and 2 thumbs. All patients received debridement under microscope in primary surgery, with the defects at 1.5 cm×2.4 cm - 2.5 cm×5.5 cm in size after debridement. In stage Ⅱ surgery, 5 patients received the treatment of free fibular great toe flap carrying peroneal nerve of the great toe, with the flap size at 1.8 cm× 2.0 cm - 2.7 cm×4.0 cm. Two patients received the treatment of transfer of free fibular medial plantar flap carrying medial plantar nerve, with flap size at 1.9 cm×2.6 cm - 4.5 cm×5.7 cm. Donor sites were directly sutured in 5 patients, and 2 patients received skin grafting. Five patients received postoperative follow-up at outpatient clinic, 1 patient via telephone interview and 1 via WeChat review.Results:All 7 flaps survived and all wounds had primary healing. All donor and recipient sites and skin grafting sites healed primarily. Postoperative follow-up lasted for 4 to 9 months, with an average of 6.4 months. All the affected digits had satisfactory appearance and function, except 1 which was slightly slimmer than the healthy side. Range of motion of the affected digits was evaluated according to total active movement (TAM): 5 were in excellent and 2 in good. Sensory recovery of the digits was evaluated according to the British Medical Research Council (BMRC): 1 digit was at S 2, 2 at S 3 and 4 at S 4. One patient had two-point discrimination (TPD) at 9.0-15.0 mm, 2 at 6.0-10.0 mm, and 4 at 3.0-6.0 mm. Conclusion:For HPIID with a defect, surgical treatment with transfer of micro-flap carrying sensory nerve should be a preferred treatment option.

Objective:To investigate the expression levels, correlation, and diagnostic efficacy of peripheral blood CD8 +T lymphocyte subsets and different immune checkpoint markers in patients with Brucellosis. Method:A case-control study was conducted on 32 patients with acute phase brucellosis (27 males and 5 females, aged 36 (30, 43) years), 38 patients with chronic phase brucellosis (30 males and 8 females, aged 40 (32, 48) years), and 30 healthy controls (24 males and 6 females, aged 39 (32, 46) years), who underwent physical examination at Xinjiang Uygur Autonomous Region People′s Hospital from February 1, 2021 to December 31, 2023. All subjects had fasting blood sampling once in the morning. Flow cytometry was used to detect the proportion of peripheral blood lymphocyte subsets, the expression levels of CD8 +T lymphocyte surface programmed cell death receptor-1 (PD-1), T lymphocyte immunoglobulin receptor with Ig and ITIM domains (TIGIT), T cell immunoglobulin and mucin domain containing protein 3 (TIM-3), perforin and granzyme B. The changes in these indicators during the acute and chronic phases of the disease were observed, and correlation analysis was performed using Spearman′s method. Receiver Operating Characteristic Curve (ROC) analysis is used to evaluate the diagnostic value of immunological indicators with differences in acute and chronic brucellosis. Results:CD3 +T lymphocyte in the chronic group (70.71%±8.78%) is significantly lower than that in the healthy control group (74.65%±7.31%) ( P<0.05), and CD4 +T lymphocyte in the acute phase group (39.52%±5.85%) is also lower than that in the healthy control group (45.10%±5.18%) ( P<0.01); while CD8 +T lymphocyte in the acute group (31.73%±5.87%) is significantly higher than that in the chronic phase group (26.75%±4.71%) ( P<0.001). There was a statistically significant difference ( P<0.001) in CD8+CD28 -T lymphocyte among the acute group (69.85% (58.62%, 78.55%)), chronic group (86.46% (73.30%, 92.52%)) and healthy control group (25.39% (20.60%,32.90%)), when compared pairwise. The expression levels of immune checkpoint PD-1, TIGIT, and TIM-3 on the surface of CD8 +T lymphocytes were higher in both the acute and chronic groups than in the healthy control group ( P<0.001). The expression level of perforin secreted by CD8 +T lymphocytes in the acute and chronic groups was lower than that in the healthy control group ( P<0.05), while the expression level of granzyme B in the acute and chronic groups was higher than that in the healthy control group ( P<0.01). The proportion of CD8 +CD28 -T lymphocytes in brucellosis patients was positively correlated with the expression levels of TIGIT and TIM-3 ( r=0.624, 0.406, P<0.001). The ROC curve combined with the proportion of CD8 +CD28 -T lymphocytes and the proportion of TIGIT on the surface of CD8 +T lymphocytes can distinguish acute and chronic brucellosis. The Area Under Curve (AUC) is 0.973, which has certain implications for clinical differentiation of patients with acute and chronic diseases. Conclusion:The CD8 +T lymphocyte subsets in patients with brucellosis exhibit dynamic changes, accompanied by changes in relevant immune checkpoint molecules, and can regulate the activation and inhibition of the immune status of brucellosis patients. The synergistic effect of CD8 +CD28 -T cells and TIGIT/TIM-3 may be a key mechanism of driving chronicity, and their combined diagnosis can serve as a clinical staging marker.

Objective:To investigate the impact of para-tumoral micro-metastasis(PTMM) and other clinicopathological characteristics on the prognosis of patients with intrahepatic cholangiocarcinoma (ICC).Methods:This is a retrospective cohort study. Clinical data from 137 ICC patients who underwent radical resection at the Hepatobiliary Surgery Center, Department of General Surgery, Huashan Hospital, Fudan University, between January 2017 and December 2022 were analyzed retrospectively. The cohort included 91 males and 46 females, with age ( M(IQR)) of 63 (13) years (range: 32 to 82 years). Kaplan-Meier curves were used to estimate median survival times, while Log-rank tests assessed differences in overall survival (OS) and recurrence-free survival (RFS). Univariate and multivariate Cox regression models were employed to identify factors associated with OS and RFS. Results:The median OS for all 137 ICC patients was 34 months, with 1-, 2-, and 3-year OS rates of 90.7%, 69.4%, and 39.5%, respectively. The results of univariate and multivariate Cox analysis showed that Child-Pugh grade, CA19-9, carcinoembryonic antigen, and PTMM were independent prognostic factors for OS in ICC patients after radical resection (all P<0.05), Child-Pugh grade, maximum tumor diameter, whether lymph node metastasis, and PTMM were independent prognostic factors for RFS in radical resection in ICC patients (all P<0.05). PTMM-positive patients had a median OS of 21 months and median RFS of 12 months, whereas PTMM-negative patients exhibited a median OS exceeding 60 months and median RFS of 36 months. Log-rank tests demonstrated statistically significant differences in OS and RFS between PTMM-positive and PTMM-negative patients ( P<0.01 and P=0.001, respectively). Conclusion:Preliminary findings suggest that PTMM holds significant prognostic value in evaluating outcomes for ICC patients undergoing curative resection.

Objective:To investigate the impact of para-tumoral micro-metastasis(PTMM) and other clinicopathological characteristics on the prognosis of patients with intrahepatic cholangiocarcinoma (ICC).Methods:This is a retrospective cohort study. Clinical data from 137 ICC patients who underwent radical resection at the Hepatobiliary Surgery Center, Department of General Surgery, Huashan Hospital, Fudan University, between January 2017 and December 2022 were analyzed retrospectively. The cohort included 91 males and 46 females, with age ( M(IQR)) of 63 (13) years (range: 32 to 82 years). Kaplan-Meier curves were used to estimate median survival times, while Log-rank tests assessed differences in overall survival (OS) and recurrence-free survival (RFS). Univariate and multivariate Cox regression models were employed to identify factors associated with OS and RFS. Results:The median OS for all 137 ICC patients was 34 months, with 1-, 2-, and 3-year OS rates of 90.7%, 69.4%, and 39.5%, respectively. The results of univariate and multivariate Cox analysis showed that Child-Pugh grade, CA19-9, carcinoembryonic antigen, and PTMM were independent prognostic factors for OS in ICC patients after radical resection (all P<0.05), Child-Pugh grade, maximum tumor diameter, whether lymph node metastasis, and PTMM were independent prognostic factors for RFS in radical resection in ICC patients (all P<0.05). PTMM-positive patients had a median OS of 21 months and median RFS of 12 months, whereas PTMM-negative patients exhibited a median OS exceeding 60 months and median RFS of 36 months. Log-rank tests demonstrated statistically significant differences in OS and RFS between PTMM-positive and PTMM-negative patients ( P<0.01 and P=0.001, respectively). Conclusion:Preliminary findings suggest that PTMM holds significant prognostic value in evaluating outcomes for ICC patients undergoing curative resection.

Objective:To explore the therapeutic effect of micro-flaps carrying sensory nerve in treatment of high-pressure injection injuries of the digit (HPIID).Methods:From January 2022 to June 2024, retrospective analysis of 7 patients who had HPIID were admitted to the Department of Hand Surgery Division 1, Norinco General Hospital. The patients were 5 males and 2 females with ages from 25 to 59 years. The digital injuries were: 3 index fingers, 2 middle fingers and 2 thumbs. All patients received debridement under microscope in primary surgery, with the defects at 1.5 cm×2.4 cm - 2.5 cm×5.5 cm in size after debridement. In stage Ⅱ surgery, 5 patients received the treatment of free fibular great toe flap carrying peroneal nerve of the great toe, with the flap size at 1.8 cm× 2.0 cm - 2.7 cm×4.0 cm. Two patients received the treatment of transfer of free fibular medial plantar flap carrying medial plantar nerve, with flap size at 1.9 cm×2.6 cm - 4.5 cm×5.7 cm. Donor sites were directly sutured in 5 patients, and 2 patients received skin grafting. Five patients received postoperative follow-up at outpatient clinic, 1 patient via telephone interview and 1 via WeChat review.Results:All 7 flaps survived and all wounds had primary healing. All donor and recipient sites and skin grafting sites healed primarily. Postoperative follow-up lasted for 4 to 9 months, with an average of 6.4 months. All the affected digits had satisfactory appearance and function, except 1 which was slightly slimmer than the healthy side. Range of motion of the affected digits was evaluated according to total active movement (TAM): 5 were in excellent and 2 in good. Sensory recovery of the digits was evaluated according to the British Medical Research Council (BMRC): 1 digit was at S 2, 2 at S 3 and 4 at S 4. One patient had two-point discrimination (TPD) at 9.0-15.0 mm, 2 at 6.0-10.0 mm, and 4 at 3.0-6.0 mm. Conclusion:For HPIID with a defect, surgical treatment with transfer of micro-flap carrying sensory nerve should be a preferred treatment option.

Objective:To investigate the expression levels, correlation, and diagnostic efficacy of peripheral blood CD8 +T lymphocyte subsets and different immune checkpoint markers in patients with Brucellosis. Method:A case-control study was conducted on 32 patients with acute phase brucellosis (27 males and 5 females, aged 36 (30, 43) years), 38 patients with chronic phase brucellosis (30 males and 8 females, aged 40 (32, 48) years), and 30 healthy controls (24 males and 6 females, aged 39 (32, 46) years), who underwent physical examination at Xinjiang Uygur Autonomous Region People′s Hospital from February 1, 2021 to December 31, 2023. All subjects had fasting blood sampling once in the morning. Flow cytometry was used to detect the proportion of peripheral blood lymphocyte subsets, the expression levels of CD8 +T lymphocyte surface programmed cell death receptor-1 (PD-1), T lymphocyte immunoglobulin receptor with Ig and ITIM domains (TIGIT), T cell immunoglobulin and mucin domain containing protein 3 (TIM-3), perforin and granzyme B. The changes in these indicators during the acute and chronic phases of the disease were observed, and correlation analysis was performed using Spearman′s method. Receiver Operating Characteristic Curve (ROC) analysis is used to evaluate the diagnostic value of immunological indicators with differences in acute and chronic brucellosis. Results:CD3 +T lymphocyte in the chronic group (70.71%±8.78%) is significantly lower than that in the healthy control group (74.65%±7.31%) ( P<0.05), and CD4 +T lymphocyte in the acute phase group (39.52%±5.85%) is also lower than that in the healthy control group (45.10%±5.18%) ( P<0.01); while CD8 +T lymphocyte in the acute group (31.73%±5.87%) is significantly higher than that in the chronic phase group (26.75%±4.71%) ( P<0.001). There was a statistically significant difference ( P<0.001) in CD8+CD28 -T lymphocyte among the acute group (69.85% (58.62%, 78.55%)), chronic group (86.46% (73.30%, 92.52%)) and healthy control group (25.39% (20.60%,32.90%)), when compared pairwise. The expression levels of immune checkpoint PD-1, TIGIT, and TIM-3 on the surface of CD8 +T lymphocytes were higher in both the acute and chronic groups than in the healthy control group ( P<0.001). The expression level of perforin secreted by CD8 +T lymphocytes in the acute and chronic groups was lower than that in the healthy control group ( P<0.05), while the expression level of granzyme B in the acute and chronic groups was higher than that in the healthy control group ( P<0.01). The proportion of CD8 +CD28 -T lymphocytes in brucellosis patients was positively correlated with the expression levels of TIGIT and TIM-3 ( r=0.624, 0.406, P<0.001). The ROC curve combined with the proportion of CD8 +CD28 -T lymphocytes and the proportion of TIGIT on the surface of CD8 +T lymphocytes can distinguish acute and chronic brucellosis. The Area Under Curve (AUC) is 0.973, which has certain implications for clinical differentiation of patients with acute and chronic diseases. Conclusion:The CD8 +T lymphocyte subsets in patients with brucellosis exhibit dynamic changes, accompanied by changes in relevant immune checkpoint molecules, and can regulate the activation and inhibition of the immune status of brucellosis patients. The synergistic effect of CD8 +CD28 -T cells and TIGIT/TIM-3 may be a key mechanism of driving chronicity, and their combined diagnosis can serve as a clinical staging marker.

Cardiovascular disease is one of the diseases with high global incidence and mortality rates,po-sing a serious threat to public health.Therefore,identifying early diagnostic and treatment targets is particu-larly important.Salusins are vasoactive peptides with various biological activities,and research has shown a close relationship between Salusins and cardiovascular disease.Salusins have two subtypes,Salusin-α and Sa-lusin-β.The main function of Salusin-α is to lower blood pressure,slow heart rate,reduce inflammation and oxidative stress,and inhibit atherosclerosis,while Salusin-β primarily promote proliferation of vascular smooth muscle cells and contribute to atherosclerosis.This article reviews some of the latest research progress on Sa-lusins.

Objective To investigate and analyze a group occupational acute dimethylacetamide (DMA) poisoning incident occurred during the post-fire cleaning operation in a spandex manufacturing enterprise. Methods This study focused on the involved enterprise, employing units, poisoning patients, and workers with similar occupational exposure history from a group occupational acute chemical poisoning incident in Guangdong Province in 2023. Occupational health on-site investigation data, clinical records of poisoned patients, and occupational disease diagnostic data were collected to determine the cause of the poisoning. Results The incident occurred at a spandex manufacturing enterprise during the cleaning of polymerization reaction vessels after a fire, resulting in poisoning of six cleaning workers. The clinical symptoms of patients included varying degrees of liver function abnormalities and skin damage. All six patients wore long-tube air-supplied full-face masks during work. The patients were in a confined work space with poor ventilation, and worked more than 8 hours per day. Patients felt unwell after 5-13 days of work. Post-incident investigation revealed that the DMA exposure concentration of short term near the reaction vessels was 36.06 mg/m³. DMA accounted 13.74% to 30.09% of the volatile organic compounds in the raw and auxiliary materials and waste in the vessel. N-methylacetamide was detected in the urine of these six patients, with levels up to 1 639.78 mg/g creatinine, exceeding the occupational exposure limit (20.00 mg/g creatinine). All six patients were diagnosed as occupational acute DMA poisoning. Conclusion Occupational acute DMA poisoning mainly causes liver damage, has a latent onset, and poses a risk of group occurrence. The main causes of group poisoning are confined work space, inadequate management, insufficient protective measures, and excessive working hours.

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.