Objective To explore the risk factors of perioperative blood transfusion in patients with recurrent nasopharyngeal carcinoma undergoing nasal endoscopic surgery,and construct a nomogram predic-tion model.Methods A retrospective analysis was conducted on the clinical data of 262 patients who un-derwent the nasal endoscopic surgery from January 2021 to May 2023.The patients were divided into two groups according to perioperative blood transfusion or not:non-transfusion group and transfusion group.Uni-variate and multivariate logistic regression were conducted to identify independentrisk factors of perioperative blood transfusion,and a nomogram prediction model was developed.The receiver operating characteristic(ROC)curve was drawn,and the area under the curve(AUC)was calculated.Results The incidence of blood transfusion in patients with recurrent nasopharyngeal carcinoma undergoing nasal endoscopic surgery was 46(17.6％).Multivariate logistic regression analysis revealed that preoperative hemoglobin level 70 to＜100 g/L(OR=6.178,95％CI 2.271-16.805,P＜0.001),preoperative albumin level 25 to＜35 g/L(OR=2.126,95％CI 1.021-4.424,P=0.044),and classification of surgery grade Ⅲ or Ⅳ (OR=4.725,95％CI 1.634-13.584,P=0.004)were independent risk factors for predicting perioper-ative blood transfusion in patients with recurrent nasopharyngeal carcinoma undergoing nasal endoscopic sur-gery.The AUC of the nomogram model was 0.769(95％CI 0.701-0.838),the sensitivity was 67.6％,and the specificity was 76.1％.Conclusion Preoperative hemoglobin level 70 to＜100 g/L,preoperative albumin level 25 to＜35 g/L,and classification of surgery grade Ⅲ or Ⅳ are independent risk factors of perioperative blood transfusion in patients with recurrent nasopharyngeal carcinoma undergoing nasal endo-scopic surgery.The nomogram model established based on the above risk factors has good predictive ability for perioperative blood transfusion.

【Objective】 To analyze the dynamics of specific SARS-CoV-2 IgG antibodies in blood donors in Fuzhou area after receiving booster doses of inactivated COVID-19 vaccine and breakthrough infections, and to provide evidence for the timing of the collection of specific immune plasma or convalescent plasma and the subsequent vaccine doses. 【Methods】 A total of 109 volunteers who received the first booster dose of inactivated COVID-19 vaccine and 102 volunteers who experienced breakthrough infections were recruited at Fujian Blood Center from October to November 2021. Blood samples were collected at eight time points: 14 (11, 20) days before the booster dose (Time0), 14 (10, 23) days after the booster dose (Time1), 53 (45.5, 61) days after the booster dose (Time2), 88 (78, 101.5) days after the booster dose (Time3), 124 (112.5, 138.5) days after the booster dose (Time4), 158 (146, 174) days after the booster dose (Time5), 194 (179.5, 214) days after the booster dose (Time6) and within one month after the breakthrough infection (Time7). Serum SARS-CoV-2 IgG antibodies were detected using a chemiluminescence immunoassay. The dynamics of antibody levels were analyzed and the effects of age, gender, weight, BMI, blood type and smoking on antibody levels were also analyzed. 【Results】 The positive rate of SARS-CoV-2 IgG antibodies was 53.2% (58/109) at Time0, 100% (109/109) at Time1, and 95.4% (104/109) at Time6. The antibody levels were significantly higher at Time1 and Time6 than at Time0 (P<0.001). The highest level was observed at Time1, followed by a gradual decrease until Time2-Time6, which were 89.9% (9.74/10.84), 77.7% (8.42/10.84), 68.3% (7.4/10.84), 59.4% (6.44/10.84), and 53.9% (5.84/10.84) of the peak value at Time1 (P<0.001). There were no significant differences in IgG antibody levels among different gender, weight, BMI, age, blood type and smoker or non-smoker at the same time points (P values all >0.05). The IgG antibody level at Time7 was 2.07 times than that at Time1 (P<0.001). There were no significant differences in IgG antibody levels between asymptomatic groups and symptomatic groups and also between fever-free groups and fever groups (P values all >0.05). The IgG antibody level in breakthrough infection group was significantly higher than that in non-breakthrough infection group (P<0.001). 【Conclusion】 Booster doses of inactivated COVID-19 vaccine and breakthrough infections can stimulate stronger immune responses in the body. It is recommended to collect specific immune plasma or convalescent plasma within one month after breakthrough infections or booster doses of COVID-19 vaccine for special purposes. The timing of subsequent vaccine doses should be based on the dynamics of antibody levels. It is necessary to continuously monitor antibody levels to provide evidence for subsequent vaccine doses.

【Objective】 To explore the reasons for wrong connection between anticoagulant and normal saline solution during apheresis platelet donation, as well as the preventive measures, so as to ensure the safety of apheresis platelet donors. 【Methods】 Manual checking in the first phase (December 2008 to September 2016) was compared with double checking (manual checking plus information system) in the second phase (October 2016 to October 2020) via bilateral testing using Fisher's Exact Test to study pre-post-improvement differences. 【Results】 The incidence of solution connection errors during apheresis platelet donation in the first phase was 1.02/10 000, and the error incidence between Amicus and Trima + Mcs^®+ blood cell separator was statistically significant (P<0.05). The total incidence of errors between the first and second phases was not statistically significant (P>0.05). After the performance of double checking in the second phase, no wrong connection of anticoagulant and saline solution occurred. 【Conclusion】 The double checking method assisted by manual and information system can effectively prevent the wrong connection between anticoagulant and normal saline solution.

In the new era, enhanced Party construction of public hospitals is the fundamental assurance for the success of Healthy China strategy. Based on field survey, in-depth interview, literature review and promotion of pilot practices, the Hospital Party Construction Guidance Committee of Guangdong Province staged a " Four Virtues" program to enhance Party construction at public hospitals in the healthcare system of the province. This program, featuring " leadership competency" , " Party branch capability" , " Party construction branding" , and " Unit showcases" , aims at the limited implementation and homogenization problems commonly found in Party construction at public hospitals. Promotion of successful pilot practices of several public hospitals effectively encouraged the " parallel development" of both medical service and Party construction, providing useful references for the hospitals in their reform/development and Party construction in the new era.

Objective:To investigate the correlation between serum high sensitivity C-reactive protein and carotid intima-media thickness.Methods:A total of 5 136 health examination subjects, aged ≥40 years old, who met the inclusion criteria and had complete data, were selected as the research objects.A unified questionnaire survey, blood biochemistry and carotid artery color doppler ultrasound examination were performed.According to the diagnostic criteria of hs-CRP published by American Heart Association (AHA), the subjects were divided into three groups: 0.05 mg/L0.84 mm group.The results showed that when the concentration of hs-CRP was high, CIMT increased with the increase of hs-CRP( OR(95% CI) 1.24 (1.01~1.52), P<0.05). Conclusion:There was a positive correlation between hs-CRP and CIMT.Patients with higher levels of hs-CRP are more likely to develop CIMT thickening and increase the risk of arteriosclerotic disease.

Objective:To investigate the association of blood oxidative stress level with hypertriglyceridemia in the elderly aged 65 years and older in China.Methods:A total of 2 393 participants aged 65 years and older were recruited in 9 longevity areas from Heathy Aging and Biomarkers Cohort Study, during 2017 to 2018. Information on demographics characteristic, life style and health status were collected by questionnaire and physical examination, and venous blood was collected to detect the levels of blood oxidative stress and hypertriglyceridemia. The linear or non-linear association between oxidative stress and hypertriglyceridemia was described by restrictive cubic splines (RCS) fitting multiple linear regression model. The generalized linear mixed effect model was conducted to assess the association between oxidative stress and hypertriglyceridemia.Results:A total of 2 393 participants, mean age was 84.6 years, the youngest was 65 and the oldest was 112, the male was 47.9%(1 145/2 393), the triglyceride level was (1.4±0.8) mmol/L. The hypertriglyceridemia detection rate was 9.99%(239/2 393). The results of multiple linear regression model with restrictive cubic spline fitting showed that MDA level was linear association with triglyceride level; SOD level was nonlinear association with triglyceride level. MDA level had significantly association with hypertriglyceridemia, and the corresponding OR value was 1.063 (95% CI: 1.046,1.081) with 1 nmol/ml increment of blood MDA; SOD level had significantly association with hypertriglyceridemia, and the corresponding OR value was 0.986(95% CI: 0.983,0.989) with 1 U/ml increment of blood SOD. Conclusion:Among the elderly aged 65 and older in 9 longevity areas in China, MDA and SOD levels were associated with the risk of hypertriglyceridemia.

Objective:To investigate the association of blood oxidative stress level with hypertriglyceridemia in the elderly aged 65 years and older in China.Methods:A total of 2 393 participants aged 65 years and older were recruited in 9 longevity areas from Heathy Aging and Biomarkers Cohort Study, during 2017 to 2018. Information on demographics characteristic, life style and health status were collected by questionnaire and physical examination, and venous blood was collected to detect the levels of blood oxidative stress and hypertriglyceridemia. The linear or non-linear association between oxidative stress and hypertriglyceridemia was described by restrictive cubic splines (RCS) fitting multiple linear regression model. The generalized linear mixed effect model was conducted to assess the association between oxidative stress and hypertriglyceridemia.Results:A total of 2 393 participants, mean age was 84.6 years, the youngest was 65 and the oldest was 112, the male was 47.9%(1 145/2 393), the triglyceride level was (1.4±0.8) mmol/L. The hypertriglyceridemia detection rate was 9.99%(239/2 393). The results of multiple linear regression model with restrictive cubic spline fitting showed that MDA level was linear association with triglyceride level; SOD level was nonlinear association with triglyceride level. MDA level had significantly association with hypertriglyceridemia, and the corresponding OR value was 1.063 (95% CI: 1.046,1.081) with 1 nmol/ml increment of blood MDA; SOD level had significantly association with hypertriglyceridemia, and the corresponding OR value was 0.986(95% CI: 0.983,0.989) with 1 U/ml increment of blood SOD. Conclusion:Among the elderly aged 65 and older in 9 longevity areas in China, MDA and SOD levels were associated with the risk of hypertriglyceridemia.

Objective To analyze the clinical manifestation and genetic testing in a patient with Adams-Oliver syndrome (AOS) and summarize clinical and genetic characteristics of the dedicator of cytokinesis (DOCK) 6 gene related AOS through reviewing related references.Methods Information of the proband who was hospitalized in Affiliated Children Hospital of Capital Institute of Pediatrics in October 2016 and her family members as well as their DNA samples were collected.The gene sequencing was performed using next generation sequencing technology.Using "Adams-Oliver syndrome"and "DOCK6" as key words,the relevant articles were searched from the Pubmed,China National Knowledge Internet and Wanfang databases and reports of 19 cases were reviewed.Results The proband is an eight months old girl.She presented with severe developmental delay,terminal transverse limb defects and visual loss after birth,and then suffered from tonic seizures and myoclonic seizures at two months old.By physical examination she was found to have esotropia and visual loss.The distal phalanx and nail of the right second-fourth fingers were absent,while the phalangette of the left second-fourth fingers and bilateral distal phalanges of toes were short with small nails attachment.Thyroid function test showed hypothyroidism.The ocular fundus examination showed the residual vitreous artery in the left eye and the retinal pigment degeneration in the right eye.CT scan showed multiple bilateral periventricular calcification and cranial magnetic resonance imaging showed bilateral periventricular lesion.Two heterozygous mutations were identified in DOCK6 gene:one was a known pathogenic mutation (p.L1064Vfs*60),and the other was a novel splice site mutation (c.873+ 1G＞A).By analyzing this case and reported 19 cases,the common performances of DOCK6 gene related AOS included terminal transverse limb defects (20/20),aplasia cutis congenita (18/20),ocular abnormalities (13/20),seizures (12/20),mental retardation (12/20),microcephaly (10/20),cardiovascular malformations (10/20),intrauterine growth retardation (6/20).The mutation of the DOCK6 gene was found to be dominated by frameshift mutation and splice site mutation.Conclusions If either terminal transverse limb defects or aplasia cutis congenita was detected in a patient,AOS should be under consideration.In addition,autosomal recessive inheritance,nervous system and eyes involvement will further indicate DOCK6 gene related AOS.

Objective To explore the effects of health belief mode (HBM)-based home visits on the blood pressure (BP) and health-related behaviors of elderly hypertensive patients.Methods One-year HBM-based home visits were paid to 114 elderly hypertensive patients over 80 years old chosen from the community.The normalization rate of blood pressure after intervention at 3,6,12 months and health-related behaviors after intervention were also compared with those of pre-intervention.Results The BP after intervention was improved significantly after intervention as compared with that of pre-intervention (P＜0.01).Health-related behaviors after intervention were significantly more than those before pre-intervention (P＜0.01).Conclusions The hypertensions are controlled effectively with the implementation of the HBM-based home visits to the elderly hypertensive patients.The development of disease in elderly hypertensive patients can be slowed down and their life quality can be improved.

The paper described efforts made by Guangdong province to achieve a goal of the healthcare reform Serious diseases can be treated within the county.In this reform,the province attempts such operation mechanisms as autonomous type,guided type and trusted type for the purpose of elevating the service capabilities of county-level public hospitals.To this end,four independent operation mechanisms have also been built for talent development,remuneration incentive,specialty development,and cost control.All these efforts aim at encouraging the hospitals to improve service capability and quality.