【Objective】 To analyze the current situation of direct exemption of clinical blood fess for voluntary blood donors and their family members in Henan Province, in order to improve and fully implement the policy. 【Methods】 According to the policy on blood fees exemption issued by China and Henan Province in 2019,the data of hospitals in 18 prefecture-level cities in Henan from 2020 to 2021 were continuously collected from the system of clinical blood fees exemption,including the way of exemption,the number of people (times) of exemption,exemption amount, the proportion of blood fees exemption and the total exemption rate. The experience gained in the past two years after the implementation of the policy was summarized,and the existing problems and causes were analyzed. 【Results】 The rates of direct exemption of blood fees in Henan Province in 2020 and 2021 were 34.53% (8 709/25 221) and 71.68%(23 587/32 906) (P<0.05) ,respectively. In 2021, the direct exemption rate of blood fees in 18 cities was 6.20% (83/1 370) to 88.50% (1 332/1 505) [ (47.35±41.15)%],and increased month by month from 43.19% (1 183/2 507) in January to 83.15% (2 097/2 522) in August, then remained stable at a similar level to August from September to December, with 83.43% (2 744/3 289) in December as the highest for the year. 【Conclusion】 The implementation of the policy of blood fees exemption showed significant effectiveness, which has effectively promoted the development of voluntary blood donation in Henan. However, there is still room for improving the policy in some cities, which is expected to further increase the direct exemption rate of the city and the whole province.

【Objective】 To explore the recruitment and retention strategy of blood donors by investigating the age composition of blood donors in some areas of China, so as to promote blood donation and enhance clinical blood supply. 【Methods】 Through the working platform of Practice Comparison Working Group of China’s Mainland Blood Collection and Supply Institutions, the average age and age composition of blood donors from 22 blood centers were collected, and statistical analysis was conducted after eliminating invalid data. 【Results】 The median average age of blood donors during the survey year was 30.02.The median age in 2.89% of the blood centers was lower than 25. The average age of different genders was statistically significant only in 2018(P<0.05). Fot first-time blood donors, the median constituent ratio of donors <25 and ≥25 years old was 54.53% and 44.28%, with median retention rate at 10.30% and 9.61%, respectively. The median overall participation rate of blood donors was 2.7%, with median participation rate of blood donors <25 years old at 5.1%. 【Conclusion】 The recruitment and retention of blood donor is crucial to enhance clinical blood supply. Blood donors <25 years old, with a longer period for future donation, should be the main target of blood donation recruitment. Meanwhile, the revision of upper age limit for blood donation is another important initiative to grow the blood donor pool.

Objective:To evaluate Gamma 3 nails combined with hollow compression screw fixation in the treatment of intertrochanteric fracture of risky external wall type.Methods:From November 2015 to December 2017, 60 patients with intertrochanteric fracture of risky external wall type were treated at Department of Orthopaedic Surgery, Wuhan Fourth Hospital. Of them, 27 ones, 15 males and 12 females with an age of 57.5 years±16.2 years (group A), were fixated with Gamma 3 nails and hollow compression screws, including 14 cases of AO type of 31-A2.2 and 13 cases of AO type of 31-A2.3. The other 33 patients, 18 males and 15 females with an age of 59.3 years±15.1 years (group B), were fixated with Gamma 3 nails alone, including 17 cases of AO type of 31-A2.2 and 16 cases of AO type of 31-A2.3. The 2 groups were compared in terms of operation time, hospitalization time, intraoperative blood loss, weight-bearing time, fracture healing time, complications and Harris hip scores at the final follow-up.Results:The 2 groups were comparable due to insignificant differences between them in preoperative general data ( P>0.05). The 60 patients obtained an average follow-up of 22.6 months (from 12 to 36 months). There were no statistically significant differences in operation time, intraoperative blood loss or hospital stay between the 2 groups ( P>0.05). Group A had a significantly lower incidence of external wall redisplacement [7.4% (2/27)], significantly shorter weight-bearing time(5.4 weeks±1.0 weeks) and fracture healing time(18.3 weeks±3.9 weeks), and significantly higher Harris hip scores at the final follow-up (89.3±7.1) than group B did [24.2% (8/33), 7.4 weeks±1.3 weeks, 21.7 weeks±5.6 weeks and 79.5±8.3, respectively] (all P< 0.05). Follow-ups revealed no complications like femoral head cutting, implant breakage, deep vein thrombosis of lower limb, fat embolism, hip varus deformity or nail breakage in either group. Conclusion:In the treatment of intertrochanteric fracture of risky external wall type, compared with Gamma 3 nails alone, Gamma 3 nails combined with hollow compression screw fixation can avoid external wall displacement or fixation failure after external medullary fixation or intramedullary fixation alone but does not increase operation time or intraoperative blood loss, leading to better functional recovery.

Objective: To evaluate Kangli hollow screws with sliding compression locking plate system (KHS) in the treatment of femoral neck fractures. Methods: From February 2015 to October 2016, 47 femoral neck fractures were treated at Department of Orthopaedics, Wuhan Fourth Hospital, Wuhan Puai Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology. They were 30 men and 17 women, aged from 26 to 68 years (average, 43.5 years). According to the Pauwels classification, there were 24 cases of type Ⅰ, 16 cases of type Ⅱ and 7 cases of type Ⅲ; according to the Garden classification, there were 23 cases of type Ⅱ, 19 cases of type Ⅲ and 5 cases of type Ⅳ. All the fractures were immobilized with KHS after closed reduction or open reduction (3 cases). The fracture union time, femoral head necrosis and femoral neck shortening were observed after operation. The Harris scores were used to evaluate therapeutic effects at the final follow-up. Results: All the patients were followed up for an average of 29.7 months (from 22 to 39 months). All the fractures obtained solid bony union after 9 to 15 weeks(average, 12.2 weeks). Femoral head necrosis occurred in one case (2.1%). Femoral neck shortening ≤ 5 mm was observed in 6 cases and femoral neck shortening >5 mm <10 mm in 2 cases, giving a total shortening rate of 17.0%. The Harris scores at the final follow-up ranged from 77 to 98 points, averaging 92.2 points. There were 42 excellent, 3 good and 2 moderate cases, giving an excellent and good rate of 95.7%. Conclusion KHS can lead to excellent therapeutic effects in the treatment of femoral neck fractures.

Objective To investigate the effect of butylphthalide and sodium chloride injection on patients who received endovascular treatment for acute anterior circulation large vessel occlusive stroke.Methods A total of 173 patients were identified from February 2015 to December 2017 in the Department of Neurology of Jingling Hospital in this retrospective observational study.Propensity score-matching analysis was performed to balance differences in baseline characteristics between patients who received butylphthalide injection (butylphthalide group) and those who did not (control group).The modified Rankin Scale scores at 90 days were compared between the butylphthalide and control groups.Results A total of 144 patients who received endovascular treatment for acute anterior circulation large vessel occlusive stroke were finally analyzed,54 cases in the butylphthalide group and 90 cases in the control group.The proportion of good functional outcome at 90 days in the butylphthalide group was higher than that in the control group (63.0％ (34/54) vs 44.4％ (40/90);x2=4.633,P=0.031).Thirty-six pairs were matched successfully by the propensity score matching,36 patients in the butylphthalide group and 36 in the control group.There was no statistically significant difference in the 90-day functional outcome between the two groups (66.7％ (24/36) vs 44.4％ (16/36);x2=3.600,P=0.058).One hundred and fifteen patients were recanalized,47 cases in the butylphthalide group and 68 cases in the control group,and after the propensity score matching,30 pairs were analyzed.The proportion of good functional outcome at 90 days in the butylphthalide group was higher than that in the control group (73.3％ (22/30) vs 46.7％ (14/30);x2=4.444,P=0.035).Conclusion After propensity score-matching,butylphthalide and sodium chloride injection could improve 90-day functional outcome in patients with acute anterior circulation large vessel occlusive stroke and obtained recanalization by endovascular treatment while could not before propensity score-matching.

Objective TosummarizeMRIfeaturesofadultreversiblespleniallesionsyndrome(RESLES)andevaluateitsdiagnosticvalue. Methods ClinicalandMRIdataof15patientswithRESLESwereanalyzedretrospectively.Primarydiseasesandcausesincluded:encephalitis disease,cerebrovasculardiseases,metabolicandelectrolytedisorders.Theclinicalsymptomswereheadache,dizziness,changeofconsciousness, epilepticseizuresandothernonspecificneurologicsymptoms.Thecranialimagingexaminationwasperformedat3.0T/1.5TsuperconductingMR, includingT1WI,T2WI,T2FLAIRandDWI,inwhich7casesunderwentMRIenhancedscanand5casesunderwentMRAexamination.Results Among15patients,MRIfindingsofallpatientswerecharacterizedbythecharacteristic"boomerangsign"ortheovoidabnormalitysignalinthe corporiscallosisplenium,whichwaspresentedascytotoxicedema.Besides,4ofthem werecombinedwithposteriorreversibleencephalopathy syndrome(PRES),whichwascharacterizedbyvasogenicedemainthebilateraloccipital,temporal,parietallobeandcerebellarhemisphere.The clinicalsymptomsofallpatientsimprovedafterreasonabletreatment.Conclusion MRIcharacteristicfindingofadultreversiblesple-niallesionsyndromeisthecytotoxicedemaofthecorpuscallosum,whichcanbeshowedas"boomerangsign"orovalform.Imagingfindingsand clinicalsymptomsarereversible.Thecorrectunderstandingofthisdiseaseisofgreatsignificancetoclinicalrationaldiagnosisandtreatment.

Objective To compare the biomechanical performance of Kangli hollow screws with sliding compression locking plate system (KHS) and conventional cannulated lag screws for fixation of type Pauwels Ⅲ femoral neck fracture.Methods 7 cadaveric femurs were selected,vertical fractures (Pauwels Ⅲ fracture,at 70° to the horizontal) were artificially conducted in these cadaveric proximal femurs by an orthopaedic surgeon and fixed by KHS screws with plate system or conventional cannulated lag screws.Samples were positioned at 75° of the femoral shaft to the horizontal,embedded in the mould and fixed in the experimental console.Optical sensors were set at the femoral neck around the osteotomy line.Then the loading were input in the vertical,horizontal lateral direction and rotating direction around the femoral neck axis,the maximal and minimal values between the fractured fragments and the corresponding values of the loading were recorded.The values of stiffness in three directions were calculated and compared.The CT data of the left femur of a 25 year-old healthy male volunteer was input into the co(m)esponding software and vertical femoral neck fracture model was generated.Two finite element analysis models were obtained after the fracture being fixed using these two different implants,and the Von Mises stress distribution on the femur,implants and the interface between the fractured fragments and the relative motion between the fractured fragments were compared.Results In the vertical,horizontal lateral direction and rotating direction around the femoral neck axis,the stiffness of the KHS were 3 904±1 148 N/mm,4 324±1 234 N/mm and 11.45±4.95 N · m/° respectively,higher than those of the CSs method with the values of 3 020±1 150 N/mm,3 020± 854 N/mm.and 6.53±4.83 N· m/° respectively.The differences between the two groups were statistically significant (t=2.7194,4.7694 and 2.9424;P=0.0347,0.0050 and 0.0423).In the finite element analysis test,the maximal Von Mises stress values distributing on the femur and the screws in the KHS group were 40.1 MPa and 126.4 MPa,and those in the CSs group were 98.1 MPa and 145.5 MPa respectively,and both values of the former were lower than the latter.But the Von Mises stress value on the interface between the fractured fragments in the KHS group was 14.37 MPa,which was much higher than that in the CSs groupwhich was 9.39 MPa.The gap at the fracture site of the CSs fixation model was dramatically larger than that of KHS fixation model.Conclusion The KHS screws and plate system could provide better immobilization effect for vertical femoral neck fracture compared to the cannulated lag screws.The risk of the screws failure was lower and the fracture union would be easier to obtained by the fixation of KHS screws with plate system.

OBJECTIVE:To investigate therapeutic efficacy and safety of the use of Kubai oil and Cuyu oil by stages on wound healing after perianal abscess operation.METHODS:A total of 125 observation objects selected from Chengdu Third People' s Hospital during Jan.2014-Jan.2016 were randomly divided into control group (60 cases) and observation group (65 cases).Both groups received perianal abscess incision drainage or thread-drawing drainage.Control group was additionally given gentamicin gauze for dressing and other treatments after surgery based on routine treatment.Observation group was given Kubai oil gauze for dreassing in wound inflammation period,Cuyu oil gauze for dressing in granulation growth period and epithelial growth period.After 4 weeks of treatment,therapeutic efficacy,wound healing,wound pain,wound secretion and the growth of granulation tissue were compared between 2 groups.The occurrence of ADR was also recorded.RESULTS:The cure rate of observation group reached 80.0％,which was significantly higher than 63.3％ of control group (P＜0.05);the reduction rate of wound area was significantly higher than control group,while the carrion shedding time and wound healing time were significantly lower than control group (P＜0.01 or P＜0.05).The wound pain score in 2nd,4th week,the wound secretion score and granulation tissue growth score in 1st,2nd,4th week after operation were significantly lower than control group (P＜0.01 or P＜0.05).No significant ADR was found in 2 groups.CONCLUSIONS:For the patients underwent perianal abscess operation,the use of Kubai oil and Cuyu oil by stages can effectively improve therapeutic efficacy and wound healing,and relieve postoperative pain with good safety.

Objective To preliminarily investigate the safety and feasibility of intra-arterial cold saline infusion combined with intravascular reperfusion for acute ischemic stroke with large artery occlusion. Methods From March 2016 to March 2018, consecutive acute ischemic stroke patients with large artery occlusion within 8 h after onset admitted to the Department of Neurology, the People's Hospital of Longhua District, Shenzhen and recanalized successfully after endovascular treatment were enrolled. After recanalization, cold saline was infused through the guiding catheter via the ipsilateral guilty vessel (10 ℃, 33 ml/min for 30 min). Results A total of 20 patients were enrolled, including 15 males. Their median age was 67 years (interquartile range, 53-80 years). Fifteen patients were treated with thrombolysis. A median onset-to-needle time was 300 min (interquartile range, 260-360 min). During the infusion of cold saline, the lowest rectal temperature was only decreased 0. 1 ℃, but within 5 min after completion of perfusion, it returned to the temperature before perfusion. Complications associated with intra-arterial hypothermia were not observed. The median National Institutes of Health Stroke Scale score was significantly decreased from 21 (interquartile range 15-55) before needle to 15 (interquartile range 10-16; Z = -4. 549, P < 0. 001) at discharge. Conclusion Selective intra-arterial cold saline infusion combined with intravascular reperfusion for acute ischemic stroke with large artery occlusion is safe and feasible.