【Objective】 To objectively evaluate the quality control level of blood testing process in blood banks through quantitative monitoring and trend analysis, and to promote the homogenization level and standardized management of blood testing laboratories in blood banks. 【Methods】 A quality monitoring indicator system covering the whole process of blood collection and supply, including blood donation service, blood component preparation, blood testing, blood supply and quality control was established. The questionnaire Quality Monitoring Indicators for Blood Collection and Supply Process with clear definition of indicators and calculation formulas was distributed to 17 blood banks in Shandong province. Quality monitoring indicators of each blood bank from January to December 2022 were collected, and 31 indicators in terms of blood testing were analyzed using SPSS25.0 software. 【Results】 The proportion of unqualified serological tests in 17 blood bank laboratories was 55.84% for ALT, 13.63% for HBsAg, 5.08% for anti HCV, 5.62% for anti HIV, 18.18% for anti TP, and 1.65% for other factors (mainly sample quality). The detection unqualified rate and median were (1.23±0.57)% and 1.11%, respectively. The ALT unqualified rate and median were (0.74±0.53)% and 0.60%, respectively. The detection unqualified rate was positively correlated with ALT unqualified rate (r=0.974, P<0.05). The unqualified rate of HBsAg, anti HCV, anti HIV and anti TP was (0.15±0.09)%, (0.05±0.04)%, (0.06±0.03)% and (0.20±0.05)% respectively. The average unqualified rate, average hemolysis rate, average insufficient volume rate and the abnormal hematocrit rate of samples in 17 blood bank laboratories was 0.21‰, 0.08‰, 0.01‰ and 0.02‰ respectively. There were differences in the retest concordance rates of four HBsAg, anti HCV and anti HIV reagents, and three anti TP reagents among 17 blood bank laboratories (P<0.05). The usage rate of ELISA reagents was (114.56±3.30)%, the outage rate of ELISA was (10.23±7.05) ‰, and the out of range rate of ELISA was (0.90±1.17) ‰. There was no correlation between the out of range rate, outrage rate and usage rate (all P>0.05), while the outrage rate was positively correlated with the usage rate (r=0.592, P<0.05). A total of 443 HBV DNA positive samples were detected in all blood banks, with an unqualified rate of 3.78/10 000; 15 HCV RNA positive samples were detected, with an unqualified rate of 0.13/10 000; 5 HIV RNA positive samples were detected, with an unqualified rate of 0.04/10 000. The unqualified rate of NAT was (0.72±0.04)‰, the single NAT reaction rate [(0.39±0.02)‰] was positively correlated with the single HBV DNA reaction rate [ (0.36±0.02) ‰] (r=0.886, P<0.05). There was a difference in the discriminated reactive rate by individual NAT among three blood bank laboratories (C, F, H) (P<0.05). The median resolution rate of 17 blood station laboratories by minipool test was 36.36%, the median rate of invalid batch of NAT was 0.67%, and the median rate of invalid result of NAT was 0.07‰. The consistency rate of ELISA dual reagent detection results was (99.63±0.24)%, and the median length of equipment failure was 14 days. The error rate of blood type testing in blood collection department was 0.14‰. 【Conclusion】 The quality monitoring indicator system for blood testing process in Shandong can monitor potential risks before, during and after the experiment, and has good applicability, feasibility, and effectiveness, and can facilitate the continuous improvement of laboratory quality control level. The application of blood testing quality monitoring indicators will promote the homogenization and standardization of blood quality management in Shandong, and lay the foundation for future comprehensive evaluations of blood banks.

Objective:To explore the effects of an improved perioperative diet management based on the concept of enhanced recovery after surgery (ERAS) in patients undergoing total hip arthroplasty (THA) .Methods:From May 2020 to May 2022, convenience sampling was used to select 320 patients who underwent their first unilateral THA at the First Affiliated Hospital of Zhengzhou University. According to the random number table method, patients were divided into control group ( n=160) and observation group ( n=160). The control group adopted a routine perioperative diet management, while the observation group improved the perioperative diet management based on the ERAS concept, and nurses performed preoperative fasting and postoperative diet and drinking water nursing according to the plan. We compared the preoperative hunger and thirst between two groups of patients, and recorded the gastrointestinal function such as postoperative anal exhaust and defecation time, bowel sound recovery time, postoperative nausea and vomiting degree, and post eating nausea and vomiting degree between the two groups. Results:The number of preoperative hunger and thirst patients in the observation group was less than that in the control group, and the postoperative exhaust time, defecation time, and bowel sound recovery time were shorter than those in the control group ( P<0.05). The degree of nausea and vomiting after eating after surgery was lower than that in the control group. The differences were all statistically significant ( P<0.05) . Conclusions:The improved perioperative diet management based on ERAS has good clinical effects in THA patients, reducing perioperative discomfort and promoting postoperative gastrointestinal function recovery.

Objective:To describe the baseline characteristics of the subjects enrolled in the China Quantitative CT (QCT) big data program in 2018—2019.Methods:Based on baseline data from the Chinese health big data project from January 2018 to December 2019 from the eligible enrolled population, measurements of bone mineral density (BMD) and visceral adipose tissue (VAT) were performed using Mindways′ QCT Pro Model 4 system. The baseline data of age, gender, regional distribution, height, weight, abdominal circumference, blood pressure, blood routine and blood biochemical tests were analyzed. And the single factor analysis of variance (ANOVA) was used to check the age related trend of BMD and VAT in both genders.Results:After screening the inclusion exclusion criteria and outliers of the main indicators, 86 113 people were enrolled in the project. The enrollment rate was 92.47%, including 35 431 (41.1%) women and 50 682 (58.9%) men, and the ratio of men to women was 1.43. The mean age was (50.3±12.7) years in all the subjects, and it was (50.2±12.8) years and (50.4±12.5) years in men and women, respectively, and there was no statistical difference between the two genders ( P>0.05). Total of 43 833 people were enrolled in east China, it was the largest group by region (50.90%), it was followed by central China (16 434 people, 19.08%), and the number of people enrolled in Northeast China was the lowest (2 914 people, 3.38%). The rate of completing of health information indicators related to the main outcome of the study were all above 70%, and there were significant differences between men and women (all P<0.05). The mean BMD was (139.33±46.76) mg/cm 3 in women, (135.90±36.48) mg/cm 3 in men, which showed a decreasing trend with age in both gender (both P<0.001); the mean intra-abdominal fat area was (116.39±56.23) cm 2 in women, (191.67±77.07) cm 2 in men, and there was an increasing trend with age in both men and women (both P<0.001). Conclusions:There are gender differences in BMD and VAT measured by QCT with different age tendency, and there are gender differences in health information index. Regional factors should also be taken into account for regional differences in the inclusion of data.

Objective: Meta-analysis was used to compare the long-term efficacy and laryngeal function preservation rate of patients with advanced hypopharyngeal cancer treated with surgery plus radio(chemo)therapy (SRT) or non-surgery chemoradiotherapy (CRT). Methods: We searched publicly published articles on case-control studies of surgical and non-surgical comprehensive treatment of advanced hypopharyngeal cancer in PubMed, the Cochrane Library, Wanfang Database, Chinese Journal Full-text Database, and Chinese Science and Technology Periodical Database. The search language was limited to Chinese and English, and the period was from 1990 to 2018. These literatures were rigorously screened by inclusion and exclusion criteria. The data needed for this study were extracted and the Meta analysis was performed using RevMan 5.3 software. Results: A total of 13 literatures were included, and the overall quality of the literature was relatively high, and no significant publication bias was suggested. A total of 1 994 subjects, including 720 in the SRT group and 1 274 in the CRT group. The average 3-year overall survival rates were 42.9% in SRT group and 44.8% in CRT group,with no significant difference (OR=1.14, 95%CI: 0.62-2.06, P=0.68). The average 5-year overall survival rate (OR=1.42, 95%CI: 1.10-1.84, P<0.01), 5-year local recurrence-free survival rate (OR=1.68, 95%CI: 1.11-2.55, P=0.01) and 5-year local control rate (OR=2.17, 95%CI: 1.52-3.12, P<0.01) of SRT group were 46.4%, 47.4% and 71.2%, respectively, which were higher than those of non-surgical group (37.9%, 32.0%, and 52.2% respectively). The average laryngeal function preservation rate was 19.8%,being significantly lower than 80.6% of the non-surgical group(OR=0.03, 95%CI: 0.01-0.07, P<0.01). Conclusions SRT has better long-term efficacy, while CRT has better preservation of laryngeal function.

Objective:To explore the influencing factors of neutrophil to lymphocyte ratio (NLR) in patients with chronic heart failure (CHF) and the relationship between NLR and cardiac contractile function.Methods:From September 2016 to May 2018, 135 CHF patients were enrolled in the cardiovascular department of Fenyang hospital, Shanxi Province for prospective research.According to the level of NLR, the patients were divided into three groups: low NLR group (<2.3, 46 cases), middle NLR group (≥2.3~≤4.3, 45 cases), high NLR group (>4.3, 44 cases). The basic clinical data, laboratory examination data and noninvasive cardiac hemodynamic indexes of the three groups were compared.Results:(1) By comparing the data of different NLR groups, we found that there were significant differences in (N-terminal pro-brain natriuretic pepfide, NT-proBNP)( F=4.485, P=0.013), total bilirubin( F=6.085, P=0.003), albumin( F=3.695, P=0.027). (2)NLR was correlated with NT proBNP, total bilirubin, albumin( r=0.267, 0.256, -0.243, P=0.002, 0.003, 0.005, respectively). (3)Multiple linear regression analysis showed that NLR of CHF patients was correlated with left ventricular ejection fraction (LVEF), NT proBNP, total bilirubin and albumin (standard regression coefficients were -0.239, 0.223, 0.247 and -0.213, respectively, P<0.05). (4) Pearson correlation analysis showed that NLR and cardiac output ( r=-0.173, P=0.045), cardiac index ( r=-0.175, P=0.042), LVEF ( r=-0.278, P=0.001), maximum ejection velocity ( r=-0.207, P=0.016), systolic index ( r=-0.214, P=0.013), hearther index(HI) ( r=-0.179, P=0.038), cardiac work (CW) ( r=-0.235, P=0.006), cardiac workindex (CWI)=( r=-0.244, P=0.004) were negatively correlated. Conclusion:NT-proBNP, total bilirubin, albumin and LVEF are the factors that affect the NLR of patients with CHF.NLR has a certain value in the evaluation of CHF, therapeutic effect and prognosis prediction.

OBJECTIVE: To study the effects of Wuzhi capsule/schisantherin A (SchA) combined with cyclophosphamide on the pharmacokinetics of cyclophosphamide (CTX) in rats. METHODS: A total of 36 rats were randomly divided into CTX group (via tail vein, iv, CTX solution 300 mg/kg), CTX+WZC group (ig, Wuzhi capsule 300 mg/kg+via tail vein, iv, CTX solution 300 mg/kg), CTX + SchA low-dose, medium-dose, high-dose and excessive high-dose groups (ig, SchA 30, 300, 3 000, 30 000 μg/kg+via tail vein, iv, CTX solution 300 mg/kg) with 6 rats in each group. Blood samples were collected from orbital venous plexus of rats before medication and 0.083, 0.25, 0.5, 1, 2, 3, 4, 6, 8, 12, 24, 36, 48 h after medication.UPLC-MS/MS method was applied for concentration determination of CTX and its metabolites [de-chloroethyl CTX (DC-CTX), 4-ketone CTX (4-keto CTX), carboxyl phosphamide (CPM)] in plasma of rats. The plasma concentration-time curve was obtained. The pharmacokinetic parameters were fitted by using DAS 2. 0 software. RESULTS: The maximum plasma concentration (cmax) of DC-CTX in CTX group, CTX+WZC group, CTX+SchA low-dose, medium-dose, high-dose and excessive high-dose groups were (22 167. 85 ±2 844. 93), (10 920. 53 ± 1 490. 89), (18 951. 29 ± 1 558. 81), (18 622. 08 ± 791. 19), (18 515. 20 ± 2 560. 61), (15 133. 21 ± 1 305. 07) μg/mL, respectively; the area under the curves (AUCo-48 h) were (173 864. 01 ± 65 342. 21), (100 996. 98 ± 33 530. 02), (137 028. 16 ± 45 975. 19), (131 650. 18 ± 53 196. 41), (113 699. 40 ± 34 131. 36), (110 773. 27 ± 30 307. 15) μg·mL/h, respectively. Compared with CTX group, cmax of DC-CTX in CTX group, CTX+SchA low-dose, medium-dose, high-dose and excessive high-dose groups were decreased by 50. 74％, 14. 51％, 16. 10％, 16. 48％, 31. 73％, respectively. AUC0-48 h were decreased by about 42. 23％, 21. 45％, 24. 63％, 33. 37％, 36. 55％, respectively; with statistical significance (P<0. 05). The pharmacokinetic indexes as t1/2, tmax had no significant change. CONCLUSIONS: To some degree, both WZC and SchA can reduce the generation of DC-CTX, which indicates both of them can inhibit CTX toxicity metabolism pathway so as to reduce the generation of toxic metabolite chloroacetaldehyde. The inhibitory effect of SchA on toxicity metabolism pathway is weaker than that of WZC, and does not have a dose-dependent inhibitory effect.

Objective:To study the tonifying Qi and producing blood mechanism of Jianpi Shengxue tablets. Methods: SD rats were randomly divided into the normal group,FeSO4group, and low, medium and high dosage groups(0.65,1.3,2.6 g·kg-1). All the groups except the normal group received low iron diet,to induce anemia. After the two-week intragastric administration, real-time PCR was carried out to identify the changes of Hepcidin mRNA expression, while western blot was applied to test the changes of DMT-1 protein expression. Results:The medium and high dosage groups could significantly increase the DMT-1 expression compared with the normal group,while FeSO4 could reduced the DMT-1 expression. The Hepcidin expression in liver was increased along with the in-crease of the dosage. Conclusion:The Chinese medicine ingredients in Jianpi Shengxue tablets is beneficial to the expression of DMT-1 protein and the expression of Hepcidin mRNA in liver, which can finally improve the iron supply in the body.

Objective To investigate the effects and related mechanism of 5-aza-2'-deoxycytidine (Aza) on endothelial function in Hyperhomocysteinemia rats.Methods Adult male SD rats were divided into 3 groups (n =7 each):control group,hyperhomocysteinemia (HHcy) group and Aza group according to the random number table.Control group rats were fed with normal diet.HHcy group rats were fed with diet adding 3％ L-methionine.Aza group rats were fed with diet adding 3％ L-methionine and Aza (0.5 mg/kg) injection for consecutive three days per week for 8 weeks.After 8 weeks,content of rat plasma homocysteine (Hcy) was detected by enzyme linked immunosorbent assay (ELISA).The rat mesenteric artery endothelium-dependent diastolic function was detected.The nitric oxide synthase (eNOS) activity and asymmetric dimethyl fine ammonia acid (ADMA) content were detected by ELISA,and the content of nitric oxide was detected by nitrate reductase method in the mesenteric arteries.The mRNA expression of DNA methyl transferase 1 (DNMT1) and dimethyl arginine acid dimethylamine hydrolase 2 (DDAH2) in the mesenteric arteries were detected by real-time fluorescence quantitative PCR,and the protein expressions of DNMT1 and DDAH2 in the mesenteric arteries were detected by Western blot.The DDAH2 promoter methylation level in the mesenteric arteries was detected by nested methylation specific PCR.Results (1) The content of plasma Hcy was significantly higher in the HHcy group and Aza group compared to the control group ((29.00 ±0.94) μmol/L and (26.43 ±0.47) μmol/L vs.(10.34 ±0.63) μmol/L,both P ＜ 0.01),which was significantly reduced in the Aza group compared with the HHcy group (P ＜ 0.05).(2) Acetylcholine-mediated relaxation at various concentrations was significantly lower in the HHcy group and the Aza group compared with the control group (both P ＜ 0.05),which was significantly increased in Aza group compared with HHcy group (P ＜ 0.05).SNP-mediated relaxation at various concentrations was similar among the three groups(all P ＞0.05).(3) Compared with the control group,the content of nitric oxide in the HHcy group was significantly decreased ((0.52 ± 0.01) μmol/g vs.(0.42 ± 0.00) μmol/g,P ＜ 0.01),which could be increased by Aza((0.49 ± 0.01) μmol/g,P ＜ 0.05);the eNOS activity in the HHcy group was significantly decreased ((0.74 ± 0.01) U/mg vs.(0.57 ± 0.00) U/mg,P ＜ 0.01),which could be significantly increased by Aza ((0.65 ±0.01) U/mg,P ＜0.01);the content of ADMA in the HHcy group was significantly increased ((0.34 ± 0.01) μmol/g vs.(0.37 ± 0.00) μmol/g,P ＜ 0.05),which could be significantly decreased by Aza ((0.32 ± 0.01) μmo]/g,P ＜ 0.05).(4) Compared with the control group,the relative expression of DDHA2 mRNA in the HHcy group was significantly decreased (0.15 ±0.01 vs.0.12 s0.01,P ＜0.01),which could be significantly increased by Aza (0.13 ± 0.01,P＜ 0.05);the relative expression of DDHA2 protein in the HHcy group was significantly decreased (0.31 ± 0.02 vs.0.24 ± 0.01,P ＜ 0.01),which could be significantly increased by Aza (0.28 ± 0.01,P ＜ 0.01).Compared with the control group,the relative expression of DNMT1 mRNA in the HHcy group was significantly increased (0.23 ± 0.01 vs.0.43 ± 0.01,P ＜ 0.01),which could be significantly decreased by Aza (0.39 ±0.01,P ＜0.05);the relative expression of DNMT1 protein in the HHcy group was significantly increased (0.35 ±0.01 vs.0.50 ±0.01,P ＜0.01),which could be significantly decreased by Aza (0.47 ± 0.01,P ＜ 0.05).(5) Compared with the control group,the methylated/non methylated ratio of DDHA2 promoter in the HHcy group was significantly increased (1.04 ± 0.03 vs.1.26 ± 0.03,P ＜ 0.01),which could be significantly decreased by Aza (0.80 ± 0.03,P ＜ 0.01).Conclusion Aza can inhibit the activity of DNMT1,reduce DDAH2 promoter methylation level,increase the expression of DDAH2,decrease the content of ADMA,increase eNOS activity and content of nitric oxide,thus lead to the improvement of endothelial dysfunction in mesenteric artery of Hyperhomocysteinemia rats.

Objective The aim was to evaluate the diagnostic value of MRI in lesions with architectural distortion manifested in mammography. Methods A retrospective analysis of MRI was performed in 60 patients with 61 lesions manifested as architectural distortion in full?field digital mammography (FFDM) and subsequently confirmed by pathology or two year's follow?up, 30 were malignant and 31 were benign. All the patients underwent MRI within 2 weeks of mammography. MRI protocol included conventional MR, DWI and dynamic contrast?enhanced MRI. The breast imaging reporting and data system (BI?RADS) was used as the reference standard. BI?RADS categories 1 to 3 were considered as negative for malignancy and BI?RADS categories 4 to 5 were considered as positive for malignancy. ADCs of suspicious lesion of interest and glandular tissue were calculated. nADC was then calculated using the following formula:nADC=ADC(lesion)/ADC(glandular tissue). ADC and nADC were compared by using t test. ROC analysis was carried out to define the most effective threshold ADC and nADC value to differentiate malignant from benign lesion in the breast. Diagnostic performance of the FFDM, DCE?MRI and DCE?MRI combined nADC were calculated. Results ADC value of malignant and benign lesions was (1.35±0.31)×10?3 mm2/s and (1.07±0.40)×10?3 mm2/s, respectively . nADC values were 0.83±0.17 and 0.59± 0.25, respectively (t values were 2.82 and 4.54, P<0.01). Area under the curve of ADC and nADC were 0.829 and 0.753 respectively. When threshold of ADC was set at 1.19×10?3mm2/s, sensitivity and specificity were 71.0%and 86.7%, respectively. For a nADC value threshold of 0.589, sensitivity and specificity were 93.5%and 76.7%, respectively. Sensitivity, specificity and accuracy with FFDM were 80.0%(24/30), 9.7%(3/31) and 44.3%(27/61), Sensitivity, specificity and accuracy with DCE?MRI were 90.0%(27/30), 41.9%(13/31) and 65.6%(40/61), Sensitivity, specificity and accuracy with DCE?MRI combined nADC were 93.3%(28/30), 77.4%(24/31) and 85.2%(52/61), respectively. Conclusion Sensitivity and specificity with DCE?MRI combined nADC is higher, and DCE?MRI combined nADC values is helpful to differentiate malignant from benign lesions with architectural distortion manifested in FFDM.

AIM:To investigate the perfusion parameters using dynamic contrast-enhanced magnetic resonance imaging ( DCE-MRI) in rectal cancer patients so as to explore its potential value in estimating the microvascular condition including perfusion and permeability .METHODS:The data of 38 rectal cancer patients examined with DCE-MRI was ret-rospectively analyzed .The perfusion parameters of carcinoma and normal rectal wall in each case were calculated , inclu-ding volume transfer constant (Ktrans), rate constant of back flux (Kep), extravascular extracellular space fractional volume (Ve) and initial area under curve (iAUC).The mean values of tumor and normal rectal wall , mucinous and nonmucinous carcinoma, poorly and moderately-to-well differentiated carcinoma , case with or without lymph node metastasis were com-pared.RESULTS:All the parameters of rectal cancer were higher than normal rectal wall (P<0.01).No significant difference was found between poorly and moderately-to-well differentiated carcinoma in terms of K trans, Kep and Ve, neither was the case with or without lymph node metastasis .The cases with lymph node metastasis had lower iAUC than those with-out (P<0.05).CONCLUSION:Quantitative perfusion DCE-MRI answered the microvascular perfusion and permeability change of rectal cancer compared with normal rectal wall , besides it could be used to distinguish between mucinous and nonmucinous carcinoma , which demonstrated its value in the evaluation of rectal cancer .However , it should not be recom-mended to predict the degrees of tumor cell differentiation and lymph node metastasis just according to the perfusion param -eters.