【Objective】 To evaluate and analyze the impact of COVID-19 epidemic on inventory of red blood cells (RBCs)in local and municipal blood stations in China, and to provide reference for the management of public health emergencies. 【Methods】 Relevant data from 2018 to 2021 were collected, and the differences in the volume of qualified RBCs, the usage efficiency of inventory RBCs, the average daily distribution of RBCs,the blood distribution rate of RBCs prepared by 400 mL whole blood, the difference in the average storage days of RBCs at the time of distribution, the average daily inventory of RBCs and the time of the average daily inventory of RBCs to maintain the distribution in 24 local and municipal blood stations in China during the COVID-19 epidemic and non-epidemic periods were retrospectively analyzed. 【Results】 Compared with non-epidemic periods, the volume of qualified RBCs [(117 525.979 ±52 203.175)U] and the average daily distribution of RBCs [( 156. 468 ± 70. 186) U ] increased significantly, but the usage efficiency of inventory RBCs decreased(97.24%±0.51%) significantly (P<0.05).There was no significant difference in the blood distribution rate of RBCs prepared by 400 mL whole blood(73.88%±20.30%), the average storage days of RBCs distribution(13.040 ±3.486), the average daily stock quantity of RBCs[(2 280.542 ±1 446.538) U ] and the time of the average daily inventory of RBCs to maintain the distribution[(15.062 ±7.453) d] (P>0.5). 【Conclusion】 During the COVID-19 epidemic, the inventory management of RBCs operated well, the overall inventory remained relatively stable, the stock composition and storage period showed no significant change.

To review the diagnosis and treatment of a case of hypercalcium crisis caused by primary hyperparathyroidism（PHPT） and prophylactic treatment of hungry bone syndrome. In a 32-year-old male with hypercalcemia, the main manifestations were loss of appetite, nausea, polyuria, polydipsia, fatigue, lethargy, etc. parathyroid hormone, serum calcium increased, thyroid function was normal, thyroid color ultrasound and MRI showed space-occupying behind the right thyroid, radionuclide examination showed abnormal imaging agent concentration in the right parathyroid area, there was a history of pathological fracture. Clinically diagnosed as hypercalcemia crisis secondary to PHPT.
Male ; Humans ; Adult ; Hypercalcemia/diagnosis* ; Hyperparathyroidism, Primary/surgery* ; Parathyroid Hormone ; Hypocalcemia/complications* ; Thyroid Gland ; Calcium

Objective:To investigate feasibility, efficiency and safety of kissing pancreatojejunostomy after pancreatoduodenectomy.Methods:From Jan 2006 to Sep 2020, the clinical data of 267 patients undergoing pancreatoduodenectomy and kissing pancreatojejunostomy were retrospectively analyzed.Results:Grade B postoperative pancreatic fistula (POPF) occurred in 6.37%, Grade C POPF in 2.25% of patients. There was no mortality within 30 days postoperatively as to pancreatic fistula, by cut-off of pancreatic duct diameter at 3mm, there was no significant difference between two subgroups (15/140 vs. 8/127, P=0.20). also, when grouped by texture of the pancreas, no there was significant difference (20/194 vs. 3/73, P=0.11). Conclusions:Kissing pancreatojejunostomy is feasible and easy to perform. It also does not increase the POPF rate when applied to the pancreatojejunostomy with thin pancreatic duct and soft texture.

Objective To discuss the clinicopathological features and prognostic factors of patients with triple negative breast cancer (TNBC) in Shanxi province. Methods The medical records of 958 female TNBC patients who were admitted to Shanxi Provincial Cancer Hospital and the First Hospital of Shanxi Medical University from January 2005 to December 2015 were retrospectively analyzed. The clinicopathological features and prognostic factors were summarized. Results The median age of TNBC patients in Shanxi province was 46 years old (21-87 years old), the median body mass index (BMI) was 24.42 kg/m2 (15.0-37.5 kg/m2), and the rural population was slightly more. The left breast cancer was more than the right breast cancer, and 492 patients (51.4％) were in stage T2. The main histological type was invasive ductal carcinoma. The main surgical method was modified radical mastectomy. Univariate Cox regression analysis showed that the patient's place of residence, fertility status, age at first birth, breastfeeding history, tumor size, American Joint Committee on Cancer Staging, lymph node metastasis, and surgical approach were associated with the risk of death in TNBC patients (all P<0.05);but the BMI, menstrual status, menarche age, and family history were not associated with the risk of death (all P>0.05). Multivariate Cox regression analysis showed that rural residents (HR= 1.46, P= 0.044), positive lymph node metastasis (HR= 2.51, P< 0.01), non-fertility (HR=1.08, P= 0.009) and no surgery (HR= 2.53, P= 0.004) were independent risk factors affecting the risk of death, a history of breastfeeding was a protective factor affecting the risk of death in TNBC patients (HR=0.44, P=0.013). Conclusions In Shanxi province, TNBC is more common in premenopausal women and the main pathological type is invasive ductal carcinoma. Rural population, lymph node positive, non-fertility, and no surgical treatment are independent risk factors for the prognosis of TNBC patients.

Objective To observe the application value and therapeutic efficacy of wide-field digital pediatric retinal imaging system (Retcam Ⅲ) fundus fluorescein angiograms (FFA) assisted photocoagulation on familial exudative vitreoretinopathy (FEVR).Methods The study included 46 eyes of 34 patients with staging 2 FEVR.All patients received color fundus photography and FFA under general anesthesia.The blood vessel reliability of color fundus photography and FFA was comparatively determined.Binocular indirect ophthalmoscope laser photocoagulation was applied to peripheral retina with abnormal leakage as indicated by FFA,the wavelength was 532nm,the duration was 0.25 s and the energy was 200-280 mW.After laser photocoagulation,fundus imaging and FFA was repeated.Further laser photocoagulation was immediately added to areas with vessel leakage but missing the photocoagulation.After treatment,the mean follow-up duration was 14.4 months.The follow up focused on neovascularization,exudative lesions,vitreous traction and merging of photocoagulation spots within 3 months,and on fibrosis membrane resulting in macular traction,tractional retinal detachment,vitreous hemorrhage or Coats disease-like retinal exudates after 3 months.Results It was hard to identify the blood vessels based on the color fundus images and some avascular zone maybe missed.Neovascularization can't be determined by shape of the blood vessels.On the other hand,those new blood vessels can be easily recognized by FFA as leakage sites at the boundary of avascular zone.The surgeon could quickly and accurately locate the FEVR area guided by the color fundus images and FFA from same angle under binocular indirect ophthalmoscope.During the treatment,there was no retinal FEVR area missed laser photocoagulation for all patients.There was no neovascularization,exudative lesions,vitreous traction within 3 months,and no fibrosis membrane,tractional retinal detachment,vitreous hemorrhage or Coats disease-like retinal exudates after 3 months.There were no ocular and systemic complications during and after the FFA and laser photocoagulation.Conclusion Wide-field Retcam Ⅲ FFA can help retinal specialists to identify abnormal neovascularization,locate the lesion area,and thus increase the success rate of laser photocoagulation,reduce the ocular and systemic complications for FEVR.

OBJECTIVE: To investigate the safety and short-term efficacy of stent on 17 patients with very small intracranial aneurysms.
 METHODS: A total of 17 patients with very small intracranial aneurysms were treated by LVIS stent from October 2014 to November 2015. The location, size of the aneurysms and the branch around aneurysms were evaluated by digital subtraction angiography (DSA). The metal coverage for aneurysms was enhanced by using deployment technology ("compression" mode). The safety and efficacy were assessed after operation.
 RESULTS: LVIS stents-assisted treatments for very small aneurysms were carried out in 17 cases, including 7 cases of paraclinoid aneurysms, 4 cases of posterior communicating artery aneurysms, 3 cases of anterior communicating artery aneurysms, 2 cases of carotid bifurcation aneurysms, 1 case of the superior cerebellar artery aneurysm. The stents for 17 patients with very small intracranial aneurysms were released completely (100%); Raymond grade I embolization was seen in 13 cases (76.5%); Raymond grade II embolization was seen in 4 cases (23.5%); during the follow up from a month to a year, 16 patients showed good curative effect (with the mRS score at 0-2), 1 showed poor effect (with the mRS score at 3-6), and the efficacy rate was 94.1%; no perioperative hemorrhagic and ischemic complications happened.
 CONCLUSION LVIS stent-assisted therapy for very small intracranial aneurysms by using deployment technology was safe and feasible, which can significantly improve the embolization rate for very small aneurysms.
Basilar Artery ; Embolization, Therapeutic ; Humans ; Intracranial Aneurysm ; Safety ; Stents

Objective To investigate the effect of the second resection for unsuspected gallbladder carcinoma discovered after cholecystectomy.Methods A retrospective clincopathological analysis was conducted for 45 cases of unsuspected gallbladder carcinoma receiving second operation at our hospital from January 2000 to December 2010.Result Of the 45 cases with unsuspected gallbladder carcinoma (33 pT2,12 pT3 ),40 cases received second radical reeection of the liver bed with lymph dissection; the remaining 5 cases received palliative operation.Amongst 45 patients lymph metastasis (4 pT2,6 pT3 ) was found in 10 cases,liver metastasis ( 2 pT2,1 pT3 ) in 3,parietal seeding in 1 ( pT3 ) and distant metastasis ( pT2 ) in one.The 5 patients receiving palliative operation died in 3 ～ 8 months and 40 patients receiving the radical operation achieved long-term survival ( 40.4 ± 2.7 months) after the operation.The effect of second operation which was done within 4 weeks after the first cholecystectomy was better than that of the operation done beyond 4 weeks ( survival time 37.1 ± 2.2 vs 22.4 ± 5.8months).Conclusions Radical resection for unsuspected gallbladder carcinoma discovered after the initial cholecystectomy helps improve prognosis and prolong patients survival time.

Gastrointestinal stromal tumor( CIST) is the most common form of mesenchymal tumor of the gastrointestinal tract. Most GISTs characteristically harbor activating mutations of c-kit or PDCFRA( platelet derived growth factor receptor alpha, PDGFRA). All CISTs should be regarded having malignant potential. Tumor size and mitotic count, as two basic progonstic factors for primary CISTs, are largely site dependent. Most c-kit mutations have been found in exon 11,9,13,17 while PDGFRA mutations re found in exon 18,12,14.The sites and types of mutions are associated with the prognosis of CIST. Histopathology and immunohistochem-istry are another two factors predicting tumor outcome.

A total of 167 coronary heart disease (CHD) patients were divided into metabolic syndrome (MS) group (68 cases) and non-MS group (99 cases). There were significant differences in the disease-related metabolic indicators and coronary angiography (multivessel lesions, diffuse stenosis, occlusive lesions, Ginsini score) between MS group and non-MS group ( all P<0.05 ). When the patients with MS were divided into 3 groups according to the number of componernts of MS, three lesions, diffuse stenosis, and occlusive lesions were more frequent in five components group compared with three components group. Ginsini points rised with the increased risk factors. There existed differences in Ginsini score between three components group and four, five components group (P<0. 05 or P<0.01 ). Multivariable logistic regression analysis showed that obesity, hypertension,diabetes, high low-density lipoprotein-cholesterol, and low high-density lipoprotein-cholesterol were the predictors of CHD in patients with MS (P<0.05 or P<0.01 ).

Objective To retrospectively analyze the clinical manifestations of coronary artery ectasia and its angiographic characteristics. Methods Twenty-five patients who underwent coronary angiography were diagnosed as coronary artery ectasia from January 2005 to December 2007. 25 cases of coronary artery atheresclerosis were also included and 25 cases with normal coronary arteriography in the same period were taken as control. Results Most of the patients were male (72%). Only three patients had diabetes and thirteen patients had hypertension. All the patients with coronary artery ectasia were admitted for chest pain. Nine of them showed abnormal ST changes and four elevated ST in ECG. Coronary artery ectasia was associated with slow coronary flow in 9 patients and coronary stenosis in 4 patients. The frequency of arterial involvement, in descending order, was right coronary artery in 76%, left anterior descending artery in 60%, left circumflex artery in 48% and left main artery in 8%. Ectasia affected only one major vessel was found in 44%, and all three vessels in 36%. As compared with the patients with coronary artery atherosclerosis and patients with normal coronary artery, patients with CAE had a lower prevalence of diabetes (12%), and there were no other significant statistics in clinical demography and other risk factors such as hypertension and dyslipidemia. Conclusions Coronary artery ectasia was prevalent in males and diabetes was less frequent. The RCA was the most commonly affected vessel and most of the patients had single vessel involvement.