Objective:To retrospectively analyze the bone marrow characteristics of methimazole-induced agranulocytosis and other hematologic damage, and to explore its correlation with clinical features and prognosis.Methods:The bone marrow and clinical parameters of 20 patients of Graves′ disease diagnosed with methimazole-induced agranulocytosis at the First Affiliated Hospital of Xi′an Jiaotong University from January 2000 to December 2022 were collected. The intergroup differences in bone marrow characteristics and granulocyte recovery time were analyzed. Differences in peripheral blood and bone marrow characteristics between patients with single agranulocytosis and pancytopenia were compared. Besides, literature review of the bone marrow characteristics of methimazole-induced hematologic diseases was conducted.Results:Compared to patients with bone marrow characteristics of granulocyte and precursor maturation disorders(Type Ⅱ), patients with aplastic marrow(Type Ⅰ) had significant decreases in the proportions of granulocytes in all phases( P<0.05). Patients with bone marrow characteristics of Type Ⅰ had a significant increase in the proportion of the lymphocyte system [51.00%(41.50%, 75.50%) vs 22.00%(14.00%, 35.00%), P=0.002], and got a longer to recovery time [(6.58±1.68)d vs(3.71±1.60)d, P=0.003]; Correlation analysis suggested the granulocyte to erythrocyte ratio was negatively correlated with the granulocyte recovery time( r=-0.520, P=0.023), and the proportion of the bone marrow lymphocyte was positively correlated with granulocyte recovery time( r=0.622, P=0.004). Compared to patients with single agranulocytosis, patients with pancytopenia had a markedly longer hospital stay duration [(27.14±5.27)d vs(14.15±7.36)d, P=0.001]. Literature review suggestsed that methimazole may cause various degrees of damage to blood system and bone marrow. Conclusion:Methimazole can induce a variety of hematologic damages. Analysis of bone marrow characteristics can aid in further prognosis assessment. Clinicians should be vigilant about potential hematologic adverse reactions when using methimazole and promptly diagnose and treat them to prevent serious consequences.

Objective:To compare the consistency of lymphoma multigene detection panels based on next-generation sequencing (NGS) with FISH detection of B-cell lymphoma gene rearrangement.Methods:From January 2019 to May 2023, fusion genes detected by lymphoma-related 413 genes that targeted capture sequencing of 489 B-cell lymphoma tissues embedded in paraffin were collected from Henan Cancer Hospital, and the results were compared with simultaneous FISH detection of four break/fusion genes: BCL2, BCL6, MYC, and CCND1. Consistency was defined as both methods yielding positive or negative results for the same sample. The relationship between fusion mutation abundance in NGS and the positivity rate of cells in FISH was also analyzed.Results:Kappa consistency analysis revealed high consistency between NGS and FISH in detecting the four B-cell lymphoma-related gene rearrangement ( P<0.001 for all) ; however, the detection rates of positive individuals differed for the four genes. Compared with FISH, NGS demonstrated a higher detection rate for BCL2 rearrangement, a lower detection rate for BCL6 and MYC rearrangement, and a similar detection rate for CCND1 rearrangement. No correlation was found between fusion mutation abundance in NGS and the positivity rate of cells in FISH. Conclusions:NGS and FISH detection of B-cell lymphoma gene rearrangement demonstrate overall good consistency. NGS is superior to FISH in detecting BCL2 rearrangement, inferior in detecting MYC rearrangement, and comparable in detecting CCND1 rearrangement.

Objective:To investigate the influence of sulforaphane(SFN)on ventricular remodeling in myocardial infarction(MI)rat model by regulating extracellular regulated protein kinase(ERK)/nuclear respiratory factor 1(NRF1)signaling pathway.Methods:Among 48 SD male rats,12 were randomly selected as Sham group.The remaining rats were treated with ligation of left ante-rior descending coronary artery to establish myocardial infarction model.After modeling,36 rats were randomly divided into MI model group,SFN treatment group(10 mg/kg),SFN+SCH772984(ERK inhibitor)group(10 mg/kg+15 mg/kg),with 12 rats in each group.Animal ultrasound was performed to detect cardiac structure and function.Histological analysis was performed to evaluate myo-cardial fibrosis and cell apoptosis.ELISA was used to measure pro-inflammatory factor levels in serum,and Western blot assay was used to observe the expression of ERK/NRF1 pathway related proteins in myocardium of rats in each group.Results:Compared with rats in Sham group,rats in MI model group showed a loss of myocardial compliance and disarray of ventricular myocardial fibers,along with increased myocardial fibrosis and myocardial cell apoptosis.Moreover,rats in MI model group also exhibited overactive inflammatory response and inhibition of the ERK/NRF1 signaling pathway in cardiac tissues(P<0.05).Notably,SFN treatment signifi-cantly not only improved cardiac function,but also ameliorated myocardial fibrosis and cell apoptosis(P<0.05).SFN treatment inhib-ited inflammatory cytokine expression and activated the ERK/NRF1 pathway as well(P<0.05).However,SCH772984 significantly abrogated the protective effect of SFN against myocardial fibrosis and apoptosis in MI rats.Conclusion:SFN may protect against ventricular remodeling in MI rat by activating ERK/NRF1 pathway.

Objective To observe area of coagulation necrosis after microwave ablation(MWA)of rabbit liver showed on contrast-enhanced ultrasound(CEUS)in comparison with pathological findings.Methods Twenty-five healthy male experimental rabbits were equally randomly divided into L0,M0,H0,M7 and M14 groups.MWA was achieved with different power and time,and then CEUS and pathological examinations were performed,respectively.Four target areas of rabbit liver were ablated under 20 W for 1 min in L0 group,under 30 W for 1 min in M0 group and under 30 W for 3 min in H0 group,and the ablated areas were observed on the same day after MWA,while 2 target areas of rabbit liver were ablated under 30 W for 1 min in M7 and M14 groups,and the ablated areas were observed 7 days and 14 days after MWA,respectively.The ablated foci and ablated foci+edema band(inflammatory reaction band,IRB)showed on CEUS and pathology were compared,and their differences and changes with time going were analyzed.Results On the day of ablation,the extent of ablation foci,ablation foci+IRB as well as IRB in L0,M0 and H0 groups showed on CEUS were all larger than pathological findings under light microscopy(all P＜0.05),and the difference value of the length of the ablation foci between 2 methods increased sequentially among group L0,M0 and H0(all adjusted P＜0.05).Seven days after ablation,the area of ablation foci measured with CEUS in M 7 group was slightly larger than that measured with pathology(adjusted P=0.045),but no significant difference of the length nor the short diameter was found(both adjusted P＞0.05).Fourteen days after ablation,no significant difference of the length,the short diameter nor the area of ablation foci was detected between 2 methods in M14 group(all adjusted P＞0.05).The length,short diameter and area of ablation foci in M0 group measured with CEUS or pathology were all smaller than those in M 7 and M14 groups(all adjusted P＜0.05),while no significant difference was found between the latter 2 groups(all adjusted P＞0.05).Conclusion On the day of MWA of rabbit liver with different power and time settings,the areas of ablation foci,ablation foci+IRB and IRB showed on CEUS were larger than pathological findings.The range of ablation foci showed on CEUS 7 days after ablation was basically in line with pathology,indicating that CUES should be reexamined 7 days after ablation to evaluate the actual extent of coagulation and necrosis of ablation foci.

【Objective】 To investigate the effect of isoliquiritigenin on inflammatory response of vascular endothelial cells and whether the regulatory effect of isoliquiritigenin on inflammation is mediated by histone deacetylase 3 (HDAC3). 【Methods】 Human umbilical vein endothelial cells (HUVECs) were cultured in vitro and treated with LPS, different concentrations of isoliquiritigenin and HDAC3 specific inhibitor, respectively. Real-time PCR and Western blotting were used to detect the mRNA and protein expressions of inflammatory cytokines and HDAC3. Male C57BL/6J mice were randomly divided into vehicle group and isoliquiritigenin treatment group. The vascular inflammation model of C57BL/6J mice was established by ligation of the left carotid arteries. The mRNA expressions of inflammatory cytokines and HDAC3 in the carotid arteries of mice were detected by Real-time PCR. A molecular docking study was performed to investigate the interaction between isoliquiritigenin and HDAC3. 【Results】 Compared with the vehicle group, isoliquiritigenin reduced the mRNA expressions of inflammatory cytokines NLRP3, IL-1β, IL-18, MCP-1 and ICAM-1 and decreased the expression of HDAC3 mRNA and protein in HUVECs stimulated with LPS. In addition, isoliquiritigenin also decreased the mRNA expressions of NLRP3, IL-1β and HDAC3 in carotid arteries of ligated C57BL/6J mice. The docking of isoliquiritigenin in the active site of HDAC3 showed that isoliquiritigenin might act through HDAC3. Furthermore, HDAC3 specific inhibitor RGFP966 further promoted the inhibitory effect of isoliquiritigenin on the expression of inflammatory cytokines in vascular endothelial cells. 【Conclusion】 These results suggest that isoliquiritigenin suppresses the inflammatory response of vascular endothelial cells via HDAC3.

OBJECTIVE To investigate the effectiveness of clinical pharmacists’ participation in the refined pharmaceutical management for inpatients of oncology center based on diagnosis related groups （DRG）.　METHODS Patients who entered DRG and stayed in hospital for less than 60 days in oncology center of Daping Hospital， Army Medical University were selected as the research objects to analyze the changes of DRG indicators and related hospitalization indicators before the intervention of clinical pharmacists’ participation in the refined pharmaceutical management （Jan.-Dec. 2019）， the first year after the intervention （Jan.- Dec. 2020）， and the second year after the intervention （Jan.-Dec. 2021）； the key DRG groups were selected from the oncology center according to DRG enrollment and disease diagnosis and treatment methods， and related hospitalization indicators before and after the intervention and rational drug use after intervention were analyzed.　RESULTS Compared with before intervention， in the first and second years after the intervention， the number of DRG groups increased to 157 and 184， and the case mix index increased significantly （P＜0.05）， while costconsumption index， time consumption index， average hospital stay and average hospitalization expense per time were decreased or shortened significantly （P＜0.05）； drug cost per time was increased significantly （P＜0.05）， and there were no low- risk deaths and severe adverse drug reactions. Among the 4 key DRG groups， the average hospital stay in RE19 disease group and RU29 disease group in the first and second year after intervention and those of RU14 disease group in the first year after intervention were significantly lower than before （P＜0.05）； the average hospitalization expense per time of RE19 disease group in the first and second year after intervention and those of RU14 disease group， RV19 disease group and RU29 disease group in the second year after intervention were significantly lower than before （P＜0.05）； drug cost per time of RU14 disease group in the second year after intervention was significantly lower than before， while those of RE19 disease group and RU29 disease group in the first and second year after intervention were significantly higher than before （P＜0.05）. There was some irrational drug use in the DRG disease groups with a significant increase in the drug cost per time after the intervention， such as inappropriate selection of drugs， inappropriate usage and dosage， off-label drug use， etc.　CONCLUSIONS In the context of DRG， after the clinical pharmacists participated in the refined pharmaceutical management， the overall diagnosis and treatment service capacity of oncology center are improved， the efficiency of diagnosis and treatment are improved， and there are no low-risk deaths and severe adverse drug reactions， which promote the management of rational drug use in medical institutions.

Objective:To explore the efficacy of different unipolar electrocoagulation power on pathological injury of porcine kidney suffering suture-free partial nephrectomy (SFPN).Methods:From April 2018 to July 2018, nine Guizhou pigs were selected, with an average age of 3 years and an average weight of 48 kg. According to different hemostatic power of unipolar electrocoagulation during open partial nephrectomy, they were divided into three groups(60W group, 80W group, and 100W group), with 3 in each group. The left kidney was exposed with a surgical incision, parallel to the lumbosacral muscle.The left renal artery was clamped and about 2 cm renal tissue was excised at the middle pole of the left kidney. 60W, 80W and 100W were used by unipolar electrocoagulation for hemostasis until no bleeding occurred after the artery clamp was released. The total ischemia time was controlled within 20 min. Temperature was measured by a multi-channel thermometer probe which was inserted into the healthy kidney tissue at a distance of 2 mm, 5 mm, and 10 mm away from the unipolar electrocoagulation hook, and the upper pole of the kidney far away from the operation area. The time of operation, the volume of renal bleeding, the time of hemostasis and the temperature were recorded. On the 7th day after operation, the left kidneys were taken and the pathological changes were observed by toluidine blue staining.Results:All operations were completed safely and successfully. The operation time in 60W group, 80W group, and 100W group was (41.2±5.5)min, (35.1±3.7)min, (31.3±2.2)min , respectively. There was no significant difference of operation time among those group ( P>0.05). The blood loss of renal was (35.3±4.1)ml, (21.4±4.7)ml, (15.3±4.1)ml, respectively. The blood loss in the 100W group and 80W group was less than that in the 60W group ( P<0.05). And the blood loss in the 100W group was less than that in the 80W group ( P<0.05). The hemostasis time was (15.2±1.9)min, (10.1±1.4)min, (6.4±0.8)min. The hemostasis time in the 100W and 80W groups was less than that in the 60W group ( P<0.05). And the hemostasis time in the 100W group was less than that in the 80W group ( P<0.05). At the place of 10 mm away from the electrocoagulation hook, the temperature in the three groups were (33.1±1.1)℃, (34.0±1.0)℃, (34.3±0.6)℃, which was not significantly different from that of the respective upper poles. And there was no significant difference between the three groups( P>0.05). At the place of 5 mm and 2 mm away from the electrocoagulation hook, the temperature in the 100W group (41.7±1.3)℃, (61.4±6.4)℃ and the 80W group (38.6±2.4)℃, (50.3±6.0)℃ was higher than that in the 60W group (36.9±4.1)℃, (42.0±4.7)℃, and the temperature in 100W group is higher than that in 80W group ( P<0.05). When the power was 60W, 80W or 100W, the temperature in the place 10 mm away from the electrocoagulation hook was less than that in the place 5 mm away from the electrocoagulation hook ( P<0.05), and the temperature of the place 5 mm away from the electrocoagulation hook was lower than that of the place 2 mm away from the electrocoagulation hook ( P<0.05). The total pathological injury depth of wounds in 60W, 80W, 100W group was (7 323±50)μm, (8 119±100)μm, (8 896±40)μm, respectively. The depth in 100W group and 80W group was deeper than that in 60W group ( P<0.05), and the depth in 100W group was deeper than that in 80W group ( P<0.05). Conclusions:In SFPN, the hemostatic effect of three different monopolar electrocoagulation output power is satisfactory. With the increase of power, the hemostasis speed is faster. However, the temperature of surrounding healthy renal tissue would be higher, and the total pathological injury depth would be deeper.

Trauma is the leading cause of death for people under 40 years old in the world. At present, the rescue and treatment system of trauma patients in China is not yet well established, and the mortality of trauma patients is higher than those in the developed countries. Improving the treatment system is the key to reducing the trauma mortality. In order to innovate the service mode of trauma first aid, further promote the establishment of regional trauma first aid system, improve the ability of trauma treatment, reduce the mortality and disability rate of trauma patients in Jiangxi Province, recently Health Commission of Jiangxi Province and the First Affiliated Hospital of Nanchang University have reached a consensus on the establishment of Jiangxi trauma first aid center. In order to provide reference for the construction of trauma treatment system, the author analyzes the following aspects including functional positioning, basic requirements, organization management, and evaluation of core indicators.

Objective: To study the relationship between ABO blood type and spontaneous re-canalization (SR) in patients with acute myocardial infarction (AMI). Methods: A total of 1209 consecutive AMI patients were enrolled. Based on TIMI grade, the patients were divided into 2 groups: Non-SR group, the patients with TIMI grade 0-1,n=442 and SR group, the patients with TIMI grade 2-3,n=767. The relationship between ABO blood type and SR was investigated. Results: Compared with Non-SR group, SR group had more patients with blood type O (32.3% vs 24.7%) and less blood type A (31.7% vs 24.9%). Meanwhile, we found that a lower cholesterol level was related to patients with O blood type and SR occurrence, bothP<0.05. Multi regression analysis indicated that with adjusted age, gender, BMI, hypertension, diabetes, smoking, LDL-C and C-reactive protein, ESR, fibrinogen, D-dimmer, endothelial cardiac function, blood type O may independently predict SR occurrence in AMI patients (OR=1.49, 95% CI 1.10-2.05), while blood type A may have disadvantage for SR (OR=0.65, 95% CI 0.48-0.80). Conclusion: ABO blood type has been related to SR in AMI patients, blood type O is in favor of SR, while blood type A has disadvantage for SR occurrence.