Objective:To investigate the predictive value of anti-Müllerian hormone (AMH) on the outcome of microscopic testicular sperm extraction (micro-TESE) in patients with non-mosaic Klinefelter syndrome (KS) of the clinical data and to identify effective predictors for successful micro-TESE.Methods:A retrospective case-control study was conducted on the clinical data of 118 non-mosaic KS patients treated at the Center for Reproductive Medicine of the First Affiliated Hospital of Zhengzhou University between May 2018 and September 2023. Patients were divided into two groups based on whether sperm were successfully retrieved via micro-TESE: the sperm retrieved group ( n=45) and the no sperm retrieved group ( n=73). Differences between the two groups were compared, and multivariate logistic regression analysis was used to identify factors influencing sperm retrieval. Changes in testicular volume and sex hormone levels before and after surgery were also assessed. Results:The sperm retrieval rate was 38.1% (45/118). Patients in the sperm retrieved group were significantly younger [(26.93±3.80) years] than those in the no sperm retrieved group [(28.27±3.92) years, P=0.029], and the AMH level was significantly higher [0.44 (0.18, 1.13) μg/L] than that in the no sperm retrieved group [0.10 (0.03, 0.22) μg/L, P<0.001]. AMH was identified as an independent predictor of micro-TESE outcome in non-mosaic KS patients ( OR=7.867, 95% CI: 2.727-27.242, P=0.001). The area under the receiver operating characteristic curve was 0.802 (95% CI: 0.722-0.883), and the optimal reference threshold for AMH was ≥0.265 μg/L. Postoperatively, testosterone levels decreased significantly by a median of 0.27 μg/L ( P=0.019), while luteinizing hormone levels increased by a median of 2.08 U/L ( P=0.049), with a more significant decline in testosterone levels observed in the no sperm retrieved group by a median of 0.29 μg/L ( P=0.022). Conclusion:AMH can predict successful micro-TESE in non-mosaic KS patients, with higher AMH levels indicating a higher likelihood of success.

Objective:To investigate the predictive value of anti-Müllerian hormone (AMH) on the outcome of microscopic testicular sperm extraction (micro-TESE) in patients with non-mosaic Klinefelter syndrome (KS) of the clinical data and to identify effective predictors for successful micro-TESE.Methods:A retrospective case-control study was conducted on the clinical data of 118 non-mosaic KS patients treated at the Center for Reproductive Medicine of the First Affiliated Hospital of Zhengzhou University between May 2018 and September 2023. Patients were divided into two groups based on whether sperm were successfully retrieved via micro-TESE: the sperm retrieved group ( n=45) and the no sperm retrieved group ( n=73). Differences between the two groups were compared, and multivariate logistic regression analysis was used to identify factors influencing sperm retrieval. Changes in testicular volume and sex hormone levels before and after surgery were also assessed. Results:The sperm retrieval rate was 38.1% (45/118). Patients in the sperm retrieved group were significantly younger [(26.93±3.80) years] than those in the no sperm retrieved group [(28.27±3.92) years, P=0.029], and the AMH level was significantly higher [0.44 (0.18, 1.13) μg/L] than that in the no sperm retrieved group [0.10 (0.03, 0.22) μg/L, P<0.001]. AMH was identified as an independent predictor of micro-TESE outcome in non-mosaic KS patients ( OR=7.867, 95% CI: 2.727-27.242, P=0.001). The area under the receiver operating characteristic curve was 0.802 (95% CI: 0.722-0.883), and the optimal reference threshold for AMH was ≥0.265 μg/L. Postoperatively, testosterone levels decreased significantly by a median of 0.27 μg/L ( P=0.019), while luteinizing hormone levels increased by a median of 2.08 U/L ( P=0.049), with a more significant decline in testosterone levels observed in the no sperm retrieved group by a median of 0.29 μg/L ( P=0.022). Conclusion:AMH can predict successful micro-TESE in non-mosaic KS patients, with higher AMH levels indicating a higher likelihood of success.

【Objective】 To explore the model of "One Core, Multiple Elements" emergency blood donation volunteer team (referred to as the Model) . 【Methods】 The Nanjing City Voluntary Blood Donation Joint Meeting serves as the core, with diverse entities including party committees, government departments, district governments, social organizations, enterprises, blood donors, etc. Following the principles of "emergency response in emergencies, wartime readiness, combining regular and wartime efforts," and adhering to the framework of the Model, the emergency blood donation volunteer team system in Nanjing was constructed. 【Results】 1) After the construction of the Model (2018—2022), the total number of emergency blood donation volunteers in Nanjing City increased by 191% compared to the pre-construction period (2013—2017), with an average annual blood donation of 20 929, showing significant differences (P<0.05). 2) After the construction of the Model, the number of emergency blood donation during the winter and summer increased by 206% and 185%, respectively, compared to the pre-construction period, demonstrating significant differences (P< 0.05) .3) Prior to the construction of the Model, Nanjing lacked a relatively stable emergency volunteer team. After the construction, Nanjing established a total of 5 relatively stable volunteer teams, with the district-level government and township personnel accounting for the highest proportion (52.96%), followed by medical personnel (23.95%), enterprise team (11.10%), State-owned Assets Supervision and Administration Commission team (7%), and Nanjing municipal government team (4.98%). 4) Following the Model, during the COVID-19 pandemic, Nanjing successfully initiated two Level Ⅱ blood emergency responses, with emergency blood donations reaching 23 041. 【Conclusion】 The Model can effectively ensure the blood supply in Nanjing region during emergencies.

【Objective】 To analyze the implementation effect of points-based household registration policy for blood donors in Nanjing, so as to provide reference for other provinces and cities to develop incentive policies for blood donation. 【Methods】 The basic demographic profile, registration situation and deferral reasons of blood donors who applied for points-based household registration from 2017 to 2021 were analyzed by Excel. 【Results】 1) A total of 388 blood donors applied for points-based household registration for blood donation from 2017 to 2021, accounting for 0.042% of the total blood donors in Nanjing (388/923 160), and 357 applications were approved, accounting for 0.039% (357/923 160). 2) The proportion of male applicants was higher than that of female applicants (55.15% vs 44.85%). Applicants aged 26~35 accounted for the largest, followed by applicants aged 36~45, and applicants aged 18~25 accounted for the least. The proportion of applicants in Jiangsu province(23.27%) was higher than that of applicants from other provinces. The top three occupations were employees, workers and jobless. In terms of education level, applicants with junior high school education or below accounted for the largest, followed by high school and secondary school (35.05% vs 29.38% vs 23.20%). The proportion of first-time blood donors was the highest (33.24%). Among the repeated blood donors, blood donors who donated blood 2~3 times were with the highest share (23.93%). Nineteen donors(4.90%) got more than 100 points. 3) A total of 31 blood donors were deferred from 2017 to 2021, accounting for 7.90% of the total applicants. Among them, 23 applicants donated in other cities than Nanjing, 5 applicants failed to provide valid blood donation certificates, and 3 applicants submitted irrelevant material. 【Conclusion】 The implementation of points-based household registration policy for voluntary blood donors in Nanjing helped blood donors who could not reach other points due to low education level and income to become registered permanent residence in Nanjing

【Objective】 To investigate the status of blood donation of pregnant women's family members, so as to recruit their family members and establish potential blood donation team. 【Methods】 Questionnaire survey was carried out among family members of pregnant women who participated in blood preparation plan by random sampling. 【Results】 The motivations of self-efficacy, internal reward, severity and stress of blood donors were significantly higher than those of non-donors, but non-donors concerned more about negative feelings of phlebotomy(P<0.05). People with rare blood type, low age, high income, weak negative motivation and strong positive motivation had stronger blood donation intention and higher probability of blood donation behavior(P<0.05). 【Conclusion】 It is necessary to expand blood sources through multiple channels by organizing publicity activities around targeted groups, such as establishing channels for blood donation reservation, taking the lead role of the donated crowd, so as to build up a recruitment team for voluntary blood donation.

【Objective】 To analyze the implementation and problems in the process of the first policy of serious illness benefits for voluntary blood donors in China, therefore provide reference for other provinces and cities to formulate care policies for voluntary blood donors. 【Methods】 The number of blood donors who received serious illness benefits and the proportion to the total number of blood donors in that year were obtained by Excel, and their basic demographic information, illness and reasons for failing to receive benefits were analyzed. 【Results】 From 2015 to 2019, a total of 198 blood donors applied for serious illness benefits, and 159 received benefits (638 000 yuan), accounting for 0.017% of the total number of voluntary blood donors in Nanjing. The average age of the recipients was 52.66, with the proportion of males (63.5%) higher than that of females (36.5%). 52.8% (the highest proportion) got benefits of 5 000 yuan. 39 applicants failed to obtain serious illness benefits, among which 27 applicants failed during 2017 to 2018 due to unidentifiable funding source. But after Nanjing Blood Donation Regulations clarified the funding sources, the implementation of serious illness benefits policy was continued in 2018. 【Conclusion】 The implementation of serious illness benefits for voluntary blood donors presented the Nanjing municipal government's care for voluntary blood donors. The legalization of this policy is conducive to the continuity and stability of policy implementation. Relevant departments and blood centers should continue to strengthen the policy publicity and make sure the policy is implemented effectively.

【Objective】 To analyze the influencing factors of blood re-donation among street voluntary blood donors in Nanjing, and to provide basis for increasing the proportion of blood donation/donors. 【Methods】 29 650 street voluntary blood donors in Nanjing from May 21, 2017 to May 21, 2018 in the information management system of Nanjing Red Cross Blood Center were taken as the sampling population, and 2 965 (10%) were randomly selected to ask whether they donated again and reasons by telephone calls. They were divided into re-donation group and lapsed group.The demographic variables and donation frequency of street blood donors in the two groups were analyzed and compared by Chi-square test, and multivariate logistic regression was used to analyze the influencing factors of re-donation of blood donors. 【Results】 The response rate of this survey was 63.37% (1 879/2 965), and the re-donation rate of street blood donors in Nanjing from May 2017 to May 2018 was 40.34% (758/1 879), which was lower than the re-donation rate of global blood donors as 50%. The primary motivation for street blood donors in Nanjing to donate blood again was "help others", accounted for 62.27% (472/758), and the primary deterrent to redonate blood again was "too busy to donate blood", accounted for 49.15% (551/1 121). 【Conclusion】 There is a certain gap between the rate of blood re-donation in Nanjing and worldwide, therefore, further incentive measures are needed and flexible recruitment and blood donation methods should be adopted to facilitate blood donation for donors.

【Objective】 To explore the promote and deter factors of blood donation among street blood donors in Nanjing, in order to improve the accuracy of street blood donors recruitment. 【Methods】 A questionnaire with high confidence was designed based on the theory of planned behavior(TPB). The multi-stage hierarchical sampling method was adopted according to the geographical location and economic development level of 11 districts(regions) in Nanjing, and the street blood donors were divided into three groups according to the history of blood donation: one donation(n=361), donation numbers ≥ 2(n=417)and non-donation (n=241). The blood donation behavior was investigated from four aspects as external promote factors (such as seeking a free blood examination, self-interest factors, etc.), internal promote factors(such as altruistic, self-interest factors, blood donation can help others, etc.), external deter factors (too busy to donate blood, opposition from my family, etc.) and internal deter actors ( worry about dizziness after blood donation, fear of needles, ect.). The database was established using Epidata software, and chi-square test was applied for statistical analysis between groups. 【Results】 The groups mainly affected by the promote factors (altruistic and self-interest factors) of Nanjing street population in blood donation were unmarried, 18~24 years old, childless, below bachelor degree, and have barely no income. The main groups less affected by the deter factors were students, male, unmarried, 18~24 years old, childless and have barely no income.Promote factors increases with the number of blood donations, while deter factors decreases with the number of blood donation. 【Conclusion】 TBP can better analyze and explain the promote and deter factors affecting blood donation behavior among street blood donors in Nanjing, which is helpful for blood stations to formulate targeted measures to improve the availability of street blood donors.

【Objective】 To explore the feasibility and necessity of establishing a scheduled blood donation team focusing on pregnant women′s blood preparation by the comparative analysis between RhD positive and negative pregnant women′s family participation in the team, so as to provide basis for decision-making on fine management of key groups of voluntary blood donation. 【Methods】 A questionnaire survey was conducted between the families of RhD negative and positive pregnant women participating in the blood preparation program from January to September 2020 to compare the differences in incentive measures, blood donation cognition, motivation, intention and behavior between the two groups. 【Results】 For common incentive measures for blood donation, both families of RhD negative pregnant women(the former) and families of RhD positive pregnant women(the latter) preferred expectant mothers to use blood first, accounting for 98.02% (99/101) and 98.51% (132/134), respectively, with no significant difference.For other incentive measures, the preference of the former were significantly higher (P<0.05). For the cognition of voluntary blood donation, the awareness of the former was higher than that of the latter, with significant difference(P<0.05), except for clinical blood use expenses; the score of intention to donate blood of the former was higher than that of the latter(P<0.05); among the six factors of motivation to blood donation, the score of severity of the former(understanding of the status of blood supply) was higher than that of the latter, and the difference was statistically significant(P<0.05). Analysis of ROC curve showed that AUC of fitting model of the former and latter was 0.816 (95% CI: 0.731~0.902) and 0.924 (95% CI: 0.871~0.977). 【Conclusion】 Pregnant women families participated in the program are more interested in the incentive measures of health policies.The former has higher awareness of the current supply situation hence demonstrates higher intention to donate blood than the latter.Therefore, relevant policies should be formulated to improve the enthusiasm of pregnant women families to participate in voluntary blood donation, optimize the construction strategy of scheduled blood donation team and expand the donation team while ensuring blood use of pregnant women.

【Objective】 To investigate the feelings of blood donors during blood donation and its influencing factors, thus providing references for high quality blood donation service for blood banks. 【Methods】 A self-developed questionnaire concerning voluntary blood donation was randomly issued by the research group and recruited investigators among blood donors in 6 street blood donation sites of Nanjing Red Cross Blood Center at weekends during December 1~23, 2018. The basic information of blood donors, the difference of feelings during blood donation and the influencing factors were analyzed by descriptive analysis, chi-square test and binary Logistic regression analysis, respectively. 【Results】 A total of 405 questionnaires were issued, and all 405 copies were valid, with the response rate at 100% (405/405). Among the valid questionnaires, 46.67% (189/405) were first-time blood donors, 27.65% (112/405) had donated for 2~3 times, and 25.68% (104/405) donated more than 4 times. 53.59%(97/181), 23.7%(43/181) and 22.65%(41/181) of the above three groups of blood donors worried about the needles, and 55.48%(81/146), 22.60%(33/146) and 21.92%(32/146) worried about the blood outflow, 52.69% (88/167), 28.14% (47/167), and 19.16% (32/167 )worried about the pain during blood collection (P<0.05). The anxiety of unqualified blood test was similar to that of poor service (P>0.05). There were differences in blood donation experience among the three groups (P<0.05), and gender (P<0.05) was its influencing factor showed by binary Logistic regression analysis. 【Conclusion】 The majority of blood donors, who have donated at the street sites of Nanjing, are worried during blood donation collection. Therefore, the blood centers should provide high-quality services and humanized nursing interventions as well as strengthen the citizens′ awareness of blood donation.