[Objective] To investigate the factors influencing the detection of HLA-C expression by flow cytometry. [Methods] A total of 12 hematopoietic stem cell suspension samples from peripheral hematopoietic stem cell volunteer donors were randomly collected after CD34⁺ cell counting detection. The influence of detecting different number of nucleated cell (500 000, 50 000 and 5 000), sequential order of red blood cell lysis and antibody incubation, and the HLA-C antibody with varied remaining time from the expiration date on the detection results of HLA-C expression by flow cytometry were investigated, respectively. The significance of differences between different groups was analyzed through Student t test. [Results] There was no significant difference in the proportion of HLA-C positive cells and mean fluorescence intensity (MFI) among the three groups with different nucleated cell numbers detected (500 000, 50 000 and 5 000) (P>0.05). The sequential order of red blood cell lysis and antibody incubation had no influence on the proportion of HLA-C positive cells (P>0.05), but HLA-C MFI value was significantly lower when antibody incubation was performed after red blood cell lysis than that when antibody incubation was performed before red blood cell lysis (P<0.05). The proportion of HLA-C positive cells and MFI value detected by HLA-C antibody remaining 24 months from the expiration date were significantly higher than those detected by HLA-C antibody remaining only 5 months from the expiration date (P<0.05). [Conclusion] The present study has investigated the factors of influencing HLA-C expression level by flow cytometry, the results have important reference and application value for standardizing the experimental operation of HLA-C expression and improving the accuracy and comparability of detection results.

Objective To analyze the possible mechanism and drug treatment plan of diffuse alveolar hemorrhage induced by human granulocyte colony-stimulating factor injection, point out medication risks and provide reference for medical treatment and pharmaceutical care of such patients. Methods The abnormal lung conditions of a patient treated with human granulocyte colony-stimulating factor injection was found by clinical pharmacists, who participated in clinical diagnosis and treatment by analyzing of adverse drug reactions, optimization of medical treatment and pharmaceutical care. Results Diffuse alveolar hemorrhage was likely an adverse drug reaction caused by human granulocyte colony-stimulating factor injection. The physician discontinued the medication immediately and provided treatment such as oxygen inhalation, high-dose hormone shock, plasma exchange, etc. The patient’s oxygen saturation was improved, alveolar bleeding was decreased, and the condition was improved. Conclusion Clinical pharmacists participate in patients’ medication treatment, carry out pharmaceutical guardianship, and assist physicians in adjusting treatment plans, which could contribute to the effectiveness and safety of patient treatment.

Objective To investigate the effect and mechanisms of celecoxib on right heart function in mice with acute high-altitude hypoxia exposure.Methods Male C57BL/6J mice(7 weeks old)were housed in a hypobaric chamber simulating an altitude of 5 800 m for 2 d to establish an animal model of acute hypobaric hypoxia.①Eighteen mice were randomly assigned to plain+saline(P+S),high-altitude hypoxia exposure+saline(H+S),and high-altitude hypoxia exposure+celecoxib(H+Cel).Body weight and routine blood indicators were measured,and cardiac ultrasound examination were performed for heart rate(HR),pulmonary artery acceleration time to ejection time ratio(AT/ET),tricuspid annular plane systolic excursion(TAPSE),tricuspid annular systolic velocity(S'),and left ventricular ejection fraction(LVEF)and fractional shortening(FS).Targeted metabolomic profiling was applied to detect the cardiac arachidonic acid(AA)metabolite levels.The contents of 12,13-dihydroxy-9Z-octadecenoic acid(12,13-diHOME)in the heart,liver,brown adipose tissue,and plasma were quantified by ELISA.② Eighteen mice were randomly assigned into plain+saline(P+S),high-altitude hypoxia exposure+saline(H+S)and high-altitude hypoxia exposure+12,13-diHOME(H+di)groups.Body weight,routine blood tests,and echocardiography were performed as above.③ Thirty-two mice were randomly divided into high-altitude hypoxia exposure+saline(H+S),high-altitude hypoxia exposure+celecoxib(H+Cel),high-altitude hypoxia exposure+soluble epoxide hydrolase inhibitor(sEHI)(H+sEHI),and high-altitude hypoxia exposure+sEHI+celecoxib(H+sEHI+Cel)groups.Body weight,routine blood tests,and echocardiography were performed as above.Cardiac and plasma contents of 12,13-diHOME and epoxyeicosatrienoic acids(EETs)were measured by ELISA.Results ① Compared to the P+S group,the H+S group exhibited significantly reduction of cardiac 12,13-diHOME level(P<0.001),increased counts of white blood cells(WBC)and neutrophils(P<0.01)and decreased TAPSE,S'and AT/ET both at resting state and under stress(P<0.01,P<0.001).Compared to the H+S group,the H+Cel group exhibited significantly increase of cardiac 12,13-diHOME level(P<0.05),reduced WBC and lymphocyte counts(P<0.01,P<0.05)and improved TAPSE and S'levels at resting state and under stress(P<0.01,P<0.001).② Compared to the H+S group,the H+di group demonstrated significantly improvement of TAPSE at basal and under stress(P<0.001)and a trend towards improved TAPSE at resting state(P=0.0532),but no obvious differences was observed in WBC and neutrophil counts between the H+di group and the H+S group.③ Compared to the H+Cel group,both the H+sEHI and H+sEHI+Cel groups exhibited significantly reduction of cardiac 12,13-diHOME level(P<0.01,P<0.05)though no statistical changes in cardiac function indicators.Compared to the H+S group,WBC counts and lymphocyte were decreased,and serum EETs level was incrased in the H+Cel group,H+sEHI group and H+sEHI+Cel group(P<0.01,P<0.001).Conclusion Celecoxib can elevate cardiac level of 12,13-diHOME and improves right heart function in mice after acute high-altitude hypoxia exposure through the CYP450-sEH metabolic pathway.

Objective To analyze the clinical characteristics of thyroid dysfunction induced by camrelizumab in the treatment of classical Hodgkin lymphoma(cHL)and explore the influencing factors.Methods The medical records of cHL patients treated with camrelizumab from January 1st,2017 to December 31st,2020,were collected.The clinical characteristics of thyroid dysfunction induced by camrelizumab were analyzed,and the influencing factors of adverse drug reactions(ADRs)were discussed.Results A total of 47 patients were included,12 patients(25.53%)experiencing thyroid dysfunction after receiv-ing camrelizumab.Among them,3 patients had hypothyroidism,7 had subclinical hypothyroidism,and 2 had subclinical hyperthy-roidism.The severity of ADRs was between grade 1 and 2(mild to moderate).None of the patients with thyroid dysfunction dis-continued camrelizumab.Thyroid dysfunction occurred between 1 and 22 months after camrelizumab treatment,with a median time of 6 months.2 patients with hypothyroidism treated with levothyroxine,the thyroid function returned to normal in 1 patient and was improved in the other.1 patient with subclinical hypothyroidism was treated with levothyroxine with the thyroid function continued to be abnormal.The rest of the 9 patients with thyroid dysfunction received no intervention,and 4 of them returned to normal,and others remained with no obvious change or loss in follow-up.Thyroid dysfunction was associated with baseline thyroid stimulating hormone level(P=0.03).The level of thyroglobulin antibodies and thyroid peroxidase antibodies was increased in 2 patients a-mong 3 patients with moderate thyroid dysfunction.Conclusion The incidence of thyroid dysfunction induced by camrelizum-ab in cHL was high.Camrelizumab-induced thyroid dysfunction was related to TSH baseline level(P=0.03).The severity was between grade 1 and 2,which was related to the level of TgAb and TPOAb.The subtype of thyroid dysfunction was mainly sub-clinical hypothyroidism with a long period.Patients could continue camrelizumab treatment,and the thyroid function of patients with grade 2 hypothyroidism was improved after the treatment with levothyroxine.

A 50-year-old male patient diagnosed with extensive stage small cell lung cancer was treated with pamiparib in combination with temozolomide.Five days later,the patient developed fever with fatigue.After 10 days,the patient stopped taking the drug due to worsening symptoms and was diagnosed with chemotherapy-induced myelosuppression(grade 4).The clinicist evaluated the patient's condition and assessed the association of adverse reactions using the Naranjo's evaluation scale,and concluded that myelosuppression may be induced by the combination of pamiparib and temozolomide.After symptomatic treatment,the patient's myelosuppression recovered completely.This article discusses the correlation between myelosuppression and the combination of the two drugs,provides treatment measures for this situation,briefly describes the risk factors of myelosuppression,treatment and prevention,and guides medical personnel to adjust the treatment plan in time according to different individuals in the process of using similar programs,and strengthens the monitoring and education of adverse drug reactions,so as to provide references for safe drug use.

Objective To investigate the sleep structure of Parkinson's disease (PD) patients with rapid eye movement sleep behavior disorder (RBD) and its correlations with cognitive function, depressive state and motor function. Methods A total of 120 PD patients were enrolled in this study, and divided into PD+RBD group (n=45) and PD group (n=75) based on the presence or absence of RBD. Sleep structure was recorded for both groups. The scores of the Montreal Cognitive Assessment (MoCA), Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), Unified Parkinson's Disease Rating Scale Part Ⅲ (UPDRS-Ⅲ) and Scales for Outcomes in Parkinson's Disease-Autonomic (SCOPA-AUT) were compared between the two groups. The correlations of MoCA, HAMA, HAMD, UPDRS-Ⅲ and SCOPA-AUT scores with sleep structure in the PD+RBD group were analyzed. Results The PD+RBD group showed significantly higher percentage of non-rapideye movement (NREM) at stage 1, arousal index, periodic limb movements during sleep (PLMS) and apnea-hypopnea index (AHI) compared to the PD group, while the percentages of NREM at stage 3, rapid eye movement (REM) sleep, sleep efficiency and lowest oxygen saturation were significantly lower (P < 0.05). The PD+RBD group also had significantly higher HAMA, HAMD, UPDRS-Ⅲ and SCOPA-AUT scores, and significantly lower MoCA scores compared to the PD group (P < 0.05). In the PD+RBD group, the percentages of NREM at stage 1, arousal index, PLMS and AHI were positively correlated with HAMA, HAMD, UPDRS-Ⅲ and SCOPA-AUT scores, and negatively correlated with MoCA scores (P < 0.05). Conversely, the percentages of NREM at stage 3, REM sleep, sleep efficiency and lowest oxygen saturation were negatively correlated with HAMA, HAMD, UPDRS-Ⅲ and SCOPA-AUT scores, and positively correlated with MoCA scores (P < 0.05). Conclusion PD patients with RBD exhibit disrupted sleep structure, which is closely associated with cognitive function, depressive state, motor function, and autonomic nervous system function.

Objective:To explore the team construction and treatment strategy of the Diabetic Foot-Multidisciplinary Team.Methods:The clinical data of 19 patients with severe ischemic diabetic foot treated by our Diabetic Foot-Multidisciplinary Team Center from Apr 2021 to Mar 2022 were collected, and the overall amputation rate, above-ankle major amputation rate, minor amputation rate and mortality, Diabetic Foot-Multidisciplinary Team consultation discipline participation rate and treatment participation degree were retrospectively analyzed.Results:Nineteen patients (15 males and 4 females) were enrolled, aged 26 to 94 (68.6±14.2). All were with severe ischemic diabetic foot ulcer:Rutherford grade 5 or up and dysfunction in 2 or more organs. Complications included arteriosclerosis obliterans of the lower extremities in 18 cases, heart diseases in 18, hypertension in 15, and renal insufficiencies in 10. The overall amputation rate was 36.8%, major amputation rate in 21.1%, minor amputation rate in 15.8%, and mortality rate was 15.8%. A total of 16 disciplines participated in Diabetic Foot-Multidisciplinary Team; the main participating disciplines were vascular surgery (19 times), endocrinology (12 times), and cardiology (11 times). The main treatment disciplines were vascular surgery (14 times), plastic surgery (3 times), and cardiology (2 times).Conclusion:For the diagnosis and treatment of diabetic foot, it is necessary to set up a multidisciplinary team as early as possible to control the causes of diabetic foot ulcer, prevent the recurrence of diabetic foot ulcer, reduce the mortality and amputation rate, and improve the quality of life of patients.

Objective:To evaluate the safety and efficacy of bipolar plasmakinetic endoscopic enucleation of the prostate (BEEP) in the treatment of benign prostatic hyperplasia (BPH) in a day surgery mode.Methods:The clinical data of 162 BPH patients admitted to the First Affiliated Hospital of Anhui Medical University from January 2021 to June 2022 were analyzed retrospectively. The patients were divided into day group(80 cases) and conventional group(82 cases) according to hospitalization mode. In the day group, preoperative screening and anesthesia evaluation was completed during the pre-hospitalization period, and the patient was discharged within 24 hours. The two groups were treated with BEEP, the urethral mucosa was cut at a " Ω" 5 mm proximal to the external sphincter ring in front of the verumontanum. Following the standard of anatomical enucleation of the prostate, the gland tissue was cut out after enucleation. There were no significant differences in age [(63.6±8.9) years vs. (67.5±7.1) years], body mass index [(24.3 ±2.6) kg/m 2vs. (23.0±3.2) kg/m 2], prostate volume [(55.8±16.9) ml vs. (53.7±20.7) ml], preoperative prostate-specific antigen [3.8(1.2, 5.3)ng/ml vs. 3.5(2.1, 5.6)ng/ml], the international prostate symptom score (IPSS) [(25.9±5.2) vs. (26.3±5.9)], the quality of life score (QOL) [(5.0±0.7) vs.(5.0±0.6)], the maximum urine flow rate (Q max) [(8.2±4.5) ml/s vs. (7.9±4.1) ml/s] and residual urine volume (PVR) [49(0, 131) ml vs. 45(11, 106) ml] between the two groups ( P>0.05). The waiting time before admission was [(2.6±1.2) d vs. (5.3±1.5) d], and the difference between the two groups was statistically significant ( P<0.05). The perioperative efficacy indicators, total hospitalization expenses and short-term postoperative complications were compared between the two groups. Results:In this study, all patients successfully completed the operation. There were no statistical significances in the perioperative indicators between the day group and the conventional group including the operation time [(38.4±15.2) min vs. (40.4±13.9) min], enucleated tissue weight [(34.6±9.6) g vs. (35.4±10.8) g], the decrease value of hemoglobin [(13.0±2.5) g/L vs. (12.0±3.7) g/L] and the decrease value of blood sodium [(2.2±0.9) mmol/L vs. (2.4±1.3) mmol/L]( P>0.05). The significant differences were observed in bladder irrigation time [(16.9±2.1)h vs. (22.7±12.1)h], catheterization time [(18.8±5.1) h vs.(65.6±13.0)h], postoperative hospital stay [(16.8±2.4)h vs. (64.8±6.3)h] and the total hospitalization expenses [(13 282.2±2 236.3) yuan vs. (15 969.3±2 420.6) yuan] between the day group and the conventional group ( P < 0.01). In the day group, 1 case was transferred to the general ward for observation for 1 day. There were no significant differences in the incidence of complications as urinary retention [6.3% (5/80) vs. 3.7% (3/82)], temporary incontinence [2.5% (2/80) vs. 2.4%(2/82)], urethra stricture [7.5% (6/80) vs. 6.1% (5/82)], and hematuria for intervention [1.3% (1/80) vs. 1.2% (1/82)]between the day group and the conventional group ( P > 0.05). After 6 months of follow-up, there were no significant differences in IPSS[(6.7±2.8) vs. (6.1±2.5)], QOL[(1.8±0.9) vs. (2.0±0.8)], Q max [(26.4±5.5)ml/s vs. (25.8±4.6)ml/s] and PVR [7(2, 11)ml vs. 5(4, 8)ml] between the two groups at 6 months after operation ( P > 0.05), but there were significant improvements when compared with those items of preoperation ( P < 0.01). Conclusions:The treatment of BPH with BEEP in the day surgery mode is as safe and effective as that in the conventional surgery mode, with little bleeding, high resection efficiency, definite therapeutic effect and low incidence of complications. BEEP can shorten the length of hospital stay and reduce medical expenses in the day surgery mode, and can be carried out in hospitals with conditions.

Pancreatic cancer is a kind of digestive system tumor with insidious clinical manifestations,rapid development and very poor prognosis,and its early diagnosis and surgical treatment can significantly improve the survival rate and prognosis of patients.So far,no tumor marker with sufficient sensitivity and specificity for early pancreatic cancer has been found for tumor screening.In recent years,more and more pancreatic canc-er-related tumor markers have been discovered and studied.Liquid biopsy has shown potential utility in a range of applications,with the advantages of non-invasive,non-destructive,real-time,multiple,and has broad prospects in many aspects of tumor diagnosis and treatment.This article discusses and summarizes the screen-ing and early diagnosis of circulating tumor cells and circulating tumor DNA in liquid biopsy,so as to provide reference for early detection and early treatment of pancreatic cancer.

AIM: To evaluate the clinical efficacy of amoxicillin from volume-based procurement (VBP) and potassium amoxicillin clavulanate in the eradication of helicobacter pylori (Hp) infection, providing basis for the selection of treatment programs. METHODS: Data from the patients who received Hp eradication therapy from May 2021 to May 2022 were recruited from the rational drug use management system. The data from the patients treated by amoxicillin (amoxicillin 1.0 g bid + bismuth potassium citrate 220 mg bid + esomeprazole 20 mg bid + clarithromycin 0.5 g bid, for 14 days) and potassium amoxicillin clavulanate (potassium amoxicillin clavulanate 0.914 g bid + bismuth potassium citrate 220 mg bid + esomeprazole 20 mg bid + clarithromycin 0.5 g bid, for 14 days) were selected and compared. RESULTS: A total of 171 cases were collected in the group treated by Amoxicillin program, and the eradication rate was 87.8% (150/171). A total of 69 cases were collected in the group of potassium amoxicillin clavulanate, and the eradication rate was 76.8% (53/69). There was no significant difference in baseline data between the two groups (P>0.05). There was a significant difference in clinical efficacy between the two groups (P< 0.05). In addition, the cost-effectiveness ratio (C/E) of the Amoxicillin treatment program was lower than that of the potassium amoxicillin clavulanate program CONCLUSION: The clinical efficacy of VBP Amoxicillin program in eradicating Hp infection is better than that of the potassium amoxicillin clavulanate program, which is worthy of clinical recommendation.