Objective:Four methods were used to count platelets to recommend suitable retest methods for abnormal blood platelet count.Methods:A total of 300 patients who received treatment in the Second People's Hospital of Lianyungang during August-September 2020 were included in this study. They were divided into low-value, median-value, and high-value groups ( n = 100/group) according to blood platelet counts determined by the electrical impedance method. The consistency in blood platelet counting was analyzed between flow cytometry and electrical impedance method, Neubauer chamber method, and modified blood smear method. Results:There was no significant difference in blood platelet count between the electrical impedance method [low-value group: (86.1 ± 10.3) × 10 9/L, median-value group: (221.8 ± 41.8) × 10 9/L, high-value group: (441.3 ± 51.4) × 10 9/L, Neubauer chamber method [low-value group: (85.2 ± 10.1) × 10 9/L, median-value group: (219.3 ± 37.7) × 10 9/L, high-value group: (443.1 ± 54.5) × 10 9/L, modified blood smear technique [low-value group: (86.1 ± 10.1) × 10 9/L, median-value group: (218.1 ± 37.7) × 10 9/L, high-value group: (442.6 ± 53.3) × 10 9/L], and flow cytometry [low-value group: (85.4 ± 10.1) × 10 9/L, median-value group: (220.7 ± 42.0) × 10 9/L, high-value group: (440.9 ± 50.0) × 10 9/L] (all P > 0.05). The Bland-Altman analysis revealed that the electrical impedance method, Neubauer chamber method and modified blood smear method, and flow cytometry showed consistency in blood platelet count. Conclusion:The modified blood smear method showed consistency with the electrical impedance method, Neubauer chamber method, and flow cytometry in blood platelet counting. It does not require a special instrument and can help observe cell morphology for blood platelet counting. In addition, the blood smears are easy to be preserved. The modified blood smear technique should be the first choice for re-checking blood platelet counts.

The present study designed and prepared near-infrared responsive sinomenine hydrochloride(SIN) reservoir microneedles and evaluated the feasibility of this type of microneedles in increasing the drug loading and transdermal absorption by characterizing their mechanical properties and in vitro release characteristics.SIN was selected as the model drug, and methoxy poly(ethylene glycol) poly(caprolactone)(mPEG-PCL) copolymers and indocyanine green(ICG) were employed as amphiphilic block copolymers and light inductor to prepare near-infrared responsive nanoparticles.Based on the preparation principle of bubble microneedles, near-infrared responsive SIN reservoir microneedles were designed and prepared.The features of the near-infrared responsive SIN reservoir microneedles were characterized by measuring the morphology, length, mechanical properties, and skin penetration of microneedles.Meanwhile, the drug release performance of reservoir microneedles was evaluated by in vitro release assay.The results showed that the prepared SIN microneedles were conical, with an exposed tip height of about 650 μm.Each needle could load about 0.5 mg of drugs per square centi-meter, and this type of microneedle showed good mechanical properties and performance in skin penetration.The results of the in vitro release assay showed that the 24 h cumulative release per unit area and release rate of the microneedle were 825.61 μg·cm~(-2) and 74.3%, respectively, which indicated that its release kinetics was in line with the first-order kinetic model.This study preliminarily proved that the reservoir microneedle could effectively increase the drug loading with good mechanical properties and release perfor-mance.
Drug Delivery Systems/methods* ; Drug Liberation ; Indocyanine Green ; Morphinans ; Needles ; Polyethylene Glycols

Objective To investigate the intra-and inter-observer reproducibility of iodine concentrations of abdominal parenchymal organs based on spectral CT.Methods The water-free iodine images of the venous phase were retrospectively obtained from 50 patients with abdominal dynamic spectral CT scans.The iodine concentrations were measured in the left,right and caudate lobes of liver,spleen,pancreas and bilateral kidneys.Intraclass correlation coefficient(ICC)and Bland-Altman plot were employed to analyze the intra-and inter-observer reproducibility.Results The intra-observer ICCs of the left,right and caudate lobes of liver,spleen,pancreas,and left and right kidneys were 0.938(0.894,0.965),0.932(0.884,0.961),0.939(0.895,0.965),0.947(0.909,0.970),0.912(0.851,0.949),0.946(0.906,0.969)and 0.907(0.842,0.946),which indicated good intra-observer reproducibility.The inter-observer ICCs of the left,right and caudate lobes of liver,spleen,pancreas,and left and right kidneys were 0.947(0.909,0.970),0.927(0.875,0.958),0.943(0.902,0.968),0.956(0.924,0.975),0.934(0.887,0.962),0.927(0.875,0.958)and 0.892(0.818,0.937),which indicated good inter-observer reproducibility.Bland-Altman plots presented that more than 95% points of the intra-observer differences located within 95% CI of limits of agreement for the caudate lobe of liver,spleen,pancreas and bilateral kidneys,which was same as inter-observer differences of the caudate lobe of liver,spleen and right kidney.Conclusion The iodine concentration measurement based on the spectral CT presented good intra-and inter-observer reproducibility for the caudate lobe of liver and spleen.
Humans ; Iodine ; Observer Variation ; Reproducibility of Results ; Retrospective Studies ; Tomography, X-Ray Computed

Objective To investigate the epidemic characteristics of human brucellosis in Jiangxi province from 2011 to 2017，thereby providing reference for future prevention and control work. Methods We analyzed the case information reported in the National Notifiable Infectious Diseases Reporting Information System of Jiangxi Province during 2011-2017 by combining with the monitoring data. Results A total of 239 cases were recorded over these six years, with an average incidence rate of 0.08/100 000. Most cases and agglomerations were concentrated in the Nanchang area (48 cases/4 cases), with the case distribution ranging from 1 in 2011 to all in 2016, and the number of counties(districts) involved had increased from 1 in 2011 to 68 in 2017, which increased rapidly year by year ( 2= 94.31, P<0.001). The gender ratio was 3.12 ∶〗1(181 ∶〗58). Most cases were concentrated in the 40-65 age group, while farmers and herdsmen were high-risk population, accounting for 59.83 % (143/239). The incidence of brucellosis peaked from May to September (May peak and September peak). In 2012-2017, 7 160 blood samples were collected from risk population, with 95 being positive for Brucella (1.33 %). From 2013 to 2017, 62 strains of the Brucella, 4 were Brucella melitensis type1, 54 were Brucella melitensis type3 and 4 were Brucella suis were isolated from 193 cases. Conclusions The human brucellosis was aggravated in Jiangxi province, with the expansion of regional scope. Therefore, more efforts should be focused on regulation to prevent and control brucellosis better.

Objective To evaluate the optic nerve impairment using MRI histogram texture analysis in the patients with optic neuritis.Methods The study included 60 patients with optic neuritis and 20 normal controls. The coronal T2 weighted imaging (T2WI) with fat saturation and enhanced T1 weighted imaging (T1WI) were performed to evaluate the optic nerve. MRI histogram texture features of the involved optic nerve were measured on the corresponding coronal T2WI images. The normal optic nerve (NON) was measured in the posterior 1/3 parts of the optic nerve. Kruskal-Wallis one-way ANOVA was used to compare the difference of texture features and receiver operating characteristic (ROC) curve were performed to evaluate the diagnostic value of texture features for the optic nerve impairment among the affected optic nerve with enhancement (ONwEN), affected optic nerve without enhancement (ONwoEN), contralateral normal appearing optic nerve (NAON) and NON.Results The histogram texture Energy and Entropy presented significant differences for ONwEN vs. ONwoEN (both P=0.000), ONwEN vs. NON (both P=0.000) and NAON vs. NON (both P<0.05). ROC analysis demonstrated that the area under the curve (AUC) of histogram texture Energy were 0.758, 0.795 and 0.701 for ONwEN vs. ONwoEN, ONwEN vs. NON and NAON vs. NON, AUC of Entropy were 0.758, 0.795 and 0.707 for ONwEN vs. ONwoEN, ONwEN vs. NON and NAON vs. NON.Conclusions The altered MRI histogram texture Energy and Entropy could be considered as a surrogate for MRI enhancement to evaluate the involved optic nerve and normal-appearing optic nerve in optic neuritis.
Adolescent ; Adult ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Optic Nerve ; diagnostic imaging ; Optic Neuritis ; diagnostic imaging

Objective: To explore the significance of minimal residual disease (MRD) in predicting prognosis and guiding therapy of adults with Philadelphia-chromosome negative acute lymphoblastic leukemia (Ph(-) ALL) in high-risk. Methods: Data of newly diagnosed adults with Ph(-) ALL in high-risk who achieved CR were reviewed. Variables associated with outcome were identified by COX regression model and Landmark analysis. Results: A total of 177 patients, 99 (56%) cases male with a median age of 40 years (range, 16-65 years) were included in this study. Of them, 95 (54%) patients received allo-HSCT in CR(1). Multivariate analyses showed that MRD negativity after the first cycle of consolidation (HR=0.52, 95%CI 0.30-0.89, P=0.017) and achieving CR within 4 weeks (HR=0.43, 95%CI 0.24-0.79, P=0.006) were the factors significantly-associated with longer DFS, and allo-HSCT was associated with both longer DFS (HR=0.13, 95%CI 0.08-0.22, P<0.001) and OS (HR=0.24, 95%CI 0.15-0.41, P<0.001) . Landmark analysis was performed on 121 patients, of 85 patients achieving MRD negativity after the first cycle of consolidation, multivariate analyses showed that MRD negativity after the third cycle of consolidation was significantly-associated with longer DFS (HR=0.18, 95%CI 0.05-0.64, P=0.008) and OS (HR=0.14, 95%CI 0.04-0.50, P=0.003) . For the patients achieving MRD negativity after both the first and the third cycles of consolidation, the 3-year DFS rate in the allo-HSCT cohort had a higher trend compared with that in the chemotherapy cohort (75.2% vs 51.3%, P=0.082) , however, the 3-year OS rates in the 2 cohorts were similar (72.7% vs 68.7%, P=0.992) . In those with MRD positivity after the first and/or the third cycle of consolidation, 3-year DFS (64.8% vs 33.3%, P=0.006) and OS (77.0% vs 33.3%, P=0.028) rates in the allo-HSCT cohort were significantly higher than those in the chemotherapy cohort, and similar to those in the cohort achieving MRD negativity after both the first and the third cycles of consolidation and receiving allo-HSCT. Conclusions: MRD negativity after the first cycle of consolidation was a predictor for better outcome in adults with Ph(-) ALL in high-risk. The survival advantage of the allo-HSCT cohort was not pronounced compared with that in the chemotherapy cohort even in those with high-risk features but achieving MDR negativity after both the first and third cycles of consolidation. However, allo-HSCT could be a good option for the patients with MRD positivity after the first and/or the third cycle of consolidation.
Adolescent ; Adult ; Aged ; Hematopoietic Stem Cell Transplantation ; Humans ; Male ; Middle Aged ; Neoplasm, Residual/diagnosis* ; Philadelphia Chromosome ; Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapy* ; Prognosis ; Retrospective Studies ; Young Adult

AIM:To explore the role of ginsenoside Rg1 in the growth of degenerative human lumbar nucleus pulposus cells(HNPCs).METHODS:Cultured HNPCs were subjected to oxygen-glucose deprivation(OGD)to mimic the micro-environment of degenerative HNPCs.The morphological changes of the cells in control group and OGD group were observed under optical microscope.The cells were treated with ginsenoside Rg 1 at concentrations of 25,50 and 100 μmol/L.The expression of collagen II and aggrecan at mRNA and protein levels was determined by real -time PCR and Western blot analysis.The cell viability was measured by CCK-8 assay.The mRNA level of Ki67 was detected by real-time PCR.The apoptosis was analyzed by flow cytometry.The activity of caspase-3 was measured by a caspase-3 kit.The ex-pression of Wnt/β-catenin pathway-related proteins was determined by Western blot.Furthermore,the expression of Wnt/β-catenin pathway-related proteins,the cell viability and apoptosis,and the expression of extracellular matrix synthesis pro-teins were assessed after the cells were co-treated with LiCl and 100 μmol/L ginsenoside Rg1.RESULTS:Normal HNPCs attached on the cell culture plate faster, and were almost round with rich cytoplasm.However, the cell adherence was slower,and the cells were long fusiform with decreased cytoplasm after OGD treatment,indicating that the model of degen-erative HNPCs was successfully established.Compared with normal HNPCs,the expression of collagen II and aggrecan at mRNA and protein levels was decreased in OGD group(P<0.05),which was then increased after the cells were treated with ginsenoside Rg1 at 25,50 and 100 μmol/L(P<0.05).Compared with normal HNPCs,the cell viability and Ki67 expression were decreased in OGD group(P<0.05), which were increased after treatment with ginsenoside Rg 1(P<0.05).Meanwhile,the apoptotic rate and caspase-3 activity were significantly increased in OGD-treated cells(P<0.05), which were decreased after treatment with ginsenoside Rg 1(P<0.05).In addition,the activation of Wnt/β-catenin path-way was also inhibited by ginsenoside Rg 1 treatment at dose of 100 μmol/L(P<0.05).LiCl,a Wnt/β-catenin pathway agonist,obviously decreased the protective effects of ginenoside Rg 1 on OGD-induced cells(P<0.05),indicating that the Wnt/β-catenin pathway was involved in the protective effects of ginenoside Rg 1 on degenerative HNPCs.CONCLUSION:Ginsenoside Rg1 promotes growth and extracellular matrix synthesis of degenerative HNPCs through inhibiting Wnt /β-cate-nin pathway.This study will provide a new idea for prevention and treatment of degenerative HNPCs.

Objective To evaluate the effect of long-term microwave radiation on the expression of N-methyl-D-aspartate receptor(NMDAR),brain derived neurotrophic factor(BDNF) and related molecules in signal pathways in the hippocampus of rats.Methods Fifty male Wistar rats were exposed to microwave radiation at an average power density of 0,5,10,20 and 30 mW/cm2for 6 min/time,3 times/week,and for 6 weeks,which were sacrificed and the hippocampus was quickly removed at 14 d and 28 d after exposure.The changes in NMDAR (NR1,NR2A,NR2B),postsynaptic density protein(PSD)-95,cortactin,BDNF and tyrosine kinase receptor B (TrkB) in hippocampal neurons of each group were detected by Western blotting and image analysis techniques.Results Compared with the control group,the expressions of related proteins did not change significantly after microwave irradiation of 5 mW/cm2 at each time point.After 20 mW/cm2 microwave radiation,the expression of NR1 was increased at 14 and 28 d (P ＜0.05),the expression of NR2A was increased at 28 d (P ＜ 0.05),but the expression of NR2B was decreased at 14 and 28 d (P ＜ 0.05).At a average power density of 30 mW/cm2,the expressions of NR1,NR2A and PSD-95 and the expression of NR2B were decreased at 14 and 28 d(P ＜0.05),and cortactin,BDNF and TrkB were increased at 14 d after irradiation (P ＜ 0.05).Conclusion The effect of different dosages of long-term microwave radiation on the proteins of NMDAR and its signal pathway related molecules is different.Microwave radiation may affect the NMDAR of postsynaptic information transmission through the BDNF-TrkB signaling pathways,which might play an important role in the impediment of learning and memory function caused by microwave radiation.

Objective To investigate the epidemiological characteristics of device-associated infection (DAI)in neonatal intensive care units(NICUs)of tertiary first-class hospitals in China,and provide scientific evidence for the prevention and control of neonatal DAI.Methods Neonates in NICUs at 17 hospitals of 9 provinces from October 2013 to September 2014 were selected for multicenter study,DAI was surveyed prospectively according to the uni-form diagnostic criteria and methods.Results A total of 12 998 neonates were monitored,the total patient-days were 126 125 d,13 cases of central line-associated bloodstream infection (CLABSI)and 70 cases of ventilator-asso-ciated pneumonia (VAP)occurred,central line utilization rate was 15.56%,incidence of CLABSI was 0.66/1 000 device-days;ventilator utilization rate was 7.67%,incidence of VAP was 7.23/1 000 device-days.Utilization rates of central line and respirator in neonates with body weight ≤ 1 000 g was the highest,which were 61 .06% and 29.91 % respectively;In NICUs with 20-30 beds,utilization rate of central line was the highest(16.67%),and res-pirator was the lowest(4.11 %);of hospitals in different regions,central line and respirator utilization rate in south-west China was the highest.Of different sizes of ICUs,VAP per 1 000 device-days was the lowest in NICUs with 20-30 beds(2.36 ‰).Difference in incidence of CLABSI and VAP per 1 000 device-days in neonates at NICUs of different regions were significantly different;incidence of CLABSI and VAP per 1 000 device-days was highest in southern China(2.68 ‰ and 31 .06‰ respectively),followed by southwest region.Of different quarters,incidence of CLABSI,and VAP per 1 000 device-days were not significantly different(all P >0.05).Conclusion Device utili-zation rate and incidence of DAI in China are both high,and are different in neonates of different birth weight,at different sizes of NICUs,as well as different regions,monitoring should be intensified,prevention and control measures should be implemented according to infection characteristics.

Objective To assess the value of brain protection measures in carotid angioplasty and stenting(CAS)for carotid stenosis and contralateral occlusion in reducing the perioperative cerebral isehemic events.Methods Twelve patients undergoing CAS in our department were included in this analysis.All the patients received balloon occlusion test(BOT)of the carotid artery preoperatively.Two patients who were intolerant to BOT received extracranial-intracranial vascular anastomosis,and another 2 patients relatively intolerant to BOT received CAS under general anesthesia.The brain protection measures including reduction of the cerebral blood flow occlusion time and prophylactic management of thrombosis were administered to prevent the ischemic events.The efficacy of the brain protection measures was evaluated by diffusion-weighted imaging(DWI)and observation of the clinical ischemic neurological symptoms.Results Three patients suffered transient ischemic attacks(TIAs),1 patient had temporary vision loss,and 1 had permanent ischemic neurological deficits after the operation.DWI yielded positive results in 50% of the patients after the operation,characterized mostly by small local lesions of 1-2 ram.Eight patients presented with carotid artery dilation by over 90%,and 4 by 70% to 90% after the operation.Conclusion The brain protection measures including precise preoperative evaluation of the ischemic tolerance and blood flow and reduction of cerebral blood flow occlusion time and prevention of thrombosis during the operation can effectively reduce the incidence of perioperative ischemic events in high-risk patients with carotid stenosis and contralateral occlusion.