Objective To observe the role of dried tangerine peel in Yigong Powder improves iron metabolism and promotes red blood cell generation in anemia of chronic disease (ACD).Methods With a two-by-two factorial design,the Yigong Powder was divided into dried tangerine peel and Chenpi absent Decoction. According to the random number table method,32 zymosan-induced generalized inflammation (ZIGI) mice were randomly divided into the model group,the dried tangerine peel group,the Chenpi absent Decoction group,and the Yigong Powder group. The dried tangerine peel group,Chenpi absent Decoction group and the Yigong Powder group were given dried tangerine peel(3.083 g/kg),Chenpi absent Decoction(12.33g/kg),and Yigong Powder(15.413g/kg)by gavage to the corresponding group of mice. The model group was given an equal amount of physiological saline by gavage,and treated continuously for 7 days. After the completion of administration,the body weight of each group of mice was recorded. The hemoglobin content of each group of mice was detected using a fully automatic cell counter,the serum iron content was detected using colorimetry,the serum ferritin content was detected using enzyme-linked immunosorbent assay (ELISA),and the spleen index was calculated. The liver tissue inflammatory factors interleukin-1β (IL-1β),interleukin-6 (IL-6),tumor necrosis factor-α (TNF-α),interferon-γ (IFN-γ),interleukin-4 (IL-4),and interleukin-10 (IL-10) levels were detected using Luminex method. The mRNA expressions of liver tissue hepcidin gene (HAMP) and membrane iron transporter ( Fpn) were detected using real-time fluorescence PCR method. Results Dried tangerine peel and Chenpi absent Decoction both showed interactive effects in regulating hemoglobin,serum iron,serum ferritin content,improving spleen index,and regulating the mRNA expressions of HAMP,Fpn,as well as IL-1β and IFN-γ (P<0.05). Compared with the model group,dried tangerine peel significantly increased hemoglobin,serum iron content,and Fpn mRNA expression in ZIGI model mice,while decreasing ferritin content,spleen index,HAMP mRNA expression,and the levels of IL-1β,IL-6,TNF-α,and IFN-γ (P<0.05). Chenpi absent Decoction significantly increased serum iron content and Fpn mRNA expression in ZIGI model mice,while reducing spleen index,ferritin content,HAMP mRNA expression,and the levels of IL-1β and IFN-γ、IL-4 (P<0.05). Conclusion The effects of dried tangerine peel on inflammatory factors (IL-6 and TNF-α) and Fpn may play a key role in the improvement effects of Yigong Powder on ACD and iron metabolism.

Objective To study the changes in erythrocyte osmotic fragility(EOF)in patients with hypercythemia,pol-ycythemia and anemia under a high altitude environment.Methods A total of 174 outpatients,inpatients and people un-dergoing physical examination in Tibet Autonomous Region People′s Hospital in October 2020 were enrolled and divided into four groups according to hemoglobin levels:the polycythemia group(n=42),the physiologic increase group(n=48),the a-nemia group(n=29)and the healthy control group(n=55).They were compared with 67 anemia patients and 67 healthy people in the laboratory of Peking Union Medical College Hospital in the same period as the plain control group.The classic EOF test method was used to compare the results of each group′s EOF.The concentrations of NaCl solution for starting he-molysis(STH)and NaCl solution for complete hemolysis(CTH)were included,and the data were statistically analyzed by SPSS software.Results There was a significant difference in CTH between Zang and Han healthy people(P＜0.05).STH in high altitude polycythemia group(0.52)was higher than that in high altitude healthy control group(0.48)(P＜0.001).Compared with plain,the median CTH of plateau anemia group(0.36)and plateau health control group(0.36)was signifi-cantly higher than that of plain anemia group(0.28)and plain control group(0.28)(P＜0.001).Multivariate logistic regres-sion analysis showed that plateau region,female polycythemia and anemia were risk factors for STH elevation.Conclusion This study finds that the EOF increases in the plateau population and patients with polycythemia,which provides reference for studying red blood cell disorders and blood transfusion strategy in the plateau region.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Background/Aims: Metabolic syndrome is common in patients with acute pancreatitis and its components have been reported to be associated with infectious complications. In this post hoc analysis, we aimed to evaluate whether metabolic abnormalities impact the effect of immuneenhancing thymosin alpha-1 (Tα1) therapy in acute necrotizing pancreatitis (ANP) patients. Methods: All data were obtained from the database for a multicenter randomized clinical trial that evaluated the efficacy of Tα1 in ANP patients. Patients who discontinued the Tα1 treatment prematurely were excluded. The primary outcome was 90-day infected pancreatic necrosis (IPN) after randomization. Three post hoc subgroups were defined based on the presence of hyperglycemia, hypertriglyceridemia, or both at the time of randomization. In each subgroup, the correlation between Tα1 and 90-day IPN was assessed using the Cox proportional-hazards regression model. Multivariable propensity-score methods were used to control potential bias. Results: Overall, 502 participants were included in this post hoc analysis (248 received Tα1 treatment and 254 received matching placebo treatment). Among them, 271 (54.0%) had hyperglycemia, 371 (73.9%) had hypertriglyceridemia and 229 (45.6%) had both. Tα1 therapy was associated with reduced incidence of IPN among patients with hyperglycemia (18.8% vs 29.7%: hazard ratio, 0.80; 95% confidence interval, 0.37 to 0.97; p=0.03), but not in the other subgroups. Additional multivariate regression models using three propensity-score methods yielded similar results. Conclusions Among ANP patients with hyperglycemia, immune-enhancing Tα1 treatment was associated with a reduced risk of IPN (ClinicalTrials.gov, Registry number: NCT02473406).

Objective:To analyze the clinical value of noninvasive pressure strain loop (PSL) in assessing left ventricular myocardial work in patients with essential hypertension.Methods:In this cross-sectional study, 66 patients with essential hypertension who were admitted to the Affiliated Hospital of Yangzhou University from August to December 2020 were continuously enrolled. According to left ventricular mass index (LVMI) >95 g/m 2 in women and >115 g/m 2 in men,≤95 g/m 2 in women and ≤115 g/m 2 in men, the 66 patients were divided into left ventricular hypertrophy (LVH) group (14 cases) and non-left ventricular hypertrophy (NLVH) group (52 cases). Furthermore, the NLVH group was divided into a mild group (30 cases) and a moderate/severe group (22 cases) according to the systolic blood pressure of 140~159 mmHg (1 mmHg=0.133 kPa) and ≥160 mmHg. Another 25 healthy adults who underwent physical examination during the same period were included as healthy control group. The height, weight and blood pressure were measured in all the subjects, and routine echocardiography and speckle tracking imaging analysis were performed. PSL results were obtained by combining the results of speckle tracking imaging analysis with systolic blood pressure. The differences of general clinical data, basic parameters of two-dimensional ultrasound and myocardial work parameters of PSL (global work index, global effective work, global wasted work, and global work efficiency) were compared among the groups, and the clinical value of PSL in assessing left ventricular myocardial work in patients with essential hypertension was analyzed. Results:There was no significant difference in left ventricular ejection fraction among all groups (all P>0.05). The global work index of moderate/severe NLVH group was significantly higher than that of mild NLVH group, LVH group and healthy control group [(2 630±231) vs (2 254±179), (1 847±261), (1 724±209) mmHg%]. The global effective work of moderate/severe NLVH group was significantly higher than that of LVH group and healthy control group [(2 965±261) vs (2 330±258) and (2 121±163) mmHg%] (all P<0.05). The global wasted work of LVH group was significantly higher than that of moderate/severe NLVH group, mild NLVH group and healthy control group [(248±107) vs (141±57), (116±57), (83±58) mmHg%] (all P<0.05). The global work efficiency was significantly lower than that of moderate/severe NLVH group, mild NLVH group and healthy control group (89.1%±3.9% vs 94.3%±1.9%, 95.0%±1.8%, 95.8%±2.3%) (all P<0.05). With the increase of blood pressure, the PSL decreased in the LVH group and increased in the other three groups. The bull′s eye diagram of myocardial work in the healthy control group was uniform green (normal effective work area), red began to appear in the mild NLVH group (high intensity myocardial work area), red area increased in the moderate/severe NLVH group, and blue appeared in the LVH group (ineffective work area). Conclusions:PSL has good clinical value in assessing left ventricular myocardial work in patients with primary hypertension. The parameters derived from PSL data can sensitively identify impaired systolic function in individuals with normal left ventricular ejection fraction.

Objective To compare the ultrasonographic characteristics of different molecular sub-types of invasive breast cancer and analyze their relationships with prognosis.Methods The clinical and ultrasonic data of 250 patients with invasive breast cancer were retrospectively analyzed,and they were divided into Luminal A type(n=53),Luminal B type(n=104),human epidermal growth fac-tor receptor 2(HER2)overexpression type(n=45)and triple-negative type(n=48)according to pathological findings.The ultrasonic characteristics as well as 3-year disease-free survival(DFS)and overall survival(OS)among different molecular subtypes were compared,and the influencing factors the prognosis of invasive breast cancer were analyzed.Results There were significant differences in ultrasonic imaging characteristics such as tumor growth direction,posterior echo and microcalcification between different molecular subtypes of invasive breast cancer(P＜0.05).Single factor analysis showed that molecular subtypes,tumor size,tumor staging,axillary lymph node metastasis and hypere-choic halo were associated with DFS and OS of patients with invasive breast cancer(P＜0.05).Multi-factor Cox regression analysis showed that molecular subtypes,tumor staging and hyperechoic halo were the independent influencing factors of DFS and OS in patients with invasive breast cancer(P＜0.05).Conclusion There are some differences in the ultrasonic characteristics and prognosis of dif-ferent molecular types in patients with invasive breast cancer.Molecular subtypes,tumor staging and hyperechoic halo are the independent prognostic factors of invasive breast cancer.

Objective To compare the ultrasonographic characteristics of different molecular sub-types of invasive breast cancer and analyze their relationships with prognosis.Methods The clinical and ultrasonic data of 250 patients with invasive breast cancer were retrospectively analyzed,and they were divided into Luminal A type(n=53),Luminal B type(n=104),human epidermal growth fac-tor receptor 2(HER2)overexpression type(n=45)and triple-negative type(n=48)according to pathological findings.The ultrasonic characteristics as well as 3-year disease-free survival(DFS)and overall survival(OS)among different molecular subtypes were compared,and the influencing factors the prognosis of invasive breast cancer were analyzed.Results There were significant differences in ultrasonic imaging characteristics such as tumor growth direction,posterior echo and microcalcification between different molecular subtypes of invasive breast cancer(P＜0.05).Single factor analysis showed that molecular subtypes,tumor size,tumor staging,axillary lymph node metastasis and hypere-choic halo were associated with DFS and OS of patients with invasive breast cancer(P＜0.05).Multi-factor Cox regression analysis showed that molecular subtypes,tumor staging and hyperechoic halo were the independent influencing factors of DFS and OS in patients with invasive breast cancer(P＜0.05).Conclusion There are some differences in the ultrasonic characteristics and prognosis of dif-ferent molecular types in patients with invasive breast cancer.Molecular subtypes,tumor staging and hyperechoic halo are the independent prognostic factors of invasive breast cancer.

Animals ; COVID-19/virology* ; Disease Models, Animal ; Evolution, Molecular ; Humans ; Polymorphism, Single Nucleotide ; SARS-CoV-2/metabolism* ; Spike Glycoprotein, Coronavirus/genetics*

OBJECTIVES: The epidemic of coronavirus disease 2019 (COVID-19) brought psychological stress to the public, especially to patients. This study aims to investigate the mental health of patients with COVID-19 in Changsha. METHODS: We took cross-section investigation for the mental health of 112 patients with COVID-19 via questionnaires. Mann-Whitney test, Chi-square test, and Fisher's exact test were performed to compare general and clinical data between the slight-ordinary patients and severe patients. Single sample -tests were used to compare the difference between the factor scores of the Symptom Check-List 90 (SCL-90) in COVID-19 patients with the norm of 2015 and factor scores of SCL-90 in patients with the severe acute respiratory syndrome (SARS). RESULTS: The obsessive-compulsive, depression, sleep and eating disorders had the highest frequency among the positive symptoms of SCL-90 in patients with COVID-19 in Changsha. The factor scores of somatization, depression, anxiety, phobia anxiety, sleep and eating disorders in patients with COVID-19 were higher than those of the norm (≤0.001 or <0.05). Slight-ordinary patients with COVID-19 in Changsha showed lower factor scores of somatization, depression, anxiety, and hostility compared with the patients with SARS (<0.001 or <0.05). There was no difference in factor scores of SCL-90 between the patients with severe COVID-19 and those with SARS(>0.05). CONCLUSIONS The levels of somatization, depression, anxiety, phobia anxiety, sleep and eating disorders in patients with COVID-19 in Changsha are higher than those of the norm. However, the mental health of slight-ordinary patients with COVID-19 is better than that of patients with SARS. It needs to provide targeting psychological interventions depending on the severity of patients.
Anxiety ; Betacoronavirus ; China ; Coronavirus Infections ; psychology ; Depression ; Feeding and Eating Disorders ; Health Status ; Humans ; Mental Health ; Pandemics ; Pneumonia, Viral ; psychology ; Sleep Wake Disorders ; Surveys and Questionnaires

Objective: To investigate the principles of differential diagnosis of pulmonary infiltrates in cancer patients during the outbreak of novel coronavirus (2019-nCoV) by analyzing one case of lymphoma who presented pulmonary ground-glass opacities (GGO) after courses of chemotherapy. Methods: Baseline demographics and clinicopathological data of eligible patients were retrieved from medical records. Information of clinical manifestations, history of epidemiology, lab tests and chest CT scan images of visiting patients from February 13 to February 28 were collected. Literatures about pulmonary infiltrates in cancer patients were searched from databases including PUBMED, EMBASE and CNKI. Results: Among the 139 cancer patients underwent chest CT scans before chemotherapy, pulmonary infiltrates were identified in eight patients (5.8%), five of whom were characterized as GGOs in lungs. 2019-nCoV nuclear acid testing was performed in three patients and the results were negative. One case was a 66-year-old man diagnosed as non-Hodgkin lymphoma and underwent CHOP chemotherapy regimen. His chest CT scan image displayed multiple GGOs in lungs and the complete blood count showed decreased lymphocytes. This patient denied any contact with confirmed/suspected cases of 2019-nCoV infection and without fever and other respiratory symptoms. Considering the negative result of nuclear acid testing, this patient was presumptively diagnosed as viral pneumonia and an experiential anti-infection treatment had been prescribed for him. Conclusions The 2019 novel coronavirus disease (COVID-19) complicates the clinical scenario of pulmonary infiltrates in cancer patients. The epidemic history, clinical manifestation, CT scan image and lab test should be combined consideration. The 2019-nCoV nuclear acid testing might be applicated in more selected patients. Active anti-infection treatment and surveillance of patient condition should be initiated if infectious disease is considered.