ObjectiveTo observe the clinical effectiveness of point ligation therapy combined with catgut embedment in acupoint for patients with refractory facial paralysis， and to explore the possible mechanisms from the perspective of neurotrophic factors. MethodsTotally 168 patients with intractable facial paralysis were randomly divided into point ligation plus catgut embedment group and electroacupuncture group， with 84 cases in each group. Both groups took methylcobalamin tablets orally， on the basis of which the point ligation plus catgut embedment group gave point ligation therapy at Quanliao （SI 18）， Dicang （ST 4）， Jiache （ST 6）， and catgut embedment in the local acupoints on the affected side combined with the distal acupoints， and the point ligation therapy combined with catgut embedment in acupoint was performed once every 30 days for three treatments； the electroacupuncture group took the same acupoints and gave electroacupuncture， with sparse and dense waves， once every other day. Both groups were treated for 90 days. Before treatment and after 30， 60， 90 and 120 days （follow-up）， patients of both groups were observed for House-Brackmann Facial Nerve Grading （HB） and modified Portmann score； facial nerve electromyography was performed before treatment and after 90 days of treatment to record the wave amplitude and latency of facial nerve motor conduction， and serum brain-derived nerve growth factor （BDNF）， nerve growth factor （NGF）， fibroblast growth factor （FGF2） levels were determined. The clinical effectiveness of both groups after 90 days of treatment was compared， and the adverse events occurred in the course of treatment in all patients were recorded. ResultsAt 30 days， 60 days， 90 days and follow-up visits， the HB grading of patients in both groups improved compared with that before treatment （P＜0.05）； the distribution of the number of patients with HB grading in the point ligation plus catgut embedment group was superior to that in the electroacupuncture group after 60 days and 90 days of treatment and at follow-up visits （P＜0.05）. The maximal amplitude of the facial nerve electromyography in both groups after 90 days of treatment was large， and the latency was shorter when compared with those before treatment （P＜0.05）， and the maximum wave amplitude of the point ligation plus catgut embedment group was higher than that of the electro-acupuncture group， and the latency period was shorter than that of the electro-acupuncture group （P＜0.05）. The modified Portmann scores of the both groups of patients after 30， 60 and 90 days of treatment and follow-up were higher than those before treatment， and the scores of the point ligation plus catgut embedment group were higher than those of the electroacupuncture group （P＜0.05）. Serum BDNF， NGF and FGF2 levels in both groups after 90 days of treatment were higher than before， and the point ligation plus catgut embedment group was significantly higher than the electroacupuncture group （P＜0.05）. The total clinical effective rate of the point ligation plus catgut embedment group （92.68%） was higher than that of the electroacupuncture group （81.01%， P＜0.05）. Adverse reactions occurred in both groups， mainly including local haematoma or subcutaneous bleeding， allergic reaction， severe pain， and needle fainting， all of which disappeared after symptomatic treatment. ConclusionThe point ligation therapy combined with catgut embedment in acupoint for patients with refractory facial paralysis are effective. The therapy improve the facial nerve function， and its mechanism of action may be related to increasing the level of serum neurotrophic factor and thus promoting facial nerve repairment.

【Objective】 To analyze the situation of regular whole blood donation in Tianjin between 2013 and 2022, in order to provide data support for improving the recruitment and retention measures of regular blood donors and ensuring safe clinical blood supply. 【Methods】 From 2013 to 2022, 185 639 regular whole blood donors in Tianjin were selected as the study group and 1 015 312 other whole blood donors in the same period were selected as the control group. The demographic data, blood collection volume and blood retest screening of blood donors in the two groups were statistically analyzed. 【Results】 The number of regular blood donors and the volume of blood donated in Tianjin increased year by year from 2013 to 2022, with an average annual growth rate of 6.22% and 6.18%, respectively. From 2013 to 2021, the retention rate of regular blood donors increased first and then decreased. The proportion of male blood donors in the study and control groups showed a decreasing trend but the proportion of female donors showed an increasing trend, with the proportion of male donors in the study group higher than that in the control group and the proportion of female donors lower than that in the control group (both P<0.05). In the study group, the majority of blood donors were in the age of 26-35 years old, followed by those of 36-45 years old; in the control group, the majority of blood donors were in the age of 18-25 years old, followed by those of 26-35 years old; the proportion of blood donors in the study group in the age of 18-25 years old was lower than that in the control group, while the proportion of blood donors of other age group was higher than that in the control group, and the difference was statistically significant (P<0.05). The rates of 200 mL and 300 mL blood donations and insufficient blood donations in the study group were lower than those in the control group, while the rate of 400 mL blood donations was higher than that in the control group, and the differences were statistically significant. Among the blood donors in the study group, the proportion of students, civil servants, medical workers, military personnel, teachers and others was lower than that of the control group, while the proportion of the rest occupations was higher in the study group than that of the control group, and the differences were all statistically significant. There was a significant difference in the proportion of regular blood donors among blood donors of different professions. The re-test deferral rates of ALT and anti-TP in the study group showed a decreasing trend followed by an increasing trend, and the re-test deferral rates of HBV, HCV and HIV showed an increasing trend followed by a decreasing trend, and all the re-test deferral rates in the study group were lower than those in the control group, and the differences were statistically significant (P<0.05) . 【Conclusion】 From 2013 to 2022, the situation of regular blood donors in Tianjin has a certain regularity, and there is certain room for growth. Precise recruitment strategies targeting different populations should be adopted to have more regular blood donors.

ObjectiveTo analyze the characteristics of HIV-1 subtypes and drug-resistance mutation sites among HIV-infected patients who received high-efficiency antiretroviral therapy but failed. MethodsA total of 130 plasma samples were collected from the patients who received antiviral treatment for 6 months in Taizhou City of Zhejiang Province in 2021 but failed the treatment and the viral load was ≥1 000 copies·mL^-1. Nucleic acid in the samples was extracted， and the pol gene was amplified by nested reverse transcription PCR. After next-generation sequencing， online tools were used to compare and analyze the subtypes and drug-resistant mutation sites. ResultsA total of 110 samples were successfully sequenced. The main HIV-1 subtype was CRF01_AE， accounting for 42.72% （47 cases）， followed by CRF07_BC， 35.45% （39 cases）； CRF08_BC， 10.00% （11 cases）； CRF85_BC ， 8.18% （9）； and a small number of B subtype， 1.81% （2 cases） and C subtype， 1.81% （2 cases）. The online tool comparison showed that there were 67 cases with mutations of drug-resistance sites and 61 cases with drug-resistance. The mutation sites were mainly M184V， K103N， K65R and V181C， and the mutation rates were 20.00% （22 cases）， 10.91% （12 cases）， 8.18% （9 cases） and 8.18% （9 cases）， respectively. These mutation sites caused different degrees of resistance to nucleoside reverse transcriptase inhibitors （NRTI）， non- nucleoside reverse transcriptase inhibitors （NNRTI） and protease inhibitors （PI）， including 45 cases of NRTI， 61 cases of NNRTI and 2 cases of PI resistance. ConclusionThe HIV infected people who fail the treatment in Taizhou are mainly with the subtypes CRF01_AE and CRF07_BC. The rate of drug-resistance mutation is at a moderate level， mainly due to the mutation of NRTI and NNRTI drug-resistance sites， and a small number of PI drug-resistance sites. Therefore， the antiviral treatment plan for HIV infected people should be reasonably adjusted， and the detection of drug-resistance mutation sites should be strengthened to avoid the generation of transmissible drug-resistance strains.

ObjectiveTo compare the efficacy and safety of acupuncture combined with auricular acupoints patches and nicotine transdermal patch in treating moderate to severe nicotine dependence. MethodsIn a rando-mized controlled trial， 64 quit smoking voluntary subjects with moderate to severe nicotine dependence were randomly divided at a ratio of 1∶1 into a treatment group and a control group， with 32 cases in each group. The treatment group was given acupuncture combined with auricular acupoints patches， twice weekly， four weeks as a course for two courses. The control group was given nicotine transdermal patch， one patch per day for 24 hours， 8 weeks. The cure rate was assessed after treatment and at follow-up （the 16th week after treatment）.The daily smoking volume， exhaled carbon monoxide （CO） value， Nicotine Dependence Scale （FTND）， Minnesota Nicotine Withdrawal Symptoms Scale （MNWS）， and Pittsburgh Sleepiness Index Inventory （PSQI） were evaluated before and after treatment and at follow-up， and adverse effects were recorded. ResultsIn terms of the cure rate， there were both six cured cases （20%） after treatment and at follow-up in the treatment group， while in the control group， seven （23.3%） and five （16.7%） patients were cured after treatment and at follow-up， respectively， with no statistically significant differences between the two groups both after treatment and at follow-up （P＞0.05）. The daily smoking volume and exhaled CO value significantly decreased after treatment and at follow-up in both groups （P＜0.05）， but were not significantly different between the groups after treatment and at follow-up （P＞0.05）. After treatment and at follow-up， FTND， MNWS， and PSQI scores were significantly reduced in both groups compared with those before treatment （P＜0.05）. There was no statistically significant difference in the FTND scale scores between the two groups after treatment and at follow-up （P＞0.05）， while the MNWS and PSQI scale scores were lower in the treatment group than in the control group （P＜0.05）. ConclusionAcupuncture combined with auricular acupoint patches for moderate to severe nicotine dependence has comparable effect with the first-line drug nicotine patch in terms of increasing the cure rate and decreasing the degree of nicotine dependence， and is superior to nicotine patch in terms of relieving withdrawal symptoms and improving sleep， with stable long-term effect.

OBJECTIVE To establish the quality standard of Lixieling tablets. METHODS Thin layer chromatography was used to identify Bistortae Rhizoma, Andrographis Herba and Sophorae Flavescentis Radix in Lixieling tablets. The components of andrographolium and matrine were determined by HPLC. RESULTS The thin layer spots of Bistortae Rhizoma, Andrographis Herba and Sophorae Flavescentis Radix were clear, with good separation effect and repeatability. The linear relationship between andrographolide, neoandrographolide, 14-deoxygenated andrographolide, dehydrated andrographolide, sophorine, oxymatrine, sophorine and oxysophorine and their respective concentration ranges was good. The RSDs of instrument precision, repeatability, stability and recovery all met the requirements. CONCLUSION The method is simple and reproducible, and can be used for the quality control of Lixieling tablets.

ObjectiveWe examined the principal respiratory pathogens in patients with acute respiratory tract infection in Taizhou， Zhejiang Province during 2020‒2021 to provide evidence for prevention， diagnosis and treatment of acute respiratory tract infection. MethodsFrom September 2020 to August 2021， a total of 2 831 cases with acute respiratory tract infection were collected from two influenza sentinel surveillance hospitals in Taizhou， which had then received the examination of 22 respiratory pathogens by multiple fluorescence quantitative PCR. ResultsThe total positive rate of respiratory pathogens in 2 831 samples was 14.13%， among which enterovirus （7.77%） and respiratory syncytial virus （1.59%） were the principal pathogens. Except enterovirus， there was no significant difference in the positive rate of pathogens detected by gender（P>0.05）. Moreover， there was significant difference in pathogens by age （P<0.05）， with the highest positive rate in 0‒4 years（35.21%）. There was also significant difference in pathogens by seasons （P<0.05）， with the highest positive rate in summer（20.54%）. ConclusionThe positive rate of acute respiratory tract infection decreases significantly， compared with that before the COVID-19 epidemic. The differences in the positive rate differ significantly by age and seasons. Comprehensive consideration of diverse factors before diagnosis and the utilization of multiple fluorescent quantitative PCR can quickly and effectively determine the pathogens in the early stage of infection. Our findings may provide certain support for the diagnosis and treatment of acute respiratory infections in the context of COVID-19 in Taizhou.

【Objective】 To study the adverse reactions(ADRs) in blood donors after whole-blood donation in terms of frequency and types, so as to explore the predisposing factors of adverse reactions. 【Methods】 A questionnaire was designed to investigate ADRs within 2 weeks after whole blood donation. A total of 812 whole blood donors were randomly selected from September to October 2021. They were interviewed by trained medical staff before leaving the site after blood donation, then followed up by telephone 24 hours and 2 weeks after blood donation. The frequency and type of ADRs were surveyed, and the physical examination data such as gender, age, blood pressure, mean arterial pressure (MAP) and weight were collected to, analyze the predisposing factors that correlated with ADRs. 【Results】 Finally, 734 people [90.39% (734/812)], with valid demographic and physical examination information, were included in this study after on-site interviews and two follow-ups within two weeks after blood donation. The incidence of ADRs was 13.22% (97/734), of which the incidence of on-site vasovagal reactions during blood donation was 10.49% (77/734) (with the constituent ratio as 79.38%, 77/97)and the incidence of ADRs ≤ 2 weeks after leaving the blood collection site was 2.73% (20/734, including 12 donors had (1.63%, 12/734) local symptoms)(with the constituent ratio as 20.62%, 20/97). Multivariate logistic regression analysis showed that the factors influencing the occurrence of ADRs were as follows: 400mL-blood donation (OR 6.312, 95% CI 3.336-11.944), 45~60kg weight (OR 3.744, 95% CI 2.017-6.949), MAP ≤ 90 mmHg (OR 3.101, 95% CI 1.416-6.788), novel blood donor (OR 2.237, 95% CI 1.199-4.174), age of 18~30 years (OR 2.197, 95% CI1.107-4.361), female (OR 1.871, 95% CI 1.026-3.413); blood pressure, occupation, education background, body mass index (BMI) and Hb of blood donors were not the influencing factors and risk predictors of ADRs. 【Conclusion】 The application of on-site interview and two follow-ups after donation can effectively obtain the true information of blood donors′ ADRs, which can timely grasp and predict the relevant factors affecting the occurrence of ADRs, so as to take targeted preventive measures to ensure the safety of blood donors.

Adaptation, Psychological ; Adolescent ; COVID-19 ; Child ; China ; Cross-Sectional Studies ; Female ; Humans ; Male ; SARS-CoV-2

【Objective】 To study and analyze the basic characteristics of blood donors under the COVID-19 epidemic in Tianjin area, so as to provide data support for improving the blood collection for emergency incidents. 【Methods】 The blood collection data of Tianjin Blood Center under the COVID-19 epidemic in 2020 were collected in terms of the number of blood donations, changes in blood donation units over time, group blood donation, donations given by regular blood donors and donations inside fixed blood donation sites, registered residence, gender, age, education, occupation, individual donation, group donation, and the annual daily blood collection and delivery data in Tianjin. 【Results】 The number of blood donations and donation units in Feb 2020 decreased by 56.96%(3 226/7 496-1)and 62.40%(5 382/14 314.5-1)compared with the same period in 2019, and decreased by 56.87%(3 226/7 480-1)and 60.70%(5 382/13 695.7-1)compared with the average value in the previous five years. The number of blood donations, donation units and rate of 400 mL donation in 2020 decreased by 13.25%(119 107/137 293-1), 17.7%(205 196.5/249 405-1)and 12.83%(66.0/75.8-1)respectively. Meanwhile the units of group donation increased by 22.59%(44 118.5/35 989.0-1)as compared with those in 2019. The proportion of regular blood donors raised up to 17.31%(20 623/119 107, which was the highest in recent 6 years. During the epidemic period, the number of blood donations of local registered residence, women, over 36 years old, with bachelor and above degree increased by varied extent compared with previous years. Workers, staff members and others were the main groups of voluntary blood donation, and civil servant, medical workers, farmers and teachers also played a certain role during the epidemic. 【Conclusion】 The clinical blood use in Tianjin was basically guaranteed during the COVID-19 epidemic. It is suggested to further optimize the structure of voluntary blood donors, establish a diversified and multi-level group blood donation team, and increase the number of regular blood donors.

【Objective】 To explore the application value of narrative nursing in blood collection nursing. 【Methods】 The quantitative questionnaire covering three periods, i. e. prior to narrative nursing intervention, January to June 2019 and July to December 2019, was designed. The pre-, 6-month-post-, and 12-month-post-intervention differences of 10 medical and nursing staff were scored by 100 donors, concerning active listening, reflective writing skill, empathy skill, communication skill and professionalism. 980 valid questionnaires out of 1 000 were returned and analyzed statistically, with P<0.01 indicating that the difference is statistically significant. 【Results】 After six months of narrative nursing, active listening, reflective writing, empathy skill, communication skill and professionalism increased to 91.54, 90.00%, 80.51%, 92.31%, and 91.54%, respectively. All items improved significantly except empathy skill(P>0.05). After 12 months of narrative nursing, active listening, reflective writing, empathy skill, communication skills and professionalism increased to 97.46%, 96.44%, 97.97%, 98.73% and 99.24%, respectively, and all items increased significantly (P<0.01). 【Conclusion】 The empathy between medical staff and blood donors as well as the lack of humanistic care during the blood collection nursing could be promoted by the application of narrative nursing, which is helpful for providing high-quality nursing service for blood donors.