[Objective] To retrospectively analyze the detection results of alanine aminotransferase (ALT) unqualified repeat blood donors in Guangzhou, so as to provide evidence for further expanding the repeat blood donor pool, reducing the rate of blood discarding and improving the qualified rate of blood test. [Methods] Blood donors with unqualified ALT in Guangzhou Blood Center from January 2018 to April 2024 were selected as the research objects. The past blood donation and population characteristics were analyzed according to the number of blood donations and ALT unqualified times. [Results] Among repeat blood donors with previous ALT disqualification, 99.5% to 99.7% did not have reactive markers for transfusion-transmitted diseases (TTD), which was higher than the rate among first-time blood donors with unqualified ALT (95.8%) (P<0.05). The rate of single-item ALT disqualification in repeat blood donors was higher in males than in females (P<0.05); it also varied by age (18-25 years > 26-35 years > 36-45 years > over 45 years) (P<0.05); and by quarter (third and fourth quarters > first and second quarters) (P<0.05). The ALT unqualified rate was significantly higher whole blood donors than that of platelet donors and returning blood donors (P<0.05). The overall ALT level (51.0 U/L), individual ALT level (56.0 U/L) and individual ALT unqualified rate (66.7%) of repeat blood donors with multiple ALT disqualifications were higher than those of repeat blood donors with single-item ALT disqualifications (26.0 U/L, 38.5 U/L, and 33.3%, respectively) (P<0.05). Moreover, as the number of ALT disqualifications increased, the overall level of ALT in repeat blood donors also increased (P<0.05), and the average level of individual ALT and individual ALT unqualified ratio tended to increase. Repeat blood donors with frequent ALT disqualifications had higher ALT levels (69.0 U/L). [Conclusion] The ALT unqualified rates of repeat blood donors were mostly non-specific elevation without TTD. Repeat blood donors with multiple ALT disqualifications tend to have continuous high ALT. Moreover, and with the increase of ALT disqualifications times, the overall ALT levels the average individual ALT levels and individual ALT unqualified rates showed an increasing trend.

Objective:To investigate the correlation between CHA 2DS 2-VASC score and the recurrence risk of paroxysmal atrial fibrillation after radiofrequency ablation. Methods:It was a retrospective cohort study. A total of 150 patients who underwent radiofrequency ablation for paroxysmal atrial fibrillation in Xingtai People′s Hospital from January 2017 to January 2021 were consecutively included in the study. According to the preoperative CHA 2DS 2-VASC score, patients were divided into high score group (≥3 points, n=90) and low score group (<3 points, n=60). Baseline clinical data was collected. All patients underwent circumferential pulmonary vein isolation, and those with atrial flutter before ablation also underwent tricuspid isthmus isolation. Holter and electrocardiogram examinations were performed at 3, 6 months and 1 year after ablation to evaluate whether there was recurrence of atrial fibrillation. Univariate and multivariate Cox regression was used to analyze the risk factors for recurrence of atrial fibrillation after radiofrequency ablation. Results:Among 150 patients 90 were males and 60 were females with a mean age of (64.0±3.6) years. There were no significant differences in age, sex, and proportion of hypertension, diabetes, chronic heart failure and stroke or transient ischemic attack (TIA), medication of antiarrhythmic and anticoagulant drugs between the two groups (all P>0.05). The longest duration of atrial fibrillation in the high score group was significantly longer than that in the low score group (26.0±6.1) hours vs. (10.0±2.1) hours, P<0.05). There were no patients with cardiac tamponade, atrial esophageal fistula and severe vascular puncture complications in the two groups. During the follow-up period, the recurrence rate in the high score group was significantly higher than that in the low score group (16.7% (15/90) vs. 8.3% (5/60), P<0.05). Multivariate Cox regression analysis showed that CHA 2DS 2-VASC score≥3 was an independent risk factor for atrial fibrillation recurrence in patients with paroxysmal atrial fibrillation after radiofrequency ablation ( HR=3.84, 95% CI: 1.87-7.89, P=0.02). Conclusion:CHA 2DS 2-VASC score≥3 is an independent risk factor for atrial fibrillation recurrence in patients with paroxysmal atrial fibrillation after radiofrequency ablation.

Objective:To investigate the risk factors of atrial fibrillation (AF) in patients with typical atrial flutter after radiofrequency ablation.Methods:This study was a case-control study. The clinical data of 120 patients with typical atrial flutter who underwent radiofrequency ablation in Xingtai People′s Hospital from January 2017 to January 2021 were retrospectively analyzed. Patients were followed up every 3-6 months for a period of 2 years, and AF occurred in 30 patients (25.0%). The risk factors of AF were analyzed with univariate and multivariate logistic regressions.Results:The mean age of patients was (62.0±6.5) years and 64(53.3%) were males. No patients in the two groups had complications such as cardiac tamponade, pulmonary embolism and cerebral infarction after radiofrequency ablation. Compared with non-AF patients, patients in AF group had older age and higher CHA 2DS 2-VASC score ( P<0.001). Multivariate regression analysis showed that age ( HR=1.09, 95% CI:1.01-1.17) and CHA 2DS 2-VASC score ( HR=3.84, 95% CI:1.87-7.89) were independent risk factors for the occurrence of atrial fibrillation after radiofrequency ablation in patients with atrial flutter. Conclusion:After radiofrequency ablation of typical atrial flutter, nearly 25% of patients will relapse into AF, old age and higher CHA 2DS 2-VASC score increase the risk of AF recurrent.

Purpose To investigate the protective effect and mechanism of A-485 on renal tubular injury in diabetic mice.Methods Eighteen male C57BL/6J mice were randomly divided into three groups:Control group,diabetic kidney dis-ease(DKD)group and A-485 treatment group.The DKD mice model was established by feeding high-fat diet for 8 weeks and intraperitoneal injection of streptozotocin for 5 days.Subsequent-ly,the A-485 treatment group was given A-485(10 mg/kg/day)by intraperitoneal injection every other day for 4 weeks.After treatment,the renal function,P300 enzyme activity and lipid deposition in renal tissue were measured.Western blot a-nalysis was performed to detect SREBP-1,FASN,ACC,ChREBP,P300,CBP,H3K18ac and H3K27ac protein levels.Results Compared with control mice,the levels of FBG,BUN,Scr and UAE were significantly increased in diabetic mice(FBG:2.52 times,BUN:2.89 times,Scr:2.13 times,UAE:4.21 times),while diabetic mice treatment with A-485 exhibi-ted a remarkable decrease on BUN,Scr and UAE(BUN:0.511 times,Scr:0.636 times,UAE:0.574 times,P＜0.01).The results of the transmission electron microscopy and oil red O stai-ning showed that A-485 treatment prevents lipid droplets forma-tion and up-regulation of SREBP-1,FASN,ACC and ChREBP in renal tubular cells of diabetic mice(SREBP-1:0.544 times,FASN:0.449 times,ACC:0.306 times,ChREBP:0.317 times,P＜0.01).Furthermore,A-485 intervention downregu-lated the enzyme activity of P300(0.546 times)and suppressed the expression of H3K18ac(0.337 times)and H3K27ac(0.308 times,P＜0.01).Conclusion A-485 can significant-ly improve renal lipid metabolic disorder in diabetic mice,which may be achieved by inhibiting p300-induced H3K18ac and H3K27ac.

Objective:To explore the effectiveness of the comprehensive healthcare management model for children with bacterial meningitis after discharge.Methods:This study was a retrospective cohort study that included 268 children with bacterial meningitis who were discharged from the infectious medicine ward of Beijing Children′s Hospital from September 2018 to September 2023. The children were managed with a multidisciplinary collaborative comprehensive healthcare management model after discharge. Outpatient data at 1 month and 6, 12 and 24 months after discharge were collected, including (height, weight, body mass index, nutritional feeding status, hearing and vision screening results, Gesell developmental assessment results and intervention guidance services. The follow-up interval or frequency was dynamically adjusted or increased according to the child′s situation. The paired sample t-test and chi square test were applied to compare the differences in Gesell developmental quotient (DQ) and developmental delay rate between the first and last assessments to preliminarily explore the effectiveness of the comprehensive healthcare management model for children with bacterial meningitis after discharge. Results:All the 268 children completed their first assessment one month after discharge, and 37 children were found to have abnormal physical growth, mainly obesity (28 children), and another 9 children were malnutrition. Nutritional intervention and feeding guidance services were provided to all the 37 children, and as of the last follow-up, 20 children′s physical growth evaluations had turned normal. A total of 188 children completed at least 2 developmental assessments, with an interval of (14.2±9.4) months between the first and last assessments (range: 3.1-49.5 months). The DQ values of in the energy region of adaptability, gross motor skills, fine motor skills, language, and personal social skills at the last assessment were significantly higher than those at the first assessment [(91.93±13.28) vs (80.73±15.96) points, (91.69±12.96) vs (78.31±16.58) points, (89.32±16.11) vs (80.68±15.63) points, (90.10±16.65) vs (82.04±18.43) points, (92.01±14.05) vs (77.82±17.42) points]; moreover, the rates of developmental delay in each energy region were significantly lower than those at the initial assessment (9.6% vs 35.1%, 9.6% vs 42.0%, 18.1% vs 33.0%, 13.3% vs 31.9%, 9.6% vs 42.0%) (all P<0.05). Among the 200 children who completed the hearing screening, 18 were found with hearing abnormalities, and 2 were diagnosed with hearing loss in the Otolaryngology Department. Among 217 children who completed vision screening, 23 had abnormalities, and 5 were diagnosed with ophthalmic abnormalities in Ophthalmology Department (2 with strabismus, 2 with refractive errors, and 1 with optic nerve injury). Two children were found to have autism-like behavior during monitoring, and were referred to a developmental behavior clinic to be diagnosed with autism spectrum disorder and were given early diagnosis and intervention guidance. Conclusion:The comprehensive healthcare management model for children with bacterial meningitis after discharge can integrate clinical and healthcare resources, which is beneficial for improving the prognosis and enhancing the quality of life for children with special health status.

Objective:To compare the efficacy of high density grid mapping catheter (HD-Grid) and circular mapping catheter in the ablation of paroxysmal atrial fibrillation.Methods:Patients with paroxysmal atrial fibrillation undergoing radiofrequency ablation in Xingtai People′s Hospital from March 2020 to March 2021 were randomly divided into the HD-Grid group and the circular mapping catheter group. The baseline data, operation time, X-ray exposure time, pulmonary vein isolation time, recovery of pulmonary vein conduction, the number of recovery sites, and perioperative complications were compared between the two groups. The patients were followed up at 1, 3, 6 and 12 months after operation, and a continuous electrocardiogram was performed to evaluate recurrence of atrial fibrillation.Results:Sixty patients were enrolled in the study with 30 cases in each group, including 33 males and 27 females with an average age of 63.0 (57.0, 70.3) years. There were no significant differences in age, gender ratio, comorbidity proportion, CHADS 2-VASC score, history of atrial fibrillation, B-type natriuretic peptide level, and left atrial diameter between the two groups (all P>0.05). The operation time of the HD-Grid group was longer than that of the circular mapping catheter group ((136.6±7.7) minutes vs. (127.5±7.7) minutes, P<0.001). During the observation period, 8 cases (26.67%) with pulmonary venous conduction recovery were identified in the HD-Grid group, which was higher than that in the circular mapping catheter group (2 cases(6.67%)) ( P=0.038). Eighteen (60.00%) pulmonary vein reconnection sites were identified in the HD-Grid group, which were more than that in the circular mapping catheter group (2 sites(6.67%), P=0.013). There was no significant difference in X-ray exposure time and pulmonary vein isolation time between the two groups (both P>0.05). There was no significant difference in the proportion of patients taking anticoagulant drugs and antiarrhythmic drugs during the perioperative period between the two groups (both P>0.05). No serious complications such as cardiac tamponade, phrenic nerve injury, pulmonary embolism, cerebral infarction and death occurred in both groups. During the follow-up period, 1 patient (3.33%) in the HD-Grid group had recurrence of atrial fibrillation, while 5 patients (16.67%) in the circular mapping catheter group had recurrence of atrial fibrillation, but there was no significant difference between the two groups ( P=0.197). Conclusions:HD-Grid for radiofrequency ablation of paroxysmal atrial fibrillation improves the identification rate of pulmonary vein potentials and pulmonary vein reconnection sites, and it may reduce the recurrence rate of atrial fibrillation. Although the operation time was prolonged, it would not increase the risk of perioperative complications.

With accelerated aging process of the population, femoral intertrochanteric fractures have gradually become another major social health problem in China. Internal fixation is still the gold standard treatment for the fractures. Fracture reduction is the first step of the treatment and also the first element that affects the treatment efficacy. It is still controversial in clinical practice how to evaluate the quality of fracture reduction during internal fixation of the fractures. This article systematically expounds and analyzes the 7 systems of judging criteria for the reduction of intertrochanteric fractures from the aspects of fracture alignment, fracture apposition, difference in judgment criteria, and difference in imaging methods, in order to provide a reference for reaching consensus and improving curative effects.

Objective: To investigate the current status of myopia in children and adolescents in Qamdo, Tibet, and analyze related influencing factors, so as to provide a basis for the prevention and control of adolescents in plateau areas. Methods: A cross sectional study was conducted among 959 children and adolescents randomly selected from one district and two counties in Qamdo (from the fourth grade of elementary school to the second grade of high school) for visual acuity and refraction tests and filled out a vision related behavior questionnaire to analyze the incidence of myopia among adolescents in the region and its associated factors. Results: The myopia rate of adolescents in grades 4-11 was 54.43%, the rate of undercorrection of refractive errors was 85.25%, and the percentage of students wearing eyeglasses was 34.67%,fully vision correction rate was 42.54%. The myopia rate of students in grades 4-6 was 35.14%, 64.71% in grades 7-9, and 73.48% in grades 10-11. The myopia rate increased with grades( χ 2= 101.18 , P <0.01). The myopia rate (70.40%) of urban students (grades 4-9) was higher than that of county level(41.45%), and the myopia rate of students with myopia from either parent (68.24%) was higher than that of students without myopia (51.91%) , the myopia rate of girls (59.96%) was higher than that of boys (48.36%)( χ 2=53.19，13.46，12.98， P <0.01). Use electronic products for more than 2.5 hours per day, electronic devices usage after bedtime, the light low indoor brightness when studying on a sunny day, and only use one of the table lamps or roof lights when studying at night, preference for fried food, poor sleep quality, in the morning the students who still feel tired are at higher risk of myopia( χ 2=10.35, 10.91, 6.87, 4.25, 4.97, 5.71, 12.11, P < 0.05). Multivariate regression analysis showed that the occurrence of myopia was related to region, grade, gender, parental myopia, time spent on electronic products every day in the past 5 months, and sleep quality( P <0.05). Conclusion The high rate of myopia in children and adolescents in Qamdo may be related to the quality of sleep, the length of time electronic products are used, the eye environment, and the frequency of eating fried foods. Outdoor activities do not show significant differences.

Objective:To investigate the correlation between social and linguistic parenting behaviors and developing capability of children with autism.Methods:From August 2020 to December 2020, the social and linguistic parenting behaviors of 302 parents of children diagnosed with autism were investigated in the outpatient department of the hospital.Meanwhile, the data of Gesell scale for children, the social life competence scale for infant and junior middle school students, the autism behavior checklist and the Cancy autism behavior scale were collected.SPSS 20.0 software was used for statistical analysis.Independent sample t test and analysis of variance were used to compare the social and linguistic parenting behaviors of different parents.Pearson correlation analysis was used to analyze the correlation between the social and linguistic parenting behaviors of parents and children's developmental ability and symptom severity. Results:There were no statistically significant differences in children's social and language development parenting behavior between father and mother ( t=1.033, P=0.303; t=-0.312, P=0.756). There were no statistically significant differences in children's social and linguistic parenting behaviors between fathers of different age groups ( F=1.425, P=0.244; F=1.127, P=0.345). Among mothers of different age groups, the social parenting behaviors of <30 years old and 30-34 years old groups were significantly better than those of 35-39 years old group ( F=3.374, P=0.019; LSD: P=0.010, P=0.006). Among fathers, the social parenting behavior( F=4.346, P=0.008; LSD: P=0.020, P=0.001) and social + linguistic parenting behavior in the graduate group and college group were significantly better than those in the high school/vocational group( F=3.965, P=0.012; LSD: P=0.020, P=0.002). Among mothers, the social parenting behavior ( F=2.812, P=0.040; LSD: P=0.008, P=0.023, P=0.009), linguistic parenting behavior ( F=3.769, P=0.011; LSD: P=0.010, P=0.025, P=0.001), social + linguistic parenting behavior ( F=3.654, P=0.013; LSD: P=0.005, P=0.015, P=0.002) in graduate and above groups were significantly better than those in college group, high school/vocational group, junior high school and below groups.The scores of social parenting behavior(40.72±6.80), linguistic parenting behavior(27.20±5.22), and social + linguistic parenting behavior(67.92±11.10) were significantly correlated with children’s fine motor(61.75±16.41)( r=0.193, P=0.001; r=0.153, P=0.009; r=0.190, P=0.001), cognition(68.28±16.83)( r=0.231, P=0.000; r=0.186, P=0.001; r=0.229, P=0.000), language(53.01±18.55) ( r=0.262, P=0.000; r=0.305, P=0.000; r=0.304, P=0.000) and social self-care(61.44±17.85) ( r=0.264, P=0.000; r=0.238, P=0.000; r=0.274, P=0.000). The scores of linguistic parenting behavior and social + linguistic parenting behavior were correlated with children's social life ability (8.65±0.89) ( r=0.142, P=0.046; r=0.140, P=0.049). There was no significant correlation between social parenting behavior, linguistic parenting behavior, social + linguistic parenting behavior and the scores of ABC scale (50.53±21.39) ( r=-0.089, P=0.336; r=-0.115, P=0.215; r=-0.107, P=0.250) and CABS scale (13.96±4.54) ( r=-0.050, P=0.490; r=-0.059, P=0.411; r=-0.058, P=0.421). Conclusions:The social and linguistic parenting behaviors are related to their age and educational level, and are significantly correlated to developing capability of children with autism, but have nothing to do with the severity of children's symptoms.

Objective:To explore the status quo and influencing factors of spiritual health in children with acute leukemia during treatment.Methods:The children with leukemia admitted in the First Affiliated Hospital of Zhengzhou University from August 2018 to April 2019 were selected. The general data questionnaire and Functional Assessment of Chronic Illness Therapy-Spiritual-12 (FACIT-Sp-12) were used to investigate the status quo of their spiritual health and analyze its influencing factors. A total of 150 questionnaires were distributed and 147 valid questionnaires were recovered, with an effective recovery rate of 98%.Results:The total score of spiritual health among 147 children with acute leukemia was (25.21±6.62) , including (10.17±3.92) for belief, (8.72±2.58) for meaning, and (9.39±3.28) for peace. There were statistically significance differences in spiritual health scores between children with different age, disease type and educational background of their guardians ( P<0.05) . Multiple linear regression analysis showed that age, type of disease, and education background of the guardian were factors affecting the spiritual health level of children with leukemia ( P<0.05) . Conclusions:The spiritual health of children with acute leukemia is at a medium level, which is related to the age, type of disease and educational background of the guardian. Medical staff should provide spiritual care to children with leukemia and improve the quality of life of children.