[Objective] To establish a cryopreservation protocol for small-volume (≤1 mL) red blood cells (RBCs) and to evaluate the reactivity and stability of blood group antigens after cryopreservation, so as to explore its potential application in immunohematology reference laboratories. [Methods] Small-volume RBCs were cryopreserved for 120 days, followed by thawing and deglycerolization to restore the RBC components. The quality of the RBCs was assessed. Serum antibodies were serially diluted and reacted with RBCs before and after cryopreservation, and agglutination scores were recorded to quantitatively evaluate the reactivity and stability of blood group antigens such as Rh, Duffy, Lewis, Kidd, M, and H. Flow cytometry was used to analyze the percentage and mean fluorescence intensity of ABO antigen expression on RBCs before and after cryopreservation to assess the usability of cryopreserved RBCs in flow immunophenotyping and blood group subtype studies. [Results] The hemolysis rate of thawed and deglycerolized RBCs was (0.27±0.10)%, with a supernatant free hemoglobin level of (0.52±0.14) g/L, and the RBC recovery rate was (69.12±7.91)%. The direct antiglobulin test (DAT) was negative for all thawed RBCs. There was no difference in the reactivity of blood group antigens before and after cryopreservation, and no difference in the percentage and mean fluorescence intensity of A and B antigen expression on RBCs before and after cryopreservation. [Conclusion] The small-volume RBC cryopreservation protocol can be applied to immunohematology analysis in reference laboratories and is expected to be widely used in blood group identification, antibody screening, identification, and blood group-related research.

Congenital heart disease (CHD) is a congenital malformation resulting from abnormal embryonic development of the heart and great vessels, accounting for approximately 25% of all congenital malformations. Children with CHD are often complicated by short stature. Although surgical treatment can improve their growth and development to a certain extent, some children still experience growth retardation after surgery. Recombinant human growth hormone (rhGH) is the main drug for treating short stature, but its efficacy and safety in the treatment of patients with concomitant CHD warrant further investigation. This article reports six cases of children with CHD and short stature who were treated with rhGH. Through a literature review, we summarize and discuss the therapeutic efficacy, follow-up experiences, and adverse reactions of rhGH treatment, aiming to provide references for clinicians in applying rhGH to treat patients with CHD and short stature.

Objective To investigate the virulence and drug resistance characteristics of diarrheagenic Escherichia coli isolated from patients with infectious diarrhea in our hospital.Methods The preliminary identification of microbes was carried out by the VITEK-MS microbial mass spectrometry detection system and virulence genes were detected by the multiplex real-time PCR.Five types of diarrhea-genic Escherichia coli(DEC)clinically isolated from patients with infectious diarrhea in our hospital were identified.The drug resist-ance characteristics of DEC strains were detected by the microbroth dilution and E-test.The drug-resistant molecular characteristics were analyzed by the next-generation sequencing and bioinformatics.The Fisher exact probability method was used for statistical analy-sis.Results The detection rate of DEC in our hospital was 11.9%,with enteroaggregative E.coli(EAEC)accounting for 37.5%,a-typical enteropathogenic Escherichia coli(EPEC)accounting for 34.38%,enterotoxigenic E.coli(ETEC)accounting for 25.0%,and enteroinvasive E.coli(EIEC)accounting for 3.12%.None of enterohemorrhagic E.coli(EHEC)strain was detected.The resistance rates of 32 DEC strains to ampicillin,tetracycline,and trimethoprim/sulfamethoxazole were 53.12%,43.75%,and 37.5%,respec-tively.ESBLs(+)strains accounted for 18.75%,and the detection rate of multidrug-resistant strains was 83.83%,significantly higher than that of ESBLs(-)strains(P=0.042).A total of 25 ST genotypes were obtained from 32 DEC strains.The dominant genotypes were ST10(4 strains,12.5%),followed by ST28(2 strains,6.25%),ST31(2 strains,6.25%),ST3153(2 strains,6.25%),and the other 21 genotypes(1 strain,3.13%).One carbapenem resistant strain carrying the blaNDM-1 gene was detected in EAEC.Conclu-sion Four virulence genes such as aggR,pic,astA,and eae,are more common in the DEC of patients with infectious diarrhea in our hospital,with EAEC and EPEC as the main subtypes.The genotypes are highly polymorphic,and multidrug-resistant strains have been detected.

Objective Explore the factors affecting rural residents'willingness to use telemedicine in China,and put forward relevant suggestions to promote the development of telemedicine in rural areas.Methods A research model was built based on Technology Acceptance Model,data were collected through using a questionnaire survey and analyze by structural equation modelling for validation.Results The awareness rate of telemedicine among rural residents was 62.0%and the usage rate was 10.0%,which was low.Perceived usefulness,perceived ease of use,social participation,social support,and facilitators positively influence rural residents'willingness to use telemedicine(P＜0.05),while perceived risk and social connection have no effect on the willingness of rural residents to use telemedicine(P＞0.05).Conclusion Promote the construction of telemedicine system infrastructure to comprehensively enhance the level of rural medical and health services;improve telemedicine laws and regulations to promote the policy guarantee of the three medical institutions;give full play to the role of social capital to improve the information literacy of rural residents in the use of telemedicine.

In the context of high-quality development in medical institutions, the supply-processing-distribution(SPD) management mode has gradually been widely applied. The authors described in detail the procurement, supply, inventory, distribution, and settlement management of medical consumables and in vitro diagnostic reagents in a certain hospital under the SPD mode. It was found that SPD was conducive to strengthening the supervision of medical consumables and in vitro diagnostic reagents in the hospital, ensuring quality and safety of use, reducing hospital operating costs, and improving hospital′s competitiveness. However, attention should be paid to preventing data security risks, strengthening operational management, and improving the cost-benefit analysis of in vitro diagnostic reagents.

Objective To explore the therapeutic mechanism of compound Yuye Decoction against diabetic cardiomyopathy(DCM).Methods Drugbank,Gene Cards,OMIM and PharmGKb databases were used to obtain DCM-related targets,and the core targets were identified and functionally annotated by protein-protein interaction network analysis followed by GO and KEGG enrichment analysis.The"Traditional Chinese Medicine-Key Component-Key Target-Key Pathway"network was constructed using Cytoscape 3.9.1,and molecular docking was carried out for the key components and the core targets.In the animal experiment,Wistar rat models of DCM were treated with normal saline or Yuye Decoction by gavage at low(0.29 g/kg)and high(1.15 g/kg)doses for 8 weeks,and the changes in cardiac electrophysiology and histopathology were evaluated.The changes in serum levels of LDH,CK,and CK-MB were examined,and myocardial expressions of PI3K,P-PI3K,Akt,P-AKT,BAX,IL-6,and TNF-α were detected using Western blotting.Results We identified 61 active compounds in Yuye Decoction with 1057 targets,3682 DCM-related disease targets,and 551 common targets between them.Enrichment of the core targets suggested that apoptosis,inflammation and the PI3K/Akt pathways were the key signaling pathways for DCM treatment.Molecular docking studies showed that the active components in Yuye Decoction including gold amidohydroxyethyl ester and kaempferol had strong binding activities with AKT1 and PIK3R1.In DCM rat models,treatment with Yuye Decoction significantly alleviated myocardial pathologies,reduced serum levels of LDH,CK and CK-MB,lowered myocardial expressions of BAX,IL-6 and TNF-α,and increased the expressions of P-PI3K and P-AKT.Conclusion The therapeutic effect of compound Yuye Decoction against DCM is mediated by its multiple active components that act on multiple targets and pathways to inhibit cardiomyocyte apoptosis and inflammatory response by regulating the PI3K/Akt signaling pathway.

Objective To compare the efficacy and safety of endoscopic ligation treatment and endoscopic tissue glue injection for secondary prevention of gastric variceal bleeding.Methods Patients with cirrhosis and esophagogastric variceal bleeding treated with gastric variceal ligation in Zhongshan Hospital,Fudan University,from January 2017 to December 2019 were screened(ligation group).And during the same period,patients underwent endoscopic cyanoacrylate treatment were also screened(tissue glue group).59 patients were included in the two groups after propensity score matching.Univariate and multivariate Cox proportional hazard regression models were used to anslyze risk factors for re-bleeding.Kaplan-Meier curves were plotted to analyze re-bleeding rate and mortality of the two treatment groups.Results There was no statistically significant difference in the eradication rate of esophagogastric varices between the ligation group and the tissue glue group(83.05％vs 79.66％,P=0.778);the ligation group required fewer median endoscopic treatments for variceal eradication(2 vs 3,P=0.017)and a lower average dosage of cyanoacrylate(0.70 mL vs 2.67 mL,P＜0.001).Multivariate Cox regression analysis showed that portal shunt was a risk factor for esophagogastric varices re-bleeding(HR=3.14,95％CI 1.02-9.68,P=0.046),endoscopic variceal ligation was a protective factor against re-bleeding(HR=0.25,95％CI 0.08-0.71,P=0.010).Compared with endoscopic cyanoacrylate injection,endoscopic ligation treatment did not significantly increase the 2-year risk of esophagogastric variceal re-bleeding(18.69％vs 36.29％,P=0.067)or risk of death(1.69％vs 3.39％,P=1.000);patients with GOV1 type had a significantly lower risk of re-bleeding after endoscopic ligation treatment(0 vs 40.27％,P=0.012)and there was a trend towards a lower re-bleeding risk in patients with GOV2 type after endoscopic ligation treatment(13.27％vs 34.16％,P=0.056).Conclusions Endoscopic ligation treatment has higher eradication rate for esophagogastric varices,and does not increase the risk of re-bleeding,death,or other adverse events.Therefore,it can be considered an effective secondary prevention way for patients with gastric varices.

Based on the principle of "kidney suffers from dryness and can be moistened by pungent drugs", this article discussed the pathogenesis and treatment of chronic kidney disease-associated pruritus (CKD-aP), and believed that this disease begins with deficiency of kidney qi, and dampness, blood stasis, cold, heat, and turbid toxin are the symptoms, which ultimately leads to the kidney's inability to transport fluids, and develops into "dryness of kidney". It suggested that the treatment of CKD-aP should be "using pungent drugs to moisten" as the core, according to the stage of development of the disease and the contradiction of the primary and secondary, respectively, the use of pungency-warm (heat) declination, pungent-cold (cool) declination of the treatment, to help to restore the normal transmission of fluid operation, qi and blood, and promote fluids to reduce dryness, so as to promote the recovery of the disease.

This study searched for Kampo Medicine patents on the PatSnap platform and analyzed them from five aspects: patent application trends, regional distribution, legal status, technical dimensions, and patent value. It has found that the patent awareness of Kampo Medicine companies started early and matured, based on local patent technology, while paying attention to overseas market layout and expanding the scope of protection; the core technology and competitiveness were concentrated in top enterprises; enterprises have attached great importance to cooperation with research institutes and universities. This article explored the development trend of Kampo Medicine patents through data analysis, in order to provide references for the cultivation and protection of high-value Chinese materia medica of relevant departments, TCM enterprises, and research institutions in China.

Objective To study the effect of temperature on microleakage of Beautifil Flow Plus F00,FiltekTM Z350 XT,SDR,Tet-ric?N-Flow and Constic,and to provide reference for clinical selection of ideal fluid resins.Methods A total of 60 adult detached premolars removed for orthodontic extraction were divided into 10 groups(n=12),which were divided into F00A group,Z350A group,SDRA group,TetricA group and ConsticA group according to whether they had undergone cold and hot cycle aging test,and F00B group,Z350B group,SDRB group,TetricB group,ConsticB group,a total of 10 groups.The occlusal surface of each isolated tooth was prepared into a type Ⅰhole with the width of 2 mm,length of 4 mm and depth of 2 mm,which was filled with the corresponding fluid resin respectively.Methylene blue staining experiment was performed on specimens in group A,and methylene blue staining experiment was performed on specimens in group B after 5 000 times of cold and hot cycling aging experiment.The crowns of all specimens were dissected longitudinally along the long axis of the tooth body from the direction of buccal tongue(palate).The degree of microleakage in each group was observed under stereomicroscope,and the data were recorded and analyzed statistically.Results ①There was no sig-nificant difference in the degree of microleakage between the F00A group,the Z350A group,the SDRA group,the TetricA group and the ConsticA group(P>0.05).②The degree of microleakage in the SDRB group and TetricB group was significantly higher than that in the F00B group and Z350B group(P<0.05).③Temperature had a significant effect on the microleakage degree of Beautifil Flow Plus F00,FiltekTM Z350 XT,SDR,Tetric? N-Flow and Constic(P<0.05).Conclusion ①There was no significant difference in the de-gree of immediate microleakage of Beautifil Flow Plus F00,FiltekTM Z350 XT,SDR,Tetric?N-Flow,and Constic without cold and hot cycle aging experiments.②After the cold and hot cycle aging experiments,the microleakage degree of SDR fluid resin and Tetric? N-Flow fluid resin was high,and the edge tightness was poor.Beautifil Flow Plus F00 fluid resin and FiltekTM Z350 XT fluid resin had a low degree of microleakage and better edge tightness.③The micro-leakage degree of Beautifil Flow Plus F00，FiltekTM Z350 XT，SDR，Tetric? N-Flow and Constic was aggravated by the cold and hot cycle aging ex-periments.