【Objective】 To demonstrate the real incidence and clinical features of acute transfusion reactions (ATRs) and analyze its association with transfusion effectiveness. 【Methods】 The blood transfusion process of patients in the Hematology Department in our hospital from March 16, 2018 to March 16, 2019 was observed and followed up. The vital signs and clinical features were recorded, the clinical data and relevant laboratory examination results were collected, and the correlation between ATRs, clinical features and transfusion effectiveness was statistically analyzed. 【Results】 A total of 2500 transfusions were observed in the Hematology Department, out of which 138 patients developed 242 ATRs. The overall incidence of ATRs was 9.68% (95% CI, 8.52%~10.94%) and the incidence of ATRs during platelets transfusion was the highest. The clinical features of most ATRs were mild and no fatal consequences occurred. No significant difference was found in the association between transfusion effectiveness with ATRs in platelets and red blood cells transfusion (P>0.05). 【Conclusion】 None of the ATRs observed in this study resulted in serious consequences or had effect on the transfusion effectiveness. The characteristics presented in these reactions may provide certain references for clinical practice.

OBJECTIVE:To investigate clinical efficacy of intravenous drip of alprostadil combined with acupuncture in the treatment of diabetic foot ulcer and its effects on inflammatory factors levels and wound microvascular density. METHODS:A total of 72 patients with diabetic foot ulcer in our hospital during May 2014 to Sept. 2015 were divided into observation group and con-trol group according to random number table,with 36 cases in each group. Control group was given Alprostadil injection 10μg add-ed into 250 mL 0.9% Sodium chloride injection intravenously,qd,on the basis of routine treatment as insulin. Observation group was additionally given acupuncture therapy (Sanyinjiao,Zusanli,Fenglong,Yanglingquan,Yinlingquan and other acupuncture points),qd,on the basis of control group. Treatment courses of 2 groups lasted for 3 weeks. Clinical efficacy,wound healing time,fasting blood glucose,urine microalbumin,inflammatory factors,wound microvascular density as well as the occurrence of ADR were compared between 2 groups. RESULTS:The total response rate of observation group(91.67%)was significantly higher than that of control group(72.22%),and wound healing time was significantly shorter than control group,with statistical signifi-cance(P<0.05). Before treatment,there was no statistical significance in fasting blood glucose,urine microalbumin and inflamma-tory factors between 2 groups (P>0.05). After treatment,above indexes of 2 groups were significantly lower than before,and urine microalbumin and inflammatory factors of the observation group was significantly lower than the control group,with statisti-cal significance (P<0.05). 14,21 d after treatment,wound microvessel density of observation group was significantly higher those of control group,with statistical significance(P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Intrave-nous drip of Alprostadil combined with acupuncture can boost angiogenesis through mitigating inflammatory reactions,thus shorten the time of wound healing and enhance therapeutic efficacy.

Objective To investigate the recurrence and survival of postoperative patients with differentiated thyroid carcinoma (DTC) aged from 25 to 59 years.Methods We retrospectively analyzed the clinical data of 36 patients with DTC treated in our hospital from 1996 to 2011,and the recurrence and survival status of the patients were recorded.Kaplan-Meier analysis was carried out to analyze factors that affect the patient's survival.Results Nine patients died of recurrence or metastasis,and the interval between the initial surgery and recurrence ranged from 22 to 46 months.The survival time of the 36 patients ranged from 34 to 135 months with a 10-year survival rate of 75.0％.Kaplan-Meier analysis showed that male patients had a significantly shorter mean survival time than female patients (χ2＝3.164,P=0.041);the median survival time of patients aged 45-59 years was obviously shorter than that of patients aged 25-44 years (χ2＝4.622,P=0.032);the postoperative survival in patients with 131I therapy was significantly longer than those who did not receive the therapy (χ2＝4.527,P=0.033),and was not affected by total excision of the thyroid gland (χ2=0.988,P＝0.320).No significant difference was found in the median survival of patients in different clinical stages (χ2=2.2132,P=0.167).Conclusion In young and middle-aged patients with DTC,postoperative recurrence is the most likely in 2 to 4 years after the surgery.Male patients at 45-59 years of age who do not receive 131I treatment are at high risks of tumor recurrence.

Objective To investigate the recurrence and survival of postoperative patients with differentiated thyroid carcinoma (DTC) aged from 25 to 59 years.Methods We retrospectively analyzed the clinical data of 36 patients with DTC treated in our hospital from 1996 to 2011,and the recurrence and survival status of the patients were recorded.Kaplan-Meier analysis was carried out to analyze factors that affect the patient's survival.Results Nine patients died of recurrence or metastasis,and the interval between the initial surgery and recurrence ranged from 22 to 46 months.The survival time of the 36 patients ranged from 34 to 135 months with a 10-year survival rate of 75.0％.Kaplan-Meier analysis showed that male patients had a significantly shorter mean survival time than female patients (χ2＝3.164,P=0.041);the median survival time of patients aged 45-59 years was obviously shorter than that of patients aged 25-44 years (χ2＝4.622,P=0.032);the postoperative survival in patients with 131I therapy was significantly longer than those who did not receive the therapy (χ2＝4.527,P=0.033),and was not affected by total excision of the thyroid gland (χ2=0.988,P＝0.320).No significant difference was found in the median survival of patients in different clinical stages (χ2=2.2132,P=0.167).Conclusion In young and middle-aged patients with DTC,postoperative recurrence is the most likely in 2 to 4 years after the surgery.Male patients at 45-59 years of age who do not receive 131I treatment are at high risks of tumor recurrence.

Objective To observe the effect of the rehabilitation garden on hemiplegic stroke patients. Methods 160 cases of cerebral vascular accident patients were randomized into observation group and control group. All patients were given conventional drug treatment and conventional rehabilitation training. The observation group was given the rehabilitation garden for rehabilitation training two times a day , each time 60 minutes. Results BBS, BI, FMA, HAMA and HAMD of The two groups of patients significantly improved. The improvement ofBBS and BI in observation group was better than that in control group (P < 0.05). HAMD and HAMA score inobservation group was significantly higher than that in control group (P < 0.01), the improvement in observationgroup is better than in control group (P < 0.01), the satisfaction rate in observation group is better than in controlgroup (P < 0.01), and the hospital stay period in observation group is better than in control group (P < 0.01).Conclusion The application of rehabilitation garden has a good effect on the rehabilitation effect of the hemiplegicstroke patients.

[ ABSTRACT] AIM:To investigate the role of ATP-sensitive potassium ( KATP ) channels in the inhibitory effect of hydrogen sulfide ( H2 S) on high glucose ( HG)-induced inflammation mediated by necroptosis in H 9c2 cardiac cells. METHODS:The expression levels of receptor-interacting protein 3 ( RIP3; an indicator of necroptosis ) and cyclooxyge-nase-2 (COX-2) were determined by Western blot.The levels of interleukin-1β(IL-1β) and tumor necrosis factor-α( TNF-α) were detected by ELISA .RESULTS:After H9c2 cardiac cells were treated with 35 mmol/L glucose ( HG) for 24 h, the expression of RIP3 was significantly increased .Pre-treatment of the cells with 100 μmol/L diazoxide ( DZ; a KATP channel opener) or 400 μmol/L NaHS (a donor of H2S) for 30 min considerably blocked the up-regulation of RIP3 induced by HG.Moreover, pre-treatment of the cells with 100 μmol/L 5-hydroxydecanoic acid (5-HD; a KATP channel
blocker) attenuated the inhibitory effect of NaHS on HG-induced up-regulation of RIP3.On the other hand, co-treatment of the cells with 100μmol/L necrostatin-1 ( a specific inhibitor of necroptosis ) or pre-treatment of the cells with 100 μmol/L DZ or 400 μmol/L NaHS attenuated HG-induced inflammatory responses , evidenced by decreases in the expression of COX-2 and secretion levels of IL-1βand TNF-α.However , pre-treatment of the cells with 100 μmol/L 5-HD significantly attenuated the above anti-inflammatory effects of NaHS.CONCLUSION:KATP channels play an important role in the inhib-itory effect of H2 S on HG-induced inflammation mediated by necroptosis in H 9c2 cardiac cells.

Objective To explore the influence of acute myocardial infarction (AMI) patients with coronary lesions to the ST segment resolution (STR) and clinical prognosis after percutaneous coronary intervention (PCI).Methods 380 patients with AMI were detected twice each hour for the situation of STR,before and after coronary angiography and PCI.According to the STR,the patients were divided into STR (≥ 50％) group and no STR (＜ 50％) group.The relationship between STR and clinical prognosis of hospitalization or follow up were analyzed.Results The STR rate of patients with coronary multivessel disease or proximal lesions after PCI was lower than the rate of patients with coronary single vessel disease or distal lesions (P ＜ 0.05).The incidence rate of major cardiac events and LVEDd during hospitalization in patients with proximal coronary lesions was obviously higher than patients with distal lesions,while LVEF was lower than distal lesions(P ＜0.01).It had no significant differences in LVEF,LVEDd between coronary multivessl disease and single vessel disease during follow up (P ＜ 0.01).Conclusion It has significant relationship between coronary multivessel disease,proximal coronary,STR resolution in patients with AMI after PCI and the prognosis during hospitalization and follow up.

Objective To explore the relationship between ST-segment level,T-wave early inversion and patients' left ventricular function,prognosis specifically for ST-segment elevation acute myocardial infarction patients,which underwent emergency PCI.Methods 62 patients (M:40,F:22 ) with acute myocardial infarction were randomly divided into groups as follows:according to whether one hour ST segment's changes more than 50％ after PCI,they were divided into group A and B:group A (PCI after one hour ST segment ≥50％ ),group B (PCI ST segment after one hour ＜50％ ).According to whether 24-hour T wave inversion after PCI,they were divided into group C and D:group C (24-hour T-wave inversion),group D (24 hours without T wave inversion).After six months,the different LVEF betweeen group A and B,C and D was observed.Results Of group A and group C,after 6 months,the left ventricular function recovery was better than that of group B and group D ( P ＜ 0.05 ).Conclusion The analysis of ST segment and T wave are simple,practical and effective methods to predict myocardial reperfusion,especially for PCI therapy in patients with acute myocardial infarction.

Objective To observe the mechanisms that Xiaoyao powder influences the hypothalamus-pituitary-adrenal (HPA) axis of chronic-stress rats. Methods Chronic stress rats were as researching object,and RU-38486 acted as tool drugs. The serum-GC density of rats were tested with ELISA,and the glucocortcoid(GR) in hippocampus neuron were tested with immunofluorescence,the CRH mRNA in hypothalamus were tested by in situ hybridization (ISH). Results Compared with normal group ( 1.09 ± 0.11 ;0.57 ± 0.10), the expression of GR in hippocampus of model group decreased(0.65 ± 0. 10; P ＜ 0. 01 ), and the expression of CRH mRNA in hypothalamus of model group increased ( 1.12 ±0. 11; P＜0. 0l ) ,the GR in hippocampus of RU-38486 group increased ( 1.59 ± 0. 11; P ＜ 0. 01 ), and the expression of CRH mRNA in hypothalamus of RU-38486 group reduced (0.48±0.10; P＜0.05) ,but both the expression of GR in hippocampus and the CRH mRNA in hypothalamus of Xiaoyao powder group were no change (0.62 ±0.08;0.97 ±0.13; P＞0.05). Compared with model group,both the expression of GR in hippocampus of RU-38486 and Xiaoyao powder group increased (P＜0. 01) ,and both the expression of CRH mRNA in hypothalamus of RU-38486 and Xiaoyao powder group reduced (P＜0.01). Conclusion Multi-stress can result in the expression of GR in hippocampus of rats decreasing and the expression of CRH mRNA in hypothalamus increasing, but those changes can be restrained by Xiaoyao powder, and it is the maybe mechanism of Xiaoyao Powder resisting chronic stress in HPA axis.

Objective To determine the effect of transcription and translation in telomeric related proteins,and synergism of progressive telomere shortening and cell cycle alteration in human lung adenocarcinoma A549 cell line,which is induced by antisense tankyrase oligonucleotide(asTANKS) combinated with antisense human telomerase reverse transcriptase(ashTERT) oligonucleotide.Methods A549 cells were randomly assigned as 3 test groups: ashTERT,ashTERT + asTANKS and asTANKS,three control groups(shTERT,sTANKS and blank).With individual intervention for different hours,the effect of transcription in hTERT mRNA was evaluated by RT-PCR,and telomerase activity was tested by ELISA-PCR,tankyrase activity was tested by Western blot as well.Moreover,telomere average length was analyzed by Q-FISH,and duration of proliferation was observed by population double test.Results Transcription in hTERT mRNA and telomerase activity for 48 hrs was inhibited obviously by ashTERT,but not by asTANKS.Progressive telomere shortening in A549 cells for 48 hrs was induced by either asTANKS or ashTERT(vs control,P