[Objective] To validate and optimize the platelet transfusion refractoriness (PTR) prediction model for patients with hematological disorders established by our center. [Methods] The data of patients with hematological diseases who received platelet transfusions from December 2021 to December 2022 were used as the training set, and data from January 2023 to December 2023 as the validation set. The validation set data was used to validate the predictive model constructed on the training set. Relevant risk factors for PTR were collected through literature review and preliminary studies。 The patients were divided into effective and ineffective groups according to the corrected count increment (CCI) of platelet counts. Predictive factors were screened using univariate and multivariate logistic regression. The calibration of the model were assessed via calibration curves, while discrimination, accuracy, sensitivity, and specificity were evaluated using receiver operating characteristic (ROC) curves Clinical utility was further analyzed with decision curve analysis (DCA). [Results] The Hosmer-Lemeshow (H-L) goodness-of-fit test for the validation set yielded S: P=0.000, indicating that the original model needs optimization. Baseline comparisons and logistic regression identified the number of red blood cell units (RBCU) and platelet units (PLT-U) transfused as key predictors for the optimized model. The H-L goodness-of-fit test S: P values for the training and validation sets were 0.930 and 0.056, respectively; the ROC areas were 0.793 5 and 0.809 4, specificities 90.95% and 84.21%, sensitivities 59.26% and 70.04%, and accuracies 78.14% and 74.10%, respectively. DCA demonstrated clinical net benefit within a prediction probability threshold range of 0.2-0.8. [Conclusion] Transfusion volumes of RBC-U and PLT-U were inversely associated with PTR in hematological patients. The resulting PTR prediction model exhibits moderate predictive efficacy and clinical benefit.

Objective To explore the risk factors for platelet transfusion refractoriness(PTR)in patients with hemato-logical disorders,construct a prediction model and validate the model efficacy.Methods Patients with hematological disor-ders who received platelet transfusion therapy in the Chengdu Second People's Hospital from December 2021 to December 2022 were retrospectively included to judge the effectiveness of platelet transfusion and screened for risk factors by univariate and multivariate logistic regression.A prediction model for PTR was constructed using receiver operating characteristic(ROC)curve,calibration curve and decision curve(DCA)to assess the differentiation,calibration and clinical value of the model,respectively.Results A total of 334 hematological patients were included,including 168 males and 176 females,with a PTR incidence of 40.4%.Univariate and multivariate logistic regression analysis showed that platelet transfusion vol-ume,erythrocyte transfusion volume,and neutrophil ratio were risk factors for PTR(P<0.05).A prediction model for PTR in hematological patients was established based on these risk factors.The area under the model's curve was 0.8377(95%CI:0.723-0.772),the sensitivity was 58.52%,and the specificity was 89.95%.The calibration curve showed that the S∶P was 0.964,the maximum absolute difference Emax was 0.032,and the average absolute difference Eavg was 0.009.The DCA a-nalysis showed that the model had clinical application value when the risk threshold ranged from 0.2 to 0.9.Conclusion The PTR prediction model based on platelet transfusion volume,erythrocyte transfusion volume and neutrophil ratio can pro-vide a basis for effective platelet transfusion in hematological patients.

Objective To study the clinical characteristics of outpatients with hand,foot and mouth disease (HFMD) caused by different serotypes of enteroviruses.Methods This was a prospective study.From February 2017 to March 2018,563 outpatients with HFMD were enrolled by systematic sampling in the Department of Infectious Diseases,Henan Children's Hospital.Throat swabs were collected to determine the serotypes via PCR.Demographic,clinical,and laboratory data were collected by standard questionnaire.All cases were followed up twice at 2 and 9 weeks after the initial outpatient visit through telephone interview.A total of 563 cases were enrolled and 555 (98.6％) cases were positive for human enteroviruses,including 338 (60.9％) males.Analyses were stratified by enterovirus serotypes,Chi square test or Fisher's exact test,Rank sum test was used for comparison among different groups.Results The age of 555 cases was 24.2 (16.4,41.3) months.Among them 44.0％ (224 cases) were identified as coxsackievirus (CV)-A6,while 189 cases,35 cases,14 cases and 73 cases were identified as CV-A16,enterovirus (EV)-A71,CV-A10 and other serotypes,respectively.Fever (≥37.5 ℃C) was present in 51.4％(285/555) of laboratory confirmed cases.The proportions of fever in cases of CV-A6 (68.9％(168/244)) and CV-A10 (12/14) were significantly higher than those in cases of CV-A16 (31.7％(60/189),x2=57.344,14.313,both P=0.000),other serotypes (43.8％(32/73),x2=15.101 and 8.242,P=0.000 and 0.004) and EV-A71 (37.1％(13/35),x2=13.506 and 9.441,P=0.000 and 0.002) respectively.There was no significant difference between CV-A6 and CV-A10 in presentation of fever (x2=1.785,P=0.182).There were 359 cases (64.7％) with eruptions in mouth,hands,feet and buttocks.Cases infected with EV-A71 had the highest proportions (74.3％(26/35)) of rash emerging simultaneously in mouth,hands,feet,and buttocks.The proportion in cases of CV-A 16,CV-A6,CVA 10 and other serotype were 73.5％ (139/189),61.9％ (151/244),7/14 and 49.3％ (36/73),respectively.The proportion of rash on other parts of body,such as face,limbs or torso in cases infected with CV-A6 (16.8％ (41/244)) was the higherest and the proportion in cases of CV-A16,EV-A71,CV-A10 or other serotypes were 8.5％(16/189),5.7％(2/35),1/14,6.8％(5/73),respectively.None of these cases developed serious complications.Desquamation occurred in 45.5％ (179/393) cases 7.5 (5.0,9.0) days after disease onset and 13.5％ (53/393) cases showed onychomadesis 31.0 (18.0,33.5) days after disease onset.The proportion of desquamation and onychomadesis associated with CV-A6 (64.2％ (95/148) and 31.8％ (47/148)) was significantly higher than CV-A16 (31.8％ (49/154) and 1.3％ (2/154),x2=33.601 and 52.482,both P=0.000) and other serotypes (38.0％(19/50) and 6.0％(3/50),x2=10.236 and 12.988,P=0.001 and 0.000).Desquamation appeared more in cases of CV-A6 than in cases of CV-A10 (2/11,x2=9.386,P=0.002),with the proportion of onychomadesis higher in CV-A6 than in EV-A71 (3.3％ (1/30),x2=11.088,P=0.001).Conclusion Clinical manifestation such as fever,rash emerging parts,desquamation and onychomadesis are different among outpatient HFMD cases infected with CV-A16,CV-A6,EV-A71,CV-A10 and other enteroviruses.

Objective To investigate the clinical efficacy of nerve growth factors in the treatment of sudden deafness.Methods A retrospective analysis was performed on 124 cases of hospitalized patients who suffered from unilateral sudden deafness from November 2013 to February 2015.The patients were divided into two groups: 59 in the treatment group and 65 in the control group.Each group was further divided into four subgroups according to different audiometric curves: the low-frequency declining type, the high-frequency declining type, the flat type, the completely deafness type.The control group: the patients were treated with the conventional therapy according to different audiometric curves.The treatment group: intramuscular mouse nerve growth factor treatment was added on the basis of conventional therapy mentioned above.The both treatments lasted 10 days.The total efficiency of two groups was compared ,and the efficiency of the subgroups was also compared.Results The total efficiency of the treatment group was 64.40% and 44.62% for the control group.The total efficiency of the treatment group was significantly higher than the control group.The analysis revealed as having statistically significant differences (x2=4.877,P=0.032<0.05).The total efficiency of the sub-groups by different audiometric curves was further analyzed.All the total efficiency of the sub-groups in treatment group were higher than the sub-groups in the control group, but the results were notconsidered as significantly different(P>0.05).Conclusion The mouse nerve growth factor has a positive effect on the treatment of sudden deafness, and has shown the acceptable clinical efficacy without side-effect.Thus the mouse nerve growth factor is a safe and effective drug for treating sudden deafness.

Objective To observe the effects of rehabilitation in the 55 prelingually deaf pediatric cases for two years after cochlear implantation ,factors including cochlear implantation and recovery time ;to compare the re-covery effects in the group of 1 to 3 years old children with the group of 3~5 years old (including the age of 3 years old) who lost their hearing before learning to speak ,and to provide clinical evidence for providing cochlear implant therapy to the prelingually deaf children as early as possible .Methods A total of 55 pediatric relingually deaf cases were included in this study .According to their implantation time and application duration ,they were divided into 2 groups :1 to 3 years old group (32 cases) ,and >3 to 5 years old group (23 cases) respectively .The hearing ,lan-guage and learning abilities on 1 ,3 ,6 ,12 ,18 ,24 months after cochlear implantation were evaluated ,using statisti-cal method to record CAP and SIR scores .Results The rehabilitation effects ,the average ages ,CAP ,speech rec-ognition rates and SIR were increased two years afterwards .The effects of younger age group were more noticeable than that in the older group .The differences between the two groups were statistically significant (P<0 .05) .Av-erage speech recognition rates ,average speech rehabilitation effects in each postoperative period of younger age group were better than those of in older age group ,showing significant differences (P<0 .05);CAPs in the younger age group on 1 ,3 and 12 months after CI surgery were significantly higher than those of in the older group (P value were 0 .001 ,0 .001 and 0 .002 ,respectively) .SIR in the younger age group at the time of 1 ,3 ,12 ,24 months were significantly higher than those of in the older group(P values were 0 .00 ,0 .00 ,0 .00 and 0 .024 ,respectively) . Conclusion Implanted age and recovery time are the key factors that influence the effects of postoperative rehabilita-tion .The younger when the children get cochlear implantation and the longer the recovery time takes during two years after cochlear implantation ,the better the results are .The standardization of domestic assessment for the re-covery effects and the international evaluation method have a certain degree of equivalence .

Objective To explore the relationships of quality of life ( QOL ) and functional status in patients with malignant bone tumors after operation. Methods European organization for research and treatment of cancer quality of life questionnaire C30 (EORTC-QLQ-C30), social support revalued scale (SSRS) and Karnofsky performance scale (KPS) were used to investigate the levels of QOL, social support and functional status. The correlations between them were explored. Results The overall score by QOL was (58.33 ± 18.94). The score by KPS was positively related to somatic function, role function, social function, and general health status (P<0.01), but negatively related to tiredness, pains, insomnia and financial burden (P<0.01). Conclusions The QOL in patients with malignant bone tumors after operation is at a lower level and the function is at a medium level. Nurses should assess the function and make out interventional measures for them so as to improve their QOL.

Objective To assess the prospect of integrated biphasic silk fibroin scaffold made by annulus fibrosus-nu?cleus pulposus tissue engineering in application as integrated intervertebral disc(IVD). Methods An integrated annulus fi brosus-nucleus pulposus(AF-NP)biphasic scaffold was made by silk fi broin using two different uncomplicated methods which were paraffin spheres-leaching method(outer AF phase)and phase separation method(inner NP phase). The scaf?fold was investigated by general observation, stereomicroscope and scanning electron microscopy(SEM). Its pore size, poros?ity, and compressive elastic modulus were determined. AF and NP cells were isolated from rabbit IVD and seeded into the corresponding phase of the scaffold respectively. The cell-scaffold complex was cultured for 48 hours. The biocompatibility of the scaffold was evaluated by SEM, live/dead staining while CCK-8 assay was used to assess cell proliferation. Results Stereomicroscope and SEM showed that AF phase and NP phase integrated perfectly without cross-linking. Both phases pos?sessed highly interconnected porous structure [pore size of AF and NP phase were(220.0±23.1)μm and(90.0±17.8)μm, re?spectively] and highly porosity(AF and NP phase were respectively 91%and 93%). In addition, this silk biphasic scaffold had impressive mechanical properties(150.7 ± 6.8)kPa. SEM revealed that disc cells attached to regions of pore walls, dis?tributed uniformly and secreted extracellular matrix. Live/Dead staining and cell count kit-8(CCK-8)analysis showed that the silk composite scaffold was non-cytotoxic to disc cells. Conclusion This silk biphasic AF-NP scaffold has satisfied pore size, porosity, biomechanical properties and biocompatibility, so it is ideal candidate for IVD tissue engineering.

Objective To investigate variations in bFGF,NGF,and brain-derived neurotrophic factor(BDNF) following sciatic nerve injury in rabbits and the optimum time to perform stem cell transplantation.Methods Sixteen New Zealand rabbits were divided into control group and groups at 3,7,and 14 days postinjury according to the random number table,with 4 rabbits per group.Rabbit models of the sciatic nerve injury were induced by forceps.Structural change of the injured nerve tissues were observed with HE staining.Contents of NGF,bFGF,and BDNF in supernatants of homogenated sciatic nerves were detected by ELISA test.Results Level of bFGF increased slowly postinjury,reached the peak at day 7 (P ＜ 0.05),and then restored to the normal level at day 14 (P ＞ 0.05).Level of BDNF raised quickly postinjury,reached the peak at day 7 (P ＜ 0.05),and then restored to the normal level at day 14 (P ＞ 0.05).Level of NGF increased rapidly postinjury,reached the peak at day 3 (P ＜ 0.05),and then restored to the normal level at day 7 (P ＞ 0.05).Conclusions In the early recovery process after peripheral nerve injury,the nerve tissues regulate the secretion of NGF,bFGF,and BDNF immediately and secretions of these growth factors correlate with the time of injury.Early period (3-7 days) after injury is the best time to perform nerve repairing,nerve transplantation,and stem cell transplantation.

Cell transplantation has great potentials in repairing damaged tissue.If we want to use the cell transplants to treat diseases that respond poorly to the conventional treatment,or provide better treatments,in vivo dynamic tracking is particularly important.The application of superparamagnetic iron oxide (SPIO) improves a common inconvenience of the current invasive tests including immunohistochemical study or transmission electron microscopy (TEM) study and so on.Researchers has established a variety of preparation methods of the particles,groped the optimal condition of cell marking.SPIO were proved to be feasible and superior in cell tracking in vivo through animal experiments.The results provide the reliable means of using SPIO to track cell in clinical treatments.This review gives a summary of the related study.

ObjectiveTo study the method of cell isolation,primary culture and identification of subchondral bone cell of osteoarthritis(OA) rabbits.Methods The rabbit instable knee joint models were made by modified Hulth modeling method.The osteoblasts were harvested from the subchondral bone of rabbits by collagenase and tissue explants attachment.The morphology observation and biological identification were performed by inverted microscope and immunocytochemistry staining,respectively.The proliferative activity of cells were detected by MTT and the expression of Ⅰ-collagen at gene level was detected.ResultsThe cells started to appeared on the 11th day after the attachment.The cells form were fusiformis and triangle,the nucleolus were clear.The cultured cells had typical osteoblast morphological characteristics.The cells obtained from subchondral bone of rabbits were identified to be osteoblast by immunocytochemistry staining.The proliferative activity of cells were equably proliferation which detected by MTT.ConclusionThe modified method provides better way to obtain ideal subchondral osteoblast and the co-culture method is suitable for the study of OA microenvironment,which can simulate interactions of the subchondral osteoblast,synovial cells and chondrocyte.