Objective: Data on syncopal donation-related vasovagal reaction (DRVR) collected from 74 blood centers between 2020 and 2023 was statistically analyzed to provide a reference for developing preventive strategies against syncopal DRVR. Methods: Data on blood donation adverse reactions and basic information of donors from 2020 to 2023 were collected through the information management system at monitoring sentinel sites. Statistical analysis was performed on the following aspects of syncopal DRVR: characteristics of donors who experienced syncope, reported incidence, triggers, duration, presence and occurrence time of syncope-related trauma, clinical management including outpatient and inpatient treatment, and severity grading. Results: From 2020 to 2023, 45 966 donation-related adverse reactions were recorded. Of these, 1 665 (3.72%) cases were syncopal DRVR. The incidence of syncopal DRVR decreased with age, being the highest in the 18-22 age group. Incidence was significantly higher in female donors than male donors, in first-time donors than repeat donors, and in university and individual donors than group donors (all P<0.05). There was no statistically significant difference among different blood donation locations (P>0.05). The top three triggers were tension, fatigue, and needle phobia or fear of blood. Among syncopal DRVR cases, 60.36% occurred during blood collection, 87.63% lasted for less than 60 seconds, and 5.05% were accompanied by trauma. Notably, 57.14% of these traumas occurred after donor had left the blood collection site. Syncope severity was graded based on required treatment: grade 1 (fully recovered without treatment, 95.50%); grade 2 (recovered after outpatient treatment, 4.02%); and grade 3 (recovered after inpatient treatment, 0.48%). Conclusion: By analyzing the data of syncopal DRVR cases, it is possible to provide a reference for formulating blood donor safety policies.

Objective:To investigate the application of 3.0T high resolution magnetic resonance imaging(HR-MRI)in acute ischemic stroke(AIS)and the influence factors of prognosis.Methods:A total of 92 AIS patients who underwent treatment in Hainan General Hospital from January 2019 to June 2022 were selected as the research objects.All patients were treated by thrombolytic therapy,and they were divided into favorable prognosis group(mRS scores≤2 points,n=66)and poor prognosis group(mRS score>2 points,n=26)according to modified Rankin Scale after they received 90d treatment.All of patients underwent Magnetom Trio type of 3.0 T HR-MRI examination within 1 week after they hospitalized,and the changes of luminal stenosis rate,the luminal area at the narrowest point,the plaque load,T2WIsignal intensity index,T1WI signal intensity index,plaque enhancement rate and other parameters were compared.The receiver operating characteristics(ROC)curve was adopted to analyze the predictive value of 3.0T HR-MRI parameters on the AIS prognosis.Binary Logistic regression model was used to analyze the risk factors that affected the prognosis of AIS patients.Results:The difference of infarction diameter between two groups was statistically significant(x2=6.574,P<0.05).The lumen area at the narrowest point in the poor prognosis group was significantly lower than that in the favorable prognosis group,while the T2WI signal intensity index,T1WI signal intensity index and plaque enhancement rate in the poor prognosis group were significantly higher than those in the favorable prognosis group(t=-3.378,4.443,4.413,3.890,P<0.05),respectively.ROC curve analysis showed that the area under curve(AUC)values of T2WI signal intensity index,T1WI signal intensity index,lumen area at the narrowest point and plaque enhancement rate in predicting the AIS prognosis were respectively 0.743,0.739,0.706 and 0.748.The Logistic regression analysis showed that infarction diameter>3.0cm,T1WI signal intensity index,T2WI signal intensity index,lumen area at the narrowest point and plaque enhancement rate were respectively independent risk factors that could affect AIS prognosis(OR=3.889,257.151,105.073,4.091,1.121,P<0.05).Conclusion:3.0T HR-MRI has higher efficiency in the assessment for the prognosis of patients with AIS,which can provide guidance for the judgement of prognosis and the formulation of treatment scheme through observes the changes of a series of parameters include T2WI signal strength index,T1WI signal strength index,the lumen area at the narrowest point,plaque enhancement rate.The above parameters are risk factors that affect the prognosis of patients,which often represent the progress of patients'conditions.

Objective: To evaluate the clinical value of high-risk factors in combination with stratification method in predicting the clinical prognosis of patients diagnosed with N_2-3M₀ nasopharyngeal carcinoma (NPC). Methods: A total of 226 N_2-3M₀ NPC patients who underwent IMRT from November 2013 to May 2015 were enrolled in this study. The relationship between tumor volume, cervical metastatic lymph node characteristics (necrosis and fusion) and T and N staging was analyzed. The high-risk factors that affected the survival were identified. The value of high-risk factors combined with stratification method in predicting the clinical prognosis was assessed. Results: N₃ staging, V_n≥47.15cm³ and lymph node fusion (LNF) were the high-risk factors for distant metastasis in patients with stage N_2-3M₀ NPC. All patients were classified into the low-risk, medium-risk, high-risk and extremely high-risk groups according to high-risk factors. For patients in the low-risk, medium-risk, high-risk and extremely high-risk groups, the 3-year overall survival rates were 84.2%, 76.7%, 58.7% and 36.4%(all P<0.001), 87.3%, 85.2%, 54.5% and 12.1% for the distant metastasis-free survival (DMFS) rates (all P<0.001), 76.8%, 74.3%, 49.2% and 12.1%for the progression-free survival (PFS) rates (all P<0.001), and 89.2%, 88.5%, 91.5% and 88.3% for the loco-regional recurrence-free survival (LRRFS) rates (P=0.914), respectively. The risk stratification method showed the best curve separation for DMFS compared to the V_n, N staging and LNF classification groups (all P<0.05). Conclusion High-risk factors in combination with stratification method has the highest clinical value in predicting the clinical prognosis of N_2-3M₀ NPC patients.

Objective To explore the imaging features of MRI in the patients with gouty arthritis of knee and the diagnostic value.Methods The MR imaging and clinical date of 31 knees in 22 patients with gouty arthri-tis of the knee confirmed by pathology were retrospectively analyzed. Results All of the 31 knees showed synovial thickness,21 knees showed hydrarthrosis.29 knees had the gouty tophus which located at the patella bursa,patel-lar fat pad,joint cavity,intercondylar fossa,femoral condyle or surrounding,patella or before,and tibial platform or before.Tophi showed hypointensity on T1WI,showed isointensity,slight hyperintensity,and hypo-/slight hyper-intensity on T2WI.Conclusion MRI is very effective image examination method of diagnosis the gout arthritis of the knee,MRI can clearly show synovial thickeness,hydrarthrosis and soft tissue swelling,sensitively observe the bone erosion and the gouty tophi.

Objective To observe CT features of primary yolk sac tumor (YST).Methods Clinical data and CT findings of 31 patients with primary YST proved by pathology were analyzed retrospectively.Plain CT was performed in 31 patients,while contrast enhanced CT scanning was performed in 23 patients.Results The lesions in 19 patients located in the gonads,including ovaries (n=11) and testes (n=8).Other lesions in 12 patients located out of gonads,including sacrococcygeal region (n =7),anterior mediastinum (n =3) and vagina (n=2).The tumors were oval shaped in 20 patients,while irregular shaped in other 11 patients.Well-defined boundary was found in 20 patients,whereas ill-defined boundary was found in 11 patients.Fat and calcification were found in 2 patients with teratomas.Moderate to marked enhancement of the solid part of tumors were observed in 23 patients,loofahs enhancement were observed in 17 patients,the blood vessels were found in 18 patients,while delayed enhancement of coated edge was found in 21 patients.The rupture of tumor capsule was found in 4 patients.Conclusion CT manifestations of YST have certain characteristics,which can provide imaging diagnostic evidences.

Objective To explore the CT and MRI findings of Kimura disease in different location.Methods The CT and MRI obtained in 19 patients with histologically proved Kimura disease were reviewed retrospectively.Results Of these 19 patients with Kimura disease, the head and neck was involved in 16 patients, other locations less commonly involved were the lung(n=1),chest wall(n=1),liver and spleen(n=1).Kimura disease of head and neck,the density abnormal appeared as nodular,mass or diffuse on CT imaging, the CT value of lesion was similar to muscle, MRI manifested as a slightly hypo-or isointense lesion on T1WI and hyperintense on T2WI,most of the lesions demonstrated moderate or marked enhancement on postcontrast CT and MR images.Kimura disease of lung and chest wall,lesion appeared as a solid mass on imaging, there was moderate enhancement in the lung lesion and rim enhancement in the chest wall lesion.Kimura disease of liver and spleen: lesion showed nodular, mild and gradual upward enhancement.Conclusion Imaging findings of Kimura disease are not characteristic, it is very essential to know the lesion combined with the laboratory and pathologic features.

Objective Corneal alkali burn is a major cause of corneal neovascularization ( CNV) .Confocal microscopy was used to observe the therapeutic effects of KH902 eye drops for the treatment of corneal alkali burns. Methods 24 adult rabbits were randomly divided into two groups( n=12) , alkali burn model being established:experimental group by KH902 eye drops and control group by saline solution 3 times a day.Confocal microscopy was given at 3, 7, 14, 28 d post-operatively (po). Results Corneal epithelium deletion or vacuolar necrosis was found at 3 d po, along with stromal edema.There was no obvious inflammatory cell or no immunocyte infiltration.No difference was found in the corneal structures between two groups.CNV appeared in the peripheral stroma in both groups at 7d po.Inflammatory cell infiltration was more severe in the limbus and peripheral sections in control group than in control group.At 14 d po, inflammatory cells declined gradually and CNV took shape.At 28 d po, scarring and decreased inflammatory cells were found in both groups, while the experimental group had fe-wer and smaller blood vessels than the control group.As to the area of CNV, it was respectively (35.42 ±6.40) mm2, (60.23 ±5.35) mm2, (60.23 ±5.35)mm2 at 7, 14, 28d po in control group, statis-tical difference being found among different time points(P<0.05).While in experiment group, the area of CNV was respectively (22.11 ±5.45)mm2, (31.62 ±7.19)mm2, (28.54 ±3.01) mm2at 7, 14, 28 d po without statistical difference.(P>0.05).The CNV area in experiment group is significantly less than that in the control group at 14 d and 30 d po(P<0.05).The inflammatory cell density in control group was respectively (74.21 ±9.33)mm2, (1883.39 ±43.11)mm2, (2532.10 ±98.00)mm2, (723.05 ± 23.34)mm2at 3,7, 14, 28 d po, and (58.0 ±10.22)mm2, (656.90 ±33.01)mm2, (432.32 ±60.11)mm2, (122.11 ±30.37) mm2respectively at 3,7, 14, 28d po in experiment group, significant difference was found at different time points in both groups(P<0.05), among which significant decreased inflammatory cells was found in experiment group compared with control group (P<0.05). Conclusion KH902 eye drops can be used for the inhibition of CNV and inflammatory cell infiltration after alkali burn.

Xanthone and its derivatives occupy a large part of the family of natural polyphenolic compounds with various biological and pharmacological activities.In recent years (from 2006 to 2011),it was reported that 127 xanthones were discovered from plants and fungi using various modem separation methods including silica gel/polyamide column chromatography,HPLC,high-speed counter-current chromatography,high-performance centrifugal partition chromatography,etc.Since total synthesis and structure modification for xanthone and its derivatives have been given attention worldwide,we introduced the synthetic methods of xanthone skeletons as well.Unfortunately,to date,there are still weaknesses in current methods of separation and synthesis,which need to be improved.This review,to a certain extent,provides necessary foundation for the further research and development of medicines containing xanthone and its derivatives.

Objective To analyze characteristics of severe liver trauma and efficacy of different surgical procedures. Methods Clinical data of 109 patients with severe liver trauma treated in the recent 10 years were retrospectively analyzed. Debriding suture was performed in 32 patients, gauze tamponade in 5, debridement hepatectomy in 59 and anatomical hepatectomy in 13 patients. Results In all the 109 patients, 92 were cured and 17 died. The dead patients included 3 with grade Ⅲ trauma,9 with grade Ⅳ trauma, and 5 with grade V trauma. Among the dead patients, there were 3 patients with simple liver injury (17.6%) and 14 with associated injury (82.4%). Conclusion Right hepatic serious damage is the main type of severe liver trauma and is always complicated with associated injury and needs emergency treatment. Application of the most appropriate surgical approach according to the traumatic condition is important to promote the successful rate of treatment.

Objective To summarize clinical experience of emergent surgery for severe liver trauma with rupture of major blood vessels. Methods The clinical data of 12 cases suffering from severe liver trauma with rupture of perihepatic and intrahepatic large blood vessels were retrospectively analyzed. These cases were from Dec 2000 to May 2008. All the cases underwent emergency operation, 6 cases were treated with liver lobectomy: among those 1 case with right posterior lobe liver resection, 1 case with irregular right lobe liver resection, 3 cases with left hemihepatectomy, and 1 case with left lateral lobectomy. Seven cases with rupture of major blood vessels were treated by repair or ligature and/or packing including repair of posthepatic inferior vena though the middle fissure in 2 cases, and through retrahepatic space in one case, interrupted suture of the portal vein in 2 cases, interrupted suture of the right hepatic veins in 2 cases. Mattress suture was applied to the ruptured hepatic veins in 7 cases including mattress suture of the branch of right hepatic vein and middle hepatic vein in 1 case, mattress suture of right hepatic vein in 1 case, suture of middle hepatic vein in 2 cases, and suture of left hepatic vein in 3 cases. One case was treated with ligation of hepatic artery and 3 cases with gauzes packing. Results Among all the 12 cases, 9 cases were cured, 3 cases died: two were caused by severe trauma together with hemorrhagic shock, one by sever brain injury together with hemorrhagic shock. Conclusions Prompt operation, precise stop bleeding and correct operation style are the key for successful rescue of patients suffering from severe liver trauma and massive bleeding.