【Objective】 To study the changes of platelet components(PC), apheresis platelets (AP) and pooled platelet concentrates (PPC) production of 19 provincial blood centers before and during the COVID-19 epidemic. 【Methods】 The data related to the collection of AP and the preparation of PPC from 2016 to 2021 of 19 provincial blood centers was collected. The production of PC, AP and PPC during the four years before the epidemic (i.e. 2016-2019) and during the COVID-19 epidemic (i.e. 2020 and 2021) were calculated respectively, and the change of production was analyzed. 【Results】 The total production of PC in 19 blood centers steadily increased from 2016 to 2019, with a decrease of 4.16% in 2020 and an increase of 15.60% in 2021, exceeding the output before the COVID-19 epidemic. In 2020, the production of PC of 42.11% (8/19) blood centers decreased compared with 2019, while 94.74% (18/19) in 2021 increased compared with 2020. The changes of AP output was basically consistent with the trend of PC. The total production of PPC in 2017 and 2018 both doubled compared to the previous year, while decreased by 67.98% in 2019, increased by 30.38% in 2020 and decreased by 27.08% in 2021. 【Conclusion】 The total production of PC kept increasing steadily between 2016 and 2019, but decreased in 2020 under the COVID-19 epidemic, with some blood centers being significantly affected. In 2021, with the strong support from government and various measures by blood centers, the total production of PC increased.

Objective To analyze the recurrence of breast cancer without use of chest wall bolus during adjuvant intensity modulated radiotherapy after modified radical mastectomy, so as to investigate the necessity of bolus use. Methods A total of 218 patients undergoing adjuvant intensity modulated radiotherapy after modified radical mastectomy during the period from January 2013 to June 2019 were enrolled as the study subjects. The chest wall bolus was not used during the whole period of radiotherapy after modified radical mastectomy, and the recurrence of breast cancer in the chest wall was analyzed after radiotherapy. Results The post-surgical follow-up through outpatient records, inpatients records, local residents’ health system and telephone was performed until June 31, 2021. The proportion of follow-up was 100%, and the mean follow-up period was 48.9 months. There were three cases with breast cancer recurrence in the chest wall, including one case with recurrence in the chest wall alone and two cases with recurrence in the chest wall and regional lymph nodes, and the overall recurrence of breast cancer was 1.4% in the chest wall. Among the 3 cases with breast cancer recurrence in the chest wall, there were two cases with N3 stage and positive for HER2, and one triple-negative breast cancer case, and all three cases developed distal metastases upon local recurrence. Among 218 study subjects, there were 5 cases with grade Ⅰ radioactive skin reaction, 3 cases with grade Ⅱ radioactive skin reaction, and no grade Ⅲ or Ⅳ radioactive skin reaction occurred. In addition, no grade Ⅲ or Ⅳ acute radioactive injury was seen in the chest wall skin among the 218 study subjects. Conclusion No use of chest wall bolus may be considered during adjuvant intensity modulated radiotherapy after modified radical mastectomy in presence of systemic therapy if tumor invasion into skin is not observed prior to therapy.

Objective:To preliminarily estimate and study the effect of nucleic acid testing in blood screening on the residual risk (RR) of transfusion transmitted HBV infection (TTI HBV).Methods:Using the NAT yield/WP ratio model and adopting the relevant data of information management system of practice comparison working party in the Mainland of China, this paper analyzed the trend of the RR of TTI HBV among 18 blood centers from 2015 to 2019 in China, and compared the impact of two kinds of blood screening strategies which were ELISA+ ID-NAT/MP-NAT (individual-donation nucleic acid testing or mini-pool nucleic acid testing) and ELISA + MP-NAT on RR in 2019.Results:The overall trends of the 5-year RR of HBV among 18 blood centers showed by trend chi square test were NAT single positive rate trend χ2= 39.42( P<0.01) and residual risk trend χ2= 279.792( P<0.01); The influence on RR from the differences of ELISA+ ID-NAT/MP-NAT and ELISA+ MP-NAT was statistically significant, and chi square test showed that χ2= 7.4( P<0.01). Conclusions:Since the implementation of nucleic acid testing in the blood screening in China from 2015, the residual risk of transfusion transmitted HBV infection has decreased year by year. The observed two blood screening strategies which dominated in China may lead to discrepancy in the residual risk of TTI.

OBJECTIVE:To observe clinical efficacy and safety of butylphthalide in the treatment of Alzheimer’s disease (AD). METHODS:94 AD patients selected from our hospital during Jan. 2013-Jun. 2014 were divided into control group(45 cas-es)and observation group(49 cases). Control group was given routine treatment as nourishing nerve,lowering blood lipid,taking Memantine hydrochloride tablet orally 5 mg,bid. Observation group was additionally given Butylphthalide soft capsule orally 0.2 g,tid,on the basis of control group. Both groups were treated for consecutive 1 year. Clinical efficacy of 2 groups were observed, and MMSE,ADL,the levels of TNF-α,IL-1,CRP and BDNF were observed before and after treatment;the incidence of ADR was compared. RESULTS:The total effective rate of observation group was 85.71%,which was significantly higher than that of control group(66.67%),with statistical significance(P<0.05). There was no statistical significance in MMSE and ADL between 2 groups before treatment (P>0.05);those of 2 groups increased significantly after treatment,the observation group was higher than the control group,with statistical significance (P<0.05). There was no statistical significance in the levels of TNF-α,IL-1, CRP and BDNF between 2 groups before treatment(P>0.05). Above indexes of 2 groups were improved significantly after treat-ment,the observation group was better than the control group,with statistical significance(P<0.05). There was no statistical dif-ference in the incidence of ADR between 2 groups (P>0.05). CONCLUSIONS:Butylphthalide is effective in the treatment of AD,can improve cognitive and life skills and reduce inflammatory level with good safety.

BACKGROUNDLittle is known about the value of (31)P-magnetic resonance spectroscopy ((31)P-MRS) in in vivo assessment of exhaustive exercise-induced injury in skeletal muscle. We aimed to evaluate the value of a (31)P-MRS study using the quadriceps femoris after a single bout of acute exhaustive swimming in rats, and the correlation between (31)P-MRS and histological changes.

METHODSSixty male Sprague-Dawley rats were randomly assigned to control, half-exhaustive, and exhaustive exercise groups. (31)P-MRS of the quadriceps femoris of the right lower limb was performed immediately after swimming exercise to detect Pi, PCr, and β-ATP. The Pi/PCr, Pi/β-ATP, PCr/β-ATP, and PCr/(PCr+Pi) were calculated and pH measured. Areas under the receiver operating characteristic curve (AUCs) were calculated to evaluate the diagnostic potential of (31)P-MRS in identifying and distinguishing the three groups. HE staining, electron microscopy and desmin immunostaining after imaging of the muscle were used as a reference standard. The correlation between (31)P-MRS and the mean absorbance (A value) of desmin staining were analyzed with the Pearson correlation test.

RESULTSPi, PCr, Pi/PCr, and PCr/(PCr+Pi) showed statistically significant intergroup differences (P < 0.05). AUCs of Pi, PCr, Pi/PCr, and PCr/(PCr+Pi) were 0.905, 0.848, 0.930, and 0.930 for the control and half-exhaustive groups, while sensitivity and specificity were 90%/85%, 95%/55%, 95%/80%, and 90%/85%, respectively. The AUCs of Pi, PCr, Pi/PCr and PCr/(PCr+Pi) were 0.995, 0.980, 1.000, and 1.000 for the control and exhaustive groups, while sensitivity and specificity were 95%/90%, 100%/90%, 100%/95%, and 100%/95%, respectively. The AUCs of Pi, PCr, Pi/PCr, and PCr/(PCr+Pi) were 0.735, 0.865, 0.903, and 0.903 for the half-exhaustive and exhaustive groups, while sensitivity and specificity were 80%/60%, 90%/75%, 95%/65%, and 95%/70%, respectively. In the half-exhaustive group, some muscle fibers exhibited edema in HE staining, and the unclear Z-discs and the mitochondria with vacuolar degeneration under electron microscopy. Compared with the half-exhaustive group, muscle fiber edema was increased in the exhaustive group, and the Z-discs were broken and the mitochondria exhibited marked vacuolar degeneration under electron microscopy. There were significant difference in A values of desmin staining in the right vastus lateralis among the control, half-exhaustive, and exhaustive groups with 0.58 ± 0.06, 0.30 ± 0.04, and 0.21 ± 0.02, respectively (P < 0.05). Histological examination also showed injury-induced changes in the vastus lateralis among the different intensities groups. Statistically a moderate correlation between (31)P-MRS and desmin was observed, the correlation coefficients of Pi, PCr, Pi/PCr, and PCr/(PCr+Pi) were -0.706, 0.709, -0.726, and 0.791, respectively (P < 0.01).

CONCLUSIONS(31)P-MRS can effectively reflect the changes in energy metabolism in the skeletal muscle after a single bout of acute exhaustive swimming in rats. Based on the significant correlation between (31)P-MRS parameters and histological changes, the changes of Pi, PCr, Pi/PCr, and PCr/(PCr+Pi) can indirectly reflect the degree of exercise-induced injury.

Animals ; Energy Metabolism ; physiology ; Magnetic Resonance Spectroscopy ; methods ; Male ; Physical Conditioning, Animal ; physiology ; Quadriceps Muscle ; metabolism ; Rats ; Rats, Sprague-Dawley

Objective To study the changes of apparent diffusion coefficient（ADC）values and the feature of the cranial bone in the pituitary adenomas patients with different levels of prolactin（PRL）.Methods A total of 37 patients with pituitary adenoma and 20 healthy volunteers（serum prolactin 7.5～21.7 ng/ml,as control group G1）underwent routine MR and axial EPI-DWI scan（b=0,500 s/mm2）.The patients were divided into group G2（PRL 26.72 ng/ml,n =7）,group G3（PRL 26.72~200 ng/ml,n =17）,and group G4（PRL200 ng/ml,n =13）.The signal intensity of the interested regions（ROIs）was measured on DWI maps containing frontal,parietal,occipital bone marrow.The averaged ADC values were calculated among the 4 groups and compared with case groups and control group.The correlation between prolactin levels in patients with pituitary adenomas and ADC values of their skull bone marrow was explored.Results All patients had a hyperintensity of skull bone marrow signal on DWI maps.The ADC values of frontal,parietal and occipital bone marrow were as follows：G1（1.11±0.21,1.18±0.18,1.16±0.15×10-3 mm2/s）,G2（0.95±0.20,0.86±0.12,1.09±0.11×10-3 mm2/s）,G3（0.99±0.16,0.83± 0.21,0.98±0.25×10-3 mm2/s）,G4（0.81±0.20,0.69±0.16,0.83±0.28×10-3 mm2/s）.The ADC values of G3 and G4 were lower than those of G1（P 0.05）.There was no significant difference（P 0.05）between G2 and G1.Conclusion The ADC values of skull bone marrow were negatively correlated with serum prolactin levels in patients with pituitary adenomas.DWI examination might be beneficial for the identification of pituitary adenomas.

Objective To assess the value of contrast-enhanced computed tomography (CT) in the differentiation of benign solitary pulmonary nodules(SPN) from malignant ones.Methods Thirty-seven patients with solitary pulmonary nodules(≤3 cm phi)were examined by contrast-enhanced CT.Qualitative and quantitative characters of benign and malignant lesions were analysed after administration of Ultravist in order to evaluate the attenuation value of contrast-enhanced CT in the differentiation of benign SPN from malignant ones .Results A threshold value of 30 HU was selected on enhanced CT images to distinguish malignant( CT value≥30 HU)from benign( CT value

Objective To evaluate the correlation between the irradiation dose and superparamagnetic iron oxide (SPIO) enhanced MR imaging of the irradiated liver. Methods 25 rabbits were separated randomly into 5 groups. 3 days after focal irradiation (0, 10, 20, 30 and 40Gy), MR imaging was performed before and after SPIO injection with TSE-T 2W sequence, and the number of Kupffer cell containing SPIO particles was counted. The characteristics of MR enhancement were evaluated according to the pathological findings.Results The liver injury induced by no less than 30Gy irradiation can be detected by SPIO-enhanced T 2 weighted imaging (P

Objective To evaluate the role of dynamic contrast-enhanced magnetic resonance imaging (MRI) in the diagnose of prostatic cancer and benign prostatic hyperplasia (BPH), and to determine the correlation between dynamic MRI findings with angiogenesis.Methods Thirty-two cases of prostatic cancer and 40 cases of BPH underwent dynamic contrast-enhanced MRI.All the patients in this study were diagnosed by histopathology.The results of dynamic contrast-enhanced MRI were evaluated by early-phase enhancement parameters and time-signal intensity curves (SI-T curves), and the curves were classified according to their shapes as type Ⅰ, which had steady enhancement; type Ⅱ, plateau of signal intensity; and type Ⅲ, washout of signal intensity.The pathologic specimens of region of interest (ROI) were obtained, and HE staining, immunohistochemical vascular endothelial growth factor (VEGF), and microvessel density (MVD) measurements were performed.The relationships among dynamic contrast-enhanced MRI features, VEGF, and MVD expression were analyzed.Results In the early-phase enhancement parameters of dynamic contrast-enhanced MRI, onset time,maximum signal intensity, and early-phase enhancement rate differed between prostatic cancer and BPH(P

Objective To investigate the MR features of adenomyosis and its diagnostic value.Methods Forty-six patients with suspicious adenomyosis underwent preoperative ultrasound and MR exam.Inversion recovery sequence(IR)T 1-weighted images and turbo spin echo sequence(TSE)including T 1-weighted and T 2-weighted images were adopted.All patients were performed with contrast enhancement.Comparative analysis between MRI findings and pathology results was done. Results The diagnostic specificity,sensitivity and accuracy of MRI was 100%,94.74% and 97.14% respectively.The effect of MRI for diagnosis of adenomyosis was better than that of US significantly.All cases showed enlargement of uterus with regular contour.Diffuse and local thickening of junctional zone or low signal intensity lesion in outer myometrial layer was found on T 2-weighted images,sometimes bright foci observed in lesion on T 2-weighted images or on T 1-weighted images.Conclusion MRI has high value in gualitative diagnosis and localization of adenomyosis.It can be used as an important complementary method to ultrasound.