Objective To analyze the relationship between serum hyaluronic acid levels and Child classification of liver function in Steatosis patients. Methods A total of 110 Steatosis patients admitted to Shaanxi People's Hospital from January 2017 to September 2018 were selected There were 23 cases in Child a group, 52 cases in Child B group and 35 cases in Child C Group. Sex, age, body mass index (BMI) and serum hyaluronic acid (ha) were compared among the three groups. Results There were no significant differences in sex, age and BMI among Child A, Child B and Child C groups (P>0.05) . The level of serum hyaluronic acid in Child class C (91.39±24.67) was significantly higher than that in Child class B (38.26.9.36) and Child class A (29.55±6.97)（P<0.05）. There was no significant difference in serum hyaluronic acid levels between Child B (38.26.9.36) and Child A (29.55 ± 6.97) groups (P > 0.05). Conclusion Serum hyaluronic acid levels are high in Steatosis patients with poor liver function.

Objective To investigate the expression and prognostic significance of serum protease C1 inhib-itor(SERPING1)and plasminogen activator inhibitor type 1(SERPINE1)in patients with sepsis.Methods A total of 132 patients with sepsis treated in the hospital from March 2018 to March 2020 were se-lected as the sepsis group.According to whether they died within 28 days of admission,they were divided into a death group(n=34)and a survival group(n=98).Enzyme linked immunosorbent assay was used to detect the expression of serum SERPING1 and SERPINE1.Multivariate Logistic regression model and receiver oper-ating characteristic curve were used to study the value of serum SERPING1 and serpine1 in evaluating the prognosis of patients'death.Results[Compared with the control group,serum SERPING1(331.12±51.80 ng/L vs.639.04±91.12 ng/L)was lower and serum serpine1(412.67±64.84 ng/L vs.42.33±10.32 ng/L)was higher in the sepsis group,and the differences were statistically significant(P＜0.05).[Compared to the survival group,the levels of serum SERPINE1,procalcitonin,C-reactive protein,Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score and Sequential Organ Failure Assessment(SOFA)score in the death group were higher,while serum SERPING1 was lower,and the differences were statistically significant(all P＜0.05).Serum SERPING1 showed negative correlation with APACHE Ⅱ and SOFA scores(r=-0.779,-0.653,P＜0.05),while serum SERPINE1 showed positive correlation with APACHE Ⅱ and SO-FA scores(r=0.740,0.685,P＜0.05).APACHE Ⅱ score,SOFA score,and serum SERPINE1 were risk fac-tors affecting the prognosis of sepsis patients,while serum SERPING1 was a protective factor.The area under the curve of serum SERPING1 and SERPINE1 combined for the evaluation of the death in sepsis patients was 0.938(95％CI:0.893-0.968),which was significantly higher than 0.860(95％CI:0.812-0.899)and 0.838(95％CI:0.781-0.868)of the single detection,and the differences were statistically significant(Z=3.861,4.015,P＜0.001).Conclusion The elevated levels of serum SERPING1 and SERPINE1 in patients with sepsis are related to the severity of the patient's condition.The combination of the two has high prognos-tic value for sepsis patients.

Objective:To evaluate the performance of an artificial intelligent (AI)-based automated digital cell morphology analyzer (hereinafter referred as AI morphology analyzer) in detecting peripheral white blood cells (WBCs).Methods:A multi-center study. 1. A total of 3010 venous blood samples were collected from 11 tertiary hospitals nationwide, and 14 types of WBCs were analyzed with the AI morphology analyzers. The pre-classification results were compared with the post-classification results reviewed by senior morphological experts in evaluate the accuracy, sensitivity, specificity, and agreement of the AI morphology analyzers on the WBC pre-classification. 2. 400 blood samples (no less than 50% of the samples with abnormal WBCs after pre-classification and manual review) were selected from 3 010 samples, and the morphologists conducted manual microscopic examinations to differentiate different types of WBCs. The correlation between the post-classification and the manual microscopic examination results was analyzed. 3. Blood samples of patients diagnosed with lymphoma, acute lymphoblastic leukemia, acute myeloid leukemia, myelodysplastic syndrome, or myeloproliferative neoplasms were selected from the 3 010 blood samples. The performance of the AI morphology analyzers in these five hematological malignancies was evaluated by comparing the pre-classification and post-classification results. Cohen′s kappa test was used to analyze the consistency of WBC pre-classification and expert audit results, and Passing-Bablock regression analysis was used for comparison test, and accuracy, sensitivity, specificity, and agreement were calculated according to the formula.Results:1. AI morphology analyzers can pre-classify 14 types of WBCs and nucleated red blood cells. Compared with the post-classification results reviewed by senior morphological experts, the pre-classification accuracy of total WBCs reached 97.97%, of which the pre-classification accuracies of normal WBCs and abnormal WBCs were more than 96% and 87%, respectively. 2. The post-classification results reviewed by senior morphological experts correlated well with the manual differential results for all types of WBCs and nucleated red blood cells (neutrophils, lymphocytes, monocytes, eosinophils, basophils, immature granulocytes, blast cells, nucleated erythrocytes and malignant cells r>0.90 respectively, reactive lymphocytes r=0.85). With reference, the positive smear of abnormal cell types defined by The International Consensus Group for Hematology, the AI morphology analyzer has the similar screening ability for abnormal WBC samples as the manual microscopic examination. 3. For the blood samples with malignant hematologic diseases, the AI morphology analyzers showed accuracies higher than 84% on blast cells pre-classification, and the sensitivities were higher than 94%. In acute myeloid leukemia, the sensitivity of abnormal promyelocytes pre-classification exceeded 95%. Conclusion:The AI morphology analyzer showed high pre-classification accuracies and sensitivities on all types of leukocytes in peripheral blood when comparing with the post-classification results reviewed by experts. The post-classification results also showed a good correlation with the manual differential results. The AI morphology analyzer provides an efficient adjunctive white blood cell detection method for screening malignant hematological diseases.

Objective:To explore the effects of two dimensional gray-scale blood flow imaging (hereinafter referred to as " B-flow" ) combined with color Doppler flow imaging (CDFI) in guiding arterial puncture and catheterization through wounds in patients with large burns.Methods:Sixty-seven patients with large burns who met the inclusion criteria and hospitalized in the First Hospital of Jilin University from January 2017 to January 2019 were enrolled in the prospectively randomized control study. According to the random number table, CDFI alone group was allocated with 35 patients (23 males and 12 females) and B-flow+ CDFI group with 32 patients (22 males and 10 females), aged 19-60 and 18-58 years, respectively. According to the progress of the disease, arterial puncture and catheterization were performed in the right time. During the operation, CDFI was used alone for guidance in patients of CDFI alone group, while B-flow and CDFI were used together for guidance in patients of B-flow+ CDIF group. Based on the first time of catheterization, the catheterization location, one-time catheterization success rate, post-back stitching re-catheterization success rate, catheterization failure rate, catheterization duration, and incidences of wound sepsis, catheter-related bloodstream infection, and arterial thrombosis within post catheterization day (PCD) 3 of patients in the two groups were recorded. Data were statistically analyzed with the independent-sample t test, chi-square test or Fisher′s exact probability test. Results:(1) All the patients underwent catheterization through wounds, and there was no statistically significant difference in catheterization location of patients between the two groups ( &chi;2=0.574, P>0.05). The one-time catheterization success rate of patients in B-flow+ CDFI group was 81.25% (26/32), which was obviously higher than 51.43% (18/35) in CDFI alone group ( &chi;2=6.594, P<0.05). The catheterization failure rate of patients in B-flow+ CDFI group was 3.12% (1/32), which was obviously lower than 20.00% (7/35) in CDFI alone group ( P<0.05). The post-back stitching re-catheterization success rate of patients was similar between the two groups ( &chi;2=1.029, P>0.05). (3) The catheterization duration of patients was (15.7±1.1) min in B-flow+ CDFI group, which was obviously shorter than (17.1±2.2) min in CDFI alone group ( t=11.316, P<0.01). (4) Within PCD 3, the incidences of wound sepsis and catheter-related bloodstream infection of patients in CDFI alone group were 2.86% (1/35) and 0, close to 0 and 3.12% (1/32) in B-flow+ CDFI group ( P>0.05); the incidence of arterial thrombosis of patients in B-flow+ CDFI group was 0, which was obviously lower than 20.00% (7/35) in CDFI alone group ( P<0.05). Conclusions:Compared with CDFI alone, B-flow combined with CDFI can improve the success rate of arterial puncture and catheterization through wounds in large area burn patients, shorten the catheterization duration, and effectively reduce the incidence of arterial thrombosis after catheterization, with a good clinical application value.

Objective:To evaluate the efficacy and safety of anti-human T lymphocyte porcine immunoglobulin (P-ATG) with recombinant human tumor necrosis factor-α receptor Ⅱ:IgG Fc fusion protein (rhTNFR∶Fc, Etanercept) on grade Ⅲ/Ⅳ acute graft-versus-host disease (aGVHD) after allogenic hematopoietic stem cell transplantation (allo-HSCT) .Methods:Thirty-five patients with Grade Ⅲ/Ⅳ aGVHD who received P-ATG with etanercept therapy after allo-HSCT were retrospectively analyzed. P-ATGs (5 mg·kg -1·d -1) were administrated for 3 to 5 days, and then 5mg/kg was sequentially administrated, QOD to BIW. Etanercepts were administrated 25 mg, twice a week (12.5 mg, BIW for pediatric patients) . Results:Among the 35 patients with grade Ⅲ/Ⅳ aGVHD, 21 were males and 14 females, with a median age of 10 (3-54) years. A total of 19 cases of acute myeloid leukemia, 13 of acute lymphoblastic leukemia, 1 of severe aplastic anemia, 1 of myelodysplastic syndrome, and 1 of mixed phenotypic acute leukemia were noted. The overall response (OR) rate of P-ATG with etanercept was 85.7% (30/35) , with complete response (CR) and partial response (PR) rates of 34.3% (12/35) and 51.4% (18/35) , respectively, on day 28. The OR rate of grade Ⅲ aGVHD group was higher than of grade IV aGVHD group [100% (19/19) vs. 68.8% (11/16) , P=0.004]. On day 56, the OR rate became 77.2% (27/35) , with CR and PR rates of 62.9% (22/35) and 14.3% (5/35) , respectively. The OR rate of grade Ⅲ aGVHD group was also higher than of grade Ⅳ aGVHD group [89.5% (17/19) vs. 62.5% (10/16) , P=0.009]. Thirty-five patients had no adverse effects such as fever, chills, and rash during the P-ATG infusion, and no obvious liver and kidney function damage was observed after treatment. The main treatment-related complication was infection. The reactivation rates of CMV and EBV were 77.1% (27/35) and 22.9% (8/35) , respectively, and the bacterial infection rate was 48.6% (17/35) . With a median follow-up time of 13 (1-55) months after HSCT, the 1-year and 2-year OS rates were (68.1±8.0) % and (64.3±8.4) % , respectively. The 1-year OS rate of grade Ⅲ aGVHD group was superior to grade Ⅳ aGVHD group [ (84.2±8.4) % vs. (47.6±13.1) % , &chi;2=3.38, P=0.05]. Conclusion:This study demonstrated that P-ATG with etanercept was effective and safe in treating grade Ⅲ-Ⅳ aGVHD after allo-HSCT.

Qi arrival is the meridian qi response to acupuncture stimulation. Through analyzing the relevant concepts of qi arrival and summarizing the general understanding of it in clinic and on the basis of the collection of the relevant literature at home and abroad on the determination of qi arrival and its strength, the characteristics are analyzed on the present method and the method for the determination of qi arrival and its strength is discussed in terms of the results in the needling sensation scale. It is believed that the needling sensation and its strength can be used to determine whether the qi is arrived or not and its strength. The components of different types of needling sensation are much better applicable for the analysis on the characteristics and rules on the influence on qi arrival. This method is in compliance not only with the theoretic connotation of qi arrival, but also with the clinical general understanding, which lays the foundation for the analysis on the scale results.
Acupuncture Therapy ; instrumentation ; methods ; Humans ; Meridians ; Qi ; Sensation

From the time of Neijing (Internal Classic) and Nanjing (Classic of Medical Problems) till the end of Qing dynasty, the medical scholars of each dynasty had taken the recognition of deqi as the subject in the stud- ies. Through the historical analysis, the content of regulating deqi was further understood in relevant ancient liter- ature. By checking the ancient works of acupuncture in each dynasty till the end of Qing dynasty, in reference to the evidences in over 10 works, such as Zhenjiu Dacheng (Great Compendium of Acupuncture and Moxibustion) , Zhenjing Zhinan (Instruction of Acupuncture Canon), Zhenjiu Daquan, and in association with the academic views of acupuncture masters in modern time, it was discovered that the medical scholars after the time of Neijing and Nanjing had enriched the understandings of deqi, such as the connection of cold and heat reaction, radiation to the affected site, reinforcing and reducing purpose in qi regulation. The methods of deqi regulations had, been explored till the end of Qing dynasty since the time of Neijing and Nanjing and the understandings of it were vari- ous among scholars.
Acupuncture Therapy ; history ; methods ; Books ; history ; China ; History, Ancient ; Humans ; Medicine in Literature ; Qi ; history ; Sensation

Objective To explore the feasibility of using short-latency somatosensory evoked potentials (SLSEP) to quantitate Deqi.Methods A randomized crossover controlled trial was carried out. Healthy subjects were enrolled and allocated to treatment (thick needle, deep insertion and manipulation for Deqi) and control (thin needle, shallow insertion and no manipulation without Deqi) groups. Somatosensory evoked potentials were recorded before, during and after acupuncture. Deqi was assessed using the score scale in the subjets. The effects of Deqi and no Deqi at point Sanyinjiao (SP 6) on the potentials were observed.Results The preliminary exploration of the feasibility by the trial test showed that the effect of Deqi on short-latency somatosensory evoked potentials had certain regularity. It was worthy to be observed.Conclusion The plan is feasible. The formal test can be conducted.

Acupuncture-moxibustion theory believes that needling sensation is a crucial factor in influencing acupuncture efficacy. Judgment of occurrence of needling qi (qualitative measurement) and the intensity of needling qi (quantitative measurement) is the key section in studying the relationship between needling qi and efficacy. According to the relevant literatures, the judgment of the occurrence of needling qi mostly depended on the needling sensations, while a small amount of researches mentioned self-determined threshold or range of needling qi; the quantity of needling qi was measured by factor analysis, Massachusetts General Hospital Acupuncture Sensation Scale (MASS) based on exponential smoothing method, weighted average, addition of needling sensation score, etc. This article holds that the needling qi should be divided into two parts: overall needling qi and needling sensation components, the former referring to the occurrence and intensity of needling qi, and the latter for judging the different sensations and intensity. Currently, the studies on needling qi and efficacy should begin with single treatment at single point and multiple treatments at multiple points, to generally estimate the quality and quantity of needling qi, for seeking a qualitative and quantitative measurement in accordance with both acupuncture-moxibustion theory and clinical practice.

ObjectiveTo explore the relation between the uterine position and acupoint effect by analyzing the data of a clinical trial of electroacupuncture in treating primary dysmenorrhea.MethodThe uterine position was detected by ultrasonic examination;Visual Analogue Scale (VAS) was used to evaluate the pain degree before and after intervention; Retrospective Symptom Scale (RSS) was adopted to determine the improvement of symptoms.ResultThere were no significant differences in comparing the VAS score, real-time effect and post-treatment effect, and effective rate among different uterine positions (P>0.05). Electroacupuncture at Sanyinjiao (SP 6) can produce a real-time effect in releasing abdominal pain and relevant symptoms of dysmenorrhea in patients with anteversion of uterus, a less significant effect was shown in patients with retroposition of uterus, while no effect was shown in patients with uterus at middle position.ConclusionElectroacupuncture at Sanyinjiao possibly has a specific effect in releasing abdominal pain and relevant symptoms of dysmenorrhea at anteversion of uterus, and the uterine position may be related to the corresponding meridians and Zang-fu organs. The current statistical result indicates that there is no relation between the uterine position and the effect of Sanyinjiao, but this conclusion still needs proving by prospective randomized controlled clinicaltrials.