Objective To explore application value of transaxillary single-port gasless endoscopic-assisted fibroadenomas excision in adolescents.Methods A retrospective analysis was conducted on clinical data of 60 cases of fibroadenoma from June 2019 to June 2023.The patients were 17.3(range,13-19)years old.There were 54 cases of unilateral tumors and 6 cases of bilateral tumors.The average number of tumors was 2.5(range,1-13),and the mean tumor diameter was 4.0(range,3-10)cm.The fibroadenoma excision was performed by using transaxillary single-port gasless endoscopy.Results Of the 60 patients,the average operation time was 64.9(range,35-130)min and the intraoperative blood loss was less than 20 ml.Postoperative complications occurred in 5 cases(8.3％).At 3 months after surgery,the psychosocial well-being scores of BREAST-Q Scale were increased from(79.2±8.9)to(83.4±9.9)(P＜0.001).Conclusion Transaxillary single-port gasless endoscopic-assisted fibroadenomas excision is safe and effective for multiple or large fibroadenomas in adolescents,offering minimal invasion and concealed incision.

Objective To investigate the effect of nicotine on coagulation in intestinal ischemia-reperfusion injury rats.Methods 32 male Sprague-dawley rats,weighing 250-300g,were randomly divided into 4 groups(n=8):sham operation group(S),intestinal ischemia-reperfusion(IR)group,nicotine(NIC)group,α7 nicotinic acetylcholine receptor(α7nAchR)antagonist group α-bungarotoxin(α-BGT)group.Intestinal IR was induced by clamping superior mesenteric artery for 45min and 120min of reperfusion.In group NIC nicotine 400μg/kg was injected intraperitoneally at 30min before superior mesenteric artery occlusion.In group α-BGT 1μg/kg was injected intraperitoneally at 15min before superior mesenteric artery occlusion.Plasma tumor necrosis factor-α(TNF-α),tissue factor(TF),antithrombin(AT),tissue plasminogen activator(tPA),fiber plasminogen activator inhibitor-1(PAI-1),D-dimer levels and platelet count(PLT)were measured after 120min reperfusion.Chiu's count was used to assess the changes in intestinal mucosal pathlolgical morphology.Results Compared with group S and group NIC,the plasma TNF-α,TF,tPA,PAI-1 and D-dimer levels were significantly increased,and plasma AT level and platelet count were significantly decreased,in group IR and group α-BGT(P<0.05),Chiu's scores were significantly increased(P<0.05).Conclusion Nicotine can inhibit the excessive activation of coagulation function in intestinal ischemia-reperfusion injury rats.Its mechanism may be related to activation of cholinergic antiinflammatory pathway,reducing the release of pro-inflammatory cytokines thereby reducing endothelial cell injury.

【Objective】 To analyze the basic characteristics of whole blood donors from blood stations before and after the outbreak of COVID-19. 【Methods】 After excluding invalid data, data related to the basic characteristics of whole blood donors collected from 26 blood stations in China during 2018 to 2021 were statistically analyzed, including the trend of total whole blood donors, the number of repeated blood donors, the frequency of blood donation, the average age of donors and the recruitment of first-time blood donors. 【Results】 Affected by the epidemic, 8 out of 14 indicators were with large variations, accounting for 57%. The overall growth rate of total whole blood donors during the epidemic was higher than before the epidemic (P<0.05).The number of repeated blood donors has shown an increased trend, with a higher number during the epidemic than before (P<0.05). The frequency of blood donation was lower during the epidemic than before(P<0.05).Average ages of blood donors and female blood donors fluctuated widely during the epidemic, both higher than those before the epidemic(P<0.05).The donation rate of first-time blood donors <25 years old and ≥25 years old varied widely and irregularly during the epidemic (both P<0.05). The percentage of first-time blood donors fluctuated irregularly during the epidemic, with overall percentage lower than that before the epidemic(P<0.05). 【Conclusion】 Whole blood donors from 26 blood stations increased after the outbreak of COVID-19, and some indicators in certain areas showed significant fluctuations during the epidemic.

As a sensor of cytosolic DNA, the role of cyclic GMP-AMP synthase (cGAS) in innate immune response is well established, yet how its functions in different biological conditions remain to be elucidated. Here, we identify cGAS as an essential regulator in inhibiting mitotic DNA double-strand break (DSB) repair and protecting short telomeres from end-to-end fusion independent of the canonical cGAS-STING pathway. cGAS associates with telomeric/subtelomeric DNA during mitosis when TRF1/TRF2/POT1 are deficient on telomeres. Depletion of cGAS leads to mitotic chromosome end-to-end fusions predominantly occurring between short telomeres. Mechanistically, cGAS interacts with CDK1 and positions them to chromosome ends. Thus, CDK1 inhibits mitotic non-homologous end joining (NHEJ) by blocking the recruitment of RNF8. cGAS-deficient human primary cells are defective in entering replicative senescence and display chromosome end-to-end fusions, genome instability and prolonged growth arrest. Altogether, cGAS safeguards genome stability by controlling mitotic DSB repair to inhibit mitotic chromosome end-to-end fusions, thus facilitating replicative senescence.

【Objective】 To investigate the status of blood safety and the effectiveness of preventive measures. 【Methods】 The data of Fengxian Blood Bank from 2018 to 2020 were extracted from Shanghai blood collection and supply information system. HBsAg sero-conversion samples of repeated blood donors were confirmed, and HBV serologic supplemental test were performed to obtain the number of new infections during the blood donation interval. The incidence and residual risk of HBV infection were evaluated by the sero-conversion model in donation intervals for repeated donors, and residual risk trend between the study period of 2002 to 2005, 2007 to 2011, 2011 to 2013 and 2018 to 2020 was compared. 【Results】 During 2018~2020, nine new HBV infections occurred among repeated donors during blood donation interval, with an incidence rate of 2.71 per 10 000. The residual risk of window period HBV transmission by transfusion could be reduced by 58.33% using HBsAg test plus NAT (HBsAg test 1∶30 637 vs HBsAg test plus NAT 1∶73 529). The residual risk of HBV transmission was decreasing when stratifying by periods, especially one order of magnitude dropped in 2018~2020 as in comparison of 2002 to 2005. 【Conclusion】 The residual risk of HBV transmission by transfusion showed a decrease trend. Although NAT could greatly reduce the risk, comprehensive preventive measures are needed to further reduce the risk.

Objective Newborn bilirubin encephalopathy seriously threatens the life and health of newborns, Both the mortality and morbidity are high.Cerebrospinal fluid bilirubin concentration can better reflect the blood-brain barrier function and brain bilirubin levels, which can help the diagnosis of bilirubin encephalopathy.Methods In order to meet the clinical needs, we confirmed the detection performance of the existing serum bilirubin detection system for cerebrospinal fluid bilirubin, including precision, accuracy and analysis of measurement range.Results The results showed that the detection system was linear at 1.0-25.1μmol/L, and the daytime CVat normal and pathological values was less than the precision requirement (6％) .The bias of each sample and the average bias are less than the allowable bias (5％) , the total error is less than the total allowable error (15％) .Conclusion Therefore, the performance of the detection system meet the industry standards, can be used for neonatal cerebrospinal fluid bilirubin detection.

Objective To raise awareness of the late-onset meningitis caused by group B streptococcus (GBS) which was homogenous to the maternal colonization.Methods The clinical data of late-onset GBS meningitis in neonates twins whose pathogens were homogenous to their maternal colonization were collected from Department of Neonatology,Guangzhou Women and Children's Medical Center.The general conditions,clinical symptoms,laboratory tests and drug treatment of the twins and their mother were retrospectively analyzed,and the GBS homology during inpatient care was tested.And the progress of the twins' condition was investigated by telephone follow-up.Results The mother had two pregnancies without prenatal GBS screening or intrapartum antimicrobial intervention for GBS,everything was normal during pregnancy and delivery.Twins were born through cesarean section.The elder sister was discharged with Linezolid taken orally after 167 days in hospital without convulsions,shaking or other discomfort.The elder sister was followed up for every 2 weeks,and in the last time of follow-up,cerebrospinal fluid white blood cell counts were 45 × 106/L,protein level was 1.52 g/L and Linezolid was withdrawn.The younger brother was discharged after 58 days in hospital with follow-up for every 2 weeks,and in the last time of follow-up,cerebrospinal fluid white blood cell counts were 30 × 106/L,protein level was 0.66 g/L.During the hospitalization and follow-up without convulsions and irritation,and the cranial magnetic resonance imaging of the twin brother was normal.Test results showed that the GBS bacteria strain for twins and their mother were all serotype Ⅲ.The possibility of the GBS homology was more than 90％.Conclusions The toxicity of serotype Ⅲ GBS strain was strong.More proactive precautions should be considered to apply for the mother whose first birth already had GBS infection.Early identification and intervention of infection risk factors would help optimize the anti-infection treatment program and reduce nerve system damage and other adverse outcomes caused by invasive GBS infection.

Objective To explore the effects of different nutritional pathways on nutrition metabolism and respiratory muscle strength in critical elderly patients in Intensive Care Unit (ICU). Methods Totally 99 critical patients admitted in the ICU of Shandong Provincial Third Hospital between January and September 2017 and were equally randomized into enteral nutrition group (EN group), parenteral nutrition group (PN group) and enteral nutrition plus parenteral nutrition group (EN+PN group), which received nutritional support via different pathways. The patients' hemoglobin (Hb), plasma albumin (ALB) and nitrogen balance were measured 7 days post nutritional support; the maximal inspiratory pressure (PImax) was monitored; and the nutritional status and respiratory muscle strength were compared in the patients receiving nutritional support via different pathways. Results After 7 days' nutritional support, EN+PN group showed better Hb (133.52±12.96) g/L, ALB (40.16±4.42) g/L and nitrogen balance (-4.31±1.67) g than PN group and EN group (F=5.602, 4.594, 2.854; P＜0.05). The PImax of EN+PN group was (-34.52±12.96) cmH2O, which was better than EN group and PN group (F=3.651, P＜ 0.05). Conclusions The combined EN and PN support has better effects on improving the nutritional status and respiratory muscle strength in critical elderly patients as compared to simply using EN or PN, and it also shows better short-term clinical outcomes than simply using EN or PN.

This study aimed at exploring the inhibitory effect behind its mechanism on acid-soluble polysaccharides from G.incamatum in transplanted H22 tumor mice.Different indices,including tumor inhibitory rate,organ index of liver,thymus and spleen,IL-2,IFN-γ and TNF-α were detected for the evaluation of anti-tumor effects and the mechanism.Furthermore,HE staining and TUNEL assay were adopted to investigate the pathological changes of tumor tissue and cell apoptosis,respectively.As a result,the three dose groups of acidsoluble polysaccharides of G.incamatum successfully inhibited the proliferation of tumor cells,while organ indexes of spleen and thymus were improved and serum IL-2,IFN-γ and TNF-α increased.H&E staining and TUNEL assay showed the polysaccharides induced cell apoptosis,playing a significant role in the inhibition of tumor growth.In conclusion,acid-soluble polysaccharides of G.incamatum possessed significant anti-tumor effects,behind which the mechanism could be related to the regulation of immune regulation,cell apoptosis,and the protection of liver function.

Objective: To explore the clinical features and prognosis in patients with Takayasu arteritis (TA) combining neurological symptoms. Methods: We retrospectively studied 274 TA patients combining neurological symptoms who admitted to our hospital from 2002-01 to 2013-10 for their clinical and imaging features with prognosis. Results: The ratio of male to female was 1:4.3 and the mean age of disease onset was at (28.2±11.2) years. The most common neurological symptom was dizziness (214/274 cases, 78.1%), most frequent type was type III TA (112 cases, 40.9%), most common affected artery was left subclavian artery (147 cases, 53.6%), and there were 77 cases (28.1%) with (3-4) branches of the aortic arch involvement. For stroke conditions, ischemic stroke was more frequently observed in patients with steno-occlusive lesions in subclavian artery and common carotid artery, while hemorrhagic stroke was more frequently found in patients with steno-occlusive lesions in descending aorta, abdominal aorta and/or renal artery. Heart failure was the most common cause of death, it was also the most common cardiovascular event in surviving cohorts. Conclusion: TA patients could have many neurological symptoms, which were related to the number and site of artery involvement.