【Objective】 To investigate whether the blood donors' coagulation status may lead to apheresis platelet aggregation in vitro. 【Methods】 Thirty blood donors with aggregation in apheresis platelets collected by AMICUS blood cell separator no less than 3 times previously and occurred when the last time of apheresis donation were observed in aggregated group (referred to as the experimental group); Thirty donors without aggregation in apheresis platelets collected by AMICUS blood cell separator no less than 3 times were observed in the control group simultaneously. The basic platelet parameters in the two groups, including Plt, MPV, PDW, Pet, P-LCR were detected by automatic blood cell analyzer (BC-3000Plus), and thromboelastogram indexes including reaction time(R), kinetics time(K), kinetics of clot development(α), maximum amplitude (MA) and coagulation index(CI) were tested by Thrombosis elastography (TEG) before collection. With SPSS24.0 software, t test was used to compare the differences between the two groups. 【Results】 The CI value in experimental group was significantly different from that of the control group (0.48± 1.00 vs -0.99 ±1.96, P< 0.05), and there was no significant difference in all above basic platelet parameters and other TEG parameters (P>0.05 ) . 【Conclusion】 The coagulation status of blood donors may be an independent risk factor for the in vitro aggregation of apheresis platelets.

Objective:To evaluate the role of Dorea in glucose intolerance of people with obesity. Methods:This study recruited 113 young individuals with obesity and varying degree of glucose tolerance [body mass index(BMI)≥30 kg/m 2] and 105 controls, comparing the metabolic phenotypes and Dorea abundance. Correlation analysis and ROC analysis were performed to assess the association between Dorea and clinical parameters and its predictive role in predicting glucose intolerance. Results:(1) Metabolic parameters were higher in obesity group than the control group. There was no difference in body weight, BMI and WHR among subgroups classified by glucose tolerance in people with obesity. (2) The abundance of Dorea, Dorea formicigenerans were higher in obese individuals, however showing a downward trend in accordance with glucose intolerance. The abundance was inversely associated with OGTT-2 h plasma glucose and HbA 1C, while positively associated with HOMA-β. Logistic regression demonstrated that Dorea formicigenerans was an independent protective factor after adjusting confounders such as age and gender in the prevention of glucose intolerance. (3) ROC analysis exhibited that the AUC values of Dorea formicigenerans was 0.73 in the total population. Conclusion:Dorea and Dorea formicigenerans exert protective effect on glucose metabolism in obese subjects. The abundance of Dorea and Dorea formicigenerans can be used as predictors of glucose intolerance risk in obese subjects, which facilitate the early screening and monitoring.

Cyperi Rhizoma is a common Chinese medicine in clinical practice， which has a long history of processing. In order to sort out the process of its processing， starting with the angle of processing excipients， the historical evolution and developmental venation of Cyperi Rhizoma processing were analyzed and summarized by consulting relevant literature of ancient medical records and modern codes. After combing the ancient and modern literature， it was found that there were many processing methods of Cyperi Rhizoma， the processing methods without auxiliary materials included frying， boiling， steaming and so on， and the adding auxiliary materials included vinegar， ginger， salt， multiple excipients， etc. However， with the evolution of history， some characteristic excipients have gradually disappeared， while vinegar-processed products are mainly used in modern times. Meanwhile， processing methods of Cyperi Rhizoma are well documented in various processing standards， the phenomenon of multiple methods adopted in one place and different methods in different places exists， which lacks unified quality standards and leads to uneven quality of Cyperi Rhizoma decoction pieces， which may even affect the safety and effectiveness of its clinical medication. Based on this， the problems existing in the processing research of Cyperi Rhizoma were analyzed in this paper， and made an outlook on the inheritance of the ancient processing methods and the quality standard improvement of the decoction pieces， in order to provide important literature evidence and theoretical support for the study of processing process and mechanism of Cyperi Rhizoma.

Objective:To investigate the correlation between the uterine incisional hematoma following cesarean section and scar diverticulum.Methods:This is a retrospective study involving 1 939 women who underwent cesarean section for the first time at the People's Hospital of Longhua Shenzhen from January 2020 to December 2021. Women with uterine incisional hematoma were selected as the hematoma group ( n=149) and were further divided into the dehiscence group, including patients with uterine incisional dehiscence caused by hematoma, and non-dehiscence group, including those without uterine incisional dehiscence. The patients without uterine incisional hematoma during the same period were selected as the control group ( n=110). The incidence of scar diverticulum after uterine incision healing and the long-term outcomes in the two groups were compared. Statistical analysis was performed using a t-test or Chi-square test. Results:(1) The incidence of uterine incisional hematoma was 7.7% (149/1 939). In the 149 cases with uterine incisional hematoma detected by postoperative ultrasonography, 74 were in the dehiscence group and 75 in the non-dehiscence group. (2) The number of women developing cesarean section scar diverticulum was 41, with an incidence of 2.1% (41/1 939), and all of them were in the hematoma group, accounting for 27.5% (41/149). The proportion of women who developed scar diverticulum in the dehiscence group was higher than that of the non-dehiscence group [52.7% (39/74) vs. 2.7% (2/75), χ2=35.96, P<0.001]. (3) The incidence of scar diverticulum in patients with uterine incisional dehiscence caused by intra-incision hematoma, intra- and posterior incision hematoma, as well as a combination of intra-, anterior, and posterior incision hematoma were 10/18, 55.1% (27/49), and 2/2, respectively. None of the five patients with uterine scar diverticulum were caused by anterior incision hematoma plus partial intra-incision hematoma. The incidence of scar diverticulum was 2.7% (2/75) in the non-dehiscence group. (4) Among the 41 cases with scar diverticulum, ultrasound re-examination by postpartum 6-24 months found that the results of 40 (97.6%) cases were consistent with the last ultrasound findings. A small "v"-shaped scar diverticulum was observed in another patient by ultrasound 42 d after delivery, which disappeared in a re-examination 13 months after surgery. Conclusions:Uterine incisional hematoma is associated with scar diverticulum following cesarean section. Uterine incisional dehiscence due to hematoma may be an influencing factor for diverticulum formation.

Objective:To explore the application of the Simodont dental trainer in preclinical manual dexterity training for dental students of different grades, and to discuss its effect by quantitatively evaluating their practice results.Methods:The evaluation was conducted among 118 students in the Department of Stomatology, Shantou University Medical College from Batch 2015 to Batch 2018. Each student had five different manual dexterity modules for training. Each module had three levels of difficulty and was required to be completed in 30 minutes. The assessment index included Target, Leeway Bottom and Sides, Container Bottom and Sides, which was provided by the Simodont dental trainer. The operating time (in seconds), the displacement of the dental hand pieces and the dental mirrors (in meters) were simultaneously recorded. SPSS 25.0 was used for statistical analysis.Results:For the index Target, Leeway Bottom and Sides, Container Bottom and Sides, the results showed that there was a statistical difference between students who passed pre-clinical training and who did not take the professional course ( P < 0.001). For the index Target, differences were showed among students from different grades in all modules ( P < 0.001). Conclusion:The circle module, channel module, hollow-circle module and cross-module in the Simodont dental trainer have sensitivity to discriminate the manual dexterity of different levels of dental students. The further assessment of the discrimination of the manual dexterity is required for assume-block module. The Simodont dental trainer can quantitatively measure the manual dexterity of dental students, which is important for the quantitative evaluation of dental preclinical education.

Objective To systematically evaluate the therapeutic effect of pulse high volume hemofiltration (PHVHF) for treatment of patients with sepsis. Methods Databases such as PubMed in American National Medical Library, Holland medical abstract Embase, the Cochrane Library, China National Knowledge Internet (CNKI), China Biological Medical Literature Database (CBM), VIP, WanFang databases, etc. were searched by computer to retrieve randomized controlled trials (RCTs) on PHVHF for treatment of patients with sepsis, and the retrieval time ranged from the creation of database to March 25, 2017. Both groups of patients received conventional treatments, including antibiotics, fluid resuscitation, vasoactive agents as well as other organ function support treatments to maintain the basic vital signs stable. Patients in PHVHF group received PHVHF besides conventional treatment, while the patients in control group received conventional treatment or any other continuous renal replacement therapy (CRRT) mode with PHVHF excluded. The literatures accepted should at least include one of the following changes of outcome indicators, such as overall mortality, the levels of inflammatory mediators eliminated, acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ) score, service life of filter, amount of replacement fluids used. Two researchers independently screened literatures, extracted data, and assessed the methodological quality of included studies. Meta-analysis was conducted by using RevMan 5.3 software and the publication bias was evaluated by visually inspecting funnel plots. Results A total of 11 RCTs involving 410 patients met eligibility criteria, of which 204 patients in the PHVHF group and 206 patients in the control group. In the control group 5 RCTs used other CRRT modes, and 6 RCTs applied the conventional therapy. Meta-analyses showed that interleukin-6 [IL-6, standard mean difference (SMD) = -0.80, 95% confidence interval (95%CI) = -1.56 to -0.06, P = 0.04], tumor necrosis factor-α (TNF-α, SMD = -0.78, 95%CI = -1.33 to -0.23, P = 0.006), APACHE Ⅱ scores [mean difference (MD) = -3.80, 95%CI = -5.08 to -2.52, P < 0.000 01] were obviously lower than those in control group, but no significant statistical significance in mortality was seen between the two groups [relative risk (RR) = 0.72, 95%CI = 0.49 - 1.07, P = 0.10]. Further subgroup analyses suggested that compared with conventional treatment group, in PHVHF group mortality (RR = 0.40, 95%CI = 0.16 - 0.95, P = 0.04), IL-6 (SMD =-1.87, 95%CI = -3.58 to -0.16, P = 0.03), TNF-α (SMD = -1.32, 95%CI = -2.24 to -0.40, P = 0.005), and APACHE Ⅱscore (MD = -4.29, 95%CI = -6.02 to -2.56, P < 0.000 01) were significantly decreased; however, only a significantly decreased APACHE Ⅱ score (MD = -2.95, 95%CI = -4.56 to -1.35, P = 0.000 3) was observed in PHVHF group compared to that in subgroup of other CRRT modes. Conclusions Compared with using conventional therapy alone, using PHVHF combined with conventional therapy for treatment of patients with sepsis can more effectively improve their prognosis, and PHVHF can be the efficacious alternatives of other CRRT modes especially the HVHF. However, due to the limited quantity and quality of the included studies, further high-quality, multicenter, large-scale RCTs are needed to verify the above conclusion.

Kallmann syndrome ( KS) is a rare disease and characteristic of an absence of puberty, infertility, and a defective sensation of smell (anosmia or hyposmia). Here, we analyze the features of a case of KS diagnosed clinically. In addition, the etiology, genetic features, clinical manifestations, diagnosis, and treatment of KS were reviewed.

Klinefelter syndrome(KS) is the most common sex chromosome disorder in males,which is caused by the presence of the extra X chromosome that maybe inherited from mother or father. Approximately 80% karyotype of the cases is 47,XXY. KS is characterized by small firm testes, hypergonadotropic hypogonadism, infertility,gynaecomastia, increased height. However, cognitive disabilities and psychiatric disorders are rarely diagnosed in KS because they lack screening in related aspects. At the present, the pathogenesis of cognitive disabilities and increased risk of psychiatric diseases in KS have not been delineated. In this article,we report two cases of KS,and review their clinical manifestations,diagnosis,and treatments.

Fulminant type 1 diabetes (FT1 D) has been identified as a new subtype of idiopathic diabetes.FT1D is characterized by abrupt and complete destruction of pancreatic β cells,with diabetic ketosis or diabetic ketoacidosis occurring within a week after the onset of hyperglycemic symptoms.At the time of initial presentation,plasma glucose level is increased,with near normal HbA1C.Serum pancreatic enzyme is elevated in the majority of patients with FT1D.Flu-like symptoms or gastrointestinal symptoms precede disease onset in most of patients.However,the pathogenesis of this disease remains unclear.Factors such as viral infection,autoimmune,and pregnancy based on the background of genes may account for FT1D.We herewith report two cases of FT1 D,and review its clinical features,diagnosis,and treatment.

17α-hydroxylase/17,20-lyase deficiency (17OHD) is a rare cause of congenital adrenal hyperplasia.The patient predominantly presents with low-renin hypertension,hypokalemia,lack of secondary sexual development,and in women with primary amenorrhea,in male with pseudohermaphroditism.We herewith analyse the clinical features of a case of 17OHD diagnosed by gene sequencing.And the etiology,clinical manifestations,genetic features,diagnosis and treatment for 17OHD were reviewed.