Objective To statistically analyze the perioperative results of patients with ABO-incompatible kidney trans-plantation(ABOi-KT),in order to explore the changes in blood group antibody of type-A/B recipients.Methods A total of 33 cases of blood group A/B ABOi-KT recipients in our hospital from January 2021 to October 2023 were recruited and divided into two groups of group A(n=18)and group B(n=15)according to the different blood types of recipient.The effects of preoperative plasmapheresis on antibody titer,antibody rebound and renal function after operation(serum urea ni-trogen,creatinine and estimated glomerular filtration rate on the 1st,3rd,7th and 14th day)were analyzed between the two groups.According to the postoperative rebound of blood type antibodies,33 recipients were divided into antibody rebound group(n=7)and non rebound group(n=26),and the differences in initial blood type antibody titers between the two groups were analyzed.Results There was no significant difference in the clearance rate of IgM with preoperative plasma ex-change between the two groups(Z=-0.26,P＞0.05);Levels of serum urea nitrogen and creatinine on the 1st,3rd,7th and 14th day after operation between group A and group B were not statistically significant(P＞0.05),the same as eGFR.Group B was more prone to rebound antibody compared with group A(P＜0.05).There was a significant difference in the in-itial IgM antibody titer between the blood type antibody rebound group and the non rebound group(Z=-2.127,P＜0.05),but no statistically significant difference in the initial IgG antibody titer(Z=-1.835,P＞0.05)between the two groups was found.Conclusion The patients type B receiving type AB kidney donors are more prone to rebound antibody after ABOi-KT operation compared to the the patients type A receiving type AB.

ObjectiveTo understand the epidemiological characteristics of severe fever with thrombocytopenia syndrome （SFTS）， and the association with seasonal fluctuation in tick density， so as to provide scientific evidence for better control and prevention measures. MethodsDescriptive epidemiological methods were used to analyze the SFTS epidemic situation in Chongyang County from 2013 to 2021. The cloth flag method was used to investigate the seasonal fluctuation in tick density and determine the association with the SFTS. ResultsA total of 71 SFTS cases were reported in Chongyang County from 2013 to 2021 including 8 deaths， with the annual morbidity rate of 1.88/10^-5. The majority were mainly from June to August， accounting for 61.97% of the total reported cases. The cases were geographically distributed in 41 administrative villages and 4 urban areas in 11 towns. The highest incidence was in Lukou town （n=26） and Baini town （n=12）， which accounted for 53.52% of the total reported cases. Furthermore， the cases were mainly 50‒69 years old， accounting for 57.75% of the total reported cases. The ratio of male to female was 1.84∶1， and most were farmers. Blood samples during acute phase in 41 cases were collected for examination of SFTS virus， of which 25 cases tested positive （60.98%）. There was a positive association between tick density and the number of reported SFTS cases （r=0.78， P=0.003）. ConclusionSeasonal density of free adult ticks and nymphs is associated with the number of reported SFTS cases in Chongyang County.

In this study, artificial intelligence aided diagnosis system of fundus images was applied to clinical teaching of ophthalmology to explore its role in improving the teaching quality. Taking the clinical teaching of diabetic retinopathy as an example, we analyzed the specific steps, effects and improvement strategies. The results revealed that the course could be more interesting and impressing by using the typical cases provided by the artificial intelligence aided diagnosis system of fundus images. In the meanwhile, this system provided the excellent chances for ophthalmology postgraduates to exercise after class, which deepened their understanding of knowledge and enhanced their learning enthusiasm. The application effect has been affirmed and recognized by students.

Objective To investigate the relationship between the expressions of osteopontin (OPN), matrix metalloproteinase 2 (MMP-2) and vascular endothelial growth factor (VEGF) in gastric cancer and the poor prognosis of gastric cancer patients. Methods A total of 35 patients with gastric cancer after radical gastrectomy from January 2014 to March 2015 in Dalian Third People ' s Hospital were retrospectively analyzed. The expressions of OPN, MMP-2 and VEGF in gastric cancer tissues and adjacent normal tissues were detected by immunohistochemical SP staining. The relationship between the expressions of OPN, MMP-2 and VEGF and the poor prognosis of gastric cancer patients was analyzed. Results The positive expression rates of OPN, MMP-2 and VEGF in postoperative pathological tissues of gastric cancer were 80.0％ (28/35), 77.1％(27/31) and 88.6％(31/35), respectively. OPN expression was associated with vascular invasion, lymph node metastasis, degree of differentiation, degree of invasion, and Lauren classification (all P< 0.05). MMP-2 expression was associated with vascular invasion, lymph node metastasis, and degree of invasion (all P<0.05). VEGF expression was associated with vascular invasion, lymph node metastasis, degree of invasion, and Lauren classification (all P< 0.05). OPN, VEGF and MMP-2 had synergistic effects in the invasion and metastasis of gastric cancer, and the expressions of them were positively correlated (all P< 0.05). The sensitivity of combined detection of OPN, VEGF and MMP-2 (87.5％) was higher than the sensitivity of individual detection (68.8％, 62.5％ and 56.3％) (P< 0.05). Conclusions OPN, MMP-2 and VEGF expressions are closely related to the poor prognosis of gastric cancer patients, and have synergistic effects in the invasion and metastasis of gastric cancer. The combined detection of OPN, MMP-2 and VEGF may have a more accurate prediction of the prognosis of gastric cancer.

Objective The objective of this study was to investigate the relationship between CYP2D6 gene polymorphisms and the concentrations of tamoxifen metabolites in breast cancer patients. Methods Peripheral blood samples from breast cancer pa-tients were collected to detect the single nucleotide polymorphism(SNP)of s16947,rs1065852 and rs28371725 gene sites on CYP2D6 gene from January 2010 to December 2012. Genotypes of the three SNPs of CYP2D6 and the concentrations of tamoxifen metabolites were detected in breast cancer patients. Statistical analysis was performed using an independent sample Kruskal-Wallis test in a non-parametric test. Results There was a statistical difference in the concentrations of tamoxifen metabolites 4-OH-N-D-TAM and 4′OH-N -D -TAM in the blood in different CYP2D6 gene genotype carriers at rs16947 site ( P =0. 049), indicating that the rs16947 site of CYP2D6 gene affected the metabolism of tamoxifen drug in breast cancer patients. Conclusion The genotype of CYP2D6 gene at rs16947 site is related to the blood concentration of tamoxifen metabolites in breast cancer patients.

Objective: To study the expression and significance of Notch1-Jagged1 in nasal mucosa of allergic rhinitis (AR) mouse model in various stages and in the serum of AR patients. Methods: Thirty-six mice were divided into 3 groups: control group, basal sensitization group (OVA) and OVA/AR group, with 12 mice in each group. Allergic symptom in each group were scored after AR model establishment. HE staining method was used to observe the nasal mucosa eosinophils infiltration. ELISA was used to detect the serum level of total IgE. Flow cytometry was used to detect the change of Treg cells in each group. Western blot was used to detect the expression of Notch1 and Jagged1 in nasal mucosa. Flow cytometric bead array (CBA) was used to detect the level of Th1/Th2/Th17 cytokines in splenic lymphocytes. The serum was obtained from 50 patients with AR and 30 control volunteers in Department of Otorhinolaryngology Head and Neck Surgery, Renmin Hospital of Wuhan University from June to October 2017. ELISA was used to detect the expression of Notch1 and Jagged1. Results: Compared with the control group, the allergy symptom, the number of nasal mucosal eosinophils and the level of total IgE were not significantly different in basal sensitization group, but increased significantly in OVA/AR group (6.11±0.78 vs 0.67±0.50, 77.67±5.61 vs 10.33±0.82, (106.80±11.91) pg/ml vs (82.45±19.80) pg/ml, t value was 19.471, 34.848, 2.542, respectively, all P<0.05). Compared with the control group, the ratio of Treg cell increased in basal sensitization group but decreased in OVA/AR group ((10.29±0.47)% vs (9.28±0.16)%, (8.49±0.15)% vs (9.28±0.16)%, t value was 5.838, 4.540, respectively, all P<0.01). Compared with control group, the expression of Notch1 increased significantly both in basal sensitization group and OVA/AR group (1.04±0.05 vs 0.71±0.05, 1.83±0.10 vs 0.71±0.05, t value was 9.293, 31.363, respectively, all P<0.01); and the expression of Jagged1 only increased significantly in OVA/AR group (0.41±0.04 vs 0.21±0.01, t=13.472, P<0.01). It was found that Notch1 was positively correlated with the level of IL-6, IL-10 by Pearson test (r value was 0.98, 0.87, respectively, all P<0.01). Compared with control volunteers, the expression of Notch1 and Jagged1 increased significantly in AR group patients ((1 135.0±254.9) pg/ml vs (436.0±139.3) pg/ml, (1 200.2±401.0) pg/ml vs (559.9±124.2) pg/ml, t value was 13.99, 11.94, respectively, all P<0.01). Conclusions The expression of Notch1 receptor and ligand increased significantly in the pathogenesis of AR. Notch1-Jagged1 may promote the occurrence and development of AR by up-regulating the expression of IL-6 and IL-10.

Objective To evaluate the effect of targeted monitoring and comprehensive intervention measures on reducing the occurrence of catheter-associated urinary tract infection(CAUTI)in patients in non-intensive care unit(Non-ICU).Methods In quarter 4 of 2015,patients with indwelling urinary catheter in clinical departments were conducted a baseline survey(before intervention),risk factors for CAUTI in patients were analyzed,targeted monitoring programmes and comprehensive intervention measures were initiated in 2016(after intervention),incidence of CAUTI before and after intervention was compared.Results After taking intervention measures,hand hygiene compliance rate increased from 78.51%in quarter 4 of 2015 to 92.99%in quarter 3 of 2016 and 90.73%in quarter 4 of 2016(x2=7.342,3.998,respectively,both P<0.05),the correct disposal rate of patients' urinary catheterization system increased from 72.83%in quarter 4 of 2015 to 95.44%in quarter 4 of 2016(x2=30.267,P<0.05).A total of 12 067 patients with indwelling urinary catheter were monitored,incidence of CAUTI dropped from 1.03%(24/23 313)in quarter 4 of 2015(before intervention)to 0.53%(14/26 595)in quarter 4 of 2016(after intervention),difference was statistically significant(x2=4.126,P=0.042).Conclusion Improving the quality of urinary catheterization system in patients with indwelling catheter through targeted monitoring can effectively reduce the incidence of CAUTI in patients in Non-ICU.

Objective To evaluate hospital acquired infection control using the risk assessment method of hazard vulnerability analysis (HVA). Methods The HVA risk assessment method was used to screen out two hospital-level priority improvement projects in hospital acquired infection management in 2016, and assess the relative risk of the risk factors,for selective intervention according to the"20% -80% principle". 2015 was set as baseline survey, while the first and second half of 2016 as the outcome evaluation stage. The comparison of the count data was performed using the χ2test. Results Baseline survey of hand hygiene found the compliance rate and high-touch surface cleaning pass rate as 64.4% and 57.0% respectively. The first stage of evaluation found the rate as 69.0% and 73.7% respectively, while in the second stage rate was 72.9% and 82.4% respectively. These differences were statistically significant (P<0.001). Baseline survey found the incidence of hospital acquired infection and surgical site infection as 1.26% and 0.29% respectively, while the figures in the stage of evaluation were 1.07% and 0.22% respectively,figures being statistically significant (P<0.05). Conclusions The HVA risk management proves significant for the prevention and control of hospital acquired infection, as it can identify and assess risk factors of hospital acquired infection,for better risk control.

Objective To investigate the effect of visual management on the prevention of nosocomial infection for the patients in hospital in the department of gynecology and obstetrics.Methods Three hundred and sixteen in-patients who were treated in the department of obstetrics and gynecology in our hospital from July 2013 to June 2014 were included in the control group. The routine prevention infection management was used in the control group. Three hundred and twenty-five in-patients who were treated in the department of obstetrics and gynecology in our hospital from October 2014 to September 2015 were included in the observation group. The visual management was used to prevent infection in the observation group. Hospital infection,infection site,length of hospital stay and patients' satisfaction were compared between the two groups.Results There were 22 cases of hospital infection in the two groups,including 5 cases in the observation group and 17 cases in the control group. The difference between the two groups was statistically significant (x2=8.532,P<0.01). In the observation group, the infection rate of infection sites of the patients was significantly lower compared with the patients in the control group (P<0.05). In the observation group,the average hospitalization time was (6.2±1.6) d,which was significantly shorter compared with the patients in the control group (8.6±2.1) d (t=3.26, P=0.001). The total satisfaction in the observation group was 100.0%,which was significantly different from that in the control group (89.6%) (x2=7.814,P<0.05).Conclusions The implementation of visual management to prevent infection in the patients of the department of gynecology and obstetrics can reduce the infection rate of patients,shorten their hospitalization time and improve patients'satisfaction of the intervention.