【Objective】 To explore the perioperative blood management in patients with pancreatic pseudocyst combiend with coagulation factor Ⅴ(FⅤ) deficiency. 【Methods】 Preoperative: In order to determine the effect of cryoprecipitated antihemophilic factor and fresh frozen plasma (FFP) on the elevation level of factor Ⅴ, we alternately infused cryoprecipitate and FFP in the resting state. TEG, coagulation function and coagulation factor activity were monitored before and 1 h, 24 h and 48 h after infusion, and intraoperative and postoperative blood transfusion strategies were formulated. FFP 600 mL and cryoprecipitate 10 U were supplemented preoperatively. Intraoperative: The operation procedure was performed for 7 hours with an infusion of 600 mL FFP without significant bleeding. Postoperative: FFP was infused. 【Results】 Preoperative: The coagulation factor Ⅴ activity on pre-operation was 1.9% and 1.8%. After alternating infusion cryoprecipitate 10 U and FFP 1 200 mL, the FⅤactivity increased to 5.1% and 6.0%, respectively. There was no significant difference in TEG parameters, PT and ATPP results were decreased to varying degrees. Intraoperative: The operation was successful without obvious bleeding. Postoperative: FFP 500 mL was infused 2 h after operation, and FFP 250-500 mL was injected daily from 1 to 7 days after surgery. No significant bleeding was observed in the wound, the results of TEG, PT, APTT and hemoglobin (Hb) did not change significantly compared with those before surgery. The patient was discharged successfully 12 days after surgery. The genetic test results showed that he had inherited coagulation factor Ⅴ deficiency, which was a compound heterozygous variation. 【Conclusion】 Perioperative blood management in patients with FⅤ deficiency combined with surgical disease, requiring pre-transfusion evaluation and post-transfusion evaluation in combination with laboratory investigations and clinical manifestations, cryoprecipitate and fresh frozen plasma can be effective in supplementing coagulation factors. The TEG seems to be better than the Seven items of coagulation function in judging the clotting status of patients with FⅤ deficiency.

Objective:To explore the effect of pulmonary rehabilitation training based on Chronic Obstructive Pulmonary Disease (GOLD) classification on self-efficacy and rehabilitation effect in patients with acute exacerbation of chronic obstructive pulmonary disease.Methods:From May 2019 to April 2021, a total of 85 patients with acute exacerbation of chronic obstructive pulmonary disease who were admitted to China-Japan Union Hospital of Jilin University were selected and divided into the observation group (43 cases) and the control group (42 cases) using the random number table method. The control group received routine pulmonary rehabilitation training, and the observation group conducted pulmonary rehabilitation training based on GOLD classification. Two weeks after intervention, the self-efficacy, pulmonary function, 6-Minute Walking Test (6MWT), quality of life, and the condition of adverse reactions were compared between the two groups.Results:Two weeks after intervention, the scores of dyspnea management, emotion, physical activity, safety behavior, and total score of self-efficacy of the observation group were higher than those of the control group, and the differences were statistically significant ( P<0.05). The forced exhalation volume in one second (FEV1), forced vital capacity (FVC), FEV1/FVC and 6MWT of the observation group were higher than those of the control group, and the differences were statistically significant ( P<0.05). The scores of respiratory symptoms, activity limitation, disease impact on life and total score of St. George's Respiratory Questionnaire (SGRQ) of the observation group were lower than those of the control group, and the differences were statistically significant ( P<0.05). There were no serious adverse reactions in two groups. Conclusions:Pulmonary rehabilitation training based on GOLD classification can help patients' promote the recovery of lung function, improve their self-efficacy and the quality of life, which has good security.

【Objective】 To explore the quality of autologous platelet-rich plasma prepared by manual and automatic method and to study the clinical injection therapeutic effects in patient with knee arthritis. 【Methods】 28 patients with knee arthritis in Orthopedics Department of our hospital were enrolled. PRP was prepared manually in 12 patients and automatically in 16. The whole blood of 50~70 mL was drawn from 12 patients and prepared into PRP of 10 mL manually by centrifugation. The 20~30 mL PRP was collected by automatic apheresis. Plt, RBC, WBC and other related indexes of PRP were detected after collection. Among the 28 patients, 12 in the manual group received injection twice, while 16 in the automatic group 4 episodes, with an interval of 15~20 days. The treatment effect was evaluated after the last treatment. 【Results】 The PRP prepared by two methods can both reach the required quality standard of platelet counts..The patient′s pain symptoms relieved significantly after injection treatment and the effect was remarkable. There was no significant difference in clinical efficacy between the two groups. 【Conclusion】 The PRP prepared by manual and automatic methods can be used for injection treatment for patient with knee arthritis. The clinical therapeutic effects were good and worth promotion and application.

【Objective】 To explore the effect of allogeneic platelet gel on hemostasis and repair of vascular anastomoses and wounds in patients with giant aortic aneurysms during surgery. 【Methods】 One adult dose of allogeneic platelets, applied as platelet rich plasma (PRP), was prepared as platelet gel (PG) (about 220 mL) for spraying or smearing at the vascular anastomosis and thoracic wound during the surgery of giant aortic aneurysms. 【Results】 The gel formation was presented about 30 seconds after spraying or smearing with PG on the anastomotic and wound surface. The hemostatic effect is good, with less postoperative drainage fluid from pericardium and mediastinum than usual, and the ICU stay was 4 days. 【Conclusion】 Allogeneic platelets as a source of PRP to prepare PG may be applied to obtain the clotting and healing during surgical operation.

[Absract] Objective This paper was designed to reveal the new mechanism on ASI Ⅱ triggered CD4+T cells activation via regulating CD45 molecular and provide a basis for the theoretical foundation of antitumor immunotherapy of Astragalus.Methods The CD4+T cells were randomly divided into negative group,stimulated control group,ASI Ⅱ group,CD45 inhibitor group,and the combination of ASI Ⅱ and CD45 inhibitor group.Besides negative group,the cells from other groups were activated by anti-CD3/CD28 antibody.ASI Ⅱ group was treated with 10 nmol/L ASI Ⅱ,CD45 inhibitor group was treated with 0.8 μmol/L CD45 inhibitor,and the combination group were treated with 10 nmol/L ASI Ⅱ and 0.8 iμmol/L CD45 inhibitor.After 36h culture,the proliferation of CD4+T cells was detected by Ki-67 intracellular staining assay.Cytokine production of Th1 and Th2 were examined ELISA method.The proportion of surface marker (CD44 and CD25)and Th1 intracellular cytokines (IFN-γ) were detected by flow cytometry.Results Compared with stimulated group,Astragaloside Ⅱ group in CD4+Ki67+T positive proportion (5.37％ ± 0.92％ vs.1.19％ ± 0.23％),in CD4+CD25+ positive proportion (50.23％ ± 4.65 ％ vs.15.89％ ± 1.13％),in CD4+CD44+ positive proportion (33.16％ ± 6.08％ vs.15.36％ 4 1.45％),in CD4+IFN-γ+ positive proportion (1.42％ ± 0.44 ％ vs.0.38％ ± 0.06％) were significntly increased.And the secretion of IFN-γ,IL-4 and IL-2 in ASI Ⅱ group were higher than stimulated group.The anti-mouse CD45 Ab treatment markedly blocked the proliferation and Th1 cytokines production which induced by ASI Ⅱ.Furthermore,the anti-mouse CD45 Ab treatment significantly decreased the expression of surface marker (CD44 and CD25).Conclusions Activating CD45 protein tyrosine phosphatase may be involved in ASI Ⅱ triggered CD4+T cells activation.This study will provide a basis for antitumor immunotherapy of Astragalus.

Objective To investigate associations of herpes simplex virus(HSV)infection with elevated high-sensitivity C-reactive protein(hsCRP)level and the development of atrial fibrillation(AF) in elderly individuals.Methods Through screening a total of 2,603 individuals,49 patients aged 60 years or over with AF and without structural heart diseases and known risk factors for AF were selected for data collection.Fifty-five elderly healthy control subjects were selected from a population based Chinese Arrhythmia Registry.Baseline characteristics,plasma antibody levels against HSV-1 and-2,and level of hsCRP were analyzed.Results Level of antibodies against HSV-1 was significantly higher in AF patients[(314.5±63.6)mg/L than in control subjects(216.0±50.7) mg/L,P＜0.01].Level of antibodies against HSV-2 was significantly higher in AF patients[(400.1±50.7) mg/L than in control subjects (306.3 ± 64.5) mg/L,P ＜ 0.01].Linear regression analysis demonstrated a positive correlation of plasma levels of hsCRP with both anti-HSV-1 and anti-HSV-2 IgG antibodies (r =0.291,0.188,all P ＜ 0.01).In multiple logistic regression analysis,HSV-1 and HSV-2 antibody levels were significantly associated with AF occurrence(OR =1.035 and 1.034,all P ＜0.01).The optimal cut-off point for predicting AF occurrence was 284.96 mg/L for anti-HSV-1 with sensitivity of 67.3％ and a specificity of 92.7％,and was 366.26 mg/L for anti-HSV-2 with a sensitivity of 67.3％ and a specificity of 85.5％,respectively.Conclusions The increased plasma levels of anti-HSV-1 and anti-HSV-2 antibodies are significantly associated with AF occurrence in elderly adults.

Objective To investigate the clinical features of 4 cases with systemic lupus erythematosus (SLE) complicated by chylothorax and chylous ascites.Methods Clinical manifestations,laboratory examinations,treatment and prognosis of 4 patients with SLE complicated by chylothorax and chylous ascites,who were admitted to our center in recent 13 years,were retrospectively analyzed.Results Four patients were female.The average age of SLE at presentation was 38 years (ranging from 31 to 47 years of age).The average disease duration of chylothorax and chylous ascites was 6.5 months (ranging from 3 to 12 months).Of the 4 patients,3 were complicated with chylothorax and chylous ascites,and 1 with chylothorax.Three patients were treated with corticosteroid,and 2 patients were treated combined with immuno-suppressive agents (cyclophosphamide or ciclosporin A).Chylothorax and chylous ascites improved in 1 patient.Conclusion The clinical manifesta-tions of chylothorax and chylous ascites are relatively rare in patients with systemic lupus erythematosus,and more attention should be given to improve the quality of life of these patients.

Objective To test amyloid beta protein(Aβ)40 and Aβ42 levels in CSF and apolipoprotein E (ApoE) genotype in patients with Alzheimer's disease(AD) and study whether or not the Aβ is related to the severity of dementia and the genotypes of ApoE.Methods 48 AD patients including 27 cases of mild type and 21 cases of serious type and 35 normal controls were selected.Aβ40 and Aβ42 in CSF and ApoE genotype were analyzed.Results Aβ40 levels were ( 12.3 ±4.6) μg/L,( 11.7 ±4.1 ) μg/L,( 12.6 ±4.9) μg/L and ( 11.0 ±3.7) μg/L(t = 1.377,0.705 and 1.385 ,all the p values were greater than 0.05) and Aβ42 levels were ( 105.3 ±25.4) ng/L,(110.7 ±21.7) ng/L,(96.9 ±23.9) ng/L and (123.5 ±29.6) ng/L(t=3.006,2.832,and 3.488,all the p values less than 0.01 ),in AD group,mild AD group,moderate to serious AD group and normal controls,respectively.Aβ40 levels were (11.9 ± 5.2) μg/L vs.(10.5 ± 3.8) μg/L in AD and controls with ApoEε4(t=0.696,P＞0.05) and (12.6 ±4.5) μg/L vs.(11.4 ±3.4) μg/L without ApoEε4(t = 1.008,P＞0.05).Aβ42 levels were (99.7 ± 23.8) ng/L vs.( 129.6 ± 31.0) ng/L in AD and controls with ApoEε4( t =1.632,P ＞ 0.05 ) and ( 110.4 ± 28.4) ng/L vs.( 129.6 ± 31.0) ng/L in those without ApoEε4 ( t = 2.110,P ＜0.05 ).Conclusions The CSF level of Aβ is abnormal in AD,and it is related to the severity of the disease and the ApoE genotypes.

Reverse transcription-PCR and methylation-specific PCR (MSP) were used to determine the expression levels of Syk gene and the methylation status of its promoter in tissue samples from 60 patients with cervical cancer, 50 patients with cervical intraepithelial neoplasia (CIN), and 20 normal controls. We also analyzed the association of the methylation status and expression levels of Syk gene with linicopathological features of patients. The expression rates of Syk gene in 20 normal cervical tissue samples and 18 CIN Ⅰ samples were both 100% ; those of CIN Ⅱ- Ⅲ and cervical carcinoma were 56% (18/32)and 35% (21/60) respectively. Among cervical carcinoma patients, the expression of Syk mRNA was detected in one out of 13 cases with lymph node metastasis (1/13) and in 20 out of 47 cases with no lymph node metastasis (43%). The methylation of Syk gene in promoter region was detected in 34 out of 60 cases of cervical carcinoma (57%) ; while there was no methylation in CIN cases. In 13 cases with lymph node metastasis, 11 were found to have the methylation of Syk gene. The methylation rate of Syk promoter in cervical carcinoma was higher than that of CIN tissue( x~2 = 7. 13, P ＜0. 01 ). The methylation status of Syk gene was correlated with the lymph node metastasis ( P＜ 0. 05 ), but not with other clinicopathological parameters ( P ＞ 0. 05). There was a significant correlation between methylation status and expression level of Syk gene ( P ＜ 0. 05 ). The hypermethylation leads to silencing of the Syk gene in human cervicalcarcinoma. Syk hypermethylation may be associated with oncngenesis, metastasis of cervical carcinoma.

ObjectiveAnalyzing the left atrium and pulmonary vein morphologicallv by 64 multislice spiral CT(MSCT)scan to guide the catheter ablation of Atrial fibrillation.MethodsTwo hundred and thirty-two patients(146 cases in atrial fibrillation group and 86 cases in control group)received 64 MSCT examination of the left atrium and pulmonary vein.The incidence of anatomical variation of pulmonary vein was compared between atrial fibrillation group and control group. For each group,the anatomical morphology ot every pulmonary vein and the auricle of left atrium was analyzed, the diameter of the orifice of each pulmonary vein and the size of left atrium were measured.ResultsSixty-four MSCT of left atrium and pulmonary vein could demonstrate detailed connecting type between left atrium and pulmonary Veins and the possible anatomieal variation. Anatomical variation of pulmonary vein in this study accounted for 16.8% (39/232)of total sample. For both groups,orifices of pulmonary veins appeared oval and their superoinferior diameters were larger than their anteroposterior diameters. There was significant difference in the inner diameter of left atrium between atrial fibrillation group and control group[atrial fibrillation group:(39.47±8.98)mm,control group:(36.94 ±5.49)mm,P=0.02],while there was no difference in the diameters of orifices ot puhnonary veins between two groups [ superoinferior diameters of pulmonary veins in atrial fibrillation group:left-up(18.15±1.35)mm,left-down(16.96 ±1.18)mm,right-up(17.50±