[Abstract] [Objective] To establish a detection method for complement C3d-sensitized platelets. [Methods] Parallel detection of the same platelet sample under conditions of complement C3d sensitization and non-sensitization was conducted using microcolumn gel immunoagglutination inhibition assay technology. The supernatant obtained after the reaction between anti-C3d monoclonal antibodies and platelet samples was then reacted with C3d-sensitized red blood cells to observe whether agglutination occurs. Subsequently, this method was used to test samples from 22 clinical patients to determine whether their platelets were sensitized by complement C3d. [Results] The same platelet sample, after being sensitized with complement C3d, showed negative or weakened aggregation, which was determined as a positive result, whereas platelets that were not sensitized with complement C3d exhibited aggregation, which was determined as a negative result. A total of 22 clinical patient samples were tested, of which 16 were negative and 6 were positive. [Conclusion] A microcolumn gel immunoagglutination inhibition test was established to detect whether platelets are sensitized by complement C3d, which aids in the auxiliary diagnosis of complement-related immune diseases involving platelets.

【Objective】 To establish a highly sensitive detection method of platelet HPA-3 and HPA-15 genotyping by droplet digital PCR (ddPCR), and to explore the feasibility of applying it to the detection of human platelet antigen (HPA) compatibility in maternal peripheral blood fetal free DNA. 【Methods】 For SNP mutation sites of HPA-3 and HPA-15, specific primers and MGB probes were designed, and amplification conditions such as annealing temperature and primer concentration of ddPCR were optimized to establish the optimal reaction system and clarify the test procedures. The methodological performance of the assay was evaluated, including specificity, sensitivity, repeatability and stability. ddPCR was used to detect 67 clinical blood samples, and the allele typing results were compared with the gene sequencing results. The fetal free DNA HPA antigen of 52 maternal peripheral blood samples was detected. 【Results】 The ddPCR method for detecting platelet HPA-3 and HPA-15 showed good specificity of primers and probes. The optimal annealing temperatures for HPA-3 and HPA-15 were 61.6℃ and 60.2℃, respectively. The optimal concentrations of primers were 900 nM and 700 nM respectively. The final concentration of the probe was 250 nM. The quantitative detection range of copy number was 2 to 20 000 copies, with lower limit of detection of 0.1 copies/μL, and the linearity is good. In low copy number samples, the intra - and inter batch coefficient of variation (CV) of actual detection values for HPA-3 and HPA-15 were both lower than 5%. The detection results of HPA-3 and HPA-15 genotypes of 67 blood samples were consistent with the gene sequencing results, and its application in fetomaternal platelet HPA-3, HPA-15 genotype detection met expectations. 【Conclusion】 The HPA-3 and HPA-15 ddPCR detection system constructed in this study has high accuracy, good repeatability, stability and sensitivity, and can be applied to the establishment of platelet HPA-3 and HPA-15 genotype donor pool, gene matching and fetomaternal platelet compatibility detection.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective:To analyze the operational efficiency of the oncology department in multi-campus hospital, providing reference for rational resource allocation and efficiency enhancement.Methods:A certaion tertiary grade A Hospital is a multi-campus public hospital with integrated management. This study focused on its oncology department, with 9 wards located in different campus as decision-making units. Data from 2020 to 2022 were extracted from the hospital′s medical records management system, disease diagnosis-related groups management system, and hospital information system. The super-efficiency DEA model and Malmquist index model were used to evaluate efficiency variations of the oncology department in different time slots and decision-making units. Identifying input redundancies and output deficiencies in wards not achieving constant returns to scale through projection value analysis. Selecting the total number of medical staff and the actual total number of bed-days occupied as input indicators, while bed utilization rate, discharge rate, and case mix index as output indicators.Results:From 2020 to 2022, the wards with a DEA super-efficiency value greater than 1 were 0, 2, and 4, respectively, showing a gradual increase in overall efficiency. In 2022, wards S3, S4, S7, and S9 achieved constant returns to scale with super-efficiency values of 1.001, 1.005, 1.113, and 1.112, respectively. The other five wards had zero input redundancy, but some suffered from insufficient outputs. For example, wards S5 and S8 should increase their bed utilization rates by 5% and 4%, respectively. Wards S1 and S8 needed to increase their annual discharge numbers by 24% and 1%, respectively, while wards S2 and S6 should increase their annual case mix index by 21% and 20%, respectively. From 2020 to 2021, the Malmquist index of the oncology department was 0.959, while from 2021 to 2022 it rose to 1.030, and the Malmquist index of each ward was greater than 1.Conclusions:By implementing integrated management across multiple campus, the operational efficiency of the oncology department has been comprehensively improved. The use of the super efficient DEA-Malmquist index model to evaluate the operational efficiency of departments has practical significance.

Objective:To investigate the status quo of nurses' practice environment in Class Ⅲ Grade A hospitals in Sichuan Province and analyze its influencing factors, so as to provide a basis for optimizing the practice environment of nurses.Methods:This study was a cross-sectional study. Using the convenient sampling method, from April to September 2019, a total of 6 320 nurses from 21 Class Ⅲ Grade A hospitals in Sichuan Province were selected as the research objects. An online survey of nurses was conducted using the General Information Questionnaire and the Revised Nurse Practice Environment Assessment Scale. Multiple linear regression analysis was used to analyze the influencing factors of nurses' practice environment. A total of 6 320 questionnaires were distributed in this study and 6 180 valid questionnaires were recovered, with an effective recovery rate of 97.78%.Results:The total score of Revised Nurse Practice Environment Assessment Scale for 6 180 nurses was (70.85±18.69) . Multiple linear regression analysis showed that gender, education level, professional title, working years, and whether it was an only child were the influencing factors of the nurse's practice environment ( P<0.05) . Conclusions:The overall level of nurses' practice environment in ClassⅢ Grade A hospitals in Sichuan Province is in the middle. Nursing managers should encourage nurses to actively participate in hospital management, optimize the allocation of human resources, establish a scientific and reasonable salary distribution system, pay attention to the characteristics of special groups of nurses and further build a good nurse practice environment.

Objective To explore the effect of different delivering methods on the pelvic floor function in vaginal delivery by transvaginal three-dimensional ultrasound.Methods Eighty-four patients delivered transvaginal were classified into three groups according to the mode of delivery (perineal integrity group [n=32],episiotomy group [n=30] and forceps delivery group [n=22]).The hiatal images at resting,Valsalva,levator ani muscle maximum contraction were obtained and compared in three groups.Results There were no differences between perineal integrity group and episiotomy group in hiatal diameter and area (P＞0.05).There were significantly differences between perineal integrity group and forceps delivery group in hiatal diameter,area and change in hiatal area from rest to pelvic floor muscle contraction and from rest to Valsalva (all P＜0.05).Conclusion The injury of the pelvic floor of forceps delivery group is bigger than perineal integrity.And episiotomy is no significant difference with pelvic floor function injury.

Aim To explore the effects of salvianolic acid B(SAB) and tanshinone ⅡA(TA) alone or the compatibility of these two effective components on the proliferation of rat vascular adventitial fibroblasts, and to observe the effects of the compatibility of the two on cell proliferation with the stimuation of angiotensin Ⅱ(Ang Ⅱ).Methods The effects of SAB and TA alone or the compatibility of the two on cell proliferation were detected by methyl thiazolyl tetrazolium(MTT) method, and flow cytometry was adopted to detect cell cycle with or without the induction of Ang Ⅱ.Results It was shown that SAB and TA alone could inhibit fibroblast proliferation in different degree.Through a series of concentration screening, three effective concentrations were obtained respectively and then the inhibition of cell growth was detected by Pairwise compatibilities.The results showed that the compatibility of TA(10-8 mol·L-1) and SAB(10-5 mol·L-1) had the most significant inhibitory effect(P<0.01), and they could inhibit cell proliferation, further flow cytometry was adopted to detect drug effects on cell cycle, the results indicated that the compatibility of SAB and TA mainly blocked the cells in G0/G1 phase.Induced by Ang Ⅱ, the compatibility of SAB and TA group, compared with Ang Ⅱ group, blocked thee cells in G0/G1 phase;and compared with combination of SAB and TA group, it mainly blocked cell cycle in S phase.Conclusion SAB and TA have certain inhibitory effect on fibroblast proliferation, also they could inhibit the proliferation induced by Ang Ⅱ, mainly by blocking the cells in G0/G1 phase.

Thyroid nodule is a common diseases of neck,which property is usually identified by ultrasound examination.Color doppler ultrasonography can reflect the distribution of blood vessels and blood flow within the nodules.And with development of new technologies,three-dimensional ultrasound increase the accuracy of identification.Three-dimension power doppler ultrasound (3D-PDUS) can reflect blood flow information within the nodule space,which is more accurate than two-dimensional ultrasound and it can be used to evaluate the blood flow in nodules qualitatively and quantitatively,provide a new reference for clinical diagnosis of thyroid nodule.

Objective To explore the diagnostic value of comparing enhanced transvaginal ultrasound (E-TVS),none enhanced transvaginal ultrasound (TVS),and transrectal ultrasound (TRS) in preoperative detection of deep infiltrating endometriosis (DIE) in the rectosigmoid by Meta-analysis.Methods The literatures published from January 1990 to June 2016 were searched.The information of literatures were selected and evaluated.The included data was statistically analyzed by Meta-disc 1.4 software.Results Totally 25 literatures were enrolled.The pooled sensitivity,specificity,positive likelihood ratio,negative likelihood ratio,diagnostic odds ratio were 0.92,0.96,16.64,0.09,227.95 for E-TVS,0.83,0.97,16.95,0.17,112.97 for TVS,0.94,0.96,14.43,0.08,208.72 for TRS,respectively.Area under the curve were 0.980 4,0.966 3,0.979 0,respectively.Conclusion Diagnostic value of the three ultrasonography in preoperative detection of DIE in the rectosigmoid are E-TVS,TRS,TVS.E-TVS can be used as the preferred method of ultrasonic diagnosis of DIE in the rectosigmoid.