Clinicopathological features of patients with RET fusion-positive non-small cell lung cancer / 中华病理学杂志

Objective: To investigate the clinicopathological features, treatment and prognosis of patients with RET fusion positive non-small cell lung cancer (NSCLC). Methods: A total of 1 089 NSCLCs were retrieved at Affiliated Hospital of Jiangnan University from August 2018 to April 2020. In all cases, multiple gene fusion detection kits (fluorescent PCR method) were used to detect the gene status of RET, EGFR, ALK, ROS1, KRAS, BRAF and HER2; and immunohistochemical method was used to detect the expression of PD-L1 and mismatch repair related proteins. The correlation between RET-fusion and patients' age, gender, smoking history, tumor stage, grade, pathologic type, and PD-L1, mismatch repair related protein expression was analyzed. Results: There were 22 cases (2.02%) detected with RET fusion-positive in 1 089 NSCLC patients, in which 11 males and 11 females; and the median age was 63.5 years. There were 20 adenocarcinomas, including 11 acinar predominant adenocarcinoma (APA), five solid predominant adenocarcinoma (SPA) and four lepidic predominant adenocarcinoma (LPA); There were one case each of squamous cell carcinoma (non-keratinizing type) and sarcomatoid carcinoma (pleomorphic carcinoma). There were 6 and 16 patients with RET fusion-positive who were in stage Ⅰ-Ⅱ and Ⅲ-Ⅳ respectively, and 16 cases with lymph node metastasis, 11 cases with distant metastasis. Among RET fusion-positive cases, one was detected with HER2 co-mutation. The tumor proportion score of PD-L1≥1% in patients with RET fusion positive lung cancer was 54.5% (12/22). Defects in mismatch repair protein expression were not found in patients with RET fusion positive NSCLC. Four patients with RET fusions positive (two cases of APA and two cases of SPA) received pratinib-targeted therapy, and two showed benefits from this targeted therapy. Conclusions: The histological subtypes of RET fusions positive NSCLC are more likely to be APA or SPA. RET fusion-positive NSCLC patients are associated with advanced clinical stage, lymph node metastases, and they may benefit from targeted therapy with RET-specific inhibitors.

Multimodal imaging analysis of the cyst like lesion of condyle in temporomandibular joint / 中华口腔医学杂志

Objective: To investigate the imaging features of condylar cystic degeneration of temporomandibular joint (TMJ) by cone-beam CT (CBCT), spiral CT, MRI and radionuclide bone imaging. Methods: From January 2018 to December 2020, thirty-two patients with cyst-like lesions of condylein temporomandibular joint were examined by CBCT, spiral CT, MRI and radionuclide bone imaging at the Department of Oral and Maxillofacial Surgery in General Hospital of Chinese PLA. There were 12 males and 20 females involved, aged from 16 to 65 years with an average age of (33.9±12.5) years. The characteristics of CBCT, spiral CT, MRI and radionuclide bone imaging were analyzed. Condylar cyst like lesions were classified as type A and type B based on the presence or absence of surface bone defects. Condylar cyst like lesions were classified as type Ⅰ(yes) and type Ⅱ(no) according to the accompanying bone marrow edema-like lesions of the condyles. The incidence of condylar bone marrow edema, disc displacement and abnormal bone metabolism were analyzed. Results: A total of 64 joint images of 32 patients were included, including 34 sides with TMJ cyst-like lesion and 6 sides with multiple cyst-like lesions,the total cyst-like lesions were 42. The largest diameter of cyst-like lesion ranged from 1.0 to 12.4 mm, with an average length of (3.7±1.8) mm. There were 24 cases of type A TMJ cyst like lesion and 10 cases of type B cyst-like lesion. The detection rate of CBCT was 95.2% (40/42) and that of spiral CT was 100% (42/42), there was no significant difference (Calibration Chi-square=0.51, P=0.474). The detection rate of nuclear magnetic resonance was 80.1% (34/42), and the detection rate of cyst-like lesions less than 2 mm was 3/11. In the cyst like lesion side, there were 9 sides with anterior disc displacement with reduction, 20 sides with anterior disc displacement without reduction. In the non-cyst like lesion side, 10 sides with anterior disc displacement with reduction and 6 sides with anterior disc displacement without reduction. There was a significant difference in the displacement of the disc between cyst-like and non-cystic lesion side (χ²=7.80, P=0.005). MRI showed that 6 cases of cystic side[17.6% (6/34)] had bone marrow edema-like lesions (all type A), 1 case of non-cyst like lesions side [3.3% (1/30)]had bone marrow edema-like lesion, there was no significant difference between cystic and non-cystic lesions (Calibration Chi-square=2.04, P=0.153). There was a significant difference between type A and B cystic lesions (Fisher exact probability method, P= 0.024). Radionuclide bone imaging showed abnormal bone metabolism in 26 patients in the cyst-like lesion side and 5 patients in the non-cyst like lesion side (χ²=22.82, P<0.001). Conclusions Multi-slice Spiral CT could detect the cyst-like lesion of TMJ condyle in the early stage, which is different from the large joint. And the formation mechanism may vary from the different classifications.

Multimodal imaging analysis of the cyst like lesion of condyle in temporomandibular joint / 中华口腔医学杂志

Objective: To investigate the imaging features of condylar cystic degeneration of temporomandibular joint (TMJ) by cone-beam CT (CBCT), spiral CT, MRI and radionuclide bone imaging. Methods: From January 2018 to December 2020, thirty-two patients with cyst-like lesions of condylein temporomandibular joint were examined by CBCT, spiral CT, MRI and radionuclide bone imaging at the Department of Oral and Maxillofacial Surgery in General Hospital of Chinese PLA. There were 12 males and 20 females involved, aged from 16 to 65 years with an average age of (33.9±12.5) years. The characteristics of CBCT, spiral CT, MRI and radionuclide bone imaging were analyzed. Condylar cyst like lesions were classified as type A and type B based on the presence or absence of surface bone defects. Condylar cyst like lesions were classified as type Ⅰ(yes) and type Ⅱ(no) according to the accompanying bone marrow edema-like lesions of the condyles. The incidence of condylar bone marrow edema, disc displacement and abnormal bone metabolism were analyzed. Results: A total of 64 joint images of 32 patients were included, including 34 sides with TMJ cyst-like lesion and 6 sides with multiple cyst-like lesions,the total cyst-like lesions were 42. The largest diameter of cyst-like lesion ranged from 1.0 to 12.4 mm, with an average length of (3.7± 1.8) mm. There were 24 cases of type A TMJ cyst like lesion and 10 cases of type B cyst-like lesion. The detection rate of CBCT was 95.2% (40/42) and that of spiral CT was 100% (42/42), there was no significant difference (Calibration Chi-square=0.51, P=0.474). The detection rate of nuclear magnetic resonance was 80.1% (34/42), and the detection rate of cyst-like lesions less than 2 mm was 3/11. In the cyst like lesion side, there were 9 sides with anterior disc displacement with reduction, 20 sides with anterior disc displacement without reduction. In the non-cyst like lesion side, 10 sides with anterior disc displacement with reduction and 6 sides with anterior disc displacement without reduction. There was a significant difference in the displacement of the disc between cyst-like and non-cystic lesion side (χ²=7.80, P=0.005). MRI showed that 6 cases of cystic side[17.6% (6/34)] had bone marrow edema-like lesions (all type A), 1 case of non-cyst like lesions side [3.3% (1/30)] had bone marrow edema-like lesion, there was no significant difference between cystic and non-cystic lesions (Calibration Chi-square=2.04, P=0.153). There was a significant difference between type A and B cystic lesions (Fisher exact probability method, P=0.024). Radionuclide bone imaging showed abnormal bone metabolism in 26 patients in the cyst-like lesion side and 5 patients in the non-cyst like lesion side (χ²=22.82, P<0.001). Conclusions Multi-slice Spiral CT could detect the cyst-like lesion of TMJ condyle in the early stage, which is different from the large joint. And the formation mechanism may vary from the different classifications.

Epidemiological characteristics of pulmonary tuberculosis patientsaged 60 years and older in Quzhou City / 预防医学

Objective@#To analyze the epidemiological characteristics of pulmonary tuberculosis cases at ages of 60 years and older in Quzhou City, Zhejiang Province, so as to provide the evidence for formulating the pulmonary tuberculosis control strategy among the elderly. @*Methods@#The data pertaining to pulmonary tuberculosis cases at ages of 60 years and older in Quzhou City from 2010 to 2020 were collected through the Tuberculosis Management Information System of the China Disease Prevention and Control Information System. The trends for incidence, population distribution, diagnosis and treatment of pulmonary tuberculosis cases aged 60 years and older were analyzed using a descriptive epidemiological method.@*Results@#Totally 8 754 pulmonary tuberculosis cases aged 60 years and older were reported in Quzhou City from 2010 to 2020, accounting for 47.65% of all pulmonary tuberculosis cases, and the number of pulmonary tuberculosis appeared a tendency towards a rise ( χ2trend=173.320, P<0.001 ), while the incidence of pulmonary tuberculosis showed a tendency towards a decline ( χ2trend=389.820, P<0.001 ), with an annual decline rate of 177.11/105. There were 4 307 smear-positive pulmonary tuberculosis cases, accounting for 58.71% of all smear-positive cases, and the number of smear-positive pulmonary tuberculosis cases showed a tendency towards a rise ( χ2trend=126.320, P<0.001 ), while the proportion of smear-positive cases showed a tendency towards a decline ( χ2trend=21.680, P<0.001 ), with an annual smear-positive rate of 87.14/105. The incidence of pulmonary tuberculosis was 256.94/105 among males and 91.43/105 among females at ages of 60 years and older ( χ2=20.903, P<0.001 ). The highest incidence of pulmonary tuberculosis was seen in patients aged 80 to 84 years ( 235.17/105 ), and farmers were the predominant occupation ( 7 171 cases, 81.92% ), while the highest number of cases was reported in Quzhou City (8 676 cases, 99.11%). There were 7 752 treatment-naïve cases ( 88.55% ), while 5 830 cases with delay in seeking healthcare services, and the proportion of delay in seeking healthcare services showed a tendency towards a rise from 2010 to 2020 ( χ2trend=4.853, P=0.028 ), with an annual mean delay rate of was 66.60%.@*Conclusion@#The incidence of pulmonary tuberculosis appeared a tendency towards a decline among patients aged 60 years and older in Quzhou City from 2010 to 2020, and the elderly aged 80 years and older and farmers should be paid more attention.

Epidemiological characteristics of pulmonary tuberculosis in Zhejiang Province from 2016 to 2020 / 预防医学

Objective@#To investigate the epidemiological characteristics of pulmonary tuberculosis ( PTB ) incidence and mortality in Zhejiang Province from 2016 to 2020, so as to provide the evidence for formulating the PTB control strategy.@*Methods@#The data regarding the PTB patients in Zhejiang Province from 2016 to 2020 were collected from the Tuberculosis Management Information System of the Chinese Disease Control and Prevention Information System. The reported cases and deaths of PTB cases were descriptively analyzed by time, population and regions.@*Results@#A total of 129 985 PTB cases were reported in Zhejiang Province from 2016 to 2020, and the overall reported incidence rate of PTB was 45.81/105, with a tendency toward a decline in the reported incidence ( χ2trend=298.899, P<0.001 ) and an annual decline rate of 3.72%. The prevalence rates of rifampicin resistance, positive etiological tests, negative etiological tests and no etiological results were 1.51%, 47.17%, 46.67% and 4.65%, respectively. A total of 546 PTB deaths occurred in Zhejiang Province from 2016 to 2020, and the reported mortality of PTB was 0.19/105, with a tendency towards a decline ( χ2trend=10.818, P<0.001) and an annual decline rate of 11.99%.The prevalence rates of rifampicin resistance, positive etiological tests, negative etiological tests and no etiological results were 1.83%, 82.97%, 13.37% and 1.83%, respectively. The highest reported incidence ( 92.18/105 ) and mortality ( 1.19/105 ) of PTB was found in patients aged 65 years and older, and farmer was the predominant occupation of PTB cases (60 774 cases, 46.75%) and dead PTB cases ( 345 cases, 63.19% ). In addition, the top three cities with the highest incidence of PTB included Quzhou City ( 66.43/105 ), Jinhua City ( 64.24/105 ) and Lishui City ( 53.91/105 ), and the top three cities with the highest mortality of PTB included Quzhou City ( 0.67/105 ), Lishui City ( 0.27/105 ) and Jiaxing City ( 0.26/105 ).@*Conclusions@#Both the reported incidence and mortality of PTB appeared a tendency towards a decline in Zhejiang Province from 2016 to 2020; however, the proportion of positive etiological tests increased. Higher attention should be paid to the elderly aged 65 years and older and and farmers, and active screening and health education are recommended; in addition, PTB control requires to be intensified in highly prevalent regions, including Quzhou City, Jinhua City and Lishui City.

The screening of patients with hepatocellular carcinoma suitable for TACE after radical resection based on microvascular invasion and Ki-67 expression / 中华肝胆外科杂志

Objective:To investigate the patients with hepatocellular carcinoma suitable for transcatheter arterial chemoembolization (TACE) after radical resection who were screened based on microvascular invasion (MVI) and Ki-67 expression.Methods:Of 400 patients with hepatocellular carcinoma who underwent radical resection in the Affiliated Hospital of Qingdao University from January 2013 to December 2019 were included and analyzed retrospectively, including 324 males and 76 females, aged (59.7±9.8) years, ranging from 32 to 87 years. According to whether they received adjuvant TACE treatment after operation, they were divided into simple operation group ( n=210) and TACE + operation group ( n=190). The recurrence in the first year after operation was followed up by outpatient reexamination. Univariate and multivariate Cox regression analysis were used to analyze the influencing factors of recurrence free survival after surgical resection. Subgroup analysis was performed according to Ki-67 and MVI to compare the recurrence free survival. Results:Multivariate Cox regression analysis showed that patients with proportion of Ki-67 positive cells ≥27.5% ( HR=2.073, 95% CI: 1.433-3.000, P<0.001) and MVI positive ( HR=2.339, 95% CI: 1.584-3.456, P<0.001) had increased risk of recurrence after radical resection. The 1-year cumulative recurrence free survival rate in the simple operation group was 70.0%, and there was no significant difference compared with 67.9% in the operation + TACE group( χ 2=0.08, P=0.774). Subgroup analysis: in the low expression of Ki-67 combined with negative MVI group ( n=128), the cumulative recurrence free survival rate of one year after operation in the simple operation group ( n=84) was 91.7%, which was significantly higher than 72.7% in the operation + TACE group ( n=44)( χ 2=8.22, P=0.004). There was no significant difference in the 1-year cumulative recurrence free survival rate between the simple operation group and the operation + TACE group (both P>0.05) in patients of Ki-67 high expression combined with MVI negative or Ki-67 low expression combined with MVI positive. In the Ki-67 high expression combined with MVI positive group ( n=107), the cumulative one-year recurrence free survival rate in the simple operation group ( n=62) was 40.3%, which was significantly lower than 60.0% in the operation + TACE group ( n=45)(χ 2=4.22, P=0.040). Conclusion:High expression of Ki-67 (≥27.5%) combined with positive MVI are the prediction factors for postoperative TACE treatment. Low expression Ki-67 (<27.5%) combined with negative MVI was contraindicated for postoperative TACE treatment.

Bone marrow mesenchymal stem cells attenuate pyroptosis lipopolysaccharide-induced renal injury rats / 中华危重病急救医学

Objective:To investigate the effect and mechanism of bone marrow mesenchymal stem cell (BMSC) on pyroptosis of rats with kidney injury.Methods:Bone marrow of 4-5 week-old female Sprague-Dawley (SD) rats was isolated in vitro and BMSC was obtained. The third generations of BMSC were used to further experiments. Fifteen 6 week-old SD rats were cluster-randomized divided into control group, kidney injury group and BMSC group (5 rats in each group). Rats in kidney injury group were injected with lipopolysaccharide (LPS) 1 mg/kg via tail vein; the control group was given the same amount of normal saline. BMSC group was injected with 0.5 mL BMSC (including 2×10 6 BMSC) via tail vein after modeling; the kidney injury group received the same amount of normal saline. On day 3 after these injections, serum creatinine (SCr) was detected by picric acid method, and blood urea nitrogen (BUN) was detected by diacetyl monoxime. The levels of cystatin C (Cys C), interleukins (IL-1β and IL-18) in blood were detected by enzyme-linked immunosorbent assay (ELISA). The rats were then sacrificed and their kidneys were removed for subsequent detection. The mRNA expression levels of NOD-like receptor protein 3 (NLRP3) and cysteinyl aspartate-specific protease-1 (caspase-1) of kidney were detected by quantificational real-time quantitative polymerase chain reaction (qRT-PCR). The protein expression levels of NLRP3 and caspase-1 of kidney were detected by Western blotting. Results:In vitro, after bone marrow cell suspension was cultured for 24 hours, a large number of round adherent cells and suspended cells appeared in each culture flask. After 4-5 days of culture, a large number of long spindle cells adhered to the wall, and there were still obvious impurity cells. After trypsin digestion and passage to the third generation, the long spindle adherent cells grew mainly in the culture flask and were basically purified as BMSC. In vivo, compared with the control group, the levels of SCr, BUN, Cys C, IL-1β and IL-18 in kidney injury group were increased [SCr (μmol/L): 85.22±2.29 vs. 21.80±0.59, BUN (mmol/L): 11.50±0.64 vs. 5.86±0.83, Cys C (mg/L): 0.13±0.01 vs. 0.11±0.02, IL-1β (ng/L): 31.49±1.42 vs. 4.74±0.49, IL-18 (ng/L): 29.01±1.95 vs. 1.52±0.03, all P < 0.05]. The mRNA and protein expression levels of NLRP3, caspase-1 were significantly increased [NLRP3 mRNA (2 -ΔΔCt): 3.635±0.296 vs. 1.000±0.002, caspase-1 mRNA (2 -ΔΔCt): 4.020±0.228 vs. 1.001±0.003; NLRP3 protein (NLRP3/β-actin): 1.560±0.868 vs. 0.902±0.036, caspase-1 protein (caspase-1/β-actin): 1.392±0.097 vs. 0.895±0.046, all P < 0.05]. Compared with kidney injury group, the levels of SCr, BUN, IL-1β and IL-18 in BMSC group were significantly decreased [SCr (μmol/L): 51.64±3.84 vs. 85.22±2.29, BUN (mmol/L): 9.90±0.46 vs. 11.50±0.64, IL-1β (ng/L): 24.20±1.45 vs. 31.49±1.42, IL-18 (ng/L): 12.97±1.25 vs. 29.01±1.95, all P < 0.05]. The mRNA and protein expression levels of NLRP3, caspase-1 were significantly decreased [NLRP3 mRNA (2 -ΔΔCt): 1.488±0.136 vs. 3.635±0.296, caspase-1 mRNA (2 -ΔΔCt): 1.643±0.143 vs. 4.020±0.228; NLRP3 protein (NLRP3/β-actin): 1.227±0.053 vs. 1.560±0.868, caspase-1 protein (caspase-1/β-actin): 1.159±0.107 vs. 1.392±0.097, all P < 0.05]. Conclusion:In vivo, BMSC may attenuate pyroptosis in LPS-induced kidney injury rats.

Revealing the Common Mechanisms of Scutellarin in Angina Pectoris and Ischemic Stroke Treatment via a Network Pharmacology Approach / 中国结合医学杂志

OBJECTIVE@#To investigate the shared mechanisms of scutellarin in angina pectoris (AP) and ischemic stroke (IS) treatment.@*METHODS@#A network pharmacology approach was used to detect the potential mechanisms of scutellarin in AP and IS treatment by target prediction, protein-protein interaction (PPI) data collection, network construction, network analysis, and enrichment analysis. Furthermore, molecular docking simulation was employed to analyze the interaction between scutellarin and core targets.@*RESULTS@#Two networks were established, including a disease-target network and a PPI network of scutellarin targets against AP and IS. Network analysis showed that 14 targets, namely, AKT1, VEGFA, JUN, ALB, MTOR, ESR1, MAPK8, HSP90AA1, NOS3, SERPINE1, FGA, F2, FOXO3, and STAT1, might be the therapeutic targets of scutellarin in AP and IS. Among them, NOS3 and F2 were recognized as the core targets. Additionally, molecular docking simulation confifirmed that scutellarin exhibited a relatively high potential for binding to the active sites of NOS3 and F2. Furthermore, enrichment analysis indicated that scutellarin might exert a therapeutic role in both AP and IS by regulating several important pathways, such as coagulation cascades, mitogen-activated protein kinase (MAPK) signaling pathway, phosphatidylinositol 3 kinase (PI3K)/protein kinase B (Akt)/mammalian target of rapamycin (mTOR) signaling pathway, Toll-like receptor signaling pathway, hypoxia inducible factor-1 (HIF-1) signaling pathway, forkhead box O (FoxO) signaling pathway, tumor necrosis factor (TNF) signaling pathway, adipocytokine signaling pathway, insulin signaling pathway, insulin resistance, and estrogen signaling pathway.@*CONCLUSIONS@#The shared underlying mechanisms of scutellarin on AP and IS treatment might be strongly associated with its vasorelaxant, anticoagulant, anti-inflammatory, and antioxidative effects as well as its effect on improving lipid metabolism.

Impact of adjuvant transcatheter arterial chemoembolization with anti-tumor drug for prevention early recurrence of hepatocellular carcinoma patients with microvascular invasion after radical hepatectomy / 中华肝胆外科杂志

Objective:To study combined adjuvant transcatheter arterial chemoembolization (TACE) with anti-tumor drug treatment on early hepatocellular carcinoma (HCC) recurrence in patients with microvascular invasion (MVI) after partial hepatectomy with curative intent.Methods:The clinical and pathological data of 169 patients with HCC who underwent partial hepatectomy with curative intent from January 2015 to December 2018 at the Affiliated Hospital of Qingdao University were retrospectively analyzed. MVI was diagnosed by postoperative histopathology. There were 147 males and 22 females, with the median age 56 years(ranged 32-79 years). The patients were divided into surgery group ( n=62, patients who did not receive adjuvant therapy), TACE group ( n=42, patients who only received TACE) and combined group ( n=65, patients who received TACE with anti-tumor drug) according to the therapies after resection. Patients in each group were further divided into grade M1 (mild) and grade M2 (severe) subgroups according to the severity of MVI. All patients were followed-up for observing tumor recurrence. The relapse-free survival in the three groups were compared using the Kaplan-Meier method and the log-rank test was used to compare the tumor-free survival rates. Results:The tumor-free survival rates of 169 patients at 1 and 2 years after operation were 59.2% and 40.8%. The tumor-free survival rates at 1 and 2 years after operation were 45.2% and 25.8% in surgery group, 61.9% and 40.5% in TACE group, 70.8% and 52.3% in combined group respectively. The differences among the three groups were significant: TACE group was better than surgery group, and combined group was better than TACE group, combined group was better than surgery group (all P<0.05). In TACE group and combined group, tumor-free survival rates of M1patients better than M2 patients, and the difference was significant ( P<0.05). Among M1 patients and M2 patients, tumor-free survival rates of combined group patients were better than surgery group and TACE group, the difference was significant (all P<0.05). The cumulative tumor-free survival rate was not significantly affected by different antineoplastic agents. Conclusion:Adjuvant TACE reduced the early recurrence rate of HCC patients with MVI. Adjuvant TACE combined with anti-tumor drug further reduced early tumor recurrence.

Application of the logistic regression model for the analysis of accuracy related influencing factors on HPLC measurement of preservatives / 公共卫生与预防医学

Objective To employ Logistic regression modeling to analyze the related factors influencing the accuracy of the high performance liquid chromatography (HPLC) determination of preservatives in beverages. Methods The HPLC separation was performed on a Zorbax Eclipse Plus C18 column with methanol-ammonium acetate solution as mobile phase. The external standard method was used to determine 5 beverage preservatives. The influencing factors on the measurement accuracy were statistically evaluated with univariate and multivariate analysis. Results Univariate analysis showed that the recovery rate of the added standard in the determination of coffee beverage preservatives by HPLC was affected by the pretreatment method, and the difference was statistically significant (P<0.05). Multivariate analysis showed that the main influencing factors on the accuracy of determination of sorbic acid was the pretreatment method (OR=5.406, P<0.05), while the sample type was a protective factor (OR=0.134, P<0.05). For the determination of benzoic acid, the main factor influencing the accuracy was the sample type (OR=1.112, P<0.05), while the pretreatment method was a protective factor (OR=0.447, P<0.05). Conclusion Logistic regression analysis can identify risk factors for the accuracy of the determination, and provide statistical modeling support for the experimental optimization.

Analysis of factors associated with disease outcomes in hospitalized patients with 2019 novel coronavirus disease / 中华医学杂志(英文版)

Background@#Since early December 2019, the 2019 novel coronavirus disease (COVID-19) has caused pneumonia epidemic in Wuhan, Hubei province of China. This study aims to investigate the factors affecting the progression of pneumonia in COVID-19 patients. Associated results will be used to evaluate the prognosis and to find the optimal treatment regimens for COVID-19 pneumonia.@*Methods@#Patients tested positive for the COVID-19 based on nucleic acid detection were included in this study. Patients were admitted to three tertiary hospitals in Wuhan between December 30, 2019, and January 15, 2020. Individual data, laboratory indices, imaging characteristics, and clinical data were collected, and statistical analysis was performed. Based on clinical typing results, the patients were divided into a progression group or an improvement/stabilization group. Continuous variables were analyzed using independent samples t-test or Mann-Whitney U test. Categorical variables were analyzed using chi-squared test or Fisher’s exact test. Logistic regression analysis was performed to explore the risk factors for disease progression.@*Results@#Seventy-eight patients with COVID-19-induced pneumonia met the inclusion criteria and were included in this study. Efficacy evaluation at 2 weeks after hospitalization indicated that 11 patients (14.1%) had deteriorated, and 67 patients (85.9%) had improved/stabilized. The patients in the progression group were significantly older than those in the disease improvement/stabilization group (66 [51, 70] years vs. 37 [32, 41] years, U =4.932, P =0.001). The progression group had a significantly higher proportion of patients with a history of smoking than the improvement/stabilization group (27.3% vs. 3.0%, χ2=9.291, P =0.018). For all the 78 patients, fever was the most common initial symptom, and the maximum body temperature at admission was significantly higher in the progression group than in the improvement/stabilization group (38.2 [37.8, 38.6]℃ vs. 37.5 [37.0, 38.4]℃, U=2.057, P =0.027). Moreover, the proportion of patients with respiratory failure (54.5% vs. 20.9%, χ2=5.611, P=0.028) and respiratory rate (34 [18, 48] breaths/min vs. 24 [16, 60] breaths/min, U=4.030, P=0.004) were significantly higher in the progression group than in the improvement/stabilization group. C-reactive protein was significantly elevated in the progression group compared to the improvement/stabilization group (38.9 [14.3, 64.8] mg/L vs. 10.6 [1.9, 33.1] mg/L, U=1.315, P=0.024). Albumin was significantly lower in the progression group than in the improvement/stabilization group (36.62±6.60 g/L vs. 41.27±4.55 g/L, U =2.843, P =0.006). Patients in the progression group were more likely to receive high-level respiratory support than in the improvement/stabilization group (χ2=16.01, P=0.001). Multivariate logistic analysis indicated that age (OR, 8.546; 95% CI: 1.628-44.864; P = 0.011), history of smoking (OR, 14.285; 95% CI: 1.577-25.000; P = 0.018), maximum body temperature at admission (OR, 8.999; 95% CI: 1.036-78.147, P = 0.046), respiratory failure (OR, 8.772, 95% CI: 1.942-40.000; P = 0.016), albumin (OR, 7.353, 95% CI: 1.098-50.000; P = 0.003) and C-reactive protein (OR, 10.530; 95% CI: 1.224-34.701, P = 0.028) were risk factors for disease progression.@*Conclusions@#Several factors that led to the progression of COVID-19 pneumonia were identified, including age, history of smoking, maximum body temperature on admission, respiratory failure, albumin, C-reactive protein. These results can be used to further enhance the ability of management of COVID-19 pneumonia.

Clinical characteristics of novel coronavirus cases in tertiary hospitals in Hubei Province / 中华医学杂志(英文版)

Background@#A novel coronavirus (2019-nCoV) causing an outbreak of pneumonia in Wuhan, Hubei province of China was isolated in January 2020. This study aims to investigate its epidemiological history, and analyzed the clinical characteristics, treatment regimens and prognosis of patients infected with 2019-nCoV during this outbreak.@*Methods@#Clinical data from 137 2019-nCoV-infected patients admitted to the respiratory departments of nine tertiary hospitals in Hubei province from December 30, 2019 to January 24, 2020 were collected, including general status, clinical manifestations, laboratory test results, imaging characteristics, and treatment regimens.@*Results@#None of the 137 patients (61 males, 76 females, aged 20-83 years, mean age 55 ± 16 years) had a definite history of exposure to Huanan Seafood Wholesale Market. Major initial symptoms included fever (112/137, 81.8%), coughing (66/137, 48.2%), and muscle pain or fatigue (44/137, 32.1%), with other, less typical initial symptoms observed at low frequency, including heart palpitations, diarrhea, and headache. Nearly 80% of the patients had normal or decreased white blood cell counts, and 72.3% (99/137) had lymphocytopenia. Lung involvement was present in all cases, with most chest computed tomography scans showing lesions in multiple lung lobes, some of which were dense; ground-glass opacity co-existed with consolidation shadows or cord-like shadows. Given the lack of effective drugs, treatment focused on symptomatic and respiratory support. Immunoglobulin G was delivered to some critically ill patients according to their condition. Systemic corticosteroid treatment did not show significant benefits. Notably, early respiratory support facilitated disease recovery and improved prognosis. The risk of death was primarily associated with age, underlying chronic diseases, and median interval from the appearance of initial symptoms to dyspnea.@*Conclusions@#The majority of patients with 2019-nCoV coronavirus pneumonia present with fever as the first symptom, and most of them still showed typical manifestations of viral pneumonia on chest imaging. Middle-aged and elderly patients with underlying comorbidities are susceptible to respiratory failure and may have a poorer prognosis.

Clinical characteristics of novel coronavirus cases in tertiary hospitals in Hubei Province / 中华医学杂志(英文版)

BACKGROUND@#The 2019 novel coronavirus (2019-nCoV) causing an outbreak of pneumonia in Wuhan, Hubei province of China was isolated in January 2020. This study aims to investigate its epidemiologic history, and analyze the clinical characteristics, treatment regimens, and prognosis of patients infected with 2019-nCoV during this outbreak.@*METHODS@#Clinical data from 137 2019-nCoV-infected patients admitted to the respiratory departments of nine tertiary hospitals in Hubei province from December 30, 2019 to January 24, 2020 were retrospectively collected, including general status, clinical manifestations, laboratory test results, imaging characteristics, and treatment regimens.@*RESULTS@#None of the 137 patients (61 males, 76 females, aged 20-83 years, median age 57 years) had a definite history of exposure to Huanan Seafood Wholesale Market. Major initial symptoms included fever (112/137, 81.8%), coughing (66/137, 48.2%), and muscle pain or fatigue (44/137, 32.1%), with other, less typical initial symptoms observed at low frequency, including heart palpitations, diarrhea, and headache. Nearly 80% of the patients had normal or decreased white blood cell counts, and 72.3% (99/137) had lymphocytopenia. Lung involvement was present in all cases, with most chest computed tomography scans showing lesions in multiple lung lobes, some of which were dense; ground-glass opacity co-existed with consolidation shadows or cord-like shadows. Given the lack of effective drugs, treatment focused on symptomatic and respiratory support. Immunoglobulin G was delivered to some critically ill patients according to their conditions. Systemic corticosteroid treatment did not show significant benefits. Notably, early respiratory support facilitated disease recovery and improved prognosis. The risk of death was primarily associated with age, underlying chronic diseases, and median interval from the appearance of initial symptoms to dyspnea.@*CONCLUSIONS@#The majority of patients with 2019-nCoV pneumonia present with fever as the first symptom, and most of them still showed typical manifestations of viral pneumonia on chest imaging. Middle-aged and elderly patients with underlying comorbidities are susceptible to respiratory failure and may have a poorer prognosis.

Analysis of factors associated with disease outcomes in hospitalized patients with 2019 novel coronavirus disease / 中华医学杂志(英文版)

BACKGROUND@#Since early December 2019, the 2019 novel coronavirus disease (COVID-19) has caused pneumonia epidemic in Wuhan, Hubei province of China. This study aimed to investigate the factors affecting the progression of pneumonia in COVID-19 patients. Associated results will be used to evaluate the prognosis and to find the optimal treatment regimens for COVID-19 pneumonia.@*METHODS@#Patients tested positive for the COVID-19 based on nucleic acid detection were included in this study. Patients were admitted to 3 tertiary hospitals in Wuhan between December 30, 2019, and January 15, 2020. Individual data, laboratory indices, imaging characteristics, and clinical data were collected, and statistical analysis was performed. Based on clinical typing results, the patients were divided into a progression group or an improvement/stabilization group. Continuous variables were analyzed using independent samples t-test or Mann-Whitney U test. Categorical variables were analyzed using Chi-squared test or Fisher's exact test. Logistic regression analysis was performed to explore the risk factors for disease progression.@*RESULTS@#Seventy-eight patients with COVID-19-induced pneumonia met the inclusion criteria and were included in this study. Efficacy evaluation at 2 weeks after hospitalization indicated that 11 patients (14.1%) had deteriorated, and 67 patients (85.9%) had improved/stabilized. The patients in the progression group were significantly older than those in the disease improvement/stabilization group (66 [51, 70] vs. 37 [32, 41] years, U = 4.932, P = 0.001). The progression group had a significantly higher proportion of patients with a history of smoking than the improvement/stabilization group (27.3% vs. 3.0%, χ = 9.291, P = 0.018). For all the 78 patients, fever was the most common initial symptom, and the maximum body temperature at admission was significantly higher in the progression group than in the improvement/stabilization group (38.2 [37.8, 38.6] vs. 37.5 [37.0, 38.4]°C, U = 2.057, P = 0.027). Moreover, the proportion of patients with respiratory failure (54.5% vs. 20.9%, χ = 5.611, P = 0.028) and respiratory rate (34 [18, 48] vs. 24 [16, 60] breaths/min, U = 4.030, P = 0.004) were significantly higher in the progression group than in the improvement/stabilization group. C-reactive protein was significantly elevated in the progression group compared to the improvement/stabilization group (38.9 [14.3, 64.8] vs. 10.6 [1.9, 33.1] mg/L, U = 1.315, P = 0.024). Albumin was significantly lower in the progression group than in the improvement/stabilization group (36.62 ± 6.60 vs. 41.27 ± 4.55 g/L, U = 2.843, P = 0.006). Patients in the progression group were more likely to receive high-level respiratory support than in the improvement/stabilization group (χ = 16.01, P = 0.001). Multivariate logistic analysis indicated that age (odds ratio [OR], 8.546; 95% confidence interval [CI]: 1.628-44.864; P = 0.011), history of smoking (OR, 14.285; 95% CI: 1.577-25.000; P = 0.018), maximum body temperature at admission (OR, 8.999; 95% CI: 1.036-78.147, P = 0.046), respiratory failure (OR, 8.772, 95% CI: 1.942-40.000; P = 0.016), albumin (OR, 7.353, 95% CI: 1.098-50.000; P = 0.003), and C-reactive protein (OR, 10.530; 95% CI: 1.224-34.701, P = 0.028) were risk factors for disease progression.@*CONCLUSIONS@#Several factors that led to the progression of COVID-19 pneumonia were identified, including age, history of smoking, maximum body temperature at admission, respiratory failure, albumin, and C-reactive protein. These results can be used to further enhance the ability of management of COVID-19 pneumonia.

Clinical characteristics of fatal and recovered cases of coronavirus disease 2019 in Wuhan, China: a retrospective study / 中华医学杂志(英文版)

BACKGROUND@#The 2019 novel coronavirus has caused the outbreak of the acute respiratory disease in Wuhan, Hubei Province of China since December 2019. This study was performed to analyze the clinical characteristics of patients who succumbed to and who recovered from 2019 novel coronavirus disease (COVID-19).@*METHODS@#Clinical data were collected from two tertiary hospitals in Wuhan. A retrospective investigation was conducted to analyze the clinical characteristics of fatal cases of COVID-19 (death group) and we compare them with recovered patients (recovered group). Continuous variables were analyzed using the Mann-Whitney U test. Categorical variables were analyzed by χ test or Fisher exact test as appropriate.@*RESULTS@#Our study enrolled 109 COVID-19 patients who died during hospitalization and 116 recovered patients. The median age of the death group was older than the recovered group (69 [62, 74] vs. 40 [33, 57] years, Z = 9.738, P < 0.001). More patients in the death group had underlying diseases (72.5% vs. 41.4%, χ = 22.105, P < 0.001). Patients in the death group had a significantly longer time of illness onset to hospitalization (10.0 [6.5, 12.0] vs. 7.0 [5.0, 10.0] days, Z = 3.216, P = 0.001). On admission, the proportions of patients with symptoms of dyspnea (70.6% vs. 19.0%, χ = 60.905, P < 0.001) and expectoration (32.1% vs. 12.1%, χ = 13.250, P < 0.001) were significantly higher in the death group. The blood oxygen saturation was significantly lower in the death group (85 [77, 91]% vs. 97 [95, 98]%, Z = 10.625, P < 0.001). The white blood cell (WBC) in death group was significantly higher on admission (7.23 [4.87, 11.17] vs. 4.52 [3.62, 5.88] ×10/L, Z = 7.618, P < 0.001). Patients in the death group exhibited significantly lower lymphocyte count (0.63 [0.40, 0.79] vs. 1.00 [0.72, 1.27] ×10/L, Z = 8.037, P < 0.001) and lymphocyte percentage (7.10 [4.45, 12.73]% vs. 23.50 [15.27, 31.25]%, Z = 10.315, P < 0.001) on admission, and the lymphocyte percentage continued to decrease during hospitalization (7.10 [4.45, 12.73]% vs. 2.91 [1.79, 6.13]%, Z = 5.242, P < 0.001). Alanine transaminase (22.00 [15.00, 34.00] vs. 18.70 [13.00, 30.38] U/L, Z = 2.592, P = 0.010), aspartate transaminase (34.00 [27.00, 47.00] vs. 22.00 [17.65, 31.75] U/L, Z = 7.308, P < 0.001), and creatinine levels (89.00 [72.00, 133.50] vs. 65.00 [54.60, 78.75] μmol/L, Z = 6.478, P < 0.001) were significantly higher in the death group than those in the recovered group. C-reactive protein (CRP) levels were also significantly higher in the death group on admission (109.25 [35.00, 170.28] vs. 3.22 [1.04, 21.80] mg/L, Z = 10.206, P < 0.001) and showed no significant improvement after treatment (109.25 [35.00, 170.28] vs. 81.60 [27.23, 179.08] mg/L, Z = 1.219, P = 0.233). The patients in the death group had more complications such as acute respiratory distress syndrome (ARDS) (89.9% vs. 8.6%, χ = 148.105, P < 0.001), acute cardiac injury (59.6% vs. 0.9%, χ = 93.222, P < 0.001), acute kidney injury (18.3% vs. 0%, χ = 23.257, P < 0.001), shock (11.9% vs. 0%, χ = 14.618, P < 0.001), and disseminated intravascular coagulation (DIC) (6.4% vs. 0%, χ = 7.655, P = 0.006).@*CONCLUSIONS@#Compared to the recovered group, more patients in the death group exhibited characteristics of advanced age, pre-existing comorbidities, dyspnea, oxygen saturation decrease, increased WBC count, decreased lymphocytes, and elevated CRP levels. More patients in the death group had complications such as ARDS, acute cardiac injury, acute kidney injury, shock, and DIC.

Effect of thyroid stimulating hormone level and thyroid peroxidase antibody status on pregnancy outcome in early pregnancy / 中国医师杂志

Objective:To investigate the relationship between thyroid stimulating hormone (TSH) level and thyroid peroxidase antibody (TPOAb) status in the first trimester on pregnancy outcomes.Methods:A total of 2 095 pregnant women with complete clinical data from department of pregnancy endocrinology or department of obstetrics in Dongying People′s Hospital from January 1, 2018 to November 31, 2019.According to the TSH level detected before 12 + 6 weeks of gestation, all pregnant women were divided into normal TSH (0.1 μIU/ml≤TSH< 2.5 μIU/ml), high TSH (2.5 μIU/ml≤TSH≤4.0 μIU/ml), sub-clinical hypothyroidism during gestation (4.0 μIU/ml<TSH<10.0 μIU/ml). According to negative and positive of TPOAb, they were divided into group A [TSH normal + TPOAb (-) group, n=1 523], group B [TSH normal + TPOAb (+ ) group, n=185], group C [high TSH + TPOAb (-) group, n=234], group D [high TSH + TPOAb (+ ) group, n=47], group E [subclinical hypothyroidism + TPOAb (-) group, n=70], and group F [subclinical hypothyroidism + TPOAb (+ ) group, n=36]. Taking group A as the control, the differences of pregnancy complications and pregnancy outcomes between the groups were compared, and the correlation between TSH and TPO antibodies and pregnancy complications and pregnancy outcomes was analyzed by multivariate logistic regression. Results:There was a significant difference in the number of gestational diabetes cases among pregnant women ( P<0.05). Further compared with control group A, group F had the highest percentage (55.6% vs 20.5%). There was a statistical difference in the distribution of preterm delivery among pregnant women in each group ( P<0.05), and the percentage of preterm delivery in group D and group F were increased. There was no statistically significant difference in pregnancy complications and adverse pregnancy outcomes between the other groups and the control group ( P>0.05). Multivariate logistic regression analysis of gestational diabetes mellitus and preterm delivery showed that the risk of gestational diabetes mellitus was significantly increased in group F compared with the control group. Age, gestational status, and TPOAb positivity were risk factors for gestational diabetes. The risk of premature birth in group D, group E and group F was higher than that in the control group [odds ratio ( OR)>1]. Age and TPOAb positivity were risk factors for preterm delivery in pregnant women ( OR>1, P<0.05). Conclusions:TPOAb positive in early pregnancy combined with subclinical hypothyroidism in pregnancy will increase the risk of gestational diabetes, while TPOAb positive in early pregnancy combined with TSH on the high side or subclinical hypothyroidism in pregnancy will increase the risk of premature delivery, so the management of such pregnant women should be strengthened and active treatment should be given if necessary.

Masquelet technique combined with artificial dermis for the treatment of bone and soft tissue defects in rabbits / 中国修复重建外科杂志

Objective: To investigate the effect of Masquelet technique combined with artificial dermis on repairing bone and soft tissue defects in rabbits, and to observe the microstructure and vascularization of induced membrane, so as to guide the clinical treatment of Gustilo-Anderson type Ⅲ open fracture with large bone defect and soft tissue defect. Methods: Eighty male rabbits, weighing 2.03-2.27 kg (mean, 2.11 kg), were selected. The bilateral thighs of 64 rabbits were randomly divided into experimental group and control group, the remaining 16 rabbits were sham operation group. Bone and soft tissue defect models of femur were made in all rabbits. In the experimental group, the first stage of Masquelet technique was used [polymethyl methacrylate bone cement was filled in bone defect area] combined with artificial dermis treatment; in the control group, the first stage of Masquelet technique was used only; in the sham operation group, the wound was sutured directly without any treatment. Four rabbits in sham operation group and 16 rabbits in the experimental group and control group were sacrificed at 2, 4, 6, and 8 weeks after operation, respectively. The induced membranes and conjunctive membranes were observed on both sides of the femur. The membrane structure was observed by HE staining, and the microvessel density (MVD) was counted by CD34 immunohistochemical staining. Results: Gross observation showed that the spongy layer of collagen in the artificial dermis of the experimental group disappeared completely at 4 weeks after operation, and the induced membrane structure of the experimental group and the control group was complete; the membrane structure of the control group was translucent, and the membrane structure of the experimental group was thicker, light red opaque, accompanied by small vessel proliferation. The membrane structure of the experimental group and the control group increased gradually from 6 to 8 weeks after operation. In the sham operation group, only scar tissue proliferation was observed over time. HE staining showed that a large number of muscle fibers and a small amount of collagen fibers proliferation with inflammatory cell infiltration could be seen in the experimental group and the control group at 2 weeks after operation; most of the sham operation group were muscle fibers with a small amount of interfibrous vessels. At 4 weeks after operation, collagen fibers increased and some blood vessels formed in the experimental group. The nuclei of collagen fibers in the control group were round-like, while those in the experimental group were flat-round. At 6 and 8 weeks after operation, the collagen fibers in the experimental group and the control group increased. The nuclei of the collagen fibers in the control group were still round-like. The nuclei of the collagen fibers in the experimental group were fusiformis and deeply stained compared with those in the control group. The proliferation of blood vessels was observed in both groups, and the number of proliferation vessels in the experimental group was increased compared with that in the control group. In the sham operation group, a large number of fibroblasts still appeared, but no significant proliferation of blood vessels with time was observed. CD34 immunohistochemical staining showed that MVD in each group increased gradually with the prolongation of time after operation. MVD in the sham operation group was significantly higher than that in the experimental group and the control group at 2 weeks after operation, and significantly smaller than that in the experimental group and the control group at 4, 6, and 8 weeks after operation ( P0.05). Conclusion: Masquelet technique combined with artificial dermis in the treatment of femoral bone defect and soft tissue defect in rabbits can significantly promote the vascularization of membrane structure at 4-6 weeks after operation. The combination of these two methods has guiding significance for the treatment of Gustilo-Anderson type Ⅲ open fracture with bone and soft tissue defects.

Comparison of artificial dermis Lando(R) versus Pelnac(R) combined with induced membrane technique in treatment of composite trauma in rabbit bilateral femurs / 中华创伤骨科杂志

Objective To compare 2 kinds of artificial dermis Lando(R) versus Pelnac(R) combined with induced membrane technique in the treatment of composite trauma in rabbit bilateral femurs.Methods Twenty-seven male rabbits,weighing from 1.92 kg to 2.21 kg (average,2.04 kg),were used in the experiments.After models of composite trauma were created in the bilateral femurs of all the rabbits,the bilateral femurs of 9 random rabbits were subjected to the treatment of artificial dermis Lando(R) plus induced membrane (Lando(R) group),the bilateral femurs of another 9 random rabbits to the treatment of artificial dermis Pelnac(R) plus induced membrane (Pelnac(R) group),the left femur of the remaining 9 rabbits to the treatment of induced membrane (control group) and the right femur of the remaining 9 rabbits to no treatment (sham operation group).Three rabbits from each group (the same for the control and sham operation groups) were randomly sacrificed at 2,4 and 6 weeks after operation.Samples from the operation sites were taken for gross observation of the induced membrane and observation of the microstructure of the membrane by conventional hematoxylin-eosin staining.In addition,the microvessel density (MVD) was counted under microscopy taking CD34 immunohistochemistry as the standard.The data were statistically analyzed.Results The collagen sponge layer was completely degraded 2 weeks after operation in the Lando(R) group but not in the Pelnac(R) group.The MVD [(0.90 ± 0.55)/HPF] in the Lando(R) group was significantly greater than that in the Pelnac(R) group [(0.28 ± 0.13)/HPF] (P ＜ 0.05).The collagen sponge layer was degraded 4 weeks after operation in the Lando(R) and Pelnac(R) groups and there was no significant difference between the 2 groups in MVD [(3.61 ± 1.31)/HPF versus (4.34 ± 0.77)/HPF] (P ＞ 0.05).At 6 weeks postoperatively,the MVD [(4.97 ±0.76)/HPF] in the Lando(R) group was significantly smaller than that in the Pelnac(R) group [(7.06 ± 1.03)/HPF] (P ＜ 0.05).At 2 weeks after operation,the MVD was (0.11 ±0.19)/HPF in the control group and the sham operation group,showing a significant difference compared with the Lando(R) group (P ＜ 0.05) but no significant difference compared with the Pelnac(R) group (P ＞ 0.05).The MVD at 4 and 6 weeks after operation in the control and the sham operation groups were all significantly different from those in the Lando(R) and the Pelnac(R) groups (P ＜ 0.05).Conclusions In the treatment of composite trauma in rabbits,the 2 kinds of artificial dermis combined with the induction membrane technique can lead to formation of induced membrane structure,providing a new alternative treatment for patients with bone and soft tissue defects caused by various causes in the clinic.The Lando(R) artificial dermis may accelerate the vascularization of induced membrane at 2 weeks while the Pelnac(R) may accelerate the vaseularization at 4 and 6 weeks.

Development of new radial artery puncture and fixation device / 医疗卫生装备

Objective To develop a new radial artery puncture fixing device to conquer the deficiencies of traditional method. Methods The device was composed of an arm support,a hand support,a wrist part,an arm fixing belt,a palm fixing belt and a tourniquet.The arm support was concave-shaped,and was connected with the hand support with the wrist part.The wrist part had a raised block which was gifted with an inflatable bag.The balloon linked with an inflation balloon with an inflation tube.There was a valve between the inflation tube and balloon.The fixing belt had one end directly connected with the arm support, hand support and wrist part, and the other end linked with the other ends of the above components with Velcro. There was a compression hemostatic balloon at the internal surface of the tourniquet. Results The device behaved well in puncture time and success rate,and decreased the incidence rates of errhysis and hematoma after withdrawing the puncture needle while increased the satisfaction of medical staffs and patients. Conclusion The device gains advantages in simple structure,convenience,practicability and safety,and meets the desired requirements.[Chinese Medical Equipment Jour-nal,2018,39(5):44-46]

Development of disposable anticoagulant negative pressure syringe / 医疗卫生装备

Objective To develop a disposable negative pressure syringe to solve the problems in bone marrow aspiration. Methods The syringe was composed of an injector and a self-contained puncture needle.The injector consisted of a barrel,a plunger and a tip.The plunger had its front end placed in the barrel and connected with the tip.The tip clung to the inner wall and could slide along it,and the upper end of the cylinder was connected closely with a negative-pressure sealing cap.A negative-pressure cavity was formed between the sealing cap and the tip,and an anticoagulation layer existed at the cylinder inner wall in the cavity.The blood taking needle was made up of a bone puncture needle and a hub.Results The developed syringe gained stable negative pressure,low time and workload consumption during bone marrow aspiration when compared with the conventional tools. Conclusion The syringe increases the quality of bone marrow aspiration while decreases the workload of medical staffs,and thus is worthy promoting practically.