Abstract:Objective To investigate the transfusion effects of red blood cells(RBCs)with different storage time on serum interleukin-6(IL-6)in low birth weight preterm infants and analyze the relationship between RBC storage time and proinflammatory responses.Methods A retrospective cohort study was conducted,the 75 preterm infants(gestational age<37 weeks)admitted to Neonatal Intensive Care Unit(NICU)of Hunan Children's Hospital from January 2020 to July 2022 were included.The infants were divided into≤14 days group(45 cases)and≥21 days group(30 cases)according to different RBC storage time.The clinical data and laboratory indexes[IL-6,C-reactive protein(CRP),hemoglobin(Hb)and white blood cell count(WBC)]were collected before and 24 hours after blood transfusion.The differences in above indexes between two groups were compared,and multivariate regression was used to analyze the association between RBC storage time and changes of IL-6 level.Results At 24 hours after blood transfusion,the≤14 days group showed a decrease in IL-6 level by(5.2±3.6)mmol/L,while the≥21 days group exhibited an increase of(19.9±14.0)mmol/L,with statistically significant difference(P<0.05).Multivariate regression analysis revealed that RBC storage time≥21 days(P=0.02)and lower 5 minute Apgar score(P=0.02)were independent risk factors for elevated IL-6 level after blood transfusion.No significant differences were observed in Hb,WBC and CRP levels between two groups.Conclusions Transfusion of RBCs stored for≥21 days significantly increases serum IL-6 level in low birth weight preterm infants,suggesting that prolonged storage may induce stronger proinflammatory responses.Preferential use of shorter-storage RBCs is recommended for preterm infants to mitigate inflammatory risks.

Abstract:Objective To analyze the prevalence and population gender and age distribution of hyperuricemia(HUA)in Hohhot area,Inner Mongolia Autonomous Region,and explore the related risk factors.Methods A cross-sectional study was conducted on 11 807 physical examination patients in Inner Mongolia Maternal and Child Health Hospital from January to December 2024,including 5 299 males and 6 508 females.They were divided into≤20 years old group(82 cases),21-30 years old group(2 013 cases),31-40 years old group(3 550 cases),41-50 years old group(2 476 cases),51-60 years old group(2 354 cases),61-70 years old group(1 064 cases),71-80 years old group(234 cases)and≥81 years old group(34 cases).The clinical data were collected,including serum uric acid(UA),fasting blood glucose(FBG),total cholesterol(TC),triacylglycerol(TG),low-density lipoprotein cholesterol(LDL-C)and high-density lipoprotein cholesterol(HDL-C).The differences in UA abnormal rates,UA levels and HUA prevalence among different gender and age groups were analyzed.The patients were divided into HUA group(3 516 cases;UA>420 μmol/L in male and UA>357 μmol/L in female)and normal UA group(6 859 cases;UA 208-420 μmol/L in male and UA 149-360 μmol/L in female).The differences in UA,FBG,TC,TG,LDL-C and HDL-C between two groups were compared.Spearman correlation analysis was used to explore the correlation between HUA and biochemical indicators.Results In males,the level of UA was the highest in≤20 years old group and the lowest in≥80 years old group[(447.09±95.73)μmol/L and(342.86±102.11)μmol/L,respectively],and the UA level gradually decreased with age,with statistically significant differences.In females,the level of UA was the highest in 71-80 years old group and the lowest in 41-50 years old group[(329.94±85.29)μmol/L and(275.81±68.21)μmol/L,respectively],with statistically significant differences.Except for 41-50 years old group and 71-80 years old group,there were statistically significant differences in the detection rates of HUA between males and females in all other age groups,and there were also statistically significant differences in detection rates of HUA among different age groups of males and femals.The levels of TC,TG and LDL-C in HUA group were higher than those in normal UA group,while the level of HDL-C was lower than that in normal UA group[TC(mmol/L):4.96±1.07 vs.4.34±0.72;TG(mmol/L):2.38±1.28 vs.1.24±0.64;LDL-C(mmol/L):2.41±1.22 vs.1.07±0.25;HDL-C(mmol/L):2.27±1.12 vs.2.69±0.45;all P<0.05].Spearman correlation analysis showed that HUA was positively correlated with TC,TG and LDL-C,and negatively correlated with HDL-C(r values were 0.241,0.438,0.335,-0.221,P values were<0.001,<0.001,0.035,0.042,respectively).Conclusion The elevated UA levels in physical examination population of Hohhot are associated with gender,TC,TG,LDL-C and HDL-C,and preventive measures and dietary management should be strengthened.

Abstract:Objective To explore a simple and rapid diagnostic and differential method for macroamylasemia and eliminate the interference of macroamylase in clinical test results.Methods The clinical data of three patients with suspected macroamylasemia who visited Jiangsu Province Official Hospital from July 2020 to January 2023(cases 1,2 and 3)were collected and included in experimental group.Two patients with confirmed acute pancreatitis(cases 4 and 5)were included in control group.Before and after precipitation of giant amylase by modified polyethylene glycol(PEG)precipitation method,the level of serum amylase(AMY)was detected using dry chemical detection system and wet chemical detection system,respectively,and the detection results were compared.Results After PEG precipitation,the results of AMY in cases 1,2 and 3 of experimental group detected by wet chemical detection system decreased significantly compared with those before precipitation,with the decrease rates of 94%,97%and 97%,and the results of AMY in cases 4 and 5 in control group was reduced with a decrease rate of 18%and 13%.After PEG precipitation,the AMY levels of cases 1 and 2 in experimental group and cases 4 and 5 in control group detected by dry chemical detection system were decreased compared with those before precipitation,with the decrease rates of<10%,<10%,30%and 34%respectively.However,the level of AMY in case 3 of experimental group decreased after PEG precipitation,with a decrease rate of>86%.Before PEG precipitation,compared with the results of wet chemical detection system,the AMY levels of cases 1 and 2 in experimental group detected by dry chemical detection system decreased significantly,with the decrease rates of 92%and>95%,respectively.Before PEG precipitation,the results of AMY detected by dry chemical detection system for case 3 in experimental group and cases 4 and 5 in control group decreased by 3%,3%and-3%respectively compared with those detected by wet chemical detection system.After PEG precipitation,the AMY detection results of cases 1,2,4 and 5 by wet chemical detection system were reduced compared to those by dry chemical detection system before precipitation,with decrease rates of 44%,<10%,16%and 16%,respectively.However,the AMY level of case 3 in experimental group was significantly reduced by wet chemical detection system after PEG precipitation,with a decrease rate of 97%compared to that of dry chemical detection system.Conclusion The PEG precipitation method is a simple and effective way to identify amylasemia,and dry chemical detection system could be used to screen for macroamylase with relatively high molecular weight.

Abstract:Objective To explore the changes in levels of red blood cell distribution width to albumin ratio(RDW/ALB),neutrophil to lymphocyte ratio(NLR)and serum ferritin(SF)in patients with chronic obstructive pulmonary disease(COPD)and their correlation with pulmonary function.Methods A total of 100 patients with COPD admitted in Longyan People's Hospital and 100 healthy controls from January 2022 and October 2024 were enrolled as COPD group and control group,respectively.The levels of RDW/ALB,NLR,SF and pulmonary function indexes[vital capacity(VC),forced expiratory volume in 1 second to forced vital capacity ratio(FEV1/FVC)and peak expiratory flow(PEF)]were compared between the two groups.The relationship between RDW/ALB,NLR,SF and pulmonary function indexes was analyzed by Pearson correlation analysis.Receiver operator characteristic curve(ROC curve)was drawn and area under ROC curve(AUC)was calculated to analyze the diagnostic value of NLR,RDW/ALB,SF alone and in combination for COPD.Results The levels of NLR,SF and RDW/ALB in COPD group were higher than those in control group,while the levels of VC,FEV1/FVC and PEF were lower than those in control group[NLR:3.31±1.27 vs.1.94±0.63;SF(μg/L):284.56±121.35 vs.182.34±81.63;RDW/ALB:(1.35±0.24)%vs.(0.92±0.16)%;VC(L):1.93±0.31 vs.3.14±0.36;FEV1/FVC:(55.36±6.01)%vs.(79.86±7.24)%;PEF(L/s):3.42±0.79 vs.5.33±0.85;all P<0.05].The AUC of RDW/ALB combined with NLR and SF in diagnosis of COPD was 0.921,which was significantly greater than those of single indexes(which were 0.767,0.793 and 0.755,respectively;all P<0.05).The results of Pearson correlation analysis showed that RDW/ALB,NLR and SF were all negatively correlated with VC,FEV1/FVC and PEF(VC:r values were-0.402,-0.517,-0.461,all P<0.001;FEV1/FVC:r values were-0.416,-0.454,-0.508,all P<0.001;PEF:r values were-0.429,-0.554,-0.405,P values were<0.001,<0.001,0.003).Conclusions The combined detection of RDW/ALB,NLR and SF has higher diagnostic value in COPD.The levels of the above indexes are relatively higher in COPD patients,and are related to pulmonary function indexes.

Abstract:Objective To investigate the application effect of prophylactic heated infusion combined with massive blood transfusion in emergency patients with severe trauma.Methods The 90 patients with severe trauma admitted to the emergency department of Longyan Second Hospital from January 2023 to December 2024 were selected as research objects,and the patients were divided into control group(45 cases;emergency routine treatment and blood transfusion treatment were given)and observation group(45 cases;preventive heated infusion was implemented on the basis of control group)based on different emergency intervention methods.The coagulation indicators[activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(FIB)and prothrombin time(PT)],alkaline indicators[pH value and blood lactic acid(Lac)],inflammatory factors[C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)],body temperature,incidence of adverse event and outcomes were compared between the two groups.Results Before treatment,there were no significant differences in PT,FIB,APTT,TT,pH value,Lac,CRP,TNF-α,IL-6 and body temperature between the two groups.After 6 hours of treatment,the PT,APTT and TT in observation group were significantly longer than those in control group,and the level of FIB was significantly higher than that in control group[PT(s):15.43±1.68 vs.13.49±1.69;APTT(s):33.15±3.71 vs.28.96±3.84;TT(s):19.72±1.74 vs.17.26±1.76;FIB(g/L):3.10±0.36 vs.2.43±0.46;all P<0.05].After 6 hours of treatment,the levels of pH value and Lac in observation group were significantly higher than those in control group[pH value:7.29±0.07 vs.7.20±0.08;Lac(mmol/L):2.01±0.31 vs.1.73±0.33;both P<0.05].After 24 hours of treatment,the levels of CRP,TNF-α and IL-6 in observation group were significantly lower than those in control group[CRP(mg/L):21.29±2.25 vs.25.73±2.49;TNF-α(μg/L):19.72±3.16 vs.26.73±3.36;IL-6(ng/L):45.29±6.42 vs.61.93±7.88;all P<0.05].The body temperatures in observation group were significantly higher than those in control group after 1 hour,2 hours and 4 hours of treatment[after 1 hour of treatment(℃):35.93±0.24 vs.35.56±0.23;after 2 hours of treatment(℃):36.29±0.25 vs.35.79±0.28;after 4 hours of treatment(℃):36.42±0.42 vs.36.11±0.41;all P<0.05].The incidence of adverse events and first aid failure rate in observation group were significantly lower than those in control group(incidence of adverse events:8.89%vs.26.67%;first aid failure rate:4.44%vs.17.78%;both P<0.05).Conclusion The application of prophylactic heated infusion combined with massive blood transfusion could improve the coagulation function of patients with severe trauma,thereby regulate the acid-base balance in the body,control the inflammatory reaction,help to maintain the patient's body temperature and reduce the incidence of adverse events and first aid failure rate.

Abstract:Objective To investigate the effect of combination of insulin degludec and insulin aspart and acarbose tablets on indicators related to glucose and lipid metabolism in type 2 diabetes mellitus(T2DM)patients.Methods The 72 cases of T2DM patients admitted to Tongzi County Hospital of Traditional Chinese Medicine from May 2023 to December 2024 were selected as study subjects and divided into control group(36 cases;treated with acarbose tablets)and observation group(36 cases;combined with insulin degludec and insulin aspart on basis of control group)according to different treatment regimens.The clinical efficacies of two groups were compared.The automated biochemical analyzer was used to measure blood glucose and lipid indicators.The hexokinase method was adopted to examine fasting plasma glucose(FPG)and 2-hour postprandial glucose(2hPG).Total cholesterol(TC)and triacylglycerol(TG)were detected with oxidase method,while low-density lipoprotein cholesterol(LDL-C)and high-density lipoprotein cholesterol(HDL-C)were measured through direct detection.Glycated hemoglobin(HbA1c)was analyzed using an automated glycated hemoglobin analyzer via high-performance liquid chromatography(HPLC).Body fat indicators including body mass index(BMI)and visceral adiposity index(VAI)were calculated,and the adverse reactions were recorded.Results After treatment,a comparison of the total effective rates between two groups showed that the observation group was significantly higher than the control group(94.44%vs.77.78%,P<0.05),and observation group had lower FPG,HbA1c,2hPG,TC,TG and LDL-C,higher HDL-C,and smaller BMI and VAI than control group[FPG(mmol/L):6.91±0.89 vs.8.06±1.24;HbA1c:0.069±0.007 vs.0.082±0.013;2hPG(mmol/L):7.54±1.04 vs.9.25±1.20;TC(mmol/L):3.81±0.75 vs.4.79±1.38;TG(mmol/L):0.94±0.27 vs.1.32±0.53;LDL-C(mmol/L):1.77±0.39 vs.2.14±0.49;HDL-C(mmol/L):5.84±0.55 vs.5.55±0.51;BMI(kg/m2):23.27±2.08 vs.25.86±2.12;VAI:3.03±0.64 vs.3.41±0.79;all P<0.05].The comparison of the incidence of adverse reactions in observation group and control group expressed no difference(22.22%vs.13.89%,P>0.05).Conclusion The synergistic administration of insulin degludec and insulin aspart and acarbose tablets is beneficial to the decrease of blood glucose and lipid indicators in patients with T2DM,maintaining endocrine stability,and has high safety.

Abstract:Objective To investigate the application value of blood test in diagnosis and differential diagnosis of mediterranean anemia and iron deficiency anemia. Methods 100 cases of anemia patients in our hospital from January 2011 to January 2015 were selected, and which including 50 cases mediterranean ane-mia patients and 50 cases iron deficiency anemia patients. The detection results of red cell distribution width (RDW), hemoglobin (Hb), red blood cell (RBC), mean corpuscular hemoglobin (MCH), mean corpuscular volume(MCV) and mean corpuscular hemoglobin concentration(MCHC) were analyzed by retrospective inves-tigation method. Results The RDW, RBC, MCV of the mediterranean anemia patients were significantly lower than that of iron deficiency anemia patients, the differences all had statistical significance (t=8.21,9.12,5.65, Pall<0.05). The MCHC and Hb were significantly higher in mediterranean anemia patients than that of iron defi-ciency anemia patients, and the differences all had statistical significance (t=6.34,6.20, Pall<0.05). There was no statistical significance in the difference of MCH between the two groups(t=4.21, P>0.05). Conclusion The blood test has significance in the differential diagnosis of mditerranean anemia and iron deficiency anemia , and which worthy of clinical application.

Abstract:Objective To study the clinical application value of procalcitonin (PCT) in patients with sepsis in different pathological processes. Methods 120 patients with sepsis who were admitted in our hospi-tal between August 2010 and August 2015 were selected as study subjects. All the patients were divided into sepsis group (47 cases), severe sepsis group (39 cases) and septic shock group (34 cases) according to the pathogenetic condition. The concentrations of PCT were detected by immunofluorescence assay on the 1st to 7th day after admission. The results of PCT in different sepsis groups were analyzed statistically. Results The PCT levels showed a increasing trend along with the severity degree of sepsis. There were statistical significance in the differences of PCT levels among three different sepsis groups at different time(Pall<0.05). The PCT level in septic shock group was higher than that of severe sepsis group and sepsis group, and the severe sepsis group was higher than that of sepsis group, and the differences all had statistical significance (Pall<0.05). The PCT levels in three sepsis groups were all decreased along with the increase of hospitalization time. The PCT levels on 3rd, 5th and 7th day after admission in death group were all higher than that of survival group, and the dif-ferences all had statistical significance (Pall< 0.05). The PCT level in survival group showed a decreasing trend, but showed a increasing trend in death group along with the increasing hospitalization time, and the dif-ferences all had statistical significance(Pall<0.05). Conclusion The detection of PCT has better clinical ap-plication value in the diagnosis, therapy and prognosis evaluation.

Abstract:Objective To evaluate the clinical value of procalcitonin (PCT), high sensitive C-reac-tive protein(hs-CRP) and N-terminal brain natriuretic peptide precursor(NT-proBNP) in chronic heart fail-ure(CHF) diagnosis. Methods 80 cases patients with CHF from January 2015 to June 2015 in our hospital were collected. The patients were divided into different cardiac function group according to NYHA method in-cluding 38 cases gradeⅡ, 30 cases gradeⅢand 12 cases gradeⅣ. 80 cases healthy controls were selected as control group. The serum PCT, hs-CRP and NT-proBNP of all the subjects were detected, and the results were analyzed statistically. Results The levels of PCT, hs-CRP and NT-proBNP in CHF group were all higher than that of control group, and the differences all had statistical significance(t=63.689,22.015,35.600, Pall<0.05). There were statistical significance in the difference of PCT , hs-CRP and NT-proBNP levels among three dif-ferent cardiac function groups (F= 601.284,973.150,4.829, Pall<0.05). The serum PCT, hs-CRP and NT-proBNP levels in CHF patients were all increasing along with the severity of the disease , and there were statisti-cal significance in the difference of PCT, hs-CRP and NT-proBNP levels between each two groups(Pall<0.05). The positive rates of PCT, hs-CRP and NT-proBNP in CHF patients were 85.0%(68/80), 92.5%(74/80) and 93.8%(75/80), and the positive rate of combine detection was 96.3%(77/80). The sensitivity of PCT, hs-CRP and NT-proBNP in diagnosis CHF were 85.0%, 92.5% and 93.8%, respectively. Thespecificity were 65.2%, 73.9%, 78.2% , respectively. The sensitivity, specificity and Youden index of com-bine detection were 96.3%, 82.6%and 0.79. The other diagnosis index of combine detection were all higher than that of index lonely detection. Conclusion The detection of PCT, hs-CRP and NT-proBNP can be used for diagnosis and cardiac function grading , and the combine detection can improve the accuracy of CHF diag-nosis.

Abstract:Objective To investigate the epidemic situation of children with respiratory viruses in Qingyuan, Guangdong. And to provide evidence for the diagnosis of respiratory virus infections in children. Methods 5121 inpatients with respiratory disease were collected in our hospital from February 2014 to Jan-uary 2015. Influenza virus (IF)A, IFB, parainfluenza virus (PIV)1, PIV2, PIV3, respiratory syncytial virus (RSV) and adenovirus (ADV) were detected by direct immunofluorescent. All data were analyzed statistical significance. Results There were 1801 cases (35.17%) were viral positive in 5121 patients. Among the posi-tive cases, there were 937 cases in RSV(52.03%), 312 cases in IFA(17.32%), 209 cases in ADV(11.60%), 186 cases in PIV3(10.33%), 60 cases in PIV1(3.33%), 38 cases in IFB(2.11%), 5 cases in PIV2(0.28%) and 54 cases in mixed infection(3.00%). Postitive rates of respiratory viruses in male and female had no statis-tical significance(P>0.05). Positive rates of patients between≤1 age and 2~3 age were all higher than that of 4~5 age, 6~7 age and 8~12 age patients, and the differences had statistical significance (Pall<0.05). The highest positive rate of respiratory viruses in≤1 age and 2~3 age patients was RSV(61.84%,44.99%), and in other three groups was ADV (44.52%,36.84%,53.49%). The highest positive rate of respiratory viurses was in spring, which compared with summer, autumn and winter had statistical significance (P<0.05). The highest positive rate of respiratory viruses in spring, summer and autumn was RSV(52.26%,73.61%,33.12%), and in winter was ADV (23.34%). The positive rate of patients with acute tracheitis was higher than that of patients with upper respiratory infection, pneumonia and bronchitis, and the differences had statistical significance (P< 0.05). The highest positive rate of respiratory viruses in upper respiratory infection, acute tracheitis and pneumonia was RSV(66.53%,38.81%,61.25%), and in bronchitis was IFA(37.58%). In 54 patients with mixed infection, the most cases was patients with RSV (26 cases). Conclusion Spring is the high incidence of res-piratory virus infection in children in Qingyuan. The infection rate of children under 3 years old is the highest. The main pathogen is RSV.