Multimorbidity substantially increases health and economic burdens, and reduces productivity in working-age individuals. We conducted a study using data from 393,170 working-age inpatients (18–59 years) in Shaanxi, China, collected from 1998 to 2018. We aimed to identify multimorbidity profiles by sex and age and explore multimorbidity patterns using network analysis. The sampling technique in our study involved forming two cohorts—blood donor and non-blood donor groups—from Shaanxi Province, China, based on age, sex, and region using a 1:1 matching method, resulting in 393,170 inpatient hospitalisation records for the working-age population. A total of 223,524 logistic regressions were conducted to explore statistically significant multimorbidity patterns, combined with network analysis, to create sex-specific and age-sex-stratified multimorbidity networks, identifying hub diseases with the most distinct multimorbidity patterns. Our study found that 46.61

Background and Objectives:Multimorbidity is increasingly prevalent among the middle-aged population, yet it is largely often overlooked. We aimed to explore and compare the differences in multimorbidity patterns by sex and age among middle-aged inpatients from China and the United Kingdom. Research Design and Methods:We analyzed 184 133 hospitalization records from Shaanxi, China, and 180 497 from the UK Biobank for -middle-aged populations. Using network analysis, we examined multimorbidity patterns by sex, age groups (40-44, 45-49, 50-54, and 55-59 years), and countries. We also identified hub diseases in both sex-specific and sex-age-specific networks and their corresponding roles in forming multimorbidity patterns. Results:In both China and the United Kingdom, males exhibited higher multimorbidity prevalence (China: 58.51% vs 55.33%, 1.06×; United Kingdom: 31.15% vs 29.79%, 1.05×) and greater complexity of multimorbidity patterns (China: 1179 patterns vs 990 patterns, 1.19×; United Kingdom: 438 patterns vs 377 patterns, 1.16×) than females. In sex-specific networks, males in both countries demonstrated the specificity of circulatory, genitourinary, and endocrine/nutritional/metabolic-associated multimorbidity patterns, while females demonstrated specific genitourinary and neoplasm-associated multimorbidity patterns. Hub diseases in these networks are distributed in similar disease categories. In sex-age-specific networks, dominant multimorbidity patterns and hub diseases shifted by age. In males, both countries showed stable but dominating circulatory, endocrine/nutritional/metabolic and digestive-associated multimorbidity patterns with aging. In comparison, Chinese females demonstrated an increase in nervous system-associated multimorbidity patterns and a decrease in genitourinary-associated multimorbidity patterns with ageing; British females demonstrated an increase in mental/behavioral-associated multimorbidity patterns and a stable but dominating -genitourinary-associated multimorbidity patterns. Discussion and Implications:In both China and the United Kingdom, males demonstrated more complex multimorbidity than females. With ageing, multimorbidity patterns are stable in males, while females in China and the United Kingdom each develop different and specific multimorbidity patterns. These findings may inform targeted interventions for middle-aged inpatients with multimorbidity by sex and age.

Our study seeks to provide a theoretical foundation for the clinical use of cold-stored platelets (CSPs) by interpreting ultrastructural images and quantitatively analyzing structural changes. CSPs, room temperature -stored platelets (RTPs), and delayed CSPs (delayed-CSPs) were continuously observed using scanning electron microscopy and transmission electron microscopy at eight time points. Super-resolution fluorescence microscopy was employed to observe changes in platelet microtubules and mitochondrial structure and function, whereas platelet counts, metabolism, and relevant functional indicators were measured concurrently. Quantitative statistical analysis of platelet size, morphology, canalicular systems, and five organelles was performed under electron microscopy. In CSPs stored for 1 day, the platelet shape changed from circular or elliptical to spherical, with size decreasing from 2.8 pound 2.2 mm to 2.0 pound 2.0 mm. CSPs exhibited wrinkling and reorganization of platelet microtubule proteins, with organelles aggregating toward the central region. CSPs stored for 14 days and delayed-CSPs for stored for 10 days exhibited numerous structurally intact and active cells. The percentage of structure-intact active cells was 92% in both groups, respectively. RTPs stored for 5 and 7 days showed minimal changes in size, a normal microtubule skeleton, and were primarily in a resting state. However, RTPs stored for 10 and 14 days displayed swelling, irregular disintegration of the microtubule skeleton, and the presence of membranous structures and vacuolated cells. The percentage of structure-intact active cells was only 45% and 7%, respectively. Our findings confirmed that the maximum storage time of platelets was 5-7 days for RTPs, within 10 days for delayed-CSPs, and 14 days for CSPs. (c) 2024 International Society for Experimental Hematology. Published by Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

BackgroundThe World Health Organization emphasizes the importance of completely voluntary blood donation to maintain safe and sustainable blood supplies. However, the benefits of blood donation for donors, such as reducing the risk of disease, remain a topic of debate due to the existence of the healthy donor effect (HDE). This effect arises because of inherent health differences between blood donors and the general population, and it is also considered a methodological issue. ObjectiveThis study aims to generate a more detailed health profile of blood donors from a donor cohort study to mitigate and quantify the HDE and properly interpret the association between blood donation and disease outcomes among blood donors. MethodsA retrospective cohort study was conducted between January 2012 and December 2018 among donors before their first donation. One-to-one propensity score matching was conducted through a random selection of individuals without any history of blood donation, as reported from their electronic health records. We conducted a Poisson regression between blood donors and non–blood donors before the first donation to estimate the adjusted incidence rate ratio (AIRR) of selected blood donation–related diseases, as defined by 13 categories of International Classification of Diseases, Tenth Revision (ICD-10) codes. ResultsOf the 0.6 million blood donors, 15,115 had an inpatient record before their first donation, whereas 17,356 non–blood donors had an inpatient record. For the comparison between blood donors and the matched non–blood donors, the HDE (the disease incidence rate ratio between non–blood donors and blood donors) was an AIRR of 1.152 (95% CI 1.127-1.178; P<.001). Among disease categories not recommended for blood donation in China, the strongest HDE was observed in the ICD-10 D50-D89 codes, which pertain to diseases of the blood and blood-forming organs as well as certain disorders involving the immune mechanism (AIRR 3.225, 95% CI 2.402-4.330; P<.001). After age stratification, we found that people who had their first blood donation between 46-55 years old had the strongest HDE (AIRR 1.816, 95% CI 1.707-1.932; P<.001). Both male and female donors had significant HDE (AIRR 1.082, 95% CI 1.05-1.116; P=.003; and AIRR 1.236, 95% CI 1.196-1.277; P<.001, respectively) compared with matched non–blood donors. Conclusions: Our research findings suggest that the HDE is present among blood donors, particularly among female donors and those who first donated blood between the ages of 46 and 55 years. Trial RegistrationChinese Clinical Trial Registry ChiCTR2200055983; https://www.chictr.org.cn/showproj.html?proj=51760

Background Platelets play an important role in acute bleeding.Whether 4℃cold stored platelets (CSPs) can be an effective substitute for platelets at room temperature (RTPs) is rarely reported, we carried out the clinical application observation trial of CSPs in China for the first time. Method A prospective, double-blind, randomized clinical trial was conducted on surgical patients with related bleedingto assess the hemostatic potential of CSPs compared with RTPs. The primary outcomes measured were drainage volume, platelet counts, and Thrombelastography-maximum amplitude. Secondary outcomes included hospital stays, length of stay in the intensive care unit, medical expenses. Results A total of 62 patients were completed the final clinical observation. There were 31 cases ineach of the CSPs group and RTPs group. With in 1–12 hours, 13–24 hours, 25–48 hours, and 49–72 hours after platelet transfusion, drainage volume: 8.5ml/h vs 20.83ml/h ,0.52ml/h vs 5.0ml/h, 3.5ml/h vs 5.0ml/h, 0.63ml/h vs 4.1ml/h. platelet counts:58×109/L vs 79×109/L, 54×109/Lvs77×109/L,63×109/L vs 75×109/L, 66×109/Lvs79×109/L. TEG-MA: 50.1mm vs 52.0mm ,50.1mm vs 54.8mm, 53.0mm vs 56.6, 56.0mm vs 53.2mm.There was no overall difference between the two groups by Generalized estimation equation at different times (Pdrainage=0.933,PPLT counts=0.473,PTEG−MA=0.246). The secondary outcomes (hospital stay, ICU stay time, medical cost, discharge outcome) were no difference between the CSPs group and RTPs group (P > 0.05). There were no significant differences in adverse platelet transfusion events between the groups (P > 0.05). Conclusion CSPs and RTP have equivalent efficacy and safety in the treatment of surgery-related bleeding. This trial provides reliable evidence to support the clinical application of CSPs. Trial registration Chinese Clinical Trial Registry: ChiCTR2000036353;Principal investigator's name: Jiangcun Yang. Date of registration: 22/08/2020.

Background Blood transfusion therapy is extremely important for certain neonatal diseases, but the threshold for neonatal blood transfusion is not the same in different countries. Until now, clinical studies to determine the suitable threshold for newborns in China are lacking. Therefore, it is of high importance to establish a multi-center cohort study to explore appropriate transfusion thresholds for newborns in China. Methods This retrospective cohort study investigated neonatal blood transfusion therapy administered from January 1, 2017 to June 30, 2018, with the aim of evaluating the effect of restricted and nonrestricted blood transfusion on neonatal health. The subjects were enrolled in 46 hospitals in China. A total of 5669 neonatal cases were included in the study. Clinical diagnosis and transfusion treatment of these neonates were collected and the data were retrospectively analyzed. The neonates were followed up 1 week and 1 month after leaving the hospital. The newborns’ and their mothers’ data were collected containing 280 variables in the database. The primary outcome of the study was mortality, and the secondary outcomes were complications, hospital stays, NICU hospital stays and hospital costs. Results Results from the < 1500 g group showed that there was a higher mortality rate in the restricted transfusion group (11.41%) when compared with the non-restricted transfusion group (5.12%) ( P = 0.000). Among the secondary outcomes, the restricted transfusion group had fewer costs. Results from the 1500-2500 g group showed that the mortality rates of the restricted and non-restricted transfusion groups were 3.53% and 4.71%, respectively, however there was no statistical significance between the two groups ( P = 0.345). Among the secondary outcomes, the restricted transfusion group had fewer hospital stays, NICU hospital stays and hospital costs. The incidence of necrotizing enterocolitis was lower in the restricted transfusion group (OR, 2.626; 95% confidence interval [CI], 1.445 to 4.773; P = 0.003). The results from the ≥ 2500 g restricted transfusion group suggested that the mortality rate of (3.02%) was significantly lower than that of non-restricted transfusion group (9.55%) ( P = 0.000). Among the secondary outcomes, the restricted transfusion group had fewer hospital stays and hospital costs. The incidence of retinopathy of prematurity was lower in the restricted transfusion group (OR, 4.624; 95% confidence interval [CI], 2.32 to 9.216; P = 0.000). Conclusions Current transfusion protocols for newborns weighing less than 1500 g may be inappropriate and lead to higher mortality. The current transfusion threshold performed better for the other two weight groups.

目的 调查全国住院输血新生儿血气检测指标,为深入研究不同阶段新生儿血气分析参考范围提供数据支持.方法 本研究采用多中心回顾性调研方式,以全国46家医院2017年1月1日～2018年6月30日收治的输血新生儿5669例为研究对象,按照统一的数据采集表,采集新生儿住院诊治数据,对采集数据按胎龄分为<32 w组,32～36 w组,≥37 w组三组,统计分析新生儿住院期间输血干预前血气分析数据.结果 随着新生儿日龄及胎龄的增大,pH值呈小幅波动,但总体呈升高的趋势.PO2结果显示<32 w组随日龄增大呈降低趋势,≥37 w组自0～1 d(61.80 mmHg)升高至4～5 d(72.50 mmHg)后趋于平稳,相同日龄三组间PO2值比较,日龄0～3 d时早产儿PO2大于足月儿.PCO2结果显示相同日龄三组间比较,随着胎龄的增大PCO2逐渐降低.新生儿随着日龄和胎龄的增大,HCT值均呈逐渐降低的趋势.SaO2结果显示≥37 w组自0～1 d(93％)升高至2～3 d(96.40％)后趋于稳定.结论 不同胎龄不同日龄新生儿血气相关指标变化显著,依据胎龄日龄制定新生儿血气指标参考范围有助于指导临床对新生儿疾病的精准诊疗.

ABO blood groups distribution shows obvious geographical differences globally, but the reliability of the Blood data for assessing relationships between population groups is limited. This is mostly due to the lack of availability and interchange of this important data. We collected data of 23 million ABO blood group population from 34 provincial-level administrative regions in China. To ensure the reliability of the results, we standardized the 23 million data by the China seventh census data. The ranking of ABO blood groups phenotypic distribution in China is O > A > B > AB. The proportions of A, B, O and AB type in China population are 28.72%, 28.17%, 34.20%, and 8.91%, respectively. Accordingly, the frequencies of p [A], q [B], and r [O] gene at the ABO blood group are 0.211, 0.208, and 0.584, respectively. China blood phenotype is dominated by O type, but the r gene frequency is obviously lower than other countries. The distribution of ABO blood groups in China varies geographically. Clustering analysis results show that ABO blood groups divide into four regions from north to south in China, and reveal that the r [O] gene shows an increasing trend from North to South, and conversely the q [B] gene exhibited a decreasing trend at these coordinates. These analyses present interesting characteristics of the blood group distribution across the geography of China.

目的 分析不同胎龄不同日龄住院输血新生儿输血前肝功能检测指标,为深入研究不同胎龄新生儿肝功能指标参考范围提供数据支持.方法 本研究采用多中心回顾性调研方式,以全国46家医院2017年1月1日～2018年6月30日收治的5669例输血新生儿为研究对象,按照统一的数据采集表,采集新生儿住院诊治数据,对采集数据按胎龄分为<32周组,32～36周组,≥37周组三组,分析不同日龄不同胎龄的新生儿输血前肝功能检测指标.结果 (1)ALT结果显示,早产儿两组ALT中位数0～28 d分别为5～8 U/L和8～11 U/L,足月儿ALT较高为11～22 U/L,不同胎龄组内比较差异有统计学意义.相同日龄组间比较,ALT随胎龄增大逐渐增高,足月儿ALT值最高.各组间比较时除日龄13～14 d无差异外,其余日龄组间差异均有统计学意义.(2)不同胎龄新生儿随日龄增大,TBIL及DBIL呈先升高后减低趋势,相同日龄组间比较时,随胎龄增大TBIL及DBIL值更高.(3)三组TP值比较显示,出生后1～2 d下降,随后呈现逐渐上升趋势,不同日龄比较差异均有统计学意义,相同日龄组间比较时,随胎龄增大TP多呈现增高趋势.(4)相同日龄组间比较时,随胎龄增大ALB呈现增长趋势.结论 肝功能指标参考区间与新生儿胎龄和日龄有关,研究不同胎龄不同日龄新生儿肝功能指标范围,有助于提高对新生儿疾病的精准治疗.

This study aims to identify the relationship between blood donation and malignant and benign tumour hospitalization risk. The cohort study was constructed in Shaanxi, China, to include blood donors and match nonblood donors one-to-one by gender, age, and county of residence. The study compared the hospitalization records of two groups from 2012 to 2018. A log-binomial regression model was used to estimate the relative risk (RR) of tumour risk between donors and nonblood donors among different age groups. A total of 1,625,599 donors were recruited (including 968,823 males) and compared with the matched nonblood donor group. Significantly lower risk of malignancy in males was found among donors (adjusted RR: 0.82, 95% CI: 0.75–0.92). Lower risks for specific types of tumours among donors were observed, including liver (0.42, [0.28–0.67]), lung (0.74, [0.59–0.87]), lymphoma (0.75, [0.62–0.85]), and oesophagus (0.55, [0.41–0.72]). However, the risk of brain cancer was higher among male donors (RR 1.19 [1.06–1.29]). Among female donors, lower risk of liver (0.57, [0.42–0.79]) and oesophagus malignancy (0.73, [0.62–0.88]) was observed. For benign tumours, male donors have a lower risk of benign skin tumour (0.79, [0.62–0.94]) and hemangioma and lymphangioma (0.75, [0.51–0.89]), while female donors have a lower risk in hemangioma and lymphangioma (0.65, [0.44–0.83]). We also found that the risk decreased with age among donors in the prevalence of tumours compared to that in nonblood donors (p<0.05). Blood donation appears to be significantly associated with various tumour risks among both males and females. Overall, the risk of tumours decreased more substantially with age in blood donors compared with nonblood donors. Further research is warranted to investigate the impact of ‘health donor effects’ on these findings.

PurposeThe Shaanxi Blood Donor Cohort was set up to investigate the impact of blood donation on the health of donors compared with non-blood donors. The specific aims of the study include (1) identifying the geographical and temporal trends of incidence for diseases in both blood donors and non-blood donors; (2) assessing the impact of environmental exposures, lifestyle, body mass index (BMI) and blood type on disease burdens, stratified between blood donors and non-blood donors; and (3) among blood donors, investigating if regular blood donation has a positive impact on donors’ health profiles, based on a cohort with a mixed retrospective and prospective study design.ParticipantsA total of 3.4 million adults, with an equal number and identical demographic characteristics (year of birth, sex and location of residence) of blood donors and non-blood donors, were enrolled on 2012. The one-to-one matching was conducted through a repeated random selection of individuals without any history of blood donation from the Shaanxi Electronic Health Records. The cohort has been so far followed up to the end of 2018, summing to nearly 24 million years of follow-up. The cohort will be followed up prospectively every 3 years until 2030.Findings to DateOf the 1.7 million blood donors, 418,312 (24.5%) and 332,569 (19.5%) individuals were outpatients and inpatients, accounting for 1,640,483(96.2%) outpatient and 496,061 (29.1%) inpatient visits. Of the same number of non-blood donors, 407,798 (23.9%) and 346,097 (20.3%) individuals were hospital outpatients and inpatients, accounting for 1,655,725 (97.1%) outpatient and 562,337 (33.0%) inpatient visits. The number of outpatient and inpatient visits by non-blood donors was 0.9 and 3.9% higher than those of the blood donors (p < 0.01). Blood donors demonstrate significantly fewer inpatients visits than non-blood donors for major chronic disease categories (p < 0.01).Future PlansWe are currently exploring the long term benefits of blood donation on major chronic disease categories and multimorbidities in this large population cohort. The study results are adjusted by the “healthy donor effect.” This cohort study will continue until 2030.

目的 通过分析住院死亡患者最后一次住院期间的用血情况,探究人的一生用血概率,提倡健康适龄人群积极献血.方法 根据《国际疾病分类》原则、献血年龄及血液成分分类,对该院2011～2020年8053例住院死亡病例进行用血情况统计分析.结果 2011～2020年该院住院患者平均输血率为13.13％,病死患者平均输血率为47.42％.死亡患者输血率最高的前三位疾病为妊娠、分娩和产褥期,血液及造血器官免疫性疾病,消化系统疾病,输血率分别为90％、89.74％和79.52％.<18岁、18～60岁及>60岁死亡患者输血率逐渐降低,输血率分别为64.13％、56.00％、44.80％(P<0.05).死亡患者平均红细胞输血量为2.05 U,血浆和血小板分别为4.19 U和2.8 U.结论 住院死亡患者输血率较高,提示人们在适龄健康时应积极参与无偿献血,利己利人提高献血意识,促进我国无偿献血事业发展.

Objective By investigating the distribution of ABO and Rh blood groups in Shaanxi Province, to discuss the influence of regional division and population migration on blood group distribution. Methods The data of 3 691 624 blood donors from 10 cities in Shaanxi province in the past 20 years was collected. According to the geographical characteristics of Shaanxi province, the data was divided into three regions: Northern Shaanxi, Southern Shaanxi, and Guanzhong, to statistically analyse the distribution of ABO and Rh blood groups across different regions. Heat map software was used to present the ABO blood group on Shaanxi map. The temporal and spatial characteristics of ABO blood group distribution during 2008 and 2018 were analysed and compared. Results ABO blood group distribution of Shaanxi people was O>B>A>AB, with a Rh negative ratio of 0.41%. Based on the ABO blood group distribution map of Shaanxi Province, obvious regional differences were found in ABO blood group distribution. The ABO blood group distribution in Guanzhong, Southern Shaanxi and Northern Shaanxi was B>O>A>AB, O>A>B>AB, and O>B>A>AB respectively, with the lowest proportion of type A being 26.12% in Northern Shaanxi, the lowest proportion of type B being 27.48% in Southern Shaanxi, and the highest proportion of type O being 32.60% and 32.10% in Northern Shaanxi and SouthernShaanxi respectively. Compared with 2008, the distribution of ABO blood groups in the three regions of Shaanxi province changed significantly in 2018. Conclusion The distribution of ABO blood group in Shaanxi province is O>B>A>AB in general. However, there are significant differences in blood group distribution among different regions. It was also found that population migration had an impact on blood group distribution from 1998 to 2018.

目的 探究下一代测序技术(next generation sequencing,NGS)在弥漫大B细胞淋巴瘤(diffuse large B cell lymphoma,DL-BCL)辅助诊断中的应用价值.方法 收集陕西省人民医院病理科存档的20例组织蜡块,其中15例诊断为DLBCL,5例诊断为淋巴组织反应性增生(reactive lymphoid hyperplasia,RLH).采用天根公司石蜡包埋组织基因组DNA提取试剂盒进行DNA提取,安捷伦4200评价DNA质量.采用LymphoTrack IGH FR2 Assay和LymphoTrack Dx TCRG Assay进行组织克隆性测定.结果 5例RLH均为多克隆性,11例DLBCL出现NGS IgH FR2单克隆重排(阳性率73.3％,11/15),另有4例未检测出单克隆性重排(2、5、8、15号).15例中有3例出现TCRG重排性扩增(6、7、14号).经PCR凝胶电泳法进行验证:4例NGS检测的IgH FR2多克隆性病例均检测到IgH单克隆性基因重排;3例NGS检测到TCRG单克隆性重排病例中,PCR凝胶电泳法只检测到1例呈TCRG克隆性重排.结论 高通量测序方法特异性较高,但由于其检测过程复杂,影响因素较多,检测方法的敏感性受到一定影响.虽然该方法可以准确得到基因重排序列,但由于其检测成本较高,对技术平台和人员要求更高,其在临床上的应用尚需时日.

Galectin-4是半乳凝集素(galectins)亚家族成员,广泛分布于各种动植物组织中,并参与各种如细胞增殖、凋亡、黏附、信号转导等功能.近几年,Galectin-4在生理及病理过程中所起的作用正日益受到人们的重视.目前发现Galectin-4的低表达与结肠癌、肝癌、肺癌、尿路上皮癌等多种肿瘤的预后不良相关,有望成为判断肿瘤预后的可靠检测指标.