Objective To understand the incidence of hemolytic disease in newborn (HDN)among the newborns with jaundice and the coincidence degree of the blood group serological results and the clinical diagnosis in HDN.Methods The microcolumn gel method was adopted to detect the 3 serological indexes in 276 jaundice newborns of maternal fetal blood group incompatibility,in-cluding the direct antiglobulin test,free antibody test and antibody release test.Results 108 cases of HDN were clinically diagnosed with the positive rate of 39.13%.The positive detection rate in newborns with 0-2 d old was highest(50.00%).Conclusion The serological test can provide the basis for the early diagnosis and treatment of HDN.Collecting the specimen as early as possible can improve the positive diagnosis rate of HDN.

Objective To determine the effect of transcription and translation in telomeric related proteins,and synergism of progressive telomere shortening and cell cycle alteration in human lung adenocarcinoma A549 cell line,which is induced by antisense tankyrase oligonucleotide(asTANKS) combinated with antisense human telomerase reverse transcriptase(ashTERT) oligonucleotide.Methods A549 cells were randomly assigned as 3 test groups: ashTERT,ashTERT + asTANKS and asTANKS,three control groups(shTERT,sTANKS and blank).With individual intervention for different hours,the effect of transcription in hTERT mRNA was evaluated by RT-PCR,and telomerase activity was tested by ELISA-PCR,tankyrase activity was tested by Western blot as well.Moreover,telomere average length was analyzed by Q-FISH,and duration of proliferation was observed by population double test.Results Transcription in hTERT mRNA and telomerase activity for 48 hrs was inhibited obviously by ashTERT,but not by asTANKS.Progressive telomere shortening in A549 cells for 48 hrs was induced by either asTANKS or ashTERT(vs control,P

Objective: To compare the pharmacodynamic action of Radix Notoginseng after fermented by different strains bioconversion.Methods:The models of cerebral ischemia and hypoxia were established,thrombosis in vivo were induced by collagen-Adr,ventricular fibrillation of mice by chloroform,and perfusion experiment of the ex vivo heart of cavia cobaya was used.Results:100,200mg/kg doses of all samples had protective effects on ischemia and hypoxia mice,1# sample can inhibit thrombosis induced by collagen-adrenaline obviously after intraperitoneal injection in dosage of 200mg?kg-1?d-1 for 5days.All groups significantly reduced the incidents of ventricullar fibrillation induced by chloroform in mice except 100mg/kg dose of 1#,furthermore,compared with control high dose group(5#),the incidents of high dose groups of 3、4# deceased significantly.All samples had the effect of dilating coronary artery,but there effects on myocardial contractile force and cardiac preload were different.Conclusion:The primary cardiovascular related pharmacological researches demonstrated the vary action changes of 1-4# samples compared with the sample 5#.This result has revealed that the chemical structure of Radix Notoginseng transformed and that is coincide with initial analysis of phytochemical analysis.

Objective:To obtain the parameters associated with hematoma morpholoy by finite element analysis(FEA) and investigated their performance on predicting and diagnosis hematoma expansion(HE) in patients with spontaneous intracrebral hemorrhage(SICH).Methods:Patients with SICH who met research criteria were retrospective enrolled between June 2015 and December 2017. Clinical parameters on admission were collected, Perform 2 independent methodology on same patient to analysis the hematoma shape base on computed tomography(CT): Clinical routine method that performed by clinical investigator to identified margin irregularity of hematoma by CT ,and calculated the volume of hematoma by simplify Tada formula(ABC/2);The FEA method performed by FEA investigator and gain the hematoma 3 dimensional morphology and variables, include Volume, Surface area, and The quantity of triangles per square milimet surface(TQOT/mm 2). The HE was defined as volume enlargement of >33% compared with that on addmission. All patients were divided into HE and none HE group ,respectively, ABC/2 and FEA generated thire own HE and none HE group as different volume calcuation. The HE risk factors of ABC/2 and FEA were assessed in univariate and multivariable Logistic regression models. and the risk fators diagnosis value for HE were determined by the receiver operating characteristic(ROC) curves. Results:Total of 127 patients were enrolled, The mean time of symptom onset to hospital admitted was 3.08±1.34 h. There were 34(26.77%) cases HE identifed by ABC/2 and 31(24.41%)by FEA. Althought there are significant different (pearson χ2=53.66, P<0.01) of HE identification between ABC/2 and FEA, the 2 methods has moderate consistency (Kappa=0.65). All patients’ hematoma 3D reconstruction were performed by FEA and general observation show that TQOT/mm 2 most likely correlate to irregularity of hematoma 3D shape. Multivariable Logistic regression models indicated that ICH score( OR=1.79, 95% CI:1.19~2.68)was independent HE risk factor for ABC/2, respectively, TQOT/mm 2≥1.95/mm 2 ( OR=16.99,95% CI:5.98~48.33)and Ultraearly Hematoma Growth,(uHG) ( OR=1.05, 95% CI:1.01~1.09)were independent HE risk factor for FEA. With ROC analysis, both the ICH score of ABC/2 and uHG of FEA have low HE predictive and diagnosis value ,the area under the curve (AUC) were 0.64 and 0.67 respectively. However, TQOT/mm 2 was found to have excellent diagnosis value (AUC:0.9), sensitivity and specificity were 77% and 83% when the cut-off value was 1.95. Panel parameter model (TQOT/mm 2+uHG) was not be found to have a significant higher AUC than single parameter on FEA and the clinical routine parameters panel model (ICH +SB P>180 mmHg on addmission) have a unacceptable AUC(<0.7) as well as single parameters. Conclusions:Hematoma shape could be reconstructed and analysis by FEA and TQOT/mm 2 was likely relevance to hematoma morphology. TQOT/mm 2≥1.95 was indicate to have a better HE predicting and diagnosis value than any other risk factors and clinical parameters panel models in our reaserch.

OBJECTIVETo assess the pathologic markers for evaluation of reversibility in pulmonary hypertension (PAH) related to congenital heart disease.

METHODSTwenty-eight patients with congenital heart disease complicated by PAH were subclassified into reversible pulmonary hypertension (RPAH) and irreversible pulmonary hypertension (IPAH), according to post-operative mean pulmonary artery pressure (MPAP). Pulmonary vascular lesion was analyzed according to Ruan's method. Mean medium thickness percent, mean medium area percent and pulmonary arteriolar density were measured by quantitative morphometry. Immunohistochemical study for transgelin and filamin A was carried out.

RESULTSAmongst the 28 cases studied, 24 were RPAH and 4 were IPAH. Of the 24 patients with RPAH, 13 (54.2%, 13/24) had pulmonary vascular lesion of grade 0, 9 (37.5%, 9/24) of grade 1 and 2 (8.3%, 2/24) of grade 2. Of the 4 patients with IPAH, 1 had lesion of grade 1, 1 of grade 2 and 2 of grade 3. Both preoperative and postoperative MPAP were higher in IPAH patients than that in RPAH patients[(53.3±23.4) mmHg versus (34.1±12.7) mmHg, P=0.020 and (35.0±8.8) mmHg versus (17.8±3.9) mmHg, P<0.01]. Compared to patients with pulmonary vascular lesion of grades 0 and 1, the preoperative MPAP in patients with grades 2 and 3 showed no significant difference, but the postoperative MPAP was higher (P<0.05 or 0.01). Compared to control group, mean medium thickness percent and mean medium area percent were significantly higher in RPAH and IPAH categories (12.0±3.5, 8.5±2.0 versus 5.7±1.0, P<0.01 and 55.8±11.1, 49.0±9.4 versus 34.0±5.5, P<0.01). Mean medium thickness percent was significantly higher in IPAP group than that in RPAH group (12.0±3.5 versus 8.5±2.0, P=0.001). Correlation analysis demonstrated that mean medium thickness percent and mean medium area percent had positive correlation with preoperative and postoperative MPAP. There was no correlation between grading of pulmonary vascular lesion and reversibility. Transgelin and filamin A had stronger staining in pulmonary vascular smooth muscle cells in IPAH than those in RPAH and controls(P<0.05).

CONCLUSIONSPathologic assessment of lung biopsy remains the gold standard for evaluation of the reversibility in PAH related to congenital heart disease. Mean medium thickness percent, mean medium area percent and immunoreactivity for transgelin and filamin A are useful parameters.

Biomarkers ; metabolism ; Biopsy ; Filamins ; metabolism ; Heart Diseases ; complications ; pathology ; Humans ; Hypertension, Pulmonary ; complications ; diagnosis ; pathology ; Lung ; pathology ; Microfilament Proteins ; metabolism ; Muscle Proteins ; metabolism

OBJECTIVETo identify clinical and pathological features of giant cell myocarditis.

METHODSClinical presentation and follow-up data of three patients with giant cell myocarditis were collected.Gross, histopathological, immunohistological and ultrastructural findings of extransplantated hearts of the patients were documented.

RESULTSGrossly, multifocal involvement of the myocardium with variably dilated cardiac chambers were observed in all 3 cases.Histological examination revealed pronounced focal inflammatory infiltrates with multinucleated giant cells. Multinucleated giant cells were positive for CD68 and CD11b immunostains but were negative for CD163 in all cases. Transmission electron microscopy showed that the multinucleated giant cells derived from fusion of several macrophages with adherent lymphocytes and secretary cells. Clinically, the overall patient condition improved in all three cases after heart transplantation.One patient experienced acute cellular rejection (2R level) 4 months after transplantation, but recovered after treatment. One patient developed multinucleated giant cells observed in heart biopsy two weeks after transplantation.

CONCLUSIONSGiant-cell myocarditis is a rare disease of adult, and cardiac transplantation could improve the clinical outcome. Multinucleated giant cell in the myocarditis lesions were derived from macrophages, likely participating in the immune response. Endomyocardial biopsy is important for the diagnosis of giant cell myocarditis.

Acute Disease ; Adult ; Biopsy ; Giant Cells ; pathology ; ultrastructure ; Heart Transplantation ; Humans ; Lymphocytes ; pathology ; Macrophages ; pathology ; Microscopy, Electron, Transmission ; Myocarditis ; pathology ; Myocardium ; pathology ; ultrastructure

OBJECTIVETo investigate the histopathological features of primary restrictive cardiomyopathy (PRCM).

METHODSNine extransplanted hearts from heart transplantation recipients were examined. Gross and histopathological findings were observed, photographed and final pathological diagnosis was compared to clinical diagnosis. The myocardial ultrastructure changes were determined using transmission electron microscopy.

RESULTSThe hallmark pathologic feature of PRCM was distinguished by myocardial cell degeneration and hyperplastic collagen fibrils around the myocardial cells.Fibrosis was severer in left ventricle free wall than in ventricular septum and right ventricle. The degree of myocardial cell degeneration and poloidal disorder were severer in patients with reduced ejection fraction (EF) than in patients with preserved EF. Transmission electron microscope evidenced severe interstitial fibrosis, myofibrillar changes of sarcomere structure, abnormalities both on intercalated disc number and distribution.

CONCLUSIONSPRCM is characterized by hyperplastic collagen fibrils around the cardiomyocytes. Fibrosis is severer in left ventricle than in right ventricle. Sarcomere dysplasia is the main cause of PRCM, and ultrastructural examination is helpful for PRCM diagnosis.

Cardiomyopathy, Restrictive ; surgery ; Fibrosis ; Heart Transplantation ; Heart Ventricles ; Humans ; Myocardium ; pathology ; Myocytes, Cardiac ; Sarcomeres

OBJECTIVETo investigate the association between clinical and histopathological features in patients with left ventricular non-compaction cardiomyopathy (LVNC).

METHODSHistopathological examinations were made on 11 LVNC recipient hearts from June 2004 to June 2014 in Fuwai Hospital, myocardial ultrastructure changes were detected using transmission electron microscopy. Association between clinical and pathological features were analyzed.

RESULTSPatients were (24 ± 11) years old. There were 6 patients with mucus matrix LVNC, 3 patients with fibrous fatty infiltration, and 2 patients with cardiomyocytes proliferation. The gross morphological changes of LVNC hearts were characterized by numerous and prominent trabeculations with deep intratrabecular recesses in left ventricular myocardium. Ratios of the thicker noncompacted endocardial layer (N) and thin epicardial compacted layer (C) (N/C ratio) were ≥ 2.0, and the most serious lesions were located in the left ventricular apex, and followed by the left ventricular free wall. Histological microscopic examinations evidenced numerous matrix-like material and immature cardiomyocytes on endocardial tissue. Transmission electron microscopy revealed mitochondrial abnormalities on morphology, number, and distribution, underdeveloped cardiomyocytes and anomalies of intercalated disc structure, increased deposition of extracellular matrix-like substance and perinuclear glycogen. Pathological changes on cytoplasmic matrix and intercalated disc were present in all three tissue types of LVNC in this cohort and mitochondria hyperplasia was detected in patients with fibrous fatty infiltration. Heart weight ≥ 350 g is often associated with increased number of mitochondria. Increased cytoplasmic matrix was often detected in patients with LVEF ≥ 30% while intercalated disc anomalies were often detected in patients with LVEF < 30%.

CONCLUSIONHistological changes were closely related clinical features in patients with LVNC.

Adolescent ; Adult ; Cardiomyopathies ; pathology ; Endocardium ; pathology ; Heart Ventricles ; pathology ; Humans ; Mitochondria, Heart ; pathology ; Myocardium ; pathology ; ultrastructure ; Young Adult

Objective To analyze the situation and changing trend of free medication service in Beijing from 2013 to 2020, and to propose policies and service improvement measures. Methods A retrospective survey was conducted in Beijing to collect and analyze the service subjects, service process, drug catalog, fiscal investment and patient participation of free medication in each district in recent years. Results Among the 16 districts of Beijing, 81.25% of the districts included the patients listed in Item (2) of Paragraph 2 of Article 30 of the Mental Health Law into the scope of free medication, and 75% of the districts broke the restriction that the service targets were registered residents in Beijing. 56.25% of the districts provided a variety of free medication modes, and 81.25% of the districts provided a mode of nearby community service. The catalog of free medications in various areas was still based on the Beijing catalog, and only 18.75% of the districts supplemented the list. In 2020, the total investment of free medicines and subsidies was 88.3768 million RMB, and the per capita investment was 1 616.02 RMB. The total cost showed an increasing trend year by year. From 2013 to 2020, the difference of per capita annual financial investment in drugs and subsidies was statistically significant (F=9.248, P<0.001). The per capita cost basically showed an increasing trend year by year except for individual years. In 2020, 54,688 patients participated in the free medication service in Beijing, and the participation rate was 67.23%. From 2013 to 2020, the difference of annual participation rate of patients was statistically significant (χ²=37098.759, P<0.001), and the number and proportion of patients increased year by year. Conclusion The practice of the district level has proved feasible to expand the scope of free medication service and to optimize the service process, which should be paid more attention in the future. With the continuous advancement of policies and services, the level of patient participation in various areas will tend to be relatively balanced after rising year by year.