Objective To explore the coincidence rates of positive and reverse blood group of infants younger than six months in Xiamen area in recent years,and to analyze the difference of anti-A or anti-B antibody in infants of different age groups and different ABO blood groups.Methods 2 993 hospitalized infants from 0 to 6 months in five hospitals of Xiamen area were selected.EDTA-K2 anticoagulant blood samples were collected.Micro-column gel agglutination assay was used in ABO blood group.All the infants were divided into six groups,which aged from 0-7 days,8-14 days,15-31 days,1-2 months,3-4 months and 5-6 months.The coincidence rates of positive and reverse blood group of each group were compared.Results Of the 2 993 infants,303 cases were AB type.The coincidence rates of positive and reverse blood group of the other infants which aged from 0-7 days,8-14 days,15-31 days,1-2 months,3-4 months and 5-6 months were 57.0%,61.0%,63.0%,71.8%,84.9% and 91.0%,respectively.The coincidence rates of positive and reverse blood group between different blood groups had no statistically significant difference(x2=0.842,P=0.657).The coincidence rates of positive and reverse blood group had statistically significant difference among different age groups(x2=185.683,P<0.05).Conclusion The IgM antibody of ABO blood group is detected in infants younger than six months.Positive and reverse blood group is necessary in ABO blood group identification of infants to guarantee the safety clinical blood transfusion.

Objective To compare theγpassing rate between measurements at actual degree gantry angle and zero degree gantry angle for dose verification of intensity?modulated radiotherapy ( IMRT) in the treatment of nasopharyngeal carcinoma ( NPC) and cervical carcinoma. Methods Thirty patients with NPC and thirty patients with cervical carcinoma were randomly chosen from 87 patients with NPC and 54 patients with cervical carcinoma, respectively. Using a gamma criterion of 3 mm/3%, the γ passing rates at actual gantry angle and zero degree gantry angle were measured using ArcCHECK and compared by paired t test. Results The γ passing rate was significantly lower at actual gantry angle than at zero degree gantry angle in patients with NPC or cervical carcinoma ((93.8±3. 6)% vs. (97.8±1. 1)%, P=0. 00;(96.3±2. 1)% vs. (98.2±1. 0)%, P=0. 00). Moreover, the variation range of the γ passing rate at actual gantry angle was larger than that at zero degree gantry angle. Bothγpassing rates at actual gantry angle and zero degree gantry angle were lower in the patients with NPC than in the patients with cervical carcinoma . Conclusions Compared with that at zero degree gantry angle, theγpassing rate at actual gantry angle is closer to reality. Therefore, the actual gantry angle is recommended for dose verification. In order to meet the clinical requirement, a higher standard of γ passing rate should be proposed when zero degree gantry angle is used for dose verification.

AIM:To study the effects of ischemic postconditioning on cerebral ischemia following middle cerebral artery occlusion in rats. METHODS: 21 rats were randomly divided into three groups: middle cerebral artery occlusion (MCAO), MCAO+transient unilateral common carotid artery occlusion (u-CCA-O), MCAO+transient bilateral common carotid artery occlusion (b-CCA-O)(n=7, respectively). u-CCA-O/b- CCA-O was generated by transient middle cerebral artery occlusion plus transient unilateral/bilateral common carotid artery (CCA) occlusion. After the suture was removed, ischemic postconditioning was performed by occluding CCA for 10s, reperfusion 10s, and then allowing for another 4 cycles of 10s of reperfusion and 10s of CCA occlusion. Rats were sacrificed 2 d later and infarct size was measured. Cerebral blood flow (CBF) was measured in different 15 time points: 0 min, 10 min, 1 h after MCA occlusion, 0 min after MCA reperfusion, 10s of CCA occlusion and 10s of CCA reperfusion in all five cycles, 30 min after MCA reperfusion. Functional neurological outcome was determined 1 h and 48 h after reperfusion. Infarct volume was measured 48 h after reperfusion. RESULTS: The infarct volumes in u-CCA-O group and b-CCA-O group diminished compared to the control group. The results of CBF demonstrated that b-CCA-O group diminished 9% compared with control and u-CCA-O group when 30 min after intervention. The rats in u-CCA-O and b-CCA-O group had better neurological performance at 1 h after reperfusion. CONCLUSION: Ischemic postconditioning reduces infarct size, improves functional neurological outcome, most plausibly by diminishing cerebral blood flow.

BACKGROUND:The number of hematopoietic stem cel s in the peripheral blood is very low at normal physiological state. So it is critical to mobilize hematopoietic stem cel s from donor’s bone marrow into the peripheral blood.
OBJECTIVE:To study the combination effect of AMD3100 and dexamethasone on the mobilization of hematopoietic stem cel s in mice, thereby laying the foundation for clinical application.
METHODS:C57BL/6 mice were injected with AMD3100 and dexamethasone alone or in combination. Then, hematopoietic stem cel s in the peripheral blood and bone marrow were col ected. CD34+cel concentration in the peripheral blood and bone marrow was determined by flow cytometer and the content of leucocytes in the peripheral blood was counted by a normal method. The CFU-Mix colony formation ability of hematopoietic stem cel s was identified by cel colony forming assay.
RESULTS AND CONCLUSION:The concentration of CD34+cel s in the peripheral blood and bone marrow, the content of leukocytes in the peripheral blood and the CFU-Mix colony formation ability of hematopoietic stem cel s were al improved by both AMD3100 and dexamethasone and especial y their combined use. This indicates that both AMD3100 and dexamethasone could mobilize hematopoietic stem cel s to migrate from the bone marrow to the peripheral blood, and when used in combination, the mobilization effect is better than that of single drug.

Objective To examine the prevalence of chikungunya virus in brain tissue samples from rat?like animals in Xiamen, Shenzhen and Guangzhou, and to explore whether the rat?like animals are potential sources of human chikungunya fever infections and the host of the virus. Methods Rat?like animals were trapped in residential areas, city parks, hospitals, markets and schools in Xiamen, Shenzhen and Guangzhou (Yuexiu and Baiyun districts) between January 2013 and June 2016. Brain tissue samples of the trapped animals were collected under sterile. Chikungunya virus was detected by using reverse transcription polymerase chain reaction (RT?PCR). Results Totally 1092 rat?like animals were trapped, which belonged to 7 species, 3 genera, 2 families, 2 orders. Rattus norvegicus was the dominant species in the indoor environment, Rattus losea was dominant in wild environment, and 1092 brain tissue samples were collected. No detectable chikungunya virus was found in the brain tissue samples by RT?PCR. Conclusion There is a low possibility that rat?like animals act infectious sources of human chikungunya fever infections and the host of the virus.

Objective To study the optimal timing of preoperative injection of indocyanine green in laparoscopic liver tumor resection under indocyanine green fluorescent navigation to obtain the most satisfactory fluorescence imaging effects.Methods 60 patients with liver tumors who underwent laparoscopic hepatectomy from April 2017 to October 2018 were retrospectively studied on the intraoperative fluorescence imaging effects.A simple grading of the fluorescence imaging effects was developed.The ICG R15 and preoperative injection times of ICG were correlated with the intraoperative fluorescence imaging effects.Results Of 60 patients with liver tumors,59 patients underwent laparoscopic liver resection and one patient was converted to open surgery.The overall satisfaction rate of intraoperative fluorescence imaging was 73.4％ (44/60).In the patients with an ICG R15 rate ≤ 7％,it was easier to obtain good fluorescence imagings when the preoperative administration time was longer than 48 hours.Even when the preoperative administration time was longer than 5 days,satisfactory fluorescence imaging effect could still be obtained in these patients.In the patients with an ICG R15 rate ＞ 7％,intraoperative fluorescence imagings were unsatisfactory when the administration time was less than 6 days.Relative better imagings were obtained in these patients when the preoperative administration time was more than 6 days.Conclusions When the pre-operative ICG injection dose was not changed,the preoperative administration time should be adjusted according to the value of the ICG R15 to obtain better intraoperative fluorescence imaging effects of the liver tumors.The optimal timing needs to be further studied by a large case study.

Objective:To investigate the molecular pathogenesis of a newly discovered gene mutation in a family with hereditary coagulation factor Ⅺ(FⅪ) deficiency.Methods:The proband was admitted to the First Affiliated Hospital of Wenzhou Medical University in September 2021 due to "calculus of intrahepatic duct". The patient had no symptoms of spontaneous bleeding.The clinical data and blood samples of the proband and her family members (10 persons in 3 generations) were collected.The activated partial thromboplastin time (APTT) and FⅪ activity (FⅪ:C) were performed by the one-stage clotting assay. FⅪ antigen (FⅪ:Ag) were detected by enzyme linked immunosorbent assay (ELISA). Genomic DNA extracted from peripheral blood cells of subjects was used as template to analyze F11 gene mutation by DNA direct sequencing. Bioinformatics software was used to analyze the effects of mutations on protein structure and function. Wild-type and mutant FⅪ protein expression vectors were constructed and transient transfected into HEK293T cells. The total RNA was extracted from positive transfected cells and then reversely transcribed into cDNA. The mRNA expression level of F11 gene in transfected cells was detected by real-time fluorescence quantitative PCR (qRT-PCR). The content of FⅪ:Ag and the expression of FⅪ protein in transfected cell lysates and culture supernatant were detected by ELISA and western blot.Results:The APTT of the proband was significantly prolonged to 107.9s (reference range 29.0-43.0s), while FⅪ:C and FⅪ:Ag were significantly decreased to 2% (reference range 84%-122%) and 5% (reference range 76%-127%), respectively. Gene sequencing analysis indicated that the proband had c.536C>T (p.Thr161Met) heterozygous missense mutation and c.1556G>A (p.Trp501Ter) heterozygous nonsense mutation in exon 6 and 13 of the F11 gene, respectively. Bioinformatics analysis showed that the amino acids at site 161 of FⅪ protein were threonine (Thr) in the matrix composed of five different species, indicating that Thr161 site was highly conserved among homologous genes in different species. p.Thr161Met heterozygous mutation affected the stability of local intermolecular structure of FⅪ protein. In vitro expression experiments of p.Thr161Met mutation showed that FⅪ protein had a normal synthesis in the cells but secretion dysfunction.Conclusions:c.536C>T (p.Thr161Met) heterozygous missense mutation and c.1556G>A (p.Trp501Ter) heterozygous nonsense mutation were mainly responsible for the decrease of FⅪ in this family. p.Thr161Met mutation was first reported in the world and did not affect the normal synthesis of FⅪ protein, but caused secretion dysfunction.

Objective To explore the value of dual-phase enhanced CT radiomics in predicting post-acute pancreatitis diabetes mellitus(PPDM-A).Methods A total of 145 patients with acute pancreatitis(AP)were retrospectively collected,including 62 patients in PPDM-A group and 83 patients in non-PPDM-A group.The patients were randomly divided into training set and test set at a ratio of 7︰3,the pancreatic parenchyma in arterial phase and venous phase was delineated and the radiomics features were extracted.Vari-ance threshold method,univariate selection method and least absolute shrinkage and selection operator(LASSO)were used to screen radiomics features.The prediction performance of the model was evaluated by the area under the curve(AUC).The DeLong test was used to compare the prediction efficiency between the models,and the calibration curve and decision curve were used to evaluate the prediction efficiency of the model.Results The AUC of arterial phase model,venous phase model,combined arterial venous phase model,clinical model and radiomics combined clinical model in the training set were 0.845,0.792,0.829,0.656 and 0.862,respec-tively.The DeLong test results showed that only the difference between the radiomics combined clinical model and the clinical model in the training set and the test set was statistically significant(P<0.05).The decision curve showed that the radiomics combined clinical model had high clinical practicability in a certain range,and the calibration curve showed that the radiomics combined clinical model had the best fitting degree with the actual observation value.Conclusion Based on the dual-phase enhanced CT radiomics combined clinical model,PPDM-A can be predicted more accurately,and it can provide a certain reference value for the clinical development of per-sonalized treatment programs.

Objective To observe and compare the effect of Cordyceps sinensis ( bailing ) capsules com-bined with weight-bearing breathing exercises, and weight-bearing breathing exercises combined with tiotropium bro-mide and seretide, on patients with stable but moderate-to-severe chronic obstructive pulmonary disease (COPD). Methods Sixty-three patients with moderate-to-severe COPD were randomly divided into an observation group and a control group. Both groups performed weight-bearing breathing exercises, supplemented in the observation group with the oral administration of bailing capsules. The control group instead inhaled tiotropium bromide and seretide. Six-mi-nute walking distance, the COPD assessment test ( CAT scores) and concentrations of interleukin-6 ( IL-6) , interleu-kin-8 ( IL-8) and tumor necrosis factor-α ( TNF-α) were observed after 1 ( T1) , 30 ( T2) and 58 ( T3) days of the treatments. Results At T1 there were no significant differences between the two groups in any of the measurements ( P≤0.05) . At T2, there were still no significant differences except that a significant decrease in IL-8 and TNF-αlevels was observed in the control group. At T3 the average CAT scores had decreased significantly in both groups compared to before the treatment but there was no significant difference between the two groups. In the observation group, the average 6MWT distance had increased significantly compared to before the treatment and compared to the control group, where there was no significant improvement. The average IL-6, IL-8 and TNF-αreadings of the control group were significantly lower than those of the observation group at T3 and compared to before the treatment. No sig-nificant changes in those indicators were observed in the observation group at T3. Conclusions Bailing capsules combined with weight-breathing exercises are more effective for relieving dyspnea symptoms and improving exercise capacity than weight-breathing exercises combined with tiotropium bromide and seretide. However, in controlling air-way inflammation and airway hyper-responsiveness, the triple inhalation combined with weight-bearing breathing exer-cises is more effective.

【Objective】 To analyze the causes and treatments for the incompatible crossmatching between a patient, who underwent the minor ABO mismatches lung transplantation, and the blood donor with ABO-compatible blood. 【Methods】 A patient, who underwent the minor ABO mismatches (donor group O; recipient group A) lung transplantation developed a continuous decrease in Hb for 13 days after surgery, The blood sample of the patient presented major crossmatching incompatibility with the blood donors and the causes of it were analyzed by the recipient′s blood type reviewing, direct antiglobulin test, antibody screening and erythrocyte elution. 【Results】 The patient’s serum reacted with A1 erythrocyte reagent with agglutination strength at ±, and enhanced to 1+ at 4℃ after 10 min incubation.Antibodies were not detected by 10-cell panel and the effects of unexpected antibodies were excluded.The results of direct antiglobulin test and elution test were positive, and eluted anti-A antibody was detected.Combined with the patient′s continuous decline in Hb and elevated total bilirubin, passenger lymphocyte syndrome (PLS) was clinically diagnosed.After the transfusion of 6 U of O-type washed RBCs, the symptoms of anemia were improved and no adverse reactions occurred. 【Conclusion】 PLS may occur after an ABO mismatched solid organ transplantation.Most of the hemolytic symptoms are not obvious and easy to ignore, therefore clinical indicators of direct antiglobulin test results, Hb and total bilirubin should be continuously monitored after transplantation for early detection and timely treatment of PLS to avoid major adverse consequences.