Blunt traumatic thoracic aortic injury (BTAI) is an extremely serious medical condition with a high rate of associated mortality. Recent advances in techniques such as thoracic endovascular repair offer new opportunities to manage the critical BTAI patients in an efficacious yet less invasive manner. A 65 year-old-male suffered from multiple injuries after a fall, including BTAI in the aortic arch, which resulted in dissection of the descending thoracic-abdominal aorta and iliac artery, development of an intimal flap in the left common carotid artery, and dissection of the left subclavian artery. Based on the imaging information of this patient and our clinical experience, the combined treatment of fenestrated thoracic endovascular repair and a chimney technique was immediately planned to fully repair these dissections and moreover prevent further dissection of the branching vessels, additionally to ensure sufficient blood flow in the left subclavian artery and left common carotid artery. The intervention yielded satisfactory early outcomes. Follow-up assessment at six months reported no symptoms or complications associated with the stent-graft. Computed tomography angiography further confirmed adequate stent-graft coverage of the aortic injury.

【Objective】 To understand the antigen profile and antibody frequency of Wr^a in voluntary blood donors in Shaanxi province. 【Methods】 Wr^a antigen and antibody screening as well as blood group typing and antibody identification were performed by serological tests and confirmed by genetic testing. 【Results】 The incidence of Wr^a antigen in 7 490 voluntary blood donors was 0.013%(1/7 490), and the frequency of anti-Wr^a in 729 voluntary blood donors was 0.823%(6/729). 【Conclusion】 This study explored the polymorphism of Wr^a antigen and antibodies in blood donors, which is informative in the risk assessment of blood transfusion and the screening and identification of respective antibodies.

Objective To evaluate the efficacy of different methods of biliary stenting for intractable choledocholithiasis.Methods A total of 137 patients with intractable choledocholithiasis were randomly divided into 4 groups to receive different managements.The treatments included single biliary stent placement in group A (n=32),single stent placement plus oral medication in group B (n=35),double stents placement in group C (n=33) and double stents placements plus oral medication in group D (n=37).All biliary stents were placed via endoscopic retrograde cholangiopancreatography (ERCP).Oral medication included ursodeoxycholic acid and/or anethol trithione after the procedure.All patients were closely followed up.Results The size of stones in common bile duct (CBD) decreased in all cases at 3 months after stent placement,with most significant changes in groups C and D than in groups A and B (P＜0.05).The stents kept unobstructed for a mean time of 7.6 months (3.5-20 months),with a significant difference between every 2 groups (P＜0.05) and a longest duration time in group D.A second procedure of ERCP was performed in 72 patients (52.6%),with achievement of total choledocholithiasis clearance in 51 (84.7%).Hyperamylasemia (HA) occurred in 41 cases (29.9%),which were mainly observed in the groups C and D (P ＜0.05).Conclusion Biliary stent placement is a safe and effective palliative therapy for intractable choledocholithiasis,while double stents placements combined with pharmacotherapy is most effective.

OBJECTIVETo determine the frequency of RHD1227A allele in Chinese Hans.

METHODSFor a total of 890403 ethnic Han blood donors, the D antigen was determined with a saline method and indirect antiglobulin test. The RHD1227A allele and number and type of zygosity of RHD gene were determined with PCR sequence specific primer (PCR-SSP). Allelic frequency was calculated through statistics.

RESULTSIn total 2385 donors were found to be Rh-negative, 108 individuals were found to be weakly positive for D antigen (including weak D and partial D phenotypes). The remaining 887 910 individuals were Rh-positive. Among the Rh-negative individuals, 516 were found with RHD1227A. Among these, 467 were RHD1227A/d and 49 were RHD1227A/RHD1227A. Two of 108 D antigen weak-positive individuals were found as RHD1227A/RHD+. In addition, 8 of 1073 random Rh-positive samples were found to be RHD1227A/RHD+. The allele frequency of RHD1227A in the population was calculated as 0.004 036. The figure should be 0.006 682 if calculated based on the detected rate of the allele in Rh-negative individuals, and 0.007 884 if calculated based on the reported average phenotype rate of DEL in Rh-negative individuals.

CONCLUSIONBy taking main influencing factors such as the RHD zygosity, the rate of RHD1227A and DEL phenotype may be determined. The allele frequency of RHD1227A in Chinese Hans is between 0.004 036 and 0.007 884.

Adolescent ; Adult ; Asian Continental Ancestry Group ; ethnology ; genetics ; China ; ethnology ; Exons ; Female ; Gene Frequency ; Genotype ; Humans ; Male ; Middle Aged ; Mutation, Missense ; Rh-Hr Blood-Group System ; genetics ; Young Adult

OBJECTIVETo investigate the molecular basis of an individual featuring weak A phenotype of ABO blood group system.

METHODSSerologic investigations, serum transferases activity assay and absorption-elution test were carried out to identify the ABO blood group. The 7 exons and flanking introns of ABO glycosyltransferase gene were amplified with polymerase chain reaction (PCR). The products were sequenced bidirectinally following enzyme digestion. Haplotypes of exons 6 and 7 of the ABO gene were analyzed.

RESULTSA weak A antigen was identified on red blood cells of the proband. Eight heterozygous sites in exons 6 and 7 (261delG 297A/G, 421C/T, 467C/T, 646T/A, 681G/A, 771C/T, 829G/A) of the ABO gene were identified. Based on haplotype analysis, one allele was determined as O02, while a novel mutation 421T>C was identified in another allele, which resulted in the amino acid change Ser141Pro of the A glycosyltransferase.

CONCLUSIONAbove results suggested that amino acid substitutions resulted from a novel mutation 421T>C of the ABO gene may decrease the enzymatic activity and result in the weak A phenotype.

ABO Blood-Group System ; genetics ; Adult ; Alleles ; Female ; Humans ; Mutation ; N-Acetylgalactosaminyltransferases ; genetics

Typodont models of bilateral canines gingival displaced vertically for 3 mm and bilateral lateral incisors palatal displaced horizontally for 3 mm are made and every kind of the two kind models was divided into four groups: MDD, MBT, self-ligating and Tip-Edge. Each group of the two kinds of models had 5 models, so a total of 40 models for the two kinds of models were set up. The experimental models were aligned with a 0.30 mm of nickel titanium round wire in a water-bath with constant temperature 45 degrees C for 30 minutes. The three-dimensional digital images of the experimental models before and after the water bath were obtained by scanning with the three dimensional optical scanner ATOS. Geomagic software was used to overlap the digital images taken before and after the water bath treatment. The vertical changes of sign points of canines, the movements of sign points of lateral incisors in the sagittal plane and the horizontal plane were quantified by using the Color map. The data was then processed by a two-factor analysis of variance by using SAS 9.2 software package. Analysis of the results shows that the vertical changes of sign points of canines , the movements of sign points of lateral incisors in the sagittal plane and the horizontal plane of MDD group are all less than those in the other three groups, a statistically significant difference (P < 0.0001). And the size of the teeth displacement is directly related to the size of orthodontic force on the typodont models. Thus the preliminary results suggest that MDD appliance might have advantages of light force in the alignment stage, and that the possible relevant factors are the improvement of its sub-slot and the single ligation wing design.
Cuspid ; Dental Models ; Humans ; Imaging, Three-Dimensional ; methods ; Incisor ; anatomy & histology ; Malocclusion ; therapy ; Orthodontic Appliance Design ; Tooth Movement Techniques ; instrumentation ; methods

Objective: To analyse the mental state of patients with allergic rhinitis (AR) in Chengdu. Methods: One thousand five hundred and thirty-six AR patients from Sichuan Provincial Integrated Traditional Chinese and Western Medicine Hospital, West China Hospital of Sichuan University, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Sichuan People′s Hospital, Sichuan Second Hospital of Traditional Chinese Medicine were selected from July 2013 to January 2018. Eight hundred and twenty-seven patients were screened into study group by inclusion and exclusion standards. The symptom check list 90 (SCL-90) was used to group and score the mental state of these patients according to nine classification criteria: gender, BMI, age, marital status, monthly salary, disease duration, living environment, education level and working environment. Then, the scores were compared within groups. Inter-group comparison was made between the study group and the Chinese norm, and the positive factors for psychological disorders were extracted. Four symptoms in the study group, i.e. nasal itching, sneezing, clear discharge and nasal congestion, were scored on the visual analogue scale (VAS). SPSS 19.0 software was used to carry out statistical analysis. Partial correlation analysis was performed between the positive factors and the symptom scores by multiple regression statistical method. Results: The total score of SCL-90 in the study group was 2.64±0.25, which was accorded with mild to moderate mental health impairment. There were 124 (15.0%) without mental health damage, 176 (21.3%) with mild damage, 474 (57.3%) with mild to moderate damage, 41 (5.0%) with moderate to severe damage and 12 (1.4%) with severe damage. The in-group comparison showed that the top three categories of different items were the living environment, gender and working environment. The scores of somatization, obsessive-compulsive symptoms, interpersonal sensitivity, depression, anxiety, psychosis, other (sleep, diet) and total average score of urban residents were higher than that of country residents (3.29±0.61 vs 2.65±0.50, 2.81±0.77 vs 2.05±0.38, 3.10±0.19 vs 2.49±0.67, 3.40±0.84 vs 2.49±0.70, 3.04±0.64 vs 2.33±0.51, 3.02±0.55 vs 2.40±0.77, 3.40±0.41 vs 2.52±0.77, 2.91±0.11 vs 2.29±0.40, Z value was 4.88, 5.25, 4.57, 5.91, 5.09, 4.63, 5.55, -4.55, respectively, all P<0.05). Women scored higher than man for somatization, interpersonal sensitivity, depression and others (2.66±0.51 vs 2.00±0.45, 3.37±0.47 vs 2.63±0.51, 3.44±0.57 vs 2.85±0.52, 3.47±0.36 vs 2.76±0.45, Z value was -5.10, -5.51, -4.86, -5.28, respectively, all P<0.05). The scores of somatization, interpersonal sensitivity, psychosis and other (sleep, diet) were higher in the indoor group than those in the outdoor group (3.49±0.64 vs 2.78±0.46, 3.33±0.30 vs 2.56±0.68, 3.28±0.60 vs 2.67±0.31, 3.50±0.85 vs 2.85±0.37, Z value was 5.31, 5.79, 4.89, 5.00, respectively, all P<0.05). The outdoor group scored higher on obsessive-compulsive symptoms, anxiety and hostility (3.44±0.40 vs 2.83±0.35, 3.40±0.50 vs 2.57±0.93, 3.34±0.88 vs 2.69±0.56, Z value was 4.96, 6.22, 5.08, respectively, all P<0.05). The inter-group comparison found that depression, anxiety, psychosis and other (sleep, diet) could be partially correlated with VAS scores as 4 positive factors. The results of partial correlation analysis showed that depression was positively correlated with sneezing and nasal runny discharge, anxiety was positively correlated with nasal itching and nasal obstruction, psychosis was positively correlated with nasal itching and sneezing, and other (sleep, diet) was positively correlated with nasal runny discharge and nasal obstruction. Conclusion AR patients have mild to moderate mental health impairments, which are correlated with AR symptoms.

【Objective】 To screen individuals with rare blood type of Kidd, Diego, Duffy blood group system among the voluntary blood donor in Shaanxi province and to establish on-line and physical database of rare blood type. 【Methods】 Jk(a-b-)phenotype donors were screened by 2 mol/L urea hemolysis test. Blood donors with Di(a+ b-) phenotype were screened by genotyping; Fy(a-) and D-- phenotype donors were screened by modified antiglobulin assay. 【Results】 Three cases of Jk(a-b-) phenotype were detected out of 158 484 voluntary blood donors. The distribution frequency of Jk(a-b-) phenotype was 0.019‰. Di(a+ b-) phenotype was detected in 2(0.436‰) cases out of 4 586 voluntary blood donor. Fy(a-) phenotype was detected in 8(4.034‰) cases out of 1 983 voluntary blood donors. D-- phenotype was not detected in 29 430 voluntary blood donors. 【Conclusion】 The on-line database of Kidd, Diego, Duffy blood group system had been established by large-size screening of blood donor samples, which can conclude the region′s population distribution and genetic characteristics of RBC blood group. And physical database could further be established using the technology of red blood cells cryopreservation when the conditionspermit, so as to provide the most compatible blood for the clinical effectively improve blood transfusion safety, and provide data support for blood early warning.

【Objective】 To observe the distribution of the unexpected antibodies in order to study the safety and strategies in 1 779 cases of clinical blood transfusion. 【Methods】 A total of 1 779 patients with unexpected antibodies were enrolled from transfusion candidates in various hospitals in Xi′an during a 10-year period(from 2012 to 2022.5). 【Results】 The unexpected antibodies were detected in 926(52.05%) of 1779 samples. The detected antibodies were mainly from 8 blood group systems and their distributions were as follows: Rh antibodies in 69.76%(646/926), Kidd in 2.59%(24/926), Lewis in 4.21%(39/926), MNS in 12.53%(116/926), P in 0.43%(4/926), Diego in 0.65%(6/926), Duffy in 0.54%(5/926), I in 0.97%(9/926), Rh+ MNS in 1.30%(12/926), Rh+ Lewis in 0.65%(6/926), Rh+ Kidd in 3.24%(30/926), Rh+ Diego in 1.51%(14/926), Rh+ Duffy in 0.86%(8/926), MNS+ Diego in 0.11%(1/926), Rh+ MNS+ Kidd in 0.22%(2/926), Rh+ Lewis+ Kidd in 0.22%(2/926), Rh+ Kidd+ P in 0.11%(1/926), Rh+ Kidd+ Diego in 0.11%(1/926). 【Conclusion】 According to the distribution of unexpected antibodies in Xi′an, antibodies from Rh system, were the most common ones.First, the production of unexpected antibodies can be effectively reduced by establishing Rh compatible blood transfusion. Secondly, antibody screen cells containing low-frequency antigens, such as Mur, Di^a and Wr^a, should be reasonably selected to prevent missing detection of anti-low frequency antigen antibodies in Xi′an. Furthermore, the genotyping technology of rare blood group should be promoted and a rare blood group red blood cell bank be established to optimize the blood inventory and ensure the safety of blood transfusion.