Objective To investigate the diagnostic value of the modified esophageal capsule endoscopy (stringed esophageal capsule endoscopy,SCE) for esophageal diseases.Methods A total of 80 patients with esophageal related symptoms underwent SCE followed by esophagogastroduodenoscopy (EGD).The examination time,detection rate of esophageal lesions,complications and adverse effects were compared.Results All patients completed the study.The mean examination time of SCE and EGD was 226.18 ± 1 10.30 seconds and 21.28 ± 8.01 seconds respectively (t =-16.665,P =0.000).A total of 119 lesions were detected by SCE and EGD,and the diagnostic accordance rate of SCE and EGD was 82.4％ (98/119).Ten lesions of advanced squamous carcinoma,5 lesions of high grade intraepithelial neoplasia and 3 lesions of early squamous carcinoma were detected by both examinations,all of which were confirmed by histopathologic examination.The overall rate of complication in SCE (1.3％,1/80) was significantly lower than that of EGD (8.8％,7/80,x2 =4.238,P =0.040) and the rates of swallow difficulty (P =0.022),throat discomfort (P =0.007) and vomiting (P =0.000) of SCE were significantly lower than those of EGD.Conclusion SCE is a feasible,easy-to-operate,safe,well tolerated and accurate method for detection of esophageal diseases,and could be a non-invasive alternative for conventional EGD.

【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 prepare serum cholesterol and triglycerides reference materials.Methods Blood units were collected from healthy donors and the sera separated and screened for cholesterol and triglycerides levels.Four serum pools were prepared by pooling sera grouped according to cholesterol and triglyceride levels.The materials were tested for homogeneity and stability and their values for total cholesterol,total glycerol and free glycerol and triglycerides were assigned by HPLC methods.Results The materials were tested to be homogeneous and stable for at least 4 years at-20℃.The certified values (reference value±expanded uncertainty)of the 4 materials for total cholesterol were(5.110±0.065) mmol/L,(4.761±0.062)mmol/L,(3.941±0.050)mmol/L and(3.158±0.041)mmol/L,respectively;for total glycerol(2.212±0.043)mmol/L,(1.679±0.033)mmol/L,(1.275±0.027)mmol/L and(1.067±0.023)mmol/L;for free glycerol(0.142±0.005)mmol/L,(0.149±0.004)mmol/L,(0.146±0.003)mmol/L and(0.122±0.003)mmol/L;and for triglycerides(2.069±0.043)mmol/L,(1.530±0.033)mmol/L,(1.129±0.027)mmol/L and(0.945±0.023)mmol/L.Conclusion Certified reference materials for serum total cholesterol,total glycerol,free glycerol and triglycerides have been prepared.

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

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

Objective:To explore the value of endoscopic ultrasonography-guided carbon nanoparticles tattooing for preoperative localization of laparoscopic surgery for rectal cancer.Methods:Sixty patients diagnosed as having rectal cancer who underwent laparoscopic radical resection in the 900th Hospital of Joint Logistics Support Force from April 2018 to April 2019 were randomly divided into the endoscopic ultrasonography-guided tattoo group (group A), the colonoscopy-guided tattoo group (group B) and the control group (group C) by random number table. The leakage rate of dye in intestinal tract, complications, and the tattooed serosa stained with carbon nanoparticles during laparoscopic surgery were recorded. Identification time of lesions, the total operation time, the length of resected rectal segment, tumor distance to distal resection margin, and the rate of anal preservation were analyzed and the postoperative pathology were compared.Results:In group A, endoscopic ultrasonography revealed 2 cases of suspected tumor extension toward the anal side within distal intestinal wall. The extension length was 0.42 cm and 0.71 cm respectively, and the extension length was 0.36 cm and 0.64 cm under microscope respectively. In group B, the pathology result showed that the extension length was 0.53 cm under microscope. In group C, the pathology result showed that the extension length were 0.43 cm, 0.36 cm and 0.28 cm under microscope respectively. Obvious black staining in the rectal serosa was found in all tattooed patients during the surgery. There were scattered black staining spots at the surface of peritoneum and mesentery in 3 cases in group B. The identification time of lesions in group A and B were shorter than that in group C (1.29 ± 0.87 min, 1.31 ± 0.63 min VS 15.3 ± 10.50 min, P<0.05). The total operation time in group A and B were shorter than that in group C (176.12 ± 27.64 min, 175.67 ± 26.48 min VS 198.65 ± 38.67 min, P<0.05). The length of resected rectal segment in group A and B were shorter than that in group C (11.81 ± 5.76 cm, 12.31 ± 3.94 cm VS 15.24 ± 4.12 cm, P<0.05). The tumor distance to distal resection margin in group A and B were shorter than that in group C (3.61 ± 1.26 cm, 4.57 ± 1.58 cm VS 6.13 ± 2.47 cm, P<0.05). Anal preservation rates of three groups were 65.0% (13/20), 60.0% (12/20), 40.0% (8/20) respectively with no significant difference ( P>0.05). No residual tumor cells were found in any specimens. Conclusion:Carbon nanoparticles tattooing guided by endoscopic ultrasonography could reduce unnecessary intestinal segment incision and shorten the operation time. It can also reveal tumor extension toward the anal side within intestinal wall, which provides more accurate localization for the distal incision of the lower rectal cancer.

OBJECTIVE： To study the academic characteristics and connotation of Sichuan Nanpai Tibetan medicine （SNTM）， to provide relevant information for the inheritance and development of Nanpai Tibetan medicine， and to provide reference for the development and utilization of commonly used medicinal materials in SNTM. METHODS： The type characteristics， medication frequency， main treatment disease and medication rule of 672 preparations of Tibetan hospital of SNTM were analyzed by means of data mining， statistical analysis and inductive deduction methods of TCM inheritance support system （TCMISS）. Based on the core combination drugs， the new prescriptions were evolved by the entropy hierarchical clustering method. RESULTS： A total of 624 medicinal materials were used in formulation of SNTM， involving 509 plant drugs （81.67％）， 61 mineral drugs （9.77％） and 54 animal drugs （8.65％）. There were 16 medicines with frequency＞120； among them， top 3 medicines were Terminalia chebula （57.44％）， Carthamus tinctorius （43.15％） and Aucklandia lappa （42.26％）. Main treatment diseases involved 13 categories， and top 3 categories were gastric diseases （28.13％）， hepatobiliary diseases （12.80％） and neurological diseases （11.90％）. In the treatment of stomach diseases， T. chebula， C. tinctorius， Alpinia katsumadai， Piper longum， A. lappa and Punica granatum were mainly used； totally 61 commonly used drug combinations were obtained and the most commonly used combination was P. longum-A. katsumadai. In the treatment of hepatobiliary diseases， T. chebula， C. tinctorius， Herpetospermum caudigerum， Swertia bimaculata， Zhaxun were mainly used； 64 commonly used drug combinations were obtained and the most commonly used combination is T. chebula-C. tinctorius. In the treatment of neurological diseases， Myristica fragrans， T. chebula， A. lappa， Syzygium aromaticum， Aquilaria sinensis， Choerospondias axillaris were mainly used； 73 commonly used drug combinations were obtained， and the most commonly used combination was T. chebula-M. fragrans. 5 candidate new formulations had been evolved by the entropy hierarchical clustering method， involving Lacciferlacca-Lithospermum erythrorhizon-Rubia cordifolia- Punica granatum. CONCLUSIONS： Obtained high frequency drug pairs and evolved new candidate formulation based on the core combinations drugs of SNTM for commonly diseases can provide reference for the development of modern new Tibetan medicines for gastric， hepatobiliary and neurological diseases.

BACKGROUND:This meta-analysis aimed to assess the efficacy of high-dose glucose-insulin-potassium(GIK)therapy on clinical outcomes in acute coronary syndrome(ACS)patients receiving reperfusion therapy. METHODS:We searched the PubMed,Web of Science,MEDLINE,Embase,and Cochrane Library databases from inception to April 26,2022,for randomized controlled trials(RCTs)that compared high-dose GIK and placebos in ACS patients receiving reperfusion therapy.The primary endpoint was major adverse cardiovascular events(MACEs). RESULTS:Eleven RCTs with 884 patients were ultimately included.Compared with placebos,high-dose GIK markedly reduced MACEs(risk ratio[RR]0.57,95％confidence interval[95％CI]:0.35 to 0.94,P=0.03)and the risk of heart failure(RR 0.48,95％CI:0.25 to 0.95,P=0.04)and improved the left ventricular ejection fraction(LVEF)(mean difference[MD]2.12,95％CI:0.40 to 3.92,P=0.02)at 6 months.However,no difference was observed in all-cause mortality at 30 d or 1 year.Additionally,high-dose GIK was significantly associated with increased incidences of phlebitis(RR 4.78,95％CI:1.36 to 16.76,P=0.01),hyperglycemia(RR 9.06,95％CI:1.74 to 47.29,P=0.009)and hypoglycemia(RR 6.50,95％CI:1.28 to 33.01,P=0.02)but not reinfarction,hyperkalemia or secondary reperfusion.In terms of oxidative stress-lowering function,high-dose GIK markedly reduced superoxide dismutase(SOD)activity but not glutathione peroxidase(GSH-Px)or catalase(CAT)activity. CONCLUSION:Patients with ACS receiving reperfusion therapy exhibited a reduction in MACEs and good oxidative stress-lowering efficacy in response to high-dose GIK.Moreover,with a higher incidence of complications such as phlebitis,hyperglycemia,and hypoglycemia.Furthermore,there were no observed survival benefits associated with high-dose GIK.More trials with long-term follow-up are still needed.

[Abstract] [Objective] To evaluate the immunogenicity of red blood cell blood group antigens in the population of Xi'an. [Methods] Data on blood group antigens of voluntary blood donors from the Shaanxi Province Blood Center and unexpected antibody detection results from clinically submitted cases between January 2019 and May 2024 were analyzed. The Giblett blood group antigen immunogenicity calculation formula was used to calculate the immunogenicity of blood group antigens based on the frequency of unexpected antibodies and the probability of antigen-negative patients receiving antigen-positive red blood cells. The relative immunogenicity of each blood group antigen was obtained by multiplying the immunogenicity of the K antigen (0.095). [Results] A total of 30 921 individuals were included for red blood cell blood group antigen analysis, with 511 cases of unexpected antibody identification. The ranking of red blood cell blood group antigen immunogenicity for the overall population was: Wr^a>E>Di^b>Fy^a>K>C>e>c>Di^a>Jk^a>M>Le^a>Jk^b>Le^b>Fy^b>S, while for males, it was: Di^b>Wr^a>E>K>Fy^a>C>e>c>M>Di^a>Jk^a>Fy^b>Le^a>Le^b>Jk^b>S. [Conclusion] Based on the immunogenicity ranking from strong to weak of red blood cell antigens in the population of Xi'an, this study provides theoretical support for the expansion and matching of antigens, and technical support for achieving precise red blood cell transfusions to improve transfusion efficacy and safety.