Objective To investigate the appropriate cross-matching methods for the direct antiglobulin test (DAT)positive patients.Methods The DAT was used to screen the irregular antibodies on the surface of erythrocytes.The microcolumn gel test was used for blood identification.The antiglobulin test and manual polybrene test were used for cross-matching.Re-sults A total of five DAT positive cases were collected in study.The blood groups of each case were detected,including A-DCcEe,O-DCCee,O-DCcee,A-DCCee and A-DCcee.The donor samples with corresponding blood-antigen negative were cho-sen for cross-matching,and the agglutination intensity of each cross-matching tube was weaker than the control.The transfu-sion of washed red blood cells was suggested.Finally,each transfusion was safe and efficient.Conclusion The infusion of the washed red blood cells with corresponding blood-antigen negative could efficiently ensure the safety of blood transfusion.

According to the physiological characteristics of lumbar vertebrae in Chinese, we designed and made a lumbar vertebral fusion cage of titanium and then engaged in its biomechanical test. T12-S1 of lumbar vertebrae from 18 fresh dead bodies were used. We measured the stress relaxation and the creep effects of the normal group (T12-S1 of intact lumbar vertebrae), the control group 1(simulating operation of excising intervertebral disc and planting bone on the back route) and the control group 2(simulating operation of excising intervertebral disc and inserting fusion cage). The data and stress, strain-time curves under the condition of constant stress and strain were obtained. Regression analysis yielded the reduced stress relaxation and creep functions. Finally, we analyzed and discussed the effects of the operation of excising intervertebral disc and planting bone on the back route and the operation of excising intervertebral disc and inserting fusion cage on the stability of spine.
Elasticity ; Humans ; Intervertebral Disc ; physiology ; surgery ; Lumbar Vertebrae ; physiology ; Spinal Fusion ; Spine ; Titanium

Child and adolescent mental disorders are common disorders with various symptoms,and attracting more attention due to the increasing prevalence.Mental disorders,especially the attention-deficit hyperactivity disorder (ADHD) and the autism spectrum disorder (ASD),have great influence on the development of children and adolescents.Nowadays,the biomarkers from neuroimaging such as magnetic resonance imaging (MRI) have a great importance on the diagnosis of mental disorders,and machine learning has been proved to be very powerful in the processing for neuroimages.Nowadays,many researchers are focusing on the studies of computer-aided diagnosis (CAD) based on machine learning and neuroimaging.In this review,the technical details of machine learning based CAD of child and adolescent mental disorders are briefly introduced,and the research progress in CAD of ADHD and ASD based on machine learning and structural MRI are summarized.These studies showed that many machine learning methods have been used in the diagnosis of child and adolescent mental disorders,but the relevant methods cannot be applied to clinical diagnosis.Further studies should be conducted to improve the diagnostic ability of machine learning methods from multiple perspectives,and provide an objective and reliable tool for the clinical diagnosis of child and adolescent mental disorders.

Objective:To investigate the effects of cerebral ischemic postconditioning (CIP)on the expressions of Cyclin D1 and CDK4 proteins in hippocampal neurons of the rats with global cerebral ischemia and reperfusion (I/R)based on Notch1 signaling pathway,and to explore the mechanisms.Methods:A total of 128 healthy male SD rats were randomly divided into sham operation group,I/R group (modified Pulsinelli four vessel occlusion method), CIP group (repeated 3 times of reperfusion or blocking blood vessel before complete reperfusion)and DAPT group (intraperitoneal injection of 10 mg·kg-1 ·d-1 DAPT 3 h before CIP),and there were 32 rats in each group.HE staining was used to observe the morphology of the neurons at 6, 24, 48 and 72 h after ischemia;immunohistochemical staining was used to observe the expressions of Cyclin D1, CDK4 and Notch1 in the hippocampus of the rats;Western blotting method was used to observe the expression levels of Cyclin D1,CDK4 and Notch1 proteins in the hippocampus of the rats at different time points. Results:The HE staining results showed that compared with sham operation group,the structure of neurons in hippocampus area of the rats in I/R group was damaged and the survival rate of neurons was significantly decreased (P <0.05).Compared with I/R group,the survival rates of neurons in the hippocampus area of the rats in CIP group were significantly increased at the corresponding time (P <0.05).Compared with CIP group,the survival rates of neurons in hippocampus area of the rats in DAPT group at the corresponding time were significantly decreased (P < 0.05 ). The immunohistochemical staining results showed that compared with sham operation group,the number of cells with positive Notch1,Cyclin D1 and CDK4 in I/R group was increased (P < 0.05).Compared with I/R group,the number of Cyclin D1 and CDK4 positive cells in CIP group was decreased (P <0.05),and the number of Notch1 positive cells of was significantly increased (P <0.05).Compared with CIP group,the number of Cyclin D1 and CDK4 positive cells in DAPT group was increased (P < 0.05 ),and the number of Notch1 positive cells was significantly decreased (P < 0.05 ). The Western blotting results showed that compared with sham operation group,the expression levels of Notch1,Cyclin D1 and CDK4 proteins in the hippocampus of the rats in I/R group were increased (P <0.05);compared with I/R group,the expression levels of Cyclin D1 and CDK4 proteins in the hippocampus of the rats in CIP group were significantly decreased (P <0.05),and the expression level of Notch1 protein in the hippocanpus of the rats was significantly increased (P < 0.05 ); compared with CIP group,the expression levels of Cyclin D1 and CDK4 proteins in the hippocampus of the rats in DAPT group were increased (P <0.05),and the expression level of Notch1 protein was significantly decreased (P < 0.05).Conclusion:CIP may play an important role in protecting the neurons by increasing the activity of Notch1 and inhibiting the expressions of Cyclin D1 and CDK4.

Objective:To discuss the clinical features of a family with Welander distal myopathy and analyze the genetic characteristics of the T-cell intracellular antigen 1 (TIA1) gene mutation in this family.Methods:The clinical data, electrophysiological and pathological examination results of some family members were collected, and the proband was tested by next generation sequencing techniques to detect possible pathogenic mutations. Sanger sequencing was performed in some family members for the gene mutations closely related to the clinical phenotype.Results:The proband, a 30-year-old man, manifested progressive weakness and muscle atrophy in distal limbs, followed by the involvement of muscles in proximal limbs. A gene mutation of c.91G>A was detected by genetic testing in the TIA1 gene, which was associated with Welander distal myopathy. The further Sanger sequencing revealed the same mutation site in the proband′s mother, one younger brother and his youngest uncle, who showed similar symptoms as the proband including muscle weakness and atrophy. The youngest brother of the proband was a mutation carrier without obvious symptoms, and his electromyography test showed myogenic injuries.Conclusions:Welander′s distal myopathy is a slowly progressing autosomal dominant disorder, characterized by weakness and muscle atrophy mainly in the extremities. In this family, the patients showed the onset in the extremities of the lower limbs and presented weakness and atrophy in distal and proximal limbs, with disease heterogeneity among patients. Genetic testing and the analysis of the family members confirmed the diagnosis of Welander′s distal myopathy and the pathogenic mutation c.91G>A in the TIA1 gene.

To systematically construct a guideline to provide a methodological guide for researchers to develop patient decision aids.

Objective To assess the effect of ischemic postconditioning on the Notch1 signaling pathway,and learning and memory in rats with global cerebral ischemia.Methods A total of 128 healthy male SD rats were randomly divided into the sham operation (sham),whole-brain ischemia(CIR),ischemic treatment(CIP),and inhibitor(DAPT) groups,with 32 rats in each group.A global cerebral ischemia model was generated using the modified Pulsinelli's four-vascular occlusion model,and the inhibitor group was injected intraperitoneally with gamma secretase inhibitors (DAPT) before ischemic treatment.Rats' learning and memory function results from the Morris water maze test were assessed by observing the changes in hippocampal CA1 neurons with HE staining.The expression of Notch1 in the CA1 area of the hippocampus was assessed using immunohistochemical and Western blotting methods in rats.Results Compared with the sham group,the hippocampal cell survival rate in the CIR group decreased significantly (P ＜ 0.05) and the expression level of Notch1 increased significantly (P ＜ 0.05).Compared with the CIR group,the CIP group revealed a significantly higher hippocampal cell survival rate (P ＜ 0.05) and an increase in Notch 1 expression (P ＜ 0.05);compared with the CIP group,the hippocampal cell survival rate significantly decreased after DAPT administration (P ＜ 0.05) and Notch1 expression decreased significantly.Conclusion Ischemic postconditioning can promote the recovery of learning and memory ability,which may relate to the activation of the Notch 1 signaling pathway.

Healthy lifestyles and good living habits are effective strategies and important approaches to prevent chronic non-communicable diseases. With the development of evidence-based medicine, the evidence translation system has made some achievements in clinical practice. There is, however, no comprehensive, professional and efficient system for translating lifestyle evidence globally. Therefore, the Health Lifestyle Evidence (HLSE) Group of Lanzhou University constructed the HLSE Evidence Translation System (https://hlse.cn/), with the aim of synthesizing, evaluating, translating, and applying lifestyle-related evidence resources. This paper aims to introduce the functional module design of the evidence translation system, the system development process and testing, introduce the interface design and function demonstration, and explain the significance of constructing the HLSE.

Objective:Through a typical case of corticobasal degeneration (CBD) with primary progressive aphasia (PPA) to analyze the clinical characteristics of CBD and the special manifestations of aphasia with that disease.Methods:Retrospective analysis was performed on a patient with PPA based CBD who was admitted to the First Affiliated Hospital, Sun Yat-sen University in July 2020 to summarize the clinical features and diagnostic thinking of CBD.Results:The patient was a 59-year-old male, manifested rapidly progressive dysfunction of language and memory function. The aphasia was mainly featured as slow speech, reduced content and grammatical errors, and diagnosed as PPA, non-fluent grammatical variation. The imaging results showed the atrophy of the left frontal lobe, parietal lobe, basal ganglia and thalamus, coupled with the reduction in 18F-fluorodeoxyglucose radioactive uptake. The patient was finally diagnosed as possible CBD. Conclusions:PPA as the initial manifestation of CBD is very rare in clinical practice. The high non-specificity of clinical features and the lack of typical motor symptoms result in the difficulty of correct diagnosis of CBD. Timely functional imaging in nuclear medicine and reliable biomarkers help to facilitate early diagnosis of atypical CBD.

Objective:To explore the clinical efficacy of disease-modifying drug nusinersen on children with spinal muscular atrophy.Methods:The baseline and longitudinal clinical data of 15 children who were treated with nusinersen in the Children′s Hospital, Zhejiang University School of Medicine from October 2019 to October 2021 were retrospectively collected. The general data (gender, age, genotype, and clinical classification, etc.), motor function, nutritional status, scoliosis and respiratory function were analyzed. Wilcoxon rank-sum test was used for comparing multi-system conditions before and after treatment.Results:The age of 15 cases (7 males, 8 females) was 6.8 (2.8, 8.3) years, with 2 cases of type 1, 6 cases of type 2, and 7 cases of type 3 respectively, and the course of disease was 55.0 (21.0, 69.0) months. After 9.0 (9.0, 24.0) months of treatment, the motor function scale evaluations of the Hammersmith neurological examination section 2 (13.0 (7.0, 23.0) vs. 18.0 (10.0, 25.0) scores, Z=-2.67, P=0.018) of 15 children, the Hammersmith functional motor scale expanded (38.0 (18.5, 45.5) vs. 42.0 (23.0, 51.0) scores, Z=-2.38, P=0.018), and the revised upper limb module (27.0 (19.5, 32.0) vs. 33.0 (22.5, 35.5) scores, Z=-2.52, P=0.012) of children with type 2 and 3 had significantly improved. Thirteen patients achieved clinically significant motor function improvement, and 2 of them had kept stable scale scores. Subjective reports also indicated that the muscle strength and daily exercise ability of these children improved after treatment, and no serious adverse reactions were reported. Supplemented by the multi-disciplinary team management, the levels of some indicators such as Cobbs angle of scoliosis and forced vital capacity all had significantly improved (all P<0.05). Conclusions:Nusinersen can improve the motor function of patients with 5q spinal muscular atrophy, which is also proved safe to be used in children. The drug treatment supplemented by the multi-disciplinary team management is helpful to improve the multi-system function of the children with spinal muscular atrophy.