Objective To explore the operative main point and clinical effects of laparoscopic treatment for hepatic cyst. Methods Between August 2006 and April 2009, Forty-eight cases of laparoscopic treatment for hepatic cyst were performed, and the data were analyzed retrospectively. Of these treatments, there were laparoscopic fenestration (46 cases) and laparoscopic anatomical resection of left hepatic lobe (2 cases). Of the patients, there were solitary cyst (41 cases) and multiple cyst (7 cases). Results Fortyeight cases all performed laparoscopic treatment successfully. There were no converting to open operation, no biliary leakage and no bleeding. Except for resection of left hepatic lobe, the operating time was 30 -96 minutes (mean, 45 minutes), the intraoperative blood loss was 10 -90 mL (mean, 26 mL) and the postoperative hospital stay was 3 - 9 days (mean, 5 days). All the 48 patients were followed up for 6 to 36 months (mean, 32 months), 2 cases were found recurrence. Conclusions Affluent experience and proper standard of operation are key points for avoiding recurrence and complication in laparoscopic treatment for hepatic cyst. Laparoscopic treatment for hepatic cyst is safe, characterized by less pain and rapid recovery.

Objective To study the application value of multi-parameter imaging of Revolution energy spectrum CT in identifying the tumor-lung interface between central lung cancer and accompanying atelectasis.Methods The spectral CT imaging data of 73 patients with central lung cancer and accompanying atelectasis confirmed by pathology were collected.The polychromatic image,the best monochromatic image,the best monochromatic image combined with iodine concentration map and the effective atomic number(Eff-Z)of the tumor-lung interface in the arterial,venous and delayed phases were compared,and the CT value,iodine concentration(IC)value,Eff-Z and the slope of energy spectrum curve(λHU)of tumors and atelectasis in the venous phase were also compared.Results(1)On tri-phase CT,the subjective score of the tumor-lung interface in the venous phase was the highest.(2)There were differences among the subjective scores of tumor-lung interface on polychromatic image,best monochromatic image,best monochromatic image com-bined with iodine concentration map and Eff-Z on tri-phasic enhanced CT.The subjective score of the best monochromatic image combined with iodine concentration map was the highest,followed by the best monochromatic image.(3)There were significant differences in CT values,IC values,Eff-Z and λHU between tumors and atelectasis in venous phase,with the highest difference of IC value.Conclusion Revolution energy spectrum CT can identify the tumor-lung interface between central lung cancer and accompanying ate-lectasis through multi-parameter imaging,which may provide helpful information for the diagnosis and therapeutic evaluation of the disease.

Objective To investigate the distribution,phenotype and genotype of D-elute type(Del)in blood donors with RhD negative blood in Guangzhou,so as to understand the molecular biological background of DEL blood group in this area.Methods During the period from November 1,2021 to June 30,2022,the RhD-negative blood initially screened by saline method was confirmed by indirect anti-human globulin test(IAT)serology,and RhCE phenotype was determined by RhCE typing card.A total of 1 146 RhD-negative samples,including all RhD-negative samples with RhCE C+(n=459)and a randomly selected subset of RhCE C-(n=175),were subjected to adsorption-elution(Del)screening(a total of 634 sam-ples).DNA from Del-positive samples was extracted for real-time fluorescent PCR detection of the RHD gene c.1227 locus using high-resolution melting curve analysis(HRM).For samples without mutations detected at the RHD?1227 locus by HRM,restriction fragment length polymorphism polymerase chain reaction(PCR-RFLP)was performed to amplify the prod-uct which was subsequently digested with Pst I enzyme and analyzed by electrophoresis to determine RHD gene haplotypes.Sanger sequencing was performed for exon sequencing(exon 1-10)of the RHD gene,and gene mutations were analyzed u-sing SeqMan software.Suspected Del-positive samples were subjected to RHD whole gene analysis using third-generation sin-gle-molecule sequencing technology.Results Among the 634 confirmed RhD-negative samples,229(36.1%)displayed Del phenotype,accounting for20%(229/1 146)of the total confirmed RhD-negative samples.The RhCE phenotypes of the 229 DEL cases were as follows:Ccee in 181 cases,CCee in 40 cases,CcEe in 7 cases,and ccEe in 1 case.HRM combined with RHD haplotype analysis showed that there were 170 cases with RHD gene as RHD?1227A/01N.01,32 cases with RHD gene as RHD?1227A/1227G,26 cases with RHD gene as RHD?1227A/1227A,and 6 cases with RHD gene as RHD?1227G/1227G(sequencing results included 1 case of weak D type 12,4 cases of D-,and 1 case of RHD?01EL.02).Con-clusion The individual genotype of DEL blood donors in Guangzhou area is mainly characterized by RHD?1227A/01N.01,and their RhCE phenotypes are all C+.HRM can be used as a molecular biology method for routine screening of Asian-type DEL blood type genes.

【Objective】 To identify three cases of pregnant women with the D variant phenotype using serological and molecular tests, and discuss the strategy of prenatal examination. 【Methods】 The peripheral blood samples from three pregnant women with the D variant phenotype were collected. RhD variant phenotype was determined using routine serological methods with two different kinds of monoclonal anti-D. The serological characteristic for the epitope of D antigen was further analyzed using the commercial panel anti-D reagents (D-Screen, Diagast). The hybrid RHD-CE-D allele was analyzed by the Multiplex Ligation-dependent Probe Amplification (MLPA) assay and polymerase chain reaction with sequence specific primers (PCR-SSP) method. Further Sanger sequencing of RHD gene exons was also performed. 【Results】 DFR phenotype was primarily determined by serological characteristic for the epitope of D antigen. RHD^*DFR2/01N.01(n=2) and RHD^*DFR1/1227A(n=1) genotypes were identified by the MLPA assay, PCR-SSP and Sanger sequencing. 【Conclusion】 Two pregnant women with RHD^*DFR2/01N.01 genotype should be treated as D negative patients clinically, while the pregnant woman with RHD^*DFR1/1227A genotype can be treated as Asia type DEL to avoid unnecessary antibody screening and anti-D prophylaxis.

OBJECTIVETo explore the safety and efficacy of pegylated recombinant human granulocyte colony-stimulating factor (PEG-rhG-CSF) in preventing chemotherapy-induced neutropenia in patients with breast cancer and non-small cell lung cancer (NSCLC), and to provide the basis for clinical application.

METHODSAccording to the principle of open-label, randomized, parallel-group controlled clinical trial, all patients were randomized by 1∶1∶1 into three groups to receive PEG-rhG-CSF 100 μg/kg, PEG-rhG-CSF 6 mg, or rhG-CSF 5 μg/kg, respectively. The patients with breast cancer received two chemotherapy cycles, and the NSCLC patients received 1-2 cycles of chemotherapy according to their condition. All patients were treated with the combination chemotherapy of TAC (docetaxel+ epirubicin+ cyclophosphamide) or TA (docetaxel+ epirubicin), or the chemotherapy of docetaxel combined with carboplatin, with a 21 day cycle.

RESULTSThe duration of grade 3-4 neutropenia in the PEG-rhG-CSF 100 μg/kg and PEG-rhG-CSF 6 mg groups were similar with that in the rhG-CSF 5 μg/kg group (P>0.05 for all). The incidence rate of grade 3-4 neutropenia in the PEG-rhG-CSF 100 μg/kg group, PEG-rhG-CSF 6 mg group, and G-CSF 5 μg/kg group were 69.7%, 68.4%, and 69.5%, respectively, with a non-significant difference among the three groups (P=0.963). The incidence rate of febrile neutropenia in the PEG-rhG-CSF 100 μg/kg group, PEG-rhG-CSF 6 mg group and G-CSF 5 μg/kg group were 6.1%, 6.4%, and 5.5%, respectively, showing no significant difference among them (P=0.935). The incidence rate of adverse events in the PEG-rhG-CSF 100 μg/kg group, PEG-rhG-CSF 6 mg group and G-CSF 5 μg / kg group were 6.7%, 4.1%, and 5.5%, respectively, showing a non-significant difference among them (P=0.581).

CONCLUSIONSIn patients with breast cancer and non-small cell lung cancer (NSCLC) undergoing TAC/TA chemotherapy, a single 100 μg/kg injection or a single fixed 6 mg dose of PEG-rhG-CSF at 48 hours after chemotherapy show definite therapeutic effect with a low incidence of adverse events and mild adverse reactions. Compared with the continuous daily injection of rhG-CSF 5 μg/kg/d, a single 100 μg/kg injection or a single fixed 6 mg dose of PEG-rhG-CSF has similar effect and is more advantageous in preventing chemotherapy-induced neutropenia.

Antineoplastic Agents ; adverse effects ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; Breast Neoplasms ; drug therapy ; Carboplatin ; administration & dosage ; adverse effects ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; Cyclophosphamide ; administration & dosage ; adverse effects ; Epirubicin ; administration & dosage ; adverse effects ; Female ; Granulocyte Colony-Stimulating Factor ; therapeutic use ; Humans ; Incidence ; Induction Chemotherapy ; Lung Neoplasms ; drug therapy ; Neutropenia ; chemically induced ; epidemiology ; prevention & control ; Polyethylene Glycols ; Recombinant Proteins ; administration & dosage ; Taxoids ; administration & dosage ; adverse effects