Objective To explore the medical coping strategies and impact factors of patients with coronary heart disease in Wuhan.Methods Both medical coping strategies and impact factors of 90 patients with coronary heart disease in Wuhan were analyzed by using Spearman coefficient and multiple linear regression analysis,and compared with the norm of 701 cases.Results Compared with the norm,patients with coronary heart disease in Wuhan preferred less facing coping strategies and more avoidance coping strategies:(17.89±2.67) points vs.(19.48±3.81) points,(16.95±2.54) points vs.(14.44±2.97) points,and there were significant differences (t=2.146,P=0.035;t=1.994,P=0.048).The yielding coping strategies was indicated insignificant differences (t=1.758,P=0.173).The facing coping strategies were correlated with age (r=-0.212,P=0.036),education levels (r=0.190,P=0.041),family monthly income (r=-0.106,P=0.049) and disease course (r=0.327,P=0.017).The avoidance coping strategies were correlated with marital status (r=-0.304,P=0.013).The yielding coping strategies were correlated with length of disease(r=0.294,P=0.023)and therapy methods (r=0.308,P=0.017).Conclusions Based on patients' characteristics and impact factors,nursing staff should guide and encourage patients to use positive medical coping styles.

Objective To evaluate the effect of uterine-reserved in the pelvio floor reconstruction,and select the best surgery for patients. Methods Through the observation and follow-up for 14 cases of uterine-reserved (experimental group) and 17 cases of uterine-removed (control group), to compare the information during the surgery, postoperative recovery, and quality of life of the two groups. Results The operation time, blood loss, postoperative discharge time, antibiotics application time and hospitalization time in experimental group were significantly lower than those in control group(P ＜ 0.05). The paruria, abdominal distention in experimental group [14%(2/14), 14%(2/14)] were significantly lower than those in control group [53% (9/17), 24% (4/17)] (P ＜ 0.05), and sexual satisfaction was significantly higher in experimental group than that in control group [71% (10/14) vs. 47% (8/17)] (P ＜ 0.05). There were no significant difference in pelvic pain, constipation of the two groups (P＞ 0.05). The POP-Q scores were normal after the operation both the two groups, each group beforeand after surgery compared the POP-Q score, were statistically significant (P ＜ 0.05). Conclusions Uterine-r eserved in the pelvic floor reconstruction can maintain the structural stability of the pelvic floor, and has the advantage of shorter operation time, less bleeding, more rapid recovery. Recent results are similar with hysterectomy, can reduce the risk of perioperative period to the elderly women.

ObjectiveTo investigate the effect of artesunate on the expression of vascular endothlial growth factors(VEGF)and VEGFR in SHI-1 cell line.MethodsEnzyme-linked immunosorbent assay analysis was performed to detect the amount of VEGF in culture supernatants of SHI-1 cell in the condition of artesunate or not. The expression of VEGFR1 and VEGFR2 in SHI-1 cell in the condition of artesunate or not were detected by flow cytometry.ResultsWithout artesunate,the concentration of VEGF in the culture supernatant of SHI-1 cell were (980.3±2.2) pg/ml in 24 h and (982.4±2.3) pg/ml in 48 h. The expression of VEGFRI in SHI-1 cell were (6.40±3.11) ％ in 24 h and (6.45±2.85) ％ in 48 h. The expression of VEGFR2 in SHI-1 cell were (13.90±2.26) ％ in 24 h and (13.95±1.96) ％ in 48 h. With artesunate at 5, 10, 20 ng/ml, the concentration of VEGF in culture supematant of SHI-1 cell were (234.6±1.8)pg/ml, (114.9±1.6)pg/ml, (108.8±1.5) pg/ml in 24 h and (62.3±1.7) pg/ml, (60.9±1.6) pg/ml, (32.7±1.7) pg/ml in 48 h, respectively. The levels of VEGF in SHI-1 cells treated with artesunate at different concentrations decreased significantly (P ＜0.05).There was significant difference between 24 hours group and 48 hours group(P ＜0.05).The expression of VEGFR1 in SHI-1 cell were (4.30±2.21) ％, (4.20±1.37) ％, (3.90±1.86) ％ in 24 h and (3.80±2.87) ％, (3.60±1.73) ％, (3.00±1.82) ％ in 48 h, respectively. The expression of VEGFR1 in SHI-1 cell treated with artesunate at different concentrations were not significantly different (P ＞0.05). No significant difference between 24 hours group and 48 hours group was observed (P ＞0.05). VEGFR2 expression of SHI-1 cell were(4.40±1.15) ％, (3.10±0.68) ％, (1.10±0.72) ％ in 24 h and (3.00±1.68) ％, (2.20±0.93) ％, (0.60±0.92) ％ in 48 h, respectively. The results indicated that the expression of VEGFR2 in SHI-1 cells treated with artesunate at different concentrations reduced significantly (P ＜0.05),but there was no significant difference between 24 h group and 48 h group (P ＞0.05). ConclusionThe concentration of VEGF in SHI-1 cell was high, and artesunate can down-regulate the expression of VEGF and VEGFR2,but the effect of artesunate on the VEGFR1 was not significant.

AIM: To set up a method for determining ferulic acid and gastrodine in Dachuanxiong Hydrochloride for Injection(Rhizoma Chuanxiong, Rhizoma Gastrodiae). METHODS: HPLC conditions consisted of ODS column, methanol-water-acetic acid (30 ∶68 ∶2) and water-acetic acid (100 ∶1) as mobile phases, detection wavelengths were at 320 nm and 270 nm. RESULTS: For ferulic acid, the linear range was within 0.031 6 - 0.505 6 ?g and the average recovery was 98.43% with RSD= 1.52% . For gastrodine, the linear range was within 0.442 - 3.536 ?g and the average recovery was 98.15% with RSD= 1.68% . CONCLUSION: The method proves to be simple, precise and reproduciable and is suitable for the use of quantitative control of Dachuanxiong Hydrochloride for Injection.

ObjectiveTo study the molecular genetic mechanism of para-bombay phenotype in two individuals.MethodsThe proband was a female.When the proband donated blood,because the forward blood group wasn't coincident with her reverse blood group,the blood and saliva specimen from proband and her family members were sent to Guangzhou Blood Center for further identification.Routine serological techniques were used to determine proband's and her family members' blood group and ABH antigen in saliva.The coding regions of FUT1 and FUT2 gene,exon 6 and exon 7 of ABO gene were amplified by polymerase chain reaction using proband's and her family members' genomic DNA.All amplified products were analyzed after being directly sequenced.The two-base deletion regions of FUT1 gene were certified by cloning and haplotype sequencing.Results Proband's and her little brother's blood group were identified as para-bombay while other family members' blood group were normal.Two-base deletion heterozygous mutations of FUT1 gene were found in proband and her brother,AG deletion at position 547-552 and TT deletion at position 880-882,which caused a reading frame shift and a premature stop eodon.Meanwhile,880-882del TT heterozygous mutation was found in proband's grandfather and her father and 547-552del AG heterozygous mutation was found in proband's mother and her little sister.ResultsOf cloning and haplotype sequencing certified that these two-base deletion mutations occurred at 547-548 and 881-882 position respectively.Three new mutations were found in FUT2 gene,390C ＞ T,418A ＞ T and 749G ＞ A,which could cause the change of amino acid at position 140Ile ＞ Phe and 250Arg ＞ Gln.Conclusions Two-base deletion heterozygous mutations in different positions in FUT1 gene were found in 2 individuals,which maybe the molecular genetic mechanism of para-bombay phenotype.Heterozygous deletion mutation in one-strand DNA wouldn't change the ABO blood group.Three new mutations were also found in FUT2 gene.( Chin J Lab Med,2012,35:815-819)

OBJECTIVETo evaluate the application of anti-T-lymphocyte globulin (ATG) based nonmyeloablative but profoundly immunosuppressive regimens followed by donor lymphocyte infusion (DLI) for the treatment of hematologic malignancies.

METHODSThe protocol was designed to minimize the intensity of the conditioning regimen to the range of nonmyeloablative therapies based on ATG with low-dose busulfan (Bu) and Cytoxan (CTX) (15 - 19.5 mg/kg, 8 mg/kg and 80 mg/kg, respectively). The patients received the first lymphocytic infusion from HLA-identical sibling donors on days 28 - 30 after transplant, and the first T cell dosage of 10(6)/kg followed by the escalated dosage in the range of (0.5 - 1.5) x 10(8)/kg. The total number of procedures were performed at a median of 4.2 procedures (range of 2 - 8 procedures).

RESULTSEngraftment was documented in all six patients in the form of donor-recipient hematopoietic cells mixed chimera at early-stage posttransplant, which was converted gradually into complete chimera by DLI in four patients. Graft-versus-host disease (GVHD) developed in three of six cases, only one of which was severe. To date, four patients are disease free and alive.

CONCLUSIONSAllogeneic donor stem cell engraftment into host can be achieved by nonmyeloablative conditioning regimen based on ATG. Transient mixed donor-recipient hematopoietic cell mixed with chimeras may be successfully converted into complete chimerism by DLI posttransplant. GVHD remains major clinical concern in our study.

Adolescent ; Adult ; Antilymphocyte Serum ; therapeutic use ; Female ; Graft vs Host Disease ; etiology ; Hematologic Neoplasms ; therapy ; Hematopoietic Stem Cell Transplantation ; Histocompatibility Testing ; Humans ; Lymphocyte Transfusion ; Male ; Middle Aged ; T-Lymphocytes ; immunology ; Transplantation Chimera ; Transplantation Conditioning

In order to evaluate the efficacy and safety of submucosal tunneling endoscopic resection (STER) for the treatment of multiple submucosal tumors (SMT) in the upper gastrointestinal tract, data of 24 cases with upper gastrointestinal SMT (including 56 SMT lesions) treated at Taizhou Municipal Hospital and Shanghai East Hospital from January 2016 to June 2021 were collected for retrospective observation. The treatment effect, occurrence of major adverse events and follow-up results were analyzed. The results showed that 19 cases (79.2%) underwent tumor resection through one tunnel, and 5 cases (20.8%) underwent tumor resection through two tunnels. The length of the tunnel was 3-12 cm, with an average of 6.2 cm. The surgical time ranged from 19 to 130 minutes, with an average of 55.6 minutes. The overall resection rate was 89.29% (50/56). The hospitalization time was 2-7 days, with an average of 3.5 days. Major adverse events occurred in 2 cases (8.3%), all of which were mucosal injuries, and were cured with titanium clips and self expanding metal sealing stents. During a follow-up period of 6-64 months, with an average of 32.0 months, there was no residual tumor, tumor implantation tunnel, local recurrence, distant metastasis or death. To sum up, STER is safe and feasible for the treatment of multiple SMT in the upper gastrointestinal tract. The main resection method is single tunnel, and double tunnel is required for multiple SMT far apart.

OBJECTIVETo report a rare case of hemolytic disease of the newborn (HDN) with kernicterus caused by anti-Di(a) diagnosed using high-throughput genotyping multiplex ligation-dependent probe amplification (MLPA).

METHODSConventional serological methods were used to detect the antibodies related with HDN. The genotypes of more than 40 red blood cell antigens for the newborn and her parents were obtained using the high-throughput MLPA assay. The antibody titers were tested using a standard serological method.

RESULTSThe unknown antibody against the low-frequency antigens was predicted based on the primary serological tests. The genotyping results for more than 40 red blood cell antigens of the newborn and her parents showed incompatible antigens of MNS and Diego blood group system, indicating the existence of anti-N or anti-Di(a). Further serological tests confirmed anti-Di(a) existence in the plasma of the newborn and her mother. The titer of anti-Di(a) in the mother's plasma was 1:32.

CONCLUSIONSevere HDN including kernicterus can result from anti-Di(a). High-throughput genotyping MLPA assay can help type some rare antigens in complicated cases. The reagent red cell panels including Di(a)-positive cells are necessary in routine antibody screening test in Chinese population.

Blood Group Incompatibility ; genetics ; Erythroblastosis, Fetal ; diagnosis ; immunology ; Exchange Transfusion, Whole Blood ; Female ; Genotype ; Humans ; Infant, Newborn ; Nucleic Acid Amplification Techniques ; methods ; Rh-Hr Blood-Group System ; genetics ; immunology ; Rho(D) Immune Globulin ; genetics ; immunology

OBJECTIVETo investigate the frequency of anti-Mur and Mur antigen among blood donors in Guangzhou to provide evidence for guiding clinical transfusion and prenatal screening.

METHODSDG Gel Coombs cards were used to screen active anti-Mur at 37 degrees celsius; from 2725 blood donors. Multiplex ligation-dependent probe amplification (MLPA) was used to genotype Mur antigen from 91 blood donors, and human anti-Mur serum was used to verify the phenotypes deduced from the genotypes.

RESULTSThe frequency of anti-Mur and genotyped Mur antigen was 0.04% (1/2725) and 6.59% (6/91), respectively, and the phenotyping results were consistent with the genotyping results.

CONCLUSIONThe blood donors in Guangzhou show a low frequency of anti-Mur and a relatively high frequency of Mur antigen. Genotyping using MLPA allows Mur antigen genotyping when commercial anti-Mur is not available.

Blood Donors ; Blood Group Antigens ; genetics ; immunology ; China ; Genotype ; Genotyping Techniques ; Humans ; Multiplex Polymerase Chain Reaction ; Phenotype

We report a case of a newborn baby who suffered from hemolytic disease of fetus and newborn (HDFN) caused by anti-Di a. The baby presented with worsening jaundice started at three hours after birth and was transferred to Dongguan Maternal and Child Health Care Hospital. The newborn's hemoglobin (Hb) was 82 and 76 g/L at five and nine hours after birth, and the total bilirubin (TBIL) was 243.2 and 309.8 μmol/L, respectively. Blood samples of the newborn and the parents were collected for HDFN immunohematology test twelve hours after birth. They showed that the newborn and the father's blood type was A and RhDCCee, while the mother was A and RhDCcee. Direct antiglobulin test (DAT) indicateda strong positive for the newborn and negative for the parents. The reaction of the reagent to red blood cells for antibody screening with the patient's plasma, red cells eluate, and the mother's plasma were all negative, but were positive with the father's red blood cells. The newborn was recovered after treating with phototherapy, intravenous immunoglobulins and urgent blood exchange (the exchanged blood was the same ABO and RhD blood type and cross-matched). The newborn's plasma and red cells eluate were collected before blood exchange, and the mother's plasma were used to assess the red blood cells reaction, and IgG anti-Di a was identified in each sample. Di a blood typing was positive for the newborn and the father, and negative for the mother. Therefore, the newborn was diagnosed as HDFN caused by anti-Di a.