Anti-D immunoglobulin effectively prevents RhD alloimmunity and has a low incidence of adverse reactions, which are generally mild. A consensus is yet to be reached regarding the clinical norms in China. We provide an overview of anti-D immunoglobulin in preventing RhD alloimmunity, including its mechanism of action, dose-effect, and safety, the timing and rationality of prenatal antibody screening, the timing and dosage of routine prenatal administration of anti-D immunoglobulin, as well as the prenatal indications for an additional dosage of anti-D immunoglobulin and postpartum prevention based on evidence from both domestic and abroad.

Heart rate variability (HRV) is a reliable, innocuous and sensitive new index to measure cardiac autonomic nervous function. Anxiety disorder is often accompanied by autonomic nerve dysfunction and its main sign is abnormal HRV. Acupuncture can affect HRV indices, correct abnormal HRV and improve cardiac autonomic nerve dysfunction to relieve anxiety. This article sorts out and analyzes recent years’ studies on abnormal HRV in anxiety disorder, the effect of acupuncture on HRV and acupuncture regulation of abnormal HRV in anxiety disorder to provide a therapeutic basis for clinical acupuncture intervention in abnormal HRV in anxiety disorder.

CCAAT enhancer binding protein A (CEBPA) and its product transcription factor CCAAT enhancer binding protein α (C/EBPα) play pivotal roles in early granulocyte development. C/EBPα induces the transition and keeps the balance of differentiation and proliferation of myeloid progenitors. The mutation and dysregulation of CEBPA at transcription, translation or post-translation level lead to differentiation block and over proliferation of immature hematopoietic cells, which are important mechanisms of acute myeloid leukemia (AML). The mutation and dysregulation of CEBPA also provide clues for evaluating the outcome of AML patients and potential targets for differentiation-inducing therapies. This review focus on CEBPA mutation and AML, dysregulation of C/EBPα protein expression and AML, as well as C/EBPα protein and targeting therapy.
CCAAT-Enhancer-Binding Proteins ; genetics ; metabolism ; Humans ; Leukemia, Myeloid, Acute ; genetics ; metabolism ; Mutation

Objective To quantitatively analyze the value of color Doppler twinkling artifact and CT in distinguishing urinary stone composition of uric acid from that of cystine,and to assess the ability of color Doppler twinkling artifact and CT to diagnose urinary stone composition of uric acid.Methods Artificial stones made of uric acid and cystihe were inserted in porcine kidneys respectively.Color Doppler ultrasound and CT scanning were performed in vitro and twinkling artifact videos were recorded.The CT attenuation value,the width and length of twinkling artifact (TAW,TAL) were measured.The color pixels representing twinkling artifact intensity (TAI) were calculated.The differences between artificial cystine and artificial uric acid stones in TAW,TAL,TAI and CT attenuation value were compared.The receiver operating characteristic (ROC) curve was used to assess the ability of TAW,TAL,TAI and CT attenuation value to diagnose urinary stone composition of uric acid.Results The TAW [(4.16 ± 1.54)mm vs (4.97 ± 1.93)mm],TAL[(3.75 ± 1.05)mm vs (5.12 ± 2.51)mm] and TAI [(3 005.50 ± 812.33) vs (5 433.86±2 505.81)] of artificial cystine stones were less than those of artificial uric acid stones while the CT attenuation value of artificial cystine stones [(573.75 ± 110.10)HU vs (364.09 ± 67.28)HU] were greater (P ＜0.05).The ROC curve was displayed to diagnose urinary stone composition of uric acid,and the area under curve of CT attenuation value was bigger than that of TAI (0.936 vs 0.817,Z =2.308,P =0.021).Combination of color Doppler twinkling artifact and CT value would dramatically increase the diagnostic accuracy to 98％.Conclusions Both color Doppler ultrasound and CT were reliable examinations for distinguishing urinary stone composition of cystine from that of uric acid.Combination of color Doppler ultrasound and CT would be good references to diagnose urinary stone composition of uric acid.

Objective To investigate the diagnostic value of twinkling artifact in urinary calcium stones.Methods Calcium oxalate monohydrate,hydroxyapatite and whitlockite stone phantoms were prepared and embedded in porcine kidneys for ultrasound scanning.The length and width of twinkling artifact were measured.The intensity of twinkling artifact and the contrast-to-noise ratio (C/N ratio) of acoustic shadowing were recorded and all the data was analyzed statistically.Results All the stone phantoms generated twinkling artifact and acoustic shadowing.The difference of the intensity,length and width of twinkling artifact and the C/N ratio of acoustic shadowing had statistically significant each composition (P ＜0.01).There was no overlap between 95％ confidence interval of the intensity of twinkling artifact for any two compositions,and any two compositions of stones could be differentiated by the intensity of twinkling artifact (P ＜0.05).The C/N ratio of acoustic shadowing of calcium oxalate monohydrate and whitlockite stone phantoms were higher than those of hydroxyapatite ones (P ＜0.05).The receiver operating characteristic (ROC) curve displayed that the cutoff value of 1 127 of the intensity of twinkling artifact could be used to diagnose hydroxyapatite stones.The sensitivity,specificity,positive predictive value (PPV),negative predictive value (NPV) and area under the curve (AUC) were 74 ％,68 ％,69.8％,72.3％ and 0.743 respectively.Conclusions Twinkling artifact could be used to differentiate the calcium stones,which will be helpful for clinical treatment.

Objective To study the expression and the mechanism of miR-155in the villi of patients with unexplained recurrent spontaneous abortion (URSA).Methods The expression of miR-155 in the villi of 36 cases with URSA (URSA group) and 25 women with normal early pregnancy (control group) were detected by stem-loop real-time reverse transcription (RT) qPCR.Expression of hypoxia inducible factor-1 (HIF-1α),vascular endothelial cell growth factor(VEGF) and micro lymphatic vessel density (MVD) in the villi of were measured by immnohistochemical staining among two groups.Results (1) miR-155 expression:the mean miR-155 expression were 1.456 (0.489,2.459) in URSA group and 2.833 (1.740,3.794) in control group,which reached statistical difference (P ＜0.05).The mean expression of miR-155 of 1.683 (0.902,2.459) in URSA group with abortion times (≤ 3) was significantly higher than 1.229 (0.489,1.719) in URSA group with more than 4 times abortion (P ＜ 0.05).(2) Indexes:the expression of HIF-1α,VEGF and MVD value were 121 ± 12,134 ± 12,36 ± 6 in URSA group and 99 ± 10,109 ± 10,28 ±4 in control group,which reached statistical difference(P ＜ 0.01).The expression of HIF-1α,VEGF and MVD value of 119 ± 12,134 ± 12,35 ± 5 in URSA group with less than 3 times abortion was significantly lower than 128 ± 12,138 ± 12,43 ± 6 in URSA group with more than 4 times abortion (P ＜ 0.01).Conclusions The expression of miR-155 and HIF-1α is topically stimulated by oxygen signal.HIF-1α adjusts the transcription and translation of VEGF,which together involved in placental trophoblast invasion and placental angiogenesis.The low expression of miR-155 could interfere with expression of HIF-1α and VEGF,which might be involved in villous vascular dysplasia in URSA.

Objective To explore the bioeffect of different parameters on 4 cell lines by ultrasoundmediated microbubble destruction.Methods The orthogonal experimental design was used to investigate the effect of three factors on the bioeffects of four cell lines under three levels.Three factors included microbubble concentration,sound intensity,irradiation time.Human breast tumor (MCF-7) cells,ovarian tumor (A2780) cells,liver tumor (Bel7402) cells and thyroid tumor (ARO) cells were exposed to ultrasound in the presence of SonoVue.The cell survival rate was determined by MTT methods and the cell luminosity factor was detected by flow cytometry.Results The optimum parameters for Bel7402 and ARO cell were the same (A2B3C2),and they were different from those from MCF-7 (A3B1C1) and A2780 (A1B3C3) cell.The cell survival rates for 4 cell lines were above 75％,and the cell luminosity factors were different among 4 cell lines.Conclusions The optimum parameters by ultrasound-mediated microbubble destruction for different cell lines are different,and under the optimum parameters the bioeffects of different cell lines are different.

According to the association between liver injury and pregnancy, liver diseases during pregnancy can be classified as pregnancy-specific liver diseases and liver diseases with pregnancy. Pregnancy-specific liver diseases refer to the liver diseases that only occur during pregnancy, while liver diseases with pregnancy refer to pregnancy with previous liver diseases. Due to the particularity of maternal and fetal health during pregnancy, the diagnosis and treatment of liver diseases during pregnancy is challenging for both obstetricians and hepatologists. Rapid identification, diagnosis, and treatment of related diseases during pregnancy are very important for the prognosis of the mother and the fetus. This article summarizes and reviews the research advances in the epidemiology, pathogenesis, clinical manifestations, diagnosis, treatment, and prognosis of liver diseases during pregnancy, in order to provide a reference for more clinicians.

Objective:To investigate the effect of low-frequency ultrasound combined with hydroxychloroquine (HCQ) on the growth and invasion of 4T1 breast cancer in mice.Methods:4T1 cells in logarithmic growth phase were divided into 4 groups: control group, ultrasound group, HCQ group and ultrasound combined with HCQ group. Western blot was performed to detect the effects of ultrasound combined with HCQ on the protein expression levels of autophagy-related proteins LC3, p62 and matrix metalloproteinase 9 (MMP-9). Transmission electron microscopy was used to observe the formation of autophagic vesicles. The cell proliferation and cell viability were determined by EdU and CCK-8. Transwell assay was performed to detect the effect of ultrasound combined with HCQ on the invasive ability of 4T1 cells. Flow cytometry was performed to detect the effect of ultrasound combined with HCQ on the apoptosis of 4T1 cells. The transplantation tumor model of 4T1 breast cancer in BALB/c mice was constructed.The mice were randomly divided into 4 groups ( n=5 for each group), including control group, ultrasound group, HCQ group, ultrasound combined with HCQ group. The tumor volume and mice body weight were evaluated and measured in each group every 2 days. Results:The expression of LC3-Ⅱ and p62 protein levels increased in the ultrasound combined with HCQ group, and intracellular autophagosome accumulation was evident by transmission electron microscopy. In cellular experiments, compared with the other groups, the ultrasound combined with HCQ group showed stronger growth inhibition, significantly decreased cell proliferation rate, decreased expression of MMP-9, and significantly inhibited invasion (all P<0.050). In the in vivo experiments, compared with the control group, the tumor growth rate of all 3 inter vention groups of mice decreased (all P<0.050), and the ultrasound combined with HCQ group had better therapeutic effects than the ultrasound and HCQ groups. The treatment effect of ultrasound combined with HCQ group was better than that of ultrasound and HCQ groups (all P<0.001). Conclusions:The combination of low-frequency ultrasound and hydroxychloroquine could synergistically inhibit tumor cell proliferation, promote apoptosis, and significantly inhibit tumor growth in 4T1 tumor-bearing mice.

Objective:To detect the changes of liver stiffness before and after chemotherapy in postoperative breast cancer patients using the two-dimensional shear wave elastography (2D-SWE) technique, and analyze its correlation with liver serum indexs, then discuss the application value of 2D-SWE technique in the quantitative diagnosis for chemotherapeutic liver injury.Methods:Sixty breast cancer patients underwent postoperative chemotherapy in Qilu Hospital of Shandong University from January 2021 to November 2021 were included. Conventional two-dimensional ultrasound, 2D-SWE and the serum tests including alanine aminotransferase(ALT), aspartate aminotransferase(AST), γ-glutamyltransferase(γ-GT), alkaline phosphatase(AKP) were performed before and after chemotherapy, respectively. The medians of ElastQ Imaging stiffness (EQI meds) of the whole liver and different liver segments (S4, S5/S6, S7/S8) before and after chemotherapy were measured and compared. The EQI meds of different liver segments (S4, S5/S6, S7/S8) after chemotherapy were compared. The correlation between EQI med of the whole liver and serum indexes after chemotherapy was analyzed. Results:①Compared with before chemotherapy, the EQI meds of the whole liver and different liver segments after chemotherapy were significantly decreased ( P<0.001, respectively). ②The EQI meds among different liver segments were different after chemotherapy ( F=7.489, P=0.001). Moreover, the EQI meds of S5/S6 and S7/S8 were significantly lower than those of S4 after chemotherapy ( P=0.002, 0.001). ③The EQI med of the whole liver was negatively correlated with ALT, AST, and γ-GT ( r=-0.776, P<0.001; r=-0.656, P<0.001; r=-0.428, P=0.010), while there was no correlation between the EQI med of the whole liver and AKP ( r=-0.146, P=0.267). Conclusions:2D-SWE is expected to be a new, real-time, noninvasive and quantitative method to evaluate the changes of liver stiffness before and after chemotherapy in postoperative patients, thus provides a promising method for the early clinical diagnosis of chemotherapy-induced liver injury in breast cancer patients.