Objective To analyze the biomechanical changes of lateral atlantoaxial articulation by means of three‐dimensional fnite element models of craniocervical junction malformation(CJVM) .Methods CT scan images of 1 patients with CJVM were ob‐tained .The analytical model was constructed by advanced three‐dimension modeling and finite element softwares .A comparison of range of motion difference between the deformity model and normal model ,referring to the experience of clinical observation ,was used to verify the validity of the model .Applying respectively the same loads and boundary conditions on finite element model .The effectiveness was verified by contrastive analysis of the variation in lateral atlantoaxial joint stresses .Results The finite CJVM ele‐ment model with high geometric accuracyand reliable parameter had built .Compared to the results of cadaver test and finite element model based in normal cranio‐cervical junction ,the segment mobility coincides with the actual clinical performance in patients .The stress distribution the lateral junction between atlas and axis of can be reasonably explained the deformation of lateral atlanto‐axial joint structure and its important role in remaining stable between atlantoaxial vertebraeunder different physiological conditions .Con‐clusion The structure of lateral atlantoaxial joint changes in patients of CJVM ,the biomechanical stability for preoperative diagno‐sis and intraoperative treatment operation has a certain value .

Objective To investigate the health-related quality of life(HRQOL)of the recovered patients with depression and its influential factors.Methods From March 2008 to April 2009,150 depressive patients andergoing the following up treatment were recruited,and finally 124 patients rocovered,and quality of life for patients recovered were compared to published norms for the general Chinese people.The general demography material seale.Hamilton Depression Scale(HAMD),Hamilton Anxiety Scale(HAMA),personality traits(Eysenck personality Inventory-EQP)the short form 36 item(SF-36)questionnaire and social support scale(SSS)were applied to an subjects.The SPSS 13.0 software for data processing,the group t test and the multiple linear regression analysis was adopted.Results ①The average score of seven domains of quality of life(RP,BP,GH,VT,SF,RE,MH )for the recovered patients were better than that of the pre-treatment patients(P<0.01),except the PF(89.23±14.09,87.23±16.81,t=1.044,P>0.05).But the average score of seven domains of quality of life for the re-covered patients were worse than that of the healthy people(P<0.01),except the PF(89.23±14.09,89.01±15.73,t=1.266,P>0.05).②The quality of life 0f the recovered patients remarkably related with the anxiety level, neuroticism, extraversion, recurrent depression,economic condition and social support(P<0. 01) . Conclusion The recovered depressive patient s health-related quality of life were improved significantly afer treatment, what were influenced by neuroticism,extraversion,anxiety as a trait,recurrent depression,economic condition and social support.Above mentioned factors should be taken into account when rehabilitation.

Objective To investigate the clinical effect of angioplasty for symptomatic intracranial atherosclerotic stenosis. Methods Eighty-two patients with symptomatic intracranial atherosclerotic stenosis whom underwent angioplasty after the failure of standard medical therapy were enrolled from Nan-jing Stroke Registry Program from September 2010 to June 2013.Nine of them underwent routine balloon angioplasty alone and 73 underwent intracranial stenting.The median time from onset to surgery was 24.5 days.The occurrence of endpoint events (any stroke ≤30 d after procedure,death and ischemic stroke >30 d in guilty vessels or original stenosis had restenosis and needed to be treated again)was assessed. The incidence of restenosis was followed up with imaging (CTA or DSA). Results (1)In the 82 patients, the success rate of operation was 92.7%(n=72 ),and 78 (95.1%)received follow-up,4 were lost to follow-up.The median follow-up time was 22.5 months (range 9 to 29 months ).Ten patients had an endpoint event,7 of them were ischemic stroke,1 was cerebral hemorrhage,and two were severe asymptomatic restenosis who underwent stenting again.The endpoint events of 3 patients occurred at day 30 after procedure (at ≤24 h after procedure).Kaplan-Meier curves showed that the incidences of cumulative endpoint events at 1,6,12,and 24 months were 3.7%,8.6%,11%,and 13%,respectively.(2)60 patients (73.2%)received imaging examination (11 CTA and 49 DSA ).Restenosis occurred in 17 patients (28.3%),among them the incidence of symptomatic restenosis was 5%(n =3 ),and asymptomatic restenosis was 23.3%(n=14). Conclusion After a comprehensive assessment and a rigorous screening, the safety is high and the mid- and long-term efficacy are satisfactory in patients with symptomatic intracranial arterial stenosis who are treated with angioplasty when their medical treatment is invalid.

Serious diseases and other negative events bring serious physical and mental damage to individuals, but there are still some individuals can construct positive meaning of life from adversity, which is closely related to the role of benefit finding. According to the theory of stress system, if negative events such as disease are taken as stressors, benefit finding can be regarded as a good manifestation of individual psychological stress response. At present, most of the studies on benefit finding are cross-sectional studies, ignoring the characteristics of its dynamic development and the predictive role of individual advantages and disadvantages on benefit finding. This paper reviews the predictive factors in the longitudinal study of benefit finding from protective factors and risk factors, in order to reduce the adverse effects of risk factors on the basis of exploring individual protective factors and provide a starting point for the research design of positive psychological cognitive intervention.

Objective To statistically analyze the perioperative results of patients with ABO-incompatible kidney trans-plantation(ABOi-KT),in order to explore the changes in blood group antibody of type-A/B recipients.Methods A total of 33 cases of blood group A/B ABOi-KT recipients in our hospital from January 2021 to October 2023 were recruited and divided into two groups of group A(n=18)and group B(n=15)according to the different blood types of recipient.The effects of preoperative plasmapheresis on antibody titer,antibody rebound and renal function after operation(serum urea ni-trogen,creatinine and estimated glomerular filtration rate on the 1st,3rd,7th and 14th day)were analyzed between the two groups.According to the postoperative rebound of blood type antibodies,33 recipients were divided into antibody rebound group(n=7)and non rebound group(n=26),and the differences in initial blood type antibody titers between the two groups were analyzed.Results There was no significant difference in the clearance rate of IgM with preoperative plasma ex-change between the two groups(Z=-0.26,P＞0.05);Levels of serum urea nitrogen and creatinine on the 1st,3rd,7th and 14th day after operation between group A and group B were not statistically significant(P＞0.05),the same as eGFR.Group B was more prone to rebound antibody compared with group A(P＜0.05).There was a significant difference in the in-itial IgM antibody titer between the blood type antibody rebound group and the non rebound group(Z=-2.127,P＜0.05),but no statistically significant difference in the initial IgG antibody titer(Z=-1.835,P＞0.05)between the two groups was found.Conclusion The patients type B receiving type AB kidney donors are more prone to rebound antibody after ABOi-KT operation compared to the the patients type A receiving type AB.

Objective:To explore the RH genotype for a female with RhD(-) blood type and its molecular basis. Methods:A 26-year-old female who had attended the outpatient clinic of the First Affiliated Hospital of Zhengzhou University in August 2019 was selected as the study subject. Peripheral blood samples were collected from the proband and her parents for Rh phenotyping with gel card method. PCR-sequence-based typing (PCR-SBT) and DNA sequencing were used to determine the RHD zygosity and RH genotype of the proband and her parents. Homology modeling of Rh proteins was performed with bioinformatic software, and protein structural alterations caused by the variant was simulated by molecular dynamics. This study was approved by the Medical Ethics Committee of the First Affiliated Hospital of Zhengzhou University (Ethics No. 2023-KY-0870-003). Results:Serological tests showed that the proband and her father both had weakened e antigen of the Rh phenotype. PCR-SBT and DNA sequencing showed that the genotypes of the proband and her parents were dce/ dCE, dce/ DcE and dCE/ DcE, respectively. And the genotypes of the RHD and RHCE of the proband were RHD*01N.01/ RHD*01N.16, RHCE*01.01/RHCE*04, respectively. Protein simulation and molecular dynamics analysis revealed that the ce_16C variant resulted from RHCE* ce (c.48G>C) may alter the structure of intracellular and extracellular loops, mainly affecting the mobility of extracellular loops 2, 6 and intracellular loops 3, 4. Conclusion:Variant of the RHCE* ce allele c. 48G>C probably underlay the weakened e antigen in this proband.

Objective To investigate the clinical and prognostic significance of ABO promotor methylation level in adult patients with leukemia and myelodydysplastic syndrome(MDS). Methods ABO promoter methylation level of 182 malignant hematological disease patients and 68 normal controls were detected by bisulfite sequencing PCR. Then clinical features and outcome were compared between hypermethylation group and hypomethylation group. Results The median methylation rate of ABO promoter in newly diagnosed acute myeloid leukemia (AML) and acute lymphocytic leukemia (ALL) were 46.98％ and 11.01％ respectively, which were both higher than that in controls (2.30％, P<0.05). The methylation rates in remission AML and ALL were 1.58％and 2.30％respectively, which were comparable with that in normal group (P>0.05). As to relapse AML and ALL, methylation rates were 41.26％ and 17.50％respectively, also significantly higher than that in controls (P<0.05).In patients with chronic myeloid leukemia (CML) chronic phase, the median methylation rate was 1.00％, which was similar to normal group. But a CML patient who transformed to ALL hadextremely high methylation rate 92.56％. The median methylation rate in patients with MDS significantly elevated as 5.81％ compared with that in controls (P<0.05). The median overall survival (OS) of ALL and AML (non-M3) patients with hypermethylation were 12.5 months and 15.3 months, which were significantly shorter than those with hypomethylation (24.0 months and 20.0 months) (P<0.05). The median disease-free survival (DFS) of ALL and AML (non-M3) patients with hypermethylation were 9.9 months and 12.0 months, which were significantly shorter than those with hypomethylation (22.3 months and 18.5 months), (P<0.05). Multivariable analysis suggested that ABO promoter methylation level was an independent predictive factor of OS and DFS in ALL and AML (non-M3) patients. Conclusion ABO promoter hypermethylation is closely related to genesis, development and prognosis of leukemia and MDS. Hypermethylationis related to a clinical poor prognosis compare with hypomethylation.

OBJECTIVE: To explore the molecular basis for an A subtype of the ABO blood group. METHODS: The forward and reverse typing of the ABO blood group were identified by gel card and test tube methods. The ABO gene of the patient was detected by PCR-sequence specific primer (PCR-SSP). Exons 1 to 7 of the ABO gene was amplified by PCR and sequenced. The ABO gene was also subjected to subclone sequencing for haplotype analysis. RESULTS: The patient's red cells showed weak agglutination with anti-A but non-agglutination with anti-B. The patient's serum showed 1+ agglutination with A cells and 4+ agglutination with B cells. Based on above serological characteristics, the patient was defined as Aw subtype of the ABO blood group. Sequencing analysis showed that the patient was heterozygous for c.106G>T, c.188G>A, c.189C>T, c.220C>T, c.297A>G, c.467C>T, c.543G>C, c.646T>A, c.681G>A, c.771C>T, c.829G>A, in addition with a c.261G deletion. Combined with the result of subclone sequencing, the ABO genotype of the patient was determined as ABO*AW.33. new/O.01.02, which harbored c.467C>T and c.543G>C variants compared with ABO*A1.01 and c.543G>C variant compared with ABO*A1.02. The novel allele has been submitted to GenBank with an accession number of MK302122. CONCLUSION A novel allele of Aw33 subtype has been identified with its GTA transferase gene harboring c.467C>T and c.543G>C variants compared with A1.01.
ABO Blood-Group System ; genetics ; Alleles ; Exons ; genetics ; Genotype ; Humans ; Phenotype

Objective To compare the clinical efficacy and drug safety between oral apatinib combined with conventional chemotherapy and conventional chemotherapy alone for the treatment of osteosarcoma and soft tissue sarcoma patients with pulmonary metastasis. Methods Thirty?three osteosarcoma and soft tissue sarcoma patients with pulmonary metastasis who were treated in the Department of Bone and Soft Tissue Tumor Surgery, Cancer Hospital of China Medical University from January 2015 to December 2017 were enrolled in this study. Patients with osteosarcoma received methotrexate, adriamycin (ADM), cisplatin (CDDP), ifosfamide (IFO) sequential regimen; patients with soft tissue sarcoma were treated with IFO and ADM regimen. Eighteen of these patients received an additional oral dose of apatinib. The patients were followed up regularly for changes in primary tumors and metastases, adverse reactions and prognosis. Results Before treatment, the maximum diameter of pulmonary metastases in patients of apatinib group and routine treatment group were ( 4.46 ± 1.70) cm and ( 4.53 ± 2.00) cm, respectively, without significant difference ( P＝0.909). After treatment, the maximum diameter of pulmonary metastases in patients of apatinib group was (1.46 ± 1.39) cm, significantly smaller than ( 3.02 ± 1.20) cm of routine treatment group (P＝0.002). After treatment, the maximum diameter of the primary lesions in the apatinib group and the conventional treatment group median decreased 0.31 cm and 0.12 cm, respectively, without significant difference ( P＝0.542). After treatment, the maximum diameter of the lung metastases in the apatinib group median decreased 0.59 cm, significantly more than 0.18 cm of the conventional treatment group (P＝0.027). The median progression?free survival ( PFS) was 9.4 months in the 33 patients. The median PFS was 9.6 months and 8.3 months in the apatinib group and the conventional treatment group, respectively, without significant difference (P＝0.593). Specific adverse reactions both occurred in apatinib group and routine treatment group, mainly including oral mucosal reactions and digestive tract reactions (including nausea, vomiting and diarrhea). Conclusions Apatinib can effectively reduce the volume of primary and metastatic lesions in patients with bone and soft tissue sarcoma accompanied by lung metastasis without reducing the survival rate or causing uncontrollable adverse reactions. The safety and clinical efficacy of apatinib are significant.

Osteosarcoma is a kind of primary malignant tumor of bone originated from mesenchymal tissue, which mainly occurs in children and adolescents, and presents the characteristics of high malignancy, rapid growth, early metastasis and poor prognosis. Currently, most of the studies at home and abroad mainly focused on therapeutic procedures. However, reliable prediction indices or evaluation systems are also pivotal for monitoring disease change, guiding treatment and evaluating prognosis. Multiple clinical predictors have been reported to be related to the prognosis of osteosarcoma, which can be roughly divided into 9 categories according to their characteristics. Each kind of predictor owns its inherent advantage and disadvantage, and full understanding of them and their characteristics can be helpful to improve the prognosis of osteosarcoma.