Objective To further investigate the association among clinical pathology,complement activation and renal secretory IgA (SIgA) deposition in patients with IgA nephropathy (IgAN).Methods The activation of serum complements were detected by immunoturbidimetry and ELISA.Renal deposition of SIgA and activation of complements were detected by immunofluorescence.Then the association among clinical pathology,complement activation and renal SIgA deposition were analyzed in IgAN patients.Results In all 201 patients with IgAN,59 patients had SIgA deposition with higher incidences of mucosal infection history and hematuria (P ＜ 0.05),lower levels of serum cystatin C,β2 microglobulin and lower tubulointerstitial lesion grades and T-grade in the Oxford classification (P ＜ 0.05),when compared with patients without SIgA deposition.Both alternative and mannose binding lectin (MBL) pathways were activated in patients with or without SIgA deposition.Patients with MBL pathway activation had lower estimate glomerular filtration rate (P ＜ 0.01),higher serum creatinine,higher proportion of glomerulosclerosis and S-grade in the Oxford classification,more severe tubulointerstitial lesion (P ＜ 0.05).Conclusions Compared with patients without SIgA deposition,patients with SIgA deposition have a stronger link to mucosal immune.The deposition of SIgA is associated with different clinical and pathological manifestations;however,the complement activation is similar in both groups of patients.Patients with MBL pathway activation show more severe kidney injury.

Objective: To compare serum-free medium AIMV with standard serum-containing medium in culturing cells activated with IFN-?,IL-2 and anti-CD3. Methods: Peripheral blood mononuclear cells (PBMC) separated from donors were cultured with IFN-?,IL-2 and anti-CD3 in serum-free medium AIMV or in standard serum-containing medium separately. Proliferation, phenotypes and cytokine secretion of cells cultured in the two different media were compared. The inhibitory effects on hepatitis B virus replication in vivo were observed after transfusion of cells cultured in different media. Results: Compared with cells cultured in standard serum-containing medium, cells cultured in serum-free medium AIMV could proliferate well enough to be applied to immunotherapy; More percentage of cells cultured in AIMV expressed CD25; Cells cultured in serum-free medium secreted more IFN-?; After transfusion of cells cultured in AIMV, hepatitis B replication could be inhibited more evidently. Conclusion: Serum-free medium AIMV was better than serum-containing medium in culturing cells for immunotherapy.

Objective To determine the usefulness of tricuspid annular displacement(TAD),based on twodimensional speckle tracking imaging, for assessment of right ventricular(RV)systolic function.Methods Eighteen patientswith dilated cardiomyopathy and 20 age-matched healthy volunteers were in volved. Twodimensional and real-time three-dimensional(RT3D)imaging were obtained in all patients at apical four-chamber view.The parameters of TAD were derived from off-line QLAB software.RT3D-RV ejection fraction(RVEF)was calculated by using 4D RV function software.Results TAD data were acquired in all 38 cases, while RT3D-RVEF was done in 30 out of 38.The parameters of TAD correlated well with RVEF(P<0.01).The parameters of TAD in dilated cardiomyopathy group were significantly lower than the corresponding values in healthy subjects (P<0.01).The intra-and interobserver variabilities for measurement of TAD were(0.49±2.69)mm and(0.21± 0.60)mm, respectively.Conclusions TAD,based on two-dimensional speckle tracking imaging,proved to be a rapid and reproducible method in determining RV global systolic function.

Objective:To investigate the role of C3a,C5a and their receptors in the pathogenesis of IgA nephropathy (IgAN). Methods:A total of twenty-eight 6-8 weeks old female BALB/c mice were investigated.And they were negative control group , WT group,C3aR-/-group,C5aR-/-group(the latter three groups were named as experimental groups ),seven mice in each group.All the mice were infected through respiratory tract with infectious SV (experimental groups) or PBS(negative control group),combined with tail vein challenge to make IgAN animal model.Testing 24 h total urinary protein , serum urea nitrogen ( BUN ) and creatinine ( Cr ) , using direct immunofluorescence to test the renal deposition of IgA and C 3,observing renal pathologic lesion under PAS staining with light microscopy.RT-qPCR was used to test the relative mRNA expression of TNF-α,TGF-β,IL-1β,IL-6,MCP-1.Results: After 15 weeks,the level of UTP in experimental group was significantly higher than negative control group ,and the same results as WT group than C3aR-/-group and C5aR-/-group.There was no significant difference among groups for BUN and Cr.Combined with negative control group , experimental groups had significant renal pathological lesions , and the changes of WT group was more severe than C3aR-/-group and C5aR-/-group.The results of relative mRNA expression of TNF-α,TGF-β,IL-1β,IL-6,MCP-1 was the same as the level of 24 h UTP,at the same time,the relative mRNA expression of IL-1β,IL-6,MCP-1 in C3aR-/-group was significantly less than C5aR-/-group.Conclusion:The deficiency of C3a/C5a receptors can protect kidney from injury in IgAN ,and C3a receptor has more significant role in protect kidney from injury in IgAN.

Objective To investigate the preliminary value of mitral annular displacement (MAD) with two-dimensional speckle tracking in evaluating left ventricular systolic function. Methods Forty-nine patients with dilated cardiomyopathy, aged 51±14 years (DCM group), and 43 age-matched (46±14 years) normal subjects (control group) were enrolled in this study. Two-dimensional and real-time three-dimensional (RT3D) imaging were obtained all at the apical four-chamber view. The parameters of MAD and RT3D-LVEF were obtained using off-line QLAB software. Results Compared with control group, MAD reduced significantly in DCM group (P＜0.01). The parameters of MAD correlated positively with LVEF (P＜0.01). The intra- and inter-observer variabilities for measurement of MAD were low. When one point was placed at the chest wall, the ratio of long axis shortening correlated best with LVEF among all the data of MAD. Conclusion Based on two-dimensional speckle tracking imaging, MAD is a rapid and reproducible method of determining LV global systolic function, may even replace LVEF in the future.

Objective:To investigate the clinical characteristics and prognosis of Philadelphia (Ph) chromosome-positive chronic myeloid leukemia (CML) patients with additional chromosomal abnormalities.Methods:The data of 351 CML patients with Ph-positive in the Affiliated Hospital of Qingdao University from January 2009 to January 2019 were retrospectively analyzed. The bone marrow chromosomal karyotype analysis of all patients was performed by using R-banding technique. The clinical characteristics and karyotype of Ph-positive CML patients with additional chromosomal abnormalities at initial diagnosis were summarized, and Kaplan-Meier was used to analyze the differences in overall survival (OS) of patients with different karyotypes.Results:Among 351 patients with Ph-positive CML, 32 (9.1%) cases had variant translocation. At initial diagnosis, 47 cases had additional chromosomal abnormalities including 29 cases in chronic phase accounting for 9.15% (29/317) of all patients in chronic phase, 3 cases in accelerated phase accounting for 25.00% (3/12) of all patients in accelerated phase, 15 cases in blast crisis accounting for 68.18% (15/22) of all patients in blast crisis; there was a statistically significant difference in the chromosomal abnormalities rate of all different phases ( χ2=50.799, P<0.05). Among 47 Ph-positive CML patients with additional chromosomal abnormalities, 13 patients had complex karyotypes with more than 3 additional chromosomal abnormalities, the proportion of complex karyotypes in chronic phase, accelerated phase and blast crisis was 13.79% (4/29), 33.33% (1/3) and 53.33% (8/15), respectively, and the difference was statistically significant ( χ2=9.26, P<0.05). The study showed that the most common additional chromosomal abnormalities in chronic phase were double Ph (48.28%, 14/29) and -Y (10.34%, 3/29), while the most common chromosomal abnormalities in the blast crisis were +8 (26.67%, 4/15) and double Ph (26.67%, 4/15). Kaplan-Meier survival analysis showed that at initial diagnosis the OS time of patients with additional chromosomal abnormalities was worse than that of those with the non-additional chromosomal abnormalities group ( χ2 = 61.138, P<0.05). The OS of patients with complex karyotypes for Ph - positive CML patients with additional chromosomal abnormalities at initial diagnosis was worse than that of patients with non-complex karyotypes, and the difference was significant ( χ2 = 4.945, P < 0.05). Conclusions:The additional chromosomal abnormalities is closely related to the progression of CML, and the prognosis of CML patients with additional chromosomal abnormalities is poorer than that of patients with only Ph translocation. Moreover, the more complex the additional chromosomes are, the more likely blastic changes are, and the poorer prognosis. And additional chromosomeal abnormalities during the treatment of CML patients may also lead to the progression of blastic changes.

【Objective】 To establish an intelligent management system of surgery blood (IMSSB) and explore its effectiveness in promoting rational and timely blood transfusion in surgical patients. 【Methods】 IMSSB was constructed based on the hospital closed-loop blood transfusion information management system, clinical transfusion mobile nursing APP system, and the Internet of Things blood bank forward management system to dynamically guide, supervise and evaluate the whole process of perioperative blood transfusion management. Blood management data of 100 patients undergoing cardiac vascular surgery before( from May to October, 2018) and after (from November 2018 to April 2019) the application of IMSSB were selected and compared to evaluate the role of the system in the management of surgical blood. 【Results】 Time, from blood application to transfusion, during surgery was shortened(30 minutes before vs less than 2 minutes after). The proportion of patients with Hb over 110g/L after intraoperative blood transfusion decreased significantly from 30.5%(25/82) to 8.5%(4/47)(P<0.01). The incidence of surgical blood transfusion decreased from 82.0%(82/100) to 47.0%(47/100)(P<0.01). 【Conclusion】 IMSSB, as an innovation of clinical blood management mode for surgical patients, can promote timely and rational blood transfusion during operation, which is of great significance to improve operation safety.

【Objective】 To facilitate the reimbursement of blood expenses in the hospital through information platform and promote the healthy development of blood donation. 【Methods】 The publicity of blood expense reimbursement was conducted through the hospital information platform,, and direct reimbursement of clinical blood use of voluntary blood donors and their relatives was achieved using the hospital reimbursement management system and Ding Talk office platform. 【Results】 Compared with the traditional mode of reimbursement of blood expenses through blood stations after discharge, direct reimbursement in the hospital simplified the reimbursement process, shortened the distance and time, and improved the satisfaction of blood donors and their relatives significantly. 【Conclusion】 As a new reimbursement model, reimbursement of blood expenses directly in the hospital can improve the satisfaction of blood donors and their relatives, and promote the healthy development of blood donation.

BACKGROUNDMycophenolate mofetil (MMF) and cyclophosphamide (CTX) are widely used in treating various kidney diseases. However, whether they are effective and which one is better for treating IgA nephropathy patients with proliferative pathological phenotype in renal diseases, such as endocapillary proliferation, cellular crescents, and/or capillary loops fibrinoid necrosis is still unknown. We, therefore, initiated a study to compare the effects of MMF and CTX in treating IgA nephropathy with the above pathological lesions.

METHODSOne hundred and nineteen patients with IgA nephropathy who had at least one of the three aforementioned lesions were enrolled. All patients were treated with prednisone; 48 patients received prednisone only (Pred group), 40 received MMF and prednisone (MMF + Pred group), and 31 were treated with CTX and prednisone (CTX + Pred group). The median time of follow-up was 30 months (maximum: 96 months). The primary endpoint was defined as renal survival. The incidence of remission of proteinuria was the secondary endpoint.

RESULTSSerum creatinine in all groups declined significantly at different follow-up times (P = 0.002), and the differences among the three groups were significant (P < 0.001). At 24 months of follow-up, the decline rates were 12.35%, 32.95%, and 24.14% in the Pred, MMF + Pred, and CTX + Pred groups respectively. For urine protein excretion, the decline rates were 49.12% (Pred), 73.67% (MMF + Pred), and 63.53% (CTX + Pred) respectively at 24 months of follow-up. The differences among the three groups were not significant (P = 0.714). Renal survival (the primary endpoint) was significantly different (P = 0.027); however, the sencondary endpoint was similar for all the three groups (P = 0.100).

CONCLUSIONSFor IgA nephropathy patients with endocapillary proliferation, cellular crescents, and/or fibrinoid necrosis of capillary loops, prednisone combined with MMF was more effective in lowering the serum creatinine than with CTX. Combined MMF and prednisone treatment led to a better renal survival compared to that of prednisone with CTX.

Adult ; Female ; Glomerulonephritis, IGA ; drug therapy ; pathology ; Humans ; Immunosuppressive Agents ; therapeutic use ; Male ; Mycophenolic Acid ; analogs & derivatives ; therapeutic use ; Retrospective Studies ; Young Adult

【Objective】 To explore the application of capillary ultracentrifugation technology in accurate identification of Rh phenotype and clinical blood transfusion. 【Methods】 132 samples, presenting mixed field agglutination during Rh phenotyping in our laboratory from May 2019 to February 2020, were separated using capillary ultracentrifugation technology, and the proximal and distal red blood cells were taken for Rh phenotype test, and then blood donors with the same Rh phenotype as the proximal cells were selected for cross matching. 【Results】 132 samples were subjected to capillary ultracentrifugation, and new red blood cells were successfully isolated from the proximal side in 128 (96.97%)cases, and the Rh phenotype was accurately identified, i.e. CcDEe in 47 cases (36.72%), CcDee in 12(9.38%). ), ccDEEin 11 (8.59%), CCDee in 52(40.63%), ccDEe in 5 (3.91%), and ccDee in 1(0.78%). 4 cases of mixed field reaction remained after centrifugation, and all of them had a history of blood transfusion within 2 days. For the 128 patients whose Rh phenotype was accurately identified, blood donors with the same type of Rh phenotype were selected, and 4 patients whose Rh phenotype could not be determined, donors with CCDee phenotype were selected based on the frequency of phenotype distribution and the principle of reducing antigen exposure. The cross-matched blood of all patients were consistent. 【Conclusion】 Capillary ultracentrifugation technology can effectively separate the new red blood cells, improve the accurate identification of Rh phenotype, and provide safety guarantee for clinical targeted blood transfusion.