Objective:To investigate the RHD genotypes of RhD-negative pregnant women and explore the optimum strategy for fetal RHD screening among this population in the region. Methods:This prospective study recruited 33 cases of RhD-negative singleton pregnancies at ≥12 weeks of gestation in Nanjing Drum Tower Hospital from March to November 2021. On the basis of RHD genotyping, quantitative real-time polymerase chain reaction (PCR) was used to amplify the exons 5 and 10 of RHD gene in the circulating cell-free DNA of RhD-negative pregnant women harboring whole RHD gene deletion and RHD-CE(2-9)- D. High-throughput sequencing was performed to detect chr1:25648453 locus from circulating cell-free DNA in plasma of RhD-negative pregnant women harboring RHD 1227A mutation to screen the fetal RhD blood group. Neonatal umbilical cord blood samples were collected for verifying fetal RHD genotyping. Descriptive statistical analysis was used. Results:Whole RHD gene deletion homozygous genotype ( n=20, 60.6%), RHD-CE(2-9) -D/whole RHD gene deletion heterozygous genotype ( n=5, 21.2%), RHD 1227A/whole RHD gene deletion heterozygous genotype ( n=7, 15.2%) and RHD 711delC/whole RHD gene deletion heterozygous genotype ( n=1) were identified in the 33 RhD-negative pregnant women. In the 25 cases with whole RHD gene deletion homozygous genotype or RHD-CE(2-9)- D/whole RHD gene deletion heterozygous genotype, 22 fetuses were RhD-positive and three were RhD-negative based on prenatal screening, which were confirmed by the neonatal serological test results after birth. In the seven cases carrying RHD 1227A/whole RHD gene deletion heterozygous genotype, all fetuses were RhD-positive, which were consistent with the results of serological detection after delivery. The case harboring RHD 711delC/whole RHD gene deletion heterozygous genotype did not receive fetal RHD screening. Conclusions:This study suggests that whole RHD gene deletion homozygous genotype is the most common allele in RhD-negative population in this area, followed by RHD 1227A/whole RHD gene deletion heterozygous genotype and RHD- CE(2-9)- D/whole RHD gene deletion heterozygous genotype. For women with whole RHD gene deletion homozygous genotype, RHD- CE(2-9)- D, or RHD 1227A mutation, fetal RHD screening with quantitative real-time PCR and high-throughput sequencing are important for the management of RhD-negative pregnant women.

OBJECTIVE To understand the safety of Ilaprazole sodium for injection in clinical practice. METHODS From Jan. 1st 2019 to Feb. 29th 2020， the data of 3 926 valid hospitalized patients receiving Ilaprazole sodium for injection were collected prospectively from 5 third-level hospitals through CHPS， and the post-marketing safety analysis was performed by using retrospective multicenter single cohort study. At the same time， a nested case-control study （the ratio of trial group and control group was 1∶4） was used to confirm the baseline stability of this study cohort and the correlation between adverse reactions and Ilaprazole sodium for injection. RESULTS Among 3 926 patients， 3 patients experienced 5 adverse drug events after using Ilaprazole sodium for injection， with the incidence of 0.076%. There was no serious adverse event， and the occurrence time was 2 days after medication； adverse drug events mainly include elevated liver function indicators （alanine transaminase， aspartate transaminase， total bilirubin）， which were mild and untreated， and all adverse drug events were improved. The results of the nested case-control study showed that the trial group and the control group belonged to the same background baseline， and the occurrence of adverse drug events was more closely related to Ilaprazole sodium for injection. CONCLUSIONS The overall safety of Ilaprazole sodium for injection is relatively high， and the occurrence of adverse events is more related to it.

Objective:To study the characteristics of video electroencephalogram (VEEG) and cranial magnetic resonance imaging (MRI) in neonates with inborn errors of metabolism (IEM) and to determine the predictive value for prognostic.Method:From June 2016 to December 2018, a retrospective study was performed on newborns diagnosed with IEM receiving VEEG examinations at the Neonatology Department of our hospital. VEEG and cranial MRI were used as prognostic indicators and the follow-up results were used as criteria predicting the accuracy of prognosis. The accuracy of the prediction was calculated using a 4 × 4 table.Result:A total of 21 eligible cases with 14 types of IEM were included. The most common type of IEM was organic acidemia (47.6%, 10/21). 16 cases (76.2%) had abnormal VEEG background patterns, including 8 cases of organic acidemia, 3 cases of urea cycle disorders, 1 case of energy metabolism disorder and 4 cases of other IEMs. No significant differences existed in the abnormality rate of VEEG background patterns among these groups ( P=0.882). VEEG showed 3 cases of seizures including 2 cases of electrographic-only seizures. Interburst interval durations were shortened on VEEG background with the decrease of blood ammonia level. The positive predictive values of the moderate-to-severe abnormal VEEG background and the presence of major cerebral lesions on MRI in predicting poor prognosis were 90.0% (95% CI 55.5%~99.7%) and 100% (95% CI 66.4%~100%), respectively, and the negative predictive values were 50.0% (95% CI 18.7%~81.3%) and 85.7% (95% CI 42.1%~99.6%), respectively. Conclusion:Neonates with IEM have higher incidences of abnormal VEEG. Continuous VEEG may accurately diagnose neonatal seizures and effectively monitor brain function. VEEG is a useful tool monitoring infants with IEM and predicting adverse outcomes, especially when used in combination with brain MRI.

Objective: To assess blood levels of renal function related influencing factors with baseline clinical parameters for predicting the risk of 8-year survival in patients with chronic heart failure (CHF). Methods: A total of 293 CHF patients admitted in our hospital from 2006-07 to 2009-11 were enrolled. The patients were followed-up until 2014-6-30, the end point was death. According to followed-up results, they were divided into 2 groups: Survival group,n=107 and Death group,n=186. All patients received routine renal function and electrolytes examination including blood levels of urea nitrogen, creatinine, uric acid, sodium, potassium, chloride, calcium, anion gap and phosphorus; GFR was calculated by MDRD formula. Baseline clinical parameters as left ventricular end diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF) were measured by echocardiography; blood pressure (BP) and heart rate (HR) were recorded. The risk factors for 8-year survival in CHF patients were analyzed. Results: Compared with Survival group, Death group had increased LVEDD, urea nitrogen, creatinine and uric acid, while decreased LVEF, HR, GFR, blood sodium and calcium, allP<0.05. Univariate analysis indicated that LVEDD, LVEF, GFR, urea nitrogen, creatinine, uric acid, blood sodium, calcium and phosphorus had the better predictive value for the risk of 8-year survival in CHF patients, allP<0.05. Multivariate analysis presented that LVEDD, GFR and blood sodium had the highest predictive value for the risk of 8-year survival, allP<0.001; the next one was blood calcium,P<0.01. Conclusion: LVEDD, GFR, blood sodium and calcium were the independent predictors for the risk of 8-year survival in CHF patients.

Objective To investigate and compare the prevalence of overweight,obesity and central obesity in 2003 and 2013 in a community in Chongqing,and to analyse their prevalence trends.Methods Surveys were conducted in 2003 and 2013 in the community population,and the investigation included questionnaires,anthropometric measurements,blood glucose and lipid determination.Results The number of participants in 2003 and 2013 were 3 073 and 5 938,respectively.The age standardized prevalence of overweight increased from 44.3％ in 2003 to 45.5％ in 2013 in males and declined from 28.3％ to 26.6％ in females,but there was no statistically significant difference(P=0.407,0.260).The age standardized prevalence of obesity was steady in males (10.0％ vs.10.3％,P＞0.05),but declined significantly in females (8.3％ vs.6.3％,P＜0.05).For central obesity,the age standardized prevalence in 2003 and 2013 was 50.9％,53.9％ in males and 39.6％,35.7％ in females,which increased significantly among males and decreased significantly among females (P=0.042,0.017).Conclusion The prevalence of overweight,general obesity and central obesity is relatively high in the community,and males have a more significant increase in the prevalence of central obesity.

Objective: To analyze and to predict the 1 year re-admission risk in patients of chronic heart failure with reduced left ventricular ejection fraction (HFrEF) by echocardiography.
Methods: A total of 313 HFrEF patients in our hospital community from 2007-01 to 2008-12 were studied. The patients were followed-up for (6-7) years and the end point was 1 year re-admission. All patients received routine echocardiography and the parameters included left ventricular ejection fraction of (LVEF), left ventricular diameter (LVd), pulmonary artery systolic pressure (PASP), mitral regurgitation (MR), tricuspid regurgitation (TR) and pericardial effusion. Based on the above 6 parameters, the risk factors for 1 year re-admission were analyzed.
Results: Univariate analysis indicated that MR (HR=1.437, 95%CI 1.190-1.737, P=0.000), TR (HR=1.288, 95%CI 1.056-1.572, P=0.013) and pericardial effusion (HR=1.560, 95%CI 1.050-2.318, P=0.028) had better predictive value for 1 year re-admission. Multivariate analysis presented that MR (HR=1.404, 95%CI 1.159-1.701, P=0.001) took ifrst place for predicting the 1 year re-admission and pericardial effusion took second place (HR=1.410, 95%CI 1.030-1.928, P=0.032).
Conclusion: MR, TR and pericardial effusion were the independent predictors for 1 year readmission in HFrEF patients;while MR and pericardial effusion were the independent risk factors for 1 year re-admission.

Objective To explore the effect of community family nursing intervention on glycemic control of type 2 diabetic patients. Methods Ninety-two patients with type 2 diabetes after discharge in 6 communities of Tianhe District in Guangzhou were divided into a study group and a control group , 46 cases in each . The control group received routine care , while patients in the study group received additional community family nursing intervention, including personalized health education, diabetes family day and sharing, telephone follow-up and family home visits. The fasting plasma glucose, 2h-postprandial glucose and glycosylated hemoglobin A1c were compared. Results There were no significant differences in fasting plasma glucose, 2h-postprandial glucose and glycosylated hemoglobin A1c (all P>0.05). After intervention, there were significant differences in the three eridoxes between the two groups(all P<0.05). Conclusion The community family nursing intervention is of great importance to control the blood glucose, improve the therapeutic compliance and self-management ability in patients with type 2 diabetes.

Objective Deep brain stimulation (DBS) can greatly improve the clinical symptoms of Parkinson's disease (PD),but it can poorly improve the similar clinical symptoms of multiple system atrophy P-type (MSA-P);therefore,identification is a necessity for the two diseases before DBS is carried out on these patients;surface electromyography (sEMG) was employed to analyze the surface electromyographic characteristics associated with tremor and rigidity of PD and MSA-P to explore the role of sEMG in the differential diagnosis of PD and MSA-P.Methods Twenty patients with PD and 25 patients with MSA-P,admitted to our hospital from June 2013 to January 2015,were enrolled in the study.The sEMG was performed on all patients on the 2nd d of hospitalization.Tremor frequency,tremor sEMG activity intensity and postural tremor latency were analyzed.Synchronous sEMG activity intensity during passive activities was analyzed.Root mean square (RMS) in two states was calculated,and t-test was applied to compare tremor frequency,postural tremor latency and sEMG activity intensity.Results The incidence of rest tremor in MSA-P patients was 36％ and that in PD patients was 60％,with significant difference (P＜0.05).And the incidence ofpostural tremor in MSA-P ones was 44％ and that in PD ones was 35％,with significant difference (P＜0.05).Besides,the postural tremor latency in MSA-P patients was significantly longer than that in PD patients ([9.3±3.2] s vs.[5.3±2.1] s,P＜0.05).Thepostural tremor and rest tremor frequencies of MSA-P patients ([7.3±2.1] and [6.4±3.6]-Hz) were significantly higher than those in PD patients ([5.3±2.4] and [4.9±1.2] Hz,P＜0.05).In rest tremor,RMS of flexor and extensor in MSA-P patients was significantly decreased as compared with that in PD patients (P＜0.05);in postural tremor,RMS of flexor and extensor in MSA-P patients was significantly decreased as compared with that in PD patients (P＜0.05).During passive activities,RMS of extensor in MSA-P patients was statistically higher than that in PD patients ([27.927.9± 11.4] vs.[18.318.3±6.4] μV,P＜0.05),while there was no significant difference between RMS of flexor in MSA-P and PD patients ([31.1±13.6] vs.[29.2±8.9] μV,P＞0.05).Conclusion The sEMG can be applied in the preoperative differential diagnosis for DBS of PD and MSAP.

Species identification of biological samples is widely used in such fields as forensic science and food industry. A variety of accurate and reliable methods have been developed in recent years. The cur-rent reviewshows common target genes and screening criteria suitable for species identification, and de-scribed various DNA-based molecular biology methods about species identification. Additionally, it dis-cusses the future development of species identification combined with real-time PCR and sequencing technologies.

In this study ,we aimed to understand the sequence characteristics ,transmembrane structures ,line B cell epitopes present in the OMP18 from Campylobacter jejuni ,and provide candidate antigens for the antibody detection and vac-cine development .NCBI/Blast ,TMHMM Server V2 and DNA Star softwares were used for the OMP18 sequence analysis . Based on the ELISA ,the whole bacterial antibody IgG of Campylobacter jejuni was used for the identification of the predicted line B cell epitopes .The OMP18 gene was found conserved in different Campylobacter jejuni strains .The OMP18 was predic-ted to be located on the outer surface of the bacteria .And three line B cell epitopes were determined to be present in the OMP18 protein .As a conclusion ,the OMP18 protein was confirmed to be an important outer membrane protein ;three line B cell epitopes were identified in the OMP18 ,which could be further used for Campylobacter jejuni antibody detection and vaccine development .