CHO cells expressing human GPIb/IX and rabbit red blood cells coated with human von Willebrand factor (VWF) were adapted to our study on the binding probability and the detachment force of GPIb/IX and VWF. With the micropipette system, the two cells were impinged under a constant force for controlled time. When the cells were pulled apart, the deformation of RBC was recorded, and the binding score and detachment force of the proteins were determined. After the two cells were impinged into 0.5 microm for 30 s, the binding probability of the two cells carrying GPIb/IX and VWF was 15.0%. Via analyzing the deformation of red blood cells, we found out the distribution of rupture forces of cells with GPIb/IX and VWF. Therefore, we infer that the continuous distribution of the detachment force is due to the stochastic effect. The most probable value of the detachment force was 10 pN.
Animals ; Binding Sites ; Blood Platelets ; metabolism ; CHO Cells ; Cell Adhesion ; Cricetinae ; Cricetulus ; Humans ; Platelet Activation ; physiology ; Platelet Glycoprotein GPIb-IX Complex ; chemistry ; metabolism ; Rabbits ; von Willebrand Factor ; chemistry ; metabolism

Objective TostudythevalueofDCE-MRItechniqueindifferentialdiagnosisofthyroidadenoma(TA)andpapillary thyroidcarcinoma(PTC).Methods 71thyroidnoduleswereanalyzedretrospectively,includingTA (28cases)andPTC (43cases), whichwereconfirmedbyhistologyafterMRIscanning.AfterconventionalMRIandDCE-MRIwereperformed,TICswereobtained. ThediagnosticindicatorsofPTCwithDCE-MRItechniquewereanalyzed,includingthesensitivity,specificity,accuracy,positivepredictive valueandnegativepredictivevalue.Results 23TAshowedⅠcurve,41PTCshowedⅢcurve,5TAand2PTCshowedⅡcurve, withstatisticallysignificantdifference(P＝0.000).Thesensitivity,specificity,accuracy,positivepredictivevalueandnegativepredictive valuewere95.3%,82.1%,90.1%,89.1%and92.0%,respectively.Conclusion DCE-MRItechniquehelpstoidentifyTAandPTC, andTICcanbeamorecomprehensivemethodtoanalyzemicrovascularhemodynamicprocessesofTAandPTC.

OBJECTIVETo detect potential mutation of the UGT1A1 gene in a child affected with Crigler-Najjar syndrome type II.

METHODSBlood samples were collected from the patient and his parents for the extraction of genomic DNA. Potential mutation of the UGT1A1 gene was detected with polymerase chain reaction (PCR) and direct sequencing. The child was followed up until the age of 3 years and 6 months.

RESULTSThe patient showed persistent unconjugated hyperbilirubinemia. Sequencing of the UGT1A1 gene has detected a rare heterozygous c.610 A>G (p.Met204Val) mutation in the exon 1, in addition with a heterozygous c.1091 C>T (p.Pro364Leu) mutation in exon 4. The two mutations were inherited from his father and mother, respectively. The patient was diagnosed with Crigler-Najjar syndrome type II and received oral phenobarbital treatment.

CONCLUSIONThe compound UGT1A1 gene mutation probably accounts for the disease in the patient manifesting persistent mild unconjugated hyperbilirubinemia. Genetic counseling and prenatal diagnosis should be provided for his family.

Objective To evaluate the application of exponential apparent diffusion coefficient (eADC)value in differentiating benign from malignant thyroid nodules.Methods Routine MR sequences and axial diffusion weighted imaging (DWI)sequences with different b-values(0, 300,500,800 s/mm2)were performed in 46 patients with 51 histopathologically confirmed thyroid nodules,including 35 malignant nodules and 1 6 benign nodules.The eADC values of each thyroid nodules’solid component with different b-values were measured and assessed by independent samples t test.Receiver operating characteristic (ROC)curves were drawn and used to determine the diagnostic threshold and assess the screen test.Results The eADC values of the malignant nodules were higher than that of benign nodules (P<0.05)in all of the three different b-values.The eADC values of the malignant nodules and the benign nodules were 0.618±0.080 and 0.492±0.071 (b=300 s/mm2),0.520±0.104 and 0.371±0.077 (b=500 s/mm2)and 0.407±0.114 and 0.286±0.097 (b=800 s/mm2)respectively. According to the ROC curve,the area under the curve(AUC)was 0.883,0.890 and 0.824 when the b-value was set as 300,500 and 800 s/mm2respectively.When the b-value was set as 500 s/mm2and the diagnostic threshold was 0.454,the sensitivity,specificity, positive predictive value,negative predictive value and Youden index were 74.3%,93.8%,96.3%,60.9% and 0.68,respectively.Conclusion The eADC value is helpful in differentiating benign from malignant thyroid nodules,and the best result can be obtained by using DWI with b-value of 500 s/mm2.

Objective:To study the clinical characteristics and differences of severe hyperbilirubinemia caused by hemolytic disease of the newborn (HDN) and glucose-6-phosphate dehydrogenase (G6PD) deficiency.Methods:From January 2014 to December 2021, newborns (gestational age ≥ 35 weeks and postnatal age ≤ 28 d) admitted to the Department of Neonatology of Hunan Children's Hospital with severe hyperbilirubinemia caused by HDN or G6PD deficiency were retrospectively analyzed. According to the etiology of hyperbilirubinemia, they were assigned into HDN group and G6PD deficiency group. The general conditions, clinical manifestations, laboratory results, treatment and prognosis of the two groups were compared using SPSS 26.0 software.Results:A total of 532 cases were in the HDN group and 413 cases in the G6PD deficiency group. The HDN group reached peak hyperbilirubinemia earlier than the G6PD deficiency group [3(2,5) d vs. 6(4,8)d, P<0.05]. The HDN group had lower peak value of total serum bilirubin [379.5(345.6,426.7) μmol/L vs. 486.4 (413.5,577.4) μmol/L] and lower incidence of anemia [37.4% (199/532) vs. 55.0% (227/413)]than the G6PD deficiency group.The incidence of anemia with elevated reticulocyte percent(Ret%) in the HDN group was higher than the G6PD deficiency group[66.3%(132/199) vs. 5.7%(13/227), P<0.05]. Compared with the G6PD deficiency group, the incidences of exchange transfusion and repeated (≥2 times) exchange transfusion, acute bilirubin encephalopathy(ABE) and the mortality rate after withdrawal of treatment in the HDN group were significantly lower ( P<0.05). Conclusions:Neonatal severe hyperbilirubinemia caused by HDN has early onset. G6PD deficiency caused hyperbilirubinemia has higher incidences of anemia, more severe jaundice and ABE, without increased Ret%.

Objective To analyze the expression levels of 25-hydroxyvitamin D3[25-(OH)D3],insulin-like growth factor 1(IGF-1)and complement C3 in children patients with Henoch-Sch?nlein purpura(HSP)and their predictive efficiency on disease progression.Methods A total of 102 children patients with HSP ad-mitted and treated in this hospital from June 2018 to June 2023 were selected as the study subjects and includ-ed in the observation group.They were divided into the mild group(35 cases),moderate group(41 cases)and severe group(26 cases)according to the severity degree.Additionally,50 healthy children undergoing physical examination during the same period served as the control group.The differences in serum 25-(OH)D3,IGF-1 and complement C3 levels were compared among the groups,as well as their correlations with the disease se-verity.Logistic regression analysis was used to determine the influencing factors of disease progression in chil-dren patients with HSP,and the value of 25-(OH)D3,IGF-1 and complement C3 in predicting disease progres-sion was assessed by using the receiver operating characteristic(ROC)curve.Results The levels of 25-(OH)D3 and C3 in the observation group were lower than those in the control group,while the level of IGF-1 was higher than that in the control group(P＜0.05).The levels of 25-(OH)D3 and C3 in the severe group were lower than those in the mild group and moderate group,moreover the moderate group was lower than the mild group(P＜0.05).The level of IGF-1 in the severe group was higher than that in the mild group and moderate group,moreover the moderate group was higher than the mild group(P＜0.05).The Spearman correlation a-nalysis results indicated that the levels of 25-(OH)D3 and complement C3 were negatively correlated with dis-ease severity(r=-0.375,-0.576,P＜0.05),while the level of IGF-1 was positively correlated with the dis-ease severity(r=0.866,P＜0.05).The ROC curve analysis results revealed that the area under the curve(AUC)of the combined detection of 25-(OH)D3,complement C3 and IGF-1 for predicting the disease pro-gression was the maximal(0.888),the sensitivity was 81.4％,the specificity was 82.0％and the Youden in-dex was 0.634.Conclusion 25-(OH)D3,IGF-1 and complement C3 have the higher sensitivity and specificity in comprehensively assessing the disease progression of children patients with HSP,and possess the higher clinical value on the risk evaluation of the disease progress in the children patients with HSP.

Objective To analyze the pathogenic bacteria and drug resistance of peritoneal dialysis-associated peritonitis(PDAP),and provide a clinical reference for the rational use of antibiotics.Methods The demographic data of PDAP patients admitted to the peritoneal dialysis(PD)Center of the First Affiliated Hospital of Soochow University from July 1,2015 to December 30,2021 were collected,and the pathogens,drug resistance and prognosis were retrospectively analyzed.Results A total of 150 episodes of PDAP occurred in 92 patients.The positive rate of PD fluid culture was 61.33％,including 65 cases(70.65％)of Gram-positive(G+)bacteria,mainly Staphylococcus and Streptococcus.Gram-negative(G-)bacteria were in 16 cases(17.39％),mainly Escherichia coli and Enterobacter cloacae.There were 11 cases(11.96％)of multiple infections,including 5 cases of combined fungal infection.From 2016 to 2021,the incidence of G+bacteria-related PDAP decreased from 14 to 8 cases.G+strains were resistant to methicillin(35.00％),and were sensitive to linezolid(100.00％),teicoplanin(100.00％)and rifampicin(100.00％).The sensitivity rate to vancomycin was 98.59％.G-strains were sensitive to ceftazidime(86.36％),ceftizoxime(88.89％)and amikacin(100.00％).The MIC of vancomycin against Staphylococcus showed an upward trend in 2019-2021.The overall cure rate of PDAP was 81.33％in patients who responded to antibiotic treatment,and the cure rate of G+bacteria was higher than that of multiple infections(89.23％vs.36.36％,P＜0.01).The outcome of patients with multiple infections,especially those with concurrent fungal infection was poor.Conclusion The incidence of PDAP in the PD center has shown a decreasing trend in recent years.G+bacteria are still the main pathogenic bacteria causing PDAP,and they are highly resistant to methicillin,so vancomycin should be used as empirical therapy.For G-bacteria,cefotaxime and amikacin can be chosen as empirical therapy.There is a drift in the MIC values of vancomycin against Staphylococcus in the study period,so it is necessary to monitor the MIC of vancomycin against Staphylococcus and its changing trend.

Objective:To investigate the efficacy of hemodiafiltration combined with hemoperfusion in the treatment of secondary hyperparathyroidism (SHPT) in patients undergoing maintenance hemodialysis (MHD).Methods:A total of 40 patients with SHPT undergoing MHD who received treatment at the Blood Purification Center of The First Affiliated Hospital of Anhui University of Science and Technology from February 2021 to March 2023 were included in this prospective cohort study. They were randomly divided into a control group and an observation group ( n = 20/group).The control group received a single high flux hemodialysis, while the observation group used a combination of hemodialysis filtration and hemoperfusion for 3 months. In both groups, the changes in hemoglobin, blood urea nitrogen, serum creatinine, serum calcium, serum phosphorus,and parathyroid hormone levels were compared before and after dialysis. Results:After dialysis, the hemoglobin level in the observation group was (119.45 ± 5.27) g/L, which was significantly higher than (106.30 ± 6.52) g/L in the control group ( t = -7.02, P < 0.001). The serum phosphorus level in the observation group was (1.18 ± 0.17) mmol/L, which was significantly lower than (1.52 ± 0.22) mmol/L in the control group ( t = 5.49, P < 0.001). The parathyroid hormone level in the observation group was (122.14 ± 40.57) ng/L, which was significantly lower than (168.78 ± 78.27) ng/L in the control group ( t = 2.39, P = 0.023). Conclusion:Hemodiafiltration combined with hemoperfusion can reduce clinical symptoms, increase hemoglobin level, and reduce phosphorus and parathyroid hormone levels in patients with SHPT undergoing MHD, which deserves clinical promotion.

Objective To study the effect of acupuncture combined with clean intermittent catheterization in the treat-ment of neurogenic bladder. Methods A total of 46 patients were randomly divided into test and control groups. There were 23 patients in the each group. The clean intermittent catheterization only used in the control group. However inte-grated acupuncture and clean intermittent catheterization were used in the test group. Final the residual urine volume and the incidence of bacteriuria were researched after 5 months. Results There were 17 cases restored the micturating function in the test group, however only 7 cases in the control group. There were 3 cases suffered bacteriuria in the test group, but there were 11 cases suffered bacteriuria in the control group. The difference between the two groups was sta-tistical ly significantly (P<0.05). Conclusion Combined acupuncture with clean intermittent catheterization can effi-ciently maintain the normal function of bladder, decrease the residual urine volume, and reduce the incidence of bac-teriuria.

Objective:To investigate the association between body mass index (BMI) trajectories in children and adolescents and subclinical renal damage (SRD) in adulthood.Methods:4 623 participants aged 6-18 years old were recruited from the ongoing cohort of Hanzhong adolescent hypertension study in 1987, and the subjects were followed up in 1989, 1992, 1995, 2005, 2013 and 2017, respectively. Group-based trajectory modeling was used to identify distinct BMI trajectories in longitudinal analysis. Generalized linear model was applied to examine the association between different BMI trajectories and SRD incidence in adulthood.Results:A total of 2 678 subjects from childhood to adulthood were enrolled in this study. All subjects were divided into three groups according to three distinct BMI trajectories: low-increasing BMI group ( n=1 017), moderate-increasing BMI group ( n=1 353), and high-increasing BMI group ( n=308). Over follow up for 30 years, a total of 248 participants (9.3%) developed SRD. Urinary albumin-to-creatinine ratio (uACR) in low to high-increasing BMI group was 0.9(0.6, 1.4), 1.0(0.7, 1.7), 1.6(0.8, 3.2), respectively ( P trend<0.001), and estimated glomerular filtration rate was 98.5(87.6, 111.6) , 96.2(86.4, 109.7), 95.3 (87.5, 125.0) ml·min -1·(1.73 m 2) -1, respectively ( P trend=0.025). The generalized linear model analysis showed that uACR was increased linearly from low to high-increasing BMI group [ β=3.16(95% CI 1.02-5.31), Ptrend=0.004]. There was no correlation or linear trend between BMI trajectory and estimated glomerular filtration rate [ β=-2.30(95% CI-5.18-0.57), Ptrend=0.117]. Compared with the low-increasing BMI group, the high-increasing BMI group had greater odds of experiencing SRD in adulthood after adjusting for multiple confounders such as age, gender, medical history and lifestyle ( OR=2.83, 95% CI 1.84-4.36, Ptrend<0.001). Conclusions:Higher BMI trajectorie is correlated with higher level of uACR and risk of SRD in middle age. Identifying long-term BMI trajectorie from early age may assist in predicting individuals′ renal function in later life.