Objective To investigate the RHD gene polymorphism among the RhD negative Han individuals in Xuzhou.Methods The RhD antigen phenotypes were detected by routine serological techniques,and were identified with indirect antiglobulin test (IAT).The genotypes of RHD were detected by using sequence specific primer polymerase chain reaction(SSP-PCR).Results A-mong 110 RhD negative individuals,there were 5 cases carring RHD positive gene,47 cases carring RHD negative gene,22 cases carring RHD-CE(2-9)-D gene,17 cases carring DVI Ⅲ gene,2 cases carring weak D15 gene,and 17 carring DEL-1227A gene,re-spectively.Conclusion The RhD negative Han individuals present complex RHD gene polymorphism in Xuzhou region,and variant alleles such as RHD-CE(2-9)-D,DVI Ⅲ,DEL-1227A are given priority.

OBJECTIVE To acknowledge the important factor of bacterial infection of patients after tracheotomy. METHODS Thirty five patients′ lower respiratory tract sputa were sent to conduct bacterial culturing and determine their susceptibility to antibiotics and analyze results with statistics methods. RESULTS Total 8 main kinds of bacteria were isolated and drug resistance rate of Gram-positive cocci over 50 percent was erythromycin,that of(Gram-negative) bacilli included ampicillin,gentamicin,ciprofloxacin,and cefuroxime.The average time of antibiotics usage among 35 patients was(27?19.17) days and 12 kinds of antibiotics were used. CONCLUSIONS The time of usage of different antibiotics is an important factor to aggravate patients′ infection after tracheotomy.

Objective To explore a more effective way to enhance the clinical efficacy of cluster immunotherapy for perennial allergic rhinitis. Methods A total of 60 perennial allergic rhinitis patients were evenly randomized into treatment goup and control group. The two groups were given cluster immunotherapy, and the treatment group was given daily vesiculating moxibustion additionally . Before and after treatment, the scores of traditional Chinese medical constitution and the rhinitis quality of life ( QOL) were observed, and one year after treatment, the therapeutic effect and safety were evaluated. Results ( 1) One year after treatment, the treatment group showed better total clinical efficiency than the control group ( 96.67% vs 80.00%, P<0.05). ( 2) After treatment, the average scores of Qi deficiency constitution, yang deficiency constitution and special constitution were significantly lower than those before treatment in the treatment group ( P<0.01). The improvement of Qi deficiency constitution and yang deficiency constitution in the treatment group was superior to that in the control group ( P<0.05). ( 3) The total QOL scores and the scores of each dimension of QOL scale were improved in both groups, and the differences were significant except for the emotion dimension ( P<0.01). Insignificant differences were shown between the two groups after treatment ( P>0.05). ( 4) Two cases had grade 1 general adverse reaction and 5 cases had local adverse reaction during cluster immunotherapy. During vesiculating moxibustion, 3 cases had blistering and the blistering disappeared after symptomatic treatment. Conclusion Daily vesiculating moxibustion combined with cluster immunity therapy is effective for the treatment of allergic rhinitis, showing good effect on improving Qi deficiency constitution, yang deficiency constitution and special constitution as well as the quality of life of the patients.

Objective To explore the gait features under dual task walking and its relationship of fear of falling in elderly patients with type 2 diabetes.Methods A total of 168 elderly patients with type 2 diabetes were selected.Patients were asked to complete the general information questionnaire,mini-mental state examination and fear of falling assessment.The gait parameters under normal and dual task walking were measured objectively and quantitatively by IDEEA,and the relationship between fear of falling and the gait parameters under dual task walking were explored.Results Elderly patients with type 2 diabetes were more prone to gait abnormalities in dual task walking,and compared with those who are not fear of falling,the gait performance in dual task walking decreased significantly in the patients with fear of falling,such as lower velocity and step length,higher variability of stride time(all P＜0.05).Conclusion Elderly patients with type 2 diabetes were more prone to gait disorders in dual tasking than normal walking.Normal walking test may overestimate the actual walking ability of patients.In contrast,dual task walking test can better reflect the challenges of daily life,and be closer to the patient walking patterns in real life,which might be better suited for assessing actual mobility of patients.In addition,elderly patients with type 2 diabetes who are fear of falling are more prone to gait abnormalities in dual tasking walking.

Objective To evaluate the diagnostic efficacy of pelvic floor ultrasound parameters in post-cesarean stress urinary incontinence(SUI)and biofeedback efficacy evaluation.Methods A total of 215 pregnant women who underwent cesarean section were selected by simple sampling meth-od.According to whether postpartum SUI occurred,they were divided into SUI group(n=88)and non-SUI group(n=127).The SUI group received biofeedback therapy.The ultrasonic parameters of pelvic floor were compared between the two groups.The ultrasound parameters of pelvic floor in the SUI group were compared before and after treatment.Results Bladder neck descent(BND),ure-thral rotation angle(URA)as well as levator hiatal area(LHA)and posterior urethrovesical angle(PUVA)in Valsalva state of the SUI group were significantly higher than those in the non-SUI group(P＜0.05).After biofeedback therapy,the total effective rate of 88 patients with SUI after cesarean section was 94.32％.The BND,URA as well as LHA and PUVA in Valsalva state of the SUI group after treatment were significantly lower than those before treatment(P＜0.05).The area under the curve(AUC)of BND,URA,LHA and PUVA in predicting the effect of biofeedback on post-cesare-an section SUI were 0.853,0.897,0.865 and 0.887,respectively.Conclusion Pelvic floor ultra-sound parameters are highly effective in diagnosing SUI after cesarean section and evaluating the effect of biofeedback therapy.

Objective To evaluate the diagnostic efficacy of pelvic floor ultrasound parameters in post-cesarean stress urinary incontinence(SUI)and biofeedback efficacy evaluation.Methods A total of 215 pregnant women who underwent cesarean section were selected by simple sampling meth-od.According to whether postpartum SUI occurred,they were divided into SUI group(n=88)and non-SUI group(n=127).The SUI group received biofeedback therapy.The ultrasonic parameters of pelvic floor were compared between the two groups.The ultrasound parameters of pelvic floor in the SUI group were compared before and after treatment.Results Bladder neck descent(BND),ure-thral rotation angle(URA)as well as levator hiatal area(LHA)and posterior urethrovesical angle(PUVA)in Valsalva state of the SUI group were significantly higher than those in the non-SUI group(P＜0.05).After biofeedback therapy,the total effective rate of 88 patients with SUI after cesarean section was 94.32％.The BND,URA as well as LHA and PUVA in Valsalva state of the SUI group after treatment were significantly lower than those before treatment(P＜0.05).The area under the curve(AUC)of BND,URA,LHA and PUVA in predicting the effect of biofeedback on post-cesare-an section SUI were 0.853,0.897,0.865 and 0.887,respectively.Conclusion Pelvic floor ultra-sound parameters are highly effective in diagnosing SUI after cesarean section and evaluating the effect of biofeedback therapy.

[Abstract] [Objective] To establish a new centrifugal-membrane hybrid plasmapheresis (CMHP) model, and observe its clinical efficacy, safety and advantages in the treatment of hyperlipidemia by comparing with centrifugation therapeutic plasma exchange (cTPE). [Methods] A retrospective analysis was performed on 47 patients with hyperlipidemia treated in our department from August 2021 to September 2023, with a total of 60 treatments. They were divided into two groups: CMHP group with 37 patients and 46 treatments; cTPE group included 10 patients with 14 treatments. In the CMHP group, the plasma was separated by a blood cell separator and the plasma components were separated by a two-stage membrane plasma component separator. In the cTPE group, the plasma was separated by a blood cell separator for therapeutic plasma exchange. The clinical efficacy, safety and advantages of the two groups were compared. [Results] The reduction ratios of total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C) before and after treatment in CMHP group were 68.56%[59.81%, 73.42%], 65.80%[55.55%, 75.98%] and 46.57%[36.02%, 54.83%] and 66.67%[43.48%, 76.24%] respectively, with statistically significant difference (P<0.001). The decrease ratios of TC, TG and HDL-C before and after treatment in cTPE group were 42.52%[29.67%, 49.85%], 52.32%[38.43%, 67.07%] and 22.36%[8.51%, 33.65%], respectively, and the difference was statistically significant (P<0.05). The plasma treatment multiple was 1.48 (0.29) in CMHP group, which was significantly higher than 0.87 (0.26) in cTPE group, with a statistically significant difference (P<0.001), resulting in higher TC and HDL-C reduction ratios in CMHP group than in cTPE group, with a statistically significant difference (P<0.001), while there was no significant difference in TG reduction rate between the two groups (P>0.05). At the same time, the cTPE group required 1 520.00 mL[1 462.50 mL, 2 000.00 mL] plasma input, while the CMHP group achieved zero blood input. The adverse reaction ratio was 6.52%(3/46) in CMHP group and 7.14%(1/14) in cTPE group, and the difference was not statistically significant (P>0.05). [Conclusion] Compared with cTPE, CMHP can better reduce blood lipid levels without any blood products, avoid the spread of blood infectious diseases, and have a low incidence of adverse reactions, so it has a good clinical application prospect.

Objective:To analyze the clinical characteristics of adult Chinese patients with syncope.Methods:This is a cross-sectional survey study. Patients with preliminary diagnosis of syncope in the Emergency Department, Geriatrics and Cardiology Outpatient Department, or Syncope Unit of 37 hospitals in 19 provinces, autonomous regions and the Hong Kong Special Administrative Region from June 2018 to March 2021 were included in this study. The clinical features of these patients with syncope were analyzed.Results:A total of 4 950 consecutive patients with syncope were included in this study. The age was (56.3±16.8)years, and 2 604 cases (52.6%) were male. The most common type of syncope was neurally mediated syncope (2 345 (47.4%)), followed by cardiac syncope (1 085 (21.9%)), orthostatic hypotensive syncope (311 (6.3%)), and unexplained syncope accounted for nearly one third (1 155 (23.3%)). Predisposing syncope was more common in patients under 65 years of age(2 066(72.4%) vs. 786(27.6%),χ 2=136.5, P<0.001). Presyncope was more common in patients with neurally mediated syncope (1 972(79.0%) vs.1 908(73.9%), χ 2=17.756, P<0.001). Premonitory symptoms were more common in women(1 837(80.0%) vs. 1 863(73.0%),χ 2=33.432, P<0.001). Presyncope syndrome was more common in patients under 65 years of age (2 482(77.8%) vs. 1 218(73.4%),χ 2=17.523, P=0.001). Cyanosis was more common in ≥65 years old patients (271(18.2%) vs. 369(12.7%), χ 2=23.235, P<0.001). Urinary incontinence was more common in old patients aged ≥65 years(252(15.2%) vs. 345(10.8%), χ 2=19.313, P<0.001). Family history was more common in patients with cardiogenic syncope compared with other types of syncope (264(24.3%) vs. 754(19.5%), χ 2=11.899, P=0.001). Hypertention(1 480(30.5%)), coronary heart disease(1 057(21.4%)), atrial flutter and atrial fibrillation(359(7.2%)), second degree atrioventricular block(236(4.8%)) were common complications of syncope. The proportion of patients with coronary heart disease was significantly higher in cardiac syncope than that of other types of syncope(417(38.4%) vs. 640(16.6%), χ 2=241.376, P<0.001). Other common complications included cerebrovascular diseases (551 (11.1%)) and diabetes mellitus (632(12.8%)). Conclusions:Neurally mediated syncope is the most common syncope in adult Chinese population. Patients with predisposing conditions and premonitory conditions are younger. Presyncope is more common in women. The proportion of family history and coronary heart disease is higher in patients with cardiogenic syncope.

Obesity is increasingly prevalent globally, searching for therapeutic agents acting on adipose tissue is of great importance. Equisetin (EQST), a meroterpenoid isolated from a marine sponge-derived fungus, has been reported to display antibacterial and antiviral activities. Here, we revealed that EQST displayed anti-obesity effects acting on adipose tissue through inhibiting adipogenesis in vitro and attenuating HFD-induced obesity in mice, doing so without affecting food intake, blood pressure or heart rate. We demonstrated that EQST inhibited the enzyme activity of 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1), a therapeutic target of obesity in adipose tissue. Anti-obesity properties of EQST were all offset by applying excessive 11β-HSD1's substrates and 11β-HSD1 inhibition through knockdown in vitro or 11β-HSD1 knockout in vivo. In the 11β-HSD1 bypass model constructed by adding excess 11β-HSD1 products, EQST's anti-obesity effects disappeared. Furthermore, EQST directly bond to 11β-HSD1 protein and presented remarkable better intensity on 11β-HSD1 inhibition and better efficacy on anti-obesity than known 11β-HSD1 inhibitor. Therefore, EQST can be developed into anti-obesity candidate compound, and this study may provide more clues for developing higher effective 11β-HSD1 inhibitors.

Autologous ozonized blood transfusion(AOBT) is a therapy of re-transfusion of 100-200 mL of autologous blood after shaking and agitation with appropriate amount of oxygen-ozone in vitro. The oxidation of blood through the strong oxidation of ozone can enhance the non-specific immune response of the body, regulate the internal environment and promote health. This therapy has been increasingly applied in clinical practice, while no unified standard for the operation process in terms of ozone concentration, treatment frequency and treatment course had been established. This operation process of AOBT is primarily explored in order to standardize the operation process and ensure its safety and efficacy.