【Objective】 To explore how to identify rare unexpected antibodies using routine serology methods in blood transfusion department of grassroots hospitals. 【Methods】 A patient with gastrointestinal bleeding with inconsistent forward and reverse blood typing, positive antibody screening and incompatible blood matching in our hospital was selected as the research object. Mixed human O cell absorption method was used for blood type identification, and 10-panel reagent red blood cells, manual polybrene test, 2-mercaptoethanol(2-ME) test, blind match and pedigree study were used to explore the antibody characteristics. 【Results】 The serological test results of the patient′s serum were as follows: The blood group was type B and RhD positive, and negative for direct antiglobulin test; The antibody was IgM; The likelihood of this antibody being anti-s, anti-Fy^a or anti-k was low, and compound antibodies could not be excluded; The blood of the patient did not match with blood samples of 20 blood donors in the major side, while it matched with all the blood samples of her three sisters. 【Conclusion】 When the antibodies of high-prevalence antigen series in plasma cannot be identified, the matched blood may be found tthrough family survey for irradiation and transfusion.

Objective:To investigate the predictive value of serum soluble urokinase-type plasminogen activator receptor (suPAR) combined with alpha-fetoprotein (AFP) and model for end-stage liver disease (MELD) score in short-term prognosis assessment of patients with chronic hepatitis B (CHB) related acute-on-chronic liver failure (ACLF).Methods:From January 2018 to May 2020, 66 patients with CHB related ACLF from Fuzhou First People′s Hospital were enrolled. After 90 days of follow-up, the patients with CHB related ACLF were divided into death group and survival group according to the outcome. Meanwhile, 30 patients with CHB were enrolled by simple random sampling method. The differences of serum suPAR in patients with CHB related ACLF and patients with CHB were analyzed. The values of suPAR, AFP and MELD score were compared between death group and survival group in patients with CHB related ACLF. The predictive value of suPAR, AFP, MELD score, Child-Turcotte Pugh score (CTP score) and suPAR combined with AFP and MELD score in the short-term prognosis of patients with CHB related ACLF were analyzed by area under the receiver operator characteristic curve (AUROC). Data were analyzed by two independent sample t test or non-parametric test. Results:The serum suPAR level of patients with CHB related ACLF was (9.6±0.8) ln ng/L, which was higher than that of patients with CHB ((8.0±0.3) ln ng/L). The difference was statistically significant ( t=14.533, P<0.01). The suPAR and MELD score of patients with CHB related ACLF in the death group were (9.9±0.7) ln ng/L and 29.6 (7.1) points, respectively, which were higher than those in the survival group ((9.4±0.7) ln ng/L and 21.0 (5.0) points, respectively). The AFP level in the death group was 45.9 (108.1) μg/L, which was lower than that in the survival group (209.3 (187.1) μg/L). There were significant differences in suPAR ( t=2.895, P=0.005), MELD score ( Z=4.708, P<0.01) and AFP ( Z=3.051, P<0.01) between the death group and the survival group. AUROC of suPAR (0.741, P=0.001), AFP (0.724, P=0.002) and MELD score (0.885, P<0.01) had predictive value for death in patients with CHB related ACLF. The sensitivities of suPAR, AFP, MELD score, CTP score and suPAR combined with AFP and MELD score were 84.6%, 73.1%, 88.5%, 96.2% and 84.6%, respectively, and the specificities were 75.0%, 72.5%, 70.0%, 52.5% and 92.5%, respectively. The AUROC of suPAR combined with AFP and MELD score was 0.871 ( P<0.01), which was higher than that of CTP score (0.793, P<0.01). Conclusions:Serum suPAR is increased in patients with CHB related ACLF. SuPAR combined with AFP and MELD score could apply in the prognostic value for patients with CHB related ACLF.

MicroRNA (microRNA) is a kind of non-coding single-stranded RNA encoded by endogenous genes.Its main function is to regulate protein synthesis.The role of microRNAs in liver diseases has been a research hotspot in recent years.A large number of studies have found that microRNAs are expressed in different types of liver diseases and at different stages of the same disease.Detection of microRNAs is of great help in the diagnosis and treatment of liver diseases.This article reviews the research progress of the role of microRNAs in liver diseases in recent years.

Objective:To study the relationship between polymorphism of estrogen receptor β gene(ESR2)and unexplained recurrent spontaneous abortion(URSA).Methods:A total of 85 women with recurrent spontaneous abortion were recruited in our hospital from August 2010 to May 2015.A total of 85 healthy ethnically matched women with two or more successful pregnancies and live births and no history of complicated pregnancies were recruited as the control group.5 ml elbow vein blood was extracted in the menstrual cycle of 2-3 days,and serum levels of follicle stimulating hormone(FSH),luteinizing hormone(LH),and estradiol(E2) were measured and compared between two groups,the rs1256049,rs4986938 and rs1256030 polymorphisms of ESR2 gene were detected and the correlation between ESR2 gene locus polymorphism and URSA was analyzed.Results:There was no significant difference in FSH and E2 level between the two groups (P ＞ 0.05).The level of LH in the study group was significantly higher than that in the control group (P ＜ 0.05).There were no significant differences in the rs1256049 locus,rs4986938 locus and rs1256030 locus between the two groups.The level of FSH,LH and E 2 in rs1256049 locus,rs4986938 locus,rs1256030 locus of all genotypes of females were not statistically significant (P ＞ 0.05).There was a negative correlation between the polymorphism of rs1256049 locus and the rs4986938 locus among all subjects,and rs4986938 locus were positively correlated with rs1256030 polymorphism.There was a positive correlation between the rs4986938 locus and rs1256030 locus polymorphism (r =0.38,P =0.00) in the control group,and there was a negative correlation between the rs1256049 locus and the polymorphism of the rs4986938 locus in the study group (r =-0.17,P =0.02).Conclusions:There is no significant relationship between ESR2 polymorphism and URSA.There is a certain correlation between the three mutation sites of ESR2 gene,and this correlation is different between the two groups,but whether there is a link between URSA and this difference still needs further study.

Objective To evaluate the causes of local masses found after periocular fat grafting,and the way of treatment in order to avoid the medical dispute.Methods In 37 patients with local mass being repaired,15 patients with superficial bulges were treated through surgical removal and as piration;10 patients with focal masses were treated with aspiration;12 patients with bulges close to eyelid margin and failure after the first two treatment methods were treated through incision.Results Histopathologic findings showed the characteristic features of lipogranuloma.Chronic inflammatory cells were infiltrated.Numerous,variable-sized lipid vacuoles were surrounded by histiocytes and for eign body-type giant cells.There were areas of fibrosis and fat necrosis.35 cases were followed-up for 3 months to 1 years.Both doctors and patients were satisfied with results in 27 cases,basically satisfied in 6 cases,but not satisfied in 2 cases.Two patients were lost to follow up.Conclusions The special complication of masses in the periocular fat grafting operation can be greatly improved with the personalized therapy.

Objective To evaluate the clinical effect and experience of correcting tear trough by transconjunctival fat reposition.Methods The study was performed in 60 patients with lower eyelid fat prolapse and tear trough deformity,in whom eyelid skin tightening was deemed unnecessary.All patients were divided into observation group and control group according to their desire.The observation group received the orbital fat release through the conjunctiva.The control group corrected eyelid bag without releasing orbital fat.The control group received filler treatment 2 months after operation.Postoperative complications were recorded,and the degree of outcome satisfaction was obtained at the 6-month postoperative follow-up.Results Of the 30 patients in the observation group,excellent result was achieved in 25 cases,basically satisfactory in 2 cases,unsatisfactory in 3 cases.Of the 30 patients in the control group,excellent result was achieved in 16 cases,basically satisfactory in 8 cases,unsatisfactory in 6 cases.Conclusions Transconjunctival fat repositioning is a better procedure for patients with lower eyelid fat prolapse,tear trough deformity and eyelid skin tightening.

Objective To evaluate the clinical effect and experience of correcting tear trough by transconjunctival fat reposition.Methods The study was performed in 60 patients with lower eyelid fat prolapse and tear trough deformity,in whom eyelid skin tightening was deemed unnecessary.All patients were divided into observation group and control group according to their desire.The observation group received the orbital fat release through the conjunctiva.The control group corrected eyelid bag without releasing orbital fat.The control group received filler treatment 2 months after operation.Postoperative complications were recorded,and the degree of outcome satisfaction was obtained at the 6-month postoperative follow-up.Results Of the 30 patients in the observation group,excellent result was achieved in 25 cases,basically satisfactory in 2 cases,unsatisfactory in 3 cases.Of the 30 patients in the control group,excellent result was achieved in 16 cases,basically satisfactory in 8 cases,unsatisfactory in 6 cases.Conclusions Transconjunctival fat repositioning is a better procedure for patients with lower eyelid fat prolapse,tear trough deformity and eyelid skin tightening.

Objective Acute kidney injury (AKI) frequently occurs after catheter-based interventional procedures and increases mortality. How-ever, the implications of AKI before thoracic endovascular aneurysm repair (TEVAR) of type B acute aortic dissection (AAD) remain un-clear. This study evaluated the incidence, predictors, and in-hospital outcomes of AKI before TEVAR in patients with type B AAD. Meth-ods Between 2009 and 2013, 76 patients were retrospectively evaluated who received TEVAR for type B AAD within 36 h from symptom onset. The patients were classified into no-AKI vs. AKI groups, and the severity of AKI was further staged according to kidney disease:im-proving global outcomes criteria before TEVAR. Results The incidence of preoperative AKI was 36.8%. In-hospital complications was significantly higher in patients with preoperative AKI compared with no-AKI (50.0%vs. 4.2%, respectively;P<0.001), including acute renal failure (21.4%vs. 0, respectively;P<0.001), and they increased with severity of AKI (P<0.001). The maximum levels of body tem-perature and white blood cell count were significantly related to maximum serum creatinine level before TEVAR. Multivariate analysis showed that systolic blood pressure on admission (OR:1.023;95%CI:1.003–1.044;P=0.0238) and bilateral renal artery involvement (OR:19.076;95%CI:1.914–190.164;P=0.0120) were strong predictors of preoperative AKI. Conclusions Preoperative AKI frequently oc-curred in patients with type B AAD, and correlated with higher in-hospital complications and enhanced inflammatory reaction. Systolic blood pressure on admission and bilateral renal artery involvement were major risk factors for AKI before TEVAR.

Background and purpose: Little about the function of p53 isoforms in gastric cancer was reported. This study was designed to explore the role ofΔ133p53 in the effect of recombinant mutant human tumor necrosis factor (rmhTNF) on gastric cancer cells, and provide a new basis for the diagnostics and therapeutics of gastric carcinoma. Methods: MKN45 (withΔ133p53 expression) or SGC7901 (withoutΔ133p53 expression) cells were treated with rmhTNF of different concentrations only or combined with 5-FU (a traditional gastric cancer cellular killer), and the growth inhibition rate and apoptosis was detected by CCK-8 and lfow cytometry. mRNA expressions ofΔ133p53, Gadd45αand CyclinB1 were measured by nested reverse transcription-polymerase chain reaction (nRT-PCR) or real-time polymerase chain reaction(RT-PCR). Results:On MKN-45 cells with positiveΔ133p53 expression, the inhibitory effect of rmhTNF was signiifcant, the inhibition rates of 50 and 500 IU/mL rmhTNF were 24.82%, 72.33%after culturing for 24 h (t=-9.558, P<0.01);also, the inhibitory effect of 5-FU was improved by rmhTNF remarkably in time-and dose-dependence, the inhibition rates of 5-FU (25 μg/mL), rmhTNF (50 IU/mL) combined with 5-FU (25 μg/mL), rmhTNF (500 IU/mL) combined with 5-FU (25 μg/mL) were 18.20%, 48.66%, 59.83%, separately, after culturing for 24 h (F=82.742, P<0.01);the inhibition rates of rmhTNF (50 IU/mL) combined with 5-FU (25 μg/mL) were 48.66%, 68.20%, 85.23%, separately, after culturing for 24 h, 48 h and 72 h (F=128.583, P<0.01). However, on SGC-7901 cells with negativeΔ133p53 expression, no growth inhibition was showed by rmhTNF only, the inhibition rates of 50 and 500 IU/mL were 2.74%, 3.25%after culturing for 24 h (t=-0.121, P>0.05). In apoptosis test, the apopto-sis-enhancing effect of rmhTNF was signiifcant on MKN45 cells, and the apoptosis-enhancing effect of 5-FU was fur-ther promoted signiifcantly by rmhTNF, the apoptosis of rmhTNF (50 IU/mL), rmhTNF (50 IU/mL) combined with 5-FU (25 μg/mL), rmhTNF (500 IU/mL) combined with 5-FU (25 μg/mL) were 18.20%, 48.66%, 59.83%, separately, after culturing for 24 h (F=123.931, P<0.05). In mRNA measurement, down-regulation ofΔ133p53 and CyclinB1, up-regula-tion of Gadd45αwere signiifcant in MKN45 cells treated by rmhTNF alone or combined with 5-FU. In nRT-PCR anal-ysis, the mRNA levels ofΔ133p53 were relatively 0.886, 0.499, 0.330, 0.161 (F=240.927, P<0.01);In real-time PCR analysis, the mRNA levels of Gadd45αwere 1.227, 1.694, 3.394, and the mRNA levels of CyclinB1 were 1.221, 0.722, 0.316, relatively. The expression ofΔ133p53 was positively related to CyclinB1 (r=0.977, P<0.01), but negatively re-lated to Gadd45α(r=-0.950, P<0.01). Conclusion:InΔ133p53 positively expressed MKN45 cells, rmhTNF showed as an effective tumor inhibitor and an enhancer of 5-FU as well, and this effect might be helped by two p53 down-stream molecules CyclinB1 and Gadd45α. The results suggest thatΔ133p53 might be a key target for the biological effect of rmhTNF against gastric cancer.

Objective To compare the application of National Standard GB/T 20470-2006 and Industry Standard WS/T 403-2012 in quality management of biochemical detection .Methods Comparison of indexes such as σ level ,quality goal index (QGI ) , priority improvement measure and performance evaluation were conducted in projects of external quality assessment launched in this department .Results Differences of performance evaluation showed no statistically significant between National Standard GB /T 20470-2006 and Industry Standard WS/T 403-2012(P= 0 .069) ,while their differences of σ value classification and priority im-provement measure were statistically significant (P were 0 .007 ,0 .012 ,respectively ) .Conclusion Industry Standard WS/T 403-2012 is more stringent than National Standard GB/T 20470-2006 .