Objective To investigate the effects of anti-HLA donor-specific antibodies(DSA)and desensitization for DSA+patients on engraftment of haploidentical hematopoietic stem cell transplantation(haplo-HSCT).Methods The patients who underwent haplo-HSCT and examinations for HLA antibodies and DSA in our department from March 2017 to July 2023 were recruited in this study.The effects of desensitization measure on engraftment in the DSA+patients after haplo-HSCT were analyzed.Results Among the 70 patients who underwent haplo-HSCT and test for HLA antibodies,15(21.4％)patients were DSA positive,including 7(46.7％)cases of strong positive,3(20.0％)cases of moderate positive,and 5(33.3％)cases of weak positive.The median duration for neutrophil implantation was significantly extended in the DSA+patients than the negative patients(P=0.027).For the 6 patients developed graft failure(GF),4 were DSA+which was statistically higher than the DSA-patients(P=0.025).Multivariate regression analysis showed that DSA was an independent factor affecting GF(HR=9.273,95％CI:1.505～57.124,P=0.016).Among the 10 patients(7 strong positive and 3 moderate positive DSA)received desensitization therapy,4 patients received combination desensitization,with a 100％rate of successful transplantation,and 6 received single desensitization,with 4(66.7％)experiencing GF,so the GF rate was obviously lower in the combination than the single desensitization(P=0.008).Conclusion In haplo-HSCT patients,DSA is an important factor leading to implantation delay and GF.While,single desensitization treatment has limited efficacy.In combined DSA desensitization therapy,the decrease of antibody titer should be dynamically monitored to ensure the successful implantation of stem cells and reduce GF rate.

Objective:To explore the protective effects of hematoma aspiration combined with hyperbaric oxygen（HBO）therapy on the brain tissue of rats after cerebral hemorrhage.Methods:A total of 40 rats were randomly divided into four groups：sham operation group，model group，operation group（hematoma aspiration），and combined treatment group（minimally invasive hematoma aspiration + HBO），with 10 rats in each group. The neurological deficits of rats in each group were scored by Longa scoring method. The water content of the brain tissue of rats in each group was detected by dry/wet weight measurement. The pathological changes in the hippocampus tissue of rats in each group were observed by H&E staining. The number of hippocampal neuronal apoptosis of rats in each group was detected by TUNEL assay. The expression levels of brain derived neurotrophic factor（BDNF）and Aquaporin-4（AQP4）in the hippocampus of rats in each group were detected by qRT-PCR and Western blotting. The protein expressions of Bax，Bcl-2，JAK2，p-JAK2，STAT3，and p-STAT3 in the brain tissue of rats in each group were detected by Western blotting.Results:Compared with the sham operation group，the model group had significantly higher nerve injury function scores and brain tissue water content，and showed brain tissue hemorrhage，cell pyknosis，enlarged intercellular space，increased glial cells，and decreased neurons；the apoptosis level of hippocampal neurons in the model group increased（ P<0.05）；the AQP4，p-JAK2，and p-STAT3 expressions in the model group increased，while the BDNF expression in the model group decreased（ P<0.05）. Compared with the model group，the operation group and the combined treatment group had lower nerve injury function scores and less brain tissue water content，and the brain tissue injury in the two groups was reduced. In both groups，the apoptosis level of hippocampal neurons decreased（ P<0.05）；the AQP4，p-JAK2，and p-STAT3 expressions decreased，while the BDNF expression increased（ P<0.05）. Compared with the operation group，the combined treatment group had significantly lower nerve injury function score and less brain water content，and its cell pyknosis，edema，and other conditions significantly subsided. In the combined treatment group，the apoptosis level of hippocampal neurons decreased（ P<0.05）；the AQP4，p-JAK2，and p-STAT3 expressions decreased，while the BDNF expression increased（ P<0.05）. Conclusion:Hematoma aspiration combined with HBO therapy has a protective effect on rat brain with injury due to cerebral hemorrhage，and the protective mechanism may be related to the inhibition of JAK2/STAT3 signaling pathway．

Objective:To explore the protective effects of hematoma aspiration combined with hyperbaric oxygen（HBO）therapy on the brain tissue of rats after cerebral hemorrhage.Methods:A total of 40 rats were randomly divided into four groups：sham operation group，model group，operation group（hematoma aspiration），and combined treatment group（minimally invasive hematoma aspiration + HBO），with 10 rats in each group. The neurological deficits of rats in each group were scored by Longa scoring method. The water content of the brain tissue of rats in each group was detected by dry/wet weight measurement. The pathological changes in the hippocampus tissue of rats in each group were observed by H&E staining. The number of hippocampal neuronal apoptosis of rats in each group was detected by TUNEL assay. The expression levels of brain derived neurotrophic factor（BDNF）and Aquaporin-4（AQP4）in the hippocampus of rats in each group were detected by qRT-PCR and Western blotting. The protein expressions of Bax，Bcl-2，JAK2，p-JAK2，STAT3，and p-STAT3 in the brain tissue of rats in each group were detected by Western blotting.Results:Compared with the sham operation group，the model group had significantly higher nerve injury function scores and brain tissue water content，and showed brain tissue hemorrhage，cell pyknosis，enlarged intercellular space，increased glial cells，and decreased neurons；the apoptosis level of hippocampal neurons in the model group increased（ P<0.05）；the AQP4，p-JAK2，and p-STAT3 expressions in the model group increased，while the BDNF expression in the model group decreased（ P<0.05）. Compared with the model group，the operation group and the combined treatment group had lower nerve injury function scores and less brain tissue water content，and the brain tissue injury in the two groups was reduced. In both groups，the apoptosis level of hippocampal neurons decreased（ P<0.05）；the AQP4，p-JAK2，and p-STAT3 expressions decreased，while the BDNF expression increased（ P<0.05）. Compared with the operation group，the combined treatment group had significantly lower nerve injury function score and less brain water content，and its cell pyknosis，edema，and other conditions significantly subsided. In the combined treatment group，the apoptosis level of hippocampal neurons decreased（ P<0.05）；the AQP4，p-JAK2，and p-STAT3 expressions decreased，while the BDNF expression increased（ P<0.05）. Conclusion:Hematoma aspiration combined with HBO therapy has a protective effect on rat brain with injury due to cerebral hemorrhage，and the protective mechanism may be related to the inhibition of JAK2/STAT3 signaling pathway．

Objective To study the application value of ultrasound(US) examination for evaluating the knee joint status in the patients with hemophilia.Methods The US examination data of 44 patients (70 knee joints) with hemophilia were collected,among them 11 cases aged below 18 years old,16 knee joints completed the MRI examination,meanwhile the knee joint health status was evaluated by adopting the 2.1 version of hemophilia joint health assessment (HJHS) form.Then the correlation between the US score with the age and bleeding times and the relation between MRI score with HJHS score were analyzed.Results The severity of hemophilia arthropathy had no obvious correlation with hemophilia severity (F=0.013,P =0.987).With the age increase and bleeding frequency increase,the knee joint lesion was aggravated.The detection of early synovial thickening and cartilage change in arthropathy had no obvious difference between US and MRI examinations(P＞0.05);the obvious correlation existed among US score,MRI score and HJHS (P＜0.05).Conclusion US has an important significance for the early diagnosis of hemophilic arthropathy.

Objective:To compare the alveolar cortical bone density and thickness of jaw bones between teenagers (12-18 years of age) and adults(19-48 years of age).Methods:Spiral computed tomographic images of 60 cases were obtained from the subjects with the ages of 12 to 48 years(27 Males and 33 females,35 teenagers and 25 adults).Buccal cortical bone thickness and density in Hounsfield units were measured at 12 interradicular sites and to a depth of 14 mm.Results:The alveolar cortical bone thicknesses and densities of the jaw bones significantly increased from the crest to base of alveolar crest.The average cortical bone thicknesses rangedfrom 1.0 to 1.5 mm in the anterior part of the jaw bones,1.1 to 1.8 mm in maxillary posterior area and 1.5 to 2.8 mm in the mandible posterior areas.The cortical bone thickness and density were greater in the mandible than in the maxilla(P ＜ 0.05).The thickness values did not show difference between males and females,between adolescents and adults.Higher values of bone density were found in the adults than in the teenagers(P ＜0.05).The highest bone density in the mandible posterior area of adults was observed,and the lowest bone density in the maxillary posterior area of adolescents.Conclusion:Alveolar cortical bone density of adolescents is lower than that of adults,especially in the maxilla posterior region.

Objective To investigate the role of thrombelastography(TEG) in assessing the risk of bleeding and diagnostic value in patients with acute leukemia(AL) .Methods The TEG and PLT data were counted in 127 patients(272 sets of data) who were diagnosed with AL .Those patients were divided into two groups :group 1 (including patients with bleeding) and group 2 (in‐cluding patients with no bleeding) .The indicators(R values ,K values ,α‐angle ,MA values)and PLT count were compared between two groups .Those data with PLT<30 × 109/L of these two groups also were divided and the 4 indicators of TEG were compared between the two groups .We used the ROC curve to evaluate the sensitivity and specificity in assessing the risk of bleeding .Results According to the data in total ,the K value ,R value of the group 1 were higher than those of the group 2(P<0 .05);theα‐angle and MA value ,PLT counts of group 1 were lower than those of the group 2(P<0 .05) .In those AL patients whose PLT<30 × 109/L ,the K value of the group 1 was higher than that of the group 2(P<0 .05);theα‐Angle and MA value of the group 1 were lower than those of the group 2(P<0 .05);R values and PLT count were not different between the two groups(P>0 .05);the are‐as under the ROC curve about the PLT counts ,MA value andα‐angle were more than 0 .5 (0 .750 ,0 .740 and 0 .653) .Conclusion T EG could predict the risk of bleeding in acute leukemia patients and it could be used in clinical application .

Objective To investigate the status of nutritional risk and nutritional support in general surgery patients, and to explore their association with postoperative complications and length of hospital stay.Methods From January 2014 to February 2015, 853 inpatients in general surgical wards in the Second Hospital of Hebei Medical University were enrolled.Nutritional Risk Screening 2002 (NRS 2002) was used to estimate nutritional status of patients.The patients were divided into 2 groups based on whether they received nutritional support.The length of hospital stay in days and postoperative complications were recorded.The association of nutritional risk and nutritional support with complications and length of hospital stay were analyzed.Results In the 853 surgery patients, the prevalence of nutritional risk was 31.1％ (265/853) and that of malnutrition was 5.4％ (46/853).The incidence of postoperative complications was 14.2％ (121/853).The patients with nutritional risk had a significantly higher incidence of postoperative complications compared to those without nutritional risk [29.8％ (79/265) vs.7.1％ (42/588) , P ＜ 0.000] , and a longer hospital stay [(12.5 ±6.4) days vs.(4.2 ±3.9) days, P ＜0.001].In the 853 patients, 27.3％ (233/853) received nutrition support.In the patients with nutritional risk, those on nutritional support had a significantly lower incidence of complications compared with those not on nutritional support [16.7％ (32/192) vs.64.4％ (47/73), P＜0.05] and shorter hospital stay [(7.5±4.6) days vs.(16.3±8.5)days, P ＜ 0.05].Conclusions According to NRS 2002 result, a fairly high percentage of general surgery patients may have nutritional risk.Patients with decreased body mass, less dietary intake, and at higher age may be more likely to have nutritional risk.Nutritional risk may be associated with a higher incidence of postoperative complications and longer hospital stay.Patients at nutritional risk appear to be more likely to benefit from nutritional support.

Objective T o investigate the expression of hyperpolarization-activated cyclic nucleotide-gated cation channel 4 (H C N 4) and connexin43 (C x43) in the sinoatrial node of electric shock death. Meth-ods As experim ental group, 34 cases of electric shock death who had definite current m ark evidence were selected from pathology departm ent of X uzhou M edical C ollege from 2010 to 2013. As the control group, 20 cases of fatal severe craniocerebral injury in traffic accidents were chosen. T he expressions of H C N 4 and C x43 in the sinoatrial node were observed by im m unohistochem ical technology. Results H C N 4 positive cells expressed in the cell m em brane and cytoplasm of the sinoatrial node. C x43 positive cells expressed in the cell m em brane and cytoplasm of T cells and m yocardial cells. T he expression of H C N 4 was significantly higher than that of the control group (P<0.05) and the expression of C x43 was signifi-cantly lower than that of the control group (P<0.05). Conclusion T he changes of H C N 4 and C x43 ex-pressions in the sinoatrial node illustrate electric shock death m ight be related to the abnorm alities of cardiac electrophysiology and conduction.

Objective To investigate the relationship between hypertensive disorder complicating pregnancy(HDCP)with homo-cysteine,D-D and high sensitive C-reactive protein(hs-CRP).Methods 80 HDCP women included 38 cases of gestational hyperten-sion,26 cases of mild preeclampsia and 16 cases of severe preeclampsias,and at the same time 36 normal late-term pregnant women and 30 non-pregnant normal women were selected as the control group.The plasma Hcy was determined by the enzymatic cycling assay,D-D was determined by the latex immune turbidimetry and hs-CRP was determined by the nephelometry immuno assay,re-spectively.Results The plasma Hcy,D-D and hs-CRP levels in the HDCP group were significantly increased compared with the normal non-pregnancy women group and the normal late-term pregnancy women group controls and showed the increasing trend with the aggravation of disease condition,the differences had the statistical significance(P <0.01).Conclusion Timely monitoring the plasma Hcy,D-D and hs-CRP levels can effective conduct the adverse pregnancy prediction,thus timely takes the medication in-tervention for correcting the occurrence and development of the disease condition,and provides the significant reference indexes for evaluating the change and prognosis of the disease condition in clinic.

Objective To study whether the green fluorescent protein ( GFP) gene can be successfully expressed in green fluorescent nude mice and the tissue distribution characteristics.Methods Small animal imaging system and RT-PCR assay were used to detect the GFP tissue distribution and fluorescence expression level.Results The GFP can be expressed in multiple tissues in green fluorescent nude mice.A higher expression was observed in the pancreas, heart, brain, and skin.Conclusion Exogenous GFP can be stably expressed and inherited in green fluorescent nude mice, with the highest expression in the pancreas.