【Objective】 To investigate the distribution of ABO and RhD blood groups among voluntary blood donors in Guangzhou, in order to ensure clinical blood safety and better serve blood donors. 【Methods】 Routine ABO and RhD blood group screening tests were carried out among voluntary blood donors from January 2021 to December 2022. The composition ratio of ABO blood group was statistically analyzed. The samples with discrepancy between forward and reverse blood grouping and negative RhD blood group samples were further verified by serological test to analyze the ABO subtypes and the reasons for missed detection. 【Results】 A total of 749 123 blood samples were screened from January 2021 to December 2022, and 513 291 samples were collected after excluding repeat blood donors, with the ABO blood groups as 208 126(40.55%) of O type, 138 859(27.05%) of A type, 130 987(25.52%) of B type and 35 319(6.88%) of AB type. The screening results showed discrepancy between forward and reverse blood grouping in 506 samples, of which 58 were with weak/non-erythrocyte reaction, 16 with erythrocyte reaction, 215 with weak/non-serum reaction, and 217 with serum reaction. Further serological test indicated that 44 samples were ABO subtypes, among which 13 were subtype A, 26 subtype B, 5 subtype AB and 3 B (A) and 14 Bombay-like blood group. The blood group with the highest missed detection rate in repeat blood donors were A3/B3 subtype (68.42%). A total of 128 unexpected antibody positive samples were detected among 513 291 samples A total of 2 277 samples were screened negative for RhD blood type, of which 2 188 were confirmed to be Rh negative (2 188/513 291, 0.43%), 89 were D variants (89/513 291, 0.02%, ) and 30 were detected with unexpected antibodies (30/2 188, 1.37%). 【Conclusion】 The ABO blood group distribution of blood donors in Guangzhou is O>A>B>AB, and the proportion of RhD negative population is 0.43%, slightly highter than 0.3%-0.4% of Han population nationwide. The ABO blood group subtype is dominated by B subtype. The detection rate and missed detection rate of A3/B3 subtypes in routine blood group tests are the highest.

Objective To establish a quality control mechanism based on the Poisson distribution for monitoring con-tamination in nucleic acid testing(NAT)laboratories.Methods The study collected NAT single-reactivity rates and dis-criminatory test reactivity rates from the Grifols Panther NAT system from 2022 to 2023.The Poisson distribution probability method was used to calculate the daily probability of nucleic acid single reactivity.Sensitivity and specificity of the quality control model were further validated using single-reactivity rates,discriminatory reactivity rates and ROC curve analysis,fol-lowed by proposing corresponding multi-rule quality control strategies.Results Using P=0.05 as the threshold for out-of-control,the Poisson distribution probability quality control model identified 40 out-of-control points with P<0.05.After man-ual verification using discriminatory reactivity rates,20 out-of-control points were confirmed.The sensitivity of determining out-of-control was 60.0%,and the specificity was 95.6%.Due to the high number of out-of-control points,it is recommen-ded to combine discriminatory reactivity rates and employ multi-rule quality control methods for quality monitoring.Under the multi-rule quality control,there were 18 warning points and 2 out-of-control points for NAT single reactivity from 2022 to 2023.Conclusion The multi-rule NAT single-reactivity monitoring mechanism based on the Poisson distribution probability is more suitable for nucleic acid laboratories to monitor and warn of laboratory contamination,thereby enhancing the manage-ment capabilities and detection quality of nucleic acid laboratories.

Objective:To investigate the risk factors for severe hyperbilirubinemia complicated by acute bilirubin encephalopathy (ABE), and the value of total serum bilirubin (TSB) and bilirubin (B)/albumin (A) ratio in predicting ABE.Methods:Clinical data of children with severe hyperbilirubinemia admitted to the Affiliated Hospital of Inner Mongolia Medical University, Ordos Central Hospital, People's Hospital of Inner Mongolia Autonomous Region, the Fourth Hospital of Baotou, Tongliao Hospital, Maternal and Child Health Hospital of Hohhot, the Affiliated Hospital of Chifeng University, Manzhouli People's Hospital, and Chifeng Hospital from January 1, 2020, to December 31, 2021, were retrospectively collected. The subjects were divided into ABE and non-ABE groups based on the occurrence of ABE. Multivariate logistic regression analysis was used to identify high-risk factors for ABE. Statistical analysis was performed using t-test, Wilcoxon signed-rank test, or Chi-square tests. Indicators with statistically significant differences were included in the multivariate logistic regression model, and stepwise regression was used to analyze the influencing factors of ABE. Results:(1) A total of 543 children were included in this study, accounting for 3.7% (543/14 831) of the total admissions during the same period. Among the 543 children, 81 (14.9%) had ABE, and 462 (85.1%) did not. The age at admission was (7.2±2.1) d, and the length of hospital stay was (5.2±2.2) d. The breastfeeding initiation time was 2 d (1-4 d) after birth. The peak TSB of the 543 cases was (385.98±51.22) μmol/L, and the age at peak TSB was (4.4±2.1) d. Fourteen cases (2.5%) gradually reached the peak TSB after admission [(392.01±61.24) μmol/L], while 529 cases (97.5%) had already reached the peak TSB at admission [(386.42±50.22) μmol/L]. Among the 543 cases, 356 had a clear etiology (65.6%, with 278 cases having a single cause and 78 cases having more than two causes), and 187 cases (34.4%) had an unknown etiology. (2) Compared with the non-ABE group, the breastfeeding initiation in the ABE group was later [6 h (2-6 h) vs. 2 h (1-3 h), Z=－6.87] and the length of hospital stay was longer [(6.5±1.9) d vs. (5.0±2.1) d, t=0.55]. The proportions of breastfeeding, delayed meconium passage, isoimmune hemolysis, and maternal gestational diabetes, as well as peak TSB and B/A ratio at peak TSB, were higher in the ABE group than in the non-ABE group [64.2% (52/81) vs. 36.8% (170/462), χ2=21.96; 16.0% (13/81) vs. 2.4% (11/462), χ2=27.32; 27.2% (22/81) vs. 10.6% (40/462), χ2=16.61; 24.7% (20/81) vs. 13.6% (63/462), χ2=6.50; (442±68) vs. (375±39) μmol/L, t=－8.55; (11.9±1.6) vs. (9.8±1.2), t=－11.61; all P<0.05]. The admission weight, proportion of transfer from the hospital's obstetrics department, unknown etiology, and breast milk jaundice were lower in the ABE group than in the non-ABE group [(3 098±482) vs. (3 278±493) g, t=3.04; 12.3% (10/81) vs. 42.4% (196/462), χ2=30.48; 3.7% (3/81) vs. 39.8% (184/462), χ2=39.83; 0.0% (0/81) vs. 5.8% (27/462), χ2=3.81; all P<0.05]. (3) Isoimmune hemolysis, peak TSB, and B/A ratio at peak TSB were independent risk factors for ABE [ OR(95% CI) were 2.924 (1.209-7.073), 1.006 (0.997-1.014), and 2.647 (1.841-3.805), respectively]. When the peak TSB was 380.05 μmol/L and the B/A ratio at peak TSB was 10.45, the sensitivity for predicting ABE was 0.963, the specificity was 0.789, and the area under the receiver operating characteristic curve was 0.752. Conclusions:Isoimmune hemolysis, peak TSB, and B/A ratio at peak TSB are independent risk factors for ABE. The B/A ratio at peak TSB and peak TSB can effectively predict ABE.

Objective:To investigate the risk factors for severe hyperbilirubinemia complicated by acute bilirubin encephalopathy (ABE), and the value of total serum bilirubin (TSB) and bilirubin (B)/albumin (A) ratio in predicting ABE.Methods:Clinical data of children with severe hyperbilirubinemia admitted to the Affiliated Hospital of Inner Mongolia Medical University, Ordos Central Hospital, People's Hospital of Inner Mongolia Autonomous Region, the Fourth Hospital of Baotou, Tongliao Hospital, Maternal and Child Health Hospital of Hohhot, the Affiliated Hospital of Chifeng University, Manzhouli People's Hospital, and Chifeng Hospital from January 1, 2020, to December 31, 2021, were retrospectively collected. The subjects were divided into ABE and non-ABE groups based on the occurrence of ABE. Multivariate logistic regression analysis was used to identify high-risk factors for ABE. Statistical analysis was performed using t-test, Wilcoxon signed-rank test, or Chi-square tests. Indicators with statistically significant differences were included in the multivariate logistic regression model, and stepwise regression was used to analyze the influencing factors of ABE. Results:(1) A total of 543 children were included in this study, accounting for 3.7% (543/14 831) of the total admissions during the same period. Among the 543 children, 81 (14.9%) had ABE, and 462 (85.1%) did not. The age at admission was (7.2±2.1) d, and the length of hospital stay was (5.2±2.2) d. The breastfeeding initiation time was 2 d (1-4 d) after birth. The peak TSB of the 543 cases was (385.98±51.22) μmol/L, and the age at peak TSB was (4.4±2.1) d. Fourteen cases (2.5%) gradually reached the peak TSB after admission [(392.01±61.24) μmol/L], while 529 cases (97.5%) had already reached the peak TSB at admission [(386.42±50.22) μmol/L]. Among the 543 cases, 356 had a clear etiology (65.6%, with 278 cases having a single cause and 78 cases having more than two causes), and 187 cases (34.4%) had an unknown etiology. (2) Compared with the non-ABE group, the breastfeeding initiation in the ABE group was later [6 h (2-6 h) vs. 2 h (1-3 h), Z=－6.87] and the length of hospital stay was longer [(6.5±1.9) d vs. (5.0±2.1) d, t=0.55]. The proportions of breastfeeding, delayed meconium passage, isoimmune hemolysis, and maternal gestational diabetes, as well as peak TSB and B/A ratio at peak TSB, were higher in the ABE group than in the non-ABE group [64.2% (52/81) vs. 36.8% (170/462), χ2=21.96; 16.0% (13/81) vs. 2.4% (11/462), χ2=27.32; 27.2% (22/81) vs. 10.6% (40/462), χ2=16.61; 24.7% (20/81) vs. 13.6% (63/462), χ2=6.50; (442±68) vs. (375±39) μmol/L, t=－8.55; (11.9±1.6) vs. (9.8±1.2), t=－11.61; all P<0.05]. The admission weight, proportion of transfer from the hospital's obstetrics department, unknown etiology, and breast milk jaundice were lower in the ABE group than in the non-ABE group [(3 098±482) vs. (3 278±493) g, t=3.04; 12.3% (10/81) vs. 42.4% (196/462), χ2=30.48; 3.7% (3/81) vs. 39.8% (184/462), χ2=39.83; 0.0% (0/81) vs. 5.8% (27/462), χ2=3.81; all P<0.05]. (3) Isoimmune hemolysis, peak TSB, and B/A ratio at peak TSB were independent risk factors for ABE [ OR(95% CI) were 2.924 (1.209-7.073), 1.006 (0.997-1.014), and 2.647 (1.841-3.805), respectively]. When the peak TSB was 380.05 μmol/L and the B/A ratio at peak TSB was 10.45, the sensitivity for predicting ABE was 0.963, the specificity was 0.789, and the area under the receiver operating characteristic curve was 0.752. Conclusions:Isoimmune hemolysis, peak TSB, and B/A ratio at peak TSB are independent risk factors for ABE. The B/A ratio at peak TSB and peak TSB can effectively predict ABE.

Objective:To understand the clinical features and risk factors of the first seizures in children with febrile seizures, to guide clinicians to take appropriate intervention measures for children with risk factors, and to reduce the incidence of febrile seizures.Methods:A total of 616 children with first-onset febrile seizures admitted in our hospital from August 2016 to August 2018 were enrolled in this study.The clinical characteristics and risk factors of first-onset seizures were retrospectively analyzed.And 601 children with fever but no seizures were randomly selected as the control group.Results:There were 616 children with febrile seizures, including 344 males and 272 females, 584 Hans and 32 Mongolian.A total of 126 cases (20.5%) were under 1 year old, 405 cases (65.8%) were 1-3 years old, and 85 cases(13.7%) were over 3 years old.The upper third of the episodes were acute upper respiratory tract infections[53.6%(330/616)], herpetic angina[25.9% (160/616)], and infant acute rash[10.5%(65/616)]. There were 570 cases(92.5%) with seizures at 38.0 ℃ and above, 16 cases(2.6%)had fever after seizures.A total of 534 cases(86.7%) had seizures within 24 hours of fever, and 608 cases(98.7%) presented with a generalized seizures.The duration of seizures was less than 5 min in 548 cases (89.0%), 5-14 min in 48 cases (7.8%), 15-29 min in 16 cases (2.6%) and more than 30 min in 4 cases (0.4%). Of the 572 patients (92.9%), only one seizure occurred in a single heat stroke.In the clinical type, simple febrile seizures accounted for 88.3%(544/616), complex febrile seizures accounted for 11.0%(68/616), and seizures persisted in 0.7%(4/616). Risk factors analysis showed that age, low sodium, low iron and low zinc, cesarean section, abnormal birth history, vaccine exposure history one week before convulsion, and family history of febrile seizures were statistically different between the febrile seizure group and the control group( P<0.05). Logistic regression analysis found that the age of first febrile seizures, low iron, cesarean section, low sodium and family history of febrile seizures were the independent risk factors for the first episode of febrile seizures ( P<0.05). Conclusion:The first episode of febrile seizures are more common in infants and young children under 3 years old.It is mainly caused by simple febrile seizures.The temperature of seizures is high and it is easy to occur within 24 hours after fever.Viral infection is the most common cause.The risk factors for the first episode of febrile seizures are episode age, low iron, cesarean section, low sodium and family history of febrile seizures.Taking appropriate interventions for risk factors can reduce the incidence of febrile seizures.

Febrile seizure (FS) is the most common type of seizures in infants, toddler, and preschool children. Inlfamma-tory mediators as triggers of fever are considered to be involved in the occurrence of such seizures. There is evidence that FS is accompanied by inlfammation. The potential role of inlfammatory mediators in the development of epilepsy after long term FS has not been fully determined. In this article the inlfammatory reaction, febrile convulsion, and the occurrence of secondary epi-lepsy will be reviewed. The progress in research of the interaction among them at home and abroad will be explored.

BACKGROUNDAn zidovudine (AZT)-substitution regimen containing 24-week stavudine (d4T) followed by long-term AZT for HIV therapy is potential to trade off short-term AZT-related anemia and long-term risks associated with d4T in resource-limited settings. However, evidence is scarce. This study aims to assess the efficacy and safety of AZT-substitution regimen, aiming to find a regimen with better efficacy, less adverse events, and more affordability in resource-limited settings.

METHODSThis prospective, multicenter study enrolled 499 (190 on d4T regimen, 172 on AZT regimen, and 137 on AZT-substitution regimen) HIV-1-infected subjects who initiated combined antiretroviral therapy and attended follow-up visits over 96 weeks from 2009 to 2011. Lamivudine (3TC) and either nevirapine (NVP) or efavirenz (EFV) were the other two drugs in the antiretroviral regimens. Virologic and immunologic responses and adverse events were monitored at baseline and at weeks 4, 12, 24, 36, 48, 60, 72, 84, and 96.

RESULTSIn terms of hematological adverse effects, AZT-substitution group had similar safety profiles to d4T group and was superior to AZT group. In comparison with AZT-substitution group, AZT group was associated with higher risk of developing anemia (adjusted hazard ratio (aHR) for anemia ≥ grade II, 8.44, 95% CI 1.81-39.46) and neutropenia (aHR for neutropenia ≥ grade II, 1.86, 95% CI 1.19-2.93). The prevalence of lipodystrophy in d4T group was 19.5%, while that in AZT-substitution group was zero. As to antiretroviral efficacy, these three groups showed no differences.

CONCLUSIONAZT-substitution regimen provides a relatively safe and effective first-line antiretroviral strategy in resource-limited settings.

Adult ; Anti-HIV Agents ; administration & dosage ; adverse effects ; therapeutic use ; Female ; HIV Infections ; drug therapy ; Humans ; Male ; Middle Aged ; Prospective Studies ; Stavudine ; administration & dosage ; adverse effects ; therapeutic use ; Zidovudine ; administration & dosage ; adverse effects ; therapeutic use

Procalcitonin (PCT), a precursor of hormone calcitonin, is used as an indicator of bacterial infections in recent years. PCT plays an important role in early identiifcation of pathogens, evaluation of the severity of infection, medication guidance and prognosis judgment in children with community acquired pneumonia.

Objective To evaluate the expression of epidermal growth factor-like domain 7 (Egfl7) in atherosclerotic plaques and effects of its small interference RNA (siRNA) on angiogenesis gene expression in human endothelial cell line (HUVEC). MethodsEgfl7 expression in atheroscleroticplaquesweredetectedinhumaniliacarteryandmousearteriaeusing immunohistochemistry and immunofluorescence stainings.The siRNA targeting Egfl7 was transfected into HUVEC by lipofectamine with non-transfected cells and unconcerned siRNA as controls.At 0 h,12 h,24 h and 48 h after intervention,the levels of mRNA and protein of Egf17,vascular endothelial growth factor(VEGF),platelet derived growth factor-A (PDGF-A),platelet derived growth factor-B (PDGF-B),vascular cell adhesion molecule(VCAM) and intercellular adhesion molecule (ICAM)were measured by RT-PCR and Western blotting,respectively. ResultsThe expressions of Egfl7 in human iliac artery and mouse arteriae were increased.The expressions of Egfl7 in HUVEC at the levels of mRNA were[(0.14±0.02),(0.09±0.01),(0.02±0.01)]and the levels of protein[(0.71±0.11),(0.39±0.09),(0.07±0.01)]at 12 h,24 h and 48 h after siRNA intervention,respectively,which were decreased as compared with 0 h intervention [(0.31 ±0.05) and (0.93±0.08) ].Other genes such as VEGF,PDGF-A and PDGF-B were reduced or silenced at the levels of protein and mRNA in HUVEC with siRNA longer interventions(all P＜0.05).ConclusionsThe expression of Egfl7 in atherosclerotic plaques is increased.The siRNA inhibiting Egfl7 gene expression results in silence of other factors involved in angiogenesis.

Objective To study the molecular mechanism of atherosclerosis induced by intravascular pressure.Methods Technic aortic coarctation (TAC) was performed in ApoE-/-mice (n＝8) and control littermate (n＝8) mice.HE staining was performed in the vessels upstream and downstream of the mice models.In vitro,hypoxia inducible factor-1a (HIF-1α),heme oxygenase,reactive oxygen species and phosphorylated AMP activated protein kinase (AMPK) were analyzed in different intravascular pressure with a myograph system that allowed independent variation of flow and pressure.Results After one month of TAC,ApoE/ mice in a normal chow diet developed occlusive plaque and accelerated atherosclerotic lesions exclusively in upstream high-pressure vessel segments.In vitro,HIF-1α was increased,heme oxygenase was higher over(2.7 ±0.6) fold,reactive oxygen species and phosphorylated AMPK were also enhanced in high intravascular pressure perfused vessel segments as compared with low intravascular pressure perfused vessel segments (all P＜0.05).Conclusions Intravascular pressure elevation can activate hypoxia and metabolism-associated pathways in the arterial wall,and predispose atherosclerosis accelerated.