[Objective] To study on the genotyping of a sample with inconsistent forward and reverse serological tests, and to conduct a pedigree investigation and molecular biological mechanism study. [Methods] The ABO blood group of the proband and his family members were identified using blood group serological method. The ABO gene exon 1-7 of samples of the proband and his family were sequenced by Sanger and single molecule real-time sequencing (SMRT). DeepTMHMM was used to predict and analyze the transmembrane region of proteins before and after mutation. [Results] The proband and his mother have the Bw phenotype, while his maternal grandfather has ABw phenotype. The blood group results of forward and reverse typing of other family members were consistent. ABO gene sequencing results showed that there was B new mutation of c.3 G>C in exon 1 of ABO gene in the proband, his mother and grandfather, leading to a shift in translation start site. DeepTMHMM analysis indicated that the shift in the translation start site altered the protein topology. [Conclusion] The c.3G>C mutation in the first exon of the ABO gene leads to a shift in the translation start site, altering the protein topology from an α-transmembrane region to a spherical signaling peptide, reducing enzyme activity and resulting in the Bw serological phenotype.

Objective:To analysis of the efficacy and safety of entecavir monotherapy and entecavir combined with probiotic therapy in the treatment of hepatitis B cirrhosis.Methods:A total of 88 patients with hepatitis B cirrhosis diagnosed and treated in Binzhou Central Hospital from May 2020 to May 2022 were prospectively selected as the study objects, and divided into the control group (44 cases) and the observation group (44 cases) according to random number table method. The control group was given entecavir monotherapy, and the observation group was given entecavir combined with probiotics. The levels of intestinal flora, blood ammonia (BUN), liver function index and liver fibrosis were compared between the two groups before and after treatment, and the clinical efficacy after 3 months of treatment and the occurrence of adverse reactions during treatment were compared between the two groups.Results:After treatment, the ratio of harmful/beneficial bacteria, serum BUN, total bilirubin (TBIL), alanine aminotransferase (ALT), azelaic aminotransferase (AST), glutamyltransferase (GGT), pre-collagen type Ⅲ(PCⅢ), collagen type Ⅳ (Ⅳ-C), laminin (LN), and hyaluronidase (HA) in the observation group were lower than those in the control group: (10.52 ± 1.35)% vs. (11.38 ± 2.19)%, (70.26 ± 6.94) μmol/L vs. (76.34 ± 10.59) μmol/L, (32.76 ± 4.27) μmol/L vs. (36.82 ± 6.41) μmol/L, (51.82 ± 6.37) U/L vs. (56.34 ± 5.74) U/L, (37.83 ± 5.61) U/L vs. (42.75 ± 12.89) U/L, (42.67 ± 11.84) U/L vs. (48.16 ± 13.49) U/L, (118.76 ± 23.65) μg/L vs. (129.24 ± 21.16) μg/L, (74.34 ± 17.58) μg/L vs.(82.39 ± 20.05) μg/L, (127.65 ± 12.23) mg/L vs. (138.97 ± 11.76) mg/L, (107.78 ± 23.47) mg/L vs. (119.65 ± 22.35) mg/L, there were statistical differences ( P<0.05). During the 3-month treatment period, the total effective rate in the observation group was higher than that in the control group and the total incidence of adverse reactions was lower than that in the control group: 88.64%(39/44) vs. 70.45%(31/44), 4.55%(2/44) vs. 18.18%(8/44), there were statistical differences ( χ2 = 4.47, 4.06, P<0.05). Conclusions:In the treatment of hepatitis B cirrhosis patients, entecavir combined with probiotics can effectively regulate gastrointestinal function, reduce BUN level, and then more conductive to liver function recovery, reduce the process of liver fibrosis, improve efficacy, and reduce the occurrence of adverse reactions.

Objective:To analysis of the efficacy and safety of entecavir monotherapy and entecavir combined with probiotic therapy in the treatment of hepatitis B cirrhosis.Methods:A total of 88 patients with hepatitis B cirrhosis diagnosed and treated in Binzhou Central Hospital from May 2020 to May 2022 were prospectively selected as the study objects, and divided into the control group (44 cases) and the observation group (44 cases) according to random number table method. The control group was given entecavir monotherapy, and the observation group was given entecavir combined with probiotics. The levels of intestinal flora, blood ammonia (BUN), liver function index and liver fibrosis were compared between the two groups before and after treatment, and the clinical efficacy after 3 months of treatment and the occurrence of adverse reactions during treatment were compared between the two groups.Results:After treatment, the ratio of harmful/beneficial bacteria, serum BUN, total bilirubin (TBIL), alanine aminotransferase (ALT), azelaic aminotransferase (AST), glutamyltransferase (GGT), pre-collagen type Ⅲ(PCⅢ), collagen type Ⅳ (Ⅳ-C), laminin (LN), and hyaluronidase (HA) in the observation group were lower than those in the control group: (10.52 ± 1.35)% vs. (11.38 ± 2.19)%, (70.26 ± 6.94) μmol/L vs. (76.34 ± 10.59) μmol/L, (32.76 ± 4.27) μmol/L vs. (36.82 ± 6.41) μmol/L, (51.82 ± 6.37) U/L vs. (56.34 ± 5.74) U/L, (37.83 ± 5.61) U/L vs. (42.75 ± 12.89) U/L, (42.67 ± 11.84) U/L vs. (48.16 ± 13.49) U/L, (118.76 ± 23.65) μg/L vs. (129.24 ± 21.16) μg/L, (74.34 ± 17.58) μg/L vs.(82.39 ± 20.05) μg/L, (127.65 ± 12.23) mg/L vs. (138.97 ± 11.76) mg/L, (107.78 ± 23.47) mg/L vs. (119.65 ± 22.35) mg/L, there were statistical differences ( P<0.05). During the 3-month treatment period, the total effective rate in the observation group was higher than that in the control group and the total incidence of adverse reactions was lower than that in the control group: 88.64%(39/44) vs. 70.45%(31/44), 4.55%(2/44) vs. 18.18%(8/44), there were statistical differences ( χ2 = 4.47, 4.06, P<0.05). Conclusions:In the treatment of hepatitis B cirrhosis patients, entecavir combined with probiotics can effectively regulate gastrointestinal function, reduce BUN level, and then more conductive to liver function recovery, reduce the process of liver fibrosis, improve efficacy, and reduce the occurrence of adverse reactions.

Objective To investigate the characteristics of epitope distribution on HLA class Ⅰ antigen in the regular platelet donors from Nanjing area and establish the HLA epitope database for regular platelet donors.Methods High-resolution HLA typing was per-formed using Sanger method for the blood samples from 649 regular platelet donors in Nanjing area.The polymorphism of HLA antigen epitopes corresponding to the high-resolution HLA typing results was analyzed using the HLA Eplet Registry website.The frequencies of allele frequencies,HLA haplotype,and HLA antigen epitope were calculated by using the direct counting method.Results Among the 649 regular platelet donors,38 HLA-A alleles were detected,corresponding to 36 HLA-A epitopes,and the higher frequencies were 79GT,144K and 138MI.Seventy-three HLA-B alleles were detected corresponding to 35 HLA-B epitopes,and the higher frequencies were 131S,69TNT,and 80N.Sixty-four HLA class Ⅰ antigen epitopes were detected,in which the higher frequencies were 79GT,131S,and 144K.Conclusions The distribution of HLA antigen epitopes in the regular platelet donors of Nanjing area exhibited u-nique polymorphic characteristics.The epitope matching strategies should be established based on the distribution characteristics of HLA antigen epitopes,which may expand the range of available donors and reduce the incidence of platelet transfusion refractoriness.