Objective: To conduct screening for rare blood types within important blood group systems for the Chinese population, such as Rh, Duffy, Kidd, P1Pk, Diego, and MNS, in the Guangzhou region, and to establish a corresponding rare blood type database and physical repository. Methods: The saline medium microplate method was used to screen blood donors with the ccDEE phenotype combined with either Jk(a-) or Jk(b-). The polybrene microplate method was employed to screen for donors with Fy(a-), s(-), Lu(b-), Di(b-), k(-), and p phenotypes. The urea lysis microplate method was applied to screen for the Jk(a-b-) phenotype. A high-resolution melting (HRM) curve method was established for screening some donors with the Di(b-) phenotype. Subsequently, expanded phenotyping of antigens in the Rh, Kidd, MNS, Duffy, P1Pk, Lewis, Kell, and Lutheran blood group systems was performed on identified rare blood type donors using monoclonal antibodies. The test results are entered into the Rare Blood Type Bank Management System of the Guangzhou Blood Center, enabling functions such as confirmation reminders and cryopreservation storage when the donor donates again. Red blood cells of rare blood types are processed into frozen red blood cells for long-term storage. Results: Among voluntary blood donors, 16 cases of the ccDEE combined with Jk(a-) phenotype were identified (0.221 7%, 16/7 216); 10 cases of the ccDEE combined with Jk(b-) phenotype (0.138 6%, 10/7 216); 78 cases of the Fy(a-) phenotype (0.169 5%, 78/46 012); 39 cases of the Lu(b-) phenotype (0.138 2%, 39/28 214); 31 cases of the s(-) phenotype (0.081 8%, 31/37 913); 22 cases of the Di(b-) phenotype (0.029 9%, 22/73 691); 30 cases of the Jk(a-b-) phenotype (0.010 1%, 30/298 250); and 1 case of the k(-) phenotype (0.001 3%, 1/77 382), which was further identified as KELnull phenotype (K0). No p phenotype donors were identified (0/88 528). A total of 228 units of frozen red blood cells were prepared. The screening results were compared and analyzed with rare blood type data from other regions. Conclusion: This study, through a combination of different screening methods, significantly improved the efficiency of rare blood type screening while remaining cost-effective. By conducting large-scale screening and performing data informatization processing, a database and physical repository of rare blood types in the Guangzhou region were successfully established. This provides a strong guarantee for the timely supply of blood to patients with difficult-to-match and rare blood types in the region, effectively enhances the level of transfusion safety in the region, and offers a practical paradigm for constructing a comprehensive blood transfusion support system.

Objective:To investigate the characteristics of elastic program of excited shear wave of plantar soft tissue of diabetic patients and its correlation with levels of glucose metabolism.Methods:A total of 92 patients with type 2 diabetes who admitted to Cangzhou Hospital of Integrated Traditional Chinese Medicine and Western Medicine during January 2022 and January 2023 were selected as diabetes group,and another 92 patients in the prediabetes stage were included in the prediabetes group.Both groups of patients used excited shear wave with different frequencies(400,450,500,550,and 600 Hz)under elastic technique of shear wave.The velocities of shear waves at the 1st metatarsal head,the 3rd metatarsal head and calcaneus of plantar soft tissue,and the thickness of soft tissue of these patients were assessed.The fasting plasma glucose(FPG),2-hour postprandial glucose(2hPG),and glycosylated hemoglobin(HbA1c)levels of sugar metabolism level of two groups were measured,and the correlations between velocity of shear wave,thickness of soft tissue,and level of glucose metabolism were further analyzed.The occurrence of diabetic foot ulcer in the diabetes group was investigated by using follow-up.The receiver operating characteristic(ROC)curve was adopted to assess the predictive value of the velocity of shear wave,and the thickness of soft tissue for diabetic foot ulcer.Results:The FPG,2hPG and HbA1c of glucose metabolism level in the diabetes group were(6.48±0.48)mmol/L,(9.64±1.31)mmol/L and(6.21±0.15)%,respectively,all of which were higher than those[(8.03±0.62)mmol/L,(12.26±1.25)mmol/L and(7.66±0.42)%]in the prediabetes group,and the differences were statistically significant(t=18.961,18.961,31.185,P<0.05).The thickness level of soft tissue at the first metatarsal head was(10.42±3.11)mm in the diabetes group,which was less than(11.76±3.24)mm in the prediabetes group,with a statistically significant difference(t=2.862,P<0.05).Spearman correlation analysis showed that the velocity of shear wave at 500 Hz frequency had a strongest correlation with FPG and HbA1c(r=0.320,0.256,P<0.05),respectively.In the follow-up for patients of diabetes group,14 cases occurred ulcers and 78 cases did not occur ulcers.The velocities of shear wave of the first metatarsal head of 14 patients with ulcers were higher than those of patients without ulcers at all tested frequencies(400,450,500,550,and 600 Hz).The area under curve(AUC)value of ROC curve,specificity and sensitivity of 500 Hz were respectively 0.775,88.46%,and 78.57%in predicting plantar ulcer of patients with diabetes.Conclusion:The velocity of shear wave of soft tissue at the first metatarsal head is significantly correlated with abnormal glucose metabolism in patients with type 2 diabetes.The velocity of shear wave appeared strongest correlation with FPG and HbA1c at500 Hz frequency,which has higher predictive value for diabetic foot ulcer.

Objective:To investigate the impact and mechanism of polydatin(PD)on lipopolysaccharide(LPS)induced in-flammatory damage in pancreatic acinar cells.Methods:Rat pancreatic exocrine cells AR42J were cultured in vitro,LPS treated cells were used to construct a cell inflammatory injury model,and co-cultured with 0,12.5,25,50,100 and 200 μg/L PD,CCK-8 method was applied to detect cell proliferation activity;AR42J cells were grouped into blank group(CT group),inflammatory injury model group(M group),PD group(100 μg/L),and PD+WZ811 group[stromal cell derived factor 1(SDF-1)/CXC chemokine receptor 4(CXCR4)pathway inhibitor](100 μg/L PD+1 μmol/L WZ811),dinitrophenylhydrazine method was applied to detect the leakage rate of lactate dehydrogenase(LDH)in each group of cells,flow cytometry was applied to detect cell apoptosis rate,ELISA kit was ap-plied to determine the levels of IL-1β and TNF-α in cell supernatant,thiobarbituric acid method were applied to determine the content of malondialdehyde(MDA),Xanthine oxidation method was applied to measure superoxide dismutase(SOD)activity,immunofluo-rescence staining was applied to detect the expressions of SDF-1 and CXCR4 proteins.Results:Compared with 0 μg/L group,100 μg/L and 200 μg/L PD obviously increased cell proliferation activity;compared with the CT group,the leakage rate of LDH,apoptosis rate,and the contents of IL-1β,TNF-α and MDA of cells in the M group increased,the SOD activity and expressions of SDF-1 and CXCR4 proteins decreased(P<0.05);compared with the M group,the leakage rate of LDH,apoptosis rate,and the contents of IL-1β,TNF-α and MDA of cells in the PD group decreased,the SOD activity and expressions of SDF-1 and CXCR4 proteins increased(P<0.05);compared with the PD group,the leakage rate of LDH,apoptosis rate,and the contents of IL-1β,TNF-α,and MDA of cells in the PD+WZ811 group increased,the SOD activity and expression of SDF-1 and CXCR4 proteins decreased(P<0.05).Conclusion:The protective effect of PD on LPS-induced inflammatory damage in AR42J cells may be related to the activation of the SDF-1/CXCR4 signaling pathway.

Objective:To investigate the characteristics of elastic program of excited shear wave of plantar soft tissue of diabetic patients and its correlation with levels of glucose metabolism.Methods:A total of 92 patients with type 2 diabetes who admitted to Cangzhou Hospital of Integrated Traditional Chinese Medicine and Western Medicine during January 2022 and January 2023 were selected as diabetes group,and another 92 patients in the prediabetes stage were included in the prediabetes group.Both groups of patients used excited shear wave with different frequencies(400,450,500,550,and 600 Hz)under elastic technique of shear wave.The velocities of shear waves at the 1st metatarsal head,the 3rd metatarsal head and calcaneus of plantar soft tissue,and the thickness of soft tissue of these patients were assessed.The fasting plasma glucose(FPG),2-hour postprandial glucose(2hPG),and glycosylated hemoglobin(HbA1c)levels of sugar metabolism level of two groups were measured,and the correlations between velocity of shear wave,thickness of soft tissue,and level of glucose metabolism were further analyzed.The occurrence of diabetic foot ulcer in the diabetes group was investigated by using follow-up.The receiver operating characteristic(ROC)curve was adopted to assess the predictive value of the velocity of shear wave,and the thickness of soft tissue for diabetic foot ulcer.Results:The FPG,2hPG and HbA1c of glucose metabolism level in the diabetes group were(6.48±0.48)mmol/L,(9.64±1.31)mmol/L and(6.21±0.15)%,respectively,all of which were higher than those[(8.03±0.62)mmol/L,(12.26±1.25)mmol/L and(7.66±0.42)%]in the prediabetes group,and the differences were statistically significant(t=18.961,18.961,31.185,P<0.05).The thickness level of soft tissue at the first metatarsal head was(10.42±3.11)mm in the diabetes group,which was less than(11.76±3.24)mm in the prediabetes group,with a statistically significant difference(t=2.862,P<0.05).Spearman correlation analysis showed that the velocity of shear wave at 500 Hz frequency had a strongest correlation with FPG and HbA1c(r=0.320,0.256,P<0.05),respectively.In the follow-up for patients of diabetes group,14 cases occurred ulcers and 78 cases did not occur ulcers.The velocities of shear wave of the first metatarsal head of 14 patients with ulcers were higher than those of patients without ulcers at all tested frequencies(400,450,500,550,and 600 Hz).The area under curve(AUC)value of ROC curve,specificity and sensitivity of 500 Hz were respectively 0.775,88.46%,and 78.57%in predicting plantar ulcer of patients with diabetes.Conclusion:The velocity of shear wave of soft tissue at the first metatarsal head is significantly correlated with abnormal glucose metabolism in patients with type 2 diabetes.The velocity of shear wave appeared strongest correlation with FPG and HbA1c at500 Hz frequency,which has higher predictive value for diabetic foot ulcer.

Objective:To investigate the impact and mechanism of polydatin(PD)on lipopolysaccharide(LPS)induced in-flammatory damage in pancreatic acinar cells.Methods:Rat pancreatic exocrine cells AR42J were cultured in vitro,LPS treated cells were used to construct a cell inflammatory injury model,and co-cultured with 0,12.5,25,50,100 and 200 μg/L PD,CCK-8 method was applied to detect cell proliferation activity;AR42J cells were grouped into blank group(CT group),inflammatory injury model group(M group),PD group(100 μg/L),and PD+WZ811 group[stromal cell derived factor 1(SDF-1)/CXC chemokine receptor 4(CXCR4)pathway inhibitor](100 μg/L PD+1 μmol/L WZ811),dinitrophenylhydrazine method was applied to detect the leakage rate of lactate dehydrogenase(LDH)in each group of cells,flow cytometry was applied to detect cell apoptosis rate,ELISA kit was ap-plied to determine the levels of IL-1β and TNF-α in cell supernatant,thiobarbituric acid method were applied to determine the content of malondialdehyde(MDA),Xanthine oxidation method was applied to measure superoxide dismutase(SOD)activity,immunofluo-rescence staining was applied to detect the expressions of SDF-1 and CXCR4 proteins.Results:Compared with 0 μg/L group,100 μg/L and 200 μg/L PD obviously increased cell proliferation activity;compared with the CT group,the leakage rate of LDH,apoptosis rate,and the contents of IL-1β,TNF-α and MDA of cells in the M group increased,the SOD activity and expressions of SDF-1 and CXCR4 proteins decreased(P<0.05);compared with the M group,the leakage rate of LDH,apoptosis rate,and the contents of IL-1β,TNF-α and MDA of cells in the PD group decreased,the SOD activity and expressions of SDF-1 and CXCR4 proteins increased(P<0.05);compared with the PD group,the leakage rate of LDH,apoptosis rate,and the contents of IL-1β,TNF-α,and MDA of cells in the PD+WZ811 group increased,the SOD activity and expression of SDF-1 and CXCR4 proteins decreased(P<0.05).Conclusion:The protective effect of PD on LPS-induced inflammatory damage in AR42J cells may be related to the activation of the SDF-1/CXCR4 signaling pathway.

The Chinese Pharmacopoeia 2025 Edition added the 9213 Guideline for validation,verification,and transfer of microbiological analytical methods.Based on the characteristics of pharmaceutical microbiological analyt-ical methods and practical applications,it specified definitions of relevant terms and application scenarios,estab-lished technical indicators and acceptance criteria for methodological evaluation,and introduced key statistical tools and evaluation principles.This article systematically elaborates on the drafting background and process of the Guideline,and interprets its key content,aiming to offer theoretical guidance and practical reference for relevant practitioners in applying this guideline.This guideline strengthens the foundation of pharmaceutical microbial analytical methods in China and enhances the scientificity and accuracy of the pharmaceutical microbial standards system.

OBJECTIVE To carry out regular monitoring of carbapenem-resistant Klebsiella pneumoniae(CRKP)contamination status in the environment of intensive care unit(ICU)and take targeted prevention and control measures so as to reduce the incidence of hospital-associated infections with multidrug-resistant organisms(MDROs).METHODS The surfaces of surroundings of the patients who were colonized and infected with CRKP in the ICU of grade A tertiary hospital of Shanghai and the hands of relevant staff were sampled by stages from Jan 1,2021 to Jun 30,2024.The distribution of the CRKP strains in the surroundings were analyzed according to the locations positive for CRKP,and the disinfection measures were accordingly and continuously modified.The trend of isolation rate of CRKP strains from the ICU patients was analyzed during the time period when the measures were implemented.RESULTS Totally 266 environmental samples were collected during the baseline period(from Jan.1 2021 to Dec.31 2021),265 during intervention period(from Jan.1 2022 to Dec.31 2023),274 during con-solidation period(from Jan.1 to Jun.30 2024);the isolation rates of the CRKP strains were 4.51％,4.91％and 3.65％,respectively.The isolation rate of the strains was highest from the bed unit(10.40％),followed by the article for public use(6.74％),articles used by health care workers(2.98％)and diagnosis and treatment arti-cles(1.91％).The isolation rate of CRKP of the patients was 24.75％during the baseline period,15.48％during the intervention period,5.69％during the consolidation period,showing a continuously downward trend(x2=30.330,P＜0.001).CONCLUSION It is necessary to regularly carry out the environmental monitoring of CRKP strains,seek for the weak links of environmental disinfection and implement the intensified prevention and control measures so as to reduce the incidence of CRKP infection,which may provide theoretical bases for effective control of the CRKP strains.

The Chinese Pharmacopoeia 2025 Edition added the 9213 Guideline for validation,verification,and transfer of microbiological analytical methods.Based on the characteristics of pharmaceutical microbiological analyt-ical methods and practical applications,it specified definitions of relevant terms and application scenarios,estab-lished technical indicators and acceptance criteria for methodological evaluation,and introduced key statistical tools and evaluation principles.This article systematically elaborates on the drafting background and process of the Guideline,and interprets its key content,aiming to offer theoretical guidance and practical reference for relevant practitioners in applying this guideline.This guideline strengthens the foundation of pharmaceutical microbial analytical methods in China and enhances the scientificity and accuracy of the pharmaceutical microbial standards system.

OBJECTIVE To carry out regular monitoring of carbapenem-resistant Klebsiella pneumoniae(CRKP)contamination status in the environment of intensive care unit(ICU)and take targeted prevention and control measures so as to reduce the incidence of hospital-associated infections with multidrug-resistant organisms(MDROs).METHODS The surfaces of surroundings of the patients who were colonized and infected with CRKP in the ICU of grade A tertiary hospital of Shanghai and the hands of relevant staff were sampled by stages from Jan 1,2021 to Jun 30,2024.The distribution of the CRKP strains in the surroundings were analyzed according to the locations positive for CRKP,and the disinfection measures were accordingly and continuously modified.The trend of isolation rate of CRKP strains from the ICU patients was analyzed during the time period when the measures were implemented.RESULTS Totally 266 environmental samples were collected during the baseline period(from Jan.1 2021 to Dec.31 2021),265 during intervention period(from Jan.1 2022 to Dec.31 2023),274 during con-solidation period(from Jan.1 to Jun.30 2024);the isolation rates of the CRKP strains were 4.51％,4.91％and 3.65％,respectively.The isolation rate of the strains was highest from the bed unit(10.40％),followed by the article for public use(6.74％),articles used by health care workers(2.98％)and diagnosis and treatment arti-cles(1.91％).The isolation rate of CRKP of the patients was 24.75％during the baseline period,15.48％during the intervention period,5.69％during the consolidation period,showing a continuously downward trend(x2=30.330,P＜0.001).CONCLUSION It is necessary to regularly carry out the environmental monitoring of CRKP strains,seek for the weak links of environmental disinfection and implement the intensified prevention and control measures so as to reduce the incidence of CRKP infection,which may provide theoretical bases for effective control of the CRKP strains.

Objective To elucidate the prediction ability of monocyte monolayer assay(MMA)used in hemolytic dis-ease of fetus and newborn(HDFN)caused by IgG anti-M.Methods Plasma from eight pregnant women containing IgG an-ti-M were collected,and were divided into two groups(4 cases with HDFN,with severe clinical symptoms such as fetal hy-drops,and 4 cases without HDFN)according to the clinical outcomes.M antigen positive cells were sensitized with dithioth-reitol(DTT)treated plasma from eight pregnant women respectively.MMA was performed by coincubation with monocytes and sensitized M cells,along with negative and positive control set up.T-test was conducted to compare the difference in phagocytic efficiency between two groups.Results The phagocytic efficiency in group with HDFN were 15.37%,13.05%,9.17%and 24.50%respectively,with the mean value of 15.52%,while the group without HDFN were 8.74%,11.07%,5.12%and 6.23%respectively,with the mean value of 7.79%.There was no significant difference in phagocytic efficiency between two groups(P>0.05).The mean values of both groups were not significantly different from the negative control(P>0.05),but both were significantly lower than positive control(P<0.05).Conclusion The low phagocytic efficiency couldn't convince that the MMA is an effective predictor for the HDFN caused by IgG anti-M,indicating that another mech-anism might be responsible for it rather than monocyte phagocytosis.The assessment of the peak systolic velocity in middle cerebral artery of the fetal should be considered in the management for pregnant women who produce IgG anti-M to estimate the situation of fetal anemia.