Objective: To analyze the demographic characteristics of patients with red blood cell transfusion reactions, the usage of red blood cell preparations, and the differences in the composition ratio of adverse reactions based on multi-center data from the Haemovigilance Network, in order to reveal the clinical characteristics of red blood cell transfusion and its underlying issues. Methods: Clinical data of patients who experienced transfusion reactions after red blood cell transfusion in the Haemovigilance Network from 2018 to 2023 were collected. The demographic characteristics of patients who experienced transfusion reactions with different types of red blood cell preparations, the utilization of these preparations, and the differences of the composition ratios of transfusion reactions were analyzed. Count data were expressed as numbers (n) or percentages (%), and comparisons between groups were performed using the Chi-square test. Results: Red blood cell transfusion reactions were more common in females (53.56%), with the majority of patients aged 50-69 years (35.54%). The Han polulation accounted for the vast majority of patients (92.77%), and patients in the hematology and obstetrics/gynecology departments had a relatively high proportion of transfusion reactions (13.26% and 14.26%, respectively). Leukocyte-reduced red blood cells and suspended red blood cells were the most common types of transfusion reactions reported among red blood cell preparations. Allergic reactions and non-hemolytic febrile reactions were the most common transfusion reactions, and there were significant differences in the composition ratios of allergic reactions (χ =869.89, P<0.05) and non-hemolytic febrile reactions (χ =812.75, P<0.05) across various types of red blood cell preparations. Conclusion: There are differences in the demographic characteristics and composition ratio of transfusion reactions among different red blood cell preparations. The management of red blood cell transfusion reactions should be tailored to patient characteristics and conditions, and the selection and use of blood products should be optimized to reduce or avoid the occurrence of transfusion reactions, such as considering the use of washed red blood cells for patients with a history of transfusion allergies or those prone to allergies.

OBJECTIVE To develop a population pharmacokinetic （PPK） model for mycophenolate mofetil active metabolite mycophenolic acid （MPA） in children with primary IgA nephropathy， explore the factors affecting the pharmacokinetic parameters of MPA， and provide a basis for clinical individualized therapy. METHODS Retrospective collection was conducted on 636 concentrations and clinical data from 47 pediatric patients with primary IgA nephropathy. PPK analysis was carried out by using the nonlinear mixed-effects model； the covariates were tested with a stepwise method. Goodness-of-fit plots， Bootstrap and visual predictive check were employed to evaluate the final model. RESULTS The pharmacokinetics of MPA in children with IgA nephropathy in vivo conformed to the first-order absorption and elimination two-compartment model （objective function value of 3 276.31）. Covariate analysis suggested that body weight and albumin （ALB） levels were significant influencing factors on apparent clearance rate and apparent distribution volume. The typical values of PPK parameters of MPA in the final model were as follows： the central room had a distributed volume of 5.79 L， the clearance rate was 4.06 L/h， the volume of peripheral ventricular distribution was 430.93 L， the clearance rate between compartments was 15.40 L/h， the oral absorption rate constant was 1.29 h－1. After verification， most of the predicted corrected observed concentration points were within the 90% confidence interval of the predicted corrected simulated concentration， indicating that the MPA final model had good predictive performance. CONCLUSIONS The PPK model of MPA in children with primary IgA nephropathy is established in this study， identifying body weight and ALB levels are significant factors affecting MPA metabolism.

Objective To investigate the effects of long intergenic non-coding RNA 467(linc00467)on the proliferation,apoptosis and migration,invasion ability of endometrial carcinoma cells.Methods Human endometrial carcinoma cells HC1A,Ishikawa,KLE and RL-95-2 were cultured in vitro,the expression level of linc00467 in the four cells was detected by real-time fluorescence quantitative polymerase chain reaction(RT-qPCR).Endometrial carcinoma cell lines HEC-1A and Ishikawa with the highest linc00467 expression levels were selected for subsequent experiment.Two Iinc00467 lentivirus silencing expression vectors of sh-linc00467#1 and sh-linc00467#2,and empty lentivirus plasmids were constructed,respectively;the HEC-1A and Ishikawa cells in logarithmic growth phase were divided into sh-NC group,sh-linc00467#1 group,and sh-linc00467#2 group.The cells in the sh-NC group were transfected with empty lentivirus plasmids,the cells in the sh-linc00467#1 group and sh-linc00467#2 group were transfected with sh-linc00467#1 and sh-linc00467#2,respectively;the relative expression level of linc00467 in cells of the three groups was detected by RT-qPCR,the proliferation ability of cells in the three groups was detected by 5-ethynyl-2-deoxyuridine(EdU)assay and colony formation assay,the migration ability of cells in the three groups was detected by scratch assay,the invasion ability of cells in the three groups was detected by Transwell assay,and the cell apoptosis in the three groups was detected by flow cytometry.Results The relative expression level of linc00467 mRNA in HEC-1A cells was significantly higher than that in KLE and RL-95-2 cells(P＜0.05);the relative expression level of linc00467 mRNA in Ishikawa cells was significantly higher than that in KLE and RL-95-2 cells(P＜0.05);there was no statistically significant difference in the relative expression level of linc00467 mRNA between HEC-1A and Ishikawa cells(P＞0.05);the relative expression level of linc00467 mRNA in KLE cells was significantly lower than that in RL-95-2 cells(P＜0.05).The relative expression levels of linc00467 mRNA in HEC-1A and Ishikawa cells in the sh-linc00467#1 group and sh-linc00467#2 group were significantly lower than those in the sh-NC group(P＜0.01);there was no statistically significant difference in the relative expression level of linc00467 mRNA in HEC-1A and Ishikawa cells between the sh-linc00467 # 1 group and the sh-linc00467#2 group(P＞0.05).The number of EdU positive HEC-1A and Ishikawa cells in the sh-linc00467#1 group and sh-linc00467#2 group was significantly lower than that in the sh-NC group(P＜0.01);there was no statistically significant difference in the number of EdU positive HEC-1A and Ishikawa cells between the sh-linc00467#1 group and sh-linc00467#2 group(P＞0.05).The number of cloned HEC-1A and Ishikawa cells in the sh-linc00467#1 group and sh-linc00467#2 group was significantly lower than that in the sh-NC group(P＜0.01);there was no statistically significant difference in the number of cloned HEC-1A and Ishikawa cells between the sh-linc00467#1 group and sh-linc00467#2 group(P＞0.05).The apoptosis rates of HEC-1A and Ishikawa cells in the sh-linc00467#1 group and sh-linc00467#2 group were significantly higher than that in the sh-NC group(P＜0.01);there was no statistically significant difference in the apoptosis rates of HEC-1A and Ishikawa cells between the sh-linc00467#1 group and sh-linc00467 #2 group(P＞0.05).The scratch healing rates of HEC-1A and Ishikawa cells in the sh-linc00467#1 group and sh-linc00467#2 group were significantly lower than those in the sh-NC group(P＜0.01);there was no statistically significant difference in the scratch healing rates of HEC-1 A and Ishikawa cells between the sh-linc00467#1 group and sh-linc00467#2 group(P＞0.05).The number of invasive cells of HEC-1 A and Ishikawa in the sh-linc00467#1 group and sh-linc00467#2 group was significantly lower than that in the sh-NC group(P＜0.01);there was no statistically significant difference in the number of invasive cells of HEC-1 A and Ishikawa between the sh-linc00467#1 group and sh-linc00467#2 group(P＞0.05).Conclusion Down-regulation of linc00467 expression can inhibit the proliferation,migration and invasion,and promote apoptosis of endometrial carcinoma cells.

Objective:To explore the relationship between thyroid hormone sensitivity and obesity phenotype in people with normal thyroid function.Methods:In this retrospective study, 6155 euthyroid subjects who underwent a health check-up in the First Hospital of China Medical University between January 2017 and December 2018 were included. Participants were categorized into four obesity phenotypes according to body mass index and metabolic status. Thyroid Feedback Quantile-based Index(TFQI), Parametric TFQI, free triiodothyronine to free thyroxine ratio(FT 3/FT 4), and sum activity of peripheral deiodinases(SPINA-GD) were calculated to evaluate thyroid hormone sensitivity. Results:Compared with metabolically healthy non-obese(MHNO) phenotype, the subjects with metabolically healthy obese(MHO) or metabolically unhealthy obese(MUO) phenotype showed higher FT 3/FT 4ratio. Metabolically unhealthy non-obese(MUNO) and MUO subjects showed lower TFQI. After adjusting for confounders, FT 3/FT 4ratio was positively associated with MHO( OR 1.18, 95% CI 1.11-1.26) and MUO phenotype( OR 1.28, 95% CI 1.19-1.39). With 1 s increase of TFQI, the OR for MUNO phenotype was 0.77(95% CI 0.64-0.94). The results of Parametric TFQI and SPINA-GD were similar to TFQI and FT 3/FT 4ratio, respectively. Conclusion:In euthyroid individuals, thyroid hormone sensitivity was positively associated with increased risk for unhealthy obesity phenotypes.

【Objective】 To establish RH gene mRNA sequencing method based on nanopores sequencing and to explore the RHD and RHCE mRNA transcripts in D positive and D^el individuals. 【Methods】 From March 2021 to May 2022, 5 RhD positive samples and 5 D^el samples screened out by hospitals in Chengdu were sent to our laboratory for futher examination. The erythrocytes and buff coat were isolated, then DNA and RNA were extracted.All 10 samples were genotyped by PCR-SSP. After the mRNA was reversely transcribed into cDNA, the full-length mRNA of RHD and RHCE genes were simultaneously amplified by a pair of primers. Sanger sequencing and third-generation sequencing technology based on Nanopore were used to sequence the amplified products, and the types and expressions of different splices of RHD and RHCE gene mRNA transcripts were analyzed. 【Results】 The method established in this study can simultaneously amplify the full length transcripts of RHD and RHCE. Ten different RHD gene mRNA transcripts and nine RHCE gene mRNA transcripts were detected in 10 samples. RHD full-length transcript (RHD-201) can be detected in RhD D^el type, but the expression amount was significantly lower than that in RhD positive samples. The expression amount of transcript RHD-207 (Del789) in D^el samples was significantly higher than that in RhD positive samples. The transcript RHD-208 (Del8910+ 213) was only detected in RhD D^el type individuals, and no significant difference was found between other RHD transcripts and all RHCE transcripts in the two phenotypes. 【Conclusion】 In this study, an analytical method for sequencing full-length transcript isomers of RHD and RHCE mRNA via the third generation was successfully established, and complex alternative splicing patterns were found in RHD and RHCE genes, providing a new method for the study of alternative splicing of blood group gene variants mRNA.

【Objective】 To analyze the genetic background of RhD-negative blood donors by detecting RHD and RHCE genes of those donors. 【Methods】 From March 2021 to May 2022, the blood samples of RhD-negative blood donors, who had been screened out by RhD primary screening and confirmatory experiments in the Yaan Blood Center, were firstly identified whether the RHD allele was completely deleted, then whether there were deletions in 10 exons of non-RHD allele complete deletion samples, finally, the remaining samples without RHD alleles and exon deletions were further analyzed by DNA sequencing. RHCE gene was detected by SSP-PCR method. 【Results】 Among the RHD gene test results of 104 RhD-negative samples, 65 cases were completely deleted (d/d), 33 were RHD partially deleted (one allele deletion), and 6 were without RHD gene deletion. The RHD alleles of 33 samples with partial deletion were detected by 10 exons, 13 had partial exon deletion, with genotype as RHD^*D-CE(3-9)-D/d and phenotype as RhD negativity, and the remaining 20 samples had no exon deletion. The exon sequencing results of the non-deletion samples showed RHD^*1227A/RHD^*1227A in 6 samples, RHD^*1227A/d in 19, RHD^*3A/d in 1; both of the last two were considered D^el by ISBT. The RHCE gene test results showed that all cc genotype blood donors were RhD true negative, while D^el blood donors had no cc genotype. 【Conclusion】 Through the genetic background study of RhD negative blood donors, it is found that there is a high proportion of D^el with weak expression of RhD antigen, whether this blood type affects clinical blood safety needs further researches.

Multiple lines of evidence, including anti-inflammatory effects of vitamin D and the association of lower circulating vitamin D levels with the higher risk and worse outcomes in patients with coronavirus disease 2019 (COVID-19), suggested a potential role for vitamin D to prevent and treat COVID-19. However, existing results from quasi-experimental studies and clinical trials do not support routine use of high-dose vitamin D to curb COVID-19. It is still important to emphasize on correction of vitamin D deficiency before more results of ongoing clinical trials become available.

The thyroid function test is universally used for the evaluation of thyroid function. However, there are factors other than endocrine diseases, such as special physiological conditions, interference in laboratory measurement, or disorders in other systems that should be taken into consideration. When encountering thyroid function test results that are not in line with clinical manifestation, a comprehensive evaluation is essential for a correct and timely diagnosis. We presented a case of a significant rise in serum total triiodothyronine(TT 3) secondary to multiple myeloma. Through case studies and literature review, we intended to provide clinicians with experience for better interpretation of abnormal thyroid function test results.

Objective:To investigate the correlation between concomitant diabetes mellitus and clinical features in patients with COVID-19.Methods:Fifty patients with COVID-19 admitted to the Sixth People′s Hospital of Shenyang were divided into 2 groups with and without diabetes mellitus. Indexes such as hospitalization days, duration of positive virus-PCR result, secondary infection, duration of fever, rate of liver dysfunction, and rate of cardiac injury were compared between 2 groups.Results:The average hospitalization durations of diabetes group and control group were(24.0±6.8) and(18.4±5.9) days, respectively, and the duration of positive virus-PCR testing results were(16.0±4.5) and(12.3±4.4) days respectively, suggesting longer hospital stay and longer time for virus clearance in the diabetes group than those in the control group(both P<0.05). The rates of secondary infection, severe subtype, liver dysfunction and cardiac injury in the diabetes group increased, though without significant difference( P>0.05). Conclusion:Prolonged duration of positive virus-PCR result and average days of hospitalization in patients with COVID-19 may be associated with diabetes mellitus.