Objective To investigate the relationship between platelet/hemoglobin ratio(PHR)and the severity of diabetic foot ulcer(DFU)and its predictive value for DFU progression.Methods A retrospective study was performed in 345 DFU patients treated in Department of Endocrinology,the First Affiliated Hospital of Army Medical University from March 2018 to March 2023.Their general demographic information was obtained,and the results of laboratory tests,including hemoglobin Alc(HbA1c),fasting plasma glucose(FPG),biochemical and related blood routine indicators were collected.According to Wanger grading,the patients were assigned into mild(n=145)and severe ulcer groups(n=200).The demographic data and clinical parameters were compared between the 2 groups.Multivariate logistic regression model was applied to identify the independent predictors for severe ulcer in DFU,and receiver operating characteristic(ROC)curve was plotted to evaluate the predictive performance of PHR for DFU progression.Results The severe ulcer group presented remarkable increases in male proportion,HbA1c and FPG levels,platelet(PLT)count and PHR when compared with the mild ulcer group(P＜0.05).Multivariate logistic regression analysis revealed that PHR and male were independent risk factors,while,HDL-C was a protective factor for progression to severe ulcer in DFU patients(P＜0.05).ROC curve analysis showed that the area under the curve of PHR for predicting severe ulcer was 0.701(95％CI:0.646～0.756).Conclusion PHR is strongly associated with the severity of DFU,and shows certain predictive value for the progression to severe ulcer in DFU patients.

Objective:To study the effects of modified maxillary protraction therapy on the changes in facial soft tissue in patients with maxillary hypoplasia using cephalometric measurements.Methods:26 cases(16 males and 10 females)of Class Ⅲ skeletal malocclu-sion with maxillary hypoplasia during the later period of pubertal peak(CVM Ⅴ to Ⅵ)were included.Treatment was carried out using modified palatal anchorage with a combination of a modified bite-jumping appliance and bilateral maxillary anterior traction.Cephalo-metric measurements were taken before and after treatment using lateral cephalograms,the changes in facial soft tissue-related parame-ters were compared.Results:(1)After treatment,the measurements of soft tissue landmarks in the midfacial region showed a signifi-cant increase(P＜0.05),with the average anterior movement exceeding 3 mm for the nasal tip,subnasale,soft tissue A point and upper lip protrusion point.(2)The changes in the G-Sn-Pos,Ns-Prn-Pos,and S-Ns-Sn were highly significant(P＜0.01),with an average increase in the G-Sn-Pos of 3.23°±3.74°,a decrease in Ns-Prn-Pos of 2.56°±4.99°,and an average increase in S-Ns-Sn of 2.63° ±3.39°.(3)Changes in soft tissue tension and facial height proportion after treatment were not statistically significant(P＞0.05).Con-clusion:The use of a modified pad type intraoral appliance in conjunction with bilateral maxillary anterior traction can effectively pro-mote the improvement of mid facial soft tissue profile in patients with maxillary underdevelopment during the peak growth and develop-ment period,and coordinate the relationship between nasal,lip and chin soft tissue.

【Objective】 To explore the impact of the COVID-19 epidemic on platelets supply management and its countermeasures. 【Methods】 Relevant data on platelets collection, supply, daily inventory and adjustment were collected through the blood information management system of our blood center after the outbreak of the epidemic in Xi′an (from December 9, 2021 to February 2, 2022), and then compared with the data during the corresponding period of last year (from December 9, 2020 to February 2, 2021). 【Results】 In this study, in the first half month of the epidemic, the collection and supply of platelets were slightly higher than the same period of the previous year. After the first-level response to the epidemic was initiated, the collection and issuing of platelets decreased significantly compared with the same period of the previous year. Half a month after the home isolation had been gradually lifted, the collection and issuing of platelets increased significantly as compared with the home isolation period. Otherwise, the collection and issuing of platelets had been increased as compared with the same period of the previous year. 【Conclusion】 After the outbreak of the epidemic, the timely adjustment of platelet collection strategy as well as the launch of emergency plan for platelets collection and supply during the first-level response to the epidemic effectively ensured the supply of clinical platelets in Xi′an during the period of home isolation.

【Objective】 To investigate the establishment of multi-center haemovigilance (HV) and the monitoring of adverse reactions to blood donation (ARBD), in order to provide basis for the management of blood donors. 【Methods】 The operation of HV was investigated by questionnaire. The total number of blood donations (including plateletpheresis) and ARBD cases occurred in each blood center from 2014 to 2018 were analyzed. 【Results】 Among the 24 blood centers in this survey, only nine got HV operated. The incidence of ARBD of 19 blood centers that fulfilled the questionnaire was in the range of (0.003~1.151) %. The change trend of number and incidence of ARBD cases were indeterminate. 【Conclusion】 Most blood centers did not got HV established. The incidence of ARBD varied greatly and was indeterminate. The application of HV should be further improved to strengthen ARBD management.

OBJECTIVE: To verify a rare allele of human leukocyte antigen (HLA) and analyze its inheritance and 3D molecular structure. METHODS: PCR-sequence-based typing, PCR-single strand oligonucleotide polymorphism and single allele-specific sequencing were carried out to characterize the rare HLA-C allele and its transmission in the family. Its protein structure was modeled by using SWISS-MODEL, Phyre2 and FATCAT software. RESULTS: Analysis indicated that the rare allele (HLA-C*08:84) has transmitted from the proband's mother and has differed from HLA-C*08:01 by a single base (g.512G>C), resulting in substitution of an amino acid (p.Trp147Ser). Modeling of the 3D structure of the encoded protein indicated that the amino acid residue variation is located at the alpha 2 helix, which participates the formation of pocket F. Modeling of the structures of C*08:84, C*08:01, C*08:02, C*08:03 and C*08:22 has suggested significant variation in the peptide binding regions of the backbone, with root mean square errors being 1.70 nm, 1.79 nm, 0.71 nm and 1.70 nm, respectively. CONCLUSION A rare HLA-C*08:84 allele has been identified, and its clinical significance has been analyzed.
Alleles ; Base Sequence ; HLA-B Antigens/genetics* ; HLA-C Antigens/genetics* ; Humans ; Molecular Structure ; Sequence Analysis, DNA

【Objective】 To estimate the seroprevalence of SARS-CoV-2 infection among blood donors during the COVID-19 outbreak, in order to provide reference for formulating coping strategies. 【Methods】 A total of 3 623 samples of healthy blood donors in Xi′an from January 1 to June 14, 2020 were collected and tested by chemiluminescence microparticle immunoassays(CMIA). The correlation between the number of confirmed cases of COVID-19 in Xi′an and the monthly prevalence trend of SARS-CoV-2 antibody in Xi′an was also studied. 【Results】 Among the 3 623 blood donors, 3 were reactive by CMIA, with the seroprevalence rate of SARS-CoV-2 at 0.083%(95%CI: 0.00, 0.18). The earliest yielding of SARS-CoV-2 in Xi′an was in February 4, 2020. 【Conclusion】 The SARS-CoV-2 seroprevalence rate in Xi′an is low, which is in line with the local prevalence status. It is suggested that serological detection of blood donors is a way to monitor the prevalence of COVID-19.

【Objective】 To study the molecular mechanism of para-bombay blood group caused by two rare mutation combinations and investigate the pedigree. 【Methods】 ABO and H antigens were detected by serological test, and the ABO blood group was confirmed by gene detection; the FUT1 gene was amplified by PCR and sequenced. 【Results】 Serological results showed that the proband was a rare para-bombay blood Bhm, Le(a-b+ ), and the proband′s parents were both B Le (a-b + ). The sequencing results showed that the proband and his mother had mutation at h²³⁵ G→C of FUT1 gene. Proband and his father had mutation at h⁶⁴⁹ G→T of FUT1 gene. 【Conclusion】 The combination of two rare mutations resulted in the formation of a para-bombay phenotype, which is helpful to clarify the gene polymorphism and genetic heterogeneity of para-bombay phenotype, providing data support and theoretical basis for its blood group identification and safe and reasonable blood use of para-bombay phenotype.

【Objective】 To explore the development and changes of blood use in various hospitals through statistical analysis of clinical blood use data in Xi′an, so as to provide basis for the decision making of blood banks to formulate and adjust the blood donation recruitment, collection, preparation and supply plan. 【Methods】 The clinical blood supply data of Shaanxi Blood Center from 2015 to 2019 were collected, and statistical analysis was conducted in terms of red blood cells, plasma, platelets, and cryoprecipitate. 【Results】 The blood supply in Xi′an showed an upward trend from 2015 to 2019, and the blood supply in 2019 was the highest in history(737 852 U). Both tertiary hospitals and secondary hospitals had shown an increasing trend in blood consumption, and the average consumption of red blood cells and plasma per person in operation kept decreasing year by year. The consumption of red blood cells in municipal hospitals and private hospitals had increased greatly, and the average consumption of red blood cells per person in operation had shown a downward trend. The amount of platelet use in all kinds of hospitals increased significantly. The proportion of platelet supply in the total annual blood supply kept increasing year by year. The ratio of platelet consumption to red blood cells consumption (hereinafter referred to as platelet-to-red blood cells ratio) in tertiary hospitals was higher than that in secondary hospitals. The platelet-to-red blood cells ratio of all kinds of hospitals had increased year by year. 【Conclusion】 The increase in the number of clinical diagnosis and treatment is the main reason for the increasing demand for clinical blood supply year by year. On this basis, the government and blood banks can predict the clinical blood demand and adjust the plan of blood donation in time. There is still much room for improvement in the annual platelet collection in Xi′an. Hospitals with higher levels of clinical disciplines have relatively high plate-to-blood ratios.The ratio of plasma to red blood cells consumption in tertiary hospitals is abnormal, there might be unreasonable use of blood.

【Objective】 To explore the association of HLAII(-DRB1, -DQB1, -DPB1) alleles and haplotypes polymorphisms with acute myeloid leukemia (AML) in northern Han population. 【Methods】 A total of 308 AML (non-M3) patients (patient group) and 824 unrelated healthy bone marrow donors (control group) were genotyped at a high-resolution level using polymerase chain reaction-sequence-based typing (PCR-SBT), next-generation sequencing (NGS) with Ion Torrent S5 platform and sequence specific oligonueleotide probes (SSO) with LABScan^® 3D platform. Frequencies of HLA II alleles and haplotypes were calculated with Arlequin 3.5.2.2 software. The odds ratio (OR) of AML was also calculated for case-control study. 【Results】 By χ² test and correction, an increased frequency of HLA-DRB1^*07∶01(14.61% vs 9.53%, P<0.01), HLA-DQB1^*02∶02(12.82% vs 8.31%, P<0.01), HLA-DQB1^*06∶02(11.53% vs 8.74%, P<0.05) and HLA-DPB1^*17∶01(5.84% vs 3.16%, P<0.01) among AML patients was discovered in significant comparison with the control group. After Bonferroni correction, the frequency of HLA-DRB1^*07∶01(Pc<0.05), HLA-DQB1^*02: 02(Pc<0.05) and HLA-DPB1^*17∶01(Pc<0.05) in AML patients were still higher than those in the control group, which had a strong positive correlation with AML (OR=1.62 (95% CI=1.23~2.14), 1.62(95% CI=1.21~2.18) and 1.91(95% CI=1.23~2.94), respectively. The frequency of two loci haplotype HLA-DRB1^*07∶01-DQB1^*02∶02 in AML patients was still higher than that of the control group after Bonferroni correction (12.66% vs 8.19%, Pc<0.05). The frequency of the 3 loci haplotype HLA-DRB1^*07∶01-DQB1^*02∶02-DPB1^*17∶01, as a susceptible haplotype of AML, was higher than that of the control group and was strongly correlated with AML. 【Conclusion】 The data on the association of HLA II (-DRB1, -DQB1, -DPB1) alleles and haplotype polymorphisms with AML in northern Han populations was obtained in this study. HLA-DRB1^*07∶01, HLA-DQB1^*02∶02, HLA-DPB1^*17∶01 and the HLA-DRB1^*07∶01-DQB1^*02∶02-DPB1^*17∶01 haplotype are the risk genes and susceptible extended haplotype for AML. The risk prediction based on HLA haplotype might be more accurate than that based on single allele.