Objective To analyze the value of MRI in evaluating the treatment efficacy of neoadjuvant chemotherapy(NAC)in breast cancer patients.Methods The clinical data of 130 patients with breast cancer were analyzed retrospectively.All patients under-went 4-8 cycles of NAC,with MRI examinations was performed before and after NAC treatment.Based on postoperative response eval-uation criteria in solid tumors(RECIST),the patients were categorized into effective and ineffective groups.The MRI related param-eters,early enhancement parameters and peak enhancement parameters before and after NAC were observed to evaluate the efficacy of MRI in evaluating the treatment efficacy of NAC in breast cancer.Results The sensitivity,specificity,and accuracy of MRI in evalua-ting the treatment efficacy of NAC in breast cancer were 96.74％,89.47％,and 94.62％,respectively.The Kappa value for consis-tency analysis between MRI and postoperative pathology reached 0.869,indicating good agreement.Receiver operating characteristic(ROC)curve analysis showed that the area under the curve(AUC)for MRI in predicting the treatment efficacy of NAC in breast cancer was 0.935[95％ confidence interval(CI)0.831-0.981].Significant differences were observed between the effective and ineffec-tive groups in early and peak enhancement parameters before and after NAC(P＜0.05).Conclusion MRI can effectively assesses the treatment efficacy of NAC in breast cancer patients,demonstrating high value in clinical applications.

Objective To analyze the value of MRI in evaluating the treatment efficacy of neoadjuvant chemotherapy(NAC)in breast cancer patients.Methods The clinical data of 130 patients with breast cancer were analyzed retrospectively.All patients under-went 4-8 cycles of NAC,with MRI examinations was performed before and after NAC treatment.Based on postoperative response eval-uation criteria in solid tumors(RECIST),the patients were categorized into effective and ineffective groups.The MRI related param-eters,early enhancement parameters and peak enhancement parameters before and after NAC were observed to evaluate the efficacy of MRI in evaluating the treatment efficacy of NAC in breast cancer.Results The sensitivity,specificity,and accuracy of MRI in evalua-ting the treatment efficacy of NAC in breast cancer were 96.74％,89.47％,and 94.62％,respectively.The Kappa value for consis-tency analysis between MRI and postoperative pathology reached 0.869,indicating good agreement.Receiver operating characteristic(ROC)curve analysis showed that the area under the curve(AUC)for MRI in predicting the treatment efficacy of NAC in breast cancer was 0.935[95％ confidence interval(CI)0.831-0.981].Significant differences were observed between the effective and ineffec-tive groups in early and peak enhancement parameters before and after NAC(P＜0.05).Conclusion MRI can effectively assesses the treatment efficacy of NAC in breast cancer patients,demonstrating high value in clinical applications.

Objective:To investigate the laboratory detection methods for immune hemolytic transfusion reactions caused by anti-tigecycline antibody and the clinical diagnosis and treatment of one patient.Methods:The correlation between hemolysis-related laboratory indexes of the patient and the duration of medication was analyzed. Blood samples of the patient were tested using direct anti-human globulin test, free antibody test, and release test. Erythrocyte sensitization method and immune complexome analysis were used to detect the antibody against tigecycline in the serum of the patient. The properties and the titers of anti-tigecycline antibody were analyzed.Results:Anti-tigecycline antibody was found in the patient through the erythrocyte sensitization method and the immune complexome analysis, and the result of the direct anti-human globulin test was positive. The clinical symptoms and physical signs of the patient improved rapidly after withdrawal of tigecycline and blood transfusion. The patient was discharged after 14-day treatment with immunoglobulin and hormone.Conclusions:Tigecycline can cause hemolytic transfusion reactions. Serological tests are essential for the diagnosis of drug-induced hemolytic anemia. Withdrawal of medications and symptomatic treatment should be conduceted immediately when patients develop drug-related hemolytic anemia.

[Objective] To identify a mimicking alloantibody, analyze its serological characteristics and antibody specificity, and explore transfusion strategies for mimicking alloantibody. [Methods] The antibody specificity of patients was identified by direct anti-globulin test, antibody identification, antibody titration test and absorption-elution test. Related literature was retrospectively reviewd. [Results] The anti-Ec was detected in both the diluted serum and elution liquid. The patient's antibody corresponded to antigen negative red blood cells (type O, CCDee) from blood donors who absorb serum and elute anti-Ec. In both serum and elution liquid, the titer detected by E-positive cells was stronger than that by E-negative cells, with a difference of 5-6 tubes in the serum and a difference of 2 tubes in the elution liquid. Thirty articles at home and abroad were reviewed and analyzed, revealing that the distribution of mimicking specificity autoantibodies was mainly in the Rh blood group system, accounting for 86.4%, followed by blood type systems such as Kidd, MNS, Duffy, etc. [Conclusion] The presence of mimicking anti-Ec antibody in the patient's serum was confirmed, with specific and non-specific anti-E antibodies in the mimicking antibody. Reasonable use of antibody titer test, and absorption-elution test can help identify the specificity of anti-E antibodies and provide transfusion strategies for clinical transfusion.

【Objective】 To investigate the frequency of P1PK and GLOB blood group in Chinese Lahu population and their genetic status, so as to provide data support for the safety of blood transfusion and give advice and transfusion guidance for pregnant women. 【Methods】 Unrelated individuals of Chinese Lahu population were randomly selected for serological identification of P1PK and P blood group and gene sequencing analysis. The frequency of P1PK and GLOB blood group were analyzed. 【Results】 Six cases of anti-PP 1P^k(formerly known as anti-Tj^a) negative blood type were identified as the rare P1-PK-P- blood type (formerly known as Tj^a- blood type or p blood type, hereinafter referred to as p blood group) from 300 Lahu population, with phenotypic frequency of p blood group in P1PK and GLOB blood group system in Lahu population at 2.0%(6/300). 【Conclusion】 The phenotypic frequency of blood group p in Lahu population was significantly higher than that in Europe (5.8 persons per million) and Hong Kong, China (1 person per million),indicating significant ethnic specificity and regional ethnic differences.

【Objective】 To determine the rare ABO blood subgroups rapidly and ensure the blood transfusion safety of five patients by a series of serological tests and family investigation, as their preliminary serological results of ABO blood grouping was inconsistent. 【Methods】 ABO blood grouping, antibody screening and Coombs′ tests were performed by the routine serological methods, including manual tube and automatic blood group analyzer, which had matched micro-column gel cards from Diagnostic Grifols. Polymerase chain reaction (PCR) was used to amplify the 6 and 7 exons as well as their adjacent intron region of ABO gene. The patients and their relatives′ ABO blood group and subgroup were analyzed and identified through the comparison with serological phenotype database of ABO blood group. The products of PCR were sequenced directly, and the gene mutation was identified through the comparison with the Blood Group Antigen Gene Mutation Database. 【Results】 Whether micro-column gel cards or manual tube test, the forward and reverse tests of serological grouping were not supported by each other on the five patients′ ABO blood grouping. The forward tests of patients No.1~3 showed AwB phenotype and the reverse tests showed B group. No.4 patient was the forward ABw phenotype and the reverse A group, and No.5 patient was the forward normal AB phenotype and the reverse B group, respectively. All of 5 patients′ Rh C/D/E blood grouping showed clearly; the IDT test and antibody screening result of patient No.1 was positive, while the antibody screening result of patient No.4 was negative. 【Conclusion】 The blood group serological characterization of patient No.1~3 met B(A) blood group, and patient No.4~5 met CisAB blood group. These tests can make a preliminary diagnosis of blood group phenotype, which are verified correctly via blood group genotype.

【Objective】 To construct an in-vitro model of erythrocyte antibody-mediated complement activation, and establish quantitative detection methods based on flow cytometry and spectrophotometry, so as to explore the correlation of anti-body titers and complement activation speed, and provide a methodological basis for studying the adverse transfusion reactions of anti-body mediated complement hemolysis. 【Methods】 Mouse monoclonal antibody that recognized human C3b and fluorescent secondary antibody were used to label C3b fragments on erythrocytes, and the deposition of C3b fragments after complement activation was detected by flow cytometry. The absorbance at 540 nm of the supernatant in the complement activation reaction system was measured by spectrophotometry as the amount of hemoglobin released was related to the absorbance. 【Results】 The complement activation system was constructed according to the ratio of 3% red blood cell suspension (mixed for 6 people) 1∶anti-Tj^a 1∶complement 2. The repeatability was good (P value>0.05) as different red blood cell mixtures had been used to repeat the detection reaction system. When using 32×, 64× and 128× dilutions of anti-Tj^a mediated complement activation, the deposition of C3b fragments has been detected by flow cytometry at 30 s, 1 min and 2 min, respectively, and MFI peaked at 5 min, 10 min and 30 min, respectively. No obvious hemolysis has been observed within 1.5 h. 【Conclusion】 In vitro model of anti-Tj^a-mediated complement activation demonstrates the speed of complement activation is related to the concentration of antibody. At a certain antibody concentration, the speed of complement activation has been slowed down, and no obvious hemolysis observed.

Objective:To study the changes and imaging features of arachnoid granulation (AG) in patients with cerebral venous sinus thrombosis (CVST).Methods:The clinical and imaging data of 35 patients with idiopathic CVST confirmed by MR imaging combined with CE-MRV or DSA in our hospital from January 2013 to December 2018, and 35 healthy controls collected at the physical examination center at the same time period were detected. The sizes and numbers of AG were compared between the two groups, and the MR imaging features of CVST and AG in patients with CVST at different courses were compared.Results:(1) In 35 patients with CVST, AG was found in 14 patients, and the average diameter was (5.19±2.40) mm, ranged from 1.83-11.77 mm; in the control group, AG was found in 23 patients, and the average diameter was (4.45±2.03) mm, ranged from 1.45-9.87 mm; no statistical difference was noted in diameter between the two groups ( t=2.121, P=0.221), and the number of AG showed statistical difference between the two groups (χ 2=4.644, P=0.031). (2) In 8 patients with CVST at acute phase, CVST showed hypointense on T2WI and FLAIR; in 20 patients with CVST at subacute phase, CVST showed hyperintense on T2WI and FLAIR; in 7 patients with CVST at chronic phase, CVST showed hyperintense on T2WI and FLAIR. At any stage of venous sinus thrombosis, AG showed high signal on T2WI and low signal on FLAIR. Conclusion:AG detection rate in CVST patients is lower than that in normal controls; MR imaging T2WI and FLAIR sequences could effectively distinguish CVST with AG.

Objective:To explore the diagnostic values of MRI T2WI and 3D contrast enhanced magnetic resonance venography (3D CE-MRV) in transverse sinus arachnoid granulations (AGs).Methods:Clinical data were obtained from 811 patients who were subjected to non-contrast MR imaging and 3D CE-MRV between January 2016 and April 2019 in our hospital. And the number of patients whose transverse sinus AGs could be shown by T2WI and MRV, the number, size, and shape of AGs, and the number of AGs-related veins were recorded.Results:MRI T2WI showed 242 AGs in 184 patients (22.7%), and 3D CE-MRV showed 138 AGs in 119 patients (14.7%); MRI T2WI had a significantly higher percentage in showing AGs patients as compared with 3D CE-MRV ( P<0.05). Two hundred and forty-two AGs showed by MRI T2WI were divided into 3D CE-MRV observation group ( n=138) and 3D CE-MRV non-observation group ( n=104); the diameter of AGs in the 3D CE-MRV non-observation group ([5.30±2.10] mm) was significantly smaller than that in the 3D CE-MRV observation group ([6.14±2.03] mm, P<0.05). MR T2WI showed that 231 AGs were like circles or ellipses and 11 AGs were like fractal; while 3D CE-MRV showed that 138 AGs were like circles or ellipses and 0 AG were like fractal. MRI T2WI showed that 289 veins were closely related to AGs, and 3D CE-MRV showed that 97 veins were closely related to AGs. MRI T2WI could demonstrate significantly higher proportion of non-labbe veins which were closely related to AGs than 3D CE-MRV ( P<0.05). Conclusion:As compared with 3D CE-MRV, T2WI can find larger number of AGs in the transverse sinus, and better display the shape of AGs and the vein adjacent to them.

Objective To study the curative effect and the prognostic factors of endoscopic traumatic optic neuropathy (TON). Methods The clinical data of 53 patients with TON from 2010 to 2015 years was retrospectively analyzed. Divided the patients into the surgery group and the non-surgery group, according to whether or not accept the treatment of endoscopic optic decompression. And evaluating the potential prognostic factors in chi-square test, group t-test and multiple regression analysis. Results In 53 patients (55 eyes ), 31 eyes have no visual acuity before treated: 8 eyes’ visual acuity was improved in 16 eyes (8/16) that accepted operation; 3 eyes’ visual acuity was improved in 15 eyes (3/15) that with non-operation;24 eyes have visual acuity before treated:11 eyes’ visual acuity was improved in 14 eyes (11/14) that accepted operation;3 eyes’ visual acuity was improved in 10 eyes (3/10) that with non-operation;19 eyes’ visual acuity was improved in 30 eyes (19/30) that accepted operation, the total effective rate was 63.3%, and there was no complications happened in the patients who accepted operation. The age, eye-side, sex, visual acuity, optic canal fracture , orbit fracture , all these factors have no correlation to the prognosis (P>0.05), but the interval time between injury and operation (less than 3 days) and the way of the treatment are benefit to improve vision (P<0.05). Conclusions The endoscopic optic decompression is an effective treatment in TON, and it’s better to improve vision in 3-day after TON.