[Objective] To explore the effectiveness of applying the PDCA (Plan-Do-Check-Act) cycle to enhance the compatibility rate of five Rh blood group antigen phenotypes between donors and recipients across multiple hospital campuses. [Methods] Clinical blood transfusion data from May to July 2022 were selected. Specific improvement measures were formulated based on the survey results, and the PDCA cycle management model was implemented from August 2022. The post-intervention phase spanned from August 2022 to October 2023. The Rh phenotype compatibility rate, the detection rate of Rh system antibodies, and the proportion of Rh system antibodies among unexpected antibodies were compared between the pre-intervention phase (May to July 2022) and the post-intervention phase. [Results] After the continuous improvement with the PDCA cycle, the compatibility rate for the five Rh blood group antigen phenotypes between donors and recipients from August to October 2023 reached 81.90%, significantly higher than the 70.54% recorded during the pre-intervention phase (May to July 2022, P<0.01), and displayed a quarterly upward trend (β=0.028, P<0.05). The detection rate of Rh blood group system antibodies (β=-9.839×10^-5, P<0.05) and its proportion among all detected antibodies (β=-0.022, P<0.05) showed a quarterly decreasing trend, both demonstrating a negative correlation with the enhanced compatibility rate (r values of -0.981 and -0.911, respectively; P<0.05). [Conclusion] The implementation of targeted measures through the PDCA cycle can effectively increase the compatibility rate of five Rh blood group antigen phenotypes between donors and recipients, reduce the occurrence of unexpected Rh blood group antibodies, thereby lowering the risk of transfusion and enhancing the quality and safety of medical care.

Objective: To summarize the laboratory findings of a case of hemolytic disease of the fetus and newborn (HDFN) caused by Rh system anti-c antibodies and to review the literature, so as to explore the characteristics of anti-c HDFN. Methods: The ABO blood type, Rh blood type, direct antiglobulin test (DAT) results, and the presence of unexpected antibodies and their titers were determined by serological methods. The cases of anti-c HDFN in our laboratory in China and abroad were statistically analyzed, and the incidence of severe HDFN caused by anti-c, anti-D and anti-E was compared. Results: The blood type of the child was B (Rh CcDee) with a positive DAT. Anti-c antibody was detected in both serum and eluate, with a serum antibody titer of 4. The mother’s blood type was AB (Rh CCDee) with a negative DAT, and anti-c antibody was detected in the serum with a titer of 128. Among 20 cases of anti-c HDFN, 17 were DAT positive, and 9 (45%, 9/20) underwent blood transfusion or exchange transfusion. The incidence of severe HDFN was 47.60% (10/21) for anti-c, 47.60% (10/21) for anti-D and 31.30% (5/16) for anti-E. Conclusion: Maternal pregnancy and/or blood transfusion are the main reasons for the production of Rh alloantibodies such as anti-c. The prevention and management of anti-c should be similar to that of anti-D. Rh antigen-matched (five antigens of Rh blood group) transfusion is necessary for women of childbearing age to avoid antibody production, and Rh typing and antibody screening during prenatal examination is recommended to ensure early detection, intervention and treatment.

Neurodegenerative diseases are a type of disease characterized by specific types of neuronal loss and progressive progression,mainly represented by Alzheimer's disease and Parkinson's disease.This type of disease,due to its intractable and irreversible symptoms,brings great physical and psychological burden to patients,which is seriously disturbing their normal life.In terms of treatment,there is currently no specific treatment for Alzheimer's disease in clinical practice,and first-line treatment drugs for Parkinson's disease also have great limitations.In traditional Chinese medicine,kidney governs bone,generates marrow,and connects to the brain.In clinical evidence typing,premature aging,fatigue and forgetfulness,and tremor of limbs caused by kidney deficiency and medullary reduction are considered to be the main pathologies of these diseases.Di-Huang-Yin-Zi decoction which is derived from the"General Records of Holy Universal Relief",is recorded as a good formula for nourishing kidney yin and filling kidney yang.Clinical data shows that this formula has significant therapeutic effects in treating neurodegenerative diseases caused by kidney essence deficiency.Modern research results indicate that its mechanism of action involves inhibiting inflammatory reactions,regulating mitochondrial autophagy,reversing The hypothalamic-pituitary-adrenal axis abnormalities,and neuroprotection.The main effective ingredients in this formula include loganin,echinarin,and schisandrin A.This article aims to summarize and analyze the clinical efficacy,mechanism of action,and active ingredients of Di-Huang-Yin-Zi decoction in the treatment of Alzheimer's and Parkinson's disease in recent years,in order to clarify the research status of Di-Huang-Yin-Zi decoction in the neurodegenerative disease and provide reference for further research.

Lung cancers are the leading cause of cancer deaths worldwide and pose a grave threat to human life and health. Non-small cell lung cancer (NSCLC) is the most frequent malignancy occupying 80% of all lung cancer subtypes. Except for other mutations (

[Abstract] Objective: To investigate the effect of lncRNA MAFG-AS1/ miR-11181-3p/GLG1 axis on cell migration, invasion and aerobic glycolysis of gastric cancer (GC) cells and its possible mechanism. Methods: AGS, a GC cell line with relatively high expression of MAFG-AS1, was selected as the study object. qPCR was used to detect RNA expression levels of MAFG-AS1, miR-11181-3p and GLG1. Transwell and glycolysis analysis were used to investigate cell migration, invasion and aerobic glycolysis. Bioinformatics analysis and Dual luciferase reporter gene assay were used to analyze the interaction among MAFG-AS1, miR-11181-3p and GLG1. Results: Knockdown of MAFG-AS1 significantly up-regulated miR-11181-3p and down-regulated GLG1 expression (both P<0.01), and significantly inhibited migration, invasion and aerobic glycolysis of GC cells (all P<0.01). Luciferase reporter gene assay confirmed that MAFG-AS1 competitively sponged miR-11181-3p (P<0.01). Inhibition of miR-11181-3p or overexpression of GLG1 partially reversed the inhibitory effect of MAFG-AS1 knockdown on GC cell migration, invasion, and aerobic glycolysis (all P<0.05 or P<0.01). Conclusion: MAFG-AS1 promotes cell migration, invasion and aerobic glycolysis of GC cells via miR-11181-3p/GLG1 axis, and may be a potential molecular target for GC diagnosis and therapy.

Objective To construct an interfering lentivirus vector of long non-coding RNA 4.9 (lncRNA4.9) transcribed by human cytomegalovirus (HCMV).Methods Three interfering sequences targeting lncRNA 4.9 were designed and synthesized.The shuttle plasmid GV248 and the target interfering sequence were combined and constructed.The recombinant plasmid was co-transfected with the skeleton plasmids pHelper1.0 and pHelper2.0 to 293T cells.Viral particles were collected and copies were determined.The interfering lentivirus vector was transfected into THP-1 cells to observe the fluorescence expression,and the interfering efficiency was detected by real-time RT-PCR.Results Three groups of lentivirus interference vectors (LV1,LV2,LV3) were constructed,LV2 and LV3 can interfere with the expression of lncRNA4.9,and the interference efficiency of LV2 group was the highest.Conclusions The interfering lentivirus vector of lncRNA 4.9 was successfully constructed,which laid a foundation for further study on the function of lncRNA 4.9.

Objective: To study the relationship between human cytomegalovirus (HCMV) envelope glycoprotein gene H and clinical features of children with congenital cytomegalovirus infection. Methods: A cohort study was conducted. Newborns diagnosed with congenital cytomegalovirus infection, hospitalized in the Department of Neonatology and Neonatal Intensive Care Unit (NICU) of the Children′s Hospital, Zhejiang University School of Medicine, were included from July 2013 to December 2015.HCMV-DNA gH typing in urine, sputum or blood was conducted. Patients then were divided into gH1 group and gH2 group according to gH genotypes. Patients′ data during hospitalization in newborn and 3-5 years of follow-up were collected.The relationships between gH genotype and clinical manifestations, laboratory examinations, hearing loss and neurological prognosis were analyzed by chi-square test, t test and non-parametric test. Results: A total of 21 cases were enrolled as congenital HCMV infection and followed-up for 3-5 years. Among them, 14 (67%) were gH1 type and 7 (33%) were gH2 type. No mixed infection was found. In the two groups, there were no significant differences in the ratio of males (9/14 vs. 3/7,P=0.397), or birth weight ((2 609±686) vs. (3 021±451) g, t=-1.436, P=0.167). Gestational age of gH1 group was younger than that of gH2 group (38 (29-40) vs. 39(38-40) weeks, Z=-2.18, P=0.029). Moderate to severe hearing loss detected by neonatal auditory brainstem response were found in 40 ears (20 cases). It was higher in gH1 group than that in gH2 group (4/22 vs.0/18, χ²=5.145, P=0.023). In the imaging examination of the nervous system, the Alarcon score of gH1 group was lower than that of gH2 group (0.4±0.3 vs. 1.3±1.1, t=-2.459,P=0.024).No significant statistical difference was found in the probability of motor or language development lag in gH2 group and gH1 group (4/7 vs.4/14, P=0.346). Conclusions Compared with gH2 infection, gH1 infection in children has a younger gestational age. The major type of hearing loss in neonatal period is gH1 infection. Children with gH2 congenital infections are more likely to suffer from nervous systems damage.

Objective To study the relationship between human cytomegalovirus (HCMV) envelope glycoprotein gene H and clinical features of children with congenital cytomegalovirus infection. Methods A cohort study was conducted. Newborns diagnosed with congenital cytomegalovirus infection, hospitalized in the Department of Neonatology and Neonatal Intensive Care Unit (NICU) of the Children′s Hospital, Zhejiang University School of Medicine, were included from July 2013 to December 2015. HCMV‐DNA gH typing in urine, sputum or blood was conducted. Patients then were divided into gH1 group and gH2 group according to gH genotypes. Patients′data during hospitalization in newborn and 3-5 years of follow‐up were collected. The relationships between gH genotype and clinical manifestations, laboratory examinations, hearing loss and neurological prognosis were analyzed by chi‐square test, t test and non‐parametric test. Results A total of 21 cases were enrolled as congenital HCMV infection and followed‐up for 3-5 years. Among them, 14 (67%) were gH1 type and 7 (33%) were gH2 type. No mixed infection was found. In the two groups, there were no significant differences in the ratio of males (9/14 vs. 3/7, P=0.397), or birth weight ((2 609±686) vs. (3 021±451) g, t=-1.436, P=0.167). Gestational age of gH1 group was younger than that of gH2 group (38 (29-40) vs. 39(38-40) weeks, Z=-2.18, P=0.029). Moderate to severe hearing loss detected by neonatal auditory brainstem response were found in 40 ears (20 cases). It was higher in gH1 group than that in gH2 group (4/22 vs. 0/18, χ2=5.145, P=0.023). In the imaging examination of the nervous system, the Alarcon score of gH1 group was lower than that of gH2 group (0.4±0.3 vs. 1.3±1.1, t=-2.459,P=0.024). No significant statistical difference was found in the probability of motor or language development lag in gH2 group and gH1 group (4/7 vs. 4/14, P=0.346). Conclusions Compared with gH2 infection, gH1 infection in children has a younger gestational age. The major type of hearing loss in neonatal period is gH1 infection. Children with gH2 congenital infections are more likely to suffer from nervous systems damage.

Objective To compare the effect on intraoperative cerebral metabolism between the propofol combined with remifentanil infusion in total intravenous anesthesia and the desflurane combined with remifentanil intravenous inhalation anesthesia in patients in neurosurgery.Methods Thirty-four patients were randomly divided into the propofol combined with remifentanil group (group A,n=16) and the desflurane combined with remifentanil group (group B,n =18).The B-ultrasound under the guide of retrograde catheterization through right internal jugular vein and artery was prepared after the patients entered the operation room.Atropine,propofol,fentanyl,rocuronium were used in the induction of anesthesia.The mechanical ventilation was applied after conventional trachea cannula.Once patients were anesthetized steadily,jugular bulb venous oxygen saturation (SjvO2),jugular bulb venous oxygen partial pressure (PjvO2),Jugular Bulb venous hemoglogin (Hbv),jugular bulb venous lactate (Ljv),jugular bulb venous gluxose (Gv),arterial oxygen saturation (SaO2),arterial oxygen pressure (PaO2),arterin (Hba),arterial blood lactate (La),arterial blood gluxose (Ga),arterial blood oxygen content (CaO2),jugular bulb venous oxygen content (CjvO2),arteriovenous oxygen difference (AVDO2),cerebral extraction of oxygen (CEO2),cerebral lactate production rate (CLP) and cerebral glucose uptake rate (CGU) at different time [before anesthesia induction (T1),1 hours after the start of the operation (T2),2 hours after the start of the operation (T3),half an hour after the operation]were collected.Results (1) The value of SjvO2,PjvO2,CjvO2 and CaO2 in group B was significantly higher than that in group A (P＜0.001);The value of AVDO2 and CEO2 in group B was lower than that in group A (P＜0.05);(2) The value of Gv and Ga in group B was higher than that in group A (P＜0.05);There were no significant differences about CGU in two groups (P＞0.05);(3) The value of CLP in group B was lower than that in group A (P＜0.05);there were no significant differences about Ljv and La in two groups (P＞0.05);(4) Compared with the value at moment of T1 between group A and group B,the value ofPaO2,SaO2,PjvO2 and SjvO2 were increased with time (P＜0.05),the value of CaO2,CjvO2,AVDO2 and CEO2 showed a downward trend (P ＜0.05).Conclusion (1) Both total intravenous anesthesia and intravenous inhalation anesthesia can reduce the cerebral oxygen metabolism;(2) For the cerebral protection of neurosurgery operation,it seems that the effect of intravenous inhalation anesthesia is more stronger than total intravenous anesthesia.

Esophageal squamous cell carcinoma(ESCC) is a common malignancy in china,and TNM staging is the standard staging system for ESCC.However,in clinical practice,patients' prognosis is not always consistent with the staging.This phenomenon may be attributed from the fact that the current limitation and imperfect of the TNM staging system,and besides,another possible reason might be that some prognostic factors for ESCC other than TNM descriptors may exist.Among all the prognostic factors for ESCC,molecular biomarkers received widely concern.We searched the literatures and identified 12 molecular biomarkers that received the most concern and validated them in our single surgeon team.The results showed that only P21,COX-2 and E-cadherin were significant prognostic factors for ESCC in this series.Therefore,in the current study,we reviewed the literature regarding the prognostic significance of the above mentioned three biomarkers for clinical reference.