Objective: To develop a RHCE genotyping assay based on kompetitive allele-specific PCR (KASP) and assess its clinical accuracy for RhCE blood group determination. Methods: KASP primers were designed to interrogate three RHCE loci: the 109 bp insertion/deletion in intron 2, c. 307T>C, and c. 676C>G. A total of 1 194 RhD-positive inpatients from Chengdu were typed by both KASP genotyping and manual tube serology. Discordant samples (n=10) were retested by both methods and further resolved by Sanger sequencing. An additional 377 cases were tested for the c. 48C>G locus to evaluate the predictive accuracy of individual loci and combined locus testing for RhC antigen. Results: Genotyping concordance with serology was 100.0% for both the c. 676C>G locus (RhE/Rhe) and the c. 307T>C locus (Rhc). For RhC prediction using the 109 bp insertion, overall accuracy was 99.7% (1 191/1 194); the 3 discordant cases were confirmed by Sanger sequencing to be false negatives attributable to 109 bp deletion in intron 2. Testing the c. 48C>G allele for RhC prediction yielded 7 false positives, with an accuracy of 98.1% (370/377). RhC antigen status was determined by combining the 109 bp insertion and the c. 48C allele. After excluding 10 samples with inconsistent results between the two loci, the accuracy reached 100% in the remaining 367 samples. When both loci were applied in combination, accuracy reached 100% in the 367 cases with concordant results. Among the 1 194 patients, CCee (45.8%) and CcEe (31.7%) were the most common RhCE phenotypes. The e antigen had the highest positivity rate (92.2%), and the Ce haplotype was the most frequent (66.9%). Conclusion: The KASP-based RHCE genotyping method achieves high accuracy for clinical RhCE typing. Combining the 109 bp insertion/deletion with the c. 48C allele significantly improves RhC antigen prediction compared with either locus alone. This method was applied to RhCE genotyping of 1 194 RhD-positive inpatients in Chengdu, providing local RhCE phenotype and haplotype distribution data to support RhCE-matched transfusion practice.

[Objective] To analyze the distribution of Rh blood group phenotype in some ethnic groups in China, so as to provide references for accurate blood transfusion. [Methods] The data of CNKI, Wanfang data and VIP were retrieved using "Rh blood group" and "nationality", and the search of PubMed database was conducted with the keywords "Rh blood group", "nationalities", "ethnic groups" and "China", with retrieval time until September 19, 2024 Data were extracted from eligible studies and the literature quality was evaluated using the criteria for cross-sectional studies in STROBE statement. Meta analysis was performed using Stata 11.0 software. [Results] A total of 350 relevant literature were retrieved, of which 26 were included. The total sample size for Rh phenotype distribution detection were 31 432, and the total population for RhD negative screening was 47 227, covering 26 ethnic groups. Meta-analysis revealed that the Rh blood groups phenotype distribution in certain ethnic populations in China was mainly CCDee 46.7% (95%CI=46.2%-47.2%), CcDEe 30.1% (95%CI=29.5%-30.6%), and CcDee 9.0% (95%CI=8.7%-9.3%). Analysis of the RhD-negative phenotype indicated an negative rate of RhD of 0.3% (95%CI=0.2%-0.3%), with the main phenotype distributions of ccdee at 0.2% (95%CI=0.1%-0.2%) and ccdEe at 0.2% (95%CI=0.0%-0.4%). The meta-analysis results of the distribution of common phenotypes among different ethnic groups showed that the CCDee phenotype was mainly distributed as Hani>Dong>Buyi>Miao>Tujia>Hui>Zang>Kazakh>Mongol>Uygur; the CcDEe phenotype: Zang>Mongol>Hui; the CcDee phenotype: Uygur>Kazakh>Mongol>Zang>Hui>Dong>Miao>Tujia>Buyi; the ccDEE phenotype: Zang>Hui=Mongol. The results of this study are similar to those of Qingdao population in China, but differ from studies conducted in North India, German individuals of European ancestry and Saudi Arabian populations. [Conclusion] The distribution of Rh blood group phenotypes in some ethnic groups in China shows no significant difference compared to the Han population, but there are differences when compared to populations in other countries and regions.

Recent studies have indicated that the expression of ubiquitin-specific protease 51 (USP51), a novel deubiquitinating enzyme (DUB) that mediates protein degradation as part of the ubiquitin‒proteasome system (UPS), is associated with tumor progression and therapeutic resistance in multiple malignancies. However, the underlying mechanisms and signaling networks involved in USP51-mediated regulation of malignant phenotypes remain largely unknown. The present study provides evidence of USP51's functions as the prominent DUB in chemoresistant triple-negative breast cancer (TNBC) cells. At the molecular level, ectopic expression of USP51 stabilized the 78 kDa Glucose-Regulated Protein (GRP78) protein through deubiquitination, thereby increasing its expression and localization on the cell surface. Furthermore, the upregulation of cell surface GRP78 increased the activity of ATP binding cassette subfamily B member 1 (ABCB1), the main efflux pump of doxorubicin (DOX), ultimately decreasing its accumulation in TNBC cells and promoting the development of drug resistance both in vitro and in vivo. Clinically, we found significant correlations among USP51, GRP78, and ABCB1 expression in TNBC patients with chemoresistance. Elevated USP51, GRP78, and ABCB1 levels were also strongly associated with a poor patient prognosis. Importantly, we revealed an alternative intervention for specific pharmacological targeting of USP51 for TNBC cell chemosensitization. In conclusion, these findings collectively indicate that the USP51/GRP78/ABCB1 network is a key contributor to the malignant progression and chemotherapeutic resistance of TNBC cells, underscoring the pivotal role of USP51 as a novel therapeutic target for cancer management.

OBJECTIVE To investigate the current status and existing problems in pretreatment of digestive endo-scopes in medical institutions of Jiangsu Province so as to optimize the pretreatment procedures.METHODS From Nov.7,2024 to Nov.17 2024,a questionnaire was preliminarily designed based on the current endoscope-related guidelines and standards by the infection control team of digestive endoscopy center of The Affiliated Drum Tower Hospital of Nanjing University Medical School.A cross-sectional survey was conducted for various levels of medi-cal institutions of Jiangsu Province by Wenjuanxing platform.The content of the survey covered basic information of the digestive endoscopy center,implementation status of pretreatment,operation status of pretreatment,quali-ty monitoring and management.RESULTS A total of 122 medical institutions were finally included in the survey,61 of which were tertiary hospitals,35 were secondary hospitals,and 26 were primary hospitals.97.54％of the medical institutions could implement the pretreatment procedures after every endoscopes use,while there was significant difference in the concrete details of pretreatment among the various grades of hospitals.64.75％of the medical institutions used dedicated buttons for pretreatment,however,there was significant difference in the cause for failed change of dedicated buttons among the various grades of medical institutions(x2=14.657,P＜0.001).76.23％of the medical institutions carried out the pretreatment for special sites of the endoscopes(pli-ers' pipelines,auxiliary water rinsing pipelines).Gas and water insufflation were maintained for over 10 seconds(77.87％).The suction duration was judged mainly based on subjective knowledge.The enzyme solution was the major pretreatment solution(94.26％).The changing frequency was dominated by'one use per change'(45.08％).There was significant difference in the time interval between pretreatment and cleaning among the va-rious grades of medical institutions(x2=10.032,P=0.012).57.38％of the medical institutions evaluated the quality of the pretreatment,and visual observation was the major method for quality assessment(53.28％).There was significant difference in the establishment of pretreatment system among the various grades of medical institu-tions(x2=7.033.P=0.030).CONCLUSIONS The pretreatment of the endoscopes is overall performed well in the 122 medical institutions of Jiangsu Province;however,the details of pretreatment procedure,quality monito-ring and management need to be improved.It is suggested that the related departments should accelerate the revi-sion of endoscope pretreatment-related standards so as to standardize professional behavior.

OBJECTIVE To investigate the current status and existing problems in pretreatment of digestive endo-scopes in medical institutions of Jiangsu Province so as to optimize the pretreatment procedures.METHODS From Nov.7,2024 to Nov.17 2024,a questionnaire was preliminarily designed based on the current endoscope-related guidelines and standards by the infection control team of digestive endoscopy center of The Affiliated Drum Tower Hospital of Nanjing University Medical School.A cross-sectional survey was conducted for various levels of medi-cal institutions of Jiangsu Province by Wenjuanxing platform.The content of the survey covered basic information of the digestive endoscopy center,implementation status of pretreatment,operation status of pretreatment,quali-ty monitoring and management.RESULTS A total of 122 medical institutions were finally included in the survey,61 of which were tertiary hospitals,35 were secondary hospitals,and 26 were primary hospitals.97.54％of the medical institutions could implement the pretreatment procedures after every endoscopes use,while there was significant difference in the concrete details of pretreatment among the various grades of hospitals.64.75％of the medical institutions used dedicated buttons for pretreatment,however,there was significant difference in the cause for failed change of dedicated buttons among the various grades of medical institutions(x2=14.657,P＜0.001).76.23％of the medical institutions carried out the pretreatment for special sites of the endoscopes(pli-ers' pipelines,auxiliary water rinsing pipelines).Gas and water insufflation were maintained for over 10 seconds(77.87％).The suction duration was judged mainly based on subjective knowledge.The enzyme solution was the major pretreatment solution(94.26％).The changing frequency was dominated by'one use per change'(45.08％).There was significant difference in the time interval between pretreatment and cleaning among the va-rious grades of medical institutions(x2=10.032,P=0.012).57.38％of the medical institutions evaluated the quality of the pretreatment,and visual observation was the major method for quality assessment(53.28％).There was significant difference in the establishment of pretreatment system among the various grades of medical institu-tions(x2=7.033.P=0.030).CONCLUSIONS The pretreatment of the endoscopes is overall performed well in the 122 medical institutions of Jiangsu Province;however,the details of pretreatment procedure,quality monito-ring and management need to be improved.It is suggested that the related departments should accelerate the revi-sion of endoscope pretreatment-related standards so as to standardize professional behavior.

Informed consent is an important ethical symbol in clinical research,and researchers have the responsibility to fully inform participants of the research information before conducting clinical research.However,it is difficult to obtain complete informed consent form participants or their guardians within a narrow treatment time period in clinical research conducted in emergency situations.Currently,in addition to traditional general informed consent,there are also reality-accepted informed consent,including exemption of informed consent,broad informed consent,and deferred informed consent.By introducing the origin and development process of deferred informed consent in clinical research,this paper sorted out the current application status of deferred informed consent,proposed the prerequisites for applying deferred informed consent in emergency situations,and explored the issues that need to be noted during the application process of deferred informed consent.It is hoped to provide an ethical defense and ethical procedure for the application of deferred informed consent in clinical research in emergency situations.

BACKGROUND:The researchers noted that upon embedding clinical-grade catgut and polyglycolide-co-lactide threads in the normal human"Zusanli"(ST 36)acupoint,the local area displayed temporal and inflammatory stimulatory effects,resulting in thread differentiation.However,the underlying mechanism behind thread involvement remains to be studied. OBJECTIVE:To investigate the expression levels of calcitonin gene-related peptide,5-hydroxytryptamine,leukotriene B4,and bradykinin at point"Zusanli"(ST 36)in rats after embedding catgut and polyglycolide-co-lactide respectively at different time points. METHODS:110 male SD rats were divided into a blank group(10 rats),a catgut embedding group(50 rats),and a polyglycolide-co-lactide embedding group(50 rats)according to the random number table method.In the blank group,no thread was embedded.In catgut embedding group and the polyglycolide-co-lactide embedding group,the thread was embedded in the left side of the ST36 acupoint once.Tissue was collected from the left side of the ST36 acupoint area 8 hours,3,7,14,and 21 days after embedding.The expression levels of calcitonin gene-related peptide and 5-hydroxytryptamine were detected by immunohistochemistry,and the contents of leukotriene B4 and bradykinin were detected by ELISA. RESULTS AND CONCLUSION:(1)Compared with the blank group,the expression of calcitonin gene-related peptide,5-hydroxytryptamine,bradykinin,and leukotriene B4 was significantly increased in the 8 hours,3,7,14,and 21 days of the catgut embedding group(P<0.05);calcitonin gene-related peptide expression was significantly increased in 8 hours,3,7,and 14 days in the polyglycolide-co-lactide embedding group(P<0.05);the expression of bradykinin was significantly increased in 8 hours,3,and 7 days(P<0.05);the expression of leukotriene B4 was significantly increased at 8 hours,3,7,14,and 21 days(P<0.05).(2)Compared with the polyglycolide-co-lactide embedding group,the expression of calcitonin gene-related peptide was increased at 7,14,21 days after thread embedding(P<0.05),and the expression of 5-hydroxytryptamine was increased at 8 hours,3,7,14 and 21 days after thread embedding(P<0.05);contents of leukotriene B4 and bradykinin in tissues were increased at 8 hours,3,14 and 21 days after embedding(P<0.05)in the catgut embedding group.(3)The results show that calcitonin gene-related peptide,5-hydroxytryptamine,leukotriene B4,and bradykinin in the acupoint region alter after catgut embedding in the ST36 of rats,as well as the alteration of calcitonin gene-related peptide,leukotriene B4,and bradykinin is found in the acupoint region after polyglycolide-co-lactide embedding in rats,which may be one of the mechanisms involved in the local time sensitive stimulus effects caused by embedding threads at acupoints.Moreover,there is a discernible difference between the two thread types.

Objective:To establish an active monitoring model for adverse reactions/events of sodium-glucose cotransporter 2 inhibitor (SGLT2i) for application and promotion in medical institutions.Methods:The subjects were type 2 diabetes patients who were discharged from the First Affiliated Hospital of Guangdong Pharmaceutical University (our hospital) from March 1, 2021 to October 1, 2022 and treated with SGLT2i. The patients were divided into 2 parts and assigned to the pre-trial phase and clinical application validation phase, respectively. SGLT2i-related adverse reactions/events from domestic and foreign databases and drug labels were retrieved, and triggering items were developed preliminarily. After soliciting opinions from experts in our hospital, referring to relevant medical orders, disease course records, and laboratory indicator reference values, the triggering items were modified, and a questionnaire survey was conducted using the Delphi method. According to expert opinions, the items were sorted, analyzed, discussed, and modified to form preliminary triggering items. A monitoring model was established based on the Chinese hospital drug surveillance system, the triggering items were improved during the pre-trial phase, and validated during the clinical application phase.Results:A total of 218 and 858 patients were obtained in the pre-trial phase and clinical application validation phase, respectively. Based on literature and drug labels, 44 triggering items were preliminarily formed. A total of 16 survey questionnaires from experts were collected. After being modified based on expert opinions, and further improved during the pre-trial phase, 24 triggering items were determined finally, including 8 laboratory indicators (A), 4 rescue agents (B), 11 clinical symptoms (C), and 1 intervention measure (D). The number of positive cases monitored by the model during the pre-trial phase and clinical application validation phase was 56 and 189, respectively. The actual number of positive cases under manual review was 12 and 57, respectively. The positive predictive value (PPV) of the triggering items in the pre-trial phase and clinical application phase were 25.0% (18/72) and 30.9% (77/249), respectively, with adverse reaction/event detection rates of 5.5% (12/218) and 6.6% (57/858), sensitivity of 92.3% (12/13) and 100% (57/57), and specificity of 78.5% (161/205) and 83.5% (669/801). Among the 12 positive cases in the pre-trial phase and 57 positive cases in the clinical application validation phase, the association evaluation was probable and possible (4, 8 cases and 16, 41 cases, respectively). The severity of adverse reactions/events was mainly grade 2 (11 cases and 55 cases, respectively). The main adverse reactions/events of SGLT2i were hypoglycemia, urinary tract infections, rashes, etc. Pancreatitis, weight loss, etc., which were not stated in the drug labels, were evaluated as probable.Conclusion:Through pre-trial and internal clinical validation phase, the adverse reaction/event active monitoring model established for SGLT2i in this study has high sensitivity and specificity, and can be applied practically in medical institutions.

Objective:To establish an active monitoring model for adverse reactions/events of sodium-glucose cotransporter 2 inhibitor (SGLT2i) for application and promotion in medical institutions.Methods:The subjects were type 2 diabetes patients who were discharged from the First Affiliated Hospital of Guangdong Pharmaceutical University (our hospital) from March 1, 2021 to October 1, 2022 and treated with SGLT2i. The patients were divided into 2 parts and assigned to the pre-trial phase and clinical application validation phase, respectively. SGLT2i-related adverse reactions/events from domestic and foreign databases and drug labels were retrieved, and triggering items were developed preliminarily. After soliciting opinions from experts in our hospital, referring to relevant medical orders, disease course records, and laboratory indicator reference values, the triggering items were modified, and a questionnaire survey was conducted using the Delphi method. According to expert opinions, the items were sorted, analyzed, discussed, and modified to form preliminary triggering items. A monitoring model was established based on the Chinese hospital drug surveillance system, the triggering items were improved during the pre-trial phase, and validated during the clinical application phase.Results:A total of 218 and 858 patients were obtained in the pre-trial phase and clinical application validation phase, respectively. Based on literature and drug labels, 44 triggering items were preliminarily formed. A total of 16 survey questionnaires from experts were collected. After being modified based on expert opinions, and further improved during the pre-trial phase, 24 triggering items were determined finally, including 8 laboratory indicators (A), 4 rescue agents (B), 11 clinical symptoms (C), and 1 intervention measure (D). The number of positive cases monitored by the model during the pre-trial phase and clinical application validation phase was 56 and 189, respectively. The actual number of positive cases under manual review was 12 and 57, respectively. The positive predictive value (PPV) of the triggering items in the pre-trial phase and clinical application phase were 25.0% (18/72) and 30.9% (77/249), respectively, with adverse reaction/event detection rates of 5.5% (12/218) and 6.6% (57/858), sensitivity of 92.3% (12/13) and 100% (57/57), and specificity of 78.5% (161/205) and 83.5% (669/801). Among the 12 positive cases in the pre-trial phase and 57 positive cases in the clinical application validation phase, the association evaluation was probable and possible (4, 8 cases and 16, 41 cases, respectively). The severity of adverse reactions/events was mainly grade 2 (11 cases and 55 cases, respectively). The main adverse reactions/events of SGLT2i were hypoglycemia, urinary tract infections, rashes, etc. Pancreatitis, weight loss, etc., which were not stated in the drug labels, were evaluated as probable.Conclusion:Through pre-trial and internal clinical validation phase, the adverse reaction/event active monitoring model established for SGLT2i in this study has high sensitivity and specificity, and can be applied practically in medical institutions.

OBJECTIVE To study the effect and mechanism of N1,N2 bis(2,3-dihydroxy-4,6-disul-fonic acid benzyl)ethylenediamine sodium salt(NBED)on uranium excretion.METHODS ICR mice were divided into the blank control group,uranium exposure group(0.03 mg·mouse-1),uranium expo-sure+diethylenetriamine pentaacetic acid(DTPA-CaNa3)(150 mg·kg-1)group,and the uranium expo-sure+NBED(45,90,180 mg·kg-1)group.After uranyl acetate was injected into the tail vein of mice,appro-priate doses of NBED or DTPA-CaNa3 were injected into the tail vein.After 24 h,the uranium contents in the kidney,bone and liver+spleen+muscle were determined by inductively coupled plasma mass spectrometry(ICP-MS).The dissociation constant of NBED and the complexation constant of NBED with uranyl were determined via potentiometric titration.RESULTS Animal experiments showed that NBED 45,90 and 180 mg·kg-1 could significantly reduce the uranium accumulation in the kidney by 48.2%-66.5%,in the bone by 21.4%-54.8%,and in liver+spleen+muscle by 38.2%(P<0.01),compared to the uranium exposure group,47.8%,21.4%and 22.7%respectively by DTPA-CaNa3(P<0.05),and the effect in the NBED 180 mg·kg-1 group was significantly better than in the DTPA-CaNa3 group(P<0.05).The results of potentiometric titration showed that there was about 22.3%LH5,59.8%LH4 and 17.85%LH3(L means NBED)in NBED at pH 7.4,and the secondary dissociation LH4 was the main form.In the range of pH 3-11,there were four complex compounds of NBED and uranyl,and their step-wise complex cumulative constants were logβ111(12.5),logβ101(9.8),logβ102(15.3),logβ1-12(6.5)respectively.The(UO2)L22-was the main species(75.3%)at physiological pH 7.4,and the-log[UO22+free]value(pUO2)of free uranyl ion in solution was 9.57.CONCLUSION NBED mainly exists in the form of secondary dissociated LH4in vivo,and chelates with uranyl 2:1 to form uranyl complex,which is excreted in vitro.Intravenous administration of NBED can more effectively promote excretion than DTPA-CaNa3.