Objective:To explore the radiation protection awareness of pediatric CT chaperones and the guidance effects under different scenario modes.Methods:This study investigated 491 pediatric CT chaperones aged 24 to 63 who were treated in the Guangzhou Women and Children′s Medical Center from October 2023 to January 2024. These pediatric CT chaperones were guided to wear lead protective equipment, including a lead apron, neck shield, and cap, in the order of the self-pickup mode, single voice-sign language prompt mode, and multiple voice-sign language prompt mode. They were assigned 0.5 to 3 points/piece for each wearing, and their scoring result under different guidance modes were recorded. Moreover, the relationship of the scoring result with the age, gender, education, residence, and accompanying frequency was statistically analyzed.Results:In the self-pickup mode, the wearing accuracy rates of three kinds of protective equipment decreased in the order of the lead apron (31.57%, 155/491), lead cap (23.01%, 113/491), and lead neck shield (16.29%, 80/491). The number of pediatric CT chaperones wearing three kinds of protective equipment properly in the self-pickup mode represented 15.48% (76/491), including two first-time chaperones (2.63%, 2/76) and 74 chaperones experiencing two or more accompanying examinations (97.37%, 74/76). In the single prompt mode, the wearing accuracy rates of three kinds of protective equipment decreased in the order of the lead cap (71.89%, 353/491), lead apron (65.99%, 324/491), and lead neck shield (60.08%, 295/491). The proportion of accurate wearing of three kinds of protective equipment in the single prompt mode was 45.82% (225/491). In the multi-prompt mode, the wearing accuracy rates of three kinds of protective equipment decreased in the order of the lead neck shield (23.63%, 116/491), lead cap (5.09%, 25/491), and lead apron (2.44%, 12/491). Among all the pediatric CT chaperones, 38.70% (190/491) completed the accurate wearing of the three kinds of protective equipment until the multi-prompt mode.Conclusions:Pediatric CT chaperones typically show poor radiation protection awareness, necessitating the guidance of standardized voice-sign language prompts.

Objective:To explore the radiation protection awareness of pediatric CT chaperones and the guidance effects under different scenario modes.Methods:This study investigated 491 pediatric CT chaperones aged 24 to 63 who were treated in the Guangzhou Women and Children′s Medical Center from October 2023 to January 2024. These pediatric CT chaperones were guided to wear lead protective equipment, including a lead apron, neck shield, and cap, in the order of the self-pickup mode, single voice-sign language prompt mode, and multiple voice-sign language prompt mode. They were assigned 0.5 to 3 points/piece for each wearing, and their scoring result under different guidance modes were recorded. Moreover, the relationship of the scoring result with the age, gender, education, residence, and accompanying frequency was statistically analyzed.Results:In the self-pickup mode, the wearing accuracy rates of three kinds of protective equipment decreased in the order of the lead apron (31.57%, 155/491), lead cap (23.01%, 113/491), and lead neck shield (16.29%, 80/491). The number of pediatric CT chaperones wearing three kinds of protective equipment properly in the self-pickup mode represented 15.48% (76/491), including two first-time chaperones (2.63%, 2/76) and 74 chaperones experiencing two or more accompanying examinations (97.37%, 74/76). In the single prompt mode, the wearing accuracy rates of three kinds of protective equipment decreased in the order of the lead cap (71.89%, 353/491), lead apron (65.99%, 324/491), and lead neck shield (60.08%, 295/491). The proportion of accurate wearing of three kinds of protective equipment in the single prompt mode was 45.82% (225/491). In the multi-prompt mode, the wearing accuracy rates of three kinds of protective equipment decreased in the order of the lead neck shield (23.63%, 116/491), lead cap (5.09%, 25/491), and lead apron (2.44%, 12/491). Among all the pediatric CT chaperones, 38.70% (190/491) completed the accurate wearing of the three kinds of protective equipment until the multi-prompt mode.Conclusions:Pediatric CT chaperones typically show poor radiation protection awareness, necessitating the guidance of standardized voice-sign language prompts.

Objective:To understand the current genotype distribution, epidemiological characteristics, and their relationship with pregnancy outcomes in pregnant women with hepatitis C in Nanjing city.Methods:An epidemiological survey method was used to analyze the data of 113 pregnant women with hepatitis C who were successfully genotyped and admitted to Nanjing Second Hospital from January 2018 to December 2023. The comparison of the quantitative data was analyzed by a t-test or rank-sum test between the two groups. The comparison of the enumeration data was analyzed using the χ2 test, adjusted χ2 test, or Fisher's exact probability method between the two groups. Results:A total of six kinds of genotypes (1b, 2a, 3a, 3b, 6a, 6n) were identified in 113 cases. The primary genotype was 1b (accounted for 76.1%), followed by 6, 3, and 2 rare genotypes, while 1 mixed type (type 2 mixed with type 6) and genotypes 4 and 5 were non-identified. The proportion of genotype 1b increased with the extension of the birth cohort, and the difference was statistically significant ( χ2=24.35, P＜0.001). There was a difference in genotyping proportions with educational and employment background ( χ2=14.74, P＜0.001; χ2=19.50, P＜0.001). The proportion of non-1b types increased in populations with low educational backgrounds and unemployment. The proportion of type 1b was higher in those with a history of blood transfusion and hospitalization during infancy ( χ2=5.57, P=0.018; χ2=5.17, P=0.023). The proportion of non-1b type was higher in those with a history of drug abuse ( χ2=22.32, P＜0.001). Normal pregnancy outcomes had no statistically significant difference between genotype 1b and non-1b groups. However, all pregnant women who experienced adverse infant outcomes had genotype 1b. Conclusion:Pregnant women with hepatitis C in Nanjing city are mainly genotype 1b, with genotype 3b<5%, and there is no significant difference in maternal and infant outcomes among different genotype subtypes. Therefore, no testing of genotype for women of childbearing age. However, the focus should be on the management of pregnancy, health education, and postpartum preparation for direct acting antiviral treatment.

Objective:To understand the current genotype distribution, epidemiological characteristics, and their relationship with pregnancy outcomes in pregnant women with hepatitis C in Nanjing city.Methods:An epidemiological survey method was used to analyze the data of 113 pregnant women with hepatitis C who were successfully genotyped and admitted to Nanjing Second Hospital from January 2018 to December 2023. The comparison of the quantitative data was analyzed by a t-test or rank-sum test between the two groups. The comparison of the enumeration data was analyzed using the χ2 test, adjusted χ2 test, or Fisher's exact probability method between the two groups. Results:A total of six kinds of genotypes (1b, 2a, 3a, 3b, 6a, 6n) were identified in 113 cases. The primary genotype was 1b (accounted for 76.1%), followed by 6, 3, and 2 rare genotypes, while 1 mixed type (type 2 mixed with type 6) and genotypes 4 and 5 were non-identified. The proportion of genotype 1b increased with the extension of the birth cohort, and the difference was statistically significant ( χ2=24.35, P＜0.001). There was a difference in genotyping proportions with educational and employment background ( χ2=14.74, P＜0.001; χ2=19.50, P＜0.001). The proportion of non-1b types increased in populations with low educational backgrounds and unemployment. The proportion of type 1b was higher in those with a history of blood transfusion and hospitalization during infancy ( χ2=5.57, P=0.018; χ2=5.17, P=0.023). The proportion of non-1b type was higher in those with a history of drug abuse ( χ2=22.32, P＜0.001). Normal pregnancy outcomes had no statistically significant difference between genotype 1b and non-1b groups. However, all pregnant women who experienced adverse infant outcomes had genotype 1b. Conclusion:Pregnant women with hepatitis C in Nanjing city are mainly genotype 1b, with genotype 3b<5%, and there is no significant difference in maternal and infant outcomes among different genotype subtypes. Therefore, no testing of genotype for women of childbearing age. However, the focus should be on the management of pregnancy, health education, and postpartum preparation for direct acting antiviral treatment.

【Objective】 To analyze the influence of β-lactam antibiotics on RBC aging and clearance by detecting various indicators of aging and clearance on RBCs, as well as the differences in phagocytosis for erythrocytes before and after drugs treated in vitro. 【Methods】 RBCs were treated by β-lactam antibiotics, including Penicillin, Cefepime, Cefoperazone and Ceftazidime, and the changing of phosphatidylserine (PS) and clearance related CD markers, including CD35, CD47, CD55 and CD59 on the surface of the RBCs, were detected by flow cytometry at 0h and 24h after drugs treatment. The proportion of acanthocytes by microscope also at 0h and 24h after drugs treatment was calculated. The phagocytosis of drug-treated RBC was detected by monocyte monolayer assay (MMA). Untreated RBCs were incubated in PBS by the same condition as a negative control.The influence of β-lactam antibiotics on RBC aging and clearance by all the results above was studied. 【Results】 Compare to the untreated RBCs, the drug treated RBCs showed a higher PS level on the cell surface. The results showed by percentage as following(0 h vs 24 h): Penicillin 9.42% vs 93.30%, Cefepime 3.88% vs 57.27%, Cefoperazone 4.71% vs 75.75% and Ceftazidime 3.05% vs 43.19%. The acanthocytes ratio was as following(0 h vs 24 h): Penicillin 7.33% vs 86%, Cefepime 2.67% vs 52.67%, Cefoperazone 3.33% vs 67.67% and Ceftazidime 3.33% vs 90.67%. On the opposite, the clearance related CD markers, showed an obviously lower level after drugs treated(0 h vs 24 h): CD35: Penicillin 7.36% vs 11.87%, Cefepime 0.14% vs 28.51%, Cefoperazone 11.85% vs 21.55% and Ceftazidime 7.63% vs 8.73%; CD47: Penicillin 1.22% vs 9.13%, Cefepime 1.80% vs 0.86%, Cefoperazone 0.08% vs 6.85% and Ceftazidime 1.54% vs 5.50%; CD55: Penicillin 14.46% vs 44.31%, Cefepime 17.27% vs 38.41%, Cefoperazone 19.28% vs 33.28% and Ceftazidime 14.62% vs 34.13%; CD59: Penicillin 4.71% vs 20.56%, Cefepime 4.03% vs 7.60%, Cefoperazone 5.91% vs 22.38% and Ceftazidime 5.93% vs 30.89%. Drug-treated RBCs attached more to monocytes than untreated RBCs. 【Conclusion】 The β-lactam antibiotics could induce the changing of PS and the clearance of related CD markers on surface of RBCs. They also could lead acanthocytes and make the RBCs more susceptible to phagocytosis by monocytes. The β-lactam antibiotics could promote the RBCs aging and clearance, which might deteriorate the DIIHA.

【Objective】 To explore the application of matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS) in the genotyping of difficult blood typing samples, and to provide evidence for clinical blood transfusion. 【Methods】 Three ambiguous blood group samples, submitted to Shanghai Blood Center by Shanghai regional hospitals, were studied, of which Sample1 included the proband and his parents. Serological methods were used to perform blood group typing, direct antibody test, unexpected antibody screening and identification test. Blood group genotyping was performed by using the MALDI-TOF MS detection systeme stablished in our laboratory. Sanger sequencing was used to confirm gene mutation sites, and serological or flow methods were used to verify specific samples′ phenotype. 【Results】 Serological results indicated the existence of antibodies against high frequency antigens in sample 1 (including proband and her mother), 2 and 3. The genotyping results of MALDI-TOF MS showed that the proband of sample 1 was Di(a+ b+ ), her father was Di(a-b+ ), her mother was Di(a+ b-), sample 2 was p, and sample 3 was Jr(a-). Sequencing results of three samples were consistent with mass spectrometry typing results. Serological results showed that sample 2 had a p phenotype. The flow cytometry results suggested that sample 3 had a Jr(a-) phenotype. 【Conclusion】 For the first time, we applied MALDI-TOF MS technology to blood type genotyping of ambiguous clinical samples in China. Compared with other genotyping methods such as PCR-SSP, MALDI-TOF MS has the advantages of rapid detection, high throughput and high specificity, which would contribute to identification of difficult blood typing samples in the future, as well as rare blood group screening.

【Objective】 To establish human hybridoma cell lines, secreting monoclonal antibody against antigens of Rh blood system, from a donor with rare D--phenotype. 【Methods】 Peripheral blood B lymphocytes of an O type female donor, lacking C/c/E/e antigens on her erythrocyte, were transformed with Epstein-Barr virus (EBVs). EBVs were harvested from the cultural supernatant of B95-8 cells. The transformed lymphoblastoid cell line (LCL) secreting antibodies to C antigens were picked up and then hybridized with the myeloma SHM-D33 using electric fusion technique. Hybridoma cells were selected by HATD-Ouabain(HOTD)(Hypoxantine, Aminopterin, Thymidine, 2-Deoxycytide, and Ouabain)culture medium, microplate antibody screening and limited dilution subcloning. The monoclonal antibody was assayed by serological test and was confirmed by flow cytometry (FCM). 【Results】 From the cultural supernatant of D--peripheral blood transformed B lymphocytes, 3A6-C6, which agglutinated with R1R1(DCe/DCe)O-type RBCs but not with R2R2(DcE/DcE)O-type RBCs, was screened and preliminarily identified as anti-C. We established a hybridoma cell line secreting anti-C immunoglobulin M from B cells of D--individual successfully after hybridization with SHM-D33 myeloma cells. 【Conclusion】 The study had laid the groundwork for future research and development of human monoclonal antibodies against Rh antigens of RBC in future for diagnosis and screening purpose.

Objective To investigate any correlation between cognition and auditory event-related potential (ERP) after traumatic brain injury (TBI),and to explore the diagnostic value of the P300 ERP for TBI patients.Methods Thirty TBI patients and 28 healthy subjects were recruited.Their P300 auditory event-related potentials were measured and the Montreal cognitive assessment (MoCA) was administered.Results The TBI patients' total MoCA scores and their scores on most of the sub-item components were significantly lower than those of the control subjects,though their naming and speech showed no significant difference.The TBI patients had abnormal P300 responses.Their N1,P2,N2 and P3 latencies were significantly longer and their P2 and P3 amplitudes were significantly lower than those of the control group.Stepwise regression and multivariate analysis showed that the P300 latency was significantly associated with delayed memory,impaired visual spatial executive functioning and total MoCA score.Conclusion P300 can be used as a quantitative electrophysiological index for detecting cognitive impairment in patients with TBI.

Objective To study the distribution of pathogenic spectrum in children with severe community-acquired pneumonia(CAP) and bacteria antibiotic resistance.Methods One hundred and ninety-three children with severe CAP were enrolled from Mar 2011 to Feb 2012.Sputum specimens were collected for bacterial culture and drug sensitive test.Meanwhile mycoplasma pneumonia and chlamydia trachomatis were detected by fluorescent quantitative polymerase enzyme technology.Antigen of virus were detected by immunofluorescence assay.Results A total of 96 cases (49.7％) were bacteria positive in 193 children with severe CAP.The top four bacteria strains were klebsiella pneumoniae,staphylococcus aureus,escherichia coli and streptococcus pneumoniae.Most of gram-negative bacteria were resistant to ampicillin,cefazolin,ceftriaxone,ceftazidime,and compound sulfamethoxazole,but were sensitive to piperacillin/tazobactam,imipenem,ciprofloxacin,levofloxacin,amikacin.Gram-positive bacteria were resistant to penicillin and erythromycin,but sensitive to vancomycin.Fifty-three cases (27.5 ％,53/193) were virus Positive,81.1％ of which were less than 1 year old.Respiratory syncytial virus accounted for the most prevalent pathogen,followed by adenovirus,influenza virus A.Mycoplasma pneumoniae were positive in 4 patients (2.1％,4/193),chlamydia trachomatis were positive in 3 patients (1.6％,3/193).Mixed infection was found in 23 cases (11.9％,23/193).There were 14 cases (7.2％,14/193) with undetected pathogens.Conclusion Bacterium is the major pathogen in children with severe CAP and the virus is the second.The initial antibiotics administration of piperacillin/tazobactam or carbapenem and vancomycin should be chosen for severe bacteria pneumonia.

Objective To observe the changes of cognition and auditory event-related potential P300 on vascular cognitive impairment-no dementia (VCIND) patients before and after cognitive rehabilitation training,then further to explore the application value of P300 in early diagnosis of vascular cognitive impairment (VCI). MethodsA total of 57 patients with VCIND were randomly assigned to the treatment group ( n =30) and the control group ( n =27),and 30 healthy volunteers without cognitive deficits were recruited as normal group.Each patient was examined with auditory-P300 and scored with mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA) scale.The measurement indicators were analyzed and evaluated with the factors of education,age and so on. ResultsThe P300 latency in VCIND group was longer,and the amplitude lower than those in normal group before treatment (P＜0.05 ),the latency lengthening was more significant than the lowering of the amplitude ( P＜0.01 ).The cognitive assessment scale scores of MMSE,MoCA and ADL (Barther index,BI) in VCIND group were lower than those in normal group (P＜0.05),while no significant difference was revealed between the VCIND and normal groups with regard to naming and speech( P ＞ 0.05 ).A highly positive correlation between age and P300 latency as well as a significantly negative correlation between years of education and P300 latency were demonstrated( P＜0.05 ).After cognitive rehabilitation therapy the P300 latency in VCIND group was shortened,the amplitude increased (P＜0.05 ),scores of the items of cognitive scale raised(P＜0.05 ) and the change of each indicator was more statistically significant in treatment group(P＜0.05). ConclusionP300 could objectively reflect early cognitive dysfunction in VCIND patients.Early cognitive training could effectively promote cognitive function of VCI patients.