【Objective】 To explore the feasibility of blood transfusion compatibility testing for multiple myeloma(MM) patients treated with anti-CD38 monoclonal antibody daratumumab (DARA) after DARA-Fab fragment blocking, and to evaluate the transfusion efficacy by comparing with dithiothreitol(DTT) method. 【Methods】 After DARA was prepared into DARA-Fab fragments using PierceFab preparation kit, the neutralization effects of different volumes (5, 10, 15, 30 μL) on screening cells and panel cells were confirmed. DARA-Fab fragments and screening cells with specific antigens and corresponding monoclonal antibody reagents were used as the experimental group and the control group with the same volume of saline for incubating and centrifugin.Twenty MM patients treated with DARA were selected for cross-matching with DARA-Fab and DTT respectively, and the laboratory indexes before and after transfusion were statistically analyzed, and the two blood matching methods were compared. 【Results】 After incubating and centrifuging, the results of DARA-Fab fragments(15, 30 μL) with screening cells and serum mixed with DARA were negative, while those of DARA-Fab(5, 10 μL) were positive. 15μL DARA-Fab treated antibody identification cells (2, 3, 4, 5, 7, 9, 11) were negative, antibody identification cells (1, 6, 8, 10, 12) were negative after 30 μL DARA-Fab fragments treatment; the results of MNS, Duffy, Kidd, Kell, Lewis, Rh blood group system of the experimental group were consistent with those of the control group; the hemoglobin (Hb) (g/L) of 20 patients after infusion of RBC (73.90±1.90) was significantly higher than that before transfusion (63.60±1.58), P<0.01. There was no significant difference in total bilirubin(TBil)(μmol/L)(16.25±3.54 vs 17.87±3.57), direct bilirubin(DBIL)(μmol/L)(6.31±2.32 vs 7.10±2.80)and indirect bilirubin(I-Bil)(9.94±1.38 vs 10.77±1.22) before and after infusion(P>0.05).And no statistical difference was noticed in Hb (10.75±1.04 vs 10.30±0.98), TBil (3.31±1.47 vs 3.31±0.55), DBIL(2.76±1.24 vs 2.60±0.83), and I-Bil(1.97±0.40 vs 2.82±0.53) between the DTT treatment method and the DARA Fab fragment treatment before and after transfusion(P>0.05). 【Conclusion】 DARA-Fab can remove the interference of RBC on cross matching by blocking CD38 antigen. This method has no effect on the antigens of common RBC blood group systems, and shows significant blood transfusion efficacy as that of DTT method.

Benign biliary strictures is a common complication of hepatobiliary surgery and disease. For conventional benign biliary stenosis, endoscopic treatment or percutaneous intervention can usually achieve a more satisfactory therapeutic effect, but for refractory benign biliary stenosis that cannot pass the guide wire or the above treatments all have failed, the clinical treatment is quite difficult. Compared with traditional surgery, magnetic compression anastomosis has the advantages of convenient operation, low risk of complications, and low recurrence rate, and can be used as a treatment for refractory benign biliary strictures. In this article, we review the research progress of magnetic compression anastomosis in the treatment of refractory benign biliary strictures.

Objective:To explore effects of somatosensory games combined with high frequency repetitive transcranial magnetic stimulation on cognitive function rehabilitation in patients with mild cognitive impairment after stroke.Methods:Using the convenience sampling method, a total of 64 patients with post stroke cognitive impairment (PSCI) admitted to Rehabilitation Department of the First Affiliated Hospital of Wenzhou Medical University from January to June 2021 were selected as the research objects. According to the order of admission and the 1∶1 matching principle, they were randomly divided into the control group and the observation group, with 32 cases in each group. The patients in the control group received high-frequency repetitive transcranial magnetic stimulation and conventional cognitive rehabilitation training, while the observation group received somatosensory game training on the basis of the control group. Scores of National Institute of Health Stroke Scale (NIHSS) , Montreal Cognitive Assessment (MoCA) , Mini-mental State Examination (MMSE) and Modified Barthel Index (MBI) were compared between the two groups before and after the intervention.Results:After 20 days of intervention, the NIHSS score of the observation group was lower than that of the control group, and the difference was statistically significant ( P<0.05) . The scores of MoCA, MMSE and MBI in the observation group were higher than those in the control group, and the differences were statistically significant ( P<0.05) . The compliance rate of rehabilitation therapy in the observation group was higher than that in the control group, and the difference between the two groups was statistically significant (χ 2=4.267, P=0.039) . Conclusions:Somatosensory games combined with high-frequency repetitive transcranial magnetic stimulation can improve the cognitive ability of patients with PSCI, improve the compliance rate of patients with rehabilitation exercises and help patients recover.

Guided by the emphasis on learning process, the educational reform has designed a "trinity" comprehensive evaluation system (quantitative clinical practice, in-class medical record analysis, and staged comprehensive written test) as the formative evaluation of the course. Through this assessment system, students' self-learning potential is stimulated, clinical skills practice is strengthened, and "taking exams to promote learning and taking exams to promote teaching" is realized. In the practice of teaching reform, it has been found that compared with the conventional teaching class, the students in the teaching reform class have higher participation and are more satisfied with the process assessment of the "trinity" comprehensive evaluation system.

[ ABSTRACT] AIM:To study the influence of Raptor on the invasion ability of glioma cells.METHODS: The technique of RNA interference was used.U87 cells were transfected with Raptor restricted siRNA plasmid, and the expres-sion level of Raptor in the transfected cells was detected by Western blotting.The invasive ability of the cancer cells in vitro was determined.The phosphorylation level of ARK5 and the expression of MMP-2 and MMP-9 were detected by Western blotting.The expression levels of Raptor in the tumor samples of low-grade gliomas ( WTO grade I and grade II) and high-grade gliomas (WTO grade III and grade IV) were also analyzed by immunohistochemical staining.RESULTS: Raptor siRNA was transfected into U87 cells and the cells were named siRaptor/U87 cells.The cells transfected with the control plasmid was named Scr/U87 cells.The expression level of Raptor in siRaptor/U87 cells was lower than that in Scr/U87 cells.The results of in vitro invasion assay showed that the number of siRaptor/U87 cells penetrating the Matrivgel matrix membrane was less than that of Scr/U87 cells (P<0.01).The protein expression of MMP-2 and MMP-9, and phosphoryl-ation of ARK5 protein in the cells in the experimental group were lower than those in control group.The correlation between the expression of Raptor in gliomas and the degree of deterioration was also observed ( P<0.01) .CONCLUSION: The expression of Raptor may contribute to the invasion ability of glioma cells by phosphorylation of ARK5 and increase in the levels of MMP-2 and MMP-9.

Objective: To observe theclinical effect of tuina reduction manipulation on leg length discrepancy and lumbosacral pain due to sacroiliac joint subluxation.
Methods: A total of 60eligible cases were randomly allocated into an observation group and a control group, 30 in each group. Cases in the observation group were treated with conventional tuina plus reduction manipulation of sacroiliac joint subluxation; whereas cases in the control group were treated with conventional tuina plus acupuncture. The clinical effects were observed after 10 times of treatment. In addition, the relapse rates were observed 2 months after treatment.
Results: The total effective rate in the observation group was 80.0%, versus 50.0% in the control group, showing a statistically significant difference (P<0.05). The relapse rate of lumbosacral pain in the observation group was 12.5%, versus 66.7% in the control group, showing a statistically significant difference (P<0.01). The relapse rate of leg length discrepancy in the observation group was 16.7%, versus 80.0% in the control group, showing a statistically significant difference (P<0.01).
Conclusion: Tuina reduction manipulation can obtain substantial therapeutic effect for leg length discrepancy and lumbosacral pain due to sacroiliac joint subluxation, coupled with a low relapse rate.

OBJECTIVE:To study the effect of penehyclidine on the level of cytokines in infants with congenital heart disease undergoing cardiopulmonary bypass(CPB).METHODS:A total of 60 children with congenital heart disease(CHD)were divided into three groups:Group P1(intramuscularly injected with penehyclidine before operation),Group P2(intramuscularly injected with penehyclidine before and after operation),and Group C(intramuscularly injected with atropine before operation).The levels of cytokine were determined at different time.Postoperative salivary secretion and X-ray of chest were observed.RESULTS:After CPB,the levels of the inflammatory cytokine in all the three groups were significantly higher,with those in Group P1 and P2 significantly lower than in Group C(P