OBJECTIVE: By analyzing the correlation between genotypes and phenotypes, we explored the impact of the variant c.917T>C (p.L306P) in the ABO*B.01 allele on the expression and function of B-glycosyltransferase (GTB). This study aims to elucidate the molecular mechanisms underlying the occurrence of this subtype. METHODS: The study subjects included a blood donor specimen with incompatible forward and reverse ABO typing results. ABO phenotyping was determined using ABO blood group serology and GTB activity testing. Subsequently, Sanger sequencing and third-generation sequencing based on the PacBio platform were employed to sequence the ABO gene, resulting in the determination of haplotype sequences. Mutations were identified through sequence alignment. An in vitro cell expression system was established to assess the impact of the mutation site on antigen expression. RESULTS: The index case in this study was identified as B subtype with the allelic genotype c.917T>C in ABO*B.01/ABO*O.01.01 , which has not been previously reported. in vitro expression results revealed decreased levels of GTB expression and overall GTB activity in the mutant cells. Furthermore, the expression of the B antigen on the cell membrane was weaker in the mutant cells compared to the wild-type cells. CONCLUSION The p.L306P variation caused by the c.917T>C mutation in the ABO*B.01 allele may be a genetic factor contributing to the reduced expression of B antigens on the surface of red blood cells.
Humans ; ABO Blood-Group System/genetics* ; Alleles ; Genotype ; Mutation ; Glycosyltransferases/genetics* ; Haplotypes ; Phenotype

Objective:To search and evaluate the relevant evidence of percutaneous external fixation needle care management, and integrate the evidence to provide the best nursing management strategy for clinical needle care.Methods:BMJ best clinical practice, UpToDate, PubMed, CINAHL, ProQuest, CNKI, Wanfang database and other domestic and foreign databases related to clinical practice guidelines, evidence summary, expert consensus, systematic evaluation, randomized controlled trial were searched. The search period was from database inception to November 2023. Evaluated the quality of the included literatures, and conduct evidence extraction, level evaluation and evidence summary analysis.Results:A total of 11 articles were included, including 1 guideline, 1 evidence summary, 3 systematic reviews, 2 expert consensus, and 4 randomized controlled trials. The 10 pieces of best evidence were summarized in 5 categories, including needle evaluation, cleaning management, scab management, disinfection management, and dressing management.Conclusions:This study summarized the best evidence on the management of percutaneous external fixation needle care, and provides evidence- based basis for clinical nurses to perform needle care. In clinical practice, evidence should be selectively and reasonably applied in combination with clinical situations and relevant factors to promote the improvement and development of clinical nursing work.

Abstract: Objective　To understand and evaluate the current situation of health emergency personnel capacity building in Chongqing, clarify the main factors that affect and restrict this capacity building, and propose countermeasures and suggestions. This will provide a reference for further improving the capacities of health emergency response in Chongqing. Methods　Questionnaire surveys and expert interviews were used to analyze the current situation of health emergency personnel capacity building in 39 disease control and prevention centers and 10 medical institutions in Chongqing from four dimensions: general status, health status, training and drilling status, and health emergency capability. Spearman's rank correlation analysis was used to analyze the correlation between self-evaluation of health status and self-evaluation of sleep quality, and multiple linear regression was employed to analyze the main factors influencing emergency response capability. Results　Among Chongqing's health emergency personnel, 34.85% had a BMI of overweight or above, only 37.92% regularly conducted health monitoring, and 9.19% experienced health problems during emergencies. The proportions of personnel who participated in two or more training sessions per year, two or more drills per year, and one or more physical fitness evaluations per year were 52.07%, 22.76%, and 31.12%, respectively. The average score of emergency response capability of Chongqing's health emergency personnel was 76.11, with the lowest score in the policy advice capability (48.59). Personnel with a medical background (β=1.025), longer years of emergency response work (β=1.774), better self-evaluated physical condition (β=3.664), better self-evaluated mental condition (β=4.362), and participation in drillings twice or more per year (β=2.696) had higher scores in terms of health emergency response capability (P<0.05). Conclusions　There are still some weaknesses in the capacity building of Chongqing's health emergency response personnel. Future efforts should focus on optimizing the staffing structure of the health emergency response team, strengthening the physical training of emergency personnel in normal times and health monitoring and management under emergency conditions, continuously promoting the actual, contextual, and professional emergency training and drilling, and comprehensively improving the physical and mental quality, professional quality, and emergency response capacity of health emergency personnel through multiple approaches.

This study aimed to explore key quality control factors that affected the prognosis of intensive care unit (ICU) patients in Chinese mainland over six years (2015-2020). The data for this study were from 31 provincial and municipal hospitals (3425 hospital ICUs) and included 2 110 685 ICU patients, for a total of 27 607 376 ICU hospitalization days. We found that 15 initially established quality control indicators were good predictors of patient prognosis, including percentage of ICU patients out of all inpatients (%), percentage of ICU bed occupancy of total inpatient bed occupancy (%), percentage of all ICU inpatients with an APACHE II score ⩾15 (%), three-hour (surviving sepsis campaign) SSC bundle compliance (%), six-hour SSC bundle compliance (%), rate of microbe detection before antibiotics (%), percentage of drug deep venous thrombosis (DVT) prophylaxis (%), percentage of unplanned endotracheal extubations (%), percentage of patients reintubated within 48 hours (%), unplanned transfers to the ICU (%), 48-h ICU readmission rate (%), ventilator associated pneumonia (VAP) (per 1000 ventilator days), catheter related blood stream infection (CRBSI) (per 1000 catheter days), catheter-associated urinary tract infections (CAUTI) (per 1000 catheter days), in-hospital mortality (%). When exploratory factor analysis was applied, the 15 indicators were divided into 6 core elements that varied in weight regarding quality evaluation: nosocomial infection management (21.35%), compliance with the Surviving Sepsis Campaign guidelines (17.97%), ICU resources (17.46%), airway management (15.53%), prevention of deep-vein thrombosis (14.07%), and severity of patient condition (13.61%). Based on the different weights of the core elements associated with the 15 indicators, we developed an integrated quality scoring system defined as F score=21.35%xnosocomial infection management + 17.97%xcompliance with SSC guidelines + 17.46%×ICU resources + 15.53%×airway management + 14.07%×DVT prevention + 13.61%×severity of patient condition. This evidence-based quality scoring system will help in assessing the key elements of quality management and establish a foundation for further optimization of the quality control indicator system.
Humans ; China/epidemiology* ; Cross Infection/epidemiology* ; Intensive Care Units/statistics & numerical data* ; Quality Control ; Quality Indicators, Health Care/statistics & numerical data* ; Sepsis/therapy* ; East Asian People/statistics & numerical data*

Objective To analyze the epidemiological characteristics of COVID-19 cases reported in Xianyang City from January to February 2020. Methods We retrospectively studied 17 COVID-19 patients diagnosed in Xianyang Central Hospital. The patients were characterized clinically and epidemiologically. Results The 17 patients included 10 male and 7 female, with an average age of(39.59±17.31)years. The median interval of time between onset and diagnosis was four days(1-10 days), whereas the median duration of COVID-19 was 16 days(3-23 days). Of the patients, six were mild, 10 were pneumonia, and one was severe. A total of 15 patients had fever as the onset, accompanied by fatigue, sore throat, sputum, vomit, muscle soreness; the other two patients were asymptomatic. There were no complications documented in all the patients. Patients had low levels of white blood cells and lymphocytes. Chest CT scan showed diverse diffuse ground-glass shadow. Eleven patients had travel history in Wuhan before the onset, four patients had contact with people who had travel history or residence history in Wuhan, and the other two patients did not report epidemiological exposure history. In addition, four of the 17 patients were clustered cases. Conclusion General population is susceptible to COVID-19. The majority of the confirmed cases have epidemiological exposure history. Routine examination, including white blood cell, lymphocyte count and CT scan may facilitate early diagnosis.

This study was to investigate the protective effects of puerarin on myocardial ischemia/reperfusion (MI/R) injury and the underlying mechanism. The MI/R-model was established by ligating the left anterior descending artery (LAD) for 60 min followed by 24 h reperfusion, puerarin (10, 30, and 100 mg·kg^-1) was orally administered 20 min before reperfusion. Cardiac function, myocardial infarct index, cardiac damage markers, inflammatory cytokines, and apoptosis index were measured to evaluate the protective effects of puerarin on MI/R injury. The activation of Nod-like receptor protein 3 (NLRP3) inflammasome and Toll like receptor 4 (TLR4)/myeloid differentiation factor 88 (Myd88)/nuclear factor kappa B (NF-κB) pathway were determined by Western blot. All animal experimental procedures were approved by the ethics committee of the Institute of Materia Medica, Peking Union Medical College, Chinese Academy of Medical Sciences. The results showed that puerarin could significantly improve cardiac function, reduce myocardial infarct size, decease the levels of lactic dehydrogenase (LDH), aspartate transaminase (AST), creatine kinase-MB (CK-MB), and cardiac troponin T (cTnT) and suppress cardiomyocyte apoptosis. Meanwhile, puerarin could notably decrease the levels of inflammatory cytokines such as interleukin-1β (IL-1β), IL-6, and tumor necrosis factor-α (TNF-α). Western blot analysis revealed that puerarin could downregulate the expression of TLR4, Myd88, NLRP3, apoptosis-associated speck-like protein containing a CARD (ASC), cleaved-caspase 1, cleaved-gasdermin-D (GSDMD), IL-1β, and IL-18, as well as the phosphorylation levels of inhibitor of NF-κB α (IκBα), IκB kinase β (IKKβ), and NF-κB. These findings demonstrated that puerarin could alleviate MI/R injury by suppressing NLRP3 inflammasome activation, possibly via TLR4/Myd88/NF-κB pathway.

OBJECTIVES: To study the effect of glucose metabolism disorders on the short-term prognosis in neonates with asphyxia. METHODS: A retrospective analysis was performed on the medical data of the neonates with asphyxia who were admitted to 52 hospitals in Hubei Province of China from January to December, 2018 and had blood glucose data within 12 hours after birth. Their blood glucose data at 1, 2, 6, and 12 hours after birth (with an allowable time error of 0.5 hour) were recorded. According to the presence or absence of brain injury and/or death during hospitalization, the neonates were divided into a poor prognosis group with 693 neonates and a good prognosis group with 779 neonates. The two groups were compared in the incidence of glucose metabolism disorders within 12 hours after birth and short-term prognosis. RESULTS: Compared with the good prognosis group, the poor prognosis group had a significantly higher proportion of neonates from secondary hospitals (48.5% vs 42.6%, CONCLUSIONS Recurrent hyperglycemia in neonates with asphyxia may suggest poor short-term prognosis, and it is necessary to strengthen the early monitoring and management of the nervous system in such neonates.
Asphyxia ; Asphyxia Neonatorum/epidemiology* ; Humans ; Hyperglycemia ; Infant, Newborn ; Prognosis ; Retrospective Studies

Objective:To investigate whether the adverse reactions of Xuebijing injection (XBJJ) are mainly pseudoallergic reactions and explore the influencing factors of its pseudoallergic reactions. Method:Mouse model of pseudoallergic reaction was used to study the anaphylactoid reaction of XBJJ which at 0.5, 1 and 2 times of the highest clinical concentration. Next, we compared the differences in pseudoallergic reactions caused by XBJJ for different storage times after preparation. Specifically, XBJJ was prepared into different concentrations, stored for 10 minutes, 2.5 hours, 6 hours and 24 hours, and then injected into the tail vein of mice. Finally, three different injection speeds of 3 seconds, 45 seconds and 90 seconds were selected for XBJJ injection, and then the differences in the paeudoallergic reactions induced by XBJJ in mice under different injection speeds were compared. Result:XBJJ induces pseudoallergic reactions in mice when the drug concentration is higher than the clinically recommended concentration. Compared with storage for 10 minutes after preparation, the degree of pseudoallergic reaction in mice induced by the same concentration of XBJJ increased with the extension of storage time. In addition, when XBJJ was injected in 3 s (the injection rate was 0.083 mL·s^-1), it produced the strongest pseudoallergic reaction. Conclusion:The adverse reactions induced by XBJJ are mainly pseudoallergic reactions. Excessive storage time after preparation and fast injection speed of XBJJ will lead to aggravation of pseudoallergic reactions in mice. When XBJJ is used clinically, it should strictly follow the usage, dosage, concentration, and drip rate recommended in the drug instruction manual. Rational drug use is of positive significance for improving the safety of XBJJ.

ObjectiveFundus imaging and fluorescein angiography were used to investigate the effect of apoA1 on the growth of retinal blood vessels under physiological environment and hypoxia state. MethodsUnder normal physiological conditions， by comparing apoA1 ^{+ / +} mice and apoA1 ^{- / -} mice with C57 / BL6J mice， experiments in vivo were conducted at the end of the day 17 （infancy）， 8 weeks and 20 weeks， respectively， including： ① mice fundus photography （to observe vascular morphology） and ② fundus fluorescein angiography （FFA） （to observe vascular leakage， and to analyze average retinal vascular density， porosity and numbers of junction points）. Their OIR models were prepared respectively for experiments with fundus photography and FFA. ResultsUnder constant oxygen， fundus photography showed that the retinal blood vessels of the three kinds of mice were similar at different stages； FFA suggested that the capillary distribution of the three kinds of mice was uniform at different stages， and there was no obvious perfusion area and fluorescein leakage. There was no statistical difference between groups （P_{vascular density} =0.59 > 0.05， P_porosity =0.52 > 0.05）； Under hypoxia state， fundus photography showed that the main retinal vessels were obviously tortuous and dilated； FFA showed that all three groups had venous beaded changes， uneven capillary distribution， but no perfusion area and fluorescein leakage. Analysis of vascular density， porosity， and number of connection points showed there were significant differences between groups （P_{vascular density} =0.001 6 < 0.01， P_porosity =0.001 9 < 0.01， P_{number of connection points} =0.001 3< 0.01）. ConclusionsUnder physiological conditions， the expression level of apoA1 gene has no effect on retinal vascular growth. Under hypoxia state， increased apoA1 expression might reduce retinal nonperfusion area and reduce fluorescein leakage.

【Objective】To explore the effects of liver dysfunction in the third trimester of pregnancy on maternal outcomes and identify the factors affecting the maternal prognosis.【Methods】We collected the clinical data of 1 113 women with liver dysfunction in the third trimester of pregnancy （case group） and 1 113 normal pregnancies （control group） from the Third Affiliated Hospital of Sun Yat-sen University between January 2015 and December 2018. We compared the rates of cesarean section，premature delivery，placental abruption，postpartum hemorrhage and maternal mortality in the two groups，conducted the univariate and multivariate analysis for the case group and determined the prognostic risk factors by using Logistic regression. Receiver operating characteristic（ROC）curve analysis was applied to estimate the value of each independent risk factor for predicting liver dysfunction-related maternal mortality. 【Results】The rates of cesarean section，premature delivery，placental abruption，postpartum hemorrhage in the case group were higher than those in the control group（P < 0.05），and the odds ratios（ORs）were 3.59 ，7.81 ，10.68 and 2.93 ，respectively. The maternal mortality in the case group（1.2%）was higher than that in the control group（0.0%）（P < 0.05）. Logistic analysis revealed that high total bilirubin（TBIL），low prothrombin activity（PTA）and low fasting plasma glucose（FPG）were independent risk factors for liver dysfunction- related maternal mortality. The ROC curve analysis indicated that when TBIL was 235.4 μmol/L，the Youden′ s index in maximum was 0.331 with sensitivity of 0.818 and specificity of 0.513. When PTA was 20.5% ，the Youden′ s index in maximum was 0.366 with sensitivity of 0.821 and specificity of 0.545. When FPG was 3.11 mmol/L，the Youden′s index in maximum was 0.405 with sensitivity of 0.769 and specificity of 0.636.【Conclusion】Liver dysfunction in the third trimester of pregnancy has adverse effects on maternal outcomes. TBIL ，PTA and FPG are the factors affecting the maternal prognosis and may have certain predictive value for maternal death.