[Objective] To retrospectively analyse the serological characteristics of hemolytic transfusion reactions caused by Rh and Kidd antibodies, and to provide reference for safe, timely, and effective blood transfusion. [Methods] Two cases of patients with RhCcEe and Kidd blood type who experienced allogeneic transfusion at Dazhou Central Hospital were selected. A series of immunohematological tests were performed, including ABO, RhDCcEe and Kidd blood typing, unexpected antibody screening and identification, crossmatching, direct antiglobulin test, acid elution test, and capillary centrifugation to separate the patient's own red blood cells from donated red blood cells. [Results] Unexpected antibody screening, antibody identification, and direct antiglobulin test were positive in both patients. Case 1 had anti-Jk in the plasma, but no specific antibodies were found in the eluate. Case 2 had anti-c and E in the plasma, and anti-E was detected in the eluate. High-speed capillary centrifugation revealed corresponding antigen-positive erythrocytes at the distal end of the blood samples of both patients. [Conclusion] Case 1 received Kidd allogeneic red blood cells, and case 2 received RhCcEe allogeneic red blood cells, and both patients developed the corresponding unexpected antibodies, which led to the occurrence of immune haemolytic blood transfusion reaction.

Objective To study the compliance and influencing factors of inhalation therapy in patients with stable chronic obstructive pulmonary disease (COPD),and carry out patient education and management accordingly. Methods COPD patients were selected from respiratory clinic of Luodian Hospital of Baoshan District of Shanghai from June to December in 2021. Compliance and inhalation techniques were assessed with the Morisky Medication Adherence Scale and the ten-step inhalation technique, and the factors influencing compliance were analyzed. Results A total of 58 outpatients with COPD were included, in which 25 cases (43.1%) with moderate or above compliance. Univariate analysis showed that the patients with course of disease ≥5 years, COPD assessment test(CAT)≥10 points, used 2 inhalation devices and inhalation technique score ≥8 points had better compliance when compared with other patients (P<0.05). Conclusion Patient education and management should be carried out actively. The patients with course of disease<5 years, CAT<10 points should be highly concerned. The inhalation devices should be chosen according to the patients' condition. Training on the use of devices should be strengthened and regularly follow-up evaluation should be carried out.

Metastasis serves as an indicator of malignancy and is a biological characteristic of carcinomas. Epithelial-mesenchymal transition (EMT) plays a key role in the promotion of tumor invasion and metastasis and in the enhancement of tumor cell aggressiveness. Prostaglandin E synthase 3 (p23) is a cochaperone for heat shock protein 90 (HSP90). Our previous study showed that p23 is an HSP90-independent transcription factor in cancer-associated inflammation. The effect and mechanism of action of p23 on lung cancer metastasis are tested in this study. By utilizing cell models in vitro and mouse tail vein metastasis models in vivo, the results provide solid evidence that p23 is critical for promoting lung cancer metastases by regulating downstream CXCL1 expression. Rather than acting independently, p23 forms a complex with RNA-binding motif protein 14 (RBM14) to facilitate EMT progression in lung cancer. Therefore, our study provides evidence for the potential role of the RBM14-p23-CXCL1-EMT axis in the metastasis of lung cancer.

Objective:To investigate the effect of electroacupuncture treatment on the integrity of myelin and the related molecules in the spinal dorsal horn of neuropathic pain model rat.Methods:Totally 32 SPF grade Sprague-Dawley rats were randomly divided into 4 groups: sham group, pain model group, electroacupuncture group and sham electroacupuncture group, with 8 rats in each group. Neuropathic pain model was established by right sciatic nerve ligation. Electroacupuncture stimulation of Huantiao point and Yanglingquan point was started from 1 day after surgery, 30 min/d, and lasted for 14 days. The paw withdraw mechanical threshold (PWMT) were tested before surgery, 3 days, 7 days and 14 days after surgery. Immunofluorescence was used to detect myelin basic protein (MBP) in the ipsilateral Ⅰ-Ⅲ laminae of spinal dorsal horn and Western blot was used to measure the expression of β-secreatase 1(BACE1), neuregulin 1 type Ⅲ (NRG1 Ⅲ) and phosphorylated ErbB receptor tyrosine kinase 2 (p-ErbB2) at 14 days after surgery.SPSS 24.0 was used for statistical analysis.Repeated measurement ANOVA was used for behavioral analysis and one-way ANOVA followed by Bonferroni test was used for Western blot and immunofluorescence data analysis.Results:(1) The results of pain behaviors showed that the interaction effect of time and group on PWMT was significant ( F=29.817, P<0.001), and both the time main effect ( F=240.598, P<0.001) and group main effect ( F=304.291, P<0.001) were significant. There were no significant differences among 4 groups before surgery. Compared with pain model group, the PWMT of electroacupuncture group were significantly increased at 3 days ((16.87±1.82) g, (11.31±1.36) g), 7 days ((15.09±1.75) g, (10.33±0.73) g) and 14 days ((15.07±1.49) g, (9.87±0.98) g) after surgery (all P<0.01). (2)The difference of the intensity of MBP in the ipsilateral Ⅰ-Ⅲ laminae of spinal dorsal horn staining was significant among 4 groups ( F=92.06, P<0.001). Compared with sham group, the intensity of MBP staining in the ipsilateral Ⅰ-Ⅲ laminae of spinal dorsal horn in pain model group was significantly decreased ((13.26±1.90)%, (36.37±0.68)%) ( P<0.01) ). Compared with pain model group, the intensity of MBP staining in the ipsilateral Ⅰ-Ⅲ laminae of spinal dorsal horn in electroacupuncture group ((28.21±3.15)%) was significantly increased after electroacupuncture treatment ( P<0.01). (3) The differences of the expressions of BACE1, NRG1 Ⅲ and p-ErbB2 in the ipsilateral Ⅰ-Ⅲ laminae of spinal dorsal horn were significant among the 4 groups ( F=31.04, 21.20, 11.74, all P<0.01). Compared with sham group, the expressions of BACE1, NRG1 Ⅲ and p-ErbB2 in the ipsilateral Ⅰ-Ⅲ laminae of spinal dorsal horn in pain model group were significantly downregulated (BACE1 (0.42±0.09), (1.16±0.13); NRG1 Ⅲ (0.54±0.05), (1.00±0.10); p-ErbB2 (0.73±0.06), (1.02±0.15) ) (all P<0.05). Compared with pain model group, the expression of BACE1 (0.86±0.09), NRG1 Ⅲ (0.81±0.05) and p-ErbB2 (1.12±0.04) in the ipsilateral Ⅰ-Ⅲ laminae of spinal dorsal horn in electroacupuncture group were upregulated(all P<0.05). Conclusion:Electroacupuncture treatment could relieve neuropathic pain, improve the demyelination and upregulate the expressions of myelin-related proteins in the ipsilateral Ⅰ-Ⅲ laminae of spinal dorsal horn.

Objective To investigate the epidemiological characteristics and mutation spectrum of monogenic diseases in Chinese population through a large-scale,multicenter carrier screening.Methods This study was conducted among a total of 33 104 participants(16 610 females)from 12 clinical centers across China.Carrier status for 223 genes was analyzed using high-throughput sequencing and different PCR methods.Results The overall combined carrier frequency was 55.58%for 197 autosomal genes and 1.84%for 26 X-linked genes in these participants.Among the 16 669 families,874 at-risk couples(5.24%)were identified.Specifically,584 couples(3.50%)were at risk for autosomal genes,306(1.84%)for X-linked genes,and 16 for both autosomal and X-linked genes.The most frequently detected autosomal at-risk genes included GJB2(autosomal recessive deafness type 1A,393 couples),HBA1/HBA2(α-thalassemia,36 couples),PAH(phenylketonuria,14 couples),and SMN1(spinal muscular atrophy,14 couples).The most frequently detected X-linked at-risk genes were G6PD(G6PD deficiency,236 couples),DMD(Duchenne muscular dystrophy,23 couples),and FMR1(fragile X syndrome,17 couples).After excluding GJB2 c.109G>A,the detection rate of at-risk couples was 3.91%(651/16 669),which was lowered to 1.72%(287/16 669)after further excluding G6PD.The theoretical incidence rate of severe monogenic birth defects was approximately 4.35‰(72.5/16 669).Screening for a battery of the top 22 most frequent genes in the at-risk couples could detect over 95%of at-risk couples,while screening for the top 54 genes further increased the detection rate to over 99%.Conclusion This study reveals the carrier frequencies of 223 monogenic genetic disorders in the Chinese population and provides evidence for carrier screening strategy development and panel design tailored to the Chinese population.In carrier testing,genetic counseling for specific genes or gene variants can be challenging,and the couples need to be informed of these difficulties before testing and provided with options for not screening these genes or gene variants.

Objective To analyze the co-expressed genes in blood lipid metabolism,hyperlipidemia and tacrolimus metabolism and their correlation with blood lipid levels in kidney transplant recipients.Methods Co-expressed genes were screened from Comparative Toxicogenomic Database(CTD).Baseline data of 25 kidney transplant recipients were collected.The expression levels of ATP binding cassette subfamily A member 1(ABCA1),peroxisome proliferator activated receptor γ(PPAR-γ)and glycosylphosphatidylinositol anchored high density lipoprotein binding protein 1(GPIHBP1)were measured.All recipients were followed up.The concentrations of fasting blood glucose,glycosylated hemoglobin,triglyceride,total protein,albumin,globulin,cholesterol,high-density lipoprotein,low-density lipoprotein and tacrolimus blood concentration were collected at postoperative 1,3,6 and 12 months,and the incidence of hyperlipidemia in the recipients was analyzed.The correlation between ABCA1,GPIHBP1,PPAR-γ and clinical indexes was assessed.The diagnostic effiiciency of related indexes for hyperlipidemia after kidney transplantation was evaluated.Results Three co-expressed genes including ABCA1,PPAR-γ and GPIHBP1 were screened.ABC Al was positively correlated with cholesterol level at postoperative 6 months and tacrolimus blood concentration at postoperative 3 months,whereas negatively correlated with fasting blood glucose level at postoperative 3 months(all P＜0.05).GPIHBP1 was negatively correlated with preoperative cholesterol and triglyceride levels,whereas positively correlated with tacrolimus blood concentration at postoperative 3 months(all P＜0.05).PPAR-γ was negatively correlated with preoperative globulin and low-density lipoprotein levels(both P＜0.05).ABCA1,GPIHBP1 and PPAR-γ combined with preoperative globulin and blood glucose level at postoperative 1 and 6 months after operation yielded high diagnostic effiiciency for hypertriglyceridemia after kidney transplantation(AUC=0.900).ABCA1,GPIHBP1 and PPAR-γ combined with tacrolimus blood concentrations at postoperative 1 and 6 months and blood glucose level at postoperative 6 months had high diagnostic effiiciency for hypercholesterolemia after kidney transplantation(AUC=0.931).Conclusions ABCA1,GPIHBP1 and PPAR-γ are correlated with blood lipid level and tacrolimus blood concentration after kidney transplantation to different degrees.No definite evidence has been supported for predicting hyperlipidemia after kidney transplantation.Immunity improvement and rational blood glucose management may be beneficial factors for hyperlipidemia control.

Objective To investigate the epidemiological characteristics and mutation spectrum of monogenic diseases in Chinese population through a large-scale,multicenter carrier screening.Methods This study was conducted among a total of 33 104 participants(16 610 females)from 12 clinical centers across China.Carrier status for 223 genes was analyzed using high-throughput sequencing and different PCR methods.Results The overall combined carrier frequency was 55.58%for 197 autosomal genes and 1.84%for 26 X-linked genes in these participants.Among the 16 669 families,874 at-risk couples(5.24%)were identified.Specifically,584 couples(3.50%)were at risk for autosomal genes,306(1.84%)for X-linked genes,and 16 for both autosomal and X-linked genes.The most frequently detected autosomal at-risk genes included GJB2(autosomal recessive deafness type 1A,393 couples),HBA1/HBA2(α-thalassemia,36 couples),PAH(phenylketonuria,14 couples),and SMN1(spinal muscular atrophy,14 couples).The most frequently detected X-linked at-risk genes were G6PD(G6PD deficiency,236 couples),DMD(Duchenne muscular dystrophy,23 couples),and FMR1(fragile X syndrome,17 couples).After excluding GJB2 c.109G>A,the detection rate of at-risk couples was 3.91%(651/16 669),which was lowered to 1.72%(287/16 669)after further excluding G6PD.The theoretical incidence rate of severe monogenic birth defects was approximately 4.35‰(72.5/16 669).Screening for a battery of the top 22 most frequent genes in the at-risk couples could detect over 95%of at-risk couples,while screening for the top 54 genes further increased the detection rate to over 99%.Conclusion This study reveals the carrier frequencies of 223 monogenic genetic disorders in the Chinese population and provides evidence for carrier screening strategy development and panel design tailored to the Chinese population.In carrier testing,genetic counseling for specific genes or gene variants can be challenging,and the couples need to be informed of these difficulties before testing and provided with options for not screening these genes or gene variants.

After organ transplantation, graft rejection is one of the most common complications, which will cause adverse injuries to grafts regardless of etiology. Tertiary lymphoid structures (TLS) occur in non-lymphoid tissues under pathological conditions. Identification and characterization of mechanisms regulating graft rejection can not only promote understanding of the survival and prognosis of organ grafts, but also provide ideas for treating graft rejection reaction.

Objective To investigate the influencing factors of medication adherence among renal transplant recipients taking immunosuppressive drugs. Methods In this study, 377 kidney transplant recipients who received follow-up care in the kidney transplant follow-up center of the Affiliated Hospital of Guizhou Medical University from October 2021 to July 2022 was selected by convenience sampling method. General data questionnaire and Basel Assessment Scale of immunosuppressive drug compliance were used for questionnaire analysis. Results A total of 377 renal transplant recipients were included in this study, including 236 males and 141 females. The overall adherence score was (4.90±1.55), indicating poor adherence. Multivariate Logistic regression analysis revealed that medication adherence among renal transplant recipients taking immunosuppressive drugs was correlated with marital status and postoperative time of renal transplantation. Conclusion Medication adherence among renal transplant recipients taking immunosuppressive drugs needs to be improved, with marital status and postoperative time of renal transplantation being the primary influencing factors.

ObjectiveTo analyze the research hotspots and development trends of postpartum rehabilitation at home and abroad in the past ten years. MethodsCiteSpace 6.2.R2 was used to analyze the co-occurrence, cluster, and bursting of keywords of the relevant literature in the field of postpartum rehabilitation in CNKI and Web of Science (WOS) in the past ten years. ResultsTotally, 2 686 Chinese papaers were included in CNKI and 1 247 English papers were included in WOS. Both databases showed an increasing trend in the number of publications related to the field of postpartum rehabilitation, but the overall number of publications in CNKI grew faster and the total number of publications was more than that in WOS. For CNKI, there were 455 nodes, 1 102 links, with a density of 0.010 7; nine clusters were obtained; the bursting keywords showed that the diseases of concern shifted from breast distension and pain to pelvic floor diseases, and the hot spots of treatment methods shifted from Chinese medicine to electrical stimulation, biofeedback, and then pelvic floor training. For WOS, there were 463 nodes, 1 633 connected lines, with a density of 0.015 3; 14 clusters were obtained; the bursting keywords showed that the disease hotspots of concern shifted from anal prolapse and postpartum hemorrhage to organ prolapse, the hotspots of treatment methods shifted from analgesia to exercise, and the focus of research methods shifted from trial to qualitative research and meta-analysis. ConclusionDomestic postpartum rehabilitation started later than foreign countries. Although certain research results have been achieved, there is still a certain gap compared with the development of foreign postpartum rehabilitation.