Objective: To classify the ABO blood group phenotypes of 5 cases from a family, and to explore the molecular mechanism for reduced B antigen expression in ABO blood group system. Methods: Serological identification of the ABO blood group was performed using microcolumn gel assay and saline tube method. The soluble antigens in saliva were detected by the agglutination inhibition assay. The full-length sequences and upstream promoter regions of ABO gene were sequenced for genotyping using PacBio SMRT sequencing technology. Results: The results of serological tests indicated the expression of B antigen decreased in 3 out of 5 blood samples. A mixed-field agglutination was observed with anti-B antibody. B antigen was not detected in all 5 saliva samples. The ABO genotype for all samples were ABO B.01/ABO O.01.02, and a novel mutation c. 28+5875C>T within the DNA-binding region of RUNX1 in +5.8-kb site were found in the B allele for 3 samples with reduced expression of B antigen. Conclusion: Results of serological and genetic analyses classify the 3 cases with reduced B antigen expression as B phenotype. The novel mutation c. 28+5875C>T of RUNX1 could be the key reason for reduced B antigen expression in 3 cases with B phenotype.

Objective To analyse correlation between automatic quantification of emphysema and lung function based on artificial intelligence(AI)model algorithm by chest computed tomography(CT)in patients with chronic obstructive pulmonary disease(COPD).Methods The clinical and imaging data of hospitalized COPD patients who received chest CT plain scan in Taizhou Hospital of Zhejiang Province,Enze Hospital of Taizhou Enze Medical Center(Group)from December 2020 to May 2021 were retrospectively collected,patients were classified into five levels of ventilator-function decline.By using the AI model,the extent of emphysema lesions in COPD patients were calculated,low-attenuation areas below-950HU were identified and their low attenuation area percentage(LAA％)were calculated.Combined with the output results of AI model and whether each variable met the characteristics of normal distribution,Pearson correlation coefficient between percentage of measured forced expiratory volume at the end of 1 second to estimated value(FEV1％)and LAA％of each lung lobe,and the Spearman correlation coefficient between FEV1 as a percentage of forced vital capacity(FEV1/FVC)and LAA％of each lung lobe in patients with different COPD grades were calculated respectively.Results There was a negative correlation between total lung LAA％and FEV1/FVC in moderate COPD(r=-0.632,P=0.001).Total lung LAA％in very severe COPD was negatively correlated with both FEV1/FVC and FEV1％(r=-0.562,P=0.045 and r=-0.701,P=0.004).The results of lung segment analysis showed that LAA％of the left upper lung lobe was more strongly correlated with pulmonary function indicators in extremely severe COPD(r=-0.650,P=0.016 andr=-0.731,P=0.002).The correlation between left inferior lobe LAA％and FEV1/FVC was stronger correlation in patients with moderate COPD(r=-0.712,P=0.000).In smoking patients,LAA％was moderate correlated with FEV1(r=-0.534,P=0.006),and LAA％was moderate correlated with FEV1/FVC(r=-0.564,P=0.003).Conclusion AI-based emphysema quantification results have a good correlation with FEV1/FVC and FEV1％,which can provide strong support for the diagnosis and classification of COPD based on CT plain scan images.

The occurrence of diabetes mellitus （DM） is closely related to insulin resistance and islet β cell dysfunction. Modern studies have found that macrophages are widely present in the liver，fat，skeletal muscle，islets， and other tissues and organs. Macrophage M1/M2 polarization plays an important role in the occurrence and development of diabetes mellitus and its related complications by intervening in inflammatory response，improving insulin resistance，and promoting tissue repair. Most of the traditional Chinese medicines that regulate the activation and polarization of macrophages are Qi-replenishing and Yin-nourishing，heat-clearing， and detoxicating medicinal，which are consistent with the etiology and pathogenesis of diabetes and its related complications. Therefore，by summarizing the mechanisms between macrophage activation，polarization， and insulin resistance in various tissues，this paper reviewed traditional Chinese medicine and its effective components and compounds in improving diabetes mellitus and its related complications through multi-channel regulation of macrophage polarization and regulation of M1/M2 ratio，providing references for the future treatment of DM and its related complications with traditional Chinese medicine.

Objective To analyse correlation between automatic quantification of emphysema and lung function based on artificial intelligence(AI)model algorithm by chest computed tomography(CT)in patients with chronic obstructive pulmonary disease(COPD).Methods The clinical and imaging data of hospitalized COPD patients who received chest CT plain scan in Taizhou Hospital of Zhejiang Province,Enze Hospital of Taizhou Enze Medical Center(Group)from December 2020 to May 2021 were retrospectively collected,patients were classified into five levels of ventilator-function decline.By using the AI model,the extent of emphysema lesions in COPD patients were calculated,low-attenuation areas below-950HU were identified and their low attenuation area percentage(LAA％)were calculated.Combined with the output results of AI model and whether each variable met the characteristics of normal distribution,Pearson correlation coefficient between percentage of measured forced expiratory volume at the end of 1 second to estimated value(FEV1％)and LAA％of each lung lobe,and the Spearman correlation coefficient between FEV1 as a percentage of forced vital capacity(FEV1/FVC)and LAA％of each lung lobe in patients with different COPD grades were calculated respectively.Results There was a negative correlation between total lung LAA％and FEV1/FVC in moderate COPD(r=-0.632,P=0.001).Total lung LAA％in very severe COPD was negatively correlated with both FEV1/FVC and FEV1％(r=-0.562,P=0.045 and r=-0.701,P=0.004).The results of lung segment analysis showed that LAA％of the left upper lung lobe was more strongly correlated with pulmonary function indicators in extremely severe COPD(r=-0.650,P=0.016 andr=-0.731,P=0.002).The correlation between left inferior lobe LAA％and FEV1/FVC was stronger correlation in patients with moderate COPD(r=-0.712,P=0.000).In smoking patients,LAA％was moderate correlated with FEV1(r=-0.534,P=0.006),and LAA％was moderate correlated with FEV1/FVC(r=-0.564,P=0.003).Conclusion AI-based emphysema quantification results have a good correlation with FEV1/FVC and FEV1％,which can provide strong support for the diagnosis and classification of COPD based on CT plain scan images.

This study analyzes the clinical phenotype and genetic testing results of a patient with autosomal recessive spinocerebellar ataxia type 1(SCAR1)caused by SETX gene mutations.Through medical history collection,neurological examination,radiological examination,neural electrophysiological examination,and genetic analysis,compound heterozy-gous mutations were found in the SETX gene on chromosome 9,i.e.,c.5812C>T(p.Q1938X)and c.501_508del,and these mutation sites were located in exon 14 and exon 6,respectively,and had not been reported in the literature.This study discovers for the first time that these two mutations can cause SCAR1,providing new insights into the pathogenic mechanism of the SETX gene in SCAR1 and a reference for the diagnosis and treatment of similar cases in the future.

With rapid development of information technology,blended teaching model has gradually become mainstream teaching model in most colleges and universities.How to evaluate students'learning effect and analyze factors that affect students'per-formance is a key research direction of this teaching model.Taking blended teaching of Medical Immunology course in Xinxiang Medical University as an example,this paper introduces implementation process and evaluation system of blended teaching,analyzes main factors affecting students'performance and learning effect,and focuses on discussing influence of formative evaluation and"flipped classroom"on students'academic performance.

Objective To assess the efficacy of endoscopic ultrasound-guided enteroenterostomy(EUS-EE)in the management of malignant bowel obstruction(MBO).Methods Retrospective analysis was conducted on clinical data from 14 patients who underwent EUS-EE for MBO from June 2022 to December 2023.A modified intestinal preparation protocol was employed prior to the procedure,and the resolution of symptoms,improvement in nutritional status,and occurrence of complications were statistically analyzed post-EUS-EE.Results EUS-EE was successfully performed in all 14 cases.The Colorectal obstruction scoring system(CrOSS)was used to evaluate preoperative and postoperative symptom relief and alleviation of bowel obstruction.One week after the procedure,CrOSS scores increased from 1 to 2 before surgery to 2～4.The patient-generated subjective global assessment(PG-SGA)score for malignancy patients demonstrated a mean score of(9.64±3.13)one week after surgery among the study cohort of 14 patients.This score showed a significant decrease compared to their preoperative PG-SGA score(12.36±3.22),with a statistical difference(t=2.26,P=0.032).Postoperatively,five patients experienced elevated body temperature,three had pneumoperitoneum,and two developed short bowel syndrome;However,these complications were effectively managed through symptomatic treatment resulting in recovery or relief thereof.At one-year follow-up,the median survival time was recorded as 81(41,500)d with a one-year survival rate at 64.29％.Conclusion EUS-EE offers advantages such as high remission rates for symptoms,minimal trauma,and low reintervention rates.For patients with poor baseline conditions or limited life expectancy,EUS-EE can alleviate physical discomfort symptoms,improve quality of life,and prolong survival period.

Objective To investigate the reliability and validity of the assessment tools of Brief ICF Core Sets for Arthroplasty of Knee Osteoarthritis in Perioperative Period(ICSAKOPP). Methods From May,2022 to April,2023,320 patients undergoing knee arthroplasty were selected in Peking University Third Hospital,China-Japan Friendship Hospital,Peking University First Hospital and Chinese PLA General Hospital.Trained assessors used Brief ICSAKOPP to evaluate all enrolled patients before arthroplasty,three days(±one day)after arthroplasty,three weeks(±one week)after arthroplasty,and three months(±one month)after ar-throplasty.Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)scores were recorded at the same time.Five professionals were asked to score all the items of Brief ICSAKOPP,and the content validity index(CVI)was caculated. Results A total of 64 cases were dropped down.CVI of all the items of the Brief ICSAKOPP were above 0.8,with a av-erage CVI of the scale of 0.938.The Cronbach's α coefficient of the Brief ICSAKOPP was 0.813.There was a moderate correlation(r=0.681,P<0.001)between the overall Brief ICSAKOPP and WOMAC scores,as well as body functional dimension score(r=0.668,P<0.001)and activities and participation dimension score(r=0.657,P<0.001). Conclusion Brief ICSAKOPP is good in content validity,internal consistency reliability and criterion validity.

The theory of "linkage between spleen and small intestine" has been put forward by doctors as early as the Ming dynasty. In traditional Chinese medicine， the spleen and small intestine cooperate and work together physiologically， and they are also closely related and interact with each other pathologically. The spleen governs transportation and transformation， which involves the function of the small intestine in transforming water and grain. The small intestine， governing the receiving and transformation of substances， depends on the normal transportation of the spleen. At the same time， it provides guarantee for the spleen to transform Qi and generate blood as well as ascend lucidity and descend turbidity. The dysfunction of spleen in transportation is closely related to the dysfunction of small intestine. The stability of intestinal microecology necessitates the normal functioning of the spleen. When the original balance of intestinal flora is disturbed， the spleen functioning will be affected. This study explored the pathogenesis and treatment of diabetes based on the physiological functions of the spleen and small intestine and the Western medicine targets of "nutrients-intestinal flora". According to modern medicine， nutrients are essential to maintain the normal physiological activities of the human body. Proper intake of nutrients can affect the absorption and metabolism of the human body for nutrients by regulating the composition and function of intestinal flora， so as to prevent the occurrence of diabetes. The imbalance of intestinal flora which harbors rich microorganisms may lead to the disturbance of energy metabolism and the dysfunction of the immune system， eventually leading to diabetes. As a metabolic disease， diabetes is closely related to the imbalance of intestinal flora and nutrient intake. Based on the theory of "linkage between spleen and small intestine"， this paper discusses the relationship between spleen and small intestine. Furthermore， this paper discusses the correlation between "spleen-small intestine" and "nutrients-intestinal flora" by reviewing the latest progress in modern medicine and clinical research， aiming to provide a theoretical basis and new ideas for the clinical prevention and treatment of type 2 diabetes mellitus.

Marinesco-Sj?gren syndrome (MSS), also known as hereditary ataxia-dwarf-mental retardation syndrome, is a rare autosomal recessive ataxia syndrome. This article reviews the recent advance in clinic characteristics, pathogenic gene mutation sites, pathogenesis and clinic diagnosis and treatment of MSS, in order to improve clinicians' understanding of the disease and diagnosis and treatment level, and reduce the missed diagnosis and misdiagnosis of the disease.