Objective To investigate the serological characteristics and molecular mechanism of a case of Bel subtype.Methods Serological method was used to analyze the ABO blood group of the patient,absorption and elution test was used to detect the weak antigen on red blood cells,and molecular biology method was used to analyze the ABO gene sequence of the patient.Results The forward typing of the patient was O type,but the reverse typing was B type.The weak B antigen was confirmed by absorption and elution method.This mutation was not found in ISBT and related literature,and was discov-ered for the first time.The patient's blood type was Bel(29insertG)/O.01.01 based on the sequence of exon 3-7.Conclusion In the case of ABO blood group incompatibility,the combination of serological and molecular biological detection tech-niques can improve the accuracy and reliability of ABO blood group identification.

Objective:To establish a data middle platform for data assets of medical consumables,to provide open data sharing services for the management and application development of medical consumables,and to reduce the risk of data silos.Methods:Based on the data resource management model of data middle platform,data aggregation and big data development technology were adopted to realize data loading,integration and quality control between multi-business systems.A hierarchical data management system was established through data warehousing and object modeling methods.A data assets management system was built based on the data governance process to provide functions of data standards and data lineage maintenance,metadata management,data permission control,and data lifecycle management for medical consumables data resources.A microservice architecture was adopted to provide functions such as data service generation,registration,discovery and subscription for medical consumables management.The front-end data application development workload of business data and application operation time before and after the application of data middle platform service of medical consumables were compared in the South Campus of the Fifth Medical Center of PLA General Hospital from March to May 2020.Results:The medical consumables data middle platform realized the connection between the front-end application interface and the back-end data service,and provided synchronized data services for the front-end pages.The workload of front-end data application development for data middle platform data services decreased from 64 person-months of traditional data warehouses to 6 person-months,and the operation time for testing applications reduced from 430 minutes to 16 minutes.Conclusion:The data middle platform management mode is helpful to improve the information management capabilities and efficiency of medical consumables management,and provides reference for the digital transformation of medical consumable management.

Objective:To explore the relationship between heart rate variability, severity, and prognosis in patients with acute cerebral infarction (ACI).Methods:A prospective study was conducted on 80 patients with acute cerebral infarction (ACI) admitted to Qinhuangdao Workers′ Hospital from February 2021 to March 2023. The severity of ACI patients was evaluated based on their National Institutes of Health Stroke Scale (NIHSS) scores, and they were divided into mild group (26 cases, NIHSS scores 0-15), moderate group (32 cases, NIHSS scores 16-30), and severe group (22 cases, NIHSS scores 31-45); And 30 healthy individuals who underwent physical examinations during the same period were selected as the control group. The improved Rankin Scale (MRS) was used to evaluate the prognosis of patients, who were divided into a good prognosis group (59 cases) and a poor prognosis group (21 cases) based on the scoring results. All patients underwent dynamic electrocardiogram examination, and the heart rate variability parameters of each group were compared [standard deviation of R-R interval for all sinus beats at 24 hours (SDNN), mean standard deviation of R-R interval for 5 consecutive minutes at 24 hours (SDNN Index), standard deviation of R-R interval mean every 5 minutes (SDANN), root mean square of all adjacent R-R interval differences (rMSSD), and the proportion of adjacent NN interval differences greater than 50 ms (PNN50%)]. The predictive value of heart rate variability parameters on the severity and prognosis of ACI patients was analyzed using receiver operating characteristic (ROC) curves. Logistic regression analysis was used to identify the risk factors for the severity and prognosis of ACI patients.Results:The SDNN, SDANN, SDNN Index, rMSSD, and PNN50% of the mild, moderate, and severe groups were significantly lower than those of the control group ( F=59.382, 11.859, 12.376, 11.699, 47.703, all P<0.01), and the severe group was less than the moderate group and less than the mild group (all P<0.05). The SDNN, SDANN, SDNN Index, rMSSD, and PNN50% in the poor prognosis group were lower than those in the good prognosis group ( t=4.536, 4.181, 5.091, 4.384, 2.851, all P<0.01). The results of logistic regression analysis showed that heart rate variability parameter was an independent influencing factor for the severity and poor prognosis of ACI patients (all P<0.01). The area under the curve for the combined diagnosis of the severity of ACI patients using SDNN, SDANN, SDNN Index, rMSSD, and PNN50% was 0.950, and the area under the curve for the combined prediction of ACI patients′ prognosis was 0.970. Conclusions:The heart rate variability parameter is an independent influencing factor on the severity and prognosis of ACI patients, and its predictive power for the severity and prognosis of ACI patients is high. It can be used as an effective indicator for evaluating the severity and prognosis of ACI patients.

【Objective】  To study the effects of soil environment on the growth, yield, and quality of Sharen (Amomi Fructus) under different planting patterns. 【Methods】  Soil physical and chemical indices and enzyme activities in four periods including early flowering (March), full flowering (June), fruit ripening (September), and late fruit picking (December), were measured under three planting patterns including natural forest, greenhouse, and rubber forest in Xishuangbanna, China. The changes in soil indices during the growth periods of Sharen (Amomi Fructus) under different planting patterns were analyzed, and the differences in plant growth, yield, and quality under different planting patterns were explored. Pearson correlation analysis was used to analyze the relationship between soil indices and Sharen (Amomi Fructus) growth, yield, and quality. Principal component analysis was used to investigate the effects of soil environment under different planting patterns on Sharen (Amomi Fructus) growth, yield, and quality. 【Results】  The soil moisture, available potassium content, and urease activity of the three planting patterns of Sharen (Amomi Fructus) increased initially and decreased afterwards throughout the year; pH and organic matter content showed little change in the whole year. Exchangeable manganese content and acid phosphatase activity gradually increased throughout the year. Hydrolyzed nitrogen content, exchangeable calcium content, available zinc content, protease activity, and sucrase activity decreased initially and increased afterwards throughout the year. Exchangeable magnesium content, available iron content, and catalase activity decreased annually. Total nitrogen content, total phosphorus content, and available phosphorus content fluctuated throughout the year. The total potassium content under natural forest and greenhouse planting decreased throughout the year, while the total potassium content under rubber forest showed an upward trend all year round. The organic matter content, total nitrogen content, total potassium content, available potassium content, available zinc content, urease activity, acid phosphatase activity, and catalase activity under greenhouse were significantly lower than those under natural and rubber forests (P < 0.05). Correlation analysis showed that plant growth, yield, and quality of Sharen (Amomi Fructus) were significantly correlated with soil organic matter, total nitrogen, hydrolyzed nitrogen, total phosphorus, available phosphorus, total potassium, available potassium, exchangeable manganese, exchangeable magnesium, exchangeable calcium, available zinc, urease, acid phosphatase, and invertase (P <  0.05). The results of the principal component analysis indicated that the soil environment of Sharen (Amomi Fructus) under natural forest was the best, followed by rubber forest and greenhouse. The order of its advantages and disadvantages is consistent with the growth index of Sharen (Amomi Fructus), but contrary to the yield of Sharen (Amomi Fructus), indicating that the soil environment directly affects the growth index and nutritional components of plants. 【Conclusion】  Different planting patterns of Sharen (Amomi Fructus) have different soil nutrient content, and the change rules in the growths period are not similar, with some differences. Soil indices have impacts on plant growth, yield, and quality of Sharen (Amomi Fructus). Soil ecological environment is positively correlated with the growth characteristics of Sharen (Amomi Fructus) plants, but has no direct correlation with yield and quality.

OBJECTIVE: To explore the genetic etiology of a child featuring global developmental and mental retardation. METHODS: Chromosome G-banding karyotype analysis, copy number variation sequencing (CNV-seq) and high-resolution chromosome banding were used to screen the genomic variant in the child and his parents. RESULTS: Both the child and his father were found to have a karyotype of 46,XY,del(18)(q21.1q21.3), whilst his mother was 46,XX. CNV-seq analysis showed that the child was arr[19]18q21.2-q21.32(chr18:48 422 190-58 039 582)×1, with a 10.58 Mb deletion which encompassed the TCF4 gene. The same deletion was found in neither parent. High-resolution banding revealed that the father has a fragment of 18q21.1q21.3 inserted into 5p13.1. CONCLUSION The child was diagnosed with Pitt-Hopkins syndrome due to the 18q21.2q21.32 deletion. Chromosome karyotyping and CNV-seq can effectively identify submicroscopic chromosome anomalies.
Child ; Chromosome Banding ; Chromosome Deletion ; DNA Copy Number Variations ; Facies ; Humans ; Hyperventilation ; Intellectual Disability/genetics*

Objective:To improve the understanding of splenectomy for treating common variable immunodeficiency complicated with cytopenia.Methods:A case of common variable immunodeficiency complicated with cytopenia was reported, and the literature was reviewed.Results:The patient, female, 16 years old, was hospitalized for eight years due to thrombocytopenia; she manifested recurrent thrombocytopenia with leukopenia since adolescence. The patient was diagnosed with common variable immunodeficiency with repeated mild infections, splenomegaly, and significantly reduced plasma immunoglobulin levels. Additionally, splenectomy was performed with adequate immunoglobulin replacement therapy, and the pathology confirmed hypersplenism; her blood cell level returned to normal after surgery.Conclusions:Common variable immunodeficiency has various clinical manifestations and can be complicated with cytopenia. Under the premise of adequate immunoglobulin replacement therapy, splenectomy is a safe and effective treatment for common variable immunodeficiency in patients with recurrent cytopenia.

ABSTRACT OBJECTIVE：To establish a method for content determination of paclitaxel in malignant ascites of tumor patients. METHODS：LC-MS/MS method was adopted. Using vindoline as internal standard，the content of paclitaxel in ascites of tumor patients was determined. The separation was performed on Zorbax SB-C18 column with mobile phase consisted of aqueous solution （containing 0.1％ formic acid and 10 mmol/L ammonium acetate）-acetonitrile（40 ∶ 60，V/V）at the flow rate of 0.25 mL/min. the column temperature was 30 ℃，and sample size was 5 μL. The ion source was electrospray ion source，and the detection mode was multiple ion monitoring positive ion mode. MS parameters were set as following as dry gas temperature 350 ℃，dry gas flow rate 10 L/min，capillary voltage 4 000 V. Quantitative determination was operated in the multiple reaction monitoring（MRM）mode， with the ion transitions m/z 876.5→308.0 for paclitaxel and m/z 457.3→188.1 for the internal standard. The fragment voltage/ collision energy for paclitaxel and the internal standard were 250 V/30 eV，and 150 V/20 eV，respectively. RESULTS：The linear range of paclitaxel were 25-2 500 ng/mL（r2＝0.996 5，n＝7）. The lowest limit of quantitation was 25 ng/mL. RSDs of inter-day and intra-day precision tests were 0.61％ -3.62％（n＝5，3）. Accuracies were 95.34％ -98.76％（n＝5，3）. RSDs of extraction recovery were 3.19％-3.72％（n＝3）. CV of matrix effect were 1.52％-2.93％（n＝3）. RE of stability tests were lower than 3％（n＝ 3）. CONCLUSIONS：The method is simple，accurate and suitable for the content determination of paclitaxel in malignant ascites of tumor patients.

Objective:To explore the pathogenesis, clinical characteristics, laboratory findings, diagnosis, treatment, and prognosis of congenital factor Ⅶ (FⅦ) deficiency.Methods:Clinical data of 43 patients with congenital FⅦ deficiency diagnosed from April 1999 to September 2019 were retrospectively analyzed.Results:There were 27 females and 16 males. Median age was 16 (1-70) years. Family history was found in 6 cases. There were 29 (67.4%) cases with bleeding symptoms, most common of which were mucocutaneous bleeding (13 cases, 30.2%) , oral bleeding (13 cases, 30.2%) , and epistaxis (9 cases, 20.9%) . Menorrhagia occurred in 11 cases (47.6% of female patients who were in fertile age) . Laboratory findings were characterized by significantly prolonged prothrombin time (PT) , normal partial thromboplastin time (APTT) , and decreased FⅦ activity (FⅦ∶C) . Ten cases received gene mutation analysis and 3 new mutations were found. Fourteen cases (32.6%) were treated with prothrombin complex concentrates (PCC) , 12 (27.9%) with fresh frozen plasma (FFP) , and 3 (7.0%) with human recombinant activated FⅦ (rFⅦa) . Twenty cases (46.5%) with no or mild bleeding symptoms did not receive any replacement therapy. Previous bleeding symptoms recurred in 5 patients (11.6%) , 8 females still had heavy menstrual bleeding, and 9 patients (20.9%) were lost to follow-up.Conclusion:Most patients with congenital FⅦ deficiency have mild or no bleeding symptoms, but have a tendency to excessive bleeding after surgery or trauma. There is no significant correlation between FⅦ∶C and severity of bleeding symptoms. Prophylaxis should be applied in patients with severe bleeding symptoms and rFⅦa is the first choice. Gene mutation test is significant for screening, diagnosis, and prognosis prediction of the disease.

OBJECTIVE： To investigate the effect mechanism of diazoxide on the proliferation and apoptosis of chondrocytes with oxidative injury based on endoplasmic reticulum stress （ERS） pathway. METHODS： SD mice were selected for primary culture of articular chondrocytes. The 3rd generation chondrocytes were randomly divided into control group， injury model group and diazoxide group. Control group didn’t receive any treatment. The injury model group was incubated with 300 μmol/L hydrogen peroxide （H2O2） at 37 ℃ for 8 h. Diazoxide group was pretreated with 300 μmol/L diazoxide at 37 ℃ for 0.5 h，and then incubated with 300 μmol/L H2O2 for 8 h. The proliferation of chondrocytes was detected by CCK-8 assay. The apoptosis rate of chondrocytes was detected by flow cytometry. The expression of ERS-related proteins [Caspase-3， Bcl-2-associated X（Bax），C/EBP homologous protein （CHOP）] were detected by Western blotting assay. RESULTS： Compared with control group， the proliferation activity of chondrocytes in injury model group was significantly decreased， while apoptosis rate was increased significantly（P＜0.05）；the protein expression of Caspase-3， Bax and CHOP were increased significantly （P＜0.05）. Compared with injury model group， the proliferation activity of chondrocytes in diazoxide group was increased significantly， while the apoptosis rate was decreased significantly （P＜0.05）； the expression of above related proteins were decreased significantly （P＜0.05）. CONCLUSIONS： Diazoxide can improve the proliferation activity of chondrocytes with oxidative injury and inhibit their apoptosis by inhibiting ERS pathway.

Objective? To investigate the effects of Ramsay sedation score on the nursing intervention for children undergoing continuous renal replacement therapy(CRRT). Methods? By retrospective non-random sampling, a total of 30 children treated with CRRT in Anhui Children＇s Hospital from January 2016 to May 2017 were assigned into the control group and nursed according to the standard operating procedures of CRRT for children. Another 30 children treated with CRRT from June 2017 to September 2018 were put into the observation group and the Ramsay sedation score was applied to adjust the sedation administration plan according to the results and doctors＇ prescriptions, and nursing intervention was given at the early stage of agitation. Machine alarm, complications and adverse events were compared between the two groups. Results? After nursing intervention with Ramsay sedation score, the incidence of complications including machine alarm (1 time), failed bloodletting (1 time), bleeding at catheter puncture point (4 cases) and unplanned accidental termination of treatment (1 time) in the observation group were lower than those in the control group with statistical significance (P＜0.05). Conclusions? Ramsay sedation score is simple and practical to apply and it is convenient for pediatric blood purification specialized nurses to evaluate its function. It can effectively reduce incidences of CRRT machine alarm, complications and adverse events.