【Objective】 To analyze differences of eplets between the patient who generated HLA allele-specific antibodies after platelet transfusion with donors. 【Methods】 The HLA genotypes of the patient and donors were detected by PCR-SBT, and the Luminex single antigen beads coating was used to screen HLA-Ⅰ antibodies in the patient’s serum. HLA Matchmaker was utilized to analyze different amino acids and eplets. 【Results】 The patient carried HLA-A^*02∶03 allele, and HLA-A2 antibodies were found in his serum after platelet transfusion (A^*02∶01, A^*02∶06, and A^*02∶07). Sequence alignment showed that the patient′s A^*02∶03 has a difference in position 149, which resulted in a different eplet between A^*02∶03 and A^*02∶01, A^*02∶06, A^*02∶07 and then induced the production of antibodies. 【Conclusion】 HLA antibodies are specific for HLA epitopes that have structural differences due to amino acid differences between HLA alleles, suggesting that high-resolution typing of HLA-A, -B need to be conducted in patients and donors, and the acceptable mismatch of HLA should be determined based on epitopes rather than antigens, so as to reduce alloimmune response and improve platelet count after transfusion.

Humans ; COVID-19/genetics* ; SARS-CoV-2/genetics* ; Clustered Regularly Interspaced Short Palindromic Repeats/genetics* ; CRISPR-Cas Systems/genetics* ; RNA, Viral/genetics*

Objective:To analyze the treatment process of a renal transplant patient infected with coronavirus disease 2019 (COVID-19), and discuss the management strategy for the immunocompromised hosts.Methods:The diagnosis and treatment of a case of transplant patients with COVID-19 admitted to Horgos designated hospital of Xinjiang Uygur Autonomous Region in October 2021 were reviewed. The medical history and laboratory and imaging examination treatment and outcome of this case were analyzed.Results:The recipient was a middle-aged male with a time from renal transplantation of 3 years. The onset was moderate to low fever, accompanied by cough and fatigue. Chest CT showed multiple ground glass shadows under the pleura of both lungs, mainly in both lower lungs, gradually worsening until "white lung" appeared, with early renal and cardiac insufficiency. In the course of treatment, immunosuppressants were reduced and the dosage of glucocorticoid was increased. In the early stage, due to renal insufficiency and hyperkalemia, dialysis was conducted for 3 times. Oral abidol and Lianhua Qingwen capsule were given as antiviral and anti-infection treatment. Special immunoglobulin and convalescent plasma of COVID-19 were used to boost the immunity of patients. The patient was eventually clinically cured.Conclusions:The clinical manifestations and diagnosis of COVID-19 for the kidney transplantation recipient are not significantly different from other populations, but immunocompromised hosts are more likely to suffer from organ dysfunction. The adjustment of immunosuppressants and glucocorticoids, respiratory support, selection of antibiotics, organ protection, nutritional support and traditional Chinese medicine intervention in the treatment of renal transplant recipients with severe COVID-19 need further discussion.

【Objective】 To study the incidence and specificity of platelet antibody in blood donors in Suzhou, analyze the distribution characteristics of platelet antibody in blood donors in this area, and explore the significance of platelet antibody detection in blood donors to reduce the adverse reactions toplatelet transfusion in clinical. 【Methods】 Platelet antibody detection was performed in 2178 blood donors in this area by solid-phase immunosorbent assay. The antibody specificity of the positive samples was analyzed by commercial kit, and the anti-CD36 antibody positive samples were further identified by flow cytometry and gene sequencing. 【Results】 Twelve positive samples were detected by platelet antibody screening, with a positive rate of 0.55%(12/2 178), including 5 males (0.33%, 5/2 178)and 7 females(1.06%, 7/2 178). Among the positive samples, anti-HLA-Ⅰ antibody was identified in 2 cases, anti-CD36 antibody in 1 case, and the antibody specificity was not identified in the other 9 cases. In one case, the positive rate of anti-HLA-Ⅰ antibody PRA was 31.31%(31/ 99), which was mainly specific to anti-B15, anti-B35 and anti-B40. The positive rate of anti-HLA-Ⅰ antibody PRA in the other case was 45.45%(45/ 99), which was mainly specific to anti-A2, anti-A11, anti-A24, anti-A29, anti-A33, anti-A66, anti-B15 and anti-B35. The blood donor with anti-CD36 antibody was type I CD36 deficiency, and 329_330delAC mutation occurred in exon 5. 【Conclusion】 Through antibody screening and specificity identification, the positive rate of platelet antibody in females was significantly higher than that in males(P<0.05). In addition to the common anti-HLA-I antibodies, anti-CD36 antibody was also detected in type I CD36 deficient blood donor. Therefore, the detection of platelet antibodies in blood donors is of certain clinical significance to reduce the adverse reactions to blood transfusion caused by antibodies in platelet products.

Cervical spondylosis belongs to the category of "arthralgia syndrome" in traditional Chinese medicine.From the number and distribution range of disease,the incidence of cervical spondylosis is yearly increasing and shows a trend of younger age.Cervical spondylosis has become one of the common diseases that seriously affect people's health.This article reviews the relevant literature of TCM nursing interventions in the rehabilitation of cervical spondylosis and explores the influence of TCM nursing interventions on patients with cervical spondylosis including tuina,cupping,moxibustion,scrapping,TCM fumigation,auricular therapy and so on,in order to provide a reference for the future practice and research of TCM nursing interventions for patients with cervical spondylosis.

Objective To investigate the feasibility of using leukocytes that were filtered out by LeukoReduction System ( LRS) to replace conventional human peripheral blood leukocytes in experimental researches and to comparatively analyze the differences between them in vitro biological functions and pheno-types of T cells. Methods Mononuclear cells were isolated from LRS-separated leukocytes and whole blood sample that collected from the same person by using Ficoll. Fluorescence-activated cell sorting ( FACS) was performed to analyze the phenotypes of T cells. CD3+T cells were sorted out by using magnetic beads. The T cells that were collected by using two different ways were incubated with anti-CD3 and anti-CD28 antibodies and IL-2 in vitro for 10 days. Several assays including cell counting, FACS and cytometric beads array ( CBA) were performed to comparatively analyze the differences in biological functions and phenotypes of T cells that were isolated by different methods. Results The phenotypes of T cells isolated from LRS filter and whole blood sample were highly similar at the initial stage. The sorting rate of CD3+T cells form LRS filter reached a high level and met the requirements for experimental researches. No statistically significant differ-ences in cell count, phenotype, expression of costimulatory molecules and cytokine secretion were observed between T cells isolated from LRS filter and whole blood sample. Conclusion This study suggested that the T cells isolated from LRS filter could be used as an alternative to whole blood T cells for fundamental resear-ches since they were similar in cell vitality, phenotype and biological functions. It provided a new way to solve the problem of blood shortage in clinic and scientific research.

Objective: To explore the role of angiotensin receptor type I (AT1)-calcineurin (CaN) signaling pathway in transient outward potassium ion channel (Ito) remolding in hypertrophic atrial myocytes of neonatal rats. Methods: 1 day old neonatal rats’ atrial myocytes were isolated and the cells were divided into 4 groups:①Control group, normal cells were cultured for 24 h,②Stretching group, the cells were cultured for 24 h with mechanical stretching to induce hypertrophy,③Telmisartan group, the cells were treated by telmisartan at 1 μmol/L for 1 h, then cultured for 24 h and ④Cyclosporin-A (CsA) group, the cells were treated by CsA at 0.25 μg/ml for 1 h, then cultured for 24 h. The ratios of protein/DNA in myocytes were compared between Control group and Stretching group, cell hypertrophy was deifned by mRNA expression of atrial natriuretic peptide (ANP). Ito changes were detected by whole-cell patch clamping technique, proteins expressions of Kv4.3 and CaN A subunit were examined by Western blot analysis. Results: Compared with Control group, Stretching group showed obviously decreased Ito density and Kv4.3 protein expression, while increased CaN A protein expression; Compared with Stretching group, the above effects were reduced in Telmisartan group and CsA group. Conclusion: AT1-CaN signaling pathway was involved in the regulation of Ito channel remodeling in hypertrophic atrial myocytes of neonatal rats.

Objective To analyze the epidemic characteristics of volunteer blood donors with HIV infection in Suzhou city, in order to make countermeasures to recruit appropriate volunteer blood donors. Methods Infectious situation and population characteristics of volunteer blood donors with HIV infection were explored by a retrospective analysis method in Suzhou city between 2012 and 2013. Results Among 755 643 volunteer blood donors from 2002 to 2013, 51 donors were HIV infection, the positive rate was 6.75/100000, and the highest detection rate was found in 2013 (23.25/10万), following as 2012 for 9.71/100000, and the lowest was 1.66/100000. There was a statistically significant differ-ence among these years(χ2=37.96, P<0.01). 42 cases of 51 cases with HIV infection were men, the other 9 were women, sex ratio between male and female was nearly 5:1. The donors with 18 to 30 years old (60.79%) were predominant pop-ulation, unmarried people were as high as 62.75%, the staff were 56.86%, the donors with high school, technical sec-ondary school degrees and following degrees primarily accounted for 50.98%, and individual donors accounted for 70.59% of HIV infections. Conclusion There is an upward trend of HIV infection rate from voluntary blood donors in Suzhou in recent years. Blood collection organization should strengthen the health consultation of voluntary blood donors before the blood donation, especially among young adults, strict screening for HIV, which guarantee for clinical safety of blood transfusion.

Objective To observe the clinical effect of HuaYu TongFu KaiQiaoFang on serum homocysteine (Hcy)in patients with acute cerebral infarction. Methods Sixty cases of acute cerebral infarction admitted into the comprehensive ward and intensive care unit(ICU)of the First Affiliated Hospital of Guiyang College of Traditional Chinese Medicine from December 2010 to January 2012 were randomly divided into two groups,each group including 30 cases. The control group was given conventional treatment,and based on the conventional therapy,the treatment group was additionally given HuaYu TongFu KaiQiaoFang(a traditional Chinese medicine decoction including the following ingredients:Safflower 10 g,Chishao 10 g,Chuanxiong 10 g,Notoginseng 10 g,Angelica Sinensis 10 g, Shichangpu 10 g,Polygalae 10 g,Glauber's salt 5 g,Rhubarb 6 g),one dose a day by oral or nasal administration for consecutive 14 days. Before and after treatment in the two groups,the serum Hcy level was detected by enzyme-linked immunosorbent assay(ELISA),and the clinical efficacy was assessed by Pearson or Spearman correlation analysis to observe the correlation between neurological deficit score(NDS)and Hcy levels. Results Before treatment, the difference of serum Hcy(μmol/L)and NDS levels between the two groups was not statistically significant(both P>0.05),while after treatment,the levels in the two groups were significantly decreased in comparison with those before treatment(P<0.05 or P<0.01),and the degree of descent in treatment group was more obvious compared with that in control group(Hcy:7.78±2.51 vs. 10.18±2.41,NDS:10.60±2.25 vs. 14.60±3.70,both P<0.05). After treatment,the total effective rate in the treatment group was significantly higher than that in the control group (90.0%vs. 76.7%,P<0.05). Before treatment,the NDS was positively correlated with Hcy(r=0.675,P<0.05). Conclusion HuaYu TongFu KaiQiaoFang can significantly reduce the level of serum Hcy and improve the nerve function,thus its clinical effect for treatment of acute cerebral infarction is remarkable.

Objective To explore the prevalence,awareness and risk factors of chronic kidney disease (CKD) in general adult population of Anhui province,China. Methods A total of 3800 residents (older than 18 years) from Anhui province were randomly selected using a stratified,multi-stage sampling.All the residents were interviewed and tested for urinary albumin to creatinine ratio (abnormal:≥30 mg/g) and reduced estimated GFR [abnormal:＜60 ml·min1·(1.73 m2)-1]. The associations of CKD with demographic characteristics, healthy charactefistcs (hypertension,diabetes and hyperuricemia) were examined. Results Eligible data of 3374 subjects were enrolled in the study.After the adjustment of age and gender component,the prevalence of albuminuria was 9.8％ (95％CI 8.8％-10.9％),and reduced eGFR was 2.1％ (95％ CI 1.7％-2.7％).Approximately 10.4％(95％CI 9.4％-11.5％)subjects had at least one indicator of kidney damage.The awareness rate of CKD was 6.5％.Female,age,hypertension,diabetes mellitus,and hyperuricemia were independently associated with CKD.While obesity,hyperlipdemia.smoking and alcohol drinking were not associated with the prevalence of CKD. Conclusions The prevalace of chronic kidney disease is 10.4％ and the awareness rate is 6.5％ in general adult population of Anhui province.Independent risk factors associated with CKD are female,age,hypersion,diabetes mellitus and hyeruricemia.