Zhuang medicine believes that "toxin deficiency" is a key factor in the onset of primary dysmenorrhea, and the failure of the "three pathways and two pathways" is the direct cause of its onset. The treatment should follow the method of "restoring visceral function". The Zhuang medicine lotus needle cupping and dredging method has strong Zhuang characteristics, and is widely used in the treatment of neuropathic pain and has achieved good therapeutic effects. Based on the theory of "toxin deficiency" in Zhuang medicine, this article discussed the application of lotus needle cupping and dredging method in primary dysmenorrhea, and provided reference for its treatment.

ObjectiveTo systematically evaluate the efficacy and safety of integrated traditional Chinese and western medicine in the treatment of chronic liver failure（CLF）. MethodSeveral databases was searched from the establishment date of these databases to January， 2023， including China National Knowledge Infrastructure（CNKI）， WanFang Data Knowledge Service Platform（WanFang）， China Biomedical Literature Database（CBM）， VIP Chinese Science and Technology Journal Database（VIP）， Cochrane Library， Embase and PubMed. The randomized controlled trial（RCT） conforming to the treatment of CLF with integrated traditional Chinese and western medicine were screened and included， the control group was treated with basic western medicine， and the test group was treated with traditional Chinese medicine on the basis of western medicine. Then， the Cochrane risk bias assessment tool was used to evaluate the quality of the included literature， and Meta analysis was performed by RevMan 5.3 software. ResultEleven literatures with a total of 1 110 patients were included， and Meta analysis showed that the integrated traditional Chinese and western medicine was better than western medicine alone in the treatment of patients with CLF in improving the overall effective rate［relative risk（RR）=1.36， 95% confidence interval（CI） （1.27， 1.46）， P<0.000 01］， reducing the mortality［RR=0.35， 95% CI（0.23， 0.53）， P<0.000 01）］， reducing alanine aminotransferase（ALT） level［mean difference（MD）=-38.73， 95% CI（-54.59， -22.87）， P<0.000 01］， reducing the aspartate aminotransferase（AST） level［MD=-58.16， 95% CI（-83.45， -32.79）， P<0.000 01］ and reducing the total bilirubin（TBil） level［MD=-69.21， 95% CI（-94.15， -30.53）， P<0.000 01］， promoting serum albumin（ALB） level［MD=3.24， 95% CI（0.82， 5.66）， P=0.009］ and prothrombin activity（PTA） level［MD=5.44， 95% CI（3.38， 7.50）， P<0.000 01］， and improving the traditional Chinese medicine（TCM） symptom score［MD=-4.28， 95% CI（-8.39， -0.17）， P=0.04］. ConclusionThe treatment of CLF with integrated traditional Chinese and western medicine has good clinical efficacy and safety. However， due to the limitations of the quality and quantity of the included literature， the above conclusions still need to be verified by larger scale of high-quality RCT， which is worthy of further expansion of the study.

Liver failure is an acute and critical disease in the field of liver diseases， and liver failure in China is mainly caused by hepatitis B virus （HBV） infection. Professor Mao Dewen has made remarkable achievements in the prevention and treatment of HBV-related liver failure in basic and clinical research by using the detoxicating， stasis-resolving， and Yang-warming method， and in particular， with this method as the technical core， the new clinical prevention and treatment regimen for reconstructing immune balance in HBV-related liver failure lays a foundation for synergistic integrated traditional Chinese and Western medicine therapy for HBV-related liver failure， highlights the therapeutic advantages of traditional Chinese medicine， and makes breakthroughs in the technical and therapeutic bottlenecks of current clinical treatment of HBV-related liver failure， thereby attempting to reduce the incidence and mortality rates of liver failure.

The cytochrome P450 (CYP) family is the most important drug-metabolizing enzyme in human body and is responsible for the metabolism of endogenous and exogenous compounds. As the main site of the expression of the CYP family, the liver is the metabolic center of drugs, and in recent years, the role of the CYP family in the liver has attracted wide attention from the scholars in China and globally. This article reviews the distribution differences of the CYP family from the aspects of anatomy, genetics, and genomics, changes in the expression of the CYP family in the pathological processes such as non-alcoholic fatty liver disease, alcoholic liver disease, liver fibrosis, liver cirrhosis, and hepatocellular carcinoma, and the effect of CYP family-mediated enzyme activity on the treatment effect of pharmacotherapy for metabolic-associated liver diseases, in order to provide important enlightenment for identifying key drug intervention targets in diseases and enhancing clinical efficacy and safety.

【Objective】 To explore the influence of anti-HLA-Ⅰ with different mean fluorescence intensity (MFI) on the efficacy of HLA-A and -B gene matching platelet transfusion, so as to provide scientific data for clinical platelet gene matching transfusion strategy. 【Methods】 A total of 81 PTR patients had applied for HLA-Ⅰgene matched platelets from the platelet gene database established by our laboratory, and 28 (MFI <5 000) of them needed further avoiding of partial donor-specific antibodies and they were enrolled as the research subjects. According to the platelet MFI value of HLA-Ⅰ antibody-targeting antigen, they were divided into negative transfusion group (MFI <500) (group A) and positive transfusion groups (MFI≥500) ; the latter were further divided into group B (500≤MFI <1 000), group C (1 000≤MFI <3 000) and group D (MFI≥3 000) according to MFI value. Corrected count increment (CCI) in platelet count was used to compare the platelet transfusion effect in 4 groups. 【Results】 Among 28 platelet recipients with MFI <5 000, 19(67.86%) patients successfully received 72 effective transfusions. The first CCI (×10⁹/L) in groups A, B, C and D were 10.27±7.46, 7.58±4.75 (P>0.05), 17.36±7.63 (P>0.05) and -0.77±2.30 (P<0.05), respectively. There was no statistical difference among group A, B and C. 【Conclusion】 The application of HLA-Ⅰ gene matching platelets in PTR patients can adjust the MFI threshold(<2 000) appropriately according to the patient′s condition without compromising the platelet transfusion effect.

【Objective】 To construct a platelet digital matching information system (PMIS). 【Methods】 The framework of PMIS was designed and the main functions were developed. The information system was connected with the information modules of clinical application, laboratory testing, blood donation service, blood inventory and distribution. Further, the preliminary application of this system will be carried on in clinical. 【Results】 The PMIS had been successfully developed and 5048 blood donors with HLA and HPA genotypes were registered in the system. A total of 306 patients applied for matching and 16.5% of them received compatible platelet reports immediately from the inventory bloods, with the median waiting time of all matching as 3 days, which was significantly shorter than that of the manual method (3.8±3.1 days vs 5.4±5.4 days). 【Conclusion】 The developed PMIS has realized the whole process management of blood donors and patients, which is helpful to improve the platelet matching level.

【Objective】 To analyze the specificity and Eplets of HLA allele-specific antibody in patients with platelet transfusion refractoriness (PTR). 【Methods】 HLA-A and B genotypes were detected by PCR-SBT, and HLA-Ⅰ antibodies in patients′ serum were detected by Luminex single antigen beads coating method. IPD-IMGT/HLA Database was used to find the differential amino acids of allele-specific antibodies, and HLA Eplet database was used to analyze the registry Eplets. 【Results】 HLA allele-specific antibodies were found in 12 out of 82 patients with PTR.After sequence alignment, a total of 18 differential amino acids were found, such as 19E>19K, 166D>116E, 167G>167W and so on. Among these differential amino acids, 16 registry Eplets were retrieved such as 19E>19K, 95I>95L, 113YD>113HD and so on.The amino acid substitution of 166DG>166EW, 70Q>70H, 67S>67Y, 94I>94T, 82LR>82RG, and 211G>211A may form new Eplets that have not been registered.The antigens of A11, A24, B15, B27 and B38 can be further subdivided into HLA narrow specific antigens. 【Conclusion】 It was found that there were HLA allele-specific antibodies in patients with PTR, suggesting that high-resolution typing of HLA-A, B should be carried out for these patients and platelet donors in HLA compatible transfusion of PTR.

OBJECTIVE: To analyze the molecular characteristics of a recombinant allele of the ABO blood group. METHODS: The ABO phenotype was determined with the tube method. The coding regions of the ABO and FUT1 genes were analyzed by PCR-sequence based typing. The ABO alleles of the proband were determined by allele-specific primer sequencing. The full sequences of the ABO gene of the proband and her mother were determined through next generation sequencing. RESULTS: The red blood cells of the proband did not agglutinate with anti-H, and the sequence of the FUT1 gene was homozygous for c.551_552delAG.The proband was thereby assigned as para-Bombay. Bi-directional sequencing also found that she was heterozygous for c.261G/del,467C>T,c.526C>G,c.657C>T,c.703G>A,c.796C>A,c.803G>C and c.930G>A of the coding regions of the ABO gene. Allele-specific primer sequencing also found her to carry a ABO*A1.02 allele and a recombinant allele from ABO*O.01.01 and ABO*B.01. The recombination site was located between nucleotide c.375-269 and c.526, and the allele was maternally derived. CONCLUSION An recombinant allele of the ABO gene has been identified, which has originated from recombination of ABO*O.01.01 with the ABO*B.01 allele.
ABO Blood-Group System/genetics* ; Alleles ; Blood Grouping and Crossmatching ; Female ; Fucosyltransferases/genetics* ; Genotype ; Humans ; Phenotype ; Recombination, Genetic

OBJECTIVETo explore the molecular basis of an individual with Bel variant of the ABO blood group.

METHODSThe ABO antigen and serum antibody of the individual were detected by serological method. All coding regions and flanking introns of the ABO gene were amplified with PCR and sequenced bidirectionally. The haplotypes of the individual were analyzed by cloning and sequencing. A three dimensional model of the mutant protein was constructed and analyzed.

RESULTSThe individual has expressed a very weak B antigen on its red blood cells by absorption and elution testing, which was identified as a Bel variant phenotype. The heterozygous sites in exon 6 (261del/G) and exon 7 (297A/G, 484del/G, 526C/G, 657C/T, 703G/A, 796C/A, 803G/C, 930G/A) of the coding region of the ABO gene were identified by direct sequencing. Haplotype analysis showed that the individual has carried an O01 allele and a novel B allele. The sequence of the novel B allele was identical to B101 except for a del G at nucleotide position 484 (484delG), which was nominated as B120 by the Blood Group Antigen Gene Mutation Database (dbRBC NCBI). The 484delG mutation of the B allele has led to a reading frame shift and created a premature terminal codon for the glycosyltransferase (GT) enzyme. Prediction of the 3D structure suggested that the GT enzyme has become an incomplete protein only with its N-terminal region.

CONCLUSIONThe 484delG mutation of the glycosyltransferase B gene has probably abolished or reduced the enzymatic activity and resulted in the Bel variant phenotype.

ABO Blood-Group System ; genetics ; Alleles ; Base Sequence ; Exons ; Female ; Genotype ; Glycosyltransferases ; genetics ; Humans ; Molecular Sequence Data ; Mutation ; Sequence Deletion

OBJECTIVETo explore the function of a novel nonsense mutation c.1476G>A of ITGB3 gene using an in vitro expression system.

METHODSAn eukaryotic expression vector containing ITGB3 c.1476G>A cDNA was generated by site-directed mutagenesis and transformed into E.coli. Plasmid DNA was extracted and sequenced to confirm the target mutations. Wild-type and mutant recombination plasmids were transfected into Chinese hamster ovarian cancer (CHO) cells by nonliposome method, and the stable expression cells were harvested by G418 screening. The ITGB3 gene mRNA transcription and GPIIIa expression level in CHO cells were detected with real-time quantitative PCR, Western blotting and flow cytometry, respectively.

RESULTSThe eukaryotic expression vectors of wild ITGB3 cDNA and c.1476G>A mutant were successfully constructed. CHO cells with stable expression were obtained after transfection and screening. Compared with the wild-type transfected cells, the amount of CD61 antigen expression was 37% and mRNA transcription level was only 6% in the mutant-transfected cells. Full length GPIIIa protein was found only in the stably wild-type-transfected cells, but not in mutant-transfected cells by Western blotting analysis.

CONCLUSIONThe ITGB3 c.1476G>A mutation can decrease the transcription level and further affect GPIIIa synthesis and CD61 antigen expression.

Animals ; Base Sequence ; Blood Platelets ; cytology ; metabolism ; CHO Cells ; Cloning, Molecular ; Codon, Nonsense ; genetics ; Cricetinae ; Cricetulus ; Humans ; Integrin beta3 ; genetics ; metabolism ; Molecular Sequence Data ; Plasmids ; genetics ; metabolism ; Point Mutation