Objective:To investigate the reasons for the weak expression of RHCE gene in a patient whose mimicking anti-Ce combined with anti-Jkb caused cross-matching non-combination.Methods:ABO,Rh,and Kidd blood group antigens were identified by test tube method and capillary centrifugation.Antibody screening and antibody specificity identification were performed using saline,polybrene and antiglobulin in tri-media association with multispectral cells.RHCE gene sequencing and haploid analysis were performed by multiplex PCR technique and RHCE protein modeling was performed using Swiss-Model.Results:The serum of the patient contained anti-Ce mimicking autoantibodies along with anti-Jkb antibodies.c.48G＞C,c.150C＞T,c.178C＞A,c.201A＞G,c.203A＞G,and c.307C＞T mutations were detected in the RHCE triple-molecule sequencing.A 109 bp insertion sequence was found in intron 2,with fragment loss from intron 5-8.The Rh-group genotype was DCe/DCe,and phenotype was CCDee.Conclusion:Genotyping techniques can assist in deducing the molecular mechanisms of some weakly expressed RhC,c,E,and e in patients'sera to aid in the identification of difficult antibodies and thus ensure the safety of patients'blood transfusion.

Objective:To investigate the diagnostic accuracy of serological indicators and evaluate the diagnostic value of a new established combined serological model on identifying the minimal hepatic encephalopathy (MHE) in patients with compensated cirrhosis.Methods:This prospective multicenter study enrolled 263 compensated cirrhotic patients from 23 hospitals in 15 provinces, autonomous regions and municipalities of China between October 2021 and August 2022. Clinical data and laboratory test results were collected, and the model for end-stage liver disease (MELD) score was calculated. Ammonia level was corrected to the upper limit of normal (AMM-ULN) by the baseline blood ammonia measurements/upper limit of the normal reference value. MHE was diagnosed by combined abnormal number connection test-A and abnormal digit symbol test as suggested by Guidelines on the management of hepatic encephalopathy in cirrhosis. The patients were randomly divided (7∶3) into training set ( n=185) and validation set ( n=78) based on caret package of R language. Logistic regression was used to establish a combined model of MHE diagnosis. The diagnostic performance was evaluated by the area under the curve (AUC) of receiver operating characteristic curve, Hosmer-Lemeshow test and calibration curve. The internal verification was carried out by the Bootstrap method ( n=200). AUC comparisons were achieved using the Delong test. Results:In the training set, prevalence of MHE was 37.8% (70/185). There were statistically significant differences in AMM-ULN, albumin, platelet, alkaline phosphatase, international normalized ratio, MELD score and education between non-MHE group and MHE group (all P<0.05). Multivariate Logistic regression analysis showed that AMM-ULN [odds ratio ( OR)=1.78, 95% confidence interval ( CI) 1.05-3.14, P=0.038] and MELD score ( OR=1.11, 95% CI 1.04-1.20, P=0.002) were independent risk factors for MHE, and the AUC for predicting MHE were 0.663, 0.625, respectively. Compared with the use of blood AMM-ULN and MELD score alone, the AUC of the combined model of AMM-ULN, MELD score and education exhibited better predictive performance in determining the presence of MHE was 0.755, the specificity and sensitivity was 85.2% and 55.7%, respectively. Hosmer-Lemeshow test and calibration curve showed that the model had good calibration ( P=0.733). The AUC for internal validation of the combined model for diagnosing MHE was 0.752. In the validation set, the AUC of the combined model for diagnosing MHE was 0.794, and Hosmer-Lemeshow test showed good calibration ( P=0.841). Conclusion:Use of the combined model including AMM-ULN, MELD score and education could improve the predictive efficiency of MHE among patients with compensated cirrhosis.

Chest trauma is one of the most common injuries. Venous thromboembolism (VTE) as a common complication of chest trauma seriously affects the quality of patients′ life and even leads to death. Although there are some consensus and guidelines on the prevention and treatment of VTE at home and abroad, the current literatures lack specificity considering the diagnosis, treatment and prevention of VTE in patients with chest trauma have their own characteristics, especially for those with blunt trauma. Accordingly, China Chest Injury Research Society and editorial board of Chinese Journal of Traumatology organized relevant domestic experts to jointly formulate the Chinese expert consensus on the diagnosis, treatment and prevention of chest trauma venous thromboembolism associated with chest trauma (2022 version). This consensus provides expert recommendations of different levels as academic guidance in terms of the characteristics, clinical manifestations, risk assessment, diagnosis, treatment, and prevention of chest trauma-related VTE, so as to offer a reference for clinical application.

ObjectiveTo investigate the effect of Yiqi Jiedu prescription-containing serum on the proliferation of medullary thymic epithelial cells （mTEC） and regulatory T （Treg） cells in myasthenia gravis （MG） patients with thymus hyperplasia. MethodAccording to serological methods，35 SD rats were adaptively fed for one week and randomized into the low-，medium-， and high-dose Yiqi Jiedu prescription groups，control group， and prednisone group，with seven rats in each group， which were then gavaged with the corresponding drugs for one week for preparing the drug-containing serum. The effect of Yiqi Jiedu prescription-containing serum at different concentrations on the proliferation of mTEC and Treg cells were determined by cell counting kit-8 （CCK-8） assay. Besides， the effect of mTEC and Yiqi Jiedu prescription-containing serum on Treg cell proliferation were observed through co-culture. ResultThymocytes were cultured for a period of time. Their mean positive rate revealed by flow cytometry using mTEC characteristic marker Ulex europaeus agglutinin Ⅰ （UEAI） was 92.54%. Treg cells were sorted by magnetic beads. The purity of Treg cells after repeated magnetic bead sorting was as high as 92%. mTEC and Treg cells showed high positive expression rates，and their cell purity met the requirements of subsequent experiments. When the concentration of Yiqi Jiedu prescription-containing serum was 2.5%-15%，it exhibited an inhibitory effect against mTEC and Treg cells. When the concentration was equal to or greater than 20%，it promoted cell proliferation，which was further enhanced with the extension of action time. The results after 48 h of culture showed that compared with the control group，prednisone and low-dose Yiqi Jiedu prescription had no significant effect on the proliferation of these two kinds of cells，but the medium- and high-dose Yiqi Jiedu prescription remarkably reduced their proliferation inhibition rate （P<0.01）. After co-culture with mTEC， the control group was not significantly different from the prednisone group and the low-dose Yiqi Jiedu prescription-containing serum group in the proliferation of Treg cells，while the medium- and high-dose Yiqi Jiedu prescription-containing serum groups significantly lowered the proliferation inhibition rate （P<0.01）. ConclusionYiqi Jiedu prescription-containing serum affects the proliferation of mTEC and Treg cells in MG patients with thymus hyperplasia. Compared with the solely cultured Treg cells isolated from MG patients，the Treg cells co-cultured with mTEC exhibit enhanced proliferation in MG patients，suggesting that mTEC can regulate the proliferation of Treg cells. This effect becomes more obvious after the intervention with Yiqi Jiedu prescription-containing serum，indicating that intervention effect of Yiqi Jiedu prescription on Treg cells can be produced during its treatment of mTEC， which may be one of the mechanisms of Yiqi Jiedu prescription-containing serum in alleviating MG.

Objective:This paper reviewed the current development of education of physical therapy and discussed the growing demand for physical therapists and gaps of their professional education. It is crucial to reconstruct a framework and system of sciences and specialty in physical therapy at the undergraduate level using WHO International Classification of Functioning, Disability and Health (ICF) to meet the requirement of core competency of physiotherapist developed by World Confederation of Physical Therapy. The core curricula should be integrated into the conceptual framework and approaches of functioning and rehabilitation. Methods:Using ICF, the construction framework, system of specialty and development of curricula of physical therapy at undergraduate education had been proposed and reconstructed. Results:With the theories and approaches of modern pedology and curriculum theory and ICF, referenced by competency requirements for physical therapists from World Confederation of Physical Therapy, three core courses had been proposed and their content had been reconstructed, involving the theories, methods and practical skills in the fields of physical therapy. These courses include functional diagnosis, intervention and evaluation based on ICF. Conclusion:It is implicated from the theory and approaches of ICF that the education and professional training of physical therapy should be tailored to the needs of health-related services.

Objective This study aimed to evaluate the effects of in-utero exposure to HIV and ART on pregnancy outcome and early growth of children.Methods This cohort study enrolled 802 HIV-infected pregnant women between October 2009 and May 2018 in Guangzhou,China The women were assigned to receive combination ART (cART) or mono/dual ART or no treatment.The primary outcomes were the combined endpoints of any adverse pregnancy outcome [including ectopic pregnancy,spontaneous abortion,stillbirth,preterm birth,small for gestational age (SGA)] and adverse early growth outcome (including infant death,HIV infection of mother-to-child transmission,and underweight,wasting and stunting of infants at 4 weeks of age).Results Adverse pregnancy outcomes occurred in 202 (35.1％) of all enrolled HIV-infected women,and 121 (31.3％) of all infants exhibited adverse effects on early growth at 4 weeks of age.The rates of adverse pregnancy outcomes,spontaneous abortion,ectopic pregnancy,stillbirth,infant death and perinatal HIV infection were higher among women not receiving ART,compared to those treated with cART or mono/dual ART (P ＜ 0.05).However,women treated with cART had a higher rate of SGA,compared to untreated women (P ＜ 0.05).No differences in early infant growth were observed among the different treatment regimens.Conclusion Our findings underscore the essentiality of prioritizing HIV-positive pregnant women for ART,as even mono/dual ART available in resource-limited countries could improve pregnancy outcomes and infant survival

The analysis of Forsythia suspensa was performed on Waters Symmetry C₁₈ column( 4. 6 mm×250 mm,5 μm) and mobile phase was methanol( A)-0. 1% formic acid aqueous solution( B) with the elution gradient. Column temperature was maintained at 30℃,and the flow rate was 1. 0 m L·min^-1 with detection wavelength 265 nm. The HPLC-PDA fingerprint of F. suspensa was optimized.Chemical constituents in F. suspensa were analyzed by UFLC-Q-TOF-MS in positive and negative ion mode. The quality of 48 batches of F. suspensa from different habitats,processing methods and specifications was evaluated by similarity evaluation and cluster analysis.The 18 common peaks were confirmed. The similarity of F. suspensa from different habitats was more than 0. 98,and 56 chemical constituents were identified. Different processing methods had great influence on the quality of F. suspensa. Compared with boiled and direct drying,the quality of F. suspensa processed by sun-drying was obviously decreased. The similarity was about 0. 58. Different specifications of F. suspensa also had obvious distinction,and the similarity was about 0. 78. The effective components of grown F. suspensa,such as forsythoside A and phillyrin,were significantly reduced. The results of cluster analysis were basically consistent with the results of similarity evaluation. The establishment of fingerprint and the recognition of chemical pattern of F. suspensa can provide a more comprehensive reference for the quality control of herbs.
Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal/chemistry* ; Forsythia/chemistry* ; Quality Control

Objective To explore the role of signal transducer and activator of transcription 3 (STAT3) phosphorylation in the pathogenesis of Behcet's disease (BD),and to investigate the association between STAT3 phosphorylation and disease activity in BD patients.Methods Peripheral blood mononuclear cell (PBMC) was isolated from 15 mL peripheral boood of 10 active BD patients (BD-A),10 BD patients in remission (BD-R) and 10 healthy controls (HC) respectively.The blockade of STAT3 phosphorylation was performed by Stattic.The PBMC was divided into Stattic subgroup (treated with 2.5 μmol/L stattic and 1 640 medium,5 mL) and blank control subgroup (treated with 5 mL 1 640 medium),respectively.The protein levels of phosphorylated STAT3 (pSTAT3) and STAT3 were examined by flow cytometry and Western blot.The protein and mRNA levels of TNF-α,IFN-γ and IL-17 were tested by RT-PCR and ELISA.Two-way ANOVA and Bonferroni post hoc test were used to analyze the results.Results Compared with HC,the BD patients showed higher protein levels of pSTAT3 and STAT3,and higher protein and mRNA levels of TNF-α,IFN-γ and IL-17;compared with blank control subgroup,the protein levels of pSTAT3 and STAT3,and protein and mRNA levels of TNF-α,IFN-γ and IL-17 decreased in Stattic subgroup.In the BD-A group,the protein level of pSTAT3,and protein and mRNA levels of TNF-α,IFN-γ and IL-17 were significantly higher than those in the BD-R group.Conclusions An increased activation of the STAT3 pathway may contribute to the pathogenesis of BD and relate to disease activity in BD patients by inducing TH1 and Th17 cells activation.

Objective To understand the antimicrobial susceptibility profiles,serotype distribution and virulence genes.Methods A total of 515 group B Streptococcus (GBS) including 108 virulence,112 non virulence,and 295 colonizing isolates were collected in four Shenzhen hospitals.Isolates were characterized by conventional and molecular serotyping.The virulence genes of scpB,lmb,hylB,cylE,bac,bca and rib of GBS isolates were detected by PCR.Antimicrobial susceptibility to penicillins,macrolides,lincosamides,quinolones and tetracyclines was tested using disk diffusion and the MICs for penicillin were determined by E test.Results Molecular serotyping for all eight serotypes (Ⅰa,Ⅰb,Ⅱ ～ Ⅵ,Ⅸ) was in full accordance with conventional serotyping.Taking MS and CS together,serotype Ⅲ was the most common capsular type (56.5 ％),followed by Ⅰb (17.5 ％),Ⅰa (12.6 ％),V (7.4 ％),Ⅱ (2.7 ％),Ⅵ (1.4 ％),Ⅳ (1.0 ％) and Ⅸ (1.0 ％).Serotype Ⅲ was the main serotype in different groups,serotype Ⅰ a was significantly more common among patients with invasive infections (11.1％) and no invasive infections (29.5％),serotype Ⅰb isolates were significantly more common among clone (19.3％).Virulence gene screening using PCR method showed the presence of cylE,lmb,scpB and hylB in almost all the isolates,while rib,bca and bac genes were found in 29.1％,14.6％ and 9.7％ of the isolates.Certain genes were significantly associated with specific serotypes,for example,rib with serotypes Ⅲ,Ⅰa and Ⅰb,bca and bac with serotypes Ⅲ and Ⅰb.Drug susceptibility results showed that GBS susceptibility to β lactam antimicrobials was prevalent (100 ％).Resistance rates for erythromycin,clindamycin and tetracycline were 67.0 ％,61.9 ％ and 86.0 ％,respectively.Conclusion Serotype distribution,virulence genes and antimicrobial susceptibility profiles of GBS contributes to the clinical therapy,epidemiological studies and design of Vaccines.