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 evaluate the fixation with a locking fibular intramedullary nail for treatment of extra-articular distal tibial fracture complicated with fibular fracture (AO/OTA 43A).Methods:A retrospective study was conducted to analyze the data of 31 patients who had been treated by fixation with a locking fibular intramedullary nail for extra-articular distal tibial fracture complicated with fibular fracture at Department of Orthopaedics, The 909th Hospital of Joint Logistics Support Force between January 2018 and December 2021. There were 20 males and 11 females; (41.5±15.7) years in age; AO classification of the distal tibial fractures: 10 cases of type 43A1, 10 cases of type 43A2, and 11 cases of type 43A3; 11 open fractures and 20 closed fractures. Fracture healing, fibular alignment, tibiotalar angle, and incidence of complications were regularly followed up and recorded after surgery. At the last follow-up, the ankle joint function was assessed using the Olerud Molander ankle score (OMAS) and the ankle-hindfoot score of American Orthopaedic Foot and Ankle Society (AOFAS).Results:All the 31 patients were followed up for (17.5±3.3) months after surgery. All of them achieved fine fracture union. The union time was (3.9±0.8) months for tibial fractures, and (3.6±0.9) months for fibular fractures. No internal fixation failure was observed. The last follow-up revealed the following: the fibular alignment was 1.8°±1.3° and the ankle tibiotalar angle 9.1°±2.3°; no fibular rotation, shortening, or separation displacement happened; the OMAS score was (88.3±6.2) points, and the AOFAS ankle-hindfoot score (87.4±6.0) points. Two patients required removal of the distal locking screw of the fibular intramedullary nail due to soreness around the lateral malleolus caused by screw loosening. There were no other related complications.Conclusion:Fixation with a locking fibular intramedullary nail is an effective treatment for extra-articular distal tibial fracture complicated with fibular fracture, demonstrating advantages of firm fixation, limited complications, minimal trauma and soft tissue irritation, and good clinical efficacy.

Objective To explore the predictive value of cognitive function trend after ACI for the recurrence risk of cerebral infarction.Methods A total of 256 ACI patients admitted to our hospi-tal from January 2021 to December 2023 were enrolled retrospectively.Based on their MoCA score at 3 months after onset,they were assigned into 96 cases of no PSCI,51 cases of improved PSCI,17 cases of delayed PSCI and 92 cases of persistent PSCI.According to the results of MoCA at 2 weeks after onset,they were divided into 133 cases of PSCI group and 123 cases of non-PSCI group.The clinical data of the ACI patients were compared between the two groups,and their cog-nitive function trends were analyzed.Results Advanced age,and larger proportions of female,du-al antiplatelet therapy and PSQI＞5 were observed in the PSCI group than the non-PSCI group(P＜0.05,P＜0.01).There were significant differences in the incidences of recurrence and poor prognosis in the ACI patients with different cognitive function trends(P＜0.01).The persistent PSCI was associated with the increased risk of recurrence of cerebral infarction and poor prognosis(P＜0.05).The AUC value of persistent PSCI in predicting the recurrence and poor prognosis of cerebral infarction was 0.703(95％CI:0.631-0.767)and 0.595(95％CI:0.521-0.666),respec-tively.Conclusion Persistent PSCI can be used as a predictor of recurrence of cerebral infarction,and it also increases the risk of cognitive dysfunction in ACI patients.

Objective To analyze and discuss the medication rule of professor Ruan Yan in the treatment of children with allergic rhinitis by using data mining method,and to provide reference for the clinical research and patented drugs development for the treatment of children with allergic rhinitis.Methods The outpatient medical records of professor Ruan Yan for the treatment of children with allergic rhinitis were collected.Microsoft Excel 2010 software was used for frequency statistics.SPSS Clementine 12.0 software was used for association rule analysis,cluster analysis and factor analysis to obtain the data.The frequency of use of various drugs and the association rules between drugs were obtained.Then the medication rules in professor Ruan Yan's prescription were analyzed.Results A total of 308 Chinese medicine compounds were included,involving 80 kinds of Chinese medicines,among which relieving drugs and qi-invigorating herbs were high-frequently used.The distribution of traditional Chinese medicine syndrome types was mainly characterized by lung-qi deficiency-cold syndrome and lung-spleen qi deficiency syndrome.The medicinal properties were mainly spicy,warm and sweet,and most of them belonged to the lung,spleen and stomach meridians.Five core prescriptions were extracted by factor analysis.Four drug combinations were obtained by systematic cluster analysis.Conclusion Ventilating lung and opening the orifices,expelling wind and removing cold,strengthening the spleen and replenishing qi are basic therapeutic principles for professor Ruan Yan in the treatment of children with allergic rhinitis.The treatment mainly focused on dispelling evil,ventilating lung and opening the orifices,expelling wind and removing cold during the acute stage of allergic rhinitis.In the remission period,according to the principle of"treating disease must be based on its origin",the treatment should enhance children's physical fitness,tonify lung and strengthen spleen,thereby reducing recurrence.

OBJECTIVE: To investigate the effectiveness of compression screw combined with Buttress plate through direct axillary approach for Ideberg typeⅡ scapular glenoid fractures. METHODS: A retrospective analysis was conducted on 11 patients with Ideberg type Ⅱ scapular glenoid fractures treated with compression screws combined with Buttress plate fixation through the direct axillary approach between January 2014 and June 2022. There were 7 males and 4 females, aged from 34 to 75 years, with an average of 56.0 years. The causes of injury included 4 cases of falling from height injury, 4 cases of heavy object injury, and 3 cases of traffic accident injury. The time from injury to operation was 2-5 days, with an average of 3.8 days. The operation time, intraoperative blood loss, hospital stay, complications, and fracture healing time were recorded. The Constant-Murley score, American Society of Shoulder and Elbow Surgeons (ASES) score, and shoulder joint flexion, abduction, external rotation (neutral position), and internal rotation (neutral position) range of motion were used to evaluate shoulder joint pain and function. RESULTS: The operation time was 45-105 minutes, with an average of 79.0 minutes; the intraoperative blood loss was 80-200 mL, with an average of 99.2 mL; the hospital stay was 3-8 days, with an average of 5.8 days. One patient had poor wound healing after operation, and the wound healed after strengthening dressing change; the rest wounds had primary healing, and no axillary nerve paralysis occurred. Except for 1 patient lost follow-up, the remaining 10 patients were followed up 10-54 months, with an average of 26.4 months. The postoperative X-ray film examination showed that the fractures healed well within 8-15 weeks, with an average of 11.0 weeks. There was no complication such as fracture displacement, internal fixator failure or fracture during follow-up. At last follow-up, the patient's shoulder joint flexion, abduction, external rotation (neutral position), and internal rotation (neutral position) range of motion, Constant-Murley score, and ASES score significantly improved when compared with those before operation ( P<0.05). CONCLUSION Compression screw combined with Buttress plate through direct axillary approach is an effective way to treat Ideberg typeⅡ scapular glenoid fracture, with advantages of small trauma, concealed incision, and good effectiveness.
Male ; Female ; Humans ; Retrospective Studies ; Blood Loss, Surgical ; Fracture Fixation, Internal ; Treatment Outcome ; Shoulder Fractures/surgery* ; Bone Screws ; Bone Plates

ObjectiveTo investigate the therapeutic effect of Xiao Qinglongtang （XQLT） on ovalbumin （OVA）-induced allergic rhinitis （AR） in mice and its effect on the interleukin-33 （IL-33）/suppression of tumorigenicity 2 （ST2） signaling pathway. MethodSeventy-two female BALB/c mice of SPF grade were randomly divided into a control group， a model group， a positive control group （loratadine， 2.05 mg·kg^-1）， and low-， medium-， and high-dose （5.005，10.01，20.02 g·kg^-1） XQLT groups. All mice except for those in the control group were sensitized by intraperitoneal injection of OVA solution， and the AR model was induced by intranasal drops of OVA solution. Thirty minutes before local intranasal drops， drugs were administered once， and mice in the control group and the model group received phosphate buffered saline （PBS） at 20 mL·kg^-1 for 7 days. After the last intranasal drop of OVA solution， the times of sneezing and nasal rubbing of mice within 10 min was recorded. After drug administration for 7 days， blood samples were collected， and nasal bones of mice were decalcified for the preparation of pathological sections. The content of OVA-specific immunoglobulin E （OVA-sIgE）， interleukin-4 （IL-4）， interleukin-5 （IL-5）， and interleukin-13 （IL-13） was detected by enzyme-linked immunosorbent assay （ELISA） kits. Hematoxylin-eosin （HE） staining， periodic acid-Schiff （PAS） staining， and Giemsa staining were used to observe the pathological changes， goblet cell hyperplasia， and eosinophil infiltration of nasal mucosa， respectively. Western blot was used to detect the expression levels of IL-33， ST2， and IL-1 receptor accessory protein （IL-1RAP） in nasal mucosa. ResultCompared with the control group， the model group showed increased times of sneezing and nasal rubbing （P<0.01）， edema and thickening of nasal mucosa， goblet cell hyperplasia and eosinophil infiltration， increased serum levels of OVA-sIgE， IL-4， IL-5 and IL-13 （P<0.01）， and increased protein expression of IL-33， ST2， and IL-1RAP in nasal mucosa （P<0.05，P<0.01）. After drug administration， compared with the model group， the high-dose XQLT group showed reduced times of sneezing and nasal rubbing （P<0.01）， improved pathological conditions of nasal mucosa， reduced serum levels of OVA-sIgE， IL-4， IL-5， and IL-13 （P<0.01）， and declining protein expression of IL-33， ST2， and IL-1RAP in nasal mucosa （P<0.05，P<0.01）. ConclusionXQLT has a therapeutic effect on OVA-sensitized AR mice， and the mechanism may be related to the regulation of the IL-33/ST2 signaling pathway and Th2 inflammatory cytokine to reduce Th2 inflammatory response and alleviate nasal mucosal injury.

Objective:To explore the effects of varicella-zoster virus (VZV) on the glycosylation characteristics of cellular prion protein (PrP C) in human Schwann cells (hSC) and the regulation of methylcobalamin (MeB 12). Methods:The hSC were inoculated with VZV at 1.0 multiplicity of infection for 48 hours, then 250 μg/ml of MeB 12 were added and cultured for 48 hours. PrP C from the supernatant and sediment were coated with anti-PrPC antibody (3F4) respectively and subjected to screening for glycans by sandwich lectin-ELISA. Meanwhile, the superoxide dismutase (SOD) and malondialdehyde (MDA) from the supernatant were detected by diagnostic reagent kit. Results:The ratio of PrP C glycans in the supernatant to sediment of VZV-infected cells was found to be significantly different compared with those in the VZV-non-infected cells. The overall glycans ratios of the supernatant to the sediment was 1∶2.6 in the uninfected cells, while the ratio was 1∶1.5 in the VZV-infected cells (F=24.18, P<0.001, LSD-t=8.27, P<0.001), suggesting that stability of PrP C decreased after VZV infection, and correspondingly the activity of SOD (4.43±2.05 U/mg) was significantly reduced in the VZV-infected hSCs compared with those(14.23±1.27 U/mg) in the uninfected cells (F=18.19, P=0.001, LSD-t=6.54, P<0.001), the level of MDA (11.17±1.89 nmol/mg) was significantly elevated in the VZV-infected hSCs compared with those (3.73±0.35nmol/mg) in the uninfected cells (F=30.70, P<0.001, LSD-t=8.25, P<0.001). When the VZV-infected cells were added with 250 μg/ml MeB 12, glycans in the sediment of infected cells significantly increased compared with those in the VZV-infected cells without MeB 12, the overall glycans ratio of the supernatant to the sediment was 1∶2.4, suggesting that MeB 12 improved the stability of PrP C. Moreover, SOD activity (11.07±2.07 U/mg) was significantly increased (LSD-t=4.42, P=0.002), MDA level (5.23±0.96 nmol/mg) was significantly decreased (LSD-t=6.58, p<0.001) in the VZV-infected cells added with MeB 12 compared with those in the VZV-infected cells without MeB 12. Conclusions:The glycosylation characteristics of PrP C in hSC could be changed by VZV, while MeB 12 could regulate the glycosylation characteristics to improve the stability of PrP C, thereby increase the antioxidant capacity of hSC.

Background:Inflammatory bowel disease (IBD)is a group of chronic gastrointestinal inflammatory disease and its diagnosis depends on analysis of clinical,endoscopic and pathological characteristics. Aims:To analyze the clinical, endoscopic and pathological characteristics of IBD. Methods:Clinical,endoscopic and pathological characteristics of 99 patients with IBD [including 61 ulcerative colitis (UC)and 38 Crohn's disease (CD)]from January 2010 to April 2017 at Yijishan Hospital were retrospectively analyzed. Results:Compared with CD patients,age in UC patients was significantly increased,incidences of diarrhea,bloody stool were significantly increased while incidence of abdominal mass was significantly decreased (P < 0. 05). Extensive type UC and ileocolonic type CD were common. Proportion of patients received 5-aminosalicylic acid (5-ASA)was significantly higher in UC than in CD (90. 2% vs. 71. 1%,P = 0. 014). Two UC patients achieved remission shown by endoscopy,and endoscopic remission achieved in 3 CD patients. The main pathological features of UC were cryptic branching (57. 1%),cryptic twisting (76. 2%),cryptic atrophy (54. 8%)and cryptic irregularity (28. 6%). Ulcer was seen in 78. 9% of CD patients with active chronic inflammation (mainly lymphocyte and plasmocyte infiltration),and the detection rate of non-caseating granuloma was 15. 8% . Conclusions:UC patients are characterized with older age,diarrhea,bloody stool and higher administration rate of 5-ASA,and the endoscopic features were mucosal bleeding and ulcers. Pathological characteristics of UC were mainly cryptic architectural change and inflammatory infiltration,while those of CD were mainly segmental lesions and chronic inflammation with lymphocyte and plasmocyte infiltration and some with non-caseating granuloma.

Objective To investigate the clinical efficacy of acupuncture plus ashi point pricking bloodletting in treating acute gouty arthritis.Methods Seventy patients with acute gouty arthritis were randomly allocated to a treatment group of 38 cases and a control group of 32 cases. The treatment group received acupuncture plus ashi point pricking bloodletting and the control group, routine medication. Blood uric acid and C reaction protein contents were measured in the two groups before and after treatment. The clinical therapeutic effects were compared between the two groups.Results There were statistically significant differences in blood uric acid and C reaction protein contents after one and two courses of treatment compared with before treatment in the two groups (P<0.01). After two courses of treatment, there was a statistically significant difference in comparing C reaction protein contents between the two groups (P<0.05). The total efficacy rate was 84.2% in the treatment group and 81.3% in the control group; there was a statistically significant difference between the two groups (P<0.05).Conclusion Acupuncture plus ashi point pricking bloodletting is an effective way to treat acute gouty arthritis.

Objective To explore the three ultrasonic technologies of two -dimensional ultrasound(2D -US),ultrasonic elastography(UE) and contrast -enhanced ultrasound(CEUS) for the measurement error in breast cancer and the correlation with the expression of ER,PR,VEGF.Methods 50 patients with breast cancer were meas-ured by 2D -US,UE,CEUS preoperatively,and the pathological specimen were measured postoperatively.Then used the immunohistochemistry to detect the expression of ER,PR,VEGF in tumor,and analyzed the correlation with the measurement errors.Results The results of differences between 2D -US,UE,CEUS and pathology were respectively as follows:( -0.59 ±-0.34)cm,( -0.20 ±-0.14)cm,( -0.40 ±-0.31)cm,and the differences were statistically significant(F =20.497,P <0.001).The positive expression rate of ER and PR was high if the difference between UE and 2D -US was less than or equal to 0.44cm.And the positive expression rate of VEGF was low if the difference between CEUS and 2D -US was less than or equal to 0.19cm.Three ultrasonic technologies in the measurement of breast cancer were different,the trend of difference between UE and 2D -US was smaller if the ER and PR were positively expression,and the trend of difference between CEUS and 2D -US was bigger if the VEGF was positively expression.Conclusion There is correlation between different immunohistochemical expression of breast cancer with measurement error in three different ultrasonic imaging technologies.The results suggest that the molecular pathology difference of breast cancer can impact on ultrasonic imaging,which contributes to know the reason and regulation of measurement error in different ultrasonic imaging technology.