Objective To statistically analyze the perioperative results of patients with ABO-incompatible kidney trans-plantation(ABOi-KT),in order to explore the changes in blood group antibody of type-A/B recipients.Methods A total of 33 cases of blood group A/B ABOi-KT recipients in our hospital from January 2021 to October 2023 were recruited and divided into two groups of group A(n=18)and group B(n=15)according to the different blood types of recipient.The effects of preoperative plasmapheresis on antibody titer,antibody rebound and renal function after operation(serum urea ni-trogen,creatinine and estimated glomerular filtration rate on the 1st,3rd,7th and 14th day)were analyzed between the two groups.According to the postoperative rebound of blood type antibodies,33 recipients were divided into antibody rebound group(n=7)and non rebound group(n=26),and the differences in initial blood type antibody titers between the two groups were analyzed.Results There was no significant difference in the clearance rate of IgM with preoperative plasma ex-change between the two groups(Z=-0.26,P＞0.05);Levels of serum urea nitrogen and creatinine on the 1st,3rd,7th and 14th day after operation between group A and group B were not statistically significant(P＞0.05),the same as eGFR.Group B was more prone to rebound antibody compared with group A(P＜0.05).There was a significant difference in the in-itial IgM antibody titer between the blood type antibody rebound group and the non rebound group(Z=-2.127,P＜0.05),but no statistically significant difference in the initial IgG antibody titer(Z=-1.835,P＞0.05)between the two groups was found.Conclusion The patients type B receiving type AB kidney donors are more prone to rebound antibody after ABOi-KT operation compared to the the patients type A receiving type AB.

Objective:To explore the molecular basis for an individual with Bel subtype of the ABO blood type due to a novel c. 620T>C variant gene, and assess its impact on the structure of GTB transferase.Methods:An individual who had visited the First Affiliated Hospital of Zhengzhou University on February 11, 2023 was selected as the study subject. ABO phenotyping was initially conducted with serological methods, which was followed by direct sequencing of 7 exons of the ABO gene. Subsequently, single-strand sequencing was carried out by using allele-specific primers, and the variant in the B transferase was homology-modeled using the Modeller software. The impact of the variant on the transferase′s spatial structure was analyzed with the PyMOL software. Results:The serological phenotype of the patient was identified as the Bel subtype. Direct sequencing revealed that she has harbored a novel c. 620T>C variant, resulting in a p. Leu207Pro substitution in the polypeptide chain. Combined with single-strand sequencing, her genotype was ultimately determined as ABO* BELnew/ ABO* O.01.02. Three-dimensional protein structure modeling showed that, compared with the wild type, the distance of one hydrogen bond between Proline and Glycine at position 272 has increased, along with disappearance of another hydrogen bond. Conclusion:The novel c. 620T>C (p.Leu207Pro) variant of B allele may affect the structural stability of the glycosyltransferase. The weakened enzyme activity in turn may lead to reduced B antigen expression, manifesting as the Bel subtype by serological analysis.

Objective:To explore the RH genotype for a female with RhD(-) blood type and its molecular basis. Methods:A 26-year-old female who had attended the outpatient clinic of the First Affiliated Hospital of Zhengzhou University in August 2019 was selected as the study subject. Peripheral blood samples were collected from the proband and her parents for Rh phenotyping with gel card method. PCR-sequence-based typing (PCR-SBT) and DNA sequencing were used to determine the RHD zygosity and RH genotype of the proband and her parents. Homology modeling of Rh proteins was performed with bioinformatic software, and protein structural alterations caused by the variant was simulated by molecular dynamics. This study was approved by the Medical Ethics Committee of the First Affiliated Hospital of Zhengzhou University (Ethics No. 2023-KY-0870-003). Results:Serological tests showed that the proband and her father both had weakened e antigen of the Rh phenotype. PCR-SBT and DNA sequencing showed that the genotypes of the proband and her parents were dce/ dCE, dce/ DcE and dCE/ DcE, respectively. And the genotypes of the RHD and RHCE of the proband were RHD*01N.01/ RHD*01N.16, RHCE*01.01/RHCE*04, respectively. Protein simulation and molecular dynamics analysis revealed that the ce_16C variant resulted from RHCE* ce (c.48G>C) may alter the structure of intracellular and extracellular loops, mainly affecting the mobility of extracellular loops 2, 6 and intracellular loops 3, 4. Conclusion:Variant of the RHCE* ce allele c. 48G>C probably underlay the weakened e antigen in this proband.

Recently,increasing attention has been paid to the study of orthostatic hypotension.Othostatic hypotension is a common systemic multisystem disease,with many clinical symptoms such as dizziness,headache,and blurred vision,which have a great impact on the quality of life of patients.Othostatic hypotension is divided into initial upright hypotension,delayed blood pressure recovery,classical orthostatic hypotension and delayed orthostatic hypotension.This paper aims to explore the research progress and clinical application value of delayed othostatic hypotension,and provide some reference for clinical diagnosis and treatment.

BACKGROUND: Since the popularization of computed tomography (CT) technology, the detection rate of pulmonary ground glass nodules (GGNs) with imaging follow-up as the main management method has increased significantly. The purpose of this study is to quantitatively analyze the changes of pulmonary GGNs during the follow-up process with three-dimensional reconstruction technology, explore the natural progression of pulmonary GGNs, and provide effective basis for clinical guidance for patients to conduct reasonable management of nodules. METHODS: A total of 115 cases of pulmonary GGNs with regular follow-up in the Combined Outpatient Department of Zhoushan Hospital from March 2015 to November 2022 were enrolled. Quantitative imaging features of nodules were extracted by semi-automatic segmentation of 3D Slicer software to evaluate the growth of nodules and clinical intervention during follow-up. RESULTS: The average baseline age of the patients was (56.9±10.1) yr. The mean follow-up time was (48.8±18.9) months. The two-dimensional diameter of baseline CT scan was (7.9±2.9) mm, and the maximum three-dimensional diameter was (10.1±3.4) mm. The two-dimensional diameter of the last CT scan was (9.9±4.7) mm, and the maximum three-dimensional diameter was (11.4±5.1) mm. A total of 27 cases (23.5%) showed an increase during follow-up, with a median volume doubling time of 822 days and a median mass doubling time of 1,007 days. 32 cases were surgically resected, including 6 cases of invasive adenocarcinoma (IAC), 16 cases of minimally invasive adenocarcinoma (MIA), 8 cases of adenocarcinoma in situ (AIS) and 2 cases of atypical adenomatous hyperplasia (AAH). Five nodules underwent surgical intervention due to the progression of two-dimensional diameter, which was pathologically confirmed as pre-invasive lesions, but their three-dimensional maximum diameter showed no significant change. Nodular morphology, lobulated sign, spiculated sign and vacuole signs all promoted the growth of nodules in univariate analysis. There were significant differences in age, baseline diameter, mean CT value, median CT value, 10% and 90% percentile CT number between the growth group and the stable group (P<0.05). Multivariate Logistic regression analysis showed that age and average CT value were risk factors for nodule growth (P<0.05). Receiver-operating characteristic (ROC) curve analysis results indicated that the age ≥63 years old, the baseline three-dimensional maximum diameter ≥9.2 mm, and the average CT value ≥-507.8 HU were more likely to accelerate the growth of GGNs. The maximum three-dimensional diameter ≥14.4 mm and the average CT value ≥-495.7 HU may be a higher malignant probability. CONCLUSIONS GGNs show an inert growth process, and the use of three-dimensional measurements during follow-up is of greater significance. For persistent glass grinding nodules ≥63 years old, the baseline three-dimensional maximum diameter ≥9.2 mm, and the average CT value ≥-507.8 HU are more likely to increase. However, most nodules still have good prognosis after progression, and long-term follow-up is safe.
Humans ; Middle Aged ; Lung Neoplasms/pathology* ; Imaging, Three-Dimensional ; Neoplasm Invasiveness ; Retrospective Studies ; Multiple Pulmonary Nodules/pathology* ; Adenocarcinoma/pathology*

Objective To investigate the effect ofcranioplasty on prognosis of patients accepted intracranial aneurysm clipping combined with simultaneous decompressive craniectomy.Methods One hundred and forty-four patients accepted intracranial aneurysm clipping combined with simultaneous decompressive craniectomy (first-stage operation) in our hospital from January 2013 to June 2017 were chosen;there were 56 patients without cranioplasty in the control group and 88 patients with cranioplasty (second-stage operation) in the observation group.The degrees of coma before first-stage operation were assessed by Glasgow coma scale (GCS).The general state three months after first-stage operation was assessed by GCS and activity of daily living (ADL) scale.The prognoses of these patients 9 and 15 months after first-stage operation were assessed by Glasgow outcome scale (GOS) and ADL scale.The clinical data,prognoses and incidence of hydrocephalus of patients from the two groups were compared.Related factors associated with hydrocephalus were analyzed by multivariate Logistic regression analysis.Results GCS,GOS and ADL scale scores in the observation group 9 and 15 months after first-stage operation were all significantly higher than those in the control group (P＜0.05);incidence of hydrocephalus in the observation group after first-stage operation (31.82％) was significantly lower than that in the control group (62.5％,P＜0.05).Logistic regression model revealed that cranioplasty,Hunt-Hess grading and Fisher grading were independent related factors for incidence of hydrocephalus (P＜0.05);cranioplasty was the protective factor of hydrocephalus (OR=0.126),and Hunt-Hess grading and Fisher grading were the risk factors of hydrocephalus (OR=5.311 and 5.073).Conclusion Cranioplasty can reduce the incidence of hydrocephalus and improve the prognosis of patients accepted intracranial aneurysm clipping combined with simultaneous decompressive craniectomy.

Objective To evaluate the efficacy and adverse reactions of platinum-based combined chemotherapeutical regimens in treating relapsed or refractory non-Hodgkin lymphoma(NHL).Methods The clinical data of 68 patients with relapsed or refractory NHL treated with platinum-based combined chemotherapeutical regimens in the Affiliated Tumor Hospital of Guangxi Medical University from January 2008 to December 2014 were retrospectively analyzed.The curative effect of related regimens,adverse reactions and related influence factors were analyzed.Results Sixty-eight cases received 283 cycles of chemotherapy.In all cases,11 cases(16.18 ％) achieved the complete response(CR),31 cases(45.59 ％) achieved the partial response(PR),the overall response rate(ORR) was 61.76％;the median progression-free survival(PFS) was 6.51 months(95％CI:4.97-8.04 months).ORR and PFS in the cases of stage Ⅱ-Ⅲ,IPI score 0-2 and receiving only one chemotherapeutical regimen were superior to those in the cases of corresponding subgroup(P＜0.05);ORR and PFS had no statistical difference between the B cells lymphoma and Tcells lymphoma(P＞0.05).The medion PFS in the combined R group was 11.16 months,which was longer than 5.84 months in the non-combined R group(P =0.004).The major adverse events (stage Ⅱ-Ⅲ) included leukopenia (41.18 ％),thrombocytopenia (27.94％),hemoglobin decrease(11.76％),vomiting(8.82％) and diarrhea(1.47％).Conclusion The platinum-based combined chemotherapeutical regimens are effective with good safety in the treatment of relapsed or refractory NHL.

Purpose To explore the independent predictors of malignant solitary pulmonary nodule (SPN) manifesting as ground-glass nodule (GGN),and to establish a prediction model.Materials and Methods The clinical data and CT images of 362 patients (group A) with pathological-confirmed SPN appearing as GGN in Shanghai Chest Hospital Shanghai Jiaotong University from January 2014 to December 2015 were retrospectively analyzed.The independent predictors of malignant SPN were identified,and the clinical prediction model was established.Another 119 SPN patients in Affiliated Zhoushan Hospital of Wenzhou Medical University were selected as group B to verify the diagnostic efficiency of the prediction model.Results Using multivariate Logistic regression analysis,clear border (OR=6.274,P＜0.01),smooth edge (OR=0.391,P＜0.01),lobulation (OR=3.387,P＜0.01),pleural retraction sign (OR=2.430,P＜0.01),and vocule sign (OR=3.076,P＜0.01)were identified as independent predictors of malignant SPN.The area of the model under the ROC curve was 0.859 with 95％ CI (0.804-0.903).The diagnostic accuracy rate,sensitivity,specificity,positive predictive value and negative predictive value were 85.92％,91.03％,81.97％,92.03％ and 73.53％,respectively.Conclusion In this study,the independent predictors of malignant SPN appearing as GGN were identified,and the prediction model was established.The model can accurately identify SPN and provide effective help for early diagnosis of SPN.

Objective The explore regulation mechanism of specific proteins c-kit of interstitial cells of Cajal in the pathogenesis of slow transit constipation in rats.Methods Slow transit constipation in rat model was duplicated by injections of morphine (25 mg/kg,45 d).The number and weight of fecal granule were assayed.Daily average number of fecal particles,quality,and the time for first black discharge were analyzed.At the same time,the c-kit and SCF expression were detected by Real-time PCR and Western blot.The changes of inflammatory factors such as IL-1β,IL-2 and IL-10 were also detected by ELISA.Results Daily average number of fecal particles in constipation group was decreased,quality was higher,and the first time for first black discharge was prolonged,which showed significant differences (P ＜ 0.05).The expression levels of c-kit and SCF were decreased significantly,and levels of inflammatory factors IL-1β,IL-2 and IL-10 were higher in constipation rats than the controls (P ＜ 0.05).Conclusion The pathogenic progress of slow transit constipation rats are regulated,which is also related with inflammatory reactions.

Objective The explore regulation mechanism of specific proteins c-kit of interstitial cells of Cajal in the pathogenesis of slow transit constipation in rats.Methods Slow transit constipation in rat model was duplicated by injections of morphine (25 mg/kg,45 d).The number and weight of fecal granule were assayed.Daily average number of fecal particles,quality,and the time for first black discharge were analyzed.At the same time,the c-kit and SCF expression were detected by Real-time PCR and Western blot.The changes of inflammatory factors such as IL-1β,IL-2 and IL-10 were also detected by ELISA.Results Daily average number of fecal particles in constipation group was decreased,quality was higher,and the first time for first black discharge was prolonged,which showed significant differences (P ＜ 0.05).The expression levels of c-kit and SCF were decreased significantly,and levels of inflammatory factors IL-1β,IL-2 and IL-10 were higher in constipation rats than the controls (P ＜ 0.05).Conclusion The pathogenic progress of slow transit constipation rats are regulated,which is also related with inflammatory reactions.