Application of nomogram in corneal refractive surgery / 中华实验眼科杂志

Corneal refractive surgery is widely used to correct myopia and astigmatism because of its safety, effectiveness and stability.Precision medicine is the future direction of development, and the demands for accuracy in corneal refractive surgery are also increasing, which has a direct impact on patient satisfaction.Nomogram, as a key design in refractive surgery, needs to be combined with several important predictors to quantify individual risk.Different surgical methods need different nomograms.In this paper, the effects of corneal surface surgery, lamellar surgery, modeling algorithm and possible factors such as patient's sex, age, expected correction, corneal curvature, preoperative spherical equivalent, etc.on the predicted values were discussed.At the same time, the application of nomograms in corneal refractive surgery at home and abroad in recent years and the research progress of nomogram influencing factors were explored, in order to provide more and more accurate reference for clinical practice, to improve the accuracy of corneal refractive surgery and help patients achieve satisfactory postoperative visual quality.

On-demand integrated nano-engager converting cold tumors to hot via increased DNA damage and dual immune checkpoint inhibition

Cancer immunotherapy has become a promising strategy. However, the effectiveness of immunotherapy is restricted in "cold tumors" characterized with insufficient T cells intratumoral infiltration and failed T cells priming. Herein, an on-demand integrated nano-engager (JOT-Lip) was developed to convert cold tumors to hot via "increased DNA damage and dual immune checkpoint inhibition" strategy. JOT-Lip was engineered by co-loading oxaliplatin (Oxa) and JQ1 into liposomes with T-cell immunoglobulin mucin-3 antibodies (Tim-3 mAb) coupled on the liposomal surface by metalloproteinase-2 (MMP-2)-sensitive linker. JQ1 inhibited DNA repair to increase DNA damage and immunogenic cell death (ICD) of Oxa, thus promoting T cells intratumoral infiltration. In addition, JQ1 inhibited PD-1/PD-L1 pathway, achieving dual immune checkpoint inhibition combining with Tim-3 mAb, thus effectively promoting T cells priming. It is demonstrated that JOT-Lip not only increased DNA damage and promoted the release of damage-associated molecular patterns (DAMPs), but also enhanced T cells intratumoral infiltration and promoted T cell priming, which successfully converted cold tumors to hot and showed significant anti-tumor and anti-metastasis effects. Collectively, our study provides a rational design of an effective combination regimen and an ideal co-delivery system to convert cold tumors to hot, which holds great potential in clinical cancer chemoimmunotherapy.

Para-Bombay phenotype in a pregnant woman / 中华围产医学杂志

We report the successful management of a pregnant woman with para-Bombay phenotype. The woman received routine prenatal check-ups and underwent vaginal delivery in the Affiliated Shenzhen Maternity & Child Healthcare Hospital. Blood grouping at 12 weeks of pregnancy showed that the forward typing of the patient was group O, but reverse typing indicated group AB. Her ABO genotype was determined as ABO*A1.02/B.01. There was c.551-552del AG and c.880-882 del TT in the FUT1 gene, and 357C>T and 716G>A in the FUT2 gene. Thus, her FUT1 genotype was h1/h2 and FUT2 genotype was Se/Se. No significant abnormalities were found in the routine prenatal examination. A male infant was born vaginally at 39 +2 gestational weeks, who was grouped as B-positive without neonatal hemolytic disease. Para-Bombay is a rare blood group. It is necessary to clarify the blood type during prenatal examination and develop a management strategy for those with special blood groups to reduce the incidence of postpartum hemorrhage and ensure safe delivery.

Construction of a core competence evaluation index system for NICU nurses / 中国实用护理杂志

Objective:To construct the evaluation index system of core competence for NICU nurses, and to provide basis for training and assessment.Methods:The first draft of the core competence model and evaluation index system for nurses in the NICU was constructed by literature review, and group discussions. The Delphi method was used to conduct 2 rounds of consultation with 19 experts from 8 provinces and cities, and the weight of indexes at all levels was determined by the Delphi method and Precedence Chart method.Results:The constructed evaluation index system for the core competence of nurses in the NICU included 5 first-level indicators, 11 second-level indicators, and 34 third-level indicators. In the two rounds of expert consultation, the experts′ positive coefficients were all 100%, the authority coefficients were 0.934 and 0.945, and the Kendall′s rank-order correlation coefficients of all levels of indicators were 0.255-0.309, 0.202-0.297, all P<0.01. Conclusions:The evaluation index system for NICU nurses is scientific, reliable and feasible, which can be used in clinical nursing.

Molecular polymorphism Analysis on CD36 Deficiency among Platelet Blood Donors in Shenzhen / 中国实验血液学杂志

OBJECTIVE@#To analyze the molecular polymorphisms of CD36 among 58 blood donors with CD36 deficiency and compare with CD36 positive controls.@*METHODS@#A total of 58 donors with CD36 deficiency during a screening conducted in the laboratory from September 2019 to December 2020 were enrolled as the test group, including 39 males and 19 females, while 120 platelet donors with CD36 positive were randomly selected as the controls, including 76 males and 44 females. All of the subjects were Han nationality. The PCR-SBT method was used to detect coding region of CD36 gene, and molecular mutations were compared with those CD36 positive controls.@*RESULTS@#Among the 58 donors with CD36 deficiency, mutations appears in 32 individuals. The detection rate for type I was 71.43% (5/7), and type II was 51.92% (27/52), while among the 120 controls, mutations appears in 12 donors (10%). In the CD36 antigen-deficient donors, 16 variations were found, in which 329-330 del AC with the highest frequency accounted for 20.69%, followed by 1228-1239 del ATTGTGCCTATT(15.52%) and 1156 C>T(10.34%). Two variations, 198-205 del GATCTTTG and 220 C>T, led to premature termination of translation; four mutations, 329-330 del AC, 560 ins T, 1011-1049 39bp dupl and 1343-1344 ins TCTT, caused translation frame shift; 1228-1239 del ATTGTGCCTATT led to deletion of four amino acids (Ile-Val-Pro-Ile) at sites 410-413 of the peptide chain. The 1140 T>A and 1275 G>A were synonymous mutations, and the other 7 mutations resulted in the substitution of single nucleotide. The platelet expression in the donors of CD36 positive with 329-330 del AC or 1228-1239 del ATTGTGCCTATT mutation (heterozygote) was lower than those CD36 positive individuals without mutations (homozygote).@*CONCLUSION@#Multiple gene mutations in the CD36 coding region may cause CD36 deficiency, and the heterozygous individuals with mutations may lead to CD36 antigen reduction or deletion. Mutation is not detected in 44.83% of CD36 deficient individuals, there may be some other reasons for the CD36 antigen deficiency.

The Establishment and Application of Flow Cytometry on the Detection of Jka Antigen in Kidd Blood Group / 中国实验血液学杂志

OBJECTIVE@#To establish a based method flow cytometry to identify the antigen Jka in human red blood cells (RBCs) and verify its accuracy.@*METHODS@#A total of 96 blood samples were enrolled in the study randomly from the voluntary blood donors in Shenzhen Blood Center. The RBCs were incubated with IgG anti-Jka primary antibody, and then labeled with the secondary antibody anti-IgG-Alexa Fluor 647. The fluorescence histograms of each sample were obtained by flow cytometry. Serological agglutination test was used to compare the accuracy of flow cytometry in the detecting of antigen Jka, while PCR-SSP and gene sequencing genotyping were used to verify the accuracy of flow cytometry in the detecting of the antigen in human RBCs.@*RESULTS@#The results of flow cytometry for antigen Jka in human RBCs were consistent with those from serological tests. Samples that demonstrated higher serological agglutination intensity also showed higher fluorescence activity, which indicate more stronger of Jka antigen. The sensitivity of flow cytometry was higher than that of serological test; especially in distinguish Jka weak and negative samples. Flow cytometric results of all samples were consistent with the genotyping results, which confirmed the accuracy of flow cytometry.@*CONCLUSION@#The study established a new flow cytometry-based method successfully for the identification of Jka antigen of Kidd blood group in human RBCs. The Kidd blood group antigen Jka of different intensities can be accurately distinguished by the technique.

Molecular mechanism and bioinformatics analysis of 9 samples with rare RhD variants / 中国输血杂志

【Objective】 To study the molecular mechanism of 9 samples with rare RhD variants and their RhD epitopes and protein structure. 【Methods】 The 9 blood samples with rare RhD variants were collected from 210 644 blood donors of Shenzhen Blood Center. Regular serological assaying was used for determination of Rh type for the 9 samples. Indirect anti-human globulin test (IAT) was used to confirm the RhD antigen and to screen the antibodies. D-screen reagent was sued to analyze the RhD epitopes of the samples. RHD zygosity testing of the samples was detected by PCR-SSP. The nucleotide sequences of all 9 exons and adjacent flanking intron regions of RHD gene were sequenced. The prediction of the effects of mutations on RhD protein function were analyzed using PROVEAN, SIFT, PolyPhen-2 and MutationTaster software. Robetta and Swiss-PdbViewer 4.1.0 were used for modeling the tertiary structures of RhD. 【Results】 A total of 9 individuals with rare RhD variants were identified as follows: RHD*weak D type 25, RHD*weak D type 50, RHD*weak D type 95, RHD*weak D type 12, RHD*weak D type 128 and four novel RHD alleles. The prediction of the tertiary structures showed that the RhD protein conformation was disrupted in the 9 rare RhD variants samples. 【Conclusion】 Five rare and four novel RHD alleles have been identified. Their phenotypic and genotypic descriptions enrich the database of reported RHD alleles. Bioinformatics analysis provided evidences for further study of the structure and functions of RhD protein.

Diagnosis and genetic analysis of severe neonatal anemia caused by α-Thalassemla combined with cold IgG anti-M / 中国输血杂志

【Objective】 To investigate the family inheritance of α-Thalassemla gene and the risk of severe anemia in neonates caused by cold IgG anti-M. 【Methods】 ABO, Rh, MN blood groups and the specificity of unexpected antibody were identified by blood group serology. The IgG subtype and antibody titer of anti-M antibody were detected. The etiology of neonatal hemolytic disease was identified by three tests and α-Thalassemla gene diagnosis. 【Results】 Family investigation showed that father was B, CCDee, MN with no α-Thalassemla gene detected; Mother B, CcDee, NN, carrying α-Thalassemla gene; both the proband and his brother were B, CCDee, MN, carrying α-Thalassemla gene. Cold IgG anti-M was present in plasma of both the mother and the proband. The titer of the mother was 128 and that of the proband was 64. The subtype of IgG anti-M was IgG1 and IgG3. The direct anti-globulin test, release test and free test of the proband and his brother were negative, and the diagnosis was severe anemia and hemolysis caused by α-Thalassemla combined with cold IgG anti-M. 【Conclusion】 The direct antiglobulin test of neonatal hemolytic disease caused by IgG anti-M can be negative or weakly positive, and α-Thalassemla gene could be hereditary in families. The presence of α-Thalassemla gene can cause anemia, hemolysis and splenomegalysis in neonates, which could be aggravated when accompanied by cold-type IgG anti-M. In the presence of high-valency IgG antibody in plasma, blood exchange combined with transfusion can improve the curative effect.

Application of Au nanoplates in tumor therapy and diagnosis / 中国药科大学学报

@#Au nanoplates (Au NPLs), a kind of novel two-dimensional metal materials with nanometer scale thickness, have attracted much attention due to their excellent properties; and have been widely used in the fields of tumor diagnosis and treatment in recent years.This article introduces the characteristics and preparation methods of Au nanoplates and summarizes their application in tumor diagnosis and treatment in recent years, in order to provide reference and ideas for the research and application of Au nanoplates in tumor.

Association between ambulatory arterial stiffness index and poor prognosis in patients with chronic kidney disease / 中华肾脏病杂志

Objective:To investigate the association between ambulatory arterial stiffness index (AASI) and renal poor prognosis in patients with chronic kidney disease (CKD).Methods:A prospective study was conducted to enroll 117 non-dialysis patients with CKD who volunteered for receiving ambulatory blood pressure monitoring test from December 2017 to December 2018 in the Department of Nephropathy of the First Medical Center of Chinese PLA General Hospital. According to the AASI tertiles, patients were divided into low AASI group (≤0.414, n=38), medium AASI group (0.414-0.517, n=40), and high AASI group (≥0.517, n=39). The differences of clinical baseline information among the three groups were compared. The follow-up time was until August 2020. Kaplan-Meier curve and Cox proportional hazard regression model were used to explore the effect of AASI on renal poor prognosis. Results:The median age of 117 patients was 61(49, 65) years old. There were 80 males (68.4%) and patients with hypertension accounted for 77.8%(91 cases). After a median follow-up of 27 months, 34 cases had composite endpoint events [renal replacement therapy (dialysis or kidney transplantation), 40% estimated glomerular filtration rate (eGFR) decline, and death], of which 10 patients were on dialysis, 19 patients had 40% eGFR decline, and 5 patients died. There were significant differences in age, hemoglobin, body mass index, eGFR, 24 h systolic blood pressure (SBP), daytime SBP, nighttime SBP, morning SBP, 24 h mean arterial pressure and 24 h pulse pressure among the three groups (all P<0.05). Kaplan-Meier survival analysis indicated that higher AASI was associated with lower cumulative survival rate in patients (Log-rank test χ2=13.111, P=0.001). Univariate Cox regression analysis showed that high AASI was an influencing factor for renal endpoint events ( P<0.05), and after adjusting for age, gender, mean arterial pressure, eGFR, 24 h urine protein, diabetes and body mass index, high AASI was an independent influencing factor for renal poor prognosis in classification and continuous variable analysis models ( HR=2.88, 95% CI 1.00-8.26, P=0.050; HR=1.50, 95% CI 1.02-2.21, P=0.039). Conclusion:High AASI is an independent influencing factor for renal poor prognosis in CKD patients.

Current status of quality of working life among male nurse in China / 中国实用护理杂志

Objective:To investigate the states of quality of working life among male nurses in China so as to provide the theory basis to conduct further intervention researches on quality of working life of male nurses.Methods:From January to December 2019, a questionnaire survey was conducted among 10 775 male nurses from 31 provinces, autonomous regions and municipalities directly under the central government.Results:The mean score of quality of working life among male nurses in China was 3.10 (2.86, 3.60) points. The score of work mastery dimension and career satisfaction dimension were 3.40 (3.00, 4.00) and 3.50 (3.00, 4.00) points respectively, in a high scoring position; and the score of work pressure dimension was relatively low 2.60 (2.00, 3.00) points. Significant differences were detected on the score of quality of working life in male nurses with varied educational background, professional title, position, employment mode and annual income, as well as those male nurses who obtained the certificate of specialized nurse and held the post of nursing association ( χ2 values were -2.833, -6.034, -8.755, Z values were 34.163-90.239, P<0.01). Regression analysis showed that professional title, education background, annual income had a positive forecast effect on the quality of working life of male nurses ( t values were 8.445, 6.651, 6.188, P<0.01). Whether to hold the post of community or obtain the qualification of specialized nurse had a negative predictive effect on the quality of work life ( t values were -3.698, -3.698, P<0.01). Conclusion:The quality of working life of male nurses in China is in the middle level. Nursing managers should take targeted measures to improve the quality of work and life of male nurses and further stabilize and expand the ranks of male nurses.

Study on the Effect and Mechanism of Total Flavonoids from Marchantia convoluta on the Anti-hepatic Fibrosis in Mice / 中国药房

OBJECTIVE：To study the effect and potential mechanism of the total flavonoids from Marchantia convoluta on anti-hepatic fibrosis in the mice. METHODS ：Seventy-two mice were randomly divided into blank group ，model group ，positive control group （colchicine 0.2 mg/kg）and M. convoluta total flavonoids high-dose ，medium-dose and low-dose groups （300，150， 75 mg/kg），with 12 mice in eac group. Except for blank group ，other groups were subcutaneously given 25％ CCl4-peanut oil solution on the back to induce liver fibrosis model. At the same time ，blank group and model group were given water intragastrically，while other groups were given relevant medicine intragastrically 20 mL/kg，once a day ，for consecutive 10 weeks. After last administration ，the serum levels of ALT and AST were detected . Histopathological changes of liver tissue in mice was observed. The levels of COL- Ⅰ，COL-Ⅲ and TGF-β1 in liver tissue were detected . The protein expression levels of α-SMA and TGF-β1，Smad2，Smad4 and Smad 7 in liver tissue were detected . The expression levels of TGF-β1，Smad2，Smad4 and Smad 7 mRNA in liver tissue were detected . RESULTS ：Compared with blank group ，the serum levels of ALT and AST in model group，the levels of COL- Ⅰ，COL-Ⅲ and TGF-β1 in liver tissue，protein expression levels of α-SMA，TGF-β1，Smad2 and Smad 4，mRNA expression levels of TGF-β1，Smad2 and Smad4 were increased significantly （P＜0.05 or P＜0.01）.The mRNA and protein expression levels of Smad 7 in liver tis sue were decreased significantly （P＜0.05）. The degree of liver tissue injury and collagen fiber hyperplasia were serious. Compared with model group ，above indexes of mice were reversed significantly in positive control group and M. convoluta total flavonoids high-dose group （P＜0.05 or P＜0.01）. Serum level of ALT ，the levels of COL- Ⅰ，mRNA and protein expression of TGF-β1，Smad2 and Smad 4 in liver tissue were decreased significantly in M. convoluta total flavonoids medium-dose group （P＜0.05 or P＜0.01）. Protein expression of Smad 2 and Smad 4 in liver tissue were decreased significantly in M. convoluta total flavonoids low-dose group （P＜0.05）. The liver injury and fibrosis of mice were relieved in administration groups. CONCLUSIONS ：M. convoluta total flavonoids possess the effect of anti-hepatic fibrosis ，the mechanism of which is related to the regulation of mRNA and protein expression of TGF-β1，Smad2，Smad4 and Smad 7 in the signaling pathway of TGF-β/Smad.

Progress of research on inhibition strategy of bromodomain-containing protein 4 and its application in tumor therapy / 中国药科大学学报

@#Bromodomain-containing protein 4 (BRD4), a new target for tumor therapy, is the most important member of the bromodomain and extra-terminal family. The overexpression of BRD4 is associated with genesis and development of various cancers.Used either alone or in combination with other treatments such as chemotherapy, photothermal therapy and immunotherapy, the BRD4 inhibitors or degraders exhibited excellent antitumor effects, providing a new direction in tumor treatment. In this review, the structure and function of BRD4, the inhibition strategies of BRD4, the application in tumor combination therapy and drug resistance are introduced, which provides reference for targeting BRD4 in tumor therapy.

Anti-rheumatoid arthritis potential of diterpenoid fraction derived from Rhododendron molle fruits / 中国天然药物

Rhododendron molle G. Don is first recorded in Shengnong's Herbal Classic, and its fruits, which are termed as Liuzhouzi, are often used to treat rheumatoid arthritis in Chinese folk. During our ongoing investigation to develop a safer and potential new arthritis therapy, a process for the preparation of diterpenoid fraction from Rhododendron mollefruits was established. In order to evaluate the main components and the anti-rheumatoid arthritis effect of the diterpenoid fraction, phytochemical and pharmacological experiments were used. As the result, the main components of diterpenoid fraction were identified as rhodojaponin III (1), rhodojaponin VI (2), 2-O-methylrhodojaponin (3), and 5'-β-D-glucopyranosy-loxyjasmonic acid (4). These four components constitute greater than 95% of diterpenoid fraction using area normalization method of HPLC-ELSD. The results of CIA rat experiment showed that high dose of diterpenoid fraction (0.6 mg·kg

Solutions to cross-matching incompatibility in clinical: retrospective study of 1 770 cases in Shenzhen / 中国输血杂志

【Objective】 To analyze the blood samples sent by hospitals in Shenzhen to solve ABO cross-match incompatibility during 2011 to 2020, so as to find corresponding solutions to improve the efficacy of blood transfusion. 【Methods】 The clinical data of 1 770 cases of cross-match incompatibility in our laboratory from January 2011 to December 2020 were collected and reviewed. The causes of cross-match incompatibility were analyzed, the types of unexpected antibodies were determined. The overall incidence of antibodies was evaluated by statistical method of classified variables. The safety of blood transfusion was safeguarded by ABO homotype plus cross-matching compatibility. 【Results】 1) The 1 770 samples, presenting cross-matching incompatibility, involved 956 patients. The average number of cross-matching per patient from 2011 to 2015 was 1.32(307/232), which increased from 1.27(103/81) in 2016 to 2.23(286/128) in 2018, and remained stable in 2019 and 2020. 2) Among 956 patients, auto-and/or allo-antibody in plasma were yielded in 90.38%(864/956), including auto-antibody plus alloantibody in 42.26%(404/956), solo auto-antibody in 20.71%(198/956) and solo allo-antibody in 27.41%(262/956). Up to 20 kinds of specific allo-antibodies were detected, belonging to 8 blood groups. Among them, 70.82%(551/778) were Rh blood group, such as anti-E(37.15%)>anti-c(20.95%)>anti-C(5.27%)=anti-e(5.27%)>anti-D(2.19%), followed by MNS [11.40%(112/778)], Kidd [5.66%(44/778)], Leiws [3.21%(25/778)], Duffy [1.80%(14/778)], Diego [1.03%(8/778)], P1 [0.39%(3/778)] and H [0.26%(2/778)]. 3) 86%(37/43) of multiple transfusion recipients, aged below 20 years old, were thalassemia, and 1-4 kinds of allo- and/or auto-antibody were yielded. 【Conclusion】 The cross-matching incompatibility were mainly caused by allo- and/or auto-antibodies, which may be induced by blood transfusion, pregnancy or autoimmune diseases such as autoimmune hemolytic anemia.Those suspicious blood samples in clinical should be sent to blood group reference laboratory for further determination, in order to ensure the safety and efficacy of blood transfusion.

The morbidity and relevant factors of uveal effusion observed in primary glaucoma patients / 中华实验眼科杂志

Objective:To analyze the incidence of uveal effusion observed in primary glaucoma and explore the relevant factors.Methods:In this case control study, 692 primary glaucoma patients in the Second Hospital of Hebei Medical University from July 2016 to July 2017 were recruited, including 256 acute primary angle-closure glaucoma (APACG) patients, 368 chronic primary angle-closure glaucoma (CPACG) patients, and 68 primary open angle glaucoma (POAG) patients.Ultrasound biomicroscopy (UBM) was performed to determine the presence of uveal effusion, and to grade the effusion.The incidence of uveal effusion and the degree of effusion were analyzed statistically.The study protocol was approved by the Ethics Committee of the Second Hospital of Hebei Medical University.Results:The incidence levels of uveal effusion in the remission stage of APACG, the pre-clinical stage of APACG, and the progress stage of CPACG were 20.45% (54/264), 3.76% (8/213) and 1.45% (8/548), respectively; the incidence of uveal effusion among the three groups was statistically significant ( χ2=105.02, P<0.05). The incidence levels of uveal effusion in the pre-clinical stage of APACG and the progress stage of CPACG were obviously lower than that in the remission stage of APACG ( χ2=29.07, χ2=91.15; both at P<0.01). In the remission stage of APACG, the initial intraocular pressure was higher, and intraocular pressure fluctuation was larger in the patients with uveal effusion than that in the patients without uveal effusion, and these differences were statistically significant ( Z=-3.626, Z=-4.022; both at P<0.05). Uveal effusion was detected in 54 eyes of the 50 APACG patients in the remission stage, including Grade 3 in 16 eyes, Grade 2 in 12 eyes, and Grade 1 in 26 eyes.Uveal effusion was demostrated in eight eyes of eight patients in the preclinical stage of APACG, and all at Grade 1.In the progress stage of CPACG, uveal effusion was also revealed in eight eyes of eight patients, all at Grade 1.In the remission stage of APACG, the degree of effusion was positively correlated with the initial intraocular pressure and the fluctuation of intraocular pressure ( r s=0.912, r s=0.923; both at P<0.01). However, the degree of effusion was inversely associated with intraocular pressure after treatment ( r s=-0.269, P<0.05). Conclusions:Uveal effusion can be observed in the remission and preclinical stages of APACG, and in the progress stage of CPACG.The remission stage of APACG shows both the highest rate and the severest degree of this complication.The degree of effusion is positively correlated with the initial intraocular pressure and the decrease in intraocular pressure, but it is inversely associated with intraocular pressure after treatment.

Thyroid stimulating hormone levels predict short-term outcome after intravenous thrombolysis in patients with acute ischemic stroke / 国际脑血管病杂志

Objective:To investigate the predictive value of thyroid stimulating hormone (TSH) levels on short-term outcome after intravenous thrombolysis in patients with acute ischemic stroke.Methods:From January 2016 to June 2019, patients with acute ischemic stroke receiving intravenous alteplase in the Department of Neurology, Jinshan Branch of Shanghai Sixth People's Hospital were enrolled retrospectively. The National Institutes of Health Stroke Scale (NIHSS) was used to assess the degree of baseline neurological deficits. The modified Rankin Scale was used for short-term outcome evaluation at 14 d after onset. 0-2 was defined as good outcome and >2 was defined as poor outcome. Multivariate logistic regression analysis was used to determine the independent risk factors for poor short-term outcomes. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of thyroid stimulating hormone on short-term prognosis of patients with acute ischemic stroke. Results:A total of 90 patients with acute ischemic stroke received intravenous thrombolysis were enrolled. Their age was 70.08±9.76 years, and 49 (54.44%) were male. The median NIHSS score before thrombolysis was 11.00 (interquartile range, 5.00-16.00). Forty-eight patients (53.33%) had good short-term outcomes, and 42 (46.67%) had poor short-term outcomes. Multivariate logistic regression analysis showed that after adjusting for confounding factors, severe neurological deficits at admission (severe stroke vs. mild stroke: odds ratio [ OR] 9.390, 95% confidence interval [ CI] 2.015-43.764; P=0.004) and low levels of TSH (the 2nd quartile vs. 4th quartile: OR 5.999, 95% CI 1.038-34.657, P=0.045; the 1st quartile vs.4th quartile: OR 6.525, 95% CI 1.107-38.469, P=0.038) were the independent predictors of poor short-term outcome after intravenous thrombolysis in patients with acute ischemic stroke. The ROC curve analysis showed that the area under the curve of TSH for predicting poor outcomes was 0.682 (95% CI 0.572-0.793; P=0.003). The best cutoff value was 1.695 mIU/L, the sensitivity was 76.19%, and the specificity was 60.42%. Conclusion:The decreased serum TSH is an independent predictor of poor short-term outcome after intravenous thrombolysis in patients with acute ischemic stroke.

Allele Frequency and Distribution of Single Nucleotide Polymorphisms in Promoter Region of Gene Encoding the Kidd Blood Group Antigens / 中国实验血液学杂志

OBJECTIVE@#To study the single nucleotide polymorphisms (SNPs) in promoter region of the Jk gene and its allele frequency as well as distribution characteristics in the Chinese Han nationality population.@*METHODS@#127 blood samples containing 8 Jk(a-b-) and 119 samples (as control) taken randomly from voluntary blood donors of Chinese Han nationality persons in Shenzhen Blood Center were collected. The Kidd phenotypes were identified by using the serologic test and urea hemolysis test; the Jk promoter, exon 1-11 region and respective flanking area were amplified and sequenced, then the sequence information was analyzed.@*RESULTS@#8 Jk(a-b-) samples all carried JkB/JkB allele which belongs to 2 kind of Jk genotypes commonly observed in Chinese Han nationality population. 6 IVS5-1g>a and 2 896G>A were found in 8 Jk(a-b-) samples. Besides, all Jk(a-b-) samples were homozygous for JkB/JkB allele. Three SNPs-110(rs900974), -160(rs1484877) and -258(rs1484878) in promoter region of the Jk gene were found and sequenceds calculation of allele and genotype frequencies showed that the result accorded with Hardy-Weinberg equilibrium, indicating that the population in this study possesses representative characteristics of the Chinese Han nationality population.@*CONCLUSION@#The polymorphism of the Jk gene occurs in promoter region. This study calculates the allele frequencies of three SNPs-110(rs900974), -160(rs1484877) and -258(rs1484878) in promoter region of the Jk gene, and shows their distribution characteristics in distinct Kidd phenotypes. These findings provide the basic foundation for further population genetics research.

Clinical features of acute kidney injury in patients with nephrotic syndrome and minimal change disease: a retrospective, cross-sectional study / 中华医学杂志(英文版)

BACKGROUND@#Minimal change nephropathy (MCD) is a common pathological type of nephrotic syndrome and is often associated with acute kidney injury (AKI). This study aimed to investigate the clinical characteristics and related factors of AKI in patients with MCD and nephrotic syndrome.@*METHODS@#Patients from Chinese People's Liberation Army General Hospital who were diagnosed with pathological renal MCD with clinical manifestations of nephrotic syndrome were included from January 1, 2013 to December 31, 2017. Patients diagnosed with membranous nephropathy (MN) by renal biopsy from January 1, 2013 to December 31, 2017 are included as a control population. We retrospectively analyzed the clinical and pathological characteristics of patients as well as the percentages and clinical characteristics of AKI in different age groups. We assessed the correlation of pathological characteristics with serum creatinine using multivariate linear regression analysis.@*RESULTS@#A total of 367 patients with MCD were included in the analysis, with a sex ratio of 1.46: 1 (male: female) and an age range of 6 to 77 years. Among all the patients, 109 developed AKI (29.7%), and of these patients, 85 were male (78.0%). In the 586 patients with MN, 27 (4.6%) patients developed AKI. The percentage of AKI in MCD patients was significantly higher than that in MN patients (χ2 = 41.063, P < 0.001). The percentage of AKI increased with age in the MCD patients. The percentage of AKI in patients aged 50 years or older was 52.9% (46/87), which was significantly higher than that [22.5% (63/280)] in patients under 50 years (χ2 = 6.347, P = 0.013). We observed statistically significant differences in age (43 [27, 59] years vs. 28 [20, 44] years, Z = 5.487, P < 0.001), male (78.0% vs. 51.4%, χ2 = 22.470, P < 0.001), serum albumin (19.9 ± 6.1 g/L vs. 21.5 ± 5.7 g/L, t = 2.376, P = 0.018), serum creatinine (129.5 [105.7, 171.1] μmol/L vs. 69.7 [57.7, 81.9] μmol/L, Z = 14.190, P < 0.001), serum urea (10.1 [6.2, 15.8] mmol/L vs. 4.7 [3.6, 6.4] mmol/L, Z = 10.545, P < 0.001), IgE (266.0 [86.7, 963.0] IU/ml vs. 142.0 [35.3, 516.5] IU/ml, Z = 2.742, P = 0.007), history of diabetes (6.4% vs. 1.2%, P = 0.009), and history of hypertension (23.9% vs. 5.1%, χ2 = 28.238, P < 0.001) between the AKI group and the non-AKI group. According to multivariate linear regression analysis, among the renal pathological features analyzed, renal tubular epithelial cell damage (β = 178.010, 95% CI: 147.888-208.132, P < 0.001) and renal interstitial edema (β = 28.833, 95% CI: 11.966-45.700, P = 0.001) correlated with serum creatinine values.@*CONCLUSIONS@#The percentage of AKI in MCD patients is significantly higher than that in MN patients. Patients over 50 years old are more likely to develop AKI. Renal tubular epithelial cell injury and renal interstitial edema may be the main pathological lesions that are associated with elevated serum creatinine in patients with MCD.

Correction of wide and bulbous nasal tip: a clinical study / 中华医学美学美容杂志

Objective:To investigate the methods and effects of judging and surgically correcting the Asian wide and bulbous nasal tip.Methods:For shrinking the tip of nose and making the nose look more harmonious, we not only dealt with the nasal tip, also the nasal dorsum, nasal alar, nasal threshold, inside pedal and nasal base. In two years, we measured the changes before and after operation in 60 patients (10 males and 50 females, age arange from 18 to 48 years, with average of 29 years. Group A included 30 cases, using auricular cartilage and nasal septum as support; Group B included 30 cases and costal cartilage was used.Results:The prominence of nasal tip, the length of nose were increased ( t=20.831, 13.029, P<0.05); the width of the nose and nasal aral basal and nasal tips were reduced ( t=8.461, 11.877, 16.122, P<0.05). After the follow-up, 55 patients were satisfied, 3 were dissatisfied, and 2 were lost to follow-up. Conclusions:The nasal tip hypertrophy is obviously corrected by using this procedure with a natural and harmonious appearance.