Transfusion Strategy for Rare Anti-LW Antibody Autoimmune Hemolytic Anemia Patients with Neonatal Hemolytic Disease / 中国实验血液学杂志

OBJECTIVE@#To analyze the causes of positive irregular antibody screening test and incompatibility of cross matching in one patient with autoimmune hemolytic anemia complicated with neonatal hemolytic disease, and to accurately identify the type of antibodies in patients, and to select a reasonable strategy for blood transfusion.@*METHODS@#One children was enrolled, blood group positive and reverse typing, Rh typing, direct anti-human globulin test, free test, dispersal test and cross matching test were carried out by test tube method and microcolumn gel card; irregular antibodies were identified by the reaction of DTT treatment and untreated panel cells with patients' plasma.@*RESULTS@#The blood group of the patient was RhD positive B and irregular antibody screening positive, while the blood group of the mother was RhD positive O and irregular anti-screening negative, the result showed that the anti-LW detected in the plasma of the patient was autoantibody and ABO neonatal hemolytic disease (ABO-HDN) was present. Both O type RhD positive washing RBCs and B type RhD negative RBCs were transfused effectively.@*CONCLUSION@#Irregular antibodies in patients are anti-LW antibodies, and transfusion of homotype RhD negative suspended erythrocytes after the exclusion of ABO-HDN shows a better effect.

Study on assessing early epidemiological parameters of coronavirus disease epidemic in China / 中华流行病学杂志

Objective@#To study the early dynamics of the epidemic of coronavirus disease (COVID-19) in China from 15 to 31 January, 2020, and estimate the corresponding epidemiological parameters (incubation period, generation interval and basic reproduction number) of the epidemic.@*Methods@#By means of Weibull, Gamma and Lognormal distributions methods, we estimated the probability distribution of the incubation period and generation interval data obtained from the reported COVID-19 cases. Moreover, the AIC criterion was used to determine the optimal distribution. Considering the epidemic is ongoing, the exponential growth model was used to fit the incidence data of COVID-19 from 10 to 31 January, 2020, and exponential growth method, maximum likelihood method and SEIR model were used to estimate the basic reproduction number.@*Results@#Early COVID-19 cases kept an increase in exponential growth manner before 26 January, 2020, then the increase trend became slower. The average incubation period was 5.01 (95%CI: 4.31-5.69) days; the average generation interval was 6.03 (95%CI: 5.20-6.91) days. The basic reproduction number was estimated to be 3.74 (95%CI: 3.63-3.87), 3.16 (95%CI: 2.90-3.43), and 3.91 (95%CI: 3.71-4.11) by three methods, respectively.@*Conclusions@#The Gamma distribution fits both the generation interval and incubation period best, and the mean value of generation interval is 1.02 day longer than that of incubation period. The relatively high basic reproduction number indicates that the epidemic is still serious; Based on our analysis, the turning point of the epidemic would be seen on 26 January, the growth rate would be lower afterwards.

Advances in the diagnosis and treatment of intersphincteric resection for ultra-low rectal carcinoma / 国际外科学杂志

It has been 20 years since Intersphincteric resection(ISR) was used as a supplement to Abdominoperineal resection(APR) for ultra-low rectal cancer. With the help of removing conjointed longitudinal muscle and total or partial internal sphincter, R0 resection is achieved under the condition of preserving external sphincter, levator ani muscle, and part of internal sphincter, thereby retaining part of the anal function. This article reviews the indications, anatomy, physiology and treatment outcomes of ISR.

Pathogenetic factors affecting gastroesophageal reflux in patients with esophagitis and concomitant duodenal ulcer: a multivariate analysis.

AIM:To assess the relationship between gastric acid output (GAO) and both pattern of gastroesophageal reflux (GER) and esophageal lesions,and to evaluate the role of GAO and other potential pathogenetic factors in the development of esophagitis.METHODS:Gastric acid secretory testing and 24h intraesophageal pH monitoring were performed in 31 patients with esophagitis and concomitant duodenal ulcer (E+DU) and compared with those of 72 patients with esophagitis (E) alone.RESULTS: The GAO in patients with E+DU was significantly higher than in patients with E (P <0.05). There was no significant difference between the two groups of patients as to endoscopicl findings and parameters of GER (P >0.05). A multiple regression analysis with stepwise deletion showed that the pre-sence of hiatal hernia (HH), GER in upright position and age appeared to correlate significantly with the presence of esophagitis.CONCLUSION:No parallel relationship between GAO and severity of GER or esophageal lesions exists in patients with E+DU, and that GAO is not a major pathogenetic factor in GER disease.