Use of indocyanine green fluorescence navigation in laparoscopic anatomical hepatectomy / 中华外科杂志

Objective: To examine the clinical value of fluorescence-guided indocyanine green (ICG) laparoscopic anatomical hepatectomy in the treatment of primary hepatocellular carcinoma. Methods: Data from patients diagnosed with hepatocellular carcinoma and who underwent laparoscopic hepatectomy with ICG fluorescence navigation in the Department of Liver Surgery and Liver Transplantation Center of West China Hospital between September 2020 and May 2022 were retrospectively collected. There were 53 males and 19 females, with an age of (55.5±12.9)years(range:42.6 to 68.4 years). Among them, 13 of the cases underwent laparoscopic anatomical liver resection(LALR) guided by tans-arterial ICG,43 of the cases received LAIR guided by portal vein negative ICG, and 16 of the cases received LALR positive by portal vein. Comparison among the three groups was performed by one-way ANOVA; and the rank sum test was used for comparison between groups. The counting data was expressed as percentage,and the χ2 test or Fisher's exact probability method was used for comparison between groups. Results: (1) Postoperative pathology: Resection R0 was achieved in all operations. The maximum tumor diameter of the patients in the arterial staining group, the reverse staining group, and the positive staining group(M (IQR)) was 2.5 (2.4) cm, 3.0 (2.5) cm and 3.0(2.4) cm,respectively. There were no statistically significant differences in the maximum tumor diameter between the three groups (P=0.364). The minimum tumor margin was 1.1 (1.1) cm, 1.0 (1.0) cm, 1.1 (1.6) cm in the the arterial staining group, reverse staining group and the positive staining group, respectively. There was no significant difference in the margin among the three groups (P=0.878). (2) Operation conditions: the operation time of the arterial staining group, the negative staining group, and the positive portal staining group was (348±93)minutes,(277±112)minutes,and (295±116)minutes,respectively. There were no significant differences in operation time among the three groups (P=0.134). The intraoperative blood loss of the three groups was 80(150)ml,200(350)ml,and 100(150)ml,respectively. There was no statistically significant difference in intraoperative bleeding volume between the three groups(P=0.743). All cases were not transfused during the operation and were not converted to laparotomy. ALT in the arterial staining group was higher than in the negative staining group in the first two days after the operation ((559±398)IU/L307(257) IU/L, q=235.5,P=0.004;(611±389)IU/L(331±242) IU/L, q=265.2, P=0.002). There was only one case of a grade III complication (Clavien-Dindo grading system) postoperative complication in the negative and positive staining group of the portal vein, respectively. Tumor markers in all patients decreased to the normal range after 2 months of operation. Conclusion: Laparoscopic anatomical hepatectomy guided by ICG fluorescence through arterial staining and portal vein staining is safe and feasible for primary hepatocellular carcinoma treatment.

Prognosis of traumatic spinal cord injury in children: Follow-up of 86 patients / 中华创伤杂志(英文版)

PURPOSE@#The long-term situation of children with spinal cord injury (SCI) was investigated, and suggestions for helping them better return to the society were provided.@*METHODS@#SCI patients less than 18 years old hospitalized in Beijing Boai Hospital from January 2011 to December 2020 were retrospectively analyzed. Information including motor function, complications, characteristic changes, self-care abilities, school attendance and social participation were collected by telephone interview and electronic questionnaire. All the answers were statistically analyzed.@*RESULTS@#A total of 86 cases were enrolled, 77 girls and 9 boys, with a median injury age of 6 years and 2 months. The follow-up time was 3-130 months. The main cause of trauma in these children was sport injury (66.3%), the thoracic spinal cord was involved the most (91.9%), and complete SCIs accounted for the majority (76.7%). In terms of complications, children with complete SCIs were more likely to have urinary incontinence, constipation and characteristic changes (p < 0.05); whereas the incomplete SCIs often have spasticity (p < 0.05). As to the daily living abilities, children with incomplete lumbar SCIs were more capable to accomplish personal hygiene, transfer, and bathing independently than those with complete injuries, or cervical/thoracic SCIs, respectively (p < 0.05). Moreover, children older than 9 years care more able to dress and transfer independently than the youngers (p < 0.05). Wheelchair users accounted for 84.9% and more than half of them were able to propel wheelchair independently, and those who move passively in wheelchairs were mostly introverted kids (p < 0.05). Almost all (93.8%) children with incomplete injuries were able to walk independently. Most (79.1%) children continued to attending school, and 41.9% participated in interest classes. Unfortunately, 67.4% of the children spent less time playing with their peers than before the injury.@*CONCLUSION@#SCIs impair physical structures and function of children, affect their independence in daily living, and restrict school attendance and social interaction. Comprehensive rehabilitation after injury is a systematic work. Medical staff and caregivers should not only pay attention to neurological function, but also help them improve self-care abilities. It is also important to balance rehabilitation training and school work and social participation.

Influence of different drainage modes of pancreatic duct on the incidence of pancreatic fistula after pancreaticoduodenectomy / 中华肝胆外科杂志

Objective:To investigate the effect of different drainage methods on pancreatic fistula after pancreaticoduodenectomy (PD).Methods:The data of all patients with PD in Xijing Hospital, the First Affiliated Hospital of the Fourth Military Medical University from January 2007 to December 2018 were retrospectively analyzed. A total of 670 patients were enrolled, including 415 males and 255 females, aged (58.4±7.3) years, ranging from 24 to 82 years. According to the different method of pancreatic duct drainage, the propensity score was matched, and the patients were divided into internal drainage group ( n=529) and external drainage group ( n=141). The pancreatic fistula rate was compared between the two groups. Factors influencing pancreatic fistula after PD were analyzed by univariate and multivariate logistic regression. Results:The incidence of pancreatic fistula in the internal drainage group was 12.5% (66/529), which was significantly higher than that in the external drainage group 6.4% (9/141) (χ 2= 4.16, P=0.041). Multivariate logistic regression analysis showed that age ≥65 years ( OR=2.004, 95% CI: 1.185-3.390), complicated with digestive diseases ( OR=3.087, 95% CI: 1.599-5.959), history of upper abdominal surgery ( OR=2.031, 95% CI: 1.104-3.734) increased the risk of pancreatic fistula after PD (all P<0.05), decreased the risk of pancreatic fistula after PD in patients with external drainage ( OR=0.470, 95% CI: 0.223-0.989, P=0.047), and decreased the risk of pancreatic fistula after PD with the tumor size ( OR=0.725, 95% CI: 0.556-0.944, P=0.017), tumor located in the common bile duct after PD increased the risk of pancreatic fistula ( OR=1.497, 95% CI: 1.192-1.880, P=0.001). Conclusions:Compared with pancreatic duct drainage, external pancreatic duct drainage is better because of preventing postoperative pancreatic fistula.

Development and validation of a prediction model for treatment failure in peritoneal dialysis-associated peritonitis patients: a multicenter study / 南方医科大学学报

OBJECTIVE@#To develop and validate a risk prediction model of treatment failure in patients with peritoneal dialysis-associated peritonitis (PDAP).@*METHODS@#We retrospectively analyzed the data of patients undergoing peritoneal dialysis (PD) in 3 dialysis centers in Jilin Province who developed PDAP between January 1, 2013 and December 31, 2019. The data collected from the Second Hospital of Jilin University and Second Division of First Hospital of Jilin University) were used as the training dataset and those from Jilin Central Hospital as the validation dataset. We developed a nomogram for predicting treatment failure using a logistic regression model with backward elimination. The performance of the nomogram was assessed by analyzing the C-statistic and the calibration plots. We also plotted decision curves to evaluate the clinical efficacy of the nomogram.@*RESULTS@#A total of 977 episodes of PDAP were included in the analysis (625 episodes in the training dataset and 352 episodes in the validation dataset). During follow-up, 78 treatment failures occurred in the training dataset and 35 in the validation dataset. A multivariable logistic regression prediction model was established, and the predictors in the final nomogram model included serum albumin, peritoneal dialysate white cell count on day 5, PD duration, and type of causative organisms. The nomogram showed a good performance in predicting treatment failure, with a C-statistic of 0.827 (95% CI: 0.784-0.871) in the training dataset and of 0.825 (95% CI: 0.743-0.908) in the validation dataset. The nomogram also performed well in calibration in both the training and validation datasets.@*CONCLUSION@#The established nomogram has a good accuracy in estimating the risk of treatment failure in PDAP patients.

Effects of exogenous γ-Aminobutyric acid on the regulation of respiration and protein expression in germinating seeds of mungbean (Vigna radiata) under salt conditions

BACKGROUND: γ-Aminobutyric acid (GABA) bypasses the TCA cycle via GABA shunt, suggesting a relationship with respiration. However, little is known about its role in seed germination under salt conditions. RESULTS: In this study, exogenous GABA was shown to have almost no influence on mungbean seed germination, except 0.1 mM at 10 h, while it completely alleviated the inhibition of germination by salt treatment. Seed respiration was significantly inhibited by 0.1 and 0.5 mM GABA, but was evidently enhanced under salt treatment, whereas both were promoted by 1 mM GABA alone or with salt treatment. Mitochondrial respiration also showed a similar trend at 0.1 mM GABA. Moreover, proteomic analysis further showed that 43 annotated proteins were affected by exogenous GABA, even 0.1 mM under salt treatment, including complexes of the mitochondrial respiratory chain. CONCLUSIONS: Our study provides new evidence that GABA may act as a signal molecule in regulating respiration of mungbean seed germination in response to salt stress.

Effectiveness of Auricular Acupressure for Acute Postoperative Pain after Surgery: A Systematic Review and Meta-Analysis / 中国结合医学杂志

OBJECTIVE@#To identify the effectiveness of auricular acupressure (AA) in patients with acute postoperative pain after surgery by systematic review.@*METHODS@#A search of randomized controlled trials was conducted in 5 English medical electronic databases and 4 Chinese databases. Two reviewers independently retrieved related studies, assessed the methodological quality, and extracted data with a standardized data form. Meta-analyses were performed using all time-points meta-analysis.@*RESULTS@#A total of 26 studies with 1,682 participants were included. Results showed that compared with conventional therapy, AA significantly improved the total effective rate [risk ratio=1.25, 95% confidence interval (CI), 1.13 to 1.37, Plt;0.0001; heterogeneity: Plt;0.0001, I=85%]. In the subgroup analysis, the results changed in different follow-up time and surgery categories. The pain relief in the AA group might be the most significant at 72 h after surgery (mean difference=-0.85, 95% CI,-1.20 to-0.50, Plt;0.0001) and in abdominal surgery (mean difference=-1.15, 95% CI,-1.41 to-0.90, Plt;0.0001). Sensitivity analysis demonstrated that the results of this meta-analysis were stable. No serious adverse effects were recorded.@*CONCLUSION@#It was recommended to provide AA to patients with acute postoperative pain. However, a more accurate estimate of the effect requires further rigorously designed large-scale and high-quality RCTs for improving acute postoperative pain after surgery.

Factors influencing the decision to pursue emergency medicine as a career among medical students in Singapore

<p><b>INTRODUCTION</b>The introduction of the residency programme in Singapore allows medical students to apply for residency in their graduating year. Our study aimed to determine the interest levels and motivating factors for pursuing emergency medicine (EM) as a career among medical students in Singapore.</p><p><b>METHODS</b>A self-administered questionnaire was distributed to Year 1-5 medical students in 2012. Participants indicated their interest in pursuing EM as a career and the degree to which a series of variables influenced their choices. Influencing factors were analysed using multinomial logistic regression.</p><p><b>RESULTS</b>A total of 800 completed questionnaires were collected. 21.0% of the participants expressed interest in pursuing EM. Perceived personality fit and having done an elective in EM were strongly positive influencing factors. Junior medical students were more likely to cite the wide diversity of medical conditions and the lack of a long-term doctor-patient relationship to be negative factors, while senior medical students were more likely to cite personality fit and perceived prestige of EM as negative factors.</p><p><b>CONCLUSION</b>Careful selection of EM applicants is important to the future development of EM in Singapore. Our study showed that personality fit might be the most important influencing factor in choosing EM as a career. Therefore, greater effort should be made to help medical students explore their interest in and suitability for a particular specialty. These include giving medical students earlier exposure to EM, encouraging participation in student interest groups and using appropriate personality tests for career guidance.</p>

Clinical Study on Acupuncture Treatment for Parkinson's Non-motor Symptoms / 上海针灸杂志

Parkinson disease (PD) is a neurodegenerative disorder resulting from alpha-synuclein lesions, which affects about eight million patients over the world. PD is manifested in progressive motor and non-motor symptoms. With understanding of PD gradually deepened, motor symptoms mainly manifested in resting tremor are not the only manifestations of PD. Clinically many non-motor symptoms such as autonomic nervous symptoms, mental symptoms and paresthesia are also the important manifestations of PD and can appear earlier than motor symptoms. The effect of the non-motor symptoms on the patients' life is often not less than that of the motor symptoms. Clinically the changeable non-motor symptoms are far more complex and more difficult to treat than the motor symptoms. Conventional anti-PD drugs such as levodopa have little effect on the non-motor symptoms. Present clinical studies have showed that acupuncture has a certain therapeutic effect on the non-motor symptoms of PD. This provides important help for expanding the way to treat PD.

Medium-term follow-up of laparoscopic surgery on radical gastrectomy with D2 dissection for gastric cancer / 中国内镜杂志

Objective To explore the feasibility and clinical outcome of laparoscopy-assisted gastrectomy with D2 dissection by comparing the efficacy of open surgery on radical gastrectomy with D2 dissection for gastric cancer patients. Methods The patients with gastric cancer from October 2008 to August 2013 were divided into two groups according to the different surgical methods. Among them, 175 patients underwent laparoscopic surgery (laparoscopy-assisted surgery group, Group L), and 163 patients underwent laparotomy surgery (open surgery group, Group O). The number of lymph nodes dissected, postoperative recovery, complications, mortality and survival rate of the two groups were compared and analyzed. Results There was no significant difference in the number of lymph nodes resect between the two groups [Group L and Group O: (26.3 ± 13.9) vs (26.8 ± 10.2), t = -0.40, P = 0.684]. Compared with open surgery, the laparoscopy-assisted surgery showed significantly less intraoperative blood loss and quicker recovery of gastrointestinal function. The postoperative hospitalization time of laparoscopic group was less than that of laparotomy group, the difference was statistically significant (P < 0.05). No significant difference was found in 3-year survival rate between the two groups (Group L vs Group O: 92.00％ vs 92.63％, P = 0.262). Conclusions Compared to open surgery, laparoscopic gastrectomy is safer and has quicker postoperative recovery. There is no statistical difference in the number of resect lymph nodes between lapamscopic and open gastrectomy.

Research progress of hepatocyte necroptosis in liver injuries / 中国药理学通报

Various pathological factors can result in the death of hepatocytes during liver injury. Persistent hepatocyte death initi-ates and aggravates chronic inflammation and fibrosis,ultimately leading to liver cirrhosis and hepatocellular carcinoma. Thus, limiting hepatocyte death is an effective strategy for improving liver injury. Necroptosis is a newly characterized form of cell death,which is highly regulated by signaling pathways and has typical morphological features of necrosis. Increasing evidence indicates that necroptosis plays a key role in drug-induced or im-munological acute liver injuries,and in chronic liver injuries in-cluding alcoholic fatty liver,nonalcoholic fatty liver and liver fi-brosis. This article reviews the recent advances on the hepato-cyte necroptosis in liver injury,providing novel insights into the pathogenesis of liver disease and related therapeutic reagents.

Comparative Study on Transformation of Tecomin by Using Liver Microsomes and Liver S9 QIAO Shan-shan, / 中国中医药信息杂志

Objective To compare the difference of transformation profile and transformation rate of tecomin by using two in vitro liver metabolism models. Methods Liver microsomes and liver S9 fraction models were employed to transform tecomin. HPLC was used to determine the contents of tecomin and its metabolites at the detecting wavelength of 254 nm. The gradient elution (0–6 min, 5％–40％ A; 6–9 min, 40％–50％ A; 9–11 min, 50％–5％ A) was carried out by using mobile phase of acetonitrile (A) - 1％ acetic acid (B) at a flow rate of 1 mL/min. Results Both models could transform tecomin into veratric acid; however, the metabolites obtained with liver S9 were more than those obtained with liver microsomes, and the transformation rate of the former was higher than that of the latter. Conclusion The liver S9 fraction can more efficiently transform esters than liver microsomes.

Diagnosis and therapy of cerebral cysticercosis with 6 case reports attached / 中国人兽共患病学报

We explored the feature and therapeutic methods of cerebral cysticercosis.The effect of different surgical treatment was analyzed on 6 patients with cerebral cysticercosis who had undergone surgery at Fujian Provincial Hospital.Results showed that 2 of 6 cases underwent an excision of ventricle or cisternalcysticercus.Three cases were performed an excision of brain parenchyma cysticercus.The decompressivecraniectomy under bilateral temporalis was performed on 1 patient with cerebral cysticercosis.One case underwent ventriculo-peritoneal shunt because of hydrocephalus after a year of follow-up.The operations of 6 cases were all successfully performed.All patients recovered well after the operation.No newly neurobiological injuries were observed.Timely and accurate neurosurgery contributes to reduce the incidence of complications and cut down disability rate of cerebral cysticercosis,and buy time and fight for an opportunity for drug therapy of cerebral cysticercosis as well.It significantly improves the safety and therapeutic effect of anti-cysticercosis drugs.

Study on establishing perioperative nursing prevention strategies for patients with deep venous thrombosis in department of orthopedics / 中华护理杂志

Objective To establish nursing prevention strategies for patients with deep venous thrombosis in department of orthopedics,so as to guide the specific context of clinical nursing practice,offer evidence-based evidence.Methods Clinical practice guidelines and original researches at home and abroad were retrieved using systematic review approach,and appraisal of literatures was conducted using Australia JBI based Quality Evaluation Center for health care evaluation methods and Johns Hopkins standard.The preliminary nursing prevention strategies for patients with deep venous thrombosis in department of orthopedics and Delphi mail questionnaire were developed.Using Delphi method,the operational feasibility of the final evidence strategies was improved for clinical evidence application through two rounds of consultation from clinical experts.Results A total of 111 articles were included in this study.Forty-nine prevention strategies were established under 3 dimensions including "risk assessment graded prevention" and "education and instruction" through systematic review and Delphi method.Conclusion Nursing prevention strategies in department of orthopedics for patients with deep venous thrombosis based on systematic review and Delphi method have scientific practicability and operability,and can provide objective reference and implementation strategies for nursing practice,assisting the implementation of effective preventive measures.

Effect of ASO Blood Stasis Syndrome Serum on Vascular Endothelial Cell Injury and Regulation of Taohong Siwu Decoction on it / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To explore the effect of arteriosclerosis obliterans (ASO) blood stasis syndrome (BSS) serum on vascular endothelial cell injury and to study the regulation of Taohong Siwu Decoction (TSD) on it.</p><p><b>METHODS</b>Umbilical vein endothelial cell culture system was established. The serum endothelial cell injury model with ASO BSS was prepared. Low, medium, and high concentrations TSD containing serums were respectively added. The endothelial cell proliferation activity was observed by MTT method. Ultrastructures of endothelial cells were observed under transmission electron microscope. Changes of intracellular calcium ion concentration and the cytoskeleton were observed under laser confocal microscope. Contents of ET, NO, and transforming growth factor beta1 (TGF-beta1) in endothelial cell culture supernatant were detected by ELISA.</p><p><b>RESULTS</b>In ASO BSS serum group endothelial cell proliferation activities decreased, the cell structure was obviously destroyed, calcium ion concentration increased, contents of ET, NO and TGF-beta1 increased significantly (P < 0.01), and ET/NO ratio was imbalanced. After incubating with TSD drug containing serum, endothelial cell proliferation activities and injured cell structures were obviously improved; ET, NO and TGF-beta1 levels decreased (P < 0.05, P < 0.01), ET/NO ratios approximated to the normal level.</p><p><b>CONCLUSION</b>The main mechanism of TSD for treating ASO ASS lied in improving injured vascular endothelial cells and endocrine disorder.</p>

A study of HLA-DPA1 and DPB1 matching status for unrelated donor-recipient pairs matched at allele level for HLA-A, -B, -C, -DRB1 and -DQB1 loci / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To analyze the status of HLA-DPA1 and DPB1 matching for unrelated donor-recipient pairs matched at high-resolution allele level for HLA-A, B, C, DRB1 and DQB1 loci.</p><p><b>METHODS</b>A total of 76 unrelated donor-recipient pairs matching at allele level for HLA-A, B, C, DRB1 and DQB1 loci were subjected to HLA-DPA1 and DPB1 sequence-based typing (SBT). HLA-DPA1and DPB1 matching status at high-resolution allelic level was also analyzed.</p><p><b>RESULTS</b>The allelic identity ratio for single HLA-DPA1 and DPB1 were 17.1% and 9.2%, respectively. HLA-DPA1 and DPB1 allelic identity ratio were both very low. The majority of unrelated donor-recipient pairs (73.7%) had an incompatibility at 1 HLA-DPA1 allele, 9.2% of pairs had an incompatibility at 2 DPA1 alleles. As for the high-polymorphic HLA-DPB1 gene, 57.9% of studied donor-recipient pairs had an incompatibility at 1 HLA-DPB1 allele, almost 1/3 (32.9%) of them were completely incompatible. When HLA-DPA1 and DPB1 genes were analyzed together, the donor-recipient pairs matched at 2/4 was the most common (51.4%), 4/4 allelic complete matched pairs accounted for 5.6%, and 0/4 matched pairs accounted for 8.3%.</p><p><b>CONCLUSION</b>Our results indicated that the ratio of HLA-DPA1 and DPB1 complete match in the unrelated donor-recipient pairs matching at allelic level for HLA-A, B, C, DRB1 and DQB1 loci were very low. The effect of HLA-DPA1 and DPB1 matching status on clinical unrelated stem cell transplantation still needs to be elucidated.</p>

Establishment of a large-scale bi-directional sequencing and genotyping platform for MICA gene exons 2 to 4 / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To establish a stable and large-scale bi-directional sequencing platform for genotyping MICA gene exons 2 to 4, and to analyze single nucleotide polymorphisms(SNP) of the region.</p><p><b>METHODS</b>Primers for particular alleles of MICA gene exons 2 to 5 were designed. Optimal conditions for PCR amplification and sequencing reaction were explored. A commercialized one-way sequencing kit for MICA allele was used as a parallel control. Four samples carrying a MICA *010 allele were subjected to cloning and haplotype sequencing.</p><p><b>RESULTS</b>Results of MICA allele typing of 100 samples for a parallel control group were confirmed by the establish method. Twenty-two SNP in MICA gene exons 2 to 4 were detected in Chinese population. Two novel allelic sequences were accepted by GenBank and IMGT/HLA database and officially named as MICA*065 and MICA*066 by the WHO Nomenclature Committee. A novel SNP in MICA gene intron 3 was discovered, with allelic sequence submitted to GenBank and IMGT/HLA database.</p><p><b>CONCLUSION</b>The bi-directional sequencing genotyping platform may be applied for large-scale study of MICA allelic polymorphisms, tissue typing, organ transplantation and disease research.</p>

Cloning and sequencing analysis of a novel allele HLA-A*02:251 / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To identify a novel human leukocyte antigen (HLA) allele A*02:251 and analyze the sequences in Chinese population.</p><p><b>METHODS</b>Routine HLA-A, -B, -DRB1 high resolution genotyping for healthy Chinese donors and patients was performed with polymerase chain reaction-sequence based typing. An unknown HLA-A allele was initially detected by HLA typing in the healthy donor. Genomic DNA of the HLA-A locus in the proband was amplified, the amplified product was cloned by PMD18-T to split the two alleles, and selected clones were sequenced.</p><p><b>RESULTS</b>The sequencing results showed that a normal A*02:06:01 and a novel A*02:251 variant allele were identified. The sequence of the novel allele has been submitted to GenBank (HM245348). Nucleotide sequence alignments with HLA-A allele from the IMGT/HLA Sequence Database showed that the novel A*02 variant allele differed from the closest allele A*02:01:01:01 by nt 383 G to C (codon 128 GAG to GAC) in exon 3, which resulted in one amino acid substitution of Glu to Asp. The HLA-A, B, C and DQB1 alleles of the healthy donor did not match with that of the patient.</p><p><b>CONCLUSION</b>This novel allele is officially designated as HLA-A*02:251 by World Health Organization(WHO) Nomenclature Committee (Submission ID HWS10010755). The sequence of HLA-A locus in exon 3 is confirmed to be polymorphic in Chinese population.</p>

Study on HLA nucleotide sequence matching in epitope positions among recipient-donor pairs for allogenic hematopoietic stem-cell transplantation / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To analyze the human leukocyte antigens(HLA)-A, -B, -Cw, -DRB1 and DQB1 nucleotide sequences between patients waiting for allogenic hematopoietic stem-cell transplantation (HSCT) and donors in Chinese population, and to establish strategy for maximizing optimal donor selection.</p><p><b>METHODS</b>HLA high-resolution typing in a total of 537 recipient-donor pairs was determined by sequence based typing (SBT) method. The nucleotide BLAST tool was used to compare the nucleotide sequences among recipient-donor pairs.</p><p><b>RESULTS</b>Only 16.20% (88/537) of recipient-donor pairs were found to fully match for nucleotide sequences of all HLA-A,-B,-Cw, -DRB1 and -DQB1 loci. Mismatch rate in single locus were 8.38% in HLA-A, 0.74% in HLA-B, 12.29% in HLA-C, 2.42% in HLA-DRB1, and 2.79% in HLA-DQB1, respectively. Mismatch rate in two or multiple HLA loci was 42.65%. Nonpermissive allele mismatch combinations (A 02:01-A 02:06, A 02:06-A 02:07, Cw 03:04-Cw 15:02, Cw 03:03-Cw 04:01, Cw 03:04-Cw 14:02, Cw 03:03-Cw 08:01, DRB1 04:03:01-DRB1 04:05) were detected in single mismatch HLA locus of recipient-donor pairs, mismatches of B 07:05:01-B 07:06, Cw 07:01:01-Cw 07:06 combinations outside of epitope positions were detected in two recipient-donor pairs.</p><p><b>CONCLUSION</b>Our data suggested that attention should be paid in comparing nucleotide sequences between recipient and donor, and in distinguishing nucleotide sequence mismatches within and outside of the epitope positions. These results could serve as guidelines for donor selection.</p>

Correlation of killer immunoglobulin-like receptor gene diversity with nasopharyngeal carcinoma in Chinese southern Han population / 中国实验血液学杂志

The objective of this study was to elucidate the correlation of killer immunoglobulin-like receptor (KIR) gene diversity with nasopharyngeal carcinoma (NPC) in the Chinese southern Han population. KIR genotyping of peripheral blood samples from 67 patients with NPC and 77 randomly-selected healthy controls was performed by PCR-SSP, the relative risk (RR) value was calculated by means of Wolf method. The results showed that the KIR2DL3 gene frequency in NPC patient group was significantly lower than that in healthy controls (χ²>3.84, p < 0.05, RR = 0.08), whereas the KIR2DS5 and KIR2DL5B gene frequencies in patient group were significantly higher than those in healthy controls (χ²>3.84, p < 0.05, RR > 1), the other KIR gene frequencies were no statistically different between two groups. It is concluded that the KIR2DL3, KIR2DS5 and KIR2DL5B genes may be correlated with pathogenesis of NPC in the Chinese southern Han population.

Analysis of full intronic sequences of HLA-A alleles / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To analyze the full intronic sequences of human leukocyte antigen (HLA)-A alleles in Han Chinese.</p><p><b>METHODS</b>The full-length HLA-A alleles, including 8 exons and 7 introns, were amplified with a long-template PCR system from 165 donors from the Chinese Marrow Donor Program (CMDP). The products were cloned into a PGEM-T Vector System and sequenced from both directions. Genetic analysis was performed using a MEGA4.0 software. All sequences were aligned with a ClustalW algorithm. Phylogenetic trees were constructed with a neighbor-joining method. Genetic distances were estimated based on p-distance, and a bootstrap analysis was applied for assessing the confidence limits of the trees.</p><p><b>RESULTS</b>A total of thirty-three full-length sequences of HLA-A alleles, containing 2902-2918 nucleotides, were derived. A total of 138 point mutations and 9 insertions or deletions were found among the 7 introns, which showed remarkable group specificity. Intron 1 appeared to be most polymorphic with the highest average GC content and evolutionary distances. Eight phylogenetic trees were constructed respectively with the derived full-length sequences as well as each of the 7 introns sequences. Based on full-length sequences, sequences of the HLA-A locus were classified into five groups: group I consisted of A*01/03/11/30; group II consisted of A*23/24(A9); group III consisted of A*02/68/69(A2/28); group IV consisted of A*26/34(A10); and group V consisted of A*29/31/32/33/74(A19). The five groups were derived from two ancient lineages, one including groups I and II, and another including groups III, IV and V. No substantial difference was detected between the trees constructed with the 7 intronic sequences, except that group II belonged to different lineages based on introns 2-5 and introns 1 and 7. The A*30 variant cluster was close to group I (A*01/03/11/30) and differed from group V (A19).</p><p><b>CONCLUSION</b>The full-length sequences of 18 alleles have been submitted to GenBank and accepted by the international ImMunoGeneTics database (IMGT). Polymorphisms identified within the introns of HLA-A alleles showed remarkable group specificity. Such sequences seem to have substantially contributed to the recombination of the HLA-A alleles. The A*30 may represent an atypical group in which the rates of gene conversion and mutation have been unusually high.</p>