Identification and clinical transfusion of B (A) subgroup / 中国输血杂志

【Objective】 To carry out serological and molecular biological identification of B (A) subtype, and discuss the rational blood transfusion strategy. 【Methods】 Serological and direct sequencing methods were used to detect serotype and genotype of 7 cases of B (A) subtype, and cross matching was performed by saline medium and anti human globulin card to analyze the red blood cells(RBCs) transfusion strategy. 【Results】 The serology results of blood type of 7 samples were similar, with B(A)04/O01 in 3 cases, B(A)04/O02 in 2 cases and B(A)02/O01 in 2 cases. 7 cases of B (A) subtypes were matched with randomly selected blood donors of type O and B on the major side. 【Conclusion】 B(A) subtypes should be identified by genotyping techniques. Washed RBCs of type B and O can be used for B(A) blood type transfusion.

Significance on Cerebral Infarction's Fatality Rate for the Retrospective Analysis of Hypertension under Serum Lipids Layer Management / 现代检验医学杂志

Objective By analyzing the mortality of patients with hypertension and cerebral infarction in different blood lipid stratification,the significance of blood lipid stratification management in the treatment of hypertension was clarified.Methods 604 patients with hypertension combined with cerebral infarction were divided into middle risk group (198 cases),high risk group (n=198) and extremely high risk group (n=208) and each group of different stratification according to the serum lipid HCY level,divided into H type hypertension group (HCY=10 μmol/L) and hypertension group ((HCY＜10 μmol/L group) and comparison of the 10 year mortality in each group.Results Comparison of mortality between H type hypertension group and simple hypertension group,among them,the difference between the two groups in middle risk group was statistically significant (x2 =5.095,P =0.024 205).The difference between the two groups in extremely high risk group was statistically significant (x2 =7.859,P=0.005 056).The difference between the two groups in high risk group was statistically significant (x2 =9.961,P=0.001 599).There was a significant difference in mortality between the groups with different blood lipids in simple hypertension group.Among the high-risk group and the middle risk group,the difference was statistically significant (x2=6.575,P=0.010 343),and there was significant difference between high risk group and high risk group (x2 =6.868,P=0.008 774).Comparison of mortality between different lipid levels in H type hypertension group,the difference was statistically significant.There was significant difference between the extremely high risk group and the high risk group (x2 =4.745,P=0.029 388) and there was significant difference between the high risk group and the middle risk group (x2 =11.668,P=0.000 636).Conclusion Hyperlipidemia,especially high LDL and high HCY are the main causes of death in patients with hypertension complicated with cerebral infarction,the clinical use of blood lipid levels can reduce the level of LDL and reduce the mortality of patients by strengthening the control of HCY level.Improve the survival rate of patients.

Correlation between Non High Density Lipoprotein Cholesterol and Cardiac Function in Patients with Coronary Heart Disease / 现代检验医学杂志

Objective To investigate the correlation between non high density lipoprotein cholesterol (non-HLD-C)and cardi-ac function in patients with coronary heart disease (heart disease cardiac,CHD).Methods 162 patients with CHD were se-lected as the experimental group of CHD,100 cases of healthy physical examination qualified as the normal control group. CHD experimental group was divided into mild impairment group and severe impairment group according to the degree of impairment of the heart function.The mild impairment group include I and II levels of cardiac function classification and the severe impairment group included III and IV levels of cardiac function classification.To measure separately total cholesterol (TC),triglyceride (TG),high density lipoprotein cholesterol (HDL-C),low density lipoprotein cholesterol (LDL-C),and to calculate the content of non high density lipoprotein cholesterol (non-HDL-C).To compare the differences between CHD ex-perimental group and normal control group,and the correlation between different indexes of blood lipid and the degree of loss of cardiac function.Results The serum levels of non-HDL-C,TG and LDL in the Cardiac function in mild damage group of the CHD experimental group were significantly higher than those in the normal control group,and there were statistically significant differences between the two groups(t=2.438,2.887,5.253,P<0.05).The serum levels of non-HDL-C,TG and LDL in the severe heart function impairment group of the CHD experimental group were significantly higher than those in the normal control group,and there were statistically significant differences between the two groups (t=2.438,2.887,5.253,P<0.05).The serum level of HDL in the cardiac function in mild damage group of the CHD experimental group was significantly lower than that in the normal control group (t=-3.132,P<0.05).The serum level of HDL in the severe heart function impairment group of the CHD experimental group was significantly lower than that in the normal control group (t=-6.028,P<0.05).In the CHD group,only the serum level of TC in the severe impairment group was signifi-cantly different from that in the control group (t=3.278,P<0.05).The serum levels of non-HDL-C,TG,LDL of mild im-pairment of cardiac function in the CHD experimental group were significantly different from the serum levels of the severe impairment group (t=2.051,2.057,2.281,P<0.05).Logistic regression analysed that the OR value of serum non-HDL-C in CHD group was slightly lower than that of LDL,and significantly higher than TC and TG.With the increase of the degree of cardiac function,the value of OR increased significantly.Conclusion Serum non-HDL-C had a positive correlation with severity of CHD.To a certain extent,it can reflect the severity of CHD and is an important reference index for clinical diag-nosis and treatment of CHD.

The significance of serum light chain ratio in the diagnosis of multiple myeloma and primary nephritic / 中国医师杂志

Objective To explore the clinical value of serum κ/λ ratio in the differential diagnosis of multiple myeloma (MM) and primary nephritic,and to explore its relationship with MM other laboratory markers.Methods We obtained 88 cases of MM patients with serotyping by immunofixation and 109 cases of primary nephritic patients.In accordance with the composition of protein M in immunofixation electrophoersis (IFE),88 patients were divided into 4 groups:IgGκ,IgGλ,IgAκ and IgAλ.In addition,45 serum samples of health examination were collected as control samples.The levels of serum IgG,IgA,IgM,light chain κ and λ in each group were tested by immune turbidimetry,and κ/λ ratio was calculated.The levels of serum β2-microglobin (β2-MG),albumin (ALB),serum urea (BUN),creatinine (CRE),and M protein percentage were also detected.Results (1) In MM group,there was no significant difference of sex and International Staging System (ISS) stages between each type(P ＞ 0.05),while there was significant difference in age distribution between each type (P ＜ 0.05).(2) Compared to control,the levels of se-rum light chain κ,κ/λ ratio,and matched Ig were significantly higher and the level of light chain λ and other Ig were significantly lower in κ typed MM patients,while the levels of serum light chain λ were significantly higher and the levels of serum light chain κ,and κ/λ ratio were significantly lower in λ typed MM patients(P ＜0.01).The levels of light chain κ,λ,and IgG in primary nephritic patients were significantly lower than control(P ＜0.01),while there was no significant difference in κ/λ ratio between two group (P ＞ 0.05).There were also significant difference of light chain,Ig,BUN and CRE levels between MM patients and primary nephritic patients (P ＜ 0.05).(3) The κ/λ ratio correlated with serum ALB (r =-0.264,P =0.013) and β2-MG (r =0.235,P =0.040) levels in MM.Conclusions Serum levels of light chain κ,λ,and κ/λ ratio have great significance in the differential diagnosis of multiple myeloma and primary nephritic.The κ/λ ratio correlated with several tumor markers in MM progresses,rendering it as a promising method for diagnosis and prognosis monitoring of MM.

The clinical application of zero notch anterior cervical fusion plate (Zero-P) on anterior cervical decompression and bone fusion / 中国组织工程研究

BACKGROUND:In recent years, with the continuously improving of the fixation systems and technology, conducting anterior cervical decompression bone graft accompanying with anterior plate fixation have been accepted by most scholars, however, the complications related to this also appeared constantly. In view of this, the zero notch interbody fusion plate (Zero-P) has been approved for the clinical treatment of cervical degenerative disease. OBJECTIVE:To discuss the early application effect of Zero-p on anterior cervical decompression and fusion. METHODS:The study enrol ed 22 patients who underwent anterior cervical decompression and fusion with Zero-P between February and December 2014. The number of Zero-P implanted in the C3-4, C4-5, C5-6 was 1, 3 and 18 respectively. Pain and neurological improvement were evaluated using Visual Analog Scales score and Japanese Orthopaedic Association (JOA) score for al the patients after operation. The X-ray plain of lateral and flexion-extension lateral of cervical vertebra were shot. The degradation degree was judged based on the measurement results from the cervical lateral X-ray films about the ratio of cephalad and caudal adjacent intervertebral space to vertebral body height, and adjacent segments osteoarthritis situation. The abnormal activity at the surgical spaces was observed by the extension and flexion lateral X-ray plain. RESULTS AND CONCLUSION:Twenty-two patients obtained fol ow up for 10-28 months. 2 patients had dysphagia on the fourth day and the fifth day after operation (extremely mild). The symptom disappeared within 2 weeks after treatment. The Visual Analog Scales score was significantly lower compared with preoperation (P0.05). In cephalad adjacent intervertebral space, 3 cases had developed hyperosteogeny (first level). In caudal adjacent intervertebral space, 1 had developed hyperosteogeny (first level). There was no significant difference in the hyperosteogeny between cephalad adjacent intervertebral space and caudal adjacent intervertebral space (P>0.05). There was no significant difference in the R value in cephalad adjacent intervertebral space and caudal adjacent intervertebral space between preoperation and postoperation (P>0.05). During the fol ow-up, no abnormal activity at the surgical spaces and implant displacement was observed. These results suggest that using Zero-p in the treatment of monosegmental disc disease has significant effect, can effectively improve the cervical curvature and establish good cervical stability. The incidence of postoperative dysphagia is low. The degeneration of adjacent segments after treatment was not increased in early stage.

Artificial cervical disc replacement and anterior cervical decompression and fusion for the treatment of single segmental cervical disc herniation:a 3-year follow-up / 中国组织工程研究

BACKGROUND:Anterior cervical discectomy and fusion surgery is a good choice for repair of degenerative cervical disc herniation, but it is reported that fusion can affect the exercise of cervical neighboring stages. Artificial disc replacement can not only play a role in mitigation of cervical disease neurological symptoms and signs, but also maintain stability and semental activity of cervical spine, and reduce secondary adjacent segmental degeneration. These two methods which applied in cervical degenerative intervertebral disc herniation stil remain controversial. OBJECTIVE:To investigate the short-term effect of artificial cervical disc replacement and anterior cervical decompression and fusion for the treatment of single segmental cervical disc herniation. METHODS:Total y 48 patients with single segment radiculopathy or myelopathy cervical diseases induced by cervical disc herniation that required surgery and received a three-month fol ow-up were included and retrospectively analyzed. These patients were divided into replacement group (n=21) and fusion group (n=27) according to the different repair programs. Patients in the replacement group were subjected to Prestige LP cervical artificial disc replacement, and patients in the fusion group were subjected to disc fusion using interbody fusion cage of Johnson or al ogeneic fibularing. They were fol owed up at 1 week, 3, 6, 12, 24, 36 months after treatment. Complications were recorded during the fol ow-up. The pain of patients was evaluated using neck and upper limb pain visual analogue scale scores. The therapeutic effect was evaluated using Japanese Orthopaedic Association (JOA) score. The clinical symptoms improvement and daily functional status of patients after treatment were evaluated using cervical disability index. RESULTS AND CONCLUSION:During the final fol ow-up, the fusion rate in fusion group was 93%(25/27). Comparisons between groups:at the 1 week and final fol ow-up after treatment, the visual analog scale scores of neck and upper limbs and cervical dysfunction indexes were al lower than those before treatment;the Japanese Orthopaedic Association scores were higher than those before treatment (P0.05). The cervical activity and surgical segmental motion after cervical disc replacement were significantly higher than those in the fusion group;the difference was statistical y significant (P0.05). These results suggest that the artificial cervical disc replacement and anterior cervical decompression and fusion for the treatment of single cervical disc herniation have the same effect in terms of patients’ symptoms mitigation. With respect to fusion technique, artificial disc replacement surgery has the advantage of maintaining cervical stability and activities of replacement segments.

Association between male infertility and either the +331G/A or the progins polymorphism of the progesterone receptor gene in a Chinese population

Progesterone has been suggested to contribute to the regulation of spermatogenesis and to facilitate the production of viable sperm. Investigations have showed that polymorphism of progesterone receptor [PGR] is associated with some diseases. To analyze the potential relationship between male infertility and the +331G/A and progins polymorphisms of PGR gene. The cross-sectional study was carried out at the Department of Male Reproduction, Reproductive Medical Center, the Second Hospital of Jilin University. The restriction fragment length polymorphism [RFLP] technique was used to detect gene point mutations. Of the 145 semen samples analyzed, 35 were asthenozoospermic, 50 were oligoasthenozoospermic, 21 were azoospermic, 11 were teratozoospermic and 28 were from fertile male subjects. Statistical analyses revealed that the genotypes of the +331G/A polymorphisms were in Hardy-Weinberg equilibrium in both the fertile [chi[2]=0, p=0.534] and oligospermic groups [chi[2]=0.021, p=0.537]. Similarly, the genotypes of the progins polymorphisms were also in Hardy-Weinberg equilibrium in both the fertile [chi[2]=0, p=1] and oligospermic groups [chi[2]=0.005, p=1]. Our results indicated that polymorphisms of the +331G/A and progins of the PGR gene are unrelated to male infertility, at least in a Chinese population

Application of laparoscopic cholecystectomy in the treatment of acute cholecystitis / 中国基层医药

Objective To summarize the clinical experience of laparoacopic cholecystectomy(LC) for acute cholecystitis. Methods LC was performed in 68 cases of acute cholecystifis for 2004 to 2007. The operation was completed under CO2 pneumoperitoneum by using 4-port technique. Results The LC was successfuUy accomplished in 64 cases, while a conversion to open surgery was required in 4 cases. A drainage tube at the foramen of Winslow was placed in 1 cases. Conclusion Strict adhesion to surgical indications of LC, standard performance of the proce-dure, timely conversion to open surgery, and proper placement of drainage tube are key factors to ensure a successful operation.