A Study on the Tendency of Medical Students’ Choice of Moral Dilemma / 中国医学伦理学

【Objective:】 Using classic moral dilemma cases, this paper investigates the choice tendency of medical students when facing the moral dilemma, and analyzes their cognitive status and characteristics when facing the "moral dilemma", in order to provide effective enlightenment for optimizing the teaching cases of medical ethics. 【 Method:】 771 medical students in Shanghai Jiao Tong University School of Medicine were investigated by electronic questionnaire and SPSS 20.0 for statistical description and statistical analysis. 【Result:】 In the emergency room doctors and transition scenes, medical students tend to the principle of maximum happiness, and in the ring track scene and pedestrian overpass scene, they tend to the principle of deontology; In the loop track scene and pedestrian overpass scene, boys are more inclined to deontological principles than girls, and undergraduates are more inclined to deontological principles than postgraduates, and the difference is statistically significant (P<0.05). 【Conclusion:】 Although medical students have different moral tendencies in different scenes, they generally do not agree with the practice of sacrificing one person to save five people. Especially when more rigorous sacrifice conditions cause greater moral pressure, the vast majority of medical students will tend to the latter between utilitarianism and deontological principles.

Technical Realization of Integrating Bone Age Artificial Intelligence Assessment System with Hospital RIS-PACS Network / 中国医疗器械杂志

OBJECTIVE@#To explore the integration method and technical realization of artificial intelligence bone age assessment system with the hospital RIS-PACS network and workflow.@*METHODS@#Two sets of artificial intelligence based on bone age assessment systems (CHBoneAI 1.0/2.0) were developed. The intelligent system was further integrated with RIS-PACS based on the http protocol in Python flask web framework.@*RESULTS@#The two sets of systems were successfully integrated into the local network and RIS-PACS in hospital. The deployment has been smoothly running for nearly 3 years. Within the current network setting, it takes less than 3 s to complete bone age assessment for a single patient.@*CONCLUSIONS@#The artificial intelligence based bone age assessment system has been deployed in clinical RIS-PACS platform and the "running in parallel", which is marking a success of Stage-I and paving the way to Stage-II where the intelligent systems can evolve to become more powerful in particular of the system self-evolution and the "running alternatively".

Efficacy and safety of apatinib in the further line treatment for patients with advanced colorectal cancer failed after standard therapy and the preliminary analysis of efficacy predictors / 中国临床药理学与治疗学

AIM: To investigate the efficacy and safety of apatinib monotherapy in the third line and further line treatment for patients with advanced colorectal cancer failed after standard therapy and the preliminary analysis of efficacy predictors. METHODS: The required sample size in this study was calculated with the PASS 15.0 software. Advanced colorectal cancer patients failed after standard therapy from May 2017 to October 2018 were included in this study. Patients enrolled in this study were given apatinib either 750 mg or 500 mg monotherapy. The objective remission rate (ORR) and disease control rate (DCR) were evaluated after 2 cycles treatment. The progression-free survival (PFS) and overall survival (OS) were evaluated at the follow-up period, and adverse events during treatment were recorded. The prognosis of patients with or without hypertension was analyzed. The primary endpoint of this study was PFS, and second endpoint was ORR, DCR, OS, safety evaluation and efficacy predictor analysis.RESULTS: Of the 51 patients included, 45 patients were available for efficacy and safety evaluation. Of the 45 advanced colorectal cancer received apatinib monotherapy, the objective response rate (ORR) was 11.11%, and the DCR was 77.78%, the median PFS was 3.95 months, the median OS was 10.3 months. And the common adverse reactions were hypertension, hand-foot syndrome, proteinuria and diarrhea. And the adverse reactions above grade 3 with higher incidence were hand-foot syndrome 6 cases (13.33%), hypertension 5 cases (11.11%), proteinuria 3 cases (6.67%) and diarrhea 3 cases (6.67%). PFS of patients with hypertension was significantly longer than that of patients without hypertension, which was statistical difference (P=0.01). CONCLUSION: Patients with advanced colorectal cancer failed the standard therapy and received apatinib treatment had potential clinical benefits, and the overall toxicity profile was manageable. Patients with hypertension might confer a better prognosis.

Depression and Structural Factors Are Associated With Symptoms in Patients of Irritable Bowel Syndrome With Diarrhea

Background/Aims@#A strong correlation between depression and irritable bowel syndrome with diarrhea (IBS-D) has been identified. The aim of this study is to identify the correlations among depression, structural factors, gastrointestinal (GI) and extra-GI symptoms, and efficacy of neuromodulators in patients with IBS-D. @*Methods@#Patients meeting the Rome III Diagnostic Criteria for IBS-D were enrolled. The intestinal symptoms and psychological states were evaluated using IBS-specific symptom questionnaires and Hamilton Depression Rating Scale. @*Results@#In total, 410 patients with IBS-D were enrolled, 28.8% (118/410) had comorbid depression. Patients with depression did not readily experience improvement in abdominal pain/discomfort after defecation, and had a higher prevalence of passing mucus, overlapping functional dyspepsia, and extra-GI symptoms. The structural factor “mental disorders” significantly correlated with main bowel symptom score and degree of pre-defecation abdominal pain/discomfort. No structural factor significantly correlated with bowel movements or stool form. Patients who had passing mucus, overlapping functional dyspepsia and extra-GI painful symptoms have higher score of “anxiety/somatization.” Patients with sexual dysfunction have higher score of “retardation symptoms.” In total, 28.3% of patients with IBS-D were prescribed neuromodulators. Baseline scores of “anxiety/somatization” and “retardation symptoms” positively correlated with improvement of diarrhea after paroxetine, and “sleep disturbances” positively correlated with improvement of abdominal pain/discomfort and diarrhea after mirtazapine. @*Conclusions@#Comorbid depression and higher scores of structural factors might aggravate GI and extra-GI symptoms other than bowel movements and stool form. Structural factors of Hamilton Depression Rating Scale correlated with efficacy of paroxetine and mirtazapine in patients with IBS-D.

Clinical effect of elbasvir/grazoprevir in treatment of chronic hepatitis C in the real world / 临床肝胆病杂志

ObjectiveTo investigate the clinical effect of elbasvir/grazoprevir in the treatment of patients with genotype 1b chronic hepatitis C (CHC). MethodsA total of 99 patients with genotype 1b CHC and compensated cirrhosis who received elbasvir/grazoprevir treatment for 12 weeks and completed treatment and follow-up for 12 weeks after drug withdrawal in Tianjin Third Central Hospital from December 2018 to October 2019 were enrolled. Related clinical data, serological markers, virological indices, and liver stiffness measurement were collected at baseline, at the end of treatment, and at week 12 after drug withdrawal, and virologic response was observed. The Friedman test and Wilcoxon signed rank sum test were used to observe virologic response rate and the changes in liver function and liver stiffness measurement at the end of treatment and at week 12 after drug withdrawal, and the safety of elbasvir/grazoprevir was evaluated. ResultsFor the 99 patients treated with elbasvir/grazoprevir for 12 weeks, the proportion of patients with HCV RNA below the lower limit of detection was 100% at the end of treatment and 99% at week 12 after drug withdrawal. There were significant reductions in alanine aminotransferase (ALT) and aspartate aminotransferase (AST) from baseline to the end of treatment (Z=-5.857 and -5.941, both P＜0.05). Liver stiffness measurement decreased from 10.5 kPa at baseline to 8.0 kPa at week 12 after drug withdrawal (Z=-4.036, P＜0.05). Among the 99 patients, 24 patients with compensatory cirrhosis reached a virologic response rate of 100% at the end of treatment and at week 12 after drug withdrawal, as well as significant reductions in ALT and AST from baseline (both P＜0.05), and liver stiffness measurement decreased from 21.1 kPa at baseline to 17.5 kPa at the end of treatment (Z=-1.832, P=0.067) and 13.6 kPa at week 12 after drug withdrawal (Z=-3.182, P=0.001). Compared with the non-liver cirrhosis group, the liver cirrhosis group had significantly greater reductions in liver stiffness measurement (P＜0.05). The patients had good tolerance throughout the treatment, and 4 patients reported mild adverse events during the treatment. ConclusionPatients with genotype 1b CHC have a high virologic response rate to elbasvir/grazoprevir in the real world, with significant improvements in liver function and liver stiffness measurement and good tolerance.

Chinese Society of Allergy and Chinese Society of Otorhinolaryngology-Head and Neck Surgery Guideline for Chronic Rhinosinusitis

The current document is based on a consensus reached by a panel of experts from the Chinese Society of Allergy and the Chinese Society of Otorhinolaryngology-Head and Neck Surgery, Rhinology Group. Chronic rhinosinusitis (CRS) affects approximately 8% of Chinese adults. The inflammatory and remodeling mechanisms of CRS in the Chinese population differ from those observed in the populations of European descent. Recently, precision medicine has been used to treat inflammation by targeting key biomarkers that are involved in the process. However, there are no CRS guidelines or a consensus available from China that can be shared with the international academia. The guidelines presented in this paper cover the epidemiology, economic burden, genetics and epigenetics, mechanisms, phenotypes and endotypes, diagnosis and differential diagnosis, management, and the current status of CRS in China. These guidelines—with a focus on China—will improve the abilities of clinical and medical staff during the treatment of CRS. Additionally, they will help international agencies in improving the verification of CRS endotypes, mapping of eosinophilic shifts, the identification of suitable biomarkers for endotyping, and predicting responses to therapies. In conclusion, these guidelines will help select therapies, such as pharmacotherapy, surgical approaches and innovative biotherapeutics, which are tailored to each of the individual CRS endotypes.

Molecular screening for Vel- blood type and analysis of SMIM1 gene variants / 中华医学遗传学杂志

OBJECTIVE@#To screen for Vel- rare blood type donors and determine the frequency of SMIM1 c.64_80del allele in Yili Prefecture of Xinjiang, China.@*METHODS@#DNA pooling and PCR-sequence-specific primers (PCR-SSP) was conducted to screen individuals carrying the SMIM1 c.64_80del variant, and Sanger sequencing of SMIM1 exon 3 was carried out to verify the genotype of those with the variation. SMIM1 intron 2 was also sequenced to identify single nucleotide polymorphisms (SNPs) that may affect the expression of Vel antigen.@*RESULTS@#Among 3328 blood donors, 14 were identified as heterozygotes for the SMIM1 c.64_80del allele, its allele frequency was 0.21%; no homozygous SMIM1 c.64_80 deletions was found. For SNP rs1175550, all of the 14 individuals had an AA genotype, among whom 5 carried heterozygous 7111ins GCA variant in intron 2.@*CONCLUSION@#The allelic frequency of SMIM1 c.64_80del in Yili area is approximately 0.21%, which is reported for the first time.

Acute necrotizing encephalopathy with onset of youth: a case report / 中华神经科杂志

A young female patient with acute necrotizing encephalopathy (ANE) is reported,who aged 15 years,with a history of upper respiratory tract infection,main clinical manifestations of seizures and consciousness disorders,and brain MRI examination showing characteristic symmetrical bilateral abnormal signals at both thalamic area,pons,and cerebellar hemisphere.Imaging changes corresponded to pathophysiological changes.The initial manifestations were found to be brain swelling and edema.In the acute phase,hemorrhage and necrosis of the affected brain tissues were observed.The recovery period was characterized by hemosiderin deposition and cystic space formation,which was consistent with ANE diagnosis.By early use of high-dose gammaglobulin and methylprednisolone,the prognosis of the patient was good,proving that immunosuppressive therapy by corticosteroids and gammaglobulin is effective for ANE.

The 470th case: recurrent vomiting / 中华内科杂志

Patients with cyclic vomiting syndrome usually have comorbid psychological disorders,the trigger and aggravating factors of gastrointestinal symptoms.It may decrease the quality of life and the response to the conventional therapies,bring the patients to seek medical care frequently and perform unnecessary examinations,result in the waste of medical resources.We reported a 20-year-old woman with complaint of recurrent vomiting since infant,and less response to symptomatic and supportive treatment.Her vomiting relieved with antidepressant after consultation with gastroenterological specialist and psychologist.Physicians should pay more attention to recognize the comorbid psychological disorders in patients with functional gastrointestinal disorders (FGIDs),including cyclic vomiting syndrome.It is important to refer the patients with refractory symptoms to the psychologists for further professional evaluation and antidepressants.

Study on the application of oral magnesium sulfate solution in split doses as bowel preparation for colonoscopy in elderly patients / 中华内科杂志

Objective To evaluate the efficacy and safety of oral magnesium sulfate solution in split doses as bowel preparation in elderly patients undergoing colonoscopy.Methods A total of 368 elderly patients undergoing colonoscopy were enrolled at PLA General Hospital.The patients were randomly divided into magnesium sulfate solution orally in split doses group (group A,n=178) and single dose group (group B,n=190).Parameters including general information,defecation frequency,Boston bowel preparation score (BBPS),detection rate of lesions and adverse reactions.Results The frequency of defecations in group A was (7.6± 1.4),more than that in group B (6.6± 1.5) with statistical significance (P＜0.05).The duration of bowel preparation in group A was (128.6±25.3) min,shorter than that of group B (165.4±29.7) min (P＜0.05).The BBPS in group A was (8.09±0.67),better than that of group B (7.34±0.58) (P＜0.05).The detection rates of intestinal polyps and micropolyps (diameter＜0.5 cm) in group A were 73/178 (41.0％) and 51/178 (28.7％) respectively,compared with 58/190 (30.5％) and 37/190 (19.5％) in group B (both P＜0.05).In group A,8 patients reported adverse reactions as abdominal distension and discomfort.One patient had ST-T abnormality of electrocardiogram (ECG).No nausea or vomiting occurred,yet 2 cases needed enema for inadequate bowel preparation.Twenty-one cases in group B reported adverse events including 7 with nausea and vomiting.There were 13 patients treated with enema.Abnormal ECG was found in 4 patients in group B.The satisfaction rate of group A was 97.8％,higher than that of group B (91.6％) (P＜0.05).Conclusions The effect of bowel preparation of elderly patients with magnesium sulfate solution in split dose has a better tolerance,good cleaning effect and low incidence of adverse reactions.It is an ideal choice for the elderly to prepare colonoscopy.

Artificial intelligence-based bone age assessment using deep learning of characteristic regions in digital hand radiograph / 中华放射学杂志

Objective@#To detect the feasibility and efficiency of bone age(BA) artificial intelligence(AI) estimation based on deep learning features from traditional regions of interest(ROI) in hand digital radiographs(DR).@*Methods@#BA dataset of left hand DR with 11 858 subjects aged from 0 to 18 years in Children′s Hospital of Shanghai were split to training(80.0%) and validation (20.0%) set in this study. An improved regression convolutional neural networks and extreme gradient boosting decision tree method were utilized for the BA analysis based on traditional ROIs in the images. Another set of BA data with 1 229 subjects also in the hospital was adopted for test. Mean average precision(mAP) and mean absolute error(MAE) were used to assess model accuracy of detection and BA prediction, respectively.@*Results@#The mAP of ROIs detection of the model was 0.91,and MAE of all male and female subjects was 0.461 and 0.431 years respectively in validation and test sets. The difference less than 1 year in test accounted for 90.07% between BA assessment of the model and of the peadiatric radiologists, with an accuracy rate of 96.67%.The difference over 1 year was 9.03% (with underestimation of 6.43% and overestimation of 2.60%), in which corresponding age data was of being less in training set or sesamoid nearby adductor pollicis or fusion of epiphysis appeared in test set.@*Conclusion@#An AI model based on deep learning of traditional ROIs′ features in hand DR images is initially achieved to automatically predict BA rapidly and effectively, yet it still needs further optimization.

Artificial intelligence?based bone age assessment using deep learning of characteristic regions in digital hand radiograph / 中华放射学杂志

s] Objective To detect the feasibility and efficiency of bone age(BA) artificial intelligence(AI) estimation based on deep learning features from traditional regions of interest(ROI) in hand digital radiographs(DR). Methods BA dataset of left hand DR with 11 858 subjects aged from 0 to 18 years in Children′s Hospital of Shanghai were split to training(80.0%) and validation (20.0%) set in this study. An improved regression convolutional neural networks and extreme gradient boosting decision tree method were utilized for the BA analysis based on traditional ROIs in the images. Another set of BA data with 1 229 subjects also in the hospital was adopted for test. Mean average precision(mAP) and mean absolute error(MAE) were used to assess model accuracy of detection and BA prediction, respectively. Results The mAP of ROIs detection of the model was 0.91,and MAE of all male and female subjects was 0.461 and 0.431 years respectively in validation and test sets. The difference less than 1 year in test accounted for 90.07% between BA assessment of the model and of the peadiatric radiologists, with an accuracy rate of 96.67%.The difference over 1 year was 9.03% (with underestimation of 6.43% and overestimation of 2.60%), in which corresponding age data was of being less in training set or sesamoid nearby adductor pollicis or fusion of epiphysis appeared in test set. Conclusion An AI model based on deep learning of traditional ROIs′features in hand DR images is initially achieved to automatically predict BA rapidly and effectively, yet it still needs further optimization.

Comparing research of doctor-patient communication between residents under standardized training and eight-year medical students: an example of Peking Union Medical College / 中华医学教育探索杂志

Objective The purpose of this study was to compare the self-evaluation and doctor-patient orientation between medical students and residents before the courses in different communication sections,and gave guide to different objects for their targeted teaching.Methods We set a sample made of 331 medical students and 308 residents who were trained in Clinical communication skills course in Peking Union Medical College from Oct.2009 to Oct.2013.Before the course,they were investigated by two self-assessment questionnaires.One is communication skills and occupation practice confidence;the other is doctor-patient orientation.Their result data were analyzed and handled by SPSS 17.0 software,adopting an independent samples t test.Results The order of the different aspects of doctor patient communication skills was same in two groups,gathering complete history [(4.340 ± 0.756) vs.(4.050 ± 0.707)] first,and establishing good doctor patient relationship [(4.310 ±0.740) vs.(4.030 ±0.790)],discussing a therapeutic plan with patient [(4.050 ± 0.812) vs.(3.600 ± 0.823)],informing bad news [(3.850 ± 0.897) vs.(3.260 ± 0.907)] followed.According to the self-assessment,residents were more confident than medical students in all these aspects above mentioned and establishing good doctor patient relationship.The doctorpatient orientation scale indicated that the residents group is more inclined to doctor-centric mode than the medical students group.Conclusion This study suggested that the residents is more confident in doctorpatient communication skills than medical students,while is less inclined to patient-centric mode than them.The focus of the communication teaching is similarity in the distribution of the two groups.Medical students' communication curriculum needs to take into account the limited clinical experiences,and training for residents needs to emphasize the capacity of empathy and perspective-taking.

Impact of comorbid psychological disorders on intestinal symptoms in patients with irritable bowel syndrome with diarrhea / 中华消化杂志

Objective To investigate the clinical symptoms and mental state of patients with irritable bowel syndrome with diarrhea (IBS-D ) , and to analyze the characteristics of psychological disorders in patients with IBS-D and their impacts on intestinal symptoms .Methods From July 2009 to June 2012 ,patients met Rome Ⅲ criteria of IBS-D were consecutively enrolled at Peking Union Medical College Hospital .The symptoms of IBS were investigated by IBS symptoms questionnaire and mental state were evaluated by Hamilton anxiety scale (HAMA ) and Hamilton depression scale (HAMD ) . The differences in intestinal symptoms between patients with comorbid psychological disorders and without psychological disorders were compared .And the correlation between the scores of HAMA ,HAMD and intestinal symptoms were analyzed . Two independent sample t-tests ,chi square test and Fisher exact probability were performed for statistical analysis .Spearman rank correlation was used for correlation analysis .Results A total of 231 patients with IBS-D were enrolled .There were 133 males and 98 females with an age of (42 .8 ± 11 .1) years old and a disease course of (4 .5 years (8 .0 years)) .The HAMA and HAMD scores were 17 .00 ± 7 .12 and 14 .05 ± 6 .00 ,respectively ,and 72 .29％ (167/231) patients had comorbid psychological disorders ,32 .90％ (76/231 ) patients had moderate to severe anxiety and/or depression ,mainly had anxiety .The proportion of patients with ordinary abdominal pain or discomfort and the proportion of moderate to severe abdominal pain or discomfort in patients with psychological disorders were higher than those of patients without psychological disorders (53 .29％ , 89/167 vs . 34 .37％ , 22/64;49 .44％ ,44/89 vs .18 .18％ ,4/22) ,and the differences were statistically significant (χ2=6 .634 and 7 .002 , P=0 .010 and 0 .009) .In patients with comorbid psychological disorders ,more patients had frequent onset of abdominal pain or discomfort ,less achieved completely improvement after defecation , and often accompanied with defecation related symptoms .The HAMD score was positively correlated with the onset frequency of IBS (r=0 .172 ,P=0 .009) ,and the HAMA score was positively correlated with the degree of abdominal pain or discomfort before defecation (r=0 .134 , P= 0 .042) .The HAMA and HAMD scores were negatively correlated with the improvement degree of abdominal pain or discomfort after defecation (r= -0 .215 , P=0 .001 ;r= -0 .251 , P<0 .01) ,and were positively correlated with waiting time for symptoms improvement (r=0 .175 , P=0 .008;r=0 .219 , P= 0 .001) .Conclusion Most IBS-D patients have comorbid psychological disorders , anxiety and/or depression greatly impact the intestinal symptoms of patients with IBS .

Simultaneous Determination of 12 Kinds of Organophosphates inWater and Sediment by High Performance LiquidChromatography-Tandem Mass Spectrometry / 分析化学

A method was developed for determination of 12 kinds of phosphate compounds in water and sediment by high performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) coupled with solid phase extraction (SPE) and ultrasonic extraction.The water samples were concentrated by HLB solid-phase extraction (SPE) column and eluted twice with ethyl acetate, ultrasonic solvent extraction for sediment samples and then repeated the operation of water samples after diluted with deionized water.The sample were separated on a ZORBAX Eclipse Plus C18 (150 mm × 2.1 mm, 3.5 μm) column by a gradient elution with 0.2% formic acid aqueous solution and methanol as the mobile phase.Ion mode analysis was monitored by high performance liquid chromatography mass spectrometer (MRM).The target compounds were quantified by external standard method.At the spiked levels (0.05, 0.1 and 0.5 μg/L), the average recoveries of 12 kinds of OPEs in water samples ranged from 66.4% to 115%, except for TMP (28.5%-47.8%) and TEHP (22.4%-73.8%).The relative standard deviation RSD (n=3) was 0.5%-9.09%, and the method quantification (MOQ) was 0.001-0.05 μg/L, However at the spiked levels of 5, 10 and 50 μg/kg, the average recoveries of 12 kinds of OPEs in sediment samples ranged from 65.4% to 120.0%, except for TMP (35.7%-44.9%) and TCEP (31.2%-48.9%).The relative standard deviation RSD (n=3) was 0.01%-9.54%, and the MOQ for sediment was 0.02-2.0 μg/kg dw.Based on the above methods, the detection and analysis of the targets in the water and sediments samples of Taihu Lake were carried out.The results showed that the concentrations of ΣOPEs were 0.1-1.7 μg/L and 8.1-420 μg/(kg dw), respectively.

Electronic health records-based contracted family doctor service / 中华医学图书情报杂志

How to effectively using the electronic health records (EHR) in contracted family doctors service was studied according to the new model of HER-based community medical service with community health service station as a center in combination with large hospitals,and suggestions were put forward for the solution of problems in contracted family doctor service,namely establishing and perfecting the community health service system,enlarging the scale of HER,strengthening the construction of general doctors team,and training the technically competent community health service staff.

A correlation between ER, PR,C-erbB-2 ,serum CA125 and MRI signs of endometrial carcinoma / 实用放射学杂志

Objective To explore the correlation between tumor markers including estrogen receptor (ER),progesterone receptor (PR),C-erbB-2 and serum CA125 and MRI findings of endometrial carcinoma(EC).Methods A retrospective analysis of preoperative MRI images of 158 patients with EC was conducted.The expression levels of ER,PR,C-erbB-2,serum CA125 were analyzed with immunohistochemical S-P method and chemiluminescence method.The postoperative pathological results were taken as the gold standard and the relevance between tumor markers and MR signs was analyzed.Results The expression of the four tumor markers were associated with MRI findings of carcinoma staging(P ＜0.05).The expression of ER and PR were negatively associated with the tumor stages by MRI but the expression of C-erbB-2 and serum CA125 were opposite.Conclusion The expression of ER and PR have a high diagnostic value in early endometrial cancer (stage Ⅰ a and stage Ⅰ b) and dynamic detection of C-erbB-2 and serum CA125 can help to predict the metastasis of endometrial carcinoma.

A case of Bw39 subtype caused by 562C to T mutation of exon 7 of α -1,3-D-galactosyltransferase gene / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To analyze a sample with ABO subgroup using serological and molecular methods.</p><p><b>METHODS</b>The ABO phenotype of the sample was determined with a tube method, and the activity of glycosyltransferases was determined with an uridine diphosphate galactose transferring method. The ABO gene of the propositus was identified by PCR with sequence-specific primers (PCR-SSP). In addition, exons 6 and 7 of the ABO gene were cloned and sequenced.</p><p><b>RESULTS</b>Neither A nor B antigen was identified in the propositus, despite that its anti-B antibody was found to be attenuated. No activity of α -1, 3-D-galactosyltransferase was detected in the serum. The presence of B and O alleles were confirmed by PCR-SSP, and a novel mutation (562C to T) of the exon 7 was confirmed by sequencing, which has led to an amino acid substitution (Arg to Cys) at position 188. The genotype of the propositus was determined as Bnew/O.</p><p><b>CONCLUSION</b>A novel B allele has been identified, which was named as Bw39 by the Blood Group Antigen Gene Mutation Database (BGMUT).</p>

Pedigree investigation and genetic analysis of a case with Vel heterozygous deletion mutation / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To analyze an individual with SMIM1 c.64_80 heterozygous deletional mutation and his family members.</p><p><b>METHODS</b>Based on the molecular basis of Vel negative blood type, PCR primers specific for SMIM1 wild-type allele and c.64_80del allele were designed. PCR-sequence specific primer (PCR-SSP) and Sanger sequencing were employed to determine the genotype of all subjects. Inheritance of the Vel blood group system was investigated by pedigree analysis.</p><p><b>RESULTS</b>PCR-SSP and DNA sequencing demonstrated that the proband was heterozygous for the SMIM1 c.64_80del allele. Pedigree investigation showed that his father had the same mutation, while his mother and elder sister were of wide type. No individual with homozygous c.64_80del allele was found.</p><p><b>CONCLUSION</b>PCR-SSP and DNA sequencing confirmed that the proband was heterozygous for the c.64_80del mutation. The mutation inherits form his father.</p>

Emerging methods and management model for self management of diabetes mellitus patients / 中华医学图书情报杂志

Diabetes mellitus is a chronic disease, it is thus necessary for its patients to participate in its treatment and self-management. The emerging foreign and domestic methods for self-management of diabetes mellitus pa-tients were detected on different Websites and suggestions were proposed for its treatment and self-management in order to improve the quality of life in diabetes mellitus patients.