The History,Science, and Innovation of Holter Technology

Holter technology has endured for more than 40 years, and proven to be a valuable adjunctive noninvasive diagnostic technology to record the ambulatory or long‐term electrocardiogram in the study of living creatures. During this span of time, many scientists, physicians, and innovators contributed to the development and evolution of Holter technology. This essay seeks to document a view of the history and evolution of the technology during that time, and concomitantly give recognition to the scientists, physicians, and engineers who contributed so greatly.     

Molecular background of Rh D-positive,D-negative,D(el) and weak D phenotypes in Chinese

BACKGROUND AND OBJECTIVES: The aim of this study was to elucidate the genetic background of D-negative and D(el) in the Chinese population. MATERIALS AND METHODS: We investigated nine D-positive, 76 D-negative, 26 D(el) and three weak D Chinese individuals by amplification and sequencing of the complete coding region of the RHD gene from genomic DNA. A new RHD polymerase chain reaction with sequence-specific primers (PCR-SSP) method was developed with optimized specificity for typing Chinese individuals. RESULTS: In D-positive samples the RHD sequence was in complete concordance with RHD in other populations. In 12 of 76 (15.8%) D-negative individuals we detected regions of RHD. Three new alleles were found. All 26 D(el), as well as two weak D, individuals carried an RHD 1227A allele. In the remaining weak D sample we identified a weak D type 15. CONCLUSIONS: It should now be possible to correctly predict the RhD phenotype in Chinese subjects. D(el) can also be designated as a particular weak D type.     

Detection of del(16q) using the CBFB-MYH11 translocation dual fusion probe

Del(16q) is an uncommon cytogenetic abnormality that can occur in different types of myeloid neoplasms. A small number of cases with del(16q) have been reported. Here, we report del(16q) in an adult patient with acute myelomonocytic leukemia (AMML). Examination of bone marrow aspirate smears and cytochemical stains, and flow cytometric immunophenotyping diagnosed the case as AMML. Fluorescence in situ hybridization (FISH) for inv(16) was performed using the CBFB-MYH11 translocation dual fusion probe. Accidently, FISH analysis revealed a loss of 16q22 in most of the examined interphase cells, indicating the presence of del(16q). The CBFB-MYH11 translocation dual fusion probe can be very helpful in detecting del(16q).     

Re-dosing of del Nido cardioplegia in adult cardiac surgery requiring prolonged aortic cross-clamp

Open in a separate window OBJECTIVESFew data exist on the use of del Nido cardioplegia in adults, specifically during operations requiring prolonged aortic cross-clamp. In this pilot study, we evaluate outcomes of patients undergoing surgery with cross-clamp time >3 h based on re-dosing strategy, using either full dose (FD; 1:4 blood to crystalloid ratio) or dilute (4:1 blood to crystalloid ratio) solution.METHODSConsecutive adult patients (>18 years) undergoing cardiac surgery from 2012 to 2018 with cross-clamp time >3 h were reviewed. Patients were excluded if del Nido cardioplegia was not used. Patients were categorized into FD or dilute groups based on re-dosing solution. Propensity score matching was used to control for baseline differences between groups. The primary endpoint was in-hospital mortality. Other outcomes examined included: postoperative mechanical support, arrhythmia, stroke, dialysis and cardiac function.RESULTSIncluded for analysis were 173 patients (115 male) with median age of 63.8 (interquartile range 53.9–73.1). Major comorbidities included diabetes (45), cerebrovascular disease (34), hypertension (131), atrial fibrillation (52) and previous cardiac surgery (83). There were 108 patients (62%) who received FD re-dosing, while 65 (38%) received dilute. A greater proportion of patients in the dilute group received retrograde delivery, for both induction (32/108 vs 39/65, P < 0.001) and re-dose (50/108 vs 53/65, P < 0.001). After propensity score matching, in-hospital mortality was not different between groups (6/48 vs 1/48, P = 0.131). There were no differences in rates of postoperative mechanical circulatory support, stroke, left ventricular ejection fraction or right ventricle dysfunction.CONCLUSIONSDel Nido cardioplegia has been used in complex cardiac surgery requiring prolonged cross-clamp. Re-dosing can be performed with either FD or dilute del Nido solution with no statistical difference in outcomes.     

Rh阴性孕妇血型D抗原同种免疫反应研究

目的研究Rh阴性孕妇血型D抗原同种免疫反应,为建立有区别的D亚型的输血规则提供参考。方法对RhD阴性孕妇进行基因分型,并检测是否有抗-D;总结分析孕妇妊娠次数以及胎儿红细胞的检出与产生抗-D之间的相关性。结果在122名RhD表型阴性的孕妇中,检出d/d基因型97例,Del型20例,弱D15型1例,RHD-CE(2—9)-D/d融合基因型3例,DⅥⅢ型1例。在97名RhD阴性(d/d)孕妇中,有38例产生抗-D;20名Del血型孕妇均未检出抗-D;3名RhD-CE(2—9)-D/d中有2例产生抗-D;1名弱D15型的孕妇未检出抗-D;1名DⅥⅢ型孕妇抗-D检出阳性。统计分析表明孕妇的妊娠次数以及外周血中检出胎儿红细胞的检出与抗-D的产生有相关性,这可以成为Rh阴性孕妇被D抗原免疫的证据。结论不同D亚型的个体可能会对D抗原有不同的免疫反应,我们认为在中国Del血型的受者可以接收D阳性血液。建立有区别的输血规则可以节约有限的Rh阴性血资源和提高输血安全。     

Rh弱D、Del的检测及意义

目的：探讨初筛为Rh（D）阴性样本中弱D，Del的检测及临床意义。方法：采用常规血清学方法初筛Rh（D）血型，用微柱凝胶抗人球蛋白试验检测弱D，用吸收放散试验检测Del，用PCR—SSP法检测样本RhD基因8个外显子结构。结果：常规血清学初筛Rh（D）阴性60例中经微柱凝胶抗人球蛋白试验确认勾弱D4例，占6．67％：56例Rh（D）阴性标本经吸收放散试验后确认13例为Del，占21．67%：对其中2例弱D和5例Del标本的D基因8个外显子检测都完整存在，排除了弱D、Det的10例Rh（D）阴性标本其基因检测有完全缺失和部分缺失两种可能。结论：为了临床输血安全，常规血清学检测Rh（D）阴性者，应当再用抗人球蛋白试验或吸收放散试验检测是否为弱D或Del。