HLA-DRB typing among polyarticular juvenile idiopathic arthritis and progressive pseudorheumatoid dysplasia patients

Juvenile Idiopathic Arthritis (JIA) is a multi-factorial disease influenced both by environmental and genetic factors. Progressive pseudorheumatoid dysplasia (PPD) is a rare autosomal recessive genetic disorder affecting multiple joints, mimicking JIA. Aim of the work: to reveal the frequency of HLA-DR types among the studied patients and to correlate the different allele variations clinically. Patients and methods: Thirty JIA patients, in addition to 15 molecularly diagnosed PPD patients were subjected to full history taking and clinical examination. HLA-DRB1 typing was performed to 24/30 JIA and 12/15 PPD cases and thirty healthy age and sex matched children who were included as a control group. Results: The JIA patients were 22 females and 8 males with mean age of 15.8 ± 1.96 years and disease duration 5.3 ± 4.4 years. PPD patients were 8 males and 7 females with mean age of 8.7 ± 3.06 years and disease duration 3.95 ± 2.68 years. A significant frequency of HLA-DRB 04 (p = 0.049) among JIA patients was present in comparison to the controls (OR = 2.81, CI:1.02–7.75), other risky alleles were HLA-DRB 10, 13 and 15. However, HLA-DRB 01, 03, 07, 11 and 14 were found to be protective. HLA-DRB 01, 04, 10 and 13 were found to be risky alleles in PPD. However, HLA 03, 07, 11 and 15 were found to be protective alleles among PPD patients. Conclusion: HLA-DRB 04 was found in a higher frequency in JIA patients with a significant difference in comparison to the controls, denoting that it may play a role in the genetic pathogenesis of JIA.     

三阳型乳腺癌的临床病理学特点及辅助治疗

三阳型乳腺癌是一种较为特殊的乳腺癌类型。虽然发病率低,但是此类型乳腺癌容易发生腋窝淋巴结转移和远处转移。这些临床病理学特点引起人们的高度重视。因此,辅助治疗方案的选择成为影响三阳型乳腺癌患者预后的重要因素。本综述意在整合国内外研究结果以为三阳型乳腺癌患者提供较为合理的个体化治疗方案。     

某院耐碳青霉烯类肠杆菌科细菌耐药基因分析

目的研究某院耐碳青霉烯类肠杆菌科细菌(CRE)在细菌耐药方面的分子流行病学特征,为CRE的防控提供依据。方法收集某院2013—2017年细菌室保存的CRE,对其进行多位点序列分型(MLST)、药敏试验、全基因序列测定,选取部分CRE中携带的碳青霉烯耐药基因进行基因环境分析。结果共收集62株CRE,成功复活51株;其中耐碳青霉烯类肺炎克雷伯菌(CRKP)30株,耐碳青霉烯类大肠埃希菌(CREC)9株,耐碳青霉烯类阴沟肠杆菌(CRECL)6株,耐碳青霉烯类其他肠杆菌6株。CRKP MLST主要包括3株ST147、2株ST11;CREC MLST主要包括3株ST167;CRECL MLST主要包括3株ST93、2株ST88。51株CRE对氨苄西林、头孢噻肟的耐药率最高,均为100%。耐碳青霉烯类耐药基因分布:1株携带blaKPC-2,14株携带blaIMP-4,18株携带blaNDM-1,22株携带blaNDM-5,2株携带blaNDM-9,10株携带blaOXA-1,10株携带blaOXA-10,2株携带blaOXA-23,2株携带blaOXA-66。分析blaNDM-1、blaNDM-5、blaNDM-9、blaIMP-4不同菌种的基因环境,发现几种耐药基因各自的基因环境都与已报道的基因环境相似,无明显的菌种间差异性。结论耐药基因通过水平传播能稳定存在于不同的CRE菌株中,对医院感染防控造成一定的威胁。     

肾上腺嗜铬细胞瘤的临床病理特征分析

目的探讨肾上腺嗜铬细胞瘤(PCC)的临床病理特征。方法收集22例PCC患者的临床病历资料,分析临床表现、病理特征、免疫组织化学特征、鉴别诊断、治疗和预后。结果患者中位年龄46岁(23~67岁);男性13例、女性9例;临床常见症状包括高血压、腹胀腹痛;Ⅰ期10例、Ⅱ期12例;中位随访时间为72.5个月(14.9~117.7个月),其中1例复发、1例转移,其余患者均未发生复发及转移;CgA、Syn和CD56阳性表达率分别为95.2%、95.2%、100.0%,CK、Melan-A阴性表达率分别为90.5%和100.0%,Ki-67增殖指数低于10%,S100阳性表达率为76.2%。结论肾上腺PCC发病率低,但有转移和复发的可能,需要定期随访。     

La 8.ª edición de la clasificación AJCC-TNM: nuevas aportaciones a la estadificación del cáncer de la unión esofagogástrica

The new 8th edition of the TNM classification system for esophageal and cardia or esophagogastric junction cancer provides important innovations in the TNM stages. Two classifications are presented, updated by stages, clinical (cTNM) and pathological (pTNM) methods, together with another pathological classification applicable to cases receiving neoadjuvant treatment (ypTNM). There is a notable increase in complexity compared to previous versions, but it is still early to determine whether the current modifications will result in a clear improvement in the prognostic discrimination of survival among the patient groups (which is their main objective), although the initial expectations are favorable.     

Retrospective analysis of molecular biology mechanism of ABO blood group typing discrepancy among blood donors in Jinan blood station

BackgroundTo accurately identify ABO blood typing in pre-transfusion testing is very important to ensure blood transfusion safely, which is a major responsibility of blood station.MethodsEighty-one blood donors samples with ABO blood group typing discrepancy was collected among 61952 donor samples in our blood station from January 2019 to July 2020. Blood group serological method was used to detect ABO blood group. DNA Sequencing was used to determine the genotype. The antibody screening test detects antibodies other than ABO.ResultsIn total, 61,952 donor samples were analysed for ABO typing discrepancies. The incidence among blood donors was 0.13% (81/61952). The most common reason of ABO typing discrepancies was due to specific antibody or non-specific agglutination (54.32%, 44/81), mainly anti-M antibody, cold autoantibody, anti-D antibody, anti-N antibody and anti-Lea antibody. The major cause of forward typing discrepancies among blood donors was ABO subgroups (25.93%, 21/81), including 10 cases of A subtype (1 case of A2, 2 cases of A3, 2 cases of Ax, 3 cases of AxB, 1 case of Ael, 1 case of Ahm), 6 cases of B subtype (2 cases of B3, 1 case of Bel, 3 cases of AB3), 2 cases of B subtype (A), 1 case of cisAB, and 2 cases of acquired B. The serum antibody was weakened in 16 cases (19.75%).ConclusionsThe blood types should be correctly identified by combining serology with gene sequencing to ensure the safety of clinical blood transfusion, when the forward and reverse typing discrepancies among the blood donors.     

抚触护理在病理性黄疸患儿中的应用效果

目的:观察抚触护理在病理性黄疸患儿中的应用效果。方法:选取114例病理性黄疸患儿作为研究对象,按照随机数字表法分为观察组与对照组各57例。对照组实施常规护理,观察组在对照组的基础上实施抚触护理,比较两组黄疸消退时间、护理前后血清总胆红素(TSB)水平、护理总有效率和患儿家长护理满意度。结果:观察组黄疸消退时间为(7.85±1.36)d,明显短于对照组的(9.56±2.85)d,差异有统计学意义(P<0.05);护理后,观察组血清TSB水平低于对照组,差异有统计学意义(P<0.05);观察组护理总有效率为96.5%,明显高于对照组的73.7%,差异有统计学意义(P<0.05);观察组患儿家长满意度为98.2%,明显高于对照组的82.4%,差异有统计学意义(P<0.05)。结论:在常规护理基础上采用抚触护理可缩短病理性黄疸患儿黄疸消退时间,降低血清TSB水平,提高护理总有效率和患儿家长护理满意度,其效果优于单纯常规护理。     

温针对肌筋膜痛扳机点模型大鼠病理形态及致痛性炎性介质的影响

目的:在建立扳机点大鼠模型的基础上用温针进行干预,通过显微病理技术及微透析技术,评价其对扳机点模型大鼠病理形态及致痛炎性介质的影响。方法:将64只SD雄性大鼠随机分为A组(空白对照)、B组(模型对照)和C组(模型干预);A、B每组又分3小组(A0,A1,A2和B0,B1,B2),C组分为2小组(C1,C2)。B、C两组建立MTr Ps模型,造模成功后并分别给予C1组7 d和C2组15 d温针干预。分批处死大鼠,MTr Ps局部取材,制片后进行苏木精-伊红染色,光镜下观察其病理变化,通过微透析技术对大鼠动物模型扳机点局部白细胞介素-1β和前列素E2进行检测。结果:镜下可见,造模组的肌纤维排列紊乱、断裂、扭曲,局部肌纤维纤维化、挛缩增粗等;局部可见有巨噬细胞等炎症细胞侵入及挛缩结节部位出现大面积粘连,温针干预后局部肌纤维的病理状态明显改善,局部微小血管形成和成熟,局部肌纤维修复。在造模成功后,进行温针干预前B0组的白细胞介素-1β和前列素E2的量明显高于A0组(P0.01),通过7d的温针干预,C1和B1组白细胞介素-1β和前列素E2的量差异无统计学意义(P0.05),C1、B1组明显高于A1组(P0.01);通过15d温针干预,C2组的白细胞介素-1β和前列素E2的量低于B2组(P0.05),但C2、B2组明显高于A2组(P0.01),C2组的白细胞介素-1β及前列素E2的量低于C1组(P0.05)。结论:运动联合击打的造模方式通过病理组织学证实是有效的;温针能够改善大鼠肌筋膜痛扳机点局部肌纤维的病理状态及炎症状态,促进局部微小血管形成和成熟,有助于扳机点局部肌纤维修复。