北京大学学报（医学版）最新文献

{"title":"[Clinical characteristics of pregnancy complicated with inflammatory bowel disease].","authors":"Huichao Ma, Jun Li, Yongqing Wang","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the clinical characteristics of patients with inflammatory bowel diseases (IBD) in pre-pregnancy, pregancy and loctation.</p><p><strong>Methods: </strong>The clinical data of pregnancy complicated with IBD in Department of Obstetrics and Gynecology of Peking University Third Hospital and deli-very from September 2011 to June 2022 were collected. The clinical characteristics of the patients were analyzed retrospectively. According to the state of diseases during pre-pregnancy, pregnancy and lactation, the patients were divided into active and remission group, and the two groups were compared interms of pre-pregnancy counseling, nutritional status, pregnancy and delivery complications, gestational week, mode of delivery, and neonatal outcome.</p><p><strong>Results: </strong>A total of 33 pregnant women with IBD were included in this study, of which 7 delivered a second child, for a total of 40 deliveries, with 36 natural pregnancies (90.0%) and 4 assisted reproductions (10.0%). Among the 40 cases, 21 cases (52.5%) were sustained in remission in pre-pregnancy, pregnancy and lactation, and 19 cases (47.5%) in disease activity, of which 8 cases (42.1%) were due to self-withdrawal of drugs or failure to take medicine regularly. Compared with the activity group, the disease remission group had a higher rate of pre-pregnancy counseling (57.1% <i>vs</i>. 15.8%, <i>P</i>=0.010), and higher levels of hemoglobin [(112.67±8.53) g/L <i>vs</i>. (102.84±5.23) g/L, <i>P</i> < 0.001], serum total protein [(66.58±6.34) g/L <i>vs</i>. (60.83±6.25) g/L, <i>P</i>=0.006], serum albumin [36.4 (35.1, 38.3) g/L <i>vs</i>. 34.3 (31.1, 35.6) g/L, <i>P</i>=0.006], serum calcium [(2.25±0.10) μmol/L <i>vs</i>. (2.13±0.15) μmol/L, <i>P</i>=0.004], but a lower incidence of gestational hypertensive disorders (0 <i>vs</i>. 31.6%, <i>P</i>=0.007). In 40 deliveries, there were 27 cases of vaginal delivery (67.5%), 13 cases of cesarean section (32.5%). The analysis of neonatal outcomes showed 38 full-term deliveries and 2 preterm deliveries; 1 case of macrosomia, 1 case of small-for-gestational-age, 1 case of low birth weight and 3 cases of birth defects. There were 10 newborns admitted to neonatal intensive care unit, including 4 cases of neonatal infections and 2 cases of neonatal jaundice.</p><p><strong>Conclusion: </strong>Pre-pregnancy counseling and evaluation of IBD patients are very important, and good pregnancy outcomes can be obtained through careful management during pregnancy in the most of the patients.</p>","PeriodicalId":8790,"journal":{"name":"Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences","volume":"56 2","pages":"260-266"},"PeriodicalIF":0.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11004958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140852838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Characteristics of resting energy expenditure and evaluation of prediction formulas in young men with different body mass indexes].","authors":"Yifan Wu, Yingxiang Yu, Lan Xie, Zhida Zhang, Cuiqing Chang","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To compare the resting energy expenditure (REE) characteristics among young men with different body mass indexes (BMI).</p><p><strong>Methods: </strong>Thirty young men [average age was (26.93±4.16) years] were enrolled in this study. They underwent resting metabolism tests in the Department of Sports Medicine of Peking University Third Hospital from December 2017 to June 2021. The resting metabolic rate (RMR) was measured by indirect calorimetry, the body composition was measured by bioresistance antibody component analyzer. The REE characteristics were analyzed, and 11 predictive equations were used to estimate RMR and compared with the measured value. The differences were analyzed by paired <i>t</i>-test and intra-class correlation coefficient (ICC).</p><p><strong>Results: </strong>The RMR of the overall 30 young men was (1 960.17±463.11) kcal/d (1 kcal=4.186 8 kJ). Including (1 744.33±249.62) kcal/d in those with normal BMI, which was significantly lower than that in those who were overweight or obese [(2 104.06± 520.32) kcal/d, <i>P</i> < 0.01], but the weight-corrected RMR in those with normal BMI was significantly higher than that in those who were overweight or obese [(24.02±2.61) kcal/(kg·d) <i>vs</i>. (19.98±4.38) kcal/(kg·d), <i>P</i> < 0.01]. The RMR was significantly and positively correlated with body weight, adiposity, lean body mass, body surface area, and extracellular fluid in the subjects with diffe-rent BMI (all <i>P</i> < 0.05). The predicted values of the 11 prediction equations were not in good agreement with the measured values (all ICC < 0.75), with relatively high agreement between the predicted and measured values of the World Health Organization (WHO) equation in overweight obese young men (ICC=0.547, <i>P</i> < 0.01).</p><p><strong>Conclusion: </strong>There were significant differences in RMR among young men with different BMI, and the RMR after weight correction should be considered for those who were overweight or obese. The consistency between the predicted values of different prediction equations and the actual measured values of RMR was relatively poor, and it is recommended to accurately measure RMR by indirect calorimetry. For overweight or obese young men, the WHO prediction equation can be considered to calculate RMR, but it is necessary to establish an RMR prediction equation applicable to different BMI populations.</p>","PeriodicalId":8790,"journal":{"name":"Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences","volume":"56 2","pages":"247-252"},"PeriodicalIF":0.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11004973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140847363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Incidence and risk factors of deep vein thrombosis in patients with rheumatoid arthritis].","authors":"Xiaofei Tang, Yonghong Li, Qiuling Ding, Zhuo Sun, Yang Zhang, Yumei Wang, Meiyi Tian, Jian Liu","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the incidence and risk factors of deep vein thrombosis (DVT) in patients with rheumatoid arthritis (RA).</p><p><strong>Methods: </strong>The clinical data of RA patients who were hospi-talized in the Department of Rheumatology and Immunology of Aerospace Center Hospital from May 2015 to September 2021 was retrospectively analyzed, including demographic characteristics, concomitant diseases, laboratory examinations (blood routine, biochemistry, coagulation, inflammatory markers, rheumatoid factor, antiphospholipid antibodies and lupus anticoagulant, <i>etc</i>.) and treatment regimens. The patients were compared according to the presence or absence of DVT, and the <i>t</i> test, Mann-Whitney <i>U</i> test or Chi-square test were applied to screen for relevant factors for DVT, followed by Logistic regression analysis to determine risk factors for DVT in patients with RA.</p><p><strong>Results: </strong>The incidence of DVT in the RA patients was 9.6% (31/322); the median age of RA in DVT group was significantly older than that in non-DVT group [64 (54, 71) years <i>vs</i>. 50 (25, 75) years, <i>P</i> < 0.001]; the level of disease activity score using 28 joints (DAS28)-erythrocyte sedimentation rate (ESR) in DVT group was higher than that in non-DVT group [5.2 (4.5, 6.7) <i>vs</i>. 4.5(4.5, 5.0), <i>P</i> < 0.001]; the incidence of hypertension, chronic kidney disease, fracture or surgery history within 3 months, and varicose veins of the lower extremities in DVT group was higher than that in non-DVT group (<i>P</i> < 0.001). The levels of hemoglobin and albumin in DVT group were significantly lower than that in non-DVT group (<i>P</i>=0.009, <i>P</i>=0.004), while the D-dimer level and rheumatoid factor positive rate in DVT group were significantly higher than that in non-DVT group (<i>P</i> < 0.001). The use rate of glucocorticoid in DVT group was higher than that in non-DVT group (<i>P</i>=0.009). Logistic regression analysis showed that the age (<i>OR</i>=1.093, <i>P</i> < 0.001), chronic kidney disease (<i>OR</i>=7.955, <i>P</i>=0.005), fracture or surgery history within 3 months (<i>OR</i>=34.658, <i>P</i>=0.002), DAS28-ESR (<i>OR</i>=1.475, <i>P</i>=0.009), and the use of glucocorticoid (<i>OR</i>=5.916, <i>P</i>=0.003) were independent risk factors for DVT in RA patients.</p><p><strong>Conclusion: </strong>The incidence of DVT in hospitalized RA patients was significantly increased, in addition to traditional factors, such as age and chronic kidney disease, increased DAS28-ESR level and the use of glucocorticoid were also independent risk factors for DVT.</p>","PeriodicalId":8790,"journal":{"name":"Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences","volume":"56 2","pages":"279-283"},"PeriodicalIF":0.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11004972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140854233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Investigation on the current situation and influencing factors of sitting time and health literacy among high school students in China].","authors":"Hejun Shen, Chongyan Shi, Qing Zheng, Yu Huang, Tao Jing","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the current situation of sitting time and health literacy among high school students in China, in order to provide a basis for improving their physical and mental health levels.</p><p><strong>Methods: </strong>A stratified random cluster sampling method was used to investigate the length of sitting time and health literacy of first and second grade high school students from 31 provinces, cities, and autonomous regions in China(data did not include that of Hong Kong and Macao Special Administrative Region, and Taiwan Province of China). The Kruskal-Wallis <i>H</i> method, independent sample Mann-Whitney <i>U</i> test, and regression model were used to analyze the influencing factors of sitting time and total health literacy score.</p><p><strong>Results: </strong>(1) The total score of health literacy was statistically significant (<i>P</i> < 0.01) in different regions, urban and rural distribution, annual family income, parents' educational background, age, and gender. (2) The length of sitting was statistically significant (<i>P</i> < 0.01) among multiple groups in different regions, family annual income, parental education, and gender. However, there was no statistically significant difference between groups of different ages and urban-rural distribution (<i>P</i>>0.05). (3) The analysis of multiple linear regression model showed that the total score of health literacy was positively correlated with the family' s annual income and the mother' s education, and negatively correlated with the father' s education and the length of sitting. Standardized regression coefficient <i>β</i> comparison: Father' s education (-0.32) > family annual income (0.15) > mother' s education (0.09) > average daily sitting time (-0.02), with father' s education having the greatest impact, followed by family annual income. The length of sitting was positively related to the family' s annual income and the mother' s educational background, and negatively related to the total score of health literacy. Standardized regression coefficient <i>β</i> comparison: Annual family income (0.14) > education background of mother (0.13)> total score of health literacy (-0.02), with the impact of annual family income the largest, followed by education background of mother.</p><p><strong>Conclusion: </strong>China' s first and second grade high school students generally spend a long time sitting every day, and the level of health literacy is generally low. The level of health literacy and sitting time are negatively correlated with each other, and are most influenced by the educational background of high school students' parents and their family economic levels.</p>","PeriodicalId":8790,"journal":{"name":"Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences","volume":"56 2","pages":"239-246"},"PeriodicalIF":0.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11004951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140855093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Clinical remission and transmural healing of ustekinumab in patients with Crohn's disease].","authors":"Yun Wu, Yalan Xu, Guoyan Zhang, Yuanyuan Zhang, Junyao Wang, Peng You, Tao Peng, Yulan Liu, Ning Chen","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To treat the Crohn's disease (CD) patients with ustekinumab (UST), to eva-luate their clinical and endoscopic remission, and to evaluate their transmural response (TR) and transmural healing (TH) condition using intestinal ultrasonography (IUS).</p><p><strong>Methods: </strong>Retrospective analysis was made on patients diagnosed with CD in Peking University People's Hospital from January 2020 to August 2022, who were treated with UST for remission induction and maintenance therapy. All the patients were evaluated on both week 8 and week 16/20 after treatment, including clinical, biochemical indicators, colonoscopy and IUS examination.</p><p><strong>Results: </strong>A total of 13 patients were enrolled in this study, including 11 males and 2 females. The minimum age was 23 years, the maximum age was 73 years and the mean age was 36.92 years. All the patients were in the active stage of disease before treatment, and the average Best Crohn's disease activity index (Best CDAI) score was 270.12±105.55. In week 8, the Best CDAI score of the patients decreased from 270.12±105.55 to 133.16±48.66 (<i>t</i>=4.977, <i>P</i> < 0.001). Eight patients achieved clinical remission while 5 patients remained in the active stage. Nine patients underwent colonoscopy evaluation. The average simple endoscopic score for Crohn's disease (SES-CD) score decreased from 10.71±7.14 before treatment to 6.00±7.81(<i>t</i>=2.483, <i>P</i>=0.048) in week 16/20. Four patients achieved endoscopic remission while 5 patients did not. In week 8, 5 patients achieved TR, 2 patients achieved TH, the other 6 patients did not get TR or TH. In week 16/20, 6 patients achieved TR, 3 patients achieved TH while the other 4 patients did not get TR or TH. There was no significant statistical difference in the TR effect of UST between small intestine and colon lesions (Fisher test, <i>P</i> > 0.999). The rate of UST transmural response in the patients who had had previous biological agent therapy was lower than those with no previous biological agent therapy, but there was no significant statistical difference (Fisher test, <i>P</i>=0.491).</p><p><strong>Conclusion: </strong>After treatment of UST, the clinical and endoscopic conditions of the CD patients had been improved, and some patients could achieve clinical remission and endoscopic remission. UST had good TR and TH effects on CD. TR might appear in week 8, and the TR effect increased in week 16/20. There was no significant statistical difference in the TR effect between small intestine and colon lesions. TR effect of UST was better in the patients who had no previous biological agent therapy than those who had had other biological agents, but the result had no significant statistical difference.</p>","PeriodicalId":8790,"journal":{"name":"Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences","volume":"56 2","pages":"253-259"},"PeriodicalIF":0.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11004953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140856059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Vertebral fractures combined with prolonged activated partial prothrombin time: A case report].","authors":"Xinzhu Bai, Jinhui He, Songsong Lu, Chun Li, Yilin Wang, Jian Xiong","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>With the development of modern medical standards, autoimmune diseases and their associated successive osteoporosis have received increasing attention in recent years. Patients with autoimmune diseases, due to the characteristics of the disease and the prolonged use of glucocorticoid hormone therapy, may affect the bone formation and bone absorption of the patient, followed by severe successive osteoporosis, thereby increasing the risk of osteoporotic vertebral fractures. Vertebral compression fractures of the spine are common fracture types in patients with osteoporotic fractures. Osteoporosis is a common complication after glucocorticoid therapy in patients with autoimmune diseases. Percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) are minimally invasive operation and are commonly used surgical methods for the treatment of osteoporotic vertebral compression fractures. However, due to the operation of spinal puncture during the operation, there are serious surgical risks such as bone cement leakage, spinal epidural hemorrhage, subdural hemorrhage, and subarachnoid hemorrhage in both PVP and PKP. As a result, it is necessary to evaluate the patient' s body before surgery carefully, especially in the case of blood coagulation. This article reports a case of autoimmune disease patient admitted to Peking University People' s Hospital due to lumbar 4 vertebral compression fracture combined with Sjögren' s syndrome. The patient' s preoperative examination showed that the activated partial thromboplastin time (APTT) was significantly prolonged. After completing the APTT extended screening experiment and lupus anticoagulant factor testing, the multi-disciplinary team (MDT) of Peking University People' s Hospital jointly discussed the conclusion that the patient' s test results were caused by an abnormal self-immunity anti-copulant lupus (LAC). Based on the results of the laboratory examination, the patient was considered to be diagnosed with combined antiphospholipid syndrome (APS). For such patients, compared with the patient' s tendency to bleed, we should pay more attention to the risk of high blood clotting in the lower limbs of the patient, pulmonary clots and so on. With timely anti-coagulation treatment, the patient safely passed the peripheral period and was successfully discharged from the hospital. Therefore, for patients with autoimmune diseases with prolonged APTT in the perioperative period, doctors need to carefully identify the actual cause and carry out targeted treatment in order to minimize the risk of surgical and perioperative complications and bring satisfactory treatment results to the patients.</p>","PeriodicalId":8790,"journal":{"name":"Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences","volume":"56 2","pages":"371-374"},"PeriodicalIF":0.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11004961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140847790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Preliminarily study of arthrocentesis combined with liquid phase concentrated growth factor injection in the treatment of unilateral temporomandibular joint osteoarthritis].","authors":"Hongguang Li, Weihua Han, Xun Wu, Jiling Feng, Gang Li, Juanhong Meng","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To observe the clinical effect of arthrocentesis combined with liquid phase concentrated growth factor (CGF) injection in the treatment of unilateral temporomandibular joint osteoarthritis (TMJOA), in order to provide a new treatment option for TMJOA patients.</p><p><strong>Methods: </strong>In this non-randomized controlled study, patients diagnosed with unilateral TMJOA who visited the center for temporomandibular joint disorder and orofacial pain of Peking University School and Hospital of Stomatology from June 2021 to January 2023 were selected as research objects. The patients were divided into experimental group and control group, which were selected by patients themselves. The experimental group received arthrocentesis combined with liquid phase CGF injection and the control group received arthrocentesis combined with HA injection. Both groups were treated 3 times, once every two weeks. The clinical effect was evaluated by the maximum mouth opening, pain value and the degree of mandibular function limitation 6 months after treatment. The change of condylar bone was evaluated by cone beam CT (CBCT) image fusion technology before and after treatment.</p><p><strong>Results: </strong>A total of 20 patients were included in the experimental group, including 3 males and 17 females, with an average age of (34.40±8.41) years. A total of 15 patients were included in the control group, including 1 male and 14 females, with an average age of (32.20±12.00) years. There was no statistical difference in general information between the two groups (<i>P</i> > 0.05). There were no statistical differences in the mouth opening, pain value and the degree of jaw function limitation between the two groups before treatment (<i>P</i> > 0.05), and all of them improved 6 months after treatment compared with before treatment (<i>P</i> < 0.05). However, the mouth opening of experimental group was significantly higher than that of control group 6 months after treatment (<i>P</i> < 0.05), and the degree of jaw function limitation was significantly lower than that of control group (<i>P</i> < 0.05). CBCT 2D images showed that the condylar bone of both groups was smoother after treatment than before treatment, and image fusion results showed that 10 patients (50.0%) in the experimental group and 5 patients (33.3%) in the control group had reparative remodeling area of condylar bone, and there was no statistical difference between them (<i>P</i> > 0.05). Except for one CGF patient, the other patients in both groups had some absorption areas of condylar bone.</p><p><strong>Conclusion: </strong>The arthrocentesis combined with liquid phase CGF injection can improve the clinical symptoms and signs of unilateral TMJOA patients in short term, and is better than HA in increasing mouth opening and improving jaw function. CBCT fusion images of both patient groups show some cases of condylar bone reparative remodeling and its relevance to treatment p","PeriodicalId":8790,"journal":{"name":"Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences","volume":"56 2","pages":"338-344"},"PeriodicalIF":0.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11004960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140852650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Molecular biology analysis of 2 rare RhD variant individuals with <i>RHD</i>*<i>DEL37</i>].","authors":"Peng Wang, Ziyao Yang, Meng Wang, Wei Wang, Aizhi Li","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The Rh blood grouping system is a critical standardized test in transfusion medicine, especially for the cases related to haemolytic transfusion reactions and neonatal haemolytic disease caused by clinical RhD blood group incompatibility. In the present case report, we presented two cases with the uncommon <i>RHD</i> gene variation <i>RHD</i>*<i>DEL37</i>. The blood samples of the two subjects were mistakenly identified as RhD-negative through conventional serological testing. Firstly, both blood samples were tested negative for the RhD antigen using traditional tube test and gel microcolumn methods. The phenotyping of RhCE were identified as ccEe and ccee for each sample, respectively. Secondly, genetic analysis was performed using polymerase chain reaction-sequence specific prime (PCR-SSP) which revealed that neither sample belonging to the several common <i>RHD</i> gene variants which was found in Asia. Moreover, they turned out to be positive for the <i>RHD</i> haplotype, which indicated that exons 1-10 on one of the <i>RHD</i> alleles were entirely absent. In addition, a T>C mutation was observed at bases 1154-31 in intron 8 of the other allele, which was located at the intron 8 breakpoint. This result was obtained after further Sanger sequencing of exons 1-10 of the <i>RHD</i> gene. The mutant allele was designated as <i>RHD</i>*<i>DEL37</i> by the International Society of Blood Transfusion (ISBT) and was identified as D-elute(D^el) by phenotype ana-lysis. Both samples were genotyped as <i>RHD</i>*<i>DEL37</i> and showed positive results. In summary, the true genotype of the two blood samples, of which the screening results only using serological testing method was negative, were <i>RHD</i>*<i>DEL37</i> /<i>RHD-</i>(<i>RHD</i>*<i>01N.01</i>). Notably, this kind of genotype was reported for the first time in Chinese population. Moreover, the two individuals did not have ties of consanguinity, indicating that some of the Chinese individuals could be carriers of the genetic mutation. Therefore, it might be necessary to further confirm the frequency of this mutation in the Chinese population and the possibility of homozygosity for this mutation. This report identifies infrequent <i>RHD</i> gene mutation samples by coupling molecular biology and serological methods to prevent misclassification of blood groups. Combining serological and molecular biology test results to determine blood group is critical in protecting patients during clinical transfusion procedures.</p>","PeriodicalId":8790,"journal":{"name":"Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences","volume":"56 2","pages":"352-356"},"PeriodicalIF":0.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11004959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140851287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Risk factors for acute respiratory distress syndrome in patients with traumatic hemorrhagic shock].","authors":"Xiaoqian Si, Xiujuan Zhao, Fengxue Zhu, Tianbing Wang","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the risk factors of acute respiratory distress syndrome (ARDS) after traumatic hemorrhagic shock.</p><p><strong>Methods: </strong>This was a retrospective cohort study of 314 patients with traumatic hemorrhagic shock at Trauma Medicine Center, Peking University People's Hospital from December 2012 to August 2021, including 152 male patients and 162 female patients, with a median age of 63.00 (49.75-82.00) years. The demographic data, past medical history, injury assessment, vital signs, laboratory examination and other indicators of these patients during hospitalization were recorded. These patients were divided into two groups, ARDS group (<i>n</i>=89) and non-ARDS group (<i>n</i>=225) according to whether there was ARDS within 7 d of admission. Risk factors for ARDS were identified using Logistic regression. The C-statistic expressed as a percentage [area under curve (AUC) of the receiver operating characteristic (ROC) curve] was used to assess the discrimination of the model.</p><p><strong>Results: </strong>The incidence of ARDS after traumatic hemorrhagic shock was 28.34%. Finally, Logistic regression model showed that the independent risk factors of ARDS after traumatic hemorrhagic shock included male, history of coronary heart disease, high acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, road traffic accident and elevated troponin Ⅰ. The <i>OR</i> and 95% confidence intervals (<i>CI</i>) were 4.01 (95%<i>CI</i>: 1.75-9.20), 5.22 (95%<i>CI</i>: 1.29-21.08), 1.07 (95%<i>CI</i>: 1.02-1.57), 2.53 (95%<i>CI</i>: 1.21-5.28), and 1.26 (95%<i>CI</i>: 1.02-1.57), respectively; the <i>P</i> values were 0.001, 0.020, 0.009, 0.014, and 0.034, respectively. The ROC curve was used to analyze the value of each risk factor in predicting ARDS. It was found that the AUC for predicting ARDS after traumatic hemorrhagic shock was 0.59 (95%<i>CI</i>: 0.51-0.68) for male, 0.55 (95%<i>CI</i>: 0.46-0.64) for history of coronary heart disease, 0.65 (95%<i>CI</i>: 0.57-0.73) for APACHE Ⅱ score, 0.58 (95%<i>CI</i>: 0.50-0.67) for road traffic accident, and 0.73 (95%<i>CI</i>: 0.66-0.80) for elevated troponin Ⅰ, with an overall predictive value of 0.81 (95%<i>CI</i>: 0.74-0.88).</p><p><strong>Conclusion: </strong>The incidence of ARDS in patients with traumatic hemorrhagic shock is high, and male, history of coronary heart disease, high APACHE Ⅱ score, road traffic accident and elevated troponin Ⅰ are independent risk factors for ARDS after traumatic hemorrhagic shock. Timely monitoring these indicators is conducive to early detection and treatment of ARDS after traumatic hemorrhagic shock.</p>","PeriodicalId":8790,"journal":{"name":"Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences","volume":"56 2","pages":"307-312"},"PeriodicalIF":0.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11004962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140874489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Tibiotalocalcaneal arthrodesis for end-stage ankle and hindfoot arthropathy: Short- and mid-term clinical outcomes].","authors":"Wenjing Li, Baozhou Zhang, Heng Li, Liangpeng Lai, Hui DU, Ning Sun, Xiaofeng Gong, Ying Li, Yan Wang, Yong Wu","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the clinical data of patients with end-stage ankle and hindfoot arthropathy who underwent tibiotalocalcaneal (TTC) arthrodesis by the same surgeon, explore the short- and mid-term clinical results, complications and functional improvement, and discuss the clinical prognosis and precautions of TTC arthrodesis.</p><p><strong>Methods: </strong>Retrospective analysis was made on the clinical data of 40 patients who underwent TTC arthrodesis by the same surgeon from March 2011 to December 2020. In this study, 23 males and 17 females were included, with an average age of (49.1±16.0) years. All the patients underwent unilateral surgery. The clinical characteristics, imaging manifestations, main diagnosis and specific surgical techniques of the patients were recorded. The clinical outcomes were evaluated by comparison of the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and visual analogue scale (VAS) between pre-operation and at the last follow-up. The fusion healing time, symptom improvement (significant improvement, certain improvement, no improvement or deterioration) and postoperative complications were also recorded.</p><p><strong>Results: </strong>The median follow-up time was 38.0 (26.3, 58.8) months. The preoperative VAS score was 6.0 (4.0, 7.0), and the AOFAS score was 33.0 (25.3, 47.3). At the last follow-up, the median VAS score was 0 (0, 3.0), and the AOFAS score was 80.0 (59.0, 84.0). All the significantly improved compared with their preoperative corresponding values (<i>P</i> < 0.05). There was no wound necrosis or infection in the patients. One patient suffered from subtalar joint nonunion, which was syphilitic Charcot arthropathy. The median bony healing time of other patients was 15.0 (12.0, 20.0) weeks. Among the included patients, there were 25 cases with significant improvement in symptom compared with that preoperative, 8 cases with certain improvement, 4 cases with no improvement, and 3 cases with worse symptoms than that before operation.</p><p><strong>Conclusion: </strong>TTC arthrodesis is a reliable method for the treatment of the end-stage ankle and hindfoot arthropathy. The function of most patients was improved postoperatively, with little impact on daily life. The causes of poor prognosis included toe stiffness, stress concentration in adjacent knee joints, nonunion and pain of unknown causes.</p>","PeriodicalId":8790,"journal":{"name":"Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences","volume":"56 2","pages":"299-306"},"PeriodicalIF":0.0,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11004964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140847857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}