Tumor-Specific Histo-Blood Group Antigens: Apropos of Two Cases

Cancer cells with immunogenic properties having altered protein glycosylation, modified blood group substances have been widely studied. Due to the genetic instability occurring during carcinogenesis the glycosyltransferases may suffer from posttranslation sequence modification. The author describes 2 autopsy cases, where in the background of the unusual metastatic tumor presentation, incompatible blood group antigenic determinants have been demonstrated using blood group specific lectins and monoclonal antibodies (mAb). In the first case, reported here, a 10-year-old girl developed an acute myeloid leukemia and died in a septic endotoxin shock after successful cytostatic treatment of a juvenile signet ring cell cancer of her colon. At autopsy there were no signs of tumor except bilateral apple-sized mucinous ovarian (Krukenberg) metastases. While she had erythrocyte phenotype of blood group A, the signet ring adenocarcinoma cells expressed blood group B incompatible antigenic determinants with lectin/mAb. In the second case, the autopsy of a 78-year-old female resulted in no macroscopic tumor sign except a moderately enlarged, ham hard spleen. Light microscopy revealed adenocarcinomatous infiltration in the splenic sinusoids. The patient had blood group O, while the metastatic cells in the spleen reacted with Breast Carcinoma Antigen (BioGenex) and incompatible anti-B Banderiaeasimplicifolia agglutinin I and anti-B mAb. It proved to be a case of an occult, completely regressed breast cancer. Based on these observations the expression of tumor specific incompatible blood group antigens might occur from time to time, mostly in adenocarcinomas. Accordingly, blood group-based specific immuno-oncotherapy could be considered in some cancer cases.

Norovirus Infection and Histo-blood Group Antigens in Children Hospitalized with Diarrhea in Lulong and Chenzhou in China

Norovirus （NOV） is a pathogen that commonly causes viral diarrhea in children. Studies indicate that NoV recognizes human histo-blood group antigens （HBGAs） as cell attachment factors. In order to explore the correlation between of NoV infection and HBGAs, a cross-sectional study was conducted in children less than five years old who were hospitalized with diarrhea in two areas of China between November 2014 and February 2015. Of the paired stool and saliva samples taken from 424 children,

Histo-blood group antigens in Crassostrea gigas and binding profiles with GⅡ.4 Norovirus

Noroviruses(NoVs) are the main cause of viral gastroenteritis outbreaks worldwide, and oysters are the most common carriers of NoV contamination and transmission. NoVs bind specifically to oyster tissues through histo-blood group antigens(HBGAs), and this facilitates virus accumulation and increases virus persistence in oysters. To investigate the interaction of HBGAs in Pacific oysters with GⅡ.4 NoV, we examined HBGAs with ELISAs and investigated binding patterns with oligosaccharide-binding assays using P particles as a model of five GⅡ.4 NoV capsids. The HBGAs in the gut and gills exhibited polymorphisms. In the gut, type A was detected(100%), whereas type Leb(91.67%) and type A(61.11%) were both observed in the gills. Moreover, we found that seasonal NoV gastroenteritis outbreaks were not significantly associated with the specific HBGAs detected in the oyster gut and gills. In the gut, we found that strain-2006 b and strain-96/96 US bound to type A and H1 but only weakly bound to type Leb; in contrast, the Camberwell and Hunter strains exhibited weak binding to types H1 and Ley, and strain-Sakai exhibited no binding to any HBGA type. In the gills, strain-96/96 US and strain-2006 b bound to type Leb but only weakly bound to type H1; strains Camberwell, Hunter, and Sakai did not bind to oyster HBGAs. Assays for oligosaccharide binding to GⅡ.4 NoV P particles showed that strain-95/96 US and strain-2006 b strongly bound to type A, B, H1, Leb, and Ley oligosaccharides, while strains Camberwell and Hunter showed weak binding ability to type H1 and Ley oligosaccharides and strain-Sakai showed weak binding ability to type Leb and Ley oligosaccharides. Our study presents new information and enhances understanding about the mechanism for NoV accumulation in oysters. Further studies of multiple NoV-tissue interactions might assist in identifying new or improved strategies for minimizing contamination, including HBGA-based attachment inhibition or depuration.

Functional and structural characterization of Norovirus GII.6 in recognizing histo-blood group antigens

Noroviruses(NoVs)are the primary cause of acute gastroenteritis worldwide.Histo-blood group antigens(HBGAs)are receptors or attachment factors that affect the prevalence and host susceptibility of NoVs.GII.6 NoV is one of the predominant genotypes in humans,which recognizes the type ABO secretor of HBGAs.However,the structural basis of GII.6 NoV's interaction with HBGAs receptors remains elusive.In this study,we investigated the binding features of the GII.6 strain to HBGAs using saliva-and glycan-ELISA assays and characterized the molecular basis of the GII.6 virus that recognizes H disaccharide.We showed that the GII.6 P domain recognized some A and O secretor's saliva samples,most B secretor's saliva samples,and H disaccharide antigen,but did not bind non-secretors’saliva.Further,we determined the crystal structures of GII.6 and its complex with H disaccharides at 1.7Å,revealing that the P domain of GII.6 shares the conventional binding interface and mode of GII HBGAs.Single residue mutations at the GII.6-H binding sites could inhibit the binding of GII.6 to HBGAs,demonstrating that the interaction residues were crucial in maintaining NoV-glycan integrity.Finally,structural and sequence analyses showed that the major residues of the GII.6-H interaction were conserved among NoVs in the GII genogroup.Taken together,our study characterized the functional and structural features of GII.6 that allow it to interact with HBGAs,and shed light on NoV evolution,epidemiology,and anti-viral drug development.

Blood group type antigens in pancreatic intraductal papillary mucinous neoplasms

BACKGROUND: There are few data on blood group(BG) types and types of pancreatic cancers. The aims of this study were to study BG types and BG-antigens in pancreatic intraductal papillary mucinous neoplasms(IPMNs). METHODS: BG type and tumor BG-antigen(glycoprotein) expression(studied by immunohistochemistry on tissue microarrays) were analyzed with regard to characteristics of 101 surgically resected pancreatic IPMNs. RESULTS: Non-O BG type predicted invasive carcinoma independently from high serum CA19-9 and male gender. BG type A was observed more frequently in women than in men. Chronic pancreatitis was more frequently seen in patients with BG type B or AB. Aberrant tumor expression(with regard to BG type) of loss of A antigen expression type occurred in 15.0% of IPMNs and of loss of B antigen expression type in 62.5% of IPMNs. Intraneoplasm BG-antigen expression was not related to dysplasia grade or invasion. CONCLUSION: The results of the study suggest that in pancreatic IPMN, non-O BG type predicted invasive carcinoma, whereas for intratumor BG-antigen expression no specific patterns were detected with regard to the progression of glandular epithelial dysplasia or invasion.

Relationship of A,B,H blood group antigens with pathomorphological grading and prognosis of transitional-cell carcinoma of the urinary bladder

After being labelled with monoclonal antibodies against A,B, H blood group antigens,100 specimens of transitional-cell carcinoma of the urinary bladder were studied with ABC immunohistochemical technique and the cases were followed up.It was found that the overall positive rate of A,B,H antigens was 63%. The mortality rate and recurrence were significantly lower in the positive group than in the negative group(P<0.01)and 5-years survival rate was higher in the positive than in the negative(P<0.01).The findings suggest that the expression of blood group antigens is more effective for the prognosis of transitional-cell bladder carcinoma than the pathomorphological grading.

Clinical significance of the detection of Rh blood group antigens and irregular antibodies in pregnant women with a second pregnancy

Objective:To investigate the phenotype distribution of five antigens of Rh blood group system and the specificity of Rh blood group irregular antibodies in pregnant women with second child.To analyze the relationship between Rh blood group antibody and hemolytic disease of the newborn(HDN)in second-child pregnant women,and to provide laboratory basis for the diagnosis and treatment of hemolytic disease of the newborn(Rh-HDN).Methods:500 pregnant women with second child were collected as the study group and 500 pregnant women with first pregnancy as the control group(all pregnant women underwent obstetric examination in the integrated obsteric clinic of our hospital from January 2020 to January 2021).To detectethe Rh blood group antigens(D,C,c,E,e)of the two groups of samples,screene the irregular antibodies,identify the specificity of irregular antibodies,determine the titer and record the hemolytic disease of the newborn of pregnant women with positive Rh blood group antibodies.Results:There were 11 Rh phenotypes in the pregnant women with second child in the study group:CCDee(152cases,30.4%),CcDEe(136cases,27.2%)CcDee(84cases,16.8%),ccDEE(30cases,6%),ccDee(31cases,6.2%),CCDEe(14cases,2.8%),ccDEe(9cases,1.8%),cc dee(18cases,3.6%),CCDEE(2cases,0.4%),CcdEe(12cases,2.4%),Ccdee(6cases,1.2%),CCd ee(6cases,1.2%).A total of 42 cases(8.4%)in the pregnant women with second child were negative for RhD.There were 10 Rh phenotypes in the pregnant women with first pregnancy in the control group:CCDee(144cases,28.8%),CcDEe(138cases,27.6%),CcDee(90cases,18%),ccDEE(42cases,8.4%),ccDee(28cases,5.6%),CCDEe(10cases,2%),ccDEe(8cases,1.6%),cc dee(19cases,3.8%),CCDEE(1cases,0.2%),CcdEe(11cases,2.2%),Ccdee(9cases,1.8%).A total of 39 cases(7.8%)in the pregnant women with first pregnancy were negative for RhD.In the pregnant women with second child in the study group,the positive rate of irregular antibody screening was 4.0%(20/500),and the specificity of Rh blood group antibodies was found as follows:anti-E 1.8%(9/500),anti-D 1.4%(7/500),anti-C 0.4%(2/500)and anti-Ec 0.4%(2/500).The positive rate of irregular antibody screening in the pregnant women with first pregnancy in the control group was 0,and the difference between the two groups was statistically significant(P<0.05).Rh-HDN was found in 10 newborns(2%)of the 20 women with positive irregular antibodies in the pregnant women with second child,and the antibody titer during pregnancy was more than 32.No Rh-HDN occurred in newborns in the pregnant women with first pregnancy,and the difference between the two groups was statistically significant(P<0.05).Conclusion:Pregnancy stimulation can increase the probability of irregular antibodies in pregnant women,and irregular antibodies in Rh blood group can easily cause Rh-HDN,so attention should be paid to routine detection of five antigens of Rh blood group and irregular antibody screening during prenatal examination.It is helpful for the early detection of Rh-blood irregular antibodies and the assessment of fetal or neonatal risk of Rh-HDN.

Identification and Characterization of Peptide Mimics of Blood Group A Antigen

In order to investigate peptide mimics of carbohydrate blood group A antigen, a phage display 12-mer peptide library was screened with a monoclonal antibody against blood group A antigen, NaM87-1F6. The antibody-binding properties of the selected phage peptides were evaluated by phage ELISA and phage capture assay. The peptides were co-expressed as glutathione S-transferase （GST） fusion proteins. RBC agglutination inhibition assay was performed to assess the natural blood group A antigen-mimicking ability of the fusion proteins. The results showed that seven phage clones selected bound to NaM87-1F6 specifically, among which, 6 clones bore the same peptide sequence, EYWYCGMNRTGC and another harbored a different one QIWYERTLPFTF. The two peptides were successfully expressed at the N terminal of GST protein. Both of the fusion proteins inhibited the RBC agglutination mediated by anti-A serum in a concentration-dependent manner. These results suggested that the fusion proteins based on the selected peptides could mimic the blood group A antigen and might be used as anti-A antibody-adsorbing materials when immunoabsorption was applied in ABO incompatible transplantation.

血液病患者异基因造血干细胞移植后Rh血型转变研究

目的检测血液病患者造血干细胞移植(HSCT)前供、受者及移植后患者的Rh血型抗原C、c、E、e,探究受者Rh血型抗原转变为供者Rh血型抗原C、c、E、e转变时间与过程。方法收集HSCT前供、受者以及移植后患者的抗凝全血标本,用微柱凝胶卡检测ABO血型、Rh血型,统计分析并比较ABO、Rh血型抗原转变与时间。结果排除红细胞输注的影响,58例HSCT患者Rh血型抗原C、c、E、e完全转变为供者的Rh血型抗原所需时间为(57.81±8.99)d,患者的年龄和血液病种类影响Rh血型抗原转换时间,性别、移植方式和供受者ABO血型相合性对Rh抗原转变时间无影响。移植后第3周部分患者开始出现少量供者红细胞,第4周开始检测到混和嵌合状态,第7~10周Rh血型抗原完全转变。此外,比较25例供、受者ABO血型和Rh血型均不相同的HSCT患者的Rh血型抗原转变时间和ABO血型转变时间,Rh血型抗原转变时间较ABO更短,差异具有统计学意义。结论定期检测HSCT患者移植后Rh血型抗原可以作为辅助判断移植效果的指标之一,对HSCT患者移植后输注Rh血型相容性的红细胞具有指导意义。

GI.5和GII.4诺如病毒P蛋白的克隆表达及与长牡蛎类HBGAs的结合特性

为明确人诺如病毒(human norovirus,HuNoV)与长牡蛎类组织血型抗原(histo-blood group antigens,HBGAs)的结合特性,本实验运用大肠杆菌表达系统,克隆表达了基因簇I.5(genogroup I.5,GI.5)和GII.4 HuNoV P蛋白,采用酶联免疫吸附测定研究HuNoV P蛋白与唾液HBGAs和长牡蛎类HBGAs的结合特性。结果表明,GII.4 HuNoV与唾液A型、B型、AB型和O型HBGAs均有较好的结合,而GI.5 HuNoV与B型HBGAs结合较弱,与O型HBGAs具有明显的结合优势。GI.5和GII.4 HuNoV在长牡蛎鳃、消化腺和外套膜中均可富集,其中在消化腺中富集最多,二者主要与类A型和H1型HBGAs结合,GII.4HuNoV与类Lea型、Leb型、Lex型和Ley型HBGAs有不同程度的结合,而GI.5 HuNoV与类Leb型HBGAs仅微弱结合,与类H1型HBGAs具有明显结合优势。综上,不同型别HuNoV与HBGAs的结合特性不尽相同,GII.4HuNoV具有广谱结合特性,GI.5HuNoV具有选择结合特性。

广西贺州地区无偿献血人群Mur血型筛查及基因型研究

目的 筛查广西贺州地区无偿献血者Mur血型抗原分布频率,并对Mur抗原阳性样本进一步分析其分子基础。方法 采用微孔板血型血清学方法筛查广西贺州地区无偿献血者Mur表型,分析Mur血型抗原在不同少数民族人群中分布频率。对血清学筛查结果阳性样本通过PCR-SSP方法进行基因定型,验证血清学方法的准确性,并测序分析其基因背景。结果 在3 298例贺州地区无偿献血者标本中筛选出Mur抗原阳性432例(13.10%,432/3 298),PCR-SSP基因分型验证显示432例标本均为电泳阳性。其中,汉族献血者Mur抗原阳性占比12.79%(331/2 587),瑶族13.25%(64/483),壮族16.51%(36/218),3组数据无统计学差异(P>0.05)。进一步的测序结果显示,其中428例为GYP(B-A-B)Mur,即GYP.Mur型(12.98%,428/3 298),其余4例为GYP(B-A-B)Bun,即GYP.Bun型(0.12%,4/3 298)。结论 广西贺州地区无偿献血人群Mur血型频率较高,且以GYP.Mur基因型为主。由于民族融合等因素,汉族与壮族、瑶族等少数民族Mur血型分布频率无显著性差异。因此,本地区广泛开展Mur血型抗原抗体检测,对于保障临床输血安全具有重要意义。

广西地中海贫血患者同种异体免疫发生情况分析

目的调查广西长期反复输血的地中海贫血患者同种异体免疫发生率,并鉴定同种异体抗体特异性,为临床完善输血策略、提高患者生存质量提供依据。方法利用地中海贫血管理系统,收集2017-01/2022-06月在作者医院进行输血治疗的1115例患者的资料,统计同种异体抗体阳性发生率,比较不同类型地中海贫血、民族、性别、年龄段以及同种异体抗体阳性发生率,比较不同类型地中海贫血抗体阳性和阴性患者的年龄、Hb水平,对地中海贫血抗体阳性患者抗体进行特异性鉴定。结果1115例地中海贫血患者中有92例(8.25%)抗体筛查阳性。对比重型β地中海贫血(beta-thalassemia major,β-TM)、血红蛋白H病(hemoglobin H disease,HbH),中间型β地中海贫血(beta-thalassemia intermedia,β-TI)的抗体阳性发生率最高;女性抗体阳性发生率高于男性;年龄>20岁患者的抗体阳性发生率最高。β-TM、β-TI、HbH患者中抗体阳性患者的年龄均明显高于抗体阴性患者(P<0.05)。β-TM患者中抗体阳性患者Hb水平低于抗体阴性患者(P<0.05)。地中海贫血抗体阳性患者Rh血型系统抗体及其合并其他抗体占73.92%(68/92),抗-Mur抗体及其合并其他抗体占8.70%(8/92),抗-JK~a、抗-JK~b抗体及其合并其他抗体占7.61%(7/92)。结论反复输血的广西地中海贫血患者,有较高的同种异体抗体阳性发生率,Rh血型系统抗体阳性最多。β-TI患者、汉族患者、女性患者和年龄大于20岁患者更易发生同种异体免疫反应。

结直肠癌组织中HMGB2、MAGE-A9、MMR蛋白表达及其临床意义

目的探讨结直肠癌组织中高迁移率族蛋白B2(HMGB2)、黑色素瘤相关抗原-A9(MAGE-A9)、DNA错配修复基因(MMR)蛋白表达情况,以及其在评估患者预后中的临床价值。方法选取52例结直肠癌患者作为研究对象,术中采集所有患者肿瘤标本及癌旁组织标本,检测HMGB2、MAGE-A9、MMR蛋白表达水平,并分析各指标表达情况与病理特征、预后间的关系。结果肿瘤组织内HMGB2、MAGE-A9、MMR阳性表达高于癌旁组织,差异有统计学意义(P<0.05)。肿瘤分期Ⅲ期、分化程度低分化、淋巴结转移患者HMGB2、MAGE-A9、MMR阳性表达率高于Ⅰ期、Ⅱ期、中高分化、无淋巴结转移患者,差异有统计学意义(P<0.05)。随访3年,52例患者存活率为71.15%(37/52);HMGB2阳性组存活率[61.76%(21/34)]低于HMGB2阴性组[88.89%(16/18)],差异有统计学意义(χ^(2)=4.219,P=0.040);MAGE-A9阳性组存活率[58.62%(17/29)]低于MAGE-A9阴性组[86.96%(20/23)],差异有统计学意义(χ^(2)=5.018,P=0.025);MMR阳性组存活率[52.00%(13/25)]低于MMR阴性组[88.89%(24/27)],差异有统计学意义(χ^(2)=8.606,P=0.003)。结论HMGB2、MAGE-A9、MMR在结直肠癌中呈高表达状态,其表达与肿瘤分期、分化程度、淋巴结转移关系密切,且不同表达患者存活率存在较大差异,可作为评估预后的重要指标。

急性髓系白血病血型变化及其与治疗效果的关系

目的探究2名血型正反定型不符且疑似O型的急性髓系白血病患者血型变化,及其与疾病治疗效果的关系。方法血型鉴定使用微柱凝胶法、试管法、吸收放散试验对患者ABO血型做血型血清学分析;微流控芯片法检测ABO的血型基因分型,采用PCR法扩增ABO基因外显子E2~E7,扩增产物用Sanger法进行基因测序。结果2例的常规血型血清学检测结果,均为正定O型,反定A型,正反不符,吸收放散试验结果均有A抗原检出;2例的ABO基因表型均为A型;基因分型结果分别为A_(102)/A_(102);A_(102)/O_(01),基因测序结果显示ABO血型基因SNP位点分别为:467T/T;261G/delG、467C/T。其中1例,随着治疗的有效进展,与抗-A凝集反应强度出现明显地由弱到强的变化。结论在临床中遇到正反定型不符且疑似O型的急性髓系白血病患者标本,我们应重视反定型结果的参考价值,须做吸收放散试验,并结合基因检测结果,做出正确的血型判断,为患者制定合适的输血策略。

桂北地区Rh血型系统分布及Rh分型配合性输注的临床应用价值

目的探讨桂北地区人群Rh血型系统C、E、c、e抗原和表型分布情况,分析RhC、E、c、e表型配合性输注的疗效,为临床Rh表型配合性输注提供参考依据。方法选取2021年9月至2022年4月该院9645例血液标本作为研究对象,其中RhD阳性标本9610例,RhD阴性标本35例。检测并分析9610例RhD阳性标本RhC、E、c、e抗原和表型分布情况。另选取2021年7月至2023年7月该院收治的有输血史或妊娠史的210例输血患者进行配血观察研究。在ABO和RhD同型的基础上,将210例输血患者分为RhC、E、c、e配合性输注组(观察组,105例)和非配合性输注组(对照组,105例)。两组输注去白细胞红细胞悬液2 U,检测两组输血前后白细胞计数(WBC)、血小板计数(PLT)、血红蛋白(Hb)水平和红细胞压积(HCT),记录两组输注后红细胞输注有效率、不规则抗体阳性率及不良反应发生率。结果桂北地区RhD阳性抗原阳性率为99.64%(9610/9645)。9610例RhD阳性血型主要抗原C、c、E、e的分布频率分别为94.09%(9042/9610)、41.43%(3981/9610)、33.04%(3176/9610)、96.44%(9268/9610)。9610例RhD阳性标本中,有9种形式,其表型及分布频率分别为CCDee(57.76%,5551/9610)、CcDEe(26.56%,2552/9610)、CcDee(8.76%,842/9610)、ccDEE(3.34%,321/9610)、ccDEe(2.14%,206/9610)、CCDEe(0.79%,76/9610)、ccDee(0.43%,41/9610)、CcDEE(0.20%,19/9610)、CCDEE(0.02%,2/9610)。两组输血前Hb水平、HCT、WBC及PLT比较,差异均无统计学意义(P>0.05)。两组输血后Hb水平、HCT均高于输血前,观察组输血后WBC低于输血前,差异均有统计学意义(P<0.05)。观察组输血后Hb水平、HCT均高于对照组,差异均有统计学意义(P<0.05)。输血后两组红细胞输注有效率、不规则抗体阳性率及不良反应发生率比较,差异均有统计学意义(P<0.05)。结论桂北地区人群Rh表型为CCDee和CcDEe占优势,表型CCDEE最少。有妊娠史或需反复输血患者,在ABO和RhD同型基础上,优选Rh表型配合性血制品进行输注,可减少Rh系统抗体的产生,降低输血不良反应的发生率,提高患者红细胞输注效果,保障输血的安全性和治疗效果。

微柱凝胶检验法在RhD、ABO血型抗原鉴定中的应用价值分析

目的探讨微柱凝胶检验法在RhD、ABO血型抗原鉴定中的应用价值。方法120例需行RhD及ABO血型鉴定患者,将所有取得的血样分为两份,分别使用试管法及手工微柱凝胶免疫检验法(微柱凝胶检验法)对血型进行分析。比较两种检测方式的鉴定结果。结果120例患者血样经试管法及微柱凝胶检验法检测后,结果均发现ABO阳性112例(其中A型34例,B型33例,AB型11例,O型34例),ABO阳性率为93.33%;RhD阴性1例,RhD阴性率为0.83%。两种方法的抗原检测结果符合率为100.00%,两种方法检测血型结果比较差异无统计学意义(P>0.05)。结论微柱凝胶检验法应用在RhD、ABO血型抗原鉴定中,操作简便,准确率高,值得在临床中推广应用。

双参数磁共振影像组学联合PSAD在前列腺癌Gleason分级分组中的应用价值

目的探讨双参数磁共振成像(biparametric magnetic resonance imaging,bpMRI)影像组学联合前列腺特异性抗原密度(prostate-specific antigen density,PSAD)在低、高级别前列腺癌(prostate carcinoma,PCa)中的诊断价值。方法回顾性分析2018年6月至2022年10月台州市中心医院经病理证实为PCa患者的临床及影像资料。根据Gleason分级分组(Gleason grade group,GGG),将GGG≤2定义为低级别PCa,GGG>2定义为高级别PCa。按7∶3比例将不同级别的PCa患者随机分为训练组和测试组。基于T2加权成像(T2 weighted imaging,T2WI)、表观扩散系数(apparent diffusion coefficient,ADC)序列提取影像组学特征,采用最大相关最小冗余、最小绝对收缩和选择算子进行特征选择和降维,并进行5倍交叉验证,保留最佳特征组合构建影像组学模型。通过受试者操作特征曲线(receiver operating characteristic curve,ROC曲线)和Delong检验评估各模型的诊断性能。采用决策曲线分析(decision curve analysis,DCA)评价模型的临床效用。结果所有模型中,T2WI-ADC-PSAD联合模型的诊断效能最高,在训练组和测试组中的曲线下面积(area under the curve,AUC)分别为0.882、0.772。Delong检验结果显示,在训练组中,T2WI-ADC-PSAD模型与T2WI模型的AUC比较差异无统计学意义(P>0.05),与其他模型的AUC比较差异均有统计学意义(P<0.05)。在测试组中,T2WI-ADC-PSAD模型与其他模型的AUC比较差异均无统计学意义(P>0.05)。DCA结果显示,当阈值概率低于97%时,T2WI-ADC-PSAD模型可为临床决策提供更高的净效益。结论BpMRI影像组学联合PSAD可提高对低、高级别PCa的诊断效能,并指导患者的治疗决策。

肺癌化疗后肺部感染病原菌的分布及血清细胞角蛋白19片段抗原、高迁移率族蛋白B1及可溶性血红蛋白清道夫受体的诊断价值

目的探讨肺癌化疗后肺部感染病原菌分布及血清细胞角蛋白19片段抗原(CYFRA21-1)、高迁移率族蛋白B1(HMGB1)、可溶性血红蛋白清道夫受体(sCD163)水平变化和诊断价值。方法将2022年7月—2023年11月收治的83例肺癌化疗患者根据肺部感染情况分为未感染组(n=43)和感染组(n=40)。收集肺癌化疗患者痰液标本,记录标本来源并进行菌种鉴定。比较2组血清CYFRA21-1、HMGB1、sCD163水平变化;采用多因素Logistic回归模型分析肺癌化疗后肺部感染的影响因素;分析血清CYFRA21-1、HMGB1、sCD163水平对肺癌化疗后肺部感染的诊断价值。结果80例肺癌化疗患者中,发生肺部感染者40例;病原菌检测出55株,其中革兰阴性菌、革兰阳性菌分别为34、18株,占比61.82%、32.73%,真菌仅3株,占比5.45%。感染组血清CYFRA21-1、HMGB1、sCD163水平均高于未感染组,差异有统计学意义(P<0.05)。年龄、肺部疾病史、CYFRA21-1、HMGB1、sCD163为肺癌化疗患者发生肺部感染的影响因素(P<0.05)。血清CYFRA21-1、sCD163、HMGB1水平诊断肺癌化疗后肺部感染的曲线下面积依次为0.677、0.763、0.819(P<0.05)。结论肺癌化疗后,肺部感染患者病原菌以革兰阴性菌为主,血清CYFRA21-1、HMGB1、sCD163水平显著升高,其可作为早期诊断和评估感染的生物学指标。

全自动血型分析系统检测Kk血型抗原方法的建立与验证

目的针对BECKMAN PK7300全自动血型分析系统检测Kk血型抗原建立非配套检测方法并进行验证,为后期常规开展Kk抗原检测提供基础数据支持。方法随机抽取青岛市中心血站2021年11月—2022年4月的40名无偿献血者样本。基于相关文献查阅梳理结果,优化试验参数选择孵育温度、试剂加注量、稀释标本加注量,根据设备厂家推荐参数评价验证样本红细胞的稀释浓度、抗-K和抗-k血清的稀释浓度对样本检测的影响。结果利用PK7300全自动血型分析仪进行非配套检测Kk抗原后得到的各项参数为样本红细胞和抗-K、抗-k血清的稀释浓度分别为1.50%和1∶20;孵育温度和时间分别为30℃和1 h;试剂和样本的反应体积相同,均为25μL。结论针对Kk抗原检测建立的PK7300非配套血型检测系统得出的实验参数特异性好、敏感度高,符合实验预期。经过对样本及试剂稀释倍数的检测验证,有助于本研究建立的检测系统进行稀有血型批量检测准确判读和检测效率的提升,同时可降低试剂损耗。

E．coli O86 O-Antigen全保护五糖重复单元的化学简易合成

以5个单糖组分为原料,经过7步,以21%的总产率得到E.coliO86抗原全保护的五糖重复单元.在合成路线中,充分利用糖基化反应的立体选择性原则,结合HClO4-SiO2固体催化剂和"IP"策略,大大提高了合成的效率.整个合成路线设计操作简单,选择性高,消耗低,产率高,可以用于快速高效地合成其它一些具有生物活性的寡糖分子.