Objective: To investigate the impact of RhE antigen-matched transfusion during liver transplantation on early postoperative recovery and complications. Methods: In this retrospective cohort study, ninety-five patients undergoing liver transplantation at Kunming First People's Hospital between January 2022 and July 2025 were enrolled. Patients were divided into two groups: Group 1 (RhE-mismatched transfusion, n=57) and Group 2 (RhE-matched transfusion, n=38). The baseline data, complete blood counts, hepatic and renal function, coagulation parameters, and complication rates between the two groups were compared at postoperative days 1, 3, 5, 7, and 10. Survival analysis was performed using the Kaplan-Meier method. Results: The baseline characteristics were well-balanced and comparable between the two groups (all P>0.05). The early postoperative mortality rate in the mismatched group (31.58%, 18/57) was significantly higher than that in the matched group (10.53%, 4/38) (P=0.017). The incidence of postoperative hepatic encephalopathy was significantly higher in the mismatched group (50.88%, 29/57) than in the matched group (10.53%, 4/38) (P<0.001). The incidence of postoperative haemorrhage in the mismatched group (24.56%, 14/57) was higher than that in the matched group (5.26%, 2/38), with a statistically significant difference (P=0.014). The incidence of perioperative infection in the mismatched group (28.07%, 16/57) was higher than that in the matched group (10.53%, 4/38), with a statistically significant difference (P=0.04). Corresponding odds ratios (OR) and 95% confidence intervals indicated a lower risk of these adverse events in the matched group. On postoperative day 1, the change in activated partial thromboplastin time (-1.6, 20.5) in the mismatched group was greater than in the matched group (-0.2, 5.5). The change in international normalised ratio (-0.56, 1.22) in the mismatched group was greater than in the matched group (-0.18, 0.32), while the change in albumin (-4.0, 4.8) was smaller in the mismatched group than in the matched group (-2.5, 8.8). On postoperative day 5, the change in albumin (-0.41±7.83) in the mismatched group was smaller than in the matched group (2.68±4.53). At postoperative day 7, the change in albumin in the mismatched group (-0.61±7.38) was smaller than that in the matched group (2.51±5.85), while the change in D-dimer in the mismatched group (0.73, 7.4) was greater than that in the matched group (-1.6, 4.3). On postoperative day 10, the mismatched group exhibited significantly higher fibrinogen levels (-1.21, 1.78) than the matched group (-0.49, 0.97), and significantly longer prothrombin times (-11.3, -2.7) than the matched group (-6.2, -0.8) (all P<0.05). The matched group exhibited a mean overall survival (OS) of 32.803 months (95% CI:29.171-36.436 months), significantly exceeding the mismatched group's 28.996 months (95% CI:24.202-33.790 months). The log-rank test yielded statistically significant results (χ =4.307, P=0.038). Conclusion: Implementing RhE blood group-matched transfusion during liver transplantation may help reduce early postoperative mortality and the incidence of major complication rates, promote faster recovery of coagulation and liver function, and thereby improve short-term patient outcomes.

Panvascular diseases represent systemic vascular disorders characterized by atherosclerosis as their core pathological feature. Their incidence rates continue to rise， posing significant challenges for clinical management. Based on Traditional Chinese Medicine （TCM） theory of ''positive deficiency phlegm stasis''， this study delved into the pivotal role of mitochondrial homeostasis dysregulation in the pathogenesis and progression of pan-vascular diseases， along with its intrinsic connection to TCM pathogenesis. Mitochondrial homeostasis dysregulation pervades the entire course of these diseases， with mitochondrial oxidative stress serving as the initiating factor. Excessive reactive oxygen species （ROS） trigger endothelial dysfunction， lipid accumulation， and inflammatory initiation. Additionally， the imbalance between mitochondrial autophagy and apoptosis constitutes a pivotal link in disease progression. Excessive or insufficient autophagy may lead to the accumulation of damaged mitochondria and excessive cellular apoptosis， thereby promoting plaque instability. Furthermore， mitochondrial metabolic reprogramming impairs energy supply and function in vascular wall cells， hindering subsequent vascular repair. These pathological processes constitute the microscopic manifestation of the core pathogenesis， which is characterized by ''the intermingle of phlegm and stasis and the deficiency of healthy Qi''. Specifically， the endogenous phlegm-turbidity drives mitochondrial oxidative stress injuries， the mutual entanglement of phlegm and stasis induces an imbalance between mitochondrial autophagy and apoptosis， while deficiency of healthy Qi propels mitochondrial energy metabolism disorders and reprogramming. In view of this， this study proposed to employ phlegm-resolving and turbidity-clearing methods to mitigate mitochondrial oxidative stress injuries， phlegm-resolving and blood-activating methods to regulate mitochondrial autophagy and apoptosis， and spleen-tonifying and kidney-nourishing methods to modulate mitochondrial metabolic reprogramming. This approach can prevent and treat panvascular diseases by multi-target regulation of mitochondrial homeostasis， providing a theoretical framework and therapeutic strategies for the prevention and treatment of panvascular diseases through integrated Chinese and Western medicine.

Objective:To investigate the changes in serum levels of interleukin-1β (IL-1β) and hypoxia-inducible factor-2α (HIF-2α) in patients with intracranial aneurysms before and after surgery, and their relationship with clinical prognosis.Methods:A prospective research method was used, a total of 120 patients with intracranial aneurysms who underwent endovascular embolization treatment in Xi'an NO.9 Hospital from December 2019 to December 2022 were selected as the study subjects. According to the prognosis after one-year follow-up, they were divided into poor prognosis group and good prognosis group. The general data of the two groups and the changes of serum IL-1β and HIF-2α levels before and after surgery were compared and analyzed. The changes of serum IL-1β and HIF-2α before and after surgery in patients with intracranial aneurysms and their relationship with the prognosis of patients were analyzed.Results:Among the 120 patients, 98 (81.67%) had a good prognosis and 22 (18.33%) had a poor prognosis. The proportion of large and wide necked aneurysms in the poor prognosis group was higher than that in the good prognosis group: 40.91% (9/22) vs. 10.20% (10/98), 45.45% (10/22) vs. 20.41%(20/98), with statistical significant differences ( P<0.05). On postoperative day 7, the serum levels of IL-1 β and HIF-2 α in the poor prognosis group were higher than those in the good prognosis group: (62.58 ± 6.12) ng/L vs. (56.95 ± 5.33) ng/L, (101.62 ± 10.55) ng/L vs. (92.70 ± 7.82) ng/L, with statistical significant differences ( P<0.05). Multivariate Logistic regression analysis showed that the size of aneurysms, including giant aneurysms, wide necked aneurysms, and high levels of serum IL-1β and HIF-2α 7 d after surgery, were independent risk factors for clinical prognosis in patients with intracranial aneurysms ( P<0.05). The working characteristic curve of the subjects was drawn, and the results showed that serum IL-1β and HIF-2α had certain predictive value for the clinical prognosis of intracranial aneurysm patients 7 d after surgery, but their sensitivity was relatively low. The parallel experiment method was used to jointly predict the samples. The results showed that the area under the curve for predicting the clinical prognosis of intracranial aneurysm patients with serum IL-1β and HIF-2α at 7 d after surgery was 0.867, with sensitivity and specificity of 86.40% and 74.50%, respectively, indicating high predictive value. Conclusions:The levels of serum IL-1β and HIF-2α are significantly elevated in patients with intracranial aneurysms after surgery, and are closely related to their clinical prognosis, which can help predict the clinical prognosis of intracranial aneurysm patients.

Intracranial artery stenosis is a major pathogenetic factor in ischemic stroke,and early diagnosis and timely intervention are the main means of preventing stroke and its complications.Transcranial color-coded Doppler sonography is an imaging technique widely used in clinical practice for the diagnosis of intracranial artery stenosis,due to its advantages of being noninvasive,reproducible,and readily accessible.This imaging modality allows direct visualization of the degree of vascular stenosis and enables indirect assessment of distal perfusion.This article provides a systematic review of the current status and advances in the use of transcranial color-coded Doppler sonography in the assessment of intracranial arterial stenosis.

Substantia nigra hyperechogenicity detected by transcranial sonography(TCS)is a key imaging marker for diagnosing Parkinson disease(PD).In order to further standardize and promote the application of TCS in PD,Ultrasound Doctor Branch of the Chinese Medical Doctor Association organized relevant experts to discuss and develop this guideline of Chinese standard TCS examination of PD with domestic and foreign evidence-based medicine and their own experiences.

Objective To investigate the biomechanical characteristics of clear aligners combined with Class Ⅱelastics during retraction of upper anterior teeth,and compare the differences between two traction methods.Methods A case with a molar distal relationship and extraction of four first premolars was selected.The finite element method was applied to analyze tooth displacement,force distribution,and periodontal ligament(PDL)stress during 0.2 mm en-masse retraction of the anterior teeth.Three working conditions were defined:en-masse retraction without elastics(Condition 1),120 g Class Ⅱ elastics with aligner-cut hooks on upper canines and lower first molars(Condition 2),120 g Class Ⅱ elastics with aligner windows and bonded buttons on upper canines and lower first molars(Condition 3).Results Class Ⅱ elastics significantly enhanced lingual movement of the upper anterior teeth and mesial movement of the lower posterior teeth,while reducing mesial movement of the upper posterior teeth and lingual movement of the lower anterior teeth.In the transverse direction,the forces exerted on the teeth in all three conditions were minimal.In the sagittal direction,in Condition 2,the mesial force of the upper posterior teeth was effectively reduced by an average of 0.13 N,and the mesial force of the lower posterior teeth was increased by an average of 0.31 N.In Condition 3,the distal force of the upper canine teeth and the mesial force of the lower first molar were significantly increased by 0.40 N and 1.14 N,respectively.In the vertical direction,In condition 2,the average extrusive force of the upper teeth and the extrusive force of the lower molars were increased by 0.22 N and 0.20 N,respectively.In Condition 3,the upper canine extrusive force was increased by 0.91 N,while the lower molar intrusive force and the second molar extrusive force were reduced by 0.27 N and 0.25 N,respectively.The PDL stress distribution in the three conditions was generally similar.In Condition 3,the maximum principal stress distribution area on the lower first molars expanded slightly,but the magnitude did not increase significantly.Conclusions Condition 2 optimized the lower posterior teeth mesialization through balanced force distribution and protected the upper posterior teeth anchorage.Condition 3 significantly increased extrusive and distal forces on the upper canines and mesial forces on the lower first molars but did not substantially elevate periodontal risks for these teeth.

Objective To investigate the biomechanical characteristics of clear aligners combined with Class Ⅱelastics during retraction of upper anterior teeth,and compare the differences between two traction methods.Methods A case with a molar distal relationship and extraction of four first premolars was selected.The finite element method was applied to analyze tooth displacement,force distribution,and periodontal ligament(PDL)stress during 0.2 mm en-masse retraction of the anterior teeth.Three working conditions were defined:en-masse retraction without elastics(Condition 1),120 g Class Ⅱ elastics with aligner-cut hooks on upper canines and lower first molars(Condition 2),120 g Class Ⅱ elastics with aligner windows and bonded buttons on upper canines and lower first molars(Condition 3).Results Class Ⅱ elastics significantly enhanced lingual movement of the upper anterior teeth and mesial movement of the lower posterior teeth,while reducing mesial movement of the upper posterior teeth and lingual movement of the lower anterior teeth.In the transverse direction,the forces exerted on the teeth in all three conditions were minimal.In the sagittal direction,in Condition 2,the mesial force of the upper posterior teeth was effectively reduced by an average of 0.13 N,and the mesial force of the lower posterior teeth was increased by an average of 0.31 N.In Condition 3,the distal force of the upper canine teeth and the mesial force of the lower first molar were significantly increased by 0.40 N and 1.14 N,respectively.In the vertical direction,In condition 2,the average extrusive force of the upper teeth and the extrusive force of the lower molars were increased by 0.22 N and 0.20 N,respectively.In Condition 3,the upper canine extrusive force was increased by 0.91 N,while the lower molar intrusive force and the second molar extrusive force were reduced by 0.27 N and 0.25 N,respectively.The PDL stress distribution in the three conditions was generally similar.In Condition 3,the maximum principal stress distribution area on the lower first molars expanded slightly,but the magnitude did not increase significantly.Conclusions Condition 2 optimized the lower posterior teeth mesialization through balanced force distribution and protected the upper posterior teeth anchorage.Condition 3 significantly increased extrusive and distal forces on the upper canines and mesial forces on the lower first molars but did not substantially elevate periodontal risks for these teeth.

Aim To investigate the interventional effects of polysaccharides from Dicliptera chinensis(L.)Juss.(DCP)on acute liver failure(ALF)in-duced by lipopolysaccharide(LPS)combined with D-galactosamine(D-GalN)in mice,and on LPS-induced inflammatory responses in RAW264.7 cells,based on the TLR-4/MyD88/NF-κB signaling pathway.Meth-ods Mice were randomly divided into the control,model,silymarin,DCP low,medium,and high dose groups,and toxicity test groups.After 10 consecutive days of treatment,ALF models were established by in-jecting mice with LPS+D-GalN.Additionally,an in-flammatory response model was established by stimula-ting RAW264.7 cells with LPS.Results Biochemical assays showed that compared with the model group,the medium-and high-dose DCP groups exhibited de-creased serum ALT,AST,ALP,TBIL,and γ-GT activi-ties(P＜0.05),reduced levels of ROS,MPO and MDA in liver(P＜0.05),increased activities of SOD,GSH-Px,CAT,and elevated T-AOC levels(P＜0.05).ELISA revealed lower levels of ICAM-1,VCAM-1,IL-6,IL-1β,and TNF-α in liver(P＜0.05).HE staining indicated reduced inflammatory cell infiltration and improved hepatocyte necrosis in liv-er after DCP administration.The use of DCP alone showed no significant organ toxicity.qRT-PCR and Western blot results indicated that DCP inhibited the expression of key factors in TLR-4/MyD88/NF-κB sig-naling pathway(P＜0.05).Cell validation experi-ments also confirmed that this pathway was inhibited by DCP.Conclusion DCP alleviates ALF primarily by inhibiting oxidative stress and blocking the activation of the TLR-4/MyD88/NF-κB signaling pathway.

Objective To validate the diagnostic performance and risk stratification ability of an AI-based recognition system(PE-AI)for pulmonary embolism(PE)using computed tomography pulmonary angiography(CTPA)so as to analyze its diagnostic value in clinical practice.Methods A total of 416 patients with suspected PE who underwent CTPA from January 1,2023 to December 10,2023 at our hospital were included in this study.Two junior radiologists and PE-AI separately detected and diagnosed emboli in the collected cases by double-blind method,and recorded the diagnosis time respectively.Three senior radiologists reviewing with clinical follow-up results were used as the gold standard in this study.Diagnostic performance was evaluated by using the receiver operating characteristic(ROC)curve analysis and Delong-t test.For positive cases,the pulmonary artery obstruction index(PAOI)calculated by AI and manually were collected respectively and consistency analysis was performed.Results The area under the curve(AUC)of PE-AI,manual and combined diagnosis was 85.6％,90.8％and 95.1％,respectively,which differed significantly(P＜0.05).The reading time of PE-AI[(0.16±0.07)min]was significantly lower than the time of manual[(4.42±1.85)min,P＜0.001]and combined diagnosis[(4.58±1.84)min,P＜0.001].The PAOI measured by PE-AI and manually had high consistency(intraclass correlation efficient,ICC=0.80)in the subgroup analysis of confirmed cases.Conclusion AI can quickly identify pulmonary artery emboli in a short time and assist radiologists to improve diagnostic efficiency.At the same time,through the intelligent detection of PAOI,it is helpful for the risk stratification of patients with PE and optimizing the diagnosis and treatment pathway for pulmonary embolism.

Objective:To investigate the changes in serum levels of interleukin-1β (IL-1β) and hypoxia-inducible factor-2α (HIF-2α) in patients with intracranial aneurysms before and after surgery, and their relationship with clinical prognosis.Methods:A prospective research method was used, a total of 120 patients with intracranial aneurysms who underwent endovascular embolization treatment in Xi'an NO.9 Hospital from December 2019 to December 2022 were selected as the study subjects. According to the prognosis after one-year follow-up, they were divided into poor prognosis group and good prognosis group. The general data of the two groups and the changes of serum IL-1β and HIF-2α levels before and after surgery were compared and analyzed. The changes of serum IL-1β and HIF-2α before and after surgery in patients with intracranial aneurysms and their relationship with the prognosis of patients were analyzed.Results:Among the 120 patients, 98 (81.67%) had a good prognosis and 22 (18.33%) had a poor prognosis. The proportion of large and wide necked aneurysms in the poor prognosis group was higher than that in the good prognosis group: 40.91% (9/22) vs. 10.20% (10/98), 45.45% (10/22) vs. 20.41%(20/98), with statistical significant differences ( P<0.05). On postoperative day 7, the serum levels of IL-1 β and HIF-2 α in the poor prognosis group were higher than those in the good prognosis group: (62.58 ± 6.12) ng/L vs. (56.95 ± 5.33) ng/L, (101.62 ± 10.55) ng/L vs. (92.70 ± 7.82) ng/L, with statistical significant differences ( P<0.05). Multivariate Logistic regression analysis showed that the size of aneurysms, including giant aneurysms, wide necked aneurysms, and high levels of serum IL-1β and HIF-2α 7 d after surgery, were independent risk factors for clinical prognosis in patients with intracranial aneurysms ( P<0.05). The working characteristic curve of the subjects was drawn, and the results showed that serum IL-1β and HIF-2α had certain predictive value for the clinical prognosis of intracranial aneurysm patients 7 d after surgery, but their sensitivity was relatively low. The parallel experiment method was used to jointly predict the samples. The results showed that the area under the curve for predicting the clinical prognosis of intracranial aneurysm patients with serum IL-1β and HIF-2α at 7 d after surgery was 0.867, with sensitivity and specificity of 86.40% and 74.50%, respectively, indicating high predictive value. Conclusions:The levels of serum IL-1β and HIF-2α are significantly elevated in patients with intracranial aneurysms after surgery, and are closely related to their clinical prognosis, which can help predict the clinical prognosis of intracranial aneurysm patients.