Objective: To investigate the effects of clinical routine X-ray irradiation dose (average irradiation dose: 29.7±0.54 Gy) on the function, apoptosis, activation state and mitochondrial function of platelets during in vitro storage, so as to provide experimental evidence for optimizing platelet irradiation strategies. Methods: A paired experimental design was adopted. Platelets were collected from 12 healthy donors, and each sample was equally divided into the irradiated group and the control group (non-irradiated). All samples were stored for 5 days under standard platelet preservation conditions (22±2℃, continuous oscillation). Flow cytometry was used to detect platelet count, apoptosis rate (Annexin V+ positive rate), activation markers (CD62P, PAC-1, CD42b) and reactive oxygen species (ROS) level. Meanwhile, mitochondrial-specific probes were used to evaluate changes in mitochondrial count, membrane potential and adenosine triphosphate (ATP) content. Additionally, transmission electron microscopy (TEM) was employed to observe the ultrastructure of platelets, with a focus on mitochondrial morphology, platelet membrane integrity and granule distribution. Results: Within 5 days of storage, the platelet count was (841±89.16)×10 /L in the irradiated group and (824.5±92.88)×10 /L in the control group, with no statistically significant difference between the two groups (P=0.54). The apoptosis rate was (4.94±1.39) % in the irradiated group and (5.50±0.83) % in the control group, showing no significant difference (P=0.31). For activation indicators, the CD62P expression rate was (24.32±7.57) % in the irradiated group versus (25.21±8.13) % in the control group (P=0.43). The PAC-1 positive rates were (12.15±4.43) % and (11.75±3.40) % in the irradiated group and control group, respectively (P=0.44). The CD42b expression rates were (12.14±4.43) % and (11.75±3.4) % in the two groups, respectively (P=0.47). The ROS levels were (31.98±8.1) % and (30.64±5.89) % in the two groups, respectively (P=0.45). No significant differences were found in the above indicators. For mitochondrial function indicators, the mitochondrial count was (55.88±11.49) % in the irradiated group and (53.5±7.24) % in the control group (P=0.57). The ATP contents were (42.45±5.29) % and (41.58±9.50) % in the irradiated group and control group, respectively (P=0.77). The relative membrane potential values were (59.53±10.89) % and (57.49±6.54) % in the two groups, respectively (P=0.47). No significant difference were observed on the mitochondrial function-related indicators. TEM further confirmed that the ultrastructure of platelets in the irradiation group was intact, the mitochondrial morphology was normal, and no pathological changes such as swelling or vacuolization were observed. Conclusion: This study evaluated the impact of conventional-dose X-ray irradiation on platelet storage quality, confirming that this dose does not significant impair platelet count, apoptosis rate, activation status, or mitochondrial function. This finding provides important experimental evidence for the clinical promotion of X-ray irradiation technology and suggests its potential as a safe alternative to γ irradiation. Future studies could further expand the sample size and extend the observation period to verify the effects of X-ray irradiation on long-term platelet storage and post-transfusion in vivo survival rate.

Objective: To systematically analyze the confirmatory positivity of different combinations of HBsAg screening results in blood testing, providing data to support the optimization of blood donor eligibility management. Methods: A retrospective analysis was conducted on blood screening data from 174 266 voluntary blood donor samples at the Chongqing Blood Center between October 2021 and September 2022. Samples with inconsistent results between the two HBsAg enzymelinked immunosorbent assays (ELISA) and individual donor nucleic acid testing (NAT) were confirmed using an electrochemiluminescence immunoassay (ECLIA) and a neutralization test. The detection efficacy of four different HBsAg ELISA reagents was compared using the HBsAg-confirmed positive samples. Results: A total of 767(0.44%) HBV-reactive (HB-sAg and/or HBV DNA reactive) samples were detected. Among them, 344 samples with discordant serological and NAT results were collected, of which 64(18.6%) were confirmed positive by neutralization test. Additionally, 5 samples that were neutralization-negative but double-reactive for HBsAg and HBV DNA were confirmed as positive according to FDA guidance, resulting in a total of 69(20.1%) confirmed HBsAg-positive samples. There were significant differences in the neutralization test confirmation rates among different screening result categories (P<0.05): The group with dual HBsAg reagent reactivity (double reactive) & NAT-negative had the highest confirmation rate (96.9%, 31/32); the group reactive to only reagent 2 (single reactive) had a rate of 25.7% (29/113); while the confirmation rates for samples reactive to only reagent 1 and samples with isolated HBV DNA positivity were extremely low [0(0/34) and 2.4%(4/165), respectively]. The four commercial reagents showed significant differences in their ability to detect confirmed positive samples that were initially single reactive (P<0.05). Conclusion: Given the performance variations among HBsAg screening reagents, thorough performance verification is essential before implementation. When NAT is negative, dual HBsAg reactivity in screening can serve as a basis for confirming infection and directly deferring blood donors. However, confirming infection in donors with single HBsAg reactivity is more challenging, necessitating supplementary tests to rule out infection risk.

The proband was a 32-year-old female patient who sought medical attention for over 9 months of pregnancy, reduced fetal movement, and discomfort in the lower abdomen. The proband and her father had normal activated partial thromboplastin time and prothrombin time, decreased fibrinogen activity and antigen levels, and prolonged thrombin time, whereas the test results of her mother were normal. Ultrasonography showed intermuscular vein thrombosis in the left calf of the proband. Peripheral blood DNA was extracted from the proband and her parents, and Sanger sequencing was performed to detect the base sequences of the FGA, FGB, and FGG genes. The proband and her father had heterozygous missense mutations in exon 6 c.615A > C (p. Leu205Phe) and exon 8 c.1121A > C (p. Tyr374Ser) of the FGG gene. Bioinformatics analysis suggested that the two gene mutations may be the pathogenic mechanism of this congenital hypodysfibrinogenemia family.

Objective:To construct an evaluation index system for rural order-oriented general practice residents based on Entrustable Professional Activities (EPAs) and conduct an empirical analysis. ?Methods:A mixed-methods study design was adopted (November 2022-April 2023). The preliminary draft of the index system was developed through literature review and group discussions, then refined and improved via two rounds of expert consultation using the Delphi method. The analytic hierarchy process (AHP) was applied to determine the weight of each index. Meanwhile, questionnaires were distributed to 181 participants, including general practitioners from general hospitals, general practitioners from community hospitals, and general practice residents. The scores of the three groups regarding the importance and feasibility of the indices were compared. Ten general practitioners of the above three types were selected for semi-structured interviews on their cognitive and practical aspects of the system. ?Results:The positive coefficients of the two rounds of expert consultation were 16/17 and 16/16, respectively. The expert authority degree was >0.70, and the test of coordination coefficient was statistically significant ( P<0.05). Finally, an index system consisting of 20 first-level indices and 56 second-level indices was established. In terms of weight, among the first-level indices,"EPA1: Information Acquisition"had the highest weight (0.11), while"EPA12: Clinical Research"had the lowest (0.02). Among the second-level indices, "Medical History Taking" and "Physical Examination" under EPA1 had the highest weight (both 0.056), while "Healthcare for Patients with Severe Mental Illness" and "Healthcare for Disabled and Handicapped Populations" under EPA15 had the lowest (both 0.003). The 181 participants gave scores ranging from 4.49 to 4.92 for the importance of the 20 first-level indices and from 4.16 to 4.81 for their feasibility. Only for" EPA19: Common Diseases in Primary Care and Health Management", the feasibility score given by general practitioners from community hospitals was higher than that from general hospitals ( t=2.157, P=0.032); no statistically significant differences were observed among the groups for the other indices ( P>0.05).The interview results showed that general practitioners have a relatively high level of recognition for this system, but there is still room for improvement in its practical application.? Conclusions:The evaluation index system for rural order-oriented general practice residents constructed based on EPAs has high reliability, and it is consistently recognized by different types of general practitioners. It can provide a reference for the cultivation of post competency of this group.?

Ovarian immature teratoma is a relatively rare malignant ovarian tumor that predominantly occurs in children, adolescents, and young adults. In clinical diagnosis and treatment, tumor marker detection and imaging examinations serve as crucial bases for differentiating mature and immature terotomas. A comprehensive preoperative evaluation followed by the selection of an appropriate surgical approach and extent is key to improving prognosis. Some studies have indicated that for stage Ⅰ ovarian immature teratoma, avoiding adjuvant chemotherapy under close follow-up does not increase the risk of recurrence or affect long-term survival of patients; however, for advanced-stage ovarian immature teratoma, standardized postoperative chemotherapy is still recommended. Some patients may experience benign-malignant transformation of malignant germ cell components after surgery, such as growing teratoma syndrome or squamous cell carcinoma transformation. Due to the rarity of ovarian immature teratoma, current understanding of its pathogenesis and clinical management remains limited. This paper provides a review focusing on key clinical issues related to ovarian immature teratoma and proposes corresponding diagnostic and therapeutic recommendations, aiming to offer references for promoting multidisciplinary collaboration and individualized treatment.

Objective:To explore the application effect of BOPPPS teaching model in the teaching of Food Safety Supervision and Management course.Methods:Students of two parallel classes majoring in the Food Quality and Safety of the same grade of a university in Liaoning Province were selected,and the traditional teaching model and BOPPPS teaching model were used for teaching practice respectively.The scores,teaching effect and satisfaction of two groups were compared.Results:The regular performance and total scores of the experimental group were significantly higher than those of the control group(P＜0.05).In terms of enhancing students'interest in food safety supervision,improving knowledge and skills,cultivating self-directed learning and teamwork abilities,strengthening the close connection between the course and real cases,and providing assistance for future career,the experimental group performed significantly better than the control group(P＜0.05).Moreover,the satisfaction of the experimental group was higher than that of the control group(P＜0.05).Conclusion:BOPPPS teaching model has a remarkable effect in the teaching of Food Safety Supervision and Management course,providing an effective approach for the teaching reform of this course.

Objective: Our study was aimed to construct a predictive model to advance ovarian cancer diagnosis by machine learning. Methods: A retrospective analysis of patients with pelvic/adnexal/ovarian mass was performed. Potential features related to ovarian cancer were obtained as many as possible.The optimal machine learning algorithm was selected among six candidates through 5-fold cross validation. Top 20 features having the most powerful predictive significance were ranked by Shapley Additive Interpretation (Shap) method. Clinical validation was further performed to confirm whether our model could advance diagnosis of ovarian cancer. Results: A total of 9,799 patients were collected. The inclusion criteria included age >18 years old, the first diagnosis being pelvic/adnexal/ovarian mass of undetermined significance, and pathological report indispensable. Four hundred and thirty-eight dimensional features were obtained after filtration. LightGBM showed the best performance with accuracy 88%.Among the top 20 features, 55% belonged to laboratory test report, 35% came from imaging examination report, and 10% were attributed to basic demographics and main symptom.Age, CA125, and risk of ovarian malignancy algorithm were the top three. Our predictive model performed stably in testing and clinical validation datasets, and was found to advance the diagnosis of ovarian cancer about 17 days before clinical pathological examination. Conclusion LightGBM was the optimal algorithm for our predictive model with accuracy of 88%. Laboratory test and imaging examination played essential roles in diagnosing ovarian cancer. Our model could advance the diagnosis of ovarian cancer before clinical pathological examination.

Objective: To evaluate the efficacy and safety of adding toripalimab to bevacizumab and platinum-based chemotherapy as first-line treatment for refractory recurrent or metastatic (R/M) cervical cancer (CC). Methods: Patients were administered toripalimab (240 mg) + bevacizumab (7.5 mg/kg) combined with platinum-based chemotherapy once every three weeks for six cycles, followed by the maintenance therapy involving toripalimab + bevacizumab once every 3 weeks for 12 months or when disease progression or intolerable toxicity occurred. The primary endpoint was the objective response rate (ORR) per Response Evaluation Criteria in Solid Tumors version 1.1. The secondary endpoints were safety profiles, disease control rate (DCR), progression-free survival (PFS), and overall survival (OS). Results: Twenty-four patients were enrolled in this study and in the final analysis. The median follow-up duration was 18.6 (range, 3.3–28.5) months. The ORR was 83.3% (95% confidence interval [CI]=62.6–95.3) and the DCR was 95.8% (95% CI=78.9–99.9); 9 (37.5%) patients achieved complete response, 11 (45.8%) achieved partial response, and 3 (12.5%) had stable disease. The median PFS was 22.6 (95% CI=10.4–34.7) months and the median OS was not reached. The most common grade 3 treatment-related adverse events (AEs) were neutropenia (41.7%) and leukopenia (16.7%). The most common immune-related AEs (irAEs) were thyroid dysfunction (37.5%) and increased adrenocorticotropic hormone (37.5%) and serum cortisol levels (33.3%). No grade ≥3 irAEs were observed. Conclusion Toripalimab combined with bevacizumab and platinum-based chemotherapy show promising clinical efficacy and favorable safety profile, providing an alternative firstline treatment option for patients with R/M CC.

Objective: The study aimed to establish humanized patient-derived xenograft (PDX) mouse models of ovarian clear cell carcinoma (OCCC) and evaluate their therapeutic responses. Methods: PDX models and their humanized counterparts (CD34+ humanized PDX models) derived from the same tumor source were developed, and the therapeutic responses were compared between the models. Results: Treatment with a phosphatidylinositol 3-kinase (PI3K) inhibitor significantly reduced tumor size in traditional OCCC PDX models (p=0.021). Although differences in tumor growth between traditional PDX models and humanized PDX models were observed, they were not statistically significant (p=0.438). However, treatment effects of PI3K inhibitor differed significantly between conventional and humanized mice (p=0.006). In the Humanized PDX cohort, both programmed cell death protein-1 antibody monotherapy and PI3K inhibitor treatment slowed tumor growth relative to controls, with a synergistic effect noted during the latter part of the study, though these effects were not statistically significant. Conclusion This pioneering study successfully develop a humanized PDX model for OCCC, highlighting differential responses to treatments compared to conventional PDX models.

Objective To evaluate the intra-rater and inter-rater consistency of GRBAS and CAPE-V in Chi-nese context.Methods Five experts used the"Voice Assessment Assistant"APP to evaluate voice samples extrac-ted from The Sixth Medical Center of Chinese PLA General Hospital Pathological Voice Database V1.0.Fifty-two cases were used for inter-rater consistency analysis,and 38 cases were used for intra-rater consistency assessment.Intraclass correlation coefficient(ICC)was used for intra-rater and inter-rater consistency analysis of CAPE-V,while Cohen's Kappa method was applied for intra-rater consistency analysis of the five features of GRBAS.Inter-rater consistency analysis for GRBAS used Fleiss Kappa method,and Spearman's correlation analysis was conducted for the same features in both scales.Results The results of intra-rater consistency analysis showed that all six fea-tures of CAPE-V exhibited high consistency,with ICC coefficients of overall severity(OS)=0.80,roughness(R)=0.69,breathiness(B)=0.77,strain(S)=0.75,pitch(P)=0.74,and loudness(L)=0.78.For GRBAS,ex-cept for the features G(0.48)and S(0.45)which showed weaker intra-rater consistency,the rest of the features had poor intra-rater consistency.The results of inter-rater consistency analysis showed that the ICC correlation coef-ficients for all features of CAPE-V were greater than 0.85,indicating a high degree of consistency in the scoring of each feature by different raters.For GRBAS,except for the feature G(correlation coefficient=0.48),the rest of the features had correlation coefficients less than 0.40,indicating that the inter-rater consistency was poor for all features except G.When evaluating the same sample with both GRBAS and CAPE-V,the Spearman correlation co-efficients for the overall voice quality OS/G,roughness R,breathiness B,and strain S were 0.89,0.85,0.91,and 0.91,respectively,suggesting a high degree of correlation between the scoring results of the four features in the two scales.Conclusion In the auditory perceptual assessment of Chinese voice samples,the CAPE-V scale has higher intra-rater and inter-rater consistency compared to the GRBAS scale and is more suitable for clinical practice.