Objective: To provide evidence for improving emergency blood supply protocols by analyzing the clinical characteristics and disease distribution of emergency transfusion patients, especially those receiving≥10 units of red blood cells (RBCs). Methods: The data of 4 157 patients who urgently applied for large-volume blood transfusion in various hospitals in Shanghai from May 2024 to April 2025 were selected and analyzed statistically. Results: Tertiary gradeA hospitals accounted for the largest proportion of total transfusion volume (U) (48.79%, 8 420/17 256.5), with no statistically significant differences in RBC transfusion volumes among hospitals of different grades (P>0.05). All blood products are most widely used in tertiary hospitals. Obstetric blood transfusion (U)(19.07%, 3 277.5/17 190.5) was the most frequent. A-mong the hospitals of patients who received emergency blood transfusion with red blood cell suspension≥10 U, tertiary gradeA hospitals also had the largest transfusion volume (U)(47.19%, 1 107/2 346). In terms of disease types, the top three diseases in terms of blood transfusion volume (U) were obstetric transfusion (24.59%, 572/2 326), digestive diseases (14.53%, 338/2 326) and tumors (14.19%, 330/2 326). Conclusion: Tertiary grade A hospitals are the main demand units for emergency blood transfusion, with pregnant women and cancer patients being the core blood-using groups. It is suggested that the safety, timeliness and sufficiency of emergency blood transfusion be guaranteed by establishing a hierarchical blood supply mechanism, formulating single-disease blood transfusion plans and promoting precise blood transfusion guided by thromboelastography.

Objective To explore the potential causal relationship between 91 inflammatory factors and the risk of lung cancer (LC). Methods By extracting related data of inflammatory factors and LC and its subtypes from public databases of Genome-wide Association Studies (GWAS), bidirectional, repeated, multivariable Mendelian randomization (MR) and subgroup MR methods were used for analysis. The inverse variance weighted method was mainly used for causal inference, and a series of sensitivity analyses were applied to verify the strength of the results. Results Higher levels of CD5, interleukin-18 (IL-18), and oncostatin-M (OSM) were causally associated with a lower risk of LC, while nerve growth factor-β (NGF-β) and S100 calcium-binding protein A12 (S100A12) were associated with an increased risk of LC. Subgroup MR analysis results showed that IL-18 had a causal relationship with a reduced risk of lung adenocarcinoma, while NGF-β and S100A12 had a causal relationship with an increased risk of lung adenocarcinoma; CD5 and OSM had a causal relationship with a reduced risk of lung squamous cell carcinoma; NGF-β had a causal relationship with an increased risk of small cell lung cancer. Conclusion Five inflammatory factors, including CD5, IL-18, OSM, NGF-β, and S100A12 have a causal correlation with the risk of LC, providing potential targets for early screening of LC patients and development of therapeutic drugs.

OBJECTIVE: To analyze the clinical characteristics, treatment, and prognosis of seven pediatric patients with Acute myeloid leukemia (AML) positive for the t(16;21)(p11;q22) FUS::ERG fusion gene. METHODS: A retrospective analysis was carried out on the clinical data, treatment, and prognosis of seven AML patients with t(16;21)(p11;q22) FUS::ERG fusion gene admitted to Henan Children's Hospital between June 2015 and November 2024. Relevant literature was also reviewed. This study was approved by the Medical Ethics Committee of the Hospital (Ethics No.: 2024-102-001). RESULTS: Among 297 pediatric patients with AML, 7 cases (2.36%) were positive for the t(16;21)(p11;q22) FUS::ERG fusion gene, including 3 males and 4 females, with a median age of 11 years (range: 3 ~ 12 years). According to the FAB classification, these included 1 case of M2, 3 cases of M5, and 3 cases of AML-not otherwise specified (non-M3). All 7 patients were found to harbor the t(16;21)(p11;q22) translocation, with 3 cases showing additional chromosomal abnormalities. Immunophenotyping revealed universal expression of CD13, CD33, CD34, and CD117, with partial expression of CD56, CD4, CD64, CD123, CD15, CD38, CD11b, HLA-DR, cMPO, and CD16. One patient achieved complete remission (CR) after the first course of DAE (cytarabine + daunorubicin + etoposide) induction chemotherapy but relapsed and discontinued the treatment. Six patients received DAH (cytarabine + daunorubicin + homoharringtonine) induction therapy, of whom 2 achieved CR after two courses and underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT), resulting in an overall CR rate of 42.86%. Five children did not receive allo-HSCT and had a median overall survival of 9 months (range: 6 ~ 18 months). Two children who underwent transplantation achieved bone marrow morphological and molecular biological relapse at 6 and 9 months post-transplantation, respectively. After receiving combined chemotherapy and donor lymphocyte infusion, one child failed to achieve remission and died at 22 months post-transplantation, while the other has been followed up to date with positive fusion gene status. Their overall survival was 25 months and 30 months, respectively. CONCLUSION The t(16;21)(p11;q22) FUS::ERG fusion gene is rare in pediatric AML and associated with poor prognosis. Allo-HSCT may mitigate the adverse prognostic impact of the FUS::ERG fusion gene and contribute to prolonged survival.
Humans ; Male ; Child ; Female ; Leukemia, Myeloid, Acute/drug therapy* ; Oncogene Proteins, Fusion/genetics* ; Translocation, Genetic ; Retrospective Studies ; RNA-Binding Protein FUS/genetics* ; Chromosomes, Human, Pair 16/genetics* ; Adolescent ; Child, Preschool ; Chromosomes, Human, Pair 21/genetics* ; Prognosis ; Treatment Outcome

Postoperative cognitive dysfunction (POCD) is a clinically significant complication in elderly patients, largely driven by surgery-induced neuroinflammation. The cyclic GMP-AMP synthase-stimulator of interferon genes (cGAS-STING) pathway, a crucial regulator of innate immunity, has been implicated in neuroinflammatory activation. This study investigated whether electroacupuncture (EA) improves POCD by modulating this pathway in aged rats. Aged male Sprague-Dawley rats were subjected to sevoflurane anesthesia and splenectomy to establish a POCD model. Animals were divided into sham, POCD, POCD+EA, and POCD+EA+cGAS inhibitor groups. The EA groups received stimulation at Baihui (Governor Vessel 20 (GV20)), Neiguan (Pericardium 6 (PC6)), and Zusanli (Stomach 36 (ST36)) acupoints. Cognitive function was evaluated using the Morris water maze, while hippocampal expression of cGAS-STING pathway components and downstream effectors—interferon regulatory factor 3 (IRF3), nuclear factor kappa B (NF-κB), and interleukin-1 beta (IL-1β)—was assessed by Western blot. Cellular localization was determined by immunofluorescence staining. Compared with the Sham group, rats in the POCD group showed significant impairments in spatial memory, accompanied by upregulated protein expression of cGAS, STING, NF-κB, IRF3, and IL-1β in the hippocampus. Upon pathway activation, cGAS and STING proteins were predominantly co-localized with neurons, and their fluorescence intensity in the hippocampus was markedly increased. These behavioral deficits and molecular alterations were partially reversed in both the POCD+EA and POCD+EA+inhibitor groups. Electroacupuncture alleviates POCD in aged rats by inhibiting hippocampal cGAS-STING pathway activation and reducing neuroinflammation, suggesting a promising non-pharmacological strategy for POCD management.

The surgical management of empyema (excluding those caused by mycobacterium tuberculosis and non-tuberculous mycobacteria) is rapidly evolving towards minimally invasive, precise, and stepwise approaches. The traditional three-stage classification (exudative, fibrinopurulent, and organizing) has limitations in guiding dynamic clinical decision-making. For the first time, this consensus explicitly identifies two critical junctures in the pathological progression of empyema: "early transformation" (stage Ⅰ to Ⅱ) and "late transformation" (stage Ⅱ to Ⅲ), and thereby constructs a corresponding "identification-early warning-intervention" stepwise therapeutic framework. The consensus emphasizes that proactive debridement via video-assisted thoracoscopic surgery should be performed during the early transformation phase to halt disease progression. Conversely, during the late transformation phase, therapeutic goals should be rationally adjusted to prioritize adequate drainage, avoiding futile pleural decortication. Moreover, the consensus underscores the pivotal role of precise perioperative etiological diagnosis (e.g. metagenomic nest-generation sequencing) and standardized anti-infective therapy. Integrating practical experiences from multiple thoracic surgery centers in China and relevant evidence-based literature, this consensus formulates recommendations on the precise definitions of staging, surgical indications for each phase, key technical points, perioperative management, and training systems. It aims to promote the standardized and individualized surgical management of empyema, ultimately optimizing patient prognosis.

Orthokeratology is an effective intervention for myopia control in adolescents,and the precision of lens fitting and the efficacy of follow-up monitoring directly influence treatment outcomes.The conventional fitting process depends largely on physicians' subjective experience,which leads to bottlenecks such as poor consistency in lens fitting and insufficient quantitative evaluation of therapeutic effects.In recent years,artificial intelligence has achieved groundbreaking progress in the field of medical image analysis,offering new options for the fitting of orthokeratology lenses.This article reviews the application and research advances of machine learning in orthokeratology lens fitting as reported in recent publications indexed in PubMed and Web of Science,aiming to provide a reference for future research.

OBJECTIVE To analyze a strain of multidrug-resistant Pseudomonas fulva by whole genome sequencing,investigate the genomic characteristics and analyze the significance in phyletic evolution.METHODS A strain of P.fulva,NY4814,was isolated from the Chinese PLA General Hospital in 2014.The genome sequence data of the strain were obtained after the purification,preservation and whole genome sequencing.The specie of the strain was identified by comparing with average nucleotide identity(ANI);the minimum inhibitory concentra-tions(MIC)of the strains were determined by VITEK2 system.All of the data regarding to the genomic se-quences of P.fulva were downloaded from RefSeq database of National Center of Biotechnology Information(NCBI)to construct the phylogenetic tree.RESULTS The P.fulva NY4814 was resistant to carbapenems and quinolones.The chromosome carried a newly discovered Tn7675 unit transposon,which mediated resistance to aminoglycosides and chloramphenicol.Simultaneously,the plasmid pNY4814-IMP drove the wide dissemination of the blaIMP resistance gene across Pseudomonas species via a highly conserved conjugative and transfer mechanism,and the Tn6485i unit transposon carried by the chromosome mediated the resistance to β-lactams.CONCLUSIONS As one of the potential carriers for the transmission of carbapenems resistance genes and other types of drug re-sistance genes,the P.fulva leads to the infection as a seldom opportunistic pathogen.The genetic structure of NY4814 and its association with genetic evolution of the species are observed in the study,which intensify the un-derstanding of the species and provide theoretical bases for prevention and monitoring of bacterial infections.

Objective:To investigate the clinical effect of near-infrared autofluorescence (NIRAF) imaging combined with nano-carbon in the identification of parathyroid gland.Methods:A total of 80 patients with thyroid cancer requiring bilateral thyroidectomy plus single/bilateral central area lymphatic dissection were prospectively enrolled in the Department of Thyroid and Breast Surgery of the Shenzhen Third People′s Hospital from January 2020 to June 2023. Two groups were divided in order of time of admission. In the combined group (40 cases), the parathyroid glands were identified by NIRAF+ nano-carbon negative imaging. The nano-carbon group (40 cases) was negatively developed with nano-carbon alone. The detection rate and accuracy of parathyroid gland and the changes of parathyroid hormone (1 d and 6 months after operation) were compared between the two groups.Results:There was no significant difference in the detection rate of parathyroid glands between the two groups ( P=0.65), and the accuracy rate in the combined group was higher than that in the nano-carbon group, the difference was statistically significant (χ 2=8.79, P=0.003). The level of parathyroid hormone in the combined group was higher than that in the nano-carbon group 1 day after surgery, and the difference was statistically significant ( Z=-1.19, P=0.03). There was no significant difference in parathyroid hormone levels between the two groups 6 months after operation ( P=0.18). Conclusions:NIRAF imaging combined with nano-carbon negative imaging can improve the accuracy of intraoperative parathyroid identification, and may reduce the incidence of temporary postoperative hypoparathyroidism.

Aim To investigate the effects of edaravone(EDA)on depression-like behaviors in a rat model of post-stroke depression(PSD)and to explore the un-derlying mechanisms.Methods SD rats were ran-domly divided into:sham operation group(Sham),cerebral ischemia group(CI),post-stroke depression(PSD),fluoxetine(10 mg·kg-1)group,and EDA(5,15 mg·kg-1)group.A PSD rat model was estab-lished using the suture method combined with 56 d of chronic unpredictable mild stimulation.Drug treatment was given once daily for 28 d after stimulation.Body weight and sucrose water preference were measured during the stimulation period,and serum TNF-α,IL-1 β,IL-6,MDA,SOD levels,and hippocampal tissue HO-1 and GPX4 protein expression were detected at the end of stimulation.Results Compared with the sham group,the rat neurological function scores of the remaining groups increased(P＜0.01).Compared with the PSD group,EDA increased the body weight and sucrose water preference of the rats(P＜0.01),significantly decreased the serum TNF-α,IL-1β and IL-6 levels,decreased the MDA level,increased the SOD level(P＜0.01),and up-regulated hippocampal HO-1 and GPX4 protein expression(P＜0.01).Con-clusions EDA improves depression-like behaviors and inhibits peripheral inflammation and oxidative stress in-jury in PSD rats,and its mechanism may be related to the activation of HO-1/GPX4 pathway to inhibit oxida-tive stress.

Objective To explore the impacts of different surgical methods under hysteroscopy on the surgical time and endometrial thickness of patients with endometrial polyp(EP).Methods 180 patients with EP from April 2021 to April 2023 were regarded as the subjects.They were separated into group A,group B,and group C according to surgical methods,with 60 cases in each.Group A underwent hysteroscopic resection,group B underwent hysteroscopic cold knife surgery,and group C underwent hysteroscopic curettage surgery.The pictorial blood loss assessment chart(PBAC)score before and after treatment,endometrial lesion,intraoperative bleeding volume,hospitalization time,surgical time,hospitalization cost,clinical efficacy,complications,pregnancy rate and recurrence rate were compared.Results The intraoperative bleeding volume in group C was obviously less than that in group A and group B,hospitalization time,and surgical time were obviously shorter than those in group A and group B,and the hospitalization cost was obviously higher than that in group A and group B,the differences were statistically significant(P<0.05).The PBAC score in groups C was obviously less than that in group A and group B,the endometrial thickness was obviously smaller than that in group A and group B,the differences were statistically significant(P<0.05).The clinical efficacy of group A was obviously lower than that of group B and group C,the differences were statistically significant(P<0.05),and there was no statistically obvious difference between group B and group C(P>0.05).The complication rate in group C and group B were obviously less than that in group A(P<0.05),and there was no statistically obvious difference between group B and group C(P>0.05).The recurrence rate within 12 months in three groups was not statistically significant(P>0.05).The pregnancy rate in group C was obviously higher than that in group B and group A,and group B was higher than group A,the differences were statistically significant(P<0.05).Conclusion Hysteroscopic curettage is more effective in clearing lesions,shortening surgical time,reducing intraoperative bleeding,lowering endometrial thickness,and promoting menstrual recovery in patients compared to other hysteroscopic surgical methods,with high safety.