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.

Objective:To compare the safety and accuracy between robotic-assisted screw placement and free-hand screw placement in adolescent idiopathic scoliosis (AIS) surgery.Methods:The clinical data of 69 AIS patients underwent posterior spinal scoliosis orthomorphia from December 2021 to October 2023 in Beijing Chaoyang Hospital, Capital Medical University were retrospectively analyzed. Among them, 37 patients underwent robot-assisted screw placement (robot group), and 32 patients underwent fluoroscopy-assisted free-hand screw placement (free-hand group). The basic information of surgery (operation time, intraoperative blood loss, intraoperative radiation exposure time, postoperative hospital stay and postoperative complications), screw placement indexes (single screw placement time and accuracy of screw placement) and imaging indexes (main curve correction rate, kyphotic change and lumbar lordosis change) were compared between two groups. The ln curve regression analysis method was used to evaluate the learning curve of robot-assisted screw placement therapy for AIS.Results:A total of 716 screws were placed in 32 patients of free-hand group, and 766 screws in 37 patients of robot group. The operation time, intraoperative radiation exposure time, single screw placement time and accuracy of screw placement in robot group were significantly higher than those in free-hand group: (272.30 ± 67.98) min vs. (221.66 ± 67.32) min, (149.81 ± 57.21) s vs. (116.03 ± 63.10) s, (497.97 ± 51.74) s vs. (381.47 ± 46.58) s and 97.91% (750/766) vs. 91.48% (655/716), and there were statistical differences ( P<0.01 or <0.05); there were no statistical differences in intraoperative blood loss, postoperative hospital stay, incidence of neurological complications, incidence of incision infection and number of screw between two groups ( P>0.05). There were no statistical differences in the main curve correction rate, kyphotic change and lumbar lordosis change between two groups ( P>0.05). When the fitting degree was the highest ( R2 = 0.729, P<0.01), the fitting equation was y = - 50.93ln x + 634.7 ( x was the number of operation, and y was the single screw placement time), and the number of vertices was 12 cases. The robot group was divided into three subgroups according to the order of surgery, subgroup A consisted of 12 patients who underwent the surgery from first to twelfth, subgroup B consisted of 12 patients who underwent the surgery from thirteenth to twenty-fourth, and subgroup C consisted of 13 patients who underwent the surgery from twenty-fifth to thirty-seventh. Among them, the single screw placement time in subgroup A was significantly longer than that in subgroup B and subgroup C: (560.92 ± 35.03) s vs. (465.75 ± 21.20) and (469.62 ± 24.94) s, and there was statistical difference ( P<0.05); there was no statistical difference between subgroup B and subgroup C ( P>0.05). Conclusions:Robot-assisted screw placement for AIS can effectively improve the accuracy of screw placement without affecting deformity correction, but it can increase screw placement time, operation time and radiation exposure time. A smooth learning curve is obtained after performing 12 procedures.

Objective To explore the scheme for the deployment and withdrawal of the surgical module of the new-type tent hospital system.Methods A set of standardized scheme for deploying and withdrawing the surgical module of the new-type tent hosital system was proposed and implemented in terms of labor division,operation precedure,operation technique and precaution.The operating time,number of operational errors and number of equipment damages were recorded for each of the five deployment and withdrawal operations before and after the program was executed,and the team members'immediate heart rate,percentage of maximum heart rate(MHR)and rating of perceived exercise(RPE)at the end of the operation were recorded after the program was implemented.SPSS 26.0 software was used for statistical analysis.Results The standardized scheme had the deployment time shortened from(85.15±11.430)min to(58.23±8.513)min,withdrawal time decreased from(65.36±9.369)min to(48.92±7.129)min,with the differences being statistically significant(P＜0.05);the numbers of operatio-nal errors and equipment damages were both reduced when compared with those before the implementation of the schemce;the immediate heart rate of the team members at the end of the operation ranged from 43 to 157 beats/min,with an average value of 151.1 beats/min,the individual MHR percentages were from 75％to 87％,with an average value of 81.1％,and the RPE scores were from 14 to 17,with an average value of 15.3,which all could be categorized as moderate-operation intensity.Condusion The standardized deployment and withdrawal scheme for the surgical module meets the needs of actual combat and training assessment,and thus is worthy promoting in medical institutions equipped with the surgical module of the new-type tent hosital system.[Chinese Medical Equipment Journal,2025,46(2):74-79]

Objective To investigate the relationship between deep medullary vein(DMV)score and enlarged perivascular space(EPVS)score with cranial MRI to explore the mechanisms of EPVS occurrence and development.Methods Totally 118 patients with cerebral small vessel disease in some hospital had their clinical and imaging data analyzed retrospectively.On T2-weighted images,EPVS scores ranging from 0 to 4 were assigned to the basal ganglia and centrum semiovale regions based on the number of EPVS.For DMV scoring on magnetic susceptibility weighted images,the brain lobes were divided into six regions,including bilateral frontal,parietal and occipital lobes,and scored according to the significance and continuity of the DMV signals(0 to 3 points),and the scores of the regions were summed up as the total DMV score(0 to 18 points).Spearman correlation analysis was employed to investigate the correlation between DMV and EPVS scores.Kruskal-Wallis test was used to analyze the differences among groups with different EPVS scores.Additionally,multinomial ordinal regression analysis was conducted to explore the factors influencing EPVS.Results No significant correlation was found between EPVS scores in centrum semiovale and DMV scores(r2=0.015,P=0.191),while DMV scores and EPVS scores in basal ganglia showed a significant positive correlation(r2=0.558,P<0.000 1).Univariate analysis revealed statisti-cally significant differences in age,hypertension and DMV scores when different scoring groups of EPVS in the basal ganglia region were compared(P<0.05);multinomial ordinal regression analysis showed that age,hypertension and DMV scores were independently correlated with EPVS scores in the basal ganglia region.Conclusion There is a positive correlation between DMV scores and EPVS scores in the basal ganglia.Age,hypertension,and DMV score are independent influe-ncing factors for EPVS in the basal ganglia region.[Chinese Medical Equipment Journal,2025,46(4):52-56]

Objective To develop an objective and precise prognostic model for assessing severity and prognosis in elderly patients with community-acquired pneumonia(CAP)admitted to the emergency department.Methods A retrospective analysis was conducted on elderly patients with CAP admitted to Department of Emergency,Minhang Hospital,Fudan University between Jun 2018 and Dec 2020.With the primary outcome being the 30-day in-hospital mortality rate of elderly CAP patients,four systemic inflammatory response markers,including the neutrophil-to-lymphocyte ratio(NLR),monocyte-to-lymphocyte ratio(MLR),platelet-to-lymphocyte ratio(PLR),and systemic immune-inflammation index(SII)were evaluated using univariate and multivariate Logistic regression analyses.The predictive performance of different scoring systems was compared.Results A total of 421 elderly CAP cases were enrolled.The results of the multivariate Logistic regression analysis demonstrated that NLR was an independent risk factor for elderly inpatients with CAP.We combined NLR with the existing CURB-65 score for joint optimization to construct a scoring system or a clinical prognosis model,by quantifying and assigning optimal cut-off value of 11.4 for NLR,and established the NLR+CURB-65 score.The ROC curve was constructed to compare the areas under the curve of the three different scoring systems(NLR,CURB-65,and NLR+CURB-65).The area under the curve of the NLR+CURB-65 score was significantly higher than that of the CURB-65 score.Based on the optimal cut-off value of 3 for NLR+CURB-65 score,the patients were stratified into high-risk group(n=188)and low-risk group(n=233).The K-M survival curve was utilized and indicated that compared with high-risk group,low-risk group had a lower mortality rate and a higher discharge rate.Conclusion For elderly emergency hospitalized patients with CAP,the combination of NLR and CURB-65 score showed high predictive value for assessing disease severity and prognosis.

Objective To investigate the types and mechanisms of microglial cell death induced by interaction between palmitic acid(PA)and lipopolysaccharide(LPS).Methods BV-2 microglial cells were divided into three groups for apoptosis research,BSA group,PA treatment group,and staurosporine(STA)group.They were further divided into four groups for necrosis research,BSA group,BSA+inhibitor group,PA group,and PA+inhibitor group.Western blotting was conducted to assess the expression levels of key proteins involved in apoptosis and necrosis pathways.The effect of PA on microglial cells was validated through feeding a high-fat diet to Institute of Cancer Research(ICR)mice.Results Apoptotic microglia were observed in both BSA group and PA group,PA significantly induced the activation of caspase-3,caspase-7,and poly ADP-ribose polymerase(PARP).However,compared to the BSA group,the level of activated Caspase-7 in the STA group did not change significantly.Inhibition of ferroptosis,necroptosis,or autophagy did not protect against PA-induced cell damage,while the Caspase-11 inhibitor,wedelolactone(WE),significantly improved PA induced cell damage.This study also found that PA could promote LPS entry into microglial cells and induce pyroptosis.This phenomenon and the protective effect of WE were further confirmed in a high-fat diet mouse model through immunofluorescent staining and Western blotting.Conclusion PA induces apoptosis and pyroptosis in microglial cells,while simultaneously promoting LPS entry into microglial cells and inducing pyroptosis.

Objective To analyze the development trends,research status,and hotspots in the field of gut microbiota and cognitive dysfunction from 2015 to 2025,providing a more comprehensive reference for researchers in this field and exploring cutting-edge research directions.Methods Liter-ature in relevant research fields was retrieved from the WoSCC database.Bibliometric and visualiza-tion analyses were conducted using VOSviewer,CiteSpace,ScimangoGraphica,and the R package"bibliometrix".Results A total of 665 eligible English articles were retrieved from the WoSCC data-base.The analysis revealed that the number of publications has shown an increasing trend annually since 2018.China and the United States had the leading roles globally in terms of the number of pub-lications and collaborative relationships.Huazhong University of Science and Technology are the most influential research institution in this field,with NUTRIENTS(IF=4.8)being the journal with the highest number of publications,and KIM D H ranking first in outstanding contributions and influ-ence.Keyword co-occurrence analysis indicated that"neuronal apoptosis","SCFAs","synaptic dysfunction",and"dementia prevention"were the research hotspots in this field.Furthermore,trend analysis revealed that short-chain fatty acids(SCFAs),important metabolites of gut microbiota,insulin resistance,and neuroinflammation were the research frontiers in this field,highlighting insulin resistance as a mediating hub in microbiota-cognition research.Additionally,traditional Chinese medicine interventions(such as electroacupuncture)were identified as an emerging characteristic direction in this field.Conclusion Through bibliometric research,the current status and develop-ment trends of gut microbiota and cognitive dysfunction research are analyzed from multiple perspec-tives in the paper.Comprehensive insights into the cutting-edge dynamics of this research field are provided,offering valuable references for further in-depth research by more scholars in this area.

Objective To investigate the dosimetric differences in preoperative short-course volumetric modulated arc therapy(VMAT)for rectal cancer using different fluence smoothing(FS)levels in the Monaco Treatment Planning System(Monaco TPS).Methods Twenty rectal cancer patients who received preoperative neoadjuvant short-course VMAT at some hospital from September 2021 to December 2022 were retrospectively selected.Four groups of radiotherapy plans were formulated using the Monaco TPS for each case,which were classified into an off group,a low group,a medium group and a high group based on the FS levels.Then the four groups were compared in terms of the dosimetric parameters,monitor unit and number of the segments in the planning target volume(PTV)and organ at risk(OAR).Statistical analysis was performed using SPSS 27.0 software.Results All the four groups had the doses to the target volume meeting clinical requirements,which had no significant differences in the doses to 5％(D5％)and 95％(D95％)to the target volume and the maximum dose(Dmax),minimum dose(Dmin),mean dose(Dmean)and conformity index(all P＞0.05).Statistical differences were found between the homogeneity indexes of the four groups(P＜0.05),with the medium group behaving the best.The number of the segments rose while the mornitor units decreased siginificantly with the increase of FS levels,with the differences being statistically significant(P＜0.05).There were no significant differences between the V25,V20,V15 and V10 of the small intestine,the V25 and V20 of the bladder and the V15 and V10 of the left and right femur(all P＞0.05).Conclusion In preoperative short-course VMAT for rectal cancer,clinical requirements can be met with different FS levels in the Monaco TPS,and medium-level FS results in optimal overall dose distribution in terms of treatment planning.[Chinese Medical Equipment Journal,2025,46(5):48-53]

Rheumatoid arthritis(RA)is a chronic autoimmune disease of unknown etiology that can cause joint destruction and deformity.As a small molecule cytokine,the chemokine C-X-C motif chemokine ligand 12(CXCL12)regulates the pathogenesis of rheumatoid arthritis by binding to the specific receptor CXC chemokine receptor 4(CXCR4).Therefore,based on the bio-logical characteristics of CXCL12 and CXCR4,this paper intro-duces the pathogenesis of CXCL12/CXCR4 in RA and summari-zes the progress in RA-related research,with the aim of providing clinical value for understanding the pathogenesis of RA and de-veloping novel therapeutic targets.

Objective To investigate the relationship between deep medullary vein(DMV)score and enlarged perivascular space(EPVS)score with cranial MRI to explore the mechanisms of EPVS occurrence and development.Methods Totally 118 patients with cerebral small vessel disease in some hospital had their clinical and imaging data analyzed retrospectively.On T2-weighted images,EPVS scores ranging from 0 to 4 were assigned to the basal ganglia and centrum semiovale regions based on the number of EPVS.For DMV scoring on magnetic susceptibility weighted images,the brain lobes were divided into six regions,including bilateral frontal,parietal and occipital lobes,and scored according to the significance and continuity of the DMV signals(0 to 3 points),and the scores of the regions were summed up as the total DMV score(0 to 18 points).Spearman correlation analysis was employed to investigate the correlation between DMV and EPVS scores.Kruskal-Wallis test was used to analyze the differences among groups with different EPVS scores.Additionally,multinomial ordinal regression analysis was conducted to explore the factors influencing EPVS.Results No significant correlation was found between EPVS scores in centrum semiovale and DMV scores(r2=0.015,P=0.191),while DMV scores and EPVS scores in basal ganglia showed a significant positive correlation(r2=0.558,P<0.000 1).Univariate analysis revealed statisti-cally significant differences in age,hypertension and DMV scores when different scoring groups of EPVS in the basal ganglia region were compared(P<0.05);multinomial ordinal regression analysis showed that age,hypertension and DMV scores were independently correlated with EPVS scores in the basal ganglia region.Conclusion There is a positive correlation between DMV scores and EPVS scores in the basal ganglia.Age,hypertension,and DMV score are independent influe-ncing factors for EPVS in the basal ganglia region.[Chinese Medical Equipment Journal,2025,46(4):52-56]