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.

Purpose: Due to the preservation of the entire stomach after endoscopic resection, the occurrence of metachronous gastric cancer (MGC) remains a possibility. In this study, we investigated the incidence and risk factors for MGC in patients with early gastric cancer who underwent endoscopic submucosal dissection (ESD) and successfully eradicatedHelicobacter pylori. Materials and Methods: A retrospective analysis was conducted of 1,191 patients who underwent ESD and successfully eradicated H. pylori at the Affiliated Drum Tower Hospital of Nanjing University. Endoscopic surveillance was performed at 3, 6, and 12 months post-resection, and annually thereafter. MGC was defined as the development of a new cancer at a site other than the primary gastric cancer site, at least 1 year after the initial endoscopic resection. Results: A total of 77 patients were diagnosed with MGC during a median follow-up of 41.5 months. Kaplan-Meier analysis showed a 5-year cumulative incidence of MGC of 9.4% after successful H. pylori eradication. Multivariate analysis of the training set using Cox proportional hazards models identified male sex, severe atrophic gastritis, multiple gastric cancers before H. pylori eradication, and smoking history as independent risk factors for MGC.The nomogram exhibited favorable discrimination, with area under the curves of 0.767 and 0.822 in the training set and 0.724 and 0.745 in the testing set at 3 and 5 years, respectively. Conclusions Patients with gastric cancer who undergo endoscopic resection, even after successful H. pylori eradication, should undergo annual and continuous endoscopic surveillance for MGC.

The core pathogenesis of pediatric IgA vasculitis （IgAV） is considered to involve qi movement disorder， with the failure of clear-turbid separation and internal generation of turbid pathogens. Accordingly， the viewpoint of "qi disorder causing turbidity" is proposed. In clinical practice， the disease is divided into the acute， persistent， and stable stages. The acute stage is characterized by impaired dispersion of wei （卫） qi and the internal generation of heat turbidity， while the persistent stage by congestion of ying （营） qi and retention of stasis-turbidity， and the stable stage by depletion of pectoral qi with lingering latent turbidity. In clinical practice， regulating qi and transforming turbidity is taken as the basic therapeutic principle， and the self-formulated Tiaoqi Huazhuo Decoction （调气化浊汤） is used as the basic prescription for staged treatment with flexible modifications. Specifically， the acute stage is treated with the method of dispersing wei qi and clearing heat-turbidity； the persistent stage is recommended to harmonize ying qi and purging stasis-turbidity； and the stable stage should focus on securing pectoral qi and venting latent turbidity.

Objective To investigate the effects of modified Zhujing Pill(ZJP)-medicated serum on mitochondrial autophagy and related proteins in a pressure-induced retinal ganglion cell(RGC)injury model in rats.Methods The modified ZJP-medicated serum and blank serum were prepared by the intragastric administration of modified ZJP(10 mL·kg-1)to 10 male Sprague-Dawley(SD)rats and equivalent normal saline to another 10 male SD rats.The RGC injury models of rats were constructed under the in vitro pressure of 0 mmHg,20 mmHg,40 mmHg,60 mmHg,and 80 mmHg(1 kPa=7.5 mmHg),respectively.According to the pressurization experiment results,the RGC injury model established under the in vitro pressure of 80 mmHg was selected for subsequent experiments.The RGCs of rats were divided into the normal group(NG group,untreated RGCs),model group(MG group,injured RGCs without serum intervention),blank serum group(KB group,injured RGCs treated with blank serum),and modified ZJP-medicated serum group(LVP group,injured RGCs treated with modified ZJP-medicated serum).The apoptosis of RGCs was detected by flow cytometry;the mitochondrial ultrastructure was observed via transmission electron microscopy;the protein expression level of PINK1,Parkin,LC3 Ⅱ/Ⅰ,and p62 was measured by Western blotting.Results Transmission electron microscopy revealed the in-tact double-membrane structure of mitochondria and evenly distributed mitochondrial crista in the NG group,while the MG and KB groups exhibited disrupted mitochondrial membranes,accompanied by a large number of vacuoles in the mitochon-dria.The mitochondria of the LVP group had a double-membrane structure and the vacuoles in the mitochondria decreased compared with those of the MG and KB groups,and the mitochondrial morphology was basically the same as that of the NG group.The flow cytometry results demonstrated the apoptosis rate of RGCs was(4.25±0.55)％,(20.79±3.06)％,(30.07±3.23)％,and(11.42±0.16)％in the NG,MG,KB,and LVP groups,respectively.Compared with the NG group,the ap-optosis rate of RGCs in rats increased in the MG group,and the difference was statistically significant(P＜0.01).Com-pared with the MG and KB groups,the apoptosis rate of RGCs in rats decreased in the LVP group,and the difference was statistically significant(both P＜0.05).The Western blotting results indicated that the MG group had an increased relative protein expression level of PINK1,Parkin,and LC3 Ⅱ/Ⅰ but a decreased relative protein expression level of p62 compared with the NG group,and the difference was statistically significant(all P＜0.01).Compared with the MG and KB groups,the LVP group had a decreased relative protein expression level of PINK1,Parkin,and LC3 Ⅱ/Ⅰ but an increased relative protein expression level of p62,and the difference was statistically significant(all P＜0.05).Conclusion The modified ZJP-medicated serum may protect RGCs by suppressing pressure-induced mitochondrial autophagy in vitro of rat RGCs via modulating PINK1/Parkin-mediated mitochondrial autophagy.

Objective To investigate the effects of modified Zhujing Pill(ZJP)-medicated serum on mitochondrial autophagy and related proteins in a pressure-induced retinal ganglion cell(RGC)injury model in rats.Methods The modified ZJP-medicated serum and blank serum were prepared by the intragastric administration of modified ZJP(10 mL·kg-1)to 10 male Sprague-Dawley(SD)rats and equivalent normal saline to another 10 male SD rats.The RGC injury models of rats were constructed under the in vitro pressure of 0 mmHg,20 mmHg,40 mmHg,60 mmHg,and 80 mmHg(1 kPa=7.5 mmHg),respectively.According to the pressurization experiment results,the RGC injury model established under the in vitro pressure of 80 mmHg was selected for subsequent experiments.The RGCs of rats were divided into the normal group(NG group,untreated RGCs),model group(MG group,injured RGCs without serum intervention),blank serum group(KB group,injured RGCs treated with blank serum),and modified ZJP-medicated serum group(LVP group,injured RGCs treated with modified ZJP-medicated serum).The apoptosis of RGCs was detected by flow cytometry;the mitochondrial ultrastructure was observed via transmission electron microscopy;the protein expression level of PINK1,Parkin,LC3 Ⅱ/Ⅰ,and p62 was measured by Western blotting.Results Transmission electron microscopy revealed the in-tact double-membrane structure of mitochondria and evenly distributed mitochondrial crista in the NG group,while the MG and KB groups exhibited disrupted mitochondrial membranes,accompanied by a large number of vacuoles in the mitochon-dria.The mitochondria of the LVP group had a double-membrane structure and the vacuoles in the mitochondria decreased compared with those of the MG and KB groups,and the mitochondrial morphology was basically the same as that of the NG group.The flow cytometry results demonstrated the apoptosis rate of RGCs was(4.25±0.55)％,(20.79±3.06)％,(30.07±3.23)％,and(11.42±0.16)％in the NG,MG,KB,and LVP groups,respectively.Compared with the NG group,the ap-optosis rate of RGCs in rats increased in the MG group,and the difference was statistically significant(P＜0.01).Com-pared with the MG and KB groups,the apoptosis rate of RGCs in rats decreased in the LVP group,and the difference was statistically significant(both P＜0.05).The Western blotting results indicated that the MG group had an increased relative protein expression level of PINK1,Parkin,and LC3 Ⅱ/Ⅰ but a decreased relative protein expression level of p62 compared with the NG group,and the difference was statistically significant(all P＜0.01).Compared with the MG and KB groups,the LVP group had a decreased relative protein expression level of PINK1,Parkin,and LC3 Ⅱ/Ⅰ but an increased relative protein expression level of p62,and the difference was statistically significant(all P＜0.05).Conclusion The modified ZJP-medicated serum may protect RGCs by suppressing pressure-induced mitochondrial autophagy in vitro of rat RGCs via modulating PINK1/Parkin-mediated mitochondrial autophagy.

Objective:To analyze the factors influencing the prognoses of stroke survivors with pseudobulbar palsy (PBP) dysphagia and construct a prediction model.Methods:Data on two hundred and fifty-one stroke survivors with PBP dysphagia were collected and analyzed retrospectively. The subjects were divided into a good prognosis group ( n=164) and a poor prognosis group ( n=87) according to the results of Kubota water swallowing tests administered at discharge. Their clinical data were analyzed using univariate correlation analysis, and the statistically significant independent variables found were further analyzed using multivariate logistic regression to obtain the important predictors of prognosis. R software was then used to assemble the useful factors into a nomogram prediction model. The area under the receiver operating characteristics (ROC) curve was employed to verify the model′s predictive power. Results:According to the univariate correlation analysis, significant differences were found between the two groups′ average National Institutes of Health Stroke Scale (NIHSS) scores, mouth opening grades and ages. The multivariate logistic regression analysis showed that NIHSS score, mouth opening grade and age could be useful and independent predictors of poor prognosis. The ROC curve analysis showed that the area under the curve for the nomogram model was 0.727, with a sensitivity of 59.8% and a specificity of 81.6%, suggesting that the model had good predictive power and was properly calibrated.Conclusions:NIHSS score, mouth opening grade and age are independent predictors of prognosis for stroke patients with PBP dysphagia. The nomogram model constructed in this study is of great value in developing a prognosis for such patients, which is helpful in the prevention and treatment of post-stroke dysphagia.

Objective:To analyze the factors influencing the prognoses of stroke survivors with pseudobulbar palsy (PBP) dysphagia and construct a prediction model.Methods:Data on two hundred and fifty-one stroke survivors with PBP dysphagia were collected and analyzed retrospectively. The subjects were divided into a good prognosis group ( n=164) and a poor prognosis group ( n=87) according to the results of Kubota water swallowing tests administered at discharge. Their clinical data were analyzed using univariate correlation analysis, and the statistically significant independent variables found were further analyzed using multivariate logistic regression to obtain the important predictors of prognosis. R software was then used to assemble the useful factors into a nomogram prediction model. The area under the receiver operating characteristics (ROC) curve was employed to verify the model′s predictive power. Results:According to the univariate correlation analysis, significant differences were found between the two groups′ average National Institutes of Health Stroke Scale (NIHSS) scores, mouth opening grades and ages. The multivariate logistic regression analysis showed that NIHSS score, mouth opening grade and age could be useful and independent predictors of poor prognosis. The ROC curve analysis showed that the area under the curve for the nomogram model was 0.727, with a sensitivity of 59.8% and a specificity of 81.6%, suggesting that the model had good predictive power and was properly calibrated.Conclusions:NIHSS score, mouth opening grade and age are independent predictors of prognosis for stroke patients with PBP dysphagia. The nomogram model constructed in this study is of great value in developing a prognosis for such patients, which is helpful in the prevention and treatment of post-stroke dysphagia.

The corona virus disease 2019(COVID-19)infection has assumed global pandemic status in a short period of time since its outbreak.This public health crisis has inflicted unprecedented damage and challenges to more than 200 countries and regions around the word.As the peak of the epidemic gradually subsides,an increasing amount of attention has been shifted to the issue of long-term sequelae in COVID-19 patients.These sequelae are manifested as the continuous dysfunction of multiple organ systems and are known as Long COVID.In response to this new issue,clinical pathological research has continuously made new progress,posing new requirements and challenges for the pre-vention and treatment of Long COVID.This article aims to review the progress of clinical pathological research on Long COVID in recent years,with the expectation of providing new ideas and methods for the prevention and treatment of this disease.

Post-traumatic stress disorder(PTSD)is a severe mental disorder that significantly impacts an indi-vidual's health,with its primary symptom being fear-based memories.In the pathological state of PTSD,fear-based memo-ries are prolonged and intensified by certain physiological mechanisms.Therefore,expediting the extinction of fear-based memories and preventing their excessive consolidation are crucial for successful treatment.Recently,researchers have dis-covered that ketamine,beyond its role as an anesthetic,also plays a substantial part in regulating fear-based memories.This paper aims to elucidate the role of ketamine in modulating conditioned fear-based memories across various time frames and brain regions,as well as the associated molecular mechanisms.Furthermore,it seeks to clarify the specificity of dif-ferent molecular mechanisms in distinct time frames of fear-based memories and assess whether ketamine could be a prima-ry medication for treating PTSD.