Objective: To investigate the genetic basis of RhD-negative phenotype in the blood donor population of Nantong City. Methods: RHD genotyping was performed on 386 randomly selected RhD-negative donor samples (from a total of 676 RhD-negative donors identified between January 20, 2023, and June 28, 2024) using polymerase chain reaction (PCR), and the inconclusive results were confirmed by nucleotide sequencing. Results: Ten RHD allele types were identified: The complete deletion variant RHD 01N.01 was predominant (64.25%, 248/386); followed by RHD 01EL.01 (19.69%, 76/386). RHD 01N.03, RHD 01N.04, RHD 01N.16 and RHD 01EL.32 were frequently observed., RHD 01EL.02, RHD 01EL.08, RHD 01EL.37 and RHD 01N.25 were rare, and two exon deletion variants remained uncharacterized. The phenotypic distribution of RhD-negative blood donors was ccee (55.44%)>Ccee(31.09%)>ccEe(5.96%)>CCee(5.44%)>CcEe(1.81%)>CcEE(0.26%), and the antigen distribution trend was e(99.74%)>c(94.56%)>C(38.60%)>E(8.03%). A correlation was observed between RHD genotypes and RhCE phenotypes. Conclusion: The Nantong blood donor population exhibits unique RHD gene polymorphisms. Integrating RhCE serological phenotyping with RHD genotyping is essential for ensuring transfusion safety.

Objective: To investigate the genetic basis of RhD-negative phenotype in the blood donor population of Nantong City. Methods: RHD genotyping was performed on 386 randomly selected RhD-negative donor samples (from a total of 676 RhD-negative donors identified between January 20, 2023, and June 28, 2024) using polymerase chain reaction (PCR), and the inconclusive results were confirmed by nucleotide sequencing. Results: Ten RHD allele types were identified: The complete deletion variant RHD 01N.01 was predominant (64.25%, 248/386); followed by RHD 01EL.01 (19.69%, 76/386). RHD 01N.03, RHD 01N.04, RHD 01N.16 and RHD 01EL.32 were frequently observed., RHD 01EL.02, RHD 01EL.08, RHD 01EL.37 and RHD 01N.25 were rare, and two exon deletion variants remained uncharacterized. The phenotypic distribution of RhD-negative blood donors was ccee (55.44%)>Ccee(31.09%)>ccEe(5.96%)>CCee(5.44%)>CcEe(1.81%)>CcEE(0.26%), and the antigen distribution trend was e(99.74%)>c(94.56%)>C(38.60%)>E(8.03%). A correlation was observed between RHD genotypes and RhCE phenotypes. Conclusion: The Nantong blood donor population exhibits unique RHD gene polymorphisms. Integrating RhCE serological phenotyping with RHD genotyping is essential for ensuring transfusion safety.

Objective To explore the value of MRI classification of extraprostatic extension(EPE)of prostate cancer(PCa)for predicting positive surgical margin after laparoscopic radical prostatectomy(LRP).Methods Prostate MRI data of 114 PCa patients with stage T3a who underwent LRP were retrospectively analyzed.The patients were divided into type Ⅰ(n=14),Ⅱ(n=50)and Ⅲ group(n=50)according to EPE location,also into positive margin group(n=58)and negative margin group(n=56)according to postoperative pathology.Then clinical,imaging,surgical and pathological data were compared among type Ⅰ—Ⅲ groups and between positive and negative margin groups.The indicators being significantly different between positive and negative margin groups were included in multivariate logistic regression analysis to screen the independent impact factors of positive margin of stage T3a PCa after LRP.Results Significant differences of patients'age,prostate-specific antigen(PSA),tumor location and positive surgical margin rate were found among type Ⅰ—Ⅲ groups(all P＜0.05).Positive surgical margin rate in type Ⅲ group was 68.00%(34/50),higher than that in type Ⅰ(14.29%[2/14])and Ⅱ group(44.00%[22/50])(both P＜0.05).Meanwhile,significant differences of PSA,the proportion of positive puncture needles and EPE MRI classification of PCa were found between positive and negative margin groups(all P＜0.05),among which the proportion of positive puncture needles and EPE MRI classification of PCa were both independent impact factors of positive margin of stage T3a PCa after LRP(both P＜0.05).Conclusion MRI classification of PCa-EPE could be used to predict positive surgical margin after LRP.Positive surgical margin after LRP tended to occur in PCa with MRI type Ⅲ EPE.

Objective:To explore the application and clinical significance of Automatic Functional Imaging (AFI) technology in evaluating left ventricular and left atrial damage in patients with alcoholic cardiomyopathy.Methods:A total of 120 patients with alcoholic cardiomyopathy who visited the Affiliated Hospital of Jining Medical University from April 2021 to March 2023 were selected, including 40 patients with mild, moderate, and severe alcohol consumption each. At the same time, 40 healthy volunteers who did not drink alcohol were selected as controls. All subjects underwent ultrasound examination, and the differences in two-dimensional ultrasound and AFI parameters among the groups were analyzed. Pearson correlation analysis was used to evaluate the correlation between AFI parameters and two-dimensional ultrasound parameters. The diagnostic value of global long axis peak systolic strain (GLPS) of the left ventricle in alcoholic cardiomyopathy was analyzed using receiver operating characteristic (ROC) curves.Results:The left ventricular end diastolic diameter (LVDd), left ventricular end systolic diameter (LVDS), end diastolic interventricular septal thickness (IVSTd), end diastolic left ventricular posterior wall thickness (PWTd), left atrial minimum volume (LAVmin), left atrial maximum volume (LAVmax), and left atrial active pre systolic volume (LAVp) in the severe group were significantly larger than those in the control group, mild group, and moderate group (all P<0.05), while the left ventricular ejection fraction (LVEF) and the ratio of E peak velocity to A peak velocity (E/A) were significantly smaller than those in the control group, mild group, and moderate group (all P<0.05); The left ventricular end diastolic volume (LVEDV), left ventricular end systolic volume (LVESV), left ventricular mass index (LVMI), LAVmin, LAVmax, and LAVp in the moderate and severe groups were significantly higher than those in the control and mild groups (all P<0.05); There was no statistically significant difference in LVDd, LVDS, IVSTd, PWTd, and LVEF among the control group, mild group, and moderate group (all P>0.05). The GLPS levels in the mild, moderate, and severe groups were significantly higher than those in the control group (all P<0.05), with the severe group having significantly higher GLPS levels than the mild and moderate groups ( P<0.05); There was no statistically significant difference in peak strain dispersion (PSD) among the control group, mild group, moderate group, and severe group (all P>0.05). GLPS was negatively correlated with LVEF ( r=-0.441, P<0.05), while GLPS was positively correlated with LVMI ( r=0.504, P<0.05). The area under the ROC curve for diagnosing alcoholic cardiomyopathy with GLPS was 0.912 (95% CI: 0.869-0.955, P<0.05), with a cutoff value of -20.16, sensitivity and specificity of 76.70% and 95.00%, respectively. Conclusions:The mechanical properties of the left ventricle and left atrium in patients with alcoholic cardiomyopathy are significantly altered, and AFI parameters have certain application value in the diagnosis of alcoholic cardiomyopathy.

Objective:To investigate the efficacy and prognosis of different surgical approaches in sporadic medullary thyroid carcinoma.Methods:A retrospective analysis was conducted on 101 patients with sporadic medullary thyroid carcinoma (MTC) who underwent surgical treatment at the Department of Thyroid Surgery, China-Japan Union Hospital of Jilin University, from Feb. 2009 to Nov. 2023. The patients included 36 males and 75 females, with a male-to-female ratio of 1:2.1. The median age of the patients was 47 years old, with an age range of 21 to 72 years old. The study divided participants into two groups based on their surgical methods: an observation group (78 cases) and a control group (23 cases). The observation group received surgical methods in accordance with expert consensus, while the control group did not. The study compared the efficacy and prognosis of the two groups.Results:Statistical differences were found between the two groups in terms of stage II and III in TNM staging, intraoperative frozen pathological findings, number of lymph node resections in the central group, number of lymph node metastases in the central group, number of lymph node resections in the lateral cervical region, postoperative follow-up time, and five-year postoperative serum procalcitonin (Ctn) levels ( P<0.05) .Both groups of patients obtained a significant decrease in Ctn after surgical treatment. In the observation group, Ctn was at the remission level in 57 cases (73.1%), at the stable level in 13 cases (16.7%), and at the progression level in 8 cases (10.2%), while in the control group, Ctn was at the remission level in 20 cases (86.9%), at the progression level in 3 cases (13.1%), and there were no patients at the stable level after the operation.One patient (1.3 per cent) in the observation group had a recurrence after surgery; Two patients (8.7 per cent) in the control group had a recurrence. Conclusions:Standardised and thorough surgery can maximise the clearance of metastatic lymph nodes, effectively reduce the recurrence rate, achieve better efficacy, and improve the long-term prognosis of patients without increasing the risk of surgery and postoperative complications.

Trials within cohorts （TwiCs） are design methods derived from randomized controlled trials （RCTS）. They have been widely used in chronic disease areas such as tumors and cardiovascular diseases. The basis of the TwiCs design is a prospective cohort of specific diseases. When RCTS need to be implemented， some patients meeting the inclusion and exclusion criteria are randomly sampled from the cohort to receive "trial interventions"， while the remaining patients in the cohort who meet the inclusion and exclusion criteria continue to receive conventional treatment as control groups. By comparing the efficacy differences between the intervention measures of the trial group and the control group， the efficacy of intervention measures was evaluated. Within the cohort， the same process could be repeated to carry out multiple RCTS， so as to evaluate different intervention measures or compare the efficacy of different doses or timing of interventions. Compared with classical RCTS， TwiCs make it easier to recruit patients from the cohort and have higher external validity， providing a new research paradigm for improving the efficiency and applicability of RCTS in clinical practice. However， TwiCs may also face the challenge of poor compliance of patients in the cohort. Researchers need to take effective measures to control these patients in the design and operation of TwiCs. This article focused on the methodological key points during the implementation of TwiCs， including multi-stage informed consent （patients are informed of consent at three stages： entering the cohort， entering the trial group， and after the trial）， randomization procedures （only random sampling of patients from the cohort to receive "trial interventions"）， sample size calculation， and statistical analysis methods. The article also compared the differences between TwiCs and traditional RCTS and illustrated TwiCs research design and analysis with examples， so as to provide new research ideas and methods for clinical researchers.

This paper summarized Professor LI Haisong's clinical experience in treating spermatorrhea based on the view of "spirit controlling essence and qi". It is emphasized that the heart spirit has the function of controlling the essence and qi of the human body， believing the frenetic stirring of heart spirit and the insecurity of essence gate are the core pathogenesis of spermatorrhea， LI advocates to regulate the heart spirit first and take into account of the zang-fu organs， essence and qi simultaneously for the treatment. Treatment should be performed according the clinical syndromes differentiatied. For those with heart spirit failing to nourish syndrome， it is recommended to supplement heart qi， nourish spirit and consolidate essence with self-made Yangxin Mijing Formula （养心秘精方）. In case of heart fire hyperactivity， the method of clearing heart heat and draining fire， calming spirit and consolidating essence should be used， and self-made Xiexin Gujing Formula （泻心固精方） is recommended. For heart-liver qi constraint， it is advised to soothe the liver and calm heart， calm the mind and regulate essence with self-made Jieyu Anshen Tiaojing Formula （解郁安神调精方） which is a modifcation to Chaihu Shugan Powder （柴胡疏肝散）. In terms of deficiency of both heart and liver， the treatment principle is supplementing spleen and nourishing heart， calming the mind and controlling essence， for which self-made Xinpi Tongtiao Shejing Formula （心脾同调摄精方） modified from Guipi Decoction （归脾汤） can be used. For deficiency of both heart and kidney， it is better to nourish the kidney and calm heart， calm the mind and consolidate essence with self-made Xinshen Liangzi Tianjing Formula （心肾两滋填精方） that modified from Shuilu Erxian Elixir （水陆二仙丹） and Wuzi Yanzong Pill （五子衍宗丸）. Prescriptions are used to treat the root by harmonizing the zang-fu organs， nourish the spirit by regulating qi and blood， and calm the mind by taking special medi-cinals， and they should be flexibly modified according to the disease.

This paper summarized Professor LI Yueqing's clinical experience in treating prostate cancer by stages from the perspective of deficiency and stasis. It is believed that the onset of prostate cancer is due to kidney deficiency， while blood stasis is the core pathogenesis， and dampness-heat， phlegm-turbid， and cancer toxins are the key pathological factors in the progression of the disease. The pathogenesis in the early stage of the disease is kidney qi depletion and dampness， heat and phlegm coagulation； in the middle stage， it is spleen and kidney depletion， phlegm coagulation and blood stasis； and in the late stage， the pathogenesis changes into yin deficiency and essence depletion， and stasis-turbid toxin obstruction. For treatment， the basic principle is to supplement and boost kidney qi， enrich and nourish the kidney yin. The main treatment methods are draining dampness， dissolving phlegm， dispelling stasis， clearing heat and resolving toxins， and the method of invigorating blood and dispelling stasis runs through the whole course of treatment. In the early stage， radical treatment is mainly used， and Longshe Yangquan Decoction （龙蛇羊泉汤） with modifications is supplemented to clear and drain dampness and heat. In the middle stage， androgen deprivation therapy is the basic treatment， and Bushen Tongqiao Decoction （补肾通窍汤） with modifications is used in combination to nourish the spleen and kidney， dissolve phlegm and dispel stasis. In the late stage， Dabuyin Pills and Liuwei Dihuang Pills （大补阴丸合六味地黄丸） with modifications is mainly used to enrich yin and supplement essence， resolve toxins and dissolve stasis， and prevent cancer recurrence.

Chronic prostatitis is a common and frequently occurring disease in male clinics. Due to the diverse symptoms， complex etiology， unclear mechanisms， and recurrent episodes of chronic prostatitis， Western medicine often faces the challenge of limited treatment options and unsatisfactory outcomes. In order to fully leverage the unique advantages of traditional Chinese medicine （TCM） in the treatment of chronic prostatitis， the China Association of Chinese Medicine organized a discussion among experts from the fields of TCM urology， Western urology， and related pharmacy. The experts focused on the advancements in the understanding of chronic prostatitis in modern medicine， various theories on the etiology， pathogenesis， and treatment of chronic prostatitis in TCM， entry points from interdisciplinary fields， the role and advantages of TCM in the comprehensive management of chronic prostatitis， and research into mechanisms related to chronic prostatitis. After discussions， the experts concluded that chronic prostatitis is one of the diseases where TCM has a distinct advantage. TCM can effectively improve the clinical syndromes of chronic prostatitis， including urinary issues， social psychology， organ specificity， infection， nervous system problems， pain and discomfort， sexual dysfunction， etc.， and can enhance the quality of life. For patients with chronic prostatitis who cannot tolerate or may not accept the adverse effects of Western medicine， as well as for those with non-inflammatory chronic prostatitis/chronic pelvic pain syndrome （CP/CPPS）， those with pain as the primary symptom， those with urinary tract symptoms， those with coexisting anxiety and depression， and those with abnormal semen liquefaction， TCM-based treatment can be the main approach. Currently， the optimal diagnosis and treatment strategy for chronic prostatitis has not yet been established， and further research from perspectives such as clinical epidemiology， evidence-based medicine， and molecular biology is needed. Both TCM and Western medicine should integrate their respective strengths， clarify the role and advantages of TCM interventions based on mutual reference， and improve the diagnosis and treatment standards for chronic prostatitis in China.

Objective To investigate the early warning value of miR-29b in evaluating coronary plaque rupture in patients with stable coronary artery disease(SCAD),and the possible mecha-nism of its causing coronary plaque rupture.Methods A total of 210 SCAD patients treated in our department from April 2020 to April 2022 were selected and divided into PCI group(95 cases)and coronary angiography(CAG)group(115 cases).The expression level of miR-29b in peripheral blood before and after treatment were compared between the two groups.Human peripheral blood mononuclear cells(PBMC)were divided into blank control group,miR-29b group(transfected with miR-29b plasmid)and miR-29b blank group(transfected with miR-29b blank plasmid).The mRNA and protein levels of extracellular matrix metalloproteinase-inducing factor(EMMPRIN),NF-κB,and IL-6 were compared in the 3 groups.Results The expression of miR-29b after PCI was higher than that before PCI,and the expression level after PCI was significantly higher than that after CAG(P＜0.01).ROC curve analysis showed that the cut-off value of preoperative miR-29b in diagnosing coronary plaque rupture was 0.86,and the AUC value was 0.838(95％CI:0.707-0.970).Multivariate logistic regression analysis indicated that preoperative miR-29b was an independent predictor of plaque rupture in the SCAD patients(OR=0.598,95％CI:0.394-0.908,P=0.016).Pearson correlation analysis displayed that preoperative miR-29b was negative-ly correlated with EMMPRIN mRNA level in PBMC(r=-0.575,P＜0.01).In the in vitro experiment,the expression of EMMPRIN,NF-κB and IL-6 at mRNA and protein levels were sig-nificantly lower in the miR-29b group than the blank control group and the miR-29b blank group(P＜0.05).Conclusion Elevated miR-29b level after PCI in SCAD patients is a protective factor for coronary plaque rupture.Its mechanism may be that miR-29b inhibits plaque rupture by down-regulating the expression of EMMPRIN in PBMC.