Objective: To characterize perioperative dynamic changes in immune-cell phenotypes and inflammatory cytokines in patients undergoing CPB (cardiopulmonary bypass) cardiac surgery, and to explore their associations with postoperative outcomes. Methods: In this prospective cohort study, 120 adult patients who underwent elective cardiac surgery under CPB at West China Hospital from May 2022 to March 2023 were enrolled. Perioperative immune-cell phenotypes and concentrations of 40 inflammation-related cytokines were measured. The primary outcomes were the sequential organ failure assessment (SOFA) score at 24 h after surgery and ΔSOFA (the peak SOFA score within 48 h after surgery minus the preoperative SOFA score). Secondary outcomes included major adverse cardiovascular events (MACE), acute kidney injury (AKI), respiratory failure, severe liver injury, and infection. Results: The mean age of enrolled patients was 57±10 years. Of these, 52% (62/120) were male and 90% (108/120) underwent valve surgery. During the rewarming to the end of CPB, neutrophil counts rapidly increased (7.39×10 /L vs preoperative 3.07×10 /L, P<0.001), with significant upregulation of CD11b (7.30×10 /L vs preoperative 3.05×10 /L, P<0.001) and CD54 (7.15×10 /L vs preoperative 2.99×10 /L, P<0.001). Lymphocyte counts increased at the end of CPB (1.75×10 /L vs preoperative 1.12×10 /L, P<0.001) but decreased significantly at 24 h after surgery (0.59×10 /L vs preoperative 1.12×10 /L, P<0.001). Plasma analysis showed that multiple pro-inflammatory cytokines increased during CPB and remained elevated up to 24 h after surgery; five chemokines and the anti-inflammatory cytokine IL-10 peaked at the end of CPB. The SOFA score increased from 1 (1, 2) preoperatively to 7 (5, 10) at 24 h after surgery, with a ΔSOFA of 6 (4, 8). Within 30 days after surgery, 48 patients (40.0%) developed AKI, 17 (14.2%) developed infection, 4 (3.3%) developed severe liver injury, 3 (2.5%) developed respiratory failure, and 3 (2.5%) experienced MACE. During the 2-year follow-up, 8 patients (6.7%) experienced MACE and 5 (4.2%) died. Conclusion: Multi-organ dysfunction is common after cardiac surgery under CPB (median ΔSOFA, 6), accompanied by perioperative activation of multiple immune-cell subsets and upregulation of pro-inflammatory, anti-inflammatory, and chemotactic mediators. This study provides data-driven evidence and research clues for further investigation of the associations between CPB-related immune perturbations and postoperative organ dysfunction and clinical outcomes.

Objective: To develop a quality appraisal tool for case reports in traditional Chinese medicine (TCM) based on their characteristics. [Methods]: An extensive literature search was conducted in Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), and China Science and Technology Journal Database (CSTJ), focusing on expert consensus statements and checklists for TCM case reports. Relevant items were extracted, and a Delphi method involving 34 experts was used in two rounds to rate each item on a 5-point Likert scale. Items were screened based on measures of central tendency and coordination (including total score, mean score, percentage of items rated as unimportant, and coefficient of variation). The weighted average method was used to determine item weights and construct the appraisal tool. Internal consistency was assessed using Cronbach’s α coefficient. The finalized tool was pilot-tested by two reviewers independently appraising 20 case reports, with an additional four reviewers evaluating 5 of these cases to compare inter-rater consistency. Results: A total of 9 513 articles were retrieved, and 96 items from 25 articles were extracted. After two rounds of the Delphi method, 27 items across 10 domains were retained. The Cronbach’s α coefficient was 0.72 in the first round (acceptable range), and 0.96 in the second round, indicating strong internal consistency. The tool was piloted by six reviewers, achieving a kappa value of 0.663 and a Kendall’s coefficient of concordance of 0.845, demonstrating high consistency among reviewers. Conclusion The developed TCM case report quality appraisal tool, consisting of 27 items in 10 domains, offers a scientific and reliable means of assessing the quality of TCM case reports. The tool showed high consistency and practical utility, and its application is expected to enhance the standardization, scientific rigor, and evidence quality of TCM case reports, facilitating the integration of traditional medical knowledge with modern evidence-based standards.

Objective: To construct a 5G unmanned aerial vehicle (UAV) airport platform for blood transportation and explore its feasibility and advantages within the blood emergency support system. Methods: Based on 5G high-speed network transmission technology, a UAV management system was designed to achieve a closed-loop management of the entire transportation process, including blood distribution, route information, flight status, emergency dispatch, hospital reception, real-time temperature monitoring, and video surveillance. Integrated with an open UAV airport, the first "5G UAV Blood Transportation Intelligent Airport Platform" was established. Results: At present, the platform has settled in 2 sets of UAV systems, established 17 routes, and carried out regular UAV blood transportation services for 15 hospitals. From January 1, 2024 to June 30, 2025, a total of 12 134 sorties were completed, with a total transported blood weight of 7 692.38 kg, including 25 500 units of red blood cells, 3 824.5 units of platelets, 1 350 370 mL of plasma, and 10 810 units of cryoprecipitate. Compared to land transportation, UAV delivery saved an average of 46.8 minutes during rush hours (maximum: 89.3 minutes) and an average of 32.3 minutes during non-rush hours (maximum: 59.1 minutes). In terms of the quality of UAV blood transportation, the temperature of suspended red blood cells was between 4 and 8℃, that of platelets was between 20 and 24℃, and that of plasma was below 0℃. No damage has occurred so far. Conclusion: The UAV blood transportation platform can stably provide blood delivery services during both routine and emergency conditions, ensuring timely blood delivery and stable blood quality.

In order to search for coumarin-based anti-platelet aggregation compounds with high efficacy and good druggability,twenty-five 3-acetyl-7-hydroxy-coumarin oxime derivatives(6a-6y)were synthesized via Vilsmeier-Haack reaction,Knoevenagel reaction,Williamson reaction,electrophilic substitution reaction and oximation reaction from resorcinol.Their structures were confirmed by HRMS and 1H NMR spectra.The anti-platelet aggregation activity of the target compounds was evaluated using Born's turbidimetric method.The results revealed that most of them could significantly inhibit platelet aggregation induced by adenosine diphosphate(ADP),collagen,arachidonic acid(AA)and thrombin.Among them,the target compounds 6a and 6b not only had strong inhibitory activity on platelet aggregation induced by the four inducers,but also exhibited good water solubility(3.46 mg/mL and 3.85 mg/mL,respectively)and lipid-water partition coefficient(2.56 and 2.85,respectively)and were expected to become a preclinical candidate compound with multi-target action against platelet aggregation.

In order to afford new antiplatelet agents with higher potency, a series of paeonol oxime derivatives (4a-4y) were designed and synthesized from paeonol.Their structures were confirmed by HRMS, 1H NMR spectra.The anti-platelet aggregation activity of the target compounds was evaluated.The results revealed that most of them had moderate to good anti-platelet aggregation activity.Among them, compound 4h and 4j were the most potent on adenosine diphosphate (ADP)-induced platelet aggregation and collagen-induced platelet aggregation. Furthermore, the target compound 4h not only showed strong antiplatelet aggregation activity, but also exhibited good water-solubility and drug-like properties, which can be used as a new antiplatelet active compound for further research.

Objective:To implement hierarchical quantitative evaluation management and test its effectiveness in the quality management of intravenous therapy was in order to improve the quality of intravenous therapy and ensure the safety of patients.Methods:In this cross-sectional study, totally 3 935 patients receiving infusion in 42 infusion departments at the Eighth Medical Center of Chinese PLA General Hospital from January to December 2018 were selected. The hierarchical quantitative evaluation management method was developed and applied in the quality management of intravenous therapy. Before the introduction of the hierarchical quantitative evaluation management in early January 2018, a cross-sectional survey of the infusion patients in the hospital that met the inclusion criteria was conducted based on the observation indicators. After the implementation, at the end of December 2018, a cross-sectional survey was performed again on the infusion patients who met the inclusion criteria based on the observation indicators. The infusion route, puncture site, infusion connection, medication, catheter maintenance, application fixation, indwelling time, and infusion-relation complications were compared before and after the implementation.Results:After the implementation of hierarchical quantitative evaluation, steel needle usage, application fixation and maintenance issues, wrong selection of infusion sites (lower limbs and joints) , incidence of redness at puncture points decreased, and the use of indwelling needles increased, and there were statistically significant differences compared with those before the implementation ( P<0.01) . Conclusions:The application of hierarchical quantitative evaluation in the quality management of intravenous therapy gives full play to the role of the intravenous therapy team, effectively mobilizes the enthusiasm for self-improvement of the department, which can improve the quality of intravenous therapy and the level of intravenous therapy for nurses, and ensure patients' safety.

Objective? To define the difficulty coefficient of Operating Room nursing items which is suitable for difficulty evaluation and can represent the workload of Operating Room nursing. Methods? From January 2017 to March 2018, through literature review, questionnaire survey and expert demonstration meeting, the nursing work items and operational difficulty indicators suitable for difficulty evaluation in Operating Room were determined. The weight of difficulty indicators was determined by analytic hierarchy process. Fifteen experts were selected for three rounds of Delphi inquiry. The coefficients of difficulty were determined by weighted linear method. Results? Finally, the difficulty coefficients of 68 operating room nursing items were obtained. The top three difficulty coefficients were "position placement and observation of lateral traction bed (7.268 7)", "position placement and observation of fixed skull (7.254 0)" and "position and observation of skull-brain frame lateral decubitus position (7.243 3)"; the last three difficulty coefficients were "horizontal supine position placement and observation (2.178 2)" and "sterile sheet laying (2.046 0)" , "no-contact wearing of sterile gloves (1.000 0)". Conclusions? This study defines 68 difficulty coefficients of operating room nursing work items which are suitable for difficulty evaluation and can represent the workload of Operating Room nursing. It can quantify the difficulty of Operating Room nursing work items and enhance the rationality of Operating Room nursing workload counting.

Objective To investigated the etiologic characteristics of Shigella (S.) sonnei strains causing outbreaks and sporadic cases in some areas of Guangdong province and Guangxi Zhuang Autonomous Region during 2014-2016. Methods Fourteen S. sonnei strains isolated from outbreaks and 6 S. sonnei strains from sporadic cases from Guangdong and Liuzhou of Guangxi Zhuang Autonomous Region were tested for antimicrobial resistance and analyzed by pulsed-field gel electrophoresis (PFGE). Six typical strains were selected for whole genome sequencing typing and compared with 51 strains isolated both at home and abroad from NCBI genome database. Results The antibiotic resistance test indicated the isolates had high resistance rate to ampicillin, tetracycline, gentamicin, trimethoprim/sulfamethoxazole and nalidixic acid, while sensitive to azithromycin, chloromycetin and imipenem. PFGE showed high similarity (93.2%) among the strains isolated from different areas. The whole genome sequencing analysis also revealed that all the typical strains wereclustered into a same evolution branch, close to some strains from Korea. Conclusions The S. sonnei strains isolated from some areas of Guangdong and Guangxi Zhuang Autonomous Region showed high resistance to commonly used antibiotics, but they were sensitive to azithromycin, chloramphenicol and imipenem. The isolates in this study also showed similar PFGE patterns and close phylogenic evolution.

Objective: To evaluate the clinical effects of troponin alone and troponin combining copeptin in early diagnosis of Non-ST segment elevation myocardial infarction (NSTEMI) by meta-analysis. Methods: We searched Medline, EMBASE, Cochrane, Pubmed, CNKI and Wanfang database (1995-01 to 2015-10) for the publications of troponin alone and troponin combining copeptin in early diagnosis of NSTEMI. Based on inclusion and exclusion criteria, we screened the literatures and evaluated their quality by QUADAS items. Manager 5.2 and Meta-DiSc 1.4 software were used to study the pooled sensitivity and speciifcity for troponin alone and troponin combining copeptin in NSTEMI early diagnosis, and to calculate the summary receiver operating characteristic curve (SROC) with the area under curve (AUC). Results: There were 11 articles including 1 Chinese article enrolled. For NSTEMI diagnosis, compared with troponin alone, troponin combining copeptin showed the higher sensitivity (90% vs 75%), but lower speciifcity (60% vs 87%). For SROC, both AUC were > 0.7, while the AUC of troponin combining copeptin was even lower (0.805 vs 0.891). Conclusion: Combination of troponin and copeptin had the better sensitivity for NSTEMI early diagnosis, although it with lower speciifcity while increased copeptin level might suggest the patients associated with other clinical conditions such as heart failure or stroke which were important in clinical practice.

The healing of chronic wounds is a very complicated process,affected by many factors,and the wound is closely related to the local environment.Appropriate dressing contributes to improving the healing of the wound.Wet dressings are widely used in the clinical care of chronic wounds for the advantage of making moderately moist,low oxygen,slightly acid,and being close to the body temperature.