Objective: To investigate the current knowledge status of transfusion medicine among pediatricians/postgraduates and the reliability of large language models (LLMs) for assisted learning, and to assess changes in pediatricians' transfusion medicine knowledge before and after the implementation of the "Pediatric Transfusion Guideline" (hereafter referred to as the "Guideline"). Methods: In January 2022 (prior to the implementation of the "Guideline"), a questionnaire was developed based on the "Guideline" content and distributed to pediatricians. Subsequently, in July 2025 (after the implementation of the "Guideline"), the "Pediatric Transfusion Medicine Knowledge Questionnaire" was designed based on the content of the January 2022 questionnaire. This questionnaire survey was conducted on pediatricians/postgraduates and LLMs. We analyzed the level of transfusion medicine knowledge among pediatricians/postgraduates and the reliability of LLMs for assisted learning, and compared the accuracy of pediatricians' responses before and after "Guideline" implementation. Results: The survey results after the implementation of the "Guidelines" revealed that pediatricians/postgraduates achieved response accuracy rates exceeding 80% on the topic of "Patient Blood Management". However, response accuracy rates were below 30% for topics including "Types and Indications of Blood Components/Products" and "E-valuation of Transfusion Efficacy". The pediatricians' accuracy rates for related questions before and after the implementation of the "Guidelines" were 14.7%-68.9% and 3%-38%, respectively, and the comparison of accuracy rates for each question showed significant differences (P<0.001). The accuracy rates of the LLMs on the questionnaire were all below 90%. Among them, Doubao (81.1%) and Kimi (86.4%) achieved relatively higher accuracy rates, while Tencent Yuanbao (Hunyuan) had the lowest accuracy rate at only 59.5%. Conclusion: The implementation of the "Guideline" may have improved pediatricians' knowledge level of pediatric transfusion medicine. However, their knowledge level of pediatric transfusion remains low, and LLMs cannot yet provide absolutely reliable guidance. Systematic training in pediatric transfusion medicine is urgently needed.

ObjectiveTo delineate imaging findings using an imaging platform and investigate the correlation between MRI characteristics of spinal cord atrophy and clinical diagnosis in children with spinal cord injury (SCI). MethodsImaging data of 150 children with SCI admitted to Beijing Bo'ai Hospital, China Rehabilitation Research Center, from January, 2002 to March, 2024 were collected and imported into the imaging platform. The anteroposterior and transverse diameters of the middle part of the spinal cord at the cross-section with the most severe atrophy were measured, and the relevant indicators of the previous normal spinal cord segment were measured as controls; the radiomic features were extracted. Clinical data of the children including gender, age, cause of injury, sensory level, motor level, spinal cord injury level, injury severity and disease course were collected. ResultsSpinal cord atrophy was identified in 81 cases (54%), among which 78 cases (96%) were American Spinal Injury Association Impairment Scale (AIS) grade A and 3 cases (4%) were AIS grade C. The upper boundary of the spinal cord atrophy site strongly correlated with the injury level, motor level and sensory level (r > 0.8, P < 0.001). ConclusionMore than half of children with SCI may develop secondary spinal cord atrophy, the vast majority of whom suffer from complete spinal cord injury; the upper boundary of spinal cord atrophy is correlated with the injury level.

Objective To investigate the characteristics and clinical significance of serum immunoglob-ulins in patients with Cronkhite-Canada syndrome(CCS).Methods This retrospective study included CCS patients admitted to Peking Union Medical College Hospital from December 2009 to September 2024 who under-went serum immunoglobulin testing.Clinical manifestations and ancillary examination results were analyzed ret-rospectively.Results Fifty-two patients were included(male:36[69.2%],female:16[30.8%]),with median onset age of 60(54-64)years and median diagnostic delay of 5(3-12)months.Common manifesta-tions included diarrhea(86.5%),abdominal pain(40.4%),hematochezia(19.2%),weight loss(86.5%),nail malnutrition(100.0%),pigmentation(88.5%),hair loss(84.6%),and hypogeusia(69.2%).Serum IgG reduction occurred in 21 patients(50.0%),while total IgE elevation was observed in 20(71.4%).Elevated serum IgG4 levels were noted in 11 patients(23.4%),with no significant clinical differences between IgG4-elevated and normal groups.IgG4 levels showed no statistical difference between active(n=43)and remission(n=27)groups.The hair loss rate was significantly higher in the total IgE-ele-vated group than that in the normal total IgE group(P=0.0383).Conclusions CCS patients exhibit periph-eral blood immunoglobulin disorders,with elevated IgE levels correlating with hair loss.This suggests an im-mune-mediated mechanism may underlie hair loss in CCS.

Objective To compare the benefits and drawbacks of primary patch expansion versus pericardial tube right ventricular-pulmonary artery connection in patients diagnosed with pulmonary atresia with ventricular septal defect (PA/VSD). Methods A retrospective study was conducted on patients diagnosed with PA/VSD who underwent primary right ventricular-pulmonary artery connection surgery at our center between 2010 and 2020. Patients were categorized into two groups based on the type of right ventricular-pulmonary artery connection: a pericardial tube group and a patch expansion group. Clinical data and imaging findings were compared between the two groups. Results A total of 51 patients were included in the study, comprising 31 males and 20 females, with a median age of 12.57 (4.57, 49.67) months. The pericardial tube group included 19 patients with a median age of 17.17 (7.33, 49.67) months, while the patch expansion group consisted of 32 patients with a median age of 8.58 (3.57, 52.72) months. In both groups, the diameter of pulmonary artery, McGoon index, and Nakata index significantly increased after treatment (P<0.001). However, the pericardial tube group exhibited a longer extracorporeal circulation time (P<0.001). The reoperation rate was notably high, with 74.51% of patients requiring further surgical intervention, including 26 (81.25%) patients in the patch expansion group and 12 (63.16%) patients in the pericardial tube group. No statistical differences were observed in long-term cure rates or mortality between the two groups (P＞0.005). Conclusion In patients with PA/VSD, both patch expansion and pericardial tube right ventricular-pulmonary artery connection serve as effective initial palliative treatment strategies that promote pulmonary vessel development and provide a favorable foundation for subsequent radical operations. However, compared to the pericardial tube approach, the patch expansion technique is simpler to perform and preserves some intrinsic potential for pulmonary artery development, making it the preferred procedure.

Objective:To construct a long non-coding RNA(lncRNA)model based on ferroptosis and predict the prognosis of non-small cell lung cancer(NSCLC)patients after radiotherapy,to develop a comprehensive framework that integrates genomic data with clinical outcomes,and to identify lncRNA associated with ferroptosis and evaluate their predictive power for patient survival and progression-free survival following radiotherapy.Methods:This study commenced by acquiring standardized transcrip-tome data from primary tumors and normal tissues,along with corresponding clinical information,from the cancer genome atlas(TCGA)database.This dataset provided a robust foundation for identifying differentially expressed genes(DEGs)related to ferroptosis.These analyses helped pinpoint specific pathways and biological processes involved in ferroptosis,such as glutathione metabolism,lipid signa-ling,oxidative stress,and reactive oxygen species(ROS)metabolism.Subsequently,univariate and multivariate Cox regression analyses were conducted to construct a predictive model based on lncRNA as-sociated with ferroptosis.The goal was to differentiate between the high-risk and low-risk groups of NSCLC patients who had undergone radiotherapy.By incorporating these lncRNA into the model,we aimed to provide a more accurate prediction of patient outcomes.The performance of the model was vali-dated by comparing the survival rates and progression-free survival between the high-risk and low-risk groups.Additionally,differences in gene expression patterns and pathway activities between these two groups were examined to further validate the model's effectiveness.Results:Our analysis revealed that the differentially expressed genes related to ferroptosis were significantly enriched in several key path-ways,including ferroptosis itself,glutathione metabolism,lipid signaling,and processes involving oxida-tive stress and ROS metabolism.Based on these findings,we constructed a prognostic model using 14 lncRNA that showed strong associations with ferroptosis.Further data analysis demonstrated that these lncRNA could independently predict the prognosis of NSCLC patients after radiotherapy.Specifically,age,stage,and gender were used as clinical pathological variables,and the results indicated that the high-risk group of NSCLC patients had a poorer prognosis following radiotherapy.This finding underscores the po-tential of the model to serve as a valuable tool for predicting prognosis for NSCLC patients undergoing ra-diotherapy.Conclusion:The risk model developed in this study can independently predict the prognosis of NSCLC patients after radiotherapy.This model provides a solid basis for understanding the role of fer-roptosis-related lncRNA in the prognosis of NSCLC patients following radiotherapy.Furthermore,it offers clinical guidance for combining radiotherapy with ferroptosis-targeted treatments,potentially improving therapeutic outcomes for NSCLC patients.The integration of genomic and clinical data in this study high-lights the importance of personalized medicine approaches in oncology,paving the way for more precise and effective treatment strategies.

Objective To investigate the characteristics and clinical significance of serum immunoglob-ulins in patients with Cronkhite-Canada syndrome(CCS).Methods This retrospective study included CCS patients admitted to Peking Union Medical College Hospital from December 2009 to September 2024 who under-went serum immunoglobulin testing.Clinical manifestations and ancillary examination results were analyzed ret-rospectively.Results Fifty-two patients were included(male:36[69.2%],female:16[30.8%]),with median onset age of 60(54-64)years and median diagnostic delay of 5(3-12)months.Common manifesta-tions included diarrhea(86.5%),abdominal pain(40.4%),hematochezia(19.2%),weight loss(86.5%),nail malnutrition(100.0%),pigmentation(88.5%),hair loss(84.6%),and hypogeusia(69.2%).Serum IgG reduction occurred in 21 patients(50.0%),while total IgE elevation was observed in 20(71.4%).Elevated serum IgG4 levels were noted in 11 patients(23.4%),with no significant clinical differences between IgG4-elevated and normal groups.IgG4 levels showed no statistical difference between active(n=43)and remission(n=27)groups.The hair loss rate was significantly higher in the total IgE-ele-vated group than that in the normal total IgE group(P=0.0383).Conclusions CCS patients exhibit periph-eral blood immunoglobulin disorders,with elevated IgE levels correlating with hair loss.This suggests an im-mune-mediated mechanism may underlie hair loss in CCS.

Objective:To construct a long non-coding RNA(lncRNA)model based on ferroptosis and predict the prognosis of non-small cell lung cancer(NSCLC)patients after radiotherapy,to develop a comprehensive framework that integrates genomic data with clinical outcomes,and to identify lncRNA associated with ferroptosis and evaluate their predictive power for patient survival and progression-free survival following radiotherapy.Methods:This study commenced by acquiring standardized transcrip-tome data from primary tumors and normal tissues,along with corresponding clinical information,from the cancer genome atlas(TCGA)database.This dataset provided a robust foundation for identifying differentially expressed genes(DEGs)related to ferroptosis.These analyses helped pinpoint specific pathways and biological processes involved in ferroptosis,such as glutathione metabolism,lipid signa-ling,oxidative stress,and reactive oxygen species(ROS)metabolism.Subsequently,univariate and multivariate Cox regression analyses were conducted to construct a predictive model based on lncRNA as-sociated with ferroptosis.The goal was to differentiate between the high-risk and low-risk groups of NSCLC patients who had undergone radiotherapy.By incorporating these lncRNA into the model,we aimed to provide a more accurate prediction of patient outcomes.The performance of the model was vali-dated by comparing the survival rates and progression-free survival between the high-risk and low-risk groups.Additionally,differences in gene expression patterns and pathway activities between these two groups were examined to further validate the model's effectiveness.Results:Our analysis revealed that the differentially expressed genes related to ferroptosis were significantly enriched in several key path-ways,including ferroptosis itself,glutathione metabolism,lipid signaling,and processes involving oxida-tive stress and ROS metabolism.Based on these findings,we constructed a prognostic model using 14 lncRNA that showed strong associations with ferroptosis.Further data analysis demonstrated that these lncRNA could independently predict the prognosis of NSCLC patients after radiotherapy.Specifically,age,stage,and gender were used as clinical pathological variables,and the results indicated that the high-risk group of NSCLC patients had a poorer prognosis following radiotherapy.This finding underscores the po-tential of the model to serve as a valuable tool for predicting prognosis for NSCLC patients undergoing ra-diotherapy.Conclusion:The risk model developed in this study can independently predict the prognosis of NSCLC patients after radiotherapy.This model provides a solid basis for understanding the role of fer-roptosis-related lncRNA in the prognosis of NSCLC patients following radiotherapy.Furthermore,it offers clinical guidance for combining radiotherapy with ferroptosis-targeted treatments,potentially improving therapeutic outcomes for NSCLC patients.The integration of genomic and clinical data in this study high-lights the importance of personalized medicine approaches in oncology,paving the way for more precise and effective treatment strategies.

OBJECTIVE To analyze the efficacy of combined traditional Chinese and Western medicine in treating AIDS pa-tients with pulmonary infection(qi-yin deficiency and phlegm-damp obstructing lung).METHODS From Jun.2021 to Aug.2024,patients with AIDS combined with pulmonary infection admitted to our hospital were selected as the study subjects.A total of 86 cases were classified into two groups according to traditional Chinese medicine(TCM)syndromes:42 cases of qi and yin deficiency and 44 cases of phlegm-damp obstruction.These patients were then randomly divided into a study group and a control group using a randomized number table method.The study group was treated with traditional Chinese medicine(Lily Bulb Metal-Securing Decoction and Pulse-activating Decoction jiajian or Erchen Decoction and Three-Seed Filial Devotion Decoction jiajian)combined conventional western medicine for anti-infection,while the control group was treated with conventional western medicine for anti-infection,the changes of procalcitonin(PCT),C-reactive protein(CRP),CD4+T lymphocyte count,TCM syndrome score before and after treatment of patients in both groups were observed.RESULTS After 7 days of treatment,there was no significant difference in the levels of PCT and CRP be-tween the two groups.After 14 days of treatment,CRP level of the patients with qi and yin deficiency and phlegm-damp obstruction in the study group were(10.37±5.94)and(13.58±6.98)mg/L,respectively,which were lower than those in the control group(P＜0.001 and P=0.011,respectively),while PCT level had no statistical difference(P=0.928 and P=0.873,respectively).After 28 days of treatment,CD4+T lymphocyte count of the patients with qi and yin deficiency and phlegm-damp obstruction in the study group were(102.24±57.94)and(101.82±62.43)units/μl,respectively,which were higher than those in the control group(P=0.048 and P=0.039,respectively).The therapeu-tic effects of TCM dialectical combined with conventional Western medicine anti-infective drugs in treating patients with qi-yin deficiency and phlegm-damp obstructing lung were better than those of the control group(P=0.025 and P=0.014,respectively).CONCLUSION Lily Bulb Metal-Securing Decoction and Pulse-activating Decoction jiajian or Erchen Decoction and Three-Seed Filial Devotion Decoction jiajian combined with conventional western medicine anti-infective treatment of AIDS combined with pulmonary infection can reduce the inflammatory response,increase the levels of CD4+T lymphocyte counts,alleviate the clinical symptoms of the patients,and improve the quality of their lives.

OBJECTIVE To analyze the efficacy of combined traditional Chinese and Western medicine in treating AIDS pa-tients with pulmonary infection(qi-yin deficiency and phlegm-damp obstructing lung).METHODS From Jun.2021 to Aug.2024,patients with AIDS combined with pulmonary infection admitted to our hospital were selected as the study subjects.A total of 86 cases were classified into two groups according to traditional Chinese medicine(TCM)syndromes:42 cases of qi and yin deficiency and 44 cases of phlegm-damp obstruction.These patients were then randomly divided into a study group and a control group using a randomized number table method.The study group was treated with traditional Chinese medicine(Lily Bulb Metal-Securing Decoction and Pulse-activating Decoction jiajian or Erchen Decoction and Three-Seed Filial Devotion Decoction jiajian)combined conventional western medicine for anti-infection,while the control group was treated with conventional western medicine for anti-infection,the changes of procalcitonin(PCT),C-reactive protein(CRP),CD4+T lymphocyte count,TCM syndrome score before and after treatment of patients in both groups were observed.RESULTS After 7 days of treatment,there was no significant difference in the levels of PCT and CRP be-tween the two groups.After 14 days of treatment,CRP level of the patients with qi and yin deficiency and phlegm-damp obstruction in the study group were(10.37±5.94)and(13.58±6.98)mg/L,respectively,which were lower than those in the control group(P＜0.001 and P=0.011,respectively),while PCT level had no statistical difference(P=0.928 and P=0.873,respectively).After 28 days of treatment,CD4+T lymphocyte count of the patients with qi and yin deficiency and phlegm-damp obstruction in the study group were(102.24±57.94)and(101.82±62.43)units/μl,respectively,which were higher than those in the control group(P=0.048 and P=0.039,respectively).The therapeu-tic effects of TCM dialectical combined with conventional Western medicine anti-infective drugs in treating patients with qi-yin deficiency and phlegm-damp obstructing lung were better than those of the control group(P=0.025 and P=0.014,respectively).CONCLUSION Lily Bulb Metal-Securing Decoction and Pulse-activating Decoction jiajian or Erchen Decoction and Three-Seed Filial Devotion Decoction jiajian combined with conventional western medicine anti-infective treatment of AIDS combined with pulmonary infection can reduce the inflammatory response,increase the levels of CD4+T lymphocyte counts,alleviate the clinical symptoms of the patients,and improve the quality of their lives.

Objective To compare the efficacy of additional tricuspid valve annuloplasty (TVP) and isolated closure for atrial septal defect (ASD) with moderate to severe tricuspid regurgitation (TR). Methods Clinical data of the patients diagnosed with ASD combined with secondary moderate to severe TR and treated in our hospital from January 2009 to June 2020 were retrospectively analyzed. Patients were divided into a TVP group and a non-TVP group based on whether TVP was performed simultaneously. The baseline data of two groups were matched with a ratio of 1∶1 propensity score. Results A total of 32 pairs from 257 patients were successfully matched. In the TVP group, there were 24 females and 8 males with an average age of 44.0±13.1 years. In the non-TVP group, there were 28 females and 4 males with an average age of 44.5±11.6 years. The TR area and estimated pulmonary artery pressure in the two groups were significantly decreased compared with preoperation (all P<0.001). The TR area (P=0.001) and the estimated pulmonary artery pressure (P=0.002) were decreased more significantly in the TVP group than those in the non-TVP group. Linear regression analysis showed that age and preoperative TR area had a positive correlation with TR area at follow-up (β=0.045 and 0.259, respectively, both P<0.05), while additional TVP had a negative correlation (β=–1.542, P=0.001). Conclusion Additional TVP can significantly reduce the TR area and pulmonary artery pressure, and elderly patients with severe TR before surgery should actively receive TVP.