Objective:To explore the clinical phenotypes and hematological characteristics of β-thalassemia combined with α-globin gene triplet.Methods:A retrospective case analysis study was conducted, taking individuals diagnosed with thalassemia who sought for outpatient services in No 1 people′s hospital of Chenzhou affiliated to South China University from August 10, 2021, to December 31, 2023 as study objectives. Among them, there were 8 768 males and 11 707 females, aged 31.5 (23.0, 46.0) years old. Blood analysis were analyzed by hematology analyze.The hemoglobin(Hb) Hb A, HbA 2,Hb F bands were analyzed by Capillary electrophoresis method, and the genotypes of thalassemia were analyzed by high-throughput sequencing technology.Hematological parameters between different genotypes of thalassemia were analyzed using t-tests and calibrated t-tests for data analysis. Results:A total of 27 cases of beta thalassemia combined with alpha globin triplet were detected, The average hemoglobin (Hb) of 11 cases of β Codon41/42 (-CTTT)/β N combined with ααα anti 4.2 (3.7) (92±16)g/L was lower than that of β Codon41/42 (-CTTT)/β N(112±11)g/L, and the difference was statistically significant ( t=3.97, P0.05). The average Hb of 8 cases of β IVS-Ⅱ-654 (CT)/β N combined with ααα anti 4.2 (3.7)(85±21) g/L was lower than that of β IVS-Ⅱ-654 (CT)/β N(116±12) g/L, and the difference was statistically significant ( t=4.05, P0.05). Conclusion:When the mutation site is at Codon41/42 (-CTTT) or IVS-Ⅱ-654 (CT), β-thalassemia combined with alpha globin triplet can make the clinical manifestations of β-thalassemia at this site more pronounced.

Objective:To explore the clinical phenotypes and hematological characteristics of β-thalassemia combined with α-globin gene triplet.Methods:A retrospective case analysis study was conducted, taking individuals diagnosed with thalassemia who sought for outpatient services in No 1 people′s hospital of Chenzhou affiliated to South China University from August 10, 2021, to December 31, 2023 as study objectives. Among them, there were 8 768 males and 11 707 females, aged 31.5 (23.0, 46.0) years old. Blood analysis were analyzed by hematology analyze.The hemoglobin(Hb) Hb A, HbA 2,Hb F bands were analyzed by Capillary electrophoresis method, and the genotypes of thalassemia were analyzed by high-throughput sequencing technology.Hematological parameters between different genotypes of thalassemia were analyzed using t-tests and calibrated t-tests for data analysis. Results:A total of 27 cases of beta thalassemia combined with alpha globin triplet were detected, The average hemoglobin (Hb) of 11 cases of β Codon41/42 (-CTTT)/β N combined with ααα anti 4.2 (3.7) (92±16)g/L was lower than that of β Codon41/42 (-CTTT)/β N(112±11)g/L, and the difference was statistically significant ( t=3.97, P0.05). The average Hb of 8 cases of β IVS-Ⅱ-654 (CT)/β N combined with ααα anti 4.2 (3.7)(85±21) g/L was lower than that of β IVS-Ⅱ-654 (CT)/β N(116±12) g/L, and the difference was statistically significant ( t=4.05, P0.05). Conclusion:When the mutation site is at Codon41/42 (-CTTT) or IVS-Ⅱ-654 (CT), β-thalassemia combined with alpha globin triplet can make the clinical manifestations of β-thalassemia at this site more pronounced.

OBJECTIVE To investigate the biodistribution of lipid nanoparticles(LNPs)with different surface charges and different particle sizes in mice.METHODS LNPs were prepared using microfluidic technology by incorporating positively charged phospholipids,negatively charged phospholipids,ioniz-able phospholipids,and neutral phospholipids into the formulation to create LNPs with corresponding surface charges.The particle size of the LNPs was controlled by polyethylene glycol(PEG)modifica-tion and measured using dynamic light scattering(DLS)and transmission electron microscopy(TEM),while the surface charge was analyzed using a zeta potential analyzer.The LNPs were labeled with a fluorescent dye,and the mice were intravenously injected with 0.625 μmol·kg-1 of LNPs.At 1,4,12 and 24 h post-injection,the brain,heart,livers,spleen,lungs and kidneys were collected.The fluorescence distribution in different organs was detected using an in vivo imaging system to reflect the distribution of LNPs in various organs.RESULTS Particle size analysis showed that,except the ionizable lipid nanoparticles without PEG modification(LNP-MC3),which had a particle size>200 nm,the particle sizes of positively charged LNPs without PEG modification(LNP-Pos),PEG-modified positively charged LNPs(LNP-Pos-P),PEG-modified neutral LNPs(LNP-Neu-P),PEG-modified ionizable LNPs(LNP-MC3-P),and PEG-modified negatively charged LNPs(LNP-Neg-P)were all<200 nm.Zeta potential analysis revealed that the surface charges of the LNPs were the highest in LNP-Pos,followed by LNP-Pos-P,LNP-MC3-P,LNP-Neu-P,LNP-MC3 and LNP-Neg-P.In vivo imaging results indicated that LNP-Pos-P,LNP-Pos and LNP-MC3-P were primarily distributed in the livers,lungs and kidneys,respectively,while LNP-Neu-P and LNP-Neg-P in the livers,kidneys,and lungs,respectively.The distribution of LNP-MC3-P in the brain,heart,spleen and kidneys peaked at 12 h post-injection,but at 24 h in the livers.The distribution of LNP-Pos-P in the lungs peaked at 1 h post-injection.CONCLUSION LNPs are primarily distributed in the livers.Surface charges influence the second most highly-distributed organs.LNP-Pos-P and LNP-MC3-P are the second most highly-distributed in the lungs,and LNP-Neu-P and LNP-Neg-P in the kidneys.

Objective To investigate the level 4 surgical safety management in tertiary public hospitals in Sichuan Province.Methods A combination of questionnaires and qualitative interviews was used to investigate the basic situation of four-level surgery performed,the volume of surgery,and the management of surgery in 34 tertiary public hospitals in Sichuan Province.Results Among the 34 tertiary public hospitals surveyed,the percentage of patients discharged with level Ⅳ surgery in 2023 was 18.96％,which was lower than the level of the percentage of patients discharged with level Ⅳ surgery did not establish a leading group for level Ⅳ surgery (17.65％),a system for preoperative multidisciplinary discussion of level Ⅳ surgery(14.71％),and a system for preoperative multidisciplinary discussion of level Ⅳ surgery with various department-related expert pool(41.18％),multidisciplinary joint examination room(23.53％),and the monitoring and evaluation mechanism for the completion of preoperative multidisciplinary discussion for level 4 surgery(20.59％).Conclusion The volume of level Ⅳ surgeries in tertiary public hospitals in Sichuan Province needs to continue to be improved,and the establishment of a standardized management system for level Ⅳ surgeries is imperative.

Objective To investigate the short-and long-term prognoses and the risk factors affecting"text-book outcome"(TO)after laparoscopic pancreaticoduodenectomy(LPD)for pancreatic ductal adenocar-cinoma(PDAC).Methods The clinical and follow-up data of patients diagnosed with PDAC and treated with LPD from January 2019 to Dec-ember 2022 were retrospectively anal-yzed.The prognosis was compared bet-ween TO and non-TO groups,and uni-variate and multivariate logistic regre-ssion analyses were used to identify independent prognostic factors for TO.Results A total of 284 patients were enrolled in this study,including 185 cases in the TO group and 99 cases in the non-TO group.The 1-,3-and 5-year overall survival(OS)rates of the TO and non-TO groups with PDAC were 87.3%vs.85.9%,52.5%vs.38.4%,and 18.0%vs.4.5%,respectively(P=0.020);the recurrence-free survival(RFS)rates were 74.1%vs.65.7%,27.1%vs.21.0%,and 10.0%vs.0%,respectively(P=0.042).Multivariate logistic regression analysis showed that operation time>360 min(OR=0.561,95%CI:0.321-0.979,P=0.042),intraoperative blood loss>400 ml(OR=0.392,95%CI:0.175-0.879,P=0.023),hard or tough texture of pancreas(OR=2.240,95%CI:1.247-4.022,P=0.007),and main pancreatic duct dia-meter>3 mm(OR=1.931,95%CI:1.126-3.312,P=0.017)were independent prognostic factors for TO.Conclusion After the learning curve,more than 60%of patients with PDAC can achieve TO after LPD.The chances of achieving TO are significantly reduced when the operation time>360 min,the intraoperative blood loss>400 ml,the texture of pancreas was soft,and the diameter of the main pancreatic duct>3 mm.

Objective To investigate the short- and long-term prognoses and the risk factors affecting “textbook outcome” (TO) after laparoscopic pancreaticoduodenectomy (LPD) for pancreatic ductal adenocarcinoma (PDAC). Methods The clinical and follow-up data of patients diagnosed with PDAC and treated with LPD from January 2019 to December 2022 were retrospectively analyzed. The prognosis was compared between TO and non-TO groups, and univariate and multivariate logistic regression analyses were used to identify independent prognostic factors for TO. Results A total of 284 patients were enrolled in this study, including 185 cases in the TO group and 99 cases in the non-TO group. The 1-, 3- and 5-year overall survival (OS) rates of the TO and non-TO groups with PDAC were 87.3% vs. 85.9%, 52.5% vs. 38.4%, and 18.0% vs. 4.5%, respectively (P=0.020); the recurrence-free survival (RFS) rates were 74.1% vs. 65.7%, 27.1% vs. 21.0%, and 10.0% vs. 0%, respectively (P=0.042). Multivariate logistic regression analysis showed that operation time >360 min (OR=0.561, 95%CI: 0.321-0.979, P=0.042), intraoperative blood loss >400 ml (OR=0.392, 95%CI: 0.175-0.879, P=0.023), hard or tough texture of pancreas (OR=2.240, 95%CI: 1.247-4.022, P=0.007), and main pancreatic duct diameter >3 mm (OR=1.931, 95%CI: 1.126-3.312, P=0.017) were independent prognostic factors for TO. Conclusion After the learning curve, more than 60% of patients with PDAC can achieve TO after LPD. The chances of achieving TO are significantly reduced when the operation time >360 min, the intraoperative blood loss >400 ml, the texture of pancreas was soft, and the diameter of the main pancreatic duct >3 mm.

OBJECTIVE To explore the differences in T lymphocyte subsets of the severe pneumonia(SP)patients among different age groups and analyze its relationship with the prognosis.METHODS A total of 100 patients with SP who were treated in the First Affiliated Hospital of Zhengzhou University from Mar.2018 to Jun.2024 were enrolled in the study and were divided into the youth group with 22 cases(less than 40 years old),the middle age group with 36 cases(aging between 40 and 65 years old)and the old age group with 42 cases(more than 65 years old).The clinical data and the laboratory test indexes were compared among the three groups.The levels of CD3+,CD4+,CD8+and CD4+/CD8+before and after the treatment were compared among the three groups by repeated measures variance method.RESULTS The length of hospital stay of the old age group was longer than those of other two groups;the acute physiology and chronic health evaluation(APACHE)Ⅱ score,clinical pul-monary infection score(CPIS)and the levels of interleukin-6(IL-6),platelets(PLT),white blood cells(WBC),C-reactive protein(CRP)and lactic dehydrogenase(LDH)levels were higher in the old age group than in other two groups(P＜0.05).The levels of CD3+,CD4+,CD8+and CD4+/CD8+of all the three groups were elevated after the treatment,with the highest in the young group after the treatment for 2 months[the CD3+level(56.25±5.21)％,the CD4+level(35.65±2.43)％,the CD8+level(22.33±1.74)％,and the CD4+/CD8+(1.97±0.25)],the lowest in the old age group[after the treatment for 2 months the CD3+level(49.46±2.67)％,the CD4+level(28.45±3.45)％,the CD8+level(15.68±2.23)％,and the CD4+/CD8+(1.46±0.14)],there were significant differences(F=21.830,P=0.045;F=41.870,P=0.024;F=71.914,P=0.014;F=48.463,P=0.020).CONCLUSION The CD3+,CD4+,CD8+and CD4+/CD8+have great clinical significance in diagnosis of SP for different age groups of patients and assessment of illness condition.

Objective:To investigate the clinical data, drug resistance and treatment prognosis of Cryptococcus neoformans isolated from patients with acquired immunodeficiency syndrome(AIDS) in a hospital in Shanghai. Methods:The clinical data of AIDS patients with Cryptococcus neoformans infection in Shanghai Public Health Clinical Center from January 2014 to December 2023, and the drug sensitivity to 5 antifungal drugs in vitro, treatment and prognosis were retrospectively analyzed. Results:From January 2014 to December 2023, there were 295 AIDS patients with Cryptococcus neoformans infection in our hospital, with 255 males and 40 females. CD4 + T lymphocyte counts ≤100 cells/μl were detected in 251 patients. A total of 384 strains of Cryptococcus neoformans were isolated from the 295 patients, with the highest detection rate in cerebrospinal fluid samples (65.9%, 253/384), followed by blood samples (29.4%, 113/384). The sensitivity of 384 strains of Cryptococcus neoformans to 5-fluorocytosine was the highest (98.5%, 379/384), followed by fluconazole (95.6%, 367/384) and amphotericin B (95.3%, 366/384). After treatment against cryptococcal infection, 252 patients (86.0%, 252/293) were discharged and 20 patients (6.8%, 20/293) died. The other 2 cases were not treated for cryptococcal infection. Conclusions:As Cryptococcus neoformans is an important pathogen of AIDS patients, clinicians should actively carry out laboratory examination of Cryptococcus and rational drug use according to the results of drug sensitivity test, while alert to the occurrence of drug resistance.

Objective To explore the symptom clusters in renal transplant recipients and con-struct a concurrent symptom network to identify core symptoms.Methods A total of 343 patients with followed up after renal transplantation were selected as the study subjects.A general information questionnaire and the Chinese version of the Modified Transplant Symptom Occurrence and Symptom Distress Scale were employed to analyze the occurrence of symptoms in patients.In this study,only symptoms with an incidence rate greater than 20％and Spearman correlation coefficient greater than 0.40 between symptom severity and total score were retained.Exploratory factor analysis was used to extract symptom clusters with a factor loading of ≥0.45 as the criterion.The R language was utilized to construct symptom network,based on which core symptoms and bridge symptoms were identified.Results A total of 5 symptom clusters were extracted in this study:the neuro-gastrointestinal symp-tom cluster,the mood-related symptom cluster,the hormone-related symptom cluster,the energy de-ficiency symptom cluster and the vision-related symptom cluster.The core symptoms were anxiety(rs=1.75),mood swings(rs=1.50)and muscle weakness(rs=1.27).The top three symptoms in terms of bridge strength were muscle weakness(rb=0.87),lack of vitality(rb=0.66)and fa-tigue(rb=0.65).Conclusion Multiple symptoms are presented in patients after renal transplanta-tion.Based on the results of symptom network analysis,clinicians can strengthen the assessment of core symptoms and bridge symptoms to develop precise intervention strategies and improve the effectiveness of symptom management.

Objective To investigate the correlation between single nucleotide polymorphisms(SNPs)of the EGF gene,including rs11569017(A>T),rs2237051(A>G),rs3733625(C>T),and rs4444903(A>G),and the risk of non-small cell lung cancer(NSCLC)in a Han population of Yunnan.Methods A total of 439 patients with NSCLC and 520 healthy controls were recruited in Yunnan Province between January 2022 and December 2023.Genotyping of four SNP loci in the EGF gene was performed using TaqMan probes,followed by analysis of allele,genotype,genetic model,and haplotype distribution frequencies between NSCLC and control groups.Stratified analyses were further conducted based on NSCLC pathological types and clinical stages.Results The rs2237051 locus showed significant differences in allele(P=0.011)and genotype(P=0.042)frequencies between the squamous cell carcinoma(SCC)group and the control group.The frequency of the A allele was lower in the SCC group than in the control group(OR=0.71,95%CI 0.54～1.85),but there was no difference after Bonferroni correction(P>0.0125).Under the log-additive model,the rs2237051-2G/G+A/G genotype was associated with an increased risk of SCC(P=0.01;OR=1.42,95%CI 1.08～1.86).However,the association lost statistical significance after Bonferroni correction(P>0.0125).The haplotype rs11569017-rs2237051-rs3733625-rs4444903 has no difference between the two groups(P>0.0125).The stratified analysis revealed no significant associations between the genetic loci and different disease stages(P>0.0125).Conclusion In the Yunnan Han population,the individuals carrying the rs2237051-A allele of the EGF gene have a significantly lower risk of squamous lung cancer,but further functional experiments are needed to verify the protective mechanism.