Objective: To establish an accurate and rapid typing method for Rh typing of samples from patients who have received recent blood transfusions by utilizing the difference in osmotic fragility between fresh and old red blood cells. Methods: A lysing solution suitable for destroying old RBCs was prepared. Sixty-one samples collected in our hospital in 2024 with Rh typing of double groups were treated with the lysing solution to remove the old allogeneic red blood cells while preserving the patient's own fresh red blood cells, followed by repeat Rh typing tests. Results: For 61 samples with Rh typing in double groups, 41 were accurately detected identified through the red blood cell lysis method, yielding an identification rate of 67.21%. No significant difference was observed compared to the detection rate of the commonly used capillary centrifugation modified method (χ =0.103, P>0.05). Conclusion: The red blood cell lysis method provides a novel and rapid experimental approach for clinical use in processing Rh-typed samples that are of double groups, thereby offering a basis for Rh compatibility blood transfusion.

OBJECTIVE:To evaluate the efficacy and safety of different immunosorbent columns in the treatment of rheumatoid arthritis through a network meta-analysis,and provide evidence-based basis for clinical diagnosis and treatment.METHODS:By computer,the databases of VIP,WanFang,CNKI,PubMed,CBM,CochraneLibrary,and Web of Science were searched for published cohort studies of immunosorbent column for the treatment of rheumatoid arthritis,with a time limit until August 2024.The quality of the included randomized controlled trials was assessed using the Cochrane5.4 manual.The quality of retrospective cohort studies were evaluated via the Newcastle-Ottawa Scale(NOS).Bayesian network meta-analysis was performed using R4.1.1 software.RESULTS:A total of 13 studies were included,with a total sample size of 891 cases,and 4 immunosorbent columns were included.The results of the network meta-analysis showed that the top three orders that reduce C-reactive protein level:HA280 adsorption column+conventional Western medicine＞PH-350 adsorption column+conventional Western medicine＞A protein adsorption column;the top three orders that reduce erythrocyte sedimentation rates:leukocyte adsorption column＞HA280 adsorption column+conventional Western medicine＞PH-350 adsorption column+conventional western medicine;the top three orders that reduce swollen joint count:leukocyte adsorption column＞A protein adsorption column+conventional western medicine＞PH-350 type adsorption column+conventional Western medicine;the top three orders that reduce tenderness joint counts:leukocyte adsorption column＞A protein adsorption column+conventional western medicine＞PH-350 adsorption column+conventional Western medicine;the top three orders that reduce patients' disease activity evaluation:PH-350 adsorption column+conventional western medicine＞leukocyte adsorption column＞A protein adsorption column;the top three orders that reduce visual analogue scale scores:PH-350 adsorption column+conventional Western medicine＞A protein adsorption column＞leukocyte adsorption column;the top three orders that reduce physician's disease activity assessment:PH-350 adsorption column+conventional Western medicine＞leukocyte adsorption column＞conventional Western medicine.CONCLUSION:Based on the 13 articles,in terms of reducing C-reactive protein level,HA280 adsorption column and conventional Western medicine are the preferred choice.In terms of reducing erythrocyte sedimentation rate,swollen joint count,and tender joint count,leukocyte adsorption column is the preferred choice.In terms of reducing patient's disease activity evaluation,physician's disease activity evaluation and visual analogue scale scores,PH-350 adsorption column and conventional Western medicine are the first choice.Different immunosorbent columns can be reasonably and accurately selected according to the patient's specific conditions.

OBJECTIVE:To evaluate the efficacy and safety of different immunosorbent columns in the treatment of rheumatoid arthritis through a network meta-analysis,and provide evidence-based basis for clinical diagnosis and treatment.METHODS:By computer,the databases of VIP,WanFang,CNKI,PubMed,CBM,CochraneLibrary,and Web of Science were searched for published cohort studies of immunosorbent column for the treatment of rheumatoid arthritis,with a time limit until August 2024.The quality of the included randomized controlled trials was assessed using the Cochrane5.4 manual.The quality of retrospective cohort studies were evaluated via the Newcastle-Ottawa Scale(NOS).Bayesian network meta-analysis was performed using R4.1.1 software.RESULTS:A total of 13 studies were included,with a total sample size of 891 cases,and 4 immunosorbent columns were included.The results of the network meta-analysis showed that the top three orders that reduce C-reactive protein level:HA280 adsorption column+conventional Western medicine＞PH-350 adsorption column+conventional Western medicine＞A protein adsorption column;the top three orders that reduce erythrocyte sedimentation rates:leukocyte adsorption column＞HA280 adsorption column+conventional Western medicine＞PH-350 adsorption column+conventional western medicine;the top three orders that reduce swollen joint count:leukocyte adsorption column＞A protein adsorption column+conventional western medicine＞PH-350 type adsorption column+conventional Western medicine;the top three orders that reduce tenderness joint counts:leukocyte adsorption column＞A protein adsorption column+conventional western medicine＞PH-350 adsorption column+conventional Western medicine;the top three orders that reduce patients' disease activity evaluation:PH-350 adsorption column+conventional western medicine＞leukocyte adsorption column＞A protein adsorption column;the top three orders that reduce visual analogue scale scores:PH-350 adsorption column+conventional Western medicine＞A protein adsorption column＞leukocyte adsorption column;the top three orders that reduce physician's disease activity assessment:PH-350 adsorption column+conventional Western medicine＞leukocyte adsorption column＞conventional Western medicine.CONCLUSION:Based on the 13 articles,in terms of reducing C-reactive protein level,HA280 adsorption column and conventional Western medicine are the preferred choice.In terms of reducing erythrocyte sedimentation rate,swollen joint count,and tender joint count,leukocyte adsorption column is the preferred choice.In terms of reducing patient's disease activity evaluation,physician's disease activity evaluation and visual analogue scale scores,PH-350 adsorption column and conventional Western medicine are the first choice.Different immunosorbent columns can be reasonably and accurately selected according to the patient's specific conditions.

Objective: To develop a RHCE genotyping assay based on kompetitive allele-specific PCR (KASP) and assess its clinical accuracy for RhCE blood group determination. Methods: KASP primers were designed to interrogate three RHCE loci: the 109 bp insertion/deletion in intron 2, c. 307T>C, and c. 676C>G. A total of 1 194 RhD-positive inpatients from Chengdu were typed by both KASP genotyping and manual tube serology. Discordant samples (n=10) were retested by both methods and further resolved by Sanger sequencing. An additional 377 cases were tested for the c. 48C>G locus to evaluate the predictive accuracy of individual loci and combined locus testing for RhC antigen. Results: Genotyping concordance with serology was 100.0% for both the c. 676C>G locus (RhE/Rhe) and the c. 307T>C locus (Rhc). For RhC prediction using the 109 bp insertion, overall accuracy was 99.7% (1 191/1 194); the 3 discordant cases were confirmed by Sanger sequencing to be false negatives attributable to 109 bp deletion in intron 2. Testing the c. 48C>G allele for RhC prediction yielded 7 false positives, with an accuracy of 98.1% (370/377). RhC antigen status was determined by combining the 109 bp insertion and the c. 48C allele. After excluding 10 samples with inconsistent results between the two loci, the accuracy reached 100% in the remaining 367 samples. When both loci were applied in combination, accuracy reached 100% in the 367 cases with concordant results. Among the 1 194 patients, CCee (45.8%) and CcEe (31.7%) were the most common RhCE phenotypes. The e antigen had the highest positivity rate (92.2%), and the Ce haplotype was the most frequent (66.9%). Conclusion: The KASP-based RHCE genotyping method achieves high accuracy for clinical RhCE typing. Combining the 109 bp insertion/deletion with the c. 48C allele significantly improves RhC antigen prediction compared with either locus alone. This method was applied to RhCE genotyping of 1 194 RhD-positive inpatients in Chengdu, providing local RhCE phenotype and haplotype distribution data to support RhCE-matched transfusion practice.

OBJECTIVE To develop and validate interpretable machine learning models for predicting the risk of medication-related osteonecrosis of the jaw （MRONJ） and surgical outcomes， thereby providing quantitative support for MRONJ risk assessment and treatment decision-making.METHODS Two study cohorts were established. Cohort A adopted a nested case-control study design to develop a predictive model for the risk of MRONJ onset. Cohort B comprised patients with MRONJ from Cohort A who underwent surgical treatment and met the follow-up eligibility criteria， and employed a prospective follow-up cohort study design to develop a predictive model for the efficacy of MRONJ surgery. After missing-data processing， variable standardization， and encoding， predictive features were selected using the least absolute shrinkage and selection operator （LASSO） regression， and collinearity was assessed using the variance inflation factor （VIF）. Random Forest （RF）， eXtreme Gradient Boosting （XGB）， Multi-layer Perceptron （MLP）， Support Vector Machine （SVM）， and Gaussian Naive Bayes （NB） models were subsequently developed using the selected features. Hyperparameter optimization and internal performance evaluation were performed using two-level nested cross-validation repeated 20 times. In Cohort B， the synthetic minority over-sampling technique （SMOTE） was applied within the inner training folds to address class imbalance. Model performance was comprehensively evaluated using the receiver operating characteristic （ROC） curve， the precision-recall （PR） curve， calibration curve， and decision curve analysis （DCA）. Shapley additive explanations （SHAP） were used to quantify the relative contributions of individual clinical features to model predictions.RESULTS Seven clinical features， including alkaline phosphatase and tooth extraction， were retained for Cohort A； whereas eight clinical features， including age and duration of medication use， were retained for Cohort B. In Cohort A， the area under the ROC curve， the area under the PR curve， Brier score， sensitivity， and specificity of the RF model were 0.94， 0.92， 0.09， 0.92， and 0.85， respectively； the corresponding values in Cohort B were 0.93， 0.93， 0.12， 0.83， and 0.93， respectively. The results of calibration curves and DCA indicated that the RF models achieved favorable calibration and clinical net benefit， with VIF values for all variables below 5. SHAP visualization results showed that alkaline phosphatase， tooth extraction， and cumulative drug dose made substantial contributions to MRONJ risk prediction in Cohort A， whereas age， duration of medication use， and MRONJ stage contributed substantially to surgical outcome prediction in Cohort B.CONCLUSIONS The RF-based models for predicting MRONJ risk and surgical outcomes demonstrated good discrimination， accuracy of probabilistic predictions， and potential clinical utility during internal validation. These models may provide decision support for comprehensive MRONJ risk management and individualized clinical decision-making. However， external validation in independent， multicenter， and geographically diverse cohorts is still required.

Inflammatory bowel disease（IBD）is a type of disease characterized by chronic intestinal inflammation，mainly including Crohn's disease，ulcerative colitis，and undifferentiated IBD. Its pathogenesis is very complex and involves multiple factors. In recent years，studies have shown that heat shock proteins（HSPs）and cell apoptosis play important roles in the occurrence and progression of IBD. HSPs not only participate in cellular stress response，but also play a crucial role in regulating cell apoptosis. The specific mechanism of the interaction between HSPs and apoptosis in IBD is currently unclear. This article reviews the relationship and mechanism between HSPs and apoptosis in the occurrence and development of IBD，explores the roles of HSPs and apoptosis in IBD，and proposes potential treatment strategies to provide more effective treatment options for IBD patients in the future.

Objective:To establish fingerprints of Faeces Bombycis and simultaneously determine the content of four amino acids; To evaluate the quality of Faeces Bombycis from different regions. The fingerprint of Faeces Bombycis was established and the contents of 4 amino acids were determined.Methods:Kromasil 100-5 C18 (4.6 mm×250 mm, 5 μm) column was used for phenyl isothiocyanate (PITC) pre-column derivation-high performance liquid chromatography with acetonitrile-0.1 mol/L sodium acetate solution (pH adjusted to 6.5 with acetic acid) (7:93) mixed solution, and acetonitrile-water (4:1) mixed solution were mobile phase for gradient elution. The flow rate was 1.0 ml/min; the column temperature was 35 ℃; the detection wavelength was 254 nm; the injection amount was 5 μl. The fingerprints of 17 batches of Faeces Bombycis were established, the common peaks were identified by comparison of reference materials, and the similarity evaluation and principal component analysis (PCA) were carried out. The contents of glycine, alanine, proline and phenylalanine were determined simultaneously.Results:A total of 12 common peaks were identified from the fingerprints of Faeces Bombycis, and 12 amino acids were identified. The similarity of 17 batches of samples was greater than 0.95. PCA analysis showed that the regional difference of the quality of Faeces Bombycis was not significant. Faeces Bombycis produced in Qujing city in Yunnan Province had the highest total contents of 4 amino acids.Conclusion:The method has good repeatability and can provide reference for the quality evaluation and standard improvement of Faeces Bombycis.

Objective To investigate the association between 8 insulin resistance(IR)surrogate markers and incident atherosclerotic cardiovascular disease(ASCVD)in population with cardiovascular-kidney-metabolic syndrome(CKM)of stages 0-3,and to identify the surrogate marker with the best predictive performance.Methods A study was conducted on 20121 community residents classified as CKM stages 0-3 from the Chengdu cohort of the China Multi-Ethic Cohort.A Cox proportional hazards model was used to calculate hazard ratios(HRs)between each IR surrogate marker and incident ASCVD.Cubic spline regression was employed to explore the dose-response relationships between these markers and incident ASCVD.The relative relationships between different markers and incident ASCVD were examined through the ratio of HRs(RHRs).Time-dependent area under the receiver operating characteristic curve(TDAUC)and Uno's C-statistic were calculated to compare the predictive performance of each marker for incident ASCVD.Based on the PREVENT equation components and the 8 surrogate markers under analysis,random forest feature selection was used to determine the contribution of each marker to accurate prediction.Results During a follow-up period of82 741.93 person-years,1447 incident cases of ASCVD were recorded,with an incidence density of 17.49 per 1000 person-years.Association analyses indicated that the triglyceride to high-density lipoprotein cholesterol ratio(TG/HDL)and the TyG/(TG/HDL)index were not associated with incident ASCVD(P＞0.05).The TyG index combined with obesity measurement parameters emerged as a reliable predictor of ASCVD incidence.The most promising indicator,TyG index with waist-to-height ratio(TyG_WHtR),exhibited an inverted J-shaped association with incident ASCVD(P for nonlinearity=0.045;TDAUC=0.640;C=0.634),while the TyG index with body mass index(TyG_BMI),waist circumference(TyG_WC),and waist-to-hip ratio(TyG_WHR)showed positive linear associations(all P for trend＜0.05),with relatively lower predictive performance(C=0.564,0.588,and 0.598,respectively).Although both the TyG index and the metabolic score for insulin resistance(METS-IR)were associated with increased ASCVD risk(TyG:Q2 vs.Q1,HR=1.23 and Q4 vs.Q1,HR=1.24;METS-IR:P for non-linearity=0.045),they exhibited poor predictive performance for incident ASCVD.Conclusion The TyG index combined with obesity measurement parameters is an ideal IR surrogate marker for predicting incident ASCVD in populations with stages 0-3 CKM.Monitoring these markers will facilitate the prevention and control of cardiovascular diseases in CKM populations.

The cultivation of top innovative nursing talents with Chinese characteristics in the new era lends critical support to the accomplishment of the strategic goal of the Healthy China Initiative.Herein,we reviewed the historical development of nursing science in China,clarified the conceptual framework of nursing science with Chinese characteristics in the new era,and identified the essential qualities and competencies required for top innovative nursing talents.Furthermore,we analyzed the mission and challenges in cultivating these nursing talents,and put forward new approaches,including formulating new ethics and political education theories specific to nursing science with Chinese characteristics,establishing a cross-disciplinary educational model of Nursing+X,and creating a new nursing talent cultivation ecosystem adapted to the era of human-machine symbiosis.This study provides theoretical insights into the cultivation of top innovative nursing talents who align their development well with national strategic needs,embody patriotism,and possess a strong sense of contemporary responsibility.

Objective:To investigate the intervention effect of exercise rehabilitation based on constructivism teaching mode on pelvic girdle pain (PGP) in pregnant women in late pregnancy, and to provide guidance for improving the pregnancy experience of PGP pregnant women.Methods:A quasi-experimental study was conduced, from November 2023 to February 2024, using convenience sampling method to select late pregnant women with PGP who had been filed and had regular obstetric checkups in the Second Hospital of Shandong University as the study subjects, they were randomly divided into intervention group (granted exercise rehabilitation based on the constructivism teaching model) and control group (granted exercise rehabilitation based on the traditional teaching model) according to the random number table method. Compare the pain scores and teaching effectiveness of pregnant women before and after the intervention in the two groups.Results:The final number of the two groups were 50 in each group, aged (32.38 ± 3.93) years in the intervention group; aged (31.34 ± 3.19) years in the control group. After the intervention, the pain scores of pregnant women in the intervention group (1.48 ± 1.26) scores were significantly lower than those in the control group (2.96 ± 1.42) scores, and the difference was statistically significant ( t = -5.45, P<0.05). The scores of the evaluation of the teaching effect memory problem scores, movement mastery scores, and classroom evaluations were (7.96 ± 1.30) scores, (13. 96 ± 0.88) scores, (27.54 ± 3.08) scores in the intervention group, which were significantly higher than those in the control group (5.80 ± 1.29) scores, (8.48 ± 1.82) scores, (16.24 ± 3.80) scores, the differences were statistically significant ( t = 8.30, 19.16, 16.31, all P<0.05). Conclusions:Based on the constructivism teaching model, exercise rehabilitation for pregnant women with PGP in late pregnancy can effectively alleviate their pelvic girdle pain, and the teaching effect is better than the traditional teaching model, which has the potential to be promoted and applied in the teaching of obstetric maternity schools.