Objective: To evaluate the safety and efficacy of preoperative autologous blood donation (PABD) under anesthesia monitoring in elective surgical procedures, and to provide scientific data for promoting its clinical application. Methods: 1) A total of 1 164 patients scheduled for elective surgery and met the criteria for stored autologous blood transfusion in our hospital from March 2022 to September 2023 were enrolled. Prior to surgery, stored autotransfusion was performed under anesthesia monitoring. During the operation, blood pressure (BP), heart rate (HR), blood oxygen saturation (SpO ) and other basic life indicators before and after blood collection were recorded and analyzed. Adverse reactions during blood collection were documented, and potential influencing factors were analyzed. 2) The autologous transfusion group (experimental group, patients receiving intraoperative autologous blood reinfusion) was compared with the allogeneic transfusion group (control group, patients without PABD during the same period) using propensity score matching. The length of hospital stay, transfusion-related costs, perioperative hemoglobin (Hb), hematocrit (Hct), platelet count (Plt) and coagulation function were compared between the two groups after matching. Results: 1) Three patients (0.26%) had adverse reactions during blood collection. Autologous blood transfusion was performed in 443 patients (38.1%) during or after operation, with no adverse reaction during blood transfusion. 2) The systolic blood pressure (SBP) and diastolic blood pressure (DBP) of patients after blood collection were lower than before blood collection, and the SpO was higher than before blood collection, with statistically significant differences (P<0.05); There was no significant difference in heart rate before and after blood collection (P>0.05); Our analysis found that age, gender, blood collection volume, department, or mild-to-moderate circulatory system complications didn’t significantly affect BP, HR and SpO fluctuations (P>0.05). 3) The experimental group had shorter hospital stays and lower transfusion costs than the control group (P<0.05). 4) No significant differences were observed in Hb, Hct, Plt levels or coagulation function (PT, APTT) between the two groups after operation (P>0.05). The hospitalization duration and transfusion related expenses in the experimental group were lower than those in the control group (P<0.05). Conclusion: PABD under anesthesia monitoring is safe and feasible in elective surgeries across diverse patient groups and surgical fields. It reduces the costs and conserves blood resources, which is worthy of further promotion.

As an important department to solve students’ daily psychological problems， the mental health counseling center in colleges and universities often results in many practical dilemmas due to the mismatch between the duty limitation and professional ability when facing the help of students with mental disorders. From the perspective of ethics， this paper discusses the difficulties in campus management， responsibility allocation and responsibility clarificationfaced by the school in dealing with student autonomy， home-school coordination， and properly settling the students returning to school. In order to alleviate ethical conflicts and provide some reference for colleges and universities to intervene and help students with mental disorders， the author tries to implement improvement measures by adhering to the concept of rehabilitation to improve autonomy， treating family members as help objects， establishing a complete system and sound regulations， and conducting joint efforts and supportive intervention assistance. This can alleviate ethical conflicts and provide certain references for the practice of colleges and universities’ intervention and assistance in dealing with students with mental disorders.

Objective: To analyze the epidemiological characteristics and trends of other infectious diarrhea among children under 18 years old in Guangzhou City from 2014 to 2020, and to explore the correlation between climatic factors and the incidence of the disease, so as to provide reference for the early prevention of infectious diseases. Methods: The data of cases of other infectious diarrhea and meteorological data of children under 18 years old in Guangzhou City from 2014 to 2020 were collected through the Chinese Infectious Disease Reporting System and the Guangzhou Meteorological Bureau. The correlation between meteorological factors and the incidence of other infectious diarrhea was analyzed using negative binomial regression. Results: A total of 104 566 cases of other infectious diarrhea among children under 18 years old were reported in Guangzhou City from 2014 to 2020, with a male to female ratio of 1.48∶1. The incidence rate was the highest in 2017 (980.83 per 100 000) and the lowest in 2020 (388.22 per 100 000). The peak of incidence occurred from October to March of the following year. Children under 5 years old accounted for 87.95% of all cases. The number of cases of other infectious diarrhea was negatively correlated with the temperature of the previous 6 days ( IRR = -0.07 ), and positively correlated with the temperature difference on the day of onset ( IRR =0.02) (both P <0.05). It was also positively correlated with the wind speed of the previous 7 days ( IRR=0.07, P <0.05), but there was no statistically significant correlation with the relative humidity on the day of onset ( IRR=-0.00, P >0.05). Conclusions Low temperature, large temperature difference, and high wind speed can increase the risk of other infectious diarrhea. It is necessary to strengthen the prediction and early warning in conjunction with meteorological changes, and warn kindergartens and schools to enhance preventive measures against the clustering of other infectious diarrhea cases.

Objective To compare the value of the 2018 Chinese guideline prognostic score with that of the 2019 European Society of Cardiology(ESC)in the predicting efficiency for acute pulmonary embolism(APE)in 30-day all-cause mortality.Methods The data of the hospitalized patients with confirmed APE from January 2015 to December 2019 were retrospectively collected.According to death within 30 days,the patients were divided into a death group and a survival group.Subgroup analysis was performed according to gender,oxygen saturation and infection.The SPSS software was used to establish the receiver operating characteristic curve(ROC)for the two scores and calculated the area under the curve(AUC).The Delong's test was applied to compare the AUC differences.The net reclassification index(NRI)and integrated discrimination improvement(IDI)were calculated using the R software packages of survival,survIDINRI,and PredictABEL.Results 626 APE patients were enrolled,and 30-day death was predicted in those patients using two scores.In terms of overall discrimination,the 2018 Chinese guideline prognostic score was better than the 2019 ESC guideline prognostic score,with an AUC of 0.782 and 0.749,respectively;but there were no statistical differences between the two AUC(P＞0.05).In terms of prediction accuracy,the NRI of the 2019 ESC guideline prognostic score was 44.4%(95%CI:0.091～0.753),higher than that of the 2018 Chinese guidelines prognostic score,which increased by 58.6%(95%CI:0.161～0.917)in the correct reclassification to death group,while decreased by 14.2%(95%CI:-0.249～0.08)in the correct reclassification to survival group.IDI increased by 3.38%(P＜0.05).Subgroup analysis showed the prognostic scores of the 2018 Chinese guidelines and the 2019 ESC guidelines prognostic scores had predictive ability for patients with different gender and different oxygen saturation(P＜0.05),and the prognostic scores for co-infected population(AUC:0.749,0.772)(P＞0.05),non-coinfected population(AUC:0.652,0.833).Conclusions Both the 2018 Chinese guideline prognostic score and the 2019 ESC guideline prognostic score can predict 30-day mortality in APE patients,and have a better predictive ability for the co-infected population.However,the predictive accuracy of the former is higher than that of the latter in the survival group,and the score is more rapid and convenient for clinical application,while the latter has improved the prediction ability in the death group.

Objective To comapre and analyze the differences and commonalities of expression profiles of serum exosomal microRNA between patients with thyroid nodules and healthy persons at different iodine levels,and then provide evidence for screening early diag-nostic markers of thyroid nodules at different iodine levels.Methods The peripheral blood samples from 10 patients with thyroid nod-ules and healthy volunteers at different iodine levels were collected.Their serum iodine levels were measured by the arsenic cerium cat-alytic spectrophotometry.Serum exosomal microRNA were extracted and the expression levels of microRNA were determined by the high-throughput sequencing technology.The differential target genes were predicted and further performed Gene ontology(GO)analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)analysis.Results Compared with healthy volunteers,there were 6 downreg-ulated miRNAs in the patients with thyroid nodules at different iodine levels,namely miR-324-5p,miR-6511b-3p,miR-9903,miR-550a-3p,miR-5001-3p,and miR-3688-3p.Differentially expressed exosomal microRNA could regulate the MAPK signaling path-way,PI3K-AKT signaling pathway,VEGF signaling pathway,and NF-κB signaling pathway.Conclusion Six differentially expressed microRNAs is identified,which may serve as biological markers for the early diagnosis of thyroid nodules at different iodine levels.

Hormonal receptor positive human epidermal receptor 2 negative (HR⁺/HER2^-) is the commonest molecular subtype of breast cancer (BC). Patients with HR⁺/HER2^- BC may manifest clinically a late recurrence whose BC metastasizes 10-15 years post-operatively. We report one case who presented with pulmonary mass in upper lobe of lung and Horner syndrome 16 years after BC surgery. FDG PET/CT suggested pulmonary malignancy but could not differentiate between primary or metastatic cancer when invasive biopsy was quite risky. Novel ¹⁸F-FES PET/CT facilitated the non-invasive functional diagnosis of estrogen-receptor positive (ER+) pulmonary metastasis of BC, and the patient experienced partial response (PR) after CDK4/6 inhibitor and aromatase inhibitor as endocrine therapy. This article reviews the diagnosis and treatment process of this case, to provide guidance for non-invasive global evaluation of ER status among metastatic HR⁺/HER2^- BC patients with ¹⁸F-FES PET/CT.

Acute pancreatitis is one of the most common acute abdominal diseases in clinical practice,and the common etiologies of acute pancreatitis include biliary diseases,alcohol,pancreatic duct diseases,metabolic disorders(hypertriglyceridemia and hypercalcemia),excessive eating,and diseases of the descending duodenum(periampullary duodenal diverticula).According to the etiology,acute pancreatitis is classified into biliary pancreatitis and hyperlipidemic pancreatitis,and although there are various pathogenic factors for biliary pancreatitis,biliary diseases including bile duct stones remain the most important etiology of biliary pancreatitis.Obstructed biliopancreatic duct drainage and abnormal pressure due to various causes,bile reflux into the pancreatic duct,obstruction of pancreatic juice drainage,and abnormal activation of pancreatic enzymes are the central links in the development of biliary pancreatitis.The location,size,texture,number and shape of bile duct stones are associated with the incidence rate and severity of biliary pancreatitis to a certain degree.

A 70-year-old man had radical surgery for colon cancer one year before the symptoms of memory loss and decreasing cognitive function.Subsequent magnetic resonance imaging revealed a brain mass,which was surgically resected and confirmed to be metastatic intestinal adenocarcinoma.Immunohistochemistry of the primary tumor and brain metastasis showed mismatch repair deficiency.The patient received adjuvant chemotherapy after surgery.However,the brain metastasis relapsed one month after the last chemotherapy.Genetic testing on the resected colon tumor samples confirmed microsatellite instability-high with a high tumor mutation burden by 77.7 muts/Mb.The patient was subsequently treated with programmed death-1(PD-1)monoclonal antibody pembrolizumab(keytruda).The brain metastatic lesions were completely shrunk,and a complete clinical response was achieved.

Objective:To analyze the growth characteristics of different genotypes of Japanese encephalitis virus (JEV) in different cell lines, and to provide scientific basis for the selection of cell lines in the study of JEV.Methods:BHK-21, Vero, C6/36, PK-15, DF-1, N2a, SH-sy5y and MDCK cell lines were selected. The proliferation ability of genotype 1 (NX1889 strain), genotype 3 (P3 strain) and genotype 5 (XZ0934 strain) JEV in these cell lines was evaluated by plaque assay and RT-qPCR.Results:Significant cytopathogenic effects (CPE) were observed in BHK-21, Vero, C6/36, DF-1, N2a and PK-15 cell lines across all three JEV genotypes. However, no significant differences in CPE characteristics were observed within the same cell line. SH-sy5y and MDCK cell lines did not show significant CPE, but virus proliferation was detected in SH-sy5y cell line, while MDCK cell line were found to be insensitive to JEV. No significant difference was observed in the proliferation curves of G1, G3 and G5 JEV in BHK-21, Vero and SH-sy5y cell lines. In C6/36 and PK-15 cell lines, the titer of G1 JEV was higher than that of G3 and G5. In DF-1 cell line, G5 demonstrated a higher titer than the other two genotypes, whereas in N2a cell line, G5 showed a lower titer than the other two.Conclusions:There are differences in the proliferation of three different genotypes of JEV in different cell lines, which can provide reference for the study of JEV in different directions.

Objective Genotypes(G)1,3,and 5 of the Japanese encephalitis virus(JEV)have been isolated in China,but the dominant genotype circulating in Chinese coastal areas remains unknown.We searched for G5 JEV-infected cases and attempted to elucidate which JEV genotype was most closely related to human Japanese encephalitis(JE)in the coastal provinces of China. Methods In this study,we collected serum specimens from patients with JE in three coastal provinces of China(Guangdong,Zhejiang,and Shandong)from 2018 to 2020 and conducted JEV cross-neutralization tests against G1,G3,and G5. Results Acute serum specimens from clinically reported JE cases were obtained for laboratory confirmation from hospitals in Shandong(92 patients),Zhejiang(192 patients),and Guangdong(77 patients),China,from 2018 to 2020.Seventy of the 361 serum specimens were laboratory-confirmed to be infected with JEV.Two cases were confirmed to be infected with G1 JEV,32 with G3 JEV,and two with G5 JEV. Conclusion G3 was the primary infection genotype among JE cases with a definite infection genotype,and the infection caused by G5 JEV was confirmed serologically in China.