Objective: To investigate the identification process of a case with anti-Fy combined with Rh blood group system antibodies and to review the transfusion strategy and epidemiological characteristics of Duffy blood group system antibodies. Methods: The antibody specificity of a patient diagnosed with liver cirrhosis, who exhibited unexpected antibodies, was determined using the microcolumn gel method, enzyme method, and elution test. A retrospective analysis was performed to assess the incidence and clinical characteristics of antibodies associated with the Duffy blood group system among a cohort of 652 003 patients treated at our hospital from 2014 to 2024. Results: The patient's serum contained anti-Fy , anti-c, and anti-E antibodies. Through the targeted recruitment of African international students, the patient successfully received four units of Fy -negative blood that matched the ABO and Rh phenotypes. Between 2014 and 2024, the incidence of Duffy blood group system antibodies was 0.005 7% (37 out of 652 003), with 9 cases (24.3%) combined with Rh antibodies. Conclusion: Patients with anti-Fy combined with Rh antibodies require Fy -negative blood with matched Rh phenotypes. Targeted recruitment based on racial antigen differences can effectively resolve rare blood type transfusion challenges.

OBJECTIVE: To evaluate precise assessment methods for predicting the optimal acetabular cup size in total hip arthroplasty (THA). METHODS: A clinical data of 73 patients (80 hips) who underwent primary THA between December 2022 and July 2024 and met the inclusion criteria was analyzed. There were 39 males and 34 females with an average age of 66.3 years (range, 56-78 years). Among them, 66 cases were unilateral THA and 7 were bilateral THAs. There were 29 patients (34 hips) of osteoarthritis, 35 patients (35 hips) of femoral neck fractures, and 9 patients (11 hips) of osteonecrosis of the femoral head. Based on anteroposterior pelvic X-ray films, three methods were employed to predict acetabular cup size, including preoperative template planning, radiographic femoral head diameter (FHD) measurement, and intraoperative FHD measurement. The predicted acetabular cup sizes from these methods were compared with the actual implanted sizes. RESULTS: The predicted acetabular cup sizes using the preoperative template planning, radiographic FHD measurement, and intraoperative FHD measurement were (51.25±2.81), (49.72±3.11), and (49.90±2.74) mm, respectively, compared to the actual implanted cup size of (50.57±2.74) mm, with no significant difference ( P>0.05). Regarding agreement with the actual implanted cup size, the preoperative template planning achieved exact matches in 35 hips (43.75%), one-size deviation in 41 hips (51.25%), and two-size deviations in 4 hips (5%); the radiographic FHD measurement achieved exact matches in 12 hips (15%), one-size deviation in 57 hips (71.25%), and two-size deviations in 11 hips (13.75%); and the intraoperative FHD measurement achieved exact matches in 26 hips (32.5%), one-size deviation in 52 hips (65%), and two-size deviations in 2 hips (2.5%). There were significant differences in agreement distributions between the three methods and the actual implanted cup sizes ( H=18.579, P<0.001). CONCLUSION The intraoperative FHD measurement, as a simple, cost-effective, and accurate method, effectively guides acetabular cup selection, reduces the risk of prosthesis wear, enhances postoperative joint stability.
Humans ; Arthroplasty, Replacement, Hip/instrumentation* ; Male ; Female ; Middle Aged ; Acetabulum/diagnostic imaging* ; Aged ; Hip Prosthesis ; Prosthesis Design ; Femur Head/surgery* ; Osteoarthritis, Hip/surgery* ; Radiography ; Femoral Neck Fractures/surgery* ; Femur Head Necrosis/surgery*

Objective:To evaluate the clinical utility of machine learning model based radiomics in predicting high-risk molecular subtypes of lower-grade gliomas(LrGGs).Methods:This was a cross-sectional study. A total of 287 patients diagnosed with LrGGs in the First Hospital of Shanxi Medical University, Shanxi Provincial People′s Hospital, and the Third Hospital of Shanxi Medical University from January 2011 to September 2023 were retrospectively collected, including 166 males and 121 females; 114 cases of high-risk molecular subtypes and 173 cases of non-high-risk molecular subtypes. All patients were divided into 201 cases in the training set and 86 cases in the test set according to 7∶3 in simple randomized grouping method. All patients underwent contrast-enhanced T 1WI (CE-T 1WI) and T 2-weighted fluid-attenuated inversion recovery sequence imaging (T 2-FLAIR), and the imaging features of high-risk and non-high-risk molecular subtypes were analyzed. Analysis of variance, recursive feature elimination, and Kruskal-Wallis were used for radiomics feature screening, and a support vector machine (SVM) classifier was used to construct a radiomics-based classifier model. Univariate and multivariate logistic regression were used to analyze clinical variables independently influencing high-risk molecular subtypes of LrGGs to construct a clinical model; a combined model was developed by integrating radiomics labels and clinical variables. Receiver operating characteristic curve and area under the curve (AUC), calibration curve, and decision curve were used to compare the predictive performance of different models. Results:The patient′s age ( OR=1.042, 95% CI 1.018-1.068, P=0.001), pathological grade ( OR=2.270, 95% CI 1.212-4.311, P=0.011), MGMT methylation status ( OR=0.456, 95% CI 0.238-0.866, P=0.017), and ependymal involvement ( OR=7.335, 95% CI 2.929-18.370, P<0.001) were independent influencing factors for the high-risk molecular subtype of LrGGs, and a clinical model was developed based on these factors. An SVM model was constructed based on 12 radiomics features (3 radiomics features based on CE-T 1WI and 9 radiomics features based on T 2-FLAIR). The radiomics score of the probability output by the SVM model was combined with age, pathological grade, MGMT methylation status, and ependymal involvement to develop a combined model. The AUC values of the SVM model for predicting the high-risk molecular subtype of LrGGs were 0.824 and 0.859 in the training set and test set, respectively; the AUC values of the clinical model in the training set and test set were 0.759 and 0.721, respectively; and the AUC values of the combined model in the training set and test set were 0.823 and 0.815, respectively. The combined model had a high clinical net benefit. Conclusion:The machine learning MRI radiomics model can preoperatively predict high risk molecular subtypes of LGGrs, assist in individualized treatment decisions.

Systematically sort out the successful development experience and current shortcomings of various aspects of combined Chinese and Western medicine first aid,and on this basis,we discuss the development ideas of combined Chinese and Western medicine first aid.Based on the complementary advantages of the combination of Chinese and Western medicines in first aid,it takes the special diseases with bottlenecks in the efficacy of the current single system as an entry point,and further optimizes the combination of Chinese and Western medicines in first aid through the dynamic and sequential coordination of Chinese medicine's holistic conditioning and Western medicine's targeted treatment,and promotes the development of the synergistic strategy of the first aid of Chinese and Western medicines,so as to better play the advantageous roles of the combination of Chinese and Western medicines in first aid to enhance the clinical efficacy,reduce the toxicity and side-effects,and improve the prognosis of the diseases.We also strive to promote the improvement of the dosage form of traditional first aid prescriptions and the technical innovation of the production process,so as to realize the improvement of the key indexes such as the timeliness of the onset of action,the controllability of the quality,and the targeting of the efficacy of the Chinese medicinal preparations in the first aid,in order to better support and guarantee the medicines for the first aid of the combination of traditional Chinese and Western medicines.At the same time,we should also promote the systematic construction of the standardized operation specification and efficacy evaluation system of acupuncture and moxibustion,explore the integration of acupuncture and moxibustion with modern first aid,and optimize acupuncture and moxibustion intervention strategies in emergency departments to enhance the efficacy of first aid under the restriction of medical equipments.The proposal of these suggestions may provide some enlightenment in the development of the idea of integrating Chinese and Western medicine in emergency care,and may have some reference value for the development of emergency medicine model with Chinese characteristics.

Objective To investigate the influence of the liver failing to convey and disperse on space navigation aging.Methods High and low neuroticism subjects screened by Eysenck personality questionnaire were included in liver failing to convey and disperse group and liver controlling conveyance and dispersion group,respectively.The two groups were then divided into youth and elderly groups based on age.Finally,spatial navigation task was conducted to record and analyze behavioral(reaction time and accuracy)and EEG data(amplitude and latency of P2 and N2 components)of all the four groups(30 subjects each group).Results Compared with liver controlling conveyance and dispersion group,the accuracy in subjects with liver failing to convey and disperse decreased significantly(P<0.001)and reaction time was prolonged significantly(P<0.05).The interaction effect between age and liver regulation status showed a marginal significant difference(P=0.078).The accuracy of elderly people was lower than that of youth people(P=0.002)for liver failing to convey and disperse subjects,while there was no significant difference between the two groups for subjects with liver controlling conveyance and dispersion.The P2 amplitude in the elderly group was significantly smaller than that in the youth group(P=0.027).The amplitude of P2 in group of liver failing to convey and disperse was significantly smaller than that in group of liver controlling conveyance and dispersion(P=0.042).The interaction effect of P2 amplitude between age and liver regulation status showed a marginal significance(P=0.073).For youth subjects,the P2 amplitude in group of liver controlling conveyance and dispersion was significantly larger than that in group of liver failing to convey and disperse(P=0.007),while there was no significant difference in P2 amplitude between the two groups for the elderly subjects.The N2 amplitude for tasks of allocentric frames of reference was significantly greater than that of egocentric frames of reference(P=0.024).Conclusion Liver failing to convey and disperse caused by long-term emotional disturbance accelerates spatial navigation aging,and selective attention feature inhibition disorder may be the underlying ERPs neuroelectrophysiological mechanism.

Objective To investigate the influence of the and mechanism of liver failing to convey and disperse on age-related changes in attentional search based on ERPs.Methods oddball attention search task was administrated to record and analyze behavioral and EEG data(N2pc、SPCN、N2pc-Ptc components)of 120 subjects.Results Compared with liver controlling conveyance and dispersion group,the accuracy in subjects with liver failing to convey and disperse decreased significantly(P<0.05).The elderly group had a lower accuracy(P<0.001)and a longer reaction time(P<0.001)compared to the young group.The N2pc amplitude in subjects with liver failing to convey and disperse was significantly greater than that in subjects with liver controlling conveyance and dispersion(P<0.05).The interaction effect of SPCN amplitude between age and liver failing to convey and disperse status was significant(P=0.024).And in the elderly group,SPCN amplitude in subjects with liver dysregulation was significantly smaller than that of liver controlling conveyance and dispersion(P=0.042).The N2pc-Ptc peak to peak amplitude interaction effect between age and liver regulation status was marginal significant(P=0.087),and in liver failing to convey and disperse group,N2pc-Ptc peak to peak amplitude of the elderly was significantly smaller than that of the young(P=0.008).Conclusion Attention search ability is impaired in the elderly with liver failing to convey and disperse,and the electrophysiological abnormalities,such as directed attention allocation,spatiotemporal dynamic cohesion and short-term memory maintenance,may be part of the mechanism.

Alcohol use disorder(AUD)is a common mental disorder and physiological disease impac-ting millions globally.Although multiple studies have explored the causes and treatments of AUD,its exact mechanisms remain poorly understood.The development of lipidomics technology provides a new perspective for studying AUD and can be used to investigate its biological mechanisms.This review summarizes recent ap-plications and progress of lipidomics in AUD research,as well as its potential value in prevention and treat-ment strategies.

Objective:To compare the clinical efficacy of Chevron-Akin osteotomy with cannulated compression screw and absorbable screw fixation in the treatment of moderate and severe hallux valgus.Methods:The data of 52 patients with moderate to severe hallux valgus treated in Sichuan Provincial Orthopaedic Hospital from January 2020 to December 2022 were retrospectively analyzed. According to the fixation method, they were divided into metal screw group and absorbable screw group. In the metal screw group, there were 25 cases (26 feet), 2 males (2 feet) and 23 females (24 feet), aged 36.7±4.9 years (range, 21-59 years), 12 feet on the left side, 14 feet on the right side, moderate 20 feet and severe 6 feet. There were 27 cases (29 feet) in the absorbable screw group, including 1 male (1 foot) and 26 female (28 feet), aged 34.1±5.5 years (range, 19-56 years), 16 feet on the left side, 13 feet on the right side, moderate 22 feet and severe 7 feet. The healing time and complications of osteotomy were recorded between the two groups, and the hallux valgus angle (HVA), first-second intermetatarsal angle (1-2 IMA), American Orthopaedic Foot and Ankle Society (AOFAS), hallux-metatarsophalangeal-interphalangeal joint score and visual analogue scale (VAS) for pain were compared before and after the operation.Results:All 52 patients were followed up. The follow-up time was 14.0±3.4 months (range, 11-27 months) in the metal screw group and 15.1±2.7 months (range, 13-24 months) in the absorbable screw group. In all patients, the incision healed in one stage, and no endovegetal rejection occurred. The osteotomy healing time was 3.8±0.8 months (range, 2-5 months) in the metal screw group and 3.4±1.1 months (range, 2.5-5 months) in the absorbable screw group, with no statistically significant difference ( t=1.014, P=0.417). In the metal screw group, there were symptoms of medial internal fixation irritation in 2 feet, medial osteophyte or thread knot irritation in 2 feet, and hallux valgus recurrence in 1 foot. The complication rate was 19%(5/26). In the absorbable screw group, medial osteophyte or thread knot stimulated one foot and hallux valgus recurred one foot, and the complication rate was 7%(2/29). The difference in complications between the two groups was statistically significant (χ 2=8.051, P=0.012). At 12 months after operation, for the metal screw group and the absorbable screw group, HVA (13.7°±2.1° and 12.9°±3.8°), 1-2 IMA (7.2°±1.5° and 7.8°±1.2°), AOFAS score (91.4±2.2 and 90.8±3.6 points) and VAS score (1.1±0.3 and 1.3±0.4 points), respectively, were significantly higher than those in the preoperative (HVA: 37.2°± 5.4° and 35.8°±4.7°, 1-2 IMA: 18.3°± 1.8° and 17.9°±1.7°, AOFAS score: 60.4±5.6 and 58.4±7.1 points, VAS: 6.4±0.6 and 6.8±0.4 points) improvement ( P<0.05), while there was no statistically significant difference between the two groups ( P>0.05). The incidence of complications in metal screw group was 19%(5/26), while in absorbable screw group it was 7%(2/29), with a statistically significant difference (χ 2=8.051, P=0.012). Conclusions:Both cannulated compression screw in Chevron-Akin osteotomy and absorbable screw fixation can have a good fixation effect in the treatment of moderate and severe hallux valgus. Absorbable screw fixation has the advantages of low complication rate, less interference with artifacts in later imaging examination and evaluation.

With the rapid development of artificial intelligence (AI) technology, its applica-tion in diagnosis and treatment of colorectal cancer (CRC) has deepened, covering preoperative diagnosis, surgical assistance, and prognostic evaluation. AI can accurately detect precancerous lesions and tumor characteristics during screening of CRC, improving diagnostic precision.During surgery, AI provides real-time feedback and navigation support, helping surgeons improve precision and reduce complications. After surgery, AI integrates multidimensional data to optimize treatment decisions and resource allocation. However, current AI models still face challenges in accuracy, generalization, and integration with existing medical systems, and societal issues such as privacy and ethics need to be addressed. With ongoing technological advancements, AI is expected to play a greater role in minimally invasive surgeries for CRC, particularly in robotic surgery, offering more precise and personalized treatment options in the future. The authors summarize application and prospect of artificial intelligence in minimally invasive treatment of colorectal cancer, aiming to provide references for clinical practice.

Objective:This study evaluated the efficacy of the PST technique: Preservation of the left colic artery (P), suture reinforcement (S), and transanal tube (T) combined with selective fecal diversion via end ileostomy, in preventing anastomotic leakage following laparoscopic anterior resection (LAR) for mid-to-low rectal cancer.Methods:We retrospectively collected data for this descriptive case series from patients who underwent laparoscopic LAR with complete or partial application of the PST technique, some of whom received prophylactic ileostomy, at the Department of Colorectal Surgery, Zhongshan Hospital Affiliated to Fudan University, and its Xiamen Branch between July, 2022 and December, 2024. "Partial PST" was defined as the implementation of PS (Preservation of the left colic artery + suture reinforcement), PT (Preservation of the left colic artery + transanal tube), ST (suture reinforcement + transanal tube), or a single T procedure (Transanal tube). The primary outcome measures were the proportion of patients who received the PST technique and terminal ileostomy, as well as the incidence of anastomotic leaks.Results:Among 198 patients, 145 received complete PST. Fifty-three patients underwent partial PST (PT) because anastomotic reinforcement was not feasible due to an excessively low anastomosis or obesity. All patients achieved R0 resection. Postoperative pathology showed that 108 patients (54.5%) were at T3-T4 stage, and 81 patients (40.9%) had poorly differentiated adenocarcinoma or mucinous adenocarcinoma. A total of 19.7% (39/198) of patients developed grade II or higher postoperative complications, including 11 cases (5.6%) of surgical site infection and 7 cases (3.5%) of urinary retention. Five patients were rehospitalized within 30 days after surgery, among whom 2 had intestinal obstruction, and 3 developed grade C anastomotic leaks that required reoperation for salvage enterostomy. The overall incidence of anastomotic leakage was 3.0% (6/198). Fifty-three patients (26.8%) received protective ileostomy, with an anastomotic leak incidence of 1.9% (1/53). Methylene blue leakage occurred in 20 patients (10.1%), all of whom received prophylactic ileostomy and had no anastomotic leakage postoperatively. Among 61 patients who received neoadjuvant chemoradiotherapy before surgery, 28 underwent prophylactic ileostomy, and none developed anastomotic leaks after surgery.Conclusions:Routine application of the PST technique during laparoscopic low anterior resection, along with prophylactic enterostomy for ultra-high-risk populations, can effectively control the incidence of anastomotic leakage.