Objective: Data on syncopal donation-related vasovagal reaction (DRVR) collected from 74 blood centers between 2020 and 2023 was statistically analyzed to provide a reference for developing preventive strategies against syncopal DRVR. Methods: Data on blood donation adverse reactions and basic information of donors from 2020 to 2023 were collected through the information management system at monitoring sentinel sites. Statistical analysis was performed on the following aspects of syncopal DRVR: characteristics of donors who experienced syncope, reported incidence, triggers, duration, presence and occurrence time of syncope-related trauma, clinical management including outpatient and inpatient treatment, and severity grading. Results: From 2020 to 2023, 45 966 donation-related adverse reactions were recorded. Of these, 1 665 (3.72%) cases were syncopal DRVR. The incidence of syncopal DRVR decreased with age, being the highest in the 18-22 age group. Incidence was significantly higher in female donors than male donors, in first-time donors than repeat donors, and in university and individual donors than group donors (all P<0.05). There was no statistically significant difference among different blood donation locations (P>0.05). The top three triggers were tension, fatigue, and needle phobia or fear of blood. Among syncopal DRVR cases, 60.36% occurred during blood collection, 87.63% lasted for less than 60 seconds, and 5.05% were accompanied by trauma. Notably, 57.14% of these traumas occurred after donor had left the blood collection site. Syncope severity was graded based on required treatment: grade 1 (fully recovered without treatment, 95.50%); grade 2 (recovered after outpatient treatment, 4.02%); and grade 3 (recovered after inpatient treatment, 0.48%). Conclusion: By analyzing the data of syncopal DRVR cases, it is possible to provide a reference for formulating blood donor safety policies.

The conventional identification and prediction for failures of medical equipment mainly depend on experience and knowledge of manager for equipment,which are not able to be quantified and have lower efficiency. Therefore,it is obvious that the prediction for the failure of medical equipment is not accurate. With the technical development of computer and machine learning,the conventional identification and prediction that depend on experiences can deal with characteristics of failures through machine learning method to improve efficiency,which are hopeful in filling the gap of discipline about the identification and prediction for failures of medical equipment. This article summarized the application situation of machine learning in identifying and predicting failures of the medical equipment and the similarly electric equipment at home and abroad. Based on the key technique of identification and prediction,this article proposed suggestion about corresponding design architecture. According to the characteristics of the failure of medical equipment,this article summarized a series of information about algorithms of various machine learning in scene and accurate rate of identification and prediction,so as to provide references for relevant research of this field.

The conventional identification and prediction for failures of medical equipment mainly depend on experience and knowledge of manager for equipment,which are not able to be quantified and have lower efficiency. Therefore,it is obvious that the prediction for the failure of medical equipment is not accurate. With the technical development of computer and machine learning,the conventional identification and prediction that depend on experiences can deal with characteristics of failures through machine learning method to improve efficiency,which are hopeful in filling the gap of discipline about the identification and prediction for failures of medical equipment. This article summarized the application situation of machine learning in identifying and predicting failures of the medical equipment and the similarly electric equipment at home and abroad. Based on the key technique of identification and prediction,this article proposed suggestion about corresponding design architecture. According to the characteristics of the failure of medical equipment,this article summarized a series of information about algorithms of various machine learning in scene and accurate rate of identification and prediction,so as to provide references for relevant research of this field.

Objective To investigate the influence of oral midazolam on postoperative behavioral changes(NPOBCs)in preschool children undergoing laparoscopic inguinal hernia sac ligation.Methods A total of 197 preschool children,118 males and 79 females,aged 1-6 years,BMI 14.0-24.5 kg/m2,ASA physical status Ⅰ or Ⅱ,who undergoing laparoscopic inguinal hernia sac ligation from July 2022 to A-pril 2023 were selected.The children were divided into two groups by random number table method:the oral midazolam group(group M,n=100)and the oral saline group(group C,n=97).In the observation room,group M received an oral dose of 0.5 mg/kg midazolam while group C received an oral dose of 5％sa-line 0.25 ml/kg before being accompanied by a clown doctor to the operating room after 30 minutes.Modi-fied Yale preoperative anxiety scale(m-YPAS)scores before entering the observation room and before ente-ring the operating room,as well as induction compliance checklist(ICC)scores before anesthesia induction were recorded.Postoperatively,FLACC and PAED scores were recorded at immediately,6,and 24 hours after surgery along with occurrences of postoperative nausea and vomiting and hypoxemia.Family members of the children were followed up at 1 day,7,14,and 30 days after discharge using PHBQ to record NPOBCs occurrence in children.Results Compared with group C,m-YPAS score,ICC score before anesthesia in-duction,PAED score immediately after surgery,and the incidence of NPOBCs 1 day,7,14,and 30 days after surgery were significantly reduced in group M(P＜0.05).There were no significant differences in YPAS scores before entering the observation room,6 and 24 hours PAED scores,incidence of postoperative nausea and vomiting,hypoxemia between the two groups.Conclusion Preoperative oral administration of midazolam to children undergoing laparoscopic inguinal hernia sac ligation can effectively alleviate periopera-tive anxiety and reduce the incidence of NPOBCs.It does not increase the risk of delayed awakening or post-operative adverse reactions in children.

Significant research progress has been made in the development of antibody-drug conjugates (ADCs) for the treatment of ad-vanced breast cancer (ABC),ushering new hope for patients with this refractory disease. Through the conjugation of specific antibodies with highly potent cytotoxic drugs,tumor cells can be precisely targeted and killed while minimizing damage to normal tissues. ADCs such as trastuzumab-emtansine (T-DM1) and trastuzumab deruxtecan (T-DXd),have shown excellent efficacy in the treatment of HER2-positive ABC,significantly prolonging patient survival. Furthermore,ADCs targeting triple-negative breast cancer (TNBC),such as sacituzumab govitecan (SG),have also achieved positive results in clinical trials. With the continuous research,development,and optimization of ADCs,as well as the exploration of combination treatment strategies,ADCs are expected to play an increasingly important role in the treatment of ABC in the future. This article provides an overview of the research progress of ADCs in the treatment of ABC,exploring their efficacy and safety. We aim to offer more treatment options and renewed hope for patients with ABC.

Significant research progress has been made in the development of antibody-drug conjugates (ADCs) for the treatment of ad-vanced breast cancer (ABC),ushering new hope for patients with this refractory disease. Through the conjugation of specific antibodies with highly potent cytotoxic drugs,tumor cells can be precisely targeted and killed while minimizing damage to normal tissues. ADCs such as trastuzumab-emtansine (T-DM1) and trastuzumab deruxtecan (T-DXd),have shown excellent efficacy in the treatment of HER2-positive ABC,significantly prolonging patient survival. Furthermore,ADCs targeting triple-negative breast cancer (TNBC),such as sacituzumab govitecan (SG),have also achieved positive results in clinical trials. With the continuous research,development,and optimization of ADCs,as well as the exploration of combination treatment strategies,ADCs are expected to play an increasingly important role in the treatment of ABC in the future. This article provides an overview of the research progress of ADCs in the treatment of ABC,exploring their efficacy and safety. We aim to offer more treatment options and renewed hope for patients with ABC.

Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is an extracorporeal circulation technique that provides circulatory and oxygenation support, and it is currently used in the treatment of cardiogenic shock (CS), pulmonary embolism, cardiac arrest (CA), and other diseases. However, this technology is still associated with high complications and mortality. The use of predictive scores for risk stratification before VA-ECMO will be helpful to screen the optimal benefiting population, make optimal clinical decisions, and allocate medical resources reasonably. At present, there are few reports about predictive scores for VA-ECMO. This article systematically reviewed the predictive performance of various scoring tools [the survival after venoarterial ECMO (SAVE) score, prediction of cardiogenic shock outcome for acute myocardial infarction (AMI) patients salvaged by VA-ECMO (ENCOURAGE) score, model for end-stage liver disease (MELD-Ⅺ) score, post-cardiotomy extracorporeal membrane oxygenation (PC-ECMO) score, the predicting mortality in patients undergoing VA-ECMO after coronary artery bypass grafting (REMEMBER) score, predictors of mortality with VA-ECMO for acute massive pulmonary embolism, extracorporeal cardiopulmonary resuscitation (ECPR) score, the hypothermia outcome prediction after extracorporeal life support (HOPE) score] for patients receiving VA-ECMO to provide reference for clinical treatment.

by lfow cytometry. According to CAG morphology, the plaques included 3 types as Type I, Type II and TypeⅢ. The patients also received coronary CT angiography (CTA), upon CTA value, the plaques were classiifed by soft plaque, ifbrous plaque and calciifed plaque. Expressions of platelet surface EMMPRIN and GPVI among different groups were compared.
Results:①Compared with Control group, ACS and SAP groups had increased expressions of EMMPRIN (5.82 ± 0.81 and 3.45 ± 0.48) vs (1.35 ± 0.15) and GPVI (16.22 ± 5.27 and 8.20 ± 2.87) vs (4.14 ±1.17); the expressions in ACS group were higher than those in SAP group, allP<0.05.②In ACS group, compared with Type I plaque, the patients with Type II and TypeⅢ plaques had elevated levels of EMMPRIN (6.35 ± 1.05 and 4.09 ± 0.67) vs (2.45 ± 0.27) and GPVI (19.50 ± 4.55 and 10.81 ± 2.33) vs (5.89 ± 1.28); the expressions in patients with Type II plaque was higher than those with Type III plaque, allP<0.05.③In ACS group, compared with calciifed plaque, the patients with soft and ifbrous plaques had the higher levels of EMMPRIN (6.18 ± 1.01 and 3.87 ± 0.56) vs (2.43 ± 0.25) and GPVI (19.14 ± 4.27 and 11.08 ± 1.94) vs (5.96 ± 0.99); the expressions in patients with soft plaque was higher than those with ifbrous plaque, allP<0.05.④In CAD patients, EMMPRIN expression was negatively related to plaque type (95% CI: -0.359 to -0.206, β: -0.211) and positively related to clinical type (95% CI: 0.893-1.034, β: 0.893); GPVI expression was negatively related to plaque type (95% CI: -1.222 to -0.586, β: -0.181) and positively related to clinical type (95% CI: 3.576-4.164, β: 0.960).
Conclusion: Expression levels of platelet surface EMMPRIN and GPVI were closely related to the stability of coronary plaque, both of them were the risk factors for severe coronary lesions. EMMPRIN and GPVI may have certain predictive value for early diagnosis of arteriosclerosis in ACS patients.

BACKGROUND: There are many in vitro selection method of sperm, and swim-up and density gradient centrifugation are commonly used. It remains unclear which method minimizes bad stimulation to the sperm and select sperm with high fertilization potential. OBJECTIVE: To evaluate the effectiveness of swim-up and gradient centrifugation preparation techniques on intrauterine insemination (IUI).METHODS: A computer-based online search of Cochrane Library, PubMed, EMBASE databases was performed, and some related journals were manually searched for related articles published between January 1966 and February 2009. The quality of included randomized controlled trials (RCT) and q-randomized trials (Q-RCT) was evaluated and Meta-analysis was conducted by the Cochrane Collaboration's software RevMan5.0. Experts.RESULTS AND CONCLUSION: A total of 6 studies were included, involving 4 RCTs and 2 Q-RCTs. A total of 486 patients (1 099 IUI cycles) were enrolled. The Meta-analysis indicated that there was no difference between swim-up and gradient centrifugation preparation techniques for the IUI in terms of cycle pregnancy rates [OR = 1.11, 95%CI(0.8,1.55)], miscarriage rates [OR = 0.31, 95%CI(0.09,1.04)], sperm count [the weight mean difference (WMD) =-0.89, 95%CI(-14.17,12.38)], sperm motility [WMD = -2.31, 95%CI(-7.27,2.65)]. There is insufficient evidence to confirm which is the best method in the two specific preparation techniques. The quality of study methods should be improved. And more measure parameters should be included when comparing it before or after treatment, such as sperm motility, sperm count, sperm function.

Objective To observe the therapeutic effect of Shen Wu Guanxin Granules(SWGG),a prescription with the actions of tonifying kidney,strengthening Qi and activating blood,for angina pectoris(AP) due to coronary heart disease(CHD) with kidney deficiency and blood stasis.Methods Ninety patients with AP due to CHD with kidney deficiency and blood stasis were randomized into two groups according to the double-blind and double-dummy principles.The two groups received routine western medicine,and the treatment group(N=60) received SWGG and the control group(N=30) received Di'ao Xinxuekang Capsules additionally.The treatment lasted 4 weeks.After treatment,the therapeutic effect on AP and electrocardiogram(ECG) was evaluated,and the changes of main symptoms as well as the laboratory parameters were observed before and after treatment.Results In the treatment group,the total therapeutic effect on AP and ECG was 91.7% and 85.0% respectively,higher than 73.3% and 66.7% in the control group(P