Objective: To evaluate repeated testing on blood screening platforms in confirmation of non-discriminatory reactive (NDR) samples in nucleic acid testing (NAT). Methods: A total of 102 HBsAg-negative/NAT NDR samples were collected from voluntary blood donors at Dalian Blood Center between January 2021 and December 2023. Repeated testing was performed using two NAT platforms (Cobas s201 and Panther). For the first round of repeated testing, all samples were tested 12 times on each system; for the second round, the samples which were non-reactive or only reactive once in the first round were tested an additional 8 times. Anti-HBc and anti-HBs was detected using electrochemiluminescence assay (ECA). Meanwhile, blood donors were followed up. Results: The proportion of anti-HBc+ in 102 NDR samples was 88.2%. Forty-one samples (40.2%, 41/102) and 7 samples were confirmed HBV DNA+ in first-round and second-round repeated testing, respectively. The cumulative confirmation rate of HBV DNA+ was 47.1% (48/102) after repeated testing. Extra five blood donors detected HBV DNA+ in follow-up were identified as anti-HBc+ occult hepatitis B virus infection (OBI), while no window period infection was observed. Ultimately, there were 53 HBV infected donors confirmed, 46 HBV infection-unconfirmed, and 3 HBV uninfected. No significant difference was observed between the confirmation rate of the first-round testing and the cumulative confirmation rate after the second-round testing (P>0.05). The proportion of anti-HBc+ donors was quite high in both HBV infection-confirmed (98.1%) and unconfirmed group (82.6%), and donors with seronegative and anti-HBs-only occupied a high proportion in the latter (P<0.05). Conclusion: Numerous repeated testing of NDR samples using NAT platforms cannot achieve complete confirmation of HBV infection. Supplementary anti-HBc testing can minimize potential OBI risk among NDR donors, and is low-cost and efficient.

Objective: To evaluate the effects of a multidisciplinary weight management intervention, so as to provide a reference for the formulation of overweight and obesity intervention measures. Methods: From April to September 2025, overweight and obese residents aged 18-60 years who participated in a weight loss competition at the Health Management Center of Beilun People's Hospital in Ningbo City were selected as study subjects. They were divided into a control group and an intervention group. The control group received conventional weight management, while the intervention group received the multidisciplinary integrated weight management in addition to the conventional weight management, for a total intervention period of 8 weeks. Weight, body mass index (BMI), waist circumference, hip circumference, waist-to-hip ratio, fasting blood glucose (FBG), triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and blood pressure were collected before and after the intervention through physical examinations and laboratory tests. The generalized estimating equations (GEE) method was employed to analyze the differences in indicators between the two groups before and after the intervention. Results: The control group comprised 241 participants, including 161 females (66.80%), with a mean age of (35.66±7.80) years. The intervention group consisted of 127 participants, including 86 females (67.72%), with a mean age of (36.80±7.05) years. No statistically significant differences were observed between the two groups at baseline in terms of age, gender, weight, BMI, or waist-to-hip ratio (all P>0.05). Results from the GEE analysis indicated significant interactions between group and time for weight, BMI, waist circumference, and hip circumference (all P<0.05) with greater reductions in these parameters observed in the intervention group compared to the control group before and after the intervention. Similarly, significant interactions between group and time were observed for FBG, TG, TC, and LDL-C (all P<0.05), with the intervention group demonstrating larger decreases in these markers compared to the control group. However, no statistically significant interactions between group and time were observed for waist-to-hip ratio, HDL-C, systolic blood pressure, and diastolic blood pressure (all P>0.05). Following the intervention, a weight loss exceeding 10% was achieved by 13 participants (5.39%) in the control group and 62 participants (48.82%) in the intervention group. The proportion of individuals with a weight loss exceeding 10% was significantly higher in the intervention group compared to the control group (P<0.05). Conclusion Compared to conventional weight management, multidisciplinary integrated weight management demonstrated greater efficacy in improving weight-related indicators and blood glucose, blood lipids, and enhancing weight loss outcomes among overweight and obese residents.

Objective Estimating the residual risk of transfusion-transmitted diseases in voluntary blood donors is crucial for monitoring blood safety.and to analyze the evolution trend over a five-year period in Yantai,Shandong Province.Methods This study retrospectively reviewed screening data from Yantai Central Blood Station between 2018 and 2022.We compared the positivity rates between first-time and repeat donors,calculated the prevalence of each virus,and estimated the residual risk using the prevalence-window period model.Meanwhile,the age characteristics of all positive donors were analyzed.Results Over the five-year period,a total of 320 016 individuals donated blood.The overall reaction rate of transfusion-transmitted diseases was 0.165%,with HBV(0.129%)being the most common.The positivity rate among first-time donors[P(FTDs)](0.310%)was significantly higher than that among repeat donors[P(RDs)](0.054%)(χ2=312.783,P<0.05).The serological residual risks for HBV,HCV,and HIV were 1∶188 090,1∶1 042 805,and 1∶392 995,respectively.During the five-year period,they decreased from 1∶129 495 to 1∶390 011,from 1∶697 002 to 1∶1 145 826,and from 1∶684 109 to 1∶1 067 317,respectively.The residual risks of HCV and HIV after NAT were 1∶22 369 329 and 1∶6 639 965,respectively,which were significantly reduced by 21.5-fold and 16.9-fold,and decreased steadily during the study period.Among the HBV-DNA(+)donors,61.8%(68/110)were RDs,and the residual risk was 1∶65 350.Conclusion This study demonstrates the remarkable effectiveness of introducing nucleic acid amplification technology(NAT)in reducing the residual risk of HBV,HCV,and HIV,particularly for HCV and HIV.The residual risk for HBV remains higher compared to HCV and HIV due to the discovery of occult HBV infections(OBI).Therefore,a crucial step toward further reducing this residual risk is the use of more sensitive reagents and detection platforms.Furthermore,implementing effective long-term incentive mechanisms and strategic planning to increase the proportion of repeat donors(RDs)is critical for enhancing transfusion safety.

Objective To summarize the clinical experience of the first case of sulbactam-durlobactam treatment for extensively drug-resistant Acinetobacter baumannii infection after lung transplantation in China.Methods A retrospective analysis was conducted on a case of a patient with severe chronic obstructive pulmonary disease who received sulbactam-durlobactam treatment after lung transplantation.Results A 68-year-old male patient with a history of drug-resistant Acinetobacter baumannii infection before surgery,experienced worsening infection and impaired renal function after lung transplantation,with sputum culture showing extensively drug-resistant Acinetobacter baumannii.After receiving combination treatment with sulbactam-durlobactam and meropenem,the infection was controlled,and the function of the transplanted lung was restored.Conclusions Sulbactam-durlobactam has potential therapeutic value for extensively drug-resistant Acinetobacter baumannii infection after lung transplantation and provides a new strategy for clinical practice.

Objective To understand the serologic prevalence and infection status of Cytomegalovirus(CMV)in children aged 0～1 years,and explore the risk factors of CMV infection for clinical reference.Methods The data of 4 938 children aged 0～1 years who underwent chemiluminescence enzyme immunoassay for TORCH in Department of Inpatient and Department of Pediatrics Outpatient of Maternal and Child Health Hospital of Inner Mongolia from January 2020 to December 2022 were retrospectively analyzed to understand the seroprevalence of human CMV(HCMV)among children in the region,and analyzed the risk factors associated with HCMV infections by combining the results of laboratory tests and clinical information.Results In 4 938 children,the total antibody positivity rate was 94.01%(4 642/4 938),the total IgG antibody positivity rate was 93.86%(4 635/4 938),the total IgM antibody positivity rate was 8.10%(400/4 938),and the positive rate of the two simultaneous detections was 7.96%(393/4 938).The difference in HCMV-IgG and HCMV-IgM antibodies positivity rates beteen different age groups were statistically significant(χ2=36.350,1 043.199,all P<0.05),and the differences in HCMV-IgG and IgM antibodies between boys and girls were not statistically significant(χ2=0.215,1.184,all P＞0.05).According to univariate analysis,the breast-feeding and vaginal delivery rates in the infected group were higher than those in the control group,and the differences in feeding and birth methods were statistically significant(χ2=10.777,5.725,all P<0.05).Multifactorial analysis found that breast-feeding and transvaginal delivery were independent risk factors for HCMV infection,and the differences was statistically significant(Wald χ2=6.247,10.057,all P<0.05).Conclusion The serologic antibody positivity rate of HCMV in children within 1 year of age is as high as 94.01%,and infants aged 3 months to 6 months are most susceptible to infection.Breastfeeding and transvaginal delivery are independent risk factors for HCMV infection in children within 1 year of age.

Objective:To compare the dose-response effects of single-fraction ultra-high dose rate (FLASH) and conventional dose rate (CONV) whole abdominal irradiation (WAI) with X-rays on acute radiation-induced intestinal injury in mice, in order to identify optimal dose parameters and potential mechanisms.Methods:A total of 186 male C57BL/6J mice were randomly assigned to a non-irradiation group ( n=6), FLASH irradiation groups ( n=90), and CONV irradiation groups ( n=90). Acute radiation-induced intestinal injury models were established using single-fraction WAI with 11, 12, 13, 14, and 15 Gy X-rays (200 Gy/s for FLASH and 4 Gy/min for CONV). Changes in body weight, stool characteristics, and disease activity index (DAI) scores were assessed at 9 d post-irradiation. At 7 d post-irradiation at 11, 12, and 13 Gy, the intestines were collected for macroscopic examination and length measurement. The small intestine was selected for HE staining and quantitative analysis of intestinal crypt number and mucosal epithelial thickness. The survival of mice was assessed at 15 d post-WAI across all dose groups. Results:After single-fraction WAI at 11, 12, and 13 Gy, the body weight was higher in the FLASH group than that in the CONV group ( t=10.17, 12.65, 10.16, P<0.05). The DAI scores for the FLASH group were 1.00±1.10, 3.17±0.75, and 2.83±1.17, respectively, which were lower than those of the CONV group (4.33±0.52, 7.00±0.00, 8.60±0.55; t=8.70, 11.71, 14.99, P<0.05). However, after WAI at 14 Gy and 15 Gy, there were no significant differences in body weight and DAI between the FLASH group and the CONV group ( P>0.05). At 7 d after single-fraction WAI at 11, 12, and 13 Gy, mice in the FLASH group exhibited less intestinal congestion, edema, and shortening compared with the CONV group. The difference between the FLASH and CONV groups were statistically significant in small intestine length at 11 and 13 Gy ( t=4.42, 3.78, P<0.05), and in colorectal length at 11 and 12 Gy ( t=3.97, 3.12, P<0.05). Small intestine HE staining revealed superior preservation of intestinal architecture in the FLASH group compared with the CONV group, characterized by longer villi, increased crypt numbers, thicker mucosal epithelium, and enhanced structural integrity. The differences in crypt number and mucosal epithelial thickness were statistically significant ( tcrypt=13.10, 23.80, 11.90; tmucosal=5.75, 2.64, 7.74; P<0.05). At 15 d post-irradiation, the survival rate in the 15 Gy FLASH group was higher than that in the CONV group (50% vs. 10%, χ2=5.39, P<0.05), with a median survival extension of 6 d ( HR=0.340, 95% CI: 0.115 4-0.999 9). No significant survival differences were observed between the FLASH group and the CONV group at 11, 12, 13, and 14 Gy ( P>0.05). Conclusions:FLASH irradiation significantly alleviated acute radiation-induced intestinal injury from medium single-fraction WAI with 11, 12, and 13 Gy X-rays compared with CONV irradiation, and showed potential to improve mouse survival after single-fraction WAI at 15 Gy. This effect is likely associated with the preservation of intestinal crypts and exhibits a dose-dependent relationship.

The morbidity and mortality associated with diphtheria have been effectively managed through mass immunization strategies. Nevertheless, recent outbreaks of diphtheria have been reported in various regions of Africa and Asia. In addition to infections among children, there has been a notable increase in cases among middle-aged and elderly individuals, underscoring the necessity of continued vigilance in the control of diphtheria. This paper reviewed the epidemiology of diphtheria, the current application of vaccines, and immunization strategies, with the aim of providing evidence for the prevention and control of this disease.

Objective Estimating the residual risk of transfusion-transmitted diseases in voluntary blood donors is crucial for monitoring blood safety.and to analyze the evolution trend over a five-year period in Yantai,Shandong Province.Methods This study retrospectively reviewed screening data from Yantai Central Blood Station between 2018 and 2022.We compared the positivity rates between first-time and repeat donors,calculated the prevalence of each virus,and estimated the residual risk using the prevalence-window period model.Meanwhile,the age characteristics of all positive donors were analyzed.Results Over the five-year period,a total of 320 016 individuals donated blood.The overall reaction rate of transfusion-transmitted diseases was 0.165%,with HBV(0.129%)being the most common.The positivity rate among first-time donors[P(FTDs)](0.310%)was significantly higher than that among repeat donors[P(RDs)](0.054%)(χ2=312.783,P<0.05).The serological residual risks for HBV,HCV,and HIV were 1∶188 090,1∶1 042 805,and 1∶392 995,respectively.During the five-year period,they decreased from 1∶129 495 to 1∶390 011,from 1∶697 002 to 1∶1 145 826,and from 1∶684 109 to 1∶1 067 317,respectively.The residual risks of HCV and HIV after NAT were 1∶22 369 329 and 1∶6 639 965,respectively,which were significantly reduced by 21.5-fold and 16.9-fold,and decreased steadily during the study period.Among the HBV-DNA(+)donors,61.8%(68/110)were RDs,and the residual risk was 1∶65 350.Conclusion This study demonstrates the remarkable effectiveness of introducing nucleic acid amplification technology(NAT)in reducing the residual risk of HBV,HCV,and HIV,particularly for HCV and HIV.The residual risk for HBV remains higher compared to HCV and HIV due to the discovery of occult HBV infections(OBI).Therefore,a crucial step toward further reducing this residual risk is the use of more sensitive reagents and detection platforms.Furthermore,implementing effective long-term incentive mechanisms and strategic planning to increase the proportion of repeat donors(RDs)is critical for enhancing transfusion safety.

Objective To investigate the predictive value of early fluid balance combined with daily average fluid intake on the prognosis of patients who received hematoma evacuation for spontaneous intracerebral hemorrhage(sICH).Methods This study retrospectively and consecutively enrolled patients who underwent hematoma evacuation for sICH admitted to the Neurosurgical Intensive Care Unit of North China University of Science and Technology Affiliated Hospital between January 2023 and January 2025.Patients'baseline and clinical data were collected,including gender,age,admission vital signs(body temperature,respiratory rate,heart rate,systolic and diastolic blood pressure),medical history(hypertension,diabetes mellitus,coronary heart disease),admission Glasgow coma scale(GCS)score,admission laboratory parameters(including white blood cell count,red blood cell count,platelet count,urine bacterial levels,urine ketones,urine pH,homocysteine),hemorrhage location,hemorrhage volume,time from ictus to surgery,and hematoma evacuation rate(hematoma evacuation rate[％]=[preoperative hematoma volume-postoperative hematoma volume]/preoperative hematoma volume × 100％).Fluid intake,output,balance,daily average intake,and cumulative fluid balance during the early postoperative period(the first to seventh 24-hour periods)were assessed and recorded.Fluid intake comprised the sum of intravenously administered fluids(crystalloids,hypertonic fluids,colloids,blood products,and parenteral nutrition),enteral nutrition(nasogastric feeding solutions and water),and renal replacement therapy fluids.Fluid output comprised the sum of urine volume,vomitus,drainage fluid,and dialysis fluid losses.Fluid balance was defined as the difference between fluid intake and output.Daily average intake was calculated as the average of the fluid intake over the first seven postoperative 24-hour periods.Cumulative fluid balance was the sum of the fluid balances over the first seven postoperative 24-hour periods.Patient outcomes were assessed at 30 days postoperatively.Discharged patients underwent outpatient review or telephone follow-up,while inpatients were evaluated by neurosurgeons.Prognosis was evaluated using the 30-day modified Rankin scale(mRS)score:mRS scores 0-3 were classified as favorable prognosis,and mRS scores 4-6 as poor prognosis.Patients were subsequently divided into favorable prognosis and poor prognosis groups based on mRS scores.Factors with P＜0.05 in univariate comparisons and without collinearity(multicollinearity was defined by:tolerance＜0.1 and variance inflation factor＞10)were included in multivariate Logistic regression analysis to identify independent risk factors for poor 30-day prognosis after hematoma evacuation in sICH patients.Receiver operating characteristic(ROC)curve analysis was employed to evaluate the predictive value of relevant factors for poor 30-day prognosis after hematoma evacuation in sICH patients.Results A total of 320 patients who underwent hematoma evacuation for sICH were enrolled,including 192 males and 128 females,with an age range of 20-91 years(median age 62[53,68]years).Among them,144 patients were assigned to the favorable prognosis group and 176 to the poor prognosis group.The poor prognosis group exhibited significantly higher hemorrhage volume,homocysteine level,fluid intake at the 3rd,5th,6th,and 7th 24-hour periods,fluid balance at the 3rd,5th,6th,and 7th 24-hour periods,daily average intake,and cumulative fluid balance compared to the favorable prognosis group(all P＜0.05).The favorable prognosis group had a significantly higher hematoma evacuation rate,GCS score,proportion of supratentorial hemorrhage and negative urine ketones than the poor prognosis group(all P＜0.05).No significant differences were found in other clinical data(all P＞0.05).Fluid balance over the first seven postoperative 24-hour periods displayed a rise-decline-rise pattern in the poor prognosis group and a rise-decline pattern in the favorable prognosis group.Both groups peaked at the 3rd 24-hour period.Multivariate Logistic regression analysis identified fluid balance at the 3rd 24-hour period(OR,2.013,95％CI 1.386-2.922,P＜0.01)and daily average intake(OR,3.583,95％CI 1.793-7.161,P＜0.01)as independent influencing factors for poor 30-day prognosis after hematoma evacuation in sICH patients.ROC curve analysis revealed that the area under the curve(AUC)for fluid balance at the 3rd 24-hour period and daily average intake in predicting poor 30-day prognosis were 0.699(95％CI 0.642-0.757)and 0.765(95％CI 0.712-0.819),respectively.The combined model of fluid balance at the 3rd 24-hour period and daily average intake achieved an AUC of 0.804(95％CI 0.756-0.853),demonstrating significantly superior predictive performance compared to either variable alone(both P＜0.05).Conclusions The combination of fluid balance at the 3rd 24-hour period and daily average intake demonstrates modest predictive value for poor 30-day prognosis after hematoma evacuation in sICH patients.These findings require validation through multicenter,large-scale,prospective studies.

Objective: To establish a method for determining the molecular weight and molecular weight distribution of Poly(Lactide-co-Glycolide Acid) (PLGA) using Size Exclusion Chromatography-Refractive Index-Multiangle Laser Light Scattering (SEC-RI-MALLS) and Size Exclusion Chromatography-Refractive Index (SEC-RID), and to compare the results obtained from these two methods.
Methods: For SEC-RI-MALLS, tetrahydrofuran was used as the mobile phase, Shodex GPC KF-803L was employed as the chromatographic column with a flow rate of 1 mL·min^-1, column temperature at 30 ℃, and an injection volume of 100 μL. For SEC-RID, tetrahydrofuran was also used as the mobile phase, Agilent PLgel 5 μm MIXD-D was used as the chromatographic column with a flow rate of 1 mL·min^-1, column temperature at 30 ℃, differential detector temperature at 35 ℃, and an injection volume of 20 μL. The molecular weight and molecular weight distribution were calculated using Agilent’s GPC software. The newly established methods were validated methodologically, and the molecular weight and molecular weight distribution of 13 batches of samples were determined.
Results: The precision, accuracy, stability, and repeatability tests for SEC-RI-MALLS showed RSD values of 1.35%, 1.58%, 1.53%, and 1.26%, respectively. The SEC-RID method exhibited good linearity (r=0.999 9), with RSD values for precision, accuracy, stability, and repeatability tests (n=6) of 2.05%, 1.62%, 1.30%, and 2.97%, respectively. The results obtained from SEC-RI-MALLS were lower than those from SEC-RID, and the molecular weight distribution coefficient was smaller, but the results from the paired T-test performed with the value measured by SEC-RID method and the value measured by SEC-RI-MALLS method multiplied a conversion coefficient of 1.5 showed no significant difference between the two methods.
Conclusion: Both methods are stable and reliable, and can be used for the determination of PLGA molecular weight and molecular weight distribution based on the specific situations.