Objective: To analyze the characteristics and key risk factors of abnormal blood disposal throughout the 2024-2025 blood collection and supply process based on nationwide multi-site monitoring data, develop a comprehensive prevention and control strategy across the entire chain, reduce preventable blood waste, and ensure clinical blood safety. Methods: According to the Guidelines for Haemovigilance (T/CSBT 001-2026), we extracted 74 cases of abnormal blood disposal events reported by the China Blood Transfusion Association′s Blood Safety Monitoring System from January 1 2024, to December 31 2025, and conducted descriptive statistical analysis on the distribution of events, types of deviations, root causes, and classifications of disposal manifestations. Results: A total of 664 adverse events related to blood collection and supply were reported over two years, with 74 cases involving discarded abnormal blood units, accounting for 11.1% of the total. Among these, blood component preparation (40.5%) and blood collection (37.8%) remained traditional high-risk stages. The proportion of blood waste occurring during storage, distribution, and transportation increased from 7.7% in 2024 to 34.3% in 2025. Deviations from standard operating procedures (SOP) by personnel were the primary cause, accounting for 74.3% of cases. Discarded blood units were categorized into four types: compromised closed blood bag systems (40 cases), mainly due to inadequate heat sealing, physical damage, or dropped bags; blood out of the cold chain (12 cases), primarily resulting from blood being left at work sites; imbalanced proportion of preservation solution (10 cases), mostly caused by blood collection volumes exceeding the standard capacity of blood bags; and other causes (12 cases). Conclusion: Human operational errors are the core cause of abnormal blood waste. The collection and preparation stages have long been at high-risk, and the risks in the storage and transportation stages have been increasing year by year. We should focus on standardizing personnel management, improving specialized operation norms such as heat sealing, transportation, and storage, establishing a full-process intelligent cold chain monitoring and multi-node visual verification mechanism, and systematically reducing the occurrence rate of abnormal blood waste through a closed-loop quality intervention system, thereby improving the utilization efficiency of voluntary blood donation resources.

Objective To analyze the clinical and epidemiological characteristics of influenza A(H3N2) in Tangshan City, Hebei Province, from 2023 to 2025, and to provide a scientific basis for precise prevention and control of local influenza. Methods The influenza-like cases and influenza outbreak cases in the influenza surveillance sentinel hospitals in Tangshan City from January 2023 to December 2025 were included in this study. The clinical characteristics and epidemic characteristics of H3N2 influenza patients were analyzed by descriptive epidemiological methods and chi-square test. Results A total of 11 567 influenza case samples were tested in the study, with a positive rate of 9.34% (1 080/11 567). Influenza A (H3N2) remained the predominant circulating subtype throughout the study period. January 2023 to February 2023 marked the tailing end of the previous season’s H3N2. Then, a minor peak dominated by H1N1 occurred from March to June, and H3N2 circulated again from October to December, peaking in December. From September 2024 to December 2024, H1N1 and H3N2 circulated concurrently, with H3N2 as the dominant strain, peaking in January of the following year. From March 2025 to September 2025, influenza activity remained at low level, and activity began to rise in October, with H1N1 peaking in November before declining, and H3N2 becoming the dominant strain in December. H3N2 mainly occurred in the 5-14 years old group. Cases in the 0–4-year-old group were primarily characterized by gastrointestinal symptoms, with high fever being common. Cases in the 5–59-year-old group were primarily characterized by systemic and respiratory symptoms, with better clinical outcomes. Cases aged 60 and older exhibited the highest rates of hospitalization, severe illness, and incidence of complications. Conclusion From 2023 to 2025, the influenza virus in Tangshan City, Hebei Province is dominated by influenza A (H3N2). The epidemic is characterized by a peak incidence during autumn and winter, co-circulation with H1N1, and fluctuations during the peak period. It is necessary to pay attention to the clinical management and prevention and control of influenza A (H3N2) in infants and the elderly.

ObjectiveTo observe the clinical efficacy of modified Yuejuwan in the treatment of thyroid cysts after microwave ablation. MethodsA total of 90 patients with thyroid cysts who met the inclusion criteria and treated in the First Affiliated Hospital of Hebei University of Chinese Medicine from September 2022 to December 2023 were randomly assigned to either the control group or the observation group， with 45 patients in each group. The control group received conventional postoperative drug treatment and was followed up regularly. The observation group was additionally administrated with modified Yuejuwan for one month and followed up regularly. The alterations in volume， thyroid function parameters ［thyroid-stimulating hormone （TSH）， free triiodothyronine （FT₃）， and free thyroxine （FT₄）］， quality of life scores， and clinical efficacy were monitored and compared between the two groups. Additionally， the safety profile was appraised. ResultsAfter treatment， both the observation group and the control group showed a reduction in cyst volume （P<0.05）， and the observation group exhibited a more significant reduction in cyst volume than the control group （P<0.05）. After treatment， both the observation group and the control group showed a decrease in TSH level and increases in FT₃ and FT₄ levels （P<0.05）， and the changes were more significant in the observation group （P<0.05）. In addition， both groups exhibited elevations in the quality of life scores （P<0.05）. Moreover， the observation group showed more increments in physiological， psychological， and social scores than the control group （P<0.05）. The total response rate of the observation group was higher than that of the control group （Z=-2.516， P<0.05）. The incidence of adverse reactions was similar between the two groups， with no statistically significant difference. ConclusionModified Yuejuwan is effective in the treatment of thyroid cysts after microwave ablation. It can promote the absorption of cysts， improve the thyroid function and quality of life， and has high safety.

ObjectiveTo observe the clinical efficacy of modified Yuejuwan in the treatment of thyroid cysts after microwave ablation. MethodsA total of 90 patients with thyroid cysts who met the inclusion criteria and treated in the First Affiliated Hospital of Hebei University of Chinese Medicine from September 2022 to December 2023 were randomly assigned to either the control group or the observation group， with 45 patients in each group. The control group received conventional postoperative drug treatment and was followed up regularly. The observation group was additionally administrated with modified Yuejuwan for one month and followed up regularly. The alterations in volume， thyroid function parameters ［thyroid-stimulating hormone （TSH）， free triiodothyronine （FT₃）， and free thyroxine （FT₄）］， quality of life scores， and clinical efficacy were monitored and compared between the two groups. Additionally， the safety profile was appraised. ResultsAfter treatment， both the observation group and the control group showed a reduction in cyst volume （P<0.05）， and the observation group exhibited a more significant reduction in cyst volume than the control group （P<0.05）. After treatment， both the observation group and the control group showed a decrease in TSH level and increases in FT₃ and FT₄ levels （P<0.05）， and the changes were more significant in the observation group （P<0.05）. In addition， both groups exhibited elevations in the quality of life scores （P<0.05）. Moreover， the observation group showed more increments in physiological， psychological， and social scores than the control group （P<0.05）. The total response rate of the observation group was higher than that of the control group （Z=-2.516， P<0.05）. The incidence of adverse reactions was similar between the two groups， with no statistically significant difference. ConclusionModified Yuejuwan is effective in the treatment of thyroid cysts after microwave ablation. It can promote the absorption of cysts， improve the thyroid function and quality of life， and has high safety.

Objective:To explore the clinical application value of MRI ultra-short echo time sequence (MRI-UTE) in the diagnosis of pulmonary nodules.Methods:This study was a cross-sectional study. A total of 101 consecutive patients were recruited prospectively from January to August 2024 at Huazhong Fuwai Hospital of Zhengzhou University. All of the included patients were diagnosed with pulmonary nodules by chest CT examination and intended for treatment. All patients underwent low-dose CT examination and MRI-UTE examination. The number, classification, and lung imaging reporting and data system (lung-RADS) grading of the pulmonary nodules were analyzed. Nodules classification was determined as solid nodules or sub-solid nodules, and sub-solid nodules included part-solid nodules and pure ground-glass nodules. Taking the evaluation results of radiologists with 10 and 12 years of experience in chest imaging diagnosis as the reference standard, the Kappa test was used to analyze the agreement of CT and MRI-UTE in terms of the accurate diagnosis, classification, and lung-RADS grading of pulmonary nodules. Results:Among the 101 patients, a total of 216 pulmonary nodules were identified. MRI-UTE accurately diagnosed 180 pulmonary nodules, while 203 pulmonary nodules were detected by CT. The concordance was moderate ( Kappa=0.48, P<0.001). In terms of nodule classification, CT correctly classified 167 nodules as solid and 36 as sub-solid, whereas MRI-UTE correctly classified 153 as solid and 23 as sub-solid, with good agreement (weighted Kappa=0.73, P<0.001). For lung-RADS grading, CT correctly graded 186 nodules, with 85 graded as category 2, 46 as category 3, 33 as category 4A, 12 as category 4B, and 10 as category 4X; MRI-UTE correctly graded 155 nodules, with 74 graded as category 2, 30 as category 3, 30 as category 4A, 12 as category 4B, and 9 as category 4X. The agreement between the two modalities in determining lung-RADS grade was also good (weighted Kappa=0.74, P<0.001). Conclusion:MRI-UTE demonstrates good agreement with CT in the accurate diagnosis, classification, and lung-RADS grading of pulmonary nodules, indicating certain clinical application value.

Paraplegia caused by spinal cord injury is a serious neurological complication, for which surgery is currently the main treatment method. Due to different surgical approaches, patients are usually expected to maintain a passive prone position for a long time or switch between the supine and prone positions. Affected by multiple factors such as neurogenic sensory disorders, pathological changes in muscle tone and operative duration, the risk of intraoperative acquired pressure injury (IAPI) is significantly increased. Current clinical prevention strategies for IAPI in these patients predominantly focus on localized pressure relief during positioning, lacking systematic, standardized comprehensive prevention protocols or evidence-based guidelines. To address it, Department of Nursing, Orthopedics Branch, China International Exchange and Promotive Association for Medical and Health Care, Spinal Trauma Professional Committee, Orthopedics Branch, Chinese Medical Doctor Association, Nursing Group of Spine and Spinal Cord Professional Committee of Chinese Association of Rehabilitation Medicine organized experts in relevant fields to formulate Guideline for the prevention of intraoperative acquired pressure injury in paraplegic patients with spinal cord injury ( version 2025), based on evidence-based medical evidence and latest research results and clinical practice at home and abroad. Eleven recommendations were put forward from the aspects of preoperative risk assessment, intraoperative prevention strategies, postoperative handover and monitoring, and supportive mechanisms for IAPI prevention, aiming to standardize the prevention measures and management strategies of IAPI in paraplegic patients with spinal cord injury and accelerate the recovery of patients and improve the therapeutic effect.

Objective:To assess the application effects of an energy-restricted diet combined with high-protein, high-dietary-fiber meal replacement powder and probiotics in overweight/obese adults.Methods:It was a randomized controlled trial. A consecutive sample of 150 overweight/obese adults who underwent physical examinations at the Health Care Center of the First Hospital of Hebei Medical University between November 2021 and March 2022. The participants were randomly assigned into the combined group, the high-protein group, and the common group (50 participants per group) using a random number table method. All three groups of subjects received weight loss health education, energy-restricted diet, and interventions with meal replacement powder and probiotics (or probiotic placebo). The combined group was given high-protein and high-dietary fiber meal replacement powder and probiotics. The high-protein group was given high-protein meal replacement powder and probiotic placebo. The common group was given ordinary meal replacement powder and probiotic placebo. The meal replacement powder was packaged in 35 g per bag, with main components of varying amounts of protein, fat, carbohydrates, vitamins, and trace elements. Both the probiotic powder and the probiotic placebo came in 2 g sachets. The primary components of probiotic powder were various Bifidobacterium, Lactobacillus and excipients, while the main component of probiotic placebo was excipients. The meal replacement powder and the probiotic powder or probiotic placebo were taken twice a day for a total of 12 weeks, one sachet of each time, followed by a 4-week follow-up. The body weight, body mass index, body fat mass, abdominal circumference and hip circumference were measured before the trial (week 0) and at the end of weeks 2, 4, 8, 12, and 16. The change rates of each indicator were calculated. Biochemical indicators, trace elements, and 25-hydroxyvitamin D levels were measured at the end of week 0, 4, 8, and 12. A product evaluation questionnaire was conducted at the end of week 12. A total of 19 cases dropped out due to various reasons. Finally, 46 cases in the combined group, 42 cases in the high-protein group, and 43 cases in the common group were included in the analysis. Paired-samples t test, Kruskal-Wallis H test, one-way analysis of variance, and Mann-Whitney U test were used to compare the differences in weight-loss and maintenance effects, safety and patient acceptance among the three intervention groups, and to analyze the application effect of the energy-restricted diet combined with high-protein and high-dietary fiber meal replacement powder plus probiotics in overweight/obese adults. Results:Among the 131 overweight/obese adults included in the analysis, there were 57 males and 74 females, with a mean age of (37.30±8.33) years. By the end of the week 12, the body mass index [26.87(25.77, 30.38) vs 29.61(27.96, 33.09) kg/m2; 27.10(24.70, 31.37) vs 29.40(27.20, 34.17) kg/m2; 27.98(26.43, 30.12) vs 29.88(28.22, 31.93) kg/m2] and body fat masses [22.15(17.70, 30.15) vs 30.75(25.63, 35.40) kg; 23.35(19.12, 28.70) vs 29.45(26.20, 37.05) kg; 26.80(24.10, 31.60) vs 30.00(26.00, 34.70) kg] in the combined group, the high-protein group and the common group were all lower than those at baseline (week 0) (all P<0.05). At the end of the week 12, the change rates of body fat mass and body mass index in the combined group were both higher than those in the high-protein group and the common group [(25.98%±9.58%) vs (23.88%±11.15%) and (9.35%±11.00%), 9.29%(7.23%, 11.58%) vs 7.96% (5.51%, 10.92%) and 5.77% (2.68%, 10.03%)] (all P<0.05). At the end of the week 12, the body fat mass in the combined group and the high-protein group were both lower than that in the common group [22.15(17.70, 30.15), 23.35(19.12, 28.70) vs 26.80(24.10, 31.60) kg] (both P<0.05). At the end of the week 12, the decreased values of uric acid and high-sensitivity C-reactive protein in the combined group were both higher than those in the high-protein group and the common group [17.15(13.02, 23.45) vs 1.50(0.22, 28.60) and 4.20(0.15, 19.95) μmol/L, 0.43(0.24, 0.60) vs 0.21(0.06, 0.43) and 0.28(-0.04, 0.88) mg/L](both P<0.05). No serious adverse events were observed during the intervention period and at the end of the intervention. In the product evaluation questionnaire, the combined group scored higher than the high-protein group and the common group on items such as usage frequency, taste, satiety, willingness to continue use, willingness to recommend to others, and willingness to purchase [4(3, 4) vs 3(3, 4) and 3(2, 4) points, 4(3, 4) vs 3(3, 4) and 3(2, 4) points, 4(3, 4) vs 3(3, 4) and 3(3, 3) points, 4(3, 4) vs 3(3, 4) and 3(3, 4) points, 4(3, 4) vs 3(3, 4) and 3(3, 3) points, 3(3, 4) vs 3(3, 4) and 3(2, 3) points] (all P<0.05). Conclusion:An energy-restricted diet combined with high-protein, high-dietary-fiber meal replacement powder and probiotics demonstrates superior weight-loss and weight-maintenance effects in overweight/obese adults, with high safety and great user acceptability.

Objective To investigate the therapeutic mechanism of Dingkun Dan(DKD)in polycystic ovary syndrome(PCOS)by examining the effects of microRNA-30d-5p on ovarian granulosa cells(GCs).Methods A PCOS rat model was established using dehydroepiandrosterone(DHEA).Normal rat GCs and PCOS rat GCs were cultured in vitro and divided into four groups:blank control group,model group,low-dose DKD group,and high-dose DKD group.After grouping,GCs viability was assessed using the methyl thiazolyl tetrazolium(MTT)assay,GCs apoptosis was analyzed by flow cytometry,and the gene expression of transforming growth factor β1(TGF-β1),Smad2,Smad3,and microRNA-30d-5p in GCs was measured by real-time polymerase chain reaction(RT-PCR),protein expression of TGF-β1,Smad2,and Smad3 in GCs was detected by Western Blot.Results Compared with the blank control group,the model group exhibited significantly decreased GCs viability,increased GCs apoptosis,upregulated mRNA and protein expression of TGF-β1,Smad2,and Smad3,and downregulated microRNA-30d-5p expression,the differences were statistically significant(P＜0.01).Compared with the model group,both low-and high-dose DKD groups showed increased GCs viability,reduced GCs apoptosis,downregulated mRNA and protein levels of TGF-β1 Smad2 and Smad3,elevated microRNA-30d-5p expression,and the differences were statistically significant(P＜0.05 or P＜0.01).Conclusion DKD promotes GCs proliferation by targeting Smad2 via microRNA-30d-5p,suggesting a potential therapeutic role in PCOS-related ovulatory dysfunction.

Objective To develop a nomogram model based on the nucleotide-binding oligomer-ization domain-like receptor protein 3(NLRP3)/caspase-1 signaling pathway to predict the value of secondary vascular dementia(VaD)after acute cerebral infarction(ACI)following thrombolytic ther-apy.Methods A total of 289 patients with ACI admitted to Yuncheng Central Hospital Affiliated to Shanxi Medical University from March 2021 to March 2024 were selected as study subjects,and were divided into VaD group(n=60)and non-VaD group(n=229)based on the occurrence of VaD.Rele-vant clinical data were compared between the two groups,and influencing factors for secondary VaD af-ter ACI were analyzed.A nomogram prediction model was constructed and validated.Results The proportions of patients with a history of smoking,hypertension and coronary heart disease,infarction in key areas,responsible large vessel stenosis ≥50％,leukoaraiosis,and thrombolysis benefit were higher in the VaD group than in the non-VaD group(P＜0.05).Logistic regression analysis showed that the degree of responsible vessel stenosis,infarctionin key areas,leukoaraiosis,and the expression of NLRP3,apoptosis-associated speck-like protein containing a CARD(ASC),and caspase-1,which are related to the NLRP3/caspase-1 signaling pathway,were independent influencing factors for sec-ondary VaD after ACI(P＜0.05).Receiver operating characteristic(ROC)curve,calibration curve,and decision curve analysis(DCA)indicated that the nomogram model had high discrimina-tion and predictive efficacy,with significant positive net benefit.Conclusion The independent in-fluencing factors for secondary VaD after ACI include the degree of responsible vessel stenosis,in-farction in key areas,leukoaraiosis,and the expression of NLRP3,ASC,and caspase-1 related to the NLRP3/caspase-1 signaling pathway.The nomogram prediction model established based on these indicators has high predictive value and clinical efficacy.

Intentional tooth replantation (ITR) is an advanced treatment modality and the procedure of last resort for preserving teeth with inaccessible endodontic or resorptive lesions. ITR is defined as the deliberate extraction of a tooth; evaluation of the root surface, endodontic manipulation, and repair; and placement of the tooth back into its original socket. Case reports, case series, cohort studies, and randomized controlled trials have demonstrated the efficacy of ITR in the retention of natural teeth that are untreatable or difficult to manage with root canal treatment or endodontic microsurgery. However, variations in clinical protocols for ITR exist due to the empirical nature of the original protocols and rapid advancements in the field of oral biology and dental materials. This heterogeneity in protocols may cause confusion among dental practitioners; therefore, guidelines and considerations for ITR should be explicated. This expert consensus discusses the biological foundation of ITR, the available clinical protocols and current status of ITR in treating teeth with refractory apical periodontitis or anatomical aberration, and the main complications of this treatment, aiming to refine the clinical management of ITR in accordance with the progress of basic research and clinical studies; the findings suggest that ITR may become a more consistent evidence-based option in dental treatment.
Humans ; Tooth Replantation/methods* ; Consensus ; Periapical Periodontitis/surgery*