Objective: To investigate the distribution characteristics of ABO and Rh blood group antigen phenotypes among blood donors in the Yantai, Shandong. Methods: Blood samples from 310 180 voluntary blood donors in Yantai collected from January 2019 to December 2023 were tested for ABO and Rh blood group antigens using standard serological methods. RhD-negative samples were further typed for C, c, E, and e antigens. Population genetic analysis of blood groups was performed: allele frequencies were inferred from ABO phenotypes, and Rh allele/haplotype frequencies were estimated based on the proportion of RhD-negative donors and CcEe antigen typing, followed by Hardy-Weinberg equilibrium testing. Results: The phenotypic distribution frequency of ABO blood groups was B(32.72%)>O(28.93%)>A(27.65%)>AB(10.70%). The inferred allele frequencies were r(53.74%)>q(24.78%)>p(21.48%), consistent with Hardy-Weinberg equilibrium (P>0.05). A total of 1 872 Rh-negative donors (0.603%) were identified. The most common Rh phenotypes were ccdee (59.56%) and Ccdee (30.18%). The distribution of Rh antigen phenotypes deviated significantly from Hardy-Weinberg equilibrium (χ =37.15, P<0.001), with the cde haplotype showing the highest frequency. There was no statistically significant difference in ABO blood group distribution between RhD-positive and RhD-negative donors (P>0.05). Conclusion: The ABO blood group distribution among voluntary blood donors in Yantai is generally stable and consistent with population genetic equilibrium, whereas the Rh antigen phenotype distribution deviates from equilibrium, indicating potential underlying genetic structural differences.

Objective To analyze the main causes and risk factors of unplanned reoperation after liver transplantation. Methods The clinical data of 242 liver transplant recipients in the First Affiliated Hospital of Anhui Medical University from January 2015 to December 2024 were retrospectively analyzed. According to whether unplanned reoperation was performed during the same hospitalization after surgery, the recipients were divided into the reoperation group (n=36) and the non-reoperation group (n=206). The preoperative, intraoperative and postoperative data of the two groups, as well as donor and graft-related data, were compared to analyze the risk factors of unplanned reoperation after liver transplantation and the survival status of the two groups. Results Among the 242 liver transplant recipients, 36 underwent unplanned reoperations, with a total of 54 procedures including various laparotomies, endoscopic and interventional surgeries, among which there were 20 laparotomies, 18 endoscopic surgeries and 16 interventional surgeries. The most common cause of unplanned reoperation was biliary complications (20 times), followed by vascular complications (17 times). Compared with the non-reoperation group, the reoperation group had longer graft cold ischemia time, higher postoperative fatality rate of recipients, longer length of stay in the intensive care unit and postoperative hospital stay, and higher total hospitalization costs (all P<0.05). The incidence of unplanned reoperation was higher in recipients who underwent split liver transplantation (P<0.05). Multivariate analysis showed that intraoperative blood loss ≥1 000 mL, positive culture of graft perfusate and split liver transplantation were independent risk factors for unplanned reoperation (all P<0.05). The postoperative 7-day, 1-month, 3-month and 6-month survival rates of recipients in the reoperation group and the non-reoperation group were 100% vs. 98.1%, 88.9% vs. 94.2%, 69.4% vs. 90.8% and 66.7% vs. 90.8%, respectively, and the postoperative survival rate of recipients in the reoperation group was lower than that in the non-reoperation group (P<0.05). Conclusions The main causes of unplanned reoperation after liver transplantation are biliary complications, vascular complications, abdominal incision infection and intra-abdominal hemorrhage. Intraoperative massive blood loss, positive culture of graft perfusate and split liver transplantation are the risk factors associated with unplanned reoperation after liver transplantation.

The disease-syndrome combination model of spleen deficiency with dampness pattern in ulcerative colitis（SDDP-UC） is an important experimental carrier for traditional Chinese medicine （TCM） research on the prevention and treatment of ulcerative colitis （UC）， and the quality of model construction and evaluation directly influences the scientific rigor and translational value of related research conclusions. However， this field still lacks methodological synthesis and a standardized consensus. Based on a comprehensive review of existing literature， this paper summarized isomorphic cues between the spleen deficiency with dampness pattern and UC across four dimensions， including energy metabolism， immune homeostasis， mucosal barrier， and intestinal microecology. The cues were mainly involved in impaired mitochondrial energy supply and glucose metabolic reprogramming， a lowered pro-inflammatory threshold of innate immunity with insufficient adaptive immune regulation， disruption of epithelial barrier gating accompanied by compromised repair capacity， and attenuation of the luminal hypoxia barrier with accumulation of toxic metabolites. A mutually reinforcing process between local "form damage" and systemic "Qi depletion" was further interpreted from a holistic perspective. Regarding modeling strategies， existing studies predominantly use rats as the carrier， apply combined interventions such as improper diet， external damp exposure， and fatigue-related dysregulation to establish the spleen deficiency with dampness pattern background， and subsequently superimpose chemical stimulation to induce UC-like colonic damage， with a total modeling period generally spanning three to four weeks. In terms of the evaluation system， a multidimensional framework integrating syndrome assessment， histopathology， mechanistic indices， and pharmacodynamic counter-verification was outlined. On this basis， current methodological bottlenecks of models were systematically identified， including syndrome drift risk and compounded stress dilemma in temporal sequencing， syndrome confounding from etiological simulation， cross-sectional evaluation bias related to modeling duration， inadequate disease-syndrome linkage and control design within the evaluation system， and limited controls with overly single-track decision logic in formula-based syndrome verification. To address the above issues， a construction and evaluation strategy emphasizing streamlining of core etiological factors， multi-node dynamic monitoring， integration of core disease-syndrome indicator clusters， and establishment of a formula-based syndrome verification system was proposed， providing a reference for the standardized construction and scientific evaluation of the SDDP-UC model.

Objective To analyze the postoperative complications and survival outcomes of elderly patients with renal cell carcinoma undergoing laparoscopic surgery, and to identify the influencing factors, so as to provide reference for improving the safety of laparoscopic surgery in such patients. Methods A retrospective analysis was conducted on the clinical, surgical, and pathological data of 153 patients aged ≥75 years who underwent laparoscopic nephrectomy for renal cell carcinoma at our hospital during 2012 and 2025.Logistic regression analyses were performed to identify factors influencing postoperative complications, and a nomogram was constructed and validated to predict the complications.Kaplan-Meier method was used to draw the survival curve, and the effects of different surgical approaches on the prognosis and the survival difference in the age subgroups (75-＜80 years, ≥80 years) were analyzed.Cox regression analyses were conducted to determine factors affecting survival outcomes. Results Among the 153 patients, 15 developed postoperative complications, including 5 severe cases. Multivariate logistic regression identified Charlson Comorbidity Index (CCI) ≥3 and prolonged operation time as independent risk factors for postoperative complications (P＜0.05).The C-index of the logistic regression model constructed based on these factors (age, CCI≥3 and operation time) was 0.77 (95%CI:0.64-0.90), with an average absolute error of 1.6%.Subgroup analysis revealed superior overall survival in patients aged 75-＜80 years undergoing partial nephrectomy compared to radical nephrectomy (P=0.005 6).No statistically significant difference in overall survival was observed among patients ≥80 years who received different surgical approaches (P=0.062).Multivariate Cox regression analysis identified preoperative low albumin levels, preoperative renal insufficiency, tumor diameter＞4 cm, and pathological stage as independent risk factors for overall survival (P＜0.05). Conclusion Laparoscopic surgery is safe and effective for elderly patients with renal cell carcinoma, with survival outcomes correlated to nutritional status, renal function, tumor size and pathological staging.Patients aged ≥80 years still derive surgical benefit, and no survival differences exist between different surgical approaches in this age group.

Objective To evaluate the consistency of multi-slice spiral CT (MSCT), Digital Radiography (DR) and fat-suppression MRI in detecting occult knee joint injury. Method Clinical data from 150 patients with suspected occult knee injuries who presented to the Department of imaging at the General Hospital of Ordnance Industry between August 2022 and August 2023 were retrospectively reviewed. All patients underwent MSCT, DR, and fat-suppression MRI for diagnostic evaluation. Arthroscopic or surgical findings served as the gold standard. We analyzed and compared the detection rates of specific types of occult knee injuries (ligament, meniscus, occult fracture, etc.) across the three modalities, as well as their ability to assess the degree of collapse and horizontal displacement in patients with knee fractures, and their overall diagnostic performance. Result According to the gold standard, among the 150 patients with suspected occult knee injury, 103 tested positive and 47 negative. Statistically significant differences were observed among MSCT, DR, and fat-suppression MRI in detecting occult fractures(P<0.05). The detection rates ranked in descending order asfollows: fat-suppression MRI>MSCT>DR. However, no significant difference were found in the detection rates of joint effusion and patellar cartilage injuries among the three techniques (P>0.05). Statistically differences were also note among the three techniques in detecting the degree of collapse and horizontal displacement in patients with knee fractures (P<0.05). Specifically fat-suppression MRI identified a higher proportion of grade 1 and 2 lesions than both MSCT and DR. Statistically significant differences were observed among the three techniques in diagnostic sensitivity and accuracy for occult knee injuries (P<0.05). Fat-suppression MRI demonstrated superior sensitivity (99.03%) and accuracy (96.67%) compared with MSCT (75.73%, 79.33%) and DR (61.17%, 68.00%). However, no significant difference was found in diagnostic specificity among the three techniques (P>0.05). Conclusion Compared with MSCT and DR, fat-suppression MRI offers higher diagnostic sensitivity and accuracy for occult knee injuries, particularly in identifying ligament injuries, meniscus injuries, and occult fractures.

Objective To evaluate the consistency of multi-slice spiral CT (MSCT), Digital Radiography (DR) and fat-suppression MRI in detecting occult knee joint injury. Method Clinical data from 150 patients with suspected occult knee injuries who presented to the Department of imaging at the General Hospital of Ordnance Industry between August 2022 and August 2023 were retrospectively reviewed. All patients underwent MSCT, DR, and fat-suppression MRI for diagnostic evaluation. Arthroscopic or surgical findings served as the gold standard. We analyzed and compared the detection rates of specific types of occult knee injuries (ligament, meniscus, occult fracture, etc.) across the three modalities, as well as their ability to assess the degree of collapse and horizontal displacement in patients with knee fractures, and their overall diagnostic performance. Result According to the gold standard, among the 150 patients with suspected occult knee injury, 103 tested positive and 47 negative. Statistically significant differences were observed among MSCT, DR, and fat-suppression MRI in detecting occult fractures(P<0.05). The detection rates ranked in descending order asfollows: fat-suppression MRI>MSCT>DR. However, no significant difference were found in the detection rates of joint effusion and patellar cartilage injuries among the three techniques (P>0.05). Statistically differences were also note among the three techniques in detecting the degree of collapse and horizontal displacement in patients with knee fractures (P<0.05). Specifically fat-suppression MRI identified a higher proportion of grade 1 and 2 lesions than both MSCT and DR. Statistically significant differences were observed among the three techniques in diagnostic sensitivity and accuracy for occult knee injuries (P<0.05). Fat-suppression MRI demonstrated superior sensitivity (99.03%) and accuracy (96.67%) compared with MSCT (75.73%, 79.33%) and DR (61.17%, 68.00%). However, no significant difference was found in diagnostic specificity among the three techniques (P>0.05). Conclusion Compared with MSCT and DR, fat-suppression MRI offers higher diagnostic sensitivity and accuracy for occult knee injuries, particularly in identifying ligament injuries, meniscus injuries, and occult fractures.

Objective To evaluate the consistency of multi-slice spiral CT (MSCT), Digital Radiography (DR) and fat-suppression MRI in detecting occult knee joint injury. Method Clinical data from 150 patients with suspected occult knee injuries who presented to the Department of imaging at the General Hospital of Ordnance Industry between August 2022 and August 2023 were retrospectively reviewed. All patients underwent MSCT, DR, and fat-suppression MRI for diagnostic evaluation. Arthroscopic or surgical findings served as the gold standard. We analyzed and compared the detection rates of specific types of occult knee injuries (ligament, meniscus, occult fracture, etc.) across the three modalities, as well as their ability to assess the degree of collapse and horizontal displacement in patients with knee fractures, and their overall diagnostic performance. Result According to the gold standard, among the 150 patients with suspected occult knee injury, 103 tested positive and 47 negative. Statistically significant differences were observed among MSCT, DR, and fat-suppression MRI in detecting occult fractures(P<0.05). The detection rates ranked in descending order asfollows: fat-suppression MRI>MSCT>DR. However, no significant difference were found in the detection rates of joint effusion and patellar cartilage injuries among the three techniques (P>0.05). Statistically differences were also note among the three techniques in detecting the degree of collapse and horizontal displacement in patients with knee fractures (P<0.05). Specifically fat-suppression MRI identified a higher proportion of grade 1 and 2 lesions than both MSCT and DR. Statistically significant differences were observed among the three techniques in diagnostic sensitivity and accuracy for occult knee injuries (P<0.05). Fat-suppression MRI demonstrated superior sensitivity (99.03%) and accuracy (96.67%) compared with MSCT (75.73%, 79.33%) and DR (61.17%, 68.00%). However, no significant difference was found in diagnostic specificity among the three techniques (P>0.05). Conclusion Compared with MSCT and DR, fat-suppression MRI offers higher diagnostic sensitivity and accuracy for occult knee injuries, particularly in identifying ligament injuries, meniscus injuries, and occult fractures.

Objective: To explore the feasibility of synthetic magnetic resonance imaging (syMRI) combined with clinicopathological characteristics for the pre-treatment prediction of chemoradiotherapy (CRT) response in advanced nasopharyngeal carcinoma (ANPC). Materials and Methods: Patients with ANPC treated with CRT between September 2020 and June 2022 were retrospectively enrolled and categorized into response group (RG, n = 95) and non RGs (NRG, n = 32) based on the Response Evaluation Criteria in Solid Tumors (RECIST) 1.1. The quantitative parameters from pre-treatment syMRI (longitudinal [T1] and transverse [T2] relaxation times and proton density [PD]), diffusion-weighted imaging (apparent diffusion coefficient [ADC]), and clinicopathological characteristics were compared between RG and NRG. Logistic regression analysis was applied to identify parameters independently associated with CRT response and to construct a multivariable model. The areas under the receiveroperating characteristic curve (AUC) for various diagnostic approaches were compared using the DeLong test. Results: The T1, T2, and PD values in the NRG were significantly lower than those in the RG (all P < 0.05), whereas no significant difference was observed in the ADC values between these two groups. Clinicopathological characteristics (Epstein–Barr virus [EBV]-DNA level, lymph node extranodal extension, clinical stage, and Ki-67 expression) exhibited significant differences between the two groups. Logistic regression analysis showed that T1, PD, EBV-DNA level, clinical stage, and Ki-67 expression had significant independent relationships with CRT response (all P < 0.05). The multivariable model incorporating these five variables yielded AUC, sensitivity, and specificity values of 0.974, 93.8% (30/32), and 91.6% (87/95), respectively. Conclusion SyMRI may be used for the pretreatment prediction of CRT response in ANPC. The multivariable model incorporating syMRI quantitative parameters and clinicopathological characteristics, which were independently associated with CRT response, may be a new tool for the pretreatment prediction of CRT response.

Pulmonary infection is one of the infectious diseases that have long plagued human health.The receptor for advanced glycation end-products(RAGE)is a non-specific,multi-ligand pat-tern recognition receptor expressed on the surface of various tissues and cells.It can bind to a series of structurally different ligands,including pathogen-associated molecular patterns from pathogenic micro-organisms.Soluble receptor for advanced glycation end-products(sRAGE)is a soluble form generated when cell surface RAGE is excessively stimulated by inflammatory cytokines.As a competitive recep-tor,it inhibits multiple RAGE-dependent cellular signaling pathways and participates in the inflamma-tory response process.This review summarized the clinical significance of serum sRAGE levels in in-fection-related pulmonary diseases,explored the biological characteristics of sRAGE in these diseases,and evaluated its clinical application value.

Objective To investigate the relationships of CXC motif chemokine ligand 10(CXCL10)and CC motif chemokine ligand 11(CCL11)in the peripheral blood with type 2 diabetic osteoporosis(T2DOP),and to construct a predictive model.Methods A total of 260 patients with type 2 diabetes mellitus(T2DM)were prospectively selected as the T2DM group.They were divided into T2DOP group(n=82)and non-T2DOP group(n=178)according to the occurrence of T2DOP.Additionally,68 healthy volunteers with physical examinations in the same period were se-lected as control group.Enzyme-linked immunosorbent assay was used to detect the levels of CXCL10 and CCL11 in the peripheral blood as well as bone metabolism indicators[β-C-terminal te-lopeptide of type Ⅰ collagen(β-CTX),N-terminal propeptide of type Ⅰ procollagen(PⅠNP)].Pear-son correlation analysis was used to explore the correlation of CXCL10 and CCL11 in peripheral blood with bone metabolism indicator levels in patients with T2DM.Multifactor non-conditional Logistic regression analysis was used to explore the influencing factors of T2DOP and construct a pre-dictive model.The Hosmer-Lemeshow(H-L)test was used to assess the goodness of fit.The re-ceiver operating characteristic(ROC)curve analysis was used to evaluate the predictive value of each indicator and the predictive model for T2DOP,and decision curve analysis and Bootstrap resa-mpling were used for internal validation.Results Compared with the control group,the levels of CXCL10 and CCL11 in the peripheral blood as well as β-CTX in the T2DM group were significantly increased,while the level of P Ⅰ NP was significantly decreased(P＜0.05).Pearson correlation a-nalysis showed that CXCL10 and CCL11 in the peripheral blood in patients with T2DM were posi-tively correlated with β-CTX level(r=0.786,0.816,P＜0.001)and negatively correlated with P ⅠNP level(r=-0.675,-0.716,P＜0.001).Compared with the non-T2DOP group,the T2DOP group had significantly increased age and the ratio of diabetic nephropathy,prolonged dura-tion of diabetes,decreased body mass index(BMI)and P ⅠNP levels,and increased fasting blood glucose,glycated hemoglobin(HbA1c),β-CTX,CXCL10,and CCL11 levels(P＜0.05).Non-conditional Logistic regression analysis showed that advanced age,long duration of diabetes,high HbA1c,high CXCL10,and high CCL11 were independent risk factors for T2DOP(P＜0.05),while high BMI was an independent protective factor(P＜0.05).The ROC curve showed that the area under the curve(AUC)of the predictive model for predicting T2DOP was 0.919,which was significantly greater than the AUCs of 0.643,0.742,0.654,0.715,0.759 and 0.741 respectively for age,duration of diabetes,BMI,HbA1c,CXCL10 and CCL11 alone(Z=7.468,5.400,7.415,6.365,5.242,5.800,P＜0.001).After internal validation,the decision curve of the predictive model was higher than the two extreme curves.After 1,000 times of Bootstrap resampling internal validations,the concordance index of the predictive model was 0.919(95％CI,0.914 to 0.923).Conclusion Increased levels of CXCL10 and CCL11 in the peripheral blood are associat-ed with T2DOP,and the predictive model constructed based on these factors has a high predictive value for T2DOP.