Objective: To investigate the impact of RhE antigen-matched transfusion during liver transplantation on early postoperative recovery and complications. Methods: In this retrospective cohort study, ninety-five patients undergoing liver transplantation at Kunming First People's Hospital between January 2022 and July 2025 were enrolled. Patients were divided into two groups: Group 1 (RhE-mismatched transfusion, n=57) and Group 2 (RhE-matched transfusion, n=38). The baseline data, complete blood counts, hepatic and renal function, coagulation parameters, and complication rates between the two groups were compared at postoperative days 1, 3, 5, 7, and 10. Survival analysis was performed using the Kaplan-Meier method. Results: The baseline characteristics were well-balanced and comparable between the two groups (all P>0.05). The early postoperative mortality rate in the mismatched group (31.58%, 18/57) was significantly higher than that in the matched group (10.53%, 4/38) (P=0.017). The incidence of postoperative hepatic encephalopathy was significantly higher in the mismatched group (50.88%, 29/57) than in the matched group (10.53%, 4/38) (P<0.001). The incidence of postoperative haemorrhage in the mismatched group (24.56%, 14/57) was higher than that in the matched group (5.26%, 2/38), with a statistically significant difference (P=0.014). The incidence of perioperative infection in the mismatched group (28.07%, 16/57) was higher than that in the matched group (10.53%, 4/38), with a statistically significant difference (P=0.04). Corresponding odds ratios (OR) and 95% confidence intervals indicated a lower risk of these adverse events in the matched group. On postoperative day 1, the change in activated partial thromboplastin time (-1.6, 20.5) in the mismatched group was greater than in the matched group (-0.2, 5.5). The change in international normalised ratio (-0.56, 1.22) in the mismatched group was greater than in the matched group (-0.18, 0.32), while the change in albumin (-4.0, 4.8) was smaller in the mismatched group than in the matched group (-2.5, 8.8). On postoperative day 5, the change in albumin (-0.41±7.83) in the mismatched group was smaller than in the matched group (2.68±4.53). At postoperative day 7, the change in albumin in the mismatched group (-0.61±7.38) was smaller than that in the matched group (2.51±5.85), while the change in D-dimer in the mismatched group (0.73, 7.4) was greater than that in the matched group (-1.6, 4.3). On postoperative day 10, the mismatched group exhibited significantly higher fibrinogen levels (-1.21, 1.78) than the matched group (-0.49, 0.97), and significantly longer prothrombin times (-11.3, -2.7) than the matched group (-6.2, -0.8) (all P<0.05). The matched group exhibited a mean overall survival (OS) of 32.803 months (95% CI:29.171-36.436 months), significantly exceeding the mismatched group's 28.996 months (95% CI:24.202-33.790 months). The log-rank test yielded statistically significant results (χ =4.307, P=0.038). Conclusion: Implementing RhE blood group-matched transfusion during liver transplantation may help reduce early postoperative mortality and the incidence of major complication rates, promote faster recovery of coagulation and liver function, and thereby improve short-term patient outcomes.

Objective: To investigate the damaging effects of red blood cell supernatant (RBC-S) stored for different durations (7 d, 14 d, and 28 d) on vascular endothelial cells, and to explore the underlying mechanisms using bioinformatics analysis, so as to provide references for optimizing red blood cell transfusion strategies. Methods: Human umbilical vein endothelial cells (HUVECs) were co-cultured with RBC-S stored for 7, 14 and 28 days, designated as the 7 d group, 14 d group and 28 d group respectively, which were collectively defined as the experimental groups. Cell damage was evaluated by cell proliferation assay (Cell Counting Kit8, CCK8), lactate dehydrogenase (LDH) release assay, 4′, 6diamidino2phenylindole (DAPI) staining, and flow cytometry for apoptosis and reactive oxygen species (ROS) levels. The damage degree of RBC-S on vascular endothelial cells was assessed by statistical analysis of damage data among different groups. Since the damage effect reached a plateau at all time points, the 28 d storage group was selected as the representative for further mechanistic studies. Transcriptomic analysis was performed to explore the role of frizzled class receptor 1 (FZD1) and Wnt signaling pathway in red blood cell storagerelated endothelial dysfunction. Results: Compared with the control group, the storage groups treated with 7 d, 14 d, and 28 d RBC-S showed significantly decreased cell proliferation rates [control group 100%, 7 d group (69.51±2.30)%, 14 d group (74.54±2.89)%, 28 d group (73.59±2.36)%, P<0.05], significantly reduced numbers of DAPI-stained cell nuclei [control group (213±12.5) per field, 7 d group (140.33±17.04) per field, 14 d group (152.00±23.72) per field, 28 d group (144.33±19.09) per field, P<0.05] and significantly increased LDH release [control group (1), 7 d group (8.33±1.41), 14 d group (9.23±0.83), 28 d group (9.16±0.60), P<0.05]. There was no significant difference in the degree of damage caused by RBC-S among different storage groups (P>0.05). With the prolongation of storage time, free hemoglobin (FHb) gradually increased [control group (not detected), 7 d (16.57±6.38) mg/L, 14 d (76.80±22.83) mg/L, 28 d (286.97±29.02) mg/L, P<0.05]. The apoptotic rate (20.53±2.94)% and ROS relative intensity (5.13±0.91) in the 28 d storage group were significantly higher than those in the control group (P<0.05). Transcriptomic analysis showed that FZD1 played a key role in vascular endothelial dysfunction induced by red blood cell storage and was closely related to the Wnt signaling regulatory network. Conclusion: RBC-S stored for 7 d, 14 d, or 28 d can all significantly damage vascular endothelial cells, and the damaging effect reaches a plateau at 7 d of storage. Mechanistic investigation of the 28 d group indicated that the downregulation of the FZD1/Wnt signaling pathway may play a critical role in vascular endothelial dysfunction induced by red blood cell storage, providing a theoretical basis for further optimizing red blood cell storage and transfusion strategies.

BACKGROUND:Existing studies have preliminarily summarized the potential association between muscle activity of the affected lower limb and gait stability during walking in patients undergoing anterior cruciate ligament reconstruction.However,there are some issues such as incomplete observation of muscle categories,incomplete observation of walking action phases,and failure to consider synergistic effects among multiple muscle groups,which urgently require further improvement in this study.OBJECTIVE:To monitor muscle synergy information of the affected leg during walking in patients undergoing anterior cruciate ligament reconstruction and to analyze the association between muscle synergy information and gait stability.METHODS:Twenty-four male patients aged(21.66±4.09)years undergoing anterior cruciate ligament reconstruction,were recruited.Electromyographic and center of pressure data were collected from the affected lower limb during walking.A non-negative matrix decomposition algorithm was used to extract the number of muscle synergic elements from the affected leg,the time spent in peak activation of each muscle synergic element,and the muscle relative weight indexes.Correlation analysis was then performed with the center of pressure indexes.RESULTS AND CONCLUSION:Six types of muscle synergies were identified in the affected leg.The number of muscle synergic elements showed no significant correlation with the distance and speed of lateral displacement of the center of pressure.Regarding the peak activation time of muscle synergic elements,synergic element 3 in the dominant gait loading response period showed a significant negative correlation with the lateral displacement distance of the center of pressure(r=-0.413,P=0.045)and a significant negative correlation with the lateral displacement velocity of the center of pressure(r=-0.470,P=0.020).The activation time of the remaining types of muscle synergic elements was not significantly related with patient's gait stability indices.In terms of muscle relative weights,the rectus femoris muscle of synergistic element 1 in the dominant gait loading response period showed a significant negative correlation with the lateral displacement distance of the center of pressure(r=-0.592,P=0.005)and a significant negative correlation with the lateral displacement speed of the center of pressure(r=-0.529,P=0.014).Additionally,the relative weight of the biceps femoris muscle of synergistic element 3 in the dominant gait loading response period showed a significant negative correlation with the lateral displacement distance of the center of pressure(r=-0.428,P=0.037).To conclude,the central system in patients undergoing anterior cruciate ligament reconstruction regulates the synergistic muscle activity of the affected leg during walking to enhance gait stability in two primary ways:by prolonging the activation time of the muscle synergists during the dominant loading response period and enhancing the activation of the quadriceps muscle,in order to enhance the control of eccentric contractions of the knee joint during the landing of the affected leg and improve the stability of the knee joint;and by increasing the activation of the biceps femoris muscle during the loading response period,which increases the degree of knee flexion and enhances the lower limb's cushioning function during the landing of the affected leg.

BACKGROUND:Existing studies have preliminarily summarized the potential association between muscle activity of the affected lower limb and gait stability during walking in patients undergoing anterior cruciate ligament reconstruction.However,there are some issues such as incomplete observation of muscle categories,incomplete observation of walking action phases,and failure to consider synergistic effects among multiple muscle groups,which urgently require further improvement in this study.OBJECTIVE:To monitor muscle synergy information of the affected leg during walking in patients undergoing anterior cruciate ligament reconstruction and to analyze the association between muscle synergy information and gait stability.METHODS:Twenty-four male patients aged(21.66±4.09)years undergoing anterior cruciate ligament reconstruction,were recruited.Electromyographic and center of pressure data were collected from the affected lower limb during walking.A non-negative matrix decomposition algorithm was used to extract the number of muscle synergic elements from the affected leg,the time spent in peak activation of each muscle synergic element,and the muscle relative weight indexes.Correlation analysis was then performed with the center of pressure indexes.RESULTS AND CONCLUSION:Six types of muscle synergies were identified in the affected leg.The number of muscle synergic elements showed no significant correlation with the distance and speed of lateral displacement of the center of pressure.Regarding the peak activation time of muscle synergic elements,synergic element 3 in the dominant gait loading response period showed a significant negative correlation with the lateral displacement distance of the center of pressure(r=-0.413,P=0.045)and a significant negative correlation with the lateral displacement velocity of the center of pressure(r=-0.470,P=0.020).The activation time of the remaining types of muscle synergic elements was not significantly related with patient's gait stability indices.In terms of muscle relative weights,the rectus femoris muscle of synergistic element 1 in the dominant gait loading response period showed a significant negative correlation with the lateral displacement distance of the center of pressure(r=-0.592,P=0.005)and a significant negative correlation with the lateral displacement speed of the center of pressure(r=-0.529,P=0.014).Additionally,the relative weight of the biceps femoris muscle of synergistic element 3 in the dominant gait loading response period showed a significant negative correlation with the lateral displacement distance of the center of pressure(r=-0.428,P=0.037).To conclude,the central system in patients undergoing anterior cruciate ligament reconstruction regulates the synergistic muscle activity of the affected leg during walking to enhance gait stability in two primary ways:by prolonging the activation time of the muscle synergists during the dominant loading response period and enhancing the activation of the quadriceps muscle,in order to enhance the control of eccentric contractions of the knee joint during the landing of the affected leg and improve the stability of the knee joint;and by increasing the activation of the biceps femoris muscle during the loading response period,which increases the degree of knee flexion and enhances the lower limb's cushioning function during the landing of the affected leg.

Objective:To systematically synthesize the real experiences of women who have undergone emergency cesarean sections, providing evidence-based insights to inform the development of personalized care strategies.Methods:A comprehensive literature search was conducted across PubMed, Web of Science, Embase, CINAHL, Cochrane Library, PsycINFO, ProQuest, China National Knowledge Infrastructure, Wanfang Data, VIP, and China Biology Medicine disc for qualitative and mixed-methods studies related to the psychological experiences of women who underwent emergency cesarean sections. The search covered all publications up to January 31, 2025. The methodological quality of included studies was appraised using the Joanna Briggs Institute Center for Evidence-Based Health Care Quality Assessment Criteria for Qualitative Research. The results were integrated using an aggregative synthesis approach.Results:A total of 16 studies were included, from which 78 findings were extracted and grouped into nine new categories. These were further synthesized into three overarching themes: shift in birth plan and emergence of dynamic emotional responses; desire for diversified external support and encouragement; emotional investment and character growth.Conclusions:Women undergoing emergency cesarean sections commonly experience intense negative emotions. It is essential for healthcare providers and family members to pay close attention to the physical and psychological well-being of postpartum women, offer timely emotional support, and help them recover from psychological trauma, thereby promoting maternal mental and physical health.

Objective:To investigate the current state of oral health knowledge,attitude and practice(KAP)of plateau military personnels and to analyze the disease condition,aiming to explore new strategies for enhancing oral health.Methods:A question-naire was developed to survey 500 individuals at high altitudes(≥3 000 m)and 500 at low altitudes(≤1 000 m)regarding their oral health KAP,with 100 subjects randomly selected from each group for oral examinations.Logistic regression analysis was ap-plied to examine the correlation between KAP and disease status.Based on these findings,a survey of the oral health needs of mili-tary personnels was conducted in conjunction with their KAP.And an innovative training system,"Perception-Comprehension-Inte-gration"(PCI),was established to improve the competencies of primary healthcare providers,with its effectiveness being evaluated.Results:The high altitude group had significantly lower rates of overall oral health awareness(53.61％),positive attitude(55.00％)and positive practice(40.29％)compared with the low altitude group(P＜0.05);the incidence in high altitude group experiencing dental caries(73％),wedge-shaped defects(34％),pericoronitis(16％),gingival bleeding(74％),dental calculus(81％)and cheilitis(37％)were significantly higher than those in the low altitude group(P＜0.05).There was a significant nega-tive correlation between KAP scores and disease prevalence.The subjects in both groups showed a substantial demand(exceeding 70％)for oral health.The innovative PCI training system has markedly strengthened the health personnel's compre-hensive preventive and health care capabilities.Conclu-sion:The oral health status of plateau military personnels is in dire need of enhancement.And the PCI training sys-tem is poised to serve as a novel approach to tackling this critical concern.

Objective:To evaluate the clinical value and safety of an intraperitoneal chemotherapy port technique in patients with gastric cancer and peritoneal metastases undergoing intraperitoneal chemotherapy.Methods:This was a retrospective, descriptive case analysis. From November 2022 to October 2024, patients diagnosed with gastric cancer and peritoneal metastases at Wuxi Branch of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine with an expected survival >3 months, underwent laparoscopic exploration combined with implantation of an intraperitoneal chemotherapy port [PORT-A-CATH II system (Model 21-4055-24)] implantation. The procedure was as follows: (1) after laparoscopic exploration, a 4-cm skin incision was made at a predetermined site and a subcutaneous pocket created by dissecting to the muscle fascia and removing subcutaneous fat as needed to position the port septum 0.5-1.0 cm from the skin surface; (2) under direct laparoscopic visualization, the abdominal cavity was punctured and a guidewire inserted, followed by an 8.5 Fr sheath, through which a catheter with three trimmed side holes was placed after removal of the sheath; (3) the catheter length in the abdominal cavity was adjusted to 25–30 cm and the catheter trimmed, and connected to the port base, ensuring it extended beyond the connector's visible hole; (4) the whole port was placed within the subcutaneous pocket, and non-absorbable sutures used to create a double purse-string suture at the catheter's abdominal entry, forming an anti-reflux ring; (5) non-absorbable sutures were used to securely fix the port to the fascia through its four base holes and the exposed catheter segments on the fascia sutured and buried; (6) patency was confirmed by injecting saline and followed by intermittent skin closure provided there was no bleeding; and (7) the catheter tip was positioned in the pelvic cavity under laparoscopic guidance. Postoperatively, the patients underwent normothermic intraperitoneal and systemic treatment. The port infusion protocol involved disinfecting the skin (>10 cm diameter) around the port, confirming the puncture site, inserting a Huber needle vertically at 90° to the port base, infusing 100 mL saline to ensure patency, followed by continuous infusion of 1000 mL paclitaxel solution, and sealing with 20 mL saline before removing the needle. No saline flushing was required between chemotherapy infusions. The primary outcomes were the incidence and management of complications post-port implantation.Results:The study cohort comprised 225 patients with gastric cancer and peritoneal metastases. Using standardized port implantation and postoperative puncture procedures, the complication rate during follow-up was 14.2% (32/225), including effusion in 14 patients (6.2%), port infection in 10 (4.4%), incision dehiscence in four (1.8%), port inversion in two (0.9%), hematoma in one (0.4%), and catheter rupture in one (0.4%). Seventy-five percent (24/32) of patients with complications recovered and continued using the port after conservative treatments (e. g., aspiration of effusions, antibiotic therapy, incision management), whereas the remaining 25.0% (8/32) with complications required surgical removal of the port because the treatment was ineffective. The presence of preoperative ascites ( P=0.019) and peritoneal cancer index score>15 ( P=0.038) were significantly associated with development of complications. Conclusions:Our standardized procedure for intraperitoneal chemotherapy port implantation is safe and feasible for patients with gastric cancer and peritoneal metastases, having a low overall complication rate. Most complications can be successfully managed with conservative treatment, the device thus providing reliable support for intraperitoneal chemotherapy.

Objective:To systematically synthesize the real experiences of women who have undergone emergency cesarean sections, providing evidence-based insights to inform the development of personalized care strategies.Methods:A comprehensive literature search was conducted across PubMed, Web of Science, Embase, CINAHL, Cochrane Library, PsycINFO, ProQuest, China National Knowledge Infrastructure, Wanfang Data, VIP, and China Biology Medicine disc for qualitative and mixed-methods studies related to the psychological experiences of women who underwent emergency cesarean sections. The search covered all publications up to January 31, 2025. The methodological quality of included studies was appraised using the Joanna Briggs Institute Center for Evidence-Based Health Care Quality Assessment Criteria for Qualitative Research. The results were integrated using an aggregative synthesis approach.Results:A total of 16 studies were included, from which 78 findings were extracted and grouped into nine new categories. These were further synthesized into three overarching themes: shift in birth plan and emergence of dynamic emotional responses; desire for diversified external support and encouragement; emotional investment and character growth.Conclusions:Women undergoing emergency cesarean sections commonly experience intense negative emotions. It is essential for healthcare providers and family members to pay close attention to the physical and psychological well-being of postpartum women, offer timely emotional support, and help them recover from psychological trauma, thereby promoting maternal mental and physical health.

Objective:To establish a dose-response curve of dicentric chromosomes and centromeric rings (dic+ r) in γ-ray irradiation-induced chromosomal aberrations in human peripheral blood lymphocytes through automated analysis.Methods:Peripheral blood samples from three healthy donors were irradiated in vitro at doses of 0, 0.5, 0.75, 1, 1.5, 2, 3, 4, and 5 Gy and a dose rate of 0.80 Gy/min using a 137Cs γ-ray source. Post-irradiation, lymphocytes were cultured based on standard protocols, harvested using an automatic cell harvester, and prepared on slides using an automatic slide preparation system. dic+ r were analyzed fully automatically using the DCScore software, and a dose-response curve of dic+ r was established through fitting and then validated using the CABAS software. Results:The dose-response curve followed a linear-quadratic model, i. e., y = 0.093 65+ 0.030 21 D+ 0.025 31 D2 ( R2 = 0.999 2), where y was the quantity of dic+ r and D was the absorbed dose of γ-ray irradiation (Gy). Doses to samples for blind validation were estimated using this curve, yielding deviations of less than 24% from the actual irradiation doses. Conclusions:The fully automated analysis of dic+ r in 137Cs γ-ray irradiation-induced chromosomal aberrations, followed by the construction of the dose-response curve, holds significant potential for rapid, high-throughput biodosimetry in large-scale nuclear emergencies.

Background:Ribosomal protein L22-like 1(RPL22L1)exerts regulatory effects on various malignant tumors such as lung cancer,prostate cancer,and cervical cancer.However,its role in colorectal cancer(CRC)remains unclear.Aims:To investigate the expression of RPL22L1 in CRC and its role in patients' prognosis and glucose metabolism of tumor cells.Methods:A total of 142 newly diagnosed CRC patients admitted to the Taizhou First People's Hospital from February 2022 to June 2024 were enrolled.The expression levels of RPL22L1 mRNA and protein were detected by quantitative real-time PCR and immunohistochemistry,respectively.The correlation between RPL22L1 expression and clinicopathological characteristics was analyzed.Kaplan-Meier survival analysis was used to evaluate the impact of RPL22L1 expression on the prognosis of CRC patients.RPL22L1 siRNA was transfected into SW480 cells to establish a low-expression cell model.Cell proliferation was assessed by CCK-8 assay,cell migration by Transwell chamber assay,and apoptosis by flow cytometry.Gene set enrichment analysis(GSEA)was performed to evaluate the effect of RPL22L1 on glucose metabolism of tumor cells.Results:The expression levels of RPL22L1 mRNA and protein were significantly higher in CRC tissues than in adjacent normal tissues(all P<0.05).The expression level of RPL22L1 mRNA was correlated with the TNM stage and carcinoembryonic antigen level of CRC(all P<0.05).Kaplan-Meier analysis showed that the cumulative survival rate of high RPL22L1 mRNA expression group was significantly lower than that of low-expression group(P=0.027).The expression level of RPL22L1 mRNA was significantly higher in SW480 cells than in normal intestinal epithelial cells(P<0.001).After inhibiting RPL22L1 expression,the proliferation and migration capacities of SW480 cells were significantly decreased(all P<0.05),the apoptosis rate was significantly increased(P=0.005),and the lactate level and relative glucose uptake level were significantly reduced(all P<0.05).GSEA indicated that RPL22L1 gene was associated with glycolysis/gluconeo-genesis(P=0.02).Conclusions:RPL22L1 is highly expressed in CRC and is associated with poor prognosis of patients,suggesting its potential as a molecular target for CRC therapy.Furthermore,RPL22L1 may promote the tumorigenesis and progression of CRC by modulating glucose metabolism.