Objective: To retrospectively analyze the prevalence of hepatitis C virus (HCV) infection among voluntary blood donors in Qinghai Province over a ten-year period and to provide evidence for refining blood safety screening strategies. Methods: Blood samples from 362 066 blood donors in Qinghai collected between January 2015 and April 2024 were simultaneously screened using enzyme-linked immunosorbent assay (ELISA) and nucleic acid testing (NAT). Follow-up was conducted for donors with reactive HCV RNA screening results, and alanine transaminase (ALT) was detected by rate method. Results: The HCV positive rate among blood donors in Qinghai was 0.22%. Gender, marital status, number of blood donations, and educational level were associated with HCV infection. Significant differences in HCV positive rates were observed among donors across regions and ethnic groups. The HCV positive rate among donors in Golog Tibetan Autonomous Prefecture (with an average altitude of 4 330 m) was significantly higher than that in Xining (0.52% vs 0.21%, P<0.001). Positivity rates were also significantly higher in Salar (0.84%), Hui (0.81%), Zang (0.60%), and Tu (0.45%) ethnic groups compared to the Han ethnic group (0.17%) (P<0.001). The abnormal rate of ALT in HCV-positive donors was higher than in non-HCV donors (6.13% vs 1.55%) (P<0.001). Conclusion: The relatively high HCV positivity rate among blood donors in Qinghai highlights the need for further investigation into viral sources, risk factors, and transmission routes. Optimized screening strategies are essential to ensure blood safety.

Objective:To explore the prognostic value of monocyte to high-density lipoprotein cholesterol (HDL-C) ratio (MHR) in assessing patients with heart failure with reduced ejection fraction (HFrEF).Methods:Patients with HFrEF (LVEF<40%) admitted to the TEDA International Cardiovascular Disease Hospital between 2 January 2019 and 15 January 2023 were selected. The MHR levels were recorded at admission in patients with HFrEF who were followed up regularly for 12 months. The major adverse cardiovascular events (cardiac death and readmission for heart failure) were defined as poor prognosis. Multivariate Cox regression was used to analyze factors associated with poor prognosis. The receiver operator characteristic (ROC) curves were used to assess the diagnostic value of MHR for poor prognosis. The DeLong test was used to analyze whether there was a difference in the effectiveness of MHR and BNP for detecting poor prognosis. The critical value grouping for poor prognosis was evaluated by MHR, and survival analyses were performed using Kaplan-Meier.Results:A total of 286 subjects were enrolled in the study, including 206 males and 80 females, with a median age ( Q1, Q3) of 67 (58, 74) years. Multivariate Cox regression showed that MHR ( HR=1.482, 95% CI:1.015-2.164) and BNP ( HR=1.001, 95% CI:1.000-1.001) were associated with poor prognosis in patients with HFrEF. The area under the ROC curve for the adjunctive diagnostic value of MHR, BNP and the combination of both for poor prognosis in patients with HFrEF was 0.709, 0.738 and 0.769, respectively. The critical values were 0.486, 1 090 pg/ml and 0.41, respectively. The DeLong test showed no differences in the validity of MHR, BNP and their combination for detecting poor prognosis. Kaplan Meier survival analysis of 12-month follow-up showed that the time for poor prognosis in HFrEF patients with MHR>0.486 group (8.645 months) was significantly shorter than that in MHR≤0.486 group (10.296 months, P<0.001), and the risk of poor prognosis in MHR>0.486 group was 2.843 times higher than that in MHR≤0.486 group ( HR=2.843, 95% CI:1.867-4.327). Conclusion:MHR can be an indicator of poor prognosis in patients with HFrEF.

Objective:To explore the relationship between the differential genes derived from transcriptome mRNA sequencing and prognosis among heart failure patients with mildly reduced ejection fraction (HFmrEF) and preserved ejection fraction (HFpEF).Methods:This was a case-control study. Ten patients with HFmrEF and 10 patients with HFpEF treated at TEDA International Cardiovascular Disease Hospital from November 2021 to January 2022 were selected and differentially expressed genes were screened by transcriptome mRNA sequencing. Ten healthy people served as control group. In addition, 50 patients with HFmrEF, 62 patients with HFpEF, who were treated at TEDA International Cardiovascular Disease Hospital at the same period, were selected as validation groups, 57 healthy people served as control validation group. Real-time quantitative PCR (RT-qPCR) was used to detect the expression of differential genes in each group. Receiver operating characteristic (ROC) curves and the area under the curve (AUC) were used to assess the differential diagnosis and prognostic value of differential genes in these patients. Patients were followed up regularly to document adverse events within 1 year after discharge including cardiac death and readmission for heart failure. Survival analysis was performed using Kaplan-Meier curves and tested by log rank test. Cox regression analysis was used to explore whether differential mRNA was risk factors for poor prognosis in HFmrEF and HFpEF patients.Results:A total of four genes were differentially expressed (three upregulated and one downregulated gene) between the HFmrEF group and HFpEF group (adjust P<0.05). SLC12A1, C15orf48 and SPP1 were associated with the progress of cardiovascular disease, and selected for validation in the clinical cohort. RT-qPCR results showed that the gene expression of SLC12A1 in the HFmrEF group was significantly higher than that in the HFpEF group ( P<0.001). The AUC for the adjunctive differential diagnostic value of SLC12A1 for HFmrEF and HFpEF was 0.802 ( P<0.001) and the AUC of SLC12A1 with a cut-off value of 6.634 was 0.737 ( P=0.003) in determining poor prognosis in patients with HFpEF. Kaplan-Meier survival analysis showed that patients with SLC12A1≤6.634 had a higher incidence of adverse cardiac events than patients with SLC12A1 >6.634 ( P=0.001). Cox regression analysis showed that the risk of adverse cardiac events in the SLC12A1 ≤6.634 group was 6.787 times higher than in the SLC12A1 >6.634 group ( HR=6.787, P=0.011). Conclusions:Transcriptome mRNA sequencing analysis is valuable for detecting clinical relevant differentially expressed genes in HFmrEF and HFpEF patients, among which SLC12A1 can be used as a novel molecular biomarker to aid the differential diagnosis of HFmrEF and HFpEF. In addition, SLC12A1 may be used as an adjunctive biomarker for the prognosis evaluation in patients with HFpEF.

Objective:To investigate the applicability and surgical effect of direct horizontal suture in the repair of defects after the excision of eyelid nevus.Methods:The clinical data of patients with eyelid nevus who were admitted to Department of Facial and Neck Plastic Surgery, Plastic Surgery Hospital of Chinese Academy of Medical Sciences from March 2015 to March 2023 were retrospectively analyzed. After the eyelid nevus was removed, the defect was closed by horizontal suture parallel to the eyelid margin. In the preoperative simulation suture scheme, one or more horizontal lines were marked on the eyelid skin according to the scope of the nevus. The intersection points of the horizontal lines and the edges of the nevus were marked for simulated suturing. If the marked points aligned horizontally, direct suturing was applied. After 3 months of postoperative follow-up, the therapeutic effect was evaluated based on eyelid function (classified as excellent, good and poor), cosmetic effects (classified as excellent, good and poor) and patient satisfaction (classified as very satisfactory, satisfactory and dissatisfactory). At the same time, the effect of different wound length (<1 cm, 1-2 cm, >2 cm) on the therapeutic effect was also analyzed. SPSS 27.0 software was used for statistical analysis of the data. The counting data were represented by examples and percentages, and Kruskal-Wallis H test was used for comparison between groups. P<0.05 indicated that the difference was statistically significant. Results:A total of 71 patients were enrolled, including 30 males and 41 females. Aged 4 to 35 years old, with an average age of 15 years old. The lesions involved the upper eyelid in 47 cases, the lower eyelid in 14 cases, and co-involved in 10 cases. Lesion areas ranged from 0.5 cm×0.5 cm to 2.3 cm×2.0 cm. None of the lesions involved the palpebral margin and conjunctiva, and the depth did not reach the orbicularis oculi muscle. Immediately after the operation, all the patients had different degrees of eyelid deformation, and some severe patients had difficulty opening their eyes. The above symptoms were relieved within 7 days to 3 months after the operation, and eventually the eyelid movement returned to normal, leaving only mild scarring. In cases where the eyelid nevus was close to or involved the eyebrow area, eyebrow shape changed after surgery, and it gradually returned to normal after 1 month. Some patients with part of the eyebrow defect were able to improve their appearance through eyebrow tattoos, eyebrow transplatation and other methods. The eyelid function of 71 patients was excellent. The evaluation of cosmetic effect, 41 cases (58%) were excellent, and 30 cases (42%) were good. The evaluation of patient satisfaction, 56 cases (79%) were very satisfied, and 15 cases (21%) were satisfied. Statistical analysis showed that with the increase of the horizontal length of the wound, the cosmetic effect and patient satisfaction would be affected to a certain extent, but the differences were not statistically significant ( P>0.05). Conclusion:For eyelid nevus excision defects that can be closed horizontally, direct suturing method should be considered priority. This method is simple to perform, offers stable postoperative effects, and leads to high patient satisfaction.

The incidence of epicanthal folds is high in the Asian population, and aesthetic correction surgery is currently the most effective method for improving appearance. Common techniques include flap transposition, flap advancement, and skin reposition, with the Z-plasty-based approach as the most widely adopted method. This article begins by classifying and grading epicanthal folds and provides a systematic review of the development and evolution of Z-plasty-based techniques. It highlights advancements in surgical design, flap design, and tension-release strategies that have emerged from an improved understanding of the anatomical features and formation mechanisms of epicanthal folds. The aim is to provide a theoretical foundation and practical reference for the ongoing optimization and future advancement of surgical techniques in this field.

Objective To analyze the characteristics of weekend surgery,and explore to shorten the preoperative hospital stay and average hospital stay of patients.Method Extract actual data on the number of discharged surgical patients and length of hospital stay,and use the Questionnaire Star to investigate the recognition of weekend surgeries by medical staff.Using chi square test and independent sample rank sum test,compare the differences in patients and surgical characteristics between weekend surgery and non weekend surgery,and analyze the influencing factors of surgical physicians using binary logistic regression model.Result The median length of hospital stay(3.0 days)and preoperative hospital stay(0.5 days)was lower than that of non weekend surgery patients(5.0,1.5 days);The proportion of fourth grade surgeries on weekends(28.9％)was lower than that of non weekend surgeries(37.0％);The consultation rate(10.74％)was lower than that of non weekend surgeries(17.0％);The proportion of daytime pilot surgeries(30.7％)was higher than that of non weekend surgeries(20.4％).The factors with the highest recognition among medical staff for conducting weekend surgeries were:improving patient satisfaction(84.7％)and reducing preoperative waiting risks(84.4％).The lowest factors were family support(45.5％)and multi departmental assistance and cooperation(58.8％).Conclusion Weekend surgery effectively shortens the average preoperative and average hospitalization days.Move the hospitalization consultation required for comorbidities management and preoperative examinations to the outpatient department.Mobilize the coordination and supporting resources of various departments within the hospital,and organically integrate various surgical methods such as weekend surgery and day surgery to improve the efficiency of medical operation.

Hepatitis E is an acute and self-limiting viral hepatitis caused by the hepatitis E virus (HEV). It has a higher mortality rate among immunosuppressed patients and pregnant women infected with HEV. Although HEV infections in humans are mostly caused by contaminated water or food worldwide, the incidence of transfusion-transmitted hepatitis E is continuously rising. Additionally, the prevalence of serum anti-HEV IgG in the blood donors in China is at a relatively high level, making it worth considering screening blood donors for HEV. This article briefly reviews the globally reported cases of transfusion-transmitted hepatitis E and the HEV screening strategies for blood donations.

ObjectiveTo evaluate the overall dietary intake of adult residents in Sijing Town, Songjiang District, Shanghai, and to explore the association between dietary health literacy and diet quality. MethodsA total of 1 280 adult residents were selected as the research subjects using a multi-stage sampling method, and face-to-face questionnaire surveys were administered on site. Dietary intake data were collected using a Food Frequency Questionnaire (FFQ), and the overall diet quality of the participants was evaluated based on the Chinese Healthy Eating Index (CHEI). Participants were divided into low- and high-CHEI groups according to the median CHEI score. Logistic regression models were used to examine the association between dietary health literacy and diet quality. ResultsThe median CHEI score for adults in the area was 63.68 points. Multivariate logistic regression analysis revealed that adults with lower dietary health literacy had lower CHEI scores and poorer overall diet quality compared to those with higher dietary health literacy (OR=1.435, 95%CI:1.132‒1.819). ConclusionThe overall diet quality of adult residents in this region requires improvement. There is a significant positive correlation between the level of dietary health literacy and CHEI scores, suggesting that enhancing dietary health literacy may be an important strategy to improve resident’ dietary quality.

Chemiluminescence immunoassay (CLIA), a non-radioactive immunoassay technology that has developed rapidly over the past three decades, has increasingly demonstrated its application value in blood screening due to its advantages such as high sensitivity, high specificity, rapid detection, and high degree of automation. This article systematically reviews the application status, technical characteristics, differences from traditional methods, influencing factors for promotion and application of CLIA in blood screening at home and abroad, and looks forward to its development prospects. Countries such as the United States, Germany, and Japan have widely adopted CLIA in the screening of pathogens like HBV, HCV, and HIV, predominantly using "1 CLIA test + 1 nucleic acid testing (NAT) test" model. Some regions have also expanded testing items to include anti-HBc and HTLV. In China, enzyme-linked immunosorbent assay (ELISA) combined with NAT remains the primary method. CLIA is still in the stage of detection performance comparison. However, domestic reagents have gradually been approved, and more enterprises are accelerating their layout in this field. CLIA is superior to ELISA in terms of sensitivity, detection range, and automation adaptability, which can reduce missed detection and shorten the window period. But it is limited by factors such as high cost, closed system characteristics, and domestic batch release supervision. In the future, CLIA is expected to complement existing technologies, expand the detection of emerging and re-emerging pathogens, and combine with fully automated assembly lines to improve screening quality, providing more comprehensive protection for clinical blood transfusion safety.

[Objective] To conduct a retrospective statistical comparison of alanine aminotransferase (ALT) test values in blood donors prior to blood collection, aiming to analyze the objective characteristics of the population with elevated ALT levels (ALT>50 U/L) and provide reference data for adjusting the screening eligibility threshold for ALT. [Methods] The preliminary ALT screening data of 30 341 blood donor samples collected prior to blood donation from three smart blood donation sites at the Shenzhen Blood Center between 2022 and 2023 were extracted and compared with data from a health examination department of a tertiary hospital in Shenzhen (representing the general population, n=24 906). Both datasets were categorized and statistically described. A retrospective analysis was conducted to examine the associations between ALT test results and factors such as donors' gender, age, ethnicity, donation site, donation season, and frequency of blood donation. [Results] The ALT levels in both blood donors and the general population were non-normally distributed. The 95th percentile of ALT values was calculated as 61.4 U/L (male: 67.8 U/L, female: 39.3 U/L) for blood donors and 58.1 U/L (male: 63.7 U/L, female: 51.2 U/L) for the general population. The non-compliance rates (ALT>50 U/L) were 7.65% (2 321/30 341) in blood donors and 7.08% (1 763/24 906) in the general population. There were significant differences (P<0.05) in the ALT failure rate among blood donors based on gender, age, and donation site, but no significant differences (P>0.05) during the blood donation season. There was no statistically significant difference (P>0.05) in the positive rates of four serological markers (HBsAg, anti HCV, HIV Ag/Ab, anti TP) for blood screening pathogens between ALT unqualified and qualified individuals (2.05% vs 1.5%). If the ALT qualification threshold was raised from 50 U/L to 90 U/L, the non qualification rates of male and female blood donors would decrease from 9.82% (2 074/21 125) to 2.23% (471/21 125) and from 2.70% (249/9 216) to 0.75% (69/9 216), respectively. Among the 154 blood donors who donated blood more than 3 times, 88.31% of the 248 ALT test results were in the range of 50-90 U/L. Among them, 9 cases had ALT>130 U/L, and ALT was converted to qualified in subsequent blood donations. [Conclusion] There are differences in the ALT failure rate among blood donors of different genders and ages, and different blood donation sites and operators can also affect the ALT detection values of blood donors. The vast majority of blood donors with ALT failure are caused by transient and non pathological factors. With the widespread use of blood virus nucleic acid testing, appropriately increasing the ALT qualification threshold for blood donors can expand the qualified population and alleviate the shortage of blood sources, and the risk of blood safety will not increase.