[Objective] To use Platelet Additive Solution Ⅲ M to suspend concentrated platelets and evaluate their quality at different storage periods, in order to investigate the optimal ratio of Ⅲ M to plasma in the medium for storing concentrated platelets. [Methods] Disposable plastic blood bags with platelet storage bags were used to collect whole blood from healthy voluntary blood donors, and concentrated platelets were collected by plasma-rich method, with a volume of about 50 mL and ≥4.0×10¹⁰ platelets contained in each bag. According to the Platelet Addictive Solution ⅢM/plasma volume ratio in the medium of suspended platelets, the platelets were divided into 3 groups: control group (plasma only), experimental group 1(Platelet Addictive Solution ⅢM/plasma volume ratio of 6.5∶3.5) and experimental group 2 (low plasma group, Platelet Addictive Solution ⅢM/plasma volume ratio of 9∶1), each group of 50 samples. Three groups of platelets were stored at (22±2) ℃ at a flat-bed shaker, and 5 mL were sampled by sterile connection at day 1, 3, 5 and 7 respectively to detect platelet count, pH value, lactate dehydrogenase, CD62P positive rate and Annexin V positive rate. All the data were analyzed with SPSS24.0 software. One-way ANOVA was employed to compare the differences among three groups. In order to pairwise comparisons between means of multiple samples, Bonferroni method was applied. [Results] With the extension of storage time, the platelet count decreased and the Annexin V positive rate increased in the 3 groups, and the difference of the 3 groups was not statistically significant (P>0.05). The pH value decreased in the 3 groups, with values at day 1, 3, 5 and 7 of 7.44±0.13 vs 7.44±0.14 vs 7.41±0.11, 7.31±0.68 vs 7.43±0.23 vs 7.22±0.12, 7.30±0.15 vs 7.42±0.14 vs 7.17±0.12, 7.29±0.33 vs 7.26±0.18 vs 7.04 ± 0.12, respectively. The pH decline in the control group and experiment group 1 was minor, with no statistically significant difference, but experiment group 2 showed relatively larger decreases in day 5 and day 7, with statistically significant difference (P<0.05). LDH concentrate was elevated in 3 groups (mmol/L), with values at day 1,3,5 and 7 of 169.62±99.33 vs 105.80±150.71 vs 77.14±105.38, 225.10±112.86 vs 116.00±72.77 vs 94.42±88.74, 249.42±79.55 vs 119.00±53.51 vs 118.35±80.39, 253.34±86.95 vs 147.71±90.71 vs 124.68±128.68 respectively. Compared with the control group, the difference was statistically significant (P<0.05). Experimental group1 had the smallest increase; CD62P positive rate increased in 3 groups (%), with values at day 1, 3, 5 and 7 of 26.22±11.74 vs 23.48±12.48 vs 40.49±11.86, 41.29±8.36 vs 33.53±25.64 vs 50.42±22.36, 59.59±10.13 vs 36.39±23.10 vs 50.94±20.50, 72.92±15.44 vs 55.54±23.65 vs 61.89±18.82 respectively. Compared with the control group, the increase in experiment group1 was smaller, and the difference was statistically significant (P<0.05). [Conclusion] Platelet Addictive Solution ⅢM/plasma volume ratio of 6.5∶3.5 is superior to traditional plasma in maintaining platelet quality during the in vitro preservation period of platelets.

Objective:To understand the expectations of Hong Kong residents to seek for medical treatment in Shenzhen and the influencing factors,so as to provide a reference for promoting the medical cooperation between Shenzhen and Hong Kong and the integration of medical services in Guangdong-Hong Kong-Macao Greater Bay Area.Methods:Based on the Anderson model,a questionnaire survey on medical expectations was conducted among 1 592 Hong Kong residents who sought medical treatment at the University of Hong Kong-Shenzhen Hospital.Binary logistic regression was used to analyze the influencing factors of medical ex-pectations in different dimensions.Results:The overall expectation score of Hong Kong residents for medical treatment in Shenzhen was 3.01,and the most important concern was the professionalism and accessibility of medical services.The results of binary logis-tic regression analysis showed that gender,education level,birth and growth area,long-term living area,frequency of visiting Shenzhen,opinions of relatives and friends and monthly income were the influencing factors of medical treatment expectation of Hong Kong residents(P＜0.05).Conclusion:It is suggested that Hong Kong residents'sense of identity and trust in Shenzhen's healthcare should be enhanced,and that Shenzhen and Hong Kong should make innovations in the convergence of medical security systems,the supply of Hong Kong's medicines and devices in Shenzhen,so as to promote the integrated development of medical and health services in Shenzhen and Hong Kong,and jointly build a"health community"in the GBA.

Objective::To analyze fetal renal abnormality genetic features and the prenatal characteristics of the 17q12 microdeletion syndrome.Methods::This prospective cohort study examined prenatal ultrasound findings of renal abnormalities in pregnant women who underwent single nucleotide polymorphism (SNP) array or copy number variation sequencing (CNV-seq) testing on amniotic fluid or fetal tissue at Tianjin Central Obstetrics and Gynecology Hospital between January 2016 and August 2022. The study cohort comprised women with advanced maternal age, fetal ultrasound anomalies, high-risk non-invasive prenatal testing results, or suspected 17q12 microdeletion syndrome. Comprehensive clinical data, including maternal age, detailed ultrasound findings, and pregnancy outcomes, were systematically collected. SNP-array analysis was conducted using an Affymetrix CytoScan 750 K Array Chip to identify CNVs and loss of heterozygosity, while CNV-seq was performed on the Illumina HiSeq 2000 platform. Detected variants were classified according to the American College of Medical Genetics and Genomics guidelines. Statistical analyses were performed using SPSS version 27.0.Results::Abnormal renal development was identified in 141 patients, among whom 26 exhibited hyperechogenic kidneys (HCK). Of these, 12 cases were associated with 17q12 microdeletion syndrome, while the remaining 14 were linked to other chromosomal abnormalities. When excluding patients with HCK, those diagnosed with polycystic kidney disease demonstrated a higher prevalence of chromosomal abnormalities compared to those with multicystic dysplastic kidney and renal dysplasia. Although isolated conditions such as horseshoe kidney, hydronephrosis, ectopic kidney, and unilateral kidney typically presented with normal chromosomal findings, the incidence of chromosomal abnormalities increased when these conditions coexisted with other anomalies. A detailed analysis of the correlation between 17q12 microdeletion syndrome and HCK revealed that 12 out of the 14 patients diagnosed with 17q12 microdeletion syndrome exhibited HCK. Genetic testing confirmed the syndrome in seven patients, with five cases attributed to novel mutations and two cases resulting from inherited mutations.Conclusion::Fetal HCK was closely associated with the 17q12 microdeletion syndrome, and polycystic kidney disease showed a higher rate of chromosomal abnormalities. Chromosome test results were mostly normal in patients with other renal abnormalities, such as kidney dysplasia, horseshoe kidneys, hydronephrosis, kidney deficiency, and ectopic kidneys. Prenatal diagnosis is recommended, especially in cases of non-isolated fetal renal abnormalities. This study provides strong evidence supporting a link between fetal renal abnormalities and genetic syndromes.

Objective:To understand the expectations of Hong Kong residents to seek for medical treatment in Shenzhen and the influencing factors,so as to provide a reference for promoting the medical cooperation between Shenzhen and Hong Kong and the integration of medical services in Guangdong-Hong Kong-Macao Greater Bay Area.Methods:Based on the Anderson model,a questionnaire survey on medical expectations was conducted among 1 592 Hong Kong residents who sought medical treatment at the University of Hong Kong-Shenzhen Hospital.Binary logistic regression was used to analyze the influencing factors of medical ex-pectations in different dimensions.Results:The overall expectation score of Hong Kong residents for medical treatment in Shenzhen was 3.01,and the most important concern was the professionalism and accessibility of medical services.The results of binary logis-tic regression analysis showed that gender,education level,birth and growth area,long-term living area,frequency of visiting Shenzhen,opinions of relatives and friends and monthly income were the influencing factors of medical treatment expectation of Hong Kong residents(P＜0.05).Conclusion:It is suggested that Hong Kong residents'sense of identity and trust in Shenzhen's healthcare should be enhanced,and that Shenzhen and Hong Kong should make innovations in the convergence of medical security systems,the supply of Hong Kong's medicines and devices in Shenzhen,so as to promote the integrated development of medical and health services in Shenzhen and Hong Kong,and jointly build a"health community"in the GBA.

Objective::To analyze fetal renal abnormality genetic features and the prenatal characteristics of the 17q12 microdeletion syndrome.Methods::This prospective cohort study examined prenatal ultrasound findings of renal abnormalities in pregnant women who underwent single nucleotide polymorphism (SNP) array or copy number variation sequencing (CNV-seq) testing on amniotic fluid or fetal tissue at Tianjin Central Obstetrics and Gynecology Hospital between January 2016 and August 2022. The study cohort comprised women with advanced maternal age, fetal ultrasound anomalies, high-risk non-invasive prenatal testing results, or suspected 17q12 microdeletion syndrome. Comprehensive clinical data, including maternal age, detailed ultrasound findings, and pregnancy outcomes, were systematically collected. SNP-array analysis was conducted using an Affymetrix CytoScan 750 K Array Chip to identify CNVs and loss of heterozygosity, while CNV-seq was performed on the Illumina HiSeq 2000 platform. Detected variants were classified according to the American College of Medical Genetics and Genomics guidelines. Statistical analyses were performed using SPSS version 27.0.Results::Abnormal renal development was identified in 141 patients, among whom 26 exhibited hyperechogenic kidneys (HCK). Of these, 12 cases were associated with 17q12 microdeletion syndrome, while the remaining 14 were linked to other chromosomal abnormalities. When excluding patients with HCK, those diagnosed with polycystic kidney disease demonstrated a higher prevalence of chromosomal abnormalities compared to those with multicystic dysplastic kidney and renal dysplasia. Although isolated conditions such as horseshoe kidney, hydronephrosis, ectopic kidney, and unilateral kidney typically presented with normal chromosomal findings, the incidence of chromosomal abnormalities increased when these conditions coexisted with other anomalies. A detailed analysis of the correlation between 17q12 microdeletion syndrome and HCK revealed that 12 out of the 14 patients diagnosed with 17q12 microdeletion syndrome exhibited HCK. Genetic testing confirmed the syndrome in seven patients, with five cases attributed to novel mutations and two cases resulting from inherited mutations.Conclusion::Fetal HCK was closely associated with the 17q12 microdeletion syndrome, and polycystic kidney disease showed a higher rate of chromosomal abnormalities. Chromosome test results were mostly normal in patients with other renal abnormalities, such as kidney dysplasia, horseshoe kidneys, hydronephrosis, kidney deficiency, and ectopic kidneys. Prenatal diagnosis is recommended, especially in cases of non-isolated fetal renal abnormalities. This study provides strong evidence supporting a link between fetal renal abnormalities and genetic syndromes.

Objective To investigate the relationships of urinary liver-type fatty acid-binding protein (L-FABP) and serum galectin-3 (Gal-3) with early renal dysfunction in gout patients. Methods A total of 124 gout patients in the hospital from January 2022 to December 2023 were selected as gout group, and they were divided into non-renal injury group with 42 cases and early renal injury group with 82 cases according to the urinary albumin-to-creatinine ratio (UACR). Additionally, 40 healthy volunteers with physical examinations in the hospital in the same period were selected as control group. The levels of urea nitrogen, creatinine, cystatin C, urinary L-FABP, and serum Gal-3 were measured in all participants. Receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of urinary L-FABP and serum Gal-3 for early renal dysfunction in gout patients. Results The levels of cystatin C, urinary L-FABP, and serum Gal-3 in the gout group were significantly higher than those in the control group (P < 0.05). The levels of cystatin C, urinary L-FABP, and serum Gal-3 in the early renal injury group were significantly higher than those in the non-renal injury group (P < 0.05). Pearson analysis showed that urinary L-FABP level in gout patients was significantly positively correlated with UACR, cystatin C, and serum Gal-3 (P < 0.05), and serum Gal-3 level in gout patients was significantly positively correlated with UACR, cystatin C, and urinary L-FABP (P < 0.05). ROC curve analysis indicated that urinary L-FABP and serum Gal-3 had high diagnostic values for assessing early renal dysfunction in gout patients, with areas under the curve (AUCs) of 0.804 (95%CI, 0.726 to 0.882) and 0.781 (95%CI, 0.697 to 0.866) respectively. The AUC for the combination of urinary L-FABP and serum Gal-3 was 0.923 (95%CI, 0.874 to 0.972). Conclusion The levels of urinary L-FABP and serum Gal-3 are abnormally elevated in gout patients, and their expression levels are closely related to early renal dysfunction. The combination of urinary L-FABP and serum Gal-3 has a high diagnostic value for early renal dysfunction in gout patients.

Objective:To explore the efficacy and safety of whole-brain low-dose radiotherapy(LDRT)combined with PD-1 inhibitor sin-tilimab and intrathecal pemetrexed(IP)for the treatment of refractory non-small cell lung cancer(NSCLC)with leptomeningeal metastases(LM).Methods:Retrospective analysies were was performed on eight NSCLC patients with LM at the West China Hospital of Sichuan Uni-versity from December 2022 to May 2024.Among the eight patients,there were four were males and four were females,with a median age of 49 years(rangeing,between 34 to 58 years).All patients were treated with whole-brain LDRT combined with immune checkpoint inhibit-or(ICI)and intrathecal chemotherapy regimens,and the therapeutic efficacy was evaluated according to the Response Assessment in Neuro-Oncology(RANO)criteria and the Karnofsky physical status(KPS)score.Adverse reactions were assessed according to the Common Criteria for the Evaluation of Adverse Events(CTCAE version 5.0).Survival analysis was performed using the Kaplan-Meier method.The classification proportion of cerebrospinal fluid subsets before and after treatment was analyzed using by single-cell sequencing,and the differential ana-lysis of gene expression in parallel cells was performed.Results:The best clinical treatment effects in eight patients were were evaluated us-ing the RANO criteria:five patients(62.5%)were evaluated as improved and three(37.5%)as stable.The median KPS score of the eight pa-tients was 30(20-50)before treatment,which was significantly improved to 60(40-90)after treatment(P=0.000 9).The remission rate of neurological symptoms was 100%(8/8)in eight patients.The median neurological progression-free survival(NPFS)was 12 months.The res-ults of single-cell sequencing in CSF of patientss(P1)showed that the proportion of T cells in the patient samples after whole-brain LDRT treatment was significantly higher than that before treatment(6.08%vs.68.87%),and the proportion of tumor cells was significantly lower(12.92%vs.0.6%).The differential analysis of gene expression showed that CCL5 and CXCL13 were significantly upregulated in T cells of CSF after WB-LDRT treatment.Conclusions:The combination of whole-brain LDRT with ICI and IP in the treatment of NSCLC with LM can signific-antly alleviate neurological symptoms,improve quality of life and prolong the NPFS of patients,which is a safe and effective treatment.

OBJECTIVE To investigate the improvement effect and mechanism of different extracts from Tylophora yunnanensis on non-alcoholic steatohepatitis （NASH）. METHODS Normal human liver LO2 cells were induced to steatosis by free fatty acid， then were divided into normal group， model group， silybin group （100 μmol/mL）， T. yunnanensis ethanol extracts （TYS） group （50 μg/mL）， T. yunnanensis ethyl acetate extracts （TYSA） group （50 μg/mL）， and T. yunnanensis n-butanol extracts （TYSB） group （50 μg/mL）. After 24 hours of drug intervention， the deposition of lipid droplets was observed in LO2 cells in each group. The contents of total cholesterol （TC）， triacylglycerol （TG）， malondialdehyde （MDA） and glutathione （GSH）， the activities of aspartate transaminase （AST）， alanine transaminase （ALT） and superoxide dismutase （SOD）， the mRNA expressions of Kelch-like ECH-associated protein 1（ Keap1）， nuclear factor E2-related factor 2（ Nrf2） and heme oxygenase 1（ HO- 1） were detected. NASH rat model was induced by a high-fat diet， and then divided into normal group， model group， silybin group （12.6 mg/kg）， TYS group （80 mg/kg）， TYSA group （80 mg/kg） and TYSB group （80 mg/kg）， with six rats in each group. The liver indexes of rats in each group were calculated after 6 weeks of drug intervention. The liver histopathological changes were observed， and the contents of TC， TG， HDL-C and LDL-C， AST and ALT activities in serum， the contents of MDA and GSH， SOD activities in liver tissue were detected. RESULTS Compared with model group， TYS， TYSA and TYSB could reduce lipid droplet deposition， intracellular TC， TG and MDA contents， AST and ALT activities， and increase SOD activity， GSH content， and Keap1， Nrf2， HO-1 mRNA expression levels in LO2 cells after steatosis to varying degrees， with some differences being statistically significant （P＜0.05）. They also significantly improved liver injury in NASH model rats， reduced their liver indexes， TC， TG， LDL-C and MDA contents， AST and ALT 1-042） activities， and increased HDL-C （except for TYS and TYSB）， GSH contents and SOD activity， with TYSA having the most significant effect （P＜0.05）. CONCLUSIONS TYS， TYSA and TYSB have a certain improvement effect on NASH， among which TYSA has the most obvious effect. Its mechanism of action may be related to upregulating the Keap1/Nrf2/HO-1 signaling pathway and inhibiting oxidative stress

【Objective】 To investigate whether the blood donors' coagulation status may lead to apheresis platelet aggregation in vitro. 【Methods】 Thirty blood donors with aggregation in apheresis platelets collected by AMICUS blood cell separator no less than 3 times previously and occurred when the last time of apheresis donation were observed in aggregated group (referred to as the experimental group); Thirty donors without aggregation in apheresis platelets collected by AMICUS blood cell separator no less than 3 times were observed in the control group simultaneously. The basic platelet parameters in the two groups, including Plt, MPV, PDW, Pet, P-LCR were detected by automatic blood cell analyzer (BC-3000Plus), and thromboelastogram indexes including reaction time(R), kinetics time(K), kinetics of clot development(α), maximum amplitude (MA) and coagulation index(CI) were tested by Thrombosis elastography (TEG) before collection. With SPSS24.0 software, t test was used to compare the differences between the two groups. 【Results】 The CI value in experimental group was significantly different from that of the control group (0.48± 1.00 vs -0.99 ±1.96, P< 0.05), and there was no significant difference in all above basic platelet parameters and other TEG parameters (P>0.05 ) . 【Conclusion】 The coagulation status of blood donors may be an independent risk factor for the in vitro aggregation of apheresis platelets.

Objective:To explore the obstacle factors and promoting factors of exercise guidance and implementation after breast cancer surgery, so as to provide reference and basis for the formulation of exercise program after breast cancer patients.Methods:Using the objective sampling method, a total of 10 medical staff and 10 patients with breast cancer after operation from the breast surgery department of the Seven People's Hospital Affiliated to Shanghai University of Traditional Chinese Medicine hospital in Shanghai were selected as research objects from July to September 2022. A semi-structured interview was conducted. The interview outline was developed based on the knowledge transformation framework, and the results were analyzed by the content analysis method.Results:The study extracted three levels of influencing factors. The system level included caregiver workload, educational materials, norms and responsibilities and trust in evidence-based evidence. The practitioner level included the level of exercise knowledge, the concern about patient compliance and the emphasis on exercise. The patient level included sports knowledge level, personality and interest, venous line, adverse reaction of treatment, psychological state, weather environment, attention to health and concern of family members.Conclusions:The medical staff need to consider the postoperative exercise guidance for breast cancer patients from the department, themselves and patients, and should fully consider the patients' conditions and subjective experience to improve the patients' exercise compliance.