Objective: To investigate the identification process of a case with anti-Fy combined with Rh blood group system antibodies and to review the transfusion strategy and epidemiological characteristics of Duffy blood group system antibodies. Methods: The antibody specificity of a patient diagnosed with liver cirrhosis, who exhibited unexpected antibodies, was determined using the microcolumn gel method, enzyme method, and elution test. A retrospective analysis was performed to assess the incidence and clinical characteristics of antibodies associated with the Duffy blood group system among a cohort of 652 003 patients treated at our hospital from 2014 to 2024. Results: The patient's serum contained anti-Fy , anti-c, and anti-E antibodies. Through the targeted recruitment of African international students, the patient successfully received four units of Fy -negative blood that matched the ABO and Rh phenotypes. Between 2014 and 2024, the incidence of Duffy blood group system antibodies was 0.005 7% (37 out of 652 003), with 9 cases (24.3%) combined with Rh antibodies. Conclusion: Patients with anti-Fy combined with Rh antibodies require Fy -negative blood with matched Rh phenotypes. Targeted recruitment based on racial antigen differences can effectively resolve rare blood type transfusion challenges.

Objective To explore the clinical efficacy of single-branch intraoperative stent combined with modified bilateral cerebral perfusion in type A aortic dissection. Methods A retrospective analysis was conducted on the clinical data of patients who underwent surgery for type A aortic dissection at the First Affiliated Hospital of Anhui Medical University from January 2021 to May 2024. Patients were divided into a test group (single branch stent+modified bilateral cerebral perfusion) and a control group (traditional surgical method, straight stent+unilateral cerebral perfusion) according to the surgical method. Propensity score matching analysis was used to match the two groups of patients with a ratio of 1:1, and the perioperative data and clinical efficacy after matching were compared. Results A total of 14 patients were included in the test group, including 13 males and 1 female, with an average age of (46.6±16.4) years. There were 56 patients in the control group, including 38 males and 18 females, with an average age of (52.1±11.7) years. After propensity score matching, 14 patients were included in each group. Compared with the control group, the ventilator support time [(27.4±24.3) h vs. (93.4±88.0) h, P=0.018], length of stay in the intensive care unit [(2.8±1.8) d vs. (8.7±6.5) d, P=0.009], and postoperative awakening time [(5.4±2.2) h vs. (8.8±4.8) h, P=0.047] in the test group were shorter than those in the control group, with statistically significant differences. There was no statistical difference in neurological complications between the two groups (P=1.000). Conclusion Single-branch intraoperative stent combined with modified bilateral cerebral perfusion can effectively shorten ventilator support time, length of stay in the intensive care unit, and postoperative awakening time, and is safe and effective for the treatment of type A aortic dissection, which is worth further promotion.

Diabetic nephropathy(DN)is a significant causative factor of end-stage renal disease globally,and its pathogenesis involves dysregulation of multiple cellular and hormonal pathways.Podocytes play crucial roles in the process of DN,with the extent of podocyte injury closely associated with key pathological manifestations of renal damage,such as proteinuria,glomerular filtration rate,and glomerulosclerosis.However,due to the complexity and interplay of mechanisms contributing to podocyte injury,such as oxidative stress,abnormal lipid metabolism,and mitochondrial damage,the precise mechanisms underlying podocyte injury remain incompletely understood.This review integrated the latest research findings from both domestic and international studies on the core mechanisms of podocyte injury in DN.Furthermore,this article summarized the implications of these mechanisms for DN treatment,particularly focusing on potential therapeutic targets and the development of related pharmacological interventions derived from targeting podocyte injury pathways,so as to provide a theoretical foundation for the development of clinical therapeutic strategies for DN.

Traditional development of small protein scaffolds has relied on display technologies and mutation-based engineering, which limit sequence and functional diversity, thereby constraining their therapeutic and application potential. Protein design tools have significantly advanced the creation of novel protein sequences, structures, and functions. However, further improvements in design strategies are still needed to more efficiently optimize the functional performance of protein-based drugs and enhance their druggability. Here, we extended an evolution-based design protocol to create a novel minibinder, BindHer, against the human epidermal growth factor receptor 2 (HER2). It not only exhibits super stability and binding selectivity but also demonstrates remarkable properties in tissue specificity. Radiolabeling experiments with ^99mTc, ⁶⁸Ga, and ¹⁸F revealed that BindHer efficiently targets tumors in HER2-positive breast cancer mouse models, with minimal nonspecific liver absorption, outperforming scaffolds designed through traditional engineering. These findings highlight a new rational approach to automated protein design, offering significant potential for large-scale applications in therapeutic mini-protein development.

OBJECTIVES: To explore the risk factors for malnutrition in patients with ulcerative colitis complicated with pyoderma gangrenosum and establish a nutritional risk prediction model for these patients. METHODS: A total of 277 patients with ulcerative colitis complicated with pyoderma gangrenosum treated from 2019 to 2024 were divided into malnutrition group (n=185) and normal nutrition group (n=92) according to whether malnutrition occurred. The data of 25 potential related factors pertaining to general demography, living and eating habits, and disease-related data were compared between the two groups. Lasso regression was used to screen the risk factors, and a nomogram model was established based on the screened factors and its prediction performance was assessed. RESULTS: The patients in the malnutrition group and normal nutrition group showed significant differences in 21 factors including gender, age, education level, BMI, place of residence, course of disease, and SAS language score (P<0.05). Lasso regression analysis identified 6 factors associated with malnutrition in these patients, namely the duration of ulcerative colitis, activity of ulcerative colitis, duration of pyoderma gangrenosum, number of chronic diseases, SAS score, and sleep quality. The nomogram prediction model established based on these 6 factors had an AUC of 0.992 (95% CI: 0.984-1.000) for predicting malnutrition in these patients, and its application in 14 clinical cases achieved an accuracy rate of 100%. CONCLUSIONS The duration of ulcerative colitis, activity of colitis, duration of pyoderma gangrenosum, number of chronic diseases, anxiety, and sleep quality are closely related with malnutrition in patients with ulcerative colitis complicated by pyoderma gangrenosum, and the nomogram prediction model based on these factors can provide assistance for predicting malnutrition in these patients.
Humans ; Colitis, Ulcerative/complications* ; Malnutrition/etiology* ; Risk Factors ; Pyoderma Gangrenosum/complications* ; Female ; Male ; Adult ; Nomograms ; Middle Aged ; Nutritional Status ; Regression Analysis

Objective:To investigate the effects of body habitus and gender on radiation dose assessment methodologies in low-dose chest CT, with particular emphasis on clarifying discrepancies among various dose quantification approaches and their associations with patient characteristics.Methods:Imaging data from 19 371 patients who underwent low-dose chest CT at the First Affiliated Hospital of Chongqing Medical University between January 2021 and January 2024 were retrospectively analyzed. Patients were categorized into eight groups based on water-equivalent diameter (WED) and gender: Group A (150 mm≤WED<210 mm; 71 males, 1 032 females), Group B (210 mm≤WED<260 mm; 4 525 males, 8 005 females), Group C (260 mm≤WED<300 mm; 4 234 males, 1 105 females), and Group D (WED≥300 mm; 357 males, 42 females). WED, size-specific dose estimate (SSDE), and organ dose-based effective dose(ED Radimetrics)were calculated using Radimetrics software. Scanner-reported dose metrics, including volume CT dose index (CTDIvol), dose-length product (DLP), and DLP-derived effective dose(ED DLP), were recorded. The ratios of SSDE/CTDIvol and ED Radimetrics/ED DLP were used to quantify discrepancies between dose evaluation methods. The Kruskal-Wallis test was employed to analyze dose metric differences across WED groups within the same gender, while the Wilcoxon rank-sum test compared gender-based differences within each WED group. Results:All dose metrics significantly increased with WED for both genders (all P<0.05). Within the same WED group, ED Radimetrics was significantly higher in females ( P<0.05), whereas ED DLP was higher in males ( P<0.05). The SSDE/CTDIvol ratio decreased with increasing WED, declining from 1.74 in Group A to 1.16 in Group D for females and from 1.68 to 1.12 for males. The ED Radimetrics/ED DLP ratio exhibited a decreasing trend with WED in females (1.82 to 1.30) but showed an initial increase in males (1.29 in Group A to 1.31 in Group B) before decreasing to 0.94 in Group D (all intergroup P<0.05). SSDE/CTDIvol and ED Radimetrics/ED DLP ratios of females were consistently higher than that of males within each WED group (all P<0.05). Conclusions:Patient body habitus and gender significantly influence radiation dose distribution in low-dose chest CT. Larger body habitus is associated with higher radiation doses, while females receive greater ED Radimetrics than males within comparable body habitus. Traditional dose metrics (CTDIvol and ED DLP) were underestimated for patients with small body sizes and female individuals.

Psoriasis is a chronic, recurrent, systemic, inflammatory disease. Over the past 20 years, with the development and application of biologics targeting tumor necrosis factor (TNF) or TNF receptors, interleukin-17A (IL-17A) or IL-17A receptors, IL-23, and others, significant progress has been made in the treatment of psoriasis. However, recurrence remains a major challenge in the management of psoriasis after discontinuation of biologic therapy or during maintenance treatment. This review summarizes the recurrence of psoriasis following biologic treatment and proposes comprehensive management recommendations to prevent its recurrence.

Objective:To optimize the scan parameters for ultra-low dose computed tomography (ULDCT) of the chest using spectral purification technology, and assess the feasibility of maintaining image quality while reducing radiation dosage.Methods:An anthropomorphic chest phantom embedded with simulated pulmonary nodules was utilized for low-dose computed tomography(LDCT) and ULDCT scans. LDCT was conducted using a reference tube current of 25 mAs and a pitch of 1.0. ULDCT incorporating spectral purification technology was conducted using four reference tube currents, i. e., 50, 100, 150, and 200 mAs (labeled ULDCT1-4), and a pitch of 1.5. Other parameters were consistent. The volume CT dose index and the dose-length product were extracted from the dose reports, and then the effective doses were calculated. The objective image quality was assessed using metrics including image noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR). The subjective image quality of ULDCT images was assessed on a four-point scale with LDCT images as reference.Results:The ULDCT4 at a reference tube current of 200 mAs showed a lower effective dose compared to LDCT ( t = -17.30, P < 0.001). The objective image quality assessments indicated that noise levels in four ULDCT groups were higher than those in LDCT ( t = 21.96, 10.56, 3.15, 3.14, P < 0.05). Notably, the SNR and CNR for the aortic arch were higher in ULDCT4 compared to LDCT ( t = 3.55, 71.96, P < 0.05). The SNR of pulmonary nodules in ULDCT4 was comparable to that in LDCT ( P > 0.05), but the CNR was higher ( t = 0.79, P < 0.001). Subjective image quality assessments reveal that the image quality of ULDCT4 was higher than that of LDCT, with scores of 3.80±0.46 for noise, 3.70±0.46 for contrast and sharpness, and 3.37±0.66 for pulmonary nodules. Conclusions:ULDCT (200 mAs) using spectral purification technology can yield higher image quality than LDCT while substantially reducing the radiation dose, thus demonstrating substantial clinical potential and the promise of replacing LDCT in early lung cancer screening.