[Objective] To explore the accuracy and feasibility of non-invasive prenatal diagnosis of fetal RhE genotype using cell-free fetal DNA (cff-DNA) from maternal peripheral blood. [Methods] A total of 134 pregnant women with single fetuses and RhE-negative blood group were selected from our hospital from November 2023 to August 2024. Free DNA extraction kit was used to extract free DNA from peripheral blood of pregnant women, and the RhE blood group genotype of free DNA was detected by real-time fluorescent quantitative PCR (RT-qPCR). If the qPCR amplification signal of the sample was negative, the methylated RASSF1A gene was amplified, and the positive amplification result was used as a sign of successful extraction of cff-DNA. Serological microcolumn gel method was used to detect the phenotype of RhE blood group in neonatal peripheral blood. [Results] Among the 134 maternal peripheral blood samples, the cff-DNA detection of RhE blood group phenotypes was consistent with the RhE blood group genotyping of neonatal peripheral blood in 133 cases, including 90 cases of Rhee genotype and 43 cases of RhE genotype, with diagnostic concordance rate of 99.3%, sensitivity of 97.7%, specificity of 100%, youden index of 0.977, area under ROC curve of 0.995, the Kappa value of 0.983, positive predictive value of 100%, and negative predictive value of 98.9%. The sample of 1 case failed to be detected. After the amplification of methylated RASSFIA gene, it was confirmed that the reason for the failure was that no cff-DNA was extracted from the sample. The diagnostic concordance rates of the first, second and third trimesters were 93.8% (15/16), 100% (51/51) and 100% (67/67), respectively. Fisher's exact test method was used to calculate the P value, which was P>0.05, indicating that there was no statistical significance in the difference of diagnostic concordance rate among the three pregnancy periods, and there was no difference in the detection concordance rate of this method in different pregnancy periods. [Conclusion] The use of cff-DNA in maternal peripheral blood for the detection of fetal RhE blood group genotype is an accurate and highly feasible non-invasive prenatal diagnostic method, which is helpful for the clinical diagnosis of fetal and neonatal hemolytic disease caused by anti-E antibody.

Identifying drug-drug interactions (DDIs) is essential to prevent adverse effects from polypharmacy. Although deep learning has advanced DDI identification, the gap between powerful models and their lack of clinical application and evaluation has hindered clinical benefits. Here, we developed a Multi-Dimensional Feature Fusion model named MDFF, which integrates one-dimensional simplified molecular input line entry system sequence features, two-dimensional molecular graph features, and three-dimensional geometric features to enhance drug representations for predicting DDIs. MDFF was trained and validated on two DDI datasets, evaluated across three distinct scenarios, and compared with advanced DDI prediction models using accuracy, precision, recall, area under the curve, and F1 score metrics. MDFF achieved state-of-the-art performance across all metrics. Ablation experiments showed that integrating multi-dimensional drug features yielded the best results. More importantly, we obtained adverse drug reaction reports uploaded by Xiangya Hospital of Central South University from 2021 to 2023 and used MDFF to identify potential adverse DDIs. Among 12 real-world adverse drug reaction reports, the predictions of 9 reports were supported by relevant evidence. Additionally, MDFF demonstrated the ability to explain adverse DDI mechanisms, providing insights into the mechanisms behind one specific report and highlighting its potential to assist practitioners in improving medical practice.

Surgery-based multidisciplinary comprehensive treatment is the preferred treatment strategy for local advanced esophageal cancer. Neoadjuvant chemotherapy and neoadjuvant chemoradiotherapy have been recommended by the Chinese Society of Clinical Oncology (CSCO) guideline. With the advent of immunotherapy, neoadjuvant immunotherapy combined with chemotherapy has received much attention, and the first phase Ⅲ study has also confirmed that neoadjuvant immunotherapy combined chemotherapy is a promising treatment option. This article will review the recent advances and hot spots of neoadjuvant immunotherapy combined with chemotherapy.

Over the past decade, mitochondrial dysfunction has been investigated as a key contributor to acute and chronic kidney disease. However, the precise molecular mechanisms linking mitochondrial damage to kidney disease remain elusive. The recent insights into the cyclic guanosine monophosphate-adenosine monophosphate (GMP-AMP) synthetase (cGAS)-stimulator of interferon gene (STING) signaling pathway have revealed its involvement in many renal diseases. One of these findings is that mitochondrial DNA (mtDNA) induces inflammatory responses via the cGAS-STING pathway. Herein, we provide an overview of the mechanisms underlying mtDNA release following mitochondrial damage, focusing specifically on the association between mtDNA release-activated cGAS-STING signaling and the development of kidney diseases. Furthermore, we summarize the latest findings of cGAS-STING signaling pathway in cell, with a particular emphasis on its downstream signaling related to kidney diseases. This review intends to enhance our understanding of the intricate relationship among the cGAS-STING pathway, kidney diseases, and mitochondrial dysfunction.

Objective     To explore the causes of conversion to thoracotomy in patients with minimally invasive esophagectomy (MIE) in a surgical team, and to obtain a deeper understanding of the timing of conversion in MIE. Methods     The clinical data of patients who underwent MIE between September 9, 2011 and February 12, 2022 by a single surgical team in the Department of Thoracic Surgery of the Fourth Hospital of Hebei Medical University were retrospectively analyzed. The main influencing factors and perioperative mortality of patients who converted to thoracotomy in this group were analyzed. Results     In the cohort of 791 consecutive patients with MIE, there were 520 males and 271 females, including 29 patients of multiple esophageal cancer, 156 patients of upper thoracic cancer, 524 patients of middle thoracic cancer, and 82 patients of lower thoracic cancer. And 46 patients were converted to thoracotomy for different causes. The main causes for thoracotomy were advanced stage tumor (26 patients), anesthesia-related factors (5 patients), extensive thoracic adhesions (6 patients), and accidental injury of important structures (8 patients). There was a statistical difference in the distribution of tumor locations between patients who converted to thoracotomy and the MIE patients (P<0.05). The proportion of multiple and upper thoracic cancer in patients who converted to thoracotomy was higher than that in the MIE patients, while the proportion of lower thoracic cancer was lower than that in the MIE patients. The perioperative mortality of the thoracotomy patients was not significantly different from that of the MIE patients (P=1.000). Conclusion     In MIE, advanced-stage tumor, anesthesia-related factors,extensive thoracic adhesions, and accidental injury of important structures are the main causes of conversion to thoracotomy. The rate varies at different tumor locations. Intraoperative conversion to thoracotomy does not affect the perioperative mortality of MIE.

Objective To explore the application effect of quality control circle in the quality management improvement of the occupational disease diagnostic and code.Methods To established across departmental team of medical record QCC,we Select 132 cases of the occupational disease departmentin specialized Hospital from May 1,2022 to June31,2022,Analyze the reasons of inaccurate that main diagnosisselection and code mapping.After formulating a series of improvement measures,we Se-lect 71 cases of occupational disease department from November 1,2022 to December 31,2022.To compared effect that before and after the implementation of QCC.Results After6 months of improvement,The utilization rate of main diagnosis mapping Z-code was decreased from 36.3%to 12.7%,goal achievement rate of 106.3%,improvement rate of 65.0%.Enrollment rate of major diagnostic was increased from 53.0%to 86.3%,goal achievement rate of 116.4%,Improvement rate of 62.8%.Conclu-sion We have changed the quality control management mode of diagnosis and coding by the QCC,implement targeted feedback,supervision,and training,establish a reward and punishment mechanism that matches indicators to improved accuracy of enroll-ment.Upgrading the quality management level of medical records and medical safety at the same time.Should continue to pro-mote theimplementation.

Infectious stones are produced by urease producing microorganisms, which have a fast generation rate, high recurrence and mortality rates, and are prone to complications related to infection. At present, the treatment of infectious stones includes surgical treatment and drug treatment, and the research on its treatment methods has become one of the hotspots in the field of urology. This article provides a review of the research progress in the treatment of infectious stones, with the aim of improving understanding of the treatment of infectious stones.

Objective:To investigate the clinical efficacy of manual reduction under general anesthesia combined with anterior cervical discectomy and fusion (ACDF) in the treatment of lower cervical locked facet dislocation.Methods:Retrospectively analyzed were the data of 53 patients with traumatic single segment dislocation of lower cervical spine combined with single/bilateral facet articular lock who had been admitted to Department of Orthopaedic Spine Surgery, Xiangya Hospital, Central South University from January 2019 to December 2020. There were 36 males and 17 females, aged from 18 to 64 years (average, 45.5 years). All the patients were treated with ACDF under neuroelectrophysiological monitoring. Clinical efficacy was assessed by observing complications and comparing American Spinal Injury Association (ASIA) grading, Modified Japanese Orthopaedic Association (mJOA) scores, neck disability index (NDI) and visual analogue scale (VAS) before and after surgery.Results:All patients were followed up for 16 to 30 months (mean, 24 months). All incisions healed by primary intention with no infection after operation. There were 2 cases of delirium, 9 cases of abdominal distension, 4 cases of lower extremity venous thrombosis, and one case of central diabetes insipidus. Postoperative imaging data showed that all patients achieved sequential reduction of the cervical spine, intervertebral bony fusion, and no internal fixation loosening. The last follow-up showed that the overall improvement rate of ASIA grading of spinal cord function was 84.9% (45/53) compared with the preoperation and that the VAS score (2.0±0.5), mJOA score (13.1±3.1) and NDI index (16.6±5.9) were significantly improved compared with the preoperative values (7.5±1.5, 6.9±3.5, and 37.8±7.8) ( P< 0.05). Conclusion:On the premise of fully assessing the patient's injury status, manual reduction under general anesthesia combined with ACDF is a safe and effective treatment of single-level lower cervical fracture combined with facet dislocation.

Background::The study aimed to clarify the characteristics of lymph node metastasis (LNM) and to compare the oncologic outcomes of minimally invasive esophagectomy (MIE) with open esophagectomy (OE) in terms of lymph node dissection (LND) in thoracic esophageal cancer patients.Methods::The data from esophageal cancer patients who underwent MIE or OE from January 2016 to January 2019 were retrospectively reviewed. The characteristics of LNM in thoracic esophageal cancer were discussed, and the differences in numbers of LND, LND rate, and LNM rate/degree of upper mediastinum between MIE and OE were compared.Results::For overall characteristics of LNM in 249 included patients, the highest rate of LNM was found in upper mediastinum, while LNM rate in middle and lower mediastinum, and abdomen increased with the tumor site moving down. The patients were divided into MIE ( n = 204) and OE groups ( n = 45). In terms of number of LND, there were significant differences in upper mediastinum between MIE and OE groups (8 [5, 11] vs. 5 [3, 8], P < 0.001). The comparative analysis of regional lymph node showed there was no significant difference except the subgroup of upper mediastinal 2L and 4L group (3 [1, 5] vs. 0 [0, 2], P < 0.001 and 0 [0, 2] vs. 0, P = 0.012, respectively). Meanwhile, there was no significant difference in terms of LND rate except 2L (89.7% [183/204] vs. 71.1% [32/45], P = 0.001) and 4L (41.2% [84/204] vs. 22.2% [10/45], P = 0.018) groups. For LNM rate of T3 stage, there was no significant difference between MIE and OE groups, and the comparative analysis of regional lymph node showed that there was no significant difference except 2L group (11.1% [5/45] vs. 38.1% [8/21], P = 0.025). The LNM degree of OE group was significantly higher than that of MIE group (27.2% [47/173] vs. 7.6% [32/419], P < 0.001), and the comparative analysis of regional LNM degree showed that there was no significant difference except 2L (34.7% [17/49] vs. 7.7% [13/169], P < 0.001) and 4L (23.8% [5/21] vs. 3.9% [2/51], P= 0.031) subgroups. Conclusion::MIE may have an advantage in LND of upper mediastinum 2L and 4L groups, while it was similar to OE in other stations of LND.

Objective:To explore effect and feasibility of family members' encouragement video on improving the psychological state of patients in declining visiting Cardiac Surgical Intensive Care Unit (ICU) .Methods:A total of 300 patients who were hospitalized in Cardiac Surgical ICU of Beijing Chaoyang Hospital Affiliated to Capital Medical University from January 1 to December 31, 2019 were selected. The patients were divided into the experimental group ( n=150) and the control group ( n=150) by the random number table method. The patients in the experimental group adopted the intervention method of watching encouragement videos of family members, while patients in the control group adopted routine care (that was, the nurses encouraged the patients after telephone communication with their family members) . The psychological status of patients in the two groups before and after the intervention was evaluated using Mental Status Scale in Non-psychiatric (MSSNS) , and the differences in the scores between and within the two groups before and after the intervention were compared. Results:After the intervention, the MSSNS total score, depression score and loneliness score of the experimental group showed a downward trend, and the differences were statistically significant compared with those before the intervention ( P<0.05) . There was no statistically significant difference in all aspects of the control group before and after the intervention ( P>0.05) . After the intervention, the MSSNS total score and loneliness score of the experimental group were lower than those of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Encouragement video of family members can improve the psychological state of patients in declining visiting Cardiac Surgical ICU, mainly to relieve the negative emotions related to loneliness and depression.