Objective: To analyze the characteristics and key risk factors of abnormal blood disposal throughout the 2024-2025 blood collection and supply process based on nationwide multi-site monitoring data, develop a comprehensive prevention and control strategy across the entire chain, reduce preventable blood waste, and ensure clinical blood safety. Methods: According to the Guidelines for Haemovigilance (T/CSBT 001-2026), we extracted 74 cases of abnormal blood disposal events reported by the China Blood Transfusion Association′s Blood Safety Monitoring System from January 1 2024, to December 31 2025, and conducted descriptive statistical analysis on the distribution of events, types of deviations, root causes, and classifications of disposal manifestations. Results: A total of 664 adverse events related to blood collection and supply were reported over two years, with 74 cases involving discarded abnormal blood units, accounting for 11.1% of the total. Among these, blood component preparation (40.5%) and blood collection (37.8%) remained traditional high-risk stages. The proportion of blood waste occurring during storage, distribution, and transportation increased from 7.7% in 2024 to 34.3% in 2025. Deviations from standard operating procedures (SOP) by personnel were the primary cause, accounting for 74.3% of cases. Discarded blood units were categorized into four types: compromised closed blood bag systems (40 cases), mainly due to inadequate heat sealing, physical damage, or dropped bags; blood out of the cold chain (12 cases), primarily resulting from blood being left at work sites; imbalanced proportion of preservation solution (10 cases), mostly caused by blood collection volumes exceeding the standard capacity of blood bags; and other causes (12 cases). Conclusion: Human operational errors are the core cause of abnormal blood waste. The collection and preparation stages have long been at high-risk, and the risks in the storage and transportation stages have been increasing year by year. We should focus on standardizing personnel management, improving specialized operation norms such as heat sealing, transportation, and storage, establishing a full-process intelligent cold chain monitoring and multi-node visual verification mechanism, and systematically reducing the occurrence rate of abnormal blood waste through a closed-loop quality intervention system, thereby improving the utilization efficiency of voluntary blood donation resources.

Objective To investigate the causes and management strategies for lower limb ischemic necrosis following xenogeneic heterotopic heart transplantation from a multigene-edited pig to a rhesus monkey. Methods A xenogeneic heterotopic heart transplantation was performed on December 16, 2023, at the Institute of Experimental Animals of Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, using a quintuple-gene-edited pig as the donor and a rhesus monkey as the recipient. On postoperative day (POD) 9, the recipient monkey underwent left lower limb amputation due to ischemic necrosis. Blood samples were collected at various time points after transplantation for analysis of hematologic parameters, liver and renal function, myocardial enzymes, and coagulation profiles. Ultrasound and computed tomography (CT) were used to evaluate anastomotic patency and cardiac structure. Immunological assays, including complement-dependent cytotoxicity (CDC) and IgG/IgM antibody detection, combined with clinical observations, were employed to assess rejection type and therapeutic response. Results The recipient monkey survived for 46 days after transplantation. Echocardiography demonstrated preserved biventricular systolic function in the recipient’s native heart, with left ventricular ejection fraction (LVEF) consistently exceeding 50%. In the donor pig heart, left ventricular endocardial thickening was noted on POD 9, followed by right ventricular endocardial thickening on POD 24, while LVEF remained around 35%. No hyperacute or acute rejection was detected immunologically. CDC positivity ranged between 3.4% and 5.1%, with IgG/IgM antibody binding trends consistent with CDC results. Following amputation, the recipient exhibited elevated inflammatory markers, coagulopathy, and reactive thrombocytosis, which later normalized. Immunohistochemical staining of the necrotic limb revealed arterial and venous thrombosis; however, no T-cell or B-cell infiltration was observed in vascular structures, thrombi, nerves, muscles, fascia, or skin tissues, with CD3 and CD20 staining both negative. Conclusion Limb ischemia after xenogeneic heart transplantation may be associated with lower extremity vascular thrombosis triggered by local trauma in the context of transplantation-induced inflammatory activation and coagulation dysfunction. While no clear lymphocyte-mediated rejection was observed, further studies are needed to explore the potential role of non-lymphocyte-mediated immune mechanisms.

Objective To explore the potential categories of diet management ability in elderly patients suffering from diabetes and analyze the influencing factors of different potential categories,for the reference of clinical nurs-ing practice.Methods A convenient sampling method was used to select elderly patients suffering from diabetes with the risk of malnutrition treated in endocrinology departments in 2 tertiary hospitals in Zhenjiang City,Jiangsu Province from September 2023 to September 2024.General information questionnaire,Diabetes Diet Management Scale,Electronic Health Literacy Scale,Simple Disease Perception Scale and Perceived Social Support Scale were used for investigation.Results A total of 376 questionnaires were sent out,in which 349 were effectively collected with an effective questionnaire recovery rate of 92.8％.Totally 3 potential categories of diet management behavior were identified through the analysis of effective questionnaire,namely low self-management(24.9％),middle self-man-agement(45.9％)and high self-management(29.2％).Disease duration of diabetes,glycosylated hemoglobin level,Al-bumin level,E-health literacy,perceived family support level and disease perception level were the risk factors of diet management ability in elderly patients suffering from diabetes with the risk of malnutrition(P＜0.05).Conclusion There are significant category characteristics of diet management ability in elderly patients suffering from diabetes with the risk of malnutrition.Medical staff can formulate targeted clinical intervention measures to help patients im-prove their diet management ability according to different category characteristics.

Objective:To analyze the changes in the incidence trend of liver cancer in Taizhou of Jiangsu Province, from 2012 to 2020 and provide reference for tumor prevention and control and management.Methods:Liver cancer incidence data from 2012 to 2020 were extracted from the Taizhou Center for Disease Control and Prevention's tumor registry system. Demographic data were used to calculate the crude incidence rate, age-standardized incidence rate (ASIR), Chinese age-standardized incidence rate (CASIR; based on China's 2010 standard population), and world age-standardized incidence rate (WASIR; based on Segi's world standard population). The Joinpoint regression model was applied to identify inflection points in liver cancer incidence trends during 2012-2020, and annual percentage change (APC) with average annual percentage change (AAPC) were calculated.Results:In 2020, the crude incidence ratio (CIR) of liver cancer in Taizhou was 34.6 per 100 000, with CASIR and WASIR at 19.6 per 100 000 and 14.9 per 100 000, respectively. From 2012 to 2020, the male-to-female ratio of new liver cancer cases was 2.94∶1 (10 455 males vs. 3 559 females), with male incidence consistently higher than female. Overall liver cancer incidence in Taizhou initially increased and then decreased after 2017 (2012-2017: APC=6.4%, P=0.014; 2017-2020: APC=-9.5%, P=0.035), peaking at a CASIR of 26.2 per 100 000 in 2017. The trend in male incidence mirrored the overall pattern, rising before 2017 and declining thereafter (2012-2017: APC=6.2%, P=0.005; 2017-2020: APC=-9.0%, P=0.016). Female incidence remained relatively stable (2012-2016: APC=11.0%, P=0.054; 2016-2020: APC=-6.5%, P=0.130). Conclusions:Liver cancer incidence in Taizhou increased before 2017 and declined thereafter, with 2017 as the turning point. Amid population aging, liver cancer remains a persistent public health challenge requiring sustained attention.

Objective·To evaluate the relationships between disc-condyle distance and anterior disc displacement,as well as between disc-condyle distance and disc morphology,in patients with temporomandibular disorders(TMD)using magnetic resonance imaging(MRI)of the temporomandibular joint(TMJ).Methods·From September 2023 to March 2024,90 patients(180 TMJs)who visited the TMJ clinic of Department of Stomatology,The Second Affiliated Hospital of Anhui Medical University,with clinical symptoms of TMD and were diagnosed via MRI with either anterior disc displacement or no significant displacement,were included.Clinical data were collected,and MRI images were used to measure the angle of disc displacement,disc-condyle distance,disc length,and thickness.The degree of disc deformation was assessed.The relationships between clinical symptoms and anterior disc displacement,between anterior disc displacement and both disc morphology and disc-condyle distance,and between disc-condyle distance and disc morphology were analyzed.Results·Among the 90 patients,there were 16 males and 74 females,with a mean age of(28.1±14.5)years.Among the 180 TMJs,175 had clinical symptoms and 5 were asymptomatic.There were 40 joints with no displacement,78 with reducible anterior disc displacement,and 62 with irreducible anterior disc displacement.In the joints with irreducible anterior disc displacement,the proportion of those with two or more symptoms was slightly higher at 62.9%,but the difference was not statistically significant compared with the joints with no displacement or reducible anterior disc displacement.MRI assessment revealed that in the joints with irreducible anterior disc displacement,the proportion of disc deformation type Ⅲ or higher was significantly higher compared with the non-displaced joints(P<0.001).The disc length was significantly shorter(P<0.001),and the intermediate zone thickness was significantly greater(P<0.001)compared with the non-displaced joints.The disc displacement angles at centric closure and maximum opening were also significantly larger(P<0.001).The disc-condyle distance was 3.10(2.70,3.70)mm for non-displaced joints,3.40(3.00,4.00)mm for joints with reducible anterior disc displacement,and 6.60(4.78,7.90)mm for joints with irreducible anterior disc displacement,with significant differences(P<0.001).The disc-condyle distance was 3.10(2.80,3.60)mm for type Ⅰ discs,3.70(3.10,4.60)mm for type Ⅱ discs,5.10(4.00,7.30)mm for type Ⅲ discs,and 6.80(4.98,8.20)mm for type Ⅳ/Ⅴ discs,with significant differences(P<0.001).The disc-condyle distance was negatively correlated with disc length(rs=-0.469,P<0.001),positively correlated with intermediate zone thickness(rs=0.319,P<0.001),and positively correlated with disc displacement angle at centric closure(rs=0.626,P<0.001).Conclusion·With increasing severity of disc deformation,intermediate zone thickness,and disc displacement angle at centric closure,as well as decreasing disc length,the disc-condyle distance increases.The disc-condyle distance is an important indicator for MRI assessment of pathological changes in TMD.

Objective To investigate the relationship between the threonine and tyrosine kinase(TTK)gene and eyelid basal cell carcinoma(BCC).Methods Bioinformatics methods were used to screen the core gene(namely,TTK)associated with the occurrence and development of BCC from the Gene Expression Omnibus(GEO)database.Surgically removed eyelid BCC tissue specimens(BCC cells were divided into BBC Grade Ⅰ,Ⅱ and Ⅲ groups by tumor grade)and be-nign tumor tissue specimens(Control group)were collected from Ziyang Central Hospital for subsequent experiments.Cel-lular immunofluorescence assay(CIA)was used to detect the expression of the TTK gene in benign and malignant eyelid tumor cells.After knocking down TTK in BCC cells through transfection with lentiviruses(the cells transfected with LV-TTK-shRNA were taken as the TTK-shRNA group,and those transfected with LV-BBC-shRNA were taken as the BBC nega-tive control group),CIA was used to detect the expression of key proteins Bcl-2 and Bax in the apoptotic signaling pathway of each group of cells.Results The bioinformatics analysis showed that the TTK gene was the core gene associated with the occurrence and development of eyelid BCC.CIA detection results revealed that the fluorescence signal intensities in the tumor cytoplasm of Control,BCC Grade Ⅰ,Ⅱ,and Ⅲ groups were 1.03±0.07,1.28±0.11,1.58±0.13 and 1.92±0.17,respectively.The fluorescence signal intensity gradually increased,and the difference in fluorescence signal intensity among the four groups was statistically significant(all P＜0.05).Compared with that in the Control group(1.02±0.05),the cell fluorescence intensity was increased in the BCC negative control group(1.74±0.12)and decreased in the TTK-shRNA group(1.31±0.09)(P＜0.05).The difference in cell fluorescence intensity was significant among the Control,BCC nega-tive control and TTK-shRNA groups(all P＜0.05).The fluorescence intensity of the anti-apoptotic protein Bcl-2 was 1.04±0.12 in the Control group,2.12±0.23 in the BCC negative control group,and 1.43±0.15 in the TTK-shRNA group.The fluorescence intensity of the pro-apoptotic protein Bax was 1.02±0.08 in the Control group,0.64±0.11 in the BCC negative control group,and 1.47±0.16 in the TTK-shRNA group.After TTK knockdown,the expression level of BcL-2 in BCC cells decreased,and that of Bax increased.The fluorescence intensities of BcL-2 and Bax were significantly different among the Control,BCC negative control and TTK-shRNA groups(all P＜0.05).Conclusion The TTK gene plays a role in the regulation of eyelid BCC cell proliferation,and this effect is closely related to the PI3K-AKT-Bcl-2/Bax signaling path-way.

Objective:To analyze the changes in the incidence trend of liver cancer in Taizhou of Jiangsu Province, from 2012 to 2020 and provide reference for tumor prevention and control and management.Methods:Liver cancer incidence data from 2012 to 2020 were extracted from the Taizhou Center for Disease Control and Prevention's tumor registry system. Demographic data were used to calculate the crude incidence rate, age-standardized incidence rate (ASIR), Chinese age-standardized incidence rate (CASIR; based on China's 2010 standard population), and world age-standardized incidence rate (WASIR; based on Segi's world standard population). The Joinpoint regression model was applied to identify inflection points in liver cancer incidence trends during 2012-2020, and annual percentage change (APC) with average annual percentage change (AAPC) were calculated.Results:In 2020, the crude incidence ratio (CIR) of liver cancer in Taizhou was 34.6 per 100 000, with CASIR and WASIR at 19.6 per 100 000 and 14.9 per 100 000, respectively. From 2012 to 2020, the male-to-female ratio of new liver cancer cases was 2.94∶1 (10 455 males vs. 3 559 females), with male incidence consistently higher than female. Overall liver cancer incidence in Taizhou initially increased and then decreased after 2017 (2012-2017: APC=6.4%, P=0.014; 2017-2020: APC=-9.5%, P=0.035), peaking at a CASIR of 26.2 per 100 000 in 2017. The trend in male incidence mirrored the overall pattern, rising before 2017 and declining thereafter (2012-2017: APC=6.2%, P=0.005; 2017-2020: APC=-9.0%, P=0.016). Female incidence remained relatively stable (2012-2016: APC=11.0%, P=0.054; 2016-2020: APC=-6.5%, P=0.130). Conclusions:Liver cancer incidence in Taizhou increased before 2017 and declined thereafter, with 2017 as the turning point. Amid population aging, liver cancer remains a persistent public health challenge requiring sustained attention.

A 57-year-old female patient with small cell lung cancer was treated with serplulimab (100 mg by intravenous infusion on the first day, 21 days as a cycle). After the 10th cycle of treatment, the patient suddenly presented drowsiness, shortness of breath, dry mouth, nausea, vomiting, fatigue and other symptoms. Laboratory tests showed fasting blood glucose 38.9 mmol/L, glycosylated hemoglobin 7.9%, serum C peptide 0.2 μg/L, pH value 7.05, anion gap 31 mmol/L, anti-islet cell antibody 36 kU/L, anti-glutamic acid decarboxylase antibody 131 kU/L, urine ketone body (+++). The patient was diagnosed with fulminant type 1 diabetic ketoacidosis, which was considered to be related to serplulimab. The drug was stopped, and insulin, rehydration, correction of acid-base imbalance, and other treatments were given. After 3 days, the patient′s consciousness returned to normal. After 12 days, her breathing was stable, dry mouth, nausea, vomiting and other symptoms were relieved. Laboratory tests showed random blood glucose 13.6 mmol/L, pH value 7.44, anion gap 6 mmol/L, and urine ketone body negative. After 26 days, her random blood glucose was controlled at 10.0-12.0 mmol/L.

Objective To investigate the effects of composite nanoparticles E/Ce@MCSNs loaded with epigallocatechin-3-gallate(EGCG)and cerium dioxide(CeO2)on the odonto/osteogenic differentiation of human stem cells from the apical papilla(SCAPs)and macrophage polarization under inflammatory conditions.Methods E/Ce@MCSNs were synthesized and characterized.Cell viabil-ity of SCAPs and RAW 264.7 cells treated with varying concentrations of E/Ce@MCSNs was assessed via CCK-8 assay.The antioxidant enzyme-mimetic activity of E/Ce@MCSNs was evaluated.Under simulated inflammatory conditions,intracellular reactive oxygen species(ROS)scavenging capacity was measured via DCFH-DA fluorescent probe.Alkaline phosphatase(ALP)staining/activity,alizarin red staining/semi-quantitative analysis,and RT-qPCR were performed to detect odonto/osteogenic differentiation markers,in-cluding dentin sialoprotein(DSPP),ALP,runt-related transcription factor 2(Runx-2),type Ⅰ collagen(COL-Ⅰ),and osteopontin(OPN)in SCAPs.The effects of E/Ce@MCSNs on the odontogenic/osteogenic differentiation of SCAPs under this condition were eval-uated.RT-qPCR were used to analyze cytokine expression(TNF-α,IL-1β,IL-6,iNOS,TGF-β,IL-10)and secreted TNF-α/IL-6 levels in RAW264.7 cells.The concentrations of TNF-α and IL-6 in cell cul-ture supernatants were measured by ELISA.Results E/Ce@MCSNs exhibited excellent biocompatibility at concentrations≤100 μg/mL.They demonstrated potent ROS-scavenging activity(P＜0.05)and sig-nificantly enhanced ALP activity(P＜0.001),promoted calcium nodule formation(P＜0.001),and upregulated odonto/osteogenic gene expression(DSPP,ALP,Runx-2,COL-Ⅰ,OPN)in SCAPs under inflammatory conditions(P＜0.05).In RAW264.7 cells,E/Ce@MCSNs downregulated pro-inflammatory cytokines(TNF-α,IL-1 β,IL-6,iNOS)(P＜0.01)and upregulated anti-inflammatory factors(TGF-β,IL-10)(P＜0.001),while reducing TNF-α and IL-6 secretion(P＜0.001).Conclusion E/Ce@MCSNs exert antioxidant and anti-inflammatory effects in apical periodontitis by scavenging excessive ROS,thereby promoting odonto/osteogenic differentiation of SCAPs.

Objective:To analyze the correlation and consistency of urine protein creatinine ratio (UPCR) with 24-hour urine protein quantification (24hUTP) in patients with lupus nephritis (LN).Methods:LN patients were enrolled from the STAR cohort of Peking University First Hospital, The time period is January 1, 2007 to July 31 2024. The correlation and consistency of UPCR with 24hUTP were analyzed in overall patients and various subgroups, such as,the levels of proteinuria and multiple parameters. The correlation was analyzed using Spearman′s method. The consistency was evaluated by using Kappa test, cross tabulation consistency probability, and UPCR/24hUTP ratio.Results:A total of 261 LN patients were included in this study. Overall, UPCR was positively correlated with 24hUTP ( r=0.892, P<0.001), and the consistency between then was good ( Kappa=0.603, P<0.001). Subgroup analysis based on multiple levels including different urine volume, eGFR grading, albumin, urea nitrogen, total cholesterol, low-density lipoprotein cholesterol, SLEDAI-2K, also revealed good correlation ( r=0.747~0.951; P<0.001) and consistency ( Kappa=0.393~0.771; P<0.001). Patients were divided into subgroups according to the 24hUTP (≤ 0.5 g, >0.5 g to ≤1.0 g, >1.0 g to ≤3.5 g, and>3.5 g). The best correlation and consistency were observed in ≤ 0.5g group ( r=0.728, Kappa=0.395, P<0.001), while the correlation was average or poor in other subgroups ( r=0.16~0.46). The consistency evaluated by UPCR/24hUTP ratio showed good consistency (ratios between 0.8~1.2) in 74 patients (28.4%), however, the unsatisfactory consistency in most patients, with 128 patients (68.4%) having ratios < 0.8, indicating a significantly lower UPCR than 24hUTP, and 59 patients (31.6%) having ratios > 1.2, indicating significantly higher UPCR than 24hUTP.The cross tabulation evaluation showed that the probability of consistency was distributed in a gradient, we found the worst consistency (48.9%) in >0.5 g to ≤1.0 g group, moderate consistency (64.0%) in >1.0 g to ≤3.5 g group, and the best consistency (73.3%) in >3.5 g group. Conclusion:In LN patients, the overall correlation and consistency between UPCR and 24hUTP are good, but the degree of correlation and consistency is closely related to the total amount of proteinuria. When 24hUTP ≤ 0.5 g, UPCR can be used to replace 24hUTP, but UPCR cannot be simply equated with 24hUTP at other urinary protein levels. Detecting 24hUTP to accurately reflect the total amount of proteinuria remain necessary.