Objective: To characterize perioperative dynamic changes in immune-cell phenotypes and inflammatory cytokines in patients undergoing CPB (cardiopulmonary bypass) cardiac surgery, and to explore their associations with postoperative outcomes. Methods: In this prospective cohort study, 120 adult patients who underwent elective cardiac surgery under CPB at West China Hospital from May 2022 to March 2023 were enrolled. Perioperative immune-cell phenotypes and concentrations of 40 inflammation-related cytokines were measured. The primary outcomes were the sequential organ failure assessment (SOFA) score at 24 h after surgery and ΔSOFA (the peak SOFA score within 48 h after surgery minus the preoperative SOFA score). Secondary outcomes included major adverse cardiovascular events (MACE), acute kidney injury (AKI), respiratory failure, severe liver injury, and infection. Results: The mean age of enrolled patients was 57±10 years. Of these, 52% (62/120) were male and 90% (108/120) underwent valve surgery. During the rewarming to the end of CPB, neutrophil counts rapidly increased (7.39×10 /L vs preoperative 3.07×10 /L, P<0.001), with significant upregulation of CD11b (7.30×10 /L vs preoperative 3.05×10 /L, P<0.001) and CD54 (7.15×10 /L vs preoperative 2.99×10 /L, P<0.001). Lymphocyte counts increased at the end of CPB (1.75×10 /L vs preoperative 1.12×10 /L, P<0.001) but decreased significantly at 24 h after surgery (0.59×10 /L vs preoperative 1.12×10 /L, P<0.001). Plasma analysis showed that multiple pro-inflammatory cytokines increased during CPB and remained elevated up to 24 h after surgery; five chemokines and the anti-inflammatory cytokine IL-10 peaked at the end of CPB. The SOFA score increased from 1 (1, 2) preoperatively to 7 (5, 10) at 24 h after surgery, with a ΔSOFA of 6 (4, 8). Within 30 days after surgery, 48 patients (40.0%) developed AKI, 17 (14.2%) developed infection, 4 (3.3%) developed severe liver injury, 3 (2.5%) developed respiratory failure, and 3 (2.5%) experienced MACE. During the 2-year follow-up, 8 patients (6.7%) experienced MACE and 5 (4.2%) died. Conclusion: Multi-organ dysfunction is common after cardiac surgery under CPB (median ΔSOFA, 6), accompanied by perioperative activation of multiple immune-cell subsets and upregulation of pro-inflammatory, anti-inflammatory, and chemotactic mediators. This study provides data-driven evidence and research clues for further investigation of the associations between CPB-related immune perturbations and postoperative organ dysfunction and clinical outcomes.

Transfusion and Anemia Expertise Initiative-Control/Avoidance of Bleeding developed a strategy for platelet and plasma infusion management in critically ill children based on systematic reviews and consensus meetings of international multidisciplinary experts. One good practice statement and six expert consensus statements were proposed for plasma and platelet transfusions in critically ill children following severe trauma, traumatic brain injury, and/or intracranial hemorrhage. This article introduces the specific methods and basis for the formation of recommendations in this part of the guide.

Objective:To understand the workflow and key tasks of the transformation of scientific and technological achievements in public hospitals,and propose optimization strategies from the perspective of managers.Methods:Based on the research method of Grounded Theory,semi-structured interviews were conducted among 23 managers of scientific and technological achievements transformation in public hospitals,and relevant concepts and categories were summarized by three stages coding with NVivo 12.Results:Through the three stages of coding,64 initial concepts,19 categories and 4 main categories were sorted out,and a framework diagram of the process of transforming scientific and technological achievements in public hospitals covering four stages was constructed.Conclusion:The scientific and technological achievements of public hospitals can be divided into four phases:project initiation and demand docking,research and development process and achievements incubation,achievements transformation and market docking,product promotion and industrial development,which can be used to achieve high-quality development of scientific and technological achievements through standardized management of the whole process,excavation of high-quality results,enhancement of humanistic construction,accumulation of scientific research experience,and standardization of qualification of technological managers.

Objective:This study aimed to evaluate the long-term efficacy and safety of rituximab(RTX)combined with calcineurin inhibitors(CNI)in the treatment of refractory nephrotic syndrome(RNS).Methods:A total of 80 patients with steroid-dependent/resistant RNS were prospectively enrolled and randomly assigned to an observation group(RTX+CNI,n=40)and a control group(CNI monotherapy,n=40).Patients were followed up for 24 months.Dynamic comparisons were made between the two groups regarding complete remission rate,relapse rate,24-hour urinary protein,kidney injury molecule-1(KIM-1),and adverse reactions.Results:The complete remission rate(CR)in the observation group was significantly higher than that in the control group at all time points(24-month CR:100％vs 90％,P＜0.05).The 24-month relapse rate was significantly lower in the observation group compared to the control group(0％vs 10％,P＜0.05).Combination therapy significantly reduced 24-hour urinary protein levels(6 months:2.13±0.63 vs 3.86±1.01 g/24 h,P＜0.001)and the renal injury marker KIM-1(6 months:1.53±0.41 vs 2.23±0.65 ng/mL,P＜0.001),and increased the CD4+/CD8+ ratio(24 months:2.03±0.52 vs 1.72±0.41,P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups(15％vs 20％,P=0.556).Conclusion:RTX combined with CNI significantly improves the long-term remission rate and reduces the risk of relapse in RNS.Its dual immunomodulatory and multi-target renal protective effects provide evidence-based support for optimizing the treatment of refractory nephrotic syndrome.

Based on systematic review and consensus meetings of international multidisciplinary experts, the Transfusion and Anemia Expert Initiative—Control/Avoidance of Bleeding (TAXI-CAB) project team developed management strategies for platelet and plasma transfusion in critically ill children. This consensus presents five expert consensus statements and two recommendations addressing two key questions: 1) What Laboratory Tests and Physiologic Triggers Should Guide the Decision to Administer a Platelet or Plasma Transfusion in Critically ill Children? 2) What Product Attributes Are Optimal to Guide Specific Product Selection? This consensus provides guidance for decision-making regarding plasma and platelet transfusion in critically ill children in two aspects: relevant laboratory testing indicators and additional special properties of blood components. This article explains the rationale behind the recommendations in this part of the guideline, aiming to emphasize the need for clinicians to develop transfusion strategies based on multidimensional assessment, while calling for enhanced interdisciplinary collaboration and evidence-based research to optimize blood management in critically ill children, reducing the risk of over-transfusion and improving treatment outcomes. Furthermore, there remains an urgent need for further research to explore laboratory indicators associated with bleeding risk to guide transfusion therapy.

Obesity, as a chronic recurrent disease, has become a major public health challenge in China. To implement the requirements of the Healthy China Initiative (2019—2030), under domestic guidelines or consensus statements on overweight and obesity, and in alignment with the latest scientific advances globally, the Quality control protocol for adult overweight and obesity screening in health management (examination) institutions (2025 edition) was developed. This protocol was drafted by the Health Management Center of Shanghai Changzheng Hospital and formulated through multiple rounds of deliberation by experts in China’s health examination quality control field. The protocol establishes unified standards for screening facilities, personnel qualifications, and measurement or testing procedures. It defines specific screening items, outlines a standardized screening pathway, and sets requirements for the final medical review, ensuring the scientific validity, effectiveness, and safety of the screening process. The implementation of this protocol will enhance the consistency of weight management practices for adults across health examination institutions and strengthen the quality control of overweight and obesity screening programs.

A quantitative analytical method was established for 275 kinds of metabolites in plasma based on ultra-high performance liquid chromatography-triple quadrupole mass spectrometry/multiple reaction monitoring-selected ion monitoring(UHPLC-QQQ-MS/MRM-SIM)technique.Based on UHPLC-high resolution(HRMS)/full MS-parallel reaction monitoring(PRM)technique,165 kinds of lipid metabolites in plasma were qualitatively identified and quantitatively detected to address the analytical challenges of lipid isomers.This quantitative metabolomics approach was successfully applied to a rat myocardial infarction study,identifying and quantifying 372 kinds of metabolites in total.Comparative analysis with the sham-operated group revealed significant alterations in 59 kinds of plasma metabolites in myocardial infarction rats.Key metabolic pathways,which included amino acid metabolism(alanine,aspartate,and glutamate metabolism;glycine,serine,and threonine metabolism,etc.),one-carbon unit metabolism,and tricarboxylic acid cycle,were significantly disrupted.

Foodborne illnesses caused by Salmonella pose significant threats to worldwide public health safety.In this study,a rapid method for screening viable Salmonella in oyster sauce and milk was developed by utilizing an electronic microbial growth analyzer(EMGA).Target food samples were diluted 10-fold with RVS broth and loaded into test tubes.Test tubes were positioned in the EMGA to determine the bacterial growth curves and the time required to reach the maximum growth rate(Tmgr).Using Salmonella typhimurium(S.typhimurium)asan model species,there was linear relationship between the logarithmic value of viable bacterial concentration(lgC)and Tmgr over the range of 5×101-5×106 CFU/mL,with a detection limit of 10 CFU/mL.For oyster sauce,the regression equation was Tmgr(min)=-80.775lg[C/(CFU/mL)]+754.96(R2=0.9907),and the recovery rates of S.typhimurium ranged from 95.2%to 119.8%,with relative standard deviations(RSD)ranging from 3.5%to 16.3%.For milk,the regression equation was Tmgr(min)=-71.922 lg[C/(CFU/mL)]+618.65(R2=0.9985),with recovery rates ranging from 98.4%to 110.6%and RSD ranging from 6.4%to 12.8%.The EMGA method required only one portable instrument,and involving only three manual steps,i.e.,dilution,transfer,and insertion.When S.typhimurium contamination reached 106 CFU/mL,the total time consumption,from the unwrapping of samples to the readout of bacterial concentration,was no more than 7 h.When applied to detection of actual oyster sauce and milk samples,the new method demonstrated strong consistency with plate counting results in positive detection rates.This method was superior to the plate counting method,which was generally considered as a gold standard,in terms of accuracy,precision,simplicity and efficiency,representing a promising alternative for the on-site screening and quantification of viable Salmonella in oyster sauce and milk products.

OBJECTIVE To investigate the positive test of high-risk human papillomavirus(HR-HPV)among the female population undergoing physical examination in Shenyang,analyze the influencing factors and establish and validate the risk prediction model.METHODS The data were collected from the female population who received HPV test in the physical examination center of a three-A hospital in the whole year of 2023.The prevalence rates of HR-HPV infections and subtypes were described,the influencing factors for the infections were identified.Uni-variate analysis and multivariate logistic regression analysis were performed for the influencing factors for positive test of HR-HPV,and the prediction model was established and validated.RESULTS Totally 6 130 out of 7 759 fe-male population who received HPV test were from Shenyang,the total positive rate of HR-HPV was 10.72％a-mong the population from Shenyang,11.11％among the population from other areas,and there was no signifi-cant difference.The population from Shenyang aged between 21 and 84 years old,with the mean age(48.58±11.64)years old.Among the local population who had the infections,80.21％were the single HPV infection,and 19.79％were multiple infections;HPV52 was the predominant subtype of HPV causing the infections,followed by HPV58 and HPV 16.The result of multivariate analysis showed age,smoking history,gynecological surgery history,allergic history,family annual income and sleep condition were the influencing factors for the positive HR-HPV.The prediction model was established based on the result of the multivariate analysis,the internal vali-dation of the model was carried out by modeling data and receiver operating characteristic(ROC)curves,the area under the curve(AUC)of the prediction model was 0.919,and 95％CI was 0.878 to 0.960,indicating that the prediction model had a high efficiency.CONCLUSIONS The positive rate of HR-HPV test is not relatively high among the physical examination female population in Shenyang,and the positive result is affected by a variety of factors.The population can be vaccinated for prevention and control based on the prediction model targeting to the non-variable factors such as age,meanwhile,the measures such as enhancement of health education,adjustment of health polies and interven-tion to health behaviors should be taken for other controllable factors.

Objective:To observe the effect of high-frequency repetitive transcranial magnetic stimulation (rTMS) at different frequencies on cognitive impairment due to high-altitude hypoxia.Methods:Sixty officers and soldiers displaying cognitive impairment in a hypoxic high-altitude environment were randomly divided into 15Hz, 20Hz and 25Hz groups, each of 20. They were given rTMS at those frequencies for 30 days. Before the stimulation and after 15 and 30 days, event-related potentials, latencies of mismatched negativity (MMN) and P300 signals were recorded. The participants′ cognition was also evaluated using the Montreal Cognitive Assessment Scale (MoCA). Correlation between the electrophysiological indexes and the MoCA scores was computed.Results:After 15 days, all had shorter MMN latencies, higher total MoCA scores and better memory scores. The only significant difference among the three groups was in the average memory scores. After 15 days, MMN latency was significantly negatively correlated with the memory scores in all three groups ( r=0.44 to -0.54). Conclusions:rTMS at frequencies above 15Hz can effectively relieve cognitive impairment, especially memory dysfunction, resulting from high-altitude hypoxia.