Real-world study (RWS), based on multi-source data from real medical environments, is gradually becoming an important supplement to traditional randomized controlled trials, and its application in the field of transfusion medicine is becoming increasingly widespread. This article systematically reviews the definition and methodological system of RWS, examines its application cases in clinical blood transfusion research, and discusses the advantages, limitations, and future research directions of RWS, aiming to provide a reference for evidence-based research in blood transfusion medicine.

Objective This study investigated feasible cases and their significance in promoting the"generalized"development of inspection through digital-intelligent equipment.Methods A qualitative research approach was used,involving interviews conducted between February 2025 and March 2025 with experts in traditional Chinese medicine diagnostics,clinical research methodology,medical engineering integration,and related disciplines,using both online and offline methods.In accordance with the Consolidated Criteria for Reporting Qualitative Research,feasible cases involving the specific application of digital equipment in various parts of observation were collected through item enrichment.The significance of extending observation capabilities via these cases was analyzed,along with the overall implications of integrating digital technologies with traditional inspection method.Results Interviews were completed with 11 experts from domestic universities and research institutes in the fields of traditional Chinese medicine diagnosis,medical engineering integration,and related disciplines.A total of 78 feasible cases of digital-intelligent inspection were identified,along with 69 insights regarding the significance of enhancing the inspection capabilities.These insights were synthesized into two dimensions and 23 holistic meanings.The first dimension is to expand the scope of inspection,including obtaining internal environmental characteristics,observing external environmental characteristics,expanding thermodynamic characteristic data,and crossing time and space.The second dimension is to improve the quality of observation and diagnosis information collection and analysis,including 19 specific meanings,such as standardized collection environment,objective quantification,and refined observation.Conclusion Digital-intelligent equipment plays a significant role in expanding the scope of inspection content and achieving high-quality acquisition and analysis of extensive inspection information.These advancements extend and enrich the capabilities of traditional inspection method in traditional Chinese medicine.

Real-world study (RWS), based on multi-source data from real medical environments, is gradually becoming an important supplement to traditional randomized controlled trials, and its application in the field of transfusion medicine is becoming increasingly widespread. This article systematically reviews the definition and methodological system of RWS, examines its application cases in clinical blood transfusion research, and discusses the advantages, limitations, and future research directions of RWS, aiming to provide a reference for evidence-based research in blood transfusion medicine.

OBJECTIVE To observe the intervention effect of puerarin on the rats with bacterial periodontitis by reg-ulating nucleotide-binding oligomeric domain-like receptor protein 3/Caspase-1(NLRP3/Caspase-1)signaling pathways.METHODS Totally 44 male SPF rats were chosen as subjects and were divided into the blank group,the model group,the puerarin group and the puerarin plus inhibitor group.The models of rats with bacterial periodon-titis were successfully established.The periodontal indexes and alveolar resorption were observed and compared a-mong the groups.RESULTS The sulcus bleeding index(SBI)and plaque index(PLI)scores of the model group and the puerarin plus inhibitor group were higher than those of the blank group;the NLRP3 level was 0.87±0.09 in the model group,0.85±0.08 in the puerarin plus inhibitor group,higher than 0.18±0.03 in the blank group;the Caspase-1 level was 1.15±0.11 in the model group,1.03±0.10 in the puerarin plus inhibitor group,higher than 0.35±0.04 in the blank group.The trabecular separation spacing(Tb.Sp),cemento-enamel junction-facial bone crest(CEJ-FBC),interleukin--1β(IL-1β)level,interleukin-6(IL-6)level,tumor necrosis factor-α(TNF-α)level and osteoclast counts of the model group and the puerarin plus inhibitor group were higher than those of the blank group;while the trabecular thickness(Tb.Th),bone volume/tissue volume(BV/TV)and bone mineral density(BMD)of the model group and the puerarin plus inhibitor group were lower than those of the blank group.The SBI and PLI scores of the puerarin group were lower than those of the model group;the NLRP3 level of the puerarin group was 0.20±0.04,lower than 0.87±0.09 of the model group;the Caspase-1 level of the puerarin group was 0.37±0.05,lower than 1.15±0.11 of the model group.The Tb.Sp,CEJ-FBC,IL-1βlevel,IL-6 lev-el,TNF-α level and osteoclast counts of the puerarin group were lower than those of the model group;while the Tb.Th,V/V and BMD of the puerarin group were higher than those of the model group.The SBI and PLI score of the puerarin plus inhibitor group were higher than those of the puerarin group;the NLRP3 level of the puerarin plus inhibitor group was 0.85±0.08,higher than 0.20±0.04 of the puerarin group;the Caspase-1 level of the pu-erarin plus inhibitor group was 1.03±0.10,higher than 0.37±0.05 of the puerarin group.The Tb.Sp,CEJ-FBC,IL-1β level,IL-6 level,TNF-α level and osteoclast counts of the puerarin plus inhibitor group were higher than those of the puerarin group,while the Tb.Th,V/V and BMD of the puerarin plus inhibitor group were low-er than those of the puerarin group,there were significant differences in the above comparisons(P＜0.05).CONCLUSIONS Puerarin can effectively reduce the periodontal plaque index and bleeding index of the rats with bacterial,reduce the levels of inflammatory factors and alleviate the damage of tissue.The action mechanisms may be associated with the NLRP3/Caspase-1 signaling pathways.

Objective This study investigated feasible cases and their significance in promoting the"generalized"development of inspection through digital-intelligent equipment.Methods A qualitative research approach was used,involving interviews conducted between February 2025 and March 2025 with experts in traditional Chinese medicine diagnostics,clinical research methodology,medical engineering integration,and related disciplines,using both online and offline methods.In accordance with the Consolidated Criteria for Reporting Qualitative Research,feasible cases involving the specific application of digital equipment in various parts of observation were collected through item enrichment.The significance of extending observation capabilities via these cases was analyzed,along with the overall implications of integrating digital technologies with traditional inspection method.Results Interviews were completed with 11 experts from domestic universities and research institutes in the fields of traditional Chinese medicine diagnosis,medical engineering integration,and related disciplines.A total of 78 feasible cases of digital-intelligent inspection were identified,along with 69 insights regarding the significance of enhancing the inspection capabilities.These insights were synthesized into two dimensions and 23 holistic meanings.The first dimension is to expand the scope of inspection,including obtaining internal environmental characteristics,observing external environmental characteristics,expanding thermodynamic characteristic data,and crossing time and space.The second dimension is to improve the quality of observation and diagnosis information collection and analysis,including 19 specific meanings,such as standardized collection environment,objective quantification,and refined observation.Conclusion Digital-intelligent equipment plays a significant role in expanding the scope of inspection content and achieving high-quality acquisition and analysis of extensive inspection information.These advancements extend and enrich the capabilities of traditional inspection method in traditional Chinese medicine.

OBJECTIVE To observe the intervention effect of puerarin on the rats with bacterial periodontitis by reg-ulating nucleotide-binding oligomeric domain-like receptor protein 3/Caspase-1(NLRP3/Caspase-1)signaling pathways.METHODS Totally 44 male SPF rats were chosen as subjects and were divided into the blank group,the model group,the puerarin group and the puerarin plus inhibitor group.The models of rats with bacterial periodon-titis were successfully established.The periodontal indexes and alveolar resorption were observed and compared a-mong the groups.RESULTS The sulcus bleeding index(SBI)and plaque index(PLI)scores of the model group and the puerarin plus inhibitor group were higher than those of the blank group;the NLRP3 level was 0.87±0.09 in the model group,0.85±0.08 in the puerarin plus inhibitor group,higher than 0.18±0.03 in the blank group;the Caspase-1 level was 1.15±0.11 in the model group,1.03±0.10 in the puerarin plus inhibitor group,higher than 0.35±0.04 in the blank group.The trabecular separation spacing(Tb.Sp),cemento-enamel junction-facial bone crest(CEJ-FBC),interleukin--1β(IL-1β)level,interleukin-6(IL-6)level,tumor necrosis factor-α(TNF-α)level and osteoclast counts of the model group and the puerarin plus inhibitor group were higher than those of the blank group;while the trabecular thickness(Tb.Th),bone volume/tissue volume(BV/TV)and bone mineral density(BMD)of the model group and the puerarin plus inhibitor group were lower than those of the blank group.The SBI and PLI scores of the puerarin group were lower than those of the model group;the NLRP3 level of the puerarin group was 0.20±0.04,lower than 0.87±0.09 of the model group;the Caspase-1 level of the puerarin group was 0.37±0.05,lower than 1.15±0.11 of the model group.The Tb.Sp,CEJ-FBC,IL-1βlevel,IL-6 lev-el,TNF-α level and osteoclast counts of the puerarin group were lower than those of the model group;while the Tb.Th,V/V and BMD of the puerarin group were higher than those of the model group.The SBI and PLI score of the puerarin plus inhibitor group were higher than those of the puerarin group;the NLRP3 level of the puerarin plus inhibitor group was 0.85±0.08,higher than 0.20±0.04 of the puerarin group;the Caspase-1 level of the pu-erarin plus inhibitor group was 1.03±0.10,higher than 0.37±0.05 of the puerarin group.The Tb.Sp,CEJ-FBC,IL-1β level,IL-6 level,TNF-α level and osteoclast counts of the puerarin plus inhibitor group were higher than those of the puerarin group,while the Tb.Th,V/V and BMD of the puerarin plus inhibitor group were low-er than those of the puerarin group,there were significant differences in the above comparisons(P＜0.05).CONCLUSIONS Puerarin can effectively reduce the periodontal plaque index and bleeding index of the rats with bacterial,reduce the levels of inflammatory factors and alleviate the damage of tissue.The action mechanisms may be associated with the NLRP3/Caspase-1 signaling pathways.

Objective To observe the value of transesophageal echocardiography(TEE)for guiding left atrial appendage closure(LAAC)with LAmbre occluder.Methods Data of 40 non-valvular atrial fibrillation(NVAF)patients who underwent LA AC with LAmbre occluder were retrospectively analyzed.CT angiography(CTA)before treatment,TEE and digital subtraction angiography(DSA)findings during LAAC were comparatively observed,and the correlations of the anchor area diameter and left atrial appendage opening diameter measured with the above three as well as occluder size were analyzed,and TEE and DSA for evaluating peri-device leak(PDL)were compared.Results LAAC were successfully performed with LAmbre occlude in all 40 cases.The diameter of the fixed umbrella was positively correlated with anchor area diameter measured with CTA,TEE and DSA(r=0.79,0.82,0.91,all P＜0.01),of occlusion umbrella was positively correlated with left atrial appendage opening diameter measured with CTA,TEE and DSA(r=0.56,0.89,0.86,all P＜0.01).Immediately after the release of occluder in LAAC,PDL occurred in 16 cases and were detected with both TEE and DSA,while in the rest 24 cases no PDL was found with neither TEE nor DSA.Conclusion TEE had comparable value to DSA for guiding LAAC using LAmbre occluder.

Objective To systematically evaluate the psychological feelings and real experience of ICU nurses'moral dilemma,and the aim is to provide references for the formulation of targeted psychological intervention programs.Methods Pubmed,CINAHL,Embase,Web of Science,Cochrane Library,PsycNET,CNKI,Wanfang database,VIP database,and China Biomedical Literature Database were searched by computer to retrieve qualitative studies on psychological perceptions and real experiences of moral dilemmas of ICU nurses,and the search time was from the establishment of databases to March 2023.The quality of literature was evaluated using the 2016 version of the Australian JBI Centre for Evidence-Based Health Care Quality Evaluation Criteria for qualitative studies,and the results were integrated and analyzed by the Meta integration method.Results A total of 10 pieces of literature were included,including 3 phenomenological studies and 7 descriptive studies.The results of 27 studies were summarized into 8 new categories,and 3 integrated results were obtained:①The internal and external causes of moral dilemmas,including conflicting concepts of life and death,differences of the idea of the superior death,conflict of clinical decision-making,and insufficient organizational support;②The progressive effects of moral dilemmas,including aggravating negative emotional burden and breeding professional identity bias;③ Coping strategies for moral dilemmas,including active self-debugging and seeking support from colleagues.Conclusion It is urgent to popularize the scientific concept of life and death of patients and families,deepen the concept of superior death of ICU nurses,and alleviate the conflict of nursing and patient decision-making.It is important to pay attention to the negative emotional state of ICU nurses,improve their professional identity,improve the self-adjustment ways of ICU nurses,and to provide multi-organization support for ICU nurses.

Objective::This study aimed to evaluate the major adverse cardiovascular and cerebrovascular events (MACCEs) and overall safety profile associated with iodixanol in Chinese patients undergoing percutaneous coronary intervention (PCI).Methods::Patients at 30 centers in China registered in the OpenClinic v3.6 database from October 30, 2013, to October 7, 2015, were included in the study. The primary endpoint was in-hospital MACCEs including target lesion revascularization (TLR), stroke, stent thrombosis, cardiac death, and PCI-related myocardial infarction (MI) within 72 h post-PCI. Secondary endpoints were MACCEs from 72 h to 30 d post-PCI and other safety events within 30 d post-PCI.Results::A total of 3,042 patients were enrolled. The incidence of MACCEs within 72 h post-PCI was 2.33% ( n = 71), including cardiac death (0.03%, n = 1) and PCI-related MI (2.30%, n = 70). The incidence of MACCEs from 72 h to 30 d post-PCI was 0.16% ( n = 5), including cardiac death (0.10%, n = 3), PCI-related MI (0.03%, n = 1), and TLR for stent thrombosis (0.03%, n = 1). The incidence of composite angiographic or procedural complications was 2.86% ( n = 87); 233 (7.86%) patients had results suggesting contrast-induced acute kidney injury. Conclusions::These findings indicate that the use of iodixanol in Chinese patients undergoing PCI is associated with a low incidence of MACCEs, confirming its safety in this population.

Objective::This study aimed to evaluate the major adverse cardiovascular and cerebrovascular events (MACCEs) and overall safety profile associated with iodixanol in Chinese patients undergoing percutaneous coronary intervention (PCI).Methods::Patients at 30 centers in China registered in the OpenClinic v3.6 database from October 30, 2013, to October 7, 2015, were included in the study. The primary endpoint was in-hospital MACCEs including target lesion revascularization (TLR), stroke, stent thrombosis, cardiac death, and PCI-related myocardial infarction (MI) within 72 h post-PCI. Secondary endpoints were MACCEs from 72 h to 30 d post-PCI and other safety events within 30 d post-PCI.Results::A total of 3,042 patients were enrolled. The incidence of MACCEs within 72 h post-PCI was 2.33% ( n = 71), including cardiac death (0.03%, n = 1) and PCI-related MI (2.30%, n = 70). The incidence of MACCEs from 72 h to 30 d post-PCI was 0.16% ( n = 5), including cardiac death (0.10%, n = 3), PCI-related MI (0.03%, n = 1), and TLR for stent thrombosis (0.03%, n = 1). The incidence of composite angiographic or procedural complications was 2.86% ( n = 87); 233 (7.86%) patients had results suggesting contrast-induced acute kidney injury. Conclusions::These findings indicate that the use of iodixanol in Chinese patients undergoing PCI is associated with a low incidence of MACCEs, confirming its safety in this population.