OBJECTIVE To ensure the safety of patients’ drug use and control the risk of medical insurance expenditure by upgrading the pre-prescription review system to conduct pre-review on prescriptions from internet hospitals and external prescriptions， as well as to review the payment methods of drugs （including in-hospital and external drug dispensing）. METHODS The data interfaces of prescriptions from internet hospitals and external prescriptions were integrated to achieve real-time rational drug use intervention. Additionally， an intelligent review project for payment method was added to precisely intervene in the medical insurance payment methods of drugs. The effect of the system upgrade was evaluated by comparing the qualification rates of prescriptions from internet hospitals and external prescriptions and the suspected amounts of drug violations from January to April 2025 （before the system upgrade） and May to August 2025 （after the system upgrade）. RESULTS After the upgrade of the pre-prescription review system， the qualification rates of prescriptions from internet hospitals and external prescriptions increased by 3.5% [95% confidence interval （CI）＝0.3%-6.7%， P ＝0.037 ] ； the suspected amounts of drug violations decreased to 52.9% of the pre-upgrade level （95%CI＝31.6%-88.5%， P ＝0.026）， and the average monthly sequential decrease was 29.5% （95%CI＝12.2%-43.4%， P ＝0.012）. Moreover， the addition of the intelligent review project for payment methods promoted the management of off-label drug use in our hospital. After the upgrade， a total of 79 filling valid applications for off-label drug use were received and archived. CONCLUSIONS The upgrade of the pre-prescription review system effectively improves the review qualification rates of prescriptions from internet hospitals and external prescriptions and the accuracy of medical insurance payment for drugs， and strengthens the supervision of off-label drug use， achieving dual guarantees of clinical rationality and medical insurance compliance.

Objective To analyze the infection status and epidemic trends of soil-borne nematode infections in Yubei, Chongqing City, in 2010,2021, and 2022. Methods The local populations from four survey sites of four towns in 2010 and five sites of five towns in 2021 and 2022 were surveyed regarding their basic information using a unified form. Fecal samples of the participants were collected and tested for soil-borne nematode infections using the modified Kato-Katz thick smear method. Results In 2010, 2 049 participants were surveyed, followed by 1 000 participants in 2021 and 2022. The overall prevalence of parasitic infections declined significantly from 3.86% to 0.20%. In 2010, soil-transmitted nematode included hookworms(3.81%) and roundworms(0.29%). In 2021, the infection rates of roundworms and hookworms were 1.70% and 0.10% respectively. Notably, only Ascaris was identified in 2022(0.20%). The≥60 age group consistently exhibited the highest infection rates across all surveys, followed by the 40-59 age group. The infection rates of males in the three surveys were 3.31%,1.92%, and 0.20% respectively, and those of females were 4.37%, 1.46%, and 0.20% respectively. There was no statistically significant difference in the infection rates between males and females. Educational attainment was inversely associated with infection; in 2010, the highest prevalence was observed among those with primary education or below, whereas in 2021, illiterate or semi-literate individuals showed the highest susceptibility. The occupational distribution of infections in 2010 indicated that retirees (8.33%), farmers(4.86%), and homemakers or unemployed individuals(3.45%)were the most affected. However, in 2021 and 2022, farmers emerged as the predominant occupational group with soil-transmitted nematode infections. Conclusions The infection rate of soil-borne nematodes showed a decreasing trend in Yubei, and the infection species changed from hookworms in 2010 to Ascaris in 2022. Farmers, the elderly, and people with low education levels should continue to be the focus of preventive and control efforts.

Osteoarthritis （OA） is currently the most common type of joint degenerative disorder， typically characterized by cumulative onset at the affected sites and slow disease progression， posing a serious threat to the physical and mental health of the elderly population. Traditional Chinese medicine （TCM） has long been a hot research area in the prevention and treatment of osteoarthritis， attracting widespread attention due to its high safety and low adverse reactions. In recent years， with the continuous emergence of new research technologies and methods， significant progress has been achieved in the application of omics technologies in osteoarthritis research. Omics technologies， with their high-throughput， dynamic， and comprehensive features， provide a new technical platform for identifying biomarkers with diagnostic potential， objectifying the syndrome differentiation and treatment in TCM， and developing precise targeted therapies with TCM prescriptions. This study conducted searches in the China National Knowledge Infrastructure （CNKI） and PubMed databases， with keywords such as "osteoarthritis"，"osteoarthritis （oa）"，and "genomics" for retrieval. It classified and analyzed publications based on their specific contents to elaborate on the recent application of omics technologies in osteoarthritis research and to summarize the research progress in TCM for the prevention and treatment of osteoarthritis. This review aims to provide a basis for the diagnostic research on osteoarthritis and to offer new ideas and directions for expanding the research on TCM in preventing and treating osteoarthritis.

Osteoarthritis （OA） is currently the most common type of joint degenerative disorder， typically characterized by cumulative onset at the affected sites and slow disease progression， posing a serious threat to the physical and mental health of the elderly population. Traditional Chinese medicine （TCM） has long been a hot research area in the prevention and treatment of osteoarthritis， attracting widespread attention due to its high safety and low adverse reactions. In recent years， with the continuous emergence of new research technologies and methods， significant progress has been achieved in the application of omics technologies in osteoarthritis research. Omics technologies， with their high-throughput， dynamic， and comprehensive features， provide a new technical platform for identifying biomarkers with diagnostic potential， objectifying the syndrome differentiation and treatment in TCM， and developing precise targeted therapies with TCM prescriptions. This study conducted searches in the China National Knowledge Infrastructure （CNKI） and PubMed databases， with keywords such as "osteoarthritis"，"osteoarthritis （oa）"，and "genomics" for retrieval. It classified and analyzed publications based on their specific contents to elaborate on the recent application of omics technologies in osteoarthritis research and to summarize the research progress in TCM for the prevention and treatment of osteoarthritis. This review aims to provide a basis for the diagnostic research on osteoarthritis and to offer new ideas and directions for expanding the research on TCM in preventing and treating osteoarthritis.

Objective Jejunal interposition is an important option for restoring gastrointestinal continuity in patients with complex esophageal cancer in whom the stomach is unavailable for reconstruction due to previous gastrectomy, tumor involvement, failed gastric conduit, or other constraints. Although the jejunum offers a caliber similar to the esophagus, a rich blood supply, and preserved peristaltic function, anatomical variations in mesenteric length and vascular arcades render long-segment and high-level reconstruction susceptible to excessive tension, mesenteric torsion, venous congestion, and inadequate distal perfusion. This consensus aims to provide standardized recommendations for the application of jejunal interposition in this specific patient population. Methods This consensus was developed in accordance with the WHO Handbook for Guideline Development and Chinese national guideline development standards, with reference to the Appraisal of Guidelines for Research & Evaluation Ⅱ(AGREE Ⅱ), Reporting Items for Practice Guidelines in Healthcare (RIGHT), and Scientific, Transparent and Applicable Rankings (STAR) checklists. The project was registered on the international practice guidelines registry platform (PREPARE-2026CN1384). The working group systematically searched Chinese and English evidence addressing 12 clinical questions. Evidence was graded using the Oxford Centre for Evidence-Based Medicine (OCEBM) 2009 system, with structured appraisal of risk of bias, inconsistency, indirectness, and imprecision. Recommendations were formulated through two rounds of Delphi surveys and a face-to-face consensus meeting, with an agreement threshold of ≥75%. Results The consensus generated 12 recommendations covering indications, selection between jejunum and colon, preoperative assessment, surgical approach and reconstruction route, pedicled jejunal interposition (PJI), supercharged pedicled jejunal interposition (SPJ), indocyanine green (ICG) perfusion assessment, perioperative nutrition, management of anastomotic leakage, long-term follow-up, and special treatment scenarios. Given that the available direct evidence is predominantly derived from single-center retrospective cohorts and case series, recommendations extrapolated from general esophagectomy or other gastrointestinal surgical evidence are deliberately phrased with caution. Conclusion Jejunal interposition is a safe and effective approach for digestive tract reconstruction in patients with complex esophageal cancer in whom the stomach is unavailable. This consensus emphasizes that clinical decision-making should be individualized based on the patient's prior treatment history, reconstruction height, vascular anatomy, technical availability, and institutional experience in the Chinese context.

The surgical treatment of thoraco-abdominal aortic aneurysm (TAAA) requires a unique multidisciplinary approach. A thorough preoperative examination and evaluation are essential to determine the optimal timing for surgery and to optimize organ function as needed. During the perioperative period, excellent surgical skills and an appropriate strategy for extracorporeal circulation will be employed based on the extent of the aneurysm. Additionally, necessary measures will be taken to monitor and protect the functions of vital organs. Close monitoring and management in the postoperative stage, along with early detection of complications and effective treatment, are crucial for improving the prognosis of TAAA surgery. This article reviews the current research progress in the perioperative management of TAAA surgery.

Objective: To analyze the frequency and investigate the causes of unexpected antibodies in D-negative blood donors. Methods: From January 2022 to December 2024, 3 768 D-negative blood donors sent to our laboratory were selected as research subjects. D-negative confirmation test and RhCE phenotype detection were applied by saline tube method and microcolumn gel indirect antiglobulin test (IAT), respectively. Antibody screening and identification were performed using the polybrene method and IAT column agglutination methods. Anti-D, anti-C and anti-G specificities were identified by a two-step adsorption-elution method, and the genotypes of D-negative samples were determined by RHD gene amplification, Sanger sequencing, and PacBio Single Molecule Real-Time (SMRT) sequencing. Results: Among D-negative donors, ccee and Ccee phenotypes accounted for the highest proportion, 55.68% (2 098/3 768) and 29.56% (1 114/3 768), respectively, while CcEE and CCEe phenotypes were the least, with one case detected in each, accounting for 0.03% (1/3 768). A total of 165 cases with D variant phenotype were detected, and the proportion of D variant was 4.38% (165/3 768) in the donors detected by D-negative confirmation test. Antibody screening positive blood donors were identified in 93 cases with a proportion of 2.47% (93/3 768). Antibody specificity was determined in 84 blood donors, and 9 samples showed no clear specificity. Anti-D was detected most frequently (n=68), in which 6 of them were detected having multiple antibodies, anti-D + anti-C (n=2), anti-D + anti-G(n=1), and anti-D + anti-E(n=3). The other antibodies detected were anti-E (n=1), anti-M(n=9), anti-P1 (n=3), anti-Le (n=1), and anti-HI(n=2). Fourteen cases were detected with anti-D in serological D-negative donors with C+ or E+ phenotype, in which three of them were DVI type 3 individuals and 11 cases were D negative individuals. Conclusion: The incidence of unexpected antibodies was higher in D-negative blood donors than in the total donors, with anti-D being the most common. The data provide insights for prevention and monitoring hemolytic disease of the fetus and newborn (HDFN) caused by anti-D. To ensure the safety of blood transfusion, routine unexpected antibody screening for RhD-negative blood donors is recommended to prevent the use of unexpected antibodies positive plasma in the clinic.

Objective:To investigate the correlation between upper limb grip strength and total body bone mineral density(BMD)us-ing public data.Methods:During the 2011-2012 and 2013-2014 cycles of National Health and Nutrition Examination Surveys,a total of 5148 participants with grip strength,BMD,and multiple potential confounding factors were identified,and baseline levels were cal-culated after weighting.R language survey package was used for the multiple linear regression analysis to investigate the correlation be-tween grip strength and BMD,and then stratified analysis was performed based on sex and age.The rcssci package was used for curve fitting to analyze the curve relationship between the two indicators.Results:A total of 5 148 participants(2 493 male participants and 2 655 female participants)were included in this study.The overall grip strength was(77.48±0.40)kg,with a value of(93.98±0.45)kg for male participants and(59.71±0.24)kg for female participants;overall left upper limb grip strength was(37.75±0.21)kg,with a value of(28.89±0.12)kg for female participants and(45.98±0.24)kg for male participants;overall right upper limb grip strength was(39.73±0.20)kg,with a value of(30.83±0.13)kg for female participants and(48.00±0.23)kg in male par-ticipants.Overall left grip strength values of body mass index was 46.87±0.33,with a value of 53.65±0.46 for male participants and 39.56±0.26 for female participants(P<0.000 1);overall right grip strength values of body mass index was 49.37±0.33,with a value of 56.01±0.47 for male participants and 42.21±0.26 for female participants;overall mean grip strength index was 48.12±0.33,with a value of 54.83±0.46 for male participants and 40.89±0.26 for female participants;overall BMD was(1.11±0.00)g/cm2,with a value of(1.15±0.00)g/cm2 in male participants and(1.08±0.00)g/cm2 in female participants.After exclusion of confounding factors,grip strength showed a significant positive correlation with total BMD(P<0.000 1),and in addition,age was negatively correlated with BMD.Black race(with Mexican descent as reference),college graduation or above(with the participants not graduated from high school as reference),body height,and body mass index(BMI)were positively correlated with BMD.Stratified analysis showed that age,sex,and BMI had interaction with BMD.The curve fitting results showed that there was only a linear relationship between grip strength and BMD(P<0.001),but there was an L-shaped curve relationship between grip strength index(mainly of the left side)and BMD.With the increases in grip strength and grip strength index,BMD increased in a linear and L-shaped curve(BMD increased slowly with the increase in grip strength index),with a variation range of 0.1 g/cm2.Conclusion:Grip strength of both upper limbs and grip strength index(mainly of the left side)are positively correlated with BMD,and BMD shows a linear relationship with grip strength and an L-shaped curve relationship with grip strength index.The results of this study further support the correlation between grip strength and BMD and provide important empirical data for understanding the impact of grip strength on BMD,which has important significance for further research on the regulatory mechanism of BMD and the prevention and treatment of osteoporosis.

In this work,with tris(4-aminophenyl)amine(TAPA)and 1,3,5-tris(4-formylphenyl)benzene(TFPB)as monomers,an imine-type porous organic polymer,TAPA-TFPB,was synthesized using a simple method under the catalysis of acetic acid.The material TAPA-TFPB was used as solid-phase extraction adsorbent and combined with ultra-performance liquid chromatography/quadrupole time-of-flight-tandem mass spectrometry(UHPLC-QTOF-MS)to establish a detection method for four kinds of nitrofuran metabolites(NFMs)residues in meat samples.The parameters of the adsorbent dosage,the pH value and volume of sample,and the type and volume of washing and eluent solvents were optimized,respectively.Under the optimal extraction conditions,low detection limits(0.11-1.60 μg/kg)were achieved for four kinds of NFMs.At three different spiked levels,the intra-day and inter-day precisions(Relative standard deviations)were 2.8% -10.9% and 4.3% -16.2%,respectively,and the spiked recoveries were 72.0% -107.2%.The results showed that the method chould be used for efficient extraction and analysis of trace NFMs residues in meat samples,indicating that TAPA-TFPB was a kind of promising SPE adsorbent.

Objectives:QT interval prolongation during treadmill test exercise is one of the clinical feature of patients with long QT syndrome(LQTS).This study aimed to explore the feasibility and efficacy of treadmill exercise testing as an auxiliary diagnosis tool for LQTS in clinical practice.Methods:We enrolled normal healthy individuals,common cardiovascular disease patients,and clinically diagnosed or suspected LQTS patients,who underwent treadmill exercise test from July 2023 to July 2024 at Fuwai Hospital.A special treadmill exercise testing procedure was designed to record the QT interval correction(QTc)intervals of the twelve lead electrocardiogram at 6 time points when performing the exercise tablet,including supine,sitting,standing,peak exercise,and recovery at 1-minute and 4-minute.The differences in QTc intervals among healthy group,cardiovascular diseases group,and suspected LQTS group were compared.Results:A total of 80 cases were consecutively enrolled,including 37 normal healthy controls,25 patients with common cardiovascular disease,and 18 patients with suspected LQTS.The QTc intervals at 6 points did not differ significantly between normal healthy controls and patients with cardiovascular disease,with QTc intervals less than 480 ms at all measurement.For patients with suspected LQTS,67.7%(12/18)of these patients presented a QTc interval≥480 ms at the 4-minute during recovery period.Among them,5 cases were confirmed to have pathogenic gene mutations of LQTS by genetic testing(including 1 case with a lying electrocardiogram QTc interval of 489 ms diagnosed with LQTS 1 type and a QTc interval of 636 ms during the 4-minute recovery period after exercise);5 clinically diagnosed patients(negative or undetectable in genetic testing)with a Schwartz score≥4,and the remaining 2 patients had a Schwartz score of 3.The remaining 5/18 patients,include 2 patients with clinical Schwartz scores≥4 and 3 patients with clinical suspicion(Schwartz scores 2-3)had a 4 min QTc interval of 445-480 ms during exercise recovery.Another patient with clinical suspicion(Schwartz score 3)had a 4 min QTc interval of<445 ms during exercise recovery and a negative genetic test at a later stage.Receiver operating characteristic curve analysis showed a sensitivity of 83.3%and specificity of 98.4%for QTc interval≥482 ms during the 4-minute recovery period of exercise as the LQTS diagnostic cutoff.Conclusions:This study results suggest that this special treadmill exercise testing protocol is effective in identifying LQTS and has strong feasibility and generalizability for clinical practice.