Objective: To establish an accurate and rapid typing method for Rh typing of samples from patients who have received recent blood transfusions by utilizing the difference in osmotic fragility between fresh and old red blood cells. Methods: A lysing solution suitable for destroying old RBCs was prepared. Sixty-one samples collected in our hospital in 2024 with Rh typing of double groups were treated with the lysing solution to remove the old allogeneic red blood cells while preserving the patient's own fresh red blood cells, followed by repeat Rh typing tests. Results: For 61 samples with Rh typing in double groups, 41 were accurately detected identified through the red blood cell lysis method, yielding an identification rate of 67.21%. No significant difference was observed compared to the detection rate of the commonly used capillary centrifugation modified method (χ =0.103, P>0.05). Conclusion: The red blood cell lysis method provides a novel and rapid experimental approach for clinical use in processing Rh-typed samples that are of double groups, thereby offering a basis for Rh compatibility blood transfusion.

Objective To evaluate the impact of an integrated management mode of prenatal diagnosis-postnatal treatment for congenital heart disease (CHD) on perioperative and long-term outcomes of the arterial switch operation (ASO), and to analyze the efficacy of ASO in a single center. Methods This retrospective study analyzed the clinical data of 183 children who underwent ASO at Guangdong Provincial People’s Hospital from 2018 to 2024. The cohort included 106 (57.9%) patients of transposition of the great arteries with intact ventricular septum (TGA/IVS), 61 (33.3%) patients of transposition of the great arteries with ventricular septal defect (TGA/VSD), and 16 (8.7%) patients of Taussig-bing anomaly (TBA). Perioperative indicators were compared between 91 patients in the prenatal-postnatal integrated management group (an integrated group) and 92 patients in the traditional management group (a non-integrated group). Long-term survival and reoperation rates were analyzed using Kaplan-Meier curves. Results The overall perioperative mortality rate was 4.9% (9/183), showing a downward trend year by year. The primary cause of perioperative mortality was low cardiac output syndrome (LCOS), which occurred in 12 patients (6.6% incidence) with a mortality rate of 75.0%. The integrated group had a higher proportion of males (89.0% vs. 72.8%, P<0.05) and lower body weight [3.1 (2.7, 3.3) kg vs. 3.3 (3.0, 3.7) kg, P<0.05] compared to the non-integrated group. The age at surgery was significantly earlier in the integrated group [7 (3, 10) d vs. 14 (9, 48) d, P<0.05], and all children in the integrated group underwent ASO within the optimal surgical window (100.0% vs. 82.6%, P<0.05). Intraoperatively, cardiopulmonary bypass time [173 (150, 207) min vs. 186 (159, 237) min, P<0.05] and aortic cross-clamp time [100 (90, 117) min vs. 116 (97, 142) min, P<0.05] were significantly shorter in the integrated group. Although the integrated group had longer postoperative mechanical ventilation time [145 (98, 214) h vs. 116 (77, 147) h, P<0.05] and higher 48-hour maximum vasoactive inotropic score [15 (10, 21) points vs. 12 (8, 16) points, P<0.05], there was no statistically significant difference in the incidence of severe complications (LCOS, necrotizing enterocolitis, extracorporeal membrane oxygenation) or mortality rate (3.3% vs. 6.5%, P=0.51) between the two groups, despite earlier surgical intervention and a higher proportion of critically ill cases in the integrated group. The length of hospital stay in the emergency surgery group was significantly shorter than that in the elective surgery group [20 (15, 28) d vs. 25 (21, 30) d, P<0.05], suggesting that early surgery may be of potential benefit. A total of 163 patients were successfully followed up for a median of 4.7 years, with a 5-year survival rate of 95.1% and a freedom from reintervention survival rate of 95.1%. There were no late deaths, and the most common postoperative complication was pulmonary artery stenosis. Conclusion The integrated management model allowed critically ill children with lower body weights to safely undergo surgery, significantly optimizing the timing of surgery and shortening intraoperative times. The long-term risk of reoperation after ASO is primarily concentrated on pulmonary artery stenosis, necessitating long-term follow-up and monitoring.

Objective: To evaluate the effects of a home-school collaborative intervention on improving sugar sweetened beverages (SSBs) consumption behaviors among primary school students in grades 3 to 5 in Chengdu, so as to provide evidence for SSBs prevention and control strategies among primary school students. Methods: Using a stratified cluster random sampling method, a total of 2 006 students in grades 3 to 5 from 4 primary schools in Chengdu were enrolled from October to December 2024, including an intervention group ( n =769) and a control group ( n =1 237). The control group received routine psychological counseling, while the intervention group received a comprehensive home-school collaborative intervention integrating time perspective cultivation and family functioning improvement. A two level linear mixed effects model was used to analyze the net intervention effect, and the EBICglasso algorithm was used to construct variable association networks to identify core intervention targets. Results: After adjusting for confounders and clustering effects, the intervention significantly reduced the weekly frequency of SSBs consumption (decreased from baseline by 1.29 in the intervention group, 95% CI =-1.84 to -0.73; by 0.84 in the control group, 95% CI =-1.21 to -0.46; interaction P =0.01, Cohen s d=-0.16), improved SSBs consumption behavioral intention (decreased from baseline by 0.62 in the intervention group, 95% CI =-1.26 to -0.02; by 0.14 in the control group, 95% CI =-0.57 to 0.29; interaction P =0.02, Cohen s d =-0.15) and increased family functioning level (increased from baseline by 0.34 in the intervention group, 95% CI =-0.16 to 0.85; decreased by 0.08 in the control group, 95% CI =-0.42 to 0.25; interaction P =0.01, Cohen s d =0.17). A permutation test with 1 000 iterations showed no statistically significant difference in global network strength between the two groups ( P =0.19), whereas the differences in overall network structure and maximum edge weight were both statistically significant (all P <0.05), with present hedonistic time perspective, SSBs consumption attitude and behavioral intention identified as the core intervention targets. Conclusion The comprehensive home-school collaborative intervention effectively reduces SSB consumption frequency among primary school students and improves behavioral intention and family functioning.

Objective: To eliminate the interference of daratumumab (DARA) in the titer determination of IgG antiA/antiB antibodies, resolve the discrepancy between test results and theoretical expectations, and obtain accurate and reliable test results. Methods: A group A blood sample with a positive IgG antiA titer result was confirmed to have a recent history of DARA administration. After removal of IgM antibodies from the plasma, IgG antiA/antiB titers were determined using the antiglobulin test card with a serial twofold dilution method, following pretreatment of reagent red blood cells with a rabbit antihuman CD38 functional monoclonal antibody. Results: Without pretreatment with the rabbit antihuman CD38 functional monoclonal antibody, the IgG antiA titer of the sample was 128. After pretreatment, the IgG antiA titer became negative. Conclusion: Based on the red blood cell CD38 antigen masking strategy, pretreatment of red blood cells with a rabbit antihuman CD38 functional monoclonal antibody can eliminate the interference of DARA on the titer determination of IgG antibodies, thereby providing accurate diagnostic evidence and decision support for clinical treatment.

Objective:To investigate the clinical efficacy of lumbar lateral interbody fusion (LLIF) versus posterior lumbar interbody fusion (PLIF) in the treatment of severe lumbar spinal stenosis.Methods:The data of patients with severe lumbar spinal stenosis who underwent LLIF or PLIF from February 2019 to December 2023 were retrospectively analyzed. There were 30 patients in the LLIF group, 10 males and 20 females, aged 62.7±5.6 years (range, 53-74 years), including 21 cases of single segment and 9 cases of double segment. There were 46 patients in the PLIF group, including 20 males and 26 females, aged 63.2±8.4 years (range, 43-75 years), 40 cases of single segment and 6 cases of double segment. The visual analogue scale (VAS), Oswestry disability index (ODI), intervertebral space height, intervertebral foramen height and postoperative complications were compared between the two groups.Results:All patients were followed up for an average of 21.3±6.4 months (range, 12-32 months). The intraoperative blood loss in the LLIF group was 112.2±76.9 ml, which was significantly lower than 193.9±88.2 ml in the PLIF group ( P<0.05). The VAS scores of back pain and leg pain after operation were significantly lower than those before operation in the two groups ( P<0.05). There was no statistically significant difference between groups in back pain VAS scores at preoperative, 6 months postoperative, and final follow-up ( P>0.05); the back pain VAS score at 1 month postoperatively in the LLIF group was 1.6±1.2, which was less than 2.8±0.7 in the PLIF group ( P<0.05). There was no statistically significant difference between groups in leg pain VAS scores at preoperative, 1 month postoperative, and 6 months postoperative ( P>0.05); the leg pain VAS score at the final follow-up in the LLIF group was 1.2±1.5, which was smaller than 1.8±1.0 in the PLIF group ( P<0.05). The postoperative ODI was smaller than the preoperative one in both groups, and the difference was statistically significant ( P<0.05); the preoperative, 1-month postoperative, 6-month postoperative, and final follow-up ODIs in the LLIF group were 45.7%±16.0%, 17.9%±12.0%, 16.2%±11.6%, and 15.7%±11.7%, and those in the PLIF group were 47.9%±15.4%, 20.1%±9.3%, 16.9%±10.6%, and 14.6%±11.0% in the PLIF group, and the difference between the groups was not statistically significant ( P>0.05). The preoperative intervertebral space height in the LLIF group was 10.6±2.0 mm, which was smaller than that in the PLIF group 11.8±2.2 mm ( P<0.05). The intervertebral space heights in the immediate postoperative period and at the final follow-up were 13.3±2.3 mm and 12.3±2.2 mm in the LLIF group and 13.7±1.7 mm and 13.0±1.9 mm in the PLIF group ( P>0.05). The preoperative intervertebral foraminal height in the LLIF group was 18.0±3.2 mm, which was smaller than that of 19.7±2.4 mm in the PLIF group ( P<0.05); the intervertebral foraminal heights in the immediate postoperative period and at the final follow-up were 21.4±2.5 mm and 20.2±2.4 mm in the LLIF group, and in the PLIF group were 20.7±2.4 mm and 19.7±2.6 mm in the PLIF group ( P>0.05). In the LLIF group, 2 cases had femoral nerve injury and 2 cases had transient back pain after operation. There were 2 cases of cerebrospinal fluid leakage, 1 case of screw loosening, and 2 cases of deep vein thrombosis in the PLIF group. In the PLIF group, 2 patients underwent revision, including 1 case due to cage displacement and 1 case due to screw malposition. The fusion settling rate was 21% (8/39) in the LLIF group and 12% (6/52) in the PLIF group ( P>0.05). Conclusion:Both LLIF and PLIF can effectively restore the intervertebral height, improve the lumbar function and the symptoms of back and leg pain in the treatment of severe lumbar spinal stenosis.

Objective:To investigate the risk factors for complications following lateral lumbar interbody fusion (LLIF) surgery.Methods:A retrospective analysis was conducted on 196 patients who underwent LLIF surgery via the psoas major muscle approach in the Department of Spinal Surgery, Tianjin Hospital, Tianjin University, from October 2018 to July 2024. The age, gender, body mass index (BMI), presence of hypertension, type 2 diabetes, heart disease, osteoporosis, history of lumbar surgery, history of abdominal surgery, history of abdominal inflammation, smoking status, operative time, surgical segments (whether the surgery was single-segment or multi-segments), and use of internal fixation or not were compared between patients with and without postoperative complications, the indicators with P<0.10 were included in the binary variable logistic regression analysis, and determine the independent risk factors for complications after LLIF surgery. Complications included anterior thigh symptoms (pain, numbness, weakness), cage subsidence, surgery-related complications (nerve injury, surgical site infection, postoperative buttock pain, urinary and fecal incontinence, etc.), and medical complications (cerebrovascular accident, deep vein thrombosis, urinary tract infection, etc.). Results:All 196 patients were followed up for 27.02 (12.6, 40.69) months. Postoperative complications occurred in 71 cases (96 times), and no complications occurred in 125 cases. In the complication group, there were 15 males and 56 females with a mean age of 61.82±7.57 years; in the non-complication group, there were 43 males and 82 females with a mean age of 62.00± 8.39 years. In the complication group, there were 43 cases of anterior thigh symptoms, 38 cases of cage subsidence, 11 cases of surgical operation-related complications, and 4 cases of medical complications. There were statistically significant differences in gender (χ 2=3.829, P=0.051), operation time ( t=2.391, P=0.018), and surgical segment (χ 2=4.245, P=0.039) between the complication group and the non-complication group. No statistically significant differences were found in age, gender, BMI, presence of hypertension, type 2 diabetes, heart disease, osteoporosis, history of lumbar surgery, history of abdominal surgery, history of abdominal inflammation, smoking status, or use of internal fixation ( P>0.10). Binary variable logistic regression analysis indicated that prolonged operative time [ OR=1.007, 95% CI(1.001, 1.013), P=0.019] and multilevel surgery [ OR=2.099, 95% CI(1.095, 4.025), P=0.026] were independent risk factors for complications following LLIF. Conclusion:Prolonged operative time and multi-segments surgery are independent risk factors for complications following LLIF.

Objective To conduct a Meta-analysis on the efficacy and safety of traditional Chinese medicine for soothing the liver for soothing the liver in the treatment of double heart disease.Methods China National Knowledge Infrastructure(CNKI),VIP Database,Wanfang Database,China Biology Medicine disc(CBMdisc),Chinese Clinical Trial Registry,PubMed Database,Cochrane Library were searched.Randomized controlled trials on the treatment of cardiovascular diseases combined with mental disorders(anxiety and depression,etc.)with traditional Chinese medicine for soothing the liver were collected from March 28,2025.The control group received conventional treatment,while the observation group was treated with additional soothing the liver traditional Chinese medicine in addition to the conventional therapy.The outcome indicators included the overall clinical efficacy,the score of the self-rating depression scale(SDS),the score of the self-rating anxiety scale(SAS),and the incidence of adverse reactions.A Meta-analysis was conducted using Stata 15.0 statistical software,and a funnel plot was drawn to evaluate publication bias in the literature.Results A total of 14 literatures were included,all of which were in Chinese.The results of the Meta-analysis showed that compared with the control group,the observation group treated with addition traditional Chinese medicine for soothing the liver could effectively improve the clinical efficacy[odds ratio(OR)=2.14,95%confidence interval(95%CI)was1.71-2.68,P=0.00],and improve the depressive and anxious state of patients[depression:Standardized mean difference(SMD)=-2.00,95%CI was-2.92 to-1.07,P=0.00;anxiety:SMD=-1.88,95%CI was-2.42 to-0.99,P=0.00].The incidence of adverse reactions in the experimental group was significantly lower than that in the control group(16.1%vs.34.0%,χ2=29.347,P<0.05).Conclusion The total effective rate and safety of patients treated with traditional Chinese medicine for soothing the liver on the basis of conventional treatment are higher.

Objective:To analyze the clinical characteristics of renal abscess in children and provide suggestions for early diagnosis and treatment.Methods:The clinical data including general information, laboratory data, imaging results, treatment and prognosis of 20 pediatric patients with renal abscess admitted to the Department of Nephrology, Capital Center for Children's Health Capital Medical University were analyzed retrospectively.Results:A total of 8 males and 12 females were enrolled. The age of onset was 3.0 (0.8, 9.0) years. All cases had fever. Six cases presented with abdominal pain, 6 cases had poor appetite, 5 cases had vomiting and 5 cases urinary tract irritation symptoms. Laboratory data showed elevated white blood cells 20.4 (17.4,26.3)×10 9/L, C-reactive protein 126 (77, 154)mg/L, erythrocyte sedimentation rate 60 (41,73) mm/1 h in 20 cases and procalcitonin 4.7 (1.2,33.5)μg/L in 10 cases. Totally 18 cases had pyuria. Urine culture was positive in 8 cases. Enterococcus faecium and Pseudomonas aeruginosa was detected in 2 cases. Klebsiella pneumoniae was found in 1 case after performing blood culture. Renal abscess was confirmed in all cases by doing contrast-enhanced CT scan, while only 9 cases with abscesses were identified by using renal ultrasound. There were 14 cases with renal abscess formation confirmed at onset by performing magnetic resonance imaging. Nine cases were accompanied with congenital anomalies of the kidney and urinary tract. All cases received conservative medical treatment. Intravenous broad-spectrum antibiotics were administered for 23 (14, 39) d initially, while the medication in 11 cases were upgraded to meropenem or imipenem. Oral antibiotics were continued for 23 (14, 28) d after discharge in all cases. Within 1 year of follow-up, except for 1 case of recurrence, the others had a favorable prognosis. Conclusions:Renal abscess should be suspected for children presenting with unexplained fever, vomiting, abdominal pain, elevated white blood cell count, C-reactive protein, erythrocyte sedimentation rate and pyuria. Ultrasonography is suitable for screening and follow-up, while CT or magnetic resonance imaging can be used to confirm the diagnosis. Conservative management with broad-spectrum antibiotics is effective and can be considered the first-line therapy for pediatric renal abscess.

Objective To explore the expression of pepsinogen Ⅰ/Ⅱ(PG Ⅰ/PG Ⅱ),nucleosome assembly protein 1 like protein 1(NAP1L1),and SERPINB5 in the serum of gastric cancer patients and their correlation with prognosis.Methods From February 2019 to February 2022,200 gastric cancer patients admitted to Zhuozhou Hospital were served as the gastric cancer group and another 100 patients with benign gastric lesions who received the treatment at Zhuozhou Hospital during the same period were served as the benign group,with 200 healthy adults as the control group.Chemiluminescence and ELISA methods were used to detect the serum PG Ⅰ/PG Ⅱ,NAP1L1,and SERPINB5.ROC curve was used to explore the diagnostic value.Kaplan-Meier method was used to explore the survival curve.Moreover,multivariate Cox method was used to analyze the factors that affected the prognosis.Results Compared with the control group,the benign group and gastric cancer group had the lower serum PGⅠ/PG Ⅱ and higher serum NAP1L1 and SERPINB5,and the difference was statistically significant(P<0.05).Compared with the benign group,the gastric cancer group had the lower serum PG Ⅰ/PG Ⅱ and higher serum NAP1L1 and SERPINB5,and the difference was statistically significant(P<0.05).PG Ⅰ/PG Ⅱ,NAP1L1,and SERPINB5 were all influential factors in gastric carcinogenesis(P<0.05).The AUC values of serum PG Ⅰ/PG Ⅱ,NAP1L1,and SERPINB5 alone in the diagnosis of gastric cancer were 0.821,0.808,and 0.833,respectively.The AUC of the combination of the three was 0.916,indicating that their combined diagnostic value was superior(Z=3.142,3.896,3.114,P<0.05).During the 3-year follow-up period of gastric cancer patients,57 cases died,accounting for 28.50%(57/200),and 143 cases survived.Patients with the high expression of PG Ⅰ/PG Ⅱ had a higher 3-year overall survival rate after the surgery compared to those with low expression,and the difference was statistically significant(χ2=7.830,P<0.05);and patients with the low expression of NAP1L1 and SERPINB5 had a higher 3-year overall survival rate after the surgery compared to those with high expression,and the difference was statistically significant(χ2=8.612,13.321,P<0.05).The serum PG Ⅰ/PG Ⅱ levels in the death group were lower than those in the survival group,and the serum NAP1L1,SERPINB5 levels were higher in patients with preoperative lymph node metastasis and TNM stage Ⅲ-Ⅳ than those in the survival group,and the difference was statistically significant(P<0.05).Elevated level of PG Ⅰ/PG Ⅱ was a protective factor for the prognosis of gastric cancer patients,while preoperative lymph node metastasis,elevated levels of NAP1L1 and SERPINB5 were risk factors affecting the prognosis of gastric cancer patients(P<0.05).Conclusion Serum PG Ⅰ/PG Ⅱ levels are decreased and NAP1L1 and SERPINB5 levels are increased in gastric cancer patients,and NAP1L1 and SERPINB5 are risk factors affecting the prognosis of gastric cancer patients,while PG Ⅰ/PG Ⅱ is a protective factor.

Objective:To explore the diagnostic value and clinical application of metagenomic next-generation sequencing (mNGS) technology in pediatric urinary tract infections (UTI).Methods:In this retrospective study, the clinical data of children with UTI admitted to the Department of Nephrology, Children′s Hospital, Capital Institute of Pediatrics, from March 2023 to March 2024 were collected.The positive detection rates, timeliness, and consistency of mNGS technology were compared with those of urine culture.Measurement data were subject to test of normality.The independent sample t test, Chi-square test or Fisher′s exact probability test were used for comparison between groups. Results:A total of 193 patients were included.The positive detection rate of urine culture was 36.3% (70/193).Among 42 patients who underwent mNGS testing, 37 cases (88.1%) tested positive.The positive detection rate of mNGS was significantly higher than that of urine culture ( χ2=37.357, P<0.001).It took significantly less time to report mNGS results than to report urine culture results ( Z=3.524, P<0.001).In the 42 cases that underwent mNGS testing, 5 cases (11.9%) were negative for urine pathogens by both methods, and 21 cases (50.0%) were positive by mNGS but negative by urine culture.Among the remaining 16 cases (38.1%) positive by both mNGS and urine culture, 14 cases (33.3%) achieved fully matching results, 1 case (2.4%) was fully mismatched, and 1 case (2.4%) was partially matched.Comparison of the positive detection rate and the duration of anti-infective treatment prior to specimen collection between urine culture and mNGS showed that the median durations for urine culture and mNGS positivity were 5 and 20 days, and the difference was statistically significant ( χ2=0.537, P<0.001). Conclusions:mNGS technology has high sensitivity for diagnosing pathogens in pediatric UTI.Compared with urine culture, mNGS provides good consistency and significantly shortens the detection time.The positive detection rate is less affected by antimicrobial treatment.For children with UTI, especially those who have failed empirical anti-infective treatment and whose pathogen cannot be identified by urine culture, mNGS testing is recommended as early as possible.