Objective: To analyze a case of hemolytic disease of the fetus and newborn (HDFN) caused by anti-Jk3 antibody, which was induced in a rare Jk (a-b-) blood type resulting from a gene mutation in the Kidd blood group system, so as to provide a reference for the diagnosis and treatment of HDFN associated with this antibody. Methods: HDFN-related blood group serological testing, antibody identification and specific blood group antigen identification were performed on blood samples from the infant and the mother. The mother's Kidd blood group was analyzed by molecular biology methods. Clinical data of the infant and the mother were collected, and changes in bilirubin, hemoglobin (Hb), and other results during the disease progression of the infant were analyzed. Results: The infant was blood type B, Rh (D) positive, and Kidd blood group Jk (a-b+). The mother was blood type O, Rh (D) positive. Due to an IVS5-1 G>A mutation, the mother exhibited a Jk (a-b-) phenotype. Anti-Jk3 antibodies were detected in the mother's plasma. The infant was diagnosed with HDFN due to anti-Jk3. During treatment, the total bilirubin (TBil) and indirect bilirubin (IBil) levels of the infant initially increased and then decreased, with peak monitored values of 228.2 μmol/L and 208.9 μmol/L, respectively. Hb decreased from 180 g/L at birth to 93 g/L. After phototherapy and symptomatic treatment, the infant's indicators stabilized, and the general condition improved. The infant was discharged after recovery. Conclusion: Clinically, HDFN caused by anti-Jk3 antibodies is relatively rare. For HDFN induced by this antibody, early detection, intervention, and treatment are essential to address the transfusion challenges posed by the extreme scarcity of Jk3-negative blood sources, thereby minimizing adverse outcomes in affected infants to the greatest extent possible.

Objective To explore the method for establishing a pig left lung orthotopic transplantation model. Methods A total of 4 male Yorkshire pigs weighing (40.0±2.5) kg underwent surgical procedures, including anesthesia, tracheal intubation, donor lung procurement, and recipient lung transplantation. Histological morphology and blood gas analysis of the transplanted lungs were assessed 2 hours after reperfusion to evaluate the histological changes and function of the transplanted lungs. Results The pigs underwent left lung in situ transplantation, effectively simulating conditions relevant to human lung transplantation. Two hours after the transplantation, arterial blood gas analysis showed that arterial partial pressure of oxygen was 155.4-178.6 mm Hg, arterial partial pressure of carbon dioxide was 53.1-62.4 mm Hg, and the oxygenation index was 310.8-357.2 mm Hg. Hematoxylin and eosin staining indicated a low degree of pulmonary edema and minimal cellular infiltration. Conclusion The pig left lung orthotopic transplantation model possesses strong operability and stability. Researchers can replicate this model according to the described methods and further conduct basic research and explore clinical translational applications.

ObjectiveTo investigate the epidemic trends, key populations, and high-risk area characteristics of hand-foot-mouth disease (HFMD) in Ningbo from 2018 to 2023, and to provide evidence-based references for optimizing prevention strategies and precise allocation of prevention and control resources. MethodsData on HFMD cases with current addresses in Ningbo from 2018 to 2023 were collected from the China Information System for Disease Control and Prevention. Descriptive epidemiological methods were used to analyze the epidemiological characteristics of HFMD. Global spatial autocorrelation analyses were applied to detect spatial clustering of HFMD, and spatiotemporal scan analyses were conducted to identify spatiotemporal clusters. ResultsA total of 116 967 HFMD cases, were reported of which 2 were severe and none were fatal. The average annual incidence rate was 206.33 per 100 000 population, showing an overall declining trend. Seasonal patterns were observed, with bimodal distributions in 2018, 2019, 2021, and 2022 (main peak from May to July; secondary peak from September to November), and unimodal distributions in 2020 (peak from October to December) and 2023 (peak from July to October). Children aged 5 years and under accounted for the majority of cases (104 634 cases, 89.46%), with a mean age of (3.48±3.29) years. The male-to-female ratio was 1.44∶1. Children cared for at home (56.39%) and those attending kindergarten (35.97%) were the predominant populations. The highest average incidence rate was observed in Ninghai County (261.46/100 000), and the lowest in Fenghua District (152.46/100 000), while the average incidence rates in most districts/counties ranged from 188.22 to 226.53 per 100 000 population. The highest incidence rate was observed in areas classified as urban-rural fringes (240.08 per 100 000 population). Spatial analyses revealed global clustering in 2020 (Moran’s I=0.35, P<0.05), with hotspots concentrated in Ninghai county and Xiangshan county. Spatiotemporal scan analyses identified significant clusters each year from 2018 to 2023. The strongest cluster was detected in Cixi City from May to September in 2018 (LLR=27 249.53, RR=13.06, P<0.01), followed by Yinzhou District from April to October in 2019 (LLR=25 172.16, RR=10.61, P<0.01). ConclusionThe overall incidence of HFMD in Ningbo City shows a declining trend. The disease shows bimodal (spring-summer and autumn-winter) or unimodal (autumn-winter) seasonal patterns. Cases are predominantly seen in boys aged 5 years and under, and who are cared for at home or attend kindergarten、 High-risk areas are concentrated in southern counties (Ninghai and Xiangshan). It is recommended to strengthen health education and vaccination coverage for children aged 5 years and under, and to implement dynamic surveillance and targeted interventions in key areas during high-incidence seasons, so as to reduce transmission and spread.

Turning to critical illness is a common stage of various diseases and injuries before death. Patients usually have complex health conditions, while the treatment process involves a wide range of content, along with high requirements for doctor′s professionalism and multi-specialty teamwork, as well as a great demand for time-sensitive treatments. However, this is not matched with critical care professionals and the current state of medical care in China. Telemedicine, which shortens the distance of medical professionals and the gap of disease diagnosis and treatments in various regions through electronic information, can effectively solve the current problem. Therefore, there is an urgent need to develop a standardized, high-quality visualization telemedicine round system .Therefore, experts have been organized to search domestic and foreign literature on telemedicine round for critically ill patients and to form this consensus based on clinical experiences so as to further improve the level of critical care treatments in regions.

Objective To explore the efficacy of goal management training(GMT)on core symptoms and mental status in college students with attention deficit hyperactivity disorder(ADHD)inattentive type.Methods Delphi method was used to construct a GMT program for college students with inattentive ADHD.Then,totally 68 college students with inattentive ADHD were recruited through advertisements published by hospitals and universities(Second Affiliated Hospital of Army Medical University,and 3 universities in Chongqing from March to June 2024.The subjects were randomly divided into an intervention group(n=34)and a control group(n=34).The intervention group received GMT for 2 h,once a week,for 7 weeks,and the control group did not receive training for the time being.The 2 groups were evaluated within 1 week before and in 7 weeks after intervention by using Adult ADHD Self-Report Scale(ASRS),Dysregulation of Emotions Rating Scale(DERS),Generalized Anxiety Disorde-7(GAD-7),Patient Health Questionnaire-9(PHQ-9),Self-Compassion Scale(SCS),and Satisfaction with Life Scale(SWLS).Results ① The expert authority coefficient(Cr)of 2 rounds of expert consultation was 0.83,with a questionnaire recovery rate of 100%and 95%,respectively,the Kendall's coordination coefficient was 0.081(P<0.01)and 0.226(P<0.01),and the coefficient of variation was<0.3,indicating the results of the expert consultation were reliable.The constructed GMT program includes 1 first-level indicator,7 second-level indicators,and 20 third-level indicators.② After 7 weeks of GMT intervention,the interaction between the 2 groups and time showed that the experimental group obtained significant improvements than the control group in terms of inattention symptoms(Wald Chi-square=28.35,P<0.001),dysregulation of emotions(Wald Chi-square=23.81,P<0.001),anxiety(Wald Chi-square=22.79,P<0.001),depression(Wald Chi-square=20.52,P<0.001),self-compassion(Wald Chi-square=9.36,P<0.01),and life satisfaction(Wald Chi-square=3.97,P<0.05).Conclusion GMT intervention can significantly improve the core symptoms of college students with inattentive ADHD,reduce anxiety and depression levels,enhance their emotion regulation and self-compassion abilities,and improve their life satisfaction.

Objective:To explore the key factors affecting health-related quality of life in children with brain tumors following initial diagnosis and to analyze its impact on survival and prognosis.Methods:Seventy-eight pediatric brain tumor patients who participated in a prospective cohort study between June 1st，2016 and June 30th，2021 were included for health-related quality of life assessment and long-term follow-up（median follow-up duration：52 months）.Results:The male-to-female ratio among the 78 children was 1.1：1，with a median age of 7.0（4.0，10.0）years. The scores of the Pediatric Quality of Life Inventory? 4.0 Generic Core Scales（PedsQL? 4.0）were（67.40±18.26）for parent proxy reports and（67.87±20.40）for child self-reports. Cronbach's α coefficients ranged from 0.790 to 0.927，with the intraclass correlation coefficient（ICC）was 0.673. According to the PedsQL? 4.0，impaired quality of life was observed in 50.0% of children by parent proxy report and 52.8% by child self-report，primarily affecting physical and role functioning. In addition，70% of caregivers reported impaired quality of life，with worry being the most prominent issue. Key factors affecting children's quality of life included radiotherapy，tumor stage，annual family income，and parents' marital status，while caregivers' quality of life was influenced by radiotherapy and the child's IgA levels（all P<0.05）. Children with decreased total scores，impaired physical functioning，or impaired emotional functioning on the PedsQL? 4.0 parent proxy report exhibited an increased risk of mortality（all P<0.05）. In multivariate Cox regression analysis，independent prognostic factors included a decrease in the total score on the PedsQL? 4.0 parent proxy report（ HR=6.702，95% CI：1.442-31.151， P<0.05），presence of hydrocephalus（ HR=33.602，95% CI：4.354-259.333， P<0.05），tumor recurrence（ HR=16.846，95% CI：3.158-89.852， P<0.05），and absence of hydrocephalus shunt surgery（ HR=13.428，95% CI：1.761-102.394， P<0.05）. Conclusion:The quality of life of newly diagnosed children with brain tumors is lower than that of healthy children，and quality of life is an important prognostic factor. Quality of life assessment should be an integral component of a comprehensive management program for children with brain tumors.

Gene regulation relies on the precise binding of transcription factors (TFs) at regulatory elements, but simultaneously detecting hundreds of TFs on chromatin is challenging. We developed cFOOT-seq, a cytosine deaminase-based TF footprinting assay, for high-resolution, quantitative genome-wide assessment of TF binding in both open and closed chromatin regions, even with small cell numbers. By utilizing the dsDNA deaminase SsdAtox, cFOOT-seq converts accessible cytosines to uracil while preserving genomic integrity, making it compatible with techniques like ATAC-seq for sensitive and cost-effective detection of TF occupancy at the single-molecule and single-cell level. Our approach enables the delineation of TF footprints, quantification of occupancy, and examination of chromatin influences on TF binding. Notably, cFOOT-seq, combined with FootTrack analysis, enables de novo prediction of TF binding sites and tracking of TF occupancy dynamics. We demonstrate its application in capturing cell type-specific TFs, analyzing TF dynamics during reprogramming, and revealing TF dependencies on chromatin remodelers. Overall, cFOOT-seq represents a robust approach for investigating the genome-wide dynamics of TF occupancy and elucidating the cis-regulatory architecture underlying gene regulation.
Transcription Factors/genetics* ; Humans ; Chromatin/genetics* ; Animals ; Binding Sites ; Mice ; DNA Footprinting/methods*

Objective To investigate the correlations of fibrinogen-to-albumin ratio(Fib/Alb),soluble myeloid cell triggering receptor-like transcript factor-1(sTLT-1)and neutrophil gelatinase-as-sociated lipocalin(NGAL)in peripheral blood at admission with the risk of poor prognosis in patients with acute thoracoabdominal trauma and their early warning values.Methods A prospective study was conducted in 152 patients with acute thoracoabdominal trauma in the hospital from January 2022 to May 2024.The patients were divided into good prognosis group(n=120)and poor prognosis group(n=32)according to their prognosis.Baseline data and the levels of Fib/Alb,sTLT-1 and NGAL in peripheral blood at admission were compared between the two groups.The relationships between the levels of Fib/Alb,sTLT-1,and NGAL in peripheral blood at admission and the severity of trauma[the Circulation,Respiration,Abdomen,Movement,and Speech(CRAMS)score]and the risk of poor prognosis were analyzed.The early warning values of the levels of Fib/Alb,sTLT-1 and NGAL in peripheral blood at admission for the risk of poor prognosis were evaluated.Results The time from injury to admission in the poor prognosis group was longer than that in the good prognosis group,the CRAMS score,the Glasgow Coma Scale(GCS)score,and the levels of Fib,Alb and Fib/Alb in peripheral blood at admission in the poor prognosis group were lower than those in the good prognosis group,while the Sequential Organ Failure Assessment(SOFA)score and the levels of sTLT-1 and NGAL in peripheral blood at admission were higher than those in the good prognosis group,with statistically significant between-group differences(P＜0.05).The levels of Fib,Alb and Fib/Alb in peripheral blood at admission showed a decreasing trend,while the levels of sTLT-1 and NGAL showed an increasing trend in patients with mild,severe,and extremely severe trauma,with statistically significant differences(P＜0.05).Pearson correlation analysis showed that the level of Fib/Alb in peripheral blood at admission(r=0.839)was positively correlated with the CRAMS score,while the levels of sTLT-1 and NGAL(r=-0.832,-0.808)were negatively cor-related with the CRAMS score(P＜0.05).Logistic regression analysis showed that after adjusting for confounding factors,the levels of Fib/Alb(OR=0.769),sTLT-1(OR=1.562)and NGAL(OR=1.575)in peripheral blood at admission were still independently correlated with the risk of poor prognosis(P＜0.05).The receiver operating characteristic(ROC)curve showed that the area under the curve(AUC)for the combined early warning of the risk of poor prognosis by the levels of Fib/Alb,sTLT-1,and NGAL in peripheral blood at admission was 0.918,which was superior to the early warning value of individual indicators(Z=2.992,2.291,2.082,P＜0.05).Conclusion The levels of Fib/Alb,sTLT-1 and NGAL in peripheral blood are closely related to the severity of trauma and prognosis in patients with acute thoracoabdominal trauma.Combined detection has a certain ear-ly warning value for the risk of poor prognosis and can be used as potential factors for clinical assess-ment of trauma condition and early warning of the risk of poor prognosis.

Objective: To investigate the value of metagene next⁃generation sequencing ( mNGS) in the detection of pathogens in patients with pulmonary infection. Methods: A retrospective analysis was performed on clinical data from 434 patients with pulmonary infections admitted over the past four years. Based on the presence of underlying comorbidities , patients were divided into underlying disease group (n = 262) and non⁃underlying disease group (n = 172) . Pathogen detection was conducted using both mNGS and conventional tests. Clinical and laboratory parameters , radiographic findings , and pathogen detection results were systematically analyzed. The diagnostic performance of the two methods in identifying causative pathogens of pulmonary infections was compared. Results: The positive rate of mNGS in 434 patients was higher than that of conventional tests , and the difference was statisti⁃cally significant (P < 0. 05) . The efficacy of mNGS in detecting bacteria and viruses was significantly higher than that of conventional tests , and the difference was statistically significant (P < 0. 05) . Although the fungal detection rate of mNGS was higher than that of conventional tests , the difference was not statistically significant. Among them , the detection rates of Mycobacterium tuberculosis , Mycoplasma pneumoniae , Haemophilus influenzae , Strepto⁃ coccus pneumoniae , Streptococcus constellation , Staphylococcus aureus and Aspergillus fumigatus were significantly higher than those of conventional tests , and the difference was statistically significant (P < 0. 05) . Subgroup analy- sis showed that the proportion of males , hospital stay , smoking prevalence and average age in the underlying dis- ease group were higher than those in the non-underlying disease group , and the difference was statistically signifi- cant (P < 0. 05) , while there were no significant differences in antibiotic use and endotracheal intubation rate be- tween the two groups. The most common pathogens detected by mNGS in the underlying disease group were Myco⁃ bacterium tuberculosis , Haemophilus influenzae , Streptococcus pneumoniae , Pseudomonas aeruginosa , human herpes⁃ virus type 4 and Aspergillus fumigatus , while the most common pathogens in the non-underlying disease group were Mycobacterium tuberculosis , Haemophilus influenzae , Streptococcus pneumoniae , Mycoplasma pneumoniae and Kleb⁃ siella pneumoniae. The positive rate of mNGS in the two groups was significantly higher than that of conventional tests , and the difference was statistically significant (P < 0. 05) , while the difference in the positive rate of mNGS between the two groups was not statistically significant. Conclusion mNGS has significant advantages over con- ventional tests of pathogen in lung infection , and is less affected by underlying diseases , which can provide an etio- logical basis for lung infection.