Objective: To analyze the distribution characteristics of unexpected antibodies among voluntary blood donors at a hospital in Beijing, with a focus on the seasonal distribution patterns of natural antibodies represented by the MNS and Lewis systems, as well as their correlation with concurrent local epidemic trends of the influenza virus, so as to provide a scientific basis for clinical transfusion safety early-warning and management strategies. Methods: A total of 82 780 voluntary blood donors from March 2023 to February 2026 at our hospital were enrolled. Positive screening for unexpected antibodies was identified through ABO blood group re-evaluations and minor crossmatch incompatibilities. Based on climatological seasonal definitions—spring (March to May), summer (June to August), autumn (September to November), and winter (December to February of the following year) —differences in the detection rates of various antibody classifications across different seasons were compared. Local influenza surveillance data from the same period were collected, and their correlation with the positive rate of influenza virus was analyzed. Results: A total of 98 cases (0.12%) positive for unexpected antibodies were identified among the 82 780 blood donors, including 87 cases with specific antibodies. The MNS system antibodies (anti-M) accounted for the highest proportion (54 cases, 55.10%). The detection rate of unexpected antibodies was significantly different in different seasons (P<0.05), and the detection rate in winter was significantly higher than that in spring, summer, and autumn (P<0.05). Correlation analysis showed that the monthly detection rate of total unexpected antibodies was positively correlated with the positive rate of influenza virus (r=0.423, P=0.010); The correlation between the monthly detection rate of unexpected antibodies and the positive rate of influenza virus in Lewis system (r=0.398, P=0.016) and MNS system (r=0.389, P=0.019) was statistically significant; However, no correlation was found for other antibodies such as those of the Rh system (P>0.05). Conclusion: The detection of unexpected antibodies in voluntary blood donors showed significant aggregation in winter, and was ecologically correlated with the positive rate of influenza virus in the region at the population level, which was more obvious in MNS and Lewis blood group system antibodies. These results suggest that influenza virus infection may have a potential impact on the expression of natural antibodies. Enhancing unexpected antibody identification and early warning for clinical crossmatch risks during winter is of great significance for ensuring the safety of clinical blood transfusion.

Objective: To investigate the molecular mechanism of ABO blood type gene c. 899G>A leading to the occurrence of subtype A. Methods: Serological methods were used to identify ABO blood types. Genotyping was performed using polymerase chain reaction sequence specific (PCR-SSP) kits, and Sanger sequencing was used to analyze the ABO gene exons 1-7. PacBio third-generation sequencing was employed for ABO gene full-length haplotype analysis. AlphaFold3 was used to predict protein structure, and ChimeraX software was used to analyze the impact of amino acid changes caused by base mutations on protein structure. Results: The patient exhibited group O of forward typing and group A of reverse typing. Weak A. antigen was detected by absorption-elution test. Molecular biology detection revealed three mutation sites, c. 261delG, c. 297A>G, and c. 899G>A. Third-generation sequencing showed that one haplotype was recombinant ABO O.01.01 and the other haplotype was recombinant ABO B.01-O.01.01, with c. 297A>G and c. 899G>A located on this recombinant haplotype. Protein structure prediction indicated that c. 899G>A resulted in premature termination codons and translation interruption of ABO blood group genes, leading to a 55 amino acid deletion at the C-terminus. Conclusion: The c. 899G>A mutation in the ABO gene of the patient resulted in reduced A antigen expression and an A subtype phenotype.

[Abstract] [Objective] To compare and analyze the efficacy of platelet transfusion in patients with different doses, and to analyze the risk factors for platelet transfusion refractoriness. [Methods] A total of 5 827 patients who received platelet transfusion in the PLA General Hospital from May 2023 to May 2024 were selected as the research subjects, among which 4 780 patients were transfused with 1 therapeutic dose of platelets, and 1 047 patients were transfused with 0.5 therapeutic dose of platelets, and the efficacy of platelet transfusion was compared between the two groups. The effects of gender, disease type, white blood cell count before transfusion, fever, number of platelet transfusions, and platelet antibodies on platelet transfusion refractoriness were analyzed using univariate analysis, and the independent risk factors affecting platelet transfusion refractoriness were further analyzed by multivariate logistic regression. [Results] Among 4 780 patients, 3553 (74.3%) were effective and 1 227 (25.7%) were ineffective. Among 1 047 patients, 0.5 platelet infusion was effective in 755 cases (72.1%) and ineffective in 292 cases (27.9%). There was no significant difference in the effective rate of platelet transfusion between the two groups (P>0.05). Univariate analysis showed that the therapeutic effect of platelet transfusion was related to age, the number of platelet transfusion, disease type, platelet antibodies and white blood cell count before transfusion (P<0.05), while age, gender, fever and blood type were not related to the therapeutic effect of platelet transfusion (P>0.05). The results of multi-factor analysis showed that age, white blood cell count >50×10⁹/L, platelet transfusion times, disease type and platelet antibody were independent risk factors for ineffective transfusion (P<0.05). [Conclusion] There is no significant difference in the efficacy of platelet infusion with 0.5 therapeutic dose or 1 therapeutic dose. In addition, age, white blood cell count >50×10⁹/L, the number of platelet transfusion, disease type and platelet antibodies were the factors affecting the ineffective platelet transfusion in group 2.

Objective:To investigate the sensitivity of tumor organoids derived from samples of colorectal cancer to lobaplatin and oxaliplatin hyperthermic perfusion in vitro and to assist clinical development of hyperthermic intraperitoneal chemotherapy. Method:Tumor samples and relevant clinical data were collected from patients with pathologically confirmed colorectal cancer in the Sixth Affiliated Hospital of Sun Yat-sen University from July 2021 to December 2022. Organoids were cultured and tumor tissue were passaged. In vitro hyperthermic perfusion experiments were performed on organoids with good viability. Firstly, 10 organoids were treated with oxaliplatin and lobaplatin at the following six concentrations: 1 000, 250, 62.5, 15.6, 3.9, and 0.98 μmol/L. The organoids were exposed to oxaliplatin at 42℃ for 30 minutes and to lobaplatin at 42℃ for 60 minutes. Dose-response curves of responses to in vitro hyperthermic perfusion with these two drugs were constructed and evaluated. Clinical doses of oxaliplatin and lobaplatin were further tested on 30 organoids. This testing revealed oxaliplatin was effective at 579 μmol/L at a hyperthermic perfusion temperature of 42℃ for 30 min and lobaplatin was effective at 240 μmol/L at a hyperthermic perfusion temperature of 42℃ for 60 minutes. Result:Thirty-two tumor organoids were cultured from samples of colorectal cancer. The median concentration required for oxaliplatin to eliminate 50% of tumor cells (IC50) was 577.45 μmol/L (IQR: 1846.09 μmol/L). The median IC50 for lobaplatin was 85.04 μmol/L (IQR: 305.01 μmol/L).The difference between the two groups was not statistically significant ( Z=1.784, P=0.084). In seven of 10 organoids, lobaplatin showed a greater IC50 after in vitro hyperthermic perfusion than did oxaliplatin. Testing of 30 organoids with clinical doses of oxaliplatin and lobaplatin revealed that oxaliplatin achieved an average inhibition rate of 39.6% (95%CI: 32.1%?47.0%), whereas the average rate of inhibition for lobaplatin was 89.7% (95%CI: 87.0%?92.3%): this difference is statistically significant ( t=?15.282, P<0.001). Conclusion:The rate of inhibition achieved by hyperthermic perfusion of lobaplatin in vitro is better than that achieved by hyperthermic perfusion with oxaliplatin. Lobaplatin is more effective than oxaliplatin when administered by hyperthermic intraperitoneal perfusion and therefore has the potential to replace oxaliplatin in this setting.

Objective:To investigate the sensitivity of tumor organoids derived from samples of colorectal cancer to lobaplatin and oxaliplatin hyperthermic perfusion in vitro and to assist clinical development of hyperthermic intraperitoneal chemotherapy. Method:Tumor samples and relevant clinical data were collected from patients with pathologically confirmed colorectal cancer in the Sixth Affiliated Hospital of Sun Yat-sen University from July 2021 to December 2022. Organoids were cultured and tumor tissue were passaged. In vitro hyperthermic perfusion experiments were performed on organoids with good viability. Firstly, 10 organoids were treated with oxaliplatin and lobaplatin at the following six concentrations: 1 000, 250, 62.5, 15.6, 3.9, and 0.98 μmol/L. The organoids were exposed to oxaliplatin at 42℃ for 30 minutes and to lobaplatin at 42℃ for 60 minutes. Dose-response curves of responses to in vitro hyperthermic perfusion with these two drugs were constructed and evaluated. Clinical doses of oxaliplatin and lobaplatin were further tested on 30 organoids. This testing revealed oxaliplatin was effective at 579 μmol/L at a hyperthermic perfusion temperature of 42℃ for 30 min and lobaplatin was effective at 240 μmol/L at a hyperthermic perfusion temperature of 42℃ for 60 minutes. Result:Thirty-two tumor organoids were cultured from samples of colorectal cancer. The median concentration required for oxaliplatin to eliminate 50% of tumor cells (IC50) was 577.45 μmol/L (IQR: 1846.09 μmol/L). The median IC50 for lobaplatin was 85.04 μmol/L (IQR: 305.01 μmol/L).The difference between the two groups was not statistically significant ( Z=1.784, P=0.084). In seven of 10 organoids, lobaplatin showed a greater IC50 after in vitro hyperthermic perfusion than did oxaliplatin. Testing of 30 organoids with clinical doses of oxaliplatin and lobaplatin revealed that oxaliplatin achieved an average inhibition rate of 39.6% (95%CI: 32.1%?47.0%), whereas the average rate of inhibition for lobaplatin was 89.7% (95%CI: 87.0%?92.3%): this difference is statistically significant ( t=?15.282, P<0.001). Conclusion:The rate of inhibition achieved by hyperthermic perfusion of lobaplatin in vitro is better than that achieved by hyperthermic perfusion with oxaliplatin. Lobaplatin is more effective than oxaliplatin when administered by hyperthermic intraperitoneal perfusion and therefore has the potential to replace oxaliplatin in this setting.

Diabetes, hypertension, and dyslipidemia, collectively referred to the " Three Highs, " represent increasingly prevalent metabolic risk factors in China. Many individuals experience all three conditions concurrently, significantly heightening the risk of cardiovascular disease and mortality. Although the National Metabolic Management Center(MMC) has been established for over eight years and has its unique features, the awareness, treatment, and control rates of these diseases in China remain low, and the efficiency of community management is insufficient. According to the previous two editions of management guidelines and the most recent domestic and international diagnostic and treatment guidelines, this paper conducts an in-depth analysis of the operational experience and management strategies of the MMC. Its aim is to improve the efficiency of grassroots MMC mode management for " Three Highs" patients and ensure that patients receive more standardized management.

Objectives:To investigate the binary coping mode of hospitalized patients with digestive system tumors and their spouses,and its relationship with anxiety and depression symptoms in both spouses,aiming to provide a reference for medical staff to develop intervention plans to improve the quality of life for patients and their spouses.Methods:A convenience sampling method was used to select 103 patients with digestive system tumors and their spouses who were admitted to a tertiary-level hospital in Shanghai from January to June,2024,and the Dyadic Coping Inventory and the Hospital Anxiety and Depression Scale were used for the survey.Latent profile analysis was utilized to identify different types of binary coping patterns among the couples.One-way ANOVA or χ2 tests were used to compare the intergroup differences in anxiety and depression symptom scores or positive rates among the couples under different binary coping patterns.Results:Of the 110 couples surveyed,103 provided complete and valid responses of questionnaires,resulting in a response rate of 93.64%.The overall binary coping levels of the couples were above average(130.74±30.64,130.35±27.29).The binary coping strategies of patients with digestive system tumors and their spouses could be divided into three potential categories including general coping,high coping and low coping groups.Significantly differences in anxiety symptom score,depression symptom score and positive rate were observed among the subgroups(P=0.001 5,P=0.013 5,P=0.017 5,P=0.001 2).The anxiety and depression symptom scores and positive rate of patients in the low coping group were higher than those in the other two groups.Conclusion:Patients and their spouses in the low coping group represent a high risk of anxiety and depression,warranting early screening and focused attention.Interventions tailored to the couple should be developed and implemented.

Objectives:To investigate the binary coping mode of hospitalized patients with digestive system tumors and their spouses,and its relationship with anxiety and depression symptoms in both spouses,aiming to provide a reference for medical staff to develop intervention plans to improve the quality of life for patients and their spouses.Methods:A convenience sampling method was used to select 103 patients with digestive system tumors and their spouses who were admitted to a tertiary-level hospital in Shanghai from January to June,2024,and the Dyadic Coping Inventory and the Hospital Anxiety and Depression Scale were used for the survey.Latent profile analysis was utilized to identify different types of binary coping patterns among the couples.One-way ANOVA or χ2 tests were used to compare the intergroup differences in anxiety and depression symptom scores or positive rates among the couples under different binary coping patterns.Results:Of the 110 couples surveyed,103 provided complete and valid responses of questionnaires,resulting in a response rate of 93.64%.The overall binary coping levels of the couples were above average(130.74±30.64,130.35±27.29).The binary coping strategies of patients with digestive system tumors and their spouses could be divided into three potential categories including general coping,high coping and low coping groups.Significantly differences in anxiety symptom score,depression symptom score and positive rate were observed among the subgroups(P=0.001 5,P=0.013 5,P=0.017 5,P=0.001 2).The anxiety and depression symptom scores and positive rate of patients in the low coping group were higher than those in the other two groups.Conclusion:Patients and their spouses in the low coping group represent a high risk of anxiety and depression,warranting early screening and focused attention.Interventions tailored to the couple should be developed and implemented.

Diabetes, hypertension, and dyslipidemia, collectively referred to the " Three Highs, " represent increasingly prevalent metabolic risk factors in China. Many individuals experience all three conditions concurrently, significantly heightening the risk of cardiovascular disease and mortality. Although the National Metabolic Management Center(MMC) has been established for over eight years and has its unique features, the awareness, treatment, and control rates of these diseases in China remain low, and the efficiency of community management is insufficient. According to the previous two editions of management guidelines and the most recent domestic and international diagnostic and treatment guidelines, this paper conducts an in-depth analysis of the operational experience and management strategies of the MMC. Its aim is to improve the efficiency of grassroots MMC mode management for " Three Highs" patients and ensure that patients receive more standardized management.

The latest epidemiological data suggests that the situation of adult diabetes in China is severe, and metabolic diseases have become significant chronic illnesses that have a serious impact on public health and social development. After more than six years of practice, the National Metabolic Management Center(MMC) has developed distinctive approaches to manage metabolic patients and has achieved a series of positive outcomes, continuously advancing the standardized diagnosis and treatment model. In order to further improve the efficiency, based on the first edition, the second edition guideline was composed by incorporating experience of the past six years in conjunction with the latest international and domestic guidelines.