Objective: Through analyzing the current handling capabilities for complex cases in blood transfusion compatibility detection and the application status of artificial intelligence-assisted (AI-assisted) technologies, this study explores the establishment of an effective AI-augmented protocol for managing challenging blood transfusion compatibility detection. Methods: This research systematically analyzes, designs, and explores an AI-augmented operational workflow for resolving challenging blood transfusion compatibility detection cases. Through three representative case studies, we evaluate its effectiveness, accuracy, and efficiency in addressing real-world diagnostic challenges. Results: The AI-augmented operational model demonstrates significant efficacy in resolving complex blood transfusion compatibility challenges, including complex blood typing, antibody specificity identification, challenging cross-matching, and transfusion strategy formulation. Conclusion: AI-augmented technologies demonstrate immense potential in resolving complex blood transfusion compatibility detections. By enabling intelligent, automated, precise, and standardized solutions, they significantly enhance diagnostic accuracy and operational efficiency, which is critical for ensuring transfusion safety and advancing personalized transfusion medicine. This study delineates both the advantages and existing limitations of AI implementation, explores future developmental trajectories, and provides a theoretical framework and practical implementation pathways for deeper integration of AI in transfusion 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.

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 address the national requirements for high-quality development of public hospitals issued by the National Health Commission(NHC),this study establishes a knowledge-value-oriented performance management system tailored to dental specialty characteristics,aiming to synergistically enhance disciplinary advancement and operational efficiency.Methods Guided by policies such as Guidelines on Strengthening Operational Management in Public Hospitals,we integrated resources in oral and maxillofacial surgery through data-driven decision-making and multidimensional investigations.A"2-3-3"performance manage-ment model was developed,featuring dual objectives(public welfare and economic efficiency),a three-tier allocation mechanism(hospital-department-individual),and triple support strategies(key disciplines,young talents,and under-resourced projects).Im-plementation involved organizational restructuring,business-finance integration,and digital transformation.Results Post-reform outcomes demonstrated a 14％year-on-year increase in outpatient volume and a 9％growth in bed-to-surgery ratio.Both medical quality indicators and revenue and expenditure structures were optimized,achieving better equilibrium between public welfare and economic sustainability.Conclusion This model replaces the egalitarian distribution approach with a value-driven incentive mech-anism,effectively promoting disciplinary specialization and talent engagement.It provides a replicable framework for performance reform in dental specialty hospitals,aligning with the NHC's policy orientation on refined public hospital management.

Objective To address the national requirements for high-quality development of public hospitals issued by the National Health Commission(NHC),this study establishes a knowledge-value-oriented performance management system tailored to dental specialty characteristics,aiming to synergistically enhance disciplinary advancement and operational efficiency.Methods Guided by policies such as Guidelines on Strengthening Operational Management in Public Hospitals,we integrated resources in oral and maxillofacial surgery through data-driven decision-making and multidimensional investigations.A"2-3-3"performance manage-ment model was developed,featuring dual objectives(public welfare and economic efficiency),a three-tier allocation mechanism(hospital-department-individual),and triple support strategies(key disciplines,young talents,and under-resourced projects).Im-plementation involved organizational restructuring,business-finance integration,and digital transformation.Results Post-reform outcomes demonstrated a 14％year-on-year increase in outpatient volume and a 9％growth in bed-to-surgery ratio.Both medical quality indicators and revenue and expenditure structures were optimized,achieving better equilibrium between public welfare and economic sustainability.Conclusion This model replaces the egalitarian distribution approach with a value-driven incentive mech-anism,effectively promoting disciplinary specialization and talent engagement.It provides a replicable framework for performance reform in dental specialty hospitals,aligning with the NHC's policy orientation on refined public hospital management.

Objective:To systematically review the efficacy and safety of new oral anticoagulants(NOACs)for the treatment of patients over 70 years with atrial fibrillation.Methods:Studies comparing NOACs(dabigatran, rivaroxaban, apixaban, ximelagatran and edoxaban)versus warfarin for the treatment of patients over 70 years with atrial fibrillation were searched through databases including PubMed, Embase and the Cochrane Library, from the earliest electronic records to those published in March 2021.Stata15.0 software was used for meta-analysis.Results:A total of 19 studies and 215 471 patients were included.Meta-analysis results showed that, compared with warfarin, either a low-dose(110 mg)or a standard-dose(150 mg)of dabigatran reduced the risk of stroke/systemic embolism(SSE)in patients over 70 years with atrial fibrillation.A standard-dose of dabigatran did not decrease the risk of major bleeding, but a low dose was able to achieve it.A standard-dose(20 mg)of rivaroxaban could considerably reduce the risk of SSE in geriatric patients over 70 years with atrial fibrillation without increasing the risk of major bleeding.A standard-dose(5 mg)of apixaban could considerably decrease the risk of SSE and major bleeding in patients over 70 years with atrial fibrillation; A standard-dose(36 mg)of ximelagatran was as effective as warfarin in decreasing the incidence of SSE in patients over 70 years with atrial fibrillation, but could also considerably decrease the risk of major bleeding; A low-dose(15-30 mg)or a standard-dose(30-60 mg)of edoxaban decreased the incidence of SSE in patients over 70 years with atrial fibrillation, as did warfarin, but edoxaban considerably decreased the risk of major bleeding.Conclusions:Compared with warfarin, most of new oral anticoagulants show good efficacy in patients over 70 years old with atrial fibrillation, NOACs given at standard doses increase the risk of major bleeding, but at low doses can realize both efficacy and safety.

Objective:To investigate the relationship between sarcopenia and early renal dysfunction in elderly patients with type 2 diabetes mellitus(T2DM).Methods:A total of 198 elderly patients with T2DM aged over 60 years undergoing treatment in the Geriatric Department of Beijing Hospital from July 2018 to July 2019 were enrolled in this retrospective case-control study.The estimated glomerular filtration rate(eGFR)is calculated according to the CKD-EPI Cr-Cys formula.Based on the eGFR, the patients were divided into normal renal function group(n=63, in CKD 1 stage)and mild renal dysfunction group(n=135, in CKD 2-3a stage). All subjects underwent physical examination, laboratory examination and dual energy X-ray bone density examination. Results:The age, weight, body mass index, abdominal circumference, serum creatinine, cystatin C, uric acid, diastolic pressure, the proportions of diabetes and hypertension were lower, and the high-density lipoprotein cholesterol, appendicular skeletal muscle mass(ASM)and skeletal muscle mass index(SMI)were higher, in the normal renal function group than in the mild renal dysfunction group( P<0.05 or 0.01). Spearman correlation analysis showed that eGFR was positively correlated with SMI( r=0.343, P<0.01). Logistic regression analysis showed that body weight( OR=1.318, 95% CI: 1.091-1.594), uric acid( OR=1.007, 95% CI: 1.001-1.012), diastolic blood pressure( OR=1.072, 95% CI: 1.033-1.112), years of diabetes( OR=1.075, 95% CI: 1.013-1.142)were risk factors, and the LSM( OR=0.136, 95% CI: 0.047-0.392)and SMI( OR=0.778, 95% CI: 0.703-0.860)were protective factors for the early renal dysfunction in elderly patients with T2DM. Conclusions:Elderly patients with T2DM are often co-existed with sarcopenia.Sarcopenia is associated with early renal dysfunction in elderly patients with T2DM.

With the acceleration of the aging process in China, the incidence rates of coronary heart disease and cerebral infarction have significantly increased.And iodine contrast agent is often used in imaging diagnosis and percutaneous intervention therapy.The contrast medium is filtered from the glomerulus in its original form and is not absorbed by renal tubules.However, the accumulation of iodine contrast medium in the kidney can lead to acute kidney injury.Kidney is one of the most important excretory and endocrine organs in human body.The prevention and treatment of contrast-induced nephropathy(CIN)have been widely concerned.The incidence rate of contrast-induced renal damage is higher and the prognosis is poorer in the elderly than in the non-elderly due to the decline of organ function in the elderly.At present, the mechanism of action for oxygen free radicals in CIN of the elderly is still unclear.This article reviews the researches on the role of oxygen free radical in CIN of the elderly studied by domestic and foreign scholars in recent years.

Objective To evaluate the use of unilateral pedicle lymphography (PLG) in preoperative localization and treatment of chyluria.Methods From October 2010 to March 2017,25 cases with severe chyluria and undergoing cystoscopy and unilateral PLG before renal pedicle lymphatic disconnection were reviewed.There were 11 males and 14 females,aged 44-71 years,with an average of 58.5 years.The course of the disease was 6 months to 30 years,with an average of 8.3 years.Of them,18 cases had undergone unilateral PLG and spiral CT angiography preoperatively.Surgical treatment was performed according to PLG imaging.Results Unilateral ureteral chyluria was discovered in 16 out of the 19 cases through cystoscopy,with the sensitivity of 84.2％ (16/19).In contrast,unilateral chyluria was only detected in 4 of the other 6 patients with bilateral chyluria.Albiduria were found in the remaining 5 cases in bladder,without ureteral excreted chyle.The sensitivity for chyluria positioning by cystoscopy was 64.5％ (20/31).The location of lesion in 19 patients with unilateral chyuria and 6 patients with bilateral chyluria could be correctly displayed by PLG and the sensitivity was 100％ (31/31).There was no significant difference in location between cystoscopy and PLG in 19 patients with unilateral chyluria (P =0.2482).But in total lesion location,the sensitivity of PLG was higher than cystoscopy(P =0.0026).Eighteen patients who had undergone PLG combined with spiral CT angiography,could not only locate the chylous fistula,but also determine the number of renal vessels as well as their relationship with diseased lymphatic vessels.Chyluria had disappeared immediately after unilateral renal pedicle lymphatic exfoliation in 23 patients.However,it still presented in the other 2 patients who were confirmed contralateral pyeloymphatic fistulas by PLG 3 months after surgery and cured by reoperation.Chyluria recurred in 6 cases during follow-up of 6 to 58 months,and 4 were confirmed bilateral pyelolymphatic fistulas by PLG.Two of these 4 cases were cured by laparoscopic surgery or open surgery,respectively.The other 2 patients were cured by conservative treatment.Moreover,2 patients with unilateral chyluria recurred in situ after the first laparoscopic surgery,which was confirmed by PLG.Notably,all these patients were cured by ESWL finally.Conclusions This study suggested that PLG displays remarkable advantage in terms of localization sensitivity.PLG combined with spiral CT angiography preoperatively can not only locate the chylous fistula,but also determine the number of renal vessels as well as their relationship with diseased lymphatic vessels.Depending on PLG and spiral CT angiography,renal pedicle lymphatic disconnection can effectively protect renal vessel.In addition,it can avoid the omission of ligation for perivascular lymphatic vessels.Furthermore,PLG plays a key role in temporarily obstructing the leakage of pyelolymphatic fistulas to some extent.

To explore the optimized dispatch of the rescue resources based on the mastered resources informa-tion. The objective function was set as the shortest rescue time, and 0-1 programming models were established and solved for the conditions that the number of medical rescue units was more or less than needed by the missions. In the two conditions, the model's calculated results were both optimal, and could be used to obtain the optimal dispatch solutions while the medical rescue time was the shortest. The 0-1 programming model can be effectively used to optimize dispatch strategy for medical rescue team.