Objective: To explore a simple, effective, and safe method for excluding false positives and identifying infections by comprehensively evaluating blood donors with reactive HIV screening results, thereby providing a basis for developing management strategies for such donors. Methods: HIV testing data of blood donors from our laboratory from January 2022 to December 2024 were collected. The results of ELISA and nucleic acid testing (NAT) were combined with confirmatory results from the CDC and analyzed. Results: A total of 605 929 samples were tested for HIV over the three-year period, with 682 reactive samples (reactive rate: 11.25 per 10 000). All were sent to the CDC for Western blot (WB) confirmation, resulting in 53 confirmed positives ((confirmed positive rate: 7.77%). Among these, 619 samples showed isolated HIV Ag&Ab reactivity with non-reactive NAT (HIV Ag&Ab+-&HIV RNA or NAT NR), with a confirmed infection rate of 0%; 9 samples showed dual HIV Ag&Ab reactivity with non-reactive NAT (HIV Ag&Ab++&HIV RNA NR or NAT NR), also with 0% confirmed infection; 52 samples showed dual HIV Ag&Ab reactivity and reactive NAT (HIV Ag&Ab++&HIV RNA R or NAT R), all confirmed as positive (100% infection rate); and 2 HIV Ag&Ab dual-reactive samples without NAT detection were also confirmed infected (100%). For all four HIV Ag&Ab assays, the S/CO values in the true positive group with dual reactivity were significantly higher than those in the false-positive groups (P<0.05). The S/CO distributions for both single-reactive false positives and dual-reactive false positives were narrow, with the upper box (Q3, 75th percentile) below optimal cutoff values in all cases (The optimal cutoff values for the four reagents were 5.00, 11.67, 8.50, and 20.90, respectively). Conclusion: Blood donors with positive NAT results in HIV blood screening are permanently deferred. Donors with dual positive HIV Ag&Ab but negative NAT results are classified and managed based on the S/CO values of HIV Ag&Ab and the optimal screening thresholds. Donors with single positive HIV Ag&Ab but negative NAT results are placed under evaluation status and retain their eligibility to donate blood. Optimizing the management measures for blood donors and establishing a scientific stratified management and assessment mechanism can effectively maintain the stability of the blood donor team.

ObjectiveTo explore the regulatory effects and mechanisms of Astragali Radix polysaccharide （APS） on inhibitor of differentiation1 （ID1） and protein kinase B （Akt） in gastric cancer. MethodsImmunohistochemical staining was used to detect the expression of ID1 and Akt in 61 gastric cancer tissue samples and 20 adjacent normal gastric tissue samples. Immunofluorescence was used to detect the localization of ID1 and Akt. The effects of APS at the concentrations of 0.625， 1.25， 2.5， 5， 10， 20 mg·L^-1 on the proliferation of gastric cancer MGC-803 cells were examined by the cell counting kit-8（CCK-8） method and the colony formation assay. The target information of APS was retrieved from the Traditional Chinese Medicine Systems Pharmacology and Analysis Platform and Swiss Target Prediction. Keywords such as gastric cancer， gastric tumor， and stomach cancer were searched against GeneCards， UniProt， DisGeNET， and Online Mendelian Inheritance in Man （OMIM） for the screening of gastric cancer-related targets. The online tool jvenn was used to create the Venn diagram to identify the common targets， and STRING and Cytoscape were used to construct the protein-protein interaction network. Gene Ontology （GO） and Kyoto Encyclopedia of Genes and Genomes （KEGG） pathway enrichment analyses were conducted via R 4.2.2 to predict the potential roles of APS in the development of gastric cancer. The cell scratch assay was employed to assess the effect of APS on the migration of MGC-803 cells. The protein and mRNA levels of ID1 and Akt in the cells treated with APS were determined by Western blot and Real-time PCR， respectively. ResultsCompared with the adjacent normal gastric tissue， the gastric adenocarcinoma tissue showed increased positive expression of ID1 （χ² =81.00， P<0.01）. Immunofluorescence detection showed that ID1 and Akt were mainly located in the cytoplasm of gastric adenocarcinoma cells. Bioinformatics analysis identified 14 common genes shared between APS and gastric cancer. The average degree of protein-protein interaction network nodes was 14.29. GO and KEGG pathway enrichment results showed that ID1 and Akt were significantly enriched in the Rap1 and phosphatidylinositol-3-kinase （PI3K） /Akt signaling pathways. Cell experiments demonstrated that 5-fluorouracil （0.1 mg·L^-1） and APS （10， 20 mg·L^-1） groups showed decreased cell proliferation， migration， and colony formation. Compared with the control group， 10， 20 mg·L^-1 APS inhibited the proliferation of MGC-803 cells （P<0.01）， with 10 mg·L^-1 APS demonstrating stronger inhibitory effect. In addition， APS at 10， 20 mg·L^-1 inhibited the migration （P<0.01） and colony formation （P<0.05， P<0.01） of MGC-803 cells. Compared with the control group， APS at 10， 20 mg·L^-1 down-regulated the protein levels of ID1 （P<0.01） and Akt （P<0.05） and the mRNA levels of ID1 （P<0.05， P<0.01） and Akt （P<0.05， P<0.01） in MGC-803 cells. ConclusionID1 and Akt are highly expressed in the gastric adenocarcinoma tissue， which may be related to the development of gastric cancer. APS can down-regulate the protein and mRNA levels of ID1 and Akt to exert anti-tumor effects， which is expected to provide new therapeutic targets for gastric cancer treatment.

Objective:To explore the effect of companion robot therapy in dementia patients through Meta-analysis.Methods:Randomized controlled trials of companion robot therapy in patients with dementia were searched in both English and Chinese databases with a search period from database establishment to April 30, 2024. Two researchers used the Risk of Bias ROB 2 software to evaluate the quality of the included literature and analyzed it using Stata 17.0 software.Results:A total of 10 papers were included. Meta-analysis showed that the effect of the companion robot on depression in dementia patients was statistically significant when comparing experimental group with control group [ SMD=1.09, 95% CI (0.02, 2.17), P=0.047], and that the improvement of agitated behavior [ SMD=-0.28, 95% CI (-0.53, -0.04), P=0.02] and anxiety [ WMD=2.80, 95% CI (2.70, 2.90), P<0.01] in experimental group were better than those in control group, and the differences were all statistically significant. However, the differences in the effects on quality of life and neuropsychiatric symptoms in experimental group compared with control group were not statistically significant ( P>0.05) . Conclusions:Companion robots have positive effects on improving depression, agitated behavior, and anxiety in dementia patients, and are not yet effective in improving quality of life and neuropsychiatric symptoms, which need to be validated by high-quality studies in the future.

Objective:To study the current status of transitional readiness from adolescence to adulthood of patients with inflammatory bowel disease（IBD）in China,analyze the factors affecting transitional readiness,and provide a basis for developing scientific and targeted transitional preparedness programmes.Methods:The IBD patients aged 12-24 years who were admitted to the Department of Gastroenterology,Beijing Children's Hospital Affiliated to Capital Medical University from January 1,2016 to January 15,2025 were enrolled.From November 1,2024 to January 15,2025,the survey was conducted through online distribution of the transition readiness assessment questionnaire (TRAQ)6.0 Chinese version scale to IBD patients by using the convenient sampling method.The scores of each dimension of TRAQ scale were calculated,and multiple linear regression analysis was used to analyze the factors influencing the scores of TRAQ during the transitional period.Results:A total of 184 patients were included and 184 questionnaires were collected.Male patients were slightly more than female(109:75),with an average age of (14.94±2.35) years.70.11% of patients had a disease duration of 1 to 5 years,with Crohn's disease accounting for the highest proportion(54.89%),and the severity of the disease was mostly mild to moderate.Family support was generally higher(84.24%).Parents were highly involved in patient disease management(94.02%).There were 52.72% of the patients received social support.The mean score of the TRAQ was 4.14 ± 0.89,and the mean scores of the four dimensions from high to low were following health problems(4.28±0.97),insisting on making an appointment and seeing a doctor on time(4.20±1.10),talking with medical staff(4.17±1.05) and drug management(4.14±0.99).Multiple linear regression analysis showed that family status,the encourage,supports and help from the family members,and the supports from the society were the independent influencing factors of IBD patients' readiness score for transition from adolescence to adulthood( P<0.05).Among them,family status had a positive effect on transition readiness score,and the degree of readiness score increased with the increase of harmony( P<0.05).Social support also had a positive effect on transition readiness score( P<0.05).Compared with no encouragement,support and help from family members,the situation of little encouragement had a certain improvement on the readiness score( P<0.05). Conclusion:Children with IBD have better overall performance during the transition from adolescence to adulthood.Family status,the encourage,supports and help from the family members,and the supports from the society are the important factors influencing transitional preparedness.

Objective:By using cognitive interviews,the interviewees' cognition and understanding of the inflammatory bowel disease(IBD) self-efficacy scale for adolescents and young adults (IBDSES-A) were evaluated,and the semantic content of IBDSES-A,which was initially translated into Chinese,was tested and revised.Methods:Using purposive sampling,15 IBD patients aged 12-18 were selected from Beijing Children's Hospital,Capital Medical University,between January and February 2025,stratified by age group and disease type.Two rounds of cognitive interviews were conducted.Feedback and suggestions from interviewees were analyzed using a question appraisal system for coding and integration.Based on expert panel discussions,ambiguous items were revised to finalize the Chinese version of the IBDSES-A.Results:In the first round,10 interviewees were interviewed,followed by 5 interviewees in the second round.There were no statistically significant differences ( P>0.05) between the interviewees of two rounds in terms of age,gender,and education level.During the first round of interview,interviewees expressed comprehension difficulties with 76.9% (10/13) of the items.Coding analysis revealed that the primary issue was "clarification",as unclear wording made it difficult for interviewees to fully grasp the intended meaning of certain items.Based on these findings,the expert panel revised 10 of the 13 items in the IBDSES-A.The second round of cognitive interview showed that the interviewees generally understood the revised items，achieving linguistic and semantic consistency with the original scale. Conclusion:The application of cognitive interviews in the translation process of the IBDSES-A helps reduce comprehension biases caused by inappropriate wording，ensuring that the localized version of the scale is more accessible and understandable to the target population.

Objective To design an image processing system for skeletal measurement of arch,calcaneus and knee joint.Methods The image processing system had its hardware part composed of an image acquisition system,a body mass measurement system and a height measurement system.The image acquisition system consisted of an arch image acquisition module,a calcaneus image acquisition modue and a knee joint image acquisition module;the height measurement system included mainly a height meter component with a mechanically retractable structure;the body mass measurement system used CZL902 sensor combined with the hardware architecture to determine the body mass.The software system of the image processing system was developed with C#language and the application program interface was constructed by combining WinForm technique.Thirty-two healthy children and adult volunteers without significant foot or knee disease were recruited to assess the reliability and validity of the system by means of the consistency testing method.Results The system developed gained high reliability in the reliability and validity of the data on arch,calcaneus and knee joint(intragroup coefficient>0.75,P<0.05),and all the indexes except ankle sapcing width had higher intra-and inter-tester reliablity for the child volunteers than for the adult ones.Conclusion The system developed with high convenience and accuracy can be used for skeletal measurement of arch,calcaneus and knee joint.[Chinese Medical Equipment Journal,2025,46(10):36-40]

Sepsis is a life-threatening organ dysfunction syndrome caused by a dysregulated host response to infection. Septic acute kidney injury (SAKI) is one of the most common complications of sepsis, and the occurrence of acute kidney injury (AKI) indicates that the patient's condition is critical with a poor prognosis. The traditional view holds that the main mechanism of SAKI is the reduction of renal blood flow, inadequate renal perfusion, inflammatory response, and microcirculatory dysfunction caused by sepsis, which subsequently leads to ischemia and necrosis of renal tubular cells. Recent research findings indicate that processes such as autophagy and other forms of programmed cell death play an increasingly important role. Autophagy is a programmed intracellular degradation process and is a form of programmed cell death. Cells degrade their cytoplasmic components via lysosomes, breaking down and recycling intracellular constituents to meet their metabolic needs, maintain intracellular homeostasis, and renew organelles. During SAKI, autophagy plays a crucial protective role through various mechanisms, including regulating inflammation and immune responses, clearing damaged organelles, and maintaining stability in the intracellular environment. In recent years, the role of autophagy in the pathogenesis and treatment of SAKI has received widespread attention. Research has confirmed that various intracellular signaling pathways and signaling molecules targeting autophagy [such as mammalian target of rapamycin (mTOR) signaling pathway, AMP-activated protein kinase (AMPK) signaling pathway, nuclear factor-κB (NF-κB) signaling pathway, and Sirtuins (SIRT), autophagy associated factor Beclin-1, and Toll-like receptor (TLR)] are involved in the development of SAKI. Due to the complex pathogenesis of SAKI, current treatment strategies include fluid management, infection control, maintenance of internal environment balance, and renal replacement therapy; however, the mortality remains high. In recent years, it has been found that autophagy plays a critical protective role in sepsis-mediated AKI. As a result, an increasing number of drugs are being developed to alleviate SAKI by regulating autophagy. This article reviews the latest advances in the role of autophagy in the pathogenesis and treatment of SAKI, with the aim of providing insights for the development of new drugs for SAKI patients.
Humans ; Acute Kidney Injury/etiology* ; Autophagy ; Sepsis/complications* ; Signal Transduction

Objective:To study the morphological characteristics and ethnic differences of the chin soft and hard tissue of Han and Uyghur adult females of class Ⅱ 1.Methods:90 Uyghur and Han female subjects of class Ⅱ 1 aged 18-35 years old were enrolled and respectively divided into 3 groups according to the vertical skeletal types:high,average and low angle groups(n=30).The various indexes of the chin soft and hard tissue of the subjects were measured by X-ray lateral cephalic radiographs.The data were statisti-caly analyzed.Results:(1)The Po-Pos of the Han subjects with high angle was higher than that of those with low and average an-gle;the minimum chin thickness,the ratio of the chin thickness to the chin height,the ratio of the minimum chin thickness to the chin thickness and the angle of chin in the high angle group were smaller than those in the average angle group and the low angle group(P＜0.05).The chin height,the chin depression and the cervical-mandibular angle of the Uyghur subjects with high angle were higher than those of the Uyghur subjects with low angle and average angle;the minimum chin thickness,the ratio of the chin thickness to the chin height and the ratio of the minimum chin thickness to the chin thickness in the high angle group were smaller than those in the average and the low angle groups(P＜0.05).(2)In the low angle group,there were significant differences in the angle of chin,cervical-mandibular angle,soft tissue chin angle and Me-Mes between the 2 ethnic groups(P＜0.05).In the average angle group,there were significant differences in the height of chin,LI-LL and Me-Mes between the 2 ethnic groups(P＜0.05).In the high angle group,there were significant differences in the ratio of anterior to posterior chin thickness,in the angle of chin,LL-Pos and Po-Pos between the 2 ethnic groups(P＜0.05).(3)The positive correlation between FH/MP and Po-Pos,cervical-mandib-ular angle,chin depression,chin lip angle,chin height,ratio of anterior and posterior chin thickness and LL-Pos were found in Han and Uyghur subjects(P＜0.05).Mentolabial sulcus,the chin thickness,the ratio of the chin thickness to the chin height,the angle of chin and the ratio of the minimum chin thickness to the chin thickness were negatively correlated with FH/MP in both ethnic groups(P＜0.05).Conclusion:Han and Uy-ghur adult females of class Ⅱ 1 have different chin soft and hard tissue morphology in different vertical skeletal types with certain differences between the ethnic groups in the same vertical skeletal types,and there is a correlation between the chin soft and hard tis-sue morphology of different vertical skeletal types and the vertical skeletal types in Han and Uyghur adult females of class Ⅱ 1.

Neuroendocrine neoplasms(NENs)are a rare group of tumors that originated from peptidergic neurons and neuroendocrine cells,which has neuroendocrine differentiation characteristics and expresses neuroendocrine markers.NENs occur in all parts of the body,especially in lung,gastrointestinal tract and pancreas.Both domestic and foreign researches showed that the incidence of NENs is on the rise.NENs have high heterogeneity and can originate in multiple tissues and organs,including pituitary,thyroid,parathyroid,skin,bronchial lung and thymus,gastrointestinal tract and pancreas,adrenal glands,genitourinary organs,etc.At the same time,when the classification and grading of NENs originating from the same tissue or organ are different,they also have significantly different biological behaviors.The high heterogeneity of NENs determines the difficulty and complexity of its diagnosis.In addition to clinical symptoms,it also needs to include special biomarkers,endoscopy,ultrasound,computed tomography(CT),magnetic resonance imaging(MRI)and various functional imaging methods for integrated diagnosis.In addition,the treatment of NENs also covers endoscopic therapy,surgical treatment,interventional therapy,drug therapy,radiotherapy and peptide receptor radionuclide therapy(PRRT).The development of treatment strategies requires not only following guidelines,but also making individual choices on the basis of multidisciplinary team(MDT)collaboration and integrated diagnosis and treatment.In 2024,the Society of Neuroendocrine Neoplasm of China Anti-Cancer Association once again organized experts in relevant fields to formulate the"China Anti-Cancer Association guideline for diagnosis and treatment of neuroendocrine neoplasms(2025 edition)"on the basis of the"China Anti-Cancer Association guideline for diagnosis and treatment of neuroendocrine neoplasm(2022 edition)",domestic and international guidelines and consensus,as well as the latest clinical research results.The guideline had been registered on Practice guideline REgistration for transPAREncy(PREPARE)with the registration number PREPARE-2024CN1158.The 2025 edition updated and revised the relevant content from the 2022 edition and further expanded recommendations beyond thoracic,gastrointestinal tract and pancreas NENs,including pituitary neuroendocrine tumors(PitNETs),medullary thyroid carcinoma(MTC),pheochromocytoma/paragangliomas(PPGLs)and Merkel cell carcinoma(MCC),with the expectation of providing references for clinical practitioners.

Objective To observe the feasibility of photon-counting detector(PCD)-CT combined with"four-lows"protocol(low contrast agent concentration,low contrast dose,low contrast agent flow rate,low radiation dose)for coronary CT angiography(CCTA).Methods Totally 106 patients with suspected coronary artery disease were prospectively enrolled and randomized into energy-integrating detector(EID)-CCTA(group A,using conventional scanning protocol,n=52)or PCD-CCTA(group B,using"four-lows"scanning protocol,n=54)groups and underwent relative examinations.The radiation dose,subjective and objective evaluation results of imaging quality were compared between groups.Results The contrast agent dose and flow rate,volume CT dose index,dose length product and effective dose in group B were all lower than those in group A(all P＜0.001).The subjective scores in group B were higher than in group A(5[4,5]vs.4[4,5],Z=-2.310,P=0.021).Compared with group A,CT value,signal-to-noise ratio and contrast-to-noise ratio of aortic root and most of the main branches of coronary arteries increased in group B,while standard deviation of CT value decreased(all P＜0.05).Conclusion PCD-CT combined with"four-lows"protocol could be used for CCTA,which could improve imaging quality and reduce contrast agent usage and radiation dose.