Objective: To investigate the serological identification and blood group gene sequencing analysis of two rare cases of K phenotype producing high-frequency antigen antibodies (anti-Ku), and to study the serological interrelationship between K cells and the high-frequency antigen antibody anti-KL. Methods: Serological methods were used to identify the antigen phenotypes of the ABO, Rh, and Kell blood group systems and to screen for and identify unexpected antibodies in the two patients. The characteristics of the unexpected antibodies were verified by the indirect antiglobulin test (IAT) using papain or dithiothreitol (DTT) -treated screening cells. The titer of anti-Ku was determined via the tube method using DTT-treated plasma. The Kell blood group genotype was determined by gene sequencing. The distinctive antigenicity of K cells was validated through their reactivity with anti-KL in IAT, and absorption-elution techniques were employed to corroborate the type of anti-KL. Results: Serological findings: Case 1 was blood group O, CCDee; Case 2 was blood group A, CCDee. Both cases exhibited the Kell phenotype: K-k-, Kp (a-b-). High-frequency antigen antibodies were detected in the plasma of both patients. The reactivity of these antibodies was slightly enhanced with papain-treated screening cells but became negative with DTT-treated cells. The anti-Ku (IgG) titer for Case 1 was 64. For Case 2, the anti-Ku (IgM) titer was<1, and the anti-Ku (IgG) titer was 32. Gene sequencing revealed that both cases harbored a homozygous c.715G>T mutation in the KEL gene, corresponding to the genotype KEL02N.24, consistent with the rare K phenotype. The unique high expression of the Kx antigen on K cells was confirmed through the antibody characteristics of anti-KL. Absorption-elution techniques demonstrated that K cells could separate anti-Km and anti-Kx, thereby supporting the classification of anti-KL. Conclusion: Serological and molecular biological assays identified both patients as having the rare Kell-null (K ) phenotype. If such rare blood types go undetected in transfusion medicine, the administration of standard blood products can readily induce the production of high-frequency antigen antibodies such as anti-Ku, potentially leading to a transfusion crisis due to the subsequent difficulty in finding compatible blood. The serological relationship between K cells and anti-KL clarified the characteristic high expression of the Kx antigen on K phenotype erythrocytes and concurrently supported the typological features of the rare high-frequency antibody anti-KL. This represents the first such verified report in China.

With the continuous deepening of the concept of precision diagnosis and treatment for lung cancer, how to achieve higher efficiency and accuracy in the screening, diagnosis, and treatment pathways in clinical practice has become an important issue that urgently needs to be overcome. The current clinical difficulty lies in the fact that despite continuous advancements in imaging and molecular diagnostic technologies, there are still limitations in manual efficiency and subjective experience when it comes to massive data analysis and multi-scale feature extraction. Artificial intelligence (AI), especially algorithm systems based on deep learning, is an innovative technology capable of deeply empowering medical big data. This method utilizes algorithms such as convolutional neural networks, combined with radiomics, pathomics, and multi-modal data fusion analysis, demonstrating immense potential in early precise detection and benign-malignant differentiation of pulmonary nodules, digital pathological subtype recognition and non-invasive prediction of driver genes, precise 3D surgical planning and automatic delineation of radiotherapy target volumes, as well as dynamic risk warning during follow-up. This innovative technology provides a brand-new solution for realizing intelligent and individualized lung cancer diagnosis and treatment models. This consensus, based on the latest evidence from evidence-based medicine and combined with the development trends in the AI field and real-world clinical needs, was ultimately formed by gathering the consensus opinions of multidisciplinary experts in radiology, pathology, thoracic surgery, and other fields. The main content covers the application specifications of AI in the three core scenarios of lung cancer screening, diagnosis, and treatment, the technical standards for data collection and algorithm validation, as well as the ethical and regulatory challenges faced at the current stage. It aims to clarify the applicable boundaries of AI as a clinical auxiliary decision support tool, providing scientific guidance and standardized exploration directions for peers currently engaged in or planning to carry out AI-assisted clinical diagnosis, treatment, and translation of lung cancer.

To summarize the applications of data-intelligence technology in diagnosing lysosomal storage disease(LSD), analyze their opportunities and challenges in clinical practice as well as their development trends, and provide insights and recommendations for advancing digitally driven auxiliary diagnostic technologies.

To review the randomized controlled trials (RCTs) at home and abroad on digital intelligence (DI)-driven rehabilitation in patients of neuromuscular disease, compare the effects of DI-driven rehabilitation with traditional rehabilitation, summarize the special needs and challenges faced by patients in rehabilitation of rare neuromuscular diseases, and provide evidence for the development and quality improvement of rehabilitation for rare neuromuscular diseases.

To provide references to and give suggestions to the development and optimiza-tion of Digital Intelligence (DI) technology in management of non-hospitalized patients by systematical review the application of digital technology in non-hospital settings.

Objective To analyze the risk factors for prolonged length of hospital stay in patients with peritoneal dialysis associated peritonitis(PDAP)and construct a nomogram based on Logistic regression model.Methods A retrospective study was conducted on patients with PDAP who were hospitalized at the Affiliated Hospital of Jiangsu University from January 2013 to December 2023.Using the 75th percentile of hospitalization time as the cutoff(>21 days),the patients were divided into prolonged length of hospital stay group and normal length of hospital stay group.Clinical data were compared between the two groups.Logistic regression analysis was used to analyze the risk factors for prolonged hospital stay in PDAP patients and to construct a nomogram.Results A total of 131 PDAP patients were included in this study,including 40 cases in prolonged length of hospital stay group and 91 cases in normal length of hospital stay group.Multivariate Logistic regression analysis showed that Gram-negative bacteria detected in ascites(OR=6.012,95% CI=1.878-19.248,P=0.003)and elevated platelet count(OR=1.010,95% CI=1.005-1.015,P<0.001)were independent risk factors for prolonged length of hospital stay,while elevated serum chloride(OR=0.885,95% CI=0.802-0.978,P=0.016)was a protective factor.Based on the above three indicators,a nomogram was constructed.The multivariate Logistic regression model showed an area under the receiver operating characteristic curve(AUC)of 0.755,with an internal validation AUC of 0.727 using the Bootstrap method.The calibration curve indicated that the predicted probability was consistent with the actual probability.The decision curve showed that the model was clinically applicable when the threshold probabilities were 9%-10%,13% and 18%-92%.Conclusion A nomogram,based on the detection of gram-negative bacteria in ascites,platelet count and serum chloride,was helpful for clinical screening PADP patients at risk for prolonged length of hospital stay,and can provide a basis for optimizing clinical decision-making.
Humans ; Nomograms ; Risk Factors ; Peritoneal Dialysis/adverse effects* ; Retrospective Studies ; Length of Stay ; Peritonitis/etiology* ; Logistic Models ; Male ; Female ; Middle Aged ; Aged

Objective:To investigate the clinical value of dynamic AI ultrasonic intelligent assisted diagnosis system for preoperative evaluation of thyroid nodules with diameter ≤1.0 cm.Methods:From Apr. 1, 2023, to Dec. 30, 2023, 742 thyroid nodules with diameter ≤1.0 cm were removed from 532 patients with thyroid nodule disease who received surgical treatment in the Department of Thyroid (hernia) of the First Medical Center of the Chinese People’s Liberation Army General Hospital. Among them, 423 were d≤0.5 cm. 319 cases (235 males and 507 females) with 0.5

Objective Investigate the clinical efficacy and application value of gasless trans-subclavian approach endoscopic surgery(GTAES)for the treatment of primary hyperparathyroidism(PHPT).Methods 55 PHPT patients who underwent unilateral parathyroid adenoma resection from January 2023 to October 2024 were absorbed.Based on surgical approaches,31 patients were divided into the traditional low-collar arc incision open surgery group(open group)and 24 patients were divided into gasless trans-subclavian approach endoscopic surgery group(endoscopic group).The perioperative data,anterior neck function recovery,and incision healing were compared between two groups.Results There were no significant differences in operation time,intraoperative blood loss,postoperative drainage volume and postoperative hospital stay between the two groups(P＞0.05).The preoperative blood calcium levels of the endoscopic group and the open group were(2.68±0.10)mmol/L and(2.63±0.16)mmol/L,respectively.The blood calcium levels on the first day after surgery were(2.39±0.12)mmol/L and(2.36±0.16)mmol/L,respectively.Preoperative parathyroid hormone(PTH)was 27.55(110.05,155.75)pg/ml in endoscopic group and 137.00(107.00,210.30)pg/ml in open group,respectively.PTH on the first day after surgery was 18.98(12.64,23.53)pg/ml and 13.85(7.36,23.23)pg/ml,respectively.Blood calcium and PTH in each group 1 day after surgery decreased compared with that before surgery,and the difference was statistically significant(P＜0.05).There were no postoperative complications such as hoarseness,bleeding and incision infection in both groups.Postoperative hand and foot numbness:5 cases(20.8％)in endoscopic group and 8 patients(25.8％)in the open group,there was no significant difference between the two groups(P=0.667).There was no significant difference in the score of neck pain 3 days after surgery between the two groups(P＞0.05).The score of swallowing tension[(1.92±1.06)points compared with(2.77±1.38)points,P=0.015]and the score of anterior neck discomfort[(1.63±0.88)points compared with(2.35±1.33)points,P=0.018]in the endoscopic group one month after surgery were better than those in the open group.There was no significant difference in the score of neck scar scale between the two groups 3 months after surgery(P＞0.05).VAS score of incision satisfaction was(9.08±0.88)in endoscopic group and(8.19±1.30)in open group,and the endoscopic group was better than the open group,the difference was statistically significant(P=0.004).Conclusion For PHPT patients caused by unilateral parathyroid adenoma confirmed through preoperative localization examination,GTAES is a safe and effective surgical approach,which offers unique advantages in intraoperative lesion identification,cosmetic outcomes of the incision,and preservation of anterior neck function,providing a new surgical option for PHPT patients.

Objective To explore the relevant factors affecting the efficacy of traditional Chinese medicine in treating MG,and to develop and validate a nomogram model,in order to personalize the prediction of the probability of benefits for MG patients after traditional Chinese medicine treatment,further guide clinical physicians in targeted medication,and provide guidance for the traditional Chinese medicine treatment of MG.Method Retrospective analysis of MG patients who visited the Affiliated Hospital of Changchun University of Traditional Chinese Medicine from March 2018 to June 2022,13 clinical factors were selected to evaluate the results.To acquire independent factors,univariate and multivariate Logistic analyses were performed.The area under the receiver operating characteristic curve,Harrell's concordance index,calibration curve,and decision curve analyses were used to evaluate the predictive ability,accuracy,and clinical practicability of the prediction model.Results A total of 204 cases were included,divided into derivation cohort 139 cases and temporal validation cohort 65 cases.Multivariate Logistic regression showed 4 independent predictors affecting effectiveness of traditional Chinese medicine in treating MG,including age at onset,repetitive nerve stimulation positive,oral immunosuppressant and anxiety/depression.AUC values for the model group and validation group were 0.76(95%CI:0.68-0.84)and 0.83(95%CI:0.71-0.95),respectively,and based on calibration curve and decision curve analysis,we concluded that the nomogram showed excellent performance.Conclusion MG patients may experience a decrease in short-term efficacy with age,positive RNS,concomitant emotional abnormalities,or recent history of immunosuppressive therapy.This nomogram effectively predicts the possibility of short-term effective traditional Chinese medicine treatment in MG patients.

Objective:To investigate the relationship among social support, anxiety and cancer pain behavior in patients undergoing radiotherapy for advanced colorectal cancer, and to explore the mediating role of social support between anxiety and cancer pain behavior.Methods:A sample of 100 patients with advanced colorectal cancer admitted to the Oncology Radiotherapy Department of the Affiliated Hospital of Jiangnan University was recruited from March 2021 to March 2023. The hospital anxiety and depression scale (HADS), perceived social support scale (PSSS) and visual analogue scale (VAS) were utilized to assess patients' anxiety levels, individually perceived levels of social support and cancer pain intensity.The SPSS 25.0 software and AMOS 26.0 software were used for data analysis.Pearson correlation analysis was conducted to examine the relationships between these variables, and the Bootstrap method was employed to investigate the mediating role of social support in the relationship between anxiety and cancer pain behavior.Results:The patients' HADS anxiety score was (10.63±2.56), VAS pain score was (5.31±1.92), and PSSS social support score was (56.19±6.28). Pearson correlation analysis showed that anxiety was positively correlated with cancer pain behavior ( r=0.785, P<0.001), and social support was significantly correlated with both anxiety ( r=0.671) and cancer pain behavior ( r=0.672) (both P<0.001). Structural equation modeling indicated that social support partially mediated the relationship between anxiety and cancer pain behavior, with an indirect effect value of 0.177 (95% CI=0.033-0.287), accounting for 22.55%(0.177/0.785) of the total effect and the direct effect value was 0.608 (95% CI=0.287-0.642), accounting for 77.45%(0.608/0.785) of the total effect. Conclusion:Social support plays a mediating role in the effect of anxiety on cancer pain behavior in patients with advanced colorectal cancer undergoing radiotherapy. Enhancing social support can effectively alleviate anxiety in patients with advanced colorectal cancer undergoing radiotherapy, thereby alleviating cancer pain behavior, providing a theoretical basis for clinical comprehensive interventions.