Objective: To establish an accurate and rapid typing method for Rh typing of samples from patients who have received recent blood transfusions by utilizing the difference in osmotic fragility between fresh and old red blood cells. Methods: A lysing solution suitable for destroying old RBCs was prepared. Sixty-one samples collected in our hospital in 2024 with Rh typing of double groups were treated with the lysing solution to remove the old allogeneic red blood cells while preserving the patient's own fresh red blood cells, followed by repeat Rh typing tests. Results: For 61 samples with Rh typing in double groups, 41 were accurately detected identified through the red blood cell lysis method, yielding an identification rate of 67.21%. No significant difference was observed compared to the detection rate of the commonly used capillary centrifugation modified method (χ =0.103, P>0.05). Conclusion: The red blood cell lysis method provides a novel and rapid experimental approach for clinical use in processing Rh-typed samples that are of double groups, thereby offering a basis for Rh compatibility blood transfusion.

Objective To construct a mammography image classification assistant system suitable for Chinese population,and explore the potential of artificial intelligence technology to assist early screening of breast cancer in China.Methods Curated breast imaging subset of digital database for screening mammography(CBIS-DDSM),Mammographic image analysis society database(MIAS)and other international open datasets were used to conduct model training respectively in order to reproduce the mainstream in-depth learning methods in the current literature.The model was also tested on the Chinese breast mammography database(CBMD)provided by Huajiao Technology Co.,Ltd,and the performance was compared.Aiming at the problem that the Chinese population data are not ideal in the performance test of the open dataset training model,an optimization strategy based on the sliding window adjustment mechanism was implemented in combination with the characteristics of Chinese population data.Then a two-stage migration learning method was designed to improve the overall performance of the model,and then development of our system was carried out.Results With the sliding window adjustment mechanism and the CBMD training model after two-stage transfer learning,the accuracy of our developed system was improved from 0.50 of the open datasets to 0.80,precision from 0.54 to 0.82,sensitivity from 0.52 to 0.80,F1 value from 0.52 to 0.80,and AUC value from 0.51 to 0.89 based on the Chinese population dataset as the test set.Conclusion Through the introduction of sliding window adjustment mechanism and two-stage migration learning strategy,the performance of the breast molybdenum target image classification model has been significantly improved in the Chinese population dataset,and our system primarily achieves the purpose of assisting the classification of breast molybdenum target images for the Chinese population.

Objective To conduct an in-depth analysis and feature extraction of the transcriptomics data of 10 types of cancers in order to realize the staging diagnosis of cancer samples.Methods The transcriptomics data of the top 10 cancers having the highest incidence were amassed from the UCSC Xena website,which comprised 4 938 samples and 59 428 genes.With the aid of variational autoencoder,we developed an incremental feature ranking and selection variational autoencoder(IFRSVAE)based on feature importance ranking and incorporating the masking algorithm and the Incremental Feature Selection(IFS).Subsequently,the performance efficiency of our IFRSVAE model was evaluated in conjunction with Random Forest(RF),Support Vector Machine(SVM),and eXtreme Gradient Boosting(XGboost),and it was also compared with other methods.Results Our research extracted 21 features for the ensuing classification.In comparison to the conventional variational autoencoder,recursive feature elimination,and Lasso regression models,the IFRSVAE model attained more favorable performance across all 3 classifiers(highest AUC value,and well performed other indicators).Notably,the IFRSVAE-RF exhibited the most outstanding performance,with an AUC value reaching 85.49%(95%CI:83.24%～87.74%).Moreover,Shapley additive explanations(SHAP)interpretable model illustrated well contributions of the features in our model.Conclusion Our developed IFRSVAE shows certain effectiveness in feature extraction.The constructed IFRSVAE-RF model demonstrates relatively good performance in the task of cancer staging diagnosis,which providing a new and referable idea for research orientation of deep-learning-based diagnostic methods for cancer staging.

Objective:To prepare a novel ginseng polypeptide thermosensitive hydrogel,and to investigate its repair effect on heat-induced skin injury in the rats and explore the underlying mechanisms.Methods:Thermosensitive hydrogels were formulated using Pluronic F127 and β-sodium glycerophosphate(β-GP),and their phase transition temperatures,spatial structures,elemental compositions,and water retention capacities were evaluated.The rat models of heat-induced skin injury were established and the model rats were divided into PBS group,Gel group,and ginseng polypeptide gel(GP-Gel)group.After 11 d of treatment,the morphological changes of wound and collagen deposition in the wound of the rats in various groups were observed by HE and Masson staining.Immunohistochemistry was used to detect the expression levels of α-smooth muscle actin(α-SMA),connective tissue growth factor(CTGF),basic fibroblast growth factor(bFGF),proliferating cell nuclear antigen(PCNA),cell proliferation marker Ki67,epidermal growth factor(EGF),CD31,vascular endothelial growth factor(VEGF),P50 and P65 proteins in the skin wound tissue of the rats in various groups.Western blotting method was used to detect the expression levels of Toll-like receptor 4(TLR4)in the skin wound tissue of the rats in various groups.ELISA method was used to measure the levels of tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),interleukin-6(IL-6),interleukin-15(IL-15),and interleukin-10(IL-10)in the serum of the rats in various groups.Results:Compared with PBS and Gel groups,the wound area of the rats in GP-Gel group was reduced(P＜0.01),the expression levels of PCNA,Ki67,EGF,CD31,VEGF,α-SMA,and CTGF proteins in the skin wound tissue were increased(P＜0.05 or P＜0.01),and the expression levels of P65 and TLR4 proteins were decreased(P＜0.01);the level of anti-inflammatory factor IL-10 in serum was increased(P＜0.01),while the levels of pro-inflammatory factors TNF-α,IL-1β,IL-6 and IL-15 were decreased(P＜0.05 or P＜0.01).Conclusion:The ginseng polypeptide thermosensitive hydrogel promotes the repair of heat-induced skin injury by enhancing cell proliferation,collagen synthesis,angiogenesis,and reducing inflammatory responses.

Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death worldwide, causing a significant socioeconomic burden. This article reviews the effects of influenza vaccination on COPD and finds that influenza vaccine can significantly reduce the risk of influenza infection, reduce the number of acute exacerbations, and reduce the hospitalization rate in patients with COPD. The vaccine has a favorable safety profile and significant economic benefits, which can reduce medical costs. Currently, influenza vaccination mainly faces challenges such as insufficient patient awareness, insufficient support from the medical system, and socio-cultural and economic factors. Efforts should be focused on reducing the acute exacerbation of COPD patients and providing a scientific basis for the prevention and management of COPD patients.

The paper reports a 32-year-old female acute myeloid leukemia patient who developed graft-versus-host disease after paternal hematopoietic stem cell transplantation, which subsequently led to renal thrombotic microangiopathy. She subsequently required a kidney transplant from the same donor 5 years later due to renal failure. Considering that both the bone marrow and kidney were from the same donor and the recovery of renal function was favorable, immunosuppressive therapy was discontinued after a short course of anti-rejection treatment, with maintained stable kidney function. This case suggests that under the condition of high chimerism, allogeneic hematopoietic stem cell transplantation and kidney transplantation from the same donor can achieve immune tolerance, potentially improving solid organ transplantation success rate. The findings provide a novel therapeutic approach for solid organ transplantation following allogeneic hematopoietic stem cell transplantation.

Objective:To analyze the salary satisfaction and influencing factors of medical staff in public hospitals in Guangxi under the background of salary system reform, and to provide suggestions for deepening the salary system reform of public hospitals in Guangxi.Methods:From July to December 2022, medical staff from 39 public hospitals that have carried out salary system reform were selected through stratified random sampling, and self-made questionnaires were used to survey them, which mainly included salary, salary expectations and salary satisfaction. Descriptive analysis of the questionnaire data was performed, and binary logistic regression was used to analyze the influencing factors of salary satisfaction.Results:A total of 10 299 valid questionnaires were obtained. 6 869 (66.7%) medical staff had a lower average monthly income after tax than those employed in urban non-private units in Guangxi in that year; 8 100 (78.6%) medical staff expected to be paid 30%~50% higher than the current salary level; 4 073 (39.5%) were satisfied with the overall salary satisfaction, of which 2 377 (23.1%) were satisfied with the salary increase after the reform of the salary system in 2017. The results of multivariate analysis showed that education, hospital type, hospital level, professional title, position and job type were the main influencing factors of salary satisfaction of medical staff ( P<0.05), and hospital level interacted with education, hospital type and job type respectively ( P<0.05). Conclusions:The external competitiveness of the salary of medical staff in Guangxi was insufficient, and the salary satisfaction was not high. It is suggested to pay attention to the inter-embeddedness of the reform of the salary system and the reform of the " three-medical linkage" , pay attention to the balanced development of different levels and types of hospitals, scientifically calculate the value coefficient of different positions, and effectively improve the salary level of medical staff.

Objective:To explore the effects of Xiaoyao Conger Decoction pretreatment on model rats of tinnitus with syndrome of liver-qi stagnation and spleen deficiency (TLSSD) and its preliminary mechanisms.Methods:The rats were divided into four groups: a blank group, a model group, a positive group, and Xiaoyao Conger high- and low-dosage groups, with 7 rats in each group according to random number table method. Except for the blank group, the TLSSD model was prepared by the composite etiological method in all groups of rats. The positive group received a gavage of carbamazepine at 15 mg/kg, while Xiaoyao Conger high- and low-dosage groups were given 30 g/kg and 15 g/kg of Xiaoyao Conger Decoction, respectively. The blank and model groups were administered an equal volume of saline once daily for 4 weeks. The frequency of conditioned avoidance response behaviors in rats was recorded before and at 2 and 4 weeks post-drug administration; TCM syndrome scores were documented before and after treatment; auditory brainstem response (ABR) thresholds were monitored at frequencies of 4, 12, 20, and 28 kHz; IL-1β mRNA expression in the inferior colliculus and cochlea was detected by RT-qPCR; and the levels of γ-aminobutyric acid (GABA) and glutamic acid (Glu) in hippocampal tissues were determined by LC-MS/MS.Results:The model group exhibited symptoms of liver depression, including irritability, yellow fur, and a dark red tongue, along with signs of spleen deficiency such as lethargy, decreased activity, and loose stools. Compared to the model group, rats in the Xiaoyao Conger high- and low-dosage groups demonstrated a reduction in conditioned avoidance response behaviors ( P<0.05 or P<0.01), a decrease in TCM syndrome scores ( P<0.05 or P<0.01), lower ABR thresholds at 12, 20, and 28 kHz ( P<0.01), reduced levels of IL-1β mRNA in the inferior colliculus and cochlea ( P<0.05 or P<0.01), and decreased hippocampal Glu levels ( P<0.01). Conclusion:The therapeutic effect of Xiaoyao Conger Decoction pretreatment on TLSSD rats may be related to its ability to improve the mood disorders and stress, reduce the neuroinflammatory response, regulate the CNS neurotransmitter balance, and correct the overexcitability of the auditory centre, etc.

This paper focuses on extreme environments and systematically analyzes sleep disorders caused by multiple pathogenesis,including circadian rhythm disorder,yin-yang imbalance and qi-blood disorder under weightlessness,emotional depression due to environmental changes,abnormal diet and excretion,and six excesses pathogenic factors,in accordance with the theory of correspondence between nature and human.It proposes harmonizing yin and yang as the core therapeutic principle and guiding framework,with specific methods including calming rebellious qi-blood,regulating qi movement,harmonizing heart and kidney,and dredging and regulating blood vessels,thus forming the"one guiding principle and four specific methods"treatment strategy.Additionally,by integrating the modified application of classic formulas,a diagnostic and therapeutic approach targeting multi-dimensional pathogenesis is established.This study aims to promote the in-depth integration of Traditional Chinese Medicine(TCM)in extreme environmental medicine through TCM theories and innovative application of prescriptions,provide TCM-characterized solutions for health management of workers in extreme environments,and facilitate the transformation of extreme environmental medicine toward the modern medical model of"prevention-treatment integration".

Objective To conduct preliminary evaluation of the reliability and safety of pancreatic duct-to-jejunum stent-bridging internal drainage as a supplementary approach to pancreaticojejunostomy in central pancreatectomy.Methods The clinical data of 28 patients who underwent robotic central pancreatectomy performed by our team between January 2021 and November 2024 were retrospectively collected,and and follow-up of postoperative endocrine and exocrine functions was performed.Based on the methods of digestive tract reconstruction adopted,the patients were divided into a conventional pancreaticojejunostomy group and a pancreatic duct-to-jejunum stent-bridging internal drainage group(PancreaticoJejunal-Stent bridge group).The operative time,digestive tract reconstruction time,and short-term complications were compared between the two groups.Results Among patients undergoing robotic central pancreatectomy,the digestive tract reconstruction time was shorter(t=5.168,P<0.001)in the PancreaticoJejunal-Stent bridge group([31.1±6.3]min)than that in the conventional pancreaticojejunostomy group([49.7±8.9]min)(t=5.168,P<0.001).The total operative time was(172.7±64.6)min in the PancreaticoJejunal-Stent bridge group and(200.1±52.7)min in the conventional pancreaticojejunostomy group,showing no statistically significant difference(t=1.215,P=0.235).In the PancreaticoJejunal-Stent bridge group,one patient developed a postoperative biochemical fistula,and 14 patients developed grade B pancreatic fistulas.Among the 14 patients with grade B pancreatic fistulas,1 case was complicated by fistula-related intra-abdominal infection,and 13 cases had drainage tube retention time of more than 21 days.In the conventional pancreaticojejunostomy group,2 patients developed postoperative biochemical fistulas,and 11 patients developed grade B pancreatic fistulas.Among the 11 patients with grade B pancreatic fistulas,1 case was complicated by fistula-related intra-abdominal infection,and 1 case was complicated by fistula-related intra-abdominal bleeding and infection.No postoperative gastroparesis,pancreatitis,or grade C pancreatic fistulas occurred in either group.There were no statistically significant differences between the two groups in overall postoperative complication rate(P=0.522),postoperative pancreatic fistula rate(P=0.583),intra-abdominal infection rate(P=0.583),or bleeding rate(P=0.464).Conclusion Pancreatic duct-to-jejunum stent-bridging internal drainage optimizes the anastomosis between the distal end of the pancreas and the jejunum during central pancreatectomy,shortens digestive tract reconstruction time,and reduces surgical complexity without increasing the risk of short-term severe postoperative complications.This approach is safe and feasible.