Objective To explore the clinical efficacy of plasma exchange (PE) and double-filtration plasmapheresis (DFPP) pretreatment regimens for high-titer ABO-incompatible kidney transplantation (ABOi-KT). Methods A retrospective analysis was conducted on 31 cases of ABOi-KT with a follow-up period ≥1 year admitted to Zhongshan Hospital Affiliated to Fudan University from April 2016 to August 2025. The efficacy differences between the PE combined with rituximab (RTX) + oral triple immunosuppressive regimen and the DFPP combined with RTX + oral triple immunosuppressive regimen were compared and analyzed. The titers of blood group antibodies and serum creatinine levels before and after the operation were monitored. The survival curves and cumulative risk occurrence curves were plotted using the Kaplan-Meier method. The survival rates of recipients and transplanted kidneys and the occurrence of complications were analyzed. Results Both the PE regimen and the DFPP regimen may effectively reduce the preoperative blood group antibody titer of the recipients to ≤1∶16. The one-year survival rate of the recipients and the transplanted kidneys both reached 100% after the operation. The postoperative serum creatinine levels of recipients who received the DFPP regimen were lower and more stable. There was no statistically significant difference in the incidence of complications between the two regimens during the same follow-up period. Conclusions Both the PE and DFPP regimens are effective pretreatment regimens for ABOi-KT. The DFPP regimen has more advantages in reducing treatment operations, lowering drug dosage and maintaining the stability of postoperative renal function. For recipients with a high initial antibody titer (≥ 1∶32), individualized determination of the number and frequency of plasma processing for pretreatment may achieve ideal therapeutic effects.

Central serous chorioretinopathy(CSC), the first described pachychoroid disease, is characterized by visual distortions and loss of vision, which are commonly seen in middle-aged male. Research has demonstrated that ocular blood flow in CSC is in a state of overload, characterized by the dilation of vortex vein ampullae and choroidal vasculature. The obstruction of venous outflow is linked to scleral thickness, while the choriocapillaris exhibits perfusion deficits due to compression from the engorged vascular layer. Over time, vascular remodeling occurs, with venous anastomoses forming to create alternative drainage pathways and mitigate blood stasis. These abnormalities in vortex vein dynamics and choroidal circulation play a critical role in elucidating the underlying pathogenesis and clinical manifestations of CSC. This review highlights the alterations in vortex vein and choroidal vasculature in CSC, hoping to understand how the changes of blood flow affect the course of CSC and their correlation with treatment response. By evaluating blood flow dynamics, we aim to determine the disease stage more accurately, optimize therapeutic strategies, and ultimately enhance patient outcomes.

Immune repertoire is defined as the sum of T cells and B cells, which possesses high diversity and enables immune system to respond to various antigen stimuli. With the development of sequencing technique, immune repertoire sequencing can be utilized to deeply understand the changes of lymphocyte clones when rejection occurs at the gene level, and also provide the possibility for the emergence of novel non-invasive diagnostic techniques based on immune repertoire sequencing. In recent years, more and more attempts have been made to apply immune repertoire sequencing in solid organ transplantation, especially in the fields of kidney transplantation, liver transplantation, heart transplantation and post-transplantation infection. In this article, research progresses on the application of immune repertoire sequencing in these fields were reviewed, and current status of immune repertoire sequencing in organ transplantation and its potential as a novel technique for early non-invasive diagnosis of rejection were summarized, aiming to provide reference for subsequent development and clinical application of this technique.

Hypervirulent Klebsiella pneumoniae (HvKP) is a new variant of Klebsiella pneumoniae. It is characterized by strong virulence and easy dissemination. It mainly causes liver abscess with multiple invasive infections, including eye, lung and central nervous system, with a high fatality rate. A case of severe intracranial infection caused by HvKP was reported. The patient was a 44-year-old formerly healthy man. He had acute onset of fever, headache, and disturbance of consciousness, which rapidly progressed to intracranial hypertension and respiratory failure. Cerebrospinal fluid examination suggested purulent infection, and bacterial culture suggested Klebsiella pneumoniae, which was sensitive to other commonly used antibiotics except ampicillin. Brain magnetic resonance imaging showed multiple abnormal signals in bilateral frontal, parietal and temporal lobes, right centrum semiovale, bilateral corona radiata, basal ganglia, thalamus and insula, as well as enhancement of meningeal and ependymal membrane, and swelling of brain tissue. During hospitalization, the patient developed a blood stream infection of pan-drug-resistant Klebsiella pneumoniae and was in critical condition. After aggressive treatment, the patient was cured and discharged from the hospital. After half a year follow-up, his prognosis was good and his social function was restored. The clinical data, diagnosis and treatment of the patient were reported and the literature was reviewed to provide clinical reference for the disease.

The detection of electrocardiogram (ECG) characteristic wave is the basis of cardiovascular disease analysis and heart rate variability analysis. In order to solve the problems of low detection accuracy and poor real-time performance of ECG signal in the state of motion, this paper proposes a detection algorithm based on segmentation energy and stationary wavelet transform (SWT). Firstly, the energy of ECG signal is calculated by segmenting, and the energy candidate peak is obtained after moving average to detect QRS complex. Secondly, the QRS amplitude is set to zero and the fifth component of SWT is used to locate P wave and T wave. The experimental results show that compared with other algorithms, the algorithm in this paper has high accuracy in detecting QRS complex in different motion states. It only takes 0.22 s to detect QSR complex of a 30-minute ECG record, and the real-time performance is improved obviously. On the basis of QRS complex detection, the accuracy of P wave and T wave detection is higher than 95%. The results show that this method can improve the efficiency of ECG signal detection, and provide a new method for real-time ECG signal classification and cardiovascular disease diagnosis.
Algorithms ; Arrhythmias, Cardiac ; Electrocardiography ; Heart Rate ; Humans ; Signal Processing, Computer-Assisted ; Wavelet Analysis

Objective: To explore the relationship between intra-operative blood product transfusion and post-operative prognosis in children with pediatric open heart surgery by cardiopulmonary bypass (CPB).
Methods: A total of 1028 consecutive pediatric patients received the open heart surgery by CPB in our hospital were retrospectively studied. Uni- and multivariate Logistic regression analysis were conducted to analyze the relationship between intra-operative blood product transfusion and post-operative in-hospital death and complication rates.
Results: There were 45/1028 (4.4%) of patients died, 143 (13.9%) with low cardiac output syndrome, 43 (4.2%) received dialysis, 26 (2.5%) with sustained pulmonary failure, 17 (1.7%) with infection, and 28 (2.7%) developed neurologic complications. Multivariate Logistic regression analysis indicated that duration and the lowest temperature of CPB, 24-hour post-operative pediatric risk of mortality (PRISM-III) score and intra-operative transfusion amount of RBC > median (20.3 ml/kg) were the independent risk factors for post-operative in-hospital death. Congenital heart disease (CHD) with pre-operative cyanosis, duration of CPB, 24-hour post-operative PRISM-III score, 6-hour post-operative mediastinal drain loss and intra-operative transfusion amount of RBC > 20.3 ml/kg were the independent risk factors for post-operative complication occurrence.
Conclusion: Large volume of RBC transfusion in the open heart pediatric surgery with CPB may increase the risk of post-operative in-hospital death and complication occurrence, reducing RBC transfusion might be improving the post-operative prognosis in CHD patients.

A high performance liquid chromatography tandem mass spectrometric ( HPLC-MS/MS ) method was developed for the determination of seven perfluorinated alkyl acidin ( C4-C10 ) and perfluorooctane sulfonate in water. After the particulate was removed by leaching, surrogate standard was added, then the sample was loading to a pre-conditioned WAX cartridge for purification, and then the eluent was concentrated and analyzed by HPLC-MS/MS. Due to the situation that the fluoride polymer was unavoidable to be used in the LC system, a delay column was employed and the perfluorooctanoic acid ( PFOA ) of interference was departed from the PFOA in sample. The method detection limit ( MDL) of PFOA was 0. 8 ng/L, and the lowest quantitative concentration (LQC) was 3. 2 ng/L. For other compounds, the MDL was ranged from 0. 2 to 1. 2 ng/L, and the LQC was 0. 8-4. 8 ng/L. This method also had good reproducibility, for six duplicated samples, the relative standard deviations ( RSD ) of all target compounds were less than 16%. And the recoveries of target compounds at six spiked matrix samples ranged from 87% to 129%, and the RSD were less than 15%. Because of the connection of delay column, the background was well controlled, and a relatively lower MDL were obtained.

Objective To understand the distribution of the blood donors with positive blood test results in Wuzhou .Methods The detection results of ALT ,HBsAg ,anti‐HCV ,anti‐HIV and anti‐TP of 108 879 cases of blood donors were retrospectively ana‐lyzed in 2010 -2012 .Results In the 108 879 cases of blood donors ,the total positive rate of 5 indicators was 6 .01% (6 548/108 879) .The positive rates of ALT ,HBsAg ,anti‐HCV ,anti‐HIV and anti‐TP were 4 .86% ,0 .57% ,0 .20% ,0 .07% and 0 .59% , respectively .The positive rates of ALT ,HBsAg and anti‐HCV were significantly different between males and females (P<0 .05) . The blood donors in 18-30 age group had the highest positive rates of ALT and anti‐TP ,and the blood donors in >30 -40 age group had the highest anti‐HCV positive rate .Conclusion Enhancing the blood donation propaganda ,doing a good job in the blood before consulting ,and choosing low risk blood donors are important to guarantee of the blood quality and reduction of blood transfu‐sion transmitted diseases .

Objective To assess the nutritional status of hospitalized patients during radiotherapy and conduct multivariate analysis , to provide a basis for intervention in the nutritional status of nursing esophageal cancer patients .Methods From June 2012 to April 2013 , fifty-nine cases of hospitalized patients with esophageal cancer received radiotherapy in our hospital were analyzed , using anthropometric indicators , laboratory data on nutritional assessment of patients at the time of admission , and use of European Nutritional Risk Screening Tool ( NRS2002 ) for patients with nutritional risk screening .Results Of fifty-nine cases of esophageal cancer patients before radiotherapy , 17 patients had a NRS2002 score≥3 points.28.9% patients had the risk of malnutrition when they admitted to hospital .Anthropometric indicators of nutritional assessment indicated that 46 cases (78%) patients had varying degrees of malnutrition . Nutritional assessment of biochemical evaluation indicated that 27 cases (45.7%) patients had varying degrees of malnutrition , within which one patient (1.7%) had severe malnutrition.Multivariate analysis showed that gender , educational level, whether surgery or not , body mass index , arm circumference , arm muscle circumference , TLC when admission had significant impact on the score of NRS 2002 .Conclusions The risks of malnutrition present in esophageal cancer patients before radiotherapy , and have the physical and biochemical changes in nutritional indicators, so attentions should be paid to that .

Objective To evaluate the risks of malnutrition and nutritional status of patients with esophageal cancer during radiotherapy , so as to explore nursing countermeasures to improve their nutritional status.Methods 60 inpatients with esophageal cancer receiving routine radiotherapy from June 2012 to April 2013 were investigated with anthropometric indicators and laboratory data for weekly nutritional evaluation on admission, during radiotherapy, and after radiotherapy.Meanwhile, the patients were conducted with Nutritional Risk Screening ( NRS2002 ) per week .Results NRS2002 score showed that the malnutrition risk values of patients with esophageal cancer gradually increased after radiotherapy .The score was (2.06 ±1.22) after 2 weeks of radiotherapy, suggesting that the difference was statistically significant (t=-2.457, P<0.05). After the radiotherapy , the scores of body mass index ( BMI ) , triceps skinfold ( TSF ) , arm circumference (AC), total protein (TP), albumin (ALB) and total lymphocyte count (TLC) were (20.21 ±2.69)kg/m2, (7.27 ±3.20)mm, (24.71 ±2.68)cm, (65.50 ±5.25)g/L, (38.48 ±5.00)g/L and (6.55 ±3.42) × 109/L, respectively, compared with those of admission , they decreased gradually in the subsequent weekly examinations and had statistical significance ( t=3.204,2.777, 3.053,7.174,5.685,12.508, respectively;P<0.05).After 2 weeks of radiotherapy, the incidence of malnutrition increased compared to that of admission, and the scores of TSF, TP and TLC were 95.00%, 11.67% and 98.33% respectively, which showed the statistically significant difference (χ2 =11.800, 7.792, 73.024, respectively; P <0.05 ). Conclusions Patients with esophageal cancer gradually have higher risk of malnutrition and worse nutritional status during radiotherapy and their incidence of malnutrition increased after 2 weeks of radiotherapy .