Objective: To analyze the cause of discrepancy between ABO genotype B102/O01 and serological results in one case by PCR-SSP, to clarify the serological characteristics of this special blood group, and to explore relevant blood transfusion strategies. Methods: Blood group serological tests were performed on blood donor in August and December 2024, including forward and reverse ABO typing using tube method, H antigen identification, direct anti-human globulin test by tube method, red blood cell absorption-elution test, and determination of ABH blood group substance in saliva. Exons 1-7 of the ABO gene were amplified by PCR-SSP and sequenced. Results: The two separate serological tests consistently identified the donor as having an A B phenotype, but the results of gene sequencing indicated a B102/O01 genotype, showing an discrepancy between serological and genetic results. Conclusion: It is very likely that the blood type of the blood donor is B102/O01 with a microchimerism of type A, or an AB type masked by A type reference gene.

Objective To investigate the long-term efficacy and postoperative complications of artificial urinary sphincter (AUS) implantation in patients with stress urinary incontinence caused by traumatic urethral injury, so as to provide reference for the treatment of this condition. Methods A retrospective study was conducted on the clinical data of 26 patients treated at our center during Apr.2002 and Dec.2024. All patients had severe persistent urinary incontinence due to traumatic urethral injury and underwent AUS implantation. The daily pad usage and visual analog scale (VAS) scores before surgery and 6 months to 1 year after surgery were compared to evaluate the efficacy. Complications were recorded and analyzed, and the survival was analyzed using the Kaplan-Meier method. Results The patients included 25 males and 1 female, with a mean age (41.8± 16.0) years, median disease duration of 10.0 (2.0,16.0) years and follow-up of (11.7±5.9) years. One month postoperatively, all patients successfully activated the AUS device. At the latest follow-up (Jun.2025),20 devices (including 3 revised) were functioning. The social continence rate was 61.5% (16/26), and complete continence rate 38.5% (10/26). Daily pad usage decreased significantly from a preoperative median of 3.5 (3.0,5.0) pads/day to 0.5 (0,1.0) pads/day (P<0.05). The median VAS score decreased from 8.0 (7.0,8.0) to 1.0 (0,1.0) (P<0.05). Complications occurred in 34.6% (9/26) patients, including urethral erosion (4 cases), fluid leakage (3 cases) and infection (2 cases). There was a significantly difference in age between patients with complications and those without complications [ (33.1±12.3) years vs. (46.4±16.1) years, P<0.05]. The median survival was 16 years, with the 5-year,10-year, and 15-year survival probabilities of 75.8%, 75.8% and 58.3%. Conclusion AUS implantation demonstrates good long-term efficacy and durability, and is a recommended treatment option.

Objective To explore the effects of home-based exercise rehabilitation on cardiac structure, valvular function, and exercise capacity in patients with severe aortic stenosis (AS) after transcatheter aortic valve replacement (TAVR). Methods 49 patients with severe AS who underwent TAVR at Zhongshan Hospital, Fudan University, from January 2024 to February 2025 were enrolled. They were divided into an exercise group (n＝25) or a non-exercise group (n＝24) based on participating or not in home-based rehabilitation after TAVR. The exercise group received 12 weeks of home-based exercise training (aerobic exercise plus resistance training every week); the non-exercise group received routine care. Transthoracic echocardiography (TTE) was used to assess cardiac structural parameters before discharge (T0) and after 12 weeks of exercise (T1). Functional outcomes including the 6-minute walk test (6MWT), Duke Activity Status Index (DASI), and Short Physical Performance Battery (SPPB) were compared between the two groups. A linear mixed-effects model was used to analyze the effect of home-based rehabilitation on echocardiographic parameters. Patients were stratified by baseline 6MWT (＜240 m as low-function subgroup, ≥240 m as high-function subgroup) to compare exercise-related outcomes between subgroups. Results At T1, the exercise group had a longer 6MWT distance than the non-exercise group (P＝0.012). The linear mixed-effects model showed that after 12 weeks of exercise, the left ventricular end-diastolic diameter (LVEDD) decreased in the exercise group but slightly increased in the non-exercise group, with a significant difference in changes over time between the two groups (P_interaction＝0.030). The exercise group also showed greater improvement in effective orifice area index (P_interaction＝0.028) and effective orifice area (P_interaction＝0.042) than the non-exercise group. Subgroup analysis revealed that in the low-function subgroup, the exercise group showed greater improvement in the 6MWT (P_interaction＝0.035) and the effective orifice area index (P_interaction＝0.046) compared to the non-exercise group; in the high-function subgroup, the exercise group showed greater improvement only in LVEDD compared to the non-exercise group (P_interaction＝0.046). Conclusions Home-based exercise rehabilitation improves exercise capacity, optimizes left ventricular remodeling, and enhances valvular function in patients with severe AS after TAVR, with greater benefits observed in patients with lower baseline 6MWT.

Objective To investigate the relationship between serum metalloproteinase-2(MMP-2),total antioxi-dant capacity(T-AOC),C-reactive protein(CRP),and recurrence in inguinal hernia(IH)patients with postoperative laparoscopic total extraperitoneal repair(TEP),as well as their predictive value.Methods A total of 122 IH pa-tients undergoing TEP in the First Affiliated Hospital of Xi'an Jiaotong University from January 2019 to De-cember 2022 were selected as the observation group,and 122 healthy subjects during the same period were se-lected as the control group.The patients were followed up for 10 months,and were divided into relapse group(n=37)and recovery group(n=85)according to their recurrence situation.Serum MMP-2 levels were detec-ted by automatic biochemical analyzer,T-AOC levels were determined by chemical colorimetric method,and CRP levels were assessed by enzyme-linked immunosorbent assay.The influencing factors of TEP recurrence in IH patients were analyzed by Logistic regression.The predictive value of serum MMP-2,T-AOC and CRP for postoperative TEP recurrence in IH patients was analyzed by receiver operating characteristic(ROC)curve.Results Serum MMP-2 and CRP levels in observation group were significantly higher than those in control group(P＜0.05),and T-AOC levels were significantly lower than those in control group(P＜0.05).MMP-2 and CRP in relapse group were significantly higher than those in recovery group(P＜0.05),and T-AOC level was lower than that in recovery group(P＜0.05).The area under the curve(AUC)of serum MMP2,T-AOC and CRP in pre-dicting TEP recurrence in IH patients were 0.775,0.804 and 0.731,respectively,and the AUC of the combined pre-diction of the three was 0.887,which was better than that of each indicator alone(Z=2.597,1.983,3.275,P=0.009,0.047,0.001).Conclusion Serum levels of MMP-2,T-AOC and CRP in IH patients with postoperative TEP recurrence significantly increase,which can be used as effective indicators to predict the postoperative TEP recurrence in IH patients,and the combined prediction efficiency of the three is higher.

Objective: To analyze the influencing factors of psychological flexibility for cancer-related pain patients, so as to provide insights for improving their psychological flexibility. Methods: Cancer-related pain patients hospitalized in the Oncology Department of Anhui Cancer Hospital were selected as the subjects of the survey. Demographic information and disease information were collected through questionnaires. Pain belief was assessed using the Pain Beliefs and Perceptions Inventory. Alexithymia was assessed using the Twenty-Item Toronto Alexithymia Scale-Ⅱ. Psychological flexibility was assessed using the Psychological Inflexibility in Pain Scale. The influencing factors of psychological flexibility among cancer-related pain patients was analyzed by using a multiple linear regression model. Results: A total of 202 cancer-related pain patients were surveyed, including 114 males (56.44%) and 88 females (43.56%). The mean age was (59.99±11.53) years. The primary tumor type was digestive system cancer, with 121 cases (59.90%). The average pain intensity in the past 24 hours was mainly mild, with 150 cases (74.26%). The median pain beliefs score was -0.19 (interquartile range, 0.39) points. The total score of alexithymia was (66.86±5.60) points. The total score of psychological flexibility in cancer-related pain patients was (66.35±7.23) points. Multiple linear regression analysis showed that pain belief (β'=0.321), alexithymia (β'=0.222), and average pain intensity in the past 24 hours (β'=-0.481) were influencing factors for psychological flexibility in cancer-related pain patients. Conclusion The psychological flexibility of cancer-related pain patients is related to pain beliefs, alexithymia and average pain intensity in the past 24 hours.

【Objective】 To investigate the safety and effectiveness of suctioning flexible ureteroscopy with intelligent pressure-control at different times after drainage for patients with urogenic sepsis complicated with upper urinary tract stones. 【Methods】 Clinical data of 59 patients treated in the Department of Urology, Affiliated Hospital of Nantong University during May 2022 and May 2023 were collected.The patients were divided into early lithotripsy (≤1 week) group (n=27) and late lithotripsy (>1 week) group (n=32).Baseline data, imaging data and postoperative data of the two groups were compared. 【Results】 There were no significant differences between the two groups in the stone-free rate, total incidence of complications, incidence of high-grade complications, length of stay after lithotripsy, hospitalization costs after lithotripsy and total hospitalization costs (P>0.05). 【Conclusion】 Both early lithotripsy (<1 week) and late lithotripsy (>1 week) are safe and effective in the treatment of urogenic sepsis after drainage.

Ankylosing spondylitis (AS) combined with lower cervical fracture is often categorized into unstable fracture, with a high incidence of neurological injury and a high rate of disability and morbidity. As factors such as shoulder occlusion may affect the accuracy of X-ray imaging diagnosis, it is often easily misdiagnosed at the primary diagnosis. Non-operative treatment has complications such as bone nonunion and the possibility of secondary neurological damage, while the timing, access and choice of surgical treatment are still controversial. Currently, there are no clinical practice guidelines for the treatment of AS combined with lower cervical fracture with or without dislocation. To this end, the Spinal Trauma Group of Orthopedics Branch of Chinese Medical Doctor Association organized experts to formulate Clinical guidelines for the treatment of ankylosing spondylitis combined with lower cervical fracture in adults ( version 2024) in accordance with the principles of evidence-based medicine, scientificity and practicality, in which 11 recommendations were put forward in terms of the diagnosis, imaging evaluation, typing and treatment, etc, to provide guidance for the diagnosis and treatment of AS combined with lower cervical fracture.

Objective To investigate the genetic causes of auditory neuropathy with optic atrophy in a family.Methods The proband's medical history and family history were inquired in detail,and relevant clinical examina-tions were performed to confirm the diagnosis of auditory neuropathy with optic atrophy,and the genetic pedigree of the family was drawn.Peripheral blood of proband(Ⅲ-7)was collected for whole exome sequencing,and the patho-genicity of the detected mutations were interpreted.Blood samples of proband's wife(Ⅲ-8),eldest daughter(Ⅳ-7),second daughter(Ⅳ-9)and son(Ⅳ-10)were tested for mutation sites by Sanger sequencing.Combined with clinical manifestations and examination results,the family was studied.Results The genetic pattern of this family was autosomal dominant.The proband showed decreased visual acuity at the age of 19,bilateral sensorineural deaf-ness at the age of 30,and decreased speech recognition rate.Among 20 members of the family of 5 generations,10(2 deceased)showed similar symptoms of hearing and visual impairment.Proband(Ⅲ-7),eldest daughter(Ⅳ-7)and son(Ⅳ-10)underwent relevant examination.Pure tone audiometry showed bilateral sensorineural deafness.ABR showed no response bilaterally.The 40 Hz AERP showed no response in both ears.OAE showed responses in some or all of the frequencies.No stapedial reflex was detected.The eye movement of Ⅲ-7 and Ⅳ-10 were reasona-ble in all directions,and color vision was normal.Ocular papilla atrophy was observed in different degrees in fundus examination.OCT showed thinning of optic disc nerve fibers in both eyes,and visual evoked potential showed pro-longed P100 wave peak.They were diagnosed as hereditary auditory neuropathy with optic atrophy.A mutation of the OPA1 gene c.1334G＞A(p.Arg445His,NM_015560.2)at a pathogenic locus on chromosome 3 was detected by whole exon detection in Ⅲ-7.The results of generation sequencing analysis showed that the OPA1 gene c.1334G＞A(p.Arg445His,NM_015560.2)mutation of chromosome 3 was also found in Ⅳ-7 and Ⅳ-10.Meanwhile,the gen-otypes of Ⅲ-8 and Ⅳ-9 were wild homozygous,that is,no mutation occurred.Conclusion The OPA1 c.1334G＞A(p.Arg445His,NM_015560.2)mutation site might be the pathogenic mutation in this family.

BACKGROUND:Osteonecrosis due to drugs is a serious adverse reaction occurring after the application of such drugs.Increasing evidence suggests that the gut microbiota composition is associated with osteonecrosis due to drugs.However,the causal relationship of the gut microbiota to osteonecrosis due to drugs is still unclear. OBJECTIVE:To evaluate the potential causal relationship between the gut microbiota and the risk of osteonecrosis due to drugs using the Mendelian randomization method. METHODS:A two-sample Mendelian randomization study was performed using the summary statistics of gut microbiota from the largest available genome-wide association study meta-analysis(n=13 266)conducted by the MiBioGen consortium as well as the summary statistics of osteonecrosis due to drugs obtained from the FinnGen consortium R9 release data(264 cases and 377 013 controls).Inverse variance weighted,MR-Egger,weighted median,weighted model and simple model were used to examine the causal association between gut microbiota and osteonecrosis due to drugs.Sensitivity analysis was used to test whether the results of the Mendelian randomization analysis were reliable.Reverse Mendelian randomization analysis was performed on all the bacteria as an outcome for effect analysis and sensitivity analysis. RESULTS AND CONCLUSION:Inverse variance weighted estimates suggested that Lentisphaerae(phylum),Lentisphaeria(class),Melainabacteria(class),Gastranaerophilales(order),Rhodospirillales(order),Victivallales(order)and Bifidobacterium(genus)had protective causal effects on osteonecrosis due to drugs.Methanobacteria(class),Bacillales(order),Methanobacteriaceae(family),Lachnospiraceae(family),Methanobacteriales(order),Holdemania(genus),Holdemania(UCG010 group)(genus),Odoribacter(genus)and Tyzzerella3(genus)had negative causal effects on osteonecrosis due to drugs.According to the results of reverse Mendelian randomization analysis,Clostridiaceae1(family),Peptostreptococcaceae(family),Streptococcaceae(family),Clostridiumsensustricto1(genus)and Streptococcus(genus)showed negative causal effects on osteonecrosis due to drugs.However,Eisenbergiella(genus)showed protective causal effects on osteonecrosis due to drugs.None of the bidirectional sensitivity analysis revealed heterogeneity or horizontal pleiotropy.When gut microbiota were used as exposure and osteonecrosis due to drugs as the outcome,Mendelian randomization analysis found that seven bacterial traits were positively correlated to osteonecrosis due to drugs,nine bacterial traits were negatively related to osteonecrosis due to drugs.When osteonecrosis due to drugs were used as exposure and gut microbiota as the outcome,reverse Mendelian randomization analysis found a negative correlated relationship with five bacterial traits and a positive causal relationship with one bacterial trait.By changing the diversity and composition of gut microbiota,it is expected to improve the incidence and prognosis of osteonecrosis due to drugs,providing new ideas for the study of orthopedic diseases.