Objective: To report the antibody identification, blood management during pregnancy and the monitoring process of fetal hemolytic disease of fetus and newborn (HDFN) in a pregnant woman with a history of blood transfusion and pregnancy who developed anti-Jr . Methods: Saline tube technique and anti-human globulin technique were used for maternal blood typing, unexpected antibody screening and identification, as well as for determining antibody titer and IgG subclasses. PCR-SSP was employed for genotyping of 18 blood group systems. Next-generation sequencing (NGS) was utilized for gene sequencing of 38 blood group systems. Sanger sequencing was applied to verify rare blood group mutations detected by NGS and to investigate the corresponding rare blood group genes in family members. Blood preparation was achieved through anemia management in prenatal clinics and autologous blood collection during pregnancy. The newborn underwent the three primary tests for HDFN and plasma IgG subclass testing. Results: The pregnant woman's blood type was B, RhD positive, with a positive unexpected antibody screen, and the antibody identification pattern was consistent with a high-frequency antigen antibody. Gene sequencing revealed a homozygous ABCG2 c.376C>T mutation in the woman, resulting in the Jr(a-) phenotype, and anti-Jr antibody was present in her plasma. No compatible Jr(a-) blood was found among family members. The maternal anti-Jr IgG titer remained stable at 256 during pregnancy, with no detectable IgG1 or IgG3 subclasses against the Jr antigen. A total of 800 mL of autologous blood was collected in two stages during pregnancy. The newborn was B, RhD positive, Jr(a+), with a positive unexpected antibody screen (anti-Jr ). IgG subclass typing detected no IgG1 or IgG3. The direct antiglobulin test was positive, while the acid elution test was negative. Conclusion: The combination of serology and blood group genetic analysis provides a diagnostic basis for identifying antibodies to high-frequency antigens. Managing perinatal anemia and implementing staged autologous blood storage can secure blood supply for the perioperative period. IgG antibody subclass typing offers a reference for clinical assessment and prevention of HDFN.

Linxian County in Henan Province, Northern China is known as the region with the highest incidence and mortality rate of esophageal cancer worldwide. Since 1959, the Henan medical team has conducted field work on esophageal cancer prevention and treatment in Linxian. Through three generations of effort exerted by oncologists over 65 years of research on esophageal cancer prevention and treatment in Linxian, the incidence rate of esophageal squamous cell carcinoma in this area has dropped by nearly 50%, and the 5-year survival rate has increased to 40%, reaching the international leading level. This article aims to summarize the history, present opportunities and new challenges, and explore the experience of esophageal cancer prevention and treatment in Linxian (referred to as the “Linxian experience”), providing reference and guidance to cancer prevention and treatment research in China.

ObjectiveTo investigate the safety and efficacy of puncture cyanoacrylate selective seal （PCSS） under endoscopic ultrasound in the treatment of gastroesophageal varices （GOV）. MethodsA total of 100 patients with liver cirrhosis who underwent endoscopic therapy for the secondary prevention of GOV bleeding in Beijing Ditan Hospital， Capital Medical University， from March 1 to December 31， 2023 were enrolled and randomly divided into PCSS group and traditional endoscopy group. The patients were followed up for 6 months after surgery， and the two groups were compared in terms of clinical outcome and complications. The primary outcome measure was the rate of alleviation or disappearance of GOV， and the secondary outcome measure was variceal rebleeding and death. The independent-samples t test was used for comparison of normally distributed or approximately normally distributed quantitative data between two groups， and the Wilcoxon non-parametric test was used for comparison of non-normally distributed quantitative data between two groups； the chi-square test or the Fisher’s exact test was used for comparison of qualitative data between two groups. ResultsThere were 50 patients in the PCSS group， among whom 1 patient was lost to follow-up， and there were 50 patients in the traditional endoscopy group， among whom 3 patients were lost to follow-up. There were no significant differences between the two groups in baseline data such as age， sex， Child-Pugh class， varices grade， and GOV typing （all P>0.05）. Compared with the traditional endoscopy group， the PCSS group had significantly better results of the number of endoscopic treatment sessions （t=-15.671， P=0.001）， the total amount of tissue adhesive used （t=-2.830， P=0.006）， and the rate of alleviation or eradication of varices sclerosis （χ²=7.078， P=0.029）. Both groups had low rates of postoperative rebleeding， adverse reactions， and complications， and there were no significant differences between the two groups （all P>0.05）. ConclusionCompared with traditional endoscopy， PCSS can significantly enhance treatment outcome while maintaining safety standards.

AIM: To quantitatively evaluate the clinical characteristics of haze after transepithelial photorefractive keratectomy(TPRK)for astigmatism using corneal densitometry.METHODS:In this retrospective clinical study, a total of 74 patients(106 eyes)with astigmatism ≥1.25 D who underwent TPRK in our hospital from October 2022 to December 2024 were continuously collected. All of the study subjects were divided into transparent group(65 eyes)and haze group(41 eyes)based on whether haze occurred after surgery. Pentacam examination was performed before and after surgery, and corneal densitometry was recorded at the time points of preoperation, 1 mo postoperation in the transparent group and the most severe haze degree in the haze group. The collected corneal densitometry included the average densitometry of the entire corneal layer in the central 2 mm, 2-6 mm, and 6-10 mm areas, as well as the average densitometry of the entire layer of the corneal section in the center 6 mm of the astigmatism axis(astigmatism expressed in negative cylindrical form)and orthogonal axis(the axis perpendicular to the astigmatism axis), and the average densitometry of the entire layer of the corneal section in the nasal and temporal 2-6 mm areas of the astigmatism axis in the haze group of patients with regular astigmatism. The change in corneal densitometry after surgery compared with that before surgery was calculated.RESULTS:There was no statistically significant difference in baseline data such as gender, age, and spherical equivalent between the transparent group and the haze group(all P>0.05). The change in corneal densitometry in the 2-6 mm area of the haze group was greater than that in the transparent group(Z=-2.226, P=0.026), while there was no significant difference in the change of corneal densitometry in the central 2 mm and 6-10 mm areas between the two groups(both P>0.05). There was no significant difference in the change of corneal densitometry between the transparent group and haze group along the orthogonal axis(all P>0.05), while the change of corneal densitometry in the haze group along the astigmatism axis was greater than that in the transparent group(Z=-2.371, P=0.018). The temporal corneal densitometry of patients with regular astigmatism in the haze group after surgery was higher than that of the nasal side, and the change in corneal densitometry was also greater than that of the nasal side(Z=-4.288, P<0.001; Z=-4.043, P<0.001).CONCLUSION:Unlike spherical correction for myopia and hyperopia, haze after TPRK for astigmatism was mainly manifested in the peripheral cutting area of the astigmatism axis, and patients with regular astigmatism had a higher probability or severity of haze on the temporal side of the astigmatism axis than on the nasal side.

Objective To investigatethe relationship between gastroesophageal reflux disease (GERD) symptoms and clinicopathological characteristics, p53 expression, and survival of Chinese patients with esophageal adenocarcinoma. Methods A total of 3882 patients with esophageal adenocarcinoma, 970 matched patients with esophageal squamous cell carcinoma, and 970 matched patients with gastric cardia adenocarcinoma were included to compare the incidence of GERD symptoms. Patients with esophageal adenocarcinoma were divided into two groups according to the presence and absence of GERD symptoms. The differences in clinicopathological characteristics and p53 expression between the two groups were compared by chi-square test, and the differences in survival between the two groups were compared by landmark analysis. Results The incidence of GERD symptoms increased successively in esophageal squamous cell carcinoma, esophageal adenocarcinoma, and gastric cardia adenocarcinoma. In patients with esophageal adenocarcinoma, the proportions of male, less than 65 years old, lower thoracic tumors, tumors without squamous cell carcinoma, poorly differentiation, early tumors (stage 0-I), and p53-positive tumors in the group with GERD symptoms were higher than those in the group without GERD symptoms; moreover, the long-term survival (≥15 years) was better. Conclusion GERD symptom is an important clinical sign of esophageal adenocarcinoma. It is closely related to specific clinicopathological characteristics, p53 overexpression, and good long-term prognosis.

The prevalence of periodontitis in China is as high as 74.2%, making it the leading cause of tooth loss in adults and severely impacting both oral and overall health. The treatment of periodontitis and periodontal tissue regeneration are global challenges of significant concern. GE Shaohua' s group at School and Hospital of Stomatology, Shandong University has focused on the key scientific issue of "remodeling the periodontal inflammatory microenvironment and optimizing tissue repair and regeneration". They have elucidated the mechanisms underlying the persistence of periodontitis, developed bioactive materials to enhance stem cell regenerative properties, and constructed a series of guided tissue regeneration barrier membranes to promote periodontal tissue repair, leading to the establishment of a comprehensive technology system for the treatment of periodontitis. Specific achievements and progress include: (1) Elucidating the mechanism by which key periodontal pathogens evade antimicrobial autophagy, leading to inflammatory damage; developing intelligent antimicrobial hydrogels and nanosystems, and creating metal-polyphenol network microsphere capsules to reshape the periodontal inflammatory microenvironment; (2) Explaining the mechanisms by which nanomaterial structures and electroactive interfaces regulate stem cell behavior, developing optimized nanostructures and electroactive biomaterials, thereby effectively enhancing the regenerative repair capabilities of stem cells; (3) Creating a series of biphasic heterogeneous barrier membranes, refining guided tissue regeneration and in situ tissue engineering techniques, stimulating the body' s intrinsic repair potential, and synergistically promoting the structural regeneration and functional reconstruction of periodontal tissues. The research outcomes of the group have innovated the fundamental theories of periodontal tissue regeneration, broken through foreign technological barriers and patent blockades, established a cascade repair strategy for periodontal regeneration, and enhanced China' s core competitiveness in the field of periodontal tissue regeneration.
Humans ; Stem Cells/physiology* ; Periodontitis/therapy* ; Guided Tissue Regeneration, Periodontal/methods* ; Regeneration ; Biocompatible Materials ; Tissue Engineering/methods*

Objective: To evaluate the therapeutic potential and underlying mechanisms of action of propolis in db/db mice. Methods: The chemical composition of propolis was analyzed using UHPLC-MS/MS. Thirty mice, including six wt/wt and 24 db/db mice, were randomly assigned to four groups (n = 6 per group): control, model, metformin (250 mg/kg), low dose propolis (100 mg/kg), and high dose propolis (HDP; 400 mg/kg). Treatments were administered orally for four weeks. Body weight and FBG levels were recorded weekly, and an oral glucose tolerance test was conducted on the 25th day. Serum levels of FIN, GSP, connecting peptide, AST, ALT, HDL, LDL, TG, and TC were quantified using ELISA. Liver histopathology was assessed using H&E and PAS staining. Western blotting was performed to examine the expression levels of NF-κB, phosphorylated NF-κB, IκBα, pIκBα, and AKT in liver tissues. Results: The top 10 metabolites of propolis were identified in positive and negative ion modes. The HDP group exhibited a significant reduction in FBG levels, body weight, connecting peptide levels, homeostatic model assessment of β-cell function scores, and homeostasis model assessment of insulin resistance scores (all P < .05). GSP levels were significantly reduced in both treatment groups (all P < .001). The HDP group also exhibited a reduction in TC and LDL levels (both P < .05), whereas HDL levels increased in both treatment groups (all P < .05). Liver weight, AST levels, and ALT levels were reduced in both treatment groups (all P < .05). Histological analysis revealed improved liver morphology. Protein analysis demonstrated downregulation of phosphorylated NF-κB and phosphorylated IκB, alongside upregulation of AKT. Conclusion Propolis exhibited significant antihyperglycemic effects in db/db mice, potentially by modulating the AKT and NF-κB signaling pathways, highlighting its potential as a therapeutic agent for diabetes management.

Ovarian sclerosing stromal tumor(OSST)is a benign tumor originating from the ovarian sex cord-stroma,accounting for only 2%-6%of ovarian stromal tumors.It predominantly occurs in young women,and cases of OSST concurrently presenting with Meigs syndrome are extremely rare.This study reports a case of OSST,summarizes its clinical manifestations,and reviews relevant literature.The patient,a 22-year-old female,was admitted due to abdominal distension for 2 months,worsening over the past week.The physical examination results revealed abdominal distension,shifting dullness,mild tenderness,and no muscle tension or rebound tenderness.A mass measuring approximately 16.0 cm×14.0 cm×8.0 cm was palpated in the pelvic and abdominal cavity,with a firm texture,moderate mobility,and no tenderness.The gynecological ultrasound results showed a mixed cystic-solid echo of about 15.3 cm×14.0 cm×8.4 cm above the left side of the uterus,with clear boundaries,and fluid-filled dark areas in the pelvic and abdominal cavity,with a maximum anteroposterior diameter of about 11.9 cm.The-CT results revealed a cystic-solid mixed-density mass in the lower abdomen and right adnexal area,suggestive of a neoplastic lesion,with increased glucose metabolism in the solid portion,leaning toward malignancy.Carbohydrate antigen 125(CA125)was>800 U·mL-1,and pelvic puncture cytology indicated no cancer cells.The findings suggested a benign or borderline ovarian tumor,requiring differentiation from ovarian malignant tumors.Based on intraoperative observations and rapid pathological results,a left ovarian tumor enucleation was performed.Postoperative pathology confirmed ovarian sclerosing stromal tumor.Follow-up over 2 years showed no abnormalities.As a benign ovarian tumor,the clinical manifestations of OSST often mimic those of malignant tumors,leading to frequent misdiagnosis.Early diagnostic accuracy should be improved to develop the optimal treatment plan for patients.

Objective To investigate the expression levels of micro RNA-651(miR-651)and the transcrip-tion factor Forkhead Box N2(FOXN2)in lung cancer tissues and to analyse their relationship with patients' prognosis after lobectomy.Methods A total of 98 patients with lung cancer who underwent lobectomy from January 2020 to December 2021 in Nantong Cancer Hospital were selected as research objects,the lung cancer tissue specimens and corresponding paracancerous tissue specimens of patients were collected,the expression levels of miR-651 and FOXN2 were detected by real-time fluorescence quantitative PCR(qPCR),and their re-lationship with the prognosis of patients after lobectomy was analyzed.Results At 2-year follow-up,19(19.39％)of 98 patients had recurrent metastasis,and the median time to recurrent metastasis was 20 months(95％CI:18.626--21.374).qPCR assay showed that the expression levels of miR-651 and FOXN2 in lung cancer tissues were significantly lower than those in paracancerous tissues(P＜0.05).miR-651 and FOXN2 expression levels were significantly correlated with clinicopathological features such as tumour size,TNM stage and lymph node metastasis(P＜0.05).The results of univariate Cox regression analysis showed that the percentages of maximum tumor diameter ≥3 cm,TNM stage Ⅱ,lymph node metastasis,miR-651 low ex-pression and FOXN2 low expression were higher in the poor prognosis group than those in the good prognosis group(P＜0.05).Multifactorial Cox regression analysis showed that maximum tumor diameter ≥ 3 cm(HR=3.185,95％CI:1.105-9.182),TNM stage Ⅱ(HR=5.167,95％CI:1.939-13.771),lymph node metastasis(HR=2.860,95％CI:1.115-7.338),low miR-651 expression(HR=5.345,95％CI:1.845-15.483)and low FOXN2 expression(HR=5.404,95％CI:1.744-16.745)were independent risk factors for the prognosis of lung cancer patients after lobectomy(P＜0.05).Conclusion The expression levels of miR-651 and FOXN2 were reduced in the tissues of lung cancer patients,and both were associated with tumour size,TNM stage,lymph node metastasis,and patients' prognosis after lobectomy.

Objective To study the relationship between vaginal microecological balance and serum T cell subsets,Toll-like receptor 2(TLR2)and Toll-like receptor 4(TLR4)after hysterectomy.Methods The clinical data of 120 patients who underwent laparoscopic total hysterectomy in Daxing Teaching Hospital of Capital Medical University from June 2020 to June 2022 were retrospectively analyzed.The patients were assigned to normal group(n=50)and unbalanced group(n=70)according to postoperative vaginal microecological changes.General information,such as age,body mass index(BMI),disease type,expression of CD+4,CD+8,CD+4/CD+8,TLR2,and TLR4 were compared between the two groups.The risk factors affecting vaginal microecological balance after hysterectomy were analyzed by multivariate Logistic regression.Receiver operating characteristic(ROC)curve was drawn to evaluate the efficacy of serum T cell subsets,TLR2,and TLR4 in predicting vaginal microecological imbalance after hysterectomy.Results The levels of CD+4 and CD+4/CD+8 in the unbalanced group were significantly lower than those in the normal group,while the levels of CD+8,TLR2 and TLR4 in the unbalanced group were significantly higher than those in the normal group(P<0.05).Multivariable Logistic regression analysis showed that CD+4,CD+8,CD+4/CD+8,TLR2 and TLR4 expression were the influence factors of vaginal microecological imbalance after hysterectomy(P<0.05).ROC analysis confirmed that the expression of CD+4,CD+8 and CD+4/CD+8 and the levels of TLR2 and TLR4 could be used to predict vaginal microecological imbalance after hysterectomy,and the areas under the curve were 0.718,0.813,0.785,0.851,and 0.945,respectively(all P<0.05).Conclusion CD+4,CD+8,CD+4/CD+8,TLR2 and TLR4 expression levels are the influence factors of vaginal microecological imbalance after hysterectomy.They can be used as biological indicators for evaluating vaginal microecological balance after hysterectomy.