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.

Objective To systematically evaluate the efficacy and safety of traditional Chinese medicine (TCM) compound in treating pulmonary nodules, providing evidence-based medical evidence for TCM intervention in pulmonary nodules. Methods Computer search of PubMed, CNKI, Wanfang, VIP, and SinoMed was conducted to select randomized controlled trials (RCTs) of TCM compound intervention in pulmonary nodules, with the retrieval time from the inception to November 29, 2023. The Cochrane bias risk assessment tool was used to evaluate the quality of the included studies, and Review Manager 5.4 was used for Meta-analysis. Results A total of 18 RCTs were included, covering 8 provinces across the country, with a total sample size of 1301 patients. The TCM compounds used in the included studies all incorporated the method of dissolving phlegm and dissipating nodules. There was a high risk of bias uncertainty in the included studies. Meta-analysis results suggested that TCM compound could significantly reduce the diameter of pulmonary nodules [MD=−1.41, 95%CI (−1.70, −1.13), P<0.001], decrease the number of nodules [MD=−0.37, 95%CI (−0.73, −0.01), P=0.05], alleviate clinical symptoms [MD=−4.84, 95%CI (−6.04, −3.64), P<0.001], and improve lung function [forced expiratory volume in one second (FEV1), MD=0.55, 95%CI (0.09, 1.01), P=0.02; FEV1/forced vital capacity, MD=6.12, 95%CI (4.47, 7.78), P<0.001]. However, there was no statistically significant difference in the probability of malignancy between the experimental group and the control group [MD=−0.01, 95%CI (−0.01, 0.00), P=0.09]. Conclusion TCM compound can significantly reduce the diameter of pulmonary nodules, decrease the number of nodules, alleviate clinical symptoms, and improve lung function, but future multicenter, large-sample, high-quality RCTs are still needed to further explore and verify this conclusion.

Objective:To establish a linear calibration method using two reference substances for seven characteristic peaks of Cassiae Semen under complicated chromatographic condition,and to optimize the method.Methods:Using 15 different types of screened chromatographic columns and 2 components as reference compounds pair,the linear calibration method with 2 reference substances was established to predict the retention time of the other 5 components,and the method was verified by unknown chromatographic columns and unknown samples.Combined with column confirmation number and average coincidence rate of target peaks,the location results were compared comprehen-sively,and the method was optimized according to the defect under the influence of complicated chromatographic condition.Results:The average conformity rate of the target peak of the method before optimization was 73.3％,and the average conformity rate of the target peak of the optimized method was 98.7％.The optimized method has a high-er average peak coincidence rate and a wider range of applicability for the chromatographic column.Conclusion:The optimized linear calibration method using two reference substances can assist the localization analysis of chromato-graphic peaks in the characteristic chromatogram under complicated chromatographic condition.

Objective To investigate the effects of five-element music on depressive behaviors and intestinal flora in offspring of fear-stress rats during pregnancy.Methods Thirty-six 0.5-day pregnant Wistar rats were divided randomly into a control group,fear-stress group,and five-element music group,and the subsequent litters continued the maternal grouping.Pregnant rats in the fear-stress and five-element music groups were modeled on days 1～19 of gestation using the bystander electric method,while the five-element music group was also exposed to Feather Tune five-element music intervention.The fear behavior and serum glucocorticoid(GC)levels in pregnant rats were assessed on day 20 of pregnancy by open field test and enzyme-linked immunosorbent assay,respectively,to evaluate the effectiveness of the model.Depression in 3-week-old offspring was evaluated by open field,tail suspension,and sucrose preference tests.Norepinephrine(NE),dopamine(DA),and 5-hydroxytryptamine(5-HT)levels in the hippocampus of the offspring were measured by high-performance liquid chromatography.Changes in the intestinal flora of the offspring were analyzed by 16S rRNA sequencing.Expression levels of the proximal colonic proteins claudin1,occludin,and ZO1 in the offspring were measured by Western blot assay.Results Pregnant rats in the fear-stress group stayed longer in the area around the open field(P＜0.05),had fewer entries into the central area(P＜0.001),and had higher serum GC levels compared with those in the blank group(P＜0.001).In contrast,five-element music exposure reversed these behavioral changes(P＜0.05)and serum GC levels(P＜0.001)in the fear-stress group.Offspring in the fear-stress group exhibited decreased open-field crossing frequency(P＜0.01),reduced sucrose preference index,and longer immobility time in the tail suspension test(P＜0.05),compared with those in the blank group,together with significantly decreased NE,DA,and 5-HT levels in the hippocampus(P＜0.05).Rats in the fear-stress group showed decreased diversity of the intestinal flora(P＜0.01)and significant alterations in flora structure,including higher abundance of Proteobacteria,Enterobacteriaceae,Enterococcus,and Escherichia(P＜0.05),and lower abundance of Spirochaetes,Spirochaetaceae,Lachnospiraceae,Ruminococcaceae,Treponema,Prevotella,Coprococcus,Allobaculum,Ruminococcus,and Dorea(P＜0.05).The proximal colonic proteins Claudin1,Occludin,and ZO1 were significantly downregulated(P＜0.05).The open-field crossing frequency,sucrose preference index,and duration of tail suspension immobilization were improved in the five-element music group compared with those in the fear-stress group(P＜0.05),while DA and 5-HT levels were significantly restored in the hippocampus(P＜0.05),species diversity of the intestinal flora increased(P＜0.01)and changes in the abundance of the flora were reversed,and the proximal colonic proteins Occludin and ZO1 expression were significantly upregulated(P＜0.05).Conclusions Five-element music intervention during pregnancy can ameliorate fear-stress-induced depression behaviors and intestinal flora disorders in the offspring.

Objective This study aims to investigate the epidemiological characteristics of mental disorders in a rural town of Huazhou City,Guangdong Province,and explore their association with the rural revitalization strategy,so as to provide evidence for policy formulation.Methods A combination of questionnaire surveys and in-depth interviews was used to collect in-formation on the demographic characteristics,disease status,economic conditions,and policy awareness of registered mental dis-order patients in the town.Semi-structured interviews were also conducted with local doctors and village committee members.Da-ta were analyzed using descriptive statistics and logistic regression models to assess the impact of awareness of rural revitalization policies on patients'income.Results The average age of the study subjects was 47.71 years,with an average disease duration of 18.38 years.A total of 86.36％of patients had a family history of mental disorders.After onset,42.11％of patients had an annual income≥￥ 10 000,which was an increase compared to pre-illness levels,but 60.75％had completely lost their ability to work.Awareness of rural revitalization policies was low(only 18.29％were fully aware),but policy awareness was significant-ly associated with increased patient income(OR=18.03,P＜0.001).Additionally,medical expenditures were significantly higher among female patients than male patients(P＜0.001).Conclusion In a town in Huazhou City,Guangdong Province,60.75％of mental disorder patients have completely lost their ability to work,while 42.11％have an annual income exceeding ￥ 10,000.Income is positively correlated with policy awareness(OR=18.03).It is recommended to strengthen policy promo-tion,optimize the allocation of medical resources,and develop specialized assistance programs to promote the coordinated devel-opment of mental health and rural revitalization.

Objective:To evaluate the effect of acupuncture on postoperative delirium (POD) in diabetic patients undergoing surgery under general anesthesia.Methods:In this randomized controlled trial, 92 diabetic patients of either sex, aged 30-80 yr, with a body mass index of 18-28 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ, scheduled for elective surgery under general anesthesia, were divided into 2 groups ( n=46 each) using a table of random numbers: control group (group C) and acupuncture group (group A). Group A received acupuncture at the Baihui (GV20), Shenting (GV24) and Sishencong (EX-HN1) acupoints before anesthesia. The needles were retained for 30 min, with manual stimulation applied every 10 min for 10 s each time. After 4 stimulations, routine anesthesia was carried out. Group C received routine anesthesia only. Regional cerebral oxygen saturation was recorded on admission to the operating room (T 0), after anesthesia induction (T 1), at the start of surgery (T 2), at the end of surgery (T 3), and immediately after tracheal extubation (T 4). The POD developed within 3 days after surgery was assessed. The occurrence of needle-related adverse effects such as fainting, subcutaneous bleeding, and local paresthesia was recorded. Results:Compared with group C, the incidence of POD was significantly reduced, and the regional cerebral oxygen saturation was increased at T 1, 4 in group A ( P<0.05). Conclusions:Acupuncture can decrease the development of POD in diabetic patients undergoing surgery under general anesthesia, which is related to an increase in regional cerebral oxygen saturation.

To enhance the practical ability and job competency of full-time master of public health (MPH) postgraduates and explore a collaborative training mode that integrates medical education with a prevention-and-control approach, in line with standardized public health physician training, the Beijing Center for Disease Control and Prevention, in collaboration with the School of Public Health affiliated to Capital Medical University, had recruited full-time MPH postgraduates since 2015. These students were trained and assessed through a collaborative training mode based on the Beijing public health physician training mechanism. Through the introduction and analysis of the training objectives, training process, practical assessment methods, training quality, and results, this article suggests that the construction of a collaborative training mode integrating MPH postgraduate education of public health professionals and standardized public health physician training has explored a new pathway for cultivating "four-certification integration" public health professionals. This aligns with the Chinese national strategy for public health talent development and can alleviate the problems of "contradictions between work and study", including the current shortage of public health physicians at present and the difficulties in standardized training enrollment. In addition, this collaborative training mode provides valuable experience for other medical schools in training applied public health professionals who meet national public health standards and combine prevention with treatment.

Objective The purpose of writing the"expert consensus on humanistic care for patients in hospice care"(hereinafter referred to as the"consensus")aims to standardize the practice of humanistic care in the field of hospice care,ensuring that humanistic care is integrated throughout the entire service process for hospice care patients and their families.Methods A systematic search was conducted in domestic and foreign databases for literature related to hospice care and humanistic care,including guidelines,expert consensuses,systematic reviews or Meta-analyses,and evidence summaries.High-quality evidence was evaluated,extracted,and summarized to form the initial draft of the"consensus".From June to October 2024,20 experts from the fields of hospice care,nursing humanities,and evidence-based nursing were invited to participate in 1 round of expert consultation.Among them,13 experts were selected for 2 rounds of expert demonstration meetings.After collating and analyzing the experts' opinions,the initial draft was revised and refined,ultimately resulting in the final version of the"consensus".Results The effective response rate of the consultation questionnaire was 100％,with expert authority coefficient of 0.880,judgment coefficient of 0.935,and familiarity level of 0.825.The Kendall harmony coefficient of the expert consultation was 0.134(P＜0.05).The"consensus"consisted of 13 aspects,including the targets and objectives,principles,institutional guarantees,environmental requirements,etc.Conclusion This"consensus"possesses strong scientific rigor and practicality,which can provide guidance and references for the practice of humanistic care in the field of hospice care,promoting the standardization and humanization of hospice care services.

Objective:To investigate the prevalence and influencing factors of depression,anxiety and comorbid depression-anxiety symptoms among college freshmen,providing a theoretical basis for promoting their mental health.Methods:From Jan to Feb 2022,an online questionnaire survey was conducted,involving 483 online questionnaires from college freshmen(184 males,299 females).The depression-anxiety-stress self-rating scale,smartphone dependence self-rating scale for adolescents,and Pittsburgh sleep quality index(PSQI)were used for online surveys.The influencing factors of depression,anxiety,and their comorbidity among college freshmen were analyzed by multivariable logistic regression analysis.Results:The detection rates of smartphone dependence,sleep disorders,depression,anxiety and comorbid depression-anxiety symptoms among college freshmen were 26.1%,12.8%,26.3%,32.1%,and 23.6%,respectively.The detection rates of depression,anxiety and comorbid depression-anxiety symptoms in male students were significantly higher than those in female students(P＜0.05).Multivariable logistic regression analysis showed that self-perceived poor mental health,smartphone dependence and sleep disorders were risk factors for depression,anxiety and comorbid depression-anxiety symptoms.Low satisfaction with college life was a risk factor for depression.Medical specialty was a risk factor for anxiety and comorbid depression-anxiety symptoms(P＜0.05).Conclusions:Male college freshmen show higher rates of depression,anxiety,and their comorbidity.Low satisfaction with college life,self-perceived poor mental health,high academic pressure,smartphone dependence,medical specialty,and sleep disorders may be risk factors for depression,anxiety and comorbid depression-anxiety symptoms among college freshmen.

Objective:To investigate the prevalence and influencing factors of depression,anxiety and comorbid depression-anxiety symptoms among college freshmen,providing a theoretical basis for promoting their mental health.Methods:From Jan to Feb 2022,an online questionnaire survey was conducted,involving 483 online questionnaires from college freshmen(184 males,299 females).The depression-anxiety-stress self-rating scale,smartphone dependence self-rating scale for adolescents,and Pittsburgh sleep quality index(PSQI)were used for online surveys.The influencing factors of depression,anxiety,and their comorbidity among college freshmen were analyzed by multivariable logistic regression analysis.Results:The detection rates of smartphone dependence,sleep disorders,depression,anxiety and comorbid depression-anxiety symptoms among college freshmen were 26.1%,12.8%,26.3%,32.1%,and 23.6%,respectively.The detection rates of depression,anxiety and comorbid depression-anxiety symptoms in male students were significantly higher than those in female students(P＜0.05).Multivariable logistic regression analysis showed that self-perceived poor mental health,smartphone dependence and sleep disorders were risk factors for depression,anxiety and comorbid depression-anxiety symptoms.Low satisfaction with college life was a risk factor for depression.Medical specialty was a risk factor for anxiety and comorbid depression-anxiety symptoms(P＜0.05).Conclusions:Male college freshmen show higher rates of depression,anxiety,and their comorbidity.Low satisfaction with college life,self-perceived poor mental health,high academic pressure,smartphone dependence,medical specialty,and sleep disorders may be risk factors for depression,anxiety and comorbid depression-anxiety symptoms among college freshmen.