Objective: To investigate the distribution frequency and molecular mechanism of the rare blood type Lu(a-b-) in Shenzhen, and to compare the polymorphisms of the Lutheran blood group system encoding gene LU and the In (Lu) phenotype-related gene KLF1 among Han Chinese, Indian, and Uyghur populations in Xinjiang. Methods: Serological methods were used to screen the Lu(a-b-) phenotype of blood donors in Shenzhen. Third-generation sequencing was employed to sequence the full-length of the LU and KLF1 genes in Lu (a-b-) phenotype samples as well as the samples from the Han Chinese, Indians, and Uyghur population, followed by analysis of gene haplotypes frequencies. Results: Ten individuals with the Lu(a-b-) phenotype were screened out of 14 367 blood donors in Shenzhen, yielding a frequency of approximately 0.07%. Only 2 cases showed mutations in the coding region of the LU gene, while all individuals showed heterozygous mutations in the coding region of the KLF1 gene. The highest mutation frequencies of the LU and KLF1 genes were observed in the Uyghur population in Xinjiang and the Han Chinese in Shenzhen, respectively. Conclusion: All Lu(a-b-) phenotypes are of the In (Lu) type, and their formation mechanism is mainly related to KLF1 gene mutations. Both the LU and KLF1 genes exhibit significant polymorphism in the Han Chinese, Indians, and Uyghur populations.

Objective: To develop QingNangTCM, a specialized large language model (LLM) tailored for expert-level traditional Chinese medicine (TCM) question-answering and clinical reasoning, addressing the scarcity of domain-specific corpora and specialized alignment. Methods: We constructed QnTCM_Dataset, a corpus of 100 000 entries, by integrating data from ShenNong_TCM_Dataset and SymMap v2.0, and synthesizing additional samples via retrieval-augmented generation (RAG) and persona-driven generation. The dataset comprehensively covers diagnostic inquiries, prescriptions, and herbal knowledge. Utilizing P-Tuning v2, we fine-tuned the GLM-4-9B-Chat backbone to develop QingNangTCM. A multi-dimensional evaluation framework, assessing accuracy, coverage, consistency, safety, professionalism, and fluency, was established using metrics such as bilingual evaluation understudy (BLEU), recall-oriented understudy for gisting evaluation (ROUGE), metric for evaluation of translation with explicit ordering (METEOR), and LLM-as-a-Judge with expert review. Qualitative analysis was conducted across four simulated clinical scenarios: symptom analysis, disease treatment, herb inquiry, and failure cases. Baseline models included GLM-4-9B-Chat, DeepSeek-V2, HuatuoGPT-II (7B), and GLM-4-9B-Chat (freeze-tuning). Results: QingNangTCM achieved the highest scores in BLEU-1/2/3/4 (0.425/0.298/0.137/0.064), ROUGE-1/2 (0.368/0.157), and METEOR (0.218), demonstrating a balanced and superior normalized performance profile of 0.900 across the dimensions of accuracy, coverage, and consistency. Although its ROUGE-L score (0.299) was lower than that of HuatuoGPT-II (7B) (0.351), it significantly outperformed domain-specific models in expert-validated win rates for professionalism (86%) and safety (73%). Qualitative analysis confirmed that the model strictly adheres to the “symptom-syndrome-pathogenesis-treatment” reasoning chain, though occasional misclassifications and hallucinations persisted when dealing with rare medicinal materials and uncommon syndromes. Conclusion Combining domain-specific corpus construction with parameter-efficient prompt tuning enhances the reasoning behavior and domain adaptation of LLMs for TCM-related tasks. This work provides a technical framework for the digital organization and intelligent utilization of TCM knowledge, with potential value for supporting diagnostic reasoning and medical education.

The ethical review exemption system was introduced to meet the needs of modernized ethical governance， implement hierarchical management for ethical review projects involving human subjects， and explore an ethical management model that reduces procedural supervision for specific types of research involving no greater than minimal risk. Through a comparative study， this paper seeks to elaborate on the differences between China and the United States （US） in the ethical review exemption system from multiple aspects， such as ethical regulations， risk definition， preconditions， applicable scenarios， and operational procedures. The aim is to provide references for ethical review committees to better implement the ethical review exemption system， enhance policy research， and ensure the fairness and objectivity of ethical review. Through the comparative study of the ethics review exemption system in China and the US， the following recommendations are proposed for institutions implementing the ethical review exemption system for reference. First， the system should clearly define the meaning of ethical review exemption to prevent researchers or even committee members from misunderstanding it as falling outside the scope of ethical review， thereby exposing research participants’ rights and interests to unnecessary risks. Second， the system should specifically explain the preconditions， including the requirements for research types and research risks. Among them， risks should be considered from multiple dimensions such as physiology， psychology， society， and economy. Clear explanations should be provided for involving commercial interests and sensitive personal information. Finally， the system should establish basic principles and judgment criteria for applicable scenarios， including specifying exactly what the public data refers to and legal requirements that need to be met， providing a concept of anonymization to distinguish it from deidentified information data， and clarifying the relevant regulations and ethical principles to be followed， as well as the clear requirements for informed consent.

OBJECTIVE:Although wearable electronic devices have demonstrated potential utility as intervention tools to enhance physical activity,comprehensive evaluations of their specific effects on the healthy adolescent population remain scarce.Consequently,this article aims to systematically explore and summarize the impact of interventions based on wearable electronic devices on the physical activity and sedentary behavior of healthy adolescents,thereby providing more precise and reliable evidence-based support for public health practices. METHODS:Randomized controlled trials assessing the effects of wearable electronic device-based interventions on the physical activity and sedentary behavior of healthy adolescents were retrieved from databases including Web of Science,PubMed,Scopus,The Cochrane Library,and EBSCO.Meta-analysis was conducted using Review Manager 5.4 and Stata 17,evaluating the effects of interventions on physical activity and sedentary behavior through the standardized mean difference.To ensure the robustness of the research findings,a Leave-One-Out sensitivity analysis was conducted,and subgroup analyses were carried out to explore the potential influence of different factors on the results.The review protocol was registered with the International Prospective Register of Systematic Reviews(CRD42023406645). RESULTS:(1)Twelve publications were ultimately included,consisting of three randomized controlled trials and nine cluster-randomized controlled trials,involving a total of 4 933 healthy adolescents.(2)Meta-analysis results revealed that interventions based on wearable electronic devices had a positive effect on moderate to vigorous physical activity[standardized mean difference(SMD)=0.10;95%confidence interval(CI):0.04 to 0.17;P<0.05).However,the interventions did not significantly improve low-intensity physical activity(SMD=-0.15;95%CI:-0.32 to 0.02;P>0.05),daily step count(SMD=0.13;95%CI:-0.65 to 0.91;P>0.05),and sedentary behavior(SMD=0.00;95%CI:-0.09 to 0.09;P>0.05).(3)Subgroup analyses indicated that short-term interventions(≤12 weeks)(SMD=0.11;95%CI:0.03 to 0.18;P=0.008),studies using pedometers worn at the waist or hip(SMD=0.10;95%CI:0.04 to 0.17;P=0.002),and experiments registered at clinical trial centers(SMD=0.11;95%CI:0.04 to 0.17;P=0.001)had a more significant effect on enhancing daily moderate to vigorous physical activity. CONCLUSION:The current evidence suggests that interventions based on wearable electronic devices possess certain advantages in enhancing the daily moderate-to-vigorous physical activity of healthy adolescents.It is recommended that interventions not exceeding 12 weeks and utilizing pedometers positioned at the waist or hip may yield more favorable results.However,the effects of these interventions on daily step count,low-intensity physical activity,and sedentary behavior exhibit some limitations.Consequently,future investigations necessitate higher-quality,larger-scale randomized controlled trials for further validation.

The release of the medical service price item guide is an important content of deepening the reform of medical service price,and is also a major measure to unify and standardize the medical service price item.Taking the Nursing Medical Service Price Item Proposal Guide(hereinafter referred to as the Nursing item Proposal Guide)as an example,it introduces the preparation ideas,framework structure design and item element changes of the nursing item proposal guide,sorts out the progress of docking and implementation of the Nursing Item Proposal Guide in typical provinces,and makes comparisons to obtain inspiration for accelerating the implementation of the item proposal guide in other regions:ensure the participation of clinical and price experts,mapping old and new items and integrating elements according to item guidelines;comprehensive use of cost pricing,reference pricing and value pricing,check and standardize the integrated item price;to standardize the integration of new item price adjustment and medical insurance payment policy coordination,forming a positive superposition effect;make a list of consumables that can be charged separately,and do a good job in the connection between product registration and price medical insurance policies;strengthen publicity and training,update information systems,monitor service volume,and track the effect of price policy implementation.

Objective:To explore the effect of EAERI (E: environment; A: accompany; E: emotion; R: respect; I: information) support strategies in the application of nurse second victims in restoring the passage of a patient safety incident, and to provide support to nurse second victims experiencing a safety incident in restoring the incident and mitigating secondary victimization from the incident.Methods:The method of historical comparison was adopted. A convenience sampling method was used to select nurses who experienced patient safety events in Shanxi Bethune Hospital (Shanxi Academy of Medical Sciences) from January 2023 to February 2024 as the study subjects, which were divided into observation group and control group by the historical control grouping method. The observation group used the EAERI support strategy for patient safety incident reduction, and the control group used the conventional reduction method. The second victims of the nurses in both groups were assessed for their level of harm and support in the patient safety incident using the Second Victim Experience and Support Tool before and after the event reduction, respectively.Results:A total of 124 second victims completed the study. There were 63 cases in the control group, including 13 males and 50 females, with an age of (30.24 ± 4.91) years old. There were 20 males and 41 females in the observation group, with an age of (30.85 ± 5.50) years old. Before the restoration event, there was no significant differences in the total scores of victim experience and support, the degree of injury and the degree of support between the two groups (all P>0.05). The total scores of victim experience and support, the degree of injury and the degree of support were (89.35 ± 10.69), (44.57 ± 6.19), (44.78 ± 9.40) points in the control group, and (64.13 ± 9.36), (33.56 ± 8.84), (30.56 ± 3.17) points in the observation group. The differences were significant between the two groups ( t=14.02, 8.07, 11.29, all P<0.01). Conclusions:The EAERI support strategy is feasible and effective. The implementation of the EAERI support strategy can reduce the degree of injury when the second victim of the nurse restores the safety incident and improve the degree of support.

As the main body of scientific research and innovation in hospitals,timely understanding of medical person-nel's scientific research outputs and its influencing factors has practical guiding significance for hospital management to identify scientific research talents,formulate targeted training programs,customize relevant science and technology policies,etc.This ar-ticle will comprehensively elaborate the concept of scientific research outputs,evaluation methods and influencing factors of scien-tific research outputs among medical personnel.Meanwhile,the article will provide suggestions for influencing factors,in order to provide references for the hospital management in the future.

Inflammatory bowel disease(IBD)is a non-specific chronic inflammatory bowel condition.Crohn's disease(CD)and ulcerative colitis(UC)are the 2 main types of IBD.IBD is prone to recurrent attacks,which is associated with many factors,such as immune dysfunction,intestinal microenvironment homeostasis imbalance,and environmental and genetic factors;however,its specific pathogenesis is still unclear.Zebrafish has recently emerged as an emerging animal model and have been used extensively for mechanistic research into IBD,model construction,activity evaluation,and screening of anti-IBD agents,due to their unique biological advantages.Based on the latest research progress using zebrafish in the field of IBD,this review systematically introduces the intestinal development characteristics,tissue structure,intestinal immunity,IBD model,and the application of drug screening in zebrafish,to demonstrate the value of zebrafish in the study of IBD.

The release of the medical service price item guide is an important content of deepening the reform of medical service price,and is also a major measure to unify and standardize the medical service price item.Taking the Nursing Medical Service Price Item Proposal Guide(hereinafter referred to as the Nursing item Proposal Guide)as an example,it introduces the preparation ideas,framework structure design and item element changes of the nursing item proposal guide,sorts out the progress of docking and implementation of the Nursing Item Proposal Guide in typical provinces,and makes comparisons to obtain inspiration for accelerating the implementation of the item proposal guide in other regions:ensure the participation of clinical and price experts,mapping old and new items and integrating elements according to item guidelines;comprehensive use of cost pricing,reference pricing and value pricing,check and standardize the integrated item price;to standardize the integration of new item price adjustment and medical insurance payment policy coordination,forming a positive superposition effect;make a list of consumables that can be charged separately,and do a good job in the connection between product registration and price medical insurance policies;strengthen publicity and training,update information systems,monitor service volume,and track the effect of price policy implementation.

Objective:To explore the distribution characteristics of Mycoplasma pneumoniae (MP) antibody detection data in hospital, provide data reference for the prevention and control of MP infections.Methods:A single-center retrospective study was conducted on 20 639 patients with suspected Mycoplasma pneumoniae (MP) infection from March 2017 to February 2024 at the outpatient, emergency, and inpatient departments of Peking University Third Hospital. The age range was from 0 to 105 years, with 11 286 males and 9 353 females. The passive agglutination method was used to detect MP antibodies in patient serum, and SPSS 22.0 statistical software was used for statistical analysis. The χ2 test was used to analyze the differences in positive rates of MP antibodies among different genders, age groups, seasons, years, and antibody titers. The trend χ2 test was used to analyze the trend of detection rates with age changes. Results:Among the 20 639 patients, the positive rate of MP antibodies was 23.19%(4 786/20 639), with a higher positive rate in females was 27.16%(2 540/9 353) compared to males (19.90%, 2 246/11 286; χ2=151.191, P<0.01). The positive rate in children was 37.13%(2 731/7 356)significantly higher than in adults(15.47%, 2 055/13 283; χ2=1 246.433, P<0.01). The 6 to <12 year age group (63.11%, 1 223/1 938) had the highest positive rate of MP antibodies, followed by 12 to <18 year old group (56.78%, 385/678). The positive rate of MP antibodies increased with age from 0 to 12 years old but gradually decreased after 12 to <18 years old ( χ2=3 848.393, P trend<0.01). The annual MP antibody positivity rates from 2017 to 2023 were 26.92%, 29.23%, 27.46%, 18.43%, 17.16%, 11.89%, and 23.72%, respectively, with statistically significant differences among the years ( χ2=387.519, P<0.01). The MP antibody positive rate was high in autumn over the course of 7 years ( χ2=242.560, P<0.01). The positive rates of MP antibodies for the years 2017-2019, 2020-2022, and 2023-2024 are (28.00%, 16.60%, 21.84%), respectively, with statistically significant differences among the three periods( χ2=295.845, P<0.01).The monthly positive rates of MP antibody in different years were (5.63% to 43.11%). In the MP antibody titer, qualitative testing was conducted on 4 563 patients and 16 076 patients had a semi-quantitative MP antibody titer of ≥1∶160 with a positive rate of 16.03%(2 577/16 076). Among the proportion of children with high titers of MP antibodies ≥1∶1 280 was 11.11%(798/7 182). Conclusion:The positive rates of MP antibodies in hospital in the Beijing area vary among different genders, ages, and seasons, with a higher incidence in autumn, mainly among children and adolescents.