Objective: To evaluate the safety and efficacy of ABO non-identical platelets with reduced plasma (ABO-NPRP) transfusion in patients with hematological diseases. Methods: A retrospective analysis was conducted on 52 therapeutic doses of apheresis platelets with reduced plasma prepared at Chongqing Blood Center of the Chinese People's Liberation Army. The transfusion efficacy (24 h CCI) and the transfusion adverse reactions of these apheresis platelets were also observed in 35 patients with hematological diseases in First Affiliated Hospital of Army Medical University. Comparisons were made with a control group consisting of patients who received only identical apheresis platelets during the same period. Meanwhile, the effect of ABO-NPRP on the subsequent platelet transfusion efficacy was observed. Results: There was no statistically significant difference in PDW, MPV, and PLCR before and after the preparation of apheresis platelets with reduced plasma (P>0.05), while the difference in platelet count was statistically significant [(2.86±0.34)×10 per therapeutic dose vs (2.46±0.28)×10 per therapeutic dose, P<0.001]; there was no statistically significant difference in the 24 h CCI transfusion efficacy between conventional identical apheresis platelets and ABO-NPRP, with transfusion efficacy rates of 76.60% and 78.85%, respectively (P>0.05); there was no statistically significant difference in platelet transfusion efficacy between the group with ABO-NPRP and the group without ABO-NPRP (completely identical transfusion group), with transfusion efficacy rates of 77.78% and 75.25%, respectively (P>0.05). Conclusion: ABO-NPRP transfusion is safe, effective, demonstrating comparable efficacy to conventional identical transfusion. It can serve as an important complementary strategy to optimize the utilization of blood resources.

Objective: To evaluate the safety and efficacy of ABO non-identical platelets with reduced plasma (ABO-NPRP) transfusion in patients with hematological diseases. Methods: A retrospective analysis was conducted on 52 therapeutic doses of apheresis platelets with reduced plasma prepared at Chongqing Blood Center of the Chinese People's Liberation Army. The transfusion efficacy (24 h CCI) and the transfusion adverse reactions of these apheresis platelets were also observed in 35 patients with hematological diseases in First Affiliated Hospital of Army Medical University. Comparisons were made with a control group consisting of patients who received only identical apheresis platelets during the same period. Meanwhile, the effect of ABO-NPRP on the subsequent platelet transfusion efficacy was observed. Results: There was no statistically significant difference in PDW, MPV, and PLCR before and after the preparation of apheresis platelets with reduced plasma (P>0.05), while the difference in platelet count was statistically significant [(2.86±0.34)×10 per therapeutic dose vs (2.46±0.28)×10 per therapeutic dose, P<0.001]; there was no statistically significant difference in the 24 h CCI transfusion efficacy between conventional identical apheresis platelets and ABO-NPRP, with transfusion efficacy rates of 76.60% and 78.85%, respectively (P>0.05); there was no statistically significant difference in platelet transfusion efficacy between the group with ABO-NPRP and the group without ABO-NPRP (completely identical transfusion group), with transfusion efficacy rates of 77.78% and 75.25%, respectively (P>0.05). Conclusion: ABO-NPRP transfusion is safe, effective, demonstrating comparable efficacy to conventional identical transfusion. It can serve as an important complementary strategy to optimize the utilization of blood resources.

Background::Atopic dermatitis (AD) affects approximately 10% of adults worldwide. CM310 is a humanized monoclonal antibody targeting interleukin-4 receptor alpha that blocks interleukin-4 and interleukin-13 signaling. This trial aimed to evaluate the efficacy and safety of CM310 in Chinese adults with moderate-to-severe AD.Methods::This multicenter, randomized, double-blind, placebo-controlled, phase 2b trial was conducted in 21 medical institutions in China from February to November 2021. Totally 120 eligible patients were enrolled and randomized (1:1:1) to receive subcutaneous injections of 300 mg CM310, 150 mg CM310, or placebo every 2 weeks for 16 weeks, followed by an 8-week follow-up period. The primary endpoint was the proportion of patients achieving ≥75% improvement in the Eczema Area and Severity Index (EASI-75) score from baseline at week 16. Safety and pharmacodynamics were also studied.Results::At week 16, the proportion of EASI-75 responders from baseline was significantly higher in the CM310 groups (70% [28/40] for high-dose and 65% [26/40] for low-dose) than that in the placebo group (20%[8/40]). The differences in EASI-75 response rate were 50% (high vs. placebo, 95% CI 31%–69%) and 45% (low vs. placebo, 95% CI 26%–64%), with both P values <0.0001. CM310 at both doses also significantly improved the EASI score, Investigator’s Global Assessment score, daily peak pruritus Numerical Rating Scale, AD-affected body surface area, and Dermatology Life Quality Index compared with placebo. CM310 treatment reduced levels of thymus and activation-regulated chemokine, total immunoglobulin E, lactate dehydrogenase, and blood eosinophils. The incidence of treatment-emergent adverse events (TEAEs) was similar among all three groups, with the most common TEAEs reported being upper respiratory tract infection, atopic dermatitis, hyperlipidemia, and hyperuricemia. No severe adverse events were deemed to be attributed to CM310. Conclusion::CM310 at 150 mg and 300 mg every 2 weeks demonstrated significant efficacy and was well-tolerated in adults with moderate-to-severe AD.Trial Registration::ClinicalTrials.gov, NCT04805411.

Objective:To explore the occurrence and influencing factors of post-burn psychological stress disorder in preschool children.Methods:This study was a multi-center cross-sectional survey. From January 2022 to February 2023, 85 preschool children (aged 1 to 6 years) with burns admitted to the Affiliated Hospital of North Sichuan Medical College, Nanchong Central Hospital, Suining Central Hospital, Guang'an People's Hospital, and Guangyuan Central Hospital who met the inclusion criteria were selected as respondents. A self-made general information questionnaire was used to investigate the children's general data including gender, age group, residential area, main caregiver and their education level, and family type, as well as the injury condition including cause of injury and burn severity. The Child Stress Disorders Checklist was used to investigate the occurrence of psychological stress disorder in children at 3 days to 1 month after injury, and the incidence rate was calculated. The children were classified according to their general data and injury condition, and the occurrence of psychological stress disorder in children at 3 days to 1 month after injury was recorded, and the influencing factors for post-burn psychological stress disorder in preschool children were screened.Results:A total of 85 questionnaires were distributed and 85 valid questionnaires were recovered, with an effective recovery rate of 100%. Among the children, there were 45 boys and 40 girls, with most children aged 1 to 3 years. There were slightly more children in rural areas than in cities. About half of the children were mainly cared for by their parents and grandparents, respectively, and the education level of the main caregivers was mainly high school/technical secondary school. The family type was mainly core family and extended family. The main cause of injury was hydrothermal scald, and the severity of burns was mainly moderate. The incidence rate of psychological stress disorder in this group of children at 3 days to 1 month after injury was 34.12% (29/85). There were statistically significant differences in the occurrence of psychological stress disorder in children with different age groups, causes of injuries, and burn severity at 3 days to 1 month after injury (with χ2 values??of 9.18, 7.80, and 25.47, respectively, P<0.05); there were no statistically significant differences in the occurrence of psychological stress disorder in children with different genders, residential area, main caregivers, main caregivers' education levels, or family types at 3 days to 1 month after injury ( P>0.05). Multivariate logistic regression analysis showed that age group and burn severity were independent influencing factors for the occurrence of psychological stress disorder in preschool children after burns (with odds ratios of 8.21 and 33.99, respectively, and 95% confidence intervals of 1.57-43.04 and 5.55-207.93, respectively, P<0.05), the older the child and the more severe the burn, the higher the possibility of the occurrence of psychological stress disorder. Conclusions:The incidence rate of psychological stress disorder is high in preschool children after burns. Age group and burn severity are independent influencing factors for the occurrence of post-burn psychological stress disorder in this type of children.

Objective To explore the role of β-1,3-galactosyltransferase 2(B3galt2)in mice with cerebral ischemic injury.Methods Adult male C57BL/6J mice were randomly divided into the sham,suture-occluded middle cerebral artery occlusion(MCAO)model,MCAO model+lentiviral vector control(LV-GFP),and MCAO model+lentiviral vector overexpression B3galt2(LV-B3galt2)groups,with six mice in each group.Neurological deficit scoring and rotating rod experiments were performed 24 h after ischemia in each group,and 2,3,5-triphenyltetrazolium chloride(TTC)staining was used to determine the infarction volume.The number of neurons in the ischemic cerebral cortex was determined in each group using Nissl staining.The levels of oxidative stress-related factors in the brain tissues were detected using the relevant kits.Results Compared with the sham group,the MCAO model group showed increased infarct volume and neurological deficits(P<0.05),significantly decreased number of neurons in the ischemic cerebral cortex and levels of super-oxide dismutase(SOD)and glutathione peroxidase(GSH)(all P<0.05),and significantly increased levels of reactive oxygen species(ROS)and malondialdehyde(MDA)(all P<0.05).Compared with the MCAO model group,the LV-B3galt2 group had reduced volume of cerebral infarction,significantly improved neurological deficits(all P<0.05),significantly increased number of neurons in the ischemic cerebral cortex of mice,significantly decreased levels of ROS and MDA(P<0.05),and significantly elevated levels of SOD and GSH(all P<0.05).Conclusion B3galt2 overexpression can reduce brain injury in an ischemic damage mouse model,and its mechanism may be through the inhibition of oxidative stress reactions.

Objective To use the deep learning methods to extract features of the 1st to 7th adult costal cartilage CT reconstruction images to realize the automatic estimation of adult costal cartilage bone age.Methods 625 male and 625 female samples aged between 20 and 70 years old were collected retrospectively,and the corresponding VRT images were reconstructed by volume rendering technology(VRT).After image preprocessing and data augmentation,500 cases were used as the training set and 125 cases as the test set.The performance of ResNet,ResNeXt,DenseNet and GoogleNet networks was evaluated by using 5-fold cross-validation,and the average value of 5-fold cross-validation results was taken as the final estimation result.Results The ResNet50 network achieved the best results in both male and female datasets.The mean absolute error was 4.56 years and 3.91 years,the accuracy rate was 64.00%and 70.88%in the range of±5.0 years,88.96%and 94.40%in the range of±10.0 years,respectively.Conclusion Compared with traditional methods and machine learning methods,the deep learning models can avoid the influence of human factors,greatly improve the accuracy of adult costal cartilage bone age estimation,and reduce the error between predicted age and real age,which has high clinical application value.

Objective: To clinically validate the feasibility and accuracy of cine images acquired through the multitasking method, with no electrocardiogram gating and free-breathing, in measuring left ventricular (LV) function indices by comparing them with those acquired through the balanced steady-state free precession (bSSFP) method, with multiple breath-holds and electrocardiogram gating. Materials and Methods: Forty-three healthy volunteers (female:male, 30:13; mean age, 23.1 ± 2.3 years) and 36 patients requiring an assessment of LV function for various clinical indications (female:male, 22:14; 57.8 ± 11.3 years) were enrolled in this prospective study. Each participant underwent cardiac magnetic resonance imaging (MRI) using the multiple breath-hold bSSFP method and free-breathing multitasking method. LV function parameters were measured for both MRI methods. Image quality was assessed through subjective image quality scores (1 to 5) and calculation of the contrast-to-noise ratio (CNR) between the myocardium and blood pool. Differences between the two MRI methods were analyzed using the Bland–Altman plot, paired t-test, or Wilcoxon signed-rank test, as appropriate. Results: LV ejection fraction (LVEF) was not significantly different between the two MRI methods (P = 0.222 in healthy volunteers and P = 0.343 in patients). LV end-diastolic mass was slightly overestimated with multitasking in both healthy volunteers (multitasking vs. bSSFP, 60.5 ± 10.7 g vs. 58.0 ± 10.4 g, respectively; P < 0.001) and patients (69.4 ± 18.1 g vs. 66.8 ± 18.0 g, respectively; P = 0.003). Acceptable and comparable image quality was achieved for both MRI methods (multitasking vs. bSSFP, 4.5 ± 0.7 vs. 4.6 ± 0.6, respectively; P = 0.203). The CNR between the myocardium and blood pool showed no significant differences between the two MRI methods (18.89 ± 6.65 vs. 18.19 ± 5.83, respectively; P = 0.480). Conclusion Multitasking-derived cine images obtained without electrocardiogram gating and breath-holding achieved similar image quality and accurate quantification of LVEF in healthy volunteers and patients.

Objective:To investigate the efficacy and safety of retroperitoneal soft tissue sarcoma resection combined with nephrectomy.Methods:The clinical data of 27 cases undergoing retroperitoneal soft tissue sarcoma resection combined with nephrectomy at the Gastrointestinal Tumor Center , Guangdong Provincial Hospital , Traditional Chinese Medicine from Jun 2017 to Aug 2022 were retrospectively analyzed for the indication of nephrectomy, postoperative progression of renal insufficiency and survival rate.Results:Twenty-six cases (96%) achieved R 0/R 1 resection and 1 case nderwent R 2 resection. Six cases underwent combined unilateral nephrectomy and 21 patients underwent combined multi-organ resection with a median number of resections of 4 (2,5). Postoperative pathology suggested that the combined resected kidney was positive for tumor infiltration in 17 cases. Five cases had Clavien-Dindo grade 3 or higher complications and no deaths occurred within 30 days after surgery. At the 90th day after surgery, 19 cases (70%) had decreased renal function ( Z=2.88, P=0.04), with a median decrease of -3.96 (-30.36, 0.31)ml·(min·1.73 m 2) -1, including 8 cases of preoperative Chronic Kidney Disease(CKD)1 stage progression (6 cases of CKD 2 stage, 2 cases of CKD 3 stage); 2 cases of CKD 2 stage progressed to CKD 3 stage; 1 case of preoperative CKD 3 stage progressed to CKD 4 stage. During the follow-up period of 3-38 months, no patient progressed to CKD 5 stage and no patient required dialysis treatment. Conclusion:Retroperitoneal soft tissue sarcoma resection combined with nephrectomy is safe and feasible while improving tumor radicality.

Objective:To explore the feasibility and value of performing a three-sided encapsulation procedure based on fascia anatomy in laparoscopic lateral lymph node dissection (LLND) for middle and low rectal cancer.Methods:This was a retrospective review. The study cohort comprised patients who met the diagnostic criteria for rectal cancer according to the Chinese Guidelines for the Diagnosis and Treatment of Colorectal Cancer, had a short lymph node diameter of >5 mm on the lateral side within the 15 days before surgery, were evaluated as feasible candidates for laparoscopic total mesorectal excision+LLND surgery, had been diagnosed with low or intermediate level rectal cancer, and whose tumor was less than 8 cm away from the anal verge according to pathological examination of the operative specimen. Patients with a history of other malignant tumors of the abdomen or with incomplete follow-up data were excluded. Forty-two patients with middle and low rectal cancer who had undergone lateral lymph node dissection in diagnosis and treatment center of Gastrointestinal Cancer of Guangdong Hospital of Chinese Medicine from Jan.2018 to Dec.2022 were enrolled. There were 24 men (57.1%) and 18 women (42.9%) aged 58.4±11.8 years and the median BMI was 22.5 (19.3–24.1) kg/m 2. The main point of the three-sided encapsulation procedure is to expand the external side medial to the external iliac artery and vein, narrowing the range of exterior side dissection. The anterior-medial side is designed to expand the vesical fascia to define the range of anterior-medial side extension. The internal side is fully extended to the ureterohypogastric nerve fascia; the distal point of the caudal extension reaches the level of the Alcock canal and the bottom reaches the piriformis, enabling dissection of the obturator nerve and No.283 lymph nodes. No.263D lymph nodes are dissected by exposing the internal iliac artery and its branches, dissecting the group No.263P lymph nodes, and severing the inferior vesical artery. Finally, the lateral lymphatic tissue is completely resected. Relevant variables were recorded, including the number of lateral lymph nodes detected, the rate of lymph node metastasis, operation duration, intraoperative blood loss, postoperative complications, postoperative hospital stay, and 3-year overall survival rate. Results:Laparoscopic surgery was successfully completed in all patients with no conversions to open surgery and no intraoperative complications. Twenty-seven (64.3%) of the study patients underwent left-sided LLND, 10 (23.8%) right-sided LLND, and five (11.9%) bilateral LLND, with lymph nodes cleared on both sides. All patients' lymph nodes were examined pathologically. A median of 17.0 (11.7, 26.0) lymph nodes was detected, the median of lateral lymph nodes being 5.0 (2.0, 10.2). The median operation time was 254.5 (199.0, 325.2) minutes. The median intra-operative blood loss was 50.0 (30.0, 100.0) mL. All patients were diagnosed with adenocarcinoma by pathological examination of the operative specimen. Two patients developed postoperative intestinal obstruction, one lymphatic leakage, and one a perineal incision infection. There were no cases of anastomotic leakage. The median postoperative hospital stay was 6.0 (5.0, 7.0) days and the median follow-up time 23.5 (9.0, 36.7) months. During follow-up, three patients (7.1%) died of tumor recurrence and metastasis. Two (4.8%) experienced mild urinary dysfunction, and one (2.4%) had moderate postoperative erectile dysfunction. One patient (2.4%) was found to have prostate and lung metastases 3 month after surgery. The 3-year overall survival rate was 74.4%.Conclusions:Three sided encapsulation is a safe and feasible procedure for LLND, achieving accurate and complete clearance of lateral lymphatic tissue.

Objective:To explore the feasibility and value of performing a three-sided encapsulation procedure based on fascia anatomy in laparoscopic lateral lymph node dissection (LLND) for middle and low rectal cancer.Methods:This was a retrospective review. The study cohort comprised patients who met the diagnostic criteria for rectal cancer according to the Chinese Guidelines for the Diagnosis and Treatment of Colorectal Cancer, had a short lymph node diameter of >5 mm on the lateral side within the 15 days before surgery, were evaluated as feasible candidates for laparoscopic total mesorectal excision+LLND surgery, had been diagnosed with low or intermediate level rectal cancer, and whose tumor was less than 8 cm away from the anal verge according to pathological examination of the operative specimen. Patients with a history of other malignant tumors of the abdomen or with incomplete follow-up data were excluded. Forty-two patients with middle and low rectal cancer who had undergone lateral lymph node dissection in diagnosis and treatment center of Gastrointestinal Cancer of Guangdong Hospital of Chinese Medicine from Jan.2018 to Dec.2022 were enrolled. There were 24 men (57.1%) and 18 women (42.9%) aged 58.4±11.8 years and the median BMI was 22.5 (19.3–24.1) kg/m 2. The main point of the three-sided encapsulation procedure is to expand the external side medial to the external iliac artery and vein, narrowing the range of exterior side dissection. The anterior-medial side is designed to expand the vesical fascia to define the range of anterior-medial side extension. The internal side is fully extended to the ureterohypogastric nerve fascia; the distal point of the caudal extension reaches the level of the Alcock canal and the bottom reaches the piriformis, enabling dissection of the obturator nerve and No.283 lymph nodes. No.263D lymph nodes are dissected by exposing the internal iliac artery and its branches, dissecting the group No.263P lymph nodes, and severing the inferior vesical artery. Finally, the lateral lymphatic tissue is completely resected. Relevant variables were recorded, including the number of lateral lymph nodes detected, the rate of lymph node metastasis, operation duration, intraoperative blood loss, postoperative complications, postoperative hospital stay, and 3-year overall survival rate. Results:Laparoscopic surgery was successfully completed in all patients with no conversions to open surgery and no intraoperative complications. Twenty-seven (64.3%) of the study patients underwent left-sided LLND, 10 (23.8%) right-sided LLND, and five (11.9%) bilateral LLND, with lymph nodes cleared on both sides. All patients' lymph nodes were examined pathologically. A median of 17.0 (11.7, 26.0) lymph nodes was detected, the median of lateral lymph nodes being 5.0 (2.0, 10.2). The median operation time was 254.5 (199.0, 325.2) minutes. The median intra-operative blood loss was 50.0 (30.0, 100.0) mL. All patients were diagnosed with adenocarcinoma by pathological examination of the operative specimen. Two patients developed postoperative intestinal obstruction, one lymphatic leakage, and one a perineal incision infection. There were no cases of anastomotic leakage. The median postoperative hospital stay was 6.0 (5.0, 7.0) days and the median follow-up time 23.5 (9.0, 36.7) months. During follow-up, three patients (7.1%) died of tumor recurrence and metastasis. Two (4.8%) experienced mild urinary dysfunction, and one (2.4%) had moderate postoperative erectile dysfunction. One patient (2.4%) was found to have prostate and lung metastases 3 month after surgery. The 3-year overall survival rate was 74.4%.Conclusions:Three sided encapsulation is a safe and feasible procedure for LLND, achieving accurate and complete clearance of lateral lymphatic tissue.