Objective: To assess the current status of bacterial detection capabilities in various blood collection and supply and related laboratories across China, and to identify key factors affecting the consistency of test results. Methods: A pooled analysis was conducted on data from 21 external quality assessment (EQA) rounds for blood bacterial detection carried out by the China International Transfusion Infection Prevention and Control (CITIC) project from 2019 to 2025. The study covered three types of laboratories-blood centers, central blood stations, and commercial laboratories—across 23 provincial-level administrative regions in China. Statistics were compiled on the number of participating laboratories, and the concordance rates were calculated for different institution types, different automated blood culture systems, different bacterial concentrations, and different strains. Non-standard reporting issues were also reviewed, and statistical methods were applied for analysis. Results: Over the seven-year period, the number of participating laboratories increased from 161 to 236, with an average annual growth rate of 6.58%, and the annual concordance rates ranged from 82.61% to 94.92%. The overall laboratory concordance rates for the three types of participating laboratories were all>89.0% (P>0.05), while commercial laboratories showed a significant year-by-year increase (70.97%-100%, P<0.05). The concordance rates of automated blood culture systems from eight manufacturers showed no significant differences (97.98%-100%, P>0.05), indicating stable performance across all devices. The overall sample concordance rate was 98.88%, with negative samples showing a lower rate than positive samples (97.97% vs 99.14%); positive sample rates increased with higher concentrations; and low-concentration Gram-negative bacterial samples had a lower concordance rate than Gram-positive ones (93.15% vs 100%). A total of 50 instances of non-standard result reporting were identified, with incorrect time units accounting for the highest proportion (52.0%). Conclusion The participation scale and overall testing proficiency of blood collection and supply and related laboratories nationwide have improved year by year, and all types of automated blood culture devices can meet the requirements for blood bacterial screening. Detection of negative and low-concentration positive samples remains a weak link in current bacterial EQA, and the standardization of laboratory data reporting requires further strengthening. Continuous: external quality assessment, targeted training, and standardized reporting procedures can effectively enhance the homogenization level of blood bacterial testing across the country and ensure the safety of clinical transfusion.

OBJECTIVE To formulate the Expert Consensus on the Management of Radiopharmaceuticals in Medical Institutions （hereinafter referred to as “the Consensus”）， focusing on key aspects such as the procurement of radiopharmaceuticals， the management of self-made radiopharmaceutical preparations， standardized clinical application， and patient medication safety management， so as to provide a reference for improving the whole-process management of radiopharmaceuticals in medical institutions.METHODS The Consensus was initiated by the Chinese Society of Nuclear Medicine， the Clinical Pharmacy Professional Committee of the China Anti-Cancer Association， and the Committee of Integrative Oncology Pharmacy of the China Anti-Cancer Association. Organized by the consensus drafting group more than 90 experts from the fields of nuclear medicine， nuclear pharmacy， and pharmacy science across China were involved. The Consensus was developed through systematic review of relevant laws， regulations， policy documents， and existing experience in radiopharmaceutical management， followed by extensive discussion and deliberation to finalize the consensus. RESULTS &CONCLUSIONS The Consensus establishes 10 key points for whole-process management of radiopharmaceuticals in medical institutions， covering organizational management and personnel requirements， procurement， preparation， acceptance， storage， risk prevention and control during use， radiation protection， and waste disposal. The Consensus provides a reference for improving radiopharmaceutical management in medical institutions and for ensuring their efficacy and safety in clinical application.

[Purpose]To analyze the incidence and mortality of thyroid cancer in Zhejiang cancer registration areas in 2021 and trends from 2000 to 2021.[Methods]Based on cancer data from 22 registries across Zhejiang Province between 2000 and 2021,the crude incidence/mortality rates,age-standardized incidence/mortality rates of thyroid cancer by Chinese and world standard population(ASIRC/ASMRC,ASIRW/ASMRW),cumulative rate(0～74 years old)and truncated rate(35～64 years old)were analyzed.Joinpoint regression model was employed to calculate the annual percentage change(APC)and average annual percentage change(AAPC)with 95％confidence in-terval(CI)for analyzing trends of thyroid cancer incidence and mortality rates from 2000 to 2021.[Results]The crude incidence rate of thyroid cancer increased from 3.62/105 in 2000 to 79.66/105 in 2021,and ASIRC rose from 3.11/105 to 69.49/105(AAPC=15.55％,95％CI:14.65％～16.61％).The AAPC for ASIRC was slightly higher in female(15.54％,95％CI:14.71％～16.49％)than that in male(15.02％,95％CI:13.53％～16.82％).The increase was significantly more pronounced in rural areas(AAPC=23.34％,95％CI:21.48％～25.33％)compared to urban areas(AAPC=14.12％,95％CI:13.15％～15.43％).Among age groups,the age group of 15～44 years old showed the fastest increase in crude incidence rate(AAPC=20.37％,95％CI:18.46％～22.31％),followed by the age group of 45～64 years old(AAPC=18.41％,95％CI:16.65％～20.19％).Between 2000 and 2021,the crude mortality rate of thyroid cancer rose from 0.34/105 to 0.56/105(AAPC=5.52％,95％CI:3.45％～7.70％),the trend of ASMRC was relatively stable.[Conclusion]From 2000 to 2021,the incidence of thyroid cancer in Zhejiang Province increased markedly,especially among females and younger to middle-aged adults,while the age-standardized mortality rate remained stable.

[Purpose]To analyze the incidence and mortality of colorectal cancer in Zhejiang can-cer registration areas in 2021 and its temporal trends from 2000 to 2021.[Methods]Data from 22 cancer registries in Zhejiang Province in 2021 that met the quality standards were included.The crude incidence/mortality rate,age-standardized incidence/mortality rates by Chinese standard population(ASIRC/ASMRC)and by world standard population(ASIRW/ASMRW),and cumulative incidence(mortality)rate for 0～74 years old were calculated.Trends from 2000 to 2021 were ana-lyzed using the Joinpoint regression model by calculating the annual percentage change(APC)and average annual percentage change(AAPC).[Results]In 2021,the number of new colorectal cancer cases in Zhejiang cancer registration areas was 12 265,with 4 323 deaths.ASIRC and ASMRC were significantly higher in men(32.74/105 and 10.11/105)than those in women(20.78/105 and 5.99/105).Urban areas showed higher ASIRC and ASMRC(28.27/105 and 8.06/105)than rural areas(24.12/105 and 7.85/105).The age-specific incidence and mortality rates of colorectal cancer in Zhejiang Province showed an increasing trend with age,with a peak of 219.63/105 in the age group of 80～84 years old.The age-specific mortality rate peaked in the age group of 85 years old and above,with a peak of 199.65/105.From 2000 to 2021,ASIRC in Zhejiang Province showed an upward trend(AAPC=2.23％,P＜0.001),ASMRC showed a marginal increase(AAPC=0.78％,P=0.067).[Conclusion]The incidence of colorectal cancer in Zhejiang Province had been on a continuous rise in the past 22 years,and health education and early screening should be empha-sized.

Objective:To report the preclinical trial results of the application of a domestic high-flow percutaneous left ventricular assist device (pLVAD) in patients with low cardiac output syndrome (LCOS) following cardiac surgery.Methods:Six patients who developed LCOS after direct cardiac surgery were implanted with a domestic high-flow pLVAD. Clinical outcomes, including hemodynamic changes, complications, and survival rates were observed post-implantation.Results:Four patients underwent pLVAD implantation under digital subtraction angiography (DSA) guidance, while two patients had the procedure performed under ultrasound guidance. The implantation process was straightforward, rapid, and uneventful, with no instances of bleeding or arrhythmias. The flow rate at the initiation of pLVAD support was 3.8-5.0 (4.22±0.44)L/min, and the flow rate during pump removal was 1.0-1.3(1.18±0.15)L/min. The duration of pLVAD support was 16.5-165.0(101.3±60.65)h. Hemodynamic parameters showed immediate improvement following pLVAD support: mean arterial pressure increased from (62.67±4.46)mmHg to (80.50±18.96)mmHg (1 mmHg=0.133 kPa, P=0.049), cardiac output increased from (2.45±0.66)L/min to (4.35±1.32)L/min( P=0.01), cardiac index improved from (1.95±0.21)L·min -1·m -2 to (2.77±0.33)L·min -1·m -2( P<0.001), pulmonary artery diastolic pressure decreased from (27.50±1.87) mmHg to(18.33±4.18)mmHg( P=0.001), and left ventricular ejection fraction improved from 0.27±0.04 to 0.37±0.06 ( P=0.004). No visible hemoglobinuria was noted during the support period. No malignant arrhythmias or cerebrovascular complications occurred. One patient required transition to surgical LVAD implantation, while the other five patients had the pLVAD successfully removed and were discharged. Three months later, all six patients were alive, with functional status classified as New York Heart Association (NYHA) Class Ⅰ-Ⅱ. Conclusion:The implantation of a domestic high-flow pLVAD provides a safe and effective therapeutic option for patients with LCOS following cardiac surgery.

Objective:This article studies the abilities and quality that medical technical managers should possess and provides a reference for promoting the professional training and development of medical technical managers.Methods:The data were obtained through semi-structured interviews and literature collection. The interview subjects were 20 scientific researchers with transformation projects and 10 management staffs with technical manager certificates in medical colleges. The documents are 6 articles related to ″technical manager capabilities″ collected on open academic platforms. Grounded theory was used to code and analyze above data.Results:After three-level coding and combining with the iceberg competency model, the knowledge, skills, self-awareness, traits and motivation of medical technology managers were sorted out, totalling 5 core categories, 10 main categories, and 50 initial categories, to construct a competency model for medical technology managers.Conclusions:Based on the complex knowledge structure and high occupational requirements of medical technology managers, policy insights such as systematic knowledge training, raising skill requirements in practice, and enriching assessment standards and communication channels are proposed.

Objective To develop and validate a nomogram model that integrates systemic inflammatory markers to predict the likelihood of pelvic lymph node metastasis(PLNM)in prostate cancer patients prior to surgery.Methods This study retrospectively analyzed the clinical data and preoperative inflammatory markers—including neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),systemic immune-inflammation index(SII),and monocyte-to-lymphocyte ratio(MLR)—of patients diagnosed with prostate cancer.Univariate and multi-variate logistic regression analyses were conducted to identify markers that were significantly associated with PLNM.Based on the results of the multivariate analysis,a nomogram was developed and its predictive accuracy was assessed using receiver operating characteristic curves(ROC)and calibration plots.Results Among the 334 enrolled patients with prostate cancer,107 were identified with PLNM.Univariate analysis revealed statistically significant differences in free prostate-specific antigen(fPSA),Gleason score,NLR,PLR,MLR,and SII between the PLNM and non-pelvic lymph node metastasis(NPLNM)groups(P<0.05).Multivariate analysis confirmed that fPSA,Gleason score,and SII were independent predictors of PLNM(P<0.05).A nomogram incorporating these predic-tors exhibited strong discriminative ability,with an area under the ROC curve(AUC)of 0.79(95%CI:0.73～0.84).Calibration analysis further demonstrated good consistency between the predicted and observed probabilities of PLNM.Conclusions This study successfully developed a nomogram model based on systemic inflammatory markers for preoperative prediction of pelvic lymph node metastasis in prostate cancer.Owing to its user-friendly design and high predictive accuracy,this tool may serve as a valuable complementary method to conventional imaging techniques,thereby supporting personalized treatment decision-making.

Objective To quantitatively measure the density of hydroxyapatite(HAP)(water)within lumbar vertebral bodies using the gemstone spectral imaging(GSI)material decomposition technique and to compare and analyze the clinical significance of density variations of HAP(water)in different regions of L1-L3 vertebral bodies.Methods A total of 242 patients who underwent lumbar quantitative computed tomography(QCT)scans via utilizing the GSI technique were selected.Following the scans,the HAP(water)density values in four regions(anterosuperior,posterosuperior,anteroinferior,and posteroinferior)of each L1-L3 vertebral bodies were quantitatively measured using the material decomposition technique.Based on the QCT results,all cases were divided into three groups of normal bone mineral density,osteopenia,and osteoporosis.The distributions of HAP(water)density values in the four regions within each vertebral body were compared and analyzed among the groups.Results In all three groups of patients,the highest HAP(water)density values in the L1-L3 vertebral bodies were all located in the posteroinferior region,followed by the posterosuperior region.In the normal bone mineral density group,the lowest HAP(water)density values was found in the anterosuperior region of the L1 vertebral body.In the osteopenia and osteoporosis groups,the lowest HAP(water)density values was found in the anteroinferior region of the L1-L3 vertebral bodies.Conclusion Significant differences in HAP(water)density are present across different regions within lumbar vertebral bodies,which may be related to the development of vertebral osteoporosis and the location of fractures.

OBJECTIVE: Peritoneal fibrosis (PF) is an adverse event that occurs during long-term peritoneal dialysis, significantly impairing treatment efficiency and adversely affecting patient outcomes. Astragaloside IV (AS-IV), a principal active component derived from Astragalus membranaceus (Fisch.) Bunge, has exhibited anti-inflammatory and antifibrotic effects in various settings. This study aims to investigate the potential therapeutic efficacy and mechanism of AS-IV in the treatment of PF. METHODS: The PF mouse model was established by intraperitoneal injection of 4.25% peritoneal dialysis fluid (100 mL/kg). The epithelial-mesenchymal transition (EMT) of HMrSV5 cells was induced by the addition of 10 ng/mL transforming growth factor β (TGF-β). The differentially expressed genes in HMrSV5 cells treated with AS-IV were screened using transcriptome sequencing analysis. The potential targets of AS-IV were screened using network pharmacology and analyzed using molecular docking and molecular dynamics simulations. RESULTS: Administration of AS-IV at doses of 20, 40, or 80 mg/kg effectively mitigated the increase in peritoneal thickness and the development of fibrosis in mice with PF. The expression of the fibrosis marker α-smooth muscle actin in the peritoneum was significantly decreased in AS-IV-treated mice. The treatment of AS-IV (10, 20, and 40 μmol/L) significantly delayed the EMT of HMrSV5 cells induced by TGF-β, as demonstrated by the decreased number of 5-ethynyl-2'-deoxyuridine-positive cells, reduced migrated area, and decreased expression of fibrosis markers. A total of 460 differentially expressed genes were detected in AS-IV-treated HMrSV5 cells through transcriptome sequencing, with notable enrichment in the phosphatidylinositol-4,5-bisphosphate 3-kinase (PI3K)-AKT serine/threonine kinase 1 (AKT) signaling pathway. The reduced levels of phosphorylated PI3K (p-PI3K) and p-AKT were detected in HMrSV5 cells with AS-IV treatment. Epidermal growth factor receptor (EGFR) was predicted as a direct target of AS-IV, exhibiting strong hydrogen bond interactions. The activation of the PI3K-AKT pathway by the compound 740Y-P, and the activation of the EGFR pathway by NSC 228155 each partially counteracted the inhibitory effect of AS-IV on the EMT of HMrSV5 cells. CONCLUSION AS-IV delayed the EMT process in peritoneal mesothelial cells and slowed the progression of PF, potentially serving as a therapeutic agent for the early prevention and treatment of PF. Please cite this article as: Huang Y, Chu CL, Qiu WH, Chen JY, Cao LX, Ji SY, Zhu B, Wang GK, Shen QQ. Astragaloside IV delayed the epithelial-mesenchymal transition in peritoneal fibrosis by inhibiting the activation of EGFR and PI3K-AKT pathways. J Integr Med. 2025; 23(6):694-705.
Epithelial-Mesenchymal Transition/drug effects* ; Animals ; Saponins/pharmacology* ; Triterpenes/pharmacology* ; Mice ; Peritoneal Fibrosis/pathology* ; Proto-Oncogene Proteins c-akt/metabolism* ; ErbB Receptors/metabolism* ; Phosphatidylinositol 3-Kinases/metabolism* ; Signal Transduction/drug effects* ; Male ; Humans ; Molecular Docking Simulation ; Cell Line ; Mice, Inbred C57BL

OBJECTIVE: Emerging evidence suggests that exposure to ultrafine particulate matter (UPM, aerodynamic diameter < 0.1 µm) is associated with adverse cardiovascular events. Previous studies have found that Shenlian (SL) extract possesses anti-inflammatory and antiapoptotic properties and has a promising protective effect at all stages of the atherosclerotic disease process. In this study, we aimed to investigated whether SL improves UPM-aggravated myocardial ischemic injury by inhibiting inflammation and cell apoptosis. METHODS: We established a mouse model of MI+UPM. Echocardiographic measurement, measurement of myocardialinfarct size, biochemical analysis, enzyme-linked immunosorbent assay (ELISA), histopathological analysis, Transferase dUTP Nick End Labeling (TUNEL), Western blotting (WB), Polymerase Chain Reaction (PCR) and so on were used to explore the anti-inflammatory and anti-apoptotic effects of SL in vivo and in vitro. RESULTS: SL treatment can attenuate UPM-induced cardiac dysfunction by improving left ventricular ejection fraction, fractional shortening, and decreasing cardiac infarction area. SL significantly reduced the levels of myocardial enzymes and attenuated UPM-induced morphological alterations. Moreover, SL significantly reduced expression levels of the inflammatory cytokines IL-6, TNF-α, and MCP-1. UPM further increased the infiltration of macrophages in myocardial tissue, whereas SL intervention reversed this phenomenon. UPM also triggered myocardial apoptosis, which was markedly attenuated by SL treatment. The results of in vitro experiments revealed that SL prevented cell damage caused by exposure to UPM combined with hypoxia by reducing the expression of the inflammatory factor NF-κB and inhibiting apoptosis in H9c2 cells. CONCLUSION Overall, both in vivo and in vitro experiments demonstrated that SL attenuated UPM-aggravated myocardial ischemic injury by inhibiting inflammation and cell apoptosis. The mechanisms were related to the downregulation of macrophages infiltrating heart tissues.
Animals ; Apoptosis/drug effects* ; Particulate Matter/adverse effects* ; Mice ; Male ; Inflammation/drug therapy* ; Drugs, Chinese Herbal/therapeutic use* ; Mice, Inbred C57BL ; Myocardial Ischemia/drug therapy* ; Cell Line