Objective To explore the clinical efficacy of plasma exchange (PE) and double-filtration plasmapheresis (DFPP) pretreatment regimens for high-titer ABO-incompatible kidney transplantation (ABOi-KT). Methods A retrospective analysis was conducted on 31 cases of ABOi-KT with a follow-up period ≥1 year admitted to Zhongshan Hospital Affiliated to Fudan University from April 2016 to August 2025. The efficacy differences between the PE combined with rituximab (RTX) + oral triple immunosuppressive regimen and the DFPP combined with RTX + oral triple immunosuppressive regimen were compared and analyzed. The titers of blood group antibodies and serum creatinine levels before and after the operation were monitored. The survival curves and cumulative risk occurrence curves were plotted using the Kaplan-Meier method. The survival rates of recipients and transplanted kidneys and the occurrence of complications were analyzed. Results Both the PE regimen and the DFPP regimen may effectively reduce the preoperative blood group antibody titer of the recipients to ≤1∶16. The one-year survival rate of the recipients and the transplanted kidneys both reached 100% after the operation. The postoperative serum creatinine levels of recipients who received the DFPP regimen were lower and more stable. There was no statistically significant difference in the incidence of complications between the two regimens during the same follow-up period. Conclusions Both the PE and DFPP regimens are effective pretreatment regimens for ABOi-KT. The DFPP regimen has more advantages in reducing treatment operations, lowering drug dosage and maintaining the stability of postoperative renal function. For recipients with a high initial antibody titer (≥ 1∶32), individualized determination of the number and frequency of plasma processing for pretreatment may achieve ideal therapeutic effects.

Objective: To explore the correlation between allogeneic red blood cell (RBC) transfusion and healthcare-associated infections (HAIs) in patients undergoing coronary artery bypass grafting (CABG) during the perioperative period. Methods: A single-center retrospective cohort of 1,170 patients undergoing isolated CABG was analyzed. Multivariable logistic regression and restricted cubic splines (RCS) were employed to explore the nonlinear association between perioperative RBC transfusion (from intraoperative period to 72 hours postoperatively) and HAIs. Results: Among the 1,170 CABG patients, 109 patients (9.2%) received RBC transfusion during the operation or within 3 days after the operation. The risk of HAIs in those who received ≥4 units of RBCs during and within 3 days after the operation was 6.89 times higher than that in the non-transfusion group (95% CI: 3.65-17.20). Furthermore, there was a nonlinear threshold effect between the blood transfusion volume and postoperative HAIs (inflection point: 7.8 units). When the transfusion volume was ≤7.8 units, the risk of HAIs increased by 61% for each additional unit transfused (OR=1.61, 95% CI: 1.21-2.15). Beyond this threshold, no statistically significant association was observed (P=0.289). Conclusion: Perioperative RBC transfusion in CABG patients is associated with an increased incidence of HAIs. The perioperative blood transfusion volume has a curvilinear relationship with the risk of postoperative HAIs. When the blood transfusion volume is ≤7.8 units, the blood transfusion volume has a dose-dependent relationship with postoperative infection, with higher blood transfusion volumes correlating with greater postoperative infection risk. When the blood transfusion volume is >7.8 units, the relationship between the two is not statistically significant. The preventive effect of reducing RBC transfusion on HAIs requires further validation in the future.

Objective:To investigate the value of MRI radiomics model in evaluating the pathological complete response (pCR) status of human epidermal growth factor receptor 2(HER-2) positive breast cancer after neoadjuvant therapy.Methods:The study was a cross-sectional study. The clinical, pathological, and MRI data of 243 HER-2 positive breast cancer patients who received neoadjuvant therapy in Shanxi Province Cancer Hospital from January 2021 to June 2023 were retrospectively analyzed. All patients were female, aged 26?75 years. All patients were randomly divided into training set (146 cases) and validation set (97 cases) at a ratio of 6∶4 according to the simple random sampling method. Univariate and multivariate logistic regression were used to screen independent predictors of pCR. Radiomics features were extracted from the early-phase (the 2nd phase) images of breast dynamic contrast-enhanced-MRI after neoadjuvant therapy.The four-step procedure was adopted for feature screening. The radiomics model was constructed by logistic regression. A combined model was constructed by integrating radiomics features and independent predictors. Two radiologists (Reader 1 with 10 years experience and Reader 2 with 13 years experience) who major in breast MRI visually evaluated the pCR status of breast cancer after neoadjuvant therapy. The receiver operating characteristic curve and area under the curve (AUC) were used to evaluate the efficacy of Reader 1, Reader 2, the radiomics model, and the combined model in predicting pCR status. The Hosmer-Lemeshow goodness-of-fit test was used to evaluate the calibration of the model.Results:Among 243 HER-2 positive breast cancer patients, totally 118 achieved pCR. In clinical and pathological features, HER-2 3+ was an independent predictor of pCR ( OR=2.71, 95% CI 1.03?7.12, P=0.043). In the training set and validation set, the AUCs of the radiomics model in predicting pCR status were 0.899 and 0.853, respectively.The AUCs of the combined model were 0.917 and 0.890, respectively. In the validation set, the AUC value of the radiomics model in predicting pCR status was higher than that of Reader 1 and Reader 2. Hosmer-Lemeshow goodness-of-fit test showed that there was no significant difference between the prediction of pCR status by the combined model and radiomics model and the actual results in the training set and validation set, and the fitting was good ( P>0.05). Conclusion:The MRI-based radiomics model can be used to predict pCR status in HER-2 positive breast cancer and outperforms the visual qualitative assessments of radiologists.

Abstract Ring finger protein 183(RNF183) is an E3 ubiquitin ligase that catalyzes the covalent attachment of ubiquitin molecules to substrate proteins. RNF183 is expressed in tissues such as kidney and testis, and it is mainly localized to the endoplasmic reticulum, Golgi apparatus, and lysosomes in cells. As one of the components of the endoplasmic reticulum membrane, it participates in the endoplasmic reticulum stress-responsive pathway that affects cellular and protein ubiquitination. In recent years, the study of E3 ubiquitin ligase member-RNF183 with various diseases such as colorectal cancer, endometrial cancer and bladder cancer has gradually increased. In this review, the role of RNF183 in colorectal cancer, inflammatory bowel disease and other diseases, as well as biological functions such as endoplasmic reticulum stress are summarized, aiming to provide reference ideas for the study of related diseases.

Objective:To investigate the value of MRI radiomics model in evaluating the pathological complete response (pCR) status of human epidermal growth factor receptor 2(HER-2) positive breast cancer after neoadjuvant therapy.Methods:The study was a cross-sectional study. The clinical, pathological, and MRI data of 243 HER-2 positive breast cancer patients who received neoadjuvant therapy in Shanxi Province Cancer Hospital from January 2021 to June 2023 were retrospectively analyzed. All patients were female, aged 26?75 years. All patients were randomly divided into training set (146 cases) and validation set (97 cases) at a ratio of 6∶4 according to the simple random sampling method. Univariate and multivariate logistic regression were used to screen independent predictors of pCR. Radiomics features were extracted from the early-phase (the 2nd phase) images of breast dynamic contrast-enhanced-MRI after neoadjuvant therapy.The four-step procedure was adopted for feature screening. The radiomics model was constructed by logistic regression. A combined model was constructed by integrating radiomics features and independent predictors. Two radiologists (Reader 1 with 10 years experience and Reader 2 with 13 years experience) who major in breast MRI visually evaluated the pCR status of breast cancer after neoadjuvant therapy. The receiver operating characteristic curve and area under the curve (AUC) were used to evaluate the efficacy of Reader 1, Reader 2, the radiomics model, and the combined model in predicting pCR status. The Hosmer-Lemeshow goodness-of-fit test was used to evaluate the calibration of the model.Results:Among 243 HER-2 positive breast cancer patients, totally 118 achieved pCR. In clinical and pathological features, HER-2 3+ was an independent predictor of pCR ( OR=2.71, 95% CI 1.03?7.12, P=0.043). In the training set and validation set, the AUCs of the radiomics model in predicting pCR status were 0.899 and 0.853, respectively.The AUCs of the combined model were 0.917 and 0.890, respectively. In the validation set, the AUC value of the radiomics model in predicting pCR status was higher than that of Reader 1 and Reader 2. Hosmer-Lemeshow goodness-of-fit test showed that there was no significant difference between the prediction of pCR status by the combined model and radiomics model and the actual results in the training set and validation set, and the fitting was good ( P>0.05). Conclusion:The MRI-based radiomics model can be used to predict pCR status in HER-2 positive breast cancer and outperforms the visual qualitative assessments of radiologists.

Objective:To explore the clinical characteristics of pregnancy complicated by primary Sj?gren's syndrome (pSS) and the related factors of adverse outcomes in pregnant women with pSS.Methods:A retrospective analysis was conducted on the clinical data of 32 pregnancies complicated by pSS treated in the Department of Obstetrics at the Third Affiliated Hospital of Guangzhou Medical University from February 2017 to August 2022. The patients were divided into two groups according to whether they had perinatal adverse outcomes: an adverse outcome group ( n=20) and a favorable outcome group ( n=12). The clinical characteristics of the two groups were compared with two independant sample t-test, Mann-Whitney U test, and Fisher's exact test, and multivariate logistic regression analysis was used to analyze the related factors of adverse outcomes in pregnant women with pSS. Results:(1) The average maternal age of the 32 pSS pregnancies was (32.9±4.6) years, the pre-pregnancy body mass index was (21.1±3.8) kg/m 2, and the median gestational age at delivery was 37.8 (35.4-38.5) weeks. There were 18 women (56.3%, 18/32) were diagnosed before pregnancy and 14 women (43.7%, 14/32) during pregnancy. Out of the 32 pregnancies, 25 (79.1%, 25/32) received therapy with glucocorticoids and/or hydroxychloroquine during pregnancy, whereas seven (21.9%, 7/32) had no medication during pregnancy. (2) The main adverse maternal outcomes included oligohydramnios (25%, 8/32), hypertensive disorder of pregnancy (18.8%, 6/32), preterm birth (18.8%, 6/32), fetal growth restriction (15.6%, 5/32), miscarriage (12.5%, 4/32), gestational diabetes mellitus (9.4%, 3/32), and postpartum hemorrhage (3.1%, 1/32). (3) Adverse neonatal outcomes included low birth weight infants in seven cases (25.0%, 7/28), neonatal asphyxia in seven cases (25.0%, 7/28), and two cases of congenital heart block (7.1%, 2/28). (4) The rate of diagnosis before pregnancy in the favorable outcome group was higher than the adverse outcome group [10/12 vs. 40.0%(8/20), Fisher's exact test, P=0.028]. There were no significant differences between the two groups concerning maternal age, pre-pregnancy BMI, weight gain during pregnancy, parity, rates of positivity for autoantibodies (antinuclear antibody, Sj?gren-specific antibody A, Sj?gren-specific antibody B, anti-Ro-52), and proportion of drug treatment (glucocorticoids, hydroxychloroquine) (all P>0.05). (5) Multivariate logistic regression analysis showed that diagnosis before pregnancy ( OR=0.02, 95% CI: 0.00-0.62, P=0.024) and positive Sj?gren-specific antibody B ( OR=0.01,95% CI: 0.00-0.75, P=0.038) were the protective factors. Conclusions:The clinical manifestations of pSS among pregnant women are varied and atypical,often with insidious onset. For pregnant women with pSS, being diagnosed before pregnancy, positive Sj?gren-specific antibody B may reduce adverse outcomes. It is important to address pre-pregnancy examination, early diagnosis and timely intervention to reduce the occurrence of adverse outcomes in pregnant women with pSS.

With the continuous development of healthcare industry,hospital publicity plays a pivotal role in brand con-struction,image shaping,and fostering harmonious doctor-patient relationships.This article highlights the strategic approach of The First Affiliated Hospital/School of Clinical Medicine of Guangdong Pharmaceutical University to bolstering its correspondent team and enhancing its publicity efforts.By establishing a"1+2+3"working system--one principle,two systems,and three types of training--the goal is to build a correspondent team that is politically steadfast,high-quality,and dedicated.From 2021 to 2023,the hospital has witnessed a notable improvement in submissions from the correspondents.These advancements have not only elevated the hospital's media output but also significantly contributed to the broader dissemination of its publicity materials and the advancement of its brand identity.These efforts support the favorable development of news and public opinion within the health industry.

Objective To rationally allocate pharmaceutical and healthcare human resources,and to explore the feasibility of implementing the system of licensed assistant pharmacists in retail pharmacies.Methods Through literature review,questionnaire surveys,and statistical analysis of exam scores,the training status of pharmacy technicians with secondary vocational education,the employment situation in retail pharmacies,and the results of the licensed pharmacist qualification examination were deeply understood.Results Every year,a certain number of graduates with a secondary vocational education in pharmacy entered society,and retail pharmacies were willing to recruit pharmacy technicians with this educational background,their professional competence were recognized.Pharmacy technicians with secondary vocational education can obtain the professional qualification of practicing pharmacists through hard work,and demonstrated the basic competency for working as licensed assistant pharmacists.Conclusion The implementation of the licensed assistant pharmacist system among pharmacy technicians with secondary vocational education in retail pharmacies is feasible.This system can fully leverage the role of pharmacy technicians with secondary vocational education,make up for the shortage of professional personnel in certain regions,promote the construction of the pharmaceutical care system in retail pharmacies,and ensure drug quality and medication safety.

Objective To compare different treatment methods for patients with gastric calculi and provide data support for clinical treatment.Methods A total of 197 patients diagnosed with gastric calculi by gastroscopy at the General Hospital of Ningxia Medical University and Cardio-Cerebrovascular Disease Hospital of General Hospital of Ningxia Medical University from July 2013 to January 2024 were enrolled.The study collected general information and other data of the patients,and divided them into groups based on the selected treatment method using a real-world research approach.The subjects were divided into four groups:drug conservative treatment group,endoscopic homemade snare treatment group,disposable snare treatment group,and stone fragmentation treatment group.Statistical analysis was performed using one-way analysis of variance.Results Gastric calculi were more common in men,with an average age of(55.45±14.21).85.3%of the patients had a history of eating persimmon,86.3%had ulcers,and 65.9%were located in the gastric angle.The self-made snare group had the lowest treatment cost,while the stone fragmentation group had the highest.There was no significant difference in the remission time of clinical symptoms among the three endoscopic treatment methods.The self-made snare had the highest patient satisfaction,but the drug combined with carbonated beverage group had the longest remission time of clinical symptoms and the lowest patient satisfaction.The frequency and duration of endoscopic treatment of dark green gastric stones were significantly higher than those of mottled and golden yellow gastric stones.Conclusion When treating patients with gastric stones,it is important to consider the size and color of the stone,as well as the patient's preferences.Patients should be fully informed about their condition and the advantages of different treatments.For patients with larger stones(about 5 cm),endoscopic snare treatment is recommended as the first choice.

Objective To investigate the role of pharmacists in smoking cessation abroad and foster the dissemination and initiation of smoking cessation services led by pharmacist. Methods A search and compiles information on the value of pharmacists in offering smoking cessation services were carried out through the PubMed and Scopus electronic databases and the evolution of supportive policies were analyzed. The feasibility and barriers to pharmacists providing these services were examined. Results The involvement of pharmacists in smoking cessation positively impacted public health and the economy. Endowing pharmacists with the authority to prescribe smoking cessation medications, providing training in this service, and bolstering their potential through interprofessional collaboration can effectively address the barriers to their role in smoking cessation. Conclusion It is advisable to consider integrating smoking cessation services led by pharmacist into healthcare and public health policy guidelines ,which could enhance the efficacy and sustainability of smoking cessation initiatives.