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.

SMYD5 is a ribosomal methyltransferase with SET and MYND structural domains， which is a member of the SMYD family and is expressed in a variety of tissues， including ovary and testis. This enzyme participates in biological processes such as gene expression regulation， cell development and differentiation， and maintenance of genomic stability through ribosomal protein methylation modification. In recent years， research on SMYD5 has increased in cancers including hepatocellular carcinoma， gastric adenocarcinoma， and lung cancer. Studies have revealed that SMYD5 exhibits high expression levels in various diseases including hepatocellular carcinoma， gastric adenocarcinoma， lung cancer， and inflammatory bowel disease， influencing the progression of these conditions. This review summarizes the role of SMYD5 in hepatocellular carcinoma， inflammatory bowel disease， and other biological functions， aiming to provide a reference for related disease research.

Objective: To investigate the effect of a novel RHD genotype (RHD 01N.01/RHD 01.01 with IVS4+ 2delT mutation)on the RhD phenotype through in vitro experiments in a case with a serologically RhD-negative phenotype. Methods: Serological screening was performed using saline method, and confirmed by indirect antiglobulin test (IAT). RhCE phenotyping was determined by RhCE typing cards. The full-length RHD gene was sequenced using PacBio long-read sequencing technology. Bioinformatics analysis and Minigene splicing variant analysis technology were used to elucidate the abnormal splicing mechanism of novel splice site variations. Results: The serological presentation was RhD negative. The PacBio sequencing revealed a compound heterozygote RHD 01N.01 and a new RHD 01.01 allele, which carried a new mutation at the 5′ splice site (IVS4+2delT) of intron 4. Bioinformatics predicted that the mutation disrupts the donor splice site and activates downstream recessive splice sites. The minigene experiment confirmed that this mutation leads to abnormal splicing, producing two types of mRNA: one with a 10 bp insertion and the other with a 15 bp insertion. Conclusion: A novel allele of the RHD gene IVS4+2delT causing an RhD-negative phenotype was identified, revealing that it affects D expression through an abnormal splicing mechanism.

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.

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 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:This study aims to explore the prevalence of hepatitis E virus (HEV) infection in patients and the screening value of serological indicators for HEV infection patients.Methods:Retrospective analysis was conducted on 97 440 cases of anti-HEV IgM and IgG simultaneously tested in two Beijing hospitals from January 1, 2018 to August 31, 2023. Among them, there were 61 005 males and 36 435 females, with an average age of 51.65±13.05 years old. According to the positivity of anti HEV specific antibodies, they were divided into anti-HEV IgM positive group (3 588 cases), anti-HEV IgG positive group (18 083 cases), and anti-HEV antibody negative group (78 892 cases). Results of HEV RNA, liver function, AFP, PIVKA-Ⅱ and PT were collected, and their basic clinical information were recorded. The prevalence of HEV infection in patients, as well as the relationship between the positivity of anti-HEV specific antibodies and the patient′s age group, HEV RNA, and clinical characteristics were analyzed.Results:Among 97 440 patients who tested anti-HEV IgM and IgG simultaneously, the positivity rate of anti-HEV IgM was 3.68% (3 588/97 440), and was 18.56% for anti-HEV IgG (18 083/97 440). The overall positivity rates of anti-HEV IgM in two Beijing hospitals from 2018 to 2023 were 2.51%, 2.53%, 3.02%, 4.59%, 5.72%, and 4.26% ( χ2=1 401.73, P<0.001), while the positivity rates of anti-HEV IgG were 12.56%, 12.32%, 12.85%, 22.65%, 27.42%, and 26.66% ( χ2=1 058.29, P<0.001). These rates showed a gradual increase until 2023 when a decline was observed. The positivity rates of anti-HEV IgM (2.28%, 3.60%, 4.47%) ( χ2=89.62, P<0.001) and IgG (4.71%, 17.86%, 25.94%) ( χ2=2 017.32, P<0.001) increased with age in patients who aged 1-30, >30-60, and over 60 years old. The age and ALB values of patients in the anti-HEV IgM positive group were lower than the IgG-positive group, while the proportion of males, TBIL, ALT, AFP and PT values were higher than the IgG-positive group, and the differences were statistically significance ( P<0.05). Furthermore, patients in both the anti-HEV IgM and IgG positive groups had higher age, male proportion, TBIL, ALT, AFP, PIVKA-Ⅱ, and PT values than the anti-HEV negative group. Additionally, both groups had lower ALB values than the anti-HEV negative group, all of which were statistically significant ( P<0.05). 2 162 HEV infected patients were grouped based on HEV RNA positivity. The proportion of anti-HEV IgM single positive, IgG single positive, IgM+IgG double positive, and antibody negative patients in the HEV RNA positive group were 5.42% (18/332), 3.62% (12/332), 90.36% (300/332), and 0.60% (2/332), respectively. Among them, the proportion of anti-HEV IgM+IgG double positive patients in the HEV RNA positive group was higher than that in the HEV RNA negative group ( χ2=302.87, P<0.001), while the proportion of anti-HEV IgG single positive ( χ2=174.36, P<0.001) and anti-HEV antibody negative patients ( χ2=59.28, P<0.001) were lower than that in the HEV RNA negative group, both of which were statistically significant ( P<0.001). In addition, the positive rates of HEV RNA in anti-HEV IgM positive, IgG positive, and antibody negative patients were 29.23% (318/1 088), 17.59% (312/1 774), and 0.65% (2/306), respectively. Conclusion:The HEV infection rate among patients declined in 2023. HEV infection is age-related, with older individuals being more susceptible. Abnormal liver function and jaundice were commonly observed during HEV infection. It is crucial to note that the absence of anti-HEV specific antibodies cannot rule out HEV infection; therefore, additional testing for HEV RNA and/or HEV Ag is necessary for accurate diagnosis.

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.

Objective:To improve the perception of computed tomography(CT)images in detecting fine fracture through multi-task network of global attention,and to realize the detection of the target of fine fracture at case level through multi-task,and to quickly and accurately identify and locate fracture from a large number of CT images,so as to assist doctors to timely conduct treatment.Methods:A grouped Non-local network method was introduced to calculate the remote dependency relationship between each position of CT image continuous sections and channel.A single-stage detector of multi-objective detection model three dimension(3D)RetinaNet was integrated with the medical image semantic segmentation architecture(3D U-Net).A end-to-end multi-task 3D convolutional network was realized,which realized the detection of case level for fine fracture through multi-task collaboration.Select 600 CT scan images from the Rib Frac Dataset of rib fractures provided by the MICCAI 2020 Challenge,and they were divided into training set(500 cases)and test set(100 cases)as the ratio of 5:1 to test the precise performance of multi-task 3D convolutional network.Results:The precise performance of multi-task 3D convolutional network method was better than that of single-task FracNet,3D RetinaNet and 3D Retina U-Net in detection,which average precision was respectively higher 7.8%and 11.4%than 3D RetinaNet and 3D Retina U-Net.It was better than two kinds of single-task network detection method included 3D Faster R-CNN and 3D Mask R-CNN,and the average precision of that was respectively higher 6.7%and 3.1%than them.Conclusion:The integrated different modules of global attention multi-task network can improve the detection performance of fine fracture.The introduction of grouped Non-local network method can further improve the precise performance for the targets of fine fractures in detection.