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.

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.

Epithelial splicing regulatory protein 1(ESRP1)is an epithelial cell-specific splicing factor that in-volved in selective splicing and translation of multiple genes.ESRP1 regulates signaling pathways that affect cell proliferation and tumor growth via mediating target genes and regulating cyclic RNA cyclization and biogenesis in a variety of cancers,including head and neck squamous cell carcinoma,carcinoma of colon,and prostate cancer.Through integrating and analyzing the link between ESRP1 and related cancers,provide new ideas for the treatment of tumor cells in which ESRP1 as a key factor.

Objective To investigate the clinical efficacy of preoperative therapeutic plasma exchange(TPE)in pre-venting acute rejection after ABO incompatible kidney transplantation(ABOi-KT).Methods Nine patients with ABOi-KT who were admitted to the renal transplant department of our hospital from April 2022 to April 2024 were retrospectively ana-lyzed.They received a total of 28 TPEs before kidney transplantation,and the treatment plan was summarized as follows:The proportion of the substitute fluid,as well as the frequency and volume of TPE were determined based on the patient′s ABO blood group system antibody titer,gender,height,weight,hematocrit and other indicators upon admission.The pa-tient′s relevant laboratory indicators,including hemoglobin,platelets,leukocytes,coagulation function,total protein,albu-min,globulin,A/G,creatinine and urea nitrogen upon admission and after TPE were monitored and statistically analyzed.After transplantation,changes in renal function indicators such as ABO blood group system antibody titers,creatinine and u-rinary excretion were observed,and clinical symptoms of acute rejection,such as swelling,pain and edema in the transplan-ted kidney area were observed.Results Nine ABOi-KT patients had an average of about 3 TPEs before transplantation sur-gery,with an average total volume of approximately 2 500 mL to 3 500 mL per TPE,or approximately about 1.01 to 1.16 plasma volume(PV).After multiple TPEs,pre-transplantation antibody titers decreased by an average of 3 times compared to before TPE.There were no statistically significant differences in Hb,PLT,PT,PTA,INR,TBil,ALB,Cr and BUN(P＞0.05),while statistically significant differences were found in WBC,APTT,Fbg,TP,GLB and A/G(P＜0.05).After surgery,the creatinine level of 9 patients dropped to approximately 100 to 140 μmol/L,the urine output was normal,and the urine protein dropped to weakly positive or negative values.None of the nine patients experienced acute rejection.Con-clusion TPE can effectively reduce the level of ABO blood group antibody and prevent the occurrence of acute rejection in ABOi-KT patients.

Objective Mitochondrial reactive oxygen species(mtROS)could cause damage to pancreatic β-cells,rendering them susceptible to oxidative damage.Hence,investigating the potential of the mitochondria-targeted antioxidant(Mito-TEMPO)to protect pancreatic β-cells from ferroptosis by mitigating lipid peroxidation becomes crucial. Methods MIN6 cells were cultured in vitro with 100 μmol/L sodium palmitate(SP)to simulate diabetes.FerroOrange was utilized for the detection of Fe2+fluorescence staining,BODIPY581/591C11 for lipid reactive oxygen species,and MitoSox-Red for mtROS.Alterations in mitophagy levels were assessed through the co-localization of lysosomal and mitochondrial fluorescence.Western blotting was employed to quantify protein levels of Acsl4,GPX4,FSP1,FE,PINK1,Parkin,TOMM20,P62,and LC3.Subsequently,interventions were implemented using Mito-TEMPO and Carbonyl cyanide 3-chlorophenylhydrazone(CCCP)to observe changes in ferroptosis and mitophagy within MIN6 cells. Results We found that SP induced a dose-dependent increase in Fe2+and lipid ROS in MIN6 cells while decreasing the expression levels of GPX4 and FSP1 proteins.Through bioinformatics analysis,it has been uncovered that mitophagy assumes a crucial role within the ferroptosis pathway associated with diabetes.Additionally,SP decreased the expression of mitophagy-related proteins PINK1 and Parkin,leading to mtROS overproduction.Conversely,Mito-TEMPO effectively eliminated mtROS while activating the mitophagy pathways involving PINK1 and Parkin,thereby reducing the occurrence of ferroptosis in MIN6 cells.CCCP also demonstrated efficacy in reducing ferroptosis in MIN6 cells. Conclusion In summary,Mito-TEMPO proved effective in attenuating mtROS production and initiating mitophagy pathways mediated by PINK1 and Parkin in MIN6 cells.Consequently,this decreased iron overload and lipid peroxidation,ultimately safeguarding the cells from ferroptosis.

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.

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 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.