Objective: To evaluate the practical effectiveness of confidential unit exclusion (CUE) in ensuring blood safety in Zhengzhou, analyze its application characteristics and existing problems, and provide a basis for optimizing blood safety management strategies. Methods: A retrospective analysis was conducted on CUE data handled by Henan Red Cross Blood Center from January 2019 to December 2024. Parameters such as the number of cases, demographic characteristics, reasons for exclusion, and time of report were statistically analyzed and compared with those of non-CUE. Results: From 2019 to 2024, the CUE reporting rate in Zhengzhou was 0.002 6% (40/1 547 666). CUE donors were predominantly male (65.00%, 26/40), aged 18-34 years (47.50%, 19/40), had college degree orabove (50.00%, 20/40), and were employees of enterprises or public institutions (32.50%, 13/40). Among the 40 CUE blood units, only one was reactive for anti-TP, while all others were qualified. The main reasons for CUE were recent vaccination (32.50%, 13/40), medical conditions unsuitable for donation (27.50%, 11/40), and high-risk sexual behavior (17.50%, 7/40). A total of 70.00% of reports occurred within 24 hours after donation, during which none of the corresponding blood units had been released; all units reported after more than 7 days had already been issued for clinical use, with no adverse transfusion reactions reported upon follow-up. Conclusion: The confidential unit exclusion program has played an active role in establishing a supplementary information feedback channel for blood donors. The procedure can be optimized by strengthening interactive communication and confirmation before donation, improving the accuracy of donors' self-assessment, and expanding convenient and rapid information-based reporting channels.

BACKGROUND:Flap transplantation technique is a commonly used surgical procedure for the treatment of severe tissue defects,but postoperative flap necrosis is easily triggered by ischemia-reperfusion injury.Therefore,it is still an important research topic to improve the survival rate of transplanted flaps. OBJECTIVE:To review the pathogenesis and latest treatment progress of flap ischemia-reperfusion injury. METHODS:CNKI,WanFang Database and PubMed database were searched for relevant literature published from 2014 to 2024.The search terms used were"flap,ischemia-reperfusion injury,inflammatory response,oxidative stress,Ca2+overload,apoptosis,mesenchymal stem cells,platelet-rich plasma,signaling pathways,shock wave,pretreatment"in Chinese and English.After elimination of irrelevant literature,poor quality and obsolete literature,77 documents were finally included for review. RESULTS AND CONCLUSION:Flap ischemia/reperfusion injury may be related to pathological factors such as inflammatory response,oxidative stress response,Ca2+overload,and apoptosis,which can cause apoptosis of vascular endothelial cells,vascular damage and microcirculation disorders in the flap,and eventually lead to flap necrosis.Studies have found that mesenchymal stem cell transplantation,platelet-rich plasma,signaling pathway modulators,shock waves,and pretreatment can alleviate flap ischemia/reperfusion injuries from different aspects and to varying degrees,and reduce the necrosis rate and necrosis area of the grafted flap.Although there are many therapeutic methods for skin flap ischemia/reperfusion injury,a unified and effective therapeutic method has not yet been developed in the clinic,and the advantages and disadvantages of various therapeutic methods have not yet been compared.Most of the studies remain in the stage of animal experiments,rarely involving clinical observations.Therefore,a lot of research is required in the future to gradually move from animal experiments to the clinic in order to better serve the clinic.

Flap surgery is a complex surgical procedure that has become an effective method for the treatment of many diseases and traumas.Flap survival is closely related to a variety of factors including cellular autophagy,oxidative stress,inflammatory response,mesenchymal stem cells(MSCs)function,and vascular regeneration.Cellular autophagy maintains intracellular homeostasis and plays a key role in reducing oxidative stress and inflammation and promoting injury repair.Excessive oxidative stress and inflammatory responses pose a threat to flaps,affecting their survival and successful transplantation.Endothelial cells are involved in vascu-lar regeneration through proliferation,migration,and production of angiogenic factors,and vascular endothelial growth factor directly promotes blood vessel formation and maintains endothelial cell function.MSCs play an important role in promoting flap survival and tissue repair due to their unique biological properties and multiple mechanisms of action.The multiple roles played by cellular autophagy,oxidative stress,inflammatory response,MSCs function,and vascular regeneration in influencing postoperative flap survival are hereby elaborated.The aim is to provide a basis for the clinical application of regulating the above factors to improve postoperative flap survival,improve the success rate of flap surgery,reduce complications,and bring more hope for the recovery and quality of life of patients.

Objective To observe the value of CT angiography(CTA)radiomics for evaluating the risk of basilar tip aneurysm(BTA)rupture.Methods Totally 133 BTA patients were retrospectively enrolled and divided into ruptured group(n=39)and unruptured group(n=94)based on BT A ruptured or not,also divided into training set(n=93)and test set(n=40)at the ratio of 7∶3.CTA radiomics features of BTA were extracted,the best radiomics features were screened,and the radiomics score(Radscore)was calculated.Then machine learning(ML)models were established with logistic regression(LR),random forest(RF),decision tree(DT)and K-nearest neighbor(KNN)algorithms,respectively.Radscore model was also established,and finally a combined model was constructed based on clinical data,routine imaging findings and Radscore.The efficacy of the above models for evaluating the risk of BTA rupture were comparatively analyzed.Results Finally 4 radiomics features of BTA were obtained.The area under the curve(AUC)of LR,RF,DT and KNN radiomics models for differentiating ruptured and unruptured BTA in training set was 0.770,0.816,0.817 and 0.795,respectively,while that in test set was 0.795,0.793,0.786 and 0.824,respectively,both being not significant different(both P＞0.05).Patient's gender,alcohol consumption history,BTA morphology and Radscore were all independent impact factors of BT A rupture(all P＜0.05),which were used to establish a clinical-routine imaging model.For all 133 cases,AUC of the combination model for differentiating ruptured and unruptured BTA was 0.877,of Radscore model was 0.775,while that of clinical-routine imaging model was 0.677,of the former was significantly higher than of the last two(both P＜0.05).Conclusion CTA radiomics was helpful for evaluating the risk of BTA rupture.Combining with clinical data and routine imaging findings could further improve the value of CTA radiomics.

Objective Exploring the clinical efficacy of using autologous rib cartilage grafting to reconstruct finger hemiarticular defects.Methods From August 2022 to February 2024,for 6 patients with hemiarticular surface defects in the metacarpophalangeal joints and interphalangeal joints of 8 fingers,costal cartilage was used for joint remodeling and transplantation to reconstruct the hemiarticular surface defects of the fingers.All 8 joint transplants in 6 patients were two-stage surgeries.In the first stage,antibiotic bone cement was used to fill the space-occupying lesions,and in the second stage,costal cartilage joint remodeling was performed to reconstruct the finger joint defects.Postoperative follow-up and assessment of fracture healing according to Paley fracture healing scoring criteria.Outpatient and WeChat follow-up,upper limb function is evaluated according to the upper limb functional assessment standards of the Chinese Medical Association Hand Surgery Society.Record VAS pain score.Results In this group,there were a total of 6 patients with 8 cases of hemiarticular defects.Among them,2 patients had two joint surgical sites,while the remaining 4 patients had a single joint surgical site.There were 2 cases of metacarpophalangeal joint head defects,2 cases of proximal articular surface defects,3 cases of proximal articular head defects,and 1 case of thumb proximal articular head defect.After surgery,8 out of 6 patients'hand wounds healed successfully.All patients were followed up for 6-12 months postoperatively,with an average of 9 months.The VAS pain score(affected finger)for the last follow-up was 0-2 points,with an average of 0.6 points.According to Paley's scoring criteria,all 6 patients had excellent fracture healing.According to the evaluation criteria for upper limb functional assessment of the Chinese Medical Association Hand Surgery Society,3 cases were rated as excellent,3 cases were rated as good,and 2 cases were rated as fair.Conclusion For patients with half joint defects on one side of the finger,rib rib cartilage was used for joint reconstruction,which significantly improved the joint shape and function at the defect site,and reduced joint pain scores.

Abstract In recent years, the prevalence of overweight and obesity among children and adolescents has risen rapidly, posing a serious threat to their physical and mental health. To provide scientific, systematic, and standardized weight management guidance for overweight and obese children and adolescents, the study focuses on the core concept of healthy lifestyle intervention, integrates multidisciplinary expert opinions and research findings,and proposes a comprehensive multidisciplinary intervention framework covering scientific exercise intervention, precise nutrition and diet, optimized sleep management, and standardized psychological support. It calls for the establishment of a multi agent collaborative management mechanism led by the government, implemented by families, fostered by schools, initiated by individuals, optimized by communities, reinforced by healthcare, and coordinated by multiple stakeholders. Emphasizing a child and adolescent centered approach, the consensus advocates for comprehensive, multi level, and personalized guidance strategies to promote the internalization and maintenance of a healthy lifestyle. It serves as a reference and provides recommendations for the effective prevention and control of overweight and obesity, and enhancing the health level of children and adolescents.

Objective To explore the short-term efficacy and safety of programmed death receptor-1(PD-1)antibody combined with chemoradiotherapy in early high-risk nasal extranodal natural killer/T cell lymphoma(ENKTCL,Nomogram modified risk index ≥1).Methods This study was a prospective phase Ⅱclinical study.A total of 20 patients with stage Ⅰ/Ⅱ nasal ENKTCL initially treated in the Affiliated Hospi-tal of Guizhou Medical University from June 2021 to December 2023 were selected as the study subjects.They were given 3 cycles of PD-1 antibody+P-Gemox(pegaspargase+gemcitabine+oxaliplatin)regimen induced immunochemotherapy and 3 cycles of PD-1 antibody concurrent immunoradiotherapy,14 d/cycle.The com-plete response(CR)rate after 3 cycles of induced immunochemotherapy,CR rate after treatment,objective re-sponse rate(ORR)after 3 cycles of induced immunochemotherapy and ORR after comprehensive treatment,occurrence of adverse reactions and plasma Epstein-Barr virus DNA copy number were observed.Results Af-ter 3 cycles of induction immunochemotherapy,the CR rate was 35.0％(7/20)and ORR was 90.0％(18/20).After the concurrent immunoradiotherapy,the CR rate was 95.0％(19/20)and ORR was 100.0％(20/20).The adverse reactions were mainly the grade 1/2.the immune-related adverse reactions included 9 ca-ses of grade 1/2 hypothyroidism(45.0％),4 cases of grade 1 capillary vessel hyperplasia(20.0％),1 case(5.0％)of grade 2 infusion reaction,and no immune myocarditis occurred.All 7 cases of positive EBV DNA turned to negative after 3 cycles of induced immunochemotherapy.Conclusion PD-1 antibody combined with P-Gemox in the radiotherapy of early high-risk ENKTCL has a high short-term remission rate with good tol-erance for treatment.

Micronutrients are essential trace bioactive compounds that play a pivotal role in maintaining vital physiological functions,with particular significance in immune regulation among critically ill patients.Critical illness induces profound alterations in micronutrient metabolism,characterized by accelerated consumption and diminished reserves.This dysregulation is further exacerbated by malabsorption and various iatrogenic factors,creating substantial challenges in maintaining micronutrient homeostasis.As the significance of nutritional therapy in critical care continues to gain recognition,micronutrient supplementation has become an essential component of comprehensive treatment protocols.This review explores the dynamic changes in micronutrient status during critical illness and their associated immunomodulatory effects,while addressing key considerations for implementing targeted supplementation strategies.Furthermore,we evaluate contemporary methods for micronutrient monitoring and provide evidence-based guidelines to assist clinicians in optimizing nutritional support within critical care environments.

Widespread utilization of glyphosate has led to environmental residues,posing potential threats to ecological systems and human health.Traditional methods for detection of glyphosate are limited by specialized equipment and operational techniques,resulting in inefficient responses.Therefore,it is urgent to develop a convenient,sensitive and accurate detection method for detection of glyphosate.Herein,a new naphthalenesulfonamide-based"Turn-on"fluorescent probe was synthesized using 2-chloroaniline and dansyl chloride as raw materials through a one-step process,which showed a good linear relationship between the glyphosate concentration in concentration range of 0.003-70 μmol/L and the fluorescence intensity(R2=0.995),with a detection limit of 2.73 nmol/L(S/N=3).Analytical techniques such as nuclear magnetic resonance(NMR)spectroscopy and high-resolution mass spectrometry(HRMS)were used to investigate the interaction mechanism between the fluorescent probe and glyphosate.The results indicated that a nucleophilic substitution reaction occurred between the probe and the secondary amine(—NH—)of glyphosate,inducing a photoinduced electron transfer(PET)effect which enhanced the fluorescence intensity by 11.2 times.The probe showed good anti-interference ability towards coexisting metal ions,anions and pesticides in water.When applied to determination of glyphosate in the samples such as tap water,river water(Xiangxi River Reservoir),soil,soybeans,and corn,the spiking recoveries ranged from 94.7％to 109.9％,demonstrating the high accuracy and broad applicability of this detection method.A portable test strip based on this fluorescent probe was developed for rapid semi-quantitative analysis of glyphosate.The developed method was rapid,sensitive,and portable,providing theoretical and technical support for on-site measurement of environmental contaminants.