Objective: To statistically analyze the association between blood donation intervals and the incidence of adverse reactions to blood donation based on blood donor data from Shenzhen. Methods: Basic data and records of adverse reactions to blood donation among voluntary whole blood donors in Shenzhen from January 2017 to June 2025 were extracted. A total of 795 404 whole blood donations were recorded, including 502 743 from males and 292 661 from females, with 1 088 and 751 cases of adverse reactions, respectively. Analyses were performed using R software, including restricted cubic spline (RCS), binary logistic regression, and generalized estimating equations (GEE) to evaluate the correlation between donation intervals and adverse reactions. Results: A total of 1 839 cases of adverse reactions were recorded, accounting for 0.23% of the total donations. Both binary logistic regression analysis and the generalized estimating equations (GEE) model showed that there was no significant difference in the incidence of adverse reactions between male and female donors with an interval of ≥6 months compared to those with an interval of ≥3 months but<6 months. Furthermore, using the 3-5 month interval group as the reference, the analysis indicated that the incidence of adverse reactions significantly increased in males with a 9-12 month interval, while no statistically significant differences were observed across any of the female subgroups. Conclusion: There was no significant correlation between adverse reactions to blood donation and the donation interval. Compared with a donation interval of ≥6 months, an interval of<6 months does not lead to an increase in the incidence of adverse reactions among male or female donors. The findings of this study may help enhance the willingness of blood donors to participate.

Objective: To statistically analyze the association between blood donor age and the incidence of adverse reactions based on whole blood donor data from Shenzhen. Methods: Data on basic characteristics and records of adverse donation reactions among voluntary whole blood donors in Shenzhen from January 2017 to June 2025 were extracted. A total of 795 404 whole blood donations were recorded, including 502 743 from males and 292 661 from females, with 1 088 and 751 cases of adverse reactions, respectively. Analyses were performed using R software, including restricted cubic spline (RCS) analysis, binary logistic regression, and generalized estimating equations (GEE) to evaluate the correlation between donor age and adverse reactions. Results: A total of 1 839 cases of adverse reactions were recorded, accounting for 0.23% of the total donations. Both binary logistic regression and GEE model revealed that, compared with the≤55 years age group, the incidence of adverse reactions was reduced in both male and female donors in the >55 years age group, with the difference being statistically significant in males. Using the <23 years age group as a reference, the incidence of adverse reactions significantly decreased in both male and female donors across the 23-30, 31-40, 41-50, and 51-60 age groups, with the differences being statistically significant. Conclusion: There is a negative correlation between the rate of adverse donation reactions and age, with the incidence of such reactions among whole blood donors over 55 years old being no higher than that among donors aged 55 years or younger. These findings carry positive significance for safeguarding the donation rights of older donors and meeting clinical blood demand.

[Objective] To conduct a retrospective statistical comparison of alanine aminotransferase (ALT) test values in blood donors prior to blood collection, aiming to analyze the objective characteristics of the population with elevated ALT levels (ALT>50 U/L) and provide reference data for adjusting the screening eligibility threshold for ALT. [Methods] The preliminary ALT screening data of 30 341 blood donor samples collected prior to blood donation from three smart blood donation sites at the Shenzhen Blood Center between 2022 and 2023 were extracted and compared with data from a health examination department of a tertiary hospital in Shenzhen (representing the general population, n=24 906). Both datasets were categorized and statistically described. A retrospective analysis was conducted to examine the associations between ALT test results and factors such as donors' gender, age, ethnicity, donation site, donation season, and frequency of blood donation. [Results] The ALT levels in both blood donors and the general population were non-normally distributed. The 95th percentile of ALT values was calculated as 61.4 U/L (male: 67.8 U/L, female: 39.3 U/L) for blood donors and 58.1 U/L (male: 63.7 U/L, female: 51.2 U/L) for the general population. The non-compliance rates (ALT>50 U/L) were 7.65% (2 321/30 341) in blood donors and 7.08% (1 763/24 906) in the general population. There were significant differences (P<0.05) in the ALT failure rate among blood donors based on gender, age, and donation site, but no significant differences (P>0.05) during the blood donation season. There was no statistically significant difference (P>0.05) in the positive rates of four serological markers (HBsAg, anti HCV, HIV Ag/Ab, anti TP) for blood screening pathogens between ALT unqualified and qualified individuals (2.05% vs 1.5%). If the ALT qualification threshold was raised from 50 U/L to 90 U/L, the non qualification rates of male and female blood donors would decrease from 9.82% (2 074/21 125) to 2.23% (471/21 125) and from 2.70% (249/9 216) to 0.75% (69/9 216), respectively. Among the 154 blood donors who donated blood more than 3 times, 88.31% of the 248 ALT test results were in the range of 50-90 U/L. Among them, 9 cases had ALT>130 U/L, and ALT was converted to qualified in subsequent blood donations. [Conclusion] There are differences in the ALT failure rate among blood donors of different genders and ages, and different blood donation sites and operators can also affect the ALT detection values of blood donors. The vast majority of blood donors with ALT failure are caused by transient and non pathological factors. With the widespread use of blood virus nucleic acid testing, appropriately increasing the ALT qualification threshold for blood donors can expand the qualified population and alleviate the shortage of blood sources, and the risk of blood safety will not increase.

[Objective] To investigate the factors associated with alanine aminotransferase (ALT) abnormalities in multi-ethnic blood donors across five Zang autonomous prefectures in the plateau regions of Qinghai Province, and to provide evidence for ensuring blood safety and formulating screening strategies. [Methods] A retrospective analysis was performed on the ALT abnormal test results of blood donors in the Zang autonomous prefectures of Qinghai from 2022 to 2024. The correlations between ALT levels and factors including gender, age, altitude, and infectious markers were investigated. [Results] The overall ALT unqualified rate among blood donors in this region was 9.01%. Significant differences in ALT levels were observed across genders and age groups (P<0.05). Variations in ALT abnormality rates were also noted among different plateau regions (P<0.05). Overall, ALT values exhibited an increasing trend with rising altitude. The average ALT unqualified rates were 11.19% in Zang donors, 7.96% in Han donors, and 4.79% in donors from other ethnic groups (P<0.05). No statistically significant association was observed between ALT abnormality and the presence of HBV/HCV infectious markers (P>0.05). [Conclusion] In the plateau areas of Qinghai, multi-ethnic blood donors have a relatively high ALT levels and ALT unqualified rates, showing distinct regional characteristics. ALT elevation in voluntary blood donors is related to non-pathological factors such as gender, age, and dietary habits, but not to infectious indicators.

Objective: To develop a comprehensive health economics evaluation model for HIV blood screening using Markov modeling, so as to evaluate the quality-of-life adjustment years (QALYs) gained by transfusion recipients after implementation of blood HIV screening. Methods: Shenzhen Blood Center was selected as the validation case for model development. Based on historical HIV screening data of Shenzhen Blood Center and published literature, the health economics evaluation of donor HIV screening was performed using cost-utility analysis. The single factor sensitivity analysis was performed on parameters in the model. Results: 3.09 QALYs were gained for each transfusion recipient prevented from HIV infection. During 2020-2023, donor HIV screening at Shenzhen Blood Center saved 506.76 QALYs, and each QALY saved 182 900 yuan. Conclusion: From the perspective of long-term benefit of transfusion recipients, HIV screening of blood donors demonstrates high health and economic value.

Objective: To develop a comprehensive health economics evaluation model for HIV blood screening using Markov modeling, so as to evaluate the quality-of-life adjustment years (QALYs) gained by transfusion recipients after implementation of blood HIV screening. Methods: Shenzhen Blood Center was selected as the validation case for model development. Based on historical HIV screening data of Shenzhen Blood Center and published literature, the health economics evaluation of donor HIV screening was performed using cost-utility analysis. The single factor sensitivity analysis was performed on parameters in the model. Results: 3.09 QALYs were gained for each transfusion recipient prevented from HIV infection. During 2020-2023, donor HIV screening at Shenzhen Blood Center saved 506.76 QALYs, and each QALY saved 182 900 yuan. Conclusion: From the perspective of long-term benefit of transfusion recipients, HIV screening of blood donors demonstrates high health and economic value.

Objective To systematically evaluate the methodological quality and the measurement attributes of the assessment tools for risk of falls perception in the elderly,therefore to provide evidence-based references for medical staff to select a proper assessment tool.Methods Literature on studies of the assessment tools for risk of falls perception in the elderly was retrieved across databases and websites including Medline,Embase,PubMed,Web of Science,CINAHL,China National Knowledge Infrastructure(CNKI),Wanfang Data,VIP and China Biology Medicine(CBM).The retrieval period was from the inception of the databases to 1st June,2024.Two researchers independently screened the retrieved literature and extracted the data.The bias risk list and quality standards of the consensus-based standards for the selection of health measurement instruments(COSMIN)were used to systematically evaluate the attributes of the assessment tools.Results A total of 22 studies were included,covering 21 scales for the risk of falls perception in the elderly.All the scales had certain risks of bias,and none of them reported cross-cultural validity/measurement equivalence and measurement error.The fall risk questionnaire(FRQ)was rated as Class C recommendation due to the high-quality evidences indicated its"inadequate"internal consistency and responsiveness.The remaining scales were rated as Class B recommendation due to their uncertainty in content validity.Conclusion In comparison with the assessment tools for risk of falls perception in the elderly,the self-awareness of falls in elderly scale(SAFE,a primary choice)and the fall risk perception scale for the elderly in community(FRPSE,the secondary choice)are recommended for their comprehensive structure of measurement and relatively complete evaluation of measurement.However,further studies are required to validate the clinical applicability and measurement attributes of the SAFE and FRPSE.

Zishen Huoxue decoction (ZSHX) enhances cardiomyocyte viability following hypoxic stress; however, its upstream therapeutic targets remain unclear. Network pharmacology and RNA sequencing analyses revealed that ZSHX target genes were closely associated with mitophagy and apoptosis in the mitochondrial pathway. In vitro, ZSHX inhibited pathological mitochondrial fission following hypoxic stress, regulated FUN14 domain-containing protein 1 (FUNDC1)-related mitophagy, and increased the levels of mitophagy lysosomes and microtubule-associated protein 1 light chain 3 beta II (LC3II)/translocase of outer mitochondrial membrane 20 (TOM20) expression while inhibiting the over-activated mitochondrial unfolded protein response. Additionally, ZSHX regulated the stability of beta-tubulin through Sirtuin 5 (SIRT5) and could modulate FUNDC1-related synergistic mechanisms of mitophagy and unfolded protein response in the mitochondria (UPR^mt) via the SIRT5 and -β-tubulin axis. This targeting pathway may be crucial for cardiomyocytes to resist hypoxia. Collectively, these findings suggest that ZSHX can protect against cardiomyocyte injury via the SIRT5-β-tubulin axis, which may be associated with the synergistic protective mechanism of SIRT5-β-tubulin axis-related mitophagy and UPR^mt on cardiomyocytes.
Mitophagy/drug effects* ; Tubulin/genetics* ; Animals ; Myocytes, Cardiac/metabolism* ; Drugs, Chinese Herbal/pharmacology* ; Sirtuins/genetics* ; Unfolded Protein Response/drug effects* ; Myocardial Ischemia/genetics* ; Rats ; Humans ; Rats, Sprague-Dawley ; Apoptosis/drug effects* ; Male

Objective To predict the invasion degree of subsolid nodule(SSN)lung adenocarcinoma using a combined model incorporating artificial intelligence(AI)quantitative parameters and imaging signs,and to validate the predictive efficacy of this model.Methods A total of 281 SSN lung adenocarcinoma CT images in 243 patients were retrospectively collected and randomly divided into training set(224 cases)and validation set(57 cases)in an 8∶2 ratio,with atypical adenomatous hyperplasia(A AH)+adenocarcinoma in situ(AIS)+minimally invasive adenocarcinoma(MIA)(191 cases)as the non-invasive adenocarcinoma(I AC)group and I AC(90 cases)as the IAC group.Multivariate logistic regression analysis was performed based on the AI quantitative parameters and CT signs in the training set to obtain independent predictors of IAC.A combined model and nomogram were then constructed and validated.The diagnostic efficacy and clinical applicability of the model were evaluated by the receiver operating characteristic(ROC)curve,calibration curve,and clinical decision curve analysis(DCA).Results Multivariate logistic regression analysis of the training set showed nodule type,spicule sign,vascular abnormality,long diameter＞11.5 mm,median CT value＞—426.25 HU,and mass＞391.5 mg were independent predictors of IAC(P＜0.05).The area under the curve(AUC)of the training set model,based on these independent predictive factors,was 0.915[95％confidence interval(CI)0.875-0.954],and the AUC of the validation set model was 0.903(95％CI 0.824-0.982),indicating both the training set and validation set models had high efficacy in distinguishing IAC.The nomogram model,which quantified these independent factors,demonstrated enhanced predictive power for IAC.The calibration curve indicated good fit of the prediction model,and the clinical DCA showed the model had good clinical applicability.Conclusion The model combining AI quantitative parameters and imaging signs has a higher ability to predict the risk of IAC,compared to a single indicator.It helps clinicians in determining the appropriate surgical timing,formulating surgical methods,and reducing overtreatment.

Objective:To investigate the combined application of cytology, cell block histology and immunohistochemistry to improve the diagnostic accuracy of solid pancreatic lesions in endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) samples.Methods:The pathological data of EUS-FNA in 311 cases of solid pancreatic lesions submitted to the Second Hospital of Hebei Medical University, Shijiazhuang, China from May 2019 to September 2023 were retrospectively analyzed. The cases included pancreatic ductal adenocarcinoma (PDAC, 172 cases), solid pseudopapillary neoplasm (SPN, 12 cases), neuroendocrine tumors (PNET, 14 cases) and chronic pancreatitis (113 cases). The cytological features of smears, the histology of cell block sections and the diagnostic markers in PDAC, SPN and PNET were analyzed. The diagnostic accuracies of cytology, cell block histology/immunohistochemistry and combination of the two methods for classifying these pancreatic solid lesions were evaluated.Results:Irregular arrangement of atypical (cancer) cells, anisonucleosis and nuclear atypia were the typical cytological features of PDAC, while presence of pseudopapillae with a myxoid/hyalinized fibrovascular core and low adhesion/salt-and-pepper chromatin were diagnostic features of SPN and NET, respectively. Immunohistochemical results showed that CK7 and CK19 were the most sensitive markers of pancreatic ductal epithelia, and the diffuse strong expression of S-100P (102/111, 91.9%) and aberrant expression of p53 (80/111, 72.1%) were important immunophenotypic markers of PDAC. Various degrees of CDX2 expression could be found in 66.4% PDAC. The expression of CD10, PR, vimentin, CD99 and cyclinD1 and the aberrant expression of β-catenin were the immunophenotypic features of SPN, while the expression of CgA, Syn and CD56 were indispensable immunemarkers for the diagnosis of PNET. Overall, cytology had higher sensitivity than cell block histology (93.9% versus 82.8%) and lower specificity (92.9% versus 99.1%), while the combination of the two methods significantly improved the sensitivity to 96.9% in solid pancreatic lesions. The combination of cytology and cell block histology could significantly improve the diagnostic efficacy of EUS-FNA in PDAC.Conclusions:Integrated diagnosis based on cytology (including rapid on-site evaluation), cell block histology and immunohistochemical findings could significantly improve the diagnostic yield of EUS-FNA in classifying solid pancreatic lesions.