Objective: To develop a RHCE genotyping assay based on kompetitive allele-specific PCR (KASP) and assess its clinical accuracy for RhCE blood group determination. Methods: KASP primers were designed to interrogate three RHCE loci: the 109 bp insertion/deletion in intron 2, c. 307T>C, and c. 676C>G. A total of 1 194 RhD-positive inpatients from Chengdu were typed by both KASP genotyping and manual tube serology. Discordant samples (n=10) were retested by both methods and further resolved by Sanger sequencing. An additional 377 cases were tested for the c. 48C>G locus to evaluate the predictive accuracy of individual loci and combined locus testing for RhC antigen. Results: Genotyping concordance with serology was 100.0% for both the c. 676C>G locus (RhE/Rhe) and the c. 307T>C locus (Rhc). For RhC prediction using the 109 bp insertion, overall accuracy was 99.7% (1 191/1 194); the 3 discordant cases were confirmed by Sanger sequencing to be false negatives attributable to 109 bp deletion in intron 2. Testing the c. 48C>G allele for RhC prediction yielded 7 false positives, with an accuracy of 98.1% (370/377). RhC antigen status was determined by combining the 109 bp insertion and the c. 48C allele. After excluding 10 samples with inconsistent results between the two loci, the accuracy reached 100% in the remaining 367 samples. When both loci were applied in combination, accuracy reached 100% in the 367 cases with concordant results. Among the 1 194 patients, CCee (45.8%) and CcEe (31.7%) were the most common RhCE phenotypes. The e antigen had the highest positivity rate (92.2%), and the Ce haplotype was the most frequent (66.9%). Conclusion: The KASP-based RHCE genotyping method achieves high accuracy for clinical RhCE typing. Combining the 109 bp insertion/deletion with the c. 48C allele significantly improves RhC antigen prediction compared with either locus alone. This method was applied to RhCE genotyping of 1 194 RhD-positive inpatients in Chengdu, providing local RhCE phenotype and haplotype distribution data to support RhCE-matched transfusion practice.

Objective To investigate the correlation of peripheral blood follicle suppressor-like protein L(FSTL-1)and chitosanidase 1(CHIT-1)levels with cardiovascular diseases(CVD)in hemodialysis patients and their clinical value.Methods A total of 150 hemodialysis patients treated in Chongqing Liangjiang New Area People's Hospital from January 2021 to June 2023(case group)and 60 healthy people who underwent medical checkups(control group)were selected.The case group consisted of 62 patients who had CVD(CVD group)and 88 patients who did not have CVD(non-CVD group).Enzyme-linked immunosorbent assay was used to detect the levels of FSTL-1 and CHIT-1 in peripheral blood.The levels of FSTL-1 and CHIT-1 among the groups were compared,and the correlation between the levels of FSTL-1 and CHIT-1 with the Gensini scores,high-sensitivity C-reactive protein(hs-CRP),troponin T(cTnT),and left ventricular ejection fraction(LVEF)were analyzed by Pearson's correlation test.Multivariate Logistic regression was used to analyze the influencing factors affecting the occurrence of CVD.Receiver operating characteristic(ROC)curve was used to assess the predictive efficacy of FSTL-1 and CHIT-1 for the occurrence of CVD.Results The levels of FSTL-1 and CHIT-1 were higher in the CVD group and non-CVD group than those in the control group(F=229.200,273.200,P＜0.05),and the levels of FSTL-1 and CHIT-1 in the CVD group were higher than those in the non-CVD group(P＜0.05).The peripheral blood FSTL-1 and CHIT-1 levels in hemodialysis patients were positively correlated with Gensini score,cTnT,hs-CRP(r=0.662,0.724,0.712,r=0.679,0.502,0.341,P＜0.05)and negatively correlated with LVEF(r=-0.463,-0.581,P＜0.05).Compared with the non-CVD group,CVD group had longer chronic kidney disease duration,higher hs-CRP,cTnT,Gensini score,FSTL-1,CHIT-1(P＜0.05),and lower LVEF(P＜0.05).High levels of cTnT,FSTL-1,and CHIT-1 were independent risk factors for CVD in hemodialysis patients(P＜0.05).The area under the curve of the com-bined detection of peripheral blood FSTL-1 and CHIT-1 levels for predicting the occurrence of CVD in hemo-dialysis patients was 0.852(95％CI:0.789-0.915),which was significantly larger than those of the single index of FSTL-1 and CHIT-1(Z=-2.084,-3.112,P=0.038,0.002).Conclusion The increased levels of peripheral blood FSTL-1 and CHIT-1 levels in CVD patients are correlated with cardiovascular injury,cardiac function,and inflammatory indexes in hemodialysis patients,which are independent risk factors affecting the occurrence of CVD in hemodialysis patients,and the combined detection of the two could improve the predic-tive efficacy for the occurrence of CVD in hemodialysis patients.

Objective To assess the intervention effect of nicotinamide mononucleotide (NMN) on the mouse model of hematotoxicity induced by subacute benzene exposure. Methods Benzene exposure and NMN intervention were adopted in a 2×2 factorial design, as benzene exposure and non-exposure, and NMN intervention and non-intervention. Male specific pathogen-free C57BL/6J mice were randomly assigned to negative control group, NMN control group, simple benzene exposure group and NMN intervention group, with 12 mice in each group. Benzene exposure of mice in simple benzene exposure group and NMN intervention group was conducted by dynamic inhalation of benzene at a concentration of 325 mg/m³ for six hours per day, five days per week for four weeks (28 days). Mice in the negative control and NMN control group inhaled clean air. During benzene exposure, mice in the NMN control group and NMN intervention group received NMN in drinking water at a dose of 300 mg/kg body weight. Peripheral blood samples of mice were collected for complete blood count analysis and calculation of composite inflammatory indices after 28 days. Results Interaction analysis showed that the counts of peripheral white blood cell, neutrophil, lymphocyte, and platelet of mice in the simple benzene exposure group were lower than those in the negative control group (all P<0.05). Neutrophil and platelet counts in the NMN intervention group were higher than those in the simple benzene exposure group (all P<0.05). The results of main effect analysis showed that the monocyte count of peripheral blood, systemic inflammatory index, systemic inflammatory response index, neutrophil/lymphocyte ratio and platelet/lymphocyte ratio of mice in the benzene exposure group increased (all P<0.05), and the basophil count and lymphocyte/monocyte ratio decreased (all P<0.05), compared with the control group. Conclusion Oral NMN alleviates subacute benzene-induced decreases in peripheral neutrophil and platelet counts in mice. This protective effect may be related to the targeted intervention of NMN on mitochondrial energy metabolism disorder and oxidative damage induced by benzene exposure in male mice.

Objective To observe the clinical efficacy of filiform-heated needle stimulation on myofascial trigger points(MTrPs)based on the"pivot mechanism"theory in treating neck-shoulder myofascial pain syndrome(MPS).Methods Sixty-four patients diagnosed with neck-shoulder MPS from the Acupuncture Department(inpatient and outpatient)of Guangzhou University of Chinese Medicine Dongguan Hospital between January 2023 and September 2023 were selected and randomly divided into a control group and an observation group using a random number table,with 32 cases per group.The control group received oral administration of Celecoxib Capsules,while the observation group received additional filiform-heated needle therapy.The treatment duration was 2 weeks and 1 course per week.Clinical efficacy was evaluated after 2 weeks,with observing the changes in the Short-Form McGill Pain Questionnaire(SF-MPQ)scores,Neck Disability Index(NDI)scores.The cervical range of motion(ROM)was compared between the two groups.Results(1)After treatment,the SF-MPQ scores of the two groups of patients were significantly improved(P＜0.05),and the observation group was significantly superior to the control group in improving the SF-MPQ scores,and the difference was statistically significant(P＜0.05).(2)After treatment,the NDI scores of patients in the two groups were significantly improved(P＜0.05),and the observation group was significantly superior to the control group in improving the NDI scores,and the difference was statistically significant(P＜0.05).(3)After treatment,the cervical joint mobility of patients in the two groups was significantly improved(P＜0.05),and the observation group was significantly superior to the control group in improving cervical joint mobility,with a statistically significant difference(P＜0.05).(4)The total effective rate was 96.88%(31/32)in the observation group and 84.38%(27/32)in the control group.The efficacy of the observation group was superior to that of the control group,and the difference was statistically significant(P＜0.05).Conclusion Filiform-heated needle stimulation on MTrPs based on the"pivot mechanism"theory significantly alleviates pain,improves soft tissue injury,and enhances neck-shoulder mobility in patients with neck-shoulder MPS,demonstrating remarkable clinical efficacy.

Objective To investigate the association between 8 insulin resistance(IR)surrogate markers and incident atherosclerotic cardiovascular disease(ASCVD)in population with cardiovascular-kidney-metabolic syndrome(CKM)of stages 0-3,and to identify the surrogate marker with the best predictive performance.Methods A study was conducted on 20121 community residents classified as CKM stages 0-3 from the Chengdu cohort of the China Multi-Ethic Cohort.A Cox proportional hazards model was used to calculate hazard ratios(HRs)between each IR surrogate marker and incident ASCVD.Cubic spline regression was employed to explore the dose-response relationships between these markers and incident ASCVD.The relative relationships between different markers and incident ASCVD were examined through the ratio of HRs(RHRs).Time-dependent area under the receiver operating characteristic curve(TDAUC)and Uno's C-statistic were calculated to compare the predictive performance of each marker for incident ASCVD.Based on the PREVENT equation components and the 8 surrogate markers under analysis,random forest feature selection was used to determine the contribution of each marker to accurate prediction.Results During a follow-up period of82 741.93 person-years,1447 incident cases of ASCVD were recorded,with an incidence density of 17.49 per 1000 person-years.Association analyses indicated that the triglyceride to high-density lipoprotein cholesterol ratio(TG/HDL)and the TyG/(TG/HDL)index were not associated with incident ASCVD(P＞0.05).The TyG index combined with obesity measurement parameters emerged as a reliable predictor of ASCVD incidence.The most promising indicator,TyG index with waist-to-height ratio(TyG_WHtR),exhibited an inverted J-shaped association with incident ASCVD(P for nonlinearity=0.045;TDAUC=0.640;C=0.634),while the TyG index with body mass index(TyG_BMI),waist circumference(TyG_WC),and waist-to-hip ratio(TyG_WHR)showed positive linear associations(all P for trend＜0.05),with relatively lower predictive performance(C=0.564,0.588,and 0.598,respectively).Although both the TyG index and the metabolic score for insulin resistance(METS-IR)were associated with increased ASCVD risk(TyG:Q2 vs.Q1,HR=1.23 and Q4 vs.Q1,HR=1.24;METS-IR:P for non-linearity=0.045),they exhibited poor predictive performance for incident ASCVD.Conclusion The TyG index combined with obesity measurement parameters is an ideal IR surrogate marker for predicting incident ASCVD in populations with stages 0-3 CKM.Monitoring these markers will facilitate the prevention and control of cardiovascular diseases in CKM populations.

Objective:By comparing the effects of installing 3d-printed bolus with or without positioning holes on the skin fit and patient dose distribution,the advantages and disadvantages of the two installation methods in the application of radiotherapy after radical breast cancer surgery were evaluated,and the reference was provided for clinical application.Methods:A total of 48 patients(34 patients with and 14 patients without positioning holes)who received radiotherapy for breast cancer in Suining Central Hospital from December 2022 to Au-gust 2024 were randomly selected.Three dimensional reconstruction of the air gap between the patient body surface and the 3d-printed bolus was conducted,and the tissue dose distribution of each case was analyzed.Comparative analysis was conducted using t-test to ana-lyze the differences of the skin fit and the key dosimetric indexes of target areas and organs at risk between the two bolus installation meth-ods.Results:The mean values of the maximum air gap height,air gap area and air gap volume of the group with positioning holes were lower than those of the group without positioning holes(P<0.05),and the skin fit showed better consistency.The target area conformity in-dex(CI),homogeneity index(HI),and affected lung radiation acceptance(V20,V5)of patients with positioning holes were better than those of patients without positioning holes(P<0.05).There was no significant difference in target area coverage of prescription dose,cardiac dose Dmean and spinal cord dose Dmax between two groups(P>0.05).Conclusions:The skin fit,dosimetric indexes of patient target area and or-gans at risk of 3d-printed bolus with positioning holes were superior to those without positioning holes,showing significant advantages in clinical applications.

"When warm evil is received,it first attacks the lungs and then spread to the pericardium reversely"is the general rule of warm diseases.Doctors of different dynasties have different views on the phrase"reverse spread to the pericardium",especially the word"reverse".Professor Tong Xiaolin proposed that the heart governs the mind,the pericardium and the heart are connected in qi,and when the heart is affected by evil,the pericardium instead suffers from the evil.The"reverse spread to the pericardium"proposed by Ye Tianshi is actually the spread of warm evil to the brain.Taking meningococcal meningitis as the basic disease,it can be matched one by one with the typical stages of the transmission of Wei-Qi-Ying-Xue.Combined with the theory of Dingjiao,it is believed that the function of"the heart governing the mind"focuses more on the brain in the modern anatomical sense.Combining traditional Chinese medicine's ideas on diagnosis and treatment of warm diseases with modern medicine,revealing the essence of the disease,grasping the core of the pathogenesis,analyzing the word"reverse"from a new perspective,and exploring its true meaning,is of great significance for clarifying its connotation,exploring the development laws of warm diseases,and guiding the diagnosis and treatment of warm disea-ses.

Objective Exploring the construction of an electronic medical record system quality control system,impro-ving the level of hospital informatization,and providing strong support for the high-quality development of public hospitals.Meth-ods Based on the national electronic medical record system application level grading evaluation work,analyze the current situa-tion and existing problems of electronic medical record system construction in 402 hospitals participating in electronic medical re-cord grading evaluation in Zhejiang Province in 2023,and find solutions.Results To ensure the quality of electronic medical re-cord system construction,it is not only necessary to strengthen the construction of talent team,but also to strengthen the normal-ized supervision mechanism,formulate relevant quality control policies and systems,and build a multi-level quality control net-work.Conclusion The construction of electronic medical record system quality control system requires collaboration and promo-tion from multiple aspects.

Objective To investigate the occurrence of hemodialysis events in patients who received maintenance hemodialysis in outpatient setting in Liangshan Yi Autonomous Prefecture of Sichuan Province,and provide basis for the formulation of infection prevention and control strategies in this area.Methods Based on the standards from Center for Disease Control and Prevention-National Healthcare Safety Network(CDC-NHSN)as well as the WS/T 312-2023 standards,four public hospitals(two secondary and two tertiary hospitals)in three counties and one city of Liangshan Yi Autonomous Prefecture were selected,and prospective surveillance method was adopted.A total of 826 patients(n=8 675 cases)who received maintenance hemodialysis on the first two working day of each month from March 2024 to March 2025 were surveilled.Data were collected with standardized form by infection control teams in dialysis centers.Statistical analysis was conducted.Results During the surveillance period,the incidence of hemodialysis events was 5.15％(447/8 675).The incidence(16.67％,36/216)and mortality(10.00％,4/40)of hemodialysis events in patients with non-tunneled catheters were the highest among patients with all types of ac-cess.Patients with tunneled-catheters had the highest hospitalization rate(42.86％).Systemic use of antimicrobial agents accounted for 82.33％(368/447).Upper respiratory tract infection was the main infection(38.32％).In-fection at the puncture site of vascular access accounted for 16.78％(75/447).Four cases(0.89％,4/447)had positive blood culture.Conclusion Systemic antimicrobial use and infection at vascular access puncture site is the most frequent events in patients who receive maintenance hemodialysis in outpatient setting in Liangshan Yi Autono-mous Prefecture of Sichuan Province.Patients with non-tunneled catheters have the highest rate of hemodialysis events.

In 2025,the International Association of Pancreatology(IAP),in collaboration with the American Pancreatic Association,European Pancreatic Club,Indian Pancreas Club,and Japan Pancreas Society,released the International Association of Pancreatology revised guidelines on acute pancreatitis 2025.This edition represents a comprehensive revision of the 2013 guidelines,based on high-quality evidence accumulated over the past decade,particularly randomized controlled trials.The guidelines encompass 18 key areas-including pain management,fluid therapy,nutritional support,management of infected necrosis,complication control,discharge and follow-up,and recurrence prevention-offering a total of 96 recommendations that emphasize individualized treatment.These updates provide important guidance for standardizing clinical practice and improving outcomes in acute pancreatitis,while also indicating future research directions such as the development of targeted therapies.However,some recommendations remain limited by lower evidence quality,uncertain applicability in specific clinical settings,and insufficient consideration of economic burden and cost-effectiveness.