Objective: To evaluate the operational efficiency of a single-center platelet genotype database in HLA genotype-matched platelet search and applcation, and to compare the efficiency among different matching strategies, hospitals, and between first-time versus repeat application modes. Methods: Data on platelet genotype-based matching applications from December 1, 2025, to May 31, 2026, at our center were collected. Four time intervals were defined according to the workflow: the time from clinical hospital application to blood center receipt confirmation (Δt ); the time from blood center confirmation to completion of platelet gene database search (Δt ); the time from completion of database searching to availability of compatible platelet products (Δt ); and the time from clinical hospital application to availability of compatible platelet products (Δt ). Applications were classified as first-time or repeat based on application history, and as speed-priority matching strategy or classical matching strategy based on matching approach, with efficiency differences compared across the groups. Results: A total of 1 051 valid matching applications were included. The median values of Δt , Δt , Δt , and Δt were 6.2 h, 0.1 h, 0.2 h, and 11.5 h, respectively. Overall, 55.9% of genotype-based matches resulted in compatible platelets being available on the same day. The median Δt of the speed-priority strategy was significantly shorter than that of the classical strategy (5.2 h vs 39.6 h, P<0.001). Median Δt differed significantly among hospitals (P<0.001), with the shortest being 4.4 h. The median Δt for repeat applications was 6.9 h, significantly shorter than that for first-time applications (27.7 h, P<0.001). Conclusion: The platelet gene database demonstrates sufficient efficiency in HLA genotype-matched platelet searching and application to meet clinical demands. Optimizing matching strategies and hospital application workflows may shorten the time for obtaining compatible platelets.

Objective To analyze the clinical characteristics and risk factors of children with B-cell acute lymphoblastic leukemia(B-ALL)who developed acute pancreatitis(AP)after treatment with pegaspargase(PEG-ASP).Methods A retrospective analysis was conducted on the general data,clinical data,blood routine data,albumin concentration,and cumulative dose of PEG-ASP of 272 children with ALL complicated with AP who received PEG-ASP treatment in the hospital from January 2021 to February 2023.The correlations between gender,age,risk stratification,cumulative dose of pegaspargase,blood routine indicators,albumin concentration and the progression of pancreatitis were analyzed.Results Among the 272 children,the incidence of AP was 8.5%(23/272).There was no statistically significant correlation between AP and gender,age,body mass index(BMI),risk stratification,cumulative dose of pegaspargase,hemoglobin concentration,platelet count and monocyte count(P>0.05),but there was a significant correlation with white blood cell count,neutrophil count,lymphocyte count,neutrophil/lymphocyte ratio,platelet/lymphocyte ratio and albumin concentration(P<0.05).Logistic regression analysis further showed that white blood cell count,neutrophil count,lymphocyte count and albumin concentration were related to the occurrence of PEG-ASP-related AP(P<0.05).ROC analysis found that white blood cell count,lymphocyte count and albumin concentration could predict the occurrence of PEG-ASP-related AP.Conclusions White blood cell count,neutrophil count,lymphocyte count and albumin concentration are risk factors for PEG-ASP-related AP in children with B-ALL.Especially,abnormal white blood cell count,lymphocyte count and albumin concentration in blood routine examination can help identify high-risk children with B-ALL complicated with PEG-ASP-related AP at an early stage.

With changes in lifestyle,the incidence of osteoporotic vertebral burst fractures is increasing.These fractures are prone to being underdiagnosed or misdiagnosed.In severe cases,they can lead to nonunion,kyphotic deformity,and even neurological injury.The best treatment plan for such unstable fractures has always been controversial.On the one hand,the fracture degree is severe and the morphology is complex,and there is no unified classification standard.On the other hand,the general condition and bone quality of the patients are poor,which affects the surgical decision.This article reviews the progress in the diagnosis and treatment of osteoporotic lumbar body blowout fractures.

Objective To assess the mid-term clinical prognosis and radiological outcomes of a novel expandable PEEK(polyetheretherketone)vertebral replacement device used for anterior and middle column recon-struction in the thoracolumbar spine of osteoporotic patients.Methods A retrospective analysis was performed on 52 patients with single-segment osteoporotic thoracolumbar fractures who underwent vertebral body replacement surgery between January 2020 and December 2023.The surgical procedures included either a thoracoscopic or minimally invasive anterior approach,combined with posterior short-segment cement-augmented screw fixation.According to the type of replacement material used,patients were categorized into two groups:the novel PEEK group and the titanium Mesh cage group.Data on surgical time,intraoperative blood loss,and postoperative complications were collected.The Visual Analogue Score(VAS),Oswestry Disability Index(ODI),local kyphotic angle(LKA),fusion segment height(D-line),anterior vertebral body height(AVBH),and posterior vertebral body height(PVBH)were assessed at three stages:preoperatively,immediately postoperatively,and during the final follow-up.Results All patients were successfully discharged.In the PEEK group,the average operative time was(235.28±58.69)minutes,and intraoperative blood loss was(680.00±163.30)mL.The mean follow-up duration was(14.12±2.44)months.The VAS score decreased significantly from(7.44±0.87)preoperatively to(2.24±0.93)at the final follow-up,and the ODI score also decreased significantly from(42.64±4.86)preoperatively to(11.84±3.73)at the final follow-up,indicating substantial improvement in symptoms and function(P<0.05).At the final follow-up,LKA,D-line,and AVBH exhibited partial loss compared to immediate postoperative values(P>0.05),but they remained significantly improved compared to preoperative values(P<0.05).The postoperative complication rate was 12.00%(3/25),and the fusion rate at the final follow-up was 100.00%.Similarly,the Mesh group effectively improved patient symptoms,function,and vertebral height(P<0.05).However,at the final follow-up,the PEEK group demonstrated significantly better LKA,D-line,and AVBH values compared to the Mesh group(P<0.05).Conclusion The short-segment cement-augmented internal fixation in combination with the novel expandable PEEK replacement device represents a viable solution for anterior column reconstruction in osteoporotic thoracolumbar fractures,as evidenced by its mid-term outcomes of effective pain relief,significant functional improvement,sustained maintenance of vertebral height,and successful deformity correction.

Objective To assess the mid-term clinical prognosis and radiological outcomes of a novel expandable PEEK(polyetheretherketone)vertebral replacement device used for anterior and middle column recon-struction in the thoracolumbar spine of osteoporotic patients.Methods A retrospective analysis was performed on 52 patients with single-segment osteoporotic thoracolumbar fractures who underwent vertebral body replacement surgery between January 2020 and December 2023.The surgical procedures included either a thoracoscopic or minimally invasive anterior approach,combined with posterior short-segment cement-augmented screw fixation.According to the type of replacement material used,patients were categorized into two groups:the novel PEEK group and the titanium Mesh cage group.Data on surgical time,intraoperative blood loss,and postoperative complications were collected.The Visual Analogue Score(VAS),Oswestry Disability Index(ODI),local kyphotic angle(LKA),fusion segment height(D-line),anterior vertebral body height(AVBH),and posterior vertebral body height(PVBH)were assessed at three stages:preoperatively,immediately postoperatively,and during the final follow-up.Results All patients were successfully discharged.In the PEEK group,the average operative time was(235.28±58.69)minutes,and intraoperative blood loss was(680.00±163.30)mL.The mean follow-up duration was(14.12±2.44)months.The VAS score decreased significantly from(7.44±0.87)preoperatively to(2.24±0.93)at the final follow-up,and the ODI score also decreased significantly from(42.64±4.86)preoperatively to(11.84±3.73)at the final follow-up,indicating substantial improvement in symptoms and function(P<0.05).At the final follow-up,LKA,D-line,and AVBH exhibited partial loss compared to immediate postoperative values(P>0.05),but they remained significantly improved compared to preoperative values(P<0.05).The postoperative complication rate was 12.00%(3/25),and the fusion rate at the final follow-up was 100.00%.Similarly,the Mesh group effectively improved patient symptoms,function,and vertebral height(P<0.05).However,at the final follow-up,the PEEK group demonstrated significantly better LKA,D-line,and AVBH values compared to the Mesh group(P<0.05).Conclusion The short-segment cement-augmented internal fixation in combination with the novel expandable PEEK replacement device represents a viable solution for anterior column reconstruction in osteoporotic thoracolumbar fractures,as evidenced by its mid-term outcomes of effective pain relief,significant functional improvement,sustained maintenance of vertebral height,and successful deformity correction.

OBJECTIVES: To explore the efficacy of DSA-guided intrathecal drug delivery system combined with Zi Wu Liu Zhu Acupoint Therapy for management of cancer pain and provide reference for its standardized clinical application. Methods and. RESULTS: Recommendations were formulated based on literature review and expert group discussion, and consensus was reached following expert consultation. The consensus recommendations are comprehensive, covering the entire treatment procedures from preoperative assessment and preparation, surgical operation process, postoperative management and traditional Chinese medicine treatment to individualized treatment planning. The study results showed that the treatment plans combining traditional Chinese with Western medicine effectively alleviated cancer pain, reduced the use of opioid drugs, and significantly improved the quality of life and enhanced immune function of the patients. Postoperative follow-up suggested good treatment tolerance among the patients without serious complications. CONCLUSIONS The formulated consensus is comprehensive and can provide reference for clinicians to use DSA-guided intrathecal drug delivery system combined with Zi Wu Liu Zhu Acupoint Therapy. The combined treatment has a high clinical value with a good safety profile for management of cancer pain.
Humans ; Medicine, Chinese Traditional ; Cancer Pain/therapy* ; Drugs, Chinese Herbal/therapeutic use* ; Drug Delivery Systems ; Pain Management/methods* ; China

ObjectiveTo observe the clinical effectiveness and safety of Dingchan Granule （定颤颗粒） for paroxysmal atrial fibrillation with syndrome of qi stagnation and blood stasis. MethodsUsing a randomised， double-blind， placebo controlled study method， 90 patients with paroxysmal atrial fibrillation with qi stagnation and blood stasis syndrome were divided into 45 cases each in the treatment group and the control group. Both groups were given conventional western medicine treatment， and the treatment group was additionally treated with Dingchan Granule， while the control group was treated with Dingchan Granule placebo， both of which were taken orally for 8 g each time twice a day. Both groups were treated for 8 weeks. We compared the clinical effectiveness， the improvement of traditional Chinese medicine （TCM） symptoms and the recovery rate of atrial fibrillation between the two groups. We compared the number and duration of atrial fibrillation episodes， TCM symptoms score， atrial fibrillation symptom classification， 24-hour average ventricular rate， Pittsburgh Sleep Quality Index （PSQI）， anxiety index， depression index before and after treatment， and evaluated the safety of the two groups. ResultsThe total clinical effectiveness rate in the treatment group was 82.22% （37/45）， which was better than 60.00% （27/45） in the control group （P＜0.05）. The total effective rate of TCM syndrome effectiveness in the treatment group was 88.89% （40/45）， which was better than 66.67% （30/45） in the control group （P＜0.05）； and the rate of atrial fibrillation regression in the treatment group was 26.67% （12/45）， better than 6.67% （3/45） in the control group （P＜0.05）. The number and duration of atrial fibrillation episodes in both groups were significantly decreased （P＜0.01）， and the number and duration of atrial fibrillation episodes in the treatment group were lower than those in the control group （P＜0.01）. The TCM syndrome scores of both groups after treatment were significantly lower than before treatment （P＜0.01）， and the scores of the treatment group was lower than those of the control group （P＜0.05）. The severity of atrial fibrillation symptoms and the grading of atrial fibrillation symptoms in both groups after treatment were improved （P＜0.01）， and the degree of symptom improvement in the treatment group was better than that in the control group （P＜0.01）. The 24-hour average ventricular rate of both groups after treatment was significantly lower （P＜0.01）. The PSQI， anxiety index and depression index of the treatment group were all lower than before treatment （P＜0.01）， while the PSQI and anxiety index of the control group were both lower than before treatment （P＜0.01 or P＜0.05）， the PSQI， anxiety index and depression index of the treatment group being lower than those of the control group （P＜0.05 or P＜0.01）. No adverse events occurred in both groups， and no abnormalities were observed in blood， urine， stool routine， liver and kidney function， and coagulation function indexes. ConclusionDingchan Granule for paroxysmal atrial fibrillation with qi stagnation and blood stasis syndrome can alleviate clinical symptom， improve TCM symptom scores， increase atrial fibrillation recovery rate， stabilise the average ventricular rate， and significantly improve the quality of sleep， alleviate the anxiety and depression， with a good safety profile.

Objective To explore the efficacy of DSA-guided intrathecal drug delivery system combined with Zi Wu Liu Zhu Acupoint Therapy for management of cancer pain and provide reference for its standardized clinical application.Methods and Results Recommendations were formulated based on literature review and expert group discussion,and consensus was reached following expert consultation.The consensus recommendations are comprehensive,covering the entire treatment procedures from preoperative assessment and preparation,surgical operation process,postoperative management and traditional Chinese medicine treatment to individualized treatment planning.The study results showed that the treatment plans combining traditional Chinese with Western medicine effectively alleviated cancer pain,reduced the use of opioid drugs,and significantly improved the quality of life and enhanced immune function of the patients.Postoperative follow-up suggested good treatment tolerance among the patients without serious complications.Conclusion The formulated consensus is comprehensive and can provide reference for clinicians to use DSA-guided intrathecal drug delivery system combined with Zi Wu Liu Zhu Acupoint Therapy.The combined treatment has a high clinical value with a good safety profile for management of cancer pain.

Objective To analyze the clinical characteristics and risk factors of children with B-cell acute lymphoblastic leukemia(B-ALL)who developed acute pancreatitis(AP)after treatment with pegaspargase(PEG-ASP).Methods A retrospective analysis was conducted on the general data,clinical data,blood routine data,albumin concentration,and cumulative dose of PEG-ASP of 272 children with ALL complicated with AP who received PEG-ASP treatment in the hospital from January 2021 to February 2023.The correlations between gender,age,risk stratification,cumulative dose of pegaspargase,blood routine indicators,albumin concentration and the progression of pancreatitis were analyzed.Results Among the 272 children,the incidence of AP was 8.5%(23/272).There was no statistically significant correlation between AP and gender,age,body mass index(BMI),risk stratification,cumulative dose of pegaspargase,hemoglobin concentration,platelet count and monocyte count(P>0.05),but there was a significant correlation with white blood cell count,neutrophil count,lymphocyte count,neutrophil/lymphocyte ratio,platelet/lymphocyte ratio and albumin concentration(P<0.05).Logistic regression analysis further showed that white blood cell count,neutrophil count,lymphocyte count and albumin concentration were related to the occurrence of PEG-ASP-related AP(P<0.05).ROC analysis found that white blood cell count,lymphocyte count and albumin concentration could predict the occurrence of PEG-ASP-related AP.Conclusions White blood cell count,neutrophil count,lymphocyte count and albumin concentration are risk factors for PEG-ASP-related AP in children with B-ALL.Especially,abnormal white blood cell count,lymphocyte count and albumin concentration in blood routine examination can help identify high-risk children with B-ALL complicated with PEG-ASP-related AP at an early stage.

With changes in lifestyle,the incidence of osteoporotic vertebral burst fractures is increasing.These fractures are prone to being underdiagnosed or misdiagnosed.In severe cases,they can lead to nonunion,kyphotic deformity,and even neurological injury.The best treatment plan for such unstable fractures has always been controversial.On the one hand,the fracture degree is severe and the morphology is complex,and there is no unified classification standard.On the other hand,the general condition and bone quality of the patients are poor,which affects the surgical decision.This article reviews the progress in the diagnosis and treatment of osteoporotic lumbar body blowout fractures.