Congenital blood group chimerism refers to the coexistence of two or more distinct blood types within an individual, resulting from the presence of hematopoietic cell populations with different genotypes. Consequently, red blood cells in such individuals may express different blood group antigens. Based on the timing and mechanism of formation, blood group chimerism can be classified as either congenital or acquired. Although congenital blood group chimerism is rare and involves complex mechanisms, it holds significant implications in transfusion medicine, transplantation, and obstetrics. This article reviews the formation mechanisms, detection methods, and clinical significance of congenital blood group chimerism in transfusion medicine. Particular emphasis is placed on the principles, advantages, and limitations of various detection techniques. Furthermore, the potential applications of these technologies in clinical diagnosis are discussed, providing a technical foundation for the development of precise transfusion strategies.

ObjectiveTo investigate the differential expression of integrin alpha-6（ITGA6） in abdominal wall endometriosis （AWE） tissues and its molecular mechanisms in regulating AWE. Methods36 AWE lesions were designated as the experimental group， while 36 cases of normal endometrial tissues served as the controls. Differential expression of ITGA6 between the two groups was assessed through immunohistochemical （IHC） staining. Human ITGA6 gene-specific interference sequences were designed， synthesized， and packaged into lentiviral vectors to establish the Ishikawa cell line with ITGA6-knockdown. Similarly， the ITGA6-overexpression cell line was constructed using the coding sequence （CDS） of the gene. Real-time PCR and Western blot were performed to detect changes in epithelial-mesenchymal transition（EMT）-related markers and angiogenesis-related indicators. Cell invasion and migration capabilities were assessed by Cell Scratch and Transwell assays. Furthermore， Western blot was conducted to profile PI3K/AKT pathway dynamics. ResultsEctopic endometrial tissues exhibited a marked increase in the number of ITGA6-positive cells and their expression intensity compared to eutopic endometrium （each P < 0.001）. Compared with the NC group， the ITGA6-knockdown group showed significantly reduced expression of N-cadherin， VEGF， and TGF-β1 （all P < 0.01）， while E-cadherin expression was markedly increased （P < 0.01）. Concomitantly， the invasion and migration capacities of ITGA6-low expression were significantly impaired （P < 0.001 for both）， accompanied by a marked reduction in AKT and phosphorylated AKT（p-AKT） levels （P < 0.001）. Conversely， overexpressing ITGA6 resulted in opposite effects. ConclusionITGA6 modulates EMT and angiogenesis in Ishikawa cells via the PI3K/AKT signaling pathway， thereby enhancing cell invasion and migration capabilities， which contributes to the pathogenesis of AWE.

Background/Aims: Acetyl coenzyme A (acetyl-CoA) is one of the most essential metabolites in cell metabolism but its function and concentration in hepatocellular carcinoma (HCC) remain elusive and controversial. Methods: A comprehensive analysis of acetyl-CoA levels and acetyl-CoA synthetase 2 (ACSS2) expression across a range of samples, including patient specimens from both hepatitis B virus (HBV) positive and HBV negative HCC individuals, HBV-transgenic mouse HCC models, and multiple cell lines. Furthermore, to evaluate the functional significance of ACSS2 in HBV-related HCC, we implemented both genetic and pharmacological inhibition strategies targeting ACSS2. Molecular mechanism and mitophagy assessment were revealed by cleavage under target and tagmentation sequencing, RNA sequencing, bioinformatic analyses, transmission electron microscopy and JC-1 staining. Results: Our study revealed a distinct metabolic signature of HBV-related HCC, marked by elevated acetyl-CoA, which was driven by ACSS2. ACSS2 was upregulated by the carbohydrate response element-binding protein in HBV-related HCC. Furthermore, ACSS2 improved tumor cell proliferation, an effect that was dependent on its enzymatic activity. Mechanistically, ACSS2-induced acetyl-CoA accumulation activated voltage-dependent anion channels 1 transcription through increased H3K27ac occupancy, which subsequently promoted mitophagy and HBV-related HCC tumorigenesis. Notably, targeting ACSS2 by depletion or inhibition with a catalytic inhibitor significantly suppressed tumor growth. Conclusions These findings not only illustrate the interplay between metabolic reprogramming, epigenetic modification, and tumorigenesis in the context of HBV infection, but also highlight ACSS2 as a novel metabolic vulnerability in HBV-related HCC. Therefore, targeting ACSS2 could be a novel strategy against HBV-related HCC.

ObjectiveThis study aimed to construct a neural network model integrating readily available clinical data and two-dimensional （2D） conventional ultrasound images to evaluate the severity of steatotic liver disease （SLD）. MethodsClinical data and ultrasound images were retrospectively collected from 649 patients who underwent ultrasound attenuation imaging （ATI）. Using ATI as the reference standard， patients were divided into four groups： normal （S0）， mild （S1）， moderate （S2）， and severe （S3） SLD. Data were randomly divided into training and validation sets at an 8∶2 ratio. A contrastive language-image pre-training （CLIP） model was utilized to extract features from both clinical and imaging data， which were then used to train random forest （RF） and multilayer perceptron （MLP） models. The diagnostic performance of these multimodal models was compared their single-modal counterparts in the validation set. ResultsThe MLP model outperformed the RF model （AUC［95%CI］： S0 = 0.96 ［0.93-0.99］， S1 = 0.99 ［0.96-1.00］， S2 = 0.75 ［0.64-0.82］， S3 = 0.88 ［0.81-0.93］）. Furthermore， the multimodal fusion model demonstrated significantly superior performance compared to single-modal models （clinical data only： AUC［95%CI］ of 0.89 ［0.81-0.95］， 0.69 ［0.52-0.79］， 0.64 ［0.43-0.67］ and 0.80 ［0.73-0.90］ for S0-S3， respectively； image data only： AUC［95%CI］ of 0.91 ［0.86-0.96］， 0.89 ［0.67-0.89］， 0.69 ［0.58-0.78］ and 0.86 ［0.82-0.94］）. Metrics including precision， recall， F1-score， F2-score， confusion matrices， and loss function learning curves further confirmed that multimodal data fusion significantly improved the predictive capability. ConclusionThe proposed CLIP-based MLP multimodal model can effectively and automatically grade SLD severity. This demonstrates the significant advantage of integrating clinical and ultrasound data， providing an accurate and reliable adjunctive tool for the clinical management of chronic SLD.

Objective:To adapt and validate the Chinese version of the Supervisory Relationship Questionnaire(SRQ)and evaluate its psychometric properties among supervisees.Methods:Item analysis,exploratory factor anal-ysis(EFA)and confirmatory factor analysis(CFA)were conducted on data from 888 supervisees recruited via on-line platform.Test-retest reliability over a four-week interval was examined in a randomly selected subset of 70 su-pervisees.An additional sample of 367 supervisees completed the Supervisory Relationship Scale(SRS)to evaluate criterion validity.Results:The revised SRQ contained 65 items and 6 factors.Both exploratory factor analysis and confirmatory factor analysis supported six-factor structure(safe base,structure,commitment,reflective education,role model and formative feedback),explaining 66.52％of the variance,with factor loadings of the items ranging from 0.58 to 0.83.The revised SRQ had six factors with good fit indices(x2/df=1.31,GFI=0.81,NFI=0.87,CFI=0.97,TLI=0.90,IFI=0.91,RMSEA=0.03,SRMR=0.05).The scores of the revised SRQ were positively correlated with the scores of SRS(ICC=0.96,P＜0.01).The Cronbach α coefficient of the revised SRQ was 0.97,and the test-retest reliability coefficient(ICC)was 0.74.Conclusion:The SRQ-C demonstrates sound psy-chometric properties,including structural validity,criterion-related validity,internal consistency,and temporal stabil-ity.It is a reliable and valid instrument for assessing supervisory relationships from the supervisee perspective.

Objective:This study aims to provide insights into the clinical features of anti-melanoma differentiation-associated protein-5(MDA5)-positive dermatomyositis (MDA5-DM) patients with fatal outcomes, leveraging pathogenic microbiota metagenomic analysis, to guide the clinical assessment and treatment choices.Methods:From January 2020 to August 2023, deceased patients diagnosed with MDA5-DM were identified at the Department of Rheumatology and Immunology, the Second Affiliated Hospital of Xi ′an Jiaotong University. Clinical data were retrospectively collected and analyzed using Mann Whitney U test and Fisher ′s exact test to summarize risk factors and treatment assessment for MDA5-DM patients with fatal outcomes. Results:①The proportion of male patients was higher than females among MDA5-DM patients with fatal outcomes, which differed from the incidence pattern, possibly associated with smoking and gender proportions (6/11 vs. 0/7, P=0.037). ②94%(17/18) patients presented initially with elevated ferritin levels [(1 350±942)ng/ml] and CRP [(47±36)mg/L]. ③All patients (18/18) exhibited early involvement of the upper lung lobes, including multiple nodules in 9/18, ground-glass opacities in 5/18, and solitary nodules in 4/18. ④Metagenomic next-generation sequencing (mNGS) of bronchoalveolar lavage fluid was negative in 4/16 cases, with cytomegalovirus and pneumocystis jirovecii being the most commonly detected pathogens in 5/16 cases each. ⑤89%(16/18) of patients continued to have lymphocyte counts persistently <0.5×10 9/L irrespective of treatment. Conclusion:Smoking may have adverse effects on male MDA5 patients. Early involvement of the upper lobe of the lungs is more common in MDA5 antibody positive deaths, and persistent lymphocyte depletion is an important factor in poor response. Enhancing mNGS analysis of bronchoalveolar lavage fluid and vigilance towards cytomegalovirusand Pneumocystis jirovecii could provide valuable clinical guidance.

Fecal incontinence is a refractory disease.The main clinical manifestation is that patients cannot control the discharge of gas, solid or liquid feces in the rectum autonomously. It significantly compromises patients'quality of life and imposes substantial economic burdens on both families and the healthcare system. With the evolution of therapeutic paradigms and innovations in diagnosis and treatment modalities, the management approach for fecal incontinence has progressively evolved:early strategies centered on anatomical reconstruction, following the advent of sacral nerve modulation, the focus transitioned to the restoration of physiological function;and since the turn of the 21st century ,emphasis has been placed on comprehensive evaluation and stratified therapy, leading to the establishment of a precision-oriented and patient-tailored diagnostic and therapeutic framework.This paper examines the accumulation of evidence-based medical data and the drivers behind these shifts in treatment models to elucidate the underlying patterns in the management of FI. It also addresses current controversies, such as screening for asymptomatic anal sphincter defects and gaps in psychological support, proposing targeted solutions and stratified care pathways to inform clinical practice and future research.

Objective:To analyze the gene mutation spectrum of children with T-acute lymphoblastic leukemia (T-ALL) using next generation sequencing technology and to evaluate the value of gene mutations in prognosis stratification.Methods:A case series analysis was made.The clinical data of newly diagnosed pediatric T-ALL patients in the First Affiliated Hospital of Zhengzhou University from January 1, 2019 to February 29, 2024 were analyzed retrospectively.T-ALL gene mutations were analyzed.The relationships of gene mutations with clinical features and induction of responses to therapy were studied.The effects of gene mutations on overall survival (OS) and event-free survival (EFS) were examined by the Kaplan-Meier method and COX regression model.Results:A total of 80 newly diagnosed pediatric T-ALL patients were enrolled in the study, with a male-to-female ratio of 3.4∶1.0 and a median age of 8 (range, 2-17) years.A total of 57 mutations were detected in 74 patients, 46.2% (37/74) of whom showed 3 or more gene mutations.The coexistence of mutated genes was obvious. PTEN mutations were more prevalent in male patients ( P=0.018).Initial leukocyte counts were higher in patients with PTEN mutations ( P=0.038) and lower in patients with JAK3 mutations ( P=0.002).Patients with NOTCH1 mutations had a higher positive rate of fusion genes ( P=0.043).Patients with PTEN mutations had a higher rate of minimal residual disease(MRD) remission after 15/19 d of treatment with induction therapy, respectively ( P=0.013).The rate of MRD remission after 33/46 d of treatment with induction therapy was higher in patients with the FBXW7 mutation ( P=0.004) and lower in patients with JAK3 mutations ( P=0.003).Multifactorial COX regression analysis showed that IL7R mutation and three or more gene mutations were independent risk factors for OS and EFS in T-ALL patients(OS: HR=3.252, 7.357, 95% CI: 1.020-10.372, 1.646-32.882; EFS: HR=3.372, 3.009, 95% CI: 1.234-9.214, 1.174-7.708; all P<0.05). Conclusions:Gene mutations are prevalent in T-ALL children and correlate with clinical manifestations and prognosis.The coexistence of mutated genes is obvious.Pediatric T-ALL patients with IL7R mutations and three or more gene mutations have a poorer prognosis.

Objective:To investigate the association between dietary diversity and the risk of major adverse cardiovascular events (MACE) after percutaneous coronary intervention (PCI) in patients with coronary heart disease (CHD) .Methods:A total of 553 patients diagnosed with CHD and undergoing PCI in the Department of Cardiology at the Second Affiliated Hospital of Harbin Medical University between May and November 2023 were enrolled using a convenience sampling method. A Semi-Quantitative Food Frequency Questionnaire was used to assess patients' dietary intake after PCI, and the Dietary Diversity Score (DDS) was calculated. Patients were followed up for one year to determine the incidence of MACE.Results:History of hypertension, history of hyperlipidemia, body mass index, use of antiplatelet agents, use of diuretics, triglycerides, smoking index and DDS were identified as factors influencing the occurrence of MACE after PCI ( P<0.05) . Among these, higher dietary diversity had a protective effect against MACE. Conclusions:After PCI, patients with lower DDS experienced MACE more frequently than those with higher scores. Increased dietary diversity can effectively help prevent MACE in patients after PCI.

Objective Based on the bibliometric methods of CiteSpace and VOSviewer,this paper analyzes Chinese and English literature on the application of plasma in wound healing,combs the current research status and hotspots,and predicts the future development trends of basic and clinical research.Methods The data retrieval platforms include China National Knowledge Infrastructure(CNKI),Wanfang Data Knowledge Service Platform,VIP Chinese Science and Technology Journal Database,and Web of Science(WOS).A total of 310 relevant articles were included,and information such as the number of publications,authors,institutions,countries,and keywords was visualized.Results As an emerging research direction in the 21st century,the volume of publications on plasma-promoted wound healing has shown an overall upward trend,with more publications abroad;currently,most research teams at home and abroad come from higher learning institutions and present the characteristics of multidisciplinary exchange and integration.Conclusion Plasma technology has a significant effect in promoting the healing of various complex and difficult wounds,but there is a lack of basic research literature at present.Therefore,it is necessary to further verify its mechanism of action in order to expect plasma to have a wider range of clinical research and applications in promoting wound healing in the future.