Objective: To investigate the impact of RhE antigen-matched transfusion during liver transplantation on early postoperative recovery and complications. Methods: In this retrospective cohort study, ninety-five patients undergoing liver transplantation at Kunming First People's Hospital between January 2022 and July 2025 were enrolled. Patients were divided into two groups: Group 1 (RhE-mismatched transfusion, n=57) and Group 2 (RhE-matched transfusion, n=38). The baseline data, complete blood counts, hepatic and renal function, coagulation parameters, and complication rates between the two groups were compared at postoperative days 1, 3, 5, 7, and 10. Survival analysis was performed using the Kaplan-Meier method. Results: The baseline characteristics were well-balanced and comparable between the two groups (all P>0.05). The early postoperative mortality rate in the mismatched group (31.58%, 18/57) was significantly higher than that in the matched group (10.53%, 4/38) (P=0.017). The incidence of postoperative hepatic encephalopathy was significantly higher in the mismatched group (50.88%, 29/57) than in the matched group (10.53%, 4/38) (P<0.001). The incidence of postoperative haemorrhage in the mismatched group (24.56%, 14/57) was higher than that in the matched group (5.26%, 2/38), with a statistically significant difference (P=0.014). The incidence of perioperative infection in the mismatched group (28.07%, 16/57) was higher than that in the matched group (10.53%, 4/38), with a statistically significant difference (P=0.04). Corresponding odds ratios (OR) and 95% confidence intervals indicated a lower risk of these adverse events in the matched group. On postoperative day 1, the change in activated partial thromboplastin time (-1.6, 20.5) in the mismatched group was greater than in the matched group (-0.2, 5.5). The change in international normalised ratio (-0.56, 1.22) in the mismatched group was greater than in the matched group (-0.18, 0.32), while the change in albumin (-4.0, 4.8) was smaller in the mismatched group than in the matched group (-2.5, 8.8). On postoperative day 5, the change in albumin (-0.41±7.83) in the mismatched group was smaller than in the matched group (2.68±4.53). At postoperative day 7, the change in albumin in the mismatched group (-0.61±7.38) was smaller than that in the matched group (2.51±5.85), while the change in D-dimer in the mismatched group (0.73, 7.4) was greater than that in the matched group (-1.6, 4.3). On postoperative day 10, the mismatched group exhibited significantly higher fibrinogen levels (-1.21, 1.78) than the matched group (-0.49, 0.97), and significantly longer prothrombin times (-11.3, -2.7) than the matched group (-6.2, -0.8) (all P<0.05). The matched group exhibited a mean overall survival (OS) of 32.803 months (95% CI:29.171-36.436 months), significantly exceeding the mismatched group's 28.996 months (95% CI:24.202-33.790 months). The log-rank test yielded statistically significant results (χ =4.307, P=0.038). Conclusion: Implementing RhE blood group-matched transfusion during liver transplantation may help reduce early postoperative mortality and the incidence of major complication rates, promote faster recovery of coagulation and liver function, and thereby improve short-term patient outcomes.

ObjectiveTo explore the long-term dynamic trajectories of fasting blood glucose （FBG） and insulin resistance （IR） in patients with type 2 diabetes mellitus （T2DM） and their influencing factors. MethodsThis retrospective cohort study included 1 896 T2DM patients registered at Tongren Hospital from May 2020 to May 2025. Based on longitudinal follow-up data of FBG and fasting insulin， joint latent class mixed models （JLMM） were applied to identify FBG-IR trajectories. Univariate and multinomial logistic regression was used to examine demographic characteristics， lifestyle， and clinical determinants of trajectory type. ResultsFour distinct FBG-IR trajectories were identified： stable FBG-IR （9.76%）， rising FBG-stable IR （5.01%）， stable FBG-elevated IR （75.90%）， and elevated FBG-IR （9.34%）. Compared with the stable FBG-IR group， age ≥60 years was protective against the elevated FBG-stable IR trajectory （OR=0.55， 95%CI：0.33-0.92， P=0.023）. Highereducation increased the risk of stable FBG-elevated IR （OR=1.40， 95%CI：1.01-1.94， P=0.046）. Abnormal blood pressure was associated with lower risks of stable FBG-elevated IR （OR=0.66， 95%CI：0.48-0.92， P=0.013） and elevated FBG-IR （OR=0.48， 95%CI：0.31-0.74， P=0.001）. Non-drinkers were less likely to belong to the stable FBG-elevated IR trajectory （OR=0.39， 95%CI：0.16-0.95， P=0.038）. ConclusionsThe evolution trajectory of FBG and IR in T2DM patients shows significant heterogeneity. The majority of patients have a deterioration of IR first. Age， education level， blood pressure， and alcohol consumption are the main influencing factors. Joint assessment of FBG and IR is helpful for early identification of high-risk individuals and guiding individualized intervention.

This article reports the diagnosis and treatment course of a patient with granulomatosis with polyangiitis (GPA) complicated with Kennedy disease (KD). The patient presented with headache, purulent and bloody rhinorrhea, ocular pain, decreased hearing and vision, multiple nodular erythema with ulcers on both lower extremities, and lower limb weakness. Chest imaging revealed a nodule with cavity formation in the right lung, and cytoplasmic anti-neutrophil cytoplasmic antibody (c-ANCA) and proteinase 3-antineutrophil cytoplasmic antibody (PR3-ANCA) were positive. The patient was initially diagnosed with granulomatosis with polyangiitis. After treatment with glucocorticoids and cyclophosphamide, the vasculitis-related symptoms were relieved while lower limb weakness got worse. Genetic testing identified 50 CAG repeats in exon 1 of the androgen receptor (AR) gene, and the final diagnosis was GPA complicated with KD. After rehabilitation therapy, the patient′s lower limb weakness improved. Methylprednisolone combined with leflunomide was administered for maintenance treatment, and the condition remained stable during long-term follow-up.

Objective:To explore the value of baseline 18F-FDG PET/CT metabolic parameters and related clinical factors in the prognostic assessment of patients with angioimmunoblastic T-cell lymphoma (AITL). Methods:From July 2013 to December 2023, 70 patients with AITL (44 males, 26 females, age (63.9±9.6) years) from Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University (32 cases) as well as the First Affiliated Hospital of Nanjing Medical University (38 cases) who were diagnosed pathologically and underwent PET/CT imaging prior to treatment were retrospectively analyzed. PET/CT metabolic parameters (calculated using the 41%SUV max threshold method) and related clinical factors were collected. The optimal cut-off values of metabolic parameters were determined by using the ROC curve analysis. Cox proportional risk regression models were used for prognostic analyses, prediction models were constructed and efficacies were assessed by calibration curves and time-dependent ROC curves. Results:With the follow-up of 19.0(10.0, 33.3) months, disease progression or recurrence occurred in 51 patients, and 28 patients died. ROC curves showed that the optimal cut-off values on diagnosing AITL of total metabolic tumor volume (TMTV), total lesion glycolysis (TLG), and SUV max were 767.1cm 3, 2159.6g and 13.0, respectively. TMTV (hazard ratio ( HR)=0.485, 95% CI: 0.252-0.935, P=0.031) and gender ( HR=0.441, 95% CI: 0.236-0.824, P=0.010) were independent risk factors for progression-free survival (PFS); TMTV ( HR=0.422, 95% CI: 0.178-0.997, P=0.049) and treatment regimen ( HR=0.346, 95% CI: 0.154-0.777, P=0.010) were independent risk factors for overall survival (OS). Time-dependent ROC curves indicated that the combined model of TMTV combining gender or treatment regimen had better prognostic results in predicting PFS (AUCs: 0.67-0.82) or OS (AUCs: 0.62-0.80) in patients with AITL. The calibration curve showed the predicted values of the combined models were in good consistency with the actual values. Conclusions:The metabolic parameter TMTV is an independent risk factor for PFS and OS in patients with AITL. The combined model of TMTV combining gender or treatment regimen can effectively improve the prognostic prediction efficacy of PFS or OS in patients with AITL.

Objective To provide experimental evidence for selecting acupuncture timing in clinical practice,the optimal time for enhancing the brain effects of electroacupuncture at the Hegu acupoint(LI4)by observing brain imaging data,hemodynamic changes and differences in brain functional connectivity across the twelve traditional Chinese time periods were determined.Methods Thirty-six C57BL/6 mice were randomly divided into 12 groups corresponding to each of the twelve time periods(Zi,Chou,Yin,Mao,Chen,Si,Wu,Wei,Shen,You,Xu,Hai),with 3 mice per group.Each mouse received electroacupuncture stimulation using the same protocol.Brain imaging data and dynamic hemodynamic changes were collected using functional ultrasound imaging(FUS)ultrasound imaging technology every 0.4 s over a total duration of 420 s,covering pre-acupuncture(resting state),during acupuncture(task state),and post-acupuncture(post-task state)phases.The hippocampal region(HIP)was used as the observation point to analyze changes in functional connectivity between HIP and other brain regions before and after acupuncture.Results Compared to other time periods,the Mao group exhibited the largest whole-brain activation area and the highest average activation signal intensity.The hemodynamic signal increase in the hippocampal region was more pronounced,and the post-acupuncture blood flow signal intensity remained significantly higher than the pre-acupuncture resting state.Functional connectivity data revealed that,using 0.2 as the standard value,the Mao group showed the greatest number of altered brain regions before and after acupuncture.Notably,only in the Mao group was there a significant enhancement in connectivity between the bilateral hippocampal regions.Conclusion The immediate effects of electroacupuncture at the Hegu acupoint(LI4)and brain functional connectivity vary significantly across different time periods,aligning with the traditional Chinese medicine theory of meridian qi and blood flow.Mao time is identified as the optimal period.

OBJECTIVE To study the safety of Shuangshu decoction in rats and its efficacy in improving functional dyspepsia （FD） in rats. METHODS In safety test， 40 rats were divided into blank control group， Shuangshu decoction low-dose， medium- dose and high-dose groups [108， 216， 324 g/（kg·d）， calculated by raw medicine， the same applies below]； they were given relevant medicine intragastrically， for continuous 14 days. The mortality and toxic reactions of rats were recorded， and the organ indexes of the liver， kidney， spleen， lung and heart of rats were calculated； the pathological morphological changes in the liver， kidney， spleen， lung， heart， stomach， duodenum， and colon were observed to evaluate the acute toxicity of Shuangshu decoction. Another 40 rats were grouped and administered in the same way for 30 consecutive days. The mortality and toxic reactions of the rats were recorded， and the corresponding organ indexes were calculated. The pathological morphological changes in the corresponding organs were observed， and blood routine and serum biochemical indicators were measured， in order to assess the subacute toxicity of Shuangshu decoction. In pharmacodynamic experiments: 50 rats were divided into blank control group， model group， and Shuangshu decoction low-， medium-， and high-dose groups （9.45， 18.9， 37.8 g/kg）， with 10 rats in each group. Except for blank control group， rats in all other groups were used to establish the FD rat model by subcutaneous injection of loperamide （3.5 mg/kg）. Rats in each group were administered the corresponding drug solution/normal saline intragastrically， once a day， for 14 consecutive days. After the last medication， fecal moisture content， intestinal propulsion rate， gastric emptying rate and serum level of motilin were all detected， and interstitial cell of Cajal （ICC） ultrastructure of rats was observed in colon tissue. RESULTS The safety experiments showed that no death occurred in each dose group， and no significant difference was found in organ coefficient， routine blood and serum biological index， compared to blank control group （P＞0.05）； no abnormality was found in organ appearance and pathological sections. The results of the pharmacodynamic experiments showed that， compared with the blank control group， the fecal moisture content， gastric emptying rate， intestinal propulsion rate， and serum motilin levels in the model group were significantly decreased （P＜0.05）； in the colonic tissue， the mitochondria in the ICC exhibited severe swelling with the disappearance of cristae， and the endoplasmic reticulum was dilated. Compared with model group， the rats in Shuangshu decoction high-dose group showed significant increases in the above quantitative indicators （P＜ 0.05）； additionally， there was a large number of mitochondria in the ICC of the colonic tissue， with clear cristae and regular arrangement. CONCLUSIONS Shuangshu decoction is safe and has a beneficial improving effect on FD rats； its mechanism of action may be related to the regulation of gastrointestinal hormone expression to promote gastric emptying and intestinal propulsion， as well as the repair of mitochondrial structure in ICCs to restore gastrointestinal function.

We have isolated an intestinal probiotic strain, Pediococcus acidilactici HRQ-1. To improve its gastrointestinal fluid tolerance, transportation and storage stability, and slow-release properties, we employed the extrusion method to prepare the microcapsules with P. acidilactici HRQ-1 as the core material and sodium alginate and chitosan as the wall material. The optimal conditions for preparing the microcapsules were determined by single factor and orthogonal tests, and the optimal ratio was determined by taking the embedding rate, survival rate, storage stability, gastrointestinal fluid tolerance, and release rate as the evaluation indexes. The results showed that under the optimal embedding conditions, the embedding rate reached (89.60±0.02)%. Under the optimal formula of freeze-drying protective agent, the freeze-drying survival rate reached (76.42±0.13)%, and the average size of the microcapsules produced was (1.16±0.03) mm. The continuous gastrointestinal fluid simulation experiments confirmed that the microcapsules ensured the viable bacterial count and can slowly release bacteria in the intestinal fluid. The curve of the viable bacterial count during storage at 4 ℃ and room temperature indicated that the prepared microcapsules achieved strains' live number protection. The formula and preparation process of P. acidilactici microcapsules may provide a technological reserve for the preparation of more live bacterial drugs in the future.
Pediococcus acidilactici/chemistry* ; Probiotics/chemistry* ; Capsules/chemistry* ; Alginates/chemistry* ; Chitosan/chemistry* ; Drug Compounding/methods* ; Glucuronic Acid/chemistry* ; Hexuronic Acids/chemistry* ; Freeze Drying

Contrast-enhanced ultrasound（CEUS），as a non-invasive imaging technique，has been widely applied in the characterization of focal liver lesions（FLLs）. By intravenously injecting contrast agents and using specific low mechanical index imaging techniques，CEUS not only provides high spatial and temporal resolution，but also enables dynamic assessment of blood flow perfusion in both large vessels and microvessels，including capillaries in the liver. However，CEUS is highly operator-dependent. The quantitative analysis of time-intensity curves in dynamic contrast-enhanced ultrasound（DCE-US）can provide further information，overcome the subjectivity limitations of traditional CEUS and improve the accuracy of diagnosis and treatment in FLLs. This review discusses the theoretical basis of DCE-US and its quantitative analysis methods，their applications in the diagnosis and treatment of FLLs，limitations，and future directions.

Objective:To develop a preoperative differentiation model for colorectal mucinous adenocarcinoma and non-mucinous adenocarcinoma using a combination of contrast-enhanced CT radiomics and deep learning methods.Methods:This is a retrospective cohort study. Clinical data of colorectal cancer patients confirmed by postoperative pathological examination were retrospectively collected from January 2016 to December 2023 at Shanghai General Hospital Affiliated to Shanghai Jiao Tong University School of Medicine (Center 1, n=220) and the First Affiliated Hospital of Bengbu Medical University (Center 2, n=51). Among them, there were 108 patients diagnosed with mucinous adenocarcinoma, including 55 males and 53 females, with an age of (68.4±12.2) years (range: 38 to 96 years); and 163 patients diagnosed with non-mucinous adenocarcinoma, including 96 males and 67 females, with an age of (67.9±11.0) years (range: 43 to 94 years). The cases from Center 1 were divided into a training set ( n=156) and an internal validation set ( n=64) using stratified random sampling in a 7∶3 ratio, and the cases from Center 2 were used as an independent external validation set ( n=51). Three-dimensional tumor volume of interest was manually segmented on venous-phase contrast-enhanced CT images. Radiomics features were extracted using PyRadiomics, and deep learning features were extracted using the ResNet-18 network. The two sets of features were then combined to form a joint feature set. The consistency of manual segmentation was assessed using the intraclass correlation coefficient. Feature dimensionality reduction was performed using the Mann-Whitney U test and the least absolute shrinkage and selection operator regression. Six machine learning algorithms were used to construct models based on radiomics features, deep learning features, and combined features, including support vector machine, logistic regression, random forest, extreme gradient boosting, k-nearest neighbors, and decision tree. The discriminative performance of each model was evaluated using receiver operating characteristic curves, the area under the curve (AUC), DeLong test, and decision curve analysis. Results:After feature selection, 22 features with the most discriminative value were finally retained, among which 12 were traditional radiomics features and 10 were deep learning features. In the internal validation set, the Random Forest algorithm based on the combined features model achieved the best performance (AUC=0.938, 95% CI: 0.875 to 0.984), which was superior to the single-modality radiomics feature model (AUC=0.817, 95% CI: 0.702 to 0.913, P=0.048) and the deep learning feature model (AUC=0.832, 95% CI: 0.727 to 0.926, P=0.087); in the independent external validation set, the Random Forest algorithm with the combined features model maintained the highest discriminative performance (AUC=0.891, 95% CI: 0.791 to 0.969), which was superior to the single-modality radiomics feature model (AUC=0.770, 95% CI: 0.636 to 0.890, P=0.045) and the deep learning feature model (AUC=0.799, 95% CI: 0.652 to 0.911, P=0.169). Conclusion:The combined model based on radiomics and deep learning features from venous-phase enhanced CT demonstrates good performance in the preoperative differentiation of colorectal mucinous from non-mucinous adenocarcinoma.

Ionic liquids are materials with a lower melting point and higher solubility that can be regulated by changing their chemical structure.These materials can play a pharmacological role through transdermal,transmucosal and oral administration,so they can be used as carriers for drug delivery and can successfully deliver drugs to the lesion site.In addition,the ionic liquid itself also has anti-bacterial and anti-inflammatory properties,and can act as a drug itself.According to the above characteristics,ionic liquid has applica-tion prospect in the field of oral disease prevention and treatment.At present,it has the function of optimizing implant,oral antibacteri-al material,dental prosthesis and root canal therapy,and has a good therapeutic effect on oral diseases such as hand-foot-mouth disease and periodontitis,and is expected to become a clinical treatment strategy for oral diseases.In this review,the properties of ionic liquids and their applications in common oral diseases are illustrated,in order to provide new ideas for oral disease prevention and treatment.