Objective: To systematically analyze the confirmatory positivity of different combinations of HBsAg screening results in blood testing, providing data to support the optimization of blood donor eligibility management. Methods: A retrospective analysis was conducted on blood screening data from 174 266 voluntary blood donor samples at the Chongqing Blood Center between October 2021 and September 2022. Samples with inconsistent results between the two HBsAg enzymelinked immunosorbent assays (ELISA) and individual donor nucleic acid testing (NAT) were confirmed using an electrochemiluminescence immunoassay (ECLIA) and a neutralization test. The detection efficacy of four different HBsAg ELISA reagents was compared using the HBsAg-confirmed positive samples. Results: A total of 767(0.44%) HBV-reactive (HB-sAg and/or HBV DNA reactive) samples were detected. Among them, 344 samples with discordant serological and NAT results were collected, of which 64(18.6%) were confirmed positive by neutralization test. Additionally, 5 samples that were neutralization-negative but double-reactive for HBsAg and HBV DNA were confirmed as positive according to FDA guidance, resulting in a total of 69(20.1%) confirmed HBsAg-positive samples. There were significant differences in the neutralization test confirmation rates among different screening result categories (P<0.05): The group with dual HBsAg reagent reactivity (double reactive) & NAT-negative had the highest confirmation rate (96.9%, 31/32); the group reactive to only reagent 2 (single reactive) had a rate of 25.7% (29/113); while the confirmation rates for samples reactive to only reagent 1 and samples with isolated HBV DNA positivity were extremely low [0(0/34) and 2.4%(4/165), respectively]. The four commercial reagents showed significant differences in their ability to detect confirmed positive samples that were initially single reactive (P<0.05). Conclusion: Given the performance variations among HBsAg screening reagents, thorough performance verification is essential before implementation. When NAT is negative, dual HBsAg reactivity in screening can serve as a basis for confirming infection and directly deferring blood donors. However, confirming infection in donors with single HBsAg reactivity is more challenging, necessitating supplementary tests to rule out infection risk.

Objective To summarize the clinical characteristics and analyze prognostic factors of neuroblastoma (NB) in infants (≤12 months) at a single center. Methods A retrospective analysis was conducted on the clinical data of infant patients (≤12 months) diagnosed with NB and treated between January 2014 and December 2022. Clinical features were analyzed, and comparisons between two sample rates were performed using the χ² test. Univariate prognostic analysis was conducted using the log-rank test, and survival outcomes were analyzed using the Kaplan-Meier method. Results A total of 42 infants (≤12 months) with NB were enrolled. Low-risk patients underwent surgical resection alone; intermediate-risk patients received surgery combined with chemotherapy with or without maintenance therapy; high-risk patients were treated with surgery and chemotherapy with or without maintenance therapy or radiotherapy. The 5-year event-free survival (EFS) rate was (92.7±4.9)%, and the 5-year overall survival rate was (95.2±3.6)%. Only two patients died because of tumor recurrence or progression. Univariate analysis identified MYCN amplification and the initial lactate dehydrogenase (LDH) level ≥ five times the upper limit of the normal were significantly associated with poor prognosis (5-year EFS: 33.3% vs. 97.4% and 60.0% vs. 97.3%, P<0.0001 and P=0.0035). Conclusion Infant NB has a favorable overall prognosis. MYCN amplification and markedly elevated initial LDH are associated with poor outcomes.

Euodiae Fructus， a commonly used Chinese medicinal herb， has been widely used to treat gastrointestinal disorders， headaches， and vomiting， possessing significant medicinal value. According to traditional Chinese medical theory， Euodiae Fructus has the following effects： warming the middle to disperse cold， suppressing adverse Qi to relieve vomiting， and soothing the liver to alleviate pain. It is commonly used to treat diseases associated with cold stagnation in the liver and stomach， as well as gastrointestinal dysfunction. In recent years， as modern research on traditional Chinese medicine has advanced， increasing attention has been paid to the chemical constituents and pharmacological effects of Euodiae Fructus. Studies have isolated and identified various chemical constituents in this herb， including alkaloids， terpenoids， phenols， steroids， and volatile oils. Among them， alkaloids and terpenoids have been most extensively investigated. Studies suggest that Euodiae Fructus and some of its active constituents exhibit anti-inflammatory， anti-tumor， cardiovascular and cerebrovascular protective， and metabolic syndrome-regulating effects. However， current studies mainly focus on a few representative constituents. A systematic understanding of the overall bioactive material basis and mechanisms of action of this herb still requires further investigation. Additionally， more in vivo pharmacodynamic studies， clinical evaluations， and toxicological assessments are needed. This article summarizes recent advances in the pharmacological effects of Euodiae Fructus based on a systematic review of its major chemical constituents， aiming to provide a reference for further research and the rational development and utilization of this medicinal herb.

This article presents a case study of a patient who visited the Geriatric Department of Peking Union Medical College Hospital due to "palpitations, shortness of breath for more than 2 years, limb weakness for 6 months, edema, and nocturnal dyspnea for 2 months". The patient exhibited decreased muscle strength in the limbs and involvement of swallowing and respiratory muscles, alongside complications of heart failure and various arrhythmias which were predominantly atrial. Laboratory tests revealed the presence of multiple autoantibodies and notably anti-mitochondrial antibodies. Following a comprehensive multidisciplinary evaluation, the patient was diagnosed with anti-mitochondrial antibody-associated inflammatory myopathy. Treatment involved a combination of glucocorticoids and immunosuppressants, along with resistance exercises for muscle strength and rehabilitation training for lung function, resulting in significant improvement of clinical symptoms. The case underscores the importance of collaborative multidisciplinary approaches in diagnosing and treating rare diseases in elderly patients, where careful consideration of clinical manifestations and subtle abnormal clinical data can lead to effective interventions.

Objective To investigate the factors influencing poor prognosis in patients with persistent atrial fibrillation combined with heart failure undergoing catheter ablation.Methods The clinical data of 166 patients with persistent atrial fibrillation who underwent elective radiofrequency ablation in the Department of Cardiology of our hospital from January 2023 to June 2024 were retrospectively analyzed.Patients who under-went radiofrequency ablation and developed persistent atrial fibrillation were placed in the poor prognosis group(n=89),and those who did not develop heart failure were placed in the control group(n=77).Logistic regression analysis was used to identify factors influencing poor prognosis in patients with persistent atrial fi-brillation after catheter ablation;latent class analysis(LCA)was used to compare differences in the distribu-tion characteristics of influencing factors between the high-risk group for poor prognosis[B-type natriuretic peptide(BNP)>200 pg/mL]and the low-risk group(BNP≤200 pg/mL).Results There were statistically significant differences between the two groups of patients in terms of age,use of ACEI/ARB medications,dis-ease course,postoperative NYHA cardiac function classification,use of ivabradine,preoperative TG,preopera-tive TC,preoperative HDL-C,preoperative serum cholinesterase,preoperative galectin-3,preoperative LVEF,preoperative NT-proBNP,preoperative cTnI,and preoperative BNP(P<0.05).A disease course≥3.2 years,postoperative NYHA cardiac function classification score≥2 points,preoperative HDL-C<1.05 mmol/L,preoperative NT-proBNP≥12.5 μg/L,and preoperative BNP≥200.00 pg/mL were independent factors in-fluencing adverse outcomes in patients with persistent atrial fibrillation(P<0.05).LCA results showed that the"high-risk type distribution"accounted for a higher proportion in the high-risk group,while the"low-risk type distribution"accounted for a higher proportion in the low-risk group.The incidence of clinical endpoint e-vents in the poor prognosis group was 38.20%,higher than 9.09%in the control group(P<0.05).Conclu-sion Heart failure has an adverse effect on the prognosis of patients with persistent atrial fibrillation after catheter ablation,and there are differences in the incidence of adverse outcomes as well as the distribution characteristics of influencing factors between high-and low-risk groups.

Objective To explore the clinical characteristics and risk factors of upper urinary tract stones complicated with non-alcoholic fatty liver disease(NAFLD),so as to provide reference for the prevention of this disease.Methods The clinical data of 158 NAFLD patients undergoing surgical treatment in our hospital during Jan.2022 and Jul.2023 were retrospectively analyzed.According to whether the patients were complicated with NAFLD,they were divided into the NAFLD group(n=56)and non-NAFLD group(n=102).The general data,laboratory indexes and 24-h urinary metabolic indexes were compared between the two groups,and the risk factors were analyzed with univariate and multivariate logistic regression analyses.Results Compared with the non NAFLD group,the NAFLD group had higher BMI[(28.17±4.17)vs.(24.11±3.72),P＜0.001],blood uric acid[(354.13±111.01)μmol/L vs.(294.41±93.72)μmol/L,P＜0.001],and 24-h urinary oxalate level[(37.74±15.00)mmol vs.(27.73±15.27)mmol,P＜0.001].Multivariate logistic analysis showed that BMI(OR=1.311,P＜0.001),24-h urinary oxalate(OR=1.046,P=0.004),and 24-h urinary magnesium(OR=0.599,P=0.002)were the independent factors for NAFLD with upper urinary tract stones.Conclusion NAFLD complicated with upper urinary tract stones is significantly associated with high BMI,high 24-h urinary oxalate,and low 24-h urinary magnesium.

Objective To explore the expression of long non-coding RNA hypoxia-inducible factor 1 alpha antisense RNA-1(lncRNA HIF1A-AS1)levels in placenta and cord blood of pregnant women with preeclampsia(PE)and its clinical significance.Methods Fifty pregnant women with PE who underwent cesarean section in Renji Hospital,Shanghai Jiaotong University School of Medicine from January 2020 to January 2022 were selected as the research subjects,including 24 pregnant women with mild PE and 26 pregnant women with severe PE.During the same period,25 healthy pregnant women who underwent cesarean section at the hospital were selected as the control group.The general data on the admission of all patients were collected.The real-time fluorescence quantitative qRT-PCR method was used to detect the expression level of lncRNA HIF1A-AS1 in pregnant women's placenta tissue and cord blood.The relationship between lncRNA HIF1A-AS1 level and pregnancy outcome was analyzed.The Pearson method was used to analyze the correlation between the relative expression level of lncRNA HIF1A-AS1 mRNA in placenta tissue and the level of lncRNA HIF1A-AS1 in cord blood.The receiver operating characteristic(ROC)curve was used to analyze the diagnostic value of lncRNA HIF1A-AS1 in placenta and cord blood for severe PE.Logistic regression was used to analyze the influencing factors of severe PE.Results Compared with the control group,the level of lncRNA HIF1A-AS1(2.76±0.36,1.83±0.29 vs 1.03±0.21)was elevated in the placental tissues of pregnant women with PE in the severe and mild groups(q=29.687,13.456),and the expression level of lncRNA HIF1A-AS1 in the severe group was higher than that in the mild group(q=15.792),and the differences were statistically significant(all P＜0.05).Compared with the control group,the level of lncRNA HIF1A-AS1(4.68±0.58,2.66±0.49 vs 1.06±0.34)was elevated in the cord blood of pregnant women with PE in the severe and mild groups(q=37.942,14.437),and the expression level of lncRNA HIF1A-AS1 in the severe group was higher than that in the mild group(q=20.951),and the differences were statistically significant(all P<0.05).The incidence of adverse pregnancy outcomes in placenta and cord blood lncRNA HIF1A-AS1 high expression group was significantly higher than that in lncRNA HIF1A-AS1 low expression group(χ2=7.714,5.773,all P<0.05).Pearson correlation analysis showed that the expression level of lncRNA HIF1A-AS1 mRNA in placenta tissue was positively correlated with the level of lncRNA HIF1A-AS1 in cord blood(r=0.546,P<0.05).ROC curve analysis showed that the area under the curve of lncRNA HIF1A-AS1 in the placenta for the diagnosis of severe PE was 0.788,with a sensitivity and a specificity of 80.80%and 80.00%,respectively.The AUC of lncRNA HIF1A-AS1 in the cord blood for the diagnosis of severe PE was 0.829,with a sensitivity and a specificity of 80.80%and 88.00%,respectively.Logistic regression analysis showed that 24-hour proteinuria,and placental and cord blood lncRNA HIF1A-AS1 levels were independent risk factors for severe PE(all P<0.05).Conclusion LncRNA HIF1A-AS1 in the placenta and cord blood of PE pregnant women is significantly up-regulated,and it increases with the aggravation of the disease.Placenta and cord blood lncRNA HIF1A-AS1 have a certain diagnostic value for the occurrence of severe PE.Detection of lncRNA HIF1A-AS1 has important significance for the early and accurate diagnosis of PE and the prediction of the disease.

Objective:To explore the applied effectiveness of the Skin and/or tissue,Education,Cooperation,Understanding,Report and Evaluate (SECURE) nursing pathway based on action research method in the prevention process of medical device-related pressure injuries (MDRPI) of patients in the Intensive Care Unit (ICU). Methods:The SECURE nursing pathway based on action research method included the establishment of a skin care team to identify problems,and the formulation of conducting intervention plan,and the development of targeting nursing interventions to prevent the occurrence of MDRPI. A total of 84 patients hospitalized in the ICU of Hebei General Hospital from March 2022 to March 2023 were selected,and they were randomly divided into a control group and an observation group,with 42 patients in each group. The control group implemented routine method to prevent MDRPI during ICU treatment,while the observation group implemented SECURE nursing pathway based on action research method to conduct prevention. The MDRPI incidence,the quality scores of ICU nursing,the scores of the Short Form Health Survey-36 (SF-36) of patients,the assessment of the improvement of MDRPI patients,and the satisfaction of patients for nursing care were compared between the two groups. Results:The MDRPI incidence during ICU treatment in the observation group was 4.76％ (2/42),which was significantly lower than that in the control group,with a statistically significant difference (x2=11.052,P<0.05). The average scores for device usage,prevention assessment,positioning management and preventive nursing after nursing intervention in the observation group were respectively (88.45±2.05),(89.36±2.11),(89.25±2.15) and (91.45±2.25),all of which were significantly higher than those in the control group,with statistically significant differences (t=11.425,12.052,10.052,13.478,P<0.05). After nursing intervention,the average scores for physical function,social function,psychological function and material life as the SF-36 scale in the observation group were (85.47±2.05),(86.48±2.05),(88.46±2.15) and (90.25±2.44),respectively,which were respectively higher than those in the control group,with statistically significant differences (t=12.414,11.045,10.252,10.478,P<0.05). The occurrence time,improvement time of wound and ICU treatment time of presenting MDRPI patients in the observation group were respectively (4.05±0.54) days,(3.45±0.15) days,and (8.12±2.14) days. Compared to the control group,the occurrence time of the observation group was longer,while both the improvement time of wound and ICU treatment time of the observation group were shorter,with statistically significant differences (t=8.485,10.012,13.001,P<0.05). The satisfaction degree of nursing care of patients in the observation group was 95.24％ (40/42),which was significantly higher than that in the control group (x2=12.054,P<0.05). Conclusion:The SECURE nursing pathway based on action research method,which prevents MDRPI of ICU patients,can reduce the MDRPI incidence rate of ICU patients,and enhance the work quality of nursing care for MDRPI. It is helpful to the recovery of ICU patients,which can also shorten the treatment time of ICU patients.

Purpose To explore the predictive value of intravoxel incoherent motion quantitative parameters and pathological grading for the survival prognosis of patients with hepatocellular carcinoma(HCC)after surgery.Materials and Methods A retrospective analysis was performed on 65 patients with HCC who had complete imaging data and underwent radical surgery at the Fourth Hospital of Hebei Medical University from October 2018 to November 2019.All patients were followed up for a 5-year survival period.The receiver operating characteristic curve was used to determine the optimal cut-off values for intravoxel incoherent motion quantitative parameters,including standard apparent diffusion coefficient(sADC),diffusion coefficient(D),pseudo-diffusion coefficient(D*)and perfusion fraction(F).Univariate and multivariate Cox regression analyses were performed to select independent predictive factors affecting the overall survival time of HCC patients after surgery.Results Univariate Cox regression analysis showed that pathological grading(HR=1.588,95%CI 0.936-2.692,P=0.086),microscopic vascular invasion(HR=2.512,95%CI 1.308-4.823,P=0.006),neutrophil-to-lymphocyte ratio(HR=1.752,95%CI 1.000-3.068,P=0.050),sADC(HR=0.433,95%CI 0.235-0.796,P=0.007),D(HR=0.262,95%CI 0.121-0.565,P<0.001)and F(HR=2.268,95%CI 1.259-4.087,P=0.006)were all prognostic factors.Multivariate Cox regression analysis showed that pathological grade(grade Ⅲ and Ⅳ)was the independent risk factor for the survival prognosis of patients after HCC surgery(HR=1.748,95%CI 1.003-3.045,P=0.049);the D value>0.916×10-3 mm2/s was the independent protective factor for their survival prognosis(HR=0.249,95%CI 0.113-0.550,P<0.001).Conclusion The pathological grade(Ⅲ/Ⅳ)as an independent risk factor and higher D values as a protective factor are the independent predictors of survival and prognosis of patients with HCC after surgery,and the combination of the two can provide a reference for clinical prognosis assessment.

Objective:To investigate the clinical efficacy of artificial humeral head replacement versus locking plate internal fixation in the treatment of comminuted proximal humeral fractures in older adult patients. Methods:A total of 30 older adult patients with proximal humeral comminuted fractures, admitted to Beifang Hospital, Huainan Xinhua Medical Group from January 2022 to December 2024, were included in this study. A prospective randomized controlled study design was used. The patients were divided into an observation group and a control group using a random number table method, with 15 patients in each group. The observation group underwent artificial humeral head replacement surgery, while the control group received internal fixation with a proximal humeral locking plate. Clinical treatment outcomes, shoulder joint function recovery, and complications were observed and compared between the two groups.Results:The intraoperative blood loss in the observation group was less than that in the control group [(182.24 ± 24.36) mL vs. (245.17 ± 46.08) mL]. The surgery duration [(71.84 ± 7.52) minutes vs. (93.67 ± 12.50) minutes] and hospital stay [(11.37 ± 1.89) days vs. (13.52 ± 2.67) days] were also significantly shorter in the observation group compared with the control group ( t = 4.68, 5.80, 2.55, all P < 0.05). The range of motion in the shoulder joint was greater in the observation group compared with the control group [forward elevation: (94.47 ± 7.66) ° vs. (86.14 ± 5.15) °, external rotation: (61.35 ± 6.57) ° vs. (52.40 ± 4.82) °, and internal rotation: (74.35 ± 4.80) ° vs. (62.76 ± 3.59) °]. The total Constant-Murley score was higher in the observation group [(92.91 ± 10.58) vs. (76.29 ± 7.48)], and the rate of excellent recovery of shoulder function was also higher in the observation group [73.33% (11/15) vs. 53.33% (8/15)] compared with the control group. The incidence of complications was lower in the observation group [6.66% (1/15) vs. 33.33% (5/15)] compared with the control group. All differences were statistically significant ( t = 3.50, 4.25, 7.49, 4.97, χ2 = 4.12, 5.12, all P < 0.05). Conclusions:For older adult patients with severe osteoporosis or irreparable proximal humeral comminuted fractures, artificial humeral head replacement yields more favorable outcomes compared with locking plate internal fixation, resulting in a better recovery of shoulder joint function.