Objective: To investigate the causes and characteristics of immune hemolytic transfusion reactions (HTRs) triggered by anti-E antibodies, so as to provide a scientific reference for guaranteeing clinical blood transfusion safety. Methods: Five patients who experienced HTRs in our hospital from November 2023 to October 2024 were selected as the research subjects. ABO/RhD blood grouping, antibody screening, antibody identification, and the direct antiglobulin test (DAT) were conducted using the column agglutination method. The causes of HTRs in these patients were investigated using multiple techniques such as the two-step enzyme method, polyethylene glycol (PEG), acid elution technique, and capillary centrifugation method. Results: All five patients tested negative for antibody screening prior to transfusion. However, after transfusion of E+ phenotyped blood, patients 1, 2, 3, and 5 developed delayed haemolytic transfusion reaction (DHTR), while patient 4 experienced acute haemolytic transfusion reaction (AHTR). Anti-E antibodies were detected in all blood samples from the patients after the hemolytic transfusion reaction, including the enzyme-only anti-E antibody in two cases. Conclusion: Anti-E antibody can trigger both intravascular and extravascular hemolysis. It is recommended to conduct ABO/RhD and RhE antigen-matched transfusions and establish a regional blood transfusion database to reduce immune hemolytic transfusion reactions caused by anti-E antibody.

Objective:To construct an integrated early rehabilitation program for healthcare and rehabilitation system based on the information-motivation-behavioral skills (IMB) model and evaluate its application effect in patients treated with total hip arthroplasty (THA).Methods:Construction of the rehabilitation program: An integrated research team was established, composed of head burse of orthopedics, orthopedic nursing specialists, orthopedic surgeons, anesthesiologists, and rehabilitation therapists. Considering the key points of perioperative early rehabilitation of THA patients, an integrated early rehabilitation program was constructed based on the IMB model through literature review and expert panel method. Clinical application of the rehabilitation program: A retrospective cohort study was conducted to analyze the clinical data of 100 THA patients admitted to Qingdao Municipal Hospital from March to December 2023, including 47 males and 53 females, aged 60-85 years [(69.8±5.5)years]. Patients were divided into two groups according to their admission time: 50 patients admitted from March to July 2023, receiving routine care (routine care group) and 50 admitted from August to December 2023, receiving intervention through an early rehabilitation program of an integrated healthcare and rehabilitation system based on routine care (integrated care group). The first postoperative ambulation time and length of hospital stay were compared between the two groups. The Harris hip function score was used to assess hip function in both groups at 3 days, 1, 3, and 6 months postoperatively; the Barthel index was used to assess the daily living self-care capacity in both groups preoperatively, at 1, 3, and 6 months postoperatively. The incidence of complications within 6 months after surgery was compared between the two groups.Results:An early integrated rehabilitation program based on the IMB model comprised 25 specific measures of three domains: information support, motivational intervention, and behavioral skills. All the patients were followed up for 6 months. The first postoperative ambulation time and length of hospital stay in the integrated care group were (1.3±0.5)days and (7.4±2.3)days, shorter than (1.5±0.5)days and (8.5±2.3)days in the routine care group ( P<0.05). There were no statistically significant differences in the Harris hip function scores at 3 days postoperatively or preoperative Barthel index between the two groups ( P>0.05). At 1, 3, and 6 months postoperatively, the Harris hip function scores in the integrated care group were (80.3±6.0)points, (88.6±5.2)points, and (92.5±4.1)points, respectively, higher than (75.1±6.3)points, (84.2±5.7)points, and (88.0±5.2)points in the routine care group ( P<0.01); the Barthel index in the integrated care group were (79.2±8.7)points, (87.7±5.7)points, and (92.3±4.9)points, respectively, higher than (72.1±9.0)points, (83.5±6.6)points, and (88.6±5.0)points in the routine care group ( P<0.01). At 6 months postoperatively, the incidence of complications in the integrated care group was 4% (2/50), lower than 16% (8/50) in the routine care group ( P<0.05). Conclusion:Compared with the routine care, an integrated early rehabilitation program for medical care and health based on the information-motivation-behavioral skills model for THA patients can shorten the first postoperative ambulation time and length of hospital stay, restore hip joint function, improve daily living self-care capacity and reduce the incidence of complications.

As a critical component of oral diseases,the management of pulp and periapical diseases is undergoing a transformation to-ward personalized,precise,and minimally invasive therapies,driven by advancements in diagnostic and treatment technologies.These innovations have significantly improved the success rate of pulp preservation and tooth retention.The application of multimodal imaging,artificial intelligence,and molecular biology detection technologies has introduced new dimensions to the diagnosis and treatment of pulp diseases.The integration of dental microscopes with static/dynamic guided endodontics systems has enhanced root canal debride-ment efficiency.Breakthroughs in bioactive material development have achieved dual progress in infection control and tissue regeneration for pulp and periapical lesions.Furthermore,tissue engineering strategies combining stem cell delivery with biomimetic scaffold materials offer novel approaches for regenerating the pulp-dentin complex.This review summarizes recent technological advances to provide a scientific basis for optimizing clinical diagnosis and treatment.

Objective: To investigate the Alzheimer's disease (AD) influencing factors among the elderly, so as to provide a basis for early prevention and intervention. Methods: From March to June 2024, participants aged 60 years and above from a sub-district in Haishu District, Ningbo City, Zhejiang Province were selected using a convenience sampling method. Data on demographics, lifestyle, and health status were collected through questionnaire surveys. Depressive symptoms were evaluated using the short-form Geriatric Depression Scale. The Chinese Mini-Mental State Examination (MMSE) was used for the initial screening of AD, and individuals who screened positive were further diagnosed by psychiatrists. Factors affecting AD among the elderly were analyzed using a multivariable logistic regression model. Results: A total of 3 644 individuals were surveyed, comprising 1 526 males (41.88%) and 2 118 females (58.12%). The mean age was (71.85±7.44) years. AD was detected in 200 cases, with a detection rate of 5.49%. Multivariable logistic regression analysis showed that individuals aged ≥65 years (65-<70 years, OR=3.012, 95%CI: 1.007-9.012; 70-<75 years, OR=3.131, 95%CI: 1.059-9.260; 75-<80 years, OR=5.779, 95%CI: 1.989-16.784; ≥80 years, OR=16.810, 95%CI: 5.926-47.685), those who were unmarried, divorced, or widowed (OR=1.973, 95%CI: 1.383-2.815), those with hearing loss (OR=1.573, 95%CI: 1.128-2.193), those with diabetes mellitus (OR=1.958, 95%CI: 1.362-2.814), and those with depressive symptoms (OR=4.143, 95%CI: 2.997-5.728) had a higher risk of AD. Conversely, individuals with an educational level of primary school or above (primary school, OR=0.579, 95%CI: 0.401-0.835; junior high school or above, OR=0.438, 95%CI: 0.259-0.741), and those who engaged in regular physical exercise (OR=0.414, 95%CI: 0.264-0.649) had a lower risk of AD. Conclusions The detection rate of AD was relatively high among the elderly in Haishu District. AD among the elderly was related to age, educational level, marital status, physical exercise, hearing loss, diabetes mellitus, and depressive symptoms.

As a critical component of oral diseases,the management of pulp and periapical diseases is undergoing a transformation to-ward personalized,precise,and minimally invasive therapies,driven by advancements in diagnostic and treatment technologies.These innovations have significantly improved the success rate of pulp preservation and tooth retention.The application of multimodal imaging,artificial intelligence,and molecular biology detection technologies has introduced new dimensions to the diagnosis and treatment of pulp diseases.The integration of dental microscopes with static/dynamic guided endodontics systems has enhanced root canal debride-ment efficiency.Breakthroughs in bioactive material development have achieved dual progress in infection control and tissue regeneration for pulp and periapical lesions.Furthermore,tissue engineering strategies combining stem cell delivery with biomimetic scaffold materials offer novel approaches for regenerating the pulp-dentin complex.This review summarizes recent technological advances to provide a scientific basis for optimizing clinical diagnosis and treatment.

Objective:To construct an integrated early rehabilitation program for healthcare and rehabilitation system based on the information-motivation-behavioral skills (IMB) model and evaluate its application effect in patients treated with total hip arthroplasty (THA).Methods:Construction of the rehabilitation program: An integrated research team was established, composed of head burse of orthopedics, orthopedic nursing specialists, orthopedic surgeons, anesthesiologists, and rehabilitation therapists. Considering the key points of perioperative early rehabilitation of THA patients, an integrated early rehabilitation program was constructed based on the IMB model through literature review and expert panel method. Clinical application of the rehabilitation program: A retrospective cohort study was conducted to analyze the clinical data of 100 THA patients admitted to Qingdao Municipal Hospital from March to December 2023, including 47 males and 53 females, aged 60-85 years [(69.8±5.5)years]. Patients were divided into two groups according to their admission time: 50 patients admitted from March to July 2023, receiving routine care (routine care group) and 50 admitted from August to December 2023, receiving intervention through an early rehabilitation program of an integrated healthcare and rehabilitation system based on routine care (integrated care group). The first postoperative ambulation time and length of hospital stay were compared between the two groups. The Harris hip function score was used to assess hip function in both groups at 3 days, 1, 3, and 6 months postoperatively; the Barthel index was used to assess the daily living self-care capacity in both groups preoperatively, at 1, 3, and 6 months postoperatively. The incidence of complications within 6 months after surgery was compared between the two groups.Results:An early integrated rehabilitation program based on the IMB model comprised 25 specific measures of three domains: information support, motivational intervention, and behavioral skills. All the patients were followed up for 6 months. The first postoperative ambulation time and length of hospital stay in the integrated care group were (1.3±0.5)days and (7.4±2.3)days, shorter than (1.5±0.5)days and (8.5±2.3)days in the routine care group ( P<0.05). There were no statistically significant differences in the Harris hip function scores at 3 days postoperatively or preoperative Barthel index between the two groups ( P>0.05). At 1, 3, and 6 months postoperatively, the Harris hip function scores in the integrated care group were (80.3±6.0)points, (88.6±5.2)points, and (92.5±4.1)points, respectively, higher than (75.1±6.3)points, (84.2±5.7)points, and (88.0±5.2)points in the routine care group ( P<0.01); the Barthel index in the integrated care group were (79.2±8.7)points, (87.7±5.7)points, and (92.3±4.9)points, respectively, higher than (72.1±9.0)points, (83.5±6.6)points, and (88.6±5.0)points in the routine care group ( P<0.01). At 6 months postoperatively, the incidence of complications in the integrated care group was 4% (2/50), lower than 16% (8/50) in the routine care group ( P<0.05). Conclusion:Compared with the routine care, an integrated early rehabilitation program for medical care and health based on the information-motivation-behavioral skills model for THA patients can shorten the first postoperative ambulation time and length of hospital stay, restore hip joint function, improve daily living self-care capacity and reduce the incidence of complications.

Bariatric surgery is an important means to achieve weight loss in patients and improve obesity-related metabolic disorders. Evaluating the treatment compliance of patients after bariatric surgery can help medical and nursing staff develop personalized intervention plans. This paper summarizes the current status, assessment tools, and comparison of assessment tools of patient treatment compliance after bariatric surgery, providing a basis for medical and nursing staff to reasonably select treatment compliance assessment tools for patients after bariatric surgery.

Objective:To evaluate the safety and efficacy of bortezomib plus highdose melphalan (L-phenylalanine nitrogen mustard) (Bor-HDM) pretreatment regimen for multiple myeloma (MM) with autologous hematopoietic stem cell transplantation (ASCT).Methods:From August 2008 to December 2021, the relevant clinical data were retrospectively reviewed for 58 MM patients undergoing MM transplantation.The conditioning regimens were Bor-HDM (n=36) and HDM (n=22). Non-hematopoietic adverse reactions, hematopoietic reconstruction time, remission rate post-ASCT and minimal negative rate of residual disease (MRD) on flow cytometry within 3 months post-ASCT and survivals were analyzed.Results:In Bor-HDM and HDM groups, median time of neutrophil engraftment was 12(8-30) and 11(8-29) day and median time of platelet reconstitution 16(8-33) and 16(7-32) day respectively.There was no significant inter-group difference ( P=0.890, P=0.638). In Bor-HDM group, the most common non-hematological adverse reactions were nausea (n=21, 58.0%) and diarrhea (n=11, 30.6%). There was no transplant-related death.Complete remission (CR) rate was (25/36, 69.4%) versus (9/22, 40.9%). The inter-group difference was statistically significant ( P=0.032). Median follow-up period was 29.0(2.0-91.0) vs. 20.5(5.0-114.0) month, 3-year progression-free survival(PFS)62.1% vs. 39.7% and 3-year overall survival(OS) 83.8% vs. 62.5%.There were relapse (n=10 vs.10) and death (n=6 vs. 7). Median PFS in Bor-HDM and HDM groups was non-attained and 27 months( P=0.047) and median OS time non-attained and 40 months respectively ( P=0.282). Multivariate analysis revealed that CR was an independent risk factor for PFS ( HR=28.896, 95% CI: 6.130-136.198, P<0.001). Non-CR was an independent risk factor for OS ( HR=3.843, 95% CI: 1.334-11.071, P=0.013; HR=28.595, 95% CI: 6.273-130.355, P<0.001). Conclusions:Bor-HDM pretreatment regimen of ASCT is both safe and efficacious for MM patients.

Objective:To explore the clinical efficacy and risk factors of umbilical cord mesenchymal stem cells (UCMSCs) infusion at an early stage (i.e.gross hematuria) for hemorrhagic cystitis (HC) after allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods:The relevant clinical data were retrospectively reviewed for 300 patients undergoing allo-HSCT from January 2016 to July 2021.According to the presence or absence of HC, they were assigned into two groups of HC (n=89) and non-HC (control, n=211). According to whether or not receiving an infusion of UCMSCs, 51 patients of HC degree Ⅱ-Ⅳ were divided into two groups of UCMSC infusion and non-infusion.The risk factors of HC after allo-HSCT were analyzed by χ2 test.Logistic regression was employed for multivariate analysis of P<0.05.Mann-Whitney U test was utilized for statistically analyzing the duration of gross hematuria and urinary tract irritation symptoms and evaluating the clinical efficacy of UCMSCs infusion for HC. Results:Among them, 89 (29.67%) developed HC post-allo-HSCT.Clinical grades were Ⅰ (n=38, 42.70%), Ⅱ (n=36, 40.45%), Ⅲ (n=13, 14.61%) and Ⅳ (n=2, 2.25%). The median occurrence time was 29 (21.5-35.0) days post-allo-HSCT.In univariate analysis, age ≤30 years, haploid transplantation, antithymocyte globulin (ATG), acute graft-versus-host disease (aGVHD), CMV-DNA positive pretreatment significantly boosted the risk of HC ( P<0.05). In multivariate analysis, aGVHD was an independent risk factor for HC ( OR=10.281, 95% CI: 1.606-65.813, P=0.014). Among 89 HC patients, 38 grade Ⅰ patients were complete remission(CR). Among 51 patients of grade Ⅱ-Ⅳ HC, the outcomes were CR (n=48) and non-remission(NR)(n=3). And 24/51 of them received UCMSCs plus conventional treatment.The duration of gross hematuria was shorter in UCMSCs infusion group than that in UCMSCs non-infusion group [12(9-17) vs 17(12.0-26.5) day] and the difference was statistically significant ( P=0.045). And the duration of urinary tract irritation symptoms was shorter in UCMSCs infusion group than that in UCMSCs non-infusion group [18(11-30) vs 27(18.0-35.5) days] and the difference was statistically significant ( P=0.048). Conclusions:Indicated for post-ALLO-HSCT HC, infusion of UCMSCs may significantly shorten the course of disease.Age ≤30 years, haploid transplantation and preconditioning with positive ATG, aGVHD and CMV-DNA may boost the risks of HC post-allo-HSCT.And aGVHD is an independent risk factor for HC after allo-HSCT.

Objective: To investigate the preliminary screening results of Alzheimer's disease (AD) among the elderly in Ningbo City, Zhejiang Province and analyze the influencing factors, so as to provide insights into prevention and control of AD in the elderly. Methods: A multi-stage stratified proportional sampling method was used to select the registered residents aged 60 years and older in Ningbo City as subjects. Demographic characteristics, lifestyle factors, physical conditions and social activities of the subjects was evaluated with questionnaires. AD was screened using the Mini-Mental State Examination (MMSE), and factors affecting the positive rate of AD preliminary screening were identified using a multivariable logistic regression model. Results: A total of 34 027 elderly residents were investigated, with an mean age of (71.71±6.89) years. There were 15 115 males (44.42%) and 18 912 females (55.58%), 16 146 residents living in rural areas (47.45%) and 17 881 residents living in urban areas (52.55%). The positive rate of AD preliminary screening was 7.28% (2 476 cases). Multivariable logistic regression analysis showed that age (70 to 74 years, OR=1.357; 75 to 79 years, OR=1.807; 80 to 84 years, OR=2.782; 85 years and older, OR=4.907), gender (female, OR=1.118), residence (urban areas, OR=0.713), marital status (unmarried, OR=3.078; widowed/separated/divorced, OR=1.301), educational level (primary school, OR=0.629; junior high school and above, OR=0.609), occupation before retirement (others, OR=0.741), family genetic history (no, OR=0.651), household disposable monthly income (1 000 to 1 999 Yuan, OR=0.636; 2 000 to 2 999 Yuan, OR=0.569; 3 000 Yuan and above, OR=0.448), exercise (seldom, OR=0.855; regular, OR=0.780), number of chronic diseases (2~5, OR=1.328), hearing loss (no, OR=0.764), smell loss (no, OR=0.615), chronic constipation (no, OR=0.696), major negative life events (no, OR=0.804), subjective memory loss (no, OR=0.583), sleep quality (general, OR=0.640; good, OR=0.616), living style (living with spouse, OR=0.300; living alone, OR=0.315; living with children, OR=0.350) and social activities (2-3 times/week, OR=0.584; 4 times/week and more, OR=0.409) were factors affecting the positive rate of AD preliminary screening. Conclusions The positive rate of AD preliminary screening among the elderly in Ningbo City is relatively high. Age, gender, economic conditions, exercise, social activities and physical conditions were factors affecting the positive rate of AD preliminary screening.