Objective:To explore the relationship between corrected serum calcium level and clinical characteristics in patients with newly-diagnosed multiple myeloma (MM), as well as the influencing factors of concomitant hypercalcemia.Methods:A retrospective case cohort study was conducted. The clinical data of newly-diagnosed MM patients who were admitted to Shanxi Province Cancer Hospital from January 2020 to December 2023 were collected. When serum albumin (ALB) was less than 40 g/L, the serum calcium level was corrected. The hypercalcemia group was defined as the corrected serum calcium level >2.60 mmol/L, the normal blood calcium group was defined as 2.20-2.60 mmol/L, and the hypocalcemia group was defined as <2.20 mmol/L; the combination of normal blood calcium group and hypocalcemia group was the non-hypercalcemia group. The age, gender, immune typing, ALB, blood urea nitrogen (BUN), serum creatinine (Scr), β 2-microglobulin (β 2-MG), and alkaline phosphatase (ALP) of patients in the hypercalcemia group and the non-hypercalcemia group were compared. Pearson correlation analysis was used for the correlation analysis. The logistic regression model was used to conduct multivariate analysis on the influencing factors of hypercalcemia. Results:Before correction, there were 31 cases (26.5%), 48 cases (40.0%) and 38 cases (32.5%) of MM patients in the hypocalcemia group, normal blood calcium group and hypercalcemia group, respectively. After correction, there were 17 cases (14.5%), 58 cases (49.6%) and 42 cases (35.9%), respectively. The corrected serum calcium level for male MM patients was (2.58± 0.41) mmol/L, while for females it was (2.53±0.38) mmol/L, and there was no statistically significant difference between the two groups ( t = 0.79, P > 0.05). The corrected serum calcium levels for patients in stage Ⅰ, stage Ⅱ and stage Ⅲ of the International Staging System (ISS) were (2.31±0.15) mmol/L, (2.52±0.37) mmol/L and (2.65±0.42) mmol/L, respectively, and the difference between the three groups was statistically significant ( F = 53.62, P < 0.01). Corrected serum calcium showed a negative correlation with patients' serum ALB ( r = -0.201, P < 0.05), and positive correlations with Scr, BUN and β 2-MG levels ( r values were 0.470, 0.247 and 0.469, respectively, all P < 0.01), but it had no correlation with age or ALP ( r values were -0.013 and 0.078, respectively, both P > 0.05). There were 15 cases (17.1%), 48 cases (54.5%) and 25 cases (28.4%) of patients with normal renal function in the hypocalcemia group, normal blood calcium group and hypercalcemia group, respectively; there were 2 cases (6.9%), 10 cases (34.5%) and 17 cases (58.6%) of patients with impaired renal function in the hypocalcemia group, normal blood calcium group and hypercalcemia group, respectively; there were statistically significant differences between the hypocalcemia group and the hypercalcemia group, as well as between the normal blood calcium group and the hypercalcemia group ( χ2 = 4.57, P < 0.05; χ2 = 6.67, P < 0.05), but there was no statistically significant difference between the hypocalcemia group and the normal calcium group ( χ2 = 0.29, P>0.05). The patients with approximately normal bone status in the hypocalcemia group, normal blood calcium group and hypercalcemia group were 3 cases (13.0%), 17 cases (74.0%) and 3 cases (13.0%), respectively, and the patients with bone damage were 14 cases (14.9%), 41 cases (43.6%), and 39 cases (41.5%), respectively, and there was a statistically significant difference between the normal blood calcium group and the hypercalcemia group ( χ2 = 7.48, P < 0.01), while there was no statistically significant difference between the hypocalcemia group and the hypercalcemia group ( χ2 = 1.46, P > 0.05). The proportions of patients with Scr > 177 μmol/L and β 2-MG > 3.5 mg/L in the hypercalcemia group were higher than those in the non-hypercalcemia group, and the differences were statistically significant (both P < 0.05). The results of logistic regression multivariate analysis showed that β 2-MG >3.5 mg/L was an independent risk factor for hypercalcemia in newly-diagnosed MM patients ( OR = 1.178, 95% CI: 1.058-1.311, P = 0.003). Conclusions:Corrected serum calcium level may be an important indicator for evaluating the severity of disease, renal function and bone status in newly-diagnosed MM patients.

Objective:To retrieve and integrate the best evidence on foot offloading management for diabetic high-risk foot patients, and to provide evidence-based basis for effectively preventing the occurrence and development of diabetic foot ulcers.Methods:Clinical practice guidelines, evidence summaries, systematic reviews and expert consensus on the management of foot offloading at high risk of diabetes were searched in Chinese and English databases, domestic and foreign diabetes association websites, clinical decision websites and guideline websites, retrieval time for libraries to March 31, 2024, respectively, by the 2 researchers quality evaluation, evidence extraction, the final summary.Results:A total of 16 articles were included, including 6 guidesline, 5 expert consensuses, 1 evidence summary and 4 systematic reviews. According to the existing evidence, the best evidence of foot offloading management in patients with diabetic high-risk foot was summarized from 6 aspects: evaluation, monitoring, referral, offloading brace, exercise advice and risk factor intervention, 14 subcategories, 32 best evidences for foot offloading management in patients with high-risk diabetic foot.Conclusions:This study summarized the best evidence for foot offloading management in patients with high-risk of diabetic foot, which is convenient for the further development of clinical practice of foot offloading management in patients with high-risk of diabetes, and provides evidence-based basis for clinical medical staff to expand related research.

Objective:To establish a quality and safety evaluation index system for the daytime chemotherapy in the Day Medical Management Quality Control Center of Fujian Province, providing references for objectively evaluating the quality of day chemotherapy.Methods:From December 2023 to August 2024, this study screened the initial indexes of the quality and safety evaluation index system for daytime chemotherapy through literature search and expert discussions. An index system and its weights were determined by using two rounds of Delphi method and precedence chart method. The quality of daytime chemotherapy services in 8 hospitals was evaluated by using a thousand point scale checklist based on this index system.Results:The expert motivation of both rounds of Delphi method was 100%, and the expert authority coefficient was 0.92. The quality and safety evaluation index system for daytime chemotherapy included 3 first-level indicators, 13 second-level indicators, and 54 third-level indicators; Among them, the weights of the first-level indicator included structure quality, process quality, and result quality were 0.334, 0.556, and 0.110, respectively. The quality and safety scores of daytime chemotherapy in 8 hospitals ranged from 812 to 980 points, with an average of 933 points.Conclusions:The quality and safety evaluation index system for daytime chemotherapy could objectively and comprehensively evaluate the quality and safety of hospital daytime chemotherapy.

Objective:To evaluate the long-term protective efficacy of the recombinant Chinese hamster ovary cell-derived hepatitis B vaccine（CHO-HepB）26 years post-vaccination in the rural China.Methods:Zhengding county，Hebei province was designated as a rural monitoring site for CHO-HepB efficacy. Study participants included individuals born between 1997 and 1999 who had completed the three-dose CHO-HepB primary series without booster doses. A cross-sectional survey was conducted in late 2024 using random sampling. Demographic and vaccination history data were collected via questionnaires，and hepatitis B virus（HBV）serological markers were detected using chemiluminescence. Historical surveillance data were integrated to infer infection statuses of HBsAg-positive individuals and evaluate longitudinal trends in anti-HBs seropositivity and antibody titers.Results:Among 178 participants（mean time since vaccination：26.2 years），the seroprevalence rates were 0.6% for HBsAg（95% CI：0.0%-1.6%），64.6% for anti-HBs（95% CI：57.6%-71.6%），and 1.1% for anti-HBc（95% CI：0.0%-2.7%）. Compared to the pre-vaccination baseline HBsAg positivity of 11.3% in children under 10 years of age，the estimated vaccine protection rate was 95%. Two notable cases were identified：one with concurrent HBsAg and anti-HBc positivity and one with anti-HBs and anti-HBc positivity，suggestive of transient HBV exposure（1999—2009）without chronicity. Natural immune boosting was inferred for the latter case based on anti-HBs titer dynamics. Longitudinal analysis of four prior cross-sectional surveys（2005，2009，2013，and 2017）revealed no significant upward trends in HBsAg and anti-HBc positivity（both P>0.05）over 26 years，while anti-HBs seropositivity declined significantly（ P<0.05）from 6 to 26 years post-vaccination. Conclusion:The CHO-HepB vaccine demonstrates sustained immunological persistence and robust long-term protection up to 26 years post-immunization. Continued emphasis on rigorous implementation of mother-to-child transmission prevention strategies is critical for future hepatitis B control.

Objective:To analyze the hepatitis C virus（HCV）infection status and genotype of patients with digestive system tumors in Shanxi Cancer Hospital from 2020 to 2024 and provide a basis for formulating and adjusting prevention and control strategies，optimizing diagnosis and treatment plans.Methods:Selecting Shanxi Cancer Hospital as the research site，a continuous sampling method was used from January 2020 to December 2024 to investigate the population of patients with digestive system tumors who met the inclusion criteria during the survey period. Blood samples were collected and HCV antibodies were detected by enzyme-linked immunosorbent assay（ELISA）. HCV RNA was detected by reverse transcription nested polymerase chain reaction（RT-PCR），and genotyping was performed. The positive rate of HCV antibodies and the characteristics of HCV RNA genotypes were analyzed.Results:A total of 2 068 outpatients of Shanxi Cancer Hospital were investigated from 2020 to 2024. The total number of HCV antibody positive cases was 59，with an HCV antibody positive rate of 2.85%；Among the 59 HCV antibody positive patients，38 were HCV-RNA positive，accounting for 64.41% of HCV antibody positive patients；the basic information of HCV infected patients showed that the proportion of males was higher than females，and the age group with the highest proportion was 40 to 59 years old，followed by those aged 60 and above，and the proportion of patients in rural areas was higher than that in urban areas，and the HCV infection rate of liver cancer patients was the highest，followed by gastric cancer and colorectal cancer；the overall HCV antibody positivity rate showed a downward trend from 2020 to 2024（ χ2=4.718， P<0.05）. Among the 59 HCV antibody positive patients，38 were HCV RNA positive，accounting for 64.41% of the HCV antibody positive patients. Among the 38 HCV RNA positive patients，24 were genotype 1b（63.16%），5 were genotype 2a（13.16%），2 were genotype 3a（5.26%），4 were genotype 3b（10.53%），and 3 were genotype 6a（7.89%）. Genotypes 4，5，and mixed genotypes were not found. The distribution of genotypes 1b，2a，3a，3b，and 6a among patients of different genders showed statistically significant differences（ χ2=14.710， P<0.05）. The distribution of genotypes 1b，2a，3a，3b，and 6a among patients of different age groups also showed statistically significant differences（ χ2=15.179， P<0.05）. The distribution of genotypes 1b，2a，3a，3b，and 6a among patients from different residential areas also showed statistically significant differences（ χ2=10.126， P<0.05）. The average HCV RNA quantification of genotype 1b patients was（8.91±0.83）IU/ml，that of genotype 2a patients was（4.23±0.65）IU/ml，and that of patients with other genotypes was（5.06±0.98）IU/ml. The HCV RNA quantification of genotype 1b patients was significantly higher than that of genotype 2a patients（ t=11.813， P<0.001）. There were no statistically significant differences in HCV RNA quantification among genotype 1b，2a，and other genotypes（ F=0.815， P=0.665）. Conclusion:From 2020 to 2024，the HCV antibody positivity rate among patients with digestive system tumors at Shanxi Cancer Hospital was relatively high. Male，middle-aged and elderly，and rural populations were high-risk factors for HCV infection，and the HCV-RNA genotype was mainly genotype 1b，with differences in genotype distribution among different genders，ages，and residential areas.

Objective:To retrieve and integrate the best evidence on foot offloading management for diabetic high-risk foot patients, and to provide evidence-based basis for effectively preventing the occurrence and development of diabetic foot ulcers.Methods:Clinical practice guidelines, evidence summaries, systematic reviews and expert consensus on the management of foot offloading at high risk of diabetes were searched in Chinese and English databases, domestic and foreign diabetes association websites, clinical decision websites and guideline websites, retrieval time for libraries to March 31, 2024, respectively, by the 2 researchers quality evaluation, evidence extraction, the final summary.Results:A total of 16 articles were included, including 6 guidesline, 5 expert consensuses, 1 evidence summary and 4 systematic reviews. According to the existing evidence, the best evidence of foot offloading management in patients with diabetic high-risk foot was summarized from 6 aspects: evaluation, monitoring, referral, offloading brace, exercise advice and risk factor intervention, 14 subcategories, 32 best evidences for foot offloading management in patients with high-risk diabetic foot.Conclusions:This study summarized the best evidence for foot offloading management in patients with high-risk of diabetic foot, which is convenient for the further development of clinical practice of foot offloading management in patients with high-risk of diabetes, and provides evidence-based basis for clinical medical staff to expand related research.

Objective:To evaluate the long-term protective efficacy of the recombinant Chinese hamster ovary cell-derived hepatitis B vaccine（CHO-HepB）26 years post-vaccination in the rural China.Methods:Zhengding county，Hebei province was designated as a rural monitoring site for CHO-HepB efficacy. Study participants included individuals born between 1997 and 1999 who had completed the three-dose CHO-HepB primary series without booster doses. A cross-sectional survey was conducted in late 2024 using random sampling. Demographic and vaccination history data were collected via questionnaires，and hepatitis B virus（HBV）serological markers were detected using chemiluminescence. Historical surveillance data were integrated to infer infection statuses of HBsAg-positive individuals and evaluate longitudinal trends in anti-HBs seropositivity and antibody titers.Results:Among 178 participants（mean time since vaccination：26.2 years），the seroprevalence rates were 0.6% for HBsAg（95% CI：0.0%-1.6%），64.6% for anti-HBs（95% CI：57.6%-71.6%），and 1.1% for anti-HBc（95% CI：0.0%-2.7%）. Compared to the pre-vaccination baseline HBsAg positivity of 11.3% in children under 10 years of age，the estimated vaccine protection rate was 95%. Two notable cases were identified：one with concurrent HBsAg and anti-HBc positivity and one with anti-HBs and anti-HBc positivity，suggestive of transient HBV exposure（1999—2009）without chronicity. Natural immune boosting was inferred for the latter case based on anti-HBs titer dynamics. Longitudinal analysis of four prior cross-sectional surveys（2005，2009，2013，and 2017）revealed no significant upward trends in HBsAg and anti-HBc positivity（both P>0.05）over 26 years，while anti-HBs seropositivity declined significantly（ P<0.05）from 6 to 26 years post-vaccination. Conclusion:The CHO-HepB vaccine demonstrates sustained immunological persistence and robust long-term protection up to 26 years post-immunization. Continued emphasis on rigorous implementation of mother-to-child transmission prevention strategies is critical for future hepatitis B control.

Objective:To analyze the hepatitis C virus（HCV）infection status and genotype of patients with digestive system tumors in Shanxi Cancer Hospital from 2020 to 2024 and provide a basis for formulating and adjusting prevention and control strategies，optimizing diagnosis and treatment plans.Methods:Selecting Shanxi Cancer Hospital as the research site，a continuous sampling method was used from January 2020 to December 2024 to investigate the population of patients with digestive system tumors who met the inclusion criteria during the survey period. Blood samples were collected and HCV antibodies were detected by enzyme-linked immunosorbent assay（ELISA）. HCV RNA was detected by reverse transcription nested polymerase chain reaction（RT-PCR），and genotyping was performed. The positive rate of HCV antibodies and the characteristics of HCV RNA genotypes were analyzed.Results:A total of 2 068 outpatients of Shanxi Cancer Hospital were investigated from 2020 to 2024. The total number of HCV antibody positive cases was 59，with an HCV antibody positive rate of 2.85%；Among the 59 HCV antibody positive patients，38 were HCV-RNA positive，accounting for 64.41% of HCV antibody positive patients；the basic information of HCV infected patients showed that the proportion of males was higher than females，and the age group with the highest proportion was 40 to 59 years old，followed by those aged 60 and above，and the proportion of patients in rural areas was higher than that in urban areas，and the HCV infection rate of liver cancer patients was the highest，followed by gastric cancer and colorectal cancer；the overall HCV antibody positivity rate showed a downward trend from 2020 to 2024（ χ2=4.718， P<0.05）. Among the 59 HCV antibody positive patients，38 were HCV RNA positive，accounting for 64.41% of the HCV antibody positive patients. Among the 38 HCV RNA positive patients，24 were genotype 1b（63.16%），5 were genotype 2a（13.16%），2 were genotype 3a（5.26%），4 were genotype 3b（10.53%），and 3 were genotype 6a（7.89%）. Genotypes 4，5，and mixed genotypes were not found. The distribution of genotypes 1b，2a，3a，3b，and 6a among patients of different genders showed statistically significant differences（ χ2=14.710， P<0.05）. The distribution of genotypes 1b，2a，3a，3b，and 6a among patients of different age groups also showed statistically significant differences（ χ2=15.179， P<0.05）. The distribution of genotypes 1b，2a，3a，3b，and 6a among patients from different residential areas also showed statistically significant differences（ χ2=10.126， P<0.05）. The average HCV RNA quantification of genotype 1b patients was（8.91±0.83）IU/ml，that of genotype 2a patients was（4.23±0.65）IU/ml，and that of patients with other genotypes was（5.06±0.98）IU/ml. The HCV RNA quantification of genotype 1b patients was significantly higher than that of genotype 2a patients（ t=11.813， P<0.001）. There were no statistically significant differences in HCV RNA quantification among genotype 1b，2a，and other genotypes（ F=0.815， P=0.665）. Conclusion:From 2020 to 2024，the HCV antibody positivity rate among patients with digestive system tumors at Shanxi Cancer Hospital was relatively high. Male，middle-aged and elderly，and rural populations were high-risk factors for HCV infection，and the HCV-RNA genotype was mainly genotype 1b，with differences in genotype distribution among different genders，ages，and residential areas.

Objective:To establish a quality and safety evaluation index system for the daytime chemotherapy in the Day Medical Management Quality Control Center of Fujian Province, providing references for objectively evaluating the quality of day chemotherapy.Methods:From December 2023 to August 2024, this study screened the initial indexes of the quality and safety evaluation index system for daytime chemotherapy through literature search and expert discussions. An index system and its weights were determined by using two rounds of Delphi method and precedence chart method. The quality of daytime chemotherapy services in 8 hospitals was evaluated by using a thousand point scale checklist based on this index system.Results:The expert motivation of both rounds of Delphi method was 100%, and the expert authority coefficient was 0.92. The quality and safety evaluation index system for daytime chemotherapy included 3 first-level indicators, 13 second-level indicators, and 54 third-level indicators; Among them, the weights of the first-level indicator included structure quality, process quality, and result quality were 0.334, 0.556, and 0.110, respectively. The quality and safety scores of daytime chemotherapy in 8 hospitals ranged from 812 to 980 points, with an average of 933 points.Conclusions:The quality and safety evaluation index system for daytime chemotherapy could objectively and comprehensively evaluate the quality and safety of hospital daytime chemotherapy.

Objective : To investigate the partial mechanism and effect of transplanting with human umbilical cordderived mesenchymal stem cells (hUC⁃MSCs) to repair articular cartilage defects in a rat model. Methods : Critical⁃sized osteochondral defects were created in the trochlear grooves of rat femurs. The hUC⁃MSCs were transplanted into the defect of experimental knees. Sham group and model group knees were transplanted with saline. The effects of articular cartilage repair were evaluated at 10 weeks after surgery with International Cartilage Repair Society (ICRS) repair score , histological examination and immunohistochemical analysis. The effects of hUC⁃MSCs on the proliferation and migration of chondrocytes were detected by Transwell in vitro. Results : After transplanting with hUC⁃MSCs , the articular surfaces of the defect sites were changed smoother thanthose of the model group , and the cellular morphology and arrangement were also improved in Safranin O staining or Masson staining results. Similar to surrounding normal articular cartilage tissue after treatment for 10 weeks , and the ICRS repair score was signifision of type Ⅱ (Col Ⅱ ) collagen and decrease the level of type Ⅰ collagen( Col Ⅰ ) in the articular defect site. Meanwhile , the increased protein expression of SOX9 and protein transportation to the nucleus were observed after treatment with hUC⁃MSCs for 10 weeks. In vitro , chondrocytes could be proliferated and migrated after co⁃cultured with hUC⁃MSCs. Conclusion Transplanting with hUC⁃MSCs can promote cartilage repair, and its role maybe related to the protection of the cartilage matrix and the promotion of chondrocyte proliferation and migration.