Objective: To provide evidence for improving emergency blood supply protocols by analyzing the clinical characteristics and disease distribution of emergency transfusion patients, especially those receiving≥10 units of red blood cells (RBCs). Methods: The data of 4 157 patients who urgently applied for large-volume blood transfusion in various hospitals in Shanghai from May 2024 to April 2025 were selected and analyzed statistically. Results: Tertiary gradeA hospitals accounted for the largest proportion of total transfusion volume (U) (48.79%, 8 420/17 256.5), with no statistically significant differences in RBC transfusion volumes among hospitals of different grades (P>0.05). All blood products are most widely used in tertiary hospitals. Obstetric blood transfusion (U)(19.07%, 3 277.5/17 190.5) was the most frequent. A-mong the hospitals of patients who received emergency blood transfusion with red blood cell suspension≥10 U, tertiary gradeA hospitals also had the largest transfusion volume (U)(47.19%, 1 107/2 346). In terms of disease types, the top three diseases in terms of blood transfusion volume (U) were obstetric transfusion (24.59%, 572/2 326), digestive diseases (14.53%, 338/2 326) and tumors (14.19%, 330/2 326). Conclusion: Tertiary grade A hospitals are the main demand units for emergency blood transfusion, with pregnant women and cancer patients being the core blood-using groups. It is suggested that the safety, timeliness and sufficiency of emergency blood transfusion be guaranteed by establishing a hierarchical blood supply mechanism, formulating single-disease blood transfusion plans and promoting precise blood transfusion guided by thromboelastography.

Objective To investigate the levels of gross α and gross β activities in different water types within a 40-kilometer radius around the Zhangzhou Nuclear Power Plant prior to its operation. Methods In 2018, drinking water samples were collected from the area surrounding the nuclear power plant during both the wet and dry seasons, including source water, treated water, tap water, and well water. The gross α and gross β activity concentrations were measured using a low-background α/β counter, followed by statistical analysis. Results A total of 80 water samples from different sources around the Zhangzhou Nuclear Power Plant were collected. The average gross α and gross β activity concentrations during the wet season were (0.110 ± 0.036) Bq/L and (0.643 ± 0.028) Bq/L, respectively, while those during the dry season were (0.124 ± 0.032) Bq/L and (0.624 ± 0.026) Bq/L, respectively. There were no significant differences in the gross α and gross β activity concentrations between the wet and dry seasons for the overall sample set (P > 0.05). However, there were statistically significant differences in the gross α and gross β activity concentrations between the wet and dry seasons for source water and well water (Z_wet = −2.005, −2.123; Z_dry = −1.943, −3.090; P < 0.05). Conclusion The radioactivity levels in different water types within various ranges around the Zhangzhou Nuclear Power Plant before its operation were determined. The measured activity concentrations were at the same level as those from previous investigations in other regions of Fujian Province.

OBJECTIVE To study the effect and safety evaluation of percutaneous tracheotomy and traditional open tracheotomy in patients with severe pulmonary infection in ICU environment.METHODS A retrospective analysis was conducted on 80 patients with severe pulmonary infections admitted to the ICU of Shangqiu First People's Hospital from July 2019 to June 2022 as the subjects of the study.According to the tracheotomy approach,they were divided into the Percutaneous tracheotomy group(n=40)and the Conventional tracheotomy group(n=40).The Conventional tracheotomy group underwent traditional routine tracheotomy,while the Percutaneous tracheotomy group underwent percutaneous tracheotomy;all tracheotomies were performed by the same physician.The two groups were compared based on different tracheotomy techniques,and the surgical incision time,intraoperative blood loss,complete healing indicators were analyzed to evaluate the surgical outcomes and complication rates in each group.RESULTS Compared with the Conventional tracheotomy group,the Percutaneous tracheotomy group significantly reduced surgical time,intraoperative blood loss,and wound healing time after extubating(P<0.05),and the incidence of complications such as difficult cannulation,pneumothorax and subcutaneous emphysema decreased significantly,and the difference was statistically significant(P<0.05).In the BMI subgroup analysis of complications,it was found that in the BMI≥28.0 kg/m2 subgroup,the incidence of casing difficulty and pneumothorax complications in the Percutaneous tracheotomy group was lower than that in the Conventional tracheotomy group,and the difference was statistically significant(P<0.05).In the 22.0 kg/m2≤BMI<28.0 kg/m2 subgroup and BMI<22.0 kg/m2 subgroup,there was no significant difference in the difficulty of cannulation and pneumothorax complications between the two groups(P>0.05).CONCLUSION In ICU patients with severe pneumonia,early percutaneous tracheotomy can significantly reduce intraoperative bleeding blood volume,shorten the time of tracheotomy,especially in patients with BMI≥28.0 kg/m2,which has a lower incidence of complications.Percutaneous tracheotomy is worth promoting in ICU patients with severe lung infection who need tracheotomy.

Objective To investigate the relationships of the expression of serum long non-cod-ing RNA FGD5-AS1(lncRNA FGD5-AS1)and microRNA-133b(miR-133b)with clinicopathologi-cal features and prognosis in patients with colorectal cancer.Methods A total of 85 patients with colorectal cancer were selected and assigned to colorectal cancer group,and postoperative cancer tis-sues and adjacent tissues were obtained.Another 85 healthy individuals who underwent physical ex-aminations were selected as healthy group.The expression levels of lncRNA FGD5-AS1 and miR-133b in the serum of the two groups were compared,and the expression levels of lncRNA FGD5-AS1 and miR-133b in cancer tissues and adjacent tissues of patients were also compared.The correlation be-tween the expression levels of lncRNA FGD5-AS1 and miR-133b,as well as their relationships with the prognosis of colorectal cancer patients were analyzed.The influencing factors for the 3-year prog-nosis of patients were screened,and the predictive efficacy of lncRNA FGD5-AS1 and miR-133b for the prognosis of patients with colorectal cancer was evaluated.Results The expression level of ser-um lncRNA FGD5-AS1 in the colorectalcancer group was higher than that in the healthy group,while the expression level of miR-133b was lower than that in the healthy group(P＜0.05).In colorectal cancer tissues,the expression level of lncRNA FGD5-AS1 was higher than that in adjacent tissues,and the expression level of miR-133b was lower than that in adjacent tissues(P＜0.05).A negative correlation was observed between the expression of lncRNA FGD5-AS1 and miR-133b in the serum of patients with colorectal cancer(r=-0.402,P＜0.001).The expression levels of se-rum lncRNA FGD5-AS1 and miR-133b in patients were both associated with TNM stage,lymph node metastasis,and depth of tumor invasion(P＜0.05).The 3-year cumulative survival rate of patients with high expression of lncRNA FGD5-AS1 and low expression of miR-133b was lower than that of patients with low expression of lncRNA FGD5-AS1 and high expression of miR-133b,with a statistically significant difference(P＜0.05).LncRNA FGD5-AS1,miR-133b,TNM stage,and lymph node metastasis were all independent influencing factors for the 3-year prognosis of patients with colorectal cancer(P＜0.05).Receiver operating characteristic curve analysis showed that the area under the curve(AUC)for the combined prediction of the prognosis of patients with colorectal cancer by serum lncRNA FGD5-AS1 and miR-133b was 0.925,which was greater than the AUC for their individual predictions(P＜0.05).Conclusion High expression of serum lncRNA FGD5-AS1 and low expression of miR-133b are observed in patients with colorectal cancer.The expression lev-els of these two molecules are associated with clinicopathological features and poor prognosis,indica-ting their potential predictive value for the prognosis of patients.

Objective To investigate the radioactivity levels of gross α and gross β in foods around Zhangzhou nuclear power plant, China before operation. Methods Forty-nine samples from 33 kinds of foods in 5 categories of daily food around Zhangzhou nuclear power plant were collected, pretreated, dried, and ashed. The radioactivity levels of gross α and gross β were measured by the low-background α and β measuring instrument. The atomic absorption technique was employed to measure the level of potassium (K), and the radioactivity level of gross β (subtracting ⁴⁰K) was calculated with K concentrations in different foods consulted from the nutritional dietary system. Results The radioactivity levels of gross α in vegetables and fruits, grain, poultry and livestock, aquatic products, and tea around Zhangzhou nuclear power plant were < minimum detectable level (MDL)-7.97, < MDL-6.82, < MDL, < MDL-20.76, and 11.90-23.08 Bq/kg, respectively; the radioactivity levels of gross β were 34.56-122.81, 13.05-188.96, 56.00-108.34, 17.86-169.01, and 123.74-171.63 Bq/kg, respectively; the radioactivity levels of gross β (subtracting ⁴⁰K) were not detected (ND)-14.27, ND-27.86, ND-48.72, ND-45.85, and 6.69-13.79 Bq/kg, respectively. Conclusion The radioactivity of gross α and gross β in foods around Zhangzhou nuclear power plant before operation is basically at the same level as that in other areas of China.

Objective:To monitor the changes in donor gene chimerism ratio after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with severe beta-thalassemia using third-generation sequencing, and to explore the value of this technology in monitoring the proportion of donor genes chimerism in the early stage of postoperative allo-HSCT.Methods:Case analysis. Three beta-thalassemia patients at the First Affiliated Hospital of Guangxi Medical University during June-July 2022 who had undergone allo-HSCT with genotypes IVS-Ⅱ-654/CD41-42, IVS-Ⅱ-654/IVS-Ⅱ-654 and CD41-42/CD41-42 were included in this study. "Visual" analysis of the readouts of recipient DNA using third generation sequencing was used to monitor the genetic chimerism of the donor DNA and to compare with Sanger sequencing results. Post-transplantation follow-up was performed in the three patients to monitor the blood statistics and assess their implantation status and hematopoietic reconstitution.Results:The results of donor DNA chimerism status after allo-HSCT in the three patients detected by third generation sequencing were consistent with the Sanger sequencing results. The chimeric state of donor DNA gradually shifted to complete donor gene chimerism as the number of days after transplantation increased. Recipient 1 had 95.5% and 100% donor DNA chimerism at 10 and 20 d post-transplantation, respectively; recipient 2 had 100% donor DNA chimerism at 30 and 40 d post-transplantation; recipient 3 had 69.5% donor DNA chimerism at 1 d post-transplantation, and 100% donor DNA chimerism at 10 and 20 d post-transplantation. All patients achieved full donor gene chimerism within 30 d post-transplantation. Stable implantation of granulopoiesis, platelets, and erythropoiesis with hematopoietic reconstitution were obtained in all 3 patients within 1 month after transplantation.Conclusions:In this study, we developed a new method to detect the chimerism ratio of donor DNA using third-generation sequencing technology, enabling us to monitor the gene chimerism status of donor DNA at an early stage.

Background/Aims: The shortage of donor liver hinders the development of liver transplantation. This study aimed to clarify the poor outcomes of functionally marginal liver grafts (FMLs) and provide evidence for the improvement of ischemia-free liver transplantation (IFLT) after FML transplantation. Methods: Propensity score matching was used to control for confounding factors. The outcomes of the control group and FML group were compared to demonstrate the negative impact of FMLs on liver transplantation patients. We compared the clinical improvements of the different surgical types. To elucidate the underlying mechanism, we conducted bioinformatic analysis based on transcriptome and single-cell profiles. Results: FMLs had a significantly greater hazard ratio (HR: 1.969, P=0.018) than did other marginal livers. A worse 90-day survival (Mortality: 12.3% vs. 5.0%, P=0.007) was observed in patients who underwent FML transplantation. Patients who received FMLs had a significant improvement in overall survival after IFLT (Mortality: 10.4% vs 31.3%, P=0.006). Pyroptosis and inflammation were inhibited in patients who underwent IFLT. The infiltration of natural killer cells was lower in liver grafts from these patients. Bulk transcriptome profiles revealed a positive relationship between IL-32 and Caspase 1 (R=0.73, P=0.01) and between IL-32 and Gasdermin D (R=0.84, P=0.0012). Conclusions FML is a more important negative prognostic parameter than other marginal liver parameters. IFLT might ameliorate liver injury in FMLs by inhibiting the infiltration of NK cells, consequently leading to the abortion of IL-32, which drives pyroptosis in monocytes and macrophages.

Objective: To observe the effect of moxibustion on the colonic mucosal barrier of rats with ulcerative colitis (UC) induced by dextran sulfate sodium (DSS). Methods: Forty male Sprague-Dawley rats were randomly divided into a normal group and a modeling group, with 20 rats in each group. Rats in the modeling group were subjected to preparing experimental UC models by drinking 4％ DSS for seven consecutive days. Two modeled rats and two normal rats were randomly selected for model identification. After the success of UC model was confirmed, the remaining 18 modeled rats were randomly divided into three groups, a model group, a model + herbal cake-partitioned moxibustion group, and a model + mild moxibustion group, with six rats in each group; the remaining normal rats were randomly divided into three groups, a normal group, a normal + herbal cake-partitioned moxibustion group, and a normal + mild moxibustion group, with six rats in each group. After 7 d of intervention with the herbal cake-partitioned moxibustion or the mild moxibustion, hematoxylin-eosin (HE) staining technique was used to observe the pathological changes of colon tissue under a light microscope; Western blotting and/or immunohistochemical techniques were used to detect the protein expression levels of Occludin, Claudin, junction adhesion molecular 1 (JAM1), mucin 2 (MUC2), and transforming growth factor beta1 (TGF-β1) in rat colon tissue. Results: Compared with the normal group, the colon tissue was severely damaged, the pathological score was significantly increased, and the protein expression levels of Occludin, Claudin, JAM1, MUC2, and TGF-β1 were significantly decreased in the model group (P<0.01); while there were no significant differences in the colonic histopathological score, protein expression levels of Occludin, Claudin, JAM1, MUC2, and TGF-β1 in the normal + herbal cake-partitioned moxibustion group and the normal + mild moxibustion group (P>0.05). Compared with the model group, the model + herbal cake-partitioned moxibustion group and the model + mild moxibustion group showed repaired colon tissue, ulcer healing, significantly reduced pathological score, and significantly increased protein expression levels of JAM1, MUC2, and TGF-β1 (P<0.05); the Occludin protein expression level in the colon tissue of the model + mild moxibustion group was increased (P<0.01). Conclusion: Neither herbal cake-partitioned moxibustion nor mild moxibustion influences the colonic histopathology and intestinal mucosal barrier-related protein expression in the normal rats; both herbal cake-partitioned moxibustion and mild moxibustion can up-regulate the protein expression levels of JAM1, MUC2, and TGF-β1 in the colon tissue of UC rats. Mild moxibustion can up-regulate Occludin protein expression. This may be a mechanism of moxibustion in reducing colonic mucosa inflammation in UC.

Immunization of children with special health care needs has always been one of the difficulties in community-level public health. In recent years the relevant consensus opinions on vaccination have been issued in China, but for a long time there is a lack of effective communication channels between disease prevention and clinical medical systems in China. Pediatricians play an unoccupied role in immunization, and community-level vaccinators face the difficulties including dilemma of disease identification, evidence-based evaluation and upward referral. These lead to the vaccination hesitancy, thus the multi-disciplinary management and three-level referral model of children with special health care needs should be improved urgently. It should strengthen the integration of public health and clinical care, with the active participation of pediatricians, to promote the immunization of children with special health care needs effectively.

Immunization of children with special health care needs has always been one of the difficulties in community-level public health. In recent years the relevant consensus opinions on vaccination have been issued in China, but for a long time there is a lack of effective communication channels between disease prevention and clinical medical systems in China. Pediatricians play an unoccupied role in immunization, and community-level vaccinators face the difficulties including dilemma of disease identification, evidence-based evaluation and upward referral. These lead to the vaccination hesitancy, thus the multi-disciplinary management and three-level referral model of children with special health care needs should be improved urgently. It should strengthen the integration of public health and clinical care, with the active participation of pediatricians, to promote the immunization of children with special health care needs effectively.