Objective: To establish a real-time quality control scheme based on the median (MD-IC) of internal control cycle threshold value in negative samples (NEG-IC-CT), so as to monitor anomalies such as progressive drift in nucleic acid testing system not covered by conventional internal quality control (IQC) in blood center nucleic acid laboratories, and to verify its feasibility. Methods: The internal control CT values of 54 426 negative samples were retrospectively collected. These samples were from four reagent batches of the two new and old equipment sets during the operation of the Wantai nucleic acid testing system in our blood center. The daily median of NEG-IC-CT values was used as the research indicator. Control limits were calculated using median absolute deviation (MAD) to construct the Median-MAD quality control chart. The monitoring performance of this scheme for the operation status of the testing system was simultaneously evaluated. Results: Statistical analysis showed significant differences in NEG-IC-CT value distribution between the new and old equipment sets, as well as between the two different reagent batches of the old equipment (P<0.000 1). The NEG-IC-CT value performance of the two different reagent batches of the new equipment was no significant difference in distribution (P>0.05). This scheme identified three typies of distinct anomalies. The out-of-control events observed with the old equipment in both the O1 and O2 reagent batches suggested potential performance decay due to equipment aging. The unreported change of reagent batch in time of Phase B with new equipment caused a stepwise drift on the quality control chart. In the later stage of Phase A with the new equipment, an alert was triggered, indicating potential quality risks associated with practices such as the mixed use of the remaining reagents and extremely long operator working hours. Conclusion: The realtime quality control scheme based on NEG-IC-CT value established in this study has been preliminarily validated for its monitoring effectiveness in nucleic acid testing in our blood center. This scheme performed well in detecting differences among testing systems and reagent batches, serving as an effective supplement to routine internal quality control. It can provide an intuitive and effective evaluation method for monitoring the performance of the nucleic acid testing process at blood center.

Peptide-based radiopharmaceuticals targeting integrin α5β1 show promise for precise tumor diagnosis and treatment. However, current peptide-based radioligands that target α5β1 demonstrate inadequate in vivo performance owing to limited tumor retention. The use of PEGylation to enhance the tumor retention of radiopharmaceuticals by prolonging blood circulation time poses a risk of increased blood toxicity. Therefore, a PEGylation strategy that boosts tumor retention while minimizing blood circulation time is urgently needed. Here, we developed a PEGylation-enabled peptide multidisplay platform (PEGibody) for PR_b, an α5β1 targeting peptide. PEGibody generation involved PEGylation and self-assembly. [⁶⁴Cu]QM-2303 PEGibodies displayed spherical nanoparticles ranging from 100 to 200 nm in diameter. Compared with non-PEGylated radioligands, [⁶⁴Cu]QM-2303 demonstrated enhanced tumor retention time due to increased binding affinity and stability. Importantly, the biodistribution analysis confirmed rapid clearance of [⁶⁴Cu]QM-2303 from the bloodstream. Administration of a single dose of [¹⁷⁷Lu]QM-2303 led to robust antitumor efficacy. Furthermore, [⁶⁴Cu]/[¹⁷⁷Lu]QM-2303 exhibited low hematological and organ toxicity in both healthy and tumor-bearing mice. Therefore, this study presents a PEGibody-based radiotheranostic approach that enhances tumor retention time and provides long-lasting antitumor effects without prolonging blood circulation lifetime. The PEGibody-based radiopharmaceutical [⁶⁴Cu]/[¹⁷⁷Lu]QM-2303 shows great potential for positron emission tomography imaging-guided targeted radionuclide therapy for α5β1-overexpressing tumors.

Objective The aim of this study was to analysis the incidence and mortality of malignant tumors in the cancer registration area of Kunming City in 2020,as well as the trend of changes from 2016 to 2020.Methods The malignant tumor data of 12 cancer registration areas in Kunming in 2020 that met the quality criteria were used to analyze the crude incidence,crude mortali-ty,age-standardized incidence/mortality rate by Chinese standard population(ASIRC/ASMRC)of malignant tumors in different gen-ders and regions.The annual percentage change(APC)was calculated using Joinpoint 5.3.0.0 software,the incidence and mortality trends of malignant tumors from 2016 to 2020 were evaluated.Results In 2020,the crude incidence and ASIRC of malignant tumors in cancer registration areas of Kunming City were 234.27/100,000 and 141.68/100,000,respectively.The ASIRC of males was high-er than that of females(146.94/100,000 vs.137.33/100,000,Z=3.459,P<0.001),and that of rural areas was higher than that of urban areas(146.37/100,000 vs.134.09/100,000,Z=-4.462,P<0.001).The crude mortality and ASMRC of malignant tumors were 135.67/100,000 and 73.18/100,000,respectively.The ASMRC of males was higher than that of females(91.65/100,000 vs.55.43/100,000,Z=19.260,P<0.001),and that of rural areas was higher than that of urban areas(76.27/100,000 vs.70.00/100,000,Z=-3.359,P<0.001).There were 81.39%of new cases and 90.36%of deaths of malignant tumors occurred in the popu-lation aged 50 and above.The top 5 cancer incidence in the Kunming City were lung cancer,colorectal cancer,breast cancer,liver cancer and prostate cancer.The top 5 cancer mortality were lung cancer,liver cancer,colorectal cancer,prostate cancer and stomach cancer.The ASIRC(APC=-3.05%,95%CI:-5.91%--0.10%,P=0.046)and ASMRC(APC=-5.47%,95%CI:-8.52%--2.32%,P=0.012)of malignant tumors in urban areas of Kunming showed a downward trend.Conclusions From 2016 to 2020,the ASIRC and ASMRC of malignant tumors in urban areas of Kunming showed a downward trend,but there was no significant changing trend in rural tumor registration areas.Rural areas are key areas for the prevention and treatment of malignant tumors in Kunming city;Lung cancer,colorectum cancer,liver cancer and prostate cancer are the key types of cancer for prevention and treatment.

Summary of nursing experience was conducted in a case of emergency liver transplantation during the second trimester of pregnancy complicated by acute liver failure.The key nursing points are as follows:preoperative participation in multidisciplinary discussions and emergency plan desktop exercises;preparation of preoperative equipment and supplies.Intraoperative fetal protection at critical stages,prevention and management of hyperkalemia,correction of coagulation function,maintenance of circulatory stability,implementing anticipatory surgical coordination to curtail operative duration,and prevention of perioperative hypothermia under a proactive nursing model.Through multidisciplinary team collaboration and meticulous nursing care,the patient recovered well 8 days postoperatively and successfully delivered a female infant via cesarean section.The patient was transferred back to the general ward 8 days after the cesarean section and was discharged 47 days postoperatively.Follow-up for over 2 months showed good recovery for both the patient and the infant.

Objective To investigate influencing factors of textbook outcome(TO)in patients with pancreatic ductal adenocarcinoma undergoing minimally invasive pancreaticoduodenectomy(MIPD).Methods A retrospective analysis was conducted on the clinical data of 101 cases of pancreatic ductal adenocarcinoma treated with MIPD in our hospital from January 2020 to December 2022.According to the inclusion and exclusion criteria,89 cases were ultimately included in this study,of which 61 cases reached TO(TO group)and 28 cases did not reach TO(non-TO group).Variables with P<0.05 in univariate analysis were included in multivariate logistic regression analysis to identify independent prognostic factors of TO.Results Univariate analysis showed that there were significant differences in pancreatic duct dilation>3 mm,preoperative neutrophil lymphocyte ratio(NLR),extended hospital stay,postoperative hospitalstay,and drain fluid amylase(DFA)>1100 U/L at1-3 d aftersurgery(P<0.05).Multivariate logistic regression analysis showed that the independent prognostic factors affecting TO were:pancreatic duct dilation>3 mm(OR=7.290,95%CI:1.485-35.786,P=0.014),postoperative hospital stay(OR=0.862,95%CI:0.751-0.989,P=0.034),and the DFA on the first postoperative day>1100 U/L(OR=0.052,95%CI:0.005-0.545,P=0.014).Conclusions The outcome of TO in patients after MIPD is not related to the surgical approach(robot assisted minimally invasive pancreaticoduodenectomy or laparoscopic pancreaticoduodenectomy).Pancreatic duct dilation>3 mm,postoperative hospital stay,and DFA on the first postoperative day>1100 U/L are independent prognostic factors of TO after MIPD in patients with pancreatic ductal adenocarcinoma.

BACKGROUND:More and more scholars are investigating the mechanism of hypoxia-inducible factor-1α in regulating bone homeostasis and oral and maxillofacial diseases to provide new targets and strategies for the treatment of related disorders,but there is no relevant review.OBJECTIVE:To summarize the regulatory potential of hypoxia-inducible factor-1α in a variety of oral and maxillofacial diseases and bone homeostasis with the aim of providing a new research direction for oral and maxillofacial bone tissue engineering.METHODS:A literature review was conducted in databases such as PubMed,Web of Science and CNKI,for articles Published from 2003 to 2024.The keywords were"hypoxia inducible factor-1α,oral cavity,bone formation,osteoclast,angiogenesis,oxidative stress,tissue engineering,periodontitis,pulpitis,temporomandibular joint osteoarthritis"in Chinese and English.Finally,84 articles were included for review.RESULTS AND CONCLUSION:(1)Hypoxia-inducible factor-1α is essential in promoting bone tissue regeneration,facilitating osteogenic-angiogenic coupling,and mitigating damage from oxidative stress in bone tissue.(2)Increasing levels of hypoxia-inducible factor-1α in tissue cells reduces inflammation in periodontitis and promotes periodontal tissue remodeling,pulp regeneration,and involves in joint remodeling after temporomandibular joint osteoarthritis.(3)By stabilizing the level of hypoxia-inducible factor-1α in tissue cells,the micronutrient-carrying biomaterial promotes bone marrow mesenchymal stem cells to migrate and attach to the bone defect area,coupling angiogenesis and osteogenesis to achieve bone regeneration.(4)How to increase the level of hypoxia-inducible factor-1α in oral and maxillofacial tissues using bioactive materials to achieve bone regeneration at maxillofacial bone defects remains to be investigated.

Objective:To evaluate the effect of 5th generation mobile communication technology(5G) remote robot-assisted cholecystectomy on postoperative recovery and quality of life in patients with gallstones.Methods:Clinical data of patients who underwent 5G remote robotic cholecystectomy(20 cases) vs traditional robotic cholecystectomy(20 cases) at Gansu Provincial People's Hospital from May to September 2023 were retrospectively analyzed. Intraoperative and postoperative related indexes were compared between the two groups, and changes in pain analog scores before, 12 hours, and 24 hours after surgery, and global quality of life (GIQLI) scores before and 3 months after surgery were evaluated.Results:There was no significant difference between the two groups in terms of intraoperative and postoperative conditions (intraoperative blood loss, operative time, time to exhaustion, and length of hospital stay). Patients' pain analog scores at 12 and 24 hours postoperatively were lower than preoperatively, but the differences were not statistically significant( P>0.05). In addition, there was no significant difference in recovery indicators between the two groups compared to the control group ( P>0.05). Conclusion:The postoperative recovery metrics of 5G tele-robotic-assisted cholecystectomy were consistent with the results of conventional robotic surgery.

Aim To investigate the effect of cumulative non-high density lipoprotein cholesterol/high density lip-oprotein cholesterol(non-HDLC/HDLC)exposure on atherosclerotic cardiovascular disease(ASCVD).Methods A prospective cohort study was conducted.A total of 50 777 employees of Kailuan Group who participated in three physical examinations in 2006-2007,2008-2009 and 2010-2011 were selected as the study subjects.Groups were divided into Q1,Q2,Q3 and Q4 according to the cumulative non-HDLC/HDLC exposure quartiles.Kaplan-Meier curve was used to calculate the cumulative incidence of ASCVD in different cumulative non-HDLC/HDLC groups,and Log-rank test was used to compare the differences among groups.Cox proportional risk model was used to analyze the effect of cumulative non-HDLC/HDLC exposure on ASCVD.Results The average follow-up was(10.19±2.21)years,and 5 003 new cases of ASCVD occurred.The cumulative incidence of ASCVD in groups Q1 to Q4 was 6.49％,8.71％,10.86％and 14.85％,respectively(Log-rank P＜0.01).Multivariate Cox regression analysis showed that compared with group Q1,the HR(95％CI)of ASCVD in groups Q2,Q3 and Q4 were 1.13(1.03～1.24),1.18(1.07～1.29),1.22(1.12～1.34),respectively;the HR(95％CI)of myocardial infarction were 1.15(0.87～1.53),1.44(1.10～1.88),1.67(1.29～2.17),respectively;the HR(95％CI)of revascularization were 1.21(0.99～1.49),1.31(1.07～1.60)and 1.49(1.22～1.81),respectively;the HR(95％CI)of ischemic stroke were 1.17(1.03～1.32),1.17(1.04～1.33)and 1.21(1.06～1.37),respectively;but the above association was not found when heart failure and atrial fibrillation were used as the outcome events.The restricted cubic spline showed that cumulative non-HDLC/HDLC values were line-arly associated with the risk of ASCVD.Conclusion Cumulative non-HDLC/HDLC exposure was positively associated with the risk of ASCVD.

Objective To investigate the influence of Liraglutide on carotid intima-media thickness(CIMT)and serum Sirtuin protein 6(SIRT6)in patients with type 2 diabetes mellitus(T2DM)complicated with carotid atherosclerosis(CAS).Methods A total of 120 hospitalized patients with T2DM complicated with CAS were enrolled in this study from the Department of Endocrinology of Affiliated Renhe Hospital of China Three Gorges University and Yiling Hospital of Yichang City from July 2022 to January 2024.All the patients were randomly divided into Liraglutide(Lir,n=59)group and control(Con,n=61)group.Lir group was treated with Liraglutide combined with current hypoglycemic regimen.Con group was adjusted based on the original hypoglycemic scheme.The expression of serum SIRT6 and CIMT were compared between the two groups before and after treatment.Results After 24 weeks treatment,the fasting plasma glucose(FPG),2-hour postprandial blood glucose(2 hPG),glycatde hemoglobin A1c(HbA1c)and high sensitivity C-reactive protein(hs-CRP)levels were all decreased in both groups(P<0.05 or P<0.01).BMI,TC,TG,LDL-C,plasminogen activator inhibitor-1(PAI-1)and CIMT were significantly lower(P<0.05),while SIRT6 and superoxide dismutase(SOD)was significantly higher in the Lir group after treatment(P<0.05).Pearson or Spearman correlation analysis showed that CIMT was positively correlated with BMI,FPG,2 hPG,HbA1c,TC,TG,LDL-C,hs-CRP,PAI-1,DM duration(r=0.322,0.218,0.202,0.610,0.363,0.238,0.343,0.558,0.183,0.371,P<0.05 or P<0.01),and negatively correlated with SIRT6,SOD and HDL-C(r=-0.525,-0.432,-0.207,P<0.05 or P<0.01).SIRT6 was negatively correlated with BMI,HbA1c,TC,LDL-C,hs-CRP and PAI-1(r=-0.320,-0.550,-0.408,-0.422,-0.769,-0.224,P<0.05 or P<0.01),and positively correlated with SOD(r=0.550,P<0.01).Multiple stepwise regression showed that hs-CRP and SOD were independent influencing factors for SIRT6.HbA1c and SIRT6 were influencing factors for CIMT of T2DM patients.Conclusions Liraglutide could improve glucose and lipid metabolism,increase serum SIRT6 and decrease CIMT.

The development of 5G remote robot-assisted gastrointestinal surgery is an important breakthrough in remote surgery in the field of four-level surgery. This paper will review the development history of 5G remote robot assisted gastrointestinal surgery, and share the Gansu province people′s hospital in 5G remote robot assisted gastrointestinal surgery about preoperative preparation, network and equipment connection,“3+2” Trocar layout, safety emergency treatment mechanism of exploratory experience, for 5G remote robot assisted gastrointestinal surgery, and the status and prospect of 5G remote robot assisted gastrointestinal surgery.