Objective: To analyze the results of national external quality assessment (EQA) for transfusion compatibility test from 2018 to 2023, with the aim of providing references for improving laboratory testing quality and ensuring the safety of clinical blood transfusion. Methods: Three EQA programs were conducted annually, each distributing 22 quality assessment samples. Participating transfusion laboratories were required to complete testing within specified deadlines and to submit results along with documentation of testing methodologies, reagents, and equipment used. National Center for Clinical Laboratories (NCCL) conducted statistical analysis of laboratory results, evaluated testing outcomes and related circumstances, and provided feedback to participating laboratories. EQA data from transfusion laboratories across China from 2018 to 2023 were collected and systematically analyzed. Results: From 2018 to 2023, the qualification rates for all five items (ABO forward typing, ABO reverse typing, Rh blood group typing, antibody screening, and cross-matching) were 67.59%, 77.11%, 77.38%, 72.78%, 79.96%, and 85.16%, respectively. The mean qualification rates for ABO forward typing, ABO reverse typing, RhD blood group typing, antibody screening, and cross-matching over the past six years were 96.25%±0.59%, 90.45%±4.52%, 96.05%±0.71%, 90.88%±2.86%, and 88.34%±3.48%, respectively. The qualification rates in 2019, 2020, 2022, and 2023 all showed a stable trend of "blood stations>tertiary hospitals>secondary hospitals". The mean qualification rate of laboratories in secondary hospitals from 2018 to 2023 was significantly lower than those of laboratories in tertiary hospitals and blood stations (P<0.05), while no significant difference was observed between laboratories in tertiary hospitals and blood stations (P>0.05). The micro column agglutination method was the most widely used in all five tests. In the four test items, namely ABO forward typing, ABO reverse typing, antibody screening, and cross-matching, there was a statistically significant difference in the qualification rate of micro column agglutination method compared to other methods (P<0.05). There was a statistical difference in the qualification rate between manual and automated detection using micro column agglutination method in the cross-matching tests (P<0.05), whereas no significant difference was noted for the other test items (P>0.05). Conclusion: From 2018 to 2023, the number of laboratories participating in EQA activities has been increasing year by year, and the qualification rate has shown an overall upward trend. The type of laboratory is a key factor affecting the qualification rate, and the testing capabilities of some laboratories still need to be improved. The micro column agglutination method is widely used in transfusion compatibility tests. The established EQA program effectively monitors quality issues in laboratories, drives continuous improvement, and ensures sustained enhancement of testing standards to safeguard clinical blood safety.

Medical artificial intelligence （AI） is a new type of application formed by the combination of machine learning， computer vision， natural language processing， and other technologies with clinical medical treatment. With the continuous iteration and development of relevant technologies， medical AI has shown great potential in improving the efficiency of diagnosis and treatment， and service quality， but it also increases the possibility of triggering ethical issues. Ethical issues resulting from the clinical application of medical AI were analyzed， including the lack of algorithmic interpretability and transparency of medical AI， leading to information asymmetry and cognitive discrepancies； the concerning status of security and privacy protection of medical data； and the complex and unclear division of responsibilities due to the collaborative participation of multiple subjects in the clinical application of medical AI， resulting in increased difficulty in the identification of medical accidents and clarification of responsibilities. The paper proposed the principles of not harming patients’ interests， physician’s subjectivity， fairness and inclusiveness， and rapid response. It also explored the strategies and implementation paths for responding to the ethical issues of medical AI from multiple perspectives， including standardizing the environment and processes， clarifying responsibility attribution， continuously assessing the impact of data protection， guaranteeing data security， ensuring model transparency and interpretability， carrying out multi-subject collaboration， as well as the principles of being driven by ethical values and adhering to the “human health-centeredness.” It aimed to provide guidance for the healthy development of medical AI， ensuring technological progress while effectively managing and mitigating accompanying ethical risks， thereby promoting the benign development of medical AI technology and better serving the healthcare industry and patients.

Objective:To analyze the results of national external quality assessment (EQA) for transfusion compatibility test in 2023, and provide reference for quality management of clinical transfusion compatibility testing.Methods:The EQA of clinical transfusion compatibility testing by NCCL was performed 3 times in 2023 among included laboratories. The panel consisting of 22 samples was distributed to 4 186 laboratories across 31 provinces (Including 2 961 tertiary hospital laboratories, 1 085 secondary hospital laboratories, 23 primary hospital laboratories, 106 blood station laboratories and 11 independent clinical laboratories). Each panel contains 11 red blood cell and 11 plasma samples per 1.5 ml/tube. Each participant laboratory of the EQA program was required to carry out the detection and return results in expected time. Statistical analysis and evaluation on the reported results were conducted by NCCL from the aspects of regional distribution, laboratory grading, testing methodology, reagent and testing system usage.Results:The qualification rates of EQA for five items including ABO positive typing, ABO reverse typing, RhD blood type, antibody screening, and cross matching were 96.68%, 95.10%, 96.46%, 95.32%, and 91.04%, respectively. The EQA qualification rate of tertiary hospital laboratories was 87.77% (2 599/2 961), which was significantly higher than the 77.79% (844/1 085) of secondary hospital laboratories. There were significant differences in the qualification rate of participating laboratories among different regions. The utilization rates of micro column agglutination method in ABO positive typing, ABO reverse typing, RhD blood type, antibody screening, and cross matching were 80.81% (10 080/12 474), 75.06% (9 337/12 440), 81.38% (10 118/12 433), 89.59% (11 104/12 394) and 76.25% (9 495/12 453), respectively. The qualification rate of micro column agglutination method was significantly higher than that of saline slide method in ABO positive typing detection ( P<0.05). The qualification rate of micro column agglutination method was significantly higher than that of the polyamine method and anti-human globulin test tube method in antibody screening ( P<0.05). There were statistically significant differences in qualification rate of 7 reagents in ABO reverse typing, antibody screening and cross matching ( P<0.05). There was no statistically significant difference in the qualification rate between the two detection systems for other reagents, except for the ABO reverse typing where the qualification rate of reagent 1 in a single system was higher than that in a mixed system ( P<0.05). Conclusion:The testing capabilities of clinical laboratories in different regions and different type varied significantly in China. Micro column agglutination method was the most popular selection in transfusion compatibility testing. The regents used in these laboratories showed good performance. However, the detection efficiency of some reagents still need to be improved. EQA could be used to evaluate, monitor, and improve the quality of testing.

Objective:To analyze the results of national external quality assessment (EQA) for transfusion compatibility test in 2023, and provide reference for quality management of clinical transfusion compatibility testing.Methods:The EQA of clinical transfusion compatibility testing by NCCL was performed 3 times in 2023 among included laboratories. The panel consisting of 22 samples was distributed to 4 186 laboratories across 31 provinces (Including 2 961 tertiary hospital laboratories, 1 085 secondary hospital laboratories, 23 primary hospital laboratories, 106 blood station laboratories and 11 independent clinical laboratories). Each panel contains 11 red blood cell and 11 plasma samples per 1.5 ml/tube. Each participant laboratory of the EQA program was required to carry out the detection and return results in expected time. Statistical analysis and evaluation on the reported results were conducted by NCCL from the aspects of regional distribution, laboratory grading, testing methodology, reagent and testing system usage.Results:The qualification rates of EQA for five items including ABO positive typing, ABO reverse typing, RhD blood type, antibody screening, and cross matching were 96.68%, 95.10%, 96.46%, 95.32%, and 91.04%, respectively. The EQA qualification rate of tertiary hospital laboratories was 87.77% (2 599/2 961), which was significantly higher than the 77.79% (844/1 085) of secondary hospital laboratories. There were significant differences in the qualification rate of participating laboratories among different regions. The utilization rates of micro column agglutination method in ABO positive typing, ABO reverse typing, RhD blood type, antibody screening, and cross matching were 80.81% (10 080/12 474), 75.06% (9 337/12 440), 81.38% (10 118/12 433), 89.59% (11 104/12 394) and 76.25% (9 495/12 453), respectively. The qualification rate of micro column agglutination method was significantly higher than that of saline slide method in ABO positive typing detection ( P<0.05). The qualification rate of micro column agglutination method was significantly higher than that of the polyamine method and anti-human globulin test tube method in antibody screening ( P<0.05). There were statistically significant differences in qualification rate of 7 reagents in ABO reverse typing, antibody screening and cross matching ( P<0.05). There was no statistically significant difference in the qualification rate between the two detection systems for other reagents, except for the ABO reverse typing where the qualification rate of reagent 1 in a single system was higher than that in a mixed system ( P<0.05). Conclusion:The testing capabilities of clinical laboratories in different regions and different type varied significantly in China. Micro column agglutination method was the most popular selection in transfusion compatibility testing. The regents used in these laboratories showed good performance. However, the detection efficiency of some reagents still need to be improved. EQA could be used to evaluate, monitor, and improve the quality of testing.

Objective To analyze the disease burden of cervical cancer in major Asian countries and globally from 1990 to 2019,which help to provide reference for the prevention and control of cervical cancer.Methods We utilized data from the(Global Burden of Disease,GBD)2019 database,and our analysis incorporated key measures such as incidence,deaths and(Disability-Adjusted Life Years,DALY)to quantitatively assess the global impact of cervical cancer.We employed the(Estimated Annual Percent Change,EAPC)to analyze the time trends in the disease burden.Results From 1990 to 2019,the global standardized incidence rate of cervical cancer decreased from 7.64/100,000 to 6.81/100,000,while the standardized death rate decreased from 4.46/100,000 to 3.40/100,000.The standardized DALYrate also decreased from 139.98/100,000 to 107.20/100,000.The annual average reductions were 0.39%,0.96%,and 0.94%,respectively(EAPC<0,P<0.05).Among major Asian countries,China's standardized incidence rate increased from 4.20/100,000 to 5.53/100,000,with an average annual growth of 1.63%(EAPC>0,P>0.05).The number of cervical cancer deaths in China increased from 26,400 to 53,400,representing a relative increase of 1.02 times.While the standardized mortality rate and standardized DALY rate for cervical cancer decreased globally and in major Asian countries,China did not exhibit a declining trend.Relevant analysis revealed no significant correlation between incidence rate and(Socio-Demographic Index,SDI)(ρ=-0.13,P=0.11).However,mortality rate showed a negative correlation with SDI(ρ=-0.74,P<0.001),and DALY also exhibited a negative correlation with SDI(ρ=-0.77,P<0.001).Conclusion The standardized incidence and death rates of cervical cancer in China have been increasing year by year,and the disease burden is on the rise.It is imperative to proactively implement scientifically effective prevention and control measures to reduce the burden of cervical cancer.

Purpose/Significance To investigate the operation status of telemedicine facilities in hospitals of different classifications and the evaluation of medical staff on the operation of facilities,so as to provide scientific basis for further promoting the construction of telemedicine and improving the level of telemedicine services.Method/Process Through an online questionnaire survey,the configura-tion and operation of telemedicine terminals in medical institutions are collected nationwide,and the feedback of medical personnel on the convenience of operation of telemedicine system is investigated.By using SPSS 25.0 software,descriptive analysis method is adopted to evaluate the availability of telemedicine facilities,and variance analysis is used to compare the differences in equipment failure frequency,the operation convenience of telemedicine system and facility evaluation in hospitals of different classifications from the perspective of medical institutions and medical personnel.Result/Conclusion The overall failure rate of telemedicine equipment is low,and the use of telemedicine system is relatively convenient,but the hospital information system is relatively poor to meet the needs of telemedicine,and the telemedicine system connections between different hospitals,as well as the telemedicine infrastructure facilities of primary medical in-stitutions need to be further improved.

As a digestive organ, the liver has the functions of metabolism, synthesis, and detoxification. It is also an immune organ and plays an important role in maintaining anti-infection, autoimmune stability, and anti-tumor. In particular, the liver has unique immunological advantages. Its immune cells can maintain the liver's immune homeostasis and participate in immunoregulation. A variety of immunotherapy is used in clinical trials for the treatment of difficult and critical liver diseases. This review mainly summarizes the recent clinical trials of immunotherapy in chronic hepatitis B, cirrhosis, hepatocellular carcinoma, and autoimmune liver disease.

Objective To systematically review the efficacy and safety of mini-percutaneous nephrolithotomy (MPCNL) and flexible ureteroscopic lithotripsy (FURL) in management of lower pole kidney stones.Methods PubMed, Embase, Scopus, Cochrane library, CNKI, VIP and Wanfang Data were searched from the beginning of database to September 2016 and clinical trials that compared the two above operation for treatment of lower pole stones were collected.Two researchers independently filtered literature,extracted data and evaluated the methodological quality of research papers.The meta-analysis was performed using the RevMan 5.3 software.Results One randomized and seven non-randomized studies were analyzed, which consists of 621 patients including MPCNL group 327 cases, FURL group 294 cases.The results of meta-analysis showed that MPCNL was better than FURL in stones clearance (OR =2.65,95％ CI 1.58-4.46,P ＜ 0.01) and operative time (WMD =-21.86,95％ CI-28.52--15.20, P ＜ 0.01).FURL was better in hospital stay time (WMD =2.28,95％ CI 0.29-4.28, P =0.02), decrease in haemoglobin levels (WMD =0.78,95 ％ CI 0.68-0.89, P ＜ 0.01), bleeding (OR =5.11,95 ％ CI 1.12-23.31,P =0.04), transfusion(OR =7.04,95％ CI 1.59-31.15, P =0.01).There was no significant difference in fever,urinary tract infection, hematuria (P ＞ 0.05).Conclusions Both MPCN and FURL are safe and effective for the treatment of lower pole stones, MPCNL can get higher stone clearance rates and shorter operation time.However, FURL can get shorter hospitalization time and lower complication rates.

With esoterica of Infantile Tuina by LI Dexiu and Infantile Tuina Therapy of LIU Kaiyun, the differences and similarities of manipulations, acupoints and the principles of treatment were studied so as to provide theoretical evidence to popularize tuina of LI Dexiu and LIU Kaiyun.
Acupuncture Points ; China ; Female ; History, 19th Century ; History, 20th Century ; Humans ; Infant ; Infant, Newborn ; Infant, Newborn, Diseases ; therapy ; Male ; Massage ; history ; manpower ; methods

Objective To investigate the survival of Schistosoma japonicum eggs in goat feces in natural marshlands and the factors affecting its survival,so as to provide evidences for understanding of the role of eggs in goat feces in the transmission of schistosomiasis and the development of the interventions pertaining to disease control and elimination. Methods The goat ani?mals of schistosomiasis japonica were modeled in laboratory,and the feces of infected goat were collected. In laboratory,the ef?fects of environmental temperature and water content in goat feces on egg hatching were evaluated,and in the field,the effect of duration of goat feces on marshland on egg hatching and the effect of direct sunshine on egg survival were evaluated. Results At 25℃in laboratory,the hatching rate of eggs in goat feces was high?positively correlated with the water content in goat feces (r=0.87). If the water content reduced to 7.6%in goat feces,the eggs in goat feces lost the ability to hatch. Under the same wa?ter content in goat feces,the hatching rate of eggs gradually decreased with the extension of the duration of exposure of goat feces to-5℃,which reduced to 0 following 5 h exposure. At 5,15 and 25℃,the hatching rates of eggs gradually decreased with the extension of the duration of exposure of goat feces,and the miracidium hatching rates of eggs were 2.3%,5%and 0.9%respec?tively following the exposure for 52 d. At 35℃,the hatching rate of eggs gradually decreased with the extension of the duration of exposure,which reduced to 0 following 13 d exposure. In winter(-2?10℃),the hatching rate of eggs gradually decreased with the extension of the duration of exposure of goat feces on marshlands,which reduced to 0 after 21 d of exposure,and in spring(16?19℃),the hatching rate of eggs gradually decreased with the extension of the duration of exposure of goat feces on marshlands,which reduced to 0.9%after 5 d of exposure. At the same time point on the same marshland,the hatching rate of eggs in goat feces exposed to marshlands with direct sunshine was lower than that without direct sunshine. Conclusion The sur?vival of S. japonicum eggs in goat feces is associated with environmental temperature and water content(humidity)in goat feces, and the temperature and humidity are major natural factors affecting egg hatching.