Objective: To characterize perioperative dynamic changes in immune-cell phenotypes and inflammatory cytokines in patients undergoing CPB (cardiopulmonary bypass) cardiac surgery, and to explore their associations with postoperative outcomes. Methods: In this prospective cohort study, 120 adult patients who underwent elective cardiac surgery under CPB at West China Hospital from May 2022 to March 2023 were enrolled. Perioperative immune-cell phenotypes and concentrations of 40 inflammation-related cytokines were measured. The primary outcomes were the sequential organ failure assessment (SOFA) score at 24 h after surgery and ΔSOFA (the peak SOFA score within 48 h after surgery minus the preoperative SOFA score). Secondary outcomes included major adverse cardiovascular events (MACE), acute kidney injury (AKI), respiratory failure, severe liver injury, and infection. Results: The mean age of enrolled patients was 57±10 years. Of these, 52% (62/120) were male and 90% (108/120) underwent valve surgery. During the rewarming to the end of CPB, neutrophil counts rapidly increased (7.39×10 /L vs preoperative 3.07×10 /L, P<0.001), with significant upregulation of CD11b (7.30×10 /L vs preoperative 3.05×10 /L, P<0.001) and CD54 (7.15×10 /L vs preoperative 2.99×10 /L, P<0.001). Lymphocyte counts increased at the end of CPB (1.75×10 /L vs preoperative 1.12×10 /L, P<0.001) but decreased significantly at 24 h after surgery (0.59×10 /L vs preoperative 1.12×10 /L, P<0.001). Plasma analysis showed that multiple pro-inflammatory cytokines increased during CPB and remained elevated up to 24 h after surgery; five chemokines and the anti-inflammatory cytokine IL-10 peaked at the end of CPB. The SOFA score increased from 1 (1, 2) preoperatively to 7 (5, 10) at 24 h after surgery, with a ΔSOFA of 6 (4, 8). Within 30 days after surgery, 48 patients (40.0%) developed AKI, 17 (14.2%) developed infection, 4 (3.3%) developed severe liver injury, 3 (2.5%) developed respiratory failure, and 3 (2.5%) experienced MACE. During the 2-year follow-up, 8 patients (6.7%) experienced MACE and 5 (4.2%) died. Conclusion: Multi-organ dysfunction is common after cardiac surgery under CPB (median ΔSOFA, 6), accompanied by perioperative activation of multiple immune-cell subsets and upregulation of pro-inflammatory, anti-inflammatory, and chemotactic mediators. This study provides data-driven evidence and research clues for further investigation of the associations between CPB-related immune perturbations and postoperative organ dysfunction and clinical outcomes.

Objective To utilize the dental implant robot in the clinical instruction of oral implantology in order to popularize the technology and serve the medical education.Methods The effectiveness of the robotics teaching approach was assessed through a questionnaire.Results The dental implant robot technology has certain advantages in the clinical teaching of oral implant majors.Conclusion With the increasing popularity of digital implantation,the emerging dental implant robot has a wide range of applications and many advantages.It is very necessary to introduce it into the clinical teaching of oral implant majors.

Objective To explore the optimisation path of medical resource allocation efficiency improvement in Traditional Chinese Medicine (TCM) hospitals under the synergistic effect of multiple factors,so as to provide powerful support for the balanced development of medical resources in TCM hospitals.Methods The comprehensive efficiency of resource allocation in TCM hospitals in 31 provinces (cities and districts) of China obtained by Data Envelopment Analysis was taken as the outcome variable,and with the help of Fuzzy-set Qualitative Comparative Analysis,it examined the configurations of efficient medical resource allocation,considering the following conditional variables:per capital Regional GDP,the proportion of fiscal allocation revenue to total income,the ratio of TCM practicing (assistant) physicians to all practicing (assistant) physicians,the average length of hospital stay for discharged patients,the number of total diagnosis and treatments per thousand population,and the number of hospital beds per thousand population.Results By analyzing the conditional patterns of efficient allocation of medical resources in TCM hospitals,three equivalent driving paths can be summarized,which are comprehensive service capacity,TCM advantage and hospitalization driving paths.Conclusion The overall level of medical resource allocation efficiency of TCM hospitals in China needs to be improved.In the future,efforts should be made to improve the comprehensive service capacity and operational efficiency of hospitals,give full play to the advantages of TCM,build a high-quality TCM talent team,reasonably shorten the average hospital stay,and improve the utilization efficiency of hospital beds.

Objective To utilize the dental implant robot in the clinical instruction of oral implantology in order to popularize the technology and serve the medical education.Methods The effectiveness of the robotics teaching approach was assessed through a questionnaire.Results The dental implant robot technology has certain advantages in the clinical teaching of oral implant majors.Conclusion With the increasing popularity of digital implantation,the emerging dental implant robot has a wide range of applications and many advantages.It is very necessary to introduce it into the clinical teaching of oral implant majors.

Objective To explore the reliability of the reagent burstbead for field blood transfusion compatibility testing by applying it to bloodtype detection,antibody screening and cross matching tests and conduting parallel contrast with the existing arrays.Methods A field treatment shelter was used as the testing site to simulate the scene of emergency blood transfusion for the wounded under the conditions of field blood station,and 1 358 pieces of blood samples sent to some hospital for examination before transfusion were considered as the objects.Parallel contrast tests were carried out between the reagent burstbead method and the tube method for bloodtype detection and between the reagent burstbead method and the manual polybrene method for antibody screening and cross matching.The reagent burstbead method was compared with other methods in terms of the coin-cidence rate of the bloodtype detection results,the detection rate of positive samples for antibody screening and crossmatch incompatibility.Results The reagent burstbead method and the tube method had high consistency when used for bloodtype detection,with the coincidence rate being 100％.During antibody screening and cross matching tests,the reagent burstbead method found 5 cases of antibody-positive samples leading to major crossmatch incompatibility(positive rate being 0.37％),the manual polybrene method detected 2 cases of irregular antibody-positive samples(positive rate being 0.15％),and the two methods both identified 3 cases of minor crossmatch incompatibility.Conclusion The reagent burstbead has high accuracy and reliability when applied to bloodtype detection,antibody screening and cross matching tests,and thus can be used for blood transfusion compatibility testing in field conditions.[Chinese Medical Equipment Journal,2025,46(2):39-42]

Objective To systematically evaluate of the effect of autoimmune diseases(AIDs)on early spontaneous abortion(ESA).Methods Several databases such as Ovid and Web of Science were searched from January 2000 to May 2024 for retrospective analysis.Furthermore,subgroup analysis was conducted in terms of AIDs,continent and assisted reproduction.Results Total of 73 eligible studies were included in this study.There was a statistically significant difference in the risk of ESA between the population with AIDs and the population with normal pregnancy(OR=1.832,95％CI:1.619-2.073).When subgroup studies of AIDs were performed,the increased risk of ESA in patients with some AIDs was statistically significant:e.g.,thyroid autoimmunity,antiphospholipid syndrome,systemic lupus erythematosus,desiccation syndrome,antinuclear antibody positivity and rheumatoid arthritis.While the impact of some AIDs on ESA was still uncertain,e.g.inflammatory bowel disease,ulcerative colitis,Crohn's disease,autoimmune skin diseases,neuromyelitis optica spectrum disorders.In addition,patients with antiphospholipid syndrome who had underwent assisted reproductive technologies were at higher risk of ESA.Furthermore,compared to other continents,there is a difference in the risk of ESA in patients with AIDs in Africa.Conclusion AIDs are associated with the risk of ESA.

Objective To explore the effects of ultra-low tube voltage of the third-generation dual-source CT combined with advanced modeled iterative reconstruction(ADMIRE)in bronchial artery CTA for hemoptysis patients.Methods Totally 70 hemoptysis patients admitted to some hospital from March to August 2023 had their clinical and imaging data collected retrospectively,and then divided into Group A and B with the numerical table method.In Group A image reconstruction was carried out with 120 kV tube voltage and filtered back projection(FBP)(named as Group A-FBP);In Group B image reconstruction was performed with 70 kV tube voltage respectively combined with FBP,ADMIRE Ⅲ,Ⅳ and Ⅴ(named as Group B-FBP,B-ADMIRE Ⅲ,B-ADMIRE Ⅳ and B-ADMIRE Ⅴ).All the patients were scanned with Siemens third-generation dual-source CT.The groups were compared in terms of radiation dose covering volume CT dose index,dose length product and effective dose,subjective score and objective evaluation.The subjective score agreement between 2 radiologists was evaluated with Kappa test.SPSS 26.0 software was used for statistical analysis.Results The radiation dose parameters of Group B were all lower than those of Group A,and the differences were statistically significant(P<0.001).Group B-FBP and ADMIRE Ⅳ had the lowest and highest subjective scores for bronchial artery images,res-pectively,and the five groups were significantly different in subjective score(P<0.05).The two radiologists had high agree-ment for Kappa values of the subjective scores,with the Kappa values being not lower than 0.75.Group A-FBP showed the lowest vessel CT value,Group B-FBP exhibited the highest image noise and the lowest SNR and CNR,and the five groups differed significantly in the objective evaluation of image quality(P<0.05).Group B-ADMIRE Ⅲ,B-ADMIRE Ⅳ and B-ADMIRE Ⅴ had statistically significant differences with Group A-FBP in objective evaluation of image quality(all P<0.05),with Group B-ADMIRE Ⅴ exhibiting the lowest image noise while highest SNR and CNR.Conclusion Ultra-low tube voltage of the third-generation dual-source CT combined with ADMIRE decreases the radiation dose and ensures image quality when applied to hemoptysis patient CTA,and ADMIRE Ⅳ behaves well in noise reduction and image quality enhancement.[Chinese Medical Equipment Journal,2025,46(10):60-64]

Objective:Previous studies have shown that insomnia is closely related to erectile dysfunction(ED).However,the causal relationship between them is still unclear.Mendelian randomization(MR)provides a new method for studying the relationship between the two,and the theory of heart-kidney interaction in TCM provides a new idea for exploring the causal relationship between them.Methods:Based on the statistical data collected by genome-wide association studies(GWAS),the causal relationship be-tween insomnia and ED was discussed by MR.Inverse variance weighted(IVW)is the main analysis method,and weighted median(WME),simple mode(SM),weighted mode(WM)and MR Egger method were the supplementary analysis to evaluate the causal effect.MR-Egger intercept test,Cochran Q test and leave-one-out method were used in sensitivity analysis to verify the reliability of MR results.Results:Thirty-nine SNPs significantly related to insomnia were finally included for MR analysis.The results of IVW method in MR analysis showed that insomnia had a significant causal relationship with the increased risk of ED(OR=3.111,95％CI=1.566-6.181,P=1.193 × 10-3).The results obtained by MR-Egger method,WME method,WM method and SM method were consistent with IVW method in the direction of effect.The sensitivity results suggested that the results of this study were robust.Conclusion:Our study reveals the causal relationship between insomnia and ED,which provides a new basis for future clinical practice and prevention and treatment of ED.

Objective:To explore the characteristics of serum galactose-deficient IgA1 (Gd-IgA1) and Gd-IgA1/IgA ratio in normal children.Methods:The children from a kindergarten and 3 primary or secondary schools in Baoding (Hebei Province) from March to August 2023 were included in the cross-sectional study.According to their age, the children were divided into the 3-6-year-old group, >6-11-year-old group, and >11-16-year-old group.Besides, some adults were also included as the control group.The immunoturbidimetric assay was used to detect serum IgA levels, and the enzyme-linked immunosorbent assay (ELISA) was employed to detect Gd-IgA1 and Gd-IgA1/IgA levels.The above indicators were subject to normal distribution tests and analysis of variance (ANOVA)or rank sum test.Results:A total of 136 normal subjects were included for analysis.Among these subjects, there were 64 males and 72 females.There were 13 children in the 3-6-year-old group, 51 children in the >6-11-year-old group, and 56 children in the >11-16-year-old group.Besides, 16 normal adults (28-45 years old) from the physical examination center were also included as the control group.The serum IgA levels of the 3-6-year-old group, >6-11-year-old group, >11-16-year-old group, and adult group were (0.88±0.35) g/L, (1.38±0.65) g/L, (1.78±0.61) g/L, and (2.49±0.94) g/L, respectively.Except for no statistically significant difference between the 3-6-year-old group and the >6-11-year-old group, as well as between the >11-16-year-old group and the adult group, all other age groups showed statistically significant differences in serum IgA levels (all P<0.05).The serum Gd-IgA1 levels of the 3-6-year-old group, >6-11-year-old group, >11-16-year-old group, and adult group were 7.77(5.77, 16.51) μg/L, 7.12(5.29, 9.82) μg/L, 8.96(6.21, 14.30) μg/L, and 9.39(6.63, 40.00) μg/L, respectively, with statistically significant differences ( H=9.22, P=0.027).There was no significant difference in the Gd-IgA1/IgA ratio among different groups ( P=0.130).The correlation analysis suggested that Gd-IgA1/IgA1 did not correlate with age ( r=0.134, P=1.200).The Gd-IgA1 level was positively correlated with the IgA level ( r=0.204, P=0.017).There was no significant difference in serum IgA, Gd-IgA1, and Gd-IgA1/IgA levels between different gender groups. Conclusions:There are differences in Gd-IgA1 levels among different age groups among these children, but Gd-IgA1/IgA is not correlated with age.As a diagnostic biomarker, Gd-IgA1 should be emphasized from the different levels among different age groups, while Gd-IgA1/IgA seems to be more convenient for clinical research and application.

Aim To explore the impact and mechanism of proprotein convertase subtilisin kexin 9(PCSK9)on the progression of abdominal aortic aneurysm(AAA).Methods 6～8 week old ApoE-/-mice were selected to estab-lish the AAA model.Angiotensin Ⅱ(Ang Ⅱ)was continuously infused through subcutaneous implantation of a micro-os-motic pump.The mice were fed with high-fat diet and killed after 28 days.The expression of PCSK9 in abdominal aor-tic smooth muscle cells was detected by immunohistochemistry and immunofluorescence in normal abdominal aortic blood vessels and AAA samples in human and mice.Primary cultured murine vascular smooth muscle cells(mVSMC)of C57BL/6 mice were treated with different concentrations of AngⅡ for 24 h,and the expression of PCSK9 mRNA and pro-tein was detected.PCSK9 overexpression and knockdown cell models were established,and mitochondrial reactive oxygen species(mtROS),mitochondrial membrane potential(MMP),mitochondrial permeability transition pore(MPTP)open-ing,and Z-DNA binding protein 1(ZBP1)protein expression were detected.Bioinformatics was used to analyze the dif-ferential expression of multiple single-cell sequencing datasets to obtain the key differentially expressed genes,and to study their expression and role in AAA.Results Immunohistochemistry and immunofluorescence results showed that PCSK9 expression in human and mouse AAA increased(P＜0.01),and co-localized with smooth muscle.Ang Ⅱ promoted PCSK9 expression in mVSMC in a concentration-dependent manner,the 2.0 μmol/L Ang Ⅱ group showed a 2.9-fold and 1.1-fold increase in the expression of PCSK9 mRNA and protein,respectively(P＜0.01),with the most significant effect observed.After successfully constructing PCSK9 overexpression and PCSK9 interference mVSMC models,PCSK9 overex-pression led to an increase in intracellular mtROS,a decrease in MMP,an increase in MPTP opening,and a decrease in cellular activity(P＜0.01);PCSK9 knockdown could reduce Ang Ⅱ induced increase in mtROS,decrease in MMP and MPTP opening;compared with the siNC+Ang Ⅱ group,the siPCSK9+Ang Ⅱ group showed a decrease in mtROS and an in-crease in the fluorescence brightness of MMP and MPTP(P＜0.05).Bioinformatics analysis revealed that ZBP1 was a core differentially expressed gene in AAA.Immunohistochemistry and immunofluorescence results showed that ZBP1 ex-pression in human and mouse AAA tissues increased,and co-localized with smooth muscle.Western blot results showed that PCSK9 overexpression or treatment with 2.0 μmol/L Ang Ⅱ could increase ZBP1 protein expression(P＜0.01),while PCSK9 knockdown could alleviate the increased ZBP1 expression caused by AngⅡ(P＜0.05).Conclusion PCSK9 may induce mitochondrial damage in smooth muscle cells,activate downstream molecule ZBP1 to cause cell damage,and promote the development of AAA.