Objective: To summarize the laboratory findings of a case of hemolytic disease of the fetus and newborn (HDFN) caused by Rh system anti-c antibodies and to review the literature, so as to explore the characteristics of anti-c HDFN. Methods: The ABO blood type, Rh blood type, direct antiglobulin test (DAT) results, and the presence of unexpected antibodies and their titers were determined by serological methods. The cases of anti-c HDFN in our laboratory in China and abroad were statistically analyzed, and the incidence of severe HDFN caused by anti-c, anti-D and anti-E was compared. Results: The blood type of the child was B (Rh CcDee) with a positive DAT. Anti-c antibody was detected in both serum and eluate, with a serum antibody titer of 4. The mother’s blood type was AB (Rh CCDee) with a negative DAT, and anti-c antibody was detected in the serum with a titer of 128. Among 20 cases of anti-c HDFN, 17 were DAT positive, and 9 (45%, 9/20) underwent blood transfusion or exchange transfusion. The incidence of severe HDFN was 47.60% (10/21) for anti-c, 47.60% (10/21) for anti-D and 31.30% (5/16) for anti-E. Conclusion: Maternal pregnancy and/or blood transfusion are the main reasons for the production of Rh alloantibodies such as anti-c. The prevention and management of anti-c should be similar to that of anti-D. Rh antigen-matched (five antigens of Rh blood group) transfusion is necessary for women of childbearing age to avoid antibody production, and Rh typing and antibody screening during prenatal examination is recommended to ensure early detection, intervention and treatment.

Cardiovascular disease (CVD), chronic kidney disease (CKD), and metabolic disorders are the 3 major chronic diseases threatening human health, which are closely related and often coexist, significantly increasing the difficulty of disease management. In response, the American Heart Association (AHA) proposed a novel disease concept of “cardiovascular-kidney-metabolic (CKM) syndrome” in October 2023, which has triggered widespread concern about the co-treatment of heart and kidney diseases and the prevention and treatment of metabolic disorders around the world. This review posits that effectively managing CKM syndrome requires a new and multidimensional paradigm for diagnosis and risk prediction that integrates biological insights, advanced technology and social determinants of health (SDoH). We argue that the core pathological driver is a “metabolic toxic environment”, fueled by adipose tissue dysfunction and characterized by a vicious cycle of systemic inflammation and oxidative stress, which forms a common pathway to multi-organ injury. The at-risk population is defined not only by biological characteristics but also significantly impacted by adverse SDoH, which can elevate the risk of advanced CKM by a factor of 1.18 to 3.50, underscoring the critical need for equity in screening and care strategies. This review systematically charts the progression of diagnostic technologies. In diagnostics, we highlight a crucial shift from single-marker assessments to comprehensive multi-marker panels. The synergistic application of traditional biomarkers like NT-proBNP (reflecting cardiac stress) and UACR (indicating kidney damage) with emerging indicators such as systemic immune-inflammation index (SII) and Klotho protein facilitates a holistic evaluation of multi-organ health. Furthermore, this paper explores the pivotal role of non-invasive monitoring technologies in detecting subclinical disease. Techniques like multi-wavelength photoplethysmography (PPG) and impedance cardiography (ICG) provide a real-time window into microcirculatory and hemodynamic status, enabling the identification of early, often asymptomatic, functional abnormalities that precede overt organ failure. In imaging, progress is marked by a move towards precise, quantitative evaluation, exemplified by artificial intelligence-powered quantitative computed tomography (AI-QCT). By integrating AI-QCT with clinical risk factors, the predictive accuracy for cardiovascular events within 6 months significantly improves, with the area under the curve (AUC) increasing from 0.637 to 0.688, demonstrating its potential for reclassifying risk in CKM stage 3. In the domain of risk prediction, we trace the evolution from traditional statistical tools to next-generation models. The new PREVENT equation represents a major advancement by incorporating key kidney function markers (eGFR, UACR), which can enhance the detection rate of CKD in primary care by 20%-30%. However, we contend that the future lies in dynamic, machine learning-based models. Algorithms such as XGBoost have achieved an AUC of 0.82 for predicting 365-day cardiovascular events, while deep learning models like KFDeep have demonstrated exceptional performance in predicting kidney failure risk with an AUC of 0.946. Unlike static calculators, these AI-driven tools can process complex, multimodal data and continuously update risk profiles, paving the way for truly personalized and proactive medicine. In conclusion, this review advocates for a paradigm shift toward a holistic and technologically advanced framework for CKM management. Future efforts must focus on the deep integration of multimodal data, the development of novel AI-driven biomarkers, the implementation of refined SDoH-informed interventions, and the promotion of interdisciplinary collaboration to construct an efficient, equitable, and effective system for CKM screening and intervention.

Objective To explore the clinical efficacy of double beam double tunnel enhanced reconstruction technique in the treatment of knee anterior cruciate ligament(ACL)training injuries.Methods Twenty-nine cases of ACL injury of knee joint from January 2021 to December 2021 were retrospectively analyzed.All the cases were underwent ligament reconstruc-tion surgery.Cases were grouped by surgical technique:there were 14 patients in conventional reconstruction group,including 13 males and 1 female,aged from 22 to 31 years old with an average of(27.07±7.28)years old,autogenous hamstring tendon was used for ligament reconstruction.There were 15 patients in the enhanced reconstruction group,including 13 males and 2 females,aged from 25 to 34 years old with an average of(29.06±4.23)years old,double tunnel ligament reconstruction,the autogenous hamstring muscle was used as the anteromedial bundle,and the posterolateral bundle was replaced by a high-strength line.The difference between knee tibial anterior distance,Lysholm score,International Knee Literature Committee(IKDC)subjective score,Tegner motor level score and visual analog scale(VAS)at 6th and 12th months after the surgery,limb symmetry index(LSI)were recorded at the last follow-up and surgery-related adverse effects during follow-up.Results All patients were followed up,ranged from 13 to 15 months with an average of(13.7±0.8)months.There were no serious adverse reactions related to surgery during the period.There was no statistical difference between the preoperative general data and the observation index of the two groups(P＞0.05).The difference in tibial anterior distance at 6 and 12 months in the enhanced re-construction group(1.45±0.62)mm and(1.74±0.78)mm which were lower those that in the conventional reconstruction group(2.42±0.60)mm and(2.51±0.63)mm(P＜0.05).There was no significant difference in postoperative Lysholm score,Tegner motor level score,IKDC score,VAS,and limb symmetry index at the last follow-up(P＞0.05).Conclusion The enhanced recon-struction technique can more effectively maintain the stability of the knee joint and has no significant effect on the postoperative knee joint function compared with the traditional ligament reconstruction technique.The short-term curative effect is satisfac-tory,and it is suitable for the group with high sports demand.

Objective To verify the therapeutic effect of platelet lysate(PL)on spinal cord injury in rats.Methods Thirty male SD rats were randomly divided into the sham operation group,the injury group and the treatment group,with 10 rats in each group.Rats in the sham operation group did not smash the spinal cord after exposure;rats in the injury group were established the rat spinal cord injury model by smashing the spinal cord with a 20 g of self-made smashing machine weights from a height of 5 cm for 5 seconds after exposure;rats in the treatment group were given intraperitoneal injection of 2 mL of PL once a day for 19 days after established the spinal cord injury model.The hind limb function was evaluated by Basso Beattie Bresnahan(BBB)score and slope experiment;six rats were randomly selected from each group,and the spinal cords of the rats were taken on the 7th day after surgery for HE staining and electron microscopy scanning to observe their pathological changes.Results There were statistically significant differences in BBB scores on the 3rd,7th and 14th days after surgery among the three groups(P<0.05),and the BBB scores of the treatment group were higher than those of the injury group(P<0.05).There were statistically significant differences in the results of slope experiment on the 7th and 14th days after surgery between the treatment group and the injury group(P<0.01).HE staining showed that the neuronal degeneration and necrosis decreased,the cell swelling improved and the microglial phagocytosis decreased in the treatment group compared with those in the injury group.The results of electron microscopy showed that the astrocyte cytoplasmic swelling and local cell membrane damage were alleviated,and the mitochondrial swelling and degeneration in the treatment group were relieved compared with those in the injury group.Conclusion PL can improve the hind limb function and reduce the pathological changes after spinal cord injury in rats,which has therapeutic effect on spinal cord injury in rats.

Objective To explore the analgesic effect of Esketamine combined with sufentanil after laparoscopic myomectomy.Methods A total of 120 patients with laparoscopic myomectomy were divided into the routine group and the observation group according to a random number table.Patients in both groups were given routine general anesthesia.After operation,patients in the routine group were given self-controlled intravenous analgesia(sufentanil),with ondansetron hydrochloride to stop vomiting,while patients in the observation group were given self-controlled intravenous analgesia(Esketamine combined with sufentanil),with ondansetron hydrochloride to stop vomiting.The numbers of analgesia pump compressions of patients in both groups were compared.The pain visual analogue scale(VAS)score of patients at rest and activity 8 hours,12 hours,24 hours and 48 hours after operation in both groups were compared.The body stress responses of patients immediately and 48 hours after operation in both groups were compared,including adrenaline(E),norepinephrine(NE)and cortisol(Cor).The psychological stress responses of patients immediately and 48 hours after operation in both groups were compared,including anxiety and depression.The incidences of adverse reactions and outbreak pain were compared between the two groups.Results The number of analgesia pump compressions of patients in the observation group was less than that in the routine group(P<0.05).The VAS scores of patients at rest and activty in the two groups gradually decreased along with time(P<0.05),and the observation group was lower than the routine group(P<0.05).The levels of serum E,NE and Cor,anxiety and depression scores 48 hours after operation of patient in both groups were lower compared with those at immediately after surgery(P<0.05),and the observation group was lower than the routine group(P<0.05).The difference of above indicators of patients in the observation group were all higher than those in the routine group(P<0.05).There was no statistical difference in the incidence of adverse reactions between the two groups(P>0.05).The incidence of outbreak pain in the observation group was significantly lower than that in the routine group(P<0.05).Conclusion The use of Esketamine combined with sufentanil after laparoscopic myomectomy can reduce the number of analgesia pump compressions,relieve pain and stress reponse,reduce hypoanalgesia,with good safety.

Objective:To analyze the risk factors of Epstein-Barr virus(EBV)infection after allogeneic hematopoietic stem cell transplantation(allo-HSCT)and its impact on survival.Methods:The clinical data of 347 patients who underwent their first allo-HSCT in our hospital from January 2014 to June 2021 were retrospectively analyzed.Patients were divided into EBV(n=114)and Non-EBV(n=233)groups according to whether they were infected with EBV.The incidence of EBV infection after allo-HSCT was calculated,and the risk factors of EBV infection were analyzed.Results:A total of 114(32.8％)patients presented EBV infection(all peripheral blood EBV-DNA were positive).EBV infection occurred in 88 patients within 100 days after transplantation,which accounted for 77.2％of all patients with EBV infection.5 cases(1.44％)were confirmed as post-transplant lymphoproliferative disorder(PTLD).The median onset time of patients was 57(7-486)days after transplantation.Multivariate analysis showed that the use of ATG/ATG-F,occurrence of CMV viremia,and grade Ⅲ-Ⅳ aGVHD were risk factors for EBV infection.Furthermore,compared to BUCY,the use of intensified preconditioning regimens containing FA/CA was significantly increased the risk of EBV infection.Conclusion:EBV infection is a common complication after allo-HSCT.Intensified preconditioning regimens,use of ATG/ATG-F,CMV viremia and grade Ⅲ to Ⅳ aGVHD increase the risk of EBV infection after allo-HSCT.

Coronary heart disease is a physical and mental disease that is often combined with mental disorders such as depression,anxiety,sleep disorders,and stress,affecting the patient's prognosis.This review introduces the common mental disorders of patients with coronary heart disease,the types,characteristics and application status of digital and intelligent intervention technology,and analyzes the challenges of digital and intelligent intervention technology in the development of mental disorders in coronary heart disease,with a view to providing new information technology-driven nursing practice ideas and directions.

Purpose To prepare multifunctional SiO2@MnO2 nanoplatforms(SiO2@MnO2 NPs)with chemo dynamic therapy(CDT)efficacy and observe their effects on in vitro MRI and ultrasound imaging.Materials and Methods SiO2 nanoparticles(SiO2 NPs)were firstly prepared by dehydration-condensation reaction of ethyl orthosilicate in alcohol phase,and then SiO2@MnO2 NPs were prepared by reduction reaction of polyethylene glyco with KMnO4.The morphology of the two nanoparticles was observed,and the particle size and surface potential were detected.Methylene blue degradation verified the ability of SiO2@MnO2 NPs to produce toxic hydroxyl radicals,one of the reactive oxygen species.Simulation of different conditions to evaluate the effect of nanoparticles for in vitro MRI imaging.To observe the cellular uptake and the intracellular production of reactive oxygen species by SiO2@MnO2 NPs.CDT efficacy of nanoparticles was assessed on human pancreatic cancer cell PANC-1 cells.Results The SiO2@MnO2 NPs was successfully prepared,and the shell of fragmented MnO2 was observed to be encapsulated around the surface of spherical SiO2 NPs under transmission electron microscopy.The average size was(115.9±2.0)nm and the average zeta potential was(-32.51±0.30)mV.Methylene blue was gradually degraded with the increased concentration of SiO2@MnO2 NPs,suggesting the generation of toxic hydroxyl radicals.In vitro simulated tumor microenvironment,SiO2@MnO2 NPs could enhance the MRI and ultrasound imaging effect.Large amount of reactive oxygen species production was detected in PANC-1 cells and exerted CDT effect to kill tumor cells.Conclusion The successfully prepared multifunctional SiO2@MnO2 NPs possess favorable CDT effect and dual-mode imaging effect,which can also kill PANC-1 cells,laying a foundation for synergistic CDT and the construction of multifunctional nanoplatform.

Aim To investigate the mechanism of ligu aged 2 months of the same strain were used as the constilide (LIG) in delaying the senescence of auditory trol (Ctrl) group. Auditory brainstem response test was cortex and treating central presbycusis. Methods used to detect the auditory threshold of mice before and Forty C57BL/6J mice aged 13 months were randomly di after treatment. Levels of serum MDA and activity of vided into ligustilide low-dose(L-LIG) group, ligustil serum SOD were detected to display the level of oxidative ide medium-dose (M-LIG) group, ligustilide high-dose stress. The pathological changes of auditory cortex were (H-LIG) group and aging (Age) group, and 10 mice observed by HE staining. Ferroptosis was observed by

Receptor-interacting serine/threonine-protein kinase 1 (RIPK1) functions as a key regulator in inflammation and cell death and is involved in mediating a variety of inflammatory or degenerative diseases. A number of allosteric RIPK1 inhibitors (RIPK1i) have been developed, and some of them have already advanced into clinical evaluation. Recently, selective RIPK1i that interact with both the allosteric pocket and the ATP-binding site of RIPK1 have started to emerge. Here, we report the rational development of a new series of type-II RIPK1i based on the rediscovery of a reported but mechanistically atypical RIPK3i. We also describe the structure-guided lead optimization of a potent, selective, and orally bioavailable RIPK1i, 62, which exhibits extraordinary efficacies in mouse models of acute or chronic inflammatory diseases. Collectively, 62 provides a useful tool for evaluating RIPK1 in animal disease models and a promising lead for further drug development.