Objective: To evaluate the suitability of the existing hemolysis rate standards for locally processed red blood cell components by retrospectively analyzing 5-year hemolysis rate data at the end of storage. Methods: A total of 720 blood samples of three types of red blood cell components from our blood station from January 2019 to December 2023 were collected. Parameters included hemoglobin concentration (Hb), hematocrit (Hct), and free hemoglobin concentration (fHb). Hemolysis rate were taken as the control standard of 0.8% in accordance with the national standard. The hemolysis rates were compared against the national standard threshold of 0.8% (GB18469-2012), and annual trends of the detection parameters were observed. Results: The hemolysis rates (x-+s,%) of leukocyte-depleted whole blood at the end of storage were (0.038±0.023 8) in 2019, (0.049±0.039 5) in 2020, (0.043±0.040 7) in 2021, (0.049±0.030 7) in 2022, and (0.058±0.054 8) in 2023, respectively; The hemolysis rates (x-+s" />,%) of leukocyte-depleted suspended red blood cells at the end of storage were (0.093±0.050 2) in 2019, (0.086±0.049 5) in 2020, (0.123±0.072 3) in 2021, (0.122±0.052 1) in 2022, and (0.106±0.058 6) in 2023, respectively; The hemolysis rates (x-+s,%) of washed red blood cells at the end of storage were (0.127±0.038 2) in 2019, (0.150±0.066 5) in 2020, (0.121±0.052 2) in 2021, (0.124±0.038 9) in 2022, and (0.128±0.044 3) in 2023, respectively. Conclusion: Hemolysis rates at the end of blood storage of three red blood cell components were significantly lower than the limits specified in Quality Requirements for Whole Blood and Components (GB18469-2012), as well as standards from the EU, AABB and the United States. The results demonstrate excellent product quality control. A regional internal control standard of <0.2% is proposed for hemolysis rates at the end of storage.

Objective To comprehensively review the clinical research on the treatment of hyperlipidemia with traditional Chinese Medicine(TCM)through the evidence mapping,and to understand the distribution of evidence in this field. Methods Databases including CNKI,Wangfang,VIP,SinoMed,PubMed,Cochrane Library,and Embase were searched from January 2004 to December 2023 to collect clinical studies,systematic reviews/meta-analyses,guidelines and clinical pathways related to the treatment of hyperlipidemia with TCM. The results were analyzed and displayed in charts and graphs according to the screening criteria,and the Assessment of Multiple Systematic Reviews 2 (AMSTAR 2) tool and the Preferred Reporting Item for Systematic Review and Meta-analysis of Chinese herbal medicine (PRISMA-CHM) were used to evaluate the quality of the systematic review/meta-analysis. Results A total of 1223 studies were included in the analysis according to Population,Intervention,Comparison,Outcome and Study design(PICOS) principles,involving 920 RCTs,249 non-RCTs,49 systematic reviews/meta-analyses,and 5 guidelines/expert consensus. In recent years,the overall number of clinical research publications has shown a downward trend. Hyperlipidemia frequently occurs in middle-aged and elderly people,and age of onset tends to be younger. The sample size of randomized controlled studies is mostly concentrated in 60-300 cases. There are many types of clinical treatment regimens for the treatment of hyperlipidemia with TCM,among which TCM decoction (50.13％) and Chinese patent medicine (38.41％) account for a relatively high proportion,and TCM exercise therapy (0.51％) is the lowest treatment. Jiangzhi Decoction has attracted more attention in trial group of TCM decoction,while Xuezhikang Capsule has attracted more attention in trial group of Chinese patent medicine. In terms of methodological design,199 papers(21.63％) explicitly mentioned the method of generating random sequence,17 papers(1.85％) mentioned allocation concealment,37 papers (4.02％) mentioned blinding. The control group was dominated by the statins,including simvastatin and atorvastatin. The outcome indicators mainly include the total effective rate,TCM syndrome score,blood lipid level,coagulation index,and adverse reactions,while the attention of TCM characteristic efficacy,inflammation,oxidative stress,and vascular endothelial index were low. The methodological and reporting quality of the systematic review/Meta-analysis were generally not high. AMSTAR-2 evaluation was extremely low,and the average PRISMA-CHM score was 15. Conclusion TCM has certain advantages in the treatment of hyperlipidemia,but there is a lack of high-quality evidence-based proof,and more high-quality clinical studies are still needed to further provide evidence supports in the future. It has been suggested that more large-sample and multi-center clinical studies should be carried out in the future. We should formulate systematic reviews/Meta analysis and guidelines/expert consensus according to the guidelines of clinical practice issues,also consult international standards and regulations,enhance normativity and reliability to improve the quality of their evidence.

Objective To investigate the spatiotemporal distribution characteristics and potential influencing factors of newly diagnosed echinococcosis cases in Qinghai Province from 2016 to 2022, so as to provide insights into the formulation of the echinococcosis control strategy in Qinghai Province. Methods The number of individuals screened for echinococcosis, number of newly diagnosed echinococcosis cases, number of registered dogs and number of stray dogs were captured from the annual reports of echinococcosis control program in Qinghai Province from 2016 to 2022, and the detection of newly diagnosed echinococcosis cases was calculated. The number of populations, precipitation, temperature, wind speed, sunshine hours, average altitude, number of year-end cattle stock, number of year-end sheep stock, gross domestic product (GDP) per capita, and number of village health centers in each county (district) of Qinghai Province were captured from the Qinghai Provincial Statistical Yearbook, and county-level electronic maps in Qinghai Province were downloaded from the National Platform for Common Geospatial Information Services. The software ArcGIS 10.8 was used to map the distribution of newly diagnosed echinococcosis cases in Qinghai Province, and the spatial autocorrelation analysis of newly diagnosed echinococcosis cases was performed. In addition, the spacetime scan analyses of number of individuals screened for echinococcosis, number of newly diagnosed echinococcosis cases and geographical coordinates in Qinghai Province were performed with the software SaTScan 10.1.2, and the spatial stratified heterogeneity of the detection of newly diagnosed echinococcosis cases was investigated with the software GeoDetector. Results A total of 6 569 426 residents were screened for echinococcosis in Qinghai Province from 2016 to 2022, and 5 924 newly diagnosed echinococcosis cases were found. The detection of newly diagnosed echinococcosis cases appeared a tendency towards a decline over years from 2016 to 2022 (χ² = 11.107, P < 0.01), with the highest detection in Guoluo Tibetan Autonomous Prefecture in 2017 (82.12/10⁵). There were spatial clusters in the detection of newly diagnosed echinococcosis cases in Qinghai Province from 2016 to 2018 (Moran’s I = 0.34 to 0.65, all Z values > 1.96, all P values < 0.05), and the distribution of newly diagnosed echinococcosis cases appeared random distribution from 2019 to 2022 (Moran’s I = −0.09 to 0.04, all Z values < 1.96, all P values > 0.05). Local spatial autocorrelation analysis showed high-high clusters and low-low clusters in the detection of new diagnosed echinococcosis cases in Qinghai Province from 2016 to 2022, and space-time scan analysis showed that the first most likely cluster areas of newly diagnosed echinococcosis cases in Qinghai Province from 2016 to 2022 were mainly distributed in Yushu Tibetan Autonomous Prefecture and Guoluo Tibetan Autonomous Prefecture. GeoDetector-based analysis of the driving factors for the spatial stratified heterogeneity of detection of newly diagnosed echinococcosis cases in Qinghai Province showed that average altitude, number of village health centers, number of cattle and sheep stock, GDP per capita, annual average sunshine hours, and annual average temperature had a strong explanatory power for the spatial distribution of newly diagnosed echinococcosis cases, with q values of 0.630, 0.610, 0.600, 0.590, 0.588, 0.537 and 0.526, respectively. Conclusions The detection of newly diagnosed echinococcosis cases appeared a tendency towards a decline in Qinghai Province over years from 2016 to 2022, showing spatial clustering. Targeted control measures are required in cluster areas of newly diagnosed echinococcosis cases for further control of the disease.

177Lu-prostate specific membrane antigen(PSMA)radio-ligand therapy has been approved abroad for advanced prostate cancer and has been in several clinical trials in China.Based on domestic clinical practice and experimental data and referred to international experience and viewpoints,the expert group forms a consensus on the clinical application of 177Lu-PSMA radio-ligand therapy in prostate cancer to guide clinical practice.

Background::Immunoglobulin G4-related disease (IgG4-RD) is a recently recognized immune-mediated disorder that can affect almost any organ in the human body. IgG4-RD can be categorized into proliferative and fibrotic subtypes based on patients’ clinicopathological characteristics. This study aimed to compare the clinical manifestations, laboratory findings, and treatment outcomes of IgG4-RD among different subtypes.Methods::We prospectively enrolled 622 patients with newly diagnosed IgG4-RD at Peking Union Medical College Hospital from March 2011 to August 2021. The patients were divided into three groups according to their clinicopathological characteristics: proliferative, fibrotic, and mixed subtypes. We compared demographic features, clinical manifestations, organ involvement, laboratory tests, and treatment agents across three subtypes. We then assessed the differences in treatment outcomes among 448 patients receiving glucocorticoids alone or in combination with immunosuppressants. Moreover, risk factors of relapse were revealed by applying the univariate and multivariate Cox regression analysis.Results::We classified the 622 patients into three groups consisting of 470 proliferative patients, 55 fibrotic patients, and 97 mixed patients, respectively. We found that gender distribution, age, disease duration, and frequency of allergy history were significantly different among subgroups. In terms of organ involvement, submandibular and lacrimal glands were frequently involved in the proliferative subtype, while retroperitoneum was the most commonly involved site in both fibrotic subtype and mixed subtype. The comparison of laboratory tests revealed that eosinophils ( P = 0.010), total IgE ( P = 0.006), high-sensitivity C-reactive protein ( P <0.001), erythrocyte sedimentation rate ( P <0.001), complement C4 ( P <0.001), IgG ( P = 0.001), IgG1 (P <0.001), IgG4 (P <0.001), and IgA ( P <0.001), at baseline were significantly different among three subtypes. Compared with proliferative and mixed subtypes, the fibrotic subtype showed the lowest rate of relapse (log-rank P = 0.014). Conclusions::Our study revealed the differences in demographic characteristics, clinical manifestations, organ involvement, laboratory tests, treatment agents, and outcomes across proliferative, fibrotic, and mixed subtypes in the retrospective cohort study. Given significant differences in relapse-free survival among the three subtypes, treatment regimens, and follow-up frequency should be considered separately according to different subtypes.Trial Registration::ClinicalTrials. gov, NCT01670695.

Objective:To evaluate the diagnostic efficacy of the novel prostate specific membrane antigen (PSMA)-targeted PET imaging agent 18F-AlF-P16-093 in combination with multiparametric MRI (mpMRI) for prostate cancer (PCa), and to explore its application in guiding transperineal puncture biopsy. Methods:A retrospective analysis was conducted on the clinical and pathological data of 36 patients diagnosed as PCa (age: 68-76 years) who underwent 18F-AlF-P16-093 PET/CT and mpMRI examinations at the First Affiliated Hospital of Guangzhou Medical University from August 2023 to March 2024. The entire prostate was divided into 12 regions based on biopsy localization. Imaging evaluations were performed using PET/CT and mpMRI at the lesion level, with biopsy pathology as the gold standard. The correlations between mpMRI scores, PET/CT scores and pathological diagnosis results were evaluated by Phi coefficient analysis. Diagnostic efficacy was assessed by ROC curve analysis. Logistic regression was used to determine the impact of bleeding on image interpretation. Results:18F-AlF-P16-093 PET/CT showed a moderate positive correlation with pathological diagnosis result ( Phi=0.415, P<0.001), which was superior to mpMRI ( Phi=0.338, P<0.001). The diagnostic efficacy of PET single-modality model was superior to mpMRI in all indicators. The combination of 18F-AlF-P16-093 PET/CT with mpMRI significantly improved diagnostic specificity and positive predictive value, with the diagnostic specificity of the PET+ T 2 weighted imaging (WI)+ diffusion WI (DWI) and PET+ T 2WI+ DWI+ apparent diffusion coefficient (ADC) combinations exceeding 90%, and the positive predictive value exceeding 80%. Bleeding did not significantly affect the diagnosis of PCa by mpMRI and PET/CT (odds ratio ( OR): 0.463-0.785, all P>0.05). Conclusion:18F-AlF-P16-093 PET/CT is superior to mpMRI in the detection and diagnostic efficacy of PCa lesions, and the combination of 18F-AlF-P16-093 PET with mpMRI can further improve diagnostic specificity and positive predictive value, which is of guiding significance for targeted prostate biopsy.

ObjectiveTo compare the differences in clinical characteristics between kidney deficiency and stasis obstruction syndrome and damp-heat stasis obstruction syndrome in patients with ankylosing spondylitis （AS）， thereby providing reference for clinical differentiation and treatment. MethodsThe clinical data of 2339 patients with AS were collected， including 1075 cases of kidney deficiency and stasis obstruction syndrome and 1264 cases of damp-heat stasis obstruction syndrome. The basic information including age， gender， course of disease， history of ophthalmia， family history and human leukocyte antigen B27 （HLA-B27） positive history， Bath ankylosing spondylitis disease activity index （BASDAI） score， Bath ankylosing spondylitis functional index （BASFI） score， Bath ankylosing spondylitis measurement index （BASMI） score， Depression Anxiety Stress Scale 21 （DASS-21） score， single symptom score in terms of spinal pain， peripheral joint pain， tendon tenderness， morning stiffness degree and morning stiffness time， patient-reported outcomes including patient global assessment （PGA） score， chronic disease therapy function-fatigue scale （FACIT-F） score and night pain visual analog scale （VAS） score， laboratory indicators including serum C-reactive protein （CRP） and erythrocyte sedimentation rate （ESR）， and CT grading of sacroiliitis were measured and compared between groups. ResultsPatients with kidney deficiency and stasis obstruction syndrome were older and had a longer course of disease （P＜0.01）. The BASDAI， BASFI and BASMI scores of the patients with kidney deficiency and stasis obstruction syndrome were 3.84±1.79， 2.78±2.00 and 3.42±2.36， respectively， while those in patients with damp-heat stasis obstruction syndrome were 4.30±1.99， 3.43±2.12， and 2.92±1.76. The BASDAI score， BASFI score， PGA score， FACIT-F score， spinal pain score， peripheral arthralgia score， tendon tenderness score， morning stiffness degree score， depression score， anxiety score， and stress score in patients with damp-heat stasis obstruction syndrome were all higher than those with kidney deficiency and stasis obstruction syndrome， with longer duration of morning stiffness and higher CRP （P＜0.05 or P＜0.01）. BASMI score and night pain VAS score were more higher in patients with kidney deficiency and stasis obstruction syndrome （P＜0.01）. There was no significant difference in the ESR level and CT grading of the sacroiliac joint between the two groups （P＞0.05）. ConclusionAS patients with kidney deficiency and stasis obstruction syndrome have poorer spinal mobility， while those with damp-heat stasis obstruction syndrome have higher disease activity， poorer physical function， and are more prone to adverse psychological reactions.

Objective:Currently,patients with pre-exsiting donor-specific antibody(DSA)are prone to antibody-mediated rejection(AMR)after surgery and are at a relatively high risk of postoperative complications and graft failure.The risk of postoperative complications and graft failure is relatively high.This study aims to discuss the clinical outcome of DSA-positive kidney transplantation and analyze the role and safety of preoperative pretreatment in DSA-positive kidney transplantation,providing single-center treatment experience for DSA-positive kidney transplantation. Methods:We retrospectively analyzed the clinical data of 15 DSA-positive kidney transplants in the Department of Renal Transplantation of First Affiliated Hospital of Zhengzhou University from August 2017 to July 2022.Eight cases were organ donation after citizen's death(DCD)kidney transplant recipients,of which 3 cases in the early stage were not treated with preoperative desensitisation therapy(DCD untreated group,n=3),and 5 recipients were treated with preoperative rituximab desensitisation(DCD preprocessing group,n=5).The remaining 7 cases were living related donors recipients(LRD)who received preoperative desensitisation treatment with rituximab and plasma exchange(LRD preprocessing group,n=7).We observed and recorded the incidence of complications with changes in renal function and DSA levels in the recipients and the survival of the recipients and transplanted kidneys at 1,3 and 5 years,and to compare the differences in recovery and postoperative complications between 3 groups. Results:All 15 recipients were positive for preoperative panel reactive antibody(PRA)and DSA and were treated with methylprednisolone+rabbit anti-human thymocyte immunoglobulin induction before kidney transplantation.DCD untreated group all suffered from DSA level rebound,delayed renal graft function(DGF)and rejection reaction after surgery.After the combined treatment,DSA level was reduced and the graft renal function returned to normal.The DCD preprocessing group were all without antibody rebound,1 recipient developed DGF and the renal function returned to normal after plasmapheresis,and the remaining 4 recipients recovered their renal function to normal within 2 weeks after the operation.In the LRD preprocessing group,2 cases had antibody rebound and 1 case had rejection,but all of them recovered to normal after treatment,and DSA was maintained at a low level or even disappeared.The incidence of DGF and rejection in the DCD untreated group were significantly higher than that in the DCD preprocessing group and the LRD preprocessing group;and there were no significant difference in the incidence of postoperative haematuria,proteinuria,bacterial and fungal infections,and BK virus infection between the 3 groups(all P>0.05).A total of 11 of the 15 recipients were followed up for more than 1 year,6 for more than 3 years,and 1 for more than 5 years,and the survival rates of both the recipients and the transplanted kidneys were 100%. Conclusion:Effective preoperative pretreatment with desensitization therapy can effectively prevent antibody rebound in DSA-positive kidney transplantation and reduce perioperative complications.

Presynaptic dopaminergic PET imaging is a useful method for the diagnosis of parkinsonism. Based on the expert consensus on operation and clinical application of dopamine transporter brain PET imaging technology published in 2020, this paper further recommends the relevant elements of result interpretation of presynaptic dopaminergic PET imaging.

OBJECTIVE To establish an UPLC-MS/MS method for the determination of the concentrations of cyperenone and α-cyperone in rat plasma and to study the pharmacokinetics. METHODS Gradient elution was carried out on a Phenomennex C18(150 mm×2.0 mm, 3 μm) column with acetonitrile-water as mobile phase. The column temperature was 30 ℃, injection volume was 1 μL, osthenite was used as the internal standard, electrospray ion source and positive ion mode were used. The m/z values of cyperenone, α-cyperone and osthenite were 219.1/135.1, 219.1/111.0 and 245.0/123.0, respectively. The plasma concentrations of cyperenone and α-cyperone were measured, and the main pharmacokinetic parameters were calculated using DAS 2.0 software. RESULTS The linear relationship of cyperenone was good in the range of 10-500 ng·mL-1(r=0.991 0), and the linear relationship of α-cyperone was good in the range of 2.5-300 ng·mL-1(r=0.994 1), RSDs of intra-day precision were less than 9.45%. RSDs of daytime precision were less than 9.09%. The recoveries were greater than 86.79%. After intragastric administration of essential oil extract(20 mg·kg-1) from Cyperus rotundus L. in SD rats. The pharmacokinetic parameters of Cmax, AUC0-∞ and MRT(0-∞) of cyperenone and α-cyperone were (8 862.59±1 106.81)ng·L-1, (7 060.94±774.25)ng·L-1·h, (3.21±0.72)h and (934.69±106.81)ng·L-1, (792.26±74.52)ng·L-1·h, (4.94± 0.82)h, respectively. CONCLUSION The established method can be used for the rapid and accurate determination of the concentration of cyperenone and α-cyperone in plasma, and can be used for the pharmacokinetic study of cyperenone and α-cyperone in rats in vivo.