Objective To explore the influencing factors of coronary artery lesion severity in patients with acute coronary syndrome (ACS). Methods Clinical data of ACS patients admitted to Zhongshan Hospital, Fudan University from December 2017 to December 2019 were consecutively collected. The modified Gensini score was used to assess the severity of coronary artery lesions. Univariate and multivariate linear regression analyses were performed to identify independent factors associated with coronary artery lesion severity. Results A total of 1 689 ACS patients were included, with an average age of (64.04±11.45) years; 1 353 (80.11%) were male, and the mean modified Gensini score was (8.12±4.03). Multivariate linear regression analysis revealed that sex (β＝0.97, P＝0.001), age (β＝0.03, P＝0.021), estimated glomerular filtration rate (eGFR; β＝－0.03, P＜0.001), low-density lipoprotein cholesterol (LDL-C; β＝0.58, P＜0.001), apolipoprotein A1 (Apo A1; β＝－1.28, P＝0.012), lipoprotein(a) [Lp(a); β＝0.001, P＝0.033], and glycated hemoglobin A_1C (HbA_1C; β＝0.45, P＜0.001) were independent influencing factors of the modified Gensini score. Conclusions Metabolic indicators, including Apo A1, LDL-C, HbA_1C, and Lp(a), may serve as risk factors for coronary artery lesion severity in ACS patients, with Apo A1 demonstrating the strongest impact.

Osteoarthritis （OA） and stroke are common clinical diseases that reduce patients' quality of life and place a burden on families and society. Ruyi Zhenbaowan， a classic prescription in Tibetan medicine， have the functions of clearing heat， awakening the brain and opening orifices， relaxing tendons and promoting meridian circulation， and eliminating yellow water. Clinically， they are used to treat osteoarthritis， post-stroke sequelae， neuropathic pain， and other related conditions. Modern pharmacological studies have demonstrated their anti-inflammatory， analgesic， and nerve-repairing effects. However， current research remains insufficient regarding the appropriate indications， timing， and efficacy of this medicine in treating relevant diseases. To enhance clinicians' understanding of this medicine and promote its standardized and rational clinical use， a panel of national experts， including clinical specialists， Tibetan medicine practitioners， pharmacologists， and methodologists， formulated this consensus based on clinical experience and evidence-based practice. The Cochrane systematic review framework， the Grading of Recommendations Assessment， Development and Evaluation （GRADE） system， and the nominal group method were employed to generate seven graded recommendations and 19 consensus-based suggestions. These recommendations clearly define the key points in the clinical application of Ruyi Zhenbaowan， including therapeutic indications， dosage and administration， treatment duration， and medication safety. The consensus specifically addresses the clinical efficacy， appropriate timing of administration， dosage strategies， treatment cycles， and combination medication strategies for treating osteoarthritis and stroke and provides an overview of safety considerations. The aim is to provide standardized guidance for hospitals and healthcare institutions nationwide to ensure the rational application of Ruyi Zhenbaowan in the treatment of osteoarthritis and stroke， reduce medication-related risks， and further leverage its clinical advantages. This consensus has been approved and issued by the China Association of Chinese Medicine， with the standard number GS/CACM 369-2024.

Objective: To investigate the efficacy and safety of robot-assisted modified Y-shaped ileal orthotopic neobladder reconstruction，so as to provide reference for clinical practice. Methods: The clinical data of 44 patients who underwent robot-assisted laparoscopic radical cystectomy，lymph node dissection，and modified Y-shaped ileal orthotopic neobladder reconstruction during Feb.2020 and Aug.2022 were retrospectively analyzed.The surgical position，Trocar position，and key surgical steps were reported.The perioperative conditions，postoperative complications，neobladder volume，maximum urinary flow rate，postvoid residual，renal function，and urinary control function were recorded. Results: All 44 surgeries were successfully completed，with operation time of (314.32±51.02) min，modified Y-shaped ileal orthotopic neobladder reconstruction time of (103.52±9.56) min，and bleeding volume of (128.18±57.27) mL.The postoperative time for fluid intake was (4.16±0.86) days，catheter indwelling time was (14.02±3.20) days，and patients were discharged 1 to 2 days after catheter removal.Clavien-Dindo grade Ⅱ and Ⅲ complications occurred in 15 and 2 patients，respectively.During the follow-up of (20.77±5.90) months，dysuria occurred in 1 case，urethral calculi in 2 cases，and incomplete bowel obstruction in 2 cases. The postoperative neobladder capacity was (195.75±15.51) mL，maximal urinary flow rate (20.30±2.05) mL/s，postvoid residual (19.86±13.80) mL and serum creatinine (81.98±25.97) μmol/L. The incidence of daytime and nocturnal urinary incontinence 3，6 and 12 months after operation were 20.45% and 29.55%，11.36% and 18.18%，and 4.55% and 9.09%，respectively. Conclusion: Robot-assisted modified Y-shaped ileal orthotopic neobladder reconstruction has favorable efficacy and safety，and low incidence of postoperative complications，which can be applied in clinical practice.

Objective: To investigate the genetic basis of RhD-negative phenotype in the blood donor population of Nantong City. Methods: RHD genotyping was performed on 386 randomly selected RhD-negative donor samples (from a total of 676 RhD-negative donors identified between January 20, 2023, and June 28, 2024) using polymerase chain reaction (PCR), and the inconclusive results were confirmed by nucleotide sequencing. Results: Ten RHD allele types were identified: The complete deletion variant RHD 01N.01 was predominant (64.25%, 248/386); followed by RHD 01EL.01 (19.69%, 76/386). RHD 01N.03, RHD 01N.04, RHD 01N.16 and RHD 01EL.32 were frequently observed., RHD 01EL.02, RHD 01EL.08, RHD 01EL.37 and RHD 01N.25 were rare, and two exon deletion variants remained uncharacterized. The phenotypic distribution of RhD-negative blood donors was ccee (55.44%)>Ccee(31.09%)>ccEe(5.96%)>CCee(5.44%)>CcEe(1.81%)>CcEE(0.26%), and the antigen distribution trend was e(99.74%)>c(94.56%)>C(38.60%)>E(8.03%). A correlation was observed between RHD genotypes and RhCE phenotypes. Conclusion: The Nantong blood donor population exhibits unique RHD gene polymorphisms. Integrating RhCE serological phenotyping with RHD genotyping is essential for ensuring transfusion safety.

Objective: To investigate the genetic basis of RhD-negative phenotype in the blood donor population of Nantong City. Methods: RHD genotyping was performed on 386 randomly selected RhD-negative donor samples (from a total of 676 RhD-negative donors identified between January 20, 2023, and June 28, 2024) using polymerase chain reaction (PCR), and the inconclusive results were confirmed by nucleotide sequencing. Results: Ten RHD allele types were identified: The complete deletion variant RHD 01N.01 was predominant (64.25%, 248/386); followed by RHD 01EL.01 (19.69%, 76/386). RHD 01N.03, RHD 01N.04, RHD 01N.16 and RHD 01EL.32 were frequently observed., RHD 01EL.02, RHD 01EL.08, RHD 01EL.37 and RHD 01N.25 were rare, and two exon deletion variants remained uncharacterized. The phenotypic distribution of RhD-negative blood donors was ccee (55.44%)>Ccee(31.09%)>ccEe(5.96%)>CCee(5.44%)>CcEe(1.81%)>CcEE(0.26%), and the antigen distribution trend was e(99.74%)>c(94.56%)>C(38.60%)>E(8.03%). A correlation was observed between RHD genotypes and RhCE phenotypes. Conclusion: The Nantong blood donor population exhibits unique RHD gene polymorphisms. Integrating RhCE serological phenotyping with RHD genotyping is essential for ensuring transfusion safety.

BACKGROUND:Primary cortical neurons and microglial cells play a crucial role in exploring cell therapies for neurological disorders,and most of the current methods for obtaining the two types of cells are cumbersome and require separate extraction.It is therefore crucial to find a convenient and rapid method to extract both types of cells simultaneously. OBJECTIVE:To explore a novel method for simultaneous extraction of primary cortical neurons and microglial cells. METHODS:Newborn suckling SD rats were taken within 24 hours.The brain was removed and placed in a dish with DMEM,and the pia mater was removed for later use.Primary neurons were extracted from the same brain tissue,and then the remaining brain tissue was used to extract microglial cells.The whole process was performed on ice.Extraction and culture steps of primary cortical neurons:The cerebral cortex was taken 2.0-3.0 mm with forceps,and the tissue was digested with papain for 20 minutes.After aborting digestion,the blown tissue presented an adherent tissue suspension.The supernatant cell suspension was obtained,filtered,and dispensed into 15 mL centrifuge tubes.After centrifugation and re-suspension,the cells were inoculated onto 6-well plate crawls coated with L-polylysine.Neuronal morphology was observed at 1-day intervals,and staining could be performed for identification using immunofluorescence staining of MAP2 and β-Tubulin by day 7.Microglia extraction and culture steps:The remaining brain tissue at 8-10 mm thick was subjected to microglial cell extraction,digested by trypsin for 20 minutes.After digestion was stopped,the tissue was blown to a homogenate,and then the homogenate was transferred to the culture bottle for culture.On day 14,the culture flasks were sealed and subjected to constant temperature horizontal shaking for 2 hours.Microglial cells were shed in the supernatant.Purified microglial cells were taken and continued to be cultured for 3 days for identification by Iba1 immunofluorescence staining. RESULTS AND CONCLUSION:(1)After 24 hours of culture,the neurons were adherent to the wall,the cytosol was enlarged,and some neurons developed synapses.After 3 and 5 days of culture,the cytosol was further enlarged,and most of the neurons were in the form of synapses,and some neurons were growing in clusters.On day 7,neuronal synapses were prolonged and thickened,and they were connected with each other to form a network.The neurons were identified by β-Tubulin and MAP2 immunofluorescence staining.(2)The cells grew close to the wall on day 1 of culture.On days 3,5,and 7,the density of microglial cells was small,and the cell morphology was bright oval or round,but the cells basically grew in clumps on the upper layer of other cells.On day 10,the density of microglial cells increased significantly.On day 14,microglial cells grew in dense clumps on the upper layer of other cells,and then they could be isolated and purified.The isolated and purified cells were taken and re-cultured to day 3 and identified as microglial cells by Iba1 immunofluorescence;their purity was greater than 95%.(3)The results show that primary cortical neurons and microglial cells obtained by this method after extraction and culture are of high purity,good morphology,and high viability.

With the widespread use of antibiotics, drug-resistant bacterial infections have become a significant threat to human health. Finding new antibacterial strategies that can effectively control drug-resistant bacterial infections has become an urgent task. Unlike small molecule drugs that target bacterial proteins, antisense oligonucleotide (ASO) can target genes related to bacterial resistance, pathogenesis, growth, reproduction and biofilm formation. By regulating the expression of these genes, ASO can inhibit or kill bacteria, providing a novel approach for the development of antibacterial drugs. To overcome the challenge of delivering antisense oligonucleotide into bacterial cells, various drug delivery systems have been applied in this field, including cell-penetrating peptides, lipid nanoparticles and inorganic nanoparticles, which have injected new momentum into the development of antisense oligonucleotide in the antibacterial realm. This review summarizes the current development of small nucleic acid drugs, the antibacterial mechanisms, targets, sequences and delivery vectors of antisense oligonucleotide, providing a reference for the research and development of antisense oligonucleotide in the treatment of bacterial infections.

Objective To analyze the characteristics of adverse drug reactions （ADR） reported in Sixth People’s Hospital South Campus, Shanghai Jiaotong University from 2021 to 2023, to provide reference for promoting rational clinical drug use. Methods ADR data reported in our hospital were collected retrospectively, including patients’ basic information, drugs causing adverse reactions, types of adverse reactions and outcomes. Descriptive analysis methods were used to summarize and analyze the data. Results A total of 979 cases of ADR were reported in our hospital from 2021 to 2023. The highest proportion of patients with ADR occurred in the age range of 31 to 50, and more male patients （63.5%）. The top five drugs involved with adverse reactions were antibiotics （48.8%）, Chinese medicine injections（19.2%）, vitamins（7.5%）, Chinese traditional medicine（7.2%）, equine tetanus immunoglobulin（6.3%）. Among antibiotics, cefuroxime, ceftazidime and cefotiam were the majority. The organs/systems involved in all ADR were mainly skin and accessories damage （55.4%）. The clinical manifestations were rash, itching, and maculopapular rash. Conclusion From 2021 to 2023, the most common drugs causing adverse drug reactions in our hospital were mainly antibacterial drugs, and the rational clinical use of antibacterial drugs still needs to be concerned.

Disorders of consciousness (DOC) are pathological conditions characterized by severely suppressed brain function and the persistent interruption or loss of consciousness. Accurate diagnosis and evaluation of DOC are prerequisites for precise treatment. Traditional assessment methods are primarily based on behavioral scales, which are inherently subjective and rely on observable behaviors. Moreover, traditional methods have a high misdiagnosis rate, particularly in distinguishing minimally conscious state (MCS) from vegetative state/unresponsive wakefulness syndrome (VS/UWS). This diagnostic uncertainty has driven the exploration of objective, reliable, and efficient assessment tools. Among these tools, electroencephalography (EEG) has garnered significant attention for its non-invasive nature, portability, and ability to capture real-time neurodynamics. This paper systematically reviews the application of EEG biomarkers in DOC assessment. These biomarkers are categorized into 3 main types: resting-state EEG features, task-related EEG features, and features derived from transcranial magnetic stimulation-EEG (TMS-EEG). Resting-state EEG biomarkers include features based on spectrum, microstates, nonlinear dynamics, and brain network metrics. These biomarkers provide baseline representations of brain activity in DOC patients. Studies have shown their ability to distinguish different levels of consciousness and predict clinical outcomes. However, because they are not task-specific, they are challenging to directly associate with specific brain functions or cognitive processes. Strengthening the correlation between resting-state EEG features and consciousness-related networks could offer more direct evidence for the pathophysiological mechanisms of DOC. Task-related EEG features include event-related potentials, event-related spectral modulations, and phase-related features. These features reveal the brain’s responses to external stimuli and provide dynamic information about residual cognitive functions, reflecting neurophysiological changes associated with specific cognitive, sensory, or behavioral tasks. Although these biomarkers demonstrate substantial value, their effectiveness rely on patient cooperation and task design. Developing experimental paradigms that are more effective at eliciting specific EEG features or creating composite paradigms capable of simultaneously inducing multiple features may more effectively capture the brain activity characteristics of DOC patients, thereby supporting clinical applications. TMS-EEG is a technique for probing the neurodynamics within thalamocortical networks without involving sensory, motor, or cognitive functions. Parameters such as the perturbational complexity index (PCI) have been proposed as reliable indicators of consciousness, providing objective quantification of cortical dynamics. However, despite its high sensitivity and objectivity compared to traditional EEG methods, TMS-EEG is constrained by physiological artifacts, operational complexity, and variability in stimulation parameters and targets across individuals. Future research should aim to standardize experimental protocols, optimize stimulation parameters, and develop automated analysis techniques to improve the feasibility of TMS-EEG in clinical applications. Our analysis suggests that no single EEG biomarker currently achieves an ideal balance between accuracy, robustness, and generalizability. Progress is constrained by inconsistencies in analysis methods, parameter settings, and experimental conditions. Additionally, the heterogeneity of DOC etiologies and dynamic changes in brain function add to the complexity of assessment. Future research should focus on the standardization of EEG biomarker research, integrating features from resting-state, task-related, and TMS-EEG paradigms to construct multimodal diagnostic models that enhance evaluation efficiency and accuracy. Multimodal data integration (e.g., combining EEG with functional near-infrared spectroscopy) and advancements in source localization algorithms can further improve the spatial precision of biomarkers. Leveraging machine learning and artificial intelligence technologies to develop intelligent diagnostic tools will accelerate the clinical adoption of EEG biomarkers in DOC diagnosis and prognosis, allowing for more precise evaluations of consciousness states and personalized treatment strategies.

OBJECTIVE To study the effects of enteral immune microecological nutrition combined with ω-3 fish oil fat emulsion on postoperative recovery， immune function， liver function and inflammation level in patients with hepatocellular carcinoma resection， as well as the safety of the medication. METHODS A total of 106 patients with hepatocellular carcinoma admitted to our Hospital from June 2020 to December 2023 were selected and divided into control group and study group according to the random number table method， with 53 cases in each group. After undergoing hepatocellular carcinoma resection， control group was given Intacted protein enteral nutrition solution+Enhanced enteral immune microecological nutrition， and the study group was given ω-3 fish oil fat emulsion injection based on the control group. The clinical indicators （postoperative exhaust time， defecation time， postoperative ambulation， and hospital stay）， liver function indicators [alanine transaminase （ALT）， lactate dehydrogenase （LDH）， aspartate transaminase （AST）]， immune function indexes （CD3+ ， CD4+ ， CD8+ ， CD4+/CD8+）， inflammatory factor indexes [tumor necrosis factor-α （TNF-α）， interleukin-1β （IL-1β）， IL-6， IL-8]， and indicators of intestinal mucosal barrier [D-lactic acid， intestinal fatty acid binding protein （I-FABP）] were compared between 2 groups， and the occurrence of ADR was recorded. RESULTS Compared with the control group， the postoperative exhaust time， postoperative defecation time， and hospital stay of the study group were shortened significantly， and postoperative ambulation increased significantly （P＜0.05）. After treatment， ALT， LDH， AST， CD8+， inflammatory factors， D-lactic acid and I-FABP of 2 groups were significantly lower than before treatment， and the study group was significantly lower than the control group （P＜0.05）； CD4+， CD3+， and CD4+/CD8+ of two groups were significantly higher than before treatment， and the study group was significantly higher than the control group （P＜0.05）. There was no significant difference in the incidence of ADR between 2 groups （P＞0.05）. CONCLUSIONS Enteral immune microecological nutrition combined with ω-3 fish oil fat emulsion injection can shorten the recovery time of patients after hepatocellular carcinoma resection， improve immune function， reduce inflammatory response， and improve liver function with good safety.