[Objective] To investigate the factors associated with alanine aminotransferase (ALT) abnormalities in multi-ethnic blood donors across five Zang autonomous prefectures in the plateau regions of Qinghai Province, and to provide evidence for ensuring blood safety and formulating screening strategies. [Methods] A retrospective analysis was performed on the ALT abnormal test results of blood donors in the Zang autonomous prefectures of Qinghai from 2022 to 2024. The correlations between ALT levels and factors including gender, age, altitude, and infectious markers were investigated. [Results] The overall ALT unqualified rate among blood donors in this region was 9.01%. Significant differences in ALT levels were observed across genders and age groups (P<0.05). Variations in ALT abnormality rates were also noted among different plateau regions (P<0.05). Overall, ALT values exhibited an increasing trend with rising altitude. The average ALT unqualified rates were 11.19% in Zang donors, 7.96% in Han donors, and 4.79% in donors from other ethnic groups (P<0.05). No statistically significant association was observed between ALT abnormality and the presence of HBV/HCV infectious markers (P>0.05). [Conclusion] In the plateau areas of Qinghai, multi-ethnic blood donors have a relatively high ALT levels and ALT unqualified rates, showing distinct regional characteristics. ALT elevation in voluntary blood donors is related to non-pathological factors such as gender, age, and dietary habits, but not to infectious indicators.

OBJECTIVE: Anemoside B4 (AB4), the most abundant triterpenoidal saponin isolated from Pulsatilla chinensis, inhibited influenza virus FM1 or Klebsiella pneumoniae-induced pneumonia. However, the anti-SARS-CoV-2 effect of AB4 has not been unraveled. Therefore, this study aimed to determine the antiviral activity and potential mechanism of AB4 in inhibiting human coronavirus SARS-CoV-2 in vivo and in vitro. METHODS: The cytotoxicity of AB4 was evaluated using the Cell Counting Kit-8 (CCK8) assay. SARS-CoV-2 infected HEK293T, HPAEpiC, and Vero E6 cells were used for in vitro assays. The antiviral effect of AB4 in vivo was evaluated by SARS-CoV-2-infected hACE2-IRES-luc transgenic mouse model. Furthermore, label-free quantitative proteomics and bioinformatic analysis were performed to explore the potential antiviral mechanism of action of AB4. Type I IFN signaling-associated proteins were assessed using Western blotting or immumohistochemical staining. RESULTS: The data showed that AB4 reduced the propagation of SARS-CoV-2 along with the decreased Nucleocapsid protein (N), Spike protein (S), and 3C-like protease (3CLpro) in HEK293T cells. In vivo antiviral activity data revealed that AB4 inhibited viral replication and relieved pneumonia in a SARS-CoV-2 infected mouse model. We further disclosed that the antiviral activity of AB4 was associated with the enhanced interferon (IFN)-β response via the activation of retinoic acid-inducible gene I (RIG-1) like receptor (RLP) pathways. Additionally, label-free quantitative proteomic analyses discovered that 17 proteins were significantly altered by AB4 in the SARS-CoV-2 coronavirus infections cells. These proteins mainly clustered in RNA metabolism. CONCLUSION Our results indicated that AB4 inhibited SARS-CoV-2 replication through the RLR pathways and moderated the RNA metabolism, suggesting that it would be a potential lead compound for the development of anti-SARS-CoV-2 drugs.

OBJECTIVE To analyze the metabolites of Zhideke granules and speculate its metabolic pathway in rats in vivo. METHODS Male SD rats were randomly divided into blank group and administration group （Zhideke granules， 9.45 g/kg）； they were given ultrapure water or relevant medicine， twice a day， every 6-8 h， for 3 consecutive days. Serum， urine and feces samples of rats were collected， and their metabolites were identified by UPLC-Q-Exactive-MS technique after intragastric administration of Zhideke granules； their metabolic pathways were speculated. RESULTS After intragastric administration of Zhideke granules， 16 prototype components （i.g. irisflorentin， baicalin， chlorogenic acid） and 11 metabolites （i.g. hydration products of kaempferol or luteolin， methylation products of chlorogenic acid， and hydroxylation products of baicalin） were identified in serum， urine and feces of rats. Among them， 8 prototype components and 4 metabolites were identified in serum samples； 10 prototype components and 7 metabolites were identified in urine samples； 8 prototype components and 5 metabolites were identified in the fecal samples. CONCLUSIONS The metabolites of Zhideke granules in rats mainly include baicalin， irisflorentin，chlorogenic acid， and the main metabolic pathways included methylation， hydroxylation， glucuronidation.

Objective Previous studies on the association between lipid profiles and chronic kidney disease(CKD)have yielded inconsistent results and no defined thresholds for blood lipids. Methods A prospective cohort study including 32,351 subjects who completed baseline and follow-up surveys over 5 years was conducted.Restricted cubic splines and Cox models were used to examine the association between the lipid profiles and CKD.A regression discontinuity design was used to determine the cutoff value of lipid profiles that was significantly associated with increased the risk of CKD. Results Over a median follow-up time of 2.2(0.5,4.2)years,648(2.00%)subjects developed CKD.The lipid profiles that were significantly and linearly related to CKD included total cholesterol(TC),triglycerides(TG),high-density lipoprotein cholesterol(HDL-C),TC/HDL-C,and TG/HDL-C,whereas low-density lipoprotein cholesterol(LDL-C)and LDL-C/HDL-C were nonlinearly correlated with CKD.TC,TG,TC/HDL-C,and TG/HDL-C showed an upward jump at the cutoff value,increasing the risk of CKD by 0.90%,1.50%,2.30%,and 1.60%,respectively,whereas HDL-C showed a downward jump at the cutoff value,reducing this risk by 1.0%.Female and participants with dyslipidemia had a higher risk of CKD,while the cutoff values for the different characteristics of the population were different. Conclusion There was a significant association between lipid profiles and CKD in a prospective cohort from Northwest China,while TG,TC/HDL-C,and TG/HDL-C showed a stronger risk association.The specific cutoff values of lipid profiles may provide a clinical reference for screening or diagnosing CKD risk.

Purpose/Significance To sort out and analyze the application status of artificial intelligence(AI)large models in medi-cine,so as to provide new perspectives for research in this domain.Method/Process Based on a review of relevant literatures,the paper outlines the application scenarios and examples of AI large models in the fields of smart medical care,medical metaverse,medical re-search and development,etc.It also summarizes the risks and challenges in the application of AI large models in medicine.Result/Con-clusion AI large models have great development potential in medicine,and it is necessary to promote the core technologies of AI large models and improve relevant regulations and laws.

Objective To establish the method of infrared fingerprint,TLC identification and content determination of phenolic acid components of Yao medicine Calonyction muricatum(Linn)G.Methods The infrared fingerprint of 10 batches of Calonyction muricatum(Linn)G were established by infrared spectroscopy.The spectral datas were analyzed by similarity analysis,infrared spectroscopy(HCA),principal component analysis(PCA)and Partial-least-squares discriminant analysis(PLS-DA).Chlorogenic acid,heterochlorogenic acid A and caffeic acid of Calonyction muricatum(Linn)G were identified by TLC.The contents of neochlorogenic acid,chlorogenic acid,caffeic acid,cryptochlorogenic acid,isochlorogenic acid A and C were determined simultaneously by HPLC method.Results It could be suggested that organic acids,flavonoids and other compounds of Calonyction muricatum(Linn)G by infrared spectroscopy and nine common peaks were calibrated by infrared fingerprint;the similarity evaluation was above 0.999;the results of cluster analysis(CA)and principal component analysis(PCA)showed that it could be clustered into 2 categories,including S1,S2 and S3 were clustered into one categoriy and the rest were one.5 differential components(VIP>1)were selected by Partial-least-squares discriminant analysis;the test and control samples of TLC showed consistent locations the spots were clear,with good separation degree;the six components of Calonyction muricatum(Linn)G showed good linear relationship(r≥0.999 2),average sample recovery rate 97.77%-102.59%,and RSD less than 2.90% .Conclusion The TLC and infrared fingerprint were simple and stable,and the results of the six components were reliable,which can lay a scientific foundation for the quality control of the materials.

Objective:To retrospectively analyze the treatment status of tyrosine kinase inhibitors (TKI) in newly diagnosed patients with chronic myeloid leukemia (CML) in China.Methods:Data of chronic phase (CP) and accelerated phase (AP) CML patients diagnosed from January 2006 to December 2022 from 77 centers, ≥18 years old, and receiving initial imatinib, nilotinib, dasatinib or flumatinib-therapy within 6 months after diagnosis in China with complete data were retrospectively interrogated. The choice of initial TKI, current TKI medications, treatment switch and reasons, treatment responses and outcomes as well as the variables associated with them were analyzed.Results:6 893 patients in CP ( n=6 453, 93.6%) or AP ( n=440, 6.4%) receiving initial imatinib ( n=4 906, 71.2%), nilotinib ( n=1 157, 16.8%), dasatinib ( n=298, 4.3%) or flumatinib ( n=532, 7.2%) -therapy. With the median follow-up of 43 ( IQR 22-75) months, 1 581 (22.9%) patients switched TKI due to resistance ( n=1 055, 15.3%), intolerance ( n=248, 3.6%), pursuit of better efficacy ( n=168, 2.4%), economic or other reasons ( n=110, 1.6%). The frequency of switching TKI in AP patients was significantly-higher than that in CP patients (44.1% vs 21.5%, P<0.001), and more AP patients switched TKI due to resistance than CP patients (75.3% vs 66.1%, P=0.011). Multi-variable analyses showed that male, lower HGB concentration and ELTS intermediate/high-risk cohort were associated with lower cytogenetic and molecular responses rate and poor outcomes in CP patients; higher WBC count and initial the second-generation TKI treatment, the higher response rates; Ph + ACA at diagnosis, poor PFS. However, Sokal intermediate/high-risk cohort was only significantly-associated with lower CCyR and MMR rates and the poor PFS. Lower HGB concentration and larger spleen size were significantly-associated with the lower cytogenetic and molecular response rates in AP patients; initial the second-generation TKI treatment, the higher treatment response rates; lower PLT count, higher blasts and Ph + ACA, poorer TFS; Ph + ACA, poorer OS. Conclusion:At present, the vast majority of newly-diagnosed CML-CP or AP patients could benefit from TKI treatment in the long term with the good treatment responses and survival outcomes.

Objective:To explore the efficacy of negative pressure suction curettage combined with InMode diamond carving in the treatment of axillary osmidrosis.Methods:A total of 200 patients with bromhidrosis, 89 males and 111 females, aged (27.85±7.98) years, were prospectively included in the study from February 2022 to February 2023 in Huamei Zixin Medical Cosmetology Hospital in Sichuan Province. According to different treatment methods, the patients were divided into 2 groups with 100 cases in each group by random number table method. The control group received negative pressure suction curettage, and the experimental group received combination with InMode diamond carving. After follow-up for one year, the efficacy, recurrence rate and incidence of adverse reactions were compared between the two groups.Results:In the experimental group, 94 cases were cured, 6 cases were effective, 0 cases were ineffective; the effective rate was 100% (100/100). In the control group, 90 cases were cured, 5 cases were effective and 5 cases were ineffective; the effective rate was 95% (95/100). The effective rate of experimental group was higher than that of control group, and the difference was statistically significant (χ 2=5.128, P=0.024). In the experimental group, no cases relapsed, and the recurrence rate was 0. In the control group, 5 cases relapsed, and the recurrence rate was 5.3% (5/95). The recurrence rate of experimental group was lower than that of control group, and the difference was statistically significant (χ 2=5.390, P=0.020) In control group, 5 cases of subcutaneous hematoma, 1 case of scar contracture, 7 cases of scar hyperplasia, and 1 case of skin necrosis occurred; the incidence of adverse reactions was 14.0% (14/100). In the experimental group, 2 cases of subcutaneous hematoma, 5 cases of scar contracture and 5 cases of scar hyperplasia occurred; the incidence of adverse reactions was 12.0% (12/100). There was no significant difference in the incidence of postoperative adverse reactions between the two groups (χ 2 = 0.177, P=0.674). Conclusions:Negative pressure suction curettage combined with InMode diamond carving has better curative effect and lower recurrence rate in the treatment of axillary osmidrosis.

Optimizing the management of medical service appointment is an important measure to enhance the patient′s medical experience and promote the high-quality development of hospitals. In 2022, a tertiary comprehensive hospital in Jiangsu Province focused on the demand for digital appointments, and carried out coordinated management of intelligent appointment for medical examination both inside and outside the hospital, online and offline. By constructing an intelligent examination appointment system, enriching appointment categories, exchanging appointment information, improving supporting services, and establishing appointment supervision mechanisms, this practice provided intelligent, personalized, and precise examination appointment services for patients in multi-campus hospitals and member units of medical group. The average waiting time of patients for CT, MRI, and ultrasound examinations in this hospital decreased from 7.43 h, 8.75 h, and 4.63 h in 2021 to 4.63 h, 4.72 h, and 2.18 h in 2023, respectively, as well as the average satisfaction rate of patients with examination appointments increased from 90.7% to 96.5%. The intelligent examination appointment management had achieved good results, which could provide references for other hospitals to optimize appointment of medical services.

Objective To observe the clinical effect of osteoporotic vertebral compression fracture(OVCF)and analyze the value of magnetic resonance imaging(MRI)and bone metabolism indexes in predicting the poor prognosis.Methods A total of 258 OVCF patients admitted to Hangzhou Ninth Peopl's Hospital from March 2021 to March 2023 were selected as study objects.After percutaneous kyphoplasty(PKP)or percutaneous vertebroplasty(PVP),visual analogue scale(VAS)score and Cobb angle were collected.The patients were divided into poor prognosis group and good prognosis group according to whether the fracture was repeated after surgery.MRI and bone metabolism indexes of patients were collected,and the influencing factors of prognosis were analyzed.Results The VAS scores of OVCF patients decreased with the extension of time(P<0.05).One month and three months after surgery,the Cobb angle of injured vertebrae in OVCF patients was significantly lower than that before surgery(P<0.05).The proportion of vertebral fluid signs in poor prognosis group was significantly higher than that in good prognosis group(P<0.05),and N-terminal midragment of osteocalcin(N-MID)and 25-hydroxyvitamin D[25(OH)D]in poor prognosis group were lower than those in good prognosis group(P<0.05).Vertebral fluid signs,N-MID and 25(OH)D were all associated with poor prognosis in OVCF patients(P<0.05).The area under the curve(AUC)of vertebral fluid signs,N-MID and 25(OH)D alone for predicting poor prognosis of OVCF was 0.744,0.872 and 0.822,the sensitivity was 56.5%,87.0%and 73.9%,and the specificity was 92.3%,74.5%and 80.9%,respectively.Above indicators combined AUC,sensitivity and specificity were 0.967,95.7%and 80.9%.Conclusion PKP/PVP can reduce pain and improve function in OVCF patients.MRI vertebral fluid signs,N-MID and 25(OH)D are all factors affecting the poor prognosis of OVCF patients,and the combination of three factors can predict the poor prognosis of OVCF patients.