Children and adults differ significantly in physiology,biochemistry and immune function,which leads to sig-nificant differences in blood transfusion strategies between children and adults.To guide the clinical transfusion practice of pediatric patients and improve the prognosis of children,the National Health Commission organized the formulation and re-lease of the health industry standard Guideline for Pediatric Transfusion(WS/T 795-2022).This paper will briefly introduce some concepts that help understand of the Standard and the preparation process of the Standard,and explain and interpret the preparation of the"scope","general provisions"and"factors to consider"of the Standard,hoping to contribute to the understanding and implementation of the Standard.

Objective: To examine the influence of school adaptation on depression among high school students, as well as the mediating effects of social avoidance and distress and learning burnout on the relationship between school adaptation and depression among high school students, so as to provide a basis for the mental health promotion among high school students. Methods: A convenience sampling method was used to select 1 207 first year high school students from two high schools as the research subjects in Guiyang City. The School Adaptation Scale(SAS), Social Avoidance and Distress Scale(SAD), Learning Burnout Questionnaire(LBQ), Patient Health Questionnaire-9(PHQ-9) were used to conduct surveys at three time points: October 2021 (T1), May 2022 (T2), and March 2023 (T3). Common method biase was tested using the Harman s single factor method,and bias correction was conducted via the Bootstrap method, utilizing 5 000 resamples to analyze the 95% confidence intervals(95% CI ) of parameter estimates. Results: School adaptation at T1 was negatively associated with depression of high school students at T3 ( β =-0.13, P <0.01). The mediation analysis showed that the mediating effect of social avoidance and distress at T2 between school adaptation at time point T1 and depression among high school students at time point T3 was-0.100 (95% CI =-0.134--0.071, P <0.05). The mediating effect of learning burnout at T2 between school adaptation at time point T1 and depression among high school students at time point T3 was-0.157 (95% CI =-0.211--0.106, P <0.05). The chain mediation effect of social avoidance and distress and learning burnout at T2 between school adaptation at time point T1 and depression among high school students at time point T3 was -0.022 (95% CI =-0.037--0.012, P <0.05). Conclusions Good school adaptation can directly alleviate depressive mood, and can indirectly reduce depression through social avoidance and distress and learning burnout among high school students. Families and schools should pay attention to the school adaptation of high school students and provide timely interventions and assistance to students with poor adaptation.

Concurrent chemoradiotherapy (CCRT) refers to the simultaneous treatment of chemotherapy and radiotherapy, and the effect of radiotherapy is enhanced with low-dose chemotherapy, which can reduce tumor recurrence and metastasis and improve clinical prognosis of patients. At present, the main factors for the increase of radiosensitivity of concurrent chemotherapy is that concurrent chemotherapy prevents the repair of tumor cells, and chemotherapy and radiotherapy act on different cell cycles and have synergistic effects. However, even for patients with locally advanced cervical cancer (LACC) who have undergone CCRT, the 5-year survival rate is only 60%, which is still not ideal. In order to improve the efficacy, researchers have conducted a series of exploratory studies, which consist of the combination of targeted drugs and immunodrugs, and neoadjuvant regimens before CCRT, etc. Although targeted or immunologic drugs are effective treatment of LACC, in view of the lack of large-scale evidence-based medical evidence, multi-center prospective and randomized phase III clinical trials and high-level articles are needed to improve the level of evidence-based medicine. This consensus summarizes several key evidence-based medical studies published recently, especially the clinical research progress in targeted and immunological therapies, providing reference for domestic peers.

Background::Total human immunodeficiency virus (HIV) DNA and integrated HIV DNA are widely used markers of HIV persistence. Droplet digital polymerase chain reaction (ddPCR) can be used for absolute quantification without needing a standard curve. Here, we developed duplex ddPCR assays to detect and quantify total HIV DNA and integrated HIV DNA.Methods::The limit of detection, dynamic ranges, sensitivity, and reproducibility were evaluated by plasmid constructs containing both the HIV long terminal repeat (LTR) and human CD3 gene (for total HIV DNA) and ACH-2 cells (for integrated HIV DNA). Forty-two cases on stable suppressive antiretroviral therapy (ART) were assayed in total HIV DNA and integrated HIV DNA. Correlation coefficient analysis was performed on the data related to DNA copies and cluster of differentiation 4 positive (CD4 +) T-cell counts, CD8 + T-cell counts and CD4/CD8 T-cell ratio, respectively. The assay linear dynamic range and lower limit of detection (LLOD) were also assessed. Results::The assay could detect the presence of HIV-1 copies 100% at concentrations of 6.3 copies/reaction, and the estimated LLOD of the ddPCR assay was 4.4 HIV DNA copies/reaction (95% confidence intervals [CI]: 3.6-6.5 copies/reaction) with linearity over a 5-log 10-unit range in total HIV DNA assay. For the integrated HIV DNA assay, the LLOD was 8.0 copies/reaction (95% CI: 5.8-16.6 copies/reaction) with linearity over a 3-log 10-unit range. Total HIV DNA in CD4 + T cells was positively associated with integrated HIV DNA ( r = 0.76, P <0.0001). Meanwhile, both total HIV DNA and integrated HIV DNA in CD4 + T cells were inversely correlated with the ratio of CD4/CD8 but positively correlated with the CD8 + T-cell counts. Conclusions::This ddPCR assay can quantify total HIV DNA and integrated HIV DNA efficiently with robustness and sensitivity. It can be readily adapted for measuring HIV DNA with non-B clades, and it could be beneficial for testing in clinical trials.

Background::Cluster of differentiation 8 (CD8 T) cells play critical roles in eradicating human immunodeficiency virus (HIV)-1 infection, but little is known about the effects of T cells expressing CD8 at low levels (CD8 low) or high levels (CD8 high) on HIV-1 replication inhibition after HIV-1 invasion into individual. Methods::Nineteen patients who had been acutely infected with HIV-1 (AHI) and 20 patients with chronic infection (CHI) for ≥2 years were enrolled in this study to investigate the dynamics of the quantity, activation, and immune responses of CD3 +CD8 low T cells and their counterpart CD3 +CD8 high T cells at different stages of HIV-1 infection. Results::Compared with healthy donors, CD3 +CD8 low T cells expanded in HIV-1-infected individuals at different stages of infection. As HIV-1 infection progressed, CD3 +CD8 low T cells gradually decreased. Simultaneously, CD3 +CD8 high T cells was significantly reduced in the first month of AHI and then increased gradually as HIV-1 infection progressed. The classical activation of CD3 +CD8 low T cells was highest in the first month of AHI and then reduced as HIV-1 infection progressed and entered the chronic stage. Meanwhile, activated CD38 -HLA-DR +CD8 low T cells did not increase in the first month of AHI, and the number of these cells was inversely associated with viral load ( r = -0.664, P = 0.004) but positively associated with the CD4 T-cell count ( r = 0.586, P = 0.014). Increased programmed cell death protein 1 (PD-1) abundance on CD3 +CD8 low T cells was observed from the 1st month of AHI but did not continue to be enhanced, while a significant T cell immunoreceptor with immunoglobulin and immunoreceptor tyrosine-based inhibition motif (ITIM) domains (TIGIT) abundance increase was observed in the 12th month of infection. Furthermore, increased PD-1 and TIGIT abundance on CD3 +CD8 low T cells was associated with a low CD4 T-cell count (PD-1: r = -0.456, P = 0.043; TIGIT: r = -0.488, P = 0.029) in CHI. Nonetheless, the nonincrease in PD-1 expression on classically activated CD3 +CD8 low T cells was inversely associated with HIV-1 viremia in the first month of AHI ( r = -0.578, P = 0.015). Notably, in the first month of AHI, few CD3 +CD8 low T cells, but comparable amounts of CD3 +CD8 high T cells, responded to Gag peptides. Then, weaker HIV-1-specific T-cell responses were induced in CD3 +CD8 low T cells than CD3 +CD8 high T cells at the 3rd and 12th months of AHI and in CHI. Conclusions::Our findings suggest that CD3 +CD8 low T cells play an anti-HIV role in the first month of infection due to their abundance but induce a weak HIV-1-specific immune response. Subsequently, CD3 +CD8 low T-cell number decreased gradually as infection persisted, and their anti-HIV functions were inferior to those of CD3 +CD8 high T cells.

Objective : To investigate the effect of ginsenoside Rg1 (GRg1) on human retinal microvascular endothelial cells (HRMECs) glycolysis by regulating pyruvate kinase M2 ( PKM2) expression. Methods : HRMECs were cultured in vitro and divided into normal control (NC) group, high glucose (HG) group, high glucose + ginsenoside Rg1 (HG + GRg1) group, high glucose + ginsenoside Rg1 + low expression PKM2 ( HG + GRg1 + si-PKM2) group, and high glucose + ginsenoside Rg1 + overexpression PKM2 (HG + GRg1 + OE⁃PKM2) group. si-PKM2 and OE⁃PKM2 were transfected into HRMECs cells by cell transfection. The expression of PKM2 mRNA in HRMECs was detected by qRT⁃PCR. The expression levels of related proteins in HRMECs were detected by Western blot. The number of lumen formation in vitro was observed under an inverted microscope to quantify the angiogenesis ability. Cell culture medium of each group was collected, and glucose intake, lactate production and adenosine triphosphate(ATP)content were detected by glucose detection kit, lactate detection kit and ATP detection kit,re spectively. Results : HG induced HRMECs significantly increased the number of blood vessel formation, glycolysis and PKM2 expression, while GRg1 treatment significantly reduced the number of blood vessel formation, glycolysis and PKM2 expression; transfection of si⁃PKM2 assisted the inhibitory effect of GRg1 on glycolysis and angiogenesis while transfection of OE⁃PKM2 interfered with the function of GRg1 . Conclusion GRg1 inhibits angiogenesis by inhibiting PKM2 to reduce glycolysis of HRMECs.

Taking "count down your weight—start from 'diet'" as an example, this article discusses the design and practice of SPOC (small private online course) mixed teaching based on MOOC (massive open online course) in general medical courses. By designing teaching methods and teaching content, and using formative evaluation methods, the SPOC mixed teaching was implemented for 201 students from Sichuan University in the spring of 2020. According to the teaching evaluation and preliminary teaching effect, students generally believed that teaching resources were relatively abundant and the communication effects were generally recognized, as well as, it could significantly improve students' interest in and effect of general medical courses.

Objective:To explore the effect of social isolation (SI) on cognitive function and the phenotypic transition of hippocampal astrocytes in mice.Methods:Twenty male C57BL/6 mice aged 3-4 weeks were randomly divided into normal group house (GH group) and social isolation group (SI Group). The mice in SI group were fed one per cage for 8 weeks to establish a social isolation model, and the mice in GH group were fed five per cage. The cognitive function of mice was detected by the novel object recognition test and novel location recognition test. The expression of astrocyte marker glial fibrillary acidic protein (GFAP) was detected by immunohistochemistry, RT-PCR and Western blot.The astrocyte morphology change was quantitatively analyzed by Sholl Analysis.The expression of the hippocampal A1-A2 astrocytes markers proteasome subunit beta 8(PSMB8) and a member of the S100 family of Ca 2+ -binding proteins (S100A10) were determined by RT-PCR and Western blot. Statistical analysis was performed using GraphPad Prism 6.0 software, and t-test was used for comparison between two groups. Results:The results of cognitive function showed that the exploration index of novel object ((-5.54±3.30)%, (33.42±7.14)%; t=4.680, P=0.001) and the exploration index of novel location((-7.96±4.81)%, (23.55±8.20)%; t=3.670, P=0.008) in SI group were both lower than those in GH group.Immunohistochemical results showed that the number of GFAP positive cells in hippocampus of SI group was significantly lower than that of GH group((369.90±42.97), (544.90±57.64); t=2.480, P=0.023). The results of Sholl analysis showed that the protuberance of hippocampal astrocytes in SI Group retracted.There were significant differences in the number of intersections between the two groups at 6, 8, 10, 12, 14 and 16 μm away from astrocyte cell body(all P<0.05). Western blot showed that the expression of GFAP protein in SI group was lower than that in GH group((0.85±0.05), (1.03±0.06); t=2.527, P=0.028). The results of PCR showed that the expression of GFAP mRNA in SI group was lower than that in GH group ((0.83±0.05), (1.00±0.03); t=2.970, P=0.018). The expression of A1 phenotypic marker PSMB8 mRNA ((1.58±0.17), (1.00±0.06); t=2.931, P=0.011) and A2 phenotypic marker S100A10 mRNA ((1.52±0.14), (1.00±0.07); t=3.121, P=0.007) in the hippocampus of SI group were higher than those in GH group.Compared with the GH group, the expression of the neurotrophic factors IGF-1 mRNA in the SI group was down-regulated ((0.73±0.07), (1.00±0.08); t=2.327, P<0.05), while the expression of LCN2 mRNA((1.12±0.03), (1.00±0.03), t=2.575, P<0.05), IL-1β mRNA(1.76±0.19), (1.00±0.07), t=3.460, P<0.01) and TNF-α mRNA((2.18±0.42), (1.00±0.07), t=2.427, P<0.05) were up-regulated in the SI group. Conclusion:The pathological mechanism of social isolation-induced cognitive impairment in mice may be related with the phenotypic changes of astrocytes.

Objective: To evaluate the efficacy and safety of 0.05% atropine eye drops for retarding myopia progression and ocular axial elongation in school children,and to provide a reference for the relevant prevention and control measures of myopia. Methods: A total of 188 children with myopia were randomly assigned to the experimental group(93) or to the control group(95). During the phase (first 24 months) I,children received treatment in each eye once a day. During the phase II (from 25th to the 36th month),no treatment was given. Standardized eye examinations including spherical equivalent(SE),axial length(AL),intraocular pressure(IOP) and potential atropine-related side effect assessment were performed every 6 months. Results: In phase I, the annual progression rates of equivalent spherical degree [(-0.35±0.21)D/year] and axial length [(0.11±0.07)mm/year] in the experimental group were significantly lower than those in the control group [(-0.83±0.26)D/year and (0.37±0.22)mm/year] (P<0.05). After withdrawal of atropine eye drops (phase II), the equivalent spherical degree progression rate [(-0.40±0.29)D/year] and axial length progression rate [(0.10±0.04)mm/year] in the experimental group were significantly lower than those in the control group [(0.73±0.40)D/year and (0.30±0.11)mm/year]. No serious adverse events associated with atropine were found during the follow up period. After the withdrawal of atropine, the pupil size, near visual acuity and adjustment gradually returned to the pre-treatment level. Conclusion 0.05% atropine eye drops may not only maintain the efficacy and reduce potential side effects of atropine but also significantly increase the compliance of children,0.05% atropine is a safe and effective treatment for retarding myopic progression in moderate myopia.

COVID-19 ; Coronavirus Nucleocapsid Proteins ; Humans ; Nucleocapsid Proteins ; Phosphoproteins ; SARS-CoV-2