Objective: To identify the mimicking autoantibodies using papain-enhanced erythrocyte agglutination in a case of repeated red blood cell transfusion refractoriness, aiming to explore the immune hematological methods for identifying mimicking alloantibodies, autoantibodies and alloantibodies, and to develop a safe and effective blood transfusion strategy based on the results. Methods: ABO, RhD and RhEeCc blood groups were detected using routine blood group serological method. The unexpected antibodies in plasma were screened and identified, followed by identification using a two-step papain-treated indirect antiglobulin test (enzyme-IAT). The cause of transfusion refractoriness of red blood cells was analyzed and summarized, and the prognosis was followed up. Results: The patient's blood type was type A, CCDee. The direct antiglobulin test (DAT) was positive. Unexpected antibody screening and identification using saline tube method, polybrene method, IAT were negative, and the release fluid (acid release) IAT identification was negative. Mimicking anti-e antibodies in plasma was identified by enzyme-ITA. The cause of red blood cell transfusion refractoriness in patients was autoimmune hemolysis caused by mimicking anti-e antibodies. After choosing to avoid antibodies corresponding to antigen-positive red blood cells, the patient's hemoglobin (Hb) increase value is in line with theoretical expectations, indicating effective red blood cell transfusion. Conclusion: Mimicking antibodies can cause immune destruction of red blood cells by non-specific binding to their own red blood cells and specific binding to red blood cells, resulting in red blood cell transfusion refractoriness.

Objective To establish an HPLC method to determine the concentration of inositol nicotinate（IN） in rat skin, and study the pharmacokinetic characteristics of IN after transdermal administration of heparin sodium inositol nicotinate cream in rats. Methods HPLC method was used to establish a simple and rapid analytical method for the determination of IN concentration in the skin of rats at different time points after administration. The established method was used to study the pharmacokinetics of IN after transdermal administration of heparin sodium inositol nicotinate cream in rats, and the pharmacokinetic parameters were fitted with DAS software. Results The linearity of the analytical method was good in the concentration range of 0.25-20 μg/ml, the quantitative limit was 0.25 μg/ml, and the average recovery rate was 96.18%. The pharmacokinetic parameters of IN after transdermal administration of heparin sodium inositol nicotinate cream in rats were as follows: t_1/2 was （4.555±2.054） h, T_max was （6±0）h, C_max was （16.929±2.153）mg/L, AUC_0−t was （150.665±16.568） mg·h /L ,AUC_0−∞ was （161.074±23.917） mg·h /L, MRT_（0−t） was （9.044±0.618）h, MRT_{（0−∞）} was （10.444±1.91） h, CLz/F was （0.19±0.03） L/（h·kg）, and Vz/F was （1.19±0.437） L/（h·kg）. Conclusion IN could quickly penetrate the skin and accumulate in the skin for a long time, which was beneficial to the pharmacological action of drugs on the lesion site for a long time. The method is simple, rapid, specific and reproducible, which could be successfully applied to the pharmacokinetic study of IN after transdermal administration in rats.

Object To study the efficacy and potential mechanism of Tongbianling capsule in constipation. Methods The effects of Tongbianling capsule on intestinal motility in normal mice and carbon powder propulsion rate in small intestine of constipation model mice after were observed administration. The potential targets and key pathways of Tongbianling capsule in treating constipation were identified through network pharmacology. To verify the mechanism, the expression of p-PI3K/PI3K, p-AKT/AKT and CASP3 proteins in mouse colon tissue was detected by the western blot. Results The time for mice to excrete the first black stool was shortened and the number of fecal particles was increased in Tongbianling capsule administration group, and the carbon powder propulsion rate of mice in each Tongbianling capsule administration group was increased. The results of network pharmacology showed that treatment of constipation by Tongbianling capsule may be related to signaling pathways such as PI3K-Akt signaling pathway and 5-HT. The protein expression of p-PI3K/PI3K, p-AKT/AKT, and CASP3 in mouse colon tissue could be significantly downregulated in administration group. Conclusion Tongbianling capsule could effectively promote intestinal peristalsis in mice, increase the frequency of defecation, and effectively treat constipation. The mechanism of its action may be related to the direct or indirect regulation of intestinal motility by the PI3K-Akt signaling pathway.

Direct antiglobulin test (DAT), also known as Coomb's test, is a method used in blood immunology to detect whether the surface of red blood cells is sensitized by immunoglobulin or complement. It is mainly used in the diagnosis of autoimmune hemolytic anemia (AIHA), neonatal hemolytic anemia, hemolytic transfusion reaction and blood matching during blood transfusion. DAT positive has always been the focus of researchers, because it has an important impact on the efficacy of blood transfusion. In recent years, there has been extensive research on the identification of DAT positivity types and the distribution characteristics of diseases in clinical patients, and the study on hemolytic disease of the newborn has also been popular. However, the transfusion safety of DAT-positive blood donors has been a hot topic in the field of blood transfusion for many years. Moreover, there is no clear requirement from the state on the handling of DAT-positive blood and whether DAT-positive blood donors should be deferred from donation. Therefore, this article reviews the serological studies on DAT immunotyping and IgG subtype typing of voluntary blood donors, as well as the impact of DAT-positive blood on blood transfusion safety, in order to provide references for the blood issuance strategy of DAT-positive blood and whether DAT-positive blood donors should be deferred.

Cluster of differentiation 36 (CD36) is a highly glycosylated double transmembrane glycoprotein, which is involved in the inflammatory response and immune regulation of the body. It plays a key role in mediating the mechanism of immune-related blood transfusion reactions and regulating the function of immune cells. It has an important impact on blood transfusion safety and has become a current research hotspot. This article reviews and comprehensively analyzes the research progress of the specific role of CD36 in the immune response of blood transfusion and its regulatory mechanism at home and abroad. Combined with clinical cases and experimental data, the pathophysiological mechanism of CD36 in immune response and its immune-mediated blood transfusion safety issues are reviewed. It is expected to provide new theoretical support and practical guidance for the field of blood transfusion safety and promote the further development of blood transfusion medicine.

Objective To establish the fingerprint of Jianggui granules, and evaluate it by chemometrics. Methods The fingerprint of Jianggui granules was established by HPLC. Similarity evaluation system of chromatographic fingerprint of TCM （2012 edition） was used to evaluate the similarity evaluation. Then, the quality of the drug was assessed by cluster analysis （CA）, principal components analysis （PCA） and partial least squares discriminant analysis （PLS-DA）. Results The characteristic fingerprint of Jianggui granules was established and 18 common peaks were verified. Five chromatographic peaks were identified，i.e. Puerarin, glycyrrhizin, cinnamic acid, cinnamaldehyde and ammonium glycyrrhizinate. The similarities of samples were >0.9. Results of CA showed that 14 batches of samples could be classified into two categories：S1 and S4 were grouped into one category；others were grouped into the other category. The results of PCA showed that the cumulative contribution rate of the first two principal components was 96.61%. The results of OPLS-DA showed that the eleven peaks with VIP value >1 were puerarin （peak 8）, glycyrrhizin （peak 14）, cinnamaldehyde （peak 17） and ammonium glycyrrhizinate （peak 18）. Conclusion HPLC fingerprint of Jianggui granules was established. The established method was accurate and reliable，which could be used in quality evaluation of Jianggui granules.

Sepsis constitutes one of the principal causes of death globally, and the mortality rate of patients complicated with sepsis-induced cardiomyopathy (SIC) surges by over 50%. Early identification of patients with sepsis, particularly SIC, and implementing clinical intervention are vital measures to reduce the mortality. In recent years, biomarkers for the diagnosis and prognosis of SIC have emerged rapidly. Among classical myocardial injury biomarkers, cardiac troponin (cTn), brain natriuretic peptide (BNP), and soluble growth stimulation gene 2 protein (sST2) have predictive value for the prognosis of SIC. Meanwhile, heart-type fatty acid-binding protein (h-FABP) possess relatively high value in diagnosis. Moreover, plasma metabolites, microRNA (miRNA), as well as recently identified markers related to sepsis or cardiovascular diseases also demonstrate outstanding predictive value in both the diagnosis and prognosis of SIC. For instance, exosomal miR-150-5p, blood miR-155, blood miR-378a-3p, blood miR-21-3p, blood miR-233, blood miR-23b, blood miR-135, lipocalin (LCN), heme oxygenase-1 (HO-1), fibroblast growth factor-21 (FGF-21), and growth differentiation factor-15 (GDF-15) show varying degrees of predictive value when it comes to diagnosing SIC. S100A8/A9 protein, triglyceride-glucose (TyG) index, angiotensinogen II (Ang II) and lactoferrin are correlated with the prognosis of SIC. Meanwhile, it has been discovered that the combination of multiple biomarkers outperforms a single biomarker, and certain combinations exhibit superior diagnostic performance. However, most of these studies use single-center clinical data, which has certain limitations and still calls for more high-quality evidence support. Therefore, identifying biomarker combinations that are supported by high-quality evidence, have bedside application potential, and possess high sensitivity and specificity is of crucial importance for the prevention, diagnosis, and treatment of SIC. This review is carried out on the current articles that report biomarkers with predictive value and the diagnosis and prediction of multiple biomarkers in combination, in the hope of continuously optimizing the diagnostic strategy for the specific identification of early SIC.
Humans ; Biomarkers/blood* ; Cardiomyopathies/etiology* ; Sepsis/diagnosis* ; MicroRNAs/blood* ; Prognosis ; Fatty Acid-Binding Proteins/blood*

Objective:To investigate the related factors affecting the survival of adult patients with newly diagnosed chronic myeloid leukemia in the chronic phase (CML-CP) treated with tyrosine kinase inhibitor (TKI) and the prognostic predictive effect of the nomogram constructed according to them.Methods:A retrospective cohort study was conducted. Clinical general information and laboratory index data of 243 newly diagnosed adult CML-CP patients treated with TKI in the First Hospital of Lanzhou University from December 2008 to June 2023 were collected, and they were divided into a training set (194 patients) and a validation set (49 patients) by complete randomization in the ratio of 8∶2. In the training set, variables affecting poor overall survival (OS) of patients were analyzed using univariate and multivariate Cox proportional hazards models by R4.3.2 software to obtain the independent influences of poor OS, on the basis of which the Cox regression model was constructed and the nomogram predicting the OS rate at 8 and 10 years was plotted. Kaplan-Meier method was applied to analyze the OS in all 243 patients and patients stratified by the screened independent influencing factors for poor OS, and log-rank test was used for comparison between the groups. In the training and validation sets, receiver operating characteristic (ROC) curve was used to analyze the effect of the nomogram on predicting 8- and 10-year OS rates of patients with actual survival as the gold standard; calibration curve was used to assess the accuracy of predictions of the nomogram; decision curve analysis (DCA) was used to assess the clinical utility of the nomogram.Results:The median age of 243 CML-CP patients [ M ( Q1, Q3)] was 46 (35, 58) years old, 150 cases (61.7%) were male and 9 cases (38.3%) were female, 119 cases (49.0%) had comorbidities, and the efficacy of 82 cases (33.7%) reached molecular response (MR) 5.0. Differences in patient compositions for age and gender, levels of major indicators for peripheral blood and bone marrow, spleen size, comorbidities, short-term efficacy, Sokal score, and long-term survival score of European Treatment and Outcomes Study between the training and validation sets were not statistically significant (all P > 0.05). Multivariate Cox regression analysis showed that patients with elevated age ( HR = 1.04, 95% CI: 1.01-1.08, P = 0.041), comorbidities (with vs. without, HR = 3.48, 95% CI: 1.23-9.86, P = 0.019), and those who did not achieve MR5.0 (achieved vs. unachieved, HR = 0.13, 95% CI: 0.02-0.97, P = 0.046) were independent risk factors for poor OS in TKI-treated newly diagnosed adult CML-CP patients. By the last follow-up (December 2023), the median follow-up was 72 months, with the range of 6-180 months. Kaplan-Meier method analysis showed that the 8- and 10-year OS rates of 243 patients were 83.7% and 81.6%, respectively; patients with age ≥46 years compared to <46 years, with comorbidities compared to without comorbidities, and who did not achieve MR5.0 in terms of efficacy compared to who achieved MR5.0, the OS was poorer, and the differences were statistically significant (all P < 0.01). The nomogram of 8- and 10-year OS rates in TKI-treated newly diagnosed adult CML-CP patients was constructed based on the screened independent influencing factors of poor OS. The area under the ROC curve was 0.910 and 0.851 in the training set and 0.778 and 0.764 in the validation set for the predicted 8- and 10-year OS rates based on the nomogram, respectively, and the calibration curve showed that the predicted 8- and 10-year OS rates based on the nomogram were in high agreement with the actual ones in the training and validation sets; the DCA showed that the nomogram within a certain prediction threshold could benefit the clinical decision-making in both the training and validation sets. Conclusions:Having comorbidities, not reaching MR5.0 in efficacy and old age are independent risk factors for poor survival of TKI-treated adult patients with newly diagnosed CML-CP, and the nomogram constructed based on these 3 factors has a good predictive ability for the survival of such patients.

ObjectiveTePixD (Tll0078) is a blue light-using flavin (BLUF) photoreceptor protein from Thermosynechococcus elongatus BP-1. TePixD protein has a conserved Tyr8-Gln50-Met93 triad around the FAD pocket to mediate the proton-coupled electron transfer (PCET) process. But the detailed light response mechanism needs further study. We aimed to elucidate the structure and biochemical properties of TePixD mutants at key light response sites to analyze the light response process of TePixD. MethodsWe employed X-ray crystallography to resolve the crystal structure of the TePixD Y8F mutant. The side chain of Tyr8 is involved in PCET while Phe8 in mutation loses the function due to the loss of its hydroxyl group. We compared the structure of TePixD Y8F mutation to TePixD wild type (WT) and its homology protein SyPixD Y8F. Using multi-angle light scattering (MALS), we analyzed the oligomerization of multiple TePixD mutations (Y8F, Q50L, W91F, Y8F/W91F, and Q50L/W91F), focusing specifically on mutational sites that are critical residues for the protein’s photo response to dark and light conditions. ResultsWe resolved the crystal structure of TePixD Y8F mutant at a resolution of 2.54 Å and found that it shares a similar overall structure with the TePixD WT but exhibits significant differences from the SyPixD Y8F structure. Biochemical analysis revealed differences in molecular mass and elution profiles between the TePixD mutants and the WT under dark and light conditions, indicating the perturbation on the light-induced conformational change by the mutants. ConclusionOur structure determination and biochemical analyses will add information to reveal the light response mechanism of BLUF proteins.

Objective To investigate the publication status of papers written by key nursing staff of vascular interventional academic organizations and to analyze its influencing factors so as to provide a theoretical basis for improving the scientific research output of vascular interventional nursing staff.Methods The questionnaire was designed by reading and referring to the domestic and foreign literature.A survey was conducted in a total of 346 members of the Nursing Professional Committee of the China Branch of the International Vascular Alliance,who were from 22 provinces,autonomous regions,and municipalities of China.Results Of the 346 key vascular interventional nursing staff,190 had published one paper(54.91％)and 156(45.09％)had published multiple papers in the past 5 years as the first author or corresponding author,and among them 267(77.17％)wrote papers for the purpose to make a promotion.Multiple regression analysis showed that academic position,first education degree,professional position,length of nursing service,knowledge of the English literature,and source of scientific research knowledge(school study)were the independent factors affecting the paper publication by vascular interventional nursing staff(all P＜0.05).The survey showed that vascular interventional nursing staff had difficulties in carrying out scientific research because they were lack of scientific research-related knowledge,busy with daily work,and lack of scientific research atmosphere.Conclusion The publication of academic papers written by key nursing staff of vascular interventional academic organizations is influenced by many factors.It is recommended that the hospital administration should strengthen the training of English literature retrieval ability for nursing staff so as to fundamentally improve the overall scientific research level of nursing staff.(J Intervent Radiol,2024,33:309-313)