ObjectiveMicrotube associated protein-2 （MAP-2）， alpha-tubulin （α-tubulin）， and synaptophysin （SYP） are important proteins in neuronal signal communication. This paper observed the effects of modified Zhigancao Tang on the expression of serum α-Synuclein （α-Syn） and its oligomers， MAP-2， α-tubulin， and SYP of patients with liver and kidney deficiency of Parkinson's disease （PD）， analyzed their correlation， and evaluated the therapeutic effect of modified Zhigancao Tang in patients with liver and kidney deficiency of PD based on α-Syn transmission pathway mediated by neuronal communication in vivo. MethodsA total of 60 patients with PD who met the inclusion criteria were randomly divided into a treatment group （30 cases） and a control group （30 cases）. Both groups were treated on the basis of PD medicine， and the treatment group was treated with modified Zhigancao Tang. Both groups were treated for 12 weeks. The changes in UPDRS score， TCM syndrome score， and expression of serum α-Syn and its oligomers， MAP-2， α-tubulin， and SYP were observed before and after 12 weeks of treatment in each group. The correlation between the above-mentioned serum biological indexes and the levels of serum α-Syn and its oligomers was analyzed. ResultsAfter treatment， the TCM syndrome score， UPDRS score， UPDRS-Ⅱ score， and UPDRS-Ⅲ score of the treatment group were significantly decreased （P<0.05， P<0.01）. The UPDRS score， UPDRS-Ⅱ score， and UPDRS-Ⅲ scores in the treatment group were significantly decreased compared with those in the control group after treatment （P<0.05）. After treatment， the total effective rate of the control group was 63.3% （19/30）， and that of the treatment group was 86.7% （26/30）. The clinical effect of the observation group was better than the control group （Z=-2.03， P<0.05）. The total effective rate of the observation group was better than that of the control group， and the difference was statistically significant （χ²=5.136， P<0.05）. After treatment， the oligomer level of serum α-Syn and MAP-2 level in the treatment group were significantly decreased （P<0.05， P<0.01）. The levels of serum α-Syn and its oligomers， as well as α-tubulin in the treatment group， were significantly decreased compared with those in the control group after treatment （P<0.05， P<0.01）. Serum α-Syn was correlated with serum MAP-2 and α-Syn oligomer in patients with PD （P<0.05， P<0.01） but not correlated with serum SYP . Serum α-Syn oligomers of patients with PD were correlated with serum MAP-2 and α-tubulin （P<0.05， P<0.01） but not correlated with serum SYP level. Serum SYP of patients with PD was correlated with serum MAP-2 （P<0.05）. ConclusionModified Zhigancao Tang has a therapeutic effect on patients with liver and kidney deficiency of PD by inhibiting the production of α-Syn oligomers and intervening α-Syn microtubule transport pathway in vivo.

In vitro,platelets are readily activated,which complicates the process of quality control.In con-trast,nanoparticles possess distinct advantages due to their small size,high surface area ratio,biocompatibili-ty,and modifiability.These properties enable them to inhibit platelet aggregation through encapsulation or multi-modification,thereby ensuring the stability of quality control products for clinical platelet assays.This paper delineates the properties of the two existent forms of platelet-nanoparticle complexes,their synthesis principles,and their applications in the medical field.The text goes on to examine the preparation methods of some platelet-nanoparticle complexes and their applications in the fields of cancer therapy,wound healing,and immune disorders.It also explores the potential relationship between platelet-nanoparticle complexes and exo-some-nanoparticle complexes.Additionally,the future research directions of nanoparticles in platelet plasmino-genics are discussed in this paper,emphasizing the effects of nanoparticle concentration,size,and surface modi-fication on platelet aggregation.This provides a theoretical basis for the development of stable and controllable platelet plasminogenics.

Objective To explore the influencing factors of hypothermia after extraperitoneal laparoscopic radical prostatectomy in prostate cancer patients over 80 years old,so as to improve the effectiveness of treatment.Methods The clinical data of 26 cases of prostate cancer patients over 80 years old who underwent extraperitoneal laparoscopic radical prostatectomy in Shanghai 411 hospital from January 2021 to December 2023 were analyzed retrospectively.The incidence of postoperative hypothermia was investigated.Univariate and multivariate Logistic regression analyses were used to analyze the related factors of postoperative hypothermia in elderly patients.Results The incidence of hypothermia was 61.54%(16/26).Univariate analysis indicated that body mass index(BMI),intraoperative thermal insulation,intraoperative infusion volume,operation time,and anesthesia time were related to the occurrence of postoperative hypothermia in elderly patients(all P<0.05).Multivariate Logistic regression analysis indicated that BMI≤24,intraoperative infusion volume>2 000 ml,anesthesia time>3 h and operation time>2.5 h were high risk factors for postoperative hypothermia in patients over 80 years old.Conclusion The independent influencing factors of hypothermia after extraperitoneal laparoscopic prostatectomy for selected prostate cancer patients over 80 years old are BMI,intraoperative infusion volume,duration of anesthesia,and operation time.These factors should be paid more attention during perioperative period in order to improve clinical safety.

Objective To analyze the relationships between color Doppler ultrasound parameters and insulin sensitivity index(ISI)and clinical efficacy in rats with polycystic ovary syndrome(PCOS)combined with hyperinsulinemia(HI).Methods A total of 140 3-week-old female SD SPF-grade rats were divided randomly into a PCOS without HI model(control group,n=70)and a PCOS combined with HI model(study group,n=70).After successful modeling,we used color Doppler ultrasound to detect the physical indicators,hemodynamic indicators,and ultrasound features of rat ovaries,and draw venous blood to evaluate ISI.Rats in the study group were treated with metformin by intragastric administration.The color Doppler ultrasound parameters of the good-effect and the poor-effect group were compared and a receiver operating characteristic curve(ROC)was drawn to analyze the value of the color Doppler ultrasound parameters for evaluating the curative effect of metformin in rats with PCOS combined with HI.Results The total ovarian area(TA),ovarian volume(OV),ovarian interstitial area(SA),vascularization index(VI),blood flow index(FI),fasting insulin(FINS),and fasting blood glucose(BFG)of the research group were all greater than those of the control group,while the resistance index,pulsatility index and ISI were observed significantly lower compared with contrast,there were obvious difference(P＜0.05).The color Doppler ultrasound parameters TA and SA were negatively correlated with ISI(r=-0.501,r=-0.492,respectively,P＜0.05),and ovarian RI and PI were positively correlated with ISI(r=0.504,r=0.485,respectively,P＜0.05).TA,OV,SA,VI,FI,VFI,PSV,PDV,low-density lipoprotein cholesterol,FPG,FINS,LH,and FSH were all significantly lower while RI and PI were significantly higher in the good-curative-effect group compared with the poor-curative-effect group(all P＜0.05).According to ROC curve analysis,the sensitivity and specificity of color Doppler ultrasound parameters combined with clinical efficacy were 90.9％and 90.2％,respectively,and the area under the curve(AUC)was 0.901.Conclusions Color Doppler ultrasound parameters are closely related to ISI and therapeutic efficacy in rats with PCOS combined with HI,and may thus predict clinical efficacy in patients with these conditions.

Objective From the perspective of hospital grade reviewers,the evaluation index system for the clinical application of hospital medical technology is established to provide reference basis for the standardized management and continuous improvement of medical technology.Methods Based on the comprehensive application of literature analysis,Delphi expert consultation and so on,evaluation index system was established,and the weight of each index is determined by the hierarchical analysis method.Data relevant to the clinical application of medical technologies of 3 hospitals were analyzed,and the evaluation effect was evaluated using the index system by TOPSIS.Results The evaluation index system for clinical application of medical technology includes 3 first-level indicators,6 second-level indicators and 31 third-level indicators.First-level indexes include support and guarantee,organization and implementation,and quality control and management,their weights are 0.163,0.297 and 0.540,and CI=0.005.TOPSIS results showed that the effect of the 3 hospitals from high to low was hospital C,hospital A and hospital B.Conclusion The evaluation index system constructed in it is highly scientific,and the enthusiasm,authority and consistency of the experts are relatively high.This evaluation index system provides the scientific basis for standardized management and continuous improvement of medical technology,and also provides a clear evaluation criteria and basis for the hospital grade reviewers in the evaluation process.

Objective:To review the diagnosis, treatment and quality of life of patients with primary immune thrombocytopenia (ITP) in seven medical centers in some areas of Hubei Province.Methods:A retrospective analysis was conducted on age, disease course, symptoms, diagnosis, and treatment status (including testing items, drug selection, and adverse reactions) of patients with ITP in seven medical centers in Hubei Province from January 2020 to December 2022. An online survey was conducted on the quality of life of patients using the ITP Patient Assessment Questionnaire (ITP-PAQ) .Results:Among the 1033 patients, those with newly diagnosed, persistent, and chronic ITP accounted for 39.8%, 19.1%, and 41.1%, respectively. Most patients exhibit varying degrees of bleeding. Regarding treatment, corticosteroids and thrombopoietin drugs are the most commonly chosen treatment drugs for ITP, and the adverse reactions to treatment mainly include diarrhea, liver dysfunction, and thrombosis. The ITP-PAQ survey of 125 patients revealed that ITP significantly impairs their life quality. Patients with ITP scored significantly lower in fatigue, sleep, fear, exercise, work, and social aspects.Conclusion:A relatively high proportion of patients with ITP progressed to the chronic phase. Corticosteroids and thrombopoietin drugs are the two main treatment drugs for ITP patients. The quality of life of patients with ITP is significantly reduced in multiple dimensions.

Objective:To understand the clinical manifestations, laboratory characteristics, and treatment of Staphylococcus aureus ( Sa) infection in children, and explore the predictive value of lymphocyte count, neutrophil to lymphocyte ratio(NLR), and high-sensitivity C-reactive protein to albumin ratio(CAR) in patient with secondary bloodstream infection(BSI). Methods:A retrospective analysis was conducted on 72 children with Sa infection admitted to the Nanchong Hospital of Beijing Anzhen Hospital Affiliated to Capital Medical University from January 2020 to April 2024. Clinical data including basic information, drug resistance, antibiotic treatment were collected. Differences in laboratory test results and inflammatory indicators were analyzed. The influencing factors of Staphylococcus aureus bacteraemia(SAB) in pediatric patients were analyzed using univariate/multivariate Logistic regression and correlation analysis. The predictive value was analyzed by receiver operating characteristic curve (ROC) and area under curve (AUC). Results:Seventy-two patients were selected, of whom 60 (83.33%) had skin and soft tissue infections (SSTIs), mainly community-associated Staphylococcus aureus(CA-SA)(50 cases), including 16 community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) cases (32.00%, 16/50). The detection rate of MRSA was 37.50% (27/72). The resistance rates of Sa to penicillin, clindamycin, and erythromycin were 97.22%(70/72), 69.44%(50/72), and 69.44%(50/72), respectively. Compared with the SSTIs group, the levels of lymphocyte count in children with bone and joint infections were significantly lower, while NLR and CAR levels were higher ( P<0.05). Fourteen patients had secondary SAB. In the secondary SAB group, lymphocyte counts were lower, while inflammatory indicators (NLR, CAR), and D-dimer were higher. CAR and NLR are positively correlated with the occurrence of bloodstream infections ( P<0.05). CAR ( OR=4.866, 95% CI: 1.37-17.25) and NLR ( OR=1.293, 95% CI: 1.032-1.620) were independent risk factors for secondary bloodstream infection, and ROC curve results showed that the combination of the two indicators had a higher sensitivity (0.929) and AUC (0.909) than individual testing. After undergoing effective treatment, the levels of CAR and NLR in the children in the secondary SAB group were significantly reduced. Wound infection patients underwent debridement treatment in 38 cases (52.78%, 38/72), while antibiotic treatment still primarily used first- and second-generation cephalosporins. For patients with secondary bloodstream infection, vancomycin was the first choice. Conclusions:Children′s wound infections with Sa primarily involve skin and soft tissue infections, commonly seen in CA-SA. NLR and CAR are independent risk factors for children with secondary bloodstream infection, and their combined detection has certain value for early diagnosis.

Objective:To explore the value and related mechanism of preoperative serum sialic acid (SA) on evaluating microvascular invasion (MVI) in patients with intrahepatic cholangiocarcinoma (ICC).Methods:A total of 91 patients who underwent surgical resection and were pathologically diagnosed with ICC from December 2020 to September 2024 at the Oriental Hepatobiliary Surgery Hospital affiliated to the Naval Medical University were included in this retrospective analysis. The patients were divided into non-MVI (41 cases) and MVI groups (50 cases). The general data and laboratory examination indexes were collected and analyzed. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for predicting MVI. The predictive value of serum indicators for MVI was evaluated by receiver operating characteristic curves. The correlation between MVI and SA was analyzed by point-biserial correlation. ICC cells stably overexpressing β-galactoside α2, 6-sialyltransferase 1 (ST6GAL1) were generated through lentiviral transfection. ST6GAL1 protein expression and mRNA expression were detected by Western blot and quantitative real-time polymerase chain reaction, respectively. Sambucus nigra (SNA) lectin fluorescence staining was used to detect α2, 6-sialylation levels on cells. Cell migration ability was assessed by wound healing and Transwell assays, and cell proliferation was evaluated by colony formation assays.Results:Compared with the non-MVI group, patients in the MVI group exhibited significantly higher levels of fibrinogen, aspartate aminotransferase, gamma-glutamyl transferase, alkaline phosphatase, SA and 5′-nucleotidase (5′-NT) (all P<0.05). Multivariate logistic regression analysis revealed that SA ( OR=1.01,95% CI 1.01-1.02, P=0.023) was the only independent predictor for MVI. The area under curve of SA in predicting MVI was 0.757 (95% CI 0.640-0.870), sensitivity 67.65%, specificity 77.78%. SA was positively correlated with MVI ( r=0.443, P<0.001). ICC cells overexpressing ST6GAL1 were featured with increased mean fluorescence intensity of SNA lectin, and increased level of α2, 6-sialylation on the cell surface (both P<0.05). The number of colonies formed by hypersialylated ICC cells was also increased ( P<0.05), and both the migration rate and the number of migrating cells were significantly higher ( P<0.05). Conclusions:Serum SA is an independent predictor for MVI in ICC patients. Hypersialylation in ICC cells is associated with higher malignancy.

Molecular diagnosis has become an important part in the field of precision medicine. With the continuous advancement of molecular diagnostic technologies, their significance in the field of precision medicine has grown, making molecular detection technologies and solutions increasingly important. There are still certain bottlenecks in the current molecular diagnostic approaches, that is, the level of automation in the detection process is insufficient to meet the growing efficiency needs for medical personnel. Although, molecular diagnostic automation has emerged, the existing automation technologies rely on automated equipment to assist laboratory personnel, which is not considered as full automation. In this study, we conducted an in-depth investigation and proposed two distinct solutions to address the current challenges: (1) point-of-care-testing (POCT)-based molecular diagnostic automation solution; (2) pipeline-based molecular diagnostic automation solution. We hope to provide better strategies to improve clinical laboratory testing capabilities and accuracy, and to guide future development of technology in the molecular diagnostic automation industry.

Many hematological disease prediction models built by big data analysis in medical laboratory and artificial intelligence (AI) technology, especially machine learning (ML) methods are reported more and more widely in researches on disease alerting, screening, diagnosis, discrimination, treatment and prediction. Because of a lack of guidance of standards, guidelines and normative documents in standardizing the construction and validation of these models, there is deficiency in model function, data preparation, screening and labeling, algorithm selection, model evaluation, as well as local and overall interpretation after model construction, which also limit the clinical application. Therefore, with integration of the literature review, combining the practice on blood disease prediction models, this article proposes that some keypoints and efficiency should be noticed, in order to build hematological diseases related models with clinical practical application value.