Objective: To evaluate the application of blood conservation measures in obstetric patients with different red blood cell transfusion volumes and to assess the impact of different transfusion volumes on postpartum outcomes. Methods: A retrospective investigation was conducted on 448 obstetric patients who received blood transfusions at the Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine from January 2016 to December 2022. Patients were divided into four groups (1-2 units group, 3-4 units group, 5-6 units group, and >6 units group) based on the volumes of red blood cells (RBCs) transfused during and within 7 days after delivery. The maternal physiological indicators, pre- and postpartum laboratory test indicators, obstetric complications, application of blood conservation measures, use of blood products, and postpartum outcomes were reviewed. The clinical characteristics, application of blood conservation measures, and their impact on postpartum outcomes were compared among different transfusion groups. Results: There were statistically significant differences in the multivariate logistic analysis of history of previous cesarean section (OR=1.781), eclampsia/pre-eclampsia/(OR=1.972) and postpartum blood loss>1 000 mL（OR=1.699）(P<0.05) among different transfusion groups. In terms of blood conservation measures, the more RBCs transfused, the higher the rate of mothers receiving blood conservation measures such as balloon occlusion, arterial ligation, autologous blood transfusion with a cell saver, and hysterectomy. With the increase in the volume of RBCs transfusion, the demand for fresh frozen plasma（FFP）, cryoprecipitate, and platelet transfusions also increased. The hospitalization days for the four groups of parturients were 6.0 (4.0-9.0), 7.5 (5.0-14.8), 7.0 (4.5-13.0) and 11.0 (9.0-20.5), respectively (P<0.05) and the rates of ICU transfer were 2.0% (5/250), 9.4% (12/128),18.2% (6/33) and 51.4% (19/37), respectively (P<0.05). Both increased significantly with the increase in the volume of RBCs transfusion, and the differences between groups were statistically significant. Conclusion: Parturients who received higher volume of RBCs had multiple risks factors for bleeding before childbirth, had higher postpartum blood loss, and had a higher rate of application of various blood conservation measures. In addition, an increase in the volume of RBCs transfusion may have adverse effects on postpartum recovery.

Allergic rhinitis(AR)is the most common airway allergic diseases.Basophils are the classical effector cells in allergy,including AR:Both IgE and non-IgE mediated methods can activate basophils during allergic reactions and induce basophils to release various inflammatory mediators,which is accompanied by changes in the expression of multiple membrane proteins,and ulti-mately leading to the clinical manifestations of allergic diseases.IL-18 may be involved in the pathogenesis of AR by directly inducing basophil activation and inflammation response via binding to its receptor IL-18Rα.Nevertheless,the binding of IL-37b to IL-18Rα initiates the downstream anti-inflammatory signals,thus inhibiting inflammation reaction in AR.Therefore,understanding the role and mechanism of IL-18 and IL-37b in the activation of blood basophils of AR patients is of great significance for the pathogenesis,treat-ment of AR and the development of related biological agents.

Objective:To investigate the effects of allergens on expressions of IL-18,IL-18BPa and IL-18Rα in blood CD4+Th17 cells of patients with allergic rhinitis and asthma syndrome(ARA)and plasma levels of IL-17A and IL-17F in ARA patients.Methods:ARA patients(n=25)and healthy volunteers(n=22)in the First Affiliated Hospital of Jinzhou Medical University and Henan Provincial People's Hospital were recruited,and blood samples of the subjects were collected.Proportions of CD4+Th17 cells,and effects of allergens on expressions of IL-18,IL-18BPa and IL-18Rα in Th17 cells were determined by flow cytometry.Levels of IL-17A and IL-17F were examined by Bioplex system.Correlation between levels of free plasma free IL-18(fIL-18)and IL-17A,and per-centage of Th17 cells was further analyzed.Results:Proportion of IL-18+cells in Th17 cells was increased in ARA patients by 26.0%(P<0.01),and house dust mite allergen induced 1.22-fold elevation in expression of IL-18 in Th17 cells(P<0.05).In addition,Arte-misiae sieversiana wild pollen allergen enhanced expressions of IL-18 and IL-18Rα in Th17 cells of ARA patients(P<0.05).Plasma levels of IL-17A and IL-17F were increased by 2.2 and 1.1 folds,respectively(P<0.05)in ARA patients,and they correlated well with other(R=0.712,P<0.01).Moreover,the increased level of fIL-18 was moderately correlated with the increased level of IL-17A and the elevated proportion of Th17 cells in ARA patients(r=0.607,r=0.652,P<0.05).Conclusion:The increased plasma fIL-18 in ARA patients may be derived from Th17 cells.Allergens may be involved in pathogenesis of ARA by inducing elevated IL-18 and IL-18Rα expressions in Th17 cells.

Objective:To investigate the effects of allergens on expressions of IL-18,IL-18BPa and IL-18Rα in blood CD4+Th17 cells of patients with allergic rhinitis and asthma syndrome(ARA)and plasma levels of IL-17A and IL-17F in ARA patients.Methods:ARA patients(n=25)and healthy volunteers(n=22)in the First Affiliated Hospital of Jinzhou Medical University and Henan Provincial People's Hospital were recruited,and blood samples of the subjects were collected.Proportions of CD4+Th17 cells,and effects of allergens on expressions of IL-18,IL-18BPa and IL-18Rα in Th17 cells were determined by flow cytometry.Levels of IL-17A and IL-17F were examined by Bioplex system.Correlation between levels of free plasma free IL-18(fIL-18)and IL-17A,and per-centage of Th17 cells was further analyzed.Results:Proportion of IL-18+cells in Th17 cells was increased in ARA patients by 26.0%(P<0.01),and house dust mite allergen induced 1.22-fold elevation in expression of IL-18 in Th17 cells(P<0.05).In addition,Arte-misiae sieversiana wild pollen allergen enhanced expressions of IL-18 and IL-18Rα in Th17 cells of ARA patients(P<0.05).Plasma levels of IL-17A and IL-17F were increased by 2.2 and 1.1 folds,respectively(P<0.05)in ARA patients,and they correlated well with other(R=0.712,P<0.01).Moreover,the increased level of fIL-18 was moderately correlated with the increased level of IL-17A and the elevated proportion of Th17 cells in ARA patients(r=0.607,r=0.652,P<0.05).Conclusion:The increased plasma fIL-18 in ARA patients may be derived from Th17 cells.Allergens may be involved in pathogenesis of ARA by inducing elevated IL-18 and IL-18Rα expressions in Th17 cells.

Allergic rhinitis(AR)is the most common airway allergic diseases.Basophils are the classical effector cells in allergy,including AR:Both IgE and non-IgE mediated methods can activate basophils during allergic reactions and induce basophils to release various inflammatory mediators,which is accompanied by changes in the expression of multiple membrane proteins,and ulti-mately leading to the clinical manifestations of allergic diseases.IL-18 may be involved in the pathogenesis of AR by directly inducing basophil activation and inflammation response via binding to its receptor IL-18Rα.Nevertheless,the binding of IL-37b to IL-18Rα initiates the downstream anti-inflammatory signals,thus inhibiting inflammation reaction in AR.Therefore,understanding the role and mechanism of IL-18 and IL-37b in the activation of blood basophils of AR patients is of great significance for the pathogenesis,treat-ment of AR and the development of related biological agents.

Objective:To detect the expression of Toll-like receptor 7(TLR7)in blood neutrophils of patients with allergic rhi-nitis(AR),allergic asthma(AA)and allergic rhinitis combined with allergic asthma(ARA)before and after allergen challenge.Methods:A total of 44 AR,36 AA,19 ARA patients and 19 healthy control(HC)were recruited,the extracts of Artemisia siever-siana wild allergen(ASWE),house dust mite allergen(HDME)and Platanus pollen allergen(PPAE)were used to challenge periph-eral blood of HC as well as the patients,the expression of TLR7 in neutrophils was detected by flow cytometry.Results:In a resting state,compared with HC,upregulated expression of TLR7 in neutrophils in patients with airway allergy:the percentage of TLR7+neu-trophils in AR,AA,ARA patients increased 6 times,3.18 times and 6.15 times,respectively,and the mean fluorescence intensity(MFI)of TLR7 expression in neutrophil in ARA was enhanced by 24%.The results of allergen challenge tests showed that the expres-sion of neutrophils TLR7 did not change in HC subjects after the allergen challenge,whereas the expression of TLR7 in neutrophils of patients with airway allergy was upregulated after the allergens challenge.After HDME and PPAE challenge,the percentage of TLR7+neutrophils in peripheral of AR patients increased by 8.40%and 33.03%,respectively,and the MFI of TLR7 enhanced by 29.62%and 35.72%,respectively.After ASWE and PPAE challenge.The percentage of TLR7+neutrophils in peripheral of AA pa-tients increased by 59.18%and 1.06 times,respectively,and the MFI of TLR7 enhanced by 68.93%and 47.33%,respectively.How-ever,after HDME stimulation only enhanced the MFI of neutrophil TLR7 in AA patients by 66.14%;after HDME challenge,the per-centage of TLR7 and MFI in peripheral blood neutrophils of patients with ARA increased by 21.05%and 35.61%,respectively,while after PPAE challenge,the percentage of TLR7+cells in patients with ARA increased by 20.07%.Conclusion:The expression of TLR7 in blood neutrophils is increased in patients with allergic airway diseases after allergen stimulation,suggesting that allergens may be involved in the occurrence and development of allergic airway diseases by inducing TLR7 expression changes in neutrophils.

Special flight missions cover vast areas,involve urgent tasks,and often require long hours,leading to visual issues for crew,especially during night flights.These problems affect flight parameters and information access.Current special aircraft cockpit displays have low technical standards and limited product sources,restricting design choices.The absence of visual ergonomics evaluation tools and methods in the aviation industry significantly contributes to the shortcomings in military aircraft cockpit design.Considering the General Specification for Airborne Liquid Crystal Displays(GJB8187-2015)and other relevant standards,this covers modern cockpit display requirements,current cockpit display status,screen light source modification technology,and visual ergonomics assessment for cockpit displays.To determine if the visual clarity,color accuracy,and other attributes of current special aircraft airborne displays during flight meet the needs for long-duration operations,and if the operational environment ensures visual comfort and ergonomics to minimize visual fatigue.We seek to enhance the evaluation of visual ergonomics satisfaction for flight crews in current special aircraft cockpits and offers new approaches to optimize cockpit display technology,reducing visual issues from prolonged screen use during flights.

Sepsis is a life-threatening organ dysfunction,which is caused by the body's uncontrolled immune response to infection.Tissue masts cells(MC),derived from blood mast cell progenitors,are one of the classical effector cells in inflammatory response.MC plays an important role in sepsis via secreting a variety of inflammatory mediators and cytokines.Here,we summarized the potential roles of MC in sepsis,which is expected to provide novel ideas for the future research on the novel mechanisms of MC in sepsis.

Objective:To investigate the expression of IL-18, IL-18-binding protein a(IL-18BPa) and IL-18 receptor α(IL-18Rα) by peripheral blood CD4 + Th17 cells of patients with allergic rhinitis (AR) and the effects of allergens on their expression. Methods:This study enrolled 45 outpatients with AR and 23 healthy control subjects receiving physical examination in the First Affiliated Hospital of Jinzhou Medical University from October 2019 to September 2020. According to the results of skin prick test, the 45 patients were divided into two groups: AR group with positive results (24 cases) and nAR group with negative results (21 cases). Blood samples of them were collected. Flow cytometry was used to analyze the effects of allergens on the expression of IL-18, IL-18BPa and IL-18Rα at protein level by peripheral blood CD4 + Th17 cells. The level of IL-17A in plasma was measured by Bioplex system, and its correlation with the percentage of IL-18 + Th17 cells was analyzed. Results:Compared with the healthy control group, the AR group showed increased ratios of CD4 + Th17 and IL-18 + Th17 cells ( P<0.01), decreased ratio of IL-18BPa + Th17 cells ( P<0.01), enhanced mean fluorescence intensity (MFI) of IL-18BPa ( P<0.01) and reduced MFI of IL-18Rα ( P<0.01); the nAR group showed enhanced MFI of IL-18BPa ( P<0.000 1) and reduced MFI of IL-18Rα ( P<0.000 1). The ratio of IL-18 + Th17 cells and the MFI of IL-18Rα in the AR group were higher than those in the nAR group ( P<0.05, P<0.01). House dust mite extract and Platanus pollen extract induced the expression of IL-18 and IL-18BPa by CD4 + Th17 cells of AR patients ( P<0.05). Moreover, house dust mite extract directly induced the CD4 + Th17 cells isolated from the healthy control subjects to express IL-18 and IL-18R ( P<0.05). Compared with healthy control subjects, AR patients had higher level of IL-17A in plasma and it was moderately correlated with the ratio of IL-18 + Th17 cells ( P<0.05). Conclusions:Allergens may be involved in the pathogenesis of AR by inducing blood CD4 + Th17 cells to express IL-18 and IL-18Rα.

Activated eosinophils are the core effector cells in immune responses.Interleukin-18(IL-18),a classical inflammasome-related cytokine,is reported to induce eosinophil differentiation,development and activation by binding with IL-18 receptor α,and thus promoting inflammation responses.Therefore,a thorough understanding of the role of IL-18 in eosinophil differentiation,development and activation is of great significance for the diagnosis and treat-ment of eosinophil-induced inflammatory diseases,and for the research and development of IL-18-related biological agents.