Objective:To assess the effects of allergens on interleukin-18 (IL-18), IL-18 binding protein a (IL-18BPa), and IL-18 receptor α (IL-18Rα) expression levels in different monocyte subtypes of the peripheral blood samples of allergic asthma (AA) patients, and the correlations between the percentage of IL-18 +classical monocytes and plasma levels of pro-inflammatory cytokines. Methods:A cross-sectional study. Blood samples were collected from 28 healthy controls and 33 patients experiencing acute attack of AA based on a positive skin prick test of Henan Provincial People′s Hospital from February 2023 to April 2024. Flow cytometry was used to assess the effects of allergens on IL-18, IL-18BPa, and IL-18Rα expression levels in the classical, intermediate, and non-classical monocytes of the peripheral blood samples of AA patients. Kruskal-Wallis test and Pairwise test were used to analyze statistical significance between groups. Plasma tumor necrosis factor α (TNF-α) and interleukin 1β (IL-1β) levels were estimated using Bioplex assays. Pearson correlation test was used to determine the association between the percentage of IL-18 +classical monocytes and the plasma levels of IL-1β and TNF-α. Results:Compared with healthy controls, the percentages of classical and non-classical monocytes in the peripheral blood of AA patients were reduced by 20.2% ( Z=-3.89, P<0.001) and 45.8% ( Z=-4.01, P<0.001), respectively. Allergens increased the percentages of classical, intermediate, and non-classical monocytes in AA patients in vitro by 13.1%-61.5% (all P<0.05). Compared with healthy controls, the percentages of IL-18 expression in classical monocytes of AA patients was elevated by 1.08-fold ( Z=-6.40, P<0.001), whereas the percentages of IL-18 expression in intermediate and non-classical monocytes were reduced by 52.7% ( Z=-6.40, P<0.001) and 3.23% ( Z=-3.13, P=0.001), respectively. Allergens upregulated IL-18 expression by 16.4%-67.8% in the classical and intermediate monocytes of AA patients (all P<0.05). Compared with healthy controls, IL-18BPa expression level was lower in the three monocyte subtypes of AA patients (all P<0.05). However, allergens upregulated IL-18BPa expression by 8.9% and 13.3% in the classical monocytes (both P<0.05). Compared with healthy controls, IL-18Rα expression was elevated by 1.29-fold in the classical monocytes of AA patients ( Z=-6.40, P<0.001). Allergens upregulated IL-18Rα expression by 17.6%-39.2% in the three monocyte subtypes of AA patients (all P<0.05). Plasma levels of IL-1β and TNF-α in the AA patients were increased compared to those in healthy controls (all P<0.001), and correlated with the percentage of IL-18 +classical monocytes ( r=0.451, 0.714; both P<0.05). Conclusions:Allergens may participate in the inflammatory response of AA by inducing the differentiation of monocytes and the expression levels of IL-18, IL-18BPa and IL-18Rα in different blood monocytes subtypes. Classical monocytes are the potential source of elevated plasma IL-18 level in AA patients.

Objective:To assess the effects of allergens on interleukin-18 (IL-18), IL-18 binding protein a (IL-18BPa), and IL-18 receptor α (IL-18Rα) expression levels in different monocyte subtypes of the peripheral blood samples of allergic asthma (AA) patients, and the correlations between the percentage of IL-18 +classical monocytes and plasma levels of pro-inflammatory cytokines. Methods:A cross-sectional study. Blood samples were collected from 28 healthy controls and 33 patients experiencing acute attack of AA based on a positive skin prick test of Henan Provincial People′s Hospital from February 2023 to April 2024. Flow cytometry was used to assess the effects of allergens on IL-18, IL-18BPa, and IL-18Rα expression levels in the classical, intermediate, and non-classical monocytes of the peripheral blood samples of AA patients. Kruskal-Wallis test and Pairwise test were used to analyze statistical significance between groups. Plasma tumor necrosis factor α (TNF-α) and interleukin 1β (IL-1β) levels were estimated using Bioplex assays. Pearson correlation test was used to determine the association between the percentage of IL-18 +classical monocytes and the plasma levels of IL-1β and TNF-α. Results:Compared with healthy controls, the percentages of classical and non-classical monocytes in the peripheral blood of AA patients were reduced by 20.2% ( Z=-3.89, P<0.001) and 45.8% ( Z=-4.01, P<0.001), respectively. Allergens increased the percentages of classical, intermediate, and non-classical monocytes in AA patients in vitro by 13.1%-61.5% (all P<0.05). Compared with healthy controls, the percentages of IL-18 expression in classical monocytes of AA patients was elevated by 1.08-fold ( Z=-6.40, P<0.001), whereas the percentages of IL-18 expression in intermediate and non-classical monocytes were reduced by 52.7% ( Z=-6.40, P<0.001) and 3.23% ( Z=-3.13, P=0.001), respectively. Allergens upregulated IL-18 expression by 16.4%-67.8% in the classical and intermediate monocytes of AA patients (all P<0.05). Compared with healthy controls, IL-18BPa expression level was lower in the three monocyte subtypes of AA patients (all P<0.05). However, allergens upregulated IL-18BPa expression by 8.9% and 13.3% in the classical monocytes (both P<0.05). Compared with healthy controls, IL-18Rα expression was elevated by 1.29-fold in the classical monocytes of AA patients ( Z=-6.40, P<0.001). Allergens upregulated IL-18Rα expression by 17.6%-39.2% in the three monocyte subtypes of AA patients (all P<0.05). Plasma levels of IL-1β and TNF-α in the AA patients were increased compared to those in healthy controls (all P<0.001), and correlated with the percentage of IL-18 +classical monocytes ( r=0.451, 0.714; both P<0.05). Conclusions:Allergens may participate in the inflammatory response of AA by inducing the differentiation of monocytes and the expression levels of IL-18, IL-18BPa and IL-18Rα in different blood monocytes subtypes. Classical monocytes are the potential source of elevated plasma IL-18 level in AA patients.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective To analyze and evaluate the current progress of blood transfusion department establishment and clinical blood transfusion management in Hangzhou,China.Methods Questionnaires were sent to 35 medical institutions to gather information regarding blood transfusion department establishment and clinical blood transfusion management in the provincial,municipal and county tier hospitals.The investigated criteria covered the establishment of the hospital blood transfusion management committee,the utilization of software and hardware of the transfusion department,the compatibility status of various software systems in use and performance evaluation of these systems in clinical applications,etc.In addition,tests were also conducted on members of the blood transfusion departments to confirm whether they are properly trained and present adequated knowledge of clinical blood applications Results were then collected for statistical and descriptive analyses.Results The results out of the 35 hospitals surveyed presented no obvious statistical significance.Nevertheless,the average score of these hospitals in different segments helped us to reach the following conclusions:1,Triple-A hospitals scored the highest average score for patient clinical status evaluation pre-transfusion;2.Double-B hospitals came first when it comes to patient clinical status evaluation post transfusion;3.Triple-B hospitals possessed the most thorough clinical records for transfusion treatment.A total of 350 papers were issued and 350 papers were collected,with 327 out of the 350 considered valid.As for the test results regarding the departments members,triple-A,triple-B and double-A hospitals scored significantly higher than double-B and unranked hospitals.(P＜0.05);.350 clinical transfusion records were also collected and 247 of which are considered valid.It appears there are numerous difference in Hb indexes among the tested hospitals and even the departments of internal medicine and surgical presented different takes on the subject as well.Conclusion The clinical blood transfusion management in Zhejiang province and the establishment of blood transfusion departments still need to be improved.A plan to manage clinical blood use need to be carried out ASAP,which would specify evaluation references,standardize personnel training and tech investments.Ultimately,we hope such actions would help to further regulate the clinical blood use in the region.

Objective To analyze the bio-mechanics when hemiplegics reach with the unaffected upper limb.Methods Thirty post-stroke hemiplegics were selected into the patient group,while 23 healthy counterparts were chosen for the control group.Both groups completed a reaching test of their upper limbs which divided reaching into a moving stage and a holding stage.Surface electromyography (sEMG) data were recorded during the tests along with the degree of torso twist,the range of motion of the shoulder,movement velocity,smoothness of movement and angle divergence collected using a wearable micro-sensor motion capture system.Results For the stroke patients whose dominant upper limb was unaffected,the average root mean square (RMS) signal from the upper trapezius (34.3 μV) and the average torso twist (-1.4°) in the moving phase were significantly larger than among the control subjects (19.7 μV and-2.3°),but their average movement velocity was significantly slower.In the holding phase the average RMS signal from the upper trapezius (55.4 μV) was still significantly higher than in the control group,but their average pectoralis major signal and the integrated EMG ratio of the anterior segments of the deltoid and upper trapezius muscle pairs were significantly lower.For the stroke patients whose dominant upper limbs were affected,in thc moving phase their average signal from the middle segments of the deltoid were significantly greater than those of the controls,but their movement velocity was significantly slower.For the control subjects,in the moving phase the average signal from the upper trapezius on their non-dominant side was significantly higher than that from the dominant upper limb.The integrated EMG ratio from the anterior segments of the deltoid and upper trapezius muscle pairs on that side was smaller throughout the whole reaching movement.Conclusion The bio-mechanical characteristics in reaching of the unaffected upper limbs of stroke patients are not the same as those of the corresponding upper limbs of healthy subjects.It is more reasonable to select the corresponding upper limbs of healthy subjects as controls when a bio-mechanical study of the affected upper limbs is conducted.

Objective To document the kinematics of upper-limb motor dysfunction among hemiplegic stroke survivors.Methods Thirty-nine stroke survivors with hemiplegia were selected as the experimental group,while twenty-five healthy counterparts were chosen as the control group.Reaching movements performed in the sagittal plane were divided into an anteflexion phase and a holding phase.Three-dimensional kinematics data were captured using a micro-sensor motion capture system,and surface electromyograms (sEMGs) were recorded synchronously from the upper trapezius (UT),the anterior (AD) and middle (MD) segments of the deltoid,the biceps brachii (BB) and the triceps brachii (TB).The torso twist (TTD),the range of motion (ROM) of the shoulder,movement velocity (MV),isotonic instability degree (IT) and isometric instability degree (IM) were extracted.Integrated electromyography (iEMG) and work ratios were chosen as indicators to compare the two groups.The experimental group's kinematic indicators were correlated with that group's sEMG parameters.Results The average TTD,IT and IM in the experimental group were significantly larger than those of the control group,while the ROM of the shoulder and the MV were significantly smaller.During the anteflexion phase,the average iEMG from the UT in the experimental group was significantly larger than that of the control group,while the average iEMGs from their AD and TB were significantly smaller;The BB/TB work ratios in the experimental group were significantly greater than those of the conrol group,while the AD/UT and AD/MD ratios were significantly smaller.The results during the holding phase were similar.In the experimental group,torso twist was found to be positively correlated with the iEMG of the UT,and the ROM of the shoulder and movement velocity were also positively correlated with the iEMG of the AD.Conclusions Kinematics variables and sEMG features can be used to evaluate the motor dysfunction of hemiplegic stroke patients' affected upper limbs quantitatively and provide guidance for rehabilitation.

Objective To investigate the HIV-1 drug resistance in Guangxi during 2009 to 2012 and to analyze the correlations between drug resistance and HIV-1 subtypes.Methods Patients with human immunodeficiency virus infection or acquired immune deficiency syndrome ( HIV/AIDS) were randomly re-cruited from different areas in Guangxi.HIV-1 RNA was extracted from blood samples of the subjects and converted into complementary DNA ( cDNA) by using reverse transcription.The pol gene was amplified and sequenced.Subtyping analysis was performed by using the online analysis tool of Genotyping in combination with the MEGA 5.03 software.The HIV resistance mutations were determined and scored with the use of Stanford HIV Drug Resistance Database.Results A total of 196 pol gene sequences were obtained from 103 antiretroviral therapy (ART)-treated subjects (52.55%) and 93 ART-na?ve subjects (47.45%).The 196 pol gene sequences were classified into four subtypes including CRF01_AE, CRF08_BC, CRF07_BC and B, accounting for 48.47%, 44.90%, 6.12%and 0.51%, respectively.The HIV drug resistance rates in sub-jects with and without ART were 10.68% and 7.53%, respectively.Among the 196 subjects, 14 cases showed low level of drug resistance, 3 cases showed moderate level of drug resistance and 4 cases showed high level of resistance.Only one case was resistant to both nucleoside reverse transcriptase inhibitors ( NR-TIs) and non-nucleoside reverse transcriptase inhibitors ( NNRTIs) .The resistance rates of the 196 cases to protease inhibitor (PIs), NRTIs, NNRTIs, and integrase inhibitors (INs) were 6.63%, 3.06%, 11.22%and 8.67%, respectively.The frequencies of PIs-related mutations in subtypes CRF01_AE, CRF07_BC and CRF08_BC were 6.32%, 41.67% and 2.27%, respectively.Most of the PI-related A71V/T mutations were identified in strains belonging to subtype CRF07_BC, accounting for 75% of all A71V/T mutations found in the 196 strains.The NNRTI-related E138A mutations only appeared in strains belonging to subtype CRF08_BC.Conclusion The drug resistance rate among patients with HIV-1/AIDS in Guangxi was higher than the average level in China.The drug resistance rates varied with the subtypes of HIV-1 strains.

The aim of this study was to investigate the influence of opiate abuse on the expression of Toll-like receptor 9 (TLR9) in the peripheral blood mononuclear cells (PBMCs) of HIV-1-infected patients and to elucidate possible mechanisms involved in the enhancement of HIV-1 replication by opiate abuse. A total of 200 participants were enrolled in the study by random selection from methadone treatment centers and voluntary HIV counseling and testing centers in the cities of Nanning, Liuzhou, and Qinzhou. These participants included 50 HIV-positive opiate abusers (Opiates HIV(+) group), 50 HIV-negative opiate abusers (Opiates HIV(-) group), 50 HIV-positive subjects who were not opiate abusers (Non-opiates HIV (+) group), and 50 HIV-negative subjects who were not opiate abusers (Control group). PBMCs were isolated from the peripheral blood samples from the subjects and the expression levels of TLR9 mRNA and protein were determined by q-PCR and western blot respectively. There was no significant difference among the four groups in age, gender, nationality, domicile, marital status, educational background or duration of drug abuse (P > 0.05). The median viral loads of the Opiates HIV(+) were significantly higher than those of the Non-Opiates HIV(+) groups (4.450 x 10(3) and 3.977 x 10(3) copies/mL respectively, P < 0.05). The relative expression levels of TLR9 mRNA in the Opiates HIV(+), Non-Opiates HIV(+), Opiates HIV(-) and Control groups were (2.13 +/- 1.59) x 10(-3), (3.66 +/- 2.22) x 10(-3), (1.96 +/- 1.42) x 10(-3) and (7.66 +/- 4.87) x 10(-3), respectively. The expression of TLR9 mRNA was significantly lower in both HIV-1-infected and -uninfected groups of opiate abusers compared with groups of non-abusers (P < 0.05). There was no significant difference in TLR9 mRNA expression levels between the Opiates HIV(+) group and the Opiates HIV(-) group (P > 0.05). However, in the non-opiate groups, the expression levels of TLR9 mRNA in the HIV(+) group were significantly lower than that of the control group (P< 0.05). Western blot results confirmed that the expression of TLR9 protein was lower in the Opiates HIV(+), Non-Opiates HIV(+), and Opiates HIV(-) groups compared to the control group. These results suggest that opiate abuse can decrease the expression of TLR9 in PBMCs, which may result in the enhancement of HIV-1 infection and replication due to a decline in immune response mediated by the TLR9 pathway.
Adolescent ; Adult ; Female ; HIV Infections ; genetics ; metabolism ; virology ; HIV-1 ; physiology ; Humans ; Leukocytes, Mononuclear ; metabolism ; Male ; Middle Aged ; Opioid-Related Disorders ; genetics ; metabolism ; Toll-Like Receptor 9 ; genetics ; metabolism ; Young Adult

Objective To investigate the impact of methamphetamine (Meth) on the expressions of macrophage inflammatory protein (MIP)-1α ,MIP-1β ,interleukin (IL)-6 among human immunodeficiency virus(HIV)-infected patients .Methods The investigation was performed among 15 Meth-abuse and HIV-infected subjects (Meth + HIV ) ,15 non-Meth-abuse and HIV-infected subjects (non-Meth + HIV ) ,15 Meth-abuse and HIV-uninfected subjects (Meth) ,and 15 healthy subjects (HC) .CD4 + T lymphocyte counts in peripheral blood were detected by flow cytometry .The HIV viral loads in HIV-infected patients were detected by standard detection method .The levels of plasma MIP-1α ,MIP-1β and IL-6 from four groups were determined by enzyme-linked immunosorbent assay (ELISA ) .Intergroup difference was compared using t-test and interactive analysis was conducted using analysis of variance .Results In HIV-infected patients ,CD4 + T lymphocyte counts in Meth + HIV group was significant lower than non-Meth +HIV group (t= 5 .431 , P< 0 .01) ,whereas HIV viral load in Meth + HIV group was significant higher than non-Meth + HIV group (t= 4 .670 , P < 0 .01) .The levels of MIP-1α ,MIP-1β and IL-6 in Meth +HIV group were (40 .60 ± 9 .84) pg/mL , (47 .35 ± 11 .25 ) pg/mL and (37 .94 ± 11 .44 ) pg/mL , respectively ,and those in non-Meth + HIV group were (31 .31 ± 8 .11) pg/mL ,(39 .40 ± 8 .41) pg/mL and (31 .31 ± 8 .11) pg/mL ,respectively .The levels of MIP-1α ,MIP-1β and IL-6 in Meth + HIV group were all significantly higher than those in non-Meth + HIV group(t = 2 .822 , P= 0 .001 ;t = 2 .192 , P=0 .020 ;t= 1 .831 , P = 0 .043 ,respectively ) .The levels of MIP-1α ,MIP-1β and IL-6 in Meth group were (24 .45 ± 5 .90) pg/mL ,(27 .82 ± 7 .25) pg/mL and (27 .18 ± 8 .57) pg/mL ,respectively ,and those in HC group were (28 .42 ± 5 .79) pg/mL ,(31 .76 ± 9 .04) pg/mL and (23 .28 ± 6 .07) pg/mL ,respectively .But there were no significant differences of the levels of MIP-1α ,MIP-1β and IL-6 between Meth group and HC group(t= 1 .860 , P = 0 .158 ; t = 1 .317 , P = 0 .233 ; t = 1 .438 , P = 0 .228 ,respectively) .There was no association between Meth-abuse and the levels of these cytokines (P> 0 .05) ,neither between HIV infection and the levels of cytokines (P> 0 .05) .Conclusion Meth abuse results in elevated expressions of MIP-1αand MIP-1β ,which indicates that Meth abuse may play a regulating role on promoting HIV infection .

Objective To explore the expressions of Toll-like receptor 2 (TLR2 ) and the downstream proteins in patients with human immunodeficiency virus /Mycobacterium tuberculosis (HIV /M TB) co-infection .Methods A total of 119 subjects were randomly enrolled .The subjects were divided into four groups :HIV group (n = 32) ,HIV /M TB group (n = 30) ,M TB group (n = 28) and healthy control group (n= 29) .Peripheral venous blood was collected and the HIV-1 viral load was determined by standard method .The expression levels of TLR2 mRNA in peripheral blood mononuclear cells (PBMC) were determined by real-time quantitative PCR (qPCR) and mean fluorescent intensity (MFI) of TLR2 protein was detected by flow cytometry .The plasma interleukin (IL)-6 and tumor necrosis factor (TNF)-α levels were measured with enzyme-linked immunosorbent assay kits .The data were statistically analyzed by chi-square test ,students t test ,analysis of variance and rank sum test when appropriate .Results The viral load in HIV /M TB group ([5 .113 ± 1 .018] lg copy/mL ) was significantly higher than that in HIV group ([4 .416 ± 1 .020] lg copy/mL ; t = 3 .449 , P< 0 .01) .The TLR2 mRNA expressions in PBMC
among HIV ,HIV/M TB ,M TB and healthy control groups were 1 .397 ± 0 .601 ,1 .463 ± 0 .702 ,1 .429 ± 0 .630 ,and 0 .970 ± 0 .488 ,respectively ,which was significantly different among the 4 groups (F =4 .197 , P= 0 .007) .The MFI of TLR2 protein expressions on PBMC among HIV ,HIV /M TB ,M TB and healthy control groups were 28 .12 ± 4 .55 ,38 .11 ± 11 .77 ,31 .13 ± 12 .10 and 23 .33 ± 5 .14 ,respectively . The TLR2 protein expression levels were significantly different among 4 groups (F= 13 .976 ,P< 0 .01) . The plasma IL-6 and TNF-α concentrations were significantly different among 4 groups (Z = 19 .088 , 15 .475 ,both P< 0 .01) .The IL-6 concentrations in three patient groups were higher than that in healthy control group ,but the TNF-α concentrations were lower than healthy control group .Conclusions The co-infection of HIV-1 and M TB may enhance the activation of TLR2 signaling pathway ,which leads to the increased expression of IL-6 .