Objective: To evaluate the practical effectiveness of confidential unit exclusion (CUE) in ensuring blood safety in Zhengzhou, analyze its application characteristics and existing problems, and provide a basis for optimizing blood safety management strategies. Methods: A retrospective analysis was conducted on CUE data handled by Henan Red Cross Blood Center from January 2019 to December 2024. Parameters such as the number of cases, demographic characteristics, reasons for exclusion, and time of report were statistically analyzed and compared with those of non-CUE. Results: From 2019 to 2024, the CUE reporting rate in Zhengzhou was 0.002 6% (40/1 547 666). CUE donors were predominantly male (65.00%, 26/40), aged 18-34 years (47.50%, 19/40), had college degree orabove (50.00%, 20/40), and were employees of enterprises or public institutions (32.50%, 13/40). Among the 40 CUE blood units, only one was reactive for anti-TP, while all others were qualified. The main reasons for CUE were recent vaccination (32.50%, 13/40), medical conditions unsuitable for donation (27.50%, 11/40), and high-risk sexual behavior (17.50%, 7/40). A total of 70.00% of reports occurred within 24 hours after donation, during which none of the corresponding blood units had been released; all units reported after more than 7 days had already been issued for clinical use, with no adverse transfusion reactions reported upon follow-up. Conclusion: The confidential unit exclusion program has played an active role in establishing a supplementary information feedback channel for blood donors. The procedure can be optimized by strengthening interactive communication and confirmation before donation, improving the accuracy of donors' self-assessment, and expanding convenient and rapid information-based reporting channels.

ObjectiveTo investigate the clinical effect of Ershen Zhenwu Decoction on chronic heart failure （CHF） due to heart-kidney Yang deficiency and blood stasis and its regulatory effects on miR-423-5p/Smad7/transforming growth factor-β₁ （TGF-β₁）/Smads axis and myocardial fibrosis indicators. MethodsOne hundred and fourteen patients with heart failure with reduced ejection fraction （HFrEF） and heart failure with mildly reduced ejection fraction （HFmrEF） were randomly allocated into a control group and an observation group. The control group was treated with dapagliflozin tablets， sacubitril-valsartan sodium tablets， metoprolol succinate， and spironolactone， and the observation group was treated with Ershen Zhenwu Decoction on the basis of the therapy in the control group. The course of treatment was 8 weeks in both groups. The 6-min walking distance， New York Heart Association （NYHA） heart function grade， Minnesota Living with Heart Failure Questionnaire （MLHFQ） score， N-terminal pro-B-type natriuretic peptide （NT-proBNP）， angiotensin Ⅱ （Ang Ⅱ）， left ventricular ejection fraction （LVEF）， left ventricular end-diastolic diameter （LVIDd）， left ventricular end-systolic diameter （LVIDs）， interventricular septum thickness at diastole （IVSd）， left ventricular end-diastolic posterior wall thickness （LVPWd）， left ventricular shortening fraction （FS）， miR-423-5p， Smad7， Smad2， Smad3， Smad4， TGF-β₁， Ang Ⅱ， type Ⅰ collagen （Col Ⅰ）， type Ⅲ collagen （Col Ⅲ）， mRNA levels of fibronectin （Fn） and α-smooth muscle actin （α-SMA） in the myocardial tissue were observed before and after treatment in both groups to evaluate the efficacy of cardiac function and drug safety. ResultsAfter treatment， both groups showed declined levels of NT-proBNP， Ang Ⅱ， miR-423-5p， Smad2， Smad3， Smad4， TGF-β₁， Col Ⅰ， Col Ⅲ， and mRNA levels of Fn and α-SMA （P0.05）， and the levels of the indicators above were lower in the observation group than in the control group （P0.05）. After treatment， the Smad7 level increased obviously in both groups （P0.05） and was higher in the observation group than in the control group （P0.05）. After treatment， both groups showed decreased MLHFQ scores and increased 6-min walking distance （P0.05）， and the observation group had lower MLHFQ score and longer 6-min walking distance than the control group （P0.05）. After treatment， the control group showed increased LVEF and FS （P0.05） and the observation group showcased decreased LVIDd and LVIDs and increased LVEF and FS （P0.05）. Moreover， the observation group had lower LVIDd and LVIDs （P0.05） and higher LVEF and FS （P0.05） than the control group. The total response rate of cardiac function in the observation group was 90.38% （47/52）， which was higher than that （70.59%， 36/51） in the control group （P0.05）. No adverse reactions associated with Ershen Zhenwu Decoction were observed during the study period. ConclusionErshen Zhenwu Decoction can improve the cardiac function， exercise tolerance， and quality of life， regulate neuroendocrine factors， and slow down/reverse myocardial remodeling in the patients with HFrEF and HFmrEF （syndrome of heart-kidney Yang deficiency and blood stasis by regulating the miR-423-5p/Smad7/TGF-β₁/Smads axis， inhibiting α-SMA and Fn expression， and alleviating myocardial fibrosis. It is worthy of further study.

ObjectiveTo investigate the clinical effect of Ershen Zhenwu Decoction on chronic heart failure （CHF） due to heart-kidney Yang deficiency and blood stasis and its regulatory effects on miR-423-5p/Smad7/transforming growth factor-β₁ （TGF-β₁）/Smads axis and myocardial fibrosis indicators. MethodsOne hundred and fourteen patients with heart failure with reduced ejection fraction （HFrEF） and heart failure with mildly reduced ejection fraction （HFmrEF） were randomly allocated into a control group and an observation group. The control group was treated with dapagliflozin tablets， sacubitril-valsartan sodium tablets， metoprolol succinate， and spironolactone， and the observation group was treated with Ershen Zhenwu Decoction on the basis of the therapy in the control group. The course of treatment was 8 weeks in both groups. The 6-min walking distance， New York Heart Association （NYHA） heart function grade， Minnesota Living with Heart Failure Questionnaire （MLHFQ） score， N-terminal pro-B-type natriuretic peptide （NT-proBNP）， angiotensin Ⅱ （Ang Ⅱ）， left ventricular ejection fraction （LVEF）， left ventricular end-diastolic diameter （LVIDd）， left ventricular end-systolic diameter （LVIDs）， interventricular septum thickness at diastole （IVSd）， left ventricular end-diastolic posterior wall thickness （LVPWd）， left ventricular shortening fraction （FS）， miR-423-5p， Smad7， Smad2， Smad3， Smad4， TGF-β₁， Ang Ⅱ， type Ⅰ collagen （Col Ⅰ）， type Ⅲ collagen （Col Ⅲ）， mRNA levels of fibronectin （Fn） and α-smooth muscle actin （α-SMA） in the myocardial tissue were observed before and after treatment in both groups to evaluate the efficacy of cardiac function and drug safety. ResultsAfter treatment， both groups showed declined levels of NT-proBNP， Ang Ⅱ， miR-423-5p， Smad2， Smad3， Smad4， TGF-β₁， Col Ⅰ， Col Ⅲ， and mRNA levels of Fn and α-SMA （P0.05）， and the levels of the indicators above were lower in the observation group than in the control group （P0.05）. After treatment， the Smad7 level increased obviously in both groups （P0.05） and was higher in the observation group than in the control group （P0.05）. After treatment， both groups showed decreased MLHFQ scores and increased 6-min walking distance （P0.05）， and the observation group had lower MLHFQ score and longer 6-min walking distance than the control group （P0.05）. After treatment， the control group showed increased LVEF and FS （P0.05） and the observation group showcased decreased LVIDd and LVIDs and increased LVEF and FS （P0.05）. Moreover， the observation group had lower LVIDd and LVIDs （P0.05） and higher LVEF and FS （P0.05） than the control group. The total response rate of cardiac function in the observation group was 90.38% （47/52）， which was higher than that （70.59%， 36/51） in the control group （P0.05）. No adverse reactions associated with Ershen Zhenwu Decoction were observed during the study period. ConclusionErshen Zhenwu Decoction can improve the cardiac function， exercise tolerance， and quality of life， regulate neuroendocrine factors， and slow down/reverse myocardial remodeling in the patients with HFrEF and HFmrEF （syndrome of heart-kidney Yang deficiency and blood stasis by regulating the miR-423-5p/Smad7/TGF-β₁/Smads axis， inhibiting α-SMA and Fn expression， and alleviating myocardial fibrosis. It is worthy of further study.

Chirality is not only a natural phenomenon but also a bridge between chemistry and life sciences.An effective way to obtain a single enantiomer is through racemates resolution.Recent literature shows that chiral metal-organic frameworks(CMOFs)have many applications in various fields because of their diverse topologies and functionalities.This review outlines the design idea and summarizes the latest synthesis strategies and applications of CMOFs.It highlights key advances and issues in the separation domain.In conclusion,the review provides perspectives on the challenges and prospective advance-ments of CMOFs materials and CMOFs-based separation technologies.

Objective:To investigate the mechanism of the synergistic anti-leukemia effect of the combination of Bcl-2 inhibitor venetoclax(VEN)and histone deacetylase(HDAC)inhibitor chidamide(CDM)in T-cell acute lymphoblastic leukemia(T-ALL).Methods:The effect of VEN combined with CDM on the proliferation of T-ALL CEM and MOLT-4 cell lines was detected by CCK-8 assay.And the effects on the cell cycle and apoptosis were detected by flow cytometry.Cell cycle protein and apoptosis-related protein expression were detected by Western blot.The key pathways of VEN combined with CDM in T-ALL were screened through network pharmacology analysis,and verifying them in T-ALL cell lines,T-ALL patient cells and public databases.Results:VEN combined with CDM displayed a synergistic effect on cell proliferation of CEM and MOLT-4 cells.In cell cycle experiment,VEN combined with CDM induced G0/G1 phase arrest in CEM and MOLT-4 cells.Western blot experiment showed that VEN combined with CDM could significantly downregulate the expression of cyclin E2 and CDK2 and upregulate the expression of p21Waf1/Cip1.In the apoptosis experiment,VEN combined with CDM could significantly induce the apoptosis of CEM and MOLT-4 cells.Western blot experiment demonstrated that VEN combined with CDM promoted endogenous apoptosis by downregulating Mcl-1 and upregulating Bax and cleaved caspase-3 protein levels.Network pharmacology analysis identified 10 hub genes.KEGG enrichment analysis revealed the cell cycle,PI3K-AKT signaling pathway,and its downstream FoxO signaling pathway were significantly enriched.GO enrichment analysis revealed the G1/S transition of mitotic cell cycle,cyclin-dependent protein kinase holoenzyme complex,and kinase activity were significantly enriched.Western blot experiment showed that VEN combined with CDM could significantly downregulate the protein level of PI3K,AKT,and p-AKT,and upregulate FoxO1 in CEM and MOLT-4 cells.In T-ALL patients,FoxO1 showed significantly lower expression compared to the normal donors,and the same result was verified in the GSE13159 and GSE26713 datasets.Conclusion:The combination of VEN and CDM exerts synergistic anti-leukemia effects by inhibiting cellular proliferation,inducing G0/G1,phase arrest and promoting apoptosis through PI3K/AKT/FoxO1 axis in T-ALL.

Objective To investigate the effect of Huangqi Shengmai Yin(HSY)on myocardial fibrosis in rats with acute myocardial infarction(AMI)by adjusting P2X purinoceptor 7(P2X7R)/NOD-like receptor protein 3(NLRP3)pathway.Methods Sixty rats were divied into a sham operation group and model group(5 groups),with 10 rats in each group.The AMI rat model was constructed by ligating the left anterior descending branch and randomly grouped into AMI group,the HSY-low group(intragastric administration of 1.6 ml/kg HSY),the HSY group(intragastric administration of 6.2 ml/kg HSY),the compound miltiorhiza group(intragastric administration of 300 mg/kg),and the HSY-high+P2X7R agonist-ATP group(intragastric administration of 6.2 ml/kg HSY,and tail vein administration of 10 mmol/L ATP).After the intervention,cardiac function,myocardial injury and inflammatory factor markers were detected.The tissue sections were prepared to examine pathological changes,myocardial fibrosis,type Ⅰ and type Ⅲ collagen(COL1A1,COL3A1).Western blotting was performed to detecte the protein expression of P2X7R,NLRP3,tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),and the expression of activated Caspase-1.Results Compared with the sham surgery group,the AMI group showed an increase in the left ventricular end diastolic diameter(LVEDD),the coatent of brain natriuretic peptide(BNP)and cardiac troponin I(cTn I),fibrosis volume fraction,the positive expression of COL1A1,COL3A1,TNF-α,IL-1β,P2X7R,NLRP3,and activated Caspase-1 proteins(P＜0.05),and a decrease in left ventricular ejection fraction(LVEF)(P＜0.05).The HSY-low group,HSY-high groups,and compound miltiorhiza group showed a decrease in LVEDD,the content of BNP and cTn I,fibrosis volume fraction,the positive expression of COL1A1 and COL3A1,TNF-α,IL-1β,P2X7R,NLRP3,and activated Caspase-1 proteins(P＜0.05),and an increase in LVEF than these in the AMI group(P＜0.05).The HSY-high+ATP group showed an increase in LVEDD,the content of BNP,cTn I,fibrosis volume fraction,the positive expression of COL1A1 and COL3A1,TNF-α,IL-1β,P2X7R,NLRP3,and activated Caspase-1 proteins(P＜0.05),and a decrease in LVEF than those in the HSY-high group(P＜0.05).Conclusion HSY inhibits P2X7R/NLRP3 pathway to alleviate myocardial fibrosis in AMI rats.

Objective:To investigate the expression of miR-769-5p in serum exosomes of epithelial ovarian cancer(EOC)and its mechanism of influence on EOC cell proliferation,migration,and invasion.Methods:The expression level of miR-769-5p in serum exosomes from the malignant group,benign ovarian disease group,and healthy control group was detected using reverse transcription quantitative polymerase chain reaction(RT-qPCR).Lipofectamine 3000 transfection was used to construct overexpression and knockdown cell lines,which were divided into four groups:miR-769-5p mimics group,mimics-NC group,miR-769-5p inhibitor group,and inhibi-tor-NC group.The effects of miR-769-5p on cell proliferation,migration,and invasion were assessed using CCK-8,wound healing,and Transwell assays.Transcriptome sequencing was conducted on EOC cells overex-pressing miR-769-5p,and potential target genes were predicted using public databases.The interaction between miR-769-5p and its target gene was validated by dual-luciferase reporter assay.RT-qPCR and Western blotting were used to further confirm the regulatory effect of miR-769-5p on the target gene.Results:The expression level of miR-769-5p in serum exosomes from the malignant group was significantly lower than that in the healthy control and benign ovarian disease groups(P＜0.05).Compared with the mimics-NC group,the miR-769-5p mimics group exhitied lower OD450 values,migration rates,and numbers of invading cells in both SKOV3 and OVCAR3 EOC cell lines(P＜0.05).Compared with the inhibitor-NC group,cells in the miR-769-5p inhibitor group exhibited increased OD450 values,migration rates,and invasion counts(P＜0.05).The dual-luciferase reporter assay showed that co-transfection of miR-769-5p mimics with pEZX-FR02-TFAM-WT significantly reduced the luciferase activity compared to the mimics-NC group(P＜0.01),whereas co-transfection of miR-769-5p mimics with pEZX-FR02-TFAM-MUT showed no significant difference in luciferase activity compared to the control(P＞0.05).These findings indicate that miR-769-5p can directly bind to the 3'-UTR region of TFAM.Furthermore,compared with the mimics-NC group,EOC cells transfected with miR-769-5p mimics showed significantly decreased TFAM mRNA and protein expression levels(P＜0.05).Conclusion:miR-769-5p is significantly downregulated in EOC serum exosomes and may serve as a promising biomarker for early tumor diagnosis.Moreover,miR-769-5p may inhibit the proliferation,migration,and invasion of ovarian cancer cells by targeting TFAM.

Background and purpose:Tumor microangiogenesis is an important basis for tumor growth and metastasis,and its characteristics include angiogenesis,increased vascular permeability and abnormal capillary structure.Microangiogenesis not only affects the blood supply and metabolism of tumor,but also is directly related to the invasion,prognosis and treatment response of tumor.Dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)is a non-invasive imaging technique.By quantitatively analyzing the distribution and dynamic changes of contrast agents in tumor tissues,it can reflect the microvascular density(MVD),permeability and blood perfusion of tumors.The purpose of this study was to further clarify the application value of DCE-MRI in the diagnosis and treatment of rectal cancer by in-depth analysis of the relationship between quantitative analysis parameters of rectal cancer and microangiogenesis,and to promote the popularization and optimization of this technology in clinical practice.Methods:A total of 348 patients with rectal cancer who were scheduled for surgical treatment in Xinxiang Central Hospital from January 2021 to June 2024 were selected,and rectal cancer tissue specimens and adjacent tissues(＞5 cm away from tumor margin)were collected.This study was approved by the medical ethics committee of Xinxiang Central Hospital(approval number:2021-144-01K).The quantitative analysis parameters of DCE-MRI[Rate constant(Kep),volume transport constant(Ktrans),volume fraction of contrast agent in extracellular space(VE)]and MVD in cancer tissues and adjacent tissues were compared.The quantitative analysis parameters and MVD of DCE-MRI in rectal cancer patients with different differentiation degrees and clinical stages were compared.Spearman correlation was used to analyze the correlation between DCE-MRI parameters and differentiation degree,clinical stage and MVD in patients with rectal cancer.Results:The values of Kep value,Ktrans value,Ve value and MVD were higher in rectal cancer tissues than in adjacent tissues(P＜0.05).The Kep value,Ktrans value,Ve value and MVD of patients with low differentiated and middle differentiated rectal cancer were higher than those of patients with high differentiated rectal cancer(P＜0.05).The values of Kep value,Ktrans value,Ve value and MVD of patients with low differentiated rectal cancer were higher than those of patients with middle differentiated rectal cancer(P＜0.05).The Kep value,Ktrans value,Ve value and MVD of patients with stage Ⅱ,Ⅲ and Ⅳrectal cancer were higher than those of patients with stage Ⅰ rectal cancer(P＜0.05).The Kep value,Ktrans value,Ve value and MVD of patients with stage Ⅲ and Ⅳ rectal cancer were higher than those of patients with stage Ⅱ rectal cancer(P＜0.05).The Kep value,Ktrans value,Ve value and MVD of patients with stage Ⅳ rectal cancer were higher than those of patients with stage Ⅲ rectal cancer(P＜0.05).The Kep value,Ktrans value and Ve value of rectal cancer patients were negatively correlated with the differentiation degree(r=-0.683,-0.743,-0.721,P＜0.05).The Kep value,Ktrans value and Ve value of rectal cancer patients were positively correlated with clinical stage(r=0.764,0.703,0.814,P＜0.05).The Kep value,Ktrans value and Ve value of rectal cancer patients were positively correlated with MVD(r=0.812,0.754,0.835,P＜0.05).Conclusion:DCE-MRI parameters are related to the differentiation degree,clinical stage and microangiogenesis of rectal cancer.

Chinese-foreign joint education program of clinical medicine is an important means to achieve the globalization of medical education. Chongqing Medical University and University of Leicester in the UK have jointly established a Chinese-foreign joint education program of clinical medicine to achieve the integration of Chinese and British cultivation concepts, management systems, teaching resources, teacher teams, evaluation systems, and multiculturalism. They have also constructed an internal teaching quality assurance system with the main contents of the improvement of management mechanisms, the formulation of training programs, the construction of teaching staff, the design of syllabuses, the curriculum assessment system, and teaching quality evaluation, as well as an external teaching quality assurance system with the core components of clinical medicine accreditation, Chinese-foreign joint education program evaluations, international quality audits, and professional quality monitoring. Both systems can help to comprehensively improve teaching quality.