Transfusion and Anemia Expertise Initiative-Control/Avoidance of Bleeding developed a strategy for platelet and plasma infusion management in critically ill children based on systematic reviews and consensus meetings of international multidisciplinary experts. One good practice statement and six expert consensus statements were proposed for plasma and platelet transfusions in critically ill children following severe trauma, traumatic brain injury, and/or intracranial hemorrhage. This article introduces the specific methods and basis for the formation of recommendations in this part of the guide.

To meet the domestic clinical demand timely,the national health commission has released three batches of encourage generic drug catalogues,which plays a good guiding role in improving the supply level and accessibility of generic drugs.Based on literature investigation,the typical cases of novel pharmaceutical preparations were analyzed,and the pharmaceutical considerations were put forward in terms formulation,manufacturing process and quality control,aimed to provide scientific reference for research and development of such drugs.

Objective:To investigate the effects of apixaban on cardiac function,serum levels of soluble suppression of tumorigenicity 2(sST2),fibroblast growth factor-23(FGF-23)and inflammatory factors in patients with atrial fibrillation(AF)and coronary artery disease(CAD).Methods:This randomized controlled study enrolled 120 pa-tients with AF and CAD who admitted Changzhou Wujin Hospital of Traditional Chinese Medicine between July 2022 and December 2023.Patients were randomly divided into control group(n=60,warfarin therapy)and inter-vention group(n=60,apixaban therapy).Each group received corresponding medication based on routine therapy for 8 weeks.Cardiac function indicators,levels of serum sST2,FGF-23,inflammatory factors,myocardial fibrosis indicators,and incidence of adverse reactions were compared between the two groups.Results:Compared to those in the control group,participants in the intervention group had significantly higher left ventricular ejection fraction(LVEF)[(52.22±3.69)％vs.(48.37±4.14)％]and 6-minute walking distance(6MWD)[(456.29±56.47)m vs.(415.25±11.32)m](P＜0.001 all),and significantly lower left ventricular end-diastolic diameter(LVEDd)[(44.98±4.55)mm vs.(50.26±3.61)mm],levels of N-terminal pro B-type natriuretic peptide(NT-proB-NP)[(341.16±29.51)pg/ml vs.(392.33±32.27)pg/ml],cardiac troponin I(cTnI)[(3.76±1.12)ng/ml vs.(5.22±1.36)ng/ml],creatine kinase isoenzyme-MB(CK-MB)[(25.71±6.51)U/L vs.(39.13±6.33)U/L],high sensitive C-reactive protein(hsCRP)[(1.63±0.51)mg/L vs.(1.98±0.46)mg/L],tumor necrosis fac-tor-alpha(TNF-α)[(27.17±5.11)ng/Lvs.(34.19±5.32)ng/L],sST2[(52.11±5.87)μg/L vs.(62.37±5.82)μg/L]and FGF-23[(45.73±4.29)μg/L vs.(56.09±5.25)μg/L](P＜0.001 all).We detected signifi-cant lower incidence of adverse reactions in intervention group compared to control group(6.9％vs.26.3％,P=0.005).Conclusion:Apixaban could alleviate myocardial fibrosis,improve cardiac function,and reduce levels of heart failure biomarkers and inflammatory factors in patients with coronary artery disease and atrial fibrillation.

The deep integration of Party building and professional work is crucial for promoting high-quality development in university-affiliated hospitals.To address the current insufficient integration of Party building and operational development in such hospitals,the Tuina Department of the Second Affiliated Hospital of Anhui University of Chinese Medicine has adopted the"Seven Ones"Party building brand as a carrier.Using Party building as a driving force and traditional Chinese medicine culture as the core,the department has actively implemented a series of innovative Party building initiatives.By deeply integrating Party build-ing with medical services,it explores pathways for the fusion of"Party building+professional work,"leveraging high-quality Party building to facilitate the high-quality development of the hospital and contribute to the realization of the Healthy China strategy.

Pancreatic cancer has a concealed onset and poor prognosis,and surgical resection is the main treatment method.Neoadjuvant therapy may improve the rate of negative resection margin and prolong overall survival of patients with pancreatic cancer.Functional and quantitative imaging can non-invasively reflect tumor microenvironment characteristics related to chemotherapy resistance,providing a new perspective for evaluating and predicting the efficacy of neoadjuvant therapy for pancreatic cancer.The research progresses in functional and quantitative imaging for evaluating and predicting the efficacy of neoadjuvant therapy of pancreatic cancer were reviewed in this article.

Aim To investigate the effect of ACSL4 on the malignant biological behavior of esophageal cancer cells and gefitinib resistance by regulating FASN,and to explore the related mechanism.Methods Thirty-five fresh esophageal cancer tissues and adjacent nor-mal tissues,and 30 esophageal cancer tissues with ge-fitinib resistance were collected.The expressions of ACSL4 and FASN were detected by qRT-PCR and im-munohistochemistry.The expression levels of ACSL4 and FASN in human normal esophageal cells HET-1 A,esophageal cancer cell lines ECA109,EC9706,TE-1 and TE-1/GR were detected by qRT-PCR.Cells in each group were constructed by liposome transfection technique,and the drug resistance and proliferation a-bility of cells were detected by cloning and CCK-8 as-say,cell apoptosis was detected by flow cytometry,cell invasion ability was detected by Transwell,and EMT pathway protein expression was detected by Western blot.Results Compared with adjacent normal tis-sues,the expression of ACSL4 and FASN genes in cancer tissues increased,and there was a positive corre-lation.The expression of ACSL4 significantly increased in ECA109,EC9706 and TE-1 cells compared with HET-1 A cells.With the increase of gefitinib concen-tration,the expression of ACSL4 in TE-1 cells gradually increased,and the expression of ACSL4 in TE-1/GR cells was higher than that of TE-1.Compared with the control group and the si-NC group,the cell proliferation and invasion ability of si-ACSL4 group decreased,the number of apoptosis increased,the expression of E-Cadherin increased,and the expression of N-Cadherin,Vimentin and β-catenin decreased.The response ex-periment showed that compared with the si-ACSL4 group and the si-ACSL4+oe-NC group,the cells in the si-ACSL4+oe-FASN group increased drug resistance,increased proliferation and invasion ability,decreased apoptosis number and decreased expression of E-Cad-herin.The expressions of N-Cadherin,Vimentin and β-catenin increased.Conclusions By down-regulating the expression of FASN,ACSL4 reverses the resistance of esophageal cancer TE-1/GR cells to gefitinib and in-hibits the proliferation,invasion and accelerates apopto-sis of TE-1/GR cells,which may be related to the regu-lation of EMT signaling pathway.

Objective:To observe the effect of combine treatment of butorphanol combined with esketamine in patients with remifentanil induced hyperalgesia after laparoscopic gynecological surgery.Methods:Based on randomized double-blind controlled trial,120 patients undergoing laparoscopic gynecological surgery in our hospital from April 2023 to October 2024 were divided into control group 1(received esketamine treatment,n=40),control group 2(received butorphanol treatment,n=40),and study group(received butorphanol combined with esketamine treatment,n=40).The awakening time,extubation time,mean arterial pressure(MAP),heart rate(HR),visual pain analog scale(VAS)score,ramsay sedation score,and incidence of adverse reactions among three groups were compared.Results:The awakening time and extubation time in the study group were shorter than those in the control group 1 and control group 2(P＜0.05).The MAP and HR in the study group were lower than those in the control group 1 and control group 2 at 30 minutes,60 minutes after extubation(P＜0.05).The VAS scores in the study group were lower than those in the control group 1 and control group 2 at 30 minutes,60 minutes after extubation(P＜0.05).The ramsay sedation scores in the study group were higher than those in the control group 1 and control group 2 at 30 minutes,60 minutes after extubation(P＜0.05).There was no significant difference in the incidence of postoperative adverse reactions among the three groups(P＞0.05).Conclusion:Butorphanol combined with esketamine can further alleviate remifentanil induced hyperalgesia after laparoscopic gynecological surgery,exert good sedative and analgesic effects,maintain hemodynamic stability,and have good safety.

BACKGROUND:A novel aggregation induced luminescence fluorescence probe based on the mechanism of intramolecular motility restriction can be used for the detection of disease markers,tumor diagnosis,and bacterial imaging recognition.OBJECTIVE:To prepare a near-infrared Ⅱ nanoprobe called FA-DSPE-PEG-AIE@NPs based on aggregation-induced luminescence,and to explore its potential of targeted fluorescence imaging and photothermal therapy for prostate cancer.METHODS:Lecithin,polyethylene glycol phospholipids,folate polyethylene glycol phospholipids,and aggregation induced luminescent molecule 2TT-oC26B were used as raw materials.The folate-targeted nanoprobe FA-DSPE-PEG-AIE@NPs were prepared by nanoprecipitation method,and basic characterization of the nanoprobe was detected.PC3 human prostate cancer cells and human umbilical vein endothelial cells were selected as experimental objects.The cytotoxicity and phototoxicity of FA-DSPE-PEG-AIE@NPs were detected.PC3 human prostate cancer cells were selected as the experimental objects.Flow cytometry and calcein/propidium iodide staining were used to assess the efficacy of photothermal therapy.PC3 human prostate cancer cells were injected subcutaneously into the abdomen of BALB/C nude mice to establish a tumor model,and nanoprobes FA-DSPE-PEG-AIE@NPs were injected into the tail vein.The mice were immediately subjected to near-infraced Ⅱ fluorescence imaging.12 hours later,the tumor was irradiated by laser for 5 minutes,and the photothermal treatment effect was observed within 14 days.RESULTS AND CONCLUSION:(1)The nanoprobes FA-DSPE-PEG-AIE@NPs with a mean diameter of(171.0±0.3)nm showed a well-defined spherical morphology.The nanoprobe had a wide absorption spectrum and tail emission extending to the near-infrared Ⅱ which emitted a bright near-infrared Ⅱ fluorescence signal under laser irradiation.(2)The nanoprobes FA-DSPE-PEG-AIE@NPs had low cytotoxicity and high phototoxicity.The results of flow cytometry and calcein/propidium iodide staining showed that nanoprobes FA-DSPE-PEG-AIE@NPs had an obvious photothermal killing effect on human prostate cancer cells.(3)The nanoprobes FA-DSPE-PEG-AIE@NPs successfully achieved near-infrared Ⅱ fluorescence imaging of mouse blood vessels and the maximum enrichment time of the tumor was 12 hours.The vessel widths of the hind leg and single blood vessels of abdomen were estimated to be 0.63 mm and 0.42 mm.The tumor volume of mice was significantly smaller after 14 days of treatment.(4)The results show that nanoprobes FA-DSPE-PEG-AIE@NPs can achieve near-infrared Ⅱ fluorescence imaging and photothermal therapy of prostate cancer effectively,which may provide a new method for early diagnosis and combined treatment of prostate cancer.

Aim To study the effect of p-benzoyl sali-droside(pOBz)on angiogenesis after ischemic stroke and to explore the underlying mechanism.Methods The MCAO model was prepared by suture method.Rats were divided into four groups:sham,MCAO,pOBz administration,and edaravone positive control,treated for seven days.The mNSS was used to assess the neurological impairment.Western blotting was em-ployed to detect CD31,NICD,and Hes-1 protein ex-pression,while immunofluorescence staining was ap-plies to quantify CD31-positive cells in ischemic brain tissue.In vitro an OGD/R model was established in HUVECs.Following treatment with varying pOBz con-centrations(0.01,0.1,1 μmol·L-1),the CCK-8 as-say was uses to measure cell viability,and in vitro tube formation assay was utilized to evaluate angiogenesis.Western blotting was employed again to assess CD31,NICD and Hes-1 protein levels.To further elucidate the mechanism,HUVEC were treated with the Notch inhibitor DAPT prior to grouping and pOBz administra-tion,and the same parameters were evaluated.Results pOBz significantly reduced the mNSS score of MCAO rats,increased CD31-positive cell counts,and upregu-lated CD31,NICD,and Hes-1 protein expression(P＜0.01).In vitro results further showed that pOBz could dose-dependently increase the survival rate and angio-genesis ability of HUVEC induced by OGD/R,and promote CD31,NICD and Hes-1 proteins(P＜0.01),and Notch inhibitor DAPT could reverse the above effects of pOBz.Conclusion pOBz promotes angio-genesis in HUVEC,and its mechanism involves activa-tion of the Notch signaling pathway.

Aim To explore the mechanism of the syn-ergistic effect of the ferroptosis inducer erastin com-bined with shikonin in promoting ferroptosis in human hypertrophic scar fibroblasts(HSFBs).Methods Hypertrophic scar tissues provided by the General Hos-pital of Ningxia Medical University were collected,and HSFBs were extracted.HSFBs were identified by HE staining and immunofluorescence.The inhibitory rates of Era and SHK on HSFBs at different concentrations were detected by CCK-8 assay,and the IC50 value was calculated.CompuSyn software was used to calculate the co-use index(CI).Control group,Erastin(Era)group,shikonin(SHK)group and Era+SHK group were set up,and the number and morphological chan-ges of cells were observed after 24 hours of interven-tion.The ability of cell migration and invasion was de-tected by scratch test and Transwell test.The changes of malondialdehyde(MDA),total iron ion and reactive oxygen species(ROS)were detected by corresponding biochemical kits.The expressions of collagen I,α-SMA and GOT1,SLC7A11,GPX4 and FTH1 were detected by Western blot.Results The IC50 value of Era and SHK of primary HSFBs was 2.22 μmol·L-1 and 3.94μmol·L-1 respectively,which was used as the single drug concentration for subsequent experiments.The CompuSyn software was employed to calculate the CI value when the two drugs were used in combination,and the concentrations corresponding to CI=0.39597(Era:1.2 μmol·L-1+SHK:1.5 μmol·L-1)were selected as subsequent combination concentrations(Because when CI was equal to 0.395 97,the concen-tration of each drug was lower than the concentration of single drug,and the inhibition rate of combined drug was greater than 50％).Compared with the monother-apy group,the number of HSFBs in the SHK+Era group was significantly reduced,cell membrane showed breakage and vesiculation,cell wrinkling became smal-ler,and cytoplasm was concentrated.The migration and invasion ability of HSFBs in the SHK+Era group were obviously weakened(P＜0.05),and the expres-sion of fibrosis-related proteins collagen Ⅰ and α-SMA was reduced(P＜0.05);the contents of MDA,total i-ron ions,and ROS in HSFBs of the SHK+Era group increased(P＜0.05),and the protein expression lev-els of SLC7A11,GOT1,GPX4,and FTH1 further de-creased(P＜0.05).Conclusions Erastin in combi-nation with shikonin can synergistically inhibit the pro-liferation,migration and fibrosis levels of HSFBs.The mechanism may be that erastin enhances the inhibition of shikotin on GOT1,increases the levels of cellular i-ron ions,ROS,and lipid peroxides,thereby promoting ferroptosis in HSFBs.