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 guide transfusion practice in critically ill children who often need plasma and platelet transfusions, the Transfusion and Anemia Expertise Initiative-Control/Avoidance of Bleeding (TAXI-CAB) developed Recommendations and Expert Consensus for Plasma and Platelet Transfusion Practice in Critically Ill Children. This guideline addresses 53 recommendations related to plasma and platelet transfusion in critically ill children with 8 kinds of diseases, laboratory testing, selection/treatment of plasma and platelet components, and research priorities. This paper introduces the specific methods and results of the recommendation formation of the guideline.

OBJECTIVE: Several epidemiological observational studies have related particulate matter (PM) exposure to Inflammatory bowel disease (IBD), but many confounding factors make it difficult to draw causal links from observational studies. The objective of this study was to explore the causal association between PM _2.5 exposure, its absorbance, and IBD. METHODS: We assessed the association of PM _2.5 and PM _2.5 absorbance with the two primary forms of IBD (Crohn's disease [CD] and ulcerative colitis [UC]) using Mendelian randomization (MR) to explore the causal relationship. We conducted two-sample MR analyses with aggregated data from the UK Biobank genome-wide association study. Single-nucleotide polymorphisms linked with PM _2.5 concentrations or their absorbance were used as instrumental variables (IVs). We used inverse variance weighting (IVW) as the primary analytical approach and four other standard methods as supplementary analyses for quality control. RESULTS: The results of MR demonstrated that PM _2.5 had an adverse influence on UC risk (odds ratio [ OR] = 1.010; 95% confidence interval [ CI] = 1.001-1.019, P = 0.020). Meanwhile, the results of IVW showed that PM _2.5 absorbance was also causally associated with UC ( OR = 1.012; 95% CI = 1.004-1.019, P = 0.002). We observed no causal relationship between PM _2.5, PM _2.5 absorbance, and CD. The results of sensitivity analysis indicated the absence of heterogeneity or pleiotropy, ensuring the reliability of MR results. CONCLUSION Based on two-sample MR analyses, there are potential positive causal relationships between PM _2.5, PM _2.5 absorbance, and UC.
Humans ; Mendelian Randomization Analysis ; Particulate Matter/analysis* ; Polymorphism, Single Nucleotide ; Inflammatory Bowel Diseases/genetics* ; Air Pollutants/analysis* ; Crohn Disease/genetics* ; Colitis, Ulcerative/genetics* ; Genome-Wide Association Study ; Risk Factors ; Environmental Exposure

Objective:To investigate the correlation between postoperative perceived stress,quality of life and fear of cancer recurrence(FCR)in elderly non-small-cell lung cancer(NSCLC)patients.Methods:This study was a prospective research design,a total of 147 elderly NSCLC patients who visited Shanxi Integrated Traditional Chinese and Western Medicine Hospital from January 2023 to June 2024 were prospectively selected for the study.All patients underwent thoracoscopic lobectomy.FCR in patients was evaluated by fear of disease progression simplified scale(FoP-Q-SF),and they were divided into dysregulation group and non dysregulation group according to the FoP-Q-SF score.Quality of life was evaluated by functional assessment of cancer therapy-lung cancer(FACT-L).Perceived stress was evaluated by Chinese version of the perceived stress scale(CPSS)score.The scores of postoperative perceived stress,quality of life and postoperative FCR in elderly NSCLC patients were analyzed,and the influence of demographic and clinical characteristics on the postoperative FCR in elderly NSCLC patients.The postoperative perceived stress and quality of life scores of elderly NSCLC patients with different FCR were compared,the correlation between postoperative FCR and perceived stress and quality of life in elderly NSCLC patients were analyzed,as well as the model fitting index of the influence of postoperative perceived stress and quality of life on FCR in elderly NSCLC patients.Results:The postoperative CPSS score in elderly NSCLC patients was(52.17±4.02)points,the FACT-L score was(80.39±4.56)points,and the total score of FoP-Q-SF was(31.16±8.69)points.Family relationship,economic burden of disease,chemotherapy and clinical stage were closely associated with the postoperative FCR in elderly NSCLC patients(P＜0.05).The CPSS score in dysregulation group was higher than that in nondysregulation group,and the FACT-L score was lower than that in nondysregulation group(P＜0.05).Pearson correlation analysis,postoperative FCR in elderly NSCLC patients was positively correlated with perceived stress,but negatively correlated with quality of life(P＜0.05).The postoperative quality of life in elderly NSCLC patients was recorded as the independent variable,the postoperative perceived stress was recorded as the mediating variable,and the postoperative FCR was recorded as the dependent variable,a structural model of the mediating effect was routinely constructed.The results showed that the model fits well.Quality of life had a direct negative predictive effect on postoperative FCR in elderly NSCLC patients(P＜0.05),and could affect FCR through postoperative perceived pressure(P＜0.05),with the mediating effect accounting for 34.15％of the total effect.After repeatedly sampling the data using the Bootstrap method and implementing the mediating effect,the 95％CI of each model path did not include 0,indicating that the difference in the mediating effect was statistically significant(P＜0.05).Conclusion:Postoperative FCR in elderly NSCLC patients is positively correlated with perceived stress,but negatively correlated with quality of life,clinically,monitoring such indicators can be considered to better evaluate the postoperative FCR in elderly NSCLC patients.

This study aims to explore the mechanism of lung and gut protection by Tanreqing Capsules on the mice infected with influenza virus based on "the lung-gut axis". A total of 110 C57BL/6J mice were randomized into control group, model group, oseltamivir group, and low-and high-dose Tanreqing Capsules groups. Ten mice in each group underwent body weight protection experiments, and the remaining 12 mice underwent experiments for mechanism exploration. Mice were infected with influenza virus A/Puerto Rico/08/1934(PR8) via nasal inhalation for the modeling. The lung tissue was collected on day 3 after gavage, and the lung tissue, colon tissue, and feces were collected on day 7 after gavage for subsequent testing. The results showed that Tanreqing Capsules alleviated the body weight reduction and increased the survival rate caused by PR8 infection. Compared with model group, Tanreqing Capsules can alleviate the lung injury by reducing the lung index, alleviating inflammation and edema in the lung tissue, down-regulating viral gene expression at the late stage of infection, reducing the percentage of neutrophils, and increasing the percentage of T cells. Tanreqing Capsules relieved the gut injury by restoring the colon length, increasing intestinal lumen mucin secretion, alleviating intestinal inflammation, and reducing goblet cell destruction. The gut microbiota analysis showed that Tanreqing Capsules increased species diversity compared with model group. At the phylum level, Tanreqing Capsules significantly increased the abundance of Firmicutes and Actinobacteria, while reducing the abundance of Bacteroidota and Proteobacteria to maintain gut microbiota balance. At the genus level, Tanreqing Capsules significantly increased the abundance of unclassified＿f＿Lachnospiraceae while reducing the abundance of Bacteroides, Eubacterium, and Phocaeicola to maintain gut microbiota balance. In conclusion, Tanreqing Capsules can alleviate mouse lung and gut injury caused by influenza virus infection and restore the balance of gut microbiota. Treating influenza from the lung and gut can provide new ideas for clinical practice.
Animals ; Drugs, Chinese Herbal/administration & dosage* ; Mice ; Lung/metabolism* ; Mice, Inbred C57BL ; Capsules ; Orthomyxoviridae Infections/virology* ; Gastrointestinal Microbiome/drug effects* ; Male ; Humans ; Female ; Influenza A virus/physiology* ; Influenza, Human/virology*

Objective:To investigate the correlation between postoperative perceived stress,quality of life and fear of cancer recurrence(FCR)in elderly non-small-cell lung cancer(NSCLC)patients.Methods:This study was a prospective research design,a total of 147 elderly NSCLC patients who visited Shanxi Integrated Traditional Chinese and Western Medicine Hospital from January 2023 to June 2024 were prospectively selected for the study.All patients underwent thoracoscopic lobectomy.FCR in patients was evaluated by fear of disease progression simplified scale(FoP-Q-SF),and they were divided into dysregulation group and non dysregulation group according to the FoP-Q-SF score.Quality of life was evaluated by functional assessment of cancer therapy-lung cancer(FACT-L).Perceived stress was evaluated by Chinese version of the perceived stress scale(CPSS)score.The scores of postoperative perceived stress,quality of life and postoperative FCR in elderly NSCLC patients were analyzed,and the influence of demographic and clinical characteristics on the postoperative FCR in elderly NSCLC patients.The postoperative perceived stress and quality of life scores of elderly NSCLC patients with different FCR were compared,the correlation between postoperative FCR and perceived stress and quality of life in elderly NSCLC patients were analyzed,as well as the model fitting index of the influence of postoperative perceived stress and quality of life on FCR in elderly NSCLC patients.Results:The postoperative CPSS score in elderly NSCLC patients was(52.17±4.02)points,the FACT-L score was(80.39±4.56)points,and the total score of FoP-Q-SF was(31.16±8.69)points.Family relationship,economic burden of disease,chemotherapy and clinical stage were closely associated with the postoperative FCR in elderly NSCLC patients(P＜0.05).The CPSS score in dysregulation group was higher than that in nondysregulation group,and the FACT-L score was lower than that in nondysregulation group(P＜0.05).Pearson correlation analysis,postoperative FCR in elderly NSCLC patients was positively correlated with perceived stress,but negatively correlated with quality of life(P＜0.05).The postoperative quality of life in elderly NSCLC patients was recorded as the independent variable,the postoperative perceived stress was recorded as the mediating variable,and the postoperative FCR was recorded as the dependent variable,a structural model of the mediating effect was routinely constructed.The results showed that the model fits well.Quality of life had a direct negative predictive effect on postoperative FCR in elderly NSCLC patients(P＜0.05),and could affect FCR through postoperative perceived pressure(P＜0.05),with the mediating effect accounting for 34.15％of the total effect.After repeatedly sampling the data using the Bootstrap method and implementing the mediating effect,the 95％CI of each model path did not include 0,indicating that the difference in the mediating effect was statistically significant(P＜0.05).Conclusion:Postoperative FCR in elderly NSCLC patients is positively correlated with perceived stress,but negatively correlated with quality of life,clinically,monitoring such indicators can be considered to better evaluate the postoperative FCR in elderly NSCLC patients.

Aim To examine the pathogenesis of disul-fide death gene in vascular dementia(VD)by bioin-formatics analysis of disulfide death differentially ex-pressed genes(DEGs)combined with experimental verification.Methods The death DEGs of disulfide were screened and their correlation was analyzed.The VD patients data in the data set were analyzed by clus-tering and typing and gene set variation.The clustering risk of DEGs was tested with a nomogram model,and the optimal learning model was predicted.After the es-tablishment of VD rat model,water maze test,HE stai-ning and RT-qPCR detection were performed to verify the results of health information.Results Four DEGs including SLC7A11 were obtained,which had antago-nistic or synergistic interaction with each other.The genetic data could be divided into two subtypes with significant differences.After typing,VD disulfide DEGs were mainly concentrated in GnRH signaling pathways.The accuracy of the nomogram prediction model was high.Generalized linear was the best ma-chine learning model.Compared with the sham opera-tion group,the escape latency of rats in the model group was prolonged,the number of crossing platforms decreased,the relative mRNA expression levels of Slc3a2 and Slc7a11 decreased,and LRPPRC in-creased.Conclusions SLC7A11 and other disulfide death DEGs and its related GnRH signaling pathway may be an important part of the pathogenesis of VD di-sulfide death.SLC3A2,LRPPRC and SLC7A11 can be used as characteristic genes in the regulation of VD by disulfide death,which may affect VD progression through the regulation of disulfide death.

Based on systematic review and consensus meetings of international multidisciplinary experts, the Transfusion and Anemia Expert Initiative—Control/Avoidance of Bleeding (TAXI-CAB) project team developed management strategies for platelet and plasma transfusion in critically ill children. This consensus presents five expert consensus statements and two recommendations addressing two key questions: 1) What Laboratory Tests and Physiologic Triggers Should Guide the Decision to Administer a Platelet or Plasma Transfusion in Critically ill Children? 2) What Product Attributes Are Optimal to Guide Specific Product Selection? This consensus provides guidance for decision-making regarding plasma and platelet transfusion in critically ill children in two aspects: relevant laboratory testing indicators and additional special properties of blood components. This article explains the rationale behind the recommendations in this part of the guideline, aiming to emphasize the need for clinicians to develop transfusion strategies based on multidimensional assessment, while calling for enhanced interdisciplinary collaboration and evidence-based research to optimize blood management in critically ill children, reducing the risk of over-transfusion and improving treatment outcomes. Furthermore, there remains an urgent need for further research to explore laboratory indicators associated with bleeding risk to guide transfusion therapy.

Aim To examine the pathogenesis of disul-fide death gene in vascular dementia(VD)by bioin-formatics analysis of disulfide death differentially ex-pressed genes(DEGs)combined with experimental verification.Methods The death DEGs of disulfide were screened and their correlation was analyzed.The VD patients data in the data set were analyzed by clus-tering and typing and gene set variation.The clustering risk of DEGs was tested with a nomogram model,and the optimal learning model was predicted.After the es-tablishment of VD rat model,water maze test,HE stai-ning and RT-qPCR detection were performed to verify the results of health information.Results Four DEGs including SLC7A11 were obtained,which had antago-nistic or synergistic interaction with each other.The genetic data could be divided into two subtypes with significant differences.After typing,VD disulfide DEGs were mainly concentrated in GnRH signaling pathways.The accuracy of the nomogram prediction model was high.Generalized linear was the best ma-chine learning model.Compared with the sham opera-tion group,the escape latency of rats in the model group was prolonged,the number of crossing platforms decreased,the relative mRNA expression levels of Slc3a2 and Slc7a11 decreased,and LRPPRC in-creased.Conclusions SLC7A11 and other disulfide death DEGs and its related GnRH signaling pathway may be an important part of the pathogenesis of VD di-sulfide death.SLC3A2,LRPPRC and SLC7A11 can be used as characteristic genes in the regulation of VD by disulfide death,which may affect VD progression through the regulation of disulfide death.

Objective:To understand the serological characteristics of irregular antibodies in pregnant women and explore their clinical significance.Methods:From January 2017 to March 2022,151 471 pregnant women in Women and Children's Hospital of Chongqing Medical University were enrolled in this study,microcolumn gel card test was used for irregular antibody screening,and antibody specificity identification was further performed in some antibody-positive subjects.Results:The positive rate of irregular antibody screening in the enrolled pregnant women was 0.91％(1 375/151 471),0.23％(355/151 471)was detected in the first trimester,0.05％(71/151 471)in the second trimester,and 0.63％(949/151 471)in the third trimester.The positive rate of irregular antibody screening in the third trimester was significantly higher than that in the first and second trimester,and a significant increase in the number of positive cases was found in the third trimester than that in the second trimester.The analysis of agglutination intensity of 1 375 irregular antibody screening positive results showed that the weakly positive agglutination intensity accounted for 50.11％(689/1 375),which was the highest,the suspicious positive was 18.69％(257/1 375),and the positive was 31.20％(429/1 375).The significant difference in distribution of agglutination intensity was not observed between the first trimester group and the second trimester group,however,in the third trimester,the proportion of suspicious positive and weakly positive was lower than the first trimester,while,the proportion of positive was higher than the first trimester,and the difference was statistically significant(P＜0.001).Among the irregular antibody screening positive pregnant women,the proportion of pregnant women with pregnancy number ≥ 2 was significantly higher than that with pregnancy≤1.Among 60 pregnant women who underwent antibody identification,the distributions of the antibodies were as follows:Rh blood group system accounted for 23.33％(14/60),Lewis system 43.33％(26/60),Kidd system 3.33％(2/60),MNS system 16.67％(10/60),P1PK system 1.67％(1/60),autoantibodies 1.67％(1/60),and 4 cases was unable to identify(6.67％,4/60).Among specific antibodies,the anti-Lea was the most common(30.00％),followed by anti-E(16.67％)and anti-M(16.67％).Conclusion:The differences of irregular antibody serological characteristics exist in pregnant women from different regions with different genetic backgrounds,understanding the characteristics of irregular antibody in local pregnant women is of great significance for ensuring transfusion safety in pregnant women and preventing hemolytic disease of newborn.