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.

Objective To develop and compare the predictive performance of five machine learning models for adverse postoperative outcomes in cardiac surgery patients, and to identify key decision factors through SHapley Additive exPlanations (SHAP) interpretability analysis. Methods A retrospective collection of perioperative data (including demographic information, preoperative, intraoperative, and postoperative indicators) with 88 variables was conducted from adult cardiac surgery patients at the First Affiliated Hospital of Xinjiang Medical University in 2023. Adverse postoperative outcomes were defined as the occurrence of acute kidney injury and/or in-hospital mortality during the postoperative hospitalization period following cardiac surgery. Patients were divided into an adverse outcome group and a favorable outcome group based on the presence of adverse postoperative outcomes. After screening feature variables using the least absolute shrinkage and selection operator (LASSO) regression method, five machine learning models were constructed: eXtreme gradient boosting (XGBoost), random forest (RF), gradient boosting machine (GBM), light gradient boosting machine (LightGBM), and generalized linear model (GLM). The dataset was randomly divided into a training set and a test set at a 7 : 3 ratio using stratified sampling, with postoperative outcome as the stratification factor. Model performance was evaluated using receiver operating characteristic curves, decision curve analysis, and F1 Score. The SHAP method was applied to analyze feature contribution. Results A total of 639 patients were included, comprising 395 males and 244 females, with a median age of 62 (55, 69) years. The adverse outcome group consisted of 191 patients, while the favorable outcome group included 448 patients, resulting in an adverse postoperative outcome incidence of 29.9%. Univariate analysis showed no significant differences between the two groups for any variables (P>0.05). Using LASSO regression, 16 feature variables were selected (including cardiopulmonary bypass support time, blood glucose on postoperative day 3, creatine kinase-MB isoenzyme, systemic inflammatory response index, etc.), and five machine learning models (GLM, RF, GBM, LightGBM, XGBoost) were constructed. Evaluation results demonstrated that the XGBoost model exhibited the best predictive performance on both the training set (n=447) and test set (n=192), with area under the curve values of 0.761 [95%CI (0.719, 0.800) ] and 0.759 [95%CI (0.692, 0.818) ], respectively. It also significantly outperformed other models in positive predictive value, and balanced accuracy in the test set. Decision curve analysis further confirmed its clinical utility across various risk thresholds. SHAP analysis indicated that variables such as cardiopulmonary bypass support time, blood glucose on postoperative day 3, creatine kinase-MB isoenzyme, and inflammatory markers (SIRI, NLR, CAR) had high contributions to the prediction. Conclusion The XGBoost model effectively predicts adverse postoperative outcomes in cardiac surgery patients. Clinically, attention should be focused on cardiopulmonary bypass support time, postoperative blood glucose control, and monitoring of inflammatory levels to improve patient prognosis.

Objective To establish a human α-synuclein nuclear localization signal transgenic mouse model and investigate the effects of α-synuclein nuclear localization on the behavior of mice.Methods Human α-synuclein nuclear localization signal and EGFP lentiviral vectors were constructed.Transgenic mice were created with the microinjection method.Using PCR and Western Blot method to identify the genotypes and protein expression of the transgenic founder mice and their offsprings.The immunofluorescence was used to examine the localization of human α-synuclein in the mouse brain tissue.The behavioral changes of the transgenic mice were evaluated by the open field test,rotarod test,and O maze test.Results The h SNCA-NLS gene was successfully inserted into the mouse genome,the human α-syn was successfully expressed,and the human α-syn has localized with the nuclear.Further studies found that human α-synuclein nuclear localization signal transgenic mice had significant motor dysfunction,astrocyte proliferation and inflammatory response at 2 months of age and exhibited significant anxiety-like symptoms and reduced expression of the γ-aminobutyric acid(GABA)gene at 9 months of age,which persisted until 12 months of age.Conclusions A human α-synuclein nuclear localization signal transgenic mouse model has been successfully established.The mice exhibit significant motor dysfunction and anxiety-like symptoms.The successful establishment of this model provides a foundation for studying the role of α-syn nuclear localization in Parkinson's disease.

Objective To explore the application effect of key indicators of oncology nursing quality evaluation in the continuous improvement of specialist nursing quality. Methods The Delphi method was used to cons-truct 14 key indicators of oncology nursing quality evaluation, and the key indicators were used to control the quality of specialist nursing in the tumor area. Data were collected and a database was established. Based on the data, the quality of the nursing care and continuous quality improvement were carried out. Results The results of the data from the first year (before the intervention in 2016) and the second year (after the intervention in 2017) were compared with the data of the key indicators of the quality evaluation of the specialist nursing. The results showed that the indicators had different degrees of decline. The data before and after intervention were: chemotherapy drug extravasation rate 0.20% (33/16 861) and 0.10% (20/19 957), and the incidence of severe pain was 1.65% (1 747/106 114) and 1.43% (1 521/106 462). The incidence of anxiety was 2.17% (2 305/106 114) and 1.53% (1 633/106 462), and the incidence of depression was 2.27% (2 408/106 114) and 1.28% (1 359/106 462). The difference was statistically significant (χ2=5.80-300.90, P<0.05); The other 9 indicators of process have improved to varying degrees. Conclusions 14 key indicators of oncology nursing quality evaluation are applied to the oncology ward for specialized nursing quality management and quality improvement, which can monitor the quality of key specialist nursing in real time and dynamically. It can accurately select clinical nursing priority improvement projects and improve specialist nursing. Quality;energy evaluation to improve the quality of specialist nursing quality; help improve the quality management of specialist nursing and ensure patient safety.

Objective:To explore the possible mechanism of astragaloside involved in the mouse podocytes injury induced by TGF-β1 in vitro.Methods:Mouse podocytes were cultured in vitro and then all cell were divided into 5 groups:normal control group , TGF-β1 treatment group ,TGF-β1 treatment +astragaloside low dose group ,TGF-β1 treatment +astragaloside middle dose group and TGF-β1 treatment +astragaloside high dose group.The proliferation rate of each group was investigated by MTT assay ,the expression of TRPC6 protein and mRNA were measured by Western blot and RT-PCR respectively after 48 hours.Results:TGF-β1 can significantly inhibit the proliferation of podocytes ( P<0.05) ,fusions of foot processes or even effaced of podocytes were observed .TGF-β1 could also increase the expression of TRPC6.Astragaloside could reduce the inhibition of TGF-β1 to the proliferain of podocytes significantly ,make the cell shape tend to be normal,and reduce the expression of TRPC6 mRNA and protein with dose-effect relation.Conclusion:TRPC6 play an impor-tant role in the TGF-β1 induecd podocytes injury .Astragaloside can alleviate podocytes injury by reduce the expression of TRPC 6.

Objective To investigate the effects of transient receptor potential cation channel 6 (TRPC6) on the expression of nephrin, desmin and caspase 9 and on the apoptosis of podocytes in a mouse model of podocyte injury induced by TGF-β1.Methods Conditionally immortalized mouse podocytes were cultured in vitro and divided into four groups: control, TGF-β1 treatment, TGF-β1+PGPU6/GFP/Neo-TRPC6-mus-581 (TRPC6 knockdown) and TGF-β1+PGPU6/GFP/Neo-NC (negative control).Real-time RT-PCR and Western blot analysis were performed to detect the expression of nephrin, desmin and caspase 9 at mRNA and protein levels, respectively.Flow cytometry was used to analyze the apoptotic rate of podocytes.DAPI fluorescent staining was used to observe the morphological changes of apoptotic podocytes.Results Green fluorescent protein (GFP)-expressing podocytes at 48 hours after transfection were significantly more than those at 24 hours after transfection.The level of TRPC6 in mouse podocytes transfected with PGPU6/GFP/Neo-TRPC6-mus-581 was significantly decreased as compared with that of the control group (P<0.05).No significant difference in the expression of TRPC6 was observed between the negative control group and the control group.Compared with the control group, the TGF-β1 treatment group showed increased expression of desmin and caspase 9 at both mRNA and protein levels (P<0.01), but decreased expression of nephrin at mRNA and protein levels at 48 hours after TGF-β1 intervention (P<0.05).The up-regulated desmin and caspase 9 and the down-regulated nephrin induced by TGF-β1 could be inhibited by the means of TRPC6 knockdown.The apoptosis rate of podocytes in TGF-β1 treatment group was (14.0±2.1)%, while that in TRPC6 knockdown was (10.90±0.56)% (P<0.05).The apoptosis rate of podocytes in negative control group was higher than that in TGF-β1 treatment group (P>0.05).More apoptotic cells with typical morphological features of apoptosis were observed after exposure to TGF-β1 for 48 hours.Conclusion TGF-β1 could induce the apoptosis of podocytes, inhibit the expression of nephrin and enhance the expression of caspase 9 and desmin, the possible mechanisms of which may be related to TRPC6 signal pathway.These changes in TGF-β1-treated podocytes could be alleviated by inhibiting the expression of TRPC6, which might have a protective effect on podocyte injury.

Objective:To establish a method for the determination of Cu,As,Cd,Hg and Pb in spirulina health products. Meth-ods:The samples were digested by microwave and determined by ICP-MS. Results: The minimum detection limits of Cu,As,Cd,Hg and Pb was 6. 72,6. 25,3. 12,0. 331 and 8. 78 ng·g-1 , respectively, and showed good linear relationship within respective concentra-tion range (r >0. 999 7) with the average recovery of 110.4%,96.6%,93.1%,102.8%, 101.4% and RSD of 3.2%,4.2%, 2. 5%,2. 9%,3. 0%(n=9), respectively. Conclusion:The method is sensitive, simple and accurate, and can be used to determine the harmful elements in spirulina health products.

Objective To investigate the effect of simulated 400 m He-O2 saturation diving on the pulmonary oxidative-antioxidative system in rats.Methods SD rats were exposed to 4.1 MPa He-O2 mixture for 24 h in an animal chamber. Normal air pressure was used in the control group .The histopathology , contents of malondialdehyde ( MDA) , 8-hydroxy-2′-deoxyguanosine(8-OHdG),and glutathione(GSH) and activities of superoxide dismutase (SOD) and glutathione peroxi-dase( GSH-Px) in pulmonary tissues were determined .Results No difference was found during pathological examination or in MDA, 8-OHdG and SOD activity.GSH and GSH-Px activity were decreased significantly (P<0.05) after hyperbaric exposure.Conclusion Exposure to 4.1 MPa He-O2 for 24 h may promote oxidative stress and reduce antioxidative capacity rather than cause obvious oxidative damage in rat lungs .

It is very important to establish and execute the all -sided experimental animal quality monitoring in order to guarantee human health , animal health and welfare as well as the authenticity , validity, and repeatability of the experimental research results.Setting corresponding sentinel animals in the experiment can effectively monitor the quality of experimental animals.This article gives a general review of the selection of sentinel rats in the microbiological quality monitoring of the experiment animals , contact form and time between the sentinel rats and the rats being monitored , the placement of sentinel rats, and the number of rat cages being monitored by each cage of sentinel rats , as well as the test quantity, test frequency and the project.

Objective To investigate the usage of antibacterial drug in the department of operation in our hospital for improving the management and proper clinical utilization.Methods 1366 operational cases from our hospital were randomly collected from June 2004 to June 2005 and a comprehensive analysis of the usage of antibacterial drugs was conducted.Results All of the cases were given antibacterial drugs.The rate of preventive usage was 89.0%,among which those given in the period in 1h before operating was only 30.6%,and the other's was given after operating.The therapy time of antibacterial drugs were ranged from 1 to 63 days in different case and the preventive usage were 1 to 16 days.The therapy time of surpass 3 days was 94.7% and surpass 7 days was 53.5% in preventive usage.Prescriptions of more than one kind drug was widespread very much and 2～3 kinds were 87.5%.The wide-table,new-style and high-efficiency antibacterial drugs were the most frequently used in prescription.Conclusions The use of the antibacterial drugs in operational case in our hospital has some problem,especially in scope,opportunity moment,therapy time and union of usage.The management and education about rational usage of antibacterial drugs must be strengthened in order to improve the level of rationality in the clinical application.