Objective To investigate the alterations in metabolic molecules and pathways during epithelial-mesenchymal transition (EMT) in the lungs of mice induced by silica exposure. Methods A total of 30 specific pathogen-free male C57BL/6 mice were randomly divided into a control group and a silicosis model group. Mice were intratracheally instilled with 40 µL of either 0.9% sodium chloride solution or silica suspension at a mass concentration of 125 g/L. At 7, 14, and 28 days post-exposure, five mice from each group were sacrificed to evaluate lung histopathological changes. The mRNA expression of EMT-related genes was measured by real-time quantitative polymerase chain reaction. Untargeted metabolomics was used to identify metabolites in mouse lung tissues, and differential metabolites (DMs) and metabolic pathways were analyzed. Results Following silica exposure, lung tissues of mice in the silicosis model group showed progressively aggravated pathological changes, including increased inflammatory cell infiltration, thickening of alveolar walls, collagen deposition, and progressive pulmonary fibrosis, with typical silicotic nodules forming by day 28. The Ashcroft scores and the mRNA expression of cadherin (Cdh)2 and vimentin of mice in the silicosis model group increased (all P<0.05), along with decreased Cdh1 mRNA expression compared with the control group at all the three time points (all P<0.05). The Ashcroft scores and the mRNA expression of Cdh2 and vimentin of mice in the silicosis model group increased with the increase of observation time after silica exposure (all P<0.05), while mRNA expression of Cdh1 decreased (all P<0.05). Metabolomics analysis indicated that silica exposure specifically altered the expression of lipids and disrupted multiple metabolic pathways during EMT in lung tissues of silicosis model group mice,with glycerophospholipid metabolism being most obviously affected (P<0.05). Conclusion Silica exposure may induce EMT in mouse lung tissue, resulting in pulmonary fibrosis in a time-dependent manner. The underlying mechanism may be associated with silica-induced disturbances in glycerophospholipid metabolism in mouse lung tissue.

Objective: To analyze the distribution characteristics of unexpected antibodies among voluntary blood donors at a hospital in Beijing, with a focus on the seasonal distribution patterns of natural antibodies represented by the MNS and Lewis systems, as well as their correlation with concurrent local epidemic trends of the influenza virus, so as to provide a scientific basis for clinical transfusion safety early-warning and management strategies. Methods: A total of 82 780 voluntary blood donors from March 2023 to February 2026 at our hospital were enrolled. Positive screening for unexpected antibodies was identified through ABO blood group re-evaluations and minor crossmatch incompatibilities. Based on climatological seasonal definitions—spring (March to May), summer (June to August), autumn (September to November), and winter (December to February of the following year) —differences in the detection rates of various antibody classifications across different seasons were compared. Local influenza surveillance data from the same period were collected, and their correlation with the positive rate of influenza virus was analyzed. Results: A total of 98 cases (0.12%) positive for unexpected antibodies were identified among the 82 780 blood donors, including 87 cases with specific antibodies. The MNS system antibodies (anti-M) accounted for the highest proportion (54 cases, 55.10%). The detection rate of unexpected antibodies was significantly different in different seasons (P<0.05), and the detection rate in winter was significantly higher than that in spring, summer, and autumn (P<0.05). Correlation analysis showed that the monthly detection rate of total unexpected antibodies was positively correlated with the positive rate of influenza virus (r=0.423, P=0.010); The correlation between the monthly detection rate of unexpected antibodies and the positive rate of influenza virus in Lewis system (r=0.398, P=0.016) and MNS system (r=0.389, P=0.019) was statistically significant; However, no correlation was found for other antibodies such as those of the Rh system (P>0.05). Conclusion: The detection of unexpected antibodies in voluntary blood donors showed significant aggregation in winter, and was ecologically correlated with the positive rate of influenza virus in the region at the population level, which was more obvious in MNS and Lewis blood group system antibodies. These results suggest that influenza virus infection may have a potential impact on the expression of natural antibodies. Enhancing unexpected antibody identification and early warning for clinical crossmatch risks during winter is of great significance for ensuring the safety of clinical blood transfusion.

Objective: To investigate the molecular mechanism of ABO blood type gene c. 899G>A leading to the occurrence of subtype A. Methods: Serological methods were used to identify ABO blood types. Genotyping was performed using polymerase chain reaction sequence specific (PCR-SSP) kits, and Sanger sequencing was used to analyze the ABO gene exons 1-7. PacBio third-generation sequencing was employed for ABO gene full-length haplotype analysis. AlphaFold3 was used to predict protein structure, and ChimeraX software was used to analyze the impact of amino acid changes caused by base mutations on protein structure. Results: The patient exhibited group O of forward typing and group A of reverse typing. Weak A. antigen was detected by absorption-elution test. Molecular biology detection revealed three mutation sites, c. 261delG, c. 297A>G, and c. 899G>A. Third-generation sequencing showed that one haplotype was recombinant ABO O.01.01 and the other haplotype was recombinant ABO B.01-O.01.01, with c. 297A>G and c. 899G>A located on this recombinant haplotype. Protein structure prediction indicated that c. 899G>A resulted in premature termination codons and translation interruption of ABO blood group genes, leading to a 55 amino acid deletion at the C-terminus. Conclusion: The c. 899G>A mutation in the ABO gene of the patient resulted in reduced A antigen expression and an A subtype phenotype.

Objective:This study systematically summarized the construction experience of the immunology platform at the Institute of Basic Medical Sciences, Peking University Third Hospital, aiming to provide theoretical references and practical guidance for research-oriented hospitals in building high-quality research platforms.Methods:This study employed case study analysis to elaborate on the platform development initiatives, integrating literature analysis and in-depth interviews to conduct a horizontal comparison of management models among peer research platforms.Results:Through five years of development, the platform had achieved remarkable outcomes via a model integrating ″Talent cultivation-Technological innovation-Equipment procurement″ Research talents had demonstrated breakthroughs in securing national-level research grants, publishing high-impact papers, and obtaining scientific awards. The technical service system had achieved enhancement in both service scope and professional depth, fostering robust interdisciplinary synergy. The platform had effectively expanded its societal engagement capacity.Conclusions:The sustainable advancement of research-oriented hospital immunology platform necessitates establishing standardized flow cytometry databases and implementing high-dimensional data integration. Building upon multidisciplinary convergence, it is imperative to pioneer innovative operational mechanisms characterized by efficiency, open-access, and shared frameworks.

Objective:This study systematically summarized the construction experience of the immunology platform at the Institute of Basic Medical Sciences, Peking University Third Hospital, aiming to provide theoretical references and practical guidance for research-oriented hospitals in building high-quality research platforms.Methods:This study employed case study analysis to elaborate on the platform development initiatives, integrating literature analysis and in-depth interviews to conduct a horizontal comparison of management models among peer research platforms.Results:Through five years of development, the platform had achieved remarkable outcomes via a model integrating ″Talent cultivation-Technological innovation-Equipment procurement″ Research talents had demonstrated breakthroughs in securing national-level research grants, publishing high-impact papers, and obtaining scientific awards. The technical service system had achieved enhancement in both service scope and professional depth, fostering robust interdisciplinary synergy. The platform had effectively expanded its societal engagement capacity.Conclusions:The sustainable advancement of research-oriented hospital immunology platform necessitates establishing standardized flow cytometry databases and implementing high-dimensional data integration. Building upon multidisciplinary convergence, it is imperative to pioneer innovative operational mechanisms characterized by efficiency, open-access, and shared frameworks.

Objective:To construct a continuity of care plan for adolescent fixed orthodontic patients based on the theory of timing, and provide systematic and standardized nursing interventions for adolescent fixed orthodontic patients.Methods:Guided by the theory of timing, preliminary plan items were formulated through literature review and questionnaire survey. Using the Delphi method, 15 experts were consulted for two rounds to determine the continuity of care plan for adolescent fixed orthodontic patients from October to December, 2023.Results:The effective response rates of the two rounds of questionnaires were 15/15, respectively. The expert authority levels were 0.93 and 0.94, and the Kendall harmony coefficients were 0.28 and 0.38, respectively. The differences were statistically significant (both P<0.001). The final established plan included 5 primary indicators, 23 secondary indicators, and 47 tertiary indicators. Conclusions:The continuity of care plan for adolescent fixed orthodontic patients based on the timing theory is reliable and scientific, and can meet the continuity of care needs of patients at different stages, providing reliable clinical basis for carrying out continuity of care.

Objective To investigate the effect of blood glucose control parameters on the prognosis of severe pneumonia patients based on continuous glucose monitoring(CGM)system.Methods A retrospective analysis was conducted on 51 severe pneumonia patients monitored by CGM at the Fourth Affiliated Hospital of Soochow University from November 2021 to August 2023.Assessed parameters included baseline clinical characteristics,glycosylated hemoglobin(HbA1c),mean glucose,standard deviation(SD),coefficient of variability(CV),mean amplitude of glycemic excursions(MAGE),maximum glucose level,minimum glucose level,and time in range(TIR)of glucose within the target range(3.9-10.0 mmol/L)as a proportion and levels of inflammatory indicators before and after treatment.Based on the 28-day follow-up results,the patients were divided into the survival group(39 cases)and the death group(12 cases).The blood glucose parameters of the two groups were compared.Multivariate Logistic regression model was used to analyze the influence of blood glucose parameters and infection indexes on the prognosis of patients with severe pneumonia.The efficacy of blood glucose parameters in the diagnosis of 28-day mortality was further evaluated by receiver operator characteristic curve(ROC curve).Results The acute physiology and chronic health evaluationⅡ(APACHEⅡ),SD and CV of blood glucose in death group were higher than those in survival group[APACHEⅡscore:20.5(14.0)vs.15.0(7.0),SD(mmol/L):2.6±0.7 vs.2.1±0.5,CV:(27.7±5.8)%vs.(23.7±4.3)%].However,the TIR(3.9-10.0 mmol/L)proportion was statistically lower than that of survival group[59.0%(17.0%)vs.68.0%(35.0%)],the differences were all statistically significant(all P<0.05).After using CGM,the white blood cell count(WBC)and hypersensitive C-reactive protein(hs-CRP)were significantly decreased[WBC(×109/L):9.2(6.5)vs.11.1(9.2),hs-CRP(mg/L):39.4(59.0)vs.56.2(133.8),both P<0.05].Multivariate Logistic regression showed that TIR(3.9-10.0 mmol/L)proportion was an independent risk factor for 28-day mortality in patients with severe pneumonia[odds ratio(OR)=0.923,95%confidence interval(95%CI)was 0.852-0.999,P=0.046].The ROC curve showed that TIR proportion was valuable in predicting the clinical outcomes of patients with severe pneumonia.Area under the curve(AUC)=0.720,95%CI was 0.563-0.878,P=0.022;when the cut-off value was 63.5%,the sensitivity and the specificity were 59.0%and 83.3%respectively.Conclusion Increase of TIR(3.9-10.0 mmol/L)proportion in patients with severe pneumonia could improve clinical outcomes,especially when TIR proportion≥63.5%.

Objective:To analyze the clinical features and prognosis of acute B lymphoblastic leukemia (B-ALL) children carrying a TCF3: : PBX1 fusion gene and to evaluate the prognostic value of this gene.Methods:Retrospective cohort study.A total of 2 164 B-ALL children aged 0-18 years diagnosed and treated at 19 pediatric centers from October 2016 to June 2022 were enrolled.They were divided into the positive group and the negative group according to whether they carried a TCF3: : PBX1 fusion gene.The clinical characteristics, treatment response, adverse reactions, and prognosis of the 2 groups of patients were analyzed.The rank sum and Kruskal-Wallis tests were used to compare two and more than two groups of numerical variables, respectively.Fisher′s exact test was used to compare categorical variables.Results:Among the 2 164 patients, 116 (5.4%) were TCF3: : PBX1 positive, of which 70 patients were female, accounting for 60.3%.There were 840 female patients in the TCF3: : PBX1-negative group, accounting for 41.0%.There was a significant difference in the ratio of females between the TCF3: : PBX1-positive and TCF3: : PBX1-negative groups ( P<0.001).No significant difference was observed in age of onset between the two groups( P>0.05).The proportion of bone marrow naive cells [54.00 (14.00, 76.50)% vs.29.00 (3.00, 68.00)%], white blood cell counts [25.30 (10.46, 60.94)×10 9/L vs.9.03 (4.38, 30.73)×10 9/L] and hemoglobin counts [82.00(63.00, 101.00) g/L vs.74.00(60.00, 90.00) g/L] in the TCF3: : PBX1-positive group were significantly higher than those in the negative group at the onset (all P<0.05).In terms of treatment response, the proportion of peripheral blood naive cells on Day 8 in the TCF3: : PBX1-positive group was significantly higher than that in the negative group [2.00 (0, 9.00)% vs.0 (0, 2.00)%, P<0.001].The proportion of minimal residual disease <0.1% on Day 15 in the TCF3: : PBX1-positive group was significantly higher than that in the negative group ( P=0.038).There were no significant differences in cumulative recurrence rate, treatment-related mortality (TRM), and overall survival (OS) between the TCF3: : PBX1-positive group and TCF3: : PBX1-negative group (all P>0.05).The cumulative recurrence risk of TCF3: : PBX1-positive patients was 9.646 times higher than that of ETV6: : RUNX1-positive patients with better prognosis( HR=9.646, 95% CI: 1.026-90.700, P=0.047).There were no significant differences in TRM and OS between TCF3: : PBX1-positive and ETV6: : RUNX1-positive patients (all P>0.05).A significant enrichment of PAX5 mutations was detected in TCF3: : PBX1-positive patients.Among the 7 high-risk TCF3: : PBX1-positive patients in a single center, 4 patients had PAX5 mutations, and this proportion was significantly higher than that in other patients ( P<0.001). Conclusions:B-ALL children carrying a TCF3: : PBX1 fusion gene have a high remission rate and good long-term prognosis after intensive chemotherapy.It is suggesting that TCF3: : PBX1-positive B-ALL patients should be rated at intermediate risk to receive intensive chemotherapy.

Objective:To study the comparative genomic characteristics of Marmota himalayana-derived (referred to as marmota-derived) Brucella abortus (B.ab). Methods:The species and types of one strain of marmota-derived Brucella and one strain of human-derived Brucella isolated from the brucellosis epidemic area in Qinghai Province in the same year were identified. Meanwhile, DNA was extracted for whole genome sequencing and comparative genomics analysis (including phylogenetic tree construction, gene family clustering analysis, common/specific gene analysis, and genomic structural variation analysis, etc.). Results:Two Brucella strains from different hosts were identified as B.ab. By constructing a phylogenetic tree, the marmota-derived B.ab strain was grouped with strains from Heilongjiang Province and showed genetic correlation with strains from Russia. Human-derived B.ab strain was classified as a strain in Inner Mongolia Autonomous Region, Hebei Province, Beijing City, and Gansu Province. The multilocus sequence typing (MLST) of the two strains belonged to the ST2 type. Multiple locus variable-number tandem repeat analysis (MLVA) belonged to two new MLVA-8 and MLVA-11 genotypes, which were clustered in two subclusters of the same cluster and clustered with the strains from Inner Mongolia Autonomous Region, Xinjiang Uygur Autonomous Region, and Hebei Province. The pan-genome numbers of the marmota-derived B.ab and human-derived B.ab were 283 and 8, respectively; the number of core genes (common genes) was 68 and 2, respectively; and the number of unique genes was 3 and 4, respectively. The unique gene encoded proteins were inconsistent. In marmota-derived B.ab, the main ones were the ABC transporter ATP-binding protein, N-terminal acetyltransferase, and glucose/galactose transporter. The number of homologous genes of the marmota-derived B.ab and human-derived B.ab was 16 and 20, respectively; the number of translocation and inversion genes was 13 and 8, respectively; the number of deletion mutation genes was 11 and 14, respectively. Pathogenicity analysis showed that both strains had the mprF resistance gene, and the marmota-derived B.ab strain also carried bacitracin and macrolide resistance genes. Conclusions:Brucella exhibits cross-species genetic diversity. The proteins encoded by the unique genes of the marmota-derived B.ab mainly play a role in metabolic and epigenetic regulation. The strains cluster with B.ab strains from northern China, providing a reference for molecular epidemiology and pathogen tracing of B.ab infection.

Objective To investigate the effect of blood glucose control parameters on the prognosis of severe pneumonia patients based on continuous glucose monitoring(CGM)system.Methods A retrospective analysis was conducted on 51 severe pneumonia patients monitored by CGM at the Fourth Affiliated Hospital of Soochow University from November 2021 to August 2023.Assessed parameters included baseline clinical characteristics,glycosylated hemoglobin(HbA1c),mean glucose,standard deviation(SD),coefficient of variability(CV),mean amplitude of glycemic excursions(MAGE),maximum glucose level,minimum glucose level,and time in range(TIR)of glucose within the target range(3.9-10.0 mmol/L)as a proportion and levels of inflammatory indicators before and after treatment.Based on the 28-day follow-up results,the patients were divided into the survival group(39 cases)and the death group(12 cases).The blood glucose parameters of the two groups were compared.Multivariate Logistic regression model was used to analyze the influence of blood glucose parameters and infection indexes on the prognosis of patients with severe pneumonia.The efficacy of blood glucose parameters in the diagnosis of 28-day mortality was further evaluated by receiver operator characteristic curve(ROC curve).Results The acute physiology and chronic health evaluationⅡ(APACHEⅡ),SD and CV of blood glucose in death group were higher than those in survival group[APACHEⅡscore:20.5(14.0)vs.15.0(7.0),SD(mmol/L):2.6±0.7 vs.2.1±0.5,CV:(27.7±5.8)%vs.(23.7±4.3)%].However,the TIR(3.9-10.0 mmol/L)proportion was statistically lower than that of survival group[59.0%(17.0%)vs.68.0%(35.0%)],the differences were all statistically significant(all P<0.05).After using CGM,the white blood cell count(WBC)and hypersensitive C-reactive protein(hs-CRP)were significantly decreased[WBC(×109/L):9.2(6.5)vs.11.1(9.2),hs-CRP(mg/L):39.4(59.0)vs.56.2(133.8),both P<0.05].Multivariate Logistic regression showed that TIR(3.9-10.0 mmol/L)proportion was an independent risk factor for 28-day mortality in patients with severe pneumonia[odds ratio(OR)=0.923,95%confidence interval(95%CI)was 0.852-0.999,P=0.046].The ROC curve showed that TIR proportion was valuable in predicting the clinical outcomes of patients with severe pneumonia.Area under the curve(AUC)=0.720,95%CI was 0.563-0.878,P=0.022;when the cut-off value was 63.5%,the sensitivity and the specificity were 59.0%and 83.3%respectively.Conclusion Increase of TIR(3.9-10.0 mmol/L)proportion in patients with severe pneumonia could improve clinical outcomes,especially when TIR proportion≥63.5%.