Objective:To analyze the current status of red blood cell transfusion in very preterm infants (VPI) (gestational age at birth <32 weeks) from Chinese Neonatal Network (CHNN) in 2022.Methods:This cross-sectional study was based on the CHNN VPI cohort. It included 6 985 VPI admitted to CHNN 89 participating centers within 24 hours after birth in 2022. VPI with major congenital anomalies or those transferred to non-CHNN centers for treatment or discharged against medical advice were excluded. VPI were categorized based on whether they received red blood cell transfusions, their gestational age at birth, the type of respiratory support received during transfusion, and whether the pre-transfusion hemoglobin levels exceeded the thresholds. General characteristics, red blood cell transfusion rates, number of transfusions, timing of the first transfusion, and pre-transfusion hemoglobin levels were compared among different groups. The incidence of adverse outcomes between the group of VPI who received transfusions above the threshold and those who received transfusions below the threshold were compared. Comparison among different groups was conducted using χ2 tests, Kruskal-Wallis H tests, Mann-Whitney U test, and so on. Trends by gestational age at birth were evaluated by Cochran-Armitage tests and Jonckheere-Terpstra tests for trend. Results:Among the 6 985 VPI, 3 865 cases(55.3%) were male, with a gestational age at birth of 30.0 (28.6, 31.0) weeks and a birth weight of (1 302±321) g. Overall, 3 617 cases (51.8%) received red blood cell transfusion, while 3 368 cases (48.2%) did not. The red blood cell transfusion rate was 51.8% (3 617/6 985), with rates of 77.7% (893/1 150) for those born before 28 weeks gestational age and 46.7% (2 724/5 835) for those born between 28 and 31 weeks gestational age. A total of 9 616 times red blood cell transfusions were administered to 3 617 VPI, with 632 times missing pre-transfusion hemoglobin data, and 8 984 times included in the analysis. Of the red blood cell transfusions, 25.6% (2 459/9 616) were administered when invasive respiratory support was required, 51.3% (4 934/9 616) were receiving non-invasive respiratory support, while 23.1% (2 223/9, 616) were given when no respiratory support was needed. Compared to the non-transfusion group, the red blood cell transfusion group had a higher rate of pregnancy-induced hypertension in mothers, lower rates of born via cesarean section and mother′s antenatal steroid administration, smaller gestational age, lower birth weight, a higher proportion of small-for-gestational-age, multiple births, and proportions of Apgar score at the 5 th minute after birth ≤3 (all P<0.05). They were also less likely to be female, born in hospital or undergo delayed cord clamping (all P<0.01). Additionally, higher transport risk index of physiologic stability score at admission were observed in the red blood cell transfusion group ( P<0.001). The number of red blood cell transfusion was 2 (1, 3) times, with the first transfusion occurring at an age of 18 (8, 29) days, and a pre-transfusion hemoglobin level of 97 (86, 109) g/L. For VPI ≤7 days of age, the pre-transfusion hemoglobin levels for invasive respiratory support, non-invasive respiratory support, or no respiratory support, respectively, with no statistically significant differences between groups ( H=5.59, P=0.061). For VPI aged 8 to 21 days and≥22 days, the levels with statistically differences between groups (both P<0.01). Red blood cell transfusions above recommended thresholds were observed in all respiratory support categories at different stages of life, with the highest prevalence in infants aged 8 to 21 days and≥22 days who did not require respiratory support, at 90.1% (264/273) and 91.1%(1 578/1 732), respectively. The rate of necrotizing enterocolitis was higher in the above-threshold group ( χ2=10.59, P=0.001), and the duration of hospital stay was longer in the above-threshold group ( Z=4.67, P<0.001) compared to the below-threshold group. Conclusions:In 2022, the red blood cell transfusion rate was relatively high among VPI from CHNN. Pre-transfusion hemoglobin levels frequently exceeded recommended transfusion thresholds.

A chemical investigation of secondary metabolites (SMs) from Aspergillus nidulans resulted in the identification of five novel dioxopiperazine (DKP)-diphenyl ether hybrids, designated as diphenylemestrins A-E (1-5). These compounds 1-5 represent the first known dimers combining DKP and diphenyl ether structures, with compound 4 featuring an uncommon dibenzofuran as the diphenyl ether component. The structural elucidation and determination of absolute stereochemistry were accomplished through spectroscopic analysis and electronic circular dichroism (ECD) calculations. Notably, diphenylemestrin C (3) exhibited moderate cytostatic activity against NB4 cells, with a half maximal inhibitory concentration (IC₅₀) value of 21.99 μmol·L^-1, and induced apoptosis at higher concentrations.
Aspergillus nidulans/metabolism* ; Diketopiperazines/pharmacology* ; Molecular Structure ; Phenyl Ethers/pharmacology* ; Humans ; Apoptosis/drug effects* ; Cell Line, Tumor

Objective:To discuss the influencing factors of angina pectoris in the patients with diabetes mellitus(DM),to construct a Bayesian network model to explore the network relationships among the influencing factors,and to predict the risk of angina pectoris in the patients with DM.Methods:Based on the UK Biobank(UKB)database,the Logistic regression aralysis model was used to screen the influencing factors of angina pectoris in the patients with DM.The taboo search algorithm was used for structure learning,and the Bayesian parameter estimation method was used for parameter learning to construct the Bayesian network model.Results:A total of 22 712 DM patients were included.The influencing factors of angina pectoris in the patients with DM included 14 variables:gender,age,body mass index(BMI),triglycerides(TG),total cholesterol(TC),glycated hemoglobin(HbA1c),hypertension,maternal smoking around delivery,smoking status,alcohol consumption,regular exercise,insomnia,sleep duration,and childhood relative body size(P<0.05).A Bayesian network model was constructed with 15 nodes and 22 directed edges.Among them,age,HbA1c,hypertension,regular exercise,BMI,and sleep duration were directly associated with the occurrence of angina pectoris in the patients with DM,while gender,smoking status,alcohol consumption,TC,TG,insomnia,childhood relative body size,and maternal smoking around delivery were indirectly associated with the occurrence of angina pectoris in the patients with DM.Conclusion:Age,HbA1c,hypertension,regular exercise,BMI,and sleep duration are direct influencing factors of angina pectoris in the patients with DM.Controlling HbA1c,blood pressure,and BMI levels,engaging in regular exercise,and maintaining appropriate sleep duration are beneficial for reducing the risk of angina pectoris in the patients with DM.

Moyamoya disease (MMD) is a chronic progressive cerebrovascular disease, and extracranial-intracranial revascularization is the most commonly treatment for MMD. With the continuous development of imaging techniques, the perioperative monitoring methods for MMD patients have gradually become more diverse. However, Doppler ultrasound still holds an important position due to its convenience and non-invasiveness. This article reviews the role of Doppler ultrasound in the perioperative assessment of patients with MMD.

Spontaneous intracerebral hemorrhage (ICH) accounts for approximately 10% to 15% of all stroke cases, with a 30-day mortality rate as high as 40%. Hematoma expansion (HE) is a core predictive factor for poor outcome in patients with ICH. Recent studies have shown that the patients with ICH often have blood lipid abnormalities, but the correlation between blood lipids and HE in patients with ICH is not yet fully understood. This article reviews the correlation between blood lipids and HE in patients with ICH and its possible mechanisms.

Hematoma expansion (HE) in patients with spontaneous intracerebral hemorrhage (sICH) is often associated with neurological deterioration and poor prognosis. Early and accurate identification of patients at high risk for HE is crucial for guiding clinical practice. This article summarizes the imaging predictors for HE in patients with sICH, primarily focusing on non-enhanced CT and CT angiography, and briefly introduces various prediction models based on imaging features, in order to provide references for the clinical diagnosis and treatment of sICH.

The Peking Union Medical College School of Nursing has been dedicated to exploring the education of undergraduate students specializing in geriatric nursing since 2016. Through seven years of exploration and practice, aiming at the pain points and difficulties in the process of cultivating geriatric nursing students, the teaching team has developed a progressive and modular curriculum system, with the goal of training geriatric nursing professionals with specialized knowledge and practical innovation abilities, on the platform of a seamless teaching practice base connecting settings from laboratory to community/elderly care institutions/hospital to society, with an emphasis on the integration of ideological and political education with geriatric nursing education. Moreover, a specialized faculty team has been established. This course serves as a model for nurturing excellent nursing professionals possessing the right values and outlook on life as well as ability to cope with the national challenges posed by aging populations.

Objective:To investigate the geriatric nursing competency of undergraduate nursing interns in four schools of nursing in Beijing as well as the influencing factors, and to provide a reference for perfecting the geriatric nursing education system in colleges and universities.Methods:From October to November 2022, a cross-sectional survey was performed on 223 undergraduate nursing interns selected by convenience sampling from four schools of nursing in Beijing, with the use of a general information questionnaire and the Gerontological Nursing Competence instrument. A general linear regression model was established to explore the factors influencing the geriatric nursing competency of nursing interns.Results:The mean total score for gerontological nursing competency was (3.19±0.40). In all dimensions, the mean score was highest for "Providing a safe living environment for older persons" (3.40±0.47) and lowest for "Understanding the sexual needs of older persons" (2.78±0.73). The thought about whether gerontological nursing contents were enough and the level of motivation to study gerontological nursing courses were the factors affecting nursing interns' gerontological nursing competency ( P<0.05). Conclusions:The overall gerontological nursing competency of the nursing interns was at a medium level, with uneven competencies in different dimensions. Nursing schools should strengthen gerontological nursing course building and stimulate students' learning motivation to improve their gerontological nursing competency.

Objectives:This study aims to investigate the impact of different Low-Density Lipoprotein cholesterol(LDL-C)levels on progression of intermediate coronary stenosis,and the associated risk factors leading to the progression of such lesions. Methods:Data were collected on 219 consecutive patients admitted at the Fuwai Central China Vascular Hospital from January 2020 to February 2021,underwent angiographic examinations and diagnosed with intermediate coronary stenosis,with at least one follow-up angiography after 11 months.Offline quantitative flow ratio(QFR)analysis was performed on these cases.Patients were divided into two groups:LDL-C controlled group(LDL-C<1.8 mmol/L,148 patients with 191 vessels)and LDL-C uncontrolled group(LDL-C≥1.8 mmol/L,71 patients with 98 vessels).Coronary artery QFR and anatomical indicators such as minimal lumen diameter,minimal lumen area,percentage diameter stenosis,percentage area stenosis were compared within and between the groups.Further analysis was performed to identify influencing factors leading to changes in coronary physiological parameters derived from QFR. Results:Within the LDL-C controlled group,there was no significant difference in the QFR values of the vessels compared to baseline(P>0.05),whereas in the LDL-C uncontrolled group(P<0.05),a notable decline in QFR was observed.Patients in the LDL-C controlled group had lower rates of maximum diameter and area stenosis and higher minimum lumen diameter and area(all P<0.05).Through multifactorial Logistic regression analysis,it was found that a body mass index＞28 kg/m2,LDL-C≥1.8 mmol/L,and a history of myocardial infarction were independent risk factors leading to the decline in QFR(all P<0.05). Conclusions:It was found that patients in the LDL-C controlled group had higher coronary artery QFR,minimum lumen diameter and area,lower rates of maximum diameter and area stenosis.

Objective To investigate the role of microRNA(miR)-567 in the proliferation,migration and cell cycle of non-small cell lung cancer(NSCLC)through regulation of cyclin dependent kinase 8(CDK8)and its clinical relevance.Methods Tumor tissues and adjacent tissues of 40 NSCLC patients were collected,and the expressions of miR-567 and CDK8 were detected by real-time quantitative fluorescent PCR(qRT-PCR).miR-NC mimic,miR-567 mimic,oe-NC,and oe-CDK8 were transfected into A549 and H1975 cells.The ex-pressions of miR-567 and CDK8 were detected using qRT-PCR.Cell proliferation was detected by CCK-8 method,and cell migration was detected by Transwell assay.Cell cycle changes were detected by flow cytome-try.The targeting of miR-567 and CDK8 was detected by luciferase reporter gene assay.Results In the tumor tissues of NSCLC patients,the expression of miR-567 was decreased,while the expression of CDK8 was in-creased,and the two were negatively correlated(P＜0.05).In A549 and H1975 cells,miR-567 mimic group was compared with miR-NC mimic group,the expression of miR-567 was increased,the expression of CDK8 was decreased,the proliferation and migration levels of cells were decreased,the proportion of G1 phase was increased,and the proportion of S phase was decreased.The fluorescence intensity of miR-567 mimic group was lower than that of miR-NC mimic group in normal CDK8.miR-567 mimic+oe-CDK8 group was compared with miR-567 mimic+oe-NC group,the expression of CDK8 was increased,the proliferation and migration levels of cells were increased,the proportion of cells in G1 phase was decreased,and the proportion of cells in S phase was increased.Conclusion miR-567 can inhibit NSCLC proliferation and migration by targeting CDK8 expression and controlling tumor cell arrest in the S phase.