Objective:To investigate the repair effect of bone marrow mesenchymal stem cells(BMSCs)on interferon gamma(IFN-γ)induced ovarian granulosa cell immune injury.Methods:A model of IFN-γ-induced ovarian granulosa cell immune injury was estab-lished.KGN cells after modeling were co-cultured with human BMSCs(hBMSCs)and divided into three groups:negative control(NC)group,IFN-γ group,and BMSC group.After co-culture,cell proliferation was determined by a cell counting kit 8 assay for 3 consecu-tive days.Cell apoptosis was determined using an Annexin V-FITC apoptosis detection kit and a CytoFLEX flow cytometer.The estra-diol level and the mRNA expression levels of aromatase CYP19A1 and FSHR were measured to evaluate the hormone synthesis ability.The level of lactate dehydrogenase(LDH),mRNA expression levels of NLRP3,caspase-1(CASP1),and interleukin-1β,and protein expression levels of NLRP3,CASP1,and gasdermin-D were determined to evaluate cell pyroptosis.Results:The proliferation rate of granulosa cells in the IFN-γ group and the BMSC group was lower than that in the NC group at 24 h,48 h and 72 h,and that in the IFN-γ group was lower than that in the BMSC group(P<0.001).The number of apoptotic granulosa cells in the INF-γ group and the BMSC group was higher than that in the NC group,and that in the INF-γ group was higher than that in the BMSC group(P<0.001).The estradiol level in the INF-γ group and the BMSC group was lower than that in the NC group,and that in the INF-γ group was lower than that in the BMSC group(P<0.001).Compared with the IFN-γ group,the mRNA expression of CYP19A1 and FSHR in the BMSC group decreased(P<0.001).Compared with the IFN-γ group,the BMSC group had significantly decreased LDH level,mRNA expression levels of NLRP3 and CASP1,and protein expres-sion level of CASP1.Conclusion:hBMSCs repair the immune in-jury of KGN cells induced by IFN-γ by restoring cell proliferation,inhibiting cell apoptosis,repairing endocrine function,and reducing pyroptosis.

Objective To investigate the status quo of indwelling needles use in the hospitals at all lev-els in Chongqing city,and to evaluate the normalization and safety of indwelling needles use by referring to Nursing Practice Standards for Intravenous Therapy.Methods A self-designed questionnaire was used in July 2023 to conduct a cross-sectional survey on the use of indwelling needles in the hospitals at all levels in Chongqing city.Results A total of 30 807 patients in 77 hospitals were included,among them 62.67%used indwelling needles.The closed type indwelling needles accounted for 88.87%and the safety type indwelling needles accounted for 41.74%.Non-needle infusion connectors accounted for 37.78%,and steel needle con-nected with heparin caps accounted for 51.69%.95.66%of puncture site was in the upper limb,the non-cor-rosive drug infusion accounted for 87.57%,and the complications occurrence rate was 2.46%.Among the 6 419 surveyed nurses,75.51%removed indwelling needles based on clinical indications.There were statistically significant differences in the usage rates of closed type indwelling needles and non-needle infusion connectors among hospitals at different levels(P<0.05).There were also statistically significant differences in the inci-dence rates of complication and phlebitis(P<0.05).Conclusion The overall application of indwelling needles in the hospitals at all levels in Chongqing city is generally standardized,but the use of safety type indwelling needles and needle-free infusion connectors still needs to be improved.

Aim To reveal the mechanism of CIP4 homologs protein 1(RICH1)are involved in the regu-lation of myocardial fibrosis.Methods Mouse cardiac fibroblasts(MCFs)cells were treated with transforming growth factor-β(TGF-β1)to induce the formation of a myocardial fibrosis cell model;the level of the target protein was detected by Western blotting;and the RICH1 gene was detected by transfection of the cells with plasmid.The RICH1 gene was overexpressed(RICH 1 OE)using plasmid transfection;the RICH1 gene was silenced using siRNA fragment(siRICH1);and the expression levels of myocardial fibrosis marker genes,such as Col1 a1,Col3 a1,and Acta2,were de-tected using RT-qPCR.Results RICH1 was signifi-cantly down-regulated in TGF-β1-treated MCFs;the expression levels of myocardial fibrosis marker genes,such as Col1 a1,Col3a1,and Acta2,were down-regu-lated in the RICH1 OE+TGF-β1 group;and in the siRICH1+TGF-β1 group,myocardial fibrosis marker genes,such as Col1 a1,Col3a1 and Acta2 were up-regulated at the expression level;phosphorylated SMAD2(p-SMAD2)and phosphorylated SMAD3(p-SMAD3)levels were down-regulated in the siRICH1 OE+TGF-β1 group.p-SMAD2 and P-SMAD3 levels were upregulated in the siRICH1+TGF-β1 group.Conclusion RICH1 inhibits TGF-β1-induced myo-cardial fibrosis;RICH1 inhibits TGF-β1-induced myo-cardial fibrosis by negatively regulating the SMAD2/3 signaling pathway.

Aim To reveal the mechanism of CIP4 homologs protein 1(RICH1)are involved in the regu-lation of myocardial fibrosis.Methods Mouse cardiac fibroblasts(MCFs)cells were treated with transforming growth factor-β(TGF-β1)to induce the formation of a myocardial fibrosis cell model;the level of the target protein was detected by Western blotting;and the RICH1 gene was detected by transfection of the cells with plasmid.The RICH1 gene was overexpressed(RICH 1 OE)using plasmid transfection;the RICH1 gene was silenced using siRNA fragment(siRICH1);and the expression levels of myocardial fibrosis marker genes,such as Col1 a1,Col3 a1,and Acta2,were de-tected using RT-qPCR.Results RICH1 was signifi-cantly down-regulated in TGF-β1-treated MCFs;the expression levels of myocardial fibrosis marker genes,such as Col1 a1,Col3a1,and Acta2,were down-regu-lated in the RICH1 OE+TGF-β1 group;and in the siRICH1+TGF-β1 group,myocardial fibrosis marker genes,such as Col1 a1,Col3a1 and Acta2 were up-regulated at the expression level;phosphorylated SMAD2(p-SMAD2)and phosphorylated SMAD3(p-SMAD3)levels were down-regulated in the siRICH1 OE+TGF-β1 group.p-SMAD2 and P-SMAD3 levels were upregulated in the siRICH1+TGF-β1 group.Conclusion RICH1 inhibits TGF-β1-induced myo-cardial fibrosis;RICH1 inhibits TGF-β1-induced myo-cardial fibrosis by negatively regulating the SMAD2/3 signaling pathway.

OBJECTIVE To explore the influence of human cytomegalovirus(HCMV)infection on transforming growth factor β(TGF-β)/Smad signaling pathway and helper T cell(Th)1/Th2 cytokines of the patients with di-abetic retinopathy(DR)so as to provide guidance for clinical treatment of the DR patients with HCMV infection.METHODS Totally 100 DR patients complicated with HCMV infection who were treated in Xinyu People's Hospi-tal from Jan.2021 to Dec.2023 were assigned as the HCMV infection group and were divided into the non-prolif-erative DR group(NPDR group)and the proliferative DR group(the PDR group)according to the degree of path-ological change of retina.Meanwhile,100 DR patients without HCMV infection were chosen as the no HCMV in-fection group.The levels of serum TGF-β,interferon-γ(IFN-γ)and interleukin(IL)-4 as well as the relative ex-pression levels of Smad2 and Smad3 mRNA were observed.RESULTS The levels of serum TGF-β,IFN-γ and IL-4 of the HCMV infection group were respectively 1.41±0.43,(92.68±15.86)ng/L and(593.91±84.67)ng/L,higher than those of the no HCMV infection group;the relative expression levels of Smad2 mRNA and Smad3 mRNA of the HCMV infection group were respectively(1.54±0.44)and(1.68±0.50),higher than those of the no HCMV infection group(P＜0.05);the levels of the above indexes of the PDR group were higher than those of the NPDR group(P＜0.05).Receiver operating characteristic(ROC)curve analysis showed that the area under the curve(AUC)of the joint detection of TGF-β,IFN-γ,IL-4,Smad2 and Smad3 was 0.961 in prediction of HC-MV infection in the DR patients,with the sensitivity 90.70％,the specificity 85.10％.CONCLUSION The HC-MV infection may aggravate the degree of retinopathy,which may be associated with the regulation of TGF-β/Smad signaling pathways and imbalance of Th1/Th2 function.

OBJECTIVE To explore the influence of human cytomegalovirus(HCMV)infection on transforming growth factor β(TGF-β)/Smad signaling pathway and helper T cell(Th)1/Th2 cytokines of the patients with di-abetic retinopathy(DR)so as to provide guidance for clinical treatment of the DR patients with HCMV infection.METHODS Totally 100 DR patients complicated with HCMV infection who were treated in Xinyu People's Hospi-tal from Jan.2021 to Dec.2023 were assigned as the HCMV infection group and were divided into the non-prolif-erative DR group(NPDR group)and the proliferative DR group(the PDR group)according to the degree of path-ological change of retina.Meanwhile,100 DR patients without HCMV infection were chosen as the no HCMV in-fection group.The levels of serum TGF-β,interferon-γ(IFN-γ)and interleukin(IL)-4 as well as the relative ex-pression levels of Smad2 and Smad3 mRNA were observed.RESULTS The levels of serum TGF-β,IFN-γ and IL-4 of the HCMV infection group were respectively 1.41±0.43,(92.68±15.86)ng/L and(593.91±84.67)ng/L,higher than those of the no HCMV infection group;the relative expression levels of Smad2 mRNA and Smad3 mRNA of the HCMV infection group were respectively(1.54±0.44)and(1.68±0.50),higher than those of the no HCMV infection group(P＜0.05);the levels of the above indexes of the PDR group were higher than those of the NPDR group(P＜0.05).Receiver operating characteristic(ROC)curve analysis showed that the area under the curve(AUC)of the joint detection of TGF-β,IFN-γ,IL-4,Smad2 and Smad3 was 0.961 in prediction of HC-MV infection in the DR patients,with the sensitivity 90.70％,the specificity 85.10％.CONCLUSION The HC-MV infection may aggravate the degree of retinopathy,which may be associated with the regulation of TGF-β/Smad signaling pathways and imbalance of Th1/Th2 function.

Objective To evaluate the efficacy and adverse reactions of BRAF inhibitor vermorafenib on the treat-ment of refractory craniopharyngioma carrying BRAF-V600E mutation.Methods Clinical data of two patients with refractory craniopharyngiomas(CP)were recorded and reviewed.The patients were followed up for 3-5 years.Lit-erature on CPs receiving BRAF or BRAF/MEK therapy was reviewed.Results 1)Papillary CP progressed after multiple operations and radiotherapy in two patients.Further treatments were very difficult.2)The presence of BRAF-V600E mutation in the tumor was confirmed,and vermorafenib was administered for 6.5-7.5 months.Tumor volumes remarkably shrank by 95%-99%.No tumor relapse was observed during the follow-up of 3-5 years after discontinuation of vemurafenib.3)The main adverse reaction was rash,which was dose dependent.4)Litera-ture review showed the volume shrank by 50%-100%in 33/34 tumors during BRAF or BRAF/MEK inhibitor therapy.Conclusions BRAF inhibitor vemurafenib is effective in treating refractory craniopharyngioma carrying BRAF-V600E mutation with endurable side effects,which may bring some changes to the management of CP in future.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective:To explore a better virtual reality (VR) aviation rescue training mode and equipment platform by comparing the application of VR gloves and handle.Methods:A control study was used. Forty undergraduate students were enrolled by using cluster sampling method in this study. They were averagely divided into VR glove group and the VR handle group. Both groups were respectively trained with VR glove and VR handle based on an aviation rescue script of the craniocerebral trauma in traffic accident and the training effect was analyzed by comparing the assessments between VR training and reality simulation. The assessment were conducted both by VR and actual operation trainings and the content included operation, evaluation judgment, and total training time consumed. After the training was completed, the students of 2 groups were investigated by questionnaire.Results:In the VR assessment, the training time for the VR handle group [(26.94±2.00) min] was lower than that of the VR glove group [(31.23±2.23) min], and the difference was significant ( t=6.42, P<0.001). In the reality simulation assessment, the operation score of the VR glove group [(37.80±7.08) points] was higher than that of the VR handle group [(30.40±6.07) points], with a significant difference ( t=3.55, P<0.001). There was no significant difference between the scores of VR assessment and reality simulation assessment in the VR glove group. The reality simulation operation score of the VR handle group [(30.40±6.07) points] was lower than the VR operation score [(36.20±8.15) points], and the difference was significant ( t=2.55, P=0.015). The reality simulation operation time [(30.25±1.66) min] was higher than the VR operation time [(26.94±2.00) min], and the difference was significant ( t=5.59, P<0.001).The scores of assessing operation diversity and the integration with reality in VR glove group were higher than that in VR handle group ( Z=-4.00, -2.00, P<0.001,=0.045), but the scores of positioning accuracy and button functions were lower ( Z=-2.30, t=5.70, P=0.022,<0.001). Conclusions:VR technology has some advantages in helicopter aviation rescue training, has a broad prospect. As the VR human-machine data exchange equipment, both gloves and handles could bring good training effect even they have their own disadvantages. It is still necessary to improve VR software and equipment, and promote the quality of air rescue training in multiple aspects.

Objective:To explore a better virtual reality (VR) aviation rescue training mode and equipment platform by comparing the application of VR gloves and handle.Methods:A control study was used. Forty undergraduate students were enrolled by using cluster sampling method in this study. They were averagely divided into VR glove group and the VR handle group. Both groups were respectively trained with VR glove and VR handle based on an aviation rescue script of the craniocerebral trauma in traffic accident and the training effect was analyzed by comparing the assessments between VR training and reality simulation. The assessment were conducted both by VR and actual operation trainings and the content included operation, evaluation judgment, and total training time consumed. After the training was completed, the students of 2 groups were investigated by questionnaire.Results:In the VR assessment, the training time for the VR handle group [(26.94±2.00) min] was lower than that of the VR glove group [(31.23±2.23) min], and the difference was significant ( t=6.42, P<0.001). In the reality simulation assessment, the operation score of the VR glove group [(37.80±7.08) points] was higher than that of the VR handle group [(30.40±6.07) points], with a significant difference ( t=3.55, P<0.001). There was no significant difference between the scores of VR assessment and reality simulation assessment in the VR glove group. The reality simulation operation score of the VR handle group [(30.40±6.07) points] was lower than the VR operation score [(36.20±8.15) points], and the difference was significant ( t=2.55, P=0.015). The reality simulation operation time [(30.25±1.66) min] was higher than the VR operation time [(26.94±2.00) min], and the difference was significant ( t=5.59, P<0.001).The scores of assessing operation diversity and the integration with reality in VR glove group were higher than that in VR handle group ( Z=-4.00, -2.00, P<0.001,=0.045), but the scores of positioning accuracy and button functions were lower ( Z=-2.30, t=5.70, P=0.022,<0.001). Conclusions:VR technology has some advantages in helicopter aviation rescue training, has a broad prospect. As the VR human-machine data exchange equipment, both gloves and handles could bring good training effect even they have their own disadvantages. It is still necessary to improve VR software and equipment, and promote the quality of air rescue training in multiple aspects.