Objective To explore serum levels of serine/threonine protein kinase 4(MST4)and heat shock protein 70(HSP70)in children with idiopathic immune thrombocytopenia(ITP)and their clinical signifi-cance.Methods Totally 98 children with ITP admitted to Northwest Women and Children's Hospital from April 2019 to April 2023 were retrospectively selected as the ITP group,and 50 healthy children who under-went physical examination during the same period were selected as the control group.Enzyme linked immu-nosorbent assay was used to detect serum levels of MST4 and HSP70,and the serum MST4 and HSP70 levels in children with different ITP levels were compared.The correlation between the indicators were analyzed by Pearson correlation.Logistic regression model was used to screen the prognostic factors of ITP,and the as-sessment value of serum MST4 and HSP70 on ITP prognosis was analyzed by subject working characteristic curve.Results Serum MST4,HSP70,and CD8 in the ITP group were higher than those in the control group,while PLT,CD3+,CD4+,CD4+/CD8+were lower than those in the control group,with statistical significance(P＜0.05).Serum MST4 and HSP70 levels in mild group,moderate group and severe group were increased successively,with statistical significance(P＜0.05).Correlation analysis showed that serum MST4 and HSP70 were positively correlated with CD8+(P＜0.05),and negatively correlated with PLT,CD3+,CD4+,CD4+/CD8+(P＜0.05).The disease course,serum MST4 and HSP70 of ITP children in the poor prognosis group were higher than those in the good prognosis group,and the differences were statistically significant(P＜0.05).Logistic regression analysis showed that the course of disease(OR=1.579,P＜0.001),serum MST4(OR=1.451,P＜0.001)and serum HSP70(OR=1.442,P＜0.001)were independent risk factors af-fecting the prognosis of children with ITP.The area under the curve of serum MST4 and HSP70 combined in the assessment of poor prognosis of ITP children was larger than that of serum MST4 and HSP70,and the difference was statistically significant(Z=4.568,4.672,both P＜0.001).Conclusion The elevated serum MST4 and HSP70 levels in children with ITP are related to the severity of the disease and cellular immune function.The combination of the two has a high evaluation value for the prognosis of children with ITP.

The development of artificial intelligence(AI)technology has promoted major changes in the field of immunology innovation and teaching reform.Traditional teaching classrooms are developing towards digital and intelligent teaching models.In order to improve high-quality education,cultivate AI thinking and comprehensive ability of graduate students,optimize current situations of traditional large classes and diversified characteristics of student,the AI technology is used to analyze the learning situation of students before class.Next,differentiated intelligence allocates digital learning materials according to the results of pre-class survey analysis,adopts"Research on scientific literature-based flipped classroom"teaching methods,carries out differentiated assessment methods,and finally the personalized teaching mode of doctoral students is implemented.This teaching strategy of deep integration of artificial intelligence and personalization can provide theoretical support and practical guidance for the subsequent reform and innovation in the immunology classroom and meet the needs of personalized training for PhD doctoral talents.

The development of artificial intelligence(AI)technology has promoted major changes in the field of immunology innovation and teaching reform.Traditional teaching classrooms are developing towards digital and intelligent teaching models.In order to improve high-quality education,cultivate AI thinking and comprehensive ability of graduate students,optimize current situations of traditional large classes and diversified characteristics of student,the AI technology is used to analyze the learning situation of students before class.Next,differentiated intelligence allocates digital learning materials according to the results of pre-class survey analysis,adopts"Research on scientific literature-based flipped classroom"teaching methods,carries out differentiated assessment methods,and finally the personalized teaching mode of doctoral students is implemented.This teaching strategy of deep integration of artificial intelligence and personalization can provide theoretical support and practical guidance for the subsequent reform and innovation in the immunology classroom and meet the needs of personalized training for PhD doctoral talents.

Objective:To analyze the epidemiological and etiological characteristics of a death case of meningococcal meningitis in Hengyang city, Hunan Province in 2024.Methods:Epidemiological investigation of the death case was performed, and samples from the patient and close contacts were collected. Following cultivation and isolation, Neisseria meningitidis ( Nm) strains were analyzed by antimicrobial susceptibility testing, pulsed field gel electrophoresis (PFGE), and whole-genome sequencing for analyzing epidemiological and etiological characteristics. Phylogenetic analysis was carried out using core genomic multilocus sequence typing (cgMLST). Results:The case was a 16-year-old high school boarding student with fulminant meningococcal meningitis. He had shock symptoms, and died within 24 h of the onset of symptoms. Six Nm strains were isolated from the patient and his roommates, belonging to two distinct clades. Isolate 144569 from the patient was highly homologous to isolate 144572 from a close contact, both belonging to the highly pathogenic sublineage L44.1 of CC4821. The typical molecular features was C: P1.7-2, 14: F5-101: ST4821 (CC4821). The two strains carried the antimicrobial resistance genes of gyrA-71 and penA-552, indicating reduced susceptibility to quinolone and penicillin, which was with their resistance phenotype. The isolates from four close contacts clustered within the same clade, characterized by the molecular features of B: P1.18-25, 9-18: ST5829 (UA). Conclusions:The death case is caused by Nm serogroup C from highly pathogenic sublineage L44.1 of CC4821. The spread of this isolate has the potential risk of outbreaks of invasive meningococcal disease. It is necessary to enhanced the molecular epidemiological surveillance, particularly focusing on the transmission of multiple serogroups of Nm among adolescents and the increasing exposure risk.

Objective:A nationwide multi-center and large sample survey was conducted to compare the validity of the Mini International Neuropsychiatric Interview (Hypo-) Manic Episode with Mixed Features-DSM-5 Module (MINI-M) questionnaire and the Clinically Useful Depression Outcome Scale Supplemented with Questions for the DSM-5 Mixed Features Specifier (CUDOS-M) depression subscale in identifying mixed features in patients experiencing (hypo-) manic episodes.Methods:Using a convenience sampling method, 366 patients with bipolar disorder experiencing acute (hypo-) manic episodes who met the inclusion and exclusion criteria were recruited. The diagnosis of "with mixed features" was based on the DSM-5 criteria for mixed features. The predictive validity of the MINI-M questionnaire and the CUDOS-M depression subscale to screen mixed features was analyzed using the receiver operating characteristic (ROC) curve. Additionally, the difference in area under the ROC curve (AUC) between the two instruments was compared.Results:The AUC for the MINI-M questionnaire and the CUDOS-M depression subscale in screening mixed features were 0.79 (95 %CI=0.75-0.84) and 0.81 (95 %CI=0.77-0.86), respectively. There was no statistically significant difference in AUC between the two measurements ( Z=-1.19, P>0.05). Among patients with acute (hypo-) manic episodes, 45.9% (168/366) presented with mixed features according to the DSM-5 criteria, while the corresponding figures were 43.7% (160/366) using the MINI-M questionnaire (total score≥3) and 42.1% (154/366) using the CUDOS-M depression subscale (total score≥20). Screening results were comparable among the three measures. Conclusion:Mixed features are common among patients experiencing acute (hypo-) manic episodes. The MINI-M questionnaire and the CUDOS-M depression subscale demonstrate equivalent validity in identifying mixed features.

In order to meet the needs of the comprehensive development of life sciences and medicine,and fulfill the coher-ence and intersectionality of undergraduate experimental courses,it is necessary to break the teaching contents of conventional single experiment courses,and carry out the teaching reform of tumor comprehensive experimental course.Molecular biology and immuno-logy are two basic subjects which are closely related to the scientific research of life science,basic medicine and clinical medicine.Meantime,they are important sources for students to acquire skill training and scientific thinking as well.In this study,we try to inte-grate the experimental courses about the analysis and intervention of tumor-related genes based on the molecular biology and immunology technologies,facilitating to establish a new tumor comprehensive experimental course system.The course focuses on the development of students'logical thinking,and simulates the scientific research process through database screening,experimental operation,experi-mental report and paper writing,so as to significantly improve undergraduates'interest in scientific research and their ability to com-bine theory with practice,and cultivate students'rigorous scientific and innovative thinking ability as well as their ability to compre-hensively analyze and solve problems.It lays a solid foundation for future postgraduate related scientific research.At the same time,it is helpful to train teachers with multi-disciplinary knowledge reserves,and promote the coordinated development of scientific research through teaching.

Objective To investigate the safety of regular plasma donors aged 55 to 60,so as to provide reference for retention and recruitment of elderly plasma donors in China.Methods Plasma donors from 9 blood products manufacturing enterprises from 2018 to 2020 and the local general population were selected as the research objects.The total protein level,albumin and globulin ratio(ALB/GLB,A/G)and adverse reactions of plasma donation of regular plasma donors and local general population were retrospectively analyzed.Results The total protein level(g/L)and A/G of plasma donors aged 56 to 60 and the general population were 61.21±5.62 vs 60.04±6.93 and 1.610±0.299 vs 1.635±0.330,respectively,and the differences were statistically significant.The total protein level of regular plasma donors was higher than that of general popu-lation,but A/G was slightly lower than that of general population.From 2018 to 2020,there were a total of 23 056 302 plas-ma donations in 108 plasma stations,and adverse reactions occurred in 20 932 donations,with a total incidence of 0.09%,with no serious adverse reactions.Conclusion It is safe for regular plasma donors aged 55 to 60 to donate plasma,and the retention of them can alleviate the pressure of plasma supply.

Objective:A nationwide multi-center and large sample survey was conducted to compare the validity of the Mini International Neuropsychiatric Interview (Hypo-) Manic Episode with Mixed Features-DSM-5 Module (MINI-M) questionnaire and the Clinically Useful Depression Outcome Scale Supplemented with Questions for the DSM-5 Mixed Features Specifier (CUDOS-M) depression subscale in identifying mixed features in patients experiencing (hypo-) manic episodes.Methods:Using a convenience sampling method, 366 patients with bipolar disorder experiencing acute (hypo-) manic episodes who met the inclusion and exclusion criteria were recruited. The diagnosis of "with mixed features" was based on the DSM-5 criteria for mixed features. The predictive validity of the MINI-M questionnaire and the CUDOS-M depression subscale to screen mixed features was analyzed using the receiver operating characteristic (ROC) curve. Additionally, the difference in area under the ROC curve (AUC) between the two instruments was compared.Results:The AUC for the MINI-M questionnaire and the CUDOS-M depression subscale in screening mixed features were 0.79 (95 %CI=0.75-0.84) and 0.81 (95 %CI=0.77-0.86), respectively. There was no statistically significant difference in AUC between the two measurements ( Z=-1.19, P>0.05). Among patients with acute (hypo-) manic episodes, 45.9% (168/366) presented with mixed features according to the DSM-5 criteria, while the corresponding figures were 43.7% (160/366) using the MINI-M questionnaire (total score≥3) and 42.1% (154/366) using the CUDOS-M depression subscale (total score≥20). Screening results were comparable among the three measures. Conclusion:Mixed features are common among patients experiencing acute (hypo-) manic episodes. The MINI-M questionnaire and the CUDOS-M depression subscale demonstrate equivalent validity in identifying mixed features.

Objective:This study investigates the difference in the detection rate and symptomatology between ICD-10 and DSM-5 diagnostic criteria for bipolar disorder with mixed states.Methods:Based on the Phase Ⅰ (2012) and Phase Ⅱ (2021) databases of National Bipolar Mania Pathway Survey (BIPAS), patients with bipolar disorder were included. General demographic data, clinical characteristics, symptomatic phenotypes, and mixed characteristics were retrieved. The detection rates and symptomatic performances of patients with or without mixed states in Phase Ⅰ and Ⅱ were compared using the chi-square test.Results:For patients with mixed states, the detection rate during Phase Ⅱ (2021) using DSM-5 (18.79%, 199/1 059) criteria was significantly higher than that during Phase Ⅰ (2012) using ICD-10 (6.78%, 199/2 934; χ 2=125.05, P<0.001). Whether using ICD-10 or DSM-5 criteria, patients with mixed states had a significantly higher frequency of multiple symptomatic manifestations. Conclusion:The DSM-5 diagnostic criteria generate a high detection rate for bipolar disorder with mixed states. The clinical phenotypes of bipolar disorder with mixed states vary significantly using different diagnostic tools.

Objective:To investigate the expression of serum circular RNA PUM1 (circPUM1) and microRNA-760 (miR-760) in patients with polycystic ovary syndrome (PCOS) , and their correlation with BMI and biochemical indexes.Methods:A total of 118 patients with PCOS who were diagnosed and treated in Zhengzhou Central Hospital Affiliated to Zhengzhou University from Feb. 2019 to Feb. 2022 were regarded as as the research subjects (PCOS group) . Another 120 women who underwent physical examination in our hospital were regarded as the control group. Real-time quantitative PCR (RT-qPCR) was performed to detect the expression levels of circPUM1 and miR-760 in serum, and to measure serum glucose and lipid metabolism indicators and sex hormone indicators; Pearson method was performed to analyze the correlation between the expression levels of circPUM1 and miR-760, and the correlation between circPUM1 and miR-760 and each index.Results:The expression level of BMI, FBG, FINS, HOMA-IR, TG, estradiol, LH, prolactin and circPUM1 was (23.81±2.85) kg/m 2, (4.87±0.73) ] mmol/L, (8.51±2.18) mIU/L, 1.85±0.69, (1.58±0.57) mmol/L, (182.34±30.47) pmol/L, (7.43±2.05) mIU/ml, (323.45±60.25) mIU/L and 1.05±0.21, while they were (25.24±2.36) kg/m 2, (5.35±0.65) mmol/L, (14.43±4.36) mIU/L, 3.21±1.05, (1.93±0.60) mmol/L, (193.75±38.42) pmol/L, (10.42±2.60) mIU/mL, (372.31±75.44) mIU/L and 1.83±0.45. The expression level of miR-760 was 1.01±0.23 in the control group, while it was 0.77±0.16 in PCOS group. Correlation analysis showed that serum circPUM1 in PCOS patients was negatively correlated with miR-760 ( r=-677, P<0.001) , and serum circPUM1 in PCOS patients was positively correlated with FBG, FINS, HOMA-IR, and TG ( P<0.05) , while was no greatly correlated with other indicators ( P>0.05) , and miR-760 was negatively correlated with FBG, FINS, HOMA-IR, and TG ( P<0.05) , while was no greatly correlated with other indicators ( P>0.05) . Conclusion:The expression level of circPUM1 in serum of patients with PCOS is increased, and the expression level of miR-760 is decreased, which is correlated with glucose and lipid metabolism indicators and can be used to predict the occurrence of metabolic diseases in PCOS patients.