Objective: To analyze the cause of discrepancy between ABO genotype B102/O01 and serological results in one case by PCR-SSP, to clarify the serological characteristics of this special blood group, and to explore relevant blood transfusion strategies. Methods: Blood group serological tests were performed on blood donor in August and December 2024, including forward and reverse ABO typing using tube method, H antigen identification, direct anti-human globulin test by tube method, red blood cell absorption-elution test, and determination of ABH blood group substance in saliva. Exons 1-7 of the ABO gene were amplified by PCR-SSP and sequenced. Results: The two separate serological tests consistently identified the donor as having an A B phenotype, but the results of gene sequencing indicated a B102/O01 genotype, showing an discrepancy between serological and genetic results. Conclusion: It is very likely that the blood type of the blood donor is B102/O01 with a microchimerism of type A, or an AB type masked by A type reference gene.

Objective To investigate whether evodiamine(EVO)can alleviate liver injury in septic rats by influencing the nucleo-tide-binding and oligomerization domain(NOD)-like receptor protein 3(NLRP3)/interleukin-1 β(IL-1β)/caspase-1 signaling pathway.Methods A rat model of sepsis-induced liver damage was constructed,and the successfully modeled rats were assigned to the model,L-EVO,M-EVO,H-EVO(administered orally at 4,8,and 16 mg/kg of EVO),and H-EVO+NLRP3(administered orally at 16 mg/kg of EVO+intraperitoneal injection of 1 mg/kg of NLRP3 signaling pathway activator sodium salt)groups,each with ten rats.In addition,ten normal rats were selected as the control group(that is,the sham surgery group,without ligation or puncture,using the same steps as for the model group).The control and model groups were administered with equal amounts of physiological saline once daily for 28 d,consecutively.A reagent kit was used to assess rat liver function.Hematoxylin and eosin(HE)staining was used to analyze pathological changes in the liver tissue.Terminal deoxynucleotidyl transferase dUTP nick end labeling(TUNEL)staining was used to assess apoptosis in liver tissue cells.ELISA was used to analyze IL-6,tumor necrosis factor α(TNF-α),and IL-1β levels in serum.Western blotting was used to detect changes in protein expression of the NLRP3/IL-1β/caspase-1 signaling pathway components in liver tissues.Results For the control group,the liver tissues of rats in the model group lost their normal structure,with an uneven distribution of liver cells accompanied by edema and vacuoles.For the model group,the L-EVO,M-EVO,and H-EVO groups exhibited a relatively neat arrangement of liver tissue cells,reduced edema,and vacuoles.As the dose increased,the morphology of liver tissue cells recovered significantly.For the H-EVO group,the H-EVO+NLRP3 group exhibited a disordered arrangement of liver tissue cells with edema and vacuoles.For the control group,the model group showed increased alanine aminotransferase(ALT),aspartate aminotransferase(AST),liver tissue cell apoptosis rate,serum IL-6,TNF-α,and IL-1β levels,and expression of NLRP,IL-1β,and caspase-1 protein in the liver tissue(P＜0.05).For the model group,the L-EVO,M-EVO,and H-EVO groups showed lower ALT,AST,liver tissue cell apoptosis rate,serum IL-6,TNF-α,and IL-1β levels,and expression of NLRP,IL-1β,and caspase-1 protein in the liver tissue(P＜0.05).For the H-EVO group,the H-EVO+NLRP3 group had higher ALT,AST,liver tissue cell apoptosis rate,serum IL-6,TNF-α,and IL-1β levels,and expression of NLRP,IL-1β,and caspase-1 pro-tein in the liver tissue(P＜0.05).Conclusion EVO can alleviate liver injury in septic rats by influencing the NLRP3/IL-1β/caspase-1 signaling pathway.

Objective:To investigate the relationship between serum cytokeratin 18 (CK18)-M30, 8-iso-prostaglandin F2α (8-iso-PGF2α), apelin-13 and the severity of early-onset preeclampsia, as well as their impact on perinatal outcomes.Methods:A prospective study method was adopted. A total of 125 patients with early-onset preeclampsia (early-onset preeclampsia group) and 125 healthy pregnant women (healthy control group) from April 2022 to June 2024 in Xi′an International Medical Center Hospital were selected. Enzyme-linked immunosorbent assay was used to detect serum levels of CK18-M30, 8-iso-PGF2α and apelin-13. All subjects of both groups were followed up until delivery, and the perinatal outcomes were recorded, including the delivery gestational week, fetal asphyxia, fetal growth restriction, fetal death and small for gestational age infant. Point-biserial correlation analysis was used for correlation analysis. Multivariate Logistic regression analysis was used to analyze the effects of serum CK18-M30, 8-iso-PGF2α and apelin-13 on the illness severity in patients with early-onset preeclampsia.Results:The serum CK18-M30 and 8-iso-PGF2α in early-onset preeclampsia group were significantly higher than those in healthy control group: (282.55 ± 37.07) U/L vs. (117.18 ± 18.76) U/L and (478.79 ± 51.24) ng/L vs. (246.05 ± 33.73) ng/L, the serum apelin-13 was significantly lower than that in healthy control group: (337.29 ± 42.42) ng/L vs. (810.86 ± 91.47) ng/L, and there were statistical differences ( P<0.01). Among the 125 patients with early-onset preeclampsia, 68 cases were mild and 57 cases were severe. The serum CK18-M30 and 8-iso-PGF2α in severe patients were significantly higher than those in mild patients: (316.95 ± 40.22) U/L vs. (253.72 ± 31.08) U/L and (527.22 ± 56.44) ng/L vs. (438.19 ± 49.27) ng/L, the serum apelin-13 was significantly lower than that in mild patients: (291.72 ± 36.41) ng/L vs. (375.49 ± 47.08) ng/L, and there were statistical differences ( P<0.01). The point-biserial correlation analysis results showed that the serum CK18-M30 and 8-iso-PGF2α were positively correlated with the illness severity in patients with early-onset preeclampsia ( r = 0.536 and 0.521, P<0.01), the serum apelin-13 was negatively correlated with the illness severity ( r = - 0.540, P<0.01). Multivariate Logistic regression analysis result showed that high CK18-M30, high 8-iso-PGF2α and low apelin-13 were the independent risk factors of disease progression in patients with early-onset preeclampsia ( OR = 2.984, 2.855 and 0.873; 95% CI 1.670 to 5.330, 1.561 to 5.221 and 0.781 to 0.976; P<0.01 or <0.05). Taking the mean values of serum CK18-M30, 8-iso-PGF2α and apelin-13 in patients with early-onset preeclampsia (282.55 U/L, 478.79 ng/L and 337.29 ng/L) as the cut-off values, the patients were divided into high (≥mean value) and low (

Objective:To explore the lived experiences of family members of terminal ICU patients regarding their humanistic care needs and provide theoretical foundations for developing nursing care plans tailored to their needs.Methods:This study was a descriptive qualitative study. From April to December 2023, 16 family members of terminally ill ICU patients in Shanghai East Hospital, Tongji University were selected for semi-structured interviews using purposive sampling method, and the interview data were qualitatively analyzed using Colaizzi 7-step analysis.Results:The humanistic care needs of family members of terminally ill ICU patients can be categorized into five themes, namely, the need to know the condition at the first time; the need to participate in treatment and decision-making; the need to respect the wishes of terminally ill patients; the need for psychological care; and the need for social support.Conclusions:The humanistic care needs of family members of terminal ICU patients remain largely unmet. Nursing professionals should consider these needs and preferences and provide family members with professional guidance to help them establish positive coping mechanisms.

Objective:To investigate the efficacy and toxicity of blinatumomab in the first-line and second-line treatment of pediatric B-cell acute lymphoblastic leukemia (B-ALL).Methods:A multi-center retrospective cohort study was conducted to analyze clinical data from 323 pediatric B-ALL patients treated with blinatumomab across 14 hospitals in China from May 2021 to July 2023. Patients were divided into four groups based on the treatment phase and disease status when blinatumomab was used: relapsed/refractory group, post-consolidation minimal residual disease (MRD)-positive group, early MRD-positive group, and MRD-negative group. Blinatumomab for the relapsed/refractory group was considered as second-line treatment, while the other 3 groups as first-line treatment. The MRD negativity rate after treatment, the survival rates and the incidence of severe adverse events were compared across these groups. Patients who received blinatumomab for more than 7 days were included in the efficacy analysis. Survival analysis was performed using the Kaplan-Meier method, and Log-Rank test was used to compare the survival rates among groups.Results:Among the 323 patients, 191 (59.1%) were male, with the age of 6.2 (3.9, 10.5) years. There were 117 patients in the relapsed/refractory group, 62 cases in the post-consolidation MRD-positive group, 43 cases in the early MRD-positive group, and 101 cases in the MRD negative group. In the relapsed/refractory group, the complete remission rate and MRD negativity rate after one course of blinatumomab were 71.4% (35/49) and 81.5% (75/92) for the 49 children without complete remission and the 92 children with flow cytometry-positive MRD, respectively. In the post-consolidation MRD-positive group, the MRD negativity rates after one course of blinatumomab were 100.0% (27/27), 12/16 and 9/19 for patients with MRD positivity detected by flow cytometry, polymerase chain reaction and next-generation sequencing, respectively. In the early MRD-positive group, the MRD negativity rates were 96.7% (29/30) and 9/9 for flow cytometry and next-generation sequencing, respectively. The 2-year overall survival rate and event-free survival rate for the 319 children evaluable for efficacy were (90.6±1.7)% and (87.6±1.9)%, respectively, with the relapsed/refractory group showing significantly lower overall survival rates and event-free survival rate compared to the other groups ( χ2=21.40, 26.21,both P<0.001). Grade 3 or higher adverse events occurred in 128 cases (39.6%), with hematological toxicity observed in 101 cases, while cytokine release syndrome (CRS), infection, and neurotoxicity occurred in 11, 26 and 8 cases, respectively. In addition, there were statistically significant differences in the grade 3 or higher CRS among the four groups ( χ2=8.03, P<0.05). Conclusion:Blinatumomab can clear MRD more effectively and achieve superior survival outcomes when used as first-line treatment for pediatric B-ALL, with less CRS.

Objective To investigate whether evodiamine(EVO)can alleviate liver injury in septic rats by influencing the nucleo-tide-binding and oligomerization domain(NOD)-like receptor protein 3(NLRP3)/interleukin-1 β(IL-1β)/caspase-1 signaling pathway.Methods A rat model of sepsis-induced liver damage was constructed,and the successfully modeled rats were assigned to the model,L-EVO,M-EVO,H-EVO(administered orally at 4,8,and 16 mg/kg of EVO),and H-EVO+NLRP3(administered orally at 16 mg/kg of EVO+intraperitoneal injection of 1 mg/kg of NLRP3 signaling pathway activator sodium salt)groups,each with ten rats.In addition,ten normal rats were selected as the control group(that is,the sham surgery group,without ligation or puncture,using the same steps as for the model group).The control and model groups were administered with equal amounts of physiological saline once daily for 28 d,consecutively.A reagent kit was used to assess rat liver function.Hematoxylin and eosin(HE)staining was used to analyze pathological changes in the liver tissue.Terminal deoxynucleotidyl transferase dUTP nick end labeling(TUNEL)staining was used to assess apoptosis in liver tissue cells.ELISA was used to analyze IL-6,tumor necrosis factor α(TNF-α),and IL-1β levels in serum.Western blotting was used to detect changes in protein expression of the NLRP3/IL-1β/caspase-1 signaling pathway components in liver tissues.Results For the control group,the liver tissues of rats in the model group lost their normal structure,with an uneven distribution of liver cells accompanied by edema and vacuoles.For the model group,the L-EVO,M-EVO,and H-EVO groups exhibited a relatively neat arrangement of liver tissue cells,reduced edema,and vacuoles.As the dose increased,the morphology of liver tissue cells recovered significantly.For the H-EVO group,the H-EVO+NLRP3 group exhibited a disordered arrangement of liver tissue cells with edema and vacuoles.For the control group,the model group showed increased alanine aminotransferase(ALT),aspartate aminotransferase(AST),liver tissue cell apoptosis rate,serum IL-6,TNF-α,and IL-1β levels,and expression of NLRP,IL-1β,and caspase-1 protein in the liver tissue(P＜0.05).For the model group,the L-EVO,M-EVO,and H-EVO groups showed lower ALT,AST,liver tissue cell apoptosis rate,serum IL-6,TNF-α,and IL-1β levels,and expression of NLRP,IL-1β,and caspase-1 protein in the liver tissue(P＜0.05).For the H-EVO group,the H-EVO+NLRP3 group had higher ALT,AST,liver tissue cell apoptosis rate,serum IL-6,TNF-α,and IL-1β levels,and expression of NLRP,IL-1β,and caspase-1 pro-tein in the liver tissue(P＜0.05).Conclusion EVO can alleviate liver injury in septic rats by influencing the NLRP3/IL-1β/caspase-1 signaling pathway.

Objective:To investigate the relationship between serum cytokeratin 18 (CK18)-M30, 8-iso-prostaglandin F2α (8-iso-PGF2α), apelin-13 and the severity of early-onset preeclampsia, as well as their impact on perinatal outcomes.Methods:A prospective study method was adopted. A total of 125 patients with early-onset preeclampsia (early-onset preeclampsia group) and 125 healthy pregnant women (healthy control group) from April 2022 to June 2024 in Xi′an International Medical Center Hospital were selected. Enzyme-linked immunosorbent assay was used to detect serum levels of CK18-M30, 8-iso-PGF2α and apelin-13. All subjects of both groups were followed up until delivery, and the perinatal outcomes were recorded, including the delivery gestational week, fetal asphyxia, fetal growth restriction, fetal death and small for gestational age infant. Point-biserial correlation analysis was used for correlation analysis. Multivariate Logistic regression analysis was used to analyze the effects of serum CK18-M30, 8-iso-PGF2α and apelin-13 on the illness severity in patients with early-onset preeclampsia.Results:The serum CK18-M30 and 8-iso-PGF2α in early-onset preeclampsia group were significantly higher than those in healthy control group: (282.55 ± 37.07) U/L vs. (117.18 ± 18.76) U/L and (478.79 ± 51.24) ng/L vs. (246.05 ± 33.73) ng/L, the serum apelin-13 was significantly lower than that in healthy control group: (337.29 ± 42.42) ng/L vs. (810.86 ± 91.47) ng/L, and there were statistical differences ( P<0.01). Among the 125 patients with early-onset preeclampsia, 68 cases were mild and 57 cases were severe. The serum CK18-M30 and 8-iso-PGF2α in severe patients were significantly higher than those in mild patients: (316.95 ± 40.22) U/L vs. (253.72 ± 31.08) U/L and (527.22 ± 56.44) ng/L vs. (438.19 ± 49.27) ng/L, the serum apelin-13 was significantly lower than that in mild patients: (291.72 ± 36.41) ng/L vs. (375.49 ± 47.08) ng/L, and there were statistical differences ( P<0.01). The point-biserial correlation analysis results showed that the serum CK18-M30 and 8-iso-PGF2α were positively correlated with the illness severity in patients with early-onset preeclampsia ( r = 0.536 and 0.521, P<0.01), the serum apelin-13 was negatively correlated with the illness severity ( r = - 0.540, P<0.01). Multivariate Logistic regression analysis result showed that high CK18-M30, high 8-iso-PGF2α and low apelin-13 were the independent risk factors of disease progression in patients with early-onset preeclampsia ( OR = 2.984, 2.855 and 0.873; 95% CI 1.670 to 5.330, 1.561 to 5.221 and 0.781 to 0.976; P<0.01 or <0.05). Taking the mean values of serum CK18-M30, 8-iso-PGF2α and apelin-13 in patients with early-onset preeclampsia (282.55 U/L, 478.79 ng/L and 337.29 ng/L) as the cut-off values, the patients were divided into high (≥mean value) and low (

Objective:To explore the lived experiences of family members of terminal ICU patients regarding their humanistic care needs and provide theoretical foundations for developing nursing care plans tailored to their needs.Methods:This study was a descriptive qualitative study. From April to December 2023, 16 family members of terminally ill ICU patients in Shanghai East Hospital, Tongji University were selected for semi-structured interviews using purposive sampling method, and the interview data were qualitatively analyzed using Colaizzi 7-step analysis.Results:The humanistic care needs of family members of terminally ill ICU patients can be categorized into five themes, namely, the need to know the condition at the first time; the need to participate in treatment and decision-making; the need to respect the wishes of terminally ill patients; the need for psychological care; and the need for social support.Conclusions:The humanistic care needs of family members of terminal ICU patients remain largely unmet. Nursing professionals should consider these needs and preferences and provide family members with professional guidance to help them establish positive coping mechanisms.

Objective:To investigate the efficacy and toxicity of blinatumomab in the first-line and second-line treatment of pediatric B-cell acute lymphoblastic leukemia (B-ALL).Methods:A multi-center retrospective cohort study was conducted to analyze clinical data from 323 pediatric B-ALL patients treated with blinatumomab across 14 hospitals in China from May 2021 to July 2023. Patients were divided into four groups based on the treatment phase and disease status when blinatumomab was used: relapsed/refractory group, post-consolidation minimal residual disease (MRD)-positive group, early MRD-positive group, and MRD-negative group. Blinatumomab for the relapsed/refractory group was considered as second-line treatment, while the other 3 groups as first-line treatment. The MRD negativity rate after treatment, the survival rates and the incidence of severe adverse events were compared across these groups. Patients who received blinatumomab for more than 7 days were included in the efficacy analysis. Survival analysis was performed using the Kaplan-Meier method, and Log-Rank test was used to compare the survival rates among groups.Results:Among the 323 patients, 191 (59.1%) were male, with the age of 6.2 (3.9, 10.5) years. There were 117 patients in the relapsed/refractory group, 62 cases in the post-consolidation MRD-positive group, 43 cases in the early MRD-positive group, and 101 cases in the MRD negative group. In the relapsed/refractory group, the complete remission rate and MRD negativity rate after one course of blinatumomab were 71.4% (35/49) and 81.5% (75/92) for the 49 children without complete remission and the 92 children with flow cytometry-positive MRD, respectively. In the post-consolidation MRD-positive group, the MRD negativity rates after one course of blinatumomab were 100.0% (27/27), 12/16 and 9/19 for patients with MRD positivity detected by flow cytometry, polymerase chain reaction and next-generation sequencing, respectively. In the early MRD-positive group, the MRD negativity rates were 96.7% (29/30) and 9/9 for flow cytometry and next-generation sequencing, respectively. The 2-year overall survival rate and event-free survival rate for the 319 children evaluable for efficacy were (90.6±1.7)% and (87.6±1.9)%, respectively, with the relapsed/refractory group showing significantly lower overall survival rates and event-free survival rate compared to the other groups ( χ2=21.40, 26.21,both P<0.001). Grade 3 or higher adverse events occurred in 128 cases (39.6%), with hematological toxicity observed in 101 cases, while cytokine release syndrome (CRS), infection, and neurotoxicity occurred in 11, 26 and 8 cases, respectively. In addition, there were statistically significant differences in the grade 3 or higher CRS among the four groups ( χ2=8.03, P<0.05). Conclusion:Blinatumomab can clear MRD more effectively and achieve superior survival outcomes when used as first-line treatment for pediatric B-ALL, with less CRS.

In recent years,China has made great progress in basic nanomedicine,nanotoxicology and nanobiology research.Nanotechnology has been continuously applied in biomaterial and medical device,more and more medical devices applying nanomaterials are developed and manufactured.In order to gain more comprehension and accurate understanding of the research and industrial development in nanobiomaterial medical devices,this study reviewed the common nanomaterial in medical devices and the regulatory situation of nanomaterial medical devices at home and abroad,and discussed the current challenges in biological evaluation of nanomaterial medical devices,with a view to providing ideas for the safety evaluation and research of related products.