Objective: To investigate the factors influencing intraoperative blood transfusion in patients with hip fractures and to develop a machine learning (ML) model for predicting this risk. Methods: A total of 424 patients with hip fractures who underwent surgical treatment between November 2022 and March 2025 in our hospital were selected. Key feature variables of intraoperative blood transfusion risk were identified using the Boruta algorithm. Four different ML algorithms—support vector machine (SVM), linear discriminant analysis (LDA), mixed discriminant analysis (MDA), and extreme gradient boosting (XGBoost)—were used to develop predictive models for intraoperative blood transfusion risk. The predictive performance of the four ML models were evaluated using accuracy, precision, receiver operating characteristic (ROC) curves, precision-recall curves (PRC), precision-recall gain curves (PRGC), and F1 scores. Shapley additive interpretation (SHAP) was used to interpret the final model. Results: Among the 424 patients, 77(18.2%) received intraoperative blood transfusion. The Boruta algorithm identified albumin (ALB), activated partial thromboplastin time (APTT), types of anesthesia, types of fracture, and hemoglobin (Hb) as key feature variables for predicting intraoperative blood transfusion risk. In model evaluation, the SVM model outperforms the other three models across multiple metrics, including the area under the receiver operating characteristic curve (AUC), recall, recall gain, accuracy, precision, F1 score, and the area under the precision-recall curve (PRC-AUC). The SVM model, interpreted and visualized based on SHAP values, effectively predicted intraoperative blood transfusion risk in patients with hip fracture. A visual online application was developed based on the SVM model (https://pbo-nomogram.shinyapps.io/blood/). Conclusion: Preoperative low ALB and Hb levels, prolonged APTT, general anesthesia, and intertrochanteric fractures are risk factors for intraoperative blood transfusion in hip fracture patients. The risk prediction model for intraoperative blood transfusion constructed based on the SVM algorithm has optimal performance, which provides new ideas and methods for the clinical early identification of hip fracture patients with high transfusion risk and the implementation of targeted interventions.

ObjectiveTo observe the prevention and control effect of processed Polygonatum cyrtonema on depression induced by chronic unpredictable mild stress （CUMS） in female rats. MethodsForty rats were assigned into control， model， and low-， medium-， and high-dose processed P. cyrtonema groups according to the random number table method， with 8 rats in each group. The rat model of depression was established with the CUMS method. The body mass， open field test， forced swimming test， Morris water maze test， levels of neurotransmitters ［dopamine （DA）， 5-hydroxytryptamine （5-TH）， and acetylcholine （ACh）］， serum levels of sex hormones ［gonadotropin-releasing hormone（GnRH）， testosterone （T）， and estradiol （E₂）］ and inflammatory factors ［tumor necrosis factor-α （TNF-α）， interleukin （IL）-6， and IL-10］， and mRNA and protein levels of factors in the brain-derived neurotrophic factor （BDNF）/tyrosine kinase receptor B （TRKB）/cAMP-response element binding protein （CREB） pathway were employed to evaluate the effect of processed P. cyrtonema on the CUMS-induced depression in female rats. ResultsThe body mass， open field test results， and forced swimming test results showed that the rat model of depression was successfully established. The comparison of behaviors， neurotransmitters， sex hormones， inflammatory factors， and neural pathways among groups showed that processed P. cyrtonema had different effects of preventing the development of depression in female rats. SPSS 25 was used for statistical analysis of error and significance. T test was conducted between groups. Each treatment group showed significant therapeutic effect compared with the model group （P<0.05）. Processed P. cyrtonema elevated the level of 5-TH （P<0.01） and lowered the levels of DA and ACh （P<0.01） in the brain tissue of female rats. In addition， it reduced the serum levels of GnRH， T， E₂， TNF-α， and IL-6 （P<0.05） and up-regulated the mRNA levels of BDNF and TRKB in the rat brain. ConclusionProcessed P. cyrtonema has a non-hyperactive preventive effect on CUMS-induced depression in rats， which provides a theoretical basis for the development of processed P. cyrtonema as a functional food product.

ObjectiveTo observe the prevention and control effect of processed Polygonatum cyrtonema on depression induced by chronic unpredictable mild stress （CUMS） in female rats. MethodsForty rats were assigned into control， model， and low-， medium-， and high-dose processed P. cyrtonema groups according to the random number table method， with 8 rats in each group. The rat model of depression was established with the CUMS method. The body mass， open field test， forced swimming test， Morris water maze test， levels of neurotransmitters ［dopamine （DA）， 5-hydroxytryptamine （5-TH）， and acetylcholine （ACh）］， serum levels of sex hormones ［gonadotropin-releasing hormone（GnRH）， testosterone （T）， and estradiol （E₂）］ and inflammatory factors ［tumor necrosis factor-α （TNF-α）， interleukin （IL）-6， and IL-10］， and mRNA and protein levels of factors in the brain-derived neurotrophic factor （BDNF）/tyrosine kinase receptor B （TRKB）/cAMP-response element binding protein （CREB） pathway were employed to evaluate the effect of processed P. cyrtonema on the CUMS-induced depression in female rats. ResultsThe body mass， open field test results， and forced swimming test results showed that the rat model of depression was successfully established. The comparison of behaviors， neurotransmitters， sex hormones， inflammatory factors， and neural pathways among groups showed that processed P. cyrtonema had different effects of preventing the development of depression in female rats. SPSS 25 was used for statistical analysis of error and significance. T test was conducted between groups. Each treatment group showed significant therapeutic effect compared with the model group （P<0.05）. Processed P. cyrtonema elevated the level of 5-TH （P<0.01） and lowered the levels of DA and ACh （P<0.01） in the brain tissue of female rats. In addition， it reduced the serum levels of GnRH， T， E₂， TNF-α， and IL-6 （P<0.05） and up-regulated the mRNA levels of BDNF and TRKB in the rat brain. ConclusionProcessed P. cyrtonema has a non-hyperactive preventive effect on CUMS-induced depression in rats， which provides a theoretical basis for the development of processed P. cyrtonema as a functional food product.

The interaction between m⁶A-methylated RNA and chromatin modification remains largely unknown. We found that targeted inhibition of bromodomain-containing protein 4 (BRD4) by siRNA or its inhibitor (JQ1) significantly decreases mRNA m⁶A levels and suppresses the malignancy of breast cancer (BC) cells via increased expression of demethylase AlkB homolog 5 (ALKBH5). Mechanistically, inhibition of BRD4 increases the mRNA stability of ALKBH5 via enhanced binding between its 3' untranslated regions (3'UTRs) with RNA-binding protein RALY. Further, BRD4 serves as a scaffold for ubiquitin enzymes tripartite motif containing-21 (TRIM21) and ALKBH5, resulting in the ubiquitination and degradation of ALKBH5 protein. JQ1-increased ALKBH5 then demethylates mRNA of extra spindle pole bodies like 1 (ESPL1) and reduces binding between ESPL1 mRNA and m⁶A reader insulin like growth factor 2 mRNA binding protein 3 (IGF2BP3), leading to decay of ESPL1 mRNA. Animal and clinical studies confirm a critical role of BRD4/ALKBH5/ESPL1 pathway in BC progression. Further, our study sheds light on the crosstalks between histone modification and RNA methylation.

The immune related adverse events(irAE)caused by tumor immune checkpoint inhibitors(ICI)have attracted increasing attention of clinical experts.Immune-mediated liver injury caused by ICIs(ILICI)is not uncommon in clinical practice,but specific diagnostic method of ILICI is lacking.Biopsy of liver tissue can help improve the diagnosis and management of ILICI.In the treatment of ILICI,the immediate use of corticosteroid therapy is not necessarily.A balance between efficacy,toxicity,and specific treatment need to be achieved,and further refined through multidisciplinary team(MDT)cooperation.Appropriate dosaging and identification of novel predictive targets should be considered in order to reduce the incidence and severity of ILICI in the future.Meanwhile,further basic research is required to elucidate the potential pathophysiological mechanisms and risk factors of ILICI.With the refinement of evidence in clinical evidence-based medicine and deepening of basic research,the diagnosis and treatment level of ILICI will also be further improved.

【Objective】 To study the characteristics of HIV infection among voluntary blood donors in Shijiazhuang from 2011 to 2021, so as to provide reference for decision making in the control of HIV for blood centers. 【Methods】 The confirmatory results of HIV reactive samples in initial screening among voluntary blood donors from 2011 to 2021 in our center were statistical analyzed. 【Results】 A total of 2 008 299 samples from 1 667 315 blood donors were detected, among which 3 217 samples were HIV reactive and 234 were confirmed positive, with the positive rate at 11.65/100 000 and the prevalence of 14.03/100 000. The prevalence in men was higher than that in women (16.52/100 000 vs 1.39/100 000), in first-time blood donors higher than that in repeated donors (17.27/100 000 vs 8.12/100 000), in whole blood donors higher than that in plateletpheresis donors (12.01/100 000 vs 8.41/100 000), and the differences were statistically significant (P<0.05). The male homosexual transmission was the main routes of transmission, accounting for 62.39% (146/234). And 72% of double-reagent reactive samples were confirmed positive. Four samples were screened in the serological window period and 6 samples were from HIV positive confirmed donors. 【Conclusion】 The HIV prevalence among voluntary blood donors in Shijiazhuang was low. A certain percentage of repeated blood donors got newly infected. NAT could shorten the detection window period of HIV. Since some confirmed positive samples had not been detected out by NAT, publicity and education should be strengthened to reduce the probability of infected or high-risk groups to participate in blood donation.

OBJECTIVETo investigate the protective effect of bone marrow mesenchymal stem cells (BMSCs)-derived exosomesagainst testicular ischemia-reperfusion injury (IRI) in rats.

METHODSRat BMSCs were isolated, cultured and identified in theprimary culture. The exosomes were extracted from the BMSCs and characterized using nanoparticle tracking analysis, transmission electron microscopy, and Western blotting. Twenty-four healthy male SD rats were randomly divided into shamoperation group, testicular IRI with saline treatment group and IRI with exosome treatment group. The contralateral testes ofthe rats were collected for pathological observation, aseessment of superoxide dismutase (SOD) and malondialdehyde (MDA), and detection of HMGB1, caspases-3 and cleaved caspase-3 expressions using Western blotting.

RESULTSWe successfullyobtained exosomes from rat BMSCs. Testicular IRI significantly impaired testicular spermatogenesis, which was markedlyimproved by treatment with the exosomes ( < 0.05). Testicular IRI also caused significant increase in the protein expression ofHMGB1, caspase-3 and cleaved caspase-3 in the testicular tissue, and treatment with the exosomes obviously amelioratedthese changes ( < 0.05).

CONCLUSIONSBMSCs-derived exosomes protects against testicular IRI due to the anti-oxidant, antiinflammatory and anti-apoptosis activities of the exosomes.

Objective To explore the application of question-based lectures made by students in teaching chapter of nuclear chemical and biological weapon damage among field military nursing.Methods The participants were junior students of four-year undergraduate program.Questions on emergency treatment and care of chemical and biological weapon damage were proposed after a lecture by teacher.Students were divided into three groups after class and each group was assigned to a lecture on emergency treatment and care of one kind of weapon damage.Students had to collect information and prepare PPT for the next lecture.After lectures given by students at next class,discussion on the lectures was organized and comments were given by teachers.Results All students approved this kind of teaching activities,97.44％ believed that it can arouse their interest in study,94.87％ participated in the collection of data,89.74％ took part in the discussion,and 87.18％ obtained the sense of achievements.Conclusion Question-based lectures made by students are helpful in stimulating their interest in learning,cultivating their abilities of acquiring and applying knowledge.The teaching activities achieve the preferable results through proper application and meticulous organization.

The curriculum of Communitity Health Nursing has fine operation and practicability.Aiming at this point, the situational teaching method is used in teaching.This method is uniquely excellent in arousing students enthusiasm of learning,improving students' ability to integrate theory with practice, cultivating students' creative thinking and team spirit.The teaching effect has been proved correct in our practice.

Objective To study expiration time and the origin of bacteria for the sterile packages of strategic reserve between inland region and littoral under natural environment.Methods We prepared operation dressing package,apparatus package as well as dressing and apparatus mixed package with double- cotton and to be deposited in storage boxes of combat readiness warehouse under natural environment after pulsing vacuum steam sterilization.Three packages of every kind were put in a storage boxes and samples were taken from the packages and underwent bacterial culture at different time-points.Meanwhile,the bacteria strains in combat readiness warehouse' air and in the storage boxes were cultured and performed with homology analysis.Results Expiration time of sterile packages of strategic reserve was 40d in inland region whereas 24d in littoral.The major bacteria were G+ bacilli and G+ staphylococus in sterile packages of strategic reserve,combat readiness warehouse' air and storage boxes in two regions.In inland region,the 16～23SrRNA ITS sequences of bacteria strains in sterile packages shared about 97％～100％ homology with which between the air bacteria strains in combat readiness warehouse and the storage boxes whereas it was about 98％～99％ homology in littoral.Conclusions The storage environment is the most influential factor on expiration time of sterile packages of strategic reserve.The bacteria in sterile packages of strategic reserve came from the air of combat readiness warehouse.To ensure the expiration time of sterile package of strategic reserve,corresponding management methods are important guarantee which can provide new methods about management on strategic reserve.