To provide in-service medical technicians and nurses with convenient access to continuing education resources in transfusion medicine, reduce transfusion-related adverse events, and ensure the safety, rationalization, and effectiveness of clinical transfusion, we designed and developed an online transfusion continuing education platform. The platform was based on the new managed code programming model.NET Core and the powerful functions of hypertext preprocessor PHP 7.4, addressing current issues in transfusion online continuing education. Through in-depth analysis of student attributes, learning behaviors, and teaching behaviors, a comprehensive online continuous teaching quality evaluation index system was established. This system not only facilitates the quantitative assessment of teaching quality but also successfully integrates the two core functions of teaching and management, thereby achieving unified online teaching.

Objective To investigate the protective effect of miR-193a-5p on cardiac function and the regulation of IL-33/ST2 signaling pathway in rats with chronic heart failure(CHF).Methods Forty SPF-grade Wistar rats were randomly divided to four groups:Sham group,CHF group,NC group,and miR-193a-5p group,10 rats in each group.The model of chronic heart failure was duplicated in the CHF group,NC group,and miR-193a-5p group.Subsequently,the rats in the NC group and miR-193a-5p group were received 5 nmol/L of NC-agomiR or miR-193a-5p-agomiR,respectively,via tail vein injection every 3 days for 4 weeks.In contrast,the rats in the Sham and CHF groups were received an equal amount of saline injection.At the endpoint of the experiment,doppler color ultrasonography was used to detect the left ventricular posterior wall thicknesses(LVPWs),left ventricular posterior wall thickness at end-diastole(LVPWd),systolic interventricular septal thicknesses IVSs,end-diastolic interventricular septal thicknesses(IVSd),and left ventricular ejection fractions(LVEFs)in the above rats,and the changes in the cardiac phenotypic indices of HW/BW vs.LVW/BW in the 4 groups,and cardiac tissues of the rats of the 4 groups were selected.Histomorphological analysis was performed,and the expression levels of miR-193a-5p in the cardiac tissues of the four groups of the rats were detected by qPCR;apoptosis was detected by Tunel staining;the levels of the inflammatory factors interleukin-6(IL-6)and tumor necrosis factor alpha(TNF-alpha)in the myocardial tissues were measured by Elisa;Western blot was used to detect the expression levels of IL-33 and ST2 protein in myocardial tissues.Results Compared with the Sham group,the hearts in the CHF and NC groups showed increased volume,altered geometry,thinning of the myocardium,and pallor in the infarcted area,whereas the miR-193a-5p group showed partial remission.In addition,the expression levels of miR-193a-5p in cardiac tissues of the CHF and NC groups showed a decreasing trend,whereas showed a significant increase in the miR-193a-5p group(P<0.01).In CHF group and NC group,LVPWs,LVPWd,IVSS,IVSD HW/BW and LVW/BW increased significantly,and LVEF decreased significantly(P<0.01).In miR-193a-5p group,LVPWs,LVPWd,IVSs,IVSd,HW/BW and LVW/BW decreased significantly but higher than sham group,and LVEF increased significantly but lower than sham group(P<0.01).The expression of miR-193a-5p increased significantly in CHF group and NC group,decreased significantly in miR-193a-5p group but still higher than sham group(P<0.01).The expression of IL-33 and ST2 protein increased significantly in CHF group and NC group,and decreased significantly in miR-193a-5p group(P<0.01).Conclusion miR-193a-5p has a protective effect on cardiac function in the rats with chronic heart failure.The mechanism might be related to inhibiting the release of inflammatory factors,reducing cardiomyocyte apoptosis and the inhibition of IL-33/ST2 signaling pathway.

OBJECTIVE: To observe the dynamic changes of microvascular injury and repair in the penumbra of traumatic brain injury (TBI) rats with effective cerebral perfusion microvascular imaging using optical coherence tomography angiography (OCTA). METHODS: Transparent closed cranial windows were placed in craniotomy rats after TBI caused by weight drop. All the rats in TBI group and control group underwent head MRI examination on the first postoperative day, and the changes of cerebral cortical microvessel density were measured by OCTA through cranial windows on d0, d2, d4, d6, and d8. On the second day after the operation, the same number of rats in the two groups were selected to complete the immunohistochemical staining of brain tissue with pimonidazole, an indicator of hypoxia. RESULTS: MRI T2W1 and immunohistochemical staining demonstrated that edema and hypoxia in the traumatic brain tissue extended deeply throughout the entire cortex. OCTA showed that the cortical surface veins of the rats in both groups were significantly dilated and tortuous after operation, and recovered to the postoperative day level on d8. The effective perfusion microvessel density of the rats in both groups gradually recovered after a temporary decrease, and the TBI group decreased from 39.38%±4.48% on d0 to 27.84%±6.01% on d2, which was significantly lower than that on d0, d6, and d8 (P < 0.05). The highest value was 61.71%±7.69% on d8, which was significantly higher than that on d0, d2, and d4 (P < 0.05). The control group decreased from 44.59%±7.78% on d0 to 36.69%±5.49% on d2, which was significantly lower than that on d0, d6, and d8 (P < 0.05). The highest value was 51.92%±5.96% on d8, which was significantly higher than that on d2, and d4 (P < 0.05). Comparing the two groups, the effective perfusion microvessel density in the TBI group was significantly lower than that in the control group on d2 (P=0.021), and significantly higher than that in the control group on d8 (P=0.030). CONCLUSION OCTA can be used as a method of imaging and measurement of effective perfusion microvessels in the injured cerebral cortex of TBI rats. After TBI, the effective perfusion microvessel density in the wound penumbra gradually recovered after decreasing, and increased significantly on d8.
Animals ; Brain Injuries, Traumatic/physiopathology* ; Rats ; Tomography, Optical Coherence/methods* ; Male ; Rats, Sprague-Dawley ; Microvessels/pathology* ; Microvascular Density ; Cerebral Cortex/blood supply* ; Cerebrovascular Circulation

Objective To evaluate the quality of Uncaria Hook(UH)in the market.Methods Twenty-nine batches of UH were tested by legal standards(character,identification,inspection,and extract detection).The TLC method was used to explore the identification of the control herbs,pilocarcinine,dehydropilocarcinine,pilocarcinine and isocarcinine.The HPLC method was used to establish the characteristic spectrum of UH.Then cluster analysis,PCA-X,and OPLS-DA analysis methods were used to perform statistical analysis on the common peak area of unguttine,and determine the contents of heicoside,iso-dehydrounguttine,iso-unguttine,iso-unguttine,and unguttine,to screen out the key quality control components of UH and evaluate their quality.Results Among the 29 batches of samples,23 batches were qualified,and the qualified rate was 79.31％.The results of the TLC analysis showed that the chemical constituents of different base sources were very different.No pilocarcinine was detected in Uncaria macrophylla no hydropilocarcinine was detected in Uncaria sinensis,and four components were not detected in Uncaria hirsuta.Only the samples with the base source of the plant showed corresponding spots in the chromatographic position with the control drug and the control substance.The results of HPLC showed that the chemical composition and content of different base sources of UH were very different.No hydrouncinine and pilocarcinine were detected in Uncaria macrophylla.No iso-dehydrouncinine,dehydrouncinine,and dehydropilocarcinine were detected in Uncaria sinensis.And only heicoside was detected in Uncaria sinensis,and the content of heicoside was low.Based on statistical analysis,there were differences among different batches of UH,and three key quality control ingredients,iso-dehydrounguocarcinoma,dehydrounguocarcinoma,and iso-unguocarcinoma that may lead to quality differences of unguocarcinoma were found.Conclusions Overall,the UH is of poor quality,the current processing standards and testing standards can not ensure the quality of the product,affecting the safety and effectiveness of clinic use.The chemical composition categories and contents of different base sources of UH are very different,which increases the difficulty of formulating a unified quality standard.

To provide in-service medical technicians and nurses with convenient access to continuing education resources in transfusion medicine, reduce transfusion-related adverse events, and ensure the safety, rationalization, and effectiveness of clinical transfusion, we designed and developed an online transfusion continuing education platform. The platform was based on the new managed code programming model.NET Core and the powerful functions of hypertext preprocessor PHP 7.4, addressing current issues in transfusion online continuing education. Through in-depth analysis of student attributes, learning behaviors, and teaching behaviors, a comprehensive online continuous teaching quality evaluation index system was established. This system not only facilitates the quantitative assessment of teaching quality but also successfully integrates the two core functions of teaching and management, thereby achieving unified online teaching.

Objective To evaluate the quality of Uncaria Hook(UH)in the market.Methods Twenty-nine batches of UH were tested by legal standards(character,identification,inspection,and extract detection).The TLC method was used to explore the identification of the control herbs,pilocarcinine,dehydropilocarcinine,pilocarcinine and isocarcinine.The HPLC method was used to establish the characteristic spectrum of UH.Then cluster analysis,PCA-X,and OPLS-DA analysis methods were used to perform statistical analysis on the common peak area of unguttine,and determine the contents of heicoside,iso-dehydrounguttine,iso-unguttine,iso-unguttine,and unguttine,to screen out the key quality control components of UH and evaluate their quality.Results Among the 29 batches of samples,23 batches were qualified,and the qualified rate was 79.31％.The results of the TLC analysis showed that the chemical constituents of different base sources were very different.No pilocarcinine was detected in Uncaria macrophylla no hydropilocarcinine was detected in Uncaria sinensis,and four components were not detected in Uncaria hirsuta.Only the samples with the base source of the plant showed corresponding spots in the chromatographic position with the control drug and the control substance.The results of HPLC showed that the chemical composition and content of different base sources of UH were very different.No hydrouncinine and pilocarcinine were detected in Uncaria macrophylla.No iso-dehydrouncinine,dehydrouncinine,and dehydropilocarcinine were detected in Uncaria sinensis.And only heicoside was detected in Uncaria sinensis,and the content of heicoside was low.Based on statistical analysis,there were differences among different batches of UH,and three key quality control ingredients,iso-dehydrounguocarcinoma,dehydrounguocarcinoma,and iso-unguocarcinoma that may lead to quality differences of unguocarcinoma were found.Conclusions Overall,the UH is of poor quality,the current processing standards and testing standards can not ensure the quality of the product,affecting the safety and effectiveness of clinic use.The chemical composition categories and contents of different base sources of UH are very different,which increases the difficulty of formulating a unified quality standard.

ObjectiveTo explore the effect and mechanism of Sishenjian on synovial lesions induced by monosodium iodoacetate （MIA） in rats with knee osteoarthritis （KOA）. MethodSixty female Sprague-Dawley （SD） rats were randomly divided into the following six groups： normal group， model group， celecoxib group， and high-， medium-， and low-dose Sishenjian group. The KOA rat model was established by intra-articular injection of MIA. Celecoxib （18 mg·kg^-1） and Sishenjian （14.4， 7.2， 3.6 g·kg^-1） were administered by gavage according to the groups. All rats were euthanized after four weeks of continuous administration. The transverse diameter of the bilateral knee joints of rats was measured， and gross observation of the knee joint was performed. Pathological changes in knee joint synovial tissue were observed by hematoxylin-eosin （HE） staining and picrosirius red staining. Immunohistochemistry （IHC） was used to detect the expression of vascular endothelial growth factor A （VEGFA） in synovial tissue. The levels of inflammatory cytokines in the joint synovial fluid were detected by enzyme-linked immunosorbent assay （ELISA）. Real-time quantitative polymerase chain reaction （Real-time PCR） and Western blot were used to detect the expression of mRNA and proteins related to the transforming growth factor-β₁ （TGF-β₁）/Smad2/3 pathway in knee joint synovium. ResultCompared with the normal group， the transverse diameter of the knee joint in the model group significantly increased （P<0.01）. Compared with the model group， the transverse diameter of the knee joint in rats of each Sishenjian group significantly decreased （P<0.01）. Compared with the normal group， the expression levels of interleukin-1β （IL-1β） and tumor necrosis factor-α （TNF-α） in the knee joint synovial fluid of model group significantly increased （P<0.01）. Compared with the model group， the expression levels of IL-1β and TNF-α in the knee joint synovial fluid of rats in each Sishenjian group significantly decreased （P<0.01）. Compared with the normal group， the expression levels of TGF-β₁， Smad2/3， phosphorylation（p）-Smad2/3， type Ⅰ collagen α1 （ColⅠ_α1）， type Ⅲ collagen α1 （ColⅢ_α1）， VEGFA proteins and TGF-β₁， Smad2/3， ColⅠ_α1， ColⅢ_α1 mRNA in knee joint synovium of model group significantly increased （P<0.01）. Compared with the model group， the expression levels of TGF-β₁， Smad2/3， phosphorylation （p）-Smad2/3， ColⅠ_α1， ColⅢ_α1， VEGFA proteins and TGF-β₁， Smad2/3， ColⅠ_α1， ColⅢ_α1 mRNA in knee joint synovium of rats in each Sishenjian group significantly decreased （P<0.05， P<0.01）. ConclusionSishenjian can inhibit synovial inflammation and angiogenesis， and may become a potential drug for treating synovial lesions in KOA by regulating the TGF-β₁/Smad2/3 pathway.

Objective To investigate the correlation analysis of serum autotaxin(ATX),tenascin-C(TN-C)and ventricular remodeling indexes in elderly patients with dilated cardiomyopathy(DCM)with heart fail-ure(HF)and their effects on prognosis.Methods 153 elderly patients with DCM with HF who were admit-ted to the 904th Hospital of the Joint Logistic Support Force from January 2020 to January 2022 were selected as DCM with HF group,and 100 elderly patients with simple DCM in the same hospital during the same peri-od were selected as DCM group and 100 healthy elderly individuals who underwent physical examination were selectedas control group.Serum ATX and TN-C levels were detected by enzyme-linked immunosorbent assay,and ventricular remodeling indexes[left ventricular end-diastolic diameter(LVEDD),left ventricular end-sys-tolic diameter(LVESD),and left ventricular ejection fraction(LVEF)]were detected by echocardiography.The correlation between serum ATX,TN-C levels and ventricular remodeling indexes in elderly patients with DCM with HF were analyzed by Pearson correlation analysis.Elderly patients with DCM with HF were fol-lowed up for 1 year,patients were divided into poor prognosis group and good prognosis group according to the prognosis.The influencing factors of poor prognosis in elderly patients with DCM with HF were analyzed by univariate and multivariate logistic regression analysis,the predictive value of serum ATX and TN-C levels for poor prognosis in elderly patients with DCM with HF was analyzed by receiver operating characteristic(ROC)curve.Results The serum levels of ATX and TN-C in DCM combined HF group were higher than those in DCM group and control group,and the difference was statistically significant(P＜0.05).Serum ATX and TN-C levels in DCM group were higher than those in control group,and the difference was statistically significant(P＜0.05).LVEDD and LVESD in DCM with HF group were higher than those in DCM group and control group,and LVEF was lower than those in DCM group and control group,the difference was statis-tically significant(P＜0.05).Pearson correlation analysis showed that serum ATX and TNC levels in elderly patients with DCM with HF were positively correlated with LVEDD and LVESD,and negatively correlated with LVEF(P＜0.05).Univariate analysis showed that HF disease course,NYHA cardiac function grade,NT-proBNP,ATX and TN-C were the influential factors for poor prognosis in elderly patients with DCM with HF(P＜0.05).Multivariate Logistic regression analysis showed that the independent risk factors for poor prognosis in elderly patients with DCM with HF were NYHA cardiac function grade≥Ⅲ and the increase of NT-proBNP,ATX and TN-C(P＜0.05).ROC curve analysis showed that the area under the curve and 95％CI of serum ATX and TNC alone and combined for poor prognosis in elderly patients with DCM with HF were 0.743(0.576-0.911),0.721(0.551-0.911)and 0.808(0.690-0.912),respectively.Conclusion The elevated levels of serum ATX and TN-C in elderly patients with DCM with HF may be relat-ed to ventricular remodeling and poor prognosis,and have certain predictive value for the prognosis of elderly patients with DCM with HF.

Objective To detect the levels of anti-soluble liver antigen(anti-SLA)antibodies in the serum of patients with autoim-mune hepatitis(AIH)and analyze their value in liver injury.Methods A retrospective analysis was conducted on 33 AIH patients with anti-SLA antibody-positive and 33 age-and sex-matched anti-SLA antibody-negative AIH cases diagnosed at Nanjing Second Hos-pital from January 2017 to April 2024.The general and clinical data of the patients were collected along with the detection of anti-SLA antibody(by protein immunoblotting),anti-nuclear antibodies(by indirect immunofluorescence)and other autoimmune liver disease-related autoantibodies,the biochemical parameters,e.g.,total bilirubin(T-Bil),alanine aminotransferase(ALT),aspartate amin-otransferase(AST),gamma-glutamyl transferase(GGT),alkaline phosphatase(ALP),and the level of immunoglobulin IgG.The clinical characteristics,laboratory parameters,and liver histopathological features of the patients were analyzed and compared.Results There were no statistically significant differences were observed in gender,age,autoimmune liver disease-related antibodies(such as antinuclear antibody,anti-smooth muscle antibody,etc.)and liver function parameters(AST,ALT,GGT and ALP),between the two groups of patients(P＞0.05).However,in the patients with positive anti-SLA antibodies,the levels of T-Bil and IgG in serum were significantly higher than those of the negative group with both P value less than 0.05(P values of 0.017 and 0.048,respectively).The pathological examination for liver tissue revealed that the proportion of the patients with lymphocyte-plasma cell infiltration in anti-SLA-positive group was significantly higher than that in anti-SLA-negative group(χ2=4.243,P＜0.05),suggesting more active immune re-sponse.Conclusion The detection of anti-SLA antibodies levels in the serum of AIH patients may reflect the extent of liver injury,and should have the potential for assisting diagnosis and monitoring the disease condition.

Infection is one of the most common causes of death in patients with multiple myeloma, which can lead to early death. The incidence of infection in patients with (multiple myeloma, MM) complicated with diabetes is further increased. Proteasome inhibitors, immunomodulatory drugs and other new drug therapy improve the prognosis of MM, but glucocorticoids used in combination chemotherapy are easy to induce glucocorticoid diabetes, lead to elevated blood glucose, increase the risk of MM infection, and affect the prognosis of patients. This article reviews the relationship between infection and disease progression in patients with MM complicated with diabetes mellitus, infection-related factors, and prevention and treatment measures of different types of pathogen infection.