Objective: To identify the mimicking autoantibodies using papain-enhanced erythrocyte agglutination in a case of repeated red blood cell transfusion refractoriness, aiming to explore the immune hematological methods for identifying mimicking alloantibodies, autoantibodies and alloantibodies, and to develop a safe and effective blood transfusion strategy based on the results. Methods: ABO, RhD and RhEeCc blood groups were detected using routine blood group serological method. The unexpected antibodies in plasma were screened and identified, followed by identification using a two-step papain-treated indirect antiglobulin test (enzyme-IAT). The cause of transfusion refractoriness of red blood cells was analyzed and summarized, and the prognosis was followed up. Results: The patient's blood type was type A, CCDee. The direct antiglobulin test (DAT) was positive. Unexpected antibody screening and identification using saline tube method, polybrene method, IAT were negative, and the release fluid (acid release) IAT identification was negative. Mimicking anti-e antibodies in plasma was identified by enzyme-ITA. The cause of red blood cell transfusion refractoriness in patients was autoimmune hemolysis caused by mimicking anti-e antibodies. After choosing to avoid antibodies corresponding to antigen-positive red blood cells, the patient's hemoglobin (Hb) increase value is in line with theoretical expectations, indicating effective red blood cell transfusion. Conclusion: Mimicking antibodies can cause immune destruction of red blood cells by non-specific binding to their own red blood cells and specific binding to red blood cells, resulting in red blood cell transfusion refractoriness.

Direct antiglobulin test (DAT), also known as Coomb's test, is a method used in blood immunology to detect whether the surface of red blood cells is sensitized by immunoglobulin or complement. It is mainly used in the diagnosis of autoimmune hemolytic anemia (AIHA), neonatal hemolytic anemia, hemolytic transfusion reaction and blood matching during blood transfusion. DAT positive has always been the focus of researchers, because it has an important impact on the efficacy of blood transfusion. In recent years, there has been extensive research on the identification of DAT positivity types and the distribution characteristics of diseases in clinical patients, and the study on hemolytic disease of the newborn has also been popular. However, the transfusion safety of DAT-positive blood donors has been a hot topic in the field of blood transfusion for many years. Moreover, there is no clear requirement from the state on the handling of DAT-positive blood and whether DAT-positive blood donors should be deferred from donation. Therefore, this article reviews the serological studies on DAT immunotyping and IgG subtype typing of voluntary blood donors, as well as the impact of DAT-positive blood on blood transfusion safety, in order to provide references for the blood issuance strategy of DAT-positive blood and whether DAT-positive blood donors should be deferred.

Cluster of differentiation 36 (CD36) is a highly glycosylated double transmembrane glycoprotein, which is involved in the inflammatory response and immune regulation of the body. It plays a key role in mediating the mechanism of immune-related blood transfusion reactions and regulating the function of immune cells. It has an important impact on blood transfusion safety and has become a current research hotspot. This article reviews and comprehensively analyzes the research progress of the specific role of CD36 in the immune response of blood transfusion and its regulatory mechanism at home and abroad. Combined with clinical cases and experimental data, the pathophysiological mechanism of CD36 in immune response and its immune-mediated blood transfusion safety issues are reviewed. It is expected to provide new theoretical support and practical guidance for the field of blood transfusion safety and promote the further development of blood transfusion medicine.

Objective:To integrate the best evidence of non drug intervention for blood lipid management of breast cancer survivors used the evidence-based method, and provide evidence-based evidence for clinical medical staff to carry out dynamic monitoring and management of blood lipid abnormalities.Methods:According to the 6S model, the evidence summary, clinical decision, recommended practice, guidelines, systematic review, expert consensus, scientific position statement and other non-drug interventions on lipid management of breast cancer survivors were systematically searched from the evidence-based guidelines website and related databases from database establishment until June 10, 2024. The quality of the included literature was evaluated, and the evidence was extracted, summarized and formed.Results:A total of 14 literatures were included, including 7 guidelines, 5 expert consensus and 2 systematic reviews. Totally 21 best evidences were collected from the necessity of lipid management, lipid management objectives, individualized lipid monitoring and lipid management strategies.Conclusions:The quality and level of the best evidence collected in this study are generally high, which has reference significance for clinical medical staff to carry out scientific and effective non drug intervention in lipid management of breast cancer survivors. In the evidence transformation stage, it is necessary to fully consider the individual differences of patients, in order to improve the intervention effect and the quality of life of patients.

Objective:To investigate the clinical efficacy of vitamin D as an adjunct to low-dose aspirin on patients with early-onset severe preeclampsia.Methods:A retrospective analysis was conducted on the clinical data of 102 patients with early-onset severe preeclampsia admitted to Zhoushan Women and Children's Hospital from January 2020 to January 2024. Fifty patients admitted for treatment from January 2020 to January 2022 were included in the control group and received low-dose aspirin treatment. Fifty-two patients admitted between February 2022 and January 2024 were included in the observation group and received vitamin D as an adjunct to low-dose aspirin treatment. Both groups were treated for 7 days. Blood pressure, homocysteine, serum 25-hydroxyvitamin D 3, renal function indicators (glomerular filtration rate, 24-hour urine protein quantification), coagulation function indicators (prothrombin time, thrombin time, D-dimer, activated partial thromboplastin time), and pregnancy outcomes were compared between the two groups. Results:After treatment, systolic blood pressure, diastolic blood pressure, homocysteine, 24-hour urine protein quantification, and D-dimer in the observation group were (134.33 ± 6.28) mmHg (1 mmHg = 0.133 kPa), (88.57 ± 5.76) mmHg, (10.65 ± 3.15) μmol/L, (0.59 ± 0.31) g/24 hours, and (0.51 ± 0.32) mg/L, respectively. These values were significantly lower than those in the control group [(142.28 ± 6.04) mmHg, (93.85 ± 5.38) mmHg, (13.15 ± 2.89) μmol/L, (1.28 ± 0.47) g/24 hours, and (0.73 ± 0.49) mg/L, t = 4.17, -10.37, 4.17, 8.79, 2.69, all P < 0.05]. In the observation group, serum 25-hydroxyvitamin D 3 level and glomerular filtration rate were (27.94 ± 6.43) μg/L and (98.65 ± 14.72) mL·min?1·1.73 m?2, respectively. These values were significantly higher than those in the control group [(15.24 ± 5.92) μg/L, (90.19 ± 12.07) mL·min?1·1.73 m?2 ( t = -10.37, -3.18, both P < 0.05). Additionally, in the observation group, prothrombin time, thrombin time, and activated partial thromboplastin time were (12.19 ± 0.53) seconds, (12.19 ± 0.53) seconds, and (0.51 ± 0.32) seconds, respectively. These times were significantly shorter than those in the control group [(13.22 ± 1.15) seconds, (16.94 ± 2.07) seconds, and (34.21 ± 3.93) seconds ( t = 5.85, 4.27, 3.81, all P < 0.05). There was no statistically significant difference in incidence of pregnancy outcomes between the two groups ( P > 0.05). Conclusions:Vitamin D as an adjunct to low-dose aspirin for the treatment of early-onset severe preeclampsia significantly reduces blood pressure, enhances blood circulation, promotes metabolism, improves coagulation function, and aids in the recovery of renal function in patients.

This study investigates the feasibility of the VP8*protein as a subunit vaccine target for porcine rotavirus A(PoRVA),a major causative agent of diarrhea in piglets.The VP8* genes of PoRVA P[13]and P[23]genotype strains were amplified by RT-PCR.These genes were then liga-ted into the pET-28a(+)vector,yielding recombinant plasmids pET-28a-XJWF1-VP8*-P[23]and pET-28a-ShXYW13-VP8*-P[13].These plasmids were subsequently transformed into BL21(DE3)competent cells.The VP8*protein,induced by IPTG,was purified using affinity chroma-tography,and its expression and purification were verified by SDS-PAGE and Western blot.The purified VP8* protein was used to immunize mice,and serum samples were collected after three immunizations.Cross-neutralization assays were conducted to evaluate the ability of the VP8*protein immune serum to neutralize different genotype strains.The results demonstrated the ex-pression of soluble VP8*protein,with SDS-PAGE and Western blot analyses showing that the purified VP8*protein existed in both monomeric(27 kDa)and homodimeric(54 kDa)forms.ELISA results indicated that high levels of antibodies were produced in mice immunized with VP 8*-P[13]and VP8*-P[23]after three immunizations.Serum cross-neutralization assays revealed that the neutralizing titers of PoRVA VP8*-P[13]and VP8*-P[23]immune sera against homol-ogous genotype strains ranged from 1∶4 800 to 1∶19 200,significantly higher than those against heterologous genotype strains(1∶1 200).This suggests that the VP8*protein of different geno-type strains exhibits both antigenic conservation and distinct variability.The data obtained in this study provide a solid foundation for further exploration of the antigenic structure of the PoRVA VP8* protein and the development of novel subunit vaccines.

Objective:To compare the diagnostic efficacy of 68Ga-prostate-specific membrane antigen (PSMA)-617 PET/CT and multiparametric magnetic resonance imaging (mpMRI) in detecting extraprostatic extension (EPE) and seminal vesicle invasion (SVI) in prostate cancer. Methods:A retrospective analysis was conducted on the clinical data of 113 patients with localized prostate cancer who underwent both 68Ga-PSMA-617 PET/CT and mpMRI at Xiangya Hospital, Central South University, from May 2018 to May 2024 prior to radical prostatectomy (RP). The median age of the patients was 66.0 (61.3, 71.0) years old, with a median body mass index of 28.86 (19.01, 24.77) kg/m 2, and a median prostate-specific antigen (PSA) level of 13.50(9.26, 21.99) ng/ml. The pathological results after RP were used as the gold standard to compare the sensitivity, specificity, positive predictive value, and negative predictive value of the two imaging modalities in diagnosing EPE and SVI. Additionally, the diagnostic value of combining both imaging modalities was explored, employing a parallel strategy where a positive result from either modality was deemed positive, and only when both tests were negative was the result considered negative. Results:Pathological results after RP indicated EPE in 46 cases (40.71%) and SVI in 11 cases (9.70%). In diagnosing EPE, the sensitivity, specificity, positive predictive value, and negative predictive value of 68Ga-PSMA-617 PET/CT were 17.39% (8/46), 97.01% (65/67), 80.00% (8/10), and 63.11% (65/103), respectively, while for mpMRI they were 34.78% (16/46), 83.58% (56/67), 59.26% (16/27), and 65.12% (56/86), respectively. The sensitivity of mpMRI was significantly higher than that of 68Ga-PSMA-617 PET/CT ( P=0.048), while the specificity was the opposite ( P=0.008). When combining both imaging modalities, the sensitivity, specificity, positive predictive value, and negative predictive value were 45.65% (21/46), 80.60% (54/67), 61.76% (21/34), and 68.35% (54/79), respectively. In diagnosing SVI, the sensitivity, specificity, positive predictive value, and negative predictive value of 68Ga-PSMA-617 PET/CT were 27.27% (3/11), 96.08% (98/102), 42.86% (3/7), and 92.45% (98/106), respectively, while for mpMRI they were 36.36% (4/11), 88.24% (90/102), 25.00% (4/16), and 92.78% (90/97), respectively. The specificity of 68Ga-PSMA-617 PET/CT was significantly higher than that of mpMRI ( P=0.033). When combining both imaging modalities, the sensitivity, specificity, positive predictive value, and negative predictive value were 45.45% (5/11), 85.29% (87/102), 25.00% (5/20), and 93.55% (87/93), respectively. Conclusions:mpMRI has higher sensitivity in diagnosing EPE and SVI in prostate cancer, while 68Ga-PSMA-617 PET/CT shows higher specificity. The combined use of both imaging modalities can increase diagnostic sensitivity but may reduce specificity. PSMA PET/MRI may be a more accurate diagnostic tool for discerning EPE and SVI.

Objective:To explore the distant metastatic characteristics of metastatic hormone-sensitive prostate cancer (mHSPC) and metastatic castration-resistant prostate cancer (mCRPC) based on prostate-specific membrane antigen (PSMA) PET-CT.Methods:This is a retrospective cohort study. Ultimately, data from 227 patients with metastatic prostate cancer who underwent PSMA PET-CT examinations at Xiangya Hospital, Central South University between March 2016 and May 2025 were retrospectively reviewed, including 117 mHSPC patients with an age of (68.8±7.6) years (range:53 to 89 years) and 110 mCRPC patients with an age of (69.4±7.5) years (range: 49 to 88 years). Clinical and pathological data, along with metastatic characteristics identified via PSMA PET-CT, were collected and compared. Intergroup comparisons were performed using χ 2 tests. Results:The incidence rates of lymph node metastasis, bone metastasis, and visceral metastasis in the mHSPC group were 71.8% (84/117), 89.7% (105/117), and 11.1% (13/117), respectively, while those in the mCRPC group were 52.7% (58/110), 91.8% (101/110), and 15.5% (17/110), respectively. The incidence of lymph node metastasis in the mHSPC group was significantly higher than that in the mCRPC group ( χ2=8.800, P=0.003). Among patients with bone metastasis, the rates of osteoblastic metastasis, osteolytic metastasis, and mixed metastasis in the mHSPC group were 76.2% (80/105), 8.6% (9/105), and 15.2% (16/105), respectively, while the corresponding rates in the mCRPC group were 74.3% (75/101), 7.3% (8/101), and 16.4% (18/101), respectively, all indicating a relatively high probability of osteolytic and mixed bone metastases ( χ2=0.260, P=0.878). Among patients with mHSPC and mCRPC who tested positive for visceral metastasis, lung metastasis (9/13 and 8/17) and liver metastasis (4/13 and 9/17) were the most common sites of metastasis, but there was no significant difference in the composition of visceral metastasis between the two groups ( χ2=0.933, P=0.564). In this study, among 20 patients who progressed from mHSPC to mCRPC, 35.0% (7/20) had persistent or progressive activity at the original metastatic site, 35.0% (7/20) developed new metastatic lesions, and 30.0% (6/20) showed inhibitory changes in the original metastatic lesions. Among patients with imaging progression, 1/14 of patients with osteoblastic metastatic lesions at the mHSPC stage exhibited osteolytic changes upon progression to mCRPC. Conclusion:Compared with the mCRPC group, the mHSPC group has a higher lymph node metastasis rate,and both groups have common rates of osteolytic and mixed bone metastases and visceral metastasis.

AIM:To investigate the efficacy of Shenxiankang(SXK)in mitigating renal fibrosis in unilateral ureteral obstruction(UUO)mice,and elucidate its regulatory mechanism targeting the differentiation antagonizing non-protein coding RNA(DANCR)/TGF-β1/Smad3 signaling axis.METHODS:Mice were randomly assigned to:normal group(NC),model group(UUO),low,medium and high doses(1 500,3 000 and 4 500 mg·kg-1·d-1)of SXK group,and benazepril(10 mg·kg-1·d-1)group.Chronic kidney disease was modeled via unilateral ureteral ligation.Renal DAN-CR overexpression was induced using tail vein injection coupled with ultrasound microbubble technology.In vitro,human renal tubular epithelial cells(HK-2)were stimulated with TGF-β1;DANCR was either knocked down or overexpressed,followed by SXK intervention in both in vivo and in vitro models.Renal tissues were harvested for pathological assessment.DANCR expression and localization were analyzed using fluorescence in situ hybridization.Fibrosis deposition was evaluat-ed by immunohistochemistry(IHC).Western blot quantified the expression of fibrosis markers(α-SMA,FN)and key components of the TGF-β1/Smad3 signaling axis(p-Smad3,Smad3,TGF-β1).RESULTS:UUO mice exhibited signifi-cant renal tubular dilation.SXK intervention ameliorated renal lesions and reduced fibrosis.In UUO mice with DANCR overexpression,levels of renal fibrosis markers(α-SMA,FN)and TGF-β1/Smad3 signaling axis proteins(p-Smad3,Smad3,TGF-β1)were increased;these effects were reversed by SXK.In vitro,DANCR knockdown decreased the expres-sion of fibrotic proteins/mRNA and TGF-β1/Smad3 signaling axis components.SXK treatment effectively counteracted the fibrotic injury and TGF-β1/Smad3 signaling axis activation induced by DANCR overexpression.CONCLUSION:SXK ef-fectively mitigates renal fibrosis in UUO mice,potentially through regulation of the DANCR/TGF-β1/Smad3 signaling axis.

Objective To observe the effects of electroacupuncture on IL-4/STAT6/SPDEF pathway-related protein expressions in model mice of ulcerative colitis(UC);To explore the mechanism of electroacupuncture improving the intestinal mucus barrier.Methods Totally 48 BALB/c mice were randomly divided into blank group(12 mice)and modeling group(36 mice).The UC models were established in the modeling group using 3%dextran sulfate sodium free drinking.After successful modeling,mice were further randomly divided into model group,electroacupuncture group and sulfasalazine(SASP)group,with 12 mice in each group.The electroacupuncture group received electroacupuncture at"Guanyuan","Tianshu","Zusanli"and"Shangjuxu"acupoints for 20 minutes per day,the SASP group was administered sulfasalazine enteric-coated tablet suspension(500 mg/kg)by gavage,the blank group received no intervention,the model group was only confined for continuous 7 days.The general conditions were observed and disease activity index(DAI)score were recorded,HE staining was used to observe the morphology of colonic tissue and evaluate the colonic mucosal damage index(CMDI)score,AB-PAS staining was used to observe the number of goblet cells in colonic tissue,and immunofluorescence staining was used to detect the expression of mucin 2(MUC2)protein in colonic tissue,ELISA was used to detect the contents of serum tumor necrosis factor-α(TNF-α)and γ interferon(IFN-γ),and Western blot was used to detect the protein expressions of interleukin(IL)-4,signal transducer and activator of transcription(STAT)6 and epithelial specific transcription factor(SPDEF)in colonic tissue.Results Compared with the blank group,the model group showed mucous stool,bloody stool,reduced intake of food and water,reduced body mass,increased DAI and CMDI scores(P<0.01),with intestinal villi shedding and necrosis,destruction of colonic crypt villi structure,accompanied by severe neutrophil infiltration,thinning of mucus layer,atrophy and reduction of goblet cells(P<0.01),the expression of MUC2 in colonic tissue significant decreased(P<0.01),the contents of TNF-α and INF-γ in serum significantly increased(P<0.01),while the protein expressions of IL-4,STAT6 and SPDEF in colonic tissue significantly decreased(P<0.01).Compared with the model group,both the electroacupuncture group and SASP group showed improved mucous stool,bloody stool,increased body mass,decreased DAI and CMDI scores(P<0.05),the morphology of the intestinal epithelium was basically normal,the glandular structure has improved,there was a small amount of inflammatory cell infiltration and slight edema,the thickness of the mucus layer was restored,the atrophy reduced and number of goblet cells increased(P<0.05),the expression of MUC2 in colonic tissue significantly increased(P<0.05),while the contents of TNF-α and IFN-γ in serum significantly decreased(P<0.05),the expressions of IL-4,STAT6 and SPDEF protein in colonic tissue significantly increased(P<0.05).Conclusion Electroacupuncture can facilitate the repair of the intestinal mucus barrier and inhibit inflammation,potentially through the activation of IL-4/STAT6/SPDEF pathway-related protein expressions.