ObjectiveTo investigate the effects of prostaglandin E₂ （PGE₂） microinjection into the median preoptic nucleus （MnPO） on core body temperature in female mice， and to clarify its underlying mechanism. MethodsMicroinjection cannula were implanted into the MnPO of female mice using stereotaxic surgery.Subsequently， a multi-channel temperature acquisition system was used to simultaneously monitor rectal and brown adipose tissue （BAT） temperatures before and after intra-MnPO injections of different reagents.To investigate the thermoregulatory effects of the microinjection of PGE₂ into the MnPO， 12 female C57BL/6 mice were randomly divided into a saline group （n=6） and a PGE₂ group （n=6）， which were injected with 0.1 μL saline and PGE₂ （2.8 mmol/L）， respectively.To determine whether E-series prostaglandin receptor （EP）1， EP3， and EP4 receptors mediate the thermoregulatory effects of PGE₂， 15 female C57BL/6 mice were randomly divided into 3 groups （n=5 per group）.Mice in each group first received an injection of 0.1 μL PGE2 （2.8 mmol/L） into the MnPO. After their body temperature returned to baseline levels， they were subsequently injected with a mixture of either EP1， EP3 or EP4 antagonist （ant） （20 mmol/L） + PGE2 （2.8 mmol/L）. ResultsCompared with baseline level， the rectal temperature （P<0.01） and BAT temperature （P<0.001） of female mice both increased significantly after microinjection of PGE₂ into the MnPO.Compared with the saline group， the increases in rectal temperature （P<0.001） and BAT temperature （P<0.000 1） were significantly greater in the PGE₂ group of mice.Furthermore， following the injection of PGE₂ into MnPO， the increase in BAT temperature was found to be significantly greater than that in rectal temperature in mice （P<0.001）.Compared to the administration of PGE₂ alone， co-injection of an EP3 ant + PGE₂ into the MnPO of mice resulted in a significantly smaller increase in both rectal temperature （P<0.001） and BAT temperature （P<0.001）.In contrast， the increases in rectal and BAT temperatures following MnPO injection of either EP1 ant + PGE₂ or EP4 ant + PGE₂ were not statistically significant （P>0.05）. ConclusionInjection of PGE₂ into the MnPO elevates BAT and core body temperature in female mice via the EP3 receptor.

Objective: To develop a RHCE genotyping assay based on kompetitive allele-specific PCR (KASP) and assess its clinical accuracy for RhCE blood group determination. Methods: KASP primers were designed to interrogate three RHCE loci: the 109 bp insertion/deletion in intron 2, c. 307T>C, and c. 676C>G. A total of 1 194 RhD-positive inpatients from Chengdu were typed by both KASP genotyping and manual tube serology. Discordant samples (n=10) were retested by both methods and further resolved by Sanger sequencing. An additional 377 cases were tested for the c. 48C>G locus to evaluate the predictive accuracy of individual loci and combined locus testing for RhC antigen. Results: Genotyping concordance with serology was 100.0% for both the c. 676C>G locus (RhE/Rhe) and the c. 307T>C locus (Rhc). For RhC prediction using the 109 bp insertion, overall accuracy was 99.7% (1 191/1 194); the 3 discordant cases were confirmed by Sanger sequencing to be false negatives attributable to 109 bp deletion in intron 2. Testing the c. 48C>G allele for RhC prediction yielded 7 false positives, with an accuracy of 98.1% (370/377). RhC antigen status was determined by combining the 109 bp insertion and the c. 48C allele. After excluding 10 samples with inconsistent results between the two loci, the accuracy reached 100% in the remaining 367 samples. When both loci were applied in combination, accuracy reached 100% in the 367 cases with concordant results. Among the 1 194 patients, CCee (45.8%) and CcEe (31.7%) were the most common RhCE phenotypes. The e antigen had the highest positivity rate (92.2%), and the Ce haplotype was the most frequent (66.9%). Conclusion: The KASP-based RHCE genotyping method achieves high accuracy for clinical RhCE typing. Combining the 109 bp insertion/deletion with the c. 48C allele significantly improves RhC antigen prediction compared with either locus alone. This method was applied to RhCE genotyping of 1 194 RhD-positive inpatients in Chengdu, providing local RhCE phenotype and haplotype distribution data to support RhCE-matched transfusion practice.

Objective: To analyze the demographic characteristics of patients with red blood cell transfusion reactions, the usage of red blood cell preparations, and the differences in the composition ratio of adverse reactions based on multi-center data from the Haemovigilance Network, in order to reveal the clinical characteristics of red blood cell transfusion and its underlying issues. Methods: Clinical data of patients who experienced transfusion reactions after red blood cell transfusion in the Haemovigilance Network from 2018 to 2023 were collected. The demographic characteristics of patients who experienced transfusion reactions with different types of red blood cell preparations, the utilization of these preparations, and the differences of the composition ratios of transfusion reactions were analyzed. Count data were expressed as numbers (n) or percentages (%), and comparisons between groups were performed using the Chi-square test. Results: Red blood cell transfusion reactions were more common in females (53.56%), with the majority of patients aged 50-69 years (35.54%). The Han polulation accounted for the vast majority of patients (92.77%), and patients in the hematology and obstetrics/gynecology departments had a relatively high proportion of transfusion reactions (13.26% and 14.26%, respectively). Leukocyte-reduced red blood cells and suspended red blood cells were the most common types of transfusion reactions reported among red blood cell preparations. Allergic reactions and non-hemolytic febrile reactions were the most common transfusion reactions, and there were significant differences in the composition ratios of allergic reactions (χ =869.89, P<0.05) and non-hemolytic febrile reactions (χ =812.75, P<0.05) across various types of red blood cell preparations. Conclusion: There are differences in the demographic characteristics and composition ratio of transfusion reactions among different red blood cell preparations. The management of red blood cell transfusion reactions should be tailored to patient characteristics and conditions, and the selection and use of blood products should be optimized to reduce or avoid the occurrence of transfusion reactions, such as considering the use of washed red blood cells for patients with a history of transfusion allergies or those prone to allergies.

Objective To investigate the bidirectional causal relationship between circulating amino acid levels and the risk of myasthenia gravis(MG)using Mendelian randomization(MR).Methods A two-sample Mendelian randomization a-nalysis was conducted using publicly available genome-wide association study(GWAS)genetic data,with validation from GWAS data from different sources to assess the robustness of the results.Five models were used for the two-sample bidirectional MR anal-ysis,and odds ratios(OR)were calculated to evaluate the causal relationship between the levels of nine circulating amino acids and MG risk.Sensitivity analyses,heterogeneity tests,and pleiotropy tests were performed to assess the robustness of the results.The causal effect estimated by the inverse variance weighted(IVW)method was the primary result,and the IVW-estimated causal effects were further validated using data from different GWAS sources to assess robustness.Results Genetically predicted high-er circulating glutamine levels were significantly associated with a lower risk of MG[OR(95％CI)=0.696(0.524,0.926),P=0.012 7,IVW model].Validation analyses using GWAS data from various sources also demonstrated a significant negative associa-tion between genetically predicted higher circulating glutamine levels and MG risk[OR(95％CI)=0.321(0.178,0.581),P=1.67x10-1,IVW model].Moreover,genetically predicted higher MG risk was associated with lower levels of circulating glutamine and alanine(β=-0.178±0.009,P=0.049;β=-0.013±0.007,P=0.048,IVW model,respectively).Conclusion Genetic evidence reveals a potential bidirectional causal relationship between circulating amino acid levels and MG risk.Further studies are required to elucidate the mechanisms underlying this relationship.

[Objective]To explore the issues in the"14th Five-Year Plan"textbook Formulology and propose corrective suggestions,aiming to deepen students'understanding of formulology knowledge and contribute to the cultivation of high-quality and versatile talents in traditional Chinese medicine(TCM).[Methods]Through consulting the ancient books and literatures,the source research of the prescriptions involved in the teaching materials was carried out.Combined with clinical practice and TCM theory,the indications and functions of the formulas were analyzed to ensure the descriptions accurate and clinically significant.The explanation of formula composition was deepened from the perspectives of compatibility principles and drug interactions.The accuracy and logic of formula mnemonics(Fangge)were optimized.Ideological and political elements were skillfully integrated to cultivate students'medical ethics,professional and social responsibility.Suggestions were also made to address improper layout issues.[Results]The textbook was rich in content and systematic in structure,but minor issues remain in areas such as formula origins,indications and functions,formula explanation,formula mnemonics,ideological integration and layout.Through literature review,the origins of formulas such as Xijiao Dihuang Decoction,Sijunzi Decoction and Ganlu Xiaodu Pill were researched deeply,and the source information was corrected.The indications and functions of formulas like Houpo Wenzhong Decoction,Wumei Pill,and Suzi Jiangqi Decoction were reanalyzed,enhancing their clinical relevance.The new explanation of Daochi Powder,Shenqi Pill,Zhengan Xifeng Decoction,Sanren Decoction,Lianpo Decoction and Dahuang Mudan Decoction was introduced to enhance students'understanding of the principles of prescription compatibility and clinical application.The mnemonics for formulas like Puji Xiaodu Drink and Sanzi Yangqin Decoction were revised for greater accuracy and logic.Innovative ways of integrating ideological and political elements were adopted,which complemented formulary knowledge and promote the improvement of students'comprehensive quality.For layout issues,such as the misplaced"Application"section of Qingqi Huatan Pill,a comprehensive proofreading was recommended to ensure proper placement and coherence of all sections.[Conclusion]By exploring specific issues in the Formulology textbook under the"14th Five-Year Plan"—including formula origins,indications and functions,formula explanation,formula mnemonics,ideological and political education integration,and layout—and proposing targeted revisions,this initiative enhances the textbook's academic rigor and practicality.It provides high-quality educational resources for TCM education,thereby fostering the cultivation of well-rounded TCM professionals with solid theoretical foundations,specialized skills and comprehensive quality.

Objective:To investigate the diagnostic features of eosinophilic gastroenteritis (EGE) of the stomach and duodenum.Methods:A case-control study was conducted to retrospectively analyze 238 biopsy specimens of gastric and duodenal EGE (75 cases) and 133 biopsy specimens of chronic active gastroenteritis (97 cases) in Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China from 2012 to 2023. The eosinophil count, infiltration site and other pathological features (e.g., infiltration of neutrophils into the epithelium, edema, and increase of background lymphocytes and plasma cells) were examined under a microscope. Chi-square test, chi-square multiple comparison ( Bonferroni method) and modified Poisson regression were used to analyze the data. Results:The results showed that there were significant differences in eosinophil count ( χ2=43.926, P<0.01), location ( χ2=31.391, P<0.01), neutrophilic infiltration of the epithelium ( χ2=5.199, P=0.023), edema ( χ2=3.934, P=0.047), and lymphoplasmacytosis ( χ2=36.813, P<0.01) between the EGE and control cases. The results of Chi-square multiple comparisons showed that eosinophils distributed in clusters or sheets (versus other grades of eosinophil presence) were statistically associated with EGE. When eosinophils infiltrated the epithelium (versus eosinophils in other locations of the mucosa), there was a statistically significant association with EGE. Modified Poisson regression also showed that EGE was more likely to have eosinophilic infiltration of epithelium [ RR=1.661, P=0.001,95% CI (1.397,1.973)] and that of muscularis mucosa [ RR=1.818, P<0.01,95% CI (1.491,2.216)]. Conclusions:The important pathological features for diagnosing EGE of the stomach and duodenum are that eosinophils are clustered or distributed in sheets with epithelial infiltration. However, epithelial infiltration by neutrophils, edema and background lymphoplasmacytosis are relatively rare.

Objective:To analyze the epidemiological characteristics and spatiotemporal distribution of hepatitis C in Henan province from 2012 to 2022.Methods:The case report data on hepatitis C from counties and districts in Henan between 2012 and 2022 were collected. The distribution characteristics were analyzed by descriptive epidemiological methods, and GeoDa1.2 software was used to perform spatial autocorrelation analysis. The spatiotemporal epidemiological analysis was conducted using SaTScan 10.1 software.Results:A total of 274 485 hepatitis C cases were reported in Henan from 2012 to 2022. The reported annual average incidence rate was 25.84/100 000 and showed an overall downward trend from 2012 to 2022 ( Z=-4.05, P<0.001). More cases were reported in women. The cases were mainly aged 40-69 years and farmers. Spatial autocorrelation analysis showed that the reported cases of hepatitis C present spatial clustering during 2012—2022, and the areas with high incidence were mainly distributed in counties or districts of Zhengzhou, Zhumadian, Xuchang, Zhoukou, and Nanyang. One class I clustering area was detected by spatiotemporal scanning, which mainly covered Xuchang, Pingdingshan and the surrounding counties ( LLR=16 117.73, RR=1.81, P<0.001). Conclusion:The reported cases of hepatitis C in Henan Province show an overall downward trend from 2012 to 2022 and present spatiotemporal clustering. The seasonal regularity of the hepatitis C epidemic is not obvious. People aged 40-69 years old and farmers are the key population for prevention and control.

[Objective]To explore the issues in the"14th Five-Year Plan"textbook Formulology and propose corrective suggestions,aiming to deepen students'understanding of formulology knowledge and contribute to the cultivation of high-quality and versatile talents in traditional Chinese medicine(TCM).[Methods]Through consulting the ancient books and literatures,the source research of the prescriptions involved in the teaching materials was carried out.Combined with clinical practice and TCM theory,the indications and functions of the formulas were analyzed to ensure the descriptions accurate and clinically significant.The explanation of formula composition was deepened from the perspectives of compatibility principles and drug interactions.The accuracy and logic of formula mnemonics(Fangge)were optimized.Ideological and political elements were skillfully integrated to cultivate students'medical ethics,professional and social responsibility.Suggestions were also made to address improper layout issues.[Results]The textbook was rich in content and systematic in structure,but minor issues remain in areas such as formula origins,indications and functions,formula explanation,formula mnemonics,ideological integration and layout.Through literature review,the origins of formulas such as Xijiao Dihuang Decoction,Sijunzi Decoction and Ganlu Xiaodu Pill were researched deeply,and the source information was corrected.The indications and functions of formulas like Houpo Wenzhong Decoction,Wumei Pill,and Suzi Jiangqi Decoction were reanalyzed,enhancing their clinical relevance.The new explanation of Daochi Powder,Shenqi Pill,Zhengan Xifeng Decoction,Sanren Decoction,Lianpo Decoction and Dahuang Mudan Decoction was introduced to enhance students'understanding of the principles of prescription compatibility and clinical application.The mnemonics for formulas like Puji Xiaodu Drink and Sanzi Yangqin Decoction were revised for greater accuracy and logic.Innovative ways of integrating ideological and political elements were adopted,which complemented formulary knowledge and promote the improvement of students'comprehensive quality.For layout issues,such as the misplaced"Application"section of Qingqi Huatan Pill,a comprehensive proofreading was recommended to ensure proper placement and coherence of all sections.[Conclusion]By exploring specific issues in the Formulology textbook under the"14th Five-Year Plan"—including formula origins,indications and functions,formula explanation,formula mnemonics,ideological and political education integration,and layout—and proposing targeted revisions,this initiative enhances the textbook's academic rigor and practicality.It provides high-quality educational resources for TCM education,thereby fostering the cultivation of well-rounded TCM professionals with solid theoretical foundations,specialized skills and comprehensive quality.

OBJECTIVE To evaluate the influence of gram-negative bacterial infection on the prognosis of patients with heart failure with reduced ejection fraction(HFrEF),and to explore its effects on biomarker dynamics,car-diac function recovery,rehospitalization rates and all-cause fatality rate.METHODS Clinical data were retrospec-tively collected from 100 patients diagnosed with HFrEF and combined with gram-negative bacterial infection at the Second Affiliated Hospital of Guizhou Medical University and the Cardiovascular Medicine of the Army Medi-cal Center of Chinese PLA from Jan.2022 to Jan.2024.Clinical baseline data,including demographic information,medical history and biomarkers[interleukin-6(IL-6),C-reactive protein(CRP),procalcitonin(PCT),brain natriuretic peptide(BNP),N-terminal pro-brain natriuretic peptide(NT-proBNP)and troponin]were collected through follow-up visits for 12 months.Follow-up visits were conducted at discharge,3 months,6 months and 12 months,left ventricular ejection fraction(LVEF),NYHA classification(New York heart asso-ciation functional classification for heart),rehospitalization status and all-cause fatality rate were recorded.RESULTS Gram-negative bacterial infection significantly increased the rehospitalization and all-cause fatality rates in patients with HFrEF.The cumulative rehospitalization rate reached 45.00％within 12 months,and the all-cause fatality rate was 15.00％(P＜0.05).Inflammatory markers such as IL-6 and CRP were significantly ele-vated at baseline(P＜0.001)and decreased at discharge,while NT-proBNP levels were higher during the follow up period than those after the discharge,positively correlating with the numbers of rehospitalizations and fatality rates(r=0.752,P＜0.001).LVEF and NYHA classification improved in the short term but showed poor long-term prognosis.CONCLUSIONS Gram-negative bacterial infection significantly affects the long-term prognosis of patients with HFrEF,exacerbating cardiac function damage through inflammatory responses,thus increases re-hospitalization and fatality rates.This study provides new directions for clinical management,and emphasize the importance of early infection control.

There is significant inter-individual variation of pharmacokinetics and pharmacody-namics in patients receiving tacrolimus(TAC)for an-ti-rejection therapy,which cause the rejection or toxic action.Based on results of therapeutic drug monitoring and pathophysiological index of trans-plant patients,the individualized dosing regimen can be designed and adjusted by using model in-formed precision dosing(MIPD).The patients'clini-cal outcome can be improved.In the consensus,the different methods of MIPD used for patients re-ceived TAC for anti-rejection therapy were intro-duced,which can be used for the designing and ad-justing doing regimen,predicting adverse drug reac-tion,improving medication adherence and econom-ics during therapy.