Blood transfusion is an important life-support measure in modern medicine. As clinical demand for transfusion continues to rise, blood supply remains under persistent strain, making the efficient utilization of this precious medical resource a critical component of blood management. Accurate prediction of transfusion needs is of great significance for optimizing blood resource allocation and conserving blood products. Traditional transfusion decision-making relies on clinical experience and simplified scoring systems, which are insufficient to meet the demands of precision medicine. Machine learning (ML) technology can integrate multidimensional data—including demographic characteristics, laboratory indicators, surgical information, and dynamic physiological waveforms—to construct high-performance predictive models, offering a new approach to transfusion prediction. This article systematically reviews the application progress of ML in transfusion prediction across clinical scenarios such as trauma, the perioperative period, and obstetrics. In trauma, ML has been applied to early massive transfusion prediction, prehospital transfusion decision-making, and precise prediction in pediatric trauma. In the perioperative field, applications span specialties including traumatic brain injury, orthopedic surgery, cardiovascular and major vascular surgery, and hepatic surgery. In obstetrics, models can effectively predict postpartum hemorrhage and transfusion requirements associated with cesarean section. Studies have shown that algorithms such as random forest, gradient boosting machines, and deep neural networks achieve area under the receiver operating characteristic curve (AUC) values of 0.83-0.98 in massive transfusion prediction, 0.75-0.97 in perioperative scenarios, and 0.80-0.89 in obstetric transfusion prediction—significantly outperforming traditional scoring tools. However, current studies are generally limited by single-center retrospective designs, insufficient external validation, and inadequate reporting standards; limited model interpretability and challenges in clinical integration further constrain practical translation. Future research should focus on constructing multicenter data cohorts, integrating multimodal data, conducting prospective implementation studies, and deeply embedding models within electronic health record systems, thereby advancing the application of ML to optimize clinical transfusion decision-making.

As a crucial barrier to ensuring blood transfusion safety, blood virus inactivation technology plays an irreplaceable role in addressing the "window period" of detection, the threat of emerging pathogens, and the limitations of detection technologies. This article systematically reviews the current status and technical characteristics of mainstream blood virus inactivation technologies, and conducts an in-depth discussion on the application prospects and challenges of emerging technologies in this field. Among conventional technologies, the photochemical methods (including methylene blue, psoralen S-59/INTERCEPT system, and riboflavin/Mirasol system) have been widely used in clinical practice due to their broad-spectrum inactivation capacity. However, these methods are associated with functional impairment of blood components. The organic solvent/detergent (S/D) method performs excellently in inactivating viruses in plasma products yet is ineffective against non-lipid-enveloped viruses. Short-wave ultraviolet (UVC) direct irradiation technology eliminates the need for chemical additives, though its inactivation efficiency and compatibility with blood components requires optimization. The chemical modification method, while specifically designed for red blood cells, faces safety challenges such as potential immunogenicity. For emerging technologies, cold plasma technology shows great potential owing to its multi-target synergistic inactivation mechanism, though challenges regarding its biocompatibility and selectivity remain. Electrolyzed water technology has the advantages of low cost and operational simplicity, yet in-depth research is needed on the non-specific damage caused by active substances to blood components. Novel photodynamic therapy significantly improves inactivation efficiency by developing high-efficiency targeted photosensitizers and has broad prospects for combined applications with antibodies, nanomaterials, and other substances. Future development trends point to the "combination therapy" strategy, which leverages the synergy of multiple technologies to achieve the optimal balance between efficient virus inactivation and functional prservation of blood components. The development of such technologies needs to shift from "single-method" to "integrated approach", from "inactivation" to "viability preservation", and bridge the translation gap from "laboratory" to "global application". The ultimate goal is to establish a standardized, automated, and cost-controllable comprehensive blood safety assurance system.

Bacteria have posed a threat to human health,and the emergence of super bacteria has made it more difficult to cure bacterial infections in clinical practice.Currently,vaccines are one of the effective means of preventing bacterial infections.With the rapid development of cutting-edge technologies in recent years in such disciplines as biology,medicine,and materials science,various innovative strategies have been provided for vaccine research and preparation.This article summarizes the status quo and prospects of innovative vaccines for treating bacterial infections in recent years,including subunit vaccines,mRNA vaccines and attenuated live vaccine in the hopes of providing data for subsequent development and research of bacterial vaccines.

Objective To determine the neurotoxic effects of amyloid beta 42(Aβ42)oligomers and investigate the mechanism of their induction of Alzheimer's disease(AD)-like pathogenesis in neuronal cells.Methods Western blotting and transmission electron microscopy were used to identify the synthesized Aβ42 oligomers.In order to assess the impact of the oligomers,MTT assay was employed to measure cell viability in neuroblastoma cell line SH-SY5Y treated with 10μmol/L Aβ42 oligomers for 12 or 24 h,glutamatergic neurons derived from human embryonic stem cells(hESC)exposed to Aβ42 oligomers for 24,48,or 96 h,and corresponding control cells.TUNEL assay was utilized to assess the apoptosis of glutamatergic neurons.Additionally,immu-nofluorescence assay was applied to detect the changes in Aβ plaques and p-tau pathology.Results Western blotting displayed monomers and small-molecule aggregation(＜30 000)in our synthe-sized Aβ42 oligomers,and transmission electron microscopy showed that the synthesized oligomers were mainly in a shape of spherical particles.Treatment of 10 μmol/L Aβ42 oligomers for 12 and 24 h in SH-SY5Y cells significantly decreased cell viability when compared with the control cells[(70.89±2.54)％vs(100.00±2.02)％,(52.63±3.37)％vs(100.00±2.80)％,P＜0.05].The 10μmol/L oligomers treatment for 24,48 and 96 h also decreased cell viability in glutamatergic neu-rons(P＜0.05).The apoptotic rates was significantly higher in glutamatergic neurons after treat-ment for 48 and 96 h when compared to the control cells[(1.44±0.31)％vs(1.00±0.38)％,(1.75±0.64)％vs(1.00±0.31)％,P＜0.05].Furthermore,circular granular Aβ-positive plaque signals were observed in the glutamatergic neurons after treated with the oligomers for 24,48,and 96 h,but no such plaque signals were seen in the control cells.Additionally,glutamatergic neurons incu-bation with 10 μmol/L oligomers for 24 h resulted in tau hyperphosphorylation at the Thr231 site,with the average fluorescence intensity significantly higher than that in control cells(P＜0.05).Conclusion Aβ42 oligomers show toxic effects to both SH-SY5Y cells and glutamatergic neurons,and they can also induce glutamatergic neurons to produce AD pathology.

Background::Rapid initiation of antiretroviral therapy (ART) is recommended by guidelines, however, real-world studies of same-day initiation of ART in China are limited, and an optimal treatment regimen has yet to be identified. The study aims to provide a realistic reference for rapid initiation of ART.Methods::We retrospectively analyzed the clinical data of treatment-na?ve people with human immunodeficiency virus (PWHs) who were diagnosed and prescribed same-day ART initiation from January 1, 2021 to December 31, 2022 at Chongqing Public Health Medical Center. PWHs voluntarily chose an ART regimen that divided them into two groups: National Free Antiretroviral Treatment Program (NFATP)-recommended regimens group (2 nucleoside reverse transcriptase inhibitors + non-nucleoside reverse transcriptase inhibitors/protease inhibitors) and bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF) group. The primary endpoint was the virological outcome of the two groups for same-day ART initiation at 24 weeks and 48 weeks. The secondary endpoints included changes in CD4 counts, maintenance of the original ART regimen at 48 weeks, and lipid levels and renal function at 48 weeks.Results::A total of 255 PWHs were included in the study, including 131 (51.4%) in the NFATP group and 124 (48.6%) in the BIC/FTC/TAF group. The overall virological suppression rates at 24 weeks and 48 weeks were 78.2% (165/211) and 95.4% (207/217), respectively. At 24 weeks, the virologic suppression rate in the NFATP group was lower than that in the BIC/FTC/TAF group (65.3% [66/101] vs. 90.0% [99/110], P <0.001). The median increase in the CD4 count was 198.0 (126.0-300.0) cells/μL at 24 weeks, with 182.0 (108.0-245.0) cells/μL in the NFATP group and 219 (132.0-316.0) cells/μL in the BIC/FTC/TAF group ( P = 0.035). At 48 weeks, there was no significant difference in the virological suppression rate or CD4 count between the groups. The 48-week initial ART regimen retention rates and treatment retention rates were significantly higher in the BIC/FTC/TAF group than in the NFATP group (91.1% (113/124) vs. 71.8% (94/131), 99.2% (118/119) vs. 93.0% (120/129), respectively). In terms of safety, there were no significant changes from baseline in levels of creatinine, estimated glomerular filtration rate (eGFR), or lipids in either group at 48 weeks. Conclusions::ART initiation on the day of diagnosis is effective, safe, and feasible, with satisfactory rates of virologic suppression, 48-week initial ART regimen retention rates, and treatment retention rates in treatment-na?ve PWHs. In our study, the early virologic suppression rate, CD4 cell counts, and treatment retention of the BIC/FTC/TAF regimens were significantly better than those of the NFATP regimens.

Immunotherapy has become a common means of cancer treatment. In immunotherapy, PD-1/PD-L1 inhibitors have significant efficacy. Cancer and various opportunistic infections are common complications in patients with AIDS. Owing to the special immune situation of these patients, AIDS is regarded as an exclusion standard in most clinical trials for cancer immunotherapy, conferring immunotherapy difficulty in treating patients with AIDS. The popularity of effective antiretroviral drugs has prolonged the lifetime of people with AIDS. Therefore, exploiting the opportunity of using immunotherapy in AIDS with cancer is urgent.

OBJECTIVE: To investigate the protective effects of total saponins from Panax japonicus (TSPJ) against high-fat dietinduced testicular Sertoli cell junction damage in mice. METHODS: Forty male C57BL/6J mice were randomized into normal diet group, high-fat diet group, and low-dose (25 mg/kg) and high-dose (75 mg/kg) TSPJ treatment groups (n=10). The mice in the normal diet group were fed a normal diet, while the mice in the other groups were fed a high-fat diet. After TSPJ treatment via intragastric administration for 5 months, the testes and epididymis of the mice were collected for measurement of weight, testicular and epididymal indices and sperm parameters. HE staining was used for histological evaluation of the testicular tissues and measurement of seminiferous tubule diameter and seminiferous epithelium height. The expression levels of ZO-1, occludin, claudin11, N-cadherin, E-cadherin and β-catenin in Sertoli cells were detected with Western blot, and the localization and expression levels of ZO-1 and β-catenin in the testicular tissues were detected with immunofluorescence assay. The protein expressions of LC3B, p-AKT and p-mTOR in testicular Sertoli cells were detected using double immunofluorescence assay. RESULTS: Treatment with TSPJ significantly improved high-fat diet-induced testicular dysfunction by reducing body weight (P < 0.001), increasing testicular and epididymal indices (P < 0.05), and improving sperm concentration and sperm viability (P < 0.05). TSPJ ameliorated testicular pathologies and increased seminiferous epithelium height of the mice with high-fat diet feeding (P < 0.05) without affecting the seminiferous tubule diameter. TSPJ significantly increased the expression levels of ZO-1, occludin, N-cadherin, E-cadherin and β-catenin (P < 0.05) but did not affect claudin11 expression in the testicular tissues. Immunofluorescence assay showed that TSPJ significantly increased ZO-1 and β-catenin expression in the testicular tissues (P < 0.001), downregulated LC3B expression and upregulated p-AKT and p-mTOR expressions in testicular Sertoli cells. CONCLUSION TSPJ alleviates high-fat diet-induced damages of testicular Sertoli cell junctions and spermatogenesis possibly by activating the AKT/mTOR signaling pathway and inhibiting autophagy of testicular Sertoli cells.
Male ; Animals ; Mice ; Mice, Inbred C57BL ; Testis ; Sertoli Cells ; beta Catenin ; Diet, High-Fat ; Occludin ; Proto-Oncogene Proteins c-akt ; Seeds ; Cadherins ; Intercellular Junctions

This article reviews the concept, importance, and assessment tools of nurse leadership. This article introduces the characteristics of each assessment tool and its application in different cultural backgrounds, so as to provide a reference for nurses to choose appropriate assessment tools, and to provide a basis for the development of assessment tools for nurse leadership in China.

Objective:This study aimed to investigate the effect of short-term antipsychotic medication treatment of patients with schizophrenia on the effect of the thalamocortical resting-state functional connectivity.Methods:83 first-episode drug-na?ve schizophrenia patients and 117 matched healthy controls participated in the present study. The study collected resting-state fMRI data before and after the patients received short-term antipsychotics to assess the changes in the thalamocortical circuits and clinical symptoms. The directional interactions between the thalamus and other brain regions were investigated using a standard seed-based whole-brain correlation by choosing the bilateral thalamus as the seeds. Spearman′s correlation analysis was carried out between the change of abnormal functional connectivity and improved clinical symptoms in patients.Results:Compared with the healthy controls, schizophrenia patients showed decreased thalamic-prefrontal functional connectivity (including the middle frontal cortex, inferior frontal cortex, middle cingulate cortex, posterior cingulate cortex, and inferior parietal lobe, all P<0.05, FDR corrected) and increased thalamic-sensorimotor functional connectivity(including the precentral gyrus, superior temporal cortex, middle temporal cortex, inferior temporal cortex, parahippocampus, and middle occipital cortex, all P<0.05, FDR corrected)at baseline. After short-term antipsychotic treatment, the thalamic-prefrontal hypo-connectivity was significantly enhanced, and the thalamic-sensorimotor hyper-connectivity was significantly decreased. Furthermore, the changes of abnormal functional connectivity were correlated significantly with the PANSS total score changes improvement ( r=0.435, P=0.014; r=0.394, P=0.028,uncorrected). Conclusions:The present study replicates previous findings that the abnormalities of thalamocortical circuits in schizophrenia are characterized by thalamic-prefrontal hypoconnectivity and thalamic-sensorimotor hyperconnectivity. Moreover, short-term antipsychotic treatment partly improves thalamocortical abnormalities, which further relates to clinical symptom relief; Restoring of abnormal thalamocortical circuits plays an important role in the early treatment of schizophrenia.

Objective:This study aimed to investigate the effect of short-term antipsychotic medication treatment of patients with schizophrenia on the effect of the thalamocortical resting-state functional connectivity.Methods:83 first-episode drug-na?ve schizophrenia patients and 117 matched healthy controls participated in the present study. The study collected resting-state fMRI data before and after the patients received short-term antipsychotics to assess the changes in the thalamocortical circuits and clinical symptoms. The directional interactions between the thalamus and other brain regions were investigated using a standard seed-based whole-brain correlation by choosing the bilateral thalamus as the seeds. Spearman′s correlation analysis was carried out between the change of abnormal functional connectivity and improved clinical symptoms in patients.Results:Compared with the healthy controls, schizophrenia patients showed decreased thalamic-prefrontal functional connectivity (including the middle frontal cortex, inferior frontal cortex, middle cingulate cortex, posterior cingulate cortex, and inferior parietal lobe, all P<0.05, FDR corrected) and increased thalamic-sensorimotor functional connectivity(including the precentral gyrus, superior temporal cortex, middle temporal cortex, inferior temporal cortex, parahippocampus, and middle occipital cortex, all P<0.05, FDR corrected)at baseline. After short-term antipsychotic treatment, the thalamic-prefrontal hypo-connectivity was significantly enhanced, and the thalamic-sensorimotor hyper-connectivity was significantly decreased. Furthermore, the changes of abnormal functional connectivity were correlated significantly with the PANSS total score changes improvement ( r=0.435, P=0.014; r=0.394, P=0.028,uncorrected). Conclusions:The present study replicates previous findings that the abnormalities of thalamocortical circuits in schizophrenia are characterized by thalamic-prefrontal hypoconnectivity and thalamic-sensorimotor hyperconnectivity. Moreover, short-term antipsychotic treatment partly improves thalamocortical abnormalities, which further relates to clinical symptom relief; Restoring of abnormal thalamocortical circuits plays an important role in the early treatment of schizophrenia.