1.Machine learning-enabled precision transfusion: research progress, challenges, and prospects
Jiang DENG ; Chaojie WANG ; Ning ZHAO ; Liping LYU ; Ping MA ; Ke ZHANG ; Yanyu ZHANG
Chinese Journal of Blood Transfusion 2026;39(7):967-976
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.
2.Study on the effect and mechanism of oridonin improving obesity-related glomerulopathy via regulating the LXRα signaling pathway
Moyuan ZHAO ; Yanyu WANG ; Benjie ZHOU ; Shijian XIANG ; Yulian CHEN
China Pharmacy 2026;37(15):1960-1965
OBJECTIVE To explore the therapeutic efficacy and mechanism of oridonin (ORI) against obesity-related glomerulopathy (ORG) based on the liver X receptor α (LXRα) signaling pathway. METHODS Kidney tissues of LXRα wild-type homozygous (LXRα+/+) mice and LXRα homozygous knockout (LXRα-/-) mice were subjected to high-throughput renal transcriptome sequencing and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis to predict key pathways and targets regulated by LXRα, followed by verification via Western blot assay. An ORG mouse model was established by feeding a high-fat diet. The LXRα agonist GW3965 (30 mg/kg) was set as the positive control. After intragastric administration of 50 mg/kg and 100 mg/kg ORI once daily for 4 consecutive weeks, the body weight, renal weight, renal histopathological alterations, serum renal function indicators, blood lipid levels and inflammatory factor levels in renal tissue of mice were detected and observed to evaluate the efficacy of ORI in alleviating ORG. Meanwhile, the mRNA and protein expression levels of LXRα and its downstream targets in mouse renal tissues were detected to validate the mechanism by which ORI relieves ORG. RESULTS Compared with LXRα+/+ mice, the upregulated differentially expressed genes in renal tissues of LXRα-/- mice were significantly enriched in the arachidonic acid(AA) metabolic pathway, and the expression level of Cyp4a12 was markedly elevated (adjusted P<0.05). Western blot results verified that cytochrome P450 family 4 subfamily A member 12(CYP4A12)protein expression was significantly increased in the kidneys of LXRα-/- mice (P<0.05). Pharmacodynamic results showed that both 50 mg/kg and 100 mg/kg ORI notably improved renal pathological lesions in ORG mice; these two doses reduced body weight, renal weight, serum creatinine, blood urea nitrogen, blood lipid levels as well as renal interleukin-6 (IL-6) and IL-1β levels (P<0.05). In addition, ORI significantly upregulated the mRNA and protein expression of renal nuclear LXRα and ABCA1, and downregulated the mRNA and protein expression of CYP4A12(P<0.05). CONCLUSIONS ORI may exert an ameliorative effect on ORG by activating the LXRα signaling pathway, downregulating CYP4A12 expression, and inhibiting AA-induced inflammatory metabolism.
3.Recent advances in blood virus inactivation technologies and their multi-dimensional innovative applications
Chaojie WANG ; Jiang DENG ; Ning ZHAO ; Yanyu ZHANG
Chinese Journal of Blood Transfusion 2025;38(10):1435-1443
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.
4.Analysis of influencing factors on outcomes of LSIL patients undergoing cervical biopsy
Huiping LU ; Yanyu SHI ; Han WANG ; Yidi YAN ; Junyi ZHOU ; Shujun ZHAO
China Modern Doctor 2025;63(13):41-45
Objective To investigate the factors influencing the natural outcome of low-grade squamous intraepithelial lesions(LSIL)of the cervix.Methods A total of 154 patients who underwent colposcopic cervical biopsy in the Third Affiliated Hospital of Zhengzhou University from January 2022 to January 2023 were selected and divided into negative conversion group(55 cases),continuous group(70 cases)and upgraded group(29 cases)according to the follow-up results.Logistic regression was used to analyze the influence of related factors on the outcome of LSIL.Results There were statistically significant differences in the number of vaginal births,the results of thin-prep cytology test,human papilloma virus(HPV)typing,whether vaginal LSIL was combined,whether there were symptoms,and vaginal microecology among three groups(P<0.05).Multivariate Logistic analysis showed that combined vaginal LSIL,vaginal microecological abnormalities,atypical squamous cell-cannot exclude high-grade squamous intraepithelial lesion(ASC-H)/high-grade squamous intraepithelial lesion(HSIL),HPV 16/18 positive or mixed positive were independent risk factors for persistent infection(P<0.05),combined vaginal LSIL,symptomatic,vaginal microecological abnormalities,ASC-H/HSIL,HPV 16/18 positive or mixed positive were all independent risk factors for escalation of lesions(P<0.05).Conclusion Patients with vaginal LSIL,vaginal microecological abnormalities,ASC-H/HSIL,HPV 16/18 positive or mixed positive should be followed up and early intervention to reduce the risk of disease escalation.
5.Impact of meaning in life and living arrangements on association between activities of daily living and depression in older adults
Lilu DU ; Renkui YAO ; Yanyu ZHAO ; Mengxuan LI ; Min ZOU ; Gongfa ZHANG
Chinese Journal of Rehabilitation Theory and Practice 2025;31(8):987-992
Objective To analyze the mechanisms of meaning in life and living arrangements impacting the effect of activities of dai-ly living(ADL)on depression for older adults.Methods From September to November,2024,community-dwelling older adults from Weifang,Shandong,were investi-gated with questionnaire using Basic Activities of Daily Living Scale(BADL),Meaning in Life Questionnaire(MLQ),Geriatric Depression Scale(GDS),and a general information questionnaire including living arrange-ments.Results A total of 256 questionnaires were distributed,and 245 valid questionnaires were returned.There were signifi-cant differences in GDS scores among older adults with different personal monthly incomes and living arrange-ments(F>3.744,P<0.05).BADL scores were positively correlated with GDS scores(r=0.490,P<0.001)and negatively correlated with MLQ scores(r=-0.370,P<0.001),and MLQ scores were negatively correlated with GDS scores(r=-0.369,P<0.001).There was significant direct effect of BADL scores on GDS scores(effect=1.128,95%CI 0.829~1.427),and mediating effect of MLQ scores on the relationship between BADL and GDS scores(effect=0.171,95%CI 0.028~0.337).The moderating effect of living alone was significant(|B|=0.127,|t|=2.103,P<0.05)on the association between MLQ and GDS,compared with intergenerational coresidence.Conclusion Meaning in life partially mediates the association between ADL and depression in older adults,especially for those living alone.
6.Impact of meaning in life and living arrangements on association between activities of daily living and depression in older adults
Lilu DU ; Renkui YAO ; Yanyu ZHAO ; Mengxuan LI ; Min ZOU ; Gongfa ZHANG
Chinese Journal of Rehabilitation Theory and Practice 2025;31(8):987-992
Objective To analyze the mechanisms of meaning in life and living arrangements impacting the effect of activities of dai-ly living(ADL)on depression for older adults.Methods From September to November,2024,community-dwelling older adults from Weifang,Shandong,were investi-gated with questionnaire using Basic Activities of Daily Living Scale(BADL),Meaning in Life Questionnaire(MLQ),Geriatric Depression Scale(GDS),and a general information questionnaire including living arrange-ments.Results A total of 256 questionnaires were distributed,and 245 valid questionnaires were returned.There were signifi-cant differences in GDS scores among older adults with different personal monthly incomes and living arrange-ments(F>3.744,P<0.05).BADL scores were positively correlated with GDS scores(r=0.490,P<0.001)and negatively correlated with MLQ scores(r=-0.370,P<0.001),and MLQ scores were negatively correlated with GDS scores(r=-0.369,P<0.001).There was significant direct effect of BADL scores on GDS scores(effect=1.128,95%CI 0.829~1.427),and mediating effect of MLQ scores on the relationship between BADL and GDS scores(effect=0.171,95%CI 0.028~0.337).The moderating effect of living alone was significant(|B|=0.127,|t|=2.103,P<0.05)on the association between MLQ and GDS,compared with intergenerational coresidence.Conclusion Meaning in life partially mediates the association between ADL and depression in older adults,especially for those living alone.
7.Analysis of influencing factors on outcomes of LSIL patients undergoing cervical biopsy
Huiping LU ; Yanyu SHI ; Han WANG ; Yidi YAN ; Junyi ZHOU ; Shujun ZHAO
China Modern Doctor 2025;63(13):41-45
Objective To investigate the factors influencing the natural outcome of low-grade squamous intraepithelial lesions(LSIL)of the cervix.Methods A total of 154 patients who underwent colposcopic cervical biopsy in the Third Affiliated Hospital of Zhengzhou University from January 2022 to January 2023 were selected and divided into negative conversion group(55 cases),continuous group(70 cases)and upgraded group(29 cases)according to the follow-up results.Logistic regression was used to analyze the influence of related factors on the outcome of LSIL.Results There were statistically significant differences in the number of vaginal births,the results of thin-prep cytology test,human papilloma virus(HPV)typing,whether vaginal LSIL was combined,whether there were symptoms,and vaginal microecology among three groups(P<0.05).Multivariate Logistic analysis showed that combined vaginal LSIL,vaginal microecological abnormalities,atypical squamous cell-cannot exclude high-grade squamous intraepithelial lesion(ASC-H)/high-grade squamous intraepithelial lesion(HSIL),HPV 16/18 positive or mixed positive were independent risk factors for persistent infection(P<0.05),combined vaginal LSIL,symptomatic,vaginal microecological abnormalities,ASC-H/HSIL,HPV 16/18 positive or mixed positive were all independent risk factors for escalation of lesions(P<0.05).Conclusion Patients with vaginal LSIL,vaginal microecological abnormalities,ASC-H/HSIL,HPV 16/18 positive or mixed positive should be followed up and early intervention to reduce the risk of disease escalation.
8.Research on the High-quality Development Model of the National Regional Medical Center for Cardiovascular Disense Based on the Synergy Theory
Li ZHENG ; Yanyu TANG ; Keke WANG ; Yaojun ZHAO
Chinese Hospital Management 2024;44(10):26-29
The construction of regional medical centers is an important carrier for the country to further promote the reform of the new medical service system during the"14th Five-Year Plan"period.In view of the problems existing in the current construction of national regional medical centers,such as imperfect coordination mechanism,insufficient coordination power and lack of assessment and evaluation system,drawing on collaboration theory and case study method,the construction path of national regional medical centers was analyzed from three dimensions:management system collaboration,operation mechanism collaboration and evaluation mechanism collaboration;It explore and constructs the new management model of"13331"high quality development in National Regional Medical Centers;The results provide experience and case reference for promoting the high-quality development of national regional medical centers under the new situation in terms of party building leadership,medical technology,scientific and technological innovation,medical-education collaboration and brand influence.
9.Research on the High-quality Development Model of the National Regional Medical Center for Cardiovascular Disense Based on the Synergy Theory
Li ZHENG ; Yanyu TANG ; Keke WANG ; Yaojun ZHAO
Chinese Hospital Management 2024;44(10):26-29
The construction of regional medical centers is an important carrier for the country to further promote the reform of the new medical service system during the"14th Five-Year Plan"period.In view of the problems existing in the current construction of national regional medical centers,such as imperfect coordination mechanism,insufficient coordination power and lack of assessment and evaluation system,drawing on collaboration theory and case study method,the construction path of national regional medical centers was analyzed from three dimensions:management system collaboration,operation mechanism collaboration and evaluation mechanism collaboration;It explore and constructs the new management model of"13331"high quality development in National Regional Medical Centers;The results provide experience and case reference for promoting the high-quality development of national regional medical centers under the new situation in terms of party building leadership,medical technology,scientific and technological innovation,medical-education collaboration and brand influence.
10.Research on the High-quality Development Model of the National Regional Medical Center for Cardiovascular Disense Based on the Synergy Theory
Li ZHENG ; Yanyu TANG ; Keke WANG ; Yaojun ZHAO
Chinese Hospital Management 2024;44(10):26-29
The construction of regional medical centers is an important carrier for the country to further promote the reform of the new medical service system during the"14th Five-Year Plan"period.In view of the problems existing in the current construction of national regional medical centers,such as imperfect coordination mechanism,insufficient coordination power and lack of assessment and evaluation system,drawing on collaboration theory and case study method,the construction path of national regional medical centers was analyzed from three dimensions:management system collaboration,operation mechanism collaboration and evaluation mechanism collaboration;It explore and constructs the new management model of"13331"high quality development in National Regional Medical Centers;The results provide experience and case reference for promoting the high-quality development of national regional medical centers under the new situation in terms of party building leadership,medical technology,scientific and technological innovation,medical-education collaboration and brand influence.

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