From the perspective of transfusion medicine and based on the vision and framework of patient blood management, this article combines the advances in basic science, blood transfusion, laboratory, and clinical medicine. It aims to systematically review the key elements and characteristics of patient fibrinogen management by maintaining and optimizing patients' hemostatic function while reducing blood transfusions. This review enriches the connotation of transfusion medicine, especially patient blood management, and provides valuable insights for clinical practice.

Objective: To explore the influencing factors of anxiety symptoms and to construct a predictive model based on machine learning algorithms, so as to provide support for the prevention and management of anxiety symptoms among junior high school students. Methods: From April to May 2023, a stratified random cluster sampling method was adopted to select 8 176 junior high school students from Zhengzhou and Shangqiu citys. All participants completed the Adolescent Self rating Life Events Checklist, the 10item Connor-Davidson Resilience Scale, the School Connectedness Scale, the Parent-Child Cohesion Questionnaire, and the 7 item Generalized Anxiety Disorder Scale. Logistic regression analysis identified the associated factors of anxiety symptoms among junior high school students. Predictive models were constructed using Logistic regression, Random Forest, and eXtreme Gradient Boosting (XGBoost) algorithms, with SHapley Additive exPlanations analysis explaining the optimal model. Results: The detection rate of anxiety symptoms among junior high school students was 16.3%. Logistic regression analysis showed that junior high school students who were female ( OR =1.22), in the ninth grade ( OR =1.27), living in urban areas ( OR =1.37), having a father with a college education or above ( OR =1.26), having a mother with a senior high school education ( OR =1.26), and experiencing higher levels of negative life events ( OR =1.05) reported a higher risk of anxiety symptoms(all P <0.05). In contrast, those with moderate family economic status ( OR =0.71), moderate academic burden ( OR =0.59), low academic burden ( OR =0.54), moderate sleep quality ( OR =0.46), good sleep quality ( OR =0.26), excellent sleep quality ( OR =0.15), higher levels of psychological resilience ( OR =0.96), higher levels of school connectedness ( OR =0.96), and higher levels of parent-child cohesion ( OR =0.98) reported a lower risk of anxiety symptoms (all P <0.05). Three machine learning models demonstrated good predictive performance for anxiety symptoms among junior high school students (all AUC>0.8), with the XGBoost model achieving the best predictive performance. SHAP analysis revealed that negative life events, sleep quality, school connectedness, psychological resilience and parent-child cohesion were the top five relevant factors for predicting anxiety symptoms. Conclusions The detection rate of anxiety symptoms among junior high school students is relatively high. The XGBoost model is the optimal predictive model for anxiety symptoms in the population. Negative life events, sleep quality, school connectedness, psychological resilience, and parent-child cohesion are significant correlates of anxiety symptoms among junior high school students.

Objective This study aimed to investigate the effect of stage Ⅰ comprehensive cardiac rehabili-tation in patients with acute ST elevation myocardial infarction(STEMI)after emergency percutaneous coronary intervention(PCI).Methods A total of 72 patients with acute ST-segment elevation myocardial infarction combined with PCI admitted to the Department of Cardiovascular Medicine of Beijing Electric Power Hospital of State Grid Corporation from June 2021 to June 2022,which were selected as the research objectsand divided into control group and observation group randomly(36 cases in each group).The control group was treated with routine nursing and health education,and the observation group with stage Ⅰ comprehensive cardiac rehabilitation,including initial assessment(cardiovascular comprehensive assessment),exercise training(exercise training and breathing train-ing),daily activity suggestions and health education,discharge assessment(six-minute walking test and Barthel index assessment).The score of Barthel index(BI)at discharge,the 6-minute walking test distance(6MWD)at discharge,the incidence of major adverse cardiovascular event(MACE)during hospitalization and within one month of discharge,and the length of stay were compared between the two groups.Results After intervention,the six-minute walking test distance(6MWD)and Barthel index(BI)score in the observation group were better than those in the control group,the difference was statistically significant(P<0.05).The incidence of major adverse cardiovascular events(MACE)during hospitalization and one month after discharge was lower in the observation group than in the control group,and the difference was statistically significant(P<0.05).The length of hospital-ization in observation group was lower than that in control groupbut there was no statistical difference(P>0.05).Conclusion The application of phase Ⅰ comprehensive cardiac rehabilitation training in patients with acute ST-segment elevation myocardial infarction combined with emergency PCI could improve the patients'exercise ability,improve their ability of daily activity,reduce the incidence of major adverse cardiovascular events(MACE)in the early stage of the disease,facilitate the patients to return to their families and society as soon as possible,and improve their quality of life.It has high clinical application value.

Objective To investigate the effect of group cognitive behavioral therapy on anxiety and depression in patients with chronic heart failure ( CHF ) .Methods One hundred patients with CHF were recruited from January 2012 to December 2013 in cardiovascular department , and were divided into the intervention group and the control group , with 50 patients each .Comprehensive intervention including routine heart failure care and group cognitive behavioral therapy combined with other therapies was adopted on the patients in the intervention group .The Self-rating Anxiety Scale ( SAS ) and the Self-rating Depression Scale ( SDS) were used to compare the difference of anxiety and depression between groups .Results At the baseline, the incidence of anxiety was 25%, within which 11 patients had mild anxiety , and 10 patients had moderate anxiety, and 4 patients had severe anxiety.The incidence of depression was 39%, within which 19 patients had mild depression , and 14 patients had moderate depression , and 6 patients had severe depression .The score of SAS and SDS in the intervention group after intervention were (36.90 ±8.465) and (27.53 ±7.162), respectively, which were significantly lower than (40.91 ±8.019) and (36.78 ±10.562) in the control group (t=9.244,10.335, respectively;P<0.01).Conclusions Group cognitive behavioral therapy can effectively relieve the anxiety and depression in patients with chronic heart failure .

Nano drug delivery system (NDDS) is a kind of drug delivery system which are made up of drugs and drug carriers and their particle sizes are less than 1 000 nm.In general,polymeric micelles,liposome,nano capsule,microemulsion,and organic or inorganic nanoparticles are used as carriers in NDDS,pharmacodynamic substance and carriers are combined into new type of controlled/slow release preparations or the drugs are directly processed into nanoparticles.Embryo toxicity is an important index for non-clinic safety evaluation of NDDS.The in vitro studies showed that embryo toxicity of NDDS is related to physical and chemical properties of nanoparticles,such as size and modification materials on surface,exposure time of nanoparticles,and dosage.It has been shown that zinc oxide nanoparticles have embryo toxicity,titanium dioxide,silica,magnesium oxide,and quantum dots have different degrees of embryo toxicity,and polystyrene based nanoparticles have no embryo toxicity.The in vivo studies showed that zinc oxide nanoparticles,quantum dots containing cadmium or selenium,and high concentrations of nano silver have embryo toxicity in one or several animal models,such as rat,mouse,zebrafish,Paracentrotus lividus,Xenopus laevis,and Mytilus Galloprovincialis.Silica,titanium dioxide,chitosan nanoparticles and singlewalled carbon nanotubes at different dose and size showed different effects on embryonic development of different animal models.Embryotoxic or teratogenic effects of NDDS include stagnation,miscarriage,and deformity,and the mechanism of toxicity is mainly related to oxidative stress and inflammation.Though embryo toxicity of NDDS in models,methods and content need further exploration and research,studies which have been carried out provide important references for further research.

Nano drug delivery system (NDDS) is a kind of drug delivery system which are made up of drugs and drug carriers and their particle sizes are less than 1 000 nm.In general,polymeric micelles,liposome,nano capsule,microemulsion,and organic or inorganic nanoparticles are used as carriers in NDDS,pharmacodynamic substance and carriers are combined into new type of controlled/slow release preparations or the drugs are directly processed into nanoparticles.Embryo toxicity is an important index for non-clinic safety evaluation of NDDS.The in vitro studies showed that embryo toxicity of NDDS is related to physical and chemical properties of nanoparticles,such as size and modification materials on surface,exposure time of nanoparticles,and dosage.It has been shown that zinc oxide nanoparticles have embryo toxicity,titanium dioxide,silica,magnesium oxide,and quantum dots have different degrees of embryo toxicity,and polystyrene based nanoparticles have no embryo toxicity.The in vivo studies showed that zinc oxide nanoparticles,quantum dots containing cadmium or selenium,and high concentrations of nano silver have embryo toxicity in one or several animal models,such as rat,mouse,zebrafish,Paracentrotus lividus,Xenopus laevis,and Mytilus Galloprovincialis.Silica,titanium dioxide,chitosan nanoparticles and singlewalled carbon nanotubes at different dose and size showed different effects on embryonic development of different animal models.Embryotoxic or teratogenic effects of NDDS include stagnation,miscarriage,and deformity,and the mechanism of toxicity is mainly related to oxidative stress and inflammation.Though embryo toxicity of NDDS in models,methods and content need further exploration and research,studies which have been carried out provide important references for further research.