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 effect of nuclide distribution with time from the in vivo metabolism based on measurement of radioactive contamination using lung counting method. Methods:The distribution of nuclides in the body with time was calculated on a basis of a single inhalation of aerosols containing 235U and the International Commission of Radiological Protection(ICRP) nuclide metabolism compartment model. A passive efficiency calibration of the lung counter, was performed using the simulation and calculation software Geant4 to obtain the contribution of the tissue or organs of interest to the lung counter, and to investigate the effect of the nuclide distribution on the lung counting method. Results:The time elapsed after inhalation of radionuclides, as well as their physicochemical state, has the effect on their distribution in the body and on the detection efficiency of the lung counter. Radionuclides with smaller particulate sizes have a higher initial retention in the lungs, and those with an activity median aerodynamic diameter (ADAM) of 1 μm contributed more fraction to the lung counter than those with an ADAM of 5 μm. F-type compounds were metabolized more rapidly by the respiratory system, and after 8 h of ingestion, nuclides were distributed in the lungs. F-type compounds were metabolized in the respiratory system at a relatively fast rate, and 8 h after inhalation, the fraction of nuclides retained in the lung contributed no more than 30% to the lung counter. Within 3 d after ingestion of M-type and S-type compounds, radioactive particulats largely deposites in the nasopharyngeal region. With biological metabolization and clearance, the fraction contributed by lung to counter is in rising, and the fraction to the lung counter typically remained larger than 80% after 3 d.Conclusions:Radionuclide metabolization in the body varies with their physicochemical properties and measurement time and site. For estimating internal contamination, consideration should be given to the distribution of nuclides, in order to avoid the overestimation.

Objective:To investigate the effect of nuclide distribution with time from the in vivo metabolism based on measurement of radioactive contamination using lung counting method. Methods:The distribution of nuclides in the body with time was calculated on a basis of a single inhalation of aerosols containing 235U and the International Commission of Radiological Protection(ICRP) nuclide metabolism compartment model. A passive efficiency calibration of the lung counter, was performed using the simulation and calculation software Geant4 to obtain the contribution of the tissue or organs of interest to the lung counter, and to investigate the effect of the nuclide distribution on the lung counting method. Results:The time elapsed after inhalation of radionuclides, as well as their physicochemical state, has the effect on their distribution in the body and on the detection efficiency of the lung counter. Radionuclides with smaller particulate sizes have a higher initial retention in the lungs, and those with an activity median aerodynamic diameter (ADAM) of 1 μm contributed more fraction to the lung counter than those with an ADAM of 5 μm. F-type compounds were metabolized more rapidly by the respiratory system, and after 8 h of ingestion, nuclides were distributed in the lungs. F-type compounds were metabolized in the respiratory system at a relatively fast rate, and 8 h after inhalation, the fraction of nuclides retained in the lung contributed no more than 30% to the lung counter. Within 3 d after ingestion of M-type and S-type compounds, radioactive particulats largely deposites in the nasopharyngeal region. With biological metabolization and clearance, the fraction contributed by lung to counter is in rising, and the fraction to the lung counter typically remained larger than 80% after 3 d.Conclusions:Radionuclide metabolization in the body varies with their physicochemical properties and measurement time and site. For estimating internal contamination, consideration should be given to the distribution of nuclides, in order to avoid the overestimation.

This article explores the interaction between aspirin and safflower yellow injection from the perspective of pharmacokinetics, combined with pharmacological indicators such as anticoagulation. Quantitative HPLC analysis was performed for the detection of salicylic acid in plasma samples, and the pharmacokinetic effects of aspirin in combination with safflower yellow injection on aspirin’s hydrolyzed product salicylic acid was evaluated. Thromboxane B2 (TXB2) and 6-keto prostaglandin F1 in plasma were determined using enzyme-linked immunosorbent assay and fully automated biochemical analyzer α (6-keto-PGF1) α）, and the levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), blood urea nitrogen (BUN), and serum creatinine (Scr) were tested to evaluate the anticoagulant effect and safety indicators after long-term combined use of the two drugs, including liver and kidney function and cardiac pathological examination. The results showed that, compared with the aspirin group, there was no significant difference (P>0.05) in the plasma pharmacokinetic parameters of rats with combined use of safflower yellow injection. In addition, the plasma TXB2 in the combination group was significantly reduced compared to the aspirin group (P<0.01), yet with no significant difference for 6-keto-PGF1 α (P>0.05). There was no statistically significant difference in the levels of serum BUN, Scr, AST, and ALT between the two groups before and after treatment (P>0.05). These results suggest that the combination of aspirin and safflower yellow injection does not cause significant change in the blood concentration of salicylic acid. It does not affect the antiplatelet effect of aspirin.

Epigenomic imbalance drives abnormal transcriptional processes,promoting the onset and progression of cancer.Although defective gene regulation generally affects carcinogenesis and tumor suppression networks,tumor immunogenicity and immune cells involved in antitumor responses may also be affected by epigenomic changes,which may have significant implications for the development and application of epigenetic therapy,cancer immunotherapy,and their combinations.Herein,we focus on the impact of epigenetic regulation on tumor immune cell function and the role of key abnormal epigenetic processes,DNA methylation,histone post-translational modification,and chromatin structure in tumor immunogenicity,and introduce these epigenetic research methods.We emphasize the value of small-molecule inhibitors of epigenetic modulators in enhancing antitumor immune responses and discuss the challenges of developing treatment plans that combine epigenetic therapy and immuno-therapy through the complex interaction between cancer epigenetics and cancer immunology.

Objective:To investigate the application of therapeutic grade ionization chamber to rapid measurement of short pulsed and high-dose-rate X-ray.Methods:The half-value layer of pulsed X-ray caused by an electron accelerator was measured by interpolation method and its equivalent energy was estimated. The cumulative doses from a certain amount of pulsed radiation at different distances in the same direction around the equipment were compared using the therapeutic grade ionization chamber and thermoluminescence measurement method . The relationship between the measurement result by using ionization chamber dosimeter and the distances away from source was analyzed. The cumulative doses from a certain amount of pulsed radiation at the same location at different frequencies were compared.Results:In working condition, 100 pulses of radiation were received accumulatively at 1 to 12 meters away from the outer wall of the equipment. The range of air Kerma was 0.08-9.65 mGy measured by using thermoluminescence dometers and 0.08 - 9.85 mGy using the ionization chamber dosimeters, respectively. The difference between both is within 10%. At different frequencies (1-10 Hz), there was no significant difference in X-ray air Kerma from 100 pulses measured by ionization chamber dosimeter at 2 m away from the front of the equipment ( P>0.05). Conclusions:The therapeutic grade ionization chamber dosimeter can be used for the rapid measurement of short pulsed X-ray radiation dose in the range of dose rates and pulse frequencies involved in the experimental accelerator device.

Objective:To explore the clinical characteristics and predictors of severe acute pancreatitis complicated with acute respiratory distress syndrome (SAP-ARDS).Methods:Clinical data of consecutive 313 SAP patients hospitalized from January 2000 to January 2020 in Peking Union Medical College Hospital, were retrospectively analyzed, including 258 cases with ARDS (ARDS group) and 55 cases without ARDS (non-ARDS group). According to the severity of ARDS, ARDS group were further divided into mild ARDS group (165 cases) and moderate to severe ARDS group (93 cases). Clinical symptoms, laboratory examination and imaging results, ICU admission time and clinical outcome, as well as the local and systemic complications, acute physiology and chronic health evaluation (APACHEⅡ) within 24 h after admission, bedside index for severity in acute pancreatitis (BISAP), CT severity index (CTSI), sequential organ failure assessment (SOFA) and quick sequenctial organ failure assessment(qSOFA) score were recorded. Univariate and multivariate logistic regression were performed to analyze independent risk factors of SAP complicated with moderate to severe ARDS. Receiver operating characteristics curves (ROC) was drawn to calculate area under the ROC curve (area under curve, AUC) and evaluate the performance of WBC and hsCRP in predicting SAP complicated with moderate to severe ARDS, and assess the performance of APACHEⅡ, BISAP, CTSI, SOFA and qSOFA scores in predicting SAP-ARDS endotracheal intubation.Results:The ICU length of stay and mortality rate of SAP-ARDS patients were significantly higher than those without ARDS [(8.3±11.6 day vs 5.7±7.7 day, 12.4% vs 3.6%, all P value <0.05)]. Univariate analysis showed that elevated WBC ( OR 4.52, 95% CI 1.64-12.4) and hsCRP ( OR 3.69, 95% CI 1.29-10.48) on admission were independent risk factors for moderate to severe ARDS with SAP. The AUC of WBC and hsCRP for predicting SAP with moderate to severe ARDS at admission were 0.651(95% CI 0.532-0.770) and 0.615 (95% CI 0.500-0.730), respectively. The predicted cut-off values (Cut-off values) were 17.5×10 9/L and 159 mg/L, respectively, and the sensitivity was 53.1% and 78.1%, the specificity was 78.1% and 48.4% respectively. The area under the ROC curve for APACHEⅡ, BISAP, CTSI, SOFA, and qSOFA score 24 h after admission in the early prediction of endotracheal intubation were 0.739 (95% CI 0.626-0.840), 0.705 (95% CI 0.602-0.809), 0.753 (95% CI 0.650-0.849 ), 0.737 (95% CI 0.615-0.836) and 0.663 (95% CI 0.570-0.794), and the optimum Cut-off values were 14 points, 3 points, 5 points, 7 points, 2 points, and the sensitivity and specificity for these predictors were 58.8% and 81.4%, 79.4% and 60.0%, 73.5% and 67.1%, 38.2% and 98.6%, 45.5% and 83.3%, respectively. Conclusions::Elevated blood WBC and hsCRP on admission were independent risk factors for moderate to severe ARDS in SAP. APACHEⅡ≥14, BISAP≥3, CTSI≥5, SOFA≥7, or qSOFA≥2 within the 24 h admission indictaed that the risk of SAP patients to receive endotracheal intubation was high.

OBJECTIVE: To analyze the action of miRNA-326 on its target gene BCL-XL and the molecular mechanism of platelet apoptosis regulated by miRNAs. METHODS: Dual-luciferase vectors containing respectively the wild-type and mutant 3'-untranslated region (3'UTR) fragments of the BCL-XL gene were constructed with firefly and renilla luciferases and transfected into 293T cells. Relative fluorescence intensities of the transfected cells were measured. RESULTS: Dual-luciferase reporter gene vectors for PsiCHECK- BCL-XL -3'UTR-WT (wild-type) and PsiCHECK- BCL-XL -3' UTR-MT (variant) were respectively constructed. Relative fluorescence intensities of the 293T cells co-transfected by miRNA-326 and PsiCHECK- BCL-XL -3'UTR-WT plasmid were significantly lower compared with the control group (co-transfected by a miRNA-326 negative sequence and PsiCHECK- BCL-XL -3' UTR-WT plasmid) ( P = 0.034). The relative fluorescence intensity was also significantly reduced in cells co-transfected by miRNA-326 and PsiCHECK- BCL-XL -3' UTR-WT plasmid compared with the mutant control group co-transfected by miRNA-326 and PsiCHECK- BCL-XL -3'UTR-MT plasmid (P = 0.022). CONCLUSION miRNA-326 may participate in the regulation of platelet apoptosis by acting on the 3'-UTR of the BCL-XL gene.

Objective This study was aimed to evaluate the short-term antidepressive effect and the cognitive decline of the acute modified electroconvulsive therapy (MECT) course with 20％ and 40％ sub-threshold electricity stimulus dose in patients suffered with major depressive disorder.Methods A total of 108 patients who met the DSM-Ⅳ criteria of depression were enrolled and,according to the RAND procedure in excel,were randomly assigned into 3 groups:20％ electricity group,40％ electricity group,and 80％ electricity group (control),with 36 cases each accordingly.All patients were given one 8 times MECT with consecutively 5 times in the first week followed by intermittently 3 times in the second week (once every the other day).Depression symptoms (assessed by HAMD17) and the cognitive function (assessed by the Repeatable Battery for the Assessment of Neuropsychological Status,RBANS) were evaluated at baseline,4 to 8 hours after the first treatment,4 to 8 hours after the last treatment,the end of the week-4 and the week-8.The results were compared by repeated measurement analysis of variance and one-way analysis of variance (ANOVA).Results (1) There were significant differences in HAMD17 (F=10.769,P＜0.05) and RBANS (F=6.961,P＜0.05) among the three groups.(2) The time × electricity group interactions of HAMD17 (F=3.450,P＜0.05) and RBANS (F=2.501,P＜0.05) scoring were of statistical significance.(3) The scores of HAMD17 after the last treatment (F=3.673,P＜0.05),at week-4 (F=4.570,P＜0.05),and week-8 (F=4.122,P＜0.05) presented with significant difference among the three groups.There was no significant difference between either group and the control (P＞0.05).However,there was significant difference in HAMD17 between the 20％ electricity group and the 40％ electricity group (P＜0.05).(4) After the last treatment of MECT,the scores of RBANS among all three groups were significantly different (F=7.890,P＜0.05).And compared to the control (55.2 ± 11.2),the cognitive level measured by RBANS scores was relatively preserved in 20％ (65.2±12.2) and 40％ (63.9±11.5) electricity groups(P＜0.05).At week-8,the scores of RBANS (F=2.770,P＞ 0.05) were not significantly different among the three groups.Conclusion Subthreshold MECT with the stimulus dose at 40％ electricity seems not much different in antidepressive efficacy from the standard electricity dose,and the adverse impact on the cognitive function is relatively less.The efficacy of the 20％ electricity dose is poor though the cognitive decline is also minimal.

Objective This study was aimed to evaluate the short-term antidepressive effect and the cognitive decline of the acute modified electroconvulsive therapy (MECT) course with 20％ and 40％ sub-threshold electricity stimulus dose in patients suffered with major depressive disorder.Methods A total of 108 patients who met the DSM-Ⅳ criteria of depression were enrolled and,according to the RAND procedure in excel,were randomly assigned into 3 groups:20％ electricity group,40％ electricity group,and 80％ electricity group (control),with 36 cases each accordingly.All patients were given one 8 times MECT with consecutively 5 times in the first week followed by intermittently 3 times in the second week (once every the other day).Depression symptoms (assessed by HAMD17) and the cognitive function (assessed by the Repeatable Battery for the Assessment of Neuropsychological Status,RBANS) were evaluated at baseline,4 to 8 hours after the first treatment,4 to 8 hours after the last treatment,the end of the week-4 and the week-8.The results were compared by repeated measurement analysis of variance and one-way analysis of variance (ANOVA).Results (1) There were significant differences in HAMD17 (F=10.769,P＜0.05) and RBANS (F=6.961,P＜0.05) among the three groups.(2) The time × electricity group interactions of HAMD17 (F=3.450,P＜0.05) and RBANS (F=2.501,P＜0.05) scoring were of statistical significance.(3) The scores of HAMD17 after the last treatment (F=3.673,P＜0.05),at week-4 (F=4.570,P＜0.05),and week-8 (F=4.122,P＜0.05) presented with significant difference among the three groups.There was no significant difference between either group and the control (P＞0.05).However,there was significant difference in HAMD17 between the 20％ electricity group and the 40％ electricity group (P＜0.05).(4) After the last treatment of MECT,the scores of RBANS among all three groups were significantly different (F=7.890,P＜0.05).And compared to the control (55.2 ± 11.2),the cognitive level measured by RBANS scores was relatively preserved in 20％ (65.2±12.2) and 40％ (63.9±11.5) electricity groups(P＜0.05).At week-8,the scores of RBANS (F=2.770,P＞ 0.05) were not significantly different among the three groups.Conclusion Subthreshold MECT with the stimulus dose at 40％ electricity seems not much different in antidepressive efficacy from the standard electricity dose,and the adverse impact on the cognitive function is relatively less.The efficacy of the 20％ electricity dose is poor though the cognitive decline is also minimal.