[Objective] To analyze the loss rate of platelet donors and evaluate the strategies for establishing a platelet donor bank. [Methods] A total of 1 443 donors who joined the HLA and HPA gene donor bank for platelets in Henan Province from 2018 to 2020 were included in this study. Data on the total number of apheresis platelet donations, annual donation frequency, age at enrollment, donation habits (including the number of platelets donated per session and whether they had previously donated whole blood), and enrollment location were collected from the platelet donor information management system. Donor loss was determined based on the date of their last donation. The loss rates of different groups under various conditions were compared to assess the enrollment strategies. [Results] By the time the platelet bank was officially operational in 2022, 421 donors had been lost, resulting in an loss rate of 29% (421/1 443). By the end of 2023, the overall cumulative loss rate reached 52% (746/1 443). The loss rate was lower than the overall level in groups meeting any of the following conditions: total apheresis platelet donations exceeding 50, annual donation frequency of 10 or more, age at enrollment of 40 years or older, donation of more than a single therapeutic dose per session, or a history of whole blood donation two or more times. Additionally, loss rates varied across different enrollment locations, with higher enrollment numbers generally associated with higher loss rates. [Conclusion] Through a comprehensive analysis of donor loss, our center has adjusted its strategies for establishing the donor pool. These findings also provide valuable insights for other blood collection and supply institutions in building platelet donor banks.

This study aims to develop a fully automated method for tooth segmentation and root canal measurement based on cone beam computed tomography (CBCT) images, providing objective, efficient, and accurate measurement results to guide and assist clinicians in root canal diagnosis grading, instrument selection, and preoperative planning. The method utilized Attention U-Net to recognize tooth descriptors, cropped regions of interest (ROIs) based on the center of mass of these descriptors, and applied an integrated deep learning method for segmentation. The segmentation results were mapped back to the original coordinates and position-corrected, followed by automatic measurement and visualization of root canal lengths and angles. The results indicated that the Dice coefficient for segmentation was 96.42%, the Jaccard coefficient was 93.11%, the Hausdorff Distance was 2.07 mm, and the average surface distance was 0.23 mm, all of which surpassed existing methods. The relative error of the root canal working length measurement was 3.15% (< 5%), the curvature angle error was 2.85 °, and the correct classification rate of the treatment difficulty coefficient was 90.48%. The proposed methods all achieved favorable results, which can provide an important reference for clinical application.
Cone-Beam Computed Tomography/methods* ; Deep Learning ; Humans ; Dental Pulp Cavity/diagnostic imaging* ; Image Processing, Computer-Assisted/methods*

The catalytic activity of 3-mercaptopyruvate (3MP) sulfurtransferase (MPST) converts 3MP to hydrogen sulfide (H₂S). However, the regulatory mechanisms governing MPST and its impact on the brain remain largely unexplored. Our study reveals the neuroprotective role of endothelial MPST-generated H₂S, regulated by protein phosphatase 2A (PP2A). Bioinformatics analysis and RNA sequencing demonstrated that endothelial PP2A is associated with neurodegenerative disease pathways. Cerebral ischemic mice exhibited significant inactivation of endothelial PP2A, evidenced by the reduction of PP2Acα in the brain endothelium. Mice with endothelium-specific null PP2A (PP2A^EC-cKO) exhibited neuronal loss, cognitive dysfunction, and long-term potentiation deficits. Postnatal inactivation of endothelial PP2A also contributes to cognitive dysfunction and neuronal loss. However, regaining endothelial PP2A activity by overexpressing Ppp2ca rescued neuronal dysfunction. Mechanistically, PP2A deficiency is intricately linked to the MPST-H₂S signaling pathway. A robust reduction in endothelial MPST-dependent H₂S production followed PP2A deficiency. Exogenous H₂S treatment and AAV-mediated overexpression of MPST in brain endothelial cells significantly mitigated neuronal dysfunction in PP2A^EC-cKO mice. Furthermore, PP2A deficiency promotes an increase in calcium influx and calpain2 phosphorylation, subsequently leading to MPST degradation. The PP2A activator (FTY720) and MPST activator (3MP sodium) both remarkably restored endothelial MPST-dependent H₂S production, subsequently rescuing ischemia-induced neurological deficits. In conclusion, our study demonstrates that endothelial PP2A deficiency leads to MPST degradation by activating calpain2, thus damaging neuronal function.

Probiotics have shown excellent application prospects in preventing and treating many diseases. However, their sensitivity to the harsh environment in vivo always leads to a massive loss of viability and insufficient therapeutic effect. Fortunately, modified probiotics have emerged and provide multiple possibilities for their use in various diseases. Modification not only endows probiotics with extra capacity to resist severe environments but also gives them exogenous characteristics, such as prolonged retention time and improved therapeutic effects. Modified probiotics could combine with other therapies, which has opened up new avenues to enhance the efficacy of probiotic-based therapy. In this review, we have summarized the current physicochemical and biological modification strategies of probiotics. In addition, the progress of research on probiotic-based combination therapy has also been extensively reviewed, which contributes to the enhanced delivery of probiotics or other active constituents and provides new ideas for disease treatment, bioimaging, and diagnosis.

Objective:To develop a nomogram model for predicting the risk of ventilator-associated pneumonia (VAP) in patients with mechanical ventilation (MV) and to validate the stability of the prediction performance of the model.Methods:The patients with MV admitted to the Department of Critical Care Medicine of General Hospital of Ningxia Medical University from January 2019 to December 2022 were retrospectively selected according to the order of admission. The patients with MV were divided into the non-VAP group and the VAP group according to whether VAP occurred. The clinical data of the two groups, including general information, disease, medication, condition, and operation-related indicators were collected as candidate predictors of the model for comparison. Multivariate logistic stepwise forward regression analysis was used to screen the predictors that finally entered the model, and a nomogram model was constructed. The model discrimination was evaluated by the area under the receiver operating characteristic curve (AUC), the diagnostic test results of the model at the predicted threshold were calculated, the Hosmer-Lemeshow test was used to evaluate the model fit, and the Bootstrap resampling was used 1 000 times for internal validation, and model calibration and clinical applicability were evaluated by calibration curve and decision analysis curve, respectively.Results:A total of 1 250 patients with MV were included, including 1 102 patients in the non-VAP group and 148 patients in the VAP group, and the prevalence of VAP was 11.8%. The detection of multidrug-resistant organisms, chronic kidney disease, brain injury, oxygenation index, the place of tracheal intubation, reintubation, use of bronchoscopy, use of antibiotics, and MV duration were model predictors of VAP. The AUC of the nomogram model was 0.917 (95% CI: 0.895-0.939), the maximum Youden index of 0.697 corresponded to a prediction threshold of 0.096. The model accuracy, sensitivity and specificity were 0.836, 0.865, and 0.832, respectively. The positive predictive value and the negative predictive value were 0.409 and 0.979, respectively. The Hosmer- Lemeshow test indicated that the model fit well ( P=0.938). The results of the internal validation of the model showed that the predicted risk of the calibration curve was generally consistent with the actual risk, and the decision threshold probability of the decision analysis curve ranged from 2% to 90%. Conclusions:The nomogram model developed in this study is simple, convenient and has relatively stable prediction performance, which can be externally validated to evaluate the extrapolation of the model, and provide a basis for individualized clinical prediction of the risk of VAP in patients with MV.

OBJECTIVE To explore the effect of respiratory syncytial virus(RSV)infection on the expression of key factors in the epithelial barrier of the human nasal epithelial cells(hNECs)derived from patients with chronic rhinosinusitis with nasal polyps(CRSwNP)and normal control mucosa.METHODS RSV with different multiplicity of infection(MOI)(0.1 and 0.3)infected hNECs derived from patients with CRSwNP(n=21)and normal control mucosa(n=9)for 24 h and 48 h,respectively.To detect the gene expression ZO-1,ZO-2,Claudin-1,Claudin-4,Occludin,E-cadherin and N-cadherin,total RNA was extracted and reverse transcribed into cDNA for real-time fluorescence quantification PCR.RESULTS The relative expression level of ZO-1,ZO-2,Claudin-1,Claudin-4,Occludin,E-cadherin and N-cadherin were decreased in hNECs post RSV infection.However,there was a statistical difference only in hNECs derived from CRSwNP(P<0.05).There was no significant difference in hNECs infected with RSV between eosinophilic CRSwNP(ECRSwNP)and non-eosinophilic CRSwNP(nonECRSwNP).CONCLUSION RSV infection could disrupt the epithelial barrier of the nasal mucosa,and patients with CRSwNP are more severely affected by RSV infection compared to healthy controls.The impact of RSV infection on mucosa between ECRSwNP group and nonECRSwNP group was no significant difference.

To describe and evaluate the clinical studies of postoperative pain sensitization caused by sleep deprivation through the evidence map system, understand the distribution of evidence in this field, and provide reference for subsequent evidence research.

Objective:To assess the enhancement characteristics of responsibility plaque of patients with intracranial artery stenosis(ICAS)and explore the correlation between that and stroke by using three dimensional high-resolution magnetic resonance imaging(3D-HR-MRI).Methods:A total of 72 ICAS patients who admitted to Beijing Huairou Hospital from April 2019 to April 2022 were retrospectively selected as the study objects,with a total of 96 atherosclerotic stenosis plaques.The plaques were divided into mild to moderate stenosis group(33 cases)and severe stenosis group(63 cases)according to the results of whole brain digital subtraction angiography.They were also were divided into sub-acute/acute plaque group(within 1 month)(47 cases)and non-acute plaque group(including chronic and non-responsible plaques)(49 cases)according to the time of occurring plaque.The imaging characteristics of the 3D-HR-MRI results were assessed by two radiologists.The degrees of plaque enhancement referred to the degrees of pituitary enhancement,and the degrees of plaque enhancement were divided into significant enhancement group(52 cases)and non-significant enhancement group that included moderate enhancement group and non-enhancement group(44 cases).The relationships between ICAS,degree of plaque enhancement and stroke were analyzed.Results:A total of 96 atherosclerotic stenosis plaques were confirmed in 72 patients.The statistical analysis of Kruskal-Wallis H test of multiple samples showed that there was a significant correlation between the time of occurring plaque and the degree of plaque enhancement(H=3.294,P＜0.05).Univariate Logistic regression analysis indicated that the difference between the acute plaque group and the non-acute plaque group was respectively significant correlations with ICAS degree[P＜0.05,OR(95%CI)=1.0(0.3-2.6)]and degree of plaque enhancement[P＜0.05,OR(95%CI)=1.0(0.4-2.0)].The multivariate Logistic regression analysis demonstrated that both severe arterial stenosis[P＜0.05,OR(95%CI)=1.0(0.3-1.9)]and significant enhancement of plaque[P＜0.05,OR(95%CI)=1.0(0.4-2.1)]were independent risk factors of stroke.Conclusion:Severe ICAS and significant plaque enhancement are the independent risk factors of stroke,which can provide effective basis for clinical prevention,diagnosis and treatment of stroke.

Objective To observe the value of contrast-enhanced CT radiomics combined with clinical and hematology indicators for predicting lymph node(LN)metastasis(LNM)of esophageal squamous cell carcinoma(ESCC).Methods Totally 218 ESCC patients were retrospectively enrolled.Stage pN1 and pN2 were clustering as LNM(n=90),while stage pN0 were taken as non-LNM(n=128).The patients were divided into training set(n=174)and test set(n=44)at the ratio of 8∶2.In training set,clinical and LN imaging features which could be used to independently judge LNM were screened and a clinical-imaging model was constructed.The hematological indicators that might be associated with ESCC LNM were screened,and a hematological model was constructed.Radiomics features in LN ROI and ESCC volume of interest(VOI)were extracted based on venous-phase contrast-enhanced CT images,and those might be associated with LNM were screened,and a radiomics model was constructed.Finally a combined model was constructed based on all the above features.The efficacy of each model for diagnosing LNM was evaluated with the area under the curve(AUC)of receiver operating characteristic curves,and the clinical net benefit was evaluated using decision curve analysis(DCA).Results Body mass index(BMI)and internal necrosis of target LN were both independent judging factors for ESCC LNM(both P＜0.05),and AUC of clinical-imaging model for diagnosing LNM in training and test sets was 0.747 and 0.687,respectively.Seven hematological indicators were included in hematological model,and AUC in training and test sets was 0.623 and 0.583,respectively.Ten LN radiomics features and 15 ESCC radiomics features were included in radiomics model,and AUC in training and test sets was 0.769 and 0.745,respectively.AUC of the combined model for diagnosing LNM in training and test sets was 0.822 and 0.739,respectively,better than other models in training set(all P＜0.05),but no significantly different in test set(all P＞0.05).DCA showed that combined model had higher net gain than the other models in 0.55-0.80 threshold probability interval.Conclusion Combined model based on venous-phase contrast-enhanced CT radiomics and clinical and hematology indicators could relatively effectively evaluate ESCC LNM,which might bring some promotions in clinical benefit.

Objective:To investigate the characteristics and distribution of plaque of patients with mild middle cerebral artery(MCA)stenosis by using three dimensional(3D)high-resolution magnetic resonance imaging(3D HR-MRI),and the correlation between that and the occurrence of ischemic stroke.Methods:The clinical data of 64 patients with mild MCA stenosis who admitted to Beijing Huairou hospital from March 2020 to March 2022 were retrospectively analyzed.They were divided into symptomatic group(n=30)and asymptomatic group(n=34)according to whether occurred transient ischemic cerebral attack or ischemic cerebral stroke.The degree and distribution of plaque enhancement between the two groups were assessed and analyzed,and the correlation of plaque features in HR-MRI and ischemic stroke was analyzed.Results:There were a total of 71 plaques in 64 patients,including 30 responsible plaques and 41 non-responsible plaques.The enhancement degree of responsible plaques was significantly stronger than that of non-responsible plaques,and the difference was statistically significant(Z=5.645,P<0.05).Compared with non-responsible plaques,the responsible plaques more concentrated at the dorsal and upper walls of MCA,and the probability of occurring positive remodeling of responsible plaques was greater than that of non-responsible plaques,with statistical significance(x2=7.658,P<0.05).Conclusion:In patients with mild MCA stenosis,the degree enhancement and distribution location of plaque,and positively remodeling index of vessel are closely related to the occurrence of ischemic cerebral stroke.