[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.

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.

To address the common clinical problems associated with warm needling moxibustion, such as burns, bending of needle handles, and the inability to perform moxibustion during oblique needling, an adjustable warm needling moxibustion device is designed and has been granted a national patent. This device consists of five components: a moxa cylinder, an adjustable arm, a supporting tube, a temperature alarm, and a fixing strap. It allows infrared heat radiation from the moxa to pass through while blocking falling ash, thereby ensuring therapeutic efficacy and preventing burns. The device accommodates both perpendicular and oblique needling angles and adapts to various body positions, effectively avoiding deformation of the needle handle. It is easy to operate and offers high safety.
Moxibustion/methods* ; Humans ; Equipment Design ; Needles

Background::The ratio of high-density lipoprotein cholesterol (HDL-C) to low-density lipoprotein cholesterol (LDL-C) predicts cardiovascular disease (CVD) endpoints, yet its prognostic validity in high-risk populations and for type 2 diabetes mellitus (T2DM)-related adverse events remains unestablished.Methods::This study included 32,609 people aged 35-75 years in Fujian Province, China, who were at high risk for CVD. The primary endpoint was all-cause mortality during follow-up. Cox proportional hazard models and restricted cubic spline (RCS) analysis were used to evaluate the correlation between the HDL-C/LDL-C ratio and the endpoints.Result::On the basis of the restricted RCS curve, the participants were classified as having a low (< 0.3), middle (0.3-0.5), or high (> 0.5) HDL-C/LDL-C ratio. Multivariate Cox regression analyses revealed that the risk of all-cause mortality (HR = 1.48, 95% CI 1.14-1.93, p < 0.01 for low; HR = 1.30, 95% CI 1.06-1.58, p < 0.05 for high) was increased in the low and high groups. Participants without T2DM who were at high risk for CVD had similar prognoses (HR = 1.65, 95% CI 1.19-2.28, p < 0.01 for low; HR = 1.35, 95% CI 1.05-1.74, p < 0.01 for high). However, this association was not found in participants with T2DM who were at high risk for CVD. Conclusion::HDL-C/LDL-C can be used to predict the prognosis of individuals at high risk for CVD, and maintaining HDL-C/LDL-C ratios between 0.3 and 0.5 may be the most helpful range for this population. Furthermore, maintaining this ratio range holds clinical significance for cohorts without T2DM, although further exploration is needed in this T2DM cohort.

Background::The ratio of high-density lipoprotein cholesterol (HDL-C) to low-density lipoprotein cholesterol (LDL-C) predicts cardiovascular disease (CVD) endpoints, yet its prognostic validity in high-risk populations and for type 2 diabetes mellitus (T2DM)-related adverse events remains unestablished.Methods::This study included 32,609 people aged 35-75 years in Fujian Province, China, who were at high risk for CVD. The primary endpoint was all-cause mortality during follow-up. Cox proportional hazard models and restricted cubic spline (RCS) analysis were used to evaluate the correlation between the HDL-C/LDL-C ratio and the endpoints.Result::On the basis of the restricted RCS curve, the participants were classified as having a low (< 0.3), middle (0.3-0.5), or high (> 0.5) HDL-C/LDL-C ratio. Multivariate Cox regression analyses revealed that the risk of all-cause mortality (HR = 1.48, 95% CI 1.14-1.93, p < 0.01 for low; HR = 1.30, 95% CI 1.06-1.58, p < 0.05 for high) was increased in the low and high groups. Participants without T2DM who were at high risk for CVD had similar prognoses (HR = 1.65, 95% CI 1.19-2.28, p < 0.01 for low; HR = 1.35, 95% CI 1.05-1.74, p < 0.01 for high). However, this association was not found in participants with T2DM who were at high risk for CVD. Conclusion::HDL-C/LDL-C can be used to predict the prognosis of individuals at high risk for CVD, and maintaining HDL-C/LDL-C ratios between 0.3 and 0.5 may be the most helpful range for this population. Furthermore, maintaining this ratio range holds clinical significance for cohorts without T2DM, although further exploration is needed in this T2DM cohort.

BACKGROUND:For the replacement treatment of long-segment tracheal defects,although tissue engineering research has made some progress in recent years,it is still not perfect,and one of the biggest difficulties is that the hemodynamic reconstruction of the tracheal replacement cannot be achieved rapidly. OBJECTIVE:To preliminarily explore the potential of polycaprolactone scaffolds modified with exosome-loaded hydrogels to construct a rapidly vascularized tracheal substitute. METHODS:Exosomes were extracted from bone marrow mesenchymal stem cells of SD rats.After preparation of hyaluronic acid methacrylate solution,the exosome solution was mixed with hyaluronic acid methacrylate solution at a volume ratio of 1:1.Hyaluronic acid methacrylate hydrogels loaded with exosomes were prepared under ultraviolet irradiation for 5 minutes.The degradation of exosome-unloaded hydrogels and the controlled release of exosome-loaded hydrogels were detected.Polycaprolactone scaffolds were prepared by 3D printing.The pure hyaluronic acid methacrylate solution and the exosome-loaded hyaluronic acid methacrylate solution were respectively added to the surface of the scaffold.Hydrogel-modified scaffolds and exosome-modified scaffolds were obtained after ultraviolet irradiation.Thirty SD rats were randomly divided into three groups with 10 rats in each group and subcutaneously implanted with simple scaffolds,hydrogel-modified scaffolds and exosome-modified scaffolds,respectively.At 30 days after surgery,the scaffolds and surrounding tissues of each group were removed.Neovascularization was observed by hematoxylin-eosin staining and Masson staining and the expression of CD31 was detected by immunofluorescence. RESULTS AND CONCLUSION:(1)As time went by,the hydrogel degraded gradually,and the exosomes enclosed in the hydrogel were gradually released,which could be sustained for more than 30 days.The exosome release rate was faster than the degradation rate of the hydrogel itself,and nearly 20%of the exosomes were still not released after 30 days of soaking.(2)Under a scanning electron microscope,the surface of the simple polycaprolactone scaffold was rough.After hydrogel modification,a layer of gel was covered between the pores of the scaffold,and the scaffold surface became smooth and dense.(3)After 30 days of subcutaneous embedding,hematoxylin-eosin staining and Masson staining showed that more neovascularization was observed inside the scaffolds of the exosome-modified scaffold group compared with the hydrogel-modified scaffold group.The hydrogels on the scaffolds of the two groups were not completely degraded.Immunofluorescence staining showed that CD31 expression in the exosome-modified scaffold group was higher than that in the hydrogel-modified scaffold group(P<0.000 1).(4)These results indicate that hyaluronic acid methacrylate hydrogels can be used as controlled-release carriers for exosomes.The 3D-printed polycaprolactone scaffold modified by hyaluronic acid methacrylate hydrogel loaded with exosomes has good biocompatibility and has the potential to promote the formation of neovascularization.

Objective:This study explores the relationship between emotional dysregulation, attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) symptoms using network models.Method:A total of 967 children with ADHD comorbid ODD were recruited from the outpatient department of Peking University Sixth Hospital from September 2002 to June 2022. All subjects were rated for the ADHD symptom severity using the ADHD symptom rating scale. ODD symptoms and emotional dysregulation symptoms were assessed by the Children′s Clinical Diagnostic Interview Scale, and the Conners′ Parent Symptom Questionnaire. R (version 4.2.1) packages mgm, qgraph, bnlearn, etc. were used for network analysis, and centrality indices were calculated to define central symptoms and bridge symptoms. Results:The relationship between emotional dysregulation and ODD symptoms was closer. ODD symptoms had higher strength indices, especially the items "gets annoyed or irritated by the behavior of adults"(strength=3.57) and "loses temper or gets angry with adults when does not get his or her own way"(strength=2.32). Emotional dysregulation symptoms had a higher bridge strength indices, with "temper outbursts, explosive and unpredictable behavior" (bridge strength=2.64) as the most prominent item. Bayesian network analysis showed that ADHD symptoms were at the upper of DAG, directly linked with emotional dysregulation symptoms and indirectly linked with ODD symptoms through emotional dysregulation symptoms.Conclusion:Emotional dysregulation symptoms were more closely associated with ODD symptoms than ADHD symptoms, and might potentially acted as bridge symptoms between ADHD and ODD. ADHD symptoms might drive ODD symptoms indirectly through emotional dysregulation symptoms.

Objective:This study explores the relationship between emotional dysregulation, attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) symptoms using network models.Method:A total of 967 children with ADHD comorbid ODD were recruited from the outpatient department of Peking University Sixth Hospital from September 2002 to June 2022. All subjects were rated for the ADHD symptom severity using the ADHD symptom rating scale. ODD symptoms and emotional dysregulation symptoms were assessed by the Children′s Clinical Diagnostic Interview Scale, and the Conners′ Parent Symptom Questionnaire. R (version 4.2.1) packages mgm, qgraph, bnlearn, etc. were used for network analysis, and centrality indices were calculated to define central symptoms and bridge symptoms. Results:The relationship between emotional dysregulation and ODD symptoms was closer. ODD symptoms had higher strength indices, especially the items "gets annoyed or irritated by the behavior of adults"(strength=3.57) and "loses temper or gets angry with adults when does not get his or her own way"(strength=2.32). Emotional dysregulation symptoms had a higher bridge strength indices, with "temper outbursts, explosive and unpredictable behavior" (bridge strength=2.64) as the most prominent item. Bayesian network analysis showed that ADHD symptoms were at the upper of DAG, directly linked with emotional dysregulation symptoms and indirectly linked with ODD symptoms through emotional dysregulation symptoms.Conclusion:Emotional dysregulation symptoms were more closely associated with ODD symptoms than ADHD symptoms, and might potentially acted as bridge symptoms between ADHD and ODD. ADHD symptoms might drive ODD symptoms indirectly through emotional dysregulation symptoms.

Objective:To investigate the medical students' general understanding of online teaching and online learning of medical courses during the COVID-19 epidemic, and to analyze the satisfaction with online medical curriculum and its influencing factors.Methods:A total of 188 medical students in Xiangya School of Medicine of Central South University were investigated anonymously with a self-designed questionnaire. SPSS 26.0 was used for analyzing the relevant data, t test or variance analysis was conducted for coparison between groups, with test level α= 0.05. Results:The 88.83% (167) of the students believed that online teaching was much necessary, and the greatest advantage of online teaching was that they could arrange their learning time freely. However, 59.57%(112) of the students thought that the learning consciousness was reduced, and 49.47% (93) of the teachers were inadaptable to the change of teaching platform and 59.57% (112) teachers could not adapt to the change of teaching may be the main reasons affecting the teaching quality.Conclusion:Students have a high degree of acceptance of online teaching during the epidemic, but there are some problems such as decreased self-discipline, insufficient interaction between teachers and students, dissatisfaction with the construction of online course platform, inability to visit the laboratory and practice in the hospital, and so on. The investigation is still helpful to revise the medical education model in the post-epidemic period and the future. Our results suggest that the combination of online and offline teaching mode can be adopted in medical theory class and PBL discussion class, and at the same time, the construction of online learning resources for clinical practice and medical experiments should be strengthened.

Objective:To investigate the effect of arterialised Flow-through venous flap with palmaris longus tendon in repairing dorsal digit composite tissue defect.Methods:From March, 2010 to December, 2018, 23 cases (23 digits) of dorsal digit composite tissue defect were repaired with arterialised Flow-through venous flap with palmaris longus tendon. There were 17 males and 6 females aged between 23 to 53 (average, 37.2) years old. Causes of injury: 15 cases of strangulation, 5 of electric plane and 3 of thermal crush. Number of injured digit were 1 thumb, 11 index fingers, 9 middle fingers and 2 ring fingers. All of the injured digits had skin and extensor tendon defects with an area of 2.0 cm×1.8 cm-4.2 cm×2.6 cm, and the length of extensor tendon defect was 1.6-2.6 cm. One case had terminal and central tendon insertion defects and 5 suffered with terminal tendon insertion defect. Three cases were repaired by emergency surgery, and 20 were repaired by sub-emergency surgery. All donor sites were directly sutured. The shape, colour, texture, sensation, recovery of digit function and donor site appearance were followed-up at outpatient clinic.Results:The patients were followed-up for 8 to 23 (average, 11) months. The flap was soft, with mild pigmentation and recovery of protective sensation. The range of motion of the proximal and distal interphalangeal joints was 145°-170° (average,162.6°). According to Strickland hand function evaluation method, the results were excellent.Conclusion:The arterialised Flow-through venous flap with palmaris longus tendon is an ideal method in repair of the dorsal digit composite tissue defect.