Objective: To investigate the role of ferroptosis in transfusion-related acute lung injury (TRALI) and evaluate the efficacy of the specific inhibitor Ferrostatin-1 (Fer-1), thereby to provide a basis for the prevention and treatment of TRALI. Methods: This study utilized a ”2-hit” model to induce TRALI in mice. The mouse model of TRALI was validated through survival curve analysis, lung tissue wet/dry weight ratio (W/D), myeloperoxidase (MPO) activity, and total protein concentration in lung tissue. Samples from the TRALI model group, LPS group, and control group (n=6) were collected. The occurrence of ferroptosis in TRALI was confirmed by measuring key ferroptosis indicators, including iron concentration in lung tissue, malondialdehyde (MDA) level, lipid peroxidation products (LPO) level, and expression levels of related proteins (GPX4, ACSL4). Additionally, a Fer-1 intervention group was added to evaluate its preventive and therapeutic effects. The survival rates and clinical symptoms of the four groups (n=6) were dynamically monitored, and the degrees of lung injury were assessed. Ferroptosis-related indicators were also measured to elucidate the protective mechanism of Fer-1. Results: A mouse model of TRALI was successfully established. Compared to the control and LPS groups, the TRALI group showed significantly higher levels of ferrous iron [(18.32±1.11) nmol/well, MDA [(14.68±0.96) μmol/L], and LPO [(1.60±0.02) μmol/L] in lung tissue (all P<0.01), along with a downregulation of GPX4 and an upregulation of ACSL4. Fer-1 pretreatment significantly reversed these abnormalities: the W/D ratio decreased to 4.01±0.43, and MPO activity significantly decreased [Fer-1 group: (21 606±4 235) pg/mL vs TRALI group: (30 724±2 616) pg/mL], the total protein concentration in lung tissue of the Fer-1 group decreased by approximately 40.8% compared to the TRALI group (all P<0.01). These changes indicate that the lung injury in mice was alleviated after treatment. Following Fer-1 intervention, ferrous iron concentration [(7.46±1.83) nmol/well] was restored to a level close to that of the control group [(5.48±0.70) nmol/well]. Lipid peroxidation tests further revealed that Fer-1 intervention reduced MDA and LPO levels by 35.8% and 29.4%, respectively (P<0.001). Additionally, the expression levels of GPX4 and ACSL4 proteins returned to near-normal levels in the treated mice (both P>0.05). Conclusion: The progression of TRALI is closely related to the activation of ferroptosis, characterized by iron overload, lipid peroxidation accumulation, and the imbalance of GPX4/ACSL4. Ferrostatin-1 significantly alleviates pulmonary edema and inflammatory damage by inhibiting the ferroptosis pathway, suggesting that targeting ferroptosis may provide a new therapeutic strategy for TRALI.

Objective:To analyze the epidemiological characteristics and risk factors of rotavirus infected in children aged 3-5 years seeking treatment for diarrhea in Jining area.Methods:The epidemiological data of 698 children aged 3-5 years seeking treatment for diarrhea in Jining area hospitals from September 2022 to September 2023 were collected, and fecal samples were collected for laboratory examination. The epidemiological characteristics of the rotavirus infection were analyzed, and logistic regression analysis was applied to analyze the risk factors of rotavirus infection in children aged 3-5 years seeking treatment for diarrhea in Jining area. A predictive model of rotavirus infection in children aged 3-5 years seeking treatment for diarrhea in Jining area was established based on decision tree, and the predictive performance of the model was verified by receiver operating characteristic (ROC) curve.Results:The detection of rotavirus antigen showed 302 positive cases, with a positive rate of 43.27% (302/698). Gender distribution: There was no statistically significant difference in the positive rate of rotavirus infection in these diseased children etween different genders ( χ2=1.862, P=0.172). Age distribution: The positive rate of rotavirus infection in these diseased children showed a decreasing trend with age ( χ2=28.893, P<0.001). Time distribution: There was a statistically significant difference in the positive rate of rotavirus infection in these diseased children among different months ( χ2=241.607, P<0.001), showing obvious seasonal characteristics, the high incidence months were from October to the following March, the highest positive rate was in December, and the lowest was in July. Rotavirus genotype: The G genotype result showed that G9 was the most common, P genotype result showed that P[8] was the most common, and the G/P combination genotype result showed that G9P[8] was the most common. Multivariate Logistic regression analysis showed that having finger sucking habits ( OR=4.193, P=0.018), lack of vaccination against rotavirus ( OR=1.947, P=0.002), whether to clean hands before feeding ( OR=4.719, P=0.007), and a history of contact with rotavirus infected children ( OR=4.976, P=0.001) were independent risk factors for rotavirus infection in children aged 3-5 years old who seek treatment for diarrhea in Jining area. The sensitivity of the decision tree model was 58.94%, the specificity was 87.12%, and the AUC was 0.814, indicating that the four selected risk factors could predict rotavirus infection well. Conclusions:Children aged 3-5 years old who seek treatment for diarrhea in Jining area have a relatively high positive rate of rotavirus infection, showing obvious age and time characteristics. The genotype distribution was mainly G9, P[8], and G9P[8]. Rotavirus infection is related to finger sucking habits, lack of vaccination against rotavirus, whether to clean hands before feeding, and a history of contact with rotavirus infected children.

Objective:To analyze the factors affecting delayed chemotherapy in children with Burkitt lymphoma (BL) and their influence on prognosis.Methods:Retrospective cohort study. Clinical data of 591 children aged ≤18 years with BL from May 2017 to December 2022 in China Net Childhood Lymphoma (CNCL) was collected. The patients were treated according to the protocol CNCL-BL-2017. According to the clinical characteristics, therapeutic regimen was divided into group A, group B and group C .Based on whether the total chemotherapy time was delayed, patients were divided into two groups: the delayed chemotherapy group and the non-delayed chemotherapy group. Based on the total delayed time of chemotherapy, patients in group C were divided into non-delayed chemotherapy group, 1-7 days delayed group and more than 7 days delayed group. Relationships between delayed chemotherapy and gender, age, tumor lysis syndrome before chemotherapy, bone marrow involvement, disease group (B/C group), serum lactate dehydrogenase (LDH) > 4 times than normal, grade Ⅲ-Ⅳ myelosuppression after chemotherapy, minimal residual disease in the interim assessment, and severe infection (including severe pneumonia, sepsis, meningitis, chickenpox, etc.) were analyzed. Logistic analysis was used to identify the relevant factors. Kaplan-Meier method was used to analyze the patients' survival information. Log-Rank was used for comparison between groups.Results:Among 591 patients, 504 were males and 87 were females, the follow-up time was 34.8 (18.6,50.1) months. The 3-year overall survival (OS) rate was (92.5±1.1)%,and the 3-year event-free survival (EFS) rate was (90.5±1.2)%. Seventy-three (12.4%) patients were in delayed chemotherapy group and 518 (87.6%) patients were in non-delayed chemotherapy group. The reasons for chemotherapy delay included 72 cases (98.6%) of severe infection, 65 cases (89.0%) of bone marrow suppression, 35 cases (47.9%) of organ dysfunction, 22 cases (30.1%) of tumor lysis syndrome,etc. There were 7 cases of chemotherapy delay in group B, which were seen in COPADM (vincristine+cyclophosphamide+prednisone+daunorubicin+methotrexate+intrathecal injection,4 cases) and CYM (methotrexate+cytarabine+intrathecal injection,3 cases) stages. There were 66 cases of chemotherapy delay in group C, which were common in COPADM (28 cases) and CYVE 1 (low dose cytarabine+high dose cytarabine+etoposide+methotrexate, 12 cases) stages. Multinomial Logistic regression analysis showed that the age over 10 years old ( OR=0.54,95% CI 0.30-0.93), tumor lysis syndrome before chemotherapy ( OR=0.48,95% CI 0.27-0.84) and grade Ⅲ-Ⅳ myelosuppression after chemotherapy ( OR=0.55,95% CI 0.33-0.91)were independent risk factors for chemotherapy delay.The 3-year OS rate and the 3-year EFS rate of children with Burkitt lymphoma in the delayed chemotherapy group were lower than those in the non-delayed chemotherapy group ((79.4±4.9)% vs. (94.2±1.1)%, (80.2±4.8)% vs. (92.0±1.2)%,both P<0.05). The 3-year OS rate of the group C with chemotherapy delay >7 days (42 cases) was lower than that of the group with chemotherapy delay of 1-7 days (22 cases) and the non-delay group (399 cases) ((76.7±6.9)% vs. (81.8±8.2)% vs. (92.7±1.3)%, P=0.002).The 3-year OS rate of the chemotherapy delay group (9 cases) in the COP (vincristine+cyclophosphamide+prednisone) phase was lower than that of the non-chemotherapy delay group (454 cases) ((66.7±15.7)% vs. (91.3±1.4)%, P=0.005). Similarly, the 3-year OS rate of the chemotherapy delay group (11 cases) in the COPADM1 phase was lower than that of the non-chemotherapy delay group (452 cases) ((63.6±14.5)% vs. (91.5±1.3)%, P=0.001). Conclusions:The delayed chemotherapy was related to the age over 10 years old, tumor lysis syndrome before chemotherapy and grade Ⅲ-Ⅳ myelosuppression after chemotherapy in pediatric BL. There is a significant relationship between delayed chemotherapy and prognosis of BL in children.

In order to understand the infection and molecular genetic characteristics of goose astro-virus(GAstV)in Hotan,Xinjiang,visceral organs and swabs of dead goslings were collected asep-tically from three goose farms in Hotan,Yutian and Pashan counties,and GAstV was detected by RT-PCR.The positive samples were screened and identified in LMH cells,and the whole genome was sequenced,and the genetic characteristics of the isolates were analyzed.The results showed that the total positive rate of GAstV was 11.25％(65/578).Two strains of GAstV named as GAstV/XJHT-1 and GAstV/XJHT-2 were isolated and the lengths of their genome sequences were determined as 7 190 bp and 7 125 bp,respectively.Whole genome homology analysis showed that the homology of the two isolates with GAstV-1 and GAstV-2 was higher than 95％,and the homology with other sources(chicken,duck,and turkey)ranged from 54.1％to 61.5％.Genetic e-volution analysis showed that the genetic distance between GAstV isolates from Henan and Anhui was relatively close,suggesting that the isolated GAstV may be related to the introduction of gos-lings or goose eggs from these two places.The findings provide a basis for further development of vaccines or control products.

Objective:To investigate the clinical and genetic characteristics and predictive role of the severe liver disease phenotype in patients with hepatolenticular degeneration (HLD).Methods:Inpatients with HLD confirmed at Xinhua Hospital affiliated with Shanghai Jiao Tong University School of Medicine from January 1989 to December 2022 were selected as the research subjects. Clinical classification was performed according to the affected organs. Patients with liver disease phenotypes were classified into the liver disease group and further divided into the severe liver disease group and the ordinary liver disease group. The clinical characteristics and genetic variations were compared in each group of patients. The predictive indicators of patients with severe liver disease were analyzed by multiple regression. Statistical analysis was performed using the t-test, Mann-Whitney U test, or χ2 test according to different data. Results:Of the 159 HLD cases, 142 were in the liver disease group (34 in the severe liver disease group and 108 in the ordinary liver disease group), and 17 were in the encephalopathy group. The median age of onset was statistically significantly different between the liver disease group and the encephalopathy group [12.6 (7.0, 13.3) years versus 16.9 (11.0, 21.5) years, P<0.01]. 156 ATP7B gene mutation sites were found in 83 cases with genetic testing results, of which 54 cases carried the p.Arg778Leu gene mutation (allele frequency 46.2%). Compared with patients with other types of gene mutations ( n=65), patients with homozygous p.Arg778Leu mutations ( n=18) had lower blood ceruloplasmin and albumin levels, a higher prognostic index, Child-Pugh score, an international normalized ratio, and prothrombin time ( P<0.05). Hemolytic anemia, corneal K-F ring, homozygous p.Arg778Leu mutation, and multiple laboratory indexes in the severe liver disease group were statistically significantly different from those in the ordinary liver disease group ( P<0.05). Multivariate logistic regression analysis showed that the predictive factors for severe liver disease were homozygous p.Arg778Leu mutation, total bilirubin, and bile acids ( ORs=16.512, 1.022, 1.021, 95% CI: 1.204-226.425, 1.005-1.039, and 1.006-1.037, respectively, P<0.05). The drawn ROC curve demonstrated a cutoff value of 0.215 3, an AUC of 0.953 2, and sensitivity and specificity of 90.91% and 92.42%, respectively. Conclusion:Liver disease phenotypes are common in HLD patients and have an early onset. Total bilirubin, bile acids, and the homozygous p.Arg778Leu mutation of ATP7B is related to the severity of liver disease in HLD patients, which aids in predicting the occurrence and risk of severe liver disease.

Humans ; Lymphoma, Follicular ; Lymph Nodes

Humans ; Colon, Sigmoid ; Hamartoma/surgery* ; Schwann Cells ; Mucous Membrane

Influenza B virus is one of the causes for seasonal influenza, which can account for serious illness or even death in some cases. We tested the expression of extracellular domain of hemagglutinin (HA-ecto) of influenza B viruses in mammalian cells, and then determined the immunogenicity of HA-ecto in mice. The gene sequence encoding influenza B virus HA-ecto, foldon sequence, and HIS tag was optimized and inserted into pCAGGS vector. The opening reading frame (ORF) of neuraminidase was also cloned into pCAGGS. The pCAGGS-HA-ecto and pCAGGS-NA were co-transfected into 293T cells using linear polyethylenimine. Cell supernatant after transfection was collected after 96 h, and the secreted trimmeric HA-ecto protein was purified by nickel ion affinity chromatography and size exclusion chromatography. Subsequently, the mice were immunized with HA-ecto protein, and the corresponding antibody titers were detected by ELISA and hemagglutination inhibition (HAI) assays. The results showed that soluble trimeric HA-ecto protein could be obtained using mammalian cell expression system. Moreover, trimeric HA-ecto protein, in combination with the adjuvant, induced high levels of ELISA and HAI antibodies against homogenous and heterologous antigens in mice. Thus, the soluble HA-ecto protein expressed in mammalian cells could be used as a recombinant subunit vaccine candidate for influenza B virus.
Animals ; Hemagglutinin Glycoproteins, Influenza Virus/genetics* ; Hemagglutinins/genetics* ; Influenza B virus/metabolism* ; Influenza Vaccines/genetics* ; Mammals/metabolism* ; Mice ; Mice, Inbred BALB C

Objective:To explore the effect of family-centered care (FCC) on compliance behavior, emotional behavior and quality of life in children with Helicobacter pylori (Hp) infection-associated gastritis.Methods:From March 2019 to March 2021, convenience sampling was used to select 102 children with Hp infection-associated gastritis who treated in the Affiliated Hospital of Jining Medical University and their 102 primary caregivers as the research object. The subjects were divided into the observation group and the control group by random number table method, with 51 children and 51 primary caregivers in each group. The control group received routine nursing, while the observation group implemented FCC on the basis of routine nursing. The compliance behaviors of the two groups of children were compared. Before and after nursing, the Mishel Uncertainty in Illness Scale-Family Member form (MUIS-FM) was used to evaluate the illness uncertainty of the primary caregivers of the two groups of children. The State-Trait Anxiety Inventory-Form Y (STAI-Y) and the Pediatric Quality of Life Inventory TM4.0 (PedsQL TM4.0) were used to assess the anxiety and quality of life of the two groups of children. Results:After nursing, the compliance behavior rate of the observation group was higher than that of the control group, the scores of MUIS-FM and STAI-Y were lower than those of the control group, and the score of PedsQL TM4.0 was higher than that of the control group, with statistical differences ( P<0.05) . Conclusions:The FCC for children with Hp infection-associated gastritis can effectively enhance their compliance behavior, relieve their anxiety and depression, and improve their quality of life.

Objective:To explore the chain mediating effect of self-efficacy and hope in stigma and loneliness among patients with traumatic paraplegia and provide scientific theoretical guidance for effective nursing intervention for these patients in clinical practice.Methods:Totally 307 patients with traumatic paraplegia who were admitted to the Department of Orthopedics of Jiangsu Taizhou People's Hospital from June 2017 to May 2021 were selected by convenience sampling and investigated with the general information questionnaire, General Self-efficacy Scale (GSES), Herth Hope Index (HHI), Social Impact Scale (SIS), and UCLA Loneliness Scale. Pearson correlation was used to analyze the relationship between self-efficacy, hope, stigma, and loneliness. Amos 21.0 was used to construct a structural equation model (SEM) and test the mediating effect. A total of 307 questionnaires were distributed in this study, and 292 were recovered, accounting for a recovery rate of 95.11%. After excluding the questionnaires with more than 10% regular answers and missing items, 289 valid questionnaires were obtained, and the effective recovery rate was 94.14% (289/307) .Results:There were significant differences in the total score of UCLA Loneliness Scale among patients with different gender, age, marital status, family relationship, and bedridden conditions ( P<0.05). The total score of self-efficacy among the 289 patients with traumatic paraplegia was (25.54±3.37) ; the total score of hope was (27.73±3.66) ; the total score of stigma was (65.97±8.35) ; the total score of loneliness was (53.82±6.78). Pearson correlation analysis showed that loneliness was positively correlated with stigma ( P<0.05), and negatively correlated with self-efficacy and hope ( P<0.05). The mediating effect of stigma on loneliness in patients with traumatic paraplegia was established, and the total indirect effect accounted for 46.39% of the total effect, of which the specific mediating effects of self-efficacy and hope accounted for 19.91% and 19.12%, respectively. The chain mediating effect of self-efficacy and hope between stigma and loneliness accounted for 7.37%. Conclusions:The scores of self-efficacy, hope, stigma, and loneliness in patients with traumatic paraplegia are all at moderate levels. Loneliness is positively correlated with stigma, and negatively correlated with self-efficacy and hope. The chain mediating effect of self0effect between self-efficacy and hope between stigma and loneliness is established, suggesting that stigma can adjust hope through self-efficacy, and ultimately affect loneliness. While paying attention to patient' stigma, clinical medical and nursing staff should pay attention to evaluating self-efficacy and hope levels and take targeted measures to reduce the impact of stigma on loneliness.