[Objective] To retrospectively analyze the detection results of alanine aminotransferase (ALT) unqualified repeat blood donors in Guangzhou, so as to provide evidence for further expanding the repeat blood donor pool, reducing the rate of blood discarding and improving the qualified rate of blood test. [Methods] Blood donors with unqualified ALT in Guangzhou Blood Center from January 2018 to April 2024 were selected as the research objects. The past blood donation and population characteristics were analyzed according to the number of blood donations and ALT unqualified times. [Results] Among repeat blood donors with previous ALT disqualification, 99.5% to 99.7% did not have reactive markers for transfusion-transmitted diseases (TTD), which was higher than the rate among first-time blood donors with unqualified ALT (95.8%) (P<0.05). The rate of single-item ALT disqualification in repeat blood donors was higher in males than in females (P<0.05); it also varied by age (18-25 years > 26-35 years > 36-45 years > over 45 years) (P<0.05); and by quarter (third and fourth quarters > first and second quarters) (P<0.05). The ALT unqualified rate was significantly higher whole blood donors than that of platelet donors and returning blood donors (P<0.05). The overall ALT level (51.0 U/L), individual ALT level (56.0 U/L) and individual ALT unqualified rate (66.7%) of repeat blood donors with multiple ALT disqualifications were higher than those of repeat blood donors with single-item ALT disqualifications (26.0 U/L, 38.5 U/L, and 33.3%, respectively) (P<0.05). Moreover, as the number of ALT disqualifications increased, the overall level of ALT in repeat blood donors also increased (P<0.05), and the average level of individual ALT and individual ALT unqualified ratio tended to increase. Repeat blood donors with frequent ALT disqualifications had higher ALT levels (69.0 U/L). [Conclusion] The ALT unqualified rates of repeat blood donors were mostly non-specific elevation without TTD. Repeat blood donors with multiple ALT disqualifications tend to have continuous high ALT. Moreover, and with the increase of ALT disqualifications times, the overall ALT levels the average individual ALT levels and individual ALT unqualified rates showed an increasing trend.

Background The decline of physical activity in the elderly due to aging may increase the risk of sarcopenia. Currently, there is a lack of evidence from large natural populations on the relationship between PA and sarcopenia. Objective To explore the relationship between PA and sarcopenia in the elderly aged 60 years and above in 10 provinces (autonomous regions) of China. Methods Data were retrieved from the 2022—2023 round of the China Development and Nutrition Health Impact Cohort. Personal basic information and PA data were collected by questionnaire survey. Skeletal muscle mass was measured by bio-electrical impedance analysis, muscle strength was measured using a grip dynamometer, and physical performance was reflected by 6-meter walk speed. The Asian Working Group for Sarcopenia (AWGS) 2019 criteria were used to diagnose sarcopenia. Light physical activity (LPA) duration, moderate-to-vigorous physical activity (MVPA) duration, and total physical activity volume were calculated. A total of 3326 residents aged ≥60 years with complete data were selected as the survey participants. Multiple logistic regression models and restricted cubic splines (RCS) were used to assess the association between PA duration/volume and sarcopenia. Results In 10 provinces (autonomous regions) of China, the prevalence of sarcopenia in the elderly aged 60 years and above was 5.5% (95%CI: 4.7%, 6.2%). The logistic regression analysis showed that compared with the elderly reporting 0-7.0 h·week⁻¹ in LPA duration, the risk of sarcopenia in the elderly with LPA duration of >14.0-21.0 h·week⁻¹ was reduced by 51% (OR=0.49, 95%CI: 0.26, 0.96). Compared with the elderly with total physical activity ≥15.0 metabolic equivalent of task (MET)-h·week⁻¹, those with <7.5 MET-h·week⁻¹ had a 2.24-fold increased risk of sarcopenia (OR=2.24, 95%CI: 1.17, 4.29). The RCS results found that LPA duration and total physical activity volume each showed a nonlinear dose-response relationship with the risk of sarcopenia (P_overall<0.05, P_non-linear<0.05). Compared with the elderly with an LPA duration of 0 h· week⁻¹, the risk of sarcopenia in the elderly with an LPA duration of 12.6 h· week⁻¹ was the lowest (OR=0.42, 95%CI: 0.21, 0.83). Compared with the elderly with a total physical activity volume of 15.0 MET-h· week⁻¹, the elderly with a total physical activity volume of 46.0 MET-h· week⁻¹ had the lowest risk of sarcopenia (OR=0.57, 95%CI: 0.38, 0.84). There was no statistically significant association between weekly MVPA duration and the risk of sarcopenia (P>0.05). Conclusion Increasing weekly LPA duration and total physical activity volume would help to reduce the risk of sarcopenia.

AIM:To investigate the therapeutic effect of menstrual blood-derived endometrial stem cells(MenSCs)on chemotherapy-induced intestinal mucositis and flora disorders in mice,and to explore the potential mecha-nism.METHODS:The mice were randomly divided into 3 groups including normal treatment,cisplatin(Cis)treatment and Cis+MenSC treatment,with 10 mice in each group.To induce intestinal mucositis,the mice were treated with Cis(2 mg·kg-1·d-1)by intraperitoneal injection for 5 consecutive days.Control mice for normal group were received equal vol-umes of normal saline.For Cis+MenSC treatment,MenSCs(1×106)was transplanted into the mice of Cis treated mice through tail vein.The performances and weight changes of mice were examined during the experiment.After the treat-ment,the small intestine and colon were isolated for subsequent HE staining,the ratio of F4/80 and IL-6 positive cells in small intestine were detected by immunohistochemical staining,and the expression of tight junction,inflammation and apoptosis related proteins was detected by Western blot.16S rDNA amplicon sequencing was performed to detect the diver-sity and richness of intestinal flora in mice.RESULTS:Compared to the Cis group,the MenSCs-treated mice showed sig-nificantly increased body weight,relieved intestinal lymphocytes infiltration,alleviated intestinal villous edema,and or-derly arranged glands in intestinal tissues.Further analysis indicated that MenSCs transplantation significantly up-regulat-ed the expression of intestinal tight junction related proteins ZO-1 and occludin in Cis-treated mice(P＜0.05).Subse-quently,MenSCs transplantation significantly inhibited the macrophages infiltration in intestinal tissues(P＜0.01),down-regulated the expression of pro-inflammatory factors IL-1 and IL-6 and pro-apoptotic protein Bax(P＜0.01),while up-regu-lated anti-inflammatory factor IL-10 and anti-apoptotic protein Bcl-2(P＜0.01).Additionally,further microflora sequenc-ing indicated that MenSCs transplantation prevented mice from Cis-induced intestinal flora disorder,and significantly re-duced the abundance of harmful bacteria such as isenbergiella tayi and Anaerotruncus colihominis(P＜0.01).At the same time,the abundance of beneficial bacteria Lactobacillus apodemi was increased(P＜0.05),thereby restoring the composi-tion and function of healthy intestinal flora.CONCLUSION:MenSCs transplantation alleviates the chemotherapy-in-duced damage of intestinal structure,relieves the symptoms of chemotherapy-induced mucositis and restores the homeosta-sis of intestinal flora in mice.

Background::In East Asia, Helicobacter pylori ( H. pylori) infection and related diseases are common, primarily during childhood and adolescence. The rates of primary antibiotic resistance in H. pylori among East Asian children and adolescents have not been extensively explored; few relevant systematic reviews or meta-analyses have been conducted. We evaluated the rates of antibiotic resistance in H. pylori among East Asian children and adolescents, with the goal of facilitating individualized treatment recommendations. Methods::We searched PubMed, Embase, and the Cochrane Library for studies in any language published up to February 2023 that explored antibiotic resistance in H. pylori among East Asian children and adolescents. We used MeSH and non-MeSH terms related to the topic, including terms related to children, adolescents, antibiotic resistance, H. pylori, and nations or regions. Additionally, we reviewed the reference lists of relevant articles. Studies that matched our strict predefined eligibility criteria were included in the screening process. Using established assessment methods, we evaluated the quality of the included studies. Results::We identified 15 observational studies involving 4831 H. pylori isolates, all published between 2001 and 2022. There was substantial primary antibiotic resistance in H. pylori isolates from East Asian children and adolescents. The rates of primary resistance were 51% (95% confidence interval [CI]: 40–62%) for metronidazole; 37% (95% CI: 20–53%) for clarithromycin; 19% (95% CI: 11–28%) for levofloxacin; and less than 3% each for amoxicillin, tetracycline, and furazolidone. Subgroup analysis revealed a prominent increase in metronidazole resistance over time. Clarithromycin and levofloxacin resistance rates fluctuated between 2005 and 2015, then remained stable; other antibiotic resistance rates were generally stable. Metronidazole, clarithromycin, and levofloxacin resistance rates were significantly higher in the Chinese mainland than in other East Asian regions. The rates of dual and multiple antibiotic resistance were 28% (95% CI: 21–36%) and 10% (95% CI: 7–14%), highlighting the potential for diverse resistance patterns. Conclusions::H. pylori isolates from East Asian children and adolescents exhibit high levels of metronidazole and clarithromycin resistance, particularly in the Chinese mainland. The non-negligible rates of dual and multiple resistance highlight the complexity of this problem. Registration::PROSPERO, No. CRD42023402510.

Objective:To retrospectively analyze the treatment status of tyrosine kinase inhibitors (TKI) in newly diagnosed patients with chronic myeloid leukemia (CML) in China.Methods:Data of chronic phase (CP) and accelerated phase (AP) CML patients diagnosed from January 2006 to December 2022 from 77 centers, ≥18 years old, and receiving initial imatinib, nilotinib, dasatinib or flumatinib-therapy within 6 months after diagnosis in China with complete data were retrospectively interrogated. The choice of initial TKI, current TKI medications, treatment switch and reasons, treatment responses and outcomes as well as the variables associated with them were analyzed.Results:6 893 patients in CP ( n=6 453, 93.6%) or AP ( n=440, 6.4%) receiving initial imatinib ( n=4 906, 71.2%), nilotinib ( n=1 157, 16.8%), dasatinib ( n=298, 4.3%) or flumatinib ( n=532, 7.2%) -therapy. With the median follow-up of 43 ( IQR 22-75) months, 1 581 (22.9%) patients switched TKI due to resistance ( n=1 055, 15.3%), intolerance ( n=248, 3.6%), pursuit of better efficacy ( n=168, 2.4%), economic or other reasons ( n=110, 1.6%). The frequency of switching TKI in AP patients was significantly-higher than that in CP patients (44.1% vs 21.5%, P<0.001), and more AP patients switched TKI due to resistance than CP patients (75.3% vs 66.1%, P=0.011). Multi-variable analyses showed that male, lower HGB concentration and ELTS intermediate/high-risk cohort were associated with lower cytogenetic and molecular responses rate and poor outcomes in CP patients; higher WBC count and initial the second-generation TKI treatment, the higher response rates; Ph + ACA at diagnosis, poor PFS. However, Sokal intermediate/high-risk cohort was only significantly-associated with lower CCyR and MMR rates and the poor PFS. Lower HGB concentration and larger spleen size were significantly-associated with the lower cytogenetic and molecular response rates in AP patients; initial the second-generation TKI treatment, the higher treatment response rates; lower PLT count, higher blasts and Ph + ACA, poorer TFS; Ph + ACA, poorer OS. Conclusion:At present, the vast majority of newly-diagnosed CML-CP or AP patients could benefit from TKI treatment in the long term with the good treatment responses and survival outcomes.

Objective To analyze the characteristics of blood transfusion consultation cases and establish the consulta-tion route,so as to provide reference for blood transfusion doctors to participate in blood transfusion consultation practice.Methods The cases involved in clinical transfusion consultation in the blood transfusion department of our hospital from 2020 to 2023 were collected from the hospital information system(HIS),and then classified by department and consultation type to summarize the main points of transfusion consultation,formulate transfusion consultation routes,and conduct typical cases analysis.Results There were 315 clinical transfusion consultations from 2020 to 2023,with an increasing trend year by year(26 in 2020,67 in 2021,81 in 2022,141 in 2023).The consultations involved 24 departments,including cardio-vascular medicine 14.0%(44/315),orthopedics 12.7%(40/315),intensive care medicine 8.9%(28/315),general medi-cine 8.3%(28/315),cardiopulmonary disease 6.0%(19/315),etc.There were 8 categories of consultations,including 35.6%(112/315)autologous ozonized blood transfusion,23.8%(75/315)plasma exchange,14.9%(47/315)perioperative mass blood preparation(transfusion),11.4%(36/315)platelet-rich plasma therapy and 6.3%(20/315)autologous blood collection,etc.The clinical blood transfusion consultation route was formulated according to the consultation points.Six pa-tients with various diseases were treated by blood transfusion department.With effective treatment measures taken,all of them improved and were discharged.Conclusion The summary of key points of clinical blood transfusion consultation and formulation of the blood transfusion consultation route by department of blood transfusion are conducive to the implementation of blood transfusion consultation and guarantee the safety of patients.

Objective:To investigate effect of Galangin on inflammatory response in autoimmune thyroiditis(AIT)rats by regulating chemokine ligand 2(CCL2)/chemokine receptor 2(CCR2)pathway.Methods:A total of 84 rats were randomly grouped into control group,model group,Galangin low dose group,Galangin medium dose group,Galangin high dose group,selenium yeast tablet group,Galangin high-dose+rat CCL2 recombinant protein(rCCL2)group,with 12 rats in each group.Except for control group,AIT models were constructed in rats of all other groups.After successful modeling,medication was administered once a day for 8 weeks.ELISA was applied to detect levels of thyroglobulin antibody(TGAb),thyroid peroxidase antibody(TPOAb),free thyroxine(FT4),free triiodothyronine(FT3)in rats serum and TNF-α,IL-6 and IL-1β in thyroid tissue;HE staining for pathological changes in rat thyroid tissue and scoring of inflammation in thyroid tissue;qRT-PCR was applied to detect expressions of CCL2 and CCR2 mRNA in thyroid tissue;Western blot was applied to detect expressions of CCL2 and CCR2 proteins in thyroid tissue.Results:Com-pared with control group,pathological damage to thyroid tissue of rats in model group was severe,inflammation score,levels of TGAb,TPOAb,FT4,FT3,TNF-α,IL-6,IL-1β,expressions of CCL2,CCR2 mRNA and protein were increased(P<0.05);com-pared with model group,pathological damage of thyroid tissue of rats in Galangin low dose group,Galangin medium dose group,Galangin high dose group and selenium yeast tablet group were reduced,inflammation score,levels of TGAb,TPOAb,FT4,FT3,TNF-α,IL-6,IL-1β,expressions of CCL2,CCR2 mRNA and protein were decreased(P<0.05);compared with Galangin high dose group,pathological damage of thyroid tissue in Galangin high dose+rCCL2 group was aggravated,inflammation score,levels of TGAb,TPOAb,FT4,FT3,TNF-α,IL-6,IL-1β,expressions of CCL2,CCR2 mRNA and protein were increased(P<0.05).Conclusion:Galangin may inhibit inflammatory response of AIT rats by inhibiting CCL2/CCR2 signaling pathway.

Objectives:To observe the exercise tolerance and cardiopulmonary function characteristics of patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) combined with cardiovascular disease,in order to assess the cardiorespiratory reserve and health status of untreated OSAHS,and to provide a clinical evidence for the phase Ⅱ cardiac rehabilitation. Methods:This retrospective analysis included 134 cardiovascular disease patients who attended the Cardiac Rehabilitation Center of Fuwai Hospital,Chinese Academy of Medical Sciences from November 2021 to April 2024 and received home sleep apnea monitoring (HSAT).According to the apnea hypopnea index (AHI),the patients were divided into the non-OSAHS (AHI<5 times/h) group (n=24),the mild-OSAHS (5 times/h ≤AHI<15 times/h) group (n=65),and moderate-to-severe OSAHS (AHI ≥15 times/h) group (n=45),and the body composition,pulmonary function characteristics,exercise tolerance,and ventilatory response to exercise were compared among the three groups. Results:A total of 110 (82.1％) patients had comorbid OSAHS,with a higher proportion of male patients (80.0％).Height,weight,body mass index,lean body mass,skeletal muscle mass,body water content,and basal metabolic rate increased progressively with increasing OSAHS severity in three groups (all P<0.05),while cardiovascular disease comorbidity was similar.Static lung function,exercise tolerance and ventilatory function at maximal exercise were similar between the patients in the mild OSAHS group and the moderate-severe OSAHS group as compared to the non-OSAHS group (all P>0.05).With the increase in the severity of OSAHS,the cardiorespiratory fitness showed a decreasing trend among patients in the three groups,and the forced vital capacity and the maximum vital capacity of patients in the moderate-severe OSAHS group were significantly higher than that of the mild OSAHS group,while peak O2 pulse％pred was significantly lower than that of the mild OSAHS group (all P<0.05).Multivariate analysis showed that the body fat mass (β=0.307,95％CI:0.263-0.823,P<0.001),minute ventilation at rest (β=0.259,95％CI:0.429-1.785,P=0.002) were the independent influencing factors of AHI. Conclusions:The prevalence of OSAHS is high in patients with cardiovascular disease,and patients with moderate-to-severe OSAHS have reduced cardiorespiratory fitness,OSAHS is not associated with additional cardiac impairment and ventilatory function impairment in patients with cardiovascular disease.Weight loss should be the primary rehabilitation goal in patients with OSAHS combined with cardiovascular disease.

Objective To design and test the reliability and validity of patient admission nursing assessment sheet of integrated Chinese and westem medicine ward.Methods On the basis of literature research,with traditional Chinese medicine"look,hear,ask and pulse-taking"as the basic framework,physical discrimination as the evaluation outcome,combined with the general nursing evaluation points of patients admitted to hospital,we designed the patient admission nursing assessment sheet of integrated Chinese and westem medicine ward,and then we adopted the Delphi method to conduct an inquiry on the draft of the admission sheet.In April 2022,3 clinical nurses were selected to evaluate 160 admitted patients from Integrated Traditional Chinese and Western Medicine Department of a tertiary A comprehensive hospital in Hubei Province,and Fleiss'Kappa coefficient and content validity coefficient were used to test the reliability and validity.Results The recovery rates of the 2 rounds of expert correspondence questionnaires were 95.45％and 100％.The authority coefficients were 0.931 and 0.957;the Kendall harmony coefficients were 0.101 and 0.106(P＜0.01);the importance scores of articles were 4.13～4.82;the coefficient of variation was 0.07～0.19 in 2nd round of expert correspondence.The final nursing assessment list for inpatients in the integrated Chinese and Western medicine ward included 3 parts:general demographic data assessment,four-Chinese medicine diagnosis assessment/physical discrimination,and nursing risk assessment,and there are 32 evaluation contents in the assessment sheet.The Fleiss'Kappa coefficient of this assessment sheet was 0.602(P＜0.001);the item content validity index was 0.857～1.000,and the overall content validity index was 0.920.Conclusion The admission nursing assessment sheet for inpatients in integrated Chinese and Westem medicine wards has good reliability and validity,and it is suitable for the integrated Chinese and Westem medicine wards.

OBJECTIVE: To observe the effects of probiotics supplementation on the natural killer T cell (NKT cell) and inflammatory factors in children with sepsis and its protective effect on long-term lung function. METHODS: A total of 100 children with sepsis admitted to the department of pediatric intensive care unit (PICU) of Henan Provincial People's Hospital from March 2021 to May 2022 were selected as the research objects. The children were randomly divided into placebo group and probiotic group, 50 cases in each group. In addition to the conventional treatment, the probiotic group was given oral or nasal administration of 0.5 g probiotics, three times a day for 30 days, and the placebo group received oral placebo. 40 healthy children were selected as the healthy control group. The levels of interleukins (IL-4, IL-10), interferon-γ (IFN-γ) and immunoglobulin E (IgE), percentages of NKT cell in blood and induced sputum, lung function of the two groups of children with sepsis were measured before treatment, 7 days after treatment, and during follow-up. All these data were compared with those of healthy children. Kaplan-Meier analysis was used to compare the incidence of cough varied cough (CVA) between the two septic groups. Multiple linear regression analysis was used to explore the influence of various factors on the proportion of NKT cells in induced sputum. RESULTS: In the placebo group, 2 cases died and 4 cases were lost to follow-up. In the probiotics group, 3 cases died and 5 cases were lost to follow-up. All the inflammatory factors of two groups decreased slowly after 7 day after treatment. There was no significance in the parameters of the two groups, but the levels of probiotic group declined more evidently. During the follow-up, a further decrease of inflammatory factors in probiotic group could be found, the levels of IL-4 and IL-10 were significantly different from those in the placebo group [IL-4 (ng/L): 20.3±9.3 vs. 27.6±11.9, IL-10 (ng/L): 23.1±6.8 vs. 14.4±4.4, both P < 0.05], with a significant decrease in IgE level (μg/L: 53.0±15.6 vs. 64.2±16.9, P < 0.05]. The results of flow cytometry showed that the percentage of NKT cell in peripheral blood in two septic groups decreased gradually, and the proportion of peripheral blood NKT cells in the probiotics group was significantly lower than that in the placebo group after 7 days of treatment [(4.2±0.9)% vs. (5.3±1.2)%, P < 0.05]. In the follow-up, the level of NKT cell in peripheral blood and induced sputum in probiotic group were lower than the placebo group [peripheral blood: (0.024±0.009)% vs. (0.029±0.008)%, induced sputum: (0.025±0.008)% vs. (0.035±0.01)%, both P < 0.05], which were similar to those in the healthy control group. Meanwhile, the percentage of predicted peak expiratory (PEF%) and ratio of forced expiratory volume in one second/forced vital capacity (FEV1/FVC) of probiotic group were higher than those in the placebo group [PEF%: (91.3±4.8)% vs. (85.8±8.6)%, FEV1/FVC ratio: (91.8±4.7)% vs. (87.2±7.4)%, both P < 0.05]. Although there was no significance in the incidence of CVA between two septic groups according to the Kaplan-Meier curve analysis, multiple linear regression analysis showed mechanical ventilation and allergic history were the risk factors for the increase of NKT cells [β values were 0.584, 0.601, 95% confidence interval (95%CI) were 0.069 to 1.099, 0.011 to 1.192, P = 0.027, 0.046], and probiotics was an independent protective factor for the relieve of increase in NKT cells (β value was -0.984,95%CI was -1.378 to -0.591, P = 0.001). CONCLUSIONS Application of probiotics to septic children early could promote the recovery of NKT cell and inflammatory factors, and alleviate the lung function injury induced by them during follow-up, which is helpful to improve the long-term prognosis of the patients.
Child ; Humans ; Interleukin-10 ; Interleukin-4 ; Sepsis ; Probiotics/therapeutic use* ; Lung ; Cough ; Immunoglobulin E