Children and adults differ significantly in physiology,biochemistry and immune function,which leads to sig-nificant differences in blood transfusion strategies between children and adults.To guide the clinical transfusion practice of pediatric patients and improve the prognosis of children,the National Health Commission organized the formulation and re-lease of the health industry standard Guideline for Pediatric Transfusion(WS/T 795-2022).This paper will briefly introduce some concepts that help understand of the Standard and the preparation process of the Standard,and explain and interpret the preparation of the"scope","general provisions"and"factors to consider"of the Standard,hoping to contribute to the understanding and implementation of the Standard.

OBJECTIVE: The prevalence and related factors of serum anti-HCV in different regions and hospitals have not been studied extensively in China. We used routine screening data to determine the prevalence of HCV antibody in hospital patients, evaluate the epidemic trend of hepatitis C and formulate screening strategies. METHODS: Patient information and HCV antibody testing results were collected from January 2017 to December 2019 in 77 HCV sentinel hospitals in China. Univariate and multivariate logistic regression was used to determine the characteristics and associations. RESULTS: HCV antibody prevalence rates were distinct among patients in different departments, with a range of 0.33%-6.93%. Patients who were admitted to the liver disease-related departments (a OR = 10.76; 95% CI, 10.27-11.28), Internal Medicine (a OR = 2.87; 95% CI, 2.75-3.00), and Department of Surgery (a OR = 1.95; 95% CI, 1.87-2.04), were more likely to be tested for HCV antibody positive. HCV antibody prevalence was associated with patients aged 45 years and older (a OR = 2.74; 95% CI, 2.69-2.80), testing in infetious disease hospitals (a OR = 2.33; 95% CI, 2.26-2.40) and secondary hospitals (a OR = 1.72; 95% CI, 1.69-1.75). Patients in sentinel hospitals of the Northeast (a OR = 12.75; 95% CI, 12.40-13.11), the Central (a OR = 1.65; 95% CI, 1.61-1.70), and the West (a OR = 1.78; 95% CI, 1.73-1.83) China had higher HCV prevalence than those who were in the Eastern coastal area. CONCLUSION Those who were over 45 years old and saw doctors for liver diseases, and invasive diagnosis and treatment should be referred to HCV antibody testing.
Humans ; Middle Aged ; Prevalence ; Hepatitis C/complications* ; Hepacivirus ; Hospitals ; Hepatitis C Antibodies ; China/epidemiology* ; Risk Factors

Objective: To analyze the prevalence and the risk factors of fungal sepsis in 25 neonatal intensive care units (NICU) among preterm infants in China, and to provide a basis for preventive strategies of fungal sepsis. Methods: This was a second-analysis of the data from the "reduction of infection in neonatal intensive care units using the evidence-based practice for improving quality" study. The current status of fungal sepsis of the 24 731 preterm infants with the gestational age of <34⁺⁰ weeks, who were admitted to 25 participating NICU within 7 days of birth between May 2015 and April 2018 were retrospectively analyzed. These preterm infants were divided into the fungal sepsis group and the without fungal sepsis group according to whether they developed fungal sepsis to analyze the incidences and the microbiology of fungal sepsis. Chi-square test was used to compare the incidences of fungal sepsis in preterm infants with different gestational ages and birth weights and in different NICU. Multivariate Logistic regression analysis was used to study the outcomes of preterm infants with fungal sepsis, which were further compared with those of preterm infants without fungal sepsis. The 144 preterm infants in the fungal sepsis group were matched with 288 preterm infants in the non-fungal sepsis group by propensity score-matched method. Univariate and multivariate Logistic regression analysis were used to analyze the risk factors of fungal sepsis. Results: In all, 166 (0.7%) of the 24 731 preterm infants developed fungal sepsis, with the gestational age of (29.7±2.0) weeks and the birth weight of (1 300±293) g. The incidence of fungal sepsis increased with decreasing gestational age and birth weight (both P<0.001). The preterm infants with gestational age of <32 weeks accounted for 87.3% (145/166). The incidence of fungal sepsis was 1.0% (117/11 438) in very preterm infants and 2.0% (28/1 401) in extremely preterm infants, and was 1.3% (103/8 060) in very low birth weight infants and 1.7% (21/1 211) in extremely low birth weight infants, respectively. There was no fungal sepsis in 3 NICU, and the incidences in the other 22 NICU ranged from 0.7% (10/1 397) to 2.9% (21/724), with significant statistical difference (P<0.001). The pathogens were mainly Candida (150/166, 90.4%), including 59 cases of Candida albicans and 91 cases of non-Candida albicans, of which Candida parapsilosis was the most common (41 cases). Fungal sepsis was independently associated with increased risk of moderate to severe bronchopulmonary dysplasia (BPD) (adjusted OR 1.52, 95%CI 1.04-2.22, P=0.030) and severe retinopathy of prematurity (ROP) (adjusted OR 2.55, 95%CI 1.12-5.80, P=0.025). Previous broad spectrum antibiotics exposure (adjusted OR=2.50, 95%CI 1.50-4.17, P<0.001), prolonged use of central line (adjusted OR=1.05, 95%CI 1.03-1.08, P<0.001) and previous total parenteral nutrition (TPN) duration (adjusted OR=1.04, 95%CI 1.02-1.06, P<0.001) were all independently associated with increasing risk of fungal sepsis. Conclusions: Candida albicans and Candida parapsilosis are the main pathogens of fungal sepsis among preterm infants in Chinese NICU. Preterm infants with fungal sepsis are at increased risk of moderate to severe BPD and severe ROP. Previous broad spectrum antibiotics exposure, prolonged use of central line and prolonged duration of TPN will increase the risk of fungal sepsis. Ongoing initiatives are needed to reduce fungal sepsis based on these risk factors.
Infant ; Infant, Newborn ; Humans ; Birth Weight ; Intensive Care Units, Neonatal ; Retrospective Studies ; Tertiary Care Centers ; Infant, Extremely Low Birth Weight ; Gestational Age ; Infant, Extremely Premature ; Sepsis/epidemiology* ; Retinopathy of Prematurity/epidemiology* ; Bronchopulmonary Dysplasia/epidemiology*

The Chinese Neonatal Network(CHNN) was established in 2018 with the mission of establishing a national collaboration platform, conducting high-quality and collaborative research, and ultimately improving the quality of neonatal-perinatal care and health in China.At present, 112 hospitals across the country have joined CHNN.CHNN has established a national standardized cohort of very premature infants/very low birth weight infants with >10 000 enrollments each year, has been leading data-driven collaborative quality improvement initiatives, conducting multicenter clinical studies, and performing multi-level training programs.Guided by the principles of collaboration and sharing, data-driven, continuous improvement, and international integration, CHNN has become an important platform for clinical and research collaboration in neonatal medicine in China.

Objective:To evaluate the efficacy and safety of umbilical venous catheterization (UVC) by using different methods to estimate the insertion depth.Methods:PubMed, Embase and The Cochrane Library, CBM (SinoMed), CNKI, VIP Database, Wanfang Database and Chinese Medical Journal Full-text Database were electronically searched for literature on randomized controlled trials (RCTs) comparing different methods for estimating the insertion depth of UVC. The search period was from the establishment date of the above databases to April 15th, 2022. If 2 or more studies were available for each pairwise comparison, a meta-analysis was conducted using the RevMan 5.3 software. However, if only 1 study was included for each pairwise comparison, SPSS 26.0 statistical software is used for statistical analysis using the chi-square test.Results:A total of 9 RCTs were included in the final meta-analysis, with a total of 1 281 infants, using 6 methods for estimating the depth of UVC. Compared with the Shukla formula, the Dunn method showed a statistically significant improvement in the correct place rate at the first UVC attempt ( RR=1.27, 95% CI 1.09-1.47, P=0.002). When comparing the Dunn method with the revised Shukla formula, the difference in the correct place rate at the first UVC attempt was statistically significant (21.4% vs. 33.5%, χ2=7.24, P=0.007). There was no statistically significant difference in the correct place rate at the first UVC attempt between the Dunn method and the formula based on BW, the JSS formula and the revised Shukla formula, and the method based on anatomical marks and the Shukla formula. There was no statistically significant difference in the incidence of UVC complications between the Dunn method and the Shukla formula, and between the method based on anatomical marks and the Shukla formula. Conclusions:Comparing to Shukla formula, Dunn method has a higher correct place rate at the first attempt. The incidence of complications is similar between the different pairwise comparison methods.

Objective:To systematically evaluate the safety of family integrated care (FICare) model in neonatal intensive care unit (NICU).Methods:Multiple medical databases were searched for clinical studies on FICare in NICU published from January 1, 2010 to May 28, 2022. The quality of the literature was evaluated using Risk?of?Bias?2 tool?and cohort evaluation criteria from the Cochrane Systematic Evaluation Manual depending on the types of studies included. Meta-analysis was performed using Review Manager 5.3 software.Results:Six randomized controlled trials and four cohort studies were included for meta-analysis. The results of meta-analysis showed that compared with the traditional care model, FICare model did not increase the risk of nosocomial infection ( RR=0.75, 95% CI 0.46-1.24, P=0.27) and unstable medical conditions ( RR=0.86, 95% CI 0.61-1.22, P=0.40). No significant difference existed in the all-cause mortality between FICare and traditional care ( RR=2.74, 95% CI 0.88-8.57, P=0.08). Conclusions:FICare does not increase the risk of nosocomial infection, unstable medical conditions and adverse events compared with traditional care. It is safe and feasible to implement FICare in NICU.

MicroRNA-21(miRNA-21)is highly expressed in various tumors.Small-molecule inhibition of miRNA-21 is considered to be an attractive novel cancer therapeutic strategy.In this study,fluoroquinolone de-rivatives Al-A43 were synthesized and used as miRNA-21 inhibitors.Compound A36 showed the most potent inhibitory activity and specificity for miRNA-21 in a dual-luciferase reporter assay in HeLa cells.Compound A36 significantly reduced the expression of mature miRNA-21 and increased the protein expression of miRNA-21 target genes,including programmed cell death protein 4(PDCD4)and phos-phatase and tensin homology deleted on chromosome ten(PTEN),at 10 uM in HeLa cells.The Cell Counting Kit-8 assay(CCK-8)was used to evaluate the antiproliferative activity of A36;the results showed that the IC50 value range of A36 against six tumor cell lines was between 1.76 and 13.0 μM.Meanwhile,A36 did not display cytotoxicity in BEAS-2B cells(lung epithelial cells from a healthy human donor).Furthermore,A36 significantly induced apoptosis,arrested cells at the G0/G1 phase,and inhibited cell-colony formation in HeLa cells.In addition,mRNA deep sequencing showed that treatment with A36 could generate 171 dysregulated mRNAs in HeLa cells,while the expression of miRNA-21 target gene dual-specificity phosphatase 5(DUSP5)was significantly upregulated at both the mRNA and protein levels.Collectively,these findings demonstrated that A36 is a novel miRNA-21 inhibitor.

Aim To investigate the protective effect of tetramethylpyrazine ( TMP ) on cerebral ischemia/reper¬fusion ( I/R) injury in diabetes mellitus ( DM ) rats based on full-length transcriptome sequencing tech¬nique and the underlying mechanism. Methods The rat model of DM was induced by intraperitoneal injec- tion of streptozotocin (STZ,50 mg • kg" ) . The global cerebral I/R model of rats was established by double vessel occlusion (2-VO) for 10 min and reperfusion for 16 h. TMP (40 mg • kg ) was injected intraperitone-ally every day. Brain water content detection, HE stai¬ning, Nissl staining and TUNEL staining were used to evaluate the neuroprotective effect of TMP on cerebral I/R injury in DM rats. The differentially expressed genes were screened by full-length transcriptome se¬quencing. The possible candidate genes and metabolic pathways of TMP for cerebral ischemia protection in DM rats were screened by functional annotation and metabolic pathway enrichment analysis, and verified by RT-qPCR and Western blot. Results TMP treatment could reduce the degree of brain edema, increase the number of Nissl bodies and neurons, and significantly reduce cell necrosis and apoptosis after cerebral I/R in DM rats. GO enrichment analysis showed that the dif¬ferentially expressed genes after TMP treatment were mainly enriched in biological functions such as inflam¬matory response, transcription factor complex, growth factor activity and so on. KEGG pathway analysis showed that it was mainly concentrated in apoptosis, Toll-like receptor and other signaling pathways. Among them TMP down-regulated genes included TLR2, MyD88, IL-lp, Caspase-3, etc. The results of RT-qPCR and Western blot confirmed that TMP could down-regulate TLR2, MyD88, NF-KB, IL-10, IL-6 and Caspase-3 , and up-regulate the mRNA and protein expression of Bcl-2. Conclusions TMP may amelio¬rate neuronal apoptosis by inhibiting inflammatory re¬sponse, which improves cerebral I/R injury in DM rats, and the pathway may be TLR2/MyD88/NF-KB signaling pathway.

Objective:To identify the risk factors for postoperative acute kidney injury (AKI) in patients undergoing off-pump coronary artery bypass grafting (OPCABG).Methods:The medical records of patients who underwent elective OPCABG from January 1, 2018 to December 31, 2020 from the Heart Center of Henan Provincial People′s Hospital, were retrospectively collected.The patient′s gender, age, body mass index, history of diabetes, history of hypertension, history of hyperlipidemia, history of chronic obstructive pulmonary disease, history of cerebrovascular disease, history of myocardial infarction, New York Heart Association classification of cardiac function, Killip classification, values of last left ventricular ejection fraction measured by transthoracic echocardiography before operation, glycosylated hemoglobin, glucose and serum creatinine, duration of operation, intraoperative fluid intake and output such as red blood cell infusion, crystal fluid, colloid fluid, autologous blood, blood loss and urine volume, intraoperative hypotension, perioperative maximal blood glucose difference (MGD) and serum creatinine concentrations within 48 h and 7 days were recorded.Postoperative AKI was defined according to the Kidney Disease Improving Global Outcomes criteria and the patients were divided into AKI group and non-AKI group according to whether AKI occurred after surgery.Logistic regression analysis was used to identify the risk factors for AKI after OPCABG.Results:A total of 1 203 patients were included in this study, and the incidence of AKI after OPCABG was 28.1%.Logistic regression analysis showed that body mass index, history of hypertension and perioperative MGD were risk factors for AKI after OPCABG ( P<0.05). Conclusion:Body mass index, history of hypertension and perioperative MGD are risk factors for AKI after OPCABG.

Antibodies, Viral ; blood ; Betacoronavirus ; Coronavirus ; immunology ; Coronavirus Infections ; immunology ; Humans ; Immunoglobulin G ; blood ; Pandemics ; Pneumonia, Viral ; immunology