[Objective] To analyze the effects of different factors and red blood cell transfusion thresholds on the efficacy of neonatal red blood cell (RBC) transfusion, in order to provide more references for neonatal transfusions to better achieve rational and effective blood use. [Methods] A retrospective collection of data from 282 neonates who received RBC transfusions at our hospital from 2022 to 2023 was conducted, including birth weight, gestational age, number of blood transfusions, length of hospital stay, assisted ventilation during RBC transfusion, and laboratory test results before and after transfusion. SPSS software was used for statistical analysis to comprehensively analyze the impact of different factors on the efficacy of RBC transfusion in neonates. [Results] The results showed that the gestational age and weight of newborns at birth were negatively correlated with their length of hospital stay and the number of RBC transfusions during hospitalization. Newborns with younger gestational age and lower weight had longer hospital stays and more RBC transfusions during hospitalization. After administering RBCs according to the standard of 15 mL/kg, there was a statistically significant difference in the efficacy of RBC transfusion at different transfusion thresholds. In non-critical situations, RBC transfusions were ineffective when the pre-transfusion hemoglobin (Hb) level was >120 g/L. When the pre-transfusion Hb level was ≤70 g/L, RBC transfusions achieved higher efficacy in both critical and non-critical situations. [Conclusion] In critical situations, the group with pre-transfusion Hb values ≤ 70 g/L has the best RBC transfusion effect, while in non-critical situations, the group with pre-transfusion Hb levels between 81 and 90 g/L has the best RBC transfusion effect. Overall, the efficacy of RBC transfusion in non-critical situations is higher than that in critical situations.

Background Arsenic, cobalt, barium, and other individual metal exposure have been confirmed to be associated with the incidence of kidney stones. However, there are few studies on the association between mixed metal exposure and kidney stones, especially in occupational groups. Objective To investigate the association between mixed metal exposure and kidney stones in an occupational population from a metal smelting plant. Methods A questionnaire survey was conducted to collect sociodemographic characteristics, medical history, and lifestyle information of 1158 mixed metal-exposed workers in a metal smelting plant in Guangdong Province from July 2021 to January 2022. Midstream morning urine samples were collected from the workers, the concentrations of 18 metals including lithium, vanadium, chromium, manganese, cobalt, nickel, copper, zinc, arsenic, selenium, strontium, molybdenum, cadmium, cesium, barium, tungsten, titanium, and lead were measured by inductively coupled plasma mass spectrometry, and the urinary mercury levels were measured by cold atomic absorption spectroscopy. Based on predetermined inclusion criteria, a total of 919 mixed metal-exposed workers were included in the study, including 117 workers in the kidney stone group and 802 workers in the non-kidney stone group. With a detection rate of urinary metals greater than 80% as entry criterion, 16 eligible metals were finally included for further analysis. Parametric or non-parametric methods were used to compare the differences between continuous or categorical variables of the non-kidney stone group and the kidney stone group. Logistic regression models were constructed to explore the association between individual metal exposures and kidney stones. Weighted quantile sum (WQS) regression models were used to evaluate the association between mixed metal exposure and kidney stones, as well as the weights of each metal on kidney stones. Then Bayesian kernel machine regression (BKMR) models were used to explore the overall effect of mixed metal exposure on renal calculi and the potential interactions between metals. Results We found that there were significant differences in sex, age, length of service, and body mass Index (BMI) between the non-kidney stone group and the kidney stone group (P<0.05). The urinary concentrations of molybdenum and barium in the kidney stone group were higher than those in the non-kidney stone group, and the differences were statistically significant (P<0.05). The logistic regression models demonstrated that urinary cobalt, arsenic, molybdenum, and barium were positively correlated with the risk of kidney stones (P_trend<0.05). The WQS regression models showed that the mixed exposure to vanadium, cobalt, arsenic, molybdenum, and barium was positively associated with the risk of kidney stones (P<0.05). Among them, molybdenum, arsenic, and barium accounted for 0.391, 0.337, and 0.154, respectively. The BKMR results revealed a positive association between metal mixture exposure and the risk of kidney stones (P<0.05). When other metals were fixed at the 25th, 50th, or 75th percentile, arsenic, molybdenum, cobalt, and barium exhibited significant positive effects on the risk of kidney stones (P<0.05), while vanadium showed a significant negative effect (P<0.05). The interaction analysis demonstrated interactions between barium and cobalt, as well as between vanadium and cobalt (P<0.05). Conclusion In the occupational population of this smelter, occupational mixed metal exposure could increase the risk of kidney stones, and the main metals are molybdenum, arsenic, barium, and cobalt.

Objective:To investigate whether glycated haemoglobin A1c (HbA1c) can be used as a predictor of mortality risk in patients with influenza pneumonia.Methods:This study was a single-center retrospective study, and enrolled patients with influenza pneumonia in the Emergency Department and in-patient departments of Beijing Chaoyang Hospital, Capital Medical University from 2017 to 2019. Gender, age, underlying diseases, influenza virus nucleic acid or antigen results, chest X-ray or chest CT reports, routine blood test, biochemical indicators, HbA1c and procalcitonin (PCT) were collected, and all subjects were divided into survival and death groups based on 28-day mortality. The differences between the two groups were compared and Cox regression was used to analyze risk factors for 28-day mortality.Results:In this study, 122 patients with influenza pneumonia were included, and 94 (77.0%) cases were divided into the survival group and 28 (23.0%) cases into the death group. Univariate analysis showed that lymphocyte counts [0.49 (0.33, 0.73) vs. 0.77 (0.49, 1.23) ×10 9/L, Z= -3.008, P=0.003] were lower and HbA1c levels [6.5 (6.1, 7.1) vs. 6.1 (5.7, 6.8) %, Z= 2.203, P= 0.028] and PCT levels [0.64 (0.20, 6.43) vs. 0.16 (0.05, 0.87) μg/L, Z=2.594, P=0.009] were higher in dead patients compared with those in the survivors. Cox multivariate regression and survival analysis found that after adjusting for age, lymphocyte counts ( HR=0.260, 95% CI: 0.087-0.773, P=0.015) and HbA1c levels ( HR=1.295, 95% CI:1.007-1.666, P=0.044) were independent risk factors for 28-day mortality. Conclusions:HbA1c is an independent risk factor for predicting 28-day mortality in patients with influenza pneumonia.

Temporomandibular joint (TMJ) diseases are common clinical conditions. The number of patients with TMJ diseases is large, and the etiology, epidemiology, disease spectrum, and treatment of the disease remain controversial and unknown. To understand and master the current situation of the occurrence, development and prevention of TMJ diseases, as well as to identify the patterns in etiology, incidence, drug sensitivity, and prognosis is crucial for alleviating patients′suffering.This will facilitate in-depth medical research, effective disease prevention measures, and the formulation of corresponding health policies. Cohort construction and research has an irreplaceable role in precise disease prevention and significant improvement in diagnosis and treatment levels. Large-scale cohort studies are needed to explore the relationship between potential risk factors and outcomes of TMJ diseases, and to observe disease prognoses through long-term follw-ups. The consensus aims to establish a standard conceptual frame work for a cohort study on patients with TMJ disease while providing ideas for cohort data standards to this condition. TMJ disease cohort data consists of both common data standards applicable to all specific disease cohorts as well as disease-specific data standards. Common data were available for each specific disease cohort. By integrating different cohort research resources, standard problems or study variables can be unified. Long-term follow-up can be performed using consistent definitions and criteria across different projects for better core data collection. It is hoped that this consensus will be facilitate the development cohort studies of TMJ diseases.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective To investigate the influence of family resilience on patients with ischemic stroke and provide references for promoting positive handling of patients and the family adaptation.Methods Objective sampling was employed to conduct the semi-structured interviews among 20 patients with ischemic stroke in a Grade ⅢA hospital in Hunan Province between June and September 2021.The data acquired from the interviews were analysed and summarised following Colaizzi analysis method.Results A total of three themes with 10 dimensions were extracted,including promoting post-traumatic growth of patients with 3 dimensions(accepting and attaching importance to the disease to develop a right recognition of the disease,enhancing the will to combat the disease and increasing rehabilitative awareness to develop a healthy life style,cultivating spiritual believes to increase the sense of adversity;stabilising family function and providing emotional support with 4 dimensions in creating safe and satisfactory family settings,facilitating active communications among family members to jointly make decisions fighting against the disease,optimising the roles of family members,and fortifying the cohesion among family members;and proving spiritual comfort and material support with 3 dimensions of providing mutual support among family members to reduce the costs of treatment,improving family intimacy and adaptive support to reduce negative emotions,and seeking support from society to reduce financial burdens.Conclusions Family resilience brings influences to the patients with ischemic stroke from multiple perspectives.It can promote post-traumatic growth,stabilise family functions,provide emotional support,and provide spiritual consolation as well as financial support.Therefore,healthcare workers should enhance the family resilience and ensure the role of family functions to promote an early recovery of patients.

OBJECTIVE To study the effects of SR9009 and LXH0225,nuclear receptor subfamily 1 group D member(REV-ERB)agonists,on mood disorders and cognitive impairment in over-training mice.METHODS Male C57BL/6J mice were randomly divided into the normal control,over-training model,model+fluoxetine(15 mg?kg-1),model+SR9009(100 mg?kg-1)and model+LXH0225(50 mg?kg-1)groups.Mice in the normal control group were ip given15%cremophor without extra stress while those in other groups were ip given 15%cremophor or different drugs respectively 30 min before daily forced swimming stress.When stressed,mice were forced to swim in 19-21℃water for 20 min per day for 18 d.After that,locomotor activity was assessed.Rotarod test and weight-loaded swimming test were performed to measure physical strength,while open field test and stair-climbing test were performed to measure anxiety-like behavior.Tail suspension test and forced swimming test were used to measure depression-like behavior while novel object recognition test and Y maze test were conducted to measure recogni-tion function.ELISA was used to measure serum corticosterone contents.RESULTS Compared with the normal control group,the locomotor activity of mice in the model group was significantly increased(P<0.01).There were anxiety-like behaviors with a significant increase in the number of times of stair-climb-ing and rearing(P<0.01).Depression-like behaviors were observed with a significant increase immobile time in forced swimming test(P<0.01).Cognitive impairment was manifested as decreased accuracy of Y-maze spontaneous alternation response(P<0.01).The corticosterone content was significantly elevated(P<0.01)in forced swimming mice.Compared with the model group,the accuracy of Y-maze spontaneous alternations was higher(P<0.01)and the content of serum corticosterone was lower(P<0.01)in the model+fluoxetine group.The immobile time was shorter(P<0.01),the spontaneous alternation response of Y maze was was less accurate(P<0.05)and serum corticosterone content was lower(P<0.01)in the model+SR9009 group than in the model group.The latency to fall off the rotarod was longer(P<0.05),the immobile time was shorter(P<0.01)and the content of serum corticosterone was lower(P<0.01)in the model+LXH0225 group compared with the model group.CONCLUSION The REV-ERBs agonists SR9009 and LXH0225 may protect against forced swimming over-training induced mood disorders and cognitive impairment.

Objective To compare the effects of different statistical protocols on the results of external quality assessment(EQA)of se-men,and select appropriate statistical protocols for the promotion of EQA of semen.Methods Taking sperm concentration as an ex-ample,the semen EQA data of 20 laboratories in Hunan Province in 2022 were selected,and the advantages and disadvantages of the traditional statistical scheme(TSS),robust statistical scheme(RSS)and traditional statistical scheme after eliminating the"outliers"(TSEOS)combined with robust statistical technology were analyzed and compared.Results The"outliers"could not be excluded from the sperm concentration data of the four groups in the TSS,which led to the difference between TSS and RSS or TSEOS.The num-ber of qualified laboratories for TSS and RSS were 19 vs 16,19 vs 16,19 vs 19,and 19 vs 19,respectively.Conclusion The results of RSS are similar to those of TSEOS.Compared with TSS,RSS do not need to remove outlier data steps,and are more suitable for se-men EQA data analysis with small data volume.

Objective:To understand the incidence of sleep disorder in human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) patients before antiviral therapy, and to explore its risk factors.Methods:200 newly treated HIV/AIDS patients who visited the Eighth Affiliated City Hospital of Guangzhou Medical University from January to June 2016 were randomly selected. According to the Pittsburgh Sleep Quality Index (PSQI), they were divided into a good sleep group and a Sleep disorder group; The influencing factors of sleep disorder in HIV/AIDS patients were analyzed by univariate analysis and multivariate logistic regression.Results:The incidence of Sleep disorder in 200 HIV/AIDS patients before antiviral therapy was 22.5%(45/200); CD4 + T cell count was (414.13±202.16)/μl; 29%(58/200) of patients had CD4 + T cell counts<200/μl. There were significant differences in CD4 + T cell count and the proportion of patients with syphilis infection, comorbidity anxiety and comorbidity depression between the good sleep group and the Sleep disorder group (all P<0.05). Multivariate logistic regression analysis showed that syphilis infection ( OR=4.606; 95% CI: 1.973-10.752; P<0.001), comorbidity anxiety ( OR=2.496; 95% CI: 1.086-5.737; P=0.031) and comorbidity depression ( OR=2.087; 95% CI: 0.915-4.760; P=0.040) were risk factors for sleep disorder in HIV/AIDS patients before antiviral treatment. Conclusions:The incidence of Sleep disorder in HIV/AIDS patients before antiviral therapy in Guangzhou is high, especially in patients with syphilis infection, comorbidity anxiety and comorbidity depression. The sleep disorder of HIV/AIDS patients should be assessed and detected early, and multiple interventions should be taken to improve sleep quality.

Objective:To investigate the clinical features of hypereosinophilia (HE) complicated with Loffler endocarditis in children, in order to analyze the etiology, clinical stage and prognosis of HE complicated with Loffler endocarditis.Methods:A case of childhood hypereosinophilia complicated with Loffler endocarditis diagnosed and treated in the Second Hospital of Hebei Medical University was analyzed retrospectively, and its clinical characteristics, causes and clinical stages were analyzed.Results:In this study, the patient was a young male. He had diarrhea for more than 40 days due to intermittent abdominal pain, dyspnea for 10 days, and poor food intake for 3 days. The blood routine showed that he was HE. The ultrasound showed Loffler endocarditis. The child had severe heart failure and multiple organ functions were involved. After active treatment, he still had multiple organ failure, and finally died of multiple organ failure and ventricular fibrillation.Conclusion:Loffler endocarditis is a serious complication of HE, with low morbidity and rare clinical manifestations. Early intervention can reduce mortality.