Objective: Data on syncopal donation-related vasovagal reaction (DRVR) collected from 74 blood centers between 2020 and 2023 was statistically analyzed to provide a reference for developing preventive strategies against syncopal DRVR. Methods: Data on blood donation adverse reactions and basic information of donors from 2020 to 2023 were collected through the information management system at monitoring sentinel sites. Statistical analysis was performed on the following aspects of syncopal DRVR: characteristics of donors who experienced syncope, reported incidence, triggers, duration, presence and occurrence time of syncope-related trauma, clinical management including outpatient and inpatient treatment, and severity grading. Results: From 2020 to 2023, 45 966 donation-related adverse reactions were recorded. Of these, 1 665 (3.72%) cases were syncopal DRVR. The incidence of syncopal DRVR decreased with age, being the highest in the 18-22 age group. Incidence was significantly higher in female donors than male donors, in first-time donors than repeat donors, and in university and individual donors than group donors (all P<0.05). There was no statistically significant difference among different blood donation locations (P>0.05). The top three triggers were tension, fatigue, and needle phobia or fear of blood. Among syncopal DRVR cases, 60.36% occurred during blood collection, 87.63% lasted for less than 60 seconds, and 5.05% were accompanied by trauma. Notably, 57.14% of these traumas occurred after donor had left the blood collection site. Syncope severity was graded based on required treatment: grade 1 (fully recovered without treatment, 95.50%); grade 2 (recovered after outpatient treatment, 4.02%); and grade 3 (recovered after inpatient treatment, 0.48%). Conclusion: By analyzing the data of syncopal DRVR cases, it is possible to provide a reference for formulating blood donor safety policies.

OBJECTIVE To investigate the effects of quercetin on mitochondrial energy metabolism function after myocardial ischemia. METHODS H9c2 cells were divided into blank group， model group， quercetin high-dose， medium-dose and low-dose groups （40， 20， 10 μmol/L）， and positive control group （cyclosporine A， 1 μmol/L）. Reactive oxygen species （ROS）， mitochondrial membrane potential （MMP）， openness of mitochondrial permeability transition pore （MPTP）， adenosine triphosphate （ATP）， malondialdehyde （MDA）， lactate dehydrogenase （LDH） and creatine kinase （CK） were observed after cell hypoxia treatment. Rats were randomly assigned into sham operation group， model group， quercetin high-dose， medium-dose and low-dose groups （100， 50， 25 mg/kg）， and positive control group （trimetazidine， 6.3 mg/kg）， with 8 rats in each group. They were given relevant medicine intragastrically， once a day， for 7 consecutive days. After the last medication， myocardial ischemia model was induced by the ligation of the left anterior descending branch of the coronary artery. The contents of LDH， MDA， creatine kinase isoenzyme-MB （CK-MB）， superoxide dismutase （SOD）， complex Ⅰ， complex Ⅳ and ATP in serum were all determined. RESULTS Compared with the model group， ROS fluorescence intensity， openness of MPTP， the contents of CK， LDH and MDA were significantly decreased in quercetin low-dose， medium-dose and high-dose groups， and positive control group， while the contents of MMP and ATP were all increased significantly （P＜0.01）； the contents of CK-MB， LDH and MDA in serum were all decreased significantly in quercetin low-dose， medium-dose and high-dose groups， and positive control group， while the contents of SOD， complex Ⅰ， complex Ⅳ and ATP （except for positive control group） were increased significantly （P＜ 0.05 or P＜0.01）. CONCLUSIONS Quercetin can effectively reduce myocardial hypoxic injury， promote endogenous energy production and improve mitochondrial function after myocardial ischemia.

Objective To investigate the expression of neutrophil extracellular traps (NETs) and phagocytic function in the peripheral blood of patients with hepatic alveolar echinococcosis (HAE), and to examine their correlations with clinical inflamma tory indicators and liver functions. Methods A total of 50 patients with HAE admitted to Department of Hepatobiliary and Pancreatic Surgery, The Affiliated Hospital of Qinghai University from August 2022 to June 2023 were enrolled, while 50 age- and gender-matched healthy individuals from the Centre for Healthy Examinations of the hospital during the same period served as controls. The levels of NETs markers neutrophil myeloperoxidase (MPO) and neutrophil elastase (NE) were measured using enzyme-linked immunosorbent assay (ELISA). Peripheral blood neutrophils were isolated using density gradient centrifugation, stimulated in vitro using phorbol 12-myristate 13 acetate (PMA), and the levels of MPO and citrullination histone H3 (CitH3) released by neutrophils were quantified using flow cytometry. The phagocytic functions of neutrophils were examined using flow cytometry. In addition, the correlations of MPO and NE levels with clinical inflammatory indicators and liver biochemical indicators were examined using Spearman correlation analysis among HAE patients. Results The peripheral blood plasma MPO［(417.15 ± 76.08) ng/mL vs. (255.70 ± 80.84) ng/mL; t = 10.28, P < 0.05］, NE［(23.16 ± 6.75) ng/mL vs. (11.92 ± 3.17) ng/mL; t = 10.65, P < 0.05］and CitH3 levels［(33.93 ± 18.93) ng/mL vs. (19.52 ± 13.89) ng/mL; t = 4.34, P < 0.05］were all significantly higher among HAE patients than among healthy controls, and a lower phagocytosis rate of neutrophils was detected among HAE patients than among healthy controls［(70.85 ± 7.32)% vs. (94.04 ± 3.90)%; t = 20.18, P < 0.05］, and the ability to produce NETs by neutrophils was higher among HAE patients than among healthy controls following in vitro PMA stimulation. Pearson correlation analysis showed that the phagocytosis rate of neutrophils correlated negatively with platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), interleukin-6 (IL-6) level and C-reactive protein (CRP) level (r_s = −0.515 to −0.392, all P values < 0.05), and the MPO and NE levels positively correlated with inflammatory markers NLR, PLR, CRP and IL-6 (r_s = 0.333 to 0.445, all P values < 0.05) and clinical liver biochemical indicators aspartic transaminase, alanine aminotransferase, direct bilirubin and total bilirubin among HAE patients (r_s = 0.290 to 0.628, all P values < 0.001). Conclusions Excessive formation of NETs is found among HAE patients, which affects the phagocytic ability of neutrophils and results in elevated levels of inflammatory indicators. NETs markers may be promising novel biomarkers for early diagnosis, monitoring, and severity assessment of liver disease.

ObjectiveThis paper aims to analyze the current status of outcome indicators in randomized controlled trials （RCT） of traditional Chinese medicine （TCM） for treating chronic atrophic gastritis （CAG）， so as to provide references for constructing the core outcome set （COS） of TCM in the treatment of CAG. MethodChina National Knowledge Infrastructure （CNKI）， Wanfang， VIP， SinoMed， PubMed， Embase， and Cochrane Library databases were searched for RCTs of TCM in the treatment of CAG in the last five years. The risk of bias of included studies was evaluated， and the selection status of outcome indicators was statistically analyzed. ResultA total of 150 RCTs were included， with a sample size of 44-398 cases. 164 outcome indicators were reported， with an application frequency of 1 229 times. The outcome indicators were classified into seven indicator domains according to functional attributes， followed by physical and chemical examination （69.41%）， TCM syndrome （12.69%）， symptoms and signs （11.15%）， safety indicators （5.37%）， quality of life （0.65%）， long-term prognosis （0.65%）， and economic evaluation （0.08%）. According to the statistical analysis， there were problems in the selection of outcome indicators in RCTs of TCM for treating CAG， including various indicators， non-standard name reports， unclear primary and secondary indicators， random combination of subjective and objective indicators， neglected patient report outcome indicators， missing long-term prognosis and economic indicators， insufficient reporting of safety indicators， and inconsistent measurement tools and measurement time points. ConclusionIn the past five years， there have been many problems in the selection of outcome indicators in RCTs of TCM for treating CAG. It is necessary to actively promote the construction of the COS of TCM in the treatment of CAG and promote the high-quality development of clinical research of TCM.

ObjectiveTo analyze the changes in CD4⁺T lymphocyte (CD4 cells) levels and influencing factors in patients with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) before and after highly active anti-retroviral therapy (HAART) in Xining City, Qinghai Province, so as to provide a scientific basis for formulating corresponding follow-up intervention strategies. MethodsFrom February to July, 2023, 468 HIV/AIDS patients who received HAART in Xining, Qinghai Province were selected using a convenient sampling method for a questionnaire survey. Venous blood was collected and CD4 cell levels were detected by flow cytometry. SPSS 22.0 was used for t-test, analysis of variance and χ²⁃test, and multiple linear regression analysis was used to explore the level of CD4 cells and its main influencing factors in HIV/AIDS population after HAART. ResultsUnivariate analysis showed significant differences in baseline CD4 cell levels among people of different ages, nationalities, residential types and annual income (P<0.05). There were statistically significant differences in the most recent CD4 cell levels among people of different nationalities, different marital statuses, with or without regular physical exercise, with or without hypertension, different baseline CD4 cell count, different years since HIV diagnosis, different years of HAART treatment, and different treatment programs (P<0.05). Multiple linear regression analysis showed that the baseline CD4 cell count was 350‒499 (t=7.40) and ≥500 (t=6.69), the number of years of HAART treatment was 5‒9 (t=3.59) and ≥10 (t=4.54), the number of years of HIV diagnosis was ≥10 (t=-2.58), the number of people receiving second-line treatment (t=-2.49) and the latest CD4 cell levels after HAART were statistically correlated (P<0.05). ConclusionThe CD4 cell levels of HIV/AIDS population in Xining city of Qinghai Province are affected by many factors. Comprehensive health intervention should be carried out for this population, the implementation of early detection and treatment strategy should be strengthened, relevant physiological and biochemical indicators should be monitored regularly, and health education should be carried out, so as to encourage this population group to choose a healthy lifestyle, improving their quality of life from multiple dimensions.

Renal fibrosis is a common pathological change from development to end-stage renal diseases in all progressive chronic kidney diseases. Renal fibrosis after kidney transplantation will severely affect the renal graft function. Macrophages are characterized with high heterogeneity and plasticity. During the process of kidney injury, macrophages are recruited, activated and polarized by local microenvironment, and participate in the process of renal tissue injury, repair and fibrosis through multiple mechanisms. Recent studies have shown that macrophages may transit into myofibroblasts and directly participate in the formation of renal fibrosis. This process is known as macrophage-myofibroblast transition. Nevertheless, the regulatory mechanism remains elusive. In this article, the role of macrophages in renal fibrosis, the characteristics of macrophage-myofibroblast transition and the possible regulatory mechanism were reviewed, aiming to provide reference for relevant research of renal fibrosis.

Interleukin-6(IL-6) is a pleiotropic cytokine, which plays an important role in the inflammatory response. There is increasing evidence that IL-6 also plays a very important role in the development of pulmonary hypertension, as evidenced by the fact that circulating levels of IL-6 are significantly elevated in pulmonary hypertension patients and animal models, that overexpression of IL-6 in mice can induce severe pulmonary hypertension, and that treatment targeting IL-6 can improve pulmonary hypertension. This paper reviews the research progress on the role of IL-6 in pulmonary hypertension and its mechanism at the molecular level, and introduce the current candidate regimens targeting IL-6 for the treatment of pulmonary hypertension, in order to provide a reference for clinical drug research and development for pulmonary hypertension.

Objective:To understand the relevant situation of people seeking tattoo removal in laser cosmetic clinics.Methods:A face-to-face questionnaire survey was conducted among respondents seeking tattoo removal who visited the Laser Cosmetic Clinic of the Provincial Hospital Affiliated to Shandong First Medical University from June 2021 to May 2022. The questionnaire survey content included 4 categories and a total of 30 questions: basic information of the tattoo respondents, tattoo-related situations, respondents’ cognition of tattoos, and tattoo removal needs. The questionnaire responses were statistically analyzed, and differences were analyzed according to the gender, age of the tattoo respondents, and educational level at the time of tattooing. Descriptive statistical analysis was conducted on the general information of the questionnaire; Mantel-Haenszel chi-square test or Pearson’s chi-squared test were used for the analysis of the difference in the composition ratio of each data.Results:A total of 150 questionnaires were distributed and 142 valid questionnaires were collected. There were 81 male and 61 female tattoo respondents, with an age of (21.8±4.9) years (13-41 years). The result of the survey showed that 52.8%(75/142) of the respondents were minors (<18 years old) at the time of tattooing, and 97.2%(138/142) were <24 years old at the time of tattooing; 67.6% (96/142) regretted the act of tattooing; 73.2%(104/142) of the respondents themselves asked for the removal of tattoos; who removed their tattoos for personal development (joining the army, working, studying) was 68.3%(97/142); only 23.2%(33/142) of the respondents understood the harms of tattoos; and 21.8%(31/142) of the respondents suffered from adverse reactions after getting tattoos. The percentage of respondents who hid their tattoos from their family members was 82.4%(117/142); the percentage of respondents whose family members approved of the tattoos was only 25.4%(36/142). Analysis of variance showed that there was no correlation between the education level of the respondents and their knowledge of the tattoo risks( P>0.05); the reasons for removing tattoos were correlated with the age and gender of the respondents at the time of consultation ( P<0.01); the size of tattoos was correlated with the gender of the respondents ( P<0.01) and the female respondents were more inclined to choose a small tattoo; the age of tattooing of the respondents was correlated with the level of education of the respondents when they had tattooed themselves ( P<0.01), the proportion of tattoos aged <18 years old was highest among respondents with junior high school education at the time of tattooing [76.2%(32/42)], and this proportion tended to decrease significantly as the education level at the time of tattooing increased. Conclusion:The respondents seeking tattoo removal in the laser cosmetic clinic are mainly teenagers. About half of the respondents were minors at the time of tattooing, and most of them were not aware of the tattoo risks. There is a certain correlation between the age of the respondents and their educational background at the time of tattooing. There are certain differences in the reasons for removing tattoos among respondents depending on gender and age. There is no correlation between the educational background of the respondents and their understanding of the tattoo risks.

Objective:To understand the relevant situation of people seeking tattoo removal in laser cosmetic clinics.Methods:A face-to-face questionnaire survey was conducted among respondents seeking tattoo removal who visited the Laser Cosmetic Clinic of the Provincial Hospital Affiliated to Shandong First Medical University from June 2021 to May 2022. The questionnaire survey content included 4 categories and a total of 30 questions: basic information of the tattoo respondents, tattoo-related situations, respondents’ cognition of tattoos, and tattoo removal needs. The questionnaire responses were statistically analyzed, and differences were analyzed according to the gender, age of the tattoo respondents, and educational level at the time of tattooing. Descriptive statistical analysis was conducted on the general information of the questionnaire; Mantel-Haenszel chi-square test or Pearson’s chi-squared test were used for the analysis of the difference in the composition ratio of each data.Results:A total of 150 questionnaires were distributed and 142 valid questionnaires were collected. There were 81 male and 61 female tattoo respondents, with an age of (21.8±4.9) years (13-41 years). The result of the survey showed that 52.8%(75/142) of the respondents were minors (<18 years old) at the time of tattooing, and 97.2%(138/142) were <24 years old at the time of tattooing; 67.6% (96/142) regretted the act of tattooing; 73.2%(104/142) of the respondents themselves asked for the removal of tattoos; who removed their tattoos for personal development (joining the army, working, studying) was 68.3%(97/142); only 23.2%(33/142) of the respondents understood the harms of tattoos; and 21.8%(31/142) of the respondents suffered from adverse reactions after getting tattoos. The percentage of respondents who hid their tattoos from their family members was 82.4%(117/142); the percentage of respondents whose family members approved of the tattoos was only 25.4%(36/142). Analysis of variance showed that there was no correlation between the education level of the respondents and their knowledge of the tattoo risks( P>0.05); the reasons for removing tattoos were correlated with the age and gender of the respondents at the time of consultation ( P<0.01); the size of tattoos was correlated with the gender of the respondents ( P<0.01) and the female respondents were more inclined to choose a small tattoo; the age of tattooing of the respondents was correlated with the level of education of the respondents when they had tattooed themselves ( P<0.01), the proportion of tattoos aged <18 years old was highest among respondents with junior high school education at the time of tattooing [76.2%(32/42)], and this proportion tended to decrease significantly as the education level at the time of tattooing increased. Conclusion:The respondents seeking tattoo removal in the laser cosmetic clinic are mainly teenagers. About half of the respondents were minors at the time of tattooing, and most of them were not aware of the tattoo risks. There is a certain correlation between the age of the respondents and their educational background at the time of tattooing. There are certain differences in the reasons for removing tattoos among respondents depending on gender and age. There is no correlation between the educational background of the respondents and their understanding of the tattoo risks.

Objective To establish and validate a prediction model for gastric cancer lymph node metastasis based on four machine learning (ML) algorithms. Methods A retrospective analysis was conducted on clinical data of 531 patients who underwent radical gastrectomy. The patients were randomly divided into training set (399 patients) and test set (132 patients) in a ratio of 3 to 1. Univariate analysis was used to screen for variables associated with gastric cancer lymph node metastasis, and Logistic regression, random forest, K-nearest neighbor algorithm, and support vector machine algorithm models were established to rank the importance of variables. All ML algorithm models were validated in the test set, and receiver operating characteristic (ROC) curves were plotted. The optimal ML algorithm model was determined based on the area under the curve (AUC), sensitivity, specificity, and accuracy. A nomogram model was constructed based on the variable importance ranking of the optimal ML algorithm model. The discrimination, calibration, and clinical applicability of the nomogram model were evaluated using ROC curves, calibration curves, and decision curves. Results The results of the comparison of the four ML algorithm models showed that the random forest model was the optimal algorithm model. The accuracy, sensitivity, and specificity of the random forest model in the training set were 72.7%, 69.9%, and 75.0%, respectively, with an AUC of 0.803. The accuracy, sensitivity, and specificity of the random forest model in the test set were 64.4%, 66.7%, and 62.5%, respectively, with an AUC of 0.751. A nomogram model was constructed based on the variables of the random forest algorithm model. The ROC curve showed that the AUCs of the nomogram model in the training set and test set were 0.721 and 0.776, respectively. Calibration curves and decision curves showed that the nomogram model had good calibration and clinical applicability in both the training set and test set. Conclusion The random forest model is the optimal algorithm model among the four ML algorithm models. The nomogram model based on the random forest model can accurately predict the risk of gastric cancer lymph node metastasis, thereby better guiding clinical diagnosis and treatment decisions.