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 report embryonic testicular regression syndrome(ETRS) caused by DHX37 heterozygous variant for the first time in China and summarize the clinical manifestations of ETRS as to improve the understanding of doctors for this disease.Methods:The clinical data and whole exome sequencing results of five cases of ETRS from Shenzhen Children′s Hospital were collected. The reported cases of DHX37 heterozygous variant were reviewed.Results:Five patients with ETRS visited the doctors at the age of 2 months to 5 years and 5 months. Three patients raised as males came to hospital due to virilition and 2 female patients visited a doctor due to clitoral hypertrophy. No uterus was detected by ultrasound in all patients. The gonadal pathologies from 4 cases displayed no testicular tissue or gonadal dysgenesis, complicated with gonadoblastoma in one case. The genetic testing revealed that the heterozygous variant(c.923G>A, p. R308Q) in DHX37 was found in 2 cases, without variant in other 3 cases. According to the review, ETRS and 46, XY gonadal dysgenesis due to DHX37 herozygous variant was firstly reported in 2019. A total of 40 cases, including 21 cases of ETRS, presented with the virilition or female phenotype, with the disappearance of testicular tissue as the main pathologies. There is no report in China.Conclusion:The article summarized the clinical manifestations and whole exome sequencing results of 5 patients with ETRS, among which two cases were caused by DHX37 variants and one was complicated with gonadoblastoma.

Objective: To analyze the heritability of diabetes among the Chinese twin adults. Methods: A total of 10 253 same-sex twin pairs aged 25 years and older, were selected from the Chinese National Twin Registry (CNTR) program. Heritability of diabetes was calculated by using the structural equation model. Results: After adjusted for age and gender, the overall heritability rates of diabetes were 0.41 (0.15-0.75), 0.83 (0.72-0.91) and 0.34 (0.04-0.73) in the <45 and ≥45 years twin pairs, respectively. After adjusted for age, rates of heritability appeared as 0.37 (0.05-0.78) and 0.88 (0.79-0.94) in men and women, respectively. Conclusions Diabetes is affected by both genetic and environmental factors. The genetic effect of diabetes seemed stronger on female than that on male twins but was dying down along with ageing.

Objective The aim of this study was to evaluate the benefits of i.v. iron therapy in iron-defi-cient patients with left ventricular ejection fraction preserved heart failure (HFpEF). Methods 61 HFpEF pa-tients with iron deficiency were randomized to treatment with or without i.v. iron,as ferric carboxymaltose(FCM, n = 31)or placebo(saline,n = 29)for 24 weeks of a double-blind,placebo-controlled trial. The primary end-point was the change in 6-min-walk-test(6MWT)distance from baseline to Week 24. Secondary end-points includ-ed changes in New York Heart Association(NYHA)class,health-related quality of life(QoL),with NT-proBNP under observation. Results Compared with the control group at week 16 and 24,the iron treatment group has much more improve in 6MWT and the health-related quality of life(HRQoL)(P<0.05). The changes in NT-proB-NP level and NYHA heart function classification only show significance at week 24(P<0.05)but not at week 16 (P>0.05). Conclusion In this study,Treatment with intravenous ferric carboxymaltose can improve symptoms, functional capacity,and quality of life.

Objective To investigate the alteration and possible compensation mechanism of the default mode network (DMN) in patients with subacute pontine infarction.Methods Rs-fMRI data were collected from 23 patients with subacute pontine infarction and 23 normal controls.The data was analyzed with the functional connectivity (FC) method and compared between subacute pontine infarction patients and controls.All imaging was performed on a Philips Achieva 3.0T MRI scanner.Posterior cingulated cortox (PCC) was used as seed points to analyze the FC changes in the brain regions between the pontine infarction group and the controls.The discrepancies of experiment data between two groups were compared by using two-sample t-test analysis.Results The FC of the DMN showed a significant increase in the right postcentral gyrus, left medial prefrontal cortex and left precuneus compared with normal controls and a significant decrease in bilateral insula,posterior lobe of the left cerebellum,right parahippocampal gyrus and left inferior occipital gyrus.Conclusion The DMN altered in patients with subacute pontine infarction and the changes of the FC suggested the plasticity of cortical or compensation in the relevant brain areas.

This study was aimed to analyze the bioinformatics of proteomics of rat bone marrow mesenchymal stem cells (MSCs) intervened by active principle region of Yang-Xin Tong-Mai Formula (apr-YTF). The latest versions of bioinformatics tools including DAVID (http://david.abcc.ncifcrf.gov/) and GO (http://www.geneontology.org/) were combined to assign a precise function to rat bone marrow MSCs intervened by apr-YTF. KEGG and VISANT were assigned with a precise function to rat bone marrow MSCs intervened by apr-YTF. The results showed that a total of 102 biological processes were mainly involved, with 35 cellular components and 6 molecular functions. These proteins interacted in 3 signal transduction pathways. It was concluded that the following proteins and signal transduction pathways played an important role in the process of apr-YTF inducing BMSCs differentiation into cardiomyocytes. Presenilin-1 and Presenilin-2 were in the Notch signaling pathway. And syntaxin-4 protein was in soluble N-ethylmaleimide sensitive fusion protein attachment protein (SNARE). The apr-YTF played a role on MSCs from multiple sites, with multiple links through different biological processes. The bioinformatics of proteomics can predict action mechanism of traditional Chinese medicine (TCM) from the holism concept. The validation in combination with molecularbiology was a good way for TCM modernization.

BACKGROUNDNumerous studies have demonstrated that the peroxisome proliferator-activated receptor-γ (PPARγ) plays an important role in regulating endothelial progenitor cells (EPC) function. Telmisartan, as a partial agonist of PPARγ, may have an effect on the regulation of EPC functions. The purpose of this study was to investigate the effects of telmisartan on EPC proliferation and differentiation.

METHODSPeripheral blood derived mononuclear cells containing EPC were isolated from healthy volunteers and then cultured on fibronectin-coated dishes in the presence or absence of telmisartan. The proliferative activity of EPC was determined by colony forming units (CFU) and MTT assay. The migratory activity of EPC was assessed by transwell assay. The expression of endothelial cells (EC) markers, including vascular endothelial cadherin (VE-cadherin), von Willebrand factor (vWF) and endothelial nitric oxide synthase (eNOS), were measured by Western blotting analysis.

RESULTSMorphological analysis revealed that telmisartan significantly increased the proliferation of EPC and the number of endothelial cell colony forming units. Telmisartan could enhance the expression of the makers of mature EC, including VE-cadherin, vWF, and eNOS, which indicated telmisartan could stimulate EPC to differentiate into mature EC. Telmisartan increased the phosphorylation of Akt in EPC. The inhibition of Akt activation significantly attenuated the effect of telmisartan on EPC functions, suggesting that Akt is involved in the stimulatory effect of telmisartan on EPC differentiation.

CONCLUSIONSThe results of this study demonstrate that telmisartan promotes EPC functions via activation of Akt.

Benzimidazoles ; pharmacology ; Benzoates ; pharmacology ; Cell Differentiation ; drug effects ; genetics ; Cell Proliferation ; drug effects ; Cells, Cultured ; Endothelial Cells ; cytology ; Humans ; Proto-Oncogene Proteins c-akt ; genetics ; metabolism ; Stem Cells ; cytology ; drug effects

OBJECTIVETo detect the enterotoxin genes of Staphylococcus aureus (SA) isolated from clinical specimens and analyze the correlation between enterotoxin genes and drug resistance of SA.

METHODSThe mecA gene and enterotoxin genes A-F of clinical SA isolates were identified by polymerase chain reaction (PCR), and the genes were sequenced to investigate the correlation of these genes to drug resistance.

RESULTSThe detection rate of enterotoxin genes was 100% in 67 methicillin- resistant SA (MRSA), showing no significant difference from the rate in 57 methicillin-sensitive SA (MSSA) (83.5%, χ(2)=0.203, P>0.05). Of the 116 strains carrying enterotoxin genes (93.5%), the detection rates of SEA, SEB, SEC, SED and SEF were 90.5%, 6.9%, 61.3%, 5.2%, 25.9% and 93.5%, respectively, and none of the strains were positive for SEE gene. In these strains, 78 (67.2%) carried 2 or more enterotoxin genes, and the main genotypes were SEA and SEC (33.6%), SEA and SEF (7.8%), and SEA and SEC and SEF (13.8%). Compared with the strains carrying a single enterotoxin gene, those with multiple enterotoxin genes showed a higher drug resistance rate, among which 75% of the SA strains carrying SEA+SEC+SEF were resistant to SXT, significantly higher than the rates of SA carrying SEA (28.6%) and SEA+SEC (38.7%) (P<0.05). The SA strains carrying SEA+SEC+SEF and SEA+SEF showed significantly higher amikacin resistance rates than SA strain carrying SEA (75.0%, 77.0%, 21.5%, respectively, P<0.05).

CONCLUSIONClinical isolates of SA carrying multiple enterotoxin genes have a higher drug resistance rate than those with a single enterotoxin gene, suggesting the the important role of enterotoxin in multidrug resistance.

Drug Resistance, Multiple, Bacterial ; genetics ; Enterotoxins ; genetics ; Humans ; Staphylococcal Infections ; microbiology ; Staphylococcus aureus ; drug effects ; genetics ; isolation & purification

The study intended to evaluate the effect of high-dese atorvastafin on serum high sensitive C-reactive protein (hs-CRP) and renal function in patients with acute myocardial infarction undergoing elective pereutancous coronary intervention ( PCI ). One hundred and sixty seven patients were randomly divided into two groups: in test group (n =84) patients received oral atorvastatin 80 mg/d and in control group (n = 83) patients received atorvastatin 20 mg/d, the medication in both groups was lasted for 7 days before PCL Compared to levels at 24 h before PCI, serum hs-CRP and creatinine levels at 48 h after PCI were increased in both groups ( both P < 0. 05), and glomerular filtration rate was decreased ( P < 0. 05 ). Compared to control group, serum hs-CRP and creatinine levels 24 h before PCI and 48 h after PCI in test group were significantly lower, and glomerular filtration rate was significantly higher (P <0. 05, respectively). The incidence of contrast-induced nephropathy was lower in test group than that in control group[7% (6/84) vs.18% (15/83), P <0.05]. The results indicate that high-dose atorvastatin might be effective in protecting patients with acute myocardial infarction undergoing elective PCI from contrast-induced nephropathy via inflammatory response inhibition.

BACKGROUND:During culture of bone marrow mesenchymal stem cells(BMSCs),a certain serum is commonly added in the basic medium,such as calf serum and fetal bovine serum,but there are potential biological safety risks.OBJECTIVE:To study the effects of different serum microenvironments on in vitro culture of rat BMSCs.METHODS:BMSCs were harvested from adult rat bone marrow,and cultured in vitro by whole bone marrow adherence method.The cells were cultured under the following serum microenvironment.The primary cells of autoserum group were cultured with autoserum,changing the medium with fetal bovine serum after passage.The primary calls of homogeneity foreign serum group were cultured with homogeneity foreign serum,changing the medium with fetal bovine serum after passage.The primary cells of fetal bovine serum group were cultured with fetal bovine serum,and cultured with fetal bovine serum after passage.The primary cells of Dulbecco's modified Eagle's medium(DMEM)group were cultured with serum-free DMEM,changing the medium with fetal bovine serum after passage.The morphologic changes in BMSCs were detected under an inverted phase contrast microscope.Attachment rate and growth curve were measured.Surface marker CD11b,CD45 and CD90 expression was analyzed by flow cytometry.RESULTS AND CONCLUSION:In autoserum and homogeneity foreign serum groups,the homogenicity and degrees of fusion of call morphology were improved in comparison with other two groups and the day of first passage was less than other groups.The attachment rate was greater in the autoserum,homogeneity foreign serum and fetal bovine serum groups than the DMEM group at 24,48,72 hours(P＜0.01).Doubling rate was fastest in the growth curve of autoserum group,followed by homogeneity foreign serum group and fetal bovine serum group.However,no doubling phenomenon was found in the DMEM group.Flow cytometry results demonstrated that the rates of CD11b-positive and CD45-positive cells at passage 3 were above 98% under medium containing serum,and CD90-positive rate was less than 2%.We could obtain BMSCs of higher purity.However,CD11b-positive rate was 95.83%,CD90-positive rate was 2.07%,but CD45 positive rate was only 64.79% under serum-free microenvironment.BMSC purity was significantly lower under serum-free microenvironment than under serum microenvironment.Results indicated that the microenvironment of rat autoserum can improve the attachment rate,growth and purification of BMSCs.