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 Coronavirus disease 2019 (COVID-19) and tuberculosis (TB) are major public health and social issues worldwide. The long-term follow-up of COVID-19 with pulmonary TB (PTB) survivors after discharge is unclear. This study aimed to comprehensively describe clinical outcomes, including sequela and recurrence at 3, 12, and 24 months after discharge, among COVID-19 with PTB survivors. Methods From January 22, 2020 to May 6, 2022, with a follow-up by August 26, 2022, a prospective, multicenter follow-up study was conducted on COVID-19 with PTB survivors after discharge in 13hospitals from four provinces in China. Clinical outcomes, including sequela, recurrence of COVID-19, and PTB survivors, were collected via telephone and face-to-face interviews at 3, 12, and 24 months after discharge. Results Thirty-two COVID-19 with PTB survivors were included. The median age was 52 (45, 59) years, and 23 (71.9％) were men. Among them, nearly two-thirds (62.5％) of the survivors were moderate, three (9.4％) were severe, and more than half (59.4％) had at least one comorbidity (PTB excluded). The proportion of COVID-19 survivors with at least one sequela symptom decreased from 40.6％ at 3 months to 15.8％ at 24 months, with anxiety having a higher proportion over a follow-up. Cough and amnesia recovered at the 12-month follow-up, while anxiety, fatigue, and trouble sleeping remained after 24 months. Additionally, one (3.1％) case presented two recurrences of PTB and no re-positive COVID-19 during the follow-up period. Conclusion The proportion of long symptoms in COVID-19 with PTB survivors decreased over time, while nearly one in six still experience persistent symptoms with a higher proportion of anxiety. The recurrence of PTB and the psychological support of COVID-19 with PTB after discharge require more attention.

OBJECTIVE: To summarize and compare the clinical baseline characteristics of patients with monoclonal gammopathy of undetermined significance (MGUS), primary light chain amyloidosis (pAL), multiple myeloma (MM), or MM with concurrent amyloidosis, especially the differences in cytogenetic abnormalities. METHODS: The clinical data of 15 cases of MGUS, 34 cases of pAL, 842 cases of MM and 23 cases of MM with concurrent amyloidosis were analyzed and compared retrospectively. RESULTS: Cytogenetic statistics showed that the incidence of t (11; 14) in the four groups (MGUS vs pAL vs MM vs MM with concurrent amyloidosis) was 0%, 33.3%, 16.4%, and 15.8%, respectively (P=0.037); that of 13q deletion was 20.0%, 14.7%, 45.8% and 56.5%, respectively (P<0.001); gain of 1q21 was 50.0%, 12.5%, 47.4% and 40.9%, respectively (P=0.001). Proportion of pAL patients with 0, 1 and≥2 cytogenetic abnormalities (including 13q deletion, 17p deletion, 1q21 amplification and IgH translocation) accounted for 41.9%, 41.9% and 16.1%, respectively; while the proportion of the same category in MM was 17.6%, 27.3%, and 55.2% respectively; this ratio of MM with concurrent amyloidosis was more similar to MM. Subgroup analysis showed that genetic abnormalities (including 13q deletion, 17p deletion and 1q21 amplification) were comparable within t (11; 14) negative and positive groups. Compared with positive cases, t(11; 14) negative patients with MM or MGUS were more likely to have 13q deletions and multiple genetic abnormalities. CONCLUSION Clinical characteristics of pAL, especially cytogenetic abnormalities, are significantly different from MM with concurrent amyloidosis. It suggests that although the onset characteristics are similar, actually the two diseases belong to different disease subtypes which should be carefully predicted and identified.
Amyloidosis ; Humans ; In Situ Hybridization, Fluorescence ; Monoclonal Gammopathy of Undetermined Significance/complications* ; Multiple Myeloma ; Retrospective Studies

AIM:To investigate the effect of sulodexide(SDX)on the apoptosis of human dermal microvascu-lar endothelial cells(HDMECs)exposed to hypoxia and its underlying mechanism.METHODS:The HDMECs were cul-tured and divided into normoxia control group cultured under normoxic condition;hypoxia control group cultured in a humid incubator maintained at 37 ℃with 5% CO2and 1% O2for 24 h;treatment groups treated with SDX at 0.25,0.5 and 1 LSU/mL for 24 h under hypoxic condition.The cell viability was measured by CCK-8 assay.The apoptotic rate of the HD-MECs was analyzed by flow cytometry.The activity of caspase-3 in HDMECs was examined by caspase-3 activity assay kit. The expression of pro-apoptotic factor P53,caspase-3,Bax and anti-apoptotic factor Bcl-2 at mRNA and protein levels was determined by real-time PCR and Western blot.RESULTS:SDX increased the viability of HDMECs exposed to hypoxia, but also decreased the apoptosis.Furthermore, SDX down-regulated the expression of pro-apoptotic factor P53, Bax and caspase-3 at mRNA and protein levels as well as the activity of caspase-3,while the expression of anti-apoptotic factor Bcl-2 was up-regulated.CONCLUSION:SDX significantly increases the viability and decreases the apoptosis of HDMECs ex-posed to hypoxia.Inhibition of the mitochondrial apoptosis pathway may be involved in the underlying mechanism.

Objective: To design the aesthetic new gonion and osteotomy line for patients with prominent mandibular angle patients using computer-aided techniques, and to investigate the application of three-dimensional digital planning in gonioplasty. Methods: From April 2016 to April 2017, 14 female patients with prominent mandibular angle underwent preoperative surgical design and surgical simulation using digital technology. Gonioplasty was performed under the guide of surgical templates, preoperative, surgical simulation and postoperative data were measured including bilateral mandibular angles, the height of ramus(Co-Go) and the length of mandibular body(Go-Me). Paired t test was used to compare the differences between surgical simulation and postoperative measurements. Results: Gonioplasty was performed in 14 patients successfully, and all were satisfied with their facial outcomes. The mandibular angle was improved from 113.86°±4.11° to 124.52°±1.26° on the left side, and 114.30°±4.01° to 124.29°±1.24° on the right side respectively. The average ratio of Go-Me/Co-Go was 2.011 on both sides after operation, which was very close to surgical planning. No significant differences were found between surgical planning and postoperative measurements with respect to mandibular angle or the ratio of Go-Me/Co-Go on both sides(P>0.05). The deviations between them were 1.00°±0.68° and 0.058±0.038 on the left side, and 0.85°±0.63° and 0.072±0.053 on the right side respectively. Conclusions Computer-assisted gonioplasty could improve the efficiency and accuracy of surgery, reduce the risk of surgical complications, and attain higher patients′ satisfaction.

Objective To investigate the correlation between three sperm indexes and the outcome of in vitro fertilization and embryo transfer(IVT-ET) before and after semen treatment.Methods The semen derived from 298 male patients treated with IVT-ET from the Affiliated Hospital of Southwest Medical University was retrospectively analyzed.Routine analysis of semen before treatment was performed according to the WHO standard.Vitrolife density gradient centrifugation combined with upstream method was used to analyze sperm parameters after sperm analysis,and the observation and statistics were performed after fertilization and sequential culture to day 3.Results The total viability of spermatozoa before and after semen treatment,the percentage of normal spermatozoa,sperm density,and other differences were statistically significant (P＜0.05);The normal sperm morphology rate was positively correlated with fertilization rate(r=0.487,P＜0.01) and cleavage rate(r=0.250,P＜0.05);The sperm vitality of post-processed semen was positively related to the fertilization rate (r =0.249,P＜0.05,);and significantly cleavage rate (r =0.272,P＜0.05);After treatment,sperm density was positively correlated with 2 PN(r=0.609,P＜0.01) and multiple PN fertilization rates(r=0.243,P＜0.05).Conclusion Our experimental results indicate that the parameters of post-processed sperm treated at the day when the oocytes were collected may be more helpful in predicting the fertilization rate and cleavage rate of IVF-ET.Therefore,the IVF-ET treatment protocols should be chose based on the normal sperm morphology rate and sperm vitality after semen treatment.

Objective To study the effects of hypoxia on the cell migration,apoptosis and expression of related genes and proteins of human dermal microvascular endothelial cells(HDMEC). Methods To culture HDMEC in hypoxia condition by putting CoCl2in the cell incubator and all the subjects were divided to two groups which included normal group and hypoxia group.To find the appropriate CoCl2dose by CCK-8 experiment and the 200 μmol/L CoCl2was the best to establish hypoxia model.The migration of cells was measured by wound healing test.Apoptosis rate was detec-ted by flow cytometry. The gene expressions were detected by RT-PCR and the protein levels were detected by West-ern blot. Results The migration ability of cells was enhanced in hypoxia condition (P<0.05). The apoptosis rate was increased in hypoxia condition(P<0.05).The gene expressions of HIF-1α,HIF-1β,VEGF,iNOS were increased comparing with normal groups depending on time(P<0.05).The protein expressions of HIF-1α,VEGF,iNOS were in-creased comparing with normal groups depending on time(P<0.05). Conclusions Cell migration, apoptosis of HDMEC were influenced by hypoxia. It may be explained by increasing expression of related gene and proteins like HIF-1α,VEGF,iNOS in hypoxia condition.

Objective To study the effects of hypoxia on the cell migration,apoptosis and expression of related genes and proteins of human dermal microvascular endothelial cells(HDMEC). Methods To culture HDMEC in hypoxia condition by putting CoCl2in the cell incubator and all the subjects were divided to two groups which included normal group and hypoxia group.To find the appropriate CoCl2dose by CCK-8 experiment and the 200 μmol/L CoCl2was the best to establish hypoxia model.The migration of cells was measured by wound healing test.Apoptosis rate was detec-ted by flow cytometry. The gene expressions were detected by RT-PCR and the protein levels were detected by West-ern blot. Results The migration ability of cells was enhanced in hypoxia condition (P<0.05). The apoptosis rate was increased in hypoxia condition(P<0.05).The gene expressions of HIF-1α,HIF-1β,VEGF,iNOS were increased comparing with normal groups depending on time(P<0.05).The protein expressions of HIF-1α,VEGF,iNOS were in-creased comparing with normal groups depending on time(P<0.05). Conclusions Cell migration, apoptosis of HDMEC were influenced by hypoxia. It may be explained by increasing expression of related gene and proteins like HIF-1α,VEGF,iNOS in hypoxia condition.

To study the chemical constituents of the fruits of Fructus carotae, silica gel column chromatog­raphy and preparative HPLC were used to isolate and purify the extract of Fructus carotae. The structures of obtained compounds were elucidated on the basis of physicochemical property and spectral data. Nine guaiane-type sesquiterpenes were isolated and identified as 8β-angeloyloxy-11-hydroxy-4-guaien-3-one(1), 11-acetoxy-4-guaien-3-one(2), 11-acetoxy-8β-isobutyryl-4-guaien-3-one(3), 11-acetoxy-8β-propionyl-4-guaien-3-one(4), 11-hydroxy-4-guaien-3-one(5), 11-acetoxy-8β-angeloyloxy-1β-hydroxy-4-guaien-3-one(6), 11-acetoxy-8β-angeloyloxy-4-guaien-3-one(7), 11-acetoxy-8β-hydroxy-4-guaien-3-one(8)and 8β,11-dihydroxy-4-guaien-3-one(9). Compound 1 is a new compound, compound 5 is a new natural product, and compounds 2-4 were isolated from this genus for the first time.

OBJECTIVETo investigate the prevalence, current treatment, and clinical characteristics of asthma, as well as the risk factors for this disease, among children aged 0-14 years in 2010 in urban Zhongshan, China.

METHODSA total of 10 336 children aged 0-14 years were selected from urban Zhongshan by cluster random sampling. The Third National Childhood Asthma Epidemiological Questionnaire 2010 was used to analyze the prevalence, current treatment, and clinical characteristics of childhood asthma, as well as the risk factors for this disease.

RESULTSAsthma was diagnosed in 179 cases (1.73%). The prevalence of asthma in male children was significantly higher than that in female children (2.25% vs 1.16%; P<0.01). Of the 179 patients, severe attacks were common in 104 cases (58.1%), 110 cases (61.5%) had slow onset, 102 cases (57.0%) had gradually relieved conditions, 61 cases (34.1%) suffered from asthma during seasonal transition, and 150 cases (83.8%) developed asthma due to respiratory tract infection. Among all asthmatic children, 71.5% had been treated with inhaled corticosteroids, and 71.5% had been treated with bronchodilator. The multivariate logistic regression analysis showed that a history of penicillin allergy, a family history of allergy, food allergy, eczema, allergic rhinitis, cesarean delivery, family mould, and perinatal passive smoking were independent risk factors for childhood asthma.

CONCLUSIONSThe prevalence of childhood asthma in urban Zhongshan is on a high level, and is associated with gender. The treatment of asthma has been standardized, but still needs further improvement. The onset of asthma attack is influenced by various factors.

Adolescent ; Asthma ; epidemiology ; etiology ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Risk Factors ; Seasons ; Time Factors