One case of Listeria monocytogenes bacteremia in third trimester of pregnancy admitted in Zhongnan Hospital was reported .And 25 cases of maternal listeriosis were retrieved from domestic literature search up to March 2017.The clinical features of 26 cases were analyzed .The newly reported case was a 27-year-old primigravida at 37 weeks 5 days of gestation presenting with fever for 23 days. Listeria monocytogenes was identified in blood culture .She was treated with intravenous piperacillin sodium and tazobactam sodium for 3 weeks and recovered .At 39 weeks 4 days of gestation, she gave birth of a male baby by vaginal delivery .The newborn baby was healthy with negative Listeria monocytogene in blood culture.The age of onset of all 26 cases was (30.2 ±4.7)years.There were 1, 13 and 12 patients with listeriosis diagnosed in the first, second and third trimester of pregnancy , respectively.The median time from onset to symptom presentation was 2 days.Clinical manifestations included fever (92%,24/26), leukocytosis (75%,18/24), abdominal pain (27%,7/26), fetal movement decrease or lose (23%,6/26) and vaginal bleeding (15%,4/26).Listeria monocytogenes were isolated from blood (11 cases), uterus swab (7 cases), amniotic fluid (2 cases) and so on.High proportion of adverse pregnancy outcomes occurred (88%,22/25).All gravidae recovered well after the termination of pregnancy .The empirical antibiotics did not cover those sensitive to listeria in all patients .Patients with maternal listeriosis often presented with acute fever and a high incidence of adverse pregnancy outcomes , however, empirical antibiotics can hardly cover Listeria monocytogene.Thus, clinicians should improve awareness of listeriosis to avoid missed diagnosis and misdiagnosis .

Objective To select and evaluate the diluents for quantitative detection of HBV DNA of high loads sample,hope to find the most applicable diluents which could be used in clinical test.Methods The standard substance(2.00 × 109IU/ml)was 10 and 100 times diluted by different diluents,compare the result of test,and the bias was analysis taking negative quality control as standard diluents,negative serum,physiological saline,and distilled water as candidate diluents.Results When 10 times diluted,there was no statistically difference between the standard diluents and distilled water as diluents(t =2.04,P ＞ 0.05),the bias were less than the TEa regulated by professional standard.When used negative serum and physiological saline as diluents,the results were higher than that of standard diluents (P ＜ 0.05),and the ratio of the bias higher than the TEa was 16.67％ and 20.00％.When 100 times diluted,the results of candidate diluents were higher than that of standard diluents.In this time,the result of distilled water diluted detection presented a good linear relationship with the result of standard diluted detection,the formula was Y =0.963X + 0.267 (Y =result of standard diluted detection,X =result of distilled water diluted detection).All the bias were less than the TEa,the sequence of bias sort by ascending counts were negative quality control,distilled water,physiological saline and negative serum.Conclusions The most applicable diluents were negative quality control and distilled water with 10 times dilution.When 100 times diluted was used,the most applicable diluents was negative quality control,then was distilled water,physiological saline and negative serum.If using the distilled water to dilute,we could corrected the result by the formula Y =0.963X + 0.267 to ensure the result to be more exactly.

Objective:To explore the surgical method and therapeutic effect of repairing thumb pulp defect with pedicled transposition of radial proper palmar digital artery flap of middle finger.Methods:Since June, 2006 to May, 2020, 17 cases(17 fingers) with thumb pulp defect were repaired by pedicled transposition of radial proper palmar digital artery flap of middle finger. The sizes of flap ranged from 1.5 cm × 1.5 cm to 4.2 cm × 2.0 cm. The antegrade pedicled flap of radial proper palmar digital artery of middle finger was used in 2 cases and the retrograde pedicled flap of middle finger was used in 15 cases. After the flap was resected, the donor sites were covered with a medium thickness skin graft transferred from the wrist or elbow. The skin graft did not need to be packed. The dorsal branch of the digital nerve was included in the flap and it was anastomosed with the proper nerve of the injured thumb stump. After 16-22 days of the operation, the pedicles were cut off. The patients were instructed to perform digit function exercise after the pedicle was cut off. After the operation, the patients were included in regularly follow-up through outpatient visit, telephone or WeChat interview. The appearance and sensation of the thumb and finger pulps and the function recovery of the thumb and finger joints were observed through the followed-ups.Results:All 17 flaps and donor site skin grafts survived over 3 to 32 months of follow-up. The flaps achieved good texture and natural appearance. The TPD recovered to 5~11 mm. According to the Michigan Hand Function Questionnaire, all the 17 patients were very satisfied with the overall appearance and function of the hands. According to TAM, the 17 cases were all in excellent.Conclusion:Repairing thumb pulp defect with radial proper palmar digital artery pedicled flap of middle finger, the flap resection is simple, and the donor site is hidden. The appearance and texture of flap is good. It is a safe, effective and good method.

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.