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 determine whether the adenine base editor (ABE7.10) can be used to fix harmful mutations in the human G6PC3 gene. Methods: To investigate the safety of base-edited embryos, off-target analysis by deep sequencing was used to examine the feasibility and editing efficiency of various sgRNA expression vectors. The human HEK293T mutation models and human embryos were also used to test the feasibility and editing efficiency of correction. Results: ①The G6PC3(C295T) mutant cell model was successfully created. ②In the G6PC3(C295T) mutant cell model, three distinct Re-sgRNAs were created and corrected, with base correction efficiency ranging from 8.79% to 19.56% . ③ ABE7.10 could successfully fix mutant bases in the human pathogenic embryo test; however, base editing events had also happened in other locations. ④ With the exception of one noncoding site, which had a high safety rate, deep sequencing analysis revealed that the detection of 32 probable off-target sites was <0.5% . Conclusion: This study proposes a new base correction strategy based on human pathogenic embryos; however, it also produces a certain nontarget site editing, which needs to be further analyzed on the PAM site or editor window.
Humans ; Gene Editing ; CRISPR-Cas Systems ; Adenine ; HEK293 Cells ; Mutation ; Glucose-6-Phosphatase/metabolism*

We review the representatives literatures on chronic osteomyelitis, sum up the new insights in recent years into diagnostic options and treatment regimens, analyze the advantages and disadvantages of various diagnostic approaches and treatment strategies, and propose areas of interest to make current diagnostic and treatment strategies more specific.

Objective To apply and compare two occupational health risk assessment methods of Singapore occupational semi-quantitative risk assessment technique and occupational health risk assessment model provided by the International Council on Mining and Metal (ICMM) in chair furniture manufacturing enterprises. Methods Three chair furniture manufacturing enterprises were selected and investigated by occupational health. Singapore occupational semi-quantitative risk assessment technique and occupational health risk assessment model provided by the ICMM were used to evaluate the exposure risk in workers and compared. Results The result from the Singapore model indicated that there were extremely high risk for wood dust exposure at word-drilled workshop in factory C, high risk for wood dust exposure at word-drilled workshop in factory B and C, high risk for benzene exposure at glue-sprayed workshop in factory B and C, medium risk for wood dust exposure at wood-drilled workshop in factory A, toluene, xylene, dichloromethane, formaldehyde in factory B, toluene, xylene in factory C. There were inconsistent evaluation results using the ICMM tools of standard-based matrix and calculated risk rating. There were unacceptable risks for methylene chloride exposure at glue-sprayed workshop and word dust exposure at word-drilled workshop in factory A, B, C. There were unacceptable risks for benzene exposure at glue-sprayed workshop in factory B and C, toluene exposure at glue-sprayed workshop in factory A and C, ethyl acetate exposure at glue-sprayed workshop in factory B and C. The consistency of risk levels evaluated by Singapore occupational semi-quantitative risk assessment technique and rating evaluated mothod of risk assessment model provided by the ICMM was 58.33％ (weighted kappa value: 0.25) . The consistencies of risk levels evaluated by Singapore occupational semi-quantitative risk assessment technique and risk assessment model provided by the ICMM were low (weighted kappa value: 0.00) . Conclusion Singapore occupational semi-quantitative risk assessment technique and risk assessment model provided by the ICMM were both suitable for the chair furniture manufacturing enterprises, but the outcome of the two methods is inconsistent.

BACKGROUND:β-tricalcium phosphate (β-TCP) and monocalciumphosphate monohydrate (MCPM) are traditionally considered as reactants for dicalcium phosphate dehydrate (DCPD) bone cement,but little is reported on the hydroxyapatite (HA) as a reactant.OBJECTIVE:To verify whether HA and MCPM can be used to prepare DCPD bone cement and to explore the physicochemical properties.METHODS:The HA and β-TCP were prepared by wet chemical precipitation method,and mixed with appropriate proportion of MCPM.Then,the HA-DCPD and β-TCP-DCPD were obtained by adding a proper amount of curing water.The composition and structure of the two materials were analyzed by X-ray diffraction,the morphology was observed by scanning electron microscope,and the mechanical strength was tested by Instron5567 universal material test machine.These two kinds of materials were placed in simulated body fluid for detecting the weight loss ratio,soaked for 14 days and taken out for X-ray diffraction and scanning electron microscope detection.RESULTS AND CONCLUSION:X-ray diffraction findings indicated that these two kinds of materials both belonged to high-purity DCPD bone cement.Under the scanning electron microscope,β-TCP-DCPD bone cement had dense crystal structure,with less pore number;however,the HA-DCPD bone cement presented with finer grains,loose structure,and higher pore number.With the increase of curing time,the mechanical strength of two kinds of bone cements was correspondingly increased,but the compressive strength of β-TCP-DCPD bone cement was significantly higher than that of HA-DCPD bone cement (P ＜ 0.05).In the simulated body fluid,the weight loss ratio of β-TCP-DCPD bone cement was significantly lower than that of HA-DCPD bone cement (P ＜ 0.05).At 14 days after soaking in the simulated body fluid,a layer of spherical particles that was formed on the surface of both materials was identified as hydroxyapatite by scanning electron microscope observation and X-ray diffraction analysis.In summary,HA-DCPD bone cement has good biodegradability,excellent bioactivity and bone conductivity,but poor mechanical properties.

BACKGROUND: It is an urgent problem to effectively make bone marrow mesenchymal stem cells exert proper effects under hypoxic preconditioning. OBJECTIVE: To investigate the effects of diazoxide, a Mito-KATPchannel activator, on the proliferation and apoptosis of mouse BMSCs in hypoxic environment. METHODS: Mouse BMSCs were divided into four groups: blank control group, 0.16, 0.8, 4 μmol/L diazoxide groups. Cells intervened by diazoxide were cultured in a 10% O2incubator. MTT assay was performed to detect cell proliferation at 1, 2, 4, 6, 8 days after intervention, and Hoechst 33258 staining was performed to observe cell apoptosis at 14 days after intervention. RESULTS AND CONCLUSION: High homogeneity and purity but low proliferation of BMSCs was found. There was no significant difference in the activity of BMSCs among 0.16, 0.8, 4 μmol/L diazoxide groups (P > 0.05). In the blank control group, concentrated nuclei were dark blue in color and aggregated, and several round apoptotic bodies were found. In the diazoxide groups, apoptotic bodies were occasionally found, and no significant difference was found among different diazoxide groups. These findings indicate that a certain concentration of diazoxide can reduce cell apoptosis but has no effects on the proliferation of mouse BMSCs under hypoxic environment (10% O2).

We think that all the methods of puncturing into the skin to prevent and treat diseases are belong to acupuncture science. In spite of its basic theory of meridian and acupoint, anatomy and physiology have been important parts of modern acupuncture science. "Dry needling", however, is limited to trigger point theory. As for the positions, acupuncture is applied mainly at acupoints, involving in skin, muscles, tendons, vessels and nerves; while "dry needling" is used mostly at muscles. The needles of acupuncture are in various lengths and diameters and its manipulations are abundant, including the traditional skills and the achievements of modern science and technology research, such as electroacupuncture. It is different from the "dry needling" with the single tool and manipulation. Thus, acupuncture is suitable for a large range of syndromes, but "dry needling" is mainly for fascia muscularis pain and other related disorders. The acupuncturists need to embrace Chinese and western medicine, which is more rigorous than the training for "dry needling" practitioners. Based on the above reasons, we consider "dry needling" as part of acupuncture science, and it is a method during the modern development of traditional acupuncture.

Objective To evaluate occupational health risk at sites in a crane manufacturing enterprise and to provide the basis for occupational risk management and worker'health.Methods A crane manufacturing enterprise was selected and investigated for occupational health.Singapore occupational semi-quantitative risk assessment technique was used to evaluate the exposure risk in workers and compared with classification and occupational exposure limits of occupational hazards at workplaces.Results Benzene, toluene, xylene, manganese, butyl alcohol, butyl acetate, welding fume, silica dust, grinding wheel dust, noise were occupational hazard at the crane manufacturing sites.Results showed 3.28% of all the chemical substance analyzed in our study by Singapore occupational semi-quantitative risk assessment technique were high risk, and 8.2% were moderate risk, and 55.74% were low risk and 32.78% were negligible risk.The risk level of dip coating, welding, bob-weight, coremaking, sand mixing, shakeout were between moderate to high.The job grading of occupational chemical substance were correspondingly: harmless, 98.36%;slight, 1.64%.The results of the two methods were significantly different(P<0.05).Conclusion Singapore occupational semi-quantitative risk assessment technique could be used in evaluating the risk level of workplaces.However, this technique is limited in evaluating the risk level of physical factor such as noise and heat and should be combined with National Occupational Standards.

Adolescent ; Adult ; Aged ; Bone Nails ; Female ; Fracture Fixation ; methods ; Fracture Healing ; Humans ; Humeral Fractures ; surgery ; Male ; Middle Aged

Objective To screen the mimic epitopes of Rh(D)blood group antigens and identify their immunity from phage display peptide library.Methods A twelve mer phage peptide library was biopanned with anti-Rh(D)monoclonal antibody immobilized on plastic surface.After three round panning,thirty-five clones were randomly selected and positive clones were identified by ELISA and cross-reaction,followed by antibody competition inhibition assay and DNA sequencing to obtain the mimic epitopes of Rh (D)blood type antigens.The target phage clones were characterized and the antigenicity was analyzed by Western blot.Results After the third round screening,phages were enriched,and eleven positive clones were obtained.According to sequencing and competition inhibition analysis,the same"-WP-Q-"structure existed in seven of the eleven clones,and they had more than 40%inhibition ratio.The other clones had no same characteristics with low inhibition ratio possibly due to non-specific binding.Western blot analysis indicated that these phage clones could be specifically recognized by the anti-Rh(D)serum and they shared the same antigenicity of Rh(D)protein.Conclusions Rh(D)mimotope of"-WP-Q-"structure is successfully obtained by phage peptide library screening with anti-Rh(D)monoelonal antibody.The results lay the foundation for further exploration of pathogenesis and vaccine development of Rh(D)hemolytic diseases of newborn.