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 explore the manifestations of jingjin (sinews/fascia) lesions and summarize their distribution rules in the patients with neck-type cervical spondylosis so as to provide the evidences for the development of clinical diagnosis and treatment scheme of acupuncture for cervical spondylosis. METHODS: A total of 120 patients with neck-type cervical spondylosis were collected. The meridian diagnostic method was used to examine the upper back of each patient, the manifestation category of jingjin lesions, locations and the affected muscle regions of twelve meridians were recorded. RESULTS: (1) The punctate lesions of jingjin were detected in 15 regions, and the highest frequency of lesion occurred in the region from the inner upper corner of the scapula to Quyuan (SI 13) (113 cases, 94.2% of lesion frequency). The lesion frequency of 10 regions was ≥50.0%. The punctate lesions were mainly distributed in the muscle regions of hand-shaoyang (349 cases) and foot-taiyang (333 cases). (2) The linear lesions of jingjin were detected in 10 regions, and the highest frequency of lesion occurred in the region from the inner upper corner of the scapula to Quyuan (SI 13) (77 cases, 64.2% of lesion frequency). The lesion frequency of 2 regions was ≥50.0%. The linear lesions occurred mainly in the muscle region of foot-taiyang (251 cases). (3) Eight regions were examined to be the planar lesions of jingjin, and the highest frequency of lesion was found in the site of Jianjing (GB 21) (84 cases, 70.0% of lesion frequency). The lesion frequency of 3 regions was ≥50.0%. The muscle region of foot-taiyang (260 cases) was predominated in the planar lesions. (4) The distribution of all of the punctate, linear and planar lesions of jingjin was analyzed statistically. It was found that 25 regions were involved and those with the high lesion frequency were distributed in the area from the inner upper corner of the scapula to Quyuan (SI 13), the sites of Jianjing (GB 21) and Dazhui (GV 14), transverse processes of C₃ to C₅ and the area from the lateral border of the scapula to the teres minor, separately. The muscle regions of foot-taiyang, hand-shaoyang and hand-yangming were involved in various kinds of jingjin lesions. CONCLUSION Jingjin lesions in patients with neck-type cervical spondylosis can be divided into three categories, namely, punctate, linear and planar lesions; of which, the punctate lesions are dominated. A majority of jingjin lesions is related to the muscle region of foot-taiyang, and the lesion frequency is higher compared with the lesions to the muscle regions of hand-shaoyang and hand-yangming. Jingjin lesions are commonly distributed in the area from the inner upper corner of the scapula to Quyuan (SI 13).
Humans ; Meridians ; Acupuncture Therapy ; Acupuncture Points ; Spondylosis/therapy* ; Acupuncture

OBJECTIVE: To observe the effect of meridian sinew releasing technique on moxibustion sensation of heat-sensitive moxibustion in patients with knee osteoarthritis (KOA). METHODS: A total of 60 patients with KOA were randomly divided into an observation group and a control group, 30 cases each group. In the observation group, on the basis of the meridian sinew releasing technique, moxibustion sensation exploration method was applied at Dubi (ST 35) area on the affected side. In the control group, moxibustion sensation exploration method was applied at Dubi (ST 35) area on the affected side. The meridian sinew releasing technique was performed for 20 min each time, the moxibustion sensation exploration method was performed for 60 min each time, once a day for 3 days. The excitation rate, latency, duration time and intensity value of moxibustion sensation of heat-sensitive moxibustion were recorded on the 1st, 2nd and 3rd days of exploration in the two groups. RESULTS: The excitation rate on the 3rd day of exploration and total excitation rate in the observation group were higher than the control group (P<0.05). On the 1st, 2nd and 3rd days of exploration, the latency of moxibustion sensation of heat-sensitive moxibustion in the observation group was shorter than the control group (P<0.05), the duration time was longer than the control group (P<0.05), and the intensity value was higher than the control group (P<0.05). CONCLUSION Meridian sinew releasing technique could improve the excitation rate of moxibustion sensation of heat-sensitive moxibustion in patients with KOA, shorten the latency, prolong the duration time, and improve the intensity value.
Humans ; Osteoarthritis, Knee/therapy* ; Hot Temperature ; Meridians ; Moxibustion ; Sensation

Objectives: To investigate the prevalence and associated risk factors of tinnitus in Sichuan and Chongqing. Methods: We designed a tinnitus epidemiological questionnaire. The multi-stage stratified cluster random sampling methods was applied to obtain study subjects in six areas (Nanchong, Jiangjin, Fengdu, Yunyang, Suining and Ya'an), which were selected for epidemiological investigation. Home visit completion of epidemiological questionnaires was conducted. The trained investigators guided the respondents to fill in the tinnitus epidemiological questionnaires, and the epidemiological status of six areas on prevalence and risk factor was investigated. SPSS 22.0 software was used for statistical analysis. Results: Sampling population were 10 289, in which 9 273 were valid questionnaires. There were 4 281 males and 4 992 females, with an average age of 47.3 years, among which 34.83% (3 230/9 273) had tinnitus. 3.99% (370/9 273) were diagnosed with bothersome tinnitus. In a multivariable logistic regression mod, the following factors were associated with onsetting of tinnitus: sleep disorder [Odds Ratio(OR)=3.74] and noise exposure(OR=1.99). The risk of disease was lowest in the age of 30-40 years old, while the risk of disease was higher for people under 30 and over 40. In another multivariable logistic regression mode, the following factors were associated with having bothersome tinnitus: older people were more likely to suffer from tinnitus, sleep disorders (OR=4.68) and noise exposure (OR=1.56). Conclusions: The prevalence of tinnitus in Sichuan and Chongqing is about 34.83%, but most of the tinnitus is short-lived and has low loudness, which will not affect the patients. Only a small number of patients with tinnitus (3.99%) persist and affect their health and need treatment. The occurrence and exacerbation of tinnitus may be related to sleep, age, and noise exposure.
Adult ; Aged ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Prevalence ; Risk Factors ; Surveys and Questionnaires ; Tinnitus/epidemiology*

Vacuum sealing drainage (VSD) is frequently used in abdominal surgeries. However, relevant guidelines are rare. Chinese Trauma Surgeon Association organized a committee composed of 28 experts across China in July 2017, aiming to provide an evidence-based recommendation for the application of VSD in abdominal surgeries. Eleven questions regarding the use of VSD in abdominal surgeries were addressed: (1) which type of materials should be respectively chosen for the intraperitoneal cavity, retroperitoneal cavity and superficial incisions? (2) Can VSD be preventively used for a high-risk abdominal incision with primary suture? (3) Can VSD be used in severely contaminated/infected abdominal surgical sites? (4) Can VSD be used for temporary abdominal cavity closure under some special conditions such as severe abdominal trauma, infection, liver transplantation and intra-abdominal volume increment in abdominal compartment syndrome? (5) Can VSD be used in abdominal organ inflammation, injury, or postoperative drainage? (6) Can VSD be used in the treatment of intestinal fistula and pancreatic fistula? (7) Can VSD be used in the treatment of intra-abdominal and extra-peritoneal abscess? (8) Can VSD be used in the treatment of abdominal wall wounds, wound cavity, and defects? (9) Does VSD increase the risk of bleeding? (10) Does VSD increase the risk of intestinal wall injury? (11) Does VSD increase the risk of peritoneal adhesion? Focusing on these questions, evidence-based recommendations were given accordingly. VSD was strongly recommended regarding the questions 2-4. Weak recommendations were made regarding questions 1 and 5-11. Proper use of VSD in abdominal surgeries can lower the risk of infection in abdominal incisions with primary suture, treat severely contaminated/infected surgical sites and facilitate temporary abdominal cavity closure.
Abdomen ; surgery ; China ; Drainage ; methods ; Evidence-Based Medicine ; Humans ; Practice Guidelines as Topic ; Societies, Medical ; organization & administration ; Surgical Wound Infection ; prevention & control ; Traumatology ; organization & administration ; Vacuum

Objectives: To analyze and understand the risk factors related to HIV new infections among men who have sex with men (MSM). Methods: A longitudinal observational study among MSM was conducted to collect information on HIV related behaviors and sero-conversion. Univariate and multivariate generalized estimating equations (GEE) were used to discuss the risk factors for HIV new infection. Results: A total number of 4 305 MSM were followed during 2013-2015. Among those self-reported MSM who are seeking partners on the Interner tended to have higher proportion on receptive anal intercourse and consistent condom use during anal intercourse than the subgroups seeking their partners in gay bars or bathrooms. HIV incidence among followed MSM during the study period appeared as 4.3/100 person years, with adjusted RR (aRR) of HIV infection for receptive anal intercourse as group 2.20 (95% CI: 1.49-3.24) times than that of insertion anal intercourse group. Those who used rush-poppers (aRR=1.55, 95% CI: 1.10-2.17), unprotected anal intercourse (aRR=2.24, 95%CI: 1.62-3.08), and those with syphilis infection (aRR=2.95, 95%CI: 2.00-4.35) were also risk factors for HIV new infections. After controlling other factors, the relationship between the ways of seeking partners and HIV new infection was not statistical significant. Conclusion: Risk factors for HIV new infection among MSM appeared complex and interactive, suggesting that further studies are needed to generate tailored strategies for the prevention of HIV epidemic among MSM population.
Adult ; Cohort Studies ; HIV Infections/diagnosis* ; Homosexuality, Male ; Humans ; Incidence ; Male ; Risk Factors ; Risk-Taking ; Sexual Behavior ; Sexual Partners ; Sexual and Gender Minorities ; Surveys and Questionnaires ; Unsafe Sex

Objective:To introduce a novel ridge preservation technique with micro-titanium plate avoiding the use of bone grafting materials,and evaluate the potential horizontal bone preservation effect of this new technique,applied on single maxillary central incisors after tooth extraction for future implant restoration.Methods:Nine patients (six women and three men),mean age (26.0 ±5.7)years(from 1 8 to 34 years)referred to the Department of Oral Implantology,Peking University School and Hospital of Stomotology,were selected and diagnosed with unsalvageable single middle incisor with fine general con-ditions,no signs of acute local inflammation,no ongoing or previous periodontitis,healthy neighboring teeth and intact buccal bone walls.Tooth extraction,delayed implant placement and implant-supported single crown restoration were selected as treatment plan.The teeth were extracted atraumatically with lo-cal anesthesia,followed by a reflection of a minor flap to exposed 2-3 mm of the buccal bone plate.Af-ter that,a micro-titanium plate was trimmed and bended to fit the convexity of the labial bone and fixed by two mini pins with intent to support the labial soft tissue.The flap was then repositioned over the micro titanium plate and secured with two single sutures.No bone grafting materials or releasing incisions were needed.The sockets were left to heal without any intention of primary wound closure.Cone-beam compu-ted tomographic (CBCT)scans were obtained before and four months after tooth extraction.Horizontal ridge widths were measured with CBCT software,and the preservation effects were calculated and recor-ded by the percentage of horizontal ridge alteration.Results:The nine extraction sockets were healed un-eventfully.The average socket width before extraction was (7.51 ±0.48)mm (6.92-7.82 mm).The average alveolar ridge labial-palatal width at the control point of the edentulous area was (6.81 ±0.44) mm (6.04-7.38 mm)4 months after tooth extraction,the mean percentage of ridge width preserved was 90.87%±2.91%(87.28%-95.60%).Conclusion:This novel ridge preservation method by the usage of a micro-titanium plate did not interfere with the natural socket healing process,and at the same time,largely preserved the width of alveolar ridge without any bone grafting procedures.Long term results remain to be seen.

Objective To investigate the effect of early physical training on long-lasting neurological function,pathology changes,spatial learning and memory abilities,sensorimotor function and ultrastructure changes in neonatal rats with hypoxic-ischemic brain damage (HIBD).Methods Ninety 7-day-old sprague-dawley rats were randomly divided into three groups:a group that was subjected to left carotid ligation followed by 2 hours hypoxic stress (vehicle group),a group that received physical trainings (grabbing,rotation,walking and balance) 1 weeks after HIBD event (trained group) and a sham-operated group that was subjected to a sham-operation without ligation and hypoxic stress (n=30).Following four weeks of physical trainings,neurological scale was performed on all the rats; the number of neurons in the CA1 region of hippocampus and cortex forehead was measured by Nissl count; the expression levels of synaptophysin and c-fos were examined; Morris water maze tests and cortex sensorimotor tests were performed to detect the spatial learning and memory abilities and sensory functions; transmission electron microscope was employed to observe the synapses and neuronal ultrastructure.Results As compared with those in the vehicle group,the neurological scale scores were significantly increased in the trained group and the sham-operated group 14,21 and 28 days after trainings (P＜0.05).As compared with those in the vehicle group,the number of neurons in the left hippocampal CA1 area and cortex increased in the trained group and sham-operated group (P＜0.05).The expressions of synaptophysin and c-los in the trained group increased significantly as compared with those in the vehicle group (P＜0.05).As compared with those in the vehicle group,the spatial learning and memory abilities and sensorimotor functions in the trained group were significantly increased (P＜0.05).The ultrastructure of the left hippocampus and cortex was remarkably abnormal in the vehicle group by the transmission electron microscopy,while no obvious abnormality was observed in the trained group.Conclusion Early physical training can restrain neuron damage in the hippocampus and cortex and enhance synaptic plasticity to ameliorate the long-term neurological function after HIBD; the strong expression of synaptophysin and c-fos in the hippocampus and cortex caused by early physical training may be one of the improvement mechanisms.

The aim of this study was to investigate the relationship between the plasma levels of chemokine CCL-2/MCP-1 and acute graft-versus-host disease (aGVHD) and/or idiopathic pneumonia syndrome (IPS) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). ELISA assays were used to detect the plasma level of CCL-2/MCP-1 of 22 patients who received allo-HSCT, including 14 patients without or with grade I, 8 patients with grade II - IV aGVHD, respectively. 8 out of 22 patients were also diagnosed with IPS clinically. The dynamic changes of the plasma levels of CCL-2/MCP-1 chemokine and its correlation with aGVHD and/or IPS were analysized retrospectively. The results showed that the plasma levels of CCL-2/MCP-1 in the patients with moderate and serious aGVHD (grade II - IV) significantly increased, as compared with that prior to allo-HSCT (p < 0.05). The plasma levels of CCL-2/MCP-1 in the patients with aGVHD and/or IPS were higher significantly than those without any of these complications (p = 0.001). The retrospective analysis indicated that the plasma levels of CCL-2/MCP-1 in the patients with IPS significantly increased (p = 0.006). It is concluded that plasma level of CCL-2/MCP-1 correlates with aGVHD and/or IPS, and plays a role in the pathogenesis of these complications.
Adolescent ; Adult ; Chemokine CCL2 ; blood ; Child ; Child, Preschool ; Female ; Graft vs Host Disease ; blood ; Hematopoietic Stem Cell Transplantation ; adverse effects ; Humans ; Lung Diseases, Interstitial ; blood ; etiology ; Male ; Middle Aged ; Syndrome ; Young Adult

OBJECTIVE: To investigate the myocardial fibrotic indices in patients with ischemic cardiomyopathy (ICM), and explore the mechanism of myocardial fibrosis. METHODS: The concentration of serum procollagen type III aminoterminal peptide (P III P), procollagen type IV aminoterminal peptide (P IV P), lamnin (LN), and hyaluronic acid (HA), as well as plasma angiotension II (AngII), aldosterone (ALD), and transforming growth factor beta 1 (TGFbeta1) in 46 ICM patients and 37 normal controls were measured by radioimmunoassay (RIA). The correlations between the plasma levels of AngII, ADL, TGFbeta1, and serum levels of P III P, P IV P, LN, and HA were analyzed. RESULTS: Compared with normal controls, the concentrations of serum P III P, P IV P, LN, HA, and plasma AngII, ADL, and TGfbeta1, significantly increased in ICM patients. AngII, ALD, and TGFbeta1 levels were positively correlated with the indices of myocardial fibrosis. CONCLUSION The myocardial fibrosis exists in ICM patients and the serum concentrations of P III P, P IV P, LN, and HA may be an indirect index of myocardial fibrosis. AngII, ADL, and TGFbeta1 levels play important roles in myocardial fibrosis.
Aged ; Cardiomyopathies ; pathology ; Collagen Type III ; blood ; Coronary Artery Disease ; pathology ; Female ; Fibrosis ; pathology ; Humans ; Hyaluronic Acid ; blood ; Laminin ; blood ; Male ; Middle Aged ; Myocardium ; pathology