Objective To study the effects of different hypertonic saline (4.5%and 7.5%) in fluid resuscitation on hemodynamics in traumatic rabbits with hemorrhagic shock.Methods Thirty-two healthy rabbits ( male or female, 2.0-3.0 kg body weight) were divided into 4 groups randomly:SHAM group, SWT group ( shock without treatment) , 4.5%group (resuscitation with 4.5% hypertonic saline), and 7.5% group ( resuscitation with 7.5% hypertonic saline), 8 rabbits in each group.The rabbit model of uncontrolled hemorrhagic shock was established after anesthesia.The fluid used in the two methods of fluid resuscitation was infused into the rabbits at designed times.The hemodynamic data including the left intraventricular systolic pressure ( LVSP) and maximal change rate of left intraventricular pressure ( ±dp/dtmax) were determined at 0 min, 30 min, 60 min, and 90 min.Results (1) The rabbit models of uncontrolled hemorrhagic shock were generated successfully.At 30 min, data of SWT in the 4.5%and 7.5%groups had no significant difference through pairwise comparison (P>0.05).(2) The hemodynamic parameters changed similarly during the experiment.At 60 min, the values of the 7.5%group ( LVSP=115.00 ±8.37 mmHg, +dp/dtmax=4.29 ±0.50 mmHg/ms, -dp/dtmax=-3.25 ±0.25 mmHg/ms) were significantly higher than those in the 4.5%group ( ( LVSP=104.14 ±7.73 mmHg, +dp/dtmax=3.35 ±0.39 mmHg/ms, -dp/dtmax=-2.27 ±0.12 mmHg/ms) (P<0.05).At 90 min, the data of the 7.5%group were higher, but statistically not significantly different ( P>0.05 ) .Conclusions Fluid resuscitation can improve the hemodynamic function in traumatic rabbits with uncontrolled hemorrhagic shock.Comparing with the 4.5%hypertonic saline, 7.5% hypertonic saline can improve the hemodynamic function more apparently.Our results may provide an experimental support for the treatment of clinical patients with uncontrolled hemorrhagic shock.

Multiple myeloma is a type of hematological malignancy caused by clonal plasma cell proliferation. In recent years, the application of proteasome inhibitors and immune drugs (IMiDs) in multiple myeloma has prolonged the survival period of patients and improved the quality of life. However, due to the heterogeneity, recurrence and drug resistance of the disease, MM is still incurable. Relatively good response rates of immune checkpoint inhibitors such as Pembrolizumab, Nivolumab, Pidilizumab, Atezolizumab and Durvalumab offer MM a new hope. This article reviews the relevant literature in recent years, introduces the immune pathogenesis of MM, PD-1/PD-L1/2-related immune pathway and the current status of immunotherapy, to provide reference for the immunotherapy of MM.

Objective To investigate the expression of PD-1 and PD-L1/2 in T cell subsets and myeloma cells in the bone marrow from newly diagnosed multiple myeloma (NDMM) patients and their relation with clinical features. Methods We collected the bone marrow and clinical data of 22 NDMM patients and 18 cases of healthy controls. We sorted CD4⁺T cells, CD8⁺T cells and myeloma cells by flow cytometry, and observed the expression of PD-1 and PD-L1/2. Results Compared with the control group, the proportion of CD8⁺T cells in the NDMM group was significantly higher, while the ratio of CD4⁺/CD8⁺ was significantly lower (both P < 0.05). The expression levels of PD-1 and PD-L2 in CD4⁺T cells in the NDMM group were significantly higher than those in the control group (both P < 0.05). The expression levels of PD-1, PD-L1 and PD-L2 in T cell subsets and myeloma cells of NDMM patients were not correlated with the gender, age, immune typing, Durie-Salmon stage and subtypes, ISS stage or mSMART3.0 stratification (both P > 0.05). Conclusion Most of MM patients suffering immune abnormality, which may be associated with the mutual immunosuppressive effects between T lymphocytes and plasma cells which expressing PD-1 and PD-L1/2.

Objective:To explore the positive rates of 2019-nCoV nucleic acid at different time of courses of COVID-19.Methods:Patients with confirmed COVID-19 were enrolled in this study. Nasal and throat swabs were collected from different courses of disease. Real-time RT-PCR was used to detect 2019-nCoV nucleic acid.Results:From January 23 to February 20, 2020, a total of 120 confirmed cases of COVID-19 were reported in Xi’an, and 85 cases(70.83%) were positive in first detection. The COVID-19 cases included consistently nucleic acid positive and intermittently nucleic acid positive patients. 2019-nCoV nucleic acid could be detected in incubation period, and the longest observed duration of nucleic acid positive in this study was 26 days. The positive rate of 2019-nCoV nucleic acid was up to 84.21% on the 6th day, and the positive rate decreased as time passed during the course of COVID-19. Three patients (2.86%) were tested positive for 2019-nCoV nucleic acid again in nasal and throat swabs after discharge.Conclusions:The positive rate of 2019-nCoV nucleic acid was higher in the early stage of disease. 2019-nCoV nucleic acid can be detected in incubation period, and virus shedding may last for a long period.

Background::Carotid intima-media thickness (IMT) and diameter, stiffness, and wave reflections, are independent and important clinical biomarkers and risk predictors for cardiovascular diseases. The purpose of the present study was to establish nationwide reference values of carotid properties for healthy Chinese adults and to explore potential clinical determinants.Methods::A total of 3053 healthy Han Chinese adults (1922 women) aged 18-79 years were enrolled at 28 collaborating tertiary centers throughout China between April 2021 and July 2022. The real-time tracking of common carotid artery walls was achieved by the radio frequency (RF) ultrasound system. The IMT, diameter, compliance coefficient, β stiffness, local pulse wave velocity (PWV), local systolic blood pressure, augmented pressure (AP), and augmentation index (AIx) were then automatically measured and reported. Data were stratified by age groups and sex. The relationships between age and carotid property parameters were analyzed by Jonckheere-Terpstra test and simple linear regressions. The major clinical determinants of carotid properties were identified by Pearson’s correlation, multiple linear regression, and analyses of covariance.Results::All the parameters of carotid properties demonstrated significantly age-related trajectories. Women showed thinner IMT, smaller carotid diameter, larger AP, and AIx than men. The β stiffness and PWV were significantly higher in men than women before forties, but the differences reversed after that. The increase rate of carotid IMT (5.5 μm/year in women and 5.8 μm/year in men) and diameter (0.03 mm/year in both men and women) were similar between men and women. For the stiffness and wave reflections, women showed significantly larger age-related variations than men as demonstrated by steeper regression slopes (all P for age by sex interaction <0.05). The blood pressures, body mass index (BMI), and triglyceride levels were identified as major clinical determinants of carotid properties with adjustment of age and sex. Conclusions::The age- and sex-specific reference values of carotid properties measured by RF ultrasound for healthy Chinese adults were established. The blood pressures, BMI, and triglyceride levels should be considered for clinical application of corresponding reference values.

Objective: To analyze the epidemiological characteristics and etiologic agent of herpangina in Xi’an in 2016. Methods: Herpangina epidemiological data and random stool samples were collected from two sentinel hospitals. The data were statistically analyzed with Excel and SPSS 18.0 and samples were detected and enteroviruses were genotyped using real-time PCR and RT-snPCR. Results: Totally 421 cases were reported and the male-to-female ratio was 1.54∶1, age ranged from 3 month to 13 years, and 90.50% were under three years of age. Herpangina showed semiannual peaks in April to October, of which the highest was in June (23.75%, 100/421). Lab result showed that 71.05% were EV positive out of 152 samples, and further genotyping indicated 60 were non-typable, and other 48 comprised of eight serotypes of EV including EV-A71, CV-A4, CV-A5, CV-A6(6.48%), CV-A10(23.15%), CV-A12, CV-A16 and CV-B3. Conclusions Male children under 3 years of age were the main population and herpangina cases were most frequently reported in June in Xi’an in 2016. CV-A6 and CV-A10 were more frequently detected in the typable ones.