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.

ABSTRACT:Objective To establish a rapid molecular method for the detection of aldehyde dehydrogenase-2 (ALDH2)and investigate the gene polymorphisms of ALDH2?2 and determine whether the polymorphic ALDH2 gene is associated with drinking behavior in a Chinese population.Methods The gene polymorphisms of ALDH2?2 were detected using pyrosequencing,TaqMan Real-time PCR and GeneChip microarray technologies;genotyping of 302 volunteers was performed to assess their genetic associations with alcohol use behavior.Results We developed pyrosequencing,TaqMan Real-time PCR and GeneChip microarray methods to identify ALDH2? 2 polymorphisms.The allele frequency of ALDH2?2 was 20.36% in the Chinese population:16.33% in the alcoholic group and 27.83% in non-drinkers (P=0.001).In contrast,the genotype frequency of heterozygous ALDH2?1/?2 plus homozygous ALDH2?2/?2 was 45.28% in non-drinkers and 32.65% in the alcoholics group (P=0.030). Allele frequency of ALDH2 genotypes differed significantly between our Chinese sample and other ethnic groups in Asia,and it was significantly higher than that in European and American countries.Conclusion The developed pyrosequencing,TaqMan Real-time PCR and GeneChip microarray methods are rapid,accurate,high-throughput, convenient,and reliable for detecting ALDH2 polymorphisms.ALDH2?2 gene can protect against the development of alcoholism.The allele frequency of ALDH2 in this Chinese population differs from that in other ethnic groups.

Objective To evaluate the effectiveness and safety of immunosuppressive program including tacrolimus (FK506) in infants after liver transplantation.Methods The medical records of infants who underwent liver transplantation for biliary atresia and receiving the immunosuppressant of FK506 combined with methylprednisolone (MP) after operation in Beijing Friendship Hospital during June 2013 to September 2014 were collected.The infants' general clinical situation, recipient survival rate, survival rate of transplanted liver, transplant complication, acute rejection rate, and adverse reactions were recorded.The whole blood trough concentration of KF506 on day 3, 7, 15 and one month after medication and occurrence of rejection and adverse reactions were recorded.Results A total of 54 infants were enrolled into this study, 50％ were boys.The children's age was 4-19 months, the median age was 8 months.Seven infants died within 14 to 45 days after liver transplantation.Both recipient survival rate and survival rate of transplanted liver were 87％.Three cases (5.6％) developed transplant complication on days 7-9 after operation, among them 2 cases had hepatic artery thrombosis and 1 case had bile leakage, respectively.Ten infants (18.5％) developed acute rejection on days 4-14 after operation.The incidence of adverse reaction during hospitalization was 35.2％ (19/54).Twenty-five case-times adverse reactions involved 19 infants.There wcrc 5 case-times of severe adverse reactions which involved 5 infants (3 cases died from epilepsia,increased creatinine, and heart failure, respectively;2 cases recovered to normal from increased serum alanine aminotransferase after the treatment of liver protection).There were 20 case-times general adverse reactions (diarrhea, vomiting and skin rash etc.) which involved 17 infants.They all improved after symptomatic treatment.The mean blood concentration of FK506 on days 3, 7, 15 and one month after medication were (9.6 ± 5.7), (8.7 ± 4.5), (9.2 ± 3.7) and (8.6 ± 4.1) μg/L, respectively.The blood concentration of FK506 was 2.4-9.3 μg/L with an average concentration of (5.10 ± 2.04) μg/L when acute rejection occurred and 6.2-23.9 μg/L with an average concentration of (11.67 ± 3.58) μg/L when adverse reactions occurred.The average blood concentration of FK506 was (1 1.67 ± 3.58) μg/L and the concentrations in 17 of 25 cases were over 10 μg/L.Conclusion FK506 at blood concentration 6.0-11.0 μg/L in infants used for immunosuppressive therapy after liver transplantation is relatively effective and safe.

Objective To evaluate the kidney's safety of edaravone injection. Methods The clinical data of patients who were hospitalized in Neurology Department of Beijing Friendship Hospital, Capital Medical University from January 2014 to June 2014 and had complete medical records,aged ≥45 years and received edaravone injection for cerebrovascular disease were collected and analyzed retrospectively. The patients' information,complications,time of application of edaravone injection(30 mg, twice daily,IV infusion),drug combination and the levels of serum creatinine were recorded. The serum creatinine elevated to ≥26. 4 μmol/ L,or increased 1. 5 times of baseline were the diagnostic criteria of kidney injury after receiving edaravone injection. Results A total of 237 patients' medical records comprised 163 male and 74 female,with average age of(65 ± 9)years(50 to 86 years)were collected. The average time of edaravone injection administration was 11 days(2 to 26 days)for all patients. Eleven patients(4. 6% )developed kidney injury. There was no statistical significance in the incidence of kidney injury between male and female patients[4. 9%(8 / 163)vs. 4. 1%(3 / 74),P > 0. 05 for all comparisons]. The incidence of kidney injury in patients who were 75 years or older was higher than those in the patients who aged between 45 to 59 years and 60 to 74 years[11. 4%(4 / 35)vs. 3. 8%(3 / 80),3. 3%(4 / 122), P < 0. 05 for all comparisons]. The incidence of kidney injury in patients with chronic renal insufficiency or renal cyst was higher than that in patients without chronic renal insufficiency or renal cyst[9. 1%(2 / 22) vs. 4. 2%(9 / 215),7. 7%(2 / 26)vs. 4. 3%(9 / 211),P < 0. 05]. The average level of serum creatinine in the 11 patients before treatment was(68 ± 24)μmol/ L(26 to 113 μmol/ L)and increased to(101 ± 36)μmol/ L(52 to 187 μmol/ L)after receiving edaravone injection for 9 to 13 days(average days of 11). The serum creatinine levels of the 11 patients returned to the levels before administration after edaravone withdrawal. The 11 patients with kidney injury were all co-treated with three or more kinds of drugs. Conclusions The kidney's safety of edaravone injection is higher in patients who were under 75 years, without chronic renal insufficiency and renal cyst. Dynamic monitoring of kidney function should be given in patients who are 75 years or older,with chronic renal insufficiency or renal cyst when receiving edaravone injection.

Objective To evaluate the effectiveness and safety of immunosuppressive program including tacrolimus (FK506) in infants after liver transplantation.Methods The medical records of infants who underwent liver transplantation for biliary atresia and receiving the immunosuppressant of FK506 combined with methylprednisolone (MP) after operation in Beijing Friendship Hospital during June 2013 to September 2014 were collected.The infants' general clinical situation, recipient survival rate, survival rate of transplanted liver, transplant complication, acute rejection rate, and adverse reactions were recorded.The whole blood trough concentration of KF506 on day 3, 7, 15 and one month after medication and occurrence of rejection and adverse reactions were recorded.Results A total of 54 infants were enrolled into this study, 50％ were boys.The children's age was 4-19 months, the median age was 8 months.Seven infants died within 14 to 45 days after liver transplantation.Both recipient survival rate and survival rate of transplanted liver were 87％.Three cases (5.6％) developed transplant complication on days 7-9 after operation, among them 2 cases had hepatic artery thrombosis and 1 case had bile leakage, respectively.Ten infants (18.5％) developed acute rejection on days 4-14 after operation.The incidence of adverse reaction during hospitalization was 35.2％ (19/54).Twenty-five case-times adverse reactions involved 19 infants.There wcrc 5 case-times of severe adverse reactions which involved 5 infants (3 cases died from epilepsia,increased creatinine, and heart failure, respectively;2 cases recovered to normal from increased serum alanine aminotransferase after the treatment of liver protection).There were 20 case-times general adverse reactions (diarrhea, vomiting and skin rash etc.) which involved 17 infants.They all improved after symptomatic treatment.The mean blood concentration of FK506 on days 3, 7, 15 and one month after medication were (9.6 ± 5.7), (8.7 ± 4.5), (9.2 ± 3.7) and (8.6 ± 4.1) μg/L, respectively.The blood concentration of FK506 was 2.4-9.3 μg/L with an average concentration of (5.10 ± 2.04) μg/L when acute rejection occurred and 6.2-23.9 μg/L with an average concentration of (11.67 ± 3.58) μg/L when adverse reactions occurred.The average blood concentration of FK506 was (1 1.67 ± 3.58) μg/L and the concentrations in 17 of 25 cases were over 10 μg/L.Conclusion FK506 at blood concentration 6.0-11.0 μg/L in infants used for immunosuppressive therapy after liver transplantation is relatively effective and safe.

Objective To evaluate the kidney's safety of edaravone injection. Methods The clinical data of patients who were hospitalized in Neurology Department of Beijing Friendship Hospital, Capital Medical University from January 2014 to June 2014 and had complete medical records,aged ≥45 years and received edaravone injection for cerebrovascular disease were collected and analyzed retrospectively. The patients' information,complications,time of application of edaravone injection(30 mg, twice daily,IV infusion),drug combination and the levels of serum creatinine were recorded. The serum creatinine elevated to ≥26. 4 μmol/ L,or increased 1. 5 times of baseline were the diagnostic criteria of kidney injury after receiving edaravone injection. Results A total of 237 patients' medical records comprised 163 male and 74 female,with average age of(65 ± 9)years(50 to 86 years)were collected. The average time of edaravone injection administration was 11 days(2 to 26 days)for all patients. Eleven patients(4. 6% )developed kidney injury. There was no statistical significance in the incidence of kidney injury between male and female patients[4. 9%(8 / 163)vs. 4. 1%(3 / 74),P > 0. 05 for all comparisons]. The incidence of kidney injury in patients who were 75 years or older was higher than those in the patients who aged between 45 to 59 years and 60 to 74 years[11. 4%(4 / 35)vs. 3. 8%(3 / 80),3. 3%(4 / 122), P < 0. 05 for all comparisons]. The incidence of kidney injury in patients with chronic renal insufficiency or renal cyst was higher than that in patients without chronic renal insufficiency or renal cyst[9. 1%(2 / 22) vs. 4. 2%(9 / 215),7. 7%(2 / 26)vs. 4. 3%(9 / 211),P < 0. 05]. The average level of serum creatinine in the 11 patients before treatment was(68 ± 24)μmol/ L(26 to 113 μmol/ L)and increased to(101 ± 36)μmol/ L(52 to 187 μmol/ L)after receiving edaravone injection for 9 to 13 days(average days of 11). The serum creatinine levels of the 11 patients returned to the levels before administration after edaravone withdrawal. The 11 patients with kidney injury were all co-treated with three or more kinds of drugs. Conclusions The kidney's safety of edaravone injection is higher in patients who were under 75 years, without chronic renal insufficiency and renal cyst. Dynamic monitoring of kidney function should be given in patients who are 75 years or older,with chronic renal insufficiency or renal cyst when receiving edaravone injection.

Objective To study the changes of posterior corneal elevation with one-year follow-up by using Allegro Oculyzer anterior segment diagnostic system in patients who had undergone laser in situ keratomileusis with femtosecond laser (FS-LASIK) for myopia. Methods Ninety eyes of forty-five patients who had undergone FS-LASIK for myopia were included in our study . The spherical equivalent of ametropia was-10.63D to -1.63D. The preoperative and postoperative corneal tomography (including 1, 3, 6 and 12 month after operation ) were collected by Allegro Oculyzer in the posterior corneal elevation and the thickness at central corneal thinnest point of each eye were measured , and the differences of the posterior corneal elevation were calculated. The data were analyzed with ANOVA and Pearson correlation analysis. Results There were no statistically significant differences in the changes of posterior corneal elevation from the preoperative time to the any postoperative follow-up time (F = 1.50, P > 0.05). There were no statistically significant changes of the posterior corneal elevation from the 1st month to 12th month postoperatively (F = 1.47, P > 0.05). There were statistically significant differences in the changes of thickness at central corneal thinnest point from the preoperative to the 12th month postoperative (F = 369.10, P <0.01). At postoperative time, the posterior corneal elevation was not correlated with several factors including spherical equivalent , ablation depth , residual bed thickness, ablation percentage per total corneal thickness and (corneal flap thickness + ablation depth) /thinnest point preoperative corneal thickness (P > 0.05). Conclusion After strictly followed surgical indications in FS-LASIK, the posterior corneal elevation can keep good stability and has no significant change. Thickness of central cornea thinnest point increases gradually and tends to stablity at the 3th months after surgery.

Clinical data of 80 patients with renal failure due to under detected causes(from January 1998 to June 2007)were retrospectively analyzed.Of 66 patients with acute renal failure(ARF),rhabdomyolysis was found in 45,tumor in 15,anti-neutrophil cytoplasmic antibody(ANCA)related vasculitis in 2,infective endocarditis in 2,and hemolytic uremic syndrome in 2.Of 14 patients with chronic renal failure(CRF),primary hypothyroidism was seen in 3,multiple myeloma in 4,amyloidosis in 2,analgesic nephropathy in 3,and renal tuberculosis in 2.

Objective To investigate the effects of compound bifonazole solution for the treatment of superficial mycosis.Methods The study groups were treated with compound bifonazole solution and the control group with clotrimazole solution in a double-blind controlled clinical trial.The solutions were applied to skin lesions once a day.The course of treatment was two weeks for tinea corporis and tinea cruris and four weeks for tinea manus and tinea pedis.The patients were followed up weekly for two weeks after cessation of treatment and evaluated with regard to erythema,papule,blister,scale,keratinization and pruritus.Mycologic examinations were performed before,during and right after treatment and two weeks after treatment.Results A total of434patients participated into the study.The clinical cure rates of study group were82.25%in tinea corporis and tinea cruris,and68.75%tinea manus and tinea pedis,with a total response rates of95.85%and92.5%in tinea corporis and tinea cruris,and92.5%in tinea manus and tinea pedis,respectively.The clinical cure rates of control group were58.6%in tinea corporis and tinea cruris,and44.7%in tinea manus and tinea pedis,with a total response rates of83.0%and87.2%in tinea corporis and tinea cruris,and in tinea manus and tinea pedis,respectively.The MICs to350clinical isolates of pathogenic fungi were1.6~2.5mg/L for compound bifonazole solution,and3.125~25mg/L for clotrimazole solution.Conclusions Compound bifonazole solution is a high-effective,broad-spectrum anti-fungal agent.It is keratolytic,well permeable and safe for relatively long term application.