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 investigate the value of MRI in diagnosing the high expression of transcription factor E2F2 in breast cancer, in order to further evaluate the biological aggressiveness of breast cancer.Methods:The study was cross-sectional. The clinical and imaging data of 92 patients with breast cancer who were pathologically diagnosed in the Second Affiliated Hospital of Nantong University from October 2014 to December 2020 were retrospectively analyzed. All patients were female, aged 32 to 82 (56±11) years. All patients underwent MRI, including T 1WI, T 2WI, diffusion-weighted imaging (DWI), and dynamic enhanced MRI. According to the immunohistochemical results, the patients were divided into E2F2 high expression group and E2F2 low expression group. Independent sample t test, Mann-Whitney U test or χ2 test were used to compare the clinical data, MRI features and pathological features of the two groups. Characteristics with P≤0.1 from univariate analyses were included in multivariate logistic regression to screen for independent risk factors predicting high expression of the transcription factor E2F2 in breast cancer. Results:Among 92 patients, 68 were in the high E2F2 expression group and 24 were in the low E2F2 expression group. There were significant differences between the two groups in peritumoral edema, type composition ratio of time-signal intensity curve, estrogen receptor expression, human epidermal growth factor receptor 2 expression, endovascular cancer embolus and molecular type composition ratio (all P<0.05). Multivariate logistic regression analysis showed that peritumoral edema alone ( OR=7.061, 95% CI 1.837—27.144, P=0.004) was an independent risk factor for predicting the high expression of transcription factor E2F2 in breast cancer. Conclusion:MRI show that peritumoral edema is an independent risk factor for predicting high expression of the breast cancer transcription factor E2F2, which is associated with the aggressiveness of breast cancer.

Objective To investigate the role and prognostic value of matrix metalloproteinase-7(MMP7)in the migration and immune cell infiltration of hepatocellular carcinoma.Methods MMP7_siRNA for downregulating the target gene MMP7 and pMMP7 for upregulating MMP7 were constructed and were used to transfect hepatocellular carcinoma cell line(MHCC97H).RT-qPCR and Western Blot were used to measure the mRNA and protein expression levels of the target gene in cells.Scanning electron microscopy and Transwell assay were used to observe the changes in cell pseudopodia and migration ability,and bioinformatics methods were used to investigate the correlation of MMP7 with immune cells and immune infiltration score in TCGA and TIMER databases in patients with hepatocellular carcinoma,as well as the association between MMP7 and the prognosis of patients with hepatocellular carcinoma.The Spearman method was used for correlation analysis.Sanger Box online tool was used to assess the value of MMP7 in the overall survival curve and disease-specific survival of hepatocellular carcinoma.The Kaplan-Meier method was used to plot survival curves,and the Log-rank test was used for comparison of prognosis between different samples.Results After MHCC97H cells were transfected with MMP7_siRNA or pMMP7,there was a significant reduction or increase in the expression of the target gene MMP7;after downregulation of MMP7,there were significant reductions in the number and length of the pseudopodia,while after MMP7 overexpression,there were significant increases in the number and length of filopodia with radial arrangement.The Transwell chamber assay showed that MMP7_siRNA2 significantly reduced the migration ability of cells(P<0.05),and there was a significant increase in migration ability after pMMP7 transfection.The expression of MMP7 was significantly correlated with B lymphocytes(r=0.37,P<0.05),CD4+T lymphocytes(r=0.40,P<0.05),neutrophils(r=0.49,P<0.05),macrophages(r=0.49,P<0.05),and dendritic cells(r=0.47,P<0.05).In the TCGA database,the patients with hepatocellular carcinoma were divided into MMP7 high expression group with 267 patients and MMP7 low expression group with 146 patients based on overall survival,and the results showed that the MMP7 high expression group had a significantly shorter overall survival time than the MMP7 low expression group(P<0.05);based on the disease-specific survival time,the patients were divided into MMP7 high expression group with 257 patients and MMP7 low expression group with 145 patients,and the analysis showed that the MMP7 high expression group also had a significantly shorter disease-specific survival time than the MMP7 low expression group(P<0.05).Conclusion MMP7 promotes the migration of hepatocellular carcinoma cells and plays a major role in immune cell infiltration,and the expression of MMP7 is also significantly associated with the prognosis of hepatocellular carcinoma.

Objective To describe the distribution characteristics of knee and ankle joint range of motion and muscle atrophy related indexes in patients with Kashin-Beck disease(KBD)in Shaanxi Province so as to explore the correlation of knee and ankle joint range of motion(ROM)with muscle atrophy indexes and provide reference for clinical characteristics analysis of KBD patients.Methods To investigate the registered KBD patients from KBD areas in Shaanxi Province,we measured the general demographic data of the patients were collected and the ROM of the knee joint(flexion and extension),the ankle joint(dorsiflexion and plantar flexion),and the muscle atrophy related indexes such as the upper arm circumference,thigh circumference,calf circumference and grip strength.According to the population characteristics,i.e.,gender,age,body mass index(BMI)and KBD grade,the median and quartile of joint ROM and muscle atrophy of KBD patients were reported,and then the differences in each index among different groups were analyzed.Partial correlation analysis was used to explore the correlation between indicators after controlling for variables such as gender,age and BMI.Results A total of 480 patients with KBD were investigated in this study,who consisted of 249(51.9％)males and 231(48.1％)females,with an average age of(63.10±7.32)years and an average BMI of(23.49±8.90)kg/m2.The knee flexion ROM,knee extension ROM,ankle dorsiflexion ROM and ankle plantar flexion ROM were[105.0(95.0,120.0)]°,[0.0(-15.0,0.0)]°,[5.0(0.0,15.0)]° and[20.0(15.0,30.0)]°,respectively,in KBD patients in Shaanxi Province.The left thigh circumference,right thigh circumference,left calf circumference,right calf circumference,and upper arm circumference were[43.0(40.0,47.0)]cm,[43.0(39.0,47.0)]cm,[29.0(27.0,32.0)]cm,[29.5(27.0,32.0)]cm,[27.0(25.0,30.0)]cm,respectively.The left hand grip strength and right hand grip strength were[13.4(9.5,18.4)]kg and[13.9(9.8,18.2)]kg,respectively.With the increase of age,the extension range of the left and right knee joints of KBD patients showed a decreasing trend(H=31.499,31.847;all P＜0.001).The range of motion of bilateral knee flexion was higher in the normal BMI group than in the overweight or obese group,with statistically significant differences(H=7.753,12.333;P=0.021,0.002).The knee flexion,thigh circumference,and calf circumference of the left and right sides showed a decreasing trend under different KBD grades(H=14.345,17.256,8.000,8.462,8.558,9.633;all P＜0.05).Correlation analysis showed that knee flexion ROM was positively correlated with thigh circumference,calf circumference,and grip strength in patients with KBD(all P＜0.05).There was a positive correlation between knee extension ROM and thigh circumference in patients with KBD(P＜0.01).Conclusion The impaired joint ROM and muscle atrophy are serious in KBD patients in Shaanxi Province,and there is a correlation between joint motion and muscle atrophy.

Lung cancer is the top cause of cancer deaths globally.Advances in immune checkpoint inhibitors(ICIs)have transformed cancer treatment,but their use in lung cancer has led to more side effects.This study examined if past pulmonary tuberculosis(TB)affects ICIs'effectiveness and safety in lung cancer treatment.We reviewed lung cancer patients treated with ICIs at Beijing Chest Hospital from January 2019 to August 2022.We compared outcomes and side effects between patients with and without prior TB.Of 116 patients(40 with TB history,76 without),prior TB didn't reduce treatment effectiveness but did increase severe side effects.Notably,older patients(≥65 years)faced a higher risk of severe side effects.Detailed cases of two patients with severe side effects underscored TB as a risk factor in lung cancer patients receiving ICIs,stressing the need for careful monitoring and personalized care.

Objective To observe the effect of extracorporeal shockwave therapy (ESWT) in regulating endothelial cell phosphatase and tensin homolog deleted on chromosome ten (PTEN) expression on lower ex-tremity vascular lesion and its possible mechanism.Methods Twenty-four 2-month-old healthy male SD rats were randomly divided into the three groups:control group (group A),diabetes angiopathy group (group B),diabetes angiopathy+ESWT group (group C).The group B and C were fed with high fat and high sugar and intraperitoneally injected with streptozotocin 60 mg/kg to establish the rat model of diabetes vascular lesion. The group C received ESWT at 1 week (T1),2 weeks (T2),3 weeks (T3) and 4 weeks (T4) after modeling,and the blood stream velocity of rat femoral artery vascular lesion area and vascular internal diameter were measured at T4 by ultrasound.At the end of ESWT,the rats were immediately killed for taking their femoral arteries and gastrocnemius.The structures of the femoral arteries in each group were observed under electron microscopy.Western blot was used to detect the expression levels of PTEN,PI3K and Akt proteins,while qRT-PCR was used to detect the expression levels of PTEN mRNA.Immunofluorescence was used to detect the expression level of CD31 in gastrocnemius muscle .Results The peak systolic flow velocity and end-dias-tolic flow velocity of femoral artery at T4 in group B and C were significantly lower than those in group A (P<0.05),but group C was higher than group B (P<0.05).The internal diameter of femoral artery had no statistical difference among 3 groups (P>0.05).The PTEN expression level in group B and group C was sig-nificantly lower than that in group A (P<0.05),while group C was higher than group B (P<0.05).The ex-pression levels of PI3K and Akt in group B were higher than those in group A (P<0.05),and group C was lower than group B (P<0.05).The PTEN mRNA expression level in group B and group C was significantly lower than that in group A (P<0.05),but group C was higher than group B (P<0.05).Under electron mi-croscopy,it was observed that after ESWT,the endothelial cell damage in group C was obvious when com-pared with group B.The CD31 expression level in group B and group C was significantly lower than that in group A (P<0.05),but group C was higher than group B (P<0.05).Conclusion ESWT could improve the vascular function,increase the peak velocity during systolic period of femoral artery in diabetes rats and im-prove the microvessel density of gastrocnemius muscle by up-regulating PTEN in lower extremity artery and down-regulating PI3K and Akt in diabetes rats.

Objective:To explore the core prescriptions and mechanism of national TCM master Liu Bailing in the treatment of lumbar disc herniation (LDH) based on data mining and network pharmacology methods; To provide the clinical reference for the treatment of LDH.Methods:The cases of LDH treated by Professor Liu in Affiliated Hospital of Changchun University of Chinese Medicine, from January 1, 2011 to December 31, 2019 were collected and analyzed. Hierarchical clustering and association rules were used to analyze the medication rules and core prescriptions. TCMSP, GeneCards, ETCM, SymMap, DAVID, etc. were used to analyze the network pharmacology of the core compounds in treating LDH and symptoms, and reveal the mechanism.Results:A total of 1 334 prescriptions were included, involving 201 kinds of Chinese materia medica, among which the medicinal property was mainly warm, the flavor was mainly sweet and the meridians were mainly liver meridian and kidney meridian; the core medicines for the treatment of LDH included Aconiti Lateralis Radix Praeparata, Spatholobi Caulis, Cinnamomi Cortex, Corydalis Rhizoma, Eucommiae Cortex, Paederia Foetida and Amomi Fructus, reflecting that Professor Liu Bailing often treats LDH from the perspective of kidney deficiency, and commonly uses the treatment methods of dispelling wind, relieving pain, warming yang and benefiting the kidney. The core prescriptions mainly participated in three pathways of cancer, immunity and cell metabolism, including PI3K-Akt signaling pathway, TNF signaling pathway and FoxO signaling pathway. Conclusion:Professor Liu Bailing's treatment of LDH focuses on overall dialectical treatment, which mainly dispels wind, relieves pain, warms yang and benefits the kidney and the mechanism of the core prescriptions may lie in diminishing the inflammatory response. The core prescriptions may treat LDH by regulating the immune response and cellular physiological functions.

The promise of regeneration therapy for restoration of damaged myocardium after cardiac ischemic injury relies on targeted delivery of proliferative molecules into cardiomyocytes whose healing benefits are still limited owing to severe immune microenvironment due to local high concentration of proinflammatory cytokines. Optimal therapeutic strategies are therefore in urgent need to both modulate local immunity and deliver proliferative molecules. Here, we addressed this unmet need by developing neutrophil-mimic nanoparticles NM@miR, fabricated by coating hybrid neutrophil membranes with artificial lipids onto mesoporous silica nanoparticles (MSNs) loaded with microRNA-10b. The hybrid membrane could endow nanoparticles with strong capacity to migrate into inflammatory sites and neutralize proinflammatory cytokines and increase the delivery efficiency of microRNA-10b into adult mammalian cardiomyocytes (CMs) by fusing with cell membranes and leading to the release of MSNs-miR into cytosol. Upon NM@miR administration, this nanoparticle could home to the injured myocardium, restore the local immunity, and efficiently deliver microRNA-10b to cardiomyocytes, which could reduce the activation of Hippo-YAP pathway mediated by excessive cytokines and exert the best proliferative effect of miR-10b. This combination therapy could finally improve cardiac function and mitigate ventricular remodeling. Consequently, this work offers a combination strategy of immunity modulation and proliferative molecule delivery to boost cardiac regeneration after injury.

【Objective】 To explore the effectiveness of creating the obstructive sleep apnea hypopnea syndrome (OSAHS) animal model of glossocoma using the botulinum toxin type A in white rabbits, and to explore the effectiveness and safety of magnetic traction hyoid suspension operation in the OSAHS animal model of glossocoma. 【Methods】 A total of 12 adult male experimental white rabbits were randomly divided into two groups. The animals in the experimental group were injected with 0.4 mL (10 U) of botulinum toxin type A in the genioglossus muscle to construct the OSAHS animal model of glossocoma. The animals in the control group were injected with 0.4 mL of normal saline. We designed and 3D printed a polyacrylate shell that could be loaded with inner and outer neodymium iron boron (NdFeB) magnets. After the modeling, a polyacrylate shell with the inner magnet device was fixed on the hyoid bone of the animals in the experimental group. All animals in the experimental group wore the polyacrylate orthotic neck brace containing the outer magnet 10 days after the operation. The arterial blood oxygen detector was used to record the oxygen saturation (SaO2) of the femoral artery, and multi-slice CT plain scan was used to measure the diameter of the narrowest part of the upper airway. 【Results】 The animals in the experimental group gradually showed decreased activity, labored breathing, blue lips and ear margins and other manifestations of hypoxemia 5 days after intramuscular injection of botulinum toxin type A in the genioglossus, and their body weight dropped from (3.72±0.21)kg to (3.40±0.20)kg, the average SaO2 of the femoral artery decreased from (93.84±5.14)% to (84.00±3.35)%, and the diameter of the narrowest part of the upper airway decreased from (4.83±0.47)mm to (3.52±0.83)mm (P<0.05). In the control group, the animals’ weight, the average SaO2 of the femoral artery, and the diameter of the narrowest part of the upper airway did not significantly change before and after injection of normal saline into the genioglossus muscle (P>0.05). The animals in the experimental group completed the magnetic traction hyoid suspension surgery. After wearing the orthotic neck brace containing an external magnet for hyoid magnetic traction, the food intake and activity of the animals in the experimental group increased, the color of the lips changed from purple to pink, the SaO2 of the femoral artery increased significantly to (90.44±5.95)%, and the diameter of the narrowest part of the upper airway increased significantly to (4.42±0.15)mm (P<0.05). 【Conclusion】 The genioglossus muscle injection of botulinum toxin type A in white rabbits could successfully establish the OSAHS animal model of glossocoma. Magnetic traction hyoid suspension surgery in the treatment of OSAHS animal model could effectively correct the upper airway stenosis related symptoms and hypoxemia caused by glossocoma.

The purified Vero cell rabies vaccine (PVRV) has been used in rabies prevention for more than 40 years. A comprehensive review of the relevant researches on PVRV in rabies prevention at local and overseas in recent years shows that in the simplified Zagreb immunization program, PVRV has the similar immunogenicity and safety as in the standard Essen program. PVRV, purified chicken embryo cell rabies vaccine (PCECV) and human diploid cell rabies vaccine (HDCV) have similar immunogenicity and safety. PVRV also has good immunogenicity and safety in special populations such as those with diseases. The combined vaccination of PVRV and acellular diphtheria, tetanus, pertussis and inactivated poliomyelitis combined vaccine (DTP-IPV) or others did not find immune interference, which provided feasibility for children to vaccinate against rabies at the same time of vaccinating with planned vaccines. The combination of PVRV and equine rabies immunoglobulin can also achieve better prevention effect. PVRV plays an important role in the prevention of rabies, and its wide application will make a positive contribution to achieving the goal of eliminating rabies transmitted from dogs to humans by 2030 proposed by World Health Organization (WHO).