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 intervention effect and mechanism of LUO's Neiyi Prescription on the proliferation and angiogenesis of eutopic endometrium in rats with endometriosis(EMs)based on hypoxia-inducible factor 1A(HIF1A)/enhancer of zeste homolog 2(EZH2)/anthrax toxin receptor 2(ANTXR2)signaling pathway.Methods SD rats were randomly divided into sham operation group,model group,Danazol group(4.2 g·kg-1),low-dose LUO's Neiyi Prescription group and high-dose LUO's Neiyi Prescription group(15.74,31.48 g·kg-1),eight rats in each group.The rat model of EMs with qi stagnation and blood stasis syndrome was constructed by autologous endometrial transplantation combined with multi-factor intervention.Intragastric administration was given once a day for 28 consecutive days.The pathological changes of endometrial tissue were observed by HE staining.The expression levels of proliferating cell protein 67(Ki67)and platelet endothelial cell adhesion molecule 1(CD31)in endometrial tissue were detected by immunohistochemistry.The mRNA and protein expression levels of HIF1A,EZH2 and ANTXR2 in endometrial tissues were detected by qRT-PCR and Western Blot.The expression levels of YAP1,CD44 and β-catenin in endometrial tissues were detected by Western Blot.Results Compared with the sham operation group,the epithelial cells of the eutopic endometrium of the model group were thickened,the interstitial cells were arranged disorderly,and the inflammatory cells increased.The expression levels of Ki67 and CD31 in endometrial tissues were significantly increased(P＜0.01),the mRNA and protein expression levels of HIF1A and ANTXR2 were significantly increased(P＜0.01),while the mRNA and protein expression levels of EZH2 were significantly decreased(P＜0.01),and the protein expression levels of YAP1,CD44 and β-catenin were significantly increased(P＜0.01).Compared with the model group,the epithelial layer of the eutopic endometrial tissue of the rats in each administration group became thinner,the interstitial disorder and inflammatory infiltration were improved,and the levels of Ki67 and CD31 in the eutopic endometrial tissue were significantly decreased(P＜0.01).The mRNA and protein expression levels of HIF1A and ANTXR2 in the endometrium of rats in the Danazol group and the high-dose LUO's Neiyi Prescription group were significantly decreased(P＜0.05,P＜0.01),and the mRNA and protein expression levels of EZH2 were significantly increased(P＜0.05,P＜0.01).The protein expression levels of YAP1,CD44 and β-catenin in endometrial tissue of rats in each administration group were significantly decreased(P＜0.05,P＜0.01).Conclusion LUO's Neiyi Prescription can play a role in the treatment of EMs by inhibiting the proliferation and angiogenesis of eutopic endometrial cells,and its mechanism may be related to the inhibition of HIF1A/EZH2/ANTXR2 signaling pathway.

Objective:To investigate the effect of exercise rehabilitation on frailty of elderly patients with coronary heart disease after percutaneous coronary intervention (PCI) .Methods:From January to December 2021, 80 elderly patients with coronary heart disease who received PCI in Qinhuai Medical Area of General Hospital of Eastern Theater Command were selected as the study subject by convenience sampling. A total of 39 patients from January to June 2021 were set in the control group, and 41 patients from July to December 2021 were set in the experimental group. The control group was given routine nursing, and the experimental group was given systematic exercise rehabilitation on the basis of the control group. The effects of intervention were evaluated by Tilburg Frailty Index (FI) , Cardiac Exercise Self-Efficacy Instrument (CESEI) , cardiac function, exercise tolerance, and 6-minute Walking Distance (6MWD) .Results:There was no significant difference in FI and CESEI scores between the two groups before intervention ( P>0.05) . After intervention, the FI score of patients in the experimental group was lower than that in the control group, and the CESEI score was higher than that in the control group, with statistically significant differences ( P<0.05) . There was no significant difference in cardiac function, exercise tolerance and 6MWD between the two groups before intervention ( P>0.05) . After intervention, there were statistically significant differences in cardiac function, exercise tolerance and 6MWD between the two groups ( P<0.05) . Conclusions:Exercise rehabilitation can effectively alleviate the frailty of elderly patients with coronary heart disease after PCI, improve their exercise compliance, cardiac function and exercise tolerance, which is worthy of clinical promotion.

Objective:To analyze the research hotspots of the application of mobile health in cardiac function monitoring of patients with heart disease and to conduct a visual analysis.Method:Subject field retrieval was carried out based on Web of Science Core Collection. The retrieval time range was set from 2000 to 2022, and the type of paper was limited to treatise. The retrieved literatures were imported into Endnote 7 for screening, and the repetitive and unrelated literatures were excluded. A total of 291 literatures were included in this study. Open refine 2.8 was used for data cleaning of synonyms and then VOSviewer 1.6.18 was used for visualization analysis of country/region, author and keywords.Results:Research reports on the application of mobile medical in the field of cardiac function monitoring in patients with heart disease have been growing steadily since 2005, and the number of articles published in the field increased rapidly from 2020 to 2021. The top five countries with the highest number of publications were the United States (71) , Australia (20) , China (18) , the United Kingdom (14) and Sweden (13) . The cooperation and exchange among global researchers were relatively close, but they were still dominated by regional cooperation and had not formed a large core group of authors. A total of 71 high-frequency keywords were included, and the top five were mhealth (30 times) , heart failure (27 times) , smartphone (26 times) , telemedicine (15 times) and mobile phone (17 times) . Each cluster keyword was related to each other, which represented the current research hotspot content respectively.Conclusions:At present, number of publications in China ranks first in the world, but there is still a big gap compared with the United States. The development and optimization of monitoring equipment and mobile medical APP have become the focus and hot topics.

Objective:To investigate the effect of pidotimod in reducing pulmonary infection in patients with lung cancer undergoing chemotherapy.Methods:One hundred and twenty patients with lung cancer in the Fifth People′s Hospital of Dalian City from July 2017 to July 2018 were selected. The patients were divided into control group and pidotimod group by random digits table method with 60 cases each. The patients were treated with standard two drugs chemotherapy containing platinum drug according to the pathological type, and the patients in pidotimod group were combined with pidotimod. The number of pulmonary infections during chemotherapy, number of completed scheduled chemotherapy and adverse reaction were observed. The correlation between pulmonary infection and pidotimod was analyzed by multivariate orderly Logistic regression.Results:The incidence of pulmonary infection in pidotimod group was significantly lower than that in control group: 18.33% (11/60) vs. 40.00% (24/60), and there was statistical difference ( χ2 = 6.845, P<0.01). The rate of completed scheduled chemotherapy in pidotimod group was significantly higher than that in control group: 55.00% (33/60) vs. 36.67% (22/60), and there was statistical difference ( χ2 = 4.062, P<0.05). Multivariate orderly Logistic regression analysis result showed that pidotimod could reduce the risk of pulmonary infection ( OR = 0.210, 95% CI 0.072 to 0.606, P = 0.004), and help to complete the scheduled chemotherapy ( OR = 2.323, 95% CI 1.080 to 5.003, P = 0.031). In pidotimod group, no obvious adverse reaction related to pidotimod application was detected, and chemotherapy was not affected. Conclusions:Application of pidotimod can reduce the chance of pulmonary infection in patients with lung cancer undergoing chemotherapy and help patients complete scheduled chemotherapy.

Objective: To analyze the expression of c-MET and its prognostic correlation in patients with lung adenocarcinoma. Methods: The clinical data and pathological specimen of patients with lung adenocarcinoma in Dalian 5th People′s Hospital from January 2006 to December 2011 were retrospectively analyzed. The expression difference of c-MET between lung adenocarcinoma tissue and normal adjacent tissues was compared. The correlation of c-MET with the pathology and clinical factors was also analyzed. Results: A total of 82 patients were retrospective analyzed, including 82 pathological specimens of lung adenocarcinoma and 45 specimens of normal adjacent tissues. Among 53 patients with stage Ⅰ-Ⅱ lung adenocarcinoma, 31 cases had low expression of c-MET and 22 cases had high expression of c-MET. Among 29 patients with stage Ⅲ lung adenocarcinoma, 10 cases had low expression of c-MET and 19 cases had high expression of c-MET. There was a correlation between TNM stage and c-MET positive expression in lung adenocarcinoma (P=0.037). The positive expression rate of c-MET was not significantly correlated with age, sex and differentiation degree (P > 0.05). Among 82 cases of lung adenocarcinoma, 39 cases had low expression of c-MET and 43 cases had high expression of c-MET; 45 cases of para-carcinoma tissuehad low expression of c-MET. The positive expression rate of c-MET in lung adenocarcinoma tissues was significantly higher than that in para-carcinoma tissue (P < 0.01). Kaplan-Meier survival curve analysis showed that the median disease-free survival was 41.5 months in c-MET high-expression group and 55.3 months in low-expression group. The expression level of c-MET was closely related to disease-free survival in lung adenocarcinoma patients (P < 0.05). Conclusions The expression of c-MET is significantly increased in patients with lung adenocarcinoma. The expression level has relevance with TNM staging and prognosis.

Objective To use the fluorescence PCR‐melting curve method to detect CYP2C9 and VKORC1 gene polymorphism in Xinjiang Hui population ,to analyze their gene distribution and gene mutation frequency ,and to evaluate the clinical applicability of the fluorescence PCR‐melting curve method .Methods The fluorescence PCR‐melting curve method and sequencing method were adopted to contrastively detect CYP2C9*2 ,CYP2C9*3 and VKORC1(‐1639G/A)gene polymorphism .Results Among detected 228 Xinjiang Hui individuals ,199 cases of CYP2C9*1/*1 ,2 cases of CYP2C9*1/*2 ,26 cases of CYP2C9*1/*3 and only 1 case of CYP2C9*3/*3 were detected ,no case of CYP2C9*2/*2 and CYP2C9*2/*3 was detected .Two kinds of allele G and A were detected for VKORC1(‐1639G/A) ,in which VKORC1‐1639G/G type was detected in 2 cases ,VKORC1‐1639G/A type was detected in 39 cases and VKORC1‐1639A/A type was detected in187 cases ,compared with the sequencing method ,the results of the fluorescence PCR‐melting curve method were completely consistent .Conclusion Xinjiang Hui population also has CYP2C9 gene *2 ,*3 loci and VKORC1 gene(‐1639G/A) locus polymorphism ,their occurrence frequency has a certain difference with Xingjiang Uygur and other regional populations ,the adopted fluorescence PCR‐melting curve method used in the gene polymorphism detection can meet clinical detection requirements .

Objective To isolate and culture the spontaneous ascites cells from Microtus fortis under artificial conditions, so as to investigate the molecular mechanism at the cell level. Methods The cells were isolated from spontaneous ascites of M. fortis artificially bred for 90 d,and were cultured and observed under a microscope. The differences of ascites cells among nor?mal,spontaneous ascites and schistosomiasis infected samples of M. fortis were compared. The lesion of tissue was observed si?multaneously. Results There were no obvious organ tissue lesions in M. fortis with spontaneous ascites,and the number and types of cells in peritoneal fluid were irregular and significantly changed. With the extension of culture time ,the colonies ap?peared and there were a large number of vacuole?like cells in the cultured medium and sequentially presenting proliferation ,de?formation,disintegration and the fiber?like changes and could be passaged 3-4 d only. Conclusion The cells from M. fortis with spontaneous ascites are similar to its abdominal cavity cells after infection of Schistosoma japonica.

OBJECTIVETo prepare and characterize rabbit polyclonal antibodies against Toxoplasma gondii vacuolar proton pyrophosphatase type I (TgVP1).

METHODS AND RESULTSTwo synthesized peptides TgVP1-1 and TgVP1-2 as the haptens were conjugated with KLH to immunize rabbits. Indirect ELISA showed that the titers of rabbit anti-TgVP1-1 polyclonal antibody and rabbit anti-TgVP1-2 polyclonal antibody reached 1:128 000. Western blotting results revealed that both purified polyclonal antibodies could specifically bind to a purified 85 kD T. gondii protein predicted as TgVP1. The protein detected by these two polyclonal antibodies was distributed in the cytoplasm of T. gondii tachyzoite, and this distribution pattern was consistent with that of acidocalcisome.

CONCLUSIONThe peptide-based method of antibody generation is efficient and the obtained TgVP1 polyclonal antibodies possess a high specificity to facilitate further study of T. gondii acidocalcisome and the diagnosis of toxoplasmosis.

Animals ; Antibodies ; immunology ; Blotting, Western ; Enzyme-Linked Immunosorbent Assay ; Protozoan Proteins ; immunology ; Pyrophosphatases ; immunology ; Rabbits ; Toxoplasma ; enzymology

Objective To explore the application of CO2 as an insufflation agent in patients under-going colonoscopy by comparing carbon dioxide(CO2 )and air.Methods Consecutive 681 patients who un-derwent conventional colonoscopy from January to May in 2014 at endoscopy center of our hospital were in-cluded.The patients were randomly divided into the air group and CO2 group.The gas flow,capacity,oper-ation time,PaCO2 and abdominal pain during and 20 min,40 min,1 h,2 h,12 h,24 h after colonoscopy were recorded.The safety and advantages of CO2 in the colonoscopy were analyzed.Results The intubation time of CO2 group was significantly shorter than that of air group (P <0.05),but there was no significant difference in endoscopy withdrawal time between the two groups (P >0.05).There was also no difference in air flow and the total volume between the two groups (P >0.05).PaCO2 of two groups were within the nor-mal range.PaCO2 during examination was significantly higher than that before and 20 minutes after examina-tion (P <0.05),but the PaCO2 between the two groups showed no significant difference (P >0.05).The abdominal pain scores during and 20 min,40 min,1 h,2 h after the examination of air group were signifi-cantly higher than those of CO2 group (P <0.05),but they were not 12h and 24h after the examination (P>0.05).Conclusion CO2 is safe and could reduce abdominal discomfort after colonoscopy,which is suit-able for clinical application.