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: This study aims to explore the relationships of family functioning, general well-being, and exercise with psychological distress.Furthermore, we investigated the special roles of general well-being and exercise on the association between family functioningand psychological distress. Methods: Of 769 end-stage renal disease (ESRD) patients participated in the cross-sectional study which consisted of the 12-item GeneralHealth Questionnaire (GHQ-12), the Family APGAR Scales, and the General Well-Being Schedule. The collected data were analyzedusing multiple linear regression analysis and path analysis. Results: The prevalence of psychological distress was 72.3%. Family functioning, general well-being and exercise were associated factorsof psychological distress (p<0.05). The indirect effect of family functioning on psychological distress was partially mediated by generalwell-being (Effect=-0.08, 95% CI=-0.11, -0.04). In addition, the effect of family functioning on general well-being was moderated byexercise (Index=-0.092, SE=0.033, 95% CI=-0.159, -0.029). Conclusion The prevalence of psychological distress among ESRD patients was high. Family functioning, general well-being and exercisewere associated with psychological distress. Family functioning could affect psychological distress partially by affecting general wellbeing.Furthermore, exercise had a significant moderating effect on the relationship between family functioning and general well-being.Psychiatry Investig 2020;17(4):356-365

The secondary structures of hepatitis C virus (HCV) RNA and the cellular proteins that bind to them are important for modulating both translation and RNA replication. However, the sets of RNA-binding proteins involved in the regulation of HCV translation, replication and encapsidation remain unknown. Here, we identified RNA binding motif protein 24 (RBM24) as a host factor participated in HCV translation and replication. Knockdown of RBM24 reduced HCV propagation in Huh7.5.1 cells. An enhanced translation and delayed RNA synthesis during the early phase of infection was observed in RBM24 silencing cells. However, both overexpression of RBM24 and recombinant human RBM24 protein suppressed HCV IRES-mediated translation. Further analysis revealed that the assembly of the 80S ribosome on the HCV IRES was interrupted by RBM24 protein through binding to the 5'-UTR. RBM24 could also interact with HCV Core and enhance the interaction of Core and 5'-UTR, which suppresses the expression of HCV. Moreover, RBM24 enhanced the interaction between the 5'- and 3'-UTRs in the HCV genome, which probably explained its requirement in HCV genome replication. Therefore, RBM24 is a novel host factor involved in HCV replication and may function at the switch from translation to replication.
Cells, Cultured ; Hepacivirus ; genetics ; growth & development ; metabolism ; Humans ; Protein Biosynthesis ; RNA-Binding Proteins ; metabolism ; Virus Replication ; genetics

OBJECTIVE:To establish the method for dissolution determination of Metoprolol tartrate tablets,and to evaluate the similarity of dissolution curves of generics and original drugs. METHODS:The paddle method was adopted with rotational the speed of 50 r/min,using pH 1.2 hydrochloric acid solution,pH 4.5 acetate buffer solution and pH 6.8 phosphate buffer solution as dissolution media. Fiber-optical drug dissolution real-time measurement instrument was used to determine the dissolution curves of generic and original Metoprolol tartrate tablets with optical distance of 10 mm. Similarity factor (f2) method was used to evaluate its similarity. RESULTS:In 3 dissolution mediums,the f2 of generic and original Metoprolon tartrate tablets were 80.5,66.8, 69.4,respectively,which indicated that the dissolution curves showed similarity. CONCLUSIONS:Established real-time dissolution process analysis method is suitabe for the dissolution determination of Metoprolol tartrate tablets. Generic and eriginal show the sim-ilarity in dissolation behavier,so they have good consistency in quality.

BACKGROUND:Vertebroplasty with bone cement injection can achieve a correction of kyphosis, enhancement of vertebral strength, and elimination of vertebral lesions during reduction of the fracture. OBJECTIVE: To analyze the efficacy of vertebroplasty with bone cement injection on osteoporotic vertebral compression fracture. METHODS:Totaly 84 patients with osteoporotic thoracolumbar vertebral compression fractures (T6-L4), 37 males and 47 females, aged 58-80 years, were randomized into two groups: study group undergoing vertebroplasty with bone cement injection and control group subject to bed rest and conservative treatment (functional exercise of the back muscle). Visual analog scale score, Oswestry disability index and vertebral height were detected and compared between the two groups before and after treatment. RESULTS AND CONCLUSION:There was no difference in vertebral height, visual analog scale score and Oswestry disability index between the two groups before treatment. At 3 months after treatment, the vertebral height was (1.653±0.168) cm in the study group and (1.521±0.200) cm in the control group, with a significant difference (P< 0.05). The visual analog scale scores and Oswestry disability index scores in the study group were both lower than those in the control group at 3 months after treatment and at the last folow-up (P < 0.05). After treatment, there were two cases of pressure sores, three cases of deep venous thrombosis, one case of pneumonia and two cases of urinary tract infections in the control group; while only 4 cases developed bone cement leakage in the study group, but with no obvious clinical symptoms. No difference in re-fracture rate occurred between the control group (n=3) and study group (n=4;P > 0.05). These findings suggest that the bone cement injection as vertebral augmentation therapy can rapidly relieve pain, improve patients' quality of life within a short term and restore the vertebral height in patients with osteoporotic vertebral compression fractures.

OBJECTIVE:To optimize the drug placement in the automated drug dispensing machine to improve work efficien-cy. METHODS:Based on the principle of the minimum time algorithm,the drug which would be used at a high frequency was placed in the drug storage tank nearest to the drug outlet. Meanwhile,the rule of drug use was drawn from the information on a large number of prescriptions,based on which the drugs correlated with each other were placed in the drug storage tanks that were adjacent. With daily time it takes to add drugs,average time it takes to make up a prescription and the maximum number of drugs stored as the evaluated indexes,the initial drug placement in the automated drug dispensing machine was optimized. The changes in the indexes within 3 months before and after the above-mentioned optimization were statically analyzed. RESULTS:After calculat-ing the three-dimensional sizes of the packages of drugs and the dispensing frequency data of the previous year,354 drugs were se-lected and placed in the nearer or farther storage tanks in the automated dispensing machine according to the dispensing frequency and the correlation among them. After the optimization of the placement,daily time it takes to add drugs reduced by 54 min(218 vs. 165 min)on average,average time it takes to make up a prescription reduced by 8 s(24 vs.16 s)and the maximum number of drugs stored increased by 1 333 boxes(13 113 vs. 14 446 boxes)on average. There was statistical significance in differences(P<0.05). CONCLUSIONS:The initial drug placement in the automated drug dispensing machine that was optimized by minimum time algorithm has reduced daily time it takes to add drugs and average time it takes to make up a prescription and increased the maximum number of drugs stored and thus improved work efficiency.

BACKGROUND: Now, dual-energy X-ray absorptiometry is international y recognized as gold standard for the diagnosis of osteoporosis, but the errors can be found in the measurement results due to the heterotopic ossification and bone hyperplasia exists in the measurement part. OBJECTIVE: To investigate the clinical significance of bone metabolic markers in the diagnosis and treatment of elderly patients with osteoporotic fractures, and to research its correlation with the changes of pathological histology and bone mineral density. METHODS: Four bone biochemical markers in 50 elderly patients with osteoporosic fractures were measured preoperatively. According to the results, 25 patients had significantly increased tartrate-resistant acid phosphatase 5b (considered as the increased tartrate-resistant acid phosphatase 5b group), and 25 patients had increased bone alkaline phosphatase (considered as the increased bone alkaline phosphatase group). During operation, the bone tissues of eight patients in each group were treated with hematoxylin-eosin staining and electron microscopy scanning in order to detect the pathological changes. After operation, the patients in the increased tartrate-resistant acid phosphatase 5b group received salmon calcitonin anti-osteoporosis treatment, and the patients in the increased bone alkaline phosphatase group received the anti-osteoporosis treatment of bone peptide injection. The bone mineral density and the four bone biochemical markers were detected again at 6 months after treatment. RESULTS AND CONCLUSION: There were no significant differences in the preoperative bone mineral density and four biomechanical markers between two groups (P > 0.05). The pathological examination results of bone tissue on the fracture site showed that the number of osteoblasts was reduced and the number of oeteoclasts was increased in the increased tartrate-resistant acid phosphatase 5b group; while in the increased bone alkaline phosphatase group, the pathological examination results showed the number of osteoblasts was reduced; the trabecular bone/bone area ratio was decreased in two groups, and there was a significant difference in the decrease degree between two groups (P < 0.05). The electron microscope scanning showed that the osteoclasts of two groups were more active than that of the normal group. The sloppy of trabecular bone in the increased tartrate-resistant acid phosphatase 5b group was more obvious than that in the increased bone alkaline phosphatase group, and the absorption vacuoles were increased. There were significant differences in the bone mineral density and four biomechanical markers between two groups before and after anti-osteoporosis treatment (P < 0.05). The detection of bone metabolic markers could help us to make it clearly that the main function of osteoblast reduce or osteoclast increase in bone tissue of patients, and guide us to use anti-osteoporosis drugs in target. Pathological histology examination can better reflect the condition of osteoblasts, osteoclasts and trabecular bone in bone tissue on the fracture site. Target application of anti-osteoporosis drugs in the osteoporosis patients can effectively improve the efficacy and reduce the relative complications.

OBJECTIVETo study the influence of SGHWJN particles on inflammation and the mediators of inflammation in esophageal tissues of rat with reflux esophagitis.

METHODFifty SD rats were randomly divided into 5 groups, namely, a control group, a sham-operated group, a model group, a SGHWJN particles group and a PPI group. Reflux esophagitis was induced by adopting partial pyloric ligation plus cardiomyotomy. One week later, the rats were orally administered twice daily for 28 days. Pathological changes of esophagus mucous membrane were evaluated by using HE staining and Harry S. Cooper's method in every groups. MDA and SOD contents in esophageal tissues were measured by colorimetric method. Expression of TNF-alpha in esophageal tissues were examined by real-time fluorescent quantitative reverse transcriptase polymerase chain reaction (RT-FQ-PCR) with SYBR Green.

RESULTModel group, esophageal inflammation scores, expression of TNF-alpha in esophageal tissues and MDA contents compared with the normal group and sham operation group were significantly higher (P < 0.05). SOD contents in the esophageal tissues of the model group was significantly lower than that of control group and sham-operated group (P < 0.05). SGHWJN particles group and PPI group of esophageal tissue inflammation scores, expression of TNF-a in esophageal tissues and MDA levels than those in model group decreased significantly (P < 0.05). SOD content was significantly higher than that of model group (P < 0.05), SGHWJN particles group and PPI group showed no statistically significant difference between the above-mentioned indicators. The above-mentioned indicators showed no statistically significant difference between the normal group and sham-operated group. MDA content and expression of TNF-alpha in esophageal tissue was positively correlated with inflammatory scores of model group (r = 0.813). Model group esophageal tissue SOD content and inflammation scores were negatively correlated (r = -0.847). Esophageal tissue SOD levels were negatively correlated with MDA levels (r = -0.863).

CONCLUSIONSGHWJN particles can effectively inhibit inflammation in rat with reflux esophagitis through regulating TNF-alpha, SOD and MDA.

Animals ; Disease Models, Animal ; Drugs, Chinese Herbal ; administration & dosage ; Esophagitis, Peptic ; drug therapy ; genetics ; immunology ; Esophagus ; drug effects ; immunology ; Female ; Gene Expression ; drug effects ; Humans ; Inflammation Mediators ; immunology ; Male ; Rats ; Rats, Sprague-Dawley ; Tumor Necrosis Factor-alpha ; genetics ; immunology

BACKGROUND:There are reports concerning differentiation of adipose-derived mesenchymal stem cells(ADSCs)into chondrocytes using gene transfection technique.However,the transfection of adenovirus and adeno-associated virus into ADSCs is various.It is controversial whether adeno-associated virus(AAV)can transfect ADSCs.OBJECTIVE:To observe the enhanced green fluorescent protein(EGFP)expression following Ad5-EGFP and rAAV2-EGFP transfection into ADSCs,and investigate the cell proliferation ability following transfection.METHODS:ADSCs were isolated from the adipose tissue,which was from 6-month-old New Zealand albino rabbit back and neck by mechanical digestion and enzyme digestion,then ADSCs were cultured and amplified in vitro.ADSCs were infected with Ad5-EGFP and rAAV2-EGFP,and the EGFP expression was observed.A total of 2 μL sodium butyrate(1 mol/L)was added into the medium after rAAV2-EGFP transfection.MTT assay was used to detect the gene transfection effects on reproductive activity of ADSCs.RESULTS AND CONCLUSION:ADSCs isolated and cultured in vitro were flat,long-spindle and amplified stabry.The cell morphology was uniform.Many green fluorescent cells were observed in Ad5-EGFP and rAAV2-EGFP groups.Transfection efficiencies were about 88% and 83%.Adenovirus and adeno-associated virus vector can be transfected with ADSCs,and transfection efficiency is high.Adeno-associated virus needs sodium butyrate to increase its level of gene expression.

Purpose To explore the value of 64-slice spiral CT digital subtraction angiography in diagnosis of cerebral arteriovenous malformations (AVM).Materials and Methods 26 patients with AVM were performed with plain CT scan, enhanced arterial phase and venous phase CT scan on a 64-slice spiral CT scanner. The subtracted arterial phase data was obtained through subtracting the plain CT images from arterial phase images, then the subtracted venous phase data was obtained through subtracting arterial phase images from venous phase images, and subtracted mixed arterial-venous phase data through subtracting plain CT images from venous phase images. Then volume rendering (VR) and maximum intensity projection (MIP) were used to reconstruct the cerebral vessel images. Results The inference of cranial bones was completely removed in all subtracted cerebral vessel images, thus clearly demonstrating malformed vascular nest, feeding arteries and draining veins. And 7 malformed temporal vascular nests, 5 parietal vascular nests, 5 frontal vascular nests, 6 occipital vascular nests and 3 cerebellar vascular nests were revealed;39 feeding arteries were detected altogether. Single feeding artery was found in 15 cases, and multiple feeding arteries in 9 cases. Meanwhile 33 draining veins were observed, and single draining vein was found in 10 cases, multiple veins in 16 cases.Conclusion 64-slice subtraction angiography can remove the inference of cranial bones and clearly demonstrate the feeding arteries, malformed vascular nests, draining veins, potentially providing a reliable evidence for therapeutic planning and postoperative follow-up.