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.

ObjectiveThrough a randomized， double-blind， double-simulation， positive-control， multicenter design， this study aimed to analyze the relationship between the dosage， efficacy， and safety of Pudilan anti-inflammatory oral liquid in treating acute pharyngitis/tonsillitis in adults caused by bacterial infection and validate the regulatory effect of Pudilan anti-inflammatory oral liquid on inflammatory markers such as serum amyloid A （SAA）， C-reactive protein （CRP）， white blood cells （WBC）， neutrophil percentage （NE%）， and erythrocyte sedimentation rate （ESR）， thereby exploring the feasibility of using Pudilan anti-inflammatory oral liquid as a substitute for antibiotics in the treatment of infectious diseases and providing a basis for rational clinical medication. MethodUsing a stratified randomized， double-blind， double-simulation， positive-control， multicenter design， 220 participants were enrolled from nine centers. The participants were randomly divided into three groups at 1∶1∶1 — a Pudilan anti-inflammatory oral liquid 20 mL group （73 cases）， a Pudilan anti-inflammatory oral liquid 10 mL group （73 cases）， and a control group （amoxicillin group， 74 cases）. The treatment course was 7 days. The study observed parameters including the total effective rate of sore throat， onset and disappearance time of sore throat， health status score， treatment time， and inflammation markers. Result①Dataset division： The 211 cases were included in the full analysis dataset （FAS）， 208 cases were included in the per-protocol dataset （PPS）， and 218 cases were included in the safety dataset （SS）. ② Efficacy evaluation： There were statistically significant differences （P<0.05） in the comparison of the three groups regarding the total effective rate of sore throat， disappearance time of sore throat， and health status. Both the 20 mL and 10 mL groups were non-inferior to the control group， and there was a statistically significant difference between the 20 mL and 10 mL dosage groups （P<0.05）. There was no statistically significant difference in the comparison of onset time of sore throat among the groups. CRP， WBC， and NE% of patients in all three groups significantly decreased on the 7^th day of treatment compared with those before treatment （P<0.01）. ③Safety evaluation： Adverse events mainly occurred in various examination indicators. There were no statistically significant differences in the comparison between groups， and no adverse reactions or serious adverse events occurred. ④Economic evaluation： The increased cost of the 10 mL and 20 mL dosage groups was entirely justified as compared with that in the control group. When comparing the 10 mL and 20 mL dosage groups， the 10 mL dosage group was deemed less advantageous. ConclusionPudilan anti-inflammatory oral liquid can be used alone as an alternative to antibiotics in the treatment of acute pharyngitis/tonsillitis caused by bacterial infection. It demonstrates good safety and can lower inflammation markers such as CRP， WBC， and NE%， suggesting its potential to reduce the body's inflammatory response. Its mechanism of action may be related to its multi-target regulatory mechanism.

Objective To probe the gene expression of normal epithelial cell specific-1 (NES1) in normal liver cells and liver cancer cell lines , and investigate the gene methylation status and its impacts on gene expression and cell biology .Methods The expression level of NES1 mRNA was detected in HepG2 and L02 cells by RT-PCR and RT-QPCR, and the level of gene methylation was examined by MSP .We de-tected cell viability by MTT , NES1 mRNA by RT-QPCR and cyclinD1, P21 and P53 level by Western blot after treating cells with 5-Aza-CdR.Results Compared with L02, NES1 mRNA expression in HepG2 was significantly reduced, and the level of NES1 exon 3 CpG island methylation in HepG2 cells was much higher than that in L02 cells.After demethylation , NES1 mRNA expression and protein level of p 21 and p53 in HepG2 cells were up-regulated , while the cell viability and the level of CyclinD 1 were decreased .Conclu-sions In hepatocellular carcinoma , low expression of NES1 mRNA is related to the gene exon 3 CpG island methylation .NES1 exon 3 methylation may be one of the molecular mechanisms for reducing NES 1 mRNA level, and 5-aza-dC could inhibit cell proliferation by inducing cell cycle arrest in HepG 2 cells.

Objective To investigate the expression of kallikrein 9 (KLK9) in liver cancer and to determine its significance.Methods The expression of KLK9 in liver cancer was detected by immunohistochemistry and RT-PCR techniques.Results The rate of expression of KLK9 protein in liver cancer tissues was significantly higher than paracarcinoma tissues and normal liver tissues (P ＜ 0.05).The expression of KLK9 mRNA in liver cancer cells was significantly higher than normal liver cells (P ＜ 0.05).The expression of KLK9 was related to metastasis,size of tumors,degree of malignancy and clinical staging of the liver cancer (P ≤ 0.05),but there was no associated with age,HbsAg and sex (P ＞ 0.05).Conclusions KLK9 may play an important role in the occurrence and development of liver cancer.It may be used as a tumor marker and a prognostic factor.It may also provide a theoretical basis for the diagnosis and biological targeted therapy of liver cancer.

Objective:To introduce the application and practice of information technology in the pharmacy management of our hos-pital in order to provide reference for fine hospital management. Methods: The difficulties and application experience of information technology in the practice of hospital storeroom, pharmacy and medication management were summarized and analyzed. Results: The introduction of information and automation technology was beneficial to the improvement of work efficiency, prevention of medication er-rors, reduction of the incidence of clinical irrational drug use and improvement of patient treatment service quality. Conclusion:Imple-menting information-based pharmacy management is not only a new idea and method in hospital pharmacy development, but also the in-evitable tendency of the times.

Objective To understand the drug resistance in cancer patients with secondary non-fermenting bacterial lower respir-atory tract infection in order to provide a basis for clinical rational use of antibacterial drugs.Methods The lower respiratory tract specimens were collected from the patients with malignant tumor and identified by the fully automated microbial identification sys-tem,the drug susceptibility test was performed by using K-B method and the drug susceptibility test results were judged according to CLSI 2012 standard.The data were analyzed by the WHONET 5.6 software.Results 172 strains of non-fermenting bacteria were isolated from the lower respiratory tract specimens in the patients with malignant tumors,in which Pseudomonas aeruginosa was maximum,accounted for 45.9%,followed by Acinetobacter baumannii and Stenotrophomonas maltophilia ,accounted for 36. 0% and 10.5 % respectively.The drug susceptibility test showed that five kinds of non-fermenter demonstrated the high resistance or multi-resistance to multiple antibacterial drugs.Conclusion Non-fermenting bacterial multi-drug resistant phenomenon is seri-ous,clinic should pay attention to non-fermenting bacterial infection and drug resistance monitoring,antibacterial drugs should be rationally used according to the drug susceptibility test results in order to reduce the generation of drug-resistant strains.

Objective To analyze the clinical characteristics and resistance to commonly used antibacterial drugs in the intensive care unit(ICU)patients with hospital-acquired Burkholderia cepacia infection in order to provide the basis for clinical rational treatment.Methods The drug resistance situation in 32 strains of Burkholderia cepacia isolated from the bacterial culture speci-mens submitted by ICU of our hospital from January 2011 to December 2012 was performed the retrospective analysis.Results In the detection sites,the infection was mainly distributed in the lower respiratory tract (62.5%),followed by deep venous catheter (12.5%);the drug susceptibility test revealed that 32 strains of Burkholderia cepacia showed the natural resistance to multiple antibacterial drugs,but which were still sensitive to minocycline,chloromycetin,meropenem,ceftazidime,cefoperazone/sulbactam, these drugs could be used as the first choice of drugs for treating Burkholderia cepacia infection.Conclusion The drug resistance phenomenon of Burkholderia cepacia is very serious in the ICU patients.Clinic should pay great concern to the infections caused by multi-drug resistant Burkholderia cepacia ,the microbiological testing should be conducted as early as possible,and the antibacterial drugs should be rationally selected according to the drug susceptibility testing results.

Objective To investigate the therapeutic effects of early enteral nutrition by gastroscopeguided naso-jejunal feeding tube placement on the intestinal endotoxemia of patient with severe acute pancreatitis (SAP).Methods Fourty-three patients were randomized into two groups:patients receiving early enteral nutrition (EN) by gastroscope-guided naso-jejunal feeding tube placement (24 cases) and those receiving total parenteral nutrition (TPN) ( 19 cases).The serum endotoxin(ET),albumin (ALB) and amylase (AMY) levels were measured.Abdominal distension and other complications were observed in the two groups.Results The abdominal pain and distension relief time,intestinal bleeding,infectious complications of EN group were significantly improved compared with that of TPN group ( P ＜ 0.01 或 P ＜ 0.05 或 P ＜ 0.001 ).The serum ET levels of EN group was much lower ( [ 0.19 ± 0.11 ] EU/ml) than that of TPN group ( [ 0.85 ± 0.28 ] EU/ml)on day 14 post-treatment (t =10.456,P ＜ 0.001 ).The serum AMY levels were decreased significantly in two groups after treatment,and the difference between two groups was not significant (t =3.l17,t =1.889,P ＞0.05 ).The serum ALB recovery of two groups was not significantly different ( P ＞ 0.05 ).Conclusion Gastroscope-guided Naso-jejunal feeding tube placement for early enteral nutrition can protect intestinal mucosa,reduce complications,alleviate symptoms of patients with SAP,which are benefitial factors for the treatment of intestinal endotoxemia in patients with SAP.

The changes of plasma myostatin levels in patients with type 2 diabetes mellitus (T2D) and their clinical correlation were investigated. We recruited 43 T2D patients and 20 age-matched healthy subjects. Plasma myostatin, lipid and glucose, and serum insulin were determined. T2D patients showed significantly higher fasting plasma glucose (FPG), serum insulin and triglyceride levels, and lower high-density lipoprotein levels than normal control subjects (P<0.01). Mean plasma myostatin level in T2D patients and health controls was (66.5±17.8) and (46.2±13.8) ng/mL, respectively. An unpaired t test showed that the increase of myostatin in the T2D patients was significant (P<0.001). In both healthy control and T2D groups, the female subjects showed higher myostatin levels than the male subjects. In the T2D patients, plasma level of myostatin was negatively correlated with body mass index (BMI, r=-0.42, P<0.01) and FPG (r=-0.51, P[Symbol: see text]0.01), but positively correlated with insulin resistance index (HOMA-IR, r=0.48, P<0.01). Up-regulation of plasma myostatin in the T2D patients and its correlation with BMI, FPG and blood insulin sensitivity suggests that plasma myostatin may be implicated in the pathogenesis of T2D and thus presented as a therapeutic target for treating the disease. Furthermore, circulating myostatin levels may be used as a biomarker for the disease.
Blood Glucose ; Diabetes Mellitus, Type 2 ; blood ; Female ; Humans ; Insulin ; blood ; Lipids ; blood ; Male ; Middle Aged ; Myostatin ; blood

The changes of plasma myostatin levels in patients with type 2 diabetes mellitus (T2D) and their clinical correlation were investigated. We recruited 43 T2D patients and 20 age-matched healthy subjects. Plasma myostatin, lipid and glucose, and serum insulin were determined. T2D patients showed significantly higher fasting plasma glucose (FPG), serum insulin and triglyceride levels, and lower high-density lipoprotein levels than normal control subjects (P<0.01). Mean plasma myostatin level in T2D patients and health controls was (66.5±17.8) and (46.2±13.8) ng/mL, respectively. An unpaired t test showed that the increase of myostatin in the T2D patients was significant (P<0.001). In both healthy control and T2D groups, the female subjects showed higher myostatin levels than the male subjects. In the T2D patients, plasma level of myostatin was negatively correlated with body mass index (BMI, r=-0.42, P<0.01) and FPG (r=-0.51, P[Symbol: see text]0.01), but positively correlated with insulin resistance index (HOMA-IR, r=0.48, P<0.01). Up-regulation of plasma myostatin in the T2D patients and its correlation with BMI, FPG and blood insulin sensitivity suggests that plasma myostatin may be implicated in the pathogenesis of T2D and thus presented as a therapeutic target for treating the disease. Furthermore, circulating myostatin levels may be used as a biomarker for the disease.