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.

BACKGROUND:Although traditional therapies,including drugs and surgery,cannot repair the damaged myocardial tissue,the mortality rate of myocardial infarction remains high.Stem cells provide the possibility to solve this problem due to their self-renewal and multi-directional differentiation potential. OBJECTIVE:To analyze the research progress of stem cell therapy for myocardial infarction in recent ten years by bibliometric analysis. METHODS:The related articles on stem cells and myocardial infarction published in SCI-E and SSCI from January 1,2012 to December 1,2022 in the Web of Science database were searched.EXCEL,CiteSpace and VOSviewer software were used to make statistical and visualization analyses of the data such as the number of publications,authors,institutions,journals,countries and keywords. RESULTS AND CONCLUSION:A total of 3 210 core articles were published,and the total number increased year by year.hausenloy,derek j.is the author with the largest number of publications,China is the country with the largest number of publications,and the Fourth Military Medical University is the institution with the largest number of publications.The research hotspots in this field are changing from cell experiments and animal experiments to clinical trials.In the past ten years,research in this field has been highly popular and still has great development prospects.It is necessary to promote international and inter-agency exchange and learning,and further explore the role of stem cells in the treatment of myocardial infarction.

  Objective  To investigate the predictive value of albumin-bilirubin (ALBI) score combined with liver function index and carcinoembryonic antigen (CEA) for liver metastasis of colorectal cancer.  Methods  We retrospectively analyzed the clinical data of patients with colorectal cancer who underwent surgical treatment in the Second Hospital & Clinical Medical Hospital, Lanzhou University from January 2016 to July 2021 and were followed up for 24 months. According to the follow-up results, the enrolled patients were divided into liver metastasis group and non-liver metastasis group, and were randomly divided into modeling group and validation group by a ratio of 2∶1. The risk factors of liver metastasis in the patients with colorectal cancer were analyzed. Lasso-Logistic regression was used to construct the prediction model. Bootstrap method was used for internal verification. Receiver operating characteristic curve, calibration curve and clinical decision curve were used to evaluate the reliability of the prediction model. Finally, a nomogram was drawn to show the prediction results.  Results  A total of 195 patients who met the inclusion and exclusion criteria were enrolled, including 130 in the modeling group and 65 in the validation group. Through Lasso regression variable screening and Logistic regression analysis, the results showed that ALBI score(OR=8.062, 95% CI: 2.545-25.540), alanine transaminase (ALT) (OR=1.037, 95% CI: 1.004-1.071) and CEA (OR=1.025, 95% CI: 1.008-1.043) were independent predictors of liver metastasis in colorectal cancer. The area under curve (AUC) of the combined prediction of liver metastasis of colorectal cancer in the modeling group was 0.921, the sensitivity was 78%, the specificity was 95%, the C-index was 0.921, the H-L fitting curve χ²=0.851, P=0.654, and the slope of the calibration curve was close to 1, suggesting that the accuracy of the model was high, and the DCA curve showed that the model had good clinical application value. For the data of the modeling group, the Bootstrap method was used for internal verification of 1000 resamplings. The accuracy was 0.869, the kappa consistency was 0.709, and the AUC was 0.913. When ALBI score, ALT and CEA were used to diagnose liver metastasis of colorectal cancer alone, the AUC of CEA was the largest (0.897), and the combination of the three had the highest efficacy in the diagnosis of liver metastasis of colorectal cancer. In the validation group, the AUC, sensitivity, specificity, C-index of the combined prediction of liver metastasis of colorectal cancer were 0.918, 85.0%, 95.6%, 0.918, respectively, and H-L fitting curve χ²=0.586, P=0.746.  Conclusions  ALBI score, ALT and CEA have certain predictive value for liver metastasis of colorectal cancer. The combined diagnosis of liver metastasis of colorectal cancer has high efficacy, and the risk prediction model constructed has a good predictive effect.

Objective To explore the diagnostic value of urinary liquid-based cytology(LBC)targeted fluorescence in situ hybridization(FISH)for urothelial carcinoma of the bladder.Methods Nuclear matrix protein 22(NMP22)detection,urinary LBC and FISH were performed in 128 patients.The sensitivity and specificity of the three kinds of tests were analyzed with postoperative pathological results as the gold standard.Results The sensitivity of NMP22,urinary LBC and FISH was 61.11％,79.17％and 82.46％,the specificity was 57.14％,73.21％and 86.67％,respectively.The sensitivity of NMP22 and urinary LBC in detecting high BUC was better than that of low BUC,and the difference was statistically significant(P=0.01,P=0.03).There was no significant difference in the sensitivity of the three tests for the diagnosis of muscle-invasive bladder cancer and non muscle-invasive bladder cancer(P≥0.05).Conclusion Urinary LBC targeted FISH has high sensitivity and specificity in the diagnosis of urothelial carcinoma of the bladder and low-grade urothelial carcinoma.It can be an important method for the early screening and diagnosis of bladder cancer.

Objective:To investigate the effect of different negative pressure level on drain volume after augmentation mammoplasty through inframammary fold incision, and try to put forward the appropriate negative pressure level for the best prognosis of patients.Methods:This was a randomized controlled clinical study. Patients who underwent prosthetic augmentation mammoplasty through inframammary fold incision in the Medical Beauty Center of the First Affiliated Hospital of Zhengzhou University from January 2019 to August 2021 were selected as the study subjects. Patients were divided into 4 groups by random number table method and different levels of negative pressure drainage were applied: 600 ml adjustable negative pressure drain bottle was used uniformly after operation by -80--85 kPa group, -40--60 kPa group, and -15--30 kPa group. In 0--5.2 kPa group, 300 ml drain drum was applied after operation. The criteria for drain removal was that the drain volume within 24 hours was less than 10 ml and the drainage fluid was clear. Daily drain volume, duration of drain placement, total drain volume, acceptance of the drain device and postoperative complications were recorded in the four groups. The corresponding indexes of each group were statistically analyzed by SPSS 21.0. Measurement data were expressed as Mean±SD. One-way analysis of variance was used for comparison between groups, and LSD- t test was used for pair comparison between groups. P<0.05 was considered statistically significant. Results:A total of 80 patients were included, 20 in each group. Inter-group equilibrium analysis: there was no significant difference in age, body mass index, distance from midclavicular point to nipple, distance from inferior mammary fold to nipple, and breast tissue thickness among 4 groups ( P>0.05). Evaluation of curative effect between groups: on the first and second day after operation, there was no significant difference in drain volume between -80--85 kPa group and -40--60 kPa group ( P>0.05), but there was significant difference among other groups ( P<0.05). There was significant difference in drain volume on the third day after operation, total drain volume and duration of drain placement between the four groups ( P<0.05). The lower the negative pressure level was, the less drain volume on the third day after surgery and the less total drain volume, and the shorter duration of drain placement. The duration of drain placement of the four groups were (5.6±0.7) d (-80--85 kPa group), (4.8±0.5) d (-40--60 kPa group), (4.0±0.5) d (-15--30 kPa group), and (3.2±0.4) d (0--5.2 kPa group), respectively. Safety evaluation: the complication rate of -80--85 kPa group, -40--60 kPa group, -15--30 kPa group and 0--5.2 kPa group were 2.5% (1/40), 2.5% (1/40), 0(0/40) and 15.0% (6/40), respectively. The complication rate of 0--5.2 kPa group was the highest. Investigation on the acceptance of the drainage device (no impact/dissatisfaction): 75 patients expressed dissatisfaction, with a dissatisfaction rate of 93.75%(75/80). Conclusion:In augmentation mammoplasty through inferior fold incision low negative pressure provides less drain volume, shorter drain placement. Negative pressure between -15 to -30 kPa is optimal.

Objective:To investigate the effect of different negative pressure level on drain volume after augmentation mammoplasty through inframammary fold incision, and try to put forward the appropriate negative pressure level for the best prognosis of patients.Methods:This was a randomized controlled clinical study. Patients who underwent prosthetic augmentation mammoplasty through inframammary fold incision in the Medical Beauty Center of the First Affiliated Hospital of Zhengzhou University from January 2019 to August 2021 were selected as the study subjects. Patients were divided into 4 groups by random number table method and different levels of negative pressure drainage were applied: 600 ml adjustable negative pressure drain bottle was used uniformly after operation by -80--85 kPa group, -40--60 kPa group, and -15--30 kPa group. In 0--5.2 kPa group, 300 ml drain drum was applied after operation. The criteria for drain removal was that the drain volume within 24 hours was less than 10 ml and the drainage fluid was clear. Daily drain volume, duration of drain placement, total drain volume, acceptance of the drain device and postoperative complications were recorded in the four groups. The corresponding indexes of each group were statistically analyzed by SPSS 21.0. Measurement data were expressed as Mean±SD. One-way analysis of variance was used for comparison between groups, and LSD- t test was used for pair comparison between groups. P<0.05 was considered statistically significant. Results:A total of 80 patients were included, 20 in each group. Inter-group equilibrium analysis: there was no significant difference in age, body mass index, distance from midclavicular point to nipple, distance from inferior mammary fold to nipple, and breast tissue thickness among 4 groups ( P>0.05). Evaluation of curative effect between groups: on the first and second day after operation, there was no significant difference in drain volume between -80--85 kPa group and -40--60 kPa group ( P>0.05), but there was significant difference among other groups ( P<0.05). There was significant difference in drain volume on the third day after operation, total drain volume and duration of drain placement between the four groups ( P<0.05). The lower the negative pressure level was, the less drain volume on the third day after surgery and the less total drain volume, and the shorter duration of drain placement. The duration of drain placement of the four groups were (5.6±0.7) d (-80--85 kPa group), (4.8±0.5) d (-40--60 kPa group), (4.0±0.5) d (-15--30 kPa group), and (3.2±0.4) d (0--5.2 kPa group), respectively. Safety evaluation: the complication rate of -80--85 kPa group, -40--60 kPa group, -15--30 kPa group and 0--5.2 kPa group were 2.5% (1/40), 2.5% (1/40), 0(0/40) and 15.0% (6/40), respectively. The complication rate of 0--5.2 kPa group was the highest. Investigation on the acceptance of the drainage device (no impact/dissatisfaction): 75 patients expressed dissatisfaction, with a dissatisfaction rate of 93.75%(75/80). Conclusion:In augmentation mammoplasty through inferior fold incision low negative pressure provides less drain volume, shorter drain placement. Negative pressure between -15 to -30 kPa is optimal.

[摘 要] 缺氧和免疫逃逸是肿瘤的两大特征，缺氧是促进肿瘤发生免疫逃逸的重要因素。近年来的研究结果表明，缺氧诱导的长链非编码RNA（HIL）是介导缺氧促进免疫逃逸的关键因子，是肿瘤诊断、治疗和预后评估的潜在标志物，具有较好的研究和临床转化价值，有望成为肿瘤免疫治疗的潜在靶点。本文综述了HIL在肿瘤发生发展及预后中最新的研究进展，讨论了HIL通过诱导上皮间质转化发生、血管生成、肿瘤干细胞形成、糖酵解、免疫细胞浸润、免疫因子释放、干扰抗原提呈机制和免疫检查点表达上调等多种机制诱导肿瘤发生免疫逃逸，探讨双靶向HIL与免疫检查点的联合肿瘤治疗新策略的可能性及临床意义，分析了HIL领域中关于普适性和组织特异性关键HIL及其调控肿瘤免疫机制的鉴定、HIL与肿瘤免疫治疗及疗效之间关系的明确，以及肿瘤联合治疗新策略临床转化的实现等关键问题及可能的解决办法，为实现靶向HIL与免疫检查点的肿瘤免疫治疗策略提供了理论基础。

Consecutively hospitalized patients with confirmed coronavirus disease 2019 (COVID-19) in Wuhan, China were retrospectively enrolled from January 2020 to March 2020 to investigate the association between the use of renin-angiotensin system inhibitor (RAS-I) and the outcome of this disease. Associations between the use of RAS-I (angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB)), ACEI, and ARB and in-hospital mortality were analyzed using multivariate Cox proportional hazards regression models in overall and subgroup of hypertension status. A total of 2771 patients with COVID-19 were included, with moderate and severe cases accounting for 45.0% and 36.5%, respectively. A total of 195 (7.0%) patients died. RAS-I (hazard ratio (HR)= 0.499, 95% confidence interval (CI) 0.325-0.767) and ARB (HR = 0.410, 95% CI 0.240-0.700) use was associated with a reduced risk of all-cause mortality among patients with COVID-19. For patients with hypertension, RAS-I and ARB applications were also associated with a reduced risk of mortality with HR of 0.352 (95% CI 0.162-0.764) and 0.279 (95% CI 0.115-0.677), respectively. RAS-I exhibited protective effects on the survival outcome of COVID-19. ARB use was associated with a reduced risk of all-cause mortality among patients with COVID-19.
Angiotensin Receptor Antagonists/therapeutic use* ; Angiotensin-Converting Enzyme Inhibitors/therapeutic use* ; COVID-19 ; Humans ; Hypertension/drug therapy* ; Renin-Angiotensin System ; Retrospective Studies

Objective:To analyze the epidemic situation of plague among animals in the foci of Meriones unguiculatus in Inner Mongolia Plateau, and to find out key influencing factors affecting the epidemic of the plague, and to provide theoretical basis for the prediction, early warning and risk assessment of the plague. Methods:The monitoring data including gerbils density, gerbils body flea index, plague epidemic intensity, etc., as well as environmental data including temperature, precipitation and El Ni?o activity (Southern Oscillation Index, SOI) from 19 banners (counties, cities and districts) in Ulanqab Plateau area, the foci of Meriones unguiculatus in Inner Mongolia Plateau were selected. The methods of correlation analysis, structural equation model and rank correlation were used to analyze the epidemic and key influencing factors of plague among animals in the foci. Results:The plague epidemic cycle in the foci of Meriones unguiculatus in Inner Mongolia Plateau was 5 to 10 years. The correlation analysis results showed that all the factors had influence on each other. Structural equation model screened out that the main influencing factors of plague epidemic were SOI, gerbils density and temperature. SOI had a negative effect on plague epidemic intensity (-0.022) and temperature (-0.029), while gerbils density had a positive effect on plague epidemic intensity (0.014), and temperature had a negative effect on plague epidemic intensity (-0.065). In rank correlation, when the gerbils density was at a high value, the probability of high plague epidemic intensity in that year was 4/9; when SOI was at a low value, the probability was 5/9; when the temperature was at a low value, the probability was 5/9. When the plague epidemic intensity was at a high value in that year, the probability of the plague epidemic intensity being high in the following year was 5/8; when the gerbils density was at a high value in that year, the probability was 4/9; when SOI was at a low value in that year, the probability was 4/9. Conclusion:Climate and biological factors can affect prevalence of plague, and countermeasures should be taken in advance to prevent plague outbreaks when El Ni?o phenomenon, low temperature, high density of gerbils, and high previous-year prevalence of plague appear.

Objective:To explore the rules of acupoint sticking therapy based on data mining technology for the treatment of angina pectoris of coronary heart diseases, and to provide a reference for guiding acupoint selection and rational use of Chinese medicine.Methods:To search for the clinical research literature of acupoints for the treatment of angina pectoris of coronary heart diseases from China Academic Journal Database (Wanfang Data), China National Knowledge Resources Database (CNKI), China biomedical literature service system (SinoMed) and Chinese science and technology journal database (Chongqing VIP) dated from January 31, 2020. Using Microsoft Excel 2016, SPSS Statistics 21.0, and SPSS Modeler 14.2 statistical software as tools to conduct association analysis and cluster analysis on those acupoints and Chinese medicine.Results:A total of 102 acupoints application prescriptions were included, involving 38 acupoints. The top 5 frequently used acupoints were Danzhong (RN17), Neiguan (PC6), Xinshu (BL15), Zusanli (ST36), and Zhiyang (DU9). The top 5 acupuncture were Neiguan (PC6)- Sanyinjiao (SP6), Xinshu (BL15)- Geshu (BL17), Danzhong (RN17)- Geshu (BL17), Danzhong (RN17)- Jueyinshu (BL14), Danzhong (RN17)- Geshu (BL17) and Xinshu (BL15). There are 102 prescriptions of applied medicines with 88 kinds of Chinese medicine. The top 5 frequently used Chinese medicines were Chuanxiong Rhizoma, Borneolum Syntheticum, Salviae Miltiorrhizae Radix et Rhizoma, Olibanum, Santali Albi Lignum, the top three drug pairs were Chuanxiong Rhizoma- Cinnamomi Cortex, Allii Macrostemonis Bulbus- Trichosanthis Fructus, Olibanum- Myrrha. Conclusion:The commonly used single points to treat angina pectoris of coronary heart disease are Danzhong, and usually combined with Neiguan and Xinshu, and the acupoints along the Urinary Bladder Meridian of Foot- Taiyang are used frequently; the Chinese medicines are mainly used for activating blood circulation, genenrally reflects the therapeutic principle of removing blood stasis, dredging collaterals and relieving pain.