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 aimed to determine the HIV-1 subtype distribution and HIV drug resistance (HIVDR) in patients with ART failure from 2014 to 2020 in Hainan, China. METHODS: A 7-year cross-sectional study was conducted among HIV/AIDS patients with ART failure in Hainan. We used online subtyping tools and the maximum likelihood phylogenetic tree to confirm the HIV subtypes with pol sequences. Drug resistance mutations (DRMs) were analyzed using the Stanford University HIV Drug Resistance Database. RESULTS: A total of 307 HIV-infected patients with ART failure were included, and 241 available pol sequences were obtained. Among 241 patients, CRF01_AE accounted for 68.88%, followed by CRF07_BC (17.00%) and eight other subtypes (14.12%). The overall prevalence of HIVDR was 61.41%, and the HIVDR against non-nucleoside reverse transcriptase inhibitors (NNRTIs), nucleotide reverse transcriptase inhibitors (NRTIs), and protease inhibitors (PIs) were 59.75%, 45.64%, and 2.49%, respectively. Unemployed patients, hypoimmunity or opportunistic infections in individuals, and samples from 2017 to 2020 increased the odd ratios of HIVDR. Also, HIVDR was less likely to affect female patients. The common DRMs to NNRTIs were K103N (21.99%) and Y181C (20.33%), and M184V (28.21%) and K65R (19.09%) were the main DRMs against NRTIs. CONCLUSION The present study highlights the HIV-1 subtype diversity in Hainan and the importance of HIVDR surveillance over a long period.
Humans ; Reverse Transcriptase Inhibitors/therapeutic use* ; HIV-1/genetics* ; Cross-Sectional Studies ; Phylogeny ; Anti-HIV Agents/therapeutic use* ; Drug Resistance, Viral/genetics* ; HIV Infections/epidemiology* ; Mutation ; China/epidemiology* ; Prevalence ; Genotype

Objective To understand the relationship between the concentration of air pollutants and daily emergency department visits for different diseases (circulatory system disease, digestive system disease, nervous system disease and respiratory system disease) in Guangzhou, Guangdong Province. Methods The daily average concentrations of sulfur dioxide (SO2), nitrogen dioxide (NO2, carbon monoxide (CO) and PM2.5 and the daily maximum 8-hour concentrations of O3, the daily average temperature, the relative humidity and cause -specific emergency department visits of the four major diseases from 2015 to 2017 were collected in Guangzhou. Semi-parametric generalized additive model was used to analyze the relationship between the concentration of pollutants and daily cause-specific emergency department visits. Results The daily average concentrations of SO2, NO2, CO, O3 and PM2.5 during the study period were 13.24 μg /m3, 45.96 μg /m3, 0.97 mg /m3, 123.77 μg /m3 and 36.22 μg /m3, respectively. For circulatory system disease，the independently significant associations of SO2 with emergency department visits in single-pollutant models (2.91%, 95% CI: 1.00%-4.85%), and multipollutant models (4.39%, 95% CI: 1.22%-7.67%) were observed. Conclusion The ambient SO2 increases the risk of emergency department visits due to circulatory diseases in Guangzhou. Comprehensive prevention and control measures should be taken to reduce the emission of SO2.

OBJECTIVETo study the pharmacokinetic and pharmacodynamic features of different doses of aminophylline in very low birth weight (VLBW) infants with different postmenstrual ages, weights, and ages (in days).

METHODSA total of 40 VLBW infants with apnea were enrolled. After an intravenous loading dose of 5 mg/kg aminophylline, they were randomized into two groups with different maintenance doses of aminophylline (1 mg/kg and 2 mg/kg, once every 8 hours). Blood concentrations of aminophylline and liver and renal functions were monitored at 8 hours, 3 days, and 7 days after the loading dose. Attacks of apnea were documented. Pharmacokinetic data of aminophylline were compared between the two groups.

RESULTSThe steady-state plasma concentration of aminophylline and plasma clearance in the 2 mg/kg group were significantly higher than those in the 1 mg/kg group (P<0.05). However, the elimination half life was shorter in the 2 mg/kg group (P<0.05). Days of apnea attacks within 7 days after birth in the 2 mg/kg group were significantly fewer than in the 1 mg/kg group (P<0.05). Aminophylline plasma clearance was positively correlated with age (in days) after birth and postmenstrual age in both groups.

CONCLUSIONSIn VLBW infants, pharmacokinetics and pharmacodynamics are different when different maintenance doses of aminophylline are given. The maintenance dose of 2 mg/kg is associated with a better effect in the treatment of apnea. Postmenstrual age and age (in days) should be considered during the adjustment of dose, and routine blood concentration monitoring should be performed.

Aminophylline ; pharmacokinetics ; pharmacology ; Apnea ; drug therapy ; Female ; Humans ; Infant, Newborn ; Infant, Very Low Birth Weight ; Male

Objective To investigate the effect of miR-145 on human lung adenocarcinaoma A549 cell proliferation and FSCN1 expression. Methods pmR-mcherry/miR-145 was constructed and transfected into A549 cell,then the expression of miR-145 and the proliferation of A549 cell were verified by QPCR and MTS assay, respectively.The situation of FSCN1 expression in A549 cell was detected by Western blot.Results pmR-mcherry/miR-145 vector was constructed successfully,and QPCR results indicated that miR-145 expressed effectively.Western blot results showed that FSCN1 was one of the targets of miR-145 in A549 cell.MTS assay results indicated that miR-145 inhibited the proliferation of A549 cell.Conclusion Overexpression of miR-145 can inhibit the proliferation of A549 cell, and FSCN1 was one of its target.

OBJECTIVETo study the brain protection and the possible mechanism of human umbilical cord-derived mesenchymal stem cells (hUC-MSCs) in neonatal rat model of hypoxic-ischemic brain damage (HIBD).

METHODSSuccessfully establishing a neonatal rat model of HIBD, hUC-MSCs labeled with BrdU were transplanted into the lateral ventricle 24 hours after HIBD. The number of apoptotic cells and the expression of Caspase-3 were detected by TUNEL and Western blot respectively at 24 and 48 hours after transplantation. The neurological functions of HIBD rats were evaluated by Longa score, and the survival, differentiation and pro-differentiation effects of hUC-MSCs were identified by immunofluorescence at 1 to 3 weeks after transplantation.

RESULTSAt 24 and 48 hours after transplantation, apoptotic cells and Caspase-3 expression in the MSCs group were less than in the HIBD group (P<0.05). At 2 and 3 weeks after transplantation, the Longa score in the MSCs group was lower than in the HIBD group (P<0.05). After transplantation, positive cells labeled with BrdU were seen in the brain tissue. The expression levels of glial fibrillary acidic protein (GFAP) and neuron specific esterase (NSE) in the MSCs group were higher than in the HIBD and sham-operated control groups (P<0.05), and increased gradually with the transplantation time (P<0.05).

CONCLUSIONShUC-MSCs transplantation in HIBD rats can inhibit Caspase-3 expression and reduce apoptotic cells in the early stage, and in the later period, the survival hUC-MSCs can differentiate into neural-like cells and promote the differentiation of endogenous neural-like cells, providing protective effects to brain.

Animals ; Animals, Newborn ; Apoptosis ; Caspase 3 ; metabolism ; Cell Differentiation ; Cord Blood Stem Cell Transplantation ; Disease Models, Animal ; Female ; Hypoxia-Ischemia, Brain ; pathology ; therapy ; Male ; Mesenchymal Stem Cell Transplantation ; Phosphopyruvate Hydratase ; analysis ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo study the effect of β8 expression on transforming growth factor β1(TGF-β1) activation in astrocytes with oxygen glucose deprivation (OGD).

METHODSAstrocytes were cultured and then subjected to OGD to generate hypoxia-ischemia (HI) model in vitro. Immunocytochemistry was used to detect the expression and distribution of β8 in nomoxia cultured cells. β8 protein expression was quantified by Western blot at 12 hours, 1 day and 2 days after OGD. Astrocytes and luciferase reporter cells (TMLC) were co-cultured. β8 RNA interference system was established to specifically inhibit β8 expression in cultured astrocytes. TGF-β1 activation was then detected in the co-culture system.

RESULTSβ8 was mainly located in the cytoplasm and neurites of astrocytes. OGD resulted in increase of β8 protein expression at 12 hours after reoxygenation in astrocytes, which was peaked at 1 day after reoxygenation. TGF-β1 activation was in accordance with β8 expression in astrocyte-TMLC co-culture system after reoxygenation. After the inhibition of β8, TGF-β1 activation was significantly reduced in all time points.

CONCLUSIONSThe highly expressed β8 plays important roles in the regulation of TGF-β1 activation in neonatal rats with hypoxic-ischemic brain damage.

Animals ; Astrocytes ; metabolism ; Female ; Glucose ; metabolism ; Hypoxia-Ischemia, Brain ; metabolism ; Integrin beta Chains ; physiology ; Male ; Oxygen ; metabolism ; Rats ; Rats, Sprague-Dawley ; Transforming Growth Factor beta1 ; metabolism

OBJECTIVEInadequate postnatal nutritional support is an important factor contributing to growth failure, which leads to poor neurological outcome. In this study, co-word analysis was used to investigate the research on nutrition of premature infants over the last six years in China, describe the research trend in this field in China, and provide possible directions for future research.

METHODSA literature search was performed in January 2013 using the CNKI database and the key words "preterm infant" and "nutrition". A total of 772 articles were retrieved. Then high-frequency key words were extracted using Excel 2010 to create a co-occurrence matrix. Finally, a visualized network was built using Ucinet 6.0.

RESULTSThe knowledge domain map of research on nutritional support for premature infants in China showed that the major topic of relevant research is still the combination of parenteral nutrition and enteral nutrition, with the goal of maintaining appropriate growth rates in premature infants. Researchers have paid much attention to the adverse effects of parenteral nutrition. Feeding intolerance is still the main problem in nutritional support, especially enteral nutrition, for premature infants.

CONCLUSIONSA visualized network of current research on nutrition of premature infants in China has been created, and a knowledge domain map has been drawn to reflect the hot topics in this field of study over the last six years.

Enteral Nutrition ; Humans ; Infant Nutritional Physiological Phenomena ; Infant, Newborn ; Infant, Premature ; physiology ; Parenteral Nutrition

OBJECTIVETo prepare ligustrazine (TMPZ) ocular sustained-release implant, and investigate its in vitro drug release, pharmacokinetics in rabbit vitreum and in vitro correlation.

METHODLigustrazine ocular sustained-release implants were prepared by micro-twin conical screw mixers with hot-melting extrusion method, with polyactic-co-glycolic acid (PLGA) as the matrix. HPLC was adopted to determine the concentration in vitreum after ligustrazine was implanted in rabbit eyes, in order to examine its in vivo sustained-release behavior, and study the correlation between in vitro and in vivo.

RESULTLigustrazine implants were prepared with a drug-loading rate between 10% and 30%, which was in conformity to the pharmacopoeia in terms of the content uniformity. Its in vitro release was in conformity to the zero-order release model. With PLGA 5050, 2. 5A as a vector, ligustrazine implants with a drug-loading rate of 30% could slowly release drug for more than 3 weeks, indicating a good correlation between in vitro and in vivo release.

CONCLUSIONLigustrazine ocular implants prepared with hot-melting extrusion method is practicable. Ligustrazine ocular implants release drug smoothly in rabbit vitreous vitreums, suggesting good sustained-release effect.

Animals ; Biological Availability ; Drug Implants ; Eye ; Female ; Male ; Polyglycolic Acid ; chemistry ; Pyrazines ; administration & dosage ; chemistry ; pharmacokinetics ; Rabbits ; Vitreous Body

Objective To explore the risk factors and morbidity of retinopathy of prematurity(ROP) and evaluate the appropriateness of the ROP screening criteria set by Ministry of Health in 2004.Methods Two hundred and eighteen premature infants conforming to the criteria set by Ministry of Health in 2004,who were hospitalized in West China Second Hospital from Feb.2011 to Feb.2012,were enrolled,and they underwent ophthalmologic examination.The results were analyzed and compared according to criteria recommended by the United Kingdom(weight≤ 1500 g or gestational age ≤31 weeks).Results In the 218 premature infants,11 (5.0％) cases had developed ROP.Between the groups of ROP and the contrast,the Apgar scores were 8.60 ± 1.78 and 9.53 ± 0.98,and the cases of patients with respiratory distress syndrome were 6 cases and 33 cases respectively,while the cases of patients with long-term oxygen therapy were 8 cases and 44 cases,the cases of patients with mechanical ventilation were 6 cases and 23 cases,while the cases of patients with transfusion therapy were 6 cases and 53 cases,respectively.And there were significant differences between the two groups (all P ＜ 0.05).There would have been 7 cases of ROP to be missed if the screening had been done in according to British guidelines.Conclusions There is a possible association between low Apgar scores,long-term oxygen therapy,mechanical ventilation and the incidence of ROP.The ROP screening criteria set by Ministry of Health in 2004 is practical for ROP screening in our region in China.ROP screening should also be done for the premature infants who had unstable clinical course,and respiratory distress syndrome in particular.