Objective To objectively classify cancer-related fatigue(CRF)patients with qi and blood deficiency syndrome;To explore possible enrichment characteristics;To provide ideas for precise population identification.Methods A cross-sectional study was conducted,611 CRF patients with qi and blood deficiency syndrome were included from October 2019 to April 2022.Clinical symptoms of patient were documented,including pale or withered-yellow complexion,shortness of breath with reluctance to talk,dizziness,spontaneous sweating,and palpitations.Additionally,blood routine were conducted,including white blood cell(WBC)count,red blood cell(RBC)count,hemoglobin(HGB),platelet(PLT)count,and neutrophil count(NEUT).The degree of fatigue was assessed using the Piper Fatigue Scale(PFS).Data analysis was performed using R 4.2.0.Clustering analysis was performed using the K-mediods method.Results Through unsupervised clustering analysis,the target population was divided into three categories:qi and blood deficiency syndrome leaning towards qi deficiency,qi and blood deficiency syndrome with mild symptom,qi and blood deficiency syndrome leaning towards blood deficiency.In terms of fatigue severity,the first two groups showed comparable levels,while the third group exhibited the most severe fatigue.Regarding objective indicators,the group leaning towards qi deficiency had the lowest WBC count,NEUT count and PLT count,and the group leaning towards blood deficiency had the lowest HGB count and RBC count.The group of qi and blood deficiency syndrome with mild symptom exhibited the highest level of objective indicators among the three.Conclusion By using clustering analysis methods,the study has preliminarily achieved population enrichment and classification based on syndromes,providing ideas for subsequent information enrichment and accurate identification of populations.Concurrently,the anemia index,WBC count and NEUT count demonstrate a inclination towards blood deficiency syndrome and qi deficiency syndrome,respectively.These findings indicate that these indicators could be incorporated into the syndrome diagnostic criteria for CRF to aid in the classification of the CRF population.

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.

Humans ; Consanguinity ; Exome Sequencing ; Mutation/genetics* ; Sequence Analysis, DNA ; Ciliary Motility Disorders ; Axonemal Dyneins/genetics*

Purpose To investigate and summarize the clinicopathological features,immunophenotype,diagnosis and differential diagnosis of anaplastic thyroid carcinoma(ATC).Methods The clinicopathological features and follow-up data of 15 patients with ATC were reviewed and retrospectively ana-lyzed,and the histological features,immunophenotypic,and molecular features were observed.Results There were 8 males and 7 females with a mean age of 63.5 years.The largest tumor diameter was 45.9 mm(range,20-73 mm).Macroscopically,the tumors appeared nodular or lobulated,mostly firm to hard,with a cut surface of gray-white or gray-yellow in color,and were accompanied by hemorrhage,necrosis,and cystic changes.Mi-croscopically,the tumor exhibited diverse structures and cellular morphology mainly composed of epithelioid,spindle,multinu-cleated giant cells,rarely rhabdoid morphology(2 cases)and heterologous osteosarcomtoid differentiation(1 case).Two cases showed squamous cell carcinoma morphology as well.Among them,there were pure ATC in 11 cases while three cases had mixed papillary thyroid carcinoma components and one case had coexisting high-grade differentiated thyroid carcinoma compo-nent.Cervical lymph node metastasis was present in 6 cases.CK(AE1/AE3)expression was observed in 80%of the cases while PAX8 expression was seen in53.3%.Varying degrees of BRAF(VE1)expression were found in 42.9%whereas weak focal TTF-1 expression occurred only in two cases;and all cases did not express TG.Overall,genetic testing was performed in 8 cases(53.3%).The TP53 gene was the most frequently muta-ted gene(5/8,62.5%),followed by the RAS(3/8,37.5%)and BRAF(3/8,37.5%)genes,while the TERT combined with PIK3CA gene was mutated in only one case.Moreover,multiple gene mutations occurred simultaneously in five cases.Of the total fourteen patients who underwent follow-up,the mean and median survival times were 13.9 and 5.0 months,respec-tively.The disease-specific mortality rate reached 78.6%.Conclusion ATC is extremely rare,displaying unique histolog-ical characteristics,often accompanied by various gene muta-tions.It has a poor prognosis;therefore,establishing a defini-tive pathological diagnosis provides valuable evidence for predic-ting patient outcomes and guiding clinical management.

Objective To investigate the accelerating role of recombinant human parathyroid hormone (PTH) in bone fracture repair.Methods 2-month old male Sprague-Dawley rats underwent closed unilateral femoral fracture and intramedullary nail fixation.The rats were divided into 2 equal groups randomly: the treatment group receiving subcutaneous injection of rhPTH(1-34) 10 μg/(kg·d) immediately after operation and for 2,7,14,21 and 42 d,respectively, and the control group receiving subcutaneous injection of normal saline in the same volume.X-ray and micro-CT were conducted at 2, 7, 14, 21 and 42 days after surgery.Results The continuity of porosis between fracture sides was better and fracture line has been blurred in the PTH-treated group at 21 days after fracture compared with the control group, the bone volume (BV),BV/TV, bone mineral density(BMD)and trabecular pattern factor (Tb.Pf) were significantly higher, and trabecular separation (Tb.Sp) and degree of anisotropy (DA) were significantly lower in the PTH-treated group at 42 days after fracture.Conclusions Our findings suggest that a low dose recombinant human parathyroid hormone can accelerate the bone fracture healing, probably through improving the BV, BV/TV, Tb.P and BMD, and decreasing the Tb.Sp and DA.

MicroRNAs (miRNAs) play critical roles in the development and progression in various cancers.Dysfunctional miR-9 expression remains ambiguous,and no consensus on the metastatic progression of ovarian cancer has been reached.In this study,results from the bioinformatics analysis show that the 3'-UTR of the E-cadherin mRNA was directly regulated by miR-9.Luciferase reporter assay results confirmed that miR-9 could directly target this 3'-UTR.miR-9 and E-cadherin expression in ovarian cancer tissue was quantified by qRTPCR.Migration and invasion were detected by wound healing and Transwell system assay in SKOV3 and A2780.qRT-PCR and Western blot were performed to detect the epithelial-mesenchymal transition-associated mRNA and proteins.Immunofluorescence technique was used to analyze the expression and subcellular localization of Ecadherin,N-cadherin,and vimentin.The results showed that miR-9 was frequently upregulated in metastatic serous ovarian cancer tissue compared with paired primary ones.Upregulation of miR-9 could downregulate the expression of E-cadherin but upregulate the expression of mesenchymal markers (N-cadherin and vimentin).Overexpression of miR-9 could promote the cell migration and invasion in ovarian cancer,and these processes could be effectively inhibited via miR-9 inhibitor.Thus,our study demonstrates that miR-9 may promote ovarian cancer metastasis via targeting E-cadherin and a novel potential therapeutic approach to control metastasis of ovarian cancer.

Objective To study the effects of intermittent low?dose administration of recombinant human parathyroid hor?mone (1-34) [rhPTH(1-34)] in the expression of Osterix (Osx) during early stage of fracture healing. Methods Forty?eight 2?month old male Sprague?Dawley rats were underwent close unilateral femoral fracture and intramedullary nail fixation. The sub?jects were divided into 2 equal groups randomly:treatment group undergoing subcutaneous injection of rhPTH(1-34) 10 mg/kg/d immediately after the operation and control group undergoing subcutaneous injection of normal saline of the same dose. Six rats in each group were sacrifice at 2, 7, 14, and 21 days after operation. X?ray photography study was conducted at 7, 14 and 21 days. Tissue RNA and protein were extracted from the bone tissues of bilateral femurs and the expression levels of Osx mRNA and pro?tein were evaluated via real time quantitative PCR and Western?blotting. Results Fracture healing was significant at 14 days af?ter operation, and the progress of fracture healing was better in the rhPTH(1-34) group than in the control group at 14 and 21 days. The relative expression of Osx mRNA and protein in the fractured femurs of the rhPTH(1-34) group (5.02±0.5 and 10.03±0.8 for Osx mRNA, 3164.03±131 and 3509.02±126 for protein) at 14 and 21 days after the operation were significantly higher than those of the control group (2.30±0.4 and 4.01±0.7 for Osx mRNA, 1053.04±121 and 2721.03±123 for protein). However, there was no significant difference at 2 and 7 days after operation between the rhPTH(1-34) and control group. Conclusion Intermittent low?dose administration of rhPTH(1-34) up?regulates the expression levels of osteogenesis?specific Osx mRNA and protein in rats. It will accelerate the early phase of fracture healing process.

Objective To understand the status of awareness of hand hygiene(HH)knowledge and compliance among health care workers (HCWs)in China,and provide scientific basis for further improvement of HH practice. Methods A multi-centre retrospective survey on awareness of HH knowledge and compliance was conducted in 200 nationwide hospitals in 2015.Results The awareness rates of HH methods and HH indications among HCWs were 86.5% and 82.5% respectively;cleaning staff had the lowest awareness rate of HH indications(69.9%),followed by the other interns and advanced-study students (70.2%),as well as medical technicians (79.8%);attendants had the lowest awareness rate of HH methods(76.9%),followed by advanced-study students and interns(81.0%),and cleaning staff (82.4%);HH knowledge awareness rate among HCWs in secondary hospitals was lower than tertia-ry hospitals,and the district-level hospitals had the lowest awareness rate of HH.HH compliance rate and correct rate were 70.1% and 74.9% respectively;the interns and advanced-study students were at a low level of compliance and correct rates (61.4% and 60.9% respectively);the municipal hospitals had the lowest compliance and correct rates,non-teaching hospitals were lower than teaching hospitals.Conclusion HH in primary hospitals is weak,HH of interns,advanced-study students,as well as attendants and cleaning staffs are not enough,HH management should be strengthened,awareness and compliance of HH should be improved.

Objective:To establish a quality control standard for psoraleae fructus tinctures. Methods:The identification was de-tected by TLC on silica gel G plates with hexane-ethyl acetate (8∶2) as the developing solvent. An HPLC method was applied in the quantitative determination of psoralen and isopsoralen as the effective components. The analytical column was Intersil ODS-3 (250 mm × 4. 6 mm,5 μm) with methanol-water(45∶55) as the mobile phase;the flow rate was 1 ml·min-1;the detection wavelength was at 246 nm and the column temperature was set at 35℃. Results:The characteristic spots for psoralen and isopsoralen were identified by TLC. The concentration of psoralen showed good linearity within the range of 4. 88-187. 50μg·ml-1(r=0. 999 9)and the average re-covery was 102. 63% and RSD was 0. 43%. The concentration of isopsoralen showed good linearity within the range of 4. 25-163. 20μg ·ml-1(r=0. 999 9), and the average recovery was 102. 37% and RSD was 1. 13%. Conclusion: The qualitative and quantitative methods are simple, accurate, feasible and repeatable, which can be used in the quality control of psoraleae fructus tinctures.

OBJECTIVETo study the effect and safety of Kudiezi injection on patients with acute ischemic stroke.

METHODSeven hundreds patients were divided into two groups by central randomization system. The study group, 346 cases, was treated with kudiezi injection plus traditional Chinese medicine (TCM) synthesis rehabilitation project, and the control group, 354 cases, was treated with synthetic rehabilitation project. The patients were treated for 10 to 21 days. Before treatment and at the 7th, 14th and 21th day of treatment, the indexes include NIHSS used for evaluating the neurological deficit degree and the motor function score (Fugl-Meyer) for evaluating motor function were observed. The safety index is defined by adverse observation event and laboratory test. The incidence of adverse events and laboratory tests results were observed before and after treatment at the same time.

RESULTApplication of generalized estimating equation model, we found that as the treatment time, NIHSS score and FMI score of the two groups showed a trend of improvement. And at the 14th days and 21th days of treatment, compared to the control group the treatment group showed significant statistical difference on the impact of NIHSS and FMI (P<0.05). No serious adverse events were observed.

CONCLUSIONKudiezi injection plus TCM rehabilitation project of ischemic stroke showed some superiority to western medicine rehabilitation program on improving the neurological deficit and motor function. Kudiezi injection is safe and effective in the treatment of acute ischemic stroke.

Aged ; Brain Ischemia ; drug therapy ; Drug-Related Side Effects and Adverse Reactions ; Drugs, Chinese Herbal ; adverse effects ; therapeutic use ; Female ; Humans ; Injections ; Male ; Medicine, Chinese Traditional ; adverse effects ; Middle Aged ; Product Surveillance, Postmarketing ; Stroke ; drug therapy