OBJECTIVE To explore the potential mechanism of the effect of Xuebijing injection （XBJ） on neurological function and survival of rats after cardiac arrest （CA）/cardiopulmonary resuscitation （CPR） based on the S-nitrosoglutathione reductase （GSNOR）/S-nitrosoglutathione （GSNO） pathway. METHODS The CA/CPR rat model was established by ventricular fibrillation. Using a sham operation group as control， high-throughput sequencing was employed to analyze and mine the differentially expressed genes （DEGs）. Enzyme-linked immunosorbent assay was used to determine the contents of GSNOR and GSNO in the hippocampus； the active components of XBJ were screened and subjected to molecular docking analysis with GSNOR. The rats successfully modeled using the same method were divided into model group （n＝30）， inhibitor （GSNOR inhibitor） group （n＝30）， XBJ group （n＝30） and XBJ+inhibitor group （n＝30）， and a sham operation group （n＝30） was set up. Neurological function was evaluated and survival status was recorded at 3 hours， 24 hours and 3 days after the first 89） drug intervention. The contents of GSNOR and GSNO in the hippocampus of rats were determined in each group at the 0191） above time points， and the relationship of the contents of GSNOR and GSNO with modified neurologic severity scale （mNSS） score was analyzed. RESULTS GSNOR coding gene was differentially expressed between the model group and the sham operation group. Compared with the sham operation group， GSNOR content increased significantly in the hippocampus of rats in model group， while GSNO content decreased significantly （P＜0.05）. The active components of XBJ， such as 4- methylenemiltirone and salviolone， could be bound to GSNOR protein， with the binding energy lower than －6 kcal/mol， mainly connected by hydrogen bonds. Animal experiments revealed that mNSS score and GSNOR levels in the hippocampus of rats in the model group were significantly higher than those in the sham operation group （P＜0.05）， while GSNO levels and survival rate were significantly lower than those in the sham operation group （P＜0.05）. The above indexes of rats were improved significantly in administration groups， the mNSS score in the XBJ group was significantly lower than that in the inhibitor group， the content changes of GSNOR and GSNO in the inhibitor group were more obvious than those in the XBJ group， and the various indicators in the XBJ+inhibitor group were significantly better than the XBJ group and the inhibitor group （P＜0.05）. GSNOR content was positively correlated with the mNSS score， and GSNO content was negatively correlated with the mNSS score （P＜0.05）. CONCLUSIONS XBJ can improve the neurological function of rats and enhance their survival rates after CA/CPR， the mechanism of which may be associated with the down-regulation of GSNOR and the up-regulation of GSNO.

OBJECTIVE To investigate the mechanism of Yifei xuanfei jiangzhuo formula （YFXF） against vascular dementia （VD）. METHODS The differentially expressed genes of YFXF （YDEGs） were obtained by network pharmacology. High-risk genes were screened from YDEGs by using the nomogram model. The optimal machine learning models in generalized linear， support vector machine， extreme gradient boosting and random forest models were screened based on high-risk genes. VD model rats were established by bilateral common carotid artery occlusion， and were randomly divided into model group and YFXF group （12.18 g/kg， by the total amount of crude drugs）， and sham operation group was established additionally， with 6 rats in each group. The effects of YFXF on behavior （using escape latency and times of crossing platform as indexes）， histopathologic changes of cerebral cortex， and the expression of proteins related to the secreted phosphoprotein 1 （SPP1）/phosphoinositide 3-kinase （PI3K）/protein kinase B （aka Akt） signaling pathway and the mRNA expression of SPP1 in cerebral cortex of VD rats were evaluated. RESULTS A total of 6 YDEGs were obtained， among which SPP1， CCL2， HMOX1 and HSPB1 may be high-risk genes of VD. The generalized linear model based on high-risk genes had the highest prediction accuracy （area under the curve of 0.954）. Compared with the model group， YFXF could significantly shorten the escape latency of VD rats， significantly increase the times of crossing platform （P＜0.05）； improve the pathological damage of cerebral cortex， such as neuronal shrinkage and neuronal necrosis； significantly reduce the expressions of SPP1 protein and mRNA （P＜0.05）， while significantly increase the phosphorylation levels of PI3K and Akt （P＜0.05）. CONCLUSIONS VD high-risk genes SPP1， CCL2， HMOX1 and HSPB1 may be the important targets of YFXF. YFXF may play an anti-VD role by down-regulating the protein and mRNA expressions of SPP1 and activating PI3K/Akt signaling pathway.

BACKGROUND:There are differentially expressed genes in acute intracerebral hemorrhage,which are related to the occurrence and development of intracerebral hemorrhage. OBJECTIVE:To screen differentially expressed genes and key genes in brain tissue of a rat model with acute intracerebral hemorrhage,to validate them through qPCR,and to analyze the relationships between key genes and the neurological function and brain tissue water content after intracerebral hemorrhage. METHODS:Seventy-eight Sprague-Dawley rats were randomly divided into two groups:in intracerebral hemorrhage group,a rat model of acute intracerebral hemorrhage was made using collagenase injection at the right caudate nucleus;and in sham-operated group,rats were injected with equal amount of saline at the same site.RNA was extracted from rat brain tissues of both groups using the TRIzol method and transcriptome sequencing technology was used to identify differentially expressed genes in brain tissues of acute intracerebral hemorrhage,which were then verified by qPCR and analyzed for the relationships between the genes and neurological function and brain tissue water content after intracerebral hemorrhage.And the key genes were analyzed by GO and KEGG functional enrichment analysis in combination with bioinformatics. RESULTS AND CONCLUSION:Ten key genes were identified,including CXCL8,SERPINE1,TFPI2,CXCR4,GDA,KCNQ5,ERICH3,SCN3B,CACNA1E,and CCL20.The contents of GDA,KCNQ5,ERICH3,SCN3B,and CACNA1E in the intracerebral hemorrhage group were lower than those in the sham-operated group(P＜0.05).The contents of CXCL8,SERPINE1,TFPI2,CXCR4 and CCL20 in the intracerebral hemorrhage group were higher than those in the sham-operated group(P＜0.05).The contents of GDA,KCNQ5,ERICH3,SCN3B,and CACNA1E were positively correlated with brain tissue water content and neurologic deficit score(P＜0.05),while the contents of CXCL8,SERPINE1,TFPI2,CXCR4 and CCL20 were negatively correlated with brain tissue water content and neurologic deficit score(P＜0.05).GO analysis indicated that differentially expressed genes were mainly enriched in two biological processes(leukocyte chemotaxis and chemokine-mediated signaling pathways),two cell components(cation channel complexes and ion channel complexes),and two molecular functions(gated channel activity and ion channel activity).KEGG analysis indicated that differentially expressed genes were concentrated in tumor necrosis factor signaling pathway,glutamatergic synapses and GABAergic synapses.To conclude,the differentially expressed genes in intracerebral hemorrhage include CXCL8,SERPINE1,TFPI2,CXCR4,GDA,KCNQ5,ERICH3,SCN3B,CACNA1E,and CCL20,and these genes are related to brain tissue water content and neurological function after intracerebral hemorrhage.These genes are mainly enriched in cell components,binding functions,cellular protrusions,and other related biological functions.

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 To explore the mechanism of Jianshen Lishui Decoction on nerve cell apoptosis in rats with cerebral hemorrhage.Methods The expression of miR-153 in cerebral hemorrhage was analyzed by miRNA microarray and RT-PCR,and the relationship between miR-153 and neuronal apoptosis in cerebral hemorrhage was observed,and predicted the target gene of miR-153;the binding of miR-153 to target genes was studied by dual-luciferase reporter gene Experiments,and to observe the effects of overexpression and inhibition of miR-153 on target genes.Subsequently,the relationship between target genes and neuronal apoptosis in cerebral hemorrhage was determined.Finally,the effect of Jianshen Lishui Decoction on miR-153 and the target gene,and finally explored the related mechanism of Jianshen Lishui Decoction on nerve cell apoptosis in rats with cerebral hemorrhage.Results Microarray chip and RT-PCR detection showed that miR-153 was lowly expressed in cerebral hemorrhage(P<0.05),and miR-153 was negatively correlated with neuronal apoptosis(R:-0.875,P=0.0002).The online databases TargetScan and miRDB showed that miR-153 has a binding region with TREM1,and the dual-luciferase reporter gene demonstrated a binding relationship between the two.When miR-153 was overexpressed,the expression of TREM1 was down-regulated,conversely,up-regulated when miR-153 was repressed,and TREM1 was positively correlated with nerve cell apoptosis(R:0.857,P<0.001).The expression of TREM1,the number of nerve cell apoptosis and the score of Neurological Deficit Scores in the Jianshen Lishui Decoction group were lower than those in the model group(P<0.05),and the expression of miR-153 was higher than that in the model group(P<0.05).The expression of TREM1,the number of nerve cell apoptosis and the score of Neurological Deficit Scores in the Jianshen Lishui Decoction +miR-153 inhibition group were higher than those in the Jianshen Lishui Decoction group(P<0.05).Conclusion Jianshen Lishui Decoction inhibits the apoptosis of nerve cells and protects the neurologicalfunctions in rats with cerebral hemorrhage by promoting miR-153 expression and inhibitingTREM1 expression.

Background: Gastric cancer is one of the common gastrointestinal malignancies. Early diagnosis can reduce the mortality rate significantly. In the Chinese consensus published in 2017, the New Gastric Cancer Screening Scoring System was recommended to be used for risk stratification of gastric cancer. Aims: To preliminarily explore the value of the New Gastric Cancer Screening Scoring System in early gastric cancer screening in asymptomatic community population. Methods: At several communities in Suzhou City Xiangcheng District, a questionnaire survey was conducted in asymptomatic community residents willing to accept voluntary serum tests to collect information on high risk factors of gastric cancer. Serum pepsinogen (PG), PGⅡ, gastrin 17 (G-17) and Helicobacter pylori (Hp) IgG were tested simultaneously. Risk stratification of gastric cancer was carried out in accordance with the New Gastric Cancer Screening Scoring System. Gastroscopy was recommended for moderate to high risk individuals. Results: A total of 540 asymptomatic individuals completed the study, of which 11 were categorized as high risk (2.0%), 168 as moderate risk (31.1%), and 361 as low risk (66.9%). Sixty-four moderate to high risk individuals completed the gastroscopy with a response rate of 35.8%. Four precancerous lesions were detected (6.2%), including 3 gastric low-grade intraepithelial neoplasia and 1 duodenal adenoma. No gastric cancer was detected. Conclusions: The New Gastric Cancer Screening Scoring System is useful for risk stratification of gastric cancer in asymptomatic population and may provide a basis for further endoscopic examination. However, the value of this scoring system in low risk areas of gastric cancer needs to be further verified.

Objective To investigate the effect of blood transfusion physicians for participating in clinical consultation to provide a reference for blood transfusion physicians participating in clinical practice.Methods The clinical data in 5 224 inpatients receiving blood transfusion before the blood transfusion physicians participating in clinical consultation (from January 2010 to December 2015) and after participating in clinical consultation (from January 2013 to December 2015) were retrospectively analyzed.Results The occurrence rates of blood transfusion adverse reactions before and after the blood transfusion physicians participating in clinical consultation were 2.39 ％ and 1.48 ％ respectively (x2 =5.674,P=0.021),the blood transfusion ratios of inpatients were 4.85 ％ and 3.55 ％ respectively (x2 =135.5,P＜0.01),the average allogeneic blood transfusion volumes were 0.563 U and 0.420 U (t=3.986,P=0.016),and the constituent ratios of mild,moderate andsevere anemia were 5.40％ and 0.23 ％,29.60％ and 17.90％,and 65.00％ and 81.80％ respectively (x2 =237.6,P＜0.01).Conclusion Participating in clinical consultation by the blood transfusion physicians is conducive to clinical treatment.

Objective To investigate the clinical efficacy and value of low molecular weight heparin calcium combined with vertebroplasty in the treatment of osteoporotic vertebral compression fractures in elderly patients .Methods 67 elderly patients with osteoporotic vertebral compression fractures in our hospital from January 2013 to January 2016 were selected and randomly divided into control group 30 cases and treatment group 37 cases. All patients were treated with percutaneous vertebroplasty, the control group was given calcium carbonate D3 conventional treatment, the treatment group was treated with low molecular weight heparin calcium anti osteoporosis treatment, the course of treatment was one month.Measurement of bone mineral density before and after the operation of different follow-up time points ( BMD ) and the changes of the oswestry disability index ( ODI ) evaluation activities and the visual analogue scale (VAS) to assess the degree of pain, and the changes of vertebral height before and after operation were analyzed. Results All patients were followed up for an average of 16.4 months (12 to 21 months).Compared with before vertebroplasty, the BMD of the patients in the treatment group was higher than that in the control group at one month, three months and six months, the difference was statistically significant (P<0.05), the low molecular weight heparin treatment after January, treatment group VAS and ODI scores were significantly lower than the control group, and the subsequent different follow-up time points ODI and VAS score can effectively maintain, the difference was statistically significant ( P<0.05) .Compared with before vertebroplasty, postoperative anterior vertebral height, middle height better than preoperative vertebral height, the difference was statistically significant (P<0.05), and after one months of treatment, the treatment group of anterior vertebral height, middle height were better than the control group, the difference was statistically significant (P <0.05).Conclusion After treatment with low molecular weight heparin calcium, the healing process of vertebral body after vertebroplasty, to a certain extent, it can increase the bone mass and prevent bone destruction, increase bone strength, and further achieve the treatment of osteoporosis and prevention of osteoporotic fracture in elderly patients with osteoporotic vertebral compression fractures.

Objective To explore the feasibility of the perforator-based intermediate dorsal pedal flap with vessels of cutaneous nerve nutrition for repair of soft tissue defects of the forefoot.Methods A retrospective case series study was performed for seven cases of soft tissue defects of the forefoot hospitalized between February 2013 and January 2017.There were five males and two females,with a mean age of 38 years (range,18-73 years).Injury regions were lateral plantar skin defect in the forefoot in three cases,dorsal skin defect in the third webbed toe in two cases and proximal dorsal skin defect in the fourth toe in two cases.The defect area was about 2.5 cm × 1.5 cm-4.5 cm × 2.0 cm.The perforator-based intermediate dorsal pedal flap with vessels of cutaneous nerve nutrition was designed on the lateral dorsum of the foot and then was incised and transferred to repair the forefoot wound based on its surgical anatomy.The time of surgery and the amount of intraoperative blood loss were recorded.An observation was done on feeling,appearance,texture,blood supply and survival of the flap as well as swelling,hypertrophic scar,itching,paralysis of the skin grafting area.The recovery of the activity function was assessed by American Orthopedic Foot & Ankle Society (AOFAS) score.Results The surgery time was 1.0-1.5 h (mean,1 h),and intraoperative bleeding was about 50 ml (range,30-100 ml).Seven cases of perforator-based dorsal medial skin flap with vessels of cutaneous nerve nutrition all survived,with early wound healing.After 2 to 15 months follow-up,two-point discrimination of flaps was 9-15 mm(average,12.5 mm).Skin flaps were with excellent texture and without swelling,the color of which was close to normal color with good appearance.The postoperative foot did not have bone resorption,wound infection,tendon adhesion,line-type or flaky scar left locally,lower limb walking dysfunction or other complications.Patients were satisfied with the functions of donor and recipient sites and the appearance of the flap.Conclusions Perforation-based dorsal flap with vessels of cutaneous nerve nutrition has high survival rate,satisfaction of appearance and fast recovery of recipient site,with no obvious foot pain,limitation of joint movement or other complications,and therefore is a reliable method to repair soft tissue defects in forefoot.

Objective: To investigate the morphological characters of the dorsal perforators originated from the deep palmar arch, so as to provide anatomic basis for V-Y advanced perforator flap. Methods: The following contents were investigated in 30 adult hand specimens perfused with red latex under surgical magnifier: ①The origin, courses, branches and distribution of the dorsal perforators originatedd from the deep palmar arch. ②The characters of anastomosis among the dorsal perforators, the dorsal carpal and metacarpal arteries. Mimic operation was performed on another fresh specimens perfused with red latex. Results: There were three perforators originated from the deep palmar arch, which passed through the 2nd-4th dorsal interossei and then divided into an ascending branch and a descending branch at the dorsum of hand. Then the ascending branch anastomosed with the dorsal carpal artery, and the descending branch stretched to the 2nd-4th dorsal metacarpal arteries. The originating outer diameters of the 1st-3rd perforators were (1.1±0.2) mm, (0.9±0.3) mm and (0.7±0.1) mm respectively, and the length of the stems were (1.1±0.3) cm, (1.0±0.2)cm and (0.9±0.1) cm respectively. Conclusions The V-Y advanced perforator flap with the dorsal perforator of the deep palmar arch as its vascular pedicle could be used to repair the dorsal carpal or dorsal metacarpal soft tissue defects.