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.

Medical supply is a key resource for responding to public health emergencies and maintaining people's lives and health. As the medical equipment management department, the medical devices department is mainly responsible for the procurement, supply, technical support, management and coordination of medical equipment and medical consumables, playing an important role in epidemic prevention and control. Through the analysis of the expansion cases of designated hospitals, the experience of emergency management of medical equipment has been accumulated, which has strong practicability and replicability.
Humans ; Public Health ; Emergencies ; Hospitals ; Epidemics

OBJECTIVE To investigate the effects of pharmacological inhibition of STING by C-176,a STING selective inhibitor,in experimental model of Parkinson's disease.METHODS The acute and sub-acute mice mod-els of Parkinson's disease(PD)were established by in-traperitoneal injection of 1-methyl-4-(2′-methylphenyl)-1,2,3,6-tetrahydrophine(MPTP).The selective STING inhibitor C-176 was administered by intraperitoneal injec-tion.The potential neuroprotective effects of C-176 were evaluated by behavioral test,tyrosine hydroxylase(TH)immunostaining,Nissl staining,Western blotting,qPCR and immunofluorescence.For in vitro study,the effects of C-176 on LPS/MPP+-induced inflammatory responses in BV2 microglial cells were determined by real time RT-PCR and Western blotting analysis.RESULTS Our study revealed that C-176 significantly inhibited STING signaling activation,ameliorated MPTP-induced dopami-nergic neurotoxicity,motor deficit and associated neuroin-flammation.Furthermore,pharmacological inhibition of STING in BV2 microglia treated with LPS/MPP+ exhibited decreased inflammatory responses.More importantly,C176 also reduced NLRP3 inflammasome activation both in vitro and in vivo.CONCLUSION The results of our study suggest that pharmacologic inhibition of STING protects against neuroinflammation that may act at least in part through suppressing NLRP3 inflammasome acti-vation and thus ameliorated dopaminergic neurodegener-ation.STING signaling may holds great promise for the development of new treatment strategy for PD as an effective therapeutic target.

OBJECTIVE To study the pharmacokinetics and safety of etoricoxib in Chinese healthy subjects following single oral administration under fasting and fed conditions. METHODS Sixty-eight healthy subjects were randomly divided into a fasting group and a fed group, and administered using a 2-period crossover trial design, LC-MS/MS was used to determine the concentration of etoricoxib in human plasma. The pharmacokinetic parameters were calculated using WinNonLin software, to compare the pharmacokinetic differences between domestic etoricoxib and original reference preparations, and the effects of different genders and meals on the pharmacokinetic parameters of etoricoxib were compared. The safety of etoricoxib tablets was evaluated by vital signs, physical examination, laboratory test results and electrocardiogram changes. RESULTS The pharmacokinetic parameters of the test and reference preparations in the fasting group were as follows:Tmax 1.25, 1.25 h, Cmax (2 767.50±421.89), (2 707.81±674.90)ng·mL-1, AUC0-∞ (52 967.87±13 843.25), (53 479.56±16 066.32)h·ng·mL-1. The pharmacokinetic parameters of the test and reference preparations in the fed group were as follows:Tmax 2.50, 1.75 h, Cmax (2 000.61±314.89), (2 209.06±429.05)ng·mL-1, AUC0-∞ (51 450.80±17 241.02), (49 287.23±16 192.87)h·ng·mL-1. There was a statistically significant difference in Tmax between the test and reference preparations in the fed group(P<0.05), but it has no clinical significance. After the subjects took oral etoricoxib tablets on an empty stomach and after meals, there was a statistically significant difference in Tmax and Cmax(P<0.01), but there was no statistically significant difference in AUC0-∞. There was no significant difference in the main pharmacokinetic parameters Tmax, Cmax, and AUC0-∞ among subjects of different genders after oral administration of etoricoxib tablets under fasting condition, but t1/2 and AUC0-∞ were higher in female subjects compared with male subjects after postprandial administration(P<0.05). Adverse events after fasting and postprandial administration involve multiple systems and were mild without serious adverse reactions. CONCLUSION Domestic etoricoxib tablets and original reference preparations have bioequivalence; meals affect the absorption rate of etoricoxib tablets, but do not affect the extent of absorption; there are no gender differences in pharmacokinetic parameters of etoricoxib after fasting administration, but there are gender differences in t1/2, AUC0-∞ after postprandial administration. Etoricoxib tablets have good safety and tolerance in Chinese healthy subjects.

Objective:To study the efficacy and safety of EndoClot polysaccharide hemostatic system (EndoClot PHS) for heparinized arterial hemorrhage of upper digestive tract (Forrest Ⅰa) in animal model.Methods:Twelve experimental pigs were randomly divided into the test group ( n=6) and the control group ( n=6) by simple random grouping method. Gastric arterial hemorrhage models were established. Endoclot PHS and Hemospray were used to spray on the wound to stop bleeding in the test group and the control group respectively. The time of effective hemostasis, the amount of hemostatic particles used, and the blockage of the powder feeding tube and its replacement were compared between the two groups. The survival and complications of experimental pigs were observed after the operation. In 10 days after the operation, the experimental pigs were euthanized for pathological dissection. Results:Spurting or pulsatile bleeding was achieved in all experimental pigs. There were significant differences in the time of effective hemostasis (8.75±0.84 min VS 9.83±0.62 min, t=-2.53, P=0.030) and the amount of hemostatic particles used to achieve effective hemostasis (6.71±0.39 g VS 14.10±1.62 g, t=-10.86, P<0.001) between the test group and the control group. There was no significant difference in the occurence of clogging or the replacement of powder feeding pipes between the two groups (0.64±0.02 times VS 0.67±0.04 times, t=-1.64, P=0.131). In addition, the gas source of the test group was stable, and the visual field under the endoscope was clear. Neither the test group nor the control group had gastric lesions, perforation, or embolism. The blood glucose, blood routine, and liver and kidney functions were normal, and no thrombosis or embolism of the main organs occurred in either group. Conclusion:EndoClot PHS is safe and effective for heparinized upper gastrointestinal arterial hemorrhage (Forrest Ⅰa) in animal models.

OBJECTIVE：To investigate the compatibility stability of Calcium gluconate injection with different solvents within 24 h，and to provide reference for clinical drug use. METHODS ：10％ Calcium gluconate injection was mixed with 0.9％ Sodium chloride injection and 5％ Glucose injection in the proportion of 10∶100，30∶100 and 50∶100（v/v）as trial group ，and mixed with 10％ Glucose injection in the same proportion as control group. The water was mixed with 0.9％ Sodium chloride injection ，5％ Glucose injection and 10％ Glucose injection in the same proportion as the blank control group. The appearance of the infusion in the trial group and the control group was observed within 24 h after preparation. pH value and the number of insoluble particles were detected and compared with the blank control group. The content of 5-hydroxymethylfurfural and the change of UV absorption spectrum were determined by UV spectrophotometry. RESULTS ：Compared with the blank control group infusion at the same time ， the infusion of trial group and the control group were colorless ，clear solution ，no visible foreign body ，and the pH value of the infusion of trial group and the control group had no significant change within 24 h. Within 24 h after preparation ，the number of insoluble particles ≥10 and ≥25 μm in 3 groups fluctuated but met the pharmacopoeia standard ；the number of insoluble particles with small particle size （5-10 μm）increased slightly with time ，but there was no significant difference between trial group ，control group and blank control group. The linear range of 5-HMF was 0.149-4.751 μg/mL（R2＝0.999 9）；the limit of quantitation was 0.013 μg/mL；RSDs of precision ，repeatability and stability tests （24 h）were less than 2％；average recovery was 105.23％ （RSD＝1.08％，n＝9）. The content of 5-HMF and the UV absorption spectrum had no significant change in 2 groups within 24 h. The absorbance of UV measured at 284 nm was in line with the pharmacopeia. CONCLUSIONS ：Calcium gluconate injection ， 0.9％ Sodium chloride injection and 5％ Glucose injection have good stability within 24 h，and can be used according to clinical needs.

With continuous discovery of tumor immune targets and continuous changes in antibody research and development technology, antibody drugs are becoming more and more widely used in clinical practice. However, some targets are not only expressed on tumor cells, but also on red blood cells. Therefore, the clinical application of antibodies against the corresponding targets may interfere with the detection of blood transfusion compatibility, resulting in difficulty in blood matching or delay of blood transfusion. This consensus summarizes the current solutions for the interference of CD38 monoclonal antibody (CD38 mAb) in transfusion compatibility testing. After analyzing the advantages and disadvantages of different methods, polybrene and sulfhydryl reducing agents [dithiothreitol (DTT) or 2-mercaptoethanol (2-Me)], as a solution for CD38 mAb interference in blood compatibility testing, are recommended for Chinese patients, so as to eliminate blood transfusion interference produce by CD38 mAb and further provide a pre-transfusion workflow for clinicians and technicians in Department of Blood Transfusion.

【Objective】 To study the serological and genetic characteristics of a case of B(A) blood group. 【Methods】 Serological and genetic ABO blood group typing were used to analyze the ABO subtype and family inheritance of the probands and her 8 family members. The B(A) blood type sample was used as the blood recipient, and the B-type and O-type donors were selected for cross-matching using microcolumn gel anti-human globulin method to evaluate the blood transfusion strategy. 【Results】 5 out of 9 family blood samples were B(A) phenotype, carrying B(A)04 allele. Among them, 1 was B(A)04/O1 type, and 4 were B(A)04/B type. The primary blood matching of B(A) blood type samples with type B and O recipients were all negative. 【Conclusion】 A total of 5 cases of B(A)04 blood type were found in this family investigation, and there were differences in serological manifestations. Washed RBCs with B and O type can be used for B(A) blood type transfusion, and type B suspended RBCs can be considered in case of emergency.

Objective To investigate the diagnostic value of PIgP/SC in diagnosis of primary hepatic cancer.Methods 58 patients with primary hepatic cancer,60 patients with liver cirrhosis and 60 healthy volunteers were studied.4 ml fasting venous blood was collected from all subjects.Serum level of AFP was detected with electrochemical chemiluminescence immunoassay system and plasma PIgR/SC level was detected by ELISA method.The level of PIgR/SC and AFP was detected at one week after surgical resection in patients with hepatic cancer.Results The levels of AFP and PIgR/SC in the three groups were significantly different (P＜0.01),and PIgR/SC was higher than that in patients with cirrhosis and volunteers (P＜0.01).There was no significant difference between patients with liver cirrhosis and liver cirrhosis(P＞0.05).AFP was higher in patients with HCC than patients with cirrhosis and volunteers.AFP was higher in patients with cirrhosis than volunteers,and the difference was statistically significant(P＜0.01).Sensitivity of PIgR/SC and AFP was 89.3％ and 54.8％,specificity was 84.6％ and 91％,Youden index was 0.751 and 0.458,AUC was 0.920 and 0.761,respectively.There was significant difference in AUC (Z=3.251,P＜0.05) of the two detection indexes for detection of primary hepatic cancer.Conclusion The value of PIgR/SC in diagnosis of primary liver cancer may by higher than that of AFP.

Objective To evaluate the transfusion efficacy and safety of patients with non‐specificity irregular antibodies .Meth‐ods A total of 19 cases of patients with non‐specificity irregular antibodies were analyzed ,then the transfusion efficacy and the in‐cidences of adverse transfusion reactions were investigated .Blood donor samples with the same ABO blood type of patients were randomly collected ,then blood cross‐matching was carried out .And the transfusion efficacy and safety of patients with non‐specific‐ity irregular antibody were evaluated when compatible blood were found by using both micro‐column gel technique and saline meth‐od .Results The non‐specificity irregular antibodies of the 19 cases of patients all were IgG irregular antibodies .The erythrocyte transfusion was carried out in the 19 cases of patients ,the total efficiency rate ,partial efficiency rate and inefficiency rate was 73 .7% ,26 .3% and 0 .0% ,respectively .No delayed hemolytic transfusion reactions were observed in any patient .Conclusion For patients with non‐specificity irregular antibodies ,the blood transfusion could be efficacy and safety when compatible blood samples are confirmed by using both micro‐column gel technique and saline method .