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.

Aspirin combined with P2Y12 receptor inhibitors is the standard dual antiplatelet therapy for the prevention of stent thrombosis and systemic atherosclerotic thrombotic events after percutaneous coronary intervention in acute coronary syndrome(ACS).Patients with ACS combined with chronic kidney disease(CKD)have a higher risk of thrombosis and a higher incidence of bleeding.Therefore,it is important to determine the optimal antiplatelet therapy strategy for this population.Most clinical trials have excluded patients with advanced CKD,so clinicians lack evidence-based medical evidence for antiplatelet therapy strategies in these patients.This article reviews the research progress of antiplatelet therapy in ACS patients with CKD,in order to provide reference for clinicians to choose appropriate antiplatelet therapy strategies when facing such patients.

Mammals exhibit limited heart regeneration ability, which can lead to heart failure after myocardial infarction. In contrast, zebrafish exhibit remarkable cardiac regeneration capacity. Several cell types and signaling pathways have been reported to participate in this process. However, a comprehensive analysis of how different cells and signals interact and coordinate to regulate cardiac regeneration is unavailable. We collected major cardiac cell types from zebrafish and performed high-precision single-cell transcriptome analyses during both development and post-injury regeneration. We revealed the cellular heterogeneity as well as the molecular progress of cardiomyocytes during these processes, and identified a subtype of atrial cardiomyocyte exhibiting a stem-like state which may transdifferentiate into ventricular cardiomyocytes during regeneration. Furthermore, we identified a regeneration-induced cell (RIC) population in the epicardium-derived cells (EPDC), and demonstrated Angiopoietin 4 (Angpt4) as a specific regulator of heart regeneration. angpt4 expression is specifically and transiently activated in RIC, which initiates a signaling cascade from EPDC to endocardium through the Tie2-MAPK pathway, and further induces activation of cathepsin K in cardiomyocytes through RA signaling. Loss of angpt4 leads to defects in scar tissue resolution and cardiomyocyte proliferation, while overexpression of angpt4 accelerates regeneration. Furthermore, we found that ANGPT4 could enhance proliferation of neonatal rat cardiomyocytes, and promote cardiac repair in mice after myocardial infarction, indicating that the function of Angpt4 is conserved in mammals. Our study provides a mechanistic understanding of heart regeneration at single-cell precision, identifies Angpt4 as a key regulator of cardiomyocyte proliferation and regeneration, and offers a novel therapeutic target for improved recovery after human heart injuries.
Humans ; Mice ; Rats ; Cell Proliferation ; Heart/physiology* ; Mammals ; Myocardial Infarction/metabolism* ; Myocytes, Cardiac/metabolism* ; Pericardium/metabolism* ; Single-Cell Analysis ; Zebrafish/metabolism*

Humans ; Consensus ; Hypersensitivity ; Desensitization, Immunologic/adverse effects* ; Immunotherapy/adverse effects* ; Injections, Subcutaneous ; Allergens

Humans ; Tricuspid Valve/surgery* ; Heart Valve Prosthesis Implantation ; Surgical Instruments ; Treatment Outcome ; Cardiac Catheterization ; Tricuspid Valve Insufficiency/surgery*

ObjectiveTo investigate the three-year follow-up outcomes of hepatocellular carcinoma patients undergoing liver resection (LR) versus liver transplantation (LT). MethodsA retrospective analysis was performed for 171 patients with hepatocellular carcinoma who underwent surgical treatment in Beijing YouAn Hospital, Capital Medical University, from March 2009 to March 2014, and according to the treatment method, they were divided into LR group(n=83) and LT group(n=88). Related clinical data were compared between the two groups. The chi-square test was used for comparison of categorical data between two groups; the Kaplan-Meier survival curve and the log-rank test were used for comparison of disease-free survival and overall survival between two groups, and the Cox proportional hazards model was used for the univariate and multivariate analyses of disease-free survival and overall survival. ResultsCompared with the LR group, the LT group had a significantly higher proportion of patients with single tumor ［45.78% (38/83) vs 85.23% (75/88), χ2=29649,P＜0.001］, tumor size ＜3 cm ［15.66% (13/83) vs 6705% (59/88), χ2=46.383,P＜0001］, or high Child-Pugh class ［ 964% (8/83) vs 26.14% (23/88),χ2=7833,P=0.005］ and a significantly lower recurrence rate of tumor ［48.19%(40/83) vs 3295%(29/88) ,χ2=4121,P=0.042］. There was a significant difference in disease-free survival rate between the LR group and the LT group (46.02% vs 80.71%, P=0.006); the LT group had a higher overall survival rate than the LR group (86.99% vs 76.44%, P=0.219). Both univariate and multivariate analyses showed that treatment method was an independent risk factor for disease-free survival (risk ratio［RR］=3383,95% confidence interval［CI］: 1334-8579;RR=0239,95%CI:0093-0.612，both P＜005), but the prediction of overall survival by treatment method did not reach statistical significance(P=0232). ConclusionLT is recommended for patients with early-stage hepatocellular carcinoma and can achieve a satisfactory three-year disease-free survival rate.

Arthritis, Rheumatoid/complications* ; Biomarkers ; Humans ; Lung Diseases, Interstitial/etiology* ; Prognosis

Tumor, especially malignant tumor has become one of the major diseases, a serious threat to the health of people around the world. Modern clinical practice shows that the natural active products extracted from traditional Chinese medicine, marine medicine and other natural drugs, such as terpenes, alkaloids, polysaccharides, volatile oils and peptides, can effectively inhibit the growth of tumor cells. In this paper, the active components of natural antitumor products in recent years were summarized and their related mechanism was elucidated, so as to provide theoretical basis for the further development of natural antitumor drugs.

The study is aimed to clarify the spatial distribution of Epimedium koreanum( Ek) high-quality production areas. Through visiting and field investigation,collecting the distribution information of Ek samples,and based on the four kinds of flavonoids in Ek,the high-quality production areas and distribution of Ek distribution of the main environmental factors were drawn using GIS technology,the maximum entropy model( MaxEnt),geographical detector statistical analysis method,and the statistical significance of regression equation were obtained. Considering the content of 4 main flavonoids in Ek,the results of this study showed that the main environmental factors,such as precipitation,annual precipitation variation coefficient,annual average temperature and clay content exhibited the greatest influence on the growth suitability of Ek. Ek materials quality concentrated distribution in southeastern Jilin province Changbai mountain hinterland and northeastern Liaoning province. Ek with high content of epimedine A and epimedine C are mainly distributed in the southeastern Jilin province and northeastern Liaoning province,Ek with high epimedine B is distributed in eastern Liaoning province; high icariin Ek was found in most area of northeastern Liaoning province,a small amount distributed in the southeast of Jilin province. This study predicted the climate suitability distribution of Ek,and provided reference for the rational planning and establishment of the standardized cultivation base of Ek.
China ; Climate ; Drugs, Chinese Herbal ; Epimedium/chemistry* ; Flavonoids/analysis* ; Geography ; Plants, Medicinal/chemistry* ; Soil/chemistry* ; Temperature

Objective To analyze the expressions of microRNA-196a (miR-196a) and microRNA-210 (miR-210) in pancreatic cancer and their relationship with the survival time.Methods Twenty-six cases of pancreatic cancer (A group),20 patients with benign pancreatic disease (B group) and 24 healthy subjects (C group) were selected as the subjects.The expressions of miR-196a and miR-210 in the serum of 3 groups of patients were detected by real time fluorescence real time fluorescence quantitative (qRT-PCR) method,and the survival time of the patients with pancreatic cancer was observed.The relationship between the expression of miR-196a and miR-210 in 3 groups,the levels of miR-196a and miR-210 and the survival time of the patients with pancreatic cancer were analyzed.Results The levels of miR-196a expression in A,B and C groups was (1.79 ±0.95),(1.24 ±0.92) and (0.71 ±0.68),respectively,and the miR -210 expression levels were (2.32 ±0.54),(1.25 ±0.36) and (0.98 ±0.22).There were significant differences between A group and B,C groups (all P ＜ 0.05).The half year survival rate of the patients with pancreatic cancer was 61.54％,the 1 year survival rate was 46.15％,and the 2 year survival rate was 3.85％.For patients with pancreatic cancer,the survival time in miR-196a high and low expression groups was(7.58 ± 3.43) and (12.38 ±5.17) months,respectively,in miR-210 high expression group and low expression group was (6.92 ± 3.01) and (10.88 ±4.28) months,the differences were statistically significant (P ＜ 0.05).The sensitivity,specificity and accuracy of miR-196a were 76.92％,93.18％ and 70.10％,which of miR-210 68.00％,93.18％ and 61.18％,of joint detection 88.46％,95.45％ and 83.92％.The indexes obtained by combined detection had statistically significant differences compared with those detected separately (all P ＜ 0.01) Conclusion The expressions of miR-196a and miR-210 are specifically expressed in serum of patients with pancreatic cancer.The combined detection can improve the diagnostic accuracy of pancreatic cancer,and the expression levels of miR-196a and miR-210 are related to the survival time of pancreatic cancer patients.