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.

In order to build a unified teaching pattern integrating knowledge delivery, skill cultivation and value guidance, this article, based on the targets of cultivating medical talents in the new era, aims to explore the pathway of curriculum ideological and political education in Medical Parasitology teaching based on the situation of Yunnan Province. By analyzing the epidemiology of parasitic diseases in Yunnan Province, the remarkable achievements of parasitic diseases control in China and Yunnan Province, cases with parasitic disease misdiagnosis, parasitologists ’ selfless contributions, the contributions of traditional Chinese medicines to parasitic diseases control and the contributions of traditional Chinese medicines in Yunnan Province, the ideological and political education is naturally integrated into Medical Parasitology teaching, to create an educational model combining professional course teaching with ideological and political education curriculum.

OBJECTIVE: To observe the effect of moxibustion at oppositely-located points "Mingmen" (GV 4) and "Shenque" (CV 8) on the motor function of the hind limbs and bladder function in rats with neurogenic bladder after suprasacral spinal cord injury (SCI), so as to explore the effect of this therapy on bladder tissue apoptosis mediated by endoplasmic reticulum stress pathway. METHODS: Twenty-eight female Wistar rats were randomly divided into a sham-operation group (8 rats) and a model establishment group (20 rats). Using the modified Allen's method, the spinal cord of T₁₀ segment was injured to establish a neurogenic bladder model in the model establishment group. Sixteen rats were modeled successfully and then divided into a model group (8 rats) and a moxibustion group (8 rats). In the moxibustion group, 2 h after consciousness regaining from modeling anesthesia, moxibustion was exerted at "Shenque" (CV 8) and "Mingmen" (GV 4), 2 cones at each acupoint in one intervention. The intervention was administered once every two days and 5-time intervention was required totally. After intervention, Basso, Beattie and Bresnahan locomotor rating scale (BBB) score for the motor function of the hind limbs, and the urodynamics indexes (maximum bladder capacity, urine leakage pressure and bladder compliance) were compared among groups. HE staining method was adopted to observe the morphological changes of bladder tissue. With Western blot method and real-time PCR assay, the protein and mRNA expressions of the endoplasmic reticulum stress-related genes (glucose- regulated protein 78 [GRP78], activating transcription factor 4 [ATF4] and cysteinyl aspartate specific proteinase-12 [Caspase-12]) were determined. RESULTS: The transitional epithelial cells were arranged irregularly, the bladder wall was getting thinner, and the cellular vacuolar degeneration and neutrophil infiltration were found in the model group. Whereas, compared with the model group, in the moxibustion group, the arrangement of transitional epithelial cells was clear and continuous in layers, the cellular vacuolar degeneration was mild and the infiltration presented in a small amount of neutrophil granulocytes. Compared with the sham-operation group, in the model group, the BBB score was reduced (P<0.01), the maximum bladder capacity and bladder compliance were increased (P<0.01), and the protein expression levels of GRP78, ATF4 and Caspase-12, as well as mRNA expressions were all increased (P<0.01). In comparison with the model group, in the moxibustion group, BBB score was increased (P<0.01), the maximum bladder capacity and bladder compliance were decreased (P<0.01), and the protein and mRNA expression levels of GRP78, ATF4 and Caspase-12 were all decreased (P<0.01). CONCLUSION Moxibustion at the "oppositely-located points" improves the urination function, alleviate urine retention in neurogenic bladder rats after spinal cord injury. The underlying mechanism may be related to the down-regulation of the expressions of GRP78, ATF4 and Caspase-12 in the endoplasmic reticulum stress pathway of the bladder tissues, and thus to alleviate the apoptosis of bladder tissue.
Animals ; Caspase 12/genetics* ; Electroacupuncture ; Endoplasmic Reticulum Stress ; Female ; Moxibustion ; RNA, Messenger ; Rats ; Rats, Sprague-Dawley ; Rats, Wistar ; Spinal Cord ; Spinal Cord Injuries/therapy* ; Urinary Bladder, Neurogenic/therapy*

Objective To investigate the prevalence of Demodex infection among students in Kunming Medical University, and identify the factors affecting Demodex infections, so as to provide the evidence for the development of the strategy for the prevention of Demodex infections. Methods A total of 1 463 students from Grade 2014 who studied Medical Parasitology in Kunming Medical University were included in the survey. Demodex was examined in students’facial skin using the cellophane tape method, and the species was identified using microscopy. The students’gender, ethnicity, place of origin and skin type were captured using a questionnaire survey. Results The overall prevalence of Demodex infections was 19.07% (279/1 463) on the facial skin among the university students, and a higher prevalence was seen in girls (21.16%, 183/865) than in boys (16.05%, 96/598) (χ² =5.965,P <0.05).TheprevalenceofDemodex infectionswas18.33%(66/360)amongminorethnicstudents,andnoethnicity-specific prevalence was seen (P > 0.05). Demodex folliculorum was the predominant species, with a prevalence of 50.54% (141/279), and mild infections were predominant among all infections (96.77%, 270/279), without severe infections seen. Multivariate nonconditional logistic regression analysis revealed that gender and roommates with Demodex infections were risk factors of Demodex infections, and the infection was not associated with ethnicity, place of origin or skin type. There were only 2.53% (37/1 463) of the subjects understanding the knowledge pertaining to the prevention and control of Demodex infection. Conclusions A relatively low prevalence of Demodex infection is detected in the facial skin of students from Kunming Medical University, and Demodex infection is associated with gender and roommates with Demodex infections. Health education pertaining to the prevention of Demodex infections is suggested to be intensified among university students.

Objective To investigate the clinical effect of bone transport technique in the treatment of large segment infective nonunion of femoral shaft.Methods A retrospective case series study was conducted to analyze the clinical data of 33 patients with large segment infective nonunion of femoral shaft admitted to Chinese PLA General Hospital from June 2012 to October 2015.There were 25 males and eight females,aged 19-58 years (mean,34.6 years).In terms of the initial injury,23 patients were with open fracture and 10 with closed fracture.All patients previously received 1-9 times of operation,with an average of 2.3 times.The duration from injury to operation ranged from 7-60 months,with an average of 34 months.All patients underwent treatment with bone transport technique.After thorough debridement,the length of femoral defect ranged from 6 cm to 18 ema,with an average of 10.5 cm.The single arm limb reconstruction external fixator was placed on the lateral side of the femur under C-ann X-ray fluoroscopy.The wound healing,bone healing time,external fixation index (EFI),and complications were recorded.The function of the affected limb was evaluated using the modified criteria of Association for the Study and Application of the Method of Ilizarov (ASAMI).Results All patients were followed up for 21-53 months (average,38.5 months).Femoral defects were completely repaired,with no recurrent infection reported.Bone healing time ranged from 8 months to 25 months (average,13 months).The external fixation index (EFI) ranged from 1.13 months/cm to 1.83 months/cm,with an average of 1.26 months/cm.The infection rate of the nail tract was 55％ (18/33).There were 12 patients with Type A,five with Type B,and one with Type C.The function of the affected limb was graded as excellent in 18 patients,good in six,fair in five,and poor in four,with an excellent and good rate of 73％ (24/33).Conclusions In the treatment of large segment infective nonunion of femoral shaft,bone transport technique can eontrol the infection,promote defect repair,and restore the function of affected limbs.

·AIM: To investigate the role of small interference RNA interference targeted Integrin-linked kinase (ILK SiRNA) on the proliferation and apoptosis of human Tenon fibroblasts (HTFs) induced by transforming growth factor-β2(TGF-β2). · METHODS: The HTFs were identified by immunofluorescence analysis with Vimentin and keratin. HTFs with no other addiction was as normal control;H+T group:HTFs+5μ g/L TGF-β2;H+T+NC SiRNA group:HTFs+5μ g/L TGF-β2+50nmol/L negtive SiRNA; H+T+ILK SiRNA group:HTFs+5μ g/L TGF-β2+50nmol/L ILK SiRNA. The ILK SiRNA were transfected into HTFs by lipofectamine 2000, then the cells were stimulated with 5μ g/L TGF - β2. The protein expression of ILK were analyzed by Western Blot. The proliferation levels of HTFs were analyzed by CCK-8, the apoptosis of HTFs were analyzed by Hoechst 33342/PI double staining. ·RESULTS: The protein ILK were expressed in both TGF-β2treated and control groups, and TGF- β2up-regulated the expression of ILK, ILK SiRNA inhibited the protein expression of ILK(P< 0. 05). CCK- 8 analysis showed that compared with the normal control group,the cell proliferation rate of HTFs in TGF-β2treated group increased, and in ILK SiRNA group the cell proliferation rate was suppressed after exposured to ILK SiRNA for 48h (P<0.05). Hoechst 33342/PI double staining showed that there was no change on the apoptosis of TGF - β2 stimulated group (P>0.05), compared with the normal control group, however in the ILK SiRNA group, we found lots of apoptosis cells and a few of necrotic cells (P<0.05). ·CONCLUSION: The ILK SiRNA attenuates the abnormal proliferation of HTFs induced by TGF - β2, thereby enhancing the apoptosis of HTFs.

Objective To investigate the distribution characteristics of methicillin-resistant Staphylococcus aureus (MRSA)in a children's hospital,and provide basis for the prevention and control of MRSA infection in children. Methods Children who admitted to a children's hospital from 2011 to 2015 were analyzed retrospectively,clinical data of children,isolation of pathogens,types of specimens,and healthcare-associated infection(HAI)status were analyzed.Results From 2011 to 2015,a total of 911 children isolated Staphylococcus aureus (SA,1108 positive specimens),494 of whom isolated MRSA (599 positive specimens),54.23% of children isolated MRSA(isolation rate of specimens was 54.06%);there was no significant difference in the isolation rate of MRSA between children of different genders(P > 0.05);isolation rate of MRSA in different age groups was statistically significant(P <0.05).Isolation rates of MRSA from blood,puncture fluid,secretion,and pus were 68.97%,66.00%,55.81%, and 54.47% respectively.Isolation rate of SA and MRSA increased from 0.61% and 21.74% in 2011 to 1.40%and 75.59% in 2015 respectively,difference were both significant(both P <0.05).Incidence of SA and MRSA in-creased from 0.198% in 2011 to 2.697% and 2.119% in 2015 respectively,both showed an upward trend year by year(both P <0.05).Conclusion Isolation rate of MRSA and incidence of HAI in this children's hospital increased year by year,it is necessary to intensify management,use antimicrobial agents scientifically and rationally,timelyperform disinfection and isolation,so as to curb the emergence and spread of MRSA in hospital settings.

BACKGROUNDThe interaction between activated microglia and T lymphocytes can yield abundant pro-inflammatory cytokines. Our previous study proved that thymus immune tolerance could alleviate the inflammatory response. This study aimed to investigate whether intrathymic injection of myelin basic protein (MBP) in mice could suppress the inflammatory response after co-culture of T lymphocytes and BV-2 microglia cells.

METHODSTotally, 72 male C57BL/6 mice were randomly assigned to three groups (n = 24 in each): Group A: intrathymic injection of 100 μl MBP (1 mg/ml); Group B: intrathymic injection of 100 μl phosphate-buffered saline (PBS); and Group C: sham operation group. Every eight mice in each group were sacrificed to obtain the spleen at postoperative days 3, 7, and 14, respectively. T lymphocytes those were extracted and purified from the spleens were then co-cultured with activated BV-2 microglia cells at a proportion of 1:2 in the medium containing MBP for 3 days. After identified the T lymphocytes by CD3, surface antigens of T lymphocytes (CD4, CD8, CD152, and CD154) and BV-2 microglia cells (CD45 and CD54) were detected by flow cytometry. The expressions of pro-inflammatory factors of BV-2 microglia cells (interleukin [IL]-1β, tumor necrosis factor-α [TNF-α], and inducible nitric oxide synthase [iNOS]) were detected by quantitative real-time polymerase chain reaction (PCR). One-way analysis of variance (ANOVA) and the least significant difference test were used for data analysis.

RESULTSThe levels of CD152 in Group A showed an upward trend from the 3rd to 7th day, with a downward trend from the 7th to 14th day (20.12 ± 0.71%, 30.71 ± 1.14%, 13.50 ± 0.71% at postoperative days 3, 7, and 14, respectively, P < 0.05). The levels of CD154 in Group A showed a downward trend from the 3rd to 7th day, with an upward trend from the 7th to 14th day (10.00 ± 0.23%, 5.28 ± 0.69%, 14.67 ± 2.71% at postoperative days 3, 7, and 14, respectively, P < 0.05). The ratio of CD4+/CD8 + T in Group A showed a downward trend from the 3rd to 7th day, with the minimum at postoperative day 7, then an upward trend from the 7th to 14th day (P < 0.05). Meanwhile, the levels of CD45 and CD54 in Group A were found as the same trend as the ratio of CD4+/CD8 + T (CD45: 83.39 ± 2.56%, 82.74 ± 2.09%, 87.56 ± 2.11%; CD54: 3.80 ± 0.24%, 0.94 ± 0.40%, 3.41 ± 0.33% at postoperative days 3, 7, and 14, respectively, P < 0.05). The expressions of TNF-α, IL-1β, and iNOS in Group A were significantly lower than those in Groups B and C, and the values at postoperative day 7 were the lowest compared with those at postoperative days 3 and 14 (P < 0.05). No significant difference was found between Groups B and C.

CONCLUSIONSIntrathymic injection of MBP could suppress the immune reaction that might reduce the secondary immune injury of brain tissue induced by an inflammatory response.

Animals ; Anti-Inflammatory Agents ; pharmacology ; Antigens, Surface ; analysis ; Brain Injuries, Traumatic ; drug therapy ; CD4-CD8 Ratio ; Coculture Techniques ; Male ; Mice ; Mice, Inbred C57BL ; Microglia ; immunology ; Myelin Basic Protein ; administration & dosage ; pharmacology ; T-Lymphocytes ; immunology

OBJECTIVETo observe the effect of electro-acupuncture (EA) treatment on the oocyte quality in polycystic ovarian syndrome (PCOS) patients undergoing in vitro fertilization-embryo transfer (IVF-ET).

METHODSTotally 217 PCOS patients undergoing IVF-ET were assigned to two groups by random digit table, the EA group (119 cases) and the control group (98 cases). All patients received long program ovarian hyperstimulation with gonadotropin-releasing hormone agonist. Patients in the EA group received EA treatment in the process of controlled ovarian hyperstimulation till the oocyte retrieval day. The position relation of the spindle to the polocyte, the number of retrieved oocytes, the fertilization rate,the cleavage rate,the high quality embryo rate, the ovarian hyperstimulation syndrome (OHSS) incidence rate, the clinical pregnancy rate, the early abortion rate, the gonadotropins (Gn) dose and time, levels of estradiol (E2), progesterone (P), and luteinizing hormone (LH) on the day of human chorionic gonadotropin (HCG) were observed between the two groups.

RESULTSThe ratio of oocytes in which the meiotic spindle deviation angle was < 60 degrees to the all oocytes was obviously higher in the EA group than in the control group (P < 0.05). The oocytes in which the meiotic spindle deviation angle was < 60 degrees was positively related to level of E2 on the HCG day and the high quality embryo rate (r = 0.19,P < 0.01). Compared with the control group, the high quality embryo rate increased significantly (P < 0.05), the dose and days of Gn decreased significantly (P < 0.05) in the EA group. The clinical pregnancy rate was improved by 8.36%.

CONCLUSIONSThe spindle was positively correlated with the oocyte quality. EA could improve the quality of oocytes and the clinical pregnancy rate in PCOS patients undergoing IVF-ET.

Acupuncture Therapy ; methods ; Embryo Transfer ; Estradiol ; Female ; Fertilization in Vitro ; Gonadotropin-Releasing Hormone ; Gonadotropins ; Humans ; Luteinizing Hormone ; Oocytes ; Ovarian Hyperstimulation Syndrome ; Polycystic Ovary Syndrome ; therapy ; Pregnancy ; Pregnancy Rate ; Progesterone

Objective To investigate the effect of electroacupuncture (EA) on oocyte quality in patients with polycystic ovary syndrome (PCOS) undergoing in-vitro-fertilization and embryo transfer (IVF-ET).Method Totally 217 patients with PCOS undergoing IVF-ET were randomized into two groups by the random number table, 119 patients in an EA group and 98 in a control group. In addition to the long-term ovarian hyperstimulation given to the two groups, electroacupuncture was involved in the intervention in the EA group. The spindle, quality of eggs, and pregnancy result were observed and compared.Result The high-quality embryo rate was significantly higher in the EA group than the control group (P<0.05), and compared to the control group, the pregnancy rate was 8.36% higher in the EA group; it’s found that the number of eggs with spindle located between 11 and 1 o’clock was in a significant positive correlation with the level of E2 on the HCG administration day and the high-quality embryo rate (P<0.01); the EA group had a markedly higher ratio of eggs with spindle located between 11 and 1 o’clock compared to the control group (P<0.05); electroacupuncture markedly reduced the dosage and duration of using Gn in the PCOS patients (P<0.05). Conclusion It’s proven the relation between spindle and the quality of eggs; electroacupuncture can enhance the quality of eggs and the pregnancy rate in the PCOS patients.