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.

OBJECTIVETo study the effect of astrocyte exosomes on hypoxic-ischemic neurons.

METHODSRat astrocytes were cultured in vitro, and differential centrifugation was used to obtain the exosomes from the cell supernatant. Transmission electron microscopy, Nanosight, and Western blot were used for the identification of exosomes. BCA method was used to measure the concentration of exosomes. Rat neurons were cultured in vitro and then divided into control group, exosome group, oxygen glucose deprivation (OGD) group, and OGD+exosome group (n=3 each). The OGD and OGD+exosome groups were cultured in glucose-free medium under the hypoxic condition. The exosome and OGD+exosome groups were treated with exosomes at a final concentration of 22 μg/mL. The control and OGD groups were given an equal volume of phosphate-buffered saline. ELISA was used to measure the level of lactate dehydrogenase (LDH) in neurons. The terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling was used to measure the apoptotic index of neurons.

RESULTSThe identification of exosomes showed that the exosomes extracted by differential centrifugation had the features of exosomes. Compared with the control and exosome groups, the OGD group had significant increases in LDH level and apoptotic index (P<0.05). Compared with the OGD group, the OGD+exosome group had significant reductions in LDH level and apoptotic index (P<0.05).

CONCLUSIONSThe exosomes from astrocytes have a protective effect on neurons with hypoxic-ischemic injury.

Animals ; Apoptosis ; Astrocytes ; physiology ; Cell Hypoxia ; Cells, Cultured ; Exosomes ; physiology ; Glucose ; deficiency ; Hydro-Lyases ; analysis ; Neuroprotection ; Rats ; Rats, Sprague-Dawley

OBJECTIVE: To reveal the current research status on stem cell transplantation in the treatment of neonates with hypoxic-ischemic encephalopathy (HIE), and to summarize the recent hotspots of the research in this field. METHODS: Using the key words of "stem cells" and "HIE", a computerized search was performed for the articles in English published before June 1, 2018 in PubMed, EMBASE, and Web of Science. Microsoft Office Excel 2013 was used for the statistical analysis of key words. Bicomb 2.0 and VOSviewer 1.6.6 were used for the cluster analysis of hot words and plotting of knowledge maps, respectively. RESULTS: A total of 106 articles were included and 43 high-frequency key words were extracted. The words of "cell transplantation" and "hypoxia-ischemia" were in the core position of the co-word map. The cluster analysis showed that the studies of stem cell transplantation in the treatment of neonatal HIE mainly focused on umbilical cord blood cell transplantation (32.6%), mesenchymal stem cells and neural stem cells (29.5%), perinatal brain injury (28.1%), and other topics (9.8%). CONCLUSIONS In the current studies of stem cell transplantation in the treatment of neonatal HIE, umbilical cord blood cell transplantation, mesenchymal stem cells, neural stem cells, and perinatal brain injury are popular research topics at different levels.
Humans ; Hypoxia-Ischemia, Brain ; Infant, Newborn ; Mesenchymal Stem Cells ; Neural Stem Cells ; Stem Cell Transplantation

Objective:To optimize the parameters of the equation of sagittal craniofacial structures with different classes of malocclusion using genetic algorithms(GAS), and to explore the rules .Methods:A total of 240 patients with average angle malocclusion aged 8-18 years old were divided into three groups: Angle Class Ⅰ(n=79), Angle Class Ⅱ(n=76)and Angle Class Ⅲ(n=85) groups.In each group 10 cases were randomly selected as the test samples, the rest as the experimental samples.The cephalometric analysis was performed on all the patients'' cephalograms, and the results of Ba-N,Ba-A,Ba-S,S-Ptm,Ptm-A,Ba-Ar,Ar-Go,Go-PoG,Ba-PoG and N-S-Ar were analyzed by two independent samples t-test and One-Way ANOVA. The relevant influencing factors of craniofacial structures were found.The parameters of the equation was optimized to obtain the relevant equations using GAS.The predicted values of the optimized equation were compared with the measured values.Results:There were no significant differences in sex between Angle Class Ⅰ, Class Ⅱ and Class Ⅲ groups(P> 0.05);when the men and women with the same type were combined,the Ba-A,Ptm-A,Ar-Go,and Ba-PoG had statistically significant differences between Angle Class Ⅰ, Class Ⅱ, and Class Ⅲ groups (P<0.05).The correlation analysis results showed that in Angle Class Ⅰgroup:Ba-A was positively correlated with Ba-N (r=0.683),Ptm-A was positively correlated with Go-PoG (r=0.738), Ar-Go was positively correlated with Ba-PoG (r=0.833), and negatively correlated with Go-PoG (r=-0.560) and Ba-PoG was positively correlated with Go-PoG (r=0.669);in Angle class Ⅱ group,Ba-A was positively correlated with Ba-PoG and Ba-N(r=0.884,r=0.883), Ptm-A was positively correlated with Ba-A (r=0.742),Ar-Go was positively correlated with Ba-PoG (r=0.401)and negatively correlated with Go-PoG (r=-0.317) and Ba-PoG was positively correlated with Ba-A and Go-PoG(r=0.883,r=0.488);in Angle Class Ⅲ group,Ba-A was positively correlated with Ba-N and Ba-PoG(r=0.891,r=0.829),Ptm-A was positively correlated with Ba-A (r=0.807)and negatively correlated with Ba-S (r=-0.404),Ar-Go was positively correlated with S-Ptm (r=0.548) and Ba-PoG was positively correlated with Ba-A (r=0.829).The equation of sagittal craniofacial structure with different occlusal classes was established by GAS.In Angle Class Ⅰgroup:Ba-A(mm)=10.963 9+0.859 8×Ba-N,Ptm-A(mm)=6.897 6+0.557 0×Go-PoG,Ar-Go(mm)=-2.548 2+0.511 8×Ba-PoG-0.5272×Go-PoG,Ba-PoG(mm)=17.515 6+1.021 3×GO-POG;in Angle Class Ⅱ group:Ba-A(mm)=-2.121 3+0.567 6× Ba-PoG+0.513 2× Ba-N,Ptm-A(mm)=13.788 7+0.349 4×Ba-A,Ar-Go(mm)=2.447 7+0.368 8×Ba-PoG-0.427 9×Go-PoG,Ba-PoG(mm)=-7.140 2+0.751 3×Ba-A+0.295 4×Go-PoG;in Angle Class Ⅲgroup:Ba-A(mm)=3.281 0+0.545 3×Ba-N+0.394 4× Ba-PoG,Ptm-A(mm)=3.535 8+0.63 1×Ba-A-0.614 2×Ba-S,Ar-Go(mm)=-9.002 1+1.004 3×S-Ptm,Ba-PoG(mm)=-2.091 2+1.057 5×Ba-A.There were no significant differences between the predicted values of GAS and the measured data (P> 0.05), and the error was small.Conclusion: The optimal relation equation of craniofacial structure of sagittal malocclusion is established by GAS with the quantitative regularity.

Objective:To establish the quantitative relationship equation of the crantiofacial vertical points in the skeletal classⅡ malocclusion patients with various vertical types by using genetic algorithms method,and to express the measured values in the patients with different gender with the same formula.Methods:A total of 155 skeletal class Ⅱ malocclusion patients without treatment,aged from 10 to 18 years old,were selected and divided into high-angle group(n=50),average-angle group(n=58),low-angle group(n=47);5 samples were randomly selected in each group as the test samples,the rest as the experimental sample.The cephalometic radiographs were performed and measured.The relevant influencing factors of craniofacial structure were ensured.The genetic algorithm was used to optimize the equation parameters to obtain the correlation equation.The error between the predicted value and the measured value was compared.Results:The various parameters had no significant differences between different gender in high-angle,average-angle and low-angle groups(P>0.05);then the men and the women with same type were combined,most of the indicators had statistically significant differences between three groups (P<0.05).The correlation analysis results showed that there was a positive correlation between age and Ans-U1(r=0.470),there was a positive correlation between N-Me and Ans-Me(r=0.964);for Ans-U1 ,there was a positive correlation with Ans-Me(r=0.805)and negative correlation with facial angle;there was a positive correlation between N-Go and N-Me (r=0.926);for L1-Me,there was a positive correlation with Ans-Me(r=0.898)and negative correlation with the angle of Go(r=-0.468)in high-angle group. In average-angle group,there was a positive correlation between age and N-Me (r=0.531);for Ans-U1,there was a positive correlation with Ans-Me(r=0.878)and negative correlation with the facial angle(r=-0.262);for Ans-Me,there was a positive correlation with N-Me(r=0.920), negative correlation with N-Ans(r=-0.560)and negative correlation with Ar-Go(r=-0.652);for N-Go,there was a positive correlation with S-Go(r=0.867), positive correlation with N-Ans(r=0.252)and positive correlation with L1-Me(r=0.754).For S-Ar,there was a positive correlation with S-Go(r=0.671), negative correlation with Ar-Go(r=-0.250),and positive correlation with L1-Me(r=0.552).In low-angle group,for age,there was a positive correlation with S-Go(r=0.602), negative correlation with the angle of Go(r=-0.346),and positive correlation with L1-Me(r=0.576);for N-Me,there was a positive correlation with Ans-Me(r=0.869),and positive correlation with N-Go(r=0.859),and negative correlation with the facial angle(r=-0.177);for N-Ans,there was a positive correlation with N-Me(r=0.605) and negative correlation with Ans-U1(r=-0.113);for Ans-Me,there was a positive correlation with N-Me(r=0.869),positive correlation with the facial angle(r=0.070),and positive correlation with Ans-U1(r=0.785);for N-Go,there was a positive correlation with N-Me(r=0.859)and positive correlation with S-Go(r=0.829).The quantitative relationship equations of the crantiofacial vertical points in skeletal class Ⅱmalocclusion patients with various vertical types in each group were established by using genetic algorithms.In high-angle group:Age=5.883 6+0.269×Ans-U1,N-M=22.026 6+1.494 5×Ans-Me,Ans-U1=34.959 4+0.454 5×Ans-Me-0.409 7×Facial angle,N-Go=-4.588 2+0.472 4×N-Me,L1-Me=-12.590 5+0.5322×Ans-Me+0.124 3×∠Go.In average-angle group:Age=-2.944 1+0.146 8×N-Me,Ans-U1=18.917+0.476 4×Ans-Me-0.230 2×Facial angle,Ans-Me=-0.620 5+1.014 5×N-Me-0.974 1×N-Ans-0.057 6×Ar-Go,N-Go=1.631 1+0.897 8×S-Go+0.919 7×N-S+0.168 8×L1-Me,S-Ar=-1.823 1+0.845 3×S-Go-0.867 0×Ar-Go+0.202 4×L1-Me.In low-angle group:Age=11.740 6+0.152 7×S-Go-0.169 9×∠Go+0.252 5×L1-Me,N-Me=61.153 0+0.964 3×Ans-Me+0.628 6×N-Go-0.689 2×Facialangle,N-Ans=-4.949 2+1.065 8×N-Me-2.316 5×Ans-U1,Ans-Me=-25.180 0+0.418 4×N-Me+0.280 3×Facial angle+0.477 6×Ans-U1,N-Go=8.684 2+0.409 9×N-Me+0.403 3×S-Go.There was no significant difference between the predicted values of equation established with genetic algorithms and the measured data (P>0.05).Conclusion:The quantitative relationship equation of the crantiofacial vertical points in the skeletal class Ⅱmalocclusion patients with various vertical types established with genetic algorithms may show the vertical quantitative relationship and predict the growth to a certain degree.

Objective To understand the current status of paragonimiasis epidemic in western mountain areas in Hubei Prov-ince. Methods Four counties(cities)of Western Hubei Province(Xingshan,Enshi,Yunxi,Baokang)were selected as the investigation sites for active surveillance. Crabs were captured and the metacercariae of Paragonimus were detected. Meanwhile, the blood samples were collected from the residents in the surveillance sites and the unique IgG and IgM antibodies against Para-gonimus in the sera were detected by ELISA. In addition,a questionnaire survey about knowledge and behavior of prevention and control of paragonimiasis was taken among the residents. Results A total of 1143 residents were investigated in the active surveillance,the total positive rate of the serology test was 1.84%(21/1143),while the rates of the male and the female were 1.78%(10/562)and 1.89%(11/581),respectively,with no statistical significance between them(χ2=0.002,P>0.05). The average weight of 161 fresh-water crabs captured was 11.72 g,with the positive rate of 9.32%(15/161)and the infective density of 7.07 metacercariae per positive crab. The positive rates of the male and female crabs were 11.54%(9/78)and 7.23%(6/83), respectively(χ2=0.884,P>0.05),and the infective densities were 6.67 and 7.67 metacercariae per positive crab,respective-ly. Totally 1143 residents were investigated by questionnaires,and 0.44%of them had the behavior of eating raw or half-done fresh-water crab,and 0.87% of them had the behavior of drinking un-boiled stream water. Conclusions The transmission chain of paragonimiasis still exists in the nature environment of mountain area in Western Hubei Province. The positive rate of the second intermediate host rebounds in some investigation sites. Therefore,the measures of continuous surveillance and health education should be taken to avoid the appearance of the prevalence or outbreak.

BACKGROUND:Epidermal growth factor is an auxiliary growth factor,but its effect on the growth of bone marrow mesenchymal stem cells (BMSCs) is uncertain.OBJECTIVE:To establish a mature method for isolation,extraction and identification of rat BMSCs,to investigate the effects of epidermal growth factor (EGF) on the proliferation and migration ability of BMSCs and to explore its potential mechanisms at the same time.METHODS:Rat BMSCs were isolated and purified using the improved whole bone marrow adherence method.After the cells were subcultured to the third generation,we detected the expression of cells surface antigens CD29,CD45 and CD90 by flow cytometry.BMSCs were further identified by osteogenic and adipogenic differentiation.Meanwhile,the effect of EGF on the proliferation of passage 3 BMSCs was measured by cell counting kit-8 and clonogenic assay.And the migration of P3 cells was verified by Transwell chamber.In addition,we detected the expression of proteins related to PI3K/Akt and nuclear factor-κB signaling pathways by western blot assay.RESULTS AND CONCLUSION:The primary BMSCs were polygonal and spindle-shaped,and then gradually appeared to be spindle-shaped.The results of flow cytometry demonstrated that the passage 3 cells were positive for CD29 and CD90,but negative for CD45.Furthermore,we successfully induced the osteogenic and adipogenic differentiation of BMSCs in vitro.Additionally,our data demonstrated that EGF promoted the proliferation and migration of passage 3 BMSCs.The relative expression levels of p-Akt and Bcl-2 of PI3K/Akt signaling pathway was up-regulated and the expression of Bax was down-regulated.At the same time,the relative expression level of phosphorylated p65 of nuclear factor-κB signaling pathway was up-regulated and the expression of phosphorylated inhibitor κB was down-regulated.Moreover,the downstream protein of matrix metalloproteinase-9 was up-regulated.Those proteins were related to the migaration of BMSCs.In summary,our results suggest that EGF could promote the proliferation and migration of BMSCs.

OBJECTIVE To observe the effect of electroacupuncture on the expression of VEGF and VEGFR2 in the uterusof the rat model of ovulation induction and to investigate the possible mechanism.METHODS Female SD rats aged 10 weekswere divided into control,model and treat groups randomly,10 in each group.The model group and the treatment group wereperitoneal injected with pregnant horse serum gonadotrophin(PMSG)of 20 U and injected of the same dose of human chorionicgonadotropin(hCG)after 48 h,and then cohabitated with male SD nice until next morning.A week before cohabitation,thetreat group received a consecutive electroacupuncture treatment for 7 d(dilatational wave of 2/15 Hz for 30 min and stimulativeintensity of 1 mA).The animals were sacrificed 3.5 d after the cohabitation.The uterine tissue was taken to observe the morphologicalchange,immunehistochemical method was used to inspect the expression of VEGF and VEGFR2,and qPCR technologywas used to determine the expression of VEGF and VEGFR,with the calculation by 2-△△Ct .RESULTS Macroscopicobservation:the surface in control group was regular and smooth;the model group was intumescentia,dull-red and hyperaemia;the treatment group was slightly swollen,rosy and no congestion.The expression of VEGF and VEGFR2 were observed inthe 3 groups by immunohistochemical method,with no significant difference in average optical density,but differences in theexpression distribution.Compared with the control group,the expression distribution of stromal cells and glands in the modelgroup was more extensive,and the expression of VEGFR2 in myometrium increased significantly(P <0.05).The electroacupuncturetreatment inhibited the the expression of VEGFR2 significantly(P <0.05).The expression of VEGF mRNA in uterinetissues of model group was 0.68 times of control group,with significant declining trend;the treat group was 0.88 times ofmodel group,with significant increasing trend.The expression of VEGF2 mRNA in uterine tissues of model group was 0.46times of control group,with significant declining trend;the treat group was 0.82 times of model group,with significant increasingtrend.CONCLUSION The electroacupuncture can adjust the expression of VEGF and its receptor in the uterine tissue of ovulation induction rat model,thus regulate the synchronization of the endometrial planting window caused by hormone

BACKGROUNDAtopic dermatitis (AD) is an inflammatory skin disease characterized by chronic recurrent dermatitis with profound itching. Most patients have personal and/or family history of atopic diseases. Several criteria have been proposed for the diagnosis of AD. Although the clinical features of childhood AD have been widely studied, there has been less large-scale study on adult/adolescent AD. The aim of this study was to investigate the clinical features of adult/adolescent patients with chronic symmetrical eczema/AD and to propose Chinese diagnostic criteria for adult/adolescent AD.

METHODSA hospital-based study was performed. Forty-two dermatological centers participated in this study. Adult and adolescent patients (12 years and over) with chronic symmetrical eczema or AD were included in this study. Questionnaires were completed by both patients and investigators. The valid questionnaires were analyzed using EpiData 3.1 and SPSS 17.0 software.

RESULTSA total of 2662 valid questionnaires were collected (1369 male and 1293 female). Of all 2662 patients, 2062 (77.5%) patients had the disease after 12 years old, while only 600 (22.5%) patients had the disease before 12 years old, suggesting late-onset eczema/AD is common. Two thousand one hundred and thirty-nine (80.4%) patients had the disease for more than 6 months. One thousand one hundred and forty-four (43.0%) patients had a personal and/or family history of atopic diseases. One thousand five hundred and forty-eight (58.2%) patients had an elevated total serum IgE and/or eosinophilia and/or positive allergen-specific IgE. Based on these clinical and laboratory features, we proposed Chinese criteria for adult/adolescent AD. Of all 2662 patients, 60.3% were satisfied with our criteria, while only 48.2% satisfied with Hanifin Rajka criteria and 32.7% satisfied with Williams criteria, suggesting a good sensitivity of our criteria in adult/adolescent AD patients.

CONCLUSIONLate-onset of eczema or AD is common. The clinical manifestations of AD are heterogeneous. We have proposed Chinese diagnostic criteria for adolescent and adult AD, which are simple and sensitive for diagnosis of adult/adolescent AD.

Adolescent ; Adult ; Dermatitis, Atopic ; diagnosis ; immunology ; Eczema ; diagnosis ; Female ; Humans ; Immunoglobulin E ; blood ; Male ; Middle Aged ; Retrospective Studies ; Surveys and Questionnaires

This study was aimed to detect the expression of leukemia stem/progenitor cell (LSPC) related genes (ABCB1, BMI-1, HOXB4) in the patients with acute leukemia, and to explore its clinical significance in acute leukemia. Bone marrow samples were collected from de novo acute leukemia patients (41 cases), patients with complete remission (CR, 16 cases) and the patients with non-malignant hematologic diseases (10 cases) respectively. And the expressions of ABCB1, BMI-1, HOXB4 genes were detected by comparative real-time quantitative PCR (RQ-PCR) with SYBR Green assay. The results showed that the expressions of ABCB1, BMI-1, HOXB4 were not detected in the patients with non-malignant hematologic diseases, but were higher (relative expressive level: 4.26 ± 2.26, 3.72 ± 1.91, 3.74 ± 2.38) in de novo acute leukemia patients and lower (relative expressive level: 2.14 ± 1.47, 2.07 ± 0.99, 1.47 ± 0.89) in the acute leukemia patients with CR (p < 0.05). The expressions of LSPC related genes were lower (relative expressive level: 1.77 ± 1.29, 2.09 ± 1.26, 1.78 ± 1.49) in the patients acquired CR/partial remission (PR) than those in the patients not acquired CR/PR (relative expressive level: 7.23 ± 1.78, 3.96 ± 0.92, 4.48 ± 2.57) (p < 0.01). Univariate analysis revealed that there were more cases with the expression of LSPC immunophenotype (CD34(+)CD38(-)CD96(+) and CD34(+)CD38(-)CD123(+)) and more hyperleukocytosis cases in patients with any higher expression of LSPC related gene (p < 0.05). Analysis of multiple parameters discovered larger significance (p < 0.01). It is concluded that there is a good relationship between LSPC related genes (ABCB1, BMI-1, HOXB4) and LSPC immunophenotype. The expression of LSPC-related genes is higher in de novo acute leukemia patients, and lower in patients acquired CR/PR. The patients with higher expressed LSPC-related genes display worse response to chemotherapy, lower CR/PR rate and higher leukocytosis, the analysis of multiple parameters may be a good method for assessing the therapeutic efficacy/prognosis of acute leukemia.
ATP Binding Cassette Transporter, Sub-Family B ; ATP-Binding Cassette, Sub-Family B, Member 1 ; genetics ; metabolism ; Adolescent ; Adult ; Aged ; Female ; Gene Expression ; Homeodomain Proteins ; genetics ; metabolism ; Humans ; Immunophenotyping ; Leukemia, Myeloid, Acute ; genetics ; metabolism ; Male ; Middle Aged ; Neoplastic Stem Cells ; metabolism ; Polycomb Repressive Complex 1 ; genetics ; metabolism ; Transcription Factors ; genetics ; metabolism ; Young Adult