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 elucidate the therapeutic effect and mechanism of action of Zhengqing Fengtongning Sustained-release Tablets on knee osteoarthritis, this study created a knee osteoarthritis model using 0.2 mL 40 g·L~(-1) papain and randomly divided the rats into the model group, high-dose and low-dose groups of Zhengqing Fengtongning Sustained-release Tablets, and celecoxib group. All groups were given the drug for four weeks, with the diameter of their knee joint being measured during this period. Hematoxylin-eosin staining and Senna solid green staining were utilized to observe the pathology of knee joint tissue in SD rats. The initial therapeutic impact of Zhengqing Fengtongning Sustained-release Tablets on knee osteoarthritis in rats was assessed by monitoring the levels of interleukin-1β(IL-1β) and interleukin-6(IL-6) in the plasma. Using a combination of non-targeted metabolomics and 16S rRNA techniques, researchers determined the variations in endogenous molecules and intestinal flora in rats and identified potential biomarkers. The results showed that Zhengqing Fengtongning Sustained-release Tablets improved the diameter of knee joint swelling, ameliorated the pathological damage of cartilage tissue, and reduced the plasma levels of IL-1β and IL-6 in rats with knee osteoarthritis. Metabolomics analysis identified 22 potential biomarkers associated with the modulatory effects of Zhengqing Fengtongning Sustained-release Tablets, including 5-hydroxytryptamine, corticosterone, methylmalonic acid, and other biomarkers, which were mainly involved in eight metabolic pathways, including tryptophan metabolism, vitamin K metabolism, steroid synthesis, and so on. The results of intestinal flora showed a decrease in the diversity of intestinal flora in the model group, an increase in the diversity of intestinal flora, and an improvement in the microecology of intestinal flora. Significant differences were found in Lachnospiraceae＿NK4A136＿group, Helicobacter, Lactobacillus, Bacteroides, and Parabacteroides. Finally, the results of the combined analysis showed that 22 biomarkers were correlated with five genera. The above results indicate that Zhengqing Fengtongning Sustained-release Tablets can improve the tissue morphology and structure of knee joints, reduce the level of plasma inflammatory factors, regulate the diversity of intestinal flora, and balance the metabolic pathways of steroid synthesis, vitamin K metabolism, and tryptophan metabolism to exert a therapeutic effect on knee osteoarthritis.
Animals ; Drugs, Chinese Herbal/administration & dosage* ; Rats ; Rats, Sprague-Dawley ; Gastrointestinal Microbiome/drug effects* ; Osteoarthritis, Knee/genetics* ; Metabolomics ; Delayed-Action Preparations/administration & dosage* ; Male ; Tablets ; Humans ; Interleukin-1beta/blood* ; Interleukin-6/blood*

OBJECTIVE: This work aimed to evaluate the influence of smear layer on the bonding effectiveness and durability of the self-adhesive resin cements to dentin. METHODS: A total of 48 fresh caries-free third molars with exposed dentin surface were divided into two groups. The dentin surfaces were treated using a standard grit diamond bur (group A) or further polished using a fine grit diamond bur (group B) and then bonded with either of the two self-adhesive resin cements, namely, Clearfil SA Cement (CSA, Kuraray) and Multilink Speed (MS, Ivoclar Vivadent). After 24 h or 2-year water storage, a microtensile bond strength test was performed. RESULTS: In group A, the dentin surface was rough, the smear layer was thick, and the dentin tubule orifice detritus showed low embolism value. In group B, the dentin surface roughness decreased, the embolism proportion increased, and the smear layer became thin. The initial bonding strengths of CSA and MS in group A were significantly lower than those in group B (P<0.05). The bonding strengths of CSA and MS significantly decreased after two years of water storage (P<0.05). For CSA, the bond strength of group B was significantly lower than that of group A (P<0.05). For MS, the differences in the bonding strength between groups A and B were insignificant (P>0.05). CONCLUSIONS The properties of the smear layer and the types of self-adhesive resin cement used affected the bond strength and durability.
Composite Resins ; Dental Bonding ; Dental Cements ; Dentin ; Dentin-Bonding Agents ; Humans ; Materials Testing ; Resin Cements ; Smear Layer ; Surface Properties ; Tensile Strength

Acquired Immunodeficiency Syndrome ; epidemiology ; Adult ; China ; epidemiology ; Cross-Sectional Studies ; Female ; HIV Infections ; epidemiology ; Humans ; Middle Aged ; Poverty Areas ; Young Adult

Objective To evaluate the impact of insulin resistance (IR) on prognosis in nondiabetic acute coronary syndrome patients.Methods In this prospective study,we enrolled 332 nondiabetic patients suffering from acute coronary syndrome.The patients were divided into three groups by HOMA-IR which calculated by formula:low HOMA-IR group (HOMA-IR ＜ 2),44 cases; moderate HOMA-IR group (2 ≤ HOMA2-IR ＜ 6),99 cases; high HOMA-IR group (HOMA≥6) with HOMA index,179 cases.The in-hospital medical records of patients were compared,and all patients were followed up for one year after discharge.Results Incidence of hypertension (P =0.013),dyslipidemia (P ＜ 0.001),faster resting heart rate (P ＜0.001) and number of triple vessel coronary artery disease (P =0.017)in high HOMA-IR group were significantly higher than in low and moderate HOMA-IR group.During follow-up,the major end-point events increased in proportion to IR grade:64.3％ (26/44) in the high HOMA-IR group,54.7％ (52/99)in moderate HOMA-IR group and 41.3％ (74/199)in low HOMA-IR group (P =0.034).Multivariable logistic regression analysis showed that high sensitivity C reactive protein(OR =1.012,95％CI:1.002-1.022,P =0.022),HOMA-IR (OR =1.250,95％ CI:1.043-1.497,P =0.015),triple vessel coronary artery disease (OR =5.914,95％ CI:2.947-11.868,P ＜ 0.001),ischemic changes on ECG(OR =5.495,95％ CI:2.925-10.324,P ＜ 0.001) and low left ventricular ejection fraction (LVEF ≤40％) (OR =13.205,95％ CI:5.000-34.661,P ＜ 0.001) were independent risk factor for major end-point events during follow-up.Conclusions Increased insulin resistance is linked with poor prognosis of nondiabetic patients with acute coronary syndrome.

Clopidogrel was believed to be superior to aspirin by the well-known CAPRIE trial. However, no other large clinical trials demonstrated the same results, but all focused on the combination use of clopidogrel with aspirin, and combination therapy in CREDO was called the "Emperor's New Clothes". However, no one overturned the results of these clinical trials by quantitatively analyzing them. We reviewed ten large-scale clinical trials about clopidogrel. On the basis of results of CAPRIE, CREDO and CHARISMA trials, we re-estimated their minimal sample sizes and their powers by three well-established statistical methodologies. From the results of CAPRIE, we inferred that the minimal sample size should be 85 086 or 84 968 but its power was only 30.70%. A huge gap existed. The same was also true of CREDO and CHARISMA trials. Moreover, in CAPRIE trial, 0 was included in the 95% confidence interval and 1 was included in the 95% confidence interval for the relative risk. There were some paradoxical data in CAPRIE trial. We are led to conclude that the results in CAPRIE, CREDO, and from the subgroup analysis in CHARISMA trials were questionable. These results failed to demonstrate that clopidogrel was superior to aspirin or that clopidogrel used in combination with aspirin was better than aspirin alone. The cost-effectiveness analyses by some previous studies were not reliable.

AIM: To study the effects of geranylgeranylacetone(GGA) on the expression of heat shock protein70(HSP70) on retinal ganglion cells(RGC) in rats with chronic intraocular pressure(IOP) elevation.METHODS: Seventy Wistars were divided into blank control group(10 rats), chronic hypertension group(30 rats) and GGA group(30 rats). Chronic hypertension was created by cauterizing the superficial scleral veins. 800mg/(kg·d)GGA was given by oral daily after cauterization. Immunohistochemistry was used respectively to observe the changes of expression of HSP70 in the model rats and GGA interference rats at different time points during the course of chronic IOP elevation.RESULTS: The successful model was identified as the IOP over 40% of normal rats. The retinal thickness was significantly reduced in model group and model+ GGA group compared with normal rats from 21 days through 28 days after cauterization(P<0.05), and that of model rats was obviously decreased in comparison with model+ GGA rats(P<0.05). The number of ganglion cells was significantly decreased in model rats and model+ GGA rats compared with normal rats from 21 days and 28 days. The stronger expression intensity(IOD) value was seen for HSP70 in the model+ GGA rats by immunochemistry(P<0.01).CONCLUSION: Systemic administration of GGA protects retina from chronic IOP elevation by regulating the expression of HSP70.

Clopidogrel was believed to be superior to aspirin by the well-known CAPRIE trial. However, no other large clinical trials demonstrated the same results, but all focused on the combina-tion use of clopidogrel with aspirin, and combination therapy in CREDO was called the "Emperor's New Clothes". However, no one overturned the results of these clinical trials by quantitatively ana-lyzing them. We reviewed ten large-scale clinical trials about clopidogrel. On the basis of results of CAPRIE, CREDO and CHARISMA trials, we re-estimated their minimal sample sizes and their powers by three well-established statistical methodologies. From the results of CAPRIE, we inferred that the minimal sample size should be 85 086 or 84 968 but its power was only 30.70%. A huge gap existed. The same was also true of CREDO and CHARISMA trials. Moreover, in CAPRIE trial, 0 was included in the 95% confidence interval and 1 was included in the 95% confidence interval for the relative risk. There were some paradoxical data in CAPRIE trial. We are led to conclude that the results in CAPRIE, CREDO, and from the subgroup analysis in CHARISMA trials were questionable. These results failed to demonstrate that clopidogrel was superior to aspirin or that clopidogrel used in combination with aspirin was better than aspirin alone. The cost-effectiveness analyses by some pre-vious studies were not reliable.

OBJECTIVETo isolate the prevalent strain of enterovirus 71 (EV71) in Xi'an area in 2008, and compare the concordance of viral isolation, reverse transcription polymerase chain reaction (RT-PCR) and immunofluorescent technique in detecting EV71, find the fast and effective method for detection, and analyze the differences between the EV71 strains isolated from Xi'an and Fuyang, Anhui.

METHODVirus isolation and RT-PCR were carried out on vesicle fluid and throat swab specimens that were collected from the patients with hand-foot-and-mouth disease, RD and HEp-2 cell lines were used for viral isolation. The virus was identified by using immunofluorescence technique. Nucleotide sequencing was performed on positive product of RT-PCR, and compared with EV71 isolated from Fuyang in 2008, then submitted to Genbank.

RESULTAmong the 56 samples of throat swab inoculated on RD and HEp-2 cells, the positive rates were 5.4% (3/56) and 1.8% (1/56), respectively. Among the 56 samples of vesicle fluid inoculated on RD and HEp-2 cells, the positive rates were 12.5% ( 7/56 ) and 5.4% (3/56), respectively. Cytopathic effect of RD and HEp-2 cells appeared on days 7 and 10, respectively. The positive rates of RT-PCR on throat swab and vesicle fluid samples were 21.4% (12/56) and 33.9% (19/56), respectively. Cytopathic effect was found in cell culture for 14 cases and immunofluorescence, showed that 9 of them were infected with EV71. The authors obtained the EV71 strain prevalent in Xi'an during 2008. The nucleotide sequence was submitted to the NCBI Genbank and gained the accession number EU812461.

CONCLUSIONThe EV71 in Xi'an prevalent during 2008 may have a weaker epithelial tropism. Comparison of the EV71 strain isolated from Xi'an with EU703812, EU703813 and EU703814 isolated from Fuyang, Anhui showed that the homology was 97%-98%. RT-PCR is an important method for rapid detection of EV71.

Bodily Secretions ; virology ; Cell Line, Tumor ; Child ; China ; epidemiology ; Enterovirus A, Human ; classification ; genetics ; isolation & purification ; Hand, Foot and Mouth Disease ; epidemiology ; virology ; Humans ; Molecular Sequence Data ; Pharynx ; virology ; RNA, Viral ; Reverse Transcriptase Polymerase Chain Reaction ; Sequence Homology, Nucleic Acid

Membrane (M) protein genes of 20 infectious bronchitis virus (IBV) strains isolated in China between 1995 and 2004 were sequenced and analyzed. The M genes of twenty isolates were composed of 672 to 681 nucleotides, encoding polypeptides of 223 to 226 amino acid residues. Variations of the deduced amino acids of M gene mainly occurred at positions 2 to 17 and 221 to 233, comparing with that of the IBV strain LX4. There were deletions or insertions in the M gene of Chinese isolates at amino acid position 2 to 6, leading to the loss or gain of a glycosylation site. Phylogenetic tree based on amino acid sequences of M genes from 20 Chinese isolates and 34 reference strains showed that they were classified into five distinct clusters. Most of the Chinese IBV strains were included in clusters II and IV, forming distinct groups. The isolates in cluster II showed a close evolutionary relationship with Taiwan isolates. Furthermore, recombination especially the recombination between field isolates and vaccine strains had been observed while comparing the phylogeny of M genes with those of S1 and N genes.
Amino Acid Sequence ; China ; Genetic Variation ; Infectious bronchitis virus ; classification ; genetics ; isolation & purification ; Molecular Sequence Data ; Phylogeny ; Sequence Homology, Amino Acid ; Viral Matrix Proteins ; genetics