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.

Objective:To summarize the patient profiles and therapeutic efficacies of ABO-incompatible living-related kidney transplantations at 19 domestic transplant centers and provide rationales for clinical application of ABOi-KT.Methods:Clinical cases of ABO-incompatible/compatible kidney transplantation (ABOi-KT/ABOc-KT) from December 2006 to December 2009 were collected. Then, statistical analyses were conducted from the aspects of tissue matching, perioperative managements, complications and survival rates of renal allograft or recipients.Results:Clinical data of 342 ABOi-KT and 779 ABOc-KT indicated that (1) no inter-group differences existed in age, body mass index (BMI), donor-recipient relationship or waiting time of pre-operative dialysis; (2) ABO blood type: blood type O recipients had the longest waiting list and transplantations from blood type A to blood type O accounted for the largest proportion; (3) HLA matching: no statistical significance existed in mismatch rate or positive rate of PRA I/II between two types of surgery; (4) CD20 should be properly used on the basis of different phrases; (5) hemorrhage was a common complication during an early postoperative period and microthrombosis appeared later; (6) no difference existed in postoperative incidence of complications or survival rate of renal allograft and recipients at 1/3/5/10 years between ABOi-KT and ABOc-KT. The acute rejection rate and serum creatinine levels of ABOi-KT recipients were comparable to those of ABOc-KT recipients within 1 year.Conclusions:ABOi-KT is both safe and effective so that it may be applied at all transplant centers as needed.

OBJECTIVE: To evaluate the effects of a 48-week course of adefovir dipivoxil (ADV) plus Chinese medicine (CM) therapy, namely Tiaogan Jianpi Hexue () and Tiaogan Jiedu Huashi () fomulae, in hepatitis B e antigen (HBeAg)-positive Chinese patients. METHODS: A total of 605 HBeAg-positive Chinese CHB patients were screened and 590 eligible participants were randomly assigned to 2 groups in 1:1 ratio including experimental group (EG, received ADV plus CM) and control group (CG, received ADV plus CM-placebo) for 48 weeks. The major study outcomes were the rates of HBeAg and HBV-DNA loss on week 12, 24, 36, 48, respectively. Secondary endpoints including liver functions (enzymes and bilirubin readings) were evaluated every 4 weeks at the beginning of week 24, 36, and 48. Routine blood, urine, and stool analyses in addition to electrocardiogram and abdominal B scan were monitored as safety evaluations. Adverse events (AEs) were documented. RESULTS: The combination therapy demonstrated superior HBeAg loss at 48 weeks, without additional AEs. The full analysis population was 560 and 280 in each group. In the EG, population achieved HBeAg loss on week 12, 24, 36, and 48 were 25 (8.90%), 34 (12.14%), 52 (18.57%), and 83 (29.64%), respectively; the equivalent numbers in the CG were 20 (7.14%), 41 (14.64%), 54 (19.29%), and 50 (17.86%), respectively. There was a statistically significant difference between these group values on week 48 (P<0.01). No additional AEs were found in EG. Subgroup analysis suggested different outcomes among treatment patterns. CONCLUSION Combination of CM and ADV therapy demonstrated superior HBeAg clearance compared with ADV monotherapy. The finding indicates that this combination therapy may provide an improved therapeutic effect and safety profile (ChiCTR-TRC-11001263).
Adenine ; analogs & derivatives ; therapeutic use ; Adult ; Antiviral Agents ; therapeutic use ; Double-Blind Method ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Hepatitis B e Antigens ; immunology ; Hepatitis B, Chronic ; drug therapy ; immunology ; Humans ; Male ; Medicine, Chinese Traditional ; Organophosphonates ; therapeutic use ; Young Adult

Purpose To study the expression and the clinical significance of β3GnT8,MMP-2,PCNA in gastric cancer tissue. Methods The histological chips of paraffin specimens of gastric cancer were prepared,and immunohistochemical methods were used to detect the expression of β3GnT8,MMP-2 and PCNA in gastric cancer and adjacent tissue. Results The expression of β3GnT8 and MMP-2,PCNA in gastric cancer was higher than that in adjacent tissue (P = 0. 001) . The expression of β3GnT8 and MMP-2 was significantly positively correlated with the clinical stage (P = 0. 001) ,depth of invasion (P = 0. 011) and lymph node metastasis (P = 0. 003) of gastric cancer. The expression of β3GnT8 was significantly positively correlated with that of MMP-2 (r = 0. 703,P = 0. 001) and PCNA (r = 0. 231,P = 0. 024) . The overall survival time of the β3GnT8 positive expression group was significantly shorter than that of the negative expression group(χ2 = 3. 957,P = 0. 047) . Conclusion The expression of β3GnT8 is increased in gastric cancer. β3GnT8 can promote the invasion and metastasis of gastric cancer and is associated with poor prognosis in patients with gastric cancer.

The gatekeeper policy has been implemented for approximately ten years on a pilot population in China. It is necessary to assess the satisfaction of patients utilizing community health service (CHS) under the gatekeeper system. Our study showed that the cognition of gatekeeper policy was associated with four dimensions including doctor-patient relationships, information and support, organization of care, and accessibility (P < 0.001). One or more factors such as gender and self-perceived health scores also affected their satisfaction. General practitioners must be prepared to focus on these aspects of information and support, organization of care, and accessibility as indicators of potential opportunities for improvement. Additionally, policymakers can improve patients' satisfaction with CHS by strengthening their awareness of the gatekeeper policy.
Adolescent ; Adult ; China ; Community Health Services ; organization & administration ; Data Collection ; Female ; Humans ; Male ; Middle Aged ; Patient Satisfaction ; statistics & numerical data ; Young Adult

OBJECTIVETo investigate the cut-off value in screening of thalassemia in pregnant women from Shenzhen region by capillary hemoglobin electrophoresis.

METHODSThe data of capillary hemoglobin electrophoresis and genetic diagnosis of thalassemia from 2122 examined prenatal women were retrospectively analyzed. Capillary hemoglobin electrophoresis and α-, β- genetic diagnosis of thalassemia were carried out for every woman. Hemoglobin electrophoresis was performed using Capillarys 2 full-automated electrophoresis instrument. Gap polymerase chain reaction and reverse dot blot were used for genetic diagnosis of thalassemia genotyping test. The cut-off value in screening of thalassemia was determined by receiver operating characteristic curve and next to analyze the value of HbA2 and HbF in screening of thalassemia using the decided cut-off value.

RESULTSThe areas under the curve (AUC(Roc)) of HbA2 for diagnosis of α-, β- thalassemia were 0.75 and 0.981 respectively, and the AUC(Roc) of HbF for diagnosis of β-thalassemia was 0.787. When HbA2 ≤ 2.55 was taken as the cut-off value of HbA2 for diagnosis of α-thalassemia, the sensitivity, specificity, positive likelihood ratio (LR(+)) and negative likelihood ratio (LR(-)) were 89.5%, 54.8%, 1.98, 0.19 respectively. When HbA2 ≥3.9 was taken as the cut off value of HbA2 for diagnosis of β-thalassemia, the sensitivity, specificity, LR(+) and LR(-) were 96.1%, 99.8% 480.5, 0.04 respectively. When HbF ≥0.75 was taken as the cut off value of HbF for diagnosis of β-thalassemia, the sensitivity, specificity, LR(+) and LR(-) were 83.6%, 61.8% respectively.

CONCLUSIONThe cut-off value in screening of thalassemia by capillarys 2 full automated electrophoresis instrument is different from that of the traditional method of hemoglobin electrophoresis, such as cellulose acetate membrane electrophoresis and agarose gel electrophoresis. Each laboratory should establish their own respective cut off value.

Area Under Curve ; China ; Electrophoresis, Capillary ; Female ; Fetal Hemoglobin ; analysis ; Genotyping Techniques ; Hematologic Tests ; Hemoglobin A2 ; analysis ; Humans ; Mass Screening ; Pregnancy ; Reference Values ; Retrospective Studies ; Sensitivity and Specificity ; alpha-Thalassemia ; diagnosis ; beta-Thalassemia ; diagnosis

OBJECTIVE: To investigate the current status of quality of life( QOL) in patients with occupational pneumoconiosis,and explore the effects of the social demographic data and disease-related information on their QOL.METHODS: By the convenience sampling method,144 male patients with occupational pneumoconiosis were selected. The St. George's Respiratory Questionnaire( SGRQ) was used in the study and the stepwise regression analysis method was used to analyze the influencing factors of QOL in these patients. RESULTS: The SGRQ total score was( 60. 0 ± 18. 0),respiratory symptom dimension score was( 61. 2 ± 19. 7),limitation of motion dimension score was( 64. 0 ± 21. 5) and the disease influence dimension score was( 57. 7 ± 19. 5). The QOL of 52. 08%( 75 /144) of the patients were below the average level. The stage of pneumoconiosis was positively correlated with SGRQ total score and the above three dimension scores( P < 0. 01). The length of disease was negatively correlated with respiratory symptom dimension score( P < 0. 05);the educational level was negatively correlated with limitation of motion dimension score( P < 0. 01); the lung function was positively correlated with limitation of motion dimension score( P < 0. 05). CONCLUSION: The QOL of patients with pneumoconiosis was below the average level. The stage of pneumoconiosis,length of diagnosis,the educational level and lung function are the important factors affecting the QOL of these patients.

Objective To investigate the effect of paeoniflorin ( PF) on cytochrome P450 2E1( CYP450 2E1) and lipid peroxidation in L02 cell induced by ethanol.Methods L02 cell model was established by 75 mmol · L-1 ethanol.After treated with paeoniflorin, superoxide dismutase ( SOD) and malondialdehyde ( MDA) levels in the cell culture supernatant were detected by biochemical analysis.The expressions of CYP450 2E1 in L02 cell were observed by RT-PCR and immunocyto-chemistry.Results Compared with the control group, serum SOD levels in model group were significantly decreased, while MDA levels were elevated ( P <0.05 ).The levels of CYP450 2E1 mRNA and protein were significantly increased in model group (P<0.05).However, com-pared with the model group, SOD levels in the cell culture supernatant of PF group were much higher, while MDA levels were decreased, and the levels of CYP450 2E1 mRNA and protein were significantly decreased in PF group ( P<0.05 ).Conclusion The effect of PF on the improve-ment of L02 cell damaged by ethanol and reducing lipid peroxidation could be related with the regulation on the expression of CYP450 2 E1.

Objective To develop a biological canulated screw and evaluate its mechanical properties, so as to provide theoretical basis for the bio therapy of fracture with enrichment technique of bone marrow stem cells, which could be diffused through the canula, particularly for promoting bone union of femoral neck fracture and preventing avascular necrosis of femoral head. Methods TC4 titanium alloyed canulated cancellous screw (7.3 mm in diameter) commonly used for internal fixation of femoral neck fracture was improved by designing an end sealing plug and side holes in a 900 mm-long canulated screw. The side holes were arranged along the axis of screw, and the first side hole was 20 mm away from the screw tip. The distance between each side hole was 10 mm, and the number of side holes ranged from 0 to 6. The screws without holes were tested as control, and the rest were divided into two groups, i.e., group A: force direction parallel to the side hole, group B: force direction perpendicular to the side hole. Three point bending test on the screw was conducted by using Instron material testing machine, so as to study the relationship between the mechanical strength of the screw and the number of side holes, and the loading direction. Results (1) When the force direction was parallel to the side hole, which was confined within 0, 1 or 2, the bending deformation of the screw reached 3 mm, and no differences were found in the maximum loads and elastic modulus of the screw. However, when the number of side holes was increased to 3 or more, a significant reduction in the maximum load and elastic modulus of the screw was found (P＜0.05). (2) When the force direction was perpendicular to the side hole, which was confined within 0,1 or 2, and the bending deformation of the screw reached 3 mm, no significant differences were found in the maximum loads of the screw. While no significant difference was found in the elastic modulus of the screw when the side hole was 0, 1, 2 and 3. With an increase in the number of side holes, the maximum loads (≧ 3 side holes) and elastic modulus (≧ 4 side holes) were significantly reduced (P＜0.05). (3) When the force direction was perpendicular to the side hole and the number of side holes was 3 or more, the maximum loads and elastic modulus of the screw were all significantly higher than the screw with the same number of side hole under force direction parallel to the side hole. Conclusions (1) For achieving better mechanical properties of the screw, the number of side holes in titanium alloyed canulated cancellous screw (7.3 mm in diameter) should be within 2; (2) If the number of side holes was equal or over 3, screws under force direction perpendicular to the side hole could provide better mechanical properties than screws under force direction parallel to the side hole. This study may provide some theoretical evidence and support for future clinical development and practice of the biological canulated screw.

ation were complicated, with the characteristics as the obvious decreasing number of patients, with no food-borne isolates in 2007.