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.

Gastric cancer (GC) is associated with high morbidity and mortality rates. Thus, early diagnosis is important to improve disease prognosis. Endoscopic assessment represents the most reliable imaging method for GC diagnosis; however, it is semi-invasive and costly and heavily depends on the skills of the endoscopist, which limit its clinical applicability.Therefore, the search for new sensitive biomarkers for the early detection of GC using noninvasive sampling collection methods has attracted much attention among scientists.Urine is considered an ideal biofluid, as it is readily accessible, less complex, and relatively stable than plasma and serum. Over the years, substantial progress has been made in screening for potential urinary biomarkers for GC. This review explores the possible applications and limitations of urinary biomarkers in GC detection and diagnosis.

Objective:To investigate the clinical characteristics of patients who develop chronic critical illness (CCI) after sepsis.Methods:The survival patients with sepsis admitted to the department of critical medicine of Baoan Central Hospital of Shenzhen for the first time from April 2019 to October 2020 were enrolled. According to clinical outcomes, patients were divided into CCI group [intensive care unit (ICU) stay ≥14 days, with persistent organ dysfunction] and rapid recovery (RAP) group. The baseline characteristic on admission and clinical outcomes of patients in the two groups were collected and compared. Blood samples were collected to measure serum interleukins (IL-6, IL-10) levels and peripheral blood lymphocyte count (LYM) count were obtained from all patients after admission. The differences of above indexes on the 1st, 7th and 14th day in ICU between the two groups were compared, the 180 day cumulative survival rate of the two groups was observed.Results:① Twenty-two septic patients developed CCI and 28 patients with RAP were included. There were no significant differences in gender and infection site between the two groups. The age, acute physiology and chronic health evaluationⅡ(APACHEⅡ), sequential organ failure assessment (SOFA), proportion of septic shock, mechanical ventilation time, length of ICU stay, total length of hospital stay and proportion of secondary infection of CCI patients were higher than those in RAP group [age (years old): 61.0±13.8 vs. 50.3±13.9, proportion of patients aged ≥ 65 years old: 54.5% (12/22) vs. 25.0% (7/28), APACHEⅡscore: 20.5±4.4 vs. 14.4±4.3, SOFA score: 10 (7, 12) vs. 5 (3, 8), septic shock ratio: 40.9% (9/22) vs. 17.9% (5/28), time of mechanical ventilation (days): 18.5 (12.0, 28.0) vs. 5.0 (3.0, 7.0), length of ICU stay (days): 26 (18, 46) vs. 8 (6, 12), total length of hospital stay (days): 31 (26, 51) vs. 14 (12, 17), secondary infection ratio: 72.7% (16/22) vs. 7.1% (2/28), all P < 0.05]. ② The IL-6 levels of CCI group were higher than that of RAP group at all time points (ng/L: 176.86±103.54 vs. 113.32±71.34 on the 1st day, 84.72±46.06 vs. 54.98±26.61 on the 7th day, 44.28±20.20 vs. 17.76±4.70 on the 14th day, all P < 0.05). On the 1st and 7th day of admission, there were no significant differences in IL-10 and LYM levels between the two groups. On the 14th day of admission, IL-10 levels in CCI group were higher than that in RAP group (ng/L: 15.09±3.61 vs. 8.92±1.98, P < 0.05), while LYM was relatively lower [×10 9/L: 0.62 (0.43, 1.02) vs. 1.17 (0.93, 1.71), P < 0.05]. ③ The Log-Rank test results of Kaplan-Meier survival curve showed that the 180-day cumulative survival rate of CCI group was significantly lower than that of RAP group (63.6% vs. 96.4%, Log-Rank:χ 2 = 9.024, P = 0.007). Conclusions:Septic patients with advanced age, high APAHCEⅡscore and high SOFA score are prone to secondary CCI, resulting in long hospital stay, high secondary infection rate and poor prognosis. The occurrence of CCI may be related to the continuous expression of proinflammatory mediators and subsequent immunosuppression.

A 3D printed patient-specific surgical guide plate is an auxiliary device made with the help of computer-aided design and 3D printing technology according to a surgical plan. It is used in reduction and internal fixation of fracture and specific corrective osteotomy as well. It is very adaptive as it has been widely used in trauma surgery, joint surgery and spine surgery, as well as in surgical treatment of bone tumors. Digital orthopedic technology is an important means to realize orthopedic precision medicine. This paper reviews the technical advantages, applications, main problems and future prospects of 3D printed patient-specific surgical guide plates in the field of orthopedics based on the recent literature.

Nucleos(t)ide analogs (NAs) are one of the two main antiviral agents used in clinical practice, which can effectively inhibit HBV replication. Serum HBV DNA is one of the most commonly used virologic markers used to assess HBV replication level. In recent years, more and more studies have suggested that serum HBV RNA is one of the ideal surrogates of cccDNA activity. This article summarized the influence of serum viral nucleic acid properties and quantitative result during treatment with NAs, as well as current method of viral nucleic acid quantification. And finally, it evaluates the significance of HBV DNA and RNA joint testing for CHB treatment.

Antigenic purity is important for quality control of the foot-and-mouth (FMD) whole virus inactivated vaccine. The recommended method for evaluation the antigenic purity of FMD vaccine is to check the serum conversion to non-structural protein (NSP) 3AB antibody after 2 to 3 times inoculation of animals with inactivated vaccine. In this study, we developed a quantitative ELISA to detect the amount of residual 3AB in vaccine antigen, to provide a reference to evaluate the antigenic purity of FMD vaccine. Monoclonal antibody (Mab) of NSP 3A and HRP-conjugated Mab of NSP 3B were used to establish a sandwich ELISA to quantify the NSP 3AB in vaccine antigen of FMD. Purified NSP 3AB expressed in Escherichia coli was serially diluted and detected to draw the standard curve. The detectable limit was determined to be the lowest concentration of standard where the ratio of its OD value to OD blank well was not less than 2.0. Results: The OD value was linearly corelated with the concentration of 3AB protein within the range between 4.7 and 600 ng/mL. The correlation coefficient R² is greater than 0.99, and the lowest detectable limit is 4.7 ng/mL. The amount of 3AB protein in non-purified inactivated virus antigen was detected between 9.3 and 200 ng/mL depending on the 12 different virus strains, whereas the amount of 3AB in purified virus antigen was below the lowest detectable limit. The amount of 3AB in 9 batches of commercial FMD vaccine antigens was between 9.0 and 74 ng/mL, whereas it was below the detectable limit in other 24 batches of commercial vaccine antigens. Conclusion: the sandwich ELISA established in this study is specific and sensitive to detect the content of 3AB protein in vaccine antigen of FMD, which will be a useful method for evaluation of the antigenic purity and quality control of FMD inactivated vaccine.
Animals ; Antibodies, Viral ; Enzyme-Linked Immunosorbent Assay ; Foot-and-Mouth Disease/prevention & control* ; Foot-and-Mouth Disease Virus ; Viral Nonstructural Proteins/genetics* ; Viral Vaccines

Objective: To evaluate the influence of antiretroviral prophylaxis on the growth and development of HIV-exposed uninfected infants in Guangzhou. Methods: Data were from the national information system for prevention of mother-to-child transmission of HIV infection, syphilis and hepatitis B. After excluding death and perinatal HIV infection cases, 564 HIV-exposed uninfected infants were included. The infants were divided into three groups, nevirapine (NVP) group, zidovudine (AZT) group and untreated group. The influences of antiretroviral prophylaxis on the body weight and height of the HIV-exposed uninfected infants were analyzed by using generalized estimating equations. Results: The HIV-exposed uninfected infants at 1-month old had lower Z scores of body weight-for-age and body height-for-age than the World Health Organization’s reference standard. The prevalence of wasting in AZT group (17.5%) was higher than that in NVP group (6.2%) for 1-month old infants. Taking NVP or AZT was a protective factor for Z score of body length-for-age (P<0.05). Intrauterine exposure to triple antiviral drugs was a risk factor for the Z scores of body weight-for-age and body length-for-age (P<0.05). Conclusion The physical growth and development of HIV-exposed uninfected infants at 1-month old was not well, and HIV-exposed uninfected infants who taking AZT had a higher incidence of wasting. Attention should be paid to these infants.

Objective To find out the display rules of the key part of the proximal femur and fracture line and obtain the best viewing position and angle by placing the femoral neck at different positions and different angles through X-ray.Methods Six dry specimens of cadaveric femur were from Department of Anatomy,Tianjin Medical University.Three models of complete femoral neck model,tin line fracture model and steel saw fracture model were made respectively.The tin line fracture model was based on the Pauwells angle,using the tin wire(1mm) wrapped around the femoral necks to make three kinds of fracture models (Pauwells angle 30°,50° and 70°);steel saw fracture model was made by hacksaw,then reposition in situ,to make three kinds of fracture models same as the tin line fracture model.The projection manner included different positions and different angles,different projection positions include:parallel with the femoral shaft,perpendicular to the femoral shaft,parallel to the femoral neck and perpendicular to the femoral neck;different projection angles included:from 40°,30°,20°,15°,10° and 5° in the head side to 5°,10°,15 °,20 °,30 °and 40° in the foot side and vertical angle 0°.For the complete femoral neck model,we observed the imaging characteristics of the key parts of the femoral head and neck (tension trabecular bone and pressure trabecular bone;lesser trochanter;intertrochanteric line;length of neck of femur and femoral head shape),looking for the display rules,and obtained the best viewing position.For tin line fracture model and steel saw fracture model,we tried to find the best display angle and position by the different projection position and angle.Results The results of complete femoral neck model:Lesser trochanter:in perpendicular to the femoral shaft position showed the best,gradually increased with the foot side deflection;tension trabecular bone and pressure trabecular bone:in parallel with the femoral shaft position 10°on the head side;intertrochanteric line:no difference between parallel with the femoral shaft with perpendicular to the femoral shaft;Femoral neck shape:deflect to both sides,head of femur was out of shape.The results of tin line fracture model:the Pauwells angle 30° model showed the best position in parallel with the femoral shaft position 20° on the head side;the Pauwells angle 50° model showed the best position in parallel with the femoral shaft position 5° on the head side;the Pauwells angle 70° model showed the best position in parallel with the femoral shaft position 10° on the head side.The results of steel saw fracture model were the same with the tin line fracture model.Conclusion There was the best viewing angles and positions for the key anatomy of the proximal femur and different Pauwells angle classification of femoral neck fracture.The image doctor could make more accurate projection,according to the different types of femoral neck fracture.

We investigated the enhanced immune response of a recombinant T cell immunogen as an effective cellular immune adjuvant. The T cell immunogen named TI contained several T cell epitopes from the VP1, VP4, 3A and 3D proteins of foot-and-mouth disease virus (FMDV) and two pan-T helper (T(H)) cell sites to broaden the immunogenicity of the protein. Meanwhile, another fusion protein named OA-VP1 was expressed in bacteria, which contained two VP1 proteins of O and Asia1 type FMDV. Mice were vaccinated with commercially inactivated vaccine or OA-VP1 protein with or without the TI immunogen. The results show that mice inoculated with inactivated vaccine or OA-VP1 protein supplemented with TI immunogen produced significantly higher level of neutralizing antibodies (P < 0.01 or P < 0.05) than the mice only inoculated with inactivated vaccine or OA-VP1 protein by microneutralization assay. An obvious increase in T cell number by flow cytometric analysis and significantly higher concentration of IFN-gamma secreted in culture media of spleen lymphocytes were observed in groups supplemented with TI immunogen (P < 0.01). TI immunogen was an effective stimulator for humoral and cellular immunity and could help improve the immunogenicity of inactivated vaccine or protein subunit vaccine.
Adjuvants, Immunologic ; pharmacology ; Animals ; Capsid Proteins ; genetics ; immunology ; Epitopes, T-Lymphocyte ; genetics ; immunology ; Foot-and-Mouth Disease ; immunology ; prevention & control ; virology ; Foot-and-Mouth Disease Virus ; immunology ; Immunization ; Mice ; Viral Vaccines ; genetics ; immunology ; pharmacology

Objective To study the effect of Qing Yi Tang(QYT) on bacterial and endotoxin translocation from intestine in acute hemorrhagic necrotizing pancreatitis(AHNP) in rats.Methods SD rats were randomly divided into 3 groups: AHNP group,AHNP +QYT treatment group and sham operation(SO) group.AHNP models were set up in the former two group,while the pancreas was only mobilized in SO group.After setting up the model,QYT was gavaged in the QYT group,while normal saline was gavaged in the SO group and AHNP group.The concentration of endotoxin(ET) and the DNA of E.coli expressoin in portal vein blood in three groups of rats were measured 24h later.Results The concentration of ET and amount of E.coli DNA in portal vein of QYT group were lower than those of AHNP group.Conclusions QYT can reduce significantly the concentration of ET and E.coli DNA in portal vein blood and decrease bacterial and endotoxin translocation from intestine in the AHNP rats.