Objective:To investigate the relationship between lean lipid accumulation product (LAP) and metabolic associated fatty liver disease (MAFLD).Methods:This cross-sectional study consecutively enrolled 1 990 adult subjects who underwent health examinations at the Second Affiliated Hospital of Xi′an Jiaotong University between June 2021 and May 2023. All recruited participants had a body mass index (BMI)<23 kg/m2. Data collection included general information, physical examination, serum biochemical parameter measurements, and liver ultrasonography. Participants were divided into four groups (Q1-Q4) according to quartiles value of LAP from low to high. The differences of biochemical parameters and the prevalence of lean MAFLD were compared among the groups. Logistic regression, restricted cubic spline (RCS) and receiver operating characteristic (ROC) curve analysis were used to explore the relationship between LAP and lean MAFLD and assess the diagnostic predictive value of LAP for lean MAFLD.Results:A total of 1990 participants were selected, and the detection rate of lean MAFLD was 4.97% (99 cases). The detection rate of lean MAFLD showed a significant increasing trend from Q1 to Q4 groups ( P<0.001) and respectively was 0.40%, 0.81%, 4.01% and 14.70%. The average age, male proportion, BMI and waist circumference significantly increased in a dose-response manner from Q1 to Q4 (all P<0.001). Indirect bilirubin, alanine aminotransferase, aspartate aminotransferase, γ-glutamyltranspeptidase, alkaline phosphatase, total cholesterol, triglycerides, low-density lipoprotein, serum uric acid, fasting blood glucose, fatty liver index, fibrosis-4 index and every metabolic syndrome component in groups Q2 to Q4 were significantly higher than in the Q1 group, while high-density lipoprotein levels gradually decreased (all P<0.05). RCS showed that the risk of lean MAFLD rose significantly with the increase of LAP ( P<0.005), presenting a nonlinear relationship between them ( P for nonlinear<0.001). Logistic regression analysis revealed that after adjusting other confounding factors, the risk of lean MAFLD in the Q4 group remained 4.75 times higher than that in the Q1 group (95% CI: 11.22-31.69, P<0.05). ROC curve demonstrated that LAP had a better predictive value for lean MAFLD than BMI and waist circumference, with area under the curve of 0.839, critical value of 19.59, diagnostic sensitivity of 82.8% and specificity of 75.1%. Conclusions:Elevated LAP is independently and positively correlated with the risk of lean MAFLD, and its predictive efficacy is significant superior to traditional obesity indicators.

Objective:To investigate the relationship between lean lipid accumulation product (LAP) and metabolic associated fatty liver disease (MAFLD).Methods:This cross-sectional study consecutively enrolled 1 990 adult subjects who underwent health examinations at the Second Affiliated Hospital of Xi′an Jiaotong University between June 2021 and May 2023. All recruited participants had a body mass index (BMI)<23 kg/m2. Data collection included general information, physical examination, serum biochemical parameter measurements, and liver ultrasonography. Participants were divided into four groups (Q1-Q4) according to quartiles value of LAP from low to high. The differences of biochemical parameters and the prevalence of lean MAFLD were compared among the groups. Logistic regression, restricted cubic spline (RCS) and receiver operating characteristic (ROC) curve analysis were used to explore the relationship between LAP and lean MAFLD and assess the diagnostic predictive value of LAP for lean MAFLD.Results:A total of 1990 participants were selected, and the detection rate of lean MAFLD was 4.97% (99 cases). The detection rate of lean MAFLD showed a significant increasing trend from Q1 to Q4 groups ( P<0.001) and respectively was 0.40%, 0.81%, 4.01% and 14.70%. The average age, male proportion, BMI and waist circumference significantly increased in a dose-response manner from Q1 to Q4 (all P<0.001). Indirect bilirubin, alanine aminotransferase, aspartate aminotransferase, γ-glutamyltranspeptidase, alkaline phosphatase, total cholesterol, triglycerides, low-density lipoprotein, serum uric acid, fasting blood glucose, fatty liver index, fibrosis-4 index and every metabolic syndrome component in groups Q2 to Q4 were significantly higher than in the Q1 group, while high-density lipoprotein levels gradually decreased (all P<0.05). RCS showed that the risk of lean MAFLD rose significantly with the increase of LAP ( P<0.005), presenting a nonlinear relationship between them ( P for nonlinear<0.001). Logistic regression analysis revealed that after adjusting other confounding factors, the risk of lean MAFLD in the Q4 group remained 4.75 times higher than that in the Q1 group (95% CI: 11.22-31.69, P<0.05). ROC curve demonstrated that LAP had a better predictive value for lean MAFLD than BMI and waist circumference, with area under the curve of 0.839, critical value of 19.59, diagnostic sensitivity of 82.8% and specificity of 75.1%. Conclusions:Elevated LAP is independently and positively correlated with the risk of lean MAFLD, and its predictive efficacy is significant superior to traditional obesity indicators.

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.

BACKGROUND:Previous studies on immunosuppression and anti-rejection after organ transplantation mainly focused on effects of T lymphocytes-mediated immune response and immunosuppressive agents on T lymphocytes. Effects of dendritic cel s were unclear. The manifestation and mechanism of immunosuppressive agent effects on dendritic cel s are not identical. OBJECTIVE:To compare the effects of different immunosuppressive agents on expression and function of costimulatory molecules of dendritic cel s, and to explore the mechanism of action of immunosuppressive agents. METHODS:20μg/L rapamycin, 0.04 mg/L mycophenolate, 10μg/L tacrolimus and 1 mg/L cyclosporine A were separately added during bone marrow cel s of C57BL/6 mice were differentiated into dendritic cel s. RESULTS AND CONCLUSION:Flow cytometry results revealed that CD40 expression in each group:rapamycin0.05). One-way mixed lymphocyte reaction results displayed dendritic cel costimulatory T cel proliferation in each group:rapamycin

Objective To detect the lymphocyte subpopulations in patients with early syphilis ,so as to know their immunity con‐dition and guide clinical treatment .Methods Flow cytometry was used to detect CD3+ ,CD4+ and CD8+ lymphocyte subpopula‐tions in peripheral blood from 59 volunteers ,including 20 normal individuals (Cont group) ,10 patients with primary syphilis (PS group) ,15 patients with secondary syphilis (SS group) and 14 patients with early latent syphilis (ELS group) .Results CD3+ , CD4+ and CD8+ lymphocyte subpopulations in each syphilis groups were higher than Cont group .SS group had the highest CD3+level ,second was PS group ,and third was ELS group .There was significant difference among three groups (P<0 .05) .The CD3+level of SS group was significantly higher than that of Cont group (P<0 .05) .ELS group had the highest CD4+ level ,second was SS group ,third was PS group .The difference of CD4+ level was significant among three groups (P<0 .05) .PS group had the high‐est CD8+ level ,second was SS group ,third was ELS group .However ,the difference of CD8+ level among three groups was not sig‐nificant (P>0 .05) .There was no significant difference of CD4+ /CD8+ among three groups(P>0 .05) .Conclusion Cytoimmunity in early syphilis enhances ,which could be benefit to eliminate Treponema Pallidum .

BACKGROUNDTo study the clinical effects of ¹⁵³Sm-EDTMP plus chemotherapy in the treatment of bone metastasis of lung cancer.

METHODSOne hundred and ten lung cancer patients with one metastasis [male 82 and female 28, aged from 32 to 76 yrs; squamous cell carcinoma 28, adenocarcinoma 27, small cell lung cancer (SCLC) 7, mix type 41, alveolar carcinoma 7] who did not undergo an operation were entered into this study. The patients were divided into 3 groups: ¹⁵³Sm-EDTMP therapy only (37 cases), ¹⁵³Sm-EDTMP plus chemotherapy after 3 days (42 cases), 30 days after chemotherapy plus ¹⁵³Sm-EDTMP (31 cases). The dosages of ¹⁵³Sm-EDTMP ranged from 1 111 to 2 660 MBq. The patients with SCLC were adapted CCNU, MTX and CTX; those with non-small cell lung cancer (NSCLC) were adapted MMC, VCR and DDP. Statistic analysis of the data was performed by Chi-square test.

RESULTSTotal pain relief rate for ¹⁵³Sm-EDTMP only was 89.2% , for ¹⁵³Sm-EDTMP plus chemotherapy was 92.8%, and for chemotherapy plus 153 Sm EDTMP was 90.3% . The foci disappeared in 9 cases with ¹⁵³Sm-EDTMP only, in 12 cases with ¹⁵³Sm-EDTMP plus chemotherapy, and in 9 cases with chemotherapy plus ¹⁵³Sm-EDTMP. The 1 year survival rate was 29.7%(11/37) by 153 Sm only, 40.5%(17/42) by 153 Sm plus chemotherapy, 38.7%(12/31) by chemotherapy plus ¹⁵³Sm-EDTMP.

CONCLUSIONS¹⁵³Sm-EDTMP plus chemotherapy is effective in the treatment of bone metastasis of lung cancer.