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.

Emerging SARS-CoV-2 variants have made COVID-19 convalescents susceptible to re-infection and have raised concern about the efficacy of inactivated vaccination in neutralization against emerging variants and antigen-specific B cell response. To this end, a study on a long-term cohort of 208 participants who have recovered from COVID-19 was conducted, and the participants were followed up at 3.3 (Visit 1), 9.2 (Visit 2), and 18.5 (Visit 3) months after SARS-CoV-2 infection. They were classified into three groups (no-vaccination (n = 54), one-dose (n = 62), and two-dose (n = 92) groups) on the basis of the administration of inactivated vaccination. The neutralizing antibody (NAb) titers against the wild-type virus continued to decrease in the no-vaccination group, but they rose significantly in the one-dose and two-dose groups, with the highest NAb titers being observed in the two-dose group at Visit 3. The NAb titers against the Delta variant for the no-vaccination, one-dose, and two-dose groups decreased by 3.3, 1.9, and 2.3 folds relative to the wild-type virus, respectively, and those against the Omicron variant decreased by 7.0, 4.0, and 3.8 folds, respectively. Similarly, the responses of SARS-CoV-2 RBD-specific B cells and memory B cells were boosted by the second vaccine dose. Results showed that the convalescents benefited from the administration of the inactivated vaccine (one or two doses), which enhanced neutralization against highly mutated SARS-CoV-2 variants and memory B cell responses. Two doses of inactivated vaccine among COVID-19 convalescents are therefore recommended for the prevention of the COVID-19 pandemic, and vaccination guidelines and policies need to be updated.

Objective: To improve the understanding and diagnosis and treatment level of infant with Takayasu arteritis (TA) by analyzing the clinical features of 14 pediatric patients and reviewing related articles. Methods: The clinical and follow-up data of infants with TA who were admitted to the Children′s Hospital Affiliated to Capital Institute of Pediatrics between July 2016 and May 2019 were retrospectively analyzed.By reviewing related articles, the clinical features of this disease were summarized. Results: The age of 14 patients (including 6 males and 8 females) were between 1 month and 23 days and 28 months.The most common clinical manifestations were fever in 10 cases (71.4%), hypertension in 9 cases (64.3%), weak or no pulse in 5 cases (35.7%). According to the clinical type of lesion vessels, 11 cases (78.5%) were generalized type, 3 cases (21.4%) were brachiocephalic artery type, and there was no thoracic abdominal aorta or single pulmonary artery type in this group.Among 14 infants with TA, 12 cases had common carotid artery, carotid artery, subclavian artery, coronary artery and its branches (anterior descending branch, circumflex branch) involved (85.7%); 11 cases had renal artery involved (78.6%); 9 cases had radial artery involved (64.2%); 8 cases had abdominal aorta involved (57.1%); 6 cases had descending aorta involved (42.9%); 6 cases had thoracic aorta involved (42.9%); 6 cases had superior mesenteric artery involved (42.9%); 5 cases had femoral artery involved (35.7%); 5 cases had pulmonary artery involved (35.7%); and 4 cases had brachial artery involved (28.6%). In those 14 patients, 11 cases were misdiagnosed, and 3 cases had unclear diagnosis, with misdiagnosis duration of 18 days to 2 months.In misdiagnosed cases, 8 cases were misdiagnosed as atypical Kawasaki disease.Among those 14 cases, the ranges of most lesions were gradually decreased, and the slightly involved vessels even completely returned to normal state after treatment in 7 cases.The vascular imaging showed no significant exacerbation or improvement in 4 cases.Nine cases developed hypertension, the blood pressure of whom could be controlled within normal range with hypotensive drugs which could not be interrupted.Physical examination found weak or no pulse in 5 cases who were not improved.Among 14 patients, 7 cases showed normal development, while the height and body mass of another 7 cases were the 25^th percentile below those of normal children of the same age.All 14 patients were followed up for 2-22 months and received regular treatment without recurrence. Conclusions TA patients aged less than 3 years tend to have more blood vessels involved, be in serious condition and have higher rate of misdiagnosis.The disease can be controlled quickly after treatment, but vascular diseases may be developed easily.Some patients have a poor prognosis.

Objective:The aim of this study is to analyze the distribution features of patients with solitary plasmacytoma and calculate the prevalence of solitary plasmacytoma in China in the year 2016.Methods:This study was based on China’s urban employees’ basic medical insurance and the urban residences’ basic medical insurance from 21 provinces from January 1, 2016 to December 31, 2016. Patients with solitary plasmacytoma were identified by disease names and codes. Subgroup analyses were carried out by sex, region, and age. Furthermore, sensitivity analyses were performed to test the robustness of the results. Age-adjusted prevalence was calculated based on the 2010 Chinese census data, the 2013 Revised European Standard Population, the 2010 US population, and the 2011 Australian population.Results:In 2016, the prevalence of solitary plasmacytoma in China was 1.18 per 100 000 population (95% CI, 1.06-1.31) , with 1.26 per 100 000 population (95% CI, 1.10-1.43) and 1.10 per 100 000 population (95% CI, 0.93-1.29) for males and females, respectively. The age-adjusted prevalence based on the 2010 Chinese census data was 0.85 per 100 000 population (95% CI, 0.82-0.88) . Conclusion:This study estimated the prevalence of solitary plasmacytoma in China on the basis of the national urban medical insurance, which can provide clues for the enactment of solitary plasmacytoma-related medical policies and basic studies about solitary plasmacytoma.

Objective:To analyze the epidemiological features of patients with plasma cell leukemia (PCL) and calculate the prevalence of PCL in urban China in 2016.Methods:Calculation in this study was based on China's urban basic medical insurance from 23 provinces between January 1, 2016 and December 31, 2016. The identification of the patients with PCL was based on the disease names and codes in the claim data. Subgroup analyses were carried out by sex, region, and age. To test the robustness of the results, we performed sensitivity analyses. Age-adjusted prevalence was calculated, based on the 2010 Chinese census data.Results:The prevalence of PCL in urban China in 2016 was 0.11 per 100 000 population (95% CI 0.05-0.19) , and the male prevalence and female prevalence were 0.12 per 100 000 population (95% CI 0.06-0.21) and 0.10 per 100 000 population (95% CI 0.04-0.19) , respectively. The prevalence of PCL peaked at 70-79 years old. Sensitivity analyses proved the robustness of the primary result. The age-adjusted prevalence based on 2010 Chinese census data was 0.12 per 100 000 population (95% CI 0.11-0.13) . Conclusion:This study firstly analyzed the epidemiological characteristics of PCL in China, which can provide evidence for the research and policies regarding PCL.

Objective:To understand the current status of rare disease related health information release in WeChat official accounts in China.Methods:We used a series of key words containing "rare diseases" and the names of the top 30 rare diseases in hospitalizations in China to search WeChat official accounts. Eligible articles were selected by systematic sampling. All including WeChat official accounts and articles were evaluated to extract the basic information.Results:No relevant WeChat official accounts were found for 14 rare diseases (46.67 %). Most of the WeChat official accounts (52.17 %) were initiated by patients and patient groups. No significant difference was detected in the total number of articles between the official accounts related with Traditional Chinese Medicine (TCM) and non-TCM related ones, however, the frequency of the monthly information release was significantly higher in TCM related official accounts ( P<0.001), while the average reading number of articles was significantly higher in non-TCM related official accounts ( P<0.001). Nearly 80 % of the WeChat official accounts had navigation menu, and the average reading number of official accounts with menus was larger than those without menus. The top three topics were rare disease diagnosis and treatment knowledge (46.00 %), public welfare activity for rare diseases (12.81 %) and uncorrelated things (8.65 %), while the first three leading topics were cutting-edge information, public welfare activity and patient story, respectively. Conclusions:The scale for rare disease related health information release based on WeChat official accounts in China has been basically formed, but it is still in development stage. Many improvements should be made in their coverage of rare diseases, release frequency, topic and form. It is urgent to establish or recreate some high-quality WeChat official accounts in order to provide precise information and effectively facilitate the prevention and treatment of rare diseases.

Objective:To analyze the clinical characteristics of infantile Takayasu arteritis and the efficacy of infliximab (IFX).Methods:Clinical manifestations, laboratory investigations and infliximab intervention of a case with infantile Takayasu arteritis, who was admitted to Department of Rheumatism and Immunology, Children′s Hospital, Capital Institute of Pediatrics in January 2018, were reviewed and analyzed. The related literature published from the beginning to March 2020 were retrieved from CNKI, Wanfang, SinoMed and PubMed with the keywords of"Takayasu arteritis","Infant" in both Chinese and English.Results:This case was a 70-day-old boy admitted due to recurrent fever for 20 days. On admission, his blood pressure were 104/90, 95/59, 125/80, and 152/125 mmHg (1 mmHg=0.133 kPa) in the right arm, left arm, right leg, and left leg, respectively. The complete blood cell count showed leukocytosis (22.6×10 9/L), thrombocytosis (858×10 9/L) and mild anemia (80 g/L). He also had elevated erythrocyte sedimentation rate (119 mm/1h), serum ferritin (598 μg/L) and C-reactive protein (112 mg/L). Computed tomographic angiography (CTA) showed narrowing of the thoracic and abdominal aorta, with thickening and heterogenous enhancement of the vessel wall. Coronary artery ultrasound detected dilatation and wall thickening of the bilateral coronary arteries, and uneven dilatation of the middle segment of the right coronary artery, showing bead-like change. Vessel wall thickening was also found in the other main arteries, including both femoral arteries, axillary arteries, carotid arteries, and subclavian arteries, and both superficial femoral arteries were slightly narrowed in the distal segments. The diagnosis of TA was confirmed, and the boy was treated with infliximab monotherapy (5 mg/(kg·every time), a total of 13 times). Then his body temperature and all inflammatory markers were normalized, and the vascular pathology was resolved according to the radiography. No side effects such as allergy or infection were noted during the treatment. During the 2 years and 6 months of follow-up, the boy maintained normal growth and development. Literature review found 8 related articles, and one of them was in Chinese but had limited information. In the other 7 papers, a total of 7 infants with TA were reported. The most common symptom was fever (5 cases), and inflammatory markers usually elevated, and the most common affected artery was abdominal aorta (6 cases). Most cases were treated with glucocorticoid. Conclusions:TA is a rare disease in infants, usually presents with fever and increased inflammatory markers. At the early stage, infliximab monotherapy could effectively control the symptoms and ensure normal growth and development.

Objective To analyze and summarize the treatment strategies for unstable angina with no-reflow phenomenon after PTCA during early percutaneous interventional procedures.Methods A total of 32 cases with unstable angina were divided into two groups:one group with drug therapy and the other group with drug therapy and thrombus aspiration catheter.The patients were chosen when there was no-reflow phenomenon after PTCA during early percutaneous interventional procedures and their clinical data were compared and analyzed.Blood flow TIMI grade,myocardial perfusion grade (MBG),TIMI myocardial perfusion (TMP) grade and other indexes were observed and recorded.Results The general conditions had no statistical difference between two groups.Compared with the drug therapy group,the proportion of patients with TIMI,MBG and TMP grade 3 was higher in aspiration and drug therapy group (89％ VS 71％ P＜0.05).Conclusion Drug therapy and thrombus aspiration catheter in treatment helps to improve myocardial perfusion level for unstable angina with no no-reflow phenomenon after PTCA during early percutaneous interventional procedures.

Objective:To investigate characteristics of masticatory movement path in young adults with AngleⅡ1 malocclusion.Meth-ods:1 5 youths with normal occlusion(group Ⅰ)and 1 5 with AngleⅡ1 malocclusion(group Ⅱ)were included.Mandibular movement paths of the incisal point of the incisor during unilateral-sided gum-chewing were recorded by the BioEGN mandibular kinesiography an-alyzer.Both maximal distances and directions (FH-opening/closing angles)in sagittal plane were analyzed.The statistic analyses were performed with SPSS 1 3.0 software.Results:Lateral distances of left masticatory movement path in Group I and Group II were (8.24 ±1 .48)mm and (6.58 ±2.49)mm,those of right(8.05 ±1 .05)mm and (6.42 ±2.47)mm,respectively(P <0.05).The aver-age of FH-opening/closing angle of masticatory movement path in Group I was higher than that in Group II at each level(P <0.05)ex-cept 0.5 mm point in the left masticatory movement path.Conclusion:Maximal lateral distance and FH-opening/closing angle of mas-ticatory path in young adults with AngleⅡ1 malocclusion are less than those with normal occlusion.

OBJECTIVETo investigate the effects of different concentrations of paraquat (PQ) poisoning on the expression of voltage-dependent anion channel (VDAC) and caspase family in the mitochondria of rat lung tissue, and to explore possible mechanisms of acute lung injury induced by acute PQ poisoning.

METHODSTwo hundred healthy adult Wister rats with equal numbers of male and female ones were randomly and equally divided into control group and poisoned group. The control group received one-time gastric lavage with 1 ml of normal saline, and the poisoned group with PQ (50 mg/kg) diluted in 1 ml of normal saline. Twenty rats were collected at 1, 24, 72, 120, and 168 h after lavage with normal saline or PQ and dissected after anesthesia. Mitochondria were separated from rat lung tissue, and the content of VDAC and caspase-3, -8, and -9 were determined.

RESULTSThe expression of VDAC and caspase-3, -8, and -9 in the poisoned rats were significantly higher than that in the control group (P < 0.001). At 1, 24, 72, 120, and 168 h after exposure, acute diffuse damages were found in alveolar capillary endothelial cells, alveolar epithelial cells, and pulmonary interstitial cells. Inflammatory cell infiltration in the pulmonary interstitium, alveolar structural disorder, and substantially increased fibroblasts were also found in rat lung tissue.

CONCLUSIONPQ poisoning can up-regulate the expression of VDAC and caspase-3, -8, and -9 in mitochondria of rat lung tissue to induce acute lung injury.

Acute Lung Injury ; chemically induced ; pathology ; Animals ; Caspase 3 ; metabolism ; Caspase 8 ; metabolism ; Caspase 9 ; metabolism ; Caspases ; metabolism ; Female ; Lung ; drug effects ; pathology ; Male ; Mitochondria ; drug effects ; metabolism ; Paraquat ; poisoning ; Rats ; Rats, Sprague-Dawley ; Voltage-Dependent Anion Channels ; metabolism