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.

Abstract OBJECTIVE To investigate the effect and mechanism of flavonoids from Sophora flavescens Ait. on testicular tissue damage in male mice induced by local heat stress in the scrotum. METHODS TCMSP database was used to screen the targets of flavonoids in Sophora flavescens Ait., and the bioinformatics analysis was performed on the target. The mouse model of scrotal heat stress was used and the flavonoids of Sophora flavescens Ait. was used for intervention. The sperm density and sperm aberration rate of mice in each group were measured, and the morphological changes of testicular tissue were observed. Tumor necrosis factor-α (TNF-α) and interleukin 17(IL-17) mRNA and protein levels in testicalar were detected of by q-PCR and Western blotting. Na+-K+-ATPase, Mg2+-ATPase, Ca2+-ATPase, lactate dehydrogenase(LDH), sorbitol dehydrogenase(SDH) activity, malondialdehyde (MDA), NO, TNF-α level and the content of testosterone in serum were detected in tissue homogenate. RESULTS Heat stress could lead to the decrease of sperm density and increase of aberrant sperm, the obvious thinning of testicular spermatogenic epithelium, the decrease of cell level and quantity, the significant decrease of ATPase, LDH, SDH activities, and the increase of MDA, NO content, TNF-α and IL-17 expression in testicular tissue. After the intervention with 250, 500 mg·kg-1·d-1 flavonoids of Sophora flavescens Ait., the quality of sperm and the damage of testicular tissue morphology were improved. The level of TNF-α and IL-17 in serum and testicular tissue were decreased, and the activity of ATPase, SDH and the level of testosterone were increased. CONCLUSION The mechanism of flavonoids of Sophora flavescens Ait. is through inhibiting the inflammatory factor TNF-α and IL-17 levels, improve the anti-lipid peroxidation ability and inhibite the role of NO, enhance the activity of energy enzymes in spermatogenesis, improve the level of serum testosterone, and improve the reproductive disorders caused by heat stress.

Humans ; Receptors, Chimeric Antigen/therapeutic use* ; DNA-Binding Proteins/genetics* ; Precursor B-Cell Lymphoblastic Leukemia-Lymphoma ; Proto-Oncogene Proteins c-bcl-2/genetics* ; Cell- and Tissue-Based Therapy ; Oncogene Proteins, Fusion/genetics* ; Translocation, Genetic

OBJECTIVE: To investigate the clinical and prognostic characteristics of primary acute myeloid leukemia (AML) with 11q23/KMT2A rearrangements. METHODS: Clinical data of 90 patients with primary AML and 11q23/KMT2A rearrangements were analyzed retrospectively. RESULTS: By karyotyping analysis, 80 of the 90 patients had translocations involving 11q23/KMT2A, with t(9;11)(p22;q23), t(6;11)(q27;q23), t(10;11)(p12;q23) and t(11;19)(q23;p13) being the most common ones, while 10 cases were found to have non-translocation abnormalities. The overall complete remission (CR) rate was 75.6%, and patients with t(6;11) had lower CR rate compared with non-t(6;11) patients (47.1% vs. 82.2%, P = 0.005). After a median follow-up of 24.5 months, the patients receiving allo-hematopoietic stem cell transplantation (allo-HSCT) had significantly higher 3-year overall survival (OS) (80.3% vs. 16.6%, P < 0.001) and 3-year event-free survival (EFS) (73.5% vs. 16.3%, P < 0.001) compared with non-transplant patients. Patients with t(6;11) had the lowest 3-year OS (11.8% vs. 56.0%, P < 0.001) and 3-year EFS (5.9% vs. 53.8%, P < 0.001) compared with other type of abnormalities. No significant difference was noted in the survival between patients with t(9;11) and non-t(9;11) regardless whether they had received HSCT. CONCLUSION The clinical characteristics of primary AML with 11q23/KMT2A rearrangements are heterogeneous. Patients did not receive HSCT had poorer survival, particularly with the presence of t(6;11). Allo-HSCT could significantly improve the survival of such patients.
Humans ; Retrospective Studies ; Leukemia, Myeloid, Acute/therapy* ; Translocation, Genetic ; Gene Rearrangement ; Prognosis

Child ; Chronic Disease ; Humans ; Inflammatory Bowel Diseases/diagnosis* ; Prognosis

ObjectiveTo explore the association between lipoprotein a ［Lp （a）］ and major adverse cardiovascular events （MACE） in patients with coronary heart disease （CHD） within 1 year after percutaneous coronary intervention （PCI）. MethodsOur study consecutively included 297 CHD patients who underwent PCI in our hospital from January 1， 2013 to December 31， 2014 and finished follow-up visits 1 year later. All patients were divided into 3 groups according to Lp（a）≤150mg/L， 150mg/L＜Lp（a）≤300mg/L and Lp（a）＞300mg/L. MACE occurrences were recorded. MACE is defined as hospitalization for recurrent angina pectoris， unplanned revascularization， acute myocardial infarction， acute heart failure and cardiogenic death. The different incidences of MACE within one year after PCI between patients with different Lp（a） levels were compared by univariate and multivariate survival analysis. ResultsThe average event-free survival time of 297 patients was （11.41±2.04） months. A total of 30 patients suffered from MACE， and the incidence of MACE was 10.1%. After constructing the event-free survival curves and comparing the survival rate by Log-rank test， it was found that patients with LP （a） > 300mg/L had a higher incidence of MACE. Cox proportional hazards regression models were used for multivariate adjustment. As a quantitative variable， elevated Lp（a） level was risk factor of MACE occurrence in CHD patients within 1 year after PCI ［hazard ratio（HR） per 1-SD increase 1.76， 95% confidence interval （CI）： 1.41～2.19， P<0.001］. As a categorical variable， Lp （a） > 300mg/L was also positively correlated with MACE occurrence within in CHD patients 1 year after PCI （HR 2.25， 95%CI： 1.38～3.67， P=0.001）. ConclusionsThe higher the level of Lp（a）， the higher the incidence of MACE within 1 year after PCI in CHD patients. Lp（a） is an independent risk factor for MACE occurrence within 1 year after PCI in CHD patients.

【Objective】 To investigate the tracer effect of carbon nanoparticle suspension in central neck lymph node dissection of differentiated thyroid cancer with other thyroid diseases. 【Methods】 A total of 500 patients with differentiated thyroid cancer hospitalized in Meizhou People's Hospital from July 2015 to July 2019 were retrospectively analyzed. Patients were divided into carbon nanoparticles group(group A, 314 cases) and non-carbon nanoparticles group(group B, 186 cases). Group A and B were further divided into 4 subgroups according to the classifications of no other disease (subgroup 0), with nodular goiter(subgroup 1), with Hashimoto's thyroiditis(subgroup 2) and large tumor(the diameter > 30 mm, subgroup 3), and the number of lymph nodes dissected in each group and the incidence of complications were analyzed. 【Results】 The number of lymph nodes harvested and metastasis rate in group A was higher than that in group B [6.0(3.0 ~ 9.0) vs. 3.0(1.0 ~ 5.3), P < 0.001; 24.4% vs. 20.7%, P = 0.041) ] . The number of lymph nodes harvested in group A0, A1 and A2 was higher than that in group B0 [8.0(6.0 ~ 11.0) vs. 3.0(2.0 ~ 6.0), P < 0.001) ] , B1 [4.0(3.0 ~ 6.8) vs. 3.0(0.0 ~ 5.0), P < 0.001) ] and B2 [8.0(5.0 ~ 12.0) vs. 4.0(0.0 ~ 6.5), P = 0.002] . The number of lymph nodes harvested in group A1 and A3 was significantly lower than that in group A0 [4.0(3.0 ~ 6.8) vs. 8.0(6.0 ~ 11.0), P < 0.001; 3.0(2.0 ~ 6.0) vs. 8.0(6.0 ~ 11.0), P < 0.001) ] . The incidence of hoarseness in group A1, A2 and A3 was comparable with that in group A0(P > 0.05), and the incidence of postoperative parathyroid dysfunction in group A2 and A3 was significantly higher than that in group A0(51.8% vs. 34.1%, P < 0.05; 54.2% vs. 34.1%, P < 0.05) . 【Conclusions】 The application of carbon nanoparticles in the operation of differentiated thyroid cancer increases the number of lymph nodes harvested, and the best effect is without complicated diseases. The tracking effect of carbon nanoparticles is affected by the combination of nodular goiter. When the maximum diameter of the tumor is greater than 30 mm, it has no obvious effect on the dissection of lymph nodes.

Objective: To analyze the characteristics of myeloid neoplasms with t (3;21) (q26;q22) . Methods: Clinical data of patients with t (3; 21) (q26; q22) , diagnosed as hematologic malignancies in Peking University people's hospital from January 2011 to March 2018, were collected retrospectively. 19 patients in our hospital and forty-eight patients bearing t (3;21) (q26;q22) with detailed survival data reported in literature were summarized. Kaplan- Meier method was used for survival analysis. Results: Among 19 patients, including 15 males and 4 females with a median age of 36 years (22-68 years) , 4 cases was diagnosed as de novo acute myeloid leukemia (AML) , 4 as myelodysplastic syndromes (MDS) , 3 as MDS-AML and 8 as chronic myelogenous leukemia (CML) in myeloid blast transformation. All of the 19 patients were detected to have t (3;21) (q26;q22) by G-banding technique and 13 carried additional cytogenetic aberrations. 9 of the 19 patients were detected for positive AML1-MDS1 fusion genes. In the 9 patients with detailed follow-up data, 6 patients received chemotherapy and only 2 achieved complete remission (CR) while 4 with no response. During the follow-up period, 8 patients died and the median overall survival (OS) was 6 months (4.5 to 22 months) . Survival analysis of the present 9 patients together with the literature data showed that the prognosis was poor and the median OS was 7 months. In particular, AML/t-AML had the worst prognosis. Hematopoietic stem cell transplantation (HSCT) could significantly improve survival, the median OS in HSCT group and non-HSCT group were 20.9 and 4.7 months respectively (P<0.001) . Conclusions: t (3; 21) (q26; q22) is a rare recurrent chromosomal abnormality which is detected mainly in myeloid neoplasm and confer to poor clinical prognosis. HSCT should be recommended to improve the outcomes.
Adult ; Aged ; Chromosomes, Human, Pair 21 ; Chromosomes, Human, Pair 3 ; Female ; Humans ; Leukemia, Myeloid, Acute ; Male ; Middle Aged ; Myeloproliferative Disorders ; Retrospective Studies ; Translocation, Genetic ; Young Adult

Objective: To analyze the characteristics of myeloid neoplasms with t (3;21) (q26;q22) . Methods: Clinical data of patients with t (3; 21) (q26; q22) , diagnosed as hematologic malignancies in Peking University people's hospital from January 2011 to March 2018, were collected retrospectively. 19 patients in our hospital and forty-eight patients bearing t (3;21) (q26;q22) with detailed survival data reported in literature were summarized. Kaplan- Meier method was used for survival analysis. Results: Among 19 patients, including 15 males and 4 females with a median age of 36 years (22-68 years) , 4 cases was diagnosed as de novo acute myeloid leukemia (AML) , 4 as myelodysplastic syndromes (MDS) , 3 as MDS-AML and 8 as chronic myelogenous leukemia (CML) in myeloid blast transformation. All of the 19 patients were detected to have t (3;21) (q26;q22) by G-banding technique and 13 carried additional cytogenetic aberrations. 9 of the 19 patients were detected for positive AML1-MDS1 fusion genes. In the 9 patients with detailed follow-up data, 6 patients received chemotherapy and only 2 achieved complete remission (CR) while 4 with no response. During the follow-up period, 8 patients died and the median overall survival (OS) was 6 months (4.5 to 22 months) . Survival analysis of the present 9 patients together with the literature data showed that the prognosis was poor and the median OS was 7 months. In particular, AML/t-AML had the worst prognosis. Hematopoietic stem cell transplantation (HSCT) could significantly improve survival, the median OS in HSCT group and non-HSCT group were 20.9 and 4.7 months respectively (P<0.001) . Conclusions t (3; 21) (q26; q22) is a rare recurrent chromosomal abnormality which is detected mainly in myeloid neoplasm and confer to poor clinical prognosis. HSCT should be recommended to improve the outcomes.

To monitor genetic variation of porcine reproductive and respiratory syndrome virus (PRRSV),RT-PCR was used to identify a sample suspected of PRRSV infection.A PRRSV named SC-GY strain was obtained,and its Nsp2,ORF5 and ORF3 genes were used for sequence alignment and phylogenetic tree construction.The results showed that SC-GY strain is highly pathogenic PRRSV American variant strains with Nsp2 gene discontinuous deletion of 30 amino acids,ORF3 gene aa17 a serine (S) insert.Comparing to VR2332,CH-1a,JXA1,HUN4,NADC30,HENAN-XINX and SC2012,the Nsp2,ORF5 and ORF3 of SC-GY shared 70.3％-97.9％,82.4％-97.6％ and 83.1％-98.2％ of nucleotide similarity,and 62.3％-96.3％,78.0％-95.7％ and 81.6％-96.5％ of deduced amino acid similarity;and compared to LV they shared only 18.9％,60.8％ and 63.7％ of nucleotide similarity,and 14.0％,54.9％ and 57.2％ of deduced amino acid similarity.The phylogenetic tree revealed that the SC-GY formed independent small branches although it belonged to the same subgroup as highly pathogenic PRRSV strains.The results showed that in high frequency live vaccine immunization of currently PRRSV,the gene of PRRSV epidemic strain is still in constant variation.Vaccination of live PRRSV vaccines should be reduced and surveillance of PRRSV strains should be enhanced.