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.

The biomimetic strategy of using the cell membrane-coated nanoparticles can retain the physical and chemical properties of the nanoparticles and show the biological characteristics of the source cell membrane, which can further enhance the role of the nanodrug in tumor treatment. A hybrid cell membrane is the fusion of two or more different types of cell membranes. A hybrid cell membrane can endow nanoparticles with multiple biofunctions derived from the source cells compared with a single cell membrane. Hybrid cell membranes provide a foundation to stimulate extensive research into multifunctional biomimetic nano-drug delivery system (NDDS), which is expected to broaden the application of biomimetic nanotechnology in drug delivery systems. In this review paper, the types of hybrid cell membrane used to construct nano-drug delivery systems, the preparation and characterization methods, and cancer treatment research progress in recent years were reviewed.

We conducted a prospective study to assess the non-inferiority of adjuvant chemotherapy alone versus adjuvant concurrent chemoradiotherapy (CCRT) as an alternative strategy for patients with early-stage (FIGO 2009 stage IB-IIA) cervical cancer having risk factors after surgery. The condition was assessed in terms of prognosis, adverse effects, and quality of life. This randomized trial involved nine centers across China. Eligible patients were randomized to receive adjuvant chemotherapy or CCRT after surgery. The primary end-point was progression-free survival (PFS). From December 2012 to December 2014, 337 patients were subjected to randomization. Final analysis included 329 patients, including 165 in the adjuvant chemotherapy group and 164 in the adjuvant CCRT group. The median follow-up was 72.1 months. The three-year PFS rates were both 91.9%, and the five-year OS was 90.6% versus 90.0% in adjuvant chemotherapy and CCRT groups, respectively. No significant differences were observed in the PFS or OS between groups. The adjusted HR for PFS was 0.854 (95% confidence interval 0.415-1.757; P = 0.667) favoring adjuvant chemotherapy, excluding the predefined non-inferiority boundary of 1.9. The chemotherapy group showed a tendency toward good quality of life. In comparison with post-operative adjuvant CCRT, adjuvant chemotherapy treatment showed non-inferior efficacy in patients with early-stage cervical cancer having pathological risk factors. Adjuvant chemotherapy alone is a favorable alternative post-operative treatment.
Female ; Humans ; Uterine Cervical Neoplasms/drug therapy* ; Prospective Studies ; Quality of Life ; Neoplasm Staging ; Chemoradiotherapy ; Chemotherapy, Adjuvant/adverse effects* ; Adjuvants, Immunologic ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Retrospective Studies

Objective : To investigate the improvement effect and possible mechanism of cornus officinalis glyco- sides on MRL / lpr lupus nephritis． Methods : Forty mice lupus-prone MRL / lpr mice were divided into model group， cornus officinalis glycosides low-dose，medium-dose，high-dose group (27．5，55，110 mg / kg) ，with 10 mice in each group，and 10 C57BL /6 mice were taken as the control group．Gastric administration was carried out 1 time / day for 4 weeks．24-hour urine was collected before drug intervention and 2 and 4 weeks after intervention to determine the content of urine protein．After the drug intervention，mouse serum and kidney tissues were taken and the levels of serum creatinine (Scr) ，urea nitrogen (BUN) and anti-double-stranded DNA (dsDNA) antibodies were detected by kits．The levels of interleukin-6 ( IL-6) ，tumor necrosis factor-α ( TNF-α) and interleukin-1 β ( IL-1 β) in serum were detected by ELISA．The changes in peripheral blood T lymphocyte subsets were detected by Flow cytometry ; The changes of renal histopathology were observed by HE staining ; The protein expression levels of toll-like receptor 4 (TLR4) ，myeloid differentiation factor-88 ( MyD88 ) ，nuclear transcription factor ( NF-κB) p65，and p-NF-κB p65 in kidney tissue were detected by Western blotting. Results : Compared with the control group，the changes of renal histopathology of the model group was severe，and the levels of 24-hour urine protein，Scr，BUN and anti-dsD- NA antibodies，IL-1 β, IL-6 and TNF-α significantly increased (P＜0. 01) ，the peripheral blood CD4 + T / CD8 + T lymphocyte ratio was significantly reduced (P ＜0. 01) ，and the protein expression levels of TLR4，MyD88 and p- NF-κB p65 in kidney tissue were significantly up-regulated (P＜0. 01) ; Compared with the model group，the chan- ges of renal histopathology of each dose group of cornus officinalis glycosides were significantly improved，the levels of 24-hour urine protein，Scr，BUN and anti-dsDNA antibodies，IL-1 β , IL-6 and TNF-α were significantly reduced (P＜0. 01) ，the peripheral blood CD4 + T / CD8 + T lymphocyte ratio significantly increased (P ＜0. 01 ) ，and the protein expression levels of TLR4，MyD88 and pNF-κB p65 in renal tissue were significantly down-regulated (P < 0. 01) ．Among them，the high-dose group had the most significant changes in each index．While there was no signifi- cant difference in the expression of NF-κB p65 protein in the groups． Conclusion Cornus officinalis glycosides have a certain effect on renal inflammatory response in mice lupus-prone MRL / lpr mice，and the mechanism may be related to the inhibition of TLR4 / NF-κB signaling pathway.

We aimed to evaluate the effectiveness and safety of single-course initial regimens in patients with low-risk gestational trophoblastic neoplasia (GTN). In this trial (NCT01823315), 276 patients were analyzed. Patients were allocated to three initiated regimens: single-course methotrexate (MTX), single-course MTX + dactinomycin (ACTD), and multi-course MTX (control arm). The primary endpoint was the complete remission (CR) rate by initial drug(s). The primary CR rate was 64.4% with multi-course MTX in the control arm. For the single-course MTX arm, the CR rate was 35.8% by one course; it increased to 59.3% after subsequent multi-course MTX, with non-inferiority to the control (difference -5.1%,95% confidence interval (CI) -19.4% to 9.2%, P = 0.014). After further treatment with multi-course ACTD, the CR rate (93.3%) was similar to that of the control (95.2%, P = 0.577). For the single-course MTX + ACTD arm, the CR rate was 46.7% by one course, which increased to 89.1% after subsequent multi-course, with non-inferiority (difference 24.7%, 95% CI 12.8%-36.6%, P < 0.001) to the control. It was similar to the CR rate by MTX and further ACTD in the control arm (89.1% vs. 95.2%, P =0.135). Four patients experienced recurrence, with no death, during the 2-year follow-up. We demonstrated that chemotherapy initiation with single-course MTX may be an alternative regimen for patients with low-risk GTN.
Antineoplastic Combined Chemotherapy Protocols/adverse effects* ; Dactinomycin/adverse effects* ; Female ; Gestational Trophoblastic Disease/drug therapy* ; Humans ; Methotrexate/therapeutic use* ; Pregnancy ; Retrospective Studies

With continuous discovery of tumor immune targets and continuous changes in antibody research and development technology, antibody drugs are becoming more and more widely used in clinical practice. However, some targets are not only expressed on tumor cells, but also on red blood cells. Therefore, the clinical application of antibodies against the corresponding targets may interfere with the detection of blood transfusion compatibility, resulting in difficulty in blood matching or delay of blood transfusion. This consensus summarizes the current solutions for the interference of CD38 monoclonal antibody (CD38 mAb) in transfusion compatibility testing. After analyzing the advantages and disadvantages of different methods, polybrene and sulfhydryl reducing agents [dithiothreitol (DTT) or 2-mercaptoethanol (2-Me)], as a solution for CD38 mAb interference in blood compatibility testing, are recommended for Chinese patients, so as to eliminate blood transfusion interference produce by CD38 mAb and further provide a pre-transfusion workflow for clinicians and technicians in Department of Blood Transfusion.

Although the combination of surgery, radiotherapy and chemotherapy is the main methods of cancer treatment, it still fails to solve certain tumors, especially metastatic tumors. With the in-depth study of tumorigenesis and development mechanism, and the exploration and clinical application of tumor immunotherapy, the survival period of patients with malignant tumors has been significantly prolonged. Tumor immunotherapy has become an effective anti-tumor method by activating the body′s own immune system to achieve tumor suppression. The combination of chemotherapy and immunotherapy has a significant effect and has become a feasible solution for cancer treatment. The rationally designed nanomedicines can effectively combine chemical drugs and immunological preparations, and have become an effective delivery carrier basis and treatment means for clinically targeting tumor tissues, synergistic immune mechanisms to kill tumor cells, and treating tumors. In this paper, the types of multifunctional nanomedicines used in chemotherapy and various immunotherapies in recent years and their advantages in cancer therapy were reviewed.

Multiple outcomes measured repeatedly for the same subject are common in longitudinal observation.If we use the approach by analyzing each outcome separately,it may lead to wrong conclusions due to the failure of accounting for joint evolution of different outcomes.To adequately capture the interdependence among multiple outcomes,we proposed a joint modeling for multivariate longitudinal data by constructing a linear mixed-effects model for each outcome and accommodating the relationship among multiple outcomes through correlation in random effects.Maximum likelihood method was adopted to estimate parameters in this model.The application of this method was demonstrated through the analysis of stroke data.

This article mainly introduces the functional clustering methods and demonstrates its performance by the real analysis of Chinese medical Zong Qi data.The functional clustering analysis hypothesizes that the discrete time series observations are dominated by a continuous function of time,which can be expressed by infinite basis functions.Functional clustering methods include raw data method,filtering method and adaptive method.When dealing with the sparse data clustering analysis,raw data method encounters the difficulty of matrix calculation due to the lack of data on some time grids.Filtering method suits for full time data,while when facing missing data,the fitting curve is inaccurate so that the clustering outcome cannot be explainable.Adaptive method can be applied flexibly to both full time and sparsely sampled data.In the real analysis section,the adaptive method is used to cluster the sparsely sampled Chinese medical Zong Qi time series data,where the elderly individuals are divided into three clusters,the ones with high level of Zong Qi,the ones with moderate level and those with low level.The adaptive method performs well on clustering individuals.

MicroRNAs (miRNAs) play critical roles in the development and progression in various cancers.Dysfunctional miR-9 expression remains ambiguous,and no consensus on the metastatic progression of ovarian cancer has been reached.In this study,results from the bioinformatics analysis show that the 3'-UTR of the E-cadherin mRNA was directly regulated by miR-9.Luciferase reporter assay results confirmed that miR-9 could directly target this 3'-UTR.miR-9 and E-cadherin expression in ovarian cancer tissue was quantified by qRTPCR.Migration and invasion were detected by wound healing and Transwell system assay in SKOV3 and A2780.qRT-PCR and Western blot were performed to detect the epithelial-mesenchymal transition-associated mRNA and proteins.Immunofluorescence technique was used to analyze the expression and subcellular localization of Ecadherin,N-cadherin,and vimentin.The results showed that miR-9 was frequently upregulated in metastatic serous ovarian cancer tissue compared with paired primary ones.Upregulation of miR-9 could downregulate the expression of E-cadherin but upregulate the expression of mesenchymal markers (N-cadherin and vimentin).Overexpression of miR-9 could promote the cell migration and invasion in ovarian cancer,and these processes could be effectively inhibited via miR-9 inhibitor.Thus,our study demonstrates that miR-9 may promote ovarian cancer metastasis via targeting E-cadherin and a novel potential therapeutic approach to control metastasis of ovarian cancer.