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.

Objective:To compare the efficacy of Milrinone and Papaverine in relieving the spasm of internal mammary artery (LIMA) during off-pump coronary artery bypass grafting (OPCABG).Methods:Between April 2018 to December 2018, 200 patients who suffered obvious angina pectoris and three-vessel disease documented by coronary angiography, undergoing OPCABG at Beijing Anzhen Hospital, Capital Medical University were recruited in this study, including 103 males and 97 females, aged 46-74 years, with an average of (59.12±0.49) years old. For all patients, the LIMA was anastomosed to left anterior descending artery(LAD). According to different methods relieving LIMA spasm, all patients randomly divided into 4 groups (n=50): Papaverine surface infiltration group (group Ⅰ), Papaverine injection group (group Ⅱ), Milrinone surface infiltration group (group Ⅲ) and Milrinone injection group (group Ⅳ). The blood flow (ml/min) of the free LIMA, the blood flow of the LIMA-LAD after bypass, anastomotic time of obtuse marginal artery, the use of vasoactive drugs, the outcomes of perioperative period and 1 year after operation were compared in the four groups.Results:There was no significant difference between group Ⅲ and group Ⅰ in the blood flow of free LIMA and LIMA-LAD[(45.50±1.43)ml/min vs. (47.42±1.61)ml/min、(28.60±0.89)ml/min vs. (28.40±0.96)ml/min, all P>0.05]. The blood flow of free LIMA and the LIMA-LAD in group Ⅱ were significantly higher than those in group Ⅰ[(60.36±1.28)ml/min vs. (47.42±1.61)ml/min, (42.40±1.25)ml/min vs. (28.40±0.96)ml/min, all P<0.05]. The blood flow of free LIMA and LIMA-LAD in group Ⅳ were significantly higher than those in group Ⅲ[(70.86±2.00) ml/min vs. (45.50±1.43) ml/min, (59.46±1.25) ml/min vs. (28.60±0.89) ml/min, all P<0.05]. The blood flow of free LIMA and LIMA-LAD in group Ⅳ were significantly higher than those in group Ⅱ[(70.86±2.00) ml/min vs. (60.36±1.28) ml/min, (59.46±1.25) ml/min vs. (42.40±1.25)ml/min, all P<0.05]. The anastomotic time of obtuse marginal artery[(7.14±0.72)min vs. (8.30±0.93)min, (8.10±0.89)min, (8.14±0.90)min, P<0.05], the dopamine dose[(3.76±0.40)μg·kg -1·min -1 vs. (5.02±0.52)μg·kg -1·min -1, (4.84±0.48)μg·kg -1·min -1, (4.90±0.49)μg·kg -1·min -1,P<0.05] and the esmolol usage (32% vs. 60%, 58%, 58%, P<0.05) during the operation in group Ⅳ were significantly reduced compared with the other three groups. The V3 ST depression on the postoperative first day[(0.34±0.18)mv vs. (0.71±0.22)mv, (0.68±0.20)mv, (0.69±0.22) mv, P<0.05], and the TNI on the postoperative third day[(0.24±0.08)ng/ml vs. (0.56±0.15)ng/ml, (0.54±0.11)ng/ml, (0.53±0.12) ng/ml, P<0.05] were significantly lower in group Ⅳ than those in the other three groups. However, there was no significant difference about the first-year patency of LIMA-LAD among four groups. Conclusion:For relieving spasm of LIMA, the Milrinone injection was better than that of Papaverine, which could shorten the anastomotic time of obtuse marginal artery, maintain intraoperative hemodynamics stability, reduce myocardial damage during OPCABG.

Objective: To evaluate the feasibility and validity of combined directly epicardial and transapical endocardial substrate ablation guided by Carto mapping for ventricular tachycardia(VT) with left ventricular aneurysm(LVA) intra-operation in a swine model. Methods: Twenty-four swine models with sustained VT and LVA were randomly divided into study group(radiofrequency ablation, RFCA, from epicardium via direct-view and endocardium via transapical access, 12 cases) and control group(endocardial RFCA via retrograde transaortic access, 12 cases). Substrate mapping for captured abnormal potentials via endocardium and epicardium was used to precisely locate the low-voltage areas. After ablation in two groups, VT was induced again to compare the effectiveness of different RFCA strategies. Results: Three dimensional electro-anatomic mapping was implemented successfully in two groups under open chest. And VT substrates were largely located in the border zone of LVA. All objects in the study group underwent endocardial ablation via transapical access smoothly without operative failure. When VT inducing again, 2 cases of study group was with inducible VT, however, VT recurrence in control group was 5 cases, P=0.04. Conclusion Combined direct epicardial and transapical endocardial substrate mapping and ablation appeared to be feasible and effective for treating VT with LVA under thoracotomy.

Glycoprotein (GP) IIb/IIIa is an important index for assessing the function of platelets. To investigate the effects of Honghua Injection, a Chinese patent medicine made from extracts of Carthamus tinctorius L, on GP IIb/IIIa is a key study in evaluating the inhibition properties of Honghua Injection on platelet aggregation.

OBJECTIVETo examine inhibition action of multi-glycoside of Tripterygium wilfordii (GTW) on infiltration of inflammatory cell in glomeruli with anti-Thy1.1 glomerulonephritis (anti-Thy1.1 GN), and to clarify its effects on inflammatory in vitro.

METHODTwo types of anti-Thy1.1 GN were induced in rats by a single or two intravenous injections with 500 microg of anti-Thy1.1 mAb 1-22-3. Rats were randomly divided into two groups, the GTW group and control group, and sacrificed on day 7 or on day 42 after induction of anti-Thy1.1 GN. Daily oral administration of different dose of GTW and distilled water as a control was started from 3 days before injection or at the same time of injection till the day of sacrifice. Proteinuria was determined during days 7 or during days 42. Infiltration of macrophage and T lymphocyte in glomeruli and mRNA expression of interleukin (IL)-2 and interferon (IFN)-gamma in renal tissue were examined.

RESULTIncrease of infiltration of macrophage in reversible anti-Thy1.1 GN model, glomerular macrophage infiltration and IL-2 mRNA expansion were attenuated by higher dose of GTW (75 mg x kg(-1) x d(-1)), and increased accumulation of activated macrophage and T lymphocyte in irreversible anti-Thy1.1 GN model, accumulation of macrophage and T lymphocyte in glomeruli and mRNA expansion of IL-2 and IFN-gamma were decreased by middling dose of GTW (50 mg x kg(-1) x d(-1)) as well. Proteinuria was significantly ameliorated after GTW administration.

CONCLUSIONThe findings suggested that different dose of GTW can ameliorate infiltration of inflammatory cell in glomeruli with anti-Thy1.1 glomerulonephritis in vitro by decreasing the expression of IL-2 and IFN-gamma.

Animals ; Antibodies, Monoclonal ; immunology ; Dose-Response Relationship, Drug ; Female ; Gene Expression Regulation ; drug effects ; Glomerulonephritis ; immunology ; metabolism ; pathology ; physiopathology ; Glycosides ; pharmacology ; Inflammation ; metabolism ; pathology ; physiopathology ; Interferon-alpha ; genetics ; Interleukin-2 ; genetics ; Kidney Glomerulus ; drug effects ; pathology ; Macrophages ; drug effects ; metabolism ; RNA, Messenger ; genetics ; metabolism ; Rats ; T-Lymphocytes ; drug effects ; metabolism ; Tripterygium ; chemistry

Objective To study the relationship between single nucleotide polymorphisms(SNPs)of thrombospondin-1 gene(TSP-1)and coronary artery disease(CAD).Methods Fragment 8831A→G of Exon thirteen in TSP-1 gene from 437 cases of CAD and 423 subjects without coronary heart disease from November 2003 to May 2007 in The First Affiliated Hospital of Nanjing Medical University and Affiliated Yueyang Hospital of Shanghai Traditional Chinese Medicine University were analysed by polymerase chain reaction and restriction fragment length polymorphism(PCR-RFLP),and sequence analysis for confirmation.Results The prevalence of the 8831G in the 860 subjects was rare.No association of the N700S polymorphism with an altered risk of ACS was found in our study (GA VS AA:OR=1.699;95%CI 0.309-9.348,P＞0.05).Conclusion The TSP-1 8831A→G polymorphism is rare and unrelated to CAD in the Chinese Han population.

Eleven patients with small or comminuted displaced tibial avulsion fractures of posterior cruciate ligament admitted in the Department of Orthopaedics,Second Affiliated Hospital,Fujian Medical University between January 2003 and January 2008 were selected.With diameter of 4.0 mm,the length of 35 mm or 40 mm cancellous bone screw,and internal diameter of 4.0 mm spiked washer was implanted for fixation.For cases of large comminuted facture,two cancellous bone screws and spiked washer were used.Postoperatively,the limb was immobilizated in a cast plaster at a 30 degrees flexion for 2-4 weeks,followed by active exercise rehabilitation.All 11 patients were followed up with an average of 18 months(ranged 7 to 36 months).No electrolysis,corrosion reaction to metal material,or allergic response to the spiked washer were detected in patients.At 2 months,all patients achieved bony union,no fragment redisplacement,no knee laxity or instability was detected,and the affected knees regained full range of motion.The knee function was significantly improved.

Objectives:To find out the relation between main clinical character and telomerase activity in oral squamous cell carcinomas. Methods:Telomerase activity was detected by telomerase PCR ELISA assay in 12 cases of oral normal tissue and 45 cases of oral squamous cell carinoma. Results:Telomerase activity was not detectable in 12 cases of oral normal tissue. Telomerase activity was detected in 75.67 percent of oral squamous cell carcinomas. Telomerase activity was present more frequently in advanced oral squamous cell carinoma than in the early stage( P

Objective　To study the diagnostic value of pleural fluid telomerase activity in distinguishing a malignant from a benign pleural effusion. Methods　Using a PCR-based assay, telomerase activity was examined in the pleural fluid cells obstained from 69 patients with pleural effusions (37 malignant, 32 benign). Results were compared with cytologic evaluation and carcinoembryonic antigen (CEA). Results　Of the 37 malignant specimens，26（70.27%）contained detectable telomerase activity. The positive rate in malignant pleural effusions was significantly higher than that in benign origin (2/32). Detection of telomerase in effusions was more sensitive than CEA level evaluation for the identification of pleural malignancy (telomerase assay: sensitivity=70.27%, specificity=93.75%; CEA: sensitivity=51.35%, specificity=96.87%). The consistant rate of telomerase with cytology was 54.05%. Conclusion　The detection of telomerase activity may be a useful adjunct to cytopathologic methods in the diagnosis of malignant pleural effusions. It may be useful in differential diagnosis of benign and malignant pleural effusions.

Purpose　The aim is to obtain the cDNA sequence of encoding extramembrane human FL gene with high level expression in E.coli. Methods　The primers were designed based on the known FL cDNA sequence. The total RNA was isolated from fetal liver cells , and then RT-PCR was performed. The fragment was cloned into pUC-18T vector, and further sequenced by automatic sequence analyzer. The gene was inserted into GST fusion expression vector between BamH Ⅰ and EcoR Ⅰ sites. The recombinant plasmid was transformed into E.coli strain DH5 α and induced with 1mmol/L IPTG.Results　The 546bp DNA fragment was amplified by RT-PCR method from fetal liver cells and its sequence was identical to the published sequence encoding human FL. The expressed fusion protein, with molecular weight of about 22kD, was about 10% of the total bacteria protein by SDS-PAGE and densitometry analysis.Conclusion　cDNA was cloned successfully. This study provided a basis for the further fundamental research and clinical application of FL.