ObjectiveTo investigate the changes in coagulation system in acute decompensated cirrhosis （ADC） patients with or without sepsis and the association of these changes with short-term prognosis. MethodsA prospective study was conducted among 116 ADC patients who were hospitalized in Nanfang Hospital from January 2021 to July 2023， among whom there were 86 patients with sepsis and 30 patients without sepsis， and 54 patients with sepsis alone who had no chronic liver disease were enrolled as control group. Thromboelastography （TEG） and other conventional coagulation parameters were used to comprehensively evaluate the coagulation function of patients. The data including TEG results and short-term prognosis were collected， and a correlation analysis was performed. The independent-samples t test was used for comparison of normally distributed continuous data between two groups， and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups； the chi-square test was used for comparison of categorical data between two groups. The Spearman correlation coefficient was calculated to investigate the correlation between different variables. The Logistic regression model was used to perform the univariate and multivariate analyses. ResultsFor the ADC patients with sepsis， the lungs and bloodstream were the main infection sites， and bacteria were the main pathogenic microorganism. TEG results showed that compared with the patients with sepsis alone， the patients with ADC and sepsis had a significant reduction in median maximum amplitude （MA）， a significant increase in coagulation time （K time）， and a significant reduction in α angle （all P<0.05）； the patients with ADC and sepsis had a significantly longer reaction time （R time） than those with ADC alone （P=0.02）， and the patients with sepsis alone had a significantly longer R time than those with ADC and sepsis （P=0.04）. There was no correlation between MA and platelet count in the patients with ADC and sepsis （r=-0.133， P=0.057）， while there was a significant correlation between MA and platelet count in the patients with sepsis alone （r=0.595， P=0.001）. SOFA score was negatively correlated with MA in sepsis patients with or without ADC （r=-0.503 and -0.561， both P<0.001）， and for the patients with ADC and sepsis， R time， K time， and α angle were weakly correlated with SOFA score and had a relatively strong correlation with APTT （all P<0.05）. The patients with ADC alone all survived within 90 days， and compared with the death group， the patients with sepsis alone who survived had significantly higher values of MA and α angle （all P<0.05）； there was a significant difference in α angle on day 90 between the survival group and the death group， no matter whether the patients were comorbid with ADC or not （both P<0.01）， while for the patients with ADC and sepsis， there was no significant difference in MA value on day 90 between the survival group and the death group （P>0.05）. ConclusionFor ADC patients comorbid with sepsis， coagulation function assessment and monitoring should be taken seriously in clinical practice， and TEG parameters and SOFA score should be monitored when necessary to develop individualized treatment regimens.

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.

Evaluating the consistency of herb injectable formulations could improve their product quality and clinical safety, particularly concerning the composition and content levels of trace ingredients. Panax notoginseng Saponins Injection (PNSI), widely used in China for treating acute cardiovascular diseases, contains low-abundance (10%-25%) and trace saponins in addition to its five main constituents (notoginsenoside R₁, ginsenoside Rg₁, ginsenoside Re, ginsenoside Rb₁, and ginsenoside Rd). This study aimed to establish a robust analytical method and assess the variability in trace saponin levels within PNSI from different vendors and formulation types. To achieve this, a liquid chromatography-triple quadrupole mass spectrometry (LC-MS/MS) method employing multiple ions monitoring (MIM) was developed. A "post-column valve switching" strategy was implemented to eliminate highly abundant peaks (NR₁, Rg₁, and Re) at 26 min. A total of 51 saponins in PNSI were quantified or relatively quantified using 18 saponin standards, with digoxin as the internal standard. This study evaluated 119 batches of PNSI from seven vendors, revealing significant variability in trace saponin levels among different vendors and formulation types. These findings highlight the importance of consistent content in low-abundance and trace saponins to ensure product control and clinical safety. Standardization of these ingredients is crucial for maintaining the quality and effectiveness of PNSI in treating acute cardiovascular diseases.
Ginsenosides ; Saponins ; Chemometrics ; Panax notoginseng ; Cardiovascular Diseases ; Chromatography, Liquid ; Tandem Mass Spectrometry

Objective To analyze the epidemic characteristics and causes of post-exposure immunization failure of rabies in Hubei Province from 2015 to 2021, and to provide evidence for the prevention and control of rabies in Hubei Province. Methods The investigation data of rabies cases in Hubei Province from 2015 to 2021 were collected, and descriptive epidemiological methods were used for data analysis. Results A total of 127 cases of rabies were reported in Hubei Province from 2015 to 2021, with an average annual incidence of 0.31/million, showing a downward trend. The male to female ratio was 1.70:1. Farmers accounted for 82.67% of the total cases, and the 50-79 years old group accounted for 75.59%. The incidence was mainly concentrated in Xiangyang, Shiyan, Yichang and Jingmen, accounting for 77.17%. Most of the cases were concentrated in summer and autumn. Exposure of grade Ⅱand Ⅲ accounted for 24.79% and 75.21%, respectively. Hands, lower limbs below knee, head, arms and lower limbs above knee accounted for 46.15%, 25.21%, 9.40%, 8.55% and 7.69% of the exposed parts, respectively. Dogs, cats and wild animals accounted for 95.73%, 3.42% and 0.85% of the exposed animals, respectively. Stray animals, domesticated animals, neighbors' animals and wild animals accounted for 41.88%, 37.61%, 19.66% and 0.85% of animal sources, respectively. Neither the neighbors’ animals nor domesticated animals were vaccinated against veterinary rabies virus. After exposure, 8.55% of patients went to medical institutions for standard treatment of wounds, 9.40% were vaccinated with human rabies vaccine, and 4.55% of patients with grade III exposure were injected with rabies virus immunoglobulin. The incubation period within 6 months, from 6 months to 1 year, and over 1 year accounted for 72.22%, 14.74%, and 12.04%, respectively. The exposure degree (Z=-1.98, P < 0.05), exposure site (χ²=10.91, P < 0.05) and wound treatment (χ²=15.73, P < 0.05) had statistically significant effects on the incubation period. Among the 11 cases of post-exposure immunization failure, all were grade Ⅲ exposure, 63.63% were exposed to the head and face, 81.81% were not fully vaccinated with human rabies virus vaccine, 63.63% were not immunized with immunoglobulin, and 27.27% were inappropriate wound treatment. Conclusion The key to rabies prevention and control is to standardize dog management, strengthen rabies education, standardize post-exposure wound treatment, timely vaccinate against rabies virus, and inject rabies virus immunoglobulin when necessary.

Objective:To compare the clinical efficacy of autologous fat injection and conjunctival pedicled orbital septal fat grafting for infraorbital margin depression in young people.Methods:Fourty young patients with lower eyelid pouch and infraorbital margin depression with age of 20 to 40 years and average age of 30.6 yaers in the First Affiliated Hospital of Nanchang University from September 2017 to September 2019 were enrolled. According to the surgical method, all patients were divided into 2 groups with 20 cases each. Group 1 underwent transconjunctival orbital septum fat reset. Group 2 underwent various autologous fat injection after proper amount of orbital septal fat being removed, including structural fat, fine-particle fat and nano-fat, performed in different parts and layers. The tear trough rating scale (TTRS) scores and patients＇ satisfaction at 1 year after operation between 2 groups were compared.Results:Compared with the preoperative TTRS scores, the differences in scores at 6 months and 1 year after surgery were statistically significant ( P<0.01). The scores between two groups were compared at 6 months and 1 year respectively after the operation, and the difference were both statistically significant ( P<0.01). 6 months after the operation, the TTRS scores including four items were carefully compared between the two groups. It showed that the reduction of tear groove depth ( P<0.05), pigmentation ( P<0.01) and wrinkle ( P<0.01) in group 2 were more obvious than those in group 1. The percentage of satisfaction in group 2 (95%) was higher than that in the group 1 (70%), and the difference was statistically significant ( P<0.01). Conclusions:For infraorbital margin depression of young people, after proper amount of orbital septal fat being removed, various free fats graft injection into different parts and layers could obtain better treatment results, reducing not only the depth of the tear groove, but also periorbital pigmentation and fine wrinkles.

The efficient management of wounds is the focus of current research. In addition to conventional wound management and necessary surgery, the role of pro-healing drugs in wound treatment has gradually been emphasized. Platelet-rich blood products that is rich in a variety of biologically active molecules are considered as a low-cost and safe therapy in promoting tissue healing, and have great development prospects in the field of regenerative medicine. However, due to the lack of standard preparation and management and the unstable activities of the biomolecules in them, the therapeutic effects of platelet-rich blood products are uneven. In order to solve these problems, researches related to the protection and delivery of biologically active molecules in platelet-rich blood products by biomaterials have gradually increased in recent years, which is also one of the latest trends in wound treatment research. This article first briefly introduces the types of platelet-rich blood products, then outlines the latest research progress achieved by their combination with biomaterials, and finally summarizes the research progress and future research directions of the combination approach in wound treatment.

Alanine Transaminase ; Amikacin ; Anti-Bacterial Agents ; Aztreonam ; Bilirubin ; Carbapenems ; Ceftazidime ; China ; Creatinine ; Cross Infection ; Escherichia coli ; Fibrosis ; Fungi ; Gram-Negative Bacteria ; Gram-Positive Bacteria ; Hemorrhage ; Hospitals, Teaching ; Humans ; International Normalized Ratio ; Klebsiella pneumoniae ; Length of Stay ; Leukocyte Count ; Linezolid ; Methicillin-Resistant Staphylococcus aureus ; Mortality ; Multivariate Analysis ; Prevalence ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors ; Vancomycin

Objective To analyze the correlation between P73 gene G4C14-to-A4T14 double nucleotide polymorphism and the risk of lung cancer in Guangdong population. Methods Genotype analysis of P73 gene polymorphism in peripheral blood of 642 patients with lung cancers (including 450 NSCLC patients and 192 SCLC patients) and 354 normal controls was performed with HRM method (high-resolution fusion curve). Results HRM genotyping results showed that the distribution of P73 genotypes in 450 NSCLC patients was as follows: GC/GC 280 (62.3%), GC/AT 155 (34.4%), and AT/AT 15 (3.3%). P73 genotypes in 192 SCLC patients were 118 GC/GC (61.5%), 67 GC/AT (34.9%) and 7 AT/AT (3.6%). The P73 genotypes of 354 normal controls were 192 GC/GC (53.1%), 136 GC/AT (38.5%), and 26 AT/AT (8.4%). AT/AT homozygous genotypes significantly reduced the risk of NSCLC (OR=0.393；95% CI:0.037-0.873；P=0.001) and SCLC (OR=0.428；95%CI:0.050-0.880；P<0.001) compared with non-carriers. Conclusion The results of the present study indicated that the polymorphism of P73 G4C14-A4T14 may be a modification factor for the susceptibility of lung cancer in Guangdong province, and the increased GC content in the P73 gene may increase the risk of lung cancer.

Objective:To investigate the application value of new urinary biomarkers insulin-like growth factor binding protein 7 (IGFBP7) and tissue matrix metalloproteinase inhibitor-2 (TIMP-2) in acute kidney injury with decompensated hepatitis B virus-related liver cirrhosis.Methods:45 newly hospitalized cases with decompensated hepatitis B virus-related liver cirrhosis were selected. Among them, 19 cases were combined with AKI on admission (cirrhosis-AKI group), 26 cases without AKI (cirrhosis-non-AKI group), and 12 healthy cases (normal control group). First-morning urine samples were collected and IGFBP7 and TIMP-2 were detected by enzyme-linked immunosorbent assay (ELISA). Urinary IGFBP7 and serum creatinine (SCr) were dynamically monitored after hospitalization in cirrhosis-non-AKI group. Normally distributed measurement data were compared by t-test, and non-normally distributed measurement data were compared by rank sum test. The receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to evaluate the diagnostic accuracy of the indicators.Results:Urinary IGFBP7, IGFBP7 with TIMP-2 (IGFBP7×TIMP-2) in cirrhosis-AKI group ( n = 19) were equally higher than that of the cirrhosis-non-AKI group ( P < 0.05). Urinary IGFBP7, TIMP-2 and IGFBP7×TIMP-2 in cirrhosis-AKI group or cirrhosis-non-AKI group were significantly higher than those of the normal control group ( P < 0.01). The AUC of urinary IGFBP7 and urinary IGFBP7×TIMP-2 for diagnosis of AKI were 0.703 (95% CI 0.547-0.860) and 0.700 (95% CI 0.541-0.859), respectively. In the liver cirrhosis-non-AKI group ( n = 26), 5 cases of AKI were newly diagnosed according to the changes in SCr during hospitalization (progressive group). Urinary IGFBP7 was significantly increased 2 days before the diagnosis of AKI. The concentration of urinary IGFBP7 at admission in the progressive group ( n = 5) was higher than that of the non-progressive group ( n = 21) ( P < 0.05). Conclusion:Urinary IGFBP7 and TIMP-2 concentrations were significantly increased in patients with decompensated hepatitis B virus-related liver cirrhosis. When AKI occurred, urinary IGFBP7 and IGFBP7×TIMP-2 was further increased. Urinary IGFBP7 is valuable for early AKI diagnosis, and may play a role in predicting AKI occurrence.

Twenty-one protostane-type triterpenoids with diverse structures, including nine new compounds (-), were isolated from the of Linn. Structurally, alisolides A‒F (-), composed of an oxole group coupled to a five-membered ring, represent unusual C-17 spirost protostane-type triterpenoids. Alisolide H () is a novel triterpenoid with an unreported endoperoxide bridge. Alisolide I () represents the first example of 23,24-acetal triterpenoid. Their structures were elucidated based on spectroscopic analysis, wherein the absolute configurations of ‒, were further confirmed by the Mo(OAc)-induced ECD method. Furthermore, all isolates were evaluated for their inhibitory effects on LPS-induced NO production in Caco-2 cells, and all the compounds showed remarkable inhibitory activities, with IC values in the range of 0.76-38.20 μmol/L.