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 investigate the effect of left bundle branch area pacing(LBBaP)on new-onset atrial fibrillation(NOAF)and atrial high rate episodes(AHREs)in patients with atrioventricular block(AVB).Methods Eighty-four patients with Ⅲ°AVB for pacemaker implantaion were divided into the LBBaP group(n=42)and the RVSP group(n=42)based on the site of the ventricular leads.The two groupswere compared in terms of the pre-and post-operative QRSd,ventricular pacing parameters,complications,incidence of stroke,NOAF and AHREs.Results(1)The incidence of postoperative NOAF and AHREs in the LBBaP group was significantly lower compared with RVSP group(P<0.05).(2)The p-QRSd in the LBBaP group was significantly shorter compared with RVSP group(P<0.05).(3)The two groups showed no significant differences in ventricular pacing parameters,incidence of complications and stroke events(P>0.05).Conclusion LBBaP is superior to right ventricular pacing in reducing the incidence of postoperative AHREs and NOAF in patients after implantation and improving the prognosis of patients.

TSCI have dyskinesia and sensory disturbance that can cause various life-threaten complications. The patients with traumatic spinal cord injury (TSCI), seriously affecting the quality of life of patients. Based on the epidemiology of TSCI and domestic and foreign literatures as well as expert investigations, this expert consensus reviews the definition, injury classification, rehabilitation assessment, rehabilitation strategies and rehabilitation measures of TSCI so as to provide early standardized rehabilitation treatment methods for TSCI.

The monitoring of total toxicity of water is of great importance to guarantee the safety of drinking water and estimate the level of water pollution from multiple pollutants.Here, we reported an online equipment for monitoring toxicity of water, where in-site cultured microorganisms were used as the test organism and respiratory inhibition of microorganisms was regarded as the toxicity response.A three-electrode electrochemical detector was integrated in the equipment, where an array electrode composed of microsized Pt disks, a Ag/AgCl (3 mol/L KCl) electrode and a gold wire were used as the working, reference and counter electrodes, respectively.The average respiratory inhibition ratios obtained with this equipment for 5.0, 10.0, 20.0 mg/L 3,5-dichlorophenol (DCP) were 24.4%, 48.9% and 59.2%, respectively.The equipment was further used for continuous online monitoring of the total toxicity of underground water, and successfully showed the toxicity alarm when challenged randomly by toxicity samples containing 5.0 mg/L DCP.The present results suggested the good promise of the equipment in online monitoring of water total toxicity.

A buofulm reactor ( BFR ) was fabrucated vua a cultuvatuon process usung naturally occurrung mucrobual seeds from locally collected wastewaters, and a serues of researches were carrued out wuth thus BFR based onlune Buochemucal Oxygen Demand ( BOD) monutor. The results showed that the BFR cultuvatuon tume was less than 14 h, and the buodegradatuon effucuencues was 18. 5%. The munumum detectuon lumut was 0. 5 mg/L, as well as the upper detectuon lumut was 20 mg/L. The relatuve error and relatuve standard devuatuon un accuracy and long term stabuluty to standard were -0. 8% and ±3. 2%, respectuvely. The real sample determunatuons showed an average relatuve error of +5. 6% to conventuonal BOD5 method. The BFR mauntauned a good performance un long term stabuluty and accuracy durung thus test peruod, and the broad lunear range ensured the demand for surface water onlune monutorung.

OBJECTIVETo systematically review whether statins can reduce the risk of infection and infection-related mortality.

METHODSWe searched the Cochrane Library, MEDLINE, EMBASE, PubMed, Elsevier and CBM databases for randomized placebo-controlled trials of statins published by September 2013, and each trial enrolled at least 100 participants with follow-up for at least 4 weeks. Two reviewers independently assessed the quality of the included studies and extracted the relevant data for analysis using Stata 12.0 software.

RESULTSSixteen trails involving a total of 48973 patients were included in our meta-analysis. The results showed that statins significantly reduced the risk of infection (OR=0.93, 95% CI 0.89 to 0.98, P=0.004) compared to placebo but did not significantly lower infection-related mortality (OR=0.96, 95% CI 0.82 to 1.12, P=0.592).

CONCLUSIONStatins can significantly reduce the risk of infection but does not lower infection-related mortality.

Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; therapeutic use ; Infection ; epidemiology ; mortality ; Randomized Controlled Trials as Topic ; Risk Factors

Objective To systematically review whether statins can reduce the risk of infection and infection-related mortality. Methods We searched the Cochrane Library, MEDLINE, EMBASE, PubMed, Elsevier and CBM databases for randomized placebo-controlled trials of statins published by September 2013, and each trial enrolled at least 100 participants with follow-up for at least 4 weeks. Two reviewers independently assessed the quality of the included studies and extracted the relevant data for analysis using Stata 12.0 software. Results Sixteen trails involving a total of 48973 patients were included in our meta-analysis. The results showed that statins significantly reduced the risk of infection (OR=0.93, 95% CI 0.89 to 0.98, P=0.004) compared to placebo but did not significantly lower infection-related mortality (OR=0.96, 95% CI 0.82 to 1.12, P=0.592). Conclusion Statins can significantly reduce the risk of infection but does not lower infection-related mortality.

Objective To systematically review whether statins can reduce the risk of infection and infection-related mortality. Methods We searched the Cochrane Library, MEDLINE, EMBASE, PubMed, Elsevier and CBM databases for randomized placebo-controlled trials of statins published by September 2013, and each trial enrolled at least 100 participants with follow-up for at least 4 weeks. Two reviewers independently assessed the quality of the included studies and extracted the relevant data for analysis using Stata 12.0 software. Results Sixteen trails involving a total of 48973 patients were included in our meta-analysis. The results showed that statins significantly reduced the risk of infection (OR=0.93, 95% CI 0.89 to 0.98, P=0.004) compared to placebo but did not significantly lower infection-related mortality (OR=0.96, 95% CI 0.82 to 1.12, P=0.592). Conclusion Statins can significantly reduce the risk of infection but does not lower infection-related mortality.

OBJECTIVETo examine the correlation of the changes in the serum markers (C-reactive protein, endothelin-1, interleukin-6, and brain natriuretic peptide) with chronic obstructive pulmonary disease (COPD) and pulmonary hypertension secondary to COPD.

METHODSA total of 174 COPD patients with acute exacerbation, admitted between February 2011 and February, 2013, were enrolled in this study, with 43 volunteers with normal pulmonary functions as controls. Pulmonary arterial pressure was determined by Doppler echocardiograph, and the severities (mild, moderate and severe) of PH secondary to COPD was evaluated. The levels of serum markers were determined using ELISA kits.

RESULTSThe levels of serum markers in patients with COPD was significantly elevated compared with those of the control subjects (P<0.05), and further increased in patients with pulmonary hypertension secondary to COPD (P<0.05). A positive correlation was found between these serum markers and pulmonary artery pressure in COPD patients with mild and moderate pulmonary hypertension. In patients with severe pulmonary hypertension, only the serum level of brain natriuretic peptide continued to increase with pulmonary artery pressure (P<0.05), and the other markers did not further increase.

CONCLUSIONSEarly and combined examination of these serum markers in patients with COPD can help to identify pulmonary hypertension in early stage and estimate the severity of pulmonary hypertension. Hemodynamic monitoring of the changes of these serum markers can be of important clinical value in the treatment of pulmonary hypertension secondary to COPD and in evaluation of the prognosis of COPD.

Aged ; Biomarkers ; blood ; Blood Pressure ; C-Reactive Protein ; metabolism ; Endothelin-1 ; blood ; Female ; Humans ; Hypertension, Pulmonary ; blood ; complications ; physiopathology ; Interleukin-6 ; blood ; Male ; Natriuretic Peptide, Brain ; blood ; Pulmonary Disease, Chronic Obstructive ; blood ; complications ; physiopathology

OBJECTIVETo examine whether calcineurin/NFAT signaling pathway mediates endothelin-1 (ET-1)-induced proliferation of pulmonary artery smooth muscle cells (PASMCs) by regulating phosphodiesterase-5 (PDE5) and the effect of the selective calcineurin inhibitor cyclosporine A and PDE5 inhibitor sildenafil on ET-1-induced PASMC proliferation.

METHODSPASMCs were treated with ET-1 to stimulate their proliferation with or without prior treatment of the cells with CsA or sildenafil. Calcineurin activity in the cells was measured using a calcineurin activity assay kit, PDE5 expression examined using immunoblotting, and cGMP level detected using a cGMP direct immunoassay kit. PASMC proliferation following the treatments was determined using [(3)H]thymidine incorporation assay.

RESULTSET-1 caused a 2.05-fold increase in the cellular calcineurin activity, a 1.80-fold increase in PDE5 expression, and a 3.20-fold increase in the DNA synthesis rate, and reduced the cGMP level by 67%. Pretreatment of the cells with Cyclosporine blocked the effects of ET-1, and PDE5 inhibition by sildenafil pretreatment also abolished ET-1-induced reduction of cGMP level in the cells. Both Cyclosporine and sildenafil suppressed ET-1-stimulated PASMC proliferation.

CONCLUSIONActivation of calcineurin/NFAT signaling pathway mediates ET-1-induced PASMC proliferation by stimulating PDE5 expression, which further degrades cGMP. Both Cyclosporine and sildenafil can suppress ET-1-stimulated PASMC proliferation in vitro.

Animals ; Calcineurin ; metabolism ; Cell Proliferation ; drug effects ; Cells, Cultured ; Cyclic GMP ; metabolism ; Cyclic Nucleotide Phosphodiesterases, Type 5 ; metabolism ; Cyclosporine ; DNA ; biosynthesis ; Endothelin-1 ; pharmacology ; Muscle, Smooth, Vascular ; cytology ; Myocytes, Smooth Muscle ; cytology ; enzymology ; NFATC Transcription Factors ; metabolism ; Piperazines ; Pulmonary Artery ; cytology ; Purines ; Rats ; Rats, Sprague-Dawley ; Signal Transduction ; Sildenafil Citrate ; Sulfones