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 insulin-like growth factor 2 mRNA binding protein 2 (IGF2BP2) on the proliferation, migration and tumor immune microenvironment of colorectal cancer cells and its possible molecular mechanism. Methods The Cancer Genome Atlas (TCGA) database was used to analyze the expression levels of IGF2BP2 and MYC in colorectal cancer and adjacent tissues. The expression of IGF2BP2 in HCT-116 and SW480 human colorectal cancer cells was silenced by RNA interference (RNAi), and the silencing effect was detected by quantitative real-time PCR. After knocking down IGF2BP2, colony formation assay, CCK-8 assay and 5-ethynyl-2'-deoxyuridine (EdU) assay were employed to detect cell colony formation and proliferation ability. Transwell^TM assay was used to detect cell migration ability. Quantitative real-time PCR was used to detect the mRNA expression of IGF2BP2, MYC, tumor necrosis factor-α (TNF-α), transforming growth factor-β (TGF-β) and interleukin-10 (IL-10). The protein expression of IGF2BP2 and MYC was detected by western blot. The binding ability of IGF2BP2 and MYC in HCT-116 cells was detected by quantitative real-time PCR after RNA immunoprecipitation. Results The results of TCGA database showed that the expression of IGF2BP2 and MYC in colorectal cancer tissues was significantly higher than that in adjacent tissues, and the survival time of colorectal cancer patients with high expression of IGF2BP2 was shorter. After silencing IGF2BP2, the viability, proliferation and migration of HCT-116 and SW480 cells were decreased. The mRNA expression of MYC, TGF-β and IL-10 in IGF2BP2 knockdown group was significantly decreased, while the expression of TNF-α mRNA was increased. The expression of MYC protein and the stability of MYC mRNA were significantly decreased. RIP-qPCR results showed that IGF2BP2 could bind to MYC mRNA. Conclusion Knockdown of IGF2BP2 inhibits colorectal cancer cell proliferation, migration and promotes tumor immunity by down-regulating MYC expression.
Humans ; Cell Line, Tumor ; Cell Movement/genetics* ; Cell Proliferation/genetics* ; Colorectal Neoplasms/metabolism* ; Gene Expression Regulation, Neoplastic ; Interleukin-10/metabolism* ; RNA, Messenger ; RNA-Binding Proteins/metabolism* ; Transforming Growth Factor beta/genetics* ; Tumor Microenvironment/immunology* ; Tumor Necrosis Factor-alpha/metabolism* ; Proto-Oncogene Proteins c-myc/metabolism*

OBJECTIVE: To investigate the effects of Naoluo Xintong Decoction (NLXTD) on pyroptosis and angiogenesis of brain microvascular endothelial cells (BMECs) and explore the possible mechanisms in rats with oxygen-glucose deprivation/ reperfusion (OGD/R). METHODS: Rat BMECs with or without caspase-1 siRNA transfection were cultured in the presence of 10% medicated serum from NLXTD-treated rats (or blank serum) and exposed to OGD/R. CCK-8 assay, Transwell chamber assay, and tube formation assay were used to assess proliferation, migration, and tube-forming abilities of the cells. The activity of lactate dehydrogenase (LDH) in the culture supernatant was determined using a commercial assay kit, and the levels of inflammatory factors IL-1β and IL-18 were detected with ELISA. The cellular expressions of pro-caspase-1, caspase-1, NLRP3, Gasdermin D, and angiogenesis-related proteins VEGF and VEGFR2 were detected using Western blotting. RESULTS: The BMECs showed obvious injuries after OGD/R exposure. Compared with the blank serum, the medicated serum significantly improved the cell viability, migration ability, and lumen-forming ability (P < 0.01) and lowered the levels of IL-1β and IL-18 and the LDH release (P < 0.01) of the cells with OGD/R exposure. Western blotting showed that in the BMECs exposed to OGD/R, the medicated serum strongly upregulated the expression of VEGF and VEGFR2 proteins (P < 0.01) and reduced the protein expressions of pro-caspase-1, caspase-1, NLRP3, and Gasdermin D (P < 0.01), and transfection of the cells with caspase-1 siRNA further promoted the expressions of VEGFR2 protein in the cells (P < 0.01). CONCLUSION NLXTD can improve the proliferation, migration, and tube- forming ability and promote angiogenesis of BMECs with OGD/R injury probably by inhibiting the caspase-1/Gasdermin D pathway in pyroptosis, alleviating cell injury, and upregulating the expressions of VEGF and VEGFR2.
Animals ; Rats ; Endothelial Cells ; Caspase 1 ; Gasdermins ; Interleukin-18 ; NLR Family, Pyrin Domain-Containing 3 Protein ; Vascular Endothelial Growth Factor A ; Reperfusion Injury ; Brain ; Angiogenic Proteins ; Glucose

Objective:To explore the effect of atlantoaxial fusion on the growth and development of children′s cervical spine.Methods:The clinical data of 12 children with atlantoaxial dislocation who underwent posterior atlantoaxial fusion at Department of Orthopaedics,the 909th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army from June 2002 to September 2013 were retrospective analyzed. There were 7 males and 5 females,with age of (8.1±3.1)years (range:3 to 13 years).Nine cases were traumatic and 3 cases were congenital malformations,1 of the children had Down syndrome. All children underwent posterior atlantoaxial fusion. Furthermore,the information of the height and anteroposterior width of the cervical vertebral bodies and vertical growth rate of the fusion mass were collected from all patients immediately postoperatively and during the follow-up.The range of motion in cervical spine were collected preoperatively and during follow-up period. Data were compared using independent sample t test, paired sample t test and repeated-measurement. Results:All 12 children had regular follow-up within (122.4±25.3)months(range:65 to 163 months). The height and anteroposterior width of the cervical vertebral bodies were similar to these results with those in published reports of growth in normal children of the same age(all P<0.01). At the last follow-up,atlantoaxial fusion of 11 cases had substantial growth (vertical growth rate of the fusion mass:11 cases ≥10%, 1 case <10%);the range of motion in cervical spine was close to the normal level (flexion(55.2±5.0)°,extension (65.3±4.9)°,left bending (41.7±4.5)°,right bending (42.4±4.4)°,left rotation (66.4±5.6)°,right rotation (68.5±5.8)°). Conclusions:Atlantoaxial fusion surgery is satisfactory in the treatment of pediatric atlantoaxial dislocation.During the follow-up,the growth and development of the cervical spine is close to that of normal children of the same age.In long-term observation,it has been found that the operation has no negative effect on the growth and development of the children′s cervical spine.

Objective:To explore the effect of atlantoaxial fusion on the growth and development of children′s cervical spine.Methods:The clinical data of 12 children with atlantoaxial dislocation who underwent posterior atlantoaxial fusion at Department of Orthopaedics,the 909th Hospital of Joint Logistics Support Force of Chinese People's Liberation Army from June 2002 to September 2013 were retrospective analyzed. There were 7 males and 5 females,with age of (8.1±3.1)years (range:3 to 13 years).Nine cases were traumatic and 3 cases were congenital malformations,1 of the children had Down syndrome. All children underwent posterior atlantoaxial fusion. Furthermore,the information of the height and anteroposterior width of the cervical vertebral bodies and vertical growth rate of the fusion mass were collected from all patients immediately postoperatively and during the follow-up.The range of motion in cervical spine were collected preoperatively and during follow-up period. Data were compared using independent sample t test, paired sample t test and repeated-measurement. Results:All 12 children had regular follow-up within (122.4±25.3)months(range:65 to 163 months). The height and anteroposterior width of the cervical vertebral bodies were similar to these results with those in published reports of growth in normal children of the same age(all P<0.01). At the last follow-up,atlantoaxial fusion of 11 cases had substantial growth (vertical growth rate of the fusion mass:11 cases ≥10%, 1 case <10%);the range of motion in cervical spine was close to the normal level (flexion(55.2±5.0)°,extension (65.3±4.9)°,left bending (41.7±4.5)°,right bending (42.4±4.4)°,left rotation (66.4±5.6)°,right rotation (68.5±5.8)°). Conclusions:Atlantoaxial fusion surgery is satisfactory in the treatment of pediatric atlantoaxial dislocation.During the follow-up,the growth and development of the cervical spine is close to that of normal children of the same age.In long-term observation,it has been found that the operation has no negative effect on the growth and development of the children′s cervical spine.

Betacoronavirus ; Coronavirus Infections ; Humans ; Pandemics ; Pneumonia, Viral ; Single-Cell Analysis

Objective:To explore the pathogenesis and treatment of severe hematuria after sexual activity in men.Methods:A retrospective analysis of 10 patients with severe hematuria after sexual activity who were admitted from January 2017 to January 2020, including 4 cases from Peking University People’s Hospital, 3 cases from Donghua Hospital Affiliated to Sun Yat-sen University, 2 cases from Second Hospital of Tianjin Medical University, and 1 case from Tianjin Jinnan Hospital. The average age of the patients was (33.5±7.6) years old. All 10 cases had severe hematuria and blood clots within 1 hour after sexual activity. The blood routine examination revealed that there were different degrees of hemorrhagic anemia after 24 hours of admission, and the average hemoglobin was(95.8±8.9)g/L. Ten patients underwent transurethral cystoscopy electrosurgical resection and / or electrocoagulation under subarachnoid anesthesia or epidural anesthesia. All patients were confirmed to be bleeding from posterior urethral lesions, including 4 cases located in the distal seminal caruncle, 5 cases in the prostate, and 1 case in proximal seminal caruncle. Three cases whose bleeding from varicose veins in the prostate urethra were treated with electrocoagulation in order to stop the bleeding, and lesions were removed in the other 7 cases for pathological examination. The F16 urinary catheter was indwelt after the operation.Results:All 10 operations in this group were successfully completed. Six cases of posterior urethral hemangioma rupture and 1 case of posterior urethral polyp were confirmed by the pathological examination in 7 cases. The urinary catheter was successfully removed 1 week after operation. Abstinence was required for 1 month after operation. There was no recurrence of hematuria after resuming sexual activity, and no complications such as dysuria or urinary incontinence.Conclusion:Severe hematuria after sexual activity is mostly caused by rupture or bleeding of abnormal blood vessels in the posterior urethra. Transurethral resection and/or electrocoagulation are the first choice for treatment. The effect is reliable and the prognosis is satisfactory.

[Abstract ] Objective At present, few studies are reported on procalciton (PCT) and endotoxin (ET) in the diagnosis of urosepsis after percutaneous nephrolithotomy ( PCNL) .The purpose of this study was to investigate the clinical value of the detection of serum procalcitonin and endotoxin in the early diagnosis of urosepsis after PCNL . Methods We retrospectively analyzed the clinical data about 427 cases of upper urinary tract stones treated by PCNL , among which urosepsis developed postoperatively in 49 ( the urosepsis group ) and the other 378 non-urosepsis cases served as controls .At 1 day and 2 hours before PCNL , we detected the levels of serum ET and PCT and analyzed the PCT and ET levels and the results of combined detection in the two groups of patients using the ROC curve. Results At 2 hours before surgery , both the levels of PCT and ET were significantly higher in the urosepsis group than in the non-urosepsis controls ([ 5.18 ±4.43 ] vs [ 1.38 ±1.01 ] ng/mL, P<0.01;[50.91 ±35.45] vs [17.86 ±10.78] pg/mL, P<0.01).ROC curve analyses manifested that the areas under the curve (AUC) of PCT and ET were 0.841 ±0.038 and 0.786 ± 0.043, their sensitivities were 79.6%and 71.4%, and their specificities were 78.0%and 70.1%, respectively.The combined de-tection showed the AUC, sensitivity, and specificity to be 0.915 ±0.029, 85.7%, and 86.5%, respectively, all significantly higher than either PCT or ET detection alone (P<0.01). Conclusion The combined detection of PCT and ET can significantly increase the sensitivity and specificity of early diagnosis of urosepsis after PCNL and is superior to either PCT or ET detection alone .

Objective To develop a special stool collector for paraplegic patients with constipation,and to observe the clinical effects. Methods 52 paraplegic patients with constipation were divided into group A(30 cases) and group B(22 cases ).Group A used type one stool collector and goup B chose type two stool collector. The time of dealing with defecation, exposure time, pollution area, the usage of urinal pad, toilet paper, clean water before and after the special toilets were observed between the two groups. Results Each indicator significantly changed after using two types of stool collectors in the two groups of patients and above were significantly decreased. Conclusions The special stool collector for the paraplegic patients with constipation can effectively avoid the soakage of the anal and buttocks skin, reduce the environment pollution of the odor, reduce labor intensity and lower care costs.

BACKGROUND: The water molecules and biological macromolecules in human tissue may combine to form hydrate composite. Different types of macromolecules show different approaches to combine with water molecules. OBJECTIVE: To discuss the basic form of water molecules combined with biological macromolecules. METHODS: The theoretical hypothesis of texture composite hydration system was proposed. The relevant literatures were retrieved through the computer to discuss these issues. RESULTS AND CONCLUSION: According to the role of water in the hydrate composite, the composite ways can be divided into the following 4 groups. ①Surfaca composite: Hydrated membrane layers can form on the surface of globular protein or DNA molecules. The hydrated membrane layer shows that the speed of water molecular and hydrate density were reduced gradually from surface to inside. The hydrated layer makes the shape and physical state of the macromolecules stabilized, and it plays important role in forming of TCHS.②Swelling composite: As a result of the strong hydration of glycosaminoglycans, the hydrated proteoglycan often swells and shows high viscosity and hydrogel character. The hydrated proteoglycan play some mechanicalroles in connective tissue. For example, it can make the cartilage have a strong deformation-resistibility.③Hydrophobic composite: Hydr0phobic effect drives structural rearrangement, including the formation of bilayers (Bio-membrane). This hydrophilic-hydrophobic-hydrophilic "sandwich" structure is conducive to the self-stability in mechanics, combination with membrane protein and transmembrane transport. ④Slit composite: A lot of slit spaces with nano scale were existing inside and outside of the cells. Aqueous solution in the slit spaces shows some abnormal characters such as higher viscosity and lower ice point, because of the rearrangement of water molecules. Slit composite and surface composite have some universality, and it can be regarded the former as a special case of the latter. The classification way mentioned above has not any absolute connotations. However, the rational utilization of these hydration composite ways will be conducive to research the theory on textural composite hydrate system.