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.

Primary central nervous system lymphoma (PCNSL) is a rare and aggressive non-Hodgkin’s lymphoma that affects the brain, eyes, cerebrospinal fluid, or spinal cord without systemic involvement. The outcome of patients with PCNSL is worse compared to patients with systemic diffuse large B-cell lymphoma. Given potential mortality associated with severe immune effector cell-associated neurotoxicity syndrome (ICANS), patients with PCNSL have been excluded from most clinical trials involving chimeric antigen receptor T-cell (CAR-T) therapy initially. Here, we report for the first time to apply decitabine-primed tandem CD19/CD22 dual-targeted CAR-T therapy with programmed cell death-1 (PD-1) and Bruton’s tyrosine kinase (BTK) inhibitors maintenance in one patient with multiline-resistant refractory PCNSL and the patient has maintained complete remission (CR) for a 35-month follow-up period. This case represents the first successful treatment of multiline resistant refractory PCNSL with long-term CR and without inducing ICANS under tandem CD19/CD22 bispecific CAR-T therapy followed by maintenance therapy with PD-1 and BTK inhibitors. This study shows tremendous potential in the treatment of PCNSL and offers a look toward ongoing clinical studies.

Objective To investigate micro-inflammatory state and protein-energy wasting (PEW) states in maintenance peritoneal dialysis(MPD) patients,then analysis of the correlation between them.Methods Ninty-six cases of MPD patients in this Hospital were selected from March 2012 to September 2015.The status of nutrition were assessed by Quantitative Subjective and global Assessment(SGA),malnutrition-inflammation score(MIS) and albumin(Alb),micro-inflammatory state was assessed by enzyme-linked immunoassay(ELISA) method serum hypersensitive c-reactive protein (hs-CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6).At the same time,various serological markers like serum Alb,serum total protein(TP),serum prealbumin(PA),hemoglobin(Hb),transferrin(TF),serum creatinine(Scr),urea nitrogen(BUN),cholesterol(Teh) were measured.Results The incidence of PEW in MPD patients was 36.50％,among which 62.86 ％ of them were over 65 years old,57.10％ were over 2 years of dialysis time and 40.00％ with diabetic nephropathy.MPD patients with hs-CRP＞5 mg/L accounted for 58.33％,of which over 65 year old accounted for 42.86％,MPD age longer than 2 years accounted for 60.71％,32.14％ of them with diabetic nephropathy.The proportion of diabetic nephropathy,average age,dialysis duration time,hs-CRP,TNF-α and IL-6 in PEW group were higher than non-PEW group(P＜0.05);BM,TP,Alb,PA,Hb,TCh,MAC and MAMC were lower ban non-PEW group(P＜0.05).Compared with the hs-CRP≤5 mg/L group,average age,the time of dialysis duration,TNF-α,IL-6 were higher and TP,Alb,PA,TF,Hb,the proportion of Kt/V≥1.72 were lower in the hs-CRP＞5 mg/L group.After the correction of age,sex,dialysis ages,it was found that the level of hs-CRP in MPD patients was negatively correlated with the level of Alb,PA,TF,Tch,Scr,TG;The level of IL-6 was negatively correlated with the levels of Alb,PA,TF,Tch,TG.The level of TNF-α in MPD patients showed different degrees of negative correlation with the leves of Alb,PA,TF,TG,Tch(all P＜0.05).Multivariate analysis showed that elderly,the time of dialysis duration,the microinflammatory state,and hypoalbuminemia were the independent risk factors of PEW.Conclusion PEW and micro-inflammatory state are very common in PHD patients.Patients with longer duration of dialysis,elderly or associated with diabetic nephropathy are more likely to suffer PEW and micro-inflammatory.Elderly,the time of dialysis duration,microinflammatory state,hypoalbuminemia are the independent risk factors of PEW.

Objective To discuss the effect of mind map combined with physical care in the prevention and treatment of stroke for elderly patients with hypertensionin community.Methods A total of 100 cases of elderly patients with hypertension from March to September 2015 who met the inclusion criteria were included in the study. According to random numbers generated by the computer, patients were randomly divided into intervention group and control group, 50 cases respectively. The two groups were followed up routinely. Patients in the intervention group were guided by the mind map combined with physical care. The mind map was made and designed to assess the patient's constitution. Individualized health guidance was developed according to the patient's physique identification. The intervention time was 24 weeks. The self-management behavior,systolic blood pressure, diastolic blood pressure, biased syndrome, and stroke morbidity before and after the intervention were compared between the two groups.Results Before the intervention, there were no significant differences in self-management behavior, systolic blood pressure, diastolic blood pressure, biased syndrome and stroke morbidity between the two groups (P>0.05). After the intervention, dietetic adjust and nursing, sports health, emotion transfer, daily life transfer, regularly blood pressure checking in the intervention group were significantly better than those in the control group; and the scores of self-management behavior increased compared with those before the intervention; BMI, systolic blood pressure, diastolic blood pressure, and biased syndrome score were significantly lower than those in the control group and before the intervention; Control rate of blood pressure was 78% in the intervention group, which was significantly higher than that in the control group (46%) (P<0.05). The incidence of stroke was 20% in the intervention group, which was lower than that in the control group (40%), with no statistically significant difference between the two groups (P>0.05). Conclusions Mind map combined with physical care can improve the self-management behavior of patients with hypertension in the community, and reduce diastolic blood pressure, systolic blood pressure and biased syndrome. However, the effect in the prevention of stroke requires further investigations.

OBJECTIVE: To explore the molecular mechanism of human corpus myometrium contraction related proteins and parturition. METHODS: The proteins of human corpus of myometrium tissues from full term non-in labor (38- 41 weeks amenorrhea) and full term in labor (38-41 weeks amenorrhea) gravidas were separated by 2-dimensional gel electrophoresis (2-GE), respectively. Then gels were stained by Coomassie brilliant blue G250, scanned by Image scanner and analyzed with PDQuest software. The differentially expressed protein spots of corpus myometrium between the 2 groups were identified by peptide mass finger print based on matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF-MS) and database searching. Three identified differentially expressed proteins were confirmed by Western blot. RESULTS: Well resolved and reproducible 2D-GE maps of human corpus myometrium from non-in labor and in-labor gravidas were acquired. Twenty more than 2-fold differentially expressed protein spots were identified by MALDI-TOF-MS. These proteins were involved in cell structure, calcium binding, chaperone, energy metabolism, signal transduction, and antioxidant. CONCLUSION Twenty contraction related proteins of human corpus myometrium have been identified, indicating that cell structure and calcium-binding are important reasons for the contraction of human corpus myometrium.
Blotting, Western ; Electrophoresis, Gel, Two-Dimensional ; Female ; Humans ; Labor, Obstetric ; physiology ; Mass Spectrometry ; Muscle Contraction ; Muscle Proteins ; analysis ; Myometrium ; physiology ; Pregnancy ; Proteomics ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization

Objective To investigate the expression of HIF-1α protein in the placenta bed and the concentration of von Willrand factor (vWF) in maternal peripheral blood from pre-eclampsia and normal pregnancy, and to determine the effect of HIF-1α and vWF on the pathogenesis of pre-eclampsia. Methods Forty pre-eclampsia patients (20 mild and 20 severe) were recruited as 2 study groups, and another 20 normal pregnant women were served as a normal group.Western blot was used to detect the expression of HIF-1α protein in the placenta bed. ELISA was adopted to detect the concentration of vWF in the maternal peripheral blood.Correlation between HIF-1α protein expression and vWF level was analyzed by Spearman method.Results The expression of HIF-1α protein in the placenta bed was the highest in the severe pre-eclampsia patients among 3 groups, followed by the mild pre-eclampsia patients and the normal controls.There was significant difference (among) 3 groups (P＜0.001).The concentration of vWF in the maternal peripheral blood was the highest in the severe pre-eclampsia patients, followed by the mild pre-eclampsia patients and the normal controls.There was significant difference among the 3 groups (P＜0.05). Postive correlation was found between the expression of HIF-1α protein in the placenta bed and the concentration of vWF in the maternal peripheral blood in patients with pre-eclampsia (r_1=(0.65,) P＜(0.001)),and between the concentration of vWF in the maternal peripheral blood and the pathogenetic condition degree of pre-eclampsia (r_2=(0.61,)P＜0.001).Conclusion HIF-1α in coordination with vWF may play an important role in the pathogenesis of pre-eclampsia.

OBJECTIVE: To investigate the expression of Calponin-1 and Transgenlin in the uterine smooth muscles during normal labor on-sets, and to evaluate their effect on initiating the normal labor. METHODS: A total of 14 uterine bodies and lower segments of human pregnancy were divided to a non-labor group (NIL) and a labor group(IL). Immunohistochemical technology and Western blot were used to determine the expression of Calponin-1 and Transgelin in the 2 groups. RESULTS: Immunohistochemical detection and Western blot showed that Calponin-1 protein in the uterine smooth muscle tissue of the body and the lower uterine segment of smooth muscle tissues had significant difference (P<0.05). The expression of Transgelin in the uterine body smooth muscle tissue in the IL was higher than that in the NIL(P<0.05). In the lower uterine segments of the smooth muscle, the expression of Transgelin was not significantly different in the 2 groups (P>0.05). CONCLUSION Calponin-1 of the uterine smooth muscle and Transgelin of the uterine body smooth muscle may involve in the regulation of uterine smooth muscle contractility, which is closely related to child birth launch.
Adult ; Calcium-Binding Proteins ; genetics ; metabolism ; Female ; Humans ; Labor Onset ; metabolism ; Microfilament Proteins ; genetics ; metabolism ; Muscle Proteins ; genetics ; metabolism ; Myometrium ; metabolism ; Pregnancy ; Uterine Contraction ; metabolism

Objective To investigate the effect of Calponin-1 suppression on human myometrium cells through adenovirus mediated siRNA. Methods Human uterine smooth muscle tissues were digested with enzymes, cultured and confirmed with immunocytochemistry. Aadenovirus siRNA-Calponin-1 plasmid was transfected into primary cultured uterine smooth muscle cells in vitro. The expressions of Calponin-1 mRNA and protein were analyzed by RT-PCR and Western blot, respectively.Results The pAdEasy-pShuttle-U6-Calponin-1 siRNA plasmid was successfully constructed, and Calponin-1 siRNA mediated by recombinant adenovirus resulted in markedly reduced expression of Calponin-1 mRNA and protein in human myometrium cells. The gray values of Calponin-1 mRNA in the uterine smooth muscle cells in the experimental, blank control, and empty vector groups were 316.3±39.2, 1048.5±126.4 and 1027.2±127.5, respectively. The gray values of Calponin-1 protein were 323.3±43.2, 1021.5±143.4, and 1019.2±144.5,respectively. The difference between the experimental group and the blank control group as well as the empty vector group was significant (P< 0.05). There was no significant difference between the empty vector group and the blank control group (P>0.05).Conclusion The pAdEasy-pShuttle-U6-Calponin-1 siRNA plasmid can inhibit the expression of Calponin-1 in human myometrium cells in vitro,which may be a useful approach to determine the role of Calponin-1 in delivery.

OBJECTIVE: To investigate the effect of human papillomavirus types 16E6 on the sensitivity of chemotherapy for cervical carcinoma in different p53 genotype cell lines. METHODS: The apoptosis rates of each group were detected by AO/EB, immunofluorescence and Annexin V/PI stained methods. The expressions of protein HPV16E6 and p53(mt) after the treatments of different concentration of DDP were detected by Western blot. HPV16E6 mRNA in C33A, C33A-E6, C33A-P, and CaSki cell lines under different DDP treatments were detected by RT-PCR. RESULTS: AO/EB and Annexin V/PI stained tests showed that the apoptosis rates of C33A, C33A-E6, C33A-P, and CaSki cells were significantly increased when DDP concentration increased. Western blot showed that the HPV16E6 protein could be detected only in C33A-E6 and CaSki cell lines. The expression of HPV16E6 protein in C33A-E6 and CaSki cell lines gradually decreased and was hardly detected with increased dosage of DDP and the prolonged treatment time (P<0.01), and slightly increased in C33A-E6 and Caski cell lines without the treatment, but there was no significant difference between them (P>0.05). Protein p53(mt) persistently expressed in C33A-E6, C33A, and C33A-P cell lines following the increased dosage of DDP and the prolonged treatment time(P>0.05), while it couldn't be found in CaSki cell line. RT-PCR showed that without DDP intervention, there was no significant difference of HPV16E6 mRNA in C33A-E6 and CaSki cell lines within 24 h.The HPV16E6 mRNA in C33A-E6 cell line expressed much higher than that in CaSki (P<0.05), and HPV16E6 mRNA of 2 cell lines expressed much higher at 48 h than at 24 h (P<0.05).The expression of HPV16E6 mRNA in C33A-E6 and CaSki cell lines gradually decreased with the increased DDP and prolonged treatment time (P<0.01), while there was no significant difference between C33A-E6 and CaSki cell lines under the same DDP concentration (P>0.05). CONCLUSION Effect of HPV16E6 on the sensitivity of chemotherapy for cervical carcinoma cell lines is not markedly related with the different p53 genotype forms(p53(mt)/p53wt ). HPV16E6 may affect the proliferation and sensitivity of chemotherapy in C33A cell line through other mechanism.
Antineoplastic Agents ; pharmacology ; Apoptosis ; genetics ; Cell Line, Tumor ; Cisplatin ; pharmacology ; Female ; Genotype ; Human papillomavirus 16 ; genetics ; Humans ; Oncogene Proteins, Viral ; biosynthesis ; genetics ; Papillomavirus Infections ; virology ; Repressor Proteins ; biosynthesis ; genetics ; Tumor Suppressor Protein p53 ; biosynthesis ; genetics ; Uterine Cervical Neoplasms ; pathology ; virology

OBJECTIVE: To determine the difference in aspartyl-(asparaginyl) beta-hydroxylase (AAH) expression level in villi between patients with missed abortion and normal women with early pregnancy, and to confirm the expression loci of AAH in villi. METHODS: A total of 50 patients of missed abortion were collected and categorized into a test group, which was subdivided into Group 1 and Group 2. Patients in Group 1 (n=20) were of confirmed etiological disorders while those in Group 2 (n=30) showed no obviously etiological clues. In addition, 20 women of early pregnancy with artificial abortion were categorized into a control group, whose embryos were sonographically confirmed alive before surgery. The 50 patients of missed abortion were also subdivided into a group within 4 weeks and a group over 4 weeks according to the time that the embryo stayed in utrine after death. Immunohistochemical technique and computer image analysis were used to detect the expression loci and the level of AAH in villi. RESULTS: AAH was expressed in the endochylema and nucleus of trephocyte both in missed abortion and normal early pregnancy. The expression level of AAH in villi of missed abortion was much lower than that of in villi of normal early pregnancy (P<0.05). The expression level had no difference between different groups of patients with missed abortion(P>0.05). CONCLUSION Low expression of AAH in the endochylema and nucleus of trephocyte may play a role in patients with missed abortion.
Abortion, Missed ; enzymology ; Adult ; Case-Control Studies ; Chorionic Villi ; enzymology ; Female ; Humans ; Mixed Function Oxygenases ; genetics ; metabolism ; Pregnancy