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.

Humans ; Infant ; Infant, Newborn ; Infant, Extremely Low Birth Weight ; Mesenchymal Stem Cell Transplantation ; Umbilical Cord/cytology* ; Skin/injuries*

Humans ; Retrospective Studies ; Tetanus/epidemiology* ; China/epidemiology*

Polysaccharide of Balanophora involucrata Hook. f. (BPS), the major component of Balanophora involucrata Hook. f., was confirmed the protective effect on liver injury in our previous study. This research aimed to investigate the protective mechanism of BPS on experimental liver injury by attenuating cell ferroptosis through modulating solute carrier family 7 member 11/glutathione peroxidase 4 (SLC7A11/GPX4) pathway. The animal experiment was approved by the Experimental Animal Ethical Committee of Hubei Minzu University and all rats had received human care in compliance with the institutional animal care guidelines. Rats were given intraperitoneal injection of (D-galactosamine, D-GalN) solution (800 mg·kg^-1) one time to establish the acute liver injury model. The results showed aspartate amino transferase (AST), alanine aminotransferase (ALT) and 4-hydroxynonenal (4-HNE) levels in serum were decreased, and the contents of reactive oxygen species (ROS), Fe²⁺, malondialdehyde (MDA) and lipid peroxide (LPO) in liver tissues also decreased and glutathione (GSH) level increased after BPS administration with 200 mg·kg^-1. Besides, BPS reduced iron deposition and increased the expression of SLC7A11 and GPX4 proteins in liver tissue. In conclusion, BPS ameliorated experimental liver injury by alleviating cell ferroptosis through SLC7A11/GPX4 pathway. The present study pointed to the possibility of utilizing BPS for protection against liver injury in clinic.

Chronic refractory wound (CRW) is one of the most challengeable issues in clinic due to complex pathogenesis, long course of disease and poor prognosis. Experts need to conduct systematic summary for the diagnosis and treatment of CRW due to complex pathogenesis and poor prognosis, and standard guidelines for the diagnosis and treatment of CRW should be created. The Guideline forthe diagnosis and treatment of chronic refractory wounds in orthopedic trauma patients ( version 2023) was created by the expert group organized by the Chinese Association of Orthopedic Surgeons, Chinese Orthopedic Association, Chinese Society of Traumatology, and Trauma Orthopedics and Multiple Traumatology Group of Emergency Resuscitation Committee of Chinese Medical Doctor Association after the clinical problems were chosen based on demand-driven principles and principles of evidence-based medicine. The guideline systematically elaborated CRW from aspects of the epidemiology, diagnosis, treatment, postoperative management, complication prevention and comorbidity management, and rehabilitation and health education, and 9 recommendations were finally proposed to provide a reliable clinical reference for the diagnosis and treatment of CRW.

PURPOSE: SAM junctional tourniquet (SJT) has been applied to control junctional hemorrhage. However, there is limited information about its safety and efficacy when applied in the axilla. This study aims to investigate the effect of SJT on respiration when used in the axilla in a swine model. METHODS: Eighteen male Yorkshire swines, aged 6-month-old and weighing 55 - 72 kg, were randomized into 3 groups, with 6 in each. An axillary hemorrhage model was established by cutting a 2 mm transverse incision in the axillary artery. Hemorrhagic shock was induced by exsanguinating through the left carotid artery to achieve a controlled volume reduction of 30% of total blood volume. Vascular blocking bands were used to temporarily control axillary hemorrhage before SJT was applied. In Group I, the swine spontaneously breathed, while SJT was applied for 2 h with a pressure of 210 mmHg. In Group II, the swine were mechanically ventilated, and SJT was applied for the same duration and pressure as Group I. In Group III, the swine spontaneously breathed, but the axillary hemorrhage was controlled using vascular blocking bands without SJT compression. The amount of free blood loss was calculated in the axillary wound during the 2 h of hemostasis by SJT application or vascular blocking bands. After then, a temporary vascular shunt was performed in the 3 groups to achieve resuscitation. Pathophysiologic state of each swine was monitored for 1 h with an infusion of 400 mL of autologous whole blood and 500 mL of lactated ringer solution. T_b and T₀ represent the time points before and immediate after the 30% volume-controlled hemorrhagic shock, respectively. T₃₀, T₆₀, T₉₀ and T₁₂₀, denote 30, 60, 90, and 120 min after T₀ (hemostasis period), while T₁₅₀, and T₁₈₀ denote 150 and 180 min after T₀ (resuscitation period). The mean arterial pressure and heart rate were monitored through the right carotid artery catheter. Blood samples were collected at each time point for the analysis of blood gas, complete cell count, serum chemistry, standard coagulation tests, etc., and thromboelastography was conducted subsequently. Movement of the left hemidiaphragm was measured by ultrasonography at T_b and T₀ to assess respiration. Data were presented as mean ± standard deviation and analyzed using repeated measures of two-way analysis of variance with pairwise comparisons adjusted using the Bonferroni method. All statistical analyses were processed using GraphPad Prism software. RESULTS: Compared to T_b, a statistically significant increase in the left hemidiaphragm movement at T₀ was observed in Groups I and II (both p < 0.001). In Group III, the left hemidiaphragm movement remained unchanged (p = 0.660). Compared to Group I, mechanical ventilation in Group II significantly alleviated the effect of SJT application on the left hemidiaphragm movement (p < 0.001). Blood pressure and heart rate rapidly increased at T₀ in all three groups. Respiratory arrest suddenly occurred in Group I after T₁₂₀, which required immediate manual respiratory assistance. PaO₂ in Group I decreased significantly at T₁₂₀, accompanied by an increase in PaCO₂ (both p < 0.001 vs. Groups II and III). Other biochemical metabolic changes were similar among groups. However, in all 3 groups, lactate and potassium increased immediately after 1 min of resuscitation concurrent with a drop in pH. The swine in Group I exhibited the most severe hyperkalemia and metabolic acidosis. The coagulation function test did not show statistically significant differences among three groups at any time point. However, D-dimer levels showed a more than 16-fold increase from T₁₂₀ to T₁₈₀ in all groups. CONCLUSION In the swine model, SJT is effective in controlling axillary hemorrhage during both spontaneous breathing and mechanical ventilation. Mechanical ventilation is found to alleviate the restrictive effect of SJT on thoracic movement without affecting hemostatic efficiency. Therefore, mechanical ventilation could be necessary before SJT removal.
Male ; Animals ; Swine ; Shock, Hemorrhagic/therapy* ; Tourniquets ; Axilla ; Hemorrhage/therapy* ; Vascular Diseases ; Respiration

OBJECTIVE: To study the clinical features of coronavirus disease 2019 (COVID-19) in children aged <18 years. METHODS: A retrospective analysis was performed from the medical data of 23 children, aged from 3 months to 17 years and 8 months, who were diagnosed with COVID-19 in Jiangxi, China from January 21 to February 29, 2020. RESULTS: Of the 23 children with COVID-19, 17 had family aggregation. Three children (13%) had asymptomatic infection, 6 (26%) had mild type, and 14 (61%) had common type. Among these 23 children, 16 (70%) had fever, 11 (48%) had cough, 8 (35%) had fever and cough, and 8 (35%) had wet rales in the lungs. The period from disease onset or the first nucleic acid-positive detection of SARS-CoV-2 to the virus nucleic acid negative conversion was 6-24 days (median 12 days). Of the 23 children, 3 had a reduction in total leukocyte count, 2 had a reduction in lymphocytes, 2 had an increase in C-reactive protein, and 2 had an increase in D-dimer. Abnormal pulmonary CT findings were observed in 12 children, among whom 9 had patchy ground-glass opacities in both lungs. All 23 children received antiviral therapy and were recovered. CONCLUSIONS COVID-19 in children aged <18 years often occurs with family aggregation, with no specific clinical manifestation and laboratory examination results. Most of these children have mild symptoms and a good prognosis. Epidemiological history is of particular importance in the diagnosis of COVID-19 in children aged <18 years.
Adolescent ; Betacoronavirus ; Child ; Child, Preschool ; China ; Coronavirus Infections ; Humans ; Infant ; Pandemics ; Pneumonia, Viral ; Retrospective Studies

Objective: The objective was to identify the incidence of influenza-like syndromes and related health behavior factors among Beijing residents. Methods: From December 6, 2013 to January 16, 2014, we selected 150 villages or communities from 30 towns or streets as survey locations using a multi-stage random sampling method, and then conducted a cross-sectional study among 7 354 residents who aged 18 years or above and had live in Beijing for more than a half year using self-administered anonymous questionnaires, and totally 7 327 valid questionnaires are collected. The questionnaire consisted of demographic information, self-reported influenza-like syndromes in the past two weeks, and health behaviors. Multiple logistic regression models were used to identify the factors associated with self-reported influenza-like syndromes. Results: The mean (SD) age of the partcipants was 44.6 (15.2) years. Among them, 6.9% (506 cases) reported having influenza like illness during the past two weeks. The multiple logistic regression analysis indicated that regular physical exercise, optimal hand hygiene, and avoidance of going to the crowded places during respiratory infectious disease epidemics were significantly associated with a lower likelihood of reporting influenza-like syndromes, compared with those without regular physical exercises, without optimal hand hygiene, and not avoiding going to the crowded places, and the OR(95%CI) were 0.80 (0.66-0.97), 0.75 (0.57-0.99) and 0.80 (0.65-0.98), respectively. Conclusion Personal health behaviors were associated with the incidence of respiratory infectious diseases such as influenza in Beijing, and future interventions to improve personal hygiene behaviors are needed to prevent the spread of respiratory infectious diseases.

Panax ginseng is a well-known medicinal plant all over the world. It has high nutritional value and medicinal value. China and South Korea are the major countries in the world for ginseng cultivation, production and exportation. China's ginseng production accounts for more than half of the world, but the output value is less than that of Korea. The standardization process of ginseng industry plays an important role. This paper makes a detailed analysis of the Chinese and Korean ginseng national standards and the standardization process, and makes a detailed comparative analysis of the categories, standard contents, index selection, age, implementation and promotion status of the Chinese and Korean ginseng standards. The development disadvantages of ginseng industry standardization were displayed. And we give our advises on the standard revision, implementation of China's ginseng industry standardization, hoping to enhance the competitiveness of China's ginseng industry.

Objective To investigate human exposure to live poultry (poultry feeding and purchasing) in the residents in Beijing and related factors during the second wave of avian influenza A (H7N9) epidemic during 2013-2014, and provide scientific evidence for avian influenza prevention and control. Methods A total of 7366 adults aged ≥18 years were selected through multi-stage stratified sampling in Beijing for a questionnaire survey. Logistic regression model was used to analyze the influence factors of human exposure to live poultry. Results The live poultry feeding rate and live poultry purchasing rate in residents in Beijing in the past year were 5.3%(95%CI:4.8%-5.8%) and 6.0% (95%CI: 5.5%-6.5%) respectively. Logistic regression analysis indicated that lower educational level of primary school and below, (OR=1.82, 95%CI:1.22-2.72);being farmer (OR=2.49, 95%CI:1.89-3.29) or being unemployed (OR=1.65, 95%CI:1.08-2.52);being non local resident (OR=1.54, 95%CI:1.10-2.16);living in suburban area (OR=2.36, 95%CI:1.77-3.16);having one child (OR=1.76, 95%CI: 1.42-2.17) or ≥2 children (OR=2.15, 95%CI: 1.43-3.22) in the family were the risk factors associated with feeding poultry compared with higher educational level of college and above, being employed, being local resident, living in urban area and having no child. And being farmer (OR=1.61, 95%CI:1.27-2.02);being non local resident (OR=1.76, 95%CI:1.31-2.35);living in suburban area (OR=2.05, 95%CI:1.61-2.61);having one child (OR=1.24, 95%CI:1.02-1.52) or ≥2 children (OR=1.78, 95%CI: 1.21-2.63) were the risk factors for purchasing live poultry. Conclusion Some residents living in Beijing still have exposure to live poultry, and targeted measures should be taken to reduce the exposure to poultry.