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.

Trib. Lorantheae used as traditional Chinese materia medica has a long history. There are 41 genera of Trib. Lorantheae， of which 6 belong to China， all have medicinal value， mainly distributed in Southwest， Southern， and Central and Southern China， with abundant resources. Twenty-two species of Trib. Lorantheae are used as medicinal materials or herbs in China. It mainly includes Taxillus. chinensis， T. sutchuenensis， Scurrula parasitica， Loranthus tanakae， Dendrophthoe pentandra， S. ferruginea， etc.， of which T. chinensis is the most widely used. The main chemical components of Trib. Lorantheae include flavonoids， terpenoids， sterols， phenylpropanoids， curcumins， phenolic acids， violate oils， sugars， and other compounds. Modern studies show that the extracts and monomer compounds of Trib. Lorantheae have various pharmacological effects such as anti-inflammation， anti-tumor， anti-oxidation， anti-osteoporosis， bacteriostasis， anti-virus， and lowering blood sugar， blood pressure， and lipid. It is believe that most active components related to their pharmacological effects are flavonoids， most of which are the main pharmacodynamic substances of the parasitic plants of Trib. Lorantheae， playing an important role in anti-inflammation， anti-tumor， anti-oxidation， anti-osteoporosis， and other pharmacological effect. This paper systematically summarized the literature and data on plants of Trib. Lorantheae and reviewed their chemical components and pharmacological effects， which provided references for the research， development， and utilization of Trib. Lorantheae.

Background PM_2.5 pollution has become a widely concerned environmental health problem. Polycyclic aromatic hydrocarbons(PAHs) are the main harmful components of PM_2.5, and their sources and carcinogenic risk deserve attention. Objective To analyze the source apportionment of PAHs in ambient PM_2.5 in Fuzhou, and to evaluate the potential carcinogenic risk through inhalation due to exposure to PAHs. Methods In this study, two sampling sites were set up in Cangshan (industrial area) and Taijiang (commercial and residential area) districts in Fuzhou City. PM_2.5 was collected from 10th to 16th of each month from 2017 to 2020 by membrane filtration method. The concentrations of ambient PM_2.5 were measured by weighing, and the concentrations of 16 PAHs, including naphthalene(NAP), acenaphthylene(ACY), acenaphthene(ACE), fluorene(FLU), phenanthrene(PHE), anthracene(ANT), fluoranthene(FLT), pyrene(PYR), benzo[a]anthracene(BaA), chrysene(CHR), benzo[b]fluoranthene(BbF), benzo[k]fluoranthene(BkF), benzo[a]pyrene(BaP), indeno[1,2,3-cd]pyrene(IcdP), dibenzo[a,h]anthracene(DahA), and benzo[g,h,i]perylene(BghiP), were determined by ultra-high performance liquid chromatography coupled with diode array detector and fluorescence detector. The concentrations of PM_2.5 and PAHs were compared in the two districts and the concentrations of PAHs were also compared in different seasons. The diagnostic ratio [FLT/(FLT+PYR), IcdP/(IcdP+BghiP), BaA/(BaA+CHR), and BaP/BghiP] method and positive matrix factorization (PMF) analysis were used to determine the sources of PAHs in PM_2.5 in Fuzhou. The excess carcinogenic risk (ECR) model was used to assess the potential health risk of inhalation exposure to PAHs. Results During 2017–2020, the M (P₂₅, P₇₅) concentration of ambient PM_2.5 in Cangshan and Taijiang districts of Fuzhou were 35.0 (25.0, 47.5) and 34.0 (25.5, 46.0) μg·m⁻³ respectively, and the percentages of PM_2.5 exceeding the national standard in Cangshan and Taijiang were 2.68% and 4.17%, respectively, without significant differences (P＞0.05). The M (P₂₅, P₇₅) concentrations of ΣPAHs in Cangshan was 5.03 (3.07, 7.67) ng·m⁻³, higher than that in Taijiang, 3.20 (2.05, 5.59) ng·m⁻³ (P＜0.05). The M (P₂₅, P₇₅) concentrations of PAHs monomers except ACY, FLU, and ACE in Cangshan were higher than those in Taijiang (P＜0.05). The concentrations of ΣPAHs in PM_2.5 in four seasons in Cangshan were higher than those in Taijiang (P＜0.05). In both districts, the concentration of ΣPAHs in winter was higher than those in spring, summer, and autumn (P＜0.05). According to the diagnostic ratio method, the median ratios of FLT/(FLT+PYR) in the two districts ranged from 0.4 to 0.5, and those of IcdP/(IcdP+BghiP), BaA/(BaA+CHR), and BaP/BghiP were from 0.2 to 0.5, from 0.2 to 0.35, and less than 0.6, respectively. The results of PMF analysis showed the proportions of four factors in Cangshan were 37.9%, 13.2%, 24.0%, and 24.9%, respectively. The major load contributors to factor 1 included FLT, PHE, and PYR; to factor 2, FLU, ACY, and ACE; to factor 3, DahA; to factor 4, BghiP, IcdP, and BaP. The proportions of four factors in Taijiang were 23.6%, 19.3%, 22.0%, and 35.1%, respectively. The main load contributor to factor 1 was DahA; to factor 2, BghiP; to factor 3, FLT, PHE, and PYR; to factor 4, IcdP, BaP, BbF, BkF, CHR, and BaA. The benzo[a]pyrene equivalences (BEQ) in Cangshan and Taijiang districts were 1.87 ng·m⁻³ and 1.61 ng·m⁻³, respectively. The excess carcinogenic risks of PAHs through inhalation exposure was 3.83×10⁻⁶ and 3.30×10⁻⁶, respectively. Conclusion The complex sources of PAHs in ambient PM_2.5 include dust, vehicle emissions, industrial emissions in Fuzhou, and are different in selected two districts. The level of PAHs in ambient PM_2.5 may pose a potential carcinogenic risk to local population.

OBJECTIVES: Fluorouracil chemotherapeutic drugs are the classic treatment drugs of gastric cancer. But the problem of drug resistance severely limits their clinical application. This study aims to investigate whether hypoxia microenvironment affects gastric cancer resistance to 5-fluorouracil (5-FU) and discuss the changes of gene and proteins directly related to drug resistance under hypoxia condition. METHODS: Gastric cancer cells were treated with 5-FU in hypoxia/normoxic environment, and were divided into a Normoxic+5-FU group and a Hypoxia+5-FU group. The apoptosis assay was conducted by flow cytometry Annexin V/PI double staining. The real-time reverse transcription-polymerase chain reaction (RT-PCR) and Western blotting were used to detect the expression level of hypoxia inducible factor-1α (HIF-1α), multidrug resistance (MDR1) gene, P-glycoprotein (P-gp), and vascular endothelial growth factor (VEGF) which were related to 5-FU drug-resistance. We analyzed the effect of hypoxia on the treatment of gastric cancer with 5-FU. RESULTS: Compared with the Normoxic+5-FU group, the apoptosis of gastric cancer cells treated with 5-FU in the Hypoxia+5-FU group was significantly reduced (P<0.05), and the expression of apoptosis promoter protein caspase 8 was also decreased. Compared with the the Normoxic+5-FU group, HIF-1α mRNA expression in the Hypoxia+5-FU group was significantly increased (P<0.05), and the mRNA and protein expression levels of MDR1, P-gp and VEGF were also significantly increased (all P<0.05). The increased expression of MDR1, P-gp and VEGF had the same trend with the expression of HIF-1α. CONCLUSIONS Hypoxia is a direct influencing factor in gastric cancer resistance to 5-FU chemotherapy. Improvement of the local hypoxia microenvironment of gastric cancer may be a new idea for overcoming the resistance to 5-FU in gastric cancer.
Humans ; Fluorouracil/therapeutic use* ; Vascular Endothelial Growth Factor A/metabolism* ; Stomach Neoplasms/drug therapy* ; Drug Resistance, Multiple ; Vascular Endothelial Growth Factors/metabolism* ; Hypoxia ; ATP Binding Cassette Transporter, Subfamily B/genetics* ; ATP Binding Cassette Transporter, Subfamily B, Member 1/genetics* ; Cell Line, Tumor ; Cell Hypoxia ; RNA, Messenger/metabolism* ; Hypoxia-Inducible Factor 1, alpha Subunit/genetics* ; Tumor Microenvironment

Chronic liver disease has gradually become a serious health problem worldwide. Liver biopsy is the current gold standard to assess liver lesions; however, it is an invasive procedure that may cause severe complications. Therefore, there is an urgent need for an economical and rapid non-invasive detection method that can be used in clinic for diagnosis. In the past decade, protein glycosylation has become a research hotspot, and the concept of changes in serum proteoglycans structure has gradually been accepted by many researchers as an indication of liver injury. At the same time, N-linked glycans via DNA sequencing equipment-Fluorophore Assisted Carbohydrate Electrophoresis (DSA-FACE) has also brought high sensitivity and specificity diagnostic models (GlycoHepatoTest) for various chronic liver diseases, which is a new strategy for non-invasive diagnosis of liver diseases.

Objective To evaluate the levels of serum 25 hydroxyvitamin D (25(OH)D), parathyroid hormone(PTH)and osteocalcin,as well as bone mineral density(BMD),in aged men in Beijing, and the relationship among these factors.Methods A total of 668 elderly male patients who were treated at the Beijing Friendship Hospital were evaluated, and their medical data were collected. The serum concentrations of 25(OH)D,PTH,and osteocalcin were measured.Additionally,bone mineral density at the lumbar spine1- 4(L1- 4) and left femoral neck were measured using dual-energy X-ray absorptiometry. Participants were divided into 4 groups by age,3 groups according to BMD,and 4 groups according to serum 25(OH)D levels. The relationship among these factors was investigated. Results The mean serum concentrations of 25(OH)D and PTH were (40.2 ± 17.3) nmol/L and (45.19 ± 15.54) ng/L, respectively. The serum 25(OH)D levels in the group aged≥90 years[(27.1±16.8)nmol/L]was significantly lower compared to that in the other groups. Among different BMD groups, serum 25(OH)D levels reduced gradually, but differences were not significant(P>0.05).Age and PTH levels were not significantly associated with 25(OH) D groups (P>0.05). However, BMD of the femoral neck in the groups with severe [(0.782±0.121)g/m2] and mild[(0.775±0.247)g/m2]vitamin D deficiency were significantly lower than that in the group with normal vitamin D levels [(0.837 ± 0.192) g/m2] (P<0.05). With the increase in vitamin D levels, osteocalcin levels decreased significantly(P<0.05).Conclusion Vitamin D deficiency is highly prevalent among aged men in Beijing and the 25(OH)D levels have some correlation with BMD and osteocalcin.

Objective To explore the application value of ultrasound-guided fine needle aspiration biopsy(FNAB) in diagnosing thyroid nodules of TI-RADS 4-6 categories.Methods A retrospective analysis was made on the pathologic data of 494 patients (totally 501 nodules) who underwent TI-RADS ultrasonographic stratification and ultrasound-guided FNAB.168 thyroid nodules of TI-RADS 4-6 categories were selected from 163 patients and classified into three groups:group T,TI-RADS 4A categories;group Ⅱ,TI-RADS 4B category; group Ⅲ,TI-RADS 5-6 category(the pathologically confirmed cases in category 6 had been removed).The ultimate pathologic findings were taken as golden standards to calculate the accuracy,sensitivity,specificity,positive predictive value of ultrasound-guided FNAB in the three groups.ROC curve was drawn to evaluate the diagnostic value of FNAB.Results The accuracy,sensitivity,specificity,positive predictive value of the ultrasound-guided FNAB in the three groups were listed as follows:group Ⅰ 74.4％,73.3％,75.0％,64.7％;group Ⅱ 83.9％,87.5％,71.4％,91.3％;group Ⅲ 89.3％,91.7 ％,75.0％,95.7 ％ respectively.The positive predictive values of the ultrasound-guided FNAB for group Ⅰ and group Ⅱ was higher than that of conventional TI-RADS classification criteria,so the difference was statistically significant; while the positive predictive values for group Ⅲ was close to the conventional ultrasound TI-RADS classification criteria,the difference was not statistically significant.Conclusions The combination application of TI-RADS classification criteria and FNAB can improve the accuracy of ultrasound diagnosis in group Ⅰ and group Ⅱ,and reduce the puncture rate of group Ⅲ.

BACKGROUND:The kidney tissues easily affected exercise ischemia reperfusion, increased free radicals and inflammation, resulted in abnormal renal function after acute exercise. OBJECTIVE:To observe the influence of Blackcurrant Extract on the structure of kidney and expression of tumor necrosis factor-α and nuclear factor-κB at 24 hours after exhaustiveexercise. METHODS:A total of 30 male Wistar rats were randomly divided into three groups (n=10). Rats in the Blackcurrant Extract group were intragastricaly administered 0.44 g/kg Blackcurrant Extract. Rats in the quietness control group and 24-hour exhaustive exercise group were intragastricaly given an equal volume of distiled water for 6 consecutive weeks. Rats in the 24-hour exhaustive exercise group and Blackcurrant Extract group received no swimming motion until exhaustion fatigue after final intragastric administration. Twenty-four hours later, samples were obtained. Kidney tissue morphology and ultrastructure were observed by electron microscopy and light microscopy. Protein expression of tumor necrosis factor-α and nuclear factor-κB was detected using immunohistochemistry. Tumor necrosis factor-αmRNA and nuclear factor-κB mRNA expression was detected using RT-PCR. RESULTS AND CONCLUSION:Compared with the quietness control group, tumor necrosis factor-α protein and nuclear factor-κB protein expression in the kidney was higher in the 24-hour exhaustive exercise group, and tumor necrosis factor-α mRNA and nuclear factor-κB mRNA expression was significantly increased (P < 0.01). Compared with the 24-hour exhaustive exercise group, tumor necrosis factor-α protein and nuclear factor-κB protein expression was lower in the Blackcurrant Extract group, and nuclear factor-κB mRNA expression was significantly decreased (P < 0.05); tumor necrosis factor-α mRNA expression was significantly reduced (P < 0.01). Kidney in the 24-hour exhaustive exercise group showed obvious morphological changes and ultrastructural damage. The structure of the kidney in the Blackcurrant Extract group tended to be normal. Results suggested that Blackcurrant Extract can repair the kidney tissue injury, reduce the expression of inflammatory factors, and prevent inflammatory damage in the kidney at 24 hours after exhaustive exercise.

Objective To study the epidemic situation and characteristic of subtypes of HIV-1 strains prevalent in Hebei Province. Methods Viral RNA was extracted from plasma samples, HIV-1 genes (env and gag ) were amplified by RT and nested-PCR using specific primer pairs and sequenced directly.The acquired sequences were compared with international subtypes references and their phylogenetic-trees were analyzed to determine the subtype. Results Among 154 HIV-1 antibody positive cases , 148 HIV-1 gene fragments were amplified and analyzed. There were 6 kinds of HIV-1 subtypes and recombinants, moreover unidentified 2 cases in 148 samples, of which 61 (41.2%) cases of B', 59(39.9% ) cases of CRF01_AE, 16( 10.8% ) cases of CRF07_BC, 6(4.1% ) cases of CRF08_BC, and 2( 1.4% ) cases of C and B01 each. HIV-1 B01 was detected firstly in Hebei Province. Conclusion Six HIV-1 subtypes were identified in Hebei Province. B' and CRF01_AE are the primary subtypes and recombinants of HIV-1 existed in Hebei Province. The surveillance of HIV-1 gene variation should be paid more attention to.

Objective To explore the association between rs3179060C/A polymorphism in the ex-on 1 of TNF-a gene and hyperandrogenism and polycystic ovary syndrome (PCOS). Methods One hundred thirty PCOS women and one hundred seventy five normal women as controls were enrolled in this study. The genotypes were screened by polymerase chain reaction-On/off switch and the product was isolated by e-lectrophoresis on a 2. 5% agarose gel containing ethidium bromide and visualized using an ultraviolet transil-luminator. The relationship of TNF-a alleles to serum testosterone level was analyzed in PCOS patients. Results Three genotypes were identified, corresponding to CC, CA, AA, and two alleles were screened, corresponding to C and A. The frequencies of the CC, CA, AA genotypes were 58. 4% ,23.1% ,18.5% vs. 72. 0% , 17.7% , 10. 3% in PCOS group and control group, showing statistically significant difference between two groups( P < 0.05 ). The allelic frequency was 70.0% for the C allele and 30.0% for the A in P-COS group, and 80. 9% for the C allele and 19. 1% for the A in control group, respectively, showing statistically significant between two groups ( P <0.05). The relationship was not observed between rs3179060C/ A polymorphism and serum testosterone level in PCOS patients in Han Chinese racial origin ( P >0.05). Conclusions The TNF-a gene rs3179060C/A polymorphism may be a risk factor for the pathogenesis of P-COS in Chinese women, but it was not effect on hyperandrogenism in PCOS women.