Objective:To analyze and predict the future trend of the premature mortality of major chronic and non-communicable diseases in Anhui Province, evaluate the implementation of the "Healthy China 2030" Plan, and explore its influencing factors.Methods:Using data from death-cause surveillance and statistical yearbooks in Anhui, the trend prediction and analysis on influencing factors were conducted by using methods such as time series accumulation and logarithmic linear Joinpoint regression, principal component regression.Results:In Anhui, 28.10% of the deaths were premature ones, of which 84.40% were attributed to chronic and non-communicable diseases. In premature deaths attributed to chronic and non-communicable diseases, the deaths caused by malignant tumor and cardiovascular disease accounted for 45.88% and 41.65% respectively. The prediction results showed that the premature mortality of major chronic and non-communicable diseases would decrease in Anhui in the future, and by 2030, the goal in the "Healthy China 2030" Plan would be reached only in rural area. To reduce premature death, it is necessary to pay attention to the prevention and control of malignant tumor and cardiovascular disease. Men in urban area are the key population. Factors that reflect urban infrastructure had a significant impact on premature mortality of major chronic non-communicable diseases, such as garden and green space area per capita. Factors such as concentration of PM 2.5 had a negative impact on premature mortality of chronic non-communicable diseases, while factors such as garden and green space area per capita had a positive impact. Conclusions:Disease burden caused by chronic and non-communicable diseases, such as malignant tumor, exits in Anhui. Men in urban area are key population in the prevention and control of chronic and non-communicable diseases in the future.

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 ; COVID-19 Vaccines/therapeutic use* ; COVID-19/prevention & control* ; SARS-CoV-2 ; China ; Antibodies, Viral

Objective:To study the clinical efficacy of modified open elbow arthrolysis in the treatment of traumatic elbow stiffness.Methods:A retrospective analysis was performed on 120 patients who underwent modified open elbow arthrolysis in Beijing Jishuitan Hospital from January 2018 to December 2020. The age of the included patients was (37.7±12.4) years (ranged 18-64 years), including 54 males and 66 females. The medical records were reviewed, the range of motion (ROM) and functional status of the patients before operation and at the last follow-up were compared including visual analogue scale (VAS), Mayo elbow performance score (MEPS), Disabilities of the arm, shoulder and hand (DASH) score. Complications and secondary operations were also recorded. Measurement data with normal distribution were presented as mean ± standard deviation( ± s) and comparison between groups was conducted using the t-test; Measurement data of skewed distribution were expressed as M ( Q1, Q3), and Rank-sum test was used for inter-group comparison. Results:The preoperative extension of 120 patients was 43.6° (33.8°, 60.1°), the flexion was 78.7° (59.8°, 98.1°), and the flexion-extension ROM was 25.6° (0.0°, 54.5°); the preoperative pronation was 51.8° (33.0°, 67.0°), the supination was 85.1° (65.7°, 90.0°), and the rotation ROM was 136.9° (99.1°, 157.5°). Postoperative extension was 14.2° (7.0°, 24.8°), flexion was 129.5° (120.0°, 138.1°), flexion-extension ROM was 115.5° (94.4°, 127.3°); postoperative pronation was 65.0° (47.1°, 75.0°), the supination was 88.3° (78.6°, 90.0°), and the rotation ROM was 151.9° (131.7°, 163.4°). Postoperative extension, flexion, flexion-extension ROM, pronation, supination, and rotation ROM were all higher than those before operation, and the differences were statistically significant ( P<0.001). The VAS of 120 patients was 1.0 (0.0, 3.0) scores before operation and 0.0 (0.0, 1.0) scores after operation. The MEPS was 60.0 (50.0, 75.0) scores before operation and 100.0 (85.0, 100.0) scores after operation. The preoperative DASH was 37.5 (20.1, 51.3) scores, and the postoperative DASH was 7.9 (3.3, 13.3) scores. The postoperative VAS, MEPS, and DASH were significantly improved compared with those before operation, and the differences were statistically significant ( P<0.001). Residual ulnar nerve symptoms occurred in 18 cases, recurrence of heterotopic ossification in 42 cases, and hematoma in 3 cases. Conclusions:Modified open elbow arthrolysis is a safe and effective surgical method for the treatment of traumatic elbow stiffness. It can significantly improve the function of the patient, reduce the occurrence of elbow instability, avoid the use of external fixators, and reduce the cost of the patient.

Objective:To investigate the efficacy of TiRobot navigation for hinged external fixation in elbow arthrolysis.Methods:The 11 patients were retrospectively analyzed who had been treated by elbow arthrolysis at Department of Traumatology and Orthopedics, Beijing Jishuitan Hospital using TiRobot navigation for hinged external fixation. There were 9 males and 2 females with a mean age of 39.3 years (from 21 to 66 years). Their elbow range of motion (ROM) was compared between preoperation and the final follow-up. Their visual analogue scale (VAS) and Mayo elbow performance score (MEPS) and complications were documented at the final follow-up.Results:The rotation axis of the elbow joint was positioned with the aid of intraoperative robot navigation in 11 patients.The deviation of entry point averaged 0.21 mm (from 0.05 to 0.41 mm) and the deviation of exit point 0.23 mm (from 0.06 to 0.38 mm). The follow-up time for the 11 patients averaged 25.8 months (from 16 to 32 months). Their elbow flexion and extension was 133.0° (134.9°, 138.7°) and rotation 164.6° ±17.5° at the final follow-up, significantly improved compared with their preoperative values [0.8°(0°, 33.7°) and 122.9°±49.0°] ( P<0.05). Their VAS averaged 0.2 (from 0 to 1) and MEPS 96.8 (from 85 to 100) at the final follow-up, giving 9 excellent and 2 good cases. There was no case of radial nerve injury, pin instability, pin breakage, pin infection or peri-pin fracture. Conclusion:When TiRobot navigation is used for hinged external fixation in elbow arthrolysis, the axis of rotation can be accurately located, leading to satisfactory functional outcomes for the patients.

Objective:To study the locational distribution characteristics of the heterotopic ossification (HO) following traumatic elbow stiffness and the risk factors for HO development at different locations.Methods:Consecutively included according to our inclusion criteria in the present study were the patients who had been admitted to Department of Orthopaedic Trauma, Beijing Jishuitan Hospital from January 2018 to December 2018 for elbow release due to traumatic elbow stiffness but developed postoperative HO. Their baseline data and CT data were collected and processed using Mimics 20.0. The HO distribution for each patient was characterized at the anteromedial, anterolateral, posteromedial, posterolateral, posterior, medial, lateral, and proximal radioulnar locations. The patient's original injury was categorized into 5 types: distal humerus fracture, olecranon fracture, radial head fracture, coronoid fracture, and elbow dislocation. After the univariate analysis with the HO occurrence at a specific location as the dependent variable and the original injury and baseline data as the independent variables, the factors with P value less than 0.1 were included in the logistic regression analysis to determine the risk factors for HO at each location.Results:A total of 91 patients were included in this study. Of them, 88 had posteromedial HO (96.7%, 88/91), 62 posterior HO (68.1%, 62/91), 60 posterolateral HO (65.9%, 60/91), 41 anteromedial HO (45.1%, 41/91), 26 anterolateral HO (28.6%, 26/91), 13 proximal radioulnar HO (14.3%, 13/91), 8 lateral HO (8.8%, 8/91), and 7 medial HO (7.7%, 7/91). Logistic regression analysis showed that presence of ulnar nerve symptoms ( OR=4.354, P=0.017) and presence of original elbow dislocation ( OR=2.927, P=0.042) were the independent risk factors for the anteromedial HO development and that presence of original olecranon fracture ( OR=0.277, P=0.023) was the protective factor for the anteromedial HO development. Presence of original radial head fracture was the independent risk factor for the anterolateral HO development ( OR=2.891, P=0.033) and the posterolateral HO development ( OR=3.123, P=0.043). Conclusions:HO development in patients with post-traumatic elbow stiffness is closely related to their original injury. Posteromedial HO may develop in almost all the patients. Patients with ulnar nerve symptoms and original elbow dislocation are more prone to anteromedial HO development, but patients with original olecranon fracture are less likely to develop anteromedial HO. Patients with original radial head fracture are more likely to develop anterolateral and posterolateral HO.

OBJECTIVE: To analyze the changes in the gene expression profile of T cells in CML patients after TCRζ up-regulation expression, and to explore the molecular mechanism of T cell reactivation after transgenic up-regulation of TCRζ. METHODS: The peripheral blood mononuclear cells(PBMCs) from 3 newly untreated chronic-stage CML patients were collected, and the CD3 RESULTS: A total of 2248 differentially-expressed genes were obtained, including 553 up-regulated genes and 1695 down-regulated genes in experimental group as compared with those in control group (P<0.05) . The GO and KEGG enrichment analyses showed that differentially expressed genes involved in the biological processes related to T cell immune function, such as TCR signaling pathway, T cell proliferation and activation. Some of core genes involved in promoting the TCR signaling pathway, T cell proliferation, activation and apoptosis pathways were significantly up-regulated, while some core genes involved in inhibiting T cell activation were significantly down-regulated. CONCLUSION The molecular mechanism of the significantly improved T cell activation and proliferation ability in CML patients after TCRζ up-regulation may be related to the differential transcripts mediated signaling pathways of T cell activation, proliferation and apoptosis.
Humans ; Leukocytes, Mononuclear ; Lymphocyte Activation ; Receptors, Antigen, T-Cell/genetics* ; T-Lymphocytes ; Up-Regulation

Objective:To compare the clinical outcomes between OTA/AO-C open and closed fractures of the distal humerus treated by open reduction and internal fixation.Methods:The clinical data were retrospectively analyzed of the 70 patients who had been treated at Department of Traumatology and Orthopedics, Beijing Jishuitan Hospital for OTA/AO-C fractures of the distal humerus from January 2014 to June 2017. Of them, 22 suffered from open fractures (Gustilo types Ⅰ/Ⅱ) and 48 closed fractures. There were 18 males and 4 females with an age of (42.6±13.0) years in the open group and 21 males and 27 females with an age of (42.2±17.1) years in the closed group. Analyzed were interval from injury to surgery, hospitalization time, injury energy and functional outcomes which included range of motion (ROM) in elbow flexion and extension, ROM in elbow rotation, Mayo elbow performance score (MEPS), Disabilities of the Arm, Shoulder and Hand (DASH), complications and rate of secondary surgery.Results:There was no significant difference between the 2 groups in age, injury energy or interval from injury to surgery ( P>0.05), but there were significantly more males in the open group than in the closed group ( P=0.011). The follow-up time for all the patients averaged 34.0 months (from 25 to 54 months). There were no statistically significant differences between the 2 groups in hospitalization time [9.5(6.0, 13.0) d versus 8.5 (6.0, 11.0) d], ROM in flexion and extension [120.0° (100.0°, 137.8°) versus 128.5° (110.0°, 140.0°)], ROM in rotation [155.0° (151.3°, 155.0°) versus 155.0° (155.0°, 155.0°)], MEPS [95.0 (80.0, 100.0) versus 95.0 (80.0, 100.0)] or DASH [2.6 (0.63, 9.2) versus 1.7 (0.0, 8.5)] ( P>0.05). There were no statistically significant differences between the 2 groups either in rate of secondary surgery [36.4% (8/22) versus 33.3% (16/48)], ulnar nerve symptoms [54.5% (12/22) versus 60.4% (29/48)], local irritability in the region of internal fixation [9.1% (2/22) versus 6.3% (3/48)] or elbow stiffness [13.6% (3/22) versus 10.4% (5/48)] ( P>0.05). Conclusion:Open reduction and internal fixation can lead to similar clinical outcomes in the treatment of both open (Gustilo types Ⅰ/Ⅱ) and closed distal humeral fractures of OTA/AO-C, with no significant differences in postoperative ROM, functional scores or complications.

Objective:To explore the effect of combined administration of intravenous and topical tranexamic acid on perioperative blood loss in elbow arthrolysis.Methods:A retrospective analysis was conducted of 31 patients who had undergone elbow arthrolysis due to elbow stiffness from April 2019 to November 2020 at Department of Orthopaedic Trauma, Beijing Jishuitan Hospital. An observational group of 15 patients were subjected to combined administration of intravenous and topical tranexamic acid while a control group of 16 patients to no administration of tranexamic acid. In the observational group, 15 mg/kg of tranexamic acid was injected intravenously 5 to 10 minutes before surgery and 1.0 g of tranexamic acid was injected locally in the area of anterior and posterior joint capsules after incision was closed while drainage tubes were clamped for 2 hours before release. In the control group, there was no special operative procedure while drainage tubes were also clamped for 2 hours before release. The 2 groups were compared in terms of blood loss on day 1 and day 3 after operation, drainage volume on day 1 after operation, total drainage volume, time for indwelling drainage tube, complications, and Mayo elbow performance score (MEPS) at 3 months after operation.Results:There were no statistically significant difference in preoperative general data between the 2 groups, showing they were comparable ( P>0.05).On day 1 and day 3 after operation, the blood loss was respectively (533.4±318.3) mL and (792.0±375.6) mL in the observational group, and respectively (866.4±480.5) mL and (1,403.0±636.5) mL in the control group, showing significantly differences between the 2 groups ( P<0.05). The drainage volume on day 1 after operation was (151.3±90.1) mL in the observational group and (235.0±126.1) mL in the control group, showing a significant difference between the 2 groups ( P<0.05). There was no statistically significant difference in total drainage volume or time for indwelling drainage tube between the 2 groups ( P>0.05). There were no such complications as thromboembolic events in either group. There was no significant difference in MEPS between the 2 groups at 3 months after operation ( P>0.05). Conclusions:Combined administration of intravenous 15 mg/kg and topical 1.0 g tranexamic acid may reduce blood loss on day 1 and day 3 after operation and drainage volume on day 1 after operation, and may not increase the risk of thromboembolic events, but cannot reduce total drainage volume or time for indwelling drainage tube. Application of tranexamic acid may not affect early elbow joint function after operation.

A switch thrombin aptamer sensor was constructed based on the host-guest competition mode ofβ-cyclodextrin (β-CD ) . The aptamer that modified with ferrocene ( Fc ) at its terminal was fixed on the surface of the gold electrode via the host-guest recognization with β-CD. When thrombin was present, the configuration of aptamer transformed from vertical linear to "G-quadruplex" and far away from the electrode surface, which resulted in a decrease in the redox current of the aptamer probe and produce "Signal-off"effect. On the basis of this, a high sensitive detection of thrombin was made. The detection result indicated that the thrombin concentration had a consideration linear response to the signal of aptasensor between 5 . 0 × 10-13-5. 0 × 10-9 mol/L, and as low as 2. 0 × 10-13 mol/L thrombin had been detected. This method for thrombin detection showed a higher specificity compared to other protein molecules. Besides, the sensor was constructed easily and possessed excellent regeneration, which provided a significant platform for highly efficient real-time detection of thrombin in biological serum samples.