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.

Abstract: Objective To analyze the risk factors for neonatal preterm birth in 12 hospitals in Yunnan Province from 2016 to 2017, and to establish a nomogram prediction model for neonatal preterm birth, providing scientific evidence for the prevention of preterm birth. Methods A total of 20 445 pregnant women who gave birth in 12 hospitals in Yunnan Province from 2016 to 2017 were collected and grouped into a preterm group (n=1 186) and a full-term group (n=19 259) according to whether they had a premature delivery. The general information questionnaire of pregnant women designed by the research team was applied to understand the basic conditions and pregnancy information of the two groups, and the risk factors of preterm birth were determined by logistic regression analysis, R software was applied to draw a nomogram prediction model of neonatal preterm birth, and its predictive performance was tested. Results There were significant differences in the proportions of twins and above (9.11% vs 7.10%), pregnancy-induced hypertension (21.67% vs 18.57%), gestational diabetes mellitus (18.21% vs 15.90%), anemia (24.28% vs 20.70%), premature rupture of membranes (11.64% vs 9.76%), and abnormal placenta (7.08% vs 5.51%) between the preterm group and the full-term group (χ2=6.731, 7.055, 4.441, 8.691, 4.437, 5.232, all P<0.05); the logistic regression analysis showed that the risk factors for neonatal preterm birth were twins and above (OR=2.378), pregnancy-induced hypertension (OR=2.039), gestational diabetes mellitus (OR=1.824), anemia (OR=1.825), and premature rupture of membranes (OR=2.313) (all P<0.05); the discrimination (area under the curve was 0.794, 95%CI=0.738-0.850) and precision (goodness of fit HL test, χ2=8.864, P=0.312) of the nomogram model constructed to predict the occurrence of neonatal preterm birth were both good. Conclusions The nomogram model for preterm birth constructed based on 5 factors including number of fetuses, pregnancy-induced hypertension, gestational diabetes mellitus, anemia and premature rupture of membranes can predict the occurrence of neonatal preterm birth well, thus providing reference for the prevention of neonatal preterm birth.

To summarize professor
Acupuncture ; Acupuncture Points ; Acupuncture Therapy ; Facial Paralysis/therapy* ; Humans ; Needles

To achieve a comprehensive understanding of heavy metals and harmful elements residues in Niuhuang Qingwei Pills,49 samples from 18 manufactures were collected from 31 provinces in China.Risk assessment and control preparations were applied innovatively in evaluation of exogenous pollution in traditional Chinese Medicine.Determination methods for Pb,Cd,As,Hg and Cu were established by inductively coupled plasma mass spectrometry(ICP-MS).Based on the procedures including hazard identification,hazard characterization,exposure assessment and risk characterization,risk assessment was performed and residual limits for Pb,Cd,As,Hg and Cu in the drug were formulated.The results showed that the hazardous quotients(HQ) of the elements were decreased in the following order:Pb>As>Cu>Hg>Cd,and the total hazardous index(HI) of heavy metals and harmful elements in Niuhuang Qingwei Pills was above 1,implying health risk of the drug.Under the proposed limits,5 elements in the control preparation as well as Cd and Cu in the samples were within the limits range,but the excess rates of Pb,As and Hg in the samples were 12%,12% and 14%,respectively.For the first time,basic steps for risk assessment of Chinese patent medicine were established,which provided model and reference for risk assessment and limit formulation of other drugs.
China ; Drug Contamination ; Drugs, Chinese Herbal ; analysis ; standards ; Metals, Heavy ; analysis ; Risk Assessment

To minimize the predatory harvest of Heterosmilax yunnanensis and maintain the sustainable utilization of its resources, a study on the tending technology of wild H. yunnanensis was carried out. The results showed that the tuber tending model had a higher seed emergence rate, shorter growth period and easier control of male and female ratios than other tending models; by removing shrubs, topping, bending pruning, controlling insects and pests and other effective technical measures, the growth period of H. yunnanensis was shortened; the average annual net income of the tending area was 1 086 yuan/mu (1 mu≈666.67 m²), which was 86.9% higher than before. This study was conducive to increasing the yield and quality of H. yunnanensis in Karst landform area, and instructive for the tending of other wild traditional Chinese medicinal herbs in this area.
Female ; Humans ; Male ; Smilacaceae

Objective:To investigate the mechanism of excessive inflammation in the lung of C3H/HeN(C3H) mice following Chlamydia muridarum(Cm) airway infection.Methods:Chlamydial pneumonitis was induced in C3H and C57BL/6(C57) mice by intranasal inoculation with 1×103IFU (inclusion forming unites) of Cm strains.The expression of TLR2,TLR4 and MyD88 mRNA in the lung at different time point post-infection was measured by RT-PCR.Results:Cm infection induced Toll-like receptors expression in two strains of mice.The expression of TLR2 and TLR4 mRNA,especially TLR2 mRNA(P<0.001 or P<0.05),were significantly higher in highly susceptible C3H mice on day 7 and day 14 d post-infection compared with C57 mice.Further studies showed that the expression of MyD88 mRNA was also significantly higher in C3H mice on day 7 post-infection,and maintained high expression untill the day 14.Conclusion:Cm lung infection induced high level of TLR2,TLR4 and MyD88 mRNA expression in C3H mice,which may associate with excessive inflammation in C3H mice.

The experiment was aimed to investigate the difference of plasma concentration and pharmacokinetic parameters between liposome and aqueous solution of toatal ginsenoside of ginseng stems and leaves in rats, such as ginsenosides Rg₁, Re, Rf, Rb₁, Rg₂, Rc, Rb₂, Rb₃, Rd. After intravenous injection of liposome and aqueous solution in rats, the blood was taken from the femoral vein to detect the plasma concentration of the above 9 ginsenoside monomers in different time points by using HPLC. The concentration-time curve was obtained and 3p97 pharmacokinetic software was used to get the pharmacokinetic parameters. After the intravenous injection of ginsenosides to rats, nine ginsenosides were detected in plasma. In general, among these ginsenosides, the peak time of the aqueous solution was between 0.05 to 0.083 3 h, and the serum concentration peak of liposome usually appeared after 0.5 h. After software fitting, the aqueous solution of ginsenoside monomers Rg₁, Re, Rf, Rg₂, Rc, Rd, Rb₃ was two-compartment model, and the liposomes were one-compartment model; aqueous solution and liposome of ginsenoside monomers Rb₁ were three-compartment model; aqueous solution of ginsenoside monomers Rb₂ was three-compartment model, and its liposome was one-compartment model. Area under the drug time curve (AUC) of these 9 kinds of saponin liposomes was larger than that of aqueous solution, and the retention time of the liposomes was longer than that of the aqueous solution; the removal rate was slower than that of the aqueous solution, and the half-life was longer than that of the water solution. The results from the experiment showed that by intravenous administration, the pharmacokinetic parameters of two formulations were significantly different from each other; the liposomes could not only remain the drug for a longer time in vivo, but also reduce the elimination rate and increase the treatment efficacy. As compared with the traditional dosage forms, the total ginsenoside of ginseng stems and leaves can improve the sustained release of the drug, which is of great significance for the research and development of new dosage forms of ginsenosides in the future.

Objective:To explore the relationship among the self-concept clarity,social support,self-esteem and subjective well-being in secondary vocational school students.Methods:Totally 308 students were selected from one secondary vocational school in Guangzhou (196 males and 112 females).They were measured with the Self-concept Clarity Scale (SCCS),Perceived Social Support Scale (PSSS),Self-esteem Scale (SES) and Well-being Index Scale (WBIS).Results:The scores of the SCCS,PSSS,SES and WBIS were positively correlated with each other (r =0.15-0.53,Ps ＜ 0.01).Results of path analysis showed that self-concept clarity had a positive effect on social support,self-esteem and subjective well-being (β =0.21,0.47,0.20).Social support and self-es teem both had a positive effect on subjective well-being (β =0.30,0.37),social support had a positive effect on self-esteem (β =0.38).Conclusion:There may be close relationship among self-concept clarity,social support,selfesteem and subjective well-being.The role of self-concept clarity in improving subjective well-being should be paid more attention in educational practices.

AIM:To observe the application efficiency of 5g/L indocyanine green ( ICG ) staining technique for continuous circular capsulorhexis ( CCC ) during phacoemulsification in white cataract.
METHODS:Ninety-eight patients (98 eyes) with white cataract were randomly divided into staining group ( 50 cases, 50 eyes) and control group (48 cases, 48 eyes). The control group didn't do anterior capsule staining. The staining group was injected to fill the anterior chamber, 5g/L ICG 0.1mL was applied on the central surface of the anterior capsule, using a 27G blunt needle through the side-port after 30s, and the redundant ICG was replaced by BSS, and continuous curvilinear capsulorhexis was accomplished using capsulorhexis forceps.
RESULTS: In staining group: after ICG staining, the capsule, which presented uniform light green and visualization of the anterior capsule was significantly improved. There are 48 eyes capsulorhexis success. The rate of success was 96%. Meanwhile, in control group, there was 29 eyes capsulorhexis success. The rate of success was 60%. The difference was statistically significant (P<0. 05). During follow-up, no dye particle and the complications of iritis or high intraocular pressure were found in the eyes of staining group. Anterior chamber inflammation, corneal opacity compared with control group, the difference was not statistically significant.
CONCLUSION:Indocyanine green staining increases the visibility of anterior capsule in over mature cataract, and it should be an effective and helpful method which can increase the success rate of capsulorehxis. At the same time, it can reduce the incidence of intraoperative complications. This will help beginners quickly grasp continuous curvilinear capsulorhexis, and shorten the learning curve.

A Cleanert Alumina-N-SPE column (0.5 g/6 mL) chromatograpy with 5 mL of chloroform-methanol (7: 3) as eluent, instead of aluminum oxide column (100-200 mesh, 5 g, 1 cm) chromatograpy eluted successively with chloroform and the chloroform-methanol (7:3) (20 mL each), was applied to enrich matrine and oxymatrine in Sophora flavescens. Also, the optimization of the HPLC determination conditions with acetonitrile-ethanol absolute-3% phosphoric acid solution (84: 6: 10) as mobile phase, instead of acetonitrile-ethanol absolute -3% Phosphoric acid solution (80: 10: 10) recorded in Chinese Pharmacopoeia 2010 Edition, was more suitable for determination of matrine and oxymatrine in S. flavescens. This method has advantage of reducing sample handling time and solvent volume and increasing the accuracy and feasibility, which can simplify the procedure for determination of matrine and oxymatrine in S. flavescens.
Alkaloids ; analysis ; isolation & purification ; Chromatography, High Pressure Liquid ; methods ; Drugs, Chinese Herbal ; analysis ; isolation & purification ; Quinolizines ; analysis ; isolation & purification ; Solid Phase Extraction ; methods ; Sophora ; chemistry