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.

Objective To investigate the effect of atorvastatin preconditioning on cerebral myelin basic protein (MBP),glial fibrillary acidic protein (GFAP) and neurospecific enolase (NSE) in rat model of cerebral ischemia reperfusion.Methods A total of 30 male SD rats were randomly assigned to test group,model group and sham group.The rats of test group received atorvastatin 5 mg · kg-1 · d-1 by gastric gavage for 5 consecutive days before modling while the other two groups received the same volume of 0.9％ NaC1.Right middle cerebral artery occlusion (MCAO) ischemia-reperfusion model was established in both model group and test group,while sham group was only subjected to right middle cerebral artery separation and suture.The expressions of cerebral NSE,MBP and GFAP were measured with immunohistochemistry after 24 h reperfusion.Results The expressions of NSE,MBP and GFAP were 0.11 ±0.03,0.11 ±0.02,0.14 ±0.04 in model group,had significant differences with those in sham group,which were 0.18±0.02,0.11 ±0.00,0.19 ± 0.02 (P ＜ 0.05).The expressions of NSE and MBP in test group were 0.14 ± 0.02,0.14 ± 0.02,had significant differences with those of model group (P ＜0.05).The expression of GFAP in test group had no statistical significance with model group (P ＞ 0.05).Conclusion Atorvastatin preconditioning can alleviate cerebral ischemia reperfusion injury in rats with MCAO,probably through protecting oligodendrocytes and neurons.

Objective To investigate the influence of target controlled in-fusion of sufentanil on anesthesia quality in patients with heart mitral valve replacement.Methods The 60 patients with mitral valve replace-ment were randomly divided into control group ( n=30 ) and treatment group ( n=30 ).Anesthesia of patients in treatment group was induced and maintained using target-controlled infusion sufentanil at effect-site concentration of 0.8 ng · mL-1 and 0.4-0.8 ng · mL-1 ) , respective-ly.Anesthesia of patients in control group was induced by intravenous in-fusion of 10 μg · kg-1 sufentanil and maintained by injection of 10μg· kg -1 fentanyl.Extubation time after surgery, recovery time, visual analog scale ( VAS) score at extubation time, postoperative hemodyna-mics and the incidence of adverse drug reactions were compared between two groups.Results After surgery, the recovery and extubation time in the treatment group was significantly shorter than that in control group ( P<0.05).After surgery, VAS score between the two groups were not statistically significant ( P >0.05 ).After surgery, the mean arterial pressure, blood pressure, oxygen saturation in the treatment group were significantly higher ( P<0.05 ).The incidence of adverse drug reactions of treatment group was significantly lower than that in control group ( P<0.05 ).Conclusion For the patients with mitral valve replacement surgery, the treatment of target controlled infusion of sufentanil has a high anesthesia quality, rapid recovery and small adverse drug reactions.

Objective To investigate the latent infection caused by enterovirus 71 (EV71) among healthy people in Tianjin and to provide evidence on prevention and control hand-food and mouth diseases (HFMD). Methods 1611 sera specimens were collected from healthy people in Tianjin while EV71 antibody was detected by neutralization test, and then the results were analyzed statistically. Results For determining positivity, the cut-point was set at 1:4. The positive rate was 66.79%( 1076/1611) for EV71 neutralizing antibody. The lowest positive rate was 32.71% in the 0-5 age group while the highest rate was 76.67% in the 16-25 age group. Significant difference was seen in the positive rates among different age groups. The lowest positive rate (59.05%) was seen in the city areas while the highest rate (72.35%) was seen in the surrounding counties. 5.71% of the people being tested showed their neutralizing antibody as ≥1:256. The difference was statistically significant on positive rates among different areas. We constructed logistic regression models with the EV71 neutralizing antibody positive rate as the dependent variable and age, sex, floating population, area etc. as independent variables. There appeared statistical significances in all the independent variables. Conclusion Age seemed a risk factor for recessive infection of EV71, and the neutralizing antibody against EV71 might not be kept permanently. In order to prevent and control the HFMD, more attention should be paid to the areas where more floating population were resided.

OBJECTIVESTo study methodologies and relevant data-element specifications for basic dataset development in China public health information system construction

METHODSThe goals and scopes were determined through data-viewing analysis, while the function model was developed through information viewing analysis. The components and the structure of the data sets were also identified to distill data elements.

RESULTS50 basic datasets were developed and 1513 data elements were determined in 8 main domains and one public domain in China's public health information system. The 8 domains included Expanded Immunization Program (including 7 Basic Datasets and 326 data elements), Occupational Health and Poisoning (5 Basic Datasets and 158 data elements developed), Laboratory Management (9 Basic Datasets and 118 data elements included), Public Health Emergencies (including 3 Basic Datasets and 47 data elements), Infectious Disease Surveillance (4 Basic Datasets and 177 data elements developed), Non-Chronic Disease Surveillance (3 Basic Datasets and 64 data elements developed), Maternal and Child Health (totally 8 Basic Datasets and 368 data elements developed) and Environment Health (including 4 Basic Datasets and 72 data elements). One common domain consisted of 7 basic datasets and 183 data elements.

CONCLUSIONStandardizing basic datasets in public health information systems is an essential foundation in facilitating information system planning and the effective utilization of resources.

BACKGROUND: Peroxisome proliferator-activated receptor (PPAR)-gamma is a member of the nuclear receptor superfamily. PPAR-gamma plays an important role in numerous cellular processes including adipogenesis, insulin sensitivity, cell cycle progression, cell differentiation, inflammation, and extracellular matrix production. This study investigated the effect of a PPAR-gamma agonist on the progression of diabetic nephropathy in OLETF rats. METHODS: 30 week-old male OLETF rats were treated for 10 weeks as follows:diabetic control (DM), no treatment:pioglitazone therapy (DM+Pio). LETO rats were used as non-diabetic control (control). Body weight, blood pressure, blood sugar, creatinine, total cholesterol, triglyceride, and urinary protein excretion were measured. Histological analysis was taken with light microscope. Glomerular protein and mRNA expression of transforming growth factor (TGF)-beta1 and fibronectin were estimated by Western blot and RT-PCR. Kidney sections were stained for fibronectin by immunohistochemistry. RESULTS: Serum glucose, triglyceride and urinary protein excretion were decreased in DM+Pio rats compared to DM rats (p<0.05). PAS staining showed glomerular hypertrophy, mesangial expansion, nodular sclerosis, and glomerular basement membrane thickening in glomeruli of DM rats, but these changes were attenuated in glomeruli of pioglitazone-treated rats. Treatment with pioglitazone resulted in a significant decrease in TGF-beta1 protein and mRNA expression in diabetic glomeruli (80.6% and 78.4%, respectively). Glomerular expression of fibronectin protein and mRNA were also decreased in pioglitazone treatment group compared with DM group (93.1% and 98.6%, respectively). Immunohistochemical staining for fibronectin showed similar results. CONCLUSION: Increased TGF-beta1 and fibronectin mRNA and protein expressions in diabetic rat glomeruli were significantly ameliorated by pioglitazone treatment. These data suggest that activation of PPAR-gamma may play an important role in prevention and treatment of diabetic nephropathy.
Adipogenesis ; Animals ; Blood Glucose ; Blood Pressure ; Blotting, Western ; Body Weight ; Cell Cycle ; Cell Differentiation ; Cholesterol ; Creatinine ; Diabetic Nephropathies* ; Extracellular Matrix ; Fibronectins* ; Glomerular Basement Membrane ; Humans ; Hypertrophy ; Immunohistochemistry ; Inflammation ; Insulin Resistance ; Kidney ; Male ; Peroxisomes ; Rats ; Rats, Inbred OLETF ; RNA, Messenger ; Sclerosis ; Transforming Growth Factor beta1 ; Transforming Growth Factors* ; Triglycerides

Adenoviridae ; Animals ; Axons ; Brain ; Cell Line ; Clone Cells ; Discrimination (Psychology) ; DNA Restriction Enzymes ; Enzyme-Linked Immunosorbent Assay ; Fluorescence ; Gene Library ; Half-Life ; HEK293 Cells ; Immunohistochemistry ; Lingual Nerve ; Microscopy ; Models, Animal ; Molar, Third ; Myelin Sheath ; Nerve Growth Factor ; Nerve Regeneration ; Neural Conduction ; Neurons ; Peripheral Nerves ; Rats ; Regeneration ; RNA, Messenger ; Schwann Cells ; Sequence Analysis, DNA ; Sucrose ; Tongue ; Transfection ; Transplants

Adenoviridae ; Cell Line ; Cells, Cultured ; Clone Cells ; Cloning, Organism ; Enzyme-Linked Immunosorbent Assay ; HEK293 Cells ; Mass Screening ; Nerve Growth Factor ; Neurons ; Peripheral Nerves ; Polymerase Chain Reaction ; Regeneration ; RNA, Messenger ; Schwann Cells ; Transfection

BACKGROUND: Angiotensin II, a potent vasoconstrictor, plays a key role in renal injury and in the progression of chronic renal disease of diverse causes. In every organ system, the biologic effects of angiotensin II are mediated through its interaction with specific receptors on cell membranes. Angiotensin II receptor antagonist specifically inhibits angiotensin II-mediated physiologic responses such as systemic and renal vasoconstriction, sodium reabsorption by renal proximal tubule, and stimulation of aldosterone and adrenergic hormone release by the adrenal gland. It has been reported that losartan, angiotensin II receptor antagonist, has a significant antiproteinuric effect in patients with diabetic and non-diabetic renal disease. This study was carried out to investigate the effect of angiotensin-converting enzyme (ACE) gene polymorphism on the renal response to angiotensin II receptor antagonist in non-diabetic proteinuric chronic renal patients. METHODS: Seventy patients with non-diabetic chronic renal disease with urinary protein excretion greater than 500 mg/day were enrolled in this prospective study. Subjects were given losartan 50 mg o.d. for the first 12 weeks, and then were given to 100 mg o.d. for another 12 weeks. RESULTS: Twelve weeks and twenty-four weeks later, blood pressure, urinary protein excretion, total cholesterol, and triglyceride decreased significantly compared with baseline values. There was a significant correlation between the levels of baseline urinary protein excretion and the magnitudes of the reduction of urinary protein excretion after treatment with losartan. Baseline blood pressure, BUN, serum creatinine, and urinary protein excretion were not different in the responder group (patients with more than 30% reduction of urinary protein excretion after losartan treatment) compared with the nonresponder group. Systolic blood pressure and mean arterial pressure in the responder group were significantly lower than the nonresponder group after twelve and twenty-four weeks. Urinary protein excretion in the responder group was significantly lower than the nonresponder group after twelve weeks. When the patients were divided into three groups according to ACE gene polymorphism, II, ID and DD, there were no significant differences in the blood pressure change, reduction of urinary protein excretion following losartan treatment and distributions of responder among three groups. CONCLUSION: Our results suggest that angiotensin II receptor antagonist, losartan, significantly reduced blood pressure and proteinuria in patients with non- diabetic chronic renal disease. The magnitude of antiproteinuric effect of losartan was not influenced by ACE gene polymorphism. However, further studies with large number of patients are required to confirm the issues regarding the ACE gene polymorphism and the antiproteinuric effects of angiotensin II receptor antagonist in non-diabetic chronic renal disease.
Adrenal Glands ; Aldosterone ; Angiotensin II* ; Angiotensins* ; Arterial Pressure ; Blood Pressure ; Cell Membrane ; Cholesterol ; Creatinine ; Humans ; Losartan ; Prospective Studies ; Proteinuria ; Receptors, Angiotensin* ; Renal Insufficiency, Chronic* ; Sodium ; Triglycerides ; Vasoconstriction

BACKGROUND: Proteinuria is a cardinal feature of glomerular disease including diabetic nephropathy, and glomerular filtration barrier is considered as a filter restricting protein excretion in urine. We tested whether the expression of P-cadherin, a molecule known to be located at the slit diaphragm, was altered by high glucose in cultured podocytes in vitro and by diabetes in vivo. METHODS: In vitro, immortalized mouse podocytes were cultured in media with 5.6 mM glucose (NG), NG+24.4 mM mannitol (NG+M), or 30 mM glucose (HG) for 7 days at 37dgrees C. Cell lysates were used for RT-PCR and Western blot. For animal studies, twelve Sprague-Dawley rats were injected with diluent (Control, C, N=6) or streptozotocin (DM, N=6) intraperitoneally, and were sacrificed after 6 weeks. RT-PCR and Western blot for P-cadherin mRNA and protein expression, respectively, were performed with sieved glomeruli, and immunohistochemistry with renal tissue. RESULTS: HG significantly reduced P-cadherin mRNA and protein expression in cultured podocytes by 47% and 62%, respectively (p<0.05). Twenty-four hour urinary albumin excretion was significantly higher in DM (12.80+/-1.12 mg/day) compared to C rats (3.15+/-0.24 mg/day) (p<0.05). Glomerular P-cadherin mRNA expression was significantly lower in DM than that in C rats (p<0.05). P-cadherin protein expression assessed by Western blot and immunohistochemistry showed a similar pattern. CONCLUSION: Exposure of podocytes to HG in vitro and diabetes in vivo reduced P-cadherin mRNA and protein expression. These findings suggest that the decrease in P-cadherin expression is connected to the early changes of diabetic nephropathy and thus may contribute to the development of proteinuria.
Animals ; Blotting, Western ; Cadherins* ; Diabetic Nephropathies* ; Diaphragm ; Glomerular Filtration Barrier ; Glucose ; Immunohistochemistry ; Mannitol ; Mice ; Podocytes* ; Proteinuria ; Rats ; Rats, Sprague-Dawley ; RNA, Messenger ; Streptozocin