OBJECTIVE To investigate the effect and mechanism of asperuloside on liver fibrosis in non-alcoholic fatty liver disease （NAFLD） rats by regulating the sphingosine kinase 1 （SphK1）/sphingosine-1-phosphate （S1P） signaling pathway. METHODS SD rats were fed with a high-fat diet to establish a NAFLD model. They were randomly separated into model group， asperuloside low-dose group （14 mg/kg， i.g.， similarly hereinafter）， asperuloside high-dose group （28 mg/kg）， high dose of asperuloside （28 mg/kg）+pc-NC （empty plasmid， 50 µg， via tail vein， similarly hereinafter） group， and high dose of asperuloside （28 mg/kg）+pc-SphK1 （SphK1 overexpression plasmid， 50 µg） group， with 12 rats in each group. Another 12 rats were fed with a normal diet as control group. Each group was given relevant medicine or plasmid intragastrically once a day or via tail vein twice a week， for 3 consecutive weeks. After the last medication， the levels of blood lipid indexes [total cholesterol （TC）， triglyceride （TG）， and free fatty acid （FFA）] and liver function indexes [aspartate transaminase （AST） and alanine transaminase （ALT）] were detected in each group. The pathological changes of liver tissue and liver fibrosis in rats were also observed in each group. The levels of serum fibrosis-related factors [procollagen type Ⅲ （PCⅢ）， collagen type Ⅳ （Ⅳ-Col）， laminin （LN）]， pro-fibrotic factor [transforming growth factor-β1 （TGF-β1）]， and pro-inflammatory factors [interleukin-1β （IL-1β）， inducible nitric oxide synthase （iNOS）， IL-6] of rats were determined in each group. The expressions of collagen formation-related proteins （Ⅰ-Col， Ⅳ-Col） and SphK1/S1P pathway-related proteins in the liver tissues of rats were detected in each group. RESULTS Compared with control group， the liver tissue of rats in model group showed significant pathological damage； the NAFLD activity score， liver tissue collagen volume fraction， serum levels of TC，TG， FFA， AST， ALT， PCⅢ， Ⅳ-Col， LN， TGF-β1， IL-1β， iNOS and IL-6， and protein expressions of Ⅰ-Col， Ⅳ-Col， SphK1 and S1P in liver tissue were greatly increased （P＜0.05）. Compared with the model group， the liver tissue pathological damage symptoms of rats in asperuloside low-dose and high-dose groups were improved， and the above indexes were all reduced significantly （P＜0.05）； moreover， the high-dose group had a better effect （P＜0.05）. Compared to asperuloside high-dose group， high dose of asperuloside+pc-NC group， the pathological damage of liver tissue symptoms in rats were aggravated in high dose of asperuloside+pc-SphK1 group， and the above indexes were all increased significantly （P＜0.05）. CONCLUSIONS Asperuloside can reduce the expressions of pro-fibrotic factor， pro-inflammatory factors and collagen formation-related proteins by inhibiting the activity of SphK1/S1P signaling pathway， thus alleviating liver fibrosis in NAFLD rats.

OBJECTIVE To study the toxicity-reducing effects and mechanisms of Niuhuang Jiedu Tablets(NHJDT)by gas chromatography-mass spectrometry(GC-MS)metabolomics.METHODS 24 mice were randomly divided into control,realgar(1.0 g·kg-1)and NHDJT(1.0 g·kg-1)groups with 8 mice in each group.The liver and kidney of mice were collected for patho-logic examination after 14 d oral administration to mice.The content of alanine aminotransferase(ALT)and aspartate aminotransferase(AST)in liver and creatinine(Cr)and uric acid(UA)in kidney was also determined.The differences of endogenous metabolites in liver and kidney were further analyzed by GC-MS metabolomics.RESULTS The contents of ALT and AST in the liver as well as the Cr and UA in kidney of mice were significantly changed after NHJDT intervention(P<0.05).NHJDT alleviated the pathological dam-age of liver and kidney in mice.A total of 17 biomarkers related to detoxification were screened,including citric acid,ascorbic acid,asparagine,levodopa and phenylalanine.The changes of metabolites mainly involved in glutamine and glutamate metabolism,arginine biosynthesis,tryptophan metabolism,tyrosine and tryptophan biosynthesis,and phenylalanine metabolism.CONCLUSION NHJDT with compound compatibility could reduce the hepatorenal toxicity of realgar.The detoxification mechanism may be related to the regu-lation of amino acid metabolism.

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 observe the metabolomic changes of amniotic fluid in control group and administration group,and to explore the toxicity of aqueous extract of rhubarb on reproduction and embryonic development of pregnant rats.Methods Pregnant rats in teratogenic sensitive period were given rhubarb aqueous extract by gavage for 10 days.The toxicity of rhubarb to maternal rats and the abnormal conditions of dead fetus and absorbed fetus were observed.The amniotic fluid samples were detected by liquid chromatography-mass spectrometry(LC-MS),the amniotic fluid metabolic profiles were compared by principal component analysis(PCA)and partial least squares(OPLS-DA),and the differential lipids were analyzed by metaboanalyst 5.0.Results Rhubarb administration in the teratogenic sensitive period can significantly reduce the number of live fetuses,and lead to adverse phenomena such as absorption of fetuses and premature death of fetuses.The preliminary results of lipomics showed that rhubarb could cause the metabolic disorder of amniotic fluid in pregnant rats,and there were metabolic abnormalities in lipids in amniotic fluid such as PI,PC and LPC.Conclusion Under the equivalent dose of the maximum dose recommended by the clinic,the aqueous extract of rhubarb has certain reproductive and embryonic toxicity to rats;Rhubarb may affect the normal development of rat embryos by causing the disorder of lipid metabolism in amniotic fluid.

Objective:To investigate the effect of lateral tibial periosteum distraction on diabetic foot and vasculitis foot.Methods:A retrospective analysis of 13 patients (16 feet) who received lateral tibial periosteal distraction between June 2019 and May 2020 were included in the study. 9 males and 4 females; aged 39-77 years (average 66 years); left foot 7 cases, right foot 9 cases. 5 cases were patients with diabetic foot, 1 case was diabetic foot with arteriosclerosis obliterans, 2 cases were thromboembolic vasculitis, and 5 cases were arteriosclerosis obliterans. The tibial periosteum was dissected and a distraction device was placed. In the 3 patients with foot ulcers, tibial periosteum distraction devices were placed on the severer side. The periosteal distraction began on the third day after surgery, about 0.75 mm/d, the adjustment was done usually in two weeks. Two weeks later, the stretch plate was removed surgically. The followings were evaluated: visual analogue scale (VAS) pain score, foot peripheral oxygen saturation, foot capillary filling test, lower extremity arterial CT angiography (CTA), etc.Results:All 13 patients were followed up for 2-12 weeks, with an average of 3.85 weeks. VAS pain score: the average pain score of 13 patients with preoperative foot pain was 5.31±1.84 (range, 2-9) points, and 2 weeks after surgery, the average value was 2.46±1.39 (range, 1-6) points with statistical significance ( t=6.124, P<0.001) ; peripheral foot oxygen saturation: the average preoperative blood oxygen saturation of 12 patients was 87.83%±14.83% (range, 50%-98%), 1 patient was not detected before surgery, and 2 weeks after operation, the average blood oxygen saturation was 92.33%±7.91% (range, 75%-99%). There was no significant difference between them ( t=1.124, P=0.285). The foot skin temperature of 10 patients was 35.68±0.85 ℃ (range, 34.00-36.60 ℃) before surgery and 36.23±0.46 ℃ (range, 35.50-36.90 ℃) after surgery, and the difference was statistically significant ( t=3.197, P=0.008) . Capillary filling test: 2 weeks after operation, the capillary filling response was significantly improved. All 13 patients had improved CTA of both lower extremity arteries before operation, and 11 patients had CTA taken back after two weeks of operation. Compared with preoperative CTA, new vascular network was found in the operation limb. In addition to 1 patient with thromboangiitis obliterans (mainly suffering from foot pain, no wound symptoms), 2 of 12 patients with heart failure, renal failure and other basic diseases did not heal, and the wounds of the other 10 patients had improved significantly 1 month later. Conclusion:Lateral tibia periosteum distraction can be used to treat chronic ischemic diseases of lower extremities with satisfactory postoperative results.

The efficient management of wounds is the focus of current research. In addition to conventional wound management and necessary surgery, the role of pro-healing drugs in wound treatment has gradually been emphasized. Platelet-rich blood products that is rich in a variety of biologically active molecules are considered as a low-cost and safe therapy in promoting tissue healing, and have great development prospects in the field of regenerative medicine. However, due to the lack of standard preparation and management and the unstable activities of the biomolecules in them, the therapeutic effects of platelet-rich blood products are uneven. In order to solve these problems, researches related to the protection and delivery of biologically active molecules in platelet-rich blood products by biomaterials have gradually increased in recent years, which is also one of the latest trends in wound treatment research. This article first briefly introduces the types of platelet-rich blood products, then outlines the latest research progress achieved by their combination with biomaterials, and finally summarizes the research progress and future research directions of the combination approach in wound treatment.

The antigen of cluster of differentiation CD200 is widely expressed in hematological malignancies, and is of great significance for the diagnosis, monitoring of minimal residual disease and prognosis evaluation of B cell lymphoproliferative disorders, multiple myeloma and acute leukemia. In addition, CD200 plays an important regulatory role in tumor immune tolerance, suggesting that CD200 is a potential molecular target for the immunotherapy of hematological malignancies.

Objective:To investigate the clinical efficacy of Yunke(99TC-MDP) combined with strontium 89SrCl2 in the treatment of bone pain in patients with multiple bone metastases.Methods:The clinical data of 95 patients with multiple bone metastases admitted to the General Hospital of Datong Coal Group from August 2014 to July 2019 were retrospectively analyzed.According to the different treatment methods, they were divided into three groups: 37 patients in Yunke group were treated with Yunke alone, 29 patients in 89SrCl2 group were treated with 89SrCl2 alone, 29 patients in combination group were treated with Yunke combined with 89SrCl2.All patients were treated for 5 days, with a course of treatment per month.The clinical efficacy, analgesic time and adverse reactions of the three groups were compared.Results:After treatment, the pain relief rates of the Yunke group, the 89SrCl2 group and the combination group were 67.6%(25/37), 69.0%(20/29) and 79.3%(23/29), respectively.The pain relief rate of the combined group was higher than that of the Yunke group(χ 2=4.25, P<0.05). The effective rate of bone metastases in the combined group was 41.4%(12/29), which was higher than that in the Yunke group[0.0%(0/37)], the 89SrCl2 group[17.2%(5/29)], the differences were statistically significant(χ 2=13.09, 10.54, all P<0.01). No serious adverse reactions were found in the three groups. Conclusion:Yunke combined with 89SrCl2 is superior to 89SrCl2 alone, and it is safe in the treatment of bone metastases.

Objective To summarize the relationship between WT1 gene mutation and prognosis of acute myeloid leukemia (AML). Methods The related literatures were searched in PubMed, Google Scholar and Cochrane Library databases, and the deadline was April 2, 2018. The Meta_analysis was performed by using Review Manager 5.2 software. Results A total of 9 literatures were included. Meta analysis showed that for the pediatric AML patients, the overall survival (OS) time in the WT1 gene mutated group was shorter than that in the wild_type group ( HR＝1.41, 95% CI 1.07-1.87, P＝0.01). For the total AML patients, the relapse_free survival (RFS) time in the WT1 gene mutated group was shorter than that in the wild_type group ( HR＝2.21, 95% CI 1.15-3.93, P＝0.02), but there was no significant difference in OS and disease_free survival (DFS) time between the two groups ( HR＝1.65, 95% CI 0.97-2.80, P＝0.06; HR＝0.46, 95% CI 0.08-2.57, P＝0.38). For the AML patients with normal karyotype and adult AML patients, there was no difference in OS time between the WT1 gene mutated group and wild_type group ( HR＝ 2.66, 95% CI 0.57-12.31, P＝ 0.21;HR＝ 2.10, 95% CI 0.70-6.30, P＝ 0.18). Conclusion WT1 gene mutation is a risk factor affecting OS of pediatric AML patients and RFS of general AML patients.