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 effects of acupuncture at the Governor Vessel acupoints plus language training on the language function and cerebral blood flow in patients with motor aphasia after ischemic stroke. Methods: Eighty-six patients were randomized into a control group and an observation group, with 43 cases in each group. Conventional symptomatic treatment was offered to both groups. Besides, the control group received language training, while the observation group received language training plus additional acupuncture at the Governor Vessel acupoints. Before and after treatment, the aphasia battery of Chinese (ABC) and Chinese functional communication profile (CFCP) were tested, and the mean velocity (Vm) and resistance index (RI) of the left middle cerebral artery (MCA) were detected. Results: The total effective rate was higher in the observation group than in the control group (P<0.05). After treatment, the observation group gained higher scores in oral expression, comprehension, repeating, naming objects, reading, and writing, as well as the general score of ABC (all P<0.05), higher than those in the control group (all P<0.05). The CFCP score increased in both groups after intervention, showing significant intra-group differences (both P<0.05), and the CFCP score was higher in the observation group than in the control group (P<0.05). After treatment, Vm of the left side MCA increased in the control group (P<0.05), while no significant change was observed in RI (P>0.05); in the observation group, Vm of the left side MCA increased and RI decreased significantly compared with the baseline (both P<0.05), and were markedly different from those in the control group (both P<0.05). Conclusion: Acupuncture at the Governor Vessel acupoints plus language training can produce valid efficacy in treating motor aphasia after ischemic stroke; it can notably improve the language function, everyday oral communication ability, and increase cerebral perfusion of the patients.

Objective To evaluate the clinical effect of electromagnetic navigation system to locate the distal locking screw of tibia intramedullary nail. Methods From February 2010 to December 2016, 79 cases of tibia shaft fractures requiring treatment with intramedullary nailing were selected and divided into the navigation group and free hand locking group according to intramedullary nail locking methods. Forty-four cases in navigation group used an electromagnetic navigation system to lock the distal end of the intramedullary nail,while 35 cases in free hand locking group used a free-hand technique. The intraoperative X-ray exposure time,distal locking time,healing time, and the success rate of one-time distal locking were recorded compared between two groups. Results The average time of diatal locking using electromagnetic navigation technology was less than that of the free hand locking group,and the exposure time of fluoroscopy was also reduced, the differences were significant(P ＜ 0. 05). There was no difference in fracture healing time between the two groups(P ＞ 0. 05), one-time success rate of navigation group was 100％,which was higher than 37. 34％ of the free hand locking group, the difference was significant(P ＜ 0. 05). Conclusion Compared with free hand technology, the advantage of using electromagnetic navigation system to lock the distal nail of tibia intramedullary nail is high efficiency, short locking time and no radiation.

BACKGROUND: Total knee arthroplasty is usually administered by intravenous and topical ways. The two ways have been the focus of research in reducing perioperative blood loss and blood transfusion rate. OBJECTIVE:To evaluate the effects of topical tranexamic acid versus intravenous tranexamic acid on blood loss and blood transfusion rate after total knee arthroplasty and analyze whether they increased the occurrence of postoperative thromboembolic events. METHODS: Electronic databases: PubMed, Embase, Cochrane library, Wanfang and CNKI from inception to 1 August 2016 were searched for studies on the use of tranexamic acid after total knee arthroplasty. The studies meeting the criteria were included. The quality of the included studies was evaluated. Extracted data were analyzed using Revman 5.3 software for meta-analysis. RESULTS AND CONCLUSION: (1) Twelve randomized controlled trials involving 1 159 patients (548 cases of topical application; 611 cases of intravenous injection)were included.(2)There were no significant differences in perioperative total blood loss(WMD=-4.22,95%CI:-10.87–2.43,P>0.05),postoperative drainage(MD=25.03,95% CI:-30.58-80.63,P>0.05),postoperative hemoglobin decline(MD=0.54,95%CI:0.11–0.98,P>0.05),blood transfusion rate(RR=1.15,95CI:0.82-1.61,P>0.05)and incidence of deep venous thrombosis(RR=1.22,95% CI:0.512.89,P>0.05).(3)The best timing for intravenous injection and optimal dose for topical application remain to be further verified.

Objective To evaluate the feasibility of making the osteoarthritis (OA) model in the medial collateral ligament and the medial meniscus excision in rats,and to explore the mechanism of MMP-13 and ADAMTS-5 protein in the cartilage of rat osteoarthritis models.Methods Forty SD rats were randomly divided into model group(n =30) and sham operation group(n =10).The knee joint OA model was made from the medial collateral ligament of the knee and the medial meniscus,and the sham operation group was sutured after opening the capsule of the knee joint.Rats in the model group were killed at 4,6,and 8 weeks after the operation,and the sham operation group died of the rats at 8 weeks after the operation.The articular cartilage tissue of rats was taken.The expression level of MMP-13 and ADAMTS-5 protein in cartilage tissue was detected by Western blot and immunohistochemistry.Results Cartilage degeneration was observed in the model group 4 weeks after operation,and degeneration was further aggravated at 6 and 8 weeks.There was no significant degeneration in the sham operation group.There was a significant difference in the articular cartilage score between the two groups (P ＜ 0.05).The results of Western blot detection showed that the protein expression of MMP-13 and ADAMTS-5 was low in the sham operation group.The MMP-13 model began to rise for 4 weeks,and continued to rise in the 6th week,and the 8th week was lower than that of the previous one.The protein expression had significant difference in all groups at 4 weeks,6 weeks and 8 weeks (P ＜ 0.05).The ADAMTS-5 model began to rise for 6 weeks,and the expression level was maintained before the model was maintained for 8 weeks.The protein expression at 4 weeks compared to that at 6 weeks and 8 weeks had significant difference(P ＜0.05).The protein expression in rat articular cartilage tissue at 6 weeks and 8 weeks had no significant difference (P ＞ 0.05).The expression trend of immunohistochemical detection protein was consistent with that of Western blot.Conclusion The animal model of OA can be established by using the method of medial collateral ligament dissection and medial meniscectomy.The expression level of MMP-13 and ADAMTS-5 in different stages of OA has changed significantly.Further research is needed to explore its related signaling pathways.

Adult ; Azoospermia/parasitology* ; Hormones/blood* ; Humans ; Infertility, Male/parasitology* ; Male ; Polymerase Chain Reaction ; Testicular Diseases/parasitology* ; Trichomonas Infections/parasitology* ; Trichomonas vaginalis

Objective To investigate the changes of HBV markers in patients with HBeAg positive chronic hepatitis B(CHB) after a large number of blood transfusion treatment.Methods 26 patients with chronic HBV that were treated massive blood transfusion in 24h were collected from Jan 1,2015 to Jan 1,2016.The HBV serum markers and HBV-DNA were measured and compared before and after treatment.Results The HBsAg,anti-HBs and anti-HBc concentration in first day after treatment were different compared with before treatment(t=2.681,4.753 and 5.116,all P<0.01).The HBsAg,anti-HBs and anti-HBc concentration in third day after treatment exist differences compared with before treatment(t=1.681, 2.209 and 3.118,all P<0.05).The difference still exist in the seventh day after treatment compared with before treatment with only anti-HBc concentration(t=2.463,P<0.05).There was not difference of HBeAg and HBV-DNA before and after blood transfusion in patients(t=0~1.132,P>0.05).After transfusionthe concentration of HBsAg in the fifth day was the lowest concentration as 0.17±0.03 IU/ml,the seventh day rose to 387.50±31.89 IU/ml,reaching the highest value,and the concentration of HBsAb decreased gradually to minimum at the seventh day that was 1.51±5.98 mIU/mmol,and the concentrations of HBeAg,HBeAb and HBcAb had no obvious change.Conclusion The HBsAg,anti-HBs and anti-HBc could be changed in patients with HBeAg positive CHB after massive transfusion therapy in short term.HBeAg and HBV-DNA were not affected by transfusion therapy.

Background: Metastatic colorectal cancer (mCRC) patients with progressive disease after all available standard therapies need new medication for further treatment. Famitinib is a small-molecule multikinase inhibitor, with promis-ing anticancer activities. This multicenter, randomized, double-blinded, placebo-controlled, phase II clinical trial was designed to evaluate the safety and efficacy of famitinib in mCRC. Methods: Famitinib or placebo was administered orally once daily. The primary endpoint was progression-free survival (PFS). Secondary endpoints included objective response rate (ORR), disease control rate (DCR), overall survival (OS), quality-of-life (QoL), and safety. Results: Between July 18, 2012 and Jan 22, 2014, a total of 167 patients were screened, and 154 patients were rand-omized in a 2:1 ratio to receive either famitinib (n = 99) or placebo (n = 55). The median PFS was 2.8 and 1.5 months in the famitinib and placebo groups (hazard ratio = 0.60, 95% confidence interval = 0.41–0.86, P = 0.004). The DCR was 59.8% and 31.4% (P = 0.002) and the ORR was 2.2% and 0.0% (P = 0.540) in the famitinib and placebo groups, respectively. The most frequent grade 3–4 adverse events were hypertension (11.1%), hand-foot syndrome (10.1%), thrombocytopenia (10.1%), and neutropenia (9.1%). Serious adverse events occurred in 11 (11.1%) patients in the famitinib group and 5 (9.1%) in the placebo group (P = 0.788). The median OS of the famitinib and placebo groups was 7.4 and 7.2 months (P = 0.657). Conclusion: Famitinib prolonged PFS in refractory mCRC patients with acceptable tolerability. Trial registration This study was registered on ClinicalTrials.gov (NCT01762293) and was orally presented in the 2015 ASCO-Gastrointestinal Symposium

Pituitary adenomas (PAs) are well known as a common intracranial benign tumor, and a portion of PAs are refractory to current therapeutic methods. ErbB receptors family signaling pathway regulates the expression of PAs activation associated gene. Inhibition of epidermal growth factor receptor (EGFR) can inhibit proliferation of PAs. Leucine-rich repeats and immunoglobulin-like domains protein 1 ( LRIG1), a negative mediated gene of ErbB receptors family, plays a role in many tumors. However, there are seldom researches about the functional role of LRIG1 in PAs. The aim of this study is to explore the potential effect of LRIG1 and its regulating mechanism in PAs. First, we investigated the role of LRIG1 in cell migration, invasion of PAs with transfected LRIG1 or control. Then, we explored its impact on cell proliferation and apoptosis of PAs in vivo. To study the regulating mechanism of LRIG1, we examined the expression of molecular factor of PI3K/AKT and Ras/Raf/ERK pathway using Western blotting in vitro and RT-PCR in vitro and in vivo. It was found that LRIG1 over-expression inhibited cell migration, invasion and proliferation, and promoted apoptosis of PAs in vivo and in vitro. Furthermore, LRIG1 suppressed the expression of signaling of PI3K/AKT and Ras/Raf/ERK pathways in PAs. LRIG1, as a negative mediated gene of tumor, can inhibit biological function of PAs via inhibiting PI3K/AKT and Ras/Raf/ERK pathways, and it might be a new target for gene therapy of PAs.
Animals ; Apoptosis ; genetics ; Brain Neoplasms ; genetics ; pathology ; Cell Line, Tumor ; Cell Movement ; genetics ; Cell Proliferation ; genetics ; Female ; Gene Expression Regulation, Neoplastic ; Humans ; MAP Kinase Signaling System ; genetics ; Membrane Glycoproteins ; biosynthesis ; genetics ; Mice ; Oncogene Protein v-akt ; biosynthesis ; Phosphatidylinositol 3-Kinases ; genetics ; Pituitary Neoplasms ; genetics ; pathology ; Xenograft Model Antitumor Assays ; raf Kinases ; biosynthesis ; genetics