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 determine the knowledge of influenza, pneumonia, herpes zoster and related vaccines, willingness to vaccinate under multiple payment scenarios, and corresponding risk factors among people over 50 years old in Minhang District of Shanghai. Methods: A total of 1 672 respondents aged 50-69 from 13 communities/towns in Minhang district of Shanghai were included in this study using a stratified random sampling strategy on December 2020. The knowledge of influenza, pneumonia, herpes zoster and vaccines was investigated using a questionnaire, and the differences in the willingness under multiple payment scenarios were determined using chi-square test. The consistency in the willingness under multiple payment scenarios was compared using Cohen's Kappa and the risk factors of the willingness was determined using ordinal logistic regression. Results: The average age of 1 672 respondents was (60.48±5.96) years old, including 777 (46.47%) males and 895 (53.53%) females. A total of 1 350 subjects (80.74%) had local household registration in Shanghai. The proportion of the willingness to vaccinate for themselves, spouses, and parents under any payment scenario was determined to be 80.6% (influenza vaccine), 81.5% (pneumonia vaccine), and 74.0% (herpes zoster vaccine). The willingness to vaccinate against influenza and pneumonia under multiple payment scenarios remained stable (Kappa value ≥0.6), while that against herpes zoster infection was inconsistent (Kappa value ≤0.35). Logistic regression analysis showed that respondents who had higher knowledge of influenza and influenza vaccine [OR (95%CI): 1.111 (1.054-1.170), 1.182 (1.126-1.240), respectively], aged 50-59 [1.305 (1.085-1.531)] and local household registration in Shanghai [1.372 (1.079-1.721)] had higher willingness to vaccinate against influenza, while males had lower willingness [0.733 (0.551-0.910)]. Respondents who had higher knowledge of pneumonia and pneumonia vaccine [OR (95%CI): 1.837 (1.152-2.517), 2.217 (1.541-2.893), respectively] had higher willingness to receive pneumonia vaccine. Respondents aged 50-59 [1.327 (1.059-1.537)] and with local household registration in Shanghai [2.497 (1.417-4.400)] were more likely to be vaccinated against herpes zoster, while those with middle school degree or below [0.664 (0.396-0.992)] and high school degree [0.559 (0.324-0.964)] were less likely to be vaccinated. Conclusion: Among people aged over 50 years old in Minhang district of Shanghai, the willingness to vaccinate for themselves, spouses, and parents against influenza, pneumonia and herpes zoster infection is quite different under multiple payment scenarios, especially for herpes zoster vaccine.
Aged ; China ; Female ; Herpes Zoster/prevention & control* ; Herpes Zoster Vaccine ; Humans ; Influenza Vaccines ; Influenza, Human/prevention & control* ; Male ; Middle Aged ; Pneumonia/prevention & control* ; Vaccination

METHODS: To establish the acquired aplastic anemia mouse model through the X-ray irradiation in combination with lymphocytes injection. AA Group: the purified Pan T lymphocytes from the spleen of C57BL/6J mice were enriched and injected to the mice through tail vein(5×10 RESULTS: Compared with 4, 5 Gy irradiated mice in AA groups, the survival time of 3 Gy irradiated AA groups was significantly prolonged. 3, 4 and 5 Gy X-ray irradiation combined with Pan T lymphocyte injection could successfully induced severe reduction of red blood cells, blood neutrophils, and platelets, severe reduction of bone marrow nucleated cells, severe bone marrow hematopoietic failure, and the significant expansion of T lymphocytes ratio in the bone marrow. CD4 CONCLUSION 3, 4 and 5 Gy X-ray irradiation combined with 5×10
Anemia, Aplastic ; Animals ; Bone Marrow ; Bone Marrow Cells ; CD8-Positive T-Lymphocytes ; Humans ; Mice ; Mice, Inbred C57BL

The present study is to establish a quantitative analysis of multi-components by single marker(QAMS) for determining contents of seven compositions in Alismatis Rhizoma, alismoxide, alisol C 23-acetate, alisol A, alismol, alisol B, alisol B 23-acetate and 11-deoxy-alisol B. Six relative correction factors(RCFs) of alismoxide, alisol C 23-acetate, alisol A, alismol, alisol B and 11-deoxy-alisol B were established in the UPLC method with alisol B 23-acetate as the internal standard, which was to calculate the mass fraction of each. The mass fraction of seven effective constituents in Alismatis Rhizoma was calculated by the external standard method(ESM) at the same time. Compared with the content results determined by the ESM and QAMS, the feasibility and accuracy of QAMS method were verified. Within the linear range, the RCFs of alismoxide, alisol C 23-acetate, alisol A, alismol, alisol B, 11-deoxy-alisol B were 0.946, 4.183, 0.915, 1.039, 0.923 and 1.244, respectively, with good repeatability in different experimental conditions. There was no significant difference between the QAMS method and ESM method. Then, QAMS method was applied to determination of the different degree Alismatis Rhizoma from different areas. As a result, the concentrations of 7 components have differences in different areas, but no significant differences in different grades. The QAMS method is feasible and accurate for the determination of the seven chemical compositions, and which can be used for quality control of Alismatis Rhizoma.
Alismatales ; chemistry ; Drugs, Chinese Herbal ; analysis ; Phytochemicals ; analysis ; Rhizome ; chemistry

ABSTRACT:Objective To investigate the nursing methods of artificial lens implantation by three points suspension in the treatment of aphakic eye.Methods 12 cases with aphakic eyes were included in this study.XLSTABI -SKY foldable artificial lens was implanted by suspension of three points in the second phase,and all the patients was followed-up by more than six months. Preparation before operations,human-based nursing during operations and individualized nursing after operations were done and complications were observed.Results Through the operation and special nursing,each patient got a better corrected visual acuity than that before operation,en-dothelial decompensation and endophthalmitis of artificial artificial lens were not observed.Conclu-sion Special nursing and education for patients with implantation of foldable artificial lens sus-pended by three points could improve visual acuity and satisfactory consequences.

ABSTRACT:Objective To investigate the nursing methods of artificial lens implantation by three points suspension in the treatment of aphakic eye.Methods 12 cases with aphakic eyes were included in this study.XLSTABI -SKY foldable artificial lens was implanted by suspension of three points in the second phase,and all the patients was followed-up by more than six months. Preparation before operations,human-based nursing during operations and individualized nursing after operations were done and complications were observed.Results Through the operation and special nursing,each patient got a better corrected visual acuity than that before operation,en-dothelial decompensation and endophthalmitis of artificial artificial lens were not observed.Conclu-sion Special nursing and education for patients with implantation of foldable artificial lens sus-pended by three points could improve visual acuity and satisfactory consequences.

OBJECTIVETo study the toxicity features of high glucose on the endothelial cell cycle and the influence of Dan Gua-Fang, a Chinese herbal compound prescription, on the reproductive cycle of vascular endothelial cells cultivated under a high glucose condition; to reveal the partial mechanisms of Dan Gua-Fang in the prevention and treatment of endothelial injury caused by hyperglycemia in diabetes mellitus (DM); and offer a reference for dealing with the vascular complications of DM patients with long-term high blood glucose.

METHODSBased on the previous 3-(4,5)-dimethylthiahiazo (z-y1)-3-5-diphenytetrazoliumromide (MTT) experiment, under different medium concentrations of glucose and Dangua liquor, the endothelial cells of vein-304 (ECV-304) were divided into 6 groups as follows: standard culture group (Group A, 5.56 mmol/L glucose); 1/300 herb-standard group (Group B); high glucose culture group (Group C, 16.67 mmol/L glucose); 1/150 herb-high glucose group (Group D); 1/300 herb-high glucose group (Group E); and 1/600 herb-high glucose group (Group F). The cell cycle was assayed using flow cytometry after cells were cultivated for 36, 72 and 108 h, respectively.

RESULTS(1) The percentage of cells in the G0/G1 phase was significantly increased in Group C compared with that in Group A (P<0.05), while the percentage of S-phase (S%) cells in Group C was significantly reduced compared with Group A (P<0.05); the latter difference was dynamically related to the length of growing time of the endothelial cells in a high glucose environment. (2) The S% cells in Group A was decreased by 30.25% (from 40.23% to 28.06%) from 36 h to 72 h, and 12.33% (from 28.06% to 24.60%) from 72 h to 108 h; while in Group C, the corresponding decreases were 23.05% and 21.87%, respectively. The difference of S% cells between the two groups reached statistical significance at 108 h (P<0.05). (3) The percentage difference of cells in the G2/M phase between Group C and Group A was statistically significant at 72 h (P<0.01). (4) 1/300 Dan Gua-Fang completely reversed the harmful effect caused by 16.67 mmol/L high glucose on the cell cycle; moreover it did not disturb the cell cycle when the cell was cultivated in a glucose concentration of 5.56 mmol/L.

CONCLUSIONSHigh glucose produces an independent impact on the cell cycle. Persistent blocking of the cell cycle and its arrest at the G0/G1 phase are toxic effects of high glucose on the endothelial cell cycle. The corresponding variation of the arrest appears in the S phase. 1/300 Dan Gua-Fang completely eliminates the blockage of high glucose on the endothelial cell cycle.

Cell Cycle ; drug effects ; physiology ; Cells, Cultured ; Culture Media ; pharmacology ; Cytoprotection ; drug effects ; Dose-Response Relationship, Drug ; Drug Evaluation, Preclinical ; Drugs, Chinese Herbal ; pharmacology ; Endothelial Cells ; drug effects ; physiology ; Flow Cytometry ; Glucose ; adverse effects ; Humans

OBJECTIVETo investigate the clinical effects of bone setting manipulation on simplified operation and swelling reduction in treating calcaneal fractures.

METHODSFrom December 2005 to November 2010, 42 patients with calcaneal were reviewed, including 25 males and 17 females, ranging in age from 18 to 74 years, with an average of 41.4 years. Twenty patients had fractures in the left and 22 in the right. Twenty-three patients were treated with anatomical plate fixation, 19 patients were treated with Kirchners wires or cannulated screws fixation. The average period of swelling in soft tissue, joint function and complications were evaluated.

RESULTSForty-two patients were followed up, and the duration ranged from 3 to 18 months, with a mean of 8.3 months. The pain was markedly relieved at the next day after reduction, and the swelling was relieved in 3 to 5 days. The operative was simplified and the average operative time was 90 minutes. The swelling was relieved in 4 to 7 days after the operation, and the necrosis of skin was not found. The average postoperatively Böhler angle was (31 +/- 3.2) degrees. Gissane angle was (112 +/- 5.3) degrees. Calcaneal width was (30.2 +/- 0.89) mm. According to Maryland foot function score system, 16 patients got an excellent result, 18 good, 6 fair and 2 bad.

CONCLUSIONThe operation is simplified, and skin complications decrease, as well as the detumescence period is shortened.

Adolescent ; Adult ; Aged ; Calcaneus ; surgery ; Combined Modality Therapy ; Female ; Fracture Fixation, Internal ; Fractures, Bone ; surgery ; therapy ; Humans ; Male ; Middle Aged ; Musculoskeletal Manipulations ; Young Adult

BACKGROUNDP-wave dispersion (PWD) is a useful predictor of paroxysmal atrial fibrillation (AF). The effect of cardiac resynchronization therapy (CRT) on PWD and the prognostic implications of the improvement in PWD remain undefined. The aim of the study was to explore the clinical significance of the improvement of PWD after CRT.

METHODSElectrocardiographic studies were performed before and three months after CRT in 81 patients (57 men and 24 women; age (60.5 ± 11.2) years) with standard CRT indication but no history of AF. A significant improvement of PWD (PWD responder) was defined as a relative decrease ≥ 20% from baseline PWD. The primary endpoints were new-onset AF detected by electrocardiogram (ECG) or CRT.

RESULTSAfter (30.6 ± 7.5) months of follow-up, PWD responders (n = 43) had a significantly lower incidence of AF than did PWD nonresponders, 12% vs. 29% (P < 0.001). In Cox proportional hazard analysis, PWD responders was the only predictor of lower risk of new-onset AF (HR 0.33, 95% confidence interval 0.12 - 0.96, P = 0.033).

CONCLUSIONImprovement of P-wave dispersion after CRT was associated with a lower incidence of AF, which may be related to the significant improvement in left ventricular systolic function and the reverse modeling of the left atrium.

Adult ; Aged ; Atrial Fibrillation ; prevention & control ; Cardiac Resynchronization Therapy ; Echocardiography ; Electrocardiography ; Female ; Heart Failure ; physiopathology ; therapy ; Humans ; Male ; Middle Aged