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.

Child ; Cord Blood Stem Cell Transplantation ; Hematopoietic Stem Cell Transplantation ; Humans ; Primary Myelofibrosis/therapy* ; Thiotepa ; Transplantation Conditioning

Objective: To investigate the clinical significance of tumor associated macrophages (TAM) in multiple myeloma (MM) and the relationship with angiogenesis and immunosuppression. Methods: Seventy cases of MM patients diagnosed from August 2015 to June 2017 were enrolled in the study as experimental group, 20 cases of benign hematological diseases (13 with iron deficiency anemia and 7 with megaloblastic anemia) patients as control group. Immunohistochemical method was used to detect the expression of CD163, CD34 and VEGF in bone marrow samples, and flow cytometry was used to detect the proportion of regulatory T cell (Treg cells), ELISA was used to detect the level of IL-10, and the clinical features were analyzed. Results: ①Among the 70 patients, there were 31 males and 39 females with a median age of 65 (50~78) years old. TAM infiltration density, microvascular density (MVD), VEGF expression level, Treg ratio and IL-10 level in bone marrow samples of 70 MM patients were significantly higher than those of benign hematological diseases (P<0.05). ②In the MM group, the above indexes of the patients with disease stabilized (15 cases) were lower than those of the newly diagnosed group (35 cases) and the relapse refractory group (20 cases) (P<0.05), those of relapse refractory group were higher than those of newly diagnosed group (P>0.05). ③Of the 35 newly diagnosed MM patients, 27 completed 4 courses of treatment. In the effective group (15 cases), the TAM infiltration density after treatment was significantly lower than that before treatment, the difference was statistically significant[(20.20±7.66) vs (28.87±11.97), t=2.362, P=0.025]; while in the ineffective group of 12 cases, the difference of the TAM infiltration density before and after treatment was not statistically significant[(42.00±13.76) vs (48.25±13.59), t=1.119, P=0.275]. ④TAM infiltration density in the effective group after bortezomib treatment (21 cases) were lower than those in the non-bortezomib treatment group (18 cases)[(16.52 ±4.26) vs (19.27 ±5.82), t=1.662, P=0.170]. ⑤The TAM infiltration density in MM patients was positively correlated with MVD, VEGF expression level, Treg cell ratio and IL-10 level (P<0.001). Conclusion: The infiltration of TAM in the microenvironment of MM, which may promoting angiogenesis and inhibiting immune response, is related to the occurrence, development, therapeutic effect and drug resistance of MM.
Aged ; Female ; Humans ; Macrophages ; Male ; Middle Aged ; Multiple Myeloma ; Neoplasm Recurrence, Local ; Neovascularization, Pathologic

This study was aimed to investigate the correlation between HLA gene distribution and allele frequency of the patients with leukemia. PCR-SSP technique was used to detect the HLA genotype of 2994 umbilical cord blood units from healthy newborns (as control), the detecting result of which was compared with HLA genotypes of 1246 patients with leukemia searched in our cord blood bank. The differences between two groups were compared and analyzed. The results indicated that as compared with the control group, the allele frequencies of HLA-B*56 (0.56%), B*70 (0.24%) obviously increased (RR = 2.2546, 6.2598, χ(2) = 5, 5.98, P < 0.05), while the allele frequencies of HLA-A*03 (3.45%), A*30 (4.86%), B*13 (8.75%), B44* (3.25%), B61* (5.70%), DRB1*07 (8.23%), DRB1*15 (14.21%) obviously decreased in patients with leukemia (RR = 0.5889, 0.7187, 0.7359, 0.5713, 0.7127, 0.6242, 0.7976, χ(2) = 19.23, 9.82, 14.33, 20.48, 11.99, 33.21, 11.56, P < 0.01). It is concluded that HLA-B*56, B*70 alleles seem to be characterized by the genetic susceptibility to leukemia and may be served as risk markers for leukemia occurrence, while the HLA-A*03, A*30, B*13, B*44, B*61, DRB1*07, DRB1*15 can be considered as genetic indicators for resistance of leukemia.
Adolescent ; Adult ; Alleles ; Case-Control Studies ; Child ; Child, Preschool ; Female ; Fetal Blood ; Gene Frequency ; Genotype ; HLA-A Antigens ; genetics ; HLA-B Antigens ; genetics ; HLA-DRB1 Chains ; genetics ; Humans ; Infant, Newborn ; Leukemia ; genetics ; Middle Aged ; Young Adult

Objective To study the infected information,clinical symptom and molecular epidemiological characteristics of HuCV infection among children under 5 years old in Nanjing.Methods In Nanjing Children's Hospital of Nanjing Medical University from July 2010 to June 2011,we collected 428 stool specimens from children with diarrhea and 428 asymptomatic controls.Human Calicivirus were tested by using RT-PCR.Then we sequenced the nucleic acid of PCR amplifications and identified the genotype and gene group of prevalent strains.Results 63 ( 14.72％ ) out of 428 stool samples were detected as HuCV.58 were norovirus and 5 were sapovirus,while G Ⅱ -4 2006b was the predominant strain of NoV.In the 428 control samples,19 samples were positive for calicivirus,there were 8 NoV and 13 SaV (Including 3 coinfection cases).Conclusion Human caliciviruses with different genotypes circulated among children in Nanjing,and G Ⅱ.2006b is the dominant genotype.

This study was aimed to investigate a quality control method for ABO typing of neonatal umbilical cord blood(UCB). The routine serology method was used to identify the ABO type of UCB samples. These samples with questions were further detected by sequence specific primer PCR (PCR-SSP). The results showed that among total of 76120 UCB samples identified by positive ABO typing, there were 78 samples (1 per thousand) which could not be determined. Of these 78 samples, 30 (56.92%) samples with a weak agglutination reaction were excluded by reverse ABO typing. Out of 260 samples in reverse ABO typing, 148 samples were consistent with positive ABO typing, 112 samples (43.08%) were inconsistent with the positive ABO typing. 58 undetermined samples were detected by PCR-SSP. Out of them the genotyping results of 45 samples confirmed the serological typing, the phenotyping results in 3 cases were inconsistent to that of genotyping. 10 cases showed the unconformity between positive and reverse typing, but the genotyping results were fully consistent with the positive typing. In conclusion, positive typing for red cell antigens combined with PCR-SSP is efficient and sensitive for quality control of ABO typing for neonatal UCB.
ABO Blood-Group System ; genetics ; Blood Grouping and Crossmatching ; methods ; Fetal Blood ; Genotype ; Humans ; Infant, Newborn ; Quality Control

This study was purposed to investigate the frequencies of HLA-Cw* loci in China Northern Han population at gene level and to analyze the population genetic characteristics of HLA-Cw* alleles and distribution difference of gene frequency in regions. The high resolution genotyping for HLA-Cw* loci of 420 cases in China Northern Han population was performed by using PCR-SSP typing technique and their distribution regularity was analyzed statistically. The results showed that 30 HLA-Cw* alleles were detected, among which the frequency of Cw* 0102 (0.1776), 0702 (0.1217), 0602 (0.1150) were highest; other alleles with higher frequency were as follow in proper order: Cw* 0304, 0801, 0303, 0302, 0401, 1402. The rare observed HLA-Cw* 0506, 0810, 1510, 1601 and 1701 were detected firstly in this population. The statistical analysis indicated that the genotype distribution of HLA-Cw* loci coincides with the Hardy-Weinberg test. In conclusion, application of high resolution allele typing can accurately understand the distribution regularity and characteristics of HLA-Cw* alleles in China Northern Han population which provides the basis for research related with HLA-Cw* loci.
Adolescent ; Adult ; Alleles ; Asian Continental Ancestry Group ; genetics ; Child ; Child, Preschool ; China ; Female ; Gene Frequency ; Genotype ; HLA-A Antigens ; genetics ; HLA-B Antigens ; genetics ; HLA-C Antigens ; genetics ; Haplotypes ; Humans ; Infant ; Male ; Middle Aged ; Polymorphism, Genetic ; Young Adult

Objective To investigate the infection of Cryptosporidium and its epidemiologicul characteristics in AIDS patients of Southern China. Methods Stool samples eolleted from AIDS cinfirmed patients. The samples were detected for ooeyst of Cryptesporidium by acid fast bacteria stain and indirect fluorescent antibody stain respectively, CD4 eount was detected by Flow Cytometry. Results 212 samples of fresh stool obtained from the AIDS patients who live in Guangdong and Yunnan province. The total infection rate of Cryptesporidium in AIDS patients was 4.25% (9/212), the infectious rate of ooeyst in the group of 50-59 yeats old was signifieantly higher than those in 30-39 (P ＜ 0.01); the infectious rate of oocyst in patients with antiretrovind therapy(ART) was also significantly lower (P = 0.0000);we found the patients coinfected with Cryptosporidium with CD4 count all below 100 cells/μl. However, there were no any difference between the infectious rate to the patient's gender, areas and stool shape. Conclusion AIDS patients infected by Cryptesporidium are not rare in southern China, and the infectious rate was lower than western country. Patients reeeived ART could decrease the infectious rate of Cryptesporidium, Cryptosporidium always happen in patient whose CD4 count was very low(＜ 100 cells/μl).

Objective To study the clinical and laboratory features of the mild and severe hand-foot-mouth diseases (HFMD) in Shenzhen in 2008.Methods 145 cases were observed in East-Lake Hospital and Shenzhen Children's Hospital. Of the 145 cases,124 mild eases and 21 severe cases were involved. All the clinical data and Laboratory findings were collected and summarized. After collection of the acute and convalescent consecutive stools and peripheral bloods from the patients with HFMD,EV71 genes were amplified from these samples by RT-PCR. Enterovirus 71 were cultured and isolated using Veto cell line and R&D cell line. Results The WBC counts and blood glucose levels of the severe cases were significantly elevated,but the ages of the severe ones significantly decreased compared with those of the mild cases( P < 0.05). EV71 genes could be detected by RT-PCR with 35% positive rate in mild cases and 67% in severe eases.The EV71 gene detection rate of the severe cases was significantly increased in contrast to that of the mild ones. The EV71 were isolated and cultured from the stools of 9 patients,one specimens from the dead's stool. Two severe cases died of neurngenic pulmonary edema and brain-stem encephalitis. Conclusions EV71 mainly contributes to HFMD and is responsible for death of some severe cases. High fever,less rash,elevated white blood cell counts and blood glucose concentrations as well as age less than 4 years old should be used for prediction of severe cases.