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 autoinflation on the prognosis of OME in children. Methods: Total of 325 pediatric patients, age ranged from 3 to 8 years, with OME(486 ears)diagnosed in our department from January 2019 to January 2020 were collected. Among them, 177 were males, 148 were females. Disease course ranged from 25 to 86 days. According to watchful waiting and autoinflation application during follow-up, these children were divided into two groups including 183 cases(271 ears) and 142 cases(215 ears), respectively. The average auditory threshold and tympanogram curve type in two groups were analyzed in the period of 3 months follow-up, and the recovery of OME was evaluated. Results: At the end of 1- and 2- month follow-up, the auditory threshold of patients in autoinflation group was significantly lower than that in watchful waiting group (t=2.139 5 and 2.680 6, P<0.05). However, at the end of 3- month follow-up, there was no significant difference between two groups (t=1.158 5, P>0.05). At the end of 1-, 2- and 3- month follow-up, 89 (33%, 89/271), 200 (74%, 200/271), 220 (81%, 220/271) and 176 (82%, 176/215), 178 (83%, 178/215), 183 (85%, 183/215) ears in watchful waiting group and autoinflation group had a hearing threshold <20 dB HL, respectively, in which ears with auditory threshold<20 dB HL in watchful waiting group were significantly less than those in autoinflation group at the end of 1 and 2 month follow-up (P<0.05), However, ears with auditory threshold<20 dB HL in watchful waiting group were not significantly different from that in the autoflation group at the end of 3- month follow-up (P>0.05). The proportion of ears with type A tympanogram curve was 74%(159/215), 79%(170/215), and 85%(183/215) at the end of 1-, 2- and 3- month follow-up in autoinflation group and 36%(98/271), 71%(192/271) and 76%(206/271) in watchful waiting group, respectively. Proportion of ears with type A tympanogram curve in autoflation group was significantly higher than that in watchful waiting group (P<0.05). Conclusion: Autoinflation can improve the hearing of children with OME in early stage, restore normal middle ear pressure, increase recovery rate, and reduce the choice of surgical treatment of OME.
Auditory Threshold ; Child ; Child, Preschool ; Female ; Hearing ; Humans ; Male ; Middle Ear Ventilation ; Otitis Media with Effusion/diagnosis* ; Prognosis

The present study determined five saponins in Xuesaitong Dropping Pills(XDP) by micellar electrokinetic chromatography(MEKC), and evaluated between-batch consistency by MEKC fingerprints and similarity analysis. A background buffer was composed of 20 mmol·L~(-1) sodium tetraborate-20 mmol·L~(-1) boric acid solution(pH 8.5), 55 mmol·L~(-1) sodium dodecyl sulfate(SDS), 23 mmol·L~(-1) β-cyclodextrin, and 13% isopropyl alcohol. All separations were performed at 25 ℃,20 kV and the detection wavelength was set at 203 nm. The separation channel was a fused silica capillary with a dimension of 75 μm I.D. and a total length of 50.2 cm(effective length of 40.0 cm). The contents of notoginsenoside R_1, and ginsenosides Rg_1, Re, Rb_1, Rd were determined with their quality control ranges set. The fingerprints of XDP were established and the between-batch consistency was evaluated by similarity analysis. The contents of five saponins from the 19 batches of XDP were stable in the fixed ranges. Statistical analysis was carried out on the results of multiple batches of samples, and the specific quality control ranges were recommended as follows: notoginsenoside R_1 21.92-34.16 mg·g~(-1), ginsenosides Rg_1 83.54-131.78 mg·g~(-1), ginsenosides Re 13.58-19.82 mg·g~(-1), ginsenosides Rb_1 89.40-129.90 mg·g~(-1), and ginsenosides Rd 22.34-35.67 mg·g~(-1). Eleven characteristic peaks were identified in the fingerprints. Five peaks, notoginsenoside R_1 and ginsenosides Rg_1, Re, Rb_1, Rd, were identified with reference standards. The similarities of the 19 batches of samples were all above 0.988, indicating good between-batch consistency. This method is green and simple, and can be used for the quantitative determination and quality evaluation of XDP. It can also provide references for the quality control of other Chinese medicinal dripping pills.
Chromatography, Micellar Electrokinetic Capillary ; Drugs, Chinese Herbal ; Micelles ; Quality Control ; Saponins

Objective To evaluate the changes in epithelial thickness profile and its relationship with diopter following small incision lenticule extraction (SMILE) for moderate and high myopia.Methods Together 46 myopia or myopic astigmatism (92 eyes) who underwent SMILE were included under the informed consent from January 2016 to March 2017 and were decided into 2 groups according to the diopter:moderate myopia group (58 eyes)and high myopia group (34 eyes).Epithelial thickness profile was measured using spectral-domain optical coherence tomography at different corneal zones (0-2 mm,＞ 2-5 mm and ＞ 5-6 mm cornea) preoperatively before surgery and 1 month and 6 months after surgery for observing the changes in epithelial thickness and its correction with diopter.Results The mean epithelial thickness in the central zone was (55.68 ± 3.61) μm before surgery,and,6 months after surgery,it was thickened by (3.85-±3.99),(3.46 ±3.29) and (2.85 ±3.18) μm in the 0-2 mm,＞2-5 mum and ＞5-6 mm cornea respectively,and the difference was statistically significant among the three zones (P ＜ 0.01).After surgery for 6 months,the epithelial thickness in the high myopia group was thickened more obviously compared with the moderate myopia group (t =1.440,P =-0.047).And no correlation was found between changes in the epithelial thickness at 0-2 mm cornea and diopter after surgery(moderate myopia group:r =0.219,P=0.633;high myopia group:r =0.197,P =0.585).Conclusion Significant epithelial thickening was observed after SMILE,presenting the thickened epithelium.The higher the diopter was,the more thickened the epithelium was.The epithelial changes does not appear to affect the diopter after SMILE.

OBJECTIVETo investigate the association of AKR1B10 expression in gastric cancer tissues with clinicopathologic features and prognosis of gastric cancer patients.

METHODSReal-time polymerase chain reaction (RT-PCR) was conducted to detect AKR1B10 mRNA expression in gastric cancer and adjacent gastric mucosa tissues (n=36). AKR1B10 protein expression was measured by immunohistochemistry in primary gastric cancer tissues (n=100) and non-tumorous gastric mucosa tissues (n=70).

RESULTSRT-PCR results confirmed that AKR1B10 was significantly down-regulated in gastric cancer tissues compared with that in paired adjacent mucosa [8.3% (3/36) vs. 91.7% (33/36), P=0.000]. Immunohistochemistry revealed that the percentage of AKR1B10 positive specimens in gastric carcinoma was lower than that in normal specimens [33.0% (33/100) vs. 92.9% (65/70), P=0.000]. The frequencies of positive AKR1B10 in patients was significantly correlated with tumor size (P=0.000), invasive depth (P=0.004), lymph node metastasis (P=0.028), distant metastasis (P=0.031) and TNM stages (P=0.000). The 5-year survival rate of positive AKR1B10 group was significantly higher as compared to negative group (60.6% vs. 32.8%, P<0.01).

CONCLUSIONThe down-regulation of AKR1B10 expression in gastric cancer may be associated with the progress of gastric cancer is suggestive of poor prognosis.

Adult ; Aged ; Aged, 80 and over ; Aldehyde Reductase ; genetics ; metabolism ; Female ; Gastric Mucosa ; enzymology ; pathology ; Humans ; Male ; Middle Aged ; Prognosis ; RNA, Messenger ; genetics ; Stomach Neoplasms ; diagnosis ; enzymology ; pathology

OBJECTIVETo explore the clinical application of high-frequency ultrasound in the diagnosis and treatment of epididymal stasis after vasectomy.

METHODSWe retrospectively studied the sonographic characteristics of 23 cases of epididymal stasis treated by vasectomy, which were divided into a mild (n = 5), a moderate (n = 11) and a severe group (n = 7) according to the results of color Doppler flow imaging. We analyzed the significance of high-frequency ultrasonography in the treatment of epididymal stasis after vasectomy.

RESULTSHigh-frequency ultrasonography revealed 14 cases of increased bilateral epididymal volume, 6 cases of left epididymal thickening and 3 cases of right epididymal thickening, mainly the thickening of the epididymal body and tail. After conservative treatment, 18 of the epididymal stasis cases (5 mild, 11 moderate and 2 severe) were improved, and the other 5 severe cases significantly relieved and discharged from hospital following conservative treatment combined with vasectomy reversal.

CONCLUSIONPost-vasectomy epididymal stasis has typical sonographic characteristics, and high-frequency ultrasonography has an extremely important application value in the clinical classification, diagnosis and treatment of the disease.

Adult ; Aged ; Epididymis ; diagnostic imaging ; Genital Diseases, Male ; diagnostic imaging ; etiology ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Ultrasonography ; methods ; Vasectomy ; adverse effects

BACKGROUNDMost of endovascular stent-graft modifications to preserve side branch must be customized according to extensive pre-operative assessment, which may not be possible in many hospitals and emergency settings. The study was to develop a novel stent-grafts system that would allow in situ "fenestration", with less reliance on preoperative imaging.

METHODSThe magnitude of pressure difference (PD) between left subclavian artery (LSA) and aortic arch were measured in 12 experimental pigs. Changes of PD before and after LSA was covered were analyzed respectively. The novel stent graft was made by multi-dimensional and multiple textiles forming technology. According to the PD measurement in pigs, we evaluated the feasibility of the stent-graft in a mock circulation system.

RESULTSIn pigs, the blood pressure of aortic arch was significantly higher than that of LSA after it was covered (P < 0.001) and PD was (42.78 ± 5.17) mmHg. After target vessel was covered and when PD between the LSA and aorta reached the magnitude measured in pigs, contrast media oozed from the cranny of graft to the LSA, which was generated by sliding and deformation of yarns of novel stent-graft.

CONCLUSIONSThe study proposes the design of pressure difference-induced perforation aortic stent-grafts system and verifies that the PD between LSA and aortic arch is high enough to allow in situ "fenestration" by stent graft made by multi-dimensional and multiple textiles forming technology.

Animals ; Aorta, Thoracic ; surgery ; Blood Pressure ; physiology ; Blood Vessel Prosthesis ; Blood Vessel Prosthesis Implantation ; Prosthesis Design ; Subclavian Artery ; Swine

OBJECTIVETo study correlation of brain hypoxia of different degrees with brain function and damage.

METHODSThe brain regional oxygen saturation (rSO2) was determined by using a non-invasive near infrared spectroscopy (NIRS) technique in 15 piglets; the piglets were subjected to inhale 3% - 11% oxygen-nitrogen mixed gas through mechanical ventilation for 30 min. The piglets were divided into groups according to the level of brain rSO2 (i.e. < 30%, 30% - 35%, 35% - 40%, and 40% - 50%), and the data were compared with those of the control group (rSO2 > 60%). Changes of brain function were detected through amplitude and frequency of EEG waves and signal complexity. The piglets were sacrificed via decapitation 72 h after brain damage, and then histopathological and ultrastructural examinations were performed on cerebral cortex and hippocampal CA1 area.

RESULTSIn the group with rSO2 > 40%, the mean arterial pressure (MAP) after hypoxia was (56 +/- 0.00) mm Hg (1 mm Hg = 0.133 kPa), the blood lactic acid (LA) was (2.3 +/- 1.2) mmol/L, the EEG findings were within normal range, and there was no change in brain tissue ultrastructure. In the group with brain rSO2 = 30% approximately 40%, the MAP was (73 +/- 8) mm Hg, the LA was (8.2 +/- 3.9) mmol/L, the EEG waves showed decreased amplitude, frequency and complexity, but restored to some extent after hypoxia. The brain tissue ultrastructure showed damages to the cerebral cortex and neuron mitochondria at hippocampal CA1 area. In the group with brain rSO2 < 30%, the MAP was (35 +/- 0) mm Hg, the LA was (12 +/- 2) mmol/L, the EEG showed decreased amplitude, frequency, and complexity of signals compared with those of the normal control group, and was difficult to restore after hypoxia in some of the piglets; the brain tissue ultrastructure appeared to be similar to the changes seen with high-degree swollen cerebral cortex and neuron mitochondria at hippocampal CA1 area.

CONCLUSIONDifferent degrees of hypoxia had different influence on brain function and brain damage. The lower the brain rSO2, the more severe the damages to the brain and its function. The rSO2 of brain tissues detected with noninvasive NIRS can reflect brain injury and its severity during cerebral anoxia.

Animals ; Blood Gas Analysis ; Brain Injuries ; complications ; Cerebral Cortex ; physiopathology ; Cerebrovascular Circulation ; physiology ; Electroencephalography ; Female ; Hypoxia ; metabolism ; pathology ; Hypoxia, Brain ; complications ; Hypoxia-Ischemia, Brain ; physiopathology ; Male ; Neurons ; pathology ; Oximetry ; instrumentation ; Oxygen ; metabolism ; Oxygen Consumption ; Spectroscopy, Near-Infrared ; methods ; Statistics as Topic ; Swine

OBJECTIVETo study the relationship between early brain response to extrinsic stimulation and neurodevelopment in preterm infants, assess the brain function of preterm infants in the early stage, and thereby to provide objective evidence for the degree of neurodevelopment in preterm infants and to evaluate prognosis.

METHODSUsing near infrared spectroscopy (NIRS), the brain response to sound stimulation of 90 preterm infants at different gestational age was observed and compared with the result obtained from 20 full term infants. The neonatal behavioral neurological assessment (NBNA) was performed at corrected age of 40 weeks, and the infants were followed up for 2 years. The effect of gestational age and brain damage on preterm infants, the relation between early brain response in preterm infants and their neurodevelopment was evaluated.

RESULTSAll the preterm infants responded to different degrees to auditory stimulation after birth. The time to beginning to react and the time to appearance of the peak reaction were attained after auditory stimulation and the time to beginning to resume when the auditory stimulation was stopped was (278 +/- 94) s, (446 +/- 67) s and (199 +/- 52) s, respectively, which were significantly longer than those observed in the full term infants (107 +/- 30) s, (264 +/- 51) s and (131 +/- 46) s, respectively. The maximum reactions of hemoglobin, oxyhemoglobin and regional oxygen saturation in the infants after gestational age 32 weeks was (0.3 +/- 0.3)%, (0.7 +/- 0.5)% and (0.3 +/- 0.3)%, respectively, which were significantly lower than those in the full term infants (1.7 +/- 0.7)%, (1.7 +/- 0.8)% and (1.6 +/- 0.7)%, respectively. When the brain response of preterm infants was compared with that in infants without brain damage, the speed of the reaction was slow, the maximum reaction was low. The brain response in preterm infant was correlated with NBNA at corrected age of 40 weeks. It was found during the following-up that abnormal neurodevelopment was associated with poor brain reaction.

CONCLUSIONSNIRS can be used to evaluate brain response of infants. Preterm infants display brain response to auditory stimulation. Early brain response is correlated with neurodevelopment.

Acoustic Stimulation ; Age Factors ; Brain ; growth & development ; metabolism ; Female ; Follow-Up Studies ; Gestational Age ; Hemoglobins ; metabolism ; Humans ; Infant ; Infant, Newborn ; growth & development ; metabolism ; Infant, Premature ; growth & development ; metabolism ; Male ; Neuropsychological Tests ; Oxygen ; metabolism ; Oxyhemoglobins ; metabolism ; Spectroscopy, Near-Infrared ; Time Factors

OBJECTIVETo compare the differences in cerebral oxygenation responses between the infants born preterm and full-term infants and to evaluate the early cognitive ability of infants born preterm.

METHODSCerebral oxygenation after light stimulation was detected by near infrared spectroscopy (NIRS) in preterm infants at 3 or 6 months corrected gestational age (GA). The results were compared with those of age-matched infants born at term.

RESULTSThe start and peak response time of cerebral oxygenation occurring after light stimulation in preterm infants at 3 months corrected GA was 17.2 +/- 5.2 and 38.4 +/- 9.6 seconds respectively, which were significantly longer than in age-matched term infants (13.1 +/- 2.7 and 28.9 +/- 5.0 seconds respectively) (P < 0.05). The maximum response value of hemoglobin, oxyhemoglobin and regional oxygen saturation of the preterm infants at 3 months corrected GA was (1.2 +/- 0.5)%, (1.5 +/- 0.6)%, and (1.3 +/- 0.4)% respectively , which were significantly lower than that of the term infants [(2.3 +/- 0.3)%, (2.8 +/- 0.3)% and (2.4 +/- 0.5)% respectively] (P < 0.05). Cerebral oxygenation responses to light stimulation in preterm infants examined at 6 months corrected GA were not significantly different from age-matched term infants.

CONCLUSIONSCerebral oxygenation responses to light stimulation in infants born preterm at 3 months corrected GA are not as good as age-matched term infants, but were close to the level of age-matched term infants at 6 months corrected GA. This suggests that the early cognitive ability of preterm infants before 3 months corrected GA might fall behind age-matched term infants.

Brain ; metabolism ; Cognition ; Humans ; Infant, Newborn ; Infant, Premature ; Oxygen ; metabolism ; Photic Stimulation ; Spectroscopy, Near-Infrared