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.

Osteosarcoma， a common primary bone malignancy， features high heterogeneity， poor prognosis， high propensity for local invasion and distant metastasis， and high mortality. At the moment， the major therapy is the combination of neoadjuvant chemotherapy and limb salvage surgery， which remarkably reduces the disability rate and fatality rate. However， long-term use of chemotherapeutic drugs leads to the acquisition of drug resistance by osteosarcoma cells and reduces the sensitivity of the tumor cells to the drugs. Thus， this therapy is not satisfactory. In recent years， amid the advancement in the treatment of tumor， Chinese medicine has attracted extensive attention for the obvious therapeutic effect and few adverse reactions. Phosphatidylinositol 3-kinase （PI3K）/protein kinase B （Akt） /mammalian target of rapamycin （mTOR） signaling pathway， as a classic cancer signaling pathway， is abnormally activated in osteosarcoma cells， which affects the proliferation， invasion， and metastasis of osteosarcoma cells by influencing the cycle of tumor cells， inhibiting apoptosis and autophagy of tumor cells， and promoting tumor angiogenesis. According to clinical research， Chinese medicine monomers influence proliferation， apoptosis， and autophagy of osteosarcoma cells and angiogenesis by regulating the activity of proteins in PI3K/Akt/mTOR signaling pathway， thereby suppressing osteosarcoma tissues and cells. Moreover， they can reverse the resistance of tumor cells to multiple anticancer drugs. Based on the knowledge and experience of Chinese medicine in the treatment of osteosarcoma， this paper reviews the role of PI3K/Akt/mTOR signaling pathway in the treatment of osteosarcoma by Chinese medicine monomers， which is expected to serve as a reference for the application of Chinese medicine in the treatment of osteosarcoma.

Bone marrow mesenchymal stem cells （BMSCs） are derived from stem cells isolated from bone marrow and have the potential for multidirectional differentiation and self-renewal. Under certain conditions， BMSCs can be induced to differentiate into osteoblast （OB）， chondrocyte， adipocyte， fibroblast， etc. BMSCs play an important role in maintaining the stability of bone structure and balancing bone metabolism. Promoting the proliferation of BMSCs and inducing their differentiation into OB of great significance for the clinical prevention and treatment of osteoporosis， bone defects， fracture healing， and other diseases. Because the proliferation and osteogenic differentiation of BMSCs are complex processes controlled by multiple genes and regulated by multiple signal transduction pathways， traditional Chinese medicine （TCM） happens to have the advantages of multi-bioactive component， multi-target， and multi-pathway synergism， which can affect the proliferation and differentiation of BMSCs through multiple channels and induce the proliferation of BMSCs. The transcription and expression of genes related to osteogenesis can be enhanced to promote the differentiation of BMSCs into OB， so as to achieve the purpose of preventing and treating osteoporosis， bone defects， and other bone diseases. Based on the literature on the intervention of TCM monomers and compounds in the proliferation and osteogenic differentiation of BMSCs， this study reviewed TCM monomers and compounds in promoting the proliferation and osteogenic differentiation of BMSCs by regulating secreted glycoprotein （Wnt）， neurogenic locus notch homolog protein （Notch）， mitogen-activated protein kinase （MAPK）， phosphatidylinositol-3 kinase （PI3K） /protein kinase B （Akt）， bone morphogenetic protein （BMP）/Smad， Janus kinase （JAK）/signal transducer and activator of transcription protein （STAT）， osteoprotegerin （OPG）/receptor activator of nuclear factor-kappa B （RANK）/RANK ligand （RANKL）， and other signaling pathways to provide new ideas for the research and clinical application of Chinese medicine in the prevention and treatment of orthopedic diseases.

Osteoporosis （OP） is a systemic metabolic disease that affects the health of middle-aged and elderly people by crosslinking multiple signaling pathways. With the increasing aging of the population， the incidence of OP is also increasing year by year. Because of a series of problems such as high incidence， difficulty in treatment， and poor prognosis， it has been widely studied and reported by scholars in China and abroad. At present， the drugs used by western medicine are mainly divided into two categories： Bone resorption inhibitors and bone formation promoters. Although the efficacy is reliable， there are still deficiencies such as poor dependence of patients on the drug， uncontrollable side effects， and high costs. However， in recent years， with the continuous deepening and innovation of traditional Chinese medicine （TCM） research， the treatment of OP by TCM has been widely recognized in clinical practice. Many scholars have found that the mechanism of TCM in the treatment of OP includes the widespread involvement of mitogen-activated protein kinase （MAPK） signaling pathway， which mainly promotes the differentiation of bone marrow mesenchymal stem cells （BMSCs） to osteoblasts （OB）， inhibits the differentiation of osteoclasts （OC）， and improves the expression of osteogenesis-related factors alkaline phosphatase （ALP）， Runt-associated transcription factor 2 （Runx2）， type Ⅰ collagen （ColⅠ） to treat OP. Although the current research on the TCM treatment of OP through the MAPK pathway is deepening， there are still certain deficiencies in the study of its molecular mechanism. Therefore， this paper reviewed the relationship between the MAPK signaling pathway and key target protein factors and OP to clarify the important role of the MAPK signaling pathway in OP. At the same time， the targeted regulation of MAPK signaling pathways by TCM to treat OP was systematically summarized in order to provide a scientific basis for the further accurate treatment of OP in TCM.

During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.

Gastric cancer (GC) is associated with high morbidity and mortality rates. Thus, early diagnosis is important to improve disease prognosis. Endoscopic assessment represents the most reliable imaging method for GC diagnosis; however, it is semi-invasive and costly and heavily depends on the skills of the endoscopist, which limit its clinical applicability.Therefore, the search for new sensitive biomarkers for the early detection of GC using noninvasive sampling collection methods has attracted much attention among scientists.Urine is considered an ideal biofluid, as it is readily accessible, less complex, and relatively stable than plasma and serum. Over the years, substantial progress has been made in screening for potential urinary biomarkers for GC. This review explores the possible applications and limitations of urinary biomarkers in GC detection and diagnosis.

Nucleos(t)ide analogs (NAs) are one of the two main antiviral agents used in clinical practice, which can effectively inhibit HBV replication. Serum HBV DNA is one of the most commonly used virologic markers used to assess HBV replication level. In recent years, more and more studies have suggested that serum HBV RNA is one of the ideal surrogates of cccDNA activity. This article summarized the influence of serum viral nucleic acid properties and quantitative result during treatment with NAs, as well as current method of viral nucleic acid quantification. And finally, it evaluates the significance of HBV DNA and RNA joint testing for CHB treatment.

Objective:To investigate the effect of miR-204 on the proliferation and differentiation of osteoblasts in osteoporosis mice by Wnt signaling pathway and its mechanism.Methods:Female Kunming mice were divided into: control group, sham operation group and osteoporosis group. Ovariectomy mouse models were established and identified by bilateral ovariectomy; Mouse primary osteoblasts were extracted and identified; Cells was transfected and detected the miR-204 expression levels; MTT was used to detect the viability of each group of cells; Alkaline phosphatase (ALP) activity was detected in each cell group; Cell flowmetry was used to detect apoptosis in each group; Cell flowmetry was used to detect the activity of Caspase-3 in each group of cells; Interaction between miR-204, β-catenin and LRP-5 was detected by dual luciferase reporter gene. Western blot was used to detect the expression of Wnt signaling pathway-related proteins.Results:The bone mineral density of the osteoporosis group was significantly lower than that of the control group and the sham operation group ( P=0.007, P=0.057) , indicating that the osteoporosis mice were successfully modeled; The expression level of miR-204 was significantly increased in the miR-204 mimics group ( P=0.007) , and decreased in the miR-204 inhibitor group ( P=0.031) ; The activity of bone cell and ALP activity of miR-204 mimics increased ( P=0.007, P=0.043) , and the activity of bone cell and ALP decreased by miR-204 inhibitor ( P=0.007, P=0.035) ; The invasive ability of miR-204 mimics was significantly increased ( P=0.006) , and the invasive ability of miR-204 inhibitor was decreased ( P=0.036) ; The apoptosis ability and Caspase-3 activity of miR-204 mimics were decreased ( P=0.041, P=0.045) , and the apoptosis ability and Caspase-3 activity of bone cells were enhanced by miR-204 inhibitor ( P=0.005, P=0.039) ; There were targeting relationship between miR-204 and β-catenin, LRP-5. The expressions of β-catenin and LRP-5 protein in osteoblasts of miR-204 mimics were up-regulated ( P=0.043, P=0.009) , and the expression of β-catenin and LRP-5 protein in bone cells of miR-204 inhibitor was down-regulated ( P=0.041, P=0.032) . Conclusion:miR-204 maybe promote the proliferation and differentiation of osteoblasts, activate Wnt signaling pathway, and has certain protective effect on osteoporosis.

Linear chromatin is compacted into eukaryotic nucleus through a complex and multi-layered architecture. Consequently, chromatin conformation in a local or long-distance manner is strongly correlated with gene expression. Chromosome conformation capture (3C) technology, together with its variants like 4C/5C/Hi-C, has been well developed to study chromatin looping and whole genome structure. In this review, we introduce new technologies including chromosome capture combined with immunoprecipitation, nuclei acid-based hybridization, single cell and genome sequencing, as well as their application.
Cell Nucleus ; Chromatin/genetics* ; Chromosomes/genetics* ; Genetic Techniques ; Genome/genetics*

Antigenic purity is important for quality control of the foot-and-mouth (FMD) whole virus inactivated vaccine. The recommended method for evaluation the antigenic purity of FMD vaccine is to check the serum conversion to non-structural protein (NSP) 3AB antibody after 2 to 3 times inoculation of animals with inactivated vaccine. In this study, we developed a quantitative ELISA to detect the amount of residual 3AB in vaccine antigen, to provide a reference to evaluate the antigenic purity of FMD vaccine. Monoclonal antibody (Mab) of NSP 3A and HRP-conjugated Mab of NSP 3B were used to establish a sandwich ELISA to quantify the NSP 3AB in vaccine antigen of FMD. Purified NSP 3AB expressed in Escherichia coli was serially diluted and detected to draw the standard curve. The detectable limit was determined to be the lowest concentration of standard where the ratio of its OD value to OD blank well was not less than 2.0. Results: The OD value was linearly corelated with the concentration of 3AB protein within the range between 4.7 and 600 ng/mL. The correlation coefficient R² is greater than 0.99, and the lowest detectable limit is 4.7 ng/mL. The amount of 3AB protein in non-purified inactivated virus antigen was detected between 9.3 and 200 ng/mL depending on the 12 different virus strains, whereas the amount of 3AB in purified virus antigen was below the lowest detectable limit. The amount of 3AB in 9 batches of commercial FMD vaccine antigens was between 9.0 and 74 ng/mL, whereas it was below the detectable limit in other 24 batches of commercial vaccine antigens. Conclusion: the sandwich ELISA established in this study is specific and sensitive to detect the content of 3AB protein in vaccine antigen of FMD, which will be a useful method for evaluation of the antigenic purity and quality control of FMD inactivated vaccine.
Animals ; Antibodies, Viral ; Enzyme-Linked Immunosorbent Assay ; Foot-and-Mouth Disease/prevention & control* ; Foot-and-Mouth Disease Virus ; Viral Nonstructural Proteins/genetics* ; Viral Vaccines