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.

AIM To study the chemical constituents from salt-processed Citri Reticulatae Semen and their antioxidant activities.METHODS The 85% ethanol extract from salt-processed Citri Reticulatae Semen was isolated and purified by silica gel,D101 macroporous resins,MCI,ODS,Sephadex LH-20 and semi-prepative HPLC,then the structures of obtained compounds were identified by physicochemical properties and spectral data.Their antioxidant activities in vitro of the ethanol extract of Citri Reticulatae Semen,salt-processed Citri Reticulatae Semen and all the obtained compounds were evaluated by DPPH and ABTS+assay.RESULTS Sixteen compounds were isolated and identified as limonin(1),obacunone(2),nomilin(3),deacetyl nomilin(4),kaempferol(5),nobiletin(6),diosmetin(7),isosakuranetin(8),hesperetin(9),epicatechin(10),trans-p-menthane-1α,2β,8-triol(11),byakangelicin(12),vanillin(13),p-coumaric acid(14),4-[(1-ethoxy-2-hydroxy)ethyl]phenol(15),catechol(16).Compound 10 showed strong DPPH free radical scavenging activity,with an IC50 value of(0.015±0.001)μmol/mL,and strong ABTS+radical scavenging activity,with an IC50 value of(0.010±0.005)μmol/mL.CONCLUSION Compounds 8,11,15-16 are isolated from genus Citrus for the first time,5,12,14 are obtained from Citri Reticulatae Semen for the first time.Compound 10 shows obvious antioxidant activities.After salt roasting,the antioxidant activity of the ethanol extract of Citri Reticulatae Semen is enhanced.

AIM To study the chemical constituents from the leaves of Citrus reticulata Blanco and their anti-inflammatory activities.METHODS The 85%ethanol extract from the leaves of C.reticulata was isolated and purified by silica gel,D101 macroporous resin,MCI,ODS and Sephadex LH-20,then the structures of obtained compounds were identified by physicochemical properties and spectral data.The Griess method was used to determine their inhibitory activities on lipopolysaccharide-induced NO production in macrophages RAW 264.7 cells.The mice foot swelling inflammation model induced by carrageenan was established,and the levels of IL-1β,TNF-α were detected.RESULTS Twelve compounds were isolated and identified as nobiletin(1),tangeretin(2),5-demethylinoblitin(3),5,4'-dihydroxy-6,7,8,3'-tetramethoxy flavone(4),5-hydroxy-7,8,3',4'-trimethoxyflavanone(5),3,5,6,7,8,3',4'-heptamethoxyflavanone(6),hesperetin(7),5-hydroxy-6,7,3',4'-tetramethoxyphenone(8),β-balsam alcohol(9),stigmaster-5-en-3β-alcohol(10),p-hydroxybenzaldehyde(11),vanillin(12).Compounds 1,4,6,7,10 and 12 had strong inhibitory activites on NO release in LPS-induced RAW 264.7 cells,and the IC50 values were(25.21±2.10),(37.77±0.50),(38.19±1.58),(21.89±1.73),(43.81±1.18),(47.98±2.55),(41.23±1.11),(43.80±1.43)μmol/mL,respectively.Compounds 2-3 reduced IL-1β and TNF-α levels(P＜0.05,P＜0.01).CONCLUSION Compounds 6-7,9 are isolated from this plant for the first time.Compounds 1-4,8 exhibit strong in vitro anti-inflammatory activities,and compounds 2-3 exhibit significant in vivo anti-inflammatory activities.

Objective:Take Xi′an Jiaotong University as an example, to analyze the funding status of the National Natural Science Foundation of the Comprehensive University in the field of medicine-Engineering integration, with a view to revealing the general picture of interdiscipline of medicine and engineering research of Xi′an Jiaotong University, and gaining a glimpse of the development of the interdiscipline of medicine and engineering research in universities.Methods:Descriptive statistics were used to analyze the basic situation of the National Natural Science Foundation of China approved in the field of medicine-Engineering integration.Results:A total number of 692 projects were funded in the field of medicine-Engineering integration, with a total funding of 420 million yuan. Funding types are mainly general projects, followed by Youth Science Foundation projects. The number of key and major projects is small, but it is of great significance to the growth of the funding amount. The Department of Medical Science and the Department of Engineering Science are the departments with the largest total number of funding projects and funding amounts. In terms of funding disciplines, the core disciplines of imaging medicine and biomedical engineering, mechanical design and manufacturing, mechanics, biomaterials, imaging and tissue engineering, optics and optoelectronics, and oncology have been formed.Conclusions:The research shows that the interdiscipline of medicine and engineering research of Xi′an Jiaotong University has continued to grow, attracting scholars in science, engineering, medicine, management and other fields to participate, forming an advantageous discipline group. For the development of the integration of medicine and engineering in domestic universities, it is recommended to strengthen the top-level design, increase support for young people, and pay attention to the advanced layout of key and major projects.

Objective: To examine the clinical effect of minimally invasive duodenum preserving pancreatic head resection(DPPHR) for benign and pre-malignant lesions of pancreatic head. Methods: The clinical data of patients with diagnosis of benign or pre-malignant pancreatic head tumor were retrospectively collected and analyzed,all of them underwent laparoscopic or robotic DPPHR between October 2015 and September 2021 at Division of Gastrointestinal and Pancreatic surgery,Zhejiang Provincial People's Hospital. Thirty-three patients were enrolled with 10 males and 23 females. The age(M(IQR)) was 54(32) years old(range: 11 to 77 years old) and the body mass index was 21.9(2.9)kg/m²(range: 18.1 to 30.1 kg/m²). The presenting symptoms included abdominal pain(n=12), Whipple triad(n=2), and asymptomatic(n=19). There were 7 patients with hypertension and 1 patient with diabetes mellitus. There were 19 patients who were diagnosed as American Society of Anesthesiologists class Ⅰ and 14 patients who were diagnosed as class Ⅱ. The student t test,U test, χ² test or Fisher exact test was used to compare continuous data or categorized data,respectively. All the perioperative data and metabolic morbidity were analyzed and experiences on minimally invasive DPPHR were concluded. Results: Fourteen patients underwent laparoscopic DPPHR,while the rest of 19 patients received robotic DPPHR. Indocyanine green fluorescence imaging was used in 19 patients to guide operation. Five patients were performed pancreatico-gastrostomy and the rest 28 patients underwent pancreaticojejunostomy. Pathological outcomes confirmed 9 solid pseudo-papillary neoplasms, 9 intraductal papillary mucinous neoplasms, 7 serous cystic neoplasms, 6 pancreatic neuroendocrine tumors, 1 mucous cystic neoplasm, 1 chronic pancreatitis. The operative time was (309.4±50.3) minutes(range:180 to 420 minutes),and the blood loss was (97.9±48.3)ml(range:20 to 200 ml). Eighteen patients suffered from postoperative complications,including 3 patients experienced severe complications(Clavien-Dindo Grade ≥Ⅲ). Pancreatic fistula occurred in 16 patients,including 8 patients with biochemical leak,7 patients with grade B pancreatic fistula and 1 patient with grade C pancreatic fistula. No one suffered from the duodenal necrosis and none perioperative death was occurred. The length of hospital stay was 14(7) days (range:6 to 87 days). The follow-up was 22.6(24.5)months(range:2 to 74 months). None suffered from recurrence or metastasis. During the follow-up,all the patients were free of refractory cholangitis. Moreover,in the term of endocrine dysfunction,no postoperative new onset of diabetes mellitus were observed in the long-term follow-up. However,in the view of exocrine insufficiency,pancreatic exocrine insufficiency and non-alcoholic fatty liver disease (NAFLD) was complicated in 2 and 1 patient,respectively,with the supplement of pancreatic enzyme,steatorrhea and weight loss relieved,but NAFLD was awaited to be seen. Conclusions: Minimally invasive DPPHR is feasible and safe for benign or pre-malignant lesions of pancreatic head. Moreover,it is oncological equivalent to pancreaticoduodenectomy with preservation of metabolic function without refractory cholangitis.
Adolescent ; Adult ; Aged ; Child ; Duodenum/surgery* ; Female ; Humans ; Male ; Middle Aged ; Pancreas/surgery* ; Pancreatectomy ; Pancreatic Neoplasms/surgery* ; Pancreaticoduodenectomy ; Postoperative Complications ; Retrospective Studies ; Young Adult

Objective To verify the feasibility and safety of stomach tumor marker localization based on magnetic tracer technique in dogs.Methods Six male Beagle dogs were examined by gastroscopy.Then tracer magnets were sent to the "tumor" locations assumed in advance and fixed near the "tumors" by endoscopic soft tissue clamp.Laparoscopic gastric tumor localization was performed under general anesthesia 24 hours later.The tracer magnet was placed near the tumor on the surface of the stomach through the operating hole after the conventional establishment of laparoscope puncture parallel mirror to explore the tracer magnet.After the two magnets were attracted,the location of the tracer magnet seen under the laparoscope was the location of the gastric tumor,so as to complete the labeling and positioning of the lesion.Results All the 6 Beagle dogs were successfully implanted with tracer magnets under gastroscopy.Twenty-four hours after the gastroscopy,the pursuit magnet was successfully implanted during laparoscopic surgery.The two magnets automatically attracted each other and formed a sandwich structure of "tracer magnet-gastric wall-pursuit magnet ",which completed the location and identification of gastric tumor under the laparoscopy.Conclusion Gastroscopy combined with laparoscopy based on magnetic tracer technique is simple,accurate,safe and feasible.

Objective:To design magnets to locate colorectal neoplasms based on magnetic tracer technology, and to test its feasibility and safety by animal experiments.Methods:The magnets used for endoscopic localization of colorectal tumors consist of a tracer magnet and a pursuit magnet, both of which are ring-shaped Nd-Fe-B magnets. Eight healthy Beagle dogs were used as animal models. Tumor locations were assumed in the different parts of the colon and rectum under colonoscopy. The tracer magnet was sent to the hypothetical tumors by endoscopic soft tissue clamp and fixed near the tumors. After 24 hours, laparoscopic surgery was performed under general anesthesia. The pursuit magnet was inserted near the resected colon or rectum through the main operating hole. The tracer magnet was absorbed to the pursuit magnet to identify the location of tumors.Results:The tracer magnet and pursuit magnet were successfully designed and processed. The suction force between the tracer magnet and the pursuit magnet at zero distance was 16 N. All the 8 Beagle dogs successfully received indwelling of magnets under colonoscopy, and no magnets fell off after 24 hours. After the placement of pursuit magnet under laparoscopy, the two magnets attracted each other rapidly and accurately, and successfully completed localization of tumor site without any damage during the operation.Conclusion:Colonoscopy combined with laparoscopy for colorectal neoplasms localization based on magnetic tracer technique is simple, accurate, safe and feasible.

Objective:To study the feasibility of establishing gastrointestinal anastomosis by magnetic compression technique in rabbits.Methods:Ten healthy New Zealand rabbits were selected as models for gastrointestinal anastomosis by magnetic compression technique. Daughter and parent magnets suitable for gastrointestinal anastomosis in rabbits were designed and manufactured. A daughter magnet was inserted into the stomach through the purse fistula in the lack of blood vessel area of gastric body, and was pushed into the duodenum along the intestinal tract. And then a parent magnet was inserted through the stomach fistula. The daughter and parent magnets were automatically attracted and pressed the gastric and intestinal walls after they were adjusted in the proper position. The stomach fistula was closed with purse string suture. After ischemia, necrosis, detachment of the tissues between magnets, gastrointestinal anastomosis was established, and the magnets and necrotic tissues were expelled together from the body through the digestive tract. Survival of experimental animals was observed. Anastomotic specimens were obtained one month after operation. The blasting pressure of anastomotic stoma was measured, and the healing of anastomotic stoma was observed with naked eyes.Results:According to the pre-designed operative route, 10 New Zealand rabbits all successfully completed the operation and survived one month after surgery. No complications occurred during perioperative period. The operation time was 35.80±4.71 min (range 28.00-43.00 min), and the magnet discharge time was 11.40±1.56 days (range 9.00-14.00 days). Anastomotic specimens were obtained one month after the operation. Gross observation showed that the anastomotic stoma of gastrointestinal bypass anastomosis healed well, and the surrounding tissues adhered slightly. The anastomotic bursting pressure was 103.00±7.95 mmHg (range 94.00-113.00 mmHg) (1 mmHg=0.133 kPa).Conclusion:The establishment of gastrointestinal anastomosis by magnetic compression technique in rabbits is simple and effective.

Aim To prepare hyaluronic acid nanoparti-cles(Ade/GA-HA) using glycyrrhetinic acid modified hyaluronic acid as the carrier and adenine as a model drug, and analyze their physicochemical property and proliferation effect on Bel-7402 cells. Methods Gly-cyrrhetinic acid and hyaluronic acid were combined by chemical cross-linking method, dialysis and freeze-dr-ying,based on which Ade/GA-HA was prepared using ultrasonic method, and the particle size and Zeta po-tential were determined by Malvern laser particle analy-zer,and the morphology was observed by transmission electron microscopy, and the absorbance was deter-mined by ultraviolet-visible spectrophotometer, high performance liquid chromatograph and microplate read-er to caculate drug load, encapsulation efficiency and in vitro release. MTT assays were utilized to determine the proliferation of nanoparticles treated Bel-7402 cells. Results GA-HA nanoparticles had spherical shape with a good dispersion, at diameters of 398.1 nm, of which Zeta potential was - 34.2 mV, and presented good short term stability. The drug load and encapsulation efficiency of Ade/GA-HA nanoparticles were (22.5 ± 5.8)% and (87.27 ± 0.33) %, re-spectively. Burst release was observed in Ade/GA-HA nanoparticles within 4 h, while controlled release 4 h later. Compared with free adenine,Ade/GA-HA nano-particles had a stronger inhibitory effect on cell prolif-eration with statistically significant difference. Conclu-sion GA-HA nanoparticles has excellent physico-chemical properties and meet the design requirement.

OBJECTIVEA PCR-reverse dot blot hybridization (RDBH) assay was developed for rapid detection of rpoB gene mutations in 'hot mutation region' of Mycobacterium tuberculosis (M. tuberculosis).

METHODS12 oligonucleotide probes based on the wild-type and mutant genotype rpoB sequences of M. tuberculosis were designed to screen the most frequent wild-type and mutant genotypes for diagnosing RIF resistance. 300 M. tuberculosis clinical isolates were detected by RDBH, conventional drug-susceptibility testing (DST) and DNA sequencing to evaluate the RDBH assay.

RESULTSThe sensitivity and specificity of the RDBH assay were 91.2% (165/181) and 98.3% (117/119), respectively, as compared to DST. When compared with DNA sequencing, the accuracy, positive predictive value (PPV) and negative predictive value (NPV) of the RDBH assay were 97.7% (293/300), 98.2% (164/167), and 97.0% (129/133), respectively. Furthermore, the results indicated that the most common mutations were in codons 531 (48.6%), 526 (25.4%), 516 (8.8%), and 511 (6.6%), and the combinative mutation rate was 15 (8.3%). One and two strains of insertion and deletion were found among all strains, respectively.

CONCLUSIONOur findings demonstrate that the RDBH assay is a rapid, simple and sensitive method for diagnosing RIF-resistant tuberculosis.

Antitubercular Agents ; pharmacology ; Drug Resistance, Bacterial ; Genotype ; Immunoblotting ; methods ; Microbial Sensitivity Tests ; Mycobacterium tuberculosis ; drug effects ; genetics ; Polymerase Chain Reaction ; methods ; Rifampin ; pharmacology ; Sensitivity and Specificity ; Time Factors