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.

The paper-based microfluidic chip,also known as a paper chip,uses paper as the substrate on which the sample processing,biochemical reactions and assay processes are performed.Com-pared to other microfluidic chips,the paper chip has the advantages of widely availability of raw materials,lower cost,and easier disposal after use and ease of operation,making it more suitable for rapid on-site testing.This study systematically summarizes the production technology of paper chip and its research progress in animal pathogen detection,analyzes the existing problems of pa-per chip technology,and looks forward to the future research direction,so as to provide reference for the improvement of paper chip technology and its popularization and application.

Background: Immunochemotherapy has demonstrated a promising efficacy for a variety of B-cell lymphoma but has limited efficacy for Epstein–Barr virus-positive (EBV +) diffuse large B-cell lymphoma (DLBCL) that is refractory or relapsed to conventional chemotherapy regimens. Considering higher programmed death-ligand 1 (PD-L1) expres‑ sion in the subset of patients with DLBCL with positive EBV, we speculated that PD-1 inhibitors plus chemotherapy may be an alternative regimen in patients with refractory/relapsed EBV + DLBCL. Methods: This retrospective study included six adult patients diagnosed with refractory EBV + DLBCL resistant to first-line immunochemotherapy regimens (R-CHOP). These patients received PD-1 inhibitors plus chemotherapy as second-line treatment. Results: The final analysis included six patients (four men and two women (median age, 50 years; range, 39–83 years)). Four patients were diagnosed with Epstein–Barr virus (EBV) + DLBCL, and two had DLBCL associated with chronic inflammation. Over a median follow-up of 20 months (range, 2–31 months), the objective response rate was 83% (5/6) and the complete remission rate was 67% (4/6). No severe immune-related adverse reactions occurred, and only a mild rash was reported, which did not necessitate the discontinuation of therapy. Conclusion The combination of PD-1 inhibitors and chemotherapy offers promising results as a second-line treat‑ ment for patients with refractory EBV + DLBCL that is resistant to first-line immunochemotherapy regimens. These preliminary findings warrant further investigation in larger clinical trials to validate the efficacy and safety of this therapeutic approach.

Background: Immunochemotherapy has demonstrated a promising efficacy for a variety of B-cell lymphoma but has limited efficacy for Epstein–Barr virus-positive (EBV +) diffuse large B-cell lymphoma (DLBCL) that is refractory or relapsed to conventional chemotherapy regimens. Considering higher programmed death-ligand 1 (PD-L1) expres‑ sion in the subset of patients with DLBCL with positive EBV, we speculated that PD-1 inhibitors plus chemotherapy may be an alternative regimen in patients with refractory/relapsed EBV + DLBCL. Methods: This retrospective study included six adult patients diagnosed with refractory EBV + DLBCL resistant to first-line immunochemotherapy regimens (R-CHOP). These patients received PD-1 inhibitors plus chemotherapy as second-line treatment. Results: The final analysis included six patients (four men and two women (median age, 50 years; range, 39–83 years)). Four patients were diagnosed with Epstein–Barr virus (EBV) + DLBCL, and two had DLBCL associated with chronic inflammation. Over a median follow-up of 20 months (range, 2–31 months), the objective response rate was 83% (5/6) and the complete remission rate was 67% (4/6). No severe immune-related adverse reactions occurred, and only a mild rash was reported, which did not necessitate the discontinuation of therapy. Conclusion The combination of PD-1 inhibitors and chemotherapy offers promising results as a second-line treat‑ ment for patients with refractory EBV + DLBCL that is resistant to first-line immunochemotherapy regimens. These preliminary findings warrant further investigation in larger clinical trials to validate the efficacy and safety of this therapeutic approach.

Background: Immunochemotherapy has demonstrated a promising efficacy for a variety of B-cell lymphoma but has limited efficacy for Epstein–Barr virus-positive (EBV +) diffuse large B-cell lymphoma (DLBCL) that is refractory or relapsed to conventional chemotherapy regimens. Considering higher programmed death-ligand 1 (PD-L1) expres‑ sion in the subset of patients with DLBCL with positive EBV, we speculated that PD-1 inhibitors plus chemotherapy may be an alternative regimen in patients with refractory/relapsed EBV + DLBCL. Methods: This retrospective study included six adult patients diagnosed with refractory EBV + DLBCL resistant to first-line immunochemotherapy regimens (R-CHOP). These patients received PD-1 inhibitors plus chemotherapy as second-line treatment. Results: The final analysis included six patients (four men and two women (median age, 50 years; range, 39–83 years)). Four patients were diagnosed with Epstein–Barr virus (EBV) + DLBCL, and two had DLBCL associated with chronic inflammation. Over a median follow-up of 20 months (range, 2–31 months), the objective response rate was 83% (5/6) and the complete remission rate was 67% (4/6). No severe immune-related adverse reactions occurred, and only a mild rash was reported, which did not necessitate the discontinuation of therapy. Conclusion The combination of PD-1 inhibitors and chemotherapy offers promising results as a second-line treat‑ ment for patients with refractory EBV + DLBCL that is resistant to first-line immunochemotherapy regimens. These preliminary findings warrant further investigation in larger clinical trials to validate the efficacy and safety of this therapeutic approach.

Objective To establish the method of thin layer chromatography (TLC) for identification and quantitative determination of Shipi Xiaoshui gel plaster. Methods TLC was adopted to qualitatively identify astragalus radix, plantaginis semen, curcumae rhizome, cinnamomi ramulus, polyporus umbellatus and akebia quinata. UPLC-MS was used to determine the content of astragaloside Ⅳ. Results TLC spots were clear and well-separated; RSDs of precision, reproducibility and stability tests were all lower than 3%, the linear range of astragaloside Ⅳ was 2.75-33 μg/ml (r=0.999 9, n=6), and the average recovery was 100.49% (RSD=1.98%, n=6). Conclusion The established method in this study is accurate, reliable and specific, which could be used for the quality control of Shipi Xiaoshui gel plaster.

Objective: A retrospective analysis of the predictive value of acoustic radiation force impulse (ARFI) elastography for esophageal varices in post-hepatitis B cirrhosis patients. Methods: 124 patients with post-hepatitis B cirrhosis who were admitted to Tianjin Second People’s Hospital from August 2016 to August 2017 were selected. According to the shape of esophageal varices under gastroscopy and the risk of bleeding, patients were divided into 4 groups, none, mild, moderate and severe. In ARFI mode, the VTQ function was used to detect the VTQ values of the liver and spleen. The receiver operating characteristic curve and area under the curve (AUC) were used to evaluate the diagnosis of esophageal varices by VTQ values of the liver and spleen. Analysis of variance was performed on the data between the groups, and χ ² test was performed for categorical data. Results: The difference in liver VTQ values between groups were statistically significant (F = 12.623, P < 0.01). There was a statistically significant difference in VTQ values between spleens (F = 9.022, P < 0.01). The liver VTQ predicts that the AUC value of mild esophageal varices in patients with cirrhosis was 0.701 (0.575-0.827); moderate varices was 0.802 (0.701-0.902); severe varices was 0.885 (0.784-0.986). The best cutoff value was 2.235, the specificity was 97.37%, the negative predictive value was 88.10%, and the accuracy was 90.16%. The VTQ value of spleen predicts the AUC value of mild esophageal varices in patients with liver cirrhosis was 0.688 (0.539-0.798); moderate varices were 0.762 (0.651-0.873); severe varices were 0.800 (0.671-0.928). The best cutoff value was 2.885, the specificity was 84.21%, and the negative predictive value was 82.05%. Conclusion The application of ARFI elastography in the determination of VTQ values of liver and spleen has certain predictive value for esophageal varices and it might be useful for primary screening of esophageal varices in post-hepatitis B cirrhosis patients.

From December 2011 to August 2017,56 patients with acute abdomen surgery were treated in Affiliated Zhongshan Hospital of Dalian University.The anatomical structure of ileocecal Treves folds was observed during operation,and 15 samples of Treves folds were taken for histological examination.The mean length of the fold was (5.56±0.18)cm for males and (5.22±0.05)cm for female,the width was (1.82± 0.04) cm for males and (1.78 ± 0.06) cm for females;the thickness was (0.18 ± 0.02) cm.HE and verhoeff staining showed that Treves fold was mainly composed of elastic fiber,collagen fiber and smooth muscle with abundant blood supply.Thirty patients were repaired with their own Treves folds,including the fixation with overlay suture to the stump of appendectomy in 26 cases,repairing for perforation of colonic diverticulum in 3 case,and repairing for perforation of colonic diverticulum in 1 case.There were no complications such as fecal fistula,intestinal obstruction and intussusception after operation.The Treves fold has a constant location,which can be used as a clear sign of ileal terminal.It has abundant blood supply,and is suitable for the repair and reconstruction in ileocecal operation.

Objective To investigate the association between concentrations of environmental air pollutants and the daily number of outpatient visits for urticaria in Beijing. Methods Time series analysis in combination with distributed lag non?linear model(DLNM)and Spearman′s rank correlation test was used to analyze the association between PM2.5 concentrations and the daily number of outpatient visits for urticaria. All effect estimates were expressed as a risk ratio(RR)for the daily number of outpatient visits with an interquartile range(IQR)increase of 82.8 μg/m3 in PM2.5. Results From January 1st 2013 to June 30th 2014, the daily average PM2.5 concentration, temperature, relative humidity and number of visits for urticaria were 89.3 μg/m3, 12.7 ℃, 51.9% and 27.3 respectively. Spearman′s rank correlation test showed that the daily average PM2.5 concentration and number of visits for urticaria were correlated with daily mean temperature(rs =-0.21, 0.36, respectively, P < 0.05)and relative humidity(rs = 0.49, 0.31, respectively, P < 0.05), but no correlation was observed between daily average PM2.5 concentrations and daily number of visits for urticaria(rs=0.01, P>0.05). There was no significant correlation between daily number of outpatient visits for urticaria and daily PM2.5 concentration lagged by 0-14 days(RR=1, 95%CI:0.89, 1.13). After potential confounding factors were adjusted, an 82.8μg/m3 increase in daily PM2.5 concentration at lag 0-20 days was significantly associated with a 22%(95%CI:3%, 46%)increase in daily number of outpatient visits for urticaria, suggesting that the lagged effect of PM2.5 was obviously increased. Conclusion The association between PM2.5 concentrations and the number of visits for urticaria is easily affected by meteorological factors and biological confounding factors, and relative humidity and mean temperature are both positively correlated with the number of visits for urticaria.

BACKGROUND/AIMS: This study aimed to verify the reliability of the alcoholic liver disease (ALD)/nonalcoholic fatty liver disease (NAFLD) index (ANI) for distinguishing ALD in patients with hepatic steatosis from NAFLD, and to investigate whether ANI combined with γ-glutamyl transferase (GGT) would enhance the accuracy of diagnosis in China. METHODS: A hundred thirty-nine cases of fatty liver disease (FLD) were divided into two groups of ALD and NAFLD. The ANI was calculated with an online calculator. All indicators and ANI values were analyzed using statistical methods. RESULTS: ANI was significantly higher in patients with ALD than in those with NAFLD (7.11 ± 5.77 vs. -3.09 ± 3.89, p < 0.001). With a cut-off value of -0.22, the sensitivity, specificity, and area under the receiver operating characteristic curve (AUROC) of diagnosed ALD cases was 87.1%, 92.5%, and 0.934 (95% confidence interval [CI], 0.879 to 0.969), respectively. The corresponding values for aspartate aminotransferase (AST)/alanine transaminase (ALT), mean corpuscular volume (MCV), and GGT were 75.29%, 72.94%, and 0.826 (95% CI, 0.752 to 0.885); 94.34%, 83.02%, and 0.814 (95% CI, 0.739 to 0.875) and 80.23%, 79.25%, and 0.815 (95% CI, 0.740 to 0.876), respectively. ANI AUROC was significantly higher than the AST/ALT, MCV, or GGT AUROCs (all p < 0.001), moreover, ANI showed better diagnostic performance. The combination of ANI and GGT showed a better AUROC than ANI alone (0.976 vs. 0.934, p = 0.016). The difference in AUROCs between AST/ALT, MCV, and GGT was not statistically significant (all p > 0.05). CONCLUSIONS: ANI can help distinguish ALD from NAFLD with high accuracy; when ANI was combined with GGT, its effectiveness improved further.
Alcoholics* ; Aspartate Aminotransferases ; China ; Diagnosis ; Diagnosis, Differential ; Erythrocyte Indices ; Fatty Liver* ; gamma-Glutamyltransferase ; Humans ; Liver Diseases, Alcoholic* ; ROC Curve ; Sensitivity and Specificity ; Transferases*