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 discuss the application of strengthening propaganda and education for ischemic stroke patient′s spouse.Methods Ischemic stroke patients′spouse ( n =100 ) were divided into experimental group ( strengthening propaganda and education ) and control group ( normal propaganda and education) on average by randomly controlled trail.SS-QQL, SF-36, SDS and SAS had been used for assessment of ischemic stroke patients and their spouse′s quality of life, anxiety and depression.Results The scores of SDS for patients and spouses were (51.24 ±6.65) and (49.01 ±7.32) in the experimental group comparing with (58.21 ±6.31) and (56.51 ±7.12) in the control group at reexamination after 12 months discharged (t=5.474, 5.288;P<0.05);similarly, the scores of SAS were (50.24 ±7.24) and (47.01 ± 7.51) lower than (56.21 ±7.35) and (55.51 ±7.42) in the control group (t=4.166, 5.796; P<0.05). the scores of dimensions SS-QQL and spouses′quality of life were higher than those in the control group ( P<0.05) except dimensions of physical pain (P>0.05).Conclusions Strengthening propaganda and education during hospitalization can minimize patient′s anxiety, depression and enhance them and their spouses′quality of life.

Objective To investigate the prevalence of genes conferring aminoglycoside resistance in multidrug-resistant strains of Acinetobacter baumannii (MDR-ABA).Methods Multidrug-resistant A.baumannii strains were isolated during the period from August to November 2012 from patients in the affiliated hospital of Jiangsu University and the First Hospital of Zhen-jiang.Kirby-Bauer diffusion method was used to determine the susceptibility of these strains to antimicrobial agents.PCR was performed to detect the aminoglycoside resistance genes.Results The 36 MDR-ABA strains showed high resistance rates to most antimicrobial agents except cefoperazone-sulbactam.The prevalence of the genes conferring aminoglycoside resistance, aac (3)-I,aac (6’)-Ib,aph (3’)-I and armA,was 72.2% (26/36),72.2% (26/36),80.6% (29/36)and 80.6% (29/36), respectively.Conclusions The MDR-ABA strains in this study are highly resistant to antimicrobial agents,which is closely as-sociated with the genes conferring aminoglycoside resistance.

Objective To investigate the prevalence of multidrug resistant genes in Klebsiella pncumoniae.MethodsTwenty strains of multidrug resistant Klebsiella pneumoniae were isolated from burn patients.Susceptibility of these strains to 14 antibiotics was detected by KB method.PCR was used to detect oqxA,smrKpn,qacE,tehA,mdfA and qacEΔl-sul1 genes.ResultsThe antibiotic sensitivity rates of 20 multidrug resistant Klebsiella pneumoniae isolates to antibiotics tested were ＜ 30％ except that to imipenam.The positive rates of efflux pump genes mdfA,qacEΔl-sull and oqxA were 65％,100％ and 100％,respectively; while those ofsmrKpn,qacE and tehA were 0％,0％ and 15％.ConclusionoqxA gene has been detected in multidrug resistant Klebsiella pneumoniae from burn patients with high positive rate.

Objective To investigate the prevalence of mobile genetic elements in Acinetobacter baumannii strains isolated from burn patients. Methods Polymerase chain reaction (PCR) was used to detect the genes encoding the integron, transposon, conjugative plasmid and insertion sequence in 20 strains of Acinetobacter baumannii isolated from burn patients. Results tnpU and ISaba1 genes were detected in all 20 strains, and int Ⅰ gene was detected in 19 strains (95.0%). Other genes were all negative. Conclusion Mobile genetic elements carrying multi-drug resistant genes are found in Acinctobacter baumannii strains isolated from bum patients.

OBJECTIVE To investigate the situation of prevalence for extended spectrum ?-lactamases(ESBLs)genes in multidrug-resistant Pseudomonas aeruginosa(PA). METHODS Antimicrobial susceptibility test was performed by agar dilution method and 7 kinds of ESBLs genes were detected by PCR methods in 35 strains of PA. RESULTS In 35 strains of PA, the positive rates of genes of TEM, OXA, PER and GES were 51.4%, 42.8%, 31.4%, and 22.9%, respectively, and genes of SHV, VEB, and CTX-M-1 were all negative. CONCLUSIONS This study shows that there are high positive rates of TEM, OXA, PER and GES genes in PA in our hospital. The GES genes in PA are first reported in China.

OBJECTIVE To investigate drug resistant genes associated with beta-lactamases,aminoglycosides and sulfonamides in Pseudomonas aeruginosa isolated from burned patients.METHODS Common drug resistant genes associated with beta-lactamases,aminoglycosides and sulfonamides of 20 strains of P.aeruginosa isolated from burned patients were detected by PCR.RESULTS The positive rates of genes of TEM,aac(6′)-Ⅰb,sul1 and ant(3″)-Ⅰwere 85%,85%,90% and 10%,respectively and genes of CARB and aac(6′)-Ⅱ were both positive(100%).Genes of oprD2 were all absent and genes of SHV,GES,IMP,VIM,DHA and armA were all negative.Furthermore,drug resistant genes of strains isolated from different sites of one patient on different time could be different.CONCLUSIONS Drug resistant genes of CARB and aac(6′)-Ⅱprevail in P.aeruginosa isolated from burned patients.Detections of drug resistant genes in P.aeruginosa isolated,especially continuously isolated from burned patients are essential.

OBJECTIVE To compare the three methods on relatedness analysis of Acinetobacter baumannii strains in hospital infection.METHODS Twenty-seven A.baumannii strains caused hospital infection were analyzed by pulsed field gel electrophoresis(PFGE),amplified fragment length polymorphism(AFLP) and multiple gene cluster analysis.RESULTS PFGE analysis showed 19 strains isolated from clinic were with identical clone;AFLP analysis showed 19 strains isolated from clinic were with identical clone;but multiple gene cluster analysis showed 3 clones including 11 strains carried with 8 positive genes(TEM,OXA-23group,ADC,aac(3)-Ⅰ,aac(6′)-Ⅰ,ant(3″)-Ⅰ,qacE△1-sul1 and intⅠ1),6 strains with 7 positive genes(TEM,ADC,aac(3)-Ⅰ,aac(6′)-Ⅰ,ant(3″)-Ⅰ,qacE△1-sul1 and intⅠ1) and 4 strains with 6 positive genes(TEM,ADC,aac(3)-Ⅰ,ant(3″)-Ⅰ,qacE△1-sul1 and intⅠ1).CONCLUSIONS The resolving ability of multiple gene cluster analysis is higher than that of PFGE and AFLP in relatedness analysis of A.baumannii strains from hospital infection.

OBJECTIVE To investigate the drug-resistance and the existence of genes in 16S rRNA methylases and aminoglycoside modifying enzymes in strains continuously isolated from Pseudomonas aeruginosa(PAE) in two hospitals of Jiangsu and Zhejiang Provinces.METHODS The drug-resistance of the strains continuously isolated from PAE was detected with K-B test,five kinds of genes in 16S rRNA methylases(rmtA,rmtB,rmtC,rmtD and armA) and six kinds of aminoglycoside modifying enzymes [aac(3)-Ⅰ,aac(3)-Ⅱ,aac(6′)-Ⅰb,aac(6′)-Ⅱ,ant(3″)-Ⅰ and ant(2″)-Ⅰ] were detected by PCR.RESULTS The strains were just sensitive to cefoperazone/sulbactam,imipenem,meropenem and amikacin(hospital A:74.2%,80.0%,82.9% and 68.5%;hospital B:90.0%,50.0%,50.0% and 95.0%,respectively).There was a high rate in the drug-resistance to ?-lactamase medicines,ciprofloxacin and sulfamethoxazole co.Genes in 16S rRNA methylases were not detected from PAE strains in the two hospitals.CONCLUSIONS The rates of genes in aminoglycoside modifying enzymes detected from strains in continuously isolated from PAE are different in different hospitals.

OBJECTIVETo investigate the status of the semen of the infertility patients infected by Gardnerella vaginalis (Gv).

METHODSSemen samples from 373 clinic patients of infertility and vaginal samples from 63 positive patients' wives were collected from April 2002 to May 2003. And the samples were tested by nested polymerase chain reaction (nPCR).

RESULTSThe positive rate of the infertile males' semen infected by Gv was 44.2%, while that of the postive patients' wives was 87.3%.

CONCLUSIONThe positive rate of the infertile male's semen infected by Gv is high and Gv can be spread by sexual intercourse.

Adult ; Base Sequence ; Female ; Gardnerella vaginalis ; isolation & purification ; Humans ; Infertility, Male ; microbiology ; Male ; Molecular Sequence Data ; Polymerase Chain Reaction ; Semen ; microbiology