3.Chinese expert consensus on emergency surgery for severe trauma and infection prevention during corona virus disease 2019 epidemic (version 2023)
Yang LI ; Yuchang WANG ; Haiwen PENG ; Xijie DONG ; Guodong LIU ; Wei WANG ; Hong YAN ; Fan YANG ; Ding LIU ; Huidan JING ; Yu XIE ; Manli TANG ; Xian CHEN ; Wei GAO ; Qingshan GUO ; Zhaohui TANG ; Hao TANG ; Bingling HE ; Qingxiang MAO ; Zhen WANG ; Xiangjun BAI ; Daqing CHEN ; Haiming CHEN ; Min DAO ; Dingyuan DU ; Haoyu FENG ; Ke FENG ; Xiang GAO ; Wubing HE ; Peiyang HU ; Xi HU ; Gang HUANG ; Guangbin HUANG ; Wei JIANG ; Hongxu JIN ; Laifa KONG ; He LI ; Lianxin LI ; Xiangmin LI ; Xinzhi LI ; Yifei LI ; Zilong LI ; Huimin LIU ; Changjian LIU ; Xiaogang MA ; Chunqiu PAN ; Xiaohua PAN ; Lei PENG ; Jifu QU ; Qiangui REN ; Xiguang SANG ; Biao SHAO ; Yin SHEN ; Mingwei SUN ; Fang WANG ; Juan WANG ; Jun WANG ; Wenlou WANG ; Zhihua WANG ; Xu WU ; Renju XIAO ; Yang XIE ; Feng XU ; Xinwen YANG ; Yuetao YANG ; Yongkun YAO ; Changlin YIN ; Yigang YU ; Ke ZHANG ; Xingwen ZHANG ; Guixi ZHANG ; Gang ZHAO ; Xiaogang ZHAO ; Xiaosong ZHU ; Yan′an ZHU ; Changju ZHU ; Zhanfei LI ; Lianyang ZHANG
Chinese Journal of Trauma 2023;39(2):97-106
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managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control.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.
5.AIDS, syphilis and gonorrhea testing results among 385 men who have sex with men in Dehong Prefecture in 2018
Ren-hai TANG ; Chun-yan HE ; Li-fen XIANG ; Jie GAO ; Yang TANG ; Lin LI ; Xue-xian WANG ; Yue-cheng YANG ; Ji-bao WANG ; Shi-tang YAO ; Run-hua YE ; Na HE ; Ying-ying DING ; Song DUAN
Shanghai Journal of Preventive Medicine 2021;33(12):1127-1130
ObjectiveTo understand the infection of AIDS, syphilis, and gonorrhea in men who have sex with men (MSM), and the factors influencing the acceptance of gonorrhea testing in Dehong Dai Jingpo Autonomous Prefecture (Dehong Prefecture), Yunnan Province. MethodsAcross-sectional survey was conducted to describe and analyze the acceptance of AIDS, syphilis, and gonorrhea testing among MSM tracked in Dehong Prefecture in 2018. ResultsA total of 385 MSM were included in the analysis, with a 100.0% HIV and syphilis testing rate. The HIV antibody positivity rate was 10.6% (41/385) and the positivity rate of syphilis antibody was 14.8%(57/385). Only 30.4% of the subjects were willing to test for gonorrhea, and 13.7%(16/117)of them were test positive. Further multifactorial analysis revealed that local MSM and syphilis co-infected individuals were more likely to be tested for gonorrhea (
6.The first two cases of transcatheter mitral valve repair with ARTO system in Asia
Kai-da Ren ; Zhao-xia Pu ; Lei Yu ; Feng Gao ; Li-han Wang ; Stella Ng ; Ju-bo Jiang ; Hua-jun Li ; Yong Xu ; Wei He ; Min Yan ; Xian-bao Liu ; Jian-an Wang
World Journal of Emergency Medicine 2020;11(1):33-36
BACKGROUND:
MAVERIC (Mitral Valve Repair Clinical Trial) validates the safety and efficacy of the ARTO system. We here report the first two successful cases of utilizing the ARTO system in patients with symptomatic heart failure (HF) with functional mitral regurgitation (FMR) in Asia.
METHODS:
Two patients, aged 70 and 63, had severe HF with FMR. Transesophageal echocardiography confirmed that the left ventricular ejection fractions were less than 50% with severe mitral regurgitation (MR) in both patients. Optimizing drug treatment could not mitigate their symptoms. Therefore, we used the ARTO system to repair the mitral valve for these patients on March 5 and 6, 2019, respectively.
RESULTS:
Mitral valve repairs using the ARTO system were successfully performed under general anaesthesia for these two patients. MR was decreased immediately after the procedures in both patients. The 30-day and 3-month transthoracic echocardiography (TTE) revealed a moderate to severe MR in both patients, and the New York Heart Association (NYHA) scales were also partially improved.
CONCLUSION
The first two cases in Asia indicate that the ARTO system is feasible for patients with heart failure with FMR, and the patient selection appears to be crucial.
7.Early use of dexamethasone increases Nr4a1 in Kupffer cells ameliorating acute liver failure in mice in a glucocorticoid receptor-dependent manner.
Jing-Wen DENG ; Qin YANG ; Xiao-Peng CAI ; Jia-Ming ZHOU ; Wei-Gao E ; Yan-Dong AN ; Qiu-Xian ZHENG ; Meng HONG ; Yan-Li REN ; Jun GUAN ; Gang WANG ; Shu-Jing LAI ; Zhi CHEN
Journal of Zhejiang University. Science. B 2020;21(9):727-739
BACKGROUND AND OBJECTIVE:
Acute liver failure (ALF) is a type of disease with high mortality and rapid progression with no specific treatment methods currently available. Glucocorticoids exert beneficial clinical effects on therapy for ALF. However, the mechanism of this effect remains unclear and when to use glucocorticoids in patients with ALF is difficult to determine. The purpose of this study was to investigate the specific immunological mechanism of dexamethasone (Dex) on treatment of ALF induced by lipopolysaccharide (LPS)/D-galactosamine (D-GaIN) in mice.
METHODS:
Male C57BL/6 mice were given LPS and D-GaIN by intraperitoneal injection to establish an animal model of ALF. Dex was administrated to these mice and its therapeutic effect was observed. Hematoxylin and eosin (H&E) staining was used to determine liver pathology. Multicolor flow cytometry, cytometric bead array (CBA) method, and next-generation sequencing were performed to detect changes of messenger RNA (mRNA) in immune cells, cytokines, and Kupffer cells, respectively.
RESULTS:
A mouse model of ALF can be constructed successfully using LPS/D-GaIN, which causes a cytokine storm in early disease progression. Innate immune cells change markedly with progression of liver failure. Earlier use of Dex, at 0 h rather than 1 h, could significantly improve the progression of ALF induced by LPS/D-GaIN in mice. Numbers of innate immune cells, especially Kupffer cells and neutrophils, increased significantly in the Dex-treated group. In vivo experiments indicated that the therapeutic effect of Dex is exerted mainly via the glucocorticoid receptor (Gr). Sequencing of Kupffer cells revealed that Dex could increase mRNA transcription level of nuclear receptor subfamily 4 group A member 1 (Nr4a1), and that this effect disappeared after Gr inhibition.
CONCLUSIONS
In LPS/D-GaIN-induced ALF mice, early administration of Dex improved ALF by increasing the numbers of innate immune cells, especially Kupffer cells and neutrophils. Gr-dependent Nr4a1 upregulation in Kupffer cells may be an important ALF effect regulated by Dex in this process.
Animals
;
Dexamethasone/therapeutic use*
;
Disease Models, Animal
;
Kupffer Cells/physiology*
;
Liver Failure, Acute/pathology*
;
Male
;
Mice
;
Mice, Inbred C57BL
;
Nuclear Receptor Subfamily 4, Group A, Member 1/physiology*
;
Receptors, Glucocorticoid/physiology*
8.The first four cases of successful NeoChord procedure in Chinese mainland
Li-han Wang ; Zhao-xia Pu ; Min-jian Kong ; Ju-bo Jiang ; Kai-da Ren ; Feng Gao ; Xin-ping Lin ; Lei Yu ; Wei He ; Min Yan ; Xian-bao Liu ; Jian-an Wang
World Journal of Emergency Medicine 2019;10(3):133-137
BACKGROUND:
Transapical off-pump NeoChord procedure is a novel minimally invasive surgical repair of degenerative mitral regurgitation (MR). Here, we report the first four cases of NeoChord procedure in patients with mitral valve prolapse in Chinese mainland.
METHODS:
Four patients, aged 86, 84, 80 and 60 years, with severe MR due to posterior middle scallop prolapse (P2), underwent transapical off-pump artificial chordae implantation on April 9 and 10, 2019. The procedure was performed by left mini-thoracotomy under general anaesthesia and guided by 2D and 3D dimensional transoesophageal echocardiography (TEE).
RESULTS:
Mitral valve repair via NeoChord procedure was successfully performed with implantation of 3 artificial chordae in the first patient and 3, 2, and 3 artificial chordae in the following patients, respectively. Intraoperative TEE and pre-discharge transthoracic echocardiography (TTE) showed only mild to moderate MR of these four patients and no postoperative complications were noted. There were no changes of TTE finding between one-month follow-up and pre-discharge.
CONCLUSION
The successful NeoChord procedures in four Chinese indicate that the valve repair using the NeoChord system for Chinese population is feasible.
9.Efficient Detection of Environmental Estrogens Bisphenol A and Estradiol By Sensing System Based on AuNP-AuNP-UCNP Triple Structure
Qiao-Feng LI ; Shu-Yue REN ; Yu WANG ; Jia-Lei BAI ; Yuan PENG ; Bao-An NING ; Quan-Jun LYU ; Zhi-Xian GAO
Chinese Journal of Analytical Chemistry 2018;46(4):486-492
A sensing system based on AuNP-AuNP-UCNP triple structure for efficient detection of dual targets was constructed. In the preparation of triple structure, the gold nanoparticles (AuNPs) and upconversion nanoparticles (NaYF4: Yb, Er, Gd, UCNPs) were synthesized and surface modified. Then the two nanoparticles and their aptamers were connected to form two kinds of optical fluorescent probes. A nucleic acid sequence that matches with two aptamers was designed, rendering the probes to get close based on the principle of complementary base pairing. On the basis of this, a sensing system with a triple structure was prepared,and its connecting effect was characterized by TEM. With this system, dual targets of bisphenol A and estradiol were efficiently and conveniently detected through quantitative determination by fluorescence and UV spectrophotometer. At reaction temperature of 30℃ and pH=7.8,this method exhibited good linear range for determination of bisphenol A and estradiol from 2 ng/mL to 200 ng/mL and from 10 ng/mL to 150 ng/mL, with limits of detection of 0.2 ng/mL and 0.5 ng/mL, respectively. This sensing system with the triple structure owned better specificity to structural and functional analogues, and showed good repeatability and stability. What's more,this sensing system was applied in actual water detection,with the recoveries between 86.1% and 107. 4%, and the relative standard deviation below 6. 8%. This method showed promising applications in other environmental estrogens in water samples.
10.Clinical efficacy of cefoperazone and Shubatan in the treatment of severe acute infection
yang Chui ZHOU ; lei Lei XIA ; xian Ren GAO ; qing Da CHEN
Chinese Journal of Biochemical Pharmaceutics 2017;37(10):209-210
Objective To investigate and analyze the clinical efficacy of cefoperazone and Shubatan in the treatment of severe infection in emergency department. Methods 100 cases of severe infection were randomly divided into control group and experimental group, with 50 patients in each group. The control group received routine treatment, and the experimental group was treated with cefoperazone and Shubatan on this basis. Pay close attention to the related vital signs change of the experimental group and the control group, the relevant clinical indicators of the two groups of patients were compared and analyzed. Results After the corresponding treatment, the bacteria removal rate of the experimental group was 90.00%, significantly higher thant 60.00 % of the control group (P<0.05). The effective rate of the experimental group was 90.00%, which was significantly higher than that of the control group (74.00%), which was statistically significant (P<0.05). There were no obvious adverse reactions in the two groups. After treatment, the total score of quality of life in the experimental group was (75.2±11.2) points, and the total score of QOL in the control group was (64.2±9.3) points, which was statistically significant (P<0.05). Conclusion The clinical efficacy of cefoperazone and Shubatan in the treatment of emergency severe infection is satisfactory. It can significantly improve the clinical symptoms and improve the quality of life in patients with severe acute respiratory infection.


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