ABSTRACT
The condition of patients with severe traumatic brain injury (sTBI) complicated by corona virus 2019 disease (COVID-19) is complex. sTBI can significantly increase the probability of COVID-19 developing into severe or critical stage, while COVID-19 can also increase the surgical risk of sTBI and the severity of postoperative lung lesions. There are many contradictions in the treatment process, which brings difficulties to the clinical treatment of such patients. Up to now, there are few clinical studies and therapeutic norms relevant to sTBI complicated by COVID-19. In order to standardize the clinical treatment of such patients, Critical Care Medicine Branch of China International Exchange and Promotive Association for Medical and Healthcare and Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Chinese expert consensus on clinical treatment of adult patients with severe traumatic brain injury complicated by corona virus infection 2019 ( version 2023) based on the joint prevention and control mechanism scheme of the State Council and domestic and foreign literatures on sTBI and COVID-19 in the past 3 years of the international epidemic. Fifteen recommendations focused on emergency treatment, emergency surgery and comprehensive management were put forward to provide a guidance for the diagnosis and treatment of sTBI complicated by COVID-19.
ABSTRACT
Pseudo subarachnoid hemorrhage (PSAH) is often secondary to resuscitation or severe traumatic brain injury (TBI) and has a high rate of mortality and disability. It is characterized by symmetrical subarachnoid hyper-density opacities on CT scans and is mainly venous reflux disorder caused by diffuse cerebral swelling for various causes. At present, PSAH is primarily examined by CT with reduction of cranial pressure as the treatment method. However, the CT signs of PASH are similar to subarachnoid hemorrhage caused by ruptured aneurysm, so the positive CT screening rate for PSAH is low. Effect of simple reduction of intracranial pressure on prognosis improvement of PSAH patients is also limited. Clinical understanding of PSAH is still insufficient, resulting in missed or false diagnosis and untimely treatment. The authors review the research progress in pathophysiology, diagnosis and treatment methods of PSAH so as to help clinicians better understand PSAH, make early diagnosis and timely treatment and improve patients′ prognosis.
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BACKGROUND: Human umbilical cord blood mesenchymal stem cells (hUC-MSCs) can repair the injury of nerve cells caused by ischemia and hypoxia, but which state of cells has a better therapeutic efficacy, primary isolation or induced differentiation is not yet known. OBJECTIVE: To compare the therapeutic effects of hUC-MSCs primary cultured and differentiated in a rat model of cerebral infarction.METHODS: After full-term delivery, fetal umbilical cord blood samples were obtained using quadruple bags by means of density gradient centrifugation. hUC-MSCS were induced in the medium containing basic fibroblast growth factor. Sixty rats were equivalently randomized into four groups: sham, model, primary culture and induced differentiation groups. Animal models of cerebral infarction were made in the rats in the latter three groups. Model rats in the primary culture and induced differentiation groups were subjected to tail vein transplantation of hUC-MSCs that were primary cultured or induced to differentiate in vitro at 7 days after modeling. RESULTS AND CONCLUSION: A marked improvement in balance, walking, spatial orientation, and learning and memory abilities was found in the rats after transplantation of hUC-MSCs that were primary cultured or induced to differentiate. Moreover, compared with the primary culture group, a significant improvement was found in the induced differentiation group, including improved pathological injury of the brain, higher expression of CD34 and Ki-67, lower expression of glial fibrillary acidic protein, lower expression of interleukin 1β and tumor necrosis factor β. Compared with the primary culture group, similar infarction size and expression of interleukin-6 were also found in the induced differentiation group. These findings indicate that hUC-MSCs with induced differentiation exhibit better therapeutic outcomes in the recovery of neurological function of cerebral infarction rats.
ABSTRACT
The study was aimed to analyze Del phenotype of RhD (-) unrelated blood donors. RhD (-) was initially screened by routine serological test and confirmed by indirect antiglobulin test (IAT). Del phenotype was detected by hot-ether absorption-elution test. The results indicated that 106 RhD (-) samples were confirmed out of 38526 donors, and 28 cases were Del detected by hot-ether absorption-elution test. The incidence of Del in RhD (-) samples was 26.41%, The serological phenotypes of Del were Ccee (78.57%), CCee (14.29%) and CcEe (7.14%) respectively. In conclusion, the detection of Del by using hot-ether absorption-elution test is very important for reasonable application of RhD (-) blood. There is difference in Del phenotypes of populations in different regions of China and Japan.
Subject(s)
Humans , Asian People , Blood Donors , Phenotype , Rh-Hr Blood-Group System , Genetics , Allergy and ImmunologyABSTRACT
<p><b>OBJECTIVE</b>To analyze possible difference in bronchial asthma between ethnic and geographic groups and explore its correlates among Uygur and Han adults in Turpan Prefecture, Xinjiang.</p><p><b>METHODS</b>One hundred and sixty-six clinically diagnosed asthmatic patients at Turpan Prefecture Hospital, Xinjiang, 86 of Uygur and 80 of Han ethnic, and 166 1:1 matched controls from ophthalmological outpatient department at the same hospital were recruited into the study. Interview with questionnaire was conducted and serum levels of eosinophilic cation protein (S-ECP), total IgE (T-IgE) and specific IgE (S-IgE) were measured for all of the participants to study related factors for asthma with univariate and multivariate conditional logistic regression analyses.</p><p><b>RESULTS</b>Bronchial infection (OR(U) = 5.111, 95%CI: 1.203 - 21.710; OR(H) = 2.498, 95%CI: 1.471 - 5.069), family history of asthma (OR(U) = 3.078, 95%CI: 1.812 - 5.188; OR(H) = 2.711, 95%CI: 1.010 - 6.176), personal allergy history (OR(U) = 2.083, 95%CI: 1.043 - 4.162; OR(H) = 3.998, 95%CI: 1.739 - 9.198), weather change (OR(U) = 2.218, 95%CI: 1.199 - 3.778; OR(H) = 1.733, 95%CI: 1.004 - 2.994) and positive S-IgE (OR(U) = 1.592, 95%CI: 1.018 - 2.491; OR(H) = 3.858, 95%CI: 2.246 - 8.507) correlated with asthma in patients of both Uygur and Han ethnic. Percentage of asthma attack induced by respiratory infection [59.30% (51/86)] and weather change [36.05% (31/86)] in Uygur patients was significantly higher than that in Han ethnic [42.50% (34/80) and 21.25% (17/80), respectively], but percentage of those with personal allergy history [48.75% (39/80)] and positive S-IgE [52.50% (42/80)] in Han ethnic was significantly higher than that in Uygur [32.56% (28/86) and 30.23% (26/86), respectively]. Levels of S-ECP and T-IgE in patients with moderate and severe asthma of both Uygur and Han ethnic [(S-ECP(U) = 7.95 +/- 3.98) microg/L, S-ECP(H) = (11.21 +/- 4.74) microg/L, T- IgE(U) = (72.23 +/- 45.92) kU/L, T-IgE(H) = (108.81 +/- 64.07) kU/L, respectively]were significantly higher than those in controls of the same ethnic [S- ECP(U) = (1.94 +/- 1.16) microg/L, S-ECP(H) = (2.07 +/- 1.63) microg/L, T-IgE(U) = (46.19 +/- 32.47) kU/L, T-IgE(H) = (50.97 +/- 38.51) kU/L; t values were 8.96, 10.52, 2.81, 4.97, P < 0.01], higher in Han ethnic than those in Uygur (t values were 3.01, 2.68, P < 0.01).</p><p><b>CONCLUSION</b>Bronchial infection, family asthma history, personal allergy history, weather change and positive S-IgE all were important correlates of asthma in Turpan Prefecture, Xinjiang. Levels of S-ECP and T-IgE in patients with moderate and severe asthma increased during its attacks, higher in Han ethnic than those in Uygur. Genetic and environmental factors may be involved in occurrence and development of asthma.</p>
Subject(s)
Adult , Female , Humans , Male , Asthma , Blood , Epidemiology , Ethnology , Causality , China , Epidemiology , Climate , Environmental Exposure , Eosinophil Cationic Protein , Blood , Immunoglobulin E , Blood , Logistic Models , Pedigree , Surveys and QuestionnairesABSTRACT
In order to study the serological characteristics and genetic background of Bel subtypes, A, B and H antigens on the surface of red blood cells of the proband as well as his family and the anti-A, anti-B antibodies in their serum samples were detected by hemagglutination test; the A, B, H substances in saliva were determined by inhibitory agglutination test. The results indicated that the proband, his mother and his daughter all were identified to be Bel phenotype; his two sisters were identified to be ABel phenotype; his father, son and spouse were identified to be A, B and B phenotype respectively. It is concluded that the Bel subtype exists as family genetic characteristics in China.