Objective　To investigate the role of β-endorphin (β-EP) in conA-induced spleen cell proliferation after traumatic hemorrhagic shock. Methods　①Wistar rats with traumatic hemorrhagic shock were used and killed 0, 1, 3, 6,12 and 24 h after traumatic hemorrhagic shock. Plasma specimens were collected and β-EP levels in plasma were detected. Rats with sham-operation served as the control. ②Spleen cells isolated from normal rats were cultured in shock plasma (group Ⅰ), inactivated shock plasma (group Ⅱ) and shock plasma+β-EP antiserum (group Ⅲ) respectively. Con A-induced spleen cell proliferation was observed. Results　①The plasma β-EP level was elevated significantly immediately after shock, and reached the peak 1 h later, then showed a deceasing tendency and restored to the level as before shock at 24 h. ②Shock plasma remarkedly suppressed spleen cell response to the mitogen conA (P<0.01) compared with control; ConA-induced spleen cell proliferative function in group Ⅱ was significantly increased than that in group Ⅰ (P<0.01), so did in group Ⅲ, which still lower than in control. Conclusion　The significantly elevated β-EP in the plasma after hemorrhagic shock might play an important role in inhibiting the proliferation of spleen cells.

Objective To investigate the role of plasma ? endorphin(? EP) in the regulation of cellular immunity, mainly IL 2R expression and IL 2 production in rat splenic cells, following traumatic hemorrhagic shock(T HS). Methods ①Wistar rats with T HS were used and sacrificed at 0, 1, 3, 6, 12 and 24 h after T HS. Plasma specimens were collected and ? EP levels in plasma were detected. Rats with sham operation were served as the controls. ②Models of in vitro experiment were used. Spenic cells were isolated and mixed from four normal rats and cocultured with shock plasma or shock plasma+? EP antiserum. ConA induced splenic cell IL 2 production and IL 2R expression were observed. Results ①Level of plasma ? EP increased remarkably after T HS immediately, peaked at 1 h, showed decreasing tendency and restored to pre shock level 24 h after T HS. ②Shock plasma significantly suppressed ConA induced splenic cell function; Levels of plasma ? EP were negatively correlated with IL 2 production and IL 2R expression in spenic cells; Compared with that in SP group, splenic cell function elevated markedly in SP+? EP antiserum group, but was still lower than that in controls. Conclusion The increased plasma ? EP following T HS is involved in the suppression of cellular immunity.

Medical bilingual teaching method is a developing teaching form recently.And bilingual teaching method in Laboratory Diagnosis is one of the reforms to meet the present challenge.At present,it has no uniform mode.In this paper the understanding of the objective of Laboratory Diagnosis and the strategies in the Bilingual teaching are discussed.

AIM: To explore the role of plasma ?-endorphin(?-EP) in the suppression of cellular immunity following trauma-hemorrhagic shock(T-HS). METHODS: ① Wistar rats with T-HS were sacrificed at 0 h, 1 h, 3 h, 6 h, 12 h, 24 h after T-HS. Plasma sample was collected and ?-EP levels in plasma was measured. Rats with sham-operated were served as the controls. ②In in vitro experiment, splenic cells were isolated and mixed from four normal rats and cocultured with shock plasma (SP) or SP +?-EP antiserum. ConA-induced splenic cell proliferation, IL-2 production, IL-2R expression were examined. RESULTS: ① Levels of plasma ?-EP elevated remarkably after T-HS immediately, peaked at 1h , showed decreasing tendency and restored normal 24 h after T-HS. ② Shock plasma significantly suppressed ConA-induced splenic cell function. Levels of plasma ?-EP were negatively correlated with spenic cell proliferation and IL-2 production and IL-2R expression. Compared with SP group, splenic cell function elevated markedly in SP + ?-EP antiserum group, but still lower than that in controls. CONCLUSION: The elevated plasma ?-EP following T-HS was involved in the suppression of cellular immunity.

As the importance of clinical risks management grows hospital management,reducing hospital medical errors for patients safety has become a key quality management process.Failure Mode and effect analysis( FMEA) is a proactive technique for error detection and reduction.In this paper,based on a brief review of it's history of development,described in detail the implementation method and steps of FMEA,mainly introducing the research progress for using FMEA in reducing hospital medical errors.

Objective To observe the effect of leukocytapheresis(LCAP)on the coagulation,fibrinolysis system and lung injury in the endotoxemia dog and explore the mechanism in the endotoxin-induced lung injury dog. Methods Endotoxemia-induced model in dogs was established by administration of lipopolysaccharide(LPS,2 mg/kg).Separation of the leucocytes wag performed with the automated continuous flow blood cell separators.A total of 30 male mongrel dogs were randomly divided into LPS group(group L,only injected with LPS,with no LCAP),sham LCAP group(group S,received sham LCAP at 12-14 hours after administration of LPS)and LCAP treatment group(group T,received LCAP at 12-14 hours after administration of LPS),10 dogs per group.The dynamic changes of the activated protein C(APC),soluble thrombomodulin and plagminogen activator inhibitor-1 in the serum were measured at 0 hour before LPS administration,at 2,6,12,14,16,24 and 36 hours after administration of LPS.Results Through LCAP,there found the following four results:(1) the APC level in the serum of the group T wag(50.805±4.422)μg/ml and(40.480±2.993)μg/ml at 14 hours and 16 hours respectively,which were significantly higher than(45.881±4.024)μml and(35.935±4.057)μg/ml in the group L(P<0.05).(2)The expressions of soluble thrombomadulin in the group T was (9.688±O.914)μml and(10.492±O.865)μg/ml at 14 hours and 16 hours respectively,which was statistically lower than(11.005±0.854)μg/ml and(12.04±0.954)ug/ml in the group L(P<0.05).(3)Thelevel of plagminogen activatorinhibitor-1 in the group T was lower than that in the group the group T Wag statistically lower than that in the group L(ALI/ARDS occurred in 2 and 7 dogs of the groups T and L respectively within 36 hours after infusion of LPS.P<0.05). Conclusions At the decrease the incidence of acute lung injury partly due to its role in improving the function of coagulation and fibrinolysis.

Blood transfusion is an important resuscitation method for combat casualties with severe hemorrhagic shock.The optimal resuscitation plan directly influences the treatment effect of the wounded.Whole blood,once the main resuscitation fluid,was replaced by blood components for various reasons and became a supplement when there was insufficient blood components supply.With the latest evidence of whole blood application in combat casualties,the development of blood transfusion technology and the deepened clinical and basic research,we realize that the obstacles in the use of whole blood are not insurmountable and that whole blood has the advantages that blood components do not have in the treatment of combat casualties.Therefore,whole blood has once again become a research hotspot in the field of combat casualties treatment.This article reviews the development history,advantages and disadvantages of whole blood application in the resuscitation of hemorrhagic shock after combat casualties,with a view to provide reference for further clinical and basic research.

【Objective】 To assess the sufficient information got by the informed transfusion recipients from the consents for blood transfusion and to explore the influencing factors, so as to provide scientific evidences for patients to comprehend the consent better. 【Methods】 A cohort study using questionnaire was conducted among 198 patients who received red blood cell transfusion from April 2019 to June 2019 in a tertiary hospital. 18 options were investigated, including basic information of patients, recall of the informed consent process performed by physicians and how well they comprehend the information. SPSS 23.0 statistical software was used for data statistical processing. 【Results】 All 198 questionnaires were returned and valid (100%, 198/198). The score of 198 informed transfusion recipients was 2~9 (5.293±1.549), and the score of Internal Medicine and Surgical transfusion patients was 6.07±1.77 vs 6.07±1.77 (P<0.05). Univariate comparative analysis showed that the clinical department, age, education background, instructions, including its time and identity of instructors, before transfusion were the variables that affected the comprehension of informed patients (P<0.05). Linear regression analysis indicated that the clinical department, pre-transfusion instruction and its time were independent influencing factors on the comprehension(P<0.05). The top 3 poorly-understood items included auto-transfusion, alternative transfusion therapy and 1-year donation deferral after blood transfusion. 【Conclusion】 More efforts are needed to help transfusion candidates to comprehend consent for blood transfusion better since their knowledge varied with clinical departments. Physicians′ transfusion knowledge and communication skills also need to be enhanced to provide targeted and multi-form informing methods.