Objective To study the effect of mild hypothermia on β2- microglobulin (MG) level in cerebrospinam(CSF) of traumatic brain injury (TBI) patients.Methods Thirty-six severe TBI patients were divided into two groups randomly,mild hypothermia treatment group and normathermia treatment group,and the β2- MG level and GOS score in CSF of these patients in different time- point were evaluated.Results β2-MG level increased at first,then decreased gradually,and MBP level in mild hypothermia group decreased greater than the control group( P ＜ 0.05 ),moreover,patients in mild hypothermia treatment group had better outcome than the control group( P ＜ 0.05).Conclusion Mild hypothermia may act as neuroprotection by inhibiting inflammatory response or improving immune regulation.

Objective To study the effect of mild hypothermia on MBP level in the CSF of TBI patients.Methods We investigated 36 patients with severe traumatic brain injury and randomized them into two groups,mild hypothermia treatment group and normathermia treatment group.The MBP levels in CSF and ICP and GOS scores in different time-points were evaluated.Results There was no significant difference between the two groups in the MBP level on the 1st day after treatment(P ＞ 0.05).The MBP levels in mild hypothermia group decreased greater than that in the control group on the 7th and 14th day after treatment(P ＜ 0.05).ICP decreased more in mild hypothermia group than in the control group(P ＜ 0.05)on the 7th and 14th day after treatment.Moreover,patients in mild hypothermia treatment group have better outcome than those in the control group(P ＜ 0.05),but there was no significant difference in the death rate between the two groups.Conclusion Mild hypothermia may provide neuroprotection by reducing MBP degradation and stabilizing medullary sheath,thus improving the prognosis of TBI patients.

Objective To investigate blood plasma melatonin level in night-shift nurses and explore the relationship of blood plasma melatonin level with nervous system symptom (insomnia、anxiety、depression). Methods ELISA were used for detection of blood plasma melatonin level in 80 night-shift nurses of different age group. Results Blood plasma melatonin level of shift work nurses (36to40、41to45 yearold) were significant lower than the corresponding age group of the control group, the nervous system symptom of these age group night-shift nurses correlated to melatonin level of melatonin. Conclusions Blood plasma level of melatonin have a close relation to nervous system symptom(insomnia、anxietydepression).

Objective To investigate the relationship between heart rate variability(HRV)and baseline clinical characteristics in super-aged(≥80 years old)patients with persistent atrial fibrilla-tion(AF).Methods A total of 108 super-aged patients with persistent AF were included in AF group,and 127 super-aged patients with sinus rhythm were included in control group.24-hour ambu-latory electrocardiogram monitoring was conducted to compare heart rate and HRV time-domain indi-cators[standard deviation of normal RR intervals(SDNN),standard deviation of the average of nor-mal to normal intervals(SDANN)every 5 minutes throughout the recording,mean of the sum of the squares of differences between adjacent N-N intervals(RMSSD),average value of standard deviation of 5-minute NN intervals throughout the recording(SDNN index),heart rate variability(HRV)in-dex,and percentage of NN intervals with differences greater than 50 ms accounting for the total num-ber of NN intervals(PNN50)].Clinical characteristics of AF patients were collected,and multiple linear regression analysis was used to explore the correlation between HRV time-domain indicators and heart rate and baseline clinical characteristics.Results SDNN,RMSSD,HRV index,PNN50,and SDNN index were higher in the AF group than in the control group(P＜0.01).Multiple linear regression analysis showed that increased SDNN was significantly associated with hypertension(P=0.001),use of β-blockers(P=0.003),and slow heart rate(P＜0.001).Increased RMSSD wassignificantly associated with hypertension(P=0.040),use of β-blockers(P=0.002),and slow heart rate(P＜0.001).Increased HRV index was significantly associated with heart failure(P=0.003)and slow heart rate(P＜0.001).Increased PNN50 was significantly associated with slow heart rate(P=0.004).Increased SDNN index was significantly associated with the use of β-blockers(P=0.002)and slow heart rate(P＜0.001).Increased SDANN was significantly associated with hy-pertension(P=0.006),slow heart rate(P＜0.001),and use of dabigatran(P=0.021).Con-clusion There is a correlation between HRV and baseline clinical characteristics in super-aged pa-tients with persistent AF,which may be due to the activity status of the autonomic nervous system.

Objective To investigate the relationship between heart rate variability(HRV)and baseline clinical characteristics in super-aged(≥80 years old)patients with persistent atrial fibrilla-tion(AF).Methods A total of 108 super-aged patients with persistent AF were included in AF group,and 127 super-aged patients with sinus rhythm were included in control group.24-hour ambu-latory electrocardiogram monitoring was conducted to compare heart rate and HRV time-domain indi-cators[standard deviation of normal RR intervals(SDNN),standard deviation of the average of nor-mal to normal intervals(SDANN)every 5 minutes throughout the recording,mean of the sum of the squares of differences between adjacent N-N intervals(RMSSD),average value of standard deviation of 5-minute NN intervals throughout the recording(SDNN index),heart rate variability(HRV)in-dex,and percentage of NN intervals with differences greater than 50 ms accounting for the total num-ber of NN intervals(PNN50)].Clinical characteristics of AF patients were collected,and multiple linear regression analysis was used to explore the correlation between HRV time-domain indicators and heart rate and baseline clinical characteristics.Results SDNN,RMSSD,HRV index,PNN50,and SDNN index were higher in the AF group than in the control group(P＜0.01).Multiple linear regression analysis showed that increased SDNN was significantly associated with hypertension(P=0.001),use of β-blockers(P=0.003),and slow heart rate(P＜0.001).Increased RMSSD wassignificantly associated with hypertension(P=0.040),use of β-blockers(P=0.002),and slow heart rate(P＜0.001).Increased HRV index was significantly associated with heart failure(P=0.003)and slow heart rate(P＜0.001).Increased PNN50 was significantly associated with slow heart rate(P=0.004).Increased SDNN index was significantly associated with the use of β-blockers(P=0.002)and slow heart rate(P＜0.001).Increased SDANN was significantly associated with hy-pertension(P=0.006),slow heart rate(P＜0.001),and use of dabigatran(P=0.021).Con-clusion There is a correlation between HRV and baseline clinical characteristics in super-aged pa-tients with persistent AF,which may be due to the activity status of the autonomic nervous system.

Objectives To research clinical effects of severe brain injury patients treated by acupuncture and herb combine mild hypothermia,discuss the new approach of severe brain injury patients treatment combine Chinese traditional and Western medicine.Methods Investigated 68 severe traumatic brain injured patients,randomly divided into three groups,acupuncture and herb combine mild hypothermia group (n =22),mild hypothermia group (n =24) and normal temperature routine treatment group (n =22).Dynamic intracranial pressure,brain damage index (cytoskeletal protein),immunologic function (IL-6,β2 microglobulin),combine rate of complications (including irritable ulcer,lung infection,epilepsy,sugar metabolism disorder,and so on),and long-term GOS score were analyzed.SPSS12.0 software was used for statistical processing,and the standard deviation of the measurement data were expressed as the standard deviation.The counting data were expressed as apercentage,and the chi-square test was used for the comparison between group.Results There were significant differences between three groups of intracranial pressure,immunologic function,complication occurring rate (P ＜0.05),but there had no significant difference between acupuncture and herb combine mild hypothermia group and mild hypothermia group of brain damage index and GOS,and there have significant difference between these two groups and normal temperature routine treatment group.Conclusions Acupuncture and herb combined mild hypothermia might be better in reducing intracranial pressure,the incidence of complication,and improving immune function of severe brain injury,than mild hypothermia group and normal temperature routine treatment group.

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.