Objective To compare the safety and efficacy between RevoLix 2 μ m continuous-wave (CW) laser resection of bladder tumor and transurethral resection of bladder tumor (TURBT) in patients with non-muscle-invasive bladder tumor, and to evaluate clinical value of 2 μ m CW laser resection for nonmuscle-invasive bladder tumor. Methods 62 patients with non-muscle-invasive bladder tumor were divided into 2 groups including 2 μ m CW laser resection group (32 cases) and TURBT group (30 cases) according to the random number table.The intravesical instillation of pirarubicin was performed regularly. The operative time,drop in hemoglobin,indwelling catheterization time,and operative complications were analyzed.Results All cases were completed successfully. The mean operative times of 2 μm CW laser resection group and TURBT group were 32.5±10.5 min and 31.3± 9.8 min, respectively, and no statistical difference could be found between both groups (t =0.364,P=0.674).3 cases were found to have obturator nerve reflex in TURBT group,but no obturator nerve reflex was found in 2 μn CW laser resection group.Bladder irrigation time of 2 μm laser resection group was statistically shorter than that of TURBT group [ (6.2±2.6)h vs (23.8±6.5)h,t =8.294,P=0.006]. There was also no significant difference in postoperative catheterization time between both groups [(4.2±1.5)d vs (5.2±1.8)d,t=1.468,P=0.103 ]. Postoperative hospitalization time of the two groups was not shown significant difference [ (5.3± 1.5) d vs (5.8±2.8) d,t =0.627,P =0.531 ].All cases were followed up for 6～18 months,and there were no significant difference in the recurrence rate between both groups (x2=0.481,P =0.562). Conclusion 2 μm CW laser resection is a novel excellent treatment for non-muscle-invasive bladder tumor and has the similar effect as TURBT with the advantage of significantly less blood loss and rapid recovery after surgery.

Objective To investigate the expression of P-glycoprotein(P-gp), multidrug resistance-associated protein (MRP), lung resistance-related protein (LRP) and predicts treatment outcome in the elderly acute myeloid leukemia. Methods Multi-parameter flow eytometric assay was used to quantify expression of P-go, muhidrug-associated resistance protein (MRP) and lung resistance-related protein (LRP) in bone marrow viable blasts from 12 eldely acute myeloid leukemia patients at diagnosis (M2a:4, one is come from MDS, M3a:2, M5a:5, M6a:1). Correlation of the MDR protein expression with treatment outcome were analysed. Results The frequency of expression of P-gp, MRP and LRP was 58.33 %, 8.33 %, 50 %, respectively and P-gp(+)/MRP(+) 0, P-gp(+)/LRP(+) 33.33 %, MRP(+)/LRP(+) 0, P-gp(+)/MRP(+)/LRP(+)8.33 %, P-go(-)/MRP (-)/LRP(-) 33.33 %;respectively. The frequency of overexpression of P-gp or LRP alone and both of them were relatively higher. The rate of complete remission (CR) and overall survival (OS) at one year of P-gp(+) group were significantly lower than those of P-go(-) group, and LRP(+) group also were lower than LRP(-) group. Conclusion The Frequency of expression of P-gp or LRP and coexpression of both of them were higher in elderly patients with AML. The overexpression of P-gp and/or LRP was a poor prognotic factor for eldely myeloid leukemia in elderly patients.

Surgery is an important treatment for the anterior mediastinal disease. With the rapid development of minimally invasive techniques, complete resection of the lesion in most patients with thymic disease can be achieved through thoracoscopic surgery. Practice has proved that the three-port resection of anterior mediastinal thymus disease via the subxiphoid approach is an ideal surgical method for the treatment of anterior mediastinal thymic tumors at present, which has strong popularization and popularity and can benefit the patients. The procedure focuses primarily on the anterior and upper mediastinum and can thoroughly expose the anatomy of the mediastinum and both sides, with minimal intraoperative bleeding, high safety, minimal trauma and postoperative pain, and a short hospital stay. It has clear advantages over conventional thoracic open-heart surgery and transversal resection. However, the surgical approach and field of view, and intraoperative precautions of this procedure are completely different from those of previous thoracoscopic procedures, and from the subxiphoid single-port approach adopted by other centers. Based on 10 years of surgical experience at our center, a modular mode of surgical operation has been developed and its procedure has been standardized. This paper will share and discuss relevant operational points and experiences.

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.