Objective: To determine anti oxygen free radical (anti OFR) function in each herb of Kangqianling Granules and its compound prescription. Method:The anti OFR function in herbs was tested in vitro by means of chemical luminescence .Results: The anti OFR functions of Radix et Rhizoma Rhei and Radix Salviae Miltiorrhizae are the best, other herbs also have a bit of effects.Conclusion: Kangqianling Granules retarding CRF's course can be related to it’s anti OFR function.

Objective To observe the clinical efficacy ofFufang Shenlu Granule for kidney-yang deficiency aplastic anemia (AA) and its effects on CD4+ T lymphocyte subsets, and explore its mechanism.Methods Forty AA patients were randomly divided into treatment group and control group, 20 cases in each group. The treatment group was treated withFufang Shenlu Granule combined with conventional western medicine therapy, while the control group was only treated with conventional western medicine therapy. The treatment lasted for 6 months, and follow-up visits lasted for at least one year. The clinical efficacy and T lymphocyte subsets ratio changes before and after treatment in the two groups were observed.Results The clinical efficacy of treatment group was better than that of control group (P<0.05). After treatment, the blood cell counts of the two groups were improved than those of before treatment (P<0.05,P<0.01). After treatment, the red blood cell count and hemoglobin of treatment group were higher than those of control group (P<0.05). Compared with the data before treatment in treatment group, the ratio of CD4+CD25+ cells in all CD4+ cells, and the ratio of CD4+CD25+FoxP3+ cells in all CD4+CD25+ cells increased (P<0.05); the ratio of Th1 and Th2 cells in all CD3+CD4+ decreased (P<0.05). The ratio of Th2 cells was lower than that before treatment in the control group (P<0.05).ConclusionFufang Shenlu Granule can enhance the treatment efficiency of AA with kidney-yang deficiency syndrome. The mechanism may be related to the decrease of Th1 cells, the increase of CD4+CD25+Tregs and their FoxP3 expression.

Objective:To investigate the ability of doctors in different regions and levels of hospitals in assessing the severity of severe trauma in China.Methods:A total of 38 trauma centers of China Trauma Rescue & Treatment Association (19 tertiary hospitals and 19 secondary hospitals, including 20 eastern and 18 western hospitals) were selected from November 2018 to May 2020. Two junior, two middle, and two senior emergency surgeons were selected in each center. Injury severity score (ISS) was performed on 10 patients with severe trauma, and the qualified rate was analyzed.Results:The qualified rates of junior, middle, and senior doctors were 56.05%, 56.18%, and 56.71%, respectively ( P>0.05). The qualified rates of tertiary and secondary hospitals were 63.07% and 49.56%, respectively ( P<0.01). The qualified rates of eastern and western hospitals were 67.00% and 44.44%, respectively ( P<0.01). Conclusions:The overall level of injury assessment of severe trauma patients by doctors in China is satisfactory, while there are still differences in hospital levels and regions. In the future, attention should be paid to the training and system construction in primary hospitals. We should actively support the construction and development of hospitals in the western regions and realize the standardization of trauma treatment in China as soon as possible.

Objective:To determine the accuracy of injury severity score(ISS)in the assessment of patients with severe trauma by the consistency analysis of the patients'ISS with severe trauma scored by three clinicians,and to guide the allocation of medical resource.Methods:Through retrospective analysis of 100 patients with serious or severe trauma admitted to Peking University People's Hospital since Sep-tember 2020 to December 2021(ISS ≥ 16 points),we conducted a consistency analysis of ISS within dif-ferent evaluators.The general information(gender,age),vital signs,physical examination,imaging,laboratory examination and other associated data of the patients after admission were retrospectively diag-nosed by 3 clinicians specializing in trauma surgery and ISS was determined.SPSS 22.0 software was used for statistical analysis,descriptive reports were made on the observed values of each set of data,and Fleiss kappa test was used for consistency analysis of the credibility of the ISS within three clinicians.Results:Through the consistency analysis of the ISS in 100 patients with severe trauma scored by 3 eva-luators,the total Fleiss kappa value was 0.581,and the overall consistency was medium.Consistency analysis of the different scores was conducted according to the calculation rules of ISS.Among the patients with single-site severe trauma,abbreviated injury scale(AIS)was 4 or 5 points,ISS was 16 or 25 points,and Fleiss kappa value was 0.756 and 0.712 within the three evaluators,showing a relatively high consistency.AIS of each part was more than 4 points,and total ISS was more than 41 points in the severe trauma patients,Fleiss kappa values are higher than 0.8 within the 3 evaluators,showing a high consistency.Conclusion:According to the consistency analysis of severe trauma patients ISS within the three evaluators,when the severe trauma patients with ISS≥16 points are treated or transported,there is a certain accuracy error when the score is used for inter-department communication or inter-hospital trans-portation,and the consistency of different evaluators for the same injury is moderate.It may lead to mis-judgment of the severity of trauma and misallocation of medical resources.However,for trauma patients with single or multiple site AIS ≥ 4 points,ISS is highly consistent among different evaluators,which can accurately indicate the severity of the patient's condition.

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.