Objective To retrospectively analyze of clinical application of BF-XP60 micro-bronchoscopy.Methods 135 clinical data of patients who adopted ultrafine micro-bronchoscopy and intervention were collected and analyzed for the complications.Results The frequency of local rhinomusoca damaging and errhysis was in 3 cases,the mucous of the glottis damaging and errhysis was in 2 cases,local mucous of the tracheal bronchus errhysis was in 3 cases.After intervention,the frequency of fever was in 13 cases,massive haemorrhage was in 1 case,pneumothorax was in 1 case,chest pain was in 2 cases,part fiber of inner untrafine micro-bronchoscopy broken was in 2 cases,check failure due to ultrafine micro-bronchoscopy broken in trachea was in 4 cases,and arrhythmia,asphyxia,and death were in 0 case.The overall incidence of side effects was 22.9％ (31/135).Conclusion Application of ultrafine micro-bronchoscopy was contributed to find the lesions within the bronchioles and around the lungs,moreover,it could evaluate the distal bronchus of airway obstruction which was planned to adopt intervention.The topic that how to reduce the incidence of the side effects of the micro-brohchoscopy and improve the success rate and safety of inspection and intervention was worth to be concerned.

Objective To preliminaryly explore the effect and adverse reaction of Marine Injection combined therapy through local spray in benign tracheobronchial stenosis.Methods 19 cases of bronchial tuberculosis were collected in our department.By assessing cough,shortness of breath and other symptoms,chest high -resolution CT (HRCT)of three -dimensional reconstruction,and length were observed by ultrafine bronchial stenosis.According to the pathogeny and types of stenosis,combined multiple intervention were sequentially adopted,and then Marine Injec-tion was sprayed through one -off endoscopic spray tube.All the subjects were divided into the two groups,the higher concentration Marine injection (1 200 mg/mL)group was chosen with the condition of serious inflammation,edema, ulcer and necrosis,obvious local granulation tissue hyperplasia,severe scar stenosis,and the length of stenosis greater than 2 cm or the sectional area of stenosis less than 50% of the normal sectional area,otherwise the low concentration (600 mg/mL)group was chosen.The subjects were reexamined by clinical symptoms,high -resolution CT (HRCT) of three -dimensional reconstruction,and ultrafine bronchoscopy a week after the surgery to dynamically observe the local changes.Depending on the situation,the injection was sprayed once a week,adding up to 2 -4 times.Follow -up visit lasted for 3 months,cough,expectoration or hemoptysis,and dyspnea were observed.Results 11 cases were effective fully,17 cases were effective substantially,7 cases were ineffective,the total effective rate was 80% (28 /35).The overall complication rate was 42.8% (15 /35),no deaths occurred.No complications related to local spra-ying of Marine were seen.Conclusion Local spray of Marine Injection may have preferable effect that inhibits scar formationand prevention airway restenosis.It is worth further study with a high security,precise clinic effect,easy oper-ation and etc.

Objective To observe the clinical efficacy and safety of erlotinib plus temozolomide for recurrence/progression patients with epidermal growth factor receptor (EGFR) gene mutation in non-small cell lung cancer (NSCLC) with brain metastases after whole brain radiotherapy.Methods A total of 68 EGFR gene mutation NSCLC patients with brain metastases of intracranial recurrence/progression after whole brain radiotherapy were selected from August 2013 to June 2018 in Baoji Central Hospital of Shaanxi Province and Xintai People's Hospital of Shandong Province.All the patients were randomly divided into erlotinib group and combined treatment group (erlotinib combined with temozolomide) using random number table method.The patients in erlotinib group (34 cases) were treated with oral erlotinib 150 mg/d until progression or unacceptable adverse reaction,and the patients in combined treatment group (34 cases) were given erlotinib and oral temozolomide 150 mg/(m2 · d) for 1-5 day,every 28 days was a cycle,temozolamide for 6 cycles.Comparison was made on curative effects and occurrence condition of adverse reactions between the two groups.Results The overall response rates in the erlotinib group and combined treatment group were 11.8％ (4/34)and 32.4％ (11/34) respectively,and the disease control rates in the two groups were 35.3％ (12/34) and 64.7％ (22/34) respectively,with significant differences (x2 =4.191,P =0.041;x2 =5.882,P =0.015).The median progression-free survival in the erlotinib group and combined treatment group were 3.22 months and 5.29 months respectively,and the median overall survival in the two groups were 5.60 months and 7.90 months respectively,with significant differences (x2 =9.269,P =0.002;x2 =11.005,P =0.001).The incidence of nausea and vomiting in combined treatment group was significantly higher than that in erlotinib group [67.6％ (23/34) vs.14.7％ (5/34)],with a significant difference (x2 =19.671,P ＜ 0.001),but there were no significant differences in the incidences of other adverse reactions (all P ＞ 0.05).The patients in the two groups had no more than grade Ⅲ of adverse reactions.Conclusion The curative effect of erlotinib combined with temozolomide is better in the treatment of recurrence/progression patients with EGFR gene mutation in NSCLC with brain metastases after whole brain radiotherapy,with mild adverse reactions and good patients' tolerance.

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.