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.

Objective: To understand prevalence and trend of drinking behavior among middle school students in Quzhou during 2012 to 2022, and to provide a basis for formulating scientific and effective intervention measures for adolescent drinking. Methods: By using stratified cluster sampling method, a questionnaire survey using Zhejiang adolescent health related behavior questionnaire was conducted anonymously in selected classes in May 2012, 2017 and 2022, respectively. Changes of drinking behavior of middle school students in different years were analyzed. Results: The prevalence of ever drinking, current drinking and drunkenness among middle school students in Quzhou decreased from 58.05%, 22.70% and 21.25% in 2012 to 41.83%, 15.35% and 11.54% in 2022, respectively ( χ 2 trend =82.69, 30.00，58.24, P <0.01). In the past 30 days, 66.67% of students reported drinking 1-2 days, the proportion of drinking for 3-5 days increased from 16.36% in 2012 to 26.19% in 2022, the proportion of drinking for 6-19 days decreased from 13.03% in 2012 to 3.40% in 2022. The proportion of buying alcohol increased from 22.12% in 2012 to 35.03% in 2022. The results of the three surveys showed that, now drinking rates, drinking rates, Male students (27.88%，23.96%，18.75%；24.69%，17.44%，13.75%) was higher than the girls (17.60%，17.25%，11.31%；17.87%，10.61%，8.91%)， non ordinary high schools (33.96%，34.69%，22.77%；33.65%，23.91%，19.49%) were higher than ordinary high schools (25.82%，18.80%， 12.62 %；25.82%，17.35%，9.94%) and junior middle school (16.53%，15.83%，12.22%；13.93%，8.47%，7.35%). Conclusion Progress in adolescent drinking control is being made in Quzhou, with the prevalence of ever drinking, current drinking and drunkenness significantly decreased. It is necessary to strengthen the control of drinking behavior among middle school students from the aspects of school, family and society, especially for boys and students in non ordinary high school students.

The clinical characteristics and gene variations of a family with mitochondrial myopathy and ataxia caused by MSTO1 gene mutation who visited Xiangya Hospital of Central South University in October 2019 were retrospectively analyzed.The proband was an 11-year-old female, who was found to have delayed motor and language development and dysarthria at the age of 1 year and 6 months.The 9-year-old younger brother of the proband had similar symptoms at the age of 1 year and 3 months.Both the proband and her younger brother had muscle weakness and ataxia.Their head magnetic resonance imaging showed cerebellar atrophy, and their electromyography showed neuroge-nic changes.Genetic testing revealed compound heterozygous mutations in MSTO1: c.1259delG; p.G420VfsX2 and c.571 C > T; p.R191X, which were inherited from their parents, respectively.The same site mutations were found in the younger brother.After 2 weeks of " cocktail therapy" , the symptoms of the children were alleviated, and their language and movement improved.

OBJECTIVE: To investigate the effects of astragaloside Ⅳ (AS-Ⅳ) on microglia/macrophage M1/M2 polarization and inflammatory response after cerebral ischemia in rats. METHODS: Forty eight male SD rats were randomly divided into sham operation control group, model control group and AS-Ⅳ group with 16 rats in each. Focal cerebral ischemia model was induced by occlusion of the right middle cerebral artery (MCAO) using the intraluminal filament. After ischemia induced, the rats in AS-Ⅳ group were intraperitoneally injected with 40 mg/kg AS-Ⅳ once a day for 3 days. The neurological functions were evaluated by the modified neurological severity score (mNSS) and the corner test on d1 and d3 after modelling. The infarct volume was measured by 2, 3, 5-triphenyl tetrazolium chloride (TTC) staining on d3 after ischemia. The expression of M1 microglia/macrophage markers CD86, inducible nitric oxide synthase (iNOS) and pro-inflammatory factors TNF-α, IL-1β, IL-6, M2 microglia/macrophages markers CD206, arginase-1 (Arg-1), chitinase-like protein (YM1/2) and anti-inflammatory factors interleukin-10 (IL-10) and transforming growth factor beta (TGF-β) was detected by real-time RT-PCR. The expression of CD16/32/Iba1 and CD206/Iba1 was determined by double labeling immunefluorescence method in the peripheral area of cerebral ischemia. RESULTS: Compared with model control group, AS-Ⅳ treatment improved neurological function recovery and reduced infarct volume after ischemia ( CONCLUSIONS The findings suggest that AS-Ⅳ ameliorates brain injury after cerebral ischemia in rats, which may be related to inhibiting inflammation through promoting the polarization of the microglia/macrophage from M1 to M2 phenotype in the ischemic brain.
Animals ; Anti-Inflammatory Agents/therapeutic use* ; Brain Ischemia/drug therapy* ; Cell Polarity/drug effects* ; Inflammation/drug therapy* ; Macrophages/drug effects* ; Male ; Microglia/drug effects* ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Saponins/therapeutic use* ; Triterpenes/therapeutic use*

Objective: To understand the incidence of stroke in the population of Jinchang Cohort and the relationship between metabolic diseases and stroke, and provide scientific evidence for the prevention and treatment of stroke in the population. Methods: The epidemiological investigation data and physical examination data of the 33 042 follow-up participants in Jinchang Cohort were collected for a prospective cohort study. Restricted cubic splines functions was used to analyze the dose-response relationship between metabolic indexes and the risk of stroke incidence. Results: 1) The incidence rate of stroke in Jinchang Cohort was 1.59%, and the standardized incidence rate was 3.99%. 2) Hypertension (male HR=2.20, female HR=4.45) and dyslipidemia (male HR=1.49, female HR=1.79) were the risk factors of stroke incidence in the population and diabetes had influence on the incidence of stroke only in the males (HR=1.79), while obesity had influence only in the females (HR=1.64). The more kinds of metabolic diseases, the higher risk of stroke incidence was. 3) Systolic blood pressure had a non-linear dose-response correlation with the risk of stroke incidence, while diastolic blood pressure had a positive linear correlation with the risk of stroke incidence. Conclusions The incidence of stroke in Jinchang Cohort population was high compared with both domestic level and oversea level. The patients with metabolic diseases were the population at high-risk for stroke, and more attention should be paid to them in the prevention and treatment of stroke. Diastolic blood pressure might be more closely related to stroke.

Drug delivery systems (DDS) are defined as methods by which drugs are delivered to desired tissues, organs, cells and subcellular organs for drug release and absorption through a variety of drug carriers. Its usual purpose to improve the pharmacological activities of therapeutic drugs and to overcome problems such as limited solubility, drug aggregation, low bioavailability, poor biodistribution, lack of selectivity, or to reduce the side effects of therapeutic drugs. During 2015-2018, significant progress in the research on drug delivery systems has been achieved along with advances in related fields, such as pharmaceutical sciences, material sciences and biomedical sciences. This review provides a concise overview of current progress in this research area through its focus on the delivery strategies, construction techniques and specific examples. It is a valuable reference for pharmaceutical scientists who want to learn more about the design of drug delivery systems.

Objective To identify primary gout biomarkers. Methods Isobaric tags for relative and absolute quantitation (iTRAQ) technique combined with liquid chromatography-tandem mass spectrometry (LC-MS/MS) was used to screen differentially expressed proteins, and to identify potential biomarkers by analysis of the biological process, cellular components, molecular functions, KEGG pathways and protein-protein interactions. Difference between two groups were measured byt test. Results We identified 95 differentially expressed proteins (50 up-regulated proteins and 45 down-regulated proteins, respectively), and 20 significant KEGG pathways. Among them, glyceraldehyde-3-phosphate dehydrogenase (GAPDH), α-enolase (ENOA), phosphoglycerate kinase (PGK1), glucose-6-phosphate isomerase (G6PI) and moesin might play a role in the pathogenesis of primary gout. Conclusion iTRAQ technology can detect differentially expressed proteins from proteome, provides a strong theoretical basis for the study of biomarkers and evidence for the mechanisms in primary gout. However, further studies are needed.

Objective To translate the English version of nursing home survey on patient safety culture (NHSPSC) into Chinese one, and to test the reliability and validity of Chinese version of NHSPSC. Methods The items of NHSPSC were translated into Chinese version using a standard procedure of double-back translation and cross-culture adapted. A total of 237 staff members of nursing home were recruited to examine the reliability and validity of Chinese version of NHSPSC. Results The Chinese version of NHSPSC consisted of 36 items. The Cronbach′s α coefficient was 0. 847 for the total scale and Cronbach′s α of each factors ranged from 0. 632 to 0. 832. The test-retest reliability was 0. 822. The correlation coefficient between each dimension score ranged from 0. 151 to 0. 728 and the correlation coefficient between each dimension and the total score ranged from 0. 294 to 0. 779. The content validity index was 0. 873. Twelve factors were extracted by factor analysis which could explain 63. 156% of the total variance. Conclusions The Chinese version of NHSPSC is reliable and valid, which can be used to evaluate the patient safety culture in nursing homes.

OBJECTIVETo study and design a maternal and fetal monitoring system based on the cloud computing and internet of things, which can monitor and take smart care of the mother and fetus in 24 h.

METHODSUsing a new kind of wireless fetal monitoring detector and a mobile phone, thus the doctor can keep touch with hospital through internet. The mobile terminal was developed on the Android system, which accepted the data of fetal heart rate and uterine contraction transmitted from the wireless detector, exchange information with the server and display the monitoring data and the doctor's advice in real-time.

RESULTSThe mobile phone displayed the fetal heart rate line and uterine contraction line in real-time, recorded the fetus' grow process. It implemented the real-time communication between the doctor and the user, through wireless communication technology.

CONCLUSIONSThe system removes the constraint of traditional telephone cable for users, while the users can get remote monitoring from the medical institutions at home or in the nearest community at any time, providing health and safety guarantee for mother and fetus.