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.

Osteoporosis （OP） is a systemic metabolic disease that affects the health of middle-aged and elderly people by crosslinking multiple signaling pathways. With the increasing aging of the population， the incidence of OP is also increasing year by year. Because of a series of problems such as high incidence， difficulty in treatment， and poor prognosis， it has been widely studied and reported by scholars in China and abroad. At present， the drugs used by western medicine are mainly divided into two categories： Bone resorption inhibitors and bone formation promoters. Although the efficacy is reliable， there are still deficiencies such as poor dependence of patients on the drug， uncontrollable side effects， and high costs. However， in recent years， with the continuous deepening and innovation of traditional Chinese medicine （TCM） research， the treatment of OP by TCM has been widely recognized in clinical practice. Many scholars have found that the mechanism of TCM in the treatment of OP includes the widespread involvement of mitogen-activated protein kinase （MAPK） signaling pathway， which mainly promotes the differentiation of bone marrow mesenchymal stem cells （BMSCs） to osteoblasts （OB）， inhibits the differentiation of osteoclasts （OC）， and improves the expression of osteogenesis-related factors alkaline phosphatase （ALP）， Runt-associated transcription factor 2 （Runx2）， type Ⅰ collagen （ColⅠ） to treat OP. Although the current research on the TCM treatment of OP through the MAPK pathway is deepening， there are still certain deficiencies in the study of its molecular mechanism. Therefore， this paper reviewed the relationship between the MAPK signaling pathway and key target protein factors and OP to clarify the important role of the MAPK signaling pathway in OP. At the same time， the targeted regulation of MAPK signaling pathways by TCM to treat OP was systematically summarized in order to provide a scientific basis for the further accurate treatment of OP in TCM.

During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.

Objective To investigate the prevalence of gestational diabetes mellitus (GDM) among pregnant women in Wuhan, and to explore the application value of oral glucose tolerance test (OGTT) results in the screening, diagnosis and treatment of GDM. Methods A retrospective analysis was carried out on the OGTT results of 26 558 pregnant women from Hubei Maternal and Child Health Hospital from January 2018 to December 2018. Results (1) A total of 1 754 cases were diagnosed with GDM, with a positive rate of 6.60%. Among them of 776 had fasting blood glucose ≥5.1mmol/L, 880 had 1-hour blood glucose ≥10.0mmol/L, and 798 had 2-hour blood glucose ≥8.5mmol/L. (2) The positive rates of fasting blood glucose, 1-hour blood glucose, and 2-hour blood glucose in the ≥35-year-old age group were all over two times higher than those in the <35-year-old age group (all P<0.01). (3) The ratio of people with single-point positive, two-point positive and three-point positive was 7:2:1. (4) FBG, 1-hour blood glucose and 2-hour blood glucose concentrations were all positively correlated with each other (all P＜0.01). Among these, the positive correlation between 1-hour blood glucose and 2-hour blood glucose was the most significant (r=0.618, P＜0.01). Conclusions The incidence rate of GDM among pregnant women in Wuhan reached 6.60%, and the prevalence in pregnant women over 35 years old was significantly higher. Blood glucose level during pregnancy should be monitored for early detection and intervention to prevent the development of GDM. The relationship between blood glucose concentrations at different time points in the OGTT test had reference value for clinical diagnosis and treatment.

Objective: To evaluate the influence of antiretroviral prophylaxis on the growth and development of HIV-exposed uninfected infants in Guangzhou. Methods: Data were from the national information system for prevention of mother-to-child transmission of HIV infection, syphilis and hepatitis B. After excluding death and perinatal HIV infection cases, 564 HIV-exposed uninfected infants were included. The infants were divided into three groups, nevirapine (NVP) group, zidovudine (AZT) group and untreated group. The influences of antiretroviral prophylaxis on the body weight and height of the HIV-exposed uninfected infants were analyzed by using generalized estimating equations. Results: The HIV-exposed uninfected infants at 1-month old had lower Z scores of body weight-for-age and body height-for-age than the World Health Organization’s reference standard. The prevalence of wasting in AZT group (17.5%) was higher than that in NVP group (6.2%) for 1-month old infants. Taking NVP or AZT was a protective factor for Z score of body length-for-age (P<0.05). Intrauterine exposure to triple antiviral drugs was a risk factor for the Z scores of body weight-for-age and body length-for-age (P<0.05). Conclusion The physical growth and development of HIV-exposed uninfected infants at 1-month old was not well, and HIV-exposed uninfected infants who taking AZT had a higher incidence of wasting. Attention should be paid to these infants.

Objective To investigate the relationship between different topographic locations and neurological deteriorations (ND) in patients with acute new isolated pontine infarction.Methods One hundred sixty-eight patients with acute new isolated pontine infarction during arch 2012 to March 2016 were identified by diffusion weighted imaging (DWI) for retrospective review.Patients were divided into two groups according to their clinical symptoms:patients with ND and patients without ND.According to neuroimaging of DWI,the topographic location of pontine infarction was divided into three types:The upper,middle,and lower ones,and the correlations of ND with risk factors,laboratory examination results,clinical manifestations and different topographic locations were explored by statistical tests.Results Of 168 patients,26.8％ (45/168) were diagnosed with ND,and 73.2％ (123/168) were diagnosed without ND.Univariate analysis showed that there were differences in female ratio [62.2％ (28/45) vs 41.5％ (51/ 123)],smoking ratio [13.3％ (6/45) vs 26.0％ (32/123)],mean length of hospital stay [(22.83 ± 7.12)d vs (19.31 ± 7.65)d],ratio of worse short-term clinical outcomes [77.8％ (35/45) vs 33.3％ (41/123)],and ratio of lower pontine infarction [55.6％ (25/45) vs 26.0％ (32/123)] between two groups (P ＜ 0.05).Logistic regression analysis showed that lower pontine infarction was the independent risk factor of ND (OR =1.953,95％ CI:1.092-3.535,P =0.029).Conclusions Topographic location of lower pons lesions may be reliable predictor of ND in acute new isolated pontine infarction.

Objective To analyze the correlation between clinical features and renal dysfunction in patients of acute lacunar infarction with progressive cerebral microbleeds (CMBs). Methods Two hundred and sixty-five patients with first-episode acute lacunar infarction were selected. The serum creatinine was measured within 24 h of admission and the estimated glomerular filtration rate (eGFR) was calculated. The brain MRI (including gradient-echo images) was examined within 2 d of admission and after 1 years of follow-up, respectively. The progressive CMBs was assessed with microbleeds anatomical rating scale (MARS), and the patients were divided into progressive CMBs group (progressive group, 42 cases) and non progressive CMBs group (non progressive group, 223 cases). The clinical features of 2 groups were compared and the correlation between progressive CMBs and renal dysfunction was analyzed. Results The age, 24 h pulse pressure, incidences of renal dysfunction and CMBs in progressive group were significantly higher than those in non progressive group: (69.8 ± 5.8) years vs. (61.5 ± 4.9) years, (63.3 ± 3.1) mmHg (1 mmHg=0.133 kPa) vs. (51.8 ± 4.2) mmHg, 69.0％(29/42) vs. 39.9％(89/223) and 57.1％(24/42) vs. 25.1％(56/223), and the platelet was significantly lower than that in non-progression group:(168 ± 35) ×109/L vs. (189 ± 40) ×109/L, and there were statistical differences (P<0.05 or<0.01). The Logistic regression analysis result showed that renal dysfunction and CMBs were Independent risk factors of progressive CMBs (OR = 1.571 and 1.054, 95％ CI 1.042 - 2.493 and 1.010 - 1.142, P<0.05). Conclusions The rate of renal dysfunction is higher in patients of acute lacunar infarction with progressive CMBs, and progressive CMBs are associated with renal dysfunction.

BACKGROUND:Both correspondence analysis and two-step cluster analysis are high-grade statistical analysis, the introduction of these analyses into the research on traditional Chinese medicine (TCM) syndrome type of knee osteoarthritis wil provide objective evidence for the standardization and normalization of TCM syndrome type, through the combination of mathematical statistical principle and TCM syndrome type.
OBJECTIVE:To explore distribution characteristics of knee osteoarthritis TCM syndrome type using correspondence analysis and two-step cluster analysis.
METHODS:The clinical symptoms of 200 patients with knees osteoarthritis were investigated through a knee osteoarthritis symptoms questionnaire. According to the criteria for three kinds of syndrome type issued in Diagnostic Criteria for TCM Syndrome, the characteristics of each syndrome were analyzed using two-step cluster analysis and corresponding analysis. Then knee osteoarthritis TCM syndrome type characteristics were defined.
RESULTS AND CONCLUSION:Cluster analysis is ineffective for the syndrome type, which is not present in the Diagnostic Criteria for TCM Syndrome. Corresponding analysis showed that, in addition to kidney marrow deficiency syndrome (50.5%), yang deficiency and congealing syndrome (13.5%), and blood stasis syndrome (23%), concurrent syndromes were also found, including kidney marrow deficiency combined yang deficiency and congealing syndrome (6.5%), yang deficiency and congealing combined blood stasis syndrome (3%), kidney marrow deficiency combined blood stasis syndrome (3.5%). Therefore we performed corresponding analysis. After analyzing the syndromes at 0.5, 1.0, 1.1, 1.2, 1.3, 1.4, 1.5 radius, the most reasonable syndrome was those at 1.1 radius by corresponding analysis. Corresponding analysis is a scientific method for the classification of knee osteoarthritis syndrome.

OBJECTIVE To discuss the infection conditions of Mycoplasma pneumoniae(MP),Chlamydia pneumoniae(CP),Ureaplasma urealyticum(Uu),and Chlamydia trachomatis(CT) in the respiratory tracts of neonatal infants,and that of MP and CP among the infected children.METHODS Detecting MP,CP,Uu and CT in sputa of neonatal infants and MP and CP in throat swabs of children by the fluorescence quantitative polymerase chain reaction(FQ-PCR).RESULTS The positive rate of MP was 54.2%,4.9% and 10.0%(P0.05) in premature infants and term neonatal infants.CONCLUSIONS Infection rate of MP in premature infants is obviously higher than in term neonatal infants.The infection of CP is negative in all specimens.Infection rate of Uu in premature infants is higher than in term neonatal infants.Infection rate of CT has no statistical difference between premature infants and term neonatal infants.

OBJECTIVE To investigate Epstein-Barr virus (EBV) infection and clinical symptoms among hospitalized children by detection of EBV in their throat swabs. METHODS During from Oct 2004 to Apr 2006, EBV-DNA was detected from throat swabs of inpatients in pediatric ward by the technology of fluorescence quantitative polymerase chain reaction. RESULTS Totally 3429 cases were detected, 738 cases were positive. The positive rate was 21.5%. In different age groups, the rate of EBV infection was 18.8% for ≤3 years old, 26.5% for 4-7 years old, 29.0% for 8-11 years old, and 31.7% for 12-15 years old, respectively. The rate of EBV infection increased significantly with age increasing (P