Objective To detect the protein expression changes of mitochondrial apoptotic pathway during the reverse effects of lipid emulsion on bupivacaine cardiotoxicity, so as to investigate the probable mechanism concerning the reverse effect of lipid emulsion on bupivacaine cardiotoxicity.Methods The ventricular muscles of 15 healthy SD neonatal mice (1-3 d) were chosen to conduct primary culture in vitro.And the cardiomyocytes were cultivated in a medium containing bupivacaine for 24 hours to establish its bupivacaine poisoning model.The cultured cardiomyocytes were divided into three groups: control group (group C);bupivacaine group (group B);and bupivacaine+lipid emulsion group (group BL).Flow cytometry was applied to examine the apoptosis of cardiomyocytes, and the Western blot was employed to detect the protein expression variation of cytochrome C (Cyto-C) and cleaved casepase-3.Results Compared with group C, the apoptosis rate was remarkably increased in both group B and group BL and that of the group B was dramatically higher than that of the group BL, with a statistical significance (P<0.05).Compared with group C, the protein expression levels of both Cyto-C and cleaved casepase-3 were significantly increased in groups B and BL (P<0.05), and the protein expression levels of both Cyto-C and cleaved casepase-3 in group B were significantly higher than those in group BL (P<0.05).Conclusion Lipid emulsion can regulate apoptosis through inhibiting the release of mitochondrial Cyto-C and reducing casepase-3 activation, thus it protects cardiomyocytes.

Objective To design a new type of field operation instrument for easy to spread a rescue surgery rapidly in field first -aid at the present stage. Methods The traditional field operation instrument set is innovated in its composition, structure and function. The packing instrument procedure can be omitted. The new field operation instrument set is made of four different operation instrument boxes, two of which can be put into a standard field medical case. Results It is designed to be convenient to have a rescue surgery rapidly and to be washed, sterilized, conveyed and kept in aseptic storage. Conclusion The new field operation instrument case has such advantages as compactness, reasonable allocation and function completed, so it can be used easily.

This paper aims to discuss the use and management of operation instrument in treatment of the wounded on the sea by using the new type of field operation instrument set so as to improve the rescue ability on the sea. The operation set has a new structure and is designed reasonably. It is easy to be washed and disinfected. It can be packed sterilizedly for a long time and deployed rapidly. All of the operation instrument is fixed in the box to prevent it from falling when it is used on the sea and it is convenient to count and arrange. The new type of field operation instrument set is fit for rescuing the wounded on the sea. It is convenient to be used, sterilized, stored and carried.

Objective:To explore the application effect of memory clock-in mode to promote the quality of pre class memory in hybrid teaching.Methods:Total 778 nursing students were selected as research objects,and divided into control group and observation group.Control group memorized according to the learning requirements before the general class,observation group participated in memory punching on the basis of control group.The final examination scores,memory frequency and memory difficulty of the subjects were com-pared between the two groups,then investigate the satisfaction of memory clock.Results:Final examination score of observation group was higher than that of control group(P<0.05);the number of weekly memory in observation group was significantly higher than that in control group(P<0.05),while there was no significant difference in the length of each memory between observation group and control group(P>0.05);difficulty of subjective perception and memory in observation group was lower than that in control group(P<0.05);students who participated in the whole process of clock in memory were more satisfied with knowledge grid memory than those who did not participate in the whole process of clock in memory(P<0.05).Conclusion:The memory punch in mode improves the pre class memory quality of the hybrid teaching of Pathogenic Biology and Immunology.

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.