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 investigate the impact of two target body temperatures on inflammatory response, oxidative stress, cerebral metabolism, outcomes and complications in patients undergoing extracorporeal cardiopulmonary resuscitation. Methods A retrospective analysis was conducted on the clinical data of 107 patients undergoing extracorporeal cardiopulmonary resuscitation. Fifty-three patients with a target body temperature controlled at 32.0 to 34.0 ℃ were included in the moderate hypothermia group, and 54 patients with a target body temperature controlled at 34.1 to 36.0 ℃ were included in the mild hypothermia group. Inflammatory response indicators [C-reactive protein (CRP), interleukin-6 (IL-6), interleukin-1β (IL-1β), nuclear factor kappa-B subunit p65 (NF-κB p65)], oxidative stress indicators [superoxide dismutase (SOD), total antioxidant capacity (TAC), total oxidant status (TOS), malondialdehyde (MDA)], and cerebral metabolism indicators [arterial-jugular venous oxygen content difference (Da-jvO₂), cerebral oxygen extraction ratio (CERO₂)] were compared between the two groups before temperature management and when the target temperature was achieved. Additionally, occurrence of complications and outcomes [prognosis outcomes and Glasgow-Pittsburgh Cerebral Performance Categories (CPC) score] were compared. Results When the target temperature was achieved, the levels of CRP, IL-6, IL-1β, and NF-κB p65 in both groups were lower than those before temperature management, and their levels in the moderate hypothermia group were lower than those in the mild hypothermia group(P < 0.05). At the target temperature, the levels of SOD and TAC in both groups were higher than those before temperature management, and the levels in the moderate hypothermia group were higher than those in the mild hypothermia group (P < 0.05). Meanwhile, the levels of TOS and MDA in both groups were lower than those before temperature management, and the levels in the moderate hypothermia group were lower than those in the mild hypothermia group (P < 0.05). When the target temperature was achieved, the Da-jvO₂ and CERO₂ in both groups were lower than those before temperature management, and their levels in the moderate hypothermia group were lower than those in the mild hypothermia groups (P < 0.05). There was no statistically significant difference in the incidence of complications between the two groups (P>0.05). The CPC score and prognosis in the moderate hypothermia group were slightly better than those in the mild hypothermia group, but the difference was not statistically significant (P>0.05). Conclusion Target body temperature management after cardiopulmonary resuscitation can effectively promote the recovery of cerebral function. A target body temperature of 32.0 to 34.0 ℃ is more conductive to reducing inflammatory response as well as oxidative stress, and improving cerebral metabolism and outcomes.

Objective:To discuss the the effects, indications and protective measures of tracheotomy for severe cases of coronavirus disease 2019 (COVID-19) patients.Methods:A retrospectively analysis was conducted to explore the clinical data of COVID-19 patients who received tracheotomy in February to March 2020, and descriptive statistics were used to analyze the indication of tracheotomy, particularity of intraoperative treatment and protective measures.Results:A total of 4 cases were included in this article. All patients were successfully operated. One case had postoperative incision continuous bleeding, there were not other complications and nosocomial infection among the medical staff. The patient′s condition was relieved in different degrees after the operation, who remained hospitalized.Conclusion:Tracheotomy for severe cases of COVID-19 can achieve certain curative effect, but the occurrence of tracheotomy related complications and nosocomial infection should be effectively controlled, and the risk benefit ratio of tracheotomy should be carefully weighed before surgery.

Objective: To study the etiological characteristics of an imported Chikungunya fever (CHIK) epidemic in Fujian province in 2018. Methods: Serum samples collected at different days after the onset of the two CHIK cases were detected by real-time RT-PCR and ELISA. Structural protein E1 gene was amplified by RT-PCR and sequenced for nucleotide characteristics analysis and phylogenetic tree analysis. Results: RNA of Chikungunya virus (CHIKV) was detected in the 4 serum samples collected on the first 5 days of the disease, and the earliest IgM antibodies were detected in specimens on the 5th day of the disease, however, IgG antibodies were only detected in specimen on 10th day. Compared with the S27-African prototype strain, 12 mutant points were found in the amino acids of E1 genes in this study. The E1 genes of the two CHIK cases were exactly the same, and they were closest to the evolutionary relationship with the strain isolated in the Philippines in 2014. Their genotype was Asian genotype. Conclusions This epidemic was confirmed to have been imported from the Philippines after the infection with the Asian genotype CHIKV, which suggests that Fujian province should strengthen the monitoring of persons entering from the CHIK epidemic area, so as to prevent imported cases from causing local outbreaks.

Objective To analyze the expressions of lymphocytes in the peripheral blood and serum cytokines in the children with secretory otitis media (SOM) and the effects of glucocorticoids interventions.Methods Totally 90 SOM children were selected as case group,and 30 healthy children were selected as control group.The case group was randomly divided into group A (simple oral antibiotic treatment),group B (oral antibiotics combined with local glucocorticoid treatment) and group C (oral antibiotics combined with systemic glucocorticoid treatment),30 cases in each group.The CD4 + T lymphocytes percentage,CD8 + T lymphocytes percentage,the ratio of CD4 +/CD8 + T lymphocytes in peripheral blood and the serum interleukin-2 (IL-2),interferon gamma (IFN-γ),tumor necrosis factor alpha (TNF-α),interleukin-6 (IL-6),interleukin-10 (IL-10) levels were detected and compared between case group and control group.The air conduction auditory thresholds under different frequency of the patients in group A,group B and group C were examined and compared.Results The CD4 + T lymphocytes percentage,the ratio of CD4 +/CD8 + T lymphocytes in peripheral blood and the serum IL-2,IFN-γ,TNF-α,IL-6,IL-10 levels of the patients in the case group were significantly higher than those in the control group (P ＜ 0.0 5).After the treatment,the above indicators of the children in group A,group B and group C decreased,and there were significant differences before and after the treatment between two groups (P ＜ 0.05).The air conduction auditory thresholds under different frequency of the patients in group B or group C were significantly lower than those in group A (P ＜ 0.05),while there were no significant differences in the air conduction auditory thresholds under different frequency between the children in group B and group C (P ＞ 0.05).Conclusion The patients with SOM show imbalanced cell immune function and cytokines expressions in the peripheral blood.The combination of glucocorticoids therapy and routine antibiotic therapy can effectively improve the immune function and the therapeutic effects.

Objective To analyze the expressions of lymphocytes in the peripheral blood and serum cytokines in the children with secretory otitis media (SOM) and the effects of glucocorticoids interventions.Methods Totally 90 SOM children were selected as case group,and 30 healthy children were selected as control group.The case group was randomly divided into group A (simple oral antibiotic treatment),group B (oral antibiotics combined with local glucocorticoid treatment) and group C (oral antibiotics combined with systemic glucocorticoid treatment),30 cases in each group.The CD4 + T lymphocytes percentage,CD8 + T lymphocytes percentage,the ratio of CD4 +/CD8 + T lymphocytes in peripheral blood and the serum interleukin-2 (IL-2),interferon gamma (IFN-γ),tumor necrosis factor alpha (TNF-α),interleukin-6 (IL-6),interleukin-10 (IL-10) levels were detected and compared between case group and control group.The air conduction auditory thresholds under different frequency of the patients in group A,group B and group C were examined and compared.Results The CD4 + T lymphocytes percentage,the ratio of CD4 +/CD8 + T lymphocytes in peripheral blood and the serum IL-2,IFN-γ,TNF-α,IL-6,IL-10 levels of the patients in the case group were significantly higher than those in the control group (P ＜ 0.0 5).After the treatment,the above indicators of the children in group A,group B and group C decreased,and there were significant differences before and after the treatment between two groups (P ＜ 0.05).The air conduction auditory thresholds under different frequency of the patients in group B or group C were significantly lower than those in group A (P ＜ 0.05),while there were no significant differences in the air conduction auditory thresholds under different frequency between the children in group B and group C (P ＞ 0.05).Conclusion The patients with SOM show imbalanced cell immune function and cytokines expressions in the peripheral blood.The combination of glucocorticoids therapy and routine antibiotic therapy can effectively improve the immune function and the therapeutic effects.

Objective To compare the clinical efficacy of different surgical treatment on cholesteatoma otitis media and analy‐sis its differences .Methods Totally 100 cases of patients with cholesteatoma otitis media in hospital were divided into two groups , 50 cacse in each group ,the control group used open mastoidectomy for treatment ,the experimental group used complete bi‐style mastoidectomy ,and the postoperative clinical efficacy were observed .Results The experimental group patients after radical mas‐toidectomy complete bi‐style treatment ,air conduction hearing threshold (26 .89 ± 7 .23)dBHL and gas bone conduction (12 .54 ± 3 .78)dBHL were significantly lower than after open radical mastoidectomy treatment of patients in the control group (41 .38 ± 10 .56)dBHL and gas bone conduction (22 .57 ± 5 .96)dBHL(P<0 .05);after different surgical treatment ,the cholesteatoma otitis media total efficiency (92 .00% ) of experimental group was significantly higher than control group (64 .00% ) ( P< 0 .05 ) . Conclusion The complete bi‐style mastoidectomy is the treatment of cholesteatoma otitis media ,which can effectively repair dam‐aged eardrum ,restore patient hearing to the maximum extent ,help to restore patient′s disease and improve the quality of life of pa‐tients .

ObjectiveTo investigate the main clinical characteristics of patients with autoimmune hepatitis (AIH). MethodsAn analysis was performed on the data of 194 AIH patients who visited Guanggu Branch of Hubei Provincial Hospital of Traditional Chinese Medicine from December 2010 to December 2014 and 197 healthy blood donors who served as control group. Autoantibodies, biochemical indicators, and liver biopsy were evaluated for AIH patients. The type of AIH patients was determined according to the results of test of autoantibodies and a statistical analysis was conducted for age, sex, biochemical markers, and pathological manifestations of all the AIH patients, Comparison of continuous data between groups was made by analysis of variance and comparison of categorical data between groups was made by chi-square test. ResultsThe female/male ratio was 154∶40 among the 194 AIH patients. The morbidity achieved a peak value among the patients aged 40-60 years. The proportion of the patients older than 40 years were 76.80% (149/194). According to the results of test of autoantibodies, the numbers of type-Ⅰ, -Ⅱ, and -Ⅲ AIH patients were 163, 5, and 26, respectively, the female/male ratios were 131∶32, 4∶1, and 19∶7, respectively, and the mean ages were 59.26±10.24, 16.54±8.21, and 63.38±12.92 years, respectively. There were significant differences in alanine aminotransferase, aspartate aminotransferase, gamma-glutamyltransferase, and immunoglobulin G between type-Ⅰ AIH patients and type-Ⅱ and -Ⅲ AIH patients (all P＜0.05), and immunoglobulin A significantly differed between type-Ⅱ AIH patients and type-Ⅰ and -Ⅲ AIH patients (P＜0.05). Pathological manifestations of AIH showed interface hepatitis, infiltration of lymphocytes and plasma cells, and rosette-like changes. ConclusionAIH patients are mostly female aged 40-60 years. The peak age of onset ranges from 40 to 60 years. Biochemical indicators have various degrees of increase among type-Ⅰ, -Ⅱ, and -Ⅲ AIH patients. The main pathological manifestation is interface hepatitis.

Objective To investigate the effect of elemene on mRNA expressions of tumor necrosis factor (TNF) receptor associated factor 6 (TRAF6) and caspase-8 in tumor tissues of mice bearing hepatoma H22.Methods Forty BALB/c mice models bearing hepatoma H22 were established by subcutaneous inoculating tumor cells.Forty BALB/c mice were randomly divided into 4 groups:model group,low-and high-elemene dosage groups,and cisplatin group.The tumors after executing mice were weighted.The mRNA expressions of TRAF6 and caspase-8 in tumor tissues were detected by quantitative real-time reversetranscription polymerase chain reaction (RT-PCR).Results The dosage of elemene could inhibit tumor growth.The inhibition ratio of cancer in the low-and high-elemene dosage and cisplatin group was 24.2％,27.4％,and 28.2％,respectively.It reduced significantly tumor weights(P ＜0.01).Compared to the model group,the expression level of TRAF6 mRNA on tumors was decreased significantly,while the expression level of caspase-8 mRNA was increased significantly in the other groups(P ＜ 0.05).Conclusions The present results indicated that molecular mechanism of inhibition of liver cancer growth treated by elemene might be through down-regulating mRNA expressions of TRAF6 and caspase-8,promoting tumor cells apoptosis,and achieving the anti-tumor effect.

A large real-time processing of ultrasonic signals is a very important part in the ultrasound diagnosis system,especially with digital hardware processing.A key part of the signal processing is the filter design which will affect the performance of ultrasound diagnostic equipment.In this paper,the classification of digital filters is introduced briefly,and a number of hardware implementation methods of digital filter in recent years,especially the realization of FIR filters which belongs to the classical filter based on Distributed Algorithms are discussed.Then a number of advantages and problems of digital filter in recent years are analyzed.On this basis,the paper forecasts its developing trends in the future.