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 explore the mediating effect of nurses′ self-efficacy in palliative care between the past behavioral experience of end-of-life care and core competence, and provide theoretical reference for improving the core competence of clinical nurses in palliative care.Methods:579 clinical nurses from 2 tertiary general hospitals in Shandong Province were investigated by convenience sampling method using general information questionnaire, nurses′ self-efficacy questionnaire for palliative care and palliative care nurses′ core competency questionnaire. The data were analyzed by SPSS 25.0.Results:The total score of core competence of hospice care of 579 nurses was (71.41 ± 22.74), nurses′ self-efficacy of palliative care was positively correlated with their core competence ( r = 0.648, P<0.01), past behavior experience was positively correlated with self-efficacy ( r = 0.479, P<0.01), positively correlated with core competence ( r = 0.427, P<0.01). Nurses′ self-efficacy of palliative care played a partial mediating role between the pastbehavioral experience and core competence, which accounted for 64.67% of the total effect. Conclusions:The past behavioral experience of end-stage nursing can directly or indirectly affect the core competence of nurses in palliative care through self-efficacy. It can improve the core competence of palliative care by taking active measures to enrich the past behavioral experience of end-of-life care and improve self-efficacy.

Objective To investigate the gestational weight gain and quality of life in women with gestational diabetes mellitus(GDM) who used Free-Style Libre Flash Glucose Monitoring System. Methods From August of 2017 to January of 2019, the GDM patients diagnosed in the Department of Endocrinology in 3 ClassⅢ Grade A hospitals in Guangzhou were selected and divided into the observation group(n=39) and control group(n=43) according to their glucose monitoring willingness. The Free-Style Libre Flash Glucose Monitoring System was used for the observation group(sensor changed every 14 days) combined with the fingertip blood glucose monitor, it was necessary to monitor fingertip blood glucose contrast when hypoglycemia was identified by sensors. Pregnant women at other monitoring points could selectively monitor fasting and postprandial blood glucose. In the control group, after assigned into the group patients only monitored their fingertip blood glucose(at lease 2 times/d, including fasting and 2h postprandial blood glucose). The two groups were all instructed by self-management on diet, exercise etc according to the result of blood glucose monitor, the Wechat management was included to instruct them of the daily life diary recording method. World Health Organization-5 Well-Being Index (WHO-5) was adopted at the beginning of the study and the second week of follow-up to investigate the well-being index score of the patients in the two groups; at the end of pregnancy, the average perinatal blood sugar level, incidence of hypoglycemia events and the eligible rate of weight gain in different BMI patients were recorded. Results At the 2nd week, the score of well-being index in the observation group was higher than that in the control group with statistical significance(P=0.037).There was no statistically significant difference in fasting and 2 h postprandial glucose between the two groups (P＞0.05). There was no significant difference in blood sugar control (fasting and 2 hours after meal) between the two groups (P＞0.05), but the detection rate of hypoglycemia in the group using Free-style Libre glucose monitoring system was higher than that in the control group (P=0.042). By the end of pregnancy, stratified analysis showed that the qualified rate of weight gain in the observation group with BMI between 18.5 and 24.9 kg/m2 before pregnancy was higher than that in the control group with statistical significance(P=0.035). Conclusions The use of Free- Style Libre Flash Glucose Monitoring System in GDM patients makes gestational weight control more reasonable and painless, and improves the well-being index of patients.

Objective To investigate the damage of retinal ganglion cell (RGC) axons in retinitis pigmentosa (RP) quantitatively by using reduced-filed-of-view DTI (rfov-DTI) together with optical coherence tomography(OCT).Methods Thirty four patients(68 eyes,Patient group)and 33 healthy controls (66 eyes, Control group) were enrolled in this study. Measures of rfov-DTI and OCT of both eyes in all subjects were performed by 3.0 MRI. The difference of fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (λ//) and radial diffusivity (λ⊥) were compared by two independent sample t test. The peripapillary retinal nerve fiber layer (RNFL) thickness in temporal and lateral nose, which data don't conform to normal distribution, were calculated by average and four quadrants and compared by Mann-Whitney U test,the average RNFL thickness and RNFL thickness in low quadrant and upper quadrant were compared by two independent sample t test.Spearman rank were performed to determine the correlation between DTI parameters of optic nerves (ONs) and RNFL thickness. Results The value of FA, MD, λ//, λ⊥, average, temporalside, nasal side, low quadrant and upper quadrant RNFL thickness in patient group were 0.445±0.078,(1.330±0.236)×10-3mm2/s,(5.502±0.263)×10-3mm2/s,(4.494±0.238)×10-3mm2/s,(104.7± 25.4)μm,(104.0±31.0)μm,(65.0±25.0)μm,(122.0±33.3)μm,and(117.4±37.7)μm respectively and the data in control group were 0.581±0.043,(1.079±0.146)×10-3mm2/s,(5.349±0.214)×10-3mm2/s,(4.195±0.126)× 10-3mm2/s, (101.2 ± 10.6)μm, (70.0 ± 10.8)μm, (81.3 ± 13.4)μm, (127.3 ± 12.5)μm, (126.3 ± 11.5)μm respectively.Compared with the control group,the value of MD,λ//,λ⊥were significantly higher but FA was significantly lower (t=-12.388, 7.394, 3.695, 9.062;all P<0.01). The temporal RNFL was significantly thicker while the nasal RNFL was much thinner than that in control group respectively(Z=-8.384,-4.518;all P<0.01);the average, low quadrant and upper quadrant RNFL thickness showed no significant differences compared with the control group(t=-1.217,-1.843, 1.049;P=0.227, 0.069, 0.297).Especially,there was a weak correlation between the temporal RNFL thickness and FA(r=0.268,P=0.029),however,no correlation of nasal RNFL thickness with mean FA was found(r=0.164,P=0.186). Conclusions rFOV-DTI together with OCT can provide information about the pathology of RGC axon disease in patients with RP.there is a weak correlation between the retinal nerve fiber layer and the pathological changes of optic nerve in the retinal ganglion cells,but the performance were not coincident.

Objective: To study the toxicological effects of Nao-de-kang on rats. Methods: According to the digital table, SD rats were randomly divided into blank group and Nao-de-kang small dose group(3.85g/kg), high dose group(7.71g/kg) and maximum tolerated dose group(77.14g/kg), 20 rats in each group, half male and half female.All groups were treated for 12 weeks, and the maximum tolerated dose group was treated for 1 week.The animal activity during treatment, the blood routine indicators, blood biochemical index and the organs for pathological examination were recorded and compared. Results: There was no mortality in the dose group of rats in the experimental period.The weights of 4 groups had no statistically significant differences during treatment(F=0.688, 0.540, 0.121, 0.065, 0.128, 0.239, 0.199, 0.378, 0.127, 0.446, 0.906 and 0.665, P=0.562, 0.585, 0.886, 0.937, 0.880, 0.788, 0.820, 0.687, 0.881, 0.642, 0.410 and 0.518), male and femal′s red blood cell(RBC)(♀: F=0.178, P=0.910, ♂: F=0.119, P=0.948), hemoglobin(HGB)(♀: F=0.046, P=0.987, ♂: F=0.072, P=0.975), hematokrit(HCT)(♀: F=0.126, P=0.944, ♂: F=0.054, P=0.983), platelet(PLT)(♀: F=0.515, P=0.675, ♂: F=0.500, P=0.685), white blood cell(WBC)(♀: F=0.078, P=0.972, ♂: F=0.057, P=0.982), eosnophils(Eos)(♀: F=0.078, P=0.972, ♂: F=0.057, P=0.982), lymphocyte(Lym)(♀: F=0.078, P=0.972, ♂: F=0.057, P=0.982), neutrophilic granulocyte(Neu)(♀: F=0.134, P=0.939, ♂: F=0.090, P=0.999), alanine aminotransfease (ALT)(♀: F=0.572, P=0.637, ♂: F=0.200, P=0.896), aspartate aminotransferase(AST)(♀: F=0.572, P=0.637, ♂: F=0.200, P=0.896), total protein(TP)(♀: F=0.665, P=0.579, ♂: F=0.343, P=0.795), albumin(ALB)(♀: F=0.533, P=0.663, ♂: F=0.668, P=0.577), triglyceride(TG)(♀: F=0.843, P=0.480, ♂: F=0.561, P=0.644), cholesterol(CHOL)(♀: F=0.245, P=0.864, ♂: F=0.046, P=0.987), glucose(GLU)(♀: F=0.216, P=0.884, ♂: F=0.095, P=0.963), urea nitrogen(BUN)(♀: F=0.172, P=0.914, ♂: F=0.203, P=0.894)and creatinine(Cr)(♀: F=0.172, P=0.914, ♂: F=0.203, P=0.894) had no statistically significant differences. Conclusion Nao-de-kang has no obvious side effect.

Objective To explore the electrophysiological examination results and risk factors of type 2 diabetic peripheral neuropathy. Methods 337 patients with type 2 diabetes from August 2014 to December 2016 in the first people's hospital in Shizuishan city were divided into DPN group (n=218) and NPDN group(n=119) according to the results of NCV and SSR examinations. The general information and laboratory biochemical indicators in the two groups were compared. Multivariate Logistic regression was used to analyze the risk factors of DPN. Results The diagnosis rate of DPN detected by NCV combined with SSR was higher than that of NCV or SSR alone(P<0.05);There were significant differences in age,duration of diabetes,history of hypertension,systolic blood pressure,2h FBG,HbA1c,FINS,2 h INS,FC-P, 2h FC-P,ACR between the DPN group and NPDN group(P<0.05);Logistic multivariable analysis showed that age, duration of diabetes, 2h FBG, HbA1c, ACR were independent risk factors for DPN. Conclusion It is beneficial to increase the diagnosis rate of DPN by NCV combined with SSR. There is a higher incidence rate of DPN type 2 diabetes patients with older grade, longer duration of diabetes, higher 2h FBG, HbA1c and ACR.

High expression of Fightless I (FLII) is associated to multiple tumors. Based on our previous study that FLII might be involved in the nuclear export, we assessed the possible interaction of FLII with the nuclear envelop associating proteins Importin β and Nup88. We first constructed GST-FLII, GST-LRR recombinant plasmids and transformed them into the Rosetta strain to produce GST-FLII, GST-LRR fusion protein. After purification of these proteins, GST-pull down, as well as co-immunoprecipitation, were used to test the interaction of FLII with Importin β and Nup88. FLII interacted with Importin β and Nup88, and FLII LRR domain is responsible for these interactions. Thus, FLII may play a role in nuclear export through interaction with Importin β and Nup88.
Humans ; Microfilament Proteins ; metabolism ; Nuclear Pore Complex Proteins ; metabolism ; Receptors, Cytoplasmic and Nuclear ; metabolism ; Recombinant Fusion Proteins ; metabolism ; beta Karyopherins ; metabolism

Objective:To translate the Attention to Positive and Negative Inventory(APNI)and analyze the validity and reliability in Chinese undergraduates sample,to offer a convenient and reliable tool of measuring the cognitive bias for national researchers. Methods:The English-version APNI went through translation into Chinese, retroversion into English,translation into Chinese again,and revision several stages. Two parts of samples (1450 Chinese college students)were surveyed. Sample one (n=1000)was used for item analysis,exploratory factor a-nalysis (EFA),concurrent validity and reliability analysis,while sample 2 (n=450)was used for confirmatory fac-tor analysis (CFA). Totally 68 subjects of sample 1 were randomly chosen and resurveyed with an interval of one week. Beck depression inventory (BDI-II)and patient health questionnaire (PHQ-9)was used for concurrent validi-ty. Results:Item analysis indicated that the 22 items of Chinese APNI had good discriminability. EFA focused onattention to positive information(API)and attention to negative information(ANI)two factors. CFA showed good model fit (χ2 =1376,RMESA=0. 09,CFI=0. 94). Concurrent validity result showed that the total scores of BDI-II and PHQ-9 was negatively correlated with total scores of API (r=-0. 24,-0. 29,Ps<0. 01 ),and posi-tively correlated with total scores of ANI (r=0. 36,0. 31,Ps<0. 01). The Cronbach'αcoefficients of API and ANI sub-scale were 0. 86 and 0. 82,while the retest reliability coefficients were 0. 79 and 0. 62. Conclusion:It suggests that the Chinese APNI has good validity and reliability in a sample of college students,which could be used to eval-uate the cognitive bias of Chinese college students.

Objective To survey the 238U radioactivity level in the surface soil in the Beijing-Tianjin-Hebei Border (BTHB) region,and to prepare a high resolution distribution map of 238U activity concentrations.Methods The soil samples were collected in a grid (10 km × 10 km).The activity concentrations of 238U in soil samples were measured by using HPGe γ spectrometry.The distribution of the activity concentrations of 238U in soil samples was mapped by the aid of MAPGIS software.Results In total,416 samples were collected and measured.The activity concentrations of 238U were in the range of 0.1-106.0 Bq/kg,with an average of 34.7 Bq/kg.The 238U activity concentration distribution map showed that 238U activity concentration was in the range of 15-55 Bq/kg mostly on the surface soil in the BTHB region.Conclusions The map of 238U activity concentration shows the distribution of 238U activity concentration in the BTHB region.It is of importance to map the distribution of 238U activity concentration in the BTHB region,by converting a huge amount of data into the simple and intuitive graphics,and for evaluating the regional environmental radioactivity and studying the radioactive substance migration within the locality.

Objective To determine the activity concentration of radionuclides for 137Cs and 40K in edible wild mushrooms,and to evaluate the extent of radioactive contamination and ingestion doses to adults from consumption of these wild mushrooms.Methods A total of 33 samples for 18 edible wild mushroom species were collected from natural forest Mangshi,Yunnan province.The activity concentrations of 137Cs and 40K were analyzed by using high-purity germanium (HPGe) gamma spectrometry.Results Except.for one sample that was below the MDA,137Cs artificial radionuclides were detected in other 32 samples,with activity concentration of 137Cs in the range of 0.45-339.58 Bq/kg (dry weight) and an average of 25.47 Bq/kg (dry weight).In regards to 40K in edible mushrooms,all species presented the activity concentrations for this radionuclide and the levels varied from 453.4 to 1 882.6 Bq/kg (dry weight),with an average of 815.1 Bq/kg (dry weight).After species of mushroom with only one sample were eliminated,there was significant difference for 137Cs(F =21.13,P ＜ 0.05) among 6 species of mushroom named Gomphus floccosus (Schw.) Sing.,Boletus edulis bull,Boletus edulis bull,Tylopllus bolloul (Peck) Sing.,Lentinus edodes (Berk.) Sing.and Boletus brunneissimus W.F.Chin,but without significant difference for 40K.Conclusions These 6 different mushroom species have different capacity to retain radionuclides of 137Cs in soil.These wild mushrooms,such as Gomphus floccosus (Schw.) Sing.and Lentinus edodes (Berk.) Sing.have large affinity ability for radionuclides137Cs.The effective dose to adults attributable to consuming these kinds of mushrooms is small and below the level that could cause harm.