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 effect of ultra-early nursing intervention on postoperative cognitive behavior and prognosis of patients with cerebral hemorrhage.Methods:Using the convenient sampling method, a total of 82 patients with cerebral hemorrhage who were admitted to the First Affiliated Hospital of Zhengzhou University from March 2019 to January 2021 were selected as the research objects. According to the random number table method, they were divided into the control group and the observation group, with 41 cases in each group. Both groups received surgical treatment. The control group received routine nursing, while the observation group received ultra-early nursing intervention on the basis of routine nursing when vital signs were stable 48 hours after operation. The differences in neurological function (National Institutes of Health Stroke Scale, NIHSS) , cognitive function (Loewenstein Occupational Therapy Cognitive Assessment, LOTCA) and activity of daily living scores were compared between the two groups at 48 hours and 1 month after operation.Results:The NIHSS score at 1 month after surgery in both groups was lower than that at 48 hours after surgery and the NIHSS score at 1 month after surgery in observation group was lower than that in control group ( P<0.05) . The LOTCA dimension scores of the two groups at 1 month after operation were higher than those at 48 hours after operation and the LOTCA dimension scores of the observation group at 1 month after operation were higher than those of the control group ( P<0.05) . The activity of daily living scores of the two groups at 1 month after operation were higher than those at 48 hours after operation and the activity of daily living score of the observation group at 1 month after operation was higher than that of the control group , the differences were statistically significant ( P<0.05) . Conclusions:Ultra-early nursing intervention can effectively promote the recovery of postoperative neurological function and cognitive function in patients with cerebral hemorrhage and improve the activity of daily living of patients.

Objective: To explore the application value of 3.0 T MultiVane XD (MVXD) technique in female patients with uterine adenomyosis and fibroids. Methods: Patients diagnosed with uterine fibroids with ultrasound and suspected of adenomyosis were involved prospectively from March to May 2018, 3.0 T pelvic MRI examinations were performed during peri-ovulatory period. Axialconventional turbo spin echo (TSE) T₂WI, axial MVXD T₂WI, sagittal conventional TSE T₂WI and MVXD sagittal T₂WI were acquired. Two observers rated those 4 series in the aspects of sharpness of uterine border, motion artifacts, identification capability of lesions, confidence of diagnosis and overall image quality. Cohen Kappa analysis was used to evaluate the consistency of scores between 2 observers. Scores of TSE T₂WI and MVXD T₂WI qualities were compared using Wilcoxon matched-pairs signed-ranks test. Results: Twenty patients were enrolled. Axial conventional TSE T₂WI, axial MVXD T₂WI were aquired on all of them. Sagittal conventional TSE T₂WI, sagittal MVXD T₂WI were aquired on 19 among them. Nine patients had only obvious adenomyosis, 6 had only uterinefibroids, and 5 had adenomyosis and uterine fibroids. Compared to conventional TSE technique, scores of two observers in the sharpness of uterine border, motion artifacts, and overall image quality is higher by MVXD with significant difference (P<0.05). The Kappa values for image quality scores of two observers ranged from 0.615 to 0.971, the agreement was good or very good. Conclusion Applying MVXD T₂WI technique to patients with uterine fibroids and adenomyosiscould improve image quality, without sacrificing the ability to recognize and diagnose lesions, compared to conventional TSE T₂WI technique.

OBJECTIVE: To investigate the prevalence and relevant influencing factors of gynecological diseases of grassroot level female medical staffs. METHODS: A total of 2 308 female medical workers from county, town and village in hengxian County of Guangxi Zhuang Autonomous Region were selected as study subjects by cluster sampling method. The basic information, occupational history, reproductive health and fertility of these subjects were investigated by Reproducetive Health Survey Questionnaine of Female Workers. RESULTS: The total prevalence of gynecological diseases in female medical staffs was 21.6%. Among them, the prevalence of genital tract infections was 15.6%, and gynecological tumors was 6.0%. The top three gynecologic diseases were vaginitis(9.2%), uterine fibroids(4.3%) and cervicitis(3.5%). Multivariate logistic regression analysis results indicated that the younger the patients, the higher the risk of reproductive tract infectious diseases(P<0.01), and the lower the risk of gynecological tumors(P<0.01). The risk of reproductive tract infectious diseases and gynecological tumors in married patients was higher than that in unmarried staffs(P<0.05). The higher the number of abortions, the higher the risk of reproductive tract infectious diseases and gynecological tumors(P<0.01). The risk of reproductive tract infectious diseases was higher and the risk of gynecological tumors was lower in female shift workers than that of non-shift workers(P<0.05). CONCLUSION: Vaginitis, uterine fibroids and cervicitis are the main gynecological diseases in grassroot level female medical staffs. The incidence of gynecological diseases is related to age, history of marriage, childbirth and abortion, and work-shifts.

Foodborne disease is one of the most important public health issues worldwide. China faces various and unprecedented challenges in all aspects of the food chain. Data from laboratory-based foodborne disease surveillance systems from 2013 to 2016, as well as different regions and ages, can be found along with differences in the patterns of pathogens detected with diverse characteristics. Vibrio parahaemolyticus has been the leading cause of infectious diarrhea in China, especially among adults in coastal regions. Salmonella has been a serious and widely distributed pathogen responsible for substantial socioeconomic burden. Shigella was mostly identified in Northwest China and the inland province (Henan) with less-developed regions among children under 5 years. Data from foodborne disease outbreak reporting system from 2011 to 2016 showed that poisonous animals and plant factors responsible for most deaths were poisonous mushrooms (54.7%) in remote districts in southwest regions. The biological hazard that caused most cases reported (42.3%) was attributed to V. parahaemolyticus, the leading cause of foodborne outbreaks. In this review, we summarize the recent monitoring approach to foodborne diseases in China and compare the results with those in developed countries.
Bacteria ; classification ; isolation & purification ; China ; epidemiology ; Disease Outbreaks ; Food Microbiology ; Foodborne Diseases ; epidemiology ; microbiology ; Forecasting ; Humans ; Laboratories ; Mushroom Poisoning ; epidemiology ; Population Surveillance ; Public Health

Objective To investigate the clinical features of cerebral venous sinus thrombosis (CVST)in patients with malignancy as well as its underlying pathogenesis. Methods The clinical data, including clinical presentation, laboratory results, neurological images were retrospectively reviewed in hospital patients with active malignant tumor and cerebral venous thrombosis from January 2006 to December 2016. Results Among the 586 CVST patients, 24 patients (4.10%) were with malignant tumor. Among these 24 patients, there were 8 males and 16 females with an average age of (39.88 ± 21.71) years old. Four patients (16.67%) had the risk factors of cerebral venous sinus thrombosis, while the other 20 patients(83.33%)had not any such risk factors.At the symptom onset of CVST, 22 patients(91.67%) had headache and focal neurological deficit, such as limbs weakness and numbness. The common substyles of malignant tumor were lung cancer (33.33%), breast cancer (29.17%)and acute lymphocytic leukemia(20.83%).Most patients(58.33%)were found to have cerebral metastasis.22 patients (91.67%) had elevated plasma D-dimmer level, and 19 patients (79.17%) had elevated plasma cancer biochemical marker levels.Conclusions Cancer-related CVST had the features including lacking conventional risk factors, elevated plasma D-dimmer and cancer biochemical marker levels.Cerebral metastasis and hypercoagulable state may be responsible for the pathogenesis of CVST.

Objective To investigate the effect of comprehensive intervention on asymptomatic hyperuricemia.Methods in this random controlled study,all patients diagnosed with asymptomatic hyperuricemia on health examination according to the diagnostic standards were randomly divided into intervention group and control group.Comprehensive intervention included healthy lifestyle guidance and administration of sodium bicarbonate in the intervention group.Low purine diet was used in the control group.The follow-up period for all the patients was one year.The changes of various indexes in both groups before and after intervention were observcd and compared.Results Compared with the control group,the patients in the intervention group presented significantly lower levels of BMI,serum uric acid,blood sugar,SBP,DBP,triglyceride and less frequent occurrence of obesity,hyperglycemi,hypertension,hipertrigliceridemia (P ＜ 0.05).After intervention,the patients in the intervention group also exhibited significantly lower the levels of BMI,serum uric acid,blood sugar,SBP,DBP,triglyceride and significantly lower incidences of obesity,hyperglycemia,hypertension,hypercholesteremia and hipertrigliceridemia.Conclusion Comprehensive intervention into asymptomatic hyperuricemia can reduce the incidence of complications such as central obesity,hyperglycemia,hyperlipidemia and hypertension.

Objective:To explore the application and safety of visual endotracheal tube in tracheal intubation in patients with gen eral anesthesia operation.Methods:220 patients with general anesthesia operation in Department of Anesthesiology,Guangdong No.2 provincial people's hospital firom October 2014 to December 2016 were selected,110 patients were treated with visual endotracheal intubation as observation group,110 patients were treated with general endotracheal intubation as control group.The number of intubation,intubation times and complication rate in the two groups were contrasted,compared the heart rate (HR),systolic blood pressure (SBP),diastolic blood pressure (DBP) and oxygen saturation (SpO2) in the two groups at before induction of anesthesia (T0),after induction of anesthesia (T1),airway intubation (T2),5 min after intubation (T3).Results:The number of intubation and intubation times in the observation group were significantly less than those in the control group,the differences were statistically significant (P＜0.05);At each time point,the HR,SBP,DBP and SpO2 in the two groups were no significant difference (P＞0.05);The HR,SBP,DBP and SpO2 in the two groups at T1 were significantly less than T0,T2,T3,the differences were statistically significant (P＜0.05);The incidence of throat pain in the observation group (0.91％) was significantly less than that in the control group (7.27％),the difference was statistically significant (P＜0.05).Conclusion:Use visual endotracheal tube in tracheal intubation in patients with general anesthesia operation is satisfactory,can effectively reduce the time of intubation and intubation times,and has good security,it is worthy of clinical application.

Objective To study the clinical features and possible pathogenesis of acute ischemic stroke in renal cell cancer patients. Methods The clinical data from in-hospital patients with renal cell cancer who developed acute ischemic stroke were collected, including the patients with renal cell cancer who developed acute ischemic stroke during anti-cancer therapies and those patients with acute ischemic stroke who were firstly diagnosed to have renal cell cancer during anti-stroke therapies between January 2003 and December 2015. Results A total of 2516 patients with renal cell cancer were screened, and there were 36 patients (1.43%) with acute ischemic stroke. Out of the 36 patients, there were 29 men (80.56%) and 7 women (19.44%). Their age ranged from 45 to 68 years, with a average age of (65.11 ± 14.77) years. Eight patients (22.22%) had some conventional cardiovascular risk factors, while the other 28 patients (77.78%) had no such risk factors. Magnetic resonance imaging (MRI) scans at the acute stage of ischemic stroke were carried out for all these patients. Based on the diffusion weighted imaging (DWI) of MRI, 8 patients (22.22%) had single lesion and 28 patients (77.78%) had multiple lesions in different arterial territories in their brains. The pathological types of renal cell cancer were:suprarenal epithelioma (18 patients, 50.00%), papillary cell carcinoma (12 patients, 33.33%) and chromophobe renal cell carcinoma (6 patients, 16.67%). Metastases were found 10 patients (27.78%) out of the 36 patients. Blood biochemical examination showed that 28 patients had elevated plasma D-dimer level, 22 patients had elevated plasma cancer antigen (CA)125 level, and 17 patients had elevated plasma carcinoembryonic antigen (CEA) levels. Conclusions It is suggested that the renal cell cancer associated stroke is characterized by lacking of traditional risk factors and having multiple lesions in brain;and that the elevated plasma D-dimer, CA125 and CEA levels may lead to hypercoagulable state and lead to ischemic stroke eventually .

BACKGROUND:Dexmedetomidine is an efficient, highly selective alpha-2 adrenergic receptor agonist, with sedative, analgesia and anti-anxiety effects, it has little impact on the respiration.
OBJECTIVE:To observe the analgesic effect induced by intrathecal injection of dexmedetomidine in rat model of spared nerve injury.
METHODS:A total of 60 male Sprague-Dawley rats were randomly divided into three groups (n=12):normal control group, dexmedetomidine group and saline group. Except for the normal control group, spared nerve injury model was established in the rats of dexmedetomidine group and saline group. Dexmedetomidine group was treated with intrathecal injection of dexmedetomidine 3μg/kg every day within 14 days after injury. Saline group was given equal volume of saline for 14 days. The thermal withdrawal latency and mechanical withdrawal threshold were measured respectively before injury, after injury, before injection, and 2, 7, 14 days after intrathecal injection. Four rats were sacrificed in each group at day 2, 7 and 14 after injection, and the lumbar segments (L 4-6 Hematoxylin-eosin staining was performed to detect the morphology of the spinal dorsal horn neurons and ) of the spinal cord were removed. Real-time RT-PCR and western blot analysis were used to determine the expression of protein kinase C mRNA and protein in the spinal dorsal horn neurons. immunohistochemistry staining was carried out to assess the expression level and distribution of protein kinase C.
RESULTS AND CONCLUSION:The thermal withdrawal latency and mechanical withdrawal threshold in dexmedetomidine group and saline group were significantly decreased compared with normal control group before or after injection (P<0.05). However, both the thermal withdrawal latency and mechanical withdrawal threshold in dexmedetomidine group after intrathecal injection were significantly higher than those in saline group (P<0.05). The protein kinase C expression in spinal dorsal horn neurons was significantly decreased in dexmedetomidine group compared with saline, and reached to the most lowest levels as normal control group on 14 days after injection. Moreover, the apoptosis of spinal dorsal horn neurons in dexmedetomidine group was lighter than that in saline group, and was similar to the morphology of neurons in normal control group on 14 days after injection. Intrathecal injection of dexmedetomidine could attenuate the hyperalgesia induced by spared nerve injury, which might be associated with the inhibition of protein kinase C expression in spinal dorsal horn.