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 occurrence of work-related musculoskeletal disorders (WMSDs) in logistics workers of automobile manufacturing enterprises in Guangzhou, and explore their potential categories and influencing factors, so as to provide basis for the prevention and control of WMSDs in logistics workers of automobile manufacturing enterprises.Methods:From April to May 2020, a convenient sampling method was adopted to select 1442 logistics workers in 2 automobile manufacturing enterprises in Guangzhou as the research objects. The incidence of WMSDs among them was investigated by using the Nordic Musculoskeletal Disorders Questionnaire, and the incidence pattern of WMSDs among the subjects was analyzed by the method of potential category analysis. Chi-square test and multiple logistic regression model were used to analyze the influencing factors of the disease.Results:The total prevalence of WMSDs was 42.9% (619/1442). The three parts with high prevalence of WMSDs were neck (23.5%, 339/1442), shoulder (21.3%, 307/1442) and lower back (19.1%, 275/1442). 69.0% (427/619) of the patients showed simultaneous disease in two or more sites. The subjects were divided into four latent groups by the analysis of latent categories: the group with multiple body parts (4.51%), the group with very low or no disease (70.39%), the group with shoulder and neck and upper back (11.37%), and the group with limbs and lower back (13.73%). Multivariate logistic regression showed that compared with the "very low or no disease group", the risk factors of multiple body parts of automotive logistics workers suffering from WMSDs mainly included: Working posture uncomfortable ( OR=3.10, 95% CI: 1.44~6.70, P=0.004), often bend and turn ( OR=2.36, 95% CI: 1.05~5.29, P=0.037), bend your knees homework for a long time ( OR=2.29, 95% CI: 1.17~4.47, P=0.015) ; Working posture uncomfortable ( OR=2.26, 95% CI: 1.51~3.38, P<0.001), bending the neck ( OR=1.68, 95% CI: 1.03~2.74, P=0.036), neck minister time keep the same position ( OR=1.81, 95% CI: 1.22~2.67, P= 0.003) It is a risk factor for shoulder, neck and upper back WMSDs; Risk factors for limb-lower back WMSDs include: Length > 10 years ( OR=2.16, 95% CI: 1.24~3.78, P<0.001), the working position uncomfortable ( OR=2.38, 95% CI: 1.63~3.48, P<0.001), bending the neck ( OR=1.66, 95% CI: 1.03~2.68, P=0.039) . Conclusion:The prevalence rate of WMSDs among logistics workers in automobile manufacturing enterprises is high, which has obvious characteristics of classification and comorbis, and is closely related to individual characteristics such as sufficient rest time and working posture of workers.

Objective:To investigate the occurrence of work-related musculoskeletal disorders (WMSDs) in logistics workers of automobile manufacturing enterprises in Guangzhou, and explore their potential categories and influencing factors, so as to provide basis for the prevention and control of WMSDs in logistics workers of automobile manufacturing enterprises.Methods:From April to May 2020, a convenient sampling method was adopted to select 1442 logistics workers in 2 automobile manufacturing enterprises in Guangzhou as the research objects. The incidence of WMSDs among them was investigated by using the Nordic Musculoskeletal Disorders Questionnaire, and the incidence pattern of WMSDs among the subjects was analyzed by the method of potential category analysis. Chi-square test and multiple logistic regression model were used to analyze the influencing factors of the disease.Results:The total prevalence of WMSDs was 42.9% (619/1442). The three parts with high prevalence of WMSDs were neck (23.5%, 339/1442), shoulder (21.3%, 307/1442) and lower back (19.1%, 275/1442). 69.0% (427/619) of the patients showed simultaneous disease in two or more sites. The subjects were divided into four latent groups by the analysis of latent categories: the group with multiple body parts (4.51%), the group with very low or no disease (70.39%), the group with shoulder and neck and upper back (11.37%), and the group with limbs and lower back (13.73%). Multivariate logistic regression showed that compared with the "very low or no disease group", the risk factors of multiple body parts of automotive logistics workers suffering from WMSDs mainly included: Working posture uncomfortable ( OR=3.10, 95% CI: 1.44~6.70, P=0.004), often bend and turn ( OR=2.36, 95% CI: 1.05~5.29, P=0.037), bend your knees homework for a long time ( OR=2.29, 95% CI: 1.17~4.47, P=0.015) ; Working posture uncomfortable ( OR=2.26, 95% CI: 1.51~3.38, P<0.001), bending the neck ( OR=1.68, 95% CI: 1.03~2.74, P=0.036), neck minister time keep the same position ( OR=1.81, 95% CI: 1.22~2.67, P= 0.003) It is a risk factor for shoulder, neck and upper back WMSDs; Risk factors for limb-lower back WMSDs include: Length > 10 years ( OR=2.16, 95% CI: 1.24~3.78, P<0.001), the working position uncomfortable ( OR=2.38, 95% CI: 1.63~3.48, P<0.001), bending the neck ( OR=1.66, 95% CI: 1.03~2.68, P=0.039) . Conclusion:The prevalence rate of WMSDs among logistics workers in automobile manufacturing enterprises is high, which has obvious characteristics of classification and comorbis, and is closely related to individual characteristics such as sufficient rest time and working posture of workers.

Purpose: This study aims to comprehensively evaluate the clinical efficacy of chemotherapy or endocrine therapy maintenance in metastatic breast cancer (MBC) patients. Materials and Methods: The meta-analysis of randomized clinical trials (RCTs) and propensity score matching of multicenter cohort study evaluated MBC patients who underwent first-line chemotherapy or endocrine therapy maintenance. This study is registered with PROSPERO: CRD42017071858 and ClinicalTrials.gov: NCT04258163. Results: A total of 2,867 patients from 15 RCTs and 760 patients from multicenter cohort were included. The results from meta-analysis showed that chemotherapy maintenance improved progression-free survival (PFS) (hazard ratio [HR], 0.63; 95% confidence interval [CI], 0.54 to 0.73; p < 0.001; moderate-quality evidence) and overall survival (OS) (HR, 0.87; 95% CI 0.78 to 0.97; p=0.016; high-quality evidence) than observation. In the cohort study, for hormone receptor–positive MBC patients, chemotherapy maintenance improved PFS (HR, 0.67; 95% CI, 0.52 to 0.85; p < 0.001) and OS (HR, 0.55; 95% CI 0.42 to 0.73; p < 0.001) compared with observation, and endocrine therapy maintenance also improved PFS (HR, 0.65; 95% CI, 0.53 to 0.80; p < 0.001) and OS (HR, 0.55; 95% CI, 0.44 to 0.69; p < 0.001). There were no differences between chemotherapy and endocrine therapy maintenance in PFS and OS (all p > 0.05). Regardless of the continuum or switch maintenance therapy, showed prolonged survival in MBC patients who were response to first-line treatment. Conclusion This study provided evidences for survival benefits of chemotherapy and endocrine therapy maintenance in MBC patients, and there was no difference efficacy between chemotherapy and endocrine therapy maintenance for hormone receptor–positive patients.

Objective:To analyze the detection and influencing factors of work-related musculoskeletal disorders (WMSDs) of workers in an automobile manufacturing enterprise in Guangzhou City.Methods:In April 2020, a total of 7065 workers of an automobile manufacturing enterprise in Guangzhou City were selected as research subjects using cluster sampling method. The Nordic Musculoskeletal Questionnaire (NMQ) was used to investigate the detection of WMSDs. Multiple logistic regression analysis was used to analyze the influencing factors of WMSDs.Results:The detection rate of WMSDs was 43.9% (3102/7065) , among which the detection rate of multiple WMSDs was 31.4%. The detection rates of WMSDs in different parts from high to low were as follows: neck (24.5%) , shoulder (21.1%) and ankle (20.1%) . Multivariate logistic regression analysis showed that working experience of 3-8 years, >8 years, age>30 years old, repetitive work every day, multiple repetitions per minute, uncomfortable work posture, frequent overtime work and lack of staff in the department were risk factors for multi-site WMSDs ( P<0.05) . Adequate rest time was a protective factor for multi-site WMSDs ( P<0.05) . Conclusion:The detection rates of WMSDs in neck, shoulder, ankle, and multisite in automobile manufacturing enterprise are relatively high. The primary risk factors include adverse ergonomic factors and unreasonable organization of labour factors, optimize the work breaks can effectively reduce the risk of disease, effective ergonomic interventions should be carried out to prevent the occurrence of WMSDs among workers in the automobile manufacturing industry.

Objective:To analyze the detection and influencing factors of work-related musculoskeletal disorders (WMSDs) of workers in an automobile manufacturing enterprise in Guangzhou City.Methods:In April 2020, a total of 7065 workers of an automobile manufacturing enterprise in Guangzhou City were selected as research subjects using cluster sampling method. The Nordic Musculoskeletal Questionnaire (NMQ) was used to investigate the detection of WMSDs. Multiple logistic regression analysis was used to analyze the influencing factors of WMSDs.Results:The detection rate of WMSDs was 43.9% (3102/7065) , among which the detection rate of multiple WMSDs was 31.4%. The detection rates of WMSDs in different parts from high to low were as follows: neck (24.5%) , shoulder (21.1%) and ankle (20.1%) . Multivariate logistic regression analysis showed that working experience of 3-8 years, >8 years, age>30 years old, repetitive work every day, multiple repetitions per minute, uncomfortable work posture, frequent overtime work and lack of staff in the department were risk factors for multi-site WMSDs ( P<0.05) . Adequate rest time was a protective factor for multi-site WMSDs ( P<0.05) . Conclusion:The detection rates of WMSDs in neck, shoulder, ankle, and multisite in automobile manufacturing enterprise are relatively high. The primary risk factors include adverse ergonomic factors and unreasonable organization of labour factors, optimize the work breaks can effectively reduce the risk of disease, effective ergonomic interventions should be carried out to prevent the occurrence of WMSDs among workers in the automobile manufacturing industry.

Objective:To investigate the effect of melatonin on oligodendrocyte maturation and differentiation in corpus callosum of septic neonatal rats induced by systemic lipopolysaccharide (LPS) injection.Methods:Sprague-Dawley rats were randomly allocated into the control group, septic experimental group, and melatonin group. In the septic experimental group, rats were intraperitoneally administrated with lipopolysaccharide (LPS) (1 mg/kg). In the melatonin group, melatonin was intraperitoneally administered (10 mg/kg) at 0.5 h after LPS injection. The expression level of IL-6, olig1, olig2, and the MAG protein were detected by Western blot at different time points in the three groups. BV-2 cells were used in vitro. For drug administration, the effect of LPS, melatonin and melatonin receptor antagonist, luzindole, on IL-6 expression in BV-2 microglia cell was determined by Western blot. The medium of BV2 cell were collected to treat primary OPCs. The expression level of olig1, olig2 and MAG protein in primary OPCs were detected by Western blot. SPSS 20.0 statistical software was used for analysis, and the data were analyzed by one-way ANOVA and two-way ANOVA. Differences were considered to be statistically significantly if P<0.05. Result:Compared with the LPS group, the expression of IL-6 was significantly decreased in the corpus callosum at 6 h, l d, and 3 d in the melatonin group ( P<0.05). The expression of olig1, olig2 and MAG protein were increased at day 7, 14, and 28 in the melatonin group compared with the LPS group ( P<0.05). In vitro the expressions of IL-6 was significantly increased after LPS treatment ( P<0.05), but was decreased in the LPS+melatonin treatment group ( P<0.05). After treatment with melatonin receptor inhibitor, luzindole, the expressions level of IL-6 was increased ( P<0.05). The expression of olig1, olig2 and MAG protein were decreased with conditioned medium in the LPS BV2 cell group than the control group in the primary OPCs ( P<0.05). However, those were increased with conditioned medium in the LPS+melatonin BV2 cell group than the LPS group ( P<0.05). Conclusions:Melatonin may inhibit the inflammation response in the corpus callosum through its receptor, and may promote the maturation and differentiation of oligodendrocyte, suggesting that melatonin may have therapeutic effect on neuroinflammation and axonal hypomyelination on PWM in septic neonatal rats.

Objective To evaluate the diagnosis and treatment of 37 cases of popliteal vascular entrapment syndrome (PVES).Methods The clinical data of 37 PVESA cases (44 limbs) from July 2004 to July 2016 was retrospectively analyzed.There were 28 men and 9 women,age ranging from 7 to 74 years.They all underwent B-us,CTA,MRA or DSA examination before the operation.Surgical procedures performed on 38 limbs included musculo-tendinous division,popliteal-popliteal interposition,femoralpopliteal bypass.Result One patient died of PE one day after operation.The ankle brachial index (ABI)increased from 0.54 ±0.31 to 0.87 ±0.23 after operation (P ＜0.01).30 cases were followed-up with a mean followup time of 43.8 months and intermittent claudication were relieved in all cases.Conclusions PVES is an extremely important cause of non-arteriosclerotic lower extremity arterial chronic ischemia which need early,active and appropriate surgical intervention.

Objective To study the values of clinicopathological features and expression of thyroid transcription factor 1 (TTF-1) in predicting the mutation status of epidermal growth factor receptor (EGFR) gene in patients with non-small cell lung cancer (NSCLC). Methods Mutation status of exons 18, 19, 20 and 21 in EGFR, and expression of TTF-1 protein in 283 cases of NSCLC diagnosed in Shanxi Provincial Cancer Hospital from January 2013 to December 2014 were analyzed by using amplification refractory mutation system (ARMS) and immunohistochemical method. The correlation of EGFR mutations with the clinicopathological features and TTF-1 expression were studied to explore the values of them in the prediction of EGFR mutations. Results Among 283 cases of NSCLC, the rate of EGFR gene mutation was 30.0 ％(85/283), including 3 cases with double mutations(exon 18 and exon 20 double mutations in one case, exon 19 and exon 21 double mutations in one case, exon 20 and exon 21 double mutations in one case). The EGFR gene mutations were associated with gender, histological type, history of smoking, and expression of TTF-1 (all P<0.001), but not related to age and tumor location (P= 0.785, P= 0.138). The combination of factors with high mutation rates (women, adenocarcinoma, no smoking, and TTF-1 positive) made the positive predictive value of EGFR mutations up to 57.6 ％. And the combination of factors with low mutation rates (male, nonadenocarcinoma, smoking history, TTF-1 negative) made the EGFR negative predictive value up to 90.3％. Conclusion The combination of clinicopathological features and TTF-1 expression status in patients with NSCLC has a great predictive value for EGFR mutations, which can provide a useful reference for clinical treatment decision-making.

Objective To investigate the expression of tissue factor and explore its clinical significances in pulmonary artery after acute pulmonary thromboembolism.Methods Thirty-four Japanese white rabbits (Level Ⅱ animals) were randomly (random number) assigned into four groups:group A (specimen of pulmonary artery was taken 3 hours after pulmonary embolism,n =8),group B (specimen of pulmonary artery was taken 8 hours after pulmonary embolism,n =8),group C (specimen of pulmonary artery was taken 24 hours after pulmonary embolism,n =8) and control group (pseudo-operations were carried out without injecting autologous blood clots,n =10).The animal model of pulmonary thromboembolism was established by injecting autologous blood clots into jugular vein through a 5F catheter and confirmed by digital subtraction angiography.The mRNA expression of TF in different parts of pulmonary artery was assayed by RT-PCR.The q test was utilized if there was a significant difference in a given continuous variable among three groups analyzed by ANOVA.Results The TF expression in the specimen adjacentto emboli was stable at 3 h,8 h or 24 hours after embolism.The mRNA expression of TF at 3 h and 8 h after embolism was lower in specimen taken from distal-end of morbid pulmonary artery than those adjacent to emboli.While at 24 hours after embolism,there were similar mRNA expressions in specimen either adjacent or distal to emboli.Conclusions The high expression of tissue factor in pulmonary artery tissue adjacent to emboli could lead to locally increased coagulation activity,indicating the necessity of initiating anti-coagulation treatment as soon as possible after acute pulmonary embolism.