Objective To investigate the clinical diagnostic value of plasma serine protease inhibitor Ka-zal-type 4(SPINK4)expression in colorectal adenocarcinoma(CRC)and progressive adenoma(AA).Methods A total of 62 patients with CRC(CRC group)and 15 patients with AA(AA group)diagnosed by colonoscopy and pathological examination in this hospital from June 2020 to December 2021 were selected,and 22 healthy people undergoing physical examination during the same period were selected as the HC group.The expression of SPINK4 in plasma was detected by ELISA,and the expression of CEA in plasma was detected by electrochemiluminescence,and the correlation was analyzed.The diagnostic efficiency was analyzed by re-ceiver operating characteristic(ROC)curve,and the expression of p53 in CRC tissues was detected by immu-nohistochemistry.Results The expression of plasma SPINK4 in the CRC group and AA group was lower than that in the HC group(Z=3.72,-0.41,P＜0.05),and the expression of CEA in the CRC group was higher than that in the HC group(Z=-3.63,P＜0.05).The area under the curve(AUC),accuracy,sensi-tivity and specificity of SPINK4 combined with CEA in the diagnosis of CRC and AA were higher than those of SPINK4 and CEA alone.The positive rate of mutant type p53 in SPINK4 low expression group and CEA high ex-pression group was significantly increased in CRC patients(72.55％,75.00％,P＜0.05).Conclusion The expression of plasma SPINK4 is decreased in CRC and AA,and the combined detection of SPINK4 and CEA has a good di-agnostic efficiency in CRC and AA.

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.

Cognitive impairment is a common dysfunction after central nervous system disease or injury, which seriously affects the daily life of patients and brings heavy economic burdens to the family and society. Neurofeedback training (NFT) based on electroencephalography (EEG) is a non-invasive method of neuroregulation, which can improve cognitive function and behavior by autonomously adjusting brain function through feedback. This paper reviews the application of EEG signal-based neurofeedback training in cognitive rehabilitation, and discusses the current problems and future development trends in this field, so as to provide new ideas for clinical research and treatment of cognitive disorders.

Dementia is one of the age-related diseases with the fastest increase in incidence. With the increasingly severe aging problem of the population, it further exacerbates the demand and burden of the healthcare system. Red blood cell distribution width (RDW) is an easily obtainable blood routine indicator that reflects the variability of red blood cell size. As an early marker of dementia risk, researches have shown an association between white matter hyperintensities (WMHs) and RDW. This article reviews the relationship between RDW and WMHs.

Objective To investigate the effects of low dose of gamma knife irradiation on the expression of N-methyl-D-aspartate (NMDA) receptor subunits in cortex and hippocampus of epileptic rats. Methods The rats were randomly divided into 4 groups: control group, GK group, pentylenetetrazole (PTZ) group and GK+ PTZ group. The rats were injected intraperitoneally with PTZ to establish the epileptic models. Gamma knife irradiation was performed on bilateral frontal cortex of rats at a peripheral dose of 15Gy. After irradiation, the changes of the seizure and behaviors were observed and recorded. The rats were killed on the 12th week after irradiation, Immunohistochemstry and western blotting were used to detect the relative expression levels of NMDAR subunits (NR1, NR2A, and NR2B) in the cortex and hippocampus. Results There were no epileptic seizures in the control group and the GK group. Compared with the PTZ group, the epileptic seizures of rats in the GK+PTZ group were significantly reduced after low dose gamma knife irradiation (P<0.05). Compared with control group, the protein expression levels of NR1, NR2A and NR2B in the PTZ group increased significantly in the cortex and hippocampus, and so were the positive neurons and their average absorbance value (P<0.05). Compared with PTZ group, the protein expression levels of NR1, NR2A and NR2B of the GK+PTZ group decreased remarkably in the cortex and hippocampus (P<0.05). Protein expression levels of NR1, NR2A and NR2B were not significantly different between control group and GK group (P＞0.05). Conclusion Epileptic rats exhibited an increase in the protein expression levels of NR1, NR2A and NR2B in the cortex and hippocampus while low dose of gamma knife irradiation can decrease expression levels of NMDA receptor subunits in the cortex and hippocampus of epileptic rats, which might represent a possible mechanism underlying the therapeutic effects of gamma knife irradiation on epileptic seizure.

Objective To explore the relationship between the polymophisms of interleukin?17 (IL?17)?197A/G and the outcomes of hepatitis B virus (HBV) infections. Methods The polymorphism of genotypes and al?leles of IL?17?197A/G in 222 chronic HBV infected patients and 88 HBV infected ones as controls. The contains of serum HBV DNA were detected using PCR combined with DNA amplification in vitro, serum IL?17 expression was detected with ELISA and genotype and allele frequency of IL?17?197A/G locus was detected by Beckman SNP kit. Results There was a significant difference in the serum IL?17 expression (F=158.1, r2=0.61, P<0.000 1) among all the groups. For IL?17?197A/G, there were significant differences for the comparison between the two groups, and the frequency of AA genotype was 47.72%in liver cirrhosis group. Moreover, the highest frequency of GG was in HBV clear?ance group (74.81%);and the lowest group was in chronic HBV liver cirrohosis group (19.05%). Conclusion IL?17?197A/G AA genotype and allele might be associated with susceptibility of HBV infection in Han population in Hei?bei Province.

Objective To investigate the metabolites of serum samples from liver cirrhotic patients with or without minimal hepatic encephalopathy,and even overt hepatic encephalopathy,then to find out diagnostic markers for minimal hepatic encephalopathy.Methods High performance liquid chromatography-orbit trap mass spectrometry (UPLC/LTQ-Orbit trap MS) technology was applied to analyze the serum metabolites from 38 patients of liver cirrhosiswith hepatitis B and 33 healthy volunteers.Results The serum metabolites of patients with simple liver cirrhosis were different from those of patients with minimal or overt hepatic encephalopathy.The serum metabolites of patients with minimal hepatic encephalopathy was mostly similar with those of overt hepatic encephalopathy patients.Arginase,L-tyrosine,glutamic acid,two L-phenylalanine peptide,homovanillic acid,omithine,L-serine were increased in patients with minimal or overt hepatic encephalopathy,and hypoxanthine decreased in patients with minimal or overt hepatic encephalopathy patients.Conclusions The serum metabolites of patients with minimal hepatic encephalopathy are mostly similar to those of patients with overt hepatic encephalopathy.Arginase,L-tyrosine,glutamic acid,two L-phenylalanine peptide,homovanillic acid,ornithine,L-serine maybe the early metabolites biomarkers to diagnose minimal hepatic encephalopathy.Hypoxanthine is likely to be an effective complement to treat patients with hepatic encephalopathy.

Subcortical ischemic vascular disease (SIVD) is considered to be the most important and common cause of vascular cognitive impairment (VCI). If patients with subcortical ischemic vascular cognitive impairment (SIVCI) and subcortical vascular cognitive impairment (sVCI) can be found early, it is possible that vascular dementia (VaD) can be identified before occurrence and even reverse the process. Recent studies have shown that resting-state functional magnetic resonance imaging (rsfMRI) may provide the objective basis for the diagnosis of SIVCI. This article reviews the application of rsfMRI in the diagnosis of SIVCI.

80% defined as category A,B,and C,respectively.Category A drugs were regarded as the focus of management,category B as the second focus of management,category C underwent general management,category D drugs were regarded as the focus in purchase.RESULTS:Hospital first-order drug storeroom and secondary drug storerooms classified their drugs into their own A,B,and C categories (category D was consistent).The consumption sum of category A drugs(about 20% of drugs) accounted for 60%;the consumption sum of category B drugs(about 20% of drugs) accounted for 20%;and the consumption sum of category C drugs(about 60% of drugs) plus that of small quantity of category D drugs accounted for 20%.CONCLUSION:This method can ensure drug supply and help maximize ec-onomical benefits with least human,material and financial resources.

Objective To observe the levels of cAMP and adenylyl cyclase(AC) in hippocampus of mice with vascular dementia(VD) and the effect of Dihydroergocriptine(DHE),and to explore the molecular pathogenesis of VD.Methods The mice were subjected for ischemia-reperfusion three times on bilateral common carotid arteries by knots to establish models of VD and the changes of learning and memory were tested on d29/d30 after operation.DHE was administrated to another group of mice,which was taken as treatment group.The cAMP level was evaluated by the radioimmunoassay;AC mRNA positive neurons of hippocampus CA1 area were examined through in-situ hybridization.Results Compared with shamed-operation group,the learning and memory of model group was worse(P