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 track and evaluate the implementation of the Radiation Shielding Requirements in Room of Radiotherapy Installations—Part 1: General Principle (GBZ/T 201.1–2007) among relevant personnel in medical radiation institutions, and to provide a scientific basis for revising the standard. Methods According to the Guidelines for Health Standards Tracking Evaluation (WS/T 536–2017) and the implementation protocol of standard evaluation, an online survey was conducted among 212 relevant workers from 146 medical radiation institutions across 18 provinces in China. The data were aggregated and analyzed with the use of Microsoft Excel 2010. Results A total of 215 questionnaires were returned, of which 212 were valid. Among the valid respondents, 77.8% believe that this standard is universally applied; 96.2% believe that this standard can meet work needs; 63.7% have participated in relevant training on this standard; 74.1% use this standard once or more per year; and 10.8% believe that this standard needs to be revised. Conclusion Medial radiation workers have a high rate of awareness of the basic information and content of the standard, but the understanding and application of the standard content need to be improved. We recommend that relevant departments further strengthen the promotion of and training on the standard, revise some content based on actual situation, and improve workers’ ability to use the standard.

Anterograde viral tracers are powerful and essential tools for dissecting the output targets of a brain region of interest. They have been developed from herpes simplex virus 1 (HSV-1) strain H129 (H129), and have been successfully applied to map diverse neural circuits. Initially, the anterograde polysynaptic tracer H129-G4 was used by many groups. We then developed the first monosynaptic tracer, H129-dTK-tdT, which was highly successful, yet improvements are needed. Now, by inserting another tdTomato expression cassette into the H129-dTK-tdT genome, we have created H129-dTK-T2, an updated version of H129-dTK-tdT that has improved labeling intensity. To help scientists produce and apply our H129-derived viral tracers, here we provide the protocol describing our detailed and standardized procedures. Commonly-encountered technical problems and their solutions are also discussed in detail. Broadly, the dissemination of this protocol will greatly support scientists to apply these viral tracers on a large scale.

Objective    To define the patient characteristics and perioperative management, and to define the mortality and its risk factors after arterial switch operation (ASO). Methods    We conducted a bidirectional cohort study with 571 consecutive patients undergoing ASO from 1997 to 2016 in our hospital. We enrolled patients who underwent ASO before 2012 retrospectively and after 2012 prospectively and followed up all the patients prospectively. Demographic characteristics, clinical information and mortality of these patients were summarized. Joinpoint regression analysis was used to identify the time trend of the overall mortality. Kaplan-Meier survival analysis was used to evaluate the mid- and long-term survival rate after ASO. Cox proportional hazards regression models were used to explore the potential factors associated with mortality. The cumulative incidence of complications after ASO was predicted using competing risk models. Results    Several aspects of patients’ characteristics and perioperative management in our center differed from those in the developed countries. The overall mortality and in-hospital mortality after ASO was 16.3% and 15.1%, respectively. The overall cumulative survival rate at 5, 10 and 15 years after ASO was 83.3%, 82.8% and 82.8%, respectively. A significant decrease of overall mortality from 1997 to 2016 was observed. Independent risk factors of mortality included earlier ASO (1997-2006), single or intramural coronary anatomy and longer cardiopulmonary bypass time. Ten years after ASO, re-intervention, arrhythmia, pulmonary and anastomotic stenosis were the most common complications with a cumulative incidence over 10%. Conclusion    Significant improvements in the results of the ASO were observed and the postoperative mortality rate is close to reports from developed countries. Nonetheless, we have identified the need for further improvement in the early and late postoperative periods after ASO. Pulmonary stenosis, anastomotic stenosis and arrhythmia should be paid attention to during the long-term follow-up after ASO.

OBJECTIVETo analyze the genotype of a patient suspected for thalassemia through a series of experiments.

METHODSConventional methods for detecting common thalassemia mutations was used in conjunction with multiplex ligation-dependent probe amplification (MLPA) in order to determine the genotype of the patient. Corresponding primers were designed for developing a Gap-PCR system for detecting rare type mutations.

RESULTSThe patient was identified as a homozygote for Chinese Gγ(Aγδβ)-thal deletion, with clinical manifestations tending to be intermediate or severe based on the hematological characteristics. A Gap-PCR system has been developed for detecting the above mutation with accuracy and rapidity.

CONCLUSIONThe Chinese Gγ(Aγδβ)-thal is prevalent in southern China, and caution should be taken to avoid misdiagnosis. The Gap-PCR system for detecting Chinese Gγ(Aγδβ)-thal is suitable for extended applications for its simplicity and rapidity.

[Objective] To investigate the clinical value of using prospective ECG-gating Helical protocol in whole aorta and coronary arteries CT angiography combined with low tube voltage,low contrast medium injection rate and dose technology.[Methods]A total of 60 patients (heart rate≤ 75 bpm and normal heart rhythm) with suspected aortic disease or post-operation were randomly divided into 2 groups:G1 (n =30;tube voltage:80 kV;contrast medium injection rate:3 mL/s;contrast medium dose:0.65 mL/kg)and G2 (n =30;tube voltage:120 kV;contrast medium injection rate:4 mL/s;contrast medium dose:1.2 mL/kg).The two groups underwent aorta angiography with prospective ECG-gating Helical protocol by using 320-detector CT.The mean CT values and standard deviation of aorta,coronaries and adjacent adipose tissue were measured,signal to noise ratio (signal-to-noise ratio,SNR)and contrast to noise ratio (contrast-to-noise ratio,CNR) were calculated.The subjective quality scoring of 3-d post-processing images were evaluated independently by 2 senior radiologists.The mean CT values and standard deviation of aorta,coronaries and adipose tissue,SNR,CNR,subjective quality scoring,contrast medium dose and radiation dose were compared and analyzed.[Results] The abnormal and normal rate of aorta in two groups were 83.33％ (25/30),16.67％ (5/30) and 86.67％ (26/30),13.33％(4/30);while the abnormal and normal rate of coronary arteries in two groups were 43.33％ (13/30),56.67％ (17/30) and 53.33％(16/30),46.67％ (14/30).SNR values of ascending aorta,descending aorta,abdominal aorta,superior mesenteric artery,bilateral renal artery,left main coronary artery,left anterior descending branch,left circumflex branch,right coronary artery and CNR values of abdominal aorta,superior mesenteric artery,bilateral renal artery,left anterior descending branch,left circumflex branch had no statistical significance,while the other indicators were significant differences between the two groups.The radiation dose and the contrast medium dose of G1 was significantly lower than G2 (P ＜ 0.05).There was no difference in the subjective image quality of 3D post-processing images between the two groups (P ＞ 0.05).[Conclusions] Using prospective ECG-gating Helical protocol in whole aorta and coronary arteries CT angiography combined with low tube voltage,low contrast medium injection rate and low contrast medium dose technology can help to reduce radiation and contrast medium dose without impacting on the imaging quality satisfactorily.

Objective To establish a stable lung cancer A549 cell line transfected by AMP-activated protein kinase (AMPK) expression vector,and to observe the effect of AMPK on proliferation as well as on the invasive ability of A549 cells.Methods Full-length of AMPK gene was amplified and its target gene was digested,then inserted into the GV358 plasmid.Co-tranfected 293T cells were subjected to the lentivirus equipment package.Subsequently,we collected the lentivirus supernatant to infect the A549 cells and establish a stably,overexpressed cell line A549.The mRNA and protein of AMPK were examined by real-time quantitative reverse transcriptase polymerase chain reaction (qRT-PCR) and Western blotting.The proliferation and invasion abilities of A549 cells were detected by methyl thiazolyl thiazolium (MTT) and Transwell assay.Results GV358-AMPK lentivirus vectors was successfully constructed by restrictive enzyme digestion and plasmid sequencing.There were significantly increased expressions of AMPK protein (5.87 times,P =0.002) and mRNA (16.12 times,P ＜ 0.001) after transfected with GV358-AMPK compared with the Vector group.Meanwhile,AMPK overexpression showed significantly lower proliferation (the forth day:0.53 ± 0.03 vs.0.64 ±0.05,P=0.021;the fifth day:0.58 ± 0.04 vs.0.80 ± 0.07,P =0.002) and weaken invasive ability [(1.6±0.5) ×l05 vs.(3.4±0.3) ×105,P=0.004] ofA549 cells.Conclusion The lentiviralAMPK expression vector and its A549 cell line is successfully constructed.AMPK overexpression inhibits the proliferation and invasive ability of A549 cells.

Objective To investigate the appropriate cut-off values of waist circumference(WC)for central obesity and severe central obesity in Chinese adults.Methods A total of 10 265 participants aged 35-69 years from the cross-sectional survey of the PRC-USA Collaborative Study of Cardiovascular and Cardiopulmonary Epidemiology between 1993 and 1994 with integral data were included.Each integer unit in centimeters of WC in a given range was used as the cut-off point to detect clustering of risk factors,which was defined as an individual with 2 or more risk factors including hypertension,diabetes,hypercholesterolemia,hypertriglyceridemia and low levels of high-density lipoprotein cholesterol.Sensitivity,specificity and distance from the receiver operating characteristic (ROC) curves to the upper left corner of the ROC graph were calculated.The WC value corresponding to the point on the ROC curve nearest to the upper left corner was considered as the optimal cut-off value for central obesity and the value corresponding to the point with specificity of 90％ or more was considered as the optimal cut-off for severe central obesity.Results The mean WC was (80.5 ± 9.9) cm in men and (77.8 ± 10.0) cm in women;18.1％ (890/4 921) of men and 14.5％ (776/5 344) of women were identified with two or more major risk factors.Based on the ROC curve analysis,the optimal value of WC to detect clustering of risk factors was ≥ 84 cm for men and ≥80 cm for women,and the shortest distance to the upper left comer was 0.430 and 0.450,respectively.The cut-off values of WC to detect clustering of risk factors with specificity of 90％ or more were ≥93 cm and ≥91 cm for men and women,respectively.Conclusion The cut-off points of WC for central obesity and severe central obesity in Chinese adults obtained from this study are equal or similar to the WC cut-off values proposed by the Guidelines for Prevention and Control of Overweight and Obesity in Chinese Adults.

Objective To investigate the radiation level around Jiangzha hot spring,and to analyze the sources of pollution.Methods The radon and its progeny concentration,γ dose rate in hot spring living district and surrounding area were measured with ATD monitors,radon and WL continuous measurement devices,γ dose rate meter.Results The radon concentration in water was 23 -764 Bq/L.Radon concentration indoors,outdoor and in bathing place were 254 -876 799,688 -709 and 3590-15 299 Bq/m3,respectively.γ dose rate were 205 -28718 nGy/h indoor,4104- 18254 n Gy/h outdoors.Conclusions Jiangzha hot spring is an area with rare high radon and high nature radiation.Its radiation level and health effects are worthy for further attention.

Objective To observe the analgesic effects of patient-controlled intravenous analgesia (PCIA) and continuous infusion of morphine into epidural space(CIEA) after suprapubic transvesical prostatectomy. Methods Seventy-five patients undergoing suprapubic transvesical prostatectomy were randomly assigned to PCIA group,CIEA group and control group. In PCIA group, 2 0mg/h morphine as a recommended dose would be injected intravenously by the patient through a self-controlled analgesic delivery system in which another 1 mg morphine could be injected whenever patient felt pain until the pain relieved. The lockout time was 20 minutes. In CIEA group, 0 08 mg/h morphine was injected into epidural space. 50～75mg of pethidine was injected whenever the control group patients felt pain. VAS(vision simulate score), frequency and duration of bladder spasm, discontinuance time of bladder irrigation and BP were observed. Results The CIEA and PCIA group were superior to the control group with characteristics of stable analgesic effect, shorter duration and lower frequency of bladder spasm and shorter time of bladder irrigation(P0 05); but the PCIA group had longer gastrointestinal function recovery time(P