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 compare the clinical outcomes and prognosis of transabdominal opening of the left diaphragm and traditional thoracoabdominal combination approach for Siewert type II adenocarcinoma of the esophagogastric junction.Methods:A retrospective cohort study was conducted. The clinical data of 59 patients with Siewert type Ⅱ adenocarcinoma of the esophagogastric junction who underwent radical total gastrectomy in Shanxi Provincial People's Hospital from January 2018 to March 2020 were retrospectively analyzed, and all patients were divided into the transabdominal opening of the left diaphragm group (30 cases) and the thoracoabdominal combination group (29 cases) according to surgical access. The general data, perioperative indexes, postoperative complications and postoperative survival of patients in the two groups were compared. Factors influencing the overall survival were analyzed by using Cox proportional hazards model.Results:The differences in terms of gender, age, tumor diameter, pT staging, and pN staging between the two groups were not statistically significant (all P > 0.05). The length of esophageal invasion was (3.5±1.1) cm and (3.7±1.1) cm, respectively in the transabdominal opening of the left diaphragm group and the thoracoabdominal combination group, and the difference was not statistically significant ( t = -0.70, P = 0.486). Compared with the thoracoabdominal combination group, the transabdominal opening of the left diaphragm group had less operative time, intraoperative bleeding, postoperative bedtime, chest tube extraction time and postoperative hospitalization days, and the differences were statistically significant (all P < 0.05); the differences in the number of lymph nodes cleared, the number of positive lymph nodes, the number of thoracic lymph node dissection, and the number of positive thoracic lymph node were not statistically significant in the two groups (all P > 0.05). The total incidence of postoperative complications in the transabdominal opening of the left diaphragm group and the thoracoabdominal combination group were 53.3% (16/30) and 72.4% (21/29), respectively, and the difference was not statistically significant ( χ2 = 2.30, P = 0.130), while the incidence of lung infection and pleural effusion in the thoracoabdominal combination group was higher than that in the transabdominal opening of the left diaphragm group (both P<0.05). The 1- and 3-year postoperative overall survival rates were 80.0%, 63.3% in the transabdominal opening of the left diaphragm group, and 79.3%, 62.1% in the thoracoabdominal combination group, respectively, and the difference in overall survival between the two groups was not statistically significant ( χ2 = 0.01, P = 0.934). Multivariate analysis showed that pT staging ( HR = 4.009, 95% CI: 1.851-8.683, P < 0.001) and pN staging ( HR = 2.338, 95% CI: 1.435-3.811, P = 0.001) were the independent influencing factors of overall survival. Conclusions:For patients with Siewert type Ⅱ adenocarcinoma of the esophagogastric junction with esophageal invasion length > 3 cm, transabdominal opening of the left diaphragm approach can reduce intraoperative bleeding and postoperative chest complications, and it has the advantages of shorter operation, hospitalization time, and less trauma, which can help to accelerate the recovery of the patients; pT and pN staging are the independent factors influencing the prognosis of patients.

Objective To compare the application of two endoscopic retrograde appendicitis therapies(ERAT)in acute uncomplicated appendicitis.Methods 100 patients with acute uncomplicated appendicitis from January 2021 to Jun 2023 were randomly divided into the direct vision group(50 cases)and the control group(50 cases).The control group was treated with conventional ERAT,and the direct vision group was treated with EyeMax Insight pancreaticobiliary imaging system assisted ERAT.The operation time,appendiceal intubation time,success rate of appendiceal intubation,abdominal pain relief time,body temperature recovery time,white blood cell recovery time,hospitalization time,and incidence of surgical complications were compared between the two groups.Results Comparison of appendiceal intubation time and operation time between the two groups:The appendiceal intubation time(5.43±3.51)min and operation time(45.50±10.65)min in the direct vision group were shorter than those in the control group(8.76±5.43)min and(54.32±13.45)min,and the differences were statistically significant(P=0.000).There were no significant differences in the success rate of intubation,recurrence rate,abdominal pain relief time,body temperature recovery time,white blood cell recovery time,hospitalization time and incidence of surgical complications between the two groups(P>0.05).Conclusion ERAT assisted by EyeMax Insight pancreaticobiliary imaging system can shorten the time of appendiceal intubation and operation,without increasing the incidence of complications,avoiding radiation exposure for patients and medical staff.It is safe and effective and worthy of clinical promotion.

Brain-computer interface (BCI) is a revolutionizing technology that disrupts traditional human-computer interaction by establishing direct communication and control between the brain and computer, bypassing the peripheral nervous and muscular systems. With the rapid advancement of BCI technology, growing application demands, and an increasing need for specialized BCI professionals, a new academic major-BCI major-has gradually emerged. However, few studies to date have discussed the interdisciplinary nature and training framework of this emerging major. To address this gap, this paper first introduced the application demands of BCI, including the demand for BCI technology in both medical and non-medical fields. The paper also described the interdisciplinary nature of the BCI major and the urgent need for specialized professionals in this field. Subsequently, a training program of the BCI major was presented, with careful consideration of the multidisciplinary nature of BCI research and development, along with recommendations for curriculum structure and credit distribution. Additionally, the facing challenges of the construction of the BCI major were analyzed, and suggested strategies for addressing these challenges were offered. Finally, the future of the BCI major was envisioned. It is hoped that this paper will provide valuable reference for the development and construction of the BCI major.
Brain-Computer Interfaces/trends* ; Humans ; Electroencephalography ; User-Computer Interface

During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.

In growing children, growth plate cartilage has limited self-repair ability upon fracture injury always leading to limb growth arrest. Interestingly, one type of fracture injuries within the growth plate achieve amazing self-healing, however, the mechanism is unclear. Using this type of fracture mouse model, we discovered the activation of Hedgehog (Hh) signaling in the injured growth plate, which could activate chondrocytes in growth plate and promote cartilage repair. Primary cilia are the central transduction mediator of Hh signaling. Notably, ciliary Hh-Smo-Gli signaling pathways were enriched in the growth plate during development. Moreover, chondrocytes in resting and proliferating zone were dynamically ciliated during growth plate repair. Furthermore, conditional deletion of the ciliary core gene Ift140 in cartilage disrupted cilia-mediated Hh signaling in growth plate. More importantly, activating ciliary Hh signaling by Smoothened agonist (SAG) significantly accelerated growth plate repair after injury. In sum, primary cilia mediate Hh signaling induced the activation of stem/progenitor chondrocytes and growth plate repair after fracture injury.
Mice ; Animals ; Hedgehog Proteins/genetics* ; Receptors, G-Protein-Coupled/metabolism* ; Cilia/metabolism* ; Cartilage/metabolism* ; Regeneration

Objective:The investigation and research on the application status of Hepatic Venous Pressure Gradient (HVPG) is very important to understand the real situation and future development of this technology in China.Methods:This study comprehensively investigated the basic situation of HVPG technology in China, including hospital distribution, hospital level, annual number of cases, catheters used, average cost, indications and existing problems.Results:According to the survey, there were 70 hospitals in China carrying out HVPG technology in 2021, distributed in 28 provinces (autonomous regions and municipalities directly under the central Government). A total of 4 398 cases of HVPG were performed in all the surveyed hospitals in 2021, of which 2 291 cases (52.1%) were tested by HVPG alone. The average cost of HVPG detection was (5 617.2±2 079.4) yuan. 96.3% of the teams completed HVPG detection with balloon method, and most of the teams used thrombectomy balloon catheter (80.3%).Conclusion:Through this investigation, the status of domestic clinical application of HVPG has been clarified, and it has been confirmed that many domestic medical institutions have mastered this technology, but it still needs to continue to promote and popularize HVPG technology in the future.

Objective    To compare the clinical effects of segmentectomy and lobectomy for ≤2 cm lung adenocarcinoma with micropapillary and solid subtype negative by intraoperative frozen sections. Methods    The patients with adenocarcinoma who received segmentectomy or lobectomy in multicenter from June 2020 to March 2021 were included. They were divided into two groups according to a random number table, including a segmentectomy group (n=119, 44 males and 75 females with an average age of 56.6±8.9 years) and a lobectomy group (n=115, 43 males and 72 females with an average of 56.2±9.5 years). The clinical data of the patients were analyzed. Results    There was no significant difference in the baseline data between the two groups (P>0.05). No perioperative death was found. There was no statistical difference in the operation time (111.2±30.0 min vs. 107.3±34.3 min), blood loss (54.2±83.5 mL vs. 40.0±16.4 mL), drainage duration (2.8±0.6 d vs. 2.6±0.6 d), hospital stay time (3.9±2.3 d vs. 3.7±1.1 d) or pathology staging (P>0.05) between the two groups. The postoperative pulmonary function analysis revealed that the mean decreased values of forced vital capacity and forced expiratory volume in one second percent predicted in the segmentectomy group were significantly better than those in the lobectomy group (0.2±0.3 L vs. 0.4±0.3 L, P=0.005; 0.3%±8.1% vs. 2.9%±7.4%, P=0.041). Conclusion    Segmentectomy is effective in protecting lungs function, which is expected to improve life quality of patients.

Objective:The aims of this study were to investigate the effect of gas explosion on rats and to explore the pulmonary function alterations associated with gas explosion-induced acute blast lung injury (ABLI) in real roadway environment.Methods:In April 2018, the large coal mine gas explosion test roadway and explosion test system were used to simulate the real gas explosion roadway environment, fixed the cage and set the explosion parameters. 72 SD rats, male, SPF grade, were randomly divided into nine groups by completely random grouping method according to their body weight: control group, close range group (160 m) , and long range group (240 m) . In each group, there were wound groups (24 h group and 48h group, 8/group, total 48 in six groups) and no wound groups (8/group, total 24 in three groups) . Except for the control group, the other groups were placed in cages at different distances under anesthesia, the experiment of gas explosion was carried out by placing the rats in a position that could force the lungs. The changes of respiratory function of the rats in the non-invasive group were monitored with pulmonary function instrument at 2 h, 24 h, 48 h, 72 h and 168h after the explosion, and were killed under anesthesia 7 days later; the rats in invasive groups were anesthetized and killed at 24 h, 48 h and 168 h, respectively. Gross observation, lung wet-dry ratio and lung histopathology were performed.Results:Compared with the control group, f (respiratory frequency, f) , MV (minute ventilation, MV) , PEF (peak expiratory flow rate, PEF) , PIF (peak inspiratory flow rate, PIF) and EF50 (1/2 tidal volume expiratory flow, EF50) of rats in the close and long range groups decreased significantly after gas explosion 2 h. PAU (respiration pause, PAU) , Te (expiratory time, Te) , Ti (inspiratory time, Ti) and Tr (relaxation time, Tr) were significantly increased ( P<0.05) . After 48 h, TV (tidal volume, TV) , Penh (enhanced respiration pause, Penh) , PAU, and PIF of rats in the long range group were significantly increased ( P<0.05) . After 72 h, MV in the long range group was significantly decreased ( P<0.05) . Compared with the control group, Penh, PAU, Ti and Te were significantly decreased after 168 h in the close and long range groups, with statistical significance ( P<0.05) . At the same time, the body weight of rats in different range groups was significantly decreased ( P<0.05) . In addition, both HE staining and routine observation of lung tissues of rats in different range groups showed that gas explosion caused pulmonary edema, obviously congested pulmonary capillaries, a large number of inflammatory cells and infiltrated red blood cells. Conclusion:Gas explosion in real roadway environment can cause the change of respiratory function phase and lung tissue damage in rats, suggesting that the model of gas explosion-induced ABLI has been initially established successfully, which would provide a basis for further study on the pathogenesis of ABLI.

Objective:The aims of this study were to investigate the effect of gas explosion on rats and to explore the pulmonary function alterations associated with gas explosion-induced acute blast lung injury (ABLI) in real roadway environment.Methods:In April 2018, the large coal mine gas explosion test roadway and explosion test system were used to simulate the real gas explosion roadway environment, fixed the cage and set the explosion parameters. 72 SD rats, male, SPF grade, were randomly divided into nine groups by completely random grouping method according to their body weight: control group, close range group (160 m) , and long range group (240 m) . In each group, there were wound groups (24 h group and 48h group, 8/group, total 48 in six groups) and no wound groups (8/group, total 24 in three groups) . Except for the control group, the other groups were placed in cages at different distances under anesthesia, the experiment of gas explosion was carried out by placing the rats in a position that could force the lungs. The changes of respiratory function of the rats in the non-invasive group were monitored with pulmonary function instrument at 2 h, 24 h, 48 h, 72 h and 168h after the explosion, and were killed under anesthesia 7 days later; the rats in invasive groups were anesthetized and killed at 24 h, 48 h and 168 h, respectively. Gross observation, lung wet-dry ratio and lung histopathology were performed.Results:Compared with the control group, f (respiratory frequency, f) , MV (minute ventilation, MV) , PEF (peak expiratory flow rate, PEF) , PIF (peak inspiratory flow rate, PIF) and EF50 (1/2 tidal volume expiratory flow, EF50) of rats in the close and long range groups decreased significantly after gas explosion 2 h. PAU (respiration pause, PAU) , Te (expiratory time, Te) , Ti (inspiratory time, Ti) and Tr (relaxation time, Tr) were significantly increased ( P<0.05) . After 48 h, TV (tidal volume, TV) , Penh (enhanced respiration pause, Penh) , PAU, and PIF of rats in the long range group were significantly increased ( P<0.05) . After 72 h, MV in the long range group was significantly decreased ( P<0.05) . Compared with the control group, Penh, PAU, Ti and Te were significantly decreased after 168 h in the close and long range groups, with statistical significance ( P<0.05) . At the same time, the body weight of rats in different range groups was significantly decreased ( P<0.05) . In addition, both HE staining and routine observation of lung tissues of rats in different range groups showed that gas explosion caused pulmonary edema, obviously congested pulmonary capillaries, a large number of inflammatory cells and infiltrated red blood cells. Conclusion:Gas explosion in real roadway environment can cause the change of respiratory function phase and lung tissue damage in rats, suggesting that the model of gas explosion-induced ABLI has been initially established successfully, which would provide a basis for further study on the pathogenesis of ABLI.