1.Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients (version 2024)
Yao LU ; Yang LI ; Leiying ZHANG ; Hao TANG ; Huidan JING ; Yaoli WANG ; Xiangzhi JIA ; Li BA ; Maohong BIAN ; Dan CAI ; Hui CAI ; Xiaohong CAI ; Zhanshan ZHA ; Bingyu CHEN ; Daqing CHEN ; Feng CHEN ; Guoan CHEN ; Haiming CHEN ; Jing CHEN ; Min CHEN ; Qing CHEN ; Shu CHEN ; Xi CHEN ; Jinfeng CHENG ; Xiaoling CHU ; Hongwang CUI ; Xin CUI ; Zhen DA ; Ying DAI ; Surong DENG ; Weiqun DONG ; Weimin FAN ; Ke FENG ; Danhui FU ; Yongshui FU ; Qi FU ; Xuemei FU ; Jia GAN ; Xinyu GAN ; Wei GAO ; Huaizheng GONG ; Rong GUI ; Geng GUO ; Ning HAN ; Yiwen HAO ; Wubing HE ; Qiang HONG ; Ruiqin HOU ; Wei HOU ; Jie HU ; Peiyang HU ; Xi HU ; Xiaoyu HU ; Guangbin HUANG ; Jie HUANG ; Xiangyan HUANG ; Yuanshuai HUANG ; Shouyong HUN ; Xuebing JIANG ; Ping JIN ; Dong LAI ; Aiping LE ; Hongmei LI ; Bijuan LI ; Cuiying LI ; Daihong LI ; Haihong LI ; He LI ; Hui LI ; Jianping LI ; Ning LI ; Xiying LI ; Xiangmin LI ; Xiaofei LI ; Xiaojuan LI ; Zhiqiang LI ; Zhongjun LI ; Zunyan LI ; Huaqin LIANG ; Xiaohua LIANG ; Dongfa LIAO ; Qun LIAO ; Yan LIAO ; Jiajin LIN ; Chunxia LIU ; Fenghua LIU ; Peixian LIU ; Tiemei LIU ; Xiaoxin LIU ; Zhiwei LIU ; Zhongdi LIU ; Hua LU ; Jianfeng LUAN ; Jianjun LUO ; Qun LUO ; Dingfeng LYU ; Qi LYU ; Xianping LYU ; Aijun MA ; Liqiang MA ; Shuxuan MA ; Xainjun MA ; Xiaogang MA ; Xiaoli MA ; Guoqing MAO ; Shijie MU ; Shaolin NIE ; Shujuan OUYANG ; Xilin OUYANG ; Chunqiu PAN ; Jian PAN ; Xiaohua PAN ; Lei PENG ; Tao PENG ; Baohua QIAN ; Shu QIAO ; Li QIN ; Ying REN ; Zhaoqi REN ; Ruiming RONG ; Changshan SU ; Mingwei SUN ; Wenwu SUN ; Zhenwei SUN ; Haiping TANG ; Xiaofeng TANG ; Changjiu TANG ; Cuihua TAO ; Zhibin TIAN ; Juan WANG ; Baoyan WANG ; Chunyan WANG ; Gefei WANG ; Haiyan WANG ; Hongjie WANG ; Peng WANG ; Pengli WANG ; Qiushi WANG ; Xiaoning WANG ; Xinhua WANG ; Xuefeng WANG ; Yong WANG ; Yongjun WANG ; Yuanjie WANG ; Zhihua WANG ; Shaojun WEI ; Yaming WEI ; Jianbo WEN ; Jun WEN ; Jiang WU ; Jufeng WU ; Aijun XIA ; Fei XIA ; Rong XIA ; Jue XIE ; Yanchao XING ; Yan XIONG ; Feng XU ; Yongzhu XU ; Yongan XU ; Yonghe YAN ; Beizhan YAN ; Jiang YANG ; Jiangcun YANG ; Jun YANG ; Xinwen YANG ; Yongyi YANG ; Chunyan YAO ; Mingliang YE ; Changlin YIN ; Ming YIN ; Wen YIN ; Lianling YU ; Shuhong YU ; Zebo YU ; Yigang YU ; Anyong YU ; Hong YUAN ; Yi YUAN ; Chan ZHANG ; Jinjun ZHANG ; Jun ZHANG ; Kai ZHANG ; Leibing ZHANG ; Quan ZHANG ; Rongjiang ZHANG ; Sanming ZHANG ; Shengji ZHANG ; Shuo ZHANG ; Wei ZHANG ; Weidong ZHANG ; Xi ZHANG ; Xingwen ZHANG ; Guixi ZHANG ; Xiaojun ZHANG ; Guoqing ZHAO ; Jianpeng ZHAO ; Shuming ZHAO ; Beibei ZHENG ; Shangen ZHENG ; Huayou ZHOU ; Jicheng ZHOU ; Lihong ZHOU ; Mou ZHOU ; Xiaoyu ZHOU ; Xuelian ZHOU ; Yuan ZHOU ; Zheng ZHOU ; Zuhuang ZHOU ; Haiyan ZHU ; Peiyuan ZHU ; Changju ZHU ; Lili ZHU ; Zhengguo WANG ; Jianxin JIANG ; Deqing WANG ; Jiongcai LAN ; Quanli WANG ; Yang YU ; Lianyang ZHANG ; Aiqing WEN
Chinese Journal of Trauma 2024;40(10):865-881
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.
2.Innovation of Methods for Efficacy Evaluation of Traditional Chinese Medicine Compound Prescriptions: Establishment of Characterization System for Simultaneous Treatment/Regulation Based on Correlation Patterns of Five Zang-organs
Yujie LI ; Tuo LIU ; Luqi WANG ; Lina CHEN ; Yan LIANG ; Chengcheng LIU ; Yu LI ; Xiaoxin ZHU
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(23):19-26
The clinical efficacy advantages of traditional Chinese medicine (TCM) compound prescriptions have always been inadequately characterized in experimental research,which has become a bottleneck restricting the development of TCM pharmacology and even the progress of TCM. The concept of simultaneous treatment/regulation,guided by the theory of mutual generation and restriction of five zang-organs,has guiding significance in the clinical practice of TCM throughout history and is still widely used in the current clinical practice. However,this unique and clinically valuable diagnostic and therapeutic medication system based on the syndrome differentiation has been completely ignored in the modern research of TCM pharmacology,which might be one of the key factors restricting the pharmacological characterization of the therapeutic advantages of TCM compound prescriptions. On the basis of systematically summarizing the phased progress and achievements of the efficacy evaluation of TCM compound prescriptions,this article explores the path of exploring the pharmacological advantages of TCM compound prescriptions on simultaneous treatment/regulation on the basis of the correlation patterns of five zang-organs,from the theory of Zangxiang,the core concept of five zang-organs,and the TCM disease recognition based on the theory of mutual generation and restriction of five zang-organs. With the heart-lung correlation as a breakthrough point,this study explored a new characterization method for the pharmacological advantages of TCM,aiming to provide new ideas for evaluating the efficacy of TCM compound prescriptions.
3.A Review of Theoretical Research on Interpretation of Scientific Connotation of Compatibility of Traditional Chinese Medicine Compounds
Shiyun GUO ; Zhihao DENG ; Yan LI ; Yuxuan GUO ; Xiaoxin ZHU ; Yujie LI ; Ying CHEN ; Qing YANG ; Yi SUN ; Yajie WANG ; Qi LI ; Weiyan CAI ; Xiaogang WENG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(23):338-344
Traditional Chinese medicine (TCM) has a long history of application in China and has consistently played a vital role in treating diseases and saving lives. TCM prescriptions (compounds) constitute the primary form of clinical TCM treatment and significantly differ from western medicine (chemicals) due to the diverse composition and chemical constituents of TCM (compounds). Nevertheless, the potential multi-component, multi-target, and multi-pathway action characteristics of TCM prescriptions also demonstrate their possible (complementary) therapeutic advantages when compared with single-component chemical drugs. Therefore, driven by the development of modern science and technology and the demands of the modernization and internationalization of TCM, modern theories regarding the complexity of TCM prescription effects have been continuously proposed: Different from the abstract language of traditional prescription theory, the modern TCM prescription theory is more inclined to illustrate the connotation of prescription compatibility concretely and vividly from an experimental and scientific perspective. In this paper, new theories on the complexity of TCM prescriptions proposed in recent years are summarized to provide research references and ideas for the greater role of TCM prescriptions and a better scientific understanding.
4.Study on relationship between spicy diet and uremia pruritus in maintenance hemodialysis patients
Xiaoxin BAI ; Ling YANG ; Yan HE ; Chunjing XIANG ; Yuting ZHANG ; Yiqin WANG ; Moqi LI
Chongqing Medicine 2024;53(21):3289-3294
Objective To investigate the relationship between spicy diet and uremic pruritus(UP)in the patients with maintenance haemodialysis(MHD).Methods A total of 403 patients receiving the treat-ment in the blood purification center of this hospital from December 2023 to February 2024 were selected as the study subjects and grouped by the sum of the scores of frequency and degree of pepper intake.The visual analogue rating scale(VAS)was used to conduct the preliminary pruritus score in all patients,and the pa-tients with the score>0 point conducted the multidimensional evaluation by the 14-item uremic skin pruritus scale.The blood routine and itch-related blood biochemical indexes levels of all patients were measured.Results There were 65 cases in the bland diet group,119 cases in the mild spicy diet group and 219 cases in the spicy diet group,and there was no significant difference in the number of genders between the groups(P>0.05).There were statistically significant differences in age,dialysis age and lymphocyte count among the groups(P<0.05).There was no statistically significant difference in the degree of pruritus among the groups(Z=9.301,P=0.157),but it was seen that the proportion of moderate and severe pruritus in the mild spicy diet group and the spicy diet group was decreased,and the proportions of no pruritus and mild pruritus showed the increasing trend.The itching score of the bland diet group was higher than that of the mildly spicy diet group and spicy diet group,and the difference was statistically significant(P<0.05),but there was no statistically significant difference between the mild spicy diet group and spicy diet group(P>0.05).There was a statistically significant difference in the itch score of the patients aged 40-60 years in each group(P<0.05),and there was no statistically significant difference in the itch score between the patients aged>60 years old and<40 years old in each group(P>0.05).There was no statistically significant difference in the itch-related blood biochemical indexes among the groups(P>0.05).Conclusion The spicy diet may reduce the degree of pruritus in patients with MHD,moreover which is not affected by the age and other factors,and may be associated with lymphocyte level decrease in the patients.
5.Application of family-involved nursing model under concept of rapid recovery in perioperative nursing for patients with pulmonary nodules
Ying YIN ; Yan GAO ; Xiaoxin YANG ; Wenjing MA ; Wei WANG
Journal of Clinical Medicine in Practice 2024;28(11):129-133
Objective To observe the effect of family-involved nursing model under the concept of rapid recovery in perioperative nursing for patients with pulmonary nodules. Methods A total of 180 patients with surgical treatment for pulmonary nodules were selected and randomly divided into control group and observation group, with 90 cases in each group. The control group was conducted with routine nursing, while the observation group was conducted with family-involved nursing model under the concept of rapid recovery. The time-related outcomes, preoperative anxiety, family burden, and postoperative training enthusiasm were compared between the two groups. Results The duration of chest tube indwelling and total hospital stay in the observation group were significantly shorter than those in the control group (
6.Observation on the effect of plasmatrix bone block applied on alveolar horizontal bone augmentation
Yongjun LI ; Shimin YU ; Xiaoxin ZHANG ; Yan WEI ; Hao ZENG
Chinese Journal of Stomatology 2023;58(10):1062-1066
A retrospective case series was used to evaluate the effect of plasmatrix bone blocks on bone augmentation at the level of the alveolar ridge. From January 2021 to April 2022, a total of 25 patients who underwent horizontal alveolar ridge level bone augmentation in the Department of Implantology, Wuhan Dazhong Stomatological Hospital were included. Autologous bone chips, deproteinized bovine bone matrix and plasma matrix were used to make plasma matrix bone blocks, combined with absorbable collagen membrane and plasma matrix membrane for guided bone regeneration. Three-dimensional reconstruction was performed on the cone beam CT data before operation and 6 months after operation, and the bone width and alveolar bone volume at 2 and 8 mm from the alveolar crest were measured. The paired t test was used to compare the differences between two time points of the same measurement item. The results showed that compared with preoperative [(5.5±3.4) mm] bone width, the bone width [(9.5±2.5) mm] at 2 mm from the alveolar crest was significantly increased at 6 months after operation ( t=3.40, P?0.001); there was no significant difference in the bone width at the level of 8 mm from the alveolar crest between pre-and 6 months post-operation ( t=3.13, P=0.050). The volumes of alveolar bone at 2 and 8 mm from the alveolar crest were (5 114±3 883) and (3 329±2 874) mm 3 before operation, respectively, and these increased significantly to (5 999±4 318) and (4 042±3 260) mm 3 ( t=5.69, P?0.001; t=5.689, P?0.001) 6 month post-operation. The results from this study has shown that the use of plasmatrix bone blocks+absorbable collagen membrane+plasma matrix membrane for horizontal bone augmentation in guided bone regeneration has a promising bone augmentation outcome.
7.Precision nursing for patients with visualization technology assisted pulmonary nodule surgery
Yan GAO ; Wei WANG ; Xiaoxin YANG ; Jiefang DING ; Ying YIN
Journal of Clinical Medicine in Practice 2023;27(24):97-100,106
Objective To observe the effect of precision nursing based on visualization technolo-gy in treating patients with pulmonary nodule surgery.Methods A total of 186 patients with surgery for pulmonary nodules were randomly divided into control group and observation group,with 93 cases in each group.The control group was given routine nursing,while the observation group was given vi-sualization technology assisted precision nursing on the basis of the control group.The psychological status[the Self-rating Anxiety Scale(SAS)score and the Self-rating Depression Scale(SDS)score]and postoperative recovery[score of the Quality of Recovery Scale with 15 items(QoR-15)]were compared between two groups,and the nursing satisfaction degree was compared between the two groups as well.Results After the intervention,the scores of SAS and SDS in both groups de-creased,and the score of each item in the observation group was significantly lower than that in the control group(P<0.05);after intervention,the each item of the QoR-15 and the total score in the observation group were significantly higher than those in the control group(P<0.05);the nursing satisfaction degree of the observation group was 97.8%,which was significantly higher than 89.2%in the control group(P<0.05).Conclusion Precision nursing based on visualization technology can improve the adverse psychological state of patients with pulmonary nodule surgery,enhance the quality of postoperative recovery,and increase nursing satisfaction degree.
8.Precision nursing for patients with visualization technology assisted pulmonary nodule surgery
Yan GAO ; Wei WANG ; Xiaoxin YANG ; Jiefang DING ; Ying YIN
Journal of Clinical Medicine in Practice 2023;27(24):97-100,106
Objective To observe the effect of precision nursing based on visualization technolo-gy in treating patients with pulmonary nodule surgery.Methods A total of 186 patients with surgery for pulmonary nodules were randomly divided into control group and observation group,with 93 cases in each group.The control group was given routine nursing,while the observation group was given vi-sualization technology assisted precision nursing on the basis of the control group.The psychological status[the Self-rating Anxiety Scale(SAS)score and the Self-rating Depression Scale(SDS)score]and postoperative recovery[score of the Quality of Recovery Scale with 15 items(QoR-15)]were compared between two groups,and the nursing satisfaction degree was compared between the two groups as well.Results After the intervention,the scores of SAS and SDS in both groups de-creased,and the score of each item in the observation group was significantly lower than that in the control group(P<0.05);after intervention,the each item of the QoR-15 and the total score in the observation group were significantly higher than those in the control group(P<0.05);the nursing satisfaction degree of the observation group was 97.8%,which was significantly higher than 89.2%in the control group(P<0.05).Conclusion Precision nursing based on visualization technology can improve the adverse psychological state of patients with pulmonary nodule surgery,enhance the quality of postoperative recovery,and increase nursing satisfaction degree.
9.Analysis on medical care seeking of local and non-local pulmonary tuberculosis patients reported in Beijing, 2016-2021.
Shan Hua SUN ; Yan Yuan LI ; Yan XU ; Xian Yu WEI ; Ya Nan ZHANG ; Xi CHEN ; Xiaoxin HE
Chinese Journal of Epidemiology 2022;43(11):1746-1752
Objective: To analyze the medical care seeking of local and non-local pulmonary tuberculosis (TB) patients in Beijing from 2016 to 2021 and provide evidence for TB prevention and control in Beijing. Methods: The reported pulmonary TB data from 2016 to 2021 were collected from tuberculosis management information system and standard code management system of Chinese information system for disease control and prevention. The map data were obtained from the Institute of Geographic Sciences and Natural Resources Research. Excel 2016, SPSS 19.0, Python 3.9 and ArcGIS 10.6 softwares were used for data analysis and visualization for the inter-provincial mobility and inter-district mobility of pulmonary TB patient's medical care seeking in Beijing. Results: Among the reported pulmonary TB patients in Beijing from 2016 to 2021, 35.27%(24 307/68 926) were from 30 provinces (autonomous regions, municipalities) and Xinjiang Production and Construction Corps. The top 5 provinces with pulmonary TB patients medical care seeking in Beijing were Hebei (39.58%,9 620/24 307), Shanxi (8.82%,2 145/24 307), Inner Mongolia Autonomous Region (8.66%,2 105/24 307), Heilongjiang (6.95%,1 690/24 307) and Henan (6.88%,1 672/24 307). Patients from these 5 provinces accounted for 70.89% (17 232/24 307) of total pulmonary TB patients from other provinces. The pulmonary TB patients from other provinces mainly flowed to Tongzhou district of Beijing, accounting for 46.72% (11 356/24 307). These pulmonary TB patients mainly visited grade Ⅲ (A) hospitals, such as Beijing Chest Hospital of Capital Medical University with the highest proportion of 44.76% (10 880/24 307). Among pulmonary TB patients with current residence in Beijing, those sought medical care in other districts accounted for 55.06% (24 566/44 619). The outflow and inflow of TB cases' medical care seeking occurred in 16 districts of Beijing. The median proportion of cross district medical care seeking in 16 districts was 59.30% (56.05%, 65.13%). The inflow of the medical care seeking in Tongzhou, Haidian and Xicheng district was greater than the outflow, and the outflow was greater than the inflow in the other 13 districts. The pulmonary TB patients in Beijing mainly went to Beijing Chest Hospital in Tongzhou for medical care seeking, accounting for 42.18%(18 822/44 619). Conclusions: The proportions of non-local pulmonary TB patients seeking medical care in Beijing from 2016 to 2021 and local pulmonary TB patients seeking medical care in other districts in Beijing were high, and the hospitals where non-local pulmonary TB patients and local pulmonary TB patients sought medical care respectively belonged to grade Ⅲ (A) and municipal designated medical institutions of TB.
Humans
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Tuberculosis, Pulmonary/therapy*
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Hospitals
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Asian People
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China/epidemiology*
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Chlorhexidine
10.Establishment and application of a risk prediction model for ICU acquired weakness
Zhuyue JIANG ; Shengqiang ZOU ; Jiaming HU ; Li CHEN ; Yaji YAO ; Xiaoxin YAN ; Jinhan LIU
Chinese Journal of Practical Nursing 2021;37(11):807-812
Objective:To analyze the risk factors of Intensive Care Unit-Acquired Weakness, and to develop and verify the model.Methods:A total of 247 patients admitted to ICU patients from November 2018 to October 2019 were selected, and risk factors between ICU acquired weakness group ( n=106) and non-ICU acquired weakness group( n=141)were compared using logistic regression for model construction.The Hosmer-Lemeshow test was used to verify the goodness of fit of the model. The area under the ROC curve was used to test the model to predict the effects. From November 2019 to May 2020, 106 patients were recruited for application of the model. Results:The incidence of ICU acquired weakness in this study was 42.91%(106/247), and 44.34%(47/106),the study finally included age ( OR=1.043) ,mechanical ventilation time ( OR=1.140) , APACHE II score ( OR=1.081) , blood sugar ( OR=1.117) , lactic acid( OR=1.459) ,and neuromuscular blockers ( OR=3.499) to construct the risk prediction. The model formula was P=1/1+exp (- Z) =1/1+exp (8.808-0.042×age -1.252×neuromuscular blockers-0.078×APACHE II score -0.110×blood sugar -0.378×lactic acid -0.131×mechanical ventilation time. The area under the ROC curve of this model was 0.896 (95% CI: 0.824-0.914) , the maximum value of the Youden index was 0.577, and the corresponding sensitivity was 0.754,the specificity was 0.823,the cutoff value was 0.503. The model verification results the sensibility of 70.2%, the specificity of 88.1%, and the accuracy of 80.2%. Conclusion:The predictic model of ICU acquired weakness couducted in this study has satisfactory prediction effect, which can provide a reference for clinical screening of high-risk patients.


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