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.

To conduct the association between vitamin B12 and mental health in children and adolescents. Five databases were searched for observational studies in any language reporting on mental health and vitamin B12 levels or intake in children and adolescents from inception to March 18, 2022. Two authors independently extracted data and assessed study quality. Qualitative and quantitative analysis of data were performed. The review was registered in the PROSPERO database (CRD42022345476). Fifty six studies containing 37,932 participants were identified in the review. Vitamin B12 levels were lower in participants with autism spectrum disorders (ASD) (standardized mean difference [SMD], −1.61;95% confidence interval [95% CI], −2.44 to −0.79; p ＜ 0.001), attention deficit hyperactivity disorders (SMD, −0.39; 95% CI, −0.78 to −0.00; p = 0.049) compared with control group. Vitamin B12 intake were lower in participants with ASDs (SMD, −0.86; 95% CI, −1.48 to −0.24; p = 0.006) compared with control group, but showed no difference between depression group (SMD, −0.06; 95% CI, −0.15 to 0.03; p = 0.17) and the control group. Higher vitamin B12 intake were associated with lower risk of depression (odds ratio [OR], 0.79; 95% CI, 0.63−0.98; p = 0.034) and behavioral problems (OR, 0.83; 95% CI, 0.69−0.99; p = 0.04). The vast majority of included studies supported potential positive influence of vitamin B12 on mental health, and vitamin B12 deficiency may be a reversible cause for some mental health disorders in children and adolescents.

【Objective】 To explore the status and characteristics of voluntary blood donors in rural areas of Dali Bai Autonomous Prefecture (referred as Dali), and to provide basis for scientific and effective voluntary blood donation in rural population in regions inhabited by ethnic groups. 【Methods】 The data of rural blood donors who donated blood in Dali from 2010 to 2019 were collected, including demographic data as nationality, gender, age, educational background, as well as the blood donation frequency and blood infection screening (index) results. The above data of urban blood donors who donated blood in Dali during the same period were selected to investigate the increasing trend of blood donation rate. SPSS26.0 was used for statistical analysis of the collected data of rural and urban blood donation population. 【Results】 From 2010 to 2019,the number of blood donors in Dali increased from 13 949 to 19 479,with an increasing rate of 39.64%. The number of rural blood donors increased from 2 623 to 8 727,among which the number of ethnic minority groups increased from 1 779 to 5 059.The ratio of male to female blood donors was 70.30% (1 844/2 623) vs 29.70% (779/2 623) in 2010,56.37% (4 919/8 727) vs 43.63%(3 808/8 727) in 2019. Those with educational level of junior middle school or below were the most, accounted for 43.97%(38 443/85 836),with ethnic donors of 24.47%(23 583/85 836). The proportion of donors aged between 36 and 45 was the highest[40.73% (30 477/74 827) ], with ethnic donors of [28.56% (21 374/74 827), and the proportion of repeated blood donors was 54.87%(35 279/64 299),with ethnic donors of 49.89%(18 080/36 240) [the proportion of repeated blood donors in urban donors in the same period was 48.13% (55 677/115 675) ] (P<0.01). The unqualified rate of ALT was the highest [1.21%(1 272/105 489) ] [The unqualified rate in local donors was 1.99%(3 837/192 552) ] (P<0.01), and that of the ethnic donors was 1.51%(358/56 718). There was no significant difference in the unqualified rates of HB-sAg, anti-HCV, anti-HIV and anti-TP among urban and rural blood donors (P>0.05). 【Conclusion】 It is of great significance to explore the characteristics of blood donors in rural areas (especially regions inhabited by ethnic groups) and the reasons for disqualification, in order to scientifically carry out the recruitment of voluntary blood donors and further promote blood donation for rural residents

BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) is the endoscopic modality of choice for the treatment of biliary and pancreatic diseases. However, patients with cirrhosis, particularly those with decompensated cirrhosis, are believed to be at increased risk for complications associated with ERCP. There is a paucity of literature describing the outcomes of ERCP for patients with cirrhosis. This study aimed to investigate the outcomes of ERCP for cirrhosis patients, especially adverse events, and evaluated its safety and efficacy. METHODS: We performed a multicenter, retrospective study of all patients at Beijing Friendship Hospital affiliated to Capital Medical University, Xijing Hospital affiliated to Air Force Military Medical University, Beijing Youan Hospital affiliated to Capital Medical University, and the Fifth Medical Center of the People's Liberation Army General Hospital from June 2003 to August 2019. The adverse events of inpatient ERCP for patients with ( n  = 182) and without liver cirrhosis (controls; n  = 385) were compared. RESULTS: A total of 567 patients underwent ERCP between January 2003 and December 2019 were enrolled in this study. Compared to patients without cirrhosis, patients with cirrhosis were at higher risk for postoperative complications (odds ratio [OR], 4.172; 95% confidence interval [CI], 1.232-7.031; P  < 0.001) such as postoperative pancreatitis (OR, 2.026; 95% CI, 1.002-4.378; P  = 0.001) and cholangitis (OR, 3.903; 95% CI, 1.001-10.038; P  = 0.036). The main indications for ERCP for patients with cirrhosis in this study included choledocholithiasis (101 cases; 55.5%), benign bile duct strictures (46 cases; 25.3%), and malignant bile duct strictures (28 cases; 15.4%). Among them, 23 patients (12.6%) underwent balloon dilation and 79 patients (43.4%) underwent sphincterotomy. Of the patients with cirrhosis, delayed bleeding occurred in ten patients (5.5%), postoperative pancreatitis occurred in 80 patients (44.0%), and postoperative cholangitis occurred in 25 patients (13.7%). An additional multivariate analysis showed that the total bilirubin (TBIL) level (OR, 4.58; 95% CI, 2.37-6.70) and Child-Pugh score of C (OR, 3.11; 95% CI, 1.04-5.37) were risk factors for postoperative complications in patients with cirrhosis. CONCLUSIONS Compared with the general population of patients undergoing ERCP, patients with cirrhosis were more prone to postoperative pancreatitis and cholangitis. TBIL levels and Child-Pugh scores were risk factors for postoperative complications in patients with cirrhosis.
Humans ; Cholangiopancreatography, Endoscopic Retrograde/adverse effects* ; Retrospective Studies ; Constriction, Pathologic ; Risk Factors ; Liver Cirrhosis/complications* ; Pancreatitis/etiology* ; Postoperative Complications/epidemiology* ; Cholangitis

It is a critical strategy for blood safety to screen bloodborne pathogens in blood donors. Although common viruses such as human immunodeficiency virus, hepatitis B virus and hepatitis C virus have been routinely included in the screening category, other unlisted emerging and reemerging viruses, as constant risk factors for transfusion-transmitted infections, are potential threats to blood safety and transfusion medicine. This review focuses on the association of transfusion medicine with emerging and reemerging viral diseases, from definition of post-transfusion infections with emerging and reemerging viruses, incidents of transfusion transmitted viral infections, detecting method, to current challenges. These emerging threats should be comprehensively considered for ad hoc adjustment of blood screening strategies and promoting blood safety in the future.

Objective:To discuss the the effects, indications and protective measures of tracheotomy for severe cases of coronavirus disease 2019 (COVID-19) patients.Methods:A retrospectively analysis was conducted to explore the clinical data of COVID-19 patients who received tracheotomy in February to March 2020, and descriptive statistics were used to analyze the indication of tracheotomy, particularity of intraoperative treatment and protective measures.Results:A total of 4 cases were included in this article. All patients were successfully operated. One case had postoperative incision continuous bleeding, there were not other complications and nosocomial infection among the medical staff. The patient′s condition was relieved in different degrees after the operation, who remained hospitalized.Conclusion:Tracheotomy for severe cases of COVID-19 can achieve certain curative effect, but the occurrence of tracheotomy related complications and nosocomial infection should be effectively controlled, and the risk benefit ratio of tracheotomy should be carefully weighed before surgery.

Objective: To summarize and analyze the clinical data of hepatic venous pressure gradient (HVPG) and to explore the application value of HVPG in the diagnosis, evaluation and clinical treatment of portal hypertension in cirrhosis. Methods: The patient data of HVPG measurement performed in Shandong Provincial Hospital from April 2010 to November 2017 were collected. Results: A total of 633 patients with 833 times of HVPG measurements were included. There was significant difference in HVPG between patients with different etiologies, different Child-pugh grades and different degrees of decompensated cirrhosis. Conclusion The HVPG test is suitable for the diagnosis and evaluation of portal hypertension. The HVPG of patients with different severity of liver cirrhosis can guide the choice of the treatment plan, and the HVPG measurement should also be strictly standardized and quality control.

Shuyu Pill is the representative prescription for treating deficiency-essence. This article discussed the consistency of diabetes and deficiency-essence from TCM syndromes and etiology and pathogenesis, and probed into the correlation between Shuyu Pill and diabetic Western medicine of pathomechanism diabetes from the modern pharmacological research on Shuyu Pill. Therefore, it proposed that diabetes has the essence of deficiency-essence;the pathogenesis of diabetes should meet the efficacy of Shuyu Pill; pharmacological effects of Shuyu Pill can affect various pathological mechanism of diabetes, with a purpose to provide new ideas for the clinical treatment of diabetes.

Objective To investigate the effect of Supplementing Qi and activating blood and tonifying kidney therapy on the function and quality of life in patients with prolapse of lumbar intervertebral disc after operation.Methods92 cases of lumbar disc herniation treated in Fuyang Hangzhou Hospital of traditional Chinese Medicine hospital from November 2015 to October 2016 were selected,divided into observation group and control group, there were 46 cases in each group, the observation group were treated with Supplementing Qi and activating blood and tonifying kidney therapy,the control group were given conventional western medicine treatment, the improvement of VAS score, JOA score and WHQOL-BREF score were compared between the two groups after treatment, and the clinical effects were compared between the two groups after treatment and the incidence of adverse reaction.ResultsAfter treatment,the VAS scores of the two groups were decreased, the observation group (1.85±0.43) is lower than the control group (2.97±0.69), the difference between the two groups was statistically significant(P<0.05);After treatment, patients withthe JOA scores of the two groups were increased, the observation group (25.78±5.89) higher than the control group (20.45±4.82), the difference between the two groups was statistically significant(P<0.05);After treatment, the total efficiency of observation group was 93.48% higher than 76.09% in the control group, the difference between the two groups was statistically significant(P<0.05);There was no significant difference in WHOQOL-BREF scores between the two groups before treatment;After treatment, the WHOQOL-BREF scores of the two groups were increased, the observation group was higher than the control group, the difference between the two groups was statistically significant(P<0.05), there was no significant difference in the incidence rate of complications between the two groups after treatment.ConclusionThe patients with lumbar disc herniation after operation to give Supplementing Qi and activating blood and tonifying kidney therapy,can effectively helpe patients to recover, improve the pain of patients, improve the patient's functional activities and quality of life, the effect is significant.

Objective The study aimed to evaluate the effects of web-problem-based learning (WPBL) in the application of Fundamental Nursing.Methods The sample was purposively selected.172 students in School of Nursing in Tianjin were recruited as the control group (n=83) and the intervention group (n=89).Traditional teaching method and WPBL was implemented in the control group and the intervention group,respectively.The teaching effectiveness of the two groups was measured by the examination and learning initiative evaluation scale and the teaching effect evaluation questionnaire,and the teaching satisfaction questionnaire was implemented among the intervention group.SPSS 18.0 was used and t test was performed to analyze the comparison between groups.Results In the theoretical examination,the scores of comprehensive analysis of the nursing students in the intervention group were better than those in the control group,and the difference was statistically significant (P＜0.05).In the evaluation of active learning after school,the scores of control learning in the intervention group were higher than those in the control group,and the difference was statistically significant ([14.78 ± 2.16),vs.(13.58 ± 2.16),t=-3.58,P=0.000].83 effective questionnaires of intervention group nursing students' teaching satisfaction were recovered.73 of them (88％) thought that WPBL could improve the students' ability of independent learning,71 students (85.5％) found that WPBL could enhance the ability of information processing,73 students (88％) thought they could communicate well with their classmates in WPBL and cooperate well to complete the task.Conclusion WPBL which is on the basis of PBL and make full use of the network,could promote the ability of autonomous learning,information processing and communication with classmates and good cooperation,but in the application process,it needs teachers to organize reasonably,perfect the supervision mechanism,and reduce taking up students' spare time.