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.

Autologous ozonized blood transfusion(AOBT) is a therapy of re-transfusion of 100-200 mL of autologous blood after shaking and agitation with appropriate amount of oxygen-ozone in vitro. The oxidation of blood through the strong oxidation of ozone can enhance the non-specific immune response of the body, regulate the internal environment and promote health. This therapy has been increasingly applied in clinical practice, while no unified standard for the operation process in terms of ozone concentration, treatment frequency and treatment course had been established. This operation process of AOBT is primarily explored in order to standardize the operation process and ensure its safety and efficacy.

According to the pathological characteristics of symptomatic chronic thoracic and lumbar osteoporotic vertebral fracture (SCOVF), the different clinical treatment methods are selected, including vertebral augmentation, anterior-posterior fixation and fusion, posterior decompression fixation and fusion, and posterior correction osteotomy. However, there is still a lack of a unified understanding on how to choose appropriate treatment method for SCOVF. In order to reflect the new treatment concept and the evidence-based medicine progress of SCOVF in a timely manner and standardize its treatment, the clinical guideline for surgical treatment of SCOVF is formulated in compliance with the principle of scientificity, practicability and advancement and based on the level of evidence-based medicine.

Objective To explore the mechanism of resveratrol in alleviating neuroinflammation after cerebral ischemia-reperfusion injury by inhibiting Toll like receptor 4 (TLR4) signaling pathway. MethodsSixty adult male SD rats were randomly divided into sham-operated group, cerebral ischemia-reperfusion injury group, and resveratrol treatment group (n=20). Rat models of transient middle cerebral artery occlusion (MCAO) in the latter two groups were prepared by modified thread embolization method; reperfusion was performed after 2 h of occlusion, and 20 mg/kg normal saline or resveratrol via tail vein injection was given 15 min before model preparation and one min before reperfusion, respectively. At 72 h after MACO, neurological severity scale (NSS) was applied to evaluate the neurological functions of rats. Enzyme linked immunosorbent assay was performed to detect the expressions of pro-inflammatory cytokines interleukin (IL)-1β, IL-6, tumor necrosis factor (TNF)-αand anti-inflammatory cytokines IL-4, IL-10, and transforming growth factor (TGF)-β. Reverse transcription-polymerase chain reaction was performed to detect the mRNA expressions of M1 signature markersIL-1βandCD32and M2 signature markersCD206andArginase-1. Western blotting was used to detect the expressions of TLR4 signaling molecules TLR4, myeloid differentiation protein 88 (MyD88), tumor necrosis factor receptor-associated factor 6 (TRAF6), IL-1 receptor associated kinase 1 (IRAK1) and nuclear factor (NF)-κB.ResultsAs compared with those in the sham-operated group, rats in the cerebral ischemia-reperfusion injury group had significantly decreased NSS scores, significantly elevated levels of IL-1β, IL-6, TNF-α, IL-4, IL-10, and TGF-βin the damaged brain tissues, significantly elevated mRNA expression levels ofIL-1β,CD32,CD206, andArginase-1, and significantly elevated protein expression levels of TLR4, MyD88, TRAF6, IRAK1 and NF-κB (P<0.05). As compared with rats in the cerebral ischemia-reperfusion injury group, rats in the resveratrol treatment group had significantly decreased NSS scores, significantly decreased levels of IL-1β, IL-6, and TNF-α, significantly elevated levels of IL-4, IL-10, and TGF-βin the damaged brain tissues, significantly deceased mRNA expression levels ofIL-1βandCD32, significantly elevated mRNA expression levels of CD206andArginase-1, and significantly decreased protein expression levels of TLR4, MyD88, TRAF6, IRAK1 and NF-κB (P<0.05).ConclusionResveratrol inhibits microglia M1-type polarization and promotes M2-type polarization after cerebral ischemia reperfusion by inhibiting TLR4 signaling pathway, which further reduces neuroinflammation and neurological deficits.

Objective To investigate the effects of different doses of dexmedetomidine combined with propofol and remifentanil target controlled infusion (TCI) on postanesthesia recovery of patients in functional endoscopic sinus surgery. Methods Eighty ASA Ⅰor Ⅱ grade patients, scheduled for the endoscopic sinus surgery, were divided into control group (20 cases) and dexmedetomidine group (60 cases) according to the random digits table method. The patients in dexmedetomidine group were given loading dose dexmedetomidine 0.6 μg/kg, then were given dexmedetomidine of different maintenance doses:0.3 μg/(kg·h) in D1 group, 0.6 μg/(kg·h) in D2 group and 0.9 μg/(kg·h) in D3 group. The patients in dexmedetomidine group were given TCI propofol and remifentanil during the maintenance of general anesthesia, rocuronium was administrated intermittently during operation, and bispectral index (BIS) was controlled at 40 - 50. The changes of hemodynamics 5 - 10 min after entering operation room (T0), before induction (T1), 1 min after intubation (T2), 5 min after intubation (T3), before extubation (T4) and 5 min after extubation (T5) were observed. The spontaneous breathing recovery time, call of eye-opening time, extubation time and adverse reaction after surgery were recorded. Moreover, the visual analogue score (VAS) and Ramsay sedation score were used to evaluate the comfort level of patients. Results The mean arterial pressure (MAP) at T5 in control group and D1 group were significantly higher that in D2 group and D3 group, and there were statistical differences (P<0.05). The heart rate at T1-T5 in D1-D3 group were significantly lower than that in control group, and there were statistical differences (P<0.05). The spontaneous breathing recovery time, call of eye-opening time, extubation time in D1 - D3 group were longer than those in control group, but there were no significant differences (P>0.05). The VAS 15 min after extubation in D1 - D3 group were significantly lower than that in control group: (3.7 ± 0.3), (3.1 ± 0.4) and (3.0 ± 0.5) scores vs. (6.2 ± 0.6) scores, and there were statistical differences (P<0.05). The Ramsay sedation scores in D1 - D3 group were significantly higher than that in control group:(2.5 ± 0.2), (2.7 ±0.2) and (5.3 ± 0.3) scores vs. (1.4 ± 0.3) scores. Moreover, Ramsay sedation score in D3 group was significantly higher than that in D1 group and D2 group, and Ramsay sedation score in D2 group was significantly higher than that in D1 group. There were statistical differences (P<0.05). Four and 2 patients occurred nausea vomiting respectively in control group and D1 group within 24 h after operation. Conclusions Dexmedetomidine combined with propofol and remifentanil TCI can maintain hemodynamic stability and improve anesthesia recovery quality.

Objective To provide a scientific basis for prevention of Keshan disease by observing the changes of electrocardiogram in residents from Keshan disease area and urban residents in Ju County.Method In 2013,four countries (towns) of Sangyuan,Anzhuang,Qishan and Longshan were selected as the investigation sites across the Keshan disease areas in Ju County of Shandong Province,one village was selected in each country (town),no less than 200 people were chosen from each village.There were 36 residential communities in urban area in Ju County,one residential community was selected from 4 positions (east,west,south and north) in urban area,no less than 200 non-endemic urban residents were chosen from each residential community as control,the electrocardiogram examination was conducted.According to the Keshan Disease Diagnostic Standard (WS/T 210-2011),Keshan disease was diagnosed.Results Among the 964 inhabitants investigated in Keshan disease area,143 cases showed abnormal electrocardiogram and the detection rate was 14.83％;in the 926 cases of urban electrocardiogram,78 cases showed abnormal electrocardiogram,abnormal rate was 8.42％,the difference was statistically significant (x2 =18.80,P ＜ 0.01).There were 93 cases who met the 8 Keshan disease diagnostic criteria of abnormal electrocardiogram changes in the Keshan disease areas,abnormal rate was 9.65％;while there were 37 cases in urban residents,abnormal rate was 4.00％,the difference was statistically significant (x2 =23.55,P ＜ 0.01).Conclusion These residents who have lived in Keshan disease endemic areas have a higher rate of abnormal electrocardiogram in Ju County of Shandong Province,they are still threatened by the causative factors of Keshan disease,and the authority should strengthen the prevention measures of Keshan disease.

Objective To sum up the clinical experience in diagnosis and treatment of spinal primitive neuroectodermal tumor (PNET). Methods Thirteen patients with spinal PNET were included in the study from 1999 to 2009. There were 8 males and 5 females with the mean age of 26.9 years. The lesions involved the cervical spine in 6 cases, the thoracic segment in 1 case, the lumbar segment in 5 cases and the sacrum in 1 case. The diagnosis of PNETs was made in nine patients by postoperative pathological examination. Among them, 6 patients received a preoperative CT-guided percutaneous biopsy. The other four patients were diagnosed only by CT-guided percutaneous biopsy. Osteolytic bony lesions and obvious neurological deficit were found in ten patients, while the other 3 had complained of local pain only. Nine patients had received operation followed by chemotherapy and radiotherapy. The other 4 underwent only chemotherapy and radiotherapy. The changes of symptoms and time of survival were recorded. Results Eleven patients were followed up with the mean of 21.8 months. The back pain in 7 patients who underwent operation relieved one month after the operation. The bladder and bowel function returned to normal condition after the operation. Among them, four patients died postoperatively. The mean survival time was 11.3 months. The otherthree patients survived with an average of 36 months. Three patients who had only received chemotherapy and radiotherapy died with an average of 7 months, while the other patient survived for 5 months. Conclusion The diagnoses of spine PNET mainly depend on pathological examination. Percutaneous CT-guided biopsy is a reliable method to confirm diagnose of tumor before surgery. The mortality rate of spinal PNET which is a highly malignant tumor is high. Operation can relieve clinical symptoms and improve patients' life quality, but not prolong the survive time.

Objective To explore the relationship between job stressors,montal health and intention to quit of pediatric nurses by comparing with nurses in internal medicine department. Methods Job stressors, mental health,intention to quit of pediatric nurses and their relationship were investigated among nurses in above mentioned wards from three third-level and first-class hospitals by using questionnaires. Results The scores of some factors of job stressors and nine factors of SCL- 90 of pediatric nurses were much higher than those of internal medicine nurses. There was a significantly positive correlation between some factors of job stressors, mental health and intention to quit of pediatric nurses. Conclusions Working pressure is a factor of low mental health level and intention to quit of pediatric nurses. Effective management strategies should be imple-mented to protect the mental health of pediatric nurses and decrease the loss of nurses.

Objective:To study the biological effects of new monomer 3 from Radix Curcumae on proliferation of human gastric cancer cells SGC-7901.Methods:Uing fluorescence microscope to observe the impact on SGC-7901 cells with different concentrations of the new monomer 3 at different times,using MTT assay to observe the growth inhibition rate of SGC-7901 cells,using flow cytometry to observe the apoptosis rate and cell cycle distribution of SGC-7901 cell.Results:Pronounced apoptosis had been found by fluorescence microscopy,apoptosis had a certain amount of time-dependent and concentration-dependent;Early apoptotic cells near normal morphology,normal nuclear morphology;late apoptotic cells'size shrink or round in shape,nuclear pyknosis or fragmentation.MTT method showed that the new monomer 3 had significantly inhibition on SGC-7901 cells,the half inhibition rate(IC50) was 30.14?g/mL.Flow cytometry(FCM) showed that:the new monomer 3 can increase the SGC-7901 cells in the S phase and G0/G1 and reduce it in G2/M.The change had time and concentration dependence;The apoptotic rates of dosing unit(24h,48h) compared with the control group had significant differences.The maximum apoptosis rate was 60.07%.Conclusion:The new monomer 3 inhibited human gastric cancer SGC-7901 cells significantly and had the impact on cell cycle distribution of the SGC-7901 cells and induction of apoptosis.

The biomechanical properties of eight human corneas from four normal Chinese fresh corpses were investigated by use of one dimension tensile test, tensile stress relaxation and creep test. The destructive load, stretchy ratio, spreading stress, spreading strain and elastic modulus were determined. Also obtained were the stress relaxation and creep data and curves. After reduction of data, the reduced stress relaxation and creep data and curves were worked out. The regression method was used to get the regression coefficient. The least square method was employed to fit the data of stress and strain; then the stress-strain formula was expressed and the curves of human cornea were plotted. The constitutive equation is K (lambda,t) = G(t) T(e) (lambda) and some conclusions are drawn.
Biomechanical Phenomena ; Cornea ; physiology ; Elastic Modulus ; Humans ; Stress, Mechanical