Objective:To construct a scientific and reasonable evaluation index system for the service capacity of integrated Traditional Chinese and Western medicine trauma rescue,providing a tool for assessing the synergistic efficacy of regional trauma rescue systems.Methods:Based on the collaborative governance theory framework,an initial indicator pool was developed through literature analysis and focus group discussions.Two rounds of Delphi expert consultation were conducted to screen indicators,and the analytic hierarchy process was used to determine weights.Results:The final system included 5 first-level indicators,19 second-level indicators,and 45 third-level indicators.Experts positive coefficients(0.923),authority coefficient(0.929)and coordination coefficient(0.24)met requirements.Conclusions:The index system demonstrates scientific rigor and operability,supporting the standardized construction and dynamic optimization of integrated Traditional Chinese and Western medicine trauma rescue services.

Objective:To construct a scientific and reasonable evaluation index system for the service capacity of integrated Traditional Chinese and Western medicine trauma rescue,providing a tool for assessing the synergistic efficacy of regional trauma rescue systems.Methods:Based on the collaborative governance theory framework,an initial indicator pool was developed through literature analysis and focus group discussions.Two rounds of Delphi expert consultation were conducted to screen indicators,and the analytic hierarchy process was used to determine weights.Results:The final system included 5 first-level indicators,19 second-level indicators,and 45 third-level indicators.Experts positive coefficients(0.923),authority coefficient(0.929)and coordination coefficient(0.24)met requirements.Conclusions:The index system demonstrates scientific rigor and operability,supporting the standardized construction and dynamic optimization of integrated Traditional Chinese and Western medicine trauma rescue services.

Objective:To explore the impact of pembrolizumab combined with chemotherapy on angiogenesis and circulating endothelial cells in patients with advanced non-small cell lung cancer (NSCLC) .Methods:The retrospective analysis of clinical data from 121 patients diagnosed with advanced NSCLC who were admitted to the Second Affiliated Hospital of Xingtai Medical College from August 2021 to January 2023 was conducted. These patients were divided into a control group ( n=57) and an observation group ( n=64) based on the designated treatment protocol. Specifically, individuals in the control group received standard chemotherapy (cisplatin+paclitaxel), while those in the observation group underwent penpilimab therapy in conjunction with conventional chemotherapy. The comparative assessment encompassed short-term clinical efficacy, quality of life, immune function parameters, angiogenic factors [including endostatin, insulin-like growth factor 1 (IGF-1), and vascular endothelial growth factor (VEGF) ], circulating endothelial cells, and adverse reactions within the two groups. Results:After 6 courses of treatment, the objective response rate [67.19% (43/64) vs. 49.12% (28/57) ] and disease control rate [87.50% (56/64) vs. 70.18% (40/57) ] in observation group were higher than those in control group, with statistically significant differences ( χ2=4.06, P=0.044; χ2=5.52, P=0.019). The quality of life score of observation group [ (56.77±6.81) points] was significantly higher than that of control group [ (47.73±8.23) points], with a statistically significant difference ( t=6.61, P<0.001) ; The T cell subgroup CD3 + levels [ (63.59±9.00) % vs. (53.06±8.80%), t=6.49, P<0.001], CD4 + levels [ (46.54±8.20) % vs. (30.74±7.32) %, t=11.13, P<0.001] and CD4 +/CD8 + ratio (1.90±0.36 vs. 1.21±0.28, t=11.66, P<0.001) in observation group were significantly higher than those in control group, with statistically significant differences; Endostatin in observation group [ (48.99±3.43) μmol/L] was significantly higher than that in control group [ (31.35±3.87) μmol/L], with a statistically significant difference ( t=26.58, P<0.001), IGF-1 [ (102.31±20.35) μg/L vs. (134.98±19.02) μg/L] and VEGF [ (31.70±4.32) pg/ml vs. (58.71±5.99) pg/ml] were significantly lower in observation group than those in control group, with statistically significant differences ( t=18.73, P<0.001; t=28.14, P<0.001). The number of circulating endothelial cells in observation group [ (58.77±10.03) /ml] was significantly lower than that in control group [ (87.01±8.01) /ml], with a statistically significant difference ( t=17.20, P<0.001). During treatment, there were no statistically significant differences in the incidence of gastrointestinal reaction ( χ2=0.01, P=0.908), leukopenia ( χ2=0.64, P=0.424), thrombocytopenia ( χ2=0.28, P=0.597), anemia ( χ2=1.66, P=0.197), nephrotoxicity ( χ2=0.64, P=0.424), skin rash ( χ2=1.33, P=0.249) between the two groups. Conclusion:The combination therapy of pembrolizumab and chemotherapy for the treatment of advanced NSCLC has demonstrated noteworthy effectiveness. This regimen has the potential to enhance patients' immune functionality, ameliorate their overall quality of life, suppress angiogenesis, and exhibits a commendable profile of safety and reliability.

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.

Ankylosing spondylitis (AS) combined with spinal fractures with thoracic and lumbar fracture as the most common type shows characteristics of unstable fracture, high incidence of nerve injury, high mortality and high disability rate. The diagnosis may be missed because it is mostly caused by low-energy injury, when spinal rigidity and osteoporosis have a great impact on the accuracy of imaging examination. At the same time, the treatment choices are controversial, with no relevant specifications. Non-operative treatments can easily lead to bone nonunion, pseudoarthrosis and delayed nerve injury, while surgeries may be failed due to internal fixation failure. At present, there are no evidence-based guidelines for the diagnosis and treatment of AS combined with thoracic and lumbar fracture. In this context, the Spinal Trauma Academic Group of Orthopedics Branch of Chinese Medical Doctor Association organized experts to formulate the Clinical guideline for the diagnosis and treatment of adult ankylosing spondylitis combined with thoracolumbar fracture ( version 2023) by following the principles of evidence-based medicine and systematically review related literatures. Ten recommendations on the diagnosis, imaging evaluation, classification and treatment of AS combined with thoracic and lumbar fracture were put forward, aiming to standardize the clinical diagnosis and treatment of such disorder.

The acute combination fractures of the atlas and axis in adults have a higher rate of neurological injury and early death compared with atlas or axial fractures alone. Currently, the diagnosis and treatment choices of acute combination fractures of the atlas and axis in adults are controversial because of the lack of standards for implementation. Non-operative treatments have a high incidence of bone nonunion and complications, while surgeries may easily lead to the injury of the vertebral artery, spinal cord and nerve root. At present, there are no evidence-based Chinese guidelines for the diagnosis and treatment of acute combination fractures of the atlas and axis in adults. To provide orthopedic surgeons with the most up-to-date and effective information in treating acute combination fractures of the atlas and axis in adults, the Spinal Trauma Group of Orthopedic Branch of Chinese Medical Doctor Association organized experts in the field of spinal trauma to develop the Evidence-based guideline for clinical diagnosis and treatment of acute combination fractures of the atlas and axis in adults ( version 2023) by referring to the "Management of acute combination fractures of the atlas and axis in adults" published by American Association of Neurological Surgeons (AANS)/Congress of Neurological Surgeons (CNS) in 2013 and the relevant Chinese and English literatures. Ten recommendations were made concerning the radiological diagnosis, stability judgment, treatment rules, treatment options and complications based on medical evidence, aiming to provide a reference for the diagnosis and treatment of acute combination fractures of the atlas and axis in adults.

Aim To investigate the effect of T40 on malignant biological behavior of glioma U87 and U251 cells and its mechanism. Methods U87 and U251 cells were treated with T40 at different concentrations (0,1,2 and 4 p,mol • L"1). Changes of cell proliferation, clonal formation, apoptosis, migration and invasion in each group were detected by CCK-8, cloning plate, flow cytometry, scratch and transwell experi-ments. Bioinformatics was used to explore T40 targets and analyze the relationship between targets and glioma progression. The protein expression levels of PTPN1, PTPN2, Bcl-2, Bax, pro-caspase-3 , cleaved caspase- 3, MMP-2 and MMP-9 in each group were detected by Western blot. Results T40 significantly inhibited U87 and U251 proliferation, clone formation, migration and invasion and promoted apoptosis ( P < 0. 05 ) ; T40 had 37 targets, among which the expression levels of PTPN1 and PTPN2 were negatively correlated with the overall survival rate of glioma patients; T40 signifi cantly reduced the expression of PTPN1, PTPN2, Bcl- 2, MMP-2 and MMP-9 in U87 and U251 cells, and increased the expression of Bax and cleaved caspase-3 (P < 0. 05). Conclusions T40 inhibits the proliferation , migration and invasion of glioma U87 and U251 cells and promotes their apoptosis, and its mechanism may be related to the reduction of PTPN1 and PTPN2 expression.

Objective: To study and create the algorithm for the diversity (AD) of extensible markup language (XML) tree map, and provide a new tool for the identification of Artemisiae Annuae Herba. Method: According to the literature research, the key information of Artemisiae Annuae Herba was selected from the macroscopic, mesoscopic and microscopic information, etc. Based on the key information, the relevant upper standards of domestic and foreign professional fields were cited to assign the unique identification independent of language for each data element, and the coding rules of relevant data elements were established. The digital coding technology was applied to the flexible structure editor, and the tree map was created, which could be returned as the 5^th version of hypertext markup language (HTML5) or XML format. Based on the diversity related algorithms, the authors innovatively developed the AD of XML tree map of Artemisiae Annuae Herba, which took into account both of topology and semantics, and the expression model of related mathematical functions of Artemisiae Annuae Herba was established. By comparing the calculation results with the reality, the algorithm model was debugged continuously until the convergence of the core-culvert algorithm model. Result: Through the research on AD, the diversity between two XML tree maps could be calculated, and the discrimination or identification model of Artemisiae Annuae Herba also could be finally optimized and established. After calculation and analysis of the tested tree maps, the effective rate of the model was 100%. Conclusion: In this study, the establishment of the AD of XML tree map can effectively assist in the identification of Artemisiae Annuae Herba, which provides certain technical support and theoretical guidance for the research on intelligent application of traditional Chinese medicine.

Objective To study the clinical effect of minimally invasive resection of spleen in the upper margin of the spleen pedicle. Methods 152 patients underwent splenectomy were enrolled in this study from June 2012 to June 2017. All patients underwent laparoscopic splenectomy. Among the 118 patients, the spleen pedicle was removed from the spine pedicle of the spleen pedicle and the spleen pedicle was taken as the control group. Comparison of the two groups of patients with perioperative period, 7 d postoperative hematological indicators and complications occurred. Results The intraoperative blood loss (51.85 ± 27.14) ml, the operation time (69.39 ± 19.34) min and the transfer rate (0.84%) were lower in the observation group than those in the control group (82.67 ± 36.29) ml, (119.44 ± 23.73) min and (8.82%), the difference was statistically significant (P < 0.05). There was no significant difference in the time of first anal exhaust, food time and hospitalization time (P > 0.05). The levels of blood white blood cell count (WBC) (4.32 ± 1.14) ×109/L, hemoglobin (Hb) (125.37 ± 18.28) g/L and platelet (PLT) were significantly higher than those in the observation group (378.28±112.94) (P < 0.05) were significantly higher than those in the control group (3.28 ± 1.05) ×109/L, (97.23 ± 22.43) g/L and (239.42 ± 134.82) ×109/L, respectively. The incidence of pancreatic fistula, abdominal hemorrhage, portal vein thrombosis, infection and intestinal obstruction was significantly lower in the observation group than in the control group (P < 0.05). Conclusion Splenectomy of splenic pedicle in spleen splenectomy can reduce the intraoperative blood loss and transfer rate, reduce the operation time and reduce the incidence of postoperative complications. It can be further promoted in clinical and use.

To evaluate the safety and effectiveness of Shenbei Guchang capsules in treatment of diarrhea type irritable bowel syndrome (yang deficiency of spleen and kidney) under widely used conditions, an open, multicenter, controlled, phase Ⅳ clinical trial was conducted in the drug clinical trial centers of 16 domestic hospitals. 2 123 patients from June 10, 2011 to November 29, 2012 were enrolled in the trial. Drug clinical trial was approved by Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital Ethics Committee before implementation. Before the start of trial, subjects were selected according to the research scheme and inclusion criteria, then they would step into the 14 d study after signing Informed Consent Form. All subjects were treated according to the research scheme, evaluated the conditions and filled in CFR sheet, to provide the evaluation data and information on safety and efficacy of Shenbei Guchang capsules. Shenbei Guchang capsules were used to treat diarrhea type irritable bowel syndrome in widely used conditions (2 123 cases), and 2 029 cases of them entered FAS set, cure+markedly effective in 1 921 cases, with a comprehensive curative effect rate of 94.68%; 2 010 cases of them entered PPS set, cure+markedly effective in 1 906 cases, with a comprehensive curative effect rate of 94.83%. The primary symptoms of IBS were abdominal pain and diarrhea. After treatment, both abdominal pain and diarrhea were improved, with significant differences (P<0.000 1). There were significant differences in traditional Chinese medicine symptom scores on both post-treatment day 7 and day 14 as compared with the conditions before treatment (P<0.000 1). 35 cases of adverse events occurred during the trial with an incidence of 1.65%, including 12 cases of drug-related adverse events (adverse reaction) with an incidence of 0.57%, mainly manifested as nausea, abdominal distension and dry mouth, most of which would be spontaneously relieved without any measures. No serious adverse events occurred. The commercially available Shenbei Guchang capsules are proved safe and effective for the treatment of diarrhea type irritable bowel syndrome (yang deficiency of spleen and kidney) under widely used conditions (2 123 cases), and can be continued for clinical promotion and application.