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 investigate the risk factors for acute calf muscular venous thrombosis(CMVT)in elderly patients with hip fractures and evaluate the diagnostic value of thrombotic risk index for CMVT.Methods The blood samples from elderly emergency admission patients with traumatic hip fractures were prospectively collected,and platelet count(PLT),plateletcrit(PCT),coagula-tion markers such as thrombin-activatable fibrinolysis inhibitor(TAFI),D-dimer,and fibrinogen(Fib),and biochemical markers,including serum total protein(TP),globulin(Glob),creatine kinase(CK),triglyceride(TG),and lactate dehydrogenase(LDH),were detected.The differences in these markers between the CMVT group,deep calf venous thrombosis(DCVT)group and non-deep venous thrombosis(DVT)group were compared.The multivariate logistic regression analysis was used to identify independent risk fac-tors for CMVT,and a thrombotic risk index was generated to evaluate its diagnostic value in CMVT.Results Compared with the non-DVT group,the levels of TAFI,Fib,TP,CK,TG,PCT,and LDH in the CMVT group were significantly reduced(P<0.05),while the level of D-dimer increased but the difference was not statistically significant.The level of TP in the DCVT group was significantly lower than that in the non-DVT group(P<0.05).Multivariate analysis showed that age,LDH,and Fib were independent risk factors for CMVT.The area under the receiver operating characteristics(ROC)curve of the thrombotic risk index in diagnosing CMVT was 0.718(P<0.001).Conclusion Age,LDH,and Fib are the independent risk factors of CMVT in elderly patients with hip fractures.The thrombotic risk index has a high diagnostic value in CMVT.

Objective: To evaluate the effect of multidisciplinary cooperative pain management on the rapid recovery of patients with total hip and total knee arthroplasty. Methods: A total of 120 patients, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, aged 20-64 yr, with body mass index of 18-25 kg/m², were divided into 2 groups using a random number table method: test group (group T, n=66) and control group (group C, n=54). Multidisciplinary cooperative pain management mode was adopted for pain management in the perioperative period in group T, while traditional pain management was used in group C. Numeric rating scale scores were recorded at 4 h and 1, 2, 3 and 7 days after surgery and on discharge from hospital.The postoperative joint recovery time, length of hospital stay and satisfaction were recorded in two groups. Results: Compared with group C, the numeric rating scale scores were significantly decreased at 4 h and 1, 2, 3 and 7 days after surgery and on discharge from hospital, the postoperative joint recovery time and length of hospitalization were shortened, and the degree of satisfaction was increased in group T (P<0.05). Conclusion Multidisciplinary cooperative pain management can effectively promote the rapid recovery of patients with total hip and total knee replacement.

Objective To evaluate the effect of wireless wearable intelligent body temperature monitoring system on temperature monitoring of perioperative patients. Method The body temprature of 572 patients with abdoiminal surgery who hospitalized in our hospital from June 2017 to Juanuary 2018 was measured by mercury thermometers and wireless intelligent body temprature monitoring system four times a day for three days with toally 6864 times after surgery.The measured time and data by both ways were compared and its relativity were analyzed. Results The measured data by mercury thermometers and wireless intelligent body temprature monitoring system was compared with no statistical significance (P>0.05), but the time measured by wireless intelligent body temprature monitoring system was shorter (P＜0.05). The measured data of two ways was postively related (r=0.962,P＜0.05). Conclusions The measurement results by the wireless wearable intelligent body temperature monitoring system are the same as by mercury thermometers. The accuracy of the system is well validated, and it can improve the working efficiency of nurses.

Objective To study if IRF1 could regulate the polarization by IRF 1 and M1 status and affect M1 media-ted antitumor function .Methods U937 derived M1 macrophage ( U937-M1 ) model was established .The cells were devided into 4 groups:the PMA pretreated unpolarized macrophage (M0), the PMA, IFN-γand LPS induced M1 macrophage (M1), the siRNA of IRF1 knocked down M1 macrophage (siIRF1) and the negative control siR-NA treated M1 macrophage (siC).Furthermore, the expression of CD86 and CD206 was detected by flow cytome-try, the M1/M2 associated markers (IL-12p35,IL-12p40,IL-23p19,IL-6,TNF-α/IL-10) and IFNB1 were ana-lyzed by qPCR,the expression of IL-12p70 and IL-10 was examined by ELISA, the expression of IRF1 and IRF5 was detected by Western blot , the proliferration and apoptosis of HCC were analyzed by CCK 8 and flow cytometry , respectively.Results Compared with the U937-M1, the IRF1 knocked down group showed impaired CD 86 expres-sion, but enhanced CD206 expreesion ( P<0.05 ); the expression of M1 related cytokines including IL-12p35, IL-12p40,IL-23p19,IL-6,TNF-αand IFNB1 was decreased, but M2 related cytokine IL-10 level was increased (P<0.01);the expression of IFN-β, IL-12p70 and IRF5 was impaired, but IL-10 was enhanced (P<0.05).In IRF1 knocked down U937-M1, the CCK8 analysis indicated that the M1 mediated anti-proliferation effects on hepatoma carcinoma cell were turned to pro-proliferation ( P<0.05);the flow cytometry showed that the M 1 mediated pro-ap-optosis effects were reversed to anti-apoptosis ( P<0.01 ) .Interestingly , IRF5 and IFN-βwere decreased at both mRNA and protein levels in IRF1 knocked down U937-M1 compared with the U937-M1 (P<0.01).Conclusions IRF1 may partly modulate IRF5 and IFN-β, and further regulate M1 polarization and its antitumor effects .

Objective The risk of ovarian/pelvic serous cancer can be reduced by prophylactic bilateral salpingectomy ( PBS) at the time of hysterectomy .This study was to evaluate the short-term influence of PBS plus hysterectomy on ovarian reserve in premenopausal women . Methods We retrospectively analyzed the clinical data about 60 premenopausal women treated by total lapa-roscopic hysterectomy ( TLH) for benign indications , 30 undergoing PBS at the same time ( the experimental group ) while the other 30 with the ovary preserved ( the control group ) .We compared the levels of FSH, LH, E2, and anti-Müllerian hormone ( AMH) and the inci-dence of peri-menopausal symptoms between the two groups of patients before and at 1 and 3 months after operation . Results Statistically significant differences were not observed between the two groups in the such baseline clinical characteristics as age , gravidity, parity, men-strual cycle, comorbidity, diagnosis, comorbidities, and history of abdominal surgery (P>0.05), nor in the AMH level at the baseline ([1.08±0.08] vs [1.04±0.10] ng/mL) or at 1 month ([0.86± 0.44] vs [0.81±0.48] ng/mL) or 3 months postoperatively ([0.84±0.94] vs [0.68±0.42] ng/mL) (F=0.247, P=0.746).Howev-er, the mean level of AMH was markedly reduced at 1 and 3 months after operation as compared with the baseline ( P<0.05) , though with no significant difference between 1 and 3 months ( P>0.05) .There were not any statistically significant differences in the levels FSH, LH, and E2 between the two groups before or at 1 and 3 months after surgery (P>0.05), nor in the incidence rates of peri-menopausal symptoms at 1 month (6.7%vs 3.3%, P>0.05) or 3 months postoperatively (10.0%vs 6.7%, P>0.05). Conclusion PBS at the time of total hysterectomy in premenopausal women does not affect ovarian reserve in the short term .The level of AMH has a higher sensitivity than those of FSH , LH and E2 in the assessment of postoperative ovarian function .

Depression,which is a common mental disorder with complex causes,has been a disease with high morbidity and mortality rate.The theory of neurobiochemistry,which is highly appreciated by clinical pharmacology,is used to illuminate the pathogenesis of depression.The theory shows that neurotransmitter imbalance is one of the important factors for depression.Chinese materia medica (CMM) and its extract,as well as Chinese medicine compound have unique advantages with little side effect,multicomponent,multiple target point and multi-effect in anti-depression treatment.In this study,we mainly reviewed the research progress of CMM and its compound in regulating neurotransmitter,which will provide scientific basis for the clinical application of CMM in anti-depression treatment.

Objective To evaluate the influence of SOCS3 conditional ablation in macrophage polarization and functional recovery after spinal cord injury in mice.Methods The Socs3fVfl Nes cre mice were used to obtain nervous-system-restricted SOCS3 deletion models as experimental group (n=40),and littermate Socs3fl as control group (n=40).Mice (n=35) in each group were underwent T10 spinal cord compressing injury (the left 5 were as sham-operated controls);on the third,7th and 14th d of injury,injured tissues from 15 mice of each group were harvested;immunofluorescence was performed to detect the changes of M2a and M2c phenotypic marker Arginase1 and M1 and M2b phenotypic marker CD86;on the first,third,7th and 14th d of injury,injured tissues from the left 20 mice from each group were harvested;fluorescent quantitative real time-PCR was used to detect the macrophage phenotypic markers (Arginasel,CD206,iNOS and CD32),SOCS3 and STAT3 gene expressions;the above data from the sham-operated controls were used as base data.BMS scale was used to evaluate the motor functions of posterior limbs and bodies on the first,third,7th and 14th d of injury.Results The behavioral assessments of the experimental group were superior on the third,7th and 14th d of injury as compared with those of control group (P＜0.05).Immunofluorescence showed that as compared with the controls,the Socs3fVfl Nes cre mice had a predominance in distribution and population of Arginasel-positive macrophages in spinal cords on the third,7th and 14th d of injury;in contrast,the control group showed superiority of CD86 expression on the 7th and 14th d,with significant differences (P＜0.05).Similarly,fluorescent quantitative real time-PCR analysis demonstrated that gene expression of A rginase I on the 7th d of injury,that of CD206 on the 7th and 14th d of injury,and that of STAT3 on the third,7th,and 14th d of injury were significantly increased,whereas that of CD32 on the 14th d of injury and SOCS3 on the first and third d of injury were significantly reduced in the experimental group,as compared with those in the control group (P＜0.05).Conclusion SOCS3 conditional knockout can promote the formation of M2 macrophage,as well as good functional recovery after spinal cord injury in mice.

Objective To evaluate the alveolar bone thickness and root length changes of anterior teeth with cone-beam computed tomography(CBCT).Methods CBCT scans were taken for 12 skeletal Class Ⅲ patients who accepted the improved corticotomy(IC) procedures during pre-surgical orthodontics.The CBCT data in T1(the maxillary dental arch was aligned and leveled) and T2(extraction space closure) were superimposed and the alveolar bone thickness at root apex level and root length measurements were done.Results From T1 to T2,the buccal alveolar bone thickness for the upper lateral incisors increased from (1.89±0.83) to (2.47± 1.02) mm (P＜0.05),and for central incisors and for canines from (2.32±0.71) to (2.68 ± 1.48) mm and from (2.28 ± 1.08) to (2.41 ± 1.40) mm,respectively.According to Sharpe Grading System,the root resorption grade for 69 teeth of 72 was located in Grade 1,two teeth in Grade 2,one tooth in Grade 3.Conclusions The improved corticotomy had the potential to increase the buccal alveolar bone thickness and the root resorption in most teeth was in Grade 1 according to Sharpe grading system.

Objective:To investigate the clinical efficacy and immunological mechanism of herbal cake-partitioned moxibustion for aging process.Method:The herbal cake-partitioned moxibustion was adopted for 223 cases to observe the aging scores before and after the treatment.Apart from that,the T-lymphocyte subsets and changes of IL-2 and 3-EP were also detected.Results:After treatment,the aging scores of 223 cases were all substantially reduced,along with an improvement of clinical symptoms,a strengthened cellular immune function,and an increase of total T-lymphocyte count.In addition,the CD4+/CD8+ ratio Was restored normal,the synthesis or secretion of IL-2 was increased and the β-EP(as the neurotransmitter to modulate immune function)was substantially improved.Conclusion:The aging process is closely associated with the immune function.Moxibustion Can modulate abnormal immune function and stabilize homeostasis and thus delay the aging process.