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.

BACKGROUND: Gastric cancer (GC) is one of the most globally prevalent cancers in the world. The pathogenesis of GC has not been fully elucidated, and there still lacks effective targeted therapeutics. The influence of altered kinesin superfamily protein 22 (KIF22) expression in GC progression is still unclearly. The aim of this study was to investigate the KIF22 effects on GC and related mechanisms. METHODS: Gastric carcinoma tissues and matching non-cancerous tissues were collected from patients with GC who have accepted a radical gastrectomy in Lanzhou University Second Hospital from May 2013 to December 2014. The expression of KIF22 was examined in GC of 67 patients and 20 para-carcinoma tissues by immunochemical staining. The relationship between the expression of KIF22 and clinicopathologic characteristics was next investigated in the remaining 52 patients except for 15 patients who did not complete follow-up for 5 years. Cell viability was performed via 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide (MTT) test and colony formation assay in the MGC-803 and BGC-823 GC cells. Cell scratch and trans-well invasion assay was performed to assess migration ability in the MGC-803 and BGC-823 GC cells. Gene set enrichment analysis (GSEA) pathway enrichment analysis was performed to explore the potential functions. Cell cycle was detected by flow cytometry. In addition, the two GC cell lines were used to elucidate the underlying mechanism of KIF22 in GC in vitro via assessing the effects on mitogen-activated protein kinase and extracellular regulated protein kinases (MAPK/ERK) signal transduction pathway-related expressions by Western blotting assays. The differences were compared by t tests, one-way analysis of variance, and Chi-squared tests. RESULTS: The study showed that KIF22 was up-regulated in GC, and KIF22 high expression was significantly related to differentiation degree (χ = 12.842, P = 0.002) and poorly overall survivals. GSEA pathway enrichment analysis showed that KIF22 was correlated with the cell cycle. Silence of KIF22 decreased the ability of the proliferation and migration in gastric cells, induced G1/S phase cell cycle arrest via regulating the MAPK-ERK pathways. CONCLUSIONS KIF22 protein level was negatively correlated with prognosis. KIF22 knockdown might inhibit proliferation and metastasis of GC cells via the MAPK-ERK signaling pathway.

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 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 explore the effects of setting up the post of psychological care nurses on improving the high quality nursing service. Methods According to utilization rate of beds, two or more professional psychological care nurses were employed in every clinical departments of our hospital. After professionally systematic training, a psychological nursing care model based on psychological care nurses and other auxiliary nurses was established. The patients′ physiological status and nursing care satisfaction were evaluated with Mental Status Scale in Non-psychiatric Settings ( MSSNS) and psychological nursing satisfaction questionnaire before and after psychological intervention. Results After the professional psychological care intervention, the patients′ negative emotions and nursing care satisfactions were improved significantly. The differences before and after the intervention were statistically significant (P < 0. 05). Conclusions The effective psychological nursing care model, lead by psychological care nurses, can improve patients′psychological comfort and nursing care satisfactions.

Objective To introduce the method and experience of the setting of psychological care nurses,to discuss its effect on high-quality nursing and on amelioration of the patients' negative moods.Methods Psychological care nurses were set up in all the clinical departments,after systemic training of psychological knowledge and became qualified psychological consultant via national certification examination.We took psychological care nurses as the leading role,assisted with other nursing modes.By the means of mental status scale in non-psychiatric settings (MSSNS) and the satisfaction questionnaire of psychological care to evaluate the patients' mental status and satisfaction degrees before and after the intervention in 297 cases.Results Patients'scores of anxiety scale,depression,anger,loneliness factor and the total score of the MSSNS after the psychological nursing intervention were significant differences than those before the psychological nursing intervention,[(39.66±4.70)vs (45.59±6.45),(23.31±2.28)vs (26.59±3.35),(13.91 ±3.01) vs (15.12±2.58),(17.58±3.74)vs (20.29 ±4.67),(92.09±6.85)vs (106.66±8.58),t values was 14.376,15.213,23.992,13.974,13.641 respectively,P＜0.05].The satisfaction rate of patients for psychological nursing intervention after the intervention was 96.97％(288/297),which was significant higher than that before the intervention,69.70％(207/297),x2=79.53,P＜0.05.Conclusions Psychological care demands professional qualities.Only through systemic training,can grasp the nurses master professional psychological knowledge and skill,so as to apply scientific psychological care to the patients and help them to solve their psychological perplexities and maintain physical and psychological well-beings.

Objective To develop a diagnosis model for active pulmonary tuberculosis. Methods The proteomic fingerprinting of 264 sera from active tuberculosis patients and controls were analyzed using the surface-enhanced laser desorption ionization time of flight mass spectrometry (SELDI-TOF-MS) and protein-chip technology. The peaks were detected and filtrated by Ciphergen PrnteinChip(R) Software (version 3.1.1). Using the Biomarker Pattern 5.0 software, a diagnostic model was developed for diagnosis of active tuberculosis. Re-sults Fifty protein peaks were significantly different between the patients with active pulmonary tuberculosis and the controls with overlapping clinical features (P<0.01). Five protein peaks at 4360, 3311, 8160, 5723, 15173 m/z were chosen for the system classifier and the development of diagnosis model 1. The model differenti-ated the patients with active pulmonary tuberculosis from the controls with a sensitivity of 83.0%, and a speci-ficity of 89.6%. The diagnostic accuracy was up to 86.4%. Three protein peaks at 5643, 4486, 4360 m/z were chosen for the system classifier and the development of diagnosis model 2. The model differentiated the pa-tients with active pulmonary tuberculosis from the controls with a sensitivity of 96.9%, and a specificity of 97.8%. The diagnostic accuracy was up to 97.3%. Conclusion It might be a new diagnostic test for the de-tection of sera from the patients with active pulmonary tuberculosis using SELDI-TOF-MS and protein chip.

Objective: To investigate the mechanisms of moxibustion in the treatment of the colonic fibrosis in ulcerative colitis (UC) by observing the colonic fibroblast (CFB) synthesizing and secreting collagen in ulcerative colitis fibrosis rats. Methods: A rat model of ulcerative colitis fibrosis was established by immunological methods using human colonic mucosa as antigen adding local stimulation. The rats were randomly divided into normal group, model group, herb-partition moxibustion group, mild-warm moxibustion group and western medicine group (SASP group). Herb-partitioned moxibustion group and mild-warm moxibustion group treated by herb-partitioned moxibustion and mild-warm moxibustion respectively on Qihai (CV 6) and Tianshu (ST 25, bilateral) points. SASP group fed with salicylazosulfapyridine. Colonic fibroblasts from all the rats were isolated and cultured and the effects of moxibustion on the colonic fibroblast synthesizing and secreting type I, III, and IV collagen were observed. Results: The supernatant of cultured CFB from UC rats could stimulate the CFB of normal rats to secrete type I, III, and IV collagens. The supernatant from rats treated by herb-partitioned moxibustion and mild-warm moxibustion inhibited the secretion of type I , III, and IV collagens of CFB in normal rats. And the western medicine group also had some inhibiting effects on the type I and HI collagens. Conclusion: Moxibustion can regulate the functions of CFB synthesizing and secreting type I, III, and IV collagens in ulcerative colitis fibrosis rats.

102 cases of Tourette's syndrome were divided into three types of the liver and kidney yin deficiency, phlegm and damp blockage and spleen and stomach deficiency.Acupuncture, auricular-plaster therapy, cupping therapy and herbal medicine were combined to treat this syndrome. As a result, 30 cases were satisfactorily effective, 61 cases were improved and 11 cases were ineffective with a total effective rate of 98.2% and no side effects were noticed during treatment.