Objective To investigate the relationship between the changes in P(cv-a)CO?/C(a-cv)O? ratio and hypoxic states in patients with hemorrhagic shock after effective fluid resuscitation.Methods Thirty hemorrhagic shock patients who were admitted to ICU Dongguan Eighth People's Hospital from October 1,2021 to November 30,2023 were selected as research objects.All the patients underwent early fluid resuscitation.Arterial and central venous blood gas analysis was performed,and arterial lactate concentration was measured before resuscitation,and at 2 h,6 h,12 h,and 24 h after resuscitation.The P(cv-a)CO2/C(a-cv)O2,the gradient of P(cv-a)CO2/C(a-cv)O2,and lactate clearance rate were calculated.Results There was a positive correlation between the P(cv-a)CO?/C(a-cv)O? ratio and lactate concentration,as well as between the gradient of P(cv-a)CO?/C(a-cv)O? and lactate clearance rate at each time point(P<0.05).There were significant differences in the P(cv-a)CO?/C(a-cv)O?,gradient of P(cv-a)CO?/C(a-cv)O?,and lactate clearance rate after resuscitation among patients with different prognoses(P<0.05).Conclusion The P(cv-a)CO2/C(a-cv)O2 and its change rate,as well as lactate clearance rate,can predict the prognosis of patients with hemorrhagic shock.

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.

Traumatic rib fractures are the most common injury in thoracic trauma. Previously，the patients with traumatic rib fractures were mostly treated non-surgically，of which 50%，especially those combined with flail chest presented chronic pain or chest wall deformities and over 30% had long-term disabilities，being unable to retain a full-time job. In the past two decades，thanks to the development of internal fixation material technology，the surgical treatment of rib fractures has achieved good outcomes. However，there are still some problems in clinical treatment，including inconsistency in surgical treatment and quality control in medical services. The current consensuses on the management of regional traumatic rib fractures published at home and abroad mainly focus on the guidance of the overall treatment decisions and plans，and relevant clinical guidelines abroad lacks progress in surgical treatment of rib fractures in recent years. Therefore，the Chinese Society of Traumatology affiliated to Chinese Medical Association and Chinese College of Trauma Surgeons affiliated to Chinese Medical Doctor Association，in conjunction with national multidisciplinary experts，formulate the Chinese Consensus for Surgical Treatment of Traumatic Rib Fractures（2021）following the principle of evidence-based medicine，scientific nature and practicality. This expert consensus puts forward some clear，applicable，and graded recommendations from aspects of preoperative imaging evaluation，surgical indications，timing of surgery，surgical methods，rib fracture sites for surgical fixation，internal fixation methods and material selections，treatment of combined injuries in rib fractures，in order to provide references for surgical treatment of traumatic rib fractures.

Adolescent ; Decision Making ; Emotions ; Humans

Objective:To analyze the effectiveness and safety of assisted reproductive technology in the fertility needs of female patients with malignant tumors.Methods:A total of 37 female malignant tumor patients (case group) who underwent adjuvant reproductive therapy in Fujian Provincial Maternity and Children's Hospital from 2013 to 2018 were enrolled. Totally 74 non-tumor patients were matched as control group according to age and egg retrieval time using a 1：2 matching method. By analyzing the demographic data and the first pregnancy data, the clinical pregnancy rate and the implantation rate of the first transplant cycle were calculated, and the pregnancy outcomes of case group and control group were evaluated.Results:There was no significant difference in the demographic data between the two groups. There was no significant difference in the basic follicle-stimulating hormone (FSH) level, basic luteinizing hormone (LH) level, estradiol and progesterone levels on human chorionic gonadotropin (hCG) injection day during the first treatment period ( P>0.05). The differences of total amount of gonadotropin (Gn) used [(1 984.93±756.79) IU vs. (2 610.59±988.52) IU, P=0.001], duration of Gn used [(9.68±2.57) d vs. (11.64±2.47) d, P<0.001], high-quality embryo rate (49.56% vs. 58.94%, P=0.016) and the number of embryos transferred (1.4±0.5 vs. 1.8±0.4， P=0.001) between case group and control group were statistically significant. There was no significant difference in the clinical pregnancy rate and the implantation rate between the two groups ( P>0.05). Cumulative pregnancy rate, cumulative live birth rate, the number of egg retrieval cycles per live birth, the number of transplant cycles, the number of embryos, and the number of high-quality embryos were not statistically significant ( P>0.05). Tumor patients receiving assisted reproductive assistance have not been found so far recurrence or new tumor. Conclusion:Compared with control group, the pregnancy outcomes after assisted reproductive technology in female malignant tumor patients were not significantly different. Assisted reproductive technology can fulfill the fertility needs of female malignant tumors after surgery and is safety.

Objective:To analyze the effectiveness and safety of assisted reproductive technology in the fertility needs of female patients with malignant tumors.Methods:A total of 37 female malignant tumor patients (case group) who underwent adjuvant reproductive therapy in Fujian Provincial Maternity and Children's Hospital from 2013 to 2018 were enrolled. Totally 74 non-tumor patients were matched as control group according to age and egg retrieval time using a 1：2 matching method. By analyzing the demographic data and the first pregnancy data, the clinical pregnancy rate and the implantation rate of the first transplant cycle were calculated, and the pregnancy outcomes of case group and control group were evaluated.Results:There was no significant difference in the demographic data between the two groups. There was no significant difference in the basic follicle-stimulating hormone (FSH) level, basic luteinizing hormone (LH) level, estradiol and progesterone levels on human chorionic gonadotropin (hCG) injection day during the first treatment period ( P>0.05). The differences of total amount of gonadotropin (Gn) used [(1 984.93±756.79) IU vs. (2 610.59±988.52) IU, P=0.001], duration of Gn used [(9.68±2.57) d vs. (11.64±2.47) d, P<0.001], high-quality embryo rate (49.56% vs. 58.94%, P=0.016) and the number of embryos transferred (1.4±0.5 vs. 1.8±0.4， P=0.001) between case group and control group were statistically significant. There was no significant difference in the clinical pregnancy rate and the implantation rate between the two groups ( P>0.05). Cumulative pregnancy rate, cumulative live birth rate, the number of egg retrieval cycles per live birth, the number of transplant cycles, the number of embryos, and the number of high-quality embryos were not statistically significant ( P>0.05). Tumor patients receiving assisted reproductive assistance have not been found so far recurrence or new tumor. Conclusion:Compared with control group, the pregnancy outcomes after assisted reproductive technology in female malignant tumor patients were not significantly different. Assisted reproductive technology can fulfill the fertility needs of female malignant tumors after surgery and is safety.

OBJECTIVE:To investigate the inhibitory effects mechanism of scallop skirt glycosaminoglycan(SS-GAG)on inju-ry in human umbilical vein endothelium cells (HUVEC). METHODS:In the test,there was a negative control group,a model group and the groups of SS-GAG at high,middle and low concentrations(mass concentrations of 200,100 and 50 mg/L respective-ly). The cells in latter 3 groups were cultured in SS-GAG at different mass concentrations for 12 h,and then in 50 μmol/L oxidized low-density lipoprotein(OX-LDL)for 24 h. MTT method was used to detect cell viability and the activity of lactic dehydrogenase (LDH),the flow cytometer to determine the level of reactive oxygen species (ROS),real-time fluorescence quantitative poly-merase chain reaction (RT-PCR) to detect mRNA expression of lectin-like oxidized low-density lipoprotein receptor 1 (LOX-1), and Western blot to detect NOX4 protein expression. RESULTS:Compared to the cells in the negative control group,those in the model group demonstrated lower viability,higher activity of LDH,higher level of ROS,and stronger expressions of LOX-1 mRNA and NOX4 protein. There was statistical significance (P<0.01). Compared to the cells in the model group,those in the groups of SS-GAG at high,middle and low concentrations showed higher viability,lower activity of LDH,lower level of ROS and weaker expressions of LOX-1 mRNA and NOX4 protein. There was statistical significance (P<0.01). CONCLUSIONS:SS-GAG can protect HUVEC to some degree by a mechanism which may be related to inhibiting ROS production via LOX-1/NOX4 pathway and relieving oxidative stress injury.