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 analyze the incidence and epidemiological characteristics of traumatic spinal cord injury in China in 2018.Methods:Multi-stage stratified cluster sampling was used to randomly select hospitals capable of treating patients with spinal cord injury from 3 regions，9 provinces and 27 cities in China to retrospectively investigate eligible patients with traumatic spinal cord injury admitted in 2018. National and regional incidence rates were calculated. The data of cause of injury，injury level，severity of injury，segment and type of fracture，complications，death and other data were collected by medical record questionnaire，and analyzed according to geographical region，age and gender.Results:Medical records of 4，134 patients were included in this study，with a male-to-female ratio of 2.99∶1. The incidence of traumatic spinal cord injury in China in 2018 was 50.484 / 1 million （95% CI 50.122-50.846）. The highest incidence in the Eastern region was 53.791 / 1 million （95% CI 53.217-54.365）. In the whole country，the main causes of injury were high falls （29.58%），as well as in the Western region （40.68%），while the main causes of injury in the Eastern and Central regions were traffic injuries （31.22%，30.10%）. The main injury level was cervical spinal cord in the whole country （64.49%），and the proportion of cervical spinal cord injury in the Central region was the highest （74.68%），and the proportion of lumbosacral spinal cord injury in the Western region was the highest （32.30%）. The highest proportion of degree of injury was incomplete quadriplegia （55.20%），and the distribution pattern was the same in each region. A total of 65.87% of the patients were complicated with fracture or dislocation，77.95% in the Western region and only 54.77% in the Central region. In the whole country，the head was the main combined injury （37.87%），as well as in the Eastern and Central regions，while the proportion of chest combined injury in the Western region was the highest （38.57%）. A total of 32.90% of the patients were complicated with respiratory complications. There were 23 patients （0.56%） died in hospital，of which 17（73.91%） died of respiratory dysfunction. Conclusions:The Eastern region of China has a high incidence of traumatic spinal cord injury. Other epidemiological features include high fall as the main cause of injury cervical spinal cord injury as the main injury level，incomplete quadriplegia as the main degree of injury，head as the main combined injury，and respiratory complications as the main complication.

The nephrotoxicity of Chinese materia medica (CMM) can’t be ignored so that it needs effective monitor and prevention. Recently, the determination of biochemistry and pathology indexes is the most important means of research with low sensitivity and trauma. In recent years, metabolomics has shown broad prospects in CMM nephrotoxicity studies due to its systematic advantages, and also achieved remarkable success. However, large clinical sample studies are still needed to realize the clinical transformation of research results. Thus, the application of metabolomics in the toxicology, assessment biomarkers and mechanism of CMM nephrotoxicity are reviewed in this paper, in order to provide references for further research.

Objective To compare the early clinical efficacy of unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA) for elderly patients with medial compartmental knee osteoarthritis.Methods A total of 35 elderly patients with medial compartmental knee osteoarthritis were selected from September 2014 to March 2018 in our hospital, of whom 16 cases treated by UKA were observation group and 19 cases treated by TKA were control group.ResultsThe operation time, intraoperative blood loss, the rate of perioperative blood transfusion, postoperative drainage volume and hospitalization stays of observation group were less than those of control group, the difference were significant (P＜0.05).Before the treatment, there was no significant differences in the KSS score between two groups (P＞0.05).After the treatment, KSS scores of two groups had been improved to some extent, and the observation group was better than the control group, the difference was significant (P＜0.05).No revision or infection happened in 1 year post-operative follow-up of either group.The observation group (0) were less than the control group (26.32％) in thrombosis rate, the difference was significantly (P＜0.05).ConclusionBoth UKA and TKA have certain early clinical efficacy, but UKA had advantages such as shorter operation time, shorter hospitalization, less pain, lower incidence of adverse reaction, which can promote the postoperative function recovery, the early clinical efficacy is more significant.

Laser induced breakdown spectroscopy ( LIBS ) was proposed to rapidly discriminate microbe species. Ten species of microbes were prepared in lab. Filter papers were selected as substrate for enriching bacteria and enhancing the quality of LIBS. The images of plasma were collected by ICCD camera and LIBS spectra were obtained by spectrometers. The results displayed that the images and spectra were different from 10 bacteria. It was demonstrated that this method was feasible to discriminate bacteria species by analyzing image and/or spectroscopy. Furthermore, nine smooth and multiple scattering correction ( MSC) were utilized to preprocess the LIBS full-spectrum data in the wavelength range of 200-420 nm and 560-680 nm. And principal component analysis ( PCA) and PCA-RF ( Random forest) were compared to validate the accuracy of discrimination. The investigation showed that the PCA-RF model coupled with suitable methods in preprocessing data could identify bacteria. The accuracy was 99. 6% for ten species of microbes by evaluating LIBS spectra in training set, and 96. 7% in predicting set. This report indicated that it is feasible to differentiate bacteria species by analyzing LIBS spectra.

Objective To compare the genetic diversity of imported Plasmodium falciparum by Polyα and TAA87 microsatellite markers in Southeast Asian and African geographical isolates. Methods Ninety-two and 126 filter paper samples from patients infected with P. falciparum from Southeast Asia (Myanmar) and Africa (Ghana) were collected, respectively. Two neutral microsatellite loci, Polyα and TAA87 were amplified by PCR. The length of PCR fragments was detected by capillary electrophoresis. The allele frequency and expected heterozygosity (He) were calculated by Excel 2010 and GenALEx 6.0 software. Results A total of 146 P. falciparum samples were analyzed as single infection samples with a total of 26 alleles in locus Polyα and 12 alleles in locus TAA87. The mean He value of the two loci was 0.86 ± 0.02. Ten alleles in locus Polyα and 8 alleles in locus TAA87 were distributed in Myanmar isolates, with the He values of 0.86 and 0.81 respectively. Fifteen alleles in locus Polyα and 11 in locus TAA87 were detected in Ghana isolates, with the He values of 0.91 and 0.86 respectively. In addition, the haplotype of 174 bp (Polyα) and 113 bp (TAA87) were only detected in Myanmar isolates with more than 17% gene frequency, whereas they were absent in Ghana isolates. Conclusions The two different geographical sources of imported P. falciparum strains have different allele frequencies and haplotypes at the two neutral microsatellite markers, Polyα and TAA87. Therefore, these two microsatellite loci may be considered as the potential molecular marker candidates for identifying P. falciparum strains with different geographical sources.

Objective To study the impact of earthquake disasters on the mental health of military medical personnel during emergency rescue. Methods Three hundred military medical personnel who participated in the emergency rescue of earthquake disasters in five military hospitals in Shaanxi Province were selected as the study subjects, and their mental health levels were analyzed using the Mental Symptom Checklist 90 (SCL-90). Results In this survey, a total of 300 SCL-90 questionnaires were issued, 300 were recovered, and the effective recovery rate was 100%. Only 30.67%(92/300) of people participated in emergency disaster rescue during investigation, 31.33% (94/300) had psychological problemsafter arriving in the earthquake-stricken area after one week, such as somatization, obsessive-compulsive disorder, anxiety, and horror. SCL-90 scores were 0.45±0.03, 1.13±0.13, 0.79 ±0.08, 1.07±0.09, 1.01±0.14. The psychological stress response rates of the emergency response of military medical staff of different characteristics were different. Among them, the stress response rates of military personnel with different degrees (specialty, bachelor or above) and whether they have participated in rescue work were 74.07% (40/54), 21.95% (54/246), 15.22% (14/92), 38.46% (80/208).The difference was statistically significant (χ2=55.913,16.018, P<0.01). Conclusions The medical staff of the army participating in the earthquake disaster rescue has psychological pressure due to many injuries, environmental risks, lack of supplies, etc. The medical unit should provide adequate training in theory and practice to its personnel and focus on the mental health of rescue workers, give timely psychological counseling to ensure the successful completion of the rescue.

The paper takes literature in the Health Technology Assessment (HTA) field in Web of Science and " China Academic Journal Network Publishing Database" as its study subject,draws scientific knowledge map with EXCEL,CiteSpace on data like high-frequency keywords and burst terms and analyzes study hotspots and evolution trend.It suggests that HTA theoretical system be perfected,study be converted into demonstration and study cooperation be strengthened to promote study and development of China's HTA.

Objective To study the effects of micro-capsule on the secretion capacity of insulin-producing cells(IPCs). Methods Stem cells from originate mouse bone marrow mesenchymal were isolated,induced and purified. Rat pancre-atic extract(RPE)was extracted from pancreases of rats.BMMSCs were induced by rat pancreatic extract. The induced cells were randomly divided into micro-encapsulated group and non-micro-encapsulated group.The experiment of glu-cose stimulation was performed to detect the level of insulin,respectively, at different time points (1, 2, 3, 5, 10, 15, 20, 25, 30 day).Results The level of insulin secretion was increased after 1, 2, 3, 5 days of culture in micro-encapsu-lated IPCs and non-micro-encapsulated IPCs,but there were no significantly differences among the groups. The level of insulin secretion was declined in non-microencapsulated IPCs at 10 day,while there was no decreased in micro-en-capsulated IPCs until 20 days. Conclusion The micro-capsule can promote the effect duration of IPCs,which supports the function of IPCs.