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 application value of oral stimulation combined with maternal milk sucking in the pain caused by PICC in children with congenital digestive tract malformations.Methods:Using convenience sampling method, 80 children with congenital digestive tract malformations who were admitted to Hunan Children's Hospital from July 2018 to December 2019 were selected and divided into the experimental group and the control group of 40 cases in each group according to the random number table method. The control group was given routine nursing mode, while the experimental group was given oral stimulation combined with maternal milk sucking intervention on the basis of routine nursing. The intervention effects were evaluated by the Neonatal Infant Pain Scale (NIPS), the onset time of the first cry, the duration of crying, the onset time of the first painful face, the duration of the painful face, and indicators such as heart rate, respiratory rate and SpO 2. Results:The NIPS scores of children in the experimental group were (5.60 ± 1.24) and (4.10 ± 0.31) in the puncture period and the recovery period, which were significantly lower than those in the control group (6.10 ± 0.84), (4.93 ± 0.35), the differences were statistically significant (t = 2.12, 3.00, both P<0.05). The heart rate and respiratory rate of the children in the experimental group were (151.10 ± 12.37), (147.00 ± 12.16) times/min and (47.48 ± 7.59), (45.58 ± 6.51) times/min in the puncture period and the recovery period, which were significantly lower than those in the control group (159.75 ± 13.81), (156.05 ± 12.99) times/min and (52.38 ± 8.12), (49.75 ± 7.59) times/min, the differences were statistically significant (t values were 2.64-3.22, all P<0.05). The SpO 2 in the experimental group were 0.980 5 ± 0.009 0, 0.982 5 ± 0.010 8 in the puncture period and the recovery period, which were significantly higher than those in the control group 0.970 8 ± 0.014 2, 0.971 8 ± 0.018 1, the differences were statistically significant (t = 3.66, 3.23, both P<0.05). The onset time of the first cry, the duration of crying, the onset time of the first painful face, the duration of the painful face in the experimental group were (41.55 ± 6.38), (22.05 ± 4.47), (35.08 ± 5.94), (24.65 ± 5.46) s, significantly shorter than those in the control group (46.58 ± 5.26), (29.50 ± 6.48), (44.68 ± 13.31), (30.65 ± 9.42) s, the differences were statistically significant (t values were 2.63-5.98, all P<0.05). Conclusions:Oral stimulation combined with maternal milk sucking can effectively relieve the pain caused by PICC in children with congenital digestive tract malformation, and reduce the physiological stress response of children.

Objective To provide a powerful and conclusive result for the association between the GGN polymorphic repeats in androgen receptor (AR)gene and prostate cancer (PCa)risk.Methods CNKI,VIP,Wanfang,PubMed/Medline,Embase and The Cochrance Library electronic database were used to retrieve the eligible publications addressing the association between the AR gene GGN polymorphic repeats and prostate cancer risk.16 GGN polymorphism repeats were used as cut off value,meta-analysis was ap-plied to the study on the association between the length of polymorphism repeats and prostate cancer risk.Results 9 cases of con-trol studies were included in this meta-analysis and a total of 2 438 cases and 1 968 controls were included.People with ≤16 GGN polymorphism repeats displayed a higher risk of prostate cancer(OR =1.15,95%CI :1.00 -1.31,P =0.04).Conclusion ≤16 GGN polymorphism repeats polymorphism associated with increased risk of prostate cancer.

ObjectiveTo analyze the association of human urate transporter 1 ( hURAT1 ) gene promoter single-nucleotide polymorphisms(SNPs) with primary hyperuricemia ( HUA ) in Chinese Han people.MethodsA total of 215 patients with HUA and 323 healthy subjects were chosen to be investigated of SNP of hURAT1 promoter by PCR and sequencing.ResultsFive SNPs were identified,including-454A/T,-434T/C,-382C/T,-87C/T,and + 118G/A.Pairwise linkage disequilibrium analysis displayed a high linkage disequilibrium between the five SNPs ( r2 =0.99).In HUA group,the heterozygous genotypos ( AT,CT,CT,CT,AG ) frequencies were significantly lower than those in control group ( P＜0.05 ).Logistic regression analysis showed that the heterozygosis genotypes ( AT,CT,CT,CT,AG) were protective factors of HUA ( OR 0.68-0.75 ).The minor allele ( T,C,T,T,A ) frequencies for both SNPs were significantly different between two groups ( P =0.022,P =0.038 ).ConclusionThese findings indicate that -454A/T,-434T/C,-382C/T,-87C/T,and + 118G/A SNPs of hURAT1 gene promoter area are associated with HUA in Chinese Han population.

Objective To observe the effect of leukocytapheresis(LCAP)on the coagulation,fibrinolysis system and lung injury in the endotoxemia dog and explore the mechanism in the endotoxin-induced lung injury dog. Methods Endotoxemia-induced model in dogs was established by administration of lipopolysaccharide(LPS,2 mg/kg).Separation of the leucocytes wag performed with the automated continuous flow blood cell separators.A total of 30 male mongrel dogs were randomly divided into LPS group(group L,only injected with LPS,with no LCAP),sham LCAP group(group S,received sham LCAP at 12-14 hours after administration of LPS)and LCAP treatment group(group T,received LCAP at 12-14 hours after administration of LPS),10 dogs per group.The dynamic changes of the activated protein C(APC),soluble thrombomodulin and plagminogen activator inhibitor-1 in the serum were measured at 0 hour before LPS administration,at 2,6,12,14,16,24 and 36 hours after administration of LPS.Results Through LCAP,there found the following four results:(1) the APC level in the serum of the group T wag(50.805±4.422)μg/ml and(40.480±2.993)μg/ml at 14 hours and 16 hours respectively,which were significantly higher than(45.881±4.024)μml and(35.935±4.057)μg/ml in the group L(P<0.05).(2)The expressions of soluble thrombomadulin in the group T was (9.688±O.914)μml and(10.492±O.865)μg/ml at 14 hours and 16 hours respectively,which was statistically lower than(11.005±0.854)μg/ml and(12.04±0.954)ug/ml in the group L(P<0.05).(3)Thelevel of plagminogen activatorinhibitor-1 in the group T was lower than that in the group the group T Wag statistically lower than that in the group L(ALI/ARDS occurred in 2 and 7 dogs of the groups T and L respectively within 36 hours after infusion of LPS.P<0.05). Conclusions At the decrease the incidence of acute lung injury partly due to its role in improving the function of coagulation and fibrinolysis.

Objective To investigate the influence of passive smoking during pregnancy on the ability of cognitive and behavior of attention-deficit hyperactivity disorder (ADHD) children. Methods 92 ADHD children with passive smoking during pregnancy,99 cases without passive smoking and 100 cases normal children were selected. Their abilities of cognitive and behavioral were evaluated by intelligence test, Wisconsin card sorting test and Stroop test. Results The verbal intelligence quotient ( VIQ), performances intelligence quotient (PIQ) and the full intelligence quotient (FIQ) of ADHD children were significantly lower than normal children, especially for the ADHD children with passive smoking during pregnancy. Compared to the normal children,the ADHD children showed significant difference in the time of reading card A, B,C and reading errors of card B,C,especially for the ADHD children with passive smoking during pregnancy. Compared to the normal children, the ADHD children showed significantly more in the scores of responses errors, perseverant responses, perseverant errors, perseverant errors percentage and non-perseverant errors, and lower in conceptualization plane, especially for the ADHD children with passive smoking during pregnancy. Conclusion The defect of the ability of cognitive and behavior of attention-deficit hyperactivity disorder children were the worse for passive smoking during pregnancy.

Objectlve:To assess the influential factors of decision-to-delivery inteval (DDI) in caesarean section, and its influence on neonatal outcomes.Methods:472 caesarean sections were divided into two groups according to Lucas's classification :the emergency caesarean sections as group 1 (291) ; and the e-lective caesarean sections as group 2 (181).It was divided into DDI ≤30 min group and DDI > 30 mir group in group 1.A retrospective study was performed in DDI, influential factors of DDI, neonatal Apgar score and umbilical arterial blood gas.Results: ①The mean DDI was 35.5±11.6 min in group 1,in wgich DDI≤30 min was 210 cases (72.2%) and 49.3 ±22.8 min in group 2, in which DDI≤30 min was 86 cases (47.5%).②IN group 1,umbilical artery pH and Apgar core at 1 min after birth could be improved sigbificantly in the cases of DDI ≤ 30 min (P<0.05) , but no correlation was found between the DDI and Apgar scrore at 5 min ,as compared with DDI ＞30MIN CASES(p＞0.05).③It was mainly influenced by time taken to get the patient into operation room in DDI >30 min (56 cases, 69.1 %).Concluslons :The recommended DDI ≤30 min is not routinely achieved even in emergency caesarean sections.Shortening DDI as far as pos-sible might improve the neonatal outcome.

Objective To develop the Chinese version of multidimensional measure for recurrent ab-dominal pain scale(MM-RAP) and test the reliability and validity of it. Methods The Chinese version of MM-RAP was translated and revised and 100 children with recurrent abdominal pain and their parents were surveyed by it. Then the reliability and validity of the scale was tested. Results The teat-retest reliability coefficient of MM-RAP was 0.86. The total Cronbach's coefficient α of the scale was 0.80. Cronbach's coef-ficient α of each dimensions was above 0.70. The results of correlation analysis showed that there was higher correlation between items and its belonged dimensions than that with other dimensions. The results of confir-matory factor analysis indicated the factor structure was similar with the theoretical construction of the in-strument. Conclusions The Chinese version of MM-RAP demonstrated good reliability and validity and was an effective assessment instrument for measuring recurrent abdominal pain of Chinese children.

Objective　To investigate the role of β-endorphin (β-EP) in conA-induced spleen cell proliferation after traumatic hemorrhagic shock. Methods　①Wistar rats with traumatic hemorrhagic shock were used and killed 0, 1, 3, 6,12 and 24 h after traumatic hemorrhagic shock. Plasma specimens were collected and β-EP levels in plasma were detected. Rats with sham-operation served as the control. ②Spleen cells isolated from normal rats were cultured in shock plasma (group Ⅰ), inactivated shock plasma (group Ⅱ) and shock plasma+β-EP antiserum (group Ⅲ) respectively. Con A-induced spleen cell proliferation was observed. Results　①The plasma β-EP level was elevated significantly immediately after shock, and reached the peak 1 h later, then showed a deceasing tendency and restored to the level as before shock at 24 h. ②Shock plasma remarkedly suppressed spleen cell response to the mitogen conA (P<0.01) compared with control; ConA-induced spleen cell proliferative function in group Ⅱ was significantly increased than that in group Ⅰ (P<0.01), so did in group Ⅲ, which still lower than in control. Conclusion　The significantly elevated β-EP in the plasma after hemorrhagic shock might play an important role in inhibiting the proliferation of spleen cells.

Objective: To explore the relationship between interpersonal forgiveness and revenge and some influential factors in college students. Methods: Rumination Scale,Empathy Scale, Tendency to Forgive Scale and Revenge Motivation Scale were administered to 194 college students. Results and Conclusion: ① There were significant gender differences in the degree of seeking revenge and rumination. ② Most of interpersonal transgression indeed happened between fellow students. ③ Correlation analysis showed significantly negative correlation between forgiving and hurtfulness, revenge motivations, rumination, and between revenging and tendency to forgive, empathy; and positive correlation between forgiving and empathy and between revenging and revenge motivation, hurtfulness. Further regression analysis revealed that revenge motivations, rumination and empathy were significant negative predictors of forgiving; hurtfulness and revenge motivations were significant positive predictors of revenging.