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.

Programmed cell death protein ligand-1(PD-L1)is an important immune checkpoint molecule that plays an important role in regulating the body's immune response.Several clinical studies have shown that the expression level of PD-L1 in tumors is closely related to the efficacy of immune checkpoint inhibitors.Due to the spatial and temporal heterogeneity of tumors,immunohistochemical methods commonly used in clinical practice cannot accurately and comprehensively reflect the ex-pression level of PD-L1 in patients.Given that nuclear-medicine molecular imaging technology can noninvasively,real-time,dy-namically and visually monitor the expression level of PD-L1 in vivo at the molecular level,this article mainly focuses on the re-search of peptide-based radiolabeled molecular probes targeting PD-L1,with the aim of providing guidance for the search of no-vel peptide molecular probes for immunoimaging as well as for the screening of immunotherapy-suitable patients and evaluation of therapeutic efficacy,and other clinical applications.

Objective To analyze the important abnormal results of physical examination of the staff in our hospital in recent 2 years,and to provide evidence for the health management of the staff in our hospital.Methods The physical examina-tion data of hospital staff in recent 2 years were retrospectively analyzed,and the important abnormal results were statistically ana-lyzed.Results A total of 3 584 employees participated in physical examination,including753 males and 2831 females.There were 92 cases with significant abnormal results,and the total detection rate was 2.57%.The detection rate of significant abnor-mal results was slightly lower in males(17cases,2.26%)than in females(75cases,2.65%),and the age of females[(48.89±19.53)years]was lower than that of males[(55.68±17.43)years].The age group with the most significant detec-tion rate of important abnormal results was 50-59 years old(3.07%),and the diseases detected by important abnormal results were as follows:There were 26 thyroid tumors,19 lung tumors,13 breast tumors,12 space occupying cases(3 liver,4 kidney,2 adrenal glands,1 adnexa,1 pancreas,1 mediastinum),9 vascular lesions,6 abnormal tumor markers,5 cervical lesions,1 tuberculosis,and 1 subdural hematoma.Among them,thyroid tumors,breast tumors,lung tumors and cervical lesions were the main cases in women,and vascular diseases,lung tumors,space-occupying lesions(liver and kidney)and thyroid tumors were the main cases in men.Conclusion Physical examination is of great significance in detecting important abnormal diseases.We should attach great importance to physical examination,detect serious diseases as early as possible,and strengthen health man-agement accordingly.

ObjectiveTo determine the death level and change trend of malignant tumors among residents in Yuyao， and to provide support for accurate prevention and control of malignant tumors. MethodsWe collected the death monitoring data of Yuyao registered residents from 2014 to 2021， and calculated the indicators， including crude mortality rate （CMR）， standardized mortality rate （SMR）， potential years of life lost （PYLL）， average years of life lost （AYLL）， and PYLL rate （PYLLR）. We also calculated the average annual change percentage （AAPC） using Joinpoint regression model. ResultsThere were 13 754 deaths from malignant tumors in Yuyao from 2014 to 2021， accounting for 26.54% of the total deaths in the same period. The average annual mortality rate was 205.63/10⁵， and the standardized mortality rate was 115.62/10⁵. The SMR showed a downward trend in 8 years （AAPC=-4.76%， t=-2.296， P=0.061）. The average annual mortality of malignant tumors was 274.15/10⁵， and the standardized mortality was 149.83/10⁵. The average annual mortality of female malignant tumors was 139.03/10⁵， the standardized mortality was 81.01/10⁵. Male mortality was higher than the female mortality （χ²=1 487.389， P<0.001）.The mortality rate of malignant tumors increased with age （AAPC=54.94%，t=27.678，P<0.001）. The mortality rate of malignant tumors in different age groups showed a downward trend in 8 years （AAPC=-5.74% for 0- years old group， -8.49% for 15- years old group， -6.02% for 45- years old group， and -3.49% for ≥65 years old group）. The top five causes of death from malignant tumors in residents were lung cancer， gastric cancer， liver cancer， esophageal cancer and colorectal cancer， accounting for 68.15% of all deaths from malignant tumors. Lung cancer ranked first among the causes of death from male and female malignant tumors. PYLL caused by malignant tumor death was 96 585.50 person years， AYLL was 7.02 years per person ， and PYLLR was 16.42‰. ConclusionThe mortality rate of malignant tumors among registered residents in Yuyao is on the decline， but it is still the primary death cause threatening the residents. Lung cancer is the malignant tumor that causes the greatest loss of life. It is urgent to build a comprehensive intervention system for malignant tumors that focuses on men， middle-aged and elderly people， advocate a healthy lifestyle， and combine early screening and reasonable treatment to block disease progress.

OBJECTIVE To prepare Neuritic acid oral emulsion ，to optimize its formulation and preparation technology ，and to investigate its stability. METHODS Neuritic acid oral emulsion was prepared by mechanical method. On the basis of single factor experiment ，the appearance ，centrifugal stability ，centrifugal stability constant （Ke）and particle size of the emulsion as indexes，the formulation was optimized by orthogonal design ，taking the dosage of oleic acid ，octylphenol polyoxyethylene ether-10 and propylene glycol as factors ，the preparation technology was optimized by taking emulsification temperature ，shear time，pressure of high-pressure homogenization and cycle times of high-pressure homogenization as factors. The content of neuritic acid was determined by high performance liquid chromatography. The stability of Neuritic acid oral emulsion was investigated by high temperature test ，accelerated test and long-term test. RESULTS The optimal formulation and preparation technology were as follows：neuritic acid of 1 g，oleic acid of 5％ ，octylphenol polyoxyethylene ether- 10 of 4％ ，propylene glycol of 2％ ， emulsification temperature of 60 ℃ ，shear time of 2 min，homogenization pressure of 40 MPa and cycle times of twice. After three experiments ，the average particle size of Neuritic acid oral emulsion was 158.05 nm（RSD＝1.58％，n＝3），the average Ke was 0.39（RSD＝1.49％，n＝3），and the appearance was uniform milky white ，there was no stratification. The results of high temperature test showed that Neuritic acid oral emulsion was prone to stratification in high temperature environment ，and the content of neuritic acid increased. The results of accelerated test and long-term test showed that there was no significant change in the appearance or the content of neuritic acid when Neuritic acid oral emulsion was placed at room temperature for 6 months. CONCLUSIONS The formulation and preparation technology are stable and feasible ，and can be used for the preparation of Neuritic acid oral emulsion. Neuritic acid oral emulsion should not be placed in high temperature environment. It has good stability at room temperature for 6 months.

Colorectal cancer (CRC) is the second most common cause of cancer-related death in the world. The pro-viral integration site for Moloney murine leukemia virus 1 (PIM1) is a proto-oncogene and belongs to the serine/threonine kinase family, which are involved in cell proliferation, migration, and apoptosis. Fibroblast growth factor receptor 1 (FGFR1) is a tyrosine kinase that has been implicated in cell proliferation, differentiation and migration. Small molecule HCI-48 is a derivative of chalcone, a class of compounds known to possess anti-tumor, anti-inflammatory and antibacterial effects. However, the underlying mechanism of chalcones against colorectal cancer remains unclear. This study reports that HCI-48 mainly targets PIM1 and FGFR1 kinases, thereby eliciting antitumor effects on colorectal cancer growth in vitro and in vivo. HCI-48 inhibited the activity of both PIM1 and FGFR1 kinases in an ATP-dependent manner, as revealed by computational docking models. Cell-based assays showed that HCI-48 inhibited cell proliferation in CRC cells (HCT-15, DLD1, HCT-116 and SW620), and induced cell cycle arrest in the G2/M phase through modulation of cyclin A2. HCI-48 also induced cellular apoptosis, as evidenced by an increase in the expression of apoptosis biomarkers such as cleaved PARP, cleaved caspase 3 and cleaved caspase 7. Moreover, HCI-48 attenuated the activation of downstream components of the PIM1 and FGFR1 signaling pathways. Using patient-derived xenograft (PDX) murine tumor models, we found that treatment with HCI-48 diminished the PDX tumor growth of implanted CRC tissue expressing high protein levels of PIM1 and FGFR1. This study suggests that the inhibitory effect of HCI-48 on colorectal tumor growth is mainly mediated through the dual-targeting of PIM1 and FGFR1 kinases. This work provides a theoretical basis for the future application of HCI-48 in the treatment of clinical CRC.

Objective:To investigate the clinical and pathogenic characteristics of community acquired pyogenic liver abscess (PLA).Methods:The clinical data of 172 patients in First Affiliated Hospital of Soochow University with community acquired PLA from March 2013 to September 2018 were retrospectively collected, including clinical characteristics, distribution of the causative pathogens, treatment regimens and outcomes. Chi-square test was used for statistical analysis.Results:There were 158(91.9%) cases with fever, 69(40.1%) cases with abdominal pain among 172 PLA cases. One hundred and forty-three (83.1%) were solitary, and 141(82.0%) cases localized in right hepatic lobe. One hundred and six (61.6%) cases were PLA of cryptogenic origin. There were 156 cases underwent etiology detection, with the positive etiology detection of 99(63.5%) cases. Ninety-two (92.9%) cases were infected with a single strain, and seven (7.1%) cases were infected with mixed strains. A total of 115 strains of bacteria were isolated. The main strains included 71 (61.7%) Klebsiella pneumoniae (KP), 21 (18.3%) Escherichia coli (EC), among which 17 were extended spectrum β lactamase, and two carbapenem-resistant Enterobacteriaceae. Among the 61 KP-PLA patients, 42(68.9%) cases were diagnosed with diabetes, 16(26.2%) cases with biliary diseases, and one (1.6%) case with malignant tumor. Among the 15 EC-PLA patients, six cases were diagnosed with diabetes, nine cases with biliary diseases, and four cases with malignant tumors. There were statistically significant differences ( χ2=4.307, 4.784 and 8.536, respectively, all P<0.05). After admission, the patients were treated with antibiotics alone or combined with drainage. One-hundred and sixty-seven (97.1%) cases got improved. Conclusions:The clinical manifestations of PLA are atypical, and the dominant pathogens are KP and EC. The risk factors of PLA are diabetes mellitus, biliary diseases and malignant tumors.

Objective To analyze the efficiency of perinatal group B streptococcal(GBS)infection preven-tion in the local area.Methods From June 2015 to June 2016,3 667 pregnant women were included.Both pre-natal examinations and deliveries were done in our hospital.The analysis of GBS colonization,risk factors and prevention of early-onset disease were done.Results Among preterm and term pregnant women,the rates of GBS screening were 23.4% and 35.6%,respectively.The positive results of GBS were 10.9% and 8.4%,re-spectively.The percentage of women with 2 risk factors were 22.9% and 0.3%,respectively.GBS screening has a better prediction effect for GBS colonization status of women at labor.There were significant differences in the intrapartum antibiotic prophylaxis(IAP)implementation between preterm and term pregnant women. In the IAP efficiency analysis of preterm,GBS colonization and risk factors,preterm had a high sensitivity (96.1%),while the specialties of GBS carry and risk factors were high(93.2% and 90.3% respectively).Con-clusion preterm pregnant women should be highlighted as an important population in the implementation of IAP.GBS screening strategy is better than the risk factors strategy.

Objective The aim of the study was to evaluate the hearing performance of a new transcutaneous bone conduction hearing aid.Methods One hundred and nine patients with conductive or mix hearing loss and eleven patients with single sided sensorineural hearing loss from four tertiary referral centers were tested under unaided and aided conditions with the sound processors on testbands.Free field test was performed to obtain the hearing thresholds and speech recognition thresholds in quiet.Adverse events were also documented by a self-reported questionnaire.Results ①Conductive or mixed hearing loss patients:for aged≥6 yrs subgroup,the bone conduction PTA average of aided sides was 18.55±8.99 dB HL.For aged<6 yrs subgroup, the bone conduction ABR hearing threshold average was 18.33±8.36 dB HL.②Statistically significant improvements in free field hearing thresholds were seen when compared aided hearing with unaided outcomes.The average PTA (pure tone average in free field) was measured at 32.21±10.00, 37.33±14.15, and 34.38±10.76 dB HL respectively in conductive or mixed hearing loss aged≥6 yrs subgroup;aged<6 yrs subgroup and SSD subgroup.③In aided situations;speech recognition thresholds in quiet were significantly better compared to unaided situation in patients aged≥6yrs.④None of patients presented adverse events related to the devices.Conclusion The Sophono bone conduction hearing aid has satisfactory hearing performance and can be considered an alternative device for patients with conductive or mix hearing loss or with SSD.

Objective To investigate short term effect of brachypodium total hip arthroplasty for young patients with osteonecrosis, and to provide a reference for clinical treatment. Methods From January 2008 to January 2012, 44 cases of femoral head necrosis patients (46 hips) were selected, with age from 28 to 52, and average age (39.94 ± 5.25) years old; according to prosthesis type they were divided into control group and observation group, control group( 22 cases of 24 hips, using metal-on-polyethylene Duraloc total hip prosthesis replacement treatment), and in the observation group (22 cases of 22 hips, with use of ceramic-on-ceramic Metha Brachypodium total hip prosthesis replacement therapy). Patients were followed up for 12 to 36 months, Harris score, range of motion and other indicators were compared in two groups of patients. Results In observation group and control group, the level of WOMAC score, total Harris score and function, motion range, pain, abnormalities score were significantly improved compared with those before operation:in observation group:(27.46 ± 4.19) scores vs.(66.38 ± 5.84) scores, (92.73 ± 7.68) scores vs.(42.67 ± 7.28) scores, (45.28 ± 5.34) scores vs. (22.19 ± 4.19) scores, (4.46 ± 0.63) scores vs. (3.25 ± 0.66) scores, (39.54 ± 1.54) scores vs. (15.39 ± 2.86) scores, (3.45 ± 0.65) scores vs. (1.84 ± 0.32) scores;in control group:(28.16 ± 4.07) scores vs. (65.67 ± 6.22) scores, (93.03 ± 7.54) scores vs.(43.74 ± 7.57) scores, (44.65 ± 5.26) scores vs. (22.45 ± 4.37) scores, (4.74 ± 0.71) scores vs. (3.17 ± 0.59) scores, (39.87 ± 1.26) scores vs. (16.19 ± 2.55) scores, (3.77 ± 0.73) scores vs. (1.93 ± 0.43) scores, and there were significantly differences (P<0.05). There were no significantly differences between two groups (P>0.05). All patients were follower up for 12-36(23.19 ± 3.66) months. One case in observation group had leg swelling and healed after symptomatic treatment, 1 case in the control group had limb swelling, and 1 case had extensive subcutaneous bleeding .And they were cured after symptomatic treatment 1 case had femoral dislocation, and no secondary dislocation happened after the implementation of manual reduction. Conclusions Brachypodium ceramic ceramic total hip replacement therapy has same effect for young osteonecrosis patients compared to polyethylene and metal prosthesis in improving hip function, but the ceramic-on-ceramic prosthesis brachypodium has better performance in wear resistance with smaller friction coefficient is smaller, and is suitable for young patients.