[Objective] To investigate the protective effect of Salvia miltiorrhiza injection (SMI) on the kidneys of HBOC-CHP01 resuscitated haemorrhagic shock rats. [Methods] A 50% haemorrhagic shock rat model was established, with 12 rats divided into two groups: SMI + HBOC-CHP01 group and HBOC-CHP01 group, with 6 rats in each group. The rats in the SMI+ HBOC-CHP01 group were given an equal volume of HBOC-CHP01 for resuscitation after haemorrhagic shock, and an 8 mL/kg dose of SMI. Rats in the HBOC-CHP01 group were resuscitated by administering an equilibrium blood loss volume of HBOC-CHP01 and given an 8 mL/kg dose of 0.9% NaCl solution. Blood was taken from rats at five points: before bloodletting (baseline), during haemorrhagic shock (HS), immediately after resuscitation (RS0h), 1 h after resuscitation (RS1h), and 24 h after resuscitation (RS24h). A blood gas analyser was used to detect the lactate level (Lac), glucose content (Glu), residual base (BEecf), pH, bicarbonate (HCO3-), high iron haemoglobin (MetHb). White blood cells (WBC), platelets (PLT), haemoglobin content (Hb), carboxyhaemoglobin (COHb) were detected using a quintuple classification. Blood creatinine (SCr), uric acid (UA), kidney-related indexes were detected using biochemistry instrument. Kidney tissues of the rats were taken after 24 h of resuscitation and after execution, and the inflammation of kidneys of the rats of the two groups was analyzed using HE staining. Fluorescence staining was used to detect the level of ROS in the kidneys of rats in both groups. [Results] At RS 0h, the Beecf, Glu and Lac levels of rats in the SMI+HBOC-CHP01 group were significantly lower than those of rats in the HBOC-CHP01 group, and the pH level of rats in the SMI+HBOC-CHP01 group was significantly higher than that of rats in the HBOC-CHP01 group, and the Glu levels of rats in the SMI+HBOC-CHP01 group were significantly lower than those of rats in the HBOC-CHP01 group at RS 1h. At RS 0h, the WBC, PLT and COHb contents of rats in the SMI+HBOC-CHP01 group were all significantly higher than those of rats in the HBOC-CHP01 group, and at RS 1h, the WBC content of rats in the SMI+HBOC-CHP01 group was significantly higher than that of rats in the HBOC-CHP01 group; at RS 1h, the UA content of rats in the SMI+HBOC-CHP01 group was significantly lower than that of rats in the HBOC-CHP01 group; at RS 24h, the SCr content of rats in the SMI+HBOC-CHP01 group was significantly lower than that of rats in the HBOC-CHP01 group; at RS 24h, the inflammation level of kidney tissues of rats in the SMI+HBOC-CHP01 group was significantly lower than that of rats in the HBOC -CHP01 group rats, and the ROS and MPO levels in the kidney tissues of rats in the SMI+HBOC-CHP01 group were significantly lower than those of rats in the HBOC-CHP01 group. [Conclusion] The combination of Salvia miltiorrhiza injection during the resuscitation of rats with severe haemorrhagic shock by HBOC-CHP01 can alleviate renal injury by reducing inflammatory response and oxidative stress.

[Objective] To extract hemoglobin (Hb) from red blood cells using osmotic pressure swelling method, expected to achieve a hemoglobin dissolution rate of ≥80% and a cell membrane integrity rate of ≥70%. [Methods] Human umbilical cord blood red blood cells were used as raw materials and phosphate buffer solution was used as the swelling solution for red blood cells. A three factor three-level orthogonal experiment (n=3) was conducted to determine the optimal matching conditions for selecting the osmolality molar concentration of phosphate buffer solution, pH value of hypotonic phosphate buffer solution and volume ratio of hypotonic phosphate buffer solution to washed red blood cells. Red blood cell swelling solution samples (n=6) were prepared by the optimal matching conditions and the original process conditions. The hemoglobin dissolution rate and cell membrane integrity rate were checked. In the expanded comparative experiment, red blood cell swelling solution samples (n=6) were prepared by the optimal matching conditions and the original process conditions, which was filtered by ultrafiltration membranes. The filtration time and hemoglobin yield were checked. [Results] The optimal matching conditions for preparing red blood cell swelling solution were obtained through orthogonal experiment as follows: osmotic pressure molar concentration was 30 mOsmol/Kg, pH was 7.8, and phosphate buffer to red blood cell volume ratio was 6∶1. On the basis of the above conditions, the red blood cell swelling solution sample was compared with the original process sample: the hemoglobin dissolution rate was (82.4±1.8)% vs (78.6±3.0)% (P<0.05), and the cell membrane integrity rate was (65.8±4.0)% vs (28.7±2.3)% (P<0.05). In the expanded comparative experiment, the optimal matching conditions were compared with the original process conditions: filtration time(s) (327±9) vs (434±13) (P<0.05), and hemoglobin yield was (72.3±1.2)% vs (66.0±1.4)% (P<0.05). [Conclusion] Compared with the original preparation process, the hemoglobin extraction process which optimized through orthogonal experiments greatly reduces the cell membrane fragmentation rate and minimizes the entry of cell membrane matrix into the target solution, ensuring a slightly higher hemoglobin dissolution rate, and reducing the preparation difficulty for the subsequent cell membrane separation and further purification.

Objective To investigate the population distribution,biofilm formation and drug resistance of Staphylococcus aureus isolated from pressure ulcers infected patients in the hospital,and to provide important clinical evidence.Methods From May 2019 to May 2022,a total of 126 strains of Staphylococcus aureus relat-ed to pressure ulcer infections were collected in the hospital.The bacteria were identified by Vitek MS mass spectrometer,and the drug susceptibility test was performed by disk diffusion method(K-B method).The drug susceptibility results were analyzed according to the standards of the American Association for Clinical Laboratory Standardization(ACLA),2016-M100.The crystal violet staining method was used to detect the biofilm of Staphylococcus aureus and determine its formation ability.Glucose and silver ion powder were add-ed to the biofilm respectively,and their effects on biofilm formation were observed.Results From May 2019 to May 2022,126 strains of Staphylococcus aureus related to pressure ulcer infection were collected from the hospital.Pressure ulcer was detected at all ages and levels.The proportion of strains forming biofilm was 73.00％,and the proportion of strains forming biofilm was 81.81％in the strain isolated from stage Ⅳ pres-sure ulcer,which was higher than that in the strain isolated from other stages(Ⅱ and Ⅲ)(63.33％),and the differences were statistically significant(P＜0.05).Strains with different biofilm formation ability had higher resistance rates to penicillin G,tetracycline,ciprofloxacin,sulfamethoxazole/trimethoprim,but lower resist-ance rates to teicoplanin and levofloxacin.No Gram-positive bacteria resistant to vancomycin were detected.There were no significant differences in drug resistance of Staphylococcus aureus in different biofilm levels(P＞0.05).11.10 mmol/L glucose could promote the formation of biofilm,10.00 μg/mL silver ion antibacte-rial gel could inhibit the formation of biofilm.Conclusion The biofilm formation ability of Staphylococcus au-reus to cause stage Ⅳ pressure ulcer infection is strong and the formation of biofilm is related to the stage of pressure ulcer.The antimicrobial resistance of Staphylococcus aureus producing membrane has no obvious re-lationship with the grade of biofilm.The use of silver ions and the reduction of blood glucose level have a cer-tain inhibitory effect on biofilm formation.

Objective To investigate the level of finger systolic blood pressure (FSBP) in healthy young adults. Methods A total of 28 healthy young adults were selected as the study subjects by convenient sampling method. The FSBP of the study subjects was detected at 30 and 10 ℃, and the FSBP index (F_i) was calculated. Results The FSBP of the study subjects at 30 and 10 ℃ were (102.0±16.5) and (104.4±15.2) mmHg, respectively. The FSBP in male group at 30 and 10 ℃ was (99.6±18.6) and (107.2±17.0) mmHg, respectively. The FSBP in female group at 30 and 10 ℃ was (104.4±13.9) and (101.5±2.8) mmHg, respectively. The results of factorial analysis showed that the interaction between gender and temperature on FSBP was statistically significant (P<0.05). FSBP in male group was higher at 10 than 30 ℃ (P<0.05) and higher than female group at 10 ℃ (P<0.05). There was no statistical significance for the main effect of gender, temperature, finger, or the interaction effect of gender and finger, temperature and finger for FSBP (all P>0.05). The average F_i of the study subjects was (98.0±16.6)%, with males and females having the average F_i of (100.7±20.7) % and (95.2±10.6) % respectively. The results of factorial analysis of variance showed that there was no significant difference on F_i in the main effect gender and fingers or the interaction effect between them(all P>0.05). Conclusion The FSBP test could be used as a detection method for assessing peripheral microcirculation function in Chinese population. However, further research is needed to establish reference ranges and influencing factors.

At present, there are a series of problems in the clinical teaching of postgraduates, such as insufficient integration of professional teaching and ideological and political education, insufficient understanding of teachers and students, insufficient exploration of ideological and political elements, and immature construction of teaching system. This paper mainly starts from three aspects: improving the teaching system and mechanism, building a disease-based curriculum ideological and political chain and teaching implementation strategies, organically combines different professional curriculum contents with ideological and political education, and carries out preliminary exploration and practice in the construction of ideological and political teaching system of orthopedic clinical curriculum, so as to guide students to establish correct values, outlook on life and world outlook. It provides useful practical experience for improving the quality of clinical teaching and promoting the reform and innovation of graduate teaching.

Objective: To investigate the association between obesity and insomnia among adults, so as to provide insights into obesity control and sleep health improvements among adult populations. Methods: Sixteen communities were randomly sampled from Longgang District, Shenzhen City using a multistage cluster sampling method, and permanent residents at ages of 18 years and older living in these communities were recruited as study subjects. Subjects' gender, age, educational level and marital status were collected using a self-designed questionnaire, and the body mass index ( BMI) was calculated. The sleep quality was evaluated using the Insomnia Severity Index ( ISI ), and the correlation between obesity and insomnia was evaluated using a multivariable logistic regression model. Results: A total of 10 434 questionnaires were allocated, and 9 425 valid questionnaires were recovered, with an effective recovery rate of 90.33%. The respondents included 3 448 men ( 36.58% ) and 5 977 women ( 63.42% ), and 6 940 respondents ( 73.63% ) were at ages of 18 to 44 years. There were 778 respondents with underweight ( 8.25% ), 5 522 with normal weight ( 58.59% ), 2 209 with overweight ( 23.44% ) and 916 with obesity ( 9.72% ). Among all respondents, 1 149 respondents were detected with insomnia, with a detection rate of 12.19%, including 839 subjects with mild insomnia ( 8.90% ), 247 subjects moderate insomnia ( 2.62% ) and 63 subjects with severe insomnia ( 0.67% ). Multivariable logistic regression analysis showed a statistically significant correlation between obesity and insomnia ( OR=2.179, 95%CI: 1.824-2.603 ). Conclusions There is a significant correlation between obesity and insomnia. Body weight management and sleep health education shall be intensified among adults.

Inguinal hernia is a common surgical disease, and most patients need surgical treatment. In recent years, minimally invasive surgery based on laparoscopy has been popularized in hernia surgery. With the release of clinical guidelines, the progress of instruments and materials, the update of treatment concepts and anatomical knowledge, laparoscopic inguinal hernia repair, especially laparoscopic total extraperitoneal hernia repair (TEP), is developing towards a more accurate and minimally invasive direction. Based on literatures in recent years and combined with clinical practice, the authors explore the advances in clinical application of laparoscopic TEP.

【Objective】 To study the red blood cell substitute preparation method of glutaraldehyde(GDA) and Bis(3, 5-dibromosalicyl) fumarate(DBBF) double polymerized, and also observe its curative effect. 【Methods】 The affecting factors of the crosslink of DBBF and human placental hemoglobin(Hb) were selected, including solution pH, inositol hexaphosphoric acid concentration, and molar ratios of DBBF/Hb. The changes of P50, Hill Co and methemoglobin(MetHb) content during the preparation process were studied and the molar ratio of GDA to DBBF-Hb were determined. The final product was obtained through the steps of ultrafiltration, filtration, and deoxygenation, etc., and the final product was subjected to a study on the curative effect of anti-hemorrhagic shock in rats. 【Results】 Under the condition of pH 8.0, the concentration of inositol hexaphosphoric acid was 10mM/L, the molar ratio of DBBF/hemoglobin was 6∶1, the content of dimer was(22.67±3.28)%, the content of tetramer was (74.64±7.05)%, and its P50 was (25.25±2.31) mmHg. As the molar ratio of DBBF/Hb increased, P50 and MetHb content would gradually increase, while the Hill Co will gradually decrease. The molar ratio of GDA and DBBF-Hb was 7∶1, the content of dimer was (8.23±0.79)%, the content of tetramer was (27.87±3.63)%, the content of super-macromolecule was (1.05±0.31)%. As the molar ratio of GDA and DBBF/Hb increased, MetHb content would increase, while the P50 and Hill Co would gradually decrease. The 24h survival rate of the product in rats with hemorrhagic shock was 83.33%(10/12), which was significantly higher than that in the negative control group[41.67%(5/12)], while similar with the positive control group [91.67%(11/12)]. 【Conclusion】 The red blood cell substitutes with GDA and DBBF double polymerized can effectively reduce the dimer content, which is more conducive to industrial production, and has a positive effect on the treatment of hemorrhagic shock.

Objective:To investigate the turnover intention and its influencing factors in rural general practitioners in southwest Shandong province.Methods:In May 2020, a survey with self-designed questionnaire was conducted among 2 805 rural general practitioners in southwest Shandong province selected by multi-stage sampling method. Pearson chi square test (χ2) and binary logistic regression were used to analyze the factors influencing the turnover intention of rural general practitioners.Results:A total of 2 805 questionnaires were sent out, 2 693 were collected and 2 272 were valid, with an effective rate of 84.4%. Among 2 272 participants, 1 076 (47.4%) had medium to high level turnover intention. Binary logistic regression showed that part-time job ( OR=1.443, 95% CI: 1.105-1.884, P<0.01), average monthly night shifts ≥20 times ( OR=1.340, 95% CI: 1.106-1.623, P<0.01), daily working time ≥13 hours ( OR=1.358, 95% CI: 1.107-1.666, P<0.01), insomnia ( OR=2.075, 95% CI: 1.755-2.454, P<0.01), feeling depressed at work ( OR=2.987, 95% CI: 2.516-3.546, P<0.01), degree of emotional exhaustion ( OR=3.801, 95% CI: 3.188-4.533, P<0.01) and degree of de-personalization tendencies ( OR=2.493, 95% CI: 2.086-2.981, P<0.01) were the significant factors influencing the turnover intention of rural general practitioners. Conclusions:Rural general practitioners in southwest Shandong have a high-level turnover intention, part-time jobs, average number of night shift per month, working time, insomnia, depression and job burnout are the main factors affecting the turnover intention. Necessary measures should be taken by relevant departments to enhance the stability of rural general practitioners.

Laparoscopic radical resection of transverse colon cancer is a difficult operation, which is featured by large operation area, multiple steps, and many clinical anatomical variations. It requires the concept of complete mesocolic excision. Because of its absolute high-definition picture restoration, the 4K laparoscope can effectively assist in the identification, protection and severance of blood vessels during the operation, and assist in judging the fascia space of the operation. After entering Toldt fascial space through the intermediate approach guided by the superior mesenteric vein, the left, right transverse colon and lower area of mesangium are completely dissected, the upper area of colon, hepatic and splenic flexure are sepearted. The authors summarize practical experiences, investigate the extent of lymph node dissection in 4K laparoscopic radical resection of transverse colon cancer and share surgical experience.