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 effect of osimertinib combined with aspirin on the survival pe-riod of the advanced lung adenocarcinoma patients with epidermal growth factor receptor(EGFR)mutation.Methods Sixty lung adenocarcinoma patients with EGFR mutation in advanced non-small cell lung cancer(NSCLC)first diagnosed in Banan District Second People's Hospital of from August 2020 to October 2021 were selected as the study subjects and divided into the observation group and control group by the random number table method,30 cases in each group.The observation group adopted osimertinib combined with aspi-rin,and the control used osimertinib merely.The overall response rate(ORR),disease control rate(DCR),progression-free survival(PFS),overall survival(OS)and the adverse reactions occurrence were compared between the two groups.Results ORR and DCR after 3,6,12 months medication in the observation group were higher than those in the control group,but the differences were not statistically significant(P＞0.05).Compared with the control group,PFS and OS in the observation group were longer,and the differences were statistically significant[14.9(11.8,17.2)m vs.10.5(8.9,12.5)m;24.1(19.5,27.4)m vs.18.1(16.1,21.1)m,P＜0.05].In addition,PFS and OS in male and female patients with brain metastasis,EGER19 and 21 ex-on mutation in the observation group were longer than those in the control group,and the differences were statistically significant(P＜0.05).There was no statistically significant difference in overall and≥Ⅲ degree adverse reactions between the two groups(P＞0.05).Conclusion Osimertinib combined with aspirin could prolong PFS and OS of the advanced lung adenocarcinoma patients with EGFR mutation without increasing the risk of adverse reactions.

OBJECTIVE： To observe the efficacy and safety of fluorouracil combined with paracetamol in the treatment of knee osteoarthritis and its effects on related indexes. METHODS： Totally 115 patients with knee osteoarthritis admitted to our hospital from March 2015 to March 2018 were divided into control group （57 cases） and observation group （58 cases） according to medication plan. Control group was given Paracetamol tablets 0.3 g orally， 3 times a day， for consecutive 8 weeks. Observation group was additionally given intra-articular injection of Fluorouracil injection 0.075 g on the basis of control group， once a week， 4 times as a treatment course， for 2 courses in total. Clinical efficacies， VAS scores， Lysholm knee scores， Fugl-Meyer Assessment （FMA） scores， Barthel indexes， WHO QOL-BREF scores before and after treatment and the occurrence of ADR of 2 groups were observed. RESULTS： The total response rate of observation group was 94.83％， which was significantly higher than 78.95％ of control group （P＜0.05）. Before treatment， there was no statistical significance in VAS score， Lysholm knee scores， FMA scores， Barthel index or QOL-BREF scores between 2 groups （P＞0.05）. After treatment， VAS scores of 2 groups were significantly lower than before treatment， and the observation group was lower than the control group； Lysholm knee scores， FMA scores， Barthel indexes and QOL-BREF scores were significantly higher than the same group before treatment， and observation group was significantly higher than control group （P＜0.05）. There was no statistical significance in the incidence of ADR between 2 groups （P＞0.05）. No severe ADR was found in 2 groups during treatment. CONCLUSIONS： Fluorouracil combined with paracetamol can significantly improve therapeutic efficacy of patients with knee osteoarthritis， and can significantly improve knee function， motor function， self-care ability and quality of life without increasing the occurrence of ADR.

OBJECTIVE： To investigate the effect mechanism of diazoxide on the proliferation and apoptosis of chondrocytes with oxidative injury based on endoplasmic reticulum stress （ERS） pathway. METHODS： SD mice were selected for primary culture of articular chondrocytes. The 3rd generation chondrocytes were randomly divided into control group， injury model group and diazoxide group. Control group didn’t receive any treatment. The injury model group was incubated with 300 μmol/L hydrogen peroxide （H2O2） at 37 ℃ for 8 h. Diazoxide group was pretreated with 300 μmol/L diazoxide at 37 ℃ for 0.5 h，and then incubated with 300 μmol/L H2O2 for 8 h. The proliferation of chondrocytes was detected by CCK-8 assay. The apoptosis rate of chondrocytes was detected by flow cytometry. The expression of ERS-related proteins [Caspase-3， Bcl-2-associated X（Bax），C/EBP homologous protein （CHOP）] were detected by Western blotting assay. RESULTS： Compared with control group， the proliferation activity of chondrocytes in injury model group was significantly decreased， while apoptosis rate was increased significantly（P＜0.05）；the protein expression of Caspase-3， Bax and CHOP were increased significantly （P＜0.05）. Compared with injury model group， the proliferation activity of chondrocytes in diazoxide group was increased significantly， while the apoptosis rate was decreased significantly （P＜0.05）； the expression of above related proteins were decreased significantly （P＜0.05）. CONCLUSIONS： Diazoxide can improve the proliferation activity of chondrocytes with oxidative injury and inhibit their apoptosis by inhibiting ERS pathway.

OBJECTIVE:To observe the efficacy and safety of Sanjiao fuzheng mixture combined with concurrent chemoradiotherapy of paclitaxel and nedaplatin in the treatment of local advanced non-small cell lung cancer (NSCLC). METHODS:A total of 68 patients with local advanced NSCLC selected from our hospital during Jan. 2015 to Jan. 2017 were divided into control group and observation group according to random number table,with 34 cases in each group. Control group was given Paclitaxel injection 135 mg/m2 intravenously,d1+Nedaplatin for injection 75 mg/m2 intravenously,d3,21 d as a treatment course,for 2 courses;routine fractionated intensity modulated radiation therapy,2 Gy each time,5 times a week,60-70 Gy in total;given 2 cycles of primary chemotherapy continuously after radiotherapy. Observation group was additionally given Sanjiao fuzheng mixture 250 mL/d,divided into 3 times,till the end of treatment,on the basis of control group. Clinical efficacies were observed in 2 groups. The levels of nutritional indexes (BMI,PAB,ALB,Hb) and tumor markers (SCC-Ag,CEA,TK1, CYFRA21-10) before and after treatment were observed. The occurrence of ADR were recorded. RESULTS:There was no statistical significance in the total effective rate between 2 groups (observation group 82.35％ vs. control group 73.53％)(P>0.05). After treatment,the levels of BMI,PAB,ALB and Hb in 2 groups were significantly lower than before treatment,but the observation group was significantly higher than the control group. The levels of SCC-Ag,CEA,TK1 and CYFRA21-1 in 2 groups were significantly lower than before treatment,and the observation group was significantly lower than the control group,with statistical significance (P<0.05). The incidence of Ⅲ-Ⅳ degree aleucocytosis,Ⅰ-Ⅱ degree hemoglobin reduction and thrombocytopenia in observation group were significantly lower than control group, with statistical significance (P<0.05). CONCLUSIONS:The efficacy of Sanjiao fuzheng mixture combined with concurrent chemoradiotherapy of paclitaxel and nedaplatin is similar to that of concurrent chemoradiotherapy of paclitaxel and nedaplatin for localadvanced NSCLC,which can improve nutritional status significantly,and reduce the incidence of ADR.

Objective: To evaluate the clinical value of clinical pharmacists in clinical treatment team through participating in the treatment of one case of MRSA infection.Methods: According to the infection site, MRSA infection treatment principle and the characteristics of drug treatment, clinical pharmacists assisted physicians in optimizing the therapy plan and provided the pharmaceutical care.Results: Physicians adopted the clinical pharmacist's suggestions, and the symptoms of patient were improved with effectively reduced ADR.Conclusion: The participation of clinical pharmacists in the optimization of anti-infective therapy plan can improve efficacy and security.

OBJECTIVE:To investigate the effectiveness and safety of 2 kinds of proton pump inhibitors in the treatment of coronary heart disease (CHD).METHODS:In retrospective study,a total of 92 patients with CHD were selected from our hospital during Jun.2015-May 2016,and then divided into rabeprazole group (30 cases),esomeprazole group (32 cases) and control group (30 cases) according to therapy plan.Control group received basic therapy plan.Rabeprazole group and esomeprazole group were additionally given sodium rabeprazole enteric-coated tablets and Esomeprazole magnesium enteric-coated tablets 20 mg,po,bid,on the basis of control group.A treatment course lasted for 30 d,and both medication groups received 2 courses of treatment.Blood uric acid levels,urine pH values,blood ion levels (Na+,K+,Ca2+,Cl-) were detected before and after treatment.The occurrence of cardiovascular adverse events,coronary adverse events and other adverse events were observed in 2 groups during treatment.RESULTS:Before treatment,there was no statistical significance in above indexes among 3 groups (P＞0.05).After treatment,the levels of blood uric acid,K+ (except for control group),Ca2+ and Cl-were decreased significantly,while urine pH values and blood Na+ levels were increased significantly;the levels of blood uric acid and Ca2+ in rabeprazole group and esomeprazole group were significantly lower than control group,while urine pH value and blood Na+ level were significantly higher than control group,with statistical significance (P＜0.05).After treatment,the level of blood uric acid in rabeprazole group was significantly lower than esomeprazole group,with statistical significance (P＜0.05).But there was no statistical significance in urine pH values or ion levels between 2 groups (P＞0.05).Compared with control group,the incidence of acute thrombosis in rabeprazole group and esomeprazole group were decreased significantly,and the incidence of joint swelling and pain were increased significantly,with statistical significance (P＜0.05).There was no statistical significance in the incidence of coronary adverse events among 3 groups (P＞0.05).CONCLUSIONS:Rabeprazole and esomeprazole can significantly reduce the level of blood uric acid and the incidence of acute thrombosis,increase urine pH value and blood Na+ levels,decrease blood Ca2+ level and increase the risk of fracture or hypocalcemia in patients with CHD.Therefore,the dosage regimen should be adjusted according to the specific situation of patients in clinical practice

Objective To observe the clinical efficacy of auricular point sticking plus basic nursing for constipation of excessive syndrome in acute stage of stroke.Method Ninety patients with constipation of excessive syndrome in acute stage of stroke were randomized into a treatment group and a control group, 45 cases in each group. The treatment group was intervened by auricular point sticking plus basic nursing, while the control group was by basic nursing alone. The major symptom scores were observed before intervention and after 2-treatment courses, and the clinical efficacies were compared between the two groups.Result Respectively after 1 and 2 treatment courses, there were significant differences in comparing the major symptom scores between the two groups (P<0.05). The total effective rates were respectively 60.0% and 67.5% in the treatment group respectively after 1 and 2 treatment courses, versus 37.5% and 45.0% in the control group, and the differences were statistically significant (P<0.05). Conclusion Auricular point sticking is an effective approach in treating constipation of excessive syndrome in acute stage of stroke.

Objective To observe the effect and side effects of concurrent chemoradiotherapy for stage ⅡB～ⅢB cervical cancer. Methods 126 patients with stage ⅡB～ⅢB cervical cancer were randomly allocated into 2 groups. Concurrent chemoradiotherapy group: radiotherapy carried out same as the neoadjuvant chemotherapy group, i.e.firstly with cisplatin 20 mg iv d1-5, 5-Fu 750 mg iv d1-5, repeated every 28 days, total 4 cycle; the neoadjuvant chemotherapy group i.e.firstly with cisplatin 20 mg iv d1-5, 5-Fu 750 mg iv d1-5, repeated every 28 days, total 2 cycle, after chemotherapy received routine radiotherapy 2 Gy per day, 5 times a week to a total dose of 30 Gy with 192Ir brachytherapy, 7 Gy per week. When total dose reached 46 Gy, the middle field was shielded by plumbum, then continuous radiotherapy, total dose reach A point 65-70 Gy, B point 50-56 Gy. Results All patients were followed-up for more than five years. The follow-up rate was 94.4 %. In concurrent chemoradiotherapy group the 3 year survival rate and the 5 year survival rate were 82.8 %, 65.6 %, In neoadjuvant chemotherapy group the 3 year survival rate and the 5 year survival rate were 67.7 %, 46.8 %. There was a significant difference in two groups (X2=3.86, P＜0.05; X2=5.01, P＜0.05), no significant difference in toxicity-side effect. Conclusion Concurrent chemoradiotherapy for advanced cervical cancer can significantly improve the 3-year and 5-year survival rate and has little increase in toxicity-side effect.

OBJECTIVE To estimate the value of video-assisted thoracoscopic surgery (VATS) in diagnosis and treatment of children with chest diseases. METHODS From May 1997 to October 2001, forty-one children (25 boys and 16 girls) with chest diseases received VATS under general anesthesia in our hospital. Their average age was 6.9 years (range 9 days to 16 years) and their median body weight was 22.5 kg (2.8-54.0 kg). Operative procedures included fibrinopurulent empyema with debridement and decortication in 15 children, biopsy and(or) resection of mediastinal tumor in 11, bullectomy and cystectomy of the lung in 6, lobectomy with huge cyst of the lung or sequestration in 5, clearance of hemothorax in 2, and exploration, and repair of diaphragmatic hernia in 2. RESULTS The mean operative time was 74 minutes (range 30 to 220 minutes). The lost blood volume was 33 ml (range 10 to 150 ml). The mean duration of chest drainage and hospital stay after surgery was 2.4 days and 7.0 days (range 4 to 15 days) respectively. One infant born after 9 days with congenital diaphragmatocele died of respiratory failure due to left pulmonary hypoplasia 10 days after operation. Postoperative morbidity was 7.3% (3 patients). Forty patients were followed up for an average of 15.6 months, 38 patients lived and developed normally, and 2 received chemotherapy. CONCLUSION Video-assisted thoracoscopy is a safe and effective diagnostic and therapeutic procedure for children with chest disease, and this approach has an important place in pediatric thoracic surgery.
Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Postoperative Complications ; epidemiology ; Thoracic Surgery, Video-Assisted ; adverse effects ; methods