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 prevalence of current smoking and smoking cessation, and identify the influencing factors among hypertensive patients in Nanshan District, Shenzhen City, so as to provide insights into smoking control among hypertensive patients. Methods: The demographic features, life style, status of smoking and smoking cessation in hypertensive patients were collected from 69 community health centers in Nanshan District from 2017 to 2019. The gender- and age-specific prevalence of smoking and smoking cessation was estimated among hypertensive patients, and the factors affecting hypertensive patients' smoking and smoking cessation were identified using a multivariable logistic regression model. Results: Totally 4 385 patients with hypertension were enrolled, with a mean age of (58.41±11.19) years, and the participants included 2 265 men (51.65%) and 2 120 women (48.35%). There were 724 current smokers, and the prevalence of current smoking was 16.51%, with 29.71% prevalence in males and 2.41% in females. There were 424 hypertensive patients quitting smoking, and the prevalence of smoking cessation was 36.93%, with 38.20% prevalence in males. Multivariable logistic regression analysis identified male ( OR=12.885, 95%CI: 9.567-17.354 ) and drinking ( OR=2.567, 95%CI: 2.118-3.111 ) as facilitating factors for current smoking among hypertensive patients, and increasing age (OR=0.723, 95%CI: 0.642-0.815) and high exercise frequency (OR=0.881, 95%CI: 0.817-0.950) as barrier factors, while male ( OR=7.309, 95%CI: 3.304-16.165), increasing age ( OR=1.381, 95%CI: 1.120-1.703 ), unmarried ( OR=1.819, 95%CI: 1.329-2.490 ), divorced ( OR=7.837, 95%CI: 1.254-48.975 ), retired ( OR=1.545, 95%CI: 1.095-2.180 ), unemployed (OR=1.801, 95%CI: 1.057-3.066), and high exercise frequency ( OR=1.221, 95%CI: 1.096-1.360 ) were identified as facilitating factors for smoking cessation among hypertensive patients and widowed ( OR=0.285, 95%CI: 0.089-0.906 ), high educational level ( OR=0.766, 95%CI: 0.619-0.949 ), and drinking ( OR=0.488, 95%CI: 0.368-0.647 ) as barrier factors. Conclusions The prevalence of smoking is lower, and the prevalence of smoking cessation is higher among hypertensive patients than among general populations in Nanshan District. Young and middle-aged, employed, widowed men with a high educational level are key populations for tobacco control, and alcohol consumption control and intensified exercises are important measures to reduce the prevalence of smoking and improve the prevalence of smoking cessation.

Objective: To investigate the status and identify the influencing factors of smoking behaviors among residents in Nanshan District, Shenzhen City, so as to provide insights into tobacco control. Methods: Permanent residents at ages of more than 18 years were recruited from 17 communities in Nanshan District, Shenzhen City using the stratified multistage random sampling method from July to November, 2018. Participants' demographic features, smoking, smoking cessation and exposure to secondhand smoke were collected using the Individual Questionnaire for 2018 Chinese Adult Chronic Disease and Nutrition Surveillance. The factors affecting current smoking were identified using a multivariable logistic regression model. Results: Totally 1 700 questionnaires were allocated, and 1 625 valid questionnaires were recovered, with an effective recovery rate of 95.59%. The respondents included 714 men and 911 women, with a male to female ratio of 1∶1.27, and had a mean age of ( 45.13±13.59 ) years. The prevalence of current smoking was 15.51%, with 28.15% prevalence in men and 5.60% in women. The mean age of starting daily smoke was ( 21.00±5.52 ) years, and the mean daily smoking frequency was (13.53±9.15) cigarettes/d. The prevalence of smoking cessation was 6.58%, with 10.64% in men and 3.40% in women, and the prevalence of exposure to secondhand smoke was 41.42%, including 46.63% in men and 37.32% in women. Multivariable logistic regression analysis showed that an educational level of junior high school ( OR=1.683, 95%CI: 1.088-2.602 ), an educational level of high school/technical secondary school/vocational school (OR=1.687, 95%CI: 1.185-2.402), an occupation of farmers ( OR=2.514, 95%CI: 1.404-4.500 ), and an occupation of commercial and service personnel ( OR=1.939, 95%CI: 1.093-3.439 ) were associated with current smoking. Conclusion The prevalence of current smoking is low among residents in Nanshan District, but the prevalence of current smoking in women is higher than the national level. Educational level and occupation are main factors affecting current smoking.

Objective:To explore the association between blood pressure control and risk of ischemic stroke (IS) in patients with hypertension.Methods:A total of 5 488 patients with hypertension from 60 communities were randomly selected from 101 communities in 8 streets of Nanshan District in Shenzhen City by using two-stage sampling method. The social demographic characteristics, behavior and life style, coronary heart disease and diabetes were collected and the physical condition, blood pressure and blood biochemical indexes were measured. From April 1, 2010 to August 31, 2017 as the follow-up period, the incidence of IS was annually collected by using telephone survey. Cox proportional hazard regression model was used to analyze the relationship between blood pressure control, systolic blood pressure (SBP), diastolic blood pressure (DBP) and the risk of IS.Results:The age of all patients was (58.50±12.14) years old, including 2 712 males (49.42%) and 3 112 patients with well-controlled blood pressure (56.71%). During the follow-up period, 358 new cases of IS were confirmed, and the incidence density was 1 346.27/100 000 person-years. Cox proportional hazard regression model analysis showed after adjusting for confounding factors, unstable blood pressure control, SBP≥150 mmHg (1 mmHg=0.133 kPa; compared with SBP<120 mmHg), and DBP≥95 mmHg (compared with DBP<80 mmHg) were associated with risk of IS. The HR (95% CI) was 1.29 (1.04, 1.59), 2.00 (1.26, 3.17) and 1.52 (1.01, 2.64), respectively. Subgroup analyses showed these associations only existed in female patients with hypertension. The HR (95% CI) was 1.39 (1.05, 1.85), 2.53 (1.41, 4.56) and 1.73 (1.00, 3.36), respectively. Conclusion:Unstable blood pressure control increases the risk of IS in female patients with hypertension.

Objective:To explore the association between blood pressure control and risk of ischemic stroke (IS) in patients with hypertension.Methods:A total of 5 488 patients with hypertension from 60 communities were randomly selected from 101 communities in 8 streets of Nanshan District in Shenzhen City by using two-stage sampling method. The social demographic characteristics, behavior and life style, coronary heart disease and diabetes were collected and the physical condition, blood pressure and blood biochemical indexes were measured. From April 1, 2010 to August 31, 2017 as the follow-up period, the incidence of IS was annually collected by using telephone survey. Cox proportional hazard regression model was used to analyze the relationship between blood pressure control, systolic blood pressure (SBP), diastolic blood pressure (DBP) and the risk of IS.Results:The age of all patients was (58.50±12.14) years old, including 2 712 males (49.42%) and 3 112 patients with well-controlled blood pressure (56.71%). During the follow-up period, 358 new cases of IS were confirmed, and the incidence density was 1 346.27/100 000 person-years. Cox proportional hazard regression model analysis showed after adjusting for confounding factors, unstable blood pressure control, SBP≥150 mmHg (1 mmHg=0.133 kPa; compared with SBP<120 mmHg), and DBP≥95 mmHg (compared with DBP<80 mmHg) were associated with risk of IS. The HR (95% CI) was 1.29 (1.04, 1.59), 2.00 (1.26, 3.17) and 1.52 (1.01, 2.64), respectively. Subgroup analyses showed these associations only existed in female patients with hypertension. The HR (95% CI) was 1.39 (1.05, 1.85), 2.53 (1.41, 4.56) and 1.73 (1.00, 3.36), respectively. Conclusion:Unstable blood pressure control increases the risk of IS in female patients with hypertension.

Objective To evaluate the effect of the different Child-Pugh classification on the recurrence and survival of hepatocellular carcinoma (HCC) recipients after liver transplantation. Methods Clinical data of 125 HCC recipients undergoing liver transplantation were retrospectively analyzed. The 3-year disease-free survival (DFS) and overall survival (OS) rates were calculated by Kaplan-Meier survival curve. The independent risk factors probably affecting the recurrence and survival of HCC recipients after liver transplantation were identified by using Cox's proportional hazards regression model. Results The median follow-up time was 25.6 months. The 3-year DFS and OS rates were 68.4% and 65.7% for all patients. The 3-year DFS and OS rates in 113 patients with Child-Pugh class A/B HCC were 68.6% and 66.2%, whereas 66.7% and 65.6% for 12 patients with Child-Pugh class C HCC with no statistical significance (all P>0.05). Cox's proportional hazards regression model demonstrated that vascular invasion (P=0.001)and the number of tumors>3 (P=0.025) were the independent risk factors for the postoperative recurrence of HCC in recipients undergoing liver transplantation. Alpha fetoprotein (AFP)>400μg/L (P=0.035), vascular invasion (P=0.031) and number of tumors>3 (P=0.008) were the independent risk factors affecting the survival of HCC patients. Conclusions The postoperative prognosis does not significantly differ between Child-Pugh class C and A/B HCC patients after liver transplantation. AFP, vascular invasion and number of tumors are the risk factors affecting the clinical prognosis of HCC patients after liver transplantation. Liver transplantation is an efficacious treatment for HCC patients with Child-Pugh class C.

Objective At present, the risk factors for cognitive impairment in epilepsy patients are not quite clear.This study was to explore the impacts of the clinical features, emotional health and quality of life (QOL) on the cognitive function of the adult patients with mild cognitive impairment (MCI).Methods Using the Montreal Cognitive Assessment (MoCA) and Mini Mental State Examination (MMSE) scales, we evaluated the cognitive functions of the 109 adult epileptics of the outpatient clinic of neurology in Jinling Hospital.We assessed their emotional health with Hamilton Depression Scale-24 (HAMD-24), estimated their QOL with Quality Of Life in Epilepsy-31 (QOLIE-31), and collected their baseline clinical data by questionnaire survey.Results There were 67 cases of MCI (61.5%) among the 109 patients.The residential area was the strongest predictor of MCI in the adult epileptics (OR=0.226, 95% CI: 0.082-0.627).Among other risk factors of post-epileptic MCI were the total scores of HAMD-24 (OR=0.770, 95% CI: 0.644-0.921) and QOLIE-31 (OR=0.712, 95% CI: 0.575-0.880), QOL (OR=1.070, 95% CI: 1.015-1.128), cognitive function (OR=1.120, 95% CI: 1.043-1.203), and social function (OR=1.103, 95% CI: 1.035-1.175).Conclusion The incidence of MCI is high in adult patients with epilepsy.The development and progression of post-epileptic MCI can be delayed by more emphasis on the evaluation of cognitive function, emotional health, and quality of life.

Objective To study the feasibility,effectiveness and safety of temporary pacing at the right ventricular outflow tract area in patients with inferior acute myocardial infarction(AMI)and two or three degree atrioventricular block(AVB). Methods Ninety-five patients with inferior AMI and two or three degree AVB admitted into Cangzhou People's Hospital were randomly divided into right ventricular apex pacing group(47 cases) and right ventricular outflow tract region pacing group(48 cases). Seldinger method was used to perform the right femoral vein puncture in which a 6F sheath tube was placed,and a diode temporary pacing electrode was introduced into it in the two groups. Under the X-ray guidance,in the right ventricular apex pacing group,the electrode was pushed from the inferior vena cava to enter into the right atrium,then cross the tricuspid and finally reach the right ventricular apical portion pacing. In the right ventricular outflow tract region pacing group,under the X-ray guidance, after the electrode was withdrawn and rotated slightly clockwise,it was sent forward to the right ventricular outflow tract region pacing. The duration from the puncture at the right femoral vein to the implanted electrode reaching the pacing region,the pacing threshold,the un-favorable pacing,the incidence of ventricular arrhythmia and prognosis were observed in the two groups. Results The pacing time and pacing threshold in right ventricular apex pacing group were obviously higher than those in the right ventricular outflow tract region pacing group〔pacing time(s):336±150 vs. 354±152,pacing threshold(V):0.9±0.4 vs. 0.7±0.3,both P<0.05〕. The mortality in intensive care unit (ICU)〔0(0/48)vs. 2.13%(1/47)〕,the incidence of bad pacing〔10.42%(5/48)vs. 17.02%(8/47)〕and ventricular fibrillation(VF),sustained ventricular tachycardia,contraction of non-sustained ventricular tachycardia or frequent ventricular premature beat(VPB)and other arrhythmia incidence of complications〔10.42%(5/48)vs. 12.77%(6/47)〕in the right ventricular outflow tract region pacing group were all lower than those in the right ventricular apex pacing group. Conclusion The application of right ventricular outflow tract pacing in patients with inferior AMI and two or three degree AVB is safe and effective,and its stability is fine.

AIM: To investigate the effect of nerve growth factor (NGF) on auditory and cochlear damage induced by brain ischemia and reperfusion. METHODS: The rats with brain ischemia and reperfusion were divided into two groups at random. In the experimental group, the rats were injected intramuscularly with NGF . In control group, the animals were injected with normal saline instead of NGF. Then the hearing loss and cochlear structural changes of rats in both groups were compared. RESULTS: It was found that the hearing loss of rats in NGF group were less significantly than that of control group ( P

Cochleae of guinea pig, cat, and human fetus were studied under SEM. After tbe treatment with osmic and tannic acids, they were dehydrated by a critical point drier, then coated with carbon and gold, and observed under a JSM-35 scanning electon microscope.The organ of Corti looks like a spiral staircase winding around the modiolus. It is wider at apex and narrower at base. The vestibular membrane is composed of squamous epithelia covered with microvilli. The tectorial membrane is mainly composed of parallel fibrils, but at its surface and marginal region, the fibillae interwoven. There are three rows of outer hair cells (OHC) and one row of inner hair cell (IHC) in the organ of Corti, and the head plate of pillar cells is set in between both kinds of cells. The stereocilia of OHC are arranged in W-form, whereas those of IHC are in a curved arrangement. All the cells observed have microvilli, however, in some of the animal specimens, the stereocilia are irregularly arranged, damaged or entirely disappeared owing to noise exposure.In the four-month fetal cochlea, the cuticular plates of OHC looks just like velvet balls, which afterwards become W-shaped stereocilia, while on the surface of IHC, primitive hair bundles develop into a curved arrangement.Certain broken organ of Corti shows cylindrical body of OHC and its cup-like supporting structure. Phalangeal processes of Deiter ceils and OHC are obliquely arranged forming an angle. The pillar cell body is thin above and thick below, and twined with very thin nerve network.The tunnel cavity can be exposed by removing the roof structures, then longitudinal nerve fibers going along the tunnel bottom may be clearly seen. These fibers belong to the spirotunnel bundle——an efferent branch of olivo-cochlear bundle.