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 explore the management effectiveness of emergency treatment management for emergencies.Methods:To establish precision nursing emergency management system, the response time, triage accuracy, receiving time, information delivery time and rescue success rate were compared before and after the application of the system.Results:After the application of the precision nursing emergency management, the emergency response time was shortened from (6.47±1.25) min to (3.56±1.38) min, and the time for admission and triage reduced from (5.15±0.54) min to (2.84±0.49) min. The time was shortened from (92.45±10.49) minutes to (72.35±13.20) minutes, and the time for information submission was shortened from (121.47±58.41) minutes to (65.23±10.72) minutes; the accuracy of triage diagnosis increased from 96.85% (277/286) to 99.27%(271/273). The rescue success rate increased from 96.15%(275/286) to 98.90%(270/273), and the differences were statistically significant ( t value was -2.920-5.587, χ2 value was 4.220, 4.317, P<0.05). Conclusions:The application of precision nursing emergency management in emergencies can improve the emergency response rate and overall level of nursing staff and ensure the safety of patients.

Medical ethics has a long history and rich connotations.It has developed from the simple "medical morality" of ancient times to the modem medical ethics.The basic principles of medical ethics include autonomy,non-maleficence,beneficence,justice,and so on.Researchers often conduct clinical researches in the balance between achievements and ethical norms.Clinical researchers of surgery should have a deep understanding of medical ethical principles and strictly abide by medical ethics.Ethics committee should strictly perform their duties and play the role of inspection and supervision.Modem medical knowledges should be popularized throughout the society to make clinical research correctly understood.Adhering principles of ethics first,people orientation and cooperation practice,with patients' benefit as evaluation criteria,balance of surgical "Dao" and "Shu" can be achieved.

Objective To summarize the lung HRCT findings of lung Langerhans cell histiocytosis (LCH) in children. Methods A total of 54 children with lung LCH pathologically proved in our institute from September 2006 to December 2014 were retrospectively reviewed. Patients were subdivided into two subgroups, diffuse type (n=29) and localized type (n=25). In addition, 32 children with LCH but without pulmonary infiltration were selected as control group. HRCT findings of 54 LCH with lung involvement were reviewed and analyzed for distribution pattern. The age of onset, illness duration and pulmonary function were compared between the lung LCH group and the control group. The differences of HRCT findings in LCH patients between diffuse type and localized type were compared with χ2 test. The differences on the onset age, illness duration and pulmonary function between the LCH group with lung involvement and control group were compared with non-parametric test(Mann-Whitney U Test). The differences of pulmonary function between the LCH group with lung involvement and control group were compared with Fisher exact probability test. Results The signs of pulmonary LCH on HRCT included lobular hyperinflation (n=26), interlobular septa thickening (n=11), cystic lesions (n=11), ground?glass opacity (n=10), nodules (n=9), and centrilobular nodules (n=6). The signs presented in 21, 8, 7, 9, 4 and 6 cases in diffuse type group respectively and 5, 3, 4, 1, 5, 0 in localized type group. Among them, lobular hyperinflation, ground?glass opacity and centrilobular nodules were more prevalent in the diffuse group. The difference was statistically significant (χ2=14.77,2.01,0.55,4.84,0.06 and 3.91, P<0.05). The onset age of LCH group with lung involvement was younger than the other (Z=-2.40, P<0.05). However, there was no statistically significant difference in the illness duration (Z=-1.46, P>0.05) and pulmonary function between two groups (P>0.05). Conclusions Lobular hyperinflation, ground glass opacity and centrilobular nodules are the most common manifestations in LCH patients with lung involvement and the distribution is mostly diffuse. Nodules, cystic lesions and interlobular septa thickening may exist. Several signs may coexist simultaneously. Younger children with LCH are more vulnerable to lung involvement.

Objective To explore whether 5 to -7-day of folic acid supplementation prior to pemetrexed therapy is needed. Methods We retrospectively evaluate the outcomes of non-small cell lung cancer patients received less than the advised folic acid premedication. Seventy patients with Ⅲ-Ⅳ NSCLC were randomly divided into two groups: patients who initiated vitamin supplementation on 7 days before the first dose of pemetrexed (group A) and patients who initiated vitamin supplementation on the day of the first dose of pemetrexed (group B). Results In group A and group B, CR 0 and 0, PR 10 and 8, the response rates of 28.6% and 22.9% were observed, respectively. There was no statistically significant differences between these two groups. No significant differences were observed in the incidence of hematologic and non-hematologic toxicities. Conclusions The initiation of pemetrexed-based chemotherapy does not need to accommodate a vitamin supplementation schedule.

The major satisfaction of college students will influence their learning interest and motivation, and then influence their learning achievement and future employment. Under the guidance of the concept of the micro system engineering of the education reform, the degree of the major satis-faction of the students in TCM colleges is analyzed by SIMPP method. The results show that students' behavior mode such as their preview situation, teaching adaptation, course satisfaction, students' achievement and their attitude of poor academic performance is closely related to the degree of major satisfaction. Teachers can judge the degree of major satisfaction by following these pattern behaviors;improve the rationality and accuracy of the degree of major satisfaction.

The degree of satisfaction of the curriculum is related not only to the degree of the curriculum but also to the degree of the students' development. With the concept of teaching reform micro system engineering, using the SIMPP analysis of the degree of satisfaction of the curriculum, the relevant factors of the students are studied. The results show that, the learning state, learning objec-tives, and the education level of mother affect the students more easily on the curriculum satisfaction. Research shows, in the present curriculum condition, educators should guide the students to study hard, establish a clear and reasonable learning goal, give the students the introduction and analysis of the curriculum, can effectively improve the students on the curriculum satisfaction, enhance the enthusiasm of the study.

Academic diligence level can not only directly affect the academic performance of students, but also affect the individual's emotional and physical health. In this study, through a question-naire survey of university students, with the method of SIMPP and the concept of the micro system engi-neering in higher education teaching reform, the related factors of diligence and the college students' behavior mode with respect to diligence are systematically analyzed. Analysis shows that, students' diligence level is affected not only by inherent factors such as clear learning objectives, learning state and after-school learning time, but also by the school ethos, the influence factors of the curriculum and parents' re-quirements.

The clear learning objective is one of the important factors to determine the learning effect of college students. In order to analyze the factors affecting the formation process of college stu-dents' learning objectives, to explore the teaching mode that can be helpful for college students' clear learning objective, under the guidance of the concept of the reform of the teaching system, the SIMPP analysis of the students learning objective in the TCM colleges was carried out. Results showed that the related factors that affected student learning objectives included family factors, school principals and students' subjective factors. Teachers' observing students' learning status carefully, their understanding students' background, income and other social factors, mastering the degree of students' learning spe-cific goals and behavior model, and conducting the targeted and effective inventiveness are to help students clear learning objectives. The results provide the technology and method of operation for col-lege teachers to correctly guide different types of students to establish a clear learning objective.

The influence extent of students from teachers is related to the teaching effect , which means whether it can successfully promote the study of students and reach the expected teach-ing goal during the teaching process. To have a good teaching effect, guided by the micro-system en-gineering of teaching reform, we used SIMPP to analyze the related factors of the influence of students extent from teachers during the teaching process in TCM colleges and universities. The result shows that the influence extent from teachers is related to not only teachers themselves but students and their self-condition and family backgrounds as well. Going further in researching these factors and the related behavior patterns of influence extent of students from teachers is helpful to making the teach-ing more effective and more targeted.