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 analyze the epidemiological characteristics of severe fever with thrombocytopenia syndrome (SFTS) in China from 2011 to 2021, and provide evidence for the prevention and control of SFTS.Methods:The incidence data of SFTS were collected from the National Disease Reporting Information System of Chinese Center for Disease Control and Prevention for a descriptive epidemiological analysis and Cochran-Armitage trend test was used to evaluate the association between age and the morbidity rate and case fatality rate (CFR) of SFTS.Results:From 2011 to 2021, a total of 18 902 laboratory confirmed cases of SFTS, including 966 deaths, were reported in 533 counties (districts) of 154 prefecture-level cities in 27 provinces. The annual average morbidity rate was 0.125/100 000, and the annual average CFR was 5.11%. From 2011 to 2021 the overall morbidity rate of SFTS was in increase with an average annual percentage change (AAPC) of 14.80% ( P=0.001). Most cases (99.23%) occurred in 7 provinces, including Shandong, Henan, Anhui, Hubei, Liaoning, Zhejiang and Jiangsu, with 70.28% of the cases in 11 prefecture-level cities. The average annual CFRs in the 7 provinces varied greatly from 1.30% to 11.27%. In 2011, SFTS cases were reported in 108 counties (districts) of 51 prefecture-level cities in 13 provinces, but SFTS cases were reported in 277 counties (districts) of 88 prefecture-level cities in 19 provinces in 2021, the disease spread from central area to the northeast and from the west and the south. SFTS mainly occurred in summer and autumn in both southern and northern China, and 96.63% of the cases were reported from April to October, and the incidence peak was during May-June. The cases mainly occurred in age group 50-74 years (69.46%), and the deaths mainly occurred in age group ≥60 years (79.71%). Both the morbidity rate and the CFR increased with age. The morbidity rate increased from 0.040/100 000 in age group 0-4 years to 4.480/100 000 in age group ≥80 years in males ( χ2=13 185.21, P<0.001) and from 0.038/100 000 in age group 0-4 years to 3.318/100 000 in age group ≥80 years in females ( χ2=12 939.83, P<0.001); the CFR increased from 0.70% in age group 30-34 years to 11.58% in age group ≥80 years in males ( χ2=115.70, P<0.001) and from 1.56% in age group 35-39 years to 8.98% in age group ≥80 years in females ( χ2=103.42, P<0.001). Conclusion:From 2011 to 2021, the incidence of SFTS increased in China, and the spread and obvious spatiotemporal distribution of SFTS were observed. The reported CFR varied greatly with area, and both the morbidity and mortality risk were high in the elderly.

From the perspective of technical review, this paper made statistics on the supplement contents of
Chemistry, Clinical/standards* ; China ; Indicators and Reagents ; Reagent Kits, Diagnostic/standards*

Rabies is a zoonotic infectious disease caused by lyssavirus and characterized by central nervous system symptoms. The fatality rate of rabies is almost 100%. About 59 000 cases die of rabies worldwide every year, mainly in Asia and Africa. China is an epidemic country of rabies. Grade II and III exposures are the main types of rabies exposures in China. Standardized post-exposure prophylaxis (PEP) can prevent rabies almost 100%. Human Rabies Vaccine Technical Working Group, National Immunization Advisory Committee and invited experts reached an expert consensus on PEP by referring to the World Health Organization′s position paper on rabies vaccine in 2018 and related research progress in recent.

Objective To investigate the clinical characters and treatment strategies of differentiated thyroid carcinoma in children and adolescent.Methods The clinical data of 75 cases of thyroid carcinoma in children and adolescents(≤ 18 years old)from Jan.2004 to Mar.2017 in the First Hospital of China Medical University were retrospectively analyzed.Clinical pathology characters and prognosis between patients ＜13 years old (group A) and those ≥ 13 years old (group B) were compared.Results There were 74 cases with papillary carcinoma and 1 with follicular carcinoma.The rate of lateral neck lymph node metastasis(100％ vs 54.5％,x2=6.818,P=0.025) and bilateral location (55.6％ vs 18.2％,x2=6.311,P=0.037) in group A were higher than in group B.There were no significant differences in central lymph nodes metastasis (88.9％ vs 69.7％,x2=1.758,P=0.420),gender composition ratio (22.2％ vs 31.8％,x2=0.343,P=0.841),extra-thyroid extension (33.3％ vs 18.2％,x2=1.136,P=0.534),distant metastasis(11.1％ vs 1.5％,x2=2.810,P=0.566) and recurrent disease(25％ vs 7.8％,x2=1.141,P=0.183) between the two groups.Conclusions Papillary carcinoma is the most common pathology type in children and adolescent thyroid carcinoma.Patients＜13 years old are more likely to present lateral neck lymph node metastasis and bilateral location.

Objective To explore the ultrasonographic and CT imaging features of predominantly cystic thyroid carcinoma (PCTC).Methods The retrospective analysis was performed on 30 cases of thyroid carcinoma with predominantly cystic composition confirmed by pathololy in the General Surgery Department of the First Affiliated Hospital of China Medical University from Jan.2011 to Dec.2016.The distribution of their solid portion's ultrasound characters including the eccentric configuration,irregular margin and increased vascularity were observed in all PCTCs.The CT images of 9 cases were analyzed,and the distribution of their solid portion's CT characters including irregular margin,uneven enhancement and papillary structure were observed in 9 PCTCs.Results In the ultrasound images of 30 PCTCs' whole shapes,26 cases (86.7％) showed oval and 24 cases (80.0％) showed smooth margin.26 cases (86.7％) showed eccentric configuration,20 cases (66.7％) showed rich blood flow and 19 cases (63.3％) showed irregular margin in the solid portion's ultrasound image.Only 7 cases(23.3％) showed microcalcification.Every ultrasound image of 30 PCTCs showed at least one or more of the three ultrasound characters,including eccentric configuration,irregular margin and increased vascularity.In the solid portion of 9 PCTCs,7 cases (77.8％) showed irregular margin,6 cases (66.7％) showed uneven enhancement and 6 cases(66.7％) showed papillary structure in the CT image,and every one of them showed at least one or more of the above 3 CT characters.Conclusion When the solid portion of predominantly cystic thyroid nodule appears to have some suspicious malignant characters in the image of ultrasound or CT,we should be vigilant that the nodule may be malignant.

Rabies is a zoonotic infectious disease caused by lyssavirus and characterized by central nervous system symptoms. The fatality rate of rabies is almost 100%. About 59 000 cases die of rabies worldwide every year, mainly in Asia and Africa. China is an epidemic country of rabies. Grade II and III exposures are the main types of rabies exposures in China. Standardized post?exposure prophylaxis (PEP) can prevent rabies almost 100%. Human Rabies Vaccine Technical Working Group, National Immunization Advisory Committee and invited experts reached an expert consensus on PEP by referring to the World Health Organization′s position paper on rabies vaccine in 2018 and related research progress in recent.

Rabies is a zoonotic infectious disease caused by lyssavirus and characterized by central nervous system symptoms. The fatality rate of rabies is almost 100%. About 59 000 cases die of rabies worldwide every year, mainly in Asia and Africa. China is an epidemic country of rabies. Grade II and III exposures are the main types of rabies exposures in China. Standardized post?exposure prophylaxis (PEP) can prevent rabies almost 100%. Human Rabies Vaccine Technical Working Group, National Immunization Advisory Committee and invited experts reached an expert consensus on PEP by referring to the World Health Organization′s position paper on rabies vaccine in 2018 and related research progress in recent.

Radiofrequency ablation (RFA) was originally used primarily for the treatment of regional metastatic lymph nodes from recurrent thyroid cancers in the field of thyroid surgery. In recent years it is gradually used to treat a part of benign thyroid nodules. However, the domestic issues resulting from indiscriminately enlarged RFA indication and lack of standardization of therapy become more and more prominent, including initial treatment of operable thyroid cancers by RFA, which is against by the current consensus about RFA for patients with thyroid nodules and management guidelines for patients with thyroid cancers. Therefore, RFA should be avoided for initial treatment of operable thyroid cancers before the introduction of guidelines based on evidence-based medicine.

Objective To evaluate the changing trend of serum thyrotropin (TSH) levels for hemithyroidectomy patients,and to discuss the necessity and strategy of TSH suppression for low-risk differentiated thyroid carcinoma(DTC). Methods One hundred and twenty-seven patients with benign thyroid nodules undergoing hemithyroidectomy between January 2013 and June 2014 were retrospectively studied. Serum thyroid hormones levels FT3,FT4,TSH,thyroid peroxidase antibody(TPOAb),and thyroglobulin antibody(TGAb)were detected at 1 month after surgery for all patients and at 3 month for 54 patients. Results (1)Mean TSH level at 1 month after surgery was significantly higher than preoperative TSH level(2.45 mIU/L vs 2.20 mIU/L,n=127,P<0.01). The mean TSH level at 3 month after operation was significantly higher than preoperative ones(2.46 mIU/L vs 2.35 mIU/L,n=54, P<0.05). (2)TSH<2. 0 mIU/L was found in 52 patients(40. 9%) and TSH>4. 94 mIU/L in 18 patients (14.17%) at 1 month after operation. TSH<2.0 mIU/L was found in 28 patients(51.85%)and TSH>4.94 mIU/L in 8 patients(14.81%) at 3 month after operation. (3)A preoperative TSH≥2.0 mIU/L and the coexistence of Hashimoto's thyroiditis were found to be independent risk factors for the TSH levels higher than 2.0 mIU/L. Among the patients with TSH≥2. 0 mIU/L at 1 month, 13 exhibited spontaneous recovery at 3 month, coexistence of Hashimoto's thyroiditis was related to this phenomenon. Among the patients with TSH<2.0 mIU/L at 1 month,TSH levels were elevated over 2. 0 mIU/L in 7 patients by 3 month comparing to that by 1 month. Coexistence of Hashimoto's thyroiditis was independent risk factor for the TSH elevation. Conclusion TSH suppression may still be performed to patients with low risk DTC after operation especially to whom the preoperative TSH≥2.0 mIU/L and the coexistence of Hashimoto's thyroiditis. Suppression therapy should be carefully considered with close follow-up.