Bluetongue virus is an arbovirus that seriously harms ruminants such as sheep,this study aims to investigate the molecular mechanism of bluetongue virus infection and host cell interferon antiviral immune response.The study was conducted to characterize the mRNA expression of inter-feron pathway genes by real-time fluorescence quantitative PCR,as well as Western blot analysis of MDA5,TRAF3,RIG-Ⅰ,and TBK1 protein expression in BHK-21 cells induced by BTV with a multiplicity of infections(MOI)of 1 for 18,24,and 36 h.The results showed that the most pro-nounced changes in the expression of interferon signaling pathway genes were observed at 24 h of induction,the gene mRNA expression levels of the IFN-α,IFN-β,RIG-Ⅰ,TBK1,MDA5,VISA,and TRAF3 genes were upregulated.However,the mRNA expression levels of IKKε and TRAF6 genes were downregulated.At the protein level,MDA5 and TBK1 proteins were upregulated while RIG-1 and TRAF3 proteins were downregulated,which showed that BTV infection induces a typeⅠ interferon immune response in BHK-21 cells.This study lays the foundation for further exploring the antiviral immunity mechanism of IFN-Ⅰ signaling pathway regulatory genes in host cells infected with BTV infection.

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.

Metal working fluidis widely used as coolant, lubricant and rust remover in mechanical processing. Oil mist will be formed in the process of metal working fluid. The composition of oil mist is complex, which can produce many adverse effects on the environment and operators. This paper reviews the health hazards of metal working fluid oil mist on human skin, respiratory system, teratogenic and carcinogenic aspects, and discusses the establishment of occupational exposure limits in workplaces of oil mist in foreign countries, in order to provide reference for the prevention and control of occupational health risks of metal working fluid oil mist and the establishment of occupational exposure limits of oil mist in workplaces in China.

Metal working fluidis widely used as coolant, lubricant and rust remover in mechanical processing. Oil mist will be formed in the process of metal working fluid. The composition of oil mist is complex, which can produce many adverse effects on the environment and operators. This paper reviews the health hazards of metal working fluid oil mist on human skin, respiratory system, teratogenic and carcinogenic aspects, and discusses the establishment of occupational exposure limits in workplaces of oil mist in foreign countries, in order to provide reference for the prevention and control of occupational health risks of metal working fluid oil mist and the establishment of occupational exposure limits of oil mist in workplaces in China.

Objective: The aim of this study is to explore the application and advantages of combined intrathecal and extrathecal hypothermic plasma tonsillectomy in reducing intraoperative and postoperative hemorrhage in OSA children. Method: We retrospectively reviewed 726 cases who were diagnosed as OSA. All patients were divided into two groups according to the surgical method: 320 cases by total tonsillectomy and 406 cases by combined extracapsular and intracapsular tonsillectomy. The intro operative bleeding volume, post operative haemorrhage data as time, location and degree in the two groups were compared. Result: There was no statistical difference in the intro operative bleeding volume in the two groups [（9.3±4.6） mL]vs [（7.6±3.5） mL], t=12.687, P=0.235. Two patients who underwent combined extracapsular and intracapsular tonsillectomy presented with post operative haemorrhage, the total post operative haemorrhage rate was significantly decreased that in the total tonsillectomy group（14 cases）（χ²=10.779, P=0.001）. The 2 patients in combined extracapsular and intracapsular tonsillectomy group were secondary haemorrhage, with location in the upper pole and medium, grade A haemorrhage; while in the 14 cases in in the total tonsillectomy group, there were 2 cases presented with primary haemorrhage and 12 cases with secondary haemorrhage; with regard to location of haemorrhage, 1 in the upper pole, 2 in the medium, 11 in the lower pole; 5 cases presented with grade A haemorrhage, 8 with grade B haemorrhage and 1 with grade C haemorrhage. The haemorrhage rate at 7 days after surgery （χ²=5.697, P=0.017）, at the lower pole（χ²=11.961, P=0.001） and grade B（χ²=8.097, P=0.004） were all significantly decreases in the combined extracapsular and intracapsular tonsillectomy group. Conclusion Plasma tonsillectomy combined with intrathecal and extrathecal hypothermic tonsillectomy is a safe and effective method, which has obvious advantages in reducing the postoperative hemorrhage, especially the secondary hemorrhage of Subtonsillar Pole.

The aim of this study is to explore the application and advantages of combined intrathecal and extrathecal hypothermic plasma tonsillectomy in reducing intraoperative and postoperative hemorrhage in OSA children. We retrospectively reviewed 726 cases who were diagnosed as OSA. All patients were divided into two groups according to the surgical method: 320 cases by total tonsillectomy and 406 cases by combined extracapsular and intracapsular tonsillectomy. The intro operative bleeding volume, post operative haemorrhage data as time, location and degree in the two groups were compared. There was no statistical difference in the intro operative bleeding volume in the two groups [（9.3±4.6） mL]vs [（7.6±3.5） mL], =12.687, =0.235. Two patients who underwent combined extracapsular and intracapsular tonsillectomy presented with post operative haemorrhage, the total post operative haemorrhage rate was significantly decreased that in the total tonsillectomy group（14 cases）（χ²=10.779, =0.001）. The 2 patients in combined extracapsular and intracapsular tonsillectomy group were secondary haemorrhage, with location in the upper pole and medium, grade A haemorrhage; while in the 14 cases in in the total tonsillectomy group, there were 2 cases presented with primary haemorrhage and 12 cases with secondary haemorrhage; with regard to location of haemorrhage, 1 in the upper pole, 2 in the medium, 11 in the lower pole; 5 cases presented with grade A haemorrhage, 8 with grade B haemorrhage and 1 with grade C haemorrhage. The haemorrhage rate at 7 days after surgery （χ²=5.697, =0.017）, at the lower pole（χ²=11.961, =0.001） and grade B（χ²=8.097, =0.004） were all significantly decreases in the combined extracapsular and intracapsular tonsillectomy group. Plasma tonsillectomy combined with intrathecal and extrathecal hypothermic tonsillectomy is a safe and effective method, which has obvious advantages in reducing the postoperative hemorrhage, especially the secondary hemorrhage of Subtonsillar Pole.

Objective To investigate the clinical and prognostic significance of ABO promotor methylation level in adult patients with leukemia and myelodydysplastic syndrome(MDS). Methods ABO promoter methylation level of 182 malignant hematological disease patients and 68 normal controls were detected by bisulfite sequencing PCR. Then clinical features and outcome were compared between hypermethylation group and hypomethylation group. Results The median methylation rate of ABO promoter in newly diagnosed acute myeloid leukemia (AML) and acute lymphocytic leukemia (ALL) were 46.98％ and 11.01％ respectively, which were both higher than that in controls (2.30％, P<0.05). The methylation rates in remission AML and ALL were 1.58％and 2.30％respectively, which were comparable with that in normal group (P>0.05). As to relapse AML and ALL, methylation rates were 41.26％ and 17.50％respectively, also significantly higher than that in controls (P<0.05).In patients with chronic myeloid leukemia (CML) chronic phase, the median methylation rate was 1.00％, which was similar to normal group. But a CML patient who transformed to ALL hadextremely high methylation rate 92.56％. The median methylation rate in patients with MDS significantly elevated as 5.81％ compared with that in controls (P<0.05). The median overall survival (OS) of ALL and AML (non-M3) patients with hypermethylation were 12.5 months and 15.3 months, which were significantly shorter than those with hypomethylation (24.0 months and 20.0 months) (P<0.05). The median disease-free survival (DFS) of ALL and AML (non-M3) patients with hypermethylation were 9.9 months and 12.0 months, which were significantly shorter than those with hypomethylation (22.3 months and 18.5 months), (P<0.05). Multivariable analysis suggested that ABO promoter methylation level was an independent predictive factor of OS and DFS in ALL and AML (non-M3) patients. Conclusion ABO promoter hypermethylation is closely related to genesis, development and prognosis of leukemia and MDS. Hypermethylationis related to a clinical poor prognosis compare with hypomethylation.

Objective To explore the effects of transitional nursing on the quality of life in patients with chronic obstructive pulmonary disease (COPD). Methods A total of 118 patients in the stable phase of COPD, who were discharged from the Affiliated Hospital of Xuzhou Medical University during March 2015 to June 2016 were selected by convenience sampling method and divided into observation group (n=60) and control group (n=58) according to the random number table. The patients in the control group were treated with routine nursing mode, while the patients in the observation group were given transitional care after discharged on the basis of routine nursing. The effects of the transitional care and patients' quality of life were evaluated with Care Transitions Measure (CTM) and Chronic Obstructive Pulmonary Disease Assessment Test (CAT) at three time points, before intervention, three and six months after the intervention. Results There was no statistical difference in the score of CTM between the two groups before intervention (P>0.05). After intervention for 3 and 6 months, the CTM score of the observation group patients were significantly higher than that of the control group, and the differences were statistically significant (P<0.05). Before intervention and 3 months after intervention, patients' CAT score had no statistical difference between the two groups (P> 0.05). The CAT score of the patients in the observation group was lower than that in the control group after intervention for 6 months, and the difference was statistically significant (P<0.05). Conclusions Transitional nursing mode can improve the cognition of patients in COPD stable phase, promote healthy lifestyle and behavior, and improve patients' quality of life.

Objective To provide the effective and convenient medical MOOC and remote medical education by comparatively analyzing domestic and foreign medical MOOC.Methods The following items were comparatively an-alyzed, including the number of medical MOOC, the universities offering medical MOOC, the languages used in teaching medical MOOC, the identification of MOOC, and the development of domestic and foreign medical MOOC on platforms of Coursera, edX, China university MOOC and people's health MOOC.Results The domestic medical MOOC still had a longer way to go than foreign medical MOOC in their number, scale and identification.Conclu-sion Domestic medical workers should grasp the opportunity to provide more effective and convenient medical MOOC platform.

Objective: To discuss the importance of pharmaceutical care in anti-infective treatment for one patient with severe pneumonia and renal insufficiency performed by clinical pharmacists. Methods: Clinical pharmacist participated in evaluating and changing the anti-infective treatment regimen, adjusted the drug dosage according to the renal function reasonably to avoid adverse drug reactions and completed the medication education and health education for the patient. Results:The infection was controlled effective-ly, gasp was controlled effectively and blood pressure was steady. Conclusion:Clinical pharmacists should monitor the whole treatment process,evaluate the drug regimen comprehensively and reduce adverse drug reaction to the maximum limit during the pharmaceutical care.