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 relationship between psychological distress and intimacy in stroke patients and the mediating effect of different dyadic coping style, to provide theoretical guidance for improving the intimate relationship of stroke patients.Methods:A convenient sampling method was used to select 203 patients with stroke who visited the General Hospital of Ningxia Medical University, the People's Hospital of Ningxia Hui Autonomous Region and the Department of Neurology of Yinchuan First People's Hospital from December 2020 to July 2021 as the survey objects. The general information questionnaire, Kessler Psychological Distress Scale, Quality of Relationship Index and Dyadic Coping Inventory were used to investigate patients.Results:The scores of psychological distress, intimate relationship, positive dyadic coping and negative dyadic coping were 19.33 ± 7.46, 32.75 ± 6.79, 86.25 ± 13.22, and 16.46 ± 4.08, respectively. Correlation analysis showed that psychological distress was negatively correlated with intimate relationship and positive dyadic coping ( r=-0.195, -0.204, both P<0.01), psychological distress was positively correlated with negative dyadic coping ( r=0.229, P<0.01). The mediating effect of positive dyadic coping and negative dyadic coping on psychological distress and intimate relationship was 35.87% and 53.26%, respectively. Conclusions:The psychological distress indirectly affects the intimate relationship of stroke patients through positive dyadic coping and negative dyadic coping. Health care workers can guide patients to actively cope with the disease and encourage couples to strengthen communication, so as to enhance the intimacy of couples and promote their physical and mental health development.

Microglial surveillance plays an essential role in clearing misfolded proteins such as amyloid-beta, tau, and α-synuclein aggregates in neurodegenerative diseases. However, due to the complex structure and ambiguous pathogenic species of the misfolded proteins, a universal approach to remove the misfolded proteins remains unavailable. Here, we found that a polyphenol, α-mangostin, reprogrammed metabolism in the disease-associated microglia through shifting glycolysis to oxidative phosphorylation, which holistically rejuvenated microglial surveillance capacity to enhance microglial phagocytosis and autophagy-mediated degradation of multiple misfolded proteins. Nanoformulation of α-mangostin efficiently delivered α-mangostin to microglia, relieved the reactive status and rejuvenated the misfolded-proteins clearance capacity of microglia, which thus impressively relieved the neuropathological changes in both Alzheimer's disease and Parkinson's disease model mice. These findings provide direct evidences for the concept of rejuvenating microglial surveillance of multiple misfolded proteins through metabolic reprogramming, and demonstrate nanoformulated α-mangostin as a potential and universal therapy against neurodegenerative diseases.

Objective:To explore the effect of perceived stress on fatigue and its mechanism, so as to provide theoretical support for relieving the fatigue of the main caregivers of stroke patients.Methods:From December 2020 to August 2021, 311 main caregivers of stroke patients hospitalized in the Department of Neurology of Class Ⅲ Grade A hospitals in Yinchuan were selected by convenient sampling. The caregivers were investigated with the General Information Questionnaire, Perceived Stress Scale, Resourcefulness Scale, Social Support Rating Scale and Fatigue Scale.Results:In this study, a total of 311 questionnaires were distributed, and 308 valid questionnaires were recovered, with an effective recovery rate of 99.04%. The total scores of perceived stress, fatigue, resourcefulness and social support of the main caregivers of stroke patients were (24.98±6.36) , (5.31±2.86) , (83.98±12.85) and (39.76±6.21) respectively. Perceived stress were negatively correlated with resourcefulness and social support ( r=-0.313, -0.274, P<0.01) , and positively correlated with fatigue ( r=0.261, P<0.01) . Fatigue were negatively correlated with resourcefulness and social support ( r=-0.305, -0.268; P<0.01) . There was a positive correlation between resourcefulness and social support ( r=0.210, P<0.01) . The results of intermediary test showed that the direct effect of perceived stress on fatigue was valid, and the respective intermediary effect of resourcefulness and social support between perceived stress and fatigue, and the chain intermediary effect of resourcefulness and social support were also valid, with the amount of intermediary effect being 26.92%, 15.38% and 3.85% respectively. Conclusions:The chain mediation between perceived stress and fatigue is established between the resourcefulness and social support of the main caregivers of stroke patients. In the future, the mental and physical pressure of stroke patients can be alleviated by improving the resourcefulness of their main caregivers and providing social support.

Objective:To explore ultrasonographic diagnostic characteristics of ovarian epithelial tumors and establish prediction models.Methods:The ultrasonographic images of 427 cases from multicenter with ovarian epithelial tumors confirmed by pathology from January 2015 to July 2019 were retrospectively analyzed according to the International Ovarian Tumor Analysis (IOTA). Ultrasonographic signs with distinguishing significance were obtained through univariate analysis and included into multivariate Logistic regression analysis to obtain important ultrasonagraphic indicators for distinguishing borderline, benign and malignant ovarian tumors, and to establish prediction models.Results:The microcystic pattern of papillary projections and solid components was the diagnostic characteristic between borderline and benign, malignant ovarian epithelial tumors( OR value 10.97 and 19.22, respectively). Irregular morphology, septa thickness, solid lesions, rich blood supply and ascites were diagnostic characteristics between benign and malignant tumors, with the irregular morphology having the highest value. Irregular morphology, large papillary, septa thickness and rich blood supply could be used to identify borderline and malignant tumors. At the same time, irregular morphology was the valuable sign to distinguish borderline and benign tumors. In this study, the total coincidence rate of the proposed model was 72.4%, among which the predicted coincidence rate of the borderline model was 57.2%, 78.6% for benign, and 80.7% for malignant. Conclusions:The microcystic pattern of papillary projections and solid components are the specific sonographic characteristics of borderline ovarian tumors. Irregularity, solid lesions, rich blood supply and ascites have important value in differentiating ovarian epithelial tumors. The prediction models of benign, malignant and borderline ovarian tumors in this study have higher diagnostic efficacy.

Objective To design and conduct objective structured clinical examination (OSCE) in professional postgraduates in obstetrics and gynecology, and to investigate the improvement measures for the teaching of professional postgraduates in obstetrics and gynecology by analyzing the performance of postgraduates in OSCE. Methods In October 2017, OSCE was performed for postgraduates in obstetrics and gynecology in the classes of 2016 and 2017 to evaluate their clinical ability. This OSCE consisted of the following four aspects: inquiry of standardized patients, basic practical skills in obstetrics and gynecology, utilization and interpretation of auxiliary examinations, and case analysis. The postgraduates were scored according to the following six items: doctor-patient communication skills, completeness of inquiry, basic practical skills in obstetrics and gynecology, utilization of auxiliary examinations, competence of clinical thinking, and mastery of medical knowledge. SPSS 18.0 was used for statistical analysis, and the t-test was used for comparison between groups . Results A total of 27 postgraduates participated in this OSCE . Among the six scoring items, completeness of inquiry had the lowest score (78 ±6), and utilization of auxiliary examinations had the highest score (85±3). Among the 27 postgraduates, 7 (25.9％) lacked doctor-patient communication skills, 6 (22.2％) showed serious problems in basic practical skills in obstetrics and gynecology, and 6 (22.2％) lacked the scientific thinking of clinical diagnosis. Conclusion In the training of professional postgraduate students in obstetrics and gynecology, doctor-patient communication skills and clinical thinking should be emphasized, and basic clinical skill training should be strengthened.

Objective To analyze the demands of Chongqing municipal medical and health institutions at grass-roots level for the graduates of clinical medicine,pharmacy and medical laboratory science and biotechnology.Methods The Chongqing medical and health institutions at grass-roots level served as the objects and their professionals and administrators were randomly performed the talents demands investigation by adopting the questionnaire investigation as the principal thing assisted by the interview on the spot or informal discussion.Results In the aspect of talents demands,the demands for internist,general practitioner and clinical examination staff were greater,which reached to 36.54％,30.77％and 78.10％respectively;in the aspect of professional knowledge demands,the demands for clinical diagnosis,general practice,clinical medication,clinical laboratory and blood test were greater.Con clusion The school talents cultivation does not understand the true requirements of medical and health institutions at grass-roots level and is inconsistent with the practical demands.

Objective To investigate and analyze clinical obstetrics and gynecology clinicians' mastery of basic skills, and then find the way to help clinicians master basic clinical skills. Methods A self-designed questionnaire survey was conducted among 310 clinicians working in 1-3 grade hospital from Chongqing, Sichuan, Guizhou, Yunnan provinces anonymously by spot field investigation and letter-investigations from February 1, 2015 and to March 31, 2015. The data were analyzed by descriptive analysis, using SPSS 19.0 software package for rank sum test analysis. Result Among 310 valid questionnaires, 31.6% (98) clinicians considered having inadequate clinical skills, 26% (81) average and 42.3%(131) expert. All the basic skills obtained had a relationship with the number of operations, working years and professional title. Most of the basic clinical skills were from working in hospitals 85% (270), journal 82% (254), academic conference 58% (174); 94.2% (293) willing to participate in training classes like clinical teaching and training in moulds. Conclusion The gynecology and obstet-rics basic clinical skills have a great relationship with basic skills training. Providing opportunities for the basic clinical skill trainings, academic conferences, in-service education and establishing regional medical source sharing platform can enhance their clinical skills.

The relationship between subclinical hypothyroidism (SCH) and the components of metabolic syndrome (MS) was explored.A total of 2 252 subjects aged 20 to 79 years from medical examination were identified.The prevalence of SCH was 4.88％.The rate of 7.30％ in female was markedly higher than 2.17％ in male(P＜0.01).The highest SCH prevalence in adults was in the ≥70 years old group.The prevalence of SCH in female was increased with age(P＜0.01).Compared with the euthyroid group,body mass index,triglyceride,and low density lipoprotein-cholesterol were significantly elevated (P＜0.05),while high density lipoprotein-cholesterol was significantly decreased in SCH group(P＜0.05).The incidences of hypertension,dyslipidosis,and MS in SCH group were significantly higher than those in euthyroid group(P＜0.05 or P＜0.01) ; Serum TSH in the MS group was higher than that in the Non-MS group[(2.43 ± 1.55 vs 2.21 ± 1.48) mU/L,P＜0.01].The incidence of SCH in MS group was significantly higher than that in the Non-MS group (7.69％ vs 4.25％,P＜0.05).The prevalence of SCH in women was increased with age.Multiple factors of dysbolism were clustered in subjects with SCH.There is a correlation between SCH and MS.

Objective To evaluate the performance of the hypersensitive C-reactive protein(hs-CRP) rapid quantitative chemilu-minescent detection kit .Methods According to National Committee for Clinical Laboratory Standards (NCCLS) EP10-A2 docu-ment ,hs-CRP rapid quantitative chemiluminescent detection kit was employed to measure the CRP at low ,medium and high con-centration levels of quality control serum .Bias ,total imprecision and their slope rates ,intercepts ,carryover ,non-linearity and drift were calculated ,and its clinical acceptability was evaluated .Results Bias and total imprecision of hs-CRP rapid quantitative chemi-luminescent detection kit were within the allowable ranges ,the average values of slope rates ,intercepts ,carryover ,non-linearity and drift were 1 .005 7 ,0 .537 8 ,0 .789 6% ,0 .019 2 ,0 .036 0 ,respectively ,the differences showed no statistically significance ( P>0 .05) .Conclusion hs-CRP rapid quantitative chemiluminescent detection kit has good accuracy and precision ,stable perform-ance ,and consistent with the clinical testing requirements .