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.

With the rapid development of fundus imaging technology, it is of great significance to establish a new naming system for neovascular age-related macular degeneration (nAMD) based on the multi-mode imaging. In 2020, an international panel of retina specialists, imaging and image reading center experts, and ocular pathologists reached a consensus after repeated discussions, a new name for nAMD subtype and related lesions was established based on the previous knowledge of fundus fluorescein angiography and pathology, combining indocyanine green angiography, optical coherence tomography and optical coherence tomography angiography with current pathological knowledge, in order to help ophthalmologists to study nAMD. The consensus proposed the term "macular neovascularization" and classified it into type 1, type 2 and type 3. Many lesions related to macular neovascularization, such as pigment epithelial detachment, hemorrhage, fibrosis, rip of retinal pigment epithelium and so on, were named. The new designation will help improve clinical communication between different studies, establish standard definitions and terms between reading centers and researchers, and further promote the understanding and communication of nAMD among ophthalmologists.

Objective:To explore the value of pre- and postoperative red cell distribution width-to-lymphocyte count ratio (RLR) in predicting the disease-free survival (DFS) for non-metastatic colorectal cancer patients.Methods:The data of 108 patients pathologically diagnosed with non-metastatic colorectal adenocarcinoma after surgery from December 2012 to January 2020 in Hainan Hospital of PLA General Hospital were retrospectively analyzed. RLR was calculated and its differences in patients with varied clinicopathological characteristics were analyzed. The receiver operating characteristics (ROC) curve was applied to analyze the value of pre- and postoperative RLR in predicting DFS of patients, and the cut-off value was determined by Youden index. DFS of patients with different stratification stratified by a cut-off value of RLR was analyzed by using Kaplan-Meier method followed by log-rank test. Cox proportional hazards model was used to make univariate and multivariate analysis.Results:Youden index of pre- and postoperative RLR in predicting DFS was 8.86%, 9.15%; based on the above index, the patients were divided into the preoperative RLR<8.86% group (73 cases) and preoperative RLR≥8.86% group (35 cases), postoperative RLR<9.15% group (48 cases) and postoperative RLR≥9.15% group (60 cases). According to ROC curve, the area under the curve (AUC) of preoperative RLR in predicating DFS was 0.66 (95% CI 0.55-0.77, P = 0.01), and AUC of postoperative RLR in predicating DFS was 0.62 (95% CI 0.51-0.74, P = 0.04). Pre- and postoperative RLR cut-off values were used to predict 3-year DFS rate of patients with the sensitivity of 51.60% and 71.00%, respectively, and the specificity of 76.60% and 50.60%, respectively. Kaplan-Meier analysis showed that patients in preoperative RLR<8.86% group had a better DFS compared with those in preoperative RLR≥8.86% group ( χ2 = 7.35, P < 0.01); there was no statistical difference in DFS between postoperative RLR<9.15% group and postoperative RLR≥9.15% group ( χ2 = 3.69, P = 0.06). Preoperative RLR was an independent affecting factor for DFS of patients ( HR = 1.13, 95% CI 1.04-1.22, P <0.01). Conclusions:Pre- and postoperative RLR could be useful in predicating 3-year DFS for patients with non-metastatic colorectal cancer. Preoperative RLR is an independent affecting factor for DFS, and the patients with low RLR have a better prognosis.

Objective: To compare the prevalence of dental caries and periodontal disease in patients with end-stage renal disease treated with maintenance hemodialysis with that in healthy controls and to investigate the relationship between end-stage renal disease, dental caries and periodontal disease. Methods : A total of 82 maintenance hemodialysis patients who met the inclusion criteria were selected as the case group, and 86 healthy persons who underwent oral examination in the physical examination center were selected as the control group. Dental caries and periodontal conditions were examined in the two groups. The dental caries examination was conducted by determining the number of decayed-missing-filled teeth, which was recorded as recommended by the World Health Organization. The periodontal condition parameters included the plaque index, calculus index, bleeding on probing, periodontal pocket depth and clinical attachment loss. Results: The prevalence of dental caries in the case group and healthy control group was 87.8% and 81.4%, respectively, and there was no statistically significant difference between the two groups (P > 0.05). The periodontal indexes, including the plaque index, calculus index, probe bleeding index, periodontal pocket depth and clinical attachment level, in the case group were significantly higher than those in the control group (P < 0.05), and the prevalence of periodontitis in the case group was significantly higher than that in the control group (97.6% vs 88.4%, P < 0.05). Conclusion The dental caries conditions were comparable between the case group and the control group, but the prevalence and severity of periodontitis were significantly higher in the case group than in the control group.

Objective:To observe the effect of hyperbaric oxygen (HBO) therapy on the pituitary function of patients with subacute traumatic brain injury.Methods:Sixty-six patients with subacute traumatic brain injury and hypopituitarism were randomly divided into a control group ( n=33) and an HBO group ( n=33). Patients in both groups were given conventional treatment including dehydration to reduce intracranial pressure, anti-infection medication, epilepsy and bed sores prevention measures, neurotrophic treatment, fluid replacement and rehabilitation. The HBO group was additionally given HBO at 0.2MPa (2.0ATA), once a day, 6 times a week for a total of 20 administrations. Before and after the treatment, serum adrenocorticotropic hormone (ACTH), growth hormone (GH), thyroid stimulating hormone (TSH), prolactin (PRL), luteinizing hormone (LH), follicle stimulating hormone (FSH), cortisol, insulin-like growth factor 1, free tetraiodothyronine, testosterone, and estradiol levels were detected using chemical immunoluminescence. The ACTH, GH, TSH, PRL, LH and FSH values were used to calculate general pituitary hormone scores. Results:After the treatment, the average PRL, LH and testosterone levels and the general pituitary hormone score in the HBO group were significantly higher than among the controls.Conclusions:HBO treatment can increase the levels of various hormones in patients with subacute traumatic brain injury and promote the recovery of pituitary function.

High-voltage-activated (HVA) Ca channels are widely expressed in the nervous system. They play an important role in pain conduction by participating in various physiological processes such as synaptic transmission, changes in synaptic plasticity, and neuronal excitability. Available evidence suggests that the HVA channel is an important therapeutic target for pain management. In this review, we summarize the changes in different subtypes of HVA channel during pain and present the currently available evidence from the clinical application of HVA channel blockers. We also review novel drugs in various phases of development. Moreover, we discuss the future prospects of HVA channel blockers in order to promote "bench-to-bedside" translation.

Objective To investigate the value of molecular probe USPIO-PEG-sLeX in metastasis model of nasopharyngeal carcinoma. Methods According to the pathological results of transplanted tumors of nude mice with nasopharyngeal carcinoma,the tumor-bearing mice were divided into metastatic group and non-metastatic group.T2 ? values of the transplanted tumors at four different time points were measured before and after the injection of USPIO-PEG-sLeX(t0＝plain scan,t1＝scan immediately after enhancement,t2＝1 hour post-enhancement scan,t3＝2 hours post-enhancement scan).ΔT2 ? and enhancing rates at t1 ,t2,t3 were calculated.Results The plain T2 ? values of the metastatic group and the non-metastatic group were 22.25±8.08 and 27.01±9.45,respectively.There was no significant difference between the two groups at t0 (P＞0.05).The T2 ? values at t1,t2 and t3 were 11.57±4.02 and 24.82±7.84,10.09±4.88 and 24.15±8.74,12.46±5.63,23.42±7.12 respectively in the metastatic and non-metastatic groups,differences were statistically significant (P values were 0.005,0.008 and 0.01 9,respectively).ΔT2 ? values at time t1 ,t2 and t3 in nude mice in the metastatic and non-metastatic groups were 10.69±6.23,3.86±2.20,12.1 7±8.67 and 2.87±1.37,9.80±3.03,4.32±2.28 respectively.The differences were statistically significant (P values were 0.027,0.048 and 0.043,respectively).The enhancement rates at t1,t2 and t3 in nude mice in metastatic and non-metastatic groups were 45.98±14.03,7.10±5.18,5 1.1 5±22.70 and 1 1.04±6.01 ,44.05 ±13.92,12.09 ±7.54,respectively,with statistically significant differences (P values were 0.001,0.005 and 0.007,respectively).After two-way repeated-measures analysis of variance,there was a statistically significant difference in T2 ? values between the metastatic and non-metastatic groups (P＝0.02＜0.05).There was a statistically significant difference in T2 ? values at different times (P＝0.001＜0.05).There was an interaction between the metastatic and non-metastatic groups and the scan time (P＝0.043＜0.05).Conclusion USPIO-PEG-sLeX molecular probe can non- invasively monitor E-selectin expression,and has a good application prospect in monitoring the metastasis of nasopharyngeal carcino-ma xenograft models.

Objective To understand the cognition ,attitudes and needs of the science and technology achievement trans-formation policies among the medical personnel of 21 tertiary hospitals in Shanghai .Methods Convenient sampling method was used .The self-designed questionnaires were used to survey 420 personals in 21 tertiary hospitals in Shanghai ,and 411 valid questionnaires were responded with a valid rate of 97 .86％ .Results The cognition of science and technology achievement transformation policies of the respondents was low ,and the degree of cognition was related to the professional titles ( P<0 .05) .While the recognition degree of some policies was high ;40 .47％ agreed that enterprises could be the decision-maker during the transformation process ;85 .99％ agreed that it is OK to hire the Technology intermediary service agencies to evalu-ate the achievements value ,confirmed that need such agencies to provide the services of information collection and screening . Conclusions More Policy publicity should be enhanced among the medical personnel ,communications about their needs and suggestions on the science and technology achievement transformation should be carried out to further update related policies , as well as improve the transformation of science and technology achievements in health system .

Objective To observe any effect of hyperbaric oxygen therapy on cognitive dysfunction caused by traumatic brain injury,and to explore possible neural mechanisms.Methods Sixty-four patients with cognitive impairment after a traumatic brain injury were randomly divided into a hyperbaric oxygen group (n =32) and a control group (n=32) using a random number table.Both groups accepted routine medical therapy and cognitive rehabilitation training,but the hyperbaric oxygen group additionally received hyperbaric oxygen treatment.Both groups' cognitive functioning was assessed using the Mini Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) before and after the treatment.Fifteen patients were randomly selected from both groups to receive T1WI and diffusion tensor imaging scans.The correlation between the two evaluation resuhs was analyzed.Results After the intervention,improvement was observed in the average MMSE and MoCA scores of both groups,with the improvement in both average scores in the hyperbaric oxygen group significantly greater than among the control group.There was no significant correlation between the fractional anisotropy (FA) values of damaged white matter and the average MMSE or MoCA score in the controi group,but in the hyperbaric oxygen group there were significant positive correlations between the FA values of the corpus callosum,the anterior limb of the internal capsule and the left superior longitudinal fasciculus and the average MMSE and MoCA scores.Conclusions Hyperbaric oxygen therapy combined with rehabilitation training can further improve cognition after a traumatic brain injury.This is probably due to its adjusting the structure and function of the corpus callosum,of the anterior limb of the internal capsule and of the left superior longitudinal fasciculus.

Objective To discuss the imaging features of parietal bones atrophy,and to improve the understanding of this disease. Methods Clinical and imaging data of 8 patients with parietal bones atrophy were analyzed retrospectively.Age ranged 66-90 years with median age 76 years.CT scans were performed in all cases,and CT enhanced examination in 1 case.MRI examination were performed in 3 cases,in which MRI enhanced examination in 2 cases.Imaging characteristics were analyzed along with a review of the current literature.Results Bilateral parietal sympathetic involvements were found in 4 cases,unilateral parietal involvement in 4 cases,in which the left parietal bone was found in 2 cases and the right side in other 2 cases.The lesions ranged from 2.4 cm to 7.1 cm.On CT and MRI images,the external table of the parietal bones showed symmetrical impression,the diploe revealed thinner and the inner table was intact,which presented"Step change".Two of these patients were followed up,in which 1 case become severe atrophy,and the other case was no significant change.Nothing was showed in the relative scalp and soft tissue.Conclusion According to different degrees of thinning of parietal bones,combined with specific age,symmetrical parietal bone impression should be considered.