[Objective] To investigate the correlation between human leukocyte antigen (HLA) gene polymorphism and hepatitis B virus (HBV) infection. [Methods] Venous blood samples were collected from 501 healthy individuals undergoing physical examinations at Yan’an Hospital in Kunming, Yunnan Province. Enzyme linked immunosorbent assay (ELISA) was used to detect HBV halves. Based on the results of HBV half detection, the patients were divided into three groups: HBV carrier group, previous infection group, and healthy control group. The HLA-A antigen genotype was detected using polymerase chain reaction with sequence specific primers (PCR-SSP) genotyping technology, and the distribution frequency of HLA-A gene polymorphism was compared between HBV carrier group and healthy control group, as well as between previous infection group and healthy control group. SPSS17.0 software was used for data statistical analysis. [Results] In the healthy control group, the HLA-A2 positivity rate was 47.49%, and the allele frequency was 31.29%.The overall frequency of gene distribution in the healthy control group was consistent with the HLA-A allele table commonly and confirmed in China published by the Chinese Bone Marrow Bank. The HLA-A2 positivity rate and allele frequency in the HBV carrier group were 63.04% and 42.23%, respectively; The difference in HLA-A2 positivity rate and allele frequency among carriers was statistically significant (P<0.05). the HLA-A2 positivity rate and allele frequency in the HBV previous infection group were 56.14% and 35.97%, respectively, which did not significantly differ from those in the healthy control group (P>0.05). [Conclusion] HLA-A2 gene may be a susceptibility gene for chronic hepatitis B HBV carriers.

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 investigate the development present situation of the department of critical care medicine in Inner Mongolia Autonomous Region (hereinafter referred to as Inner Mongolia), in order to promote the standardized and homogeneous development of critical care medicine in Inner Mongolia, and also provide a reference for discipline construction and resource allocation. METHODS: A survey study was conducted in comprehensive intensive care unit (ICU) of tertiary and secondary hospitals in Inner Mongolia by online questionnaire survey and telephone data verification. The questionnaire was based on the Guidelines for the Construction and Management of Intensive Care Units (Trial) (hereinafter referred to as the Guidelines) issued by the National Health Commission in 2009 and the development trend of the discipline. The questionnaire covered six aspects, including hospital basic information, ICU basic information, personnel allocation, medical quality management, technical skill and equipment configuration. The questionnaire was distributed in September 2022, and it was filled out by the discipline leaders or department heads of each hospital. RESULTS: As of October 24, 2022, a total of 101 questionnaires had been distributed, 85 questionnaires had been recovered, and the questionnaire recovery rate had reached 84.16%, of which 71 valid questionnaires had been collected in a total of 71 comprehensive ICU. (1) There were noticeable regional differences in the distribution of comprehensive ICU in Inner Mongolia, with a relatively weak distribution in the east and west, and the overall distribution was uneven. The development of critical care medicine in Inner Mongolia was still lacking. (2) Basic information of hospitals: the population and economy restricted the development of ICU. The average number of comprehensive ICU beds in the western region was only half of that in the central region (beds: 39.0 vs. 86.0), and the average number of ICU beds in the eastern region was in the middle (83.6 beds), which was relatively uneven. (3) Basic information of ICU: among the 71 comprehensive ICU surveyed, there were 44 tertiary hospitals and 27 secondary hospitals. The ratio of ICU beds to total beds in tertiary hospitals was significantly lower than that in secondary hospitals [(1.59±0.81)% vs. (2.11±1.07)%, P < 0.05], which were significantly lower than the requirements of the Guidelines of 2%-8%. The utilization rate of ICU in tertiary and secondary hospitals [(63.63±22.40)% and (44.65±20.66)%, P < 0.01] were both lower than the bed utilization rate required by the Guidelines (75% should be appropriate). (4) Staffing of ICU: there were 376 doctors and 1 117 nurses in tertiary hospitals, while secondary hospitals had 122 doctors and 331 nurses. There were significant differences in the composition ratio of the titles of doctors, the degree of doctors, and the titles of nurses between tertiary and secondary hospitals (all P < 0.05). Most of the doctors in tertiary hospitals had intermediate titles (attending physicians accounted for 41.49%), while most of the doctors in secondary hospitals had junior titles (resident physicians accounted for 43.44%). The education level of doctors in tertiary hospitals was generally higher than that in secondary hospitals (doctors: 2.13% vs. 0, masters: 37.24% vs. 8.20%). The proportion of nurses in tertiary hospitals was significantly lower than that in secondary hospitals (17.01% vs. 24.47%). The ratio of ICU doctors/ICU beds [(0.64±0.27)%, (0.59±0.34)%] and ICU nurses/ICU beds [(1.76±0.56)%, (1.51±0.48)%] in tertiary and secondary hospitals all failed to meet the requirements above 0.8 : 1 and 3 : 1 of the Guidelines. (5) Medical quality management of ICU: compared with secondary hospitals, the proportion of one-to-one drug-resistant bacteria care in tertiary hospitals (65.91% vs. 40.74%), multimodal analgesia and sedation (90.91% vs. 66.67%), and personal digital assistant (PDA) barcode scanning (43.18% vs. 14.81%) were significantly higher (all P < 0.05). (6) Technical skills of ICU: in terms of technical skills, the proportion of bronchoscopy, blood purification, jejunal nutrition tube placement and bedside ultrasound projects carried out in tertiary hospitals were higher than those in secondary hospitals (84.09% vs. 48.15%, 88.64% vs. 48.15%, 61.36% vs. 55.56%, 88.64% vs. 70.37%, all P < 0.05). Among them, the placement of jejunal nutrition tube, bedside ultrasound and extracorporeal membrane oxygenation were mainly completed independently in tertiary hospitals, while those in secondary hospitals tended to be completed in cooperation. (7) Equipment configuration of ICU: in terms of basic equipment, the ratio of the total number of ventilators/ICU beds in tertiary and secondary hospitals [0.77% (0.53%, 1.07%), 0.88% (0.63%, 1.38%)], and the ratio of injection pump/ICU beds [1.70% (1.00%, 2.56%), 1.25% (0.75%, 1.88%)] didn't meet the requirements of the Guidelines. The equipment ratio was insuffcient, which means that the basic needs of development had not been met yet. CONCLUSIONS The development of comprehensive ICU in Inner Mongolia has tended to mature, but there is still a certain gap in the development scale, personnel ratio and instruments and equipment compared with the Guidelines. Moreover, the comprehensive ICU appears the characteristics of relatively weak eastern and western regions, and the overall distribution is uneven. Therefore, it is necessary to increase efforts to invest in the construction of the department of critical care medicine.
Humans ; Intensive Care Units ; Critical Care ; Surveys and Questionnaires ; Tertiary Care Centers ; China

Objective:To systematically assess the diagnostic value of automated breast volume scanning (ABVS) versus hand-held ultrasound (HHUS) in benign and malignant breast lesions.Methods:The Cochrane Library, PubMed, Embase, Ovid, China National Knowledge Infrastructure (CNKI), VIP, Wanfang, China Biology Medicine (CBM) and other databases were searched from the beginning of database construction to January 2022. Relevant literatures were screened and included, and the characteristics of the literatures were extracted. Meta-disc 1.4 statistic software was used to analyze the pooled diagnostic odds ratio (DOR), specificity, sensitivity, 95% CI, the summary receiver operating characteristic (SROC) curve and the area under the curve of ABVS and HHUS. The heterogeneity and publication bias were also evaluated. Results:A total of 26 studies were included. Heterogeneity test showed no threshold value effect; random effect model was used to pool specificity, sensitivity and DOR.The pooled sensitivity of ABVS and HHUS was 0.86 (95% CI 0.84-0.87), 0.80 (95% CI 0.78-0.82), respectively; I2 was 89.7% and 82.3%, respectively; the pooled specificity of ABVS and HHUS was 0.91 (95% CI 0.90-0.92), 0.84 (95% CI 0.83-0.86), I2 was 89.7% and 92.2%, respectively. AUC of ABVS, HHUS, and joint diagnosis of the two was 0.954, 0.883, 0.958, respectively. No evidence of publication bias was shown in the funnel plot analysis. Conclusion:ABVS has a higher clinical value compared with HHUS in the diagnosis of benign and malignant breast lesions.

Background::Abnormal lipids are strong predictors of cardiovascular disease in type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM). However, the potential associations of insulin resistance (IR) and beta-cell function (BCF) with abnormal lipids in newly diagnosed T1DM or T2DM patients are not fully understood.Methods::A cross-sectional survey of 15,928 participants was conducted. Homeostasis model assessment and postprandial C-peptide levels were used to estimate IR and BCF. A restricted cubic spline (RCS) nested in binary logistic regression was used to examine the associations of IR and BCF with abnormal lipids.Results::High triglyceride (TG), low high-density lipoprotein cholesterol, and high low-density lipoprotein cholesterol (LDL-C) accounted for 49.7%, 47.8%, and 59.2% of the participants, respectively. In multivariable analysis, high IR was associated with an increased risk of high TGs ( P for trend <0.001) in T1DM and is associated with an elevated risk of high TG and low HDL-C (all P for trend <0.01) in T2DM. Low BCF was not associated with risks of dyslipidemia in patients with T1DM or T2DM after adjustment for potential confounders. Conclusion::High IR had different associations with the risk of dyslipidemia in newly diagnosed T1DM and T2DM patients, suggesting that early treatment that improves IR may benefit abnormal lipid metabolism.

Objective:To explore whether CT image post-processing software can accurately measure (associating liver partition and portal vein ligation for staged hepatectomy, ALPPS) related (future liver remnant, FLR).Methods:Clinical data of 9 liver cancer patients undergoing ALPPS were retrospectively analyzed in the Second Affiliated Hospital of Air Force Military Medical University from Mar 2015 to May 2019. All cases were divided into 2 groups by measurement: CT′s image post-processing software, or Myrian software. Two groups were compared with each other by paired t-test. Results:FLR from group CT′s image post-processing software was larger than that by Myrian software, there was statistical difference ( t=2.512, P=0.019). The mistakes of FLR measurements by the radiologist using CT′s image post-processing software couldbe caused by: (1)Lacking theoretical knowledge of liver surgery; (2) Adding devitalized tissue of hepatic section into future liver remnant; (3) Concept confusion about liver anatomy; (4) Lack of precision measurement. Conclusions:The inaccuracies generated during the ALPPS related future liver remnant measurements in CT′s image post-processing technique are all caused by human factors. These problems could be solved if the radiologist who operates 3D reconstruction receives liver surgery training or works with liver surgeons.

Objective To investigate the effect of muscle function on structural stress in patient with lumbar disc herniation (LDH), by observing the stress changes in LDH lumbar-pelvis finite element model loaded with muscle force. Methods One normal healthy volunteer and one LDH patient were selected. Their CT data were collected to establish two corresponding normal and LDH lumbar-pelvis finite element models, and their gait data were also simultaneously collected to drive the AnyBody musculoskeletal model. The muscle force around the lumbar and pelvis as well as the hip-joint force were obtained as the loading condition. Self-loading of the normal and LDH model as well as the normal model loaded with LDH muscle forces were conducted seperately. Then the stress changes in L4 and L5 intervertebral discs and sacroiliac joints under two above loading conditions were compared. Results The stress curve of normal model loaded with LDH muscle force showed a unimodal stress curve, instead of a bimodal curve, and such trend of stress-time curve was as same as the trend of the LDH model during self-loading. But the stress difference in L4 and L5 intervertebral discs and sacroiliac joint of the normal model loaded with LDH muscle force was smaller than that in the LDH model during self-loading. Conclusions Abnormal muscle function of LDH could lead to abnormal joint stress of the intervertebral discs and sacroiliac joint. Structural imbalance itself could lead to stress imbalance, and muscle as a driving factor was an important cause of anomaly structural dynamic stress, thus leading to abnormal joint motion patterns. Therefore, attention should be paid to assessment of the imbalance of peripheral muscle function in clinical treatment of LDH.

Objective To revise rumination on sadness scale (RSS) and evaluate the reliability and validity of the Chinese version rumination on sadness scale (RSS-C) in Chinese undergraduates.Methods A total of 1 166 undergraduates from 4 universities in Hunan province completed RSS,ruminative response scale (RRS) and Beck depression inventory-Ⅱ (BDI-Ⅱ).The test-retest was conducted in 111 participants 2 weeks later.Results Item analysis and exploratory factor analysis showed the RSS-C included 11 items,consisting of causal analysis,understanding oneself and one's sadness and uncontrollability of ruminative thinking factors.The scores of each item in the high score group were significantly higher than those in the low group(P＜0.001),and the correlation between each item and the total score was significant(r=0.594-0.719,P＜0.001).The confirmatory factor analysis indicated good fit(x2/df=3.938,GFI =0.957,NFI =0.940,CFI =0.954,TLI =0.930,IFI =0.954,RMSEA =0.070).The internal consistency for RSS-C and three factors ranged from 0.694 to 0.868,and the test-retest reliability ranged from 0.620 to 0.833.The scores on RSS-C and three factors were significantly associated with RRS(r=0.555-0.637,P＜0.01),BDI-Ⅱ (r=0.211-0.403,P＜0.01) respectively.Conclusion RSS-C has good reliability and validity and can be used as an effective instrument to assess rumination on sadness in Chinese undergraduates.

Objective To investigate the expressiorn of microRNA-622(miR-622) and dual specificity tyrosine phosphorylation-regulated kinase 2 (DYRK2) in colon cancer tissues and cell lines and explore the effect of miR-622 on SW11l6 cells migration and invasion.Methods Eighty-two colon cancer tissues and paired para-tumor tissue specimens were collected.C.olon cancer cell line SW1116,SW480 and normal human colon epithelial cell line NCM460 were cultured.MiR-622 was detected by using Real time PCR,DYRK2 expression was measured by using immunohistochemistry,Real time PCR anid Western blot in tissue level and cell level,respectively.The relation of miR-622 and DYRK2 was analyzed by Pearson correlation analysis.miR-622 mimics transfection was conducted to up-regulate miR-622,while negative control,NC group were transfected with control sequence.Expression of DYRK2 was evaluated by using Real time PCR and Western blot,while Transwell chamber assays were used to assess the migration ability changes.Results Real time PCR and Western blot results showed that miR-622 mRNA was highly expressed in colorectal cancer tissue and colon cancer cell SW1116,whereas DYRK2 mRNA and protein were lowly expressed when compared with paracancerous tissue and normal colonic epithelial cell line NCM460.An obvious negative correlation was showed between miR-622 and DYRK2(r=0.916,P＜0.01).Compared to NC group,DYRK2 mRNA and protein expression were down-regulated after transfection of miR-622 mimics,which was observerd through Real time PCR and Western blot(P＜0.01).Correspondingly,compared to NC group,the migration ability of SW116 was remarkably enhanced after transfection of miR-622 mimics(P＜0.01).Conclusion The expression of miR-622 is high and DYRK2 is low in colon cancer.Up-regulation of miR-622 could negatively regulate DYRK2 expression and promote SW1116 cells migration.

Teaching assistant was introduced to solve the outstanding issues in the teaching of authentication of TCM, such as irrationality for teaching subjects, separated theory and practice, incomplete evaluation system. With the help of teaching assistant, the new generation was able to play the advantages on Web-based course and WeChat subscription, and the students are encouraged to apply new media flexibly. Practice teaching was introduced into class to increase the combination of theory and practice. Teaching assistant played an important role in evaluation mechanism standardization and specialization, and forming the basis for formative evaluation. Updating the teaching mode, forming the strategy of autonomous learning and interactive teaching, we are hoping to improve the teaching quality of authentication of TCM, improve students' interest in specialized courses, and to provide reference for better teaching assistants' working and selection.