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 clinical characteristics of empyema caused by Streptococcus anginosus (SA).Methods The clinical data in 9 cases of SA caused empyema admitted and treated in the First Affiliated Hospital of Xi'an Medical University from January 2016 to September 2023 were analyzed ret-rospectively,summarized the clinical characteristics of empyema caused by SA.Results Among 9 patients,there were 8 males and 1 female,with a mean age of (60.8±12.8)years old.All patients had the underlying diseases,meanwhile were accompanied by fever,expectoration,chest pain and dyspnea.The onset time was (6.1±2.2)d.The hospitalization time was (19.33±7.48)d.All patients showed the increase in white blood cells (WBC),C reactive protein (CRP),procalcitonin (PCT),D-dimer (D-D) and pleural effusion lactic dehy-drogenase (LDH),and decrease in blood albumin (ALB) and pleural effusion glucose (GLU).Most of the pa-tients had elevation of adenosine deaminase (ADA) in pleural fluid.Four patients had respiratory failure.The drug sensitivity test results of pleural effusion culture suggested five patients were resistant to erythromycin and clindamycin.One patient was resistant to ceftriaxone.Nine patients were improved after symptomatic treatment such as anti-infection,closed thoracic drainage and nutritional support.Conclusion The patients with SA caused empye-ma are more common in elderly patients with underlying diseases.The incubation period is short,the hospital stay is long,the infection indexes are high,malnutrition exists,and the resistance rate to erythromycin and clindamycin is high.

OBJECTIVE：To eval uate the effect of pharmacists intervention on opioid treatment and management in outpatients with cancer pain under multidisciplinary team （MDT）mode. METHODS ：Totally 120 outpatients with cancer pain were selected from outpatient department of our hospital from Jan. 2016 to Dec. 2018，and divided into observation group and control group according to random number table method ，with 60 cases in each group. After 1 month follow-up ，patients in the control group were given opioid analgesics and routine intervention according to pain degree ，while patients in the observation group were given same treatment as control group and pharmacist intervention based on MDT. The pain condition ，medication compliance condition ， quality of life （QOL）score，the incidence of ADR and satisfaction degree were observed in 2 groups before and after intervention . RESULTS：Follow-up were completed in 2 groups. After intervention ，NRS scores of 2 groups were significantly lower than before intervention；the observation group was significantly lower than the control group ；medication compliance scores and QOL scores of 2 groups were significantly higher than before intervention ，the observation group was significantly higher than the control group at the same time . With the prolongation of treatment time ，the number of patients with mild pain and general medication compliance in 2 groups increased gradually ，and the observation group were significantly higher than the control group at the same time；the number of patients with moderate , severe pain and low medication compliance were significantly decreased gradually ， and the observation group was significantly lower than the control group at the same time. The number of patients with good medication compliance in the observation group was significantly higher than that in the same group before intervention and the control group at the same time （P＜0.05 or P＜0.01）. There was no significant difference in the incidence of ADR between 2 groups（P＞0.05）. The satisfaction of pain control results ，doctors’treatment and pharmacists follow-up in the observation group were significantly higher than control group （P＜0.05 or P＜0.01）. CONCLUSIONS ：Under MDT mode ，pharmacists participating in the management of opioid treatment for cancer pain outpatients can effectively relieve the pain ，and improve the medication compliance and quality of life .

Objective: To understand the characteristics relating to the etiology and complications of hand, foot and mouth disease (HFMD) based on data from the pilot National Sentinel Surveillance (NSS) program so as to explore the feasibility, advantages and disadvantages of the NSS. Methods: Data were extracted from the NSS system, conducted in 11 provinces of China from November 2015 to October 2016. Characteristics regarding the etiology, complications of HFMD and factors related to the positive rates of HFMD specimens were analyzed under the logistic regression method by SPSS 20.0 software. Results: A total of 4 783 specimens were collected, including 3 390 from mild, 1 390 from severe and 3 from death cases. The overall positive rate was 81.43% (3 895/4 783). Other enteroviruses (non EV71/Cox A16 enteroviruses) appeared the major serotype (52.68%, 1 482/2 813) for mild infection of the disease while EV71 was for the severe cases (65.31%, 706/1 081). The serotype spectrum revealed by the pilot NSS was almost identical with the existing surveillance system. Other enteroviruses tended to infect younger children (χ²=130.17, P<0.001) than EV71 and Cox A16, in China. The multivariate logistic regression results showed that higher positive rate was associated with specimens which were collected from males, at children’ hospitals, in peak seasons, timely and in stools. The positive rates presented downwarding trends with the extension of the onset-sampling interval (χ²=14.47, P<0.001 in stool specimen; χ²=31.99, P<0.001 in throat swab; χ²=24.26, P<0.001 in anal swab). Aseptic meningitis, non-brainstem encephalitis and brainstem encephalitis appeared the top three complications of both EV71-associated and other enteroviruses-associated severe HFMD cases. Conclusions Factors as gender, season/place/timeliness of specimen collection, and types of hospital all appeared independently influenced the positive rates. NSS seemed feasible to be used as an alternative or supplement tool to the existing surveillance program in China.

Objective To evaluate the damage of the salivary gland in Sjogren's syndrome (SS)patients with normal Young's modulus value (YMV) using salivary gland dynamic imaging (SGDI).Methods A total of 78 parotid glands and submandibular glands of SS patients and 100 parotid glands and submandibular glands of healthy people were collected in this retrospective study.The difference of YMV between 2 groups was analyzed with two-sample t test;receiver operating characteristic (ROC) curves of YMV were drawn to calculate the area under carve (AUC) and cut-off values.SGDI was used to observe the uptake ratio of 15 min (UR15) value in the SS salivary glands with normal YMV.Results The YMV of left parotid/submandibular glands and right parotid/submandibular glands were not statistically different in both SS patients and healthy people (t values:from-1.192 to-0.404,all P＞0.05).The YMV of parotid/submandibular glands in SS patients was higher than that in healthy people:(15.39±8.08) vs (9.33±2.21) kPa,(14.35±5.33) vs (9.18±2.36) kPa (t values:7.169 and 8.662,both P＜0.05).ROC curves showed that the AUC of parotid glands and submandibular glands were 0.78 and 0.83.As the cut-off values of YMV were 10.85 kPa and 10.95 kPa,the sensitivity were 69.23％ (54/78) and 73.08％ (57/78),the specificity were 77.00％ (77/100) and 83.00％ (83/100),the positive predictive value were 70.13％ (54/77) and 77.03％ (57/74),the negative predictive value were 76.24％ (77/101) and 79.81％ (83/104),respectively.There was no statistically difference between YMV and UR15 for evaluating the SS parotid glands and submandibular glands (x2 values:0.963 and 0.896,both P＞0.05).The UR15 value of 78 SS parotid glands and submandibular glands were 1.42±0.97 and 1.19±0.83,respectively.About 58.33％ (14/24) parotid glands with normal YMV (＜10.85 kPa) and 76.19％ (16/21) submandibular glands with normal YMV (＜10.95 kPa)had reduced cellular uptake in SS patients.Conclusions Parotid glands and submandibular glands in SS patients are damaged,and the tissue hardness is increased.SGDI can discover the cellular damage in SS salivary glands with normal YMV.

OBJECTIVE:To provide reference for the rational utilization of narcotic drugs in cancer pain patients. METH-ODS:In retrospective survey,2275 prescriptions of narcotic drugs for cancer pain patients in outpatient and emergency depart-ment of our hospital during 2014-2016 were analyzed statistically in respects of general information,drug amount,consumption sum and DDDs,etc. RESULTS:The proportion of male patients and female patients with cancer pain in our hospital were 65.63%and 34.37% within 3 years,mainly aged 21-90. The consumption amount and sum of narcotic drugs in our hospital increased year by year. Dosage forms were mainly tablet. The consumption amount,sum and DDDs of Morphine hydrochloride sustained-release tablets took up the first places among narcotic drugs. And those of Pethidine hydrochloride injection were the lowest. CONCLU-SIONS:The utilization of narcotic drugs is rational in outpatient and emergency department of our hospital on the whole. Morphine preparations are the predominant analgesic drugs for patients with cancer pain.

Objective To review and investigate the malaria control history of Wuzhou City,Guangxi Zhuang Autonomous Region from 1950 to 2015,so as to provide the evidence for future malaria control and surveillance. Methods The data of ma?laria control in Wuzhou City from 1950 to 2015 were collected and analyzed. Results In 1950 decade,the malaria incidence in Wuzhou City was 1 435.55/100 000,higher than the average level in Guangxi,and the mortality of malaria was 0.95/100 000. The malaria incidence of local residents was reduced to 3.61/100 000 in 1979 and no local malaria case was found since. The im?ported malaria cases were found in Wuzhou City since 1980,and were more than local cases since 1981. In recent five years, 87.50%(7/8)of imported malaria cases were from south?east Asia. Conclusions Wuzhou City has reached the national criteri?on of malaria elimination,but the imported malaria is the recent threat. The surveillance and control work of malaria should be strengthened.

Objective To investigate the clinical severity,etiological classification and risk factors of severe cases with hand,foot and mouth disease (HFMD).Methods A total of 1 489 records on severe and fatal HFMD cases reported to the national pilot surveillance system of HFMD were used to analyze the demographic,medical treatment,etiological classification of the cases.Treatment outcome related risk factors were also studied with multi-variable stepwise logistic regression method.Results Seven out of the 1 489 severe HFMD cases died of this disease.A total of 960 (72.9％) were under three years old and 62.9％ were male and most of the cases (937,62.9％) resided in rural areas.Among all the cases,494 (33.2％) went to seek the first medical assistance at the institutions of village or township level.Durations between disease onset and first medical attendance,being diagnosed as the disease or diagnosed as severe cases were 0(0-1) d,1 (0-2) d and 2 (1-4) d,respectively.In total,773 (51.9％) of the severe HFMD cases were diagnosed as with aseptic meningitis,260 (17.5％) with brainstem encephalitis,377 (25.3 ％) with non-brainstem encephalitis,6 (0.4％) with encephalomyelitis,1 (0.1％) with acute flaccid paralysis,4 (0.3％) with pulmonary hemorrhage/pulmonary edema and 68 (4.6％) with cardiopulmonary failure.Of the etiologically diagnosed 1 217 severe and fatal HFMD cases,642 (52.8％) were with EV71,other enterovirus 261 (21.5％),Cox A16 36 (3.0％),1 (0.1％) with both EV71 and Cox A16.However,277 (22.8％) showed negative on any pathogenic virus.Complication (Z=3.15,P=0.002) and duration between onset and diagnosed as severe cases (Z=3.95,P＜0.001) were shown as key factors related to treatment outcomes.Conclusions Most severe HFMD cases appeared in boys,especially living in the rural areas.Frequently seen complications would include aseptic meningitis,non-brainstem encephalitis and brainstem encephalitis.EV71 was the dominant etiology for severe and fatal cases.Early diagnosis and complication control were crucial,related to the treatment outcome of HFMD.

Objective To observe the efficacy of Zishen Anshen Decoction combined with Compound Zaoren (Ziziphi Spinosae Semen) Capsule on insomnia patients with disharmony between heart-yang and kidney-yin syndrome and its effect on sleep quality index. Methods Seventy insomnia patients were randomly divided into treatment group and control group. Both groups conventionally took estazolam as needed, the treatment group was additionally given Zishen Anshen Decoction (in the afternoon and after dinner) and Compound Zaoren Capsule (before sleep at night) for 14 d. The Pittsburgh sleep quality index (PSQI) score and dosage of estazolam were used as evaluation indexes for the comparison between the two groups. Results PSQI score of daytime function disorder and hypnotics dosage of the treatment group was significantly lower than that of the control group, and the dosages of estazolam were reduced (P<0.05). Conclusion The alternative application of Zishen Anshen Decoction and Compound Zaoren Capsule on insomnia treatment can not only improve daytime function, but also reduce the dosage of benzodiazepine, with better effect than estazolam.

Objective To explore the clinical effect of Weifuchun tablet combined with chemotherapy on patients with advanced non-small cell lung cancer (NSCLC).Methods Sixty-eight patients with advanced NSCLC was randomly divided into control group (n =34) treated with cisplatin + gemcitabine and treatment group (n =34) treated with Weifuchun tablet (1.436g × 2/d) and cisplatin + gemcitabine.After two treatment cycles,the clinical effect in both groups were evaluated.Results The clinical efficacy in the treatment group was 52.94％ (18/34),which in the control group was 41.18％ (14/34),there was no statistically significant difference between the two groups(x2 =0.94,P ＞ 0.05).The quality of life and the level of T lymphocytes were markedly improved,and the reduction of hemoglobin,leucocyte,and platelet,and nausea reaction were all significantly inhibited in treatment group compared with that in control group after two treatment cycles (x2 =4.12,4.66,5.96,4.12,5.90,all P ＜ 0.05).Conclusion Weifuchun tablet combined with chemotherapy effectively ameliorates the clinical symptoms of the patient with advanced NSCLC,reduces the toxic and side effects caused by chemotherapy,and improves the quality of life,which is worthy in the clinic.