The recently officially approved and released health industry standard Standard for Blood Storage(WS 399-2023) by the National Health Commission is the latest revised version of Standard for Blood Storage(WS 399-2012), which mainly stipulates the storage requirements for whole blood, red blood cells, platelets, granulocytes, plasma and irradiated blood. It applies to blood collection and supply institutions and healthcare institutions, and is the guideline for the safe use of blood.

Objective To observe the effects of Huatan Quyu Decoction on cognitive function and the expressions of GABA and VILIP-1 in brain tissue of rats with cerebral small vessel disease;To discuss its mechanism for treatment on cerebral small vessel disease.Methods Totally 48 male SD rats were randomly divided into blank group,model group,Huatan Quyu Decoction low-and high-dosage groups,with 12 rats in each group.Except for the blank group,a rat model of cerebral small vessel disease was prepared by in vitro injection of homologous microemboli.Huatan Quyu Decoction low-and high-dosage groups were given Huatan Quyu Decoction 1.25 and 2.5 g/kg by gavage,the blank group and model group were gavage with equal amounts of distilled water for 28 consecutive days.Morris water maze experiment was conducted on day 1,7,14,and 28 after administration to evaluate the learning and memory abilities of rats,HE staining was used to observe pathological changes in hippocampal tissue,and immunohistochemical staining was used to detect the expressions of GABA and VILIP-1 proteins in brain tissue.Results Compared with the blank group,the escape latency of Morris water maze experiment in model group significantly prolonged(P<0.05),and the number of crossing platforms was significantly reduced(P<0.05);the arrangement of hippocampal tissue cells was disordered,gaps widen,and nuclei atrophy and necrosis,the GABA expression in brain tissue significantly decreased(P<0.05),while the VILIP-1 expression significantly increased(P<0.05).Compared with the model group,the escape latency of Morris water maze experiment in the Huatan Quyu Decoction low-and high-dosage groups significantly shortened(P<0.05)on day 7,14,and 28 of administration,and the number of crossing platforms significantly increased(P<0.05),GABA expression significantly increased(P<0.05),while VILIP-1 expression significantly decreased(P<0.05).Compared with the Huatan Quyu Decoction low-dosage group,the escape latency of Morris water maze experiment in Huatan Quyu Decoction high-dosage group decreased at various time points,and the number of crossing platforms increase,the pathological damage of hippocampal tissue was reduced,the expression of GABA in brain tissue increased,and the expression of VILIP-1 decreased,with statistical significance(P<0.05).Conclusion Huatan Quyu Decoction can increase the expression of GABA in brain tissue and inhibit the expression of VILIP-1,thereby improve the cognitive function of rats with cerebrovascular disease.

OBJECTIVE To provide a reference for the improvement of pharmacoeconomic evaluation and health economic decision-making in China. METHODS From the perspective of China’s healthcare system， a three-state partitioned survival model was constructed based on the BECOME study， the quality-adjusted life year （QALY） and equal value of life-year gained（evLYG） were used as the health gain measures respectively， and the cost-utility analysis was used to evaluate the cost-effectiveness of bevacizumab combined with chemotherapy regimen versus chemotherapy alone in the first-line treatment of RAS-mutant metastatic colorectal cancer （mCRC）. The cycle length was 2 weeks， the time horizon was the patients’ lifetime， the discount rate was 5%， and the willingness-to-pay threshold was 1 to 3 times China’s gross domestic product per capita in 2023 （89 358-268 074 yuan）. One-way sensitivity analysis and probabilistic sensitivity analysis were used to assess the robustness of the results. RESULTS Compared to the chemotherapy alone， the incremental cost-effectiveness ratio （ICER） of the bevacizumab combined with chemotherapy regimen was calculated to be 330 311.33 yuan/QALY based on QALY， which exceeded the willingness-to-pay threshold （268 074 yuan）. However， when the ICER was calculated based on evLYG， it was determined to be 254 085.64 yuan/evLYG， which fell below the willingness-to-pay threshold （268 074 yuan）. The results of the one-way sensitivity analysis showed that the price of bevacizumab had the greatest impact on the ICER value. The results of the probabilistic sensitivity analysis showed that the probability of the bevacizumab combined with chemotherapy regimen being more cost-effective was approximately 3% when assessed by QALY； the probability of the regimen being more cost-effective rose to 56% when assessed by evLYG. CONCLUSIONS When evaluating the cost-effectiveness of interventions for RAS-mutant mCRC， ICER values based on evLYG may provide a fairer measure compared to ICER values calculated by QALY. It is recommended that when pharmacoeconomic evaluations are conducted for special populations， both QALY and evLYG can be used as health outcome indexes for evaluation to achieve a better allocation of healthcare resources and improve the fairness of decision-making.

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 observe the effects of Huatan Quyu Decoction on the protein expressions of β-catenin and GSK-3 β and the expression of anticardiolipin antibody and β-amyloid protein related to cognitive function in rats with vascular dementia based on Wnt/β-catenin signal pathway.Methods:A total of 96 male SD rats were divided into blank group, model group, Donepezil hydrochloride group and Huatan Quyu Decoction low-, midium-, high-dosage group according to random number table method, with 16 rats in each group. Except for the blank group, the rat model of vascular dementia was prepared by modified 2-VO method. Huatan Quyu Decoction low-, medium- and high-dosage groups were administrated with Huatan Quyu Decoction 6.1, 12.1 and 24.2 g/kg, respectively; the Western medicine group was administrated with Donepezil hydrochloride 0.5 mg/kg; the blank group and the model group were administrated with the same amount of normal saline for 28 consecutive days. On the 1st, 7th, 14th and 28th day after administration, the learning and memory ability of rats was evaluated by Morris water maze test, the levels of ACA and Aβ in serum were measured by enzyme linked immunosorbent assay (ELISA), and the expressions of β-catenin and GSK-3β proteins related to Wnt/β-catenin signal pathway in hippocampus were measured by Western blot.Results:Compared with model group, the escape latency was shortened in the Huatan Quyu Decoction high-dosage group and Donepezil group on 7 and 14 days of administration ( P<0.05), and the times of crossing the platform increased in Huatan Quyu Decoction high-dosage group on 1 and 28 days of administration ( P<0.05). Compared with model group, the serum ACA level in Donepezil group, Huatan Quyu Decoction medium- and high-dosage groups decreased at day 1, 7, 14 and 28 after administration ( P<0.05). The serum Aβ level in Donepezil group, Huatan Quyu Decoction medium- and high-dosage groups decreased at 7, 14 and 28 days after administration ( P<0.05); On the 14th and 28th days after administration, the levels of ACA and Aβ in TCM low-dosage group decreased ( P<0.05). Compared with model group, the expression of β-catenin protein in hippocampus of Donepezil group and Huatan Quyu Decoction medium- and high-dosage groups increased ( P<0.05), while the expression of GSK-3β in hippocampus of Donepezil group and Huatan Quyu Decoction low-, medium- and high-dosage groups decreased ( P<0.01). Conclusion:Huatan Quyu Decoction can activate the Wnt/β-catenin signaling pathway, up-regulate the expression of β-catenin protein in hippocampal tissue of rats, inhibit the expression of GSK-3β, reduce the levels of ACA and Aβ in serum of rats, and improve the cognitive function of rats with vascular dementia.

Objective To explore the application value of three dimensional reconstruction technique in laparoscopic hepatectomy for hepatic carcinoma.Methods From September 2019 to March 2022,the clinical data of 62 patients with primary hepatic carcinoma were gathered.The enhanced CT scanning was performed before surgery.Patients with three dimensiona reconstruction technology were set as observation group(n=31).Patients who did not use three dimensiona reconstruction technology were set as the control group(n=31),and intraoperative conditions(time of operation,bleeding volume during operation)and postoperative conditions(occurrence rate of postoperative complications,postoperative length of stay)of the two groups were compared.Results 62 patients successfully completed laparoscopic hepatectomy without liver failure or death.For patients with tumors located in liver segmentⅡ and Ⅲ,there were no significant difference of operation time,intraoperative blood loss,postoperative hospital stay and postoperative complication total rate between control group and observation group(P＞0.05).For patients with tumors located in liver segment Ⅳ-Ⅵ,operation time[(211.36±11.22)minutes vs(231.69±19.73)minutes],intraoperative blood loss[(274.29±23.84)ml vs(306.54±21.05)ml],postoperative hospital stay[(7.93±1.33)days vs(9.62±1.80)days]in observation group were lower than those in control group(P＜0.05),and there was no significant difference of postoperative complication total rate between two groups(P＞0.05).For patients with tumors located in liver segmentⅠ,Ⅶ and Ⅷ,operation time[(165.88±10.60)minutes vs(187.30±17.29)minutes],intraoperative blood loss[(271.25±12.17)ml vs(308.00±28.21)ml],postoperative hospital stay[(7.63±0.74)days vs(9.30±1.06)days]in observation group were lower than those in control group(P＜0.05),and there was no significant difference of postoperative complication total rate between two groups(P＞0.05).Conclusion The three dimensiona reconstruction technique may have prominent guiding significance for complex laparoscopic hepatectomy for hepatic carcinoma.

Objective To investigate the impact of two target body temperatures on inflammatory response, oxidative stress, cerebral metabolism, outcomes and complications in patients undergoing extracorporeal cardiopulmonary resuscitation. Methods A retrospective analysis was conducted on the clinical data of 107 patients undergoing extracorporeal cardiopulmonary resuscitation. Fifty-three patients with a target body temperature controlled at 32.0 to 34.0 ℃ were included in the moderate hypothermia group, and 54 patients with a target body temperature controlled at 34.1 to 36.0 ℃ were included in the mild hypothermia group. Inflammatory response indicators [C-reactive protein (CRP), interleukin-6 (IL-6), interleukin-1β (IL-1β), nuclear factor kappa-B subunit p65 (NF-κB p65)], oxidative stress indicators [superoxide dismutase (SOD), total antioxidant capacity (TAC), total oxidant status (TOS), malondialdehyde (MDA)], and cerebral metabolism indicators [arterial-jugular venous oxygen content difference (Da-jvO₂), cerebral oxygen extraction ratio (CERO₂)] were compared between the two groups before temperature management and when the target temperature was achieved. Additionally, occurrence of complications and outcomes [prognosis outcomes and Glasgow-Pittsburgh Cerebral Performance Categories (CPC) score] were compared. Results When the target temperature was achieved, the levels of CRP, IL-6, IL-1β, and NF-κB p65 in both groups were lower than those before temperature management, and their levels in the moderate hypothermia group were lower than those in the mild hypothermia group(P < 0.05). At the target temperature, the levels of SOD and TAC in both groups were higher than those before temperature management, and the levels in the moderate hypothermia group were higher than those in the mild hypothermia group (P < 0.05). Meanwhile, the levels of TOS and MDA in both groups were lower than those before temperature management, and the levels in the moderate hypothermia group were lower than those in the mild hypothermia group (P < 0.05). When the target temperature was achieved, the Da-jvO₂ and CERO₂ in both groups were lower than those before temperature management, and their levels in the moderate hypothermia group were lower than those in the mild hypothermia groups (P < 0.05). There was no statistically significant difference in the incidence of complications between the two groups (P>0.05). The CPC score and prognosis in the moderate hypothermia group were slightly better than those in the mild hypothermia group, but the difference was not statistically significant (P>0.05). Conclusion Target body temperature management after cardiopulmonary resuscitation can effectively promote the recovery of cerebral function. A target body temperature of 32.0 to 34.0 ℃ is more conductive to reducing inflammatory response as well as oxidative stress, and improving cerebral metabolism and outcomes.

Sudden cardiac death(SCD)in the elderly is defined as a sudden accidental death in patients over 65 years of age within one hour of symptom onset or within 24 hours with no symptoms, possibly due to arrhythmia or abrupt hemodynamic changes.It is characterized by rapid onset, rapid progression, and high mortality.Sudden cardiac death in the elderly is the most serious clinical syndrome in elderly patients with heart disease.It accounts for more than 80% of all sudden death cases and is the cause of sudden death in the vast majority of elderly patients.Clinical methods for the detection of sudden cardiac death include mostly screening through family and personal history, physical examination, electrocardiogram analysis and echocardiography, but their drawbacks include lack specificity, low detection rates and relatively limited scenarios for their use.Genetic susceptibility is also responsible for sudden cardiac death.Genetic factors play an important role in the occurrence and development of sudden cardiac death.This review summarized the correlation between sudden death and genetic factors underlying different cardiovascular diseases, including the role of genetic polymorphisms in the occurrence of sudden cardiac death in older adults.

To conduct the association between vitamin B12 and mental health in children and adolescents. Five databases were searched for observational studies in any language reporting on mental health and vitamin B12 levels or intake in children and adolescents from inception to March 18, 2022. Two authors independently extracted data and assessed study quality. Qualitative and quantitative analysis of data were performed. The review was registered in the PROSPERO database (CRD42022345476). Fifty six studies containing 37,932 participants were identified in the review. Vitamin B12 levels were lower in participants with autism spectrum disorders (ASD) (standardized mean difference [SMD], −1.61;95% confidence interval [95% CI], −2.44 to −0.79; p ＜ 0.001), attention deficit hyperactivity disorders (SMD, −0.39; 95% CI, −0.78 to −0.00; p = 0.049) compared with control group. Vitamin B12 intake were lower in participants with ASDs (SMD, −0.86; 95% CI, −1.48 to −0.24; p = 0.006) compared with control group, but showed no difference between depression group (SMD, −0.06; 95% CI, −0.15 to 0.03; p = 0.17) and the control group. Higher vitamin B12 intake were associated with lower risk of depression (odds ratio [OR], 0.79; 95% CI, 0.63−0.98; p = 0.034) and behavioral problems (OR, 0.83; 95% CI, 0.69−0.99; p = 0.04). The vast majority of included studies supported potential positive influence of vitamin B12 on mental health, and vitamin B12 deficiency may be a reversible cause for some mental health disorders in children and adolescents.

BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) is the endoscopic modality of choice for the treatment of biliary and pancreatic diseases. However, patients with cirrhosis, particularly those with decompensated cirrhosis, are believed to be at increased risk for complications associated with ERCP. There is a paucity of literature describing the outcomes of ERCP for patients with cirrhosis. This study aimed to investigate the outcomes of ERCP for cirrhosis patients, especially adverse events, and evaluated its safety and efficacy. METHODS: We performed a multicenter, retrospective study of all patients at Beijing Friendship Hospital affiliated to Capital Medical University, Xijing Hospital affiliated to Air Force Military Medical University, Beijing Youan Hospital affiliated to Capital Medical University, and the Fifth Medical Center of the People's Liberation Army General Hospital from June 2003 to August 2019. The adverse events of inpatient ERCP for patients with ( n  = 182) and without liver cirrhosis (controls; n  = 385) were compared. RESULTS: A total of 567 patients underwent ERCP between January 2003 and December 2019 were enrolled in this study. Compared to patients without cirrhosis, patients with cirrhosis were at higher risk for postoperative complications (odds ratio [OR], 4.172; 95% confidence interval [CI], 1.232-7.031; P  < 0.001) such as postoperative pancreatitis (OR, 2.026; 95% CI, 1.002-4.378; P  = 0.001) and cholangitis (OR, 3.903; 95% CI, 1.001-10.038; P  = 0.036). The main indications for ERCP for patients with cirrhosis in this study included choledocholithiasis (101 cases; 55.5%), benign bile duct strictures (46 cases; 25.3%), and malignant bile duct strictures (28 cases; 15.4%). Among them, 23 patients (12.6%) underwent balloon dilation and 79 patients (43.4%) underwent sphincterotomy. Of the patients with cirrhosis, delayed bleeding occurred in ten patients (5.5%), postoperative pancreatitis occurred in 80 patients (44.0%), and postoperative cholangitis occurred in 25 patients (13.7%). An additional multivariate analysis showed that the total bilirubin (TBIL) level (OR, 4.58; 95% CI, 2.37-6.70) and Child-Pugh score of C (OR, 3.11; 95% CI, 1.04-5.37) were risk factors for postoperative complications in patients with cirrhosis. CONCLUSIONS Compared with the general population of patients undergoing ERCP, patients with cirrhosis were more prone to postoperative pancreatitis and cholangitis. TBIL levels and Child-Pugh scores were risk factors for postoperative complications in patients with cirrhosis.
Humans ; Cholangiopancreatography, Endoscopic Retrograde/adverse effects* ; Retrospective Studies ; Constriction, Pathologic ; Risk Factors ; Liver Cirrhosis/complications* ; Pancreatitis/etiology* ; Postoperative Complications/epidemiology* ; Cholangitis