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 compare the consistency of lymphoma multigene detection panels based on next-generation sequencing (NGS) with FISH detection of B-cell lymphoma gene rearrangement.Methods:From January 2019 to May 2023, fusion genes detected by lymphoma-related 413 genes that targeted capture sequencing of 489 B-cell lymphoma tissues embedded in paraffin were collected from Henan Cancer Hospital, and the results were compared with simultaneous FISH detection of four break/fusion genes: BCL2, BCL6, MYC, and CCND1. Consistency was defined as both methods yielding positive or negative results for the same sample. The relationship between fusion mutation abundance in NGS and the positivity rate of cells in FISH was also analyzed.Results:Kappa consistency analysis revealed high consistency between NGS and FISH in detecting the four B-cell lymphoma-related gene rearrangement ( P<0.001 for all) ; however, the detection rates of positive individuals differed for the four genes. Compared with FISH, NGS demonstrated a higher detection rate for BCL2 rearrangement, a lower detection rate for BCL6 and MYC rearrangement, and a similar detection rate for CCND1 rearrangement. No correlation was found between fusion mutation abundance in NGS and the positivity rate of cells in FISH. Conclusions:NGS and FISH detection of B-cell lymphoma gene rearrangement demonstrate overall good consistency. NGS is superior to FISH in detecting BCL2 rearrangement, inferior in detecting MYC rearrangement, and comparable in detecting CCND1 rearrangement.

Objective:To study the correlation between occupational radiation exposure and chronic metabolic diseases.Methods:The status of chronic metabolic diseases of medical workers were compared in 5 hospitals in Hangzhou. As representatives of chronic metabolic diseases, diabetes and metabolic syndrome (MS) were compared in association with duration of radiation exposure.Results:Long-term ionizing radiation (IR) exposure was led to increased blood pressure, fasting blood glucose (FBG) , dyslipidemia, gallbladder disease, and MS. The years of radiation exposure was associated with lens opacity, gallstone and MS in men and gallbladder polyps in women. Radiation working more than 10 years is one of the independent risk factors for increased FBG and MS. Moreover, the risk of FBG increase in the group of radiation working more than 10 years was 3.052 times of that the non-exposed group, and the risk of MS occurrence was 4.132 times that of the non-exposed group.Conclusion:Long-term exposure to IR increases the risk of chronic metabolic diseases.

Objective:To study the correlation between occupational radiation exposure and chronic metabolic diseases.Methods:The status of chronic metabolic diseases of medical workers were compared in 5 hospitals in Hangzhou. As representatives of chronic metabolic diseases, diabetes and metabolic syndrome (MS) were compared in association with duration of radiation exposure.Results:Long-term ionizing radiation (IR) exposure was led to increased blood pressure, fasting blood glucose (FBG) , dyslipidemia, gallbladder disease, and MS. The years of radiation exposure was associated with lens opacity, gallstone and MS in men and gallbladder polyps in women. Radiation working more than 10 years is one of the independent risk factors for increased FBG and MS. Moreover, the risk of FBG increase in the group of radiation working more than 10 years was 3.052 times of that the non-exposed group, and the risk of MS occurrence was 4.132 times that of the non-exposed group.Conclusion:Long-term exposure to IR increases the risk of chronic metabolic diseases.

OBJECTIVE:To study the effects of etanercept combined with cyclophosphamide on related indexes of patients with rheumatoid arthritis complicated with interstitial pneumonia (RA-IP).METHODS:A total of 84 RA-IP patients were randomly divided into control group (42 cases) and observation group (42 cases).Control group was given Etanercept for injection 25 mg subcutaneously twice a day.Observation group was additionally given Cyclophosphamide tablets 50 mg orally,once a day,increasing by 50 mg every 7 d later,with maximum dose lower than 100 mg,for consecutive 2 weeks,2 weeks later repeated,on the basis of control group.Both groups were treated for 3 months.The number of joint tenderness and joint swelling,morning stiffness time,VAS score,DAS28 score,CRP,ESR,serum rheumatoid factor (RF),TNF-α,p (O2),VC,clinical score,imaging score,physiological score and the occurrence of ADR were observed in 2 groups before and after treatment.RESULTS:After treatment,the number of joint tenderness and joint swelling,morning stitffness time,VAS score,DAS28 score,the levels of CRP,ESR,RF and TNF-α,clinical score,imaging score,physiological score in 2 groups were significantly lower than before treatment;the observation group was significantly lower than control group.p(O2) and VC of 2 groups were significantly higher than before treatment,and the observation group was significantly higher than the control group,with statistical significance (P＜0.05).There was no statistical significance in the incidence of ADR between 2 groups (P＞0.05).CONCLUSIONS:Etanercept combined with cyclophophamide in the treatment of RA-IP can improve clinical symptom,signs,life quality and lung function without increasing the occurrence of ADR.

Objective Application of PDCA method to improve the coincidence rate of emergency inspection report time.Methods 472 cases of emergency inspection report returns the fraction defective of the time from September to December 2014 (blood routine,blood biochemistry,blood coagulation,cerebrospinal fluid,urine analysis).Analyzing the reason and take measures to improve the emergency inspection report time coincidence rate.At the same time,counted 654 cases of emergency inspection report returns the fraction defective of the time after the improvement from July to November 2015,and compared and analyzed the coincidence rate before and after the improvement measures.Results Emergency inspection report of the total fraction defective return time decreased from 13.9 ％ to 4.9 ％ by taking measures.Blood coagulation,blood biochemistry,urine analysis,routine blood,cerebrospinal fluid and urine analysis of emergency return time unqualified rate decreased from 18.2 ％,16.2 ％,10.3 ％,6.75 ％ and 9.1％ to 5.2 ％,5.0 ％,6.4％,5.0 ％ and 3.9 ％ respectively.Conclusion The application of PDCA could improve the time coincidence rate of emergency department,and to finish the emergency detection and report detection results in the shortest possible time.

Objective:To explore the efficacy of etanercept combined leflunomide to treat ankylosing spondylitis (AS) and its safety.Methods:90 cases with AS patients admitted in our hospital from June 2016 to January 2015 were selected.The patients were divided into observation group and control group by random number table method,45 cases in each group.Observation group was treated with etanercept combined with leflunomide,the control group were treated by leflunomide only.Morning stiffness time,AS activity index (BASDAI),AS measurement index (BASMI) were recorded before and after treatment in two groups,the total effective rate and adverse reaction were compared between the two groups.Results:After treatment,the BASDAI and morning stiffness time,BASMI of two groups of patients compared with before treatment were decreased,and the indexes above of the observation group were significantly lower than the control group,the difference was statistically significant (P＜0.05);The effective rate of the observation group was significantly higher than that of the control group,the difference was statistically significant (P＜0.05);During the course of treatment,the main adverse reactions occurred in patients with liver function damage,diarrhea and allergic skin rash,but there was no significant difference in the incidence of adverse reactions between the two groups (P＞0.05).Conclusion:Etanercept combined with leflunomide can obtain ideal effect,and low incidence rate of adverse reaction,it is worth popularizing in clinical use.

Objective To analyze the distribution of pathogens in female genital tract for clinical prevention and treatment in female.Methods 1 146 gynecological out -patients were accepted vaginal Wulian combined detec-tion of micro of vaginal secretions.Results Among 1 146 gynecological patients,262 gynecological patients were diagnose as Bacterical Vaginosis(BV)positive,accounted for 22.86% of all patiemnts,114 patients with fungal vagi-nitis,accounted for 12.30% of all patients,49 patients with trichomonas vaginitis,accounted for 3.58%.Further anal-ysis showed that BV,Candida mother mould and trichomonad infection rate reduced with the increase of age,between 20 -30 childbearing women with highest infected rate,and of childbearing women had the secondly infected rate. There were significant differences among these groups(χ2 =21.515,19.811,8.832,all P <0.01 ).Conclusion 20 -30 childbearing women with the highest rate of BV,Candida mother mould,BV was the main infection factors among these,trichomonad infection was the highest and it was also the main reason of infertility.

Objective:To evaluate the efficacy and safety of sequential platinum regimen in young patients with diffuse large B-cell lym-phoma (DLBCL). Methods:Newly diagnosed young patients with DLBCL, who were hospitalized from January 2005 to June 2012 in the Affiliated Cancer Hospital of Zhengzhou University, were selected according to the requirements. The patients were divided into stan-dard and sequential platinum regimen groups. The remission rates were compared usingχ2 test, whereas the five-year survival rates between the two groups were compared using the Kaplan–Meier method. Multivariate survival analysis was performed using the Cox proportional regression. Subgroup analysis was conducted to select candidate patients for the sequential platinum regimen. Results:A total of 331 patients were enrolled in the study, in which 129 were provided with sequential platinum regimen and 202 were provided with the standard regimen. Sequential regimen yielded higher rates of complete remission (80%vs. 63%, P=0.001), five-year progres-sion-free survival (PFS;60%vs. 50%, P=0.014), and overall survival (OS;70%vs. 58%, P=0.016) than the standard regimen. Multivariate analysis revealed that sequential regimen was an independent prognostic factor for PFS (hazard ratio HR=0.635, P=0.012) and OS (HR=0.625, P=0.021). Subgroup analysis showed that patients with good prognosis and patients who did not receive rituximab benefited more from the sequential platinum regimen. Sequential platinum regimen did not increase the occurrence of adverse effects com-pared with the standard regimen. Conclusion:Sequential platinum regimen is a safe treatment that can improve the survival of young patients with DLBCL. Patients with good prognosis and patients who did not receive rituximab can benefit more from the treatment with sequential platinum regimen.

OBJECTIVE: To evaluate the effect of patient education on patients with allergic rhinitis (AR). METHOD: From January 2009 to December 2013, 100 cases of allergic rhinitis were treated. The patients were randomly divided into experimental group or control group by Stochastic tables law,50 patients in control group accepted only drug treatment, 50 patients in experimental group accepted both drug treatment and patient education. The difference in compliance with treatment, treatment effect, incidence of adverse drug reactions and complications, average costs and times of treatment between two groups were evaluated by the rhinoconjunctivitis quality of life questionnaire (RQLQ) score. The independent sample t-test and χ2 test were used for statistical analysis. RESULT: The patients of experimental group showed more positive attitude to treatment compared to the patients of control group (P < 0.01). The average scores of each classification and overall symptoms after treatment in experimental group were lower than those in control group (P < 0.05). The incidence of adverse drug reactions (nose-bleed, dry nose,nasal mucosa ulcer)and complications in patients with AR (asthma, chronic cough, secretory otitis media) in experimental group was lower than that in control group, with statistically differences (P < 0.05). The average times of treatment and costs of diagnosis and treatment(calculation of budesonide nasal spray)in experimental group were significantly lower than those in control group (P < 0.01). The total score for RQLQ and the scores of seven dimensions in experimental group were lower than those in control group (P < 0.05). CONCLUSIONS Patient education can help the patients with AR to cooperate actively with treatment, to reduce the incidence of adverse drug reactions and AR complications, and to save medical costs and improve the quality of life.
Budesonide ; therapeutic use ; Chronic Disease ; Humans ; Incidence ; Patient Education as Topic ; Patient Participation ; Quality of Life ; Rhinitis, Allergic ; therapy ; Surveys and Questionnaires