Objective:To investigate the application value of cannulated screws in the treatment of Hauck type Ⅱ ulnar styloid process fracture.Methods:The clinical data of 93 patients with Hauck type Ⅱ ulnar styloid process fracture who received treatment at Fuzhou Second Hospital Affiliated to Xiamen University from December 2020 to February 2023 were retrospectively analyzed for a case-control study. Among these patients, 38 patients did not undergo surgical fixation and 55 patients underwent surgical fixation. Twenty-seven patients underwent surgical fixation with cannulated screws and twenty-eight patients underwent surgical fixation with Kirschner wires. The fracture healing, postoperative rehabilitation, and functional recovery of the wrist were compared among groups.Results:The fracture healing rate and the incidence of distal radioulnar joint instability in the surgical fixation group were 100.00% (55/55) and 5.45% (3/55), respectively. These were significantly higher and lower respectively compared with the non-surgical fixation group [57.89% (22/38), 50.00% (19/38), χ 2 = 27.66, 24.69, both P < 0.001]. The wrist function recovery in the surgical fixation group was significantly superior to that in the non-surgical fixation group ( Z = -5.18， P < 0.001). There were no statistically significant differences in operative time and intraoperative blood loss between the cannulated screw group and the Kirschner wire group [(21.41 ± 5.15) minutes vs. (20.93 ± 5.71) minutes, (2.11 ± 0.97) mL vs. (2.07 ± 0.90) mL, t = 0.32, 0.15, both P > 0.05]. The fracture healing time and rehabilitation intervention time in the cannulated screw group were shorter than those in the Kirschner wire group [(6.48 ± 1.05) weeks vs. (9.14 ± 1.24) weeks, (2.11 ± 0.32) weeks vs. (3.11 ± 0.57) weeks, t = 8.57, 7.98, both P < 0.001]. The postoperative wrist function scores in the cannulated screw group were superior to those in the Kirschner wire group ( Z = -2.21, P < 0.05). Conclusion:For patients with Hauck type Ⅱ ulnar styloid process fracture, surgical fixation can promote the recovery of wrist function after surgery, and cannulated screw fixation is an effective method for the treatment of Hauck type Ⅱ ulnar styloid process fracture.

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 knowledge, attitude and practice of general practitioners (GPs) in Shenzhen towards managing patients with common mental health problems.Methods:It was a cross-sectional study, from September 19 to October 31, 2020, 500 GPs from 100 community health centers (CHC) in 10 districts of Shenzhen municipality were randomly selected as the research subjects by stratified random sampling; the survey was conducted by self-filled questionnaire, which included general conditions, knowledge tests of common psychological problems (generalized anxiety disorder, depressive disorder, panic attacks, sleep disorders), GPs′ attitudes to take care of common psychological problems, and GPs′ practice of caring for common psychological problems.Results:A total of 500 questionnaires were distributed and 329 valid ones were collected. In terms of knowledge, GPs had the highest accuracy of answering the characteristics of depressive disorder (97.3%, 320/329), and the lowest accuracy of case analysis of panic attacks (50.2%, 165/329). In terms of attitude, 71.1%(234/329)of GPs agreed that "common psychological problems should be taken care of",there was a statistically significant difference in attitude scores among GPs with different years of working in CHC ( Z=14.60, P=0.006). In terms of practice, the most encountered mental health problem was insomnia (91.2%, 300/329), 46.5% (153/329) of GPs would use psychological assessment scales, 52.9% (174/329) of GPs would choose direct referral, and there were statistically significant differences in attitude scores among GPs with different years of working ( Z=10.70, P=0.030) and years of working in CHC ( Z=22.14, P<0.001). Conclusions:GPs have a positive attitude in taking care of common psychological problems, but lack of knowledge and confidence. As working in CHC for more years, GPs are more inclined to care for patients with common psychological problems in practice.

Objective:To explore the diversity and structural changes of intestinal flora in patients with sepsis.Methods:A total of 55 patients were enrolled who visited the Emergency Department of several Grade III-A hospitals from November 2015 to March 2016. Among them, 25 patients with sepsis metthe diagnostic criteria of Sepsis 3.0 and 30 patients had no sepsis. The intestinal flora from all fecal samples was sequenced by 16S rRNA sequencing technology. The diversity and structure changes of the flora were analyzed using Uparse, Qiime, R and LEfSe software.Results:There was no significant difference in sex, age, chronic underlying diseases, and the diversity of intestinal flora between the sepsis and non-sepsis groups (all P>0.05). The structure of intestinal flora was significant different between the two groups ( P<0.05). Abundances of Negativicutes, Selenomonadales, Veillonellaceae, Lachnospiraceae, Faecalibacterium, Hafnia, Lachnoclostridium, Blautia and Ruminococcus in intestinal flora from patients with sepsis were significantly reduced, but those of Bacilli, Coriobacteriia, Lactobacillales, Coriobacteriales, Clostridiaceae, Coriobacteriaceae, Clostridium_sensu_stricto, Collinsella and Collinsella_aerofaciens were significantly increased. Conclusions:There is no change in the diversity of intestinal flora between the sepsis and non-sepsis groups. There are structural changes of intestinal flora in patients with sepsis.

This paper summarizes the basic principles and models of early warning for infectious disease outbreaks, introduces the early warning systems for infectious disease based on different data sources and their applications, and discusses the application potential of big data and their analysing techniques, which have been studied and used in the prevention and control of COVID-19 pandemic, including internet inquiry, social media, mobile positioning, in the early warning of infectious diseases in order to provide reference for the establishment of an intelligent early warning mechanism and platform for infectious diseases based on multi-source big data.

This paper reviews the limitations of current infectious disease surveillance and early warning system in China, analyzes the concepts and countermeasures of the establishment of an intelligent early warning platform of infectious diseases based on multi-point trigger mechanism and multi-channel surveillance mechanism and proposes the realization routes for the purpose of facilitating capacity building and improvement of surveillance and early warning of infectious diseases in China.

Objective: To investigate the iodine nutritional status of children and pregnant women in Hulunbuir, Inner Mongolia after reduction of salt iodine content, and to provide theoretical bases for scientific iodine supplementation. Methods: In May to October 2018, according to "Inner Mongolia Iodine Deficiency Disorders Surveillance Project (2016)", in 14 banners (cities, districts) of Hulunbuir, each banner (city, district) was divided into 5 sampling areas according to the location of east, west, south, north and middle, and 40 non-boarding children aged 8-10 years old (age matched, half male and half female) and 20 pregnant women were selected. Salt samples and urine samples were collected to detect salt and urinary iodine levels. Salt iodine was detected based on the "General Test Method in Salt Industry-Determination of Iodine" (GB/T 13025.7-2012), and urinary iodine was detected based on the "Method for Determination of Iodine in Urine by As³⁺-Ce⁴⁺ Catalytic Spectrophotometry" (WS/T 107-2009), the iodine nutritional status was determined according to the standards of urinary iodine recommended by WHO/UNICEF/ICCIDD. At the same time, the goiter condition of children was examined by B-ultrasound. Results: A total of 4 018 salt samples from homes of children and pregnant women were collected, the median of salt iodine was 22.61 mg/kg, the iodized salt coverage rate was 94.50% (3 797/4 018), the qualified rate of iodized salt was 96.92% (3 680/3 797), and the consumption rate of qualified iodized salt was 91.59% (3 680/4 018). A total of 2 790 urine samples from children were collected, the median of urinary iodine was 179.15 μg/L; and 1 228 urine samples from pregnant women were collected, the median of urinary iodine was 156.88 μg/L. There were 9 banners (cities, districts) where children were at the iodine appropriate level, 4 banners (cities, districts) were higher than the iodine appropriate level and 1 banner was at iodine excessive level. There were 4 banners (cities, districts) where pregnant women were at the iodine deficiency level, 8 banners (cities, districts) were at the iodine appropriate level and 2 banners (cities) were higher than the iodine appropriate level. A total of 2 629 children were examined thyroid gland, and the goiter rate was 0.99% (26/2 629). Conclusions After reduction of salt iodine content, the iodine nutrition of children and pregnant women in Hulunbuir is generally at an appropriate level. In some banners (cities, districts), children and pregnant women are at iodine deficiency level, iodine over appropriate level or iodine excessive level. Iodine nutrition monitoring measures of children and pregnant women should be strengthened.

Objective To investigate the feature of fracture in elderly patients in Beijing Jishuitan Hospital from 2009 to 2016.Methods The data of elderly patients with fracture visiting the department of trauma emergency in Beijing Jishuitan Hospital from 2009 to 2016 were retrospectively reviewed.The data of patient number,age,gender,seasonal and circadian variation of visit and fracture site were collected and analyzed.Results Among all the 42 988 elderly patients with fractures visiting department of trauma emergency from 2009 to 2016,there were more female patients than male patients (P ＜ 0.01).In both male and female patient groups,there was a trend of increase in number of patients year by year (P ＜ 0.01).Elderly patients in the groups of 60-69 years,70-79 years and 80-89 years demonstrated a trend of increasing number from year to year notably in the 60-69 years group (P ＜ 0.01) but the total number of patients decreased as age increased.As for seasonal variation,autumn had the highest number of cases and spring the lowest (P ＜ 0.01).Most elderly patients visited emergency during 8:00-16:00 period (P ＜ 0.01).The commonest sites of fractures were at radius and femur.Conclusions Fracture of elderly patients has its unique feature in gender,age,seasonal and circadian variation of visit and fracture sites.The community should do a better planning for prevention and management of elderly patients with fractures according to their specially clinical features.

Objective To compare the efficacy of combined administration of receptor blockers and single administration of receptor blocker in the treatment of patients with overactive bladder syndrome and bladder outlet obstruction.Methods A total of 100 patients with overactive bladder syndrome and bladder outlet obstruction were randomly divided into two groups.Control group was treated with α receptor blocker,while study gToup was treated with α receptor blocker and M receptor blocker.Therapeutic effect was compared.Results The pain score,urinary score and total score of the study group were significantly lower than those of the control group (P ＜ 0.05).After treatment,OABSS score in the control group was (7.2 ± 1.5),which was significantly higher than (4.8 ± 1.2) in the study group (P ＜ 0.05).The incidence rate of complications in the study group was 4％,which was significantly lower than 10.0％ in the control group (P ＜ 0.05).Conclusion In the clinical treatment of patients with bladder outlet obstruction,the combination of receptor blockers has a better therapeutic effect.

Objective To compare the efficacy of combined administration of receptor blockers and single administration of receptor blocker in the treatment of patients with overactive bladder syndrome and bladder outlet obstruction.Methods A total of 100 patients with overactive bladder syndrome and bladder outlet obstruction were randomly divided into two groups.Control group was treated with α receptor blocker,while study gToup was treated with α receptor blocker and M receptor blocker.Therapeutic effect was compared.Results The pain score,urinary score and total score of the study group were significantly lower than those of the control group (P ＜ 0.05).After treatment,OABSS score in the control group was (7.2 ± 1.5),which was significantly higher than (4.8 ± 1.2) in the study group (P ＜ 0.05).The incidence rate of complications in the study group was 4％,which was significantly lower than 10.0％ in the control group (P ＜ 0.05).Conclusion In the clinical treatment of patients with bladder outlet obstruction,the combination of receptor blockers has a better therapeutic effect.