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 intestinal mucosal barrier function protective effect of ulinastatin in sepsis rats and its effect on Wnt/β-catenin signaling pathway. Methods One hundred SD rats were randomly divided into control group, sepsis group, ulinastatin group, XAV939+ulinastatin group and lithium chloride( LiCl) +ulinastatin group. The classical cecal ligation was used to duplicate sepsis model, and the jejunal mucosal injury was evaluated. The levels of inflammatory factors interleukin (IL)-6 and tumor necrosis factor(TNF)-α were detected by ELISA, and the expressions of β-catenin and cyclin D1 were detected by Real-time PCR and Western blotting. We also observed the effect of the Wnt signal pathway blockage by XAV939 or Wnt signal pathway activator by LiCl on ulinastatin protection of intestinal mucosa and proteins related to the Wnt signal pathway. Results The levels of IL-6, TNF-α and intestinal mucosal injury in the sepsis group were significantly higher than those in the ulinastatin group. The mRNA and protein expression levels of β- catenin and cyclin D1 in the sepsis group were significantly higher than those in the control group (P<0.05), After ulinastatin treatment, the expression levels of β-catenin and cyclin D1 mRNA and protein were significantly decreased, and the difference was significant (P<0.05). Compared with the ulinastatin group, combined treatment with XAV939 promoted the protective effect of ulinastatin on the intestinal mucosa of rats, and the protein expression of β-catenin and cyclin D1 was reduced (P<0.05). Combined treatment with LiCl weakened the protective effect of ulinastatin on the intestinal mucosa of rats, and the protein expression of β-catenin and cyclin D1 was increased (P<0.05). Conclusion Ulinastatin may inhibit the Wnt signaling pathway by down-regulating the expression of β-catenin, reduce the expression of inflammatory factors IL-6 and TNF-α, thereby promote repairing the intestinal mucosal barrier function damage.

Objective:To retrieve and obtain the relevant evidence for in-hospital exercise rehabilitation in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI) and to summarize the best evidence.Methods:By applying evidence-based nursing method, the relevant evidence of in-hospital exercise rehabilitation in AMI patients after PCI in domestic and foreign databases was retrieved by combining computer and manual methods, including guidelines, evidence summary, clinical practice guidelines, systematic reviews, randomized controls test and so on. The retrieval time was from the establishment of the database to December 1, 2019. A total of 4 evidence-based groups independently conducted literature quality evaluation, and the controversial content was ruled by the hospital evidence-based group, and the evidence was extracted. Appraisal of guidelines research and evaluation (AGREEⅡ) and literature evaluation criteria and evidence grading system of Australia Joanna Briggs Institute (JBI) Evidence-based Health Care Center were respectively used to evaluate quality of literature and grade the various studies.Results:A total of 15 articles were included, including 4 guidelines, 1 evidence summary, 1 systematic evaluation and 9 randomized controlled trials. Finally, 20 pieces of best evidence of in-hospital exercise rehabilitation in AMI patients after PCI were summarized.Conclusions:This study summarizes best evidence for in-hospital exercise rehabilitation of AMI patients after PCI, which can provide an evidence-based basis for clinical practice. However, in the actual implementation process, it should be carried out step by step on the premise of ensuring the safety of patients by combining the cultural background of patients and the level of medical institutions.