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 explore the expression of long non-coding RNA (lncRNA) CDK5RAP3 in gastric cancer tissue and its regulatory effect on gastric cancer cell proliferation and invasion.Methods:The expression differences of CDK5RAP3 in gastric cancer tissues and adjacent tissues were analyzed by TCGA database. By transfecting the pcDNA3.1-CDK5RAP3 plasmid into Hs-746T cells, a gastric cancer cell line overexpressing CDK5RAP3 (CDK5RAP3 group) was constructed, and the pcDNA3.1 plasmid was transfected into Hs-746T cells as a control group. The changes of CDK5RAP3 expression in the two groups of cells were detected by real-time quantitative PCR (qRT-PCR). The effects of overexpression of CDK5RAP3 on the proliferation and invasion of Hs-746T cells were detected by CCK-8 assay and Transwell assay, respectively. The binding sites of CDK5RAP3 and miR-223-3p were predicted by the starBase v2.0 database. The direct binding of CDK5RAP3 and miR-223-3p was verified by dual-luciferase reporter gene experiment. The expression levels of miR-223-3p in Hs-746T cells in each group were detected by qRT-PCR. Western blot was used to detect the expression levels of proliferation proteins and invasion proteins in Hs-746T cells in each group. The experimental data were analyzed by SPSS 17.0 software, and the measurement data conforming to the normal distribution were expressed as Mean±SD. The t-test was used to compare between two groups, and the one-way analysis of variance was used to compare the means of multiple groups. Results:Compared with adjacent tissues, the expression level of CDK5RAP3 in gastric cancer tissues was significantly lower ( P<0.01). The expressions of CDK5RAP3 in Hs-746T cells in the control group and CDK5RAP3 group were (1.08±0.77) and (10.63±2.14), respectively, and the difference was statistically significant ( P<0.01). Up-regulation of CDK5RAP3 significantly decreased the proliferation activity of Hs-746T cells ( P<0.05). The number of invasive cells in the control group and CDK5RAP3 group were (137.80±28.72) and (57.76±24.95), respectively, and the difference was statistically significant ( P<0.01). CDK5RAP3 could directly bind miR-223-3p ( P<0.01). The expression of miR-223-3p in Hs-746T cells in control group and CDK5RAP3 group were (6.22±1.20) and (1.01±0.98), respectively, and the difference was statistically significant ( P<0.01). Compared with the control group, up-regulation of CDK5RAP3 significantly reduced the expression levels of proliferation and invasive proteins. Conclusion:The expression of CDK5RAP3 is low in gastric cancer tissue, and CDK5RAP3 inhibits the proliferation and invasion of gastric cancer Hs-746T cells by targeting miR-223-3p.

Objective:To investigate the predictive role of dynamic changes of plasma biomarkers in patients with viral and mycoplasma community-acquired pneumonia (CAP).Methods:From January 2020 to June 2020, 141 patients with viral and mycoplasma CAP in People's Hospital of Ningxia Hui Autonomous Region were enrolled. Pneumonia severity index (PSI) scores [grade Ⅰ-Ⅱ(PSI score ≤ 70), grade Ⅲ (PSI score 71-90) and grade Ⅳ-Ⅴ(PSI score ≥ 91)], serum amyloid A (SAA), hypersensitive C-reactive protein (hs-CRP), procalcitonin (PCT), erythrocyte sedimentation rate (ESR) and white blood cell (WBC) on the 1 day after admission were compared between the different pathogens (viral and mycoplasma) or different disease severity. The change in level of SAA, hs-CRP on the third day (Δ 3 d = 1 d-3 d) were compared among different disease outcome groups (patients were divided into improved group, stable group and exacerbation group based on PSI scores or lung CT images on the third day). The change in the level of SAA, hs-CRP on the seventh day (Δ 7 d = 1 d-7 d) were compared among different disease prognosis groups (patients were divided into survival group and death group based on 28-day survival data). The receiver operating characteristic curve (ROC) were drawn to evaluate the value of SAA in the evaluation of disease and prediction prognosis. Results:The level of SAA in mycoplasma group (43 cases) was significantly higher than that in virus group (98 cases) on the 1 day after admission. There were no significant differences in other plasma biomarkers between the two groups. The more severe the illness, the higher the SAA level on the 1 day after admission. The trends of other plasma biomarkers in the two groups were consistent with SAA. The levels of SAA in the patients with exacerbation of the virus group and mycoplasma group (12 cases, 9 cases) were significantly higher than those of the improved group (57 cases, 26 cases) and the stable group (29 cases, 8 cases). SAA increased gradually in the exacerbation group, decreased gradually in the improved group, and slightly increased in the stable group. ΔSAA 3 d were differences among three groups. The change trend of hs-CPR was consistent with SAA. The level of SAA in the death group was higher than that in the survival group on the seventh day. SAA increased in the death group and decreased in survival group with time from hospital admission. There were differences according to ΔSAA 7 d between death group and survival group. The change trend of hs-CPR was consistent with SAA. ROC curve showed that the value of SAA was better than hs-CRP in assessing the severity of patients on admission day, and the area under ROC curve (AUC) was respectively 0.777 [95% confidence interval (95% CI) was 0.669-0.886], 0.729 (95% CI was 0.628-0.830). The value of ΔSAA 3 d was better than SAA on the third day predicting disease trends, and AUC was respectively 0.979 (95% CI was 0.921-1.000), 0.850 (95% CI was 0.660-1.000). hs-CRP on the third day and Δhs-CRP 3 d had no predictive value. Both SAA on the seventh day and ΔSAA 7 d have predictive value for prognosis. AUC was respectively 0.954 (95% CI was 0.898-0.993) and 0.890 (95% CI was 0.689-1.000). SAA on the seventh day and ΔSAA 7 d were better than hs-CRP on the seventh day. Δhs-CRP 7 d have no predictive value. Conclusions:SAA is a sensitive and valuable indicator for CAP patients with viruses and mycoplasma. Dynamic monitoring of SAA can evaluate the patient's progression, prognosis, and assist diagnosis and treatment.

ObjectiveTo investigate effect of conducting training of autism spectrum disorder （ASD） early screening skill on improving the ability to early identify ASD of medical staffs in primary care hospitals. MethodsIn September 2021， the training of ASD early screening skills was carried out for medical staffs from 20 primary care hospitals in Chengdu. After training， the training effect was evaluated. The numbers of referrals from primary care hospitals to superior hospitals， confirmed ASD as well as their average diagnostic age of children with ASD before and after training were used as evaluation indicators. ResultsAfter training， the number of children with suspected ASD referred by primary care hospitals was more than that before training ［（16.65±11.60） vs. （3.40±2.23）， t=5.431， P<0.01］， the number of children diagnosed with ASD was more than that before training［（6.85±4.93） vs. （2.45±1.67）， t=4.171， P<0.01］， and the differences were statistically significant. As for the diagnosed age of ASD children， after training， the average age was lower than that before training ［（34.95±11.67） vs. （42.2±14.64）， t=-2.553， P=0.019］. ConclusionTraining of ASD early screening skills for medical staffs in primary care hospitals may help to improve their ability to early screening ASD children.

ObjectiveTo investigate the three-year follow-up outcomes of hepatocellular carcinoma patients undergoing liver resection (LR) versus liver transplantation (LT). MethodsA retrospective analysis was performed for 171 patients with hepatocellular carcinoma who underwent surgical treatment in Beijing YouAn Hospital, Capital Medical University, from March 2009 to March 2014, and according to the treatment method, they were divided into LR group(n=83) and LT group(n=88). Related clinical data were compared between the two groups. The chi-square test was used for comparison of categorical data between two groups; the Kaplan-Meier survival curve and the log-rank test were used for comparison of disease-free survival and overall survival between two groups, and the Cox proportional hazards model was used for the univariate and multivariate analyses of disease-free survival and overall survival. ResultsCompared with the LR group, the LT group had a significantly higher proportion of patients with single tumor ［45.78% (38/83) vs 85.23% (75/88), χ2=29649,P＜0.001］, tumor size ＜3 cm ［15.66% (13/83) vs 6705% (59/88), χ2=46.383,P＜0001］, or high Child-Pugh class ［ 964% (8/83) vs 26.14% (23/88),χ2=7833,P=0.005］ and a significantly lower recurrence rate of tumor ［48.19%(40/83) vs 3295%(29/88) ,χ2=4121,P=0.042］. There was a significant difference in disease-free survival rate between the LR group and the LT group (46.02% vs 80.71%, P=0.006); the LT group had a higher overall survival rate than the LR group (86.99% vs 76.44%, P=0.219). Both univariate and multivariate analyses showed that treatment method was an independent risk factor for disease-free survival (risk ratio［RR］=3383,95% confidence interval［CI］: 1334-8579;RR=0239,95%CI:0093-0.612，both P＜005), but the prediction of overall survival by treatment method did not reach statistical significance(P=0232). ConclusionLT is recommended for patients with early-stage hepatocellular carcinoma and can achieve a satisfactory three-year disease-free survival rate.

Objective To explore the protective effect and mechanism of the dihydromyricetin (DHM) on cognitive dysfunction in Alzheimer’s disease (AD) rat model. Methods The AD model of rats was established by injecting Aβ1-42 oligomolymer into the hippocampus. According to the random number table,30 successfully constructed AD model rats were divided into AD group,AD+DHM1 group and AD+DHM2 group,with 10 in each group. And the rats in the three groups were intraperitoneally injected with nor-mal saline,100 mg/kg DHM and 200 mg/kg DHM for 21 days,respectively. Another 10 rats with body mass matching were taken as the control group. Morris water maze was used to evaluate the spatial learning and memory ability of rats in each group,the expression of inflammatory cytokines were detected by Elisa,and the expressions of AMPK and SIRT1 proteins were detected by Western blot. Results Compared with the con-trol group,the escape incubation period of rats in AD group was prolonged,and the difference was statistically significant (day 5 :(10. 36±2. 80)s,(22. 40±2. 98)s;t=-18. 63,P<0. 05). Compared with AD group,the escape latency of rats in AD+DHM1 group and AD+DHM2 group were shortened (day 5:AD+DHM1 group (15. 68±3. 06) s,AD+DHM2 group (18. 85±3. 22) s; t=10. 65,4. 13,both P<0. 05). Compared with AD group,rats in AD+DHM1 group and AD+DHM2 group had more crossing times ((1. 87± 0. 76),( 2. 75± 0. 63) and (3. 78±0. 71);t=-6. 86,-9. 83,both P<0. 05),and the target quadrant residence time were ex-tended ((17. 08±1. 99) s,(16. 33±4. 33) s,(22. 59±4. 21) s;t= 28. 5,8. 63,both P<0. 05). Compared with the control group,the levels of IL-1β,IL-6 and TNF-α in the serum and hippocampus of the AD group were significantly increased (serum: t=4. 98, 7. 87, 5. 43, all P<0. 05; hippocampus: t=11. 13, 30. 50, 23. 38,all P<0. 05). Compared with the AD group,the levels of IL-1β,IL-6 and TNF-α in the serum and hippocampus of the AD+DHM1 group and the AD+DHM2 group were significantly decreased,the difference was statistically significant ( serum: AD+DHM1 group t=-4. 13,-10. 70,-9. 22, AD+DHM2 group t=-1. 75,-3. 63,-18. 75,all P<0. 05;hippocampus:AD+DHM1 group t=-69. 13,-15. 13,-6. 50,AD+DHM2 group t=-10. 25,-39. 00,-8. 00,all P<0. 05). Compared with the control group,the expression of p-AMPK/AMPK protein and SIRT1 protein in the AD group were decreased. The expression of the two pro-teins in the AD+DHM1 group and the AD+DHM2 group were increased,comparing with those of AD group, and the difference was statistically significant(all P<0. 05). Conclusion DHM exerts protective role in AD model rats,which may be related to the activation of AMPK/SIRT1 pathway and the inhibition of inflammato-ry response.

Objective: To explore the protective effect and mechanism of the dihydromyricetin (DHM) on cognitive dysfunction in Alzheimer’s disease (AD) rat model. Methods: The AD model of rats was established by injecting Aβ1-42 oligomolymer into the hippocampus. According to the random number table, 30 successfully constructed AD model rats were divided into AD group, AD+ DHM1 group and AD+ DHM2 group, with 10 in each group.And the rats in the three groups were intraperitoneally injected with normal saline, 100 mg/kg DHM and 200 mg/kg DHM for 21 days, respectively.Another 10 rats with body mass matching were taken as the control group.Morris water maze was used to evaluate the spatial learning and memory ability of rats in each group, the expression of inflammatory cytokines were detected by Elisa, and the expressions of AMPK and SIRT1 proteins were detected by Western blot. Results: Compared with the control group, the escape incubation period of rats in AD group was prolonged, and the difference was statistically significant (day 5 : (10.36±2.80)s, (22.40±2.98)s; t=-18.63, P<0.05). Compared with AD group, the escape latency of rats in AD+ DHM1 group and AD+ DHM2 group were shortened (day 5: AD+ DHM1 group (15.68±3.06) s, AD+ DHM2 group (18.85±3.22) s; t=10.65, 4.13, both P<0.05). Compared with AD group, rats in AD+ DHM1 group and AD+ DHM2 group had more crossing times ((1.87±0.76), (2.75±0.63) and (3.78±0.71); t=-6.86, -9.83, both P<0.05), and the target quadrant residence time were extended ((17.08±1.99) s, (16.33±4.33) s, (22.59±4.21) s; t= 28.5, 8.63, both P<0.05). Compared with the control group, the levels of IL-1β, IL-6 and TNF-α in the serum and hippocampus of the AD group were significantly increased (serum: t=4.98, 7.87, 5.43, all P<0.05; hippocampus: t=11.13, 30.50, 23.38, all P<0.05). Compared with the AD group, the levels of IL-1β, IL-6 and TNF-α in the serum and hippocampus of the AD+ DHM1 group and the AD+ DHM2 group were significantly decreased, the difference was statistically significant(serum: AD+ DHM1 group t=-4.13, -10.70, -9.22, AD+ DHM2 group t=-1.75, -3.63, -18.75, all P<0.05; hippocampus: AD+ DHM1 group t=-69.13, -15.13, -6.50, AD+ DHM2 group t=-10.25, -39.00, -8.00, all P<0.05). Compared with the control group, the expression of p-AMPK/AMPK protein and SIRT1 protein in the AD group were decreased.The expression of the two proteins in the AD+ DHM1 group and the AD+ DHM2 group were increased, comparing with those of AD group, and the difference was statistically significant(all P<0.05). Conclusion DHM exerts protective role in AD model rats, which may be related to the activation of AMPK/SIRT1 pathway and the inhibition of inflammatory response.

Objective To explore the effect of applying humanistic care concept in patients that were performed radical cystectomy and urinary diversion.Methods Eighty-eight patients undergoing radical cystectomy and urinary diversion in our hospital from January 2011 to May 2016 were selected.All patients were randomly divided into experiment group and control group.Of them,control group was given routine nursing care.Experiment group was administered humanistic care pattern-based nursing measures.Self-evaluation on social function was conducted in both groups 1,3 and 6 months after surgery,and the results were compared between two groups.All evaluation indexes were expressed as differences in all scales at various stages.Results Willingness score of ostomy self-nursing and score of ostomy nursing skill in experiment group upon discharge to 1 month after discharge,1 to 3 months after discharge,and 3 to 6 months after discharge,respectively,which were better than those in control group.Differences were of statistical significance(P<0.05).Anxiety score and depression score in experiment group at those three periods,respectively,were better than those in control group(P<0.05).Evaluation score of self-nursing ability in experiment group at those three periods,respectively,were better than those in control group(P<0.05).Score of quality of life in experiment group at those three periods were better than those in control group.All differences were of statistical significance(P <0.05).Judging from the point of view of incidence of complications 6 months after surgery,10 and 23 cases in experiment and control groups developed complications,respectively(P <0.05).Conclusions Applying humanistic care concept in clinical nursing contributes to effectively improving the postoperative recovery of social function in patients and enhancing their quality of life.It shows high application value in clinical practice.

Objective To investigate the effect of a fast-track based clinical nursing pathway of hepatic carcinoma on patient satisfaction and job satisfaction of nurses. Methods A total of 91 primary hepatic carcinoma (PHC) patients undergoing elective hepatectomy were enrolled and were divided into two groups by admission time, namely the control group (48 cases) and the experimental group (43 cases). The patients in the control group received traditional perioperative nursing care of hepatectomy, while the cases in the experimental group participated in fast-track nursing pathway. Patient satisfaction and nurse job satisfaction were measured before and after implementation. Results Final analysis included 45 patients in the control group and 40 patients in the experimental group. In the experimental group, the total score of patient satisfaction and the scores of all dimensions (including services and techniques, concern and care, services and techniques and overall satisfaction) were (132.75 ± 13.71), (48.30 ± 6.53), (42.60 ± 4.62), (35.98 ± 3.85), (5.88 ± 0.94), while they were (122.89 ± 16.62), (44.53 ± 7.74), (39.49 ± 5.67), (33.53±4.40), (5.33±1.13) in the control group. And the scores of the experimental group were significantly higher than that of the control group (t=-2.961, t=-2.409, t=-2.753, t=-2.709, t=-2.389, P<0.05). Furthermore,after implementing the fast-track clinical nursing pathway,the total score of nurse job satisfaction and the scores of six factors were (143.23 ± 9.40), (28.45 ± 2.72), (24.82 ± 2.28), (23.05 ± 1.33), (13.91 ± 1.95), (15.05 ± 1.43), (16.64 ± 1.65) while they were (127.36 ± 13.14), (25.68 ± 4.16), (19.64 ± 2.75), (20.23 ± 2.35), (13.23 ± 2.22), (13.68 ± 2.01), (14.50 ± 1.95) before the implementation. The former was significantly better than the latter (t =-12.462,-7.743,-12.670,-6.560,-2.417,-1.483,-6.587,P<0.05). However, no differences were observed in the other two dimensions of wages and benefits andwork-family balance(t =-1.945,-1.312,P>0.05) since the scores after implementation were (13.86 ± 2.12), (7.45 ± 1.57), while that of (13.18 ± 2.30)、(7.23 ± 1.41) were obtained before performance. Conclusions Application of fast- track nursing pathway in perioperative patients with PHC can contribute to promoting the level of patient satisfaction and job satisfaction of nurses and improving nursing quality. It is suggested that this nursing pathway will have more potential value for PHC patients.

A biomedical entity association evolution network was constructed by mining the implicit associations in PubMed-covered literature, which can help scientific researchers to form new scientific hypotheses, to analyze the topological features of associated network, to study the scientific literature-enriched knowledge structure, associa-tions, development rules, to introduce new visual angles and methods for literature-based knowledge discovery, and to improve the knowledge discovery efficiency.