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.

In recent years, the research on boron-containing drugs, especially boric acid drugs, has been increasing gradually.Boron-containing drugs, which have been a new area of research for pharmaceutical chemists in the development of new drugs, play an increasingly important anti-inflammatory, antibacterial, and anti-tumor role.At present, five boron-containing drugs have been approved, many are under clinical trials, and more are under investigation around the world, which has greatly expanded the application of boron in the research of new drugs.This paper introduces the characteristics of boron, and reviews the indications of representative boron-containing drugs in various research stages, their binding mechanisms with targets, and their progress after entering clinical trials, aiming to provide reference for further research on boron-containing drugs.

Objective:To explore the clinical efficacy of adult donor dual kidney transplantation.Methods:Retrospective analysis of case data of 13 adult donor kidney dual kidney transplantation (DKT) performed in the The Second Xiangya Hospital of Central South University from September 2016 to December 2020. For 13 donors, the average age and BMI were (53.5±12.4)years and (24.3±2.8) kg/m 2, respectively. Their mean Serum creatinine (SCr) at admission and before procurement was (132.9±54.1)and (228.7±112.4)μmol/L, respectively. 3 of them had diabetes mellitus history, and 8 had hypertension history. 11 met the United Network for Organ Sharing (UNOS) DKT criteria and 6 met Remuzzi score DKT criteria. For 13 recipients, the average age and BMI were (39.3±8.9)years and (20.2±2.4)kg/m 2, respectively. All of them received ABO blood type-matched kidney transplants. 2 of them had their grafts transplanted in the bilateral iliac. In 12 cases, the grafts filled rapidly and urinated immediately when opening blood flow. In 1 case, the grafts were dark in color and vascular showed weak pulsation after opening blood flow. The time to recovery of perioperative graft function (from the day of surgery to the natural reduction of SCr to the normal range 44-133μmol/L), the occurrence of delayed graft function (DGF), acute rejection (AR), ureteral and surgical incision complications, as well as the recipients’ final follow-up SCr, eGFR, urinary protein, and grafts outcome were observed. Risk factors affecting outcomes were assessed by univariate logistic regression analysis. Results:The SCr dropped to the normal range at discharge in 10 recipients, and the average recovery time was (13.8±13.0) days. In other 3 cases SCr at discharge were 300.0, 149.0, 152.5μmol/L. 4 cases had DGF, 4 had AR, 1 experienced urinary fistula, and 1 experienced incisional dehiscence, which were treated with anti-rejection, J-tube implantation, continuous catheterization to maintain bladder void, secondary suturing, respectively. The follow-up time ranged from 4 to 54 months, with a median of 28(15.5, 31.0) months. At the final follow-up time, 10 cases had good graft function, 2 suffered impaired kidney function, and 1 experienced graft failure. The average SCr and eGFR except for graft failure patient were (144.2±101.3)μmol/L and (52.9±21.2)ml/min, respectively. 4 had positive urine protein. Univariate logistic regression analysis showed that donor age, BMI, history of diabetes mellitus and hypertension, and SCr were not significantly correlated with recipients’ DGF and graft impairment ( P>0.05), and due to the small sample size, multifactorial logistic regression analysis was not performed. Conclusion:The short to medium-term effects of adult donor DKT coule be safe and feasible.

Objective:To investigate the feasibility and safety of right-sided abdominal evisceration in retroperitoneal liposarcoma.Methods:The clinical data of 16 cases of retroperitoneal liposarcoma performed with right-sided abdominal evisceration at Sarcoma Center of Peking University Cancer Hospital from Sep 2015 to Feb 2019 were analyzed retrospectively.Results:Complete resection were successfully performed in all 16 cases.The median tumor size was 29cm(13-43 cm), the median operative time was 660 min(429-940 min), the median estimated blood loss was 2 000 ml(300-6 000 ml). The major postoperative complications rate (Clavien-Dindo classification Ⅲ-Ⅴ) was 38%. Median overall survival is 41.0 months while the median disease-free survival is 32.6 months.Conclusions:Right-sided abdominal evisceration is a favorable procedure to attain complete resection with acceptable complication rate.

Objective:To analyze the clinical characteristics of gastrointestinal symptoms and liver function injury in patients with coronavirus disease 2019 (COVID-19).Methods:From January 23, 2020 to February 29, 2020, the medical records of 251 patients with COVID-19 admitted to the West Campus of the Union Hospital, Tongji Medical College of Huazhong University of Science and Technology, were collected. The proportion of the patients with gastrointestinal symptoms including anorexia, nausea and vomiting, diarrhea and abdominal pain were analyzed respectively. The patients were divided into common type (76 cases), severe type (65 cases) and critical type (110 cases). The incidence of liver function injury and the changes of liver function parameters such as total bilirubin (TBil), direct bilirubin (DBil), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), γ-glutamyl transpeptidase (GGT), lactate dehydrogenase (LDH), albumin and globulin of the patients with different clinical types and with or without gastrointestinal symptoms were analyzed. Mann-Whitney U test, Chi square test and Fisher′s exact test were used for statistical analysis. Results:The main gastrointestinal symptoms of patients with COVID-19 were anorexia (33.9%, 85/251), diarrhea (12.0%, 30/251), nausea and vomiting (7.6%, 19/251) and abdominal pain (1.2%, 3/251). 143 patients (57.0%) had liver function injury, the rate of liver function injury in critical type patients was 75.5% (83/110), which was higher than that of common type patients (40.8%, 31/76) and severe type patients (44.6%, 29/65), and the differences were statistically significant ( χ2=22.765 and 16.865, both P<0.01). There was no significant difference in the proportion of patients with liver function injury between common type and severe type patients ( P>0.05). There was no statistically significant difference in the proportion of liver function injury between patients with gastrointestinal symptoms and those without gastrointestinal symptoms (57.8%(67/116) vs. 56.3%(76/135), P>0.05). The median values of TBil, DBil, ALT, AST, ALP, GGT, LDH and globulin level of critical type patients were 13.5 μmol/L, 4.9 μmol/L, 44.5 U/L, 50.0 U/L, 64.0 U/L, 41.0 U/L, 527.0 U/L and 33.6 g/L respectively. The proportions of critical type patients with TBil level >34.2 μmol/L, DBil level>13.6 μmol/L, ALT level>80 U/L and AST level>80 U/L were 7.3% (8/110), 7.3% (8/110), 17.3% (19/110) and 17.3% (19/110), respectively. These results were all higher than those of common type patients (9.5 μmol/L, 2.9 μmol/L, 28.5 U/L, 28.5 U/L, 54.0 U/L, 25.5 U/L, 225.5 U/L, 30.1 g/L, 0, 0, 6.6% (5/76) and 2.6% (2/76) ) and severe type patients (10.4 μmol/L, 3.4 μmol/L, 30.0 U/L, 31.0 U/L, 49.0 U/L, 25.0 U/L, 284.0 U/L, 30.7 g/L, 0, 0, 6.2% (4/65) and 1.5% (1/65)), and the differences were statistically significant ( Z=-4.264, -5.507, -4.000, -6.558, -3.112, -4.333, -4.858, -3.873, Fisher′s exact test, Fisher′s exact test, χ2=4.574, 9.620; Z=-3.060, -3.850, -3.923, -5.005, -9.495, -7.651, -3.853, -2.725, Fisher′s exact test, Fisher′s exact test, χ2=4.425, 10.169; all P<0.01). The median values of pre-albumin level, albumin level and the albumin to globulin ratio of critical type patients were 85.3 g/L, 28.2 g/L and 0.8, which were all lower than those of common type patients (157.3 g/L, 32.3 g/L and 1.1, respectively) and severe type patients (133.6 g/L, 31.6 g/L and 1.1, respectively), and the differences were statistically significant ( Z=-6.631, -3.647, -4.924, -4.503, -5.283 and -3.903, all P<0.01). The median albumin level of patients with diarrhea was lower than that of patients without diarrhea (28.2 g/L vs. 30.5 g/L), the proportion of diarrhea patients whose TBil level >20.0 to 34.2 μmol/L was higher than that of patients without diarrhea (70.0%, 21/30 vs. 10.9%, 24/221), and the differences were statistically significant ( Z=-2.182, χ2 =62.788; both P<0.05). Conclusions:Anorexia is the most common digestive symptom in COVID-19 patients, and the incidences of abdominal pain is low. The incidence of liver function injury of critical type patients is high. There is no significant correlation between gastrointestinal symptoms and liver function injury, and patients with diarrhea have lower albumin levels.

Objective: To explore the independent predictors for disease-specific survival (DSS) rate in patients with stage N_1-3 testicular seminoma (TS), and establish a nomogram to predict individual 5-year DSS. Methods: The data of N_1-3 TS patients registered in the SEER database of National Cancer Institute (USA) from January 2004 to December 2015 were retrospectively analyzed. The 5-year overall survival (OS) rate and DSS rate were calculated using Kaplan-Meier method and the differences among different subgroups were assessed using log-rank test. Besides, the independent predictors of DSS were defined using multivariate Cox regression analysis, and nomogram was drawn using R software. Furthermore, the predictive performance of the nomogram was internally validated using the C-index and calibration plot. Results: TNM stage ⅢA (HR=5.604, 95%CI: 1.252-25.083, P=0.024), ⅢB (HR=6.710, 95%CI: 1.923-23.410, P=0.003) and ⅢC (HR=13.189, 95%CI: 3.916-44.420, P<0.001), age at diagnosis ≥45 years old (HR=3.575, 95%CI: 2.014-6.344, P<0.001), and patients without spouse (HR=2.346, 95%CI: 1.406-3.914, P=0.001) were identified as independent risk factors for DSS. On internal validation, the predictive accuracy of our nomogram was 0.751 (C-index: 0.751, 95%CI: 0.694-0.808). Besides, the calibration plot showed that the predicted survival outcomes were highly consistent with the actual survival outcomes. Conclusion The study confirms that age at diagnosis ≥45 years old, TNM stage ≥ⅢA and patients without spouse are the independent risk factors for DSS in TS patients with stage N_1-3, and the nomogram for predicting individual 5-year DSS is established.

Objective Comparative effect of WeChat platform nursing intervention and routine nursing intervention on reducing the incidence of complications of children skin expansion in the process of external ear reconstruction. Methods 132 cases of congenital microtia received skin expander implantation at our institution from Jan 2014 to Aug 20 14 were included as control group. 122 cases of congenital microtia received skin expander implantation at our institution from Sep 2014 to Apr 2015 were included as the intervention group. Children and their families in the control group were treated with routine propaganda and education, and the intervention group were added with internet nursing intervention. Collection and analysis the family health knowledge degree and the occurrence of complications in children of the two groups. Results The score of health knowledge about skin expansion in the intervention group was (33.67 ± 2.44),which was significant higher than that of in the control group (25.07 ± 2.02), t=9.71, P < 0.01. The incidence rate of complication in the intervention group was 2.46%(3/122), which was significant lower than that of in the control group, 8.33%(11/132),χ2=4.20, P<0.05. The satisfaction rate of patients′family member in the intervention group was 95.08%(116/122), which was significant higher than that of in the control group, 84.09%(111/132 ),χ2=15.65, P<0.05. Conclusions WeChat platform nursing intervention can reduce expansion flap complications occurrence rate in the periods of expander. It is worthy of clinical application.

Objective To explore the effects of health education based on WeChat platform to reduce external ear reconstruction complications through skin quantitative expansion method.Methods A number of 254 congenital microtia patients and their families admitted from January to August 2014 were treated as control group who received routine health education.A total of 238 cases patients with the same disease and their families admitted from September 2014 to April 2015 were chosen as observation group who received routine and WeChat platform for health education.Water injection nurses collected the data of patients' health knowledge mastering degree,comparing two groups of patients and families disease knowledge mastering degree,complication rates and nursing satisfaction.Results Patients and families in observation group grasped health knowledge better than that of control group,with a lower complication incidence than that of control group(P ＜0.01).After the interventions of health education,the satisfaction was 94.96％ in the observation group comparing with 83.46％ in the control group (P ＜ 0.01).Conclusions Nursing intervention based on WeChat platform can reduce the incidence of expanded skin flap complications,improve patient and families' nursing knowledge and elevate nursing satisfaction.

Objective To study the distribution and significance of free organophosphorus poisons (FOP)with different degrees of hudrosolubility in the blood and adipose tissues of poisoned rabbits.Methods Seventy two male livid blue rabbits with 2-2.5 kg body weight were divided into 3 groups as per the rabbits intoxicated with different kinds of organophosphorous given subcutaneously,namely monocrotophos(11.12 mg/kg)group,trichloffon(556.0 mg/kg)group and methyl parathion(37.05 mg/kg)group(n =24 in each).Each group was further divided into 4 subgroups(n =6,in each).Blood samples and adipose tissues were collected 1 h,6 h,24 h and 96 h after administration of organophosphorous.Blood cells and plasma were separated.Well-formed adipose tissue homogenates were made.Acetylcholinesterase(AChE)activities were assayed with dithiobisnitrobenzoic acid(DTNB)enzyme kinetic method.The levels of FOPs in blood plasma,blood cells and adipose tissues were determined with enzyme inhibition method.Results There were signiflc.ant differences in FOP concentrations of plasma,blood cells and adipose tissues among moncrotophos group,trichlorfon group and methyl pararthion group at the intervals of 1,6 and 24 hours after organophosphorous administered(all P ＜ 0.05).There were no significant differences in FOP concentrations of moncrotophos among blood plasma,blood cells and adipose tissues at intervals of 1,6,24 and 96 hours.FOP concentrations of trichlorfon in adipose tissues were significantly higher than those in blood cells and plasma at intervals of 1,6,24 hours after organophosphorous administered(P ＜ 0.05).There were significant differences in FOP concentrations of pararthion in blood plasma compared with blood cells and adipose tissues at intervals of 1 and 6 hours after organophosphorous administered(P ＜ 0.05)and no difference was found over 24 hours after administration of organophosphorous(P ＞ 0.05).The significant differences in the rates of FOP clearance from blood and adipose tissues were also found between different organophosphates(P ＜ 0.05,moncrotophos ＞ trichlorfon ＞methyl pararthion).Conclusions With the decrease in hydrosolubility of organophosphates,the increase in adipose tissue-specific retention was found and the time required for clearance from blood and adipose tissue was prolonged.Adipose tissue was the major storage site for organophosphates with low hydrosolubility.

With the continuous development in microfluidic fabrication technology, microfluidic analysis has evolved from a concept to one of research frontiers in last twenty years. The research of enzymes and enzyme inhibitors based on microfluidic devices has also made great progress. Microfluidic technology improved greatly the analytical performance of the research of enzymes and enzyme inhibitors by reducing the consumption of reagents, decreasing the analysis time, and developing automation. This review focuses on the development and classification of enzymes and enzyme inhibitors research based on microfluidic devices.