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 application of high-pitch late artery scanning by dual-source CT in evaluating the filling defect and morphological measurement of left atrial appendage(LAA).Methods A total of 80 patients requiring LAA CT angiography(CTA)scanning due to atrial fibrillation(AF)admitted in our hospital from July to October 2022 were enrolled,and their clinical data were collected.The second-generation dual-source CT high-pitch FLASH scanning was adopted to all the patients who were randomly divided into group A(arterial phase scanning,40 cases)and group(late arterial phase scanning B,40 cases).All patients underwent dual-phase scanning and the time interval was 30 s.According to the filling defects of LAA in the first phase,the patients were divided into LAA filling group(n=59)and non-filling group(n=21).The radi-ation dose the patients received was recorded.The CT values of LAA,ascending aorta(AA)at the same slice and left atrium(LA)at its largest slice were calculated,and the short diameter,long di-ameter,area of LAA opening and depth of LAA were also measured.Results The radiation dose received in patients in phase 1 was 2.2(2.0,3.9)mSv,and that in phase 1+delayed was 2.7(2.4,4.8)mSv,with significant difference between the first and the first+delayed scanning period(P＜0.01).The ratios of CT values(LAAHU/AAHU and LAAHU/LAHU)and of LAA filling defect in the first phase were significantly higher in the group B than the group A(P＜0.05,P＜0.01).The long diameter,short diameter,area of LAA opening and depth of LAA were obviously lower in the LAA filling group than the non-filling group(26.6±3.1 mm vs 30.1±2.8 mm,P＜0.01;20.8±2.9 mm vs 22.8±2.1 mm,P＜0.01;454.6±92.1 mm2 vs 561.9±85.9 mm2,P＜0.01;35.8±4.8 mm vs 40.7±5.4 mm,P＜0.01).Conclusion High-pitch Flash late arterial phase scanning by dual source CT can significantly elevate the LAA filling defects,shorten the examination time and reduce the radiation dose in patients.It is worthy of clinical application and promotion.

During coronavirus disease 2019 epidemic, the treatment of severe trauma has been impacted. The Consensus on emergency surgery and infection prevention and control for severe trauma patients with 2019 novel corona virus pneumonia was published online on February 12, 2020, providing a strong guidance for the emergency treatment of severe trauma and the self-protection of medical staffs in the early stage of the epidemic. With the Joint Prevention and Control Mechanism of the State Council renaming "novel coronavirus pneumonia" to "novel coronavirus infection" and the infection being managed with measures against class B infectious diseases since January 8, 2023, the consensus published in 2020 is no longer applicable to the emergency treatment of severe trauma in the new stage of epidemic prevention and control. In this context, led by the Chinese Traumatology Association, Chinese Trauma Surgeon Association, Trauma Medicine Branch of Chinese International Exchange and Promotive Association for Medical and Health Care, and Editorial Board of Chinese Journal of Traumatology, the Chinese expert consensus on emergency surgery for severe trauma and infection prevention during coronavirus disease 2019 epidemic ( version 2023) is formulated to ensure the effectiveness and safety in the treatment of severe trauma in the new stage. Based on the policy of the Joint Prevention and Control Mechanism of the State Council and by using evidence-based medical evidence as well as Delphi expert consultation and voting, 16 recommendations are put forward from the four aspects of the related definitions, infection prevention, preoperative assessment and preparation, emergency operation and postoperative management, hoping to provide a reference for severe trauma care in the new stage of the epidemic prevention and control.

Objective: To understand the awareness and influencing factors of medical healthcare APP among female college students in Weifang, and to provide references for healthy lifestyle and health literacy improvement. Methods: A total of 891 female college students were selected by stratified random sampling method, and were investigated regrading awareness on medical and health care APP and associated factors. Data were statistically analyzed by composition ratio, CHI-square test and binary Logistic regression. Results: There were 54.6% of the female college students who reported not aware of medical healthcare APP. The overall awareness rates of medical and health care APP for freshmen,sophomores, juniors, seniurs and above were 39.75%,45.59%,55.78% and 52.56%, respectively, and the difference was statistically significant(χ2=16.43，P<0.05). Logistic regression analysis showed that medical costs, medical healthcare information attention, medical health care information recognition, consulting the treatment scheme were positively associated with awareness of health care APP(OR=1.40,1.51,1.27,1.33,P<0.05). Conclusion The awareness rate of medical health care APP of female college students in Weifang is relatively low,and the difference between different groups is obvious. It is necessary to improve the scientific knowledge rate of the female college students to the APP, so as to influence the life style of the female college students.

Family physicians contracted service is an important choice to deepen the reform of China′s healthcare reform and achieve the strategic goal of " health for all" . In order to effectively promote the contracted service, the central government has successively issued a number of policy documents, which are echoed by the localities in their proactive explorations, achieving remarkable results. But there are also multiple roadblocks hindering the contracted service to progress. This article referred to the three-circle theory and studied policy implementation from the three dimensions of policy value, policy resources, and policy impetus. A thorough analysis of the problems in the implementation process revealed such main problems as insufficient family physicians, inadequacy of supporting policies and low level of policy acceptance among the young healthy age groups. The follow-up work will promote the long-term implementation of the family physicians contracted service policy by enriching the family physicians team, enriching supporting policies, and focusing on promotions to key age groups.

The healthcare plus aging care is a new type of aging care model that integrates medical services and aging care services. China has successively issued a series of policies, encouraging the localities to proactively explore such a model. The authors refer to the four dimensions of exchange and communication, policy resources, policy executor preferences and organizational structure in the Edwards policy execution model, for analyzing the implementation of such a policy. The study found such constraints for the policy as follows: unclear policy implementation standards, inadequate policy resources of manpower, financial and material resources, differences in preferences among local governments, general hospitals, primary medical institutions, and pension institutions, as well as decentralized and restricted organizational structures. At present, the policy of healthcare plus aging care remains in the stage of exploration and trial. The government should continue to define and revise the policy to ensure the smooth progress and long-term implementation of the policy of healthcare plus aging care.

Objective:Based on the perspective of status-seeking, to clarify the status quo of rural doctors′ subjective social status, and put forward countermeasures and suggestions to improve the subjective social status of rural doctors.Methods:By investigating 1 395 rural doctors in both 2015 and 2017 to clarify the status quo of rural doctors′ subjective social status through descriptive analysis, we compared the subjective social status of rural doctors with different characteristics by using differential analysis.Results:The overall subjective social status scoring of rural doctors was 3.17±0.48, including decision participation scoring(3.30±0.82), income scoring(2.19±0.80), social relationship scoring(4.05±0.61), career reputation scoring(3.09±0.84), career promotion scoring(2.38±0.67), and career value scoring(4.04±0.63). Rural doctors with middle or above academic titles, high-performance levels, as well as those comparable to doctors in township hospitals and self-employed clinics were found with higher subjective social status.Conclusions:Rural doctors held their subjective social status to be at an intermediate level, with higher ratings for interpersonal relationships and professional values and lower ratings for salary and training mechanisms. Positive feedback on the status-seeking behavior of rural doctors is recommended to improve village clinic services and reshape the image of rural doctors.

Objective: To investigate the usage of medical and health care APP among female college students, and to understand possible influencing factors, so as to provide reference for medical health care behaviors and personal health among college students. Methods: A stratified random sampling method was used to select 891 female college students from 3 colleges in Weifang. A questionnaire survey on their concentration on their own health, the knowledge, cognition and behavior of medical and health care APP, and Logistic regression analysis was used to analyze the influencing factors. Results: There were 55.4% female college students who had used medical and health care APP, and most of them (290) had used fitness and weight loss APP. There was statistical significance of the different usages of students of different degrees, majors and grades(χ2=26.55, 7.72, 13.96, P<0.05). Logistic regression analysis showed that educational background, annual medical costs, awareness of medical and health care APP and attitude towards APP prospect were the factors influencing the utilization of medical and health care APP (OR=0.44，0.69，1.36，1.23，P<0.05). Conclusion The usage rate of medical and health care APP is general, and sustained utilization rate is low, the APP should enrich menstrual period consumption and figure report, add video recommendation, interactive dating, and other functions, improve female students medical and health care APP cognition, female college students to change health care APP attitude.

Objective To study the effect of the preset temperature,heating time and the spacing of radio frequency electrodes.Methods Fresh egg white was used to study the effects of heater spacing,temperature and heating time.Two electrodes were fixed to keep the needles perpendicular to the center of egg white confined on a square plate.Temperatures from 50 to 90℃ were tested with heating times of 60 and 120 seconds and electrode spac ings of 2.0,1.0,0.5 and 0.25 centimetres.The real-time temperature and the time to the appearance of a spindleshaped bridge between the electrodes was observed.The egg white's impedance and resistance,the lowest temperature of denaturation,and the mass (or volume) denatured at different time points were also observed.Results With an electrode spacing of 2 cm and the thermostat set at 63℃,the true electrode temperatures were 63.7 and 52.6℃,with the secondary electrode the cooler.Significant differences between the secondary electrode temperature and the preset temperature as well as the temperature between the primary and the secondary electrodes were observed.It was also found that different electrode spacing caused significant differences between the preset temperature and the primary as well as the secondary electrode temperature.Denaturation began at 56℃ with a spacing of 0.25 cm.At spacings of 0.25 and 0.50 cm,a spindle-shaped connection between the two electrodes was observed at temperatures above 70℃,but higher temperature was required at 1.00 and 2.00 cm.When the spacing was 0.25 cm and the preset temperature was 75℃,the denatured volume after 60 s of heating was 90.21+0.64 mm3.Heating for 120 s denatured 95.08+ 0.53 mm3 and two 60.s heatings 92.88+0.74 mm3,all significant differences.There were no significant differences in the resistance of the egg white before and after a single heating for 60 s,but after a single heating lasting 120 s it had increased significantly from 128.41+8.04 to 121.29±8.04 Ω.Conclusion Bipolar radio frequency heating can denature egg white.Higher temperature,longer heating and smaller electrode spacing heat more effectively.

Objective To investigate whether pyrrolidine dithiocarbamate (PDTC) can attenuate the acute radiation-induced heart damage (RIHD) by inhibiting the activation of NF-κB and its downstream signaling pathways in rat models. Methods Twenty-one male adult Sprague-Dawley (SD) rats were randomly divided into the blank control, irradiation and PDTC plus irradiation groups (n=7 for each group). In the irradiation and PDTC+ irradiation groups,the rats received 6 MV X-ray at a single fraction of 20.0 Gy. In the PDTC+ irradiation group, intraperitonal injection of PDTC was administered at a dose of 120 mg/kg body weight,30 minutes prior to radiation, once daily for 1-14 days. On the 14thday,pathological changes of myocardial tissue were observed. Masson's trichrome staining was performed to calculate the collagen volume fraction (CVF) of myocardial cells. The expression levels of NF-κB family members including p50, p65,HIF-1α,connective tissue growth factor (CTGF) and collagen type 1(COL-1) proteins and mRNA were quantitatively measured by Western blot and quantitative real-time PCR (qPCR). Statistical analysis was conducted by using t-test. Results HE staining demonstrated that compared with the irradiation group, the severity of myocardial edema was alleviated,the infiltration of inflammatory cells was mitigated and the quantity of fibroblasts was reduced in the PDTC+irradiation group. Masson's trichrome staining revealed that PDCT intervention could decrease the deposition of collagen fiber in the interstitial tissues. Semi-quantitative analysis demonstrated that the CVF value in the PDTC+irradiation group was (9.99± 0.32)%, significantly lower compared with (22.05±0.21)% in the irradiation group (P<0.05). Western blot and qRT-PCR demonstrated that the expression levels of p50,p65,and HIF-1αproteins and mRNA in the PDTC+ irradiation group were significantly down-regulated compared with those in the irradiation group (all P<0.05). Compared with the irradiation group,the expression levels of CTGF protein and mRNA tended to decline (all P>0.05),and the expression levels of COL-1 protein and mRNA were equally inclined to decrease (P<0.05 and P>0.05). Conclusion PDTC can alleviate the acute RIHD by suppressing the activation of NF-κB and its downstream HIF-1α transcription.