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.

Quantity is the key factor to ensure the safety and effectiveness of medicines. It is very important to study and determine the traditional measuring units and their quantity values of Tibetan medicine. Based on the literature records of Tibetan medicine and combined with modern experimental verification and investigation research, this study determined the reference, name, and conversion rate of traditional measuring units of Tibetan medicine. Meanwhile, through large sample sampling and repeated quantification of refe-rence of basic units, its weight and volume were clarified. The modern SI volume and weight unit values corresponding to the traditional volume and weight units of Tibetan medicine were deduced, and the correctness, reliability, and practicability of these determination results were demonstrated. This study also put forward some specific suggestions and reference values for formulating the standards of measuring units of weight and volume of Tibetan medicine. It is of great significance in guiding the processing, production, and clinical treatment of Tibetan medicine, and promoting the standardization and standardized development of Tibetan medicine.
Medicine, Tibetan Traditional ; Reproducibility of Results

BackgroundType 1 diabetes is caused by a chronic immune response that destroys islet beta cells， resulting in elevated blood glucose. Mesenchymal stem cells can prevent and treat the development of diabetes and its complications. However， little is known about the effects and potential mechanisms of Gingival mesenchymal stem cells （GMSCs） in preventing diabetes. The aim of this study is to investigate the mechanism of GMSCs in preventing type 1 diabetes in mice and to find targets for clinical treatment of diabetes. MethodsWe injected human GMSCs into NOD mice to observe the trend of blood glucose， observed the survival of pancreatic β-cells by immunohistochemistry， and detected the change of immune cells in the spleen of mice by flow analysis. Finally， the immune cells in NOD mice were transfused into NOD-SCID mice to observe the onset of diabetes in NOD-SCID mice. ResultsGMSCs significantly reduced the incidence of diabetes in NOD mice， with 64% of control mice developing diabetes at 27 weeks of age compared with 35% in the GMSC group， P=0.013. The percentage of Follicular B cells（FO B cell） in the spleen of GMSCs-treated mice decreased from （52.2±4.1）% to （43.2±5.3）%， P=0.008， while other types of immune cells did not change significantly. The immunohistochemical results showed that GMSCs could effectively improve the survival of pancreatic β-cells， which could continuously produce insulin to control blood glucose. Finally， we found the spleen cells transfusion could prevent the development of diabetes in NOD-SCID mice. ConclusionGMSCs can reduce diabetes in mice by reducing FO B cells in the spleen.

Objective To explore the effect and safety of target controlled infusion mode based on precision anesthesia concept in cardiac surgery anesthesia.Methods A total of 100 patients underwent cardiac surgery in our hospital were selected as the research subjects,and they were randomly divided into the control group and the observation group,with 50 cases in each group.The surgical types,surgical related indicators,dosage of anesthetic drugs,and complications of the two groups were compared.Results There was no statistically significant difference in the proportions of patients who underwent coronary artery bypass surgery,valve surgery,macrovascular surgery,artial septal defect repair surgery,or other types of surgery between the two groups(P>0.05).There were statistically significant differences in the surgical time,bleeding volume,infusion volume,proportion of cardiopulmonary bypass,times of postoperative analgesic drug use and mechanical ventilation duration between the two groups(P<0.05).The usage of various anesthetic drugs in the observation group was lower than that in the control group,with statistically significant difference(P<0.05).The incidence of complication in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion The target controlled infusion mode based on precision anesthesia concept can be used for cardiac surgery anesthesia to reduce the dosage of anesthetic drugs and postoperative complications,and improve the anesthesia effect and surgical safety.

OBJECTIVE: To analyze the clinical treatment results of male infertility caused by Y chromosome azoospermia factor c region(AZFc) deletion after synchronous micro-dissection testicular sperm extraction (micro-TESE) and intracytoplasmic sperm injection (ICSI) and to guide the treatment of infer- tile patients caused by AZFc deletion. METHODS: The clinical data of infertile patients with AZFc deletion who underwent synchronous micro-TESE in Peking University Third Hospitalfrom January 2015 to December 2019 were retrospectively analyzed. The clinical outcomes of ICSI in the patients who successfully obtained sperm were followed up and we compared the outcomes between the first and second synchronous procedures, including fertilization rate, high-quality embryo rate, clinical pregnancy rate, abortion rate and live birth rate. RESULTS: A total of 195 male infertile patients with AZFc deletion underwent micro-TESE. Fourteen patients were cryptozoospermia and their sperms were successfully obtained in all of them during the operation, and the sperm retrieval rate (SRR) was 100%(14/14). The remaining 181 cases were non obstructive azoospermia, and 122 cases were successfully found the sperm, the SRR was 67.4%(122/181). The remaining 59 patients with NOA could not found mature sperm during micro-TESE, accounting for 32.6% (59/181). We followed up the clinical treatment outcomes of the patients with successful sperm retrieved by synchronous micro-TESE and 99 patients were enrolled in the study. A total of 118 micro-TESE procedures and 120 ICSI cycles were carried out. Finally 38 couples successfully gave birth to 22 male and 22 female healthy infants, with a cumulative live birth rate of 38.4% (38/99). In the fresh-sperm ICSI cycle of the first and second synchronous operation procedures, the high-quality embryo rate, clinical pregnancy rate of the fresh embryo transfer cycle and live birth rate of the oocyte retrieve cycle were 47.7% vs. 50.4%, 40.5% vs. 50.0%, and 28.3% vs. 41.2%, respectively. The second operation group was slightly higher than that of the first synchronous operation group, but there was no significant difference between the groups. CONCLUSION Male infertility patients caused by AZFc deletion have a high probability of successfully obtaining sperm in testis through micro-TESE for ICSI and give birth to their own offspring with their own biological characteristics. For patients who failed in the first synchronous procedure, they still have the opportunity to successfully conceive offspring through reoperation and ICSI.
Azoospermia/therapy* ; Chromosome Deletion ; Chromosomes, Human, Y ; Female ; Humans ; Infertility, Male/therapy* ; Male ; Pregnancy ; Retrospective Studies ; Semen ; Sex Chromosome Aberrations ; Sex Chromosome Disorders of Sex Development ; Sperm Injections, Intracytoplasmic/methods* ; Sperm Retrieval ; Spermatozoa ; Testis

Along with increasing degree of population aging globally， senility， good health and long life have become the focus of the world. Guided by Qiluo doctrine， an essence， Qi and spirit theory is proposed as below， essence is the origin of life， Qi is the impetus of life and spirit is the embodiment of life. Based on holistic view of kidney deficiency involving the five internal organs and injuries of the five internal organs definitely affecting the kidney， a mechanism of aging is proposed as below， deficiency of kidney essence is the foundation of aging， deficiency of promordial Qi is the key of aging and physical and spiritual loss is the manifestation of aging. It provides a theoretical guidance for anti-aging study of rejuvenating the elderly and making the strong person stronger. By virtue of the experiences in kidney-tonifying medication accumulated for more than two thousand years， Bazi Bushen capsules has been developed， which has anti-aging efficacy， including tonifying kidney， replenishing essence， coordinating Yin and Yang， supplementing primordial Qi and nourishing body and spirit. Experimental researches have demonstrated that Bazi Bushen capsules can improve overall aging and systemic aging， as well as prevent and treat aging related diseases. Preliminary clinical studies demonstrate that this capsules can enhance athletic ability and improve sexual function， and is expected to become a representative Chinese patent medicine of anti-aging. This paper addresses aging and anti-aging on the basis of Qiluo doctrine， in the hope of helping prevention and treatment of aging related diseases.

The decline of body function and senile diseases caused by aging seriously affect human health and life span， which is an important topic in the field of life science. Bazi Bushen capsules is a representative Chinese patent medicine for tonifying essence， invigorating Qi and anti-aging， guided by Qiluo doctrine， and essence， Qi and spirit theory. Previous pharmacological and clinical studies have confirmed that this preparation has the comprehensive advantages of anti-aging， and prevention and treatment of aging-related diseases. Among them， pharmacological studies showed that Bazi Bushen capsules had the effect of improving the appearance status of mice， improving the level of sex hormones， inhibiting the formation of atherosclerosis， improving cardiac function， improving learning and memory cognitive ability， improving neurological function， improving osteoporosis and muscle function， improving sperm count and quality. The mechanism was related to the up-regulation of the recombinant sirtuin （SIRT6） level， down-regulation of the levels of aging-related proteins p53 and p16， up-regulation of telomerase reverse transcriptase level， and alleviation of inflammation and oxidative response. Clinical studies have proved that it can improve the symptoms of patients with kidney essence deficiency， improve exercise ability， and improve the sexual function of impotence patients. Anti-aging research of Bazi Bushen capsules based on Qiluo doctrine fully embodies the new mode of academic innovation and transformation of traditional Chinese medicine （TCM） with the combination of "theory-new drug-experiment-clinic"， which has made a demonstration for the anti-aging research of TCM.

Objective To investigate the epidemic factors of schistosomiasis in wetlands in Sichuan Province, so as to provide scientific evidence for the prevention and control of schistosomiasis in wetlands. Methods The artificial and natural wetlands were selected from Sichuan Province, and the relevant data regarding wetlands were collected. Routine snail survey, investigation on human morbidity due to schistosomiasis, snail diffusion experiments, questionnaire survey, determination of water infectivity and retrospective survey were conducted. Results In Sichuan Province, the mean densities of living snails were 0.003 snails/0.1 m² and 2.033 snails/0.1 m² in the upper and lower reaches of the Meiwan Reservoir wetlands, 0.08 snails/0.1 m² in the Jinyan Lake of Guanghan City, 0.21 snails/0.1 m² in Muhe River of Guanghan City, and 0.02 snails/0.1 m² prior to the construction of Qiong-hai wetland park in Xichang City in 2015. Artificial simulation experiments showed that the largest distance of snail diffusion in water was 2 000 m. There were 8.80% (41/466) of subjects that lived neighboring wetlands, worked in wetlands and visited wet-lands having infested water contact behaviors. A total of 690 sentinel mice were assigned, and no Schistosoma japonicum infection was detected in the 677 mice dissected. Retrospective survey showed that the construction of the Meiwan Reservoir caused the spread of schistosomiasis in Dailing County, and snails were found in the ditches entering the Jinyan Lake and in Jinyan Lake areas 5 years following the construction of the Jinyan Lake in Guanghan City, with S. japonicum -infected snails detected in the ditches entering the Jinyan Lake. Conclusions O. hupensis snails are found in some wetlands in Sichuan Province. Protection of wetlands and snail control with environmental improvements are recommended for the prevention of snail importation in natural wetlands, while in artificial wetlands, thorough snail control is recommended during the construction of the wetlands because of the likelihood of snail importation via water systems. In addition, both natural and artificial wetlands require long-term systematic surveillance of schistosomiasis.

OBJECTIVE: To discuss the clinical effects of the different pedicle screw fixation methods for the treatment of thoracolumbar fractures. METHODS: The clinical data of 55 patients with single thoracolumbar fractures treated between January 2013 and December 2016 were retrospectively analyzed. There were 32 males and 23 females, aged from 20 to 55 years with an average of 35.6 years old. All the fractures were located on a single segment, 8 cases of T₁₁, 18 cases of T₁₂, 19 cases of L₁, 10 cases of L₂. According to the classification of AO, 10 cases were type A1, 17 cases were type A2, 18 cases were type A3, 7 cases were type B2, 2 cases were type B3, 1 case was type C1. The patients were divided into three groups according to the different fixation methods, among them, 20 cases treated by traditional short-segment 4 pedicle screws fixation were control group, 22 cases treated by intermediate bilateral pedicle screws fixation (6 pedicle screws fixation) were bilateral group, 13 cases treated by intermediate unilateral pedicle screw fixation (5 pedicle screws fixation) were unilateral group. The three groups were compared by operation time, intraoperative blood loss, hospitalization cost, VAS and ODI scores, the correction of the fractured vertebrae height and kyphosis angle postoperatively and the losing rate of the fractured vertebrae height and kyphosis angle at the final follow-up and so on. RESULTS: All the patients were followed up from 12 to 20 months with an average of 15.2 months. No complications such as loosening of internal fixation and breakage were found after operation. There was no significant difference in operation time and intraoperative blood loss among three groups(>0.05). In terms of hospitalization cost, the control group[(20 932.4±298.3)yuan] was significantly lower than the unilateral group[(22 428.2±321.5)yuan] and the bilateral group [(23 630.5±310.5)yuan] (<0.05), and the unilateral group was lower than the bilateral group (<0.05). There was no significant difference in VAS and ODI scores at preoperative, postoperative 1 week and final follow-up among the groups(>0.05). And there was no significant difference in the correction of the injuried vertebrae height and kyphosis angle immediately after operation among three groups(>0.05). However, for the losing rate of the injuried vertebrae height at the final follow-up, the unilateral group[(6.3±2.1)%] and bilateral group [(5.6±2.8)%] were significantly better than the control group[(9.2±1.8)%] (<0.05), there was no significant difference between unilateral group and bilateral group; for the losing rate of kyphosis angle at the final follow-up, the unilateral group[(15.2±6.5)%] and bilateral group[(13.9±7.2)%] were significantly better than the control group[(23.6±7.5)%] (<0.05), but there was no statistical difference between the unilateral and bilateral group(>0.05). CONCLUSIONS All the three different pedicle screw fixation methods are suitable for the treatment of thoracolumbar fractures and the short-term clinical effects are consistent. Compared with traditional short-segment 4 pedicle screws fixation, intermediate bilateral or unilateral pedicle screw fixation were more effective in maintaining the height of the injuried vertebrae and preventing the occurrence of kyphosis. The intermediate unilateral pedicle screw fixation was comparable to that of bilateral fixation at clinical outcomes, but the unilateral fixed hospitalization cost was lower, which was worthy of clinical promotion.
Adult ; Female ; Fracture Fixation, Internal ; Humans ; Lumbar Vertebrae ; Male ; Middle Aged ; Pedicle Screws ; Retrospective Studies ; Spinal Fractures ; Thoracic Vertebrae ; Treatment Outcome ; Young Adult