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 examine the prevalence and trend of tobacco and e-cigarettes uses and identify the influencing factors for smoking behavior in junior middle school students in Shanghai, and provide data support and scientific basis for the development of tobacco control intervention strategy in adolescents. Methods: Multi-stage stratified random sampling method was used to select junior middle school students in 8 districts and 10 districts in Shanghai in 2013 and in 2019 respectively. Information about tobacco and e-cigarettes uses in the students were collected by using self-administrated questionnaire. The prevalence of tobacco and e-cigarettes uses were calculated, the difference between two years was compared with χ² test. The influencing factors were identified by multivariate logistic regression analysis. Results: In 2019, the current smoking rate was 0.6% in junior middle school students in Shanghai, and the smoking attempt rate was 2.9%, both were lower than the levels in 2013 (0.7% and 6.9%). The current use rate of e-cigarettes was 0.6% in 2019,with no significant change compared with 2013 (0.6%). The proportion of the students who had heard of e-cigarettes in 2019 (78.4%) was higher than that in 2013 (47.2%). In 2019, the second-hand smoke (SHS) exposure rate at home, in both indoor and outdoor public places and on public transportations was 72.5%, which was slightly lower than the level in 2013 (73.0%), the differences were all significant (P<0.05). In 2019, the students seeing close friend smoking (OR=27.381, 95%CI: 12.037-62.287), seeing someone smoking in school (OR=2.477, 95%CI: 1.155-5.312), believing that SHS may not be harmful (OR=8.471, 95%CI: 1.464-49.005) had higher possibility of smoking. Being aged ≥15 years (compared with being aged ≤12 years, OR=8.688, 95%CI: 1.922-39.266), exposure to SHS in outdoor public place (OR=8.608, 95%CI: 1.048-70.692), close friend smoking (OR=8.115, 95%CI: 1.754-37.545) were positively associated with e-cigarettes use, and believing that smoking results in uncomfortable social contact [compared with believing that smoking results in comfortable social contact (OR=0.105,95%CI: 0.018-0.615)] were negatively associated with e-cigarettes use, the difference was significant (P<0.05). Conclusion: The prevalence of tobacco and e-cigarette uses in junior middle school students in Shanghai remained at a low level in recent years. The SHS exposure rate in junior middle school students is high. Smoking behavior of junior middle school students is closely related to personal attitude and awareness of tobacco, exposure to SHS, peer smoking and the situation of tobacco control in schools. Prevention and intervention should be carried out from multi-dimensions to effectively protect teenagers from tobacco hazards.
Adolescent ; China/epidemiology* ; Electronic Nicotine Delivery Systems ; Humans ; Prevalence ; Students ; Tobacco ; Tobacco Smoke Pollution

For local treatment of ulcerative colitis, a new azoreductase driven prodrug CDDO-AZO from bardoxolone methyl (CDDO-Me) and 5-aminosalicylate (5-ASA) was designed, synthesized and biologically evaluated. It is proposed that orally administrated CDDO-AZO is stable before reaching the colon, while it can also be triggered by the presence of azoreductase in the colon to fragment into CDDO-Me and 5-ASA, generating potent anti-colitis effects. Superior to olsalazine (OLS, a clinically used drug for ulcerative colitis) and CDDO-Me plus 5-ASA, CDDO-AZO significantly attenuated inflammatory colitis symptoms in DSS-induced chronic colitis mice, which suggested that CDDO-AZO may be a promising anti-ulcerative colitis agent.
Animals ; Colitis/drug therapy* ; Mesalamine/pharmacology* ; Mice ; Nitroreductases ; Oleanolic Acid/pharmacology* ; Prodrugs

COVID-19 ; Female ; Humans ; Infectious Disease Transmission, Vertical ; Pregnancy ; Pregnancy Complications, Infectious/drug therapy* ; Pregnancy Outcome ; Premature Birth ; Retrospective Studies ; SARS-CoV-2

OBJECTIVE: To study the potential significance and clinical application of FGFR1 gene abnormality in the diagnosis, clinical features, pathological mechanism and treatment in hematological tumors. METHODS: Clinical data of total of 29 patient with chromosome of 8 short arm (8P) abnormality who had more comprehensive medical history from 2013 to 2018 were collected. The karyotype analysis of bone marrow chromosomes in patients was carried out by using chromosome R band banding technique. FGFR1 gene was detected by using fluorescence in situ hybridization (FISH). RESULTS: Seven cases of FGFR1 gene abnormalities were decteted, including 3 cases of FGFR1 gene amplification, 2 cases of translocation, and 2 cases of deletion. Five patients with FGFR1 gene amplification or deletion not accompaned with eosinophilia, moreover the chromosome was a complex karyotype with poor prognosis; Two cases of FGFR1 gene translocation were non-complex chromosomal translocation and one of which survived for 6 years after bone marrow transplantation, the other chromosome karyotype showed no rearrangement of 8 short arm. However, FGFR1 gene rearrangement was confirmed by FISH analysis, which was a rare insertional translocation. CONCLUSION FGFR1 gene amplification or deletion often occur in cases with complex karyotype, which not accompany eosinophilia, moreover have poor prognosis. The patients with FGFR1 gene translocation accompany eosinophilia which is consistent with the clinical characteristics of myeloid / lymphoid neoplasms with FGFR1 abnormality. Karyotype analysis combined with FISH method can improve the detection of abnormal clones.
Chromosome Aberrations ; Hematologic Neoplasms ; genetics ; metabolism ; Humans ; In Situ Hybridization, Fluorescence ; Karyotyping ; Receptor, Fibroblast Growth Factor, Type 1 ; genetics ; Translocation, Genetic

Adolescent idiopathic scoliosis (AIS) is a common disease with the age of 10 to 18 years, the Cobb angle more than 10 ° on the coronal plane and combined with the rotation of the vertebral body without other organic lesions. The disease can lead to deformity, pain and even damage of cardiopulmonary function, which seriously affects the physical and mental health and quality of life of patients. For mild to moderate AIS patients, regular observation, braces and other conservative treatment methods can effectively delay the progress of scoliosis. For AIS patients whose conservative treatment is ineffective and reaches the surgical threshold, surgery is recommended. Currently, the prevalent surgical method is posterior vertebral body fusion represented by the pedicle screw internal fixation system, which can often achieve good clinical efficacy. In recent years, Physical Therapeutic Scoliosis Specific Exercise (PSSE) has become more and more popular because of its safety and effectiveness. At present, the specific indications for the treatment of AIS patients are gradually improving, the concept and technology of treatment are constantly updated, and the clinical efficacy is constantly improved. This article will start from two aspects of conservative treatment and surgical treatment, mainly describes the commonly used treatment methods in clinical progress and application as well as the problems faced, in order to provide a reference for the selection of clinical treatment.

Objective To investigate the general situation, smoking status, smoking cessation status and one-month follow-up examination in Shanghai, providing scientific basis for further effective development of smoking cessation clinics in Shanghai. Methods A total of 841 smokers who visited the smoking cessation clinic from 2016 to 2018 were investigated and 725 patients were followed up one month later.The data thus obtained were analyzed by SPSS software. Results In general, of the visiting patients in 2018, 91.3% were male, 50.6% were 35-55 years old, 57.1% had educational background in primary school or below, and 60.2% were employees of enterprises, businesses and service industries.In terms of smoking, 44.1% of the patients smoked 10-20 cigarettes a day, 34.6% smoked for 10-20 years, and 38.6% smoked the first cigarette within 5 minutes after getting up.With regards to the situation of smoking cessation, 72.1% of the patients tried to quit smoking before going to the clinic; 14.8% of the patients used electronic cigarettes to help quit smoking; 33.9% learned about the smoking cessation clinic through the doctors; 61.4% decided to quit smoking because they were concerned about their health and the health of their family members.According to the follow-up, the rate of quitting smoking in one month in 2018 was 48.8%;44.0% of the patients believed that their own determination was the key to quit smoking; 46.2% of the patients who failed to quit smoking believed that if they tried to quit smoking again, the biggest obstacle was the onset of smoking addiction. Conclusion The establishment of smoking cessation clinics in Shanghai can help patients quit smoking.However, there are still some problems in this regard.In view of the characteristics of the patients going to the smoking cessation clinic, we should find out the weaknesses in the propaganda of the smoking cessation clinic in time.For example, it is found that there are fewer smoking women, less educated and less farmers visiting the clinic; according to the smoking situation of the patients, we should clearly focus on updating the service quality of the smoking cessation clinic; proceeding from the follow-up situation, we should find out the the approach to the construction and perfection of smoking cessation clinics in Shanghai.

Objective:This paper reviewed the current development of education of physical therapy and discussed the growing demand for physical therapists and gaps of their professional education. It is crucial to reconstruct a framework and system of sciences and specialty in physical therapy at the undergraduate level using WHO International Classification of Functioning, Disability and Health (ICF) to meet the requirement of core competency of physiotherapist developed by World Confederation of Physical Therapy. The core curricula should be integrated into the conceptual framework and approaches of functioning and rehabilitation. Methods:Using ICF, the construction framework, system of specialty and development of curricula of physical therapy at undergraduate education had been proposed and reconstructed. Results:With the theories and approaches of modern pedology and curriculum theory and ICF, referenced by competency requirements for physical therapists from World Confederation of Physical Therapy, three core courses had been proposed and their content had been reconstructed, involving the theories, methods and practical skills in the fields of physical therapy. These courses include functional diagnosis, intervention and evaluation based on ICF. Conclusion:It is implicated from the theory and approaches of ICF that the education and professional training of physical therapy should be tailored to the needs of health-related services.

Objective To study the effect of Kangdaxin on cardiac function in rats with cardio-renal syndrome, and to explore its protective mechanism based on ASK1-JNK/p 38 pathway. Methods Sixty SD rats were divided into sham group, heart failure group (HF group) , cardio-renal syndrome group (CRS group) , heart failure interventiongroup and cardio-renal syndrome intervention group. The sham group, heart failure group, cardio-renal syndrome group were given normal saline, the heart failure intervention group, and the cardio-renal syndrome intervention group were given 2. 7 m L·kg-1·d-1 Kangdaxin oral solution. Left ventricular shortening fraction and left ventricular ejection fraction were measured by cardiac ultrasound after modeling or treatment; heart weight/body weight (Hw/W) and left ventricular weight/body weight (LVw/W) were calculated after sacrifice of the rats. The gene and protein expression levels of ASK1, JNK and p38 in heart tissue of each group were detected by real-time quantitative polymerase chain reaction (q PCR) and immunob-lotting. The myocardial cells of each group were detected by flow cytometry.Results The left ventricular fraction, left ventricular ejection fraction, Hw/W and LVw/W in sham group were (31. 17 ± 2. 15) ％, (61. 08 ± 3. 45) ％, (3. 43 ± 0. 31) mg·g-1 and (2. 50 ± 0. 27) mg·g-1; the above indicators in heart failure group were (24. 42 ± 1. 98) ％, (42. 08 ± 4. 57) ％, (4. 10 ± 0. 21) mg · g-1, (2. 89 ± 0. 26) mg·g-1, the above indicators in cardio-renal syndrome group were (18. 50 ± 2. 84) ％, (38. 25 ± 3. 96) ％, (4. 84 ± 0. 32) mg·g-1, (3. 89 ± 0. 18) mg·g-1, compared with the sham operation group, all differences were statistically significant (all P < 0. 05) . The left ventricular shortening scores of heart failure intervention group and cardio-renal syndrome inte-rvention group were (27. 33 ± 3. 14) ％, (22. 67 ± 2. 66) ％, and the left ventricular ejection fraction were (50. 00 ± 3. 70) ％, (43. 83 ± 3. 78) ％, LVw/W were (2. 60 ± 0. 25) , (3. 63 ± 0. 22) mg·g-1.The differences between the heart failure group and the cardio-renal syndrome group were all statistically significant (all P < 0. 05) . The expressions of ASK1, JNK and p38 mRNA and protein in heart tissue of heart failure group and cardio-renal syndrome group were significantly lower than those in sham operation group (all P < 0. 05) .The apoptotic rate of cardiomyocytes in heart failure group and cardio-renal syndrome group were (24. 14 ± 5. 51) ％, (35. 60 ± 8. 75) ％, which was significantly higher than that in sham operation group (7. 87 ± 3. 13) ％ (all P < 0. 05) . The apoptotic rate of cardiomyocytes in heart failure intervention group and cardio-renal syndrome intervention group were (14. 12 ± 5. 98) ％, (26. 50 ± 7. 22) ％, compared with heart failure group and cardio-renal syndrome group, the differences were all statistically significant (all P < 0. 05) .Conclusion Kangdaxin oral solution has cardioprotective effect on cardio-renal syndrome rats which can inhibit the expressions of ASK1, JNK and p38 mRNA and protein in heart tissue, inhibit ASK1-JNK/p38 signaling pathway and decrease myocardial cell apoptosis.

OBJECTIVEThis study aimed to retrospectively analyze temporomandibular joint dislocation by surgical treatment and evaluate the treatment effect.

METHODSFrom May 2012 to April 2016, a total of 17 cases of temporomandibular joint dislocation were surgically treated, including 8 cases of irreducible dislocation (ID) and 9 cases of recurrent dislocation (RD). Synovial injection of sclerosing agent by arthroscope was performed in 5 cases, 9 sides; augmentation of the articular eminence by titanium plate implantation was performed in 7 cases, 12 sides; iliac bone transplantation was performed in 1 case, 1 side; Medpore implantation was performed in 3 cases, 6 sides; and eminectomy and capsular tightening were performed in 1 case, 2 sides. Follow-up was conducted 1-5 years after the operation, and the success rate statistics was obtained.

RESULTSThe cure rate of synovial injection of sclerosing agent by arthroscope was 77.8% (7/9), and the effective rate was 100%. The cure rate of titanium plate implantation was 75% (9/12), and the effective rate was 100%. The cure rates of augmentation of the articular eminence by Medpore implantation (6/6), iliac bone graft (1/1), and eminectomy (2/2) were 100%.

CONCLUSIONSThe surgical method of temporomandibular joint dislocation was selected according to the state of the patients. The postoperative recurrent patients were advised to undergo augmentation of the articular eminence by Medpore implantation, which offered a reduced chance of recurrence and relatively less injury, as well as a simple operative method.