Objective:To investigate the current situation of the use of transjugular intrahepatic portosystemic shunt (TIPS) for portal hypertension, which should aid the development of TIPS in China.Methods:The China Portal Hypertension Alliance (CHESS) initiated this study that comprehensively investigated the basic situation of TIPS for portal hypertension in China through network research. The survey included the following: the number of surgical cases, main indications, the development of Early-TIPS, TIPS for portal vein cavernous transformation, collateral circulation embolization, intraoperative portal pressure gradient measurement, commonly used stent types, conventional anticoagulation and time, postoperative follow-up, obstacles, and the application of domestic instruments.Results:According to the survey, a total of 13 527 TIPS operations were carried out in 545 hospitals participating in the survey in 2021, and 94.1% of the hospital had the habit of routine follow-up after TIPS. Most hospitals believed that the main indications of TIPS were the control of acute bleeding (42.6%) and the prevention of rebleeding (40.7%). 48.1% of the teams carried out early or priority TIPS, 53.0% of the teams carried out TIPS for the cavernous transformation of the portal vein, and 81.0% chose routine embolization of collateral circulation during operation. Most of them used coils and biological glue as embolic materials, and 78.5% of the team routinely performed intraoperative portal pressure gradient measurements. In selecting TIPS stents, 57.1% of the hospitals woulel choose Viator-specific stents, 57.2% woulel choose conventional anticoagulation after TIPS, and the duration of anticoagulation was between 3-6 months (55.4%). The limitation of TIPS surgery was mainly due to cost (72.3%) and insufficient understanding of doctors in related departments (77.4%). Most teams accepted the domestic instruments used in TIPS (92.7%).Conclusions:This survey shows that TIPS treatment is an essential part of treating portal hypertension in China. The total number of TIPS cases is far from that of patients with portal hypertension. In the future, it is still necessary to popularize TIPS technology and further standardize surgical indications, routine operations, and instrument application.

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 investigate the inhibitory effect of cordycepin on immune function injury in lung cancer rats after radiation therapy through JAK2/STAT3 signaling pathway. Methods Fifty rats were used to establish tumor-bearing model and other 10 rats were taken as normal group. After successful modeling, the rats were randomly divided into model group, radiotherapy group, cordycepin group, agonist group and agonist+cordycepin group (10 rats in each group). We compared tumor weight, tumor volume, tumor inhibition rate, IL-6, TNF-α, spleen index and thymus index, the number of T lymphocyte subsets, JAK2, p-JAK2, STAT3 and p-STAT3 protein expression levels among all groups. Results Compared with normal group, IL-6, TNF-α, CD8+, p-JAK2 and p-STAT3 in model group were increased, while spleen index, thymus index, CD4+ and CD4+/CD8+ were decreased (P < 0.05). Compared with model group, tumor weight, tumor volume, spleen index, thymus index, CD4+ and CD4+/CD8+ were decreased in radiotherapy group, while IL-6, TNF-α, CD8+, p-JAK2 and p-STAT3 were increased (P < 0.05). Compared with radiotherapy group, tumor weight, tumor volume, IL-6, TNF-α, CD8+, p-JAK2 and p-STAT3 were decreased in cordycepin group, while tumor inhibition rate, spleen index thymus index, CD4+ and CD4+/CD8+ were increased; tumor weight, tumor volume, IL-6, TNF-α, CD8+, p-JAK2 and p-STAT3 protein expression were increased in agonist group, while tumor inhibition rate, spleen index, thymus index, CD4+ and CD4+/CD8+ were decreased (P < 0.05). Compared with agonist+cordycepin group, tumor weight, tumor volume, IL-6, TNF-α, CD8+, p-JAK2 and p-STAT3 were decreased in cordycepin group, while tumor inhibition rate, spleen index, thymus index, CD4+ and CD4+/CD8+ were increased; tumor weight, tumor volume, IL-6, TNF-α, CD8+, p-JAK2 and p-STAT3 were increased in agonist group, while tumor inhibition rate, spleen index, thymus index, CD4+ and CD4+/CD8+ were decreased (P < 0.05). Conclusion Cordycepin can effectively inhibit the immune function injury in lung cancer rats after radiation therapy, and may play a regulatory role by inhibiting the JAK2/STAT3 signal pathway.

Objective:To evaluate the effect of transcutaneous electrical acupoint stimulation (TEAS) on postoperative gastrointestinal function in patients undergoing laparoscopic non-gastrointestinal hand surgery.Methods:Two hundred and sixty-seven patients, regardless of gender, aged 18-64 yr, of American Society of Anesthesiology physical status Ⅰ-Ⅲ, scheduled for elective laparoscopic cholecystectomy, laparoscopic bile duct exploration, and laparoscopic ovarian lesion resection under general anesthesia, were divided into 2 groups using a random number table method: control group (C group, n=147) and TEAS group ( n=120). From 30 min before induction of anesthesia to the end of operation, transcutaneous electrical stimulation of bilateral Zusanli and Hegu acupoints was performed at 30 min before induction of general anesthesia and maintained until the end of surgery with disperse-dense waves at frequency of 15-20 Hz and the maximum tolerated intensity.Combined intravenous-inhalational anesthesia was used in both groups.The time to first flatus and defecation was recorded.The occurrence of nausea and vomiting and abdominal distension within 24 h after surgery were recorded.The quantitative score of traditional Chinese medicine symptom of gastrointestinal function and Hamilton Anxiety Scale score were performed after surgery.The plasma motilin and gastrin levels were measured by enzyme-linked immunosorbent assay at 30 min before operation and 12 h after operation. Results:Compared with group C, the time to first flatus and defecation was significantly shortened, the incidence of postoperative nausea and vomiting and abdominal distension was decreased, the quantitative score of the traditional Chinese medicine and Hamilton Anxiety Scale score were decreased after operation, and the plasma motilin and gastrin levels were increased at 12 h after surgery in group TEAS ( P<0.05). Conclusion:TEAS can promote the recovery of gastrointestinal function after laparoscopic non-gastrointestinal surgery in the patients.

Objective To explore the feasibility of EPR in vivo fingernail dosimetry to address the difficulty in separating mechanically induced signals from fingernail EPR dosimetry for need of nuclear medical emergency aid.Methods Using the specially designed EPR in vivo measurement system,uncut fingernails were measured to obtain the characteristics of EPR signal without mechanically induced signals.The in vivo fingernail experiment was carried out to evaluate the impact of in vivo condition on the spectra.Actual in vivo measurement experiment was conducted to evaluate the interference of the in vivo condition on EPR spectra.Results The background signal distribution of uncut fingernails was obtained and background signals had no significant difference between male and female(P＞0.05).The dose response curve in the range of 2-10 Gy was established,and the half-life of the fingernail radiation-induced signal was approximately 5 d.The water treatment combined with temperature-changing was established for restoring the background signal.EPR signal obtained after restoring treatment has no significant difference with background signal (P＞ 0.05).The EPR spectra of in vivo fingernails were obtained.Conclusions The EPR spectra without mechanically induced signals can be acquired by this method.The feasibility of the in vivo fingernail EPR dosimetry is preliminarily verified.

MicroRNA (miRNA) negatively regulates gene expression at the post-transcriptional level.Studies find that the abnormal expression of miR-151-5p in various human tumors may play an important role in the development of human tumors,especially in the invasion and metastasis.Further studies of miR-151-5p contribute to a more in-depth understanding of tumor invasion and metastasis,which have potential value in tumor diagnosis,treatment and prognosis.

Objective To develop a promising type of radiation dosimeter based on doped hydroxyapatite,and to study the stability of dosimetric characteristics indepth.Methods The samples prepared by stereotyping techniques were stored under different temperatures,humidity and illumination conditions after 60Co γ-ray irradiation.Electron spin resonance (ESR) technique was used to quantitatively measure the radiation-induced free radical signal.Results The signal change was less than 3% when the dosimeter was preserved at 4℃ or room temperature within 3 months in the experiment.At 40℃,the signal changed by about 13%,but at room temperature with the humidity less than 36%,the signal changed less than 2%.The change rose to about 8% when humidity was 76%.However,no significant decay of signal strength occurred at relatively high temperatures and under high humidity conditions.When the samples were stored under average illumination of 1600 lux or in a light-resistant container,the signal changes were less than 3.8% or 3.4% respectively.Long-term stability inspection at room temperature suggested a signal change within 4.8%.Conclusion The dosimetric properties of the material don't change significantly below room temperature in a natural environment and exhibit good stability over long-term storage.The free radical signal is not influenced drastically by relatively strong light exposure.However,a high temperature or a highly humid environment may have some effect on the measurement process,which should be taken into consideration in further applications.

Objective To optimize the enamel electron paramagnetic resonance (EPR) spectral processing by using the EPR spectral simulation method to improve the accuracy of enamel EPR dosimetry and reduce artificial error.Methods The multi-component superimposed EPR powder spectral simulation software was developed to simulate EPR spectrum models of the background signal(BS) and the radiation- induced signal (RS) of irradiated enamel respectively.RS was extracted from the multi-component superimposed spectrum of irradiated enamel and its amplitude was calculated.The dose-response curve was then established for calculating the doses of a group of enamel samples.The result of estimated dose was compared with that calculated by traditional method.Results BS was simulated as a powder spectrum of gaussian line shape with the following spectrum parameters:g =2.00 35 and Hpp =0.65 - 1.1 mT,RS signal was also simulated as a powder spectrum but with axi-symmetric spectrum characteristics.The spectrum parameters of RS were:g(1) =2.0018,g (11) =1.996 5,Hpp =0.335 - 0.4 mT.The amplitude of RS had a linear response to radiation dose with the regression equation as y =240.74x + 76 724 ( R2 =0.9947 ).The expectation of relative error of dose estimation was 0.13.Conclusions EPR simulation method has improved somehow the accuracy and reliability of enamel EPR dose estimation.

Objective To discuss the feasibility of ultrasound in evaluating the effect of closed reduction with cast fixation on developmental dislocation of the hip.Methods Seventy-three cases with unilateral DDH treated by closed reduction with cast fixation under frog position were detected by ultrasound on the medial cross-section of the hips.The position relation between femoral head and acetabulum of the hips were demonstrated,the relevant parameters (the vertical distance between the femoral head and the central line through pubic symphysis) were measured and compared with the contralateral side to understand the situation of the femoral head.Results The contour of the femoral head and the ossification center can be visually displayed,the relative position relation of the femoral head and acetabulum can be demonstrated on the medial cross-section of the hip under frog position by ultrasound to judge the status of closed reduction.The measurement of the ultrasonic parameters can provide quantitative indicator for the status of reduction.Conclusions Ultrasound can be viewed as the first imaging tool to evaluate the effect of closed reduction with cast fixation on developmental dislocation of the hip for it is simple,intuitive and no radiation injury.

Objective To observe the lung protection of Astragalus membranaceus against radiotherapy to intermediate-stage and terminal thoracic neoplasm, and its influence on TNF-α and ET expression.Methods The patients with intermediate-stage and terminal thoracic neoplasm under radiotherapy were divided into a treatment group and a control group.Patients in the treatment group took 10 ml of Asragalus membranaceus twice a day.for consecutive 6 months from the beginning of radio therapy.TNF-α and ET in the plasma were measured before and after the radiotherapy.The clinical symptom,iconographic changes and lung diffusion were observed from the 15th day of radiotherapy.Results The TNF-α and ET in plasma afterthe radiotherapy were(2.48±0.75)as/ml and(69.32±23.03)pg/ml for the treatment group,and(5.12±1.01)ns/ml and(97.87±37.83)pg/ml for the control group with the statistial difference(x2=7.49,6.57,P<0.001).The decrease of CO diffusion 5 and 10 months after the radiotherapy in the treatment group was statistically different compared with that in the control group(x2=3.98,3.78,P<0.05).There was a statistical difference of the incidence of acute radiation pneumonitis and pulmonary fibrosis between these two groups(P<0.05).Conclusions Astragalus membranaceus could inhibit the excess expression of TNF-α and ET in plasma and reduce the deterioration of diffusion after radiotherapy,so that it can be used for intervention of lung injuries from radiotherapy.