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 evaluate the outcomes of children with Phenylketonuria(PKU)detected by newborn screening program.Methods One hundred and two children with PKU were detected and diagnosed in Shanxi Newborn Screening Center from June 2004 to September 2014.All children with PKU were followed up until December 2015.During the follow-up,the Phenylalanine(Phe)levels,physical and intellectual development, nutrition status of those children were monitored.Results Among 102 PKU children,there were 96(94.12%)with normal physical development,and 93(91.18%)with normal DQ/IQ.The average DQ or IQ score in children who started the therapy before 1 month was higher than that in those who started after 1 month old(93.07 ±9.50 vs.87.39 ±10.99,t=3.09, P=0.00).Among these children 82.47%(80/97)had zinc deficiency and 31.46%(28/89)had dyslipidemia; and the normal Phe concentration rate was(59.73 ±19.03)%.The intellectual development level was negatively correlated with the age of starting therapy(r=-0.25, P=0.01), positively correlated with the education levels of his/her father(r=0.21,P=0.03)and mother(r=0.23, P=0.02).And the intellectual development was better in urban areas than that in rural areas.Conclusions With the standardized treatment, the physical and intellectual development of children with PKU can basically reach normal levels,and the earlier treatment can make better therapeutic effect.

Objective:To study the diagnostic value of combined detection of IAA,ICA and GADA in the classification of diabetes mellitus.Methods:30 cases of patients with type 1 diabetes who were treated in our hospital from June 2015 to June 2016 were selected as A group,60 cases of patients with type 2 diabetes were selected as B group,50 cases of healthy people were selected as C group.The IAA,ICA and GADA of the three groups were detected by ELISA,and the positive rate of the three groups were compared.Results:The fasting glucose of A group was (10.12± 3.68) mmol/L,B group was (11.23± 3.26) mmol/L,A group and B group were significantly higher than that of C group (P＜0.05),but there was no significant difference between A group and B group (P＞0.05);the positive rates of GADA,ICA and IAA in A group and B group were significantly higher than those in C group (P＜0.05),and the positive rates of GADA,ICA and IAA in A group were significantly higher than those in B group (P＜0.05);the sensitivity and specificity of combined detection of IAA,ICA and GADA in type 2 and type 1 diabetes mellitus were significantly higher than that in the single test (P＜0.05).Conclusions:The combined detection of IAA,ICA and GADA has a high diagnostic value in the classification of diabetes mellitus,which is worth clinical application.

Objective To discuss the clinical features of behavioral and psychological symptoms of demen-tia(BPSD)and the relation between different sub-clinical syndromes and cognition. Methods One hundred and sixteen dementia patients were assessed with neuropsychiatric inventory and mini-mental state examination (MMSE)and made factor analysis according to DSM-IV-R. Results Twelve common behavioral and psychological symptoms could be further divided into five sub-syndromes,including disinhibition behavior,psychosis,agitation, emotion and apathy factors. MMSE total score and years of education entered regression equation of apathy factor (P<0.05). Conclusion BPSD can be divided into five factors and apathy factor are related with cognitive function.

This study summarized the experiences of disease-specific performance appraisal at tertiary hospitals in Shanghai,which was launched since year 2013 by Shanghai Hospital Development Center (SHDC). 38 tertiary hospitals in Shanghai were included in the study. A disease-specific performance appraisal system centering on quality and performance, by means of case-mix model, classified surgery management and typical disease screening, and leveraging disease and surgery difficulties analysis, and inter-hospital performance appraisal of typical diseases. This reform has established appraisal criteria of disease difficulty management,coding criteria and data norms,guiding such hospitals to consolidate their functional positioning of focusing on difficult,urgent and complicated cases in the medical service delivery system.All these efforts have paved the way for the reforms to build a hierarchical medical service system, pricing per disease, payment per disease, and consolidate performance appraisal of medical workers.

The public hospital reform is the main content of the new healthcare reform.Studying the diagnosis related group system and establishing a set of scientific and rational performance assessment, which is essential to strengthen the public hospitals'public and social benefits, improve the service capacity and enhance the specialized and delicacy management.The international diagnosis related group system localization and weight settlement have been proved suitable and consistent through the Shanghai Shenkang Hospital Development Centre.Hence, the severity-based DRGs should be introduced to reflect the actual hospitals operation and management outcome, which provides a proper guidance on the hospitals'specialized and delicacy management.

Objective To investigate the relationship between the 5-hydroxytryptamine (5-HT)1A receptor gene C(-1019)G polymorphism and geriatric depression and Alzheimer′s disease (AD) with depressive symptoms in Han Chinese. Methods The case control study was used in the study among 106 patients with geriatric depression, 72 AD patients with depressive symptoms and 150 healthy old individuals in China. The C(-1019)G polymorphism of 5-HT1A was analyzed with the technique of polymerase chain reaction-restriction fragment length polymorphism. Results The frequencies of 5-HT1A genotype C/G (39.6%), G/G(24.5%) and allele G (44.3%) in the patients with geriatric depression were significantly higher than those in the controls (respectively 35.3%, 13.3%, 31.0%, P < 0.05). The frequencies of 5-HT1A G allele in the AD patients with depressive symptoms (41.0%) were significantly higher than those in the controls (31.0%,X2=4.2879, P<0.05). No significant difference in distribution of (5-HT)1A C (-1019) G polymorphism between the patients with geriatric depression and the AD patients with depressive symptoms was observed (P > 0.05). Conclusion The 5-HT1A gene C (-1019)G polymorphism may be associated with geriatric depression and AD with depressive symptoms and (-1019)G allele may be a risk factor for them.

OBJECTIVEThis article aims to introduce the benefits of qualitative research and to discuss how such research can be applied to the study of polycystic ovary syndrome (PCOS).

DATA SOURCESRelevant articles were published in English as of May 2013 from Pubmed. Terms "polycystic ovary syndrome/PCOS, qualitative research and methodology" were used for searching.

STUDY SELECTIONArticles studying PCOS with qualitative methods were reviewed. Articles associated with the use of qualitative research in clinical research were cited.

RESULTSSix qualitative studies related to PCOS were found in the literature search. These studies addressed different aspects in PCOS women including their womanhood, lived experience, information need, and experience of treatment with acupuncture. Five of these six studies used phenomenology as guiding theory.

CONCLUSIONQuantitative research has been the dominant approach in the field so far, qualitative research is relevant to the advancement of PCOS.

With the development of translational medicine,medical equipment has become a booster of clinical and basic research,and the visualization of the Chinese traditional pulse diagnosis apparatus,NX-8-type pulse information acquisition and analysis system achieved the digital pulse diagnosis and sublimated the method of diagnosis.By using the visual sensing technology and image acquisition and processing technology,NX-8 displays the B-type ultra-sound images.With the parameter set and added,not only the pulse beat can be seen clearly,as well as border,thickness and deformation,and hens to perform direct analysis of the blood vessel elasticity,but also the objective observing and study of the dual diagnostic pulse,Anti-off pulse and other special physiological structure can be realized.By measuring pulse wave velocity (PWV) and other indicators,NX-8-type pulse information acquisition and analysis system provides diagnosis and significant prevention of arteriosclerosis,hypertension,high cholesterol,angina and other cardiovascular diseases,and is expected to achieve a digital auxiliary diagnostic equipment of traditional Chinese medicine (TCM) Sizhen,and be applied to telemedicine and the field of space science and technology.It is like a milestone in the development of TCM diagnostic techniques.

A nested case-control study was carried out to assess the effectiveness of Chinese medicines in the treatment of diabetic nephropathy, so as to explore the feasibility of using nested case-control study on effect assessment of Chinese medicine.