Neck dissection(ND)is one of the main treatment methods for oral and maxillofacial malignancies.Although ND type is in con-stant improvement,but intraoperative peal-pull-push injury of the accessory nerve,muscle,muscle membrane,fascia and ligament induced shoulder syndrome(SS)is still a common postoperative complication,combined with the influence of radiochemotherapy,not only can cause pain,stiffness,numbness,limited dysfunction of shoulder neck and arm,but also may have serious impact on patient's life quality and phys-ical and mental health.At present,there is still a lack of a systematic evaluation and rehabilitation management program for postoperative SS of oral and maxillofacial malignant tumors.Based on the previous clinical practice and the current available evidence,refer to the relevant lit-erature at home and abroad,the experts in the field of maxillofacial tumor surgery and rehabilitation were invited to discuss,modify and reach a consenusus on the etiology,assessment diagnosis,differential diagnosis,rehabilitation strategy and prevention of SS,in order to provide clinical reference.

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 efficacy of combined fluoxetine and aniracetam tablets in the treatment of senile depression and its effects on serum total bile acid (TBA) and norepinephrine (NE) levels.Methods:A total of 100 older adult patients with depression who received treatment in Heze Medical College from January 2019 to December 2019 were included in this study. They were randomly assigned to receive either fluoxetine tablets alone (control group, n = 50) or fluoxetine and aniracetam tablets (study group, n = 50). All patients received two months of treatment. Clinical efficacy, scores of the Hamilton Rating Scale for Anxiety (HAMA) and the Hamilton Rating Scale for Depression (HAMD), adverse reactions, and serum TBA and NE levels were compared between the two groups. Results:Total response rate was significantly higher in the study group than in the control group [96.0% (48/50) vs. 84.0% (42/50), χ2 = 4.00, P = 0.045]. HAMD and HAMA scores post-treatment in the study group were (5.85 ± 1.81) points and (4.81 ± 1.57) points, respectively, which were significantly lower than those in the control group [(11.65 ± 2.65) points, (10.85 ± 2.84) points, t = 10.84, P < 0.001; t = 11.16, P < 0.001). Serum NE level was significantly higher in the study group than in the control group [(138.68 ± 16.35) ng/L vs. (127.17 ± 14.34) ng/L, t = 3.17, P = 0.002]. There were no significant differences in serum TBA level [(5.85 ± 0.63) μmol/L vs. (5.91 ± 0.65) μmol/L] and the incidence of adverse reactions (8.00% vs. 6.00%) between the study and control groups ( t = 0.39, P = 0.692; χ2 = 0.15, P = 0.695). Conclusion:The combined therapy of fluoxetine and aniracetam tablets for the treatment of senile depression is safe and highly effective, does not affect metabolic function and thereby deserves clinical application.

Humans ; COVID-19 ; Consensus ; SARS-CoV-2 ; China

We detected Zika virus (ZIKV) in a febrile case returning from Suriname and entry China from Guangzhou Baiyun International Airport Port.Serum and saliva samples were collected from a suspected case returning from Suriname.We detected ZIKV RNA using real-time fluorescence RT-PCR methods by both in-house reagent and commercial detection kits.RT-PCR detection was carried out with saliva sample and sequence analysis was performed.Phylogenetic tree was constructed to analyze the source of imported cases.Real-time fluorescent RT-PCR result showed that saliva was detected ZIKV RNA positive while for serum was weakly positive.A specific 1 500 bp fragment in size was amplified with saliva sample by RT-PCR.Sequence analysis showed 99％ homologous to the corresponding sequence of Brazil ZIKV (GenBank No.KX197250).Phylogenetic tree indicated it was located on African lineage.According to the epidemiological investigation results,clinical manifestations and nucleic acid detection of case,the suspected case was confirmed to infect Zika virus,being the first case from Suriname into Guangdong Province.

OBJECTIVEDiagnosis and prenatal diagnosis to a family of hemoglobin variant with α-thalassemia.

METHODSWhole blood cell analysis, hemoglobin analysis by capillary zone electrophoresis (CZE), Gap-PCR, polymerase chain reaction-reverse dot blot (PCR-RDB) assay and DNA sequencing.

RESULTSHb Zurich Albisrieden with α°-thalassemia lead to severe anemia. The genotype of fetus is also Hb Zurich Albisrieden with α°-thalassemia.

CONCLUSIONAbnormal hemoglobin with α-thalassemia may lead to severe anemia, Prenatal diagnosis of thalassemia has the vital significance for eugenic birth.

Adult ; Base Sequence ; Child, Preschool ; Female ; Fetal Diseases ; blood ; diagnosis ; genetics ; Hemoglobins, Abnormal ; genetics ; metabolism ; Humans ; Male ; Molecular Sequence Data ; Pregnancy ; Prenatal Diagnosis ; Young Adult ; alpha-Thalassemia ; blood ; diagnosis ; embryology ; genetics

Female ; Humans ; Mutation ; Pregnancy ; Prenatal Diagnosis ; alpha-Globins ; genetics

Objective To devolope a method for extracting DNA from dried blood spots (DBS)and optimizing the operating procedure,which could be applied to clinical gene diagnosis of thalassemia.And the cross contamination of DBS punching and the storage stability of DBS were studied.Methods A total of 1 50 blood specimens were collected,and DBS were prepared.Circles (3 mm in diameter)were punched in the DBS,and eluted with lysis buffer.The eluting method and operating procedure were opti-mized.Genomic DNA extracted from the elution solution by magnetic beads,and were performed thalassemia gene test.Finally jud-ging whether the results of DBS and whole blood were consistent.Two methods of thalassemia gene test were used in DBS and the compatibility of DBS processing method was verified.Judging whether there was cross contamination of DBS punching by the thalassemia gene test results of blank hole which were punched in the blank filter paper between thalassemia positive DBS.The DBS storage stability in thalassemia gene test was verified by detecting the DBS which were dry stored at room temperature for 6 and 9 months.Results 5 circles (3 mm in diameter)DBS were vibrating eluted at 55 ℃ for 1 hour,the DNA concentration extracted from the elution solution was 10-20 ng/μL,which was dissolved in 50 μL solution,and the DNA quality was good.The thalassemia gene test results of DBS and whole blood were the same,and the DBS results of two thalassemia gene test methods were the same too. The cross contamination of DBS punching was not detected in thalassemia gene test.The DBS which were dry stored at room tem-perature for 6 and 9 months could be stably performed thalassemia gene test.Conclusion DBS could be used to perform thalassemia gene test,which is accurate,convenient and stable.It is an ideal way for specimen referral of thalassemia gene test.

Objective To evaluate the the protectice effect of dexmedetomidine combined limb remote ischemic postcondition on alleviating focal cerebral ischemic reperfusion injury in rats .Methods 48 healthy adult male SD rats were randomly divided into 4 groups(n= 12) :control group(C) ,limb remote ischemic postcondition group(R) and dexmedetomidine postconditioning group(D) and combination group(R/D) .The rat model of focal cerebral ischemic reperfusion injury was induced by middle cerebral artery oc‐clusion(MCAO) .The group C only received MCAO ,the left femoral artery was isolated without blocking ;the group R received 120 min brain ischemia ,the left femoral artery was occluded by 3 cycles of 10 min occlusion/10 min reperfusion before brain reperfu‐sion ;the group D received dexmedetomidine 3 μg/kg by intraperitoneal injection before brain reperfusion .The group R/D combined the above two kinds of processing method .The neurologic function was evaluated at 24 h of reperfusion and then the rats were sac‐rificed at 48 h of reperfusion .The brain was removed for determining the cerebral infarct volume .Results The neurologic function scores after 24 h reperfusion in the group D ,R and R/D were superior to those in the group C (P< 0 .01) .The rat cerebral infarct volume percentages after 48 h reperfusion in the group D ,R and R/D were significantly lower than those in the group C ( P <0 .01) .The infarct area volume percentage in the group R/D was significantly lower than that in the group R ,the difference showed statitistical significance(P< 0 .01) .The infarct volume percentage in group R/D was significantly decreased compared with the group D(P< 0 .05) .Conclusion Both dexmedetomidine and limb remote ischemic postcondition can attenuate the focal cerebral is‐chemic reperfusion injury in rats .Their combination can significantly reduce the cerebral infarction volume and has synergic protec‐tion effect .

Objective To develop an overall health risk model and to evaluate its convergent validity and reliability.Methods Health examination results of 230 adults from a public institution were collected by using Chinese Health Risk Appraisal Questionnaire V1.0 (CHRAQ V1.0).An CHRAQ V1.0-based overall health risk model was then developed,which included 34 items.Kolmogorov-Smirnov was used to test normal distribution of the data.Pearson correlation coefficient and Spearman correlation coefficient were used to evaluate parallel validity of the model.Crane Bach coefficient,Spearman-Brown coefficient and test-retest reliability were calculated to evaluated the reliability of the model.Results In this study,212 valid questionnaires (92.17％) were received.The average score of the newly developed overall health risk model was 41.96 ± 9.69,and its kurtosis coefficient and coefficient of skewness were 2.105 and 0.862,respectively.In Kolmogorov-Smirnov,the data were normally distributed (Z =1.073,P =0.199).The correlation coefficient of positive rate of all objective examinations with model scores was 0.774 (P ＜ 0.05).The Cronbach's alpha coefficient,Spearman-Brown coefficient and test-retest reliability of the model were 0.652,0.784 and 0.841,respectively (P ＜ 0.05).Conclusion In this investigation,our newly developed overall health risk model shows good validity and reliability and application prospect in the field of health management.