The characteristic features of dissociative conversion disorder entail a partial or complete loss of normal integration in memory,identity awareness,immediate sensation,and motor control.This article documents a case of the disorder presenting with an onset of depressive mood,diminished interest,and facial tics,subsequently accompanied by intermittent fainting spells with limb convulsions.Despite multiple consultations in both general hospitals and psychiatric settings,and despite treatment with various antidepressants and antiepileptic medications,the patient's symptoms showed no significant improvement.The report of this case deepens the understanding of a complex and commonly misdiagnosed condition,offering valuable insights for the diagnosis and treatment of patients exhibiting similar symptoms.

TCM treatment for slow transit constipation(STC)has the advantages of good efficacy,multiple levels,rich targets,multi-channel and two-way regulation.As relevant experimental research gradually deepens,it is known that SCF/C-kit and its cascading signaling pathways of PI3K/AKT,PLC-γ,MAPKs and other key pathways are involved.To further clarify the underlying mechanisms,this article reviewed current experimental research status of TCM intervention on SCF/C-kit and its cascading signaling pathways in STC rats and mice in recent years.It can be concluded that its mechanism may be to restore the normal structure and function of the colon mucosa,regulate the content and gene expression of signaling pathway related proteins,maintain the number and function of intestinal cells of Cajal,regulate the content of intestinal neurotransmitters and aquaporin,and reduce the release of inflammatory factors.It explored the specific targets and mechanisms of TCM intervention in SCF/C-kit and its cascading pathways in STC rats and mice,in order to provide reference for further in-depth research.

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 explore peptidomic changes of peptides in saliva and gingival crevicular fluid (GCF) before and after treatment of gingivitis. Methods: From January 2017 to September 2017, seventeen participants at the age of 24-62 (6 males and 11 females) at Department of Preventive Dentistry, Peking University School and Hospital of Stomatology with gingivitis were recruited in the present study. Their clinical parameters were measured and recorded. Saliva and GCF samples were collected from each of the participants at the baseline and 7 days after ultrasonic supragingival scaling, respectively. Matrix-assisted laser desorption-ionization time-of-flight mass spectrometry (MALDI-TOF MS) was employed to detect the changes of peptidomic profiles, while ano-liquid chromatography-electrospray ionization-tandem mass spectrometry (nano-LC/ESI-MS/MS) was performed to identify the possible proteins from which the peptides might derive. Results: Initially, four peptide peaks [mass-to-charge ratio (m/z) values: 1 030.6, 1 043.4, 1 053.4 and 1 064.6] were screened out exhibiting a decreasing trend after treatment (P<0.05). Besides, five peptide peaks from gingival crevicular fluid (P<0.05) exhibited differential expression, among which 1 055.5 and 1 168.3 demonstrating a decrease after treatment, while 3 363.7, 3 480.9 and 3 489.5 increased overtime. Certain positive correlations were detected between some peptides and clinical parameters. Principle component analysis using the above mentioned peptide peaks showed a distinct distribution before and after treatment and peptides from GCF showed a slightly better capacity to discriminate patients before and after treatment. The peptides with m/z values of 1 055.5 in GCF and 1 064.6 in saliva were identified to be segments of serum albumin and complement C3, respectively. Conclusions Several differentially expressed peptides were detected in saliva and GCF by MALDI-TOF MS, exhibiting the potentiality to act as biomarkers in gingivitis patients.

Objective To explore peptidomic changes of peptides in saliva and gingival crevicular fluid (GCF) before and after treatment of gingivitis. Methods From January 2017 to September 2017, seventeen participants at the age of 24?62 (6 males and 11 females) at Department of Preventive Dentistry, Peking University School and Hospital of Stomatology with gingivitis were recruited in the present study. Their clinical parameters were measured and recorded. Saliva and GCF samples were collected from each of the participants at the baseline and 7 days after ultrasonic supragingival scaling, respectively. Matrix?assisted laser desorption?ionization time?of?flight mass spectrometry (MALDI?TOF MS) was employed to detect the changes of peptidomic profiles, while ano?liquid chromatography?electrospray ionization?tandem mass spectrometry (nano?LC/ESI?MS/MS) was performed to identify the possible proteins from which the peptides might derive. Results Initially, four peptide peaks [mass?to?charge ratio (m/z) values: 1 030.6, 1 043.4, 1 053.4 and 1 064.6] were screened out exhibiting a decreasing trend after treatment (P<0.05). Besides, five peptide peaks from gingival crevicular fluid (P<0.05) exhibited differential expression, among which 1 055.5 and 1 168.3 demonstrating a decrease after treatment, while 3 363.7, 3 480.9 and 3 489.5 increased overtime. Certain positive correlations were detected between some peptides and clinical parameters. Principle component analysis using the above mentioned peptide peaks showed a distinct distribution before and after treatment and peptides from GCF showed a slightly better capacity to discriminate patients before and after treatment. The peptides with m/z values of 1 055.5 in GCF and 1 064.6 in saliva were identified to be segments of serum albumin and complement C3, respectively. Conclusions Several differentially expressed peptides were detected in saliva and GCF by MALDI?TOF MS, exhibiting the potentiality to act as biomarkers in gingivitis patients.

Patients with liver disease are at an increased risk of both embolism and bleeding. The optimal anticoagulation strategy remains unclear when associated with venous thromboembolic disease. Moreover, currently approved oral anticoagulant drugs undergo metabolism and elimination in the liver with varying degrees of hepatic dysfunction. Thus, impaired liver function may lead to increased risk of bleeding, making anticoagulant therapy more intricate. This article summarizes the risk of bleeding and thrombosis in patients with liver disease, and the clinical research progress of oral anticoagulants in patients with liver disease to facilitate evidence for choosing oral anticoagulants therapy when required.

By referring to the management model of chief residents, the system of chief resident pharmacists is established to promote the training of clinical pharmacists and the construction of clinical pharmacy disciplines. Professional clinical pharmacists are elected to be the chief resident pharmacists, who are designated based on qualification for application, appointment procedures, scope of responsibilities and job description. The establishment and implementation of the chief resident pharmacist system plays a positive role on the team building of high-quality clinical pharmacists, accelerating the development of clinical pharmacy disciplines. It can serve as an important measure to further strengthening the construction of clinical pharmacists system.

Objective To evaluate the short-term and long-term outcomes of laparoscopic splenectomy combined with eradication of Helicobacter pylori (HP) in patients with idiopathic thrombocytopenic purpura (ITP).Methods 72 patients with ITP were divided into three groups:the eradication of Hp group (group A),the untreated or failure group (group B),and the Hp-negative group (group C).Results Hppositive Patients (group A and group B) were significantly shorter in the course of disease before splenectomy (26.7± 13.8 months vs.45.2±22.1 months,P＜0.05),and lower in platelet counts peak within 7 days after splenectomy (134.9±53.9) × 109/L vs.(250.9± 160.5) × 109/L,P＜0.05) than Hp-negative patients.After discharge from hospital,in 28 patients who received infection therapy against Hp by taking amoxicillin,CLA,omeprazole for one month,21 (75.0％) patients had the Hp eradicated,but in 7 patients the eradication failed.The PLT between these 2 groups of patients were (189.6± 114.8)× 109/L vs.(124.0±45.7) × 109/L,(P＜0.05).The long-term outcomes in platelet counts and remission rates after spleuectomy of the three groups of patients were (149.7±90.6) × 109/L,76.1％ (group A);(98.5±64.1) × 109/L,66.6％(group B);(172.4± 102.0)× 109/L,80.0％ (group C).The platelet count in group B was significantly lower than group C (P＜0.05).There was no statistical significance between group A and group C (P＞0.05).There was no significant difference in the remission rates in the three groups.Conclusions Eradication of Hp improved the short-term and long-term outcomes of Hp-positive ITP patients after splenectomy.

Objective To compare the perioperative outcomes and long-term therapeutic response of laparoscopic splenectomy versus open splenectomy for idiopathic thrombocytopenic purpura.Methods A retrospective analysis of 124 patients who under-went splenectomy(68 LS and 56 OS)for ITP between January 2011 and January 2015 was conducted.Results Patients undergoing LS were found to require a longer operative time(P <0.05 )but had reduced hospital stay,lower intra-operative blood loss(P <0.05),less postoperative pain,earlier drain removal,and decreased incidence of complications(P <0.05).Conversion to OS was re-quired in 4 patients for excessive loss of blood(5.8%).Deep venous thrombosis(DVT)was observed in 1 patients after OS.One pa-tient died from pneumonia after LS.Mean follow-up of (33±11.8)months was performed in LS group and of (32±12.9)months in OS group.50 patients(73.5%)in LS group and 43(76.7%)in OS group reached sustained complete haematological response(P >0.05).Kaplan-Meier analysis showed that there was no significant difference in the relapse-free survival rate between the groups (P =0.679).Conclusion Compared with open splenectomy,laparoscopic splenectomy for patients with ITP has similar long-term therapeutic response,but it has advantages of minimally invasiveness.

Objective Irregular antibody screening and identification are very important to reduce hemolytic reaction.The dis-tribution of irregular antibodies of blood group was analyzed in patients, to provide evidence for using Micro column gel test to detect and identify irregular antibodies transfusion safety. Methods Micro column gel anti-globulin technique was used to screen the irregular an-tibodies and cross-matching in 29770 patients.If the serum had irregular antibodies, the spectrum cells were used to identify the specific-ity of irregular antibodies. Results Among 29 770 patients, 120 cases had irregular antibodies of blood group.The positive rate was 0.4%.The irregular antibodies include Rh system(n=67),MNS system (n=7), Lewis system(n=5),cases of Kidd system(n=3) and undefined specified antibodies(n=38).Among the 120 antibody-positive patients, 70 were female patients and 50 were male patients. Further study showed that the pregnancy history was to the main factor causing irregular antibodies in women (46 positive cases among 70 female patients) . Conclusion The study showed that some patients had irregular antibodies of blood group, especially female patients with pregnancy history.These results suggested that irregular antibody screening and cross-matching by micro column gel method in pa-tients before transfusion had great significance for ensuring the blood transfusion safety.