Objective To evaluate clinical efficacy and safety of Bizheng Granules combined with basic therapy in the treatment of liver and kidney insufficiency and phlegm-dampness cross-blocking syndrome of nerve root type cervical spondylosis radiculopathy.Methods Totally 108 patients with nerve root type cervical spondylosis radiculopathy were selected and divided into Bizheng Granules group,Jingfukang Granules group,and Bizheng Granules placebo group according to random number table method,with 36 cases in each group.The three groups were treated with the basic treatment(oral methylcobalamin tablets of 0.5 mg,three times a day,and cervical spine intermittent traction once a day,each time for 15 min),and Bizheng Granules were given in the Bizheng Granules group,and Jingfukang Granules in the Jingfukang Granules group,and Bizheng Granules placebo in the Bizheng Granules placebo group,twice a day after meals.All three groups were treated continuously for 2 weeks and followed up at 4 and 12 weeks after treatment.Visual analog scale(VAS),cervical dysfunction index(NDI),and 36-items short form survey(SF-36)score were recorded in the 3 groups before and after treatment and 4 and 12 weeks after treatment,respectively.Adverse reactions during treatment and follow-up were recorded in the 3 groups.Results 3 cases lost in the Bizheng Granules group,3 cases in the Jingfukang Granules group,and 1 case in the Bizheng Granules placebo group.Compared with the pre-treatment period,the differences in VAS score,NDI score,and SF-36 score among the three groups of patients at all time points of treatment and follow-up were statistically significant(P<0.05).At 12 weeks after treatment,the VAS score and NDI score of the Bizheng Granules group and the Jingfukang Granules group were lower than those of the Bizheng Granules placebo group,but the differences in VAS score and NDI score between Bizheng Granules group and Jingfukang Granules group were not statistically significant(P>0.05).12 weeks after treatment,the SF-36 score of Bizheng Granules group were higher than those of Bizheng Granules placebo group,but the difference in SF-36 score between Bizheng Granules group and Jingfukang Granules group was not statistically significant(P>0.05).The total effective rate of Bizheng Granules group was better than that of the Jingfukang Granules group and Bizheng Granules placebo group(P<0.05).The incidence of adverse reactions in the three groups was not statistically significant(P>0.05).There were no serious adverse events in the three groups.Conclusion Bizheng Granules combined with basic therapy has a definite therapeutic effect in improving pain,restoring cervical dysfunction,and improving quality of life in the treatment of liver and kidney insufficiency and phlegm-dampness cross-blocking syndrome of nerve root type cervical spondylosis radiculopathy,with good safety.

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 risk factors of white matter damage（WMD）in premature infants，especially intraventricular hemorrhage（IVH）.Methods:This retrospective study included 639 premature infants admitted to the neonatal intensive care unit of Shanxi Children's Hospital from June 2022 to June 2023.The premature infants were divided into WMD group（145 cases）and control group（494 cases）according to the results of head MRI.Univariate analysis and multivariate logistic regression analysis were used to explore the risk factors for WMD in premature infants.Results:There were no significant differences in gender，gestational age，fetal distress，cesarean section，asphyxia，Apgar 1min，umbilical artery pH，maternal age，number of pregnancy，infants of assisted reproductive technology，gestational hypertension，gestational diabetes mellitus，acute chorioamnionitis and prelabor rupture of membranes between the two groups（all P>0.05）.Compared the WMD group with the control group，birth weight［（1 571±611）g vs（1 438±489）g， t=-2.393］，umbilical artery base excess［-5.9（-8.2，-3.9）mmol/L vs -5.3（-7.2，-3.5）mmol/L， Z=-2.538］，umbilical artery lactate［3.7（2.4，5.3）mmol/L vs 2.8（2.0，4.1）mmol/L， Z=-4.607］，sepsis（28.5% vs 15.6%， χ 2=12.280），patent ductus arteriosus（82.6% vs 74.7%， χ 2=3.911），hypocarbia（57.2% vs 45.0%， χ 2=6.696），invasive ventilation（75.9% vs 53.0%， χ 2= 24.010），multifetal pregnancy（19.3% vs 30.6%， χ 2=7.111），antenatal corticosteroids（51.0% vs 61.9%， χ 2=5.451），lowest PaCO 2 value［（28.4±6.7）mmHg vs（31.4±8.0）mmHg， t=4.471］were different significantly（all P<0.05）.There was significant difference in the distribution of IVH between the two groups（ χ 2 =40.015， P<0.01）and multiple comparisons showed that the proportion of grade Ⅲ-Ⅳ IVH in the WMD group was higher than that in the control group（ P<0.05）.Multiple logistic regression analysis showed that umbilical artery lactate，grade Ⅲ-Ⅳ IVH，sepsis and invasive ventilation were high risk factors of WMD，and multifetal pregnancy was protective factor of WMD，with OR（ 95%CI）1.121（1.023，1.228），11.435（3.925，33.314），1.758（1.064，2.904），1.640（1.004，2.680），and 0.587（0.358，0.962），respectively. Conclusions:Umbilical artery lactate，grade Ⅲ-Ⅳ IVH，sepsis，and invasive ventilation are independent risk factors for WMD.

Objective:To analyze the expression of MXD1 and Ki-67 in breast invasive ductal carcinoma (IDC) and their relationship with clinicopathologic features.Methods:Clinical data of 68 patients with breast invasive ductal carcinoma admitted to Shanxi Maternal and Child Health Hospital and Shanxi Cancer Hospital from Mar. 2022 to Mar. 2023 were retrospectively analyzed,and the expressions of MXD1 and Ki67 in cancer tissues and adjacent normal tissues of patients with breast invasive ductal carcinoma were measured. The expressions of MXD1 and Ki67 in cancer tissues of patients with different clinicopathological characteristics were analyzed. The relationship between the expression of MXD1 and Ki67 and clinicopathological features; Follow-up until March 2024 was conducted to analyze the survival of different expressions of MXD1 and Ki67.Results:The high expression of MXD1 and positive Ki67 in cancer tissues of 68 patients were 63.24% and 69.12%, respectively, which were significantly higher than 8.82% and 11.76% in normal tissues ( χ2=43.67, 46.43, P<0.05). The proportion of high expression of MXD1 and Ki67 positive in histological grade Ⅲ, low differentiation, TNM stage Ⅲ or Ⅳ was significantly higher than that in histological grade Ⅰ or Ⅱ, middle and high differentiation, TNM stage Ⅰ or Ⅱ ( χ2=4.05, 5.87, 6.00, 4.00, 5.78, 5.39, P<0.05). The expressions of MXD1 and Ki67 were positively correlated with histological grade and TNM stage, and inversely correlated with differentiation degree ( r=0.34, 0.39, 0.39, 0.38, -0.39, -0.34, P<0.05). The survival curves of different expressions of MXD1 and Ki67 were statistically significant (Log-Rank χ2=10.13,10.72, P<0.05). At the end of follow-up,the median survival time of low and high expression of MXD1 was 17 months (95% CI: 15.059-18.941) and 14 months (95% CI: 12.452-15.548), respectively, and the median survival time of negative and positive expression of Ki67 was 19 months (95% CI: 13.335-24.665), 14 months (95% CI: 12.432-15.568) . Conclusion:MXD1 is highly expressed and Ki67 positiverate is higher in patients with breast invasive ductal carcinoma, which is related to histological grade, TNM stage, differentiation degree and survival time.

To investigate the molecular mechanism of modified Yigong powder(MYG)in the treat-ment of spleen deficiency syndrome based on network pharmacology and analyzed the effect of MYG on gastrointestinal simulated intestinal flora of spleen deficiency dogs and mucosal barrier of Caco-2 cells,as well as the interaction between intestinal flora and mucosal barrier.The molecular mechanism of MYG in the treatment of spleen deficiency syndrome was predicted by network pharmacology.The fecal samples of three canines(12±1)years old with spleen deficiency were collected to establish an in vitro gastrointestinal simulation system,which was divided into the o-riginal fecal sample group,the gastrointestinal simulation group and the gastrointestinal simulation treated by MYG group.The structural changes of the flora in each group were detected by 16S rD-NA sequencing.The metabolites were extracted from the gastrointestinal simulation system trea-ted by MYG group to study its effect on LPS-induced Caco-2 cell mucosal barrier injury model.The cell experiments included the blank control group,LPS model group,modified Yigong metabolite group.The permeability of mucosal was determined by fluorescein sodium,and then relative ex-pression levels of Claudin-1,Occludin and ZO-1 mRNA were determined by qPCR.The correlation between intestinal flora and Caco-2 cell mucosal barrier index after MYG intervention was further analyzed.The results showed that MYG had 76 active ingredients and 45 potential targets for the treatment of spleen deficiency syndrome.Forty key targets were obtained through protein interac-tion analysis,34 items were obtained by GO enrichment analysis,and 16 pathways were obtained by KEGG enrichment analysis.In the gastrointestinal simulation system,compared with the gas-trointestinal simulation group,at the phylum level,the abundance of Firmicutes,Bacteroides and Actinobacteriota increased significantly(P＜0.05),and the abundance of Proteobacteria decreased significantly(P＜0.05).At the genus level,the abundance of Fusobacterium,[Ruminococcus]gna-vus group and Blautia increased significantly(P＜0.05),while the abundance of Escherichia-Shi-gella and Citrobacter decreased significantly(P＜0.05).The diversity index of intestinal flora in the gastrointestinal simulation treated by MYG group was significantly increased(P＜0.05).In cell experiments,compared with the LPS model group,the mucosal permeability of Caco-2 cells in the modified Yigong metabolite group was significantly reduced(P＜0.01),and the expression levels of Claudin-1,Occludin and ZO-1 mRNA were significantly increased(P＜0.01).Correlation analysis showed that there was a certain correlation between bacterial community structure and mucosal barrier indexes.In summary,MYG may act on 40 key targets such as TNF,IL6,IL18,CX-CL8 and AKT1 through 76 active ingredients such as quercetin,arachidonic acid and naringin,and treat spleen deficiency syndrome in dogs through 16 signaling pathways such as AGE-RAGE,FoxO and HIF-l.In addition,the gastrointestinal metabolites of MYG up-regulate tight junction protein mRNA expression,reduce mucosal permeability,and repair mucosal barrier,which may be related to MYG's regulation of flora structure.

Objective:To investigate the application of CT image omics model in the differential diagnosis of ganglioneuroblastoma (GNB) and neuroblastoma (NB) in childhood.Methods:A retrospective case series study was performed. The clinical and imaging data of 23 NB and 23 GNB pediatric patients confirmed by surgery and pathology in Shanxi Children's Hospital from January 2013 to December 2013 were collected. The original CT images in the normal scan phase, arterial phase and venous phase of all the children before operation were extracted from the PACS system in DICOM format. ITK-SNAP (ver.3.4.0) software was applied to manually outline and extract the image omics features layer by layer of the lesions in the normal scan phase, arterial phase and venous phase of each patient before surgery. The minimum absolute contraction selection operator and stepwise multi-factor logistic regression method were used to screen out effective features in different scan phases. The corresponding phase image omics model was established by using logistic model. The diagnostic efficiency of each phase of the image omics model was evaluated by using the receiver operating characteristic curve, calibration curve and decision curve.Results:A total of 1 361 image omics features were extracted from the original CT images in the 3 phases. The model was established by using multi-factor logistic regression to extract 4 features in the normal scan phase, 2 features in the arterial phase, 3 features in the venous phase and 7 features in the combination of the 3 phases. The area under the curve (AUC) of the model in the normal scan phase was 0.940, the accuracy was 89.1%, the sensitivity was 91.3% and the specificity was 87.0%; the AUC of the model in the arterial phase was 0.923, the accuracy was 84.8%, the sensitivity was 82.6%, and the specificity was 87.0%; the AUC of the model in the venous phase was 0.949, the accuracy was 87.8%, the sensitivity was 83.3%, and the specificity was 91.3%; the AUC of 3 phases combined model was 0.964, the accuracy was 95.1%, the sensitivity was 94.7%, and the specificity was 95.5%. The results showed that the single-phase image omics model was effective in the differential diagnosis of NB and GNB in childhood; the AUC, accuracy, sensitivity and specificity of the 3 phases combined imaging model were higher than those of the single-phase imaging model. The calibration curve and decision curve showed that the probability of differential diagnosis of NB and GNB in childhood by the 3 phases combined model had a high consistency with the observed value, and a good net benefit could be achieved.Conclusions:CT-based image omics model has a high clinical value in the differential diagnosis of NB and GNB in childhood.

Objective The aim of this study was to collect diagnosis,treatment,and follow-up information of inpatients with malignant tumors at the Affiliated Tumor Hospital of Xinjiang Medical University,analyze the distribution and composition of malignant tumor types,mortality,and survival status,and provide reference for the prevention and treatment of malignant tumors in the local area.Methods The case and mortality data of inpatients with malignant tumor from 2010 to 2020 were calculated,and the survival status was collected by follow-up.The composition,different pathological stage,composition and sequential changes of malignant tumors,as well as survival rates of the 1-year,3-year and 5-year were analyzed.Results A total of 111,418 patients with malig-nant tumor were admitted to the hospital from 2010 to 2020.Breast cancer accounted for 20.67％of inpatients,followed by lung canc-er,thyroid cancer,cervical cancer and gastric cancer;The leading cause of malignant tumor death was lung cancer(accounting for 26.70％),followed by gastric cancer,esophageal cancer,liver cancer and colorectal cancer.The 1-year,3-year,and 5-year sur-vival rates were 87.20％,65.80％and 57.20％,respectively.The overall survival rates of patients with stages Ⅰ and Ⅱ malignant tumors were significantly higher than those of patients with stages Ⅲ and Ⅳ(P=0.003).Conclusion Breast cancer,lung cancer,thyroid cancer,cervical cancer and gastric cancer are the high incidence of malignant tumors in Xinjiang,among which thyroid cancer,breast cancer,and cervical cancer have a higher 5-year survival rate.Early screening,diagnosis and treatment of malignant tumors should be strengthened,and prevention strategies and resource allocation should be adjusted in time according to the distribution of malignant tumors to reduce the incidence and mortality of malignant tumor and improve the health level of people in Xinjiang.

Autologous ozonized blood transfusion(AOBT) is a therapy of re-transfusion of 100-200 mL of autologous blood after shaking and agitation with appropriate amount of oxygen-ozone in vitro. The oxidation of blood through the strong oxidation of ozone can enhance the non-specific immune response of the body, regulate the internal environment and promote health. This therapy has been increasingly applied in clinical practice, while no unified standard for the operation process in terms of ozone concentration, treatment frequency and treatment course had been established. This operation process of AOBT is primarily explored in order to standardize the operation process and ensure its safety and efficacy.

Objective:To investigate clinicopathological and magnetic resonance imaging (MRI) characteristics of pediatric cardiac tumors.Methods:The clinical, pathological and MRI data of 7 patients with pediatric cardiac tumors confirmed by pathological examination in Children's Hospital of Chongqing Medical University from February 2012 to December 2016 were retrospectively analyzed.Results:There were 3 males and 4 females with first diagnosis age ranging from 1 month to 3 years. As for clinical presentation, most cases were featured with cardiac murmur and enlarged cardiac boundary; only 1 case had acute cerebral infarction, and 1 case did not show any abnormal performance. Pathological findings showed that 6 cases of benign tumors (including 2 cases of fibroma, 1 case of rhabdomyoma, 1 case of myxoma, 1 case of lipoma and 1 case of hemangioma), 1 case of malignant tumor (primitive neuroectodermal tumor of pericardium). MRI results showed that the signal intensity of malignant tumor was higher than that of normal myocardium in each sequence; significant differences were found in benign tumors; first-pass perfusion, cardiac cine image and late gadolinium enhancement were the most obvious.Conclusions:The clinical presentations of pediatric cardiac neoplasms are atypical. Each tumor type has pathognomonic pathological features. MRI has great advantages in the diagnosis and differential diagnosis of cardiac tumors especially for benign tumors.

Background: Cardiopulmonary resuscitation (CPR) strategies in COVID-19 patients differ from those in patients suffering from cardiogenic cardiac arrest. During CPR, both healthcare and non-healthcare workers who provide resuscitation are at risk of infection. The Working Group for Expert Consensus on Prevention and Cardiopulmonary Resuscitation for Cardiac Arrest in COVID-19 has developed this Chinese Expert Consensus to guide clinical practice of CPR in COVID-19 patients. Main recommendations: 1) A medical team should be assigned to evaluate severe and critical COVID-19 for early monitoring of cardiac-arrest warning signs. 2) Psychological counseling and treatment are highly recommended, since sympathetic and vagal abnormalities induced by psychological stress from the COVID-19 pandemic can induce cardiac arrest. 3) Healthcare workers should wear personal protective equipment (PPE). 4) Mouth-to-mouth ventilation should be avoided on patients suspected of having or diagnosed with COVID-19. 5) Hands-only chest compression and mechanical chest compression are recommended. 6) Tracheal-intubation procedures should be optimized and tracheal-intubation strategies should be implemented early. 7) CPR should be provided for 20-30 min. 8) Various factors should be taken into consideration such as the interests of patients and family members, ethics, transmission risks, and laws and regulations governing infectious disease control. Changes in management: The following changes or modifications to CPR strategy in COVID-19 patients are proposed: 1) Healthcare workers should wear PPE. 2) Hands-only chest compression and mechanical chest compression can be implemented to reduce or avoid the spread of viruses by aerosols. 3) Both the benefits to patients and the risk of infection should be considered. 4) Hhealthcare workers should be fully aware of and trained in CPR strategies and procedures specifically for patients with COVID-19.