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.

Humans ; Retrospective Studies ; Bronchiectasis ; Mycobacterium avium Complex ; Syndrome ; Nocardia Infections/drug therapy* ; Nocardia ; Mycobacterium avium-intracellulare Infection

Objective : To analyze the genome structure and genetic characteristics of IncpGRT1 plasmids from Pseud⁃ omonas , and elucidate its potential transmission risk . Methods : The genomic DNA of the clinical isolate 15420352 was extracted after purification and preservation of the strain , and then the whole genome was sequenced , and then the type of the plasmid was identified . Sequence annotation and comparison of the backbone region and the accessory modules were performed on all five same type sequenced plasmids , including one plasmid p420352 - strA in this study and four from GenBank . The plasmids were annotated by RAST , Plasmidfinder , Blast , ResFinder , and ISfinder. The ORFs of the plasmid were annotated and drug resistance genes were found . Results : All five plasmids were classified as new IncpGRT1 type plasmids . The IncpGRT1 backbone genes or gene loci were in all five plasmids , and they contained an auxiliary replicon besides the primary IncpGRT1 replicon . Five IncpGRT1 plasmids carried at least three different accessory modules , including the srp region , the msr region , and a Tn5053 family transposon . Three resistance genes strA , strB , and mer were obtained in these plasmids , which were involved in resistance to two categories of antibiotics and heavy metals . We also found that these plasmids carried at least one virulence gene msr and five key transporters srp , emrE , mod , phn , and lpt , which could improve the environmental adaptability of the strains . Conclusion The IncpGRT1 plasmids have become the important vector for the accumulation and spread of some drug resistance genes and virulence genes in Pseudomonas , and have improved the environmental adaptability of the strain.

Objective:To investigate the diagnostic value of ultrasonography in Poland′s syndrome.Methods:From February 2016 to December 2020, the ultrasonographic images of 15 patients with Poland′s syndrome diagnosed by Provincial Hospital Affiliated to Shandong First Medical University were retrospectively analyzed, and the ultrasonographic features were summarized.Results:High-frequency ultrasound could clearly show the anatomical structures of each layer of the chest wall of the patients with Poland′s syndrome. The sonogram of Poland′s syndrome mainly showed the absence of all or part of the pectoralis major on the affected side, some of which were combined with the absence of pectoralis minor. The difference between the thickness of the affected chest wall and the healthy side was statistically significant ( P<0.01). Among the 15 cases of Poland′s syndrome, 11 cases had brachydactyly or syndactyly. Ultrasound showed that the bifurcation position of the common palmar digital artery of the middle finger was lower than that of the healthy side. Conclusions:The ultrasonography is an effective imaging method for diagnosis of Poland′s syndrome.

Objective:To investigate the value of ultrasound in the diagnosis of hourglass-like fascicular constrictions of the anterior interosseous nerve.Methods:From July 2010 to July 2020, 12 patients with hourglass-like fascicular constrictions of the anterior interosseous nerve diagnosed in Shandong Medical Imaging Research Institute Affiliated to Shandong University were retrospectively analyzed. The characteristics of the high-frequency ultrasonographic images were summarized and compared with clinical surgery.Results:The hourglass-like fascicular constrictions of the anterior interosseous nerve were all located in the median nerve of the distal upper arm in 12 patients, including 9 cases of single hourglass change and 3 cases of multiple hourglass like changes. High-frequency ultrasound can accurately locate the location of the hourglass-like fascicular constrictions of the anterior interosseous nerve and the extent of neuropathy. The sonogram of hourglass-like fascicular constrictions of the anterior interosseous nerve showed single or multiple hourglass-like changes in the median nerve of the distal upper arm. The nerve fasciculars on both sides of hourglass-like changes were thickened. There was significant difference between the diameter of the affected fascicular and the corresponding position of the contralateral fascicular[(0.20±0.04)cm vs (0.11±0.03)cm, P<0.01]. There was significant difference between the cross-sectional area of the median nerve at the widest part of the lesion side and the corresponding position of the contralateral side[(0.14±0.03)cm 2 vs (0.09±0.03)cm 2, P<0.01]. Conclusions:High-frequency ultrasound is the preferred image method for the diagnosis of hourglass-like fascicular constrictions of the anterior interosseous nerve.

Objective:To evaluate the role of high frequency ultrasonography in diagnosis of closed volar plate injury of proximal interphalangeal joint.Methods:From May 2015 to may 2021, 41 patients with acute closed volar plate injury confirmed by Department of Hand and Foot Surgery of the Provincial Hospital Affiliated to Shandong First Medical University were examined by high frequency ultrasonography. The sonographic features were analyzed and classified.Results:High frequency ultrasonography could not only clearly show the thickness, shape and echo of volar plate, but also the degree of injury and avulsion fracture of volar plate, according to which the closed volar plate injury could be divided into three types: A, B and C. Type A(13 cases): Avulsion fracture of the middle phalangeal base was found with volar plate rupture, the sonogram showed that the continuity of the volar plate attachment of the middle phalangeal base was interrupted, and avulsion fracture was found at the distal end of the volar plate. Type B(11 cases): Complete rupture of the volar plate attachment of the middle phalangeal base was found without avulsion fracture, the sonogram showed that the continuity of the volar plate attachment of the middle phalangeal base was interrupted, and the end of the volar plate contracted and thickened. Type C(17 cases): Tear of the volar plate was found, the sonogram showed enlarging volar plates, heterogeneous internal echo, and liquid dark area was visible in some cases. The average thickness of the three types of closed volar plate injury of the proximal interphalangeal joint measured by ultrasound was (0.33±0.05)cm, and the average thickness of the volar plate at the same position of the corresponding finger on the opposite side was (0.22±0.03)cm. There was significant difference between the two groups ( t=7.864, P=0.006). Conclusions:High frequency ultrasonography is the preferred imaging examination method for the diagnosis of closed volar plate injury in proximal interphalangeal joint, which has an important guiding significance for the selection of clinical treatment.

To evaluate the value of ultrasonography in diagnosing peripheral intraneural vascular anomalies . Methods The ultrasonographic images of 10 patients with peripheral intraneural vascular anomalies confirmed by surgery or pathology were retrospectively analyzed . T he ultrasonographic features were summarized . Results T he ultrasonographic images could not only clearly show the location , involvement and blood supply of peripheral intraneural vascular anomalies , but also determined the classification of them . Ultrasonography showed enlarging nerves ,within w hich tubular structures could be observed ,and the boundary between the vascular malformations and the perineurium was not clear . Abundant arteriovenous blood flow ( arteriovenous malformation) or low velocity venous blood flow ( venous malformation) within the vascular anomalies could be detected by color Doppler examination . Conclusions Ultrasonography is the preferred imaging method for diagnosis of peripheral intraneural vascular anomalies .

Microwave thermal ablation technology is widely used in the treatment of liver tumors because of its minimal invasiveness and small side effects. The precise control of the thermal dose largely determines the therapeutic effect of microwave thermal ablation. However, the current magnetron-based microwave thermal ablation device has the disadvantages of poor power output stability and high operating voltage. In view of the above problems, this paper selected the microwave solid-state source as the core device of microwave output, and designed a dual-frequency microwave thermal ablation system based on 2 450 MHz and 433 MHz. The system used the power detection circuit to perform PID feedback control on the actual output power of the system. The experimental results show that the maximum output power of the system is less than 1 W. The PID algorithm further enhances the accuracy and stability of the system output power while improving the system security. The dual-frequency microwave thermal ablation system designed in this paper can provide a safe and reliable experimental platform for subsequent research.
Catheter Ablation ; instrumentation ; Humans ; Liver Neoplasms ; therapy ; Microwaves ; Radiofrequency Ablation