Replantation of traumatic amputation in children has its own characteristics. This consensus primarily focuses on the issues related to the treatment of traumatically amputated limb injuries in children. Organised along a timeline, the consensus summarises domestic and international clinical experiences in emergency care and injury assessment of traumatic limb amputation limbs, indications and contraindications for replantation surgery, principles and procedures of replantation surgery, postoperative medication and management, as well as rehabilitation in children. The aim of this consensus is to propose standardise the treatment protocols for limb replantation for children therefore to serve as a reference for clinical practitioners in medical practices, and further improve the treatment and care for the traumatic limb amputations in children.

Hip fractures are among the most common fractures in the elderly, presenting to be a leading cause of disability and mortality. Surgical treatment is currently the main treatment method for hip fractures. The incidence of perioperative malnutrition is increased after hip fractures in the elderly due to the comorbidities, decreased basal metabolic rate, accelerated protein breakdown, weakened anabolism and surgical stress. However, malnutrition not only increases the incidence of postoperative complications, but also leads to increased mortality, indicating an important role of perioperative nursing management of nutrition for the elderly patients with hip fractures. At present, there still lacks scientific guidance and application standards on perioperative nursing management of nutrition for the elderly patients with hip fractures. Therefore, the Orthopedic Nursing Committee of Chinese Nursing Association and the Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Expert consensus on perioperative nursing management of nutrition for elderly patients with hip fractures ( version 2023) according to evidence-based medical evidences and their clinical experiences. Fourteen recommendations were made from aspects of nutrition screening, nutrition assessment, nutrition diagnosis, nutrition intervention and nutrition monitoring to provide guidance for perioperative nursing management of nutrition in elderly patients with hip fractures.

COVID-19 is caused by a novel coronavirus-severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), which has being spreading around the world, posing a serious threat to human health and lives. Neutralizing antibodies and small molecule inhibitors for virus replication cycle are the main antiviral treatment for novel coronavirus recommended in China. To further promote the rational use of antiviral therapy in clinical practice, the National Center for Infectious Diseases (Beijing Ditan Hospital Capital Medical University and the First Affiliated Hospital, Zhejiang University School of Medicine) invited experts in fields of infectious diseases, respiratory and intensive care to develop an Expert Consensus on Antiviral Therapy of COVID-19 based on the Diagnosis and Treatment Guideline for COVID-19 ( trial version 10) and experiences in the diagnosis and treatment of COVID-19 in China. The consensus is concise, practical and highly operable, hopefully it would improve the understanding of antiviral therapy for clinicians and provide suggestions for standardized medication in treatment of COVID-19.

AIM: To observe the effect of acute normovolemic hemodilution (ANH) autologous blood transfusion on the EEG bispectral index and muscle relaxation in elderly patients undergoing orthopedic surgery to explore the influence of autologous blood transfusion containing anesthetic components on the quality and safety of postoperative anesthesia recovery. METHODS: Forty patients, aged 65-75, weighing 55-80 kg, ASA grade I-II, with an estimated intraoperative blood loss of more than 600 mL, were selected for elective orthopedic surgery. The patients were randomly divided into two groups (n=20): group A was given acute normovolemic hemodilution (ANH), and the target value of Hct was 28%-30% after induction of anesthesia; group B was the control group which was given routine fluid infusion during operation without ANH. Bispectral index (BIS), TOF values and plasma concentrations of propofol and cisatracurium were measured at the beginning of autotransfusion (T

OBJECTIVE: To establish a micellar electrokinetic capillary chromatography-based method for identification and quantitative detection of interleukin-12 (IL-12) and analysis of its unfolding process. METHODS: An uncoated fused-silica capillary (inner diameter 50 μm) with a total length of 48.5 cm (40 cm to the detector) was used for the experiment. The factors influencing the separation efficiency of IL-12 were analyzed, and a standard curve of IL-12 concentration was established. The mixture of IL-12 and anti-IL-12 antibody was incubated in a water bath at 38 ℃ for 40 min, and capillary electrophoresis was then performed under the same conditions. The results were compared with those of IL-12 and anti-IL-12 antibody to identify IL-12. IL-12 and dithiothreitol (DTT) were incubated at 60 ℃ in water bath for different lengths of times, and the unfolding process of IL-12 was analyzed based on electrophoresis results of IL-12 in different states. RESULTS: A micellar capillary electrophoresis on-line sweep method was established with 80 mmol/L borate (pH=9.3) containing 30 mmol/L sodium dodecyl sulfate (SDS) as the buffer solution. This system showed a good linear relationship between the peak area and the mass concentration of IL-12 with a linear correlation coefficient of 0.9991 within the linear range of 2 to 120 ng/L. As the incubation time of IL-12 and DTT prolonged, the disulfide bond of IL-12 gradually opened and resulted in distinct changes in the protein peak. CONCLUSIONS This capillary electrophoresis-based method is simple and sensitive for IL-2 analysis and allows rapid detection of changes in IL-12 content in the setting of tumors and analysis of the possible causes.

Objective:To evaluate the effectiveness of Simplified Airway Risk Index (SARI) score in predicting difficult airway in Chinese patients.Methods:One thousand and three hundred patients of both sexes, aged 18-90 yr, with American Society of Anesthesiologists physical status Ⅰ-Ⅲ, undergoing tracheal intubation with the laryngoscope under general anaesthesia, were enrolled in this study.SARI scores (including 7 evaluation items: mouth opening, thyromental distance, Mallampati classification, neck mobility, mandibular protrusion, body weight, and history of difficulty in tracheal intubation) were determined before anesthesia induction.The receiver operating characteristic curve and area under the curve (AUC) were used to evaluate the effectiveness of SARI scores in predicting difficult tracheal intubation and difficult laryngoscopy.Results:The AUC and 95% confidence interval of the SARI score, mouth opening, modified Mallampati classification and thyromental distance in predicting difficult tracheal intubation were 0.91 (0.89-0.93), 0.84 (0.82-0.86), 0.81 (0.79-0.83) and 0.83 (0.80-0.85), respectively.The AUC and 95% confidence interval of the SARI score, mouth opening, modified Mallampati classification and thyromental distance in predicting difficult laryngoscopy were 0.90 (0.88-0.91), 0.79 (0.76-0.81), 0.76 (0.74-0.78) and 0.73 (0.70-0.75), respectively.The AUC of SARI scores in predicting difficult tracheal intubation and difficult laryngoscopy was significantly larger than that of the mouth opening, modified Mallampati classification and thyromental distance ( P<0.05). Conclusion:The SARI score produces better efficacy in predicting tracheal intubation and difficult laryngoscopy in Chinese patients.

Objective To evaluate the effect of different hemoglobin(Hb)concentrations on the lung injury in a rabbit model of hemorrhagic shock and resuscitation(HS-R).Methods Fifty healthy male New Zealand rabbits,aged 2 months,weighing 1.9-2.4 kg,were divided into 5 groups(n＝10 each)u-sing a random number table method: control group(group C),HS-R group(group H),and three HS-R plus infusion of concentrated red blood cell groups group R1(60 g/L≤Hb＜80 g/L),group R2(80 g/L≤Hb＜100 g/L)and group R3(100 g/L≤Hb＜120 g/L).The animals were sacrificed at 3 h after resuscita-tion,lung tissues were obtained for examination of the pathological changes with a light microscope,and lung tissues were obtained again for determination of wet to dry weight ratio(W/D ratio),neutrophil my-eloperoxidase(MPO),NO level and cell apoptosis(by TUNEL).Results Compared with group C,the levels of MAP and NO,W/D ratio and apoptosis index were significantly increased in the other groups(P＜0.05).Compared with group H,the levels of MAP and NO,W/D ratio and apoptosis index were signifi-cantly decreased in R2 and R3 groups(P＜0.05).Compared with group R2,the apoptosis index was signif-icantly increased at T5(P＜0.05),and no significant change was found in the other parameters in group R3(P>0.05).Conclusion Maintaining Hb 80-100 g/L after HS-R reduces acute lung injury in rabbits.

Objective: To evaluate the effect of different hemoglobin (Hb) concentrations on the lung injury in a rabbit model of hemorrhagic shock and resuscitation (HS-R). Methods: Fifty healthy male New Zealand rabbits, aged 2 months, weighing 1.9-2.4 kg, were divided into 5 groups (n=10 each) using a random number table method: control group (group C), HS-R group (group H), and three HS-R plus infusion of concentrated red blood cell groups group R₁ (60 g/L≤Hb<80 g/L), group R₂ (80 g/L≤Hb<100 g/L) and group R₃ (100 g/L≤Hb<120 g/L). The animals were sacrificed at 3 h after resuscitation, lung tissues were obtained for examination of the pathological changes with a light microscope, and lung tissues were obtained again for determination of wet to dry weight ratio (W/D ratio), neutrophil myeloperoxidase (MPO), NO level and cell apoptosis (by TUNEL). Results: Compared with group C, the levels of MAP and NO, W/D ratio and apoptosis index were significantly increased in the other groups (P<0.05). Compared with group H, the levels of MAP and NO, W/D ratio and apoptosis index were significantly decreased in R₂ and R₃ groups (P<0.05). Compared with group R₂, the apoptosis index was significantly increased at T₅(P<0.05), and no significant change was found in the other parameters in group R₃ (P>0.05). Conclusion Maintaining Hb 80-100 g/L after HS-R reduces acute lung injury in rabbits.

Objective To evaluate the application value of situational simulation method based on SimMan 3G in anesthesiology teaching. Methods 5-years anesthesiology under-graduates of 2012 grade and 2013 grade in Wannan Medical Colloge anticipating in clinical practice of anesthesia were selected as observation group. All students were divided into two groups: control group (teachers demonstrated cases, 2012 grade, n=35) and observation group (students role-played simulation cases, 2013 grade, n=36). In control group, teachers firstly applied a multimedia courseware, and then demonstrated the cases to adopt the SimMan 3G simulated system. In observation group, SimMan 3G situational simulation method was used to teach the course , and then the students played roles and videotaped the whole course in the simulated operating room. After training, the students discussed their performance in the simulated training (by the playback of the simulated video), and the teachers commented and summarized the case. The effect of teaching was evaluated by questionnaire and examination. The date were analyzed through Chi-square and t-test test. Results There was no significant difference in essential characteristics, including age, gender, the scores of specialized theory at routine examination between two groups (P>0.05). Statistical difference was found in the theoretical assessment between observation group and control group [(79.44±5.41) vs. (73.46± 4.62), P=0.001]. Meanwhile, questionnaire survey of teaching effect showed that in observation group 31 students (86.1％) were satisfied with the teaching contents, 33 students (91.7％) had consolidated clinical thinking, and 34 students (94.4％) believed it improved their teamwork and communication ability (P=0.031, P=0.018, P=0.013). Conclusion Using SimMan3G for role-playing situational simulation teaching can significantly improve student's comprehensive theoretical scores, facilitate the exercise of clinical thinking, and improve their teamwork and communication skills.

Objective: To improve the accuracy of diagnosis and to reduce the misdiagnosis rate of nasopharyngeal carcinoma by analyzing the characteristics of such masses. Methods: Clinical data from 55 patients with suspicion of nasopharyngeal carcinoma diagnosed and treated between March 2016 and September 2017 were analyzed. All patients were followed up regularly. Results: With following-up of 12 to 25 months, 6 (10.9%) of 55 cases were identified as nasopharyngeal malignant tumors, including 4 cases of nasopharyngeal carcinoma and 2 cases of lymphoma, and 49 cases (89.1%) were diagnosed with nasopharyngeal benign masses, including 29 (59.2%) cases for nasopharyngeal lymphoid proliferation, 15 (30.6%) for adenoid hypertrophy, 2 (4.1%) for nasopharyngeal cyst, 1 (2.0%) for polyp, 1 for papilloma and 1 for nasopharyngeal pharyngeal cyst. Small nasopharyngeal malignant tumor and masses with benign hyperplasia showed the overlap of images on the enhanced MRI/CT and Fibro-nasopharyngoscopy, but all 6 patients with nasopharyngeal malignant tumors presented with moderately enhanced multiple enlarged lymph nodes. Conclusions Fibro-nasopharyngoscopy and enhanced MRI/CT have some value on evaluation of nasopharyngeal masses, but biopsy is a golden standard for diagnosis. Follow-up is necessary for the patients with negative biopsy and benign nasopharyngeal hyperplasia indicated by fibro-nasopharyngoscopy and enhanced MRI/CT.