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 the application effect of exercise rehabilitation based on the Health Participation Model in patients with lung cancer surgery.Methods A total of 108 patients with lung cancer hospitalised in our hospital between January and December 2022 were randomly divided into two groups:a control group and a intervention group,with 54 patients per group.The control group was offered with routine exercise rehabilitation,while patients in the research group underwent exercise rehabilitation based on the Health Participation Model.Results One month after discharge,the research group showed higher levels in the first second maximum expiratory volume(FEV1),forced vital capacity(FVC),maximum ventilatory volume(MVV)and FEV1/FVC ratio in comparison with those in the control group(all P<0.001).The total score of postoperative rehabilitation quality and the scores of its dimensions were all higher in the research group than those in the control group one month after discharge(all P<0.001),except the dimension of psychological support.Conclusion Incorporation of the Health Participation Model into the postoperative rehabilitation program for lung cancer patients can improve lung function and promote the postoperative rehabilitation.

OBJECTIVE: To discuss the advantages and technical limitations of various molecular genetic techniques in the diagnosis of two infants featuring all-round developmental retardation. METHODS: The two patients were initially screened by using chromosomal microarray analysis (CMA). For patient 1, his parents were also subjected to CMA analysis, and the data was analyzed by using ChAS and UPD-tool software. For patient 2, methylation-specific PCR (MS-PCR) was carried out. RESULTS: Patient 1 was diagnosed with maternal uniparental disomy (UPD) type Prader-Willi syndrome (PWS) by CMA and UPD-tool family analysis. His chromosomes 15 were of maternal UPD with homology/heterology. Patient 2 was diagnosed with deletion type PWS by combined CMA and MS-PCR. CONCLUSION Correct selection of laboratory methods based on the advantages and limitations of various molecular techniques can help with diagnosis of genomic imprinting disorders and enable better treatment and prognosis through early intervention.

Objective: To analyze the risk factors of cervical anastomotic leakage after thoracoscopic-lapacoscopic esophagectomy. Methods: 530 patients with esophageal cancer underwent thoracoscopic-lapacoscopic esophagectomy at the Cancer Hospital, Chinese Academy of Medical Sciences from Jan 2011 to Dec 2015. The demographic, surgical and clinical data of patients were retrospectively analyzed. Multivariate logistic regression was used to evaluate risk factors of cervical anastomotic leakage in these patients. Results: A total of 530 patients undergoing thoracoscopic-lapacoscopic esophagectomy were enrolled in this study. There were 421 males and 109 females. The mean age was (59.40±8.08) years old, and 91 patients with cervical anastomotic leakage. Sigle factor analysis revealed that the risk grading by American Society of Aneshesiologists, previous history of chest surgery, respiratory comorbidity, diffusion capacity for carbon monoxide of the lung, operation time, anastomosis, average days of postoperative hospitalization, death within 30 days after surgery, respiratory complications, pleural effusion or empyema, and poor healing of the incision were statistically associated with cervical anastomotic leakage (all P<0.05). Multivariate analysis showed that previous history of chest surgery, hepatic insufficiency, manual anastomosis, prolonged postoperative hospitalization, and poor healing of the incision were independent risk factors for cervical anastomotic leakage after thoracoscopic-lapacoscopic esophagectomy (all P<0.05). Conclusions Previous history of chest surgery, hepatic insufficiency, poor healing of the incision, manual anastomosis and prolonged postoperative hospitalization were significantly associated with cervical anastomotic leakage after thoracoscopic-lapacoscopic esophagectomy. It′s important to strengthen perioperative nursing and surgical techniques to prevent anastomotic leakage after thoracoscopic-lapacoscopic esophagectomy.

Objective: To compare intravascular ultrasound (IVUS) with venography in the intraoperative evaluation of iliac vein compression syndrome (IVCS). Methods: From Sep 2017 to Mar 2018, consecutive patients with suspicious iliac vein compression, underwent both venography and IVUS. The results were compared between IVUS and venography. Results: 40 patients with 48 limbs were enrolled. Venography underestimated both the diameter and area stenosis compared with IVUS (39.63%±15.48% vs. 64.97%±16.42%, P<0.001; 51.83%±18.23% vs. 59.19%±14.17%, P=0.021, respectively). The eccentricity detected by venography was lower than IVUS (0.69±0.17 vs. 0.93±0.17, P<0.001). Taking IVUS as gold standard, the sensitivity and the specificity of venography for detecting a ≥50% stenosis was 18.92% and 81.82%, and the intertechnique agreement was extremely low between venography and IVUS (κ=0.004). Conclusion Compared with IVUS, venography underestimated the degree of stenosis in IVCS. The sensitivity of venography in detecting a significant stenosis was very low.

Objective To analyze the risk factors of cervical anastomotic leakage after thoracoscopic?lapacoscopic esophagectomy. Methods 530 patients with esophageal cancer underwent thoracoscopic?lapacoscopic esophagectomy at the Cancer Hospital, Chinese Academy of Medical Sciences from Jan 2011 to Dec 2015. The demographic, surgical and clinical data of patients were retrospectively analyzed. Multivariate logistic regression was used to evaluate risk factors of cervical anastomotic leakage in these patients. Results A total of 530 patients undergoing thoracoscopic?lapacoscopic esophagectomy were enrolled in this study. There were 421 males and 109 females. The mean age was (59.40±8.08) years old, and 91 patients with cervical anastomotic leakage. Sigle factor analysis revealed that the risk grading by American Society of Aneshesiologists, previous history of chest surgery, respiratory comorbidity, diffusion capacity for carbon monoxide of the lung, operation time, anastomosis, average days of postoperative hospitalization, death within 30 days after surgery, respiratory complications, pleural effusion or empyema, and poor healing of the incision were statistically associated with cervical anastomotic leakage (all P＜0.05). Multivariate analysis showed that previous history of chest surgery, hepatic insufficiency, manual anastomosis, prolonged postoperative hospitalization, and poor healing of the incision were independent risk factors for cervical anastomotic leakage after thoracoscopic?lapacoscopic esophagectomy ( all P＜0.05 ). Conclusions Previous history of chest surgery, hepatic insufficiency, poor healing of the incision, manual anastomosis and prolonged postoperative hospitalization were significantly associated with cervical anastomotic leakage after thoracoscopic?lapacoscopic esophagectomy. It′s important to strengthen perioperative nursing and surgical techniques to prevent anastomotic leakage after thoracoscopic?lapacoscopic esophagectomy.

Objective To analyze the risk factors of cervical anastomotic leakage after thoracoscopic?lapacoscopic esophagectomy. Methods 530 patients with esophageal cancer underwent thoracoscopic?lapacoscopic esophagectomy at the Cancer Hospital, Chinese Academy of Medical Sciences from Jan 2011 to Dec 2015. The demographic, surgical and clinical data of patients were retrospectively analyzed. Multivariate logistic regression was used to evaluate risk factors of cervical anastomotic leakage in these patients. Results A total of 530 patients undergoing thoracoscopic?lapacoscopic esophagectomy were enrolled in this study. There were 421 males and 109 females. The mean age was (59.40±8.08) years old, and 91 patients with cervical anastomotic leakage. Sigle factor analysis revealed that the risk grading by American Society of Aneshesiologists, previous history of chest surgery, respiratory comorbidity, diffusion capacity for carbon monoxide of the lung, operation time, anastomosis, average days of postoperative hospitalization, death within 30 days after surgery, respiratory complications, pleural effusion or empyema, and poor healing of the incision were statistically associated with cervical anastomotic leakage (all P＜0.05). Multivariate analysis showed that previous history of chest surgery, hepatic insufficiency, manual anastomosis, prolonged postoperative hospitalization, and poor healing of the incision were independent risk factors for cervical anastomotic leakage after thoracoscopic?lapacoscopic esophagectomy ( all P＜0.05 ). Conclusions Previous history of chest surgery, hepatic insufficiency, poor healing of the incision, manual anastomosis and prolonged postoperative hospitalization were significantly associated with cervical anastomotic leakage after thoracoscopic?lapacoscopic esophagectomy. It′s important to strengthen perioperative nursing and surgical techniques to prevent anastomotic leakage after thoracoscopic?lapacoscopic esophagectomy.

OBJECTIVETo assess the association of G protein-coupled estrogen receptor(GPER) gene polymorphism with social function of children with attention deficit hyperactivity disorder (ADHD).

METHODSThe social function of 135 children with ADHD were assessed by Weiss Functional Impairment Scale-Parent form (WFIRS-P). The coding region of GPER gene of all patients was subjected to Sanger sequencing. The association of polymorphisms with the social function of the ADHD children was analyzed.

RESULTSIn the case group, the social function scores of Learning and School and Risky Activities of boys were significantly higher than those of girls (t=2.704, P=0.008; t=2.289, P=0.027). No significant difference was found in the genotypic frequencies of the c.-9T/C and c.789G/A loci between different genders. But the learning and school scores of those with a TC genotype for the c.-9T to C locus were significantly higher than those with a TT genotype (t= 2.159, P=0.033).

CONCLUSIONFor children with ADHD, the social function of Learning and School of those with a TC genotype of the GPER gene c.-9T/C locus is more severely damaged compared with those with a TT genotype.

Gene editing technology has a broad development prospect in medical research and appli-cation,and it is a frontier hot spot in the field of biomedical research worldwide,especially in the field of be-havioral medicine,making it possible to treat and prevent major diseases such as brain diseases,neurodegen-erative diseases and behavioral psychology diseases. But we must recognize that gene-editing technology poses new threats to bio-security while benefiting humanity. This paper summarizes the development and application prospect of gene editing technology in the field of behavioral medicine,summarizes the ethical and relevant institu-tional problems and international regulatory policies faced by the rapid development of gene editing technology, and finally puts forward relevant regulatory suggestions for the development of gene editing technology.

Objective To evaluate the closed-cell stents in the treatment of carotid pseudo-occlusion.Methods From Jan 2014 to Dec 2017,clinical data of 34 patients undergoing carotid artery recanalization with closed-cell stents for pseudo-occlusion were analyzed retrospectively.Results The technical success rate was 97.1％ (33/34) and the intracranial blood supply improved in 91.2％ patients (31/34).The 30-day perioperative ipsilateral symptomatic ischemic stroke rate was 2.9％ (1/34).All the patients were discharged with no peri-operative hyperperfusion syndrome,myocardial infarction.The average follow-up time was 15.2 ±7.6 months.The incidence of carotid artery restenosis was 17.6％.There was no stroke-related mortality.Ultrasound or CTA found luminal dilatation of the distal internal carotid artery.The diameter increased from (2.5 ±0.5) mm to (4.1 ±0.6) mm after intervention (P ＜0.001).Conclusion Closed-cell stents for carotid artery pseudo-occlusion is safe and effective,decreasing cerebral stroke and carotid occlusion.