Objective The Hybrid Education Competence Instrument(HybridEduCom)was sinicized,and its reliability and validity were tested.Methods The translation,cultural adjustment and pre-investigation of HybridEduCom were followed by the Brislin translation model.The reliability and validity of the HybridEduCom was tested by surveying 553 educators in medical and nursing related fields by convenience sampling from March to April 2024.Results The Chinese version of HybridEduCom consisted of 46 items in 5 dimensions:planning and resourcing competence,technology competence,interaction competence,digital pedagogy competence,and ethical competence in the hybrid education.The confirmatory factor analysis resulted in the second-order five-factor model,with the chi-square and degree of freedom ratio being 1.274,approximate root mean square error being 0.022,goodness of fit index being 0.913,and standard fit index(NFI)being 0.934,and Tucker-Lewis and comparative fit index being 0.985.All main evaluation indexes were within the acceptable range of the judgment criteria.The item-content validity index was 0.833-1.000,and the scale-content validity index was 0.968.The Cronbach's α for the whole scale was 0.982,while varied from 0.892 to 0.936 for each dimension.The test-retest reliability of the scale was 0.978.Conclusion The reliability and validity of the Chinese version of HybridEduCom were satisfactory,and it can serve as a valid assessment instrument for the implementation of hybrid education competence of Chinese higher medical and nursing educators.

Objective To investigate the expression and significance of CD4+CD25+regulatory T cells(CD4+CD25+Treg)and soluble CD30(sCD30)in peripheral blood of lymphoma patients.Methods A total of 83 lymphoma patients admitted to Beijing Aerospace General Hospital from January 2018 to December 2022 were selected as the research subjects,and their peripheral blood CD4+CD25+Treg and sCD30 expressions were statistically analyzed.Spearman analysis was used to investigate the correlation between peripheral blood CD4+CD25+Treg and sCD30 expressions and bone marrow infiltration.At the same time,the research subjects were divided into an infection group(n=26)and a non-infection group(n=57)according to the presence or absence of infection after rituximab chemotherapy.The expressions and differences of peripheral blood CD4+CD25+Treg and sCD30 in the two groups were compared,and the receiver operating characteristic(ROC)curve and area under the curve(AUC)were used to analyze the predictive efficacy.Results The expression of CD4+CD25+Treg and sCD30 in peripheral blood of patients with bone marrow infiltration was higher than that of patients without bone marrow infiltration in the research group(P<0.05);the expression of CD4+CD25+Treg and sCD30 in peripheral blood of lymphoma patients was positively correlated with bone marrow infiltration(r=0.612,0.634,P<0.05);the expression of Tregs and sCD30 in peripheral blood of the infection group after chemotherapy was higher than that of the non-infection group,and the difference was higher than that of the non-infection group(P<0.05);the ROC curve showed that the combined prediction of the difference of CD4+CD25+Treg and sCD30 in peripheral blood for the infection after chemotherapy in lymphoma patients had an AUC of 0.916(0.834～0.965),which was superior to single prediction.Conclusion The high expression of CD4+CD25+Treg and sCD30 in peripheral blood of lymphoma patients is positively correlated with bone marrow infiltration.Combined testing can improve the predictive efficacy of infection after chemotherapy and guide clinical diagnosis and treatment.

Objective The Hybrid Education Competence Instrument(HybridEduCom)was sinicized,and its reliability and validity were tested.Methods The translation,cultural adjustment and pre-investigation of HybridEduCom were followed by the Brislin translation model.The reliability and validity of the HybridEduCom was tested by surveying 553 educators in medical and nursing related fields by convenience sampling from March to April 2024.Results The Chinese version of HybridEduCom consisted of 46 items in 5 dimensions:planning and resourcing competence,technology competence,interaction competence,digital pedagogy competence,and ethical competence in the hybrid education.The confirmatory factor analysis resulted in the second-order five-factor model,with the chi-square and degree of freedom ratio being 1.274,approximate root mean square error being 0.022,goodness of fit index being 0.913,and standard fit index(NFI)being 0.934,and Tucker-Lewis and comparative fit index being 0.985.All main evaluation indexes were within the acceptable range of the judgment criteria.The item-content validity index was 0.833-1.000,and the scale-content validity index was 0.968.The Cronbach's α for the whole scale was 0.982,while varied from 0.892 to 0.936 for each dimension.The test-retest reliability of the scale was 0.978.Conclusion The reliability and validity of the Chinese version of HybridEduCom were satisfactory,and it can serve as a valid assessment instrument for the implementation of hybrid education competence of Chinese higher medical and nursing educators.

OBJECTIVE To observe the expressions of micro ribonucleic acid-129-5p(miR-129-5p),interleukin-6(IL-6)/signal transducer and activator of transcription 3 gene(STAT3)/helper T cell 17(Th17)signaling path-ways in peripheral blood of the sepsis children complicated with pulmonary infection and analyze the clinical signif-icance.METHODS A total of 123 sepsis children who were complicated with pulmonary infection and were treated in the 971st Hospital of the Navy of The Chinese People's Liberation Army,the 904 Hospital of the Joint Logis-tics Support Force of the People's Liberation Army and Qingdao Women's and Children's Hospital from Jan.2020 to Dec.2023 were assigned as the sepsis complicated with pulmonary infection group,meanwhile,55 sepsis children who were not complicated with pulmonary infection were chosen as the simple sepsis group.The expres-sion levels of miR-129-5p,IL-6 mRNA,STAT3 mRNA and Th17 mRNA in peripheral blood mononuclear cells(PBMCs)were statistically analyzed.Receiver operating characteristics(ROC)curves were drawn to analyze the efficiencies of miR-129-5p and IL-6/STAT3/Th17 pathways in prediction of poor prognosis of the sepsis children with pulmonary infection.RESULTS The miR-129-5p level of the sepsis complicated with pulmonary infection group was lower than that of the simple sepsis group,while the levels of IL-6 mRNA,STAT3 mRNA and Th17 mRNA of the sepsis complicated with pulmonary infection group were higher than those of the simple sepsis group(all P＜0.05).With the aggravation of illness condition,the miR-129-5p level was reduced,and the levels of IL-6 mRNA,STAT3 mRNA and Th17 mRNA were elevated(all P＜0.05).The miR-129-5p level of the poor prog-nosis group was lower than that of the favorable prognosis group,while the levels of IL-6 mRNA,STAT3 mRNA and Th17 mRNA of the poor prognosis group was higher than those of the favorable prognosis group(all P＜0.05).ROC curve analysis showed that the area under the curve(AUC)of miR-129-5p was the largest(0.887)in prediction of the poor prognosis of the sepsis children complicated with pulmonary infection(P＜0.05).CONCLUSION The sepsis children complicated with pulmonary infection show the decline of expression level of peripheral blood miR-129-5p and enhancement of activation degree of IL-6/STAT3/Th17 pathways,which can be used as the indexes for assessment of illness condition and as auxiliary indexes for assessment of prognosis.

OBJECTIVE To observe the expressions of micro ribonucleic acid-129-5p(miR-129-5p),interleukin-6(IL-6)/signal transducer and activator of transcription 3 gene(STAT3)/helper T cell 17(Th17)signaling path-ways in peripheral blood of the sepsis children complicated with pulmonary infection and analyze the clinical signif-icance.METHODS A total of 123 sepsis children who were complicated with pulmonary infection and were treated in the 971st Hospital of the Navy of The Chinese People's Liberation Army,the 904 Hospital of the Joint Logis-tics Support Force of the People's Liberation Army and Qingdao Women's and Children's Hospital from Jan.2020 to Dec.2023 were assigned as the sepsis complicated with pulmonary infection group,meanwhile,55 sepsis children who were not complicated with pulmonary infection were chosen as the simple sepsis group.The expres-sion levels of miR-129-5p,IL-6 mRNA,STAT3 mRNA and Th17 mRNA in peripheral blood mononuclear cells(PBMCs)were statistically analyzed.Receiver operating characteristics(ROC)curves were drawn to analyze the efficiencies of miR-129-5p and IL-6/STAT3/Th17 pathways in prediction of poor prognosis of the sepsis children with pulmonary infection.RESULTS The miR-129-5p level of the sepsis complicated with pulmonary infection group was lower than that of the simple sepsis group,while the levels of IL-6 mRNA,STAT3 mRNA and Th17 mRNA of the sepsis complicated with pulmonary infection group were higher than those of the simple sepsis group(all P＜0.05).With the aggravation of illness condition,the miR-129-5p level was reduced,and the levels of IL-6 mRNA,STAT3 mRNA and Th17 mRNA were elevated(all P＜0.05).The miR-129-5p level of the poor prog-nosis group was lower than that of the favorable prognosis group,while the levels of IL-6 mRNA,STAT3 mRNA and Th17 mRNA of the poor prognosis group was higher than those of the favorable prognosis group(all P＜0.05).ROC curve analysis showed that the area under the curve(AUC)of miR-129-5p was the largest(0.887)in prediction of the poor prognosis of the sepsis children complicated with pulmonary infection(P＜0.05).CONCLUSION The sepsis children complicated with pulmonary infection show the decline of expression level of peripheral blood miR-129-5p and enhancement of activation degree of IL-6/STAT3/Th17 pathways,which can be used as the indexes for assessment of illness condition and as auxiliary indexes for assessment of prognosis.

Objective:To explore the Pharmacognostic identification for the famous three medicinal fruits—Chebu-lae Fructus,Terminaliae Belliricae Fructus and Phyllanthi Fructus from the Tibetan medicine,and to establish the standards of the macroscopic,microscopic identification and digital characterization for the authentication study of three medicinal fruits from the Tibetan medicine.Methods:Using the terms and research methods of botanical morphological identification and classification,the comparative identification and digital characterization of three medicinal fruits from the Tibetan medicine were carried out by optical microscope,stereo microscope,digital cam-era and digital imaging technology from the aspects of front,side,abdomen,basic,surface appearance,cross sec-tion and longitudinal section characteristics,as well as the microscopic characteristics of cross section and powder.Then,the related characteristics were compared.Results:The macroscopic identification characters,such as the appearance,and microscopic identification characters,such as the epidermal cells,fiber,stone cells,calcium ox-alate cluster crystals,of three medicinal fruits from the Tibetan medicine were clarified,and the identification methods were summarized,in order to provide reference for the identification of three medicinal fruits from the Ti-betan medicine.Conclusion:The identification method is simple,environmental friendly,accurate and reliable,and can be used for the identification basis of four medicinal fruits from three medicinal fruits from the Tibetan medicine.

Objective To observe and analyze the application of project achievement style quality control circle in constructing an outpatient intelligent pharmacy pre-job training model,and provide new ideas and systematic solutions for pre-job training of new pharmacists in intelligent pharmacies.Methods 70 pharmacists who were newly employed in outpatient pharmacy of Yantai Yuhuangding Hospital from January 2023 to March 2024 and had no working experience in this position were selected and divided into two groups(the control group and the experimental group)by random draw method.The control group implemented the traditional training mode,and the experimental group adopted the new mode of pre-job training of outpatient intelligent pharmacy constructed by project achievement style quality control circle.The theoretical,skill,and practical examination results at the end of the training period and the satisfaction with training of the newly-appointed pharmacists were collected.Results The assessment scores of theory,skills and practice,and the results of satisfaction with the training of newly recruited pharmacists in the experimental group were significantly higher than those of the control group(P＜0.05).Conclusion The new model of pre-job training for new pharmacists in the outpatient intelligent pharmacy has great advantages in the design of the training program,standardization of the training content,reasonable arrangement of the training cycle,and innovation of the training mode,which improves the pharmacists'satisfaction with the training and achieves good training results.

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 mechanism and management of acute kidney injury induced by the interaction be-tween voriconazole and nifedipine.Methods A patient with acute kidney injury was treated with nifedipine controlled-release tablets and voriconazole tablets at the same time.Pharmacists analyzed drug interactions and drug characteristics during diagnosis and treatment and proposed treatment recommendations,discontinued suspected drugs(cefotaxime and voriconazole),and deter-mined subsequent treatment based on the analysis results.Results The doctor accepted the advice and the patient gradually re-covered from acute kidney injury.Conclusion Drug-drug interactions,especially those based on the interaction of liver drug enzyme CYP450,should be paid attention to in clinical diagnosis and treatment,to improve efficacy and reduce adverse reactions.

Objective: To understand their appearance and microscopic characteristics, as well as their differences by studying the pharmacognosy of Yi medicine Elsholtzia rugulosa and Elsholtzia bodinieri, in order to provide a basis for identification and improvement of quality standards.
Methods: Stereo microscopy and optical microscopy and the macroscopic and microscopic identification methods were adopted to compare identification and digital representation for Elsholtzia rugulosa and Elsholtzia bodinieri from overall character, local characteristics, the microscopic identification characteristics, the transverse section and the powder.
Results:There were significant differences in the the macroscopic and the microscopic identification characteristics of Elsholtzia rugulosa and Elsholtzia bodinieri.
Conclusion: This study summarized the exclusive and practical features in pharmacognosic identification of Elsholtzia rugulosa and Elsholtzia bodinieri, it provides a useful reference for supervision the clinical medication,inspection,and standard drafting.