Presently, there are many issues in traditional Chinese medicine (TCM) decoction, such as the uncertain sources of TCM, the lack of reminder for medication taboo, the nonstardard herb operation, and difficult supervision, etc. A digital service system of TCM decoction was established to solve the problems mentioned above. The digital service system mainly includes automatic coding for checking in & out, drug medication taboo database, digital operation in decoction, distribution through 2D code, the corresponding application for mobile phone, and the information supervision platform for TCM decoction. The digital service system of TCM decoction can track the quality & duty of the pieces, remind decoction medicine contraindications, improve the standard operation process of decoction, develop decoction distribution & tracking through cell phone, save the waiting time, and hence provides a new supervising method for TCM decoction. The digital service system of TCM decoction solves the key issues for the formula, operation, delivery and supervision of TCM. In the same vein, this system will expand the market share of TCM decoction and promote the development of TCM.

One hundred and eighty three women with high risk of breast cancer identified in Baoding First Central Hospital from June 2007 to June 2014,were enrolled in the study.In these 183 cases,41 received preventive therapy (22.4％),142 did not.Factors associated with acceptance of chemoprevention included older age,menopause,comorbidities,lower level education,being married,higher BMI,having high level hyperplasia of ductal epthelia and counseling to breast specialists (P ＜ O.05);whilenot informed by doctors was the main reason for failed taking preventive agents(95.1％,135/142).Thirteen of 41 women receiving chemoprevention discontinued the therapy (31.7％);no-insurance,no side-effects and higher BMI were related to the discontinuing (P ＜ 0.05).The 1-,2-,3-,and 5-year adherence rates of chemoprevention was 86.1％ (31/36),65.4％ (17/26),59.1％ (13/22),8/13 and 5/10,respectively.The results show that chemoprevention rate is low among Chinese women at high risk of breast cancer,and the long-term adherence to preventive therapy is poor.Corresponding measures should be taken to strengthen the chemoprevention of breast cancer.

Moxibustion,which is simple for manipulation and effective,has always been a very important way for external treatment.Acupuncture and moxibustion were complementary to each other sincc ancient times.but modem people usually only pay attention to acupuncture and neglect the usage of moxibustion.In this paper the importance of moxibustion is expounded briefly.

The development mode of public hospitals has shifted from scale expansion to improving quality and efficien-cy,and specialized operation and management is an important means to improve the performance of surgical departments.Howev-er,at present,there is a gap in the performance appraisal of specialized operators,requiring the hospital to formulate a specific and accurate performance appraisal plan for the management department.Taking hospital Z as an example,based on post value(IPE),this paper analyzes the idea of its performance appraisal plan in detail,and analyzes the specific application of its per-formance allocation with specialized operation assistant as an example.Based on IPE,the responsibility,rank and performance distribution coefficient of hospital management positions can effectively solve the difficulties that the total work and quality of hos-pital management departments are difficult to quantify,and also provide some reference for the formulation of performance apprais-al plan of specialized operation staff in public hospitals.

Objective To explore the virulence of enterovirus 71 from infected children in neonatal mice. Methods Three strains of EV71 were isolated from the mild, severe and dead patients. Symptoms, weight and death of mice were recorded throughout 14 days. The mice were sacrificed on the first, third, fifth, seventh and ninth days post infection to gain the tissue virus load including the liver, spleen, lung, intestine, brain and muscle tissue which were used to detect the virus tilter by real-time RT-QPCR, and pathological lesions using HE staining. Results As to the severity of symptoms, no significant difference was found between the severe and mild groups (P＝0. 693), which were more serious than that of the fatal group. (P＝0. 000 ＜ 0. 05/6, P＝0. 000 ＜ 0. 05/6). The survival rate of the mice with mild, severe and fatal virus infection was 77. 2%, 81. 7% and 97. 8%, respectively, and there was a significant difference among the three groups (P＝0. 0010 ＜ 0. 05, P＝0. 001 ＜ 0. 05, P＝0. 0004 ＜ 0. 05). Lung hemorrhage of the mild group was the most serious, and there were no significant differences in pathological lesions of the brain, muscle, spleen and intestine. Virus titer in the liver and muscle was higher than the other tissues and that in mild group of different tissues tended to be higher than the other two groups. Conclusions Neonatal mice infected with the mild strain of enterovirus 71 presents heaviest symptoms, which are not consistent with the outcomes of humans. It is considered to be related to the virus gene, host and other factors.

Objective: To explore the status of medication adherence among patients with depressive disorder and analyze its potential influencing factors. Methods: A total of 406 patients with depression who visited our hospital from January 2015 to December 2017 were selected as subjects of study. General data of patients were collected at the time of consultation, and drug adherence questionnaire was used to score the patients at 6 months of follow-up. According to the score, 406 patients were divided into high adherence group, middle adherence group and low adherence group, the correlation between medication adherence and humanistic factors, chronic diseases and course of disease was analyzed. Results: Compared with the low adherence group, the proportion of age (>60 years old), education (<6 years), no spouse, peasant, monthly income (<3 000 yuan), self-funded medical treatment, insomnia history, solitude and negative life events decreased significantly in the middle and high adherence groups. Cadre ratio and the proportion of workers in the middle adherence group increased significantly (P<0.05). Compared with the low adherence group, the course of disease in the middle and high adherence group was significantly shorter (P<0.01). Logistic regression analysis showed that education < 6 years, no spouse, farmers, low income, self-paid medical treatment, solitude, negative life events, course of disease were independently correlated with low adherence of depression patients (P<0.05 or P<0.01). Conclusions Depression patients have low adherence with medication, so targeted health education should be carried out. Especially for patients with a long course of illness, continuous nursing and long-term follow-up should be done well.Mobilizing family support system , caring for and respecting patients can effectively reduce the occurrence of negative life events. It can improve the medication adherence of depressive patients and promote their early recovery.

Objective To compare the efficacy of trastuzumab plus pertuzumab(HP)combined with either nab-paclitaxel plus carboplatin or docetaxel plus carboplatin as neoadjuvant therapy for HER2-positive breast cancer in real-world clinical practice.Methods Clinical data of HER2-positive breast cancer patients who received neoadjuvant therapy with either HP combined with nab-paclitaxel plus carboplatin or HP combined with docetaxel plus carboplatin and subsequently underwent surgery were retrospectively collected from 11 tertiary grade-A hospitals in Hebei Province from June 2019 to December 2021.The total pathological complete response(tpCR)rates of the two groups were compared.Results A total of 76 patients were included in the study,with 47 in the nab-paclitaxel group and 29 in the docetaxel group.The tpCR rate was significantly higher in the nab-paclitaxel group than that in the docetaxel group(72.3%vs.48.3%,χ2=4.463,P=0.035).Subgroup analysis indicated that patients older than 40 years,with cN2-3,cTNM stage Ⅲ,hormone receptor-positive status,and Ki67>30%had significantly higher tpCR rates in the nab-paclitaxel group than those in the docetaxel group(P<0.05).Conclusion In real-world clinical practice,the efficacy of HP combined with nab-paclitaxel plus carboplatin as neoadjuvant therapy for HER2-positive breast cancer is superior to that of HP combined with docetaxel plus carboplatin.

Objective:To investigate the characteristics of HBV-specific T cell reactivity among pregnant, postpartum and non-pregnant women at childbearing age with chronic HBV infection.Methods:A total of 100 patients with chronic HBV infection were enrolled in this study, including 43 pregnant women (pregnant group), 26 patients giving birth within six months (postpartum group), and 31 non-pregnant patients at childbearing age (non-pregnant group). The functional HBV-specific T cells in peripheral blood were detected by ELISPOT. Clinical data as well as the results of virological and serological tests of HBV were collected for stratified analysis.Results:There was no significant difference in the number of functional HBV-specific T cells between the pregnant group and the postpartum group, but the number was significantly lesser in the pregnant group than in the non-pregnant group ( P<0.05). Furthermore, the number of functional HBV-specific T cells was significantly higher in the nucleoside analogues (NUCs)-treated pregnant women than in the NUCs-untreated pregnant women ( P<0.05). Among the patients without NUCs treatment, there were no significant differences in the numbers of hepatitis B envelope antigen/hepatitis B core antigen (HBeAg/HBcAg)-specific T cells between the pregnant group and the postpartum group, but the numbers were lower in the pregnant group than in the non-pregnant group ( P<0.05). Among the NUCs-treated patients, there was no significant difference in the number of functional HBV-specific T cells between the pregnant group and the non-pregnant group, and the numbers in the two groups were significantly higher than that in the postpartum group (both P<0.05). Additionally, receiver operating characteristic (ROC) curve indicated that the number of functional HBV-specific T cells in combination with HBV DNA load [area under the curve (AUC)=0.807] or hepatitis B surface antigen (HBsAg) levels (AUC=0.916) had a good predictive performance for hepatitis progression during pregnancy. Conclusions:Pregnancy can reduce HBV-specific T cell reactivity in women with chronic HBV infection, but NUCs treatment may improve the function of specific T cells. Routine monitoring of HBV-specific T cells during pregnancy and postpartum period can provide valuable guidance for the evaluation of immune function and treatments.

Objective To investigate the predictive value of preoperative blood inflammatory markers for the recurrence risk in patients with basal cell carcinoma(BCC).Methods A total of 225 patients with BCC were divided into the high-risk recurrence group(155 cases)and the low-risk recurrence group(70 cases).General information and preoperative hematological indicators were collected in the two groups of patients.The neutrophil-to-lymphocyte ratio(NLR),lymphocyte-to-monocyte ratio(LMR),systemic inflammation marker(SIM)and platelet-to-lymphocyte ratio(PLR)were calculated.Receiver operating characteristic(ROC)curves were used to determine the predictive value of hematological markers with statistically significant differences between the two groups for BCC recurrence and to establish optimal cutoff values.Univariate and multivariate Logistic regression analyses were conducted to identify factors influencing BCC recurrence.A multivariate Logistic regression model was established to predict the recurrence risk of BCC.Area under the curve(AUC)and the Hosmer-Lemeshow test were used to evaluate the prediction efficiency and goodness-of-fit of the model.Results ROC analysis identified that optimal cutoff values for LMR and SIM were 5.12 and 0.86,respectively.Univariate Logistic regression analysis showed that LMR,SIM,ulceration at the primary tumor site,UV exposure and tumor maximum diameter were factors influencing BCC recurrence.Multivariate Logistic regression revealed that SIM≥0.86,tumor maximum diameter≥2.0 cm and UV exposure were risk factors for BCC recurrence,while LMR≥5.12 had a protective effect.The Logistic prediction model for BCC recurrence risk was Logit(P)=-1.598-1.517×LMR+1.323×SIM+2.406×UV exposure+3.465×tumor maximum diameter,with good model fit(P=0.725)and an AUC of 0.869(95%CI:0.822-0.917)for predicting BCC recurrence risk.Conclusion Monitoring preoperative LMR and SIM levels can assist in assessing the risk of recurrence in BCC patients and provide important guidance for clinical decision-making.

This study was performed to investigate the features of HBV-specific CD8+T cell reactivity in patients with chronic hepatitis B(CHB),HBV-induced liver cirrhosis(LC)or hepatocellular carcinoma(HCC).A total of 124 CHB patients,36 LC patients,and 114 HCC patients were enrolled in this study.The reactive HBV-specific CD8+T cells in peripheral blood were enumerated using an innovative ELISPOT system.In addition,19 CHB patients and 20 HCC patients were longitudinally monitored with an interval of 3-5 months.Data showed that the numbers of reactive HBV-specific CD8+T cells in CHB group were not significantly different from that in LC group,but obviously lower than that in HCC group(P=0.009 9),especially HBsAg-,HBpol-and HBe/cAg-specific CD8+T cells.In CHB group,the patients with normal ALT level,AST level,or low HBV-DNA load showed significantly more reactive HBV-specific CD8+T cells than the patients with abnormal ALT level,abnormal AST level,or high HBV-DNA load.Furthermore,the duration of NUCs treatment had an impact on the HBV-specific CD8+T cell reactivity in CHB patients,while different NUCs at the same treatment duration did not bring different reactivity of HBV-specific T cells.In LC group,the HBeAg-positive patients presented much more reactive HBV-specific CD8+T cells than the HBeAg-negative patients did.In HCC group,the numbers of reactive HBV-specific CD8+T cells in the patients with normal AFP level or normal DCP level were significantly higher than that in the patients with abnormal AFP level or abnormal DCP level.Longitudinal monitoring results showed that HBV-specific CD8+T cell reactivity displayed a slow upward trend in the CHB patients undergoing NUCs treatment,and an obvious increasing in the HCC patients undergoing combined treatment of targeted drugs and immunotherapy.Taken together,the features of HBV-specific CD8+T cell reactivity are distinct among the CHB,LC and HCC patients,and are influenced by virological indicators,tumor markers and treatment regimens.Therefore,more attention should be paid to the changes of HBV-specific CD8+T cell reactivity during clinical treatment.