Advanced hospitals and high-level hospitals are different from grass-root hospitals,since they not only treat difficult diseases but also have the obligation of scientific studies and teaching.Grass-root hospitals mainly focus on treating common diseases,and only conduct a small amount of teaching,thus resulting in the difference between grass-root hospitals and large-scale hospitals in the aspect of purchasing medical equipment.Because the money for grass-root hospitals may only be used as designated and some even comes from loan or collecting,we have to pinch pennies and make the best use of everything so as to recover the cost rapidly and bring the equipment into full play.

Cancer related anemia( CRA)is one of the ancer complications. The incidence rate of CRA is more than 70% in patients after receiving chemotherapy,radiation therapy,or both. CRA has severe clinical symptoms which significantly attenuate effectiveness of cancer treatment and the quality of patients' life. The current treatments for CRA,such as transfusion,recombinant EPO therapy,iron supplement and so on,could correct CRA in some sense. However,the present accepted therapeutic approaches could not be satisfied since there are complexity and diversity factors accounting for CRA. More effective and safety treatments of CRA are required in the near future.

Prostatic disorders are common and frequently occur in male,which have caught wide attention in society.At present,the medication,surgery treatment and physical therapy are the main treatments for prostatic disorders.In this article,a new-type apparatus for prostate therapy is introduced.With radio frequency current on affected part,the abnormal tissues' temperature is raised so that the accelerated blood circulation can kill the pathogenic bacteria for cure.At the same time,there is a shaking device and a magnetostatic field in its probe,which can hasten the excretion of putrescence and desquamative tissues in the pathological parts with other normal tissues unaffected.It is worth popularizing for its safety and effectiveness.

Objective To explore the antibacterial effect and mechanisms of platelets (PLT)on Staphylococcus epidermidis (SE).Methods Built infectious model of SE in vitro,whose final concentration was 105 CFU/ml in the reaction.Separately cocultured these models with PLT (the final concentration 400 × 109/L)-plasma (positive control)and BHI medium 12 hours later,and detected the antibacterial effect of PLT by making a liquid thinner and spreading counting method,and draw-ing antibacterial curve.Meanwhile,observed the bacterial structure by transmission electron microscope (TEM),and initially explored the antibacterial mechanism of PLT.Results The study showed the antibacterial effect of PLT on SE was very ob-vious,which appeared later than the plasma (M)group,but enduring.The images of TEM showed an electronlight region appeared in the centre of bacterium,contained condensed DNA molecules and leaded to slower fission.Conclusion PLT can damage the DNA structure of SE,and then affect the fission of SE,finally inhibit the proliferation of SE.

Objective:To apply self-directed learning-oriented multi-channel teaching to clinical digestive system integration course and explore its teaching effect.Methods:Seventy undergraduates of Batch 2015 majoring in clinical medicine in a medical college of Shandong Province were selected as subjects. In the clinical digestive system integration course, we designed and implemented multi-channel teaching methods including problem-based learning (PBL), integrated teaching of theory and practice, standardized patient teaching, group focus teaching and moral education. The scores of students' practice examination under the two teaching methods were compared, and the self-assessment of students' autonomous learning ability before and after the intervention was compared. SPSS 20.0 was used for t test. Results:The average total score of practical assessment in the intervention group was (86.10±6.01), which was higher than that (81.84±7.08) of the Batch 2014 students ( P<0.05). The total score of students' self-assessment of autonomous learning ability was (145.41±9.42) before the intervention. By comparison, the total score was (152.94±10.18) after the intervention. Except for the dimension of "self-innovation", the scores of self-directed learning ability in general and other dimensions were significantly different before and after the intervention ( P<0.05). Conclusion:Self-directed learning-oriented multi-channel teaching is a suitable teaching method for the integration curriculum of clinical digestive system.

【Objective】 To discuss the case reports concerning anti-CD47 monoclonal antibody interfere in pre-transfusion testing, so as to find mitigation strategies for this drug interference. 【Methods】 Blood transfusion cases in clinical trials concerning CD47 mAb drugs at home and abroad were retrieved from PubMed, Medline, Web of Science, Wanfang data knowledge service platform and CNKI database. The characteristics and solutions of this drug interfering with pre-transfusion testing were analyzed. 【Results】 A total of 26 cases concerning anti-CD47 mAb interference in pretransfusion testing were retrieved, and 16 valid cases were included in this study (All received HU5F9-G4 as anti-CD47 mAb). After treatment with Hu5F9-G4, the discrepancy between forward and reverse blood typing reached 77% in pre-transfusion testing. Panagglutination was presented in antibody screenings, and all(100%) platelet antibody screenings was interfered. These results indicated that Hu5F9-G4 seriously affected the compatibility test of blood transfusion. Methods of eliminating anti-CD47 interference, as well as their advantages and disadvantages were further analyzed. 【Conclusion】 The advantages and disadvantages of eliminating anti-CD47 interference with pre-transfusion testing was analyzed according to its characteristics, which could provide reference for the laboratory testing.

As precious Chinese medicinal materials， Moschus and Bovis Calculus are often used in the treatment of acute and severe patients. However， due to their scarce sources and high prices， wild animal resources are in urgent need of protection， natural Moschus and Bovis Calculus can no longer meet the needs of preparation production. The use of substitutes such as Moschus Artifactus， Bovis Calculus Artifactus and Bovis Calculus Sativus has alleviated the shortage of original medicinal materials to some extent， and has been widely used in the production and use of traditional Chinese medicine （TCM） preparations. According to statistics， the 2020 edition of Chinese Pharmacopoeia contains 75 TCM preparations containing Moschus and 95 preparations containing Bovis Calculus， but in the quality standards of these 134 TCM preparations， the difference between natural medicinal materials and their substitutes is not very obvious， and some quality control projects are relatively simple. Based on this， the author intends to sort out the quality standards of TCM preparations containing Moschus or Bovis Calculus in the 2020 edition of Chinese Pharmacopoeia （volume Ⅰ）， including the type， drug form， prescription dosage， maximum daily （time） dosage and the quality control items of Moschus and Bovis Calculus in the preparation， in order to explore the rationality of the quality standard of TCM preparations containing Moschus or Bovis Calculus， and to give some suggestions on standardizing the use types of Moschus and Bovis Calculus， improving the quality control items of Moschus and Bovis Calculus in TCM preparations combining modern research achievements and advanced technology.

ObjectiveTo investigate the efficacy and safety of cinobufagin tablets combined with thalidomide/dexamethasone （TD） regimen in the treatment of newly diagnosed multiple myeloma （NDMM） with phlegm and stasis obstruction. MethodsThe clinical data of 50 patients with NDMM of phlegm and stasis obstruction who were hospitalized at the Jiangsu Province Hospital of Chinese Medicine from June 1st， 2015 to July 31th， 2019 were retrospectively analyzed， and they were divided into a control group （bortezomib/dexamethasone-containing regimen， 27 cases） and an observation group （cinobufagin tablets combined with TD regimen， 23 cases）. The clinical efficacy and safety were compared between the two groups after two or three courses of treatment. The primary outcomes were clinical remission rate including overall response rate and deep remission rate， one-year and two-year overall survival rate， and adverse effects. The secondary outcomes were the proportion of plasma cells in bone marrow， hemoglobin， β2-microglobulin， lactate dehydrogenase， serum creatinine， blood urea nitrogen， bone pain score， and KPS functional status score （KPS score） before and after treatment. ResultsIn terms of clinical efficacy， there was no statistically significant difference （P＞0.05） in the overall response rate ［the observation group 69.57%（16/23） vs the control group 70.37% （19/27）］ and deep remission rate ［the observation group 56.52% （13/23） vs the control group 55.56% （15/27）］ between groups after the treatment. The one-year overall survival rates of the observation group and the control group were 90.9% and 92.4%， and the two-year overall survival rates were 81.8% and 80.9% respectively， with no statistically significant differences between groups （P＞0.05）. During the treatment， no renal function injury occurred in both groups. The incidence of peripheral nerve injury in the observation group was 8.70%， which was lower than 48.15% in the control group （P＜0.01）. After the treatment， the proportion of myeloma plasma cells， β2-microglobulin， serum creatinine level， and bone pain score decreased， while the hemoglobin level and KPS score increased in both groups （P＜0.05 or P＜0.01）. Compared between groups after treatment， the bone pain score of the observation group was lower than that of the control group， while the KPS score was higher than that of the control group （P＜0.05）. ConclusionThe clinical efficacy of cinobufagin tablets combined with TD in the treatment of NDMM is equivalent to bortezomib/dexamethasone-containing regimen， but the former is more helpful in relieving the pain and improving the quality of life， and has better safety.

Paridis Rhizoma， a traditional valuable Chinese herbal medicine， has the functions of clearing heat and removing toxin， relieving edema and pain， cooling liver and calming convulsion， which can be used to treat various diseases such as mumps， abscess， burn， bleeding， and tumor. It has been used in folk medicine for a long time and is the main raw material of various Chinese patent medicines such as Gongxuening Capsules and Yunnan Baiyao. Polyphyllin Ⅰ， an isospirostanol saponin and one of the main active components in Paridis Rhizoma， is distributed in the rhizome， pericarp， and leaves of Paris polyphylla. With high polarity， polyphyllin Ⅰ is mainly extracted by n-butanol extraction and macroporous adsorption resin chromatography， separated by silica gel column chromatography and preparative high performance liquid chromatography， and purified with the combination of methods. With anti-tumor， anti-inflammatory， antibacterial， and anti-virus effects， it is generally employed to treat liver cancer， lung cancer， gastric cancer and other cancers as well as arthritis， influenza， sore toxin， and bacterial infection. However， polyphyllin Ⅰ may cause stomach irritation， hemolysis， liver damage， kidney damage， heart damage， and other adverse reactions. Pharmacokinetic studies show that it has problems such as low bioavailability and poor intestinal absorption and permeability， which affect the clinical application of polyphyllin Ⅰ. This paper summarizes the research on the plant sources， extraction and separation methods， pharmacological effects， adverse reactions， and pharmacokinetics of polyphyllin Ⅰ in recent years， which is expected to provide a reference for the rational clinical application and other in-depth research work of polyphyllin Ⅰ.

【Objective】 To analyze the impact of sporadic cases of COVID-19 on the work of Transfusion Department, so as to explore the countermeasures. 【Methods】 The admission of inpatient departments, the reception of outpatient(including emergency) departments, the workload of transfusion department(including blood typing, unexpected antibody screening and cross matching), and the consumption of blood components in the Xijing Hospital between October and November in 2021, during COVID-19 outbreak, were collected. All the above data was statistically compared to the data in same period in 2018, before the COVID-19 outbreak. 【Results】 Due to the COVID-19 epidemic, there was a significant decrease in number of inpatients(280±157.1 vs 340.4±110.2), outpatient(including emergency)(8 359±3 615 vs 10 151±3 225), the workload of blood typing(272.0±132.4 vs 341.6±110.4), unexpected antibody screening(78.26±42.22 vs 98.51±43.53) and crossmatch(237.2±99 vs 475.7±155.6), as well as the consumption(U) of all blood components(457.9±50.32 vs 579.4±62.51) in the Xijing Hospital(P<0.05). In detail, the epidemic had the most direct impact on the number of inpatients and outpatients, which shrank continuously on the 2^nd day after official announcement of the new COVID-1 cases. While the workload of blood typing, unexpected antibody screening and crossmatch decreased slightly, with a lag, usually on the 2^nd, 3^rd and 5^th day after official announcement. The decrease of the usage of red blood cells and plasma began from the 7^th day after the new epidemic to the 6^th day after the end of the epidemic. However, the usage platelets and cryoprecipitate coagulation factors decreased from the 8^th and 10^th day after the new epidemic to the 2^nd and 6^th day after the end of the epidemic, respectively. 【Conclusion】 The daily work of Blood Transfusion Department has been seriously affected by sporadic COVID-19 epidemic. The working mode, staff structure and inventory ratio of blood components should be adjusted and optimized instantly to maintain the normal conduct of medical treatments in hospitals and ensure the safety of patients.