OBJECTIVE:To provide reference to promote the proper use of TCM decoction pieces.METHODS:According to Beijing TCM Decoction Piece Dispensing Regulation,stratified random sampling method was adopted to select a group of physicians in our hospital and conduct questionnaire survey about their knowledge of the prescription handling of 8 commonly used TCM decoction pieces including Scutellaria baicalensis,Angelica sinensis,Fritillary,Phellodendron chinense,Aconitum carmichaeli,Eucommia ulmoides,Ziziphus jujuba,Rhei Radix et Rhizoma.Then,the survey data was collected and analyzed.RESULTS:A total of 81 questionnaires were given out and all were returned with effective recovery rate of 100％.In terms of professional titles,associate chief physicians showed the lowest average error rates in prescription handling cognition (27.5 ％),compared with physicians (35.8％) and attending doctors (37.0％).They made most mistakes about Fritillary and E.ulmoides.To the contrary,both physicians and attending doctors made most mistakes about E.ulmoides.In the scope of working life,physicians from different groups showed similar average error rates in prescription handing recognition (31.3％-38.8％).All of them made most mistakes about P.chinense and E.ulmoides.As for major,those who study western internal medicine shared larger average error rates (43.8％) than those who study internal medicine of TCM (36.8％),traumatology and orthopedics of TCM (31.8％) and acupuncture (36.5％).Each major showed the highest error rates in E.ulmoides.The order of 8 TCM decoction pieces from the most mistakes to the least mistakes made by physicians was E.ulmoides,P.chinense,Fritillary,Rhei Radix et Rhizoma,S.baicalensis,A.carmichaeli,Z.jujuba and A.sinensis.CONCLUSIONS:Physicians with different professional titles,working life and majors show deficiency in knowledge about the prescription handling of 8 commonly used TCM decoction pieces.Generally,physicians show the worst understanding of E.ulmoides.

Objective To detect the lymphocyte subpopulations in patients with early syphilis ,so as to know their immunity con‐dition and guide clinical treatment .Methods Flow cytometry was used to detect CD3+ ,CD4+ and CD8+ lymphocyte subpopula‐tions in peripheral blood from 59 volunteers ,including 20 normal individuals (Cont group) ,10 patients with primary syphilis (PS group) ,15 patients with secondary syphilis (SS group) and 14 patients with early latent syphilis (ELS group) .Results CD3+ , CD4+ and CD8+ lymphocyte subpopulations in each syphilis groups were higher than Cont group .SS group had the highest CD3+level ,second was PS group ,and third was ELS group .There was significant difference among three groups (P<0 .05) .The CD3+level of SS group was significantly higher than that of Cont group (P<0 .05) .ELS group had the highest CD4+ level ,second was SS group ,third was PS group .The difference of CD4+ level was significant among three groups (P<0 .05) .PS group had the high‐est CD8+ level ,second was SS group ,third was ELS group .However ,the difference of CD8+ level among three groups was not sig‐nificant (P>0 .05) .There was no significant difference of CD4+ /CD8+ among three groups(P>0 .05) .Conclusion Cytoimmunity in early syphilis enhances ,which could be benefit to eliminate Treponema Pallidum .

Objective To design a new type of field operation instrument for easy to spread a rescue surgery rapidly in field first -aid at the present stage. Methods The traditional field operation instrument set is innovated in its composition, structure and function. The packing instrument procedure can be omitted. The new field operation instrument set is made of four different operation instrument boxes, two of which can be put into a standard field medical case. Results It is designed to be convenient to have a rescue surgery rapidly and to be washed, sterilized, conveyed and kept in aseptic storage. Conclusion The new field operation instrument case has such advantages as compactness, reasonable allocation and function completed, so it can be used easily.

This paper aims to discuss the use and management of operation instrument in treatment of the wounded on the sea by using the new type of field operation instrument set so as to improve the rescue ability on the sea. The operation set has a new structure and is designed reasonably. It is easy to be washed and disinfected. It can be packed sterilizedly for a long time and deployed rapidly. All of the operation instrument is fixed in the box to prevent it from falling when it is used on the sea and it is convenient to count and arrange. The new type of field operation instrument set is fit for rescuing the wounded on the sea. It is convenient to be used, sterilized, stored and carried.

BACKGROUND:Previous studies on immunosuppression and anti-rejection after organ transplantation mainly focused on effects of T lymphocytes-mediated immune response and immunosuppressive agents on T lymphocytes. Effects of dendritic cel s were unclear. The manifestation and mechanism of immunosuppressive agent effects on dendritic cel s are not identical. OBJECTIVE:To compare the effects of different immunosuppressive agents on expression and function of costimulatory molecules of dendritic cel s, and to explore the mechanism of action of immunosuppressive agents. METHODS:20μg/L rapamycin, 0.04 mg/L mycophenolate, 10μg/L tacrolimus and 1 mg/L cyclosporine A were separately added during bone marrow cel s of C57BL/6 mice were differentiated into dendritic cel s. RESULTS AND CONCLUSION:Flow cytometry results revealed that CD40 expression in each group:rapamycin0.05). One-way mixed lymphocyte reaction results displayed dendritic cel costimulatory T cel proliferation in each group:rapamycin

Objective To investigate the treatment effect of excision via transoral-nosal-sphenoidal approach on pituitary adenoma and management of postoperative complications.Methods One hundred and four pituitary adenoma patients,admitted to our hospital from January 2010 to December 2014 and microsurgically treated via transoral-nosal-sphenoidal approach,were chosen in our study.The clinical data of these patients and microsurgical treatment efficacy were analyzed retrospectively and postoperative complications were concluded.Results Total resection was observed in 82 patients (78.8％) and subtotal resection in 22 (21.2％).Forty-two patients got vision improvement with an improvement rate of 80.7％.Hormonal readiness recovered to normal level in 34 patients (44.7％);hormonal readiness being decreased but still higher than normal level was noted in 38 (50.0％).The major postoperative complications included diabetes insipidus,cerebrospinal fluid rhinorrhea,electrolyte disturbance,hypopituitarism and hemorrhage.The symptoms and signs of patients were improved in varied degrees,and the postoperative complications were controlled.Conclusions The transoral-nosal-sphenoidal approach is an ideal method to resect pituitary adenoma and active management of postoperative complications is essential to the prognosis of patients.

Objective To investigate the clinical application value of 3D printing technique in the treatment ofintracranial aneurysms.Methods Eight patients with intracranial aneurysms,admitted to our hospital from May 2014 to June 2015,were chosen in our study;three dimensional reconstructions of anatomical models were accomplished by computer aided technology.By rapid prototyping,the intracranial aneurysm models were manufactured,operation project were formulated and preoperative sham-operation was enforced to supervise the intracranial aneurysm clipping.The clinical data and clipping efficacy were retrospectively analyzed.Results Eight patients with 11 intracranial aneurysms at stage Ⅰ were treated successfully with aneurysm clipping via unilateral craniotomy without rupture of aneurysms.Preoperative sham operation shortened the time of operation and reduced the postoperative complications.Glasgow outcome scale scores at hospital discharge indicated that good recovery was noted in 7 patients and mild disability in one.Postoperative CTA or DSA did not show residual aneurysms.Conclusions Three-dimensional printing technology can overall,intuitively,exactly display three-dimensional shape of intracranial aneurysms and spatial relation of anatomic structure.It has important role of supervising treatment of intracranial aneurysms and broad application perspective,thus deserves generalization.

Objective:To explore the application effect of memory clock-in mode to promote the quality of pre class memory in hybrid teaching.Methods:Total 778 nursing students were selected as research objects,and divided into control group and observation group.Control group memorized according to the learning requirements before the general class,observation group participated in memory punching on the basis of control group.The final examination scores,memory frequency and memory difficulty of the subjects were com-pared between the two groups,then investigate the satisfaction of memory clock.Results:Final examination score of observation group was higher than that of control group(P<0.05);the number of weekly memory in observation group was significantly higher than that in control group(P<0.05),while there was no significant difference in the length of each memory between observation group and control group(P>0.05);difficulty of subjective perception and memory in observation group was lower than that in control group(P<0.05);students who participated in the whole process of clock in memory were more satisfied with knowledge grid memory than those who did not participate in the whole process of clock in memory(P<0.05).Conclusion:The memory punch in mode improves the pre class memory quality of the hybrid teaching of Pathogenic Biology and Immunology.

Objective: To explore the anti-inflammatory immune mechanism in moxibustion treatment of Crohn.s disease (CD) from the perspective of c-Jun N-terminal kinase (JNK) signaling pathway, through observing the regulatory effect ofmoxibustion on colonic JNK, c-Jun, monocyte chemoattractant protein 1 (MCP-1) and cyclooxygenase 2 (COX2) in CDmodel rats. Method: Male Sprague-Dawley rats of clean grade were randomized into a normal group, a model group, amoxibustion group and a sham moxibustion group. CD model was developed by the mixture of 2, 4, 6 Trinitro-benzene-sulfonic acid (TNBS) and ethanol via enema. Hematoxylin-eosin (HE) staining was used to observe the morphologicalchanges in rat.s colon tissues for pathological scoring; enzyme-linked immunosorbent assay (ELISA) was used to detectthe contents of MCP-1, COX2, JNK, and c-Jun in colon tissues; real-time fluorescence quantitative PCR was adopted toexamine the mRNA expressions of JNK and c-Jun in rat.s colon. Result: Compared with the normal group, the modelgroup showed more significant colonic damage and thus had a higher colonic damage score (P ＜ 0.01), manifested astopical inflammation which involved the submucosa, fissuring ulcers and granuloma; the model group also showedincreased contents of protein MCP-1 and COX2, and elevated contents of JNK protein and mRNA in colon (all P ＜ 0.05), while the change in the content of c-Jun was insignificant (all P＞ 0.05) . Compared with the model group and shammoxibustion group, the colonic damage score was lower in the moxibustion group (P ＜ 0.01, P ＜ 0.05), with improvementin colonic structure and inflammation; the contents of MCP-1 and COX2 in colon tissues declined, so did the proteincontent and mRNA expression of JNK (all P ＜ 0.05), while the change in the content of c-Jun was insignificant (all P＞0.05) . There were no significant differences between the model group and sham moxibustion group comparing all theindexes (all P＞ 0.05) . Conclusion: Moxibustion down-regulates the expressions of JNK protein and mRNA in CD rat.scolon, as well as the contents of MCP-1 and COX2 in colon tissues, which is possibly one significant mechanism formoxibustion to ease intestinal inflammation and promote the repair of colon tissues in CD.

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.