Objective To know the usage situation of traditional Chinese medicine (TCM) injections;To improve the level of rational administration of TCM injections.Methods Totally 2686 medical records of inpatients from Aug. 2012 were randomly selected. Patient genders, ages, medication types, dosage and solvent, etc. were analyzed respectively.Results There are 38 varieties of traditional Chinese medicine injections in this survey. There are 22 varieties of traditional Chinese medicine injections involving the unreasonable usage in solvent, a total of 453 times. The total qualified rate was 80.59%. There are 9 varieties of traditional Chinese medicine injections involving the unreasonable dosage. The total qualified rate was 88.77%.Conclusion In order to guarantee the medication safety, the reasonable usage of TCM injections should be strengthened in the clinic, which can be realized by reading package inserts carefully, prescribing through syndrome differentiation.

Objective To discuss the relationship of drip velocity of nitrate on blood pressure while treating coronary disease,in order to provide appropriate drip velocity for clinical treatment.Methods 155 patients with coronary disease using nitrate to lower blood pressure were selected.They were divided into the nitro glycerin group(85 cases) and the isosorbide mononitrate group( 70 cases) according to difference of medication.The velocity of drugs was adjusted on basis of blood pressure changes.The blood pressure changes at different drip velocities were observed and compared.Results The systolic pressure and the diastolic pressure between two groups showed no difference at 20 drops/min,but the results were the opposite at 30 drops/min.The systolic pressure and the diastolic pressure in the nitro glycerin group showed evident changes at different drip velocities,but in the isosorbide mononitrate group,these changes were not so significant.9 patients in the nitro glycerin group had headache during treatment,no headache occurred in the isosorbide mononitrate group.Conclusions Intravenous use of nitrate at a velocity of 20 drops/min is relative secure.The risk of hypotension will increase if the medication speed increases.lsosorbide mononitrate has little influence on blood pressure.

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.

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.

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:The purpose of this paper is based on the concept of enhanced recovery after surgery, to discuss the timing of taking food and water in knee arthroplasty patients, as well as its feasibility and safety, so as to improve the quality of quality nursing services.Methods:The 226 knee arthroplasty patients in Luoyang Orthopedic-Traumatological Hospital (Henan Provincial Orthopedic Hospital) from September 2020 to November 2021 were selected and divided into a control group and a experimental group using the random number table method, with 113 cases in each group. The control group adopted a conventional postoperative feeding management method; the experimental group adopted the early and timely feeding management method after comprehensive assessment. The data were compared between the two groups, including the incidence and severity of postoperative nausea and vomiting within 6 h and from 6 to 24 h after surgery , the incidence of thirst and hunger at 2 h, 4 h and 6 h postoperatively, and the comfort level.Results:The incidence of postoperative nausea and vomiting was lower in the experimental group [19.5%(22/113), 13.3%(15/113)] than in the control group [32.7%(37/113), 23.9%(27/113)] within 6 h and from 6 to 24 h after surgery, and the severity (21 cases of gradeⅠ, 10 cases of gradeⅡand 6 cases of grade Ⅲ) was also lower than in the control group (17 cases of gradeⅠ, 29 cases of gradeⅡand 18 cases of grade Ⅲ), and the differences were all statistically significant ( χ2 = 5.16,4.21, Z = -2.72, P<0.05). The incidence of thirst were lower in the experimental group [14.2%(16/113), 8.0%(9/113), 2.7%(3/113)] than in the control group [26.5%(30/113), 29.2%(33/113), 40.0%(35/113) at 2 h, 4 h and 6 h postoperatively, and the incidence of hunger at 4 h and 6 h postoperatively [11.5%(13/113), 8.0%(9/113)] were lower than in the control group [32.7%(37/113), 34.5%(39/113)], with statistically significant differences ( χ2 values were 5.35 to 32.39, all P<0.05). The postoperative comfort scale scores of physiological (31.04 ± 1.00) and psychological (33.50 ± 1.45) were higher in the experimental group than in the control group (27.46 ± 1.78) and (31.37 ± 1.29), and the differences were statistically significant ( t values were -102.36 to -66.26, all P<0.05). Conclusions:Early postoperative feeding management at the right time reduces the incidence and severity of postoperative nausea and vomiting inknee arthroplasty patients. In addition, it can also reduce the incidence of thirst and hunger, and improve patients′ postoperative physiological and psychological comfort, which has a facilitating effect on achieving rapid recovery of patients.

OBJECTIVE：To ev aluate pha rmacoeconomics of magnesium isoglycyrrhizinate preventing liver damage induced by chemotherapeutic drugs for gastric cancer ，and to provide reference for rational use of liver-protecting drugs. METHODS ：Totally 200 inpatient medical records were collected from our hospital retrospectively during Jan. 2018-Feb. 2020，and then divided into group A （prophylactic use of magnesium isoglycolate ，50 cases），group B （prophylactic use of magnesium isoglycolate combined with TCM prescriptions ，50 cases），group C （prophylactic use of polyene phosphatidylcholine ，50 cases） and group D （non-prophylactic use of liver-protection drugs ，50 cases）. The effects （total response rate ）of four plans preventing liver damage were evaluated. Pharmacoeconomic evaluation was analyzed by cost-minimization analysis and cost-effectiveness method ， sensitivity analysis was carried out at the same time . RESULTS ：Total response rates of group A ，B，C and D were 94.00％， 96.00％，82.00％ and 72.00％. The total response rates of group A and B had no statistical significance （P＞0.05），but were significantly higher than those of group C and D （P＜0.05）；total response rate of group C was significantly higher than that of group D （P＜0.05）. The costs of groups A ，B，C and D were 1 936.70，2 086.96，1 800.91，2 975.42 yuan. The cost-minimization analysis was used to compare the therapeutic plan of group A and B ，and plan of group A was more economical. The cost-effectiveness method was used to compare therapeutic plan between group C and D ，and the plan of group C was more economical. The cost-effectiveness method was used to compare therapeutic plan between group A and C ，and the cost-effectiveness ratio of 2 groups were 2 060.32 and 2 196.2 3，incremental cost-effectiveness ratio was 1 131.58，and the plan of group A was more economical. Above conclusion were supported by the results of sensitivity analysis. CONCLUSIONS ：The cost-effectiveness of magnesium isoglycyrrhizinate preventing liver damage induced by chemotherapeutic drugs for gastric cancer is better than magnesium isoglycyrrhizinate combined with TCM prescription ， polyene phosphatidylcholine and non-prophylactic use of liver-protecting drugs ，showing economical advantage.

[摘 要] 目的：探究肺癌磷酸甘油酸变位酶1（PGAM1）对肺癌LLC细胞增殖和迁移的调控作用，以及PGAM1对肿瘤微环境中CD8+ T细胞功能和浸润的影响。方法：将shPGAM1及shNC慢病毒感染LLC细胞，筛选稳定细胞，分别命名为shPGAM1组和NC组，WB和qPCR法检测两组细胞中PGAM1蛋白和mRNA的表达水平。CCK-8法和实时细胞分析仪检测敲低PGAM1对LLC细胞增殖和迁移的影响；流式细胞术检测与两组细胞分别体外共培养后CD8+ T细胞功能性受体（TIM-3、PD-1、GrzmB、Ki67）表达的变化。构建小鼠肺癌LLC细胞皮下移植瘤模型，监测PGAM1表达对肿瘤生长的影响，通过流式细胞术检测敲低PGAM1对肿瘤微环境中CD8+ T细胞浸润的影响。结果：shPGAM1组细胞中PGAM1蛋白和mRNA表达水平较NC组均显著降低。敲低PGAM1可降低LLC细胞的增殖和迁移能力（Ρ < 0.000 1或Ρ < 0.05）。与shPGAM1组细胞共培养后，CD8+ T细胞的耗竭标志物（TIM-3、PD-1）表达均降低（Ρ < 0.000 1或Ρ < 0.01）。敲低PGAM1后肿瘤生长受到显著抑制，且肿瘤组织中CD8+ T细胞浸润增加（Ρ <0.000 1）。结论：靶向敲低PGAM1可抑制肿瘤细胞增殖、迁移，降低CD8⁺ T细胞耗竭标志物的表达及促进肿瘤内T细胞浸润，双重调控肿瘤生长与抗肿瘤免疫。

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.