OBJECTIVE:To study varieties,indications and usage features of Tibetan medicine preparations,and provide refer-ence for the clinical treatment and new drug development for Tibetan medicine. METHODS:Tibetan medicine preparations in offi-cial standards were collected,variety features(formula scale,license number,pharmaceutical enterprise,name and dosage form, herbal medicine number),action features(indication name,clinical application)and medicine features(category and quantity,me-dicinal part,commonly used drug,frequency,three fruitsuse feature) were summarized. RESULTS:Totally 458 preparations were included,including 18 recorded in Chinese Pharmacopoeia (part 1,2015 edition),200 recorded in Pharmaceutical Stan-dards of the Ministry of Health of China(Tibetan medicine,1995 edition),240 recorded in Tibetan Medicine Standards(six prov-inces). 129 had obtained 430 license numbers,from 52 pharmaceutical companies;the prearations were mainly named byherbal medicine+principal medicine+dosage formprincipal medicine+dosage formandindication+dosage form. Dosage forms had powder,pill,cream,oil,syrup and wine; the number of herbal medicine was(13.81±13.28). The Tibetan preparations were com-monly used in the clinical treatment of diseases of the digestive system,respiratory system,genitourinary system,circulatory sys-tem,infectious and parasitic diseases,etc. 442 medicines had been used,including 297 herbal medicines,70 animal medicines, 47 mineral medicines and other 28 medicines. The common medicinal parts were seed or fruit,root or rhizome,whole grass,flow-er,stem,over-ground part,tuber or bulb,etc. The top 10 frequency of medicines were as follows as Terminalia chebula,Cartha-mus tinctorius,Aucklandia lappa,Amomum kravanh,Phyllanthus emblica,Piper longum,Inula racemosa,Punica granatum, Moschus berezovskii,Adhatoda vasica;and 19% preparations contained three fruits(T. chebula,P. emblica,Terminalia bellirica). CONCLUSIONS:Tibetan medicine preparations have rich varieties,reasonable herbal medicines,more solid preparations,widely clinic application,contain more herbal drugs and commonly usethree fruits,while fewer preparations have obtained license number.

Training about master of nursing on professional degree and specialist nurse is the important part of nursing program in China. However, general education, lacking of specialized courses and the imperfect system of evaluation and certification is still exist. There is successful training and certification about them in American. The paper reviewed the educational status of master of nursing on professional degree and the certification standards, as well as authorities of nurse specialists in American. Hopefully, we can make reference for the future nursing field.

Spastic-paralysis impacts the function of upper extremity in most apoplexy patients.Assessing spasticity condition precisely,timely and effectively plays an important role in guiding rehabilitation treatment,therapeutic evaluation and prognosis of functional outcome.Owing to the limitations of subjective scales,the issue of quantifing the spasticity objectively has become a new research direction in recent years.By reviewing the literatures,we summed up the application of objective assessment tools,which were based on rehabilitation engineering,electrophysiology or biomechanics,in assessing the function of upper extremity with spastic paralysis,as well as put forward the research directions of prospects,in order to give a reference to the systematic integration of assessment tools in the near future.

Objective:To explore the influencing factors of drug application deviation in elderly diabetes mellitus patients during hospital-family transition period.Methods:A total of 278 elderly diabetes mellitus patients in Henan Provincial People's Hospital from March 2019 to March 2021 were selected as the study subjects.All patients were followed up by telephone 1 week after discharge.The drug deviation evaluation tool(MDT)was used to evaluate the drug application deviation in patients during the hospital-family transition period.They were divided into drug application deviation group and non-drug application deviation group.Sociodemographic and disease-related data and medication management data were compared between the two groups.Logistic regression analysis was used to analyze the influencing factors of drug application deviation in elderly patients with diabetes mellitus during hospital-family transition period.Results:Of the 278 elderly patients with diabetes, 162(58.27%)had at least one drug application deviation during hospital-family transition period.The family care index was lower in drug application deviation group than non-drug application deviation group( Z=6.578, P<0.001).As compared with non-drug application deviation group, drug application deviation group had the higher number of drugs at discharge, and had lower scores of Morisky Medication Adherence Scale with Eight-Item(MMAS-8), had lower scores of Summary of Diabetes Self Care Activities(SDSCA)and had lower scores of Self-efficacy for Appropriate Medication Use Scale(SEAMS), with statistically significant differences( Z=10.971, 6.077, t=5.947, 14.105, all P<0.001).Binary Logistic regression analysis and forest map showed that the more number of discharge medication was a risk factor for drug application deviation during hospital-family transition period in elderly patients with diabetes mellitus( OR=4.128, P<0.001); family care index, MMAS-8 score, SDSCA score and SEAMS score were its protective factors( OR=0.343, 0.523, 0.922, 0.568, all P<0.05). Conclusions:The incidence of drug application deviation during hospital-family transition period is higher in elderly patients with diabetes mellitus.The possible protective factors are high scores of family care index, MMAS-8, SDSCA and SEAMS, and the risk factor is large number of drugs ordered by discharged doctors.Therefore, targeted intervention measures can be implemented to reduce the occurrence of drug application deviation during hospital-family transition period.

Inflammation-driven endothelial dysfunction is the major initiating factor in atherosclerosis, while the underlying mechanism remains elusive. Here, we report that the non-canonical stimulator of interferon genes (STING)-PKR-like ER kinase (PERK) pathway was significantly activated in both human and mice atherosclerotic arteries. Typically, STING activation leads to the activation of interferon regulatory factor 3 (IRF3) and nuclear factor-kappa B (NF-κB)/p65, thereby facilitating IFN signals and inflammation. In contrast, our study reveals the activated non-canonical STING-PERK pathway increases scaffold protein bromodomain protein 4 (BRD4) expression, which encourages the formation of super-enhancers on the proximal promoter regions of the proinflammatory cytokines, thereby enabling the transactivation of these cytokines by integrating activated IRF3 and NF-κB via a condensation process. Endothelium-specific STING and BRD4 deficiency significantly decreased the plaque area and inflammation. Mechanistically, this pathway is triggered by leaked mitochondrial DNA (mtDNA) via mitochondrial permeability transition pore (mPTP), formed by voltage-dependent anion channel 1 (VDAC1) oligomer interaction with oxidized mtDNA upon cholesterol oxidation stimulation. Especially, compared to macrophages, endothelial STING activation plays a more pronounced role in atherosclerosis. We propose a non-canonical STING-PERK pathway-dependent epigenetic paradigm in atherosclerosis that integrates IRF3, NF-κB and BRD4 in inflammatory responses, which provides emerging therapeutic modalities for vascular endothelial dysfunction.