Objective:To preliminary explore the changes in blood system in pyrrolizidine alkaloids (PAs)-related liver damage.Methods:General situation, liver function, biochemical blood test, routine blood test, coagulation function markers, etc., of 77 cases with drug-induced liver damage admitted to the Zhongshan Hospital Affiliated to Fudan University from 2012 to 2019 were retrospectively analyzed. Patients’ were divided into PA group, other traditional Chinese medicine group and Western medicine group according to their medication history. Simultaneously, the changes in liver function were observed in the established mice model of monocrotaline-induced liver damage. Liver tissues HE staining and blood routine indexes were observed.Results:24 cases received PA, 24 cases received other traditional Chinese medicine, and 29 cases received western medicine. Alanine aminotransferase was lower in PA group than the other two groups ( P < 0.05), and the total bilirubin and direct bilirubin were significantly lower than the other traditional Chinese medicine group ( P < 0.05). The peripheral platelet count of the PA group was (84.11 ± 26.91) ×10 9/L, which was significantly lower than the lower limit of normal, and had statistically significant difference with other traditional Chinese medicine and western medicine group ( P < 0.01). Thrombocytocrit, mean platelet volume and platelet indices of PA group were statistically different from the other two groups ( P < 0.05). The D-dimer level in patients with PA group was (2.62 ± 1.93) mg/L, which was higher than the upper limit of normal, and significantly higher than the D-dimer level of the other two groups of patients ( P < 0.01). Meanwhile, prothrombin time was longer in PA group than that of the other two groups ( P < 0.01), and platelets count were decreased significantly in the mouse model of monocrotaline-induced liver damage after alanine aminotransferase and aspartate aminotransferase elevation ( P < 0.01). Conclusion:PA-related liver damage has lower peripheral platelet counts, and the peripheral platelet counts of these patients are lower than other types of drug-induced liver damage. In addition, increased D-dimer in patients with PA-related liver damage indicate a potential risk of thrombosis.

Objective:To explore the quality of working life and its related factors in patients with breast canc-er returned to work after surgery.Methods:A total of 316 patients with breast cancer who had returned to work af-ter surgery were selected,and they were investigated with the General information questionnaire,Quality of Working Life Questionnaire for Cancer Survivors(QWLQ-CS),Breast Cancer Survivors Resilience Scale(BCRS)and Strat-egies Used by People to Promote Health(SUPPH).Multivariate linear regression analysis was used to analyze the related factors of quality of working life.Results:Multiple linear regression analysis showed that the QWLQ-CS score was positively correlated with education level,per capita monthly income of family,work pattern,return to work time,personal protection and social protection score of BCRS,and positive attitude scores of SUPPH(β=1.05,1.23,2.26,0.69,0.95,1.00,0.13),while negatively correlated with the complications(β=-3.83).Con-clusion:The quality of working life for patients with breast cancer after surgery needs to be improved after they re-turn to work,psychological resilience and self-efficacy are positively correlated with quality of working life.

Objective:To understand the dilemma of active management in young and middle-aged postoperative patients with lumbar disc herniation, in order to provide reference for the formulation of active intervention program of self-health management meeting the needs of patients.Methods:Using the phenomenological research method, a total of 16 middle-aged and young patients with lumbar disc herniation were selected for semi-structured in-depth interviews, and the themes were analyzed and extracted by Colaizzi 7-step analysis method.Results:Three themes and nine sub-themes were extracted namely, inadequate disease response capacity and response resources (lack of disease symptom management capacity, limited access to disease management information, difficult use of disease management information, difficulty in maintaining positive self-management for a long time (forced to stop behavior change due to stress, lack of motivation to achieve good behavior change, doubts about the effectiveness of self-management) and multi-dimensional negative emotions (contrast between maintaining independence and dependence on others, fear of being misunderstood, fear of relapse) .Conclusions:Medical staff should provide comprehensive health information services for young and middle-aged postoperative patients with lumbar disc herniation, improve the out-of-hospital follow-up mechanism with the help of information technology, further improve family and social support strategies, reduce the difficulties faced in the process of active management and achieve long-term active disease management.

By exploring theories related to yin-yang， body and spirit， and the relationship between nature and human beings， this study proposed the holistic functional perspective in Traditional Chinese Medicine （TCM） rehabi-litation. This perspective emphasizes the influence of various internal and external factors on the body's function and health status， with the integration of form and spirit as its core concept. It integrates the principles of correspondence between nature and human beings， as well as the unity of individuals and society， positioning holistic function as the key focus in TCM rehabilitation practice. It guides the prevention， assessment， and rehabilitation treatment of functional disorders， ultimately achieving the goal of comprehensive recovery of health. Additionally， the study reviewed the current application status of the holistic functional perspective in clinical TCM rehabilitation， clarified its integration throughout the entire TCM rehabilitation process， with the goal of providing a theoretical and practical foundation for further research and application in TCM rehabilitation.