Objective To evaluate the changes of CD4+ CD25+ regulatory cells (Treg) in peripheral blood and the serum levels of transforming growth factor beta-1 (TGF-β1)in elderly patients with hepatocellular carcinoma. Methods The ratios of Treg in the peripheral blood of patients aged over 80 years from 22 hepatocellular carcinoma,26 metastatic liver cancer,20 healthy controls,were determined by flow cytometry.Meanwhile,the serum levels of TGF-β1 were detected by ELISA.Results The ratio of Treg to total CD; T cells in the peripheral blood [(9.71±3.23)％ vs.(5.81±1.18)％,P＜0.01]and the serum levels of TGF-β1 [(78.10±29.41)ng/L vs.(7.78± 3.54) ng/L,P＜0.01]of elderly patients with hepatocellular carcinoma were significantly higher than those in the healthy controls.Meanwhile,the ratio of Treg to total CD[ T cells in the peripheral blood [(9.71±3.23)％ vs.(7.36±2.07) ％,P＜0.05]and the serum levels of TGF-β1[(78.10± 29.41 )ng/L vs.(19.33± 10.90) ng/L,P＜ 0.01 ]in the patients with hepatocellular carcinoma was increased as compared with those in metastatic liver cancer (P＜0.05 or P＜0.01).The correlation indicated that the ratio of Treg to total CD4+ T cells in the peripheral blood were positively related with TGF-β1 levels and tumor clinical stage(r=0.698 and 0.782,P＜ 0.01 ),but negatively with Karnofsky performance status score(KPS) (r=-0.643,P＜0.01). Conclusions The ratio of Treg to total CD4+ T cells in the peripheral blood from elderly hepatocellular carcinoma is increased and correlated with TGF-βl level,tumor clinical stage and KPS.It might helpful to determine the prognosis of elderly hepatocellular carcinoma by detecting the ratio of Treg to total CD4+ T cells in the peripheral blood.

Objective By studying the prescriptions and medicines for treating rheumatoid arthritis (RA) prescribed by modem doctors, we tried to provide new ideas for developing the new medicines for treating rheumatoid arthritis. Methods 340 prescriptions on treating rheumatoid arthritis were collected from core medical periodicals and books published in the recent 20 years. Make a statistical analysis to the medicines in these prescriptions according to TCM etiological and pharmaceutical theories and modern researching foundlings. Results Among all 254 Chinese medicines used for treating RA, 32 medicines belong to worm and vine medicines, being used for 806 times. Conclusion The worm and vine medicines are frequently used in treating RA with good therapeutic effects combined with other kinds of medicines.

Traditional Chinese medicine (TCM) cultural tourism, with the trait of health and unique features, is based on rich resources of medicine and profound TCM culture. TCM cultural tourism focuses on making tourists get TCM knowledge and enjoy TCM tourism activities. Mawangdui Han Dynasty Tomb, a key scenic spot to develop TCM cultural tourism in Changsha, has advantages of high TCM cultural value with a good geographical position, and superior geographic and tourist viewing conditions. It has a great value in TCM cultural tourism.

Objective:Thought reviewing the literature of prescription of treating rheumatoid arthritis(RA)to enrich and improve the theory of treating RA and provide the instruction for the clinical practice of treating RA.Methods:340 Prescriptions of treating RA were collected,these prescriptions were analyze according to the theory of traditional Chinese medicine.Results:Principle of treating RA was strengthening healthy qi to eliminate pathogens.Conclution:The traditional therapeutics of RA was plentiful,and provided theory nucleus and reference for treating RA.

Dendrobii Officinalis Caulis is considered as one kind of rare and precious Chinese medicinal herb with the efficacy of nourishing yin fluid, enhancing physique, benefiting and tonifying spleen and stomach, protecting liver and cholagogue, strengthening gluten, lowering lipid and blood sugar, inhibiting tumor, brightening eyes, nourishing skin, and prolonging life. This article used SWOT method to analyze the strength, weakness, opportunity, and threat of Dendrobii Officinalis Caulis respectively so as to analyze its marketing prospects in Hunan Province comprehensively. On the basis of the analysis, the early stage and late stage strategies of development of Dendrobii Officinalis Caulis in Hunan Province was carried out, which played a role in its medicinal value, economic value, and social value.

OBJECTIVE To establish communication and cooperation between disinfection and supply department and clinical departments in order to attain the high level of work for sterile material management and quality supervision.METHODS From Jan 2004 to Sept 2006 we sent our color printed pages about disinfection and sterilization knowledge,whole-way quality supervision,management and safety usage of sterile material to each clinical department as a manner of communication.RESULTS The communication gave a harmony of demand and supply of sterile material between them and guaranteed the whole-way superior service for sterile material supply.CONCLUSIONS The communication with whole-way quality management of sterial material supply between the disinfection and supply department and other clinical departments is very important.

Objective:To investigate the care burden of primary caregivers of young patients with brain tumor and to analyze the correlation between the care burden and social support level, in order to improve the mental health of caregivers, reduce the care burden and improve the quality of care for patients.Methods:Using the convenient sampling method, a total of 173 primary caregivers of young inpatients with brain tumor who were admitted to Department of Neurosurgery of Henan Provincial People's Hospital from December 2018 to November 2019 were selected as the research objects. General data questionnaire, Caregivers Burden Inventory (CBI) and Social Support Rating Scale (SSRS) were used to collect general information of caregivers, the care burden and the level of social support, Pearson correlation analysis of the correlation between care burden of the primary caregivers and social support level of young inpatients with brain tumor and use of the Logistic regression analysis to explore the influencing factors of care burden of the primary caregivers.Results:A total of 173 primary caregivers of young inpatients with brain tumor were investigated, and their CBI total score was (34.42±7.38) , which was at the medium burden level. Among them, a total of 13 (7.51%) had severe burden, 79 (45.66%) had moderate burden and 81 (46.82%) had mild burden. The total score of SSRS of caregivers was (43.61±8.46) , which was in the middle level of social support. Among them, a total of 71 (41.04%) had high level of social support, 92 (53.18%) had medium level of social support and 10 (5.78%) had low level of social support. Pearson correlation analysis showed that CBI score of caregivers was negatively correlated with SSRS score ( P< 0.05) . Logistic regression analysis showed that age, family monthly income per capita, daily care time, with or without a co-care, depression and social support level were the influencing factors of the caring burden of the caregivers of young inpatients with brain tumor ( P<0.05) . Conclusions:The primary caregivers of young patients with brain tumor generally have different levels of care burden, and their burden degree is closely related to the level of social support. Age, family monthly income per capita, daily care time, with or without a co-carer, depression and social support level are the main factors affecting the burden of caregivers. Clinical nurses should take corresponding measures for the factors affecting the care burden and relevant institutions should actively build a policy support system for the primary caregivers, so as to reduce the burden of caregivers and improve the quality of care.

Objective To explore the clinical value of serum protein kinase N1(PKN1),tumor necrosis factor receptor superfamily member 4(TNFRSF4),and DNA damage-inducible transcription factor 4(DDIT4)in predicting lymph node metastasis and prognosis of patients with endometrial cancer.Methods A total of 180 cases of endometrial cancer patients treated in Tangshan Maternal and Child Health Hospital from October 2019 to October 2021 were selected as endometrial cancer group.In addition,180 patients with benign uterine diseases treated in this hospital during the same period were selected as the benign disease group,and 180 healthy patients who underwent physical examination in this hospital were selected as the healthy group.The endometrial cancer group was divided into 42 cases with lymph node metastasis and 138 cases without lymph node metastasis according to whether lymph node metastasis occurred.The patients were divided into poor prognosis group and good prognosis group according to the follow-up results.The levels of serum PKN1,TNFRSF4 and DD1T4 in each group were compared,the influencing factors of patient prognosis were analyzed by Logistic model,and the predictive value of serum PKN1,TNFRSF4 and DDIT4 on prognosis of patients was analyzed by drawing the receiver operating characteristic curve.Results Compared with the healthy group,the levels of serum PKN1 and DDIT4 in endometrial cancer group and benign disease group were in-creased,and the levels of serum TNFRSF4 were decreased,with statistical significance(P＜0.05).The serum levels of PKN1 and DDIT4 in lymph node metastasis group were higher than those in no lymph node metasta-sis group,and the levels of TNFRSF4 were lower than those in no lymph node metastasis group,with statisti-cal significance(P＜0.05).The proportion of poor prognosis group with low differentiation degree,positive lymphovascular space invasion and myometrial infiltration≥1/2 was higher than that of good prognosis group,and the difference was statistically significant(P＜0.05).The levels of serum PKN1 and DDIT4 in the poor prognosis group were higher than those in the good prognosis group,and the levels of TNFRSF4 were lower than those in the good prognosis group,with statistical significance(P＜0.05).Serum PKN1,DDIT4,LVSI and myometrial infiltration were risk factors for the prognosis of endometrial cancer,and serum TN-FRSF4 was protective factor for the prognosis of endometrial cancer(P＜0.05).Serum PKN1,TNFRSF4 and DDIT4 combined predicted the prognosis of patients with endometrial cancer more effectively than each serum index alone(P＜0.05).Conclusion Serum PKN1,TNFRSF4 and DDIT4 are related to lymph node metasta-sis and prognosis of patients with endometrial cancer,and have high predictive efficacy for patient prognosis.

Objective To design a storage device for lymph node specimens of gynecological malignant tumors and to evaluate its application effect.Methods The specimen depository is composed of 3 parts,including storage frame,partition plate and marking plate.391 patients with gynecological malignant tumor surgeries requiring collection of retroperitoneal lymph nodes were selected in the operating room of a tertiary A hospital in Zhejiang Province from January to December 2022 in accordance with the operation schedule.They were randomly divided into an experimental group(n=196)and a control group(n=195).Patients in the experimental group used a newly developed storage device,while the control group was with traditional device.The incidence of additional verification specimens by doctors,the average time for disposing of lymph node specimens,and the job satisfaction survey of doctors and nurses were compared.Results Within a period of 12 months after utilizing this easily recognizable specimen storage device,the additional verification rate in the experimental group was 10.62％compared with the rate of 72.48％in the control group.The average time of disposing lymph node specimens was reduced from(8.3±0.9)to(5.2±0.3)minutes.Doctors and nurses in the experimental group reported a higher level of satisfaction for the specimen storage device(P＜0.05).Conclusion Utilizing the newly designed specimen storage device can help medical staff to alleviate their workload,enhance their work efficiency,raise their job satisfaction,and ensure the accuracy of pathological results.

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.