Objective To systematically explore the prescription source,prescription composition,drug origin and processing,functional indications and clinical application of the classic Tibetan medicine Sanwei Qiangwei Powder,so as to provide scientific basis for its in-depth development,rational utilization and follow-up research.Methods By using methods of literature review,the ancient and modern Tibetan medical classics and modern literature such as'Ocha Jinmai' sporadic secret collection 'Zhigong Yi Suan Ji' were retrieved,and the prescription origin,medicinal material origin,processing technology,prescription solution,usage and dosage were studied and analyzed.Results The Sanwei Qiangwei Powder originated from the 'Ocha Jinmai'(《()》)written by Qiangba Minimatongwatundan in the 15th century.The book was written much earlier than the literature included in the 'Catalogue of Ancient Classic Prescriptions(Second Batch)'-the 'Selection of Tibetan Medicine Prescriptions·Longevity Baoru' in the 19th century.The prescription consists of 15 copies of Rosa rugosa,7 copies of Herpetospermum caudigerum,and 3 copies of Terminalia chebula Retz.It plays a significant effect on hepatobiliary diseases such as biliary fever,liver fever,primary headache,and headache after drinking in clinical practice.It is the core prescription for the treatment of Chiba-type diseases and has high development value.There are differences in the use site,dosage ratio,usage and dosage of medicinal materials in different literatures,and the dosage has been clarified by textual research and expert consultation.Conclusion This study sorted out and clarified the key information of Sanwei Qiangwei Powder,which laid a theoretical foundation for the inheritance and development,innovative application and modernization research of the prescription.

Objective To systematically explore the prescription source,prescription composition,drug origin and processing,functional indications and clinical application of the classic Tibetan medicine Sanwei Qiangwei Powder,so as to provide scientific basis for its in-depth development,rational utilization and follow-up research.Methods By using methods of literature review,the ancient and modern Tibetan medical classics and modern literature such as'Ocha Jinmai' sporadic secret collection 'Zhigong Yi Suan Ji' were retrieved,and the prescription origin,medicinal material origin,processing technology,prescription solution,usage and dosage were studied and analyzed.Results The Sanwei Qiangwei Powder originated from the 'Ocha Jinmai'(《()》)written by Qiangba Minimatongwatundan in the 15th century.The book was written much earlier than the literature included in the 'Catalogue of Ancient Classic Prescriptions(Second Batch)'-the 'Selection of Tibetan Medicine Prescriptions·Longevity Baoru' in the 19th century.The prescription consists of 15 copies of Rosa rugosa,7 copies of Herpetospermum caudigerum,and 3 copies of Terminalia chebula Retz.It plays a significant effect on hepatobiliary diseases such as biliary fever,liver fever,primary headache,and headache after drinking in clinical practice.It is the core prescription for the treatment of Chiba-type diseases and has high development value.There are differences in the use site,dosage ratio,usage and dosage of medicinal materials in different literatures,and the dosage has been clarified by textual research and expert consultation.Conclusion This study sorted out and clarified the key information of Sanwei Qiangwei Powder,which laid a theoretical foundation for the inheritance and development,innovative application and modernization research of the prescription.

Objective To track and evaluate the implementation of the Radiation Shielding Requirements in Room of Radiotherapy Installations—Part 1: General Principle (GBZ/T 201.1–2007) among relevant personnel in medical radiation institutions, and to provide a scientific basis for revising the standard. Methods According to the Guidelines for Health Standards Tracking Evaluation (WS/T 536–2017) and the implementation protocol of standard evaluation, an online survey was conducted among 212 relevant workers from 146 medical radiation institutions across 18 provinces in China. The data were aggregated and analyzed with the use of Microsoft Excel 2010. Results A total of 215 questionnaires were returned, of which 212 were valid. Among the valid respondents, 77.8% believe that this standard is universally applied; 96.2% believe that this standard can meet work needs; 63.7% have participated in relevant training on this standard; 74.1% use this standard once or more per year; and 10.8% believe that this standard needs to be revised. Conclusion Medial radiation workers have a high rate of awareness of the basic information and content of the standard, but the understanding and application of the standard content need to be improved. We recommend that relevant departments further strengthen the promotion of and training on the standard, revise some content based on actual situation, and improve workers’ ability to use the standard.

Traditional antibody drug conjugates(ADC)combine monoclonal antibodies with cytotoxic drugs to accurately strike cancer cells,but there are still many shortcomings in stability,targeting,efficacy,and safety.Novel ADC,such as bi-specific,site-specific,dual-payload,and pro-drug type ADC,can be optimized by simultaneously binding 2 different antigens or epitopes,selecting more stable linkers,coupling with specific amino acid sites of antibodies,carrying different drug payloads,and adopting prodrug strategies,while retaining the characteristics of traditional ADC.Significantly improving the stability,targeting,efficacy and safety of drugs can better meet the needs of clinical treatment.Novel ADC will play a more important role in cancer treatment in the future.Discussing the progress of novel ADC in cancer treatment and analyzing their advantages and challenges can provide theoretical support for the development of anti-cancer strategies and provide directions for drug research and development.

Although immunotherapy has made a breakthrough in the treatment of cancer,the emergence of drug resistance has limited be-nefits in most patients,and reversing immunotherapy resistance remains a hotly debated and unresolved issue.The tumor microenviron-ment(TME)comprises a large number of T lymphocytes.During the biological processes of proliferation,activation,and the effect of tumor-infiltrating lymphocytes(TILs),TILs face severe local metabolic stress,resulting in metabolic reprogramming to meet the markedly increased energy demand and biosynthesis requirements.This process of adaptive changes in the metabolic pattern is closely related to the pheno-type and function of TILs,affecting immunotherapy efficacy and mediating immunotherapy resistance.In recent years,with the study of TIL metabolism and the search for specific metabolic regulatory points,targeting the TIL metabolic pathway could restore the tumor-killing func-tion and reverse immunotherapy resistance.This review explores the relationship between the metabolic reprogramming of TILs and im-mune resistance,and provides a new strategy for reversing immune resistance.

Insomnia is an important problem facing the global public health field,presenting high morbidity and low treatment efficiency,while Tibetan medicine has rich clinical experience in treating insomnia,showing certain regional characteristics.The article adopts the method of documentary evidence to trace and analyse the diagnosis and treatment theories of Tibetan doctors on insomnia through the ages,It was found that due to three functional disorders,Bacon's inability to concentrate on the heart was the main pathogenesis of the disease,and divides into Tsh yer,Grng yer,and Gdon yer,three mainstream types of evidence.The treatment method adopted the traditional"quadruple"therapy of Tibetan medicine and carried out step treatment or comprehensive conditioning.To achieve three factors of balance,awakening and sleep in tune with the state.The article provides theoretical references to promote the standardization of the clinical diagnosis and treatment application of insomnia in Tibetan medicine and to promote the diversification of the insomnia treatment field.

Insomnia is an important problem facing the global public health field,presenting high morbidity and low treatment efficiency,while Tibetan medicine has rich clinical experience in treating insomnia,showing certain regional characteristics.The article adopts the method of documentary evidence to trace and analyse the diagnosis and treatment theories of Tibetan doctors on insomnia through the ages,It was found that due to three functional disorders,Bacon's inability to concentrate on the heart was the main pathogenesis of the disease,and divides into Tsh yer,Grng yer,and Gdon yer,three mainstream types of evidence.The treatment method adopted the traditional"quadruple"therapy of Tibetan medicine and carried out step treatment or comprehensive conditioning.To achieve three factors of balance,awakening and sleep in tune with the state.The article provides theoretical references to promote the standardization of the clinical diagnosis and treatment application of insomnia in Tibetan medicine and to promote the diversification of the insomnia treatment field.

Objective:To explore the diagnosis, surgical methods and therapeutic effect of primary duodenal malignant tumor.Methods:The clinical data of 116 patients with primary duodenal malignant tumor from January 2010 to December 2018 were retrospectively analyzed.Results:Among 116 patients, adenocarcinoma was in 74 cases, interstitial tumor was in 25 cases, carcinoid was in 9 cases, the others was in 8 cases. Before operation, duodenoscopy was performed in 107 cases, and CT examination was performed in 76 cases. There were 57 cases of pancreaticoduodenectomy, 15 cases of duodenal segmental resection, 13 cases of subtotal gastrectomy and duodenal bulbar resection, 13 cases of duodenal partial resection, and 18 cases of palliative short circuit operation. The total incidence of postoperative complication was 31.9% (37/116), including pancreatic fistula in 8 cases (grade B 5 cases, grade C 3 cases), biliary fistula in 6 cases, abdominal infection in 5 cases, pulmonary infection in 4 cases, intestinal fistula in 3 cases, delayed gastric emptying in 3 cases, and hemorrhage in 8 cases. Four cases (3.4%) died during the perioperative period. Single factor Cox regression analysis result showed that the postoperative survival time was related to the tumor differentiation degree, operation method, tumor infiltration degree and lymphatic metastasis ( P<0.05 or <0.01); multi-factor Cox regression analysis results showed that the operation method, tumor infiltration degree and lymphatic metastasis were the independent risk factors for the postoperative survival time of patients with primary duodenal malignant tumor ( P<0.05). The patients were followed up until June 2021, and 9 cases were lost to follow-up. Kaplan-Meier survival curve analysis result showed that the postoperative overall 1-,3- and 5-year survival rates were 82.11%, 57.56% and 33.11%, respectively. Conclusions:Adenocarcinoma is the main primary malignant tumor of duodenum. Duodenoscopy and CT are the main examination methods. Radical resection is the most effective treatment for primary duodenal malignant tumor, and pancreaticoduodenectomy is the first choice. Surgical method, tumor infiltration degree and lymphatic metastasis are the independent risk factors affecting the prognosis of patients.

Objective To improve the diagnosis and treatment of infective endocardits(IE)by exploring the causes,pathogenic microorganism,clinical characteristics and therapeutic results of patients with IE.Methods From January 2006 to January 2016,89 cases with IE in Ganzhou People's Hospital were collected,and the clinical charac-teristics were analyzed retrospectively.Results Among the IE patients,40.5%had congenital heart diseases,33.7%had rheumatic heart diseases,18.0% were post－PCI or operative endocarditis,and patients without basic cardiac diseases accounted for 7.9%.The most common clinical manifestations were fever (86.5%),followed by anemia (85.4%).The blood culture positive rate was 63.4%.Streptococci viridians were the most common causative organ-isms(44.2%),followed by coagulase －negative staphylococci(21.2%).Eighty－six patients received echocardio-graphy examination,vegetation was observed in 61cases (68.5%).The hospital mortality rate was 10.1%,mostly due to refractory congestive heart failure and sepsis.Conclusion Congenital heart disease showed an upward trend, rheumatic heart disease decreased significantly.Intermittent fever,anemia are the main clinical manifestations.Blood culture positive rate is not high,Streptococcus viridians is the most common causative organism.Echocardiography is the main basis for the diagnosis.

OBJECTIVE:To investigate the clinical characteristics and rules of allergic reaction caused by anti-copper treat-ment with Sodium dimercaptoproane sulfonate(DMPS)injection,and to provide reference for diagnosis,treatment and monitoring of drug-induced allergic reaction. METHODS:By using retrospective analysis,allergic reaction reports of DMPS injection were se-lected from our hospital during Jan. 2013-Dec. 2015 were analyzed statistically. RESULTS:A total of 131 cases of allergic reaction were reported. The average age of the patients was(23.26±9.63)years old,mainly concentrated on 10-39 years old(87.79%). Al-lergic reaction mainly occurred in the first and second courses of treatment,accounting for 71.76%. For systems-organs involved, skin and its appendages disorders had the highest proportion (85.90%),being mainly the lesion of limbs (27.45%) and body (22.22%) involved;followed by systemic damage (12.33%). Clinical manifestations of systemic impairment were mainly fever, with rash or itching at the same time frequently. 131 patients had good outcome after treatment. The symptoms of 115 patients (87.79%)disappeared in 7 d. Serious cases accounted for 25.19%. The proportion of drug allergy history,the rate of anti-copper treatment failure with allergy prevention or desensitization therapy,and symptom duration in patients with severe ADR were higher or longer than that in general ADR cases,the difference was statistically significant(P<0.05). CONCLUSIONS:The allergic reac-tion of DMPS injection increased the difficulty of anti-copper treatment. ADR monitoring should be strengthened in the process of using DMPS,specially for the history of allergies and the first,second treatment courses of patients.