ObjectiveTo explore the changes in volatile components， total polysaccharides， enzyme activity， and chromaticity value of Myristicae Semen Koji（MSK） during the fermentation process， and conduct correlation analysis. MethodsBased on gas chromatography-mass spectrometry（GC-MS）， the changes of volatile components in MSK at different fermentation times were identified. The phenol sulfuric acid method， dinitrosalicylic acid method（DNS）， and carboxymethyl cellulose sodium salt method（CMC-Na） were used to investigate the total polysaccharide content， amylase activity， and cellulase activity during the fermentation process. Visual analysis technology was used to explore the changes in chromaticity values， revealing the fermentation process of MSK and the dynamic changes of various measurement indicators， partial least squares-discriminant analysis（PLS-DA） was used to explore the differential compounds of MSK at different fermentation degrees， and Pearson correlation analysis was used to explore the correlation between volatile components of MSK and total polysaccharides， enzyme activity， and chromaticity values. ResultsA total of 60 volatile compounds were identified from MSK， the relative contents of components such as （+）-α-pinene， β-phellandrene， β-pinene， （+）-limonene， and p-cymene obviously increased， while the relative contents of components such as safrole， methyl isoeugenol， methyleugenol， myristicin， and elemicin significantly decreased. During the fermentation process， the total polysaccharide content showed an upward trend， while the activities of amylase and cellulase showed an initial increase followed by a decrease， and reached their maximum value at 40 h. the overall brightness（L^*） and total color difference（ΔE^*） gradually increased， while the changes in red-green value（a^*） and yellow-blue value（b^*） were not obvious. PLS-DA results showed that MSK could be clearly distinguished at different fermentation times， and 13 differential biomarkers were screened out. Pearson correlation analysis results showed that the contents of α-terpinene， β-phellandrene， methyleugenol， β-cubebene and myristic acid had an obvious correlation with chromaticity values. ConclusionAfter fermentation， the volatile components， total polysaccharides， amylase activity， and cellulase activity of MSK undergo significant changes， and there is a clear correlation between them and chromaticity values， which reveals the dynamic changes in the fermentation process and related indicators of MSK， laying a foundation for the quality control.

Objective To select the appropriate batch length and quality control procedure for the blood cell analysis project of the Women and Children's Hospital of Leshan with an online calculation tool of internal quality control frequency,and explored the measurement frequency of blood cell analysis laboratory quality control. Methods The coefficient of variation of blood cell analysis internal quality control of the Women and Children's Hospital of Leshan from April to December 2023 was collected as the imprecision of the project.The results of the laboratory participating in the 2023 National Health Commission inter-laboratory quality evaluation blood count experiment were used to evaluate the bias of each item. The allowable total error (TEa) for blood cell analysis items specified in WS/T 406-2012.Data were entered into the Westgard In-House Quality Control Frequency Calculator to calculate 10 corresponding batch lengths and different candidate statistical quality control (SQC) procedures online,including multi-rule,single-rule,and quality control concentration levels from 1 to 4.Combined with the actual situation of the laboratory,the SQC program with relatively simple quality control rules and relatively long batch length was selected. Results In blood cell analysis,13s,N=2 rule was used for WBC,HGB,MCV,MCH,MCHC,PLT,corresponding to the batch length of 1000. 13s/22s/R4s,N=2 rule was used for HCT,the corresponding batch length was 563,and the quality control frequency was 1 time per day. RBC was selected 13s/22s/R4s,N=2 rule,the corresponding batch length was 151,and the quality control frequency was 2 times a day or priority was given to improving the detection performance. Conclusion The Westgard internal quality control frequency calculator is an easy-to-use tool that allows select the right batch length and SQC program for lab,which can adjust the SQC protocol to needs.

Objective To explore the effectiveness of risk assessment in the prevention and control of central line associated-bloodstream infection(CLABSI),identify high-risk departments and processes,and develop targeted measures to reduce the risk.Methods Healthcare-associated infection control risk assessment form designed by American Association for Professionals in Infection Control and Epidemiology(APIC)was applied to assess the risk factors for CLABSI in 13 intensive care units(ICUs)in a hospital.Each risk indicator was identified,analyzed,and evaluated from three dimensions:the likelihood of risk occurrence,severity of consequences,and integrity of the current management system.Results The risk assessment results found that the general ICU and respiratory ICU had extremely high risk,cardiac surgery ICU and organ transplant ICU had high risk.Through one-year continuous intervention,the incidence of CLABSI decreased significantly,the awareness rate of CLABSI prevention and control measures and the implementation rate of partial measures increased significantly(all P＜0.05).Conclusion The application of risk assessment can screen high-risk departments,focus efforts on the intervention,and enhance the effectiveness of CLABSI risk prevention and control.

Objective To select the appropriate batch length and quality control procedure for the blood cell analysis project of the Women and Children's Hospital of Leshan with an online calculation tool of internal quality control frequency,and explored the measurement frequency of blood cell analysis laboratory quality control. Methods The coefficient of variation of blood cell analysis internal quality control of the Women and Children's Hospital of Leshan from April to December 2023 was collected as the imprecision of the project.The results of the laboratory participating in the 2023 National Health Commission inter-laboratory quality evaluation blood count experiment were used to evaluate the bias of each item. The allowable total error (TEa) for blood cell analysis items specified in WS/T 406-2012.Data were entered into the Westgard In-House Quality Control Frequency Calculator to calculate 10 corresponding batch lengths and different candidate statistical quality control (SQC) procedures online,including multi-rule,single-rule,and quality control concentration levels from 1 to 4.Combined with the actual situation of the laboratory,the SQC program with relatively simple quality control rules and relatively long batch length was selected. Results In blood cell analysis,13s,N=2 rule was used for WBC,HGB,MCV,MCH,MCHC,PLT,corresponding to the batch length of 1000. 13s/22s/R4s,N=2 rule was used for HCT,the corresponding batch length was 563,and the quality control frequency was 1 time per day. RBC was selected 13s/22s/R4s,N=2 rule,the corresponding batch length was 151,and the quality control frequency was 2 times a day or priority was given to improving the detection performance. Conclusion The Westgard internal quality control frequency calculator is an easy-to-use tool that allows select the right batch length and SQC program for lab,which can adjust the SQC protocol to needs.

Objective To explore the effectiveness of risk assessment in the prevention and control of central line associated-bloodstream infection(CLABSI),identify high-risk departments and processes,and develop targeted measures to reduce the risk.Methods Healthcare-associated infection control risk assessment form designed by American Association for Professionals in Infection Control and Epidemiology(APIC)was applied to assess the risk factors for CLABSI in 13 intensive care units(ICUs)in a hospital.Each risk indicator was identified,analyzed,and evaluated from three dimensions:the likelihood of risk occurrence,severity of consequences,and integrity of the current management system.Results The risk assessment results found that the general ICU and respiratory ICU had extremely high risk,cardiac surgery ICU and organ transplant ICU had high risk.Through one-year continuous intervention,the incidence of CLABSI decreased significantly,the awareness rate of CLABSI prevention and control measures and the implementation rate of partial measures increased significantly(all P＜0.05).Conclusion The application of risk assessment can screen high-risk departments,focus efforts on the intervention,and enhance the effectiveness of CLABSI risk prevention and control.

ObjectiveTo explore the potential mechanism of different processed products of Baiyaojian and its compound Xiangmei pills in rats with ulcerative colitis（UC） by comparing the pharmacodynamic and metabolomic differences. MethodEighty SD rats were acclimatized and kept for 3 d， and randomly divided into 8 groups［blank group， model group， mesalazine group（0.4 g·kg^-1）， Baiyaojian group（1.89 g·kg^-1）， stir-fried Baiyaojian group（1.89 g·kg^-1）， carbonized Baiyaojian group（1.89 g·kg^-1）， and Xiangmei pills low and high dose groups（1.89， 5.67 g·kg^-1）］， with 10 rats in each group. Rats in the blank group were administered physiological saline by gavage， and rats in the remaining 7 groups were orally administered 5% dextran sodium sulfate（DSS） solution daily for 8 consecutive days to induce UC model. After successful modeling， each dosing group was given the corresponding dose of drug solution by gavage， and the blank and model groups were given equal amounts of saline by gavage， and the drug was administered continuously for 8 d. Then serum levels of tumor necrosis factor-α（TNF-α）， interleukin（IL）-6， IL-10 and IL-1β were measured by enzyme-linked immunosorbent assay（ELISA）， hematoxylin-eosin（HE） staining was used to observe the histopathological changes of colon tissue， the proportion of T helper 17 cells（Th17） and regulatory T cells（Treg） in the peripheral blood of rats in each group was detected by flow cytometry. The endogenous metabolites in serum of rats were detected by ultra performance liquid chromatography-quadrupole/electrostatic field orbitrap high-resolution mass spectrometry（UPLC-Q-Exactive Orbitrap MS）， and the differential metabolites were characterized by combining principal component analysis（PCA） and orthogonal partial least squares-discriminant analysis（OPLS-DA）， and were analyzed according to the variable importance in the projection（VIP） value>1.0 and P<0.05， and potential metabolic pathways were analyzed according to Human Metabolome Database（HMDB）. ResultCompared with the blank group， the colon tissue of the model group was congested and the mucosa was ulcerated， the colon length was significantly reduced（P<0.01） and the quality was significantly increased（P<0.05）， the proportion of Th17/Treg in the peripheral blood and the serum levels of TNF-α， IL-6 and IL-1β were significantly increased， while the IL-10 expression wassignificantly reduced（P<0.05， P<0.01）. Compared with the model group， the colon tissue of UC rats in each treatment group was improved with scattered ulcers， reduced inflammatory cell infiltration， significantly increased colon length， and significantly decreased mass（P<0.05）， the proportion of Th17/Treg in the peripheral blood decreased， the expression of TNF-α，IL-6 and IL-1β was significantly reduced（P<0.05， P<0.01）， while the IL-10 expression was significantly increased（P<0.01）. The therapeutic effect of different administration groups on UC was in the order of high dose group of Xiangmei pills>low dose group of Xiangmei pills>carbonized Baiyaojian group>stir-fried Baiyaojian group>Baiyaojian group. And a total of 26 differential metabolites were screened in the metabolomics results. Compared with the blank group， 14 differential metabolites were up-regulated and 5 metabolites were down-regulated in the model group， and 14， 9， 14， 12 and 17 metabolites could be recalled in the Baiyaojian group， stir-fried Baiyaojian group， carbonized Baiyaojian group， Xiangmei pills low and high dose groups. The main metabolic pathways involved were citrate cycle pathway， pantothenic acid and coenzyme A biosynthesis pathway， aromatic hydrocarbon receptor（AhR） signaling pathway， glycolysis/gluconeogenesis pathway. ConclusionThe therapeutic effect of Baiyaojian on UC is significantly improved after charcoal stir-frying， and the efficacy is more prominent when combined with Angelicae Dahuricae Radix and Mume Fructus Carbonisata， which can provide a basis for the development of Baiyaojian compound preparations.

Objective:To investigate the clinicopathological features and genetic mutation status of pulmonary intravascular large B cell lymphoma.Methods:The clinicopathological data of eight patients diagnosed with pulmonary intravascular large B cell lymphoma, from April 2018 to May 2023, were retrospectively analyzed. The genetic profile of six patients was detected via next-generation sequencing (NGS) and followed up.Results:All patients included one male and seven females, with a median age of 64 years (ranging from 45 to 66 years). Respiratory symptoms were the most common (7 cases), B symptoms in two cases, hemophagocytic syndrome in two cases. Multiple diffuse ground-glass opacities in both lungs were observed based on the high-resolution chest CT scan. Six cases of mild to moderate ventilation or diffusion dysfunction were observed based on the pulmonary function tests. Moreover, two cases of hypoxemia and two cases with type Ⅰ respiratory failure were recorded. The serum lactate dehydrogenase level increased (7/8), β2-MG level increased (2/8), neuron-specific enolase level increased (7/8), total number of peripheral blood lymphocytes decreased (7/8), and clinical stages were all stage Ⅳ. The neoplastic lymphoid cells were lodged in the lumina of venules and capillaries of the alveolar septum; the tumor cells were large, with prominent nucleoli and frequent mitotic figures. The malignant cells were detected in the extravascular surrounding lung tissue in all cases. The tumor cells expressed mature B cell-associated antigens CD20 and CD79a, and the vascular endothelial markers CD31 and CD34 showed that the tumor cells were filled in the blood vessels, infiltrated blood vessel walls, and perivascular areas. One case was germinal center-type, seven cases were non-germinal center-type, two cases were double-expressing lymphoma, and all cases were EBER-negative. Furthermore, the top five genes with mutation frequencies detected by NGS were MYD88 (5/6), PIM1 (5/6), CD79B (4/6), TCF3 (4/6), and TP53 (3/6). Of the eight cases, seven patients received R-CHOP-based chemotherapy, six cases had complete remission after chemotherapy, one case died, and one case was lost to follow-up.Conclusions:Pulmonary vascular large B cell lymphoma is rare, which shares similar patterns with interstitial lung disease on imaging. Transbronchial lung biopsy is an effective method to confirm the diagnosis. Immunochemotherapy with BTK inhibitors can provide a survival advantage for patients in the future based on molecular typing.

Objective:To explore the impact of dual coping and marital adjustment of patients with familial clustering liver cancer and their spouses on the hope levels of both partners based on the model of mutual dependence between subject and object, and to provide a theoretical basis for clinical intervention.Methods:A cross-sectional study design was adopted. From October 2022 to July 2024, a convenience sampling method was used to select 238 pairs of patients with familial clustering of liver cancer and their spouses from the hepatobiliary cancer department of Tianjin Medical University Cancer Institute and Hospital. Data were collected using general information questionnaires, Dyadic Coping Inventory, Locke-Wollance Marital Adjustment Test, and Herth Hope Scale. The AMOS 24.0 software was employed to establish a model of mutual dependence between dual coping, marital adjustment, and hope levels.Results:A total of 238 pairs of patients with familial clustering of liver cancer and their spouses were included in the study. Among the patients, 158 were male and 80 were female, aged 24-83 (51.80 ± 10.38) years. Among the spouses, 80 were male and 158 were female, aged 23-76 (52.95 ± 9.97) years. The dual coping score of patients with familial clustering liver cancer was (118.55 ± 14.04) points, marital adjustment score was (88.96 ± 19.25), and hope level score was (35.97 ± 3.29); the dual coping score of spouses was (123.64 ± 16.05), marital adjustment score was (91.36 ± 17.08), and hope level score was (36.73 ± 3.33). There was no statistically significant difference in the binary coping scores between the two ( P>0.05), while there were statistically significant differences in the scores of marital adjustment and hope level ( t = - 4.90, - 3.37, both P<0.05). The results of the model of mutual dependence showed that the dual coping of patients and spouses could positively predict their own and each other′s hope levels ( β = 0.103, 0.097, 0.088, 0.094, all P<0.05); marital adjustment of patients and spouses could positively predict their own hope levels ( β = 0.086, β = 0.091, both P<0.05), but the marital adjustment of patients could not positively predict the hope level of their spouses ( β = 0.028, P = 0.106), while the marital adjustment of spouses could positively predict the hope level of patients ( β = 0.102, P<0.05). Conclusions:The hope levels of both partners are influenced not only by their own dual coping levels but also by marital adjustment. It is suggested that nursing staff should pay attention to the interactive effects of patients′and spouses′dual coping levels and marital adjustment and actively explore interventions targeting dual coping and marital adjustment to improve the hope levels of couples.

Objective:To explore the impact of dual coping and marital adjustment of patients with familial clustering liver cancer and their spouses on the hope levels of both partners based on the model of mutual dependence between subject and object, and to provide a theoretical basis for clinical intervention.Methods:A cross-sectional study design was adopted. From October 2022 to July 2024, a convenience sampling method was used to select 238 pairs of patients with familial clustering of liver cancer and their spouses from the hepatobiliary cancer department of Tianjin Medical University Cancer Institute and Hospital. Data were collected using general information questionnaires, Dyadic Coping Inventory, Locke-Wollance Marital Adjustment Test, and Herth Hope Scale. The AMOS 24.0 software was employed to establish a model of mutual dependence between dual coping, marital adjustment, and hope levels.Results:A total of 238 pairs of patients with familial clustering of liver cancer and their spouses were included in the study. Among the patients, 158 were male and 80 were female, aged 24-83 (51.80 ± 10.38) years. Among the spouses, 80 were male and 158 were female, aged 23-76 (52.95 ± 9.97) years. The dual coping score of patients with familial clustering liver cancer was (118.55 ± 14.04) points, marital adjustment score was (88.96 ± 19.25), and hope level score was (35.97 ± 3.29); the dual coping score of spouses was (123.64 ± 16.05), marital adjustment score was (91.36 ± 17.08), and hope level score was (36.73 ± 3.33). There was no statistically significant difference in the binary coping scores between the two ( P>0.05), while there were statistically significant differences in the scores of marital adjustment and hope level ( t = - 4.90, - 3.37, both P<0.05). The results of the model of mutual dependence showed that the dual coping of patients and spouses could positively predict their own and each other′s hope levels ( β = 0.103, 0.097, 0.088, 0.094, all P<0.05); marital adjustment of patients and spouses could positively predict their own hope levels ( β = 0.086, β = 0.091, both P<0.05), but the marital adjustment of patients could not positively predict the hope level of their spouses ( β = 0.028, P = 0.106), while the marital adjustment of spouses could positively predict the hope level of patients ( β = 0.102, P<0.05). Conclusions:The hope levels of both partners are influenced not only by their own dual coping levels but also by marital adjustment. It is suggested that nursing staff should pay attention to the interactive effects of patients′and spouses′dual coping levels and marital adjustment and actively explore interventions targeting dual coping and marital adjustment to improve the hope levels of couples.

ObjectiveTo compare the effects of different processing methods in ancient and modern times on the chemical components of Lilii Bulbus decoction， and to provide experimental support for the origin processing， decoction piece processing and clinical application of this herb. MethodUltra high performance liquid chromatography tandem quadrupole electrostatic field orbitrap high resolution mass spectrometry（UHPLC-Q-Orbitrap HRMS） was used for structural identification of the compounds using excimer ions， secondary MS and characteristic fragment ions， and referring to relevant literature and database information. Principal component analysis（PCA） and orthogonal partial least squares discriminant analysis（OPLS-DA） were used to screen the main differential components， the differential components were quantitatively studied by high performance liquid chromatography（HPLC）， in order to compare the types and contents of chemical components in the decoction of different processing products of Lilii Bulbus. ResultA total of 24 chemical components were identified from the decoction of different processed products of Lilii Bulbus， water extract and scalding liquid of fresh Lilii Bulbus， including 17 phenols， 5 saponins and 2 alkaloids. Compared with the fresh Lilii Bulbus decoction， the contents of regaloside A， p-coumaric acid， colchicine and other components in the decoction of dry Lilii Bulbus processed by scalding method decreased， the content of regaloside C in the decoction of dry Lilii Bulbus processed by steaming method decreased， and the contents of regaloside A and regaloside C in the decoction of fresh Lilii Bulbus processed by water immersion also decreased. Compared with the decoction of dry Lilii Bulbus processed by scalding method， the overall content of components in the fresh Lilii Bulbus decoction and the decoction of fresh Lilii Bulbus processed by water immersion was higher， the contents of components in the decoction of dry Lilii Bulbus processed by steaming method was higher， except for the slightly lower content of regaloside C. ConclusionDifferent processing processes have a certain effect on the types and contents of chemical components in Lilii Bulbus decoction. Scalding process is beneficial to the preservation of Lilii Bulbus， but can cause the loss of effective components. Compared with scalding method， steaming method can prevent browning of Lilii Bulbus and reduce the loss of its active ingredients. The processing method of removing foam after overnight immersion proposed by ZHANG Zhongjing may be more conducive to the treatment of Baihe disease， which can provide reference for the clinical rational application and mechanism research of different processed products of Lilii Bulbus.