γδ T cells possess both innate and adaptive immune characteristics. Their antigen recognition is independent of major histocompatibility complex presentation， and they can directly recognize abnormal tumor metabolism， showing unique application potential in tumors with low immune infiltration. This paper systematically sorts out the biological characteristics and antitumor immune functions of γδ T cells， and mainly reviews the relevant mechanisms by which active ingredients of traditional Chinese medicine regulate γδ T cells to exert antitumor immune functions. Glycyrrhiza polysaccharide and Astragalus polysaccharide can enhance the antitumor immune function of γδ T cells by promoting the expression of various cytokines， regulating intestinal flora and alleviating immunosuppressive state. Quercetin and puerarin can strengthen γδ T cell-mediated tumor cell killing by regulating the proliferation of γδ T cells， the expression of cytotoxic effector molecules and related signaling pathways. Toosendanin can potentiate γδ T cell-induced tumor cell killing by down-regulating the expression of anti-apoptotic protein in tumor cells. Artesunate can boost γδ T cell-mediated antitumor immune responses by enhancing the effector function of γδ T cells and weakening tumor immune escape. Future research shall focus on exploring the synergistic effects and molecular mechanisms of the combined application of active ingredients of traditional Chinese medicine and γδ T cell immunotherapy， and identifying the key targets for γδ T cells to exert antitumor immune functions.

γδ T cells possess both innate and adaptive immune characteristics. Their antigen recognition is independent of major histocompatibility complex presentation， and they can directly recognize abnormal tumor metabolism， showing unique application potential in tumors with low immune infiltration. This paper systematically sorts out the biological characteristics and antitumor immune functions of γδ T cells， and mainly reviews the relevant mechanisms by which active ingredients of traditional Chinese medicine regulate γδ T cells to exert antitumor immune functions. Glycyrrhiza polysaccharide and Astragalus polysaccharide can enhance the antitumor immune function of γδ T cells by promoting the expression of various cytokines， regulating intestinal flora and alleviating immunosuppressive state. Quercetin and puerarin can strengthen γδ T cell-mediated tumor cell killing by regulating the proliferation of γδ T cells， the expression of cytotoxic effector molecules and related signaling pathways. Toosendanin can potentiate γδ T cell-induced tumor cell killing by down-regulating the expression of anti-apoptotic protein in tumor cells. Artesunate can boost γδ T cell-mediated antitumor immune responses by enhancing the effector function of γδ T cells and weakening tumor immune escape. Future research shall focus on exploring the synergistic effects and molecular mechanisms of the combined application of active ingredients of traditional Chinese medicine and γδ T cell immunotherapy， and identifying the key targets for γδ T cells to exert antitumor immune functions.

ObjectiveTo apply and systematically evaluate the care-need grading assessment tool for adults with disabilities in welfare institutions. MethodsFrom June to July, 2025, four disability care institutions in Shanghai were selected, and a total of 1 002 adults with disabilities were assessed using the self-developed care-need grading assessment tool for adults with disabilities in welfare institutions. The application effectiveness of the tool was evaluated by analyzing the classification results of care need grading and the reclassification in grade distribution. The application validity was assessed through score differences across functional dimensions, reduced-dimension clustering scatter plots for each grade, and external variables. The application efficiency was evaluated based on the average assessment duration and learning curves. The application utility value was assessed through the distribution characteristics and mapping relationships of service lists across different grades. ResultsThe distribution across disability levels was 84 in Level 1, 298 in Level 2, 92 in Level 3, 246 in Level 4, and 282 in Level 5, indicating a trend where individuals from higher levels in the original system shifted toward the middle and lower levels of the new system. The tool demonstrated strong discriminatory power across the four functional dimensions (P < 0.001), indicating favorable discriminant validity. The five classified levels exhibited clear clustering boundaries in the reduced-dimension space, reflecting robust structural validity. The classification results were consistent with theoretical expectations regarding external variables, including age, disability type, disability grade, number of comorbidities, and primary clinical diagnoses (P < 0.05), demonstrating sound external validity. The median assessment duration was 5.80 minutes, with a significant learning effect (P = 0.037), showcasing high efficiency. Finally, service lists tailored to different care levels were developed, where service content exhibited graded differences across care levels and accurately mapped the care-need characteristics of each grade, reflecting substantial utility value. ConclusionThis tool can classify the care needs of adults with disabilities into five levels, with sound validity and high assessment efficiency; while the resulting service lists for different care levels can be used to guide practical implementation, which can be used for the graded assessment of care needs among adults with disabilities.

Objective:To investigate the use of earplugs among noise-exposed workers (Homo sapiens) in Bao'an District, Shenzhen, measure the personal attenuation rating (PAR) of earplugs when wearing earplugs, (Homo sapiens), analyze factors influencing the protective effect of earplugs, and evaluate the role of targeted wearing interventions in improving protective efficacy.Methods:From December 2022 to January 2023, 220 workers in noise-exposed positions from 3 enterprises in Bao'an District, Shenzhen were selected as subjects using the convenience sampling method. The Personal Attenuation Rating (PAR) values of workers wearing earplugs were measured using a fit testing system. Combined with the results of a questionnaire survey, the individual differences in workers' baseline PAR were described. A multivariate logistic regression model was used to analyze the influencing factors for earplugs to achieve the protective effect. One-on-one wearing interventions were implemented for workers who failed to achieve the protective effect, and repeated PAR tests were conducted. The changes in PAR of 120 workers before and after the intervention were compared.Results:The median baseline PAR for 220 workers was 7 (0, 14) dB, and the intervention rate was 54.55% (120/220). There were differences in the baseline PAR of workers with different length of service, earplugs wearing time and experience, daily noise exposure time and intensity, training and the comfort of earplug use ( P<0.05). The results of multivariate regression analysis showed that workers The comfort with earplugs wearing ( OR=2.81, 95% CI: 1.49~5.33, P<0.01) and training ( OR=6.60, 95% CI: 1.70~25.63, P<0.05) were the influencing factors of achieving the protective requirement. The median PAR was increased to 13 (11, 16) dB after intervention. Conclusion:The baseline protective effect of earplugs worn by workers is significantly influenced by comfort and enterprise training. One-on-one interventions can effectively improve the protective efficacy of those who fail to meet the requirements.

Medical experts across different dynasties have interpreted the phrase"heavy abdomen as if carrying a load of five thousand coins,"found in the Synopsis of Golden Chamber,in various ways.The primary viewpoint is that the phrase uses exaggerated rhetoric to vividly describe the clinical characteristics of abdominal or low back heaviness in patients with kidney stagnation.However,why ZHANG Zhongjing used"money"as a metaphor,what specific type of coins"money"referred to,why the quantity"five thousand"was selected,and whether this description focused more on the weight or the shape,have not been further discussed by the academic community.This article systematically answers these questions based on the history of the development of ancient Chinese coins,the versions of the Synopsis of the Golden Chamber,and its annotations.Using the metaphor of"five thousand coins"for feeling heavy in the abdomen originates from the ancient people′s general understanding of money.The money in"five thousand coins"specifically refers to the wu zhu qian of the Han Dynasty,and the amount of"five thousand coins"is the savings of common people′s families at that time,and has universal reference significance."Five thousand coins"emphasizes the weight of"five thousand coins"rather than its shape.This study provides a novel perspective and theoretical basis for understanding the original text of the Synopsis of Golden Chamber.

Medical experts across different dynasties have interpreted the phrase"heavy abdomen as if carrying a load of five thousand coins,"found in the Synopsis of Golden Chamber,in various ways.The primary viewpoint is that the phrase uses exaggerated rhetoric to vividly describe the clinical characteristics of abdominal or low back heaviness in patients with kidney stagnation.However,why ZHANG Zhongjing used"money"as a metaphor,what specific type of coins"money"referred to,why the quantity"five thousand"was selected,and whether this description focused more on the weight or the shape,have not been further discussed by the academic community.This article systematically answers these questions based on the history of the development of ancient Chinese coins,the versions of the Synopsis of the Golden Chamber,and its annotations.Using the metaphor of"five thousand coins"for feeling heavy in the abdomen originates from the ancient people′s general understanding of money.The money in"five thousand coins"specifically refers to the wu zhu qian of the Han Dynasty,and the amount of"five thousand coins"is the savings of common people′s families at that time,and has universal reference significance."Five thousand coins"emphasizes the weight of"five thousand coins"rather than its shape.This study provides a novel perspective and theoretical basis for understanding the original text of the Synopsis of Golden Chamber.

Objective:To report the nationwide surveillance results of pathogenic profiles and antimicrobial resistance patterns of Gram-positive bloodstream infections in China in 2023.Methods:The clinical isolates of Gram-posttive bacteria from blood cultures were collected in member hospitals of National Bloodstream Infection Bacterial Resistant Investigation Collaborative System（BRICS）during January to December 2023. Antimicrobial susceptibility testing was performed using the dilution method recommended by the Clinical and Laboratory Standards Institute（CLSI）. Statistical analyses were conducted using WHONET 5.6 and SPSS 25.0 software.Results:A total of 4 385 Gram-positive bacterial isolates were obtained from 60 participating center. The top five pathogens were Staphylococcus aureus（ n=1 544，35.2%），coagulase-negative Staphylococci（ n=1 441，32.9%）， Enterococcus faecium（ n=574，13.1%）， Enterococcus faecalis（ n=385，8.8%），and α-hemolytic Streptococci（ n=187，4.3%）. The prevalence of methicillin-resistant Staphylococcus aureus（MRSA）and methicillin-resistant coagulase-negative Staphylococci（MRCNS）was 26.2%（405/1 544）and 69.8%（1 006/1 441），respectively. Notably，all Staphylococci remained susceptible to glycopeptide or daptomycin. Staphylococcus aureus demonstrated excellent susceptibility（>97.0%）to cephalobiol，rifampicin，trimethoprim-sulfamethoxazole，linezolid，minocycline，tigecycline，and eravacycline. No Enterococcus exhibiting resistance to linezolid were detected. Glycopeptide resistance was uncommon but more frequent in Enterococcus faecium（resistance to vancomycin and teicoplanin：both 1.7%）compared to Enterococcus faecalis（both 0.3%）. The detection rates of MRSA and MRCNS exhibited significant regional variations across the country（ χ2=17.674 and 148.650，respectively，both P<0.001）. No vancomycin-resistant Enterococci were detected in central China. Institutional comparison demonstrated higher prevalence of MRSA（ χ2=14.111， P<0.001）and MRCNS（ χ2=4.828， P=0.028）in provincial hospitals than that in municipal hospitals. Socioeconomic analysis identified elevated detection rates of both MRSA（ χ2=18.986， P<0.001）and MRCNS（ χ2=4.477， P=0.034）in less developed regions（per capita GDP

Objective:To report the results of bacterial resistant investigation collaborative system（BRICS）on the distribution and antimicrobial resistance profile of clinical Gram-negative bacteria isolates from bloodstream infections in China in 2023，and provide reference for clinical tretment of bloodstream infections and prevention and control of bacterial resistance.Methods:The clinical isolates of Gram-negative bacteria from blood cultures in member hospitals of BRICS were collected during January 2023 to December 2023. Antibiotic susceptibility tests were conducted by agar dilution or broth dilution methods recommended by Clinical and Laboratory Standards Institute（CLSI）. WHONET 5.6 and SPSS 25.0 were used to analyze the data.Results:During the study period，11 492 strains of Gram-negative bacteria were collected from 60 hospitals，of which 10 098（87.9%）were Enterobacterales and 1 394（12.1%）were non-fermentative bacteria. The top 5 bacterial species were Escherichia coli（50.0%）， Klebsiella pneumoniae（26.1%）， Pseudomonas aeruginosa（5.1%）， Acinetobacter baumannii complex（5.0%）and Enterobacter cloacae complex（4.1%）. The ESBL-producing rates in Escherichia coli， Klebsiella pneumoniae and Proteus mirablilis were 46.8%（2 685/5 741），18.3%（549/2 999）and 44.0%（77/175），respectively. The prevalence of carbapenem-resistant Escherichia coli（CREC）and carbapenem-resistant Klebsiella pneumoniae（CRKP）were 1.3%（76/5 741）and 15.0%（450/2 999）；32.9%（25/76）and 78.0%（351/450）of CREC and CRKP were sensitive to ceftazidime/avibactam combination，respectively. 94.7%（72/76）and 90.2%（406/450）of CREC and CRKP were sensitive to aztreonam/avibactam combination. Furthermore，57.9%（44/76）and 79.1%（356/450）were sensitive to imipenem/relebactam combination. The prevalence of carbapenem-resistant Acinetobacter baumannii（CRAB）complex was 64.6%（370/573），while more than 80.0% of CRAB complex was sensitive to tigecycline，eravacycline and polymyxin B. The prevalence of carbapenem-resistant Pseudomonas aeruginosa（CRPA）was 17.0%（99/581）. There were differences in the composition ratio of Gram-negative bacteria in bloodstream infections and the prevalence of important Gram-negative bacteria resistance among different regions in China，with statistically significant differences in the prevalence of CREC，CRKP，CRPA and CRAB complex（ χ2=10.6，28.6，10.8 and 19.3， P<0.05）. The prevalence of ESBL-producing Escherichia coli， CREC，CRAB complex and CRKP were higher in provincial hospitals than those in municipal hospitals（ χ2=12.5，9.8，12.7 and 57.8，all P<0.01）. Conclusions:Gram-negative bacteria are the main pathogens causing bloodstream infections in China，and Escherichia coli is ranked in the top，while the trend of Klebsiella pneumoniae increases continuously with time. CRKP infection shows a slow upward trend，CREC infecton maintains a low prevalence level，and CRAB complex infection continues to exhibit a high prevalence rate. The composition and resistance patterns of pathogens causing bloodstream infections vary to some extent across different regions and levels of hospitals in China.

Objective This study aims to investigate the work fatigue risks of clinical nursing staff in a tertiary hospital in Xingguo County and analyze the influencing factors,providing a reference for formulating scientific work processes and systems and improving nursing quality.Methods A convenience sampling was conducted to select 179 clinical nurses from a tertiary hos-pital in Xingguo County from March to April 2025.A self-designed general information questionnaire,a clinical nursing staff work fatigue risk assessment questionnaire,and the nurse work stressor scale were used for the investigation.Univariate and multiple linear regression analyses were conducted to identify the influencing factors of work fatigue risks.Results A total of 186 ques-tionnaires were distributed,with 7 excluded as invalid and 179 valid responses(96.24％).The work fatigue risk assessment score of the 179 clinical nurses was(84.39±10.26),indicating a relatively high level of fatigue.There were significant differ-ences in work fatigue risk scores across genders,weekly working hours,years of work experience,contract types,and work stress levels(P＜0.05).Multiple linear regression analysis showed that gender(B=0.624,95％CI=0.194～1.054),weekly work-ing hours(B=0.037,95％CI=0.067～0.007),years of work experience(B=0.028,95％CI=0.010～0.046),contract type(B=-0.517,95％CI=-0.997～-0.037),and work stress(B=0.127,95％CI=0.050～0.204)were the influen-cing factors of work fatigue risks(P＜0.05).Conclusion The work fatigue risks of clinical nursing staff in a tertiary hospital in Xingguo County are at a relatively high level.Gender,weekly working hours,years of work experience,contract type,and work stress are the main influencing factors.Nursing managers should pay attention to these factors and take targeted measures to inter-vene and reduce the work fatigue risks of nursing staff.

Objective To conduct a scoping review of the current state of research on the application of virtual reality technology in psychological interventions for cancer patients,clarifying its types,forms,contents,intervention effects,and outcome indicators,and to provide the improvement of mental health in cancer patients.Methods A literature search was conducted on PubMed,Embase,Web of Science,Scopus,Cochrane Library,China National Knowledge Infrastructure,and Wanfang Data up to October 11,2023.The selected literature was screened,included,and analyzed for content summary.Results A total of 22 studies were included,involving both non-immersive and immersive virtual reality technologies,with various systems or programs used for intervention.The primary interventions include virtual reality relaxation therapy,virtual reality exposure therapy,and virtual reality reminiscence therapy.The outcome indicators primarily include anxiety,depression,distress,pain,fatigue,sleep,quality of life,coping,and side effects of virtual reality.Conclusion The use of virtual reality technology for psychological interventions in cancer patients offers a variety of forms and rich content,which has a positive impact on improving the physical and mental health of cancer patients.However,there is significant heterogeneity in the content elements and outcome measure tools,leading to certain limitations in its application.In the future,the specific needs of cancer patients should be considered,and the procedural norms for virtual reality-based psychological interventions should be explored.