"Spirit turns but does not reverse； if it reverses， it ceases to turn" originates from the Plain Questions： Discussion on Essential Jade Plates （《素问·玉版论要篇》）. It profoundly summarizes the objectivity of life as a phenomenon subject to the laws of the universe and nature， while also expressing the subjectivity of individuals possessing systematic， stable， and ordered biological rhythms. In light of relevant ancient philosophical insights， the theory of "spirit turns but does not reverse； if it reverses， it ceases to turn" embodies the principles of constant motion in life， change according to dao （道）， orderly progression， and the rule that reversal disrupts continuity. In clinical diagnosis and treatment， one should adopt the therapeutic principle of regulating spirit to promote "spirit turning". Guiding along the trend and acting in accordance with the natural momentum must be adopted to maintain the operation of spirit turning. Adhering to constancy while recognizing variability， and prioritizing harmony above all， should be employed to ensure the orderly progress of spirit turning. Regulating qi movement serves as the driving force behind facilitating spirit turning. This will provide clinical insights and theoretical foundations for treating diseases through the concept of "regulating spirit".

"Spirit turns but does not reverse； if it reverses， it ceases to turn" originates from the Plain Questions： Discussion on Essential Jade Plates （《素问·玉版论要篇》）. It profoundly summarizes the objectivity of life as a phenomenon subject to the laws of the universe and nature， while also expressing the subjectivity of individuals possessing systematic， stable， and ordered biological rhythms. In light of relevant ancient philosophical insights， the theory of "spirit turns but does not reverse； if it reverses， it ceases to turn" embodies the principles of constant motion in life， change according to dao （道）， orderly progression， and the rule that reversal disrupts continuity. In clinical diagnosis and treatment， one should adopt the therapeutic principle of regulating spirit to promote "spirit turning". Guiding along the trend and acting in accordance with the natural momentum must be adopted to maintain the operation of spirit turning. Adhering to constancy while recognizing variability， and prioritizing harmony above all， should be employed to ensure the orderly progress of spirit turning. Regulating qi movement serves as the driving force behind facilitating spirit turning. This will provide clinical insights and theoretical foundations for treating diseases through the concept of "regulating spirit".

Objective:To explore the predictive value of combined evaluation of neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),and lactate dehydrogenase(LDH)on the therapeutic effect and prognosis of ICIs(immune checkpoint inhibitors)in metastatic gastric cancer(MGC)patients.Methods:This study conducted a retrospective analysis of pre-and post-treatment peripheral hematological indicators of 88 MGC patients treated at Nanping First Hospital affiliated to Fujian Medical University.The recent treatment efficacy of the two patient groups was evaluated based on the solid tumor response evaluation criteria.χ2 tests were conducted to analyze and compare differences in disease control rate(DCR)and objective response rate(ORR),as well as differences in PD-L1 expression and clinical characteristics between the two groups.Survival analysis was performed using the Kaplan-Meier method for univariate analysis.Intergroup differences were detected by the Log-Rank test.Univariate analysis was conducted using the Cox proportional hazards regression model.Results:After immunotherapy,NLR3,NLR4,PLR2,PLR3,PLR4,LDH2 and LDH3 decreased significantly compared with those before treatment(all P<0.05).There were significant statistical differences in NLR1 and LDH1 before treatment between the complete-remission(CR)+partial-remission(PR)group and the progress-disease(PD)group(all P<0.05).Patients with higher levels of NLR2,NLR3,NLR4,PLR4,LDH1,LDH3,LDH4,ΔNLR1,ΔNLR2,ΔNLR3 and ΔPLR1 had shorter OS(all P<0.05),and patients with higher levels of NLR2,NLR3,NLR4,PLR1,LDH1,ΔNLR1,ΔNLR2,ΔNLR3,Δ PLR1 and Δ PLR2 had shorter PFS compared with patients in low-level group(all P<0.05).The percentage of PD-L1 negative patients among NLR3-H patients was the highest,and the number of NLR3-H patients in the NLR3-L group was larger than that in the negative group,the combined positive score(CPS)=1-5 group and the CPS≥5 group(all P<0.05).The proportion of women in the NLR3-H and PLR3-H groups was higher(all P<0.05).Conclusion:The evaluation of NLR,PLR,and LDH has certain value in predicting the efficacy and prognosis of immunotherapy for MGC.

Objective:To explore the predictive value of combined evaluation of neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),and lactate dehydrogenase(LDH)on the therapeutic effect and prognosis of ICIs(immune checkpoint inhibitors)in metastatic gastric cancer(MGC)patients.Methods:This study conducted a retrospective analysis of pre-and post-treatment peripheral hematological indicators of 88 MGC patients treated at Nanping First Hospital affiliated to Fujian Medical University.The recent treatment efficacy of the two patient groups was evaluated based on the solid tumor response evaluation criteria.χ2 tests were conducted to analyze and compare differences in disease control rate(DCR)and objective response rate(ORR),as well as differences in PD-L1 expression and clinical characteristics between the two groups.Survival analysis was performed using the Kaplan-Meier method for univariate analysis.Intergroup differences were detected by the Log-Rank test.Univariate analysis was conducted using the Cox proportional hazards regression model.Results:After immunotherapy,NLR3,NLR4,PLR2,PLR3,PLR4,LDH2 and LDH3 decreased significantly compared with those before treatment(all P<0.05).There were significant statistical differences in NLR1 and LDH1 before treatment between the complete-remission(CR)+partial-remission(PR)group and the progress-disease(PD)group(all P<0.05).Patients with higher levels of NLR2,NLR3,NLR4,PLR4,LDH1,LDH3,LDH4,ΔNLR1,ΔNLR2,ΔNLR3 and ΔPLR1 had shorter OS(all P<0.05),and patients with higher levels of NLR2,NLR3,NLR4,PLR1,LDH1,ΔNLR1,ΔNLR2,ΔNLR3,Δ PLR1 and Δ PLR2 had shorter PFS compared with patients in low-level group(all P<0.05).The percentage of PD-L1 negative patients among NLR3-H patients was the highest,and the number of NLR3-H patients in the NLR3-L group was larger than that in the negative group,the combined positive score(CPS)=1-5 group and the CPS≥5 group(all P<0.05).The proportion of women in the NLR3-H and PLR3-H groups was higher(all P<0.05).Conclusion:The evaluation of NLR,PLR,and LDH has certain value in predicting the efficacy and prognosis of immunotherapy for MGC.

Prunellae Spica is the dry ear of the labiaceae plant Prunella vulgaris， which is a traditional medicine and food plant with many functions. Prunellae Spica can clear liver-fire， improve eyesight， disperse knot detumescence. It owns hot and bitter flavors and cold property. It goes to the liver， gallbladder meridian， and is a kind of commonly-used antifebric. Prunellae Spica has been used in the treatment of mammary gland diseases since ancient times.The mammary abscess， mammary nodules， mammary carcinoma of traditional Chinese medicine all belong to breast disease， and the liver meridian is most closely related to these diseases. With the development of social life， breast disease has gradually become the most primary health problem for women. Modern pharmacological studies show that Prunellae Spica contains terpenoids， phenolic acids， flavonoids and other biological active components， which have anti-inflammatory， antibacterial， hormone regulation， anti-tumor and other effects. Prunellae Spica inhibits the p38 mitogen-activated protein kinase （p38 MAPK）/nuclear factor kappa-B （NF-κB） pathway to play an anti-mastitis role， interferes with the effects of estrogen receptors or regulates lipid levels to treat breast hyperplasia， and treats breast cancer through promoting the apoptosis of breast cancer cells， inhibiting the migration of breast cancer cells， regulating the division of breast cancer cells and other ways. While referring to the relevant literature， it was found that Prunellae Spica often exerted pharmacological effects through multi-channels and multi-target regulation， but most of the studies did not specify the specific target of its effect， which needs further study. In this review， the effects and mechanisms of Prunellae Spica in the treatment of various breast diseases were summarized， so as to provide a reference for further research on the wider clinical therapeutic effects of Prunella subtilis and its therapeutic effects on breast diseases.

OBJECTIVE：To inv estigate the effects of 4-hydroxy-2（3H）-benzoxazolone on inflammatory and apoptosis signaling pathways in non-alcoholic fatty liver disease （NAFLD）model rats. METHODS ：SD rats were divided into normal control group（10 rats）and modeling group （50 rats）. Normal control group was given basic diet ，and modeling group were given high-fat diet to induce NAFLD model. After modeling ，the rats were divided into normal control group ，model group ，silibinin group （26.25 mg/kg），and 4-hydroxy-2（3H）-benzoxazolone high-dose ，medium-dose and low-dose groups （100，50，25 mg/kg），with 8 rats in each group. Normal control group and modeling group were given 0.6％ CMC-Na intragastrically ，and other groups were given relevant medicine 10 mL/kg intragastrically ，once a day ，for consecutive 4 weeks. After last medication ，the serum levels of albumin（ALB），total protein （TP），globulin（GLB），ALB/GLB and free fatty acid （FFA）were detected ；TUNEL staining was used to observe the apoptosis of rat hepatocytes. Western blot assay was used to detect the protein expression and phosphorylation level of inflammatory signaling pathway related proteins [Toll-like receptor 4（TLR4），myeloid differentiation factor 88（MyD88）， nuclear factor-κB p65（NF-κB p65），NF-κB inhibitor protein（IκBα）] in liver tissue as well as the expression of apoptosis signaling pathway related proteins [B cell lymphoma 2（Bcl-2），Bax，caspase-3]. RESULTS ：Compared with model group ，serum levels of TP （except for low-dose group ），GLB and FFA ，the protein expression of TLR 4（except for low-dose group ），MyD88 （except for medium-dose group ）and caspase- 3，the phosphorylation levels of NF-κB p65 and IκBα protein were decreased significantly（P＜0.05 or P＜0.01）. The ratio of A LB/GLB in serum and the ratio of Bcl- 2/Bax in liver tissue were significantly increased（P＜0.05 or P＜0.01），and the phenomenon of hepatocyte apoptosis was improved. CONCLUSIONS ：4-hydroxy-2 （3H）-benzoxazolone can ameliorate NAFLD in rats ，and the mechanism may be associated with inhibiting the expression TLR 4/ MyD88/NF-κB signaling pathway-related proteins and apoptosis-related proteins in liver tissues.

Two-dimensional code technology is widely used in daily life,and its application is relatively rare in medical education.Students organized write the Chinese and English slices' information by the way of extracurricular teaching activities,and two-dimensional code transformed from slices' information as label was pasted onto slice to made slice specimen with two-dimensional code.The students can quickly and accurately read the slice information by scanning the two-dimensional code.This practice can stimulate students' interest in learning and creative ability.It not only creates convenient conditions for the opening of the histology experiment and the independent study of the students,but also provides a way of thinking for the information management of the experimental teaching.

Objective To investigate the clinical application value of real‐time PCR in the detection of bloodstream infection pathogens .Methods A total of 92 blood samples from 80 patients in our hospital were collected for conducting real time PCR de‐tection and conventional blood culture .The sensitivity and specificity were compared between the two methods .Results Among 92 samples ,66 samples (71 .7% ) were negative in both assays .Ten different pathogens were detected by either blood culture system or real‐time PCR or by both methods .Seven positive samples were detected by both assays .The consistence of the two methods was 79 .3% .The negative predictive value of real‐time PCR was 0 .94 ,the sensitivity was 0 .64 and the specificity was 0 .82 .Among them ,15 samples were positive in real‐time PCR ,while negative in blood culture system ,4 samples were positive in the blood cul‐ture ,whereas were negative in the real‐time PCR .The pathogens cultured in 2 samples were not in the detection range of real time PCR ,moreover real time pCR could not detect Candida glabrata .Conclusion Real time PCR is a valuable method for rapidly detec‐tion the sample of bloodstream infection ,but cannot completely replace the blood culture test .

Objective To introduce the construction and clinical application of nursing assessment information model to prevent deep vein thrombosis ( DVT) . Methods The electronic nursing assessment sheet was designed and perfected, the correct rate and nursing assessment length of DVT were compared. Results After the application of DVT nursing assessment information model, the correct rate of DVT assessment increased from 80%to 98% (χ2 =49. 64,P<0. 01);the assessment length decreased from (5. 36 ± 3. 02)min to (1. 24 ± 2. 89)min (t=7. 63,P<0. 05). Conclusions The application of DVT nursing assessment information model can improve nursing staff members'work efficacy and protect patients'safety.

The tissue chip is a special tissue section,which has several tens to thousands mini tissues of regular arrangement on the one glass slide.According to the deficiencies in experimental teaching section of morphology at present,the author introduced the characteristics and values of the tissue chip and explored its application prospect in experimental teaching of morphology.