[摘 要] 目的：探索性临床试验初步观察PD-1抑制剂联合脐血NK细胞治疗晚期恶性实体瘤的安全性与疗效。方法：研究对象为2019年12月至2021年12月西安医学院第二附属医院收治的3例晚期实体瘤患者，依据肿瘤类型、参照CSCO指南，采用标准化疗、靶向治疗或贝伐珠单抗联合PD-1抑制剂进行21 d为一疗程的多疗程治疗，期间适时进行脐血NK细胞输注治疗（8 × 107个/次）。每个治疗周期均检测患者靶病灶大小、肿瘤标志物水平、外周血中12种细胞因子水平及淋巴细胞亚群情况，同时评估患者不良反应发生情况。结果：3例患者经PD-1抑制剂联合脐血NK细胞治疗后，2例患者达到疾病稳定（SD；依照RECIST 1.1），其中1例患者持续118 d，另1例患者持续92 d。在NK细胞输注治疗后，患者1肿瘤标志物CA199显著下降到正常值范围内并维持3个随访期，患者2肿瘤标志物CA199、CA242和CA724均出现显著下降。结论：NK细胞与化疗和PD-1抑制剂联合治疗实体瘤具有一定的疗效，本研究中3例患者未出现严重免疫相关不良反应。

OBJECTIVE To explore the self precipitation source of Erhuang powder, determine the content of related components and its efficacy on HeLa cells. METHODS Bifurcation study to identify the main compatibility of precipitating. The self precipitation, supernatant and extract of Erhuang powder were analyzed by UHPLC-Q-Exactive MS. The main compounds in Coptidis Rhizoma and Catechu, catechin, epicatechin, epicberberine, coptisine, berberine and palmatine were selected as controls. A analysis method of UHPLC for self precipitation, supernatant and extract of Erhuang powder was established and the related components were quantitatively determined. The effects of self precipitation, supernatant and extract on HeLa cells were evaluated by MTT method and flow cytometry. RESULTS A slight flocculation precipitate appeared when the decoction of Erhuang powder was mixed in pairs, while a large amount of flocculation appeared when the decoction of Coptidis Rhizoma and Catechu water was mixed. The self precipitation, supernatant and extract samples contained 39 compounds, which were mainly alkaloids and phenolic acids. The contents of catechin and berberine in the 6 index components were mostly, which accounted for 73.56% of the total content of the index components in self precipitation and 61.89% of the total content of the index components in extract. Inhibition effect on HeLa cells: extract ≈ self precipitation > supernatant, and inducing apoptosis: self precipitate ≈ extract, supernatant had no apoptosis-inducing effect. CONCLUSION Coptidis Rhizoma-Catechu is the main compatible formula for precipitation formation. The self precipitation and extracts of Erhuang powder are mainly alkaloids and phenolic acids, among which berberine and catechin are high in content and can be used as representative components. The effect of self-precipitation and extract on HeLa cells was better than that of supernatant. This basically indicates that the self precipitation components and pharmacological effects of Erhuang powder are similar to those of the extract.

Objective:To retrieve, evaluate and integrate the evidence related to the preparation process for initiating extracorporeal cardiopulmonary resuscitation in hospital, so as to provide reference for clinical implementation of extracorporeal cardiopulmonary resuscitation.Methods:According to the evidence-based nursing method and the 6S evidence model, guidelines, clinical decisions, expert consensus, systematic review and other literatures related to the preparation process for initiating extracorporeal cardiopulmonary resuscitation in hospital were searched from National Guideline Clearinghouse, Scottish Intercollegiate Guidelines Network, National Institute for Health and Care Excellence, and other websites, UpToDate, The Cochrane Library, PubMed, Embase, CNKI, Wanfang and other databases. The retrieval date limit was from the establishment of the database to May 20, 2023. Researchers assessed the quality of the included articles, and extracted and summarized the evidence that met the quality standards.Results:A total of 11 articles were included, including 2 guidelines, 6 expert consensuses, 1 systematic review and 2 quasi-experimental studies. A total of 18 pieces of evidences were summarized from 6 aspects, including medical conditions, team building, materials management, operation mechanism, pre-initiating treatment and initiating judgment.Conclusions:This study summarizes the evidence of preparation process for initiating extracorporeal cardiopulmonary resuscitation in hospital, which can provide reference for promoting the implementation of extracorporeal cardiopulmonary resuscitation. Future studies still need to focus on team building, personnel training and assessment, and optimisation of the management system, so as to improve the efficiency and readiness of treatment.

With the increasing prevalence of total knee arthroplasty (TKA), there is a corresponding rise in the number of patients requiring revision of total knee arthroplasty (R-TKA) for various reasons. R-TKA presents several complex challenges, with severe bone defect reconstruction being a critical obstacle to securing favorable long-term outcomes. Recently, the approach to managing bone defects has seen significant advancements, with a range of techniques proposed contingent on the defect's size and location. Severe bone defects require reconstruction with autologous or allogeneic bone grafts or metal fillers. However, bone grafts have their usage constrained by limited availability, risks of resorption and collapse, and the potential for disease transmission. Consequently, metal fillers have received widespread attention in practical applications due to their advantages, such as comprehensive source, customizability, and safety. The advantages of metal augment are that they provide immediate support without reinforcement and are not subject to necrosis and resorptive collapse. However, the difference in elastic modulus between metal and bone may lead to stress shielding and increase the risk of potential bone loss. Both Cone and Sleeve can achieve biological fixation of metaphyseal bone; however, in cases of periprosthetic infections, it is generally difficult to remove them easily due to the prosthetic bone in-growth and osseointegration. This study aims to provide a comprehensive review of the use of metal fillers to reconstruct bone defects during R-TKA. It is intended to aid orthopedic surgeons in understanding the spectrum of reconstructive possibilities and provide high-performance revision strategies for their patients.

Traditional Chinese medicine,ancient Greek medicine,Ayurvedic medicine,and Arab medicine are recognized as the four major traditional medicines in the world.It reviews the education and training systems of the four major traditional medicines and finds that traditional Chinese medicine focuses on the teacher-student relation-ship and the combination of theory and practice;Ancient Greek medicine was mainly characterized by strong theoreti-cal research and experimental observation;Ayurveda highly values cultural identity as its main characteristic;Arab medicine attaches great importance to cultural exchange and practical promotion.It suggests promoting innovative de-velopment,strengthening practical teaching,improving teaching quality,strengthening international exchanges and cooperation,and increasing public acceptance abroad.

Traditional Chinese medicine,ancient Greek medicine,Ayurvedic medicine,and Arab medicine are recognized as the four major traditional medicines in the world.It reviews the education and training systems of the four major traditional medicines and finds that traditional Chinese medicine focuses on the teacher-student relation-ship and the combination of theory and practice;Ancient Greek medicine was mainly characterized by strong theoreti-cal research and experimental observation;Ayurveda highly values cultural identity as its main characteristic;Arab medicine attaches great importance to cultural exchange and practical promotion.It suggests promoting innovative de-velopment,strengthening practical teaching,improving teaching quality,strengthening international exchanges and cooperation,and increasing public acceptance abroad.

Traditional Chinese medicine,ancient Greek medicine,Ayurvedic medicine,and Arab medicine are recognized as the four major traditional medicines in the world.It reviews the education and training systems of the four major traditional medicines and finds that traditional Chinese medicine focuses on the teacher-student relation-ship and the combination of theory and practice;Ancient Greek medicine was mainly characterized by strong theoreti-cal research and experimental observation;Ayurveda highly values cultural identity as its main characteristic;Arab medicine attaches great importance to cultural exchange and practical promotion.It suggests promoting innovative de-velopment,strengthening practical teaching,improving teaching quality,strengthening international exchanges and cooperation,and increasing public acceptance abroad.

Traditional Chinese medicine,ancient Greek medicine,Ayurvedic medicine,and Arab medicine are recognized as the four major traditional medicines in the world.It reviews the education and training systems of the four major traditional medicines and finds that traditional Chinese medicine focuses on the teacher-student relation-ship and the combination of theory and practice;Ancient Greek medicine was mainly characterized by strong theoreti-cal research and experimental observation;Ayurveda highly values cultural identity as its main characteristic;Arab medicine attaches great importance to cultural exchange and practical promotion.It suggests promoting innovative de-velopment,strengthening practical teaching,improving teaching quality,strengthening international exchanges and cooperation,and increasing public acceptance abroad.

Traditional Chinese medicine,ancient Greek medicine,Ayurvedic medicine,and Arab medicine are recognized as the four major traditional medicines in the world.It reviews the education and training systems of the four major traditional medicines and finds that traditional Chinese medicine focuses on the teacher-student relation-ship and the combination of theory and practice;Ancient Greek medicine was mainly characterized by strong theoreti-cal research and experimental observation;Ayurveda highly values cultural identity as its main characteristic;Arab medicine attaches great importance to cultural exchange and practical promotion.It suggests promoting innovative de-velopment,strengthening practical teaching,improving teaching quality,strengthening international exchanges and cooperation,and increasing public acceptance abroad.

Traditional Chinese medicine,ancient Greek medicine,Ayurvedic medicine,and Arab medicine are recognized as the four major traditional medicines in the world.It reviews the education and training systems of the four major traditional medicines and finds that traditional Chinese medicine focuses on the teacher-student relation-ship and the combination of theory and practice;Ancient Greek medicine was mainly characterized by strong theoreti-cal research and experimental observation;Ayurveda highly values cultural identity as its main characteristic;Arab medicine attaches great importance to cultural exchange and practical promotion.It suggests promoting innovative de-velopment,strengthening practical teaching,improving teaching quality,strengthening international exchanges and cooperation,and increasing public acceptance abroad.