Aromatic immunity in traditional Chinese medicine(TCM) is the medical knowledge accumulated in the process of people's struggling with diseases. It plays an important role in plague prevention, disease treatment, health preservation, and rehabilitation, and has profound TCM basic theoretical support and abundant modern scientific evidence. With the in-depth promotion of the Healthy China initiative and the succession of health needs in the post-COVID-19 era, how to practice the health concept of aromatic immunity in TCM and develop its health service resources with high quality has become an important proposition to be discussed urgently. This paper summarizes the cognitive process, puts forward the basic concept, discusses the scientific connotation and clinical application value, and looks forward to the future development trend of aromatic immunity in TCM, aiming to provide guidance for the development of great health products and promote the application of aromatic immunity in TCM in serving people's health.
Medicine, Chinese Traditional/methods* ; Humans ; COVID-19/immunology* ; China ; Drugs, Chinese Herbal/therapeutic use* ; SARS-CoV-2

Objective To investigate the effects of ischemia time and storage periods on RNA quality in fresh-frozen breast cancer(BC)and esophageal cancer(EC)tissue samples in order to establish evidence-based protocols for biobank sample management.Methods The tumor(T)and paired normal(N)tissue samples from 6 cases of BC and 6 cases of EC were collected and cryopreserved in Biobank,Shantou Central Hospital.Mirror paraffin-embedded tissues were simultaneously prepared into sections for morphological analysis.The samples were divided into two groups of<15 min and 15-30 min according to ischemia time,and RNA quality was analyzed at 4 storage periods of 8-10 months(T1),14-16 months(T2),26-28 months(T3)and 38-40 months(T4).Results In 96 analyzed samples,93.8%(90/96)exhibited high quality(RIN≥6),with 89.6%(43/48)in BC and 97.9%(47/48)in EC.Significant differences in RIN were observed between BC group and EC group(8.050 vs.8.600,P=0.009).In EC group,RIN value was significantly negatively correlated with RNA yield(P<0.001).Moreover,RIN values of tumor-normal pairs exhibited markedly significant differences(7.550 vs.9.000,P<0.001).In contrast,no significant difference was detected in BC group(8.200 vs.7.700,P=0.348).Statistical analysis showed that RIN value was positively correlated with 28S/18S(P<0.001),but had no correlation with tumor content(P=0.676)and necrotic content(P=0.055).Neither ischemia time(<15 min vs.15-30 min:8.200 vs.8.300,P=0.932)nor storage periods(T1-T4:8.400,7.700,8.450,8.600,P=0.163)compromised RNA quality.Conclusion Organ origin and tissue type could influence RNA quality of fresh-frozen tissue samples.However,limited ischemia time(≤30 min)and long-term storage period(38-40 months)do not adversely affect RNA quality in fresh-frozen breast cancer and esophageal cancer tissue samples.

Objective To investigate the value of measuring optic nerve sheath diameter(ONSD)at different times after the return of spontaneous circulation(ROSC)in evaluating the neurological function prognosis of patients with cardiac arrest(CA).Methods A total of 48 patients who successfully resuscitated from CA and transferred to the ICU in Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from March 2021 to June 2024 were selected as subjects.ONSD was measured initially,12 to 24h,day 2 and day 3 after ROSC.According to the brain function score of 3 months after treatment cerebral performance categories(CPC),the patients were divided into poor neurological group(CPC 3-5 points,n=24)and neurological good group(CPC 1-2 points,n=24).The predictive value of ONSD measurements at each time for neurological outcome in CA patients was analyzed using receiver operating characteristic curves.Results There were significant difference in ONSD from 12 to 24 h,days 2 and 3 between two groups(P＜0.001),and the area under the curve were 0.785,0.837 and 0.841,respectively.Conclusion Measuring the ONSD by ultrasonography at 12-24 hours,day 2,and day 3 after ROSC in post-CA patients have good value in predicting neurologic prognosis.Measurement of ONSD on day 2 may be the optimal time to evaluate the neurological prognosis of patients after CA.

Objective To investigate the effects of ischemia time and storage periods on RNA quality in fresh-frozen breast cancer(BC)and esophageal cancer(EC)tissue samples in order to establish evidence-based protocols for biobank sample management.Methods The tumor(T)and paired normal(N)tissue samples from 6 cases of BC and 6 cases of EC were collected and cryopreserved in Biobank,Shantou Central Hospital.Mirror paraffin-embedded tissues were simultaneously prepared into sections for morphological analysis.The samples were divided into two groups of<15 min and 15-30 min according to ischemia time,and RNA quality was analyzed at 4 storage periods of 8-10 months(T1),14-16 months(T2),26-28 months(T3)and 38-40 months(T4).Results In 96 analyzed samples,93.8%(90/96)exhibited high quality(RIN≥6),with 89.6%(43/48)in BC and 97.9%(47/48)in EC.Significant differences in RIN were observed between BC group and EC group(8.050 vs.8.600,P=0.009).In EC group,RIN value was significantly negatively correlated with RNA yield(P<0.001).Moreover,RIN values of tumor-normal pairs exhibited markedly significant differences(7.550 vs.9.000,P<0.001).In contrast,no significant difference was detected in BC group(8.200 vs.7.700,P=0.348).Statistical analysis showed that RIN value was positively correlated with 28S/18S(P<0.001),but had no correlation with tumor content(P=0.676)and necrotic content(P=0.055).Neither ischemia time(<15 min vs.15-30 min:8.200 vs.8.300,P=0.932)nor storage periods(T1-T4:8.400,7.700,8.450,8.600,P=0.163)compromised RNA quality.Conclusion Organ origin and tissue type could influence RNA quality of fresh-frozen tissue samples.However,limited ischemia time(≤30 min)and long-term storage period(38-40 months)do not adversely affect RNA quality in fresh-frozen breast cancer and esophageal cancer tissue samples.

Objective To investigate the value of measuring optic nerve sheath diameter(ONSD)at different times after the return of spontaneous circulation(ROSC)in evaluating the neurological function prognosis of patients with cardiac arrest(CA).Methods A total of 48 patients who successfully resuscitated from CA and transferred to the ICU in Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine from March 2021 to June 2024 were selected as subjects.ONSD was measured initially,12 to 24h,day 2 and day 3 after ROSC.According to the brain function score of 3 months after treatment cerebral performance categories(CPC),the patients were divided into poor neurological group(CPC 3-5 points,n=24)and neurological good group(CPC 1-2 points,n=24).The predictive value of ONSD measurements at each time for neurological outcome in CA patients was analyzed using receiver operating characteristic curves.Results There were significant difference in ONSD from 12 to 24 h,days 2 and 3 between two groups(P＜0.001),and the area under the curve were 0.785,0.837 and 0.841,respectively.Conclusion Measuring the ONSD by ultrasonography at 12-24 hours,day 2,and day 3 after ROSC in post-CA patients have good value in predicting neurologic prognosis.Measurement of ONSD on day 2 may be the optimal time to evaluate the neurological prognosis of patients after CA.

Purpose: This study aims to explore whether neoadjuvant chemotherapy with immunotherapy (NACI) leads to different tumor shrinkage patterns, based on magnetic resonance imaging (MRI), compared to neoadjuvant chemotherapy (NAC) alone in patients with triple-negative breast cancer (TNBC). Additionally, the study investigates the relationship between tumor shrinkage patterns and treatment efficacy was investigated. Methods: This retrospective study included patients with TNBC patients receiving NAC or NACI from January 2019 until July 2021 at our center. Pre- and post-treatment MRI results were obtained for each patient, and tumor shrinkage patterns were classified into three categories as follows: 1) concentric shrinkage (CS); 2) diffuse decrease; and 3) no change.Tumor shrinkage patterns were compared between the NAC and NACI groups, and the relevance of the patterns to treatment efficacy was assessed. Results: Of the 99 patients, 65 received NAC and 34 received NACI. The CS pattern was observed in 53% and 20% of patients in the NAC and NACI groups, respectively. Diffuse decrease pattern was observed in 36% and 68% of patients in the NAC and NACI groups. The association between the treatment regimens (NAC and NACI) and tumor shrinkage patterns was statistically significant (p = 0.004). The postoperative pathological complete response (pCR) rate was 45% and 82% in the NAC and NACI groups (p < 0.001), respectively. In the NACI group, 17% of patients with the CS pattern and 56% of those with the diffuse decrease pattern achieved pCR (p = 0.903). All tumor shrinkage patterns were associated with achieved a high pCR rate in the NACI group. Conclusion Our study demonstrates that the diffuse decrease pattern of tumor shrinkage is more common following NACI than that following NAC. Furthermore, our findings suggest that all tumor shrinkage patterns are associated with a high pCR rate in patients with TNBC treated with NACI.

Objective     To evaluate the risk factors for postoperative in-hospital mortality in elderly patients receiving cardiac valvular surgery, and develop a new prediction models using the least absolute shrinkage and selection operator (LASSO)-logistic regression. Methods     The patients≥65 years who underwent cardiac valvular surgery from 2016 to 2018 were collected from the Chinese Cardiac Surgery Registry (CCSR). The patients who received the surgery from January 2016 to June 2018 were allocated to a training set, and the patients who received the surgery from July to December 2018 were allocated to a testing set. The risk factors for postoperative mortality were analyzed and a LASSO-logistic regression prediction model was developed and compared with the EuroSCOREⅡ. Results     A total of 7 163 patients were collected in this study, including 3 939 males and 3 224 females, with a mean age of 69.8±4.5 years. There were 5 774 patients in the training set and 1 389 patients in the testing set. Overall, the in-hospital mortality was 4.0% (290/7 163). The final LASSO-logistic regression model included 7 risk factors: age, preoperative left ventricular ejection fraction, combined coronary artery bypass grafting, creatinine clearance rate, cardiopulmonary bypass time, New York Heart Association cardiac classification. LASSO-logistic regression had a satisfying discrimination and calibration in both training [area under the curve (AUC)=0.785, 0.627] and testing cohorts (AUC=0.739, 0.642), which was superior to EuroSCOREⅡ. Conclusion     The mortality rate for elderly patients undergoing cardiac valvular surgery is relatively high. LASSO-logistic regression model can predict the risk of in-hospital mortality in elderly patients receiving cardiac valvular surgery.

Objective:To investigate the related factors of restlessness during the anesthesia recovery period in children with patent ductus arteriosus after interventional surgery.Methods:The clinical data of 92 pediatric patients with patent ductus arteriosus who underwent cardiac catheterization at Children's Hospital, Zhejiang University School of Medicine from November 2019 to October 2020 were retrospectively analyzed. These patients were divided into two groups based on the occurrence of restlessness during the anesthesia recovery period: a control group ( n = 67, without restlessness) and an observation group ( n = 25, with restlessness). Clinical data from both groups were collected and compared. Univariate and multivariate analyses were conducted to identify independent risk factors for restlessness during the anesthesia recovery period among pediatric patients with patent ductus arteriosus after interventional surgery. Results:Univariate analysis revealed no statistically significant differences in gender, age, temperament type, surgical duration, resuscitation room stay time, as well as blood pressure, heart rate, and blood oxygen saturation during the anesthesia recovery period between the two groups (all P > 0.05). However, the use of dexmedetomidine during surgery, preoperative anxiety, postoperative pain, and the use of antagonists were identified as risk factors for postoperative restlessness among pediatric patients with patent ductus arteriosus after interventional surgery χ2 = 9.03, 4.95, 5.84, 11.49, all P < 0.05). Multivariate regression analysis results further revealed that preoperative anxiety, postoperative pain, and the use of antagonists were independent risk factors for postoperative restlessness ( OR = 2.870, 4.083, 6.975, P = 0.029, 0.004, 0.002, 95% CI = 1.114-7.389, 1.555-10.722, 2.052-23.711), while intraoperative use of dexmedetomidine served as a protective factor ( OR = 0.318, P = 0.021, 95% CI = 0.120-0.839, all P < 0.05). Conclusion:The intraoperative use of dexmedetomidine, preoperative anxiety, postoperative pain, and the use of antagonists are identified as independent risk factors for postoperative restlessness in pediatric patients with patent ductus arteriosus after interventional surgery. It is crucial for clinicians to be aware of these factors and take preventive measures during the anesthesia recovery period to minimize the potential for harm resulting from postoperative restlessness.

Objectives:To evaluate and predict the risk for in-hospital mortality in elderly patients receiving cardiac valvular surgery preferably,we developed a new prediction model using machine learning. Methods:Clinical data including baseline characteristics,peri-operative data and primary endpoint of 7 163 elderly patients aged 65 years or older undergoing cardiac valvular surgery from January 2016 to December 2018 from 87 hospitals were collected from the Chinese Cardiac Surgery Registry(CCSR).Patients from January 2016 to June 2018 were assigened to the training cohort(n=5 774)and patients from July to December 2018 were assigened to the validation cohort(n=1 389).The primary endpoint was in-hospital mortality.Machine learning algorithms were used to analyze risk factors and develop prediction model. Results:Overall in-hospital mortality was 4.1%.Linear discriminant analysis(LDA),support vector classification(SVC)and logistic regression(LR)models in the training cohort all have high AUCs and low Brier scores,with good discrimination and calibration.In validation cohort,the AUC of LDA,SVC and LR were 0.744,0.744 and 0.746 respectively,which were significantly better than that of 0.642 using the European System for Cardiac Operative Risk Evaluation II(EuroSCORE II)model(P<0.05). Conclusions:The mortality rate for elderly patients undergoing cardiac valvular surgery is relatively high.LDA,SVC and LR can predict the risk for in-hospital mortality in elderly patients receiving cardiac valvular surgery with high accuracy.

Objective To investigate the impact of different infusion media on the flow rate of infusion pumps.Methods Ten infusion pumps were randomly selected and tested for infusion rates using deionized water,saline solution,glucose solution,and parenteral nutrition solution.The infusion flow rate was set at 30 mL/h,and the testing methodology conformed to the standards for the calibration and quality control of syringe pumps and infusion pumps.Results For infusion set A,the infusion rate was unaffected by the infusion media,remaining within the acceptable quality control standards.For infusion set B,when infused with deionized water,saline solution,and glucose solution,the infusion errors were within the quality control standards.However,when using parenteral nutrition solution as the infusion medium,the infusion error exceeded the acceptable quality control standards.Conclusion Both the infusion set and the infusion medium can affect the flow rate of infusion pumps.It is crucial to calibrate the flow rate according to the specific infusion medium to reduce medical risks associated with infusion pumps during clinical use.