Chronic heart failure （CHF） is the final stage of cardiovascular diseases. It is a complex syndrome， with dyspnea and edema as the main clinical manifestations， and it is characterized by complex disease conditions， difficult cure， and high mortality. Ferroptosis， a new type of programmed cell death， is different from other types of programmed cell death. Ferroptosis is iron-dependent， accompanied by lipid peroxide accumulation and mitochondrial shrinkage， becoming a hot research topic. Studies have confirmed that ferroptosis plays a key role in the occurrence and development of CHF. The regulation of ferroptosis may become a potential target for the treatment of CHF in the future. The theory of Qi deficiency and stagnation refers to the pathological state of original Qi deficiency and abnormal transportation and distribution of Qi， blood， and body fluid， which has guiding significance for revealing the pathogenesis evolution of some chronic diseases. We believe that Qi deficiency and stagnation is a summary of the pathogenesis of ferroptosis in CHF. Deficiency of Qi （heart Qi） is the root cause of CHF， and stagnation （phlegm turbidity and blood stasis） is the branch of this disease. The two influence each other in a vicious circle to promote the development of this disease. Traditional Chinese medicine （TCM） plays an important role in the treatment of CHF， improving the prognosis and quality of life of CHF patients. This paper explores the correlation between the theory of Qi deficiency and stagnation and the mechanism of ferroptosis in CHF. Furthermore， this paper reviews the mechanism of Chinese medicines and compound prescriptions in preventing and treating CHF by regulating ferroptosis according to the principles of replenishing Qi and dredging to remove stagnation， aiming to provide new ideas and methods for the treatment of CHF with TCM.

Esophageal carcinoma is a malignant disease with a high incidence rate and poor prognosis. The mitochondrial apoptosis pathway plays a pivotal role in the regulation of cell death and has become a focal point in current cancer therapeutics research. Various active components from traditional Chinese medicine （TCM） can target the mitochondrial apoptosis pathway to inhibit esophageal carcinoma， presenting as potential therapeutic agents for this disease. This paper summarizes relevant research on the inhibition of esophageal carcinoma by active components in TCM via targeting the mitochondrial apoptosis pathway. It has been found that flavonoids （casticin， icariin， luteolin， kaempferol， hesperetin， deguelin， etc.）， terpenoids （oridonin， Jaridonin， artesunate， ethyl acetate fraction of pleurotus ferulatus triterpenoid， etc.）， alkaloids （matrine， swainsonine， etc.）， polyphenols （curcumin， epigallocatechin-3-gallate， corilagin， etc.）， steroids （α-hederin， polyphyllin Ⅵ， etc.）， phenols （optimized scorpion venom peptide CT-K3K7， gecko active polypeptide， etc.）， volatile oils （cinnamaldehyde， α -asarone， etc.） and other active components from TCM can target the intrinsic mitochondrial apoptosis pathway， induce apoptosis in esophageal carcinoma cells， and inhibit their proliferation， invasion and migration by regulating oxidative stress， blocking the cell cycle， regulating signaling pathways such as PI3K/Akt and MAPK.

Hepato-pancreato-biliary diseases (HPBD) are often complicated. The diagnosis and treatment of HPBD involve many disciplines. The malignant degree of hepatobiliary pancreatic system is high, and the prognosis of patients is poor. The multidisciplinary team (MDT) brings specialists from different disciplines together to make a comprehensive and individualized treatment for patients. MDT is emerging in HPBD in recent years. MDT helps improve the accuracy of diagnosis and prognosis. However, there are still some controversies and obstacles in the application of MDT for patients with HPBD. We reviewed the development, current status and experience of MDT in the field of HPBD, analyze the current controversy and obstacles, and providing reference for its future application.

Heart failure is a group of complex clinical syndromes that represent the final stage of cardiovascular disease development， characterized by an extremely high mortality rate. However， due to the complexity of the pathological mechanisms， an effective treatment method has not yet been found. Mitochondria are among the most critical organelles in cells， playing an essential role in energy supply and widely participating in various life activities， such as the regulation of oxidative stress and apoptosis. The normal functioning of mitochondria is crucial for maintaining the body's normal life activities. In recent years， studies have found that mitochondrial dysfunction is associated with the occurrence and progression of various diseases， particularly closely related to the onset of heart failure. An imbalance in mitochondrial homeostasis is a key factor in cardiomyocyte death and the onset of heart failure. Mitochondrial autophagy， as a means of regulating mitochondrial homeostasis， is significant for the prevention and treatment of heart failure. Traditional Chinese medicine （TCM） therapy is a unique treatment approach in China now widely applied in clinical practice， demonstrating significant efficacy in treating heart failure， with unique advantages. Modern pharmacological research indicates that Chinese medicine monomers and compounds can target and regulate mitochondrial homeostasis in cardiomyocytes， affect mitochondrial autophagy， and protect cardiomyocytes， though the specific mechanisms remain unclear. Therefore， this paper explored the mechanisms of the PTEN-induced putative kinase 1 （PINK1）/Parkin pathway in mitochondrial autophagy and heart failure， reviewed the effects of PINK1/Parkin-mediated mitochondrial autophagy on heart failure， and discussed the therapeutic effects of PINK1/Parkin-mediated mitochondrial autophagy on heart failure in conjunction with TCM. This paper is expected to provide new ideas and methods for the prevention and treatment of heart failure from the perspective of PINK1/Parkin regulation of mitochondrial autophagy.

Objective: To explore the impact of function of mobile phone use on self-perceived stress and mobile phone addiction of high vocational students, and the mediating role of coping styles between different mobile phone functions and mobile phone addiction. Methods: A total of 911 participants in two vocational colleges in Wuhan and Liaocheng were investigated by using convenient sampling method. Smartphone Usage, Simplified Coping Style Questionnaire, and Stress subscale of Depression-Anxiety-Stress Scale(short version) were administered to participants. Results: Female students scored significantly higher on mobile phone social features (4.77±1.06) than males( t =2.05， P =0.04), while males scored significantly higher on MPATS and DASS-S, Negative Coping Style subscales than females( P <0.01). The social function of the mobile phone was positively related to the positive coping styles( r =0.17, P <0.01). The game features of mobile phone were positively related to negative coping styles, stress and mobile addiction( P <0.01). Negative coping style could positively predict stress and mobile phone addiction( β =0.53, 0.50, P <0.01). Negative coping styles and stress had significant chain mediation effects in nonsocial functions and mobile phone addiction(95% CI =0.06-0.24, P <0.01). Conclusion Students of vocational college who often use cellphone not for social purpose have higher self-perceived stress. The game function of mobile phones had an adverse effect on the physical and mental health of vocational students. Negative coping style is a powerful predictor of stress and mobile phone addiction.

Objective:To explore the effects of Carolina care model in standardized training of nurses.Methods:Convenience sampling was used to select 35 nurses who entered the Department of Cardiology for standardized training (referred to as training nurses) from October 2018 to March 2019 in a Class Ⅲ Grade A hospital in Changchun as control group, and 37 nurses who entered the Department of Cardiology from May to October 2019 were selected as observation group. Control group carried out routine training, and observation group implemented a training plan based on the Carolina care model. Training effects were evaluated with the Nursing Caring Characters Assessment Tool, Clinical Communication Competence Scale and Patient Satisfaction Questionnaire.Results:After training, the scores of all dimensions of the Nursing Caring Characters Assessment Tool of nurses in observation group were higher than those in control group with statistically significant differences ( P<0.05) . After training, the scores of all dimensions of the Clinical Communication Competence Scale of nurses in observation group were higher than those in control group, and the differences were statistically significant ( P<0.05) . In observation group, patients' satisfaction with training nurses was higher than that in control group with a statistically significant difference ( P<0.05) . Conclusions:The application of Carolina care model in standardized training of nurses can not only improve nurses' humanistic care and communication competence, but also improve patient satisfaction.

OBJECTIVE： Te analyze the problems of clinical use in pediatric drug in China， and to put forward related countermeasures and suggestions. METHODS： Using “children” and “pediatrics” as retrieval words， registered drug information were retrieved from the website of China Food and Drug Administration； the data of pediatric drug use prescription was retrieved from hospital prescription system of 9 hospitals； all drug information were retrieved from national drug data management system； off-label drug use investigation and the literatures of pediatric drug use in medical institutions （5 representative third grade general medical institutions） were retrieved from CNKI and Wanfang database. General information and problems of pediatric drug use in China were investigated. RESULTS： A total of 170 009 items of registered drug information were retrieved， including 2 784 drug information items labeled with ”children” or ”pediatrics”， accounting for 1.64％；320 000 drug prescriptions from hospital prescription system of 9 hospitals covered 22 treatment areas involving 1 186 drugs and 51 dosage forms. Only 10％ suitable for children. The retrieval results of database showed that the incidence of children off-label drug use in outpatients prescriptions of 5 hospitals was in high level， mainly manifesting as without the information of pediatric drug use， hyper-indication drug use， hyper-dosage drug use. There were many problems in clinical pediatric drug use in China， such as less variety for children， single dosage form and specification， widespread off-label drug use， lack of scientific reference for drug use， difficulty in developing pediatric drug clinical trials， etc. CONCLUSIONS： Although the policies to protect children’s clinical drug use have been introduced in China， the problems facing children’s clinical drug use in China are still very serious. While further implementing relevant policies， it is necessary to establish a linkage management system led by government departments， with the full participation and mutual cooperation of society， enterprises， medical institutions and patients so as to guaratee the safety of pediatric drug use in clinic.

To analyze the incidence and imaging characteristics of pulmonary nodules in a unit staff.
 Methods: Low-dose spiral CT (LDCT) scan were performed in 1 372 staffs ≥45 years old in a certain unit during the physical examination. The clinical and imaging data were collected to analyze the detection rate, imaging characteristics, and postoperative pathological conditions of pulmonary nodules.
 Results: The total detection rate for pulmonary nodules was 30.39% (417/1 372). The detected nodules were mainly single (227 cases), solid (343 cases), <5 mm in diameter (261 cases), and Lung-Reporting and Data System (Lung-RADS) category 2 nodules (340 cases). The single nodules were mostly found in the right upper lung (74 cases, 32.60%). The detection rate of pulmonary nodules tended to decrease but the detection rate of category 4 nodules increased with the increasing age (P<0.05), while the gender had no significant influence on the detection rate (P>0.05). Compared with the Lung-RADS category 3 nodules, the proportions of nodules in subsolid state, with irregular shape, lobulation sign, and vascular penetration in the Lung-RADS category 4 were increased (all P<0.05). Among them, 11 patients received surgical therapy, including 10 women. Postoperative pathology confirmed lung adenocarcinoma in 9 patients (2.16%), including 8 women, all non-smokers.
 Conclusion: The nodules in subsolid state with vascular penetration, irregular shape and lobulation sign tend to be malignant. Lung cancer screening with low-dose spiral CT in female non-smokers should be emphasized.
Early Detection of Cancer ; Female ; Humans ; Lung Neoplasms ; diagnostic imaging ; Male ; Middle Aged ; Tomography, Spiral Computed ; Tomography, X-Ray Computed

Objective: Constructing and applying the multi-module training program for junior midwives to improve the training quality. Methods: The training program was constructed according to different modules of core competence. 11 junior midwives were selected from a hospital in Zhengzhou as trainees. The training effect was evaluated. Results: Their core competence has been enhanced in theory knowledge, operating skills and training satisfaction (P < 0.05). After training, the rate of episiotomy and the rate of postpartum hemorrhage were lower than before (P<0.05). Conclusion The multi-module training program can improve the core competence of junior midwives, which provides effective training method and promotes the quality of training.

UDP-glucuronosyltransferase 1A1 (UGT1A1) plays a key role in detoxification of many potentially harmful compounds and drugs. UGT1A1 inhibition may bring risks of drug-drug interactions (DDIs), hyperbilirubinemia and drug-induced liver injury. This study aimed to investigate and compare the inhibitory effects of icotinib and erlotinib against UGT1A1, as well as to evaluate their potential DDI risksUGT1A1 inhibition. The results demonstrated that both icotinib and erlotinib are UGT1A1 inhibitors, but the inhibitory effect of icotinib on UGT1A1 is weaker than that of erlotinib. The ICvalues of icotinib and erlotinib against UGT1A1-mediated NCHN--glucuronidation in human liver microsomes (HLMs) were 5.15 and 0.68 μmol/L, respectively. Inhibition kinetic analyses demonstrated that both icotinib and erlotinib were non-competitive inhibitors against UGT1A1-mediated glucuronidation of NCHN in HLMs, with thevalues of 8.55 and 1.23 μmol/L, respectively. Furthermore, their potential DDI risksUGT1A1 inhibition were quantitatively predicted by the ratio of the areas under the concentration-time curve (AUC) of NCHN. These findings are helpful for the medicinal chemists to design and develop next generation tyrosine kinase inhibitors with improved safety, as well as to guide reasonable applications of icotinib and erlotinib in clinic, especially for avoiding their potential DDI risksUGT1A1 inhibition.