Cancer is a prevalent and challenging disease that is difficult to treat.Western medicine recognizes the disruption of the immune and inflammatory microenvironment as a crucial factor in the development and progression of cancer.According to traditional Chinese medicine,cancer falls into the categories of"accumulation"and"abnormal masses".Based on the attributes of cold and heat in the overall and local conditions as well as the characteristic of the struggle between the vital qi and pathogenic factors at different stages of this disease,this article proposes the concept of"body coldness and tumor heat"to describe the pathogenesis of cancer formation and progression.This pathogenesis aligns with the disruption of the immune and inflammatory microenvironment in modern medical oncology.The article suggests a treatment approach that focuses on balancing cold and heat,nourishing and protecting yang qi,warming the kidneys,and strengthening the spleen to address the"coldness of the entire body".This approach also involves promoting qi circulation,eliminating dampness,phlegm,and stasis,and detoxifying and dispersing nodules to address the"heat in the tumor locally".By addressing deficiencies,eliminating pathogenic factors,and promoting circulation to alleviate stagnation,the aim is to restore the balance of yin and yang and improve the complex state of"coldness of the entire body"and"heat in the tumor locally".These interventions can ameliorate the disorder in the microenvironment and enhance clinical efficacy.

Objective To understand the current status and influencing factors of patient perception for humanistic care in China hospitals,and to provide a basis for developing nursing humanistic care measures and improving the quality of nursing humanistic care services.Methods A total of 30,099 outpatients and inpatients from 107 hospitals in 30 provinces(autonomous regions and municipalities)from July to August 2022 as survey subjects.A general information questionnaire and the Relational Caring Questionnaire-Patient Form were used for a cross-sectional survey,and a single-factor analysis was used to analyze the influencing factors of patient relationship care.Results Finally,29 108 valid questionnaires were collected,and the effective questionnaire recovery rate was 96.7％.The patient evaluation of relationship care was(65.72±8.61)points.Single-factor analysis showed that gender,age,marital status,children's situation,education level,occupation,place of residence,average family income,medical insurance type,visiting department,and location of the visiting hospital,and whether or not surgery were influencing factors of patient relationship care(P＜0.05).Conclusion The evaluation score of caregiver-patient relationship care among Chinese hospital patients is above average,but there is still room for improvement in western and rural regions,seriously ill and outpatient patients,low-income and low-medical insurance reimbursement populations,and non-surgical patients.Medical institutions at all levels should optimize and improve nursing humanistic care services based on influencing factors,and further enhance patients'perception of nursing humanistic care.

Objective To investigate the effect of remimazolam(RE)on myocardial injury in myocardial ischemia-reperfusion(MI/R)rats and its mechanism.Methods The MI/R rat model was constructed and divided into sham group,MI/R model group,RE low,medium,high dose group(RE-L,RE-M,RE-H group)and Yes associated protein(YAP)inhibitor verteporfin group.Left ventricular ejection fraction(LVEF)and left ventricular fractional shortening(LVFS)were recorded in each group and commercially available kit was applied to detect the level of myocardial injury marker like LDH,c-TnI and CK-MB.The size of myocardial infarction was evaluated by TTC staining.Pathological changes in myocardial tissue was microscopied by HE staining.The apoptosis of myocardial cell was observed by TUNEL method.Expression of Hippo/YAP signaling pathway proteins in myocardial tissue was detected by Western blot.Results Compared to the sham surgery group,the myocardial structure of rats in the model group was disrupted,myocardial cells were reduced,the LVFS and LVEF were decreased,the expression of YAP was greatly reduced.The level of serum LDH,CK-MB,cTnI,myocardial infarction area,myocardial cell ap-optosis rate,p-MST1/MST1,p-LATS1/LATS1 and p-YAP expression were all significantly increased(P＜0.05);As compared to model group,the pathological change in myocardial tissue of rats in the low,medium,and high-dose RE groups was greatly reduced.The LVFS and LVEF were increased.The expression of YAP was significantly increased.The serum level of LDH,CK-MB,cTnI,the myocardial infarction area,myocardial cell apoptosis rate,p-MST1/MST1,p-LATS1/LATS1 and p-YAP expression were evidently reduced(P＜0.05).The YAP inhibitor verteporfin reversed the improvement effect of RE on myocardial injury in MI/R rats.Conclusions RE may improve cardiac function in MI/R rats,alleviate myocardial infarction and myocardial cell apoptosis and inhibit my-ocardial injury by regulating the Hippo/YAP signaling pathway.

Objective:This study aims to analyze the epidemic situation and characteristics of human plague in Inner Mongolia Autonomous Region, in order to provide scientific basis for formulating human plague prevention and control strategies.Methods:The epidemic data of human plague in Inner Mongolia Autonomous Region from 1970 to 2022 were collected, and descriptive analysis of its distribution, sources of infection and route of transmission, and case classification were conducted. The epidemic data came from the Plague Prevention and Control Management Information System form the Chinese Center for Disease Control and Prevention, as well as the summaries of plague surveillance work from 1970 to 2022, the compilation of historical data and other relevant materials in Inner Mongolia Autonomous Region.Results:From 1970 to 2022, all cases of human plague in Inner Mongolia Autonomous Region occurred in the plague foci of Meriones unguiculatus, with 18 cases of disease and 5 deaths, and the case fatality rate was 27.78%. In 2019, there were 4 cases. Three cases each in Sunitezuo Banner, Wulateqian Banner, and Etuokeqian Banner. Two cases each in Wulatezhong Banner and Siziwang Banner. One case each in Shangdu Banner, Suniteyou Banner, Xianghuang Banner, Damao Banner, and Etuoke Banner. May, and from July to November, the number of cases was 4, 4, 4, 1, 2, and 4. Of the 18 patients, 13 were males and 5 were females, age ranging from 6 years to 70 years. Three patients aged 1 - 18, 11 patients aged 19 - 59, and 4 patients aged 60 - 70. The largest number of patients (13 cases) were pastoralists by occupation, followed by field workers (3 cases). Thirteen patients contracted the disease through flea bites. Among the plague subtypes, bubonic plague was the most common with 13 cases.Conclusions:From 1970 to 2022, patients with human plague in Inner Mongolia Autonomous Region were predominantly young adult males. Herdsmen and outdoor workers were more susceptible to human plague. The most common mode of transmission was through flea bites, and the predominant subtype of plague was bubonic plague.

Objective To explore the correlation between the expression of long non-coding RNA(lncRNA)brain ischemia-related factor(BIRF)and focally amplified lncRNA on chromosome 1(lncRNA FAL1)in serum and the degree of white matter lesions(WML)in patients with cerebral small vessel disease(CSVD).Methods From June 2021 to June 2023,102 CSVD patients admitted to Affiliated Hospital of Chengde Medical University were collected,and these patients were grouped into WML group(n=72)and non WML group(n=30)based on WML diagnostic criteria.According to the Fazekas score,the WML group was further grouped into mild WML group(n=24),moderate WML group(n=36)and severe WML group(n=12).Real-time fluorescence quantitative polymerase chain reaction(qRT-PCR)was applied to detect the levels of lncRNA BIRF and lncRNA FAL1 in serum.Pearson correlation was applied to analyze the correlation between serum lncRNA BIRF and lncRNA FAL1 levels.Receiver operating characteristic(ROC)curve was applied to analyze the diagnostic value of serum lncRNA BIRF and lncRNA FAL1 levels for severe WML in CSVD patients.Results The age(70.50±5.86 years),history of hypertension(Yes/No,43/29),history of diabetes(Yes/No,45/27),IL-33(68.35±6.80 pg/ml),IL-18(97.78±9.65 ng/L),ubiquitin carboxyl terminal hydrolase L1(UCH-L1)(0.29±0.10 μg/L)and lncRNA BIRF level(2.45±0.30)of patients in the WML group were higher than those in the non WML group(67.10±5.76 years,11/19,9/21,62.48±6.13 pg/ml,92.56±9.37 ng/L,0.24±0.06 μg/L,1.02±0.11),while the expression of serum lncRNA FAL1(0.52±0.10)was lower than that in the non WML group(1.04±0.15),with significant differences(t=2.683,4.518,8.978,4.085,2.510,2.550,25.346,20.500,all P<0.05).The serum lncRNA BIRF levels of CSVD patients in the mild,moderate and severe WML groups(2.23±0.23,2.47±0.31,2.82±0.42)were increased sequentially,while the expression of serum lncRNA FAL1(0.60±0.15,0.51±0.09,0.40±0.04)was decreased sequentially,with significant differences(F=14.913,13.899,all P<0.05).Pearson correlation analysis,the serum levels of lncRNA BIRF and lncRNA FAL1 in patients with WML were negatively correlated(r=-0.603,P<0.001),serum lncRNA BIRF was positively correlated with Fazekas score in WML patients(r=0.483,P<0.001),but serum lncRNA FAL1 was negatively correlated with Fazekas score(r=-0.507,P<0.001).The AUCs of serum lncRNA BIRF and lncRNA FAL1 levels alone and both combination for predicting severe WML in CSVD patients were 0.756(0.641～0.850),0.839(0.733～0.915)and 0.892(0.796～0.953),respectively,and the combination of the two was superior to the detection of serum lncRNA BIRF alone(Z=2.111,P=0.035).Conclusion The serum lncRNA BIRF level is increased and lncRNA FAL1 is reduced in patients with CSVD and WML,and both are related to the degree of WML in CSVD patients.

Objective:To investigate the current state of missed nursing care during labor, explore the reasons why nursing care was missed, and examine the influencing factors of missed nursing care.Methods:Data were collected from 14 medical institutions of different levels in southwest China using a convenience sampling from February to April, 2023. A total of 491 midwives were included. A cross-sectional survey was conducted using a general information questionnaire and the Chinese version of the Perinatal Missed Care. Multiple linear regression analysis was conducted to identify the influencing factors on missed nursing care.Results:Among 491 midwives, there are 6 males and 485 females. 194 midwives aged ≤ 30, 205 midwives aged 31-40 years, and 92 midwives aged ≥41 years. 80.45%(395/491) of midwives reported missing at least one item of nursing care during labor in the past week, and the missing rate of single item ranged from 13.24% (65/491) to 53.36% (262/491). The average score across 23 items of missed nursing care during labor was 1.49 ± 0.58. The average scores of items spanning the three dimensions of basic care, necessary care and postnatal care were 1.67 ± 0.68, 1.36 ± 0.56, and 1.51 ± 0.70, respectively. The average score of 13 items representing reasons for missed nursing care was 1.82 ± 0.71. The average scores of items in three dimensions of communication, labor resources, and material resources were 1.75 ± 0.73, 1.97 ± 0.87, and 1.74 ± 0.83, respectively. The multiple linear regression analyses showed that gender, monthly average income level, and whether overtime hours were included in total working hours were independently associated with missed nursing care (all P<0.05). Conclusions:The current state of missed nursing care during labor needs to be improved. Missed basic care is common, and labor resources are the significant reasons, and is influenced by factors such as demographic and sociological factors. Human resource factors are an important reason for nursing deficiency, and targeted measures should be taken to reduce the occurrence of nursing deficiency.

Outpatient humanistic care refered to providing a full process of caring medical services to outpatients. In order to standardize the human caring services for outpatients in medical institutions, promote the comprehensive service level of outpatient services, and improve the patient′s medical experience, Chinese Association for Life Care issued the group standard of Management Norms for Human caring of Outpatients in April 2023. This standard clarified the relevant terms and definitions of human caring for outpatients, specified the basic requirements for human caring, the humanistic quality and care responsibilities of outpatient staff, the outpatient care environment and facilities, the outpatient care process and measures, and quality management. It designed standardized and personalized full process care service norms, providing references for medical institutions at all levels to promote the development of human caring for outpatients.

Objective To investigate the effects and potential mechanisms of ultrasound-guided thoracic paravertebral block (TPVB) combined with general anesthesia in patients undergoing thoracoscopic surgery. Methods A total of 122 patients undergoing thoracoscopic surgery were selected and randomly divided into control group and tudy group, with 61 patients in each group.The control group received general anesthesia, while the study group received ultrasound-guided TPVB combined with general anesthesia.Clinical data and perioperative indicators were recorded and compared between the two groups.Mean arterial pressure (MAP), heart rate (HR), Visual Analogue Scale (VAS) scores before surgery, 24 hours and 72 hours after surgery, and inflammatory factors[interleukin-6(IL-6), interleukin-10(IL-10), tumor necrosis factor-α(TNF-α)], oxidative stress indicators[malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px)]levels before surgery and 72 hours after surgery were compared between the two groups.Postoperative adverse reactions were recorded.Real-time fluorescence quantitative polymerase chain reaction was used to detect the expression of key molecules mRNA in the Nrf2/Keap1/ARE pathway in the peripheral blood of patients in the two groups. Results There were no statistically significant differences in operative time and intraoperative blood loss between the two groups (P>0.05).The study group had shorter extubation time and indwelling time of drainage tube, less total drainage volume, and less total PCIA drug consumption within 36 hours after surgery and times of patient controlled intravenous analgesia (PCIA) effective compression compared to the control group (P < 0.05).At 24 and 72 hours after surgery, MAP, HR, and VAS scores were higher than preoperative levels in the control group, while VAS scores were higher than preoperative levels in the study group, but MAP, HR, and VAS scores were lower in the study group compared to the control group (P < 0.05).At 72 hours after surgery, serum levels of IL-6, IL-10, TNF-α, and MDA were higher than preoperative levels, while SOD and GSH-Px levels were lower than preoperative levels in both groups.Additionally, the study group had lower serum levels of IL-6, TNF-α, and MDA and higher levels of IL-10, SOD, and GSH-Px compared to the control group (P < 0.05).The total incidence of postoperative adverse reactions was 4.92%(3/61) in the study group, which was lower than 21.31%(13/61) in the control group (P < 0.05).At 72 hours after surgery, the expression levels of Nrf2 mRNA and ARE mRNA in the peripheral blood of patients in the study group were lower than those in the control group, while the expression level of Keap1 mRNA was higher (P < 0.05). Conclusion Compared with general anesthesia, ultrasound-guided TPVB combined with general anesthesia can significantly improve hemodynamic stability and analgesic effects in patients with early-stage lung cancer after thoracoscopic surgery, relieve inflammatory and oxidative stress responses, and decrease the incidence of postoperative adverse reactions.The molecular mechanism may be related to the inhibition of Nrf2/Keap1/ARE signaling pathway activation.

Objective To investigate the shedding of CAV2-ΔE3-CGS after immunization and the background of canine adenovirus (CAV) infection, and to establish a dual fluorescent quantitative PCR detection method for rabies virus (RV) and canine adenovirus type 2 (CAV2). Methods A dual fluorescent quantitative PCR detection method was established by designing specific primers and probes for E1 gene of CAV and G gene of RV for the detection of CAV2-ΔE3-CGS. Oral swabs, anal swabs and environmental samples of stray dogs from experimental animal farm and dog detention center were tested. Results The standard curves generated by this method were Y=-3.351 × logX + 44.895, R² = .999 and Y=-3.413 × logX + 45.192, R²=0.996, respectively. The linear relationships were good, and the minimum detection limits were both 102 copies/μL. CAV2-ΔE3-CGS was not detected in experimental animal farm. CAV was detected in dog detention center, and the positive rates were 5.88% (5/85) in oral swabs, 8.24% (7/85) in anal swabs, and 4% (1/25) in environmental samples. Conclusion The dual fluorescent quantitative PCR method can be used for the detection of CAV2-ΔE3-CGS after immunization and the investigation of CAV infection. The present study has shown that no CAV2-ΔE3-CGS has been detected after immunization and CAV infection rate of stay dogs is low in Shanghai. CAV2-ΔE3-CGS oral immunization meets requirement and is applicable.

Humans ; Vaccines, Inactivated ; COVID-19/prevention & control* ; Vaccination ; Viral Vaccines ; Immunity ; Antibodies, Viral