ObjectiveTo investigate the therapeutic effects and difference in the effects of Arisaematis Rhizoma （AR） before and after processing （i.e.， Arisaematis Rhizoma Preparatum， ARP） with Zingiberis Rhizoma Recens-Alumen on allergic asthma in rats and to provide a basis for the theory of processing improving the efficacy. MethodA rat model of allergic asthma was established in 70 SD rats by intraperitoneal injection of ovalbumin （OVA）-aluminum hydroxide. The rats were administrated with the aqueous extracts of AR （1.2， 0.3 g∙kg^-1） and ARP （1.2， 0.3 g∙kg^-1） aqueous extracts by gavage， and montelukast sodium （0.001 g∙kg^-1） was used as the positive drug. The T helper cell type 1/type 2 （Th1/Th2） ratio in the serum and bronchoalveolar lavage fluid （BALF） and percentages of inflammatory cells in BALF were determined. Polymerase chain reaction （PCR） was employed to determine the mRNA level of mucin 5AC （MUC5AC） in the lung tissue. The pathological changes in the lung tissue were observed by hematoxylin-eosin （HE） staining and PAS staining. Immunohistochemical assay was employed to measure the expression of c-Jun amino-terminal kinase （JNK）， extracellular signal regulated protein kinase （ERK）， and p38 mitogen-activated protein kinase （p38 MAPK） in rat lung tissue. Western blot was employed to determine the protein levels of ERK， p-ERK， JNK， p-JNK， p38， p-p38 in the lung tissue. The effects of AR and ARP were compared based on overall desirability. ResultCompared with the blank group， the levels of interleukin-12 （IL-12） and γ interferon （IFN-γ） in serum and BALF of rats in the model group were significantly lower （P<0.05， P<0.01）， and the levels of interleukin-4 （IL-4）， interleukin-5 （IL-5） and interleukin-13 （IL-13） were significantly higher （P<0.05， P<0.01）. Compared with the model group， the serum and BALF contents of IL-12 and IFN-γ in rats in the montelukast sodium group， high-dose AR group and high-dose ARP group were significantly higher （P<0.05， P<0.01）， and the contents of IL-4， IL-5 and IL-13 were significantly lower （P<0.05， P<0.01）， and the serum contents of IFN-γ in rats in the low-dose AR group and low-dose ARP group were in BALF was significantly higher （P<0.05） and IL-4 and IL-13 were significantly lower （P<0.05， P<0.01）， the percentages of macrophages， lymphocytes， neutrophils， and eosinophils were reduced in BALF， and the expression of JNK/ERK/p38 MAPK signaling pathway and MUC5AC protein was inhibited in lung tissues. Overall assessment of the normalized analysis revealed that the ARP group was slightly more potent than the AR group after administration of the same dose. ConclusionAR and ARP can effectively treat allergic asthma by inhibiting JNK/ERK/p38 MAPK signaling pathway， and the effect is better after concoction， which can provide data support for its "concoction efficiency".

Hip fracture is considered as the most severe osteoporotic fracture characterized by high disability and mortality in the elderly. Improved surgical techniques and multidisciplinary team play an active role in alleviating prognosis, which places higher demands on perioperative nursing. Dysfunction, complications, and secondary impact of anaesthesia and surgery add more difficulties to clinical nursing. Besides, there still lack clinical practices in perioperative nursing for elderly patients with hip fracture in China. In this context, led by the Orthopedic Nursing Committee of Chinese Nursing Association, the Expert consensus on clinical practice in perioperative nursing for elderly patients with hip fracture ( version 2023) is developed based on the evidence-based medicine. This consensus provides 11 recommendations on elderly patients with hip fracture from aspects of perioperative health education, condition monitoring and inspection, complication risk assessment and prevention, and rehabilitation, in order to provide guiding advices for clinical practice, improve the quality of nursing and ameliorate the prognosis of elderly patients with hip fracture.

Objective:To study the effect of spousal voice stimulation on the recovery period of patients undergoing thoracic/lumbar surgery under general anesthesia.Methods:A total of 67 patients undergoing thoracic/lumbar surgery under general anesthesia who met the inclusion exclusion criteria were divided into 34 patients in the control group and 33 patients in the experimental group according to the random number table method. Awakening in the recovery period patients were given general anesthesia care, on the basis of the control group recovery period voice wake up by paramedics. The recovery time, pain score, the incidence of restlessness and nausea and vital signs between the two groups were compared.Results:The extubation time, exhalation time, recovery time of choking cough, recovery time, and pain score in the recovery stage were (14.00±3.90) min, (11.67±3.83) min, (10.03±3.58) min, (21.24±4.28) min, (4.15±0.79) points in the experimental group, respectively. Those were (18.00±6.60) min, (15.59±5.86) min, (12.68±5.01) min, (29.50±8.25) min, (5.26±0.86) points in the control group, respectively. The differences between the two groups were statistically significant ( t values were 2.481-5.483, P<0.05 or 0.01). There was no significant difference in the incidence of restlessness and nausea and vital signs between the two groups( P>0.05). Conclusions:Spoused-voice stimulation can shorten the extubation time, exhalation time, recovery time and recovery time of choking cough in patients undergoing thoracolumbar surgery under general anesthesia, and reduce the pain in the recovery period.

This study retrospectively analyzed the clinical data of 1 case of spermatic cord leiomyosarcoma admitted to the urology department of the Affiliated Hospital of Chengde Medical College. The clinical characteristics, diagnosis, treatment and prognosis was discussed with the literature review. Radical resection of the left testicle and high ligation of the left spermatic cord were performed. Postoperative pathology was spermatic cord leiomyosarcoma. Its clinical manifestations are painless masses, which are mainly confirmed by pathological examination. The treatment is mainly radical resection, and postoperative radiotherapy can improve the prognosis and reduce recurrence.

Objective: To compare the dosimetric differences among Target-Segmented Plan (TSP), Non-TSP, and conventional static 8-field intensity modulated radiation therapy (8F-IMRT) plan for post-mastectomy irradiation of left-sided breast cancer patients. Methods: This study enrolled thirty consecutive breast cancer patients who underwent radical mastectomy and treated with post-op radiation in Department of Radiation Oncology, Renmin Hospital of Wuhan University from June 2017 to November 2018.The clinical target volume (CTV) included the ipsilateral chest wall, supra/infra-clavicular, high-risk partial axillary in high risk, and internal mammary nodes (IMN). The organs at risk (OARs) near the targets, including ipsilateral lung, heart, contralateral breast, ipsilateral humeral head and spinal cord, were contoured as well. The maximum distance of PTV′s tangent to the outermost side of the affected lung was more than 2 cm. Depending on the maximum distance, the patients were classified into three groups: A(<3 cm), B(3~4 cm) and C(>4 cm), respectively. Three types of treatment plans (TSP, Non-TSP and 8F-IMRT) were created for each patient using the Eclipse treatment planning system with the same dose optimization objective . The dose-volume histograms were compared for the PTVs and OARs. Results: All plans achieved the intended dose criteria.The D_98% of TSP was lower than that of Non-TSP and 8F-IMRT (Z=-3.294, -3.266, P<0.05). However, the homogeneity index (HI) and conformal index (CI) of the three plans had no statistically significant difference among the three plans (P>0.05). Non-TSP required more Monitor Units (MUs)than the other two plans (Z=-3.04, -2.669, P<0.05). The D_mean of TSP was higher than that of 8F-IMRT (Z=-3.181, P<0.05). Compared with Non-TSP and 8F-IMRT plans, TSP significantly reduced V_{5 Gy}, V_{10 Gy}, V_{20 Gy} and D_meanof ipsilateral lung and heart in all patients (lung: V_{5 Gy}: Z=-3.408, -3.408; V_{10 Gy}: Z=-3.408, -3.408; V_{20 Gy}: Z=-3.408, -3.124; D_mean: Z=-3.408, -3.408, P<0.05; heart: V_{5 Gy}: Z=-3.408, -3.408; V_{10 Gy}: Z=-3.408, -3.408; V_{20 Gy}: Z=-2.499, -3.067; D_mean: Z=-3.408, -3.408, P<0.05). The D_mean of contralateral breast in Non-TSP was higher than that in TSP and 8F-IMRT (Z=-2.954, -2.215, P<0.05), and the D_maxhas no significant difference in (P>0.05). There was no significant difference in spinal cord D_max among the three plans, but the D_mean of humeral head in 8F-IMRT was higher than that in TSP and Non-TSP (Z=-3.01, -2.442, P<0.05). In the three groups, the mean amplitude of difference comparing Non-TSP and 8F-IMRT with TSP in ipsilateral lung(V_{5 Gy}, V_{10 Gy}, V_{20 Gy}) and heart(V_{5 Gy}, V_{10 Gy}, D_mean) satisfied the relation: D(N-T, A)<D(N-T, B) <D(N-T, C)和D(8F-T, A)<D(8F-T, B) <D(8F-T, C). Conclusions For post-mastectomy left-sided breast cancer patients, TSP is not only dosimetrically feasible as Non-TSP and 8F-IMRT treatment techniques, but also could effectively reduce the irradiation volume of the ipsilateral lung and heart in the low dose area with minimum adverse dosimetric impact on the treatment targets and other OARs.The advantage of TSP is more prominent with increasing curvature of the clinic target volume.

Objective: To explore the humanistic caring ability, and to analyze the relationship between the positive psychological qualities, emotional intelligence and humanistic caring ability among the nursing interns, and provide theoretical basis to improve nursing students’ humanistic caring ability. Methods: A total of 132 nursing interns from a three Level of first-class hospital in Liaoning province, were investigated by using the general questionnaire, caring ability inventory, emotional intelligence scale and Positive Mental Characters Scale for China normal university. Results: The score of humanistic caring ability was (180.74±18.75). Among them, the average score of cognitive was the highest (73.71±10.93) and the average score of courage was the lowest (48.43±11.91). Emotional intelligence and positive psychological qualities were positively correlated with the humanistic caring ability, and positive psychological qualities was a intermediate variable between emotional intelligence and humanistic caring ability, and the mediating effect size is 18.71%. Conclusion The level of humanistic caring ability in nursing interns is lower, which needs to be further improved. The emotional intelligence and positive psychological qualities have a significant positive effect on the humanistic caring ability. Schools and internship hospitals can improve their sense of humanistic caring ability by developing the emotional intelligence and positive psychological qualities to stabilize the development of nursing career.

Objective To evaluate the clinical value of multiple bladder biopsies in the diagnosis and treatment of non-muscle invasive bladder cancer (NMIBC) during transurethral resection of bladder tumor(TURBT).Methods The data of 408 NMIBC patients from January 2009 to December 2013 was analyzed retrospectively.There were 302 males and 106 females.The mean age of these 408 patients was 65 years old from 33 to 86 years.Bladder multipoint biopsies were performed in 216 patients (biopsy group),and were not performed in the other 192 patients (control group).The multipoint biopsies were taken from right and left bladder walls,anterior and posterior walls,dome,trigone,prostatic urethra and abnormal mucosa.There were 127 males and 89 females in the biopsy group,with a mean age of 64 years old (from 18 to 87 years).In the control group,118 males and 74 females aged between 15 and 92 years have an average age of 66 years old.There was no statistically significant difference in regard to gender and age between the two groups.The positive rate of biopsy and whether the diagnosis and treatment plan changed in the study group were recorded and the recurrence and progression rates were compared between study and control groups.Results Of these 216 multiple mucosa biopsies,the total abnormal detection rate was 48.1％ (104/216).There were urothelial carcinoma in 12.5％ (39/216),carcinoma in situ in 5.6％ (12/216),dysplasia in 9.7％ (21/216),cystitis in 20.4％.The final diagnosis were changed in fifteen patients (6.9％) due to the biopsy results,and 38 patients(17.6％) treatment plans were changed.The 1-,3-,and 5-year recurrence-free survival rates (RFS) of biopsy group and control groups were 96.3％ vs.85.4％(x2 =14.955,P=0.000),85.2％ vs.69.8％ (x2 =13.183,P =0.000) and 69.9％ vs.64.1％ (x2 =1.574,P =0.245);progression-free survival(PFS) were 99.1％ vs.96.3％ (x2 =8.253,P =0.006),94.0％ vs.87.0％ (x2 =5.901,P=0.017) and90.3％ vs.85.4％ (x2 =2.273,P=0.169).The 1-and 3-year RFS and PFS of biopsy group were higher than control group.There was no significant difference in the 5-year RFS and PFS between the two groups.Conclusions Multiple bladder biopsies could be helpful for pathological diagnosis and the post-TUR treatment of NMIBC.Furthermore,it may reduce the early recurrence and progression rates of NMIBC,but have no effect on long-term prognosis.

Objective:To investigate the clinical characteristics of idiopathic hypereosinophilic syndrome (IHES) with gastrointestinal manifestations,and to improve the level of diagnosis and treatment of IHES. Methods:The clinical materials, process of diagnosis and treatment and prognosis of 9 patients diagnosed as IHES with gastrointestinal manifestations were retrospectively analyzed. Results:The average age of 9 patients was (22.66± 12.86)years old,and the ratio of male and female was about 1.25∶ 1. The main clinical manifestations included abdominal pain,diarrhea and abdominal distension.The eosinophil percentages in peripheral blood and bone marrow of the patients were (42.66 ± 19.88 )% and (39.33 + 15.99 )%, respectively.The ascites exudate cytology examination showed eosinophil infiltrated.The results of gastroscope or colonoscope showed mucosal hyperemia and edema,scattered bleeding spots, and dark red granular hyperplasia; the colon was affected frecuently.The histological biopsy confirmed that the mucosal was infiltrated by eosinophils.The abdominal CT of 6 patients showed that the walls of stomach or bowel were thickened.The abdominal symptoms disappeared,and the ascites was absorpted in 9 patients after the treatment of glucocorticoid.After 2 years of follow up,2 patients had relapse, others had no recurrence.Conclusion:Performing the routine diagnosis and treatment of gastrointestinal diseases, the clinicians should consider the possibility of IHES in order to avoid the misdiagnosis and delayed treatment. When IHES is diagnosed,steroid treatment should be performed in preference.

Objective: The pathology workflow statistics, modeling, optimize procedure and establish standardized operating procedures. Methods:This paper which based on the previous studies, the standard operation management and database technology, based on pathology workflow sample collection, sample inspection, warehousing storage, picking or sorting, sample processing and handling, inspection, quality control and other aspects of the analysis, optimizing operating procedures, thus forming SOPs, and accordingly the establishment of standardized management database system. Results: The system shortens the pathological examination cycle, improve the detection efficiency. Conclusion: It can be widely used in pathology sample collection, diagnosis, management processes, and application for sound management system pathology, pathology strengthen quality control is important.

Objective:To explore the feasibility and safety of CT-guided hookwire localization of small lung nodule in video-as-sisted thoracic surgery. Methods: Preoperative localization of small lung nodule was performed using the CT-guided hookwire tech-nique, followed by video-assisted thoracic surgery in the wedge resection. The next mode of operation depends on the results of frozen biopsy. Results:Preoperative localization with CT-guided hookwire was performed in 34 patients between February 2012 and March 2014. The diameter of lung nodule ranged from 5 mm to 22 mm. CT-guided hookwire localization was successful in all patients, with a median positioning time of 23 min. Puncture needles were detached from two of the total patients during the surgery, and three other pa-tients showed pneumothorax by CT scan after localization. Conclusion:Preoperative hookwire localization of small lung nodule is an accurate and safe approach to improve the rate of wedge resection in video-assisted thoracic surgery.