In this paper， we systematically sorted out and verified the name， origin， producing area change， quality， efficacy and processing of Halloysitum Rubrum by consulting materia medica， medical books， prescription books from past dynasties， and modern literature， and combined with the comprehensive analysis of trait identification， hygroscopicity measurement and X-ray diffraction（XRD） detection， in order to provide a basis for understanding the original source of the mineral medicine. The results indicated that Halloysitum Rubrum was first contained in the Shennong Bencaojing， it had been consistently named Chishizhi， there were also aliases such as Chifu， Hongxinshi and Chiyouzhi. The description of Halloysitum Rubrum in ancient materia medica aligns with modern findings， categorizing it under the silicate kaolinite family， specifically polyhydrous kaolinite， with associated minerals mainly being dickite， nacrite， hematite， gibbsite， mica， etc. Historically， the production area of Halloysitum Rubrum was mainly located in the Qinling Mountains， Shandong and Henan， and is now primarily distributed in most parts of China， including Henan， Hubei and other provinces. Quality evaluation in ancient times included descriptions like "fresh and greasy color"， "delicately sticky tongue and lips" and "smooth as fat". Modern materia medica mostly evaluates its quality based on color， luster， texture and hygroscopicity， noting characteristics such as red color， smoothness， delicacy， softness and strong viscosity. Halloysitum Rubrum is sweet， sour and pungent in flavor， warm in nature， non-toxic， and belongs to the heart and large intestine meridians. It acts as an astringent and solidifying agent， particularly useful in the treatment of long-term dysentery and diarrhea， common processing methods include fire calcination， water flying， and vinegar quenching. Comprehensive analysis of the traits， XRD and humidity absorption of different batches of samples showed that the commercially available Halloysitum Rubrum is mainly bright red or brownish red， with a smooth surface like grease， soft and smooth texture， delicate cross-sectional texture， and some have waxy luster and strong water absorption. It is mainly composed of 10 Å（1 Å=0.1 nm） polyhydric kaolinite， and is often accompanied by 7 Å polyhydric kaolinite， nacrite， etc. Genuine products tend to have higher moisture absorption than counterfeit ones， which can be used as a key indicator to distinguish the authenticity. The quality evaluation of Halloysitum Rubrum aligns with historical materia medica， where "fresh color， delicate and greasy lips" could serve as a key feature for its quality evaluation.

Aiming to provide the foundation for the quality evaluation， in this paper， a comprehensive examination of historical materia medica， medical books and modern literature was conducted to systematically compile and verify the naming， origin and quality of Stalactitum， combined with the phase analysis of 20 batches of samples. The investigation indicates that before the Qing dynasty， Stalactitum was often referred to as Shizhongru， and there are other aliases such as Xuzhong， Xiashi and Huangshisha. In addition， there are some homologous mixed names such as Konggongnie， Yinnie， Ruchuang， Ruhua， but Zhongrushi is more commonly used. The descriptions of Stalactitum in ancient materia medica align with modern carbonate mineral calcite， slightly conical or cylindrical in shape， mostly white， grey and yellow in colour， often with a hole in the centre， and has a calcium carbonate content of 95% or more. Historical quality assessments include phrases such as gooseneck tube， cicada wing， bright and white， and brightness， the gloss is the most crucial feature. Modern evaluations encompass features like white color， hollow interior， brightness， multiple layers of patterns， and cross-sectional mask spark-like luminosity. Under the scanning electron microscope， Stalactitum showed obvious layered characteristics and uniform particle size， while the OS Balanophylliae was irregular. By comparing the characteristics and micro-features of Stalactitum from different batches， along with X-ray diffraction（XRD） and determination of calcium carbonate， the phase composition of different batches of Stalactitum was roughly similar， all of them were dominated by calcite， with magnesium calcite as an additional ingredient， the content of CaCO₃ was relatively higher for those with brightness and a lot of spark-like luminosity， which were key features of its quality evaluation， the white color could be used as a quality reference， and layered patterns and papillary bulge could be used as a medicinal material identification feature， which were basically consistent with the results of herbal textual research. This study can provide a reference for the quality evaluation of mineral medicines， and can better guide their clinical use and rational utilization of resources.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

Objective: To objectively and subjectively assess and compare the characteristics of monoenergetic images [MEI (+)] and polyenergetic images (PEI) acquired by dual-energy CT (DECT) of patients with breast cancer. Materials and Methods: This retrospective study evaluated the images and data of 42 patients with breast cancer who had undergone dual-phase contrast-enhanced DECT from June to September 2019. One standard PEI, five MEI (+) in 10-kiloelectron volt (keV) intervals (range, 40–80 keV), iodine density (ID) maps, iodine overlay images, and Z effective (Z eff) maps were reconstructed. The contrast-to-noise ratio (CNR) and the signal-to-noise ratio (SNR) were calculated. Multiple quantitative parameters of the malignant breast lesions were compared between the arterial and the venous phase images. Two readers independently assessed lesion conspicuity and performed a morphology analysis. Results: Low keV MEI (+) at 40–50 keV showed increased CNR and SNR breast lesion compared with PEI, especially in the venous phase ([CNR: 40 keV, 20.10; 50 keV, 14.45; vs. PEI, 7.27; p < 0.001], [SNR breast lesion: 40 keV, 21.01; 50 keV, 16.28; vs.PEI, 10.77; p< 0.001]). Multiple quantitative DECT parameters of malignant breast lesions were higher in the venous phase images than in the arterial phase images (p < 0.001). MEI (+) at 40 keV, ID, and Z eff reconstructions yielded the highest Likert scores for lesion conspicuity. The conspicuity of the mass margin and the visual enhancement were significantly better in 40-keV MEI (+) than in the PEI (p = 0.022, p = 0.033, respectively). Conclusion Compared with PEI, MEI (+) reconstructions at low keV in the venous phase acquired by DECT improved the objective and subjective assessment of lesion conspicuity in patients with malignant breast lesions. MEI (+) reconstruction acquired by DECT may be helpful for the preoperative evaluation of breast cancer.

Objective: To objectively and subjectively assess and compare the characteristics of monoenergetic images [MEI (+)] and polyenergetic images (PEI) acquired by dual-energy CT (DECT) of patients with breast cancer. Materials and Methods: This retrospective study evaluated the images and data of 42 patients with breast cancer who had undergone dual-phase contrast-enhanced DECT from June to September 2019. One standard PEI, five MEI (+) in 10-kiloelectron volt (keV) intervals (range, 40–80 keV), iodine density (ID) maps, iodine overlay images, and Z effective (Z eff) maps were reconstructed. The contrast-to-noise ratio (CNR) and the signal-to-noise ratio (SNR) were calculated. Multiple quantitative parameters of the malignant breast lesions were compared between the arterial and the venous phase images. Two readers independently assessed lesion conspicuity and performed a morphology analysis. Results: Low keV MEI (+) at 40–50 keV showed increased CNR and SNR breast lesion compared with PEI, especially in the venous phase ([CNR: 40 keV, 20.10; 50 keV, 14.45; vs. PEI, 7.27; p < 0.001], [SNR breast lesion: 40 keV, 21.01; 50 keV, 16.28; vs.PEI, 10.77; p< 0.001]). Multiple quantitative DECT parameters of malignant breast lesions were higher in the venous phase images than in the arterial phase images (p < 0.001). MEI (+) at 40 keV, ID, and Z eff reconstructions yielded the highest Likert scores for lesion conspicuity. The conspicuity of the mass margin and the visual enhancement were significantly better in 40-keV MEI (+) than in the PEI (p = 0.022, p = 0.033, respectively). Conclusion Compared with PEI, MEI (+) reconstructions at low keV in the venous phase acquired by DECT improved the objective and subjective assessment of lesion conspicuity in patients with malignant breast lesions. MEI (+) reconstruction acquired by DECT may be helpful for the preoperative evaluation of breast cancer.

Objective To explore the changes and significance of hepatic cytokines during ischemia and reperfusion in rats undergoing donation after circulatory death (DCD) liver transplantation in different functional warm ischemic durations.Methods Maastricht Ⅲ DCD liver transplantation was simulated and a rat model of functional warm ischemia established.DCD liver transplantation was established by cutting diaphragm.There were four groups of functional warm ischemia 0/15/30 min and living donor liver transplantation control.Liver tissues and serum samples were obtained after donor liver acquisition and 6-hour reperfusion respectively.Luminex liquid chip was employed for detecting the concentrations of 23 cytokines in liver tissue,superoxide dismutase or malondialdehyde (SOD/MDA) expression in liver tissue and alanine transaminase or aspartate aminotransferase (ALT/AST) expression in sera.And hematoxylin-eosin (HE) staining was utilized for detecting liver tissue damage.Results The levels of cytokines in liver tissues during ischemia and reperfusion were significantly different in different functional warm ischemic durations.SOD/MDA in liver tissue,AST/ALT in sera and pathological examinations also showed that,with the prolongation of functional warm ischemic duration,the degree of liver tissue injury gradually aggravated.Conclusions Functional warm ischemic duration has a significant effect on cytokines during ischemia and reperfusion in rat DCD liver transplantation.This phenomenon can help us further elucidate the mechanism of ischemia-reperfusion injury and provide new ideas for preventing ischemia-reperfusion injury during DCD liver transplantation.

Objective: To investigate the current status and influencing factors of basis of the replacement of short peripheral intravenous catheters for clinical nurses and explore the obstruction of the latest guide promoted in practice. Methods: The qualitative research method was adopted, and semistructured interviews were used to interview 11 clinical nurses. Data were analyzed by the method of category analysis. Results: Although the clinical nurses mainly used the national standards to do practical operation, they preferred to carry out catheter replacement according to clinical indications. The difference between the latest guide and the national standards was the main obstruction in the practical promotion of the latest guide. Conclusions The removal of short peripheral intravenous catheters according to clinical indications is more suitable for clinical practice. Further improving the standards of intravenous therapy in China has become a fundamental measure to solve the contradictions of work of clinical nurses, improve patients′ medical experience and save medical resources.

Objective To develop a set of quality indicators for hip replacement transitional care, and to provide reference for objective evaluation and standardization of transitional care in hip replacement. Methods Based on the"structure-process-outcome"model and the current practice of transitional care in hip replacement and patients'need,we developed an item pool dor assessing quality of transitional care by using literature review. Then a 2-round Delphi study was conducted among 16 experts to collect their opinions about these indicators. Results Aftertwo rounds expert advisory,the effective response rates were 17/17, 16/17; Cr coefficients were 0.865,0.855;Wcoefficients were 0.206-0.284, 0.135-0.253, and P values were all less than 0.01. The index system consisted of 3 first-level indicators, 12 second-level indicators,and 64 third-level indicators. Conclusions The constructed nursing quality indicator system in transitional care for hip replacement can provide references for evaluating transitional care in hip replacement qualityof care in a scientific and rational way.

Objective To test the reliability and validity of the Chinese version of Insomnia Severity Index(ISI-C) in patients with insomnia. Methods One hundred and twenty patients with insomnia were selected from Zhongshan Hospital Affiliated to Dalian University. The subjects had completed the ISI-C scale and Pittsburgh Sleep quality Index(PSQI) scale, Epworth Sleepiness Scale(ESS) at the same time. The reliability and validity of the scale were tested by Cronbach α coefficient, item correlation analysis, exploratory factor analysis and ROC curve test. Results The Cronbach α coefficient of the ISI-C was 0.804,the test-retest reliability was 0.887 (P<0.01). The items of ISI-C scale were correlated with the corresponding items of PSQI (r=0.831, P<0.01), ESS(r =0.218, P<0.05). Two common factors were extracted by factor analysis including the severity of insomnia and the influence of insomnia, and the cumulative contribution rate was 63.117% (P<0.01).When the cutting point was 10.5 points, the sensitivity and specificity were 84.0% and 92.3%, respectively (P<0.01). Conclusions ISI-C scale is a reliable and valid instrument. It can be used to measure the insomnia of patients in hospitals.

OBJECTIVE: To investigate the characteristics and regularity of ADR induced by antineoplastic drugs and provide reference for safe drug use in clinic. METHODS: ADR reports induced by antineoplastic drugs reported by 108 hospitals during Jan. 2009-Dec. 2016 were collected from PLA ADR Monitoring Center. ADR reports were analyzed respectively in respects of types of ADR reports, patients ' gender and age, administration route, occurrence time, types of antineoplastic drug, the situation of patients suffering tumor, systems/organs involved in ADR, clinical manifestations, outcome, etc. RESULTS: Among 15 183 ADR reports, there were 462 cases of new ADR and 2 873 cases of severe ADR; there were 8 039 male (52. 95％) and 7 144 female (47. 05％). The proportion of severe ADR in female (20. 00％) was significantly higher than male (17. 96％), with statistical significance (P=0. 001). ADR was mainly induced by intravenous administration (90. 53％), and mainly occurred 2-＜7 d after medication (23. 00％). Top 3 drug categories in the list of ADR were platinum antineoplastic drugs (25. 63％), plant-derived antineoplastic drugs and its derivative (24. 42％) and anti-metabolism drugs (18. 50％). Male patients mainly suffered from lung cancer, colorectal cancer and gastric cancer; female patients mainly suffered from breast cancer, lung cancer and colorectal cancer. Systems/organs involved in ADR were gastrointestinal system, hematological system and systemic damage. Main clinical manifestations were nausea, vomiting, myelosuppression, skin rash and fever. Totally 92. 57％ of ADR cases were cured and recovered after treatment, and 5 cases died. CONCLUSIONS: Antineoplastic drugs have high incidence of ADR with serious damage. Clinic should strengthen the monitoring of key population and key drugs so as to reduce the occurrence of ADR.