OBJECTIVE To evaluate the quality of Euscaphis japonica from different habitats. METHODS The relative correction factors of gallic acid， protocatechuic acid， ellagic acid， isoquercitrin， astragalin and apigenin were calculated with quercetin as the internal reference； the relative correction factors of euscaphic acid， oleanolic acid， stigmasterol and β-sitosterol were also calculated with ursolic acid as the internal reference. The contents of 12 components in 18 batches of samples were calculated by QAMS method and were compared with external standard method. At the same time， the contents of water-soluble extract， alcohol-soluble extract， total ash and acid-insoluble ash were detected. The quality of E. japonica was evaluated by principal component analysis （PCA）， orthogonal partial least squares-discriminant analysis （OPLS-DA）， and weighted technique for order preference by similarity to ideal solution （TOPSIS） method. RESULTS There was no significant difference between the results of QAMS method and external standard method for the 12 components in the 18 batches of samples. However， notable content variations were observed among different batches of samples. The results of PCA and OPLS-DA showed that S1-S7， S8- S12， and S13-S18 were clustered into one category respectively. Seven key characteristic components variable importance in projection values ＞1， euscaphic acid， ursolic acid， protocatechuic acid， apigenin， β-sitosterol， isoquercitrin， and oleanolic acid， respectively. The analysis results of the weighted TOPSIS method revealed that the relative closeness for evaluating the quality of 18 batches of samples ranged from 0.283 5 to 0.644 1， with the samples of E. japonica from Fengjie， Chongqing， demonstrating the highest quality. CONCLUSIONS The established method is accurate and feasible， which can be used for the quality evaluation of E. japonica combined with chemometrics and weighted TOPSIS model.

Objective:To investigate the differences in dosimetric impacts of the systematic errors induced by the leaf positions of a multi-leaf collimator (MLC) on the volumetric modulated arc therapy (VMAT) for patients with different T stages of nasopharyngeal carcinoma (NPC).Methods:A total of 44 patients with T 1-4N 1M 0 NPC were selected to design the VMAT plans using the Pinnacle planning system as the initial plans. The prescribed doses to the primary gross tumor volume (PGTV) were 68-70 Gy in 33 fractions for patients with T 1 and T 2 stage NPC and 71 Gy in 33 fractions for patients with T 3 and T 4 stage NPC. The prescribed doses to other target volumes were identical. In the initial plan files, a systematic error ranging from ±0.2 to ±1 mm was introduced to the position of each MLC leaf, leading to an increase or decrease in the subfield area. Then, potential error plans at the positions of MLC leaves during VMAT treatment were simulated. Dose evaluation indices involved target volumes and organs at risk (OARs). The indices related to target volumes consisted of the D98% of PGTV and PGTVnd, while those concerning OARs included the D0.1 cm 3 of the brainstem, spinal cord, and optic chiasm. Results:After the systematic errors induced by the positions of MLC leaves were introduced, the sensitivity range of each dose index range was (3.87%-9.87%)/mm ( R2 = 0.932-0.998, P < 0.01). Specifically, patients with stage T 4 NPC displayed higher sensitivity to the D98% of PGTV than those with stage T 1, T 2 and T 3 NPC ( Z = -3.12, -2.86, -2.59, P < 0.05), patients with stage T 3 NPC exhibited lower sensitivity to the D0.1 cm 3 of optic chiasm than those with stage T 1 and T 2 NPC ( Z = -2.92, -2.72, P < 0.05), and patients with stage T 4 NPC manifested lower sensitivity to the D0.1 cm 3 of chiasma than those with stage T 1 and T 2 NPC ( Z = -3.51, -3.25, P < 0.05). The relationship between the sensitivity of MU/Gy and PGTV D98% was y=-3.020+ 0.025 x ( r = 0.80, P < 0.05). Conclusion:The MU/Gy in the plans increased with the T stage of NPC, and the D98% of PGTV was more significantly affected by the systematic errors induced by the positions of MLC leaves. After the systematic errors induced by the positions of MLC leaves were introduced into the VMAT plans, doses to patients with T 4 stage NPC changed more significantly than those to patients with other T stages of NPC. Therefore, stricter quality control of leaf positions is required for patients with T 4 stage NPC, and it is recommended that the systematic errors should be less than 0.42 mm.

Objective:To explore the current situation of organizational silence among emergency nurses and analyze its influencing factors, so as to provide a basis for interventions.Methods:From April to July 2023, convenience sampling was used to select 150 nurses from the Emergency Department of the First Affiliated Hospital of Air Force Military Medical University as the research subject. These subjects were surveyed using the General Information Questionnaire, Nurse Organizational Silence Evaluation Questionnaire and the Emotional Intelligence Scale. Pearson correlation was used to analyze the correlation between organizational silence and emotional intelligence among emergency nurses, and multiple linear regression was used to analyze the influencing factors of nurse organizational silence.Results:A total of 150 questionnaires were distributed, and 132 valid questionnaires were collected, with an effective response rate of 88.00% (132/150). The score of the Nurse Organizational Silence Evaluation Questionnaire of 132 emergency nurses was (60.83±13.52). The results of Pearson correlation analysis showed that there was a negative correlation between emotional intelligence and organizational silence in emergency nurses ( r=-0.410, P<0.01). Multiple linear regression analysis showed that gender, education level, work years, perceived economic level, and emotional intelligence were the influencing factors of organizational silence among emergency nurses ( P<0.05), which could explain 33.9% of the variation. Conclusions:Nursing managers should focus on nurses who are female and with low education levels, short working years, and low perceived economic levels, and provide training to improve their emotional intelligence, thereby reducing the level of organizational silence among emergency nurses.

Objective To investigate the effectiveness of applying the CIPP(Context,Input,Process,and Product)model in the training of general workers in a disinfection supply center.Methods From January to March 2023,a total of 24 general workers in our hospital's disinfection supply center underwent traditional training as the pre-management phase.Subse-quently,from July to September 2023,a training system centered on the CIPP model was implemented as the post-management phase.After the training,the examination results and training evaluations were analyzed using SPSS 13.0 statistical software.Results The technical training of the general workers resulted in improved learning outcomes compared to before the training.Conclusion By applying the CIPP model in the training of general workers in a disinfection supply center,their grasp of basic knowledge and professional skills can be enhanced.This can reduce technical errors during operations,improve the quality of sterile items,and reduce the risk of nosocomial infections,thereby ensuring patient safety.

Objective:To study the effect of MYD88 L265P mutation on the expression of PD-L1 in tumor cells and tumor microenvironment in diffuse large B-cell lymphoma (DLBCL), and to provide theoretical basis for immunotherapy for patients.Methods:Multiplex ligation-dependent probe amplification (MLPA) was used to detect the frequency of MYD88 L265P mutation in 72 cases of DLBCL diagnosed by pathologists in Cancer Hospital of Chinese Academy of Medical Sciences from August 2008 to May 2010. Expression of PD-L1 in tumor cells and tumor microenvironment in all samples was evaluated using PD-L1 (22C3) and PD-L1 (SP142) with Ventana automatic immunohistochemical (IHC) platform. The relationship between MYD88 L265P mutation and the expression of PD-L1 in DLBCL tumor cells and tumor microenvironment was assessed.Results:Of the 72 cases of DLBCL, MYD88 L265P mutation was detected in 15 (20.8%) cases. Nine cases with JAK2 amplification were excluded, and the remaining 63 cases of DLBCL were divided into MYD88 L265P mutant group ( n=14) and MYD88 L265P wild-type group ( n=49). IHC results showed that among the 14 cases of MYD88 L265P mutant groups, PD-L1 (22C3) was positive in 7 cases (7/14) of tumor cells and PD-L1 (SP142) was positive in 4 cases (4/14) of tumor microenvironment. Among the 49 cases of MYD88 L265P wild-type group, 9 cases (18.4%) were positive for PD-L1 (22C3) in tumor cells, and 38 cases (77.6%) were positive for PD-L1(SP142) in tumor microenvironment. In addition, among the 16 cases with PD-L1(22C3) expression in tumor cells, only 2 of the 7 cases with MYD88 L265P mutation were positive for PD-L1 (SP142) in tumor microenvironment. All 9 cases with wild-type MYD88 L265P were positive for PD-L1 (SP142) in tumor microenvironment. Statistical analysis showed that the expression level of PD-L1 (22C3) in tumor cells in the MYD88 L265P mutant group was significantly higher than that in the MYD88 L265P wild-type group ( P=0.017). The expression level of PD-L1 (SP142) in tumor microenvironment in the MYD88 L265P mutant group was significantly lower than that in the MYD88 L265P wild-type group ( P=0.001). Conclusions:MYD88 L265P mutation may play an important role in the regulation of PD-L1 expression in DLBCL tumor cells and tumor microenvironment. Further studies will provide a theoretical basis for immunotherapy of DLBCL patients with MYD88 L265P mutation.

Objective To investigate the effect of compound BAM15 on the primary hepatocyte injury induced by cold storage in rats. Methods The primary rat hepatocytes were extracted by collagenase perfusion method. According to different cell culture conditions, the cells were divided into 4 groups: group A (Hibernate cell culture solution containing 250 nmol/L BAM15), group B (Hibernate cell culture solution containing 500 nmol/L BAM15), group C (Hibernate cell culture solution containing 1 000 nmol/ L BAM15), control group (Hibernate cell culture solution). The cells of each group were cryopreserved for 12 h. The purity of primary hepatocytes was observed under fluorescence microscope. The changes in the cell proliferation ability, cell apoptosis rate and mitochondrial reactive oxygen species (ROS) were measured in each group. Results The cell proliferation ability in groups B and C was significantly higher than that in the control group (both P < 0.05). The apoptosis rates in groups A, B and C were (33.7±2.2)%, (19.7±1.1)% and (28.7±1.2)%, which were significantly lower than (82.7±4.2)% in the control group (all P < 0.05). The positive rates of intracellular ROS in groups A, B and C were (11.8±4.0)%, (7.6±1.3)% and (8.9±1.6)%, remarkably lower than (27.4±4.5)% in the control group (all P < 0.05). Conclusions Compound BAM15 can effectively mitigate the primary hepatocyte injury in rats induced by cryopreservation. The underlying mechanism is probably associated with the role of BAM15 in reducing ROS generation during cold ischemia.

Neurogenic bowel dysfunction (NBD) manifested as constipation and fecal incontinence often occurs after spinal cord injury (SCI).NBD affects patients' quality of life and is an urgent clinical problem to be solved.The mechanism of NBD is related to central and autonomic nervous system dysfunction,intestinal nervous system dysfunction,changes in intestinal microorganism composition and abnormal content of neurotransmitters.The evaluation method of NBD is mainly based on scoring and imaging,which lacks unified criteria,and the treatment method for NBD is the combination of traditional Chinese and Western medicine.The author summarizes the mechanism,evaluation method,treatment and nursing of NBD in order to provide new insight into these aspects to improve clinical efficacy.

Objective To explore the physiological and psychosocial risk factors of the patients with somatoform disorders and to provide references for clinical psychological intervention.Methods Totally 60 patients with somatoform disorder and 60 normal controls were tested with biochemical analyzer,electrocardiogram machine,electroencephalogram machine,computed tomographic scanner,general situation questionnaire,minnesota multiphasic personality inventory(MMPI),toronto alexithymia scale(TAS),life event scale(LES),defense style questionnaire(DSQ) and social support rating scale(SSRS) to explore the physiological and psychosocial risk factors of the patients with somatoform disorders.Results The score of immature defense styles of the study group(4.04±0.89) were higher than those in the control group(3.43 ± 0.65)with significant difference (P＜0.05).The total and factor scores of TAS of study group((86.20±11.15),(21.12±3.28),(26.08±3.86),(18.21±4.69),(23.44±5.60)) were higher than control group((65.00±10.12),(12.43±5.18),(15.64±5.57),(15.56±3.16),(18.71 ±4.30)) with significant difference (P＜0.05).The MMPI scale scores of Hs (hypochondriasis),D (depression),Hy (hysteria),Men-Nancy (Mf),Paranoid (Pa),Psychotic (Pt) were higher in patients with somatoform disorder ((72.79± 10.50),(68.46±13.63),(79.03±12.12),(51.72±7.74),(57.98±10.60),(54.98±8.83)) than those in normal controls((51.66±10.11),(47.96±9.42),(51.47±11.90),(43.66±8.77),(47.67±6.69),(47.48±8.67)) with significant difference(P＜0.05).The total life event score and the negative life event score of LES of the study group ((89.66±68.60),(82.65±65.16)) were higher than those in the control group((56.00±56.79),(39.14± 46.05)) with significant difference (P＜ 0.05).Multiple factors logistic regression analysis showed immature defense styles,higher alexithymia score,higher negative life event score,higher HS,D,Hy of MMPI may increase the risk of somatoform disorders(OR=6.84,9.12,5.83,2.69,1.81,11.20,P＜0.01).Conclusion Patients with somatoform disorder are almost in normal physiological condition.They have the personality characteristics and significant alexithymia.Their social support are almost normal,but they have more negative life events and their defense styles are almost immature.

This paper was aimed to study the effectiveness and safety of TanshinoneⅡA Sulfonate Sodium Injection in the treatment of unstable angina pectoris (UAP). Keywords such as coronary atherosclerotic heart disease, coronary heart disease, unstable angina, chest impediment, cardialgia, TanshinoneⅡA Sulfonate Sodium Injection, tanshinone injection, tanshinoneⅡA sulfonate, unstable, angina, randomized controlled trial (RCT), and clinical trials were searched in CNKI, VIP, Wanfang and Pubmed from the construction of database until October 31st, 2014. The inclusion criteria were RCT with clinical data integrity, similar literature research methods, and good balance between groups. The Jadad score method was used to carry out quality assessment. Meta-analysis was conducted by RevMan5.2 software. Count data was processed by odds ratio (OR). Measurement data was processed with the weighted mean differences (WMD). The 95% confidence interval (CI) was also calculated. The heterogeneity test result of included literatures was P > 0.05. The fixed effects model was used in the meta-analysis. On the other hand, random effect model was used. For the analysis results of more than 10 papers, the funnel plot was used in the analysis of publication bias. The results showed that a total of 34 studies were included. The results of meta-analysis suggested that the total efficiency of conventional treatment plus TanshinoneⅡA Sulfonate Sodium Injection for UAP was [OR = 3.83, 95%CI (3.11, 4.71),P < 0.000 01]. The electrocardiogram improvement rate was [OR = 3.34, 95%CI (2.61,4.28),P < 0.000 01]; plasma viscosity improvement was [WMD = -0.20, 95%CI (-0.38, -0.03),P = 0.03]; high shear viscosity of whole blood improvement was [WMD = -0.67, 95%CI (-0.85, -0.50),P < 0.000 01]; C-reactive protein improvement was [WMD = -2.66, 95%CI (-3.31, -2.00),P < 0.000 01]. It was concluded that the conventional treatment plus TanshinoneⅡA Sulfonate Sodium Injection for UAP had certain clinical effect with no obvious adverse reaction. However, due to the poor quality of the existing research literatures, the results should be further verified by large amount of high quality RCTs.

Objective To improve the tri-primer allele gene amplification for realizing the single nucleotide polymorphisms (SNP) genotyping of the peripheral blood sample .Methods Aiming at the peripheral blood samples with the clinical usual antico-agulation processing by EDTA ,heparin and citrate ,with the locus rs1165205 as the target site ,the buffer solution(YW) suitable for whole blood was prepared and the PCR amplification system and the amplification condition were optimized for realizing the detec-tion of SNP genotyping .Results The genotyping results of locus rs1165205 by improved tri-primer allele gene amplification method were consistent with the results of the Sanger sequencing method ,and the peripheral blood samples treated by different anticoagu-lant were genotyped by the improved tri-primer ASA .Among 80 samples ,various genotypes of locus rs1165205 had no statistical differences in the distribution between the gout population and non-gout population(P= 0 .335) .Conclusion The improved tri-primer allele gene amplification method can be adopted to conduct the rapid genotyping research on gout SNP locus of the peripheral blood samples with the clinical usual anticoagulation processing .