Objective To investigate the influence of modified Shashen Maidong Decoction combined with Camrelizumab immunotherapy plus chemotherapy on the efficacy,survival status and serum cytokeratin 19 fragment(CYFRA21-1)and neuron-specific enolase(NSE)levels in patients with advanced non-small cell lung cancer(NSCLC).Methods Forty patients with advanced NSCLC of lung-stomach yin deficiency with intense heat-toxin type were randomly divided into a control group and a study group,with 20 patients in each group.The patients in the control group were given Camrelizumab immunotherapy plus chemotherapy,and the patients in the study group were given modified Shashen Maidong Decoction combined with Camrelizumab immunotherapy plus chemotherapy,with 21 days as a course of treatment and for a total of 4 courses of treatment.The changes of serum NSE and CYFRA21-1 levels in the two groups before and after treatment were observed,and the clinical efficacy,survival status and the incidence of toxic and side effects were compared between the two groups.Results(1)After 4 courses of treatment,the total effective rate of the study group was 70.00%(14/20),which was significantly higher than that of the control group(9/20,45.00%),but the intergroup comparison(tested by chi-square test)showed that the difference was not statistically significant(P＞0.05).(2)After 2 years of follow-up,the overall survival(OS),time to progression(TTP),and progression-free survival(PFS)of the patients in the study group were significantly prolonged compared with those in the control group(P＜0.01).(3)After treatment,the serum NSE and CYFRA21-1 levels of the patients in the two groups were decreased compared with those before treatment(P＜0.05),and the decrease of serum NSE and CYFRA21-1 levels in the study group was significantly superior to that in the control group(P＜0.01).(4)The incidence of toxic and side effects in the study group was 25.00%(5/20),which was significantly lower than that of 65.00%(13/20)in the control group,and the intergroup comparison showed that the difference was statistically significant(P＜0.05).Conclusion Modified Shashen Maidong Decoction combined with Camrelizumab immunotherapy plus chemotherapy has satisfactory therapeutic effect on patients with advanced NSCLC,which can reduce the toxic and side effects of chemotherapy,lower the level of serum tumor markers,and prolong the survival period and time to progression(TTP)of the patients.

Objective To evaluate the characteristics of different antigen-specific T cell immune responses to severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)after inoculation with 2 doses of SARS-CoV-2 inactivated vaccine for 12 months.Methods Fifteen healthy adults were enrolled in this study and blood samples collected at 12 months after receiving two doses of SARS-CoV-2 inactivated vaccine.The level and phenotypic characteristics of SARS-CoV-2 antigen-specific T lymphocytes were detected by activation-induced markers(AIM)based on polychromatic flow cytometry.Results After 12 months of inoculation with 2 doses of SARS-CoV-2 inactivated vaccine,more than 90%of adults had detectable Spike and Non-spike antigen-specific CD4+ T cells immune responses(Spike:14/15,P=0.0001;Non-spike:15/15,P<0.0001).80%of adults had detectable Spike and Non-spike antigen-specific CD8+ T cells immune responses(Spike:12/15,P=0.0463;Non-spike:12/15,P=0.0806).Antigen-specific CD4+ T cells induced by SARS-CoV-2 inactivated vaccination after 12 months were composed of predominantly central memory(CM)and effector memory 1(EM1)cells.On the other hand,in terms of helper subsets,antigen-specific CD4+ T cells mainly showed T helper 1/17(Th1/17)and T helper 2(Th2)phenotypes.Conclusions SARS-CoV-2 inactivated vaccination generates durable and extensive antigen-specific CD4+ T cell memory responses,which may be the key factor for the low proportion of severe coronavirus disease 2019(COVID-19)infection in China.

Objective To observe the effect of multi-modal hand hygiene(HH)intervention on HH compliance,as well as the relationship between HH compliance and the healthcare-associated(HA)case infection incidence.Methods From 2014 to 2022,the infection control team in a tertiary first-class hospital implemented multi-modal HH intervention for health care workers(HCWs).The changing trend of HH monitoring data,the correlation be-tween HH compliance rate and HA case infection incidence were analyzed retrospectively.Results The consump-tion of HH products in the wards showed a stable upward trend;HH compliance rate increased from 64.98％in 2014 to 85.01％in 2022(P＜0.001),and HA case infection incidence decreased from 1.21％to 0.83％(P＜0.05).HH compliance rate was negatively correlated with HA case infection incidence(r=-0.369,P=0.027).HH compliance rates in different regions and job posts in each quarter were increased(P＜0.001).For 5 different HH moments in each quarter,HH compliance rate fluctuated slightly before sterile manipulation and after touching patient;presented rising trend after touching surroundings around patient,and decreased before touching patient and after touching patient's body fluid since 2020(P＜0.001).Conclusion Multi-modal HH intervention can im-prove the HH compliance of HCWs,improving their HH awareness is conducive to reducing HA case infection incidence.

Objective:To analyze the body composition and influencing factors of lean non-alcoholic fatty liver disease in population receiving health examination.Methods:This is a cross-sectional study. Between January 2020 and December 2021, 1 342 individuals who had complete and reliable results of liver transient elastography and body composition testing, with a body mass index (BMI)<24 kg/m 2 and who met the inclusion criteria, were selected from the physical examination population at the Health Management Center of Jiangsu Provincial People′s Hospital. The results of body composition analysis, blood biochemical indexes and liver examination were collected from the subjects for analysis. Method of inter-group comparison: quantitative data that conform to normal distribution were tested using independent sample t-test, while non-conforming data were tested using rank sum test; count data were tested using chi-square test. The binary logistic regression analysis was used to analyze the influencing factors of body composition in lean non-alcoholic fatty liver disease in health examinees. Results:The detection rate of non-alcoholic fatty liver disease was 13.3% in all participants, and it was significantly higher in men than that in women (23.3% (125/537) vs 6.6% (53/805)). The fasting blood glucose (5.15, 5.08 mmol/L), hemoglobin A1c (HbA 1c)(5.5%, 5.6%), triglyceride (TG)(1.70, 1.64 mmol/L), low density lipoprotein cholesterol (LDL-C)(3.37, 3.27 mmol/L), alanine aminotransferase (ALT)(27.0, 21.9 U/L), aspartate aminotransferase (AST)(24.1, 24.0 U/L), gamma-glutamyltransferase (31.4, 21.1 U/L), uric acid (UA)(391, 296 μmol/L), body fat percentage (23.9%, 33.7%), waist-to-hip ratio(0.90, 0.89) and visceral fat area (70.3, 97.0 cm 2) in men and women with lean nonalcoholic fatty liver disease were all higher than those in the population without fatty liver, while the density lipoprotein cholesterol (1.25, 1.32 mmol/L) was lower. Logistic regression analysis showed that BMI, HbA 1c, TG, UA and waist-to-hip ratio were risk factors for lean nonalcoholic fatty liver disease in men, while BMI, HbA 1c, TG, UA and body fat percentage were risk factors for lean nonalcoholic fatty liver disease in women (all P<0.05). Conclusion:BMI, HbA 1c, TG, UA, body fat percentage and waist-to-hip ratio are associated with the development of lean nonalcoholic fatty liver disease.

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 investigate the relative expression level and clinical significance of LINC00475 in serum of patients with multiple myeloma(MM).Methods:The expression of LINC00475 in serum of 108 MM patients and five MM cell lines including RPMI 8226,NCI-H929,U266,OPM2 and CAG were detected by real-time fluorescence quantitative PCR.The diagnostic value of LINC00475 in MM was evaluated by receiver operating characteristic(ROC)curve analysis.The correlation of LINC00475 with patients'characteristics was analyzed.Results:Compared with control groups,the expression of LINC00475 was up-regulated in serum of MM patients and MM cell lines(all P＜0.05).ROC curve analysis showed that the optimal cut-off value of LINC00475 was 262.4,the area under curve(AUC)was 0.924(95％CI:0.884-0.964),and sensitivity and specificity was 83.3％and 91.7％,respectively,which indicated that LINC00475 had good evaluation value in MM patients.Compared with low-LINC00475 expression group,patients in high-LINC00475 expression group had higher levels of β2-microglobulin(β2-MG)and Cystatin C(Cys-C)but lower albumin(ALB)(all P＜0.05).Compared with MM patients with International Staging System(ISS)stage I,the expression level of LINC00475 was significantly higher in patients with stage Ⅱ and Ⅲ(both P＜0.05).Conclusion:LINC00475 is helpful to distinguish MM patients from healthy adults,which is correlated with the prognostic indicators such as β2-MG,ALB,and ISS stage.

Objective The Δ9-tetrahydrocannabinol in the flowers and leaves of industrial hemp plants and hemp processing products was extracted and separated,to establish a liquid chromatography-mass spectrometry(LC-MS)qualitative and quantitative test method and a liquid chromatography(LC)quantitative test method for Δ9-THC.Methods The samples were dried naturally and ground,extracted with methanol and analyzed.The ACQUITY UPLC ? BEH C18 column was used.The liquid chromatography was performed on a gradient elution with water and acetonitrile.The detection wavelength was 215 nm and the bandwidth was 4.8 nm.Liquid chromatography-mass spectrometry was performed with 0.1%formic acid water and 0.1%formic acid acetonitrile for gradient elution.Electrospray ion source,scanning mode:positive ion mode,multiple characteristic ion pairs for qualitative analysis,and externalstandard curve method for quantitative analysis.Results The linearity of Δ9-THC in the range of 0.001～0.1 mg/mL in liquid chromatography and 5～100 ng/mL in liquid chromatography-mass spectrometry was good,R2 were greater than 0.999.The relative error of the measured values of the liquid chromatography and liquid chromatography-mass spectrometry test methods was within±2%,and the precision was less than 2%.Conclusion The method established in this paper can be applied to the detection of Δ9-THC in industrial cannabis plants and cannabis processing products,which can provide technical support for the detection of industrial cannabis plants and cannabis processing products in the laboratory.

Objective To explore the clinical application effect of scenario-driven unscripted emergency drills.Methods A total of 120 nursing staff who underwent scripted drills from January 2019 to July 2021 were selected as convention group,and 120 nursing staff who underwent scenario-driven unscripted emergency drills at Ganzhou Women and Children's Health Care Hospital from August 2021 to July 2023 were selected as drill group.The two groups were compared in terms of availability of per-sonnel and materials,performance of duties,personnel protection,coordination and organization,division of labor in emergency teams,actual combat effectiveness,partial cooperation and assistance,handling of emergencies,and first aid awareness.Results The drill group demonstrated a higher proportion of personnel who arrived quickly,accurately,and basically on time compared to the convention group.The drill group showed a significantly lower proportion of individual personnel who were not in place and key position personnel who were not in place compared to the convention group(P＜0.05).The drill group performed signifi-cantly better than the convention group(P＜0.05).The drill group did better in on-site material preparation all as well as in per-sonnel protection compared to the convention group.The drill group had a more accurate and efficient overall organization than the conventional group,and the emergency team of the drill group had a more reasonable and efficient division of labor.The drill group demonstrated superior accuracy and efficiency in overall organization compared to the conventional group,with its emergen-cy team exhibiting a more effective and rational division of labor.The drill group achieved their expected outcomes in emergency drills,whereas the convention group achieved only part of their set goals,with most requiring enhancement.The drill group re-ported to superiors in a more timely and efficient manner compared to the convention group,and the group showed better coordina-tion between their departments was good,which could be achieved in a timely manner.The drill group demonstrated a significant-ly better overall response to emergencies and significantly stronger emergency awareness compared to the convention group(P＜0.05).Conclusion Scenario-driven unscripted emergency drills can enhance the emergency response capabilities of nursing staff,improve their decision-making and command skills,optimize organizational coordination,and handling abilities,and strengthen their first aid awareness.

Objective To understand the growth and development status and differences between small for gestational age(SGA)and appropriate for gestational age(AGA)preterm infants during corrected ages 0-24 months,and to provide a basis for early health interventions for preterm infants.Methods A retrospective study was conducted,selecting 824 preterm infants who received regular health care at the Guangzhou Women and Children's Medical Center from July 2019 to July 2022,including 144 SGA and 680 AGA infants.The growth data of SGA and AGA groups at birth and corrected ages 0-24 months were analyzed and compared.Results The SGA group had significantly lower weight and length than the AGA group at corrected ages 0-18 months(P<0.05),while there were no significant differences between the two groups at corrected age 24 months(P>0.05).At corrected age 24 months,85%(34/40)of SGA and 79%(74/94)of AGA preterm infants achieved catch-up growth.Stratified analysis by gestational age showed that there were significant differences in weight and length at corrected ages 0-9 months between the SGA subgroup with gestational age<34 weeks and the AGA subgroups with gestational age<34 weeks and≥34 weeks(P<0.05).In addition,the weight and length of the SGA subgroup with gestational age≥34 weeks showed significant differences compared to the AGA subgroups with gestational age<34 weeks and≥34 weeks at corrected ages 0-18 months and corrected ages 0-12 months,respectively(P<0.05).Catch-up growth for SGA infants with gestational age<34 weeks and≥34 weeks mainly occurred at corrected ages 0-12 months and corrected ages 0-18 months,respectively.Conclusions SGA infants exhibit delayed early-life physical growth compared to AGA infants,but can achieve a higher proportion of catch-up growth by corrected age 24 months than AGA infants.Catch-up growth can be achieved earlier in SGA infants with a gestational age of<34 weeks compared to those with≥34 weeks.

Objective:To explore the correlation of early urinary continence(UC)after laparoscopic radical prostatectomy(LRP)with relevant preoperative MRI parameters of the urinary tract structure and provide some theoretical evidence for screening the high-risk population with postoperative urinary incontinence.Methods:This study included 49 PCa patients aged 50-78 years trea-ted by LRP in Beijing Tongren Hospital from January 2015 to February 2021,and all followed up for 12 months.We collected the com-plete baseline data on the patients,the clinical data possibly related to early postoperative UC,the MRI anatomical parameters associat-ed with UC,and the data on the recovery of early postoperative UC.We recorded the number of urinary pads used,submitted the data obtained to SPSS 23.0 statistical analysis,and identified the possible relevant factors by univariate correlation analysis,followed by R40.3 or SPSS 23.0 multivariate logistic regression analysis of the included factors and the results of UC.Results:MRI images mani-fested that the prostate anteroposterior diameter averaged(4.0±1.11)cm,the transverse diameter(4.6±0.83)cm,the cephalo-caudal diameter 2.4-6.4 cm,the membranous urethral length(MUL)(13.16±3.52)mm,and the thickness of the urethral rhab-dosphincter(URS)1.08-4.37 mm.Multivariate analysis showed that age was significantly correlated with the recovery of UC at 1 month after LRP(P=0.035,OR=0.16),and so was the URS thickness at 3 months(P=0.011,OR=0.02),9 months(P=0.014,OR=0.039)and 12 months(P=0.014,OR=0.039).Urinary incontinence with the URS thickness ≤1.6 mm at 12 months after operation was found of a high severity(P=0.010,OR[95％CI]=0.858-6.240).The MUL was positively correla-ted with the recovery of UC at 9 months(P=0.024,OR=0.508)and 12 months(P=0.024,OR=0.508)postoperatively.Correlation analysis revealed that the prostate volume,prostate diameter and other factors included in this study were not significantly correlated to postoperative UC.Conclusion:The thickness of the URS is positively correlated with the recovery of early UC,the thinner the URS,the severer the UC,and so is MUL.Age is an independent risk factor for the recovery of UC at 1 month after LRP.These findings need to be further verified by more prospective studies with long-term follow-ups.