Objective To establish a culture method for micropapillary lung adenocarcinoma organoids and conduct targeted drug screening.Methods Organoids were extracted and cultured from a surgical tissue sample of a patient diagnosed with micropapillary lung adenocarcinoma,and the growth of lung cancer organoids was observed and recorded dynamically.The morphological and gene expression characteristics of tumor cells between lung cancer organoids and parental tissue were compared using hematoxylin eosin(HE)staining and immunohistochemical methods.Real time fluorescence quantitative polynucleotide chain reaction(qRT-PCR)method was used to detect gene mutations in lung cancer parental tissue and organoids.Finally,based on results of genetic testing,targeted drugs were selected and their therapeutic effects were verified.Results We have successfully cultured spherical organoids from micropapillary lung adenocarcinoma tissue,which can be passaged for at least 3 generations.HE staining results showed that the morphology of tumor cells in organoids was roughly consistent with that of parental tissue.The immunohistochemical results showed that the protein expression levels of various genes in lung cancer organoids and parental tissue were roughly the same.Results of gene mutation analysis showed that the mutated genes in lung cancer parental tissue and organoids were consistent,both reflecting RET fusion.The screening results of targeted drugs based on lung cancer organoids showed that vandertinib had the best anti-tumor effect in vitro.Conclusion Drug screening experiments based on micropapillary lung adenocarcinoma organoids can screen highly efficient targeted drugs in a short period of time,which may benefit patients with micropapillary lung adenocarcinoma.

Objective To explore the mechanism and management of acute kidney injury induced by the interaction be-tween voriconazole and nifedipine.Methods A patient with acute kidney injury was treated with nifedipine controlled-release tablets and voriconazole tablets at the same time.Pharmacists analyzed drug interactions and drug characteristics during diagnosis and treatment and proposed treatment recommendations,discontinued suspected drugs(cefotaxime and voriconazole),and deter-mined subsequent treatment based on the analysis results.Results The doctor accepted the advice and the patient gradually re-covered from acute kidney injury.Conclusion Drug-drug interactions,especially those based on the interaction of liver drug enzyme CYP450,should be paid attention to in clinical diagnosis and treatment,to improve efficacy and reduce adverse reactions.

Objective:To investigate the current status of the technological pedagogical content knowledge (TPACK) levels of youth teachers in a military medical university, and to provide a practical basis for improving youth teachers' ability to teach with technologies.Methods:Youth teachers (with less than 3 years of teaching experience) in a military medical university were selected by convenience sampling for a survey on TPACK abilities using a modified TPACK questionnaire. The questionnaire was distributed through the internet, and 119 valid responses were returned. SPSS 20.0 software was used to perform the independent samples t-test and one-way analysis of variance.Results:The youth teachers scored highest in technological knowledge [TK; (3.68±0.74)] and lowest in TPACK (3.17±0.74). There were no significant differences in TPACK abilities between youth teachers in different majors. Youth teachers of different educational attainments showed significant differences in the levels of technological knowledge (TK; F=12.99, P<0.001), content knowledge (CK; F=13.64, P<0.001), technological pedagogical knowledge (TPK; F=4.38, P=0.015), technological content knowledge (TCK; F=3.83, P=0.025), and TPACK ( F=3.63, P=0.029)—the TK, CK, TPK, and TCK levels of teachers with doctoral degrees were significantly higher than those with bachelor's and master's degrees. Conclusions:Efforts should be made to design a TPACK ability development system throughout the growth cycle of youth teachers, build teaching practice communities, and improve the system guarantees.

Objective: To understand their appearance and microscopic characteristics, as well as their differences by studying the pharmacognosy of Yi medicine Elsholtzia rugulosa and Elsholtzia bodinieri, in order to provide a basis for identification and improvement of quality standards.
Methods: Stereo microscopy and optical microscopy and the macroscopic and microscopic identification methods were adopted to compare identification and digital representation for Elsholtzia rugulosa and Elsholtzia bodinieri from overall character, local characteristics, the microscopic identification characteristics, the transverse section and the powder.
Results:There were significant differences in the the macroscopic and the microscopic identification characteristics of Elsholtzia rugulosa and Elsholtzia bodinieri.
Conclusion: This study summarized the exclusive and practical features in pharmacognosic identification of Elsholtzia rugulosa and Elsholtzia bodinieri, it provides a useful reference for supervision the clinical medication,inspection,and standard drafting.

Abstract Airborne microorganisms, especially pathogenic microorganisms, are easily transmitted through dust and droplets, leading to various infectious diseases. The study summarizes the status of airborne microbial pollution, potential exposure levels, particle size, and species distribution of microorganisms, discusses the impact of airborne microorganisms on human health, and analyzes specific factors affecting campus air microorganisms from four aspects:climate, anthropogenic factors, time, and space, to provide a scientific basis for formulating effective improvement measures, improving air quality and safeguarding the health of teachers and students.

Objective:To explore the Pharmacognostic identification for the famous three medicinal fruits—Chebu-lae Fructus,Terminaliae Belliricae Fructus and Phyllanthi Fructus from the Tibetan medicine,and to establish the standards of the macroscopic,microscopic identification and digital characterization for the authentication study of three medicinal fruits from the Tibetan medicine.Methods:Using the terms and research methods of botanical morphological identification and classification,the comparative identification and digital characterization of three medicinal fruits from the Tibetan medicine were carried out by optical microscope,stereo microscope,digital cam-era and digital imaging technology from the aspects of front,side,abdomen,basic,surface appearance,cross sec-tion and longitudinal section characteristics,as well as the microscopic characteristics of cross section and powder.Then,the related characteristics were compared.Results:The macroscopic identification characters,such as the appearance,and microscopic identification characters,such as the epidermal cells,fiber,stone cells,calcium ox-alate cluster crystals,of three medicinal fruits from the Tibetan medicine were clarified,and the identification methods were summarized,in order to provide reference for the identification of three medicinal fruits from the Ti-betan medicine.Conclusion:The identification method is simple,environmental friendly,accurate and reliable,and can be used for the identification basis of four medicinal fruits from three medicinal fruits from the Tibetan medicine.

Objective To observe and analyze the application of project achievement style quality control circle in constructing an outpatient intelligent pharmacy pre-job training model,and provide new ideas and systematic solutions for pre-job training of new pharmacists in intelligent pharmacies.Methods 70 pharmacists who were newly employed in outpatient pharmacy of Yantai Yuhuangding Hospital from January 2023 to March 2024 and had no working experience in this position were selected and divided into two groups(the control group and the experimental group)by random draw method.The control group implemented the traditional training mode,and the experimental group adopted the new mode of pre-job training of outpatient intelligent pharmacy constructed by project achievement style quality control circle.The theoretical,skill,and practical examination results at the end of the training period and the satisfaction with training of the newly-appointed pharmacists were collected.Results The assessment scores of theory,skills and practice,and the results of satisfaction with the training of newly recruited pharmacists in the experimental group were significantly higher than those of the control group(P＜0.05).Conclusion The new model of pre-job training for new pharmacists in the outpatient intelligent pharmacy has great advantages in the design of the training program,standardization of the training content,reasonable arrangement of the training cycle,and innovation of the training mode,which improves the pharmacists'satisfaction with the training and achieves good training results.

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 analyze the onset time and short-term clinical effect of rituximab(RTX)in the treatment of glomerular diseases.Methods All case data of rituximab used in the treatment of glomerular diseases in a tertiary hospital from January 2021 to December 2022 were extracted for retrospective study.The changes in blood routine,liver function,kidney function,immunity and other related indexes were analyzed after the treatment of RTX and the clinical effect in the short term was observed.Results A total of 52 patients were collected,of which 30 received RTX standardized therapy.During the follow-up period,plasma albumin showed an upward trend,and the 24-hour urine protein and B cell count showed a downward trend.The values of these indexes after 3 months and 6 months after treatment were significantly different from those before treatment,which was statistically significant(P<0.05).The clinical response rates after the first injection,the second injection,the third injection,the fourth injection,3 months later,and 6 months after RTX treatment were 26.92%,36.00%,51.85%,57.69%,76.92% and 81.82%,respectively.No serious adverse effects occurred during the follow-up period.Conclusions RTX can improve 24-hour urine protein,plasma albumin level and B cell count in glomerular-related diseases,stabilize renal functionand have good safety.

ObjectiveTo explore the clinical efficacy of Huanglian Jiedutang as an adjunctive treatment for acute cerebral infarction complicated with gastric motility disorder. MethodSixty patients with acute cerebral infarction complicated with gastric motility disorder with fire toxin syndrome were randomly divided into a western medicine control group （control group） and a traditional Chinese medicine （TCM） combined treatment group （observation group）， with 30 cases in each group. The control group received basic treatment for cerebral infarction and relevant western medical symptomatic treatment based on the patients' gastrointestinal symptoms. The observation group received Huanglian Jiedutang in addition to the treatment provided to the control group. The treatment course was 7 days. Neurological deficit scores and gastrointestinal dysfunction scores were assessed in both groups before treatment and on the 4^th and 7^th days of treatment. Gastrointestinal electrographic parameters， serum citrulline （CIT）， and motilin （MTL） levels were measured in both groups before treatment and on the 7^th day of treatment. Clinical efficacy was compared between the two groups. ResultCompared with the baseline in both groups， the neurological deficit scores and gastrointestinal dysfunction scores were significantly reduced on the 4th and 7^th days of treatment （P<0.05）. The reductions in these scores were more significant on the 7^th day compared with those on the 4^th day of treatment （P<0.05）. On the 4^th and 7^th days of treatment， the observation group showed a significantly greater reduction in neurological deficit scores and gastrointestinal dysfunction scores compared with the control group （P<0.05）. On the 7th day of treatment， compared with the baseline， both groups showed a significant increase in gastric antral and gastric body electric wave amplitudes as well as serum CIT and MTL levels （P<0.05）， and there were no statistically significant differences in the frequency of gastric antral and gastric body electric waves. On the 7th day of treatment， compared with the control group， the observation group had a significant increase in gastric antral and gastric body electric wave amplitudes as well as serum CIT and MTL levels （P<0.05）， and there were no statistically significant differences in the frequency of gastric antral and gastric body electric waves. After 7 days of treatment， the total effective rate in the observation group was 90.00% （27/30）， higher than 76.67% （23/30） in the control group， but the difference was not statistically significant. ConclusionAdjunctive treatment with Huanglian Jiedutang can effectively improve the symptoms of neurological function impairment and gastrointestinal dysfunction in patients with acute cerebral infarction complicated with gastric motility disorder， increase gastric antral and gastric body electric wave amplitudes， improve gastric motility disorder， and increase serum CIT and MTL levels， thereby improving the imbalanced secretion function of the gastrointestinal tract.