Background Survivors of acute respiratory distress syndrome (ARDS) frequently experience cognitive impairment, psychological symptoms, and reduced health-related quality of life after intensive care. Immersive virtual reality (VR) may provide an engaging, multimodal adjunct to conventional rehabilitation, but evidence in the ARDS recovery population remains limited. Methods In this single-center, parallel-group randomized controlled trial, 88 ARDS patients in the rehabilitation phase were randomized 1:1 to a 4-week augmented rehabilitation package incorporating immersive VR in addition to usual care (n = 44) or usual care alone (n = 44). One control participant was lost to follow-up, and 87 participants were included in the available-case analysis. The primary outcome was change in Montreal Cognitive Assessment (MoCA) score from baseline to 4 weeks. Secondary outcomes included the 36-Item Short Form Health Survey (SF-36) and Hospital Anxiety and Depression Scale (HADS) scores. The main between-group analysis used analysis of covariance (ANCOVA), with follow-up score as the dependent variable and baseline score as the covariate. Results Baseline imbalances were observed for age, MoCA, SF-36, and HADS-A scores. After adjustment for corresponding baseline scores, the VR group showed greater improvement in MoCA score than the control group (adjusted between-group effect: 1.42, 95% CI 0.86 to 1.98;p < 0.001). The VR group also showed higher SF-36 scores (adjusted effect: 13.20, 95% CI 11.85 to 14.54; p < 0.001) and lower HADS-A scores (adjusted effect: -2.55, 95% CI -3.23 to -1.88; p < 0.001). In the VR group, 29 of 44 participants (65.9%) reported being very satisfied or satisfied with the intervention. Conclusions An augmented rehabilitation package incorporating immersive VR was associated with short-term improvements in cognition, health-related quality of life, and anxiety symptoms during early ARDS recovery. Because the package also entailed additional structured rehabilitation exposure, staff attention, interaction, repeated activity, feedback, and treatment time, and because the control condition was not time- or attention-matched, the observed differences cannot be attributed specifically to VR. These single-center, short-term, hypothesis-generating findings require confirmation in larger studies with time- and attention-matched controls. Trial registration: Chinese Clinical Trial Registry, ChiCTR2600122078; retrospectively registered on 8 April 2026, after completion of participant recruitment.

OBJECTIVE:To establish a predictive model for acute kidney injury (AKI) in patients undergoing extracorporeal cardiopulmonary resuscitation (ECPR), and to evaluate and validate its predictive value. METHODS:A multicenter retrospective cohort study was conducted. 1) The clinical data of the patients undergoing ECPR during cardiopulmonary resuscitation (CPR) admitted to the First Hospital of Jiaxing between January 2016 and August 2024 were collected as the modeling cohort. The clinical data included patient characteristic information, relevant treatment information during ECPR, post-extracorporeal membrane oxygenation (ECMO) operation parameters, and ECMO-related variable information. The patients were divided into an AKI group and a non-AKI group according to the occurrence of AKI during ECMO support. The differences in clinical characteristics between the two groups were compared. Multivariate Logistic regression analysis was used to screen independent risk factors for AKI during ECMO therapy, and a nomogram model was established. The predictive value of the model was evaluated by receiver operator characteristic curve (ROC curve). Internal validation of the model was performed using the Bootstrap method with 1 000 resamplings. The predictive performance of the nomogram model was verified using calibration curves and the Hosmer-Lemeshow test, and the clinical utility of the model was assessed by decision curve analysis (DCA). 2) The clinical data of the patients who received ECPR during CPR admitted to the First People's Hospital of Tongxiang and the First People's Hospital of Pinghu from May 2024 to June 2025 were selected for external validation. The predictive efficacy of the model was evaluated by ROC curve analysis. RESULTS:1) A total of 108 ECPR patients were finally enrolled in the modeling cohort, among whom 78 developed AKI during ECMO treatment and 30 did not, with an AKI incidence of 72.2%. Compared with the non-AKI group, the patients in the AKI group had higher Sequential Organ Failure Assessment (SOFA) score, serum creatinine (SCr), blood lactic acid, lower procalcitonin (PCT), and longer hypoperfusion time (all P<0.05). There were no significant differences in other clinical data between the two groups. Multivariate Logistic regression analysis showed that increased SOFA score [odds ratio (OR)=1.288, 95% confidence interval (95%CI) was 1.055-1.571, P=0.013], SCr (OR=1.010, 95%CI was 1.002-1.018, P=0.015) and blood lactic acid (OR=1.151, 95%CI was 1.036-1.279, P=0.009), and prolonged hypoperfusion time (OR=1.059, 95%CI was 1.007-1.114, P=0.026) were independent risk factors for AKI during ECMO in ECPR patients. A nomogram prediction model was constructed based on the above independent risk factors. ROC curve analysis showed that the area under the ROC curve (AUC) of the nomogram model for predicting AKI in ECPR patients was 0.858 (95%CI was 0.782-0.934, P<0.001), with a sensitivity of 71.8% and a specificity of 83.3%. After 1 000 Bootstrap resamplings, the C-index was 0.822. The Hosmer-Lemeshow test and calibration curve showed good fitness between the predicted and ideal probabilities (χ2=6.402, P=0.602), indicating favorable model performance. DCA results suggested that using the nomogram model achieved higher net benefit for most patients. 2) A total of 31 patients who received ECPR were enrolled for external validation. There were no significant differences in baseline data such as gender, age, or underlying diseases as well as four core independent risk factors for constructing a nomogram predictive model between the external validation cohort and the primary cohort, meeting the requirements of external validation design. ROC curve analysis showed that the AUC of the nomogram model for predicting AKI in ECPR patients was 0.833 (95%CI was 0.654-1.000, P<0.001), with a sensitivity of 70.0% and a specificity of 85.7%. CONCLUSIONS:A nomogram model for predicting AKI in ECPR patients is established based on hypoperfusion time combined with SOFA score, SCr, and blood lactic acid. The model has been confirmed to possess good predictive value through both internal and external validation.

Purpose Pain is one of the most common and harmful symptoms experienced by individuals with acute herpetic neuralgia (AHN). In this population, studies to determine the causes that affect patients taking medications compliance are rare. This study aimed to construct a predictive model for medication compliance of patients with AHN and to verify its performance. Design and Methods In this prospective study of 398 patients with AHN who were discharged from a tertiary hospital with medications from July 2020 to October 2022, we used logistic regression analysis to explore the predictive factors of medication compliance of patients with AHN and to construct a nomogram. The area under the curve was used to evaluate the predictive effect of the model. Results A predictive model of drug compliance of patients with AHN was constructed based on the following four factors: disease duration, pain severity before treatment, medication beliefs, and comorbidity of chronic diseases. The area under the curve of the model was 0.766 (95% confidence interval [0.713, 0.819]), with a maximum Youden's index of 0.431, sensitivity of 0.776, and specificity of 0.655. A linear calibration curve was found with a slope close to 1. Conclusions The prediction model constructed in this study had good predictive performance and provided a reference for early clinical screening of independent factors that affected the medication compliance of patients with AHN.

目的 探讨"互联网+"经外周静脉穿刺的中心静脉导管(PICC)上门服务网络"1+3"模式的实践效果.方法 选取该院2021年6月至2022年7月新留置PICC且小于3个月的患者744例,将2021年6-7月新置管患者402例设为对照组,2022年6-7 月新置管患者342例设为观察组.对照组在云嘉平台上单点"互联网+"PICC上门服务,观察组应用结构-过程-结果三维质量管理框架搭建区域"互联网+"PICC上门服务网络提供服务,从RE-AIM模型5方面分析两组运营差异.结果 观察组总接单率、实际服务率及维持率分别为19.0%(65/342)、98.5%(64/65)、12.5%(8/64),明显高于对照组的6.5%(26/402)、80.8%(21/26)、9.5%(2/21),其中两组总接单率与实际服务率差异有统计学意义;执行度方面,观察组在总质量、过程质量及结果质量方面的合格率均高于对照组;有效度方面,对照组导管相关并发症及不良事件发生6例(28.6%),观察组发生3例(4.7%),差异均有统计学意义(P＜0.05).结论 "互联网+"PICC上门服务网络有一定优势,其在覆盖度、有效度、采纳度和执行度上表现良好,但在服务维持度上有待加强.

术后按压技术在临床应用广泛,对于血管类或疝气手术后需要用传统的沙袋按压起到止血的作用,但沙袋易从穿刺点或疝的位置滑脱,不能有效按压,如果患者从平卧位改变成侧卧位,沙袋则无法有效按压.患者长时间的平卧位会降低舒适度,无形中增加压力性损伤发生率.

Objective:To construct a core competence evaluation index system for Anesthesia Intensive Care Unit (AICU) nurses, and to provide reference for the career orientation, training and management of AICU nurses.Methods:The first draft of the core competence evaluation index system of AICU nurses was developed by literature evaluation, semi-structured interview and group discussion. Using the purposive sampling method, 26 experts were selected for 2 rounds of expert consultation from August to September 2021 to determine the evaluation index system of core competence of AICU nurses, and the weights of indicators at all levels were determined by analytic hierarchy process.Results:The effective recovery rates of the 2 rounds of expert letter consultation questionnaire were respectively 92.31% (24/26) and 91.67% (22/24) , the expert authority coefficients were respectively 0.93 and 0.93, and the Kendall's harmony coefficients were respectively 0.28 and 0.19 (all P<0.01) . The final evaluation index system of AICU nurses' core competence included 4 first-level indicators (theoretical knowledge, nursing practice, comprehensive ability, personal characteristics) , 14 second-level indicators and 52 third-level indicators. Conclusions:The constructed evaluation index system of core competence of AICU nurses is scientific and reliable, which can provide a reference for the career orientation, training and management of AICU nurses.

预防住院患者跌倒/坠床是医院护理工作的重要内容之一,跌倒/坠床发生率已经成为评价医院护理质量的标准之一[1].研究显示,夜间因患者不愿打扰家属休息或未遵医嘱而自行起床时易发生跌倒[2].目前临床上老年患者院内高危跌倒/坠床常规预防措施包括:床头、腕带放置警示标识;患者和家属的防跌倒/坠床的安全教育;床栏防护或根据病情使用约束带等[3].但现有约束设备无法有效兼顾既保证约束效果又方便肢体活动.为此,嘉兴市第一医院自行研制一款防坠床医用约束衣(专利号:ZL 2016 2 1432747.5)并应用于临床,取得了良好的效果,现报道如下.

OBJECTIVE:To explore the risk factors of intensive care unit-acquired weakness (ICU-AW), and to establishment and verify its risk prediction model.METHODS:A modeling group of 231 patients who met the inclusion criteria and were admitted to the intensive care unit (ICU) of the First Hospital of Jiaxing from July 2019 to June 2020 was collected by convenience sampling method. According to whether they developed ICU-AW, they were divided into ICU-AW group (55 cases) and non ICU-AW group (176 cases). The clinical data were collected concerning patients' individual information, disease-related factors, treatment-related factors and laboratory indicators, and the differences of the above indexes between two groups were compared. Logistic regression was used to analyze the ICU-AW risk factors and a risk prediction model was constructed. Calculate the area under ROC curve (AUC) to test the prediction effect of the model. At the same time, 60 patients who admitted to ICU from July to October 2020 and met the standards were collected to verify the model.RESULTS:Compared with non ICU-AW group, there were more males in ICU-AW group [61.8% (34/55) vs. 44.3% (78/176), P < 0.05], with higher levels of systemic inflammatory response syndrome (SIRS), sepsis, immobilization and the use of neuromuscular blockers [SIRS: 30.9% (17/55) vs. 3.4% (6/176), sepsis: 12.7% (7/55) vs. 2.3% (4/176), immobilization: 72.7% (40/55) vs. 39.2% (69/176), the use of neuromuscular blockers: 50.9% (28/55) vs. 14.2% (25/176), all P < 0.05], and acute physiology and chronic health evaluation II (APACHE II) score, blood lactic acid level and duration of mechanical ventilation, length of hospital stay were all increased [APACHE II score: 18 (15, 24) vs. 12 (8, 17), blood lactic acid (mmol/L): 2 (1, 2) vs. 1 (1, 2), duration of mechanical ventilation (days): 7 (4, 12) vs. 2 (2, 5), length of hospital stay (days): 10 (6, 16) vs. 5 (3, 9), all P < 0.05]. SIRS, APACHE II score, duration of mechanical ventilation and blood lactic acid were included to construct a risk prediction model [odds ratio (OR) values were 4.835, 1.083, 1.210, 1.790, P values were 0.018, 0.013, 0.015, 0.013]. The model equation was P = exp [-5.207+(1.576×SIRS)+(0.079×APACHE II)+(0.191×duration of mechanical ventilation)+(0.582×blood lactic acid)]. Internal verification: Calibration diagram showed the calibration curve above the ideal curve, AUC = 0.888, 95% confidence interval (95%CI) was 0.839-0.938; when the cut-off value was 0.166, the sensitivity was 89.1%, the specificity was 75.6%, and the maximum index was 0.649. External verification: Calibration diagram showed that the calibration curve was above the ideal curve, and the plotted AUC = 0.853, 95%CI was 0.753-0.953. When the cut-off value of the corresponding predictive risk value was 0.367, the sensitivity was 68.8%, the specificity was 86.4%, and the maximum approximate index was 0.552.CONCLUSIONS:The risk prediction model of ICU-AW constructed in this study has good consistency and prediction efficiency, which can provide reference for medical personnel to identify high-risk groups of ICU-AW patients in the early stage and provide targeted interventions in advance.

目前临床采用的上肢约束工具有云丝棉制作的厚棉布手套、乒乓球拍手套、分指约束手套等,约束后患者手部闷热潮湿,手指不能自由屈曲,舒适度下降,容易导致关节僵硬[1 ] ,更重要的是仍然无法避免非计划性拔管(UEX )的发生,有报道显示UEX 占据护理不良事件的首位[2 ].2014 -2016年,嘉兴市第一医院ICU 研发的一种新型透明约束保护手套(专利号:ZL 201410448534.0) ,为透明圆筒状,筒体上面设有多个直径0 .5 cm透气小孔,临床应用结果显示 UEX明显降低、手指可在筒内自由屈曲、手部闷热潮湿情况明显改善[1 ] ,但不方便调整指脉氧饱和度仪探头,无法直观肢端血运及皮肤情况.为此,本研究对该手套进行了改良,在手套底部设计为螺旋式开盖,临床应用效果更好,现报道如下.

目的 观察移动医疗结合情景模拟体验对慢性肾脏病2期患者远期疗效的影响.方法 选取符合纳入标准的300例患者为研究对象,按照随机数字表分为观察组和对照组各150例.两组均采用移动医疗技术实施远程健康管理,观察组在应用移动医疗的同时结合情景模拟体验干预.比较两组患者入组时、干预3个月、干预12个月时的自我管理行为以及肾功能指标.结果 干预3个月、12个月时观察组自我管理行为得分高于对照组,肾小球滤过率高于对照组,血肌酐指标低于对照组,差异有统计学意义(P<0.01).结论 移动医疗结合情景模拟体验干预能有效维持慢性肾脏病2期患者的远期疗效.

目的 探讨授权教育及思维导图对再生障碍性贫血患者自我感受负担及应对方式的影响.方法 选取2015年11月-2018年2月我院收治的再生障碍性贫血患者70例,将2015年11月-2017年6月收治的患者35例纳入对照组,实施常规健康教育干预;将2017年7月-2018年2月收治的患者35例纳入观察组,实施授权教育结合思维导图干预.比较两组患者自我感受负担、应对方式和治疗依从性.结果 与对照组比较,观察组患者自我感受负担量表(SPBS)各维度评分、医学应对方式问卷(MCMQ)中回避评分及屈服评分均较低,面对评分及依从良好率均较高,差异有统计学意义(P<0.05).结论 将授权教育与思维导图结合应用于再生障碍性贫血患者治疗中,能明显降低自我感受负担,有益于患者树立积极乐观的应对方式,增强治疗依从性.

目的 观察防走失马甲在老年认知功能障碍患者走失风险管理中的应用效果.方法 将嘉兴市第一医院王江泾分院2015年1月至2016年12月住院的老年认知功能障碍患者39例设为对照组,将2017年1月至2018年12月住院的老年认知功能障碍患者42例设为观察组.两组均予常规护理,观察组在此基础上应用防走失马甲在住院期间走失风险进行管控,比较走失情况及走失时间.结果 观察组走失率4.8％低于对照组的23.1％,走失时间短于对照组,差异均有统计学意义(P<0.05).结论 通过应用防走失马甲,有效地控制老年认知功能障碍患者走失情况,一旦走失也以较快的速度找回患者,降低患者走失带来的风险,保证患者安全.

住院患者在诊治过程中需要多次外出检查和治疗 ,转运过程中保证有效的氧气供应是安全转运的重要保障[1 ] .选择氧气袋进行氧疗时氧饱和度降低的发生率高[2 ] ,因而常采用氧气钢瓶供氧.呼吸内科多数患者使用轮椅进行转运 ,但普通的轮椅没有放置氧气钢瓶的专用位置 ,只能将氧气钢瓶挂在轮椅椅背上 ,转运过程中氧气钢瓶容易跌落坠地 ,导致供氧中断 ,甚至砸伤人 ,存在很大风险[3 ] .因此 ,嘉兴市第一医院呼吸内科设计了一体式轮椅氧气钢瓶架 ,经临床应用证明氧气钢瓶放置稳妥 ,效果良好.现报道如下.

目的 提高慢性肾脏病(CKD)非透析患者自我管理能力,延缓疾病进展.方法 将420例CKD非透析患者随机分为两组各210例.对照组行常规肾内科门诊复诊与随访;观察组在此基础上采取多学科专业团队联合移动医疗实施患者管理,包括设计CKD患者管理App,建立患者电子档案,多学科协作团队同时出诊,线上线下咨询与指导等.实施12个月后评价效果.结果 完成全程研究者观察组208例、对照组200例.干预6个月、12个月时,观察组自我管理行为评分,收缩压达标率显著高于对照组(均P＜0.01);肾小球滤过率、血肌酐值显著优于对照组(均P＜0.01).结论 采用多学科协作联合移动医疗针对CKD非透析患者进行持续管理,有利于培养患者自我管理能力,延缓疾病进展.

ObjectiveTo construct a quality evaluation index system for continuous aspiration of subglottic secretion(CASS), in order to provide references for clinical objective evaluation of the quality of this technology. MethodsBased on the theory of "structure-process-outcome" model, through literature review, expert meeting, expert consultation and principal component analysis, the quality evaluation index system and the index weights of all indicators for CASS were finally determined by 23 intensive care unit experts from 5 provinces (autonomous regions)and 11 cities through two rounds of consultation. SPSS 18.0 software was used in statistical analysis. ResultsThe effective responsive rate of the questionnaires in the two rounds were 92.0%,87.0%; the expert authority coefficients were 0.887, 0.895; Kendall's idea coordination coefficients were 0.13, 0.09 (P＜ 0.01).The final index system consisted of 3 first-level indicators, 8 second-level indicators, and 23 third-level indicators. ConclusionsThe process of the construction of nursing quality evaluation index system for CASS is scientific, and the contents of index entries are reasonable, which can ensure the effective implementation of the technology.

目的 观察双层痰液处置杯在痰液封闭消毒管理中的效果.方法 将60例肺结核患者按方便抽样法分为观察组和对照组各30例,对照组患者使用普通加盖痰杯收集痰液,观察组患者使用双层痰液处置杯收集痰液.比较两组患者痰液暴露发生率及患者使用痰杯依从性.结果 观察组痰液暴露发生率低于对照组,使用痰杯依从性高于对照组,比较差异均有统计学意义(P＜0.05).结论 双层痰液处置杯可降低痰液暴露发生率,提高患者使用痰杯依从性.

Objective? Through the popularization of the technique of stabilized pressure suction of the subglottic secretion, to improve the drainage effect of subglottic secretion of intensive care uni(t ICU) patients in this region, and to improve the quality of subglottic secretion management. Methods? The stabilized pressure suction device on continuous aspiration of subglottic secretion was designed and the pressure-stabilized suction technique for subglotted secretion was promoted in 7 hospitals in Zhejiang province from January to December of 2018. The quality of drainage of subglottic secretion before and after the promotion of the stabilized suction technique were compared. In every hospital the included research objects were divided into two groups, and the subglottic secretion stabilized pressure suction devices adopted two suctioning methods of intermittent suction and continuous suction accordingly in the two groups: intermittent suction group(n=161) and continuous suction group(n=160), the incidence of blockage of decompression holes and instability of negative pressure control were compared between the two groups, and the incidences of drainage, cough, blockage of suction tube and mucosal injury during suction were compared. Results? After promotion, the quality of subglotted secretion suctioning in 7 hospitals all improved, among which the dimensions of "suction operation" and "outcome indicator" showed statistically significant difference before and after promotion(P＜0.05). In terms of the performance of stabilized pressure suction device, the blockage rate of decompression holes in continuous suction group (3.13%) was higher than that in intermittent suction group, and the incidence of negative pressure control instability (3.75%) was lower than that in intermittent suction group; in terms of the effect of subglottic drainage, the drainage flow rate of subglottic secretion in continuous suction group was (53.55±5.92) ml/d, and the daily coughing times were (3.01±1.13), both better than the intermittent suction group, the difference was statistically significant (t=12.374,-2.625; P＜ 0.05). Conclusions? Subglottic secretion pressure-stabilized suction device has good performance, and the technology of pressure-stabilized suction can effectively improve drainage effect. The method of continuous suction is recommended in this study, which has a significant effect on improving the drainage quality of subglottic secretion and has a good promotion effect.

Objective? To explore the effects of the problem-oriented intervention model on major nursing issues, self-care behavior and illness perception in elderly patients with type 2 diabetes. Methods? Totally 112 elderly patients with type 2 diabetes admitted in the First Hospital of Jiaxing from September 2016 to September 2017 were selected by convenient sampling and divided into the control group (n=56) and the observation group (n=56) based on the time of admission. Patients in the control group received conventional nursing care, while patients in the observation group received conventional nursing care in addition to problem-oriented nursing interventions. The Omaha Problem Classification Scheme was used to evaluate the nursing issues in the two groups, and the Chinese version of Summary of Diabetes Self-Care Activities (SDSCA) and the Brief Illness Perception Questionnaire (BIPQ) were used to evaluate the intervention effects between the two groups. Results? After 6 months, the resolution rate of major nursing issues in the observation group was 82.93% (68/82), while that in the control group was 63.16% (48/76); (χ2=7.898, P＜ 0.05). The self-care behavior and illness perception in the observation group totaled (27.33±7.36) and (38.49±5.76), respectively, both higher than that in the control group (t=5.180, 7.201; P＜ 0.01). Conclusions? The problem-oriented nursing intervention model can effectively enhance the self-care ability and illness perception in elderly patients with type 2 diabetes.

目的 通过对ICU患者难免性压力性损伤相关危险因素的分析,建立个体化预测ICU患者难免性压力性损伤风险的列线图模型.方法 回顾性收集278例ICU患者的临床资料,采用单因素分析和多因素Logistic分析筛选难免性压力性损伤的独立危险因素;应用R3.4.0软件建立ICU患者难免性压力性损伤风险的预测列线图模型,采用BootStrap自抽样法进行模型验证,并应用ROC曲线探索列线图模型对ICU患者难免性压力性损伤风险的预测效率.结果 共纳入难免性压力性损伤组患者72例,非压力性损伤组患者206例.多因素分析提示年龄 、全身性水肿 、糖尿病 、偏瘫 、急性生理与慢性健康评分 Ⅱ 评分 、大小便失禁是影响ICU患者难免性压力性损伤的独立危险因素(P<0.05).内部验证的C-index为0.82,95％CI(0.78,0.89),具有良好的区分度与稳定性;ROC曲线显示,基于以上独立危险因素的回归模型的曲线下面积为0.83,95％CI(0.77,0.89),与列线图结论一致.结论 ICU患者难免性压力性损伤的列线图风险模型稳定性 、预测准确性良好,可作为预测ICU患者发生难免性压力性损伤的一种评估工具.

Objective: To explore the expression and distribution of programmed death receptor 1 (PD-1) and T-cell immunoglobulin mucin 3 (TIM-3) in breast cancer microenvironment and analyze the their correlation with the clinicopathological features. Methods: The specimens of tumor tissue and adjacent tissues from 30 patients with infiltrative breast cancer who were diagnosed as breast cancer from June 2016 to May 2017 in The First Hospital of Jiaxing were collected, and the specimen were divided into two parts along the center. After embedding and cryosectioning, the expression and distribution of PD-1 and TIM-3 protein in tumor tissues were observed by immunofluorescence staining. Another part of the specimen was cut and digested, and non-continuous density gradient centrifugation was used to extract tumor-infiltrating lymphocytes (TILs), real-time quantitative PCR (qRT-PCR) was used to detect the mRNA expression of PD-1 and TIM-3 in TILs. Meanwhile, the protein expression was determined by Western blotting. The relationship between the expression of PD-1 and TIM-3 and pathological parameters of breast cancer was analyzed with correlation analysis. Results: Immunofluorescence results showed that more PD-1 and TIM-3 positive cells were observed in the tumor tissues compared with the tumor-adjacent tissues. The qRT-PCR showed that the expression of PD-1 and TIM-3 mRNA in TILs were both significantly higher than those in paracancerous tissues (3.09±0.38 vs 1.26±0.23, 3.42±0.31 vs 1.57±0.29, t=4.16, 4.37, both P<0.05). At the protein level, the expression of PD-1 and TIM-3 in tumor tissue lymphocytes(0.66±0.08, 0.80±0.11) was significantly higher than those in cancerous tissues(0.10±0.01, 0.26±0.02) (t=6.79, 4.57, both P<0.05). There were significant differences in the expression of PD-1, TIM-3 mRNA in the TILs between the different tumor histological grades, tumor sizes, lymph node metastasis (t=2.22-2.99, all P<0.05). Correlation analysis showed that there was a significant positive correlation between the expression of PD-1 and TIM-3 in tumor tissues (r=0.616, P<0.01). Conclusions: In the breast cancer microenvironment, PD-1, TIM-3-mediated signaling pathway plays an important role in the occurrence and development of breast cancer, it provides a new basis for the combination therapy of breast cancer.