Objective: To systematically evaluate the incidence of falls among empty nesters in China, so as to provide the evidence for preventing falls among empty nesters. Methods: Publications pertaining to cross-sectional studies of falls among empty nesters in China were retrieved from international and national databases, including CNKI, Wanfang Data, VIP, Cochrane Library, Web of Science and PubMed from inception to August, 2022. Meta-analysis was performed using the software Stata 15.1, and the combined incidence and 95%CI of falls among empty nesters in China was analyzed. Sensitivity analysis was performed using the leave-one-out method to evaluate the stability of outcome indicators. In addition, the publication bias was evaluated using Funnel plot. Results: Initially, 795 articles were screened in the literature, and 17 articles were finally included, covering 5 468 participants. Meta-analysis revealed that the incidence of falls among empty nesters in China was 23.0% (95%CI: 16.6%-29.5%). Subgroup analysis showed that the incidence of falls among empty nesters published from 2016 to 2022 was higher than that from 2008 to 2015 (20.4% vs. 17.3%; P<0.05). The incidence of falls among empty nesters in western regions was higher than that in eastern and central regions (27.4% vs. 15.9% and 15.0%; P<0.05). The incidence of falls among empty nesters in urban areas was higher than that in rural areas (20.8% vs. 9.9%; P<0.05). Sensitivity analysis showed that the study results were stable, and the funnel plot identified some publication bias. Conclusion The incidence of falls among empty nesters in China was 16.6% to 29.5%, and it is recommended to strengthen the assessment and prevention of risk factors of falls among empty nesters.

Objective To analyzed the expression and clinical characteristics of CD 20 marker in children with B-lineage acute lymphoblastic leukemia ( B-ALL) and evaluated its medical significance in assessing the prognosis of disease.Methods From November 2008 to July 2012,125 cases of children with B-lineage acute lymphoblastic leukemia were collected from Shanghai Children ′s Hospital,including 79 males and 46 females, aged between 2 months to 14 years old.Flow cytometry based immunophenotyping and Minimal Residual Disease ( MRD) screening were applied to these children when newly diagnosed ,and MRD monitoring was again carried out after 35 days of induction remission therapy to those bears the MRD markers.These 125 patients were divided into CD20-positive group and CD20-negative group, and the corresponding clinical characteristics ,stage of immunophenotype ,MRD,risk stratification,and overall survival rates were recorded and compared.Data were statistically analyzed by using SPSS 16.0 software including χ2 test,t-test,standard deviation test and survival test.Results A total of 125 children with ALL-B,the group of CD20-positive were 48 while CD20-negative groups were 77,with a median age of 6 years old,and the median follow-up time of 30 months.Multivariate Cox regression Analysis showed that there was no clear correlation between CD20 expression level with age ,sex,white blood cell count at diagnosis ,fusion-gene,the stage of immunophenotype as well as risk stratification.The MRD-positive incidence at 35 days in the CD20 positive group was 35.4%,much higher than that of the CD20-negative group (16.9%),which is statistical significance (χ2 =5.236,P<0.05),while the overall survival rate (OS) for the CD20 positive group is 75.0%,much lower than that of the CD20 negative group (84.4%,χ2 =4.160,P<0.05).Conclusions CD20 positive expression level in children with B-lineage acute lymphoblastic leukemia at diagnosis demonstrates negative correlation with the overall survival rate of the patient ,indicating its usefulness as an additional joint marker for the current regimens to incorporate CD 20-targeted monoclonal therapy.

Objective To investigate CD38 expression characteristic and the relation of clinic prognosis in children with acute lymphoblastic leukemia,in order to improve individual treatment.Methods Seventy-nine patients with childhood acute lymphoblastic leukemia(B-lineage) were enrolled into this study.Four-color fluorochrome labeled monoclonal antibodies were applyed to analyze the cell immunophenotypes and minimal residual disease screening.When CD38 low-expression was considered to be the effective screening marker and be used to continue monitoring.All patients were divided into CD38 low-expression groups and CD38 high-expression groups,to compared the immunophenotyping characteristic,risk stratification and survive rate of the two groups.All datas were assessed by means of SPSS16.0 and a P value of 0.05or less was considered to indicate statistical significance.Results All of 79 newly diagnosed ALL-B,The group of CD38 low-expression were 50/79 (63.3％) while the other group were 29/79(36.7％).of all patients,11 chilldren showed only a screening indicator-CD38/CD10/CD34/CD19,while 46 belonged to more than one markers (Such as TdT/CD10/CD34/CD19,CD66c/CD10/CD34/CD19 and CD45/CD10/CD34/CD19) and 18 no markers.The stratification of CD38 low-expression and CD38 high-expression groups as follows:21/5 patients with low-risk,14/15 with medium risk and 15/9 with high-risk.In the CD38 low-expression group,Early Pre-B 33,Pre-B 12,Mature-B 5,while in the CD38 high-expression group,Early Pre-B 21,Pre-B 5,Mature-B 3.This study showed that the high-risk stratification in the CD38 high-expression group was obviously higher than the CD38 low-expression group(F=6.24,P=0.044),but the survival time was signicantly shorter than CD38 low-expression group (x2 ＝ 5.22,P =0.022) and the difference was statistically significant.Conclusion CD38 as a MRD monitoring indicator of most acute lymphoblastic leukemia when it low-expression,CD38 high-expression in newly diagnosis childhood acute lymphoblastic leukemia(B-lineage) may be an independent risk factor for predicting poor prognosis.

Objective To explore phenotypic modulation of vascular smooth muscle cells(VSMC) and change of p38 mitogen-activated protein kinase(MAPK) expression after intimal injury of rabbit carotid arteries. Methods The model of vascular restenosis established by balloon injury of rabbit carotid common arteries was used.HE staining,immunohistochemistry staining and Western blot were used to detect the change of proliferation cell nuclear antigen(PCNA),smooth muscle ?-actin(SM?-actin),p38 expression and morphology of sham-injured arteries and injured arteries at different time points.Results ⑴The proliferating VSMC was observed on the side of the medium lumen at 1 day and on the surface of vascular lumen at 3 days after injury.The neointima was formed and gradually being thicken at 5～7 days,and the thickening was accelerated at 14～35 days after injury.⑵PCNA was negative in the medium and endothelium of sham-injured arteries.Positive cell rate of PCNA was gradually increased at 1～14 days in the medium and at 5～14 days in the neointima after injury,with the maximum rate at 14 days.However,it declined gradually after 28 days.Positive cell rate of PCNA in the neointima was slightly higher than that in the medium.⑶SM?-actin was positive in the medium,negative in the endothelium of sham-injured arteries.Positive cell area of SM?-actin initially decreased at 1 day in the medium after injury with the minimum rate at 3 days,but it increased gradually after 5 days.Expression of SM?-actin in the neointima was slightly less than that in the medium.⑷p38 expression was very low or negative in the medium of sham-injured arteries.Expression of p38 was sustained and increased at 1～35 days after injury with the most remarkable elevation at 3～14 days.Expression of p38 in the neointima was higher than that in the medium.There was positive relationship between the p38 expression and PCNA expression in the vascular wall at different time points after injury.Elevation of p38 was earlier than decrease of SM?-actin.Conclusion There was a close relationship between the phenotypic modulation and proliferating ability of VSMC.P38 participated in signal transduction of phenotypic modulation of VSMC after intimal injury.

Objective:To retrieve, evaluate, and integrate the best evidence of low-fiber diet bowel preparation before colonoscopy in children, providing a basis for clinical nursing practice.Methods:Guidelines, systematic reviews, evidence summaries, expert consensus, randomized controlled trials and so on related to bowel preparation for low-fiber diet before colonoscopy in children were searched through computers in domestic and foreign databases, guideline websites and professional association websites. The search period was from database establishment to October 31, 2021. The evidence included was graded using the Joanna Briggs Institute (JBI) evidence pre-grading and evidence recommendation grading system (2014 version) in Australia.Results:A total of 8 articles were included, including four guidelines, one evidence summary, one systematic review, one expert consensus, and one randomized controlled trial. A total of 25 pieces of evidence were summarized from 7 aspects, including assessment before eating, duration of dietary restriction, dietary content, evaluation indicators, eating effectiveness, bowel preparation methods, and health education.Conclusions:This study strictly follows evidence-based methods and summarizes the best evidence of low-fiber diet bowel preparation before colonoscopy in children. This can provide reference for the standardization of low-fiber diet bowel preparation before colonoscopy in children in China, and improve the quality of bowel preparation before colonoscopy in children.

OBJECTIVETo study the expression level and clinical significance of miR-181c-3p and miR-5692b in esophageal cancer.

METHODSThe microRNA (miRNA) profiles of esophageal squamous cell carcinoma were analyzed by miRNA microarray in 55 cases of esophageal cancer. The expression levels of miR-181c-3p and miR-5692b from 55 pairs of tumor tissues and adjacent non-neoplastic tissues were determined by qRT-PCR analysis.

RESULTSBoth miR-181c-3p and miR-5692b were significantly up-regulated in tumor tissues compared with adjacent non-neoplastic tissues. Their expression was also significantly associated with tumor size, depth of invasion and clinical tumor stage (P<0.05). High expression of miR-181c-3p and miR-5692b were significantly associated with poor prognosis (P<0.05). Multivariate Cox regression analysis confirmed that high expression of miR-181c-3p and miR-5692b was poor prognostic indicators in esophageal cancer.

CONCLUSIONSThere are significant correlation between miR-181c-3p/miR-5692b expression, clinicopathologic parameters and prognosis. They represent potential prognostic biomarkers in esophageal squamous cell carcinoma.

Carcinoma, Squamous Cell ; genetics ; Esophageal Neoplasms ; genetics ; Gene Expression Regulation, Neoplastic ; Humans ; MicroRNAs ; genetics ; Prognosis ; Up-Regulation

Objective To investigate the prevalence of pertussis in infants and children with persistent cough in Beijing during 2011-2016.Methods The eligible infants and children from over ten hospitals who were suspected to have pertussis from 2011 to 2016 were enrolled for detection.Nasopharyngeal secretions and blood samples were collected.Multiplex-PCR was performed for Bordetella pertussis and real-time PCR was performed for nucleic acid of Bordetella pertussis.Results A total of 1 318 eligible cases were enrolled,including 820 males and 498 females.Pertussis was detected positive in 534 cases,including 81.3％ (434/534) of B.pertussis positive cases and 31.8％ (170/534) of IgG positive cases.There were 13.1 ％ (70/534) had double positive for bacteria and antibodies.From 2011 to 2016,the enrolled patients were increased from 103 cases per year to 460 cases per year,and the test positive patients were increased from 29 cases to 194 cases.Among the pertussis patients,466 (87.3 ％) cases were younger than one year old.From the first quarter to the fourth quarter of the year,There were 65 cases,151 cases,205 cases,and 113 cases,respectively.In further analysis of the 268 cases from Children's Hospital affiliated to Capital Institute of Pediatrics,90.7％ of the patients who had whooping cough were scattered children;185 cases (69.0％) of the patients had not begun programmed immunization,71 cases (26.5％) did not complete programmed immunization and 12 cases (4.5％)completed the programmed immunization.Of all the inpatients,21.6％ were critical ill,0.8％ (2 cases) dead,and the remaining patients were recovered and discharged.Conclusions The prevalence of pertussis is increasing,especially in summer.Infants are the most susceptible population.Bordetella pertussis is one of the most important pathogen that can induce persistent and chronic cough.

Objective To analyze the type-specific prevalence of human papillomavirus(HPV) among women aged 18-45 years from the general population in Liuzhou,Guangxi Zhuang Autonomous Region.Methods Totally,2 300 women aged 18-45 years old were enrolled in Liuzhou,from March to July,2013.Cervical exfoliated cells were collected for liquid based cytological and HPV DNA tests.Women were referred to colposcopy exam,based on the clinical practice guideline.Results Overall,the prevalence rates of any HPV or oncogenic HPV appeared as 22.7％ (95％CI:21.0％-24.4％) and 17.3％ (95％CI:16.0％-19.1％),respectively in this population under study.The high-risk HPV prevalence peaked at the age groups of 18-25 and 41-45,increasing along with the severity through cytological and histological tests.Statistically significant differences between the prevalence of CIN2 + (Cervical intraepithelial neoplasia 2 +) in women older than 26 years (1.7％,95％CI:1.0％-2.4％) and 18-25 years (1.2％,95％CI:0.5％-1.9％) of age,were not observed.Among samples diagnosed as CIN2+,positivity of HPV bivalent (16/18) and nine-valent (6/ 11/16/18/31/33/45/52/58) vaccine,related high risks on the types of HPV types appeared as 44.1％ and 97.1％.Conclusions The age-specific HPV prevalence rates in the general women aged 18-45 in Liuzhou presented as having bimodal distribution,suggesting that the disease burden of cervical diseases in women aged 26-45 years should not be ignored.Nine-valent HPV vaccine might provide more effective prevention outcomes on cervical cancer in China.

Objective: To assess the incidence and characteristics of thyroid dysfunction during anti-Programmed cell death 1 receptor (PD-1) antibody SHR-1210 therapy in patients with advanced solid tumor. Methods: The medical records of 98 patients who initiated SHR-1210 treatment between April 27, 2016 and June 8, 2017 in the phase 1 trial to evaluate the safety, efficacy, and pharmacokinetics of SHR-1210 in patients with advanced solid tumors were retrospectively reviewed. Serological tests of thyroid stimulating hormone (TSH) and free thyroxine (fT4) were measured at baseline and prior to each SHR-1210 administration. Results: A total of 86 patients had normal thyroid function before the first dose of SHR-1210 treatment. Nine out of 86 (10.5%) patients developed new onset hypothyroidism from euthyroid state. 12 patients presented thyroid dysfunction at baseline, 10 of whom were subclinical hypothyroid and 2 were hypothyroidism. Four out of 10 patients developed hypothyroidism from subclinical hypothyroid. Most patients with hypothyroidism were asymptomatic. Thyroid dysfunction occurred early (median, 55days) after the initiation of SHR-1210. The severity of hypothyroidism were all grade 1-2. No grade 3-4 hypothyroidism occurred. No patients discontinue the treatment of SHR-1210 due to clinical impact of the thyroid dysfunctions. Conclusions: Thyroid-related adverse events were common during anti-PD-1 antibody SHR-1210 treatment . The incidence of hypothyroidism is lower in patients with euthyroid state than in patients with thyroid dysfunction at baseline during SHR-1210 treatment . Thyroid function can be improved after thyroid hormone replacement. During SHR-1210 treatment, it is necessary to pay attention to monitor the thyroid function, especially in the patients with thyroid dysfunction at baseline. Trial registration Chinese Clinical Trial Registry, 2016L01455

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.