Purpose:To evaluate the effect of Auto-PBSCT combined with long-time low-dose interleukin-2 (after transplant) for increasing the rate of 5-year disease-free survival of lymphoid malignancies (ALL and NHL).Methods:U- sing chemotherapy combined with low dose G-CSF to mobilize peripheral blood stem cells,we carried out auto-PBSCT in lymphoid malignancies (7 cases CR_1 ALL、1 case CR_2 ALL、3 cases CR_1 NHL、5 cases refractory NHL).After transplant, 15 cases used low dose interleukin-2 at 5.10~5U/d for one year or longer.Results:7 cases CR_1 ALL are still alive,the aver- age disease-free survival is 73 months.Median disease-free survival is 51.5 months.2 of 3 cases CR_1 NHL are still alive. The 6 years disease-free survival in 10 cases CR_1 lymphoid malignancies(CR_1 NHL and CR_1 ALL) is 0.90?0.11,the aver- age disease-free survival is 66.8 months.In another PR (refractory) group of NHL and ALL (CR_2),3 years disease-free survival was 0.33?0.18,and average survival time was 20.66 months,but a chemotherapy-sensitive NHL is still alive (63 months),a case of lymphoblast cell NHL also survived for 46 months and died after relapse.Conclusions:Auto-PBSCT combined with long-turm low dose IL-2(after transplant) could effectively increase the rate of 5-year disease-free survival in CR_1 lymphoid malignancies(ALL and NHL).

Purpose:To report three cases of myelodysplastic syndrome(MDS) transformed to atypical chronic myeloid leukemia(aCML).Methods:Compared the clinical findings,hemograms and bone marrow features in two different courses of the disease,discussed with review of related literatures.Results:The three patients were all old age.They onset with chronic anemia,the results of BM smear were MDS-RAS and MDS-RAEB;Then leukocytosis occurred in 6-65 months.The aCML were diagnosed according to the BM smear and normal chromosome.Conclusions:The MDS/MPD is a new category of the WHO classification that have both dysplastic and proliferative features.Atypical CML lacks the Ph chromosome and BCR/ABL fusion gene that are the hallmarks of classic CML.This kind of case is seldom seen.

Objective To study the characteristics of cognitive development of newborns with auditory event related potentials (aERP).Methods Thirty full-term neonates who were admitted to Changzhou Children's Hospital and met the inclusion criteria, those with neonatal neural behavioral score over 37 and both ears passed the hearing screening, and exclusion criteria, those who suffered from perinatal brain injury, were sclccted randomly.Thcy wcre divided into three groups according to the days of age (group 1 : 1-10 days;group 2:11-20 days;group 3:21-28 days).aERP was recorded with auditory Oddball paradigm.The data were collected and analyzed by Brain Electrical Source Analysis software.Relationship between N2latencies/areas among the three groups and their age was researched with Pearson correlation analysis.Results During the neonatal period, there was a significant negative correlation between N2 latency and neonatal age in days (r=-0.609, P ＜ 0.05), while significant positive correlation was shown between N2 area and the age (r=0.689, P ＜ 0.05).In Fz and Cz leads, the total average waveform diagram of the three groups showed spacious flat, less smoothed curve, and mostly jagged pattern.N2 area in group 1 showed a complex plurality of peaks, and regular, soaring waves, which changed into single wave thereafter, in group 2 and 3.The N2 latencies tended to shorten gradually.Conclusions Neonatal cognitive competence, including concentration and discrimination ability, would be improved with their growth.

Objective To investigate the clinical and laboratory features of acute promyelocytic leukemia (APL).Methotis 513 APL patients in the last two decades were retrospectively analyzed in this research.We investigated the clinical features including age,sex,abnormality of peripheral hemogram before treatment.therapeutic effect and follow-up and laboratory data such as morphology,immunology,cytogenetics and molecular biology(MICM).Results The median age of the APL patients was 33 years old and the ratio of male and female was 1.21:1.Before treatment,the median level of WBC was 4.3×109/L and the deteetion rate of abnormal promyelocyte on blood film was 85.8%;with immunophenotypie detection,the expression levels of CD117、CD34、HLA-DR、CD7、CD14 and CD19 in APL were found to be lower and the expression 1evels of CD2、CD33 and MPO higher than those in other subtypes of acute myelocytie leukemia(AML)(beth P<0.01).Specific abnormal chromosome t(15;17)was detected in 91.7%of the patients,of whom 75.9%had standard translocation of t(15;17),being the most common one and 15.8% of the patients had t(15;17)with additional abnormal chromosome.There was only 7.5%of the patients with nolnlal karyotype.However,the presence of both simple translocation and complex translocation was seldom seen.With molecular biological detection.PML/RARα fusion gene positive rate was 99.6%.In a relativelv long clinical follow-up,we found that the complete remission(CR)rate in APL patients was 84.7%.incidence of DIC was 13.4%and five-year survival rate was 30.7%.111e median count of WBC in CR group was lower than that non-remission group(P<0.01).There were no significant differences on expressions of CD34 and CD2 and changes of cytogenetics between the two groups(P>0.05).Conclusions Comprehensive evaluation of MICM could be of important significance in the diagnosis and prognosis iudgrnent for APL patients.The CR rate in these patients with high WBC eount was considerable low.

ObjectiveTo observe the ultrastructural changes of Chlamydia trachomatis after treatment with azithromycin.Methods The Chlamydia trachomatis laboratory strain (D/UW-3/Cx) was cultured in McCoy cells with or without the presence of azithromycin of 0.0667,0.1340,0.1900,0.2680 and 0.3330 mg/L for 48 hours.The ultrastructural changes of host cells andChlamydia trachomatis were observed by transmission electron microscopy.ResultsAfter 48-hour culture,vesicles increased in number both inside and outside of the inclusion bodies with the rise in azithromycin concentration; there were abnormally large reticulate bodies,some of which experienced abnormal division and even necrosis or breakdown; the number of elementary bodies was decreased,while their size was enlarged,with a more wrinkled outer membrane.No inclusionbodieswereseenwhentheconcentrationofazithromycinwas0.333mg/L. Conclusions Azithromycin can induce an increment in the outer membrane of Chlamydia trachomatis,formation of vesicles,abnormal enlargement or breakdown of reticulate bodies,and a decrease in elementary bodies.

Objective: To investigate the epidemiological characteristics of foodborne disease outbreaks in Shaoxing City, Zhejiang Province, from 2012 to 2022, so as to provide the evidence for improving the foodborne disease control strategy. Methods: Foodborne disease outbreaks in Shaoxing City from 2012 to 2022 were collected from National Foodborne Disease Outbreak Monitoring System in China, including populations, places of outbreak, pathogenic factors and suspected foods. The temporal distribution, regional distribution, distribution of outbreak places and pathogenic factors of foodborne disease outbreaks were descriptively analyzed. Results: A total of 89 foodborne disease outbreaks were reported in Shaoxing City from 2012 to 2022, covering totally 699 patients, with an average annual attack rate of 6.35%. The outbreak peaked during the period between June and October (73 outbreaks, 82.02%), and family was the predominant place of outbreak (41 outbreaks, 46.07%). There were 83 outbreaks with known pathogenic factors, including 51 outbreaks caused by microbial factors, with Vibrio parahaemolyticus, Salmonella and norovirus as predominant pathogens, and 29 outbreaks caused by fungi and their toxins, which were all poisonous mushrooms poisoning, resulting in 2 deaths. In addition, there were 3 outbreaks caused by chemical factors. Conclusions The outbreak of foodborne diseases predominantly occurred in summer and autumn in Shaoxing City from 2012 to 2022. Family was the predominant place of outbreak, and toxic mushroom poisoning was the most lethal pathogenic factor.

Objective To explore the influence of Neuman theory on postoperative mental status of the patients with hypertensive cerebral hemorrhage. Methods According to their admission order, 120 patients with hypertensive intrac-erebral hemorrhage who accepted operation in our hospital from June 2011 to January 2014 were divided into the ex-perimental group and the control group, each group with 60 patients. The patients in the control group were treated with routine care while the patients in the experimental group were given psychological care interventions designed in ac-cordance with Neuman theory on the basis of the routine care. The nursing effects of the two groups were compared, detected and evaluated by Hamilton Depression Rationg Scale (HAMD) and Self-reporting inventory (SCL-90). Results The differences of HAMD total score of the two groups before interventions were not statistically significant. After 12 weeks intervention, HAMD total score of the experimental group significantly improved, especially in hopelessness, anxiety/somatization and cognitive impairment. The depression, anxiety, obsessive-compulsive symptoms, horror, hostility and psychosis of the experimental group were significantly lower than those of the control group after 12 weeks inter-vention. Conclusion Neuman theory has very high value of application to improve postoperative psychological status of the patients with hypertensive cerebral hemorrhage and is worthy of being promoted and applied in clinical work.

Objective To summarize the successful application experience of intra-hospital transport of 13 H7N9 avian influenza patients from the general wards to the avian influenza ward. Methods Form the expert group, to determine the design target and principle of the standardized workflow and point out the operation points of standard workflow in intra-hospital transport of each link. Results The standardized workflow included the disposal of the transfer notice, condition assessment, department contact,patient preparation,object preparation,custody transfer personnel preparation,transit guardianship and transfer to the avian influenza ward,a total of eight procedures.Between January 2013 and March 2017,13 cases were successfully transfered.All patients safely arrived avian influenza ward. The process was quick and smooth.Nobody was died or rescued within 1 h after transport. Conclusions The main differences of intra-hospital transport between H7N9 avian influenza patients and general critically ill patients are the transit time control, the particularity of terminal disposal, transshipment arrangement and hospital infection management personnel involved in the whole process.

Objective To summarize current status of multidrug-resistant organism (MDRO) infection in lung transplant recipients and analyze the risk factors of MDRO infection. Methods Clinical data of 321 lung transplant recipients were retrospectively analyzed. According to the incidence of postoperative MDRO infection, they were divided into the MDRO group (n=122) and non-MDRO infection group (n=199). The incidence of MDRO infection in lung transplant recipients was summarized. The risk factors of MDRO infection in lung transplant recipients were analyzed by logistic regression model. The dose-response relationship between MDRO infection and time of ventilator use was determined by restricted cubic spline model. Results Among 321 lung transplant recipients, 122 cases developed MDRO infection, with an infection rate of 38.0%. Two hundred and twenty-nine strains of pathogenic bacteria were detected in the MDRO infection group, mainly Gram-negative bacteria (92.6%), and the top three strains were carbapenem-resistant acinetobacter baumannii (46.3%), carbapenem-resistant pseudomonas aeruginosa (22.3%) and carbapenem-resistant klebsiella pneumoniae (14.8%), respectively. MDRO infection mainly consisted of lower respiratory tract infection (61.5%), followed by ventilator-associated pneumonia (26.2%). Univariate analysis showed that the risk factors of MDRO infection in lung transplant recipients were single-lung transplantation, long-time postoperative use of extracorporeal membrane oxygenation (ECMO), long operation time, long-time urinary catheterization, long-time central venous catheterization and long-time ventilator use (all P < 0.05). Multivariate logistic regression analysis indicated that single-lung transplantation and long-time ventilator use were the independent risk factors for MDRO infection in lung transplant recipients (both P < 0.05). Results of restricted cubic spline model analysis showed that the risk of infection continued to increase with the prolongation of ventilator use time within 20 d. After 20 d, prolonging the time of ventilator use failed to increase the risk of infection, showing a plateau effect. Conclusions The MDRO infection rate tends to decline in lung transplant recipients year by year. Single-lung transplantation and long-time ventilator use are the independent risk factors for MDRO infection in lung transplant recipients.

Objective To analyze the characteristics of postoperative hospital-acquired infections and drug sensitivity in lung transplant recipients over the past 5 years in a single center. Methods A total of 724 lung transplant recipients at Wuxi People's Hospital from January 2019 to December 2023 were selected. Based on the principles of hospital-acquired infection diagnosis, a retrospective analysis was conducted on the hospital infection situation and infection sites of lung transplant recipients, and an analysis of the distribution of hospital-acquired infection pathogens and their antimicrobial susceptibility test status was performed. Results Among the 724 lung transplant recipients, 275 cases of hospital-acquired infection occurred, with an infection rate of 38.0%. The case-time infection rate decreased from 54.2% in 2019 to 22.8% in 2023, showing a downward trend year by year (Z=30.98, P<0.001). The main infection site was the lower respiratory tract, accounting for 73.6%. The pathogens were mainly Gram-negative bacteria, with the top four being Acinetobacter baumannii (37.1%), Pseudomonas aeruginosa (17.3%), Klebsiella pneumoniae (13.7%), and Stenotrophomonas maltophilia (13.4%), with imipenem resistance rates of 89%, 53%, 58% and 100%, respectively. Gram-positive bacteria were mainly Staphylococcus aureus (3.6%), with a methicillin resistance rate of 67%. Conclusions Over the past 5 years, the hospital-acquired infections in lung transplant recipients have shown a downward trend, mainly involving lower respiratory tract infections, with the main pathogens being Acinetobacter baumannii, Pseudomonas aeruginosa and Klebsiella pneumoniae, all of which have high resistance rates to imipenem.