Objective The purpose of this study was to describe the influence of therapy compliance on prognosis of children with thalassaemia major (TM). Methods Children with TM was recruited by convenient sampling. The therapy compliance was measured by compliance index (CI) and serum ferritin (SF), The correlation between therapy compliance and incidence of complications were studied. Results Low therapy compliance existed in children with TM, 22.12% (CI) and 55.77% (SF). But no statistical difference existed in therapy compliance between boys and girls (P>0.05). Complication incidence in children with low therapy compliance was 85.19% (CI) and 100.00% (SF). The incidence of cardiac complication was 60.49% (CI) and 84.78% (SF), hepatic complication was 46.91% (CI) and 76.09% (SF), infectious complication was 8.64% (CI) and 10.86% (SF), growth retardation complication was 55.56% (CI) and 67.39% (SF), anemia complication was 43.21% (CI) and 21.74% (SF). The incidence rate of complications was lower in children with better therapy compliance than those with worse therapy compliance (P<0.01). Conclusions Children with TM had low therapy compliance and high incidence rate of complications. Low therapy increased the incidence rate of complications.

BACKGROUND:Studies have shown that cytokine inhibitor pirfenidone can inhibit biological activity of fibroblasts by regulating a variety of cytokines. It has made good progress in the research and application of anti-fibrosis of internal organs, but the effect and mechanism for hypertrophic scars and skin fibroblasts are unclear. OBJECTIVE:To investigate the effect of pirfenidone on human hypertrophic scar fibroblasts. METHODS:Human hypertrophic scar fibroblasts were cultured using tissue culture method. Passages 3-6 cel s grew wel in the logarithmic growth phase were col ected. Cel s were divided into the control group (0 g/L pirfenidone), 0.15, 0.3 and 1 g/L pirfenidone groups according to different mass concentrations. Cel s were intervened for 12, 36 and 48 hours. RESULTS AND CONCLUSION:MTT, reverse transcription-polymerase chain reaction and enzyme-linked immunosorbent assay results demonstrated that compared with the control group, cel proliferation, transforming growth factorβ1 mRNA expression, types I and III col agen secretion were decreased in the 0.15, 0.3 and 1 g/L pirfenidone groups (P<0.05), and the decrease was most significant in the 1 g/L pirfenidone group (P<0.05). At 24, 48 and 72 hours after intervention, significant differences in inhibitory rate of cel proliferation and the secretion of types I and III col agen were detected among 0.15, 0.3 and 1 g/L pirfenidone groups (P<0.05). Results confirmed that pirfenidone apparently inhibited the secretion of col agen of hypertrophic scar fibroblasts cultured in vitro, transforming growth factorβ1 expression and cel proliferation and viability.

Objective To evaluate the relationship between neuropeptide S (NPS) in the amygdala and 5-hydroxytryptamine (5-HT) and GABA in spinal dorsal horns of rats with neuropathic pain.Methods Eighty pathogen-free healthy male Sprague-Dawley rats,weighing 200-260 g,aged 2 months,were divided into 4 groups (n =20 each) using a random number table:sham operation group (group Sham),neuropathic pain group (group NP),low dose NPS group (group L-NPS) and high dose NPS group (group H-NPS).The neuropathic pain model was established by left L5,6 spinal nerve ligation (SNL) in anesthetized rats.NPS was injected into the bilateral amygdala at 3,6,9,12,15 and 18 days after SNL in LNPS group (10 pmol per side) and H-NPS group (100 pmol per side).The mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured at 2 days before SNL and 1,4,7,11,14,17 and 21 days after SNL.Five rats were selected at 7,14 and 21 days after SNL and sacrificed,and the lumbar segment (L5) of the spinal cord was removed for detection of the expression of 5-HT and GABA in spinal dorsal horns by immunofluorescence histochemistry.Results Compared with group Sham,the MWT was significantly decreased,the TWL was shortened,and the expression of 5-HT and GABA in spinal dorsal horns was down-regulated in NP,L-NPS and H-NPS groups (P＜0.05).Compared with group NP,the MWT was significantly increased,the TWL was prolonged,and the expression of 5-HT and GABA in spinal dorsal horns was up-regulated in L-NPS and H-NPS groups (P＜0.05).Compared with group L-NPS,the MWT was significantly increased,the TWL was prolonged,and the expression of 5-HT and GABA in spinal dorsal horns was up-regulated in group H-NPS (P＜0.05).Conclusion The spinal mechanism of endogenous analgesia induced by NPS in the amygdala may be related to up-regulation of the expression of 5-HT and GABA in spinal dorsal horns of rats with neuropathic pain.

Objective To discuss the controversial role of breast milk in late-onset group B Streptococcus (GBS) infections.Methods This study reported a case of recurrent late-onset GBS sepsis with the suspicion of breast milk transmission in an extremely preterm infant born at 22+6 weeks who was treated at the University of Hong Kong-Shenzhen Hospital in September 2016.Literatures about late-onset GBS cases associated with contaminated breast milk were reviewed to investigate whether GBS could be transmitted through breast milk.Results (1) Case report:A breast-fed extremely preterm infant born at 22+6 gestational weeks suffered from GBS sepsis along with meningitis for the first time on 100 d.The mother was negative for rectovaginal GBS screening.Breast milk wasn't tested as no signs of mastitis were found.The neonate recovered from the first GBS sepsis after 14 days of antibiotic treatment,then returned to breastfeeding.On 126 d,GBS sepsis reoccurred in this baby.Fresh breast milk culture yielded GBS which was identical with the GBS strains isolated from the neonatal blood in antimicrobial susceptibility.After recovery from the second episode,the baby was partially breastfed again without further relapses of late-onset GBS sepsis.(2) Literature review:64 cases of late-onset GBS infections that transmitted via breast milk were retrieved from PubMed,while no Chinese cases had been reported.Clinical data of the 65 cases (including this case) were reviewed and the results revealed that contaminated breast milk was associated with late-onset GBS infections.The reported relapse rate of GBS infections transmitted via breast milk was 25％ for two episodes and 7％ for three episodes.Conclusions GBS contaminated breast milk could potentially cause late-onset GBS sepsis in infants and further studies are required to identify the underlying mechanisms.

Objective:To analyze the detection rate and related factors of depressive and anxious symptoms comorbidity in 2021 and 2022.Methods:Based on the results of the Seventh National Population Census in 2021,the residents of 32 provinces,municipalities,and autonomous regions were sampled by gender and age.The gender and age of the samples were in line with the characteristics of China's population.A face-to-face interview survey was conducted in community residents in each province in 2021(n=11 005)and 2022(n=30 421)with the Gen-eralized Anxiety Questionnaire-7 and Patient Health Questionnaire-9.Results:The detection rates of depressive and anxious symptoms comorbidity were 10.67％in 2021 and 11.72％in 2022.The prevalence of depressive and anxi-ety comorbidity were higher in male,younger(age≤17 years),divorced,lower BMI(BMI＜18.5 kg/m2),higher education(graduate),students,and residents with chronic medical history(Ps＜0.001).In 2022,32.06％of people with depressive symptoms had anxious symptoms and 47.62％of people with anxious symptoms had depressive symptoms.Conclusion:In 2021 and 2022,the detection rates of depressive and anxious symptoms comorbidity were both about 10％,and half of patients with anxious symptoms were accompanied by depressive symptoms,So atten-tion should be paid to the comorbidity of depression and anxiety symptoms.

Objective To investigate the characteristics of pathogenic bacteria in cancer patients with severe infection after radiotherapy and chemotherapy and the application value of metagenomic next-generation sequencing(NGS)in the detection of pathogenic bacteria.Methods A total of 112 patients with severe infection after malignant tumor radiation and chemotherapy admitted to Department of Critical Care Medicine of Wuwei Tumor Hospital from October 2019 to August 2023 were selected as the research objects.A total of 150 specimens from suspected infection sites were collected and tested by traditional etiology and NGS.The characteristics of pathogenic bacteria in severe infection of cancer patients after chemoradiotherapy and the application value of NGS in pathogen detection were analyzed.Results Among 150 samples of 112 patients with severe infection after radiotherapy and chemotherapy,the highest proportion of respiratory system infection was 51.79%(58 cases),followed by 25.89%(29 cases)of bloodstream infection,the lowest central nervous system infection rate was 1.79%(2 cases).Gram-negative bacteria were the most common pathogenic bacteria[NGS 35.33%(53 cases),traditional pathogen detection 23.33%(35 cases)],followed by Gram-positive bacteria[NGS 20.67%(31 cases),traditional pathogen detection 12.00%(18 cases)],and multi-drug resistant bacteria infection rate was more than 80.00%,multi-drug resistant fungal infection rate also reached 28.57%.In the patients with severe infection after radiotherapy and chemotherapy,the positive rate of pathogenic bacteria of NGS was significantly higher than that of traditional pathogen detection[87.33%(131/150)vs.42.67%(64/150),P＜0.01],and the positive detection rate of Gram-negative bacteria,Gram-positive bacteria,fungi and other pathogens was significantly higher than that of traditional pathogen detection[Gram-negative bacteria:35.33%(53/150)vs.23.33%(35/150),Gram-positive bacteria:20.67%(31/150)vs.12.00%(18/150),fungi:22.67%(34/150)vs.6.67%(10/150),others:8.67%(13/150)vs.0.67%(1/150),both P＜0.05].Conclusions The detection rate of pathogenic bacteria of NGS in patients with severe infection after radiotherapy and chemotherapy was significantly higher than that of traditional pathogen detection.The distribution and drug resistance of pathogenic bacteria in severe infection after radiotherapy and chemotherapy are unique,and strengthening the detection of pathogenic bacteria is helpful to improve the curative effect.