Objective To discuss the influences of the establishment of breast milk bank to the premature infants in the hospital. Methods The clinical datas of 239 premature infants admitted in NICU from Feb 2017 to Jan 2018 were retrospectively analyzed. Dividing them into two groups, one was control group that the premature infants born before the establishment of breast milk bank, the other was observation group that the premature infants born after that. Both groups were taken the same treatment;and fed the autogenous breast milk or donated breast milk or premature milk based on the intention of infant′s family. Results In observation group,the breastfeeding rate was 67.5％ (85/126),the average hospital-stay time was (24.5±4.4) days.But in control group, the breastfeeding rate was 34.5％(39/113),the average hospital-stay time was (36.3±8.3) days, there were significant differences between the two groups (χ2=4.217, t=2.941, P<0.05).The complications in observation group included necrotizing enterocolitis (5 cases),bronchopulmonary dysplasia(3 cases), retinopathy of prematurity (5 cases) and sepsis (6 cases), the incidence of which was lower than that in control group. But, there was statistical significance in the incidence of necrotizing enterocolitis and sepsis only (χ2=3.989,5.386,P<0.05). Conclusions The establishment of breast milk bank can help to improve the breastfeeding rate of premature infants,shorten the hospital-stay time,reduce the incidence of NEC and sepsis,make premature infants recover more quickly.

Objective:To evaluate the efficacy of homodimer neutrophil gelatinase- associated lipocalin (H-NGAL) rapid test kit in diagnosing peritoneal dialysis (PD)-associated peritonitis (PDAP).Methods:It was a multicenter prospective observational study. The PD patients from the nephrology clinics or wards at four hospitals: the First Affiliated Hospital of Nanchang University, the Third Hospital of Hebei Medical University, Taian Central Hospital, and Weifang People's Hospital from December 27, 2021, and July 18, 2022 were enrolled. The patients were categorized into PDAP and non-PDAP groups based on whether PDAP occurred at the time of enrollment. PD effluent samples were collected, and H-NGAL test was performed. The patients or their families used cassette-type, strip-type, and pen-type H-NGAL test kits to detect H-NGAL. Healthcare professionals only used the cassette-type H-NGAL kit to detect H-NGAL. All participants completed a questionnaire regarding the instructions for use of H-NGAL kit before testing, and a summary of patient experience and evaluation questionnaires after testing. The sensitivity, specificity, compliance rate, and 95% confidence interval ( CI) of H-NGAL rapid test kit for diagnosing PDAP were calculated using clinical diagnosis as the standard. Kappa test was used to assess the consistency between H-NGAL detection results and clinical diagnoses. Results:A total of 221 PD patients were enrolled, with 42 PDAP patients and 179 non-PDAP patients. The sensitivity and specificity of H-NGAL rapid test kit for diagnosing PDAP were 100% (95% CI 91.62%-100%) and 99.44% (95% CI 96.90%-99.90%), respectively, with accuracy rate of 99.55% (95% CI 97.48%-99.92%). The positive agreement rate was 97.67% (95% CI 87.94%-99.59%), and the negative agreement rate was 100% (95% CI 97.89%-100%). The consistency evaluation results showed that kappa value was 0.985 (95% CI 0.956-1.000). The results obtained by patients and their families using the H-NGAL rapid test kits were consistent across all three methods (cassette, strip, and pen-type H-NGAL test kits), and the results obtained by using the H-NGAL rapid test kits were also consistent between non-healthcare professionals and healthcare professionals. The kit instruction questionnaire and the experience and evaluation questionnaire showed that the overall satisfaction of patients with the H-NGAL rapid test kits was very good. Conclusions:H-NGAL rapid test kit exhibits high sensitivity and specificity in diagnosing PDAP and can serve as a rapid diagnostic method for PDAP.

Objective? To explore the factors that affect the cognitive rehabilitation of aphasia after cerebral infarction, so as to provide reference for early diagnosis and rehabilitation. Methods? A total of 123 patients with post-infarct aphasia who were hospitalized in the Second Affiliated Hospital of Xi'an Jiaotong University from September 2016 to September 2017 were selected as the study subjects. Patients' cognitive status was assessed based on the increase in scores of the National Institute of Health Stroke Scale (NIHSS), Mini-Mental State Examination(MMSE),Aphasia Battery of Chinese(ABC), Non-Language-Based Congnitive Assessment (NLCA), and Stroke Aphasic Depression Questionnaire Hospital Version (SADQ-H) after 3 months. The level of rehabilitation was evaluated and divided into two groups: good group (n=92) and bad group (n=31). The clinical data of the two groups after 1 week of onset were compared and analyzed. Results? Univariate analysis revealed that differences in age, education level, disposable income, drinking history, smoking history, whether the lesions involved the cortex, and NIHSS score, ABC score, NLCA score, and SADQ-H score between the two groups were statistically significant (P＜0.05). Logistic regression analysis showed that age equal to or over 70 years, smoking history, drinking history, involvement of lesions in the cortex, and 1 week in hospital of NLCA score were all independent risk factors for cognitive impairment in patients with aphasia after cerebral infarction (P＜ 0.05). Conclusions? Elderly patients over 70 years of age, previous history of smoking and drinking, involvement of lesions in the cortex, and NLCA score are risk factors for cognitive rehabilitation in patients with aphasia after cerebral infarction. Based on this, we can formulate targeted interventions for patients with the above risk factors.

Objective To investigate the predictive value of serum 25-hydroxyvitamin D[25(OH)D]level in early renal transplantation for acute rejection(AR).Methods A total of 324 renal transplant recipients from January 2019 to August 2022 in the Second People's Hospital of Shanxi Province were selected.The clinical data of the recipients were collected.The levels of serum 25(OH)D,parathyroid hormone(PTH),and calcium,phosphorus in early(within 1 month)transplantation were detected by chemiluminescence immunoassay and colorimetry,respectively.The detection season was recorded,and the occurrence of AR within 1 year after renal transplantation was observed.The 25(OH)D level ≥ 20ng/ml was defined as normal,≥ 12 ng/ml～＜20 ng/ml as insufficient and＜12ng/ml as deficient,they were divided into of 25(OH)D normal group(n=106),insufficient group(n=112)and deficient group(n=106).According to the occurrence of AR,they were divided into AR group(n=51)and non-AR group(n=273).The basic situation of serum 25(OH)D level was analyzed.The differences in serum PTH,calcium,phosphorus levels and seasons as well as AR incidence among the three groups of 25(OH)D were compared.Multivariate logistic regression was used to analyze the influencing factors of AR,and receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum 25(OH)D level for AR.Results The incidence of serum 25(OH)D deficiency or insufficiency was 67.28％(218/324).In the 25(OH)D normal group,insufficient group and deficiency group,the serum PTH levels were 75.44(46.42,113.23)pg/ml,78.29(58.27,152.10)pg/ml and 86.84(54.64,127.3)pg/ml,and the incidences of AR were 2.47％(8/324),6.17％(20/324)and 7.10％(23/324),respectively.All of them were the highest in the deficiency group and the lowest in the normal group,and the differences were significant(H=6.784,x2=8.580,all P＜0.05).Additionally,25(OH)D deficiency(OR=3.340,95％CI:1.409～7.916),25(OH)D insufficiency(OR=2.442,95％CI:1.006～5.925)and human leucocyte antigen(HLA)mismatch(4～6)(OR=2.117,95％CI:1.027～4.363)were independent risk factors for AR(all P＜0.05).The area under the curve(AUC)of serum 25(OH)D level in predicting AR was 0.702(95％CI:0.625～0.779),the optimal cut-off value was 13.59 ng/ml,the specificity and the sensitivity were 66.7％and 65.6％,respectively.Conclusion In this study,25(OH)D deficiency(＜12ng/ml)or insufficiency(≥ 12～＜20ng/ml)was an independent risk factor for AR,and serum 25(OH)D level may have a certain predictive value for AR.

Ex vivo-expanded mesenchymal stem cells(MSCs)have been demonstrated to be a heterogeneous mixture of cells exhibiting varying proliferative,multipotential,and immunomodu-latory capacities.However,the exact characteristics of MSCs remain largely unknown.By single-cell RNA sequencing of 61,296 MSCs derived from bone marrow and Wharton's jelly,we revealed five distinct subpopulations.The developmental trajectory of these five MSC subpopulations was mapped,revealing a differentiation path from stem-like active proliferative cells(APCs)to multipotent progenitor cells,followed by branching into two paths:1)unipotent preadipocytes or 2)bipotent prechondro-osteoblasts that were subsequently differentiated into unipotent prechondro-cytes.The stem-like APCs,expressing the perivascular mesodermal progenitor markers CSPG4/MCAM/NES,uniquely exhibited strong proliferation and stemness signatures.Remarkably,the prechondrocyte subpopulation specifically expressed immunomodulatory genes and was able to sup-press activated CD3+T cell proliferation in vitro,supporting the role of this population in immunoregulation.In summary,our analysis mapped the heterogeneous subpopulations of MSCs and identified two subpopulations with potential functions in self-renewal and immunoregulation.Our findings advance the definition of MSCs by identifying the specific functions of their heteroge-neous cellular composition,allowing for more specific and effective MSC application through the purification of their functional subpopulations.