Objective To investigate the predictive value of serum placental growth factor(PLGF)/soluble fms-like tyrosine kinase-1(sFlt-1),combined with the placental three-dimensional energy Doppler index(3D-PDI)in preeclampsia(PE).Methods From January 2021 to December 2022,120 pregnant women with PE risk factors were selected and followed up until 1 week after delivery.Serum PLGF and sFlt-1 levels were measured at routine prenatal check-ups at 14 to 20 weeks gestation.The PLGF/sFlt-1 ratio was calculated,and placental 3D-PDI was detected by ultrasound,including the vascularization index(VI),blood flow index(FI),and vascularization-blood flow index(VFI).Based on whether PE occurred after 20 weeks of pregnancy,cases were divided into PE(55 cases)and control groups(65 cases).The PE group was further divided into mild PE(35 cases)and severe PE groups(20 cases)based on the severity of the di-sease.The differences in PLGF/sFlt-1 and 3D-PDI between the groups were compared in terms of a statistical analysis of the correlation between PLGF,sFlt-1,and 3D-PDI.The receiver operating characteristic curve(ROC)was plotted,and the predictive value of each index on PE alone or in combination was analyzed.Results The systolic blood pressure(SBP),diastolic blood pressure(DBP),24 h protein-uria level,preterm birth rate,NICU admission rate,and preconception BMI in the PE group were higher than those in the control group(P＜0.05).The two groups had no differences in age,gestational age,pregnancy history,and fertility history(P＞0.05).The serum PLGF/sFlt-1 of the PE group was lower than that of the control group,and the serum PLGF/sFlt-1 of the severe group was lower than that of the mild group(P＜0.05).The 3D-PDI index of the PE group was lower than that of the control group,and the 3D-PDI index of the severe group was lower than that of the mild group(P＜0.05).Pearson's correlation analysis indicated that PLGF and VFI were signifi-cantly positively correlated(P＜0.01),and sFlt-1 was significantly negatively correlated with VFI(P＜0.01).ROC curve analysis showed that PLGF/sFlt-1,VI,FI,and VFI all had predictive value for PE and the value of VI,FI,and VFI jointly predicted PE,and was higher than that of various parameters(AUC = 0.951).Serum PLGF/sFlt-1,VI,FI,and VFI combined predicted the highest value(AUC=0.987).Conclusion In patients with PE,serum PLGF,sFlt-1,and placental VFI are significantly correlated.Serum PLGF/sFlt-1,placenta VI,FI,and VFI are reduced in early pregnancy,and the combined application of the four indicators has the highest efficacy in predicting PE,providing a possible reference for the early clinical screening or prediction of PE.

H 1-antihistamines are widely used in the treatment of various allergic diseases, but there are still many challenges in the safe and rational use of H 1-antihistamines in pediatrics, and there is a lack of guidance on the prescription review of H 1-antihistamines for children.In this paper, suggestions are put forward from the indications, dosage, route of administration, pathophysiological characteristics of children with individual difference and drug interactions, so as to provide reference for clinicians and pharmacists.

Objective To understand the cognition，attitude and awareness on the prevention and control of COVID-19 among recent international travellers back to China（hereinafter referred to as the inbound group）and local residents（domestic group），and to provide scientific evidence for further prevention and control of the epidemic. Methods Using a questionnaire website，a questionnaire entitled “Investigation and analysis of residents’ knowledge，attitude，and practice on COVID-19”was prepared，with the targeted population of the survey being international travelers back to China and local residents who had been quarantined at home for 14 days in Jinqiao Town. Cluster sampling was used to conduct the survey through WeChat. The two groups were then compared using chi-square test by using SPSS 23.0. Results Between the two groups，the awareness on the respiratory droplet transmission and inactivation effectiveness by alcohol，peracetic acid and ultraviolet ray on the SARS-CoV-2 were statistically different（P < 0.05）. In the attitude towards prevention and control measures，there was significant difference between the two groups in selecting prevention and control plans for the whole population during the outbreak（P < 0.05）. In the comparison of behavior，there was a statistical difference between the two groups（P < 0.05）whether to maintain a distance of more than 1 meter in social communication. Regarding the choice of quarantine methods（stay-at-home，intensive quarantine and no quarantine），the difference between two groups was statistically significant（P < 0.05）. Conclusion In terms of the knowledge of COVID-19，attitude towards prevention and control measures，and their own behavior，there are some differences between the inbound group and domestic group.

Objective To investigate the effect of comprehensive management mode intervention in elderly patients with moderate/severe chronic obstructive pulmonary disease at stable stage. Methods A total of 150 elderly patients with stable-stage COPD were randomly divided into two groups, 75 in each group. The control group received routine medication, while the observation group was given comprehensive management mode intervention, including health education,rational medication, pulmonary rehabilitation training and psychological guidance. Both groups were treated for 12 months. Differences in lung function parameters, modified Medical Research Council (mMRC) dyspnea scale, COPD assessment test (CAT), 6-minute walk test (6MWT), and frequency of acute exacerbation of COPD (AECOPD) were compared between the two groups. Results: After treatment, FEV1/FVC and FEV1%pred of observation group（57.65±11.62%、61.83±13.50%）were higher than control group（52.38±13.24%、53.42±13.93%）(P<0.05), the mMRC and CAT scores of the observation group were decreased (P<0.05), and the 6MWT was increased (P<0.05), but no significant differences in the control group (P>0.05). Within 12 months of treatment, the frequency of AECOPD in the observation group was less than that in the control group (P<0.05). Conclusions: In the treatment of elderly patients with moderate/severe chronic obstructive pulmonary disease, comprehensive management mode intervention can help delay the deterioration of lung function, correct the difficulty of breathing, improve the quality of life, and reduce the number of AECOPD.

Objective:To investigate the effect of peripheral blood neutrophil to lymphocyte ratio (NLR) and platelet distribution width (PDW) on the clinical prognosis of childhood medulloblastomaMethods:Clinical data and survival data of 76 pediatric patients who were diagnosed as medulloblastoma by post-operative pathology in the First Affiliated Hospital of Zhengzhou University from January 2009 to December 2016 were collected. Kaplan- Meier method was used to calculate the overall survival(OS) and progression free survival(EFS) rates, Log- rank test was employed to compare the survival rates of different groups, and Cox proportional hazards regression model was used for multivariate analysis. Results:The log- rank test revealed that 5-year PFS rate and OS rate (22.2%, 22.2%) in the high NLR group (NLR>4.94) were significantly lower than those in the low NLR group (NLR≤4.94) (45.6%, 55.7%), and the differences were statistically significant(PFS: P=0.009, OS: P=0.001), and the 5-year PFS and OS (52.3%, 66.5%) of the high PDW group (PDW>15.90) were significantly higher than those in the low PDW group (PDW ≤ 15.90) (27.1%, 32.5%), and the differences were statistically significant(PFS: P=0.032, OS: P=0.039). Univa-riate analysis showed that the extent of resection (PFS: P=0.006, OS: P=0.009), and postoperative radiotherapy (PFS: P=0.011, OS: P=0.001) and postoperative radiotherapy(PFS: P=0.011, OS: P=0.001) were the factors influencing the prognosis of children with medulloblastoma.Multivariate Cox proportional hazards regression model analysis suggested that no postoperative radiotherapy (PFS: P=0.048, OS: P=0.008), NLR>4.94 (PFS: P=0.023, OS: P=0.003) and PDW≤15.90 (PFS: P=0.028, OS: P=0.006) were the independent risk factors for the prognosis of childhood medulloblastoma. Conclusions:Increased NLR and decreased PDW indicate unfavorable prognosis of the childhood medulloblastoma.Therefore, preoperative NLR and PDW may be the potential prognostic markers for childhood medulloblastoma.

Objective To understand the ehealth literacy of coronary disease patients and to explore the problems encountered when searching for disease related health task by computer so as to provide a reference for constructing the ehealth literacy intervention for coronary disease patients. Methods From June 2018 to December 2018, this study selected 20 coronary disease inpatients at a class Ⅲ grade A hospital in Hangzhou by purposive sampling to carry out operational experiment. Subjects operated 6 experimental tasks related to coronary network health designed by researchers in computers. In the experiment, subjects were required to use the method of think-aloud. At the same time, screen video experts recorded the screen activity track, image and sound produced when subjects operated tasks to collected subjects' experimental data. Moreover, two researchers recorded the completion, expression and time of subjects when operating 6 tasks. Colaizzi 7-step analysis was used to summary and analyze the experimental data. Results Problems encountered when coronary disease patients searched for disease related health task by computer included four themes, operating computers and browsers, navigation and location on the Web, using search strategy as well as evaluating the information correlation and reliability. Conclusions Health professionals should pay attention to the basic computer skills of patients,health information search strategy and quality evaluation ability of network health information when providing ehealth literacy training for coronary disease patients to improve the ehealth literacy of coronary disease patients.

Objective:To explore the role of cell division cycle protein 37 (Cdc37) mediating bortezomib (BTZ) resistance in multiple myeloma (MM) via the regulation of autophagy activity to provide a novel strategy for MM therapy.Methods:The expressions of Cdc37 and LC3b were investigated in BTZ-resistant MM cell line ANBL-6.BR using quantitative real-time PCR (qRT-PCR) and western blot (WB) analysis. Cdc37 was upregulated in ANBL-6.BR cells owing to lentivirus transfection. The LC3b expression was detected with WB, and BTZ-induced apoptosis was explored using flow cytometry. Cdc37 was then down-regulated by shRNA in the MM cell line NCI-H929. Sensitivity of BTZ was evaluated using CCK-8 analysis. WB analysis was performed to check the expression of the AKT/mTOR pathway and autophagy-associated proteins. The sensitivity of NCI-H929 cells to BTZ in the presence of autophagy inhibitor chloroquine (CQ) was analyzed using flow cytometry.Results:Cdc37 was down-regulated, while autophagy-associated gene LC3b was upregulated in BTZ-resistant cell line ANBL-6.BR. Up-regulated Cdc37 in ANBL-6.BR cells could inhibit LC3b expression and increase the sensitivity of MM to BTZ. Suppressing Cdc37 expression in MM cell line NCI-H929 induced BTZ resistance and autophagy activation, while CQ could rescue BTZ resistance caused by Cdc37 inhibition.Conclusion:Cdc37 may participate in BTZ resistance in MM via the regulation of autophagy activity.

Objective: To investigate and analyze the actual intake of protein and energy in adult patients with severe burns during post burn days (PBDs) 3 to 14. Methods: Records of 52 adult patients with severe burns [37 males and 15 females, (37±9) years old], admitted to the Department of Plastic Surgery and Burns of Tianjin First Central Hospital from January 1st 2011 to December 31st 2017 and meeting the study inclusion criteria, were retrospectively analyzed. Nutrition intake from routes of oral diet, enteral nutrition preparations, and parenteral nutrition preparations of patients during PBDs 3 to 14 were obtained from critical care records. During PBDs 3 to 7 and PBDs 8 to 14, the personal daily total energy intake and the ratio of it to energy target of patients were calculated and compared; the personal daily intake of carbohydrate, fat, and protein and calorigenic percentages of carbohydrate, fat, and protein accounted for total energy intake, and the ratios of non-protein calories to total nitrogen of patients were calculated and compared; the personal daily energy and protein intake of patients from routes of oral diet, enteral nutrition preparations, and parenteral nutrition preparations were analyzed; the percentages of energy intake from routes of oral diet, enteral nutrition preparations, and parenteral nutrition preparations accounted for total energy intake, and the percentages of protein intake from routes of oral diet, enteral nutrition preparations, and parenteral nutrition preparations accounted for total protein intake of patients were calculated. Vomiting and diarrhea of patients during PBDs 3 to 7 and PBDs 8 to 14 were recorded. Levels of serum albumin, prealbumin, blood glucose, and triglycerides, 24-hour excretion of urinary nitrogen, nitrogen balance values of patients on PBDs 7 and 14 were recorded or calculated. Data were processed with paired t test and chi-square test. Results: (1) The personal daily total energy intake of patients during PBDs 3 to 7 and PBDs 8 to 14 were (8 696±573) and (11 980±1 259) kJ respectively, and ratios of them to energy target [(13 290±1 561) kJ] were 65.4% and 90.1% respectively. The personal daily total energy intake of patients during PBDs 3 to 7 was obviously lower than that during PBDs 8 to 14 (t=18.172, P<0.01). (2) The personal daily intake of carbohydrate, fat, and protein of patients during PBDs 8 to 14 were obviously higher than those during PBDs 3 to 7 (t=15.628, 22.231, 10.403, P<0.01). The personal daily calorigenic percentages of carbohydrate, fat, and protein accounted for total energy intake of patients were 56.8%, 25.1%, and 18.3% respectively during PBDs 3 to 7 and 54.2%, 27.0%, and 18.7% respectively during PBDs 8 to 14. The calorigenic constituent ratio of personal daily intake of carbohydrate, fat, and protein accounted for total energy intake of patients during PBDs 3 to 7 was close to that during PBDs 8 to 14 (χ²=0.185, P>0.05). The ratios of non-protein calories to total nitrogen (kJ∶g) of patients during PBDs 3 to 7 and PBDs 8 to 14 were 469∶ 1 and 456∶ 1 respectively. (3) The personal daily energy intake of patients from routes of oral diet and parenteral nutrition preparations during PBDs 8 to 14 [(4 394±978), (5 723±898) kJ] were obviously higher than those during PBDs 3 to 7 [(2 137±453), (4 855±825) kJ, t=26.516, 6.583, P<0.01], while the personal daily energy intake of patients from routes of enteral nutrition preparations during PBDs 8 to 14 was close to that during PBDs 3 to 7 (t=1.922, P>0.05). The constituent ratio of personal daily energy during PBDs 3 to 7 was close to that during PBDs 8 to 14 (χ²=4.100, P>0.05). The personal daily protein intake of patients from route of oral diet during PBDs 8 to 14 was (58±22) g, obviously higher than (25±6) g during PBDs 3 to 7 (t=14.514, P<0.01). The personal daily protein intake of patients from routes of enteral nutrition preparations and parenteral nutrition preparations during PBDs 8 to 14 was close to those during PBDs 3 to 7 (t=1.924, 1.110, P>0.05). The constituent ratio of personal daily protein intake from routes of oral diet, enteral nutrition preparations, and parenteral nutrition preparations accounted for total protein intake during PBDs 8 to 14 was close to that during PBDs 3 to 7 (χ²=5.634, P>0.05). (4) There were 3 patients with vomiting and 4 patients with diarrhea during PBDs 3 to 7, and 1 patient experienced both of them during PBDs 8 to 14. The levels of serum albumin, prealbumin, blood glucose, and triglycerides, 24-hour excretion of urinary nitrogen, and nitrogen balance values of patients on PBDs 7 and 14 were (29±4) and (30±4) g/L, (132±42) and (171±48) mg/L, (7.4±2.8) and (6.7±2.8) mmol/L, (1.5±0.7) and (1.4±0.7) mmol/L, (30.5±4.3) and (34.5±2.2) g, -(25.1±2.6) and -(23.7±3.9) g, respectively. Conclusions The personal daily total energy intake of patients during PBDs 3 to 7 was lower than that during PBDs 8 to 14. The calorigenic constituent ratio of personal daily intake of carbohydrate, fat, and protein accounted for total energy of patients during PBDs 3 to 7 was close to that during PBDs 8 to 14. Energy and protein intake were mostly derived from parenteral nutrition preparations during PBDs 3 to 7, while those during PBDs 8 to 14 were mainly derived from parenteral nutrition preparations and oral diet.

Objective To explore the status quo of knowledge, attitude and practice (KAP) of diabetes in community diabetic patients, analyze its influencing factors, and provide a basis for community diabetes prevention and treatment. Methods Totally 820 diabetic patients from a community in Xuzhou were selected by cluster sampling and investigated with the general information questionnaire, diabetes knowledge questionnaire (DKQ), Problem Areas Diabetes Scale (PAID) and Summary of Diabetes Self-Care Activities (SDSCA) between January and November 2017. SPSS19.0 was used for statistical analysis of data. Results The scores of diabetes KAP in the 820 community diabetic patients was (35.92±7.59), (10.95±6.20) and (25.73±7.80), respectively; and there was a positive correlation between knowledge and attitude, attitude and practice, and knowledge and practice (r=0.093,0.102,0.337; P＜0.01). There were significant differences in the scores of knowledge questionnaires of patients with different occupations, educational levels, living conditions, sleep time, course of diabetes, treatment methods and BMI (P＜0.05); the score of attitude was statistically different among diabetic patients of different sex (P＜0.01); and the score of practice was statistically different between diabetic patients with different course of disease, educational background, profession and treatment methods (P＜0.01). Conclusions The KAP level of diabetes in the diabetic patients from the community in Xuzhou was of a failure level. Therefore, diabetes educators should go to grassroots units, enhance health education, and improve the overall ability of community diabetic patients.