Objective:To improve the understanding of recurrent adult Langerhans cell histiocytosis complicated with diabetes insipidus.Methods:The clinical data of 1 patient with recurrent adult Langerhans cell histiocytosis complicated with diabetes insipidus admitted to the First Affiliated Hospital of Shihezi University in January 2024 was collected. Its disease characteristics, effectiveness and safety of treatment scheme were analyzed, and literatures were reviewed.Results:The 42-year-old female patient was diagnosed as Langerhans cell histiocytosis in June 2021. After treated with cytarabine, the symptoms improved and the patient achieved sustained remission. In January 2024, the patient was admitted to the hospital due to pain in the middle part of the front chest. The PET-CT results indicated disease progression, which was manifested by new bone destruction, enlarged lymph nodes, and increased nocturnal urination, with urine volume of 3-5 L within 24 h. Based on the clinical manifestations such as cranial bone lesions, periorbital soft tissue lesions, and enlarged lymph nodes at onset, multiple systems and multiple foci involvement was considered. The diagnosis of combined diabetes insipidus was confirmed through the water deprivation and pressure test. After MACOP-B regimen (doxorubicin liposome, cyclophosphamide, vincristine, bleomycin, prednisone), the patient's bone pain was completely relieved, and no serious complications occurred.Conclusions:Recurrent adult Langerhans cell histiocytosis complicated with diabetes insipidus is rare; MACOP-B regimen is safe and effective in treatment of the disease.

Objective:To understand the current status of residents′ cognition of doctor-patient relationship and its influencing factors in a certain area of Guangxi under the background of Healthy China, so as to provide references for building the harmonious doctor-patient relationship.Methods:Convenience sampling was used to conduct an online questionnaire survey among permanent residents in a certain area of Guangxi from June 1 to July 31, 2023. The survey included residents′ sociodemographic characteristics and their perceptions of doctor-patient relationships. A logistic regression model was employed to analyze the influencing factors of residents′ perceptions of doctor-patient relationships.Results:A total of 114 796 residents participated in the survey. Among them, 44.1% (50 593) believed that the current doctor-patient relationship was harmonious, 47.8% (54 874) considered it neutral, and 8.1% (9 329) perceived it as discordant. The multinomial logistic regression model revealed that males, urban residents, older age groups, unmarried individuals, those with higher education levels, and those in poor health were more likely to perceive the doctor-patient relationship as discordant( P<0.05). Residents who valued health-related behaviors and knowledge, as well as those aware of health policies, were more likely to agree that the doctor-patient relationship was harmonious( P<0.05). Conclusions:Over 90% of residents in a certain area of Guangxi perceived the current doctor-patient relationship as either harmonious or neutral. Strengthening health education and enhancing the promotion of health policies can positively contribute to a harmonious doctor-patient relationship.

Objective:To understand the current status of residents′ cognition of doctor-patient relationship and its influencing factors in a certain area of Guangxi under the background of Healthy China, so as to provide references for building the harmonious doctor-patient relationship.Methods:Convenience sampling was used to conduct an online questionnaire survey among permanent residents in a certain area of Guangxi from June 1 to July 31, 2023. The survey included residents′ sociodemographic characteristics and their perceptions of doctor-patient relationships. A logistic regression model was employed to analyze the influencing factors of residents′ perceptions of doctor-patient relationships.Results:A total of 114 796 residents participated in the survey. Among them, 44.1% (50 593) believed that the current doctor-patient relationship was harmonious, 47.8% (54 874) considered it neutral, and 8.1% (9 329) perceived it as discordant. The multinomial logistic regression model revealed that males, urban residents, older age groups, unmarried individuals, those with higher education levels, and those in poor health were more likely to perceive the doctor-patient relationship as discordant( P<0.05). Residents who valued health-related behaviors and knowledge, as well as those aware of health policies, were more likely to agree that the doctor-patient relationship was harmonious( P<0.05). Conclusions:Over 90% of residents in a certain area of Guangxi perceived the current doctor-patient relationship as either harmonious or neutral. Strengthening health education and enhancing the promotion of health policies can positively contribute to a harmonious doctor-patient relationship.

Objective:To establish a health economics evaluation-based adjustment mechanism for the medical insurance fund package in compact county-level medical community.Methods:A health risk assessment system was designed,with weights determined using the Delphi method.Population health risks were evaluated via rapid assessment methods to calculate health risk scores for each county(city,district),which were then used to determine the medical insurance fund package adjustment amount.Results:The county-level health risk evaluation index system encompassed four dimensions:health risk influencing factor,health protection resource,population health risk,and health level.Through information collection and field surveys,health risk scores for counties(cities,districts)in a case prefecture-level city were obtained,serving as a tool for allocating medical consortium package adjustment funds.Conclusion:The health economics evaluation-based medical insurance fund adjustment mechanism enhances the equity of total medical insurance fund allocation,activates the incentive role of medical insurance in healthcare delivery,and transmits intervention pressure to reduce residents'health risks to public management departments at the county level.This approach realizes mutual benefits among medical insurance,residents,and healthcare providers.

Objective:To establish a health economics evaluation-based adjustment mechanism for the medical insurance fund package in compact county-level medical community.Methods:A health risk assessment system was designed,with weights determined using the Delphi method.Population health risks were evaluated via rapid assessment methods to calculate health risk scores for each county(city,district),which were then used to determine the medical insurance fund package adjustment amount.Results:The county-level health risk evaluation index system encompassed four dimensions:health risk influencing factor,health protection resource,population health risk,and health level.Through information collection and field surveys,health risk scores for counties(cities,districts)in a case prefecture-level city were obtained,serving as a tool for allocating medical consortium package adjustment funds.Conclusion:The health economics evaluation-based medical insurance fund adjustment mechanism enhances the equity of total medical insurance fund allocation,activates the incentive role of medical insurance in healthcare delivery,and transmits intervention pressure to reduce residents'health risks to public management departments at the county level.This approach realizes mutual benefits among medical insurance,residents,and healthcare providers.

The dissemination of culture requires carriers.The construction of hospital characteristic culture and hospital brand culture that highlights hospital characteristics needs to be recognized by medical staff and patients.A good hospital culture is one of the important factors to enhance hospital competitiveness,and can also enhance the hospital's reputation among the pub-lic.As a very common way of information circulation in China,self media and integrated media are rapidly developing and inno-vating in the field of healthcare.Hospitals should actively build their own"micro"cultural platforms.Using self media platforms to tell micro stories,popularize micro knowledge,shoot micro movies,publish micro books,hold micro forums,and micro mu-sic,to enrich patients'cultural lives and create an exclusive hospital culture.

ObjectiveTo study the pathway of cis-dichlorodiamineplatinum (DDP) inhibiting the synthesis of steroid hormones in mice, and to observe the intervention effect of dehydroepiandrosterone (DHEA).MethodsSixty adult ICR mice were randomly divided into three groups: control group, DDP modeling group, and DHEA group, with 10 male and 10 female mice in each group. The DDP modeling group mice were intraperitoneally injected with DDP solution at a dose of 2.5 mg·kg^-1·d^-1, once every 3 days, a total of 7 times. On the same day of modeling, the control group mice were injected with an equal amount of physiological saline intraperitoneally. The DEHA treatment group mice were treated with DDP and given a dose of 8.3 mg·kg^-1·d ^-1 of DHEA by gavage for 21 consecutive days. The changes of fatigue indexes of mice were observed by open field, grip and rod rotation tests. The morphology changes of adrenal gland, testicular and ovarian tissue were observed by pathological section and HE staining. The levels of serum steroid hormones were detected by high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). The mRNA and protein expression levels of the related genes of the hypothalamus, hypophysis, adrenal, testis and ovary were tested by real-time fluorescent quantitative PCR (RT-qPCR) and Western blotting.ResultsCompared with control group, both male and female mice in DDP modeling group were significantly losing weight (P＜0.05), their abilities in horizontal movement and vertical movement decreased (all P＜0.05), and the stay time and grip also significantly decreased (all P＜0.05) in female mice. Indexes of fatigue were improved after DHEA supplement (all P＜0.05). In the DDP modeling group, the arrangement of spermatogenic cells at all levels in the testicular tissue was disordered and the testicular interstitial edema was observed, and a large number of primordial follicles in the ovarian tissue were activated, the number of atresia follicles increased, and the number of granulosa cells in the follicles decreased; while in the DHEA group, the damaged phenotype of testicles and ovaries was significantly improved. Compared with control group, the levels of serum testosterone and dihydrotestosterone in both male and female DDP modeling mice significantly decreased (P＜0.01), the pregnenolone was down-regulated but corticosterone was up-regulated significantly (P＜0.05) in male mice, the corticosterone was down-regulated significantly (P＜0.05) in female mice. Compared with the DDP group, after DHEA supplement, the pregnenolone in male mice and the progesterone in female mice increased significantly (P＜0.05), but the pregnenolone in female mice and the progesterone in male mice decreased significantly (P＜0.05). Compared with control group, the expression levels of Cyp21a1 and Cyp11a1 genes in the adrenal gland and Gnrh gene in the hypothalamus of male and female mice in the DDP modeling group significantly decreased (all P＜0.05); the expression levels of Hsd3b2 gene in the adrenal gland, Star, Cyp11a1, and Lhr genes in the ovaries, Crh, Pomc, and Lhb genes in the hypothalamus, pituitary, and pituitary of female mice significantly decreased (all P＜0.05); the expression levels of Star gene and StAR protein in the testicles of male mice, as well as Fshb and Lhb genes in the pituitary gland, were significantly down-regulated (all P＜0.05). After DHEA supplement, compared with the DDP modeling group, the mRNA expression levels of Cyp17a1 in the adrenal gland of male mice and Cyp17a1, Lhr and Fshr genes in testis were down-regulated significantly (P＜0.05); the expression level of Cyp11a1 gene in the adrenal gland of female mice was also decreased (P＜0.05); while the expression levels of Hsd3b2 gene in the adrenal gland, Star, Cyp11a1, Hsd3b2 and Lhr gene in the ovary, and Lhb gene in the pituitary gland were all up-regulated ( P＜0.05).ConclusionThe function of hypothalamus-pituitary-adrenal/gonadal axis was inhibited by DDP intermittent injection, especially in female. Supplementation of DHEA can help regulate the homeostasis of steroid hormone levels.

Objective To investigate the clinical application value of contrast-enhanced ultrasound (CEUS) in hepatic artery thrombosis (HAT) after pediatric liver transplantation. Methods Clinical data of 126 pediatric recipients undergoing liver transplantation were retrospectively analyzed. The incidence of HAT after pediatric liver transplantation was summarized. Color Doppler ultrasound and CEUS manifestations of HAT were compared. Results According to color Doppler ultrasound, 17 cases were highly suspected with HAT. Nine cases were highly suspected with HAT by CEUS, who were subsequently confirmed by CT angiography (CTA) or surgery. CEUS manifestations of HAT showed that hepatic artery was not seen surrounding the portal vein during the arterial phase or even portal venous phase. Hepatocyte necrosis occurred in 4 patients with HAT, and no perfusion of intrahepatic contrast agent was observed on CEUS. Conclusions CEUS yields high clinical application value in the diagnosis of HAT after pediatric liver transplantation. It has significant advantages compared with traditional CTA, which could be widely applied in clinical practice.

Objective:To investigate the knowledge, attitudes, and practices (KAP) of pulse oximetry among pediatric healthcare providers in China and analyze the factor influencing the KAP.Methods:A self-developed questionnaire was used for an online research on the KAP of 11 849 pediatric healthcare providers from 31 provinces, autonomous regions, and municipalities of China from March 11 to 14, 2022.The factors influencing the KAP of pulse oximetry among pediatric healthcare providers were examined by Logistic regression. Results:The scores of KAP, of pulse oximetry were 5.57±0.96, 11.24±1.25 and 11.19±4.54, respectively.The corresponding scoring rates were 69.61%, 74.95%, and 55.99%, respectively. Logistic regression results showed that the gender and working years of pediatric healthcare providers, the region they were located, and whether their medical institution was equipped with pulse oximeters were the main factors affecting the knowledge score (all P<0.05). Main factors influencing the attitude score of pediatric healthcare providers included their knowledge score, gender, educational background, working years, region, medical institution level, and whether the medical institution was equipped with pulse oximeters (all P<0.05). For the practice score, the main influencing factors were the knowledge score, gender, age, and whether the medi-cal institution was equipped with pulse oximeters (all P<0.05). Conclusions:Chinese pediatric healthcare providers need to further improve their knowledge about and attitudes towards pulse oximetry.Pulse oximeters are evidently under-used.It is urgent to formulate policies or guidelines, strengthen education and training, improve knowledge and attitudes, equip more institutions with pulse oximeters, and popularize their application in medical institutions.

OBJECTIVE: To summarize the clinical and laboratory characteristics of patients with acute myeloid leukemia (AML) with inv(16)/t(16;16) (p13.1;q22), and to analyze the risk factors affecting the prognosis of the patients. METHODS: AML patients with inv(16)/t(16;16) (p13.1;q22) and/or CBFβ-MYH11⁺ admitted to the Department of Hematology, The First Affiliated Hospital of Soochow University from January 1, 2008 to October 30, 2019 were retrospective analyzed, the clinical and laboratory indicators, as well as treatment plans and efficacy evaluations of the patients were all recorded. Furthermore, related factors affecting the overall survival (OS) and event-free survival (EFS) of the patients were analyzed. RESULTS: Among 151 AML patients with inv(16)/t(16;16) (p13.1;q22) and/or CBFβ-MYH11⁺, the percentage of additional chromosomal abnormalities was about 27.8%, and the most common additional chromosomal abnormality was +22 (33/151, 21.8%), followed by +8 (11/151, 7.3%). There were 112 patients with perfect NGS examination, and the result showed the most common accompanying gene mutations were KIT mutation (34/112, 30.4%) and FLT3 mutation (23/112, 20.5%). Univariate analysis showed that factors affecting EFS included: NE≤0.5×10⁹/L (P=0.006) and combined K-RAS mutation (P=0.002); Factors affecting OS included: Age≥50 years old (P<0.001) and NE≤0.5×10⁹/L (P=0.016). Multivariate analysis showed that NE≤0.5×10⁹/L (P=0.019) was the risk factors affecting OS. The proportion of bone marrow eosinophilia (BME)≥10.00% (P=0.029) was the risk factors affecting EFS. CONCLUSION The prognosis for those newly diagnosed AML patients who were of advanced age, the high proportion of bone marrow eosinophils, K-RAS mutations, and agranulocytosis is poor. The treatment plans can be adjusted in the early stage to improve the prognosis of such patients.
Chromosome Inversion ; Humans ; Leukemia, Myeloid, Acute/genetics* ; Middle Aged ; Myosin Heavy Chains/genetics* ; Oncogene Proteins, Fusion ; Prognosis ; Retrospective Studies