Objective: To investigate the incidence and independent risk factors of adverse events (AEs) associated with therapeutic plasma exchange (TPE) in patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT), and to provide evidence to support the safe use of TPE in clinical practice. Methods: This retrospective study included 167 allo-HSCT recipients who underwent a total of 385 TPE procedures between March 2022 and December 2023. Patients were divided into two groups according to the occurrence of TPE-related AEs. Baseline characteristics, plasma exchange parameters, and clinical features were collected. Univariate analysis and multivariable Firth logistic regression were performed to identify independent risk factors for AEs. Results: A total of 385 TPE procedures were performed in 167 allo-HSCT patients, and 33 patients (19.8%) experienced TPE-related AEs. Among the 33 patients who experienced AEs, allergic reactions were the most common (n=18, 54.5%), followed by blood pressure fluctuations (n=11, 33.3%) and hypocalcemia (n=4, 12.1%). Most AEs were classified as grade II (n=23, 69.7%), and no grade IV (fatal) events were observed. Univariate analysis demonstrated a significant difference in the incidence of AEs among different hematocrit (HCT) categories (<20%, 20%-30%, and>30%) (Fisher's exact test, P=0.022). Although the overall difference was statistically significant, none of the pairwise comparisons remained significant after Bonferroni correction (adjusted P>0.0167). Multivariable Firth logistic regression identified higher HCT levels, analyzed as a continuous variable (OR=1.07, 95% CI: 1.01-1.13, P=0.020), and TPE performed for cytokine release syndrome (CRS) (OR=9.21, 95% CI: 1.25-78.00, P=0.030) as potential independent risk factors for TPE-related AEs. Receiver operating characteristic (ROC) curve analysis showed that HCT had an AUC of 0.67 (95% CI: 0.57-0.77) for predicting AEs, with an optimal cutoff value of 24.5%, a sensitivity of 60.6%, and a specificity of 75.4%. Using this cutoff, the AEs rate was significantly higher in patients with HCT≥24.5% than in those with HCT<24.5% (37.7% vs 11.4%, P<0.001). Conclusion: A-mong allo-HSCT patients receiving TPE, allergic reactions were the predominant AEs. Higher HCT levels and TPE performed for CRS may be associated with an increased risk of AEs. HCT≥24.5% may help identify patients requiring intensified monitoring, although its discriminatory ability is moderate (AUC=0.67) and it should not be used as a standalone criterion for clinical decision-making. Findings regarding the CRS subgroup require validation in larger cohorts. Optimizing extracorporeal circuit priming and strengthening peri-procedural monitoring may help improve the safety of TPE.

Objective To explore the impact of dyadic coping on fear of progression in patients with hematological tumors and their spouses based on the Actor-Partner Interdependence Model(APIM),and to provide references for clinical intervention.Methods By the convenient sampling method,136 pairs of hematological tumor patients and their spouses were selected from October 2023 to January 2024 in 5 tertiary hospitals in Shandong Province.A general information questionnaire,Dyadic Coping Inventory,Fear of Progression Questionnaire Short Form,and Fear of Progression Questionnaire Short Form/Partner Version were used to conduct the investigation.Amos 24.0 software was used to establish the APIM for dyadic coping with fear of progression.Results A total of 280 survey questionnaires were distributed,and 272 valid questionnaires were collected,including 136 from patients and their spouses,with an effective rate of 97.14％.The dyadic coping scores of hematological tumors patients and their spouses were(129.50±20.58)and(132.71±15.70),respectively,while the fear of progression scores were(31.71±3.13)and(29.01±3.05),respectively.Regarding the actors'effects,the level of dyadic coping strategies of patients and their spouses can both predict their own fear of progression,and are negatively correlated(β1=-0.52,β2=-0.41;P＜0.001).Regarding the partners'effects,the degree of fear of progression in patients is negatively correlated with the dyadic coping level of their spouses(β=-0.19,P＜0.001).Conclusion There is an interactive effect between the fear of progression and the level of dyadic coping between hematological tumor patients and their spouses.This suggests that clinical nursing staff should pay attention to the evaluation of fear of progression in patients with hematological tumors and their spouses,and effectively reduce the level of fear of progression on both sides.

Objective To explore the impact of dyadic coping on fear of progression in patients with hematological tumors and their spouses based on the Actor-Partner Interdependence Model(APIM),and to provide references for clinical intervention.Methods By the convenient sampling method,136 pairs of hematological tumor patients and their spouses were selected from October 2023 to January 2024 in 5 tertiary hospitals in Shandong Province.A general information questionnaire,Dyadic Coping Inventory,Fear of Progression Questionnaire Short Form,and Fear of Progression Questionnaire Short Form/Partner Version were used to conduct the investigation.Amos 24.0 software was used to establish the APIM for dyadic coping with fear of progression.Results A total of 280 survey questionnaires were distributed,and 272 valid questionnaires were collected,including 136 from patients and their spouses,with an effective rate of 97.14％.The dyadic coping scores of hematological tumors patients and their spouses were(129.50±20.58)and(132.71±15.70),respectively,while the fear of progression scores were(31.71±3.13)and(29.01±3.05),respectively.Regarding the actors'effects,the level of dyadic coping strategies of patients and their spouses can both predict their own fear of progression,and are negatively correlated(β1=-0.52,β2=-0.41;P＜0.001).Regarding the partners'effects,the degree of fear of progression in patients is negatively correlated with the dyadic coping level of their spouses(β=-0.19,P＜0.001).Conclusion There is an interactive effect between the fear of progression and the level of dyadic coping between hematological tumor patients and their spouses.This suggests that clinical nursing staff should pay attention to the evaluation of fear of progression in patients with hematological tumors and their spouses,and effectively reduce the level of fear of progression on both sides.

Objective:To investigate the characteristics of digestive system symptoms and its relation with the time of nucleic acid continuous positive in population infected with severe acute respiratory syndrome coronavirus 2 Omicron variant, and to analyze the abdominal computed tomography (CT) features of patients infected with Omicron variant.Methods:From April 11 to May 23, 2022, a questionnaire survey was conducted in patients infected with Omicron variant admitted to the Shanghai National Convention and Exhibition Center Fangcang Hospital. The questionnaire included basic information, the start time of nucleic acid positive, respiratory symptoms, digestive system syptoms and outcomes, etc.Combined with the clinical data, the relation between digestive tract symptoms and the time of nucleic acid continuous positive were analyzed. Thoracic and abdominal CT were performed for patients with continuous positive nucleic acid results ≥10 d, and the relationship between the abdominal CT imaging characteristics and the time of nucleic acid continuous positive was analyzed. Independent sample t-test and multivariate logistic regression were used for statistical analysis. Results:A total of 4 360 valid questionnaires were collected, including 2 475 males and 1 885 females, with a hospital stay of (6.8±4.9) d. Among the 4 360 patients, 1 979 patients (45.4%) had gastrointestinal symptoms such as loss of appetite, abdominal discomfort or pain, constipation and diarrhea. The time of nucleic acid continuous positive in patients with gastrointestinal symptoms was (7.4±5.5) d, which was longer than that of patients without gastrointestinal symptoms (6.5±3.6) d, and the difference was statistically significant ( t=3.78, P<0.001). During the isolation period in the Fangcang Hospital, the time of nucleic acid continuous positive in patients with complete remission of digestive tract symptoms was shorter than that of patients with no remission of digestive tract symptoms ((7.3±5.2) d vs. (8.5±5.7) d), and the difference was statistically significant ( t=2.25, P=0.025). The results of multivariate logistic regression analysis showed that the combination of gastrointestinal symptoms was an independent risk factor for continuous positive nucleic acid result ≥10 d ( OR=1.316, 95% confidence interval 1.294 to 2.205, P=0.046). Among the 299 patients with continuous positive nucleic acid results≥10 d, 187 cases (62.5%) had gastrointestinal symptoms, and 146 cases (48.8%) had abdominal CT findings of thickening of the gastroduodenal wall, thickening of the small intestinal wall, indistinct mesenteric vessels of the small intestine, and dilatation and pneumatosis of the colon. In patients with continuous positive nucleic acid results ≥10 d, abdominal CT indicated that patients with gastrointestinal imaging changes had a longer time of nucleic acid continuous positive than those without gastrointestinal imaging changes ((16.0±2.8) d vs. (13.0±2.1) d), and the difference was statistically significant ( t=2.62, P=0.009). Conclusions:Digestive system symptoms are common in patients infected with Omicron variant. The time of nucleic acid continuous positive in patients with gastrointestinal symptoms is longer than those without gastrointestinal symptoms. Some patients may have gastrointestinal lesions on abdominal CT.

Objective:We aimed to analyze the the genotyping of norovirus infectious diarrhea epidemic in Songjiang district, Shanghai, and explored the experience in handling the epidemic to provide a scientific basis for formulating prevention and treatment strategies.Methods:The epidemiological data and related samples of 69 outbreaks of infectious diarrhea caused by norovirus was collected from 2017 to 2019 in Songjiang district, Shanghai. Sequencing and type identification were performed by the method of gene sequencing for the junction region of Norovirus ORF1 and ORF2.Results:From 2017 to 2019, 69 outbreaks of norovirus infections diarrhea were reported in Songjiang district, Shanghai. A total of 1 767 samples were tested, including 619 case samples (positive rate 19.9%), 343 practitioner samples (positive rate 1.1%), 505 environmental samples (positive rate 0.5%) and 300 food samples (not detected). 141 sequences were obtained, and the genotype analysis showed that the genotype that mainly caused infectious diarrhea in 2017 and 2018 was GII.P16-GII.2 (50.98%, 26/51). In 2019, the genotypes that mainly caused infectious diarrhea were GII.P16-GII.2 (13.73%, 7/51) and GII.Pe-GII.4 (9.80%, 5/51).Conclusion:The main genotype of the 69 outbreaks of nororirus infectious diarrhea epidemic in Songjiang district, Shanghai from 2017 to 2019 was GII.P16-GII.2, which showed obvious peaks in spring, autumn and winter. There were more infections in kindergartens and schools. The surveillance of norovirus infection should be strengthened.

Objective:We aimed to analyze the the genotyping of norovirus infectious diarrhea epidemic in Songjiang district, Shanghai, and explored the experience in handling the epidemic to provide a scientific basis for formulating prevention and treatment strategies.Methods:The epidemiological data and related samples of 69 outbreaks of infectious diarrhea caused by norovirus was collected from 2017 to 2019 in Songjiang district, Shanghai. Sequencing and type identification were performed by the method of gene sequencing for the junction region of Norovirus ORF1 and ORF2.Results:From 2017 to 2019, 69 outbreaks of norovirus infections diarrhea were reported in Songjiang district, Shanghai. A total of 1 767 samples were tested, including 619 case samples (positive rate 19.9%), 343 practitioner samples (positive rate 1.1%), 505 environmental samples (positive rate 0.5%) and 300 food samples (not detected). 141 sequences were obtained, and the genotype analysis showed that the genotype that mainly caused infectious diarrhea in 2017 and 2018 was GII.P16-GII.2 (50.98%, 26/51). In 2019, the genotypes that mainly caused infectious diarrhea were GII.P16-GII.2 (13.73%, 7/51) and GII.Pe-GII.4 (9.80%, 5/51).Conclusion:The main genotype of the 69 outbreaks of nororirus infectious diarrhea epidemic in Songjiang district, Shanghai from 2017 to 2019 was GII.P16-GII.2, which showed obvious peaks in spring, autumn and winter. There were more infections in kindergartens and schools. The surveillance of norovirus infection should be strengthened.

Pulmonary fibrosis (PF) is a chronic, progressive, fatal interstitial lung disease with limited available therapeutic strategies. We recently reported that the protein kinase glycogen synthase kinase-3

There is no specific treatment for post-polio syndrome. The common applied therapies include mediciation, exercise, cogni-tive behavioural therapy, physiotherapy, occupational therapy, Traditional Chinese Medicine, assistive technology, psychological and social factors adjustment, interdisciplinary comprehensive rehabilitation, and so on.

Objective · To investigate the effect of metformin on insulin resistance (IR)-related metabolic parameters in olanzapine-bearing rats.Methods · Thirty female SD rats were randomly divided into metformin intervention group, olanzapine group and control group. During the first 6 weeks,5 mg /(kg·d) olanzapine was given to the two test groups . The control group was given the same amount of saline. From the 7th week, the intervention group began to combine with metformin 500 mg / (kg·d), while the olanzapine group combined with the same amount of saline, continuing for 4 weeks.At the end of 6th week and 10th week, intraperitoneal glucose tolerance and homeostasis model assessment IR index were assessed. Results · The area under the glucose tolerance curve (P=0.040) and the IR index (P=0.000) were significantly higher for the intervention group and the olanzapine group than the control group at the end of 6th week. At the 10th weekend, the glucose tolerance (P=0.015) and IR index in the intervention group were significantly lower than those in the olanzapine group (P=0.001). Conclusion · Metformin may rectify the impaired glucose tolerance and improve IR induced by olanzapine partly.

Objective: To investigate the influence of aluminum on microRNA29 (miR29) subtypes miR29a, miR29a*, miR29b1, miR29b2, miR29c1, and miR29c2 and β-site amyloid precursor protein cleaving enzyme 1 (BACE1) in the brain of rats. Methods: A total of 40 Sprague-Dawley rats were randomly divided into control group and 15, 30, and 45 μmol/kg groups according to the body weight, with 10 rats in each group. The rats were exposed to aluminum (at a dose of 0.1 ml/100 g body weight) by intraperitoneal injection for 8 weeks. The rats in control group were given 0.9% normal saline, and those in exposure groups were given aluminum-maltolate (equivalent volumesof maltolate and aluminum solution were mixed before exposure) . The cerebral cortex and hippocampus were isolated after exposure ended; Western blotting was used to measure the change in BACE1 expression, and real-time reverse transcription polymerase chain reaction was used to measure the mRNA expression of miR29 subtypes in the cerebral cortex and hippocampus. Results: Compared with the control group, the 45 μmol/kg group had a significant increase in BACE1 expression in the cerebral cortex, and the 30 and 45 μmol/kg groups had significant increases in BACE1 expression in the hippocampus (all P<0.05) . Compared with the control group, the 15, 30, and 45 μmol/kg groups had significant reductions in the mRNA expression of miR29a*, miR29b2, miR29c1, and miR29c2 in the cerebral cortex and hippocampus (all P<0.01) , and the 45 μmol/kg group had significant reductions in the mRNA expression of miR29a and miR29b1 in the cerebral cortex and hippocampus (all P<0.05) . The results of correlation analysis showed that there was no correlation between the mRNA expression of miR29a*, miR29b2, miR29c1, and miR29c2 and BACE1 expression in the cerebral cortex and hippocampus (all P>0.05) , while the mRNA expression of miR29a and miR29b1 was negatively correlated with BACE1 expression (cerebral cortex: r=-0.987 and -0.981, P<0.05; hippocampus: r=-0.992 and -0.991, P<0.05) . Conclusion Aluminum can reduce the expression of miR29 subtypes and increase BACE1 expression in the brain, and the expression of miR29a and miR29b1 is negatively correlated with BACE1 expression.