Objective:To develop a treatment-related quality of life scale for Chinese patients with multiple myeloma (MM) and to test its reliability and validity.Methods:The initial scale was constructed through a literature search, Delphi expert correspondence, and cognitive testing. This study conducted a preliminary survey of 379 patients with MM and a formal survey of 865 patients from the hematology departments of 155 hospitals nationwide from February 2024 to March 2024. The final scale was obtained after conducting item analysis and reliability and validity tests on the initial scale.Results:The constructed scale contains 36 items covering six domains: physiological, psychological, social, treatment side effects, general health, and others. In the preliminary survey, the Cronbach’s alpha coefficient of each item ranged from 0.597 to 0.939, and the test-retest reliability was 0.747 ( P<0.001). Exploratory factor analysis extracted eight common factors with a cumulative variance contribution of 60.058%. In the formal survey, the Cronbach’s alpha coefficient of each item ranged from 0.484 to 0.930, and the test-retest reliability was 0.835 ( P<0.001). Confirmatory factor analysis revealed a comparative fit index of 0.750, a root-mean-square error of approximation of 0.090, and a root-mean-square residual of 0.067. Conclusion:The treatment-related quality of life scale for Chinese patients with MM designed in this study exhibited good reliability and validity, reflecting the impact of treatment on the quality of life of patients. This scale can provide a reference to clinicians for assessing the disease status of patients.

Objective:To investigate the epidemiological characteristics and morbidity trends of hypertensive disorders of pregnancy (HDP) in Shenzhen, China.Methods:This study was a cross-sectional study. Data were based on the Shenzhen Birth Cohort. Pregnant women who gave birth from January 1, 2018 to March 31, 2023 were included. Incidence and change trends of HDP and its different pathological types were analyzed. The enrolled pregnant women were divided into the HDP group and the non-HDP group according to whether HDP occurred. General clinical data and pregnancy outcomes were collected from both groups. The incidence of adverse pregnancy outcomes among pregnant women with different pathological types of HDP was analyzed, and subgroup analyses were performed based on age and body mass index (BMI).Results:A total of 90 117 pregnant women were enrolled, aged (31.6±4.4) years. There were 4 117 cases in the HDP group and 86 000 in the non-HDP group. The overall incidence of HDP in the whole study population was 4.57% (4 117/90 117). From 2018—2023, the incidence of HDP in Shenzhen showed an increasing trend year by year, from 2.88% (523/18 155) to 7.04% (271/3 851). Specifically, the incidence of gestational hypertension increased from 0.93% (168/18 155) to 3.09% (119/3 851), the incidence of preeclampsia-eclampsia increased from 1.78% (323/18 155) to 3.17% (122/3 851), the incidence of chronic hypertension increased from 0.01% (1/18 155) to 0.42% (16/3 851), and the incidence of chronic hypertension with superimposed preeclampsia increased from 0.17% (31/18 155) to 0.36% (14/3 851). The age ((32.8±4.8) years vs. (31.5±4.3) years, P<0.05) and BMI in the first trimester ((23.37±3.77) kg/m 2 vs. (21.35±2.91) kg/m 2, P<0.05) of HDP group were higher than those of the non-HDP group. Subgroup analysis showed that the incidence of HDP in pregnant women aged≥50.0 years was the highest in all age subgroups (42.86% (6/14)). The incidence of HDP in pregnant women with BMI≥30.0 kg/m 2 in the first trimester was the highest among all BMI subgroups (20.44% (241/1 179)). The proportions of preterm birth, gestational diabetes, fetal growth restriction, small for gestational age, placental abruption, and late abortion in HDP group were 30.82% (1 269/4 117), 30.46% (1 254/4 117), 6.80% (280/4 117), 4.86% (200/4 117), 3.59% (148/4 117), and 0.80% (33/4 117), respectively. Conclusions:The incidence of HDP among pregnant women has been increased year by year in Shenzhen, China. With the increase in age and BMI during early pregnancy, the incidence of HDP showed an overall upward trend.

Objective:To develop a treatment-related quality of life scale for Chinese patients with multiple myeloma (MM) and to test its reliability and validity.Methods:The initial scale was constructed through a literature search, Delphi expert correspondence, and cognitive testing. This study conducted a preliminary survey of 379 patients with MM and a formal survey of 865 patients from the hematology departments of 155 hospitals nationwide from February 2024 to March 2024. The final scale was obtained after conducting item analysis and reliability and validity tests on the initial scale.Results:The constructed scale contains 36 items covering six domains: physiological, psychological, social, treatment side effects, general health, and others. In the preliminary survey, the Cronbach’s alpha coefficient of each item ranged from 0.597 to 0.939, and the test-retest reliability was 0.747 ( P<0.001). Exploratory factor analysis extracted eight common factors with a cumulative variance contribution of 60.058%. In the formal survey, the Cronbach’s alpha coefficient of each item ranged from 0.484 to 0.930, and the test-retest reliability was 0.835 ( P<0.001). Confirmatory factor analysis revealed a comparative fit index of 0.750, a root-mean-square error of approximation of 0.090, and a root-mean-square residual of 0.067. Conclusion:The treatment-related quality of life scale for Chinese patients with MM designed in this study exhibited good reliability and validity, reflecting the impact of treatment on the quality of life of patients. This scale can provide a reference to clinicians for assessing the disease status of patients.

Objective:To investigate the epidemiological characteristics and morbidity trends of hypertensive disorders of pregnancy (HDP) in Shenzhen, China.Methods:This study was a cross-sectional study. Data were based on the Shenzhen Birth Cohort. Pregnant women who gave birth from January 1, 2018 to March 31, 2023 were included. Incidence and change trends of HDP and its different pathological types were analyzed. The enrolled pregnant women were divided into the HDP group and the non-HDP group according to whether HDP occurred. General clinical data and pregnancy outcomes were collected from both groups. The incidence of adverse pregnancy outcomes among pregnant women with different pathological types of HDP was analyzed, and subgroup analyses were performed based on age and body mass index (BMI).Results:A total of 90 117 pregnant women were enrolled, aged (31.6±4.4) years. There were 4 117 cases in the HDP group and 86 000 in the non-HDP group. The overall incidence of HDP in the whole study population was 4.57% (4 117/90 117). From 2018—2023, the incidence of HDP in Shenzhen showed an increasing trend year by year, from 2.88% (523/18 155) to 7.04% (271/3 851). Specifically, the incidence of gestational hypertension increased from 0.93% (168/18 155) to 3.09% (119/3 851), the incidence of preeclampsia-eclampsia increased from 1.78% (323/18 155) to 3.17% (122/3 851), the incidence of chronic hypertension increased from 0.01% (1/18 155) to 0.42% (16/3 851), and the incidence of chronic hypertension with superimposed preeclampsia increased from 0.17% (31/18 155) to 0.36% (14/3 851). The age ((32.8±4.8) years vs. (31.5±4.3) years, P<0.05) and BMI in the first trimester ((23.37±3.77) kg/m 2 vs. (21.35±2.91) kg/m 2, P<0.05) of HDP group were higher than those of the non-HDP group. Subgroup analysis showed that the incidence of HDP in pregnant women aged≥50.0 years was the highest in all age subgroups (42.86% (6/14)). The incidence of HDP in pregnant women with BMI≥30.0 kg/m 2 in the first trimester was the highest among all BMI subgroups (20.44% (241/1 179)). The proportions of preterm birth, gestational diabetes, fetal growth restriction, small for gestational age, placental abruption, and late abortion in HDP group were 30.82% (1 269/4 117), 30.46% (1 254/4 117), 6.80% (280/4 117), 4.86% (200/4 117), 3.59% (148/4 117), and 0.80% (33/4 117), respectively. Conclusions:The incidence of HDP among pregnant women has been increased year by year in Shenzhen, China. With the increase in age and BMI during early pregnancy, the incidence of HDP showed an overall upward trend.

AIM: To investigate the pathogenic bacteria, drug resistance, therapy and prognosis of infectious endophthalmitis secondary to different ophthalmic surgeries.METHODS:A retrospective analysis was conducted on the clinical data of 37 patients(37 eyes)with infectious endophthalmitis secondary to different ophthalmic surgeries. All these patients were treated in the Ophthalmology Department of Hebei General Hospital between January 2009 and June 2023. The pathogenic bacteria, drug resistance and therapeutic effects of early intravitreal injection of antibiotics or vitrectomy combined with silicone oil filling were analyzed.RESULTS:There were 24 eyes following cataract phacoemulsification combined with intraocular lens implantation, 4 eyes following vitrectomy, 2 eyes following combination surgery for glaucoma and cataract, 2 eyes following anti-glaucoma surgery, 2 eyes following corneal transplantation, 2 eyes following anterior chamber puncture, and 1 eye following intravitreal injection among the 37 eyes with infectious endophthalmitis. Totally 37 samples of intraocular fluid were submitted for bacterial and fungal culture, and 20 strains of pathogenic bacteria were identified, including 17 Gram-positive bacteria, 2 Gram-negative bacteria, 1 fusarium, and 12 cases were staphylococcus epidermidis. According to the final therapy, 7 eyes only treated by intravitreal injection, 11 eyes treated by intravitreal injection and vitrectomy, and 19 eyes only treated by vitrectomy. At the last follow-up, the best corrected visual acuity(BCVA)was ≤0.05 in 15 eyes, 0.06-0.3 in 15 eyes, and 0.4-1.0 in 7 eyes. Compared to before treatment(no light perception - hand movement in 31 eyes, counting fingers -0.05 in 3 eyes, 0.06-0.3 in 3 eyes), the difference was statistically significant(P<0.001).CONCLUSION: For infectious endophthalmitis patients with relatively mild ocular manifestation and good initial visual acuity, intravitreal injection of antibiotics remains an economically viable and effective therapy option. Early vitrectomy may effectively prevent the progression of infectious endophthalmitis, reduce the number of surgeries, and significantly improve the vision outcomes.

Objective:To investigate the relationship between cardio-metabolic abnormalities in the first trimester and adverse pregnancy outcomes (APO).Methods:This cohort study recruited singleton pregnancies in the first trimester (6-13 +6 weeks of gestation) from Shenzhen Maternal and Child Health Care Hospital between January 1, 2021, and October 31, 2022. Cardiometabolic markers, including body mass index (BMI), blood pressure, fasting plasma glucose (FPG), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG), were recorded during the first trimester. Incidence of APO, including gestational hypertension, preeclampsia, gestational diabetes mellitus, preterm birth, fetal growth restriction, small for gestational age infant, and placental abruption, was documented. Cardiovascular metabolic abnormalities in the first trimester were defined as meeting one or more of the following criteria: elevated BMI (BMI≥24 kg/m2), elevated TG (TG≥1.7 mmol/L), decreased HDL-C (HDL-C<1.0 mmol/L), elevated blood pressure (systolic pressure≥130 mmHg (1 mmHg=0.133 kPa) and/or diastolic pressure≥85 mmHg), elevated FPG (FPG≥5.6 mmol/L). Enrolled women were categorized into abnormal cardio-metabolic and normal cardio-metabolic groups. Poisson regression was employed to analyze the association between cardio-metabolic abnormalities in the first trimester and APO. Results:The study included 14 197 pregnant women with an age of (32.0±4.1) years. There were 8 139 women in the normal cardio-metabolic group and 6 058 women in the abnormal cardio-metabolic group. Women with cardio-metabolic disorders in the first trimester had a younger gestational age and higher incidence rates of preterm birth, gestational hypertension, preeclampsia, and gestational diabetes mellitus (all P<0.05). In multivariable Poisson regression, elevated BMI ( RR=1.22, 95% CI 1.15-1.29), elevated FPG ( RR=1.59, 95% CI 1.38-1.82), elevated TG ( RR=1.22, 95% CI 1.13-1.31), and elevated blood pressure ( RR=1.50, 95% CI 1.39-1.63) were independent risk factors for APO, while decreased HDL-C ( RR=0.93, 95% CI 0.70-1.23) was not. Elevated blood pressure ( RR=5.57, 95% CI 4.58-6.78), elevated BMI ( RR=1.71, 95% CI 1.40-2.09), and elevated TG ( RR=1.38, 95% CI 1.10-1.74) had the greatest impact on the risk of developing preeclampsia. Elevated FPG ( RR=1.70, 95% CI 1.45-1.99) had the greatest impact on the risk of gestational diabetes. Conclusions:Elevated blood pressure, BMI, TG and FPG in the first trimester are closely related to APO.

Hypertensive disorder of pregnancy (HDP) involves two major public health issues: mother-infant safety and prevention and controlling major chronic disease. HDP poses a serious threat to maternal and neonatal safety, and it is one of the leading causes of maternal and perinatal morbidity and mortality worldwide, as well as an important risk factor for long-term cardiovascular disease (CVD). In order to explore effective strategies to prevent and control the source of CVD and reduce its risk, we have established a cohort of HDPs in Shenzhen for the primordial prevention of CVD. The construction of the HDP cohort has already achieved preliminary progress till now. A total of 2 239 HDP women have been recruited in the HDP cohort. We have established a cohort data management platform and Biobank. The follow-up and assessment of postpartum cardiovascular metabolic risk in this cohort has also been launched. Our efforts will help explore the pathophysiological mechanism of HDP, especially the pathogenesis and precision phenotyping, prediction, and prevention of pre-eclampsia, which, therefore, may reduce the risk of adverse pregnancy outcomes, and provide a bridge to linking HDP and maternal-neonatal cardiovascular, metabolic risk to promote the cardiovascular health of mothers and their infants.

Background::Gestational weight gain (GWG) is associated with the risk of gestational diabetes mellitus (GDM). However, the effect of weight gain in different trimesters on the risk of GDM is unclear. This study aimed to evaluate the effect of GWG on GDM during different trimesters.Methods::A birth cohort study was conducted from 2017 to 2020 in Shenzhen, China. In total, 51,205 participants were included comprising two models (early pregnancy model and middle pregnancy model). Gestational weight (kg) was measured at each prenatal clinical visit using a standardized weight scale. Logistic regression analysis was used to assess the risk of GDM. Interaction analysis and mediation effect analysis were performed in the middle pregnancy model.Results::In the early pregnancy model, the risk of GDM was 0.858 times lower (95% confidence interval [CI]: 0.786, 0.937) with insufficient GWG (iGWG) and 1.201 times higher (95% CI: 1.097, 1.316) with excessive GWG after adjustment. In the middle pregnancy model, the risk of GDM associated with iGWG increased 1.595 times (95% CI: 1.418, 1.794) after adjustment; for excessive GWG, no significant difference was found ( P = 0.223). Interaction analysis showed no interaction between GWG in early pregnancy (GWG-E) and GWG in middle pregnancy (GWG-M) ( F = 1.268; P = 0.280). The mediation effect analysis indicated that GWG-M plays a partial mediating role, with an effect proportion of 14.9%. Conclusions::eGWG-E and iGWG-M are associated with an increased risk of GDM. Strict control of weight gain in early pregnancy is needed, and sufficient nutrition should be provided in middle pregnancy.