OBJECTIVE To compare the effect on umbilical care of the neonates between the natural dying method and the traditional ethanol disinfection method so as to provide a better method of umbilical nursing for the neo-nates.METHODS A total of 212 healthy neonates who were given birth in the First Medical Center of Chinese PLA General Hospital from Aug.2024 to Nov.2024 were recruited as the research subjects and were randomly divided into the natural drying method with 103 cases and the traditional ethanol disinfection method with 109 cases ac-cording to the method of umbilical care.The time of umbilical cord separation,rate of umbilical bleeding and inci-dence of umbilical secretions were observed and compared between the two groups of neonates.RESULTS There were 16 neonates with the healing time of umbilical cord separation no more than 7 days under the treatment of natural drying method,with 5 cases more than the neonates under the treatment of traditional ethanol disinfection method.The average healing time of umbilical cord separation was 11.69 days under the natural drying method,1.43 days shorter than 13.12 days under the traditional ethanol disinfection method,and there was significant difference(P＜0.05).The rate of umbilical bleeding was 5.82％under the natural drying method,a reduction of 0.60％as compared with 6.42％under the traditional ethanol disinfection method;the incidence of umbilical se-cretions was 0.97％under the national drying method,a reduction of 1.78％as compared with 2.75％under the traditional ethanol disinfection method,but there were no significant differences.CONCLUSIONS As compared with the traditional ethanol disinfection method,the natural drying method can shorten the time of umbilical cord separation,reduce the risk of umbilical infection,and reduce the stress from the neonatal nursing.It is worthy to be promoted.

Objective:To explore the differences in the cost structures of Hemophagocytic Lymphohistiocytosis(HLH)and Still's disease,and provide a basis for optimizing the medical insurance and hierarchical diagnosis and treatment policies for rare diseases.Methods:Based on the theories and methods of SHA 2011,the treatment costs and financing models of HLH and Still's disease in 2020 were calculated and analyzed to calculate its financing mode.Results:In 2020,the treatment cost of HLH in China was 436 million yuan,with 98.62%occurring in inpatient services;the treatment cost of Still's disease was 159 million yuan,with 82.32%occurring in inpatient services.In terms of the financing composition,the proportion of household health expenditure in outpatient services for HLH reached to 65.51%;for adult Still's disease,the proportion of household health expenditure in outpatient services was 65.13%;for pediatric Still's disease,the proportion of household health expenditure in outpatient services was as high as 93.15%,and the compensation from social medical insurance was less than 4%.Conclusion:In China,there are problems such as imbalanced cost structures,uneven distribution of diagnosis and treatment resources,heavy family burdens,and differentiation in the attention paid to rare diseases.It is necessary to improve the accounting system,strengthen grassroots diagnosis and treatment,optimize the financing mechanism,increase the attention to"non-star"rare diseases,and promote universal protection.

OBJECTIVE To compare the effect on umbilical care of the neonates between the natural dying method and the traditional ethanol disinfection method so as to provide a better method of umbilical nursing for the neo-nates.METHODS A total of 212 healthy neonates who were given birth in the First Medical Center of Chinese PLA General Hospital from Aug.2024 to Nov.2024 were recruited as the research subjects and were randomly divided into the natural drying method with 103 cases and the traditional ethanol disinfection method with 109 cases ac-cording to the method of umbilical care.The time of umbilical cord separation,rate of umbilical bleeding and inci-dence of umbilical secretions were observed and compared between the two groups of neonates.RESULTS There were 16 neonates with the healing time of umbilical cord separation no more than 7 days under the treatment of natural drying method,with 5 cases more than the neonates under the treatment of traditional ethanol disinfection method.The average healing time of umbilical cord separation was 11.69 days under the natural drying method,1.43 days shorter than 13.12 days under the traditional ethanol disinfection method,and there was significant difference(P＜0.05).The rate of umbilical bleeding was 5.82％under the natural drying method,a reduction of 0.60％as compared with 6.42％under the traditional ethanol disinfection method;the incidence of umbilical se-cretions was 0.97％under the national drying method,a reduction of 1.78％as compared with 2.75％under the traditional ethanol disinfection method,but there were no significant differences.CONCLUSIONS As compared with the traditional ethanol disinfection method,the natural drying method can shorten the time of umbilical cord separation,reduce the risk of umbilical infection,and reduce the stress from the neonatal nursing.It is worthy to be promoted.

Objective:To explore the differences in the cost structures of Hemophagocytic Lymphohistiocytosis(HLH)and Still's disease,and provide a basis for optimizing the medical insurance and hierarchical diagnosis and treatment policies for rare diseases.Methods:Based on the theories and methods of SHA 2011,the treatment costs and financing models of HLH and Still's disease in 2020 were calculated and analyzed to calculate its financing mode.Results:In 2020,the treatment cost of HLH in China was 436 million yuan,with 98.62%occurring in inpatient services;the treatment cost of Still's disease was 159 million yuan,with 82.32%occurring in inpatient services.In terms of the financing composition,the proportion of household health expenditure in outpatient services for HLH reached to 65.51%;for adult Still's disease,the proportion of household health expenditure in outpatient services was 65.13%;for pediatric Still's disease,the proportion of household health expenditure in outpatient services was as high as 93.15%,and the compensation from social medical insurance was less than 4%.Conclusion:In China,there are problems such as imbalanced cost structures,uneven distribution of diagnosis and treatment resources,heavy family burdens,and differentiation in the attention paid to rare diseases.It is necessary to improve the accounting system,strengthen grassroots diagnosis and treatment,optimize the financing mechanism,increase the attention to"non-star"rare diseases,and promote universal protection.

ObjectiveTo systematically sort out the knowledge framework and conceptual logic relationship of "disease-syndrome-treatment-prescription-medicine" in the existing literature on traditional Chinese medicine（TCM） treatment of diabetic peripheral neuropathy（DPN）， to construct of the knowledge map of TCM treatment of DPN， and to promote the explicitation of the implicit knowledge in the literature on the treatment of DPN with TCM. MethodTaking the literature of China National Knowledge Infrastructure about TCM treatment of DPN as the main data source， TCM-related concepts and entities were constructed by manual citation， and the corresponding relationships between the entities were established. Structured data were formed by processing with Python 3.7， and the knowledge graph was constructed based on Neo4j 3.5.34 graph database. ResultThe resulting knowledge graph with TCM diagnosis and treatment logic， defined 12 node labels such as prescriptions， Chinese medicines and syndrome types at the schema layer， as well as 4 types of relationships， such as inclusion， correspondence， selection and composition. It could support the query and discovery of nodes（syndrome elements， syndrome types and treatment methods）， as well as the relationship between each node. ConclusionBased on the literature data， this study constructed a knowledge map for TCM treatment of DPN， which brought together various methods of TCM treatment of DPN， including internal and external treatment. The whole chain knowledge structure of syndrome differentiation and classification for DPN treatment is formed from syndrome element analysis， syndrome type composition to treatment method selection， which can provide new ideas and methods for literature data to serve clinical and scientific research work， as well as reference for visualization of TCM literature knowledge， intellectualization of TCM knowledge services and the standardization of TCM diagnosis and treatment.

Dermatomyositis is an autoimmune disease mainly involving the skin and muscles, as well as the heart, lungs, and joints, and it may also be complicated by malignant tumors. Among these complications, interstitial lung disease (ILD) is of particular concern. Because of the urgent onset and rapid progress, ILD is hard to diagnose at the early stage, usually leading to treatment delay. Furthermore, ILD is the common cause of death in patients with dermatomyositis. This review summarizes types of skin lesions of, serum biomarkers for and radiological features of dermatomyositis to help evaluate the risk, severity and prognosis of it complicated by ILD.

INTRODUCTION: Three doses of SARS-CoV-2 mRNA vaccines have been recommended for cancer patients to reduce the risk of severe disease. Anti-neoplastic treatment, such as chemotherapy, may affect long-term vaccine immunogenicity. METHOD: Patients with solid or haematological cancer were recruited from 2 hospitals between July 2021 and March 2022. Humoral response was evaluated using GenScript cPASS surrogate virus neutralisation assays. Clinical outcomes were obtained from medical records and national mandatory-reporting databases. RESULTS: A total of 273 patients were recruited, with 40 having haematological malignancies and the rest solid tumours. Among the participants, 204 (74.7%) were receiving active cancer therapy, including 98 (35.9%) undergoing systemic chemotherapy and the rest targeted therapy or immunotherapy. All patients were seronegative at baseline. Seroconversion rates after receiving 1, 2 and 3 doses of SARS-CoV-2 mRNA vaccination were 35.2%, 79.4% and 92.4%, respectively. After 3 doses, patients on active treatment for haematological malignancies had lower antibodies (57.3%±46.2) when compared to patients on immunotherapy (94.1%±9.56, P<0.05) and chemotherapy (92.8%±18.1, P<0.05). SARS-CoV-2 infection was reported in 77 (28.2%) patients, of which 18 were severe. No patient receiving a third dose within 90 days of the second dose experienced severe infection. CONCLUSION This study demonstrates the benefit of early administration of the third dose among cancer patients.
Humans ; SARS-CoV-2 ; COVID-19/prevention & control* ; Treatment Outcome ; Neoplasms/drug therapy* ; Hematologic Neoplasms ; Vaccination ; RNA, Messenger ; Antibodies, Viral ; Immunogenicity, Vaccine

Background: The stem of Syringa pinnatifolia is used as traditional Mongolian medicine for the treatment of cardiopulmonary diseases, in which sesquiterpenes are regarded as the primary medicinal compounds. However, only S. pinnatifolia from natural stands is able to produce medicinal-grade stems when compared with that from cultivated stands. Despite the need to develop an effective technique to promote sesquiterpene accumulation in cultivated stands to ensure sustainable resource production, studies on the potential use of fungal endophytes as fungal elicitors were limited. Objective: This study explored the potential of selected endophytic fungi isolated from the stems of wild and cultivated S. pinnatifolia and further examined their efficacy in promoting sesquiterpene production in S. pinnatifolia calli. Results: Among the 11 fungal groups, Valsa sp, isolated from wild S. pinnatifolia, emerged as a promising fungal elicitor for promoting sesquiterpene accumulation in S. pinnatifolia. This conclusion is drawn from the production of a humulane-type sesquiterpene, known to be one of the most prevalent subtypes of sesquiterpenes in S. pinnatifolia. In addition, it was demonstrated that methyl jasmonate and salicylic acid displayed little effect on sesquiterpene accumulation in S. pinnatifolia. Conclusions: The findings of this study lay a foundation for using fungal endophytes to promote sesquiterpene production in S. pinnatifolia. This contribution could subsequently advance the development of the local traditional medicine industry and aid in the protection of wild S. pinnatifolia.

Objective:To evaluate the relationship between preoperative widespread pain and chronic post-surgical pain (CPSP) following total knee arthroplasty (TKA) in the patients with knee osteoarthritis.Methods:Two hundred American Society of Anesthesiologists physical status Ⅰ-Ⅲ patients with knee osteoarthritis, aged 40-70 yr, undergoing elective the first unilateral primary TKA under general anesthesia, were enrolled.The widespread pain index, visual analogue scale score, Hospital Anxiety and Depression Scale and Central Sensitization Inventory scores were recorded at 1 day before surgery.The patients were divided into CPSP-positive group and CPSP-negative group according to visual analogue scale score at 6 months after surgery.Risk factors for CPSP were analyzed by logistic regression.Results:The results of logistic regression analysis showed that increased preoperative widespread pain index score, Central Sensitization Inventory score and Hospital Anxiety and Depression Scale score and female were risk factors for CPSP after TKA.Conclusions:Preoperative widespread pain is a risk factor for CPSP following TKA in the patients with knee osteoarthritis.

Objective:To summarize clinical characteristics of and treatment experience with patients with critical illnesses in a dermatological ward.Methods:All patients with serious or life-threatening conditions, who were hospitalized at the dermatological ward of the Second Xiangya Hospital of Central South University from July 9, 2011 to December 31, 2020, were collected, and their clinical data were retrospectively analyzed. Demographic characteristics, disease types and proportions, main complications, causes of serious or life-threatening conditions, important treatment measures and outcomes were summarized, and causes of death were also analyzed and discussed.Results:A total of 1 057 patients with critical illnesses were collected, with a male-to-female ratio of 1∶1.11, and 64.81% of them aged 18 to 65 years. The types of diseases mainly included drug eruptions (332 cases) , connective tissue diseases (226 cases) , bullous skin diseases (104 cases) , psoriasis (57 cases) , erythroderma (45 cases) , infectious skin diseases (67 cases) , etc. Among them, psoriasis (39 cases) and erythroderma (32 cases) mostly occurred in males, and connective tissue diseases (168 cases) mostly occurred in females. Common complications mainly involved infections, important organ damage or dysfunction, hypoalbuminemia, and fluid, electrolyte and acid-base imbalances. A total of 94 patients were diagnosed with life-threatening conditions, which were found to be mainly caused by primary skin diseases, hematologic abnormalities, respiratory failure, nervous system abnormalities, renal failure, sepsis, fluid, electrolyte and acid-base imbalances, etc. During the management of critical illnesses, 43 patients were treated with high-dose glucocorticoid pulse therapy, 264 were treated with gamma-globulin pulse therapy, 355 were transfused with other blood products, and 34 received special therapies such as hemoperfusion/immunoadsorption therapy, plasma exchange, dialysis, artificial liver support therapy; 42 patients were transferred to the intensive care unit (ICU) , 12 were transferred to the department of surgery for operations, and 12 were transferred to the department of obstetrics and gynecology for delivery or induction of labor. After treatment, 989 patients (93.57%) achieved improvement and were discharged. A total of 14 patients (1.32%) died, of whom 7 died of secondary sepsis, 2 died of severe pulmonary infections, 2 died of asphyxia caused by respiratory mucosa shedding-induced airway obstruction, the other 3 died of gastrointestinal hemorrhage, cerebral hemorrhage and neuropsychiatric systemic lupus erythematosus, respectively.Conclusions:Critical cases in the dermatological ward mainly suffered from serious skin diseases such as severe drug eruptions, connective tissue diseases and bullous skin diseases, as well as complications such as severe underlying diseases, severe organ dysfunction, sepsis or severe fluid, electrolyte and acid-base imbalances. In terms of treatment, it is of critical significance to make a clear diagnosis and assess the severity of disease as early as possible, monitor and prevent possible complications, and to consult with specialists in relevant disciplines in time.