Objective:To explore the efficacy and safety of cryopreservation-free integrated autologous hematopoietic stem cell transplantation (HSCT) model for patients with multiple myeloma.Methods:A total of 96 patients with newly diagnosed multiple myeloma (NDMM) between July 31, 2020, and December 31, 2022, were retrospectively analyzed, of which 41 patients in the observation group received integrated non-cryopreserved transplantation mode. After hematopoietic stem cells were mobilized and collected, melphalan was started immediately for pre-transplant conditioning, and non-cryopreserved grafts from the medical blood transfusion refrigerator were directly injected intravenously into the patient within 24-48 h after the melphalan conditioning. The control group consisted of 55 patients who received traditional transplantation mode. After hematopoietic stem cells were collected, stem cell cryopreservation was performed in liquid nitrogen, and then the transplant plans were started at the right time. All patients received mobilization of autologous hematopoietic stem cells using the G-CSF combined with the plerixafor.Results:① A total of 34 patients (82.9% ) with VGPR plus CR in the observation group were significantly higher than 33 patients (60.0% ) in the control group ( P=0.016). ②Compared with the control group, the incidence of grade 1 oral mucosal inflammation was higher in the observation group ( P<0.001) ; however, the incidence of grades 2 and 3 oral mucosal inflammation was lower ( P=0.004, P=0.048), and neither group experienced grade 4 or above oral mucosal inflammation. The incidence of grade 1 diarrhea was higher in the observation group ( P=0.002), whereas the incidence of grade 3 diarrhea was lower ( P=0.007). No statistically significant difference was observed in the incidence of grade 4 diarrhea ( P=0.506), and neither group experienced grade 5 diarrhea. ③ The incidence of bacterial infection in the observation group was lower than that in the control group (34.1% vs 65.5%, P=0.002), whereas no statistically significant difference was observed in the incidence of fungal infection (29.3% vs 31.4%, P=0.863) and viral infection (4.88% vs 3.64%, P=0.831). ④No statistically significant difference was observed in the implantation time of granulocytes and platelets between the observation and control groups [10 (8-20) days vs 11 (8-17) days, P=0.501; 13 (10-21) days vs 15 (10-20) days, P=0.245]. ⑤ All patients did not receive lenalidomide treatment 100 days post-transplantation. At 30 days post-transplantation, the CTL, NK, and Th cell counts in the observation group were lower than those in the control group ( P<0.001, P=0.002, P=0.049), and the NKT cell counts were higher than those in the control group ( P=0.024). At 100 days post-transplantation, the CTL, NKT, and Th cell counts in the observation group were higher than those in the control group ( P=0.025, P=0.011, P=0.007), and no statistically significant difference in NK cell counts was observed between the two groups ( P=0.396). ⑥ The median follow-up was 18 (4-33) months. The overall 2-year survival rates of the observation and control groups post-transplantation were 91.5% and 78.2%, respectively ( P=0.337). The recurrence-free survival rates were 85.3% and 77.6%, respectively ( P=0.386), and the cumulative recurrence rates were 9.8% and 16.9%, respectively ( P=0.373) . Conclusion:In NDMM, the cryopreservation-free integrated autologous HSCT model can achieve similar therapeutic effects as traditional transplantation models, with lower rates of severe mucosal inflammation and infection compared with traditional transplantation models.

The diagnosis of food allergy in children is one hotspot attracting people′s attention in recent years.The incidence of it shows an increasing trend which exposes problems in the understanding of children′s food allergy in China, especially in the misdiagnosis and missed diagnosis.To further standardize the diagnosis and treatment of food allergy in children, based on the current domestic, foreign guidelines and relevant research evidence, the guideline recommends 16 clinical hot-button issues in the 4 aspects of diagnosis, treatment, prognosis, and prevention.Finally, a diagnosis flowchart has been formulated.The guideline aims to improve the standard diagnosis and treatment of food allergies in children in China.

Objective:To investigate and analyze the hospital staff and patients, awareness about anesthesiologists′ work.Methods:A questionnaire survey was conducted among the hospital staff in the non-anesthesiology departments and non-operating room and the patients undergoing elective surgery at the same time in tertiary hospitals.Logistic regression was used to analyze the factors affecting the level of awareness of the respondents.Results:Sixty point three percent of the respondents had a low level of awareness about the anesthesiologists′ work.Compared with the patients, the physicians ( OR=2.866, 95%CI: 1.405-5.848) had higher level of awareness.There was no significant difference in the levels of awareness among the nurses ( OR=1.633, 95%CI: 0.815-3.273), medical technicians ( OR=1.359, 95%CI: 0.630-2.935), administrative staff ( OR=1.470, 95%CI: 0.651-3.317) and the patients.The respondents, aged 36-50 yr ( OR=1.848, 95%CI: 1.224-2.792), with master′s degree ( OR=2.068, 95%CI: 1.090-3.925) and bachelor′ s degree ( OR=3.624, 95%CI: 1.701-7.723), had higher level of awareness, and the respondents without history of anesthesia and surgery ( OR=0.574, 95%CI: 0.380-0.867) and without medicine-related education background ( OR=0.354, 95%CI: 0.145-0.865) had lower level of awareness. Conclusion:There is insufficient awareness about anesthesiologists′ work among hospital staff and patients.Hospital staff are generally better than patients in terms of the level of awareness, but there are differences among different job categories.There is no significant difference in the level of awareness among nurses, medical technicians, administrative staff and patients.The respondents who are middle-aged, with higher education level, with history of anesthesia and surgery and with medicine-related education background, have higher level of awareness.

Antibiotic resistance (AR) is a severe and fast-growing public health challenge with rapid globalization, especially in China. Although some monitoring systems were established in different fields, fragmentation of information failed to show the overall trend and spread of AR. It is necessary to establish a national monitoring system to reveal the occurrence, development, and spread of AR. The new AR monitoring system needs an updated analysis indicators system. We intend to recommend a new analysis indicators system for AR was constructed and applied to AR data monitoring and analysis for humans, animals, the environment, and foods. After investigating and analyzing the 5 Chinese major AR monitoring systems and literature, we have formulated 15 AR monitoring analysis indicators and initially established an evaluation system for the country's new AR monitoring system.

Carcinoma, Papillary/diagnostic imaging* ; Humans ; Retrospective Studies ; Thyroid Cancer, Papillary/diagnostic imaging* ; Thyroid Neoplasms/diagnostic imaging* ; Thyroid Nodule/diagnostic imaging* ; Ultrasonography

OBJECTIVE: Antimicrobial resistance (AMR) has become a global concern and is especially severe in China. To effectively and reliably provide AMR data, we developed a new high-throughput real-time PCR assay based on microfluidic dynamic technology, and screened multiple AMR genes in broiler fecal samples. METHODS: A high-throughput real-time PCR system with an new designed integrated fluidic circuit assay were performed AMR gene detection. A total of 273 broiler fecal samples collected from two geographically separated farms were screened AMR genes. RESULTS: The new assay with limits of detection ranging from 40.9 to 8,000 copies/reaction. The sensitivity rate, specificity rate, positive predictive value, negative predictive value and correct indices were 99.30%, 98.08%, 95.31%, 99.79%, and 0.9755, respectively. Utilizing this assay, we demonstrate that AMR genes are widely spread, with positive detection rates ranging from 0 to 97.07% in 273 broiler fecal samples. blaCTX-M, blaTEM, mcr-1, fexA, cfr, optrA, and intI1 showed over 80% prevalence. The dissemination of AMR genes was distinct between the two farms. CONCLUSION We successfully established a new high-throughput real-time PCR assay applicable to AMR gene surveillance from fecal samples. The widespread existence of AMR genes detected in broiler farms highlights the current and severe problem of AMR.

Nanwuweizi( Schisandrae Sphenantherae Fructus) and Wuweizi( Schisandrae Chinensis Fructus) have long-term history of use as common traditional Chinese medicines since the Eastern Han Dynasty( AD.25-220 year).However their information are always confused in ancient literature because they were both used as " Wuweizi". Nanwuweizi and Wuweizi are faced with problems such as confused distribution of producing areas,unclear source plants and efficacy characteristics,which limit modern resource development and application. Based on ancient literatures of materia medica,this study conducted a systematic review from several aspects,i.e. the name,distribution of producing areas,source plants,efficacy characteristics and processing of the two medicines in ancient time. This study clarified five main aspects,as following,ancient production areas and corresponding modern distribution areas; source plants used for medicinal purposes in ancient time; application period and application scope; efficacy characteristics in clinical application;processing method. This study provides a reference for evaluating the quality and for their clinical application and reasonable development of Nanwuweizi and Wuweizi.
China ; Drugs, Chinese Herbal/history* ; Herbal Medicine/history* ; History, Ancient ; Materia Medica ; Medicine, Chinese Traditional ; Phytotherapy ; Plants, Medicinal ; Schisandra

Objective To investigate the prevalence and related risk factors of anxiety symptoms in elderly patients from one community health service center in Shanghai.Methods Patients aged 60 to 85 years visiting Kongjiang Community Health Service Center from August to December of 2016 were included in the survey.The patients were evaluated with Generalized Anxiety Disorder Scale-7 (GAD-7),Sociodemographic and Health-related Variables Questionnaire,Mental Health Knowledge Scale and Lubben Social Network Scale-6 (LSNS-6).Results Total 2 006 questionnaires were distributed and 1 981 valid questionnaires were returned with a recovery rate of 98.75％.The overall GAD-7 score was 0 (0,2),and 13.5％ (267/1 981) participants had positive anxiety symptoms.Multivariate logistic analysis showed that 6 variables were related to anxiety symptoms,including educational background,exercise frequency,percentage of medical costs over total household expenses,life satisfaction,the amount of chronic somatic disease,mental health knowledge awareness (P ＜ 0.05).Conclusion The prevalence of anxiety symptoms in the study population is relatively high.Anxiety symptoms are associated with multiple factors,to which the attentions should be paid.

Tanshinone Ⅱ A (Tan Ⅱ A) is an extract of traditional Chinese medicine Salvia miltiorrhiza,which can play a natural antioxidant effect.It is mainly used in the treatment of cardiovascular disease.Which has anti-atherosclerosis,reduced myocardial infarct size and improve myocardial oxygen consumption,inhibition of thrombosis,inhibition of platelet aggregation,antitumor activity and other effects,and are mainly used for the treatment of cardiovascular disease in clinical applications.In recent years,a large number of clinical studies and animal experiments have confirmed that tanshinone Ⅱ A in the inhibition of colon cancer cell proliferation,promote cell apoptosis,promote cell invasion and metastasis and other aspects of prominent anti-cancer effect,making it the object of concern to researchers.In this paper,tanshinone ⅡA anti-colon cancer effect of studies were reviewed.

Objective: To investigate and analyze distribution characteristics of two multidrug resistance related genes in broiler isolates in Shandong province. Methods: The pre slaughter broilers were chosen from Shandong province in this study in June, 2014. A total of 400 fecal samples from five different zones (east, south, west, north and middle) of the hen house were collected. 373(77.2%) Escherichia coli and 110 (22.8%) Klebsiella pneumonia strains were isolated, and ISCR1 and int1 gene were detected by PCR assay and sequencing. The resistance to 10 drugs belonging to 8 classes antimicrobial drugs were obtained by using minimal broth dilution method and data analysis. The difference between isolates and drug resistance profiles was analyzed. Results: Among 483 isolates, 440 isolates (91.1%), 126 isolates (26.1%) and 126 isolates (26.1%) were detected as int1, ISCR1 and both two gene carriers, respectively. The rate of 37 E. coli isolates not carried ISCR1 or int1 gene resistant to 0 to 2, 3 to 5, 6 to 8 classes antimicrobial agents was 13.5% (n=5), 78.4% (n=29), and 8.1% (n=3), respectively; the rate of 288 only int1 gene E. coli carriers resistant to 0 to 2, 3 to 5, 6 to 8 groups antimicrobial agents was 2.4% (n=7), 74.7% (n=215), and 22.9% (n=6), respectively. The data above showed significant difference (P<0.001). The rate of 26 only int1 gene K. pneumonia carriers resistant to 0 to 2, 3 to 5, 6 to 8 classes antimicrobial agents was 11.5% (n=3), 76.9% (n=20), and 11.5% (n=3), respectively; the rate of 78 both two gene K. pneumonia carriers resistant to0 to 2, 3 to 5, 6 to 8 groups antimicrobial agents was 0, 35.9% (n=28), and 64.1% (n=50), respectively. The data above showed significant difference (P<0.001). Conclusion Gene int1 and ISCR1 showed high prevalence in E. coli and K. pneumonia isolates. High level multi-drug resistance profile could be mediated by int1 and ISCR1 gene co-existence.