Objective:To identify the relevant factors for the first-course remission of acute myeloid leukemia (AML) and to develop a predictive model as well as assess its predictive capability.Methods:Clinical data of 749 patients newly diagnosed with AML admitted to the Department of Hematology, the First Affiliated Hospital, Zhejiang University, School of Medicine from January 1, 2019, to April 30, 2023, were collected and randomly divided into training and validation sets. Multivariate logistic regression analysis was conducted to determine variables associated with complete remission in the first course of induction therapy, and a predictive model was established based on these variables. The receiver operating characteristic (ROC) curve of the predictive model was plotted, and the area under the curve (AUC) was calculated.Results:The indicators predicting the first remission course included peripheral blood white blood cell count during onset, CBF::MYH11 fusion gene, CEBPA bZIP region mutation, myelodysplastic syndrome-related gene mutation, and induction chemotherapy regimen selection as independent factors for the first remission course. The model’s area under the training and validation curves was 0.738 (95% CI: 0.696-0.780) and 0.726 (95% CI: 0.650-0.801), respectively. The Hosmer-Lemeshow test results yielded P-values of 0.993 and 0.335, respectively. Conclusion:In this study, the developed model demonstrates a strong predictive capability for the efficacy of the first course of patients with AML, providing valuable guidance to clinicians in assessing patient prognosis and selecting appropriate treatment strategies.

Objective:To identify the relevant factors for the first-course remission of acute myeloid leukemia (AML) and to develop a predictive model as well as assess its predictive capability.Methods:Clinical data of 749 patients newly diagnosed with AML admitted to the Department of Hematology, the First Affiliated Hospital, Zhejiang University, School of Medicine from January 1, 2019, to April 30, 2023, were collected and randomly divided into training and validation sets. Multivariate logistic regression analysis was conducted to determine variables associated with complete remission in the first course of induction therapy, and a predictive model was established based on these variables. The receiver operating characteristic (ROC) curve of the predictive model was plotted, and the area under the curve (AUC) was calculated.Results:The indicators predicting the first remission course included peripheral blood white blood cell count during onset, CBF::MYH11 fusion gene, CEBPA bZIP region mutation, myelodysplastic syndrome-related gene mutation, and induction chemotherapy regimen selection as independent factors for the first remission course. The model’s area under the training and validation curves was 0.738 (95% CI: 0.696-0.780) and 0.726 (95% CI: 0.650-0.801), respectively. The Hosmer-Lemeshow test results yielded P-values of 0.993 and 0.335, respectively. Conclusion:In this study, the developed model demonstrates a strong predictive capability for the efficacy of the first course of patients with AML, providing valuable guidance to clinicians in assessing patient prognosis and selecting appropriate treatment strategies.

Objective:To observe the clinical efficacy of back-Shu and front-Mu points combination needling on balance and walking function in patients after stroke and its mechanism. Methods:A total of 79 patients with post-stroke balance and walking dysfunction were randomly divided into a control group and an observation group.Both groups received conventional treatments such as dietary guidance and oral medications as well as rehabilitation training.On this basis,the control group was treated with additional conventional acupuncture,and the observation group was treated with additional back-Shu and front-Mu points combination needling.Both groups were treated for 4 consecutive weeks.The thickness of abdominal muscle group(transverse abdominal muscle,rectus abdominis,obliquus internus abdominis,and obliquus externus abdominis),the scores of Berg balance scale(BBS),Fugl-Meyer assessment(FMA),and functional ambulation categories(FAC),and walking velocity and stride were compared between the two groups. Results:During the trial,there was 1 dropout case in the control group and 4 dropout cases in the observation group.Before treatment,there were no statistical differences in the abdominal muscle group thickness,scores of BBS,FMA,and FAC,and walking velocity and stride between the two groups(P>0.05).After 4 weeks of treatment,the thickness of abdominal muscle groups,scores of BBS,FMA,and FAC,and walking velocity and stride in both groups were improved(P<0.01),and the observation group was superior to the control group(P<0.05). Conclusion:Both conventional acupuncture and back-Shu and front-Mu points combination needling are conducive to the improvement of balance and walking function in patients after stroke.The back-Shu and front-Mu points combination needling method has better curative efficacy.Strengthening the core muscle group strength may be one of the mechanisms of back-Shu and front-Mu points combination needling treatment.

ObjectiveTo sort out the historical evolution， prescription evolution and modern clinical application of Huagaisan. MethodHuagaisan and its synonym Huagaitang are used as keywords to search the databases of Traditional Chinese Medicine Think Tank， Chinese Medical Dictionary， Airusheng Chinese Medical Database and China National Knowledge Infrastructure（CNKI）. According to the inclusion and exclusion criteria， we obtained the information of ancient books and modern clinical research literature related to Huagaisan， and systematically reviewed and analyzed the historical origin， prescription composition， preparation method， dosage， efficacy， medicinal material origin， processing method and modern clinical application of Huagaisan. ResultA total of 198 pieces of ancient book information were included， involving 93 ancient Chinese medicine books. Huagaisan was composed of fried Perillae Fructus， red Poria， fried Mori Cortex， Citri Eoxcarpium Rubrum， stir-fried Armeniacae Semen Amarum， Ephedrae Herba and fried Glycyrrhizae Radix et Rhizoma， which had the efficacy of promoting the lungs and relieving epidemiological symptoms， expelling phlegm and relieving cough， and treating cough with wind-cold bundled epidemiological symptoms and stagnation of phlegm and Qi. The preparation method was suggested as boiling powder， crushing the seven herbs into coarse particles， the dosage of each drug was fried Perillae Fructus of 1.27 g， red Poria of 1.27 g， fried Mori Cortex of 1.27 g， Citri Eoxcarpium Rubrum of 1.27 g， stir-fried Armeniacae Semen Amarum of 1.27 g， Ephedrae Herba of 1.27 g and fried Glycyrrhizae Radix et Rhizoma of 0.64 g， taking 8.26 g when decocting， adding 300 mL of water， decocting to 210 mL， removing the dregs， and taking it warmly after meals. Twenty-one clinical research papers were included to analyze the modern clinical application of Huagaisan， which was mainly used in the treatment of respiratory diseases such as pneumonia， asthma， bronchitis and so on. ConclusionThis paper has verified and summarized the key information of the famous classical formula Huagaisan， which can provide a detailed reference basis for the development and clinical application of its compound preparation.

OBJECTIVE To study the difference of Huangqin decoction combined with Paeoniae Radix Alba(BS) and Paeoniae Radix Rubra(CS)'s effect on ulcerative colitis(UC) based on network pharmacological analysis and animal experiment. METHODS The active constituents of BS and CS were retrieved from TCMSP database and literature, and the potential target was predicted by Swiss Target Prediction. Ulcerative Colitis was used as key words to search disease targets in DisGenet, OMIM, and Genecard databases. The intersection target was obtained by Venny 2.1.0. Cytoscape 3.7.2 software was used to construct network of drug-consumption targets. The STRING platform was used for protein-protein interaction(PPI) network analysis, and Metascape database was applied for GO/WIKI analysis. A dextran sulfate sodium(DSS) induced UC mouse model was established to compare the anti-UC effects of Huangqing decoction combined with BS(HQT-BS) and CS(HQT-CS), respectively. RESULTS There were 7 active components of HQT-BS and 11 active components of HQT-CS in the treatment of ulcerative colitis, respectively, 5 of which were the same. There were 146 and 157 targets respectively, 106 of which were the same. The core targets of HQT-BS were SRC, HSP90AA1, and PIK3R1, while the core targets of HQT-CS were SRC, HSP90AA1, and STAT3. WIKI enrichment analysis showed that several signaling pathways were shared by both BS and CS, such as EGFR tyrosine kinase inhibitor resistance, Notch signaling pathway. EGF/EGFR signaling pathway was the specific pathway related to BS, while Nuclear receptors meta-pathway and Kit receptor signaling pathway were the specific pathways related to CS, respectively. Animal experiments showed that both HQT-BS and HQT-CS could significantly improve colon shortening and tissue pathological alternation induced by DSS. However, HQT-CS was more effective in reducing the expression of interleukin-6 and neurogenic locus notch homolog protein1. CONCLUSION Both HQT-BS and HQT-CS have anti-UC effect, and HQT-CS is the better one.

OBJECTIVE To explore the perioperative risk factors in young children with obstructive sleep apnea.METHODS The 86 young OSA children admitted to Kunming Children's Hospital from January 2020 to December 2022 were divided into general ward group and ICU ward group according to their postoperative treatment.The clinical data of the two groups were compared and analyzed.RESULTS The course of disease and operation time of children in ICU ward group were significantly longer than those in general ward group,OAHI and ODI were significantly greater than those in general ward group,the intraoperative blood loss was significantly more than that in general ward group,MSaO2 and LSaO2 were significantly lower than those in general ward group,and the tonsil size and operation method composition ratio were significantly different from those in general ward group(P<0.05).There were no significant differences in sex composition ratio,age,weight,height,BMI and adenoid size grading ratio between the two groups(P>0.05).The OAHI values of the two groups were significantly negatively correlated with MSaO2 and LSaO2(r=-0.676,-0.724),and significantly positively correlated with tonsil size grade,ODI,operation time and intraoperative blood loss(r=0.242,0.967,0.321,0.446,P<0.05).There was no significant correlation with the course of disease(r=0.172,P>0.05).Multiple linear regression analysis showed that LSaO2 and ODI were independent risk factors for the severity of the child's condition.CONCLUSION The severity of the condition in young OSA children determines the perioperative risk and is influenced by the type of surgery.LSaO2 and ODI are independent risk factors which should be taken seriously by clinicians.

Objective:To explore the current situation of nursing human caring in hospital wards and analyze its influencing factors, so as to facilitate the development of nursing human caring practice.Methods:From July to November 2022, a total of 107 hospitals were surveyed through stratified convenience sampling method, and 4 072 ward nursing managers were recruited to finish the general information questionnaire and the ward nursing human caring status questionnaire. The general information included the region, class and type of the hospital, etc. The ward nursing human caring status questionnaire included 38 items in 5 dimensions of nursing human caring system and process, humanistic quality and training of nursing staff, humanistic environment and facilities, human caring procedures and measures, and human caring quality evaluation and improvement, with a full score of 190 points. Descriptive statistics were used to analyze the general data, independent samples t-test, ANOVA and correlation analysis were used to analyze the factors influencing the current status of nursing human caring in the ward, while multiple linear regression analysis was used to conduct a multivariate analysis. Results:The score of nursing human caring in hospital wards was 156.91±27.78. Whether the hospital had carried out nursing human caring pilot(demonstration) wards, whether the ward had previously been a hospital nursing human caring pilot(demonstration) nursing unit, the type of ward, and whether nursing managers had participated in human caring training were the influencing factors of the implication of nursing humanistic caring in wards( P<0.05). Conclusions:The practice of nursing human caring in hospital wards is at a good level, but needs to be further strengthened. Nursing managers should take systematically strategies to promote the development of nursing human caring practice.

Objective:To study the effects of fluoride exposure on skeletal development of zebrafish larvae and its possible molecular mechanisms.Methods:Six hours post fertilization(6 hpf) wild-type zebrafish embryos were selected and exposed to sodium fluoride [NaF, control group (0 mg/L NaF), low fluoride group (25 mg/L NaF) and high fluoride group (100 mg/L NaF)] for 9 days. Fluorine ion selective electrode was used to detect the overall fluorine content of zebrafish larvaes, and the death and development of zebrafish larvaes were observed and counted. Bone mineralization and chondrogenesis of the zebrafish larvaes were analyzed by alizarin red staining and alcin blue staining, respectively. The expression levels of sry-related-high-mobilty-group box 9a (Sox9a), osteprotegerin (OPG) and receptor-activator of nuclear factor kappa beta ligant (RANKL) were analyzed by real-time quantitative PCR.Results:Compared with control group [(0.12 ± 0.01) μg/140 larvaes], the overall fluorine contents of zebrafish larvaes in low fluoride group [(0.28 ± 0.03) μg/140 larvaes] and high fluoride group [(0.64 ± 0.10) μg/140 larvaes] were significantly higher, and the differences were statistically significant ( P < 0.05). Compared with control group, zebrafish larvaes in high fluoride group had shorter body length, higher swim bladder loss rate and higher spinal curvature rate ( P < 0.05). The alizarin red staining area, integrated optical density (IOD) and the number of mineralized vertebrae were higher in low fluoride group, while the alcin blue staining area of cartilage formation was lower ( P < 0.05). In the high fluoride group, alizarin red staining area, IOD and the number of mineralized vertebrae were lower, while the alcin blue staining area of cartilage formation was higher ( P < 0.05). Compared with control group, the expression levels of OPG mRNA and OPG/RANKL mRNA in low fluoride group were higher ( P < 0.05); the expression level of RANKL mRNA was higher in high fluoride group, while the expression level of OPG/RANKL mRNA was lower ( P < 0.05). Conclusion:A short period of fluoride exposure from zebrafish embryo to zebrafish larvae can cause abnormal bone development of zebrafish larvae, which may be related to endochondral osteogenesis and OPG/RANKL pathway.

Objective The aim of this study was to observe the expression of human epidermal growth factor receptor( EG-FR),epidermal growth factor receptor 2(HER2)and epidermal growth factor receptor 3(HER3)in cholangiocarcinoma(CCA),and to explore the relationship between the expression of EGFR,HER2,HER3 and the clinicopathological features,overall survival time and proliferation of CCA patients. Methods Fifty patients with CCA who underwent surgery in our hospital from January 2009 to October 2013 were enrolled,and their adjacent tissues were also collected as controls. Immunohistochemistry and qRT-PCR were used to de-tect the expression of EGFR,HER2 and HER3 in CCA and adjacent tissues. The clinicopathological parameters of patients were col-lected and the relationship between EGFR,HER2,and HER3 expression and clinicopathological parameters of CCA was analyzed. Ka-plan-Meier survival curves were plotted,and the relationship between the expression of EGFR,HER2,and HER3 and total postopera-tive survival of 50 patients with CCA was analyzed using the Log-rank test and Cox proportional hazard model. The expression of EG-FR,HER2 and HER3 in CCA QBC939 cell line was knocked down by RNA interference assay. The knockdown effect of EGFR,HER2 and HER3 was detected by Western blot. The effect of EGFR,HER2 and HER3 on proliferation of QBC939 cells was determined by MTT assay. Results The positive expression of EGFR,HER2 and HER3 was determined in CCA tissues. The relationship analysis of clinicopathological characteristics showed that the HER2 expression was associated with CCA lymph node metastasis(P<0. 05). EG-FR and HER3 was associated with CCA lymph node metastasis and correlated with cancer differentiation(P<0. 05). The overall sur-vival of patients with EGFR,HER2 and HER3 positive was significantly lower than that of negative patients( P<0. 05). After knoc-king EGFR,HER2 and HER3 expression,the proliferation was significantly decreased in QBC939 cells(P<0. 05). Conclusion The expression of EGFR,HER2 and HER3 in CCA tissues is closely related to the overall survival of patients,and the mechanism may be related to the promotion of proliferation of CCA cells.

Objective To investigate the clinical efficacy and ultrasonographic changes treated with anti-thyroid drugs ( ATD ) in patients with primary hyperthyroidism(PHT).Methods 83 cases of PHT patients admitted to the department of ultrasound from February 2013 to August 2015 in Zhuji People's Hospital of Zhejiang Province were selected, the patients were divided into two groups according to the results of ultrasonography, echo nonuniform group 41 cases and echo uniform group 42 cases.ATD therapy was administered to the both groups (were treated with methimazole).The thyroid related indexes and hemodynamics of thyroid right superior diagnosed by color doppler ultrasound, and the curative efficacies of the two groups were analyzed.Results After treatment, the systemic vascular resistance index(RI) of echo uniform group was (0.62 ±0.17), and the echo nonuniform group was (0.65 ±0.18), there was no significant difference between the two groups.The echo uniform group of thyroid artery diameter on the right lobe(D), the peak systolic velocity(Vmax), minimum diastolic blood flow velocity(Vmin), thyroid volume(V) and blood flow volume(Q) were significantly lower than the echo nonuniform group, the difference was statistically significant (P <0.05).The total effective rate of the echo nonuniform group (48.78%) was significantly lower than that in the echo uniform group (85.71%), the difference was statistically significant(P <0.05).Conclusion ATD has a good effect in treating PHT, and can significantly improve the thyroid hemodynamics in patients, it has a positive effect on the regulation of thyroid-related parameters in patients, the clinical treatment is effective, and the effect is better especially in patients with uniform echo.