Mutations in the IARS1 gene are rare in clinical practice， and up to now， only ten cases with detailed clinical and genetic data have been recorded in the literature. This article reports a case of growth retardation， intellectual developmental disorder， hypotonia， and hepatopathy （GRIDHH） associated with single heterozygous mutations in the IARS1 gene and summarizes the clinical and genetic features of GRIDHH， thereby expanding the genetic spectrum of GRIDHH.

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 effect of combining acupuncture with transcranial magnetic stimulation (rTMS) in treating post-stroke dysphagia of oral stage.Methods Thirty-nine stroke survivors with dysphagia of oral stage were randomly divided into an experimental group (n=19) and a control group (n =20).Both groups were given basic supportive treatment and rehabilitation,including rTMS for 4 weeks.The experimental group additionally received acupuncture.Modified barium swallowing impairment profiles (MBSImPs) and oral transit time (OTT) were used to assess both groups after the intervention.Results There were no significant differences between the two groups before the treatment.After the treatment the average MBSImP score (8.26±2.92) and OTT (12.79±2.54)s were significantly better in the experimental group compared to before the treatment and compared to the control group's averages.In the control group a significant improvement was observed only in the average MBSImP score (10.60±4.09),but not in the average OTT.Conclusions Acupuncture combined with repetitive transcranial magnetic stimulation has positive effects on poststroke dysphagia of the oral stage.It is worthy of application and popularization.

Electric field treatment of tumor technology is of great significance in the treatment of glioma,including direct current electric field and alternating electric field.Direct current electric field affects the migration of glioma cells,and can be used as a new clue for the treatment of glioma.While alternating electric field can inhibit the proliferation and invasion of glioma cells,and induce apoptosis,and can obviously prolong the survival period of patients with glioma and improve their quality of life.

Objective To understand obstetrical nurses′awareness and attitude to breastfeeding in patients with hepatitis B in level three class A hospitals in Beijing,so as to provide references for scientific guidance and increase of breastfeeding rate in this special population in the future.Methods Using convenience sampling method,questionnaires were delivered in 1 86 obstetrical nurses from 7 level three class A hospitals in Beijing,in order to investigate their awareness on whether patients with hepatitis B could feed infants with breast milk,and their attitude toward breastfeeding of patients with hepatitis B.Results A total of 1 86 obstetrical nurses were surveyed,of whom only 64.6% could correctly answer breastfeeding-related problems about patients with hepatitis B.82.3% of the surveyed obstetrical nurses falsely thought that level of HBV DNA titer in breast milk would affect breastfeeding.Only 29.6% of the surveyed nurses were aware of Clinical Guideline on Prevention of Mother-to-child Transmission.When surveying about their willingness,only 45.2% of the nurses supported the breastfeeding of patients with hepatitis B.Differences were statistically significant among nurses on their awareness and attitude toward whether newborn infants could be fed by breast milk from patients with hepatitis B after receiving immune block,and on whether the nurses would encourage puerperas with hypatitis B to feed their infants by breast milk when they were consulted by these puerperas.Conclusions Hospital and department managers should pay increasing attention to learning and awareness of new knowledge and new technologies of obstetrical nursing staff,by implementing continuing education,enhancing their acceptance of self-worth and their confidence in self knowledge level,so as to provide more scientific,accurate and effective health education for maternal and child safety.