BACKGROUND: Delayed platelet engraftment is a common complication after umbilical cord blood transplantation (UCBT), and there is no standard therapy. Avatrombopag (AVA) is a second-generation thrombopoietin (TPO) receptor agonist (TPO-RA) that has shown efficacy in immune thrombocytopenia (ITP). However, few reports have focused on its efficacy in patients diagnosed with thrombocytopenia after allogeneic hematopoietic stem cell transplantation (allo-HSCT). METHODS: We conducted a retrospective study at the First Affiliated Hospital of the University of Science and Technology of China to evaluate the efficacy of AVA as a first-line TPO-RA in 65 patients after UCBT; these patients were compared with 118 historical controls. Response rates, platelet counts, megakaryocyte counts in bone marrow, bleeding events, adverse events and survival rates were evaluated in this study. Platelet reconstitution differences were compared between different medication groups. Multivariable analysis was used to explore the independent beneficial factors for platelet implantation. RESULTS: Fifty-two patients were given AVA within 30 days post-UCBT, and the treatment was continued for more than 7 days to promote platelet engraftment (AVA group); the other 13 patients were given AVA for secondary failure of platelet recovery (SFPR group). The median time to platelet engraftment was shorter in the AVA group than in the historical control group (32.5 days vs . 38.0 days, Z  = 2.095, P  = 0.036). Among the 52 patients in the AVA group, 46 achieved an overall response (OR) (88.5%), and the cumulative incidence of OR was 91.9%. Patients treated with AVA only had a greater 60-day cumulative incidence of platelet engraftment than patients treated with recombinant human thrombopoietin (rhTPO) only or rhTPO combined with AVA (95.2% vs . 84.5% vs . 80.6%, P  <0.001). Patients suffering from SFPR had a slightly better cumulative incidence of OR (100%, P  = 0.104). Patients who initiated AVA treatment within 14 days post-UCBT had a better 60-day cumulative incidence of platelet engraftment than did those who received AVA after 14 days post-UCBT (96.6% vs . 73.9%, P  = 0.003). CONCLUSION Compared with those in the historical control group, our results indicate that AVA could effectively promote platelet engraftment and recovery after UCBT, especially when used in the early period (≤14 days post-UCBT).
Humans ; Female ; Male ; Thrombocytopenia/etiology* ; Adult ; Retrospective Studies ; Cord Blood Stem Cell Transplantation/adverse effects* ; Middle Aged ; Adolescent ; Young Adult ; Thiazoles/adverse effects* ; Platelet Count ; Receptors, Thrombopoietin/agonists* ; Child ; Thiophenes

Objective:To explore the body image of young breast cancer patients and analyze its influencing factors.Methods:This study is a cross-sectional survey. Using the convenient sampling method, a total of 315 young breast cancer patients who were hospitalized in a ClassⅢ Grade A cancer hospital from March to May 2021 were selected as the research objects. The patients were investigated by general information questionnaire, Body Image Self-rating Questionnaire for Breast Cancer (BISQ-BC) and Medical Coping Modes Questionnaire (MCMQ) . Pearson correlation was used to analyze the correlation among variables. Multiple linear regression was used to analyze the influencing factors of body image in young breast cancer patients. A total of 315 questionnaires were sent out and 310 were effectively received, with effective recovery rate of 98.4% (310/315) .Results:The body image score of 310 young breast cancer patients was (3.03±0.58) . Univariate analysis showed that education level, family residence, per capita monthly income of the family, clinical stage, postoperative time, chemotherapy, radiotherapy, endocrine therapy and BMI were the influencing factors for the body image of young breast cancer patients ( P<0.05) . Acceptance-resignation and avoidance responses were positively correlated with the body image mean and each dimension score of breast cancer patients ( P< 0.01) , while the Confrontation was negatively correlated with the body image mean and each dimension score of breast cancer patients ( P<0.01) . The results of multiple linear regression analysis showed that educational level, clinical stage, body mass index, chemotherapy, endocrine therapy, acceptance-resignation and avoidance and confrontation were the influencing factors of body image in young breast cancer patients (adjusted R2=0.759, F=122.826, P<0.01) . Conclusions:There is a certain degree of body image distress in young breast cancer patients, and education level, clinical stage, body mass index, chemotherapy, endocrine therapy, acceptance-resignation and avoidance and confrontation of patients are closely related to the body image. In clinical practice, reasonable intervention programs should be formulated according to influencing factors to improve body image status.

Objective:To sort out the situation of disaster related projects in national social science projects in recent 10 years and discuss hot spots and front direction of disaster nursing research.Methods:relevant fund information of disaster research in the national social science foundation and the humanities and social science research foundation of the ministry of education from 2009 to 2019 was analyzed by keyword clustering.Results:A total of 648 fund information was retrieved. Four research hots pots in recent 10 years were obtained: disaster risk prediction mechanism, multi-organization disaster response management, logistics optimization model, disaster public opinion and information dissemination.Conclusion:The development of nursing is inseparable from technology and information. Nursing should cooperate with other disciplines and organizations to form a nursing emergency system.

Objective: To explore the effect of social support and rumination on posttraumatic growth of patients with human immunodeficiency virus (HIV). Methods: A total of 1 152 patients with HIV from Shanghai Public Clinical Center were investigated using General questionnaire, Perceived Social Support Scale, Event Related Rumination Inventory and Posttraumatic Growth Inventory by cross-sectional survey method from January 2018 to October 2018. The path of social support and rumination on post-traumatic growth was established by correlation analysis and structural equation model. Results: The total score of posttraumatic growth in patients with HIV was (47.93±23.55) points, which was at the low-middle level. Correlation analysis showed that posttraumatic growth was positively correlated with comprehension of social support (r=0.234, P<0.01), positively correlated with rumination (r=0.352, P<0.01). Structural equation model showed social support had directly positive effect on posttraumatic growth, path coefficient were 0.55. Rumination had a partial mediating effect between social support and posttraumatic growth, and mediation effects account for 11.65% of the total effect. Conclusions The posttraumatic growth level of patients with HIV needs to be improved. Health care providers should help patients get as high a level of social support as possible, as well as focus on guiding patients to think positive about the disease.

OBJECTIVETo study the application of serodiagnosis of human bocavirus (HBoV) lower respiratory tract infection in children.

METHODFrom January to April, 2013, samples including serum, sputum and bronchoalveolar lavage fluids (BALFs) were obtained from 714 children hospitalized with ALRI. Serums were tested for HBoV-specific IgG and IgM antibodies by ELISA and all kinds of samples were tested for HBoV DNA by quantitative real-time fluorescent PCR. The results of HBoV serologic tests, viral DNA in sputum and their combination were compared with those of HBoV DNA in serums and/or BALFs, which was considered as the "standard". Their consistence and differences were evaluated, and the diagnostic parameters including sensitivity, specificity, positive predictive value, negative predictive value, consistency rate, Kappa value and J value were calculated. Age distributions of the HBoV positive patients tested by the latter two methods were also compared.

RESULTThe positive rate of HBoV serology was 13.2% (94/714) . The results of HBoV serology, its DNA in sputum and their combination were all consistent with those of HBoV DNA in serums and/or BALFs (χ(2) = 91.834, 124.662, 138.643, P < 0.001 for all comparisons) . Differences were significant by McNemar test (χ(2) = 23.547, 33.440, 12.410, P all <0.001) . All the diagnostic parameters for single HBoV serologic test or single viral DNA test in sputa were approximate. However, they were improved to 70.4%, 94.8%, 38.0%, 98.6%, 93.7%, 0.463(P < 0.001), 0.65 for sensitivity, specificity, positive predictive value, negative predictive value, consistency rate, Kappa value and J value, respectively, when the methods were combined. HBoV was found positive mainly in children under 3 years of age, especially in the 1 year group. The positive rates were the highest in both group -1 year, and group -3 years was the next. However, the rate was the lowest in group >3 years and in the group -6 months.

CONCLUSIONDiagnostic power can be improved and age distribution can be demonstrated when serologic tests were combined with traditional sputum DNA detection in children with HBoV lower respiratory tract infection.

Acute Disease ; Adolescent ; Age Distribution ; Antibodies, Viral ; analysis ; blood ; Antigens, Viral ; analysis ; Child ; Child, Preschool ; Enzyme-Linked Immunosorbent Assay ; Female ; Human bocavirus ; genetics ; isolation & purification ; Humans ; Immunoglobulin G ; blood ; Immunoglobulin M ; blood ; Infant ; Male ; Parvoviridae Infections ; diagnosis ; virology ; Real-Time Polymerase Chain Reaction ; Respiratory Tract Infections ; diagnosis ; virology ; Sensitivity and Specificity

Objective To analyze the epidemiological and clinical characteristics of an outbreak of tsutsugamushi disease in Fuyang City of Anhui Province.Methods Epidemiological information was collected by case investigation questionnaire of tsutsugamushi disease.Diagnosis was determined by the detection of OXK antigen by Weil-Felix test.Results Seventy-eight cases with tsutsugamushi disease were discovered in the outbreak.All the patients had an experience of working in this area before the starting of symptoms.The clinical features of the patients were fever,headache,skin eschar,tetter and lymphadenectasis.No severe complications occurred in each patient.All the patients recovered after getting deoxycycline.Conclusions This was the first report for the tsutsugamushi disease occurred in Fuyang City of Anhui Province.And the declaration for the new happened tsutsugamushi disease would provide strong support evidence for the prevention and control of this event and ensure the safety for working in this area.Also the deoxycycline was very effective for the treatment of tsutsugamushi disease.