Hyperleukocytic actue leukaemia served as an acute and critical disease of the blood system,its fatality rate can be as high as 20%-30%,and the systemic treatment should be carried out immediately af-ter diagnosis.At present,a number of studies at home and abroad have confirmed that the patients with hyper-leukocytic acute leukemia can achieve a similar remission rate and prognosis as the patients with non-hyperleu-kocytic acute leukemia after effective leukocyte lowering pretreatment.This article discussed the aspects such as the mechanism of leukemia cytosis and leukocyte lowering pretreatment therapy,in order to provide a theoretical basis for the clinical diagnosis,treatment and research of this malignant hematological cancer.

OBJECTIVE To systematically summarize the working model of pharmacy consultation in medical institutions in China， and to provide reference for the normalization of process， standardization of content and homogenization of services of pharmacy consultation. METHODS A systematic search of Chinese and English literature databases was conducted to incorporate the literature on the working model of pharmacy consultation published by medical institutions in China. Two researchers screened and extracted the key information， and ultimately conducted qualitative summary and descriptive analysis. RESULTS Based on the included 11 articles， the pharmacy consultation working models were explored by clinical pharmacists in China. The contents of consultation mainly involved anti-infection， parenteral nutrition， cancer pain， etc. The general concept of pharmacy consultation should refer to the constructed flowchart， specific consultation problems could refer to the pathway， mind map， or decision tree and other framework guidance to carry out the work. Finally， consultation opinions could be written according to the consultation system or specialty consultation templates， and the adoption of a new working model （such as pharmacist active consultation） could also promote the number and acceptance rate of pharmacy consultation. CONCLUSIONS A series of working models of pharmacy consultation have been initially explored in medical institutions in China. However， it is not yet perfect and lacks a unified quality control and evaluation system for pharmacy consultation， which should be the focus of future research and practice.

In order to meet the accuracy requirements of hospitals for abnormal detection of fetal monitor data,a hospital fetal monitor data anomaly detection method based on Euclidean distance was proposed.In this method,according to the abnormal detection method of fetal monitor data in hospitals,the ultrasound Doppler detector was used to collect fetal heart rate signal data,and the fetal heart rate signal denoising method based on adaptive filtering was used to remove the noise components of the collected fetal heart rate signal.The denoised fetal heart rate signal was used as the identification sample of the abnormal fetal heart rate signal identification method based on Euclidean distance method.The Euclidean distance Euclidean distance between the denoised fetal heart rate signal and the normal fetal heart rate signal was analyzed by combining the Euclidean distance method and the strong classifier to analyze whether the virtual sinusoidal distance between the denoised fetal heart rate signal and the normal fetal heart rate signal was greater than the tuned Euclidean distance threshold.Fetal heart rate signal samples greater than the threshold were classified and diagnosed as abnormal monitoring data.The fetal heart rate information collected by the fetal monitor in the hospital was accurate,and the abnormal detection results were valid and reliable.

Boron neutron capture therapy(BNCT), a promising radiotherapy, belongs to precision treatment for cancers. BNCT can accurately kill cancer cells and protect normal cells at the same time relying on 10B compounds with high efficacy. The research about developing new 10B compounds is in progress, and novel and efficient 10B compounds are emerging, which greatly facilitate broadening the advantages and efficacy of BNCT. Considering the mixed rays generated from the BNCT process, its biological effects on tumor cells are relatively complex, and related studies are still lacking. The molecular mechanisms underlying BNCT need to be elucidated further. BNCT has been applied in the treatment of malignant brain tumors, head and neck cancers, and malignant melanoma with favorable curative effects. This review mainly focuses on the development of 10B compounds, biological mechanisms, potential advantages, and clinical applications.

Objective:To study the clinical characteristics and management strategies of late bleeding after laparoscopic pancreaticoduodenectomy (LPD).Methods:The clinical data of 58 patients with post-pancreaticoduodenectomy hemorrhage (PPH) admitted to the Department of Hepatobiliary Surgery of the Second Hospital of Hebei Medical University from March 2018 to March 2022 were retrospectively analyzed, including 42 males and 16 females, aged (61.88±11.02) years old. According to the occurrence of intra-abdominal erosion factors (e.g., pancreatic fistula, biliary fistula, gastrointestinal anastomotic fistula, intra-abdominal abscess), patients were divided into the erosion group ( n=42) and non-erosion group ( n=16). All patients underwent standard lymphadenectomy. Clinical data including the PPH time-point, occurrence of rebleeding, and treatment outcomes were accessed. The management strategies of PPH in the two groups of patients were analyzed. Results:The PPH time-point in the erosion group and non-erosion patients was 8.00 (5.00, 19.25) d and 21.50 (12.75, 26.75) d, respectively ( P=0.001). PPH can occurred within one month after surgery in both erosion and non-erosion groups. In the erosion group, 31 cases (73.81%, 31/42) were treated by re-operation, two (4.76%, 2/42) by interventional radiology and nine (21.43%, 9/42) with conservative protocol, respectively. In the non-erosion group, five cases (31.25%, 5/16) were treated by re-operation, seven (43.75%, 7/16) by interventional radiology and four (25.00%, 4/16) with conservative protocol, respectively. The incidence of re-bleeding is higher in the erosion group [47.6% (20/42) vs 12.5% (2/16), P<0.05]. Clinical manifestations, sites and severity of bleeding, and treatment outcomes were also different in the erosion and non-erosion groups (all P<0.05). Conclusions:The occurrence of intra-abdominal erosion factors can affect the clinical characteristics and treatment strategy of late bleeding after laparoscopic pancreaticoduodenectomy. Surgery remains the treatment of choice for post-pancreaticoduodenectomy hemorrhage either as an urgent or last resort.

Objective:To compare the characteristics of MSM with different types of primary sexual partners and to analyze the factors associated with MSM not being tested for HIV in the last six months.Methods:MSM were recruited in nine cities of Shandong Province from April to July 2021, and face-to-face questionnaires were conducted to collect information on sociodemographic characteristics, high-risk behaviors, and HIV testing of MSM. Blood samples were taken for serological tests of HIV and syphilis antibodies.Results:A total of 3 008 men who had anal sex with men in the last six months were divided into three groups according to the type of primary sexual partner in the last six months: the fixed sexual partner group (36.83%, 1 108/3 008), the commercial sexual partner group (3.06%, 92/3 008), and casual sexual partner group (60.11%, 1 808/3 008). There were statistically significant differences in the distribution of age, local residence time, education level, the primary place to find male sexual partners, use of new-type drugs in the last six months, consistent condom use every time during same-sex anal sex in the last six months, group sex in the last six months, no HIV testing in the last six months, having had a sexually transmitted disease in the last year, receiving peer education in the last year, and frequency of syphilis testing in the last year among different groups ( P<0.05). Multivariable logistic regression analysis showed that related factors of not being tested for HIV in the last six months in MSM were those aged less than 30 years old (a OR=1.39, 95% CI: 1.06-1.83), married/cohabiting (a OR=1.74, 95% CI: 1.39-2.16), high school education or less (a OR=1.39, 95% CI: 1.15-1.67), had not used new-type drugs in the last six months (a OR=2.27, 95% CI: 1.89-2.71), had not received peer education in the last year (a OR=1.59, 95% CI: 1.28-1.98), had never been tested for syphilis (a OR=11.30, 95% CI: 8.15-15.66), had not been tested in the last year but had been previously tested for syphilis (a OR=5.65, 95% CI: 4.19-7.62), the type of primary sexual partner in the last six months being a commercial sexual partner (a OR=1.80, 95% CI: 1.01-3.20), and the type of primary sexual partner in the last six months being a casual sexual partner (a OR=1.50, 95% CI: 1.26-1.80). Conclusions:The characteristics of MSM with different types of primary sexual partners are different, and the proportion of HIV testing still needs to be improved. In the future, we should make full use of the Internet and peer education to expand the coverage of HIV testing for MSM, targeting the characteristics of MSM with different types of primary sexual partners.

Endoscopic ultrasound (EUS) has been greatly developed in the diagnosis of digestive diseases. In recent years, with the continuous innovation of endoscopic technology and accessories, important breakthroughs have been made in endoscopic ultrasound-guided interventional therapy, especially in the treatment of refractory biliary and pancreatic diseases. Based on the latest literatures and work experience, in this paper, we reviewed the latest progress of EUS interventional treatment for biliary and pancreatic diseases, including EUS- guided bile duct drainage, EUS-guided gallbladder drainage, EUS-guided pancreatic duct drainage, EUS guided-pancreatic pseudocyst drainage, and EUS guided pancreatic tumor treatment.

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 analyze the influencing factors of attention deficit hyperactivity disorder (ADHD) in children and construct a Nomogram prediction model.Methods:A total of 5 409 children aged 7 to 16 from 5 schools in Xinjiang were investigated by using SNAP-Ⅳ assessment scale and influencing factors questionnaire.Least absolute shrinkage and selection operator (LASSO) regression and multivariate Logistic regression were used to analyze and investigate the influencing factors of ADHD in children, and then Nomogram prediction model was established. Results:(1)The detection rate of ADHD was 7.3%.(2) The LASSO- Logistic regression model showed that the history of febrile convulsions ( OR=5.97, 95% CI: 3.52-9.86), the history of epilepsy disease ( OR=11.86, 95% CI: 7.83-17.89), the history of head trauma disease ( OR=10.0, 95% CI: 7.27-13.71), mother′s delivery method ( OR=2.53, 95% CI: 1.99-3.23), mother′s education level ( OR=2.26, 95% CI: 1.45-3.67), mother′s smoking more than 1 year ( OR=12.65, 95% CI: 8.30-19.34), whether the family environment is quiet ( OR=1.27, 95% CI: 1.00-1.63), and the education method of beating and scolding ( OR=3.05, 95% CI: 2.13-4.31) was an indepen-dent risk factor for children with ADHD; (3)The Nomogram prediction model was built and verified by Bootstrap for 1 000 samples.The C-index was 0.81(95% CI: 0.78-0.83), suggesting that the Nomogram prediction model has good prediction ability, accuracy, and distinction.Decision curve analysis (DCA) of the clinical decision curve suggested that patients with Nomogram model with a predictive probability threshold greater than 0.2 had a higher clinical net benefit. Conclusions:The detection rate of ADHD was 7.3%, which was higher than the national average.The Nomogram prediction model drawn here can provide individualized ADHD risk predictions for children based on the history of hyperthermia, epilepsy, and head trauma, maternal mode of childbirth, maternal education level, maternal education level, maternal smoking for more than 1 year, quiet family environment, and scolding education methods.

Objective:To study the single purse-string parachute suturing technique for pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy, and to determine its feasibility and safety.Methods:The clinical data of 71 patients who underwent laparoscopic pancreaticoduodenectomy using the single purse-string parachute suturing technique for pancreaticojejunostomy from October 2018 to October 2021 at the Second Hospital of Hebei Medical University were retrospectively analyzed. There were 41 males and 30 females, with age (59.1±9.7) years old. The operative time, intraoperative blood loss, complication rate and other data were analyzed.Results:All 71 patients successfully underwent total laparoscopic pancreaticoduodenectomy, with 5 patients who underwent 2D laparoscopic surgery and 66 patients 3D laparoscopic surgery. There were additional vascular resection and reconstruction in 2 patients. The operative time was (388.9±92.9) min, the intraoperative blood loss was (411.3±176.9) ml, and the postoperative hospital stay was (14.1±5.8) d. The operation time of 71 patients who underwent the single purse-string parachute technique of pancreaticojejunostomy was (26.9±6.8) min. Postoperative complications occurred in 18 patients (25.4%). Grade B pancreatic fistula occurred in 2 patients (2.8%), and the longest time for removal of abdominal drain was 17 days after operation. Among the 71 patients, complications including biliary fistula occurred in 6 patients (8.5%), delayed gastric emptying in 5 patients (7.0%), pulmonary infection in 4 patients (5.6%), non-pancreatic fistula-related abdominal infection in 4 patients (5.6%), non-pancreatic fistula-related abdominal bleeding in 1 patient (1.4%), biliary tract bleeding in 1 patient (1.4%), and chylous leakage in 2 patients (2.8%).Conclusion:The single purse-string parachute technique of pancreaticojejunostomy in laparoscopic pancreaticoduodenectomy had the advantages of being safe and reliable. The procedure is worthy of furthers promotion.