Objective:To investigate the effect of exposure to histological chorioamnionitis(HCA) on premature infants with respiratory distress syndrome(RDS)complicated with bronchopulmonary dysplasia(BPD).Methods:The clinical data of premature infants with gestational age<32 weeks and survival>14 days who were born in the department of obstetrics and admitted into NICU at Qingdao Women and Children′s Hospital from January 2018 to December 2020 were collected.According to placental pathology, they were divided into positive HCA + positive RDS group(observation group)and negative HCA + positive RDS group(control group). T-test, rank sum test and χ2 test were used to analyze the occurrence and clinical characteristics of BPD between the two groups.For premature infants with positive HCA who were diagnosed as BPD, Spearman rank correlation was used to analyze the correlation between HCA stage and BPD severity. Results:There were a total of 162 premature infants with RDS.The average gestational age at birth was 29.29(28.29, 30.43) weeks, and the average birth weight was 1.32(1.13, 1.55)kg; the incidence of BPD was 69.8%(113/162), and the mortality rate of BPD was 2.7%(3/113). There were 114 cases in the observation group and 48 cases in the control group.The incidence of BPD in the observation group was 76.3%(87/114), which was higher than that in the control group(54.2%, 26/48), and the difference was statistically significant( P<0.05). Further study of 87 premature infants with positive HCA who were diagnosed as BPD showed that, the correlation between the stage of HCA and the severity of BPD had not been confirmed( rs=0.062, P=0.571). Serum C-reactive protein before the mother used antibiotics and procalcitonin on the first day after birth in the observation group were higher than those in the control group, and the differences were statistically significant( P<0.05). Among 113 premature infants with RDS who were diagnosed as BPD, the time of antibiotic use, length of stay in intensive care unit and hospitalization cost in positive HCA group were higher than those in negative HCA group, and the differences were statistically significant( P<0.05). Conclusion:HCA exposure will increase the risk of BPD in premature infants with RDS.In addition, HCA also increases the intake period of antibiotics, length of stay and cost of intensive care unit in premature infants with BPD.

Non-small cell lung cancer (NSCLC) is the most common pathological type of lung cancer. The systemic antitumor therapy of advanced NSCLC has undergone renovations of chemotherapy, targeted therapy and immunotherapy, which results in greatly improved survival for patients with advanced NSCLC. Immune checkpoint inhibitors (ICIs), especially targeting programmed cell death protein 1 (PD-1)/programmed death-ligand 1 (PD-L1), has changed the treatment paradigm of NSCLC. ICIs have become the standard treatment for advanced NSCLC without epidermal growth factor receptor(EGFR) mutation or anaplastic lymphomakinase(ALK) translocation in the first- or second-line setting, and for locally advanced NSCLC following concurrent radiotherapy and chemotherapy. ICIs are also promising in adjuvant/neoadjuvant therapy. More and more ICIs have been approved domestically for the treatment of NSCLC. Led by the NSCLC expert committee of Chinese Society of Clinical Oncology (CSCO), this consensus was developed and updated based on thoroughly reviewing domestic and foreign literatures, clinical trial data, systematic reviews, experts' discussion and the consensus(2019 version). This consensus will aid domestic clinicians in the treatment of NSCLC with ICIs.
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Non-small cell lung cancer (NSCLC) is the most common pathological type of lung cancer, most NSCLC patients are at advanced stage at the time of diagnosis. For patients without sensitive driven-oncogene mutations, chemotherapy is still the main treatment at present, the overall prognosis is poor. Improving outcomes and obtaining long-term survival are the most urgent needs of patients with advanced NSCLC. In recent years, immunotherapy has developed rapidly. Immune checkpoint inhibitors (ICIs), especially targeting programmed death-1 (PD-1)/programmed death-ligand 1 (PD-L1), have made a breakthrough in the treatment of NSCLC, beneficial to patients' survival and changed the treatment pattern for NSCLC. It shows more and more important role in the treatment of NSCLC. Led by NSCLC expert committee of Chinese society of clinical oncology (CSCO), relevant experts in this field were organized. On the basis of referring to domestic and foreign literature, systematically evaluating the results of Chinese and foreign clinical trials, and combining the experiences of the experts, the experts group reached an agreement to develop this consensus. It will guide domestic counterparts for better application of ICIs to treat NSCLC.

Acute respiratory failure due to acute hypoxemia is the major manifestation in severe coronavirus disease 2019 (COVID-19). Rational and effective respiratory support is crucial in the management of COVID-19 patients. High-flow nasal cannula (HFNC) has been utilized widely due to its superiority over other non-invasive respiratory support techniques. To avoid HFNC failure and intubation delay, the key issues are proper patients, timely application and improving compliance. It should be noted that elder patients are vulnerable for failed HFNC. We applied HFNC for oxygen therapy in severe and critical ill COVID-19 patients and summarized the following experiences. Firstly, to select the proper size of nasal catheter, to locate it at suitable place, and to confirm the nose and the upper respiratory airway unobstructed. Secondly, an initial ow of 60 L/min and 37℃ should be given immediately for patients with obvious respiratory distress or weak cough ability; otherwise, low-level support should be given first and the level gradually increased. Thirdly, to avoid hypoxia or hypoxemia, the treatment goal of HFNC should be maintained the oxygen saturation (SpO) above 95% for patients without chronic pulmonary disease. Finally, patients should wear a surgical mask during HFNC treatment to reduce the risk of virus transmission through droplets or aerosols.
Aged ; Betacoronavirus ; isolation & purification ; Cannula ; Coronavirus Infections ; therapy ; Humans ; Oxygen ; administration & dosage ; Pandemics ; Pneumonia, Viral ; therapy

Acute respiratory failure due to acute hypoxemia is the major manifestation in severe coronavirus disease 2019 (COVID-19) induced by severe acute respiratory syndrome coronavirus 2 infection. Rational and effective respiratory support is crucial in the management of COVID-19 patients. High-flow nasal cannula (HFNC) has been utilized widely due to its superiority over other non-invasive respiratory support techniques. To avoid HFNC failure and intubation delay, the key issues are proper patients, timely application and improving compliance. It should be noted that elder patients are vulnerable for failed HFNC. We applied HFNC for oxygen therapy in severe and critical COVID-19 patients and summarized the following experiences. Firstly, to select the proper size of nasal catheter, to locate it at suitable place, and to confirm the nose and the upper respiratory airway unobstructed. Secondly, an initial flow of 60 L/min and 37℃ should be given immediately for patients with obvious respiratory distress or weak cough ability; otherwise, low-level support should be given first and the level gradually increased. Thirdly, to avoid hypoxia or hypoxemia, the treatment goal of HFNC should be maintained the oxygen saturation (SpO) above 95% for patients without chronic pulmonary disease. Finally, patients should wear a surgical mask during HFNC treatment to reduce the risk of virus transmission through droplets or aerosols.
Aged ; Betacoronavirus ; Cannula ; Coronavirus Infections ; complications ; therapy ; Humans ; Hypoxia ; etiology ; prevention & control ; therapy ; Masks ; Oxygen ; administration & dosage ; Oxygen Inhalation Therapy ; instrumentation ; standards ; Pandemics ; Pneumonia, Viral ; complications ; therapy

BACKGROUND: Osteoporosis is a serious threat to the health and quality of life in the elderly. It is important to establish an ideal experimental animal model to study the etiology and treatment of osteoporosis.OBJECTIVE: To establish a rat model of osteoporosis induced by different dosages of retinoic acid, thus selecting the optimal dosage.METHODS: Eighty female Sprague-Dawley rats were randomly divided into control, low-, middle- and high-dosage groups based on body mass (n=20 per group), The rats in the latter three groups were induced with 80, 100, and 120 mg/(kg?d) retinoic acid via gastric lavage for 14 days.RESULTS AND CONCLUSION: Compared with the control group, the bone mineral density, number of osteoblasts and osteoclasts, and bone microarchitecture in the low-dosage group showed no significant changes, while there were significant decrease in the serum level of calcium and bone mineral density of femur, significant increase in the number of osteoclasts at the femur and significant changes in the femoral microarchitecture in the middle- and high-dosage groups, especially in the middle-dose group. To conclude, 120 mg/(kg?d) retinoic acid via gastric lavage for 14 days can induce a stable osteoporosis model in rats.

Objective To further identify the high-risk population at malaria elimination phase, and to provide the scientific evident for targeted prevention and control measures, we compared the demographical feature and its change trend for malaria cases between malaria control stage and elimination stage in China. Methods The data of individual case (probable and confirmed) and population during 2007-2014 were collected from China National Notifiable Infectious Disease Reporting Information System, and the data of epidemiological investigation for malaria case (imported and indigenous) during 2011-2014 were collected from China Parasite Disease Prevention and Control Information System. All of the data didn 't include China's Hongkong, Macao, Taiwan and foreign cases. We described the demographic features of malaria cases, e.g. sex, age, occupation and mobility, to compare the differences of cases between malaria control stage (2007-2010) and the elimination phase (2011-2014). Results From 2007 to 2014, a total of 108 076 malaria cases were reported nationwide, which 13 355 cases were reported at the elimination stage. The proportion of male cases considerably increased from 65.1%(6 1625 cases) at the control stage to 91.4%(12 209 cases) at the elimination phase, with the cases aged 15-64 years among male cases dramatically rose from 74.3%(45 793 cases) to 97.2%(11 870 cases). In terms of occupation, the proportion of children and students decreased from 17.8% (16 891 cases) to 2.7% (356 cases), while the percentage of migrant workers, workers and other professional cases increased from 8.5% (8 031 cases), 3.5% (3 319 cases) and 3.6% (3 435 cases) to 13.1% (1 757 cases), 11.5% (1 534 cases) and 11.4% (1 517 cases), respectively. During the elimination stage, P. faliparium cases have higher proportion of male (96.4%, 7 179 cases) and adult aged 15-64 year (99.4%, 7 399 cases) than that of P. vivax cases , 83.9%(4 344 cases) and 90.3%(4 679 cases), respectively. Moreover, the proportion of imported cases rose from 63.6% (2 599 cases) in 2011 to 97.7%(2 854 cases) in 2014, and the proportion of the migrants in indigenous cases also showed an increasing trend from 13.5%(201 cases) in 2011 to 28.4%(19 cases) in 2014. Conclusion Compared with the control stage, great changes of demographical characteristics of malaria cases occurred at the elimination stage. Male adults aged 15-64 year-old, imported cases and domestic migrants were the high-risk population for targeted control and prevention at the malaria elimination stage.

Objective To explore the epidemiological features of deaths of malaria from 2005 to 2014, so as to provide the evidence for subsequently more effective strategic planning of malaria elimination in China. Methods The data of individual malaria cases (including probable and confirmed cases, population data, geographic distribution, diagnosis and reporting information) were obtained from the National Notifiable Infectious Disease Reporting Information System from 2005 to 2014 and the epidemiological investigation information (including the clinical systems and the imported and indigenous cases) was extracted from Parasite Disease Prevention and Control Information System from 2011 to 2014. All of the data didn't include Hongkong, Macao, Taiwan and foreign cases. The population characteristics, clinical systems, geographic distribution, diagnosis and reporting and sources of infections of deaths were analyzed. Results From 2005 to 2014, a total of 228 deaths of malaria were reported, with 203 (89.0%) of P. falciparum malaria, 13 (5.7%) of P. vivax malaria, 1 (0.5%) of P. malariae malaria and 11(4.8%) other cases. The fatality rate of malaria increased since 2010. Among the deaths, 48 (81.4%) had serious complications, which included cerebral lesion, coma, severe renal and hepatic injuries and hemolysis and so on. In 2005-2010, the geographical distribution of malaria deaths was mainly in Yunnan (78 deaths, 56.1%), Sichuan (13 deaths, 9.4%), Henan (7 deaths, 5.0%), Shandong (6 deaths, 4.3%) and Zhejiang (5 deaths, 3.6%) province. However, since the initiation of malaria elimination program in 2010, the areas with malaria deaths have changed, which mainly distributed in Henan (10 deaths, 11.2%), Sichuan (9 deaths, 10.1%), Shandong (8 deaths, 9.0%), Jiangsu (7 deaths, 7.9%) and Hunan province (7 deaths, 7.9%). Besides there were nine deaths (10.0%) reported in non-endemic areas of malaria (Beijing, Inner Mongolia, Jilin, and Ningxia) in 2011-2014. The median time from illness onset to diagnosis for deaths was 5.5 (P25-P75:3.0-8.5) d, which was longer than 3.0 (2.0-6.0)d for survivors. Moreover, for deaths, the median P50 (P25-P75)(6.0, 4.0-9.0 d) from illness onset to diagnosis in 2011-2014 was longer than that in 2005-2010 (5.0, 3.0-9.0 d). Among imported deaths, 77 deaths (90.6%) originated from Africa and 8 deaths (9.4%) from Southeast Asia. Conclusion Although the reported deaths of malaria were stable in 2005-2014, the geographical distribution of malaria deaths changed significantly and the time from illness onset to the diagnosis was longer since 2010. Special attention should be paid to the diagnosis and treatment of imported cases to reduce the fatality at the malaria elimination stage.

Objective To investigate the epidemiological characteristics and impact factors on hospitalization of Plasmodium vivax (P.vivax) since initiation of national malaria elimination program, so as to facilitate the adjustment of technical guideline in response to the epidemic changing of malaria in China. Methods The data of individual P. vivax case (probable and confirmed) and population during 2011-2014 were collated from China National Notifiable Infectious Disease Reporting Information System, and the data of epidemiological investigation for individual P. vivax case (imported and indigenous) during 2011-2014 were collected from China Parasite Disease Prevention and Control Information System. All of the data didn 't include China's Hongkong, Macao, Taiwan and foreign cases. The risk factors on hospitalization were explored by multiple factors variable binary classification unconditioned logistic regression model. Results During study period of four years, a total of 5 656 Plasmodium vivax cases were detected. Among them, 69.9% (3 951 cases) were imported cases and 30.1% (1 705 cases) were autochthonous cases. The male cases accounted for 82.7%of all cases. Among the autochthonous cases, 535 cases (31.4%) occurred in the cross-bordering areas, and 577 cases (33.8%) were reported in the junction of difference provinces. The amount of autochthonous cases decreased from 1 363 cases in 2011 to 53 cases in 2014, and the county affected by autochthonous cases was shrunk from 185 counties to 10 counties. The proportion of autochthonous cases introduced by domestic migrants increased constantly, which reached 41.5%in 2014. The imported cases were detected from 614 counties of 30 provinces, who were originated from 57 overseas countries of 4 continents, with Southeast Asia being the leading origins (2 772 cases, 70.2%). There were 1 494 cases hospitalized for treatment, with the male (OR=1.41, 95%CI: 1.16-1.71), 14 years old and younger (OR=2.26, 95%CI:1.44-3.56), and oversea imported cases (OR=2.73, 95%CI:2.30-3.25) were the high risk group for hospitalization. Conclusion The scale and scope of P. vivax occurrence decreased dramatically since initiation of malaria elimination grogram in 2010. However, the risk of P. vivax introduction by the overseas imported cases and domestic migrants should be highlighted.

Objective To further identify the high-risk population at malaria elimination phase, and to provide the scientific evident for targeted prevention and control measures, we compared the demographical feature and its change trend for malaria cases between malaria control stage and elimination stage in China. Methods The data of individual case (probable and confirmed) and population during 2007-2014 were collected from China National Notifiable Infectious Disease Reporting Information System, and the data of epidemiological investigation for malaria case (imported and indigenous) during 2011-2014 were collected from China Parasite Disease Prevention and Control Information System. All of the data didn 't include China's Hongkong, Macao, Taiwan and foreign cases. We described the demographic features of malaria cases, e.g. sex, age, occupation and mobility, to compare the differences of cases between malaria control stage (2007-2010) and the elimination phase (2011-2014). Results From 2007 to 2014, a total of 108 076 malaria cases were reported nationwide, which 13 355 cases were reported at the elimination stage. The proportion of male cases considerably increased from 65.1%(6 1625 cases) at the control stage to 91.4%(12 209 cases) at the elimination phase, with the cases aged 15-64 years among male cases dramatically rose from 74.3%(45 793 cases) to 97.2%(11 870 cases). In terms of occupation, the proportion of children and students decreased from 17.8% (16 891 cases) to 2.7% (356 cases), while the percentage of migrant workers, workers and other professional cases increased from 8.5% (8 031 cases), 3.5% (3 319 cases) and 3.6% (3 435 cases) to 13.1% (1 757 cases), 11.5% (1 534 cases) and 11.4% (1 517 cases), respectively. During the elimination stage, P. faliparium cases have higher proportion of male (96.4%, 7 179 cases) and adult aged 15-64 year (99.4%, 7 399 cases) than that of P. vivax cases , 83.9%(4 344 cases) and 90.3%(4 679 cases), respectively. Moreover, the proportion of imported cases rose from 63.6% (2 599 cases) in 2011 to 97.7%(2 854 cases) in 2014, and the proportion of the migrants in indigenous cases also showed an increasing trend from 13.5%(201 cases) in 2011 to 28.4%(19 cases) in 2014. Conclusion Compared with the control stage, great changes of demographical characteristics of malaria cases occurred at the elimination stage. Male adults aged 15-64 year-old, imported cases and domestic migrants were the high-risk population for targeted control and prevention at the malaria elimination stage.