Objective:This study analyzed the clinical characteristics and early mortality risk factors in patients with hyperleukocytic acute leukemia (HAL) to provide a basis for predicting early prognosis.Methods:Data were retrospectively collected from 211 patients with primary HAL who visited the Emergency Center of the Hematology Hospital, Chinese Academy of Medical Sciences, between July 1, 2019 and November 30, 2021. The value of each indicator in early risk stratification and prognosis was analyzed.Results:The early-death group exhibited higher WBC, peripheral blood immature cell proportions, prothrombin times (PT), fibrinogen degradation products (FDP), and D-dimer levels than the non-early death group ( P<0.05). Mortality in hyperleukocytic AML (20.5% ) was significantly higher than that in hyperleukocytic ALL (9.3% ) ( P<0.05). There were significant differences in age, creatinine, PT, fibrinogen (FIB) levels, WBC, lactic dehydrogenase (LDH), uric acid, blood potassium, blood calcium, and blood phosphorus levels between the two groups of patients ( P<0.05). A WBC threshold of 255.96×10?/L predicted early mortality with 65.6% sensitivity and 69.0% specificity, with higher WBC levels associated with a 5.164-fold increased mortality risk ( P<0.05). The age, WBC, LDH, urea, PT, FDP and D-dimer of patients at the time of consultation are risk factors affecting the survival of HAL ( P<0.05) . Conclusion:HAL is a life-threatening condition with a high early mortality. Age, WBC, LDH, urea, PT, FDP and D-dimer are risk factors for early death in HAL.

Objective:To investigate the iodine nutrition level of different populations in Daxing District of Beijing, and to provide a basis for implementation of "tailored measures, classified guidance, and scientific iodine supplementation" for prevention and control of iodine deficiency disorders.Methods:From 2020 to 2023, Daxing District of Beijing was divided into 5 districts from April to September each year based on east, west, south, north, and center. One township (street) was selected from each district, and 20 pregnant women, 40 women of childbearing age, 40 adult males, and 40 non boarding children aged 8 to 10 from one primary school were selected from each township (street). At the same time, 100 pregnant women with current addresses in Daxing District, Beijing were selected from one obstetrics hospital in Daxing District every year. Once random urine sample was collected from all survey subjects, and the household edible salt samples were collected from children and 400 pregnant women for determination of urinary iodine and salt iodine levels.Results:From 2020 to 2023, a total of 3 022 urine samples were collected, including 920, 700, 702, and 700 samples from children aged 8 - 10, pregnant women, women of childbearing age, and adult males, respectively. The median urinary iodine levels were 181.1, 135.0, 144.0, and 140.0 μg/L, respectively. There were statistically significant differences in urinary iodine levels among children aged 8 - 10, pregnant women, and women of childbearing age in different years ( H = 77.88, 9.40, 22.11, P < 0.05). A total of 1 320 household edible salt samples were collected from children aged 8 - 10 and pregnant women. Among them, 920 salt samples were collected from children, the median salt iodine was 21.3 mg/kg, the iodized salt coverage rate was 88.48% (814/920), and the qualified iodized salt consumption rate was 80.76% (743/920). Four hundred salt samples were collected from pregnant women, the median salt iodine was 21.8 mg/kg, the coverage rate of iodized salt was 90.25% (361/400), and the consumption rate of qualified iodized salt was 77.50% (310/400). The results of correlation analysis showed there was no correlation between urinary iodine level of children aged 8 to 10 and pregnant women with their salt iodine level ( r = 0.06, 0.07, P = 0.055, 0.142). Conclusions:Pregnant women in Daxing District, Beijing are at a deficiency level in iodine nutrition, with children aged 8 - 10, women of childbearing age, and adult males all at an appropriate level of iodine nutrition. We should strengthen health education for pregnant women and ensure that they receive sufficient iodine nutrition. At the same time, relevant departments should increase the supervision and management of iodized salt.

Objective:To investigate the epidemiological and clinical characteristics of patients with psittacosis, in order to provide a basis for early diagnosis and prevention of the disease.Methods:Clinical data of psittacosis cases reported in 2023 from China Disease Prevention and Control Information System in Daxing District, Beijing were collected, and the patients' general information, epidemiological characteristics, clinical characteristics, imaging examination results, laboratory test results, treatment and prognosis were retrospectively analyzed.Results:A total of 7 cases of psittacosis were reported in Daxing District in 2023, with no clustered infection in households or workplaces. There were 4 males and 3 females, with a median age of 66 years old, and a range of 52 to 82 years old. Epidemiological investigation revealed that 6 patients had a clear history of contact with poultry (4 had first contact with parrots or pigeons, and 2 had long-term exposure to pigeons, parrots or wild birds). The onset time was concentrated in April and May. The primary clinical manifestations included high fever (6 cases), fatigue (4 cases), and chills (3 cases). The imaging examination results showed that inflammatory changes occurred in the unilateral lung of 6 patients, and both lungs were affected in 1 patients. Laboratory test results indicated elevated neutrophill percentage in 6 patients, decreased white blood cell counts in 2 patients, elevated white blood cell counts in 2 patients, and elevated C-reactive protein levels in 7 patients. Metagenomic next-generation sequencing test showed that all seven patients were positive for Chlamydia psittaci. All 7 patients were treated with quinolone or tetracycline antibiotics, with 6 cured and discharged, and 1 died. Conclusion:Psittacosis is usually manifested clinically as high fever, fatigue, and unilateral lung inflammation, often associated with poultry exposure.

Objective:To investigate the epidemiological and clinical characteristics of patients with psittacosis, in order to provide a basis for early diagnosis and prevention of the disease.Methods:Clinical data of psittacosis cases reported in 2023 from China Disease Prevention and Control Information System in Daxing District, Beijing were collected, and the patients' general information, epidemiological characteristics, clinical characteristics, imaging examination results, laboratory test results, treatment and prognosis were retrospectively analyzed.Results:A total of 7 cases of psittacosis were reported in Daxing District in 2023, with no clustered infection in households or workplaces. There were 4 males and 3 females, with a median age of 66 years old, and a range of 52 to 82 years old. Epidemiological investigation revealed that 6 patients had a clear history of contact with poultry (4 had first contact with parrots or pigeons, and 2 had long-term exposure to pigeons, parrots or wild birds). The onset time was concentrated in April and May. The primary clinical manifestations included high fever (6 cases), fatigue (4 cases), and chills (3 cases). The imaging examination results showed that inflammatory changes occurred in the unilateral lung of 6 patients, and both lungs were affected in 1 patients. Laboratory test results indicated elevated neutrophill percentage in 6 patients, decreased white blood cell counts in 2 patients, elevated white blood cell counts in 2 patients, and elevated C-reactive protein levels in 7 patients. Metagenomic next-generation sequencing test showed that all seven patients were positive for Chlamydia psittaci. All 7 patients were treated with quinolone or tetracycline antibiotics, with 6 cured and discharged, and 1 died. Conclusion:Psittacosis is usually manifested clinically as high fever, fatigue, and unilateral lung inflammation, often associated with poultry exposure.

Objective:To investigate the iodine nutrition level of different populations in Daxing District of Beijing, and to provide a basis for implementation of "tailored measures, classified guidance, and scientific iodine supplementation" for prevention and control of iodine deficiency disorders.Methods:From 2020 to 2023, Daxing District of Beijing was divided into 5 districts from April to September each year based on east, west, south, north, and center. One township (street) was selected from each district, and 20 pregnant women, 40 women of childbearing age, 40 adult males, and 40 non boarding children aged 8 to 10 from one primary school were selected from each township (street). At the same time, 100 pregnant women with current addresses in Daxing District, Beijing were selected from one obstetrics hospital in Daxing District every year. Once random urine sample was collected from all survey subjects, and the household edible salt samples were collected from children and 400 pregnant women for determination of urinary iodine and salt iodine levels.Results:From 2020 to 2023, a total of 3 022 urine samples were collected, including 920, 700, 702, and 700 samples from children aged 8 - 10, pregnant women, women of childbearing age, and adult males, respectively. The median urinary iodine levels were 181.1, 135.0, 144.0, and 140.0 μg/L, respectively. There were statistically significant differences in urinary iodine levels among children aged 8 - 10, pregnant women, and women of childbearing age in different years ( H = 77.88, 9.40, 22.11, P < 0.05). A total of 1 320 household edible salt samples were collected from children aged 8 - 10 and pregnant women. Among them, 920 salt samples were collected from children, the median salt iodine was 21.3 mg/kg, the iodized salt coverage rate was 88.48% (814/920), and the qualified iodized salt consumption rate was 80.76% (743/920). Four hundred salt samples were collected from pregnant women, the median salt iodine was 21.8 mg/kg, the coverage rate of iodized salt was 90.25% (361/400), and the consumption rate of qualified iodized salt was 77.50% (310/400). The results of correlation analysis showed there was no correlation between urinary iodine level of children aged 8 to 10 and pregnant women with their salt iodine level ( r = 0.06, 0.07, P = 0.055, 0.142). Conclusions:Pregnant women in Daxing District, Beijing are at a deficiency level in iodine nutrition, with children aged 8 - 10, women of childbearing age, and adult males all at an appropriate level of iodine nutrition. We should strengthen health education for pregnant women and ensure that they receive sufficient iodine nutrition. At the same time, relevant departments should increase the supervision and management of iodized salt.

Objective:This study analyzed the clinical characteristics and early mortality risk factors in patients with hyperleukocytic acute leukemia (HAL) to provide a basis for predicting early prognosis.Methods:Data were retrospectively collected from 211 patients with primary HAL who visited the Emergency Center of the Hematology Hospital, Chinese Academy of Medical Sciences, between July 1, 2019 and November 30, 2021. The value of each indicator in early risk stratification and prognosis was analyzed.Results:The early-death group exhibited higher WBC, peripheral blood immature cell proportions, prothrombin times (PT), fibrinogen degradation products (FDP), and D-dimer levels than the non-early death group ( P<0.05). Mortality in hyperleukocytic AML (20.5% ) was significantly higher than that in hyperleukocytic ALL (9.3% ) ( P<0.05). There were significant differences in age, creatinine, PT, fibrinogen (FIB) levels, WBC, lactic dehydrogenase (LDH), uric acid, blood potassium, blood calcium, and blood phosphorus levels between the two groups of patients ( P<0.05). A WBC threshold of 255.96×10?/L predicted early mortality with 65.6% sensitivity and 69.0% specificity, with higher WBC levels associated with a 5.164-fold increased mortality risk ( P<0.05). The age, WBC, LDH, urea, PT, FDP and D-dimer of patients at the time of consultation are risk factors affecting the survival of HAL ( P<0.05) . Conclusion:HAL is a life-threatening condition with a high early mortality. Age, WBC, LDH, urea, PT, FDP and D-dimer are risk factors for early death in HAL.

Objective:To investigate the delay in medical care-seeking and diagnosis of human brucellosis cases in Daxing District, Beijing City, and analyze the relevant influencing factors.Methods:Retrospective analysis method was used to collect the information on brucellosis cases reported by the Infectious Disease Reporting Information Management System of the China Disease Prevention and Control Information System in Daxing District, Beijing City from January 1, 2013 to December 31, 2022. And the case information was reviewed, including demographic information, clinical manifestations, medical care-seeking, diagnosis, etc. Binary logistic regression was used to analyze the influencing factors of delayed diagnosis.Results:A total of 120 cases of brucellosis were included, including 91 males and 29 females, with a male-to-female ratio of 3.14 ∶ 1.00. The majority were aged 40 - 79 years, accounting for 81.7% (98/120). Farmers and unemployed household workers were the main occupations, accounting for 67.5% (81/120). The main clinical manifestations were fever (85.8%, 103/120), hyperhidrosis (65.8%, 79/120), fatigue (61.7%, 74/120), and muscle soreness (60.0%, 72/120). The delay rate of medical care-seeking was 33.3% (40/120), with a median medical care-seeking time of 6 days (interquartile range: 2 - 22 days, range: 0 - 727 days). The diagnosis delay rate was 50.8% (61/120), with a median diagnosis time of 10 days (interquartile range: 3 - 22 days, range: 0 - 1 530 days). The results of binary logistic regression analysis showed that the reasons for initial diagnosis were severe or recurrent symptoms ( OR = 6.76, 95% CI: 2.40 - 19.01), serological monitoring or other diseases ( OR = 36.00, 95% CI: 3.57 - 362.72), and delayed medical care-seeking ( OR = 4.30, 95% CI: 1.68 - 11.01) were risk factors for delayed diagnosis of brucellosis cases. The location of the diagnostic hospitals outside the city ( OR = 0.27, 95% CI: 0.08 - 0.92) was a protective factor for delayed diagnosis of brucellosis cases. Conclusions:The medical care-seeking and diagnosis of brucellosis cases in Daxing District, Beijing City have been delayed to varying degrees. The reasons of initial diagnosis are severe or recurrent symptoms, serological monitoring or other diseases, and medical care-seeking delay are the risk factors for the delayed diagnosis of brucellosis cases. The location of the diagnostic hospitals outside the city is a protective factor for delayed diagnosis of brucellosis cases.

Objective:To investigate the delay in medical care-seeking and diagnosis of human brucellosis cases in Daxing District, Beijing City, and analyze the relevant influencing factors.Methods:Retrospective analysis method was used to collect the information on brucellosis cases reported by the Infectious Disease Reporting Information Management System of the China Disease Prevention and Control Information System in Daxing District, Beijing City from January 1, 2013 to December 31, 2022. And the case information was reviewed, including demographic information, clinical manifestations, medical care-seeking, diagnosis, etc. Binary logistic regression was used to analyze the influencing factors of delayed diagnosis.Results:A total of 120 cases of brucellosis were included, including 91 males and 29 females, with a male-to-female ratio of 3.14 ∶ 1.00. The majority were aged 40 - 79 years, accounting for 81.7% (98/120). Farmers and unemployed household workers were the main occupations, accounting for 67.5% (81/120). The main clinical manifestations were fever (85.8%, 103/120), hyperhidrosis (65.8%, 79/120), fatigue (61.7%, 74/120), and muscle soreness (60.0%, 72/120). The delay rate of medical care-seeking was 33.3% (40/120), with a median medical care-seeking time of 6 days (interquartile range: 2 - 22 days, range: 0 - 727 days). The diagnosis delay rate was 50.8% (61/120), with a median diagnosis time of 10 days (interquartile range: 3 - 22 days, range: 0 - 1 530 days). The results of binary logistic regression analysis showed that the reasons for initial diagnosis were severe or recurrent symptoms ( OR = 6.76, 95% CI: 2.40 - 19.01), serological monitoring or other diseases ( OR = 36.00, 95% CI: 3.57 - 362.72), and delayed medical care-seeking ( OR = 4.30, 95% CI: 1.68 - 11.01) were risk factors for delayed diagnosis of brucellosis cases. The location of the diagnostic hospitals outside the city ( OR = 0.27, 95% CI: 0.08 - 0.92) was a protective factor for delayed diagnosis of brucellosis cases. Conclusions:The medical care-seeking and diagnosis of brucellosis cases in Daxing District, Beijing City have been delayed to varying degrees. The reasons of initial diagnosis are severe or recurrent symptoms, serological monitoring or other diseases, and medical care-seeking delay are the risk factors for the delayed diagnosis of brucellosis cases. The location of the diagnostic hospitals outside the city is a protective factor for delayed diagnosis of brucellosis cases.

The number of investigator initiated research (IIR) is increasing. But the recognition and management of IIR in China is still in its infancy, and there is a lack of specific and operable guidance for the implementation process. Based on our practical experiences, previous literature reports, and current policy regulations, the authors took prospective IIR as an example to summarize the implementation process of IIR into 14 steps, which are as the following: study initiation, ethical review, study registration, study filing, case report form design, database establishment, standard operating procedure making, investigator training, informed consent, data collection, data entry, data verification, data locking and data archiving.

Telephone follow-up is one of the important ways to follow up patients. High-quality follow-up can benefit both doctors and patients. However, clinical research-related follow-up is often faced with problems such as time-consuming, laborious and poor patient compliance. The authors belong to a team that has been committed to the study of patient-reported outcomes for a long time. The team has carried out long-term follow-up of symptoms, daily function and postoperative complications of more than 1 000 patients after lung cancer surgery, and accumulated certain experience. In this paper, the experience of telephone follow-up was summarized and discussed with relevant literatures from the aspects of clarifying the purpose of clinical research follow-up, understanding the needs of patients in follow-up, and using follow-up skills.