Objective To investigate the efficacy and safety of CT-guided radioactive 125I seed implantation(ISI)for blocking celiac plexus in the treatment of refractory abdominal cancerous pain.Methods The clinical data of 60 patients with refractory cancerous pain caused by abdominal malignancies(visual analogue scale score ≥4 points)were retrospectively analyzed.Patients of group A(n=29)received anhydrous ethanol injection treatment and patients of group B(n=29)received ISI treatment.The primary endpoints were pain score(visual analogue scale,VAS),daily morphine consumption(DMC),and local tumor control(LTC)rate.Secondary endpoints included the success rate of the procedure and postoperative complications.Results The technical success rate of surgery was 100％in both groups,and no serious complications occurred after surgery.The VAS pain scores in both groups showed a continuous decline from 1 to 8 weeks after surgery,but the difference was not statistically significant.However,the VAS scores in group A was significantly increased at T8 to T12 weeks(P＜0.01).In contrast,the pain relief time in group B remained stable until T16 to T24 weeks when an increase in pain improvement was observed.At T8 week,the LTC rate in group B was significantly better than that in group A,and the difference was statistically significant(P＜0.01).Conclusion Celiac plexus block with ISI can effectively alleviate the refractory cancerous pain caused by abdominal tumors.Compared with anhydrous ethanol injection,ISI has a longer pain relief time(up to T16-T24 weeks)and can effectively control the growth of local tumor,which is worthy of clinical promotion and application.

Objective:To analyze the association between the rs562556 polymorphism of the proprotein convertase subtilisin/kexin type 9(PCSK9)gene and the degree of coronary artery stenosis in the patients with acute myocardial infarction(AMI).Methods:A total of 200 patients diagnosed with AMI from January 2021 to December 2022 were selected as AMI group,and 200 healthy individuals during the same period were selected as control group.According to the Gensini scoring standard,the patients in AMI group were divided into low risk group(Gensini score≤40,n=78)and medium-high risk group(Gensini score>40,n=122).The levels of lipid metabolism indicators in serum of the patients in two groups were detected by fully automatic biochemical analyzer;enzyme linked immunosorbent assay(ELISA)method was used to detect the PCSK9 levels in serum of the patients in two groups;ultraviolet spectrophotometry was used to detect the single nucleotide polymorphism(SNP)of PCSK9 gene of the patients in two groups;Spearman correlation analysis was used to detect the correlation between the rs562556 polymorphism of the PCSK9 gene and the degree of the disease and the levels of lipid metabolism indicators in serum of the patients.Results:Compared with control group,the percentage of smokers of the patients in AMI group was significantly increased(P<0.01).Compared with control group,the levels of low-density lipoprotein cholesterol(LDL-c)and PCSK9 in serum of the patients in AMI group were significantly increased(P<0.05).Compared with low risk group,the levels of LDL-c and PCSK9 in serum of the patients in medium-high risk group were significantly increased(P<0.05).The distribution of PCSK9 gene rs1800487 genotype in both control and AMI groups conformed to the Hardy-Weinberg(H-W)equilibrium(χ2=0.677,P=0.713;χ2=0.970,P=0.831).Compared with control group,the distribution frequencies of PCSK9 gene rs562556 genotype AA and allele A of the patients in AMI group were significantly increased(P<0.05).In the AMI patients,the distribution of PCSK9 gene rs562556 genotype in both low risk and medium-high risk groups conformed to the H-W equilibrium(χ2=0.045,P=0.978;χ2=1.290,P=0.525).Compared with low risk group,the distribution frequencies of genotype AA and allele A of PCSK9 gene rs562556 of the patients in medium-high risk group were significantly increased(P<0.05).The PCSK9 gene rs562556 genotype AA was positively correlated with the degree of AMI(r=0.193,P=0.006)and LDL-c level(r=0.301,P<0.01).Allele A was positively correlated with the LDL-c level(r=0.168,P=0.017).Conclusion:The PCSK9 gene rs562556 genotype AA is positively correlated with the degree of coronary artery stenosis of the AMI patients,and its polymorphism may promote the development of AMI by upregulating the LDL-c level.

ObjectiveTo investigate effect of conducting training of autism spectrum disorder （ASD） early screening skill on improving the ability to early identify ASD of medical staffs in primary care hospitals. MethodsIn September 2021， the training of ASD early screening skills was carried out for medical staffs from 20 primary care hospitals in Chengdu. After training， the training effect was evaluated. The numbers of referrals from primary care hospitals to superior hospitals， confirmed ASD as well as their average diagnostic age of children with ASD before and after training were used as evaluation indicators. ResultsAfter training， the number of children with suspected ASD referred by primary care hospitals was more than that before training ［（16.65±11.60） vs. （3.40±2.23）， t=5.431， P<0.01］， the number of children diagnosed with ASD was more than that before training［（6.85±4.93） vs. （2.45±1.67）， t=4.171， P<0.01］， and the differences were statistically significant. As for the diagnosed age of ASD children， after training， the average age was lower than that before training ［（34.95±11.67） vs. （42.2±14.64）， t=-2.553， P=0.019］. ConclusionTraining of ASD early screening skills for medical staffs in primary care hospitals may help to improve their ability to early screening ASD children.

Objective:To compare the occurrence and clinical characteristics of hypersensitivity reactions induced by 3 non-ionic iodine contrast media (NICMs) during percutaneous coronary intervention (PCI).Methods:The patients who developed hypersensitivity reactions in iopromide, iohexol, and iodixanol application during PCI were screened out from adverse drug reaction reports of Beijing Anzhen Hospital from January 1, 2013 to December 31, 2018 and the total number of patients who underwent the PCI during that period and received the above NICMs was obtained by searching the hospital information system. The overall incidences of hypersensitivity reactions and severe hypersensitivity reactions and incidences of those induced by each of the 3 NICMs were calculated and their clinical characteristics were analyzed.Results:The overall incidences of hypersensitivity reactions and severe hypersensitivity reactions induced by the 3 NICMs were 0.603% (422/69 955) and 0.024% (17/69 955). The incidences of hypersensitivity reactions induced by iohexol, iopromide, and iodixanol were 0.418% (109/26 097), 0.364% (83/22 787), and 1.092% (230/ 21 071), respectively; the incidences of severe hypersensitivity reactions were 0.023% (6/26 097), 0.039% (9/22 787), and 0.009% (2/21 071), respectively. Iodixanol had a higher incidence of hypersensitivity reactions than iopromide and iohexol (both P<0.001) but the lowest incidence of severe hypersensitivity reactions, which was significantly different from that of iopromide ( P=0.047). Of the 422 patients who developed hypersensitivity reactions, 327 were male and 95 were female with an average age of 59 years (range: 27-101 years). The time of hypersensitivity reactions occurrence was recorded in 373 patients and time from NICMs injection to hypersensitivity reactions occurrence were 30 minutes to 90 hours with the median time of 5 hours; hypersensitivity reactions were immediate type (latency ≤1 hour) in 127 patients (34.0%) and delayed type (latency>1 hour) in 246 patients (66.0%). The hypersensitivity reactions induced by iopromide were mainly immediate type (79.5%, 62/78), while those induced by ioxamol were mainly delayed type (87.7%, 193/220). The proportion of patients with a previous history of allergy in the immediate type patients was significantly higher than that in the delayed type patients [15.0% (15/100) vs. 7.1% (14/197), P=0.030]. The most common clinical manifestation of hypersensitivity reactions was rash [78.0% (329/422)]. Among 17 cases of severe hypersensitivity reactions, 15 (88.2%) were anaphylactic shock, 1 was laryngeal edema, and 1 was dyspnea, all of which were immediate type. Hypersensitivity reactions were all improved after treatments, but PCI failed to be fully performed in 6 patients due to severe hypersensitivity reactions. Conclusions:The safety of 3 NICMs for PCI was good and the incidence of hypersensitivity reactions was low; the incidence of severe hypersensitivity reactions due to iopromide was the highest. Severe hypersensitivity reactions such as anaphylactic shock might affect the performance of PCI and caution should be given.

Objective:To compare the occurrence and clinical characteristics of hypersensitivity reactions induced by 3 non-ionic iodine contrast media (NICMs) during percutaneous coronary intervention (PCI).Methods:The patients who developed hypersensitivity reactions in iopromide, iohexol, and iodixanol application during PCI were screened out from adverse drug reaction reports of Beijing Anzhen Hospital from January 1, 2013 to December 31, 2018 and the total number of patients who underwent the PCI during that period and received the above NICMs was obtained by searching the hospital information system. The overall incidences of hypersensitivity reactions and severe hypersensitivity reactions and incidences of those induced by each of the 3 NICMs were calculated and their clinical characteristics were analyzed.Results:The overall incidences of hypersensitivity reactions and severe hypersensitivity reactions induced by the 3 NICMs were 0.603% (422/69 955) and 0.024% (17/69 955). The incidences of hypersensitivity reactions induced by iohexol, iopromide, and iodixanol were 0.418% (109/26 097), 0.364% (83/22 787), and 1.092% (230/ 21 071), respectively; the incidences of severe hypersensitivity reactions were 0.023% (6/26 097), 0.039% (9/22 787), and 0.009% (2/21 071), respectively. Iodixanol had a higher incidence of hypersensitivity reactions than iopromide and iohexol (both P<0.001) but the lowest incidence of severe hypersensitivity reactions, which was significantly different from that of iopromide ( P=0.047). Of the 422 patients who developed hypersensitivity reactions, 327 were male and 95 were female with an average age of 59 years (range: 27-101 years). The time of hypersensitivity reactions occurrence was recorded in 373 patients and time from NICMs injection to hypersensitivity reactions occurrence were 30 minutes to 90 hours with the median time of 5 hours; hypersensitivity reactions were immediate type (latency ≤1 hour) in 127 patients (34.0%) and delayed type (latency>1 hour) in 246 patients (66.0%). The hypersensitivity reactions induced by iopromide were mainly immediate type (79.5%, 62/78), while those induced by ioxamol were mainly delayed type (87.7%, 193/220). The proportion of patients with a previous history of allergy in the immediate type patients was significantly higher than that in the delayed type patients [15.0% (15/100) vs. 7.1% (14/197), P=0.030]. The most common clinical manifestation of hypersensitivity reactions was rash [78.0% (329/422)]. Among 17 cases of severe hypersensitivity reactions, 15 (88.2%) were anaphylactic shock, 1 was laryngeal edema, and 1 was dyspnea, all of which were immediate type. Hypersensitivity reactions were all improved after treatments, but PCI failed to be fully performed in 6 patients due to severe hypersensitivity reactions. Conclusions:The safety of 3 NICMs for PCI was good and the incidence of hypersensitivity reactions was low; the incidence of severe hypersensitivity reactions due to iopromide was the highest. Severe hypersensitivity reactions such as anaphylactic shock might affect the performance of PCI and caution should be given.

Objective: To explore the relationship between parents’ unstable marital status and offspring’s suicide attempts and the possible mediating factors, and to provide reference for suicide prevention among off spring grom unst able families. Methods: From 2017 to 2018, 2 766 valid questionnaires were collected from freshmen in a university in Hunan province. Students completed questionnaires of childhood trauma and depression traits,and reported their parents’ marital status and suicide attempts etc. Results: Compared to college students with parents of stable marital status,students with parents of unstable marital status showed higher reported rate of suicide attempts and higher scores of depression trait and childhood trauma (t/χ2=2.78, 5.83, 20.30, P<0.05). Controlling possible confounding factors,unconditional Logistic regression showed that childhood trauma,unstable marital status of parents and depressive traits were positively correlated with suicide attempt(OR=1.05, 1.45, 1.08, P<0.05). The 95% confidence interval of the Bootstrapping method with four mediation pathways (parental marital status→childhood trauma→depressive trait,childhood trauma→depressive trait→suicide attempt,parental marital status→childhood trauma→suicide attempt and parental marital status→childhood trauma→depressive trait→suicide attempt) does not include zero. Conclusion Childhood trauma and depressive traits mediate the relationship between parental instable marriage and suicide attempts in off spring.

Under the background of deepening the medical and health system reform, it is necessary to explore the measures of fine and rational drug use management and strengthen the rational drug use. Through giving full play to the management functions of pharmacy administration and pharmacotherapeutics committee, formulating the performance evaluation index system of pharmacy affairs in the hospital, adhering to the prescription doctor′s advice review and prescription pre audit, continuing to carry out drug dynamic monitoring, implementing standardized-path antimicrobial drug management, the hospital implemented refined and rational drug use management. Before and after the management, the average drug cost, prescription unqualified rate, auxiliary drug amount and antibacterial drugs related indicators were significantly improved, suggesting that fine pharmacy management could promote the rational use of drugs in the whole hospital, promote the transformation of pharmacists′ work, and control the unreasonable growth of drug costs.

Objective: To analyze the prognostic value of CD7 expression in newly diagnosed acute myeloid leukemia (AML) patients, and to further explore the correlation between CD7 expression and CEBPA mutation, and to clarify the prognostic value of CD7⁺ in AML patients with wild-type (WT) or mutant-type (MT) CEBPA. Methods: The clinical data of 298 newly diagnosed non-M₃ AML patients between January 2010 and December 2016 were analyzed retrospectively. The clinical characteristics and prognosis of CD7⁺ and CD7^- patients were respectively compared in all patients, and in patients with WT and MT CEBPA. The relationship between CD7 expression and CEBPA mutation was determined by chi-square, and the effects of CEBPA mutation on survival and prognosis in CD7⁺ group by Kaplan-Meier method. Results: In CD7⁺ group, the frequencies of CEBPA mutation were 10.1% (single site) and 33.9% (double site) , significantly higher than those of the CD7^- group (5.3% and 4.2%) (P=0.000) . Subgroup prognostic analysis showed a lower CR rate (P=0.001) and a higher RR (P=0.023) in CD7⁺ group comparing to those of CD7^- group in AML patients with wild type CEBPA. There were no statistical difference between CD7⁺ group and CD7^- group in overall survival (OS) and disease free survival (P>0.05) , while in the CEBPA mutant group the CD7⁺ group has higher OS (P=0.019) and DFS (P=0.010) . Based on the CD7 expression and CEBPA mutation, 298 cases were divided into 3 subgroups, named as CD7⁺-CEBPA MT group, CD7^- and CD7⁺-CEBPA WT group. The 3-year OS of the 3 groups were 80.2%, 48.0% and 30.6%, respectively (P<0.001) , and the 3-year DFS were 74.1%, 37.4% and 22.2%, respectively (P<0.001) . Conclusion The CEBPA mutation rate was higher in CD7⁺ AML patients then that of CD7^- patients. CD7 expression has opposite prognostic significance in AML patients carrying the wild-type or mutant-type CEBPA. Based on CD7 expression and CEBPA mutation, a new risk stratification model can be established, which is helpful to guide the clinical individualized treatment for AML patients.

Objective:To explore the occurrence and risk factors of bleeding events in acute coronary syndromes (ACS) patients treated with ticagrelor combined with aspirin.Methods:The study subjects were selected from ACS patients who were admitted to Beijing Anzhen Hospital, Capital Medical University from January to December 2017 and treated with ticagrelor and aspirin (aspirin 100 mg/d, ticagrelor 180 mg/d). Medical records of the patients who met the inclusion criteria(at age>18 years, with medication duration ≥ 1 year, and with complete follow-up records) were collected and retrospectively analyzed. The patients were divided into bleeding group and non-bleeding group according to whether there were bleeding events within 1 year. Baseline clinical characteristics such as gender, age, type of ACS, comorbidities, combined drugs, history of percutaneous coronary intervention, routine blood parameters, liver and kidney function, and etc. in patients between 2 groups were compared. The risk factors of bleeding events were analyzed using logistic regression method and the odds ratio ( OR) and its 95% confidence interval ( CI) were calculated. Results:A total of 180 patients were entered in the analysis, including 135 males and 58 females, aged (57±10) years, with the range of 31 to 81 years. There were 39 patients in the bleeding group and 141 patients in the non-bleeding group, and the incidence of bleeding events was 21.7%. None of the differences in gender distribution, age, comorbidities, history of percutaneous coronary intervention or combined drugs in patients between the 2 groups were statistically significant (all P>0.05). The platelet count of patients in the bleeding group was significantly lower than that in the non-bleeding group [(197±49) ×10 9/L vs. (220±60) ×10 9/L, t=2.254, P=0.025]. The shortest time from medication to the onset of bleeding of the 39 patients in the bleeding group was 14 days and the longest one was 12 months. The cumulative incidences of bleeding events at 3, 6, and 12 months of medication were 12.2% (22/180), 18.3% (33/180), and 21.7% (39/180), respectively. All bleeding events were minor bleeding, and the skin mucous ecchymosis had the highest incidence, which was 15.0% (27/180), followed by gingival bleeding or nosebleed, which was 7.2% (13/180). The incidence of fundus hemorrhage was 1.7% (3/180) and incidences of gastrointestinal bleeding and hematuria were both 0.6% (1/180). Multivariate logistic regression analysis showed that low platelet count was an independent risk factor for bleeding events [ OR=0.991, 95 %CI: 0.984-0.999, P=0.020]. Conclusions:ACS patients have a relative high risk of bleeding events when treated with ticagrelor combined with aspirin, but most of them were minor. For ACS patients with low platelet counts, this anti-platelet regimen should be used with caution and drug monitoring should be done in the whole course.

Objective:To explore the occurrence and risk factors of bleeding events in acute coronary syndromes (ACS) patients treated with ticagrelor combined with aspirin.Methods:The study subjects were selected from ACS patients who were admitted to Beijing Anzhen Hospital, Capital Medical University from January to December 2017 and treated with ticagrelor and aspirin (aspirin 100 mg/d, ticagrelor 180 mg/d). Medical records of the patients who met the inclusion criteria(at age>18 years, with medication duration ≥ 1 year, and with complete follow-up records) were collected and retrospectively analyzed. The patients were divided into bleeding group and non-bleeding group according to whether there were bleeding events within 1 year. Baseline clinical characteristics such as gender, age, type of ACS, comorbidities, combined drugs, history of percutaneous coronary intervention, routine blood parameters, liver and kidney function, and etc. in patients between 2 groups were compared. The risk factors of bleeding events were analyzed using logistic regression method and the odds ratio ( OR) and its 95% confidence interval ( CI) were calculated. Results:A total of 180 patients were entered in the analysis, including 135 males and 58 females, aged (57±10) years, with the range of 31 to 81 years. There were 39 patients in the bleeding group and 141 patients in the non-bleeding group, and the incidence of bleeding events was 21.7%. None of the differences in gender distribution, age, comorbidities, history of percutaneous coronary intervention or combined drugs in patients between the 2 groups were statistically significant (all P>0.05). The platelet count of patients in the bleeding group was significantly lower than that in the non-bleeding group [(197±49) ×10 9/L vs. (220±60) ×10 9/L, t=2.254, P=0.025]. The shortest time from medication to the onset of bleeding of the 39 patients in the bleeding group was 14 days and the longest one was 12 months. The cumulative incidences of bleeding events at 3, 6, and 12 months of medication were 12.2% (22/180), 18.3% (33/180), and 21.7% (39/180), respectively. All bleeding events were minor bleeding, and the skin mucous ecchymosis had the highest incidence, which was 15.0% (27/180), followed by gingival bleeding or nosebleed, which was 7.2% (13/180). The incidence of fundus hemorrhage was 1.7% (3/180) and incidences of gastrointestinal bleeding and hematuria were both 0.6% (1/180). Multivariate logistic regression analysis showed that low platelet count was an independent risk factor for bleeding events [ OR=0.991, 95 %CI: 0.984-0.999, P=0.020]. Conclusions:ACS patients have a relative high risk of bleeding events when treated with ticagrelor combined with aspirin, but most of them were minor. For ACS patients with low platelet counts, this anti-platelet regimen should be used with caution and drug monitoring should be done in the whole course.