Objective To develop a home skin care guidance scheme for newborns,and initially implement it to reducing the risk of skin-related issues.Methods Searching both domestic and international databases,we identified relevant literature.Following a quality evaluation,evidence integration,and group discussions,we developed the con-tent of the home skin care guidance for newborns.Subsequently,we refined this content through 2 rounds of expert consultations to finalize the scheme.To initially implement the scheme,we conveniently selected 20 healthy new-borns born between August 1st and 15th,2024,at a tertiary-level comprehensive hospital in Fujian Province as an experimental group.Their parents received skin care guidance based on our scheme via a WeChat platform.In contrast,we selected another group of 20 healthy newborns delivered between July 1st and 15th,2024,at the same hospital as a control group;their parents were provided with conventional skin care guidance.We compared the in-cidence rates of diaper dermatitis and eczema between these 2 groups of newborns at a month of age.Results A total of 33 experts from 30 tertiary hospitals across 19 provinces(including autonomous regions and municipalities)were invited to participate in a questionnaire survey.The response rates for both rounds of expert questionnaires reached 100％.The authority coefficients for the experts were recorded at 0.78 and 0.83,while the Kendall concor-dance coefficients were found to be 0.188 and 0.142(all P＜0.001).The final newborn home skin care guidance scheme consists of 6 first-level items,41 second-level items,such as the selection of newborn care products,methods for neonatal bathing and prevention of neonatal diaper dermatitis,and so on.Preliminary application results indicated that the incidence of diaper dermatitis in the experimental group was significantly lower than that observed in the control group,with a statistically significant difference noted(P=0.047).There was no significant difference in the incidence of eczema between the 2 groups at the age of a month(P=0.201).Conclusion The Neonatal Home Skin Care Guidance Scheme for newborns has been demonstrated to be scientific,reliable and feasible.The implementa-tion of this scheme has proven beneficial in reducing the incidence of diaper dermatitis at a month of age.Howev-er,the sample size needs to be expanded to further verify its implementation effect.

Objective:To investigate the 10-year incidence of reproductive system malignancies and their associated risk factors among overweight and obese women with different metabolic phenotypes aged 40 years and older in Guiyang City.Methods:A total of 6 444 female residents in Yunyan District, Guiyang City were included from the 2011 " Epidemiological Study on the Risk of Malignancy in Chinese Patients with Type 2 Diabetes Mellitus(REACTION)". Based on body mass index(BMI) and the presence or absence of metabolic syndrome(MetS), participants were categorized into four groups: metabolically healthy normal weight(MHNW, n=2 373), metabolically unhealthy normal weight(MUNW, n=1 098), metabolically healthy overweight/obese(MHO, n=2 229), and metabolically unhealthy overweight/obese(MUO, n=744). Baseline data were collected, and participants were followed up for 10 years to document the incidence of female reproductive system malignancies, including breast cancer, ovarian cancer, cervical cancer, and endometrial cancer. Logistic regression models were used to evaluate the association between metabolic phenotype and the 10-year risk of developing reproductive system malignancies. Results:Over a mean follow-up period of (9.89±0.77) years, the overall incidence of reproductive system malignancies was 1.15%(74/6, 444). Baseline characteristics such as age, BMI, high-density lipoprotein-cholesterol(HDL-C), and triglycerides(TG) differed significantly among the groups( P<0.05). The cumulative incidence of reproductive system malignancies in each group was: MHNW 0.93%(22/2 373), MUNW 0.73%(8/1 098), MHO 1.57%(35/2 229), and MUO 1.21%(9/744). There were no statistically significant differences in incidence across the four groups( P>0.05). However, multivariable logistic regression analysis revealed that, compared with the MHNW group, the adjusted HR (95% CI) were: MUNW 0.787(0.349-1.774, P>0.05), MHO 4.835(1.708-13.688, P<0.05), and MUO 3.719(1.144-12.089, P<0.05). Conclusion:Overweight and obesity are significant risk factors for reproductive system malignancies in women aged 40 and above. The presence of metabolic abnormalities in overweight or obese women further increases the risk of developing such malignancies.

Objective:To investigate the efficacy and toxicity of blinatumomab in the first-line and second-line treatment of pediatric B-cell acute lymphoblastic leukemia (B-ALL).Methods:A multi-center retrospective cohort study was conducted to analyze clinical data from 323 pediatric B-ALL patients treated with blinatumomab across 14 hospitals in China from May 2021 to July 2023. Patients were divided into four groups based on the treatment phase and disease status when blinatumomab was used: relapsed/refractory group, post-consolidation minimal residual disease (MRD)-positive group, early MRD-positive group, and MRD-negative group. Blinatumomab for the relapsed/refractory group was considered as second-line treatment, while the other 3 groups as first-line treatment. The MRD negativity rate after treatment, the survival rates and the incidence of severe adverse events were compared across these groups. Patients who received blinatumomab for more than 7 days were included in the efficacy analysis. Survival analysis was performed using the Kaplan-Meier method, and Log-Rank test was used to compare the survival rates among groups.Results:Among the 323 patients, 191 (59.1%) were male, with the age of 6.2 (3.9, 10.5) years. There were 117 patients in the relapsed/refractory group, 62 cases in the post-consolidation MRD-positive group, 43 cases in the early MRD-positive group, and 101 cases in the MRD negative group. In the relapsed/refractory group, the complete remission rate and MRD negativity rate after one course of blinatumomab were 71.4% (35/49) and 81.5% (75/92) for the 49 children without complete remission and the 92 children with flow cytometry-positive MRD, respectively. In the post-consolidation MRD-positive group, the MRD negativity rates after one course of blinatumomab were 100.0% (27/27), 12/16 and 9/19 for patients with MRD positivity detected by flow cytometry, polymerase chain reaction and next-generation sequencing, respectively. In the early MRD-positive group, the MRD negativity rates were 96.7% (29/30) and 9/9 for flow cytometry and next-generation sequencing, respectively. The 2-year overall survival rate and event-free survival rate for the 319 children evaluable for efficacy were (90.6±1.7)% and (87.6±1.9)%, respectively, with the relapsed/refractory group showing significantly lower overall survival rates and event-free survival rate compared to the other groups ( χ2=21.40, 26.21,both P<0.001). Grade 3 or higher adverse events occurred in 128 cases (39.6%), with hematological toxicity observed in 101 cases, while cytokine release syndrome (CRS), infection, and neurotoxicity occurred in 11, 26 and 8 cases, respectively. In addition, there were statistically significant differences in the grade 3 or higher CRS among the four groups ( χ2=8.03, P<0.05). Conclusion:Blinatumomab can clear MRD more effectively and achieve superior survival outcomes when used as first-line treatment for pediatric B-ALL, with less CRS.

Objective:To analyze the predictive factors associated with late-onset sepsis(LOS) in very low birth weight infants,and to develop a risk prediction score scale applicable to these infants three days postnatal.This will provide valuable insights for early diagnosis and timely intervention.Methods:Very low birth weight infants admitted to the Children's Hospital of Fudan University from January 1,2022,to June 30,2024,were selected as research subjects.These infants were categorized into two groups:the LOS group and the non-LOS group,based on whether they developed LOS.LASSO regression analysis,alongside univariate and multivariate regression analyses,was employed to identify predictive factors for LOS in this population.A Logistic model was constructed using the optimal combination of predictive variables,and a risk assessment scale was subsequently developed.The prediction performance of the model was evaluated using the Hosmer-Lemeshow chi-square test and the receiver operating characteristic curve.Results:A total of 444 cases of very low birth weight infants were included,of which 185 had LOS and 259 did not.After screening the variables,seven independent factors were included into the model:birth weight,gestational age,tracheal intubation,abnormal skin color,abdominal distension,elevated C-reactive protein levels,and right hand perfusion index.A predictive scoring scale was developed based on the regression coefficients of each variable,with corresponding risk scores assigned as follows:1,4,3,2,1,1,and 2; a score of ≥3.5 indicated high-risk groups.The Hosmer-Lemeshow test results demonstrated that χ2 = 7.602( P = 0.473).The area under the receiver operating characteristic curve was 0.792 ( P<0.001),with a sensitivity of 73.5% and specificity of 71.0%. Conclusion:The risk score scale developed in this study exhibits significant predictive capability,providing valuable insights for clinical medical personnel to assess the risk of LOS in very low birth weight infants during the early postnatal period.

Objective To develop a home skin care guidance scheme for newborns,and initially implement it to reducing the risk of skin-related issues.Methods Searching both domestic and international databases,we identified relevant literature.Following a quality evaluation,evidence integration,and group discussions,we developed the con-tent of the home skin care guidance for newborns.Subsequently,we refined this content through 2 rounds of expert consultations to finalize the scheme.To initially implement the scheme,we conveniently selected 20 healthy new-borns born between August 1st and 15th,2024,at a tertiary-level comprehensive hospital in Fujian Province as an experimental group.Their parents received skin care guidance based on our scheme via a WeChat platform.In contrast,we selected another group of 20 healthy newborns delivered between July 1st and 15th,2024,at the same hospital as a control group;their parents were provided with conventional skin care guidance.We compared the in-cidence rates of diaper dermatitis and eczema between these 2 groups of newborns at a month of age.Results A total of 33 experts from 30 tertiary hospitals across 19 provinces(including autonomous regions and municipalities)were invited to participate in a questionnaire survey.The response rates for both rounds of expert questionnaires reached 100％.The authority coefficients for the experts were recorded at 0.78 and 0.83,while the Kendall concor-dance coefficients were found to be 0.188 and 0.142(all P＜0.001).The final newborn home skin care guidance scheme consists of 6 first-level items,41 second-level items,such as the selection of newborn care products,methods for neonatal bathing and prevention of neonatal diaper dermatitis,and so on.Preliminary application results indicated that the incidence of diaper dermatitis in the experimental group was significantly lower than that observed in the control group,with a statistically significant difference noted(P=0.047).There was no significant difference in the incidence of eczema between the 2 groups at the age of a month(P=0.201).Conclusion The Neonatal Home Skin Care Guidance Scheme for newborns has been demonstrated to be scientific,reliable and feasible.The implementa-tion of this scheme has proven beneficial in reducing the incidence of diaper dermatitis at a month of age.Howev-er,the sample size needs to be expanded to further verify its implementation effect.

Objective:To analyze the predictive factors associated with late-onset sepsis(LOS) in very low birth weight infants,and to develop a risk prediction score scale applicable to these infants three days postnatal.This will provide valuable insights for early diagnosis and timely intervention.Methods:Very low birth weight infants admitted to the Children's Hospital of Fudan University from January 1,2022,to June 30,2024,were selected as research subjects.These infants were categorized into two groups:the LOS group and the non-LOS group,based on whether they developed LOS.LASSO regression analysis,alongside univariate and multivariate regression analyses,was employed to identify predictive factors for LOS in this population.A Logistic model was constructed using the optimal combination of predictive variables,and a risk assessment scale was subsequently developed.The prediction performance of the model was evaluated using the Hosmer-Lemeshow chi-square test and the receiver operating characteristic curve.Results:A total of 444 cases of very low birth weight infants were included,of which 185 had LOS and 259 did not.After screening the variables,seven independent factors were included into the model:birth weight,gestational age,tracheal intubation,abnormal skin color,abdominal distension,elevated C-reactive protein levels,and right hand perfusion index.A predictive scoring scale was developed based on the regression coefficients of each variable,with corresponding risk scores assigned as follows:1,4,3,2,1,1,and 2; a score of ≥3.5 indicated high-risk groups.The Hosmer-Lemeshow test results demonstrated that χ2 = 7.602( P = 0.473).The area under the receiver operating characteristic curve was 0.792 ( P<0.001),with a sensitivity of 73.5% and specificity of 71.0%. Conclusion:The risk score scale developed in this study exhibits significant predictive capability,providing valuable insights for clinical medical personnel to assess the risk of LOS in very low birth weight infants during the early postnatal period.

Objective:To investigate the 10-year incidence of reproductive system malignancies and their associated risk factors among overweight and obese women with different metabolic phenotypes aged 40 years and older in Guiyang City.Methods:A total of 6 444 female residents in Yunyan District, Guiyang City were included from the 2011 " Epidemiological Study on the Risk of Malignancy in Chinese Patients with Type 2 Diabetes Mellitus(REACTION)". Based on body mass index(BMI) and the presence or absence of metabolic syndrome(MetS), participants were categorized into four groups: metabolically healthy normal weight(MHNW, n=2 373), metabolically unhealthy normal weight(MUNW, n=1 098), metabolically healthy overweight/obese(MHO, n=2 229), and metabolically unhealthy overweight/obese(MUO, n=744). Baseline data were collected, and participants were followed up for 10 years to document the incidence of female reproductive system malignancies, including breast cancer, ovarian cancer, cervical cancer, and endometrial cancer. Logistic regression models were used to evaluate the association between metabolic phenotype and the 10-year risk of developing reproductive system malignancies. Results:Over a mean follow-up period of (9.89±0.77) years, the overall incidence of reproductive system malignancies was 1.15%(74/6, 444). Baseline characteristics such as age, BMI, high-density lipoprotein-cholesterol(HDL-C), and triglycerides(TG) differed significantly among the groups( P<0.05). The cumulative incidence of reproductive system malignancies in each group was: MHNW 0.93%(22/2 373), MUNW 0.73%(8/1 098), MHO 1.57%(35/2 229), and MUO 1.21%(9/744). There were no statistically significant differences in incidence across the four groups( P>0.05). However, multivariable logistic regression analysis revealed that, compared with the MHNW group, the adjusted HR (95% CI) were: MUNW 0.787(0.349-1.774, P>0.05), MHO 4.835(1.708-13.688, P<0.05), and MUO 3.719(1.144-12.089, P<0.05). Conclusion:Overweight and obesity are significant risk factors for reproductive system malignancies in women aged 40 and above. The presence of metabolic abnormalities in overweight or obese women further increases the risk of developing such malignancies.

Objective:To investigate the efficacy and toxicity of blinatumomab in the first-line and second-line treatment of pediatric B-cell acute lymphoblastic leukemia (B-ALL).Methods:A multi-center retrospective cohort study was conducted to analyze clinical data from 323 pediatric B-ALL patients treated with blinatumomab across 14 hospitals in China from May 2021 to July 2023. Patients were divided into four groups based on the treatment phase and disease status when blinatumomab was used: relapsed/refractory group, post-consolidation minimal residual disease (MRD)-positive group, early MRD-positive group, and MRD-negative group. Blinatumomab for the relapsed/refractory group was considered as second-line treatment, while the other 3 groups as first-line treatment. The MRD negativity rate after treatment, the survival rates and the incidence of severe adverse events were compared across these groups. Patients who received blinatumomab for more than 7 days were included in the efficacy analysis. Survival analysis was performed using the Kaplan-Meier method, and Log-Rank test was used to compare the survival rates among groups.Results:Among the 323 patients, 191 (59.1%) were male, with the age of 6.2 (3.9, 10.5) years. There were 117 patients in the relapsed/refractory group, 62 cases in the post-consolidation MRD-positive group, 43 cases in the early MRD-positive group, and 101 cases in the MRD negative group. In the relapsed/refractory group, the complete remission rate and MRD negativity rate after one course of blinatumomab were 71.4% (35/49) and 81.5% (75/92) for the 49 children without complete remission and the 92 children with flow cytometry-positive MRD, respectively. In the post-consolidation MRD-positive group, the MRD negativity rates after one course of blinatumomab were 100.0% (27/27), 12/16 and 9/19 for patients with MRD positivity detected by flow cytometry, polymerase chain reaction and next-generation sequencing, respectively. In the early MRD-positive group, the MRD negativity rates were 96.7% (29/30) and 9/9 for flow cytometry and next-generation sequencing, respectively. The 2-year overall survival rate and event-free survival rate for the 319 children evaluable for efficacy were (90.6±1.7)% and (87.6±1.9)%, respectively, with the relapsed/refractory group showing significantly lower overall survival rates and event-free survival rate compared to the other groups ( χ2=21.40, 26.21,both P<0.001). Grade 3 or higher adverse events occurred in 128 cases (39.6%), with hematological toxicity observed in 101 cases, while cytokine release syndrome (CRS), infection, and neurotoxicity occurred in 11, 26 and 8 cases, respectively. In addition, there were statistically significant differences in the grade 3 or higher CRS among the four groups ( χ2=8.03, P<0.05). Conclusion:Blinatumomab can clear MRD more effectively and achieve superior survival outcomes when used as first-line treatment for pediatric B-ALL, with less CRS.

Objective:To investigate the effects of celastrol (CSR) on dendritic cell (DC) and T follicular helper cell (Tfh) subsets in the mouse of ulcerative colitis (UC) .Methods:Forty-eight male BALB/c mice were randomly divided into healthy control group, model group, and CSR intervention group, with 16 mice in each group. The healthy control group was fed with normal purified water, while the mice in model group and CSR intervention group were fed with 3% DSS solution to induce UC model. Since the induction, the mice in CSR intervention group were gavaged with 1mg/kg of CSR, and the mice in UC group were gavaged with equal volume of saline once a day. The weight and stool characteristics of the mice were recorded, and disease activity index (DAI) were evaluated. After the 8-day intervention, the length of the mouse colon was measured, the histopathological changes were observed, and the histopathological score was evaluated. Flow cytometry was used to detect the percentage of DC, conventional DC (CD8α + cDC1, CD103 + cDC1, cDC2), plasmacytoid DC (pDC), and Tfh subsets in colon lamina propria, mesenteric lymph nodes and spleen. Cytometric bead array kit was used to detect the expression levels of DC and Tfh related cytokines [interleukin 6 (IL-6), tumor necrosis factor α (TNF-α), interleukin 21 (IL-21) ] in colon tissue. The influence of CSR on naive CD4 +T cell proliferation and Tfh differentiation were validated in vitro experiments. Results:The modelling success rate was 100% and all mice survived. Compared with model group, mice in CSR intervention group had heavier weight, lower DAI, and ameliorated colonic length shortening, with all differences being statistically significant (all P < 0.05). The intestinal mucosal structure of mice in model group was disordered, with a large number of inflammatory cell infiltration; the intestinal mucosal barrier of mice in CSR intervention group approached normal structure, with fewer inflammatory cells, and the histopathological scores were significantly decreased ( P<0.05). In the colon lamina propria, compared with model group, the percentages of DC, CD8α + cDC1 and Tfh decreased, while the percentage of CD103 + cDC1 increased in CSR intervention group, and these differences were all statistically significant (all P<0.05). In mesenteric lymph nodes, the percentage of CD8α + cDC1 decreased, while the percentages of DC, CD103 + cDC1, cDC2 and Tfh increased in CSR intervention group compared with model group, and these differences were all statistically significance (all P<0.05). In the spleen, compared with model group, the percentage of pDC was significantly reduced in CSR intervention group ( P<0.05) .The expression levels of IL-6, TNF-α and IL-21 in colon tissues of CSR intervention group were lower, while IL-10 was higher than those of model group, and these differences were statistically significant (all P<0.05). In vitro experiments, CSR could inhibit naive CD4 + T cell proliferation and Tfh differentiation, with statistically significant differences (all P < 0.05) . Conclusion:CSR can alleviate intestinal damage in UC mice, potentially by modulating the local immune microenvironment through regulating DC and Tfh subsets.

Objective To develop a comprehensive family integrated care program for very low birth weight in-fants and to investigate the initial application effect of the program.Methods The family integrated care program for very low birth weight infants was developed using semi-structured interviews,a comprehensive literature review,and an expert consensus.A non-synchronous controlled trial was subsequently carried out.Between January and May 2023,35 participants accompanied by their parents for a minimum of 6 hours daily over a span of at least 3 days,were consecutively selected as an intervention group.Between January and May 2022,35 participants in the control group were treated with routine closed neonatal intensive care unit model.The application effect of the pro-gram on the clinical outcomes of very low birth weight infants was assessed,such as weight gain rate during hospi-talization,breastfeeding days,incidence of late-onset sepsis,incidence of extrauterine growth restriction at discharge,TIMP level at corrected gestational age of 37 weeks and hospitalization days.Results The authority coefficient of the 8 invited experts specializing in neonatal nursing and nursing management was 0.925.A comprehensive pro-gram was developed,consisting of 2 stages—preparation and implementation,and addressing 7 key themes:staff team formation and training,environmental support,assessment,parental training,family-integrated care implementation,peer support,and comprehensive communication.No shedding cases occurred during the application of the program.The outcomes indicated that the intervention group experienced a higher rate of weight gain and more days of breast-feeding compared to the control group,and the incidence of extrauterine growth retardation upon discharge was also lower,with statistically significant differences(all P＜0.05).However,there were no significant differences in other clinical outcomes(all P＞0.05).Conclusion The family integrated care program for very low birth weight infants de-veloped in this study is scientifically grounded,comprehensive,and practical.The implementation of this program can promote the weight gain and breastfeeding among very low birth weight infants,reduce the occurrence of extrauter-ine growth restriction upon discharge,and does not increase the incidence of late-onset sepsis.