Objective:To investigate the levels and clinical significances of miRNA-155-5p (miR-155-5p) and hypoxia inducible factor-1α (HIF-1α) in the bone marrow of patients with acute myeloid leukemia (AML)-M 5. Methods:A cross sectional study was conducted. The bone marrow samples were collected from 32 AML-M 5 patients who were admitted to the First Affiliated Hospital of Hebei North University from November 2023 to December 2024, and the bone marrow samples collected from 11 patients with megaloblastic anemia from November 2023 to May 2025 were used as controls. Reverse transcription real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) was used to determine relative expression of miR-155-5p at the transcription level in bone marrow mononuclear cells, and enzyme-linked immunosorbent assay (ELISA) was used to measure the concentration of HIF-1α protein in bone marrow supernatant. The levels of miR-155-5p and HIF-1α in bone marrow were compared between AML patients and control group, as well as among AML patients with different prognostic risks. Spearman method was used to analyze the relationship between miR-155-5p level and HIF-1α level in bone marrow of AML patients and their levels with bone marrow and peripheral blood cell indicators. Results:Among the 32 AML-M 5 patients, 20 patients (62.5%) were male and 12 patients (37.5%) were female, with a median age [ M ( Q1, Q3)] of 63 (51, 70) years; according to the clinical response criteria recommended by the European Leukemia Network (ELN) in 2022, there were 12 cases (37.5%) of complete response (CR) and 8 cases (25.0%) of non-complete response (NCR); according to the risk stratification criteria recommended by ELN in 2022, there were 8 cases (25.0%) with good prognosis, 13 cases (40.6%) with moderate prognosis and 11 cases (34.4%) with poor prognosis. In the control group, there were 5 males and 6 females, with a median age of 68 (63, 72) years. There was no statistically significant difference in gender and age between the two groups (both P > 0.05). The transcription level relative expression of miR-155-5p in the bone marrow mononuclear cells of AML-M 5 patients [5.13 (2.83, 8.84) vs. 0.87 (0.56, 1.69)] and the concentration of HIF-1α protein in the bone marrow supernatant of AML-M 5 patients [(116±32) pg/ml vs. (58±22) pg/ml] were higher than those in the control group, and the differences were statistically significant (both P < 0.001). The relative expression of miR-155-5p at the transcription level in the initial diagnosis group and NCR group and the concentration of HIF-1α in the initial diagnosis group, NCR group and CR group were higher than those in the control group (all P < 0.01), the relative expression of miR-155-5p at the transcription level in the CR group was higher than that in the control group, but the difference was not statistically significant ( P > 0.05); the relative expression of miR-155-5p at the transcription level in the newly diagnosis group was higher than that in the CR group, and the difference was statistically significant ( P < 0.01). However, there was no statistically significant difference between the newly diagnosis group and the NCR group or between the NCR group and the CR group (all P > 0.05). The concentration of HIF-1α in the newly diagnosis group and NCR group was higher than that in the CR group, and the differences were statistically significant (both P < 0.05). However, there was no statistically significant difference between the newly diagnosis group and the NCR group ( P > 0.05). There was no statistically significant difference in the relative expression of miR-155-5p at the transcription level and HIF-1α concentration in bone marrow among AML-M 5 patients with poor prognosis, moderate prognosis and good prognosis (both P > 0.05). The level of miR-155-5p in the bone marrow of AML-M 5 patients was positively correlated with the level of HIF-1α ( r = 0.446, P = 0.010); the level of miR-155-5p in bone marrow was positively correlated with the proportion of bone marrow primitive cells ( r = 0.583, P < 0.001), peripheral blood leukocyte count ( r = 0.464, P = 0.008), peripheral blood monocyte count ( r = 0.464, P = 0.007), and peripheral blood monocyte-to-leukocyte ratio ( r = 0.457, P = 0.009). The concentration of HIF-1α in the bone marrow of AML-M 5 patients was positively correlated with the proportion of bone marrow primitive cells ( r = 0.568, P = 0.001) and peripheral blood mononuclear cells-to-white blood cells ratio ( r = 0.375, P = 0.034), but not with peripheral blood white blood cell count ( r = 0.159, P = 0.385) or peripheral blood mononuclear cell count ( r = 0.300, P = 0.095). Conclusions:The levels of miR-155-5p and HIF-1α in the bone marrow of AML-M 5 patients are relatively high, and the levels of both are lower in patients with remission. However, the levels of both may not be related to the risk of prognosis. The levels of miR-155-5p and HIF-1α in the bone marrow of AML-M 5 patients are positively correlated, and their levels are also positively correlated with major hematological indicators in the bone marrow and peripheral blood.

Objective To explore medical institution-led exercise training interventions,prelimina-ry preventive measures,and comprehensive health service strategies for elderly adults.Methods Sixty elderly adults from communities under the jurisdiction of primary hospitals who voluntarily participated in the training and met the inclusion criteria were divided into 75 to 79 years old group and 80 to 84 years old group.Elastic bands exercise were selected as the method for physical training for elderly community members.A total of three sets(9 items)of exercise,including upper and lower limb mus-cle strength exercises and balance as well as coordination training,were designed.The training period lasted for 12 weeks,with each session lasting 1 hour,three times a week.The medical team partici-pated in training supervision and follow-up evaluations throughout the process,dynamically adjusting the training intensity based on individual needs.Results Comprehensive safety and support meas-ures significantly improved training participation and completion rates.No sports injuries or adverse events occurred throughout the process,and all participants completed the training plan.After train-ing,statistically significant differences were observed in grip strength,five-times sit-to-stand test duration,Berg Balance Scale(BBS)scores,and Timed Up and Go(TUG)test results(P＜0.05),indicating effective physical fitness improvement.Conclusion Elastic band exercises are a suitable mode for physical improvement training among elderly adults,significantly enhancing muscle strength in the limbs and trunk and improving balance function.The positive communication and in-teraction in group activities significantly boost elderly adults'confidence in healthy living,leading to notable improvements in their mental state.

Objective:To understand the current status of anemia, iron deficiency, and iron-deficiency anemia among preschool children in China.Methods:A cross-sectional study was conducted with a multi-stage stratified sampling method to select 150 streets or townships from 10 Chinese provinces, autonomous regions, or municipalities (East: Jiangsu, Zhejiang, Shandong, and Hainan; Central: Henan; West: Chongqing, Shaanxi, Guizhou, and Xinjiang; Northeast: Liaoning). From May 2022 to April 2023, a total of 21 470 children, including community-based children aged 0.5 to<3.0 years receiving child health care and kindergarten-based children aged 3.0 to<7.0 years, were surveyed. They were divided into 3 age groups: infants (0.5 to<1.0 year), toddlers (1.0 to<3.0 years), and preschoolers (3.0 to<7.0 years). Basic information such as sex and date of birth of the children was collected, and peripheral blood samples were obtained for routine blood tests and serum ferritin measurement. The prevalence rates of anemia, iron deficiency, and iron-deficiency anemia were analyzed, and the prevalence rate differences were compared among different ages, sex, urban and rural areas, and regions using the chi-square test.Results:A total of 21 460 valid responses were collected, including 10 780 boys (50.2%). The number of infants, toddlers, and preschoolers were 2 645 (12.3%), 6 244 (29.1%), and 12 571 (58.6%), respectively. The hemoglobin level was (126.7±14.8) g/L, and the serum ferritin level was 32.3 (18.5, 50.1) μg/L. The overall rates of anemia, iron deficiency, and iron-deficiency anemia were 10.4% (2 230/21 460), 28.3% (6 070/21 460), and 3.9% (845/21 460), respectively. The prevalence rate of anemia was higher for boys than for girls (10.9% (1 173/10 780) vs. 9.9% (1 057/10 680), χ2=5.58, P=0.018), with statistically significant differences in the rates for infants, toddlers and preschoolers (18.0% (475/2 645), 10.6% (662/6 244), and 8.7% (1 093/12 571), respectively, χ2=201.81, P<0.01), and the rate was significantly higher for children in rural than that in urban area (11.8% (1 516/12 883) vs. 8.3% (714/8 577), χ2=65.54, P<0.01), with statistically significant differences in the rates by region ( χ2=126.60, P<0.01), with the highest rate of 15.8% (343/2 173) for children in Central region, and the lowest rate of 5.3% (108/2 053) in Northeastern region. The prevalence rates of iron deficiency were 33.8% (895/2 645), 32.2% (2 011/6 244), and 25.2% (3 164/12 571) in infants, toddlers, and preschoolers, respectively, and 30.0% (3 229/10 780) in boys vs. 26.6% (2 841/10 680) in girls, 21.7% (1 913/8 821), 40.0% (870/2 173), 27.1% (2 283/8 413), 48.9% (1 004/2 053) in Eastern, Central, Western, and Northeastern regions, respectively, and each between-group showed a significant statistical difference ( χ2=147.71, 29.73, 773.02, all P<0.01). The prevalence rate of iron-deficiency anemia showed a significant statistical difference between urban and rural areas, 2.9% (251/8 577) vs. 4.6% (594/12 883) ( χ2=38.62, P<0.01), while the difference in iron deficiency prevalence was not significant ( χ2=0.51, P=0.476). Conclusions:There has been a notable improvement in iron deficiency and iron-deficiency anemia among preschool children in China, but the situation remains concerning. Particular attention should be paid to the prevention and control of iron deficiency and iron-deficiency anemia, especially among infants and children in the Central, Western, and Northeastern regions of China.

Objective To investigate the prevalence and molecular characteristics of Anaplasma infections in sheep and goats in Anhui Province in 2020, so as to provide insights into ovine anaplasmosis prevention and control. Methods A total of 355 fresh blood samples were collected from 7 sheep and goat farms in Linquan County of Fuyang City, Lixin County of Bozhou City, Yu'an District of Lu'an City, Wangjiang County of Anqing City, Nanling County of Wuhu City, and Tianchang City and Fengyang County of Chuzhou City in Anhui Province from June to December 2020. A. bovis and A. phagocytophilum 16S ribosomal RNA (16S rRNA) gene, A. ovis major surface protein 4 (MSP4) gene and A. capra citric acid synthase (gltA) gene were amplified using PCR assay in all blood samples, and the prevalence of A. bovis, A. phagocytophilum, A. ovis and A. capra infections was calculated in sheep and goats. In addition, the positive amplification products were sequenced and subjected to genetic evolutionary analysis. Results The overall prevalence of Anaplasma infections was 17.5% (62/355) in sheep and goats in Anhui Province, and the prevalence of A. bovis, A. phagocytophilum, A. ovis and A. capra infections was 2.8% (10/355), 2.5% (9/355), 2.5% (9/355), and 7.0% (25/355), while the prevalence of A. bovis and A. phagocytophilum, A. phagocytophilum and A. ovis, A. phagocytophilum and A. capra and A. bovis, A. phagocytophilum and A. ovis co-infections was 0.8% (3/355), 1.1% (4/355), 0.3% (1/355) and 0.3% (1/355), respectively. No Anaplasma was detected in the sheep and goat farms in Fengyang County, while at least three Anaplasma species were detected in other sheep and goat farms, with co-infections of multiple Anaplasma species identified. The prevalence of Anaplasma infections was 14.7% (24/163) in goats and 19.8% (38/192) in sheep, and the prevalence of Anaplasma infections was 31.0% (31/100) in goats and sheep under 6 months of age, and 12.2% (31/255) in goats and sheep at ages of 6 months and older, respectively. A. bovis, A. phagocytophilum, A. ovis and A. capra were identified in sheep and goats of different breeds and ages. Conclusions Multiple Anaplasma species infections were commonly prevalent in goats and sheep in Anhui Province in 2020, notably A. phagocytophilum, A. ovis and A. capra, which have zoonotic risks. Improved surveillance and prevention and control of Anaplasma infections are required in sheep and goats in Anhui Province.

Objective:To explore the cognition, recognition and knowledge needs of the parents of outpatient children with aerosol inhalation therapy, so as to provide a reference for the development of effective health education and improve the nursing satisfaction of the parents of the children.Methods:This study was a cross-sectional study. From March 2020 to March 2021, convenience sampling was used to select 260 parents of children who were treated with aerosol inhalation therapy in the Pediatric Clinic of the Beijing Tsinghua Changgung Hospital affiliated to Tsinghua University as the research subject. The self-made Aerosol Inhalation Therapy Related Knowledge Questionnaire was used to investigate the parents.Results:A total of 260 questionnaires were issued, and 243 valid questionnaires were returned with the valid response rate of 93.5%.The total cognitive score of aerosol inhalation therapy of the parents of children was (50.33±8.38) , and the total score of aerosol inhalation therapy attitude was (17.86±2.61) . A total of 31.7% (77/243) of the children 's parents believed that they needed knowledge about aerosol inhalation therapy very much, and 58.4% (142/243) of the children 's parents believed that they needed knowledge about aerosol inhalation therapy, and 67.9% (165/243) of the children 's parents preferred to obtain knowledge about aerosol inhalation therapy through face-to-face demonstrations. Conclusions:Parents of outpatient children have a high degree of recognition of aerosol inhalation therapy, and hope to get relevant knowledge and education. Nursing staff should mainly take face-to-face demonstrations, supplemented by videos and education manuals to carry out health education to parents of children, so as to improve the nursing satisfaction of parents of children.

Objective:To analyze the characteristics of HIV-1 molecular network in men who have sex with men (MSM) from 2016 to 2018 in Kunming, Yunnan province, explore the risk factors associated with HIV-1 transmission network and provide evidence for the effective implementation of intervention.Methods:A total of 540 samples of newly reported HIV-1 positive MSM were consecutively collected in Kunming from 2016 to 2018, the pol gene fragments were amplified by nested polymerase chain reaction (PCR). HIV-1 molecular networks were constructed according to the bootstrap value of the maximum likelihood evolutionary tree over 95% and the genetic distance less than 3%. The factors associated with the subjects entering network and network growth were further analyzed. Results:Among 459 successfully sequenced samples, seven genotypes were found, in which CRF07_BC (49.2%, 226/459) and CRF01_AE (40.3%, 185/459 ) were predominant. Other genotypes included URFs (4.8%, 22/459), CRF08_BC (3.1%, 14/459), CRF55_01B (1.7%, 8/459), B (0.7%, 3/459) and CRF68_01B (0.2%, 1/459). A total of 163 sequences entered the network, with an entry rate of 35.5%(163/459), forming 56 clusters with the number of individuals in the cluster was between 2 and 13. The analysis of the factors associated with entering network showed that the MSM who married and had multiple homosexual partners were more likely to be found in HIV-1 molecular networks. Multivariate logistic regression analysis showed that the number of sexual partners was the factor for the growth of HIV-1 molecular network. According to the criteria for the emergence of three or more newly reported cases in every year, six transmission clusters were judged as active transmission clusters, in which MSM who were not Kunming natives, had sexually transmitted diseases (STD), were divorced and students were the key targets of intervention.Conclusions:HIV-1 genotypes in MSM in Kunming were becoming complex, the risk factors associated with transmission networks in MSM in Kunming included being married and having multiple partners, the intervention targets in active transmission clusters included MSM who were not Kunming natives, had STD, were divorced and students. This study provided the basis for applying HIV-1 molecular networks to real-time intervention in this population.

Objective:To understand the characteristics of HIV-1 genotypes and drug resistance among men who have sex with men in Kunming in 2018.Methods:A total of 193 plasma samples were collected from the newly reported HIV-1 infected MSM in Kunming from January to December 2018. Viral RNA was extracted, and the gag, pol, env gene segments were amplified by nested PCR. HIV-1 genotypes and drug resistance were also analyzed. Subsequently, the evolutionary characteristics of CRF55_01B and CRF68_01B among MSM in Kunming were analyzed by Bayesian Markov Chain Monte Carlo method. Results:Multiple HIV-1 genotypes were identified among these 193 samples, including CRF07_BC (39.4%, 76/193), CRF01_AE (34.2%, 66/193), unique recombinant forms (URFs) (20.2%, 39/193), CRF08_BC (3.1%, 6/193), CRF55_01B (1.6%, 3/193), subtype B (1.0%, 2/193) and CRF68_01B (0.5%, 1/193). Results from the Bayesian evolutionary analysis showed that CRF55_01B started to spread locally after being imported from other provinces, while CRF68_01B was likely to have been brought in from the eastern provinces of China. Prevalence of HIV-1 drug resistant strains was 2.6%(5/190) before antiviral treatment, with mutation rates resistant to non-nucleoside reverse transcriptase inhibitors being the highest (2.1%, 4/190) among MSM in Kunming, 2018.Conclusion:The diversity of HIV-1 was increasing among MSM in Kunming. Although the resistance rate on pretreatment drug was relatively low, the emergence of multiple resistant strains to first-line antiviral drugs posed a challenge to antiretroviral therapy, in Kunming.

Objective To evaluate the performance of peripheral blood T-SPOT.TB and cerebrospinal fluid (CSF) interferon (IFN)-γ detection in the diagnosis of tuberculous meningitis (TBM).Methods Among the 182 consecutive cases with suspected TBM in Huashan Hospital from March 2011 to March 2013,30 patients were included in the case group according to the latest diagnostic criteria of TBM.Thirty-nine patients diagnosed with non-tuberculous meningitis were included in the control group.T-SPOT.TB was employed to detect tuberculosis-specific IFN-γ-secreting T cells in the peripheral blood.And IFN-γ in CSF was detected simultaneously by enzyme-linked immunosorbent assay (ELISA) without antigen stimulation.The CSF was collected from 10 patients of TBM group after anti tuberculosis treatment for 4 weeks to observe the dynamic changes.The t-test was used for analysis of continuous variables with normal distribution and Kruskal-Wallis test was used for analysis of variables with abnormal distribution.Results ()f the 30 TBM cases,6 were confirmed cases and 24 were highly suspected cases.The control group was comprised of 12 viral encephalitis,16 suppurative meningitis and 11 cryptococcal meningitis.The positive rate of T-SPOT.TB was significantly higher in TBM group compared with control group (70％ vs 13％,x2 =12.15,P＜0.01).The mean concentration of CSF IFN γ of TBM group was 244.35 pg/mL,which was significantly higher than that of control group 9.48 pg/mL (Z=-4.646,P＜0.01).The CSF IFN-γ was significantly decreased after 4 weeks of treatment (271.02 pg/mL vs 81.36 pg/mL,Z=-3.099,P=0.002).The sensitivity and specificity of peripheral blood T-SPOT.TB in the diagnosis of TBM were 70％ and 87％,respectively.The area under the receiver operating characteristic (ROC) curve of CSF IFN-γ for TBM diagnosis was 0.819; the optimal cut-off point was 81.36 pg/mL; the corresponding sensitivity and specificity were 83 ％ and 85 ％,respectively.Conclusion Both the detection of peripheral blood T-SPOT.TB and CSF IFN-γ are of great importance for the diagnosis of TBM.Dynamic observation of CSF IFN-γ is important for disease monitoring.

Objective To investigate the causes of complications induced by peripherally inserted central catheters(PICC)in cancer patients and summarize pertinent nursing measures.Method The clinical data of 26 tumor patients with PICC were analyzed retrospectively .Result The complications occurred in 8 patients with a rate of 30.8%, among which unsuccessful catheteration occurred in 1 case,oozing of blood at the mouth of catheter in 1 case,phlebitis in 1 case,dislocation in 1 case,skin allergy-like reactions in 2 cases and catheter emersion in 1 case,catheter breaking in 1 case and dislocation in 2 cases.Conclusion The skilled operation,preventive maintenance of catheters and health education to the patients are the important measures for prevention and reduction of the complications.

Objective To discuss the application of prospective quality management in quality control of indwelling needle .Methods Twelve wards carried out the nurse grading management and set up prospective quality control management system , which was charged by a three-grading system of responsible nurse-responsible nursing group leader-head nurse .The intravenous indwelling needle was intervened under the consult of the professional guidance .The usage and maintenance of the indwelling needle before and after applying the prospective quality control management system were compared .Results The usage of the indwelling needle was decreased from 53.6%to 31.3%.The difference was significant (χ2 =45.099,P<0.01).The incidence of bad conditions of the maintenance was significantly decreased (P<0.01).Conclusions Every level of nursing staff is responsible for the prospective quality control management system , which can improve the participation of quality control and shorten the management extent .The system is oriented from clinical practical problems , so as to improve the control efficiency , and the usage and maintenance quality has been improved obviously .