Objective To observe the efficacy and safety of flumatinib conversion in chronic myelogenous leukemia-chronicphase(CML-CP)patients with suboptimal TKI response or intolerance.Methods Patients who did not have the best response or intolerance to first-line imatinib,dasatinib,and nilotinib and switched to flumatinib(600 mg/d)from February 2020 to August 2022 were collected from 5 hospitals from Chongqing and affiliated hospitals of North Sichuan Medical College.The efficacy and safety of flumatinib were observed.The optimal response rate,major molecular response(MMR),cumulative complete cytogenetic response(CCyR)rate,cumulative MMR rate,cumulative deep molecular response(DMR),progression-free survival(PFS),event-free survival(EFS)and adverse reactions in 3,6 and 12 months after treatment were observed and analyzed.Results A total of 100 patients with CML-CP were enrolled,with a median follow-up of 18(3～36)months.The optimal response rate was 92.6％(88/95),94.4％(85/90)and 92.9％(79/85)respectively,at 3,6 and 12 months after treatment.Till August 20,2023,the cumulative CCyR and MMR rate was 98.0％(98/100)and 81.9％(77/94),respectively,the median time to reach CCyR and MMR was 3 months,and cumulative DMR rate was 51.0％(51/100).PFS rate was 100.0％(100/100)and 1-year EFS rate was 85.6％(75/90).The most common non-hematologic adverse reactions of flumatinib were diarrhea and abdominal pain(7.0％),followed by renal dysfunction(6.0％)and musculoskeletal pain(2.0％).The main hematologic adverse reactions were thrombocytopenia(12.0％),anemia(6.0％)and leukopenia(2.0％).Conclusion Flumatinib has better MMR and DMR and is well tolerated in CML-CP patients with TKI resistance or intolerance.

Objective:To learn about the awareness of brucellosis prevention and control knowledge among people in key areas of Ningxia Hui Autonomous Region (Ningxia), and analyze influencing factors.Methods:From February to March 2023, a multi-stage stratified sampling method was adopted to select residents (aged ≥12 years and resident for ≥6 months) from Yanchi County, Litong District, Pingluo County and Yuanzhou District of Ningxia as the survey subjects. Demographic information such as gender, age, education level, marital status, occupation, region, urban-rural status, as well as knowledge of brucellosis prevention and control were obtained through face-to-face questionnaire surveys. The awareness rate of brucellosis prevention and control knowledge among various populations was calculated and the influencing factors were analyzed by binary logistic regression.Results:A total of 1 592 questionnaires were distributed, of which 1 581 were valid, with an effective rate of 99.31%. There were 704 males, accounting for 44.53% (704/1 581); and 877 females, accounting for 55.47% (877/1 581). The age was (54.09 ± 14.81) years old, ranging from 14 to 88 years old. The education level was mainly primary school or below, accounting for 48.07% (760/1 581). The marital status was mainly married or cohabitating, accounting for 91.84% (1 452/1 581). The occupation was mainly farmers and herdsmen, accounting for 61.92% (979/1 581). In Pingluo County, Litong District, Yuanzhou District and Yanchi County, 392, 403, 396 and 390 people were investigated, respectively. In urban and rural areas, 797 and 784 people were investigated, respectively. The overall awareness rate of brucellosis prevention and control knowledge among the population was 47.82% (756/1 581). Univariate analysis showed that there were statistically significant differences in the awareness rates of brucellosis prevention and control knowledge among different age groups, education levels, marital status, occupation, regions and urban and rural populations ( P < 0.05). Binary logistic regression analysis showed that age, education level, marital status, occupation, urban-rural status were the factors influencing the awareness rate of brucellosis prevention and control knowledge among the population ( P < 0.05). Conclusion:The awareness rate of brucellosis prevention and control knowledge in key areas of Ningxia is relatively low, and age, education level, marital status, occupation, and urban-rural status are the main influencing factors.

Objective To observe the echocardiographic manifestations of infective endocarditis(IE)complicated with valve damage in children.Methods Totally 104 children with IE were retrospectively enrolled and divided into non-damage group(n=34),mild damage group(n=39)and dysfunction group(n=31)according to whether complicated with valve damage and damage's degree.The general and echocardiographic data were compared among groups,and the echocardiographic characteristics of IE complicated with valve damage in children were analyzed.Results Significant difference of the proportion of combining with other congenital heart diseases(excluding bicuspid aortic malformations),the incidence of embolization events during hospital stay,also of endocarditis of left cardiac system were found among groups(all P＜0.05).Pairwise comparison showed that in non-damage group,the proportion of combining with other congenital heart diseases was higher,while the incidence of endocarditis of left cardiac system was lower than those in both mild damage group and dysfunction group(all P＜0.05).The incidence of embolization events during hospital stay in non-damage group was lower than that in dysfunction group(P＜0.05).Among 70 cases of IE complicated with valve damage,mitral valve(30/70,42.86％)was the most common involved valve,mostly presented as valve stenosis(63/70,90.00％).No significant difference of valve involvement site,valve structural lesions nor the incidence of valve stenosis was found between mild damage group and dysfunction group(all P＞0.05).Conclusion IE complicated with valve damage in children mostly involved left cardiac system,and the risk of embolization events was higher than that of IE children without valve damage.Echocardiography could be used as an important method for evaluating the site of valve involvement and the degree of damage.

Objective To observe the manifestations of isolated bicuspid aortic valve(i-BAV)in children using echocardiography.Methods Echocardiographic data of 79 children with i-BAV were retrospectively analyzed,and classification of i-BAV was performed.The patients were divided into complication group(n=50)and non-complication group(n=29)according to the existence of valve and/or aortic involvement or not,and echocardiographic parameters were compared between groups.Results After adjusting body surface area(BSA),in complication group,left ventricular end-systolic diameter/BSA was lower,while left ventricular myocardial mass index group was higher than those in non-complication group(both P＜0.05).Type 0 i-BAV was found in 22 cases,with lat subtype as the most common ones(18/22,81.82％),while Type Ⅰ was observed in 57 cases with L-R subtype as the most common ones(39/57,68.42％).The most common subtype in complication group was also Type Ⅰ L-R(31/50,62.00％),with incidence of valve involvement of 90.00％(45/50),mainly including mild aortic stenosis and/or incompetence(37/45,82.22％),and incidence of aorta involvement of 24.00％(12/50),all with type Ⅰ or Ⅱ aortic widening.Conclusion The most common subtype of i-BAV in children was type Ⅰ L-R,with mild valve damage as the main complication and possibility of left ventricular myocardial remodeling.

Objective:To learn about the epidemiological characteristics and trends of brucellosis in Ningxia Hui Autonomous Region (Ningxia), and to provide reference for formulation of brucellosis prevention strategies and identification of key areas.Methods:The case data from 2004 to 2019 were collected from the "China Disease Prevention and Control Information System Infectious Disease Monitoring and Reporting System", and descriptive epidemiological methods were used to analyze the distribution of cases (time, population, and regional distribution).Results:From 2004 to 2019, a total of 15 337 human brucellosis cases and 1 death case were reported in Ningxia. The average annual incidence rate was 15.21/100 000, ranging from 0.02/100 000 to 44.83/100 000. The difference in incidence rate in different years was statistically significant (χ 2 = 14 731.60, P < 0.001). Among them, from 2004 to 2010, the incidence rate was low, with an average annual incidence rate of 1.32/100 000; from 2011 to 2019, it entered a high incidence stage, with an average annual incidence rate of 24.83/100 000. Brucellosis occured in every month of the year, and the onset time was mainly in March to September, accounting for 71.60% (10 981/15 337); seasonal indexes from April to August was all > 100%, with obvious seasonality. The age of onset mainly concentrated in 20 - < 70 years old, accounting for 89.60% (13 742/15 337); males were significantly more than females, with a sex ratio of 2.66 ∶ 1.00 (11 141/4 196); the occupations were mainly farmers and herdsmen, accounting for 86.03% (13 194/15 337). Since 2014, cases had been reported in 22 counties (districts, cities) in the region, all of which were all severely endemic areas; the top three counties (districts) with incidence rate were Yanchi County (103.73/100 000), Hongsibao District (56.01/100 000) and Tongxin County (29.18/ 100 000), respectively, the difference between different regions was statistically significant (χ 2 = 3.80, P < 0.001). Conclusions:The incidence rate of brucellosis in Ningxia is on the rise, and the epidemic situation is severe. It is recommended to carry out active and effective intervention measures in areas with high incidence of brucellosis to curb the further spread of brucellosis.

In order to improve the quality of medical records written by interns of clinical medicine in hematology department,we evaluated and analyzed 100 medical records written by the interns.The main reasons that affect the quality of medical record written by interns are the writing defects that are history of present illness,past history,personal history,the record of the clinical operation,blood transfusion and chemotherapy.There are other reasons for affecting the quality of medical records,such as students in clinical practice not paying attention to the writing of medical records,the relative lag of teaching management,the particularity of the diseases in the department of hematology and the weak legal consciousness.Therefore,we should strengthen the teaching management,improve the comprehensive quality of the clinical teaching teachers,carry out the pre job training of the medical records for the interns,train the interns' inquiries and the ability to communicate with the doctors and patients,and make use of the typical medical records of the Department of Hematology to combine the discussion and other ways,so as to strengthen the interns' clinical disease writing skills and legal consciousness as well as the quality of their writing medical records.

Objective To evaluate the efficacy of pegaspargase (PEG-ASP) combined with GEMOX regimen for the treatment of extranodal natural killer (NK) / T-cell lymphoma (ENKL),and to observe the changes of coagulation function.Methods 35 patients with histologically confirmed ENKL were enrolled from January 2010 to December 2014.All patients received 180 cycles of PEG-ASP combined with GEMOX chemotherapy and the efficacies were observed.The coagulation items such as prothrombin time (PT),activated partial thromboplastin time (APTT),fibrinogen (Fbg) and international normalized ratio (INR) were tested respectively on day 1st,day 8th and day 14th of every treatment cycle.Results Among 35 patients,11 patients (31.43 ％) were in stage Ⅰ-Ⅱ,and 24 patients (68.57 ％) were in stage Ⅲ-Ⅳ.All patients were subjected to 180 cycles of PEG-ASP combined with GEMOX chemotherapy,and each case was estimated to receive 6 cycles.The overall response (CR+PR) rate (ORR) was 71.43 ％ (25/35),the ORR was 81.82 ％ (9/11) in stage Ⅰ-Ⅱ group,and 66.67 ％ (16/24) in stage Ⅲ-Ⅳ group.The increased PT and APTT and decreased Fbg were observed on day 8th of the chemotherapy.The increased APTT and decreased Fbg were still observed on day 14th of the chemotherapy.Compared the data of patients one day before chemotherapy with healthy persons,the changes had statistical significance (P ＜ 0.05).Conclusions PEG-ASP combined with GEMOX regimen in the treatment of ENKL is safer and more effective compared with traditional chemotherapy,but the abnormal alternations of coagulation might be common during therapy.Dealing with the bleeding risk and supplement with plasma,PPSB or Fbg in time should be necessary.

Objective To establish a mouse model of bacterial vaginosis ( BV) by infecting estro-gen-treated mice with Prevotella bivia ( P. bivia) . Methods The mice were intraperitoneally injected with beta-estradiol 17 valerate which was suspended in sesame oil and then inoculated with different doses of P. bivia strains at the logarithmic phase. Samples of vaginal flushing fluid were collected at different time points after inoculation and used for the isolation of P. bivia strains and the detection of sialidase activities. Altogether 30 mice treated with estrogen and high dose of P. bivia were killed on days 2, 7 and 21 (n=10). Samples of cornua uteri, bladder and kidney were collected from those mice for P. bivia strains isolation. Re-sults Injection the estrogen-treated mice with P. bivia via vagina could cause the P. bivia infection for more than 14 days. The numbers of P. bivia strains isolated on day 21 decreased significantly. Enhanced sialidase activities and clue cells were observed in vaginal secretions of mice with P. bivia infection. Injection of mice with the high dose of P. bivia could spread the infection to cornua uteri. Conclusion Estrogen-treated mice could be used as an animal model for researches on BV.

Objective To assess the diet quality of pregnant women during the second trimester using the dietary inflammatory index ( DII) and to explore the correlation between the DII in second trimester of preg-nancy and preterm delivery.Methods A total of 253 women with singleton pregnancy in 16-20 gestational weeks who had received routine prenatal care between August 2014 and April 2015 at the First Affiliated Hospi-tal of Anhui Medical University were enrolled with cluster random sampling.The included women were asked to recall daily dietary intake in the 3 days prior to the survey.All dietary data were analyzed for energy and nutri-ents intake with a nutritional analysis software, followed by calculation of DII according to previous reports. Based on quartiles of the DII scores, the participants were divided into three groups, namely the anti-inflam-matory group (DII<-5.10), intermediate group (DII -5.10--2.55), and the pro-inflammatory group (DII>-2.55).The participants were followed up until delivery and the pregnancy outcomes were recorded. The relationship between the DII in second trimester of pregnancy and preterm delivery were analyzed. Results DII scores of the 253 pregnant women during the second trimester of pregnancy ranged from -7.913 to 3.872.The risks of preterm birth in the anti-inflammatory diet group, the intermediate group, and the pro-inflammatory diet group were 0, 1.6%, and 6.3%, respectively, with statistically significant differences among the groups (P=0.034).The higher DII scores (pro-inflammatory) were associated with higher inci-dence of preterm birth ( P<0.05 ) .Conclusion DII may be used to assess diet quality of pregnant women during the second trimester and to predict the risk of preterm birth.

Objective: To evaluate the clinical value of echocardiography in aortic valvuloplasty (AVP) in the low-age pediatric patients with congenital aortic valve stenosis. Methods: We retrospectively studied 39 low-age (at median of 23 months) patients with congenital aortic valve stenosis who received aortic valve repair in our hospital for their echocardiography information, and statistically analyzed the main indicator changes by 4 time points as pre-operation and 1 week, 1-3 months, 6-12 months after the operation respectively. Results: In our study, the bicuspid to tricuspid valve ratio was approximately at 5.5/1 and 2 patients died during peri-operative period. Compared with pre-operative time point, Doppler aortic valve peak velocity (Vmax ) and the mean aortic transvalvular pressure gradient (MPG) were reduced accordingly, for Vmax: (4.30 ± 0.73) m/s vs (2.65 ± 0.78) m/s, (2.93 ± 0.63) m/s, (3.01 ± 0.83) m/s,P<0.01, for MPG: (45.78 ± 15.19) mmHg vs (18.24 ± 10.08) mmHg, (21.01 ± 10.08) mmHg, (22.31 ± 13.41) mmHg. Compared with pre-operative time point, left ventricular ejection fractions (LVEF) were similar in 3 post-operative time points. Compared with 1 week post operative time point, left ventricular end-diastolic anteroposterior diameter (LVEDD) was increased at 6-12 months post-operative time point, the relative wall thickness (RWT) was decreased, bothP<0.05, and aorta valve regurgitation (AR) was increasedP<0.01. Pearson correlation analysis showed that aortic annulus (AA) inner diameter was positively related to LVEDD (r= 0.648,P<0.01), negatively related to Vmax (r= -0.205,P<0.05) and RWT was positively related to Vmax (r= 0.196,P<0.05). There were 6 patients with pre-operatively decreased LVEF, 1 of them died and the rest 5 with elevated LVEF at 6-12 months post-operative period,P<0.05. Conclusion: Echocardiograghy could be used as the ifrst choice of imaging method for diagnosing congenital aortic valve stenosis, it has the important role for in-operative monitoring and post-operative evaluation of AVP in relevant patients.