Objectives:the purpose of this study was to systematically evaluate the clinical value of cytokines in autoimmune diseases (AID). It was a kind of complex disease, and its pathogenesis involved cytokines, autoantibodies, immune cells and other immune factors. Especially some AID, such as Adult still′s disease (AOSD) and Takayasu arteritis(TA), had no specific biomarkers at present. This study was a retrospective case-control study.Methods:the data of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-8(IL-8) and interleukin-10(IL-10) in 834 AID patients from January 2019 to August 2022 were collected, and the serum levels of those cytokines in 30 healthy controls (HC) were detected at the same time. And AOSD, TA, systemic lupus erythematosus (SLE) and Behcet′s syndrome (BS) were divided into active group and inactive group. In addition, we also made a subgroup analysis of two important organs involved in SLE (kidney and nervous system). GraphPad Prism 9 and R 4.2.2 software were used. Nonparametric tests (Kruskal-Wallis H test, Mann-Whitney U test) were used to compare the differences among groups, and Dunn′s method was used to correct the false positive caused by multiple tests. Results:To compare the level of IL-6 in each group, except Behcet syndrome (BS) group and antiphospholipid syndrome (APS) group, the serum IL-6 level of AID group was higher than that of HC group, with antineutrophil cytoplasmic antibodies associated vasculitis(AAV) [3.85(2.00,8.55) pg/ml], idiopathic inflammatory myopathies(IIM) [7.80(2.50,6.50)pg/ml], IgG4-related disease(IgG4RD) [3.65(2.08,12.83) pg/ml], rheumatoid arthritis (RA) [5.50(2.20,16.10) pg/ml], SLE[4.70(2.75,16.55) pg/ml], Sj?gren syndrome(SS) [3.20(2.00,8.90) pg/ml], systemic sclerosis(SSc) [2.70(2.00,8.90) pg/ml], TA[3.40 (2.00,6.50) pg/ml], other AID diseases[4.40(2.00,11.10) pg/ml], especially AOSD [15.20(2.10, 39.20) pg/ml]. After correction, the differences were statistically significant ( P c<0.05). At the same time, the levels of serum TNF-α [7.40(5.60,10.95) pg/ml]and IL-10 [5.00(5.00, 7.58) pg/ml] in AOSD group were significantly higher than those in HC group[7.15(5.93,8.00) pg/ml,5.00(5.00,5.00) pg/ml] after correction ( P c<0.05). At the same time, the levels of serum TNF-α and IL-10 in AOSD group were higher than those in HC group. The serum levels of IL-6 and IL-8 in patients with active AOSD, BS, SLE and TA were significantly higher than those in patients without active disease (all P<0.05). In addition, the level of serum IL-8 in lupus nephritis group was significantly higher than that in non-lupus nephritis group ( P<0.05). At the same time, the serum levels of IL-6, IL-8 and TNF-α in neuropsychiatric lupus erythematosus group were significantly higher than those in non-neuropsychiatric lupus erythematosus group ( P<0.05), but there was no significant difference in IL-10 between neuropsychiatric lupus group and non-neuropsychiatric lupus erythematosus group. Conclusions:there was a close relationship between AID and cytokines. At present, the change of serum IL-6 level was the most classic one in clinical routine.

Objective:To understand the current situation of physicians′ innovative behavior and its influencing factors in Beijing municipal hospitals, for reference in improving their innovation ability and encouraging high-quality development of public hospitals.Methods:A stratified sampling was conducted with 22 practicing (assistant) physicians in Beijing municipal hospitals as subjects. From October to November 2022, a questionnaire survey was conducted to understand the innovative behavior, innovative self-efficacy and innovative atmosphere of such practicing (assistant) physicians. SPSS 25.0 was used for descriptive analysis of the data, while t-test, variance analysis and linear regression were used for univariate analysis. Furthermore, multiple linear regression was adopted to explore the influencing factors of innovative behavior of such practicing(assistant) physicians. Results:A total of 2 178 questionnaires were distributed in this study, and 1 906 valid ones were recovered, with effective recovery of 87.51%. Scores of innovative behavior, innovative self-efficacy and innovative atmosphere of 1 906 practicing (assistant) physicians scored (4.00±0.70) points, (3.85±0.74) points and (3.98±0.66) points respectively. The results of univariate analysis showed scores of statistical significance regarding the innovative behavior of practicing (assistant) physicians with different marital status, educational background, professional title, position, department type, innovative self-efficacy level and innovative atmosphere level. Multiple linear regression results showed that position, innovation self-efficacy score, innovation atmosphere score and subordinates′ incentive mechanism, as well as teamwork and resource security had statistical significance on innovation behavior score.Conclusions:The practicing (assistant) physicians in Beijing municipal hospitals are highly enthusiastic for innovation, but their innovative behavior is expected to be upgraded. In this regard, public hospitals should improve their innovation incentive mechanism, strengthen resource assurance, encourage cooperation and exchange, and create a desirable atmosphere for innovation. Furthermore, greater supply of continuing education resources is expected, supporting these physicians in their further study, advanced education, and promotion of professional titles.

Objective To establish and evaluate chemotherapeutic phlebitis model rats induced by vinorelbine via the dorsalis pedis vein.Methods Rats were divided randomly into control and 4 different concentration of vinorelbine-induced model groups.Control rats were injected with 0.1 mL normal saline via the dorsalis pedis vein of the hind limb,while other rats were injected with different concentrations of vinorelbine(2,3,4,5 mg/mL),as above.General observations were performed and the hind limb volume was measured daily for 7 consecutive days to calculate the swelling rate.The rats were then killed and histological changes in the dorsalis pedis vein were observed by hematoxylin and eosin staining.Microstructural changes on the surface of the vascular endometrium were observed by scanning electron microscopy.Results Injection of 2,3,4,5 mg/mL vinorelbine via the dorsalis pedis vein significantly induced hind limb swelling in a concentration-dependent manner,peaking on day 3 in each group.The phlebitis rates on day 7 were 50%in the 2 mg/mL group and 83.3%in the 3 mg/mL group.Phlebitis was also induced in the 4 mg/mL and 5 mg/mL groups,including grade Ⅲ in 66.6%and grade Ⅳ in 83.3%.Histopathology showed inflammatory cell infiltration,wall thickening,lumen stenosis,and thrombosis in the tissues surrounding the veins.Scanning electron microscopy showed destruction of tight junctions of venous endothelial cells,and a rough surface of the vascular lining,resultsing in blood cell adhesion.Conclusions Injection of 0.1 mL of 3～5 mg/mL vinorelbine via the dorsalis pedis vein could induce red,swollen,and cord-like veins,as well as infiltration of inflammatory cells around the vein,thickened vein walls,lumen stenosis,and thrombosis.In addition,the surface of the venous intima was rough and adhered to numerous blood cells.All these features are consistent with those of clinical chemotherapeutic phlebitis in terms of the symptoms and pathological structure.

Objective To explore the diagnostic value of tumor necrosis factor-alpha (TNF-α) , interleukin-6 (IL-6) and neuron enolase (NSE) in the cerebrospinal fluid of children with central nervous sys-tem infection (CNSI).Methods 54 cases of CNSI hospitalized children ,admitted in the hospital from October 2015 to January 2017 ,were enrolled in the study and divided into viral meningitis group (30 cases) and suppu-rative meningitis group (24 cases).Another 20 cases who underwent cerebrospinal fluid examination and other related examinations were enrolled in the study as the control group.The levels of three biomarkers TNF-α , IL-6 and NSE in cerebrospinal fluid of three groups were detected by enzyme linked immunosorbent assay (ELISA).Results The levels of TNF-α ,IL-6 and NSE in purulent meningitis group were the hightest ,and the levels of these three factors in viral meningitis group were highter than the control group ,and the differ-ence was statistically significant in three groups (P＜0.05).But there were a lot of data overlaps.There was no significant difference in the levels of TNF-α ,IL-6 and NSE between the brain group and the control group (P＞0.05).Conclusion The detection of TNF-α ,IL-6 and NSE in cerebrospinal fluid has a certain clinical val-ue for the diagnosis of CNSI ,but it needs to be further verified by a large sample clinical trial.

Objective To observe the clinical efficacy of acupuncture plus auricular point sticking in treating polycystic ovary syndrome (PCOS). Method A total of 80 PCOS patients were randomly divided into a treatment group of 40 cases and a control group of 40 cases. The treatment group was intervened by acupuncture plus auricular point sticking, while the control group was intervened by acupuncture only. The clinical efficacy was observed in the two groups after 3 treatment courses. Result The menstrual condition and basal body temperature (BBT) were compared in the two groups before and after the treatment. The menstrual condition and BBT in the treatment group were significantly improved (P<0.01); the menstrual condition was improved (P<0.05) and the BBT condition was significantly improved in the control group (P<0.01). The total effective rate was 82.5% in the treatment group, significantly different from that in the control group (P<0.05). Conclusion Acupuncture plus auricular point sticking can produce a satisfactory efficacy in treating PCOS.

ObjectiveTo investigate the effect of delayed cord clamping on outcomes of neonatal resuscitation.MethodsTotally, 7 429 full term infants born in the Maternal and Child Health Care Hospital of Jilin from January 2013 to January 2015 were randomly divided into two groups, the observation group (n=3 727) and the control (n=3 702). The cords were clamped 2 min delayed in the former group, while those in the latter group were clamped within 10 s after birth. The rate of asphyxia and successful resuscitation, Apgar score at 1 and 5 min after birth, and pH value, base excess (BE), blood glucose, cardiac troponin (cTn) I at 1 h after birth were compared witht-test orChi-square test.ResultsThe incidence of neonatal asphyxia in the observation group was lower than in the control [0.75%(28/3 727) vs 1.21%(45/3 702),χ2=4.115,P<0.05], but no significant difference was found in the rate of mild or severe asphyxia between the two groups [0.62% (23/3 727) vs 0.89% (33/3702), 0.13% (5/3 727) vs 0.32% (12/3 702), allP>0.05]. In observation group, those newborns who suffered from severe asphyxia had higher Apgar score at 1 and 5 min than control (1 min: 2.80±0.45 vs 2.08±0.67,t=2.181; 5 min: 8.00±1.00 vs 6.25±1.66,t=2.176; bothP<0.05). Higher blood pH value and lower glucose level were shown in the observation group than in the control group [7.16±0.41 vs 7.13±0.72, (5.91±1.19) vs (6.60±1.56) mmol/L,t=2.068 and 2.046, bothP<0.05]. However, no difference was found in BE and cTnI levels between the two groups (bothP>0.05). For those babies with severe asphyxia, the blood pH, BE, blood glucose and cTnI levels in the observation group were significantly different from the control group [7.08±0.29 vs 7.02±0.56, (-16.82±0.60) vs (-17.43±0.35) mmol/L, (7.93±0.78) vs (8.02±0.53) mmol/L and (0.203±0.041) vs (0.249±0.035) ng/ml,t=2.270, 2.387,-2.371 and-2.341, allP<0.05].Conclusion Two minutes delayed in cord clamping could help to reduce the incidence of asphyxia and improve the effect of resuscitation in severe asphyxia.

Recent years found a series of severe incidents of injuring or killing medical workers in several places in China,deteriorating patient-physician relations,and disturbing medical orders.Beijing Administration of Hospitals,since its founding,has attached great importance to the management of medical disputes,as evidenced in the full-process management covering pre-during-post disputes.The administration guided the hospitals in their dispute resolution,and included resolution rate of disputes as an index of municipal hospital performance evaluation.By means of the guidance of such evaluation, medical disputes and major medical accidents have been resolved satisfactorily,and fine management of service quality of such hospitals in terms of medical service,pharmacy,nursing and medical technology has been intensified all the time.

Objective To investigate the effects of cardiopulmonary resuscitation ( CPR ) training for residents in suburb of Beijing , and analyze its influential factors .Methods A total of 116 Residents in suburban district of Beijing received CPR training course according to 2010 ACC/AHA CPR guidelines, and chest compression related skills were tested immediately after CPR training .Results A total of 116 residents compressed (44.39 ±10.21) mm and of which adequate compression rate was 30.2% (35/116).78.4%(91/116) participants performed which was ( 118.70 ±22.81 )/min adequate mean compression rate . Residents with different ages and level of education presented different compression depth ( t/F =2.960, 4.149, respectively;P<0.05) and rate (t/F=2.037,6.587, respectively;P<0.05).Conclusions The quality of CPR is impacted by ages , the level of education and other factors among Beijing suburban residents , and the depth of compression is the key and difficult point during training .

Objective To investigate the relationship between early brain menifestation such as white matter damage and ventriculomegaly detected by magnetic resonance imaging(MRI) and adverse neurodevelopmental outcome in preterm infants.Methods From March 15,2007 to April 12,2011,122 preterm infants accepted MRI examination 8-14 days after birth in Chinese People's Liberation Army 202 Hospital.Totally,115 preterm infants were followed up at 12 months old and mental development index(MDI) and psychomotor development index (PDI) score were measured.MDI＜70 was as mental dysfunction,-84 as borderline dysfunction and-114 as normal; PDI＜70 was as psychomotor dysfunction,-84 as borderline dysfunction and-114 as normal.The relationship between clinical characteristics of preterm infants,MRI abnormalities and neurodevelopmental outcome were analyzed by analysis of variance,LSD and Kruskal-Wallis H test.Results The 122 premature infants included 69 males and 53 females with the median gestational age of 32 weeks(28-36 weeks)and the median birth weight of 2050 g (1270-3110 g).In 24 premature infants with mentaldysfunction,the average gestational age [(28.7 ± 1.7) weeks],birth weight[(1520.1-44.8) g] and 1 min Apgar score (5.5 ± 0.8) were all lower than those in normal infants [n =59,(33.5 ± 2.2)weeks,(2240.4 ± 47.1) g and 7.1 ± 0.8],while the average mechanical ventilation time was longer [(20.4±5.8) dvs (5.6±2.7) d](t=2.37,2.49,2.13 and 2.44,P＜0.05).In 20 premature infants with psychomotor dysfunction,the average gestational age [(27.9 ±± 1.4) weeks],birth weight [(1515.6±43.7) g],1 min Apgar score (5.6t0.5) were lower than those in normal infants [n=62,(33.2±2.4) weeks,(2264.3±42.5) g and 7.2±0.6],while the mechanical ventilation time was longer [(18.2±4.7) dvs (5.3±2.2) d](t=2.28,2.52,2.09 and 2.38,P＜0.05).Among thirteen preterm infants with severe white matter damage,eleven and nine developed mental or psychomotor dysfunction respectively.Among eleven preterm infants with moderate and severe ventriculomegaly,seven and six developed mental or psychomotor dysfunction respectively.The more severe the white matter damage and ventriculomegaly,the higher the incidence of mental (H=16.23 and 14.33,P＜0.05) and psychomotor dysfuction (H =18.63 and 12.69,P ＜ 0.05).Conclusions White matter damage is common in preterm infants.Prognosis of preterm infants with mental and psychomotor dysfunction is related with the degree of white matter damage and ventriculomegaly.

Objective To detect the value of autoantibedy profile in primary biliary cirrhosis (PBC). Methods 96 serum samples of patients with primiary biliary cirrhosis, 100 serum samples of other antoimmune disease and 49 serum samples of healthy were tested for anti- M2, anti-3E(BPO), anti-Sp100,anti-PML,anti-gp210,anti-LKM-1 ,anti-LC-1 ,anti-SLA/LP by EUROLine. Results The positive of the anti-M2,anti-BPO, anti-Sp100, anti-PML and anti-gp210 for PBC was 76. 0%, 84.4%, 32. 3%, 28. 1% and 35.4% ,respectively. The positive of the anti-M2, anti-BPO, anti-Sp100, anti-PML and anti-gp210 for other autoimmune disease was 13.0% ,9. 0% ,3.0% ,2.0% and 1. 0%, respectively. The sensitivity of the anti-M2 for PBC was 76. 0% ,with specificity of 87. 0%. The sensitivity of the anti-BPO for PBC was 84. 4%, with specificity of 91.0% ;the sensitivity of the anti-Sp100 for PBC was 32. 3%, with specificity of 97.0%. The sensitivity of the anti-PML for PBC was 28. 1% ,with specificity of 98.0%. The sensitivity of the anti-gp210 for PBC was 35.4%, with specificity of 99. 0% . Anti-LKM-1, anti-LC-1, anti-SLA/LP positive patients with PBC were not detected;the incidence rate of liver function failure in anti-gp210 positive serum higher than anti-gp210 negative serum (χ2 = 11.17, P < 0. 01). Conclusions Multiple autoantibedies can be detected in the sera of PBC patients. The detection of autoantibody profile is useful for the diagnosis and differential diagnosis of PBC, and may he helpful for therapy and prognosis of PBC.