Objective: To investigate the status and influencing factors of influenza vaccination among the elderly, so as to provide insights into improving the strategies for influenza vaccination among the elderly. Methods: Elderly people aged 60 years and above were recruited from one community each in five sub-districts of Shihezi City, Xinjiang Uygur Autonomous Region using a random sampling method. Demographic information, knowledge about influenza and influenza vaccines, vaccine literacy and influenza vaccination status in the past year were collected through questionnaire surveys. Factors affecting influenza vaccination among the elderly were analyzed using a multivariable logistic regression model. Results: Totally 1 121 valid questionnaires were recovered, with an effective recovery rate of 95.08%. There were 417 males (37.20%) and 704 females (62.80%). The majority were aged 60-<81 years, accounting for 80.37% (901 individuals). The awareness of knowledge about influenza and influenza vaccines was 78.86%. Low vaccine literacy was observed in 786 individuals, representing 70.12%. The influenza vaccination rate was 20.96%. Multivariable logistic regression analysis showed that age (71-<81 years, OR=1.607, 95%CI: 1.041-2.479; ≥81 years, OR=1.719, 95%CI: 1.040-2.842), educational level (middle school/technical secondary school, OR=0.616, 95%CI: 0.416-0.911), medical expense payment (employee medical insurance, OR=6.531, 95%CI: 2.030-21.010; resident medical insurance, OR=3.385, 95%CI: 1.095-10.466; public expense, OR=4.828, 95%CI: 1.700-13.712), vaccination willingness (yes, OR=6.237, 95%CI: 3.277-11.871), influenza vaccination history (yes, OR=14.600, 95%CI: 8.733-24.408) and vaccine literacy (medium and above, OR=2.412, 95%CI: 1.636-3.555) were associated with influenza vaccination among the elderly. Conclusion The influenza vaccination rate among the elderly was relatively low, and was mainly affected by age, educational level, medical expense payment, vaccination willingness, influenza vaccination history and vaccine literacy.

Objective We systematically analyze the changes in the count and function of platelet at the early sepsis based on clinical study and single cell sequencing.Methods Clinical data of sepsis patients at the early stage were collected and had been compared between different prognostic groups in the prospective case-control study.The independent risk factors of death were analyzed by logistic regression,and the predictive efficacy of clini-cal indicators was evaluated by receiver operating characteristic(ROC)curve.The healthy volunteers and sepsis patients were recruited.Clinical researchers collected peripheral venous blood samples for sorting cell samples to carry out single-cell RNA sequencing(sc-RNA seq).Through bioinformatics techniques,we analyzed the changes in platelet count,the significantly differential-expressed genes and its enriched functional signaling pathways in the early stages of sepsis.Results(1)A total of 224 patients were enrolled,with a 90 day survival rate of 70.5%.Compared with the survival group,the count of platelet and MAP in the death group at the early stage of sepsis were significantly lower,but the plasma lactate content and SOFA score were significantly higher.(2)Based on single cell sequencing technology,cells are annotated as six groups.The proportion of innate immune cells(neutrophils,monocytes,and dendritic cells)was significantly increased in the early stage of sepsis compared to the healthy volun-teers(2.15∶1),while platelets significantly decreased(0.31∶1).(3)Through bioinformatics technology,CD41/CD42a/CD61 was identified as platelet specific molecules,with significantly increased expression levels in sepsis.Three molecules can distinguish platelets together.(4)771 genes were significantly upregulated and 1101 genes were significantly downregulated in platelets of patients with sepsis,including core molecules involved in physiological functions such as cell adhesion,chemotaxis,and immune response.Functional analysis suggests that differentially expressed genes are enriched in coagulation,immune functions and cell death,participating in oxidative phosphory-lation,leukocyte chemotaxis,iron death,and NOD like receptor signaling pathways.Conclusion Reduced platelet count is associated with poor prognosis in the early stage of sepsis.The specific high expression molecules CD41/CD42a/CD61 that are significantly upregulated in platelets can serve as biomarkers for platelets.Platelets not only mediate cell adhesion and coagulation cascade,but also participate in functional changes such as immune cell chemotaxis,inflammatory response,and the pathological death of inflammatory cells.

Objective:To investigate the efficacy and safety of daratumumab (Dara) - combination regimens for newly diagnosed multiple myeloma (NDMM).Methods:A retrospective case series study was conducted. The clinical data of 34 patients with NDMM receiving treatment regimen including Dara from Qilu Hospital of Shandong University, Yantai Yuhuangding Hospital, Huangdao Branch of Affiliated Hospital of Qingdao University and Taian City Central Hospital between April 2020 and March 2022 were retrospectively collected. The efficacy, survival and adverse reactions of patients were analyzed. Cox proportional risk model was used to analyze the factors affecting overall survival (OS) and minimal residual disease (MRD) turning negative.Results:Among 34 patients with NDMM, there were 19 males and 15 females, with 21 cases aged < 65 years and 13 cases aged ≥65 years. The median follow-up duration [ M ( Q1, Q3)] was 22 months (19 months, 26 months), the median of Dara treatment cycles was 7 (5, 11), and the overall response rate (ORR) reached 97.1% (33/34). There were statistically significant differences in the optimal efficacy of patients stratified by receiving hematopoietic stem cell transplantation or not and receiving different treatment cycles (all P ≤ 0.05), while there were no statistically significant differences in patients stratified by other clinical features (all P > 0.05). The 1-year progression-free survival rate was 79.4% and the 1-year OS rate was 94.1%. Multivariate Cox regression analysis showed that the cycle number of treatment regimens containing Dara was an independent influencing factor of MRD turning negative (6 cycles vs. 2 cycles, HR = 0.267, 95% CI: 0.076-0.935, P = 0.039); age ≥ 65 years was an independent risk factor for OS ( HR = 35.313, 95% CI: 1.709-729.669, P = 0.021). The incidence of hematological adverse reactions grade 3 or above was 20.6% (7/34), and the non-hematological adverse reactions primarily included infection [44.1% (15/34)] and edema of extremity and trunk [41.2% (14/34)]. Conclusions:The Dara-based regimens for NDMM exhibit a high ORR. The remission depth accelerated with the increasing number of treatment cycle, and the adverse reactions are mild.

Objective This study aims to investigate the role of genes related to fatty acid metabolism in periodon-titis through machine learning and bioinformatics methods.Methods Periodontitis datasets GSE10334 and GSE-16134 were downloaded from the GEO database,and the fatty acid metabolism-related gene sets were obtained from the GeneCards database.Differentially expressed fatty acid metabolism-related genes(DEFAMRGs)in periodontitis were screened using the"limma"R package.Functional enrichment and pathway analyses were conducted.Recursive Feature Elimination,Least Absolute Shrinkage and Selection Operator,and Boruta algorithm were used to determine hub DEFAMRGs and construct diagnostic models with internal and external validation.Subtypes of periodontitis relat-ed to hub DEFAMRGs were constructed using consis-tency clustering analysis.CIBERSORT was used to ana-lyze immune cell infiltration in gingival tissues and ex-plore the correlation between hub DEFAMRGs and im-mune cells.Results A total of 113 periodontitis DE-FAMRGs were screened out as a result.The enrichment analysis results indicate that DEFAMRGs are mainly associat-ed with immune inflammatory responses and immune cell chemotaxis.Finally,8 hub DEFAMRGs(BTG2,CXCL12,FABP4,CLDN10,PPBP,RGS1,LGALSL,and RIF1)were identified and a diagnostic model(AUC=0.967)was con-structed,based on which periodontitis was divided into two subtypes.In addition,there is a significant correlation be-tween hub DEFAMRGs and different immune cell populations,with mast cells and dendritic cells showing higher cor-relation.Conclusion This study provides new insights and ideas for the occurrence and development mechanism of periodontitis and proposes a diagnostic model based on hub DEFAMRGs to provide new directions for diagnosis and treatment.

Objective:To investigate the clinical features of IgD multiple myeloma (MM) and the effect and prognosis of daratumumab-based combination therapy.Methods:The clinicopathological data of a IgD MM patient with disease progression and extramedullary infiltration treated with daratumumab in the Affiliated Hospital of Qingdao University in December 2019 were retrospectively analyzed.Results:The 74-year-old woman was diagnosed as IgD MM by bone marrow aspiration and immunofixation electrophoresis. The patient was given VD (bortezomib, dexamethasone), RD (lenalidomide, dexamethasone) and ID (ixazomib, dexamethasone) regimens. In June 2020, the patient developed multiple subcutaneous nodules, and she was assessed as progressive disease with extensive extramedullary infiltration. After treated with daratumumab-PAD (liposomal doxorubicin, bortezomib, dexamethasone) regimen, the patient's subcutaneous nodules were significantly reduced and partially disappeared, and the general condition was significantly improved. But the patient was in a cachexia state and finally died of the irregular treatment and disease progression.Conclusions:IgD MM has a low incidence and a short survival period, and there is no uniform standard treatment. The early application of daratumumab combined with proteasome inhibitors, immunomodulators, cytotoxic drugs and hematopoietic stem cell transplantation may improve the overall survival of patients.

Background: Although bone tissue engineering has already been applied clinically, its regeneration efficacy is not always sufficient. Local inflammatory cytokines are considered as the major factors that induce apoptosis of transplanted cells, thus leading to insufficient new bone formation. In this study, we focused on the effects of interleukin (IL)-6 and tumor necrosis factor-alpha (TNF-α) on differentiation and apoptosis of compact bone-derived cells (CBDCs). Methods: CBDCs were obtained from mouse legs and cultured. The effects of TNF-α and/or IL-6 on the osteogenic differentiation and apoptosis of CBDCs were analyzed in vitro. To confirm the expression of local inflammatory cytokines in vivo, CBDCs were transplanted to the back of immunocompetent mice. Results: IL-6 exerted inconsistent effects on the expression of the different osteogenic markers tested, while significantly upregulating Fas. By contrast, the addition of TNF-α dramatically reduced the expression of all tested osteogenic markers and increased Fas expression. The highest dose of IL-6 could partially reverse the repressive effect of TNF-α, while the addition of IL-6 further increased Fas expression in CBDCs compared to TNF-α alone. The results from in vivo experiments showed the presence of transplants with and without new bone formation. The transplants without bone formation were characterized by higher IL-6 and lower IL-10 expression than those with bone formation, while the expression of TNF-α did not show notable difference. Conclusion The results of this study suggest an important role for IL-6 in modulating the efficacy of bone tissue engineering, which can affect osteogenic cells both positively and negatively.

Background: Although bone tissue engineering has already been applied clinically, its regeneration efficacy is not always sufficient. Local inflammatory cytokines are considered as the major factors that induce apoptosis of transplanted cells, thus leading to insufficient new bone formation. In this study, we focused on the effects of interleukin (IL)-6 and tumor necrosis factor-alpha (TNF-α) on differentiation and apoptosis of compact bone-derived cells (CBDCs). Methods: CBDCs were obtained from mouse legs and cultured. The effects of TNF-α and/or IL-6 on the osteogenic differentiation and apoptosis of CBDCs were analyzed in vitro. To confirm the expression of local inflammatory cytokines in vivo, CBDCs were transplanted to the back of immunocompetent mice. Results: IL-6 exerted inconsistent effects on the expression of the different osteogenic markers tested, while significantly upregulating Fas. By contrast, the addition of TNF-α dramatically reduced the expression of all tested osteogenic markers and increased Fas expression. The highest dose of IL-6 could partially reverse the repressive effect of TNF-α, while the addition of IL-6 further increased Fas expression in CBDCs compared to TNF-α alone. The results from in vivo experiments showed the presence of transplants with and without new bone formation. The transplants without bone formation were characterized by higher IL-6 and lower IL-10 expression than those with bone formation, while the expression of TNF-α did not show notable difference. Conclusion The results of this study suggest an important role for IL-6 in modulating the efficacy of bone tissue engineering, which can affect osteogenic cells both positively and negatively.

BACKGROUND: Preoperative anxiety/depression can bring physical and mental harm to the patients with lung cancer. There is little study on whether hospital waiting time before surgery can increase the psychological burden of patients with lung cancer. The aim of this study was to investigate the preoperative anxiety and depression of patients with lung cancer in our hospital, and to analyze the related influencing factors. METHODS: A total of 135 lung cancer inpatients in the Department of Thoracic Surgery of Beijing Friendship Hospital were studied. Their general information and anxiety/depression were recorded by general questionnaire, Zung self-rating anxiety scale (SAS) and self-rating depression scale (SDS). RESULTS: The score of SAS was 36.25 (30.00, 42.50) on the day of admission, and 37.50 (31.25, 43.75) on one day before operation. The score of self-rating depression scale (SDS) was 46.25 (40.00, 52.50) on the day of admission, and 47.50 (41.25, 53.75) on one day before operation. Compared with the Chinese norm, there were 0 patient suffered from anxiety on the day of admission, and one day before operation. There were 2 patients suffered from mild anxiety; 6 patients suffered from mild depression on the day of admission, and this number went up to 8 on the day before operation. Single factor analysis showed that the hospital waiting time before surgery was positively correlated with preoperative anxiety and depression, and the results were statistically significant (P<0.05). The generalized linear model analysis showed that other factors such as knowledge, gender, age and marital status had no significant correlation with preoperative anxiety and depression. CONCLUSIONS The occurrence of preoperative anxiety in hospitalized patients with lung cancer is positively correlated to the hospital waiting time before surgery. The longer they stayed in the hospital before operation, the greater their risk of anxiety/depression. So medical staff should actively focus on the psychological condition of the patients with lung cancer, and it is strongly recommended that patients complete preoperative examination and preparation in the outpatient department, in order to reduce the waiting time before operation and reduced the risk of adverse psychological problems such as anxiety and depression.

Objective To explore the influence of tranexamic acid used in different modes in total hip arthroplasty (T HA ) blood loss by control experiment .Methods 60 patients accepted total hip arthroplasty from orthopaedics in our hospital were se‐lected between March 2010 to August 2013 ,among them femoral neck fracture were 47 cases and 13 cases were osteonecrosis .aged between 45‐82 years old ,and 62 in average .All gave unilateral total hip arthroplasty .All patients were divided into three groups ,A group(contradistinction group) ,B ,C group(experiment group) .each groups include 6 men and 14 women ,no revision surgery pa‐tients .For group A ,100 mL normal saline was dripped both in half on hour before surgery and 3 hours after surgery ;For group B , tranexamic acid diluted in 100 mL normal saline according to 10 mg/kg was dripped half on hour before surgery ,100 mL normal sa‐line was dripped 3 hour after surgery ;For group C ,tranexamic acid diluted in 100 mL normal saline according to 10 mg/kg was dripped both half on hour before surgery and 3 hour after surgery .Compute and record the visible blood cell loss and hidden blood loss ,the comparative analysis was conducted to discuss the effectiveness and safety of tranexamic acid used in the two methods .Re‐sults The visible blood cell loss in each group were (196 .20 ± 44 .45)mL ,(114 .84 ± 35 .21)mL and (104 .47 ± 30 .01)mL ;hidden blood loss in each group were:(614 .50 ± 98 .41)mL ,(425 .74 ± 70 .01)mL and (337 .12 ± 52 .23)mL .Conclusion In the unilateral total hip arthroplasty ,the use of tranexamic acid can significantly reduce a significant amount of visible and hidden blood loss .Com‐pared with tranexamic acid dripped just half one hour before surgery ,dripping tranexamic acid both half one hour before surgery and 3 hour after surgery reduced more hidden blood loss ,decreased transfusion requirement ,and this does not significantly increase the risk of deep venous thrombosis .

Objective To analyze the initial response rate of radiotherapy and chemotherapy,and the influence of different treatment modalities on pmgnnsis of primary non-Hodgkin lymphoma(NHL)of the nascl cavity.Methods From January 1993 to December 2002,70 patients were confirmed by histopathology as NHL,including 52 T cell origin,2 B cell and 16 NK cell.The main radiotherapy portal was set in front of the nose with a spade like protrusion,supplement with a portal next to the ear on one side or both sides.Combined portal in facial cervical area was first used when there was invasion of the oropharynx.The median dose to the nasal cavity wag 54.0 Gy with a range of 336 to 66 Gy,given before or during after radiotherapy or alone,consisted of 2-6 cycles chemotherapy of COP,CHOP or COBDP.Prognostic factors were analyzed with Cox model. Results The local control rates was 12.5%, 66.7% and 74.0% in chemotherapy alone,radiotherapy alone,and chemotherapy plus radiotherapy.The 5-year survival rate Wag 12.5%,50.0% and 62.0%,respectively(P＜0.05).Multifaetor analysis showed that tumor extension and treatment methods were the most important prognostic factors besides Ann-Arbor stage,but gender,pathology,age and symptoms had little effect on prognosis.Conclusion Chemotherapy plus radiotherapy group achieved a better survival rate than radiotherapy alone.For some NHL patients with good financial condition,APBSCT is a good choice.