Objective:To analyze the risk factors of bronchopulmonary dysplasia(BPD)in very preterm infants(VPI), and to provide scientific basis for the prevention and treatment of BPD in VPI.Methods:A prospective multicenter study was designed to collect the clinical data of VPI in department of neonatology of 28 hospitals in 7 regions from September 2019 to December 2020.According to the continuous oxygen dependence at 28 days after birth, VPI were divided into non BPD group and BPD group, and the risk factors of BPD in VPI were analyzed.Results:A total of 2 514 cases of VPI including 1 364 cases without BPD and 1 150 cases with BPD were enrolled.The incidence of BPD was 45.7%.The smaller the gestational age and weight, the higher the incidence of BPD( P<0.001). Compared with non BPD group, the average birth age, weight and cesarean section rate in BPD group were lower, and the incidence of male infants, small for gestational age and 5-minute apgar score≤7 were higher( P<0.01). In BPD group, the incidences of neonatal respiratory distress syndrome(NRDS), hemodynamically significant patent ductus arteriosus, retinopathy of prematurity, feeding intolerance, extrauterine growth restriction, grade Ⅲ~Ⅳ intracranial hemorrhage, anemia, early-onset and late-onset sepsis, nosocomial infection, parenteral nutrition-associated cholestasis were higher( P<0.05), the use of pulmonary surfactant(PS), postnatal hormone exposure, anemia and blood transfusion were also higher, and the time of invasive and non-invasive mechanical ventilation, oxygen use and total hospital stay were longer( P<0.001). The time of starting enteral nutrition, cumulative fasting days, days of reaching total enteral nutrition, days of continuous parenteral nutrition, days of reaching 110 kcal/(kg·d) total calorie, days of reaching 110 kcal/(kg·d) oral calorie were longer and the breastfeeding rate was lower in BPD group than those in non BPD group( P<0.001). The cumulative doses of amino acid and fat emulsion during the first week of hospitalization were higher in BPD group( P<0.001). Multivariate Logistic regression analysis showed that NRDS, invasive mechanical ventilation, age of reaching total enteral nutrition, anemia and blood transfusion were the independent risk factors for BPD in VPI, and older gestational age was the protective factor for BPD. Conclusion:Strengthening perinatal management, avoiding premature delivery and severe NRDS, shortening the time of invasive mechanical ventilation, paying attention to enteral nutrition management, reaching whole intestinal feeding as soon as possible, and strictly mastering the indications of blood transfusion are very important to reduce the incidence of BPD in VPI.

Objective: To describe the influence of post-operative anatomical structure changes on nasal airflow characteristics by 3D reconstruction and numerical simulation in real cases after nasalisation with Draf Ⅲ so as to explore the correlation between the changes of anatomical structure and subjective symptoms as well as airflow characteristics. Methods: Ten patients underwent nasalization with Draf Ⅲ in Department of Rhinology in Beijing Tongren Hospital from 2006 to 2018 were selected retrospectively. Postoperative follow-up of all patients was more than 1 year. All patients had no abnormalities in their paranasal sinus CT scans and Lund-Kennedy scores were 0 except scar. VAS scores including nasal obstruction, stimulation in frontal sinus, and headache were collected at the same period. The control model was a normal person. Numerical simulation was used for calculating airflow characteristics in deep inspiratory period of both models. Independent sample Mann-Whitney U test and Spearman correlation test were used by software SPSS 22.0. Results: The airflow pressure in frontal sinus ostium was (7.21±1.39)×10⁴ Pa (Mean±SD), which was lower than that in normal subjects (8.99×10⁴ Pa) under deep inspiratory simulation. But, the velocities in frontal sinus ostium and frontal sinus were (40.10±2.46) m/s and (28.19±1.73) m/s respectively, which were higher than those in normal one (2.70 m/s, 0.73 m/s). The airflow patterns of the two models were basically similar. There was no significant difference in the opening size and volume of frontal sinus between different groups after grouped by three symptoms respectively. No correlation could be found between the opening size and volume of the frontal sinus with the appearance and severity of three subjective symptoms. Conclusions The airflow pattern and distribution after nasalisation with Draf Ⅲ are like those of normal person. There is no correlation between the changes of anatomy in frontal recess and frontal sinus and nasal airflow characteristics as well as subjective symptoms.

Objective Through the visual analysis of the literature about the psychological distress in core journals of the Web of Science database for improving the quality of life of clinical patients and providing the reference for formulating targeted nursing measures. Methods CiteSpace V information visualization software was used to visualize and analyze 854 articles on psychological distress in the field of nursing from January 1,2008 to December 31,2017 in core journals of the Web of Science database, and draw knowledge graph about research hotspots and research frontier. Results In the recent decade, the number of psychological distress research in the field of nursing in SCI has generally risen; the research focuses on the key words of depression, stress, breast cancer, anxiety and so on;the United States issued the highest volume of documents, mainland China ranked fifth, China Taiwan ranked seventh in core journals of the Web of Science database. Conclusion Chinese research on psychological distress in the field of nursing is still lagging behind western developed countries, and nursing staff in China should work hard.

Objective To observe the role of clinical pathway method of teaching in the new nurses pre-job standardization training, and provide evidence for the exploration of scientific teaching methods. Methods Make training manual for new nurses on the basis of clinical path model. New nurses were assigned randomly to clinical pathway group (29 cases) and control group (28 cases). The clinical pathway and effective quality supervision were adopted in clinical pathway group, and the traditional teaching method were adopted in control group. The level of theory, basic skills, professional skills were evaluated, and satisfaction of teaching method and self-assessment were collected and analyzed. Results The results of theory, basic skills, and professional skills in clinical pathway group were (89.41 ± 5.07), (95.28 ± 2.96), (93.10 ± 2.86) points, and those in control group were (80.92 ± 7.64), (89.82 ± 3.77), (85.57 ± 5.33) points, the differences were significant (t=4.792, 6.083, 6.682, P=0.000).The number of satisfaction of teaching method was 28 cases in clinical pathway group and 22 cases in control group, the difference was significant (Z=38.316, P=0.000). Learning motivation, the ability of autonomous learning, communication, problem analyzing and solving, critical thinking, and the nursing behavior standardization in the self-assessment part in clinical pathway group were all better than those in the control group, the differences were significant (Z=-3.938~-2.143, P<0.01 or 0.05). Conclusions The application of clinical pathway method in new nurses pre-job training could effectively improve the level of theory, basic skills and professional skills, increase their satisfaction of teaching method and self-assessment.

Objective To explore the influence of nursing intervention on the pocket infection and other related problems following CRT-D therapy in chronic heart failure patients.Methods The causes of pocket machinery burst and skin incision dehiscence,pocket bleeding or hematoma and pocket infection following CRT-D therapy from March 2008 to March 2011 were reviewed,then analyzing and summarizing them to work out a detailed nursing interventions plan.During April 2011 to June 2013,nurses carried out the nursing intervention on patients who accepted CRT-D implantation.At last we compared the occurrence of pocket machinery burst and skin incision dehiscence,pocket bleeding or hematoma and pocket infection during the period of 6 months after CRT-D therapy between the two groups.Results After the implementation of nursing interventions,the incidence of pocket infection and other related problems following CRT-D therapy in chronic heart failure patients reduced significantly.Conclusions The interventions such as rigorous preoperative skin preparation,eliminating the potential factors of infection,intraoperative strict aseptic operation,choosing the appropriate position of pocket,the implementation of interventions to prevent bleeding,meticulous and rigorous postoperative nursing,providing healthy knowledge sufciently and strengthening follow-up,finding problems and solving them timely can prevent the pocket machinery burst and skin incision dehiscence,pocket bleeding or hematoma and pocket infection following CRT-D therapy effectively.

Objective To evaluate the role of high-dose chemotherapy combined with autologous hematopoietic stem cell transplantation in relapsed/refractory marginal zone lymphomas. Methods The transplant database was reviewed retrospectively from Tianjin Medical University Cancer Hospital identified 12 patients who underwent high-dose chemotherapy combined with autologous hematopoietic stem cell transplantation. Results Among the twelve patients who underwent autologous hematopoietic stem cell transplantation, the median duration of progression-free survival (PFS) was 104 months and the median duration overall survival (OS) was 117 months; 6 patients were still alive with disease-free. Conclusion High-dose chemotherapy combined with autologous hematopoietic stem cell transplantation is feasible to patients with relapsed/refractory marginal zone lymphomas, particularly to those insensitive to rituximabincluded combined chemotherapy.

Objective: To evaluate the efficacy and toxicity of rituximab combined with cyclophosphamide, pirarubicin, vincristine, and prednisone (R-CTOP regimen) for B cell non-Hodgkin's lymphoma and to analyze the influential factors for patient response.Methods: The clinical data of patients with CD20 antigen treated with R-CTOP regimen were reviewed and the influence of sex, age, clinical stage, pathological type, and level of LDH and IPI on patient response was analyzed.Results: A total of 33 patients were evaluated for objective response.The complete response (CR) rate was 51.5%, the par-ticel response (PR) rate was 33.3%, and the overall response rate was 84.8%.For the 23 de novo patients, the CR rate was 56.5 %, the PR rate was 34.8%, and the OR rate was 91.3%.While in the 10 recurrent patients, the CR rate was 40%, the PR rate was 30%, and the OR rate was 70%.Sex, clinical stage, pathological type, and the level of LDH and IPI were not significantly related to clinical response.While patient age was related to clinical response.None of the patients died of therapy-related side effects.The most frequent adverse event was myelosuppression (Ⅲ-Ⅳ decrease of leukocyte account-ed for 32.1%).Cardiotoxicity and alopecia were mostly grade Ⅰ to grade Ⅱ.Other side effects can be tolerated after symp-tomatic treatment.Conclusion: R-CTOP regimen is a highly effective and well-toleraed therapy and should be the first choice in the treatment for B cell non-Hodgkin's lymphoma (NHL), especially for senior patients.

Objecfive To study T cell subsets distribution in peripheral blood from patients with ankylosing spondylitis(AS)and the role of cell immunity in AS.Methods 30 patients with untreated active phase AS and 30 healthy volunteers were enrolled.The expression of CD4+ and CD8+ T cell subsets were evaluated by flow eytome try.The correlation among T cell subsets and Bath AS function index(BASFI).Bath AS measurement index(BASMI),course of disease,age,ESR,hyper-sensitive C-reactive protein (hs-CRP) were analyzed.Results The level of CD4+ T cell and CD4/CD8+ratio were significantly lower than that of healthy volunteers[(29.24±9.22)% vs.(40.09±6.86) %,(0.96±0.49 ) vs.(1.70±0.67 ),P ＜ 0.01 ],and CD8+ T cell were significantly higher than that of healthy volunteers [(32.91±6.86) % vs.(25.60± 5.97 ) %,P ＜ 0.01 ].The level of CD4+ T cell subsets in peripheral blood of AS patients was negatively correlated with BASMI (r =-0.479,P ＜ 0.01 ),and CD8+ T cell subsets were positively correlated with ESR,hs-CRP,BASFI and BASMI ( r = 0.373,0.430,0.462,0.530,P ＜0.05 ).The ratio of CD4+/CD8+ was negatively correlated with hs-CRP,BASFI and BASMI (r = -0.465,- 0.473,- 0.426,P ＜ 0.05 ).CD4+,CD8+,ratio of CD4/CD8 were not significantly correlated with age and course of disease in patients with AS.Conclusion T cell subsets are significantly abnormal in peripheral blood of patients with AS,and the imbalance degree of T cell is correlated with severity and activity of AS,suggesting that T cell subsets imbalance plays an important role in the pathologensis of AS.

Objective To evaluate the efficacy and safety of fludarabine and pirarubicin (FT) regimen in the treatment of refractory or relapsed indolent non-Hodgkin lymphoma (NHL). Methods A total of 40 patients with relapsed or refractory indolent NHL were treated with FT regimen, one cycle for 28 days, total 6 cycles. The data of indolent NHL patients treated with fludarabine, noventrene and dexamethasone (FND) regimen were collected as control. Results 40 patients were given 228 cycles chemotherapy, overall response rate was 62.5 %, median progression-free survival was more than 20 months and 2 years overall survival rate was 70.0 %. The main toxicities was leucopenia (80.0 %), but the incidence of WHO Ⅲ-Ⅳ leucopenia and pneumonia was less than that of in the control group, the rate were 12.5 % vs 29.0 % and 2.5 % vs 23.0 % respectively (P <0.05). Conclusion The efficacy of FT regimen was as good as FND regimen, but the incidence of leucopenia and pneumonia by Ⅲ-Ⅳ was lower in FT group than in FND group. So the FT regimen was an effective and safe second-line salvage regimen for relapsed or refractory indolent non-Hodgkin lymphoma.

Objective To investigate the clinical features and prognostic factors of nasal type NIGT cell lymphoma(NKTCL).Methods Records of 61 patients with pathologically confirmed nasal type NKTCL were reviewed.Detailed clinical and laboratory data were included in univariate analysis, and statistically significant factors in univariate analysis were then included in multivariate analysis.Results In univariate analysis,Ann Arbor stage,performance status,IPI,number of extra-lymphatic site,B symptoms,LDH and β-MG level.were found to be the prognostic factors associated with time to overall survival in nasal type NKTCL.In multivariate analysis, Ann Arbor stage,performance status,LDH and β2-MG level were independent prognostic factors of overall survival.Conclusion Ann Arbor stage,performance status,LDH and β2-MG level were demonstrated as independent prognostic factors of the overall survival in nasal type NKTCL.