Objective To study the influencing factors of postoperative recurrence of vocal cord leukoplakia and establish a clinical prediction model.Methods A total of 386 patients with vocal cord leukoplakia treated in our hospital from February 2016 to February 2020 were selected retrospectively.According to the follow-up results,the patients were divided into two groups:recurrent group(n=89)and non-recurrent group(n=297).The general and clinical data of the two groups were collected.The influencing factors of postoperative recurrence of vocal cord leu-koplakia were screened by univariate analysis and Logistic regression analysis,and the Logistic risk prediction model was established.The model was internally verified by R software and boostrap method.Results Age(OR=0.924),drinking history(OR=1.946),voice abuse(OR=2.436),laryngopharyngeal reflux(OR=0.487),mod-erate dysplasia(OR=0.420)and severe dysplasia(OR=0.303)were the influencing factors of postoperative recur-rence of vocal cord leukoplakia.The internal verification AUC of the model was 0.777,95％the confidence interval was 0.663～0.825,and the model fit well.Conclusion The postoperative recurrence of vocal cord leukoplakia is related to the patient's age,leukoplakia range,pathological morphology and laryngopharyngeal reflux.

Objective:To explore the mediating effect of e-health literacy on disease control and lifestyle of type 2 diabetes patients.Methods:From June 2022 to June 2023, 337 patients with type 2 diabetes who visited Beijing Friendship Hospital, Capital Medical University were selected by convenience sampling. The patients were investigated with General Information Questionnaire, e-Health Literacy Scale (eHEALS), Control Status Scale for Diabetes (CSSD), and Health Promoting Lifestyle ProfileⅡ (HPLP-Ⅱ). Pearson correlation was used to analyze the correlation between e-health literacy, disease control, and lifestyle. AMOS 21.0 software was used to establish a structural equation model and perform mediating effect validation. A total of 337 questionnaires were distributed, and 315 valid questionnaires were collected, with an effective responding rate of 93.47% (315/337) .Results:Among 315 patients with type 2 diabetes, the score of eHEALS was (20.13±5.28), among which the scores of application ability, judgment ability and decision-making ability were (14.33±4.16), (4.06±1.34) and (1.74±0.50) respectively. The CSSD score was (77.38±9.24), and the HPLP-Ⅱ score was (159.37±21.03). The eHEALS score, application ability score, judgment ability score, and decision-making ability score were all positively correlated with CSSD score and HPLP-Ⅱ score ( P<0.05), and the CSSD score was positively correlated with the HPLP-Ⅱ score ( P<0.05). Lifestyle had a direct effect on disease control (β=0.363, P<0.01), e-health literacy had a direct effect on disease control (β=0.440, P<0.01), e-health literacy partially mediated the relationship between lifestyle and disease control (β=0.322, P<0.01), and the mediating effect accounted for 47.01% of the total effect. Conclusions:The e-health literacy of patients with type 2 diabetes is low as a whole, especially the judgment ability and decision-making ability. The e-health literacy plays a partial mediating role between disease control and lifestyle.

Recent studies have highlighted spatially resolved multi-omics technologies,including spatial genomics,transcriptomics,proteomics,and metabolomics,as powerful tools to decipher the spatial heterogeneity of the brain.Here,we focus on two major approaches in spatial transcriptomics(next-generation sequencing-based technologies and image-based technologies),and mass spectrometry imaging tech-nologies used in spatial proteomics and spatial metabolomics.Furthermore,we discuss their applications in neuroscience,including building the brain atlas,uncovering gene expression patterns of neurons for special behaviors,deciphering the molecular basis of neuronal communication,and providing a more comprehensive explanation of the molecular mechanisms underlying central nervous system disorders.However,further efforts are still needed toward the integrative application of multi-omics technologies,including the real-time spatial multi-omics analysis in living cells,the detailed gene profile in a whole-brain view,and the combination of functional verification.

Model informed precision dosing for warfarin is to provide individualized dosing by integrating information related to patient characteristics, disease status and pharmacokinetics /pharmacodynamics of warfarin, through mathematical modeling and simulation techniques based on the quantitative pharmacology. Compared with empirical dosing, it can improve the safety, effectiveness, economy, and adherence of pharmacotherapy of warfarin. This consensus report describes the commonly used modeling and simulation techniques for warfarin, their application in developing and adjusting dosing regimens, medication adherence and economy. Moreover, this consensus also elaborates the detailed procedures for the implementation in the warfarin pharmacy service pathway to facilitate the development and application of model informed precision dosing for warfarin.

Objective:To explore the effect of insulin pump management led by diabetes specialist nurses in elderly diabetic patients.Methods:From January 2019 to December 2020, convenience sampling was used to select 149 patients with type 2 diabetes mellitus who used insulin pumps during hospitalization in the Department of Geriatrics, Beijing Friendship Hospital, Capital Medical University. Among them, the patients from January to December 2019 were in the control group (71 cases) , and the patients from January to December 2020 were in the observation group (78 cases) . During the use of insulin pump, the two groups were treated with conventional insulin pump management and insulin pump management led by diabetes specialist nurses. The blood glucose fluctuation coefficient, the time to reaching blood glucose target, insulin pump-related negative events, and insulin pump-related knowledge and skills were compared between the two groups.Results:The blood glucose fluctuation coefficient of the observation group was lower than that of the control group, and the time to reaching blood glucose target was shorter than that of the control group, and the differences were statistically significant ( P<0.01) . The incidences of insulin pump-related negative events in the control group and the observation group were 57.75% (41/71) and 20.51% (16/78) , respectively, and the difference was statistically significant (χ 2=21.815, P<0.01) . After intervention, the insulin pump-related knowledge and skills in the observation group were better than those in the control group, and the difference was statistically significant ( P<0.01) . Conclusions:The insulin pump management led by diabetes specialist nurses is beneficial to patients' blood glucose control, can reduce the incidence of insulin pump-related negative events, and improve patients' insulin pump-related knowledge and skills.

Stroke is considered a leading cause of mortality and neurological disability, which puts a huge burden on individuals and the community. To date, effective therapy for stroke has been limited by its complex pathological mechanisms. Autophagy refers to an intracellular degrading process with the involvement of lysosomes. Autophagy plays a critical role in maintaining the homeostasis and survival of cells by eliminating damaged or non-essential cellular constituents. Increasing evidence support that autophagy protects neuronal cells from ischemic injury. However, under certain circumstances, autophagy activation induces cell death and aggravates ischemic brain injury. Diverse naturally derived compounds have been found to modulate autophagy and exert neuroprotection against stroke. In the present work, we have reviewed recent advances in naturally derived compounds that regulate autophagy and discussed their potential application in stroke treatment.

Objective: To describe the characteristics of clinical manifestations and epidemiology of children with 2019 novel coronavirus (2019-nCoV) infection. Methods: All 34 children with laboratory-confirmed 2019-nCoV infection by quantitative real-time reverse transcription-PCR through nasopharyngeal swab specimens were admitted to the Third People’s Hospital of Shenzhen from January 19 to Febuary 7, 2020. Clinical data and epidemiological history of these patients were retrospectively collected and analyzed. Results: Among the 34 cases, 14 were males, and 20 were females. The median age was 8 years and 11 months. No patients had underlying diseases. There were 28 children (82%) related with a family cluster outbreak. There were 26 children (76%) with a travel or residence history in Hubei Province. These patients could be categorized into different clinical types, including 22 (65%) common cases, 9 (26%) mild cases and 3 (8.8%) asymptomatic cases. No severe or critical cases were identified. The most common symptoms were fever (17 cases, 50%) and cough (13 cases, 38% ). In the 34 cases, the white blood cell counts of 28 cases (82%) were normal. Five cases had white blood cell counts more than 10×10⁹/L. One case had white blood cell counts less than 4×10⁹/L. Neutropenia and lymphopenia was found in one case, respectively. C-reactive protein levels and erythrocyte sedimentation rates were elevated in 1 and 5 case, respectively. Elevated procalcitonin was found in 1 case and D-Dimer in 3 cases. The levels of lactic dehydrogenase (LDH) were more than 400 U/L in 10 cases. The CT images of these patients showed bilateral multiple patchy or nodular ground-glass opacities and/or infiltrating shadows in middle and outer zone of the lung or under the pleura. Twenty patients were treated with lopinavir and ritonavir. Glucocorticoids and immunoglobulin were not used in any cases. All the cases improved and were discharged from hospital. Further following up was need. Conclusions The clinical manifestations in children with 2019-nCoV infection are non-specific and are milder than that in adults. Chest CT scanning is heplful for early diagnosis. Children's infection is mainly caused by family cluster outbreak and imported cases. Family daily prevention is the main way to prevent 2019-nCoV infection.

Objective? To explore the correlation between frailty index of elder patients and quality of life of primary caregivers. Methods? Using convenience sampling method, 240 elderly inpatients and their main caregivers in Beijing Friendship Hospital, Capital Medical University from January to December 2017 were selected. According to the results of the Chinese version of Care Partner-Frailty Index-Comprehensive Geriatric Assessment (CP-FI-CGA) Questionnaire survey, the patients were divided into mild frailty group (＜0.3 points) with 88 patients, moderate frailty group(0.3-0.5) with 65 patients and severe group(＞ 0.5) with 87 patients, the MOS Item Short Form(SF-36) was used to evaluate the life quality of the main caregivers in each group and Spearman correlation analysis was used to analyze the correlation between the frailty index and the life quality of the main caregivers. Results? The CP-FI-CGA index (0.40±0.10) of elderly inpatients ranged from 0.03 to 0.87, which was at a moderate level of frailty. With the increase of the frailty index of elderly inpatients, the four dimensions of "overall health", "vitality", "social functioning" and "role emotional" of the main caregivers in each group gradually decreased, with statistical significance (P＜ 0.05). The scores of "general health","vitality" and "social functioning" dimensions in severe frailty group were lower than those in moderate frailty group and mild frailty group, and the scores of "role emotional" dimension in severe frailty group and moderate frailty group were lower than those in mild frailty group, with statistical significance (P＜ 0.05). Spearman correlation analysis showed that the elderly inpatients' frailty index was negatively correlated with their main caregivers' "general health", "vitality", "social functioning" and "role emotional" (P＜0.05), but not correlated with "physical functioning", "role physical", "bodily pain" and "mental health" (P＞0.05). Conclusions? The elderly inpatients are at a moderate level of frailty, the degree of frailty may mainly affect the quality of life of the main caregivers in the field of mental health.

Objective? To explore the frailty condition in elderly inpatients and analyze its influencing factors. Methods? Using convenience sampling method, 360 elderly patients with chronic diseases hospitalized in Beijing Friendship Hospital from May 2017 to September 2018 were selected as the subjects of this study. The incidence of frailty was investigated by Fried Weakness Phenotype Assessment. In addition, the general data and clinical related indicators of the subjects were collected, and the influencing factors of elderly patients' frailty were analyzed by univariate and multivariate analysis. Results? In this study, 89 patients with frailty were enrolled, accounting for 24.72%(89/360). Univariate analysis showed that there were statistically significant differences in gender, age, living conditions, sleep status, albumin level, hemoglobin level, fall risk, ability of daily living(ADL), cognitive function, mental health and nutritional risk condition between the frailty group and non-frailty group (P＜ 0.05). Multivariate logistic regression analysis showed that age, sleep status, fall risk, mental health and nutritional risk were the influencing factors of elderly hospitalized patients' frailty (P＜ 0.05). Conclusions? There is a high incidence of frailty in the elderly inpatients. Old age, poor sleep quality, high risk of falling, depression and malnutrition are the influencing factors of frailty. Therefore, it is suggested that comprehensive assessment should be carried out as soon as possible to improve the quality of life of elderly patients.

OBJECTIVETo report on a case of therapy-related acute monocytic leukemia(t-AML) with t(11;17) (q23;q21)/MLL-AF17q after successful treatment for acute promyelocytic leukemia(APL) with t(15;17) (q22;q21)/PML-RARα.

METHODSA MICM method (bone marrow morphology(M), immunophenotype(I), cytogenetics(C), and molecular biology(M)) was used for the diagnosis and classification of the disease at the time of onset and transformation.

RESULTSThe patient was initially identified with typical morphology and immunophenotype of APL. She has carried t(15;17)(q22;q21) and PML-RARα fusion gene but was without t(11;17)(q23;q21) or MLL gene abnormalities. After 13 months of successful treatment, she has transformed to AML with typical morphology and immunophenotype. t(11;17)(q23;q21) and MLL-AF17q fusion gene were detected in her bone marrow sample, while no PLZF-RARα fusion gene was detected by real-time quantitative reverse-transcription PCR(RQ-PCR) and fluorescence in situ hybridization(FISH).

CONCLUSIONt-AML is a serious complication after successful treatment of APL. t(11;17)(q23;q21) is not specific for the diagnosis of variant APL and can also be detected in t-AML. RQ-PCR and FISH are essential for the diagnosis of such patients.

Chromosomes, Human, Pair 11 ; Chromosomes, Human, Pair 15 ; Chromosomes, Human, Pair 17 ; Female ; Humans ; In Situ Hybridization, Fluorescence ; Leukemia, Monocytic, Acute ; genetics ; Leukemia, Promyelocytic, Acute ; genetics ; Middle Aged ; Neoplasms, Second Primary ; genetics