Objective To analyze the short-term survival and prognostic quality of life of patients with liver cirrhosis complicated by bacterial infection. Methods This study collected and analyzed 300 patients with liver cirrhosis complicated with infection who were hospitalized in the First Affiliated Hospital of Hebei North University, and followed up to discuss their survival and quality of life. Results In this study, the top two causes of infection were spontaneous bacterial peritonitis (60.67% of patients) and pneumonia (50.67% of patients). The second causes were urinary tract infections (15.33%), gastrointestinal infections (12.33%), and other causes. There was no statistically significant difference between male and female patients (P>0.05). In addition, the proportion of hospital infections was 71.00%, and there was no statistically significant difference between male and female patients (P>0.05). A total of 353 strains of pathogenic bacteria were isolated in this study (73.37% of patients with hospital infections). The distribution analysis of pathogenic bacteria showed that the highest proportion of ECO was 35.98%, followed by Klebsiella pneumoniae (18.98%). The distribution trend of 259 strains of pathogenic bacteria among hospital patients was consistent with that of all strains, and the difference was not statistically significant (P>0.05). Gram negative bacteria accounted for 79.60% (281/353) of all detected strains, of which Escherichia coli was mostly detected in patients with spontaneous bacterial peritonitis, Klebsiella Pneumoniae (KPN) and Pseudomonas aeruginosa (PAE) were mostly detected in patients with pneumonia, and Enterococcus (ENF) was mostly detected in patients with urinary tract infection; Among gram-negative bacteria, Staphylococcus epidermidis (SEP) and Staphylococcus aureus (SAU) are mostly found in patients with other infectious causes (blood flow infection, etc.) , and Streptococcus (STR) accounts for a high proportion in patients with Spontaneous bacterial peritonitis. In this study, 9 cases of death prognosis were detected during follow-up, and there was no statistically significant difference in the detection of death prognosis between different bacterial strains in both genders, as well as the difference in detection of death prognosis between hospital infections and out of hospital infections in both genders (P>0.05). There was no statistically significant difference in the detection of death prognosis between males and females due to different causes of infection, P>0.05. The quality of life scores of 291 surviving patients were compared between baseline and follow-up, indicating an increase in follow-up scores, especially in the dimensions of physiological function and physical pain. There was no statistically significant difference between different bacterial strains, infection causes, and hospital/non hospital infections (P>0.05) . Conclusion Spontaneous bacterial peritonitis and pneumonia are the main causes of infection that deserve special attention, and the main pathogens of infection are Gram negative bacteria. Targeted treatment and rehabilitation should be provided for patients with liver cirrhosis complicated by infection. At the same time, the proportion of hospital infections is relatively high, and attention should be paid to, prevention and control measures should be implemented as well.

Objective:To evaluate the efficacy and safety of hypomethylating agents (HMA) in patients with myelodysplastic syndromes (MDS) .Methods:A total of 409 MDS patients from 45 hospitals in Zhejiang province who received at least four consecutive cycles of HMA monotherapy as initial therapy were enrolled to evaluate the efficacy and safety of HMA. Mann-Whitney U or Chi-square tests were used to compare the differences in the clinical data. Logistic regression and Cox regression were used to analyze the factors affecting efficacy and survival. Kaplan-Meier was used for survival analysis. Results:Patients received HMA treatment for a median of 6 cycles (range, 4-25 cycles) . The complete remission (CR) rate was 33.98% and the overall response rate (ORR) was 77.02%. Multivariate analysis revealed that complex karyotype ( P=0.02, OR=0.39, 95% CI 0.18-0.84) was an independent favorable factor for CR rate. TP53 mutation ( P=0.02, OR=0.22, 95% CI 0.06-0.77) was a predictive factor for a higher ORR. The median OS for the HMA-treated patients was 25.67 (95% CI 21.14-30.19) months. HMA response ( P=0.036, HR=0.47, 95% CI 0.23-0.95) was an independent favorable prognostic factor, whereas complex karyotype ( P=0.024, HR=2.14, 95% CI 1.10-4.15) , leukemia transformation ( P<0.001, HR=2.839, 95% CI 1.64-4.92) , and TP53 mutation ( P=0.012, HR=2.19, 95% CI 1.19-4.07) were independent adverse prognostic factors. There was no significant difference in efficacy and survival between the reduced and standard doses of HMA. The CR rate and ORR of MDS patients treated with decitabine and azacitidine were not significantly different. The median OS of patients treated with decitabine was longer compared with that of patients treated with azacitidine (29.53 months vs 20.17 months, P=0.007) . The incidence of bone marrow suppression and pneumonia in the decitabine group was higher compared with that in the azacitidine group. Conclusion:Continuous and regular use of appropriate doses of hypomethylating agents may benefit MDS patients to the greatest extent if it is tolerated.

Scalp arteriovenous fistula (SAVF) is a rare complication of thread-lift sutures for facial rejuvenation.This article reports a 23-year-old female patient who suffered from entotic sounds in left ear after thread lifting. Then, the entotic sounds was gradually aggravated with palpitations. The cerebral angiography showed a high flow scalp arteriovenous fistula in the left temporal region, which got satisfactory result by endovascular embolization with coil and medical glue. There was no recurrence of the fistulas after one year of follow-up.

Scalp arteriovenous fistula (SAVF) is a rare complication of thread-lift sutures for facial rejuvenation.This article reports a 23-year-old female patient who suffered from entotic sounds in left ear after thread lifting. Then, the entotic sounds was gradually aggravated with palpitations. The cerebral angiography showed a high flow scalp arteriovenous fistula in the left temporal region, which got satisfactory result by endovascular embolization with coil and medical glue. There was no recurrence of the fistulas after one year of follow-up.

Objective:To investigate whether rumination and family functioning can predict the level of depression after 1 year of follow-up in patients with first-episode depression, and whether family functioning plays a mediating role between rumination and depression level.Methods:Sixty-five patients with first-episode depression who met the enrollment requirements were included, and all subjects were assessed the 17-item Hamilton depression scale(HAMD-17), rumination response scale(RRS) and family assessment device(FAD). All subjects were followed up for 1 year, and the predictive effects of rumination and family functioning at baseline on the level of depression after 1 year of follow-up were investigated by hierarchical linear regression analysis and mediation analysis.Results:At the baseline stage, rumination, role, affective involvement (AI) and general functioning (GF) were significantly positively associated with depression level after 1 year of follow-up in patients with first-episode depression ( r=0.49, P<0.01; r=0.30, P=0.02; r=0.43, P<0.01; r=0.50, P<0.01; respectively). Rumination, AI and GF at the baseline stage predicted depression level after 1 year of follow-up ( β=0.315, t=2.954, P=0.005; β=0.261, t=2.550, P=0.013; β=0.323, t=2.952, P=0.005). Mediation analysis showed that AI and GF partially mediated the relationship between rumination at baseline and depression level at 1 year follow-up (point estimate value for AI=0.040, 95% CI=0.012-0.090); point estimate value for GF=0.066, 95% CI=0.017-0.143). Conclusions:Rumination and family functioning at baseline in first-episode depressed patients can predict the depression level at 1 year follow-up.Family functioning partly mediates the relationship between the baseline rumination and the depression level at 1 year follow-up.

Objective:To evaluate the effectiveness and safety of the home-made umbrella-shaped Octoparms inferior vena cava filter in the prevention of pulmonary embolism.Methods:A multicenter, randomized, positive parallel controlled, non-inferiority clinical trial was conducted in ten hospitals in China from October 2017 to March 2019. A total of 188 subjects were enrolled according to the same inclusion and exclusion criteria in different institutes. The 188 subjects were randomly divided into the trial group or the control group according to 1∶1 by the central randomization system, with 94 cases in each group. Octoparms inferior vena cava filter was used in the trial group, and the Celect inferior vena cava filter in the control group. The primary effective index was clinical success rate,including the clinical success rate of filter placement and filter retrieval. The secondary index included the rate of manual success of the delivery sheath system,incidence of pulmonary embolism(within 6 months), incidence of filter fracture,migration (>20 mm),tilt(>15°) on insertion/retrieval,and the situation of inferior vena cava flow(within 6 months). Safety evaluation included the incidence of filter related complications and device-related adverse events immediately after surgery and during follow-up.Results:The success rate of implantation was 100% in 188 subjects. Filter retrieval was performed in 87 cases (92.55%) in the trial group and 91 cases (96.81%) in the control group. The clinical success rate of the trial group was 97.87%(92/94) and that of the control group 98.94%(93/94). There was no significant difference between the two groups (χ 2=0.77, P=0.380). The success rate of delivery sheath system was 96.81%(91/94) and 98.94%(93/94) in the trail group and the control group,respectively. There was no significant difference between the two groups( P=0.621). There was 1 case (1.22%) of new asymptomatic pulmonary embolism in the trial group after filter placement and 2 cases (2.44%) in the control group. There was no significant difference between the two groups ( P>0.05). No filter fracture or migration (>20 mm) occurred in either group. The tilting of filter (>15°) was found in 1 case (1.06%) in the test group and 1 case (1.06%) in the control group when the filter was placed. The tilting of filter (>15°) was found in 0 case in the test group and 2 cases (2.44%) in the control group when the filter was retrieved. There was no significant difference between the two groups ( P>0.05). Inferior vena cava thrombosis before filter retrieval was found in 5 cases (5.75%) in trial group and 3 cases (3.30%) in control group. There was no significant difference between the two groups ( P=0.489). There were no immediate serious complications during filter placement/removal in either group. No filter obstruction,migration,deformation,penetration and occlusion of inferior vena cava. The incidence of device-related adverse events was low in both group. There was no significant difference between the two groups ( P>0.05). Conclusion:The home-made umbrella-shaped Octoparms inferior vena cava filter is effective and safe in preventing pulmonary embolism, and is not worse than Celect filter.

Objective To investigate the short-term mortality of transcatheter arterial chemoembolization (TACE) in patients with primary liver cancer, and explore the possible causes of death and countermeasures. Methods All patients who underwent TACE at the Department of Interventional Radiology, First Affiliated Hospital of Soochow University from January 2015 to December 2020 were studied, but those with metastatic liver cancer or receiving combined treatment were excluded. The clinical and imaging data of all patients were collected before and 30 days after TACE, and the clinical characteristics of the patients with short-term postoperative death were analyzed. Death within 30 days after TACE was defined as short-term death. Results A total of 1466 TACE in 741 patients with primary liver cancer were included. Ten patients (10/741, 1.35%) died within 30 days after TACE, with a mortality rate of 0.68% for all TACE. The mortality rate of d-TACE and c-TACE was 1.62% (3/185) and 0.55 % (7/1281), respectively. The mortality rates of patients at China Liver Cancer Staging Ⅰ, Ⅱ, and Ⅲ stages were 0.45% (2/448), 0.33% (2/599), and 1.43% (6/419), respectively. The mean diameter of the largest lesion in death cases was 10.1±0.8 cm. The possible causes of death were liver failure (4 cases), rupture bleeding (3 cases), myelotoxicity (1 case), pulmonary embolism (1 case), and heart failure (1 case). Conclusion The mortality rate after TACE in patients with primary liver cancer is low, with occasional short-term postoperative deaths. The death cases are characterized by a large tumor volume, and the most common causes of short-term death are liver failure and rupture bleeding.

Objective:To translate the health literate healthcare organization 10 item questionnaire(HLHO-10) into Chinese and examine its reliability and validity.Methods:The Chinese version of HLHO-10 questionnaire(HLHO-10-C) was developed by following the Brislin translation model of translation, back translation, cultural adaptation and questionnaire epistemological survey.Five experts and 1 071 medical staff from 24 healthcare organizations in Zhejiang province were selected to conduct the validity and reliability test of the HLHO-10-C.Results:The content validity indices at the item level and total questionnaire level of HLHO-10-C were from 0.8 to 1.0 and 0.96 respectively, and the results of the exploratory factor analysis showed good structural validity.Conclusions:HLHO-10-C proves adequate reliability and validity to serve as a tool for healthcare organizations in evaluating and becoming HLHO. It can also help the implementation of the Healthy China Initiative(2019—2030), which is a performance assessment mechanism for health education and promotion of healthcare providers and health care organizations.

Inflammatory bowel disease (IBD) is a chronic intestinal disease with painful clinical manifestations and high risks of cancerization. With no curative therapy for IBD at present, the development of effective therapeutics is highly advocated. Drug delivery systems have been extensively studied to transmit therapeutics to inflamed colon sites through the enhanced permeability and retention (EPR) effect caused by the inflammation. However, the drug still could not achieve effective concentration value that merely utilized on EPR effect and display better therapeutic efficacy in the inflamed region because of nontargeted drug release. Substantial researches have shown that some specific receptors and cell adhesion molecules highly expresses on the surface of colonic endothelial and/or immune cells when IBD occurs, ligand-modified drug delivery systems targeting such receptors and cell adhesion molecules can specifically deliver drug into inflamed sites and obtain great curative effects. This review introduces the overexpressed receptors and cell adhesion molecules in inflamed colon sites and retrospects the drug delivery systems functionalized by related ligands. Finally, challenges and future directions in this field are presented to advance the development of the receptor-mediated targeted drug delivery systems for the therapy of IBD.

Objective: To investigate the causes of liquid leakage from the urethral meatus in patients indewelled with urinary catheter after transurethral resection of the prostate(TURP), and provide the basis for improving the nursing quality. Methods: A retrospective study was conducted in 179 patients who underwent TURP from January 2015 to February 2018. Data included in the analysis were age, IPSS, storage and voiding symptom scores (IPSS-S, IPSS-V), QoL, maximum free flow rate (Qmax), post-voided residual urine volume, first sensation of bladder filling(FS), bladder compliance(BC), BC grade, maxmium cystometric capacity(MCC), MCC grade, maximum detrusor pressure, detrusor pressure at Qmax, obstruction grade, detrusor overactivity(DO) and detrusor underactivity(DUA). Acorrding to the status of liquid leakage from the urethral meatus after TURP, patients were divided into leakage positive (LP) and negative(LN) groups. The above mentioned parameters were compared between the two groups and these with statistical significance were further analyzed in the Logistic regression model. Results: There were 76 and 103 patients in LP and LN groups, respectively. There were significant differences in age, IPSS score, IPSS-S score, BC score, BC grade, FS score, MCC score, MCC grade, Qmax and the prevalence of DO between LP and LN groups [(72.9±7.1)years old vs. (67.9±6.8)years old, (23.7±5.7)vs. (20.9±6.7), (11.4±2.9)vs.(8.8±3.3), 10.5 (5.6, 16.4) ml/cmH₂O vs.37.0 (24.3, 57.3) ml/cmH₂O, (3.6±3.3)vs. (9.4±5.0), (85.2±53.2)ml vs.(130.8±69.7)ml, (161.6±97.5) ml vs. (323.7±163.6)ml, (3.8±2.0)vs.(6.7±2.5), (6.1±2.8)ml/s vs.(7.4±3.3)ml/s, 57.9% (44/76) vs.17.4% (18/103)] (P<0.05 for each). Logistic regression analysis showed that high IPSS-S (OR=1.617, P=0.001), DO (OR=3.615, P=0.024), MCC (OR=0.591, P=0.002) and BC grades (OR=0.745, P=0.001) were risk and protective factors of liquid leakage from the urethral meatus after TURP. Conclusion When indwelled with urinary catheter, the patients with high IPSS-S, low MCC, low BC, and DO have high risks of liquid leakage from the urethral meatus after TURP. For these patients, we should give psychological guidance, and inform them of disease condition preoperatively; and after surgery we should take appropriate measures to improve nursing quality.