Objective:To summarize the clinical features associated with respiratory syncytial virus (RSV) infection in patients following the hematopoietic stem cell transplant (HSCT) and exploring the risk factors for death.Methods:Patients who had RSV infection after undergoing HSCT from October 2023 to January 2024 in the hematology department of Peking University People’s Hospital were enrolled in the study. The clinical characteristics of the participating patients were summarized. The clinical characteristics of the surviving and the dying patients were compared, and the risk factors of death were analyzed by binary logistic regression.Results:Among the 43 RSV-positive HSCT patients, 20 (46.5%) were hypoxemic, six (14.0%) were admitted to the ICU for further treatment, four (9.3%) required tracheal intubation assisted ventilation, and seven patients (16.3%) died. A comparison of the clinical features of the surviving patients and the deceased patients demonstrated that the deceased patients had a lower PLT when infected with RSV [74.5 (8.0-348.0) ×10 9/L vs 15.0 (10.0-62.0) ×10 9/L, P=0.003], a higher incidence of simultaneous bacterial infections (85.7% vs 41.7%, P=0.046), and a higher rate of hematological recurrence (71.4% vs 13.9%, P=0.004). Hematological recurrence ( OR=15.500, 95% CI 2.336-102.848, P=0.005), influenza A viral infection ( OR=14.000, 95% CI 1.064-184.182, P=0.045), and low PLT at the time of RSV infection ( OR=0.945, 95% CI 0.894-0.999, P=0.048) were the factors associated with death following HSCT. Conclusion:Patients infected with RSV after undergoing HSCT have a poor prognosis, and active prevention and treatment of RSV in the autumn and winter requires urgent attention.

Objective To construct and apply a management plan for microaspiration of oropharyngeal secretions in ICU intubated patients.Methods Based on evidence summaries and expert consultation,a management plan for microaspiration of oropharyngeal secretions in ICU intubated patients was constructed,consisting of 19 items covering 7 aspects including identification of risk factors,position management,tube and cuff selection,cuff management,mechanical ventilation management,pain and sedation management,removal of oropharyngeal and subglottic secretions,and oral care.Convenience sampling was used to select 141 ICU intubated patients from a tertiary A comprehensive hospital in Suzhou from June,2022 to September,2023.Patients were divided into an experimental group(n=72)and a control group(n=69)according to the wards.The experimental group received the management plan for microaspiration of oropharyngeal secretions in ICU intubated patients.The control group received the nursing bundle for ventilator associated pneumonia(VAP).The incidence and time from intubation to microaspiration and VAP,duration of mechanical ventilation,ICU length of stay,and disease outcome were compared between the 2 groups.Results The incidence of microaspiration of oropharyngeal secretions,the duration of mechanical ventilation,time from intubation to microaspiration showed significant differences between the 2 groups(P<0.05).There were no significant differences in the incidence of ventilator associated pneumonia,ICU length of stay,and disease outcome between the 2 groups(P>0.05).The time from intubation to VAP in the experimental group was 7.5 days,and that in the control group was 3.8 days.Conclusion The application of the management plan for microaspiration of orophaiyngeal secretions in ICU intubated patients is beneficial for reducing the incidence of microaspiration,delaying the time from intubation to microaspiration and VAP,and shortening the duration of mechanical ventilation.

Objective To explore the effect of mindfulness decompression therapy on the house-bound elders with depression. Methods By the stratified random sampling method,screening 1 371 more than 60 year old people in the community,86 cases housebound elders with depression were randomly divided into intervention group and control group. Intervention group received mindfulness decompression therapy in-tervention,and control group with blank control. The housebound state assessment scale and the Geriatric Depression Scale (GDS) were evaluated before intervention,4 weeks after intervention and 8 weeks after in-tervention. Results During the intervention period,3 cases were dropped out,83 cases were all included (41 cases in the intervention group and 42 cases in the control group). There was no significant difference between the two groups in the general situation before the intervention (P>0. 05),and the balance between the two groups was comparable. After intervention,the total score of housebound (8. 4±2. 0) and the total score of depression (12. 2±4. 3) in the intervention group were lower than those in the control group,and the differences were statistically significant(P<0. 05). Conclusion Mindfulness-based stress reduction can ef-fectively improve the depression and housebound condition of the elderly.

Based on MOOC teaching mode and the combination of flipped classroom teaching theory,the role of internship practice is integrated into medical education and the combination of MOOC teaching and traditional teaching mode in medical humanities curriculum is explored in practice applications.This paper analyzed the cur-rent situation of medical humanities curriculum teaching operation under current situation; based on the teaching concept of MOOC,introduced the reform of teaching form and teaching method in blending teaching mode,and ex-plored the practical application and practical thinking of blending teaching mode.This mode not only plays a lead-ing role of teachers teaching,but also fully embodies the subjective status of students'learning,exercises the students'ability of thinking in practice at the same time,and is an effective mode to improve medical humanities curriculum teaching.

At present, many weak points still exist in teaching practices of medical English in medical colleges, such as lack of clear learning goals and prospects for medical English among medi-cal students, as well as the absence of systematic and practical teaching materials, as well as inappro-priate construction of teacher team for teaching practice. Therefore, corresponding modifications on teaching objectives, construction of teacher team and implementation methods for medical English are urgently needed so as to achieve effective teaching and subsequently meet the new international stan-dards for medical education.

Objective To inVestigate the effect of emodin on hyPertroPhic scar fibroblasts ( HSFs ) and exPlore the underlying mechanism. Methods HSFs were treated by emodin at final concentrations of 0,20,40,and 80 μmol·L-1, resPectiVely,in the cultural media. Forty_eight hours later,the cells were subjected to MTS assay and flow cytometry assay with annexin V and ProPidium iodide as dyeing indicators. Whole cell lysates from the cells of eVery grouP were subjected to Western blotting to measure the Protein exPression leVels of ERK1∕2,Bcl_2,Mcl_1 and RIP1. Results The cell Viability of HSFs was inhibited by emodin in a dose dePendent manner. The mortality rate of HSFs treated with emodin for 48 h at the concentrations of 40 and 80 μmol·L-1 were 28. 6%and 68. 0%,resPectiVely,which was significantly higher than that of the control grouP ( P<0.01).Pretreatmentwith Z_VAD_FMK could Partially reduce the mortality caused by emodin (P<0.05).PhosPhorylation of ERK1∕2 and the exPression of RIP1 and Mcl_1 were inhibited by emodin. Conclusion Down regulation of ERK1∕2,RIP1 and Mcl_1 by emodin may account for the inhibited Proliferation and increased cell death of HSFs.

Objective To study the effects of self-management of knee osteoarthritis (KOA) on the function and quality of life in old patients. Methods From October 2011 to April 2012, 100 patients with KOA from 2 communities in Tangshan, Hebei were recruited, and were as control group and intervention group based on the community. The intervention group learned a KOA self-management course, which consisted of 6 classes of 1.5 to 2 hours, once a week, taught by health professionals. The control group read the KOA self-management handbook only. They were measured with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Arthritis Impact Measurement Scale 2nd version- Short Form (AIMS2- SF) before and 6 months after intervention. Results The score of WOMAC and AIMS2-SF improved more in the intervention group than in the control group (P<0.05). Conclusion The KOA self-management program is effective on function and quality of life in old patients with KOA in community.

Objective To investigate the status and influencing factors of quality of life among middle-aged and elderly patients with knee osteoarthritis (KOA) in rural area of Tangshan city. Methods 216 KOA patients were investigated with the demographic data questionnaire,the Numerical Rating Scale (NRS), the Arthritis Impact Measurement Scale 2 short form (AIMS2-SF) and the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis index. Results The score of AIMS2-SF was (73.10±14.72) and the average score of each dimension was in the middle level. WOMAC Osteoarthritis index, levels of pain, economic status and marital status were the main predictors of their quality of life. Conclusion The quality of life of middle-aged and elderly patients with KOA in the rural area of Tangshan city was in the middle level and interventions targeted at the influencing factors should be enhanced to improve the quality of life.

Objective To investigate the incidence of nutritional risk for stroke patients with diabetes mellitus. Methods All the stroke patients with diabetes mellitus in a neurologic department were investigated with Nutritional Risk Screening (NRS2002). Results The incidences of undernutrition and nutritional risk were 11.3% (42/372) and 35.8% (133/372), respectively. The incidence of nutritional risk was more in the patients aged over 60 years than in the patients below 60 years (P=0.001). The incidence of both undernutrition and nutritional risk was more in the patients with stroke relapsing than those of the initial stroke (P<0.001). Conclusion The stroke patients with diabetes mellitus are in the risk of undernutrition and nutritional risk, especially those over the age of 60 years and relapsed stroke.

OBJECTIVETo describe the impact of the global economic crisis on the nutritional status of children in China during and after the crisis.

METHODSData from 1990 to 2010 were sourced from the National Food and Nutrition Surveillance System. Approximately 16 000 children under 5 years old were selected using a stratified random cluster method from 40 surveillance sites. Anthropometric and hemoglobin measurements for children under 5 were conducted. Nutritional status was determined according to WHO child growth standards.

RESULTSPrevalence of underweight and stunting in children under 5 had a downward trend. Underweight prevalence was close to normal (less than 5%), with prevalence of stunting 12.6% in 2009 and 12.1% in 2010 in rural areas. Prevalence of stunting in infants under 6 months and 6-12 months old in poorer rural areas increased from 5.7%-9.1% and 6.7%-12.5%, respectively, in 2008-2009. This trend also continued post-crisis in 2010. Prevalence of stunting in children left behind by mothers was 20%-30% higher than in children the same age in general and poorer rural areas. Prevalence of anemia in children did not change in rural areas, but prevalence of anemia in all age groups increased in poorer rural areas, especially in children under 24 months old. Level reached 30%-40% in 2009, and fluctuated in 2010.

CONCLUSIONThe nutritional status of children under 5 was comparatively stable during and after the global economic crisis, attributable to the Chinese government's policy response. The nutritional status in poorer rural areas fluctuated in response to the economic crisis and, thus, relevant action and intervention must be taken immediately to help the most vulnerable population in poorer rural areas. A proper national nutritional strategy for children under 2 years old, including nutrition supplementation for pregnant women and in-home fortification for complementary feeding, should be initiated.

Aging ; Anemia ; economics ; epidemiology ; Child Development ; physiology ; Child Nutrition Disorders ; economics ; epidemiology ; Child, Preschool ; China ; epidemiology ; Economic Recession ; Female ; Humans ; Infant ; Infant Nutrition Disorders ; economics ; epidemiology ; Male ; Nutritional Status ; physiology ; Population Surveillance ; Poverty ; Pregnancy ; Prevalence ; Rural Population ; Thinness ; Time Factors