Objective:To observe the effects of repetitive transcranial magnetic stimulation(rTMS)on cognitive function,neuropsychiatric behavioral symptoms,expression of plasma microRNA-125b(miR-125b)and phosphorylated Tau181 protein(P-Tau181)of patients with Alzheimer's disease(AD). Method:Thirty-four patients with mild to moderate AD were screened and randomly divided into control group(n=16)and experimental group(n=18).The control group received cognitive training and repetitive tran-scranial magnetic pseudo-stimulation,and the experimental group received cognitive training and repetitive tran-scranial magnetic real stimulation.The magnetic stimulation intensity was 100％resting movement threshold(RMT),frequency was 10Hz.It's administered once a day,5 days a week for 4 weeks.The stimulation site were the left dorsolateral prefrontal lobe and left temporal lobe.The Addenbrooke Ⅲ cognitive examination(ACE-Ⅲ),mini-mental state scale(MMSE)and neuropsychiatric inventory(NPI)were evaluated before and af-ter treatment.The microRNA-125b expression was detected by real-time fluorescence quantitative polymerase chain reaction(qRT-PCR)and the concentration of P-Tau181 was determined by enzyme-linked immunosorbent assay(ELISA). Result:After treatment,the scores of ACE-Ⅲ,MMSE and NPI,miR-125b and P-Tau181 in the experimental group were significantly improved compared with those before treatment(P＜0.05).There was no improvement of all indexes in the control group(P＞0.05). Conclusion:rTMS improve the cognitive function and neuropsychiatric symptoms of patients with mild to mod-erate AD,which may be related to the promotion of plasma miR-125b expression and inhibition of P-Taul81 protein production by rTMS.It is worthy for clinical application.

Objective: First-line bevacizumab plus carboplatin and paclitaxel (CP) is approved for stage III/IV ovarian cancer treatment following initial surgical resection, based on global phase III GOG-0218 and ICON7 trials. This study evaluated the efficacy and safety of bevacizumab + CP as first-line ovarian cancer therapy in Chinese patients. Methods: Patients with newly diagnosed, International Federation of Gynecology and Obstetrics (FIGO) stage III/IV epithelial ovarian, fallopian tube, or primary peritoneal cancer post-primary surgery were randomized 1:1 to receive 6 cycles of CP with bevacizumab/ placebo, followed by bevacizumab/placebo maintenance until unacceptable toxicity or disease progression. Primary endpoint was investigator-assessed progression-free survival (PFS). Stratification factors were FIGO stage and debulking status (stage III optimally debulked vs stage III suboptimally debulked vs stage IV) and Eastern Cooperative Oncology Group performance status (0 vs 1 or 2). Results: Of randomized patients, 51 received bevacizumab + CP and 49 received placebo + CP. Median PFS was 22.6 months with bevacizumab + CP (95% confidence interval [CI]=18.6, not estimable) and 12.3 months (95% CI=9.5, 15.0) with placebo + CP (stratified hazard ratio=0.30; 95% CI=0.17, 0.53). Treatment-related grade 3/4 adverse events occurred in 46 of 49 (94%) patients receiving bevacizumab + CP, and 34 of 50 (68%) receiving placebo + CP. Conclusion Bevacizumab + CP showed clinically meaningful improvement in PFS vs placebo + CP, consistent with GOG-0218 results. Safety data were aligned with the known bevacizumab safety profile. These results support first-line bevacizumab + CP therapy in Chinese patients with ovarian cancer.

Objective: First-line bevacizumab plus carboplatin and paclitaxel (CP) is approved for stage III/IV ovarian cancer treatment following initial surgical resection, based on global phase III GOG-0218 and ICON7 trials. This study evaluated the efficacy and safety of bevacizumab + CP as first-line ovarian cancer therapy in Chinese patients. Methods: Patients with newly diagnosed, International Federation of Gynecology and Obstetrics (FIGO) stage III/IV epithelial ovarian, fallopian tube, or primary peritoneal cancer post-primary surgery were randomized 1:1 to receive 6 cycles of CP with bevacizumab/ placebo, followed by bevacizumab/placebo maintenance until unacceptable toxicity or disease progression. Primary endpoint was investigator-assessed progression-free survival (PFS). Stratification factors were FIGO stage and debulking status (stage III optimally debulked vs stage III suboptimally debulked vs stage IV) and Eastern Cooperative Oncology Group performance status (0 vs 1 or 2). Results: Of randomized patients, 51 received bevacizumab + CP and 49 received placebo + CP. Median PFS was 22.6 months with bevacizumab + CP (95% confidence interval [CI]=18.6, not estimable) and 12.3 months (95% CI=9.5, 15.0) with placebo + CP (stratified hazard ratio=0.30; 95% CI=0.17, 0.53). Treatment-related grade 3/4 adverse events occurred in 46 of 49 (94%) patients receiving bevacizumab + CP, and 34 of 50 (68%) receiving placebo + CP. Conclusion Bevacizumab + CP showed clinically meaningful improvement in PFS vs placebo + CP, consistent with GOG-0218 results. Safety data were aligned with the known bevacizumab safety profile. These results support first-line bevacizumab + CP therapy in Chinese patients with ovarian cancer.

Objective: First-line bevacizumab plus carboplatin and paclitaxel (CP) is approved for stage III/IV ovarian cancer treatment following initial surgical resection, based on global phase III GOG-0218 and ICON7 trials. This study evaluated the efficacy and safety of bevacizumab + CP as first-line ovarian cancer therapy in Chinese patients. Methods: Patients with newly diagnosed, International Federation of Gynecology and Obstetrics (FIGO) stage III/IV epithelial ovarian, fallopian tube, or primary peritoneal cancer post-primary surgery were randomized 1:1 to receive 6 cycles of CP with bevacizumab/ placebo, followed by bevacizumab/placebo maintenance until unacceptable toxicity or disease progression. Primary endpoint was investigator-assessed progression-free survival (PFS). Stratification factors were FIGO stage and debulking status (stage III optimally debulked vs stage III suboptimally debulked vs stage IV) and Eastern Cooperative Oncology Group performance status (0 vs 1 or 2). Results: Of randomized patients, 51 received bevacizumab + CP and 49 received placebo + CP. Median PFS was 22.6 months with bevacizumab + CP (95% confidence interval [CI]=18.6, not estimable) and 12.3 months (95% CI=9.5, 15.0) with placebo + CP (stratified hazard ratio=0.30; 95% CI=0.17, 0.53). Treatment-related grade 3/4 adverse events occurred in 46 of 49 (94%) patients receiving bevacizumab + CP, and 34 of 50 (68%) receiving placebo + CP. Conclusion Bevacizumab + CP showed clinically meaningful improvement in PFS vs placebo + CP, consistent with GOG-0218 results. Safety data were aligned with the known bevacizumab safety profile. These results support first-line bevacizumab + CP therapy in Chinese patients with ovarian cancer.

Hypoxemia is a common complication of pneumonia, asthma, and bronchopulmonary dysplasia in children.Rapid identification of hypoxemia is of great significance for the disposal and management of critical children.Pulse oximetry is recognized by the World Health Organization as the best way to monitor hypoxemia in children, and it can monitor pulse oxygen saturation noninvasively and continuously.Based on the related literature at home and abroad, combined with the clinical needs of pediatrics, the " Expert consensus on clinical application of pulse oximetry in children" is formulated to improve the understanding of pediatricians and nurses on the application in pediatric clinical practice, principle, operation techniques, and limitations of pulse oximetry.

Objective:To investigate the knowledge, attitudes, and practices (KAP) of pulse oximetry among pediatric healthcare providers in China and analyze the factor influencing the KAP.Methods:A self-developed questionnaire was used for an online research on the KAP of 11 849 pediatric healthcare providers from 31 provinces, autonomous regions, and municipalities of China from March 11 to 14, 2022.The factors influencing the KAP of pulse oximetry among pediatric healthcare providers were examined by Logistic regression. Results:The scores of KAP, of pulse oximetry were 5.57±0.96, 11.24±1.25 and 11.19±4.54, respectively.The corresponding scoring rates were 69.61%, 74.95%, and 55.99%, respectively. Logistic regression results showed that the gender and working years of pediatric healthcare providers, the region they were located, and whether their medical institution was equipped with pulse oximeters were the main factors affecting the knowledge score (all P<0.05). Main factors influencing the attitude score of pediatric healthcare providers included their knowledge score, gender, educational background, working years, region, medical institution level, and whether the medical institution was equipped with pulse oximeters (all P<0.05). For the practice score, the main influencing factors were the knowledge score, gender, age, and whether the medi-cal institution was equipped with pulse oximeters (all P<0.05). Conclusions:Chinese pediatric healthcare providers need to further improve their knowledge about and attitudes towards pulse oximetry.Pulse oximeters are evidently under-used.It is urgent to formulate policies or guidelines, strengthen education and training, improve knowledge and attitudes, equip more institutions with pulse oximeters, and popularize their application in medical institutions.

Objective:To investigate the effect of nuclear transcription factor kappa B (NF-κB)/NOD-like receptor family pyrin domain containing protein 3 (NLRP3) pathway on lipid deposition and autophagy related protein expressions in aortic atherosclerosis mice.Methods:Ten 6-week-old male C57BL/6 mice were used as control group, and 20 male apolipoprotein E gene knockout ( ApoE-/-) mice at the same age were randomly divided into AS group and bortezomib (BTZ) group ( n=10). Mice in the AS group and BTZ group were fed with high-fat diet for 8 weeks; and then, mice in the BTZ group were injected intraperitoneally with 50 μg/kg BTZ (twice a week, for 4 weeks), while mice in the AS group were injected with same amount of saline. The general states of mice in each group were observed during the experiment process. Twelve weeks after intervention, the body weight and the levels of total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL), and high-density lipoprotein (HDL) were measured; the pathological morphology and lipid deposition of plaques at the aortic roots were observed by oil red O staining and HE staining; the expressions of NF-κB and NLRP3 were detected by immunohistochemistry; the expressions of Beclin-1, P62, and Atg12 were measured by Western blotting. Results:After 12 weeks of intervention, the body weight, contents of TC and LDL, pathological degrees, proportion of lipid deposition, positive expressions of NF-κB and NLRP3, and P62 protein expression in the AS group and BTZ group were significantly higher than those in the control group, while these indexes in the BTZ group were significantly lower than those in the AS group ( P<0.05); HDL content, protein expression levels of Beclin-1 and Atg12 in the AS group and BTZ group was significantly lower than that in the control group, while these indexes in the BTZ group were significantly higher than those in the AS group ( P<0.05). Conclusion:Inhibition of NF-κB/NLRP3 pathway can reduce lipid deposition by regulating lipid content and mediate the autophagy related protein expressions to promote autophagy, thereby inhibiting the process of AS.

【Objective】 To explore a method to accurately identify the specificity of alloantibodies or autoantibodies in autoimmune hemolytic anemia (AIHA)patients with both warm and cold antibodies, so as to provide guidance for the selection of blood components. 【Methods】 Blood samples of AIHA patients with both warm and cold antibodies were screened by the direct antiglobulin testing (DAT). The plasma of patients were treated with dilution or adsorption method and the erythrocyte was dispersed for specificity identification of alloantibodies or autoantibodies.According to the results of antibody identification, appropriate phenotype of red blood cells(RBCs) were transfused to patients, and the incidence of adverse reactions and efficacy of transfusion were observed. 【Results】 Alloantibodies or specific autoantibodies were detected in serum or elution in 14 of the 16 patients. 10 patients underwent blood transfusion during hospitalization, and all of them received RBCs with the same or compatible ABO/Rh (D) type as the patients and without any reaction to the alloantibodies and specific warm autoantibodies. No hemolytic reaction occurred, and anemia symptoms were improved after blood transfusion. 【Conclusion】 The selection of appropriate methods could eliminate the influence of autoantibodies on the identification of alloantibodies in AIHA patients with both warm and cold antibodies. Therefore, the selection of blood from compatible donors for transfusion could effectively avoid the occurrence of hemolytic reaction.

Objective:To investigate the pain level of lumbar puncture and family anxiety of hospitalized children, and analyze the influencing factors of family anxiety.Methods:A multi-center cross-sectional survey was used to enroll 190 children and their families who underwent lumbar puncture in 4 hospitals of Jiangsu Province from July 2018 to December 2019. The FLACC scale and face pain scale (WONG-BAKER scale) were adopted. The visual analogue scale (VAS) was used to investigate the pain level, and the anxiety state-trait questionnaire (STAI) was used to investigate the anxiety level.Results:The pain level scores before and after lumbar puncture were (2.86 ± 1.08) and (6.24 ± 1.59) scores respectively, and the difference was statistically significant ( t = 24.241, P<0.001). The total anxiety level of the children′s family members was (73.78 ± 4.67) scores, which was affected by factors such as the pain score, the age of the child, the number of lumbar punctures, the success rate of a lumbar puncture, the level of the hospital, the family status, and the education level of the family (adjusted R2 = 0.574, F = 29.784, P = 0.001). Conclusions:The pain in children is at a high level, and the anxiety level of their family members is also at a high level and is affected by many factors. Clinical medical staff can stratify the children and their families, and adopt targeted methods to relieve the pain of the children and the anxiety of the family members and promote the smooth development of the lumbar puncture.

Objective To study the correlation between serum homocysteine (Hcy) levels and chronic heart failure (CHF) with ultrasound cardiac function patients.Methods The subjects were 88 cases of CHF (CHF group) in our hospital between April 2014 to June 2015 between patients,selected 65 cases of healthy people as a control group over the same period in our hospital,using color Doppler ultrasound measurement of two groups patients of the left ventricular ejection fraction of patients groups (LVEF) and left ventricular end-diastolic diameter (LVEDd),and compared serum Hcy and NT-proBNP levels,LVEF and LVEDd in different NYHA classification patients,analysis of serum Hcy and NT-proBNP levels and LVEF,LVEDd between correlation of serum Hcy levels on cardiovascular incident.Results CHF group of the Hcy,NT-proBNP levels and LVEDd were significantly higher than control group (P ＜ 0.01),LVEF was significantly lower than the control group (t =31.78,P =0.00);different NYHA functional class (Ⅱ ～ Ⅳ level) of Hcy,NT-proBNP,LVEDd and LVEF compared were statistically difference (P ＜ 0.01);Pearson correlation analysis showed,CHF patients with LVEF serum Hcy levels were negatively correlated (r2 =0.974,P ＜ 0.01),with LVEDd was positively correlated (r2 =0.896,P ＜ 0.05),and higher serum Hcy levels,the higher the rate of cardiovascular happened in patients with CHF.Conclusion The serum Hcy and NT-proBNP levels in patients with CHF were significantly higher than healthy,and with the deterioration of heart function and increased while the LVEF was negatively correlated positively with LVEDd,cardiovascular events in high Hcy levels may also increase the incidence risk,so Hcy levels is expected as a new diagnostic marker CHF conditions change.