Objective:To investigate the current status of women′s level of birth experience and lactation initiation time and explore the effect of level of birth experience on lactation initiation time.Methods:This was a cross-sectional study. A convenience sampling method was used to select 622 maternal cases attending the Affiliated Hospital of Jining Medical College from November, 2020 to January, 2021, and the distribution of their labor experience level and lactation initiation time was investigated by questionnaire and follow-up assessment.Results:There were 622 women with transvaginal deliveries who had lactation initiation times of more than 72 h in 241 cases (38.75%). The scores for each dimension of the Childbirth Experience Questionnaire (CEQ) were (49.63 ± 8.58)points, and the scores for each dimension of CEQ were perceived safety, professional support, involvement and self-efficacy in descending order. The results of the correlation analysis showed that there was a negative correlation between the scores on each dimension of CEQ and the total score and lactation initiation time ( r values were -0.436 to -0.146, all P<0.01). Stratified regression analysis showed that after controlling for age, number of births, gestational weeks of labour, illness during pregnancy and labour analgesia as the underlying variables affecting lactation initiation time, the scores for self-efficacy, involvement, perceived safety and professional support in the CEQ all affected lactation initiation time after delivery ( t values were -6.76 to -2.02, all P<0.05). Conclusions:The birth experience and lactation of women who deliver via vaginal birth need to be taken into account. The more negative the birth experience, the longer the lactation initiation time. The women′s involvement in the birth process, their own competence, perceived safety and level of professional support are all valid influencing indicators of lactation initiation time.

Objective:To observe the image characteristics of optical coherence tomography (OCT) in patients with primary vitreoretinal lymphoma (PVRL).Methods:A retrospective clinical study. Thirty-two eyes of 19 patients diagnosed with PVRL by vitreous pathology in the Department of Ophthalmology, Beijing Tongren Hospital from September 2016 to October 2019 were included in this study. There were 7 males and 12 females. The median age was 56 years. The mean time from symptom onset to final diagnosis was 6.1±3.8 months. The first diagnosis was uveitis in 12 cases (63.1%, 12/19), retinal vein occlusion in 2 cases (10.5%, 2/19), central retinal artery occlusion in 1 case (5.3%, 1/19), and suspected PVRL of camouflage syndrome in 4 cases (21.1%, 4/19). Routine ophthalmic examination and frequency-domain OCT examination were performed in all the patients, and typical images were stored for analysis. According to the examination results, PVRL OCT signs were divided into vitreous cells, inner retinal infiltration, outer retinal infiltration, retinal pigment epithelial (RPE) infiltration, sub-RPE infiltration, and subretinal fluid.Results:Vitreous cells were found in all eyes (100.0%, 32/32). RPE infiltrated were observed in 19 eyes (59.4%, 19/32), RPE infiltration in 16 eyes (50.0%, 16/32), outer retinal infiltration in 8 eyes (25.0%, 8/32), inner retinal infiltration in 16 eyes (50.0%, 16/32), and subretinal fluid in 4 eyes (12.5%, 4/32).Conclusions:PVRL OCT signs can involve vitreous and retinal anatomical levels, including vitreous cells, inner retinal infiltration, outer retinal infiltration, RPE infiltration, sub-RPE infiltration and subretinal fluid. The same patient can show multiple signs at the same time.

Objective:To investigate the characteristics of Parkinson's disease (PD)combined with orthostatic hypotension (OH)and the impact of the condition on cognitive function.Methods:A total of 210 PD patients admitted to Beijing Tiantan Hospital were consecutively enrolled.Demographic data and clinical characteristics were recorded.Patients were divided into the PD with OH (PD-OH)group and the PD without OH (PD-NOH)group based on blood pressure values measured in both the supine and upright positions.Cognitive function of PD patients was evaluated using the Mini-Mental State Examination (MMSE)and Montreal Cognitive Assessment (MoCA)scales.Results:Of 210 PD patients, 68 (32.4%)had OH.Patients in the PD-OH group had a higher mean age (69.7±8.9 years vs.62.1±11.3 years), longer disease duration [5.0 (3.0-8.0)years vs.4.0 (2.0-6.0)years], a higher incidence of diabetes (30.9% vs.17.4%), higher levels of fasting blood glucose (5.3±1.1 mmol/L vs.5.0±1.0 mmol/L)and glycated hemoglobin A1c (6.1±0.9% vs.5.7±0.7%), and more advanced Hoehn-Yahr staging [stage 2.5 (2.0-3.0) vs.stage 2.0 (1.5-2.5)]than the PD-NOH group ( P<0.05). The total scores of the MMSE and MoCA scales were lower in the PD-OH group than in the PD-NOH group (25.1±4.9 scores vs.26.8±4.0 scores, 19.4±5.4 scores vs.21.4±5.3 scores, P<0.05). A comparison of each cognitive domain of the MMSE scale between the two groups revealed that the scores of attention and calculation (3.7±1.7 scores vs.4.2±1.3 scores), delayed recall (2.1±1.0 scores vs.2.5±0.8 scores)and visuospatial ability (0.6±0.5 scores vs.0.7±0.5 scores)were lower in the PD-OH group than in the PD-NOH group ( P<0.05). A comparison of each cognitive domain of the MoCA scale between the two groups displayed that the scores of visuospatial and executive function (2.4±1.6 scores vs.2.9±1.7 scores)and delayed recall (1.3±1.4 scores vs.2.3±1.6 scores)were lower in the PD-OH group than in the PD-NOH group ( P<0.05). Logistic regression analysis showed that age ( OR=1.061, 95% CI: 1.022-1.102, P=0.002)and score of delayed recall of the MoCA scale ( OR=0.690, 95% CI: 0.498-0.955, P=0.025)were independent related factors for PD-OH. Conclusions:Compared with patients without OH, PD-OH patients are older and have a longer duration, increased disease severity, and a higher incidence of and more serious diabetes mellitus.Age is an independent related factor for PD-OH.Cognitive function is significantly impaired in PD-OH patients, and delayed recall is an independent related factor for PD-OH.

With many hard efforts, the epidemic prevention and control work in China has borne successful, accelerating the gradual restoration of production, living order and routine medical work. However, there is increasing evidence that many patients with COVID-19 are asymptomatic, but they are potential transmitter of the virus. There are difficulties in screening for asymptomatic infections, which makes it more difficult for national prevention and control of this epidemic. Therefore, it is urgent to develop better screening and laboratory testing for asymptomatic infections with COVID-19 with high speed, sensitivity and specificity. It is also important to improve our risk assessment, prevention and control strategies to further prevent the spread of the epidemic.

With many hard efforts, the epidemic prevention and control work in China has borne successful, accelerating the gradual restoration of production, living order and routine medical work. However, there is increasing evidence that many patients with COVID-19 are asymptomatic, but they are potential transmitter of the virus. There are difficulties in screening for asymptomatic infections, which makes it more difficult for national prevention and control of this epidemic. Therefore, it is urgent to develop better screening and laboratory testing for asymptomatic infections with COVID-19 with high speed, sensitivity and specificity. It is also important to improve our risk assessment, prevention and control strategies to further prevent the spread of the epidemic.

Objective To investigate the clinical diagnostic value of serum procalcitonin(PCT),D-dimer (DD),C-reactive protein(CRP)in acute-on-chronic liver failure(ACLF). Methods 124 ACLF patients, 63 chronic hepatitis B patients,32 chronic hepatitis C patients,24 chronic hepatitis E patients and 60 healthy controls from the second affiliated hospital of Nanchang University were enrolled in this study.PCT was detected by a sandwish immunodetection method. D-dimer was detected by Latex Turbidimetry. CRP was detected by rate nephenometry. The detection results were used for analyzing the clinical diagnostic value of ACLF with infection. Results(1)The level of PCT,DD and CRP in ACLF group were significantly higher than non-ACLF group and healthy controls(P<0.05).The levels of PCT,DD and CRP in the infection group were significantly higher than non-infection group(P<0.05).(2)The positive rates of PCT,DD and CRP in the infection group were 93.24%, 78.38%,89.19%,which were significantly higher than the non-infection group and healthy controls respectively (P < 0.05).(3)The sensitivity(93.24%)and specificity(90.00%)of PCT were the highest among all indexes. (4)The area under the ROC curve of PCT,DD,CRP were 0.892,0.715,0.755,respectively.PCT had the highest diagnostic value. Conclusion The levels of serum PCT,DD and CRP have a significant clinical value for the early diagnosis of ACLF with infection.

Objective To evaluate the treatment of current status and prognosis in childhood APL with APL2008 ,which was administrated since 2008 in our center .Methods A total of 43 children with newly diagnosed APL between 2008 to 2014 were studied retrospectively .Treatment options and current status were summarized from 28 patients who received APL2008 therapy . Results Studied 43 patients were at median age of 8 years and 4 months ,with 28 boys and 15 girls .The main clinical manifestations were infection ,anemia ,bleeding ,fever ,hepatomegaly ,splenomegaly and lymphadenopathy .The proportions of low ,intermediate and high risk groups were 27 .9% ,48 .8% and 23 .3% ,respectively .Eleven cases could be diagnosed as DIC .Bone marrow morphology showed abnormal elevation of promyelocyte .37 patients had distinctive immunophenotype such as frequent expression of CD33 , CD117 and MPO .PML/RARαfusion gene positive rate was 100% in 43 children and cytogenetic analysis were positive in 37 cases , of which specific genetic lesion in APL cells with t (15 ;17)(q22 ;q12) was found in 28 cases ,and karyotypes was found in 9 cases as infrequent chromosomal abnormalities .In 43 patients ,4 cases were early dead from intracranial hemorrhage at early stage ,and 11 cases were given up early .There were only 2 cases dead ,2 cases relapsed and 1 case lost among 28 APL children ,which enabled ef‐ficacy analysis possible .96 .4% of these 28 cases achieved HCR .The 2 year Kaplan Meier estimates of OS and EFS were 85 .9% ± 7 .6% and 80 .4% ± 8 .8% .But OS and EFS would be 94 .7% ± 5 .1% and 88 .9% ± 7 .4% if 3 patients who had non standard treat‐ment were excluded .Conclusion Childhood APL were characterized by anemia ,bleeding ,fever and infiltration .APL′s coincidence rate between PML/RARa fusion gene and morphology ,immunology and cytogenetics were 95 .3% ,90 .2% and 86 .5% ,respective‐ly .APL2008 significantly improved the prognosis of APL .

OBJECTIVE:To better carry out the pharmaceutical services in outpatient pharmacy,and provide reference for the safe,effective and rational drug use of outpatients. METHODS:Questionnaires were designed based on the related information pro-vided by consultation services of outpatient pharmacy in our hospital and referring to the related literatures to randomly select and investigate the patients of outpatient pharmacy in our hospital,and the results were statistically analyzed. RESULTS:There were to-tally 450 questionnaires,involving 417 valid questionnaires with the effective recovery of 92.67%. The questions about pharmaceuti-cal service of surveyed patients were dosage and precautions,respectively with the number of 254(60.91%)and 251(60.19%);followed by functions and indications,with the number of 234 (56.12%);besides,there were also with widespread concerns, such as drugs efficacy,medication time,and medication of elderly,children and pregnant women,etc. Among the surveyed pa-tients,20.75% were blind medication;89.45% thought the pharmacists’guidance was helpful for medication;there were still 21.35% without pharmacists’medication guidance. CONCLUSIONS:The survey shows the poor awareness of rational drug use and lacking knowledge of drugs in outpatients,they are eager for medication guidance from professional pharmacists. However,the pharmaceutical service in outpatient pharmacy needs to be improved. It is suggested to actively promote the pharmacy services by implementing points medication,adopting red and blue for warning labels,providing comprehensive drug counseling services and carrying out rational drug use education,etc.

Acute-On-Chronic Liver Failure ; mortality ; Cause of Death ; Hepatitis B, Chronic ; mortality ; Humans

Objective To investigate the relationship between the efficacy of autologous epidermal grafting and the levels of epidermal cytokines in vitiligo. Methods A total of 57 patients with stable vitiligo receiving autologous epidermal grafting were included in this study. Before grafting, 17 patients were irradiated with narrow-band UVB on vitiliginous sites. Suction blister fluid was collected from the recipient site (vitiligous lesions) and donor site (normal skin) in these patients (including the 17 patients irradiated with NB-UVB). ELISA was used to detect the levels of endothelin-1 (ET-1 ) and stem cell factors (SCF) in suction blister fluid. Clinical efficacy was evaluated through a 3-month follow-up. Resttlts Among these 57 patients, 45 successfully responded to autologous epidermal grafting. In these 45 patients, the levels of ET-1 and SCF in vitiligous lesions were 728.97±286.12 ng/L and 329.97±114.13 ng/L respectively, significantly higher than those in nomal skin (503.16±251.44 ng/L, 224.73±107.91 ng/L, t = 5.443, 5.897, respectively, both P < 0.05 ). In those who responded poorly, significant difference was also observed in the level of SCF between the normal skin and vitiligous lesions (309.00±163.89 ng/L vs 204.22±83.25 ng/L, t = 3.03, P < 0.05), but not in the level of ET-1. Increased level of ET-1 was observed in both vitiligous lesions and normal skin of patients who responded well compared to those who responded poorly, while no difference was noticed in the level of SCF between these two groups of patients. The level of ET-1 was statistically higher in vitiligous lesions in patients exposed to NB-UVB than in those without exposure (t = 1.44, P > 0.05). In those patients who responded successfully, the level of ET-1 was lower in the 15 patients exposed to NB-UVB compared to the other 30 patients without exposure (548.48±230.22 ng/L vs 794.60±278.72 ng/L, P<0.05); no significant difference in the level of SCF was noted. Conclusions ET-1 and SCF may both play important roles in the repigmentation of vitiligo, with ET-1 exerting a more important role.