The dissemination of culture requires carriers.The construction of hospital characteristic culture and hospital brand culture that highlights hospital characteristics needs to be recognized by medical staff and patients.A good hospital culture is one of the important factors to enhance hospital competitiveness,and can also enhance the hospital's reputation among the pub-lic.As a very common way of information circulation in China,self media and integrated media are rapidly developing and inno-vating in the field of healthcare.Hospitals should actively build their own"micro"cultural platforms.Using self media platforms to tell micro stories,popularize micro knowledge,shoot micro movies,publish micro books,hold micro forums,and micro mu-sic,to enrich patients'cultural lives and create an exclusive hospital culture.

ObjectiveTo study the pathway of cis-dichlorodiamineplatinum (DDP) inhibiting the synthesis of steroid hormones in mice, and to observe the intervention effect of dehydroepiandrosterone (DHEA).MethodsSixty adult ICR mice were randomly divided into three groups: control group, DDP modeling group, and DHEA group, with 10 male and 10 female mice in each group. The DDP modeling group mice were intraperitoneally injected with DDP solution at a dose of 2.5 mg·kg^-1·d^-1, once every 3 days, a total of 7 times. On the same day of modeling, the control group mice were injected with an equal amount of physiological saline intraperitoneally. The DEHA treatment group mice were treated with DDP and given a dose of 8.3 mg·kg^-1·d ^-1 of DHEA by gavage for 21 consecutive days. The changes of fatigue indexes of mice were observed by open field, grip and rod rotation tests. The morphology changes of adrenal gland, testicular and ovarian tissue were observed by pathological section and HE staining. The levels of serum steroid hormones were detected by high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). The mRNA and protein expression levels of the related genes of the hypothalamus, hypophysis, adrenal, testis and ovary were tested by real-time fluorescent quantitative PCR (RT-qPCR) and Western blotting.ResultsCompared with control group, both male and female mice in DDP modeling group were significantly losing weight (P＜0.05), their abilities in horizontal movement and vertical movement decreased (all P＜0.05), and the stay time and grip also significantly decreased (all P＜0.05) in female mice. Indexes of fatigue were improved after DHEA supplement (all P＜0.05). In the DDP modeling group, the arrangement of spermatogenic cells at all levels in the testicular tissue was disordered and the testicular interstitial edema was observed, and a large number of primordial follicles in the ovarian tissue were activated, the number of atresia follicles increased, and the number of granulosa cells in the follicles decreased; while in the DHEA group, the damaged phenotype of testicles and ovaries was significantly improved. Compared with control group, the levels of serum testosterone and dihydrotestosterone in both male and female DDP modeling mice significantly decreased (P＜0.01), the pregnenolone was down-regulated but corticosterone was up-regulated significantly (P＜0.05) in male mice, the corticosterone was down-regulated significantly (P＜0.05) in female mice. Compared with the DDP group, after DHEA supplement, the pregnenolone in male mice and the progesterone in female mice increased significantly (P＜0.05), but the pregnenolone in female mice and the progesterone in male mice decreased significantly (P＜0.05). Compared with control group, the expression levels of Cyp21a1 and Cyp11a1 genes in the adrenal gland and Gnrh gene in the hypothalamus of male and female mice in the DDP modeling group significantly decreased (all P＜0.05); the expression levels of Hsd3b2 gene in the adrenal gland, Star, Cyp11a1, and Lhr genes in the ovaries, Crh, Pomc, and Lhb genes in the hypothalamus, pituitary, and pituitary of female mice significantly decreased (all P＜0.05); the expression levels of Star gene and StAR protein in the testicles of male mice, as well as Fshb and Lhb genes in the pituitary gland, were significantly down-regulated (all P＜0.05). After DHEA supplement, compared with the DDP modeling group, the mRNA expression levels of Cyp17a1 in the adrenal gland of male mice and Cyp17a1, Lhr and Fshr genes in testis were down-regulated significantly (P＜0.05); the expression level of Cyp11a1 gene in the adrenal gland of female mice was also decreased (P＜0.05); while the expression levels of Hsd3b2 gene in the adrenal gland, Star, Cyp11a1, Hsd3b2 and Lhr gene in the ovary, and Lhb gene in the pituitary gland were all up-regulated ( P＜0.05).ConclusionThe function of hypothalamus-pituitary-adrenal/gonadal axis was inhibited by DDP intermittent injection, especially in female. Supplementation of DHEA can help regulate the homeostasis of steroid hormone levels.

OBJECTIVE: To summarize the clinical and laboratory characteristics of patients with acute myeloid leukemia (AML) with inv(16)/t(16;16) (p13.1;q22), and to analyze the risk factors affecting the prognosis of the patients. METHODS: AML patients with inv(16)/t(16;16) (p13.1;q22) and/or CBFβ-MYH11⁺ admitted to the Department of Hematology, The First Affiliated Hospital of Soochow University from January 1, 2008 to October 30, 2019 were retrospective analyzed, the clinical and laboratory indicators, as well as treatment plans and efficacy evaluations of the patients were all recorded. Furthermore, related factors affecting the overall survival (OS) and event-free survival (EFS) of the patients were analyzed. RESULTS: Among 151 AML patients with inv(16)/t(16;16) (p13.1;q22) and/or CBFβ-MYH11⁺, the percentage of additional chromosomal abnormalities was about 27.8%, and the most common additional chromosomal abnormality was +22 (33/151, 21.8%), followed by +8 (11/151, 7.3%). There were 112 patients with perfect NGS examination, and the result showed the most common accompanying gene mutations were KIT mutation (34/112, 30.4%) and FLT3 mutation (23/112, 20.5%). Univariate analysis showed that factors affecting EFS included: NE≤0.5×10⁹/L (P=0.006) and combined K-RAS mutation (P=0.002); Factors affecting OS included: Age≥50 years old (P<0.001) and NE≤0.5×10⁹/L (P=0.016). Multivariate analysis showed that NE≤0.5×10⁹/L (P=0.019) was the risk factors affecting OS. The proportion of bone marrow eosinophilia (BME)≥10.00% (P=0.029) was the risk factors affecting EFS. CONCLUSION The prognosis for those newly diagnosed AML patients who were of advanced age, the high proportion of bone marrow eosinophils, K-RAS mutations, and agranulocytosis is poor. The treatment plans can be adjusted in the early stage to improve the prognosis of such patients.
Chromosome Inversion ; Humans ; Leukemia, Myeloid, Acute/genetics* ; Middle Aged ; Myosin Heavy Chains/genetics* ; Oncogene Proteins, Fusion ; Prognosis ; Retrospective Studies

Objective To investigate the clinical application value of contrast-enhanced ultrasound (CEUS) in hepatic artery thrombosis (HAT) after pediatric liver transplantation. Methods Clinical data of 126 pediatric recipients undergoing liver transplantation were retrospectively analyzed. The incidence of HAT after pediatric liver transplantation was summarized. Color Doppler ultrasound and CEUS manifestations of HAT were compared. Results According to color Doppler ultrasound, 17 cases were highly suspected with HAT. Nine cases were highly suspected with HAT by CEUS, who were subsequently confirmed by CT angiography (CTA) or surgery. CEUS manifestations of HAT showed that hepatic artery was not seen surrounding the portal vein during the arterial phase or even portal venous phase. Hepatocyte necrosis occurred in 4 patients with HAT, and no perfusion of intrahepatic contrast agent was observed on CEUS. Conclusions CEUS yields high clinical application value in the diagnosis of HAT after pediatric liver transplantation. It has significant advantages compared with traditional CTA, which could be widely applied in clinical practice.

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 alteration of immune microenvironment in giant cell tumor of bone (GCTB) after denosumab treatment from the aspect of immune cellsat single-cell level.Methods:During Nov 2018 and May 2020, fresh tumor excision tissues from GCTB cases were collected and received CyTOF analyses. CyTOF datasets were analyzed and visualized by t-distributed stochastic neighbor embedding (TSNE) method of reduction dimension. The compositions of immune cells in GCTB with or without denosumab treatment were compared. The supernatant of culture medium of ex vivo inoculated primary tumor tissues was harvested to clarify if the culturing supernatant could affect cell growth.Results:A total of 15 primary GCTB cases and three denosumab-treated samples were included in this study and were sent for CyTOF and multicolor FACS assay. GCTB was featured of T-cell and macrophage-like myeloid cell-dominant immune microenvironment. After denosumab treatment, the percentage of T-cells was significantly elevated, while the number of macrophage-like myeloid cells were reduced. Furthermore, the ratio of macrophage-like myeloid cells in total live cells was associated with the treatment period of denosumab. The multinuclear osteoclast like giant cells were characterized by the expression of γδTCR, while most of the intratumoral CD8+ T-cells were activated PD-1+CD69+T-cells. The culturing supernatant of denosumab treatment-free GCTB tissues reinforced cell proliferation in vitro, while this phenomenon was not seen when using denosumab treated tissues.Conclusion:Illustrated the immune cell atlas of GCTB, and preliminarily investigated the potential effects of immune cells on tumor progression in GCTB, providing some theoretical clues for prolonged use of denosumab in unresectable GCTB cases.

Objective:To analyze the surgical techniques, surgical indications and early clinical effects of 3D printed hemipelvic prostheses in the reconstruction of pelvic malignant tumors resected by the sacroiliac joint.Methods:From January 2016 to March 2020, a retrospective analysis of 9 patients with malignant tumors involving pelvis I+II or I+II+III region were treated with sacroiliac joint osteotomy and 3D printed pelvic prosthesis reconstruction. There were 7 males and 2 females; their age was 51.1±10.5 years (range 27-66 years). Among them, 5 cases were chondrosarcoma, 1 case was pleomorphic undifferentiated sarcoma, 2 cases were metastatic renal cell carcinoma, and 1 case was metastatic primitive neuroectodermal tumor. Resection of pelvic area I+II or I+II+III were according to the extent of tumor involvement. During the resection of pelvic I region, osteotomy was done through sacroiliac joint surface, and 3D printed hemipelvic prosthesis that fits the sacral auricular surface was used for reconstruction. Postoperative imaging examination was used to evaluate the acetabular rotation center deviation of the pelvic prosthesis; the International Bone Tumor Society (Musculoskeletal Tumor Society, MSTS) function score was used for functional evaluation; the patient's oncology outcome and postoperative complications were evaluated.Results:All 9 patients successfully completed the operation. The operation time was 3.5-6 hours, with an average of 4.5 hours. The intraoperative blood loss was 800-3 000 ml, with an average of 1 400 ml. 3 patients underwent resection and reconstruction of pelvis I+II area, 4 patients underwent pelvic resection and reconstruction of I+II+III area, 2 patients underwent pelvic I+II+III area combined with proximal femur resection and reconstruction; all patients were followed up. The follow-up time was 6-50 months, with an average of 16 months. At the last follow-up of 9 patients, the MSTS score was 12-26, with an average of 20.2; the postoperative rotation center horizontal displacement distance was 10.67±7.12 mm, and the vertical displacement was 8.56±4.22 mm. One case of metastatic cancer was found to have multiple metastases throughout the body during chemotherapy 3 months after surgery, and died in 7 months after surgery; 1 case of pelvic metastatic renal cell carcinoma developed multiple metastases within one and a half years after surgery, controlled by targeted drugs, and survived with the tumor; the rest seven cases had no recurrence at the surgical site and no distant metastasis was found.Conclusion:The semipelvic prosthesis with 3D printed auricular surface has potential advantages in reconstructing the bone defect of the pelvis I+II or I+II+III area after the sacroiliac joint osteotomy. The short-term efficacy is relatively satisfactory, and the long-term efficacy remains to be further observed.

Acetabulum/surgery* ; Developmental Dysplasia of the Hip ; Follow-Up Studies ; Hip Dislocation, Congenital/surgery* ; Humans ; Magnetic Resonance Imaging ; Osteotomy ; Retrospective Studies ; Treatment Outcome

Objective:To investigate the etiology of necrotizing pneumonia (NP) in children and the clinical characteristics of NP caused by different pathogens in China.Methods:A retrospective, case-control study was performed in children with NP who were admitted to 13 hospitals in China from January 2008 to December 2019. The demographic and clinical information, laboratory data, etiological and radiological findings were analyzed. The data were divided into three groups based on the following years: 2008-2011, 2012-2015 and 2016-2019, and the distribution characteristics of the pathogens in different period were compared. Meanwhile, the pathogens of pediatric NP in the southern and northern China were compared. And the clinical characteristics of the Mycoplasma pneumoniae (MP) NP and the bacterial NP were also compared. T-test or Mann-Whitney nonparametric test was used for comparison of numerical variables, and χ 2 test was used for categorical variables. Results:A total of 494 children with NP were enrolled, the median ages were 4.7 (0.1-15.3) years, including 272 boys and 222 girls. Among these patients, pathogens were identified in 347 cases and the pathogen was unclear in the remaining 147 cases. The main pathogens were MP (238 cases), Streptococcus pneumoniae (SP) (61 cases), Staphylococcus aureus (SA) (51 cases), Pseudomonas aeruginosa (13 cases), Haemophilus influenzae (10 cases), adenovirus (10 cases), and influenza virus A (7 cases), respectively. MP was the most common pathogen in all three periods and the proportion increased yearly. The proportion of MP in 2016-2019 was significantly higher than that in 2012-2015 (52.1% (197/378) vs. 36.8% (32/87), χ 2= 6.654, P=0.010), while there was no significant difference in the proportion of MP in 2012-2015 and that in 2008-2011 (36.8% (32/87) vs. 31.0% (9/29), χ2=0.314, P=0.575).Regarding the regional distribution, 342 cases were in the southern China and 152 in the northern China. Also, MP was the most common pathogen in both regions, but the proportion of MP was higher and the proportion of SP was lower in the north than those in the south (60.5% (92/152) vs. 42.7% (146/342), χ 2=13.409, P<0.010; 7.9% (12/152) vs. 14.3% (49/342), χ 2= 4.023, P=0.045). Comparing the clinical characteristics of different pathogens, we found that fever and cough were the common symptoms in both single MP and single bacterial groups, but chest pain was more common (17.0% (34/200) vs. 6.1% (6/98), χ 2=6.697, P=0.010) while shortness of breath and wheezing were less common in MP group (16.0% (32/200) vs. 60.2% (59/98), χ 2=60.688, P<0.01; 4.5% (9/200) vs. 21.4% (21/98), χ 2=20.819, P<0.01, respectively). The white blood cell count, C-reactive protein and procalcitonin in the bacterial group were significantly higher than those in the MP group (14.7 (1.0-67.1)×10 9/L vs. 10.5 (2.5-32.2)×10 9/L, 122.5 (0.5-277.3) mg/L vs. 51.4 (0.5-200.0) g/L, 2.13 (0.05-100.00) μg/L vs. 0.24 (0.01-18.85) μg/L, Z=-3.719, -5.901 and -7.765, all P<0.01). Conclusions:The prevalence of pediatric NP in China shows an increasing trend during the past years. MP, SP and SA are the main pathogens of NP, and the most common clinical symptoms are fever and cough. The WBC count, C-reactive protein and procalcitonin in bacterial NP are significantly higher than those caused by MP.

Objective To evaluate the application value of quantitative parameters of contrast-enhanced ultrasound (CEUS) in evaluating the donor liver from donation after brain death (DBD). Methods Clinical data of 25 DBD donor livers and 10 healthy adult livers were retrospectively analyzed. CEUS examinations of DBD donor livers and healthy livers were collected. Quantitative parameters included the area under curve (AUC), maximum intensity (I_max), time to peak (TTP) and mean transit time (mTT), etc. Results Among 25 cases of DBD donor livers, 23 cases showed normal enhancement pattern, and the other 2 cases presented with abnormal enhancement pattern. Compared with the control group, the AUC, I_max and mTT values of DBD donor livers were significantly decreased (all P < 0.05). Conclusions CEUS quantitative parameters can be effective means to evaluate the micro-perfusion of DBD donor livers.