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.

Selective occlusion of tumor vasculature has proven to be an effective strategy for cancer therapy. Among vascular coagulation agents, the extracellular domain of coagulation-inducing protein tissue factor, truncated tissue factor (tTF), is the most widely used. Since the truncated protein exhibits no coagulation activity and is rapidly cleared in the circulation, free tTF cannot be used for cancer treatment on its own but must be combined with other moieties. We here developed a novel, tumor-specific tTF delivery system through coupling tTF with the DNA aptamer, AS1411, which selectively binds to nucleolin receptors overexpressing on the surface of tumor vascular endothelial cells and is specifically cytotoxic to target cells. Systemic administration of the tTF-AS1411 conjugates into tumor-bearing animals induced intravascular thrombosis solely in tumors, thus reducing tumor blood supply and inducing tumor necrosis without apparent side effects. This conjugate represents a uniquely attractive candidate for the clinical translation of vessel occlusion agent for cancer therapy.

Objective To investigate the expression of TP53, PDGF and EGFR in primary astrocytomas, and analyze their correlation with clinicopathological features and prognosis. Methods We analyzed retrospectively the clinicopathological data of 90 patients with primary astrocytoma. The expressions of TP53, PDGF and EGFR in primary astrocytoma tissue samples were detected by immunohistochemistry. The survival of patients was followed up and Cox regression analysis was used to determine the prognostic factors. Results TP53 was expressed in the nucleus, PDGF and EGFR were expressed in the cytoplasm and cell membrane. The positive expression rates of TP53, PDGF and EGFR were 58.89%, 51.11% and 48.89%, significantly higher than those in normal brain tissues (all P < 0.05); the positive expression rate of TP53 in patients with tumor size ≥3 cm was higher than that in patients with tumor size < 3 cm. The positive expression rates of TP53, PDGF and EGFR in patients with WHO stages Ⅲ-Ⅳ were higher than those in patients with WHO stageⅠ-Ⅱ(all P < 0.05); the survival time of patients with positive expression of TP53, PDGF and EGFR were shorter than those of negative expression (all P < 0.05). Cox regression analysis found that WHO staging, TP53, PDGF and EGFR were all factors influencing the prognosis of primary astrocytomas patients. Conclusion TP53, PDGF and EGFR are highly expressed in primary astrocytomas and closely related to tumor progression. They are factors that affect the prognosis of patients.

Objective:To explore the effect of quality feedback theory combined with humanistic care on psychological status of patients undergoing lung volume reduction surgery.Methods:From January 2017 to January 2019, 68 patients with emphysema who underwent lung volume reduction surgery in Henan Provincial Chest Hospital were selected as the research object. The patients were divided into a control group (34 cases) and an observation group (34 cases) . The control group was given nursing based on quality feedback theory during the entire perioperative period of lung volume reduction surgery, and the observation group was given humanistic care combined with nursing based on quality feedback theory during the entire perioperative period of lung volume reduction. The psychological status [Self-rating Anxiety Scale (SAS) , Self-rating Depression Scale (SDS) score] were compared between the two groups before and after intervention.Results:Before the intervention, there was no significant difference in SAS and SDS scores between the two groups ( P>0.05) . After the intervention, the SAS and SDS scores of the two groups were both decreased, and the SAS and SDS scores of the observation group were lower than those of the control group, the differences were statistically significant ( P<0.05) . Conclusions:Quality feedback theory combined with humanistic care can promote the psychological status of patients undergoing lung volume reduction surgery.

Objective:To compare the efficacy of haploid hematopoietic stem cell transplantation (haplo-HSCT) and intensive immunosuppressive therapy (IST) in children with severe aplastic anemia (SAA).Methods:The medical records of children newly diagnosed as SAA in the First Affiliated Hospital of Zhengzhou University from January 2013 to June 2018 were retrospectively analyzed.Among them, 33 patients received haplo-HSCT and 24 patients received IST that combined anti-thymocyte globulin(ATG) with Cyclosporine (CsA). The effective rate, overall survival (OS) rate, and failure free survival(FFS) rate of children in the haplo-HSCT group and the IST group were compared.Results:The median follow-up period was 25 months (9-60 months). There were 5 cases of early death in the haplo-HSCT group and 4 cases in the IST group, and the differences were not statistically significant ( P=0.822). Leaving out the early death cases, the effective rate in the haplo-HSCT group [100%(28/28 cases)] was higher than that in the IST group [30%(6/20 cases)] after 3 months of treatment, the difference was statistically significant ( χ2=27.671, P<0.01). After 6 months of treatment, the effective rate in the haplo-HSCT group [92.9%(26/28 cases)] was higher than that in the IST group [65.0%(13/20 cases)], and the difference was statistically significant ( χ2=5.943, P=0.015). After 12 months of treatment, the effective rate in the haplo-HSCT group [89.3%(25/28 cases)] was higher than that in the IST group [70.0%(14/20 cases)], but the difference was not statistically significant( P>0.05). The 3-year expected OS rate of children in the haplo-HSCT group and the IST group were 75.0% and 70.3%, respectively, with no statistically significant difference ( χ2=0.133, P=0.716). The 3-year expected FFS rate of children in the haplo-HSCT group (74.2%) was significantly higher than that in the IST group (48.7%), and the difference was statistically significant ( χ2=4.036, P=0.045). Conclusion:For children with SAA, haplo-HSCT is also an effective treatment if there is no sibling donor of hematopoietic stem cell transplantation.

Objective:To study the effect of radiotherapy on the quality of life (QOL) of patients with bone metastasis of hepatocellular carcinoma by analyzing the Function Assessment of Cancer Treatment(FACT), and to analyze the influence of clinical factors on the improvement of the QOL after radiotherapy.Methods:The FACT bone pain scale in 43 patients with bone metastasis of hepatocellular carcinoma before and after radiotherapy was retrospectively analyzed. The changes in QOL score before and after radiotherapy were analyzed by T test from five aspects: overall QOL score, general functional status, pain degree, physical function and social psychology. Further analysis was made on the scores of patients whose QOL had not been improved. Chi-square test was used to analyze the correlation between clinical factors and QOL improvement after radiotherapy. Results:After radiotherapy, the QOL of patients were improved in all aspects compared with those before radiotherapy, and there were statistical differences ( t=7.621, 5.887, 9.407, 7.785, 4.487, P<0.05). In patients whose QOL did not improve after radiotherapy, the scores of overall QOL and psychosocial assessment decreased significantly, and there were significant differences ( t=3.381, 4.982, P<0.05). Among the clinical factors, soft tissue mass at bone metastasis site and radiotherapy prescription dose had significant effects on the improvement of patients′ life after radiotherapy (χ 2=5.180, 7.457, P<0.05). Whether there were soft tissue masses in bone metastases before radiotherapy, the improvement rates of QOL after radiotherapy were 50.00% and 85% respectively. The improvement rates of QOL after radiotherapy were 44.44% and 84% in patients with prescription dose of <40 Gy and≥40 Gy respectively. Multivariate analysis showed that soft tissue mass at bone metastasis site, the dose of radiotherapy prescription and numeric rating scale (NRS) of pain had more significant effects on QOL ( OR=0.296, 0.020, 1.592, P<0.05). Conclusions:Radiotherapy at bone metastasis sites can significantly improve the QOL of liver cancer patients with bone metastasis. Psychosocial status can affect the QOL of patients. In the case of soft tissue mass in bone metastasis site, the prescription dose of radiotherapy (≥40 Gy) can better improve the QOL.

Objective:To compare the efficacy of the second generation tyrosine kinase inhibitor dasatinib combined with allogeneic hematopoietic stem cell transplantation(allo-HSCT)or chemotherapy in the treatment of Ph + acute lymphoblastic leukemia (Ph + ALL). Methods:A total of 56 Ph + ALL patients received dasatinib from January 2014 to June 2018. According to whether or not allo-HSCT was performed, they were divided into transplantation group(n=22)and chemotherapy group(n=34). The total survival rate(OS), disease-free survival rate(DFS), relapse and non-recurrence mortality(NRM)were compared between two groups. Results:The 2-year OS, DFS and cumulative recurrence rates were 69.1 % vs 47.8 %, 62.2 % vs 43.1 % and 14.6 % vs 44.1 % in transplantation and chemotherapy groups respectively. Significant inter-group differences existed in 2-year DFS, DFS and cumulative recurrence rates. The value of NRM was higher in transplantation group than that in chemotherapy group(18.6 % vs 14.1 %). However, the difference was statistically insignificant( P=0.476). Conclusions:The efficacy of dasatinib plus allo-HSCT is superior to that of dasatinib plus chemotherapy in the treatment of Ph + ALL.

Objective To study the effect of Xiaoqinglong Decoction on the expression of TSLP in airway epithelial cells of asthmatic model mice.Methods Thirty healthy female BALB/C mice were divided into the blank control group,asthma model group and Xiaoqinglong Decoction group,10 cases in each group.The each group adopted corresponding intervention measures. Then the bronchial and lung tissues were taken.The expression level of bronchial TSLP was detected by immunofluorescence,and the expression level of TSLP mRNA and protein in lung tissue was detected by qRT-PCR and Western Blot.Results The mouse bronchial epithelial cell membrane TSLP staining was strongly positive in the asthma model group,which was weakly positive in the Xiaoqinglong Decoction group and negative in the blank control group.Compared with the asthma model group,mice lung tissue TSLP mRNA expression level in the Xiaoqinglong Decoction group and blank control group was decreased(P<0.05),the Xiaoqin-glong Decoction group was slightly higher than the blank control group,but the inter-group difference was not statistically signifi-cant(P>0.05).The expression level of lung tissue TSLP protein in the Xiaoqinglong Decoction group and blank control group was lower than that in the asthma model group(P<0.05),the Xiaoqinglong Decoction group was slightly higher than the blank control group,but the inter-group difference was not statistically significant(P>0.05).Conclusion Xiaoqinglong decoction has obvious inhibiting effect on the expression of TSLP in airway epithelial cells of asthmatic model mice.

Objective To investigate the expression of C1q/TNF-related protein-1(CTRP1)in patients with acute ischemic stroke and its predictive value for the severity of neurological deficits. Methods A total of 452 patients with newly diagnosed ischemic stroke(IS)from February 2014 to February 2017 in our hospital were selected as the study subjects,and 403 healthy subjects were selected as control group in the physical examination center. The National Institutes of Health Stroke Scale(NIHSS)was used to evaluate the neurological status of pa-tients at admission and at 6 months after discharge. The expression of CTRP1 in plasma was detected by enzyme-linked immunosorbent assay(ELISA). Multiple linear regression was used to analyze the relationship between neu-rological deficit and CTRP1. Results The expression level the CTRP1in the healthy control group[(119.53 ± 17.62)ng/mL],unexplained causes IS[(145.81 ± 18.96)ng/mL],large atherosclerotic IS[(153.17 ± 19.21) ng/mL],cardiac IS[(156.56 ± 20.96)ng/mL]and small artery occlusion IS[(169.23 ± 22.34)ng/mL]in-creased gradually with statistically significant difference(P < 0.05). The level of CTRP1in the healthy control group[(119.53 ± 17.62)ng/mL],mild neurologic impairment group[(156.29 ± 19.86)ng/mL],moderate neuro-logic impairment group[(168.74 ± 18.53)ng/mL]and severe neurologic impairment group[(175.96 ± 19.15)ng/mL]increased gradually with statistically significant difference (P < 0.05). Multiple linear regression analysis showed that CTRP1,age,diabetes,Hs-CRP and LDL-C were independent factors of neurological deficits at 6 months after discharge in IS patients. Conclusion CTRP1 can effectively predict the severity of neurological defi-cits in patients with acute IS.