Humans ; Asthma/drug therapy* ; Biological Therapy

Perinatal loss is one of the most serious childbirth trauma,which seriously affects maternal physical and mental health.At present,the management strategy of maternal lactation can be divided into two aspects:milk return and milk donation.Breast milk donation may build new values of perinatal loss,which can promote maternal physical and mental recovery.This article reviewed the conception,status,motivations,facilitators,barriers and interventions of lactation management in women following perinatal loss,so as to provide bases for improving the awareness of obstetric nursing staff,quality of obstetric care and future research on lactation management in women following perinatal loss in China.

Objective To investigate the clinical characteristics and prognosis of primary testicular diffuse large B-cell lymphoma(PT-DLBCL).Methods The clinical data,treatment regimen and prognosis of PT-DLBCL patients were analyzed retrospectively,from the records of the Affiliated Hospital of Nantong University and the Second Affiliated Hospital of Dalian Medical University from Jan.1,2000 to Dec.31,2022.Results The median age of the 47 PT-DLBCL patients was 64 years old.The median overall survival(OS)was 41.6 months,with 1-year,3-year,and 5-year PT-DLBCL OS of 93%,77%,and 59%,respectively.Kaplan-Meier univariate analysis demonstrated that a diagnosed age≥70 years,Eastern cooperative oncology group(ECOG)score≥3,international prognostic index(IPI)score≥4,no combination of anthracycline and rituximab,a single treatment regimen,ineffective initial treatment and relapse,were asso-ciated with an adverse prognosis in PT-DLBCL(all P<0.05).Multivariate Cox regression analysis showed that an ECOG score≥3,no application of Rituximab,and an ineffective initial treatment response were independent risk factors for the poor prognosis of PT-DLBCL(all P<0.05).Conclusion PT-DLBCL is rare and associated with a poor prognosis.Early diagnosis and therapy with a combination of anthracyclines and rituximab may improve outcomes.

Objective:To explore the application value of copy number variation sequencing(CNV-seq) combined with chromosome karyotyping technology based on next-generation sequencing technology in prenatal diagnosis.Methods:The subjects of the study were 329 pregnant women who underwent prenatal diagnosis at Dalian Municipal Women and Children′s Medical Center from January 2019 to June 2020. The amniotic fluid samples of these pregnant women were submitted for chromosome karyotype analysis, and CNV-seq testing was performed at the same time to compare the test results of the two methods.Results:A total of 53 cases of abnormal chromosomes were detected using CNV-seq combined with chromosome karyotyping technology, with an abnormal detection rate of 16.11%(53/329). Among them, 26 cases had consistent detection results, including 22 cases of aneuploidy, 2 cases of structural abnormalities and 2 cases of mosaic; CNV-seq detected 23 cases of chromosome copy number variations that were missed by karyotyping, including 17 cases of microdeletion and 6 cases of microduplication; chromosome karyotype analysis detected 4 cases of chromosome structural abnormalities that were missed by CNV-seq, including 3 cases balanced translocation and 1 case of inversion.Conclusions:CNV-seq has obvious advantages in detecting copy number variations of small fragments, which can make up for the lack of resolution of karyotyping analysis; CNV-seq combined with chromosome karyotyping analysis can improve the detection rate of abnormal chromosomes, which is important for prenatal diagnosis meaning.

Chronic cough can occur in children of all ages, and the incidence rate and consultation rate increase each year.Clarifying the cause of chronic cough is the key to treatment.At present, there are no convenient, operable and unified standards for etiological analysis of chronic cough in the world.Therefore, the etiological analysis of chronic cough has always been a hot topic in clinical research.With the development of diagnosis and treatment technology, the role of pulmonary function and exhaled nitric oxide in the diagnosis of chronic cough has attracted attention.This article reviews the application value of pulmonary function combined with exhaled nitric oxide in etiology analysis of chronic cough in children, to provide reference for etiology analysis of chronic cough in children.

Objective: To evaluate the prognostic significance of early phase full donor chimerism (FDC) after myeloablative allogeneic peripheral blood stem cell transplantation (allo-PBSCT). Methods: The clinical data of 72 hematological patients received myeloablative allo-PBSCT from Feb. 2016 to Jul. 2017 were analyzed retrospectively. The median age was 36.5 years (range 4-59), 44 were males and 28 females. Of the donors, there were 35 HLA matched sibling donors, 27 haploidentical donors and 10 unrelated donors. Polymerase chain reaction amplification of short tandem repeat sequence (PCR-STR) was used to detect donor cell chimerism (DC) rate of recipient bone marrow at one, two and three months after transplantation. Results: The median follow-up was 462 d (range: 47-805 d), 55 cases were still alive, and 45 cases were disease-free survival (DFS) at the end of follow-up. The 2-year overall survival (OS) and DFS were (68.9±7.7)% and (59.5±6.3)%, respectively. A number of 16 cases underwent relapses, with 2-year cumulative incidence of (24.1±5.3)%. The median time of recurrence was 157(32-374) d. Forty cases (55.6%) developed acute graft-versus-host diseases (aGVHD), with median time of 35.5 (13-90) d. Chronic GVHD (cGVHD) occurred in 23 patients (31.9%), with median time of 169 (94-475) d. Univariate analysis found the following factors were not related to OS, DFS or relapse rate (RR), including age, sex, blood type and sex of donor-recipient, occurrence of aGVHD and cGVHD. The OS and DFS in cases reached FDC and no FDC at two months after transplantation were (85.2±6.9)% vs (66.1±7.7)% (P=0.051) and (76.7±7.7)% vs (48.9±8.1)% (P=0.021), respectively. The RR rate in FDC group was lower than that in no FDC group [(16.6±6.8)% vs (30.4±7.8)%, P=0.187, respectively]. Conclusion The present study confirmed the important value for predicting the prognosis with whether or not the patients reached FDC at the early phase after allo-PBSCT. The OS and DFS in cases with FDC at two months after transplantation were significantly higher than those of no FDC patients.

Total 1 452 newborns were home visited within 28 d after birth during January 2016 to December 2016,and 27 cases of skin infections were found.Umbilical inflammation was more common (11 cases),followed by folliculitis (9 cases) and impetigo (7 cases).Samples were collected for bacterial culture and identification from the skin of infected newborns,the hands and nasal cavity of family baby caretakers,and household articles,including faucets,mobile phones,toilet buttons and so on.The pathogens identified were Staphylococcus aureus in 20 cases (including 2 methicillin-resistant strains) and Escherichia coli in 7 cases.The isolation of Staphylococcus aureus in household articles was significantly correlated with newborns infected with Staphylococcus aureus (x2=678.808,P＜0.01);and the isolation of Staphylococcus aureus from family baby caretakers was also significantly associated with neonatal Staphylococcus aureus infection (x2=820.396,P＜0.01).In 7 cases of Escherichia coli infection,the Escherichia coli were detected from samples of baby caretakers or household articles.The study suggests that the awareness of baby caretakers and home hygiene are important to reduce neonatal skin infections.

Objective To construct a comprehensive evaluation model of long-term care for the elderly based on the situation of our country,which is suitable for the family,community and the pension service organization. Methods The model index item pool (7 one class indexes and 133 two class indexes) formed by literature research, theoretical extraction and qualitative interview were taken as the research object.To screen the model parameters by using the Delphi method,then formed a index system of hierarchical comprehensive evaluation model of long term care for the elderly. Results 25 experts were from 10 provinces of a total of 23 Medical Colleges and affiliated hospital,positive coefficients for the first round of 83.33% and the second round of 100.00%,the average value of the two authority coefficients were both >0.90, the coordination coefficient of the evaluation index for the first round of 0.221 and the second round of 0.266(both P<0.05).The primary model index system consists of 7 first level indicators,a total of 13 secondary indicators.Among them,the"daily life ability","cognitive ability","falling risk"and"pressure sore risk" evaluation were using very mature scales, the "medical care project", "abnormal performance/symptom" and "self care knowledge needs" evaluation were independently established in this study. Conclusions Preliminary construction process of the index system for the comprehensive evaluation model of long term care for the elderly was rigorous and had better theoretical support,and the Delphi method experts had higher degree of attention and participate in the research content, experts had good representativeness,can effectively guarantee the reliability of the selected items.

Objective: To investigate the pathogen spectrum distribution and drug resistance of febrile neutropenic patients with hematological diseases in Shanghai. Methods: A retrospective study was conducted on the clinical isolates from the febrile neutropenic patients hospitalized in the departments of hematology in 12 general hospitals in Shanghai from January 2012 to December 2014. The drug susceptibility test was carried out by Kirby-Bauer method. WHONET 5.6 software was used to analyze pathogenic bacteria and drug susceptibility data. Results: A total of 1 260 clinical isolates were collected from the febrile neutropenic patients. Gram-positive bacteria accounted for 33.3% and Gram-negative bacteria accounted for 66.7%. Klebsiella pneumoniae (12.5%) , Stenotrophomonas maltophilia (9.5%) , Escherichia coli (9.1%) , Pseudomonas aeruginosa (8.7%) , Acinetobacter baumannii (6.6%) , Staphylococcus aureus (5.6%) and Enterococcus faecium (5.0%) were ranked in the first 7 of all pathogens. In the respiratory tract secretions specimens, non-fermented strains accounted for 56.2%. Stenotrophomonas maltophilia accounted for 15.2%. Enterobacteriaceae and coagulase-negative Staphylococci accounted for 42.3% (104/246) and 32.6% (85/246) respectively in blood samples. Enterobacteriaceae and Enterococcus bacteria accounted for 39.4% (76/193) and 28.5% (55/193) respectively in pus specimens. The detection rates of methicillin resistant Staphylococcus aureus (MRSA) and methicillin resistant coagulase negative Staphylococci (MRCNS) were 54.3% and 82.5%, respectively. Staphylococcus bacterial strain was not found to be resistant to linezolid, vancomycin and teicoplanin. The detection rate of Enterococcus vancomycin-resistant strains was 8.9%. Enterococcus was not detected resistance to oxazolidinone strains. Enterobacteriaceae bacteria were highly sensitive to carbapenems. The resistance rate of Pseudomonas aeruginosa to imipenem and meropenem was 34.1% and 15.8%, respectively. Stenotrophomonas maltophilia was more sensitive to minocycline hydrochloride, levofloxacin and sulfamethoxazole. The resistance rate of Acinetobacter baumannii only to cefoperazone-sulbactam was less than 10.0%. The antibiotic resistance rate of Klebsiella pneumoniae, Stenotrophomonas maltophilia, Pseudomonas aeruginosa and Acinetobacter baumanii to most of common antibiotics was lower than that of the CHINET surveillance. Conclusions The pathogenic strain distribution in common infection sites of febrile neutropenic patients was characterized. Bacterial resistance surveillance was better than the CHINET nationwide large sample surveillance in China.

Objective To analyze the risk factors of thyroid nodule (TN) in Harbin City,Heilongjiang Province.Methods From November 2014 to January 2015,residents lived in Nangang,Daoli,Daowai districts and villagers of Xubao Town of Hulan District of Harbin City were selected as research subjects,who lived in the local regions for more than 5 years,a total of 2 650 people were surveyed.Influence factors of TN were surveyed by general survey,clinical examination and thyroid ultrasound examination.Logistic regression analysis was used to analyze relationships between various factors and TN in single factor analysis and multiple factors analysis.Results Excluding 36 cases with thyroid surgery history,the total prevalence of TN was 22.92％ (599/2 614),single factor Logistic regression analysis found that females [odds ratio (OR) =1.597,95％ confidence interval (CI) =1.328-1.919],elderly (OR =3.356,95％CI =2.699-4.173),living in cities and towns (OR =1.677,95％CI =1.391-2.021),obesity (OR =1.245,95％CI =1.036-1.497),history of hypertension (OR =1.766,95％CI =1.414-2.205) were the risk factors of TN.In multiple factors Logistic regression analysis,risk factors from high to low in the order were elderly (OR =3.076,95％CI =2.436-3.884),females (OR =1.819,95％CI =1.493-2.215),living in cities and towns (OR =1.701,95％CI =1.400-2.066),history of diabetes (OR =1.644,95％CI =1.235-2.189),obesity (OR =1.325,95％CI =1.085-1.618).Conclusions The risk factors of TN include living in cities and towns,females,elderly,obesity,history of hypertension or diabetes in Harbin City of Heilongjiang Province.