Objective To identify the risk factors of patients with frequent acute exacerbations of chro-nic obstructive pulmonary disease(AECOPD)and construct a prediction model based on the clinical data,provi-ding a theoretical basis for the clinical prevention and treatment.Methods A total of 25 638 COPD patients ad-mitted to the Department of Respiratory and Critical Care Medicine,the Third People's Hospital of Chengdu from January 1,2013 to May 1,2023 were selected.Among them,11 315 patients were included according to the inclusion and exclusion criteria,and their clinical characteristics were analyzed.Multivariate Logistic regression was carried out to identify the risk factors for frequent AECOPD.A nomogram model was utilized to quantify the risk of acute exacerbation,and the performance of the prediction model was assessed based on the area under the receiver operating characteristic(ROC)curve.Results In the patients with frequent AECOPD,male percentage(P＜0.001),age(P＜0.001),urban residence(P＜0.001),smoking(P＜0.001),length of stay(P＜0.001),total cost(P＜0.001),antibiotic cost(P＜0.001),diabetes(P=0.003),respiratory failure(P＜0.001),heart disease(P＜0.001),application of systemic glucocorticoids(P＜0.001),white blood cell count(P＜0.001),neutrophil percentage(P＜0.001),C-reactive protein(P＜0.001),total cholesterol(P＜0.001),and brain natriuretic peptide(BNP)(P＜0.001)were all higher than those in the patients with infre-quent AECOPD.Multivariate Logistic regression analysis revealed that age,urban residence,smoking,diabe-tes,heart disease,Pseudomonas aeruginosa infection,application of systemic glucocorticoids,antibiotics,re-spiratory failure,and elevated white blood cell count,total cholesterol,and BNP were independent risk factors for hospitalization due to frequent AECOPD.A nomogram model of hospitalization due to frequent AECOPD was constructed according to risk factors.The ROC curve was established to evaluate the performance of the model,which showed the area under the ROC curve of 0.899(95％CI=0.892-0.905),the sensitivity of 85.30％,and the specificity of 79.80％.Conclusions Frequent AECOPD is associated with smoking,heart disease,ap-plication of systemic glucocorticoids,Pseudomonas aeruginosa infection,age,low body mass index,and elevat-ed BNP.Predicting the risks of hospitalization due to frequent AECOPD by the established model can provide the-oretical support for the treatment and risk factor management of the patients.

The epidemic of COVID-19 has become the topmost public health threat worldwide. The authors suggested that in addition to strengthening the organization and leadership of the abovementioned work, greater attention be paid to establishing and improving the prevention and control mechanism.Furthermore, special efforts should be given to the safety of the medical workers, by strengthening their infection monitoring and outbreak management. Medical workers in different work areas and positions should be placed under careful protection with due cleaning and disinfection measures. The protection during specimen collection, transportation and medical waste management should also be prioritized. Such special issues in the management of pediatric patients, as allocation of nurses, the screening and management of caregivers, the problem of breastfeeding, and the disinfection of children′s toys and diapers were discussed. This paper also put forward management suggestions for the outpatient department, isolation ward and other key departments, which aim to guide the prevention and control of COVID-19 nosocomial infection in the pediatric outpatient and ward.

The pneumonia caused by the novel coronavirus (2019-nCoV), which began in December 2019, has become the most serious public health problem, threatening people's health and life. This threat is posing a severe challenge on the diagnosis and treatment of 2019-nCoV infection, the prevention and control of hospital cross infection of medical staff. It is suggested that in addition to strengthening the organization and leadership of the abovementioned work, establishing and improving the prevention and control mechanism deserve greater attention. Furthermore, special attention should be given to the safety of the medical staff, strengthening their infection monitoring and outbreak management. Medical staff in different work areas and positions should be placed under careful protection, cleaning and disinfection measures. The protection during specimen collection, transportation and medical waste management should also be prioritized. This paper also put forward management suggestions for the outpatient department, isolation ward and other key departments. These measures are proposed to provide a guidance for the prevention and control of 2019-nCoV nosocomial infection in the pediatric outpatient and ward.

Objective To analyze the efficiency of perinatal group B streptococcal(GBS)infection preven-tion in the local area.Methods From June 2015 to June 2016,3 667 pregnant women were included.Both pre-natal examinations and deliveries were done in our hospital.The analysis of GBS colonization,risk factors and prevention of early-onset disease were done.Results Among preterm and term pregnant women,the rates of GBS screening were 23.4% and 35.6%,respectively.The positive results of GBS were 10.9% and 8.4%,re-spectively.The percentage of women with 2 risk factors were 22.9% and 0.3%,respectively.GBS screening has a better prediction effect for GBS colonization status of women at labor.There were significant differences in the intrapartum antibiotic prophylaxis(IAP)implementation between preterm and term pregnant women. In the IAP efficiency analysis of preterm,GBS colonization and risk factors,preterm had a high sensitivity (96.1%),while the specialties of GBS carry and risk factors were high(93.2% and 90.3% respectively).Con-clusion preterm pregnant women should be highlighted as an important population in the implementation of IAP.GBS screening strategy is better than the risk factors strategy.

Objective To explore the influence of Shenqifuzheng injection on efficacy of chemotherapy and immune function in patients with gastric cancer after surgery.Methods 60 postoperative patients with gastric cancer were selected as the research subjects,and were randomly divided into the control group and observation group by the digital table,30 cases in each group.The control group was given FOLFOX regimen chemotherapy.The observation group received FOLFOX regimen combined with the treatment of Shenqifuzheng injection.The recurrence and metasta-sis,survival,immune function and adverse reactions of the patients were observed and the patients were observed before and after chemotherapy.Results The chemotherapy cycle of the observation group was (3.95 ±0.40),which was significantly higher than (3.40 ±0.30)of the control group,the difference was statistically significant (t =6.025,P <0.01).The progression free survival in the observation group was (9 ±2.4)months,which was significant-ly longer than (6.6 ±3.2)months in the control group,the difference was statistically significant (t =3.286,P <0.01).The reduction rate in the observation group was 6.67%,which was lower than 26.67% in the control group, the difference was statistically significant (χ2 =4.320,P <0.05).The incidence rate of nausea and vomiting in the observation group was 6.67%,which was lower than 26.67% in the control group,the difference was statistically sig-nificant (χ2 =4.320,P <0.05).KPS[(83.51 ±15.37)points]and QLQ -C30[(82.01 ±9.45)points]of the observation group were significantly higher than those in the control group [KPS (74.62 ±13.22)points and QLQ -C30 (74.62 ±13.22)points],the differences were statistically significant (t =2.298,2.491,all P <0.05).After chemotherapy,gastric cancer patients ratio of CD +3 ,CD +4 ,CD +4 /CD +8 in the observation group were higher than those of the control group and the ratio of CD +4 /CD +25 in the observation group was lower than control group,the differences were statistically significant (all P <0.05).Conclusion Shenqifuzheng injection combined with FOLFOX chemo-therapy for gastric cancer patients has low adverse reaction rate,and can effectively improve the immune function.

Objective To investigate the expression and clinical significance of tumor-associated macrophages (TAMs) in invasive micropapillary carcinoma (IMPC) of breast.Methods Immunohistochemical streptavidin-biotin method(LSAB) method for CD68 and CD163 were performed on 68 cases of IMPC and 72 cases of invasive ductal carcinoma,not otherwise specified(IDC-NOS).Results CD68 and CD163 were mainly expressed in IMPC interstitial macrophages in the cytoplasm or on the membrane,and occasionally expressed in tumor nest.CD68 positive rate in tumor stroma in IMPC (47/68,69.1％) was higher than in IDC-NOS group (37/72,51.5％),and the difference between the two groups was statistically significant (P =0.022).CD163 positive rate in tumor stroma between the two groups was not statistically significant(P =0.682).CD68 + macrophages in IMPC stroma were positively correlated with pathological stage,histological grade,lymph node metastasis,vascular invasion,and Ki67 expression(P ＜ 0.05),and inversely correlated with the expression of ER(P =0.037).Univariate analysis showed that CD68 + macrophages in the stroma of IMPC were significantly associated with progression-free survival(P =0.027),Conclusion The expression of TAMs was different in different types of breast carcinoma and widely expressed in IMPC,which may play a significant role in high invasion and metastasis behavior of IMPC.

Objective To prepare an influenza A(H1N1) split-virus vaccine and observe its safe-ty and effectiveness. Methods According to the process for preparing seasonal flu split-virus vaccine two batches of vaccine were prepared with the flu A (H1N1) vaccine virus strain recommended by WHO. The pilot products were tested against the requirements of flu split-virus vaccine. Results The quality of the pi-lot vaccine has been tested by National Control Laboratory and conformed to the requirements. Nine hundred and sixty volunteers received one dose of vaccine containing either 15 μg or 30 μg of hemagglutinin. The re-suits indicated the both seroconversion rate and protection rate were higher the 70%. The GMT of HIAb of the volunteers who received 1 dose of 15 μg increased significantly by 15, 39, 37 and 25 times compared to those before vaccination in the age groups of 3-11, 12-17, 18-59 and ≥60, respectively. And 26, 72, 68 and 36 times rise were found in the postvaccinated volunteers of 30 μg group. The total adverse reaction rates of 15 μg and 30 μg dose group were 29.38% and 43.75%, respectively. The grade 2 adverse reaction rates of 15 μg and 30 μg dose group were 6.25% and 15.42%, and the grade 3 adverse reaction rates of 15 μg and 30 μg dose group were 0.83% and 1.46%, respectively. No serious adverse reactions were found. Conclusion The influenza A (H1N1) split-virus vaccine prepared according to the requirements of season-al flu vaccine is safe and effective.