ObjectiveTo explore the effect of early rehabilitation on patients with severe traumatic brain injury.Methods89 patients with severe traumatic brain injury were divided randomly into the treatment group (49 cases) and control group (40 cases). All patients of two groups were treated with routine nursing, dehydrated drug, brain protective therapy and alimental therapy, and measures of preventing complications. While, the patients of the treatment group were added with motor and cognitive rehabilitation, mainly physical therapy, combined with occupational therapy, psychotherapy and speech therapy. All patients of two groups were evaluated with scores of activities of daily living (ADL), Disability Rating Scale (DRS), Fugl-Mayer Assessment (FMA), Mini-mental status examination (MMSE), three class balance scale before and after treatment.ResultsThe scores of ADL, DRS, FMA and balance function of the patients in the treatment group were significantly different from that of the control group after treatment ( P<0.05).The MMSE scores of two groups had no significantly difference after treatment ( P>0.05).ConclusionEarly rehabilitation can improve the brain function of the patients with severe traumatic brain injury, patients' living quality and ADL.

Sleep is closely related to the process of treatment and rehabilitation in patients with nasopharyngeal carcinoma ( NPC) . This paper was summarized from the sleep status and its influencing factors in patients with NPC, adverse effects of sleep disorders, and intervention strategies of sleep for patients with NPC. Intervention strategies were further demonstrated through optimization of nursing strategy, improvement of time management, application of various pharmaceutical nursing, syndrome differentiation based on traditional Chinese medicine, and psychological intervention. In order to improve sleep patterns and enhance quality of life of patients with NPC, several factors such as multidisciplinary joint intervention strategies based on alien breast cancer and prostate cancer abroad;and overall consideration of cultural background, national policy, and expert teams, etc., should be proposed to explore multidisciplinary joint intervention strategies.

Objective:To explore the prognostic factors of primary plasma cell leukemia (pPCL) in the era of novel agents.Methods:The clinical data of 66 patients with pPCL treated at the Department of Haematology, Beijing Chao-Yang Hospital, Capital Medical University from 2011 to 2022 were retrospectively collected to analyze their prognostic factors.Results:Among the 66 patients with pPCL, the median age was 59 (range: 29-79) years. The median overall survival (OS) duration was 19.0 (95% CI 10.4-27.6) months, and the median progression-free survival (PFS) duration was 11.0 (95% CI 6.5-15.6) months. The median OS and PFS were significantly longer in patients with the best post-treatment response of very good partial remission (VGPR) or better than in patients with a response of partial remission (PR) or worse (median OS: 33.0 months vs 6.0 months, P<0.001; median PFS: 16.0 months vs 3.0 months, P<0.001). OS was significantly longer in patients who underwent autologous hematopoietic stem cell transplantation than in those who did not undergo transplantation (49.0 months vs 6.0 months, P=0.002), and there was a trend toward a longer PFS in patients who underwent transplantation than in those who did not undergo transplantation (19.0 months vs 8.0 months, P=0.299). The median OS and PFS were significantly longer in patients who received maintenance therapy than in those who did not receive maintenance therapy (median OS: 56.0 months vs 4.0 months, P<0.001; median PFS: 20.0 months vs 2.0 months, P<0.001). Multivariate analysis showed that hypercalcemia was an independent risk factor ( HR=3.204, 95% CI 1.068-9.610, P=0.038) for patients with pPCL, while receiving maintenance therapy ( HR=0.075, 95% CI 0.022-0.253, P<0.001) and post-treatment response of VGPR or better ( HR=0.175, 95% CI 0.048-0.638, P=0.008) were independent protective factors for patients with pPCL. Conclusions:In the era of novel agents, hypercalcemia, receiving maintenance therapy, and post-treatment response of VGPR or better are independent prognostic factors for pPCL.

Objective:To verify the predictive value of the Second Revision of the International Staging System (R2-ISS) in newly diagnosed patients with multiple myeloma (MM) who underwent first-line autologous hematopoietic stem cell transplantation (ASCT) in a new drug era in China.Methods:This multicenter retrospective cohort study enrolled patients with newly diagnosed MM from three centers in China (Beijing Chao-Yang Hospital, Capital Medical University; the First Affiliated Hospital, Sun Yat-Sen University, and the Second Affiliated Hospital of Naval Medical University) from June 2008 to June 2018. A total of 401 newly diagnosed patients with MM who were candidates for ASCT were enrolled in this cohort, all received proteasome inhibitor and/or immunomodulator-based induction chemotherapy followed by ASCT. Baseline and follow-up data were collected. The patients were regrouped using R2-ISS. Progression-free survival (PFS) and overall survival (OS) were analyzed. The Kaplan-Meier method was used to analyze the survival curve and two survival curves were compared using the log-rank test. Cox regression analysis were performed to analyze the relationship between risk factors and survival.Results:The median age of the patients was 53 years (range 25-69 years) and 59.5% (240 cases) were men. Newly diagnosed patients with renal impairment accounted for 11.5% (46 cases). According to Revised-International Staging System (R-ISS), 74 patients (18.5 %) were diagnosed with stage Ⅰ, 259 patients (64.6%) with stage Ⅱ, and 68 patients (17.0%) with stage Ⅲ. According to the R2-ISS, the distribution of patients in each group was as follows: 50 patients (12.5%) in stage Ⅰ, 95 patients (23.7%) in stage Ⅱ, 206 patients (51.4%) in stage Ⅲ, and 50 patients (12.5%) in stage Ⅳ. The median follow-up time was 35.9 months (range, 6-119 months). According to the R2-ISS stage, the median PFS in each group was: 75.3 months for stage Ⅰ; 62.0 months for stage Ⅱ, 39.2 months for stage Ⅲ, and 30.3 months for stage Ⅳ; and the median OS was not reached, 86.6 months, 71.6 months, and 38.5 months, respectively. There were statistically significant differences in PFS and OS between different groups (both P<0.001). Multivariate Cox regression analysis showed that stages Ⅲ and Ⅳ of the R2-ISS were independent prognostic factors for PFS ( HR=2.37, 95% CI 1.30-4.30; HR=4.50, 95% CI 2.35-9.01) and OS ( HR=4.20, 95% CI 1.50-11.80; HR=9.53, 95% CI 3.21-28.29). Conclusions:The R2-ISS has significant predictive value for PFS and OS for transplant-eligible patients with MM in the new drug era. However, the universality of the R2-ISS still needs to be further verified in different populations.

Objective To investigate the relationship between nucleotide excision repair cross-complementing (ERCC) gene polymorphisms [single nucleotide polymorphism (SNP) sites: rs11615, rs13181, rs238406, rs6498486, rs17655] and susceptibility to endemic arsenic poisoning. Methods The study recruited 848 subjects, including 348 cases and 500 controls, from populations exposed to high arsenic levels through drinking water in northwest China, and 3 - 5 ml venous blood was collected. The genotypes were determined using polymerase chain reaction and restriction fragment length polymorphism techniques(PCR-RFLP). Logistic regression analysis was used to assess the association of genotypes with endemic arsenic poisoning. Results The polymorphisms of rs11615 (ERCC1), rs238406 (ERCC2), rs6498486 (ERCC4) and rs17655 (ERCC5) and endemic arsenic poisoning were not related(P > 0.05). Participants who carried the CC genotype or at least one C allele for the ERCC2 rs13181 had an increased risk of endemic arsenic poisoning[OR(95%CI)=1.63(1.13,2.34),1.64(1.14,2.34)]compared with wild type homozygous individuals. Conculsions There is no positive correlation between the polymorphisms of ERCC1 rs11615, ERCC2 rs238406, ERCC4 rs6498486, ERCC5 rs17655 and endemic arsenic poisoning. ERCC2 rs13181 polymorphism increases the risk of endemic arsenic poisoning.