ObjectiveUsing dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to evaluate the hemodynamic perfusion characteristics of bone marrow infiltration in patients with acute leukemia (AL). MethodsForty-seven patients with AL received coronal pelvic T1WI DCE-MRI with fast low angle shot (FLASH) sequence. Among them, 25 were initial onset untreated (IOU) patients, 22 were treated AL patients, including 14 with complete remission (CR) and 8 with non-remission ( NR). The hemodynamic perfusion parameters including maximum percentage of enhancement ( Emax ) and slope were determined based on enhancement-time curves ( ETCs ) of iliac and lumbar vertebra. The proportion of marrow myeloblasts was recorded.For all patients, quantitative perfusion parameters of bone marrow infiltration in ilium were compared with those in lumbar. The values of Emax and ES were compared among IOU,CR and NR patients.Correlations between perfusion parameters and histopathological results were assessed. ResultsIn all the 47 patients, the Emax values of bilateral iliac bone marrow ( 15.70 ± 7.06)were slightly higher than that of lumbar bone marrow ( 11. 28 ± 5.52 ), and the difference was statistically significant (P ＜0. 01 ).There was no significant difference in the slop value between bilateral iliac bone marrow (0. 82 ± 0. 12 ) and lumbar bone marrow (0. 80 ± 0. 09 ) ( P ＞ 0. 05 ). In the 25 untreated patients,the Emax and slop values were 17. 15 ± 5.75 and 0. 98 ± 0. 13, respectively; in the 14 CR patients, they were 8. 76 ±3.93 and 0. 26 ± 0. 04, respectively, and in the 8 NR patients, they were 21.62 ± 6. 50 and 1. 38 ± 0. 02, respectively. There was significant difference in the Emax and slop values among the three groups (P＜0. 05).Compared with IOU and NR patients, both the Emax and slop values decreased significantly in iliac bone marrow of AL patients with CR (P ＜ 0. 05 ). There was no significant difference between IOU and NR patients ( P ＞ 0. 05 ). A significant positive correlation was found between Emax value of iliac bone marrow and the proportion of marrow myeloblasts ( r ＝0. 501 ,P ＜0. 05 ). There was a negative correlation between slop value of iliac bone marrow and the proportion of marrow myeloblasts ( r ＝0. 235 ,P ＞0.05).ConclusionsDCE-MRI can beused for evaluating the hemedynamic characteristics of microcirculation of bone marrow infiltration in patients with AL, which can provide useful information in evaluating prognosis and monitoring therapeutic effect.

Objective To observe the effect of hot compress for foot on the anus exhaust time of patients after abdomen operation.Methods One hundred and twenty four patients after abdomen operation were randomly divided into two groups of the experiment group and the control group.The control group waa treated with regular nursing.Besides regular nursing,six hours after operation,the experiment group also accepted hot compress for foot with electric heater.twice perday and three minutes per treatment.The anus exhaust times were observed and recorded.Results The anus exhaust times of the experiment group were obviously earlier than those of the control group(P<0.05).Conclusions Hot compress for foot accelerates the anus exhaust time.enhances the comfort of patients,and promotes the organism heMing.

Objective:To investigate the current situation and influencing factors of clinical nurses'clinical decision-making ability,and provide a reference and evidence for improving and enhancing the correct clinical decision-making ability of clinical nurses.Methods:A total of 300 clinical nurses in Shaanxi Province were selected as the research subjects by using the convenience sampling method.The General Information Questionnaire,Clinical Decision-Making Scale,and Comprehensive Decision-Making Style Scale were used to conduct the investigation and study.The influencing factors of clinical nurses'clinical decision-making ability were analyzed by using single-factor analysis and multivariate linear regression.Results:The total score of clinical nurses'clinical decision-making ability was(163.85±13.78)points,reaching the high-level standard of clinical decision-making ability(146.68-200.00)points.The results of Spearman rank correlation analysis showed that there was a significant positive correlation between the total score and the score of each dimension of clinical decision-making ability and the score of rational decision-making style(P<0.05).The score of the dimension of searching for information or new information was only negatively correlated with the score of intuitive-impulsive decision-making style(P<0.05).Avoidant decision-making style was negatively correlated with the scores of seeking information or new information,clarifying goals and values,the total score of clinical decision-making ability,and the dimensions of finding alternative solutions(P<0.05).The results of multiple linear regression showed that rational decision-making style can positively affect clinical nurses'clinical decision-making ability,while avoidance decision-making style can negatively affect it.Conclusion:The clinical nurses'clinical decision-making ability has been maintained at a relatively constant high level,and it is greatly influenced by rational and avoidant decision-making styles.Medical managers need to organize targeted training activities and other measures to promote the construction of clinical nurses'rational decision-making style and minimize the influence of avoidant decision-making style,thus improving the clinical nurses'clinical decision-making ability.

Periarticular fracture of the shoulder is a common type of fractures in the elderly. Postoperative adverse events such as internal fixation failure, humeral head ischemic necrosis and upper limb dysfunction occur frequently, which seriously endangers the exercise and health of the elderly. Compared with the fracture with normal bone mass, the osteoporotic periarticular fracture of the shoulder is complicated with slow healing and poor rehabilitation, so the clinical management becomes more difficult. At present, there is no targeted guideline or consensus for this type of fracture in China. In such context, experts from Youth Osteoporosis Group of Chinese Orthopedic Association, Orthopedic Expert Committee of Geriatrics Branch of Chinese Association of Gerontology and Geriatrics, Osteoporosis Group of Youth Committee of Chinese Association of Orthopedic Surgeons and Osteoporosis Committee of Shanghai Association of Chinese Integrative Medicine developed the Chinese expert consensus on the diagnosis and treatment of osteoporotic periarticular fracture of the shoulder in the elderly ( version 2023). Nine recommendations were put forward from the aspects of diagnosis, treatment strategies and rehabilitation of osteoporotic periarticular fracture of the shoulder, hoping to promote the standardized, systematic and personalized diagnosis and treatment concept and improve functional outcomes and quality of life in elderly patients with osteoporotic periarticular fracture of the shoulder.

TSCI have dyskinesia and sensory disturbance that can cause various life-threaten complications. The patients with traumatic spinal cord injury (TSCI), seriously affecting the quality of life of patients. Based on the epidemiology of TSCI and domestic and foreign literatures as well as expert investigations, this expert consensus reviews the definition, injury classification, rehabilitation assessment, rehabilitation strategies and rehabilitation measures of TSCI so as to provide early standardized rehabilitation treatment methods for TSCI.

Objective:To introduce the construction of Henan Cerebral Palsy Register and Rehabilitation Management System (HCPRRMS) and to explore the construction project of regional register and surveillance of cerebral palsy. Methods:The construction process, registration content and preliminary results of HCPRRMS were systematically introduced. Results:HCPRRMS was independent developed in 2014. Since March, 2015, the system has been used to register information of patients with cerebral palsy in the Third Affiliated Hospital of Zhengzhou University. Until September, 2019, a total of 23 child rehabilitation institutions had used the registration management system. There were 1357 patients with cerebral palsy registered in this system, in which 936 cases (68.98%) were male, 501 cases (36.92%) were with gestational weeks < 37, 443 cases (32.65%) were with birth weight < 2500 g, and 430 cases (31.69%) were born with hypoxic-ischemic encephalopathy. Among them, the spastic cerebral palsy patients (1117 cases, 86.74%) accounted for the highest proportion. There was significant difference among types of cerebral palsy and the classification of GMFCS. A total of 1117 patients with cerebral palsy showed MRI-identified brain abnormalities, in which, periventricular leukomalacia accounted for the most (480 cases). For the complications, epilepsy accounted for 14.44% (196 cases), vision impairment accounted for 8.03% (109 cases), hearing impairment accounted for 11.64% (158 cases). Among 769 cases aged more than two years, language-speech dysfunction accounted for 52.66% (424 cases); and among 216 cases aged more than four years, mental retardation accounted for 37.96% (82 cases). Conclusion:HCPRRMS could help to understand the risk factors, clinical characteristics, and complications of cerebral palsy.

Background: Prospective real-life data on the safety and effectiveness of rituximab in Chinese patients with diffuse large B-cell lymphoma (DLBCL) or follicular lymphoma (FL) are limited. This real-world study aimed to evaluate long-term safety and effectiveness outcomes of rituximab plus chemotherapy (R-chemo) as first-line treatment in Chinese patients with DLBCL or FL. Hepatitis B virus (HBV) reactivation management was also investigated. Methods: A prospective, multicenter, single-arm, noninterventional study of previously untreated CD20-positive DLBCL or FL patients receiving first-line R-chemo treatment at 24 centers in China was conducted between January 17, 2011 and October 31, 2016. Enrolled patients underwent safety and effectiveness assessments after the last rituximab dose and were followed up for 3 years. Effectiveness endpoints included progression-free survival (PFS) and overall survival (OS). Safety endpoints were adverse events (AEs), serious AEs, drug-related AEs, and AEs of special interest. We also reported data on the incidence of HBV reactivation. Results: In total, 283 previously untreated CD20-positive DLBCL and 31 FL patients from 24 centers were enrolled. Three-year PFS was 59% (95% confidence interval [CI]: 50-67%) for DLBCL patients and 46% (95% CI: 20-69%) for FL patients. For DLBCL patients, multivariate analyses showed that PFS was not associated with international prognostic index, tumor maximum diameter, HBV infection status, or number of rituximab treatment cycles, and OS was only associated with age >60 years (P < 0.05). R-chemo was well tolerated. The incidence of HBV reactivation in hepatitis B surface antigen (HBsAg)-positive and HBsAg-negative/hepatitis B core antibody-positive patients was 13% (3/24) and 4% (3/69), respectively. Conclusions: R-chemo is effective and safe in real-world clinical practice as first-line treatment for DLBCL and FL in China, and that HBV reactivation during R-chemo is manageable with preventive measures and treatment. Trial Registration ClinicalTrials.gov, NCT01340443; https://clinicaltrials.gov/ct2/show/NCT01340443.
Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; China ; Cyclophosphamide ; administration & dosage ; Doxorubicin ; administration & dosage ; Female ; Follow-Up Studies ; Humans ; Lymphoma, Follicular ; drug therapy ; Lymphoma, Large B-Cell, Diffuse ; drug therapy ; Male ; Middle Aged ; Prospective Studies ; Rituximab ; therapeutic use ; Vincristine ; administration & dosage