ObjectiveTo evaluate the clinical efficacy and safety of acupuncture combined with levodopa in the treatment of Parkinson's disease（PD）. MethodsA total of 60 patients with PD were enrolled and randomly assigned to test group or control group， with 30 patients in each group. The control group received levodopa only， starting at 100 mg per dose， three times daily， with gradual increases not exceeding a maximum daily dose of 800 mg. The test group received acupuncture three times per week in addition to levodopa. Both groups were treated for 12 weeks. Assessments were conducted before treatment， after 6 and 12 weeks treatment， using the Unified Parkinson's Disease Rating Scale（UPDRS）， Wearing-Off Questionnaire-9（WOQ-9）， Montreal Cognitive Assessment（MoCA）， Mini-Mental State Examination（MMSE）， Depression Rating Scale（DRS）， Hamilton Depression Scale（HAMD）， Hamilton Anxiety Scale（HAMA）， PD Questionnaire-39（PDQ-39）， and Pittsburgh Sleep Quality Index（PSQI）. Repeated measures ANOVA was utilized to evaluate the effects of time， group， and their interaction on each index. Spearman correlation analysis was conducted to examine the relationships between combined treatment and outcome scores. Adverse events in both groups were recorded throughout the study. ResultsBoth groups showed significant improvements after 6 and 12 weeks treatment， with decreases in UPDRS total score， WOQ-9 total score， DRS score， HAMD score， HAMA score， PDQ-39 score， and PSQI score， and increases in MoCA and MMSE scores（P＜0.05）. Compared with the control group， the test group demonstrated significantly greater improvements in all the above indicators after 6 and 12 weeks （P＜0.05）. Repeated measures ANOVA showed significant time main effects， group main effects， and their interaction across all outcome measures（P＜0.01）. Spearman correlation analysis revealed that combined therapy was significantly negatively correlated with UPDRS， WOQ-9， DRS， HAMD， HAMA， PDQ-39， and PSQI scores， while positively correlated with MoCA and MMSE scores after 12 weeks of treatment（P＜0.05）. Both groups did not experience any serious adverse events and did not affect treatment. ConclusionAcupuncture combined with levodopa is more effective than levodopa alone in improving motor function， non-motor symptoms， cognitive function， depression and anxiety， quality of life， and sleep quality in patients with PD， with good safety.

Objective To use superparamagnetic iron oxide nanoparticles(SPIONs)to label chimeric antigen receptor(CAR)T cells targeting carcinoembryonic antigen(CEA),and perform magnetic resonance imaging(MRI)to real time trace CEA CAR-T cells in vivo.Methods Appropriate amount of ferumoxytol,heparin sodium and protamine sulfate were mixed at high(ferumoxytol 100 μg/mL,heparin sodium 4 IU/mL,protamine sulfate 120 μg/mL),medium(ferumoxytol 50 μg/mL,heparin sodium 2 IU/mL,protamine sulfate 60 μg/mL),and low(ferumoxytol 25 μg/mL,heparin sodium 1 IU/mL,protamine sulfate 30 μg/mL)concentrations to form a SPIONs complex ferumoxytol/heparin/protamine(FHP),and then co-incubated with CEA CAR-T cells for cell labeling.The biocompatibility of FHP was detected by CCK-8 assay,EdU assay and flow cytometry.The uptake of FHP was detected by Prussian blue staining,and SPIONs content in the cells was quantitatively detected by inductively coupled plasma-mass spectrometry(ICP-MS).Flow cytometry was used to detect the lytic effect of FHP-labeled CEA CAR-T cells on tumor cells,and MRI was employed to scan FHP-labeled CEA CAR-T cells.Results FHP at high,medium,and low concentrations had no significant effect on the activity of CEA CAR-T cells,with cell activity above 100％determined by CCK-8 assay.DNA proliferation was above 94.3％in EdU assays.Prussian blue staining showed that CEA CAR-T cells could take FHP up,with the uptake increased with the increment of FHP concentration.ICP-MS showed that the intracellular Fe content was 440.23±189.36 ng/mL.Tumor cell killing experiment showed that FHP-labeled CEA CAR-T cells had excellent killing capability against tumor cells.MRI scans indicated that T2WI signals of FHP-labeled CEA CAR-T cells were significantly reduced with increasing FHP concentration(P＜0.01).Conclusion SPIONs complex FHP shows good biocompatibility and can effectively label CEA CAR-T cells.SPIONs complex FHP can be used as a magnetic marker for CEA CAR-T cells and a feasible MRI tracer for clinical application.

Objective To investigate the value of serum double M protein analysis and laboratory index detection in predicting the efficacy of bone marrow transplantation in patients with IgA multiple myeloma(IgA-MM).Methods Sixty IgA-MM patients with double M bands admitted to the General Hospital of the Central Theater Command of the Chinese People's Liberation Army from January 2019 to January 2022 were selected as the study objects.The chromatographic data of serum protein electrophoresis and immunofixation electrophoresis(IFE)were compared.Serum with double M protein bands of IgA-MM was treated with 2-dimercaptoethanol(2-DE),and the double M protein bands were identified by IFE.Immunological test indexes of patients with two double M protein types were compared,including immunoglobulin A(IgA),immunoglobulin G(IgG),immunoglobulin M(IgM),serum free light chain(sFLC)and Bene Jone protein(BJP).The conventional experimental indexes of patients with two types of double M protein were compared.The staging and efficacy of multiple myeloma in the international staging system(ISS)were compared between two IgA types of double-M proteinemic myeloma.Kaplan-Meier method and LOG-rank test were used to analyze the survival rate of patients with two types of double M protein.Results IFE showed that monoclonal light chain type and IgA polymeric type were two types of double M protein bands in IGA-MM serum.Monoclonal light chain patients had higher levels of sFLC(2970.14±876.82 mg/L vs 118.68±74.10 mg/L)and BJP(6.22±3.01 g/L vs 0.55±0.12 g/L)than the polymeric type patients(t=21.684,12.659,all P＜0.05).Compared with polymeric type patients,serum β2-MG(β2-microglobulin)(7.88±2.14 mg/L vs 4.65±1.56 mg/L),serum Ca(calcium)(2.64±0.24 mmol/L vs 2.32±0.20 mmol/L)and serum Creatinine(Scr)(182.85±64.23 μmol/L vs 90.52±42.20 μmol/L)of monoclonal light chain patients were increased(t=21.684,12.659,6.400,5.193,6.473),while the levels of Hb(Hemoglobin)(74.32±19.44 g/L vs 90.75±15.52 g/L)and Alb(albumin)(28.42±3.64 g/L vs 31.72±4.96 g/L)of monoclonal light chain patients were decreased(t=3.386,2.428),with significant differences(all P＜0.05).Compared with IgA polymerized type patients,monoclonal light chain type patients had higher ISS stage and lower curative effect(t=11.827,4.519,all P＜0.05).Survival analysis showed that the survival rate of IgA polymerized type was higher than that of monoclonal light chain type(x2=4.482,P＜0.05).Conclusion The two types of IgA-type double-M protein differed in efficacy and prognosis,so identifying the type of IgA-MM double M protein band may be particularly important.

Hip fractures are among the most common fractures in the elderly, presenting to be a leading cause of disability and mortality. Surgical treatment is currently the main treatment method for hip fractures. The incidence of perioperative malnutrition is increased after hip fractures in the elderly due to the comorbidities, decreased basal metabolic rate, accelerated protein breakdown, weakened anabolism and surgical stress. However, malnutrition not only increases the incidence of postoperative complications, but also leads to increased mortality, indicating an important role of perioperative nursing management of nutrition for the elderly patients with hip fractures. At present, there still lacks scientific guidance and application standards on perioperative nursing management of nutrition for the elderly patients with hip fractures. Therefore, the Orthopedic Nursing Committee of Chinese Nursing Association and the Editorial Board of Chinese Journal of Trauma organized relevant experts to formulate the Expert consensus on perioperative nursing management of nutrition for elderly patients with hip fractures ( version 2023) according to evidence-based medical evidences and their clinical experiences. Fourteen recommendations were made from aspects of nutrition screening, nutrition assessment, nutrition diagnosis, nutrition intervention and nutrition monitoring to provide guidance for perioperative nursing management of nutrition in elderly patients with hip fractures.

Objective:To study risk factors and clinical outcomes of nosocomial infection (NI) in extremely premature infants (EPIs).Methods:From January 2017 to December 2021, EPIs admitted to NICU of our hospital were retrospectively studied. The infants were assigned into NI group and non-NI group. The NI group were further assigned into survival group and death group. Single factor analysis was conducted using chi-square test, t-test and non-parametric test. Multiple logistic regression was used to analyze risk factors of NI and death.Results:A total of 115 cases were enrolled, including 67 (58.3%) in NI group, 54 in survival group and 12 in death group. One case gave up treatment. 48 cases were in non-NI group. 81 episodes of nosocomial infections occurred in NI group and the case infection rate was 70.4% (81/115). 48 cases (41.7%) had late-onset sepsis, 14 (12.2%) neonatal necrotizing enterocolitis, 13 (11.3%) pneumonia, 1 (0.9%) urinary tract infection and 1 (0.9%) thrush. Hemodynamic significant patent ductus arteriosus (hsPDA) and long duration of parenteral nutrition were independent risk factors for NI in EPIs ( P<0.05). The incidence of bronchopulmonary dysplasia (BPD) (100.0% vs. 70.8%) and mortality (17.9% vs. 2.1%) in NI group was higher than non-NI group ( P<0.05). Septic shock was an independent risk factor for the death due to NI. Conclusions:The incidence of NI in EPIs is high. hsPDA and long duration of parenteral nutrition are independent risk factors for NI in EPIs. EPIs with NI have high incidence of BPD and mortality and septic shock is an independent risk factor for death.

Objective:To explore the application effect of case management mode led by specialist nurses in bladder perfusion for patients undergoing chemotherapy after bladder cancer surgery.Methods:A total of 96 patients receiving bladder perfusion treatment in Xinxiang Central Hospital from March 2018 to June 2019 were selected by the convenient sampling method and they were divided into the observation group and the control group according to random number table method, with 48 patients in each group. The control group adopted routine management, while the observation group adopted case management led by specialist nurses. Mishel Uncertainty in Illness Scale (MUIS) and Functional Assessment of Cancer Therapy-feneric Scale (FACT-G) were used to respectively evaluate the disease uncertainty and quality of life of patients of the two groups. The compliance rate and complication rate of bladder perfusion, MUIS and FACT-G scores were compared between the two groups.Results:All 48 patients in the observation group completed the entire course of chemotherapy. In the control group, 7 patients did not complete the entire course of chemotherapy, including 1 patient who withdrew from the study at the 10th month without complete data collected. Finally, 48 cases were collected in the observation group and 47 cases collected in the control group. The compliance rate of bladder perfusion in the observation group was higher than that in the control group (100.00% vs. 85.52%) , and the difference was statistically significant (χ 2=10.305, P=0.001) . The total incidence of bladder perfusion complications in the observation group was lower than that in the control group (14.58% vs. 55.32%) , and the difference was statistically significant (χ 2=17.382, P<0.001) . At the 8th and 12th months, the MUIS scores of the observation group were lower than those of the control group, and the differences were statistically significant ( P<0.05) . At 4, 8, and 12 months, the FACT-G scores of the observation group were higher than those of the control group, and the differences were statistically significant ( P<0.05) . The differences in the interaction effects, intergroup effects and time effects of MUIS and FACT-G scores between the two groups were statistically significant ( P<0.05) . Conclusions:With the prolongation of bladder perfusion treatment time, the uncertainty of bladder cancer patients gradually increases and quality of life decreases. The case management mode led by specialized nurses can improve the compliance and quality of life of patients with bladder perfusion treatment, reduce the incidence of complications and disease uncertainty and improve management efficiency of bladder perfusion treatment.

OBJECTIVE: To detect potential variant in an ethical Han Chinese pedigree affected with breast cancer. METHODS: The proband and her relatives were subjected to next-generation sequencing using a target capture sequencing kit containing 121 cancer-related genes. Candidate variants were selected by analysis of their type, frequency in population, and segregation with the phenotype. Candidate variant was verified by Sanger sequencing and TA cloning. RESULTS: A c.2013_2014ins GT variant was detected in the BRCA1 gene among all breast cancer patients from this pedigree but not among healthy females. The variant was not recorded in the 1000 Genome Project database or the Exome Aggregation Consortium (ExAC) database. The frameshifting insertion was predicted to form an premature stop codon in gene transcript and can give rise to a truncated protein. CONCLUSION The BRCA1 c.2013_2014ins GT variant probably underlies the pathogenesis of breast cancer in this Chinese pedigree.
Asian Continental Ancestry Group ; BRCA1 Protein ; genetics ; Breast Neoplasms ; genetics ; Exome ; Female ; High-Throughput Nucleotide Sequencing ; Humans ; Pedigree ; Phenotype

This paper introduced the legislative development of community benefits system of nonprofit hospitals at federal level in the United States,as well as state legislatures in this regard. Based on America's experiences, an analysis was made on the "community benefits and health promotion model", which refers to community health needs assessment, health promotion programs, program implementation, supervision and appraisal. Thus the authors put forward inspirations for the social responsibility system development of public hospitals in China as follows. This refers to the establishment of hospitals' social responsibility system; development of community health promotion planning based on health needs;and establishment of social responsibility information disclosure system for fulfillment of their social responsibilities.

Information disclosure is important for the government and society to monitor the fulfillment of social responsibility of hospitals. This paper introduced the existing legislatures of the community benefits information disclosure system for non-profit hospitals in the United States, and analyzed the "two-level and two-way reporting system" of these hospitals, based on facts of California, Illinois and other regions. In the end, the authors put forward inspirations for the development of public hospitals' community benefits system in China as follows. This refers to the establishment of a social responsibility reporting system,stipulating the hospital and its health authority as the entities accountable for disclosure;a two-level/two-way reporting mechanism to improve the integrity of information disclosure;and standardization of information disclosure content and better timeliness and accessibility of information disclosure.