Objective:To explore the efficacy and safety of the combination therapy of lenalidomide and rituximab (R2) for short-cycle maintenance therapy in patients with B-cell non-Hodgkin lymphoma (B-NHL).Methods:A retrospective case series study was conducted. The clinical data of 19 B-NHL patients who received R2 regimen maintenance therapy after achieving complete remission through chemotherapy or autologous hematopoietic stem cell transplantation at Dongguan Kanghua Hospital from February 2018 to January 2024 were collected, and the overall survival (OS), progression-free survival (PFS), adverse reactions, changes in lymphocyte subsets and cytokine levels before and after treatment were analyzed.Results:Among the 19 patients, there were 7 males and 12 females, with a median age [ M ( Q1, Q3)] of 49 (45, 65) years. The median follow-up time was 56 months, ranging from 5 to 77 months. The 1-year OS and PFS rates were 89.2% and 88.9%, respectively. The 2-year and 5-year PFS rates were both 83.2%, and the 2-year and 5-year OS rates were both 88.9%. Common adverse reactions included hematological adverse reactions and infections, with 4 cases (21.1%) experiencing grade 3-4 hematological adverse reactions and 4 cases (21.1%) experiencing infections. There was no statistically significant difference in the levels of lymphocyte subsets (total T cells, helper T cells, regulatory T cells, NK cells, B cells, and CD4/CD8) and cytokines [interleukin (IL)-2, IL-4, IL-6, IL-10, tumor necrosis factor-α, and interferon-γ] before and after treatment (all P > 0.05). Conclusions:The R2 regimen for short-cycle maintenance therapy of B-NHL is effective and well tolerated by patients.

Objective: To analyze the unregistered treatment situation and its influencing factors among pulmonary tuberculosis patients in Quzhou City, Zhejiang Province from 2017 to 2023, so as to provide a basis for promoting the management of tuberculosis patients and optimizing disease prevention and control strategies. Methods: Data of pulmonary tuberculosis patients including demographic information, etiological results, and mortality status were collected through the China Disease Prevention and Control Information System Infectious Disease Reporting and Surveillance System and the Tuberculosis Management Information System. Pulmonary tuberculosis patients not matched in the Tuberculosis Management Information System were defined as unregistered treatment patients, and the unregistered treatment rate was analyzed. Factors affecting unregistered treatment among pulmonary tuberculosis patients were analyzed using a multivariable logistic regression model. Results: A total of 10 779 pulmonary tuberculosis patients were reported in Quzhou City from 2017 to 2023, including 7 700 males (71.44%) and 3 079 females (28.56%). There were 5 484 cases aged <65 years, accounting for 50.88%. Among them, 630 cases were unregistered treatment, with an unregistered treatment rate of 5.84% (95%CI: 5.42%-6.38%). Multivariable logistic regression analysis showed pulmonary tuberculosis patients aged ≥65 years (OR=1.829, 95%CI: 1.512-2.212) had a higher risk of being unregistered treatment than those aged <65 years; patients with non-local household registration (OR=5.710, 95%CI: 4.724-6.901) had a higher risk than local patients; and patients engaged in housework/unemployed (OR=2.001, 95%CI: 1.421-2.818) or other occupations (OR=2.396, 95%CI: 1.789-3.137) had a higher risk than farmers. The mortality of unregistered treatment pulmonary tuberculosis patients was higher than the registered treatment patients (26.67% vs. 5.02%),with a significantly elevated mortality risk (OR=7.147, 95%CI: 5.738-8.902). Conclusions The unregistered treatment rate among pulmonary tuberculosis patients was well controlled in Quzhou City from 2017 to 2023, but the elderly, patients with non-local household registration, and those engaged in housework/unemployed had a higher risk of unregistered treatment. It is recommended to improve medical and social security policies, strengthen health education on tuberculosis prevention, enhance treatment adherence, and reduce mortality risk.

Objective:To explore the efficacy and safety of the combination therapy of lenalidomide and rituximab (R2) for short-cycle maintenance therapy in patients with B-cell non-Hodgkin lymphoma (B-NHL).Methods:A retrospective case series study was conducted. The clinical data of 19 B-NHL patients who received R2 regimen maintenance therapy after achieving complete remission through chemotherapy or autologous hematopoietic stem cell transplantation at Dongguan Kanghua Hospital from February 2018 to January 2024 were collected, and the overall survival (OS), progression-free survival (PFS), adverse reactions, changes in lymphocyte subsets and cytokine levels before and after treatment were analyzed.Results:Among the 19 patients, there were 7 males and 12 females, with a median age [ M ( Q1, Q3)] of 49 (45, 65) years. The median follow-up time was 56 months, ranging from 5 to 77 months. The 1-year OS and PFS rates were 89.2% and 88.9%, respectively. The 2-year and 5-year PFS rates were both 83.2%, and the 2-year and 5-year OS rates were both 88.9%. Common adverse reactions included hematological adverse reactions and infections, with 4 cases (21.1%) experiencing grade 3-4 hematological adverse reactions and 4 cases (21.1%) experiencing infections. There was no statistically significant difference in the levels of lymphocyte subsets (total T cells, helper T cells, regulatory T cells, NK cells, B cells, and CD4/CD8) and cytokines [interleukin (IL)-2, IL-4, IL-6, IL-10, tumor necrosis factor-α, and interferon-γ] before and after treatment (all P > 0.05). Conclusions:The R2 regimen for short-cycle maintenance therapy of B-NHL is effective and well tolerated by patients.

The functional role of glutamatergic (vGluT2) neurons in the pedunculopontine nucleus (PPN) in modulating motor activity remains controversial. Here, we demonstrated that the activity of vGluT2 neurons in the rostral PPN is correlated with locomotion and ipsilateral head-turning. Beyond these motor functions, we found that these rostral PPN-vGluT2 neurons remarkably respond to salient stimuli. Furthermore, we systematically traced the upstream and downstream projections of these neurons and identified two downstream projections from these neurons to the caudal pontine reticular nucleus/anterior gigantocellular reticular nucleus (PnC/GiA) and the zona incerta (ZI). Our findings indicate that the projections to the PnC/GiA inhibit movement, consistent with 'pause-and-play' behavior, whereas those to the ZI promote locomotion, and others respond to a new 'pause-switch-play' pattern. Collectively, these findings elucidate the multifaceted influence of the PPN on motor functions and provide a robust theoretical framework for understanding its physiological and potential therapeutic implications.
Pedunculopontine Tegmental Nucleus/physiology* ; Animals ; Neural Pathways/physiology* ; Vesicular Glutamate Transport Protein 2/metabolism* ; Locomotion/physiology* ; Glutamic Acid/metabolism* ; Neurons/physiology* ; Male ; Mice ; Motor Activity/physiology* ; Zona Incerta/physiology*

Cerebral small vessel disease (CSVD) is a clinical condition resulting from lesions in the small blood vessels within the brain. Cause and mechanism of CSVD are intricate, and early diagnosis and specific treatment are currently lacking in clinical practice. This paper presents a synthesis of recent methodologies for creating animal models of CSVD, as well as a compilation of imaging and biological markers for CSVD early diagnosis. Additionally, the article reviews intervention strategies that target crucial pathways in the development of CSVD, aiming to offer novel insights into early diagnosis and intervention techniques for CSVD.

Objective:To develop and validate a risk prediction model for cognitive frailty in elderly patients with type 2 diabetes.Methods:A total of 483 elderly patients with type 2 diabetes who visited Tianjin First Central Hospital from June to December 2022 were selected using convenience sampling. They were randomly divided into a modeling group ( n=338) and a validation group ( n=145). Data were collected using a self-designed general information questionnaire, the Short-Form Mini Nutritional Assessment (MNA-SF), the Geriatric Depression Scale-15 (GDS-15), the Frailty Phenotype (FP), the Montreal Cognitive Assessment (MoCA), and the Clinical Dementia Rating (CDR). Logistic regression analysis was performed to identify the influencing factors. A cognitive frailty risk prediction nomogram model was constructed based on the results. The model was validated in the validation group, and its predictive performance and clinical applicability were evaluated using the area under the receiver operating characteristic curve ( AUC), calibration curve, and clinical decision curve analysis. A total of 483 questionnaires were distributed and all were returned as valid, resulting in a 100.0% response rate. Results:The prevalence of cognitive frailty in the 483 elderly patients with type 2 diabetes was 20.3% (98/483). Age, regular exercise, duration of diabetes, HbA1c levels, depression and nutritional status were identified as predictive factors in the model. The AUC of the model was 0.886, and the Hosmer-Lemeshow test showed a χ 2 value of 8.004 ( P=0.433). The optimal cutoff value was 0.335, and the accuracy was 89.0%. Conclusions:The prediction model demonstrates good fit and strong predictive performance, and can intuitively and easily identify elderly patients with type 2 diabetes who are at high risk of cognitive frailty, providing a reference for early screening and intervention.

The rapid and accurate authentication of traditional Chinese medicines(TCMs)has always been a key scientific and technical problem in the field of pharmaceutical analysis.Herein,a novel heating online extraction electrospray ionization mass spectrometry(H-oEESI-MS)was developed for the rapid and direct analysis of extremely complex substances without the requirement for any sample pretreatment or pre-separation steps.The overall molecular profile and fragment structure features of various herbal medicines could be completely captured within 10-15 s,with minimal sample(＜0.5 mg)and solvent consumption(＜20 μL for one sample).Furthermore,a rapid differentiation and authentication strategy for TCMs based on H-oEESI-MS was proposed,including metabolic profile characterization,characteristic marker screening and identification,and multivariate statistical analysis model validation.In an analysis of 52 batches of seven types of Aconitum medicinal materials,20 and 21 key compounds were screened out as the characteristic markers of raw and processed Aconitum herbal medicines,respectively,and the possible structures of all the characteristic markers were comprehensively identified based on Com-pound Discoverer databases.Finally,multivariate statistical analysis showed that all the different types of herbal medicines were well differentiated and identified(R2X＞0.87,R2Y＞0.91,and Q2＞0.72),which further verified the feasibility and reliability of this comprehensive strategy for the rapid authentication of different TCMs based on H-oEESI-MS.In summary,this rapid authentication strategy realized the ultra-high-throughput,low-cost,and standardized detection of various complex TCMs for the first time,thereby demonstrating wide applicability and value for the development of quality standards for TCMs.

Objective:To investigate the key factors of renal damage in patients with primary Sj?gren′s syndrome (pSS), to construct a risk prediction model.Methods:Clinical data of 419 pSS inpatients in the Nanjing Drum Tower Hospital from 2017 to 2020 were retrospectively analyzed. The patients were randomly divided into the model group (315 cases) and the validation group (104 cases) in a 3∶1 ratio by R software randomized package. T test was used in accordance with the normal measurement data, Chi square test was used for counting data, and Kruskal-Wallis H and Mann-Whitney U test were used for non-normal distributed data. A nomogram model was created based on independent factors of renal damage by using LASSO Cox regression analysis, and the receiver operating characteristic (ROC) curve, calibration curve and decision curve analysis (DCA) were applied to evaluate the sensitivity, accuracy and clinical practicability of the model. Results:Renal impairment occurred in 127 (30.3%)pSS patients, including 89 (70.1%) cases with renal insufficiency, 86 cases with hematuria (67.7%), 107 cases with proteinuria (84.2%) and 49 cases with renal tubular acidosis. Compared with those without renal damage, patients with renal damage had a longer course of disease [3.00 (1.00, 8.00) years vs 1.00 (0.30, 5.00) years; Z=2.33, P=0.005], presence of fatigue [35.1% (33/94) vs 23.5% (52/221), Z=4.49, P=0.038], decreased blood cells count [white blood cell 4.50(3.30, 6.75)×10 9/L vs 5.40(3.70, 8.05)×10 9/L, Z=2.02, P=0.043; hemoglobin 99.00(79.00, 111.00)g/L vs 120.00 (109.00, 128.00)g/L, Z=6.59, P<0.001; platelet 152.00 (89.25, 204.25)×10 9/L vs 188.00 (117.99, 241.00)×10 9/L, Z=2.61, P=0.009], stronger inflammatory reactions [ESR 48.50 (29.75, 86.25)mm/1 h vs 26.00 (11.00, 52.00)mm/1 h, Z=5.83, P<0.001; CRP 5.80 (3.40, 18.45)mg/L vs 4.40 (2.60, 11.40) mg/L, Z=2.33, P=0.020] and higher positive rate for anti-SSA/B antibodies [79.79%(75/94) vs 61.99%(137/221), χ2=9.49, P=0.002; 37.23%(35/94) vs 18.10%(40/221), χ2=13.31, P<0.001], but relatively less pulmonary involvement [20.2%(19/94) vs 33.9%(75/221), χ2=5.93, P=0.016], the differences were statistically significant ( P<0.05). Lasso binary logistics regression analysis showed that EULAR Sj?gren′s syndrome disease activity index score >9[ OR(95% CI)=9.019(3.294, 24.689), P<0.001], dry eye[ OR(95% CI)=2.853(1.502, 5.422), P=0.011], anemia[ OR(95% CI)=3.819(1.913, 7.626), P<0.001], low complement C3 level[ OR(95% CI)=2.453(1.233, 4.879), P=0.011]and hypoalbuminemia [ OR(95% CI) =6.898 (3.007, 15.821), P<0.001] as well as C-reactive protein [ OR (95% CI)=2.168 (1.136, 4.139), P=0.019] were significant related factors of renal impairment. The AUC (95% CI) of the prediction group and the validation group were 0.851 (0.806, 0.896) and 0.832 (0.742, 0.922), respectively, and the model plot and DCA showed that the model had good specificity and clinical efficacy. Conclusion:We propose a new nomogram model with good differentiation and calibration to assist in clinical screening of renal damage in pSS.

Objective:To investigate the relationship between osteoarthritis and generalized anxiety disorder (GAD)/depression among rural middle-aged and elderly people in Bayannur, Inner Mongolia Autonomous Region.Methods:From 2016 to 2018, a one-to-one interview questionnaire survey was conducted among 832 rural middle-aged and elderly people aged 45 or above in Bayannur. Logistic regression model was used to explore the relationship between osteoarthritis and GAD/depression.Results:Of 832 rural middle-aged and elderly participants, 28.73% (239/832) were diagnosed with osteoarthritis. The risk of GAD and depression increased by 71% [adjusted odds ratio ( AOR): 1.71, 95% confidence interval ( CI): 1.12 - 2.60] and 68% ( AOR: 1.68, 95% CI: 1.10 - 2.58), respectively, in patients with osteoarthritis compared with those without osteoarthritis. Conclusions:The prevalence of osteoarthritis is high among the middle-aged and elderly people in Bayannur, Inner Mongolia Autonomous Region. Osteoarthritis may increase the risk of GAD/depression. It is necessary to take corresponding intervention measures to prevent the occurrence of osteoarthritis to reduce GAD/depression.

Objective:To discuss the practice effect of process evaluation on Nursing Aesthetics teaching evaluation.Methods:Vocational college nursing students from two classes of 2017 in the school were selected as the control group, and two of 2018 the experimental group. The experimental group, which contained 84 students, was implemented process evaluation method. The students′ satisfaction to the teaching method and their examination results of theory and practice were compared between the two groups. The opinions and self-evaluation of the experimental group on the process evaluation were investigated.Results:The students′ satisfaction degree with teaching of the experimental group was (96.10±0.36) points, significantly better than (90.00±0.58) points of the control group, and the difference was statistically significant ( tvalue was 5.03, P<0.05). The score of theory course and practice personal evaluation of students in experimental group (84.35±6.65, 87.21±5.47) was obviously higher than that of control group (81.57±8.21, 84.64±6.78). The t-value was 5.968 and 6.687 respectively, and the difference was statistically significant ( P<0.05 or 0.01). In experimental group, 39.3 percent (33/84) of students strongly agree that the process evaluation fully and truly reflects their knowledge and ability, while 51.2 percent (43/84) of students comparatively agree with that. More than 90 percent of students believed that the process evaluation has improved their comprehensive application ability of aesthetic knowledge, enhanced their sense of identity to nursing profession, helped to develop good study habits and so on. Conclusions:Process evaluation have helped increase students′ comprehensive quality and ability.