ObjectiveTo develop a community-family management model for older adults with mild cognitive impairment (MCI) and to formulate detailed application specifications, and to fully leverage the initiative of communities and families under limited resource conditions, for achieving community-based early detection and early intervention for older adults with MCI. MethodsA systematic literature review was conducted to identify pertinent publications. Corpus-based research methodologies were employed to extract, refine, integrate and synthesize management elements, thereby establishing the specific content and service processes for each stage of the management model. Utilizing the 5W2H analytical framework, essential elements such as management stakeholders, target populations, content and methods for each stage were delineated. The model and its application guidelines were finalized through expert consultation and demonstration. ResultsAn expert evaluation of the management model yielded mean scores of 4.84, 4.32 and 4.84 for acceptability, feasibility and systematicity, respectively. By integrating the identified core elements with expert ratings and feedback, the final iteration of the community-family management model for older adults with MCI was formulated. This model comprised of five stages: screening and identification, comprehensive assessment, intervention planning, monitoring and referral pathways to ensure implementation, and enhanced support for communities, family members and caregivers. Additionally, it included 18 specific application guidelines. ConclusionThe proposed management model may theoretically help delay cognitive decline, improve cognitive function and potentially promote reversal from MCI to normal cognition. It may also enhance the awareness and coping capacity of older adults and their families, strengthen community healthcare professionals' ability to early identify and manage MCI.

Objective:To investigate the efficacy and safety of obinutuzumab combined with short-course dexamethasone in patients with relapsed immune thrombocytopenia (ITP) who had previously been treated with rituximab.Methods:A retrospective case series study was conducted. A total of 8 patients with relapsed ITP after treatment with rituximab who received obinutuzumab combined with short-course dexamethasone between January 2023 and January 2024 in the First Affiliated Hospital of Harbin Medical University were collected. The clinical characteristics, changes in platelet counts, changes in peripheral blood B-lymphocyte counts, treatment outcome and treatment-related adverse events were analyzed.Results:There were 1 male and 7 females in 8 patients with relapsed ITP after treatment with rituximab. The median age [ M ( Q1, Q3)] of the 8 enrolled patients was 52.5 (40.5, 56.0) years. The median relapsed times was 2.0 (2.0, 2.5) times and the median course of disease was 16.0 (13.0, 18.5) months. The platelet count increased from 8.73 (5.79, 11.65)×10 9/L pre-treatment to 180.00 (83.40, 255.00)×10 9/L post-treatment, and the difference was statistically significant ( Z = -2.37, P = 0.018); conversely, peripheral blood B-lymphocyte count decreased from 322.59 (148.29, 403.07) × 10 9/L pre-treatment to 1.23 (0.57, 1.76) ×10 9/L post-treatment, and the difference was statistically significant ( Z = -2.52, P = 0.012). After obinutuzumab and short-course dexamethasone treatment, 6 patients achieved complete remission, 1 case showed response, and 1 case had no response. No severe adverse events were observed during treatment and follow-up in all patients. Conclusions:Obinutuzumab combined with short-course dexamethasone appears to be effective in treating relapsed ITP patients after treatment with rituximab, and its safety is good.

Objective:To explore the effect of ultraviolet-C (UV-C) combined with Kangfuxin liquid wet compress and oxygen blowing method on the post chemotherapy oral mucositis (OM) in patients with hematological malignancies.Methods:From January 2022 to February 2023, convenience sampling was used to select 120 patients with post chemotherapy OM in the Department of Hematology of the Affiliated Huai'an First People's Hospital of Nanjing Medical University. The patients were randomly divided into a control group and an observation group, with 60 cases in each group. The control group received Kangfuxin liquid wet compress, while the observation group carried out a combination of UV-C irradiation and oxygen oral blowing method on the basis of the control group. This study compared the Visual Analogue Scale (VAS) score before and two days after treatment, the healing status of OM after treatment on the 5th day, and the healing time of OM between the two groups of patients.Results:A total of 108 patients completed the study, with 52 in the control group and 56 in the observation group. After two days of treatment, the VAS scores of both groups of patients were lower than those before treatment, and those of the observation group were lower than those of the control group, with statistically significant differences ( P<0.05). On the 5th day of treatment, the healing rate of OM in the observation group was higher than that in the control group, and the difference was statistically significant (χ 2=5.425, P<0.05). The healing time of OM in the observation group was shorter than that in the control group, and the difference was statistically significant ( t=2.458, P<0.05) . Conclusions:The combination of UV-C, Kangfuxin liquid and oxygen blowing method can alleviate pain, improve the healing rate of OM, and shorten the healing time of post chemotherapy OM in patients with hematological malignancies, which is worthy of clinical promotion.

Objective:To analyze the features of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) co-infected with other common respiratory pathogens among coronavirus disease 2019 (COVID-19) patients in Shanghai City, and to provide a reference for scientific prevention and control of COVID-19 and other respiratory infectious diseases.Methods:Descriptive epidemiological approaches were used to analyze the data of COVID-19 reported cases in Shanghai City from January 2020 to February 2021 in the information system of Chinese Disease Prevention and Control. Clinical data of the participants were collected, and their SARS-CoV-2 nucleic acid-positive respiratory specimens were collected at the time of illness onset or admission. Multiplex reverse transcription-polymerase chain reaction (RT-PCR) was performed to detect the 22 respiratory pathogens. Independent-samples t test was used for statistical analysis. Results:Of the 272 patients with COVID-19, 15(5.5%) had co-infection of SARS-CoV-2 with other respiratory pathogens, all of which were double infection. There were three cases infected with enterovirus/rhinovirus, two of each with adenovirus, human metapneumovirus and coronavirus NL63/HKU1, and one of each with coronavirus 229E, influenza A virus H1N1, parainfluenza virus 1 and respiratory syncytial virus B. Two cases infected with Mycoplasma pneumoniae. Among the 272 COVID-19 patients, 212(77.9%) had fever, 117(43.0%) had cough, 46(16.9%) had fatigue, and 35(12.9%) had sore throat. The white blood cell count of co-infection cases was higher than that of non-co-infection cases ((6.8±1.7)×10 9/L vs (5.3±1.6)×10 9/L), and the difference was statistically significant ( t=3.09, P=0.008). Conclusions:There is a certain proportion of co-infection of SARS-CoV-2 with other respiratory pathogens among the COVID-19 cases in Shanghai City, mainly viral pathogens, especially enterovirus/rhinovirus. A rational combination of drugs was recommended to improve the cure rate. Surveillance of acute respiratory infection should be further strengthened as well.

Objective To preliminarily compare ⁶LiF-⁷LiF and CR39 in individual neutron dose monitoring, and to provide a reference for improving individual neutron dose monitoring. Methods According to the GBZ 128-2019, 26 radiation workers from 7 institutions received individual neutron dose monitoring with ⁶LiF-⁷LiF and CR39 at the same time. The monitoring results were analyzed. Results For most of the workers, the personal neutron dose equivalent H_p(10) was less than the minimum detectable level. The results with the two monitoring methods differed in 6 of 26 workers. Conclusion Both ⁶LiF-⁷LiF and CR39 monitoring methods can be used for individual neutron dose monitoring for radiation workers, but the difference between ⁶LiF-⁷LiF and CR39 (in threshold energy, energy response, etc.) should be considered so that different types of radiation workers receive appropriate individual neutron dose monitoring.

Humans ; HIV Infections/drug therapy* ; HIV-1/genetics* ; Tenofovir/therapeutic use* ; Anti-HIV Agents/therapeutic use* ; RNA ; Drug Combinations

ObjectiveTo investigate the distribution and trend of rehabilitation personnel of China Disabled Persons' Federation (CDPF) system and the people with disabilities (PWDs) using geographical gravity model. MethodsBased on ArcGIS and statistical data, the distribution of geographical center of gravity of the rehabilitation personnel of the CDPF system from 2011 to 2021 was analyzed. According to the economic development, the areas were divided into three regions, and the eastern region included eleven provincial units, the central region includes eight provincial units, and the western region included twelve provincial units. ResultsCompared with 2011, rehabilitation staffs per thousand PWDs increased at 107.5% in 2021, 81.1%, 114.2% and 174.1% for the eastern, central, and western regions, respectively; professional staffs increased at 190.5%, 148.8%, 284.6% and 280.6% for the eastern, central, and western regions, respectively; managerial staff increased at 80.0%, 46.8%, 554.3% and 128.1% for the eastern, central, and western regions, respectively. Compared with 2011, the geographical center of gravity of the rehabilitation personnel moved about 330.9 km in 2021, while the geographical center of gravity of the PWDs moved about 169.64 km. ConclusionThe rehabilitation personnel in the CDPF system is the most in the eastern region and least in the western region. The tracks of the geographical center of gravity of the three kind of rehabilitation personnel in the CDPF system are relatively consistent. The rehabilitation personnel in the eastern region are more concentrated than those in the western region, and the density of the PWDs is more westward than that of the rehabilitation personnel, and coordination is not a perfect match yet. It is necessary to strengthen the rehabilitation personnel allocation in the western region, to balance distribution of human resources for rehabilitation of PWDs among regions.

Objective:To investigate Shenqi Fuzheng Injection combined with nimodipine in the treatment of convalescent-phase cerebral infarction and its effects on neurocognitive function, hemorheology and T cell subsets. Methods:A total of 108 patients with cerebral infarction in the convalescent phase who received treatment in Hangzhou Hospital of Traditional Chinese Medicine, China between April 2016 and December 2019 were included in this study. They were randomly assigned to receive either nimodipine treatment (control group, n = 54) or treatment with Shenqi Fuzheng Injection combined with nimodipine (study group, n = 54). Curative effects and changes in neurocognitive function, hemorheology and T cell subsets after treatment relative to before treatment were compared between the control and study groups. Results:Total effective rate in the study group was significantly higher than that in the control group [90.74% (49/54) vs. 75.93% (41/54), χ2 = 4.267, P = 0.039]. After 2 weeks of treatment, whole blood viscosity at a high shear rate, whole blood viscosity at a low shear rate, plasma viscosity in the study group were (4.17 ± 0.24) mPa/s, (9.27 ± 1.98) mPa/s, (1.07 ± 0.19) mPa/s, respectively, which were significantly lower than those in the control group [(4.52 ± 0.31) mPa/s, (13.69 ± 2.13) mPa/s, (1.34 ± 0.23) mPa/s, t = 6.560, 11.169, 6.651, all P < 0.05]. The proportion of CD 3+ cells, CD 4+ and CD 4+/CD 8+ in the study group was (48.59 ± 4.59) %, (44.24 ± 6.17) % and (1.91 ± 0.17) respectively, which were significantly higher than those in the control group [(44.97 ± 5.31) %, (39.55 ± 5.13) %, (1.47 ± 0.22), t = 3.790, 4.295, 11.629, all P < 0.05]. The proportion of CD 8+ cells in the study group was significantly lower than that in the control group [(23.13 ± 5.62) % vs. (26.97 ± 4.26) %, t = 4.001, P < 0.05]. Mini-Mental State Examination score in the study group was significantly higher than that in the control group [(28.87 ± 0.85) points vs. (27.91 ± 1.45) points, t = 4.197, P < 0.05]. National Institute Health of Stroke Scale score in the study group was significantly lower than that in the control group [(9.63 ± 2.19) points vs. (15.27 ± 1.97) points, t = 14.070, P < 0.05]. Conclusion:Shenqi Fuzheng Injection combined with nimodipine can remarkably improve the neurocognitive function, hemorheology and T cell subsets in patients with cerebral infarction in the convalescent phase. The combined method is safe and reliable, and its curative effect is stable.

Objective To explore the clinical value of 3D fast spin echo with an extended echo train acquistion (CUBE) T1WI enhancement sequence for purulent meningitis by comparing to contrast?enhanced T2WI?FLAIR sequence in the detection of lesions. Methods From August 2016 to July 2017, children with clinically suspected purulent meningitis underwent cranial magnetic resonance examination in our hospital. There were 35 children, 19 males and 16 females, aged 2 months to 3 years (median age 8 months) in total.A GE Discovery MR 750 3.0 T scanner was used to perform routine plain and enhanced scan in all children. After enhancement, the sequences of CUBE T1WI and FLAIR T2WI were applied randomly. Using the FLAIR T2WI enhancement sequence as the reference, we evaluated the detection rate of CUBE T1WI enhancement sequence for dura mater and leptomeningeal thickening. The number of enhanced lesions detected was tested by χ2 test. Results The enhanced FLAIR T2WI sequence showed 21 cases with dural enhancement, showing a rate of 60.0%. The enhanced CUBE T1WI sequence showed 31cases with dural enhancement, showing a rate of 88.6%. There were significant differences between the dural lesions detected(χ2＝6.058, P<0.01). The enhanced FLAIR T2WI sequence showed 16 cases of leptomeningeal enhancement,showing a rate of 45.7%. The enhanced CUBE T1WI sequence showed 19 cases of leptomeningeal enhancement,showing a rate of 54.3%.The enhanced CUBE T1WI sequence was not significantly higher than that of enhanced T2WI?FLAIR sequence in displaying leptomeningeal enhancement (χ2=0.229, P>0.05). Conclusion Enhancement of the CUBE T1WI sequence enables better visualization of meningeal thickening than FLAIR T2WI. It has great clinical value in the diagnosis of purulent meningitis in children.

Background:The occurrence of gastric cancer is a gradual process with multiple factors and multiple steps. In addition to cytological and structural abnormalities,there are abnormal molecular expressions,which involve the activation of many oncogenes and the inactivation of tumor suppressor genes. Aims:To explore the expressions and significance of Ki-67,p53 and P504s in normal gastric mucosa,atrophic gastritis with intestinal metaplasia,low-grade intraepithelial neoplasia,high-grade intraepithelial neoplasia and early gastric cancer. Methods:A total of 44 cases of normal gastric mucosa,44 cases of atrophic gastritis with intestinal metaplasia,41 cases of low-grade intraepithelial neoplasia,38 cases of high-grade intraepithelial neoplasia and 35 cases of early gastric cancer from Jan. 2015 to Dec. 2016 at the Affiliated Drum Tower Hospital of Nanjing University Medical School were collected. Expressions of Ki-67,p53 and P504s were detected by immunohistochemical staining. Results:Compared with normal gastric mucosal tissue,the positivity rates of expression of Ki-67,p53 and P504s in atrophic gastritis with intestinal metaplasia,low-grade intraepithelial neoplasia,high-grade intraepithelial neoplasia and early gastric cancer were obviously increased (P＜0.05). With the increasing of severity of the lesion,the positivity rate gradually increased. Conclusions:The expressions of Ki-67,p53 and P504s are closely related to the occurrence and development of gastric cancer,and are involved in the early process of gastric cancer. The detections of these molecular markers are helpful for determining the severity and trend of the lesion,and beneficial for improving the detection rates of gastric precancerous lesion and early gastric cancer.