Diffuse large B-cell lymphoma (DLBCL) is characterized by heterogeneity with respect to morphology, immune phenotype, molecular pathogenesis, clinical presentation and prognosis. With the development of genome and transcriptome sequencing, DLBCL was classified as four subtypes (EZB, BN2, MCD, and N1) or five subtypes (C1-C5). The new molecular pathological typing has a deeper understanding of DLBCL from the levels of genes and molecules which makes the judgment of prognosis more accurate and specific, and it is conducive to the clinical screening of more accurate targeted therapy.

Objective: To compare the effect of intranasal dexmedetomidine and oral chloral hydrate in deep sedation of children. Methods: The Pubmed, EMBase, CENTRAL (Issue 4, 2018), Web of science, CBM, Wanfang Data, CNKI and VIP databases from the inception to January 2019 were searched. Randomized controlled trials (RCTs) with dexmedetomidine and chloral hydrate as interventions were included and the data were analyzed by RevMam 5.3 and Stata 12.0 software. The success rate of deep sedation, the indicator of sedation onset time, the recovery time, the incidence of vomiting and bradycardia were compared. Results: A total of 7 RCTs involving 1 007 patients were included for analysis. The results showed that the success rate of deep sedation (OR=2.55, 95%CI:1.46-4.44, P<0.01) and the incidence of bradycardia (OR=4.42, 95%CI:1.82-10.74, P<0.01) in the dexmedetomidine nasal group were significantly higher than those in the chloral hydrate oral group. The recovery time was significantly shorter (MD=-16.41, 95%CI:-21.54-11.28, P<0.01) and the incidence rate of vomiting (OR=0.04, 95%CI:0.01-0.17, P<0.01) in dexmedetomidine nasal group was significantly lower than those in the chloral hydrate oral group. There was no significant difference in the indicator of sedation onset time (MD=-0.47, 95%CI:-2.71-1.22, P=0.46). Conclusion Compared with the traditional oral chloral hydrate, intranasal dexmedetomidine has a higher sedation success rate and shorter recovery time after sedation with a lower incidence of nausea and vomiting.

Objective To investigate the incidence of motor system disorders or symptoms that occurred among naval afloat personnel onboard a certain naval surface ship after a prolonged distant voyage.Methods In the year of 2015,a randomized questionnaire survey was carried out among the naval afloat personnel,who experienced a prolonged ocean-going voyage greater than 5 months with a total distance as far as 32 500 nautical miles,covering 4 continents and crossing 2 great oceans.All the subjects finished the questionnaire survey independently and all the questionnaire survey forms were recovered on site and statistical analyses were made by Excel and SPSS 13.0 software.Results Totally,109 copies of questionnaire were issued and 95 copies were recovered,and 90 copies were confirmed valid,with a total valid rate of 94.7％.The average age of the subjects (11 females and 79 males) was (25.12 ± 4.63) years.There were 22 naval afloat personnel with past motor system chronic diseases,accounting for 24.4％.Before prolong distant voyage,52 people complained of motor system disorders (52/90),accounting for 58％,but after prolonged distant voyage,58 people complained of motor system disorders (58/90),accounting for 65.2％.Before prolonged distant voyage,in the ship crew who lived in the relatively dry cabins,22 people complained of motor system disorders (22/33),accounting for 66.7％,but after prolonged distant voyage,21 people complained of motor system disorders (21/33),accounting for 63.6％.However,Before prolonged distant voyage,in the ship crew who lived in the relatively humid cabins,25 people complained of motor system disorders (25/46),accounting for 54.3％,but after prolonged distant voyage,34 people complained of motor system disorders (34/46),accounting for 73.9％.Conclusions Various environmental factors during prolonged distant voyage,particularly humidity in living cabins,exerted negative effects on musculoskeletal system.More strict prophylactic countermeasures should be applied.Due to high incidence of musculoskeletal system disorders,poor knowledge of the naval ship crew about the prevention and treatment of the disorders and their urgent desire to obtain required necessary consultation on the disorders,corresponding medical service should be provided in accordance with the above-mentioned features.

Objective To investigate the incidence of motor system disorders or symptoms that occurred among naval afloat personnel onboard a certain naval surface ship after a prolonged distant voyage.Methods In the year of 2015,a randomized questionnaire survey was carried out among the naval afloat personnel,who experienced a prolonged ocean-going voyage greater than 5 months with a total distance as far as 32 500 nautical miles,covering 4 continents and crossing 2 great oceans.All the subjects finished the questionnaire survey independently and all the questionnaire survey forms were recovered on site and statistical analyses were made by Excel and SPSS 13.0 software.Results Totally,109 copies of questionnaire were issued and 95 copies were recovered,and 90 copies were confirmed valid,with a total valid rate of 94.7％.The average age of the subjects (11 females and 79 males) was (25.12 ± 4.63) years.There were 22 naval afloat personnel with past motor system chronic diseases,accounting for 24.4％.Before prolong distant voyage,52 people complained of motor system disorders (52/90),accounting for 58％,but after prolonged distant voyage,58 people complained of motor system disorders (58/90),accounting for 65.2％.Before prolonged distant voyage,in the ship crew who lived in the relatively dry cabins,22 people complained of motor system disorders (22/33),accounting for 66.7％,but after prolonged distant voyage,21 people complained of motor system disorders (21/33),accounting for 63.6％.However,Before prolonged distant voyage,in the ship crew who lived in the relatively humid cabins,25 people complained of motor system disorders (25/46),accounting for 54.3％,but after prolonged distant voyage,34 people complained of motor system disorders (34/46),accounting for 73.9％.Conclusions Various environmental factors during prolonged distant voyage,particularly humidity in living cabins,exerted negative effects on musculoskeletal system.More strict prophylactic countermeasures should be applied.Due to high incidence of musculoskeletal system disorders,poor knowledge of the naval ship crew about the prevention and treatment of the disorders and their urgent desire to obtain required necessary consultation on the disorders,corresponding medical service should be provided in accordance with the above-mentioned features.

Objective To determine the prognosis and risk factors of neonatal cerebral infarction.Methods From January 2002 to December 2010,44 newborn infants were diagnosed with cerebral infarction by imaging examinations at Peking University First Hospital.The neurodevelopmental outcomes of these newborn infants were followed up and evaluated by clinical manifestations,Gesell development scale,cranial imaging,electroencephalogram and auditory evoked potential.Factors related to prognosis were analyzed with single and multi-factor Logistic regression analysis.Results Thirty-eight (86％) cases were followed up,and of these cases,five children died and the results of three were inconclusive due to small age (less than 6 months old).Among the remaining 30 children,neurodevelopmental outcome was normal in 15 cases and abnormal in the remaining 15 cases,thus,the incidence of sequelae was 50％ (15/30) and the mortality rate was 13％ (5/38).Of the 15 abnormal cases,all had cerebral palsy and movement retardation,eight cases had cognitive impairment,eight cases had epilepsy and five had visual impairment.The incidence of large cerebral infarction (more than one lobe) was 14/15,worse cranial imaging outcome (one month after treatment,cerebral infarction lesion still present or had expanded)was 13/15,and severe complications was 8/15 in the newborns with sequelae,which were higher than in those without sequelae (4/15,5/15 and 1/15,respectively) (x2=13.889,8.889 and 7.778,all P＜0.05).Logistic regression analysis showed that large cerebral infarction was a risk factor for sequelae (OR=38.500,95％C1:3.749-395.407,P=0.002),however,worse cranial imaging outcome (OR=8.563,95％CI:0.909-80.683,P=0.061) and severe complications (OR=18.024,95％CI:0.516-630.163,P=0.111) were not risk factors for sequelae.Cerebral infarction with middle cerebral artery injury had a high risk of movement retardation (OR=6.000,95％CI:1.172-3.725,P=0.025),and those with a large cerebral infarction were more likely to have epilepsy (x2=7.273,P=0.010).The incidence of large cerebral infarction in the newborn infants with cognitive impairment was 8/8,which was much higher than in those without cognitive impairment (46％,10/22),thus,infarct area may be related to cognitive ability (x2=7.273,P=0.010).Conclusions Neonatal cerebral infarction might result in many types of sequelae,with motor impairment being the most common form.A large cerebral infarction is more likely to result in abnormal neurodevelopmental outcome.

ObjectiveTo observe the effects of moxibustion in treating knee osteoarthritis (KOA).MethodTotally105 patients with KOA were randomly divided intoamoxibustion group (n=39), anelectroacupuncture group(n=44) andaCelebrex group (n=22).The three groups were treatedsuccessively for 4 weeks.The visual analogue scale (VAS) score of knee-joint pain and knee-joint function score were observed.ResultSeven days,fourteen days and twenty-eight daysrespectivelyafterthe treatment,theVAS scores of knee-joint pain and knee-joint function scoresweresignificantlydecreased in the three groups (P<0.001). Fourteen days and twenty-eight days afterthe intervention,the knee-joint function scores ofthemoxibustion group and electroacupuncture group weresignificantlyhigherthan those oftheCelebrex group (P<0.05).ConclusionMoxibustion therapy can improve the clinical symptoms and the knee-joint function in patients with KOA,similar to the electroacupuncture group and Celebrex group, and the moxibustion group has better effect in improving theknee-joint functioncompared to the Celebrex group.

Objective To investigate the application of the risk management information system in the nursing management .Methods On the basis of our large-scale integrated nursing information system , the nursing department and information center of nursing risk management information system was developed . Results The rates of nursing evaluation , admission assessment , pressure sores risk assessment , fall risk assessment, catheter slippage assessment and self-care capacity assessment were 93.0%, 96.0%, 95.0%, 98.0%, 95.0%and 96.0%, which were all significantly higher than 78.0%, 75.0%, 71.0%, 83.0%, 80.0%and 75.0% before the intervention (χ2 =9.074, 15.686, 10.286, 13.885, 20.411, 17.786, respectively;P<0.05).The scores of work satisfaction of nurses and the patients satisfaction were (95.14 ± 0.46) and (96.17 ±2.03), which were significantly higher than (82.13 ±1.78) and (84.10 ±4.79) before the intervention (t=79.92, 23.20, respectively;P<0.05).Conclusions Nursing information system applied in risk management can ensure patient safety and improve the quality of nursing management .

Objective To explore risk factors of cerebral infarction in newborns by systematic reviews.Methods Case-control studies and case reports on risk factors of cerebral infarction in newborns from January 1997 to December 2011 were collected from database of CNKI,CQVIP,Wanfang Database,PubMed,OVID,Springer,Medline,Science Direct On Site,Besco and MD Consult.Meta analysis was performed on case-control studies with fixed or random effect model by Review Manager 5.0.Constitution ratio of risk factors of cerebral infarction in newborns in case reports was investigated.Results Two hundred and sixty-nine articles were found and among which,36 articles in English were selected for this study.Three case-control studies were found and adopted for meta analysis.Cumulative number of patients and control cases were 80 and 228,respectively.The pooled OR and 95 ％CI of selected factors were as follows:decreased fetal movement [7.10 (2.92-17.24)],abnormal fetal heart rate [4.45 (2.54-7.80)],vacuum delivery [2.99 (1.23-7.25)],resuscitation at birth [(3.14 (1.17-8.46)],premature rupture of membranes [2.40 (0.62-9.29)],cesarean section [2.64 (1.44-4.82)],preeclampsia [3.05 (1.44-6.43)],history of infertility [1.25 (0.18-8.67)],primiparous [1.79 (0.51-6.36)],oxytocin used [2.05 (0.99-4.25)],fetal growth restriction [0.99 (0.47-2.11)],meconium stained amniotic fluid [2.08 (0.94-4.58)],adverse pregnancy history [0.85 (0.43-1.68)] and breech presentation [0.38 (0.10-1.46)].Meta analysis showed that decreased fetal movement,abnormal fetal heart rate,vacuum extraction,resuscitation at birth,cesarean section and preeclampsia were risk factors of neonatal cerebral infarction.Decreased fetal movement,abnormal fetal heart rate and resuscitation at birth suggested that newborns suffered from perinatal hypoxia,vacuum extraction,cesarean section suggested abnormal delivery.It suggested that perinatal hypoxia and abnormal delivery were high risk factors of neonatal cerebral infarction.Among those factors,proportion of abnormal labor,fetal distress and hypercoagulabe state was 31.70％,21.13％ and 20.19％ respectively.Conclusions Abnormal birth,hypoxia,preeclampsia and hypercoagulation state might relate to neonatal cerebral infarction.

Objective To investigate the risk factors of cerebral infarction in newborns and to provide a theoretic basis for prevention.Methods From January 2002 to December 2010,8840 newborns were admitted into the Neonatology Department of Peking University First Hospital,among which 44 patients were diagnosed as cerebral infarction by review of brain imaging and medical records.These patients were taken as study group,and 175 patients were randomly selected as the control group matched by birthday and gestational age.Risk factors of neonatal cerebral infarction were analyzed by univariate analysis and binary Logistic regression.Results Of 27 352 infants born in Peking University First Hospital,21 infants were diagnosed as neonatal cerebral tnfarction,giving the prevalence of neonatal cerebral infarction of 7 per 10 000 live births (21/27 352).Of the 8840patients in Department of Neonatology,neonatal cerebral infarction accounts for 5.0‰ (44/8840).81.8％ (36/44) of the affected babies were delivered at term.The incidence of hypoxia and polycythemia in study group were 50.0％ (22/44) and 11.4％ (5/44),higher than those in control group [27.4％(48/175) and 2.9％(5/175)],differences were statistical significant (x2 =8.237,OR=2.646,95％CI:1.343-5.211,P=0.004; x2 =5.838,OR=4.359,95％CI:1.203-15.796,P=0.030).Logistic regression showed that hypertensive disorder complicating pregnancy (OR=3.388,95％CI:1.174-9.778,P=0.024),polycythemia (OR=4.319,95％CI:1.136-16.427,P=0.032)and hypoxia (OR =2.860,95％ CI:1.415-5.782,P =0.003) were risk factors for neonatal infarction.Further analysis suggested that the severity of hypoxia (x2 =- 3.470,P =0.001 ) and hypertensive disorder complicating pregnancy (x2=-2.074,P=0.038) had positive correlation with neonatal cerebral infarction.Conclusions Hypertensive disorder complicating pregnancy,polycythemia and hypoxia were risk factors of cerebral infarction,especially when preeclampsia and severe hypoxia occurred.

ObjectiveTo study the role of the myenteric plexus (ENS) nitrergic neurons in type 2 diabetic rats with gastroparesis.MethodsThiry male 8-week-SD rats were randomly divided into control group (CON),type 2 diabetic group (DM),insulin-treated group ( INS ) and insulin-lipoie acid group( LA ),each 15.The rats were sacrificed at 16 weeks after diabetic model established,the stomach relative residual rate of pigmented was measured and the protein content of neuronal nitric oxide synthase (nNOS) was evaluate,the level of malondialdehyde (MDA) and superoxide dismutase (SOD),were measured,the the morphological changes of gastric antrum nitrergic neurons was observed.ResultsCompared with CON group,gastric motility,gastric antrum nitrergic neuron count,T-SOD and CuZn-SOD,and were significantly decreased in DM group ( P ＜0.05).Compared with the CON group,DM group gastric antrum nitrergic neurons nNOS expression decreased,while MDA levels significantly increased ( P ＜ 0.05 ).Compared with DM group,INS group and LA group has significantly rapider gastric motility than that of DM group ( P＜ 0.05 ),the neuron counting markly increased in nitrergic neuron of gastic sinus ( P ＜ 0.05 ),increased expressions of nNOS in gastric sinus,while still lower than control group( P ＜0.05).compared with the INS group,antrum nitrergic neuron counts of LA group significantly increased ( P ＜ 0.05 ).Conclusion The gastrointestinal dyskinesis of type 2 diabetic rats might be associated with lesions of gastric myenteric plexus nitrergic neuron.Insulin intensive therapy and treated with alpha-lipoic acid as an antioxidant can inhibit the abnormally high levels of oxidative stress,protect gastrointestinal nitrergic neurons,delay the progress of diabetic gastrointestinal motility disorders.Insulin combined with a-lipoic acid treatment is superior to single-use insulin.