The awake prone position plays an important role in the treatment of hypoxemia and the improvement of respiratory distress symptoms in non-intubated patients. It is widely used in clinical practice because of its simple operation, safety, and economy. To enable clinical medical staff to scientifically and normatively implement prone position for awake patients without intubation, the committees of consensus formulation, guided by evidence-based methodology and Delphi method, conducted literature search, literature quality evaluation and evidence synthesis around seven topics, including indications and contraindications, evaluation, implementation, monitoring and safety management, termination time, complication prevention and health education of awake prone position. After two rounds of expert letter consultation, Expert consensus on implementation strategy of awake prone positioning for non-intubated patients in China (2023) was formulated, and provide guidance for clinical medical staff.
Humans ; Consensus ; Prone Position ; Wakefulness ; China ; Dyspnea

OBJECTIVETo evaluate the clinicopathological characteristics, treatment and prognosis of the patients with plasmablastic lymphoma(PBL).

METHODSThe clinical and pathological data of 21 patients with PBL diagnosed and treated in our center between January 2009 and September 2017 were retrospectively analyzed. The clinical and pathological features, treatment and therapentic outcome were summarized and the high risk factors affecting the prognosis of patients were investigated.

RESULTSThe 21 PBL patients included 12 males and 9 females, and their median age was 52 years old. The human immunodeficiency virus (HIV) was negative in all patients. The primary involved sites of 16 patients were extranodal, and the patients staged in III-IV accounted for 81%; 18 patients receved first-line chemotherapy with standard CHOP(E) (cyclophosphamide +epirubicin +vincristine +prednisone±etoposide). After treatment, only 1 patient achieved complete response (CR), and 8 patients achieved partial response (PR). The median overall survival time was 6.3 months. Multivariate analysis showed the America Eastern Cooperative Oncology Group (ECOG) physical score and bone marrow infiltration were significant prognostic factors (P<0.01).

CONCLUSIONPlasmablastic lymphoma frequently occurrs in the middle-old aged persons with all HIV negative. Primary extranodal lesions are frequent. Most patients were in advanced stage with poor treatment response. ECOG score≥2 and bone marrow infiltration are independent prognostic factors related with worse prognosis.

Objective:To investigate association between loneliness and depressive episode among rural older people.Methods:A total of 839 rural adults (aged over 60 years) from Liuyang in Hunan were enrolled by using multi-stage cluster sampling method.The Short-form of the UCLA Loneliness Scale,the Social Support Rating Scale,the Life Events Scale for the Elderly,Quality of Life Scale,and the Activity of Daily Living Scale were used to assess loneliness,the social support condition,the stimulating quantity of negative life events,the quality of life,and the abilities of daily life activities,respectively.The Structured Clinical Interview for DSM-Ⅳ-TR Axis I Disorders questionnaire survey was performed by a face-to-face interview.Results:The prevalence rate of depressive episode among the rural older people was 6.8％.Multivariable analysis showed that the elderly who were with stronger loneliness were the risk factor of depression (OR=1.126,95％CI 1.038 to 1.221).Conclusion:Loneliness is positively associated with an increased risk of depressive episode.

BACKGROUNDRetinal edema is the major complication of retinal vein occlusion and diabetic retinopathy; it can damage visual function by influencing macular region. This study was to establish a rat retinal edema model and explore the related VEGF expression and observe the responses to anti-VEGF drugs in this model.

METHODSA rat retinal edema model was established by inducing photochemical reaction using a 532 nm laser after the intravenous injection of Erythrosin B. Immediately after the laser treatment, models were given intravitreal injections of Ranibizumab or Conbercept to inhibit VEGF expression, and the changes of retinal thickness were measured. Retinal edema was observed using fundus photography (FP), optical coherence tomography (OCT), and fluoresce in fundus angiography (FFA) at 0, 1, 2, 4, 7 and 14 days after intervention. The retinal VEGF expression was measured using enzyme-linked immunosorbent assay (ELISA) and western blotting at each time point. The rat retinal edema model was also used to verify the function of anti-VEGF polypeptide ZY1.

RESULTSBoth retinal edema and vascular leakage were clearly observed at 1, 2 and 4 days after photochemical induction and the retinal thickness increased notably over the same period. The retinal VEGF expression peaked at day 1 and retina became thickening simultaneously. After the interventions, the VEGF expression of the Ranibizumab and Conbercept groups decreased at each time point compared to the edema group (26.90 ± 3.57 vs. 40.29 ± 6.68, F = 31.269 on day 1 and 22.36 ± 1.12 vs. 29.92 ± 0.93 F = 163.789 on day 2, both P < 0.01); the mean RT (278 ± 4 vs. 288 ± 3, F = 134.190 on day 1 and 274 ± 7 vs. 284 ± 6, F = 64.367 on day 2, both P < 0.05) and vascular leakage in these groups also decreased. The same results were observed in the ZY1 group, particularly at day 2 (P < 0.05).

CONCLUSIONSThis retinal edema model induced by a photochemical reaction is reliable and repeatable. Induced edema increases expression of VEGF. This model can be used to test new drugs.

Angiogenesis Inhibitors ; therapeutic use ; Animals ; Enzyme-Linked Immunosorbent Assay ; Erythrosine ; toxicity ; Fluorescein Angiography ; Intravitreal Injections ; Macular Edema ; chemically induced ; drug therapy ; metabolism ; Ranibizumab ; therapeutic use ; Rats ; Rats, Sprague-Dawley ; Recombinant Fusion Proteins ; therapeutic use ; Tomography, Optical Coherence ; Vascular Endothelial Growth Factor A ; metabolism

OBJECTIVETo investigate the influence of CD117 expression on response of multiple myeloma patients to chemo-therapy.

METHODSA total of 65 cases of newly diagnosed multiple myeloma in our hospital from 2011 to 2013 were enrolled in this study. Cytogenetic abnormalities and immunophenotype were detected by using fluorescence in situ hybridization and flow cytometry before chemotherapy. The therapeutic efficacy of patients was evaluated after 4 cycles of PAD or TAD regimen.

RESULTSThe positive rates of 1q21 amplification, RB1: 13q14 deletion, D13S319: 13q14.3 deletion, IgH: 14q32 rearrangement and p53: 17p13 deletion were 32.2%, 40%, 40%, 20% and 3.1% respectively; the positive rates of CD38, CD138, CD56, CD117, CD20 were respectively 100%, 100%, 60%, 20%, 10.8%; the positive rates of CD19 and CD10 were 4.6% and 4.6% respectively; the positive CD22, CD7, CD5, CD103 did not found in any patients. The therapeutic efficacy of CD117⁻ patients was better than that of CD117⁺ patients (P < 0.05), there was no correlation of the remaining indicators with efficacy; the proportion of CD117⁺ patients with β2-microglobulin ≥ 5.5 mg/L was significantly higher than that of CD117⁻ patients (P < 0.05); the rest of baseline data had no significant difference (P > 0.05).

CONCLUSIONCD117 can be used as an indicator for evaluating efficacy of patients with newly diagnosed multiple myeloma.

Chromosome Aberrations ; Chromosome Deletion ; Flow Cytometry ; Humans ; Immunophenotyping ; In Situ Hybridization, Fluorescence ; Multiple Myeloma ; drug therapy ; metabolism ; Proto-Oncogene Proteins c-kit ; metabolism

OBJECTIVETo compare the efficacy and safety of standard or reduced doses of bortezomib combined with adriamycin and dexamethasone (PAD) in patients with multiple myeloma (MM).

METHODSEighty-two newly diagnosed or refractory/relapsed patients received bortezomib [either 1.2-1.3 mg/m(2) (standard dose) or 1.0-1.1 mg/m(2) (reduced dose) on day 1, 4, 8 and 11], and adriamycin (10 mg/m(2)) plus dexamethasone (40 mg/m(2)) on day 1-4 at 3-week intervals for 1 to 6 courses. The International Myeloma Working Group Criteria were used to evaluate the response. Adverse events were graded according to the National Cancer Institute Common Toxicity Criteria (Version 3.0).

RESULTSTwo courses of standard dose of PAD resulted in a similar response rate of partial and very good partial complete remissions (PR) compared with reduced dose (80.0% vs 80.8%, P=0.728). Grade III- Ⅳ neutropenia and thrombocytopenia were higher with standard dose than that with reduced doses of PAD (21.1% vs11.1%, P=0.270; 10.5% vs 6.3%, P=0.619, respectively). Grade III-Ⅳ bortezomib-induced peripheral neuropathy, herpes zoster, fatigue or abdominal distention were significantly higher with standard dose than that with reduced dose of PAD (15.8% vs 1.6%, P=0.037; 26.3% vs 6.3%, P=0.028; 36.8% vs 14.3%, P=0.046; 15.8% vs 1.6%, P=0.037, respectively).

CONCLUSIONReduced dose of PAD appears to result in a similar overall response rate, but a better tolerance and safety compared with standard dose.

Aged ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Boronic Acids ; administration & dosage ; adverse effects ; therapeutic use ; Bortezomib ; Dexamethasone ; administration & dosage ; adverse effects ; Doxorubicin ; administration & dosage ; adverse effects ; Female ; Humans ; Male ; Middle Aged ; Multiple Myeloma ; drug therapy ; Pyrazines ; administration & dosage ; adverse effects ; therapeutic use ; Treatment Outcome

Objective To secreted express envelope glycoprotein (E) of dengue virus type 2 extracellularly. Methods The entire prM/E gene was amplified by RT-PCR. An optimized signal sequence gene from Japanese encephalits virus (JEV, SA14-14-2 strain) was introduced using fusion PCR. The impact of E protein transmembrane and cytoplasmatic domains was compared by amplifying prM and E with full length of E gene, with 20% truncation of the E gene at 3' terminus and one chimeric gene, which was generated by replacing the 3' terminal 20% region of E gene with the corresponding sequence of JEV ( SA14-14-2 strain). The PCR segments were inserted into the NheI and Notl sites of pcDNA5/FRT vector or into the Nhel and Xhol sites of pAcUW51-M. Then they were transfected into 293T cells or St9 cells respectively. The expression and secretion of E protein were detected by immunofluorescence assay ( IFA ) and Western Blot. Results After transected into 293T cells or St9 cells, all constructs expressed E protein intracellularly indentified by IFA while only two plasmids could secret detectable E protein into tissue culture using Western Blot analysis. Conclusion Signal peptide as well as the transmemhrane and cytoplasmatic domains is crucial for the secretion of dengue E protein.

Objective To analyze the characteristics and causes leading to civil aircrew medical temporary grounding and to provide the clinical epidemiology reference for aeromedical protection.Methods The constituent ratio of grounding cases and days of medical temporary grounding from 2003 to 2006 in China Eastern Airlines Jiangsu Ltd.were investigated and statistically analyzed by SPSS 13.0 software.Results The top ten diseases led to 516 aircrew medical temporary grounding in China Eastern Airlines Jiangsu Ltd.were upper respiratory tract infection,acute enteritis,barotraumatic otitis media,acute gastroenteritis,soft tissue injury,acute or chronic gastritis,dysmenorrhea and menoxenia,tonsillitis,lumbar sprain and lumbar muscle strain and dermatitis.Upper respiratory tract infection was the prime reason for aircrew medical temporary grounding.Hypertension disease,barotraumatic otitis media and pregnancy were the other important causes leading pilot,security officer and steward medical temporary grounding.Upper respiratory tract infection and barotraumatic otitis media,fracture,scald,nephritis and pyelonephritis and prolapse of lumbar intervertebral disc ranked the top of total and average sick leave days.Conclusions It is suggested that the health education and orientated prevention should be strengthened.Participating in physical exercise and taking good lifestyle habit would be helpful to reduce the rate of medical temporary grounding.

Objective To analyze the characteristics and causes leading to civil aircrew medical temporary grounding and to provide the clinical epidemiology reference for aeromedical protection.Methods The constituent ratio of grounding cases and days of medical temporary grounding from 2003 to 2006 in China Eastern Airlines Jiangsu Ltd.were investigated and statistically analyzed by SPSS 13.0 software.Results The top ten diseases led to 516 aircrew medical temporary grounding in China Eastern Airlines Jiangsu Ltd.were upper respiratory tract infection,acute enteritis,barotraumatic otitis media,acute gastroenteritis,soft tissue injury,acute or chronic gastritis,dysmenorrhea and menoxenia,tonsillitis,lumbar sprain and lumbar muscle strain and dermatitis.Upper respiratory tract infection was the prime reason for aircrew medical temporary grounding.Hypertension disease,barotraumatic otitis media and pregnancy were the other important causes leading pilot,security officer and steward medical temporary grounding.Upper respiratory tract infection and barotraumatic otitis media,fracture,scald,nephritis and pyelonephritis and prolapse of lumbar intervertebral disc ranked the top of total and average sick leave days.Conclusions It is suggested that the health education and orientated prevention should be strengthened.Participating in physical exercise and taking good lifestyle habit would be helpful to reduce the rate of medical temporary grounding.

Objective To explore the value of using pulse wave velocity (PWV) and ankle brachial pressure index (ABI) to detect the early arteriosclerosis in flying personnel. Methods PWV and ABI were detected in 107 cases of flying personnel by arteriosclerosis detector and 107 civil personnel were examined as control group. Results 10 cases (9.3%) of abnormal PWV were found in flying personnel group while 36 cases (33.6%) found in control group. Only one abnormal ABI case was in control group but in flying personnel group. The mean PWV of both groups' showed significant increase with the age growing (F= 3. 314-13. 819, P＜0. 05). The mean PWV of flying personnel group was significantly lower than that of the control group in same age segment (t= 2. 187-4. 208,P＜0.05). Linear regression analysis showed that PWV was closely related to the age, blood pressure, waist circumference (WC) and body mass index (BMI) in flying personnel group (β=0. 439-0. 634, P＜0. 05). Conclusions The increases of age, blood pressure and WC or BMI are the major risk factors of causing aorta elasticity decreased in flying personnel. It is suggested that the PWV would be an applicable functional index in early diagnosis of vascular pathological changes and in medical evaluation.