Objective:To evaluate the efficacy of an etoposide (Vp16) -intensified conditioning regimen in allogeneic hematopoietic stem cell transplantation (allo-HSCT) for the treatment of relapsed/refractory acute myeloid leukemia (AML).Method:A retrospective analysis was conducted on the clinical data of 27 recipients with relapsed/refractory AML who underwent allo-HSCT using a Vp16-intensified conditioning regimen at Aerospace Center Hospital from January 2019 to January 2022. Transplantation-related complications and treatment outcomes were observed. Kaplan-Meier survival analysis was used to assess the overall survival (OS) and disease-free survival (DFS) rates.Result:Among the 27 recipients, there were 14 males and 13 females, with a median age of 41 years (range: 12~55 years). Except for one recipient who experienced primary graft failure, the remaining 26 recipients achieved hematopoietic reconstitution. The median neutrophil and platelet engraftment times were 13 days (range: 9~20 days) and 13.5 days (range: 11~33 days), respectively. Regimen-related toxicity (RRT) was mainly gastrointestinal toxicity and oral mucositis, and no deaths were attributed to RRT. A total of 12 recipients (44.44%) developed acute graft-versus-host disease (aGVHD), of whom 3 cases (11.11%) had grade III~IV aGVHD. Chronic GVHD (cGVHD) occurred in 13 recipients (48.15%), including 8 cases (29.63%) of extensive cGVHD. The median follow-up time after transplantation was 17 months (range: 1~48 months). Fifteen recipients (55.56%) survived without disease, while 12 recipients (44.44%) died— 9 due to relapse and 3 due to transplant-related complications. The 1-year overall survival and DFS rates were 74.07% and 59.26%, respectively; the 2-year overall survival and DFS rates were 59.26% and 55.56%, respectively. The 2-year relapse rate and transplant-related mortality (TRM) were 33.33% and 11.11%, respectively.Conclusion:The Vp16-intensified conditioning regimen in allo-HSCT appears to be a viable treatment option for patients with relapsed/refractory AML, offering favorable efficacy and manageable safety.

Objective To explore the effects of different sealing methods in the treatment of liver failure patients using a dual plasma molecular adsorption system combined with plasma exchange.Methods A total of 120 patients with liver failure admitted between January 2022 and October 2024 were enrolled in the study and randomly divided into an observation group and a control group,each consisting of 60 patients.Both groups received treatment with a dual plasma molecular adsorption system combined with plasma exchange.The control group was administered heparin sodium for catheter sealing,whereas the observation group received protamine prior to hepa-rin sodium catheter sealing.The study compared the two groups in terms of liver function indicators—including aspartate aminotransferase(AST),alanine aminotransferase(ALT),and bilirubin—coagulation function indicators such as fibrinogen and international normalized ratio(INR),hemoglobin(HGB)levels,catheter blockage rates,and the incidence of adverse reactions.Results No statistically significant differences were observed in liver function,coagulation function,or routine blood parameters between the two patient groups following treatment(P>0.05).However,the incidence of blockage in the observation group(3.33%)was significantly lower than that in the control group(20.00%),with the difference being statistically significant(P<0.05).Additionally,no significant differences were found in the occurrence of adverse reactions between the two groups(P>0.05).Conclusions The treatment of liver failure involves the use of a dual plasma molecular adsorption system combined with plasma exchange.Administering protamine prior to heparin sodium sealing has minimal impact on the patient's liver function,blood parameters,coagulation profile,and incidence of adverse reactions,yet it effectively reduces the risk of circuit clotting.

Objective:To investigate the application value of two-dimensional ultrasound (2DUS) combined with carotid Doppler ultrasound (CDU) in differentiating the nature of thyroid nodules.Methods:This study used a prospective research design. A total of 126 patients with thyroid nodules treated at Shaoxing 7 th People's Hospital from January to September 2023 were included in this study. All patients underwent both 2DUS and CDU examinations. The diagnostic value of 2DUS and CDU was evaluated, both individually and in combination, for differentiating between malignant and benign nodules. The detection rates of specific 2DUS signs (such as indistinct margins, irregular shape, hypoechogenicity, microcalcifications, and a gravel-like appearance) were compared between malignant and benign nodules. The blood flow patterns (types I, II, and III) and parameters (end-diastolic flow velocity, peak systolic flow velocity, and resistance index) obtained from CDU were compared between malignant and benign nodules. Using surgical pathology results as the gold standard, the diagnostic value of 2DUS and CDU was compared, both individually and in combination. Results:Surgical pathology results showed that there were 78 cases of malignant nodules [61.90% (78/126)] and 48 cases of benign nodules [38.10% (48/126)]. The detection rate of malignant nodules using CDU was slightly, but not significantly, higher than that of 2DUS ( P > 0.05). However, the detection rate of malignant nodules using the combined examinations [60.32% (76/126)] was significantly higher than that of either 2DUS [41.27% (52/126)] or CDU alone [47.62% (60/126)] ( χ2 = 9.15, P = 0.002; χ2 = 4.09, P = 0.043). The detection rates of indistinct margins, irregular shape, hypoechogenicity, microcalcifications, and a gravel-like appearance in malignant nodules were significantly higher than those in benign nodules (all P < 0.001). The proportions of type II and type III blood flow in malignant nodules were significantly higher than those in benign nodules (both P < 0.05). End-diastolic flow velocities in malignant nodules were significantly lower than those in benign nodules ( P < 0.05). Peak systolic flow velocity and resistance index in malignant nodules were significantly greater than those in benign nodules (both P < 0.05). Using surgical pathology results as the standard, the accuracy, sensitivity, and specificity of the combined examinations in differentiating the nature of thyroid nodules were 96.83% (122/126), 96.15% (75/78), and 97.92% (47/48), respectively. The diagnostic accuracy and sensitivity of the combined examinations were significantly higher than those of 2DUS and CDU individually (all P < 0.05). Conclusions:The combination of 2DUS and CDU is highly valuable for the differential diagnosis of thyroid nodules. Integrating findings from 2DUS and CDU blood flow patterns and parameters offers important guidance for clinical diagnosis.

Objective To explore the effects of different sealing methods in the treatment of liver failure patients using a dual plasma molecular adsorption system combined with plasma exchange.Methods A total of 120 patients with liver failure admitted between January 2022 and October 2024 were enrolled in the study and randomly divided into an observation group and a control group,each consisting of 60 patients.Both groups received treatment with a dual plasma molecular adsorption system combined with plasma exchange.The control group was administered heparin sodium for catheter sealing,whereas the observation group received protamine prior to hepa-rin sodium catheter sealing.The study compared the two groups in terms of liver function indicators—including aspartate aminotransferase(AST),alanine aminotransferase(ALT),and bilirubin—coagulation function indicators such as fibrinogen and international normalized ratio(INR),hemoglobin(HGB)levels,catheter blockage rates,and the incidence of adverse reactions.Results No statistically significant differences were observed in liver function,coagulation function,or routine blood parameters between the two patient groups following treatment(P>0.05).However,the incidence of blockage in the observation group(3.33%)was significantly lower than that in the control group(20.00%),with the difference being statistically significant(P<0.05).Additionally,no significant differences were found in the occurrence of adverse reactions between the two groups(P>0.05).Conclusions The treatment of liver failure involves the use of a dual plasma molecular adsorption system combined with plasma exchange.Administering protamine prior to heparin sodium sealing has minimal impact on the patient's liver function,blood parameters,coagulation profile,and incidence of adverse reactions,yet it effectively reduces the risk of circuit clotting.

Objective:To investigate the application value of two-dimensional ultrasound (2DUS) combined with carotid Doppler ultrasound (CDU) in differentiating the nature of thyroid nodules.Methods:This study used a prospective research design. A total of 126 patients with thyroid nodules treated at Shaoxing 7 th People's Hospital from January to September 2023 were included in this study. All patients underwent both 2DUS and CDU examinations. The diagnostic value of 2DUS and CDU was evaluated, both individually and in combination, for differentiating between malignant and benign nodules. The detection rates of specific 2DUS signs (such as indistinct margins, irregular shape, hypoechogenicity, microcalcifications, and a gravel-like appearance) were compared between malignant and benign nodules. The blood flow patterns (types I, II, and III) and parameters (end-diastolic flow velocity, peak systolic flow velocity, and resistance index) obtained from CDU were compared between malignant and benign nodules. Using surgical pathology results as the gold standard, the diagnostic value of 2DUS and CDU was compared, both individually and in combination. Results:Surgical pathology results showed that there were 78 cases of malignant nodules [61.90% (78/126)] and 48 cases of benign nodules [38.10% (48/126)]. The detection rate of malignant nodules using CDU was slightly, but not significantly, higher than that of 2DUS ( P > 0.05). However, the detection rate of malignant nodules using the combined examinations [60.32% (76/126)] was significantly higher than that of either 2DUS [41.27% (52/126)] or CDU alone [47.62% (60/126)] ( χ2 = 9.15, P = 0.002; χ2 = 4.09, P = 0.043). The detection rates of indistinct margins, irregular shape, hypoechogenicity, microcalcifications, and a gravel-like appearance in malignant nodules were significantly higher than those in benign nodules (all P < 0.001). The proportions of type II and type III blood flow in malignant nodules were significantly higher than those in benign nodules (both P < 0.05). End-diastolic flow velocities in malignant nodules were significantly lower than those in benign nodules ( P < 0.05). Peak systolic flow velocity and resistance index in malignant nodules were significantly greater than those in benign nodules (both P < 0.05). Using surgical pathology results as the standard, the accuracy, sensitivity, and specificity of the combined examinations in differentiating the nature of thyroid nodules were 96.83% (122/126), 96.15% (75/78), and 97.92% (47/48), respectively. The diagnostic accuracy and sensitivity of the combined examinations were significantly higher than those of 2DUS and CDU individually (all P < 0.05). Conclusions:The combination of 2DUS and CDU is highly valuable for the differential diagnosis of thyroid nodules. Integrating findings from 2DUS and CDU blood flow patterns and parameters offers important guidance for clinical diagnosis.

Objective:To evaluate the efficacy of an etoposide (Vp16) -intensified conditioning regimen in allogeneic hematopoietic stem cell transplantation (allo-HSCT) for the treatment of relapsed/refractory acute myeloid leukemia (AML).Method:A retrospective analysis was conducted on the clinical data of 27 recipients with relapsed/refractory AML who underwent allo-HSCT using a Vp16-intensified conditioning regimen at Aerospace Center Hospital from January 2019 to January 2022. Transplantation-related complications and treatment outcomes were observed. Kaplan-Meier survival analysis was used to assess the overall survival (OS) and disease-free survival (DFS) rates.Result:Among the 27 recipients, there were 14 males and 13 females, with a median age of 41 years (range: 12~55 years). Except for one recipient who experienced primary graft failure, the remaining 26 recipients achieved hematopoietic reconstitution. The median neutrophil and platelet engraftment times were 13 days (range: 9~20 days) and 13.5 days (range: 11~33 days), respectively. Regimen-related toxicity (RRT) was mainly gastrointestinal toxicity and oral mucositis, and no deaths were attributed to RRT. A total of 12 recipients (44.44%) developed acute graft-versus-host disease (aGVHD), of whom 3 cases (11.11%) had grade III~IV aGVHD. Chronic GVHD (cGVHD) occurred in 13 recipients (48.15%), including 8 cases (29.63%) of extensive cGVHD. The median follow-up time after transplantation was 17 months (range: 1~48 months). Fifteen recipients (55.56%) survived without disease, while 12 recipients (44.44%) died— 9 due to relapse and 3 due to transplant-related complications. The 1-year overall survival and DFS rates were 74.07% and 59.26%, respectively; the 2-year overall survival and DFS rates were 59.26% and 55.56%, respectively. The 2-year relapse rate and transplant-related mortality (TRM) were 33.33% and 11.11%, respectively.Conclusion:The Vp16-intensified conditioning regimen in allo-HSCT appears to be a viable treatment option for patients with relapsed/refractory AML, offering favorable efficacy and manageable safety.

Objective:To design an assisted lip retraction breathing exercise tool and observe its application in home-based pulmonary rehabilitation of patients with chronic obstructive pulmonary disease(COPD). Method:A total of 116 COPD patients treated at our hospital from January 2020 to January 2021 were select-ed as study subjects and divided into the control group(n=58)and the observation group(n=58)using a ran-dom number table method.The control group was given conventional inhalation medication and lip retraction breathing training instruction,and the observation group was given an assisted lip retraction breathing exercise tool to assist lip retraction training on the basis of the control group.The pulmonary function,arterial blood gas,6-minute walk distance(6MWD),modified British medical research council(mMRC),body mass in-dex,obstruction,dyspnea,exercise capacity index(BODE index)and patient satisfaction were compared be-tween the two groups at l month,3 months,and 6 months after discharge from the hospital. Result:After 3 and 6 months of exercise,the pulmonary function(FVC,FEV1)of the observation group were better than those of the control group(t=2.196,2.613,3.022,4.200 P＜0.05),and arterial blood gas(PaCO2,PaO2)were better than the control group(t=5.223、11.536、2.086、2.223 P＜0.05),6MWD was higher than the control group(t=10.725,11.620 P＜0.05),mMRC was lower than the control group(t=10.110,22.567 P＜0.05),BODE index grade 1(17.24％,34.48％)and grade 2 rates(37.93％,48.28％)were higher than the control group(10.34％,6.90％,25.86％,27.59％),and grade 3(25.86％,17.24％)and grade 4 rates(18.97％,0)were lower than the control group(31.03％,34.48％,32.76％,31.03％)(Z=-2.060,35.273 P＜0.05),the satisfaction rate of patients in the observation group was 91.38％(53/58)at 1 month of exercise,96.55％(56/58)at 3 months,and 100％(58/58)at 6 months. Conclusion:The assisted lip retraction breathing exercise tool can improve the home-based pulmonary rehabilita-tion,enhance exercise endurance,reduce the severity of dyspnea,and improve patient satisfaction.

Objective To explore the application of nurse-performed point-of-care ultrasound in abdominal distension of ICU patients with enteral nutrition.Methods Purposive sampling method was used to select 108 patients with enteral nutrition abdominal distension admitted to the ICU of a tertiary A general hospital in Hefei City from January to December 2022,and they were divided into an experimental group and a control group according to random number table method.The experimental group used bedside ultrasound to evaluate the stomach,intestine and abdominal cavity of patients with abdominal distension,and implemented targeted treatment measures according to the evaluation results.The control group was given corresponding treatment measures according to the abdominal sight,touch,tapping,listening and traditional syringe withdrawal method.Intra-abdominal pressure,abdominal circumference,feeding compliance rate and feeding interruption rate,ICU stay time and mechanical ventilation time were compared at the 1st,3rd and 5th day.Results 11 cases dropped out of the study due to transfer,automatic discharge,death,etc.,and 97 cases were included 51 cases in the experimental group and 46 cases in the control group.Repeated measurement ANOVA showed that intra-abdominal pressure and abdominal circumference time in the 2 groups had interaction with each other(F=41.724,P＜0.001;F=17.762,P＜0.001).Generalised estimating equations showed that there was only a between-group effect for the rates of feeding compliance and feeding disruption in 2 groups(Wald y2=18.033,P＜0.001;Wald x2=6.567,P＜0.001).Simple effect analysis showed that on the 3rd and 5th day after intervention.The experimental group had lower abdominal depression and the feeding interruption rate was lower than the control group(P＜0.05).On the 5th day after interven-tion,the abdominal circumference of the experimental group was lower than that of the control group,the feeding compliance rate was higher than that of control group(P＜0.05).After intervention,in the experimental group,the mechanical ventilation time was shorter than that of the control group(P＜0.05).There was no significant difference in ICU stay time between the 2 groups(P=0.095).Conclusion The application of nurse-performed point-of-care ultrasound in the management of abdominal distension in patients with enteral nutrition in ICU is feasible and scientific,which is helpful for the management of patients with enteral nutrition abdominal distension in ICU,reducing internal abdominal pressure,shortening mechanical ventilation time,and avoiding the occurrence of feeding intolerance.

Objective:To investigate the clinical and molecular features of patients with CD7 +relapsed or refractory acute myeloid leukemia(r/rAML)and the prognosis of allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods:172 r/rAML patients who underwent allo-HSCT in department of hematology, Aerospace Center Hospital between January 1st 2017 and December 31st 2020 were retrospectively analyzed The patients were were divided into CD7 + group( n=75) and CD7 - group( n=97) according to the expression CD7 in the initial immunophenotype. Mann-Whitney U and Chi-square test were used to compare the clinical data, molecular and cytogenetic characteristics of the two groups of patients. Kaplan-Meier method was used to analyze the median progression-free survival (PFS) and median overall survival (OS) of the two groups of patients, and Cox regression screenthe prognostic factors of the patients. Results:The median follow-up time was 19 months. The recurrence rates were 23.71% and 50.67%, respectively in CD7 - and CD7 + group (χ 2=13.428 P<0.001). In relapsed patients, 86.96 percentage of CD7 - group did not express CD7 while 86.84 percentage of CD7 + group expressed CD7. The median PFS was 25 and 5 months in CD7 - and CD7 + group (χ 2=8.695, P=0.003), and the medianOS was 34 and 15 months in CD7 - and CD7 + group (χ 2=2.579, P=0.108). Univariate analysis showed that the CD7 +group, had the lower rates of morphological remission (χ 2=10.014, P=0.002), molecular remission (χ 2=22.809, P<0.001), and more male patients (χ 2=5.281, P=0.022). The incidence of CEBPA double-site mutation was higher (23.4% vs 8.2%, χ 2=8.180, P=0.004) and the rearrangement of RUNX1::RUNX1T1 was lower(4.0% vs18.6%, χ 2=8.362, P=0.004)in CD7 +group than in CD7 -group. Multivariate analysis showed that pre-transplant tumor load was the only prognostic factor for PFS (HR, 1.600; 95% CI, 1.203 to 2.127; P=0.001) and OS (HR, 1.737; 95% CI, 1.273 to 2.369; P<0.001) in r/r AML patients. Conclusion:CD7 expression is a risk factor for poor prognosis in r/r AML patients, and CD7 expression is stable after relapse. Positive CD7 can be used as a target for immune targeted therapy.

Objective:To observe the application effect of a self-designed assisted abdominal breathing rehabilitation device in elderly patients undergoing postoperative chemotherapy for lung cancer.Methods:Self-designed an assisted abdominal breathing rehabilitation device. Used the convenience sampling method, 116 elderly patients admitted to the First Affiliated Hospital of Anhui Medical University from April 2021 to April 2022 undergoing postoperative chemotherapy for lung cancer were selected as study subjects, and they were divided into control and observation groups by the random number table method, with 58 cases in each group. The control group received routine abdominal breathing training, and the observation group used auxiliary abdominal breathing rehabilitation device for abdominal breathing training, and compared the training compliance rate, lung function indexes and six minutes-walk test scores of the two groups before and after 2 weeks of training.Results:After 2 weeks of training, the training compliance rate of patients in the observation group was 100.00% (58/58), which was higher than 87.93% (51/58) in the control group, and the difference was statistically significant ( χ 2=7.45, P<0.05). After 2 weeks of training, FEV 1, FVC, FEV 1/FVC were (1.81 ± 0.29) L, (1.98 ± 0.32) L, (91.91 ± 5.98) % respectively in the observation group, and (1.49 ± 0.31) L, (1.73 ± 0.41) L, (87.11 ± 9.44) % respectively in the control group, there were statistically significant differences between the two groups ( t=-4.13, -2.60, -2.36, all P<0.05). After 2 weeks of training, the six minutes-walk test score was (0.86 ± 0.71) points in the observation group and (1.02 ± 0.74) points in the control group, and the difference was statistically significant ( t=2.05, P<0.05). Conclusions:An assisted abdominal breathing rehabilitation device helps to improve the training compliance rate, enhance lung function recovery and improve exercise endurance in elderly patients undergoing chemotherapy after lung cancer surgery.