Objective:To construct an esophageal language rehabilitation program for patients after total laryngectomy (TL) based on the behavioral change wheel theory and exploring its application effects.Methods:The multidisciplinary team constructed the first draft of the esophageal language rehabilitation program for patients after TL based on the behavioral change wheel theory, combined with a literature review, and used an expert meeting to revise the rehabilitation program to form the final draft of the program. Adopting experimental research, 35 patients after TL who attended the nursing outpatient clinic of Beijing Tongren Hospital, Capital Medical University from February 2023 to May 2023 were selected as the control group by convenience sampling method, and 35 patients after TL who attended the nursing outpatient clinic from June 2023 to September 2023 were selected as the experimental group. The experimental group applied the TL postoperative patients′ esophageal language rehabilitation program based on the behavioral change wheel theory on the basis of conventional nursing measures, and the control group received conventional nursing care. The status of language rehabilitation training, quality of life, social behavioral status, and anxiety and depression status before intervention, 1, 3, 6 months after intervention were compared between the two groups.Results:Both groups of patients completed the study. There were 29 males and 6 females in the control group, with an age of (54.63 ± 10.44) years old. There were 34 males and 1 female in the experimental group, with an age of (55.17 ± 10.67) years old. There was no statistically significant difference in the language rehabilitation training status, quality of life, social behavior status, and anxiety and depression status between the two groups before intervention (all P>0.05). The total scores of speech rehabilitation training in the experimental group at 1, 3, and 6 months after intervention were (32.80 ± 2.49), (39.80 ± 2.75), (51.91 ± 4.20) points, respectively, which were higher than those in the control group (23.40 ± 3.42), (24.40 ± 3.42), (25.80 ± 3.42) points, and the differences were statistically significant ( t=14.53, 23.44, 32.70, all P<0.05). The total scores of quality of life in the experimental group at 1, 3, and 6 months after intervention were (98.91 ± 8.49), (134.66 ± 11.31), (157.97 ± 13.97) points, respectively, which were higher than those in the control group (67.06 ± 7.64), (72.16 ± 7.64), (99.46 ± 8.09) points, and the differences were statistically significant ( t=17.53, 30.16, 21.45, all P<0.05). The scores for social occasion diet and language comprehension in the experimental group at 1, 3, and 6 months after intervention were (40.41 ± 13.94), (40.43 ± 24.08), (40.60 ± 18.56), and (43.71 ± 12.26), (47.40 ± 17.09), (52.50 ± 13.82), respectively, which were higher than those in the control group (30.59 ± 15.98), (30.57 ± 18.28), (27.21 ± 15.27), and (27.29 ± 15.13), (23.60 ± 14.78), (19.50 ± 12.78), and the differences were statistically significant ( t values were -6.88-2.16, all P<0.05). The total scores of anxiety and depression in the experimental group at 1, 3, and 6 months after intervention were (23.74 ± 2.73), (14.89 ± 3.89), (12.11 ± 3.14) points, respectively, which were lower than those in the control group (32.63 ± 1.85), (30.63 ± 1.85), (24.80 ± 2.75) points, and the differences were statistically significant (t=-19.55, -27.10, -17.97, all P<0.05). Conclusions:The esophageal language rehabilitation program for patients after TL based on the behavioral change wheel theory in this study is scientific, feasible, and can improve the patients′ esophageal language expression, quality of life, anxiety and depression, and social behavioral status, which can provide a reference for clinical care.

Prescription evaluation is an important innovative medication supervision mode in China,which is an impor-tant means to ensure rational drug use.The Pharmaceutical Specialized Committee of the Chinese Hospital Association had led the formulation of the Pharmacy Administration and Pharmacy Practice in Healthcare Institutions—Part 4-9:Pharmacy Administra-tion—Prescription Evaluation.The standard regulated 11 key elements in the three aspects of basic requirements,evaluation re-quirements,and quality management and evaluation improvement,which can be used as the basis for guiding medical institutions to standardize prescription evaluation work.This paper introduced the formulation process of the prescription evaluation standard and interpreted the key contents of the standard,which was helpful for peers to deeply understand the standard,promote the imple-mentation of the standard,and further improve the quality of prescription evaluation work.

Objective:To investigate the predictive value of endothelial activation and stress index(EASIX)for the prognosis of patients with mantle cell lymphoma(MCL).Methods:A retrospective analysis was conducted to assess prognosis and compare the clinical features of patients diagnosed with MCL who were admitted to the Affiliated Hospital of Xuzhou Medical University from January 2010 to June 2023,had therapeutic indications and received standard treatment.Results:A total of 66 patients were included and divided into high EASIX group and low EASIX group,according to a cutoff value of 0.97 determined by the receiver operating characteristic(ROC)curve.Multivariate Cox regression analysis showed that prealbumin＜0.2 g/L,high EASIX,and ECOG PS score ≥2 were independent risk factors influencing overall survival(OS)in MCL patients.The median OS of patients in the high and low EASIX group was 13.0 and 37.5 months,and the median progression-free survival was 8.8 and 26.0 months,respectively.The proportions of patients with ECOG PS score ≥2 and prealbumin＜0.2 g/L at onset significantly increased in the high EASIX group compared to those in the low EASIX group.Conclusion:At the time of initial diagnosis,EASIX can serve as an independent prognostic indicator impacting OS in patients with MCL.Furthermore,patients in the high EASIX group experience a poorer prognosis and shorter survival duration compared with those in the low EASIX group.

Prescription evaluation is an important innovative medication supervision mode in China,which is an impor-tant means to ensure rational drug use.The Pharmaceutical Specialized Committee of the Chinese Hospital Association had led the formulation of the Pharmacy Administration and Pharmacy Practice in Healthcare Institutions—Part 4-9:Pharmacy Administra-tion—Prescription Evaluation.The standard regulated 11 key elements in the three aspects of basic requirements,evaluation re-quirements,and quality management and evaluation improvement,which can be used as the basis for guiding medical institutions to standardize prescription evaluation work.This paper introduced the formulation process of the prescription evaluation standard and interpreted the key contents of the standard,which was helpful for peers to deeply understand the standard,promote the imple-mentation of the standard,and further improve the quality of prescription evaluation work.

Objective:To investigate the clinical features, pathologic characteristics, treatment and prognosis of primary mediastinal large B-cell lymphoma (PMBCL) in children.Methods:Clinical data including clinical manifestations, treatment, clinical efficacy of 8 cases of childhood PMBCL treated in Beijing Children′s Hospital, Capital Medical University from March 2017 to February 2024 were collected retrospectively, the clinical characteristics and prognosis of them were summarized.Results:Among the 8 children, there were 5 males and 3 females. The age at the time of initial diagnosis was 11.0 (10.3, 13.5) years. The first clinical symptoms were cough (8 cases) and stridor (6 cases). The lesions most often involved the mediastinum (8 cases), lungs (5 cases, hilum more often), pericardium (5 cases), and pleura (4 cases). Extra thoracic invasion was present in 4 cases, 7 cases had huge tumor lesions and 7 cases were phase Ⅲ clinical stage. Except for 1 case who underwent surgical resection of the tumor, the remaining 7 cases were treated with DA-EPOCH+R (dose adjusted-etoposide+prednisone+vincristine+cyclo-phosphamide+doxorubicin+rituximab) chemotherapy. The follow-up time was 25.0 (10.5, 43.3) months, with 7 cases in complete and partial metabolism response, 1 case had disease progression. All 8 cases survived.Conclusions:PMBCL is most common in school-age boys and most of them present with huge mediastinal tumor focus. PMBCL expresses B-cell spectrum antigens and weakly expresses CD30.The application of DA-EPOCH+R is effective in the treatment of PMBCL in children.

Objective:To evaluate the clinical characteristics, pathology, treatment and prognosis of blastic plasmacytoid dendritic cell neoplasm (BPDCN) in children.Methods:Clinical data (including gender, age of disease onset, affected sites, treatment, timing of allogeneic hematopoietic stem cell transplantation (allo-HSCT), etc.) of 7 children with BPDCN who were admitted to Beijing Children′s Hospital, Capital Medical University from December 2018 to December 2023 were analyzed retrospectively. Clinical outcomes were also assessed, with patients followed up until December 2024.Results:Among 7 patients, there were 3 males and 4 females. Age at disease onset ranged from 3.2 to 12.9 years. Initial presentations included subcutaneous nodules in 5 cases, rash in 1 case, and ankle pain in 1 case. Extra-cutaneous involvement was seen in the bone marrow, lymph nodes, and central nervous system. Six patients received induction chemotherapy using a modified lymphoblastic lymphoma regimen, 1 patient received the high-risk protocol for pediatric lymphoblastic lymphoma/leukemia and salvage therapy regimens. Allo-HSCT was performed soon after chemotherapy remission. The time to bridge allo-HSCT was 3.5 to 6.5 months. The follow-up time was 1.6 to 6.0 years. Six patients were in disease-free survival, while 1 patient survived with disease after recurrence following transplantation.Conclusions:BPDCN is rare in children and presents diverse clinical manifestations, with skin involvement being the predominant feature. Early allo-HSCT following complete remission with chemotherapy can improve prognosis.

OBJECTIVE: This study aimed to explore the association between body mass index (BMI) and mortality based on the 10-year population-based multicenter prospective study. METHODS: A general population-based multicenter prospective study was conducted at four sites in rural China between 2013 and 2023. Multivariate Cox proportional hazards models and restricted cubic spline analyses were used to assess the association between BMI and mortality. Stratified analyses were performed based on the individual characteristics of the participants. RESULTS: Overall, 19,107 participants with a sum of 163,095 person-years were included and 1,910 participants died. The underweight (< 18.5 kg/m ²) presented an increase in all-cause mortality (adjusted hazards ratio [ aHR] = 2.00, 95% confidence interval [ CI]: 1.66-2.41), while overweight (≥ 24.0 to < 28.0 kg/m ²) and obesity (≥ 28.0 kg/m ²) presented a decrease with an aHR of 0.61 (95% CI: 0.52-0.73) and 0.51 (95% CI: 0.37-0.70), respectively. Overweight ( aHR = 0.76, 95% CI: 0.67-0.86) and mild obesity ( aHR = 0.72, 95% CI: 0.59-0.87) had a positive impact on mortality in people older than 60 years. All-cause mortality decreased rapidly until reaching a BMI of 25.7 kg/m ² ( aHR = 0.95, 95% CI: 0.92-0.98) and increased slightly above that value, indicating a U-shaped association. The beneficial impact of being overweight on mortality was robust in most subgroups and sensitivity analyses. CONCLUSION This study provides additional evidence that overweight and mild obesity may be inversely related to the risk of death in individuals older than 60 years. Therefore, it is essential to consider age differences when formulating health and weight management strategies.
Humans ; Body Mass Index ; China/epidemiology* ; Male ; Female ; Middle Aged ; Prospective Studies ; Rural Population/statistics & numerical data* ; Aged ; Follow-Up Studies ; Adult ; Mortality ; Cause of Death ; Obesity/mortality* ; Overweight/mortality*

To guide clinical blood transfusion practices for pediatric patients, the National Health Commission has issued the health standard "Guideline for pediatric transfusion" (WS/T 795-2022). Blood transfusion is one of the most commonly used supportive treatments for children with hematological diseases. This guideline provides guidance and recommendations for blood transfusions in children with aplastic anemia, thalassemia, autoimmune hemolytic anemia, glucose-6-phosphate dehydrogenase deficiency, acute leukemia, myelodysplastic syndromes, immune thrombocytopenic purpura, and thrombotic thrombocytopenic purpura. This article presents the evidence and interpretation of the blood transfusion provisions for children with hematological diseases in the "Guideline for pediatric transfusion", aiming to assist in the understanding and implementing the blood transfusion section of this guideline.
Humans ; Child ; Hematologic Diseases/therapy* ; Blood Transfusion/standards* ; Practice Guidelines as Topic

To guide clinical blood transfusion practices for pediatric patients, the National Health Commission has issued the health standard "Guideline for pediatric transfusion" (WS/T 795-2022). Blood transfusion for children undergoing hematopoietic stem cell transplantation is highly complex and challenging. This guideline provides recommendations on transfusion thresholds and the selection of blood components for these children. This article presents the evidence and interpretation of the transfusion provisions for children undergoing hematopoietic stem cell transplantation, with the aim of enhancing the understanding and implementation of the "Guideline for pediatric transfusion".
Humans ; Hematopoietic Stem Cell Transplantation ; Child ; Blood Transfusion/standards* ; Practice Guidelines as Topic

To guide clinical blood transfusion practices for pediatric patients, the National Health Commission has issued the health standard "Guideline for pediatric transfusion" (WS/T 795-2022). Critically ill children often present with anemia and have a higher demand for transfusions compared to other pediatric patients. This guideline provides guidance and recommendations for blood transfusions in cases of general critical illness, septic shock, acute brain injury, extracorporeal membrane oxygenation, non-life-threatening bleeding, and hemorrhagic shock. This article interprets the background and evidence of the blood transfusion provisions for critically ill and severely bleeding children in the "Guideline for pediatric transfusion", aiming to enhance understanding and implementation of this aspect of the guidelines. Citation:Chinese Journal of Contemporary Pediatrics, 2025, 27(4): 395-403.
Humans ; Critical Illness ; Blood Transfusion/standards* ; Child ; Hemorrhage/therapy* ; Practice Guidelines as Topic