Objective:To explore the factors influencing the incidence and duration of delirium in ICU patients, so as to provide a reference for early identification and prevention of delirium in these patients.Methods:A retrospective analysis was conducted on the medical records of 1, 500 patients admitted to the ICU of the Affiliated Jiangning Hospital of Nanjing Medical University from January 2020 to December 2024. The data collected included gender, age, anesthesia method, surgical duration, infection duration, extubation time, duration of mechanical ventilation and hypoxia, Acute Physiology and Chronic Health EvaluationⅡ (APACHEⅡ) score, Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) score, duration of sedative medication, and ICU length of stay. Binary Logistic regression and multiple linear regression analysis were employed to investigate the factors influencing the incidence and duration of delirium in ICU patients.Results:The incidence of delirium among 1 500 ICU patients was 38.4% (576/1 500), with a duration of 1.10 (1.00, 3.20) d. Binary Logistic regression analysis revealed that infection duration, APACHEⅡ score, mechanical ventilation duration, and sedative medication duration were statistically significant factors influencing delirium incidence in ICU patients ( P<0.05). Multiple linear regression analysis revealed that delirium type, duration of hypoxia, use of sedative medications, and length of ICU stay were statistically significant factors influencing the duration of delirium in ICU patients ( P<0.05) . Conclusions:ICU patients have a relatively high incidence of delirium, and numerous factors influence the incidence and duration of delirium. Clinical nursing professionals should identify risk factors early and develop corresponding intervention measures to reduce the incidence of delirium in ICU patients and promote their recovery.

Objective:To explore the factors influencing the incidence and duration of delirium in ICU patients, so as to provide a reference for early identification and prevention of delirium in these patients.Methods:A retrospective analysis was conducted on the medical records of 1, 500 patients admitted to the ICU of the Affiliated Jiangning Hospital of Nanjing Medical University from January 2020 to December 2024. The data collected included gender, age, anesthesia method, surgical duration, infection duration, extubation time, duration of mechanical ventilation and hypoxia, Acute Physiology and Chronic Health EvaluationⅡ (APACHEⅡ) score, Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) score, duration of sedative medication, and ICU length of stay. Binary Logistic regression and multiple linear regression analysis were employed to investigate the factors influencing the incidence and duration of delirium in ICU patients.Results:The incidence of delirium among 1 500 ICU patients was 38.4% (576/1 500), with a duration of 1.10 (1.00, 3.20) d. Binary Logistic regression analysis revealed that infection duration, APACHEⅡ score, mechanical ventilation duration, and sedative medication duration were statistically significant factors influencing delirium incidence in ICU patients ( P<0.05). Multiple linear regression analysis revealed that delirium type, duration of hypoxia, use of sedative medications, and length of ICU stay were statistically significant factors influencing the duration of delirium in ICU patients ( P<0.05) . Conclusions:ICU patients have a relatively high incidence of delirium, and numerous factors influence the incidence and duration of delirium. Clinical nursing professionals should identify risk factors early and develop corresponding intervention measures to reduce the incidence of delirium in ICU patients and promote their recovery.

Objective:To investigate the clinical characteristics, response, and prognosis of splenic diffuse red pulp small B-cell lymphoma (SDRPL) .Methods:Eight cases of SDRPL were diagnosed and treated at Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, between May 2017 and April 2022. Data on the clinical features, laboratory results, bone marrow and spleen biopsy results, response, and prognosis were collected and analyzed.Results:The median age at diagnosis was 54 (42-69) years. Splenomegaly and lymphocytosis were present in all cases, and PET/CT revealed normal to slightly elevated splenic FDG uptake. All cases were in stage Ⅳ, with spleen, peripheral blood, and bone marrow but no proximal lymph nodes involved. The cytoplasm of neoplastic villous cells was abundant, and splenic pathology showed that small homogenous lymphocytes permeated the splenic sinus and splenic cord, and the white pulp atrophied. Immunohistochemistry was not typical, and B-cell markers including CD19, CD20 and CD79α were positive. After a median follow up of 35.5 (4-60) months, 7 cases were alive after splenectomy with or without chemoimmunotherapy. The patient with CCND3 P284A and MYC S146L mutation developed to B-cell prolymphocytic leukemia (B-PLL) 1 month after splenectomy and died at 16 months of follow-up.Conclusion:A rare indolent B-cell lymphoma that primarily affects the elderly, SDRPL. Most patients achieved long-term survival, but the prognosis of patients who progress to B-PLL was poor.

Motor dysfunction is the main clinical symptom and diagnosis basis of patients with Parkinson's disease (PD). A total of 30 subjects were recruited in this study, including 15 PD patients (PD group) and 15 healthy subjects (control group). Then 5 wearable inertial sensor nodes were worn on the bilateral upper limbs, lower limbs and waist of subjects. When completing the 6 paradigm tasks, the acceleration and angular velocity signals from different parts of the body were acquired and analyzed to obtain 20 quantitative parameters which contain information about the amplitude, frequency, and fatigue degree of movements to assess the motor function. The clinical data of the two groups were statistically analyzed and compared, and then Back Propagation (BP) Neural Network was used to classify the two groups and predict the clinical score. The final results showed that most of the parameters had significant difference between the two groups, ten times of 5-fold cross validation showed that the classification accuracy of the BP Neural Network for the two groups was 90%, and the predictive accuracy of Hoehn-Yahr (H-Y) staging and unified PD rating scale (UPDRS) Ⅲ score of the patients were 72.80% and 68.64%, respectively. This study shows the feasibility of quantitative assessment of motor function in PD patients using wearable sensors, and the quantitative parameters obtained in this paper may have reference value for future related research.

Objective To study the effect of interferon-gamma release assays (IGRAs) adenosine deaminase activity test (ADA) and tuberculosis antibody test (TB-ab) in diagnosis of tuberculous pleurisy.Materials Sixty-three patients with pleurisy were tested for IGRAs,ADA and tuberculosis antibody.Samples of blood were tested.IGRAs,ADA and tuberculosis antibody were diagnosed according to manufacturer' s instructions.Results Either of the method could detect several patients with tuberculous pleurisy.Tuberculosis antibody showed lowest sensitivity and specificity.In our experiments,ADA test only detected 58.14％ of patients,although specificity can be high.We detected highest percentage of tuberculous pleurisy (79.07％) in blood IGRAs,with a specificity of 70％.Conclusion Blood IGRAs are more effective than blood ADA and tuberculosis antibody test,and it is recommend that IGRAs should be used in diagnosis of tuberculous pleurisy.

Objective To determine the diagnosis and the prognosis of acute bilineal leukemia(aBLL).Methods The cases who had been morphologicaUy diagnosed as acute leukemia were retrospectively screened.The characteristics of aBLL blasts and the patients'responses to chemotherapy and the survival rate were identified based on the analysis of both their clinical and laboratory data.Results From total of 352 cases screened,11 cases of aBLL were identified.The incidence of aBLL was 3.1%.Among them 4 were male and 7 female.The median age was 38 years old.The median counts of white blood cell at the onset of the disease was 56.3×109/L.There were more My/B aBLL subtype cases than My/T aBLL (8 cases vs.3 cases). Cytogenefie analysis data were available for 7 cages. All were standard karyotypes except 1 who had complex karyotypie change.The complete remission(CR)rate of chemotherapy was 45.5%(5/11)and the response rate(CR+PR)Wag 54.5%(6/11).Only 2 patients achieved CR after the first course of induction chemotherapy.The median of remission duration was 11 months,ranged from 3 to 14 months.The median of survival time was 10 month. ranged from 1 to 23 months. 1 patient died during the induction course.Conclusion aBLL is a rare subtype of acute leukemia.The diagnosis of the disease could be based on the combinational analysis of morphology and immunophenotype study.The patients'responses to the conventional chemotherapy regimens were not satisfied.Therefore,the prognosis of the disease was poor.

AIM:It has been recently proved that either decreased number or impaired function of CD4+CD25+regulatory T cells(Treg)can lead to immune dysfunction.Deeper knowledge of CD4+CD25+Treg cells is crucial for a better understanding of the pathogenesis of many diseases,such as autoimmune diseases,graft-versus-host disease,and allergic disease.This study is aimed to investigate the correlation of CD4+CD25+Treg cells in patients with idiopathic thrombocytopenic purpura(ITP)and to analyze the possible immunopathogenesis. METHODS:The experiment was conducted in the laboratory of Institute of Hematology,Chinese Academy of Medical Sciences and Peking Union Medical College from June to September in 2007.After the patients and their relative signed informed consents, peripheral blood was obtained from ITP patients(n=27)and health people(n=15)admitted in the Hematology Hospital,Peking Union Medical College.All patients accorded with the standards of ITP diagnosis and curative effect.The amount of CD4+CD25+ Treg cells in peripheral blood of normal controls and ITP patients before and after therapy was detected by flow cytometry.For those 23 patients who received effective therapy,blood before and after therapy were both obtained,the mononuclear cells(MNCs)were isolated from peripheral blood by density gradient centrifugation,then reverse transcriptase polymerase chain reaction(RT-PCR) was used to analyze the expression of Foxp3 mRNA. RESULTS:The amount of CD4+CD25+Treg cells and the ratio of CD4+CD25+Treg to total CD4+T cells in peripheral blood of ITP patients were obviously decreased than those of the controls(P0.05),but the expression of Foxp3 mRNA in CD4+CD25+ Treg cells was significantly increased(P