Animals ; Cognitive Dysfunction/therapy* ; Maze Learning ; Mice ; Protein Phosphatase 2 ; Restraint, Physical ; Stress, Psychological/therapy*

Objective: To evaluate the efficacy and safety of PEG-rhG-CSF therapy in the primary and secondary prevention of chemo-therapy-induced neutropenia . Methods: This single-center, one-arm, and open-label clinical study involved 217 patients with non-my-eloid malignant tumors. These patients included 18 gynecologic oncology (3 endometrial and 15 ovarian cancer), 50 breast cancer, 30 bone tumor, and 119 lymphoma patients who underwent a total of 774 cycles of chemotherapy, comprising 146 primary and 71 sec-ondary prevention patients. The patients ≥45 kg and those <45 kg received a single subcutaneous injection of 6 mg and 3 mg PEG-rhG-CSF, respectively, 24-48 h after the chemotherapy was completed. All patients received only one dose of PEG-rhG-CSF admin-istration per chemotherapy cycle. Results: The overall incidence of febrile neutropenia (FN) was found to be 5.7%, with rates of 4.9% and 7.2% in the primary and secondary prevention groups, respectively. Univariate and multivariate Logistic regression analyses re-vealed that the longer PEG-rhG-CSF was sustained in the treatment cycle, the lower the incidence of FN was. The incidence of FN was significantly lower in the second cycle of the treatment than in the first in both the primary and secondary prevention groups (cycle 1 vs. cycle 2: 11.6% vs. 4.4%, respectively, P=0.039, in the primary group; 16.9% vs. 5.6%, respectively, P=0.034, in the secondary group). The overall incidence of gradeⅣneutropenia was 10.3% (80/774), with rates of 6.7% (34/510) and 17.4% (46/264) in the primary and secondary prevention groups, respectively (P<0.001). The incidence of gradeⅣneutropenia was significantly lower in the second cy-cle of the treatment than in the first (cycle 1 vs. cycle 2: 17.1% vs. 5.3%, respectively, P=0.004, in the primary group; 46.5% vs. 11.3%, respectively, P<0.001, in the secondary group). The treatment-induced toxicity mainly involved bone pain, with 3.7% (8/217) and 1.8% (4/217) incidence rates for grade 1-2 and 3-4 bone pain, respectively. Conclusions: PEG-rhG-CSF administration can effectively reduce the incidence of FN (5.7%) when prophylactically applied to patients with non-myeloid malignant tumors. Primary prevention can sig- nificantly reduce the risk of grade IV neutropenia in all chemotherapy cycles relative to the secondary prevention.

Objective To investigate the correlation between the subjective well-being,optimism and coping mode of patients with inflammatory bowel disease(IBD). Methods A total of 159 IBD patients were surveyed and analyzed by the general information questionnaire, General Well-Being Schedule, Revised The Life Orientation Test, and Simplified Coping Style Questionnaire. Results The subjective well-being scores of IBD patients were (75.04 ± 14.32). And the Pearson analysis showed that subjective well-being scores were positively correlated with optimism scores and positive coping scores(r=0.408, P＜0.01; r=0.429, P＜0.01). Negative coping was negatively correlated with subjective well-being scores(r=-0.174, P＜0.05). Optimism had a direct positive predictive effect on subjective well-being with a path coefficient of 0.22, and coping mode was an intermediary variable of optimism and subjective well-being. Conclusion The subjective well-being of patients with IBD needs to be further improved, which is both related to optimism and coping mode. Coping mode takes effects as a mediator in optimism and subjective well-being.

OBJECTIVETo summarize and analyze the clinical literature regarding moxibustion at Yongquan (KI 1) for insomnia, and to provide clinical evidence of moxibustion at Yongquan (KI 1) for insomnia.

METHODSWith "moxibustion" "acupuncture-moxibustion" "Yongquan (KI 1)" "insomnia" and "sleep disorder", etc. as key terms, the clinical literature regarding moxibustion at Yongquan (KI 1) for insomnia was retrieved in CNKI, and VIP databases, and reviewed, summarized and analyzed.

RESULTSA total of 27 clinical papers were retrieved, including 14 randomized controlled trials. In recent years, the number of clinical papers had increased. Few papers selected moxibustion at Yongquan (KI 1) as independent treatment for insomnia; most papers combined moxibustion with acupuncture, massage, etc. Moxibustion was commonly manipulated by patients or family members, and few papers applied moxibustion instruments to make the manipulation easier and safer.

CONCLUSIONMoxibustion at Yongquan (KI 1) for insomnia has attracted more and more attention. It is suggested to apply convenient and safe moxibustion instruments in clinical treatment, which is benefit to clinical generalization, but also provides convenient manipulation for further study regarding its clinical effect and mechanism.

Objective To conduct a systematic review on the experience of patients with inflammatory bowel disease (IBD) during self-management.Methods Five English (PubMed,Embase,Science Direct,Web of Science,PsycINFO) and four Chinese (CBM,WANFANG,CNKI,VIP) databases were chosen to retrieve literatures on selfmanagement experience of patients with inflammatory bowel disease from inception to March 31st,2017.The JBI Critical Appraisal Tool for qualitative studies in Australia was used to evaluate the quality of studies.Integrating method was applied to integrate the results.Results Totally 35 findings were extracted from 6 qualified studies,7 new categories were generated and finally 3 synthesized results were obtained:l Medical management:in order to maintain remission,diversified methods were used by IBD patients,such as adjusting behaviors and accumulating disease knowledge;2 Emotion management:positive attitude towards life was achieved via dealing with stress and negative emotions caused by IBD;3 Role management:cognitive and behavioral adjustment were taken to adapt the role of IBD patients and maintain the daily role before having IBD.Conclusion Many aspects were involved in self-management of IBD,and emotional management was often overlooked.Guidance and supports should be given by nurses targeting weak links of self-management,in order to improve disease management as well as quality of life for IBD patients.

Objective: To evaluate the prognostic value of ¹⁸F-fluorodeoxyglucose positron emission tomography (PET)/computed tomography (CT) in patients with diffuse large B cell lymphoma (DLBCL) undergoing autologous hematopoietic stem cell transplantation (auto-HSCT). Methods: Forty-eight patients with DLBCL treated at Peking University Cancer Hospital between November 2010 and December 2014 were assessed. All patients underwent PET/CT scanning prior to or after auto-HSCT. Correlation analysis was done based upon patients characteristics, PET/CT scan results and survival. Results: ①Among 48 patients, 27 was male, 21 female, median age was 43 (17-59) years old. ② Patients with negative pre-auto-HSCT PET/CT assessment demonstrated significantly better 3-year progression free survival (PFS) (87.1% vs 53.3%, χ²=7.02, P=0.019) and overall survival (OS) (90.3% vs 60.0%, χ²=6.51,P=0.022) than patients with positive pre-auto-HSCT PET/CT assessment. Three-year PFS (94.1% vs 30.0%, χ²=22.75, P=0.001) and OS (97.1% vs 40.0%, χ²=21.09, P=0.002) were also significantly different between patients with negative and positive post-auto-HSCT PET/CT assessment. ③ Multivariate analysis indicated a significant association of PFS (HR=13.176, P=0.005) and OS (HR=20.221, P=0.007) with post-auto-HSCT PET/CT assessment. Number of prior treatment regimens was associated with PFS (HR=10.039, P=0.040). ④ Harrell’s C index revealed that the value of combined use of number of prior treatment regimens and post-auto-HSCT PET/CT assessment was superior to either one used alone in PFS (Harrell’s C values were 0.976, 0.869 and 0.927 in combined use, number of prior treatment regimens and post-auto-HSCT PET/CT assessment, respectively), and the combined use of ECOG performance status and post-auto-HSCT PET/CT assessment significantly increased the Harrell’s C index in OS (Harrell’s C values were 0.973, 0.711 and 0.919 in combined use, ECOG performance status and post-auto-HSCT PET/CT assessment, respectively). Conclusions Post-auto-HSCT PET/CT assessment is the main predictor of outcomes in DLBCL patients receiving auto-HSCT. Combined use of post-auto-HSCT PET/CT assessment and number of prior treatment regimens and ECOG performance status is a better prognostic tool in patients with DLBCL undergoing transplantation.

Objective: To evaluate the clinical characteristics and survival outcomes of patients with de novo grade 3 or transformed follicular lymphoma (FL). Methods: Fifty-two patients treated at Peking University Cancer Hospital between January 2009 and September 2017 were assessed, including 28 patients with FL 3A grade, 13 patients with FL 3B grade, 11 patients with transformed FL. Baseline characteristics, survival and prognostic factors were analyzed. Results: ① Twenty-six male and 26 female patients were enrolled, including 28 patients with FL 3A grade, 13 patients with FL 3B grade, 11 patients with transformed FL. ②The 3-year progression-free survival (PFS) and overall survival (OS) for the entire cohort were 56.0% and 80.6%, respectively. Patients with international prognostic index (IPI) score 0-1 demonstrated significantly better 3-year PFS (80.3% vs 20.1%; t=18.902, P<0.001) and OS (95.7% vs 57.0%; t=10.406, P<0.001) than patients with IPI score 2-3. Three-year PFS (94.1% vs 37.2% vs 25.2%; P=0.002) and OS (100.0% vs 76.0% vs 59.8%; P=0.020) were also significantly different among patients with FLIPI 1 score 0-1, 2, ≥3. FLIPI 2 score was also identified as a prognostic factor for 3-year PFS (68.4%, 0, 0; P=0.001) and OS(87.5%, 76.2%, 0; P=0.003). ③Multivariate analysis indicated a significant association of PFS (HR=3.536, P=0.015) and OS (HR=15.713, P=0.015) with IPI. FLIPI 2 was associated with OS (score 0-1, HR=0.078, P=0.007; score 2, HR=0.080, P=0.022). Conclusion De novo grade 3 or transformed FL might be a group of curable disease with current treatment strategies. IPI is still a prognostic tool in this scenario.

Objective To explore the relationship between health?related quality of life and resili?ence of patients with inflammatory bowel disease( IBD) ,and provide a new entry point to improve the quality of life. Methods The general information questionnaire,the Chinese version of inflammatory bowel disease questionnaire ( IBDQ) and the Chinese version of Connor?Davidson mental resilience scale ( CD?RISC) were used to investigate 102 patients with IBD. Results The average scores of IBDQ and CD?RISC of IBD pa?tients were (157.6±31.7) and (62.5±15.0). Except for the correlation between the score of optimistic di?mension and the social function dimension,the total score and the scores of other dimensions of IBDQ were significantly correlated with the total score and the scores of dimensions of CD?RISC( r=0.200?0.490, P<0.05). Multiple regression analysis showed that tenacity,residence,moderate and severe disease severity,and disease duration with more than 10 years could significantly predict the level of health?related quality of life (β=0.319,0.268,-0.218,-0.373,-0.260, P<0.05) . Conclusion The health?related quality of life of IBD patients has a strong relationship with resilience. Health care workers can help improve health?related quality of life of the patients through fostering resilience.

OBJECTIVETo explore the effect of transcutaneous electrical nerve stimulation(TENS) for symptoms,life quality and sleep quality in patients with gastroesophageal reflux disease(GERD).

METHODSA total of 46 GERD patients were randomly assigned into an observation group and a control group,23 cases in each one. The conventional medication and nursing were applied in the two groups. TENS was used at Neiguan(PC 6) and Zusanli(ST 36) in the observation group for 4 weeks,20 min a time,twice a day. The indexes were compared between the two groups before and after treatment,including reflux disease questionnaire,the MOS 36-item short-form,Pittsburgh sleep quality index(PSQI).

RESULTSExcept the factor score of gengral health in the control group, the symptoms,life quality and sleep quality were superior to those before treatment in the two group (all<0.01). The symptom and PSQI scores in the observation group were lower than those in the control group(<0.01,<0.05). The scores of general health, life vitality and mental health in the observation group were more apparently improved than those in the control group (all<0.05).

CONCLUSIONSTENS at Neiguan(PC 6) and Zusanli(ST 36) can improve the clinical symptoms,life quality and sleep quality of GERD based on the conventional treatment.

Objective: To investigate the clinical features, diagnosis, treatment and prognosis of primary intestinal lymphoma (PIL) . Methods: The characteristics, diagnosis, treatment methods, and follow-up outcomes of 99 PIL patients, diagnosed in Peking university cancer hospital between Nov.1,1995 and Nov. 30, 2013. Results: There were 65 males and 34 females with a median age of 50 years. The majority of clinical manifestation were non-specific gastrointestinal symptoms, 67.68% of cases presented abdominal pain, 26.26% with acute abdomen. The most common primary sites of ileum and ileocecus were identified in 21 cases, respectively. The positive rate of endoscopic was only 24.24%, and 69 cases were diagnosed by operation. 71 patients (71.72%) were stageⅠ-Ⅱand 28 patients (28.28%) were stage Ⅳ. Hodgkin’s lymphoma was not found in all patients. Of the 99 cases, 77 were B-cell origin (77.78%) and 22 were T-cell origin. 55 cases (55.56%) were diagnosed with diffuse large B cell lymphoma (DLBCL) . 60 cases presented IPI score 0-1 point. The median overall survival (OS) was 100.0 months, and 5 year overall survival (5y-OS) was 53.5%. By multiple-factors analysis, T-cell origin lymphoma was significantly correlated with poor prognosis (P<0.05) . There was no difference of the median OS between the patients with operation and chemotherapy alone (79.0 vs 123.0 months, P=0.616) . Conclusion PIL is commonly seen in males. Abdominal pain is the most common clinical manifestations and the most primary sites are ileum and ileocecus. The diagnosis value of the endoscopic is limited. DLBCL is the most common pathologic type of PIL. T-cell origin lymphoma is an independent prognostic factor for PIL. Surgery is still commonly used in the diagnosis and treatment of PIL, and the operation do not increase the risk of death of patients with PIL.