Objective To observe the value of MR 3D-T1WI and T2WI radiomics for diagnosing early and middle stage Parkinson disease(PD).Methods A total of 96 patients with early or middle stage PD(Hoehn-Yahr[H-Y]stage≤2.5)and 96 matched healthy adults were retrospectively collected and divided into training set(n=135,including 67 cases of PD and 68 healthy adults)and validation set(n=57,including 28 cases of PD and 29 healthy adults)at the ratio of 7∶3.The optimal radiomics features of left red nucleus(LRN),right red nucleus(RRN),left substantia nigra(LSN)and right substantia nigra(RSN)were extracted and screened from cranial 3D-T1WI and T2WI in training set.Then radiomics models of single MR sequence and combined MR sequences were constructed,respectively,the radiomics scores(Radscore)were obtained,the diagnostic efficacy of each model for diagnosing early and middle stage PD was validated using validation set,and the correlations of Radscore of each model and clinical scale scores of PD patients were analyzed.Results Based on LRN,RRN,LSN and RSN on 3D-T1WI and T2WI,15,14,11 and 14,and 15,12,14 and 12 optimal radiomics features were obtained,respectively.Then models of single sequence,including LRN3D-T1W,I RRN3D-T1W,I LSN3D-T1W,I RSN3D-T1W,I LRNT2W,I RRNT2W,I LSNT2WI and RSNT2W,I as well as models of combined sequences,including LRN3D-T1WI+T2WI,RRN3D-T1WI+T2WI,LSN3D-T1WI+T2WI and RSN3D-T1WI+T2WI were constructed.The AUC of models in training and validation sets based on 3D-T1WI were 0.75-0.86,of models based on T2WI in training and validation sets were 0.82-0.90,while of combined models were 0.85-0.93.The Radscore of LRN3D-T1WI model in PD patients was negatively correlated with Hamilton depression scale(HAMD)and Hamilton anxiety scale(HAMA)scores(rs=-0.255,-0.242,P=0.011,0.016),while of RSNT2WI model was negatively correlated with HAMD score(rs=-0.254,P=0.010).Conclusion 3D-T1WI and T2WI radiomics could be used to diagnose early and middle stage PD.

Objective To investigate residents'willingness to use"internet+nursing services"of a community in Xiamen City and provide reference for the code of practice to promote the service.Methods A total of 350 community residents in Xiamen City were investigated by convenience sampling from January to December 2023.The questionnaire was self-designed with regard to their willingness to use"internet+nursing services".Results 336 questionnaires were effectively collected.The total score of willingness to use"internet+nursing services"of community residents in Xiamen City was(68.80±8.73)points,but only 19.6％of residents knew about"internet+nursing services".There were statistically significant differences in willingness to use among community residents with different ages,medical payment type,whether they knew"internet+nursing services"or not,and the number of service items needed(P＜0.05).Among them,age,whether they knew"internet+nursing services"or not and the number of service items needed were the main influencing factors of willingness to use(P＜0.05).Conclusion Community residents in Xiamen City show above the middle level of willingness to use"internet+nursing services".However,the popularity of"internet+nursing services"has a large room for improvement.The publicity to the residents should be strengthened,and the care needs of residents with different demographic characteristics should be considered.The supporting application functions of such platforms should be designed to meet the health needs of community residents,especially elderly patients with great demand for services.

Objective To investigate residents'willingness to use"internet+nursing services"of a community in Xiamen City and provide reference for the code of practice to promote the service.Methods A total of 350 community residents in Xiamen City were investigated by convenience sampling from January to December 2023.The questionnaire was self-designed with regard to their willingness to use"internet+nursing services".Results 336 questionnaires were effectively collected.The total score of willingness to use"internet+nursing services"of community residents in Xiamen City was(68.80±8.73)points,but only 19.6％of residents knew about"internet+nursing services".There were statistically significant differences in willingness to use among community residents with different ages,medical payment type,whether they knew"internet+nursing services"or not,and the number of service items needed(P＜0.05).Among them,age,whether they knew"internet+nursing services"or not and the number of service items needed were the main influencing factors of willingness to use(P＜0.05).Conclusion Community residents in Xiamen City show above the middle level of willingness to use"internet+nursing services".However,the popularity of"internet+nursing services"has a large room for improvement.The publicity to the residents should be strengthened,and the care needs of residents with different demographic characteristics should be considered.The supporting application functions of such platforms should be designed to meet the health needs of community residents,especially elderly patients with great demand for services.

Objective To observe the value of MR 3D-T1WI and T2WI radiomics for diagnosing early and middle stage Parkinson disease(PD).Methods A total of 96 patients with early or middle stage PD(Hoehn-Yahr[H-Y]stage≤2.5)and 96 matched healthy adults were retrospectively collected and divided into training set(n=135,including 67 cases of PD and 68 healthy adults)and validation set(n=57,including 28 cases of PD and 29 healthy adults)at the ratio of 7∶3.The optimal radiomics features of left red nucleus(LRN),right red nucleus(RRN),left substantia nigra(LSN)and right substantia nigra(RSN)were extracted and screened from cranial 3D-T1WI and T2WI in training set.Then radiomics models of single MR sequence and combined MR sequences were constructed,respectively,the radiomics scores(Radscore)were obtained,the diagnostic efficacy of each model for diagnosing early and middle stage PD was validated using validation set,and the correlations of Radscore of each model and clinical scale scores of PD patients were analyzed.Results Based on LRN,RRN,LSN and RSN on 3D-T1WI and T2WI,15,14,11 and 14,and 15,12,14 and 12 optimal radiomics features were obtained,respectively.Then models of single sequence,including LRN3D-T1W,I RRN3D-T1W,I LSN3D-T1W,I RSN3D-T1W,I LRNT2W,I RRNT2W,I LSNT2WI and RSNT2W,I as well as models of combined sequences,including LRN3D-T1WI+T2WI,RRN3D-T1WI+T2WI,LSN3D-T1WI+T2WI and RSN3D-T1WI+T2WI were constructed.The AUC of models in training and validation sets based on 3D-T1WI were 0.75-0.86,of models based on T2WI in training and validation sets were 0.82-0.90,while of combined models were 0.85-0.93.The Radscore of LRN3D-T1WI model in PD patients was negatively correlated with Hamilton depression scale(HAMD)and Hamilton anxiety scale(HAMA)scores(rs=-0.255,-0.242,P=0.011,0.016),while of RSNT2WI model was negatively correlated with HAMD score(rs=-0.254,P=0.010).Conclusion 3D-T1WI and T2WI radiomics could be used to diagnose early and middle stage PD.

Objectives:To investigate the clinical and genetic features of young Chinese patients with myeloproliferative neoplasms (MPN) .Methods:In this cross-sectional study, anonymous questionnaires were distributed to patients with MPN patients nationwide. The respondents were divided into 3 groups based on their age at diagnosis: young (≤40 years) , middle-aged (41-60 years) , and elderly (>60 years) . We compared the clinical and genetic characteristics of three groups of MPN patients.Results:1727 assessable questionnaires were collected. There were 453 (26.2%) young respondents with MPNs, including 274 with essential thrombocythemia (ET) , 80 with polycythemia vera (PV) , and 99 with myelofibrosis. Among the young group, 178 (39.3%) were male, and the median age was 31 (18-40) years. In comparison to middle-aged and elderly respondents, young respondents with MPN were more likely to present with a higher proportion of unmarried status (all P<0.001) , a higher education level (all P<0.001) , less comorbidity (ies) , fewer medications (all P<0.001) , and low-risk stratification (all P<0.001) . Younger respondents experienced headache (ET, P<0.001; PV, P=0.007; MF, P=0.001) at diagnosis, had splenomegaly at diagnosis (PV, P<0.001) , and survey (ET, P=0.052; PV, P=0.063) . Younger respondents had fewer thrombotic events at diagnosis (ET, P<0.001; PV, P=0.011) and during the survey (ET, P<0.001; PV, P=0.003) . JAK2 mutations were found in fewer young people (ET, P<0.001; PV, P<0.001; MF, P=0.013) ; however, CALR mutations were found in more young people (ET, P<0.001; MF, P=0.015) . Furthermore, mutations in non-driver genes (ET, P=0.042; PV, P=0.043; MF, P=0.004) and high-molecular risk mutations (ET, P=0.024; PV, P=0.023; MF, P=0.001) were found in fewer young respondents. Conclusion:Compared with middle-aged and elderly patients, young patients with MPN had unique clinical and genetic characteristics.

Objective:To analyze the efficacy of second-line regimens and prognostic factors in patients with first-relapsed multiple myeloma (MM) treated with bortezomib, cyclophosphamide, and dexamethasone (BCD).Methods:A retrospective cohort study. Clinical data were collected in first-relapsed MM patients after BCD treatment from three tertiary hospitals in north China from July 2009 to October 2022. Patients were classified according to the second-line regimen into the immunotherapy group, single novel agent group [either proteasome inhibitor (PI) or immunomodulatory drug (IMiD)], combination treatment group (both PI+IMiD), and traditional treatment group. Responses to second-line regimens and survival data were analyzed. The Kaplan-Meier method was used for survival analysis and the Cox proportional risk model was used for univariate and multivariate analyses.Results:A total of 217 patients were enrolled including 8.8% (19/217) in the immunotherapy group, 48.4% (105/217) in the PI/IMiD group, 29.9% (65/217) in the PI+IMiD group, and 12.9% (28/217) in the traditional treatment group. The median age was 62 years (range 31-83 years) and 56.2% (122/217) were males. The overall response rates (ORRs) in the four groups were 94.7% (18/19) vs. 56.2% (59/105) vs. 73.8% (48/65) vs. 32.1% (9/28) ( χ2=24.55; P<0.001), respectively. The progression-free survival (PFS) of the second-line regimens (2ndPFS) was 17.7 vs. 9.0 vs. 9.2 vs. 4.6 months ( χ2=22.74; P<0.001), respectively, among which patients in the PI/IMiD and PI+IMiD groups had comparable 2ndPFS ( χ2=1.76; P=0.923). Patients with high-risk cytogenetic abnormalities (HRCAs) achieved the longest 2ndPFS of 22.0 months in the immunotherapy group ( χ2=15.03; P=0.002). Multivariate analysis suggested that immunotherapy ( HR=0.11, 95% CI 0.05-0.27), achievement of efficacy of partial response or better ( HR=0.47, 95% CI 0.34-0.66), and non-aggressive relapse ( HR=0.25, 95% CI 0.17-0.37) were independent prognostic factors of 2ndPFS. Conclusion:In this real-world study, immunotherapy was associated with a more favorable efficacy and PFS for first-relapsed MM patients after BCD treatment, with similar outcomes in patients with HRCAs.

Objectives:To explore health-related quality of life (HRQoL) and identify its associated variables in Chinese patients with Philadelphia-negative myeloproliferative neoplasms (MPNs) .Methods:In this cross-sectional study, anonymous questionnaires were distributed to adult patients with MPNs to assess symptom burden measured by MPN-10 and HRQoL measured by Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) .Results:The data from 1405 respondents with MPNs, including 645 (45.9%) with essential thrombocythemia (ET) , 297 (21.1%) with polycythemia vera (PV) , and 463 (33.0%) with myelofibrosis (MF) , were analyzed. 646 (46.0%) respondents were male. The median age was 56 (range, 18-99) years. The mean MPN-10 scores were 13.0±12.7, 15.0±14.7, and 21.0±16.6 ( P<0.001) , and the physical component summary (PCS) and mental component summary (MCS) scores were 48.0±8.5, 47.0±9.0, and 42.0±10.0 ( P<0.001) and 51.0±11.0, 50.0±10.8, and 49.0±11.1 ( P=0.002) for respondents with ET, PV, and MF, respectively. Respondents with MF reported the lowest score of physical functioning, role functioning, emotional functioning, cognitive functioning, social function, and global health status (all P<0.01) and the highest score of fatigue, pain, dyspnea, appetite loss, diarrhea, and financial problems (all P<0.05) in EORTC QLQ-C30. Multivariate analyses revealed that higher MPN-10 scores were significantly associated with lower PCS (-0.220 to -0.277, P<0.001) and MCS (-0.244 to -0.329, P<0.001) scores; increasing age (-1.923 to -4.869; all P<0.05) , lower PCS score. Additionally, comorbidity (ies) , symptom at diagnosis, splenomegaly, anemia, unknown driver gene, and higher annual out-of-pocket cost were significantly associated with lower PCS and/or MCS scores. However, age ≥ 60 years, urban household registration, concomitant medication, and receiving ruxolitinib therapy in respondents with MF were associated with higher MCS scores. Weak correlations were found between MPN-10 score (except the subscale of appetite loss and constipation) and EORTC QLQ-C30 score in majority of subscales in respondents with ET (| r| = 0.193-0.457, all P<0.001) , PV (| r| = 0.192-0.529, all P<0.01) , and MF (| r| = 0.180-0.488, all P<0.001) , respectively. Conclusions:HRQoL in patients with MPN was significantly reduced, especially in patients with MF. Sociodemographic and clinical variables were significantly associated with the HRQoL in patients with MPNs.

Objective:To investigate the efficacy of using a pediatric-inspired regimen for adolescents and young adults (AYA) with Philadelphia chromosome-negative (Ph -) acute lymphoblastic leukemia/lymphoblastic lymphoma (ALL/LBL) at a single center in China. Methods:Clinical data of 71 consecutive newly diagnosed AYA patients with Ph - ALL/LBL on a pediatric-inspired regimen in Peking Union Medical College Hospital from January 2012 to November 2018 were retrospectively analyzed. Results:Median age at diagnosis was 20 years (range: 15-38) , and 46 patients (64.8%) were male. Forty-nine (69.0%) had B-ALL/LBL. Among 62 ALL patients, 22 (35.5%) were high-risk. Complete remission rate was 93.0%. At follow-up with a median time of 44 months, the estimated 5-year disease-free survival (DFS) and overall survival (OS) was 56.3% and 64.3%, respectively. There was no significant difference in 5-year OS between allogeneic hematopoietic stem cell transplantation group and the continuous chemotherapy group after completion of 4 courses of chemotherapy. The 5-year DFS and OS for the non-high-risk group was 63.1% and 73.7%, respectively, which were significantly higher than 32.0% and 44.4% for the high-risk group, respectively ( P<0.001) . Conclusions:The use of pediatric-inspired regimen for AYAs with Ph - ALL/LBL was feasible and effective.

Objective: To investigate the predictors of death after endovascular mechanical thrombectomy (EMT) in patients with acute vertebrobasilar occlusive stroke (VBOS). Methods: Patients with acute VBOS treated with EMT in Wuhan No. 1 Hospital were enrolled retrospectively. The demographic and clinical data were collected. According to whether the patients died at 90 d after procedure, they were divided into survival group and death group. The demographic and clinical data were compared between the two groups. Multivariate logistic regression analysis was used to determine the independent risk factors for death at 90 d after EMT. Results: A total of 47 patients were enrolled. The median age was 62 years, 34 were males (72.3%), the median baseline National Institutes of Health Stroke Scale (NIHSS) score was 16, 42 patients (89.4%) had recanalization (modified Thrombolysis in Cerebral Infarction[mTICI] 2b/3 grade), and 12 (25.5%) died within 90 d after procedure. Univariate analysis showed that the baseline NIHSS score (26 [21-28]vs. 12 [5-23]; Z=-3.165, P=0.002), percentage of neutrophil (81.61% ±11.82% vs. 72.20% ±12.09%; t=-2.137, P=0.033), neutrophil/lymphocyte ratio (10.54±7.17 vs. 4.98±3.57; t=-2.393, P=0.017), and incidence of sICH (25.0% vs. 2.9%; χ²=5.627, P=0.018) in the death group were significantly higher than those in the survival group, while the percentage of lymphocyte (12.00%±9.04% vs. 20.67%±10.39%; t=-2.429, P=0.015) was significantly lower than that of the survival group. Multivariate logistic regression analysis showed that high baseline NIHSS score (odds ratio [OR] 1.243, 95% confidence interval [CI] 1.046-1.318; P=0.038), high neutrophil/lymphocyte ratio (OR 1.278, 95% CI 1.002-1.630; P=0.049) and symptomatic intracranial hemorrhage (OR 5.088, 95% CI 1.065-38.718; P=0.046) were the independent predictors for death. Conclusion High baseline NIHSS score, high neutrophil/lymphocyte ratio and symptomatic intracranial hemorrhage are the independent predictors for death within 90 d after EMT in patients with acute VBOS.

Objective To explore the factors influencing major adverse events in patients with hematologic neoplasms and treated with high-dose methotrexate (HDMTX) chemotherapy regimens.Methods Medical records of all inpatients with hematologic neoplasms treated with HDMTX chemotherapy regimens in Peking Union Medical College Hospital from January 2014 to February 2016 were collected by Hospital Information System and retrospectively analyzed in combination with the adverse events surveillance files within 48 hours after HDMTX treatment,established by clinical pharmacists of hematology department.The effects of age,body mass index (BMI),methotrexate (MTX) dosage,time of intravenous infusion,liver and kidney function before administration,blood drug concentration of 20 hours after completion of one treatment cycle,and chemotherapy regimens on adverse events of ≥ grade Ⅱ were analyzed by single factor and multiple factor analysis.Results A total of 324 inpatients were entered in the study,including 179 males and 145 females with a median age of 43 (14-77) years.There were 72 inpatients with acute lymphoblastic leukemia,208 with non-Hodgkin lymphoma,and 44 with Langerhans cell histiocytosis.A total of 1 050 cycles of HDMTX were administered to the 324 patients.Within 48 hours after the HDMTX treatment,159 patients had 289 times of adverse events of ≥ grade Ⅱ.The incidence of adverse events of ≥grade Ⅱ was 49.07％ and the adverse events accounted for 27.52％ of the treatment cycles.Elevated serum alanine aminotransferase (ALT) was the most common adverse event [the incidence was 25.62％ (83/324)and the constituent ratio was 10.38％ (109/1 050)],followed by nausea and vomiting [the incidence was 11.73％ (38/324) and the constituent ratio was 5.43％ (57/1 050)] and elevated serum creatinine (Scr)level [the incidence was 8.64％ (28/324) and the constituent ratio was 2.76％ (29/1 050)].Multiple factor analysis showed that MTX dosage,time of intravenous infusion,and ALT level before administration were significant factors affecting ALT elevation after administration;BMI,blood drug concentration of 20 hours after completion of one treatment cycle,serum total bilirubin (TBil) and before administration were significant factors affecting Scr elevation after administration;serum TBil level before administration was the only significant factor affecting TBil elevation after administration;blood drug concentration of 20 hours after completion of one treatment cycle was the only significant factor in oral mucositis;MTX dosage,four-hour intravenous infusion regimen,and GDP/ML regimen (gemcitabine + dexamethasone + cisplatin + HDMTX +pegaspargase) were significant factors influencing adverse neuro-logical events.Conclusions After HDMTX regimen chemotherapy,patients with baseline dysfunction of liver and kidney and a 24-hour intravenous infusion regimen may increase the risk of liver and kidney injury;overweight patients may have an increased risk of kidney injury;GDP/ML regimen,4-hour intravenous infusion regimen,and higher MTX dosages may increase the risk of neurological adverse events;high blood concentration of 20 hours after completion of one treatment cycle may be a risk factor of kidney injury and oral mucositis.