Objective To analyze the effect of graded exercise rehabilitation in patients with acute exacerbation of chronic obstructive pulmonary disease,and to provide references for clinical nursing practice.Methods A total of 70 patients with acute exacerbation of chronic obstructive pulmonary disease who met the criteria in the Department of Respiratory Medicine of a tertiary hospital in Zunyi City from September to December 2023 were randomly divided into an experimental group and a control group(with 35 cases in each group).The experimental group implemented graded exercise rehabilitation based on the Global Chronic Obstructive Pulmonary Initiative guidelines,and the control group implemented routine exercise rehabilitation.After intervention,the lung function,blood gas analysis,oxygenation index,6 min walking test and the incidence of complications related to non-invasive mechanical ventilation were compared between the 2 groups.Results Finally,34 cases were included in the experimental group and 35 cases in the control group.After intervention,the forced expiratory volume in the first second of the experimental group was improved compared with the control group(P＜0.05).The 6-minute walking test of the experimental group was higher than that of the control group(P＜0.05).The total incidence of non-invasive mechanical ventilation-related complications in the experimental group was lower than that in the control group(P＜0.05).There was no significant difference in blood gas analysis and oxygenation index between the 2 groups(P＜0.05).Conclusion The implementation of graded exercise rehabilitation based on the Global Chronic Obstructive Pulmonary Initiative guidelines can help patients with acute exacerbation of chronic obstructive pulmonary disease improve their respiratory function,improve their exercise endurance,and reduce non-invasive mechanical ventilation-related complications.

Objective:To assess the safety and efficacy of thiotepa, busulfan, and etoposide (TBE) conditioning followed by autologous hematopoietic stem-cell transplantation (TBE auto-HSCT) in primary central nervous system lymphoma (PCNSL) patients.Methods:Clinical data from 27 PCNSL patients who received TBE auto-HSCT at the Fifth Medical Center of PLA General Hospital between November 1, 2021, and April 30, 2024, were retrospectively analyzed.Results:Twenty-seven patients [16 males, 11 females; median age 57 (23–72) years] were included, with 12 (44.4%, 12/27) over 60. Twenty-five had newly diagnosed PCNSL and 2 were relapsed. Median time from diagnosis to transplantation was 6.9 (5.0–10.0) months. TBE auto-HSCT increased complete remission (CR) rate from 63.0 to 96.3% ( P= 0.005), and 9 of 10 patients in partial remission achieving CR post-transplant. Median follow-up was 24.5 months (range 2.0–36.0). Two-year progress-free and OS rates were (87.2±6.9) % and (88.6±6.2) %, respectively. Common grade 3 nonhematologic adverse events were diarrhea (18.5%, 5/27) and bacterial infections (14.8%, 4/27). One patient (64 years old) died from carbapenem-resistant Enterobacteriaceae infection within 2 months post-transplant, yielding a 100-day treatment-related mortality of 3.7% (1/27) . Conclusion:TBE-conditioned high-dose chemotherapy with auto-HSCT is effective, safe, and well-tolerated in PCNSL patients, including the elderly.

POEMS syndrome is a rare condition associated with plasma cell disorders， and it often involves multiple systems and has diverse clinical manifestations. This article reports two cases of POEMS syndrome with hepatosplenomegaly as the initial manifestation. During the course of the disease， the patients presented with lower limb weakness， hepatosplenomegaly， lymph node enlargement， ascites， hypothyroidism， positive M protein， and skin hyperpigmentation， and ¹⁸F-FDG PET-CT imaging revealed bone lesions mainly characterized by osteolytic changes and plasma cell tumors. There was an increase in the serum level of vascular endothelial growth factor. The patients were finally diagnosed with POEMS syndrome， and the symptoms were relieved after immunomodulatory treatment.

Objective:To explore the relationship between life events, anxiety, depression, and behavior problems in adolescents.Methods:From September to October 2022, the cluster sampling method was used to select 5 341 adolescents from 4 middle schools in Xinxiang urban area.The subjects and their parents were investigated by the adolescent self-rating life events check list (ASLEC), generalized anxiety disorder scale (GAD-7), patient health questionnaire (PHQ-9), and child behavior checklist (CBCL). SPSS 27.0 software was used for Spearman correlation analysis, and AMOS 28.0 software was used to construct the structural equation model.Results:The scores of anxiety, depression, and behavioral problems were 1 (0, 4), 1 (0, 4), and 3 (0, 10). The total score of life events was 5 (1, 13), and the dimensions scored as follows: interpersonal conflict 1 (0, 4), academic pressure 2 (0, 5), punishment 0 (0, 2), loss 0 (0, 0), health and adaptation problem 0 (0, 1), and others 0 (0, 2). There were positive correlations between life events and its dimensions, depression, anxiety and behavioral problems ( r=0.28-0.69, all P<0.01). In the overall population, anxiety and depression played parallel mediating roles in the impact of life events on behavior problems. Life events could positively predict anxiety ( β=0.68, P<0.01), and anxiety could positively predict behavior problems ( β=0.04, P=0.02). Life events could positively predict depression ( β=0.77, P<0.01), and depression could positively predict behavior problems ( β=0.18, P<0.01). The standardized total effect size of the impact of life events on behavioral problems was 0.622 (95% CI=0.564-0.675). The standardized direct effect size and indirect effect size were 0.460 (95% CI=0.374-0.539) and 0.162 (95% CI=0.108-0.218), accounting for 74.0% and 26.0%of the total effect, respectively. After stratification by gender, the results for male adolescents were consistent with the overall population, while the mediating effect of anxiety was not significant in the female adolescents. Conclusion:Life events can lead to anxiety and depression in adolescents, thereby increasing the risk of behavior problems.

Objective:To investigate auricular acupressure combined with massage-tapping exercises on body indicators, blood lipids, and liver function in patients with obesity-related fatty liver disease.Methods:This retrospective study included 78 patients with obesity-related fatty liver disease admitted to Hangzhou Hospital of Traditional Chinese Medicine from April to December 2023. The patients were divided into two groups based on different treatment methods: the conventional group (36 patients receiving conventional interventions) and the combined group (36 patients receiving auricular acupressure combined with massage-tapping exercises in addition to conventional interventions). The total response rates, physical indicators (body weight, body mass index), blood lipid levels (triglycerides, total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol), and liver function indicators (aspartate aminotransferase, alanine aminotransferase, and gamma-glutamyltransferase were recorded and compared between the two groups.Results:The total response rate in the combined group was 94.87% (37/39), which was significantly higher than the 76.92% (30/39) in the conventional group ( χ2 = 5.19, P < 0.05). After intervention, the combined group showed lower body weight [(70.42 ± 8.32) kg vs. (75.84 ± 8.46) kg], lower body mass index [(24.32 ± 1.26) kg/m2 vs. (25.48 ± 1.30) kg/m2], lower triglycerides [(1.62 ± 0.42) mmol/L vs. (2.94 ± 0.78) mmol/L], lower total cholesterol [(5.24 ± 0.54) mmol/L vs. (6.72 ± 0.66) mmol/L], lower low-density lipoprotein cholesterol [(2.14 ± 0.46) mmol/L vs. (2.78 ± 0.50) mmol/L], lower aspartate aminotransferase [(35.32 ± 4.38) U/L vs. (40.16 ± 5.14) U/L], lower alanine aminotransferase [(31.05 ± 4.20) U/L vs. (37.24 ± 4.56) U/L], and lower gamma-glutamyltransferase [(43.35 ± 8.74) U/L vs. (57.62 ± 9.04) U/L] levels compared with the conventional group. The combined group showed higher high-density lipoprotein cholesterol level compared with the conventional group [(1.85 ± 0.26) mmol/L vs. (1.26 ± 0.30) mmol/L]. All differences were statistically significant ( t = 2.85, 4.00, 9.31, 10.84, 5.88, 4.48, 6.24, 7.09, 9.28, all P < 0.05). Conclusions:The combination of auricular acupressure and massage-tapping exercises is effective in treating obesity-related fatty liver disease in patients. This approach can regulate physical indicators, improve lipid metabolism, and enhance liver function, making it a method worth promoting in clinical practice.

Objective:To explore the relationship between life events, anxiety, depression, and behavior problems in adolescents.Methods:From September to October 2022, the cluster sampling method was used to select 5 341 adolescents from 4 middle schools in Xinxiang urban area.The subjects and their parents were investigated by the adolescent self-rating life events check list (ASLEC), generalized anxiety disorder scale (GAD-7), patient health questionnaire (PHQ-9), and child behavior checklist (CBCL). SPSS 27.0 software was used for Spearman correlation analysis, and AMOS 28.0 software was used to construct the structural equation model.Results:The scores of anxiety, depression, and behavioral problems were 1 (0, 4), 1 (0, 4), and 3 (0, 10). The total score of life events was 5 (1, 13), and the dimensions scored as follows: interpersonal conflict 1 (0, 4), academic pressure 2 (0, 5), punishment 0 (0, 2), loss 0 (0, 0), health and adaptation problem 0 (0, 1), and others 0 (0, 2). There were positive correlations between life events and its dimensions, depression, anxiety and behavioral problems ( r=0.28-0.69, all P<0.01). In the overall population, anxiety and depression played parallel mediating roles in the impact of life events on behavior problems. Life events could positively predict anxiety ( β=0.68, P<0.01), and anxiety could positively predict behavior problems ( β=0.04, P=0.02). Life events could positively predict depression ( β=0.77, P<0.01), and depression could positively predict behavior problems ( β=0.18, P<0.01). The standardized total effect size of the impact of life events on behavioral problems was 0.622 (95% CI=0.564-0.675). The standardized direct effect size and indirect effect size were 0.460 (95% CI=0.374-0.539) and 0.162 (95% CI=0.108-0.218), accounting for 74.0% and 26.0%of the total effect, respectively. After stratification by gender, the results for male adolescents were consistent with the overall population, while the mediating effect of anxiety was not significant in the female adolescents. Conclusion:Life events can lead to anxiety and depression in adolescents, thereby increasing the risk of behavior problems.

Objective:To investigate auricular acupressure combined with massage-tapping exercises on body indicators, blood lipids, and liver function in patients with obesity-related fatty liver disease.Methods:This retrospective study included 78 patients with obesity-related fatty liver disease admitted to Hangzhou Hospital of Traditional Chinese Medicine from April to December 2023. The patients were divided into two groups based on different treatment methods: the conventional group (36 patients receiving conventional interventions) and the combined group (36 patients receiving auricular acupressure combined with massage-tapping exercises in addition to conventional interventions). The total response rates, physical indicators (body weight, body mass index), blood lipid levels (triglycerides, total cholesterol, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol), and liver function indicators (aspartate aminotransferase, alanine aminotransferase, and gamma-glutamyltransferase were recorded and compared between the two groups.Results:The total response rate in the combined group was 94.87% (37/39), which was significantly higher than the 76.92% (30/39) in the conventional group ( χ2 = 5.19, P < 0.05). After intervention, the combined group showed lower body weight [(70.42 ± 8.32) kg vs. (75.84 ± 8.46) kg], lower body mass index [(24.32 ± 1.26) kg/m2 vs. (25.48 ± 1.30) kg/m2], lower triglycerides [(1.62 ± 0.42) mmol/L vs. (2.94 ± 0.78) mmol/L], lower total cholesterol [(5.24 ± 0.54) mmol/L vs. (6.72 ± 0.66) mmol/L], lower low-density lipoprotein cholesterol [(2.14 ± 0.46) mmol/L vs. (2.78 ± 0.50) mmol/L], lower aspartate aminotransferase [(35.32 ± 4.38) U/L vs. (40.16 ± 5.14) U/L], lower alanine aminotransferase [(31.05 ± 4.20) U/L vs. (37.24 ± 4.56) U/L], and lower gamma-glutamyltransferase [(43.35 ± 8.74) U/L vs. (57.62 ± 9.04) U/L] levels compared with the conventional group. The combined group showed higher high-density lipoprotein cholesterol level compared with the conventional group [(1.85 ± 0.26) mmol/L vs. (1.26 ± 0.30) mmol/L]. All differences were statistically significant ( t = 2.85, 4.00, 9.31, 10.84, 5.88, 4.48, 6.24, 7.09, 9.28, all P < 0.05). Conclusions:The combination of auricular acupressure and massage-tapping exercises is effective in treating obesity-related fatty liver disease in patients. This approach can regulate physical indicators, improve lipid metabolism, and enhance liver function, making it a method worth promoting in clinical practice.

Objective To analyze the effect of graded exercise rehabilitation in patients with acute exacerbation of chronic obstructive pulmonary disease,and to provide references for clinical nursing practice.Methods A total of 70 patients with acute exacerbation of chronic obstructive pulmonary disease who met the criteria in the Department of Respiratory Medicine of a tertiary hospital in Zunyi City from September to December 2023 were randomly divided into an experimental group and a control group(with 35 cases in each group).The experimental group implemented graded exercise rehabilitation based on the Global Chronic Obstructive Pulmonary Initiative guidelines,and the control group implemented routine exercise rehabilitation.After intervention,the lung function,blood gas analysis,oxygenation index,6 min walking test and the incidence of complications related to non-invasive mechanical ventilation were compared between the 2 groups.Results Finally,34 cases were included in the experimental group and 35 cases in the control group.After intervention,the forced expiratory volume in the first second of the experimental group was improved compared with the control group(P＜0.05).The 6-minute walking test of the experimental group was higher than that of the control group(P＜0.05).The total incidence of non-invasive mechanical ventilation-related complications in the experimental group was lower than that in the control group(P＜0.05).There was no significant difference in blood gas analysis and oxygenation index between the 2 groups(P＜0.05).Conclusion The implementation of graded exercise rehabilitation based on the Global Chronic Obstructive Pulmonary Initiative guidelines can help patients with acute exacerbation of chronic obstructive pulmonary disease improve their respiratory function,improve their exercise endurance,and reduce non-invasive mechanical ventilation-related complications.

Objective:To assess the safety and efficacy of thiotepa, busulfan, and etoposide (TBE) conditioning followed by autologous hematopoietic stem-cell transplantation (TBE auto-HSCT) in primary central nervous system lymphoma (PCNSL) patients.Methods:Clinical data from 27 PCNSL patients who received TBE auto-HSCT at the Fifth Medical Center of PLA General Hospital between November 1, 2021, and April 30, 2024, were retrospectively analyzed.Results:Twenty-seven patients [16 males, 11 females; median age 57 (23–72) years] were included, with 12 (44.4%, 12/27) over 60. Twenty-five had newly diagnosed PCNSL and 2 were relapsed. Median time from diagnosis to transplantation was 6.9 (5.0–10.0) months. TBE auto-HSCT increased complete remission (CR) rate from 63.0 to 96.3% ( P= 0.005), and 9 of 10 patients in partial remission achieving CR post-transplant. Median follow-up was 24.5 months (range 2.0–36.0). Two-year progress-free and OS rates were (87.2±6.9) % and (88.6±6.2) %, respectively. Common grade 3 nonhematologic adverse events were diarrhea (18.5%, 5/27) and bacterial infections (14.8%, 4/27). One patient (64 years old) died from carbapenem-resistant Enterobacteriaceae infection within 2 months post-transplant, yielding a 100-day treatment-related mortality of 3.7% (1/27) . Conclusion:TBE-conditioned high-dose chemotherapy with auto-HSCT is effective, safe, and well-tolerated in PCNSL patients, including the elderly.

Objective To construct and preliminarily apply a graded exercise rehabilitation program for patients with acute exacerbation of chronic obstructive pulmonary disease(AECOPD),and to provide a theoretical basis for the scientific implementation of exercise rehabilitation by medical staff.Methods Based on Triangle model and evidence-based method,the first draft of the graded exercise rehabilitation program was constructed,and the items were revised through 2 rounds of expert consultations from March to October,2023.The graded exercise rehabilitation program was preliminarily applied in 10 patients with AECOPD.Results The effective recovery rates of the 2 rounds of expert consultation questionnaires were 100％;the expert authority coefficients were 0.857 and 0.863;the coefficients of variation were 0-0.285 and 0.052-0.244;the Kendall's harmony coefficients were 0.167 and 0.145,respectively(all P＜0.001).The final plan includes 4 first-level indicators,13 second-level indicators,and 25 third-level indicators.The scores of 6 min walking test,mMRC and CAT after exercise were improved compared with those before exercise,and the differences were statistically significant(all P＜0.05).Conclusion The graded exercise rehabilitation program for patients with AECOPD constructed in this study has good scientificity and practicability,which can provide references for clinical implementation of exercise rehabilitation.