Objective:To observe the clinical efficacy of Xinyue Decoction combined with fluoxetine hydrochloride in the treatment of cognitive impairment of senile depression.Methods:A randomized controlled trial study was conducted. Totally 116 elderly patients with depression accompanied by cognitive impairment were set as observation subjects, and were divided into a control group and an experimental group using random number table method, with 58 patients in each. The control group received treatment with fluoxetine hydrochloride capsules, while the experimental group was administered Xinyue Decoction Granules in addition to the treatment regimen of the control group. The treatment lasted for 8 weeks for both groups. Comparison was made between the two groups regarding the changes in TCM syndrome scores. Hamilton Depression Scale (HAMD-24) was used to assess the degree of depression, and Montreal Cognitive Assessment (MoCA BJ) was used to assess cognitive ability; the serum levels of brain-derived neurotrophic factor (BDNF), IL-1β, IL-6 and TNF-α were detected by ELISA; the adverse reactions during treatment were observed and recorded, and the clinical efficacy was evaluated.Results:The total effective rate of TCM syndromes was 90.4% (47/52) in the experimental group and 75.5% (40/53) in the control group, with statistical significance ( χ2=4.11, P<0.05); the total effective rate of MoCA-BJ was 76.9% (40/52) in the experimental group and 58.5% (31/53) in the control group, with statistical significance ( χ2=4.61, P<0.05); the total effective rate of HAMD-24 was 88.5% (46/52) in the experimental group and 71.7% (38/53) in the control group, with statistical significance ( χ2=4.07, P<0.05). After treatment, the TCM syndrome score, HAMD-24 and MoCA-BJ scores of the experimental group were lower than those in the control group ( t=-3.51, -5.11, 2.39, P<0.01 or P<0.05); the level of serum BDNF [(10.49±1.76) ng/L vs. (9.61±1.85) ng/L, t=2.28] in the observation group was higher than that of the control group ( P<0.05), and the levels of IL-1β, IL-6 and TNF-α were lower than those in the control group ( t=-2.50, -2.46, -2.18, P<0.05). During the treatment, the incidence of adverse reactions was 5.77% (3/52) in the experimental group and 7.55% (4/53) in the control group, without statistical significance ( χ2=0.13, P>0.05). Conclusion:Xinyue Decoction combined with fluoxetine hydrochloride can reduce the degree of depression in elderly patients with cognitive impairment of depression, improve the cognitive ability of patients and clinical efficacy.

Objective:To explore the care needs of primary caregivers of children with acute lymphoblastic leukemia (ALL) developed chemotherapy-induced oral mucositis (CTOM) during hospitalization and to provide a basis for improving the caregivers′ ability to care for the children and promoting their recovery.Methods:This study adopted the phenomenological design of a qualitative approach, using purposive sampling to select 10 primary caregivers of children with ALL who developed CTOM in Zhongshan People′s Hospital from September 2022 to August 2023. A semi-structured, in-depth interview was conducted to collect the data. Colaizzi analysis was used to analyze the qualitative data.Results:Among the 10 children, 5 were males and 5 were females, aged 3-13 years old; among the 10 primary caregivers, 3 were males and 7 were females, aged 31-44 years old. The primary caregivers′ care needs were categorized into four themes: wound care needs (active oral cleaning and hygiene maintenance, lack of ability to observe wounds, and anticipation of new and more effective medications); the need for knowledge of diseases (lack of knowledge related to the causes of CTOM, lack of knowledge about care and medication, seeking information from multiple sources); nutritional knowledge and dietary care needs (active supplementation awareness, limited dietary choices, lack of specific nutritional knowledge);and social network and psychological support needs (experience sharing in primary caregiver networks, psychosocial support in primary caregiver networks).Conclusions:Primary caregivers have particular problems in caring for children with ALL developed CTOM, including the need for nursing knowledge and practical skills, social support, etc. Healthcare professionals should provide the necessary support and assistance in terms of professional resources, hospital management resources and social resources.

Objective:To analyze the clinical features and prognosis of acute B lymphoblastic leukemia (B-ALL) children carrying a TCF3: : PBX1 fusion gene and to evaluate the prognostic value of this gene.Methods:Retrospective cohort study.A total of 2 164 B-ALL children aged 0-18 years diagnosed and treated at 19 pediatric centers from October 2016 to June 2022 were enrolled.They were divided into the positive group and the negative group according to whether they carried a TCF3: : PBX1 fusion gene.The clinical characteristics, treatment response, adverse reactions, and prognosis of the 2 groups of patients were analyzed.The rank sum and Kruskal-Wallis tests were used to compare two and more than two groups of numerical variables, respectively.Fisher′s exact test was used to compare categorical variables.Results:Among the 2 164 patients, 116 (5.4%) were TCF3: : PBX1 positive, of which 70 patients were female, accounting for 60.3%.There were 840 female patients in the TCF3: : PBX1-negative group, accounting for 41.0%.There was a significant difference in the ratio of females between the TCF3: : PBX1-positive and TCF3: : PBX1-negative groups ( P<0.001).No significant difference was observed in age of onset between the two groups( P>0.05).The proportion of bone marrow naive cells [54.00 (14.00, 76.50)% vs.29.00 (3.00, 68.00)%], white blood cell counts [25.30 (10.46, 60.94)×10 9/L vs.9.03 (4.38, 30.73)×10 9/L] and hemoglobin counts [82.00(63.00, 101.00) g/L vs.74.00(60.00, 90.00) g/L] in the TCF3: : PBX1-positive group were significantly higher than those in the negative group at the onset (all P<0.05).In terms of treatment response, the proportion of peripheral blood naive cells on Day 8 in the TCF3: : PBX1-positive group was significantly higher than that in the negative group [2.00 (0, 9.00)% vs.0 (0, 2.00)%, P<0.001].The proportion of minimal residual disease <0.1% on Day 15 in the TCF3: : PBX1-positive group was significantly higher than that in the negative group ( P=0.038).There were no significant differences in cumulative recurrence rate, treatment-related mortality (TRM), and overall survival (OS) between the TCF3: : PBX1-positive group and TCF3: : PBX1-negative group (all P>0.05).The cumulative recurrence risk of TCF3: : PBX1-positive patients was 9.646 times higher than that of ETV6: : RUNX1-positive patients with better prognosis( HR=9.646, 95% CI: 1.026-90.700, P=0.047).There were no significant differences in TRM and OS between TCF3: : PBX1-positive and ETV6: : RUNX1-positive patients (all P>0.05).A significant enrichment of PAX5 mutations was detected in TCF3: : PBX1-positive patients.Among the 7 high-risk TCF3: : PBX1-positive patients in a single center, 4 patients had PAX5 mutations, and this proportion was significantly higher than that in other patients ( P<0.001). Conclusions:B-ALL children carrying a TCF3: : PBX1 fusion gene have a high remission rate and good long-term prognosis after intensive chemotherapy.It is suggesting that TCF3: : PBX1-positive B-ALL patients should be rated at intermediate risk to receive intensive chemotherapy.

Objective:To analyze the clinical features and prognosis of acute B lymphoblastic leukemia (B-ALL) children carrying a TCF3: : PBX1 fusion gene and to evaluate the prognostic value of this gene.Methods:Retrospective cohort study.A total of 2 164 B-ALL children aged 0-18 years diagnosed and treated at 19 pediatric centers from October 2016 to June 2022 were enrolled.They were divided into the positive group and the negative group according to whether they carried a TCF3: : PBX1 fusion gene.The clinical characteristics, treatment response, adverse reactions, and prognosis of the 2 groups of patients were analyzed.The rank sum and Kruskal-Wallis tests were used to compare two and more than two groups of numerical variables, respectively.Fisher′s exact test was used to compare categorical variables.Results:Among the 2 164 patients, 116 (5.4%) were TCF3: : PBX1 positive, of which 70 patients were female, accounting for 60.3%.There were 840 female patients in the TCF3: : PBX1-negative group, accounting for 41.0%.There was a significant difference in the ratio of females between the TCF3: : PBX1-positive and TCF3: : PBX1-negative groups ( P<0.001).No significant difference was observed in age of onset between the two groups( P>0.05).The proportion of bone marrow naive cells [54.00 (14.00, 76.50)% vs.29.00 (3.00, 68.00)%], white blood cell counts [25.30 (10.46, 60.94)×10 9/L vs.9.03 (4.38, 30.73)×10 9/L] and hemoglobin counts [82.00(63.00, 101.00) g/L vs.74.00(60.00, 90.00) g/L] in the TCF3: : PBX1-positive group were significantly higher than those in the negative group at the onset (all P<0.05).In terms of treatment response, the proportion of peripheral blood naive cells on Day 8 in the TCF3: : PBX1-positive group was significantly higher than that in the negative group [2.00 (0, 9.00)% vs.0 (0, 2.00)%, P<0.001].The proportion of minimal residual disease <0.1% on Day 15 in the TCF3: : PBX1-positive group was significantly higher than that in the negative group ( P=0.038).There were no significant differences in cumulative recurrence rate, treatment-related mortality (TRM), and overall survival (OS) between the TCF3: : PBX1-positive group and TCF3: : PBX1-negative group (all P>0.05).The cumulative recurrence risk of TCF3: : PBX1-positive patients was 9.646 times higher than that of ETV6: : RUNX1-positive patients with better prognosis( HR=9.646, 95% CI: 1.026-90.700, P=0.047).There were no significant differences in TRM and OS between TCF3: : PBX1-positive and ETV6: : RUNX1-positive patients (all P>0.05).A significant enrichment of PAX5 mutations was detected in TCF3: : PBX1-positive patients.Among the 7 high-risk TCF3: : PBX1-positive patients in a single center, 4 patients had PAX5 mutations, and this proportion was significantly higher than that in other patients ( P<0.001). Conclusions:B-ALL children carrying a TCF3: : PBX1 fusion gene have a high remission rate and good long-term prognosis after intensive chemotherapy.It is suggesting that TCF3: : PBX1-positive B-ALL patients should be rated at intermediate risk to receive intensive chemotherapy.

Objective:To explore the care needs of primary caregivers of children with acute lymphoblastic leukemia (ALL) developed chemotherapy-induced oral mucositis (CTOM) during hospitalization and to provide a basis for improving the caregivers′ ability to care for the children and promoting their recovery.Methods:This study adopted the phenomenological design of a qualitative approach, using purposive sampling to select 10 primary caregivers of children with ALL who developed CTOM in Zhongshan People′s Hospital from September 2022 to August 2023. A semi-structured, in-depth interview was conducted to collect the data. Colaizzi analysis was used to analyze the qualitative data.Results:Among the 10 children, 5 were males and 5 were females, aged 3-13 years old; among the 10 primary caregivers, 3 were males and 7 were females, aged 31-44 years old. The primary caregivers′ care needs were categorized into four themes: wound care needs (active oral cleaning and hygiene maintenance, lack of ability to observe wounds, and anticipation of new and more effective medications); the need for knowledge of diseases (lack of knowledge related to the causes of CTOM, lack of knowledge about care and medication, seeking information from multiple sources); nutritional knowledge and dietary care needs (active supplementation awareness, limited dietary choices, lack of specific nutritional knowledge);and social network and psychological support needs (experience sharing in primary caregiver networks, psychosocial support in primary caregiver networks).Conclusions:Primary caregivers have particular problems in caring for children with ALL developed CTOM, including the need for nursing knowledge and practical skills, social support, etc. Healthcare professionals should provide the necessary support and assistance in terms of professional resources, hospital management resources and social resources.

Objective:To investigate the value of nasal provocation test（NPT） in evaluating the efficacy of allergen immunotherapy（AIT） in patients with dust mite induced allergic rhinitis（AR）. Methods:A total of 83 patients with dust mite induced AR with/without asthma were included. Symptom score（SS）, daily medication score（DMS）, combined symptom and medication score（CSMS）, rhinoconjunctivitis quality of life questionnaire（RQLQ）, NPT and skin prick test（SPT） were assessed before and after 1 year AIT. Results:There were statistical differences in SS（P<0.000 1）, DMS（P<0.000 1）, CSMS（P<0.000 1）, and RQLQ（P<0.000 1） after 1 year of AIT compared with pre-treatment. The effective rate of CSMS was 73.49%, and the effective rate of NPT was 42.17%. CSMS was consistent with NPT in efficacy assessment（Kappa=0.437, P<0.001）; while in 54 patients with pre-treatment NPT concentrations other than the original concentration, CMSM and NPT showed better consistence（Kappa=0.895, P<0.001）. Among the 48 patients with ineffective NPT assessment in the first year, 25 patients completed the second-year follow-up, and 12 patients（48.00%） showed effective in NPT. However, 10 out of 12 patients（83.33%） with NPT concentration other than original solution pre-treatment showed effective NPT at the second year. Conclusion:NPT can be used as one of the indicators for efficacy evaluation for dust mite induced AR patients, especially for patients with positive NPT induced at lower concentrations before treatment.
Animals ; Humans ; Pyroglyphidae ; Allergens ; Nasal Provocation Tests ; Quality of Life ; Rhinitis, Allergic/therapy* ; Desensitization, Immunologic ; Skin Tests ; Dust

Objective:To investigate the value of aspirin challenge tests in the diagnosis of non-steroidal anti-inflammatory drugs-exacerbated respiratory disease (NERD).Methods:Fifty patients (22 males and 28 females; aged 16-61 years) who were diagnosed with chronic rhinosinusitis with nasal polyps (CRSwNP) with/without asthma, and underwent NERD standardized diagnosis in the Allergy Centre of West China Hospital, Sichuan University from December 2021 to November 2022 were included in the study. The first step was asking about the history of exacerbation respiratory symptoms after intake of any non-steroidal anti-inflammatory drug, including aspirin; the second step was performing intranasal aspirin challenge (IAC); and the third step was performing oral aspirin challenge (OAC). The diagnosis of NERD was made if any of the above steps was positive, and the subsequent steps were not performed, otherwise the diagnosis was made to OAC. If OAC was negative, the diagnosis was non-NERD. All patients completed the sino-nasal outcome test 22 (SNOT 22) score, Lund-Kennedy score by nasal endoscopic, allergen skin prick test, blood routine and serum total IgE test. SPSS version 20.0 was used for statistical analysis.Results:The diagnosis of NRED was confirmed in 27 patients (27/50, 54%). Seven (7/50, 14%) of them were diagnosed by clinical history and 20 (20/50, 40%) were diagnosed by aspirin challenge tests, of which 17 (17/20, 85%) were positive to IAC and 3 (3/20, 15%) to OAC. Of the 43 patients who underwent IAC testing, only 2 (2/43, 5%) developed asthma attacks during challenge. Comparing the clinical characteristics of patients in NERD and non-NERD group, there were significant differences between the two groups in gender ( P=0.001), hyposmia ( P=0.003), history of repeated CRSwNP surgeries ( P=0.028), comorbid asthma ( P=0.013), SNOT-22 score ( P=0.004) and the percentage of peripheral blood eosinophil ( P=0.043). Conclusions:Patients may be underdiagnosed if the diagnosis of NERD is made only by medical history, and it is necessary to carry out aspirin challenge tests. IAC is an important means to diagnose NERD with high accuracy and good safety. However, If IAC is negative, further OAC is required.

Objective To observe the clinical efficacy of Angong Niuhuangwan on patients with pulmonary encephalopathy, and to provide a theoretical basis of using this pill for treatment of pulmonary encephalopathy. Methods The modern pharmacological effects of Angong Niuhuangwan and the pathogenesis of pulmonary encephalopathy were analyzed, and the clinical efficacy of applying Angong Niuhuangwan for treatment of 3 patients with pulmonary encephalopathy were observed. Results Patient 1, the body temperature dropped after he took 2 Angong Niuhuangwan, and the body temperature had not exceeded 37.1 ℃ within 1 week, consciousness was clear, blood picture was better than before; after patient 2 taking 3 such pills, the consciousness was clear, and the symptoms of asthma and wheezing due to retention of phlegm at throat were significantly better than before; after patient 3 took 3 pills, his body temperature was lowered and the consciousness was better than before. Conclusion Traditional Chinese medicine Angong Niuhuangwan can be used to help treat patients with pulmonary encephalopathy, it can help them improve their respiratory function, avoid mechanical ventilation, significantly elevate their cure rate and ameliorate their sufferings.

Objective: To study the antibacterial activity in vitro of Xiyanping injection combined with cefoxitin, cefuroxime, ceftriaxone, cefmenoxime, amikacin, levofloxacin and meropenem against staphylococcus aureus, escherichia coli, klebsiella pneumoniae, pseudomonas aeruginosa and acinetobacter bauman.Methods: Minimum inhibitory concentration (MIC) of the 7 kinds of antimicrobial agents used individually or combined with Xiyanping injection on germs were determined respectively on 96 plates by using the agar dilution method and the checkerboard method.Fractional inhibitory concentration index (FICI) was calculated to evaluate the antibacterial activity of Xiyanping injection combined with the 7 kinds of antimicrobial agents in vitro.Results: MIC of Xiyanping injection combined with cefoxitin was the same as that of cefoxitin used individually on escherichia coli.MIC of levofloxacin combined with Xiyanping injection showed no difference with that of levofloxacin used individually on klebsiella pneumoniae.Besides, Xiyanping injection could increase the MIC of the other antimicrobial agents on germs.Conclusion: Xiyanping injection combined with antimicrobial agents on staphylococcus aureus, escherichia coli, klebsiella pneumoniae shows antagonistic and irrelevant relationship.