Objective To evaluate the clinical value of a modified Cancer and Aging Research Group(CARG)model in guiding anticancer drug dose adjustments for elderly cancer patients in China.Methods This prospective study enrolled patients aged≥65 years with solid tumors at the Department of Oncology,Peking Union Medical College Hospital from September 1,2022 to October 29,2023.All patients underwent comprehensive geriatric assessment(CGA)and CARG risk scoring,and were stratified into low-,intermediate-,and high-risk groups.Anti-cancer drug doses(including chemotherapy,targeted therapy or immunotherapy)were reduced proportionally based on CARG risk stratification and treatment intent(curative vs.palliative).Treatment outcomes and adverse events(AEs)were recorded regularly.Fisher's Exact Test compared AE incidence between the CARG-guided dose adjust-ment group(experimental)and the physician-experience-guided dose adjustment group(control).Receiver operating characteristic(ROC)curve analysis was used to assess the predictive value of the CARG model for severe toxicity.Results Among 166 enrolled patients(median age:71 years[range:65-90];78.3%were male;68.7%had gastro-intestinal cancers;69.3%had stageⅣ),95 were assigned to the experimental group(CARG low-risk:24[25.3%],intermediate-risk:51[53.7%],high-risk:20[21.0%])and 71 were included into the control group.By December 31,2024,81 patients experienced disease progression and 10 patients died.Overall AE rates was 92.6%in the ex-perimental group and 94.4%in the control group,while grade≥3 AEs were recorded in 45.3%vs.43.7%,respec-tively(both P＞0.05).Conclusions The modified CARG model-guided dose adjustment strategy achieved comparable safety to empirical dose adjustment,which is in line with the individualized treatment paradigm for elderly cancer pa-tients,representing a structured framework for optimizing therapeutic decision-making in geriatric oncology.

Objective To investigate the knowledge,attitude and practice of nurses from hospitals in Tibet Autonomous Region on the use of peripheral venous needle and analyze the influencing factors.Methods Utilizing a convenience sampling approach,we conducted a survey from November to December 2023 involving 1 319 nurses from 62 hospitals across 7 cities(regions)of Tibet Autonomous Region.Custom-made electronic questionnaires were utilized.Results A total of 1 320 questionnaires were collected,of which 1 319 were valid,with an effective response rate of 99.92％.The scores of nurses'knowledge,attitude and practice were 46.24±13.68,79.75±10.30,and 60.38±14.15,respectively.808(61.26％)nurses had received relevant training experience.The results of multiple linear regression analysis showed that the influencing factors of nurses'knowledge of peripheral venous indwelling needle included whether they had received training experience,ethnicity,education background,professional title,department and hospital region(P＜0.05).Training experience,ethnicity,educational background,profession title and hospital region were the influence factors of nurses'attitude of venous indwelling needle(P＜0.05).Whether they had received training,ethnicity,education background,department and hospital region were the influencing factors of nurses'practice of peripheral venous indwelling needle(P＜0.05).Conclusion Nurses from hospitals in Tibet Autonomous Region have a good attitude towards using venous indwelling needle.However,the knowledge level is not ideal and the practice is still needed to be improved.Nursing managers should implement targeted training and enrich the training form and content,so as to meet the needs of nurses and to improve the quality of intravenous therapy in the Tibet Autonomous Region.

Objective To explore the effect of hospital-community integration follow-up pattern on medication compliance in patients with mental disorder. Methods From January 2016 to January 2017, 96 patients were treated effectively with systemic therapy in psychosomatic department and TCM WM department, and 96 discharged mental disorder patients were treated with brief psychiatric rating scale (BPRS) ≤ 28. The patients were randomly divided into 48 cases in the intervention group and the control group; both groups were standardized medication; control group received an outpatient referral, intervention group combined with medical doctors in our hospital and community doctors for one year follow-up intervention. Observed the condition of illness and medication compliance after six months and one year intervention between two groups, compared the patient recurrence rate of one year after discharge. Results BPRS score of intervention group was significantly lower than control group (P＜0. 01), the difference was statistically significant, while intervention group had higher compliance than control group (P＜0. 01), and the difference was statistically significant. Recurrence rate (20. 83％) of intervention group was significantly lower than control group (38. 78％) ( 2 = 4. 03, P＜0. 05), the difference was statistically significant. Conclusion Hospital-community integration follow-up has positive effect on stabilizing patients with mental disorder and improving compliance and decreasing relapse rate.

Objective To investigate the prevalence of metabolic syndrome (MS) among adults in rural areas of Ningxia Hui autonomous region.Methods A cross-sectional study was conducted in 10 639 adults enrolled with a multistage method from Jingyuan County.The MS was identified according to Chinese type 2 diabetes prevention guide (2013).Results Among all the subjects, 17.4% of them met the MS definition with the standardized prevalence of 14.7% after adjustment of sex and age.The prevalence and standardized rate of MS in men were 19.9% and 17.3%, and in women were 15.3% and 13.5%.The prevalence of MS in men was higher than that in women(P<0.001) and increased with aging in both genders.The prevalence and standardized rate of abdominal obesity,hyperglycemia,hypertension,high triglycerides,and low HDL-C were 19.5% and 16.7%, 15.0% and 12.9%, 42.0% and 37.1%, 25.8% and 23.1%, 28.5% and 27.7%,respectively.The rate of abdominal obesity was higher in women than in men (20.5% vs 18.2%, P=0.004), whereas the rate of hypertension, high triglycerides, and low HDL-C were higher in men than in women (all P<0.01).The prevalence of having one parameter of the MS was 68.4%.Conclusion The prevalence of MS is higher in rural areas of Ningxia Hui autonomous region, suggesting that a series of comprehensive prevention measures should be carried out to prevent and control the MS so as to improve the public health conditions in rural areas.

Objective To discuss the impact on PICC infusion amphotericin B by improved flushing method. Methods A total of 20 patients with the treatment of amphotericin B were chosen as control group by convenience sampling method of time sequence from January 2011 to January 2013,while 15 patients with the treatment of amphotericin B were selected as experimental group from February 2013 to June 2014. The patients of control group underwent impulsive type flushing pipe with 5% glucose injection 10 ml before amphotericin B infusion,while the patients of experimental group received improved flushing method. We compared the length of PICC catheter indwelling time and rate of unplanned extubation caused by drug blocking. Results The length of PICC catheter indwelling time were(30. 5 ± 15. 3)days in the control group and(97. 5 ± 35. 9)days in the experimental group(t = -6.785,P <0.01);the rate of unplanned extubation because of drug blocking were 80.0%in the control group and 6.7% in the experimental group(χ2 =18.453,P <0.01). Conclusions Improved flushing pipe method can effectively extend the PICC single catheter indwelling time and reduce rate of unplanned extubation caused by drug blocking.

OBJECTIVETo evaluate the feasibility and characteristics of human engraftment in HLA disparate cord blood transplantation.

METHODSTwo human HLA-haploidentical or HLA-mismatched cord blood units were transplanted into sublethally irradiated severe combined immunodeficiency (SCID) mice. The characteristics of engraftment, hematopoietic and immunological reconstitution between the two groups were compared.

RESULTSTwo mixed cord blood units can engraft in SCID mice with donor-recipient chimerism and reconstitute hematopoiesis and immunological functions. No unfavorable factors had been observed. Only one of the two cord blood units which had higher colony forming ability in vitro could engraft in most SCID mice as shown by HLA-DQB(1) gene detection. Two HLA-haploidentical cord blood units were simultaneously engrafted in 3 SCID mice.

CONCLUSIONDouble HLA-haploidentical or HLA-mismatched cord blood can engraft in SCID mice and reconstitute hematopoietic and immunological functions. HLA disparity has no significant effect on survival and engrafting rate. However, in less HLA disparity group, two cord blood units were prone to engraft simultaneously.

Animals ; Antigens, CD ; immunology ; Cord Blood Stem Cell Transplantation ; methods ; Disease Models, Animal ; Female ; Fetal Blood ; immunology ; metabolism ; Flow Cytometry ; HLA Antigens ; genetics ; immunology ; Hematopoiesis ; Humans ; Mice ; Mice, SCID ; Random Allocation ; Severe Combined Immunodeficiency ; immunology ; physiopathology ; surgery ; Survival Analysis ; Transplantation, Heterologous

AIM: To study the effect of vascular endothelial growth factor(VEGF) on hematopoietic differentiation from mouse embryonic stem cells(ESC) in vitro.METHODS: ES-D3 was allowed to grow on mouse fetal fibroblast feeder layer,and then was developed into embryoid bodies(EB).EB cells were transferred into medium supplemented with different concentration of VEGF and VEGF+SCF for 1 week.Six groups,including.VEGF 5 ?g/L,VEGF 10 ?g/L,VEGF 20 ?g/L, VEGF 5 ?g/L+SCF,VEGF 10 ?g/L+SCF and VEGF 20 ?g/L+SCF,were designed.The group of spontaneous differentiation without cytokine(s) was used as control.Hematopoietic transcription factor GATA-2 and early hematopoietic differentiation genes(c-kit and ?-H1) were detected by RT-PCR.The content of CD34~+ cells in each group were measured by flow cytometry.The cells derived from ESC were incubated in semisolid methycellulose cultures.The numbers of total colony-forming units in culture(CFU-C) were counted by reverse microscope.RESULTS: ES-D3 grew and formed EB at day 4.VEGF had a stimulatory effect as a single factor on the expression of genes associated with early hematopoietic differentiation(GATA-2,c-kit and ?-H1),the generation of CD34~+ cells and CFU-C in EB.The effects of VEGF+SCF were the most potent in the experimental groups according to the percent of CD34~+ cells and the numbers of hematopoietic colonies.The most highest inducing efficacy was achieved in VEGF 20 ?g/L or VEGF 10 ?g/L combined with SCF.CONCLUSION: VEGF promotes the differentiation of ESC into hematopoietic cells in vitro.The strongest effect was achieved when VEGF was combined with SCF.