Objective To investigate the impact of nursing interventions based on Kales conceptual model on agitated behaviours of dementia patients.Methods A total of 80 dementia patients were randomly divided into two groups using a random number table.Patients in the control group(n=40)received routine care,while those in the observation group(n=40)received the nursing interventions based on Kales concept model on top of the routine care.The agitated behaviours and quality of life of the two groups were compared before,2 weeks and 4 weeks after the intervention.Results The repeated measures ANOVA showed statistically significant differences in three time points in terms of the time effect,inter-group effect and interactive effects on the scores of agitations and quality of life(all P<0.05).After the intervention,the score of agitations in the observation group was significantly lower than that of the control group(P<0.05),and the score of quality of life in the observation group was significantly higher than that in the control group(P<0.05).Conclusion The nursing interventions based on Kales conceptual model is effective in reducing agitations of dementia patients and improving the quality of life.

OBJECTIVE To analyze the use status and development trend of proton pump inhibitors(PPIs) in 33 hospitals in Wuhan, Hubei Province after the implementation of the national centralized drug procurement(NCDP) policy, and to provide reference for promoting the subsequent rational use of NCDP drugs and improving related policies. METHODS To make statistics and analysis of purchasing amount of PPIs, defined daily dose system(DDDs), defined daily dose consumption(DDDc) and utilization rate of 33 hospitals in Wuhan in 2019 and 2022. RESULTS After the implementation of the NCDP policy, the total purchasing amount of PPIs decreased by 53.6%, DDDs decreased by 15.4%, DDDc decreased by 45.2%, and the utilization rate of PPIs injectable dosage forms decreased by 12.6%. After NCDP, the highest growth rate of oral dosage forms was omeprazole(5.7%), followed by rabeprazole(5.0%), while injectable dosage forms showed a significant difference in utilization rate, with a significant decline in NCDP varieties and a significant increase in non-NCDP varieties. The overall NCDP utilization rate of PPIs in Wuhan was 64.9%, with little difference among hospitals of different grades. CONCLUSION The NCDP policy achieves the purpose of reducing the drug cost of patients and improving the accessibility of drugs, and is more optimized in the selection of dosage forms, which is in line with the policy expectations overall; but the quantity and price of PPIs in Wuhan decreased after NCDP, and highlighted a certain tendency in the selection of varieties. In the future, we still need to optimize measures to guide clinical priority in the selection of NCDP drugs, to ensure and improve the implementation of NCDP policy.

Follicular lymphoma (FL) is the most common indolent B-cell lymphoma. The 2023 American Society of Hematology (ASH) annual meeting announced the latest updates on newly diagnosed and relapsed/refractory FL, including the targeted therapy, bio-specific antibodies and chimeric antigen receptor T-cell (CAR-T) therapy. This review provides an overview of these updates.

Humans ; Hematopoietic Stem Cell Transplantation ; Multiple Myeloma/therapy* ; Transplantation, Autologous ; Retrospective Studies ; Combined Modality Therapy ; Stem Cell Transplantation/adverse effects*

Follicular lymphoma (FL) is the most common indolent B-cell lymphoma. The outcome of relapsed/refractory FL patients after multi-therapy is poor. The 64th American Society of Hematology annual meeting in 2022 announced the latest updates on relapsed/refractory FL, including targeted therapy, bio-specific antibodies and chimeric antigen receptor T-cell. This review provides an overview of these updates.

Follicular lymphoma (FL) is the most common indolent B-cell lymphoma. Although patients with FL generally have a good prognosis, the treatment of relapsed/refractory FL remains a challenge. The 63rd American Society of Hematology (ASH) Annual Meeting announced the latest updates on relapsed/refractory FL, including the usage of targeted therapy, bio-specific antibodies and chimeric antigen receptor T-cell (CAR-T) therapy. This article provides an overview of the updates in combination with the reports presented at the ASH Annual Meeting.

Objective:To explore the clinical features and survival of newly diagnosed follicular lymphoma (FL) patients with diffuse large B-cell lymphoma (DLBCL) component.Methods:1845 newly diagnosed FL patients aged ≥ 18 years with grades 1-3a in 11 medical centers in China from 2000 to 2020 were included, and patients with DLBCL component were screened. The clinical data and survival data of the patients were retrospectively analyzed, and the prognostic factors were screened by univariate and multivariate analysis.Results:146 patients (7.9% ) with newly diagnosed FL had DLBCL component. The median age was 56 (25-83) years, 79 males (54.1% ) . The pathology of 127 patients showed the proportion of DLBCL component. Patients were divided into two groups according to whether the proportion of DLBCL component was ≥ 50% . The study found that patients with DLBCL component ≥ 50% had higher grade 3 ratio (94.3% vs 91.9% , P=0.010) , Ki-67 index ≥ 70% ratio (58.5% vs 32.9% , P=0.013) and PET-CT SUVmax ≥ 13 ratio (72.4% vs 46.3% , P=0.030) than patients with DLBCL component<50% . All patients received CHOP or CHOP like ± rituximab chemotherapy. The overall response rate (ORR) was 88.2% , and the complete response (CR) rate was 76.4% . In the groups with different proportions of DLBCL component, there was no significant difference in the remission rate after induction treatment and the incidence of disease progression within 2 years after initiation of treatment (POD24) ( P<0.05) . The overall estimated 5-year progression free survival (PFS) rate was 58.9% , and the 5-year overall survival (OS) rate was 90.4% . The 5-year OS rate of POD24 patients was lower than that of non POD24 patients (70.3% vs 98.5% , P<0.001) . Compared with non maintenance treatment of rituximab, maintenance treatment of rituximab could not benefit the 5-year PFS rate (57.7% vs 58.8% , P=0.543) , and the 5-year OS rate had a benefit trend, but the difference was not statistically significant (100% vs 87.8% , P=0.082) . Multivariate analysis showed that failure to reach CR after induction treatment was an independent risk factor for PFS ( P=0.006) , while LDH higher than normal was an independent risk factor for OS ( P=0.031) . Conclusion:FL patients with DLBCL component ≥50% have more invasive clinical and pathological features. CHOP/CHOP like ± rituximab regimen can improve the clinical efficacy of patients. Rituximab maintenance therapy can not benefit the PFS and OS of patients. Failure to reach CR after induction therapy was the independent unfavorable factor for PFS.

Objective:To study the clinical efficacy and action mechanism of hyperbaric oxygen combined with citalopram in treating depressed patients with traumatic brain injury（TBI）.Methods:A total of 114 patients with post-TBI depression treated in Yantaishan Hospital from January 2019 to December 2021 were selected and divided into control group and observation group by random number table method，with 57 patients in each group. The control group was treated with citalopram，and the observation group was treated with hyperbaric oxygen in addition to the treatment in the control group. Before treatment and at 2，4，and 6 weeks of treatment，Hamilton Depression Scale（HAMD）was used to score depression and calculate the treatment response rate. Serum 5-hydroxytryptamine（5-HT）and dopamine（DA）levels were detected by enzyme-linked immunosorbent assay.Results:After 6 weeks of treatment，the total effective rate of the observation group（94.74%）was significantly higher than that of the control group（80.70%），and the difference was statistically significant（ P<0.05）. The levels of Serum 5-HT and DA in both groups were significantly increased compared with those before treatment，and the levels of serum 5-HT and DA in the observation group were significantly higher than those in the control group at 4 and 6 weeks after treatment，and the differences were statistically significant（ P<0.05）. The HAMD scores in both groups were significantly lower than those before treatment，and the HAMD score in the observation group was lower than those in the control group at 4 and 6 weeks after treatment，and the differences were statistically significant（ P<0.05）. Conclusion:Hyperbaric oxygen combined with citalopram can improve the depressive symptoms of TBI patients，and its action mechanism is mainly achieved by increasing the serum levels of serum DA and 5-HT.

Objective:To study the clinical efficacy and action mechanism of hyperbaric oxygen combined with citalopram in treating depressed patients with traumatic brain injury（TBI）.Methods:A total of 114 patients with post-TBI depression treated in Yantaishan Hospital from January 2019 to December 2021 were selected and divided into control group and observation group by random number table method，with 57 patients in each group. The control group was treated with citalopram，and the observation group was treated with hyperbaric oxygen in addition to the treatment in the control group. Before treatment and at 2，4，and 6 weeks of treatment，Hamilton Depression Scale（HAMD）was used to score depression and calculate the treatment response rate. Serum 5-hydroxytryptamine（5-HT）and dopamine（DA）levels were detected by enzyme-linked immunosorbent assay.Results:After 6 weeks of treatment，the total effective rate of the observation group（94.74%）was significantly higher than that of the control group（80.70%），and the difference was statistically significant（ P<0.05）. The levels of Serum 5-HT and DA in both groups were significantly increased compared with those before treatment，and the levels of serum 5-HT and DA in the observation group were significantly higher than those in the control group at 4 and 6 weeks after treatment，and the differences were statistically significant（ P<0.05）. The HAMD scores in both groups were significantly lower than those before treatment，and the HAMD score in the observation group was lower than those in the control group at 4 and 6 weeks after treatment，and the differences were statistically significant（ P<0.05）. Conclusion:Hyperbaric oxygen combined with citalopram can improve the depressive symptoms of TBI patients，and its action mechanism is mainly achieved by increasing the serum levels of serum DA and 5-HT.

Objective:To study the clinicopathologic features, and the diagnosis and differential diagnosis of mycobacterial spindle cell pseudotumor in children.Methods:The clinical data, histopathological features, immunophenotype and special staining of 2 mycobacterial spindle cell pseudotumors were analyzed. The related literatures were reviewed.Results:The age of the two boys was 11 months and 22 months respectively, but their clinical symptoms became apparent at the age of about 4 months. The lesions involved lymph nodes and skin. The first patient also had fever for more than 4 months. Both patients received anti-inflammatory treatment in the outside hospital, but had no obvious improvements of the symptoms. A tumor resection was performed at the outside hospital. Histologically, mycobacterial spindle cell pseudotumor consisted of bland spindle cells, which formed fascicles, without any obvious atypia and mitoses. The cell nuclei were vesicular, with small nucleoli and abundant cytoplasm in some of the cases. The spindle cells expressed histiocyte-associated markers, such as CD68. The Ki-67 proliferation index was low. The mycobacteria were usually readily highlighted by acid-fast staining, which located in the cytoplasm of proliferative spindle cells. In the first case, there was obstructive jaundice because of the progressive enlargement of live portal lymph nodes and systemic disseminated lesions. The second patient had disease recurrence after only operation, and gradually developed other skin nodules and superficial lymph node enlargement. The high-throughput molecular analysis of the skin biopsy confirmed the diagnosis of mycobacterium tuberculosis. After 11 days of anti-tuberculosis treatment, the patient′s condition improved significantly.Conclusions:Mycobacterial spindle cell pseudotumor in children is a very rare benign lesion. It is characterized by spindle-histiocyte proliferation caused by mycobacterium infection. An acid-fast stain appears necessary for confirming the diagnosis.