Objective:To explore the efficacy and safety of the modified VIALE-A regimen in the treatment of elderly (>75 years old) patients with intermediate or high risk myelodysplastic syndromes (MDS).Methods:A retrospective case series analysis was conducted. Clinical data were collected from 7 MDS patients aged >75 years who were continuously treated with the modified VIALE-A regimen (azacytidine 75 mg/m 2 per day from day 1 to day 7 + venetoclax 200 mg per day from day 8 to day 28) from May 2021 to August 2023, and the patients were diagnosed according to the World Health Organization 2016 staging criteria and were determined to be at intermediate or high risk according to the revised International Prognostic Scoring System. The patients' efficacy and common adverse reactions were analyzed, and the Kaplan-Meier method was used for survival analysis. Results:Of the 7 patients, 5 were female and 2 were male; the median age [ M ( Q1, Q3)] was 84 years old (80 years old, 90 years old). One patient failed the initial treatment, and the remaining 6 achieved complete remission or complete remission in bone marrow after induction therapy with the modified VIALE-A regimen in 1-2 courses. By the follow-up cut-off date of December 31st, 2023, the median follow-up was 10 months (5 months, 18 months) and the median overall survival time was 18 months (95% CI: 0-39 months). Grade 3-4 myelosuppression occurred in all 7 patients during the induction phase, with granulocytopenia lasting 7-10 d; Of the 64 courses of maintenance treatment, 54 (84%) had grade 1-3 myelosuppression; non-hematologic adverse reactions were mild; no treatment interruptions occurred in the cumulative 73 courses. Conclusions:The modified VIALE-A regimen is moderately efficacious in elderly patients with intermediate or high risk MDS, with controllable adverse reactions.

Objective To study the requirement of exogenous phosphorus for 2-year-old and 3-year-old ginseng seedings.Methods Two-and three-year-old ginsengs were used as experimental materials.Calcium superphosphate and phosphorus-free Hoagland solution were used as fertilizer,and the concentrations of P2O5 were set to be 0 mmol·L-1,0.5 mmol·L-1,1.5 mmol·L-1,3 mmol·L-1,6 mmol·L-1,8 mmol·L-1,respectively.The effects of different concentrations of phosphorus fertilizer on agronomic indexes,photosynthetic characteristics and accumulation of ginsenosides Rg1,Rb1 and Re were studied.Results The plant height,stem diameter,root weight,leaf area,relative content of chlorophyll,net photosynthetic rate and total saponins content of different year-old panax ginseng were significantly increased by applying phosphorus at 1.5-3.0 mmol·L-1.Among them,compared with the phosphorus-free group,the root weight of second-year ginseng was increased by 16％and the saponin content was increased by 24％;the root weight of third-year ginseng was increased by 89％and the saponin content was increased by 132％.The appropriate application rate of phosphorus fertilizer(phosphorus pentoxide)during the growth of second and third year ginseng was 26.6 mg and 53.3 mg of plant,respectively.Conclusion External application of suitable concentration of phosphorus fertilizer can enhance the external morphological characteristics of ginseng,improve photosynthetic physiological properties and increase the content of active ingredients.

Objective:To evaluate the effect of dexmedetomidine on the hippocampal brain-derived neurotrophic factor (BDNF)/tyrosine kinase receptor B (TrκB) signaling pathway in a rat model of cerebral ischemia-reperfusion (I/R).Methods:Forty-five clean-grade healthy Sprague-Dawley rats, half male and half female, aged 5-6 months, weighing 200-250 g, were divided into 3 groups ( n=15 each) using a random number table method: sham operation group (group S), cerebral I/R group (group I/R), and dexmedetomidine + I/R group (group Dex). A rat model of cerebral I/R injury was established by occluding the middle cerebral artery for 90 min followed by restoring perfusion. In group Dex, dexmedetomidine 50 μg/kg was intraperitoneally injected at 30 min before ischemia, while the equal volume of normal saline was intraperitoneally injected in S and I/R groups. Neurological deficit scores were evaluated at 12 h of reperfusion. The rats were anesthetized and sacrificed, and the hippocampus was isolated for determination of the percentage of cerebral infarct size (by TTC method), expression of BDNF and TrκB (by Western blot), and expression of BDNF mRNA and TrκB mRNA (by real-time polymerase chain reaction) and for microscopic examination of cell apoptosis (by TUNEL method). Results:Compared with group S, the neurological deficit scores and percentage of cerebral infarct size were significantly increased, the number of apoptotic hippocampal neurons was increased, and the expression of BDNF and TrκB protein and mRNA was down-regulated in I/R and Dex groups ( P<0.05). Compared with group I/R, the neurological deficit scores and percentage of cerebral infarct size were significantly decreased, the number of apoptotic hippocampal neurons was reduced, and the expression of BDNF and TrκB protein and mRNA was up-regulated in group Dex ( P<0.05). Conclusions:The mechanism by which dexmedetomidine alleviates cerebral I/R injury may be related to activating hippocampal BDNF/TrκB signaling pathways in rats.

Objective:To assess the treatment outcomes of endoscopic ultrasound-guided biliary drainage (EUS-BD) in patients with obstructive jaundice due to unsuccessful endoscopic retrograde cholangiopancreatography (ERCP).Methods:The clinical data of patients with obstructive jaundice who underwent EUS-BD due to ERCP failure at the Gastrointestinal Endoscopy Center of Beijing Friendship Hospital from September 2018 to November 2023, was retrospectively collected and analyzed. We explored the technical success, clinical success, and adverse events associated with EUS-BD.Results:In total, 43 EUS-BD procedures were performed in 39 patients with a technical success rate of 86.0% (37/43). The clinical success rate was 81.1% (30/37). Biliary drainage was not effectively achieved in seven cases, including two fatal cases and five cases of recurrent postoperative biliary obstruction. The incidence of adverse events was 21.6% (8/37), including two cases of postoperative bile leakage peritonitis, two cases of stent displacement, one case of stent dislocation, one case of perforation, and two cases of death.Conclusion:EUS-BD is a relatively safe and effective method for bile duct drainage, serving as a dependable alternative therapeutic option for patients with obstructive jaundice due to unsuccessful ERCP.

Background: and Purpose The eye-movement examination can be applied as a noninvasive method to identify multiple-system atrophy (MSA). Few studies have investigated eye movements during the early stage of MSA with predominant parkinsonism (MSA-P). We aimed to determine the characteristic oculomotor changes in the early stage of MSA-P. Methods: We retrospectively selected 17 patients with MSA-P and 40 with Parkinson’s disease (PD) with disease durations of less than 2 years, and 40 age-matched healthy controls (HCs).Oculomotor performance in the horizontal direction was measured in detail using videonystagmography. Results: We found that the proportions of patients with MSA-P and PD exhibiting abnormal eye movements were 82.4% and 77.5%, respectively, which were significantly higher than that in the HCs (47.5%, p<0.05). Compared with HCs, patients with MSA-P presented significantly higher abnormal proportions of fixation and gaze-holding (17.6% vs. 0%), without-fixation (47.1% vs. 0%), prolonged latency in reflexive saccades (29.4% vs. 5.0%), memory-guided saccades (93.3% vs. 10.0%), and catch-up saccades in smooth-pursuit movement (SPM, 41.2% vs. 0) (all p<0.05). Compared with those with PD, patients with MSA-P presented a significantly higher proportion of catch-up saccades in SPM (41.2% vs. 2.5%, p<0.001). Conclusions MSA-P presented the characteristic of catch-up saccades in SPM in the early stage, which may provide some value in differentiating MSA-P from PD.

ObjectiveTo investigate the influence of interference tasks and age on gait characteristics and task costs of children aged three to eight years. MethodsFrom April to August, 2021, 200 children from a kindergarten and primary school in Cangzhou, Hebei were enrolled to collect gait spatiotemporal parameters and kinematics data with infrared motion capture system; ground reaction force was collected with the Kistler force platform and simulated with Anybody 7.0, as walking naturally (standard gait), answering question (cognitive gait) and crossing obstacle (obstacle-crossing gait). ResultsA total of 182 children finished the test. The main effect of task was significant on spatiotemporal parameters (F > 5.167, P < 0.01), as well as age (F > 2.321, P < 0.05), except on stride width and speed; while the interaction effect of task and age was significant on double stance phase, single stance phase and step length (F > 3.040, P < 0.01). The main effect of task was significant on kinematics data (F > 83.019, P < 0.001), as well as age (F > 2.359, P < 0.05), except on range of motion of knee and maximum angular velocity of ankle; while the interaction effect of task and age was significant (F > 2.066, P < 0.05), except on range of motion of hip. The main effect of task and age was significant on kinetic parameters (F > 4.032, P < 0.05); while the interaction effect of task and age was significant (F > 2.189, P < 0.05), except on the strength of medial soleus, lateral gastrocnemius, medial gastrocnemius and tibialis anterior. The coefficient of variation was the most for cognitive gait, and then for the obstacle-crossing gait and standard gait. The main effect of task and age was significant on the cost of task for stride length and speed (F > 3.368, P < 0.01), while the interaction effect was not significant. ConclusionGait of early childhood is influenced by interference tasks and age. Under interference tasks, gait cycle increases, while single stance phase, stride length, frequency and speed decrease; and task costs increase, and overall gait stability decrease. Cognitive tasks impact on gait greater than obstacle crossing, which may be due to the higher costs of tasks. In terms of age, gait exhibits a non-linear age trend.

Humans ; Hypertension ; Atherosclerosis ; Colorectal Neoplasms ; Risk Factors

Objective:To compare the efficacy of domestic and imported hemostatic clips in preventing delayed post-polypectomy bleeding (DPPB) after endoscopic resection of colorectal polyps ≥ 10 mm.Methods:Clinical data of 789 patients who underwent endoscopic resection of colorectal polyps (polyp diameter ≥10 mm) in Beijing Friendship Hospital, Capital Medical University from January 2018 to December 2019 were collected. The patients were divided into DPPB group ( n=15) and non-DPPB group ( n=774). Univariate and multivariate logistic regression models were used to analyze the influential factors for DPPB. The patients using one type of hemostatic clip were divided into the domestic hemostatic clip group ( n=499) and the imported hemostatic clip group ( n=208). The efficacy of hemostatic clips in preventing DPPB in the two groups was compared. Results:Among the 789 patients undergoing endoscopic resection of colorectal polyps, 1.9% (15/789) suffered from DPPB. Multivariate logistic regression analysis showed that pedunculated polyp was an independent risk factor for DPPB ( OR=6.621, 95% CI: 2.278-19.241, P=0.001), and closure of mucosal defect was an independent protective factor for DPPB ( OR=0.169,95% CI: 0.050-0.570, P=0.004). Regardless of physician experience, there was no significant difference between the domestic and imported hemostatic clip group in preventing DPPB after endoscopic resection of colorectal polyps ≥10 mm [experienced physicians: 1.8% (7/385) VS 0.6% (1/175), χ2=1.314, P=0.445; common physicians: 2.6% (3/114) VS 3.0% (1/33), χ2=0.010, P>0.999]. The domestic hemostatic clip group paid for less medical expenses than the imported hemostatic clip group (experienced physicians: 1 433.51±889.02 yuan VS 3 033.97±1 686.87 yuan, t<0.001 , P<0.001; common physicians: 1 181.58±815.29 yuan VS 3 303.46±1 690.43 yuan, t<0.001 ,P<0.001). Conclusion:Pedunculated polyp is an independent risk factor for DPPB after endoscopic resection of colorectal polyp larger than 10 mm, and clipping can significantly reduce the risk for DPPB. There is no significant difference in the prevention of DPPB between domestic and imported clips, but domestic clips compared with imported clips yield less medical burden, which are suitable for promotion to primary hospitals and major clinical centers.

Objective:To explore the effect of multidisciplinary team cooperation intervention model on the fear of falling (FOF) of postoperative elderly patients during hospitalization.Methods:From January to December 2021, 100 elderly patients with FOF after surgery in the Surgical Ward of the International Medical Department of Peking Union Medical College Hospital were selected by convenient sampling. The patients were randomly divided into the control group and the observation group according to single and double numbers, with 50 cases each. The control group was given routine nursing, and the observation group was given multidisciplinary team cooperation intervention on the basis of routine nursing. The scores of the Modified Fall Efficacy Scale (MFES) were evaluated on the afternoon of the first day of the patient's getting out of bed (inclusion criteria) and the afternoon of the second day of the activity to compare the FOF of the two groups of elderly patients.Results:Before intervention, there was no statistical difference in MFES scores between the two groups ( P>0.05) . After intervention, the MFES score of the observation group was higher than that of the control group, and the difference was statistically significant ( P<0.01) . In the same Morse fall risk grade of low risk, medium high risk and high risk, the difference of MFES score in the observation group was higher than that in the control group, and the difference was statistically significant ( P<0.05) . Conclusions:Multidisciplinary team cooperation intervention can effectively improve the FOF of elderly patients during hospitalization after surgery and promote postoperative rehabilitation.

Objective:To explore the mediating effect of negative cognitive processing bias between type D personality and depression after percutaneous coronary intervention (PCI) .Methods:Using the convenient sampling method, a total of 340 patients who underwent PCI for the first time in Department of Cardiology in the Second Affiliated Hospital of Harbin Medical University from September to December 2021 were selected as the research objects. The General Demographic Data Questionnaire, Type D Personality Scale (DS14), Negative Cognitive Processing Bias Questionnaire (NCPBQ) and Beck Depression Inventory-Ⅱ (BDI-Ⅱ) were used to investigate. Spearman correlation analysis was used to determine the correlation between type D personality, negative cognitive processing bias and depression. The mediating effect model was established by AMOS 24.0 software to analyze the mediating effect of negative cognitive processing bias between type D personality and depression.Results:A total of 340 questionnaires were sent out in this study, and 317 valid questionnaires were recovered, with an effective questionnaire recovery rate of 93.2%. The total score of Type D Personality Scale of 317 patients after PCI was (18.05±4.15), in which the score of negative affectivity dimension was (9.51±2.33) and the score of social inhibition dimension was (8.54±2.61). The proportion of patients with type D personality is 24.9% (79/317). The score of Beck Depression Inventory-Ⅱ (BDI-Ⅱ) was (9.52±4.83), and the incidence of depression was 20.2% (64/317). Correlation analysis showed that D-type personality of patients, negative cognitive processing bias and depression were positively correlated ( P<0.05). The mediating effect analysis showed that type D personality could directly affect the occurrence of depression (effect size 0.431, P<0.001), or indirectly through negative cognitive processing bias (effect size 0.145, P<0.001) . Conclusions:The negative cognitive processing bias is an important factor in the occurrence of depression in patients with CHD and with type D personality. Improving the negative cognitive processing bias will help reduce the occurrence of depression and improve the prognosis.