Objective:To investigate the clinical effects of chidamide combined with linperlisib in treatment of recurrent angioimmunoblastic T-cell lymphoma (AITL) after autologous stem cell transplantation (ASCT).Methods:The clinical data of 1 patient with recurrent AITL receiving treatment of chidamide combined with linperlisib after ASCT in Sun Yat-Sen University Cancer Center in March, 2021 were retrospectively analyzed, and the related literatures were reviewed.Results:The 55- year-old male patient was presented with fatigue, night sweats and emaciation. According to the results of pathology, immunohistochemistry and imaging after admission, this patient was diagnosed as AITL. After treatment with venbutuximab + CDP (cyclophosphamide + doxorubicin + prednisone) regimen, the patient achieved complete remission, and then ASCT was performed. After the transplatation, programmed death receptor 1 inhibitor was maintained for 4 courses of treatment. It recurred 16 months after ASCT, and the patient achieved partial remission after 1 course of chidamide combined with linperlisib, and achieved complete remission after 2 courses of treatment. Later, recheck of hepatitis B virus showed a quantitative increase after the self withdrawal of anti hepatitis B drugs, and then the primary treatment was suspended. The last follow-up time was March, 2024, and recheck results of whole body enhanced magnetic resonance imaging indicated recurrence.Conclusions:The combination of chidamide and linperlisib is effective and safe in treatment of recurrent ATIL after ASCT.

Objective To analyze the risk factors for extrauterine growth retardation(EUGR)in late preterm infants appropriate for gestational age.Methods The clinical data in 1 402 preterm infants appropri-ate for gestational age delivered and hospitalized in this hospital from January 2016 to June 2022 were analyzed retrospectively.They were divided into the EUGR group(n=244)and the non-EUGR group(n=1 158)ac-cording to whether or not the body weight at discharge was below the 10th percentile of the growth curve for the same gestational age at the same period based on the Fenton's preterm growth curve.The clinical data of preterm infants and mothers of the two groups were collected.The risk factors for EUGR occurrence in pre-mature infants were analyzed.Results Among 1 402 preterm infants appropriate for gestational age,EUGR occurred in 244 cases with the EUGR incidence rate of 17.4％.The EUGR incidence rate had no statistical difference among the different fetal ages of premature infants(P＞0.05).The EUGR incidence rate had sta-tistical difference among different birth weights of premature infants(P＜0.05).The logistic regression anal-ysis showed that male(OR=1.694,95％CI:1.144-2.507),low birth weight(OR=0.989,95％CI:0.988-0.991),feeding intolerance(OR=2.719,95％CI:1.234-5.990),short gestational weeks(OR=0.146,95％CI:0.103-0.207)and hospitalization duration extension(OR=1.073,95％CI:1.031-1.117)were the risk factors for EUGR occurrence in late premature infants appropriate for gestational age in discharge.The sub-group analysis showed that male,low birth weight,feeding intolerance and hospitalization duration extension were the risk factors for EUGR occurrence in the preterm infants with gestational ages of 34-＜36 weeks(P＜0.05).Low birth weight and feeding intolerance only affected the preterm infants≥36 weeks of gesta-tional age(P＜0.05).Conclusion Strengthening the pregnant duration health care and active nutritional sup-port after birth may reduce the risk of EUGR occurrence in late premature infants.

Objective:To explore the effect of pre-hospital health education based on "Internet +" on self-management efficacy, anxiety and depression of patients undergoing pulmonary tumor surgery, and provide reference for pre-hospital nursing care of this group.Methods:It was a randomized controlled trial. A total of 100 outpatients in Department of Pulmonary Oncology, Tumor Hospital of Tianjin Medical University to be hospitalized for surgery during November 2021 to March 2022, were divided into experimental group ( n=50) and control group ( n=50) by random number method according to the order of outpatient visits. Patients in control group received routine thoracic surgery nursing and health education after admission. Those in experimental group received "Internet +" pre-hospital health education during patients waiting for hospital beds for surgery, nursing care after admission was the same as that of the control group. The scores of Strategies Used by People to Promote Health (SUPPH) and Hospital Anxiety and Depression Score (HADS) were compared between the two groups 1 day before discharge. Results:At the time of outpatient visit, there was no statistically significant difference between the two groups in the comparison of all dimensions and total scores of SUPPH and the score of HADS ( P>0.05). Total SUPPH score, and self-decompression, self-decision and positive attitude score of experimental group were (110.62 ± 17.73) points, (38.74 ± 6.56) points, (11.98 ± 2.20) points, (59.90 ± 10.18) points, respectively, while in the control group, the scores were (92.86 ± 18.91) points, (32.46 ± 7.39) points, (9.76 ± 2.00) points and (50.64 ± 11.50) points, respectively, with statistically significant differences ( t values were -5.29--4.27, all P<0.01). Besides, the anxiety and depression scores of HADS in experimental group were (3.92 ± 2.25) points and (3.36 ± 2.38) points, respectively, while those in control group were (7.12 ± 3.49) points and (7.00 ± 3.53) points, respectively, and the differences were statistically significant ( t=5.45, 6.04, both P<0.01). Conclusions:The "Internet +" pre-hospital health education model can promote the self-management efficacy of patients undergoing pulmonary tumor surgery, and improve their psychological state during treatment. The study provided reference for promoting diversified extended nursing services in clinical practice.

【Objective】 To explore the characteristics of white matter degeneration in amyotrophic lateral sclerosis (ALS) patients with different onset and spreading patterns by using diffusion tensor imaging (DTI). 【Methods】 We enrolled 86 ALS patients and 44 healthy controls. The patients were divided into bulbar- and spinal-onset subgroups according to their onset site, as well as horizon, vertical, interpose/skip, and caudal-rostral subgroups based on the spreading direction of the involved regions. The white matter fiber tracts corresponding to the motor network were set as the region of interest. We used tract-based spatial statistics to evaluate differences between the above groups and the normal controls, with family-wise error (FWE) correction and P<0.05 as statistical significance. 【Results】 The white matter degeneration of ALS patients with bulbar onset was mainly limited to the corona radiation part of the corticospinal tract, while those with spinal onset showed extensive degeneration of corticospinal tract and corpus callosum Ⅲ area (FWE correction, P<0.05). In patients with horizontal and vertical dissemination, decreased integrity of the entire corticospinal tract was found, with patients in the latter group showed extra degeneration in the Ⅲ part of the corpus callosum. Restricted degeneration of the corticospinal tract within bilateral corona radiata was detected in patients with caudal-rostral and interposed/skip spreading pattens (FWE correction, P<0.05). 【Conclusion】 Different onset and disease spread patterns of ALS patients correspond to divergent brain degeneration patterns. The diagnosis, treatment, and management of ALS should fully consider the heterogeneity of the disease.

【Objective】 To investigate changes in thalamus structure and function and their associations with cognitive impairment in patients with amyotrophic lateral sclerosis (ALS). 【Methods】 3D high-resolution structural imaging and resting-state fMRI were applied in 78 ALS patients and 49 healthy volunteers. The shape of the thalamus was assessed using a vortex analysis and functional connectivity between the thalamus subregion and cortex was evaluated by a seed-based correlation analysis. Partial correlation analysis was used to evaluate the correlation between focal thalamus alterations and clinical assessments. 【Results】 Compared with the control group, vertex analysis showed significant atrophy in the prefrontal and temporal subregions of bilateral thalamus in the ALS group. Patients exhibited increased functional connectivity of motor-sensory ROI with the right motor cortex, of temporal ROI with the bilateral lateral occipital cortex, precuneus and right temporal subregion. In contrast, decreased function connectivity was found mainly between temporal ROI and paracingulate gyrus, left dorsomedial prefrontal lobe and left caudate. Partial correlation analysis showed that the functional connectivity of the precuneus, paracingulate cortex, left caudate nucleus and left prefrontal lobe was correlated with multiple cognitive performances. 【Conclusion】 Selective damage of thalamic structure and function in ALS plays an important role in cognitive and behavioral disorders.

Objective To evaluate the impact of customized rehabilitation exercise plans based on the results of cardiopulmonary exercise test(CPET)on cardiac function and prognosis in patients with chronic heart failure(CHF).Methods A total of 52 CHF patients admitted to Chengde Central Hospital from February 2020 to September 2021 were selected as the study subjects,and the patients were divided into observation group and control group according to the principle of randomized controlled study,with 26 cases in each group.The control group received rehabilitation treatment excluding exercise.The observation group was given routine rehabilitation treatment and high-intensity rehabilitation exercise plans based on CPET guidance.Above anaerobic threshold Δ50%power was exercise intensity,exercise time was 30 minutes/day,4 days/week,and intervention period was 12 weeks.Before and 12 weeks after intervention,CPET functional indicators,serum brain natriuretic peptide(BNP),left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),and 6-minute walking distance(6MWD)were measured.The Minnesota CHF quality of life questionnaire(LiHFe)was used to evaluate patient's quality of life,readmission rate and cardiogenic mortality within 1 year of follow-up,and univariate and multivariate Logistic regression analysis was used to analyze factors affecting readmission of CHF patients.Results ① Cardiopulmonary function indicators:there was no statistically significant difference in the anaerobic threshold,peak oxygen uptake,and peak oxygen pulse of CPET functional indicators before and after intervention in the control group,after intervention,the CPET functional indicators in the observation group were significantly higher than those before intervention,and the above indexes in the observation group were significantly higher than those of the control group[anaerobic threshold(mL·min-1·kg-1):10.77±1.40 vs.9.59±1.11,anaerobic threshold(%ped):78.95±11.39 vs.70.09±6.48,peak oxygen uptake(mL·min-1·kg-1):15.63±1.36 vs.14.27±1.72,peak oxygen uptake(%ped):72.42±6.91 vs.63.41±7.31,peak oxygen pulse(mL/order):11.38±1.29 vs.9.05±1.64,peak oxygen pulse(%ped):90.23±10.16 vs.80.53±6.73,all P＜0.05].②Serum indicators,cardiac function indicators,exercise ability indicators,and quality of life evaluation:there was no statistically significant difference in serum indicators BNP,cardiac function indicators LVEDD,LVEF,exercise ability indicators 6MWD,and quality of life LiHFe scores between the two groups before intervention.After intervention,BNP and LiHFe scores were significantly reduced compared with before intervention,while LVEF and 6MWD were both increased compared with before intervention,and the changes of the above indexes in the observation group were more significant than those in the control group[BNP(ng/L):313.25±77.91 vs.445.89±110.67,LVEF:0.41±0.08 vs.0.37±0.06,6MWD(m):495.62±91.35 vs.416.04±65.29,LiHFe score:23.27±6.02 vs.29.50±4.61,all P＜0.05].③ Prognostic follow-up:the readmission rate within 1 year in the observation group was significantly lower than that in the control group(23.08%vs.53.85%),and there was no statistically significant difference in the mortality rate of cardiogenic diseases between the two groups.④Logistic univariate analysis showed that hyperlipidemia,New York Heart Association(NYHA)grading,BNP,and rehabilitation exercise were factors that affect the prognosis of CHF patients[odds ratio(OR)and 95%confidence interval(95%CI)were 0.098(0.019-0.494),0.069(0.016-0.294),1.018(1.007-1.029),and 3.889(1.178-12.841),respectively,all P＜0.05].Multivariate analysis showed that after adjusting for other factors,hyperlipidemia,NYHA grading,and BNP were risk factors affecting the prognosis of CHF patients(OR and 95%CI were 0.068(0.007-0.687),0.048(0.005-0.415),1.016(1.002-1.030),respectively,with P＜0.05],the use of rehabilitation exercise therapy was a protective factor affecting the prognosis of CHF patients[OR and 95%CI were 11.179(1.135-10.124),P＜0.05].Receiver operator characteristic curve(ROC curve)analysis showed that hyperlipidemia,NYHA grading,BNP,rehabilitation exercise therapy,and combined testing all had predictive value for the patient's prognosis(all P＜0.05),and the prediction value of joint detection was the highest,with the area under the ROC curve(AUC)=0.984 and P = 0.000.Conclusion Developing a high-intensity individualized cardiac exercise rehabilitation plan under the guidance of CPET can help improve the cardiopulmonary function,cardiac function,and quality of life of CHF patients,which is of great benefit for improving the long-term prognosis of CHF patients and has high safety.

Objective:To explore the psychological resilience of adolescent leukemia survivors and analyze its influencing factors.Methods:From October 2018 to August 2020, convenience sampling was used to select adolescent leukemia survivors in the routine follow-up group and follow-up group for children with leukemia who stopped taking medication in Beijing Children's Hospital affiliated to Capital Medical University as the research object. The General Information Questionnaire, Resilience Scale for Chinese Adolescents, and the General Self-Efficacy Scale were used to investigate adolescent leukemia survivors. A total of 110 questionnaires were issued, and 106 valid questionnaires were returned, with the effective response rate of 96.36%.Results:Among 106 adolescent leukemia survivors, the total score of psychological resilience was (97.83±14.93) . The results of multiple linear regression analysis showed that disease risk, duration of drug withdrawal, and general self-efficacy were the influencing factors of psychological resilience in adolescent leukemia survivors, and the difference was statistically significant ( P<0.05) . Conclusions:The psychological resilience level of adolescent leukemia survivors is at an upper-middle level. Medical and nursing staff, the family and friends of adolescent leukemia survivors should pay active attention to survivors whose disease risk is medium or high risk or whose duration of drug withdrawal is less than 5 years, and provide them with a lot of support and help. At the same time, pay attention to the general self-efficacy of survivors, provide targeted self-care guidance or substantive help for the survivors to return to school and society so as to improve their psychological resilience.

OBJECTIVE： To explore potential mechanism of “Astragalus membranaceus-Draba nemorosa” couplet medicine for heart failure. METHODS： By network pharmacology， based on drug-like and oral bioavailability， the active components of “A. membranaceus-D. nemorosa” for chronic heart failure were screened and the targets of treating chronic heart failure were predicted by using TCMSP，GeneCards database， OMIM database and DRAR-CPI. The active component-chronic heart failure target network was established by Cytoscape 3.6.0 software. The protein-protein interaction network was constructed by utilizing STRING database. Then top 5 targets in the list of connectivity were screened and performed a molecular docking in molecular docking server. Finally， GO bioprocess analysis and KEGG pathway enrichment analysis were performed in DAVID database. RESULTS： The study predicted 28 active components in total， including 20 A. membranaceus and 12 D. nemorosa， such as kaempferol and quercetin， there were four components in common. Totally 92 target gene of active components were obtained， including heat shock protein 90α （HSP90AA1）， tyrosine protein kinase SRC gene， etc. Results of GO bioprocess analysis showed an association with mitochondrial electron transport， mitochondrial intima， cytoplasmic sol， extracellular body， mitochondrial matrix and drug response. KEGG pathway enrichment analysis showed a link with MAPK signal pathway， TGF signal pathway， PI3K signal pathway， cAMP signal pathway， protein kinase B signal pathway， EPK1 signal pathway and NF-κB signal pathway. CONCLUSIONS： “A. membranaceus-D. nemorosa” couplet medicine exerts therapeutic effects on heart failure from multiple targets as HSP90AA1， SRC and mitochondrial electron transport and MAPK signaling pathway. The study can provide reference for further researches on its material basis and mechanism.

Objective: To construct influenza B virus Vero cell adapted strain by genetic recombination technology by using the influenza B virus Vero cell adapted strain as the parent strain. Methods: The chick embryo and Vero cell were co-infected with influenza virus Vero cell adapted strain B/Malaysia/2506/2004 Va (Bv) and the vaccine strain B/massachusetts/2/2012 (BX-51B) recommended by WHO. The reassortants were screened with the anti-Bv serum. Plaque-purified reassortants were used to screen for Vero cell-adapted influenza B virus strains containing the surface antigen of the epidemic strain. Results: A Vero cell-adapted influenza B virus strain was obtained with successive passage in Vero cells. The hemagglutination inhibition test and the one-way immunogold agar diffusion test both showed that the reassortant virus was homologous to NYMC BX-51B, and sequence analysis result showed that the reassortment virus has the same HA and NA gene with the vaccine strain. Conclusion B/Malaysia/2506/2004Va (Bv) can be used as a parent strain to prepare Vero cell vaccine against influenza B virus.

Objective To strengthen the system of drug supply chain collaborative service platform in drug supply, decrease drug inventory backlog, and improve the outpatient pharmacy management capacity in outpatient pharmacy.Methods Failure mode and effects analysis (FMEA) method was used to discover the potential risks in the drug supply chain collaborative service platform and formulate the corresponding improvement measures.Results The number of drug-receiving errors dropped from 137times to 32times and the risk reduction rate was 76.64％after improving the procurement process of the supply chain service platform, which significantly reduced the risk of contracting errors.Conclusion FMEA method could help to figure out the loopholes and hidden dangers of the pharmacy system, which made the outpatient pharmacy more reasonable and accurate by constantly improving the measures of the drug supply chain collaborative service platform.