Objective To investigate the clinical value of low-dose decitabine (DAC) in elderly patients with acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS) patients with intermediate-or high-risk. Methods Low-dose DAC (10 mg/d, 7 days) combined with CAG regimen were given to 19 elderly patients with AML and intermediate- or high-risk MDS patients. The efficacy and adverse reactions were evaluated after a course of treatment, and the patients were followed up for survival. Results After a course of treatment, 8 patients achieved complete remission (CR), 7 patients achieved partial remission (PR). After 4 courses of treatment, 68.4 % (13/19) of patients achieved CR, the overall response rate reached 78.9% (15/19). Fewer side effects were seen associated with chemotherapy. After 42 months of follow-up, there were 12 survival cases, the median survival time was 13.5 months (3-42 months). Conclusion Low-dose DAC combined with CAG regimen have a better efficacy, higher safety, and lower economic burden for elderly AML patients and intermediate- or high-risk MDS patients, which is beneficial to greatly improve patients' compliance.

Objective To investigate the effects of mirror visual feedback (MVF) and electromyographic biofeedback (EMGBF) on upper extremity function in hemiplegic patients after stroke based on task-oriented training. Methods 90 patients with hempiplegia after stroke were randomly divided into control group (n=30), EMGBF group (n=30) and MVF group (n=30). All patients accepted routine rehabilitation and task-oriented training once a day for 8 weeks. The EMGBF group also accepted EMGBF, and the MVF group accepted MVF in addition. They were assessed with Fugl-Meyer Assessment (FMA) and the Upper Extremity Function Test (UEFT), and their integrated electromyogram (iEMG) of affected upper extremities were recorded before and after treatment. Results All the groups improved in scores of FMA and UEFT, as well as the iEMG after treatment (P<0.05), and ranked as the MVF group, the EMGBF group and the control group from improving more to less (P<0.05). Conclusion Mirror visual feedback combined with electromyographic biofeedback may further promote the recovery of upper limb function in patients with hemiplegia after stroke based on task-oriented training.

To investigate the clinical features, genetic diagnosis, and treatment of a patient with Prader-Willi syndrome(PWS). For a case with clinically suspected PWS, methylation specific PCR(MSPCR)amplification was applied to CpG islands of SNRPN(exon α)gene locus in the 15q11-q13. Furthermore, the diagnosis was comfirmed by the method of bisulfite sequencing PCR(BSPCR). Metabolic status before and after the operation of sleeve gastrectomy were compared. Absence of amplification of paternal allele on chromosome 15q11-q13 was detected in the case by MSPCR, different from the normal control. Results of BSPCR further proved a full methylation of CpG islands in the SNRPN gene locus. Four months after sleeve gastrectomy, systemic metabolic status and ventricular function were improved. MSPCR and BSPCR were both consistent with genetic diagnosis of PWS. Weight loss surgery is expected to be a major therapy of this disease.

Objective:To explore the application effect of TBL (team-based learning) + PAL (peer assisted leaning) + Flipped Class mixed teaching mode in the course of "nursing psychology" for nursing undergraduates.Methods:A total of 146 nursing undergraduates from four classes enrolled in 2018 were subjected to cluster sampling and assigned to classes 1-2 (experimental group, n=73) and classes 3-4 (control group, n=73). The experimental group adopted the TBL + PAL + Flipped Class mixed teaching mode, while the control group adopted the traditional teaching method. After the course, the two groups were evaluated by final exam score, case analysis score, and core competence self-assessed score with a t-test in SPSS 18.0. Results:The final examination score (82.30±7.77) and case analysis score (46.13±2.91) of the experimental group were significantly higher than those in the control group (74.97±7.05 and 40.36±4.25). The experimental group showed significantly higher scores in autonomous learning ability (8.03±0.91), problem analysis ability (7.99±0.99), teamwork ability (7.67±1.09) and critical thinking ability (7.03±1.33) as compared with the control group (6.21±1.17, 5.64±1.28, 5.79±1.27, 5.15±1.16).Conclusion:TBL + PAL + Flipped Class mixed teaching mode integrates the advantages of the three teaching forms, promotes students' understanding and application of knowledge points, improves students' ability of independent learning, teamwork, and problem analysis, strengthens students' ability of transfer and application of knowledge and skills, increases the teaching effect, and expands the teaching method of nursing psychology.

Objective To investigate the clonal rearrangement characteristics and clinical application value of IGH gene in B-cell non-Hodgkin’s lymphoma (B-NHL). Methods Demographic and clinical data as well as IGH sequencing results of 55 patients with B-NHL who underwent next-generation sequencing (NGS) testing were collected, and IGH gene clonal rearrangement was detected. The characteristics of IGH gene clonal rearrangement, IGHV gene usage, and the clinical application value of NGS for IGH clonal rearrangement were analyzed. Results Among 55 patients with B-NHL and IGH clonal rearrangement, single dominant clones were mainly detected (85.45%, 47/55); a few patients had two (12.73%, 7/55) and three dominant clones (1.82%, 1/55). In terms of preference for IGHV gene usage, IGHV3 gene had the highest frequency of access in B-NHL, followed by IGHV4. Among the IGHV subtypes, IGHV3-23 had the highest frequency in chronic lymphocytic leukemia/small lymphocytic lymphoma, and IGHV4-34 had the highest frequency in primary central nervous system diffuse large B-cell lymphoma and not otherwise specified diffuse large B-cell lymphoma. Conclusion A preference for IGHV gene usage in clonal rearrangement of IGH genes is noted in B-NHL patients with different pathological types. Using NGS to detect IGH clonal rearrangement can identify subclones and clonal correlations, and assist in disease diagnosis.

OBJECTIVETo observe the effect of rosiglitazone on the content of cholesterol and expressions of Acy-coenzyme A: cholesterol acyltransferase 1 (ACAT-1) and scavenger receptor class B type I (SR-BI) in RAW264.7 macrophage-derived foam cells and explore the anti-atherosclerotic mechanism of rosiglitazone.

METHODSRAW264.7 macrophages were incubated with oxidized low-density lipoproteins (ox-LDL) or with both ox-LDL and rosiglitazone (5, 10, or 20 µmol/L). Oil red O staining was used to observe the formation of foam cells, and cholesterol oxidase was used to determine the content of cellular cholesterol contents. Western blotting was used observe the expressions of ACAT-1 and SR-BI in RAW264.7 foam cells.

RESULTSCompared with the control cells, RAW264.7 macrophage-derived foam cells showed significantly increased contents of total cholesterol and free cholesterol (P<0.01) and ACAT-1 expressions (P<0.05) with mildly increased SR-BI expression (P>0.05). Rosiglitazone treatments significantly lowered the contents of total cholesterol and free cholesterol (P<0.05), decreased the expression of ACAT-1 (P<0.05), and increased SR-BI expression (P<0.05) in the foam cells in a dose-dependent manner.

CONCLUSIONRosiglitazone can decrease the contents of total and free cholesterol, down-regulate ACAT-1 expression and up-regulate SR-BI expression in the foam cells produce the anti-atherosclerotic effect.

Acetyl-CoA C-Acetyltransferase ; metabolism ; Cell Line ; Cholesterol ; metabolism ; Foam Cells ; cytology ; drug effects ; metabolism ; Humans ; Scavenger Receptors, Class B ; metabolism ; Thiazolidinediones ; pharmacology

Objective: To perform an epidemiological survey of the first case with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in Pinghu City of Jiaxing City, Zhejiang Province on March 13, 2022, so as to provide insights into the management of coronavirus disease (COVID-19) epidemics. Methods: According to the requirements of the Protocol on Prevention and Control of COVID-19 (8th Edition), epidemiological investigations were performed among 39 cases with SARS-CoV-2 infections in Pinghu City from March 13 to 20, 2022. Cases' demographics, clinical symptoms, history of immunization and exposure were collected, and close contacts were identified. Pharyngeal swabs were sampled from infected cases for detection of SARS-CoV-2 nucleic acid and whole-genome sequencing, and the source of infection and transmission route were investigated. Results: The index case for this COVID-19 epidemic was an imported case from Shanghai Municipality, who infected 6 persons via aerosol transmission when playing in the badminton venue of Pinghu National Fitness Center on March 9; subsequently, one of these infected cases infected another 18 persons when playing in the badminton venue of Jiadian Village Resident's Fitness Center in Zhapu Township on March 12. Sixteen confirmed cases were reported, and all cases were mild; another 23 asymptomatic cases were diagnosed, with no death reported. This epidemic occurred from March 11 to 20, with 3 generations of spread and a median incubation period of 3 days. The SARS-CoV-2 infected cases had a median age of 33.5 (interquartile range, 12.0) years and included 36 cases with a history of COVID-19 vaccination. There were 16 cases with fever, cough, runny nose and sore throat, and 13 cases with imaging features of pneumonia. The effective reproductive number (Rt) of the COVID-19 epidemic was 7.73 at early stage, and was less than 1 since March 21. Whole-genome sequencing identified Omicron BA.2 variant among 33 cases, which had high homology with the index cases. Conclusion This epidemic was a cluster of COVID-19 caused by imported Omicron BA.2 variant infection from Shanghai Municipality, and the COVID-19 transmission was mainly caused by indoor aerosols.

Intractable hypokalemia and hypocalcemia are rare complications in leukemia patients. This article reports a patient with chronic myelomonocytic leukemia (CMML)with refractory hypokalemia, hypocalcemia, hypochloridemia, hypomagnesemia-a 48-year-old man complained of fatigue, nausea, and face numbness for over one month. The number of monocytosis in peripheral blood and bone marrow increased remarkably. At the same time, the patient developed hypokalemia, hypochloridemia, hypocalcemia, hypomagnesemia, metabolic alkalosis, massive proteinuria, and increase in plasma aldosterone and renin. After two coursea of treatment using Azacitidine therapy, complete remission of bone marrow was achieved and the electrolyte disturbance was almost corrected, except hypomagnesemia. We summarize the clinical characteristics of the patient so as to raise the clinical awareness of such cases.

Objective: Previous research has explored a variety of mental disorders associated with Internet Gaming Disoder (IGD) and Social Media Addiction (SMA). To date, few studies focused on the network characteristics and investigated mood and sleep symptoms across SMA and IGD of adolescence at a group-specific level. This study aims to identify different characteristics of IGD and SMA and further determine the group-specific psychopathology process among adolescents. Methods: We conducted a cross-sectional study to recruit a cohort of 7,246 adolescents who were scored passing the cutoff point of Internet Gaming Disorder Scale-Short Form and Bergen Social Media Addiction Scale, as grouped in IGD and SMA, or otherwise into the control group. Patient Health Questionnaire-9, Generalized Anxiety Disorder 7-item, and Pittsburgh Sleep Quality Index were assessed for the current study, and all assessed items were investigated using network analysis. Results: Based on the analytical procedure, the participants were divided into three groups, the IGD group (n=789), SMA group (n=713) and control group (n=5,744). The edge weight bootstrapping analysis shows that different groups of networks reach certain accuracy, and the network structures of the three groups are statistically different (pcontrol-IGD=0.004, pcontrol-SMA<0.001, pIGD-SMA<0.001). The core symptom of SMA is “feeling down, depressed, or hopeless”, while IGD is “feeling tired or having little energy”. Conclusion Although IGD and SMA are both subtypes of internet addiction, the psychopathology processes of IGD and SMA are different. When dealing with IGD and SMA, different symptoms should be addressed.