Objective To develop the Dissociative Trait Scale(DTS),and examine its reliability and validity. Methods Based on literature and research work,a preliminary questionnaire was designed to measure dissociative trait. 1306 college students completed the DTS and Symptom Checklist 90(SCL-90). Results Exploratory factor analysis extracted eight factors. The percentage of variance explained was 57.69％. The Cronbach α-coefficient of the total scale and the eight subscales ranged from 0. 830 ～ 0. 969, the test-retest reliability ranged from 0.575 ～ 763 (P ＜ 0.01 ). The scores of DTS significantly positively correlated with the scores of SCL-90 (P ＜0.01 ). Conclusion The DTS has acceptable psychometric quality,and can be applied to assess dissociative traits in Chinese college students.

Objective:To investigate the efficacy and safety of liposomal amphotericin B (L-AmB) for the salvage treatment of invasive fungal disease (IFD) in patients with hematological diseases.Methods:Data were retrospectively collected from 80 patients with hematological issues treated with L-AmB between June 2023 and December 2023 after failure of previous antifungal therapy. Baseline patient information, clinical efficacy, and factors affecting the efficacy of L-AmB were analyzed by logistic regression. Moreover, adverse effects associated with L-AmB were evaluated.Results:Among the 80 patients, 9 (11.2%) had proven IFD, 43 (53.8%) had probable IFD, and 28 (35.0%) had possible IFD. The efficacy rate of L-AmB salvage therapy for IFD was 77.5%, with a median daily dose of 3 (range: 1-5) mg·kg -1·d -1 and a median dosing course of 14 (range: 8-25) days. Multivariate logistic regression analysis showed that the disease remission status ( OR=4.337, 95% CI 1.167-16.122, P=0.029) and duration of medication ( OR=1.127, 95% CI 1.029-1.234, P=0.010) were independent factors affecting the efficacy of L-AmB. The incidence of infusion reactions associated with L-AmB, including fever and chills, was 5.0%. The incidence of hypokalemia was 28.8% (predominantly grades 1-2), and the incidence of nephrotoxicity was 11.3% (predominantly grades 1-2) . Conclusion:L-AmB is safe and effective in the treatment of patients with IFD who are intolerant to or who have experienced no effect of previous antifungal therapy, with a low rate of adverse reactions.

Objective:To analyze the efficacy and safety of CLAG regimen (cladribine, cytarabine, granulocyte colony-stimulating factor) in treatment of relapsed/refractory acute myeloid leukemia (AML).Methods:The clinical data of 30 patients with relapsed/refractory AML who were admitted to Suzhou Hongci Blood Disease Hospital from January 2018 to February 2021 were retrospectively analyzed, and the efficacy and adverse reactions were observed.Results:Among 30 patients, 1 patient was not evaluated for efficacy due to treatment-related death. Among the 29 evaluable patients, 17 patients (58.6%) achieved complete remission (CR), 5 patients (17.3%) achieved partial remission (PR) and 7 patients (24.1%) had no remission (NR). One patient in low-medium-risk group achieved CR; the CR rate in medium-risk group was higher than that in high-risk group [68.8% (11/16) vs. 41.7% (5/12)], but the difference was not statistically significant ( P = 0.250). Seven patients with M 5 achieved CR. Five patients with positive MLL gene rearrangement achieved CR. Among 6 patients with extramedullary invasion of leukemia cells, 4 patients achieved CR, and among them 3 patients with central nervous system invasion achieved CR. Among 6 patients with cladribine 3.5 mg·m -2·d -1×5 d, 1 patient died of infection after chemotherapy, 1 patient had NR, and the rest achieved CR. Among 24 patients with cladribine 5 mg·m -2·d -1×5 d, the CR rate in patients with cytarabine 2 g·m -2·d -1×5 d was higher than that in patients with cytarabine 1 g·m -2·d -1×5 d [70.0% (7/10) vs. 42.9% (6/14)], but the difference was not statistically significant ( P = 0.240). All patients developed grade Ⅳ myelosuppression after chemotherapy. 12 patients underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT) after CR, and 9 patients were still alive. Conclusions:CLAG regimen is effective and well tolerated in the treatment of relapsed/refractory AML. In order to improve the prognosis, allo-HSCT should be performed as soon as possible after CR.

Objective:To evaluate the effect of mindfulness-base cognitive therapy (MBCT) in improving patients with depression, and to explore its effect on patients early maladaptive schemas (EMSs).Methods:Sixty patients with depressive disorder were included in the pre- and post-control design, and MBCT treatment was carried out for 8 weeks. The Hamilton depression scale-17 (HAMD-17), Hamilton anxiety scale (HAMA), five facet mindfulness questionnaire (FFMQ), and Young schema questionnaire-short form (YSQ-SF) were used for evaluation. The scores of the three time points were compared by one-way repeated measure ANOVA and Kruskal Wallis test. Pearson correlation analysis and multiple linear regression analysis were used to explore the relationship between the improvement degree of depression and anxiety symptoms, as well as the changes of mindfulness level and schema.Results:There were significant differences in the total scores of HAMD-17, HAMA and FFMQ at baseline((15.4±5.0), (21.0±9.6), (115.8±11.7)), 4 weeks after intervention((11.4±6.7), (15.9±10.1), (121.9±14.2)) and 8 weeks((11.0±6.2), (15.4±8.7), (122.6±15.5)) after intervention ( F=25.22, 20.95, 14.02, all P<0.01). Further pairwise comparison, compared with baseline, the total scores of HAMD-17 and HAMA in patients with depression decreased (all P<0.05), and the total scores of FFMQ increased (all P<0.05) in 8 weeks and 4 weeks after treatment.There were no significant differences in the total scores of HAMD-17, HAMA and FFMQ between 8 weeks and 4 weeks after treatment (all P>0.05). There were significant differences on the scores of the emotional deprivation, abandonment/instability, failure, vulner ability to harm or illness, enmeshment/undeveloped self, unrelenting standards/hypercriticalness, and entitlement/grandiosity subscales in the YSQ-SF( H=2.00-17.11, all P<0.05). Regression analysis showed that the FFMQ total score difference has a linear relationship with the HAMA total score difference ( β=-0.363). There was a linear relationship between the emotional deprivation scale score difference and the HAMD-17 total score difference ( β=-0.292). Dependence/incompetence and submission scale score difference showed a linear relationship with the HAMA total score difference ( β=0.334, 0.278). Conclusion:MBCT can improve the anxiety and depression symptoms of patients with depression, and the improvement of some EMSs may be the mechanism of MBCT in the treatment of depression.

Objective:To summarize the clinical characteristics of an early death in patients with de novo acute promyelocytic leukemia (APL) , analyze the risk factors and direct causes of early death, and perform survival analysis.Methods:The clinical data of 368 patients with de novo APL in three centers (First Affiliated Hospital of Soochow University, Soochow Guangci Hospital, and Soochow Hopes Hospital of Hematology) during January 2011-December 2017 were retrospectively analyzed. The clinical characteristics of patients who suffered hemorrhagic early death and non-hemorrhagic early death were compared. The risk factors for early death, survival, and prognosis of patients with APL were analyzed.Results:Among the 368 de novo APL patients, 31 died early with an early mortality rate of 8.4%. The median time from diagnosis to death was 7 (0-29) d. On comparison of the clinical characteristics of patients with early death and non-early death and subsequent multivariate analysis using a logistic regression model, it was observed that age ≥50 years and WBC ≥10×10 9/L were independent risk factors for early death ( P<0.01) . A total of 27 (87.1%) of the 31 early deaths was directly attributed to hemorrhage as the immediate cause of early death. Hemorrhage was the only cause of death in patients <50 years old and the major cause of death in patients ≥50 years old. A comparison of the clinical characteristics of patients with hemorrhagic early death and patients with non-hemorrhagic early death suggested that the median age and indirect bilirubin concentration of patients with hemorrhagic early death were lower than those with non-hemorrhagic early death ( P<0.05) . The median follow-up time for all patients was 41.0 (0.3-101.4) months. The 2-year overall survival (OS) rate was (93.5±1.3) %, and the 5-year OS rate was (91.0±1.5) %. The 2-year disease-free survival (DFS) rate was (98.8±0.6) %, and the 5-year DFS rate was (97.1±0.9) %. The 2-year OS rate of patients ≥50 years old and patients <50 years old was 79.3% vs 94.2%, P=0.000; the 2-year DFS rate was 92.3% vs 98.1%, P=0.023. The respective 2-year OS rates of high-risk and non-high-risk patients were 77.3% and 96.7% ( P=0.000) and the respective 2-year DFS rates were 94.0% and 98.4% ( P=0.139) . Conclusion:Age and WBC are independent prognostic factors for early death. We observed a difference in early mortality between high-risk and low-risk APL, but no difference in DFS rate.