BACKGROUND: The training task for aircrew of army airmen is very heavy, the evaluation of flight personnel on psychological diathesis is performed to early discover and deal with corresponding questions.OBJECTIVE: To compare the difference of mental health between aircrew and ground crew of army airmen and provide reference data for implementing corresponding norms.DESIGN: Chester sampling investigation and paired design were applied.SETTING: the 71687 Force of Chinese PLA, the 71521 Force of Chinese PLA, Department of Epidemiology, Fourth Military Medical University of Chinese PLAPARTICIPANTS: By chester sampling, 122 aircrew and 122 ground crew of one army airmen in one stationed training troop were randomized in February 2001. The pairs were made at ratio of 1:1 according to age difference less than 3 years and same sex and nationality. The investigated persons were all male, of Han and aged varied from 23 to 52 years.METHODS: Cornell health questionnaire was adopted respectively in investigation of aircrew and ground crew of army airmen. The investigated persons finished and handed in questionnaire independently on the spot in manner of secretion and centralized filling-up. Cornell health questionnaire is composed of 18 sections, including 195 questions, involving 4 aspects,named somatic symptoms, medial and family history, general health and habit and mental symptoms. The total score of Cornell health questionnaire ≥ 30 indicates somatic and mental disturbance and the score of mental section ≥ 10 indicates mental disturbance, both of which are taken as the criteria in comparison of psychological health in receptors of two groups.MAIN OUTCOME MEASURES: Every factor score and total score in somatic and mental sections in Cornell health questionnaire for aircrew and ground crew.RESULTS: The tested results of each 122 cases in either aircrew group or ground crew group entered result analysis. Evaluated results of somatic and mental symptoms in receptors of two groups: the total score was low in Cornell health questionnaire (0-14 scores), of which, the total score in aircrew group was higher than that in ground crew group (81.5% and 59.8%,P ＜ 0.05); the score in mental section was low (0-9 scores), of which, that in aircrew group was higher remarkably than that in ground crew group (99.2% and 91.8%, P ＜ 0.01); the score for the receptors with somatic and mental disturbance (total score≥30, score in mental section ≥ 10) in aircrew group was lower than those in ground crew group (4.1% and 12.3%, P ＜ 0.05); the score for the receptors with mental disturbance (score in mental section≥ 10) in aircrew group was lower remarkably than ground crew group (0.8% and 8.2%, P ＜ 0.01). For somatic section in aircrew group, except the factors of muscle, skeleton and skin, their scores were higher than those in ground crew group (P ＞ 0.05), the scores of the rest factors were all lower than those in ground crew group, of which, the difference was significant in evaluation of factors of eye, ear, nervous system, urinary reproductive system and fatigue in comparison of two groups (P ＜ 0.05). The score of every factor in mental section of aircrew group was lower than those in ground crew group. Except tension factor, in comparison of the rest factors in two groups, the significant difference was present (P ＜ 0.05).CONCLUSION: Overall psychological health state in Cornell questionnaire of aircrew in army airmen was superior to ground crew. Aircrew still presents a part of psychological health questions, mainly in somatic section and inadaptability was the most positive response in mental section, suggesting that aircrew probably presents inadaptable phenomena.

Objective To discuss the importance of nutritional intervention through monitoring the growth and the nutritional status of children with food allergy after comprehensive nutritional intervention.Methods A total of 158 children with food allergy who were under 2 years old were divided into an intervention group and an control group according to comprehensive nutritional intervention.The intervention group received diet guidance from a dietitian regu larly and took probiotics.If necessary,nutrients (calcium,iron and zinc) could be provided.The control group was given oral guidance by the pediatrician.After 6 months 1 follow-up,growth situation was assessed in terms of height and weight indexes,and nutritional intake condition was assessed in the light of serum biochemical indexes.Results The prevalence of malnutrition in the intervention group(17.6％) was significantly lower than that in the control group (37.0％),and there was a statistical sigmficance (x2 =22.03,P ＜ 0.05);the level of zinc [(88.5 ± 9.6) μmol/L]and iron [(18.6 ± 3.4) mmol/L] in the serum were significantly higher than those [zinc:(68.2 ± 8.5) μmol/L;iron:(12.8 ±2.7) mmol/L] in the control group,and there were statistical significance (zinc:t =12.264,P ＜ 0.01;iron:t =10.762,P ＜ 0.05);the daily intake of calcium[(596.1 ± 110.3) mg] and zinc [(10.7 ± 3.7) mg] in children (＞ 6-24 months) of the intervention group were significantly higher than those [calcium:(412.8 ± 89.3) mg and zinc:(7.3 ± 2.1) mg] in the control group (calcium:t =4.011,P ＜ 0.05,zinc:t =5.367,P ＜ 0.05),and the daily intake of protein [(42.8 ± 9.4) g] in the children (＞ 12-24 months) of the intervention group was significantly higher than that [(33.2 ± 8.2) g] in the control group,and there was a statistical significance (t =3.245,P ＜0.05).Conclusions Children with food allergy have risks of malnutrition,while comprehensive nutritional intervention can obviously decrease the prevalence of malnutrition and deficiency of iron,zinc and calcium,hence normative guidance of scientific feeding of children with food allergy is needed.

Objective To investigate the value of neurite orientation dispersion and density imaging (NODDI) in quantitative evaluation of the microstructural changes in basal ganglia and thalamus in Wilson's disease (WD) patients,and to assess the diagnostic efficacy of NODDI.Methods Totally 27 WD patients (WD group) and 26 age-and sex-matched controls (control group) were enrolled.All subjects underwent MR scanning with NODDI.Parameters of NODDI,including intracellular volume fraction (Vic),orientation dispersion index (ODI) and isotropic volume fraction (Viso) of bilateral caudate nucleus,globus pallidus,putamen and thalamus were compared between the 2 groups.Correlation analysis was performed between each parameter of NODDI and clinical Young scores.Random Forest model was used to assess the relative importance of each parameter and to evaluate the diagnostic efficacy.Results The Vic and ODI of bilateral caudate nucleus,globus pallidus and putamen in WD patients were significantly lower than those in normal controls (all P＜0.05),while Viso was significantly higher than that in normal controls (all P＜0.05).The Vic of bilateral thalamus was lower,while Viso was higher in WD patients than those in normal controls (all P＜0.05),and ODI had no significant difference between the 2 groups (P=0.055).In WD patients,Vic and ODI of bilateral caudate nucleus,globus pallidus and putamen were negatively correlated with clinical Young scores.Viso of globus pallidus and putamen were positively correlated with clinical scores.The prediction accuracy of NODDI was 96.23％,and the area under ROC curve was 0.96.Conclusion NODDI can effectively evaluate changes in microstructures and metabolism during copper deposition in WD patients,and it may be useful in detecting changes of brain deep nuclei and assessing the progression of WD.

Objective To investigate the effects of Bushen Yifei Xiaozheng Decoction ( kidney-tonifying lung-boosting stasis-resolving decoction ) on the expression of key genes and proteins in Casepase-12 signaling pathways in rats with idiopathic pulmonary fibrosis ( IPF ) .Methods IPF was induced with bleomycin in rats except for the normal group .Pirfenidone was used as positive control , while Bushen Yifei Xiaozheng Decoction ( TCM ) was administered during ( TCM preventive group ) and after ( TCM treatment group ) the model established and throughout the whole experiment ( TCM preventive and treat-ment group ) .Pathological change in the rat lungs was observed with Masson staining , meanwhile the ex-pression of molecular genes and proteins involved in Caspase-12 signaling pathways was detected by using Western blot and Real-time PCR.Results Masson staining revealed that the degree of fibrosis in TCM groups improved significantly and alveolar structure changed little . Protein and gene expression of Caspase-12 pathway in the model group was higher than those of normal group (P<0.05).In addition, the protein and gene expression of pirfenidone group and TCM groups were less than the model group ( P<0.05 or P<0.01), especially TCM preventive and treatment group .Conclusion Bushen Yifei Xi-aozheng Decoction could inhibit the process of pulmonary fibrosis via acting on the gene expression of Caspase-12 pathway and releasing the endoplasmic reticulum stress .

Background::The role of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in children with high-risk (HR) T-cell acute lymphoblastic leukemia (T-ALL) in first complete remission (CR1) is still under evaluation. Moreover, relapse is the main factor affecting survival. This study aimed to explore the effect of allo-HSCT (especially haploidentical HSCT [haplo-HSCT]) on improving survival and reducing relapse for HR childhood T-ALL in CR1 and the prognostic factors of childhood T-ALL in order to identify who could benefit from HSCT.Methods::A total of 74 newly diagnosed pediatric T-ALL patients between January 1, 2012 and June 30, 2018 were enrolled in this retrospective study. Patients were stratified into the low-risk chemotherapy cohort ( n = 16), HR chemotherapy cohort ( n = 31), and HR transplant cohort ( n = 27). Characteristics, survival outcomes, and prognostic factors of all patients were then analyzed. Results::Patient prognosis in the HR chemotherapy cohort was significantly worse than that in the low-risk chemotherapy cohort (5-year overall survival [OS]: 58.5% vs. 100%, P = 0.003; 5-year event-free survival [EFS]: 54.1% vs. 83.4%, P = 0.010; 5-year cumulative incidence of relapse [CIR]: 45.2% vs. 6.3%, P = 0.011). In HR patients, allo-HSCT improved the 5-year EFS and CIR compared to that of chemotherapy (5-year EFS: 80.1% vs. 54.1%, P = 0.041; 5-year CIR: 11.6% vs. 45.2%, P = 0.006). The 5-year OS was higher in the HR transplant cohort than that in the HR chemotherapy cohort (81.0% vs. 58.5%, P = 0.084). Minimal residual disease re-emergence was an independent risk factor for 5-year OS, EFS, and CIR; age ≥10 years was an independent risk factor for OS and EFS; and high white blood cell count was an independent risk factor for EFS and CIR. Conclusion::Allo-HSCT, especially haplo-HSCT, could effectively reduce relapse of children with HR T-ALL in CR1.

Objective: To construct the BCMA-CAR using the B-cell maturation antigen (BCMA) specific ligand APRIL as antigen binding region and to validate the effect of BCMA-CAR modified T cells (BCMA-CAR-T) on myeloma cells. Methods: The BCMA-CAR was constructed using the BCMA specific ligand APRIL as antigen binding domain and 4-1BB as the costimulatory domain. The specific cytotoxicity against BCMA⁺ myeloma cell lines and primary multiple myeloma (MM) cells in vitro were evaluated. In addition, BCMA⁺ myeloma xenograft mouse model was established to assess the anti-tumor effect of BCMA-CAR-T cell therapy in vivo. Results: BCMA-CAR-T cells could specifically kill BCMA⁺ myeloma cell lines (For BCMA-CAR-T cells, BCMA⁺ cells are almost undetectable in the E∶T ratio of 1∶4) and MM patients’ bone marrow mononuclear cells (the proportion of residual cells in BCMA-CAR-T and vector-T groups was 16.0% vs 66.85%, P=0.003) with significant degranulation (CAR-T and vector-T cells cocultured with MM1.S, H929 and U266 had degranulation levels of 33.30% vs 5.62%, 16.97% vs 2.95% and 25.87% vs 2.97%, respectively, P<0.001) and cytokines release (P<0.01) in vitro. In a human BCMA⁺ myeloma xenograft mouse model, BCMA-CAR-T cells could significantly prolong the survival of mice (The median survival time of mice treated with BCMA-CAR-T and vector-T cells was 87.5 days and 67.5 days, respectively, P<0.001) . Conclusion The ligand-based BCMA-CAR-T cells could be a promising strategy for BCMA⁺ multiple myeloma treatment.

Objective To analyze the risks and related influencing factors of early screening for lung cancer,and to study prognostic factors based on survival conditions,in order to ultimately provide baseline data for the prevention and treatment of lung cancer.Methods A cluster sampling method was used to select 40 to 75 year old registered residence residents in 10 districts and 6 counties of Zhengzhou City in 2020 as screening objects.Through voluntary participation and filling in evaluation questionnaires,high-risk groups of lung cancer were evalu-ated,and then three screening tests(tumor markers,low-dose spiral CT and lung function)were performed on high-risk groups.Finally,we will adopt an active and passive follow-up approach to collect information on diag-nosed lung cancer patients.Statistically describe the screening data and describe the epidemiological results of different characteristic populations;Using multivariate logistic regression method for statistical analysis,compare the differences in various results of different factors.Results 50128 cases of early screening for lung cancer in Zhengzhou City were evaluated in 2020,with a completion rate of 100.26%.The average age of the survey was(59.86±17.67)years old,and the gender ratio was 0.81∶1.The high-risk detection rate is 30.15%.Multivariate logistic regression analysis showed that males(smoking)(OR=5.43,95%CI:5.20～5.67),individuals with a history of tobacco exposure(OR=3.82,95%CI:3.67～3.98),first-degree relatives who had previously suffered from lung cancer(OR=12.06,95%CI:11.02～13.20),and other populations were more susceptible to lung cancer(all P<0.05).Conclusion Male(smoking),exposure to secondhand smoke,cancer in first-degree relatives,previous diagnosis of other tumors,symptoms of lung infection,"chest tightness,shortness of breath,and difficulty breathing in daily life",and"significant psychological trauma in the past 3 years"are independent risk factors for lung cancer,which should be given special attention and effective intervention measures should be taken.

Objective:To analyze the influence of CD19 isoforms to the efficacy of CD19/CD3 Bispecific T-cell Engager (BiTE) antibody, and explore the resistance mechanism of BiTE immunotherapy.Methods:Semi-quantitative RT-PCR (qRT-PCR) was used to detect the expression of CD19 mRNA isoforms before and after BiTE treatment in a patient with CD19 + B cell acute lymphoblastic leukemia (ALL) . CD19 isoforms were analyzed by Sanger sequencing. Flow cytometry and transcriptome sequencing were performed to analyze the expression of cell lineage specific molecules before and after BiTE treatment. Results:The expression of CD19 isoform with exon 2 deletion was identified at diagnosis. After relapsed and treatment of BiTE antibody, the patient did not achieve remission and CD19 antigen on leukemic cells turned negative detected by flow cytometry after BiTE treatment. However the expression ratio of CD19 isoform with exon 2 deletion was not increased. Flow cytometry phenotype and transcriptome sequencing confirmed that no linage switching developed, which suggested the expression of CD19 isoform caused by exon alternative splicing and lineage switching was not related to CD19 epitope loss in this patient. This patient achieved complete remission by sequential administration of self-developed CD22 CAR-T and CD19 CAR-T after disease progression.Conclusion:Targeting or combining an alternative antigen specific CAR-T may be a promising treatment option after losing CD19 expression in relapsed ALL.

Objective:To study the distribution and drug resistance of Carbapenem-Resistant Organism (CRO) and to analysis the risk factors of CRO 30-day mortality.Methods:A total of 181 patients with CRO infection diagnosed in Department of Hematology, Fujian Medical University Union Hospital from January 2018 to June 2020 were retrospectively investigated. The clinical and laboratory data of the patients were collected, the prognosis of patients diagnosed with CRO infection in day 30 was followed up, and the risk factors of prognosis were analyzed. The clinical significance of Carbapenem-Resistant Enterobacteriaceae (CRE) active screening was further evaluated in the CRE subgroup.Results:Among the total of 181 CRO isolates, 47.2% were CRE, 37.0% were Pseudomonas aeruginosa, and 32.6% were Klebsiella pneumoniae, which were highly resistant to carbapenem and had high MIC value, 76.8% (139/181) of CRO were MIC of imipenem resistance≥16 μg/ml. The main sources of isolates were blood and sputum. The 30-day all-cause mortality rates of patients with CRO or CRE infection were (41.4±3.7) % and (44.7±5.4) %, respectively. The COX multivariate regression analysis showed that the level of procalcitonin >0.2 ng/ml and the MIC value of imipenem resistance ≥ 16 μg/ml were independent risk factors for 30-day mortality of CRO infected patients. The CRE subgroup analysis showed that MIC value of imipenem resistance ≥16 μg/ml were independent risk factors for 30-day mortality of CRE infected patients. The 30-day cumulative survival rate of patients with CRE active screening was higher than the patients without CRE active screening [ (68.0±9.3) % vs (50.0±6.5) %, P=0.21]. Conclusion:The high MIC value of imipenem resistance isolates seriously affects the prognosis of patients with CRO infection in the hematology department, and the mortality rate was high. CRE active screening is expected for early prevention, early diagnosis, and early treatment for high-risk patients.

Objective:To prepare a novel tri-specific T cell engager (19TriTE) targeting CD19 antigen, and to investigate its immunotherapeutic effect on CD19-positive hematological malignancies.Methods:19TriTE was constructed by molecular cloning technology and successfully expressed through the eukaryotic expressing system. The effects of 19TriTE on the proliferation and activation of T cells, as well as the specific cytotoxicity against CD19 positive tumor cell lines were verified.Results:①19TriTE expressing plasmid was constructed and successfully expressed through the eukaryotic expressing system. ②19TriTE can specifically bind to T cells and Nalm6 cells, with equilibrium dissociation constants of 19.21 nmol/L and 11.67 nmol/L, respectively. ③The expression rates of CD69 positive T cells and CD25 positive T cells were 35.4% and 49.8% respectively, when 2 nmol/L 19TriTE were added in the co-culture system, which were significantly higher than those in the control group. ④19TriTE can significantly promote the proliferation of T cells. The absolute count of T cells expanded from the initial one million to 74 million with an 74 fold increase at the concentration of 1 nmol/L on day 12. ⑤19TriTE can significantly mediate T cells killing of CD19 positive target cells in a dose-dependent manner. At the concentration of 10 nmol/L, the target cells lysis reached 50%. ⑥Degranulation experiment verified that 19TriTE can activate T cells in the presence of CD19 positive target cells, and the activation of T cells positively correlated with the dose of 19TriTE. ⑦When 19TriTE fusion protein co-cultured with T cells and target cells overexpression RFP and luciferase genes respectively, 19TriTE can notably mediate T cells killing of CD19 positive target cells through fluorescent microscope or bioluminescence imaging technology.Conclusion:In this study, we successfully constructed and expressed 19TriTE fusion protein and verified that it can effectively activate T cells and promote their proliferation in vitro. At the same time, it can bind to CD19 positive target cells and T cells, as well as enhance T cells anti-leukemia effect in vitro, providing the foundation for further clinical research.