Objective By exploring difference of mental characteristics,coping style,social support and health between schizophrenia primary affection and convalescent schizzy,it's expected that the related rationale will be developed for further formulating treatment for schizophrenia primary affection and convalescent schizophrenia.Methods By taking advantage of symptom checklist,questionnaire of NEO-FFI,Simplified Coping Style Questionnaire,social support scale,we compared 150 schizophrenia primary affection who were under the clinic of new antipsychotics and in convalescent period (schizzy group)with 169 normal persons (normal group)on the mental characteristics,coping style,social support and mental health of individual and correlation.Results The following factors of scl-90 showed statistical significance between patient group and normal group:somatization (1.83±0.14) vs.(1.27-±0.48),interpersonal sensitivity(1.96±0.21) vs.(1.65±0.51),depression(1.89±0.24) vs.(1.50±0.59),anxiety(1.69±0.15) vs.(1.39±0.43),photic anxiety (1.56±0.13) vs.(1.23±0.41),psychoticism factors (1.56± 0.14) vs.(1.23±0.41) (all P＜0.01).The personality traits differences between patient group and normal group were as follows:neuroticism (3.13± 0.15) vs.(2.61 ± 0.36),extraversion (2.96± 0.31) vs.(3.19± 0.23),agreeableness (3.20± 0.25) vs.(3.48±0.35) and conscientiousness (3.19±0.65) vs.(3.42± 0.16),and all these factors showed statistical significance with P＜0.01.The differences of subjective support factors between patients group and normal groups were as follows:subjective support (23.51 ±3.62) vs.(26.29±3.91),objective support (7.35±2.07) vs.(8.91 ± ±2.89),support use (7.61± 1.23) vs.(8.97± 1.35) and total score of supports (37.63± 6.52) vs.(43.51 ± 6.32) and the scores of patients group were poorer than those of normal group(P＜0.01).These two groups also showed statistical significance in coping styles:positive coping style(27.03±6.05) vs.(33.75±4.53) and negative coping style (32.63±5.31) vs.(43.51±6.32),patient group got lower scores than normal group(P＜0.01).Depression factor and obsessive compulsive symptom factor,objective support and hostility factor,passive coping and hostility,neuroticism factor in patients group are positive correlation,and photic anxiety factor and obsessive compulsive symptom,depression factor,conscientiousness factor and psychoticism factor,passive coping,neuroticism factor and somatization factor were negative correlation.Conclusion A effective recovery plan of treatment of schizophrenia primary affection and convalescent schizzy must integrate medical perspective,active interest in his personality characteristics,mental health,coping style,social support.

Objective To compare the effect of pedicles screw fixation through entry point of the “人" shape crest and traditional entry point (Weinstein method). Methods Ninety-two patients of lumbar spine disorders were treated by pedicles screw fixation combined with bone grafting through posterior approach. The screws were placed through the traditional entry point among 45 patients (group A, transverse process method, 186 screws), the others were through entry point of the “人" shape crest (group B, “人" shape crest method, 196 screws). The condition of accuracy of screw placement, operation time, bleeding amount and injury were compared. Results All patients accepted the examination of X-ray and CT scan after operation. The rate of screw bad placement was 6.5% in group A and 2.0% in group B, the incidence of injury of nerve and blood vessel was 8.9% in group A and 2.1% in group B. The accuracy of screw placement, operational time and bleeding amount in group B were significantly better than those in group A (P

Objective:To understand the characteristics of scientific research cooperation network, research hotspots, evolution paths and development trends of advance care planning (ACP) , so as to provide reference for follow-up related research.Methods:With the theme of "advance care planning", the retrieval results based on Web of Science core collection database were respectively imported into VOS viewer and CiteSpace for visual analysis, and the retrieval time was from database construction to February 3, 2021.Results:A total of 2 456 articles meet the selection criteria. The annual publications were all less than 50 from 1993 to 2009, which showed a rapid upward trend from 2010 to now. The distribution trend of citation frequency was basically the same as that of publications. Most of the authors and institutions are European and American. Chan Helen Yue-lai of the Chinese University of Hong Kong ranked first in China and 19th in the world in terms of publicationsand Chinese scholars' research in this field is still in its infancy. Research hotspots included ACP alternative decision-making skills training, and the research frontiers and evolutionary paths included ACP, severe mental illness, alternative decision-making, life planning, end-stage renal disease, doctor's orders, ACP model, advanced dementia, chronic heart failure, etc.Conclusions:Since 2010, the number of articles published in this field and the frequency of citations have shown a rapid upward trend. The United States, Belgium, Canada and other countries have developed well in this field and Scholars of China have a wide space for development in this field. The advanced research experience reported in the foreign ACP literature can be used for reference to deepen and speed up the clinical practice research in the field of ACP in China.

Objective: To probe the feasibility of decitabine (DAC) combined with micro-transplantation as consolidation treatment for older patients with acute myeloid leukemia (AML). Methods: Between November 2012 and September 2015, 37 consecutive patients with AML ≥60 years of age were analyzed. Of them, 19 patients received consolidation therapy with DAC followed by micro-transplantation (microtransplant group). Another 18 ones (chemo group) were treated with DAC plus priming regimen as consolidation chemotherapy in the same period. Results: There were no significant differences in terms of age, WBC count, and disease status of onset between the microtransplant and chemo groups (P>0.05). The two regimens were well tolerated. There was no difference of CTC grade 3-4 nonhematologic toxicities between the microtransplant and chemo groups (36.8% vs 27.8%, χ²=0.347, P=0.728). The median recovery durations for neutrophil and platelet in the microtransplant group were similar to those in the chemo group (12 vs 13 days, z=1.599, P=0.110; 14 vs 12 days, z=-1.314, P=0.189, respectively). No graft-versus-host disease was observed in the microtransplant group. The 2-year leukemia-free survival and overall survival were better in microtransplant group (50.7% and 54.9%, respectively) than in chemo group (24.3% and 30.0%, respectively) (P=0.047 and P=0.071, respectively). Conclusion DAC combined with micro-transplantation as a consolidation regimen may be a safe and promising option for older patients with AML.

OBJECTIVETo evaluate the efficacy and safety of anagrelide in essential thrombocythemia (ET).

METHODSPatients who diagnosed as ET according to the World Health Organization classification were enrolled. Each patient was assigned to take anagrelide hydrochloride capsule or hydroxyurea tablet by random 1∶1 ratio. Dose of anagrelide started at 2 mg/d, then increased gradually and the maximum dose was 10 mg/d until the platelet counts dropped to (100-400) × 10⁹/L, one month later gradually reduced to maintain dose. The dose of hydroxyurea was 1000 mg/d at beginning, then increased gradually, when platelet counts dropped to (100-400)×10⁹/L and kept for one month, reduced to maintain dose as 10 mg·kg⁻¹·d⁻¹. The observation period was 12 weeks.

RESULTSA total of 222 patients were enrolled in seventeen centers (including 113 patients treated with anagrelide and 109 with hydroxyurea). Therapy efficacy can be evaluated in 198 patients (including 97 patients administered with anagrelide and 101 with hydroxyurea). At 12th weeks of therapy, the hematologic remission rate was 87.63% (85/97) in anagrelide group and 88.12% (89/107) in hydroxyurea group, the differences between the two groups were not significant (P=0.173). Treatment with anagrelide lowered the platelet counts by a median of 393 (362-1 339) × 10⁹/L from a median of 827 (562-1657) × 109/L at the beginning of the observation to 400(127-1130)×10⁹/L after 12 weeks (P<0.001), which were similar to the treatment result of hydroxyurea by a median drop of 398 (597-1846)× 10⁹/L (P=0.982). The median time to achieving response of anagrelide group was 7 (3-14) days, superior to that of hydroxyurea for 21 (14-28) significantly (P=0.003). Frequency of anagrelide related adverse events was 65.49 % (74/113), including cardiopalmus (36.28% ), headache (21.24% ), fatigue (14.16% ) and dizzy (11.50% ).

CONCLUSIONAnagrelide was effective in patients with ET which had similar hematologic remission rate to hydroxyurea and could take effect more quickly than hydroxyurea. Incidence of adverse events was undifferentiated between anagrelide and hydroxyurea, but anagrelide treatment had tolerable adverse effects and no hematologic toxicity.

Humans ; Hydroxyurea ; administration & dosage ; therapeutic use ; Platelet Aggregation Inhibitors ; administration & dosage ; therapeutic use ; Platelet Count ; Quinazolines ; administration & dosage ; therapeutic use ; Thrombocythemia, Essential ; drug therapy ; Treatment Outcome

Objective: To study the specific killing effect of CD4 membrane protein targeted chimeric antigen receptor modified T (CAR-T) cell. Methods: The second generation CD4 targeted chimeric antigen receptor containing 4-1BB costimulation domain was insert into lentiviral vector through recombinant DNA technology. Lentivirus was prepared and packaged by 293T cells with four plasmids. Beads activated T cells were transduced with lentivirus and the transduction efficiency was checked with Protein L and flow cytometry. T cell subsets and IFN-γ concentrations were detected with probe-tagged antibody and cytometric bead assay. Results: ①The transduction efficiency of activated T cells with prepared lentivirus were 50.0%-70.0%. A subset of CD8⁺ T cell acquired dim expression of CD4 membrane protein after activation. CD4⁺T cell and CD8⁺CD4^dim T cell were gradually killed by CD4 targeted CAR-T post lentivirus transduction. ②The kill efficacy of CD4 targeted CAR-T cell and control T cell toward KARPAS 299 T cell at an E∶T ratio of 8∶1 for 24 h was (96.9±2.1)% and (11.2±3.1)%, CAR-T cell has a higher killing efficacy than control T cell (t=7.137, P=0.028). The IFN-γ concentrations in culture supernatant of CAR-T cell with K562-CD4 cell, CAR-T cell with K562 cell and CAR-T cell alone were (15 648±2 168), (1 978±354) and (1 785±268) pg/ml, CAR-T cell cocultured with K562-CD4 cell produced more IFN-γ than the other two controls (P<0.01). Conclusions CD4 targeted CAR-T has an immunophenotype of CD8⁺CD4^-T cell. CD4 targeted CAR-T cell has killing efficacy toward normal CD4⁺T cell and CD4⁺T lymphoma cell. CD4 targeted CAR-T cell also has a killing efficacy toward CD4^dim target cell.

Objective: To explore the prevalences of JAK2, CALR and MPL gene mutations and the mutation types in patients with Philadelphia chromosome negative myeloproliferative neoplasms (MPNs) , and to compare their clinical characteristics of different mutation types with each other and mutation negative group. Methods: The mutations of JAK2 V617F, JAK2 gene at exon 12, CALR gene at exon 9 and MPL gene at exon 10 in 1 648 Ph negative MPNs patients were detected by direct sequencing. Results: ① The JAK2V617F mutation was found in 471 (92.7%) of 508 PV patients, 819 (78.1%) of 1 049 ET patients and 74 (81.3%) of 91 PMF patients respectively, with the total mutation rate as 82.8% (1 364/1 648) . The JAK2 exon12 mutation was found in 9 (1.7%) of 508 PV patients, none was found in ET or PMF patients, with the total mutation rate as 0.5% (9/1 648) . The CALR mutation was found in 132 (12.6%) of 1 049 ET patients and 11 (12.1%) of 91 PMF patients respectively, with the total mutation rate as 8.7% (143/1 648) ; the MPL mutation was found in 9 (0.9%) of 1 049 ET patients and 1 (1.1%) of 91 PMF patients respectively, with the total mutation rate as 0.6% (10/1 648) . The co-occurrence of any two types of driver gene mutations was not detected by direct sequencing. ②The median onset age of patients with JAK2V617F[61 (15-95) y] was significant higher than of with JAK2 exon12 mutation[49 (33-62) y] or without mutations[42 (3-78) y] (P<0.001) , but not for patients with CALR[57 (17-89) y] or MPL mutation[59 (22-71) y] (P>0.05) . Patients with JAK2V617F had higher white blood cell count and hemoglobin level (P<0.05) when compared with patients with CALR mutation or without mutations, or only significantly higher white blood cell count when compared with patients with MPL mutation (P=0.013) . The platelet count of patients with CALR mutation was significantly higher than of with JAK2V617F[966 (400-2 069) ×10⁹/L vs 800 (198-3 730) ×10⁹/L, P<0.001]. ③Karyotype analysis was conducted in 1 160 patients with MPNs, the rates of karyotype abnormality of patients with and without CALR mutation were 9.8% (8/82) and 7.4% (80/1 078) (P=0.441) respectively; The rates of karyotype abnormality of patients with and without JAK2V617F mutation were 7.7% (75/971) and 6.9% (13/189) (P=0.688) respectively. The incidence of karyotype abnormality of patients with CALR mutation was higher than of with JAK2V617F[9.8% (8/82) vs 7.7% (75/971) ] without statistically significant difference (P=0.512) . The karyotype analysis of 7 cases of JAK2 exon12 mutation and 6 ones with MPL gene mutation revealed normal karyotype. Conclusions Driver gene mutations detection could ensure the diagnosis and prognosis judgment of MPN more reliable, different subtypes of MPNs had different profiles of driver gene mutations, the latter lead to unique clinical phenotype.

Objective:To compare the medium-term clinical effects of arthroscopic double row repair between traumatic and degenerative medium supraspinatus tear.Methods:A retrospective study was conducted to analyze the clinical data of 23 patients who had been treated for traumatic or degenerative medium supraspinatus tear by the same arthroscopic double row repair and postoperative rehabilitation at Sports Medicine Center, The First Hospital Affiliated to Army Medical University between January 2015 and August 2020. They were assigned into 2 groups according to different tears. In the traumatic group of 8 cases of traumatic medium supraspinatus tear, there were 5 males and 3 females with an age of (46.1±4.3) years and a tear size of (1.3±1.0) cm 2. In the degenerative group of 15 cases of degenerative medium supraspinatus tear, there were 4 males and 11 females with an age of (59.9±8.1) years and a tear size of (4.1±1.1) cm 2. At preoperation and the last follow-up, the shoulder pain was evaluated by visual analogue scale (VAS), and the shoulder function by American Shoulder and Elbow Surgeons (ASES) score, Constant-Murley score and Simple Shoulder Test (SST); the improvements in active range of motion (ROM) of the shoulder were recorded at the last follow-up. Results:The 2 groups were comparable because there was no significant difference between them in the general clinical data ( P>0.05). The traumatic and degenerative groups were followed up for (40.3±11.2) and (36.4±12.4) months, respectively. At the last follow-up, the improvements in range of anterior flexion and internal rotation vertebral rank in the degenerative group [55.3°±33.6° and (4.1±1.3) ranks] were significantly greater than those in the traumatic group [27.5°±22.5° and (2.3±1.9) ranks] ( P<0.05). At the last follow-up, the VAS, ASES, Constant-Murley, and SST scores in the degenerative group were improved respectively by (3.7±0.8), (40.9±14.0), (38.4±9.4), and (6.5±1.4) points compared with their preoperative values, significantly greater than those in the traumatic group [(2.3±0.7), (19.6±14.6), (19.2±7.9), and (3.8±0.7) points] ( P<0.05). Conclusion:Arthroscopic double row repair can achieve significant medium-term improvements in shoulder function for both traumatic and degenerative medium supraspinatus tears, but the improvements may be grater for the degenerative ones.

MarR family transcription regulators are ubiquitous among bacteria and archaea. They extensively control multiple cellular processes and elaborately regulate the expression of genes involved in virulence, stress response and antibiotics at translational level. In Xanthomonas campestris pv. campestris, insertional inactivation of MarR family transcription regulator HpaR (XC2827) resulted in significantly decrease in virulence and increase in the production of the extracellular proteases. Here, we reported that the genome of Xcc 8004 encodes nine MarR family transcription regulators. The MarR family transcription regulators, HpaR (XC2827) and XC0449, were heterologous expressed and purified. In vitro MST and Pull-down assay confirmed the physical interaction between HpaR and XC0449. Phenotypical assay determined that deletion of XC0449 resulted in substantial virulence attenuation. In vitro EMSA, in vivo qRT-PCR and GUS activity assay identified that HpaR and XC0449 coordinately act as the transcriptional activator to regulate the expression of the virulence-associated gene XC0705, and eventually control the bacterial virulence and the production of extracellular proteases.
Bacterial Proteins ; Gene Expression Regulation, Bacterial ; Transcription Factors ; Virulence ; Xanthomonas campestris