Objective:To explore the current situation of attitudes toward seeking professional psychological help among parents of premature infants, and to analyze its influencing factors.Methods:From January to September 2019, this study selected 121 parents of premature infants at two ClassⅢ Grade A hospitals of Zhejiang Province as subjects by convenience sampling. Those parents were investigated with the General Information Questionnaire, the Attitudes Toward Seeking Professional Psychological Help Scale-Short Form (ATSPPH-SF) , Simplified Coping Style Questionnaire (SCSQ) and the General Self-Efficacy Scale (GSES) . A total of 121 questionnaires were sent out and 112 valid questionnaires were collected with 92.6% for the valid recovery rate.Results:Among 112 parents of premature infants, the total score of ATSPPH-SF was (18.11±3.76) . There were statistical differences in the total score of ATSPPH-SF among parents with different body weight of premature infants, parents' genders, places of residence and family monthly income ( P<0.05) . Among parents of premature infants, the total score of ATSPPH-SF had a positive correlation with positive coping style ( r=0.337, P<0.05) , and had negative correlations with scores of negative coping style and self-efficacy ( r=-0.319, -0.296, P<0.05) . Multiple linear regression analysis showed that the influencing factors of attitudes toward seeking professional psychological help among parents of premature infants included the body weight of premature infants, family monthly income, positive coping style and self-efficacy with statistical differences ( P<0.05) . Conclusions:Nursing managers should pay attention to the attitudes toward seeking professional psychological help among parents of premature infants, especially in those with low levels of body weight of premature infants, family monthly income and self-efficacy. Nursing managers also should help them to establish the positive coping style so as to improve parents' acceptance of seeking professional psychological help.

Objective:To explore the role and mechanism of IL-39 in K562 cells.Methods:The expressions of IL-39R and STAT1/STAT3 in K562 cells were detected via qRT-PCR;the protein levels of phospho-STAT1/STAT3 and STAT1/STAT3 in K562 cells were detected by Western blot;the mRNA regulated by IL-39 in K562 cells was predicted by RNA sequencing.Results:rIL-39 significantly promoted the expression of IL-39R in K562 cells;IL-39 affected K562 cells through STAT1 pathway;IL-39 significantly regulated the expression of mRNA in K562 cells,thus potentially affecting a series of biological processes.Conclusion:IL-39 can directly act on K562 cells,alter gene transcriptional expression and inhibit tumor growth through the STAT1 pathway.IL-39 may similarly modulate gene expression profile in human leukemia cells.

Objective:To investigate the levels of sex hormone and fertility in female patients after hematopoietic stem cell transplantation (HSCT), as well as their correlation with conditioning regimens, and analyse the effect of hormone replacement therapy (HRT) in young women after HSCT.Methods:Retrospective case series study. The clinical data of 147 women who underwent HSCT in the First Affiliated Hospital of Soochow University from January 2010 to January 2021 were retrospectively analyzed. The sex hormone levels were measured and followed-up, and the survival, menstrual fertility and the use of HRT of the patients were also followed-up. The sex hormone levels were measured after transplantation, and the ovarian function was evaluated. Independent sample t test and χ2 test were used for comparison between the two groups. Results:The median age of the 147 patients was 26 (range, 10-45) years. Of them, 135 patients received allogeneic HSCT and 12 patients received autologous HSCT. Furthermore, 129 patients received myeloablative conditioning, and 18 patients received reduced conditioning dose. The median follow-up time was 50 months (range, 18-134 months). Five patients died of disease recurrence during follow-up. Of the 54 patients with subcutaneous injection of zoladex, three recovered menstruation spontaneously after transplantation, and all of them were myeloablative conditioning patients, one patient gave birth to twins through assisted reproductive technology. Ninety-three patients did not use zoladex before conditioning, two patients with aplastic anemia with non-myeloablative transplantation resumed menstruation spontaneously, and conceived naturally. The level of follicle stimulating hormone after transplantation in patients receiving myeloablative conditioning regimen was significantly higher than that in patients receiving reduced-dose conditioning regimen [(95.28±3.94) U/L vs. (71.85±10.72) U/L, P=0.039]. Among 147 patients, 122 patients developed premature ovarian failure, 83 patients received sex hormone replacement therapy after transplantation, and 76 patients recovered menstruation and improved endocrine function. Conclusions:The incidence of premature ovarian failure is high in female patients after HSCT, and patients have a chance at natural conception. Reducing the dose of conditioning regimen and the application of zoladex before transplantation can reduce ovarian of conditioning drugs. HRT after transplantation can partially improve the endocrine function of patients.

Objective:To investigate the survival and prognosis of B-lineage acute lymphoblastic leukemia (B-ALL) patients with TP53 mutation.Methods:The clinical data of 479 newly diagnosed B-ALL patients treated in the First Affiliated Hospital of Soochow University from January 2016 to December 2019 were retrospectively analyzed.Results:Among 479 B-ALL patients, 34 cases (7.1%) were positive for TP53 gene mutation, and a total of 36 TP53 mutations were detected, including 10 frameshift gene mutations (27.8%) , 23 missense mutations (63.9%) and 3 nonsense mutations (8.3%) . A total of 34 (94.4%) mutations were located in the DNA binding domain (exons 5-8) .The average number of mutated genes in patients with TP53 gene mutation (2.3) and the group without TP53 gene mutation (1.1) were statistically different ( P<0.001) . The proportion of Ph positive and Ph-like positive patients in the TP53 gene mutation negative group was significantly higher than that of the TP53 mutation positive group, and the difference was statistically significant ( P<0.001) . The 3-year OS and EFS rates of the TP53 gene mutation negative group were significantly higher than those of the TP53 gene mutation positive group. The differences in OS and EFS rates between the two groups were statistically significant ( χ2= 4.694, P = 0.030; χ2= 5.080, P= 0.024) . In the multivariate analysis, failure to achieve remission (CR) after one course of induction chemotherapy was an independent adverse prognostic factor affecting OS.Of the 34 patients with TP53 mutation, 16 underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT) in the CR 1 state, and 2 patients with recurrence after transplantation obtained CR 2 after infusion of donor-derived anti-CD19 chimeric antigen receptor T (CAR-T) cells. Among the 11 patients with TP53 gene mutation who relapsed during consolidation chemotherapy, 6 received anti-CD19 CAR T cell therapy, 4 patients achieved remission and minimal residual disease (MRD) turned negative, followed by bridging allo-HSCT, and 2 of them sustained CR. Conclusion:Missense mutations are the most common in B-ALL patients with TP53 gene mutation, and the majority of mutations were located in the DNA binding domain. B-ALL patients with TP53 gene mutation should undergo allo-HSCT as soon as possible after CAR-T cell therapy has cleared the MRD after recurrence. B-ALL patients with TP53 gene mutation still have a higher recurrence rate after allo-HSCT, and the infusion of donor-derived CAR-T cells can achieve better sustained remission.