Objective To explore the influence of fluoxertin on level of IL-2 ,IL-6 and TNF-α in brain tissue and serum of rats with post-stroke depression(PSD) .Methods 60 rats were divided into sham operation group ,depression group ,stroke group ,PSD group and fluoxertin group ,12 cases in each group .ELISA was used to detect the level of IL-2 ,IL-6 and TNF-αin brain tissue and serum .Results The level of IL-2 ,IL-6 and TNF-αin depression group ,stroke group and PSD group were significantly increased and higher than that in sham operation group and fluoxertin group(P<0 .05) .There was no significant difference between sham op-eration group and fluoxertin group(P>0 .05) .Conclusion Fluoxertin could significantly decrease the level of IL-2 ,IL-6 and TNF-αand play an important role in therapy of PSD .

Background Small incision cataract surgery combined with intraocular lens (IOL) implantation remains a popular way for cataract.However,some factors affect the postsurgical visual outcomes and lower the patients' satisfaction,including intraoperative and postoperative complications as well as corneal refractive and thickness changes.Objective This study was to evaluate the influence of corneal refractive and thickness changes on visual fluctuation after 2.6 mm temporal incision surgery for cataract.Methods A series cases-observational study was designed.Twenty-nine eyes of 25 age-related cataract patients received 2.6 mm temporal transparent incision phacoemulsification and IOL implantation from November,2011 through April,2012 in Eye & ENT Hospital of Fudan University under the informed consent.The uncorrected visual acuity (UCVA),best corrected visual acuity (BCVA),automatic and subjective refraction were examined,and the central corneal thickness (CCT) and corneal vector astigmatism were measured using Pentacam analysis system before and after operation.The examination outcomes were compared among different time points,and the influencing factors of UCVA or BCVA were analyzed.Results The mean UCVA (LogMAR) was 0.52±0.06 in 1 day and 0.64±0.07 in 2 months after surgery,with a significant difference between them (t=-3.051,P＜0.05).The mean BCVA (LogMAR) was 0.24±0.04 and 0.13± 0.04 in postoperative 1 day and 2 months,showing a significant difference between them (t =-3.031,P＜0.05).Spherical equivalents (SE) were (-1.74±0.28) D,(-1.99±0.27) D and (-1.69±0.24) D in postoperative 1 day,14 days and 60 days,respectively,with a significant difference among the 3 time points (F =3.562,P =0.039),and significant difference also was found between postoperative 1 day and 14 days (t =2.515,P＜0.05) or between postoperative 14 days and 60 days (t =-2.987,P ＜ 0.05).The preoperative J0 value was (0.06 ± 0.06) D,and postoperative J0 value was (0.29±0.08) D on the first day,which was significant higher than that in preoperation (t =-4.625,P＜0.01).In addition,J0 value showed a significant difference between postoperative 1 day and 14 days (t=-7.858,P＜0.01) as well as between postoperative 14 days and 2 months ([0.38±0.07] D versus [0.27±0.07] D,t=-5.649,P＜0.01).The mean CCT was (547.1±25.3) μm,(599.4±56.9) μm,(557.0±27.1) μm and (551.0 ± 25.9) μm before and 1 day,14 and 60 days after operation,with significant differences among the various time points (F =9.792,P ＜ 0.001),and significant differences also were seen in the CCT between preoperation and postoperative 1 day (t =-5.116,P＜0.01),between postoperative 1 day and 14 days (t =4.135,P＜ 0.01),between postoperative 14 days and 60 days (t=2.082,P＜0.05).UCVA=0.513-1.183×C J45(F=16.724;t=-4.089,P=0.026) and BCVA=-1.314+0.003×CCT (F=22.322;t=4.725,P=0.018).Conclusions The UCVA remains a downward trend,and BCVA sustains upward trend after 2.6 mm temporal transparent incision phacoemulsification combined with IOL implantation surgery.Postoperative UCVA is affected by corneal astigmatism change,while BCVA is influenced by CCT change.

Objective:To investigate the possible association between Thr241Met polymorphism in the DNA repair gene X-ray repair cross-complementing group 3 (XRCC3) with genetic susceptibility to glioma in a Chinese Han population living in Shanghai and the surrounding provinces in east China. Methods: Genotyping by a TaqMan assay was performed in 771 brain glioma patients living in Shanghai and the surrounding provinces (Jiangsu.Zhejiang, Anhui.etc. )and in 752 control participants matched in age and gender. The genotyping results of TaqMan assay and the association between Thr241Met polymorphism in the DNA repair gene XRCC3 with genetic susceptibility to glioma were statistically analyzed. Results: Genotypes of 1 468 subjects (760 with brain glioma and 708 were cancer-free control) were successfully performed by TaqMan assay, with the successful rate being 96.4%. Statistical analysis result showed that gene(C/T) and genotype(C/CT/CT/T) frequencies of XRCC3 were not significantly different between the glioma and cancer-free groups. Compared with the CC genotype, the variant TC(P = 0. 909; adjusted by age and gender OR = 0. 981; 95%CI = 0. 701-1. 371) or TT(P=0. 642; adjusted by age and gender OR = 0. 7; 95%CI = 0. 156-3. 146) genotypes of XRCC3 Thr241Met were associated with a non-statistically significant increase of glioma risk. Conclusion: The variant TC or TT genotypes of XRCC3 Thr241Met may not be risk factors for brain glioma in Chinese Han population living in Shanghai and the surrounding provinces in east China.

Objective To investigate the diagnosis and interventional therapeutic technology for the obstruction of hepatic vein(HV)or inferior vena cava(IVC)after liver transplantation.Methods In the 831 patients who received orthotopic liver transplantation(OLT)and 26 patients who received living donor liver transplantation(LDLT),11 cases were confirmed with HV or IVC obstruction by venography and received interventional treatment from 2 to 111 days after liver transplantation.Of the 11 patients,five had the obstruction of HV anastomosis,five had the obstruction of IVC anastomosis,and one had the obstruction of HV and IVC anastomosis.In the eleven patients,five patients underwent OLT,four patients underwent LDLT,and two pediatric patients underwent reduced-size OLT.Before interventional treatment,9 patients received CT enhanced scans,2 received MR enhanced scans.Follow-up evaluations included liver or renal function tests,clinical symptom,and monitoring of HV or IVC flow.Pressure gradients before and after interventional treatment were compared by using a paired t test.The imaging data and interventional therapeutic technology of 11 cases were retrospectively analyzed.Results In all 11 patients,CT or MRI could clearly show congested areas of the liver,and the location and degree of HV or IVC obstruction.Of the 11 patients,four with HV obstruction and five with IVC obstruction were treated with stent placement,one with HV obstruction was treated with percutaneous transluminal angioplasty(PTA),one with HV and IVC obstruction was treated with HV PTA and IVC stent placement.Interventional technical success was achieved in all patients.The venous pressure gradient across obstruction was significantly reduced from(16.5±4.1)mm Hg(1 mm Hg=0.133 kPa)before the procedure to(2.9±1.7)mm Hg after the rocedure(t= 11.5,P＜0.01).Clinical improvement was noted in 10 patients except one pediatric patient who died of multiple-organs failure at the 9 th day after the treatment During the follow-up period of 9 to 672 days,two patients with PTA treatment had recurrent HV stenosis within one month after treatment,no patient with stent placement developed venous restenosis.No major complications occurred during the procedures.Conclusions Stent placement is safe and effective for HV or IVC obstruction after liver transplantation.CT or MRI before treatment is of important value for the diagnosis of congested areas of the liver,and the observation of HV or IVC obstruction.

{L-End}Objective To understand the influence of job burnout and anxiety symptoms on work ability of biosafety laboratory (BSL) workers in Xinjiang Uygur Autonomous Region. {L-End}Methods A total of 5 808 BSL workers in Xinjiang Region were selected as the research subjects using cluster sampling method. The Job Burnout Questionnaire, Anxiety Self-rating Scale and Work Ability Index Questionnaire were used to evaluate their job burnout, anxiety symptoms and work ability. The mediation effect of anxiety symptoms on the relationship between job burnout and work ability was tested by stepwise regression analysis. {L-End}Results The detection rate of job burnout, anxiety symptoms and poor working ability was 83.1% (4 829/5 808), 37.2% (2 160/5 808) and 5.8% (339/5 808), respectively. There was a positive correlation between job burnout and anxiety symptoms score in BSL workers ［correlation coefficient (r) was 0.48, P<0.01］. The score of job burnout and anxiety symptoms was negatively correlated with the work ability score (r were -0.58, -0.51, both P<0.01). The results of mediation effect analysis show that the total effect of job burnout on work ability was -0.31, with the direct effect of -0.15. The mediation effect of anxiety symptoms on the relationship between job burnout and work ability was -0.16, accounting for 51.6% of the total effect. {L-End}Conclusion The detection rates of job burnout and anxiety symptoms among BSL workers in Xinjiang Region are relatively high. Anxiety symptoms show a mediate effect on the relationship between job burnout and work ability. The work ability of BSL workers can be improved by improving job burnout and anxiety symptoms.

Objective To explore the relationship between platelet to lymphocyte ratio(PLR) and the severity of renal impairment in elderly patients with type 2 diabetes mellitus (T2DM) Methods Two hundred elderly T2DM patients treated in our department of endocrinology from January 2017 to January 2018 included 100 cases with diabetic nephropathy(DN group)and 100 without nephropathy(control DM group),and 100 individuals undergoing physical healthy examination during the same period(normal control group)were retrospectively enrolled.DN group included 50 early,27 medium and 23 end stage patients.Albumin to globulin ratio (A/G),hemoglobin A1c (HbA1c),urea nitrogen (BUN),serum creatinine (Scr),estimated glomerular filtration rate (eGFR),24-hour urine protein quantification (24h-UTP),neutrophil-lymphocyte ratio (NLR),plateletlymphocyte ratio(PLR),etc.were collected and compared among DN group,control DM group and normal control group.Binary Logistic regression analyses were performed to predict whether elderly patients with T2DM progress to DN.Correlations between PLR and HbA1c were analyzed using Spearman correlation coefficient.Results The BMI,waist circumference,waist-hip ratio,systolic blood pressure,disease duration,A/G,Scr,BUN,eGFR,24 h-UTP,interleukin 6 (IL-6),hypersensitive C-reactive protein(hs-CRP),PLR,and NLR showed statistically significant differences among three groups(all P ＜ 0.05).The differences in A/G,Scr,BUN,eGFR,24h-UTP,hs-CRP,PLR,and NLR between early,medium and end phases of DN were statistically significant (all P ＜ 0.05).The predictors for the progression to diabetic nephropathy were the levels of A/G(OR:1.12,95％CI:0.89-1.65),Scr(OR:200.34,95％CI:65.28-412.36),BUN(OR:10.26,95％CI:8.34-16.94),eGFR (OR:85.37,95 ％ CI:78.31-103.57),24h-UTP (OR:187.32,95 ％ CI:142.92-1523.49),PLR (OR:81.51,95％CI:78.45-132.68),NLR(OR:1.20,95％CI:1.07-3.57),IL-6(OR:4.25,95％CI:3.76-9.31),and hs-CRP (OR:3.41,95％ CI:2.35-10.51) in T2DM patients.There were significant correlations of PLR with A/G,Scr,BUN,eGFR,24 UTP,NLR,IL-6,and hs-CRP (r =-0.338,0.469,0.521,-0.457,0.463,0.642,0.297,0.448,all P＜0.05).Conclusions PLR,which is inexpensive and easy to measure,can predict the risk of progressing to DN in elderly T2DM patients and may evaluate their renal function,and is worth extending in clinical practice.

Purpose: From the perspective of positive psychology, our study aimed to explore depressive symptomsand psychological well-being among Chinese nurses, as well as analyze the impacts of characterstrengths, self-efficacy and social support on the mental health of nurses. Methods: A cross-sectional and descriptive design using five self-reported questionnaires was used toinvestigate a cohort of 4238 nurses during 2018. A structural equation modeling analysis was used toverify a hypothetical model linking character strengths, self-efficacy, social support, depressive symptoms,and psychological well-being. Results: The prevalence of depression among this cohort of Chinese nurses was 58.1%. The mean scoresfor caring, inquisitiveness, and self-control were 19.93 (SD = 2.82), 15.94 (SD = 3.00), and 16.34(SD = 2.95), respectively. The hypothesized model was a good fit of the data (x2/df = 1.77, p = .183, rootmean square error of approximation = 0.04, goodness of fit index = 1.00, comparative fit index = 1.00,TuckereLewis index = 1.00). Except for the path from self-control to depression, the other hypotheticalpaths investigated were statistically significant. Conclusion Character strengths were directly and positively associated with psychological well-being.Inquisitiveness was the strongest direct protective factor for depression. In addition, characterstrengths indirectly alleviated depression and increased psychological well-being through mediatingvariables of social support and self-efficacy. This study should alert nurse managers that more attentionshould be paid to the character strengths and mental health of nurses. This study provides evidence forinterventions based on character strengths as a management strategy to support the mental health ofnurses.

Purpose: From the perspective of positive psychology, our study aimed to explore depressive symptomsand psychological well-being among Chinese nurses, as well as analyze the impacts of characterstrengths, self-efficacy and social support on the mental health of nurses. Methods: A cross-sectional and descriptive design using five self-reported questionnaires was used toinvestigate a cohort of 4238 nurses during 2018. A structural equation modeling analysis was used toverify a hypothetical model linking character strengths, self-efficacy, social support, depressive symptoms,and psychological well-being. Results: The prevalence of depression among this cohort of Chinese nurses was 58.1%. The mean scoresfor caring, inquisitiveness, and self-control were 19.93 (SD = 2.82), 15.94 (SD = 3.00), and 16.34(SD = 2.95), respectively. The hypothesized model was a good fit of the data (x2/df = 1.77, p = .183, rootmean square error of approximation = 0.04, goodness of fit index = 1.00, comparative fit index = 1.00,TuckereLewis index = 1.00). Except for the path from self-control to depression, the other hypotheticalpaths investigated were statistically significant. Conclusion Character strengths were directly and positively associated with psychological well-being.Inquisitiveness was the strongest direct protective factor for depression. In addition, characterstrengths indirectly alleviated depression and increased psychological well-being through mediatingvariables of social support and self-efficacy. This study should alert nurse managers that more attentionshould be paid to the character strengths and mental health of nurses. This study provides evidence forinterventions based on character strengths as a management strategy to support the mental health ofnurses.

Objective:To explore the predictive value of peripheral blood cytokine models on organ functional impairment after chimeric antigen receptor T(CAR-T) cell therapy in children with B-lineage lymphocytic leukemia.Methods:The clinical data of 44 children with acute B-lineage lymphoblastic leukemia who received CAR-T cell therapy at Children′s Hospital of Soochow University from September 2018 to October 2020 were retrospectively analyzed.Peripheral blood cytokines, including interleukin(IL)-2, IL-4, IL-6, IL-10, tumor necrosis factor-α, interferon(IFN)-γ and IL-17A, were measured daily for 14 days after receiving CAR-T cell therapy.The trend of peripheral blood cytokine levels was analyzed at the endpoint of organ function recovery or death within 14 days after CAR-T cell treatment.Receiver operating characteristic curve was used to establish a mathematical prediction model to predict the occurrence of organ damage in the children.Results:Of the 44 children, 31 cases were boys and 13 cases were girls, with a median age of 7.96 (5.19, 11.48)years.Cytokine release syndrome(CRS) response occurred in 95.5% (42/44) children, with 88.1% (37/42) had a grade 1-3 CRS response, and 16.7% (7/42) had a severe grade 4-5 CRS response.Using IL-6>3 892.95 pg/mL as cut-off value, the area under the curve(AUC) for predicting acute respiratory failure was 0.818, with a sensitivity of 0.8 and a specificity of 0.735, while combining IFN-γ>414.4 pg/mL, IL-6>3 892.95 pg/mL and IL-2>27.05 pg/mL were the three cut-off values, with an AUC of 0.741, sensitivity of 0.6 and specificity of 0.912 for predicting acute respiratory failure. Using IFN-γ>1 699.5 pg/mL as cut-off value, the AUC for predicting shock was 0.908, with a sensitivity of 0.722 and a specificity of 1.With IL-6>4 607.3 pg/mL as cut-off value, the AUC for predicting liver injury was 0.964, with a sensitivity of 1 and a specificity of 0.906, while combining both IL-6>4 607.3 pg/mL and IFN-γ>1 446.2 pg/mL as cut-off values, the AUC for predicting liver injury was 0.977, with a sensitivity of 1 and a specificity of 0.906.Combining both IL-6>6 972.2 pg/mL and IFN-γ>3 981.5 pg/mL predicted a positive predictive value of 62.5% and a negative predictive value of 94.4% for grade 4-5 CRS response, with an AUC of 0.846, a predictive sensitivity of 0.714 and a specificity of 0.838, and all children had a combination of two or more organ function injuries.Conclusion:The combination of IL-6 and IFN-γ can effectively predict the incidence of liver injury and cytokine release syndrome.The combination of peripheral blood cytokines IFN-γ, IL-6 and IL-2 can be used to predict the incidence of acute respiratory failure after the treatment of CAR-T cells in children with acute B-lineage lymphoblastic leukaemia.IFN-γ single index can be used to predict the incidence of shock.The combination of IL-6 and IFN-γ can be used to predict the incidence of liver injury and the severity of CRS.

Prostate cancer is the most common male malignant tumor in the world, and its death toll is second only to lung cancer. Androgen deprivation therapy (ADT) is a major treatment for prostate cancer besides radical surgery. ADT treatment will lead to the inevitable progression of prostate cancer patients to castration-resistant prostate cancer (CRPC). The current research results have confirmed that the transformation from androgen deprivation prostate cancer (ADPC) to CRP is related to the reactivation of the androgen receptor signal pathway. In this review, the research progress on the mechanism of the androgen receptor signaling pathway in CRPC was reviewed in order to provide a scientific basis and new ideas for the diagnosis and treatment of CRP.