Objective:To explore the extent of psychological counselors’ job burnout. Methods:171 psychological counselors were tested by MBI-HSS.Results:(1) In the aspects of demographic variables, male experienced higher cynicism(t=2.233,P

Objective To investigate the effects of repeated intraperitoneal dexmedetomidine on the cognitive function in rats with chronic cerebral ischemia.Methods Forty-eight male Sprague-Dawley rats,aged 3-4months,weighing 250-300 g,were randomly divided into 4 groups (n =12 each) ∶ sham operation group (group S),chronic cerebral ischemia group (group IS),dexmedetomidine treatment 1 group (group DXM1) and dexmedetomidine treatment 2 group (group DXM2).Dexmedetomidine 5 μg/kg was injected intraperitoneally at 30 min before occlusion of bilateral common carotid arteries and 3,12,24 and 48 h after occlusion in group DXM1,and at 3,12,24 and 48 h after occlusion in group DXM2.The cognitive function was assessed by Morris water maze 2 weeks after occlusion.The apoptosis was examined by TUNEL.The expression of Bcl-2 protein in hippocampus was detected by Western blot.Results Compared with group S,the escape latency was significantly prolonged from 2nd day to 5th day after the place navigation test in group IS and on 2nd day after Morris water maze test in groups DXM1 and DXM2,and the time of staying in 1 st quadrant was significantly shortened,the apoptotic rate was increased,and the expression of Bcl-2 was up-regulated in groups IS,DXM1 and DXM2 (P ＜ 0.05).Compared with group IS,the escape latency was significantly shortened from 3rd day to 5th day after the place navigation

ObjectiveTo evaluate the effect of large-spot and low-energy Q switched Nd:YAG laser on melasma,and to observe the changes of melasma lesions with confocal laser scanning microscopy (CLSM) before and after the laser treatment.MethodsTotally,45 patients aged from 24 to 48 years and diagnosed with facial melasma were included in this study,and treated with large-spot and low-energy Q switched Nd:YAG once a week for 10 or more sessions.CLSM was used to estimate the melanin content in melasma lesions before each irradiation and after the last irradiation.ResultsAmong the 45 patients,8 ( 17.78％ ) were nearly cured,25 (55.56％) markedly improved,11 (24.44％) improved,and only 1 (2.22％) unimproved after the laser irradiation.The total response rate was 73.33％.As CLSM showed,there was an increment in melanin granules in melasma lesions compared with the normal skin surrounding melasma lesions,but a reduction in melanin granules was induced by the laser treatment in melasma lesions.ConclusionsLarge-spot and lowenergy Q switched Nd∶YAG laser is substantially effective and highly safe for the treatment of melasma,and CLSM can be used to evaluate the therapeutic effect of laser on melasma.

A 27-year-old man presented with a 3-year history of persistent asymptomatic papules on the left chest and axirlary fossa. Multiple skin biopsies were performed and histopathology revealed mild acanthosis, extension of the dermal papilla, lichenoid lymphoid infiltrates in upper dermis. Some lymphoid cells migrated into the epidermis and formed Pautrier's microabscesses. Immunohistochemistry revealed that the infiltrating cells were positive for LCA, CD45RO, CD3, CD4 and CD8 (scattered), but negative for CD68 or CD30. Cutaneous laser confocal microscopy showed the shadow of scattered, oval or round, slightly refractive cells measuring 4-8 pm in diameter. A diagnosis of papular mycosis fungoides was made. The papules were softened with the lightening of lesional color after treatment with narrow-band ultraviolet B, topical fluticasone propionate cream and isotretinoin gel.

Objective To investigate the relationship between cytochrome P450 1A2 (CYP1A2) gene polymorphism and susceptibility to chronic obstructive pulmonary disease (COPD). Methods CYP1A2 gene polymorphisms in 100 COPD cases and 100 healthy controls were tested with polymerase chain reaction- restriction fragment length polymorphism (PCR- RELP). Results Genotype frequencies of 4 SNPs in both the COPD and control groups were in accordance with Hardy-Weinberg equilibrium (P>0.05). There was significant difference between the COPD and control groups in genotype and allele frequencies of 1D and 1F (P<0.05), but not of 1C and 1E (P>0.05). Conclusion CYP1A2*1D and CYP1A2*1F polymorphisms may play an important role in the development of COPD.

The effective local management of oligometastatic non-small cell lung cancer (NSCLC) has the potential to prolong patients' survival. The role of radiotherapy as a local treatment modality in patients with oligometastatic NSCLC, whether as first-line therapy or consolidation therapy, remains uncertain. Several studies have demonstrated that stereotactic ablative radiotherapy can offer clinical benefits for patients with oligometastatic NSCLC without increasing adverse reactions. Furthermore, the exploration of the potential synergistic effects of combining radiotherapy and immunotherapy on extending progression-free survival and overall survival in patients with oligometastatic NSCLC is also a topic worthy of attention.

Objective:To explore the potential pathogenesis of exosome-mediated polymyositis/dermatomyositis (PM/DM) through multi-omics combined with bioinformatic analysis approach and to identify potential new targets for the diagnosis and treatment of PM/DM.Methods:Collect serum exosome samples from PM/DM patients and healthy individuals who underwent physical examination in Wuxi Second People′s Hospital from January 2021 to June 2023. HiSeq high-throughput sequencing technology and iTRAQ quantitative proteomics techniques were used to perform a sequencing analysis of miRNA and protein components in serum exosomes from patients with PM/DM and healthy control. R language was adapted to conduct the limma differential analysis, gene ontology (GO), Kyoto encyclopedia of genes and genomes (KEGG), gene set enrichment analysis (GSEA) functional analysis, and immunological correlation analysis. Based on these analysis, we identified core genes and established a miRNA-target gene-transcription factor co-expression molecular network. Subsequently, we employed quantitative real-time PCR (qRT-PCR) to experimentally validate the core genes. Data analysis was performed using t-test statistical analysis and receiver operating characteristic (ROC) curves were plotted to evaluate the test efficacy of the core genes. Results:Initially, 42 up-regulated differential proteins and 61 DEP down-regulated differential proteins, as well as 22 up-regulated differential miRNAs and 19 down-regulated miRNAs were screened, and 7 core genes, 13 associated differential miRNAs, and 4 transcription factors were finally identified. Based on the functional analysis we concluded that the core genes CTSG, MPO, H1-5 involved in the formation of neutrophil extracellular trap network, NF-κB pathway and other inflammation-related pathways might play an important role in exosome-mediated PM/DM pathogenesis. Immune cells such as mast cells, immature dendritic cells, natural killer cells, regulatory T cells, and helper T cells 2 were expressed to a higher extent in the disease. In the t-test, MPO [(1.08 ±0.47) vs. (2.05 ±0.62), t=-3.50, P=0.004], CTSG [(1.11 ±0.51 ) vs. (2.27 ±1.10 ), t=-2.72, P=0.022], and H1-5 [(1.03 ±0.25) vs. (1.81 ±0.73), t=-2.89, P=0.019] showed statistically significant differences. In the ROC curve analysis, MPO[AUC(95% CI): 0.92(0.78, 1)], CTSG [AUC(95% CI): 0.81(0.59, 1)], and H1-5 (AUC (95% CI)= 0.84(0.64, 1)] indicated that the three core genes had good accuracy. Conclusion:We identified the key differential molecules in serum exosomes of patients with PM/DM, and constructed a regulatory network of miRNA-target gene-transcription factor, and determined that the pathogenic mechanism of PM/DM was mediated by serum exosomes was mediated through the formation of neutrophil extracellular trapping nets and the NF-κB pathway. CTSG, MPO, and H1-5 are the core genes in the these pathways, and their related miRNAs and transcription factors have been identified, which may become potential targets and biomarkers for the diagnosis and treatment of PM/DM.

Objective To analyze the current situation and characteristics of risk factors in antithrombotic therapy(in-cluding antiplatelet and anticoagulant treatments)at home and abroad,and to provide a theoretical basis for the prevention and treatment of thrombosis or bleeding associated with antithrombotic therapy.Methods The literature on risk factors of an-tithrombotic therapy published in Chinese databases(China Journal Full-text Data,Wanfang Database,VIP Database)and Eng-lish databases(PubMed,Web of Science,MEDLINE)from January 2011 to November 2021 was searched and bibliometric analy-sis was performed.The visualization analysis was performed using VOS viewer software.Results A total of 595 publications were included in the analysis.The top three countries for English publications were the USA,China,and Japan.The type of stud-ies were predominantly cohort studies,with sample sizes mostly being below 1 000.Risk factors for antithrombotic therapy are cat-egorized into those affecting antiplatelet drugs,warfarin,and new oral anticoagulants.Age,gender,renal function,and combination of antithrombotic drugs are common risk factors,and different risk factors of antithrombotic drugs also have their characteristics.Conclusion While there is substantial research on risk factors in antithrombotic therapy globally,the sample size needs to be improved.Pharmacists should provide individualized medication services based on different drugs and different groups to ensure medication safety for patients.

Objective To investigate the safety and efficacy of 177Lu-prostate specific membrane antigen (PSMA)-617 in the treatment of metastatic castration-resistant prostate cancer (mCRPC).Methods From August 2017 to September 2018,11 patients(average age 70.6 years) with mCRPC who underwent 177Lu-PSMA-617 therapy in Nanjing First Hospital were studied.All patients underwent 68Ga-PSMA-11 PET/CT before therapy to assess the tumor radioactive uptake.Blood routine examination and renal function test results were documented before and after therapy to assess the safety.The efficacy was reflected by the changes of prostate specific antigen (PSA) levels and maximum standardized uptake value (SUVmax) on 68Ga-PSMA-11 PET/CT imaging.Paired t test and Wilcoxon's sign rank test were used to analyze the data.Results No acute side effects were observed after therapy of 177Lu-PSMA-617.There were no statistically significant differences after therapy in WBC counts,RBC counts,and PLT,as well as Hb levels (t values:-0.28-1.11,all P＞ 0.05).No kidney toxicity was found.The PSA level after 177Lu-PSMA-617 therapy was significantly lower than that before therapy (80.70 (14.29,1 538.00) μg/L vs 604.60 (88.41,3 980.00) μg/L;u =59,P =0.023).Of the 11 patients,only 2 had elevated PSA levels and disease progression,while the other 9 patients had varying decreases,of which 2/11 decreased by ＞30％ and 7/11 decreased by ＞50％.After therapy,SUVmax of metastatic lesions and metastatic lymph nodes were decreased in 9 and 2 patients respectively.Conclusions 177Lu-PSMA-617 has a good therapeutic value for mCRPC.It is safe and has no obvious side effects.

Objective To survey the prevalence of greenhouse farmer's lung and related risk factors in part of rural areas of Liaoning Province.Methods Using uniform scheme,procedures and questionnaire,a survey for 5420 farmers(2660 men and 2760 women)with complete data who work inside greenhouses was performed in Shenyang,Xinmin,Chaoyang,and Jinzhou between August 2006 and June 2009.Pulmonary function tests was performed for every active farmer.Results Greenhouse farmer's lung was diagnosed in 308 cases,205 men(66.55%,205/308)and 103 women(33.44%,103/308),a prevalence of 5.7%(308/5420).The prevalence rate of greenhouse farmer's lung in males was significantly higher than that in females(?2=39.93,P0.05).In the 308 cases,the number of patiernts presented with fever chill,cough/sputum,chest tightness/shortness of breath were 180(58.44%),192(62.34%),160(51.95%)respectively,and the number of crepitations,radiological changes,spirometry abnormalities and serum IgE antibodies(+)was 164(53.25%),153(49.68%),147(47.73%)and 136(44.16%)at the time of the study.62.34%(192/308)of patients with greenhouse farmer's lung were mild and 38.66%(116/308)were severe.Conclusion The total prevalence rate of greenhouse farmer's lung in part of rural areas of Liaoning Province was 5.7% and multiple risk factors were associated with the disease.