Objective:To investigate the effect of Relative Bedrest Condition Morita Therapy(RBCMT) on the improvement of depression and anxiety symptoms and personality in patients with recurrent depression disorder.Methods:Seventy patients with recurrent depressive disorder hospitalized in Kailuan Mental Health Center were randomly divided into study group and control group( n=35 in each group) from June to October, 2019.The study group was given RBCMT on the basis of conventional treatment and nursing.The Eysenck personality questionnaire (EPQ), Hamilton depression scale (HAMD) and Hamilton anxiety scale (HAMA) were used to assess the clinical symptoms and personality characteristics of the patients and to analyze and compare them. Results:(1) EPQ score in each dimension: There were significant differences within group among different time in introverted and extroverted dimension (study group: baseline: 46.14±10.99, the fifth weekend: 50.43±8.86, the eighth weekend: 53.86±7.08, F=6.291, P=0.003.Control group: baseline: 45.29±8.99, the fifth weekend: 48.29±8.31, the eighth weekend: 50.29±7.57, F=3.211, P=0.044) and neuroticism dimension score (study group: baseline: 60.14±5.49, the fifth weekend: 53.29±4.53, the eighth weekend: 50.57±4.33, F=36.809, P<0.001.Control group: baseline: 60.29±6.18, the fifth weekend: 55.86±6.00, the eighth weekend: 53.14±5.30, F=13.353, P<0.001) among different time points in the group.Neuroticism scores between the two groups at the same time were statistically significant(the fifth weekend: F=4.095, P=0.047, the eighth weekend: F=4.940, P=0.030). After 8 weeks of inclusion, there was a statistically significant difference between the two groups in the score of introverted and extroverted dimension ( F=4.157, P=0.045). There was no significant difference in the score of spiritual quality dimension at different time within the group or at the same time point between the groups.(2)HAMD score: There were statistically significant differences within group among different time(study group: baseline: 32.00±4.04, the fifth weekend: 15.23±5.01, the eighth weekend: 9.31±3.15, F=282.376, P<0.001.Control group: baseline: 31.91±4.59, the fifth weekend: 17.86±5.11, the eighth weekend: 11.17±3.64, F=195.019, P<0.001), and the differences between the two groups at the same time were statistically significant (the fifth weekend: F=4.724, P=0.033, the eighth weekend: F=5.205, P=0.026). (3)HAMA score: There were statistically significant differences within group among different time(study group: baseline: 18.69±8.87, the fifth weekend: 10.34±5.34, the eighth weekend: 7.97±2.98, F=28.679, P<0.001.Control group: baseline: 18.60±8.02, the fifth weekend: 13.31±6.35, the eighth weekend: 10.37±4.86, F=14.241, P<0.001). The difference between the two groups at the same time point was statistically significant (the fifth weekend: F=4.161, P=0.045, the eighth weekend: F=8.315, P=005). (4)Multiple linear regression results indicated that RBCMT ( β=-0.312, t=-2.360, P=0.022) and introverted and extroverted dimension personality ( β=-0.334, t=-2.355, P=0.022) were the influencing factors of HAMA. Conclusion:Compared with the conventional treatment, the Relative Bedrest Condition Morita Therapy can reduce the anxiety symptoms and improve the depressive symptoms by enhancing the extraversion personality characteristics of the patients.

A 28-year-old woman was found to have coagulation factor Ⅷ activity (FⅧ∶C) <1% and von Willebrand factor antigen (VWF∶Ag) <1% during routine prenatal examinations. No pathogenic variation was found in the exon region of the VWF gene using next-generation sequencing. The clinical presentation of this patient does not match the clinical characteristics of type Ⅲ hemophilia [von Willebrand disease (VWD) ]; therefore, third-generation sequencing technology was used to perform whole-genome sequencing on the patient and her family members. Multiple members of the patient’s paternal family carried a heterozygous variant of VPS33B, c.869G>C. The family members carrying this variant all had varying degrees of reduced VWF levels (39% -56% ). Moreover, the proband was detected with the heterozygous variant c.1474dupA in GP1BA. The ACMG and Clinvar databases determined that this variation was associated with platelet-type pseudo VWD. The decrease in VWF levels caused by heterozygous variations in VPS33B in families is the first international report, and no previous studies have reported cases of severe decrease in plasma VWF levels caused by double heterozygous variations in VPS33B and GP1BA.

Objective:To explore the associations of urinary retinol binding protein (RBP) and β 2-microglobulin (β 2-MG) with urinary albumin to creatinine ratio (UACR) and renal function in hospitalized patients with type 2 diabetes mellitus (T2DM). Methods:A total of 1 030 Chinese patients with T2DM were included in this study. The subjects were divided into the UACR normal group (<30 mg/g), microalbuminuria group (30-300 mg/g) and macroalbuminuria group (>300 mg/g). Patients with normal UACR were further divided into two groups according to the estimated glomerular filtration rate (eGFR): the eGFR low group (<90 ml·min -1·1.73m -2) and the normal eGFR group (≥90 ml·min -1·1.73m -2). Urine RBP and β 2-MG levels among the groups were compared. Multiple linear regression analyses were applied to evaluate risk factors of urine RBP and β 2-MG. Results:In all patients ( n=1 030), urine RBP and β 2-MG increased gradually with the increase of UACR across the three groups, the proportions of abnormal urine RBP (>0.7 mg/L) and β 2-MG (>370 μg/L) in these groups were 3.8%, 8.5%, 39.0% ( P<0.001), and 12.9%, 26.7%, 46.8% ( P<0.001), respectively. In the UACR normal group ( n=788), 12.2% of the patients were with eGFR<90 ml·min -1·1.73m -2. The proportion of abnormal β 2-MG (>370 μg/L) was higher in the eGFR low group than that in the eGFR normal group (29.2% vs. 10.7%, P<0.001). Multivariate linear stepwise regression analyses were performed using natural logarithm of urine RBP or β 2-MG as dependent variable, and showed that urine RBP was independently associated with UACR ( β=0.0005, P<0.001), serum creatinine ( β=0.006, P<0.001) and glycosylated hemoglobin A1c ( β=0.050, P=0.001), and β 2-MG was independently correlated with UACR ( β=0.000 4, P<0.001), serum creatinine ( β=0.011, P<0.001), systolic blood pressure ( β=0.005, P=0.031) and fasting blood-glucose ( β=0.027, P=0.046). Conclusions:Urine RBP and β 2-MG are positively associated with high UACR and impaired renal function in T2DM patients, and these changes could occur before UACR and eGFR turned out to be abnormal. It is recommended that urine RBP and β 2-MG be detected as early as possible to identify diabetic kidney disease in patients with normal UACR and eGFR.