Objective To develop the Dissociative Trait Scale(DTS),and examine its reliability and validity. Methods Based on literature and research work,a preliminary questionnaire was designed to measure dissociative trait. 1306 college students completed the DTS and Symptom Checklist 90(SCL-90). Results Exploratory factor analysis extracted eight factors. The percentage of variance explained was 57.69％. The Cronbach α-coefficient of the total scale and the eight subscales ranged from 0. 830 ～ 0. 969, the test-retest reliability ranged from 0.575 ～ 763 (P ＜ 0.01 ). The scores of DTS significantly positively correlated with the scores of SCL-90 (P ＜0.01 ). Conclusion The DTS has acceptable psychometric quality,and can be applied to assess dissociative traits in Chinese college students.

Objective? To evaluate the effects of Sandwich teaching in school learning phase among nursing students in China. Methods? We retrieved the control studies on the application effects of Sandwich teaching and conventional teaching in school teaching phase of nursing in China National Knowledge Infrastructure (CNKI), VIP database and WanFang database from January 2000 to June 2018 by computer. The Review Manager (RevMan) 5.3 was used to the meta-analysis. Results? A total of 14 literatures were included finally. Analysis showed that the theoretical achievements and practical achievements of nursing students during school learning phase with Sandwich teaching were better than those with conventional teaching with statistical differences (P＜ 0.05), and critical thinking of them obviously improved statistically (P＜ 0.05). Conclusions? Based on the existing literatures, the effects of Sandwich teaching in school learning phase among nursing students are better than those of conventional teaching.

Objective To investigate the current status of posttraumatic growth among digestive system cancer patient' families, and explore correlation of posttraumatic growth with social support, coping style in digestive system cancer patient' s families. Methods The Posttraumatic Growth Inventory, Perceived Social Support Scale and Simplified Coping Style Questionnaire were used to survey the 280 digestive system cancer patient' s families. Results The mean posttraumatic growth total score in families of the patients with digestive system cancer was (46.03 ± 15.83) points. The highest score was found for appreciation of life, the lowest was spiritual change. Meanwhile, posttraumatic growth was significantly correlated with perceived social support. The correlation coefficient was 0.730 (P<0.01). In the coping style, there was a positive correlation between positive coping style and post-traumatic growth. The correlation coefficient was 0.644, (P<0.01). While except personal relationship and mental change dimensions, there was a negative correlation between the post-traumatic growth with the negative coping style. The correlation coefficient was-0.155 (P<0.05). Conclusions Family of patients with digestive system cancer also experience posttraumatic growth when their loved ones are diagnosed with cancer, but the posttraumatic growth was at the lower level. Social support and positive coping are the positive factors of post traumatic growth, and negative coping is the negative influencing factor.

Objective:To explore the relationship between expression levels of CLOCK mRNA and protein and the clinical characteristics of patients with nasopharyngeal carcinoma.Methods:The frozen tissue specimens from 33 patients with nasopharyngeal carcinoma in the Affiliated Tumor Hospital of Guizhou Medical University from 2018 to 2019 were collected. Seventeen cases of tissue specimens from patients with nasopharyngeal chronic inflammation in the Affiliated Hospital of Guizhou Medical University in 2019 were collected. From 2008 to 2014, 68 cases of formalin-fixed paraffin-embedding (FFPE) nasopharyngeal carcinoma tissue and 37 cases of FFPE nasopharyngeal chronic inflammation tissue were collected from the Affiliated Tumor Hospital of Guizhou Medical University. Real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR) and western blot (WB) were used to detect the mRNA and protein expression levels of CLOCK. The nasopharyngeal carcinoma cells including CNE1, CNE2, 5-8F and the normal nasopharyngeal epithelial cell NP69 were cultured. qRT-PCR was used to detect the expression level of CLOCK mRNA in each cell line at the time points of ZT2, ZT6, ZT10, ZT14, ZT18 and ZT22. The cosine method was used to fit the rhythm of CLOCK gene in nasopharyngeal carcinoma. The protein expression of CLOCK protein was detected by using immunohistochemical method in 68 cases of nasopharyngeal carcinoma and 37 cases of nasopharyngeal chronic inflammation tissue. Survival was analyzed by Kaplan-Meier method and Log rank test, and the influencing factors was analyzed by Cox regression model.Results:The expression levels of CLOCK mRNA in CNE1, CNE2 and 5-8F cells (0.63±0.07, 0.91±0.02 and 0.33±0.04, respectively) were lower than that in NP69 cell (1.00±0.00, P<0.05). The expression levels of CLOCK protein in CNE1, CNE2 and 5-8F cells (0.79±0.06, 0.57±0.05 and 0.74±0.10, respectively) were lower than that of NP69 cells (1.00±0.00, P<0.05). The expressions of CLOCK mRNA in nasopharyngeal carcinoma cells including CEN1, CNE2, 5-8F and normal nasopharyngeal epithelial cell NP69 were different at different time points, with temporal fluctuations. The fluctuation periods of CLOCK mRNA in CNE1, CNE2, 5-8F, and NP69 cells were 16, 14, 22 and 24 hours, respectively. The peak and trough times were ZT10: 40 and ZT18: 40, ZT10 and ZT3, ZT14: 30 and ZT3: 30, ZT12: 39 and ZT0: 39, respectively. CLOCK mRNA and protein expression levels in nasopharyngeal carcinoma tissues (0.37±0.20 and 0.20±0.26, respectively) were lower than those in nasopharyngeal chronic inflammation tissues (1.00±0.00 and 0.51±0.41, respectively, P<0.05). The 1, 3, and 5-year survival rates of patients in the CLOCK protein high expression group (CLOCK protein expression level ≥ 0.178) were 96.2%, 92.1%, and 80.1%, respectively, which were higher than those in the low expression group (CLOCK protein expression level <0.178, 92.9% , 78.6% and 57.1%, respectively, P=0.009). The 1, 3, and 5-year progression-free survival (PFS) rates of patients in the CLOCK protein high expression group were 96.2%, 87.8%, and 87.7%, respectively, which were higher than those in the low expression group (92.7%, 82.2%, and 70.8%, respectively, P=0.105). Compared with the low-expression group (100.0%, 96.9%, and 90.0%, respectively), the 1, 3, and 5-year recurrence-free survival rates of patients in the CLOCK protein high expression group (100.0%, 95.7%, and 95.7%, respectively) were not statistically significant ( P=0.514). Compared with the low-expression group (92.7%, 82.2%, and 79.3%), the 1, 3, and 5-year survival rates without metastasis in the CLOCK protein high expression group (96.2%, 92.0%, and 92.0%, respectively) were not statistically significant ( P=0.136). CLOCK protein expression and T stage were independent prognostic factors of overall survival ( P<0.05). Conclusions:The expression of CLCOK is downregulated in the nasopharyngeal carcinoma cell and nasopharyngeal carcinoma tissues. Clock gene CLOCK is rhythmically expressed in the nasopharyngeal carcinoma cells and normal nasopharyngeal epithelial cells. Compared with normal nasopharyngeal epithelial cells, the fluctuation period of CLOCK in nasopharyngeal carcinoma cells is shortened. The overall survival of patients in the CLOCK protein high expression group is better than that of low expression group. The expression of CLOCK protein is an independent influencing factor for overall survival. CLOCK gene may be a potential tumor suppressor gene in the nasopharyngeal carcinoma.

Objective:To explore the relationship between expression levels of CLOCK mRNA and protein and the clinical characteristics of patients with nasopharyngeal carcinoma.Methods:The frozen tissue specimens from 33 patients with nasopharyngeal carcinoma in the Affiliated Tumor Hospital of Guizhou Medical University from 2018 to 2019 were collected. Seventeen cases of tissue specimens from patients with nasopharyngeal chronic inflammation in the Affiliated Hospital of Guizhou Medical University in 2019 were collected. From 2008 to 2014, 68 cases of formalin-fixed paraffin-embedding (FFPE) nasopharyngeal carcinoma tissue and 37 cases of FFPE nasopharyngeal chronic inflammation tissue were collected from the Affiliated Tumor Hospital of Guizhou Medical University. Real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR) and western blot (WB) were used to detect the mRNA and protein expression levels of CLOCK. The nasopharyngeal carcinoma cells including CNE1, CNE2, 5-8F and the normal nasopharyngeal epithelial cell NP69 were cultured. qRT-PCR was used to detect the expression level of CLOCK mRNA in each cell line at the time points of ZT2, ZT6, ZT10, ZT14, ZT18 and ZT22. The cosine method was used to fit the rhythm of CLOCK gene in nasopharyngeal carcinoma. The protein expression of CLOCK protein was detected by using immunohistochemical method in 68 cases of nasopharyngeal carcinoma and 37 cases of nasopharyngeal chronic inflammation tissue. Survival was analyzed by Kaplan-Meier method and Log rank test, and the influencing factors was analyzed by Cox regression model.Results:The expression levels of CLOCK mRNA in CNE1, CNE2 and 5-8F cells (0.63±0.07, 0.91±0.02 and 0.33±0.04, respectively) were lower than that in NP69 cell (1.00±0.00, P<0.05). The expression levels of CLOCK protein in CNE1, CNE2 and 5-8F cells (0.79±0.06, 0.57±0.05 and 0.74±0.10, respectively) were lower than that of NP69 cells (1.00±0.00, P<0.05). The expressions of CLOCK mRNA in nasopharyngeal carcinoma cells including CEN1, CNE2, 5-8F and normal nasopharyngeal epithelial cell NP69 were different at different time points, with temporal fluctuations. The fluctuation periods of CLOCK mRNA in CNE1, CNE2, 5-8F, and NP69 cells were 16, 14, 22 and 24 hours, respectively. The peak and trough times were ZT10: 40 and ZT18: 40, ZT10 and ZT3, ZT14: 30 and ZT3: 30, ZT12: 39 and ZT0: 39, respectively. CLOCK mRNA and protein expression levels in nasopharyngeal carcinoma tissues (0.37±0.20 and 0.20±0.26, respectively) were lower than those in nasopharyngeal chronic inflammation tissues (1.00±0.00 and 0.51±0.41, respectively, P<0.05). The 1, 3, and 5-year survival rates of patients in the CLOCK protein high expression group (CLOCK protein expression level ≥ 0.178) were 96.2%, 92.1%, and 80.1%, respectively, which were higher than those in the low expression group (CLOCK protein expression level <0.178, 92.9% , 78.6% and 57.1%, respectively, P=0.009). The 1, 3, and 5-year progression-free survival (PFS) rates of patients in the CLOCK protein high expression group were 96.2%, 87.8%, and 87.7%, respectively, which were higher than those in the low expression group (92.7%, 82.2%, and 70.8%, respectively, P=0.105). Compared with the low-expression group (100.0%, 96.9%, and 90.0%, respectively), the 1, 3, and 5-year recurrence-free survival rates of patients in the CLOCK protein high expression group (100.0%, 95.7%, and 95.7%, respectively) were not statistically significant ( P=0.514). Compared with the low-expression group (92.7%, 82.2%, and 79.3%), the 1, 3, and 5-year survival rates without metastasis in the CLOCK protein high expression group (96.2%, 92.0%, and 92.0%, respectively) were not statistically significant ( P=0.136). CLOCK protein expression and T stage were independent prognostic factors of overall survival ( P<0.05). Conclusions:The expression of CLCOK is downregulated in the nasopharyngeal carcinoma cell and nasopharyngeal carcinoma tissues. Clock gene CLOCK is rhythmically expressed in the nasopharyngeal carcinoma cells and normal nasopharyngeal epithelial cells. Compared with normal nasopharyngeal epithelial cells, the fluctuation period of CLOCK in nasopharyngeal carcinoma cells is shortened. The overall survival of patients in the CLOCK protein high expression group is better than that of low expression group. The expression of CLOCK protein is an independent influencing factor for overall survival. CLOCK gene may be a potential tumor suppressor gene in the nasopharyngeal carcinoma.

Objective:To analyze the efficacy and safety of CLAG regimen (cladribine, cytarabine, granulocyte colony-stimulating factor) in treatment of relapsed/refractory acute myeloid leukemia (AML).Methods:The clinical data of 30 patients with relapsed/refractory AML who were admitted to Suzhou Hongci Blood Disease Hospital from January 2018 to February 2021 were retrospectively analyzed, and the efficacy and adverse reactions were observed.Results:Among 30 patients, 1 patient was not evaluated for efficacy due to treatment-related death. Among the 29 evaluable patients, 17 patients (58.6%) achieved complete remission (CR), 5 patients (17.3%) achieved partial remission (PR) and 7 patients (24.1%) had no remission (NR). One patient in low-medium-risk group achieved CR; the CR rate in medium-risk group was higher than that in high-risk group [68.8% (11/16) vs. 41.7% (5/12)], but the difference was not statistically significant ( P = 0.250). Seven patients with M 5 achieved CR. Five patients with positive MLL gene rearrangement achieved CR. Among 6 patients with extramedullary invasion of leukemia cells, 4 patients achieved CR, and among them 3 patients with central nervous system invasion achieved CR. Among 6 patients with cladribine 3.5 mg·m -2·d -1×5 d, 1 patient died of infection after chemotherapy, 1 patient had NR, and the rest achieved CR. Among 24 patients with cladribine 5 mg·m -2·d -1×5 d, the CR rate in patients with cytarabine 2 g·m -2·d -1×5 d was higher than that in patients with cytarabine 1 g·m -2·d -1×5 d [70.0% (7/10) vs. 42.9% (6/14)], but the difference was not statistically significant ( P = 0.240). All patients developed grade Ⅳ myelosuppression after chemotherapy. 12 patients underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT) after CR, and 9 patients were still alive. Conclusions:CLAG regimen is effective and well tolerated in the treatment of relapsed/refractory AML. In order to improve the prognosis, allo-HSCT should be performed as soon as possible after CR.

Objective:To evaluate the effect of mindfulness-base cognitive therapy (MBCT) in improving patients with depression, and to explore its effect on patients early maladaptive schemas (EMSs).Methods:Sixty patients with depressive disorder were included in the pre- and post-control design, and MBCT treatment was carried out for 8 weeks. The Hamilton depression scale-17 (HAMD-17), Hamilton anxiety scale (HAMA), five facet mindfulness questionnaire (FFMQ), and Young schema questionnaire-short form (YSQ-SF) were used for evaluation. The scores of the three time points were compared by one-way repeated measure ANOVA and Kruskal Wallis test. Pearson correlation analysis and multiple linear regression analysis were used to explore the relationship between the improvement degree of depression and anxiety symptoms, as well as the changes of mindfulness level and schema.Results:There were significant differences in the total scores of HAMD-17, HAMA and FFMQ at baseline((15.4±5.0), (21.0±9.6), (115.8±11.7)), 4 weeks after intervention((11.4±6.7), (15.9±10.1), (121.9±14.2)) and 8 weeks((11.0±6.2), (15.4±8.7), (122.6±15.5)) after intervention ( F=25.22, 20.95, 14.02, all P<0.01). Further pairwise comparison, compared with baseline, the total scores of HAMD-17 and HAMA in patients with depression decreased (all P<0.05), and the total scores of FFMQ increased (all P<0.05) in 8 weeks and 4 weeks after treatment.There were no significant differences in the total scores of HAMD-17, HAMA and FFMQ between 8 weeks and 4 weeks after treatment (all P>0.05). There were significant differences on the scores of the emotional deprivation, abandonment/instability, failure, vulner ability to harm or illness, enmeshment/undeveloped self, unrelenting standards/hypercriticalness, and entitlement/grandiosity subscales in the YSQ-SF( H=2.00-17.11, all P<0.05). Regression analysis showed that the FFMQ total score difference has a linear relationship with the HAMA total score difference ( β=-0.363). There was a linear relationship between the emotional deprivation scale score difference and the HAMD-17 total score difference ( β=-0.292). Dependence/incompetence and submission scale score difference showed a linear relationship with the HAMA total score difference ( β=0.334, 0.278). Conclusion:MBCT can improve the anxiety and depression symptoms of patients with depression, and the improvement of some EMSs may be the mechanism of MBCT in the treatment of depression.

Objective:To summarize the clinical characteristics of an early death in patients with de novo acute promyelocytic leukemia (APL) , analyze the risk factors and direct causes of early death, and perform survival analysis.Methods:The clinical data of 368 patients with de novo APL in three centers (First Affiliated Hospital of Soochow University, Soochow Guangci Hospital, and Soochow Hopes Hospital of Hematology) during January 2011-December 2017 were retrospectively analyzed. The clinical characteristics of patients who suffered hemorrhagic early death and non-hemorrhagic early death were compared. The risk factors for early death, survival, and prognosis of patients with APL were analyzed.Results:Among the 368 de novo APL patients, 31 died early with an early mortality rate of 8.4%. The median time from diagnosis to death was 7 (0-29) d. On comparison of the clinical characteristics of patients with early death and non-early death and subsequent multivariate analysis using a logistic regression model, it was observed that age ≥50 years and WBC ≥10×10 9/L were independent risk factors for early death ( P<0.01) . A total of 27 (87.1%) of the 31 early deaths was directly attributed to hemorrhage as the immediate cause of early death. Hemorrhage was the only cause of death in patients <50 years old and the major cause of death in patients ≥50 years old. A comparison of the clinical characteristics of patients with hemorrhagic early death and patients with non-hemorrhagic early death suggested that the median age and indirect bilirubin concentration of patients with hemorrhagic early death were lower than those with non-hemorrhagic early death ( P<0.05) . The median follow-up time for all patients was 41.0 (0.3-101.4) months. The 2-year overall survival (OS) rate was (93.5±1.3) %, and the 5-year OS rate was (91.0±1.5) %. The 2-year disease-free survival (DFS) rate was (98.8±0.6) %, and the 5-year DFS rate was (97.1±0.9) %. The 2-year OS rate of patients ≥50 years old and patients <50 years old was 79.3% vs 94.2%, P=0.000; the 2-year DFS rate was 92.3% vs 98.1%, P=0.023. The respective 2-year OS rates of high-risk and non-high-risk patients were 77.3% and 96.7% ( P=0.000) and the respective 2-year DFS rates were 94.0% and 98.4% ( P=0.139) . Conclusion:Age and WBC are independent prognostic factors for early death. We observed a difference in early mortality between high-risk and low-risk APL, but no difference in DFS rate.