Objective:To investigated the safety and efficacy of donor-derived CD19+ or sequential CD19+ CD22+ chimeric antigen receptor T-cell (CAR-T) therapy in patients with B-cell acute lymphoblastic leukemia (B-ALL) after allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods:The data of 22 patients with B-ALL who relapsed after allo-HSCT and who underwent donor-derived CAR-T therapy at the Zhujiang Hospital of Southern Medical University and the 920th Hospital of Joint Logistics Support Force of the People’s Liberation Army of China from September 2015 to December 2022 were retrospectively analyzed. The primary endpoint was overall survival (OS), and the secondary endpoints were event-free survival (EFS), complete remission (CR) rate, and Grade 3-4 adverse events.Results:A total of 81.82% ( n=18) of the 22 patients achieved minimal residual disease-negative CR after CAR-T infusion. The median follow-up time was 1037 (95% CI 546–1509) days, and the median OS and EFS were 287 (95% CI 132-441) days and 212 (95% CI 120-303) days, respectively. The 6-month OS and EFS rates were 67.90% (95% CI 48.30%-84.50%) and 58.70% (95% CI 37.92%-79.48%), respectively, and the 1-year OS and EFS rates were 41.10% (95% CI 19.15%-63.05%) and 34.30% (95% CI 13.92%-54.68%), respectively. Grade 1-2 cytokine release syndrome occurred in 36.36% ( n=8) of the patients, and grade 3-4 occurred in 13.64% of the patients ( n=3). Grade 2 and 4 graft-versus-host disease occurred in two patients. Conclusion:Donor-derived CAR-T therapy is safe and effective in patients with relapsed B-ALL after allo-HSCT.

Objective: To explore the current status of knowledge, attitudes and practices (KAP) regarding tuberculosis(TB)prevention and control among high school students, and to compare differences between male and female students, so as to provide a scientific basis for targeted TB prevention and control measures in high schools. Methods: From April to May 2024, a stratified cluster random sampling method was employed to conduct an electronic questionnaire survey among 1 912 students from 10 high schools using a compiled questionnaire on KAP towards TB prevention and control. The AMOS 26.0 software was utilized to construct structural equation modeling (SEM) and compared the difference among genders. Results: The overall awareness rate of core TB knowledge among high school students in Gongshu District was 76.62%. Additionally, core knowledge about TB (6.28±1.44), prevention attitudes (6.02±1.84), and prevention practices (6.38±2.11) scores of female students were higher than those of male students (5.96±1.74, 5.59±2.21, 6.15±2.23) ( t =4.31, 4.64, 2.25, P <0.05). The SEM showed that knowledge had a strong positive impact on practices and attitudes among boys, with total effect values of 0.963 and 0.819 , respectively; while the positive influence of attitudes on practices was relatively weak, with a total effect value of 0.186. Among girls, attitudes had a positive impact on practices and knowledge, with total effect values of 0.479 and 0.222, respectively. Conclusions The pathways and strengths of influence of KAP in the SEM of TB prevention and control differ between male and female high school students. Therefore, differentiated strategies should be implemented for TB health education targeting male and female high school students.

Objective:To explore the current situation of knowledge, attitude and practice in the prevention and treatment of lymphedema after tumor treatment among nurses in cancer hospitals, and analyze its influencing factors.Methods:This study is a cross-sectional study. From October to November 2021, convenience sampling was used to survey 478 nurses from Hunan Cancer Hospital using the self-made Lymphedema Prevention and Treatment Knowledge, Attitude and Practice Questionnaire, which included 41 items from three dimensions of knowledge, attitudes and practice. The influencing factors of nurses' knowledge, attitude and behaviors related to lymphedema were studied using univariate analysis and multiple linear regression analysis.Results:The knowledge, attitude and practice scores and the total score of nurses in the cancer hospital regarding the prevention and treatment of lymphedema after tumor treatment were (17.05±9.81) , (49.96±6.03) , (30.51±11.03) , and (97.53±21.52) , respectively. The score rate of knowledge dimension was the lowest at 42.63%, while the score rate of attitude dimension was the highest at 90.84%. Multiple linear regression showed that working with lymphedema patients, participation in lymphedema training, training forms (on-the-job continuing education, school studies, self-study) , and the nurses' department being the breast or gynecological oncology department were the influencing factors for the nurses' knowledge, attitude, and practice in the prevention and treatment of lymphedema ( F=15.801, P<0.01) . Conclusions:Nurses in the cancer hospital generally have a moderate level of knowledge, attitude and practice in the prevention and treatment of lymphedema after tumor treatment. They have poor knowledge mastery and need to improve their behavioral, but their attitude is relatively positive. Nursing managers in cancer hospitals should strengthen training on lymphedema related knowledge among nurses from departments other than breast and gynecological oncology, strengthen nurses' knowledge and behavior in the prevention and treatment of lymphedema, and cultivate lymphedema therapists and specialized nurses. At the national level, policies should be introduced to establish a complete lymphedema rehabilitation training system, and improve nurses' ability to prevent and treat lymphedema in clinical practice.

Objective:To explore the academic procrastination (AP) status and related factors in college students. Methods: Totally 828 undergraduates (277 male, 551 female, age 18-25 years) from Sun Yat-Sen University were investigated with a self-made questionnaire for basic information and Undergraduate Academic Procrastination Questionnaire (UAPQ) for AP status. UAPQ included overall learning procrastination (OLP), homework procrastination (HP), exam preparing procrastination (EPP) and self-learning procrastination (SLP). Students who scored more than 3 in OLP, HP, EPP, SLP were regarded as procrastinator. Result: The procrastination rates of OLP, HP, EPP, SLP were 40.7％, 29.7％, 41.5％, and 47.6％. Multiple linear regression analysis results showed that bigger (β = 0.32) and normal (β =0.15) influence for academic by mobile-phone, higher level of computer dependence (β =0.15) were positively related with academic procrastination. Higher (β =-0.27) and normal (β =-0.17) levels of grade satisfaction were negatively correlated with academic procrastination. The seniors' academic procrastination levels were lower than those in other grade (β =-0.12). Conclusion: It suggests that undergraduates procrastinate widely in many academic activities. Bigger and normal influence for academic by mobile-phone, higher level of computer dependence may be risk factors of procrastination, while being satisfied with grades and seniors may be protective factors.

Objective To explore the application effect of Interactive continuing nursing intervention model with three subjects and two tracks,which is based on internet and applied to chronic heart failure patients.Methods During January 1 to December 30,2017,110 chronic heart failure patients,who were going to discharge from the Second People's Hospital of Guangdong Province,were selected for this research.Participants were equally divided into control group and observation group with random number table with 55 cases each.Participants were adopted conventional medication and traditional care,while patients in control group were given extra interactive continuing nursing intervention with three subjects and two tracks,which was relied on internet-based cardiovascular disease management platform.Comparing patients' scores of life quality,self-care ability,anxiety and depression degree before intervention and that in 6 months after intervention with Minnesota Living with Heart Failure Questionnaire (MLHFQ),Self Care of Heart Failure Index (SCHFI),Self-rating Anxiety Scale(SAS)and Hamilton Depression Scale (HAMD) respectively.Moreover,6 minute walk test was conducted,simultaneously,the incidence of cardiovascular events was calculated respectively before intervention,3 months after intervention and 6 months after intervention.Results It showed that total scores of MLHFQ,SCHFI,SAS and HAMD for patients in observation group before intervention were (49.05 ± 4.39),(101.57 ±21.04),(58.3 ± 5.2) and (40.1 ± 3.5) points respectively while that for patients in observation group after 6 months intervention were (43.03 ± 6.85),(123.17 ± 18.23),(42.3 ± 4.2) and (24.4 ± 4.3) points respectively.The difference was statistically significant (t =5.49-20.60,all P ＜0.01).In comparison,intervention effect of observation group was better than that of control group,although,the SAS scores of the control group were statistically significant.Furthermore,after intervention,the difference of MLHFQ,SCHFI,SAS and HAMD scores were statistically significant(t =3.48-17.79,all P ＜0.01).Moreover,6 months after intervention,6 minute walk test evaluation showed that there was statistical significance between observation group and control group (~=8.11,P ＜0.05).Besides,The death rate in observation group was lower than that in control group after 6 months intervention (~=6.30,P ＜0.05).Meanwhile,readmission rate after 3 months and 6 months indicates that there was statistical significance between observation group and control group(x2=5.25,6.30,P ＜0.05).Conclusions Interactive nursing intervention model with three subjects and two tracks which based on internet is able to enhance chronic heart failure patients' self-care ability and life quality,decrease the incidence of cardiovascular events and negative emotion of patients.

Objective To explore the effect of neonatal exposure to different doses of Bisphenol A (BPA)on the hypothalamic -pituitary -testis axis in toddler and adolescent male rats.Methods Neonatal male Sprague -Daw-ley rats were randomly divided into 5 groups through random digital table method:control group,vehicle group,low -dose BPA [25 μg/(kg · d)]group,medium -dose BPA [50 μg/(kg · d)]group and high -dose BPA [250μg/(kg·d)]group.The rats were subcutaneously injected with respective agents on postnatal days 1 -7 (PND 1 -7).Pups were sacrificed on PND 22 and PND 50.The hypothalamus and testis were taken and weighed.The hypotha-lamic Kiss -1 mRNA and the testis androgen receptor (AR)mRNA were tested by using real -time fluorescence quan-titative and the levels of serum luteinizing hormone (LH),follicle stimulating hormone (FSH),testosterone (T)were tested by using radio immunity method,and inhibin B was measured by using enzyme linked immunosorbent assay. Results Compared with the controls,the level of serum FSH [(1 .610 0 ±0.693 2)IU /L,(1 .574 3 ±0.675 0)IU /L vs (2.362 9 ±0.580 3)IU /L](F =3.314,P =0.026),LH [(3.876 3 ±0.908 0)IU /L,(3.603 8 ±1 .350 2)IU /L vs (5.302 5 ±0.768 4)IU /L](F =3.1 39,P =0.027)and T [(0.383 8 ±0.1 77 8)μg/L,(0.442 5 ±0.21 4 1 )μg/L vs (0.782 5 ±0.282 1 )μg/L](F =5.1 06,P <0.01 )of medium and high -dose BPA groups,were decreased in PND 22,and the organ coefficient of testis [(0.952 90 ±0.049 1 5)%,(0.969 20 ±0.045 82)% vs (1 .022 80 ± 0.01 1 08)%](F =1 0.326,P <0.01 )and serum T [(1 .758 6 ±0.369 6)μg/L,(1 .71 8 8 ±0.395 7)μg/L vs (3.357 5 ±0.749 8)μg/L](F =1 3.799,P =0.01 2)were significantly decreased in PND 50.In high -dose BPA group of PND 22,the expression of hypothalamic Kiss -1 mRNA (0.068 80 ±0.01 1 79)was increased compared with the other groups (F =272.1 25,P <0.01 ),while in PND 50,compared with control group,the Kiss -1 mRNA (0.002 00 ±0.000 25,0.001 90 ±0.000 48 vs 0.001 40 ±0.000 1 7)of medium -and high -dose BPA groups was decreased(F =1 91 .826,P <0.01 ).Conclusions Neonatal exposure to the medium and high -dose BPA may impair the function of testis in toddler and adolescent male rats,and affect the hypothalamus -pituitary -testis axis.Neonatal exposure to the low -dose BPA does not have a significant influence on the hypothalamus -pituitary -testis axis.

were no significant differences in the detection rate of recto-sigmoid colon,mid colon,right colon and total detection of polyps among the 3 groups (P >0.05).Conclusion 4-L split-dose PEG is better than the oth-er 2 regimens in the colon cleansing quality,so it can better reach the intestinal cleaning standards before enteroscopy,which is a more suitable regimen for bowel preparation.

Objective To explore the effects of virtual reality (VR) combined with motor imagery therapy on the upper limb function of hemiplegic stroke survivors.Methods Thirty-nine hemiplegic stroke patients were divided randomly into a treatment group (n =20) and a control group (n =19).Both groups were treated with motor imagery therapy,but the treatment group also received VR training lasting 20 min/day,6 days/week for 8 weeks.All of the patients were assessed with the Fugl-Meyer (FMA) upper limb assessment,the modified Barthel index (MBI) and electromyography at the beginning and after eight weeks of treatment.Results Before the intervention there was no significant difference between the groups in any of the assessments.After eight weeks of treatment,all the assessment results in the treatment group were significantly better than those in the control group.Conclusion Virtual reality combined with motor imagery therapy can distinctly improve the upper limb motor function of hemiplegic stroke survivors and their ability in the activities of daily living.

Objective To investigate the correlation of multidrug resistance gene 1 (MDR1),NR3C1 gene polymorphisms and clinical risk factors with efficacy,dependence,and resistance of glucocorticoid (GC) in patients with inflammatory bowel disease (IBD).Methods Anti coagulation blood samples of 196 healthy controls and 105 IBD patients received GC therapy were collected.There were 62 ulcerative colitis (UC) and 43 Crohn's disease (CD) in the IBD patients.The number of GC sensitive,GC dependent and GC resistant of UC patients were 36,13 and 13,respectively,and those of CD patients were 24,11 and eight.GC refractoriness included GC dependence and resistance.The genotype of MDR1 C3435T and NR3C1 Bcl Ⅰ of all the subjects was detected by the restriction fragment length polymorphism-polymerase chain reaction (RFLP-PCR).The correlation between each genotype frequency,clinical features of patients with IBD and the efficacy of GC treatment was analyzed by Chisquare test,Fisher exact probability method or t test.Results Among UC patients,the disease course of GC refractory group and GC resistant group was longer than that of GC sensitive group ((6.660±1.523)years,(6.500±1.111) yearsvs (3.350±0.697) years,t=2.211,P=0.031; t=2.930,P=0.005).The serum level of C reaction protein (CRP) of GC refractory group was higher than that of GC sensitive group ((47.628±13.913) mg/Lvs (16.854±4.121) mg/L,t=2.121,P=0.047).The chronic relapse type was more common in GC refractory UC patients (Fisher exact probability method,P=0.035),and severe patients were more common in UC with GC resistance (Fisher exact probability method,P=0.021).The white blood cell count of GC resistant and GC refractory CD patient was lower than that of GC sensitive CD patients ((5.710 ± 0.604) ×109/L,(5.878±0.405) × 109/L vs (7.814 ±0.670) × 109/L,t=2.334,P=0.028; t=2.045,P=0.018).Patients with extraqntestinal manifestations was more common in CD with GC resistance (Fisher exact probability method,P=0.035).There was no statistically significant difference in the frequencies of MDR1 C3435T,NR3C1 Bcl Ⅰ genotypes,allelic genes and gene carrier among control group and GC sensitive dependent and resistant group of IBD patients.However,the frequency of MDR1 C3435T gene carrier was significantly different between GC sensitive group and GC refractory group,especially between GC sensitive group and GC resistance group (68.33％ vs 48.89％,x2 =4.051,P=0.044; 68.33％ vs 42.86％,x2 =4.274,P =0.039).Conclusions GC sensitivity of IBD patients with MDR1 C3435T loci T gene carrier was higher than that of IBD patients without T gene carrier.NR3C1 gene polymorphisms was not related with GC resistance and GC dependence.Compared with GC sensitive IBD patients,in GC resistant and GC dependent IBD pantient UC patients with long disease course,chronic relapse type,severe type,high level of CRP and CD patients with low white blood cell count and extra-intestinal manifestations were more common.

Objective To build the specialized transitional care process and evaluate its effect . Methods Firstly,the specialized transitional care organization structure was constructed , to make clear the responsibility of the member;to develop the specialized transitional care process .The transitional care content , medical costs including expense and time cost , patients’ satisfaction, and nurses’ satisfaction were investigated through self-made questionnaire .Results The main transitional care programs provided by the professional team were ordered from high to low: catheter care ( including PICC maintenance , stomach tube, catheter, etc., 27.3%), wound care (including colostomy care, 25.5%), pressure ulcers care(21.8%), peritoneal dialysis care ( 16.4%), function exercise guidance ( including surgery, hemiplegia after stroke, diabetic foot, postpartum breast massage guidance , etc., 9.0%).There were statistically significant differences about medical expense [(195.73 ±114.77) vs (95.11 ±25.68)] and time cost [(195.73 ±12.00)h vs (3.95 ± 1.68)h] before and after the operation of specialized transitional care process (t=69.71,80.93,respectively;P<0.05).Conclusions Building the specialized transitional care process is helpful to reduce the medical expense and time cost ,and to improve patients ’ satisfaction to nursing service .In the future it is necessary to optimize transitional care process based on the hospital-community-family ternary linkage .