Objective:To analyze the predictive effects of the Big Five personality traits and emotions on self-management behaviors in patients with type 2 diabetes mellitus (T2DM).Methods:This study was a cross-sectional research. From 2016 to 2020, community interventions for self-management among patients with chronic diseases were conducted in Hangzhou, targeting patients with type 2 diabetes recruited from 69 community health service centers across the city. The data for this study were derived from the baseline information collected during the community intervention. The Chinese Big Five Personality Inventory (CBF-PI-15), the Type 2 Diabetes Self-Management Scale (2-DSCS), the Self-Rating Anxiety Scale (SAS), and the Self-Rating Depression Scale (SDS) were employed for questionnaire assessments. Biochemical indicators, including postprandial 2-hour blood glucose, glycated hemoglobin (HbA 1c), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C), were measured. Spearman correlation analysis was used to examine the relationship between personality traits, relevant biochemical indicators, and self-management behaviors. Hierarchical regression analysis was employed to assess the predictive effects of the Big Five personality traits and emotions on self-management behaviors after controlling for demographic characteristics and factors related to health status. Results:A total of 839 patients were included in this study, comprising 518 females (61.75%) and 321 males (38.25%), with an average age of (66.92±8.67) years and an average disease duration of (8.87±6.91) years. There were significant differences in self-management behavior scores among patients with varying disease durations, educational levels, treatment methods, and levels of anxiety and depression ( t/F=6.172, 3.340, 4.699, 16.007, 27.127, all P<0.05). Neuroticism showed a negative correlation with various dimensions of self-management behaviors ( r=-0.130--0.073), while conscientiousness and agreeableness were positively correlated with various dimensions of self-management behaviors ( r=0.072-0.215). Dietary control score was negatively correlated with HbA 1c and LDL-C ( r=-0.106, -0.077), and regular exercise score was negatively correlated with postprandial 2-hour blood glucose, HbA 1c, TG, TC, HDL-C, and LDL-C ( r=-0.115--0.071). The total score of the 2-DSCS was negatively correlated with HbA 1c, TG, and TC ( r=-0.104--0.071). Patients with a disease duration exceeding 15 years and those receiving insulin injections or a combination of oral medication and insulin injections had higher total 2-DSCS score ( β=0.085, 0.146, 0.118, all P<0.05). Conversely, patients with higher HbA 1c and SDS standard scores had lower total 2-DSCS score ( β=-0.151, -0.328, both P<0.05), while those with higher agreeableness scores had higher total 2-DSCS score ( β=0.143, P<0.05). Conclusion:The traits of neuroticism, conscientiousness, and agreeableness within the Big Five Personality Traits, as well as anxiety and depressive emotions, are correlated with self-management behaviors. Specifically, agreeableness has a positive predictive effect on self-management behaviors, whereas depressive emotions have a negative predictive effect.

Objective:To analyze the predictive effects of the Big Five personality traits and emotions on self-management behaviors in patients with type 2 diabetes mellitus (T2DM).Methods:This study was a cross-sectional research. From 2016 to 2020, community interventions for self-management among patients with chronic diseases were conducted in Hangzhou, targeting patients with type 2 diabetes recruited from 69 community health service centers across the city. The data for this study were derived from the baseline information collected during the community intervention. The Chinese Big Five Personality Inventory (CBF-PI-15), the Type 2 Diabetes Self-Management Scale (2-DSCS), the Self-Rating Anxiety Scale (SAS), and the Self-Rating Depression Scale (SDS) were employed for questionnaire assessments. Biochemical indicators, including postprandial 2-hour blood glucose, glycated hemoglobin (HbA 1c), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C), were measured. Spearman correlation analysis was used to examine the relationship between personality traits, relevant biochemical indicators, and self-management behaviors. Hierarchical regression analysis was employed to assess the predictive effects of the Big Five personality traits and emotions on self-management behaviors after controlling for demographic characteristics and factors related to health status. Results:A total of 839 patients were included in this study, comprising 518 females (61.75%) and 321 males (38.25%), with an average age of (66.92±8.67) years and an average disease duration of (8.87±6.91) years. There were significant differences in self-management behavior scores among patients with varying disease durations, educational levels, treatment methods, and levels of anxiety and depression ( t/F=6.172, 3.340, 4.699, 16.007, 27.127, all P<0.05). Neuroticism showed a negative correlation with various dimensions of self-management behaviors ( r=-0.130--0.073), while conscientiousness and agreeableness were positively correlated with various dimensions of self-management behaviors ( r=0.072-0.215). Dietary control score was negatively correlated with HbA 1c and LDL-C ( r=-0.106, -0.077), and regular exercise score was negatively correlated with postprandial 2-hour blood glucose, HbA 1c, TG, TC, HDL-C, and LDL-C ( r=-0.115--0.071). The total score of the 2-DSCS was negatively correlated with HbA 1c, TG, and TC ( r=-0.104--0.071). Patients with a disease duration exceeding 15 years and those receiving insulin injections or a combination of oral medication and insulin injections had higher total 2-DSCS score ( β=0.085, 0.146, 0.118, all P<0.05). Conversely, patients with higher HbA 1c and SDS standard scores had lower total 2-DSCS score ( β=-0.151, -0.328, both P<0.05), while those with higher agreeableness scores had higher total 2-DSCS score ( β=0.143, P<0.05). Conclusion:The traits of neuroticism, conscientiousness, and agreeableness within the Big Five Personality Traits, as well as anxiety and depressive emotions, are correlated with self-management behaviors. Specifically, agreeableness has a positive predictive effect on self-management behaviors, whereas depressive emotions have a negative predictive effect.

Objective:This study aimed to analyze cytomegalovirus (CMV) reactivation and its influencing factors in patients with B-lymphocyte malignancy who received chimeric antigen receptor T (CAR-T) cell therapy.Methods:This study retrospectively reviewed patients with B-lymphocyte malignancy who received CAR-T cell therapy in the First Affiliated Hospital of Soochow University from January 2021 to December 2023. The data of patients who underwent CMV-DNA detection and/or pathogen metagenomic sequencing twice or more within 100 days after CAR-T cell therapy were analyzed. The clinical characteristics of the CMV reactivation and non-activation groups were compared. The factors related to CMV reactivation were analyzed with the Chi-square test and nonparametric rank sum test, and the risk factors were examined with Logistic regression.Results:This study included 86 patients, among whom 18 (20.9%) had CMV reactivation, and the median time of reactivation was 20 (1-95) days. All of the 18 patients had CMV viremia, and no CMV disease was observed. Seven patients turned to the latent state after continuing acyclovir antiviral therapy, and 11 patients returned to the latent state after upgrading the antiviral therapy to first-line drugs, including ganciclovir and foscarnet sodium. Six or more courses of anti-tumor treatment before CAR-T cell therapy, allogeneic hematopoietic stem cell transplantation within 2 years before CAR-T cell therapy, non-remission before treatment, and the use of high-dose glucocorticoids and/or tocilizumab were related to CMV reactivation, among which allogeneic hematopoietic stem cell transplantation within 2 years pre-treatment and the use of high-dose glucocorticoids and/or tocilizumab treatment were independent risk factors for CMV reactivation.Conclusion:Patients with B-lymphocyte malignancy who received CAR-T cell therapy have the risk of CMV reactivation, especially for those who received allogeneic hematopoietic stem cell transplantation within 2 years pre-treatment and those who received high-dose glucocorticoids and/or tocilizumab treatment.

Objective:This study aimed to analyze cytomegalovirus (CMV) reactivation and its influencing factors in patients with B-lymphocyte malignancy who received chimeric antigen receptor T (CAR-T) cell therapy.Methods:This study retrospectively reviewed patients with B-lymphocyte malignancy who received CAR-T cell therapy in the First Affiliated Hospital of Soochow University from January 2021 to December 2023. The data of patients who underwent CMV-DNA detection and/or pathogen metagenomic sequencing twice or more within 100 days after CAR-T cell therapy were analyzed. The clinical characteristics of the CMV reactivation and non-activation groups were compared. The factors related to CMV reactivation were analyzed with the Chi-square test and nonparametric rank sum test, and the risk factors were examined with Logistic regression.Results:This study included 86 patients, among whom 18 (20.9%) had CMV reactivation, and the median time of reactivation was 20 (1-95) days. All of the 18 patients had CMV viremia, and no CMV disease was observed. Seven patients turned to the latent state after continuing acyclovir antiviral therapy, and 11 patients returned to the latent state after upgrading the antiviral therapy to first-line drugs, including ganciclovir and foscarnet sodium. Six or more courses of anti-tumor treatment before CAR-T cell therapy, allogeneic hematopoietic stem cell transplantation within 2 years before CAR-T cell therapy, non-remission before treatment, and the use of high-dose glucocorticoids and/or tocilizumab were related to CMV reactivation, among which allogeneic hematopoietic stem cell transplantation within 2 years pre-treatment and the use of high-dose glucocorticoids and/or tocilizumab treatment were independent risk factors for CMV reactivation.Conclusion:Patients with B-lymphocyte malignancy who received CAR-T cell therapy have the risk of CMV reactivation, especially for those who received allogeneic hematopoietic stem cell transplantation within 2 years pre-treatment and those who received high-dose glucocorticoids and/or tocilizumab treatment.

Objective:To analyze the mediating effects of emotional changes in self-management interventions on the relationship between behavioral management and quality of life in elderly patients with type 2 diabetes and therefore to provide a reference for improving the emotional status of elderly diabetes patients and future community-based self-management interventions.Methods:From 2016 to 2020, a total of 69 self-management groups were formed in Hangzhou, each consisting of 10-15 patients with type 2 diabetes.Based on the construction of a medical consortium and family doctors signing up to provide services, intervention teams were established to conduct a series of group self-management activities for each group.Surveys via questionnaires were conducted before and after the intervention, as well as 6 months after the intervention, to collect patient data on demographics, disease status, emotions, quality of life, and self-management behaviors.The intervention effects were evaluated, and the correlations between emotional changes, self-management behaviors, and changes in quality of life were analyzed.Bootstrap analysis was used to test the mediating effects.Results:A total of 707 elderly diabetes patients were included.There were statistically significant differences in the scores of the Self-Rating Anxiety Scale(SAS), the Self-Rating Depression Scale(SDS), physical functioning, role-physical, bodily pain, general health, vitality, social functioning, role-emotional, mental health, physical component summary, mental component summary, the dietary control dimension of the type 2 diabetes self-care scale(2-DSCS), regular exercise, medication adherence, blood glucose monitoring, foot care, the dimension of prevention and management of hyperglycemia and hypoglycemia, and the total score of 2-DSCS( P<0.05 for all).Compared with pre-intervention, changes in SAS, SDS, physical component summary and mental component summary scores were all correlated with each dimension of 2-DSCS right after intervention and 6 months after intervention( r=-0.336-0.333, P<0.05), with the exception of changes in the blood glucose monitoring dimension score and changes in the emotional status score.The direct effect of self-management behavior on the quality of life in elderly patients with type 2 diabetes was 0.159, and the indirect effect through emotions was 0.229, with the mediating effect accounting for 59.02% of the total effect. Conclusions:Community-based group self-management activities can effectively improve the emotions and management behaviors of elderly diabetes patients and enhance their quality of life, Emotional changes play a certain mediating role between self-management behaviors and improvement in quality of life.

Objective:To systematically review and evaluate the effect of small-dose naloxone on the development of nausea and vomiting during postoperative analgesia with opioid drugs in patients.Methods:Electronic Databases including Pubmed, Embase, Cochrane, Web of Science, China National Knowledge Infrastructure, Wanfang Data, China Biomedical Literature Database, and China Science and Technology Journal Database databases were searched from inception to May 2023 for randomized controlled trials involving the effect of small-dose naloxone on the development of adverse effects during postoperative analgesia with opioids. All randomized controlled trials enrolled included naloxone group and control group, the primary outcome was the incidence of postoperative nausea and vomiting, and the secondary outcome was postoperative VAS. Meta-analysis was performed using Stata 16.0 software.Results:Seven randomized controlled trials involving 542 patients were finally included in this meta-analysis. Compared with control group, the incidence of nausea and vomiting during postoperative analgesia was significantly decreased in naloxone group ( P<0.05), and no significant change was found in postoperative VAS scores ( P>0.05). Conclusions:Small-dose naloxone can reduce the development of nausea and vomiting during postoperative analgesia with opioid drugs.

Objective:To assess the safety and effectiveness of amphotericin B cholesteryl sulfate complex for injection in the context of empirical and diagnostic antifungal therapy for patients with hematological malignancies in addition to invasive fungal illness.Methods:This single-arm clinical study enrolled 30 patients who received empirical and diagnostic-driven antifungal therapy for hematological malignancies combined with invasive fungal disease. The primary endpoint was safety. Response rate, fever duration, and treatment completion rate were all considered secondary objectives.Results:30 participants were eventually enrolled in the study, and the treatment completion rate was 80.0% . Most adverse events were in grades 1-2. Infusion response was the most frequent adverse event (24/30, 80% ) . The overall response rate was 80.0% (24/30) . In 24 patients (80.0% ) , the fever persisted for 1 day.Conclusions:Treatment of invasive fungal illness in conjunction with hematological malignancies showed good efficacy and safety with amphotericin B cholesteryl sulfate complex for injection.

Objective:To evaluate the effect of Activin-A on spinal inflammatory response in rats with incisional pain and the relationship with p38 mitogen-activated protein kinase (MAPK) signaling pathway.Methods:Forty-eight SPF healthy male Sprague-Dawley rats, aged 1 month, weighing 100-150 g, were divided into 4 groups ( n=12 each) by the random number table method: sham operation group (S group), incisional pain group (I group), sham operation + antagonist group (SA group) and incisional pain + antagonist group (IA group). The rat model of incisional pain was prepared in group I and group IA.At the first 30 min of model preparation, the antagonist follicle statin 5 μg/kg was intraperitoneally injected in SA and IA groups, and the normal saline 5 μg/kg was intraperitoneally injected in S and I groups.At 24 h before model preparation (T 0) and 2, 6 and 24 h after model preparation (T 1-3), 3 rats in each group were randomly selected to measure the thermal paw withdrawal latency (TWL). Then 3 rats in each group were randomly sacrificed, and the spinal cord L 4-6 segments were taken for determination of the expression of Activin-A and p38 MAPK mRNA (by quantitative real-time polymerase chain reaction) and contents of tumor necrosis factor-α (TNF-α) and interleukin (IL)-1β (by enzyme-linked immunosorbent assay). Results:Compared with group S, the TWL was significantly shortened, the contents of TNF-α and IL-1β were increased, and the expression of Activin-A and p38 MAPK mRNA was up-regulated at T 1-3 in I and IA groups ( P<0.05), and no significant change was found in each parameter in group SA ( P>0.05). Compared with group SA, the TWL was significantly shortened, the contents of TNF-α and IL-1β were increased, and the expression of Activin-A and p38 MAPK mRNA was up-regulated at T 1-3 in I and IA groups ( P<0.05). Compared with group I, the TWL was significantly prolonged, the contents of TNF-α and IL-1β were decreased, and the expression of Activin-A and p38 MAPK mRNA was down-regulated at T 1-3 in group IA ( P<0.05). Conclusions:Activin-A is involved in spinal inflammatory response through activating the p38 MAPK signaling pathway in rats with incisional pain.

Objective:To preliminarily investigate the relationship between the mechanism of sevoflurane-induced cerebral neurotoxicity and receptors of 5-HT 1A and 5-HT 3 in aged rats. Methods:Twenty-four clean-grade healthy male Sprague-Dawley rats, aged 18-20 months, weighing 600-750 g, were divided into 3 groups ( n=8 each) using a random number table method: group C, group LS and group HS.In group C, group LS and group HS, 50% O 2, 1.5% sevoflurane plus 50% O 2 and 3% sevoflurane plus 50% O 2 were inhaled for 2 h, respectively.Open field test was performed at 1 day before inhalation of sevoflurane and at 1 day after the end of inhalation, the time spent in the central square, the number of crossing the grid and the number of standing on the back legs were recorded.The Morris water maze test was performed at 6 days before inhalation of sevoflurane and at 1 day after the end of inhalation, the escape latency, the total swimming distance and the number of crossing the platform were recorded.Immediately after the end of behavioral testing, the hippocampal tissues were obtained for determination of 5-HT 1A and 5-HT 3 receptors mRNA expression and the number of positive cells (using real-time reverse transcription-polymerase chain reaction assay and immunohistochemical method). Results:Compared with group C, the time spent in the central square was significantly prolonged, the number of crossing the grid and the number of standing on the back legs were decreased, the escape latency was prolonged, the total swimming distance was increased, the number of crossing platform was decreased, the mRNA expression of 5-HT 1A and 5-HT 3 was down-regulated, and the number of positive cells was decreased in HS group ( P<0.05). Conclusion:The mechanism of cerebral neurotoxicity induced by sevoflurane may be related to the down-regulation of the activities of 5-HT 1A and 5-HT 3 receptors in aged rats.

Objective:To evaluate the effect of oxiracetam on sevoflurane-induced cognitive dysfunction in mice and the role of phosphatidylinositol 3-kinase/serine/threonine protein kinase (PI3K/Akt) signaling pathway.Methods:Eighty adult Kunming mice, half male and half female, weighing 35-55 g, were divided into 4 groups ( n=20 each) using a random number table method: control group (group C), sevoflurane group (group S), oxiracetam plus sevoflurane group (group OS), and LY294002 plus oxiracetam plus sevoflurane group (group LOS). Group S inhaled 2% sevoflurane for 6 h. A 2 h before sevoflurane anesthesia, oxiracetam 105 mg/kg was injected via the tail vein in group OS, oxiracetam 105 mg/kg and LY294002 0.3 mg/kg were injected via the tail vein in group LOS, and the equal volume of normal saline was injected in group S. The apoptosis rate of hippocampal neurons was detected using TUNEL.The expression of PI3K, phosphorylated PI3K (p-PI3K), Akt and phosphorylated Akt (p-Akt) was determined by Western blot.Cognitive function was assessed using Y-maze at 14 days after the end of anesthesia. Results:Compared with group C, the apoptosis rate of hippocampal neurons was significantly increased, the total number of times and the number of errors required for 10 times of correct responses in Y-maze test were increased, and the expression of PI3K, Akt p-PI3K and p-Akt in hippocampal tissues was down-regulated in group S ( P<0.05). Compared with group S, the apoptosis rate of hippocampal neurons was significantly decreased, the total number of times and the number of errors required for 10 times of correct responses in Y-maze test were decreased, the expression of PI3K, Akt, p-PI3K and p-Akt in hippocampal tissues was up-regulated in group OS ( P<0.05), and no significant changes were found in the parameters mentioned above in group LOS ( P>0.05). Compared with group OS, the apoptosis rate of hippocampal neurons was significantly increased, the total number of times and the number of errors required for 10 times of correct responses in Y-maze test were increased, and the expression of PI3K, Akt, p-PI3K and p-Akt in hippocampal tissues was down-regulated in group LOS ( P<0.05). Conclusion:Oxiracetam can alleviate sevoflurane-induced cognitive dysfunction in mice, and the mechanism may be related to activating PI3K/Akt signaling pathway and inhibiting apoptosis in neurons.