ObjectiveMyelodysplastic syndromes （MDS） is a group of clonal hematopoietic stem cell disorders，and this study aims to investigate the expression of hypoxia-inducible factor-1α（HIF-1α） in the bone marrow cells of patients with MDS and its correlation with the clinical features of MDS，the therapeutic efficacy of arsenic-containing Chineseherbal compound，and the survival prognosis. MethodAccording to the inclusion and exclusion criteria，27 MDS patients treated with arsenic-containing Chinese herbal compound in the Department of Hematology，Xiyuan Hospital，China Academy of Chinese Medical Sciences from January 2022 to September 2022 were included，and their bone marrow samples were collected by myelotomy. HIF-1α expression level in bone marrow cells was detected by real-time polymerase chain reaction （PCR） to analyze its correlation with clinical features，and logistic and Cox regression was used to analyze the risk factors affecting the efficacy and prognostic survival of MDS patients. ResultThe HIF-1α mRNA expression level was lower in bone marrow cells of MDS patients than in healthy subjects. HIF-1α was positively correlated with the degree of myelodysplasia（r=0.384，P<0.05） and bone marrow granulocytic system%（G%）（r=0.560，P<0.01）. Logistic regression showed that HIF-1α was a risk factor for the prognosis in the follow-up of the efficacy of treatment（P<0.05）and Cox regression showed that HIF-1α was an independent factor affecting the survival prognosis of MDS patients ［odds ratio（OR）=398.968，95% confidence interval（CI）（1.281，116 858.743），P<0.05］. ConclusionThe level of HIF-1α expression in bone marrow cells of MDS patients was closely related to the degree of clinical myelodysplasia and G%，and HIF-1α was a risk factor for the efficacy for and survival prognosis of MDS patients.

Objective: To examine the mediating effects of mindfulness level on resilience and symptoms of anxiety and depression among healthcare workers, so as to provide the reference for developing effective psychological intervention. Methods: The clinical doctors, nurses and public health professionals were selected using the stratified random cluster sampling method from hospitals, disease prevention and control centers, and health departments in five cities in Shandong Province, including Qingdao, Jinan, Rizhao, Jining and Liaocheng in January 2023. Basic information, mindfulness level, resilience and symptoms of anxiety and depression among healthcare workers were collected using general demographic questionnaires, the 5-item Mindful Attention Awareness Scale, 10-item Connor-Davidson Resilience Scale, Generalized Anxiety Disorder Scale and Patient Health Questionnaire, respectively. The Process program was used to analyze the mediating effects of mindfulness level on resilience and symptoms of anxiety and depression. Results: A total of 1 836 healthcare workers were investigated, including 472 males (25.71%) and 1 364 females (74.29%), and the median age was 39 (interquartile range, 12) years. There were 629 clinical doctors (34.26%), 963 nurses (52.45%) and 244 public health professionals (13.29%). The median scores of mindfulness level and resilience were 22 (interquartile range, 7) and 20 (interquartile range, 4) points, respectively. The detection rates of anxiety and depression symptoms were 49.78% and 72.28%, respectively. The mediation analysis showed that mindfulness level exerted a partial mediating effect between resilience and anxiety symptoms (β=-0.510, P<0.001), with a direct effect value of -0.130 and a mediating effect value of -0.046, and the mediating effect accounted for 26.14% of the total effect; mindfulness level also exerted a partial mediating effect between resilience and depression symptoms (β=-0.575, P<0.001), with a direct effect value of -0.120 and a mediating effect value of -0.052, and the mediating effect accounted for 30.23% of the total effect. Conclusion Mindfulness level plays a mediating effect between resilience and symptoms of anxiety and depression among healthcare workers.

Objective We aimed to investigate the TCM syndrome characteristics and risk factors of early death in higher-risk patients with myelodysplastic syndromes with excess blasts (HR-MDS-EB). Methods The data of 57 HR-MDS-EB patients in the hematology ward of Xiyuan Hospital, China Academy of Chinese Medical Sciences admitted between January 2013 and August 2020 were analyzed. Patients were divided into an early death group and a non-early death group according to the survival time. The basic information, clinical characteristics, specialized examination, complete blood cell counts and laboratory examination result for first diagnosis, TCM syndrome characteristics, and other data of patients were collected and analyzed to screen the risk factors of death.Results There were statistically significant differences in Charlson comorbidity index (CCI) score, Barthel index score, platelet count at first diagnosis, blast ratio in peripheral blood, lactate dehydrogenase levels, blazing pathogenic heat pattern, and constipation between the early death group and the non-early death group (P<0.05). According to the result of the above univariate analysis, logistic multivariate regression analysis was performed for significant factors P<0.05. CCI score had statistically significant effects on the risk of death (P<0.05).Conclusion Higher CCI score is an independent risk factor for early death in HR-MDS-EB patients.

ObjectiveTo investigate the efficacy of Bushen Shengxue prescription and Yiqi Yangxue prescription in the treatment of chronic aplastic anemia and the effect on T cell subsets and the expression of T-box expressed in T cells （T-bet） and GATA binding protein 3 （GATA3）. MethodA total of 585 patients with chronic aplastic anemia who were treated in 19 hospitals in China from May 2018 to June 2021 were enrolled. With the prospective， double-blind and randomized control methods， the patients were randomized into three groups： kidney deficiency group， Qi and blood deficiency group， and control group. The three groups were respectively treated with Bushen Shengxue prescription granule， Yiqi Yangxue prescription granule， and Placebo （half the dose of Bushen Shengxue formula granules）. In addition， all of them were given oral cyclosporin and androgen. The treatment lasted 6 months， with 3 months as a course. The blood routine indexes， T cell subsets， and fusion genes T-bet and GATA3 before and after treatment were analyzed， and the safety indexes were monitored. ResultDuring the observation， a total of 75 cases dropped out and 18 were rejected. Finally， 161 cases in the kidney deficiency group， 164 in the Qi and blood deficiency group， and 167 in the control group were included. After 6 months of treatment， the total effective rate was 98.8% （159/161） in the kidney deficiency group， which was higher than the 79.9% （131/164） in the Qi and blood deficiency group （χ²=30.135， P<0.01） and the 61.7% （103/167） in the control group （χ²=70.126， P<0.01）. The total effective rate was higher in the Qi and blood deficiency group than in the control group （χ²=13.232， P<0.01）. After treatment， the hemoglobin （HGB） content increased significantly in three groups （P<0.05） as compared with that before treatment， particularly the kidney deficiency group （P<0.01）. After treatment， the white blood cell （WBC） count and platelet （PLT） count in the kidney deficiency group and the control group increased compared with those in the Qi and blood deficiency group （P<0.01）. There was no specific difference in neutrophils （ANC） after treatment among the three groups. At the same time point， the level of T helper type 1 （Th1） cells， Th1/Th2 ratio （P<0.05）， level of CD4⁺， and CD4⁺/CD8⁺ ratio （P<0.05） were significantly low in the kidney deficiency group among three groups. There was no significant difference in CD19^-， HLA/DR⁺， and CD25⁺ between the kidney deficiency group and the other two groups， but the T-bet of the kidney deficiency group and the control group was lower than that of the Qi and blood deficiency group （P<0.05）. ConclusionBushen Shengxue prescription exerts therapeutic effect on the aplastic anemia by improving the immunoregulatory mechanism， inhibiting the activity of immune system， modulating T cell subsets， suppressing Th1 and CD4⁺， and promoting bone marrow hematopoiesis. Moreover， it is safe with little side effects， which is worthy of further promotion.

Objective:To study the epidemic status of drinking tea type endemic fluorosis in Qinghai Province.Methods:In 2019, in counties (cities, districts, referred to as counties) that had the habit of drinking brick tea in 8 cities (prefectures) of Qinghai Province, epidemiological investigation of drinking tea type endemic fluorosis was carried out in villages. Ten households were randomly selected from each village, to investigate the demographic data of each household and the drinking situation of brick tea, residents' drinking water and brick tea samples were collected to determine the fluorine content, and calculate the daily per capita tea fluorine intake. At the same time, skeletal fluorosis was examined in all adults over 25 years old, and dental fluorosis was examined in all children aged 8 to 12 years old in survey sites. The content of fluorine in tea and water was detected by ion selective electrode method; the diagnosis of skeletal fluorosis was based on "Diagnostic Criteria for Endemic Skeletal Fluorosis" (WS 192-2008), the diagnosis of dental fluorosis was based on "Diagnosis of Dental Fluorosis" (WS/T 208-2011).Results:The mean (range) of fluorine of the 3 602 water samples was 0.31 (0.20 - 1.00) mg/L. The geometric mean (range) of fluorine of the 31 067 brick tea samples was 646 (40 - 2 295) mg/kg, the fluorine content of the brick tea ≤300 mg/kg accounted for 7.80% (2 422/31 067) of the total samples. The proportion of drinking Fu brick-tea was 89.97% (27 952/31 067); and the daily per capita tea fluorine intake was 1.93 mg, the daily per capita tea fluorine intake in Guoluo, Yushu and Hainan prefectures were higher than the health standard (3.50 mg). The detection rate of skeletal fluorosis in adults was 0.16% (2 357/1 484 907), Yushu Prefecture was the highest [29.23% (592/2 025)], followed by Guoluo Prefecture, which was 8.21% (771/9 393). The detection rate of dental fluorosis in children was 4.79% (8 076/168 623), Yushu Prefecture was the highest [32.61% (1 562/4 790)].Conclusion:Drinking tea type endemic fluorosis is prevalent in Qinghai Province, with obvious regional characteristics, covering a large population. The disease is relatively popular in Yushu Prefecture and Guoluo Prefecture.

Objective To investigate the effect of total flavones of Rhizoma Drynariae on femur distraction osteogenesis in the rabbits. Methods Thirty-two healthy rabbits were randomly divided into treatment group and control group, 16 rabbits in each group. The femoral fracture was treated with unilateral femoral distraction and was fixed with a self-made distraction instrument. After 7-day intermittent period, the fractured femur was distracted at a rate of 1 mm/d, twice a day for 10 continuous days. The treatment group was fed with total flavones of Rhizoma Drynariae from the first post-operative day to the end of the experiment. And then all of the animals were sacrificed after fixation for 28 days. The bone specimens were used for histological observation and immunohistochemical detection. Results The area of mature bone in the newborn bone tissue of the treatment group was increased, and osteoblasts number and the percentage of trabecular bone area were significantly higher than those of the control group . The bone morphogenetic protein-2 (BMP-2) and transforming growth factor-β1 (TGF-β1) were stained brown deeply, the staining degree being stronger than that of the control group. Conclusion Rhizoma Drynariae total flavones can effectively accelerate the formation and maturation of newborn bone tissue during bone distraction.

Objective:To explore the effect of endothelin-1 on atrial ifbrosis in patients with atrial ifbrillation (AF).
Methods: A total of 72 patients with thoracotomy were studied, the patients were divided into 2 groups:AF group, n=39 and Sinus rhythm (SR) group, n=33. The mRNA and protein expressions of endothelin-1 (ET-1), platelet derived growth factor-B (PDGF-B) and collagen I (COL1) in right atrial appendage (RAA) tissue were measured by RT-PCR and Western blot analysis;meanwhile, the impact of ET-1 stimulation and non-selective ET-1 receptor antagonist (sulfafurazole SIZ) on PDGF-B mRNA and protein expressions in H9c2 cells were measured.
Results: ①The RAA tissue mRNA and protein expressions in AF group were higher than those in SR group, as for ET-1 (2.830 ± 2.276) vs (1.220 ± 0.887) and (0.835 ± 0.241) vs (0.286 ± 0.083), both P<0.01;for PDGF-B (2.568 ± 2.348) vs (1.567 ± 0.831) and (0.807±0.241) vs (0.381 ± 0.105), both P<0.05;for COL1α1 (3.376 ± 1.598) vs (1.629 ± 0.833) and (0.652 ± 0.210) vs (0.312 ± 0.12), both P<0.05.②The protein expressions of ET-1 and COL1 had positive correlation (r=0.580, P<0.01).③ET-1 promoted PDGF-B secretion in H9c2 cells in a concentration and time-dependent manner;SIZ could reduce such promotion.
Conclusion: ET-1 plays an important role in AF occurrence which might be related to PDGF-B regulation.

Objective To observe the illness change trend of drinking water type endemic arsenic poisoning in Qinghai Province, comprehensively evaluate the effect of prevention and control measures, in order to provide a scientific basis for timely adjustment of the prevention and control measures. Methods From 2010 to 2013, according to the Drinking Water Type Endemic Arsenic Poisoning Monitoring Programs, 3 villages in 2 counties within Qinghai Province were randomly selected as monitoring sites. The arsenic content in drinking water of residents was measured, water improvement projects in all monitoring villages were investigated; at the same time an investigation of arsenic disease in resident population was conducted, and urinary arsenic content was monitored. Arsenic in drinking water and urine was determined by hydride generation atomic fluorescence spectrometry, and arsenic poisoning was diagnosed using Endemic Arsenic Poisoning Diagnostic Criteria (WS/T 211-2001). Results Of the three water improvement projects, two were water arsenic exceeded the standard, and one was intermittently operated. From 2010 to 2013, the arsenic poisoning detec tion rate in Baoning Village was 27.30% (193/707), 31.90%(245/768), 29.35%(221/753) and 28.22%(219/776); in Kecai Village was 32.62%(107/328), 34.83%(124/356), 31.26%(131/419) and 29.35%(118/402);and in Manimotai Village was 56.58%(43/76), 52.81%(47/89), 45.10%(46/102) and 34.69% (34/98), there was no significant difference statistically of the arsenic poisoning detection rates in the three monitored villages in the 4 years (χ2 =3.09, 0.04, 0.92, all P>0.05). From 2010 to 2013, women arsenic poisoning detection rate was 36.45%(203/557), 40.59%(246/606), 36.12%(225/623) and 34.77%(218/627), respectively;men was 25.27%(140/554), 28.01%(170/607), 26.57%(173/651) and 23.57%(153/649), respectively;women arsenic poisoning detection rates were higher than those of men (χ2 = 16.25, 21.32, 13.49, 19.38, all P < 0.05). Arsenic poisoning detection rate of people younger than 60 years old had a tendency to increase with age. In 2012 and 2013, 105 and 93 urine samples were tested, respectively; urinary arsenic geometric mean was 0.113 and 0.149 mg/L. Conclusions Water improvement projects and water quality are not optimistic, and prevalence of arsenic poisoning is still at a higher level. A sound long-term monitoring program should be established as soon as possible, the management and maintenance of water improvement projects should be strengthened, and the monitoring and prevention work should not be neglected.

ObjectiveTo understand the difference in characteristics between juvenile dermatomyositis (JDM) and adult dermatomyositis (ADM).Methods Sixty-one cases of JDM were retrospectively analyzed and compared with 30 cases of ADM. Results The rashes were presented as the initial symptom in all expect one JDM patients. Gottron’s papules were presented in 90% JDM patients and 67% ADM patients. Calcium deposition was presented in 7% JDM patients and none of the ADM patients. The cardiovascular system was involved in 7 % JDM patients and 23% ADM patients. Cancer occurred in none of JDM patients and 13% ADM patients. In JDM and ADM patients, the ratio of elevated muscle enzymes from highest to lowest was LDH, hy-droxybutyric acid enzyme, CK-MB, AST, and CK. The positive ratio of magnetic resonance (MRI) all exceeded 80% in JDM and ADM groups. Two cases died in each group.Conclusions The clinical presentation of JDM is basically the same as that of ADM. The most common initial symptoms in JDM are skin rashes and Gottron's papules. Cardiovascular disease and cancer are less in JDM than in ADM. MRI is valuable in the diagnosis of DM.

Objective To compare the efficacy of small splint fixation and plaster fixation in treating distal radius fracture. Methods One hundred and four cases of type A2 distal radius fracture admitted from January of 2012 to May of 2013 were randomly divided into small splint fixation group and plaster fixation group. After reduction, patients in the two groups were fixed with small splint and plaster separately. Wrist function scores, 36-item Short Form ( SF-36) scores and roentgenographic scores were evaluated for the two groups at different time points. Results ( 1) Within 3 months of follow up, the improvement of wrist function in small splint fixation group was significantly superior to that in plaster fixation group (P<0.05), and the differences of wrist function scores were insignificant between the two groups with the prolongation of follow-up (P>0.05). (2) SF-36 scores of the two groups were gradually increased along with the follow up. After follow-up for one week, 2 weeks, one month and 3 months, the SF-36 scores in small splint fixation group were significantly higher than that in plaster fixation group ( P<0.05) , but there was no significant difference after 6 months ( P>0.05). ( 3) After follow up for one year, the excellent rate for roentgenographic scores was higher than 80% in both groups, and there was no significant difference between the two groups (P>0.05). Conclusion Both small splint fixation and plaster fixation have satisfacory efficacy in treating type A2 distal radius fracture. But during the therapeutic process, wrist function scores and life quality scores in the small splint fixation group were higher than those in the plaster fixation group.