Objective:To explore the mediating role of rumination thinking between demoralization and quality of life in malignant tumor patients, provide guidance and reference for helping tumor patients overcome rumination thinking and demoralization and improve quality of life.Methods:From February 2020 to June 2022, 189 patients with malignant tumors admitted to the Department of Oncology of the First Affiliated Hospital of Guangxi Medical University were selected by convenience sampling method as the research objects, and a cross-sectional survey was conducted using general information questionnaire, Demoralization Scale-Mandarin Version, Ruminative Responses Scale, Punctional Assessment of Cancer Therapy-General.Results:Among 189 malignant tumor patients, there were 102 males, 87 females, aged (43.54 ± 13.12) years old. The total score of loss of demoralization was (34.37 ± 10.34) points, the total score of rumination thinking was (41.01 ± 17.10) points, the total score of quality of life was (48.51 ± 15.41) points. The Pearson analysis results showed that the total score of demoralization in malignant tumor patients was negatively correlated with the total score of quality of life ( r = -0.502, P<0.01); the total score of rumination thinking was negatively correlated with the total score of quality of life ( r = -0.465, P<0.01), and the total score of demoralization was positively correlated with the total score of rumination thinking ( r = 0.628, P<0.01). Bootstrap mediation test results showed that ruminant thinking played a partial mediating effect between demoralization and quality of life of patients with malignant tumors, accounted for 30.9% of the total effect. Conclusions:Rumination plays a partially mediating role in the demoralization and quality of life of patients with malignant tumors, suggesting that clinical staff can improve the quality of life of patients with tumors by developing a systematic and comprehensive cognitive-behavioral intervention strategy to improve the demoralization and rumination.

Objective:To investigate the relationship between three-dimensional choroidal vascularity index (3D CVI) and the severity of diabetic retinopathy (DR) using swept-source optical coherence tomography angiography (SS-OCTA).Methods:A cross-sectional study was conducted.A total of 139 eyes of 139 subjects, including 115 eyes with diabetes mellitus and 24 control eyes without diabetes, were enrolled in the Second People's Hospital of Hefei from March to December 2022.DR was graded according to the standard seven-field ETDRS color fundus photographs.Eyes with diabetes mellitus were divided into non-DR (NDR) group (34 eyes), non-proliferative DR (NPDR) group (42 eyes), NPDR with diabetic macular edema (DME) group (21 eyes) and PDR group (18 eyes).3D CVI in central fovea 1 mm (C1) and parafoveal 3 mm (C3), choroidal vascular volume (CVV), and choroidal thickness were measured by SS-OCTA in the area of 3 mm×3 mm centered on the fovea using the built-in automated quantification software.Parafoveal region was divided into superior, inferior, temporal and nasal quadrants, and 3D CVI of the different quadrants was detected.3D CVI was defined as the ratio of CVV to total choroidal volume.The monocular data were analyzed to compare 3D CVI among the five groups, and multiple linear regression analysis was used to evaluate the influencing factors.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of the Second People's Hospital of Hefei, Hefei Hospital Affiliated to Anhui Medical University (No.2022064).All subjects were aware of the study purpose and agreed to participate the study.Results:There were significant differences in 3D CVI-C1 and 3D CVI-C3 among all groups ( F=3.103, 3.036, both at P<0.05).In PDR group, 3D CVI-C1 was lower than in non-DR group, and 3D CVI-C3 was lower than in control group and non-DR group, with statistically significant differences (all at P<0.05).There were significant differences in 3D CVI in the inferior and nasal quadrants among all groups ( F=2.714, 4.020, both at P<0.05).In PDR group, 3D CVI in the inferior quadrant was lower than that in non-DR group, and 3D CVI in nasal quadrant in PDR group was lower than that in control group, non-DR group, NPDR group and NPDR with DME group, with statistically significant differences (all at P<0.05).Multiple linear regression showed that after controlling for age, course of disease and glycosylated hemoglobin, the severity of DR was the influencing factor of 3D CVI in fovea and parafovea.PDR eyes had the greatest impact on 3D CVI in fovea and parafovea.Compared with non-DR eyes, there was a -0.019(95% CI: -0.031--0.007, P=0.003) decrease in central foveal 3D CVI and a -0.019(95% CI: -0.030--0.008, P=0.001) decrease in parafoveal 3D CVI in PDR eyes, followed by a 0.014(95% CI: -0.027-0.000, P=0.044) decrease in central foveal 3D CVI in NPDR with DME eyes. Conclusions:Macular foveal 3D CVI correlates with DR severity, and a decrease in 3D CVI of large vessels in the macular choroid may be a sensitive indicator of DR exacerbation.

Objective To compare vein valve function following pharmacomechanical thrombolysis (PMT) with simple catheter-directed thrombolysis (CDT) for deep vein thrombosis. Methods We retrospectively analyzed the clinical data of sixty patients who suffered acute lower extremity deep vein thrombsis in our hospital between October 2016 and March 2017. All patients underwent contralateral preprocedural duplex and bilateral postprocedure duplex to access patency and valve function. The patients were divided into three groups including a group A with catheter-directed thrombolysis (CDT) alone (36 patients with 20 males and 16 females at average age of 56 years), a group B with PMT alone (15 patients with 8 males and 7 females at average age of 55 years), and a group C with PMT combined CDT (9 patients with 4 males and 5 females at average age of 56 years). The valve function was compared among the Group A, Group B and Group C. Results There were 40.0% (24/60) patients with bilateral femoral vein valve reflux, 40.0% (24/60) patients with unilateral femoral vein valve reflux (all in the treated limbs), 20% (12/60) patients had no reflux in both limbs. Of the limbs treated with CDT alone, PMT alone and PMT combined CDT, the rate of valve reflux was 38.9% (14/36), 33.3% (5/15), and 55.6% (5/9) respectively (P=0.077). Conclusion In the patients suffering acute DVT, PMT or PMT combined CDT does not hamper valve function compared with CDT alone.

Objective To analyze the outcome and the prognostic factors of hepatic veno-occlusive disease (HVOD) after hematopoietic stem cell transplantation (HSCT). Methods A total of 797 patients receiving HSCT were analyzed retrospectively. The prophylaxis regimen of HVOD in the First Affiliated Hospital of Guangxi Medical University consisted of low molecular weight heparin and lipoprostaglandin E1 (PGE1). Results Fifty-nine patients (7.4%) developed HVOD at 3-49 days after HSCT (median 12 days). Age younger than 15 years at transplant( HR=6.47, P<0.001), busulphan conditioning ( HR=6.40, P<0.001), thalassemia major ( HR=6.35,P<0.001), allogeneic transplantation ( HR=7.74, P=0.005) were univariate risk factors for HVOD. Multivariate analyses suggested that thalassemia major and busulphan conditioning were independently correlated with the development of HVOD. Conclusion Thalassemia major and busulphan conditioning are independent risk factors for HVOD after HSCT.

Objective: To explore the diagnosis, treatment and prognosis of autoimmune hemolytic anemia (AIHA) after allo-HSCT in patients with thalassemia major (TM). Methods: A retrospective analysis of AIHA status after allo-HSCT in 291 TM patients from July 2007 to December 2017 was conducted. Results: Five of the 291 TM patients (1.72%) were diagnosed with post-transplant AIHA. The median time of AIHA was 7 (5-12) months after HSCT. All post-transplant AIHA patients were positive in direct and indirect Coombs test, the main clinical manifestations were dizziness, fatigue, pale complexion, skin and sclera yellow, and soy sauce urine. The incidence of AIHA was higher after unrelated donor transplantation (6.36%, 4/63) compared with that of sibling donor transplantation (0.43%, 1/228). One patient who received only prednison was dead. Four patients who received rituximab combined with prednisolone were alive, Coombs test in two of them were negative. Conclusions AIHA after allo-HSCT developed in 1.72% patients with TM. Monitoring of Coombs test was important for diagnosis of post-transplant AIHA. The incidence of post-transplant AIHA was higher in unrelated donors compared with that of sibling donors transplantation. Treatment of rituximab combined glucocorticoid was effective strategy for post-transplant AIHA.

To explore the effects of extract of selenium-enriched Astragalus membranaceus(ESAM)on insulin resistance(IR)in streptozotocin(STZ)diabetic rats. In this study, type 2 diabetes mellitus(T2DM)was established; ESAM and pioglitazone were used to intervene T2DM model rats; the general condition of rats in each group was observed, and body weight and fasting blood glucose(FBG)were recorded before modeling and after modeling. At the end of the fourth week, the blood and liver tissues of each group were collected. The total cholesterol(CHOL), triglyceride(TG), high-density lipoprotein(HDL), low-density lipoprotein(LDL)in blood were detected by biochemical detector; ELISA was used to detected content changes of blood fasting insulin(FINS), tumor necrosis factor-α(TNF-α), interleukin-6(IL-6), C-reactive protein(CRP), interleukin-1β(IL-1β); Western blotting was used for the detection of insulin receptor substrate protein 1(IRS1), phosphorylated IRS1(p-IRS1), nuclear factor κB inhibitor kinase β(IKKβ), phosphorylated IKKβ(p-IKKβ), c -Jun N-terminal kinase(JNK), phosphorylated JNK(p-JNK)protein changes. Results showed that compared with the blank group, the body weight of the model group was significantly decreased. FBG, CHOL, TG, LDL, TNF-α, IL-6, CRP, IL-1β in the blood and p-IRS1, p-IKKβ, p-JNK in the liver was increased significantly; after intervention, pioglitazone, ESAM can reverse the body weight of the model rats and the changes of the above cytokines and proteins. In conclusion, ESAM can reduce the expression of inflammatory cytokines in T2DM rats, inhibit the increase of free fatty acids(FFA), decrease the activation of IKKβ and JNK phosphorylation in surrounding tissues, activate insulin pathway and improve the IR effect of T2DM.

Objective To explore the diagnosis and treatment of Mycobacterium tuberculosis infection in a child with severe β Mediterranean anemia after allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods The clinical data of a child with severe β mediterranean anemia who had Mycobacterium tuberculosis after allo-HSCT were retrospectively analyzed.The pertinent literatures were reviewed.Results Six-year-old girl with Mediterranean anemia was infected by Mycobacterium tuberculosis after allo-HSCT.After anti tuberculosis treatment by HRZE (isoniazid,rifampicin,pyrazinamide and ethambutol),the condition was improved.Conclusion It is rare of Mycobacterium tuberculosis infection after allo-HSCT,which needs timely diagnose and treatment.

Objective To explore the association of urinary level of kidney injury molecule-1 (KIM-1) with renal tubulointerstitial lesions in patients with lupus nephritis (LN). And to find a potential clinical biomarker, which could reflect the specific tubulointerstitial lesions of LN. Methods Sixty cases of biopsy proven new-onset LN patients were enrolled into the study. And 10 normal kidney tissues were collected, which came from 10 patients with kidney trauma or renal tumor nephrectomy. Sixty patients with LN were divided into mild disease group, moderate disease group, severe disease group and the extremely severe disease group according to the criteria of 2000 Hill's morphologic index for the evaluation of renal pathology. Urine and renal tissues specimen were collected. The clinical and pathological data were analyzed retrospectively. Urine level of KIM-1 was detected by enzyme linked immunosorbent assay (-). Immunohistochemical staining was used to observe the expression of KIM-1 in the renal tissue. T-test, One-Way analysis of variance(ANOVA) test or rank sum test and Pearson or Spearman correlation analysis were used for statistical analysis. Results ①With the aggravation of tubulointerstitial lesions, the urinary level of KIM-1 was increased gradually, which was shown in the control group [(0.32 ±0.03) ng/ml], mild group [(2.31 ±0.30) ng/ml], moderate group [(6.12 ±0.51) ng/ml], severe group [(12.51 ±1.83) ng/ml] and the extremely severe group [(15.30 ±2.11) ng/ml] (all P<0.05); ② With the aggravation of tubulointerstitial lesions, the expression of KIM-1 in the renal tissue was increased gradually which was shown in the control group [(2.13±0.12)%], mild group [(35.01±0.33)%], moderate group [(51.12± 2.11)%], severe group [(63.50 ±1.80)%] and the extremely severe group [(75.31 ±3.22)%] (all P<0.05);③ Urinary KIM-1 level in LN patients was positively correlated with the expression of KIM-1 in the renal tissue (r=0.870, P<0.01);④Urinary KIM-1 level in LN patients was positively correlated with 24 hUP, systemic lupus erythematosus disease activity index (SLEDAI), renol (R)-SLEDAI, glomerular activity index (GAI), tubulointerstitial ativity imdex (TLAI), chronicity (AI) (r=0.826, 0.741, 0.824, 0.743, 0.871, 0.741, P<0.05), and was negatively correlated with estimated glomerular filtration rate (eGFR) (r=-0.726, P<0.05), while was not correlated with CI (r=0.532, P>0.05). The expression of KIM-1 in the renal tissue was positively correlated with serum creatinine (SCr), quantity of 24 h UP, SLEDAI, R-SLEDAI, GAI, TLAI and AI (r=0.780, 0.780, 0.812, 0.727, 0.735, 0.910, 0.701, P<0.05), and was negatively correlated with eGFR (r=-0.727, P<0.05), while it was no correlated with CI (r=0.543, P>0.05). Conclusion Urinary KIM-1 enables to assess the tubulointerstitial lesion in LN patients, and it can be a sensitive biomarker to predict the tubulointerstitial damage and to evaluate the degree of tubulointerstitial lesions.

Objective: To investigate the risk factors of poor graft function (PGF) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) for severe aplastic anemia (SAA) . Methods: Clinical data from 111 SAA patients who received allo-HSCT were analyzed retrospectively. Factors including age, gender, interval to transplantation, the level of serum ferritin before transplantation were analyzed by Cox multivariate regression analysis. Results: Among the 111 patients who underwent allo-HSCT, 16 developed PGF (14.4%) . Multivariate analysis showed donor type (HR=2.656, 95%CI 1.204-5.858, P= 0.016) and the level of serum ferritin before tansplantation (HR=3.170, 95%CI 1.400-7.180, P=0.006) were significant risk factors for PGF. Conclusion Unrelated donor transplantation and the high level of serum ferritin before transplantation are risk factors for PGF.

ABSTRACT:Objective To observe the effects of late Na current (INa‐L ) and rapidly activating delayed rectifier K current (IKr ) on ventricular heterogeneity and frequency dependency by using high resolution voltage sensitive optical mapping technology .Methods The model of 12 isolated hearts was constructed in rabbits . Voltage sensitive dye Di‐4‐ANEPPS were perfused into the isolated hearts by Langendorff method .LED source with the wave length of 532 nm was used to record APD80 and APD50 of the left and right ventricles .Experimental groups were divided into 3 groups by perfusion drugs dofetillide (30 nmol/L) ,dofetillide+ATX‐Ⅱ(1 nmol/L) ,and dofetillide +ATX‐Ⅱ +mexiletine (10μmol/L) .The subjects were intervened by the above drugs in order ,and they were self‐compared before dosing .After each drug administration ,the hearts were stimulated respectively with the BCL of 2 000 ms ,1 000 ms ,500 ms ,and 300 ms .Then we observed the changes of APD80 and APD50 in the left and right ventricles before and after the interventions .Results ① In the control group ,APD80 and APD50 of the right ventricle were longer than those of the left ventricle in response to different stimulation , and the differences increased with the decrease of stimulating frequency .② When BCL was 1000 ms ,APD80 and APD50 of the left and right ventricles were prolonged respectively after administration of dofetillide , but the differences in APD80 and APD50 were insignificant between the left and right ventricles (P>0 .05) .ΔAPD80 of the two ventricles increased significantly with the decrease of stimulating frequency . ③ After administration of ATX‐Ⅱ , when BCL was 1000 ms ,APD80 and APD50 of the left and right ventricles increased significantly compared with those in the control group and dofetillide intervention group (P<0 .05) .And the increase of APD in the left ventricle was greater than that of the right ventricle .ΔAPD80 of the two ventricles increased significantly with the decrease of stimulating frequency .④ After administration of mexiletine ,when BCL was 1000 ms ,APD80 and APD50 of the left and right ventricles reduced significantly compared with those of the primary state (P<0 .05) .APD80 and APD50 of the left and right ventricles reduced significantly compared with those of the control group (P< 0 .05) and ATX‐Ⅱ group (P>0 .05) .The increase of ΔAPD80 of the two ventricles became milder when the stimulating frequency decreased . Conclusion ① IKr blocked by dofetillide did not affect the heterogeneity between the two ventricles , which showed reverse‐frequency dependence . ② In the context of blocking IKr , ATX‐Ⅱ increased the heterogeneity between the left and right ventricles and enhanced the reverse‐frequency dependence .In contrast ,mexiletine ,the blocker of INa‐L ,decreased the heterogeneity between the two ventricles and reverse‐frequency dependence .