Objective: To test the effectiveness of psychological flexibility training on career adaptability among middle school students who undertook psychological courses based on acceptance commitment therapy and the adolescent mental flexibility model(DNA-V), and to provide a reference plan to improve the mental health of middle school students. Methods: This study recruited 110 junior high school students (60 boys and 50 girls) from a middle-school in Beijing. The students were randomly divided by class into a DNA-V face-to-face course group(offline group n=33), a DNA-V online course group(online group n=40), and a regular school psychology course group(control group n=37). Louise Hayes DNA-V intervention program was condensed into a six-hour middle-school DNA-V psychology curriculum. Using the Avoidance and Fusion Questionnaire for Youth and the Career Adaptability Scale, changes in psychological flexibility and career adaptability were measured before(T1), one week after(T2), and two months after (T3) the intervention. Results: Linear mixed models were used for the analysis, while controlling for demographic variables. Psychological flexibility and career adaptability in the offline group were higher at T2 and T3 than at T1(psychological flexibility t=4.22, 3.11; career adaptablity t=3.05, 4.16, P<0.01), while the difference between T2 and T3 was not statistically significant. The psychological flexibility and career adaptability of the online group were not statistically significant at T1, T2, and T3. The psychological flexibility and career adaptability of the control group increased from T1 to T2(t=4.64, 2.47, P<0.05), but T3 decreased back to a level close to T1. Conclusion In terms of both psychological flexibility and career adaptability, the DNA-V face-to-face psychology course resulted in a retention period of at least two months.

Objective:To construct an expression system of lentivirus vector encoding epidermal growth factor receptor-specific chimeric antigen receptor (EGFR-CAR) and programmed cell death ligand-1 (PD-L1) antibody.Methods:Human PD-L1-Fc protein was used to immunize BALB/c mice. Cell-fusion and subcloning were performed to screen stable hybridoma strains with high secretion of PD-L1-specific antibodies, which were identified by both ELISA and Western blot. The activity of the antibodies in blocking the binding of programmed cell death-1 (PD-1) to PD-L1 was determined by fluorescence-activated cell sorting (FACS). Antibody affinity was analyzed by Fortebio Octet96. A single-chain variable fragment (scFv) was further constructed after antibody full-length sequencing and humanization using CDR grafting method. Meanwhile, the genes encoding the light and heavy chain variable regions (VL and VH) were cloned from a hybridoma secreting antibody against human EGFR by 5′ RACE technology to construct scFv gene. The expression of scFv was confirmed using pcDNA3.1 vector. EGFR-CAR containing CD137 intracellular function domain and PD-L1-scFv was ligated using 2A gene. The synthetic single molecule was cloned into pLVX-EF1a-IRES-ZsGreen1 lentivirus expression vector, and then transfected into 293T cells using Lenti-X Packaging Single Shots (VSV-G) to prepare infectious virus. Expression of CAR on cell surface and the soluble form of PD-L1-scFv in the supernatant of transfected 293V cells were detected by FACS and ELISA.Results:A PD-L1 antibody named 11E3 with high ligand-receptor blocking performance was obtained. The humanized antibody showed a stable affinity (2.67×10 -10 mol/L) after directly grafting the mouse CDRs (CDR1, CDR2 and CDR3) to human frameworks. EGFR-scFv was effectively expressed in a form of Fc-fusion. Secretory CAR (CTZ0431-1) and membrane CAR (CTZ0431-2) expression plasmids were constructed using lentivirus vector containing EGFR-CAR and PD-L1-scFv. The infection efficiency in 293V cells was around 10%. EGFR-scFv on the cell membranes and PD-L1-scfv in the culture supernatants were detected after 293V cells were infected with CTZ0431-1. EGFR-scFv and PD-L1-scfv were expressed on the cell membranes of 293V cells infected with CTZ0431-2. The expression rate of CAR in LV-CART46407-1-transfected activated T cells was 39.3%. Conclusions:The lentivirus vectors co-expressing EGFR-CAR with moderate binding affinity and PD-L1-scFv with high binding affinity were successful constructed, which provided an essential tool for investing EGFR- and PD-L1 double targeted CAR-T cell therapy against solid tumor.

Objective To explore the relationship among psychological flexibility,coping style and job burnout of nurses.Methods A total of 694 nurses from one district level grade A tertiary general hospital in Yunnan were assessed using acceptance and action questionnaire 2nd edition (AAQ-Ⅱ),simplified coping style questionnaire (SCSQ) and nursing burnout scale (NBS).The relationship among psychological flexibility,coping style and job burnout of nurses was analyzed using structural equation model and Bootstrap test.Results (1) Correlation analysis showed that the total scores of AAQ-Ⅱ (21.81 ± 8.23),job burnout (22.71 ± 6.60) and its three dimensions including emotional exhaustion (8.93 ± 2.87),depersonalization (6.64±2.30)as well as reduced personal accomplishment(7.14±2.52) were positively correlated with negative coping dimension of coping style (10.86±4.99) (r=0.324-0.510,all P＜0.01),while negatively correlated with positive coping dimension(26.44±5.86) (r=-0.102--0.143,all P＜0.01).(2) Structural equation model analysis showed that positive and negative coping dimension had partial mediating effects on the relationship between psychological flexibility and job burnout (x2/df=2.30,GFI =0.91,AGFI =0.90,NFI=0.90,IFI=0.93,TLI=0.92,CFI=0.93,RMSEA=0.04).(3) Bootstrap test showed that the mediating effect sizes for positive and negative coping were 3.8％ and 8.9％ respectively and totally mediating effect size of coping style was 12.7％.Psychological flexibility had much larger effects on job burnout,and the direct effect size was 87.3％.Conclusion Coping style plays a mediating role in the relationship between psychological flexibility and job burnout,but its effect is less important.Psychological flexibility plays a major role and more directly influences on job burnout.

Objective:To revise the Chinese version of the Parental Psychological Flexibility Questionnaire (PPFQ) and test its validity and reliability.Methods:Totally 1015 parents from 2 primary school of Beijing were recruited and asked to complete the Chinese version of PPFQ.Item analysis was conducted to identify valid items.The parents were randomly allocated into two groups where one subset (n =510) was used for exploratory factor analysis (EFA),and the other (n =505) for confirmatory factor analysis (CFA) and discriminant validity.In addition,responses of 389 participants selected by simple random sampling was assessed in criterion validity with the Cognitive Fusion Questionnaire (CFQ),Acceptance and Action Questionnaire-Second Edition (AAQ-Ⅱ]),Self-Rating Anxiety Scale (SAS),Self-Rating Depression Scale (SDS),Mindful Attention Awareness Scale (MAAS),Trait Coping Style Questionnaire(TCSQ) and Conners Child Behavior Rating Scale (CBRS).Seven weeks later,225 of the participants were retested.Results:The exploratory factor analysis extracted 3 components,and explained 58.1％ of the total variance.The factor loading of items ranged between 0.63 and 0.86.The confirmatory factor analysis verified the 3-factors model (x2/df=1.77,NFI =0.94,IFI =0.97,GFI =0.96,TLI =0.96,CFI =0.97,RMSEA =0.04).Discriminant validity testing demonstrated the three revised factors had adequate discriminant validity in relation to one another (Ps ＜ 0.01).Criterion validity results showed that the total and subscale scores of the PPFQ were negatively correlated with the scores of CFQ,AAQ-Ⅱ,SAS,SDS,TCSQ-NC,CBRS (r =-0.16--0.52,Ps ＜ 0.01),and were positively correlated with the scores of MAAS,TCSQ-PC (r =0.14-0.37,Ps ＜ 0.01).The total and subscale scores of the PPFQ demonstrated good internal consistency Cronbach's α were 0.77-0.86 and test-retest reliability coefficient were 0.55-0.75.Conclusion:It suggests tthe validity and reliability of the adapted Chinese version of the Parental Psychological Flexibility Questionnaire be satisfactory,and could be used in the clinical and research work in China.

Objective To investigate the effect of local application of triamcinolone acetonide in promoting wound healing and recurrence after granulomatous lobular mastitis (GLM) operation. Methods The clinical data of 55 GLM patients with the diameter > 5 cm were retrospectively analyzed, and all patients treated with incision drainage to breast abscess and removal of inflammatory lesions. Thirty - one patients were treated with routine dressing change after operation (control group), and 24 patients were treated with routine dressing change and triamcinolone acetonide injection after operation (experiment group). The wound dressing time, recovery rate and recurrence rate were compared between 2 groups, and hormone related adverse reaction of experiment group was observed. Results The wound dressing time in experiment group was significantly shorter than that in control group:(58 ± 19) d vs. (71 ±25) d, and there was statistical difference (P<0.05). There were no statistical differences in the recovery rate and recurrence rate between experiment group and control group:91.7%(22/24) vs. 83.9%(26/31) and 9.1%(2/22) vs. 15.4% (4/26), P>0.05. The patients of experiment group did not have the hormone related adverse reaction. Conclusions The local application of triamcinolone acetonide after GLM operation can accelerate the wound healing, and it may also contribute to higher recovery rate and lower recurrence rate.

Objective To assess the efficacy and significance of hepatic protection by observing the incidence of liver injury in patients with chemotherapy who were treated and untreated with traditional Chinese medicine (TCM).Methods A retrospective analysis was applied to compare the changes in liver function tests and incidence rate of drug -induced liver injury between the observation group (treated with TCM)and the control group (untreated with TCM)after chemotherapy.Results The incidence rates of liver injury in the observation group and control group was 4.7%(2 /43)and 23.9%(11 /46)respectively.The difference between the two groups was statisti-cally significant(χ2 =6.611,P =0.01).The ALT,AST,TBIL,ALP between the two groups had statistically signifi-cant differences after treatment (all P <0.05).Conclusion Using TCMin hepatic protection can improve liver tests and reduce the incidence of drug -induced liver injury from chemotherapy.

Objective To investigate associate chief physician the clinical effects of Jiawei Jinhuang powder with fumigation -washing on hand -foot skin reaction(HFSR)caused by sorafenib.Methods 48 patients who received sorafenib were randomly divided into two groups.24 patients in the treatment group were administered Jiawei Jinhuang powder with fumigation -washing,and another 24 patients in the control group were given VitB6 orally.After 8 weeks,the incidence and grade of HFSR were statistically studied between the two groups.Results There was significant differences of hand -foot reaction between the treatment group and the control group (incidence rate:29.17% vs 70.83%,χ2 =8.375,P <0.05;The incidence rate of Ⅱ -Ⅲ:12.50% vs 33.33%,P <0.05 ). Conclusion Jiawei Jinhuang powder with fumigation -washing could remarkably reduce the incidence rate of HFSR caused by sorafenib.

Objective To explore the relationship between cognitive fusion and the state of anxiety and depression of perinatal women and to provide empirical evidences for acceptance and commitment therapy in mental treatment of anxiety and depression in perinatal women.Methods 309 perinatal women collected by cluster random sampling were assessed with self-made general information questionnaire,Self-Rating Anxiety Scale (SAS),Self-Rating Depression Scale (SDS) and Cognitive Fusion Questionnaire (CFQ) in predelivcry period and 3-7 days after childbirth respectively.Results (1) CFQ scores in the predelivery or postpartum anxiety group ((32.18±10.78),(31.54±10.30))were higher than that in the normal group((21.49±9.56),(20.84±9.82)),and the difference was statistically significant (t=-8.26,-8.22;all P=0.000);CFQ scores in the predelivery or postpartum depression group ((26.74 ±11.76),(26.84 ± 12.11)) were higher than that in the normal group((23.06± 10.33),(21.79±9.90)),and the difference was statistically significant(t=-2.76,-3.71;P=0.006,0.000).(2)It was found that the predelivery or postpartum CFQ scores were positively associated with the SAS scores of predelivery periods and postpartum periods respectively(r=0.51,0.45,0.50,0.55;P=0.000);the predelivery or postpartum CFQ scores were positively associated with the SDS scores of predelive1y periods and postpartum periods respectively (r =0.26,0.31,0.21,0.38;P =0.000).(3) Hierarchical multiple regression analyses were then conducted.The predelivery CFQ had a significant effect on postpartum SAS(△R 2=0.02,P=0.006)and postpartum SDS respectively(△R 2=0.02,P=0.006),and the regression equations were statistically significant.Conclusion A function to predict the occurrence of matemal postpartum anxiety and depression is obtained from the cognitive fusion which is attributed to the risk of maternal postpartum anxiety and depression.

ObjectiveTo explore the influences of perceived social support and social evaluations( including trust in others,government and social organizations,satisfaction of the government and social organizations,and satisfaction with the disaster relief and reconstruction work)on disaster area adults'life satisfaction after the Yushu earthquake.MethodsWith perceived social support scale (PSSS),satisfaction with life scale (SWLS) and self made survey,370 Tibetan adults were investigated,and the average age was 32.99 ± 12.66.Results ①Perceived fricnds' support( r =0.24,P ＜ 0.01 ),perceived others＇ support ( r =0.15,P ＜ 0.01 ),trust in others,government and social organizations ( r =0.19,P ＜ 0.01 ),satisfaction with the government and social organizations ( r =0.14,P ＜ 0.05) and satisfaction with the disaster relief and reconstruction work ( r=0.17,P ＜ 0.01 )had significant positive correlations with Yushu adults'life satisfaction.②Perceived friends' support ( β =0.21,P ＜ 0.01 )and trust in others,government and social organizations(β =0.27,P＜0.05) were significant predictors of Yushu adults'life satisfaction.ConclusionPerceived friends'support and trust in others,government and social organizations can play an important role in Yushu adults'life satisfaction after the earthquake.

Objective To compare the short-term quality of life after total gastrectomy in patients with gastric cancer with three recontructive methods of stamoch storage function. Methods Totally 62 cases underwent jejunal interposition afar total gastrectomy from March 2000 to December 2007. Patients were divided into three groups according to the procedures: functional jejunal interposition (FJI-type) group ( n = 23 ), modified jejunal interposition ( Ⅲ -type) group ( n = 20), and P-type jejunal interposition (P-type) group (n = 19). In each group,the patients' general conditions, the nutritional status at month 3 and 12, and gastrointestinal symptoms were evaluated. Results The durations of procedures were significantly different among three groups (P ＜0. 01 ). The intraoperative bleeding volume, postoperative complications, and food intake of each meal at month 3 were not significantly different ( P ＞ 0. 05 ). Compared with the data at month 3, the levels of hemoglobin and serum calcium at month 12 were significantly higher in all three groups (P ＜ 0. 01 ). Compared to the level at month 3, the level of serum albumin at month 12 significantly increased in FJI-type group (P ＜ 0. 05 ) but showed not significant difference in Ⅲ-type group and P-type group ( P ＞ 0. 05 ). The incidence of reflux esophagitis in three groups and the comparative parameters among the three groups at month 12 were not significantly different ( P ＞ 0. 05 ). Conclusions The jejunal interpositions after total gastrectomy will not increase the complexity and risk of the surgical procedure. In fact, they can reduce the reflux esophagitis and improve quality of life by keeping the storage function and restoring food passage through the duodenum. FJI-type is simpler than the other two types, and P-type is preferred for operations that need to open the pectoral cavity.