Objective To investigate the status quo of fear of disease progression(FoP)in patients after pituitary neuroendocrine tumour surgery and analyse the medication effects of positive coping style on disease perception and FoP.Methods Convenient sampling method was used to select 345 patients with pituitary neuroendocrine tumours who underwent surgical operations in the neurosurgery department of a Grade IIIA hospital in Shanxi Province from January 2022 to January 2023 as the research objects.A general data questionnaire,disease perception questionnaire,medical coping style questionnaire and fear of progression questionnaire-short form(FoP-Q-SF)were used in the investigation.Pearson correlation was employed to analyse the correlations of the disease perception,active coping style and FoP among the patients.Structural equation models were used to analyse the mediating effects of positive coping styles on disease perception and FoP.Results The FoP score of patients after pituitary neuroendocrine tumour surgery was found at(35.02±4.92).FoP was positively correlated with the disease perception(r=0.672,P<0.01),and negatively with the active coping style(r=-0.679,P<0.01).Positive coping styles were positively correlated with disease perception(r=-0.610,P<0.01).Disease perception not only had a direct effect on FoP,but also had an indirect effect on FoP via active coping style,with an intermediate effect value of 0.202(P<0.001),accounting for 25.5%of total effect.Conclusion Postoperative positive coping style in patients with pituitary neuroendocrine tumour is a mediating variable between the disease perception and FoP.Medical staff should dynamically assess and early identify coping styles of patients and adopt personalised guidance programs,therefore to guide the patients to actively cope with the disease,so as to reduce the negative disease perception and alleviate the fear of disease progression of the patients.

Objective To introduce and enhance an experimental technique for intraventricular drug delivery via an implantable osmotic pump.Methods Eight-week-old male SD rats were selected and the requisite equipment and reagents were prepared.The osmotic pump was assembled and brought to operational status before conducting the implantation surgery.Following anesthesia,the rats underwent skin preparation and the upper surface of the skull was surgically exposed.A point directly above the ventricle was located using a brain stereotaxic apparatus,and a small hole was drilled at that location with a high-speed cranial drill.The pump body was then implanted subcutaneously in the neck and the needle was inserted into the drilled hole,and secured with dental cement.Once solidified,the needle base was removed,the subcutaneous soft tissue and scalp were sutured in layers,and the animal was returned to its cage for rearing in isolation.Results The osmotic pump was successfully implanted subcutaneously in the rat's neck,the needle was securely fixed to the skull,and the catheter interface remained intact.The rats were sacrificed and the brain tissue was removed.Examination of the extracted brain tissue revealed no significant hematoma around the puncture site or needle tract,and the presence of blue dye in the ventricular and adjacent tissues indicated successful drug delivery to the ventricle.Conclusions The introduction of a brain stereotaxic apparatus to aid localization,coupled with enhancements to the operational procedure,may improve the accuracy and safety of the implantation process resulting in a high success rate for intraventricular drug administration.

Objective:To explore the construction and implementation effect of clinical-thinking patterned curriculum for parallel graduate students with "running through clinical diagnosis and treatment process."Methods:In this study, 94 Batch 2016-2017 graduate students with clinical medical professional degree in Shanxi Provincial People's Hospital were selected as the research subjects. Among them, 48 Batch 2017 parallel graduate students were selected as the experimental group. The curriculum of clinical-thinking patterned training of "running through the clinical diagnosis and treatment process" was used. In addition to participating in the degree courses and residency courses, a series of training to improve the clinical-thinking ability were introduced. And 46 Batch 2016 parallel graduate students were divided in the control group, using a traditional curriculum and only participating in degree courses and residency courses. The differences among mini-clinical evaluation exercise (Mini-CEX) scores, direct observation of procedural skills (DOPS) scores, objective structured clinical examination (OSCE) scores and students' satisfaction were compared by t test, chi-square test and repeated measures analysis of variance. Results:The Mini-CEX scores showed the average scores of other aspects except humanistic care were higher than those of the control group, and the score of communication skills was significantly higher than that of the control group [(6.55±0.98) vs. (5.77 ±1.12)], with significant differences ( t=3.62, P<0.001). In the DOPS scores, except for the skills of communication with patients, ability to consider patient's feelings and practice of occupational literacy, the average scores of other aspects of the experimental group were higher than those of the control group, and the real operation-ability score of clinical skills was significantly higher than that of the control group [(6.38 ± 1.38) vs. (5.53±1.23)], with a significant difference ( t=3.12, P=0.002). In terms of the outpatient receiving station, the emergency treatment station, the clinical thinking station①, the clinical thinking station②, the specialist skill station, the auxiliary examination station and the case writing station, their OSCE scores at different stages in the experimental group were higher than those in the control group, and in terms of clinical thinking station①, the score of the experimental group was significantly higher than that of the control group, with a significant difference ( F=6.51, P=0.012). The satisfaction rate of the experimental group in terms of curriculum was higher than that in the control group except for the future career development, and in improving logical-thinking ability, the score of the experimental group was significantly higher than that of the control group, with a significant difference ( χ2=19.18, P<0.001). Conclusion:The curriculum of clinical-thinking ability with "running through the clinical diagnosis and treatment process" can enhance the clinical practical ability of parallel graduate students, making them meet the residential academic standards as soon as possible and effectively promoting the training quality of the students.

Cognitive dysfunction is one of the serious sequelae of stroke. Brain-computer interface technology, as a rehabilitation technology to promote the neural function recovery, has been gradually applied to the assessment and rehabilitation of cognitive dysfunction after stroke. Brain computer interface establishs connection between the human brain and the machine, conducts closed-loop feedback training, helps patients improve brain functional activities, and finally achieves cognitive rehabilitation. This article introduces the current clinical application of brain-computer interface in rehabilitation of cognitive function after stroke and its possible neurophysiological mechanism, aiming to provide a new idea for rehabilitation of stroke patients.

Objective:To investigate the efficacy of minimally invasive puncture and drainage versus small bone window craniotomy in the treatment of hypertensive basal ganglia hemorrhage. Methods:Seventy-three patients with hypertensive basal ganglia hemorrhage who received treatment in Hequ County People's Hospital from April 2018 to December 2020 were included in this study. They were divided into a minimally invasive puncture and drainage group ( n = 38) and a small bone window craniotomy group ( n = 35) according to surgical methods. Clinical efficacy and postoperative complications were compared between the two groups. Results:At 3 months post-surgery, the National Institutes of Health Stroke Scale score in the minimally invasive puncture and drainage group was significantly lower than that in the small bone window craniotomy group [(3.58 ± 1.23) points vs. (6.87 ± 0.97) points, t = 12.62, P < 0.001]. Barthel index in the minimally invasive puncture and drainage group was significantly higher than that in the small bone window craniotomy group [(62.15 ± 6.78) points vs. (43.15 ± 7.15) points, t = 11.65, P < 0.001]. The total response rate in the minimally invasive puncture and drainage group was significantly higher than that in the small bone window craniotomy group [92.11% (35/38) vs. 74.3% (26/35), χ2 = 4.21, P < 0.05]. The incidence of complications in the minimally invasive puncture and drainage group was significantly lower than that in the small bone window craniotomy group [5.2% (2/38) vs. 25.7% (9/35), χ2 = 6.18, P < 0.05]. Conclusion:Minimally invasive puncture and drainage have better clinical efficacy and fewer postoperative complications in the treatment of hypertensive basal ganglia hemorrhage than small bone window craniotomy. Therefore, minimally invasive puncture and drainage for the treatment of hypertensive basal ganglia hemorrhage are worthy of clinical promotion.

[Abstract] Objective: To develop a new type of CD7 chimeric antigen receptor modified T cell (CD7-CAR-T) for the treatment of CD7 positive acute myeloid leukemia (AML), and to observe its killing effect on CD7 positive AML cells. Methods: The CD7-CAR lentiviral vector was constructed based on the CD7 Nanobody sequence and costimulatory domain sequence of CD28 and 4-1BB. The lentiviral particles were packaged and used to co-transfect human T cells with protein expression blocker (PEBL), so as to prepare CD7- CAR-T cells. Real time cellular analysis (RTCA) was used to monitor the cytotoxicity of CD7-CAR-T cells on CD7 overexpressed 293T cells. Flow cytometry assay was used to detect the effect of CD7-CAR-T cells on proliferation and cytokine secretion of AML cells with high, medium and low CD7 expressions (KG-1, HEL and Kasumi-1 cells, respectively). Results: CD7-CAR-T cell was successfully constructed and its surface expression of CD7 was successfully blocked. Compared with T cells, CD7-CAR-T cells could significantly inhibit the proliferation of CD7-293T cells and promote the release of TNF, Granzyme B and INF-γ; in addition, CD7-CAR-T cells also significantly promoted the apoptosis (t=147.1, P<0.01; t=23.57, P<0.01) and cytokine release (P<0.05 or P<0.01) in CD7 positive KG-1 and HEL cells, but had little effect on Kasumi-1 cells that only expressed minimal CD7 antigen (t=0.7058, P>0.05). Conclusion: CD7-CAR-T cells can specifically kill CD7-positive AML cells in vitro.

OBJECTIVE： To evaluate the efficacy and safety of progesterone in the treatment of acute traumatic brain injury systematically， and to provide reference for clinical use. METHODS： Retrieved from Cochrane library， ClinicalTrials， Web of Science， PubMed， Embase， CBM， CNKI and Wanfang database， randomized controlled trial （RCTs） about progesterone （trial group） versus placebo or blank control （control group） in the treatment of acute traumatic brain injury were collected. After literature screening， data extraction and quality evaluation by risk bias evalution tool of Cochrane systematic evaluator manual 5.1.0， Meta-analysis was performed by using Rev Man 5.3 statistical software. RESULTS： A total of 10 RCTs were included， involving 2 652 patients. Results of Meta-analysis showed that there was no statistical significance in mortality[RR＝0.77，95％CI（0.56，1.07），P＝0.12]， the incidence of septicemia [RR＝1.11，95％CI（0.77，1.60），P＝0.59] or elevated liver enzymes[RR＝1.30，95％CI（0.68，2.50），P＝0.43]. The number of patients with favorable neurological outcome[RR＝1.23，95％CI（1.05，1.43），P＝0.008] in trial group was significantly more than control group. Results of subgroup analysis of mortality showed that there was no statistical significance in the mortality of patient’s GCS≤8 [RR＝0.79，95％CI（0.57，1.10），P＝0.16]， that of patient’s GCS≤12[RR＝0.69，95％CI（0.23，2.10），P＝0.52] or that of patient’s GCS ranging from 9 to 12 [RR＝0.78，95％CI（0.26，2.35），P＝0.65] between 2 groups. Results of subgroup analysis of neurological outcome showed that there was no statistical significance in the number of favorable neurological outcome of patient’s GCS≤8 [RR＝1.18， 95％CI（0.98，1.43），P＝0.09]， the number of favorable outcome of patient’s GCS≤12[RR＝1.15，95％CI（0.87，1.51），P＝0.32] and the number of favorable neurological outcome of patient’s GCS ranging from 9 to 12[RR＝2.07，95％CI（0.24，17.71），P＝0.51]. CONCLUSIONS： Progesterone can improve the prognosis of neurological function in patients with acute traumatic brain injury with good safety but cannot reduce mortality.

Objective: To investigate the expression and clinical significance of PD-1 molecule in tumor cells (T-ALL cells) derived from the patient with T-cell acute lymphoblastic leukemia (T-ALL). Methods: T-ALL cells from one patient and PBMCs from four healthy volunteers provided by the Department of Hematology in Jiangsu Provincial Hospital of Traditional Chinese Medicine in December 2015, and human 293T/PD-1 cells provided by Persongen Bio Therapeutics (Suzhou) Co., Ltd. were used for this study. The mouse T-ALL xenograft model was constructed by injecting T-ALL cells into tail vein of B-NDG mice, and flow cytometry was used to verify whether the cells obtained from the spleen of transplanted mice were mainly consisted of T-ALL cells. Flow cytometry was used to study the protein expression of PD-1 in T-ALL cells, and RT-PCR was applied to further verify the mRNA expression of PD-1 in T-ALL cells. The PD-1 gene in T-ALL cells was sequenced by SNP genotyping to detect whether the DNA sequence of PD-1 gene changed. PD-1 inhibitor was used in vitro to study their effects on proliferation, apoptosis, and the mRNA expression levels of related factors in T-ALL cells. Results: The mouse T-ALL xenograft model was successfully constructed and verified by flow cytometry as T-ALL. PD-1 was highly expressed at both mRNA and protein levels in T-ALL cells (all P<0.01). A C-to-T mutation was detected in the fifth exon of the PD-1 gene. PD-1 inhibitor had no significant effect on proliferation and apoptosis of T-ALL cells in vitro; PD-1 inhibitor up-regulated the mRNA expression of tumor-suppressor protein IGFBP3 and decreased the mRNA expression of oncoprotein SULT1A3 (all P<0.01). Conclusion: PD-1 is highly expressed in T-ALL cells, and PD-1 could be used as a target for clinical diagnosis and treatment for T-ALL.

[Abstract] Objective：To investigate whether the proliferation and cytotoxicity of NK-92MI cells can be improved by IL-7 and IL-21 genes modification, and determine the effects of this genetically modified NK-92MI cells on T cells from normal human peripheral blood. Methods：IL-7 and IL-21 gene fragments were constructed into electroporation vector by genetic engineering method, and NK92MI/IL-21 and NK-92MI/IL-7&21 cells were constructed by electroporation transfection. The in vitro proliferation and cytotoxicity of NK-92MI, NK-92MI/IL-21 and NK-92MI/IL-7&21 cells were measured by cell count and flow cytometry assays. Then, normal human PBMCs were co-cultured with NK-92MI, NK-92MI/IL-21 and NK-92MI/IL-7&21 cells in vitro respectively, and the phenotype change of T cells was measured by flow cytometry. In addition, the cytotoxicity between the activated T cells and three NK-92MI cell lines (NK-92MI, NK-92MI/IL-21 and NK-92MI/IL-7&21 cells) as well as the cytotoxicity of the three NK-92MI cells on tumor cells after co-incubation with activated T cells were detected. Results: NK-92MI/IL-21 cell line (highly expressing IL-21) and NK-92MI/IL-7&21 cell line (highly expressing both IL-7 and IL-21) were successfully constructed. The toxicity of NK-92MI, NK-92MI/IL-21 and NK92MI/IL-7&21 cells on Jurkat and K562 cells showed no difference, while the proliferation of NK-92MI/IL-21 and NK-92MI/IL-7&21 cells was increased compared with NK-92MI cells. Furthermore, NK-92MI/IL-21 and NK-92MI/IL-7&21 cells promoted the activation of T cells to a certain degree, and the activated T cells showed merely no cytotoxicity on NK-92MI, NK-92MI/IL-21 and NK-92MI/IL7&21 cells; Meanwhile, the activated T cells did not affect the cytotoxicity of the three NK cells (NK-92MI, NK-92MI/IL-21, and NK92MI/IL-7&21 cells) on K562 cells under their co-existence. Conclusion: The in vitro proliferation of NK-92MI/IL-21 and NK-92MI/ IL-7&21 cells were enhanced after gene modification, which could also stimulate and promote the activation of T cells from peripheral blood. The cytotoxicity assay showed that the activated T cells had no cytotoxicity on NK-92MI, NK-92MI/IL-21, and NK-92MI/IL-7& 21 cells. Meanwhile, the presence of the activated T cells did not affect the cytotoxicity of NK-92MI cells.

Objective In order to verify an alternative method for the skin corrosion test by using transcutaneous electrical resistance ( TER) test, and to optimize the implementation criteria in OECD TG 430 procedure. Methods According to the OECD TG 430 procedure, Wistar rat skin was used to test the TER values of 16 reference chemicals, and selected the most optimal standard via different implementation criteria. The program B was chosen to make inter-laboratory comparison between 5 laboratories by testing 11 chemicals, which were identified as the optimal standard. Results After the TER test, the result of corrosion test of 16 chemicals were accordant with the reference data ( Kappa value＝0. 64). The program B was the most optimal implementation criteria, and the specificity was 66. 7% and sensitivity was 100%. There were no significant differences between the corrosion estimations of 5 laboratories, and the concordance rate of the 5 laboratories was 72. 7%. Conclusions Transcutaneous electrical resistance (TER) test is an feasible and efficient tool for skin corrosion testing, and may become a good interim test to replace the in vivo test with this ex vivo test in cosmetics chemical safety assessment, thus, to reduce the animal usage in our country.