Objective:To investigate the relationship between the levels of serum cytokines and chemokines and the prognosis of patients with acute B-ALL after receiving chimeric antigen receptor (CAR)-T cell immunotherapy and acute graft-versus-host disease (aGVHD) in patients after bridging allogeneic hematopoietic stem cell transplantation (allo-HSCT).Methods:According to the case-control principle, Forty-two patients with B-ALL who received CD19-CAR-T cell immunotherapy bridged to allo-HSCT at Heibei Yanda Ludaopei Hospital from September 18, 2019 to May 9, 2022 were enrolled. Mann-Whitney U test was used to compare the changes of aGVHD-related cytokines and chemokine levels between CAR-T cell immunotherapy and bridging transplantation in different patients at the same time. Their plasma levels of cytokines and chemokines related to aGVHD were monitored at the day before CAR-T therapy and after CAR-T treatment at day 4, 7,14,21,28. The receiver operating characteristic curve was drawn to evaluate the predictive value of cytokines and chemokines in predicting the occurrence and the death of aGVHD patients. Kaplan-Meier method and Log-rank tests were used for Overall survival (OS) analysis. Results:Twenty-four of total 42 patients had aGVHD, of which 11 patients died and 31 patients survived. There was no significant difference in cytokines and chemokines between the aGVHD group and the non-aGVHD group on the day before CAR-T cell treatment. According to statistical analysis, the serum Elafin levels of aGVHD group was higher than that of non-aGVHD group at the 21st day [4 482 (2 811, 6 061) ng/L vs 2 466 (1 948, 3 375) ng/L, Z=3.145, P=0.001] and the 28st day [4 391 (2 808, 5594) ng/L vs 2 463 (1 658, 2 830) ng/L, Z=2.038, P=0.048] separately. At the 14th day, serum cytokines and chemokines levels between the two group were as follows,MIP-1 α [21.02 (12.36, 30.35) ng/L vs 5.56 (3.64, 10.79) ng/L], sCD25 [422.47 (257.99, 1 233.78) IU/ml vs 216.11 (133.75,457.39) IU/ml], Elafin [4 101 (2 393, 5 006) ng/L vs 2 155 (1 781, 3 033) ng/L], IL-6 [119.08 (23.97, 183.43) ng/L vs 8.39 (2.91, 17.42) ng/L] and IL-8 [13.56 (12.50, 24.52) ng/L vs 2.83 (1.73,6.87) ng/L] were at higher levels ( Z=2.653, P=0.007; Z=2.176, P=0. 030; Z=2.058, P=0.041; Z=3.329, P<0.001; Z=3.162, P=0.001). The KM survival curve showed that the cumulative survival rates of patients with higher serum levels of MIP-1α, sCD25, Elafin, IL-6 and IL-8 were lower than those with low levels at day 14, and the difference was statistically significant (χ 2=12.353, 4.890, 6.551, 10.563, 20.755, P<0.05). Conclusion:The outcomes of patients treated with CAR-T cell therapy bridged to allo-HSCT was correlated with serum MIP-1α, sCD25, Elafin, IL-6 and IL-8 levels after receiving CAR-T therapy. High concentrations of MIP-1α, sCD25, Elafin, IL-6 and IL-8 suggest poor prognosis and can be used as biomarkers to suggest appropriate clinical selection of therapy.

Since the outbreak of corona virus disease 2019(COVID 19), the epidemic has spread rapidly, which brings great challenge to the surgical diagnosis, treatment and management of lung neoplasm Sichuan International Medical Exchange &Promotion Association organized thoracic surgery experts to sum up experiences from experts in major hospital, and formulated the Guidance suggestion on surgical diagnosis, treatment and management of lung neoplasm during the outbreak of COVID-19 to provide references for thoracic surgeons.

Objective: To investigate the fatigue status of military personnel stationed in plateau and high cold region, and to analyze the mediator effect of trait coping style on job stress and fatigue. Methods: In October 2010, with the method of cluster random sampling survey, 531 military personnel stationed in plateau and high cold region were chosen as subject. The fatigue status were evaluated by the Chinese version multidimensional fatigue inventory (MFI-20) , job stress were evaluated by the Job Stress Survey (JSS) , and trait coping style were evaluated by the Trait Coping Style Questionnaire (TCSQ) . Results: According to the information of different population characteristics, mean rank of physical fatigue about the urban (town) group were higher than that of rural group (Z=-2.200, P<0.05) ; mean rank of reduced motivation about the urban (town) group were higher than that of rural group (Z=-2.781, P<0.05) ; mean rank of general fatigue scores about the urban (town) group were higher than that of rural group (Z=-3.026, P<0.05) ; mean rank of physical fatigue about the up or equal 20-years old age group were higher than that of below 20-years old age group (Z=-4.045, P<0.05) ; mean rank of reduced motivation about the up or equal 20-years old age group were higher than that of below 20-years old age group (Z=-2.182, P<0.05) ; mean rank of mental fatigue about the up or equal 20-years old age group were higher than that of below 20-years old age group (Z=-2.879, P<0.05) ; mean rank of general fatigue scores about the up or equal 20-years old age group were higher than that of below 20-years old age group (Z=-3.647, P<0.05) ; mean rank of reduced motivation were significant statistical difference among the military officers, sergeancy and soldier group (F=18.965, P<0.05) ; mean rank of general fatigue scores were significant statistical difference among the military officers, sergeancy and soldier group (F=14.711, P<0.05) . The score of negative coping style were positively correlated with the score of physical fatigue (r_s=0.129) , reduced activity (r_s=0.123) , reduced motivation (r_s=0.149) and general fatigue (r_s=0.174) respectively, the score of organizational support lack strength were positively correlated with the score of physical fatigue (r_s=0.090) , reduced activity (r_s=0.098) , reduced motivation (r_s=0.099) and general fatigue (r_s=0.130) respectively. The mediator effect of negative coping style on the job stress and fatigue was 0.013 (P<0.01) . Conclusion The fatigue statuses of the urban (town) group and the up or equal 20-years old age group are poor, and the negative coping style plays mediator effect on the job stress and fatigue.

Objective To investigate the assoCI ation between DRD2 gene polymorphism and postoperative delirium in the patients undergoing coronary artery bypass grafting (CABG) and to analyze the risks of postoperative delirium.Methods A total 150 patients afteRcoronary artery bypass grafting were enrolled.And delirium rating scale-revised-98 was used as diagnosis tool foRthe analysis of morbidity and risks of postoperative delirium.DRD2 genotypes were determined by sequenCI ng analysis.The assoCI ation of rs6275 and rs6277 with delirium was studied.Results Delirium occurred in 12 patients and morbidity of postoperative delirium was 8.0%.Univariate logistic regression analysis results showed that delirium was assoCI ated with previous cerebral infarction (OR=0.784,95% CI 0.631 to 0.975,P=0.024),extracorporeal CI rculation time(OR=1.057,95% CI 0.703 to 1.590,P=0.029),surgery time (OR=2.251,95% CI 0.941 to 5.380,P=0.048) and intensive care unit time (OR=1.890,95% CI 1.201 to 2.973,P=0.005).There were no significant differences in frequencies of genotype and alleles of rs6275 polymorphism between patients with delirium and controls(OR=1.265,95% CI 0.697 to 2.303,P=0.651).There were significant differences on frequencies of genotype and alleles of rs6277 polymorphism between patients with delirium and controls(OR=2.276,95% CI 1.142 to 4.523,P=0.049).The multiple logisticstepwise regression analysis indicated that the perioperative risk factors of delirium included cerebral infarction (OR=1.861,95% CI 1.082 to 3.163,P=0.024),ICU duration time (OR=6.757,95% CI 2.376 to 19.267,P=0.001)and CC genotype of rs6277 (OR=4.019,95% CI 1.395 to 12.341,P=0.012).Conclusion DRD2 gene testing in patients with high risks may be helpful foRthe prevention of postoperative delirium.

Objective To investigate the assoCI ation between DRD2 gene polymorphism and postoperative delirium in the patients undergoing coronary artery bypass grafting (CABG) and to analyze the risks of postoperative delirium.Methods A total 150 patients afteRcoronary artery bypass grafting were enrolled.And delirium rating scale-revised-98 was used as diagnosis tool foRthe analysis of morbidity and risks of postoperative delirium.DRD2 genotypes were determined by sequenCI ng analysis.The assoCI ation of rs6275 and rs6277 with delirium was studied.Results Delirium occurred in 12 patients and morbidity of postoperative delirium was 8.0%.Univariate logistic regression analysis results showed that delirium was assoCI ated with previous cerebral infarction (OR=0.784,95% CI 0.631 to 0.975,P=0.024),extracorporeal CI rculation time(OR=1.057,95% CI 0.703 to 1.590,P=0.029),surgery time (OR=2.251,95% CI 0.941 to 5.380,P=0.048) and intensive care unit time (OR=1.890,95% CI 1.201 to 2.973,P=0.005).There were no significant differences in frequencies of genotype and alleles of rs6275 polymorphism between patients with delirium and controls(OR=1.265,95% CI 0.697 to 2.303,P=0.651).There were significant differences on frequencies of genotype and alleles of rs6277 polymorphism between patients with delirium and controls(OR=2.276,95% CI 1.142 to 4.523,P=0.049).The multiple logisticstepwise regression analysis indicated that the perioperative risk factors of delirium included cerebral infarction (OR=1.861,95% CI 1.082 to 3.163,P=0.024),ICU duration time (OR=6.757,95% CI 2.376 to 19.267,P=0.001)and CC genotype of rs6277 (OR=4.019,95% CI 1.395 to 12.341,P=0.012).Conclusion DRD2 gene testing in patients with high risks may be helpful foRthe prevention of postoperative delirium.

Objective To explore the relationship between gastric juice pH and hospital-acquired pneumonia ( HAP) , the gastric bacterial colonization and etiology of HAP in neurologic intensive care unit patients by monitoring gastric juice pH value.Methods From October 2014 to May 2015, consecutive seventy-two tube feeding patients admitted in the Department of Neurology Intensive Care Unit in Xijing Hospital were enrolled in this research.The type and concentration of pathogens from gastric contents were collected, while samples from upper respiratory tract and pharynx were detected dynamically at the same time.Results (1)The group with new onset HAP was higher in gastric juice pH (6.4(5.4,6.4) vs 5.4 (2.5, 6.4), Z=-2.37, P=0.01); (2) The isolation rate of colonized bacteria in gastric cavity was associated with the pH of gastric juice , achieving 60.8% ( 42/69 ) in HAP group; ( 3 ) When the gastric juice pH was >4, the isolation rate of Gram-negative bacilli in gastric cavity obviously increased (63.6%(28/44) vs 35.7%(10/28),χ2 =5.323, P=0.021); (4)The same pathogens were found in stomach-pharynx-upper respiratory tract in 7 cases ( 17.5%) of the total 40 HAP patients.Conclusion Increased gastric juice pH was associated with gastric colonization , especially Gram-negative bacilli , and may lead to a higher incidence of new onset HAP in patients on enteral feeding.

Objective To investigate the influence of job burnout on sleep quality of oilfield workers.Methods In January to August,2014,the Chinese Maslach Burnout Inventory (CMBI) and Pittsburgh Sleep Quality Index(PSQI) were used to conduct investigation on job burnout and sleep quality in 1180 oilfield workers.Results The scores on each subscale of CMBI showed significant differences between workers with different characteristics(marital status,working years,educational background,and type of work)(P＜0.05).The global PSQI score for oilfield workers was 5.55±3.26,which was significantly higher than the national norm (3.88±2.52)(P＜ 0.05),and the incidence of issues related to sleep quality was 32.54％.The PSQI score showed significant differences between workers with different characteristics (sex and working years)(P＜0.05).The multivariate logistic regression analysis showed that working years,sex,emotional exhaustion,and depersonalization were the major factors affecting sleep quality,and the workers with long working years,male workers with job burnout,and oilfield workers with issues related to sleep quality tend to have a high incidence of issues related to sleep quality.Conclusion Job burnout is the major factor influencing the sleep quality of oilfield workers,and reducing job burnout of such workers is an effective way to improve sleep quality.

Objective To investigate the association between 5-hydroxytryptamine 2A(5-HT2A) receptor gene polymorphisms and occupational stress in oilfield workers.Methods Cluster sampling was used to select 826 oilfield workers from January to August,2013.The SNaPshot single nucleotide polymorphism (SNP) genotyping method was used to determine the genotypes of rs6313,rs1923884,and rs2070040 in 5-HT2A receptor gene,and the Occupational Stress Inventory-Revised Edition was used to analyze occupational stress in these workers.Results There were no significant differences in occupational stress between groups with different individual characteristics (P＞0.05).As for the comparison of occupational stress scores between workers with different genotypes of each SNP of 5-HT2A receptor gene,the workers with CC and CT genotypes of rs6313 had significantly higher role boundary scores than those with TT genotype (P＜O.05),and the workers with CC genotype had a significantly higher vocational stress score than those with CT genotype (P＜0.05);the workers with CT genotype of rs1923884 had a significantly higher occupational role score than those with CC genotype (P＜ 0.05) and a significantly higher coping resources score than those with CC and TT genotypes (P＜0.05);the workers with AG genotype of rs2070040 had a significantly higher vocational stress score than those with AA genotype (P＜0.05).The ordinal multinomial logistic regression analysis showed that workers with CT genotype of rs1923884 were susceptible to occupational stress (OR=1.56,95％CI 1.10～2.20).Conclusion CT genotype of rs1923884 in 5-HT2A receptor gene may be associated with the susceptibility to occupational stress in oilfield workers.

Objective To investigate the influence of job burnout on sleep quality of oilfield workers.Methods In January to August,2014,the Chinese Maslach Burnout Inventory (CMBI) and Pittsburgh Sleep Quality Index(PSQI) were used to conduct investigation on job burnout and sleep quality in 1180 oilfield workers.Results The scores on each subscale of CMBI showed significant differences between workers with different characteristics(marital status,working years,educational background,and type of work)(P＜0.05).The global PSQI score for oilfield workers was 5.55±3.26,which was significantly higher than the national norm (3.88±2.52)(P＜ 0.05),and the incidence of issues related to sleep quality was 32.54％.The PSQI score showed significant differences between workers with different characteristics (sex and working years)(P＜0.05).The multivariate logistic regression analysis showed that working years,sex,emotional exhaustion,and depersonalization were the major factors affecting sleep quality,and the workers with long working years,male workers with job burnout,and oilfield workers with issues related to sleep quality tend to have a high incidence of issues related to sleep quality.Conclusion Job burnout is the major factor influencing the sleep quality of oilfield workers,and reducing job burnout of such workers is an effective way to improve sleep quality.

Objective To investigate the association between 5-hydroxytryptamine 2A(5-HT2A) receptor gene polymorphisms and occupational stress in oilfield workers.Methods Cluster sampling was used to select 826 oilfield workers from January to August,2013.The SNaPshot single nucleotide polymorphism (SNP) genotyping method was used to determine the genotypes of rs6313,rs1923884,and rs2070040 in 5-HT2A receptor gene,and the Occupational Stress Inventory-Revised Edition was used to analyze occupational stress in these workers.Results There were no significant differences in occupational stress between groups with different individual characteristics (P＞0.05).As for the comparison of occupational stress scores between workers with different genotypes of each SNP of 5-HT2A receptor gene,the workers with CC and CT genotypes of rs6313 had significantly higher role boundary scores than those with TT genotype (P＜O.05),and the workers with CC genotype had a significantly higher vocational stress score than those with CT genotype (P＜0.05);the workers with CT genotype of rs1923884 had a significantly higher occupational role score than those with CC genotype (P＜ 0.05) and a significantly higher coping resources score than those with CC and TT genotypes (P＜0.05);the workers with AG genotype of rs2070040 had a significantly higher vocational stress score than those with AA genotype (P＜0.05).The ordinal multinomial logistic regression analysis showed that workers with CT genotype of rs1923884 were susceptible to occupational stress (OR=1.56,95％CI 1.10～2.20).Conclusion CT genotype of rs1923884 in 5-HT2A receptor gene may be associated with the susceptibility to occupational stress in oilfield workers.