Objectives:To investigate the clinical and genetic features of young Chinese patients with myeloproliferative neoplasms (MPN) .Methods:In this cross-sectional study, anonymous questionnaires were distributed to patients with MPN patients nationwide. The respondents were divided into 3 groups based on their age at diagnosis: young (≤40 years) , middle-aged (41-60 years) , and elderly (>60 years) . We compared the clinical and genetic characteristics of three groups of MPN patients.Results:1727 assessable questionnaires were collected. There were 453 (26.2%) young respondents with MPNs, including 274 with essential thrombocythemia (ET) , 80 with polycythemia vera (PV) , and 99 with myelofibrosis. Among the young group, 178 (39.3%) were male, and the median age was 31 (18-40) years. In comparison to middle-aged and elderly respondents, young respondents with MPN were more likely to present with a higher proportion of unmarried status (all P<0.001) , a higher education level (all P<0.001) , less comorbidity (ies) , fewer medications (all P<0.001) , and low-risk stratification (all P<0.001) . Younger respondents experienced headache (ET, P<0.001; PV, P=0.007; MF, P=0.001) at diagnosis, had splenomegaly at diagnosis (PV, P<0.001) , and survey (ET, P=0.052; PV, P=0.063) . Younger respondents had fewer thrombotic events at diagnosis (ET, P<0.001; PV, P=0.011) and during the survey (ET, P<0.001; PV, P=0.003) . JAK2 mutations were found in fewer young people (ET, P<0.001; PV, P<0.001; MF, P=0.013) ; however, CALR mutations were found in more young people (ET, P<0.001; MF, P=0.015) . Furthermore, mutations in non-driver genes (ET, P=0.042; PV, P=0.043; MF, P=0.004) and high-molecular risk mutations (ET, P=0.024; PV, P=0.023; MF, P=0.001) were found in fewer young respondents. Conclusion:Compared with middle-aged and elderly patients, young patients with MPN had unique clinical and genetic characteristics.

Objective:To explore the application effect of music relaxation therapy based on Swanson's caring theory in breast cancer patients.Methods:A total of 180 breast cancer patients who were admitted to Shanxi Provincial People's Hospital from February 2018 to January 2020 were selected by the convenient sampling method. They were divided into the control group ( n=92) and the observation group ( n=88) according to the random number table method. The control group was given routine nursing, and the observation group was given music relaxation therapy based on Swanson's caring theory. The scores of Medical Coping Modes Questionnaire (MCMQ) and Herth Hope Index (HHI) were compared between the two groups before and after intervention. Results:Before intervention, there were no statistically significant differences in HHI and MCMQ scores between the two groups ( P>0.05) . After the intervention, the HHI score of the observation group was higher than that of the control group, and the difference was statistically significant ( P<0.05) . The face dimension score of the observation group was higher than that of the control group and the yield and avoidance dimension scores were lower than those of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Music relaxation therapy based on Swanson's caring theory can effectively improve the coping style of breast cancer patients and improve their hope level.

Objective:To explore the application effect of ADOPT mode in breast cancer patients with peripherally inserted central catheter (PICC) catheterization.Methods:Using the convenient sampling method, a total of 248 breast cancer patients with PICC catheterization who were admitted to Shanxi Provincial People's Hospital from June 2018 to June 2020 were selected as the research objects. The patients were divided into the observation group ( n=124) and the control group ( n=124) using the random number table method. The patients in the control group were given routine nursing care, while the patients in the observation group were given the ADOPT model on the basis of the nursing care in the control group. The incidence of PICC complications was compared between the two groups. The scores of Exercise of Self-Care Agency Scale (ESCA) , Cancer Fatigue Scale (CFS) and Quality of Life Questionnaire Breast Cancer Module 23 (QLQ-BR 23) were compared between the two groups before and after 3 months of intervention. Results:The number of unplanned extubation cases in the observation group was lower than that in the control group ( P<0.05) . After 3 months of intervention, scores of ESCA and QLQ-BR 23 function scale of the observation group were higher than those of the control group. And the scores of each dimension of the CFS, the QLQ-BR 23 symptom scale and score of the each item were lower than those of the control group, all the differences were statistically significant ( P<0.05) . Conclusions:The ADOPT model has a good effect on reducing the incidence of unplanned extubation in breast cancer patients with PICC catheterization, which can effectively improve the self-care ability and quality of life of patients and relieve cancer fatigue in patients.

Objectives:To explore health-related quality of life (HRQoL) and identify its associated variables in Chinese patients with Philadelphia-negative myeloproliferative neoplasms (MPNs) .Methods:In this cross-sectional study, anonymous questionnaires were distributed to adult patients with MPNs to assess symptom burden measured by MPN-10 and HRQoL measured by Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) .Results:The data from 1405 respondents with MPNs, including 645 (45.9%) with essential thrombocythemia (ET) , 297 (21.1%) with polycythemia vera (PV) , and 463 (33.0%) with myelofibrosis (MF) , were analyzed. 646 (46.0%) respondents were male. The median age was 56 (range, 18-99) years. The mean MPN-10 scores were 13.0±12.7, 15.0±14.7, and 21.0±16.6 ( P<0.001) , and the physical component summary (PCS) and mental component summary (MCS) scores were 48.0±8.5, 47.0±9.0, and 42.0±10.0 ( P<0.001) and 51.0±11.0, 50.0±10.8, and 49.0±11.1 ( P=0.002) for respondents with ET, PV, and MF, respectively. Respondents with MF reported the lowest score of physical functioning, role functioning, emotional functioning, cognitive functioning, social function, and global health status (all P<0.01) and the highest score of fatigue, pain, dyspnea, appetite loss, diarrhea, and financial problems (all P<0.05) in EORTC QLQ-C30. Multivariate analyses revealed that higher MPN-10 scores were significantly associated with lower PCS (-0.220 to -0.277, P<0.001) and MCS (-0.244 to -0.329, P<0.001) scores; increasing age (-1.923 to -4.869; all P<0.05) , lower PCS score. Additionally, comorbidity (ies) , symptom at diagnosis, splenomegaly, anemia, unknown driver gene, and higher annual out-of-pocket cost were significantly associated with lower PCS and/or MCS scores. However, age ≥ 60 years, urban household registration, concomitant medication, and receiving ruxolitinib therapy in respondents with MF were associated with higher MCS scores. Weak correlations were found between MPN-10 score (except the subscale of appetite loss and constipation) and EORTC QLQ-C30 score in majority of subscales in respondents with ET (| r| = 0.193-0.457, all P<0.001) , PV (| r| = 0.192-0.529, all P<0.01) , and MF (| r| = 0.180-0.488, all P<0.001) , respectively. Conclusions:HRQoL in patients with MPN was significantly reduced, especially in patients with MF. Sociodemographic and clinical variables were significantly associated with the HRQoL in patients with MPNs.

Objective: To explore the association between single nucleotide polymorphism rs12632942 in SCN10A exon and oxaliplatin-induced peripheral neuropathy (OXLIPN) in colorectal cancer (CRC) patients receiving chemotherapy. Methods:Atotal of 319 cases of blood samples from CRC patients receiving chemotherapy regimen with Oxaliplatin (OXL) were collected from the Second Affiliated Hospital of Guangzhou Medical University, the Second Affiliated Hospital of Nanchang University, and Guangzhou Baiyun District Hospital of Chinese Medicine during January 2011 and June 2013. DNAwas routinely extracted, and PCR amplification was performed to analyze the genotype of rs12632942; and OXLIPN of patients was also evaluated. The association between rs12632942 genotype and OXLIPN was analyzed by χ2 test and multivariate logistic regression model. Results: The genotypes of rs12632942 of 319 CRC patients:AAof 134 cases,AG of 156 cases and GG of 29 cases; and the genotype distribution of rs12632942 was in accordance with Hardy-Weinberg equiliberum (P>0.05). χ2 test showed that rs12632942AG+GG genotype was associated with Ⅱ-Ⅳ degree OXLIPN (P<0.01). Multivariate logistic regression model showed that rs12632942 AG + GG genotype was an independent risk factor for Ⅱ-Ⅳ degree OXLIPN（OR=2.044； 95%CI=1.231-3.392; P<0.01） . Conclusion: Colorectal cancer patients with SCN10A exon polymorphism rs12632942AG + GG genotype were susceptible to Ⅱ-Ⅳ degree OXLIPN.

Objective: To assess the value of immunoglobulin heavy/light chain (HLC) immunoassay on therapeutic response in patients with multiple myeloma(MM). Methods: A total of 45 newly diagnosed MM patients were retrospectively enrolled in Peking Union Medical College Hospital from 2013 to 2016, whose 115 serum samples were consecutively collected. HLC was tested to evaluate response and compare with other methods for M protein detection. Results: ①There were 30 males and 15 females in total of whom the monoclonal immunoglobulin was IgG in 27 (IgGκ∶IgGλ 12∶15) and IgA (IgAκ∶IgAλ 9∶9) in 18. The arerage age of the studied population was 59 (range 43-80) . ② In 34 patients with serum sample at diagnosis, 32 (94.1%) had abnormal HLC ratio (rHLC) while 2 patients with IgG had normal rHLC. The percentages of abnormal rHLC was 81.8% (18/22) at partial response、50.0%(9/18) at very good complete response and 16.0%(4/25) at complete response. ③In 25 patients reaching CR, there were 13 with IgG and 12 with IgA. 4 patients equally split of IgG and IgA had abnormal rHLC at complete response. ④By monitoring the rHLC of some patients consecutively, we found that the remission of rHLC was to some extent behind the remission of SPE and IEF, or even rFLC. Conclusion Immunoglobulin HLC detection is one feasible method for minimal residual disease detection.

[Summary] Epigenetics defines heritable changes in gene expression that are not coded in the DNA sequence itself.Three systems,including DNA methylation,RNA-associated silencing and histone modification,are used to initiate and sustain epigenetic silencing.Type 2 diabetes mellitus(T2DM) is a polygenic disorder,which is caused by both genetic and environmental factors.However,pathogenesis of T2DM has not been elucidated.Recent studies have indicated that epigenetics may play an important role in the pathogenesis of T2DM,which is involved in the development and differentiation of β cell,secretion of β cell,insulin sensitivity and so on.Researches related to epigenetics may provide a new measure and target to clarify the pathogenesis of T2DM as well as prevent and treat the disease.

Objective To assess the influence of cumulative energy balance on outcome in septic patients requiring mechanical ventilation. Methods The indirect calorimetry (IC) was used to obtain target energy in 60 septic patients. The cumulative energy balance between survivors and non-survivors were compared. Logistic regressions was used to analyze the risk factors of death. Results Non-survivors had higher negative energy balance than survivors (P<0.05). The logistic regression analysis demonstrated that the start time of feeding and cumulative caloric balance were risk factors of mortality. Conclusions Effective nutrition support might be a good strategy to improve outcomes.

Objective To investigate the relationship between the serum SRC-3 levels and the bone loss severity in postmenopausal women. Methods Fifty-eight PMW with osteopenia or osteoporosis and nineteen healthy PMW were enrolled in this study from June 2012 to September 2013. BMD at the lumbar spine and femoral neck were observed by DXA Lunar Prodigy Vision. The levels of serum SRC-3 were detected by ELISA. The diagnosis value was evaluated by the ROC curves analysis. Results The levels of serum SRC-3 were significant higher in the normal group than those in the osteopenia or the osteoporosis groups (P<0.001 for both), no statistical significance was found between the osteopenia and the osteoporosis group(P=0.056). The levels of serum SRC-3 were negatively correlated with the BMD diagnosis grading (r=-0.543, P < 0.001). By using the ROC curve analysis, the serum level of SRC-3 for PMW with osteoporosis and osteopenia were found to be 0.297 ng/mL and 0.347 ng/mL, respectively. The levels of serum SRC-3 were positively associated with BMI (r=0.395, P<0.001) and LS-BMD (r=0.503,P<0.001) in the postmenopausal women. Conclusion SRC-3 might be an useful index to reflect the severity of lumbar spine bone loss.

Objective To observe the impact of the diverse caloric energy intake on the outcomes and occurrence rate of complications in septic patients.Methods A prospective single-blind randomized controlled trial was conducted.158 cases of septic patients in intensive care unit (ICU) were enrolled and randomly assigned to three groups according to their different target value of nutrition:group A [measurements of resting energy expenditure (MREE)＜90％],B (MREE 90％-110％) and C (MREE ＞ 110％).The caloric intake,mechanical ventilation duration (MVD),nosocomial infection rate,28-day and 60-day mortality were analyzed.Results Daily energy intake in 7 days after ICU admission was as follows:the difference in target value of nutrition(kJ/d:7 075.0 ± 1 046.5,5 667.8 ± 1 908.8,4 428.8 ± 1 377.8),calory intake (kJ/d:4 671.6 ± 1 205.6,5 655.3 ± 1 373.0,6 053.0 ± 1 557.2),enteral nutrition value (kJ/d:2 051.1 ± 1 046.5,3 980.9 ± 1 586.5,5 337.1 ±2 921.8) and average intake rate [(66.0 ± 15.8)％,(100.0 ± 5.7)％,(134.0 ± 19.7)％],and they were statistically significant difference among A,B,C groups (all P＜0.05).The parenteral nutrition in group C were much higher than that in group A and group B (kJ/d:2 055.3 ± 273.4vs.427.0 ± 273.4,473.0 ± 332.0,both P＜0.05).The calories provided by glucose and diprivan were similar among three groups.The MVD and ICU stay were shorter in group B than that in groups A and C [MVD (days):8.4 ± 6.3 vs.11.0 ± 8.2,17.8 ± 13.0,P＞ 0.05 and P＜ 0.05 ; ICU stay (days):11.0 ± 6.4 vs.14.9 ± 9.6,17.8 ± 13.0,respectively,P＞0.05 and P＜0.05].The total hospital stay (days:32.0 ± 22.5,26.8 ± 7.0,30.4 ± 21.4) and nosocomial infection rate [91.1％ (51/56),84.0％ (42/50),90.4％ (47/52)] were similar among A,B,C groups (all P＞0.05).There was no difference in survival rate at 28 days among three groups as shown by the Kaplan-Meier survival curve (F=3.145,P=0.076).The survival rate at 60 days showed a tendency of lowering in groups A and C,especially in group C (F=9.284,P=0.010).Conclusion Both higher and lower caloric energy intake may be associated with an adverse impact,but appropriate caloric intake would improve the outcome and reduce the complication rate in septic patients.