Objective:To explore the mediating chain effect between attachment and coping style of disease perception and hope in patients with advanced lung cancer, and to provide theoretical basis for improving coping style in patients with advanced lung cancer.Methods:From October 2021 to June 2022, 354 patients with advanced lung cancer in the First and Second Affiliated Hospitals of Anhui Medical University were selected by convenience sampling. The general information questionnaire, the Experiences in Close Relationships Inventory, the Brief Illness Perception Questionnaire, the Herth Hope Index, and the Medical Coping Modes Questionnaire were used to conduct cross-sectional questionnaire survey. SPSS 25.0 software and Bootstrap method were used to construct and verify the chain mediation model.Results:Finally, 336 patients with advanced lung cancer were included, including 214 males and 122 females, aged 27-79(59.43 ± 8.61) years old. Attachment avoidance score was (3.31 ± 1.01) points, attachment anxiety score was (3.86 ± 1.17) points, illness perception score was (40.07 ± 12.01) points, hope score was (34.05 ± 5.87) points, and face coping score was (18.75 ± 5.34) points in patients with advanced lung cancer. The avoidance coping score was (15.47 ± 1.97) points, and the yielding coping score was (9.62 ± 3.85) points. In patients with advanced lung cancer, attachment avoidance and attachment anxiety were positively correlated with yield coping ( r=0.448, 0.747, both P<0.01), positively correlated with illness perception ( r=0.356, 0.627, both P<0.01), and negatively correlated with hope ( r=-0.406, -0.670, both P<0.01). Illness perception was positively correlated with yield coping ( r=0.744, P<0.01), and negatively correlated with hope ( r=-0.628, P<0.01). Hope was negatively correlated with yield response ( r=-0.769, P<0.01). The mediation model showed that the chain mediating effect of attachment avoidance, illness perception, hope and yield coping was significant in patients with advanced lung cancer, with an effect value of 0.009 and an effect size of 13.95%. The chain mediating effect of attachment anxiety, illness perception, hope and yield coping were significant, with an effect value of 0.010 and an effect size of 8.27%. Conclusions:Attachment can not only directly predict submission coping in advanced lung cancer patients, but also indirectly predict submission coping through the chain mediation of illness perception and hope.

Objective:To translate the Dysfunctional Beliefs and Attitudes about Sleep Scale for Cancer Patients (C-DBAS-14) into Chinese and test its reliability and validity.Methods:The Korean version of C-DBAS-14 was translated, back-translated, and culturally adapted into Chinese based on Brislin's translation model, forming the Chinese version of C-DBAS-14. From October 2022 to May 2023, 361 hospitalized cancer patients at the First Affiliated Hospital of Anhui Medical University were selected as research objects by convenient sampling method. They were surveyed using a general information questionnaire, the Chinese version of C-DBAS-14, the Insomnia Severity Index (ISI), and the Hospital Anxiety and Depression Scale (HADS) to evaluate the reliability and validity of the scale. The scale's item analysis was based on correlation coefficients and critical ratio values; structural validity, content validity, and convergent validity were used to evaluate the scale's validity; Cronbach's α coefficient and intraclass correlation coefficient were used to assess its reliability.Results:A total of 361 questionnaires were distributed, 356 were effectively returned, with an effective response rate of 98.6% (356/361). The Chinese version of C-DBAS-14 contained 14 items across four dimensions. The scale-level content validity index was 0.976, and the item-level content validity index ranged from 0.833 to 1.000. Totally four common factors were extracted in exploratory factor analysis, explaining 78.8% of the total variance. Confirmatory factor analysis showed a Chi-square/degrees of freedom ratio of 1.286, comparative fit index of 0.991, goodness of fit index of 0.945, incremental fit index of 0.991, Tucker-Lewis index of 0.988, and root mean square error of approximation of 0.036. The total Cronbach's α coefficient of the scale was 0.874, and the intraclass correlation coefficient was 0.863. The C-DBAS-14 score was negatively correlated with the ISI and HADS scores ( r=-0.734, -0.639; P<0.01) . Conclusions:The Chinese version of C-DBAS-14 has good reliability and validity and can be used as an assessment tool for irrational sleep beliefs in Chinese cancer patients.

Objective:To explore the development trajectory and influencing factors of pediatric medical traumatic stress in parents of children undergoing surgery, so as to provide reference for targeted intervention measures in the later stage.Methods:Adopting prospective research design, from January 2022 to August 2022, convenience sampling was used to recruit 199 parents of children undergoing surgery in the pediatric surgery ward of the First Affiliated Hospital of University of Science and Technology of China as subjects. The level of medical traumatic stress symptoms in parents was investigated by the PTSD Checklist for DSM-5 at one day before surgery, during postoperative recovery, after discharge and 3 months after discharge. The general data questionnaire, Parents′ Perception of Uncertainty Scale, Hospital Anxiety and Depression Scale, Simplified Coping Style Questionnaire and Perceived Social Support Scale were used to investigate the influencing factors of medical traumatic stress symptoms in parents one day before the operation.Latent growth mixture model and binary Logistic regression were used to analyze the data.Results:The development trajectory of pediatric medical traumatic stress in parents of children undergoing surgery was divided into two categories: the first was low-level decline (90.5%, 180/199) and the second was high-level stability (9.5%, 19/199). Binary Logistic regression analysis showed that postoperative complications, surgical type and negative coping styles of parents were the main influencing factors of pediatric medical traumatic stress trajectory in parents of surgical children(all P<0.05). Conclusions:The pediatric medical traumatic stress in parents of children undergoing surgery have group heterogeneity trajectory, medical staff can formulate targeted and individualized intervention programs according to their trajectories and influencing factors.

Objective:To investigate the changes in structural and functional connectivity of different hippocampal subregions in courses of Alzheimer's disease (AD).Methods:One hundred and seventeen subjects from Sino Longitudinal Study on Cognitive Decline (SILCODE) were chosen; their cognitive functions were assessed using neuropsychological tests, and brain beta-amyloid (Aβ) levels were measured using PET-MRI. These patients were divided into group of normal cognitive function and negative Aβ ( n=68), group of normal cognitive function and positive Aβ ( n=29), and group of cognitive impairment and positive Aβ ( n=20); neuropsychological characteristics and changes in volume, structural connectivity and functional connectivity of hippocampal subareas were compared among the 3 groups. Results:Compared with group of normal cognitive function and negative Aβ and group of normal cognitive function and positive Aβ, group of cognitive impairment and positive Aβ had significantly decreased scores of Mini-mental State Examination (MMSE), Montreal Cognitive Assessment-Basic Version (MoCA-B), Auditory Verbal Learning Test (AVLT)-Short-term Delayed Recall (SR), AVLT-Long-term Delayed Recall (LR), Animal Fluency Test (AFT) and Boston Naming Test (BNT), and statistically increased Shape Trails Test B (STT-B) scores ( P<0.05). Compared with group of normal cognitive function and negative Aβ and group of normal cognitive function and positive Aβ, group of cognitive impairment and positive Aβ had significantly decreased volumes of the left and right hippocampal CA1, CA2, CA3, dentate gyrus (DG), entolorhinal cortex (EC) and inferior support area (Sub, P<0.05). Compared with group of normal cognitive function and negative Aβ, group of normal cognitive function and positive Aβ had increased or decreased structural connectivity, and almost all increased functional connectivity of each hippocampal subregion; compared with group of normal cognitive function and negative Aβ, group of cognitive impairment and positive Aβ had almost all increased structural connectivity, and almost all decreased functional connectivity of each hippocampal subregion. Conclusion:Changes in gray matter volume and structural and functional connectivity in various hippocampal subregions are different in courses of AD.

Objective : To explore the molecular mechanisms of immunosuppressive activity of soluble CD83 (sCD83) . Methods : Bone marrow⁃derived dendritic cells ( DCs) and CD4 + T cells in the spleen were isolated from bone marrow progenitor cells of 6 - 8 ⁃week⁃old C57B/6 mice. DCs and CD4 + T cells were treated with 10 μl PBS (Control group) or 10 μl 10 μg/ml soluble CD83 (sCD83 group) , respectively. Immature DCs (imDCs) in DCs and CD4 + CD25 + FOXP3 + T cells (Treg cells) in CD4 + T cells were determined by flow cytometry. Western blot was used to determine the expression levels of indoleamine 2 ,3 ⁃dioxygenase (IDO) in imDCs and the expression levels of phosphatase and tensin homolog (PTEN) , phosphorylated⁃Akt serine/threonine kinase 1 ( p⁃Akt) , Akt , nucleus NF⁃κB subunit (RelB) , cytoplasm RelB and programmed cell death 1 ( PD⁃1) in Treg cells. ELISA was used to determine the level of kynurenine in DCs culture supernatant , and the levels of interleukin⁃10 ( IL⁃10) , transforming growth factor⁃β (TGF⁃ β) and IL⁃12 in imDCs and CD4 + T cells co⁃culture system. Results: Compared with Control group , the percentage of DCs cell counts expressing the surface markers of CD40 , CD83 , CD86 and major histocompatibility complex class⁃ Ⅱ (MHC Ⅱ ) in sCD83 group decreased (P < 0. 05) , with the level of kynurenine in DCs culture supernatant increased (P < 0. 05) . Compared with Control group , the percentage of Treg cell counts in sCD83 group increased ( P < 0. 05) , with the expression levels of PTEN and cytoplasm RelB enhanced (P < 0. 05) , while the expression levels of p⁃Akt , nucleus RelB and PD⁃1 decreased (P < 0. 05) . There was no significant difference in the expression level of Akt between the two groups. In the imDCs and CD4 +T cells co⁃cultured supernatants , compared with Control group , the levels of IL⁃10 and TGF⁃ β increased , and the level of IL⁃12 decreased in sCD83 group (P < 0. 05) . Conclusion sCD83 can inhibit CD4 + T cells nucleus RelB levels and regulate cytokines secretion so as to have an effects on cellular crosstalk of imDCs and Treg cells and promote imDCs and Treg cells proliferation.

OBJECTIVE：To study in vi tro inhibitory act ivities of 9 kinds of TCM for dredging collaterals and dispelling wind on xanthine oxidase （XO），and to screen TCM with outstanding activity. METHODS ：Using xanthine as substrate and xanthinase as reaction enzyme ，allopurinol as positive control ，with water extract and methanol extract （hereinafter referred to as “ethanol extract”）from the stem and leaves of Hedera nepalensis ，the whole plant of Piper wallichii ，the fruits of Rubus corchorifolius ，the root of Caragana sinica ，the root of Wisteria sinensis ，the root of Rubus crataegifolius ，the bark of Catalpa ovata ，the root of Campsis grandiflora ，the stem of P. hancei （hereinafter referred to by plant name ）and petroleum ether ，dichloromethane，ethyl acetate，n-butanol and water fraction of active extract as the objects ，inhibition rate of each sample to XO was detected by spectrophotometry；IC50values were calculated with Graphpad prism 6.0 software to screen active extract/fraction. Double reciprocal method was used to determine the type of enzyme inhibition. RESULTS ：Among 9 kinds of TCM and 18 kinds of the extracts ，the inhibitory rates to XO of 500 μg/mL extracts from each TCM（except for ethanol extract of P. wallichii ），250 μg/mL water extract and ethanol extract of H. nepalensis ，P. wallichii ，R. corchorifolius and P. hancei ，250 μg/mL water extract of C. ovata ，250 μ g/mL ethanol extract of C. sinica ，R. crataegifolius and C. grandiflora ，125 μ g/mL ethanol extract of C. sinica and R. crataegifolius，62.5 μg/mL ethanol extract of C. sinica were more than 50％. The IC 50 value of the ethanol extract from C. sinica was 43.43 μg/mL，which was lower than the extracts of other TCM ，and which was the active extract. The IC 50 values of petroleum ether，dichloromethane，ethyl acetate ，n-butanol and water fracti on of ethanol extract from C. sinica were ＞200，193.35，7.67， 14.80 and ＞200 μg/mL，respectively. The IC 50 value of ethyl XO was competitive-noncompetitive inhibition ， which was different from competi tive inhibition of positive control. CONCLUSIONS：The ethanol extracts of C. sinica ，R. crataegifolius ，P. wallichii ，R. corchorifolius ，P. hancei ，H. nepalensis and the water extracts of H. nepalensis ，P. wallichii ，C. ovata show certain inhibitory activity in vitro to XO ，especially ethanol extract of C. sinica . The ethyl acetate fraction of the ethanol extract of C. sinica has similar inhibitory activity to allopurinol but their inhibition types are different.

Background: Computer-aided diagnosis based on deep learning technology is a research hotspot in the field of gastroenterology, and computer-aided diagnosis of colorectal polyps has received more and more attention. Aims: To validate a model based on deep learning for the automatic identification of colorectal polyps, and to analyze its auxiliary learning function for helping novice endoscopists. Methods: A total of 1 200 colonoscopy images (600 colorectal polyp images and 600 normal images) in the endoscopy center database of Qingdao Municipal Hospital (East) from January 2019 to January 2020 were retrospectively collected. Deep learning model was used to identify the 1 200 images. The sensitivity, specificity, accuracy and diagnosis time of deep learning model and 5 novice endoscopists for diagnosis of colorectal polyps were compared. Results: The deep learning model showed a sensitivity of 93.2%, specificity of 98.7%, accuracy of 95.9% for detecting colorectal polyps, and the diagnosis time of each image was (0.20±0.03) second. The sensitivity, accuracy, and diagnosis time of the model were superior to 5 novice endoscopists, and the specificity was superior to some novice endoscopists. The accuracies of model for polyps with size ≤5 mm and 6~9 mm were 88.1% and 96.8%, respectively, and were superior to 5 novice endoscopists; the accuracy of model for polyps with size ≥10 mm was 100%, and was similar to 5 novice endoscopists. The accuracy of model for polyps with protrude type was 94.8%, and was superior to some novice endoscopists; the accuracy of model for polyps with flat type was 91.7%, and was superior to 5 novice endoscopists. Missing the polyps with flat type (38.8%), polyps at mucosal folds (32.7%), and mistaking the mucosal folds as polyps (12.2%) were the main causes of false negative or false positive results of the model. Conclusions: The deep learning model has a high accuracy, sensitivity, specificity and shorter diagnosis time for diagnosis of colorectal polyps, and can be used to assist novice endoscopists in diagnosing small polyps and flat polyps.

Objective:To investigate the effect of Shentai Tea Polyphenols on memory and its underlying mechanism in healthy elderly adults.Methods:According to the randomized, double blind and placebo-controlled prospective experimental design, 240 healthy middle-aged or elderly subjects with normal objective cognition were recruited in our hospital from April to December 2019 through advertising, and they were randomly divided into an experimental group ( n=120) and a control group ( n=120). Oral administration of Shentai Tea Polyphenols or placebo capsules (lasting for 90 d, 2 times/d, 2 capsules/time) was given to subjects in the two groups. The neuropsychological scale scores and near-infrared brain imaging data of all subjects were collected before and after intervention, and the mean time from baseline data collection before intervention to follow-up data collection after medication was controlled within 6 months. Results:In patients from the experimental group, as compared with those before intervention, scores of delayed recall and recognition memory in the auditory verbal learning test (Huashan version) and Boston naming test, scores of Montreal cognitive assessment scale (basis version) were significantly higher, and scores of Hamilton anxiety scale, shape trails test A and rapid-eye-movement sleep behavior disorder screening questionnaire were significantly lower after intervention ( P<0.05); however, only scores of delayed recall in the auditory verbal learning test (Huashan version) were significantly increased in the control group ( P<0.05). A total of 23 pairs of differences of brain function connection before and after intervention in the experimental group were significantly higher than those in the control group ( P<0.05), mainly involving the function connection of forehead peak network (FPN), and function connection of FPN-default network, function connection of FPN-somatosensory movement network, function connection of FPN-dorsal attention network and function connection of FPN-visual network, as well as the function connection of default network and somatosensory movement network. Conclusion:Shentai Tea Polyphenols can improve cognitive performances including memory, language and executive function, anxiety mood and sleep quality in healthy middle aged or elderly subjects by affecting the functional connections of the networks in the brain.

Objective: To identify and characterize the 4 strains of Prototheca isolated from the clinical samples of skin or ascites samples in China. Methods: The taxonomic position of 4 yeast-like organisms was revealed by polyphasic taxonomic approach, i.e., cultural and morphologic characteristics, commercial biochemical systems of Vitek 2 (YST kit) and Vitek matrix-assisted laser desorption/ionization time of flight (MALDI-TOF) mass spectrometry (MS) systems in combination with phylogenetic analysis based on the gene sequences of 16S and 28S rRNA. Results: The 4 strains of Prototheca were characterized as cream-white, smooth, moist yeast-like colonies on Sabouraud gentamicin chloramph agar after incubation for 3 days. However, round, oval-shaped or elliptical sporangiums with mulberry-like or strawberry-like endospores were observed by optical microscope, which showed distinct differences from the general yeast species. The 4 isolates were identified as Prototheca wickerhamii with Vitek YST kits by Vitek 2 systems and Vitek MALDI-TOF MS systems. The genome for the 4 isolates was characterized with the existence of the prokaryotic 16S rRNA gene and eukaryotic 28S rRNA gene. The 16S rRNA gene sequence of the 4 strains showed more than 99.7% similarity to that of P. wickerhamii. Sequence analysis of 28S rRNA gene showed that the organisms included multiple copies of different sequences, which showed sequence similarities of 91.9% to 100% even in the same strain. The phylogenetic dendrogram based on 16S rRNA and 28S rRNA gene sequences showed that the 4 strains of Prototheca formed a cluster along with P. wickerhamii. Conclusion The 4 yeast-like organisms could be identified as P. wickerhamii, and 16S rRNA gene should be the suitable molecular target for the identification.

Objective: To evaluate the clinical characteristics and prognosis of 3q26 rearrangements in chronic myeloid leukemia (CML) patients. Methods: The clinical and laboratory data of 1 075 patients with CML diagnosed from 2010 to 2016 were retrospectively analyzed, and they were divided into 3q26 rearrangement positive group (n=19) and 3q26 rearrangement negative group (n=1 056). The expression of EVI1, ABL kinase region mutation and survival time between the two groups were compared. Meanwhile, the prognostic effects of three treatment methods, including tyrosine kinase inhibitors (TKIs), TKIs combined with chemotherapy and allogeneic hematopoietic stem cell transplantation, on the patients with 3q26 rearrangements were compared. Results: Most of the patients with 3q26 rearrangements were in the advanced phase (χ 2 =181.233, P＜0.01), and the median time to enter the acute phase was shorter (9.5 months). The mutation ratio of ABL kinase region and expression levels of EVI1 in 3q26 rearrangement positive group were significantly higher than that in the negative group (χ 2 =16.758, P＜0.01; Z/U=-0.331 9, P＜0.01). After treatment with TKIs, the median survival time of the 3q26 rearrangement positive group was significantly shorter than that of the negative group (χ 2 =313.229, P＜0.01). The prognosis of the patients treated with hematopoietic stem cell transplantation was better than that with TKIs (P=0.049). Conclusion The CML patients with 3q26 rearrangements have a higher risk of sudden change, shorter survival time and poor prognosis. Hematopoietic stem cell transplantation may improve their prognosis.