Functional identification of ANR genes in apple (Malus halliana) that reduce saline-alkali stress tolerance.

As one of the major abiotic stresses restricting the development of global agriculture, saline-alkali stress causes osmotic stress, ion poisoning, ROS damage and high pH damage, which seriously restrict sustainable development of fruit industry. Therefore, it is essential to develop and cultivate saline-alkali-resistant apple rootstocks to improve the yield and quality of apples in China. Based on transcriptome data, MhANR (LOC114827797), which is significantly induced by saline-alkali stress, was cloned from Malus halliana. The physicochemical properties, evolutionary relationships and cis-acting elements were analysed. Subsequently, the tolerance of MhANR overexpression in Arabidopsis thaliana, tobacco, and apple calli to saline-alkali stress was verified through genetic transformation. Transgenic plants contained less Chl a, Chl b and proline, SOD, POD and CAT activity, and higher relative electrical conductivity (REC) compared to WT plants under saline-alkali stress. In addition, expression of saline-alkali stress-related genes in overexpressed apple calli were also lower than in WT calli, including the antioxidant genes (MhSOD and MhCAT^), the Na+ transporter genes (MhCAX5, MhCAX5, MhSOS1, MhALT1), and the H+ -ATPase genes (MhAHA2 and MhAHA8), while expression of the K+ transporter genes (MhSKOR and MhNHX4) were higher. Expression of MhANR reduced tolerance of A. thaliana, tobacco, and apple calli to saline-alkali stress by regulating osmoregulatory substances, chlorophyll content, antioxidant enzyme activity, and expression of saline-alkali stress-related genes. This research provides a theoretical basis for cultivating apple rootstocks with effective saline-alkali stress tolerance.

[Investigation on medical security and quality of life of migrant workers with pneumoconiosis].

Objective: To investigate and understand the medical security and quality of life of migrant workers with pneumoconiosis, so as to provide scientific basis for the prevention and control countermeasures of migrant workers with pneumoconiosis and targeted poverty alleviation. Methods: Using a stratified random sampling method, 200 migrant workers diagnosed with pneumoconiosis at the Shandong Academy of Occupational Health and Occupational Medicine from January 2016 to December 2021 were selected as the observation group, while 200 non migrant workers diagnosed with pneumoconiosis were selected as the control group. St. George's Respiratory Questionnaire (SGRQ) and Pneumoconiosis Questionnaire were used to collect and compare information on the age, working age of dust exposure, economic sources, employment status, income, medical security and quality of life of two groups of patients. Results: The age of migrant worker pneumoconiosis patients in the observation group was (58.1±8.1) years old, and the working age of dust exposure was (19.3±10.1) years. The main source of income was children support (85.5%, 171/200), employment status was mainly wait for employment or unemployed (69.0%, 138/200), personal monthly income was mainly non income (90.0%, 180/200), and family annual income was mainly less than 10000 yuan (48.0%, 96/200). The average personal annual medical expenditure of 5000-<10000 yuan accounted for 42.0% (84/200). The age of pneumoconiosis patients in the control group was (59.2±8.9) years old, and the working age of dust exposure was (20.2±10.5) years. The main source of income was retirement pension or salary (99.0%, 198/200), with retirement as the main employment status (66.0%, 132/200), the main personal monthly income was 2000-<4000 yuan (61.5%, 123/200), the main family annual income was 20000-<40000 yuan (44.0%, 88/200), and the average personal annual medical expenditure was mostly non-expenditure (92.0%, 184/200). There were statistically significant differences in the distribution of economic sources, employment status, personal monthly income, family annual income and average personal annual medical expenditure between the two groups (P<0.001). The main type of insurance for the observation group was rural cooperative medical care (68.5%, 137/200), and 87.0% (174/200) had no medical reimbursement and a proportion less than 50%. There were statistically significant differences in insurance type and medical reimbursement proportion between the two groups (P<0.001). The respiratory symptoms, activity ability, daily life influence and total quality of life scores of pneumoconiosis patients in the observation group were significantly higher than those in the control group, the differences were statistically significant (P<0.001) . Conclusion: Migrant workers with pneumoconiosis have low income, high medical expenditure, low medical reimbursement proportion and poor quality of life. Therefore, it is necessary to draw high attention from relevant departments and provide timely attention and assistance to improve the quality of life of migrant workers with pneumoconiosis.

Clinical effectiveness of sodium fluorescein-guided microsurgery in patients with high-grade gliomas.

OBJECTIVE: The aim of this study was to assess the clinical effectiveness of sodium fluorescein-guided microsurgery in patients with high-grade gliomas. PATIENTS AND METHODS: 120 patients with high-grade gliomas who were hospitalized in our Neurosurgery Department from January 2018 to January 2021 were selected and then divided into a control and a study group using the random number table method, with 60 cases in each group. To compare the clinical efficacy of patients in both groups, neuronavigation microsurgery was used in the control group and neuronavigation microsurgery combined with sodium fluorescein-guided microsurgery was used in the study group. RESULTS: The Gross Total Resection Rate (GTRR) of the study group was significantly higher than that of the control group. There was no significant difference in intraoperative bleeding loss or hospital stay between the two groups, and the study group had a much shorter operation time than the control group. The Karnofsky Performance Score (KPS) and the National Institutes of Health Stroke Scale (NIHSS) scores did not significantly differ between the two groups prior to surgery but declined significantly in the study group compared to the control group following treatment. In terms of adverse effects, there was no significant difference between the two groups. In the control group, the median progression-free survival (PFS) was 7.5 months, and the median overall survival (OS) was 9.6 months, whereas in the study group, the median PFS was 9.5 months, and the median OS was 11.5 months. PFS did not significantly differ between the two groups (HR=1.389, 95% CI=0.926-2.085, p=0.079); however, OS was significantly higher in the study group compared to the control group (HR=1.758, 95% CI=1.119-2.762, p=0.013). CONCLUSIONS: Fluorescein-guided microsurgery can dramatically improve total resection rate, postoperative neurological functional status, and overall survival with higher efficacy and safety in patients with high-grade gliomas.

[Clinical evaluation of antral septal maxillary sinus floor elevation by the disk-up sinus reamer].

Objective: To investigate the clinical effect of disk-up sinus reamer (DSR) in maxillary sinus floor elevation with maxillary sinus septum. Methods: Twenty-four patients were included between January 2019 to January 2020 in Department of Oral Implantology, The Affiliated Hospital of Qingdao University. There were 10 males and 14 females with the age of (39.3±11.7) years old (range 22-56 years). Pre-operative(T0) cone-beam CT (CBCT) was taken for measurement and analysis. All patients were divided into group E (easy situations, septum located anterior to the zygo-matic process), group M (moderate situations, septum located pos-terior to the zygo-matic process) and group D (difficult situations, sagittally oriented septum). The maxillary sinus floor was grafted through the crestal approach by DSR and implants were placed simultaneously. Permanent repair was performed 6-8 months after operation. All patients underwent CBCT before surgery, after surgery immediately (T1), 6 months after surgery(T2), 1 year after surgery(T3), 2 year after surgery(T4). The residual bone height (RBH) and the vertical bone height (VBH) were analyzed. The mucosal perforation rate, implant survival rate were counted. Results: All the 24 patients completed the Maxillary sinus lift surgery successfully and 24 implants were placed simultaneously. All patients had no headache, dizziness. The mucosal perforation rate was 0. The survival rate of implants during the healing period was 100%(24/24). The RBH was (5.81±2.56) mm pre-operation, the VBHT1, VBHT2, VBHT3 and VBHT4 were (11.82±1.09), (10.98±0.52), (10.66±0.44) and (10.40±0.33) mm, respectively. The differences between the groups by pairing test were statistically significant (F=187.70, P0.001), expect VBHT3 and VBHT4 (P=0.071). Bone resorption and remodeling mainly occurred 1 year after surgery. One patient developed peri-implantitis 18 months after surgery. Conclusions: With the RBH of implant site>2 mm and existence of maxillary sinus septum, using DSR for sinus floor elevation has a high success rate. It can obtain enough bone height and complete the simultaneous implantation to form a good osseointegration. The DSR is simple, safe and controllable, and can shorten the operation time.

[Analysis of the therapeutic efficacy and factors influencing sequential combination of nucleos(t)ide analogues with pegylated interferon alpha for 48~96 weeks in the treatment of patients with chronic hepatitis B].

Objective: To explore the therapeutic efficacy and factors influencing the sequential combination of nucleos(t)ide analogues (NAs) with pegylated interferon alpha (Peg-IFN-α) in the treatment of patients with chronic hepatitis B (CHB). Methods: 144 CHB cases with NAs treatment for more than 1 year, HBV DNA < 20 IU/ml, hepatitis B surface antigen (HBsAg) quantification < 3 000 IU/ml, treated with a sequential combination of Peg-IFN-α treatment for 48 to 96 weeks, and followed up were selected from the Fifth Medical Center of the PLA General Hospital between May 2018 and May 2020. Intention-to-treat analysis was used to measure the HBsAg clearance rate at 96 weeks. The Kaplan-Meier method was used to compute the cumulative HBsAg clearance rate at 96 weeks. Univariate and multivariate logistic regression were used to analyze the factors influencing HBsAg clearance at 48 weeks of sequential combination therapy. Univariate and multifactorial COX proportional hazard models were used to analyze the factors influencing HBsAg clearance following 96 weeks of prolonged PEG-IFN-α treatment. The receiver operating characteristic curve was used to assess the predictive value of factors influencing HBsAg clearance. A Mann-Whitney U test was used to compare the measurement data between groups. The count data was compared using the χ(2) test between groups. Results: 41 (28.47%) cases achieved HBsAg clearance at 48 weeks of sequential combination therapy. The HBsAg clearance rate at 96 weeks was 40.28% (58/144) by intention-to-treat analysis. The Kaplan-Meier method computed that the cumulative HBsAg clearance rate at 96 weeks was 68.90%. Multivariate logistic regression analysis showed that HBsAg quantification at baseline (OR = 0.090, 95%CI: 0.034-0.240, P < 0.001) and a 24-week drop in HBsAg level (OR = 7.788, 95%CI: 3.408-17.798, P < 0.001) were independent predictors of HBsAg clearance in CHB patients treated sequentially in combination with NAs and Peg-IFN-α for 48 weeks. Receiver operating characteristic curve analysis showed that the baseline HBsAg quantification [area under the receiver operating characteristic curve (AUC), 0.911, 95% CI: 0.852-0.952)] and 24-week drop in HBsAg level (AUC = 0.881, 95%CI: 0.814-0.930) had equally good predictive value for 48-week HBsAg clearance, but there was no statistically significant difference between the two (Z = 0.638, P = 0.523). The value of the combination of baseline HBsAg quantification and 24-week drop in HBsAg level (AUC = 0.981, 95%CI: 0.941-0.997) was superior to that of single baseline HBsAg quantification (Z = 3.017, P = 0.003) and 24-week drop in HBsAg level (Z = 3.214, P = 0.001) in predicting HBsAg clearance rate at 48 weeks. Multivariate COX proportional hazards model analysis showed that HBsAg quantification at 48 weeks (HR = 0.364, 95%CI: 0.176-0.752, P = 0.006) was an independent predictor of HBsAg clearance with a prolonged course to 96 weeks of Peg-IFN-α treatment. Conclusion: The HBsAg clearance rate can be accurately predicted with baseline HBsAg quantification combined with a 24-week drop in HBsAg level in patients with CHB who are treated with a sequential combination of NAs and Peg-IFN-α therapy for 48 weeks. Prolonging the course of Peg-IFN-α treatment can enhance the HBsAg clearance rate's capability. An independent predictor of HBsAg clearance is HBsAg quantification at 48 weeks of sequential combination therapy with a prolonged course of 96 weeks of Peg-IFN-α treatment.

[Progress in intestinal adaptation after enterectomy].

Intestinal adaptation is a spontaneous compensation of the remanent bowel after extensive enterectomy, which improves the absorption capacity of the remanent bowel to energy, fluid and other nutrients. Intestinal adaptation mainly occurs within 2 years after enterectomy, including morphological changes, hyperfunction and hyperphagia. Intestinal adaptation is the key factor for patients with short bowel syndrome to weaning off parenteral nutrition dependence and mainly influenced by length of remanent bowel, type of surgery and colon continuity. In addition, multiple factors including enteral feeding, glucagon-like peptide 2 (GLP-2), growth hormone, gut microbiota and its metabolites regulate intestinal adaptation via multi-biological pathways, such as proliferation and differentiation of stem cell, apoptosis, angiogenesis, nutrients transport related protein expression, gut endocrine etc. Phase III clinical trials have verified the safety and efficacy of teduglutide (long-acting GLP-2) and somatropin (recombinant human growth hormone) in improving intestinal adaptation, and both have been approved for clinical use. We aim to review the current knowledge about characteristics, mechanism, evaluation methods, key factors, clinical strategies of intestinal adaptation.

[The multi-dimensional molecular characteristics of the indolent pulmonary ground-glass nodules].

With the dramatically increasing detection rate of ground-glass nodules (GGN), exact understanding and treatment strategy of them has become the hottest issue currently. More and more studies have begun to explore the underlying mechanisms of their indolent characteristics and favorable prognosis from the perspectives of molecular evolution and immune microenvironment. GGN has different dominating gene mutations at different evolutional stages. The pure GGN has a lower tumor mutation burden and genomic instability, while a gradually evolutionary feature of genomic mutation along with the pathological progression can be observed. GGN has less infiltration of immune cells, and they are under the pressure of immune surveillance with weakened immune escape. With the increase of solid components, an inhibitory immune microenvironment is gradually established and immune escape is gradually enhanced, leading to rapid tumor growth. Further exploration of the molecular characteristics of GGN will help to more precisely distinguish these highly heterogeneous lesions, which could be helpful to make personalized treatment plans.

[A single-center retrospective analysis of 100 consecutive cases treated with lenalidomide/bortezomib/dexamethasone in newly diagnosed multiple myeloma].

Objective: To investigate the efficacy and safety of lenalidomide combined with bortezomib and dexamethasone (RVD) in patients with newly diagnosed multiple myeloma (NDMM). Methods: A total of 100 consecutive NDMM patients treated with RVD from August 2016 to September 2020 at Peking University People's Hospital were retrospectively analyzed, including response, drug toxicity, follow-up and survival, and subgroup analysis. Results: The median follow-up time was 19.5 (2.0-57.0) months. For patients undergoing autologous stem cell transplantation (ASCT) after RVD regimen, the objective response rate (ORR)/complete response+stringent complete response (CR+sCR)/≥very good partial response (VGPR) rates were 100%, 73.3% (33/45), 95.6% (43/45) respectively. For 54 patients not receiving transplantation, the ORR/CR+sCR/≥VGPR rates were 79.6% (43/54), 18.5% (10/54), 51.9% (28/54) respectively. As to the survival analysis, 2-year progression free survival (PFS) rates were 84.5% and 70.9% in transplant and non-transplant patients respectively (P=0.102). Two-year overall survival (OS) rates were 100% and 80.8% in transplant and non-transplant patients respectively (P=0.003). The common hematologic adverse events (AEs) were thrombocytopenia (33%) and neutropenia (25%). Abnormal liver function (43%) and peripheral neuropathy (24%) were recognized more as non-hematologic AEs. Conclusion: RVD as front-line regimen has high efficient response rate and acceptable safety in Chinese NDMM patients.

[Association between genetic predisposition to childhood obesity and the risk of adult ischemic heart disease in China].

Objective: To examine the associations of childhood obesity, assessed by genetic variations of childhood body mass index (BMI), with the risk of adult ischemic heart disease (IHD) and major coronary event (MCE). Methods: More than 69 000 participants from the China Kadoorie Biobank were genotyped. After excluding those with coronary heart disease, stroke, or cancer at baseline, a total of 64 454 participants were included in this study. Based on genome-wide significant single nucleotide polymorphisms (SNPs), childhood BMI genetic risk score were constructed for every participant and divided into quintiles, with the lowest quintile as the low genetic risk group and the highest quintile as the high genetic risk group. Cox proportional hazards regression models were used to estimate the association between genetic predisposition to childhood obesity and the risk of ischemic heart disease. Results: During a median of 10.7 years of follow-up, 7 073 incident cases of IHD and 1 845 cases of MCE were documented. After adjusting for sex, age, region, and the first ten genetic principal components, the HRs (95%CIs) for IHD and MCE in the high genetic risk group were 1.10 (1.02-1.18) and 1.10 (0.95-1.27), compared with the low genetic risk group. IHD risk increased by 4% (2%-6%) for each one standard deviation increase in genetic risk score (trend P=0.001). After further adjustment for baseline BMI, the differences between genetic risk groups were not statistically significant, but there was still a linear trend between genetic risk score and IHD risk (trend P=0.019). Conclusions: IHD risk increased with genetic predisposition to childhood obesity, suggesting that childhood obesity is an important risk factor for the development of IHD in China. As an easily identifiable feature, changes of childhood BMI should be monitored regularly to realize early intervention of IHD in adults.

[Influencing factors for postoperative survival of patients with pneumoconiosis treated by lung transplantation].

Objective: To explore the influencing factors for postoperative survival of patients with pneumoconiosis (silicosis) after lung transplantation in order to improve their clinical outcomes. Methods: In August 2021, retrospective alalysis from December 2015 to July 2021, 29 patients with end-stage pneumoconiosis underwent lung transplantation at Department of Thoracic Surgery, Affiliated Henan Provincial People's Hospital, Zhengzhou University. The survival, postoperative complications, and causes of death were analyzed. Life table and Kaplan-Meier method were used to draw survival curves, the log-rank test was used to compare the influence of each factor on survival rates, and the multivariate Cox proportional hazards regression model was used to evaluate the influence of each factor on survival. Results: All the patients underwent successful lung transplantation, with survival rates of 75% at 6 months, 70% at 1 year, 65% at 2 years, 50% at 3 years and 50% at 5 years. The Kaplan-Meier survival analysis showed that BMI, age and preoperative albumin level were influencing factors for postoperative survival rates (P<0.05) . The multivariate COX regression model showed that BMI≥18.5 kg/m(2) and the albumin level≥35 g/L were the protective factors (P<0.05) . Conclusion: Aging older, preoperative BMI<18.5 kg/m(2) and hypoalbuminemia are independent risk factors for death after lung transplantation. Survival rates are affected by preoperative BMI index, albumin level and age. Early intervention should be made before lung transplantation to promote the BMI index and albumin level to reach the standard.

[Characteristics and research progress on the role of intestinal fungi in chronic liver disease].

At present, a large number of studies have revealed that intestinal bacteria play a very complex role in benign liver diseases, while there is relatively little research on intestinal fungi. As part of the gut microbiome, intestinal fungi are insignificant in numbers compared with intestinal bacteria, but the impact of intestinal fungi on human health and diseases cannot be ignored. This paper summarizes the characteristics and research progress of intestinal fungi in patients with alcoholic liver disease, nonalcoholic fatty liver disease, viral hepatitis and liver cirrhosis, so as to provide basis of reference and ideas for the further research on the diagnosis and treatment of intestinal fungi in benign liver diseases.

[Vincristine inhibits the proliferation of ovarian cancer cells by regulating the demethylation of RASSF2A].

Objective: To investigate the effect of vincristine on the proliferation of ovarian cancer cells by regulating RASSF2A demethylation. Methods: SKOV3 cells were infected with control (LV-NC) and RASSF2A lentivirus (LV-RASSF2A) and treated with or without vincristine. Cell counting kit-8 (CCK-8) was used to detect the activity of ovarian cancer cells (SKOV3) treated with different doses of vincristine. Colony formation assay was used to detect the proliferation of SKOV3 cells. Flow cytometry was used to detect the apoptosis of SKOV3 cells. Real time polymerase chain reaction (RT-PCR) was used to examine the mRNA expression of RASSF2A in IOSE-29 and SKOV3 cells. Western blot was used to examine the protein expression of RASSF2A in IOSE-29 and SKOV3 cells. Methylation-specific PCR was used to detect methylation and demethylation levels of RASSF2A gene in IOSE-29 and SKOV3 cells. Results: The cell viabilities of SKOV3 cell treated with 6.25 nmol/L, 12.5 nmol/L, 25 nmol/L, 50 nmol/L and 100 nmol/L vincristine were (87.19±4.49)%, (73.67±8.62)%, (66.35±6.04)%, (50.32±6.00)% and (34.92±6.11)%, respectively, lower than (100.46±4.69)% of control group (P<0.05). The half maximal inhibitory concentration of vincristine at 48 hours was 50.02 nmol/L. The proliferation abilities of SKOV3 cells in vincristine 12.5 nmol/L group, 25 nmol/L group and 50 nmol/L group were (41.70±2.21)%, (32.15±1.80)% and (23.00±2.01)%, respectively, significantly lower than (100.78±5.66)% in the control group (all P<0.05). The apoptotic rates of SKOV3 cells in vincristine 12.5 nmol/L group, 25 nmol/L group and 50 nmol/L group were (3.65±0.27)%, (5.21±0.76)% and (10.46±1.00)%, respectively, significantly higher than (2.12±0.23)% in the control group (all P<0.05). Compared with the IOSE-29 group (1.00±0.07 and 0.68±0.04), the mRNA expression (0.32±0.04) and protein expression (0.24±0.02) of RASSF2A were down-regulated in SKOV3 cells (P<0.05). Compared with the LV-NC group [(101.60±4.39)%, (100.73±3.29)%, (4.06±0.30)%], over-expression of RASSF2A down-requlated cell viability (68.92±3.94)%, inhibited proliferation (16.38±2.16)%, and promoted apoptosis (8.65±0.56)%, (P<0.05). Conclusion: Vincristine can increase RASSF2A expression and inhibit ovarian cancer cell proliferation by promoting the demethylation of RASSF2A promoter.

[Early reduction of serum RANTES can predict HBsAg clearance in patients with chronic hepatitis B treated with nucleos(t)ide analogues combined with peginterferon alpha].

Objective: To observe the dynamic changes of serum RANTES during the treatment with nucleos(t)ide analogues combined with pegylated interferon alpha (peginterferon-α), and further analyze the predictive effect of RANTES on HBsAg clearance in patients with chronic hepatitis B. Methods: 98 cases of chronic hepatitis B with quantitative HBsAg < 3 000 IU/ml and HBV DNA < 20 IU/ml after≥1 year NAs treatment were enrolled. Among them, 26 cases continued to receive NAs monotherapy, 72 cases received NAs combined with pegylated interferon alpha therapy. The changes in RANTES during treatment were observed. The receiver operating characteristic curve was used to analyze the early changes of RANTES to predict the HBsAg clearance during 48 weeks. Results: During 48 weeks, 15 cases (20.83%) had achieved HBsAg clearance in combination group, while no patient had achieved HBsAg clearance in NAs group. The overall serum RANTES level had decreased from baseline in NAs and combination group. At week 48, in the combination group, the serum RANTES level was decreased more significantly in patients with HBsAg clearance than patients without. Further analysis showed that, in combination group, HBsAg clearance rate of patients with serum RANTES decreased at week 12 and 24 was higher than patients with elevated (29.17% vs. 4.17%, P = 0.014; 28.00% vs. 4.55%, P = 0.052), and quantitative HBsAg reduction was larger significantly [(1.49 ± 1.26) log(10)IU/ml vs. (0.73 ± 0.81) log(10)IU/ml, P = 0.017; (1.54 ± 1.27) log(10)IU/ml vs. (0.57 ± 0.56) log(10)IU/ml, P = 0.004]. Receiver operating characteristic curve analysis showed that the baseline quantitative HBsAg and the reduction in quantitative HBsAg and serum RANTES during the early period were predictors of HBsAg clearance after 48-week combination therapy. Furthermore, the combination of baseline quantitative HBsAg and 12 - or 24-week reduction of serum RANTES were better predictors of HBsAg clearance than that of baseline quantitative HBsAg combined with HBsAg decrease at week 12 or 24. The area under the receiver operating characteristic curve of the former was 0.925 and 0.939, while that of the latter was 0.909 and 0.929, respectively. Conclusion: Early reduction of serum RANTES at week 12 and 24 can predict HBsAg loss in CHB patients receiving addition of peginterferon-α to ongoing NAs Therapy, so serum RANTES could be one of the key immunological markers for predicting HBsAg clearance.

The impact of COVID-19 on subthreshold depressive symptoms: a longitudinal study.

AIMS: The coronavirus disease 2019 (COVID-19) pandemic represents an unprecedented threat to mental health. Herein, we assessed the impact of COVID-19 on subthreshold depressive symptoms and identified potential mitigating factors. METHODS: Participants were from Depression Cohort in China (ChiCTR registry number 1900022145). Adults (n = 1722) with subthreshold depressive symptoms were enrolled between March and October 2019 in a 6-month, community-based interventional study that aimed to prevent clinical depression using psychoeducation. A total of 1506 participants completed the study in Shenzhen, China: 726 participants, who completed the study between March 2019 and January 2020 (i.e. before COVID-19), comprised the 'wave 1' group; 780 participants, who were enrolled before COVID-19 and completed the 6-month endpoint assessment during COVID-19, comprised 'wave 2'. Symptoms of depression, anxiety and insomnia were assessed at baseline and endpoint (i.e. 6-month follow-up) using the Patient Health Questionnaire-9 (PHQ-9), Generalised Anxiety Disorder-7 (GAD-7) and Insomnia Severity Index (ISI), respectively. Measures of resilience and regular exercise were assessed at baseline. We compared the mental health outcomes between wave 1 and wave 2 groups. We additionally investigated how mental health outcomes changed across disparate stages of the COVID-19 pandemic in China, i.e. peak (7-13 February), post-peak (14-27 February), remission plateau (28 February-present). RESULTS: COVID-19 increased the risk for three mental outcomes: (1) depression (odds ratio [OR] = 1.30, 95% confidence interval [CI]: 1.04-1.62); (2) anxiety (OR = 1.47, 95% CI: 1.16-1.88) and (3) insomnia (OR = 1.37, 95% CI: 1.07-1.77). The highest proportion of probable depression and anxiety was observed post-peak, with 52.9% and 41.4%, respectively. Greater baseline resilience scores had a protective effect on the three main outcomes (depression: OR = 0.26, 95% CI: 0.19-0.37; anxiety: OR = 1.22, 95% CI: 0.14-0.33 and insomnia: OR = 0.18, 95% CI: 0.11-0.28). Furthermore, regular physical activity mitigated the risk for depression (OR = 0.79, 95% CI: 0.79-0.99). CONCLUSIONS: The COVID-19 pandemic exerted a highly significant and negative impact on symptoms of depression, anxiety and insomnia. Mental health outcomes fluctuated as a function of the duration of the pandemic and were alleviated to some extent with the observed decline in community-based transmission. Augmenting resiliency and regular exercise provide an opportunity to mitigate the risk for mental health symptoms during this severe public health crisis.

[Study on the quality of life and influencing factors of pneumoconiosis in migrant workers].

Objective: To investigate and understand the general situation and quality of life of migrant workers with pneumoconiosis, and analyze the influencing factors, so as to provide scientific basis for effective countermeasures to improve the quality of life of migrant workers with pneumoconiosis. Methods: In June 2019, 79 cases of migrant workers' pneumoconiosis diagnosed by Shandong Occupational Disease Hospital from March 2017 to August 2018 were selected as the study object by cluster random sampling method. Questionnaires and on-site visits were used to investigate the quality of life and its influencing factors. The questionnaire was administered by self-designed questionnaire and WHO quality of life questionnaire. Results: The farmer's pneumoconiosis patients are generally lower in culture. High school or above is only 6.33% (5/79) . Their economic income is low. The monthly income of less than 1000 RMB is 49.37% (39/79) . The disease was heavy and pneumoconiosis was 58.23% (46/79) . Pneumoconiosis patients without systematic treatment accounted for 69.62% (55/79) . Only 11.39% of rural workers with pneumoconiosis can timely increase or decrease clothing and wear masks to avoid respiratory irritation. Pneumoconiosis patients who smoked accounted for 77.22% (61/79) . The quality of life of the pneumoconiosis patients in the physiological, psychological, social and environmental fields were (10.40±2.31) , (11.40±2.82) , (11.46±3.03) and (8.38±3.37) respectively. The influencing factors of quality of life were pneumoconiosis stage, education level, economic income and smoking (P< 0.05) . Conclusion: The quality of life of migrant workers with pneumoconiosis is generally low. The main factors that affect the quality of life of patients are disease severity (pneumoconiosis stage) , education level, economic income and smoking.

[Cardiovascular toxicities associated with immune checkpoint inhibitors].

With the continuous development of cancer treatment, the immune checkpoint inhibitors have been applied to the treatment of a variety of malignant tumors, which improved the patient's survival time and quality of life. However, immune-related adverse reactions occur inevitably. Like chemotherapeutics and targeted drugs, immunosuppressants can also cause cardiovascular events that affect the mortality of cancer patients. With the extension of the survival time of cancer patients, it will increasingly become a key factor which affects the prognoses of these diseases. This review focuses on the cardiotoxic mechanism, clinical manifestation, and future direction of immune checkpoint inhibitors during cancer treatment.