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Objective:To investigate the efficacy and safety of daratumumab (Dara) - combination regimens for newly diagnosed multiple myeloma (NDMM).Methods:A retrospective case series study was conducted. The clinical data of 34 patients with NDMM receiving treatment regimen including Dara from Qilu Hospital of Shandong University, Yantai Yuhuangding Hospital, Huangdao Branch of Affiliated Hospital of Qingdao University and Taian City Central Hospital between April 2020 and March 2022 were retrospectively collected. The efficacy, survival and adverse reactions of patients were analyzed. Cox proportional risk model was used to analyze the factors affecting overall survival (OS) and minimal residual disease (MRD) turning negative.Results:Among 34 patients with NDMM, there were 19 males and 15 females, with 21 cases aged < 65 years and 13 cases aged ≥65 years. The median follow-up duration [ M ( Q1, Q3)] was 22 months (19 months, 26 months), the median of Dara treatment cycles was 7 (5, 11), and the overall response rate (ORR) reached 97.1% (33/34). There were statistically significant differences in the optimal efficacy of patients stratified by receiving hematopoietic stem cell transplantation or not and receiving different treatment cycles (all P ≤ 0.05), while there were no statistically significant differences in patients stratified by other clinical features (all P > 0.05). The 1-year progression-free survival rate was 79.4% and the 1-year OS rate was 94.1%. Multivariate Cox regression analysis showed that the cycle number of treatment regimens containing Dara was an independent influencing factor of MRD turning negative (6 cycles vs. 2 cycles, HR = 0.267, 95% CI: 0.076-0.935, P = 0.039); age ≥ 65 years was an independent risk factor for OS ( HR = 35.313, 95% CI: 1.709-729.669, P = 0.021). The incidence of hematological adverse reactions grade 3 or above was 20.6% (7/34), and the non-hematological adverse reactions primarily included infection [44.1% (15/34)] and edema of extremity and trunk [41.2% (14/34)]. Conclusions:The Dara-based regimens for NDMM exhibit a high ORR. The remission depth accelerated with the increasing number of treatment cycle, and the adverse reactions are mild.
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Shegan Mahuang Decoction is a classic formula for the treatment of asthma, which has the efficacy of dissipating cold and reducing phlegm, relieving cough and relieving asthma, and can be used clinically alone to control acute attacks, or to assist Western medical methods to improve the efficacy, and can also to combine with other classical prescriptions for the pathogenesis, which can improve the symptoms of cough and asthma, expectoration, and lung function indexes. The mechanism of Shegan Mahuang Decoction in the treatment of asthma is mainly related to reducing inflammatory response and inhibiting airway remodeling, and it mainly regulates immune inflammatory pathways to play a role.
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Objective:To evaluate the application effect of the vertical and horizontal step-by-step teaching mode in clinical nursing students.Methods:Using the convenient sampling method, the nursing students who were internship in the nursing college of Dalian Medical University were selected as the research objects. 27 nurses from July 9, 2016 to April 12, 2017 were the control group, and 29 nursing students from July 2017 to April 2018 were experimental groups. The control group adopts the traditional teaching mode, and the experimental group adopts the vertical and horizontal ladder teaching mode to complete the 40-week internship, and each round (four weeks) conducts theoretical and skill assessment.Results:The experimental group of nursing students in the experimental group had a score of (91.52 ± 1.75) points on the theoretical theory, a score of (90.99 ± 1.44) points on the staged skills examination, and a score of (699.34 ± 8.85) points on the national nursing qualification examination. The comprehensive quality evaluation score of the phased internship nursing students was (92.58 ± 1.17) points, which were higher than the control group's (88.89 ± 2.82), (88.27 ± 2.04), (694.26 ± 7.61), (89.44 ± 0.62) points, and the difference was statistically significant ( t values were -4.21,-5.79, -2.30, -7.50, P <0.05). Conclusion:The vertical and horizontal step-by-step teaching mode is conducive to improving the efficiency of clinical teaching, improving the learning effect of students, and playing a positive guiding role in the development of internship plans with teaching departments, and improving the overall level of nursing teaching.
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Objective@#Integrate the evaluation indexes of clinical competence of master of nursing specialist.@*Methods@#Search the Cochrane Library, Joana Briggs Institute Library, Embase, Web of Science, PubMed, CNKI, VIP and Wanfang database, from the establishment of the database to December 10th,2018, and to collect researches about master of nursing specialist clinical competence evaluation index and then analyzed by content analysis method and thematic analysis.@*Results@#A total of 9 articles were included, 26 items and 9 categories including comprehensive practical ability, professional development ability, teaching guidance ability, clinical scientific research ability, organization and management ability, professional accomplishment, professional values, professional knowledge level, relevant knowledge level were selected. 3 dimensions including skill structure, attitude structure and knowledge structure.@*Conclusion@#Evaluating the clinical competence of master of nursing specialist we should not only consider their comprehensive practical ability, but pay attention to their professional development, teaching and scientific research, organization and management, professional accomplishment, knowledge and professional values assessment.
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Objective Integrate the evaluation indexes of clinical competence of master of nursing specialist. Methods Search the Cochrane Library, Joana Briggs Institute Library, Embase, Web of Science, PubMed, CNKI, VIP and Wanfang database, from the establishment of the database to December 10th,2018, and to collect researches about master of nursing specialist clinical competence evaluation index and then analyzed by content analysis method and thematic analysis. Results A total of 9 articles were included, 26 items and 9 categories including comprehensive practical ability, professional development ability, teaching guidance ability, clinical scientific research ability, organization and management ability, professional accomplishment, professional values, professional knowledge level, relevant knowledge level were selected. 3 dimensions including skill structure, attitude structure and knowledge structure. Conclusion Evaluating the clinical competence of master of nursing specialist we should not only consider their comprehensive practical ability, but pay attention to their professional development, teaching and scientific research, organization and management, professional accomplishment, knowledge and professional values assessment.