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Objective:To explore the effect of the teaching reform of "Community Nursing" in our school in different grades of nursing undergraduates.Methods:A total 174 nursing students in Grade 2009, 2010 and 2013, from School of Nursing at Shanghai Jiao Tong University were selected. Various teaching methods were carried out, including continuously carding teaching content, gradually adopting a community assessment approach, participating in community health education, and developing family health education plans and student-centered teaching methods. At the end of the course, all students completed the self-design curriculum evaluation questionnaires. By comparing the evaluation of teaching reform in different grades, the effect of the teaching reform scheme was analyzed. One-way analysis of variance and student Newman Keuls method were performed to compare the differences among different grades with SPSS 19.0 software.Results:The scores of the five dimensions of "curriculum organization", "teaching content", "teaching form", "teaching evaluation" and "teaching arrangement" were much higher in Grade 2013 and 2010 than in Grade 2009 ( P<0.05). After the teaching reform, students' satisfaction with the curriculum organization was improved; simplifying the teaching content reduced the repetition between courses; implementing the diversified teaching form enhanced students' participation; adopting a diversified teaching evaluation system expanded students' understanding of learning content; integrating different teaching locations and equipment brought real service experience to students. Conclusion:The series of teaching reforms of "Community Nursing" have achieved positive results in adjusting the curriculum framework, focusing on community nursing, improving students' participation, combining varied assessment methods and developing multiple teaching points and have been recognized by the students, so that the results may provide a reference for the next teaching rounds of "Community Nursing" with the fourth edition.
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Objective:To investigate and analyze the influencing factors associated with transition time to achieve full oral feeding for premature infants in neonatal intensive care unit (NICU).Methods:A total of 251 NICU hospitalization preterm infants and their mothers meeting the inclusion criteria in Shanghai First Maternal and Infant Health Care Hospital were collected. Finding the medical records to obtain the basic information of the premature infants and feeding conditions, the Self-rating Anxiety Scale (SAS) and the Beck Depression Scale-Ⅱ(BDI- Ⅱ) was used to assess the mothers′ anxiety and depression.Results:The transition time to achieve full oral feeding of NICU preterm infants was (5.31±2.93) days. Greater gestational age ( β=-0.484, P<0.01), time of breast milk feeding through mouth ( β=0.042, P=0.003) had a positive effect on the transition time to achieve full oral feeding. Congenital heart disease ( β=0.587, P=0.050), maternal anxiety ( β=0.206, P<0.01), depression ( β=0.727, P<0.01) and interaction between maternal anxiety and depression ( β=0.014, P<0.01) were risk factors of longer time to achieving full oral feeding. The multiple linear regression accounting for a total of 58.2% of all the variation. Conclusions:Oral feeding progression in premature infants was influenced by many factors. Gestational age can be the indicators of implementing oral feeding. It is beneficial to initiate oral feeding and feed with breast milk early. If the infants have heart diseases, oral feeding progression would be retardant. Maternal anxiety and depression may prolong the transition time to achieve full oral feeding. Control the factors which affect oral feeding progression, pay attention on mothers′ emotion and formulate appropriate feeding intervention for premature infants to promote full oral feeding are of great importance.
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Objective@#To investigate and analyze the influencing factors associated with transition time to achieve full oral feeding for premature infants in neonatal intensive care unit (NICU).@*Methods@#A total of 251 NICU hospitalization preterm infants and their mothers meeting the inclusion criteria in Shanghai First Maternal and Infant Health Care Hospital were collected. Finding the medical records to obtain the basic information of the premature infants and feeding conditions, the Self-rating Anxiety Scale (SAS) and the Beck Depression Scale-Ⅱ(BDI- Ⅱ) was used to assess the mothers′ anxiety and depression.@*Results@#The transition time to achieve full oral feeding of NICU preterm infants was (5.31±2.93) days. Greater gestational age (β=-0.484, P<0.01), time of breast milk feeding through mouth (β=0.042, P=0.003) had a positive effect on the transition time to achieve full oral feeding. Congenital heart disease (β=0.587, P=0.050), maternal anxiety (β=0.206, P<0.01), depression (β=0.727, P<0.01) and interaction between maternal anxiety and depression (β=0.014, P<0.01) were risk factors of longer time to achieving full oral feeding. The multiple linear regression accounting for a total of 58.2% of all the variation.@*Conclusions@#Oral feeding progression in premature infants was influenced by many factors. Gestational age can be the indicators of implementing oral feeding. It is beneficial to initiate oral feeding and feed with breast milk early. If the infants have heart diseases, oral feeding progression would be retardant. Maternal anxiety and depression may prolong the transition time to achieve full oral feeding. Control the factors which affect oral feeding progression, pay attention on mothers′ emotion and formulate appropriate feeding intervention for premature infants to promote full oral feeding are of great importance.
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Objective To investigate the efficacy and safety of maintenance treatment with low-dose decitabine after allogeneic stem cell transplantation (allo-HSCT) for high-risk acute lymphoblastic leukemia (ALL). Methods The data of 10 patients with high-risk ALL who received maintenance therapy with low-dose decitabine after allo-HSCT in the First Affiliated Hospital of Zhengzhou University from July 2016 to March 2018 was collected. The incidence of post-transplant relapse and graft-versus-host disease (GVHD) and the safety of the treatment protocol were analyzed. The cumulative incidence of relapse (CIR) rate, disease-free survival (DFS) rate and overall survival (OS) rate were estimated by Kaplan-Meier method. Results Two patients relapsed and the median relapse time of these 10 patients was 575 days after transplantation. The 1-year CIR, OS and DSF rates were 16.7%, 100.0% and 83.3%, respectively. At the end of follow-up, the DFS time after transplantation of 2 patients with p53 mutation were 23 months and 11 months, respectively. There was no induction or alleviation of GVHD caused by decitabine treatment. Nine patients developed grade Ⅰ-Ⅱmyelosuppression. Three patients had unexplained thrombocytopenia after transplantation and their platelet counts recovered after decitabine treatment. Conclusion Maintenance therapy with low-dose decitabine has low hematologic toxicity without increasing GVHD, which could be a maintenance treatment option to prevent relapse after transplantation for patients with high-risk ALL.
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Objective To observe the efficacy of maintenance treatment with decitabine and dasatinib after allogenic hematopoietic stem cell transplantation for myeloid sarcoma.Methods A 29-year-old male patient was diagnosed with abdominal myeloid sarcoma and acute myeloid leukemia with c-kit mutation and t(8;21).Allogeneic hematopoietic stem cell transplantation was performed after inducted remission.The conditioning regimen was decitabine + FLAG + modified Bu/Cy.Prophylaxis of GVHD was performed with cyclosporine mycophenolate mofetil and short-term methotrexate.The patient received 11.73 × 108 mononucleated cells/kg and 17.59 × 106CD34+ cells/kg from donor.At Day 13 post-transplantation,neutrophils reached 0.5 × 109/L and platelet count was 20 × 109/L.Decitabine was prescribed since Day 50 post-transplantation monthly for 5 courses.And dasatinib was offered orally since Day 100 for 4 months.Results It was followed up to 16 months post-transplantation.There were no obvious abnormalities of bone marrow cytology,AML/ETO fusion gene quantification,cerebrospinal fluid or abdominal enhanced computed tomography (CT).Conclusions Hematopoietic stem cell transplantation is an effective treatment for myeloid sarcoma.Decitabine has some efficacy for myeloid sarcoma and it may be used for maintenance treatment after transplantation.Tyrosine kinase inhibitors reduce recurrence in myeloid sarcoma with c-kit mutation.The treatment of decitabine and dasatinib after allogeneic hematopoietic stem cell transplantation yield excellent outcomes.This is the first report in domestic and foreign literatures.
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AIM:To investigate whether KCNE 2 participates in the development of pathological hypertrophy .METHODS:Bidirectional ma-nipulations of KCNE2 expression were performed by adenoviral overexpression of KCNE 2 or knockdown of KCNE2 with RNA interfer-ence in PE-induced neonatal rat ventricular myocytes .Then overexpression of KCNE 2 in mouse model of left ventricular hypertrophy in-duced by transverse aortic constriction (TAC) by ultrasound microbubble-mediated gene transfer were used to detect the therapeutic function of KCNE2 in the development of hypertrophy .RESULTS:KCNE2 expression was significantly decreased in PE-induced hy-pertrophic cardiomyocytes and in hypertrophic hearts produced by TAC .Knockdown of KCNE2 in cardiomyocytes reproduced hypertro-phy, whereas overexpression of KCNE2 attenuated PE-induced cardiomyocyte hypertrophy .Knockdown of KCNE2 increased calcineurin activity and nuclear NFAT protein level , and pretreatment with nifedipine or FK 506 attenuated decreased KCNE 2-induced cardiomyo-cyte hypertrophy .Overexpression of KCNE 2 in heart by ultrasound microbubble-mediated gene transfer suppressed the development of hypertrophy and activation of calcineurin-NFAT and MAPK pathways in TAC mice .CONCLUSION:These findings demonstrate that cardiac KCNE2 expression is decreased and contributes to the development of hypertrophy via activation of calcineurin -NFAT and MAPK pathways .
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AIM:To investigate the regulation mechanism for insufficient KChIP 2 expression induces Ito,f downregulation and arrhythmogene-sis in cardiac hypertrophy .METHODS:Bidirectional manipulations of MG 53 expression were performed by adenoviral overexpression of MG53 or knockdown of MG53 with RNA interference in neonatal rat ventricular myocytes with or without PE stimulation .Ito,f was re-corded with patch clamp in whole-cell mode 48 h after adenoviral transfection .Then the WT or MG53 knockout ( MG53 -/-) mouse model of left ventricular hypertrophy induced by transverse aortic constriction ( TAC) were used to detect the susceptibility to ventricu-lar arrhythmia.RESULTS: Here, we show muscle-specific MG53 regulates KChIP2 expression and Ito,f densities, where they are downregulated in hearts from MG53 knockout mice and MG53 knockdown rat cardiomyocytes , but upregulated in MG53 overexpressed cells.MG53 expression is decreased in phenylephrine ( PE)-induced cardiomyocyte hypertrophy and restoration of MG 53 rescues PE-induced downregulation of KChIP2 and Ito,f.Furthermore, MG53 is decreased in a mouse model of hypertrophy induced by transverse aortic constriction and ablation of MG 53 increases the susceptibility to ventricular arrhythmia by exaggerating Ito,f remodeling.CON-CLUSION:These findings establish MG53 as a novel regulator of Ito,f and its central role in arrhythmogenesis in hypertrophy .