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Objective:To explore the pathway of psychological capital and burnout on turnover intention of nurses in hematopoietic stem cell transplantation ward.Methods:The cross-sectional research design involved 180 registered nurses in hematopoietic stem cell transplantation wards from 16 tertiary grade A general hospitals with hematopoietic stem cell transplantation qualifications in Shandong province in October 2020. SPSS 22.0 was used to analyze the data, and Bootstrap method was used to test the mediating effect of psychological capital between burnout and turnover intention.Results:The average scores of psychological capital, burnout and turnover intention of nurses in hematopoietic stem cell transplantation ward were (4.70 ± 0.73), (2.44 ± 0.88) and (2.32 ± 0.68), respectively. There were significant differences in turnover intention among nurses in hematopoietic stem cell transplantation ward at different ages, transplant nursing age, marital status and night shift ( F=3.04, 3.34, t=2.43, -3.12, P<0.05); psychological capital was negatively correlated with burnout and turnover intention ( r=-0.698, -0.450, P<0.01), while burnout was positively correlated with turnover intention ( r=0.512, P<0.01) ; optimism in psychological capital partially mediated the relationship between burnout and turnover intention, and the mediating effect accounted for 52.7% of the total effect. Conclusions:The turnover intention of nurses in hematopoietic stem cell transplantation ward was at a high level, and psychological capital had a certain impact on turnover intention. Administrators should formulate targeted strategies to improve psychological capital, reduce the burnout and turnover intention of nurses in hematopoietic stem cell transplantation ward, in order to form a stable and high-quality team of nursing personnel for hematopoietic stem cell transplantation, and promote the development of transplantation nursing specialty in China.
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Objective To observe the protective mechanism of angiotensin-converting enzyme (ACE) 2 on lipopolysaccharide (LPS)-induced hepatocyte inflammation by inhibiting P38 mitogen activated protein kinase (MAPK)/activator protein (AP)-1 pathway.Methods Rat liver BRL cells after immortalized culture were randomly divided into five kinds of groups:control group,LPS (10 μg/ mL) group,LPS + recombinant(r) ACE2 (5,10,20 ng/mL rACE2 for 30 min before cells stimulated with LPS) groups,LPS+ACE2 inhibitor MLN-4760 (10-7,10-6,105 mmol/L MLN-4760 for 30 min before cells stimulated with LPS) groups,LPS + rACE2 (20 ng/mL rACE2 for 30 min before cells stimulated with LPS) + P38MAPK inhibitor SB203580 (10-5 mmol/L SB203580 for 30 min before cells stimulated with LPS) groups.The changes in protein levels of ACE2,P38MAPK,p-P38MAPK and AP-1 were detected by western blot after LPS exposure for 6,12 and 24 hours,and the mRNA expressions of P38MAPK,AP-1 and tumor necrosis factor-α were quantified by real-time RT-PCR.Results Compared with control group,the protein levels of ACE2,P38MAPK and AP-1 were up-regulated in LPS-induced hepatic cells in a time-dependent manner,peaking at 12 h after LPS stimulation (all P＜0.05).Compared with LPS group,the mRNA expressions ofAP-l,P38MAPK,p-P38MAPK and tumor necrosis factor-oα decreased significantly in rACE2 group (all P＜0.05).The dose of 20 ng/mL rACE2 had the best inhibitory effects on the mRNA expression of AP-1 (0.12±0.002 vs.0.04±0.005,P＜0.01),P38MAPK (0.17±0.02 vs.0.02±0.002,P＜0.01) and p-P38MAPK(0.29±0.01 vs.0.02±0.01,P＜0.01)compared with LPS group.The mRNA expressions of AP-1,P38MAPK and p-P38MAPK increased in MLN-4760 group in a concentration dependent manner (all P＜0.05).Furthermore,the inhibitory effects of rACE2 on AP-1 and tumor necrosis factor-α levels were cancelled by SB203580.Conclusion The rACE2 can alleviate the LPS-induced hepatocyte injury by down regulating the P38MAPK/AP-1 signaling pathway.
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Objective To better understand the clinical features and the diagnosis of TAFRO syndrome.Methods The clinical data of a patient were analyzed and the related literatures were reviewed.Results A 51-year-old male characterized by fever,edema of the legs,serous cavity effusion,throm-bocyto-penia,and renal dysfunction;Kidney biopsy suggested a diagnosis of endocapillary proliferative glomerulon-ephritis and thrombotic microangiopathy.The pathology of lymph node biopsy supported the diagnosis of Castleman disease.After administering with glucocorticoids and supportive platelet transfusion,the clinical symptoms relieved.Conclusion Symptoms of patients with TAFRO syndrome are variable.The diagnosis relies on history and pathological examination.Currently,glucocorticoids can be used as first line therapy.TAFRO syndrome should be thoroughly investigated for differentiating with other diseases.
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OBJECTIVE:To evaluate the economic value of Shenqi fuzheng injection combined with chemotherapy vs. chemo-therapy alone for non-small lung cancer(NSCLC),and to provide reference for drug payment and clinical treatment. METHODS:By prospective cohort design,516 patients with non-small cell lung cancer from 11 hospitals were selected as subjects according to the sale distribution of Shenqi fuzheng injection in district and hospital;267 cases of Shenqi fuzheng injection combined with che-motherapy and 249 cases of chemotherapy alone formed naturally according the clinical therapy plan. The cost-effectiveness and cost-utility analysis were conducted using FACT-L score,KPS score and ZPS score as effect index,QALYs as effectiveness index observation period of 21 d. RESULTS:5 dimensions FACT-L score:the patients of Shenqi fuzheng injection combined with chemo-therapy group could be effectively improved,and the cost-effectiveness ratio was lower than chemotherapy alone group;KPS score:the cost-effectiveness ratio of Shenqi fuzheng injection combined with chemotherapy group was lower than chemotherapy alone group (1 632.44 vs. 11 145.30),and incremental cost-effectiveness ratio was 448.69. ZPS score:Shenqi fuzheng injection combined with chemotherapy group was lower than chemotherapy alone(-17 398.77 vs. 384 513.00). Shenqi fuzheng injection combined with chemotherapy group was lower than chemotherapy alone group in average cost per 1 QALYs(1 313 326 yuan vs. 13 374 365 yuan). CONCLUSIONS:Compared with chemotherapy alone group,Shenqi fuzheng injection combined with chemo-therapy can effectively improve the quality of life,and it is worth of spending more money on Shenqi fuzheng injection from the perspective of the pharmacoeconomics.
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Objective To investigate the clinical characteristics of adult patients with community acquired pneumonia (CAP) caused by acute Mycoplasma pneumoniae (MP) infection, and provide evidence for early identification of MP infection. Methods A prospective, multicenter and cross-sectional study was conducted. 452 adult patients with CAP admitted to Beijing Friendship Hospital, Beijing Guangwai Hospital and Air Force General Hospital from August 2011 to October 2015 were enrolled. The diagnosis of adult MP infection was confirmed by the combined application of double serum antibody titer and MP-DNA nested polymerase chain reaction (PCR) through testing serum and throat swab samples from patients to identify acute infections, past infections, pathogen carrying, and non-MP infection. The clinical characteristics of patients with acute MP infection were summarized by analyzing the baseline data, clinical parameters and chest imaging findings in patients with non-MP infection and acute MP infection. Results Of 452 enrolling patients with CAP, 288 patients (63.7%) suffered from MP infection, and 164 patients (36.3%) with non-MP infection. There were 56 patients (12.4%) with acute infection, 10 patients (2.2%) with past infections, 222 patients (49.1%) with pathogen carriers in MP infective patients indicating susceptible to MP in adult patients. There were no significant differences in gender, age, fever extent, duration of fever, sputum production, shortness of breath, rales, underlying diseases, etc. between non-MP infection and acute MP infection patients, which suggested that the baseline data of the two groups were equilibrium. The acute infection rates of MP in summer and autumn (43.9% and 43.5% respectively) were more than those in spring and winter (13.3% and 12.3% respectively). It was shown by laboratory examination results that serum cardiac troponin T (cTnT) increased significantly in acute MP infectious patients more than that in non-MP infection patients (30.4% vs. 9.8%, P < 0.01), which indicated that patients with acute MP infection were more likely to have myocardial injury. While there were no significant differences in blood routine, blood electrolytes, blood glucose, as well as heart, liver and kidney function between the two groups. It was shown by chest imaging that the diffuse lesions (57.1% vs. 37.2%), mediastinal lymphadenopathy (60.7% vs. 37.8%) were less founded in the middle lobe of the right lung (12.5% vs. 32.9%), which were the main manifestations in patients with acute MP infection as compared with non-MP infection patients with statistical difference (all P < 0.01). There were no significant differences in the chest imaging performances of pulmonary ground glass shadow, lobar and segmental consolidation, patch shadow, a shadow, acinar nodules, grinding glass density nodules, the photic zone, hilar lymphadenopathy and pleural effusion occurrence between the two groups. Conclusion Adult CAP patients are easy to carry MP, myocardial damage is a common complication in acute MP infectious patients which are characteristic of image findings of diffuse lung disease, mediastinal lymphadenopathy and less founded in the middle lobe of the right lung.
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The renin-angiotensin system (RAS) is a classical circulating enzyme pathway that plays an important role in regulation of pancreatic function. In recent years, with deepening understanding of RAS, researchers found that RAS not only includes the classical ACE-Ang II-AT1 axis, but also includes the new ACE2-Ang (1-7)-Mas axis. Extensive studies have confirmed that the ACE2-Ang (1-7)-Mas axis can antagonize the effect of the ACE-Ang II-AT1 axis. This paper reviews the composition and function of both axes of the RAS in the local pancreas, and also presents the comparison between the two axes.
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An ultra performance convergence chromatographic ( UPC2 ) method was established for the attribution analysis of the main peaks as well as the quantitative determination of echinacoside andβ-ecdyserone in Bushen Jiannao Grains. The samples were extracted with ethanol and separated on Waters ACQUITY UPC2TM BEH column (100 mm × 3. 00 mm, 1. 7 μm), with a gradient supercritical CO2-0. 05%phosphoric acid-methanol solvent system at 40 ℃. The flow rate was 0. 8 mL/min, the detection wavelength was set at 248 nm and the injection volume was 1 μL. Results showed that all the main peaks in the fingerprint were clearly attributed. The peak named 12 wasβ-ecdyserone with the content of 380μg/g and the peak named 15 was echinacoside with the content of 9. 562 mg/g. The method was simple, eco-friendly, accurate and reliable compared with HPLC and UPLC.
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Transforming growth factor-β (TGF-β) is a multifunctional protein and regulates a wide variety of cellular bio-effects,such as proliferation,differentiation,migration and apoptosis.Studies have proven that TGF-β is one of the important cytokines that promote fibrosis,and it is confirmed to be closely related to the progression of tumor.Smad signaling is the major pathway in which TGF-β fulfills its functions.These years,it has been found that E3 ubiquitin ligases Arkadia can enhance the biological effect of TGF-β signal transduction pathway through Smad signaling pathway.Therefore,it is increasingly attracting public attention.This study will summarize the effects of Arkadia on TGF-β/Smad signal transduction pathway.
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The literature study and survey revealed existed problems and factors such as the difficulties to maintain quality of traditional Chinese medicine (TCM), sustainable development, homogenization and indeterminacy of clinical orientation diagnosis, lack of favorable evidence-based medicine and pharmacoeconomics data to support, lack of ev-idence of safety evaluation, which restrict the development of TCM enterprises. Based on problems and factors men-tioned above, recommendations were made on the healthy development of TCM enterprises, which include guarantee of the quality of TCM herbs and the sustainable development of its resource; conduct systematic evidence-based pharmacoeconomic research, identify the clinical orientation; carry out safety assessment systematically, improve the specification; improve clinical effectiveness-oriented quality standards.
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Pelvic inflammatory disease sequela (chronic pelvic inflammation) is one of the diseases that affect women's health conditions, and leads to large economic burden. Chinese Material Medica (CMM) plays an impor-tant role in treating pelvic inflammatory disease sequela (chronic pelvic inflammatory). However, due to the lack of Evidence-based Pharmacoeconomic Evaluation Technical Essentials of CMM in Treatment of Pelvic Inflamma-tory Disease Sequela (Chronic Pelvic Inflammatory), non-standard phenomenon often appears in the research liter-ature, such as the selection of research methods, viewpoint of research, determination of cost, effect and utility. Thus, the publish of Evidence-based Pharmacoeconomic Evaluation Technical Essentials of CMM in Treatment of Pelvic Inflammatory Disease Sequela (Chronic Pelvic Inflammatory) is essential for the pharmacoeconomic evalua-tion of CMM in treating pelvic inflammatory disease sequela (chronic pelvic inflammatory).
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[Objective]To describe a new way of arthroscopic posterior cruciate ligament reconstruction and evaluate the early stage of follow up results.[Method]Twenty four consecutive cases of isolated and combined posterior cruciate ligament deficiency were studied.Quadriceps tendon patellar bone was used for preparation of "Y" shaped autograft.Double-tunnel of femur were drilled and tibia was inlayed at their anatomical footprint.[Result]All cases were followed up for 24 months to 30months,averaging 24.5 months.Lysholm rating scales were used to make clinical subjective evaluations.Lysholm scores raised from 49.20?1.44 before operation to 87.91?1.52 after operation.Finial Lysholm evaluation showed 7 patients were excellent,16 good,and 1 poor.The good to excellent rate was 95.8%.Anteroposterior translation as clinical objective evaluations was measured with KT-1000.KT1000 arthrometer measurement showed that the average posterior translation improved from 12.85?1.10mm preoperatively to 3.98?1.99mm postoperatively.One patient was graded as failure.[Conclusion]Arthrosopy assisted prodedure of double bundle posterior cruciate ligament reconsruction using quadriceps tendon patellar bone autograft by double-tunnel of femur and inlaying of tibia is effective and reproducible.The short follow up clinical results are encouraging.
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Objective:To observe the effect of Biqi capsule on human cartilage glycoprotein-39 in peripheral blood monouclear cells,research the possible mechanism of Biqi capsule.Methods: 39 patients with RA and 10 healthy people were selected.Expression levels of human cartilage glycoprotein-39(HCgp-39) mRNA in peripheral blood monouclear cells(PBMC) were detected by Rt-PCR method.Results: Obvious expression of HCgp-39 mRNA was found in patients with RA,the relative expression quantity was(0.7920?0.5240),which has a signifi cant difference(0.3104?0.2519,P=0.024) compared with the healthy controls;expression levels of the HCgp-39 mRNA after treatment were signifi cantly decreased,there were statistically signifi cant differences(0.4755?0.2431,P=0.038) between pre and post treatment.Conclusions: The HCgp-39 mRNA in PBMC of patients with RA were obviously higher than that of healthy ones.These data supported a correlation between the activity of RA and the HCgp-39 mRNA in PBMC;there was a certain fall in the expression levels after treatment,which hinted the immunological regulation of Biqi capsule.