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Objective:To explore the influence of humanistic management atmosphere on nurses′ intention to stay in hospital, so as to provide reference for stabilizing nursing team.Methods:The convenience sampling method was used to investigate 1 044 clinical nurses in 5 tertiary hospitals in Shandong province by using the general information questionnaire, nurses′ perception of humanistic management questionnaire and nurses′ intention to stay questionnaire in May 2019.Four dimensions of demographic factors and nurses′ perception of hospital humanistic management were used as independent variables, and the total score of nurses′ intention to stay was used as dependent variable for stepwise regression analysis.Results:The total scores of humanistic management perception and intention to stay were 166.70±29.42 and 23.30±4.29 respectively. There was a positive correlation between humanistic management perception and intention to stay( P<0.05). The three dimensions of human management perception, emotional management perception and cultural management perception, as well as the professional title, working years and employment form could explain 27.5% of variation. Conclusions:The nurses′ intention to stay is in the middle and upper level, which is related to the hospital′s humanistic management. The perception of humanistic management of nurses has a positive predictive effect on the intention to stay, especially in talent management, emotional management and cultural management. Hospital managers should improve the humanistic management mode, enhance nurses′ perception of humanistic management in order to stabilize the nursing team and improve nurses′ intention to stay.
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Neonatal infectious diseases (NIDs) are the main cause of neonatal death worldwide. Since the neonatal immune system is not fully developed, its pathogenic factors are more complex than adults and the clinical manifestations are more diverse. Early, rapid and comprehensive detection of infectious pathogens is of great significance for timely clinical treatment, and therefore can reduce mortality and complications. Traditional pathogen diagnosis methods are limited in small detection flux, long detection time and low screening efficiency. With the development of high-throughput sequencing technology, metagenomic next-generation sequencing (mNGS) is gradually widely applied in NIDs diagnosis. Not only can acquire the genetic information of pathogens in the samples, but also can be used to excavate the relationship between pathogens and host flora. In particular, mNGS has important reference value for the diagnosis of rare infectious diseases. In this study, the latest research progress and application of mNGS in detecting the pathogens of NIDs have been reviewed.
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Objective To elevate the prevalence of fusion gene in children with acute lymphoblastic leukemia(ALL),and compare the difference in the clinical characteristics and prognosis of children with ALL carrying different fusion genes.Methods The results of fusion gene that detected by multiplex RT-PCR in children with 341 newly diagnosed ALL between July 2013 and December 2016 in West China Second University Hospital,Sichuan university were retrospectively reviewed.Date of clinical characteristics, morphology, immunophenotype, cytogenetic characteristics and event-free survival were collected and analyzed by χ2test and survival analysis in different groups according the results of fusion genes.Results The positive rate of fusion genes was 35.2%(120/341),including 69 cases with TEL-AML1,16 cases with E2A-PBX1,16 cases with BCR-ABL,10 cases with MLL gene rearrangement,5 cases with HOX11L2 and 4 cases with SIL-TAL1.There was statistical difference in age of different fusion gene groups(χ2=29.552, P<0.05),most of children carrying TEL-AML1,E2A-PBX1 were younger than 5 years,but carrying BCR-ABL,MLL gene rearrangement were opposite.The children with BCR-ABL,MLL gene rearrangement or SIL-TAL1 had higher WBC and severer enlarged liver, spleen and lymph node(χ2=27.657,45.822,P<0.05).There also had statistical difference in morphology and immunophenotype in fusion gene groups(χ2=31.333,P<0.05).TEL-AML1,E2A-PBX1 and BCR-ABL were mainly found in B-ALL,HOX11L2 and SIL-TAL1 were only found in T-ALL,but MLL gene rearrangement were found in both.The survival analysis showed that the event-free survival(EFS)in groups of BCR-ABL and MLL gene rearrangement were lower than other groups(χ2=15.368,P<0.05), but there was no significant difference in T-ALL(χ2=1.592, P>0.05).Conclusions Fusion gene detection is an important molecular marker in ALL of children.The ALL children with different fusion genes have different clinical features, immunophenotype and prognosis.
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Objective To analyze the clinical characteristics and perinatal outcomes of listeriosis during pregnancy. Methods From July 2010 to April 2017, 70 131 women delivered in West China Second University Hospital.Nineteen cases were confirmed as listeriosis.The clinical symptoms,laboratory results,pathogens,placenta pathology and perinatal outcomes were analyzed retrospectively. Results The median age of the 19 cases was 29.7 (19.0-42.0) years old. The median time before diagnosis was 4.8 (0.5-19.0) days. The main clinical symptoms at first visits were high fever (17/19), increased white blood cells (18/19), abdominal pain (12/19). Listeria was found in samples of mother′s blood (11/19), vaginal secretions(15/19),placenta(1/19),neonatal blood(4/19),neonatal phlegm(5/19)and neonatal ear secretions (1/19),respectively.Inflammation of placenta was identified in all 19 cases.Among the 19 cases,1 was gradeⅠ chorioamnionitis,4 was grade Ⅱ,5 was grade Ⅲand 9 was grade Ⅵ. Only 4 newborn survived after therapy,and others suffered perinatal death,including 8 cases of intrauterine death,3 cases of miscarriage and 6 cases of treatment failure. Conclusions Listeriosis has characteristics of acute onset, quick development and high morbidity during pregnancy. The empiric use of antibiotics might not cover listeria. The understanding of listeriosis should be improved.
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The pre-examination process is the first key step in the total testing process of clinical laboratories.Specimen acceptability is an important indicator to measure the quality of pre-examination.In order to identify the risks and the root causes in the process , establishment and monitoring of quality indicators about specimen will effectively control the risks , enhance the acceptability of specimens , promote the improvement of pre-examination quality and finally get the aim of assuring patients′safety.
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Objective To establish the reference intervals of 20 dry biochemical items in different age periods among healthy population in Chengdu to providing better support and service for clinical diagnosis and treatment .Methods The stratified random‐ized cluster method was used to collect healthy children and adults in 4 age periods(1 month-3 years old ,>3-7 years old ,>7-18 years old and >18 years old) .Totally 1 495 healthy people (740 males and 755 female) were screened out as the research sub‐jects by the questionnaire ,physical examination and laboratory screening .Fasting venous blood samples were collected from these cases ,then the VITROS 5600 dry biochemistry analyzer was used to detect 20 biochemical items .The obtained results were statisti‐cally analyzed .Results In different groups according to sex and age ,except the conjugated bilirubin (BC) was constant 0 μmol/L , the other items had statistical differences (P<0 .05) .After merging the different groups without statistically significant difference , the obtained reference intervals had significant differences compared with the reference intervals provided by the manufacturer .Con‐clusion Laboratory should establish the different reference intervals aiming at different age and gender populations according to the special character of hospital visiting populations in order to meet the clinical requirements .
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Objective Comparison of three different molecular assays for the detection and molecular characterization of circulating tumor cells in breast cancer .Methods The retrospective study compared three different molecular assays to detect CTC in the peripheral blood of 30 healthy individuals and 71 benign breast disease patients and 83 early and 84 metastatic breast cancer patients .All samples were collected at the outpatient , inpatient and physical examination department of Sichuan Provincial People ′s Hospital from January 2011 to June 2014.The same cDNAs were analyzed by:singleplex RT-qPCR assay for BCL-2, multiplex RT-qPCR for BCL-2, HER-2, HMAM, and a commercially available molecular assay (AdnaTest BreastCancer ) for GA733-2, MUC-1, HER-2.The positive of CTC were compared among healthy individuals and benign breast disease patients and breast cancer patients .Chi square test was used to compare the expression of gene markers among the three groups , and the agreement of Kappa test was used to evaluate the method.Results (1) Detection rates of early breast cancer by single RT-qPCR, Adna kits and multiple RT-qPCR were 13.3%, 16.9% and 18.1%, respectively , and the detection of metastatic breast cancer were 31.0%, 42.9%and 35.7%, respectively.There were significant differences in the positive of CTC by three molecular assays between healthy individuals and benign breast disease patients and early breast cancer patients ( The test values were 4.235 and 4.301, 5.367 and 5.474, 5.894 and 6.023 respectively, P0.05) .There were significant differences between metastasis breast cancer patients and healthy individuals and benign breast disease patients and early breast cancer patients ( The test values were 8.429,7.553 and 7.061;10.24, 9.025 and 8.745; 9.658, 8.417 and 8.201 respectively,P<0.05).(2) In early breast cancer: The concordance between AdnaTest and single RT-qPCR was 79.5%while between AdnaTest and multiplex RT-qPCR was 77.1%.No agreement was found among them ( The test values were 1.065 and 1.871, P were 0.371 and 0.258 ) .The concordance between single RT-qPCR and multiplex RT-qPCR was 80.7%.No agreement was found between them (The test values was 2.814, P was 0.156).(3) In patients with overt metastasis:The concordance between AdnaTest and single RT-qPCR was 78.6%( The test values was 10.986).While between AdnaTest and multiplex RT-qPCR was 80.9%( The test values was 9.251 ) . Agreements were found among them ( P was 0.002 and 0.005 respectively ) .The concordance between single and multiplex RT-qPCR was 88.1%( The test values was 12.364 ) .Agreement was found between them (P was 0.001).Conclusions No correlations were found among different molecular methods to detect CTC in the early primary breast cancer , but correlations were found in the metastatic breast cancer , suggesting that different rate of CTC caused by the number of CTC and its heterogeneity should be considered to the clinical diagnosis and treatment of breast cancer while molecular method is used .
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Surgical resection is the primary treatment for locally advanced rectal cancer,but the local recurrence rate of surgical resection is still at a high level. Preoperative and postoperative chemoradiotherapy not only decreases the local recurrence rate of surgical resection,but also elevates the survival rate and life quality. Recently,adjuvant chemoradiotherapy has been applied as the standard therapy for locally advanced rectal cancer. The application of targeted drugs,new chemotherapy drugs and rapid changing radiotherapy technology provide more approaches to the treatment of locally advanced rectal cancer.
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Objective To evaluate the clinical practicality of two different D-dimer assays by studying the correlation of the testing results by two different D-dimer reagents with fibrin degradation products (FDP)result values and analyzing the Clinical alignment.Methods A representative cross-sectional study of 762 clinical patients’plasma specimens were taken to measure the results of D-dimer and FDP by using Sysmex CA-1500 automated coagulation analyzer,D-DIMER detection rea-gent respectively Siemens Innovance D-DIMER and Dade Behring D-DIMER Plus reagents.Then rating frequency analysis and Spearman correlation test were applied to analyze the correlation of measurement results.Results Overall,to the same patient,the correlation of D-dimer tested by Siemens Innovance D-DIMER Reagent with FDP level was significant positive (r= 0.954,P 5 mg/L FEU,the correlation was the best (P5μg/ml)and FDP positive rate in both different cases when D-dimer results was also positive,FDP positive rate in Innovance D-DIMER Reagent group (about 65.76%)was lower than DD Plus Reagent group,it indicated that D-dimer results tested by Innovance D-DIMER Reagent could raise before FDP reacted,so D-dimer had a higher sensitivity than FDP.Conclusion It can provide a more precise clinical diagnosis and treatment infor-mation when using Siemens Innovance D-DIMER Reagent to detect D-dimer values and combined FDP values at the same time.
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Neonatal inherited metabolic diseases are a group of metabolic disorders caused by singe gene defect to cause a series of clinical symptoms.Neonatal dried blood spots have the advantages of simple preparation,safety,good stability,and show strong practicability in different screening methods for inherited metabolic diseases.With the development of screening methods,more and more diseases could be diagnosed by screening.The emergence of tandem mass spectrometry and molecular biological techniques promote the newborn screening and automation for inherited metabolic disease effectively.Inherited metabolic diseases induce great harm to the newborn,which could cause not only system organs damage,but also lead to death.Therefore,early screening is important for patients' prognosis.
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Objective To establish the cell model of ethanol-induced liver injury and explore the protective effects of tea poly-phenols (TP)on ethanol-induced liver injury .Methods Cell morphology were observed by microscope ,and then alanine aminotrans-ferase (ALT) ,nmda transaminase (AST) ,gamma GGTP ,GGT and ROS changes were detected .Results Alcohol maked L02 hepa-tocyte fatty degeneration .Compared with ethanol group ,steatosis in TP + ethanol group was lighter ,its ALT ,AST ,GGT content and intracellular ROS reduced .Conclusion TP can decrease cell fatty change degree in vitro experiments ,improue the enzymology indexes ,reduce the generation of reactive oxygen species to avoid liver damage .
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The pre-analytical process is the first key step in the total testing process of clinical laboratories,which will directly influence the accuracy and timeliness of testing results.Efficient preanalytical quality assurance system consists of scientific personnel structure,regular training and monitoring,bright and comfortable phlebotomy environment,advanced comprehensive phlebotomy facilities,strict biosafety practice in each procedure and harmonious relationship between clinicians/patients and laboratory.Besides,the application and monitoring of sound quality indicators in pre-analytical process will promote the improvement of quality and finally get the aim of assuring patients' safety.
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Cyclooxygenase-2 (COX-2),the rate-limited enzyme that converts arachidonic acid into prostaglandin,has been found overexpression in many malignant tumors.The overexpression of COX-2 plays an important role in tumor genesis and progression and is closely associated with tumor prognosis,so this enzyme has become one of the potential therapeutic targets.Experimental studies reveal that selective COX-2 inhibitors can enhance the tumor radiosensitivity through a variety of molecular pathways and have a protective effect for normal tissues.Selective COX-2 inhibitors are promising radiotherapy modifiers and the underlying molecular mechanisms still need to be further studied.
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There is a significance of pregnancy thyroid hormone reference ranges establishment,because the consequences of thyroid dysfunction during pregnancy are terrible.This review will focus on meaning of pregnancy thyroid hormone reference range,importance of TPO antibody testing and current advances of methodology.
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Based on previous bioinformational analysis results, two Aspergillus niger lipase (ANL) mutants, ANL-Ser84Gly and ANL-Asp99Pro were constructed to screen ANL mutants with oil-water interface independence. ANL-Ser84Gly still displayed a pronounced interfacial activation, while ANL-Asp99Pro displayed no interfacial activation. The specific activity of ANL-Ser84Gly towards p-nitrophenyl palmitate (-myristate, -laurate and -decanoate) decreased by 29.8% (53.1, 60.1 and 77.1, respectively) than that of ANL, while the specific activity of ANL-Asp99Pro towards p-nitrophenyl palmitate increased by 2.2-fold. The mutation in the hinge region at both sides of the lid domain also destabilized various secondary structure factors of ANL-S84G and ANL-D99P, which resulted in a substantial decrease in thermostability. The achievement to construct oil-water interface-independent ANL mutants would help to further understand lipase interfacial activation mechanism.
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Aspergillus niger , Genetics , Base Sequence , Enzyme Stability , Fungal Proteins , Genetics , Metabolism , Lipase , Genetics , Metabolism , Molecular Sequence Data , Mutant Proteins , Genetics , Oils , Substrate Specificity , WaterABSTRACT
Objective To investigate bone strength in adults,and explore its influencing factors. Methods One hundred and ninety-one adults undergoing health examinations were selected.The questionnaires about milk intake and exercise conditions were performed,the body weight,fat mass,body mass index(BMI)and calcaneal bone strength were measured,and the relationship between each parameter and bone strength was analysed. Results Bone suength decreased with age increase,and was higher in males than that in females.Bone strength of overweight to obese adults was higher than that with normal body weight(P<0.05).Bone strength of adults with high milk intake was higher than that of those with low milk intake(P<0.05).Multivariate analysis revealed that age was negatively related to bone strength,females were more susceptible to bone strength decrease,and BMI and milk intake were positively related to bone strength. Conclusion Gender,age,BMI and milk intake are main influencing factors for bone strength.Bone strength decreases with age increase,and increase of BMI and milk intake will benefit bone strength,especially for females.
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Objective To establish age related reference value for the new reticulocyte hemoglobin equivalent (RET-He) parameter in healthy children aged one to thirteen years. Methods Reticulocyte hemoglobin equivalent was measured by Sysmex XE-2100 after completing daily internal quality control in 424 healthy children and the outlying observations was handled afterward, Age related reference value anddistribution of RET-He level were described as the 2.5th and 97.5th centiles, and the equation regardingage related reference value was established through curve fitting methods. Results After grouping accordingto sex, the medians of boys and girls in RET-He were 31.30 pg,31.80 pg. Non-parametric test showed therewas no differences between the boys and girls. When the data from two group was integrated together, thefitted equations of RET-He were: P2.5 =-0.008X3+0.125X2 - 0.178X+26.456; P97.5= 0.021X2-0.184X+34.670(X refers to age) ; R2 were 0.85 and 0.90,respectively(P <0.05). There was statisticallysignificance for the above equations. Conclusions The reference value of RET-He in healthy children isdifferent from those in adult. The equations can be used to produce age related reference value. It could beuseful for anemia diagnosis, differential diagnosis and hematopoiesis screening at early stage.
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Objective To determine the rehabilitation outcome of patients with stroke caused by middle cerebral artery insult. Methods Eighty-three patients were divided into three groups: cortex insult group, basal ganglia insult group and combined group. Activities of daily living (ADL), motor function and walk were assessed by using the Barthel Index, Brunnstrom Stages and walking assessment. Comparisons of all data were carried out among the groups. Results On admission, there were significant differences among the 3 groups in terms of activities of daily living, motor function and walk. The cortex insult group had the highest scores while the combined group the lowest. A comparison among the 3 groups at discharge demonstrated the same results as those on admission. It was shown that all the groups improved significantly at discharge when compared with admission status, indicating that stroke rehabilitation was effective. Conclusion The motor deficit in the combined group was the most severe, but systematic rehabilitation could make functional improvement in the patient. The basal ganglia insult group has the biggest rehabilitation potential. The cortex insult group has the best outcome.