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Objective:To construct a self-management intervention program for patients with adenocarcinoma chemotherapy based on chronic disease trajectory model, and to provide reference for clinical nursing intervention.Methods:From October 2021 to June 2022, a research team was established. Based on the chronic disease trajectory model and self-management theory, through preliminary quantitative research, literature review and semi-structured interview, the first draft of the intervention plan was prepared. 24 experts were selected for two rounds of Delphi expert correspondence consultation to determine the self-management intervention plan for breast cancer patients undergoing chemotherapy based on the trajectory model of chronic disease.Results:The effective questionnaire recovery rates of the two rounds of expert letter consultation were 100%, and the coefficient of expert authority degree was 0.805 and 0.863, respectively. The mean values of importance were 4.21- 4.96 and 4.46 - 5.00, the coefficients of variation were 0.00 - 0.19 and 0.00-0.17, and the Kendall concordant coefficients were 0.123 and 0.149 ( both P<0.01). Finally, the self-management intervention scheme for breast cancer chemotherapy patients based on the trajectory model of chronic disease was constructed, including 3 first-level indicators, 6 second-level indicators and 27 third-level indicators. Conclusions:The self-management intervention program for patients with adenocarcinoma chemotherapy based on chronic disease trajectory model constructed in this study can provide a certain reference for clinical nurses to carry out targeted self-management interventions.
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Objective:To explore the efficacy and prognostic factors of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in the treatment of relapsed/refractory acute myeloid leukemia (AML).Methods:The clinical data of 35 patients with relapsed/refractory AML treated with allo-HSCT in the Affiliated Cancer Hospital of Zhengzhou University from June 2011 to October 2018 was retrospectively analyzed. The overall survival (OS), disease-free survival (DFS), graft versus host disease (GVHD) incidence, transplantation related mortality and recurrence rate were calculated, and the risk factors affecting prognosis were analyzed.Results:Hematopoietic reconstitution was obtained in all patients after transplantation. The 100 d incidence of grade Ⅱ-Ⅳ acute GVHD was (22.9±7.7)%, and the 3-year incidence of chronic GVHD was (49.5±10.60)%. The median follow-up time after transplantation was 14.1 months (4.2-89.4 months). In all cases, 18 cases survived (including 16 cases of DFS), and 17 cases died. Fourteen cases relapsed, and the median recurrence time was 4.7 months (2.9-32.4 months). The 3-year OS rate and DFS rate were (44.4±9.3)% and (43.0±9.5)%, respectively. Univariate analysis showed that the non-remission disease before transplantation, poor genetic risk grade before transplantation and recurrence after transplantation were the risk factors for OS (all P < 0.05). The 3-year OS rates in complete remission before transplantation group and non-remission before transplantation group were (63.2±12.0)% and (15.7±12.8)% ( P = 0.025), the 3-year DFS rates were (62.2±12.3)% and (15.3±12.7)% ( P = 0.028), and the 3-year recurrence rates were (28.2±10.7)% and (80.6±15.7)% ( P = 0.057). The 3-year recurrence rate in genetic high-risk group was higher than that in middle-risk group and low-risk group [100.0%, (45.0±12.1)% and (14.3±13.2)%, P = 0.045]. The 3-year tansplantation related mortality was (18.7±7.7)%. Conclusions:Allo-HSCT is an effective method for salvage treatment of relapsed/refractory AML, and recurrence is the main factor affecting survival. Reducing tumor load before transplantation is very important for reducing recurrence and improving curative effect.
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Objective@#To investigate the safety and efficacy of allogeneic hematopoietic stem cell transplantation (allo-HSCT) containing cladribine sequential busulfan regimen for refractory/relapsed acute myeloid leukemia (AML) .@*Methods@#The clinical data of 12 refractory/relapsed AML patients received allo-HSCT with cladribine sequential busulfan regimen.@*Results@#① Of the 12 patients, 9 were males and 3 females, with a median age of 36 (27-50) years. The donors were identical sibling (3) , matched unrelated (1) and haploidentical family member (9) respectively. Nine patients reached partial remission and other remained no remission after chemotherapy before allo-HSCT. The median previous chemotherapy courses before allo-HSCT were 6 (2-13) . ② Conditioning regimen: Smostine 250 mg·m-2·d-1, d-7; Cladribine 5 mg·m-2·d-1, d-6 to d-2; Cytarabine Arabinoside 2 g·m-2·d-1, d-6 to d-2; Busulfan 3.2 mg·m-2·d-1, d-6 to d-3; Rabbit anti-human thymocyte immunoglobulin (ATG) 1.5 mg·m-2·d-1 (unrelated donor transplantation) or 2.0-2.5 mg·m-2·d-1 (haplo-HSCT) , d-4 to d-1. ③ Of the 12 patients, 11 patients attained complete haploidentical engraftment, one case occurred primary graft failure. The median durations for neutrophils and platelet implantations were 15 (15-21) and 19 (17-30) days respectively. ④After conditioning, no hepatic veno-occlusive diseases were observed, hemorrhagic cystitis occurred in 2 patients, 8 patients had fever, 3 cases experienced acute GVHD grade II, localized chronic GVHD occurred in 8 patients. ⑤The median follow-up was 8 (4-12) months. Leukemia relapse occurred in 2 patients at time of 6, 12 months after allo-HSCT. The estimated 1-year OS and DFS were (71.1±1.8) % and (62.2±1.8) %, respectively.@*Conclusions@#allo-HSCT with cladribine sequential busulfan regimen was a feasible choice with favorable outcome for refractory/relapsed AML.
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Objective@#To explore the availability and safety of fecal microbiota transplantation for patients with refractory diarrhea after allogeneic hematopoietic stem cell transplantation (allo-HSCT) .@*Methods@#Four acute leukemia patients suffered from refractory diarrhea after allo-HSCT. One of them was refractory intestinal infection, the others were intestinal graft versus host disease. One or two doses of fecal microbiota, 3.4-6.0 U for one dose, were infused via nasal-jejunal tube. The curative effect and side effects were reviewed.@*Results@#Three cases achieved complete remission while 1 was stable disease. The side effects included fever, abdominal pain and diarrhea, which all were Ⅰ grade.@*Conclusion@#Fecal microbiota transplantation was effective and safe for refractory diarrhea after allo-HSCT.
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Objective@#To evaluate the efficacy and safety of mesenchymal stem cells in allogeneic hematopoietic stem cell transplantation for patients with refractory severe aplastic anemia (R-SAA) .@*Method@#The clinical data of 25 R-SAA patients receiving co-transplantation of mesenchymal stem cells combined with peripheral blood stem cells from sibling donors (10 cases) and unrelated donors (15 cases) from March 2010 to July 2018 in Zhengzhou University Affiliated Tumor Hospital were retrospectively analyzed. Antithymocyte globulin (ATG) treatment was ineffective/relapsed in 11 cases, and cyclosporine (CsA) treatment ineffective/relapsed in 14 cases.@*Results@#There were 13 male and 12 female among these patients. One patient had a primary graft failure, one patient had a poorly engraftment of platelets, and the remaining 23 patients achieved hematopoietic engraftment. The median time of granulocyte engraftment was 12.5 (10-23) days and 15 (11-25) days for megakaryocyte. Incidences of grade Ⅰ/Ⅱ acute graft-versus-host disease (aGVHD) and chronic graft-versus-host disease (cGVHD) were 37.5% (9/24) and 21.7% (5/23) , respectively. There was no severe GVHD and no severe complications that related to transplantation. 21 of 25 (84%) patients were alive with a median follow-up of 22.9 (1.6-107.8) months. The 5-year overall survival rate after transplantation was (83.6±7.5) %.@*Conclusion@#The combination of mesenchymal stem cells is reliable and safe in the treatment of R-SAA in peripheral blood stem cell transplantation of unrelated donors and sibling donors, which could significantly reduce the incidence of GVHD and severe transplantation-related complications.
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The efficacy and safety of co-transplantation of unrelated donor peripheral blood stem cells (UD-PBSCs) combined with umbilical cord mesenchymal stem cells (UC-MSCs) in refractory severe aplastic anemia-Ⅱ(RSAA-Ⅱ) were analyzed retrospectively. Fifteen patients with RSAA-Ⅱ underwent UD-PBSCs and UC-MSCs co-transplantation, among whom 14 cases had hematopoietic reconstitution without severe graft versus-host disease (GVHD). The 5-year overall survival rate was 78.57%. Combination of UD-PBSCs and UC-MSCs transplantation could be a safe and effective option for RSAA-Ⅱ.
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In order to investigate the effect of S-adenosylmethionine decarboxylase (SAMDC) gene in melon resistance to powdery mildew, according to the previous results of EST sequences from cDNA-AFLP library and the melon genome sequence data, the SAMDC gene was isolated from Chinese wild melon clone 'Yuntian930' by RT-PCR and designated as CmSAMDC (GenBank Accession No. KF151861). The mORF (main open reading frame) was 1 095 bp encoding 364 amino acids with a molecular mass of 40 kDa. The predicted protein sequence showed high similarity with Cucumis sativus and Citrofortunella microcarpa. The SDS-PAGE showed that the expression protein was a fusion protein with the molecular weight of 40 kDa, which perfectly matched the mass calculated from the amino acid sequence. Quantitative real-time PCR analysis indicated that the expression level of CmSAMDC reached a maximum at 48 hpi (hours post inoculation) that over 7-fold to 0 hpi, and the expression of CmSAMDC was also detected in tendril, root, leaf and stem. These results indicate that CmSAMDC gene may play protective roles in melon resistance to powdery mildew infection.
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Performance evaluation of hospitals has become a high priority of Beijing Municipal Administration of Hospitals nowadays,application of targeted governmental allocations being a key to such evaluation.As an oral specialist hospital,such allocations were mainly used to purchase major oral equipment as important revenue makers and social benefits creators.The finance department of the hospital has paid commendable efforts in assuring satisfactory use of such funds to score high in the performance evaluation.On the other hand,however,the hospital is also faced with problems in the implementation of the evaluation of the funds and there remain rooms of improvement.
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Objective To explore the sensibility of radiation-induced normal brain injury in different regions at acute stage after all cranial radiotherapy by MR diffusion tensor imaging (DTI).Methods A total of 44 patients with brain tumors undergoing whole cranial radiotherapy were examined with convention and enhancement magnetic resonance imaging and diffusion tensor imaging before and three weeks after radiotherapy.The apparent diffusion coefficient ( ADC ),fractional anisotropy ( FA),relative anisotropy (RA) and volume ratio(VR) of DTI in contralateral brain hemisphere after radiotherapy with the dose of 27 Gy were measured and analyzed in different regions.Results No abnormal signal intensities were revealed in convention and enhancement MRI.ADC values in superficial cerebral convolution gray matter,ADC and VR values in deep gray nucleus were increased(t =- 3.321,- 2.810,P ＜ 0.05 ),while FA and RA values in deep gray nucleus were descended( t =2.906,2.349,P ＜0.05 ).There was no statistically significant difference among DTI index in other regions.Conclusions The brain gray matter more sensitive to radiation-induced brain injury in than white matter at acute stage of radiation.DTI could be used to evaluate the functional changes at the histocytology level of radiation-induced brain injury,and to explain the early clinical reactions after radiotherapy.
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Objective To study the changes and management of systemic and pulmonary hemodynamics during anhepatic period in patients undergoing orthotopic liver transplantation without veno-venous bypass.Methods Sixty-eight patients with end-stage liver disease undergoing orthotopic liver transplantation were enrolled in this research. Monitoring and recoding CVP, MAP, CI, HR, MPAP, PAWP PVR, SVR at different time points: preincision, before anhepatic, 5, 30 min of anhepatic, 5, 30, 60 min of neohepatic,ending of operation, 12 h and 24 h after operation. All the patients were divided into three groups according CVP during anhepatic period: group A(CVP <4 mmHg) ,group B(4 mm Hg≤CVP≤6 mmHg) ,group C (CVP>6 mmHg). Besides, calculating the concentration of dopamine, norepinephrine ,epinephrine and the volume of urine during of operation. Results There were different changes during different operation periods. During anhepatic period, HR, PVR and SVR increased, while CVP, CI, MAP, PAP, PAWP decreased(P<0.05). At early neohepatic period, HR decreased and CVP,PAWP, MPAP,CI,PVR SVR increased ,At the beginning of neohepatic period, MAP dacreased or increased quickly, and became steadily after 5 min. Among the three groups, the changes of hemodynamics in group B was slightest,and the concentration of dopamine, norepinephrine and epinephrine was smallest (P< 0.05 ). Conclusions The systemic and pulmonary emodynamics fluctuated sharply during anhepatic and early neohepatic period. It is important and useful to manage CVP 4 -6 mmHg, MABP ≥ 60 mmHg by infusing liquid and vasoconstrictors,such as dopamine, norepinephrine or epinephrine during anhepatic period.
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Objective To detect the inhibition of the EtOH ext. of roasted perilla seed on mast cell degranulation and histamin releasing in vitro. Methods Aliquots of OVA-sensitized rat peritoneal mast cells (PMC) were preincubated with 320, 640, 12 80 ?g/mL EtOH ext. of roasted perilla seed, disodium cromoglicate and luteolin, before an optimal concentration of OVA were added. Then the PMC degranulation response upon allergen triggering was detected by PMC degranulation percentage and histamine releasing assay. Result The protocol was optimized as PMC were preincubated with drugs for 20 min, and then triggered with 20 ?g/mL OVA. 320, 640, 12 80 ?g/mL EtOH ext. of roasted perilla seed and luteolin could inhibit PMC degranulation significantly (P
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Harmonizing mo-cou is proposed on basis of an understanding of mo-cou physiological and pathological knowledge. It belongs to the therapeatic principle category of TCM therapy. The mo-cou widely exists in the body. From the perspective of the internal and external,it belongs the intermediate zone,is kind of tissue that exists between the external of human body and the zang-fu. Harmony of mo-cou is a healthy physiological state,the disharmony of mo-cou is the common pathological link in many diseases. Clinically,harmonizing mo-cou is the essential stages of treatment for many illnesses. As a therapeutic principle,it can guide the choice of the therapeutic methods. The mo is an extensin of the tendon,dominated by the liver,so the basic requirement of regulating liver-qi is to harmonize mo-cou.
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Objective:To detect the modulation of the Th1/Th2 bias by the EtOH ext. of roasted perilla seed(RPS) in the anaphylaxis mice model.Methods:The mice were divided randomly into 5 groups, namely 1.28, 0.64 and 0.32 g/kg EtOH ext.of RPS group, anaphylaxis model and normal control. All the mice except for the normal control were sensitized by immunized intraperitoneally on days 0 and 5 with chicken OVA. The cytokine profile including IFN-?, TNF-?, IL-2, IL-4, IL-5 in serum of all the mice were evaluated by FCM.Results:The IFN-?/IL-4 ratio was decreased from 3.93 in the anaphylaxis mice model to 0.87 in the normal control group. The mice in 0.32, 0.64 and 1.28 g/kg EtOH ext of RPS group displayed a down-regulation for serum IL-4 and TNF-? levels and showed increased levels of IFN-? with the correspondent IFN-?/IL-4 ratio of 1.92, 2.85 and 3.14.Conclusion:The EtOH ext. of roasted perilla seed can modulate the Th1/Th2 bias in a dose-dependent manner.
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OBJECTIVE:To study thc purification technology of camellia saponin using D101 macroporous adsorption resin.METHODS:The loading volume of sample and the adsorption quantity of D101 macroporous adsorption resin and the concentration and volume of alcohol in eluting water -soluble foreign substances and total cemallia saponins were investigated taking the content of total cemallia saponins as index.RESULTS:The loading volume of sample of D101 macroporous adsorption resin was 3 fold that of resin D101(or 3 BV,resin bed volume) and its adsorption quantity was 566 mg?g~(-1)(crude drug);3 BV distilled water and 1 BV 20%ethanol were used for the elution of the water-soluble foreign substances,and 3BV of 85%ethanol was used for the elution of total cemallia saponins.CONCLUSION:D101 macroporous resin has good purification efficacy for camellia saponins.The purification process is simple with low cost,and it is applicable for large - scale industrialized production.
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To determine the fatty acid composition in the oil of Semen Momordicae to evaluate itspractical use. Fatty oil was obtained by Soxhlet extraction with petroleum ether and converted to methylester derivatives by methanolic potassium hydroxide. Contents of the resultant methyl esters were then de-termined by GC-MS. Eight fatty acids were characterized and determined. Results of the study may pro-vide some information for the exploitation and utilization in the oil of seed of Momordicae cochinchinensis(Lout.) Spreng.
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Different doses of fatty oil of Perilla frutescens var. arguta (Benth. ) Hand. -Mazz. (ig )to mice for i5 days can decrease errors in step-down test, improve percentage of accuracyand shorten the time to reach their goal in water maze experiments. lt also facilitate thesynthesis of RNA, DNA and proteins in brain and regulates the level of monoamine -like ne-urotransmitters. The above results indicated that fatty oil of P. frutescens var .arguta canimprove learning and memory in mice related to the symthesis of RNA, DNA, proteins andneurotransmitters in braiu.
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OBJECTIVE:To study the technical conditions and parameters of DiaionHP-20 macroporous adsorption resin for the purification of the anti-PMOP(primary Type I osteoporosis) active fraction from Camellia semiserrata seed.METHODS: With the elution ratios and purity of total flavonoids and polyphenol from Camellia semiserrata as indexes,the technical parameters of DiaionHP-20 macroporous adsorption resin including the adsorption quantity,the loading sample,the elution concentration and volume of alcohol were investigated.RESULTS: The adsorption quantity of DiaionHP-20 macroporous resin on total flavonoids and polyphenol were 59.5 mg?g-1 and 23.9 mg?g-1 respectively.The optimal technical conditions were as follows:the quantity of drug was 10.5 times that of resin;water-soluble foreign substance was washed off with distilled water weighing 3 times the weight of resin,and total flavonoids and polyphenol were eluted using 25% ethanol weighing 13.5 times the weight of resin.CONCLUSION:DiaionHP-20 macroporous resin had good purification effects on total flavonoids and polyphenol from Camellia semiserrata seeds.The process is simple,low cost,and suitable for lavge-scale production.