RESUMO
Acute promyelocytic leukemia (APL) is a unique disease entity in acute myeloid leukemia, characterized by PML-RARA fusion gene, which is generated by chromosomal translocation t(15;17)(q24;q21). We identified TNRC18-RARA as novel RARA fusion in resembling APL. Our study highlights the importance of combining multiple molecular techniques to characterize and optimally manage APL lacking classic t(15;17)(q24;q12)/PML-RARA fusion.
Assuntos
Cromossomos Humanos Par 15/genética , Cromossomos Humanos Par 17/genética , Peptídeos e Proteínas de Sinalização Intracelular/genética , Leucemia Promielocítica Aguda/genética , Proteínas de Fusão Oncogênica/genética , Receptor alfa de Ácido Retinoico/genética , Translocação Genética , Regulação Leucêmica da Expressão Gênica , Humanos , Hibridização in Situ Fluorescente , Peptídeos e Proteínas de Sinalização Intracelular/metabolismo , Leucemia Promielocítica Aguda/metabolismo , Leucemia Promielocítica Aguda/patologia , Masculino , Pessoa de Meia-Idade , Proteínas de Fusão Oncogênica/metabolismo , Receptor alfa de Ácido Retinoico/metabolismoRESUMO
While the implementation of the "graded diagnosis and treatment" system highlights the important role of general practitioners as "residents' health gatekeepers", it brings the problem of insufficient service capacity and difficulty in realizing the service value. At present, the service value of general practitioners is a relatively new topic in the field of general medicine. Therefore, few studies discuss the specific path that affects the realization of their service value. According to literature analysis, the professional quality of general practitioners plays a positive role in improving their service quality. So it can be inferred that the main reason for this phenomenon is that the professional quality level of general practitioners as the service subject is low and they have not been trusted and recognized by the residents of the service object. So far, it is difficult for most residents to change their willingness to go to large hospitals. Training is the most critical link to improving the professional quality of general practitioners. Therefore, how to enhance the professional quality of general practitioners through effective training so as to realize the service value is a problem worth discussing. Our study took 37 general practitioners from 12 Community Health Service hospitals as the interviewees and used grounded theory to mine the internal correlation between variables. The results show that: (1) the professional quality of general practitioners mainly includes three dimensions: professional ethics, theoretical knowledge, and professional skills; (2) through training, the professional quality of general practitioners has been effectively improved; (3) the improvement of general practitioners' professional quality directly affects the realization of their technical value, environmental value and information value; (4) the professional quality of general practitioners can be improved through training, which will affect the realization of their service value. Our research contribution is to break through the previous research paradigm of analyzing the relationship between variables based on the existing literature. This paper uses the procedural grounded theory method to analyze the concept of general practitioners' professional quality from scratch through continuous refinement and summary and constructs a theoretical model of the training path from general practitioners' professional quality to service value. On the one hand, the research results can realize their service value by improving the professional quality of general practitioners. On the other hand, the realization of the service value of general practitioners can provide effective support for patients to create a good medical environment.