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In the context of modern medicine, it’s difficult for doctors lacking narrative thinking to get into the hearts of patients and offer high-quality medical service. Precise classification terms and decontextualized abstract language have become communication barriers between doctors and patients, creating an atmosphere of unusual indifference and fear during the medical process. William Osler, the father of modern medicine, emphasized that doctors should respect the individuality of patients, and advocated that doctors should use life-oriented language to provide humanistic care to patients. This echoes the concept of the “doctor-patient narrative community” in the construction of the Chinese narrative medicine system. As a brand new clinical humanistic practice path, narrative medicine focuses on the keyword “narrative” and revolves around the theme of “inter-subjective relationship” in the medical context, advocates that doctors switch flexibly in the two references of science and life, achieve visual fusion with patients and their families, pay attention to patients’ life experiences, and establish narrative connections with them. On this basis, it can achieve two-way narrative interaction, build a harmonious doctor-patient narrative community, and thus enhance the patient’s medical experience.
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Objective:To investigate the efficacy and safety of ixazomib-based therapy for multiple myeloma.Methods:The data of 32 patients with multiple myeloma treated with isazomib-based regimen in the Affiliated Hospital of Jining Medical University from December 2020 to December 2021 were retrospectively analyzed. Among 32 patients, 17 cases were relapsed/refractory, and the remaining 15 cases had initial treatment. The treatment regimens included ID (isazomib + dexamethasone), IRD (isazomib + lenalidomide + dexamethasone) and ICD (isazomib + cyclophosphamide + dexamethasone). The short-term curative effect and adverse reactions of relapsed/refractory patients and patients at initial onset were analyzed.Results:The overall response rate (ORR) of relapsed/refractory patients was 52.9% (9/17), of which 6 cases achieved complete remission (CR), 2 cases achieved very good partial remission (VGPR) and 1 case achieved partial remission (PR). The ORR of refractory patients receiving bortezomib therapy was 40.0% (4/10). The ORR of patients at initial onset who could be evaluated the curative effect was 100.0% (14/14), including 9 cases of CR, 2 cases of VGPR and 3 cases of PR. After treatment, 2 patients (6.2%) had grade Ⅲ-Ⅳ adverse events (1 case of herpes zoster and 1 case of thrombocytopenia), and none of the patients had grade Ⅲ-Ⅳ peripheral neuropathy.Conclusion:Isazomib is effective and safe in the treatment of initially treated and relapsed/refractory multiple myeloma.
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Objective To observe the curative effect of erythrocyte separation in the treatment of patients with polycythemia vera (PV). Methods Sixty- five patients with P- were selected, and the patients were divided into control group (20 cases) and observation group (45 cases) according to the treatment method. All patients of 2 groups were treated with oral hydroxyurea and intramuscular interferon, but the patients of observation group combined with erythrocyte separation. The hemoglobin and hematocrit (HCT) before and after treatment and untoward reaction were compared between 2 groups. Results There were no statistical differences in hemoglobin and HCT before treatment between 2 groups:(196 ± 17) g/L vs. (182 ± 23) g/L and 0.606 ± 0.049 vs. 0.578 ± 0.066, P>0.05. The hemoglobin and HCT levels after treatment in observation group were significantly lower than those in control group:(153 ± 27) g/L vs. (168 ± 14) g/L and 0.490 ± 0.050 vs. 0.539 ± 0.054, and there were statistical differences (P<0.05). There was no obvious untoward reaction in 2 groups. Conclusions Erythrocyte separation is one of first choices for PV. It is safe and effective, and has less obvious untoward reaction.
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Objective To explore a new approach to isolate the umbilical cord-mesenchymal stem cells (UC-MSCs) from a whole umbilical cord. Methods Single enzyme was used to digest the whole umbilical cord,and passaged and cultured,draw the growth curve,cell cycle and cell wall antigen on the surface by flow cytometry. In particular inducing system, the adherent cells were induced into adipocytes and osteoblast. Results The mesenchymal stem cells (MSCs) were derived from the whole umbilical cord. The growth curve showed that the cell doubling time was (24.15 ± 0.49) h and the percentage of G1phase cells was 82.66%.The adherent cells expressed the CD93,CD105,CD44,CD29and CD73, and did not express the CD34, CD45, CD31and human leukocyte antigen DR (HLA-DR). UC-MSCs could differentiate into adipocytes and osteoblast. Conclusions Single enzyme approach is a good method to obtain UC-MSCs from whole human umbilical cord,and it provides a theoretical basis for the establishment of MSCs bank and clinical application.
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Objective To study the expression of plasma membrane Ca2 + -ATPase isoforms 1 -4 and the splice variants at sites A and C in the neonatal rat vestibular organ.Methods Ten rats at postnatal 2 days (P2 ) were decapitated and their vestibular organs (macula utriculi and macula sacculi)were isolated.The total proteins of the vestibular organs were extracted.The expression of PMCA1-4 splice variants at sites A and C was detected by RT-PCR.Results The splice variants of PMCA1-4 at sites A and C in macula utriculi and macula sacculi of neo-natal rat vestibular organs were PMCA1x/b,PMCA2w/(a,b),PMCA3z/(a,b,c)and PMCA4 (x,z)/b.Conclusion The splice variants at sites A and C among PMCA1,PMCA2,PMCA3 and PMCA4 were different in the vestibu-lar organs of neonatal rats,which could be explained that macula utriculi and macula sacculi had different require-ments of Ca2 + turning for these PMCA isoforms.
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Objective To study the expression of plasma membrane Ca2+-ATPase isoforms 1~3 (PMCA 1~3 )in the basilar membrane (BM)of the neonatal rat cochlea by Western blot.The PMCA2 content in single BM of the neonatal rat was also examined.Methods Four rats at postnatal 2 days (P2)and 8 days (P8)were respective-ly decapitated and their BMs were isolated.The total proteins of BMs were extracted.The 20μg total proteins were respectively loaded to the gel.The expression of PMCA1-3 was detected by Western blot.Likewise,3μg total proteins from P2 and P8 rat BM were loaded.The expression of PMCA2 was detected by Western blot.Four rats at P8 were decapitated and their BM was isolated.The 5μg,10μg and 20μg total proteins of P8 rat BM were added to the gel and 100 ng,400 ng and 800 ng bovine serum albumin (BSA)were also loaded as reference.After electro-phoresis,the gel was separated into two parts.One part was used for SYPRO staining and the other part was used for PMCA2 detection by Western blot.Results In the 20μg BM total proteins of P2 and P8 rats,the expression of PMCA1 was weak (0.126±0.024,0.131±0.012,respectively),PMCA2 was strong (4.16±0.528,4.25±0.319, respectively),and PMCA3 was barely expressed (0 ).There was a statistical difference among PMCA1 ,PMCA2 and PMCA3(P<0.05).In the 3μg BM total proteins of P2 and P8 rats,the expression of PMCA2 in P8 (4.571± 0.336)was higher than P2 (3.622±0.285).There was a statistical difference(P<0.05).The PMCA2 content in the BM of a P8 rat was about 2 .5 ng.Conclusion There was a different-level expression of PMCA1~3 in the neonatal rat BM with highest expression of PMCA2 ,which could be explained that cochlear hair cells had different requirements of Ca2+ turning for these PMCA isoforms.
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<p><b>OBJECTIVE</b>To investigate the location and distribution of plasma membrane Ca²⁺ -ATPase isoform 2(PMCA2) in the cochleas of C57BL/6J mice at various ages (4w, 14w, 22w, 45w), and to reveal the relationship of PMCA2 and age-related hearing loss (AHL).</p><p><b>METHODS</b>The distribution of PMCA2 in the cochleas of C57BL/6J mice was detected by immunohistochemistry at various ages (4w, 14w, 22w, 45w). Real-time polymerase chain reaction (Rt-PCR) was used to detect the level of PMCA2 mRNA in the cochleas of C57BL/6J mice at the ages of 4, 14, 22 and 45 weeks old respectively. Using SPSS17.0 software for statistical analysis.</p><p><b>RESULTS</b>PMCA2 was mainly located in the hear cells, stria vascularis, and spiral ganglion cells. Faint labeling of PMCA2 was also observed in spiral ligament. Hair cells missed and the number of spiral ganglion cells reduced with age. Expression of PMCA2 in the cochleas of C57BL/6J mice also showed age-related decreasing. The results of Rt-PCR demonstrated the expression of mRNA of gene (Atp2b2) at 14 weeks age was significantly less than 4 week-old mice cochlears (P<0.05). The expression of mRNA of gene (Atp2b2) at 22 weeks age was significantly less than 14 week-old mice cochlears (P<0.05). The expression of mRNA of gene (Atp2b2) at 45 weeks age was significantly less than 14 week-old mice cochlears (P<0.01).</p><p><b>CONCLUSIONS</b>PMCA2 is mainly located in the hear cells, stria vascularis, and spiral ganglion cells. Faint labeling of PMCA2 is also observed in spiral ligament. The expression of PMCA2 demonstrates an age-related decrease with age. The mRNA expression level of PMCA2 gene(Atp2b2) in the cochleas of C57BL/6J mice displayed an age-related decrease. PMCA2 transporters may play a critical role in maintaining the normal morphology of the inner ear and it may be related to AHL.</p>
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Animais , Camundongos , Envelhecimento , Cóclea , Células Ciliadas Auditivas , Metabolismo , Isoenzimas , Metabolismo , Camundongos Endogâmicos C57BL , ATPases Transportadoras de Cálcio da Membrana Plasmática , Metabolismo , RNA Mensageiro , Metabolismo , Reação em Cadeia da Polimerase em Tempo Real , Gânglio Espiral da Cóclea , Biologia Celular , Metabolismo , Estria Vascular , Biologia Celular , MetabolismoRESUMO
Objective To find the application effect of risk management in nursing management in delivery room.Methods 1200 hospitalized parturients in 2011 were selected as the observation group,and 1186 parturients in 2008 were set as the control group.The observation group received risk management and nursing measures,while the control group was given traditional nursing.Nursing defects rates,the rate of post-partum haemorrhage,the incidence of neonatal asphyxia,dystocia rate,nursing disputes and patient satisfaction degree were compared between two groups.Results Neonatal label defects rates,the rate of post-partum haemorrhage,the incidence of neonatal asphyxia,dystocia rate and nursing disputes in the observation group were much lower than that in the control group.The patient satisfaction degree was significandy increased in the observation group.Conclusions Summarizing the risk factors,performing risk management in delivery room can greatly increase the delivery and nursing quality and patient satisfaction degree.
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Objective To study the influence of collecting blood specimen of cancer patients through PICC on blood test result and catheter-related complication,and discuss the path and feasibility of collecting blood through PICC.Methods Adopting clinical self-contrast experiment,collecting blood specimens of 100 patients at one side through PICC (the observation group)and by ordinary method at the other side of limbs (the control group),comparing the test differences of blood routine,blood biochemistry,and coagulation function,etc.between the two groups.The incidence of catheter-related complication was also observed a week after collecting blood through PICC.Results There was no statistic difference between the two groups in terms of test results.No case of catheter-related complication in a week after collecting blood occurred in the observation group.Conclusions The method of collecting blood specimen through PICC is accurate,safe and feasible,the key point is to implement scientific and standard collecting path and entry-qualification of operators strictly.
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Objective To discuss the appropriate timing of providing enteral nutrition through nasojejunal tube for patients with severe craniocerebral injury.Methods 126 cases of patients were divided into 3 groups randomly,providing enteral nutrition through naso-jejunal tube for the first group,the second group and the third group within 12~24 hours,48 hours later and 72 hours later after injury respectively.The nutrition situation of 3 groups was recorded 6 hours later,48 hours later,on the 5th day and the 10th day,including indicators such as total serum protein,blood albumin,serum creatinine,etc and complication cases of diarrhea,hemorrhage of digestive tract,palirrhea,aspiration,inhalation pneumonia and so on within 2 weeks after injury.Results In terms of indicators of albumin,creatinine 48 hours after injury and total protein,albumin and creatinine on the 5th day and 10th day,the first group were better than the second and third group,there were statistic differences between the three groups.Complication comparison within 2 weeks after injury:the difference of palirrhea cases among the three groups was significant,the third group had a higher ratio than the first and second group.And there was no statistic difference in the other indicators like diarrhea,hemorrhage of digestive tract,aspiration and inhalation pneumonia.Conclusions It is high time that patients with simple severe craniocerebral injury are provided with enteral nutrition through naso-jejunal tube within 12 to 24 hours,which can improve patients nutrition situation without the increase of the complications.
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Objective To explore the relationship between the expression of basic fibroblast growth factor (bFGF) and microvessel density(MVD)in non-small cell lung cancer.Methods The expression of bFGF and MVD were observed in 54 eases of NSCLC were detected with in situ hybrldization and immunohistochemical detection.Resuits The expression of bFGF and MVD was greater in adenecarcinomas than in squamous cell carcinomas of NSCLC (P<0.05).The expression of bFGF was significantly different among the three groups of both squamous cell carcinomas and adenocarecnomas with varying differentiation (P<0.05).There was hisher bFGF expression and greater MVD in NSCLC patients with regional lymplmode involvement and those with laterdistant metastasis(P<0.05).Condusion bFGF may play an important role in tumor angiogenesis and lymphatic metastasis of human NSCLC,and detection of bFGF may be a good metastasis and prognostic predictors for human NSCLC.
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OBJECTIVE@#Whether inhalation of pulmicort into the sinus of chronic rhinosinusitis patients could improve reepithelization after endoscopic sinus surgery was assessed.@*METHOD@#Prospective study 60 patients with chronic rhinosinusitis after endoscopic sinus surgery were divided into 2 groups randomized, the one was treatment group, and the other was control group. The patients in treatment group received inhalation of pulmicort 2 ml plus 0.5% Aeuromycin solution 10 ml by oxygen driving force, once a day, persisting for 3 weeks. The patients in control group received Rhinocort. Besides the different therapies above mentioned above therapy was different, two groups received the same conventional route therapy. To observe the time of reepithelization under nasal endoscope, was observed, respectively.@*RESULT@#The average time of reepithelization in treatment group was (5.3333 +/- 0.9942) weeks. The other group was (6.6667 +/- 1.3476) weeks, the statistical difference between the two groups was very significant.@*CONCLUSION@#Inhalation of pulmicort into the sinus can promote reepithelization and shorten the time of treatment.
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Adolescente , Adulto , Humanos , Pessoa de Meia-Idade , Adulto Jovem , Administração por Inalação , Budesonida , Usos Terapêuticos , Doença Crônica , Endoscopia , Estudos Prospectivos , Sinusite , Tratamento Farmacológico , Terapêutica , Resultado do TratamentoRESUMO
OBJECTIVE@#To evaluate the method of the perioperative blood glucose control in chronic rhinosinusitis coexisting diabetes.@*METHOD@#Twenty-two cases of chronic rhinosinusitis coexisting diabetes were investigated retrospectively, including one case of type 1 diabetes and 21 cases of type 2 diabetes. The study cohort was divided into two groups, the one was complication group and the other was non-complication group. The patients in complication group were injected insulin to control blood glucose level, and the patients in non-complication group were prescribed oral medicine.@*RESULT@#Blood glucose levels below 9.0 mmol/L in complication group and below 7.0 mmol/L in non-complication group were both the surgical indication for the patients in this research cohort. Twenty-one cases were completely recovered and one case made progress significantly.@*CONCLUSION@#The detection of blood and urine glucose levels must be the routine item before the nasal endoscopic surgery. To control blood glucose levels in type 2 diabetes with non-complication, oral medicine is the first choice, in type 1 diabetes and type 2 diabetes with complication, insulin should be first considered.