Objective To analyze the shortcomings and explore measures in medical nursing to improve quality. Methods The students were divided into experimental group (29 students) and control group (28 students). For the former group, we put a set of new teaching methods, including enhancing students theoretical knowledge and teachers had to prepare well, helping students learn to use the nursing process, sorting out the characteristics and contacting different diseases. After clinical clerkship, we conducted students to follow the case in order to learn more .The latter group received traditional teaching methods. Results The application part and total scores in examination of experimental group were higher than the traditional group (P<0.05). Conclusion The new teaching measures may improve students' learning initiative, communication skills, and develop their clinical thinking.

Defibrillators, Implantable ; Electric Countershock ; Humans ; Ventricular Fibrillation

OBJECTIVETo establish a quantitative HPLC method for determination of protopine, palmatine hydrochloride, bicuculline and tetrahydropalmatine, in Corydalis decumbens.

METHODThe separation was performed on a ZORBAX Eclipse XDB-C18 column (4.6 mm x 150 mm, 5 microm) at a flow rate of 1.0 mL x min(-1) using mixtures of two solvents [A(20 mmol x L(-1) ammonium acetate)-B(acetonitrile)]: with a gradient elution. The column oven temperature was 30 degrees C and the detection wavelength was set at 280 nm.

RESULTThe 4 alkaloids were well separated by this HPLC method. Linearifies of protopine, palmatine hydrochloride, bicuculline and tetrahydropalmatine were good in the ranges of 1.44-46.0 (r = 0.999 4), 1.2640.2 (r = 0.999 8), 1.37-44.0 (r = 0.999 9), and 1.3643.6 mg x L(-1) (r = 0.999 9), respectively. The average recoveries were 98.2% with RSD 2.7% for protopine, 101.9% with RSD 2.5% for palmatine hydrochloride, 102.8% with RSD 3.5% for tetrahydropalmatine, and 98.8% with RSD 3.1% for tetrahydropalmatine.

CONCLUSIONThis method is proved to be convenient, reliable and accurate., and it can be used for quality control of C. decumbens.

Alkaloids ; analysis ; Chromatography, High Pressure Liquid ; Corydalis ; chemistry ; Drug Stability ; Plants, Medicinal ; chemistry ; Reproducibility of Results

Chimeric antigen receptor T-cell (CAR-T) therapy has been widely used in patients with hematologic malignancies. However, there are still problems like high relapse rate and limited persistence. Challenges remain in enhancing the efficacy of CAR-T therapy while minimizing the adverse reactions. In recent years, small-molecule compounds, such as Bruton tyrosine kinase inhibitors, tyrosine kinase inhibitors and demethylating drugs, have been shown to have potential synergistic interactions when combined with CAR-T therapy. This review summarizes the latest progress of small-molecular compounds combined with CAR-T therapy in treatment of B lymphocyte malignancies.

Objective To explore the clinical features oflymphoplasmacytic diseases with MyD88 L265P mutation.Methods To analyze the distribution of MYD88 L265P mutation in patients with lymphoplasmacytic diseases by using of ARMS PCR-CE.Results There were 25(30.9％) MyD88 L265P mutated patients in 81 patients.The mutation was frequently observed in 14 patients with WM (77.8％,14/ 18),2 patients with lymphoplasmacytic lymphoma (66.7％,2/3),1 acute lymphocytic leukemia patient (50.0％,1/2),3 multiple myeloma patients (30.0％,3/10),1 patient with monoclonal gammopathy of undetermined significance (25％,1/4),3 patients with chronic lymphocytic leukemia (13.0％,3/23) and 1 lymphoma patient (4.8％,1/21).20 (80％,20/25) patients were identified with IgM subtype.Compared with wild-type group of 56 cases,mutated patients were older (median age:67 years vs 55 years,P＜ 0.001),with lower WBC count (median count:5.23 × 109/L vs 10.80× 109/L,P=0.001),lower HGB level (median count:85 g/L vs 119 g/L,P＜0.001).Conclusion MyD88 L265P mutation was mainly observed in patients with IgM subtype lymphoplasmacytic diseases,and Waldenstrom's macroglobulinemia was the most common disease.Compared with the wild-type group,patients with MyD88 L265P mutation were older and had lower WBC count,lower level of HGB.However,further studies were needed to test the prognostic value of MyD88 L265P mutation.