Objective To investigate the expression of granulocyte colony-stimulating factor receptor(G-CSFR,CD114)in acute myelocytic leukemia(AML)bone marrow CD34+cells and evaluate G-CSF's secutiy of applying to the patients of AML after chemotherapy.Methods From March 2008 to January 2009,62 AML patients[33 deno-vo or relapsed AML patients,29 AML patients in complete remission(CR)]and 16 normal controls in the General Hospital,Tianjin Medical University were detected for the expression of G-CSFR in CD34+cells by Fluorescence-activated cell sorer(FCM)and Semi-quantitative reverse transcription-polymerase chain reaction(RT-PCR).Results The ratio of CD114+CD34+/CD34+ in the deno-vo or relapsed group,CR group and the control group were(11.69?2.91)%,(31.84?8.62)%,(32.87?8.44)% respectively(P0.05),G-CSFR mRNA expression in BMNNCs of the deno-vo or relapsed group,CR group and the control group were(30.52?6.21)%,(85.13?21.25)%,(91.57?18.64)% respectively(P0.05).13 AML patients were followed up.The ratio of CD114+CD34+/CD34+ before treatment and in CR were(12.58?2.00)% and (30.13?7.09)% respectively.The ratio before treatment was lower than that in CR(P

Objective To retrieve the relevant evidence of ICU nurse ventilator alarm management and summarize the best evidence to provide a reference for ICU nurse ventilator alarm management decision.Methods The clinical decision,guideline,systematic evaluation,expert consensus and all kinds of original studies related to the alarm management of ICU nurses in PubMed,CINAHL,Embase,Web of Science,VIP,CNKI and Wanfang were searched from database construction until April 22,2023.The literature quality evaluation and result extraction were performed independently by 2 investigators.Results 14 articles were finally involved,including 4 guidelines,2 international standards,2 national standards,2 expert consensuses,3 systematic evaluations and 1 randomized controlled trial;combined with professional judgment,27 pieces of the evidence were summarized,including multidisciplinary teamwork,alarm monitoring and processing,alarm setting,alarm management requirements,alarm education and training and ventilator maintenance.Conclusion This study summarizes the best evidence of ventilator alarm management for ICU nurses,which can provide evidence-based bases for clinical decisions,solve clinical ventilator alarm problems in a scientific management way,and improve the quality of management.

Objective:This study aimed at investigating the efficacy and safety of eltrombopag in the treatment of adult primary immune thrombocytopenia (ITP) and evaluated the factors influencing its efficacy and side effects.Methods:A total of 198 patients with adult ITP who were admitted to Tianjin Medical University General Hospital between January 2018 and March 2022 were retrospectively analyzed. The efficacy of each starting dose of eltrombopag was evaluated, and adverse events were analyzed. The factors influencing efficacy were investigated, including sex, age, adult ITP type, platelet antibodies, and combined drug treatments.Results:Of the 198 patients, 70 males and 128 females with a median age of 45 years (18-88 years) were included; 130 (65.7%) had newly diagnosed adult ITP, 25 (12.6%) had persistent adult ITP, and 43 (21.7%) had chronic adult ITP. The bleeding event scores at baseline were assessed; 84.3% had scores of<4 and 15.7% had scores of ≥4. The eltrombopag response rate (initial response) at 6 weeks was 78.8% (complete response [CR]: 49.0%; CR1: 14.6%; CR2: 15.2%). The median response time to eltrombopag was 7 (7, 14) days. The initial response rates to 25, 50, and 75 mg eltrombopag were 74.1%, 85.9%, and 60.0%, respectively ( P=0.031). The initial response rate to the 50 mg dose was significantly higher than that of the 25-mg and 75-mg doses. Two patients received 100 mg as the starting dose, and their initial response was 0. Regarding dose adjustment, 70.7% of the patients remained on the starting dose, 8.6% underwent dose adjustment to 50 mg, and 6.1% underwent dose adjustment to 75 mg. Another two patients underwent dose adjustment to 100 mg. After dose adjustment, the persistent response rates were 83.6%, 85.3%, and 85.7% for the 25-, 50-, and 75-mg doses, respectively, with no significant difference. After dose adjustment, the sustained efficacy rate for the 100-mg dose (4 patients) was 100.0%. After 6 weeks of treatment with eltrombopag, the overall bleeding score of patients with ITP decreased. The number of patients with a score of ≥4 decreased to 0, the number of patients with a score of<4 decreased, and there was no significant change in the number of patients with a score of 1-2. The most common adverse event associated with eltrombopag was impaired liver function (7.7%). No thrombosis events or other adverse events were observed. ITP type and number of megakaryocytes significantly affected the initial response to eltrombopag. The initial response rates to eltrombopag for newly diagnosed adult ITP, persistent adult ITP, and chronic adult ITP were 85.3%, 56.0%, and 76.2%, respectively ( P=0.003). For megakaryocytes, the initial response rates were 61.8%, 87.1%, and 84.3% ( P=0.009) for the decreased, normal, and increased megakaryocyte groups, respectively. Conclusion:Eltrombopag, as a second-line or higher treatment for adult ITP, has a rapid onset of action and good safety. The initial response rate is significantly higher with a dose of 50 mg than with a dose of 25 mg. Patients with newly diagnosed ITP and those with normal or increased megakaryocyte numbers have a higher initial response rate to eltrombopag.