1.DiaLecticaL nursing abiLity and training among practice nursing students of traditionaL Chinese medicine coLLeges and universities
Qixuan SUN ; Wenjing TU ; Lu HUANG ; Sixuan HAN
Chinese Journal of Modern Nursing 2019;25(7):811-814
Objective? To expLore the diaLecticaL nursing abiLity and training among practice nursing students of TraditionaL Chinese Medicine coLLeges and universities so as to provide a reference for education reform and practice management of coLLeges and universities. Methods? In March 2018, we seLected 308 practice nursing undergraduates of schooL of nursing in Nanjing University of Chinese Medicine practicing at designated hospitaLs as subjects by purposive sampLing. ALL of them were investigated with the seLf-designed diaLecticaL nursing abiLity and training of practice nursing students of TraditionaL Chinese Medicine coLLeges and universities questionnaire. In this study, a totaL of 308 questionnaires were sent out and 254 vaLid questionnaires were coLLected. ResuLts? The scores of the diaLecticaL nursing abiLity of nursing students seLf-evaLuation questionnaire before and after practice were (4.91±1.90) and (4.72±1.92) respectiveLy with no statisticaL difference (t=1.379, P=0.170). Practice nursing students' master of diaLecticaL nursing basic knowLedge ranged from 69.29% to 89.76%. ConcLusions? Practice nursing students have the Low abiLity of diaLecticaL nursing. Practice hospitaLs shouLd improve the cuLtivate awareness and teaching LeveL, and satisfy nursing students' training needs so as to improve the diaLecticaL nursing abiLity of them.
2.Effect of obesity on the efficacy of allogeneic hematopoietic stem cell transplantation
Xing SHEN ; Han ZHU ; Ruize CHEN ; Hanxin WU ; Hua LU ; Lijuan CHEN ; Sixuan QIAN ; Yu ZHU ; Jianyong LI ; Kourong MIAO
Journal of Leukemia & Lymphoma 2021;30(9):529-533
Objective:To investigate the effect of obesity on the efficacy of allogeneic hematopoietic stem cell transplantation.Methods:The clinical data of 81 patients who underwent allogeneic hematopoietic stem cell transplantation from August 2017 to September 2020 in the First Affiliated Hospital of Nanjing Medical University were retrospectively analyzed. According to the body mass index (BMI), the patients were divided into the obese group (BMI≥28 kg/m 2, 11 cases) and the non-obese group (BMI<28 kg/m 2, 70 cases). The clinicopathological characteristics, hematopoietic stem cell implantation, post-transplantation complications, survival and recurrence were compared between the two groups. Univariate and multivariate survival analyses were performed by using Cox proportional hazards regression model. Results:The median follow-up time of 81 patients was 280 d (8-1 218 d). The 1-year overall survival (OS) rate was 77.9%, and the 1-year progression-free survival (PFS) rate was 73.8%. The 1-year OS rates of the non-obese group and the obese group were 82.6% and 46.2% ( χ2 = 15.54, P<0.01), and the 1-year PFS rates were 82.1% and 36.4% ( χ2 = 15.56, P<0.01). The non-recurrence mortality (NRM) rates of the non-obese group and the obese group were 7.1% and 32.7% ( χ2 = 6.463, P = 0.01), and the cumulative recurrence rate was 11.5% and 42.9% ( χ2 = 8.146, P = 0.004). Between the non-obese group and the obese group, the median engraft time of neutrophils and platelets, acute graft-versus-host disease, chronic graft-versus-host disease, hemorrhagic cystitis, cytomegalovirus infection and Epstein-Barr virus infection had no statistical difference ( P > 0.05). The result of multivariate analysis showed that obesity was an independent adverse influencing factor for OS of patients with allogeneic hematopoietic stem cell transplantation ( HR = 3.814, 95% CI 1.343-10.827, P = 0.012). Conclusion:Obesity is an important unfavorable factor that affects patient's survival after allogeneic hematopoietic stem cell transplantation, and the improvement of the efficacy and survival of these patients is worthy of further study.
3.Difference in Adverse Reactions between Colorectal Cancer Patients with or without Spleen-kidney Yang Deficiency Syndrome after Oxaliplatin-containing Chemotherapy
Yifan LI ; Yipang ZHAO ; Boyuan HAN ; Yixuan LIU ; Sixuan XING ; Wenjing YANG ; Qing ZHANG
Journal of Traditional Chinese Medicine 2024;65(19):2010-2017
ObjectiveTo compare the difference in adverse reactions after oxaliplatin-containing chemotherapy between colorectal cancer patients with or without spleen-kidney yang deficiency syndrome. MethodsA retrospective study was conducted using the electronic medical records of Beijing Hospital of Traditional Chinese Medicine, Capital Medical University. A total of 483 colorectal cancer patients from January 1, 2009 to December 31, 2022 were selected. Patients were divided into two groups based on their syndrome types, that was spleen-kidney yang deficiency syndrome (SKYDS) group (130 cases) and non-SKYDS group (353 cases). The incidence of adverse reactions including gastrointestinal reactions, liver damage, bone marrow suppression, and peripheral neurotoxicity after completing 2, 4, 6, and more than 6 cycles of chemotherapy was compared between the two groups. Univariate and multivariate logistic regression analyses were used to analyze the associations of age, gender, alcohol history, primary tumor location, tumor differentiation, tumor staging, chemotherapy courses, and syndrome types with the occurrence of gastrointestinal adverse reactions, liver function damage, bone marrow suppression and peripheral neurotoxicity in colorectal cancer patients who have completed 2, 4, 6 and more than 6 cycles of oxaliplatin-containing chemotherapy. ResultsThere were significant differences in the occurrence of gastrointestinal reactions after completing 2, 4, 6 and more than 6 cycles of chemotherapy between the two groups (P<0.01), with much more severe conditions in SKYDS group than non-SKYDS group (P<0.01). There was no significant difference in liver function damage and bone marrow suppression between groups (P>0.05). There were statistically significant differences in the occurrence of peripheral neurotoxicity after completion of 2 cycles (P=0.044), 4 cycles (P=0.002) and more than 6 cycles (P<0.001) of chemothe-rapy, with higher rate in SKYDS group than the non-SKYDS group (P<0.05). Univariate analysis showed that female, patients with stage Ⅲ tumors and patients having completed ≥ 6 cycles of chemotherapy had a higher incidence of bone marrow suppression (P<0.05), and patients with SKYDS had a higher incidence of gastrointestinal reactions (P<0.001). Patients with a history of drinking, stage Ⅳ cancer, and ≥6 cycles of chemotherapy had a higher incidence of liver function injury (P<0.05). Patients with stage Ⅲ cancer, ≥6 cycles of chemotherapy, and SKYDS had a higher incidence of peripheral neurotoxicity (P<0.05). Multivariate analysis showed that the risk factor for bone marrow suppression was chemotherapy ≥6 cycles (P=0.001), and SKYDS was the risk factor for gastrointestinal reaction (P<0.001). The risk factor for liver function damage was tumor stage Ⅳ (P=0.001) and SKYDS (P=0.039). All variables had no significant correlation with the occurrence of peripheral neurotoxicity. ConclusionFor colorectal cancer patients, being diagnosed with SKYDS is a risk factor for developing gastrointestinal adverse reactions and peripheral neurotoxicity following chemotherapy with an oxaliplatin-based regimen.
4.Clinical study of induction chemotherapy followed by allogeneic hematopoietic stem cell transplantation in the treatment of FLT3-ITD + acute myeloid leukemia with normal karyotype
Fang LI ; Yanping LIU ; Han ZHU ; Ming HONG ; Sixuan QIAN ; Yu ZHU ; Wenyi SHEN ; Lijuan CHEN ; Guangsheng HE ; Hanxin WU ; Hua LU ; Jianyong LI ; Kourong MIAO
Chinese Journal of Hematology 2023;44(3):230-235
Objective:To assess the efficacy of induction chemotherapy followed by allogeneic hematopoietic stem cell transplantation (allo-HSCT) in the treatment of FLT3-ITD + acute myeloid leukemia (AML) with normal karyotype. Methods:The clinical data of FLT3-ITD + AML patients with normal karyotype in the First Affiliated Hospital of Nanjing Medical University from Jan 2018 to March 2021 were retrospectively analyzed. Results:The study included 49 patients with FLT3-ITD +AML, 31 males, and 18 females, with a median age of 46 (16-59) years old. All patients received induction chemotherapy, and 24 patients received sequential allo-HSCT (transplantation group) . The median follow-up time was 465 days, the one-year overall survival (OS) from diagnosis was (70.0 ± 7.4) %, and one-year disease-free survival (DFS) was (70.3±7.4) %. The one-year OS was significantly different between the transplantation group and the non-transplantation group [ (85.2 ± 7.9) % vs (52.6 ± 12.3) %, P=0.049]. but one-year DFS [ (84.7 ± 8.1) % vs (55.2 ± 11.9) %, P=0.061] was not. No significance was found in one-year OS between patients with low-frequency and high-frequency FLT3-ITD + ( P>0.05) . There were 12 patients with high-frequency FLT3-ITD + in the transplantation and the non-transplantation groups, respectively. The one-year OS [ (68.8 ± 15.7) % in the transplantation group vs (26.2 ± 15.3) % in the non-transplantation group, P=0.027] and one-year DFS [ (45.5 ± 21.3) % in the transplantation group vs (27.8±15.8) % in the non-transplantation group, P=0.032] were significantly different between the two groups. Conclusion:Induction chemotherapy followed by allo-HSCT can enhance the prognosis of FLT3-ITD + patients, particularly those with FLT3-ITD high-frequency mutation.