Objective To investigate the influence of bundled care strategies on compliance of conscious patients with continuous renal replacement therapy(CRRT). Methods A total of 56 conscious patients with CRRT from October 2013 to February 2015 were recruited and divided into control group and observation group according to the hospital number with 28 cases each. In addition, all the enrolled patients were reluctant to cooperate with the nurses during CRRT. Patients in control group were given conventional nursing operation. Patients in observation group were given bundled care strategies interventions. Results Totally 267 times of CRRT were analyzed in 56 patients. The rate of complete cooperation and general cooperation were 42.1%(51/121), 45.5%(55/121) in observation group, and 28.1%(41/146), 40.4%(59/146) in control group, and there was significant difference(χ2=14.77, P<0.05). The incidence of planed interruption was 53.7%(65/121) in observation group, and 39.0%(57/146) in control group, and there was significant difference(χ2=5.74, P<0.05). Conclusions Bundled care strategy can effectively improve the compliance of conscious patients with CRRT. The patients show better cooperation during the therapy, which is very important to assist the patients to overcome difficulties and do good for the therapy getting along well.

Objective To improve the compliance of nurses in ICU standard specimen collection of blood culture by six sigma quality management method, so as to improve the quality of blood culture sample submission, to ensure the accuracy of inspection results. Methods A total of 158 nurses in ICU from February 2016 to January 2017 were selected as the research objects. The six sigma quality management method was used to analyze the operation of blood culture samples collected by ICU nurses,and the improvement plan was worked out and implemented. The compliance rate of blood culture samples collected by nurses before and after implementation and the feedback information of laboratory about blood culture specimen quality were compared. Results Before the application of six sigma quality management method, the compliance rate of blood culture specimens collected by ICU nurses was 54.1％(152/281), and the compliance rate after improvement was 88.6％(271/306), and the difference was statistically significant (χ2=86.45, P<0.01). Among the factors influencing nurses' blood culture,the importance of blood culture was not enough, the operation process was not mastered, the relevant knowledge of blood culture was not mastered, and the allocation of related consumables was unreasonable. After implementation,the composition ratio was reduced from 50.4％(65/129), 24.0％(31/129), 45.7％(59/129), 21.7％(28/129) to 17.1％(6/35), 8.6％(3/35), 25.7％(9/35), 2.9％(1/35), and the difference was statistically significant (χ2=4.00- 12.39, P<0.01 or 0.05). The contamination rate of blood culture specimens after six sigma management was 6.2％(19/306) and significantly lower than that of 16. 4％(46/281) before implementation,and the difference was statistically significant (χ2=15.36, P<0.01). Conclusions The six sigma quality management method can improve the nurses' attention to the correct collection of blood culture samples, reveal the defects in the operation, and reduce the irregular behavior of blood culture process. Therefore, the compliance of ICU nurses with standardized blood culture samples is improved, and the contamination rate of blood culture specimens is effectively reduced.

Collaboration of c-KIT mutations with AML1-ETO (AE) has been demonstrated to induce t(8; 21) acute myeloid leukemia (AML). Targeted therapies designed to eliminate AE and c-KIT oncoproteins may facilitate effective treatment of t(8; 21) AML. Homoharringtonine (HHT) features activity against tumor cells harboring c-KIT mutations, whereas oridonin can induce t(8; 21) AML cell apoptosis and AE cleavage. Therefore, studies should explore the efficacy of combination therapy with oridonin and HHT in t(8; 21) AML. In this study, we investigated the synergistic effects and mechanism of oridonin combined with HHT in t(8; 21) AML cell line and mouse model. The two drugs synergistically inhibited cell viability and induced significant mitochondrial membrane potential loss and apoptosis. Oridonin and HHT induced significant downregulation of c-KIT and its downstream signaling pathways and promoted AE cleavage. HHT increased intracellular oridonin concentration by modulating the expressions of MRP1 and MDR1, thus enhancing the effects of oridonin. The combination of oridonin and HHT prolonged t(8; 21) leukemia mouse survival. In conclusion, oridonin and HHTexert synergistic effects against t(8; 21) leukemia in vivo and in vitro, thereby indicating that their combination may be an effective therapy for t(8; 21) leukemia.