Regeneration of axon was play an important role in the functional repair after spinal cord injury,and it was affected by vascular damage,absent availability nutrition transportation,urged to be solved.Inducing angiogenesis by electrical fields might be benefit to enhance anatomical plasticity and recovery of function after spinal cord injury.

Objective To compare the clinical features of cytomegalovirus (CMV) infection and CMV disease after allogeneic hematopoietic stem-cell transplantation (HSCT) from HLA haploidentical related doors vs.HLA-matched sibling donors.Methods A total of 327 patients who received allogeneic HSCT from Jan.2011 to Dec.2011 were enrolled.There were 312 patients who had complete serological data before HSCT including 216 cases of HLA haploidentical related HSCT and 96 cases of HLA-matched sibling HSCT.Monitoring of CMV antigenemia was performed by using real-time quantitative (RQ) PCR after transplantation.Risk factors were compared by univariate and multivariate analysis.Results The cumulative incidence of CMV infection and CMV disease was (80.1 ± 2.7) ％ and (8.7 ± 2.0) ％ in HLA haploiddentical HSCT group,and (21.1 ± 4.9) ％ and 0 in HLA-matched sibling HSCT group respectively,and the difference was statistically significant between the two groups (P＜0.01).Univariate analysis revealed that HLA haploidentical related HSCT,less than 20 years of age,high risk disease,CMV-IgG serum positivity in patients or donors,acute graft-versus-host disease (aGVHD),EB viremia,and hemorrhagic cystitis were the risk factors of CMV infection.HLA haploidentical related SCT and hemorrhagic cystitis were the risk factors for CMV disease.Multivariate analysis showed that patients less than 20 years of age had a significantly high incidence of CMV infection.Patients from HLA-matched sibling HSCT,low risk disease,aGVHD,hemorrhagic cystitis had a significantly low incidence of CMV infection.Conclusion Compared with patients receiving HLA-matched sibling HSCT,those who received HLA haploidentical related HSCT had significantly high incidence of CMV infection and CMV disease,which were correlated with incidence of hemorrhagic cystitis.

Objective To investigate the current status of perceived social support and challenge-hindrance working pressure source and explore the association between the perceived social support and challenge-hindrance working pressure source in clinical nurses. Methods The perceived social support scale and challenge-hindrance working pressure source scale were investgated in the study among 295 clinical nurses. Pearson correlation analysis was used to explore the association between the clinical nurses' perceived social support and challenge-hindrance working pressure source. Results The total score of clinical nurses' perceived social support was (62.12 ±10.48), the score of clinical nurses' challenging working pressure source was (22.63 ±3.67), and the score of hindrance working pressure source was (15.17±3.41). The clinical nurses' perceived social support and its dimensions were significantly positively related with the challenging working pressure source (P ＜0.01). Other support dimension of perceived social support was significantly negatively related with the hindrance working pressure source (P ＜0.01). Conclusions The perceived social support and challenge-hindrance working pressure source of clinical nurses are at a medium to high level. The higher level of clinical nurses' perceived social support is, the higher level of challenge working pressure sources. The family members, friends, leaders and colleagues should give more support for the clinical nurses, so as to enhance their subjective support, increase positive effect of working pressure source, promote their progress and improve their quality of nursing.

Objective To investigate the clinical characteristics of the human Adenovirus (HAdv) infections in allogeneic hematopoietic stem cell transplantation ( allo-HSCT) patients and explore the clinical significance of HAdv monitoring .Methods A total of 845 cases underwent allo-HSCT were included retrospectively in Perking University People′s Hospital from October 2012 to August 2014.Peripheral blood HAdv load were monitored twice weekly within 100 days after allo-HSCT, or whenever necessary quantitatively by real-time PCR. Meanwhile, other clinical samples such as stool , urine, and bronchoalveolar lavage fluid ( BLAF ) were also detected qualitatively whenever necessary .The follow-up period was at least six months after allo-HSCT.All clinical data were collected and analyzed .Results The total positive rate of HAdv was 3.4% ( 29/845 ) .The incidence of HAdv infection was higher in children [3.8%(6/155), <18y] than that of adults [3.3%(23/690),≥18y].HAdv infection diagnosed within 100 days after allo-HSCT accounted for 72.4%(21/29) of the total number of positive cases .There were 19 cases detected positive in peripheral blood , 16 cases in stool , 9 cases in urine , and 1 cases in BLAF , respectively.One patient was positive in peripheral blood , stool and urine.The overall median time of HAdv was 69 (13-189) d.The median time was 56 (53 -144) d in stool ,which was earlier than that of in peripheral blood , urine and stool.Among 29 cases of HAdv positive patients , 17 patients were coinfected with Cytomegalovirus(CMV) and 11 casess with Epstein-Barr virus(EBV).Twenty-five cases of HAdv were diagnosed with acute graft-versus-host disease(aGVHD) before HAdv infection, and 4 cases were diagnosed with chronic graft-versus-host disease ( cGVHD ) . The most common clinical manifestation was HAdv enteritis (14 cases), followed by hemorrhagic cystitis (7 cases).Two cases complicated with multiple organ injury ( >2 ) clinically, 1 cases with pneumonia.There were 8 cases of death at the end of follow-up.Conclusions HAdv is an important pathogen causing infection in patients after allo-HSCT. The infenction is characterized with multiple organ involvement .CMV and EBV coinfection is common .HAdv monitoring was of great significance in allo-HSCT patients.

Objective To compare the prevalence of pressure ulcers and prevention before and after a quality improvement program.Methods Descriptive comparative study based on two cross-sectional pressure ulcer surveys was conducted in 2010 and 2013.A total of 612 hospitalized patients in 2010 and 632 in 2013 were included.The pressure ulcers prevention mainly included pressure-reducing mattresses, planned repositioning and so on.Braden scale was used to estimate the effect factors and severity of pressure ulcers. Results Pressure ulcer prevalence was 23.9%in 2010 and 18.2%in 2013,and the difference was statistically significant (χ2 =4.80,P<0.05).The mean age of patients with pressure ulcers in first half year of 2013 were significantly older than those without (76.2 ±2.3 vs 66.1 ±2.0;t=23.37,P<0.01).Braden scale records of pressure ulcers patients was lower than that of patients without (11.3 ±1.1 vs 20.4 ±1.7;t =27.12,P<0.01).The severity of pressure ulcers was related to moisture, activity, mobility and friction and shear (P<0.01).Conclusions Risk assessment as well as prevention should start early in the hospitalization in order to improve the life quality of patients.

Objective To retrieve,evaluate and summarize the best evidence from home and abroad on the management of enteral nutrition complicating gastric retention in critically ill patients,and to provide a reference basis for clinical nursing staff to manage enteral nutrition complicating gastric retention in critically ill patients.Methods We searched websites and databases,including UpToDate,BMJ Best Practice,National Institute for Health and Clinical Excellence,Guidelines International Network,Registered Nurses Association of Ontario,Scottish Intercollegiate Guidelines Network,JBI,World Health Organization,Yimaitong guide network,Cochrane Library,PubMed,Embase,Web of Science,Sinomed,CNKI,Nutrition Society website,CINAHL(EBSCO),Wanfang Database,and collected relevant clinical decisions,guidelines,evidence summaries,expert consensuses and systematic reviews.2 researchers independently assessed methodological quality of included papers and extracted data.Results A total of 18 publications were included,including 3 guidelines,4 expert consensuses,4 systematic reviews,5 randomized controlled trials,1 quasi-experimental study,and 1 best evidence summary.18 pieces of the best evidence were summarized in 5 areas,including identification of gastric retention,management of enteral nutrition,management of monitoring,management of threshold determination,and management of treatment.Conclusion This study provides evidence-based evidence for nursing staff to manage enteral nutrition in critically ill patients with concomitant gastric retention,which can help reduce the incidence of gastric retention in critically ill patients.

Chimeric antigen receptor (CAR)-modified T-cell therapy has achieved remarkable success in the treatment of acute lymphoblastic leukemia (ALL). Measurable/minimal residual disease (MRD) monitoring plays a significant role in the prognostication and management of patients undergoing CAR-T-cell therapy. Common MRD detection methods include flow cytometry (FCM), polymerase chain reaction (PCR), and next-generation sequencing (NGS), and each method has advantages and limitations. It has been well documented that MRD positivity predicts a poor prognosis and even disease relapse. Thus, how to perform prognostic evaluations, stratify risk based on MRD status, and apply MRD monitoring to guide individual therapeutic decisions have important implications in clinical practice. This review assesses the common and novel MRD assessment methods. In addition, we emphasize the critical role of MRD as a prognostic biomarker and summarize the latest studies regarding MRD-directed combination therapy with CAR-T-cell therapy and allogeneic hematopoietic stem cell transplantation (allo-HSCT), as well as other therapeutic strategies to improve treatment effect. Furthermore, this review discusses current challenges and strategies for MRD detection in the setting of disease relapse after targeted therapy.

Objective: To investigate the clinical significance of minimal residual disease (MRD) monitoring by using WT1 gene and flow cytometry (FCM) in patients with myelodysplastic syndrome (MDS) who receiving allogeneic stem cell transplantation (allo-HSCT). Methods: WT1 gene and MDS-related abnormal immunophenotype were examined by real-time quantitative polymerase chain reaction (RQ-PCR) and FCM, respectively. The bone marrow samples were collected from patients with MDS who received allo-HSCT from Feb, 2011 to Oct, 2015 in Peking University People’s Hospital before and after transplantation. Results: Among 92 MDS patients, 40 (48.2%) patients were positive for WT1 (WT1⁺) and 9 (10.8%) patients were positive for flow cytometry (FCM⁺). 27 patients (29.3%) met the criteria of our combinative standard, MRDco (MRDco⁺). Only FCM⁺ post-transplant (P<0.001) and MRDco⁺ (P=0.017) were associated with relapse. The cumulative incidence of relapse (CIR) at 2 years were 66.7% and 1.2% (P<0.001) in FCM⁺ and FCM^- groups. MRDco⁺ group had a 2-year CIR of 23.0% while MRDco^- group had a 2-year CIR of 1.6% (P=0.004). The specificity of post-transplant WT1, FCM and MRDco to predict relapse was 59.0%, 96.4% and 74.7%, respectively. The sensitivity of these three MRD parameters to predict relapse was 66.7%. Conclusion Post-transplant FCM and MRDco are useful tools to monitor MRD for MDS after transplantation. The preemptive intervention based on MRDco is able to reduce the relapse rate.

Objective: To investigate the clinical significance of monitoring ETV6-RUNX1 fusion gene in children with acute lymphoblastic leukemia (ALL) after allogeneic stem cell transplantation (allo-HSCT) . Methods: Clinical data of 13 children received allo-HSCT in Peking University Institute of Hematology from May 2009 to March 2016 were retrospectively collected. The ETV6-RUNX1 gene was examined by real-time quantitative polymerase chain reaction (RQ-PCR) . The correlation between its expression level and the disease status was analyzed. Results: Of 13 enrolled ALL cases, the ETV6-RUNX1 expression of 7 patients converted to positive after transplant at a median time of 137 days (range, 28-270 days) . The expression level of the first positive sample was 0.034% (range, 0.004%-0.061%) . The duration from ETV6-RUNX1 positive to hematological relapse was 196 days (range, 28-666 days) . Four patients experienced relapse at a median time of 294 days (range, 104-803 days) after allo-HSCT. The ETV6-RUNX1 expression converted to positive prior to MRD. Patients with positive ETV6-RUNX1 gene expression pre-transplantation would be more likely to relapse. Conclusion Monitoring ETV6-RUNX1 by RQ-PCR could be used to evaluate MRD status after allo-HSCT. Patients with positive ETV6-RUNX1 after transplant had a poor prognosis.

Objective: To investigate the clinical significance of PCR detection of human herpesvirus 6 (HHV6) in gastro biopsy on the course of diarrhea in patients with severe diarrhea after allogeneic hematopoietic stem cell transplantation (HSCT) . Methods: Data from a cohort of 45 HSCT recipients (including age, sex, transplantation conditions, graft-versus-host disease, treatments, clinical signs, outcome, HHV6, and other infections) performed between 2015 and 2016 were collected. Univariate analysis was used to evaluate influences between the different parameters. Results: Of the 45 enrolled recipients, 21 patients (46.7%) presented HHV6 positive in gastro-biopsy during the analyzed period. The incidence of CMV viremia in the positive HHV6 group was comparable with that in the negative HHV6 group. But the incidence of EBV viremia in the positive HHV6 group was significantly higher than in the negative HHV6 group (P=0.028) . 44 out of 45 patients with severe diarrhea were given antiviral treatment with foscarnet and/or ganciclovir, the latter didn’t influence the course of the diarrhea. Conclusions Positive PCR results in GI tract samples didn’t necessarily reflect reactivation of HHV6. Further studies are needed to define the significance of HHV6 for GI tract symptoms after allo-HSCT.