Objective To analyze the relationship between clinical competence of baccalaureate nursing students and its potential related factors,and investigate the results of curriculum reform of 4-year nursing undergraduate education.Methods The records of 263 baccalaureate nursing graduates were retrieved.Variables including age,years of college education,sex,college entrance examination scores,average scores of basic courses,average scores of public courses and average scores of professional courses were collected.Clinical competence was measured by the clinical practice tests at various clinical units.The linear regression analysis was performed to find out the influencing factors of clinical competence.Results The clinical competence was significantly related to sex,average scores of public courses and average scores of professional courses(P

Objective: To explore the effectiveness and feasibility of social cognitive and interactive training (SCIT) in rehabilitation of schizophrenic patients, and propose to establish a new mode of community rehabilitation. Methods: A total of 60 patients with schizophrenia managed in the community in Shanghai Hongkou District were divided into control group and intervention group with 30 cases in each group. The control group was treated with conventional community management. The intervention group accepted SCIT courses at the base of conventional community management. Before and after the intervention, all patients completed the related scales for schizophrenia. Scale scores were analyzed with analysis of variance by SPSS 22.0 to explore the rehabilitation effect of training. Results: In intervention group, the time used in the face emotion identification task (FEIT) had no significant difference with the control group, but the correct rate for FEIT increased significantly. In intervention group, ambiguous intentions hostility questionnaire-ambiguous items (AIHQ-A) scores were significantly lower. The total and sub scale scores of positive and negative syndrome scale (PANSS) and scale for assessment of negative symptoms (SANS), Calgary depression scale for schizophrenia (CDSS) scores were significantly decreased in intervention group. Otherwise, Toronto alexithymia scale (TAS) scores also decreased. Personal and social performance scale (PSP) scores in the SCIT group were increased after training. Finally, according to the training participation and the feedback of the patients, the training had a higher degree of acceptance and positive affirmation. Conclusion: SCIT can improve the social cognition and social function of schizophrenic patients in the community, also improve the mental symptoms, especially the negative symptoms and depressive symptoms, and has high feasibility and acceptability, so it can be promoted in community-based rehabilitation.

OBJECTIVETo observe the pregnancy outcome among patients with chronic myelogenous leukemia (CML) treated with tyrosine kinase inhibitors (TKIs).

METHODSData associated with pregnancy, delivery and neonate from the patients or patient's spouse who conceived while receiving TKIs were collected retrospectively.

RESULTSTwo young female patients (who had been on imatinib therapy for 90 and 91 months, respectively) and spouses of 10 male patients (involving 7 patients who had received imatinib for a median of 60 months and 3 who had received dasatinib for 2.5 months to 7 months, respectively) with median age of 33.5 years (range 26 - 46 years) conceived and gave birth to 12 babies. One woman took imatinib throughout her pregnancy except one month. The other one took imatinib throughout her pregnancy and had breast-fed while on imatinib therapy for nearly half a year postpartum. Among the 12 babies, one was born prematurely with low birth weight and hypospadias (surgical repair after birth), the others were all healthy with no congenital defects. The median age of the children at the date of this report is 17.5 months (range 3 to 101 months), and they all have a normal pattern of growth and development.

CONCLUSIONSConception among patients with CML while receiving TKIs may result in normal pregnancies. The possible effects of TKIs on birth abnormalities cannot be ruled out. It is recommended that childbearing female patients should be advised to practice adequate methods of contraception and should not breast-feed while on TKIs therapy. In cases of accidental pregnancy, risk/benefit evaluations must be carried out carefully on an individual basis. No special precautions apply for male patients being treated with imatinib.

Adult ; Antineoplastic Agents ; therapeutic use ; Benzamides ; Dasatinib ; Female ; Humans ; Imatinib Mesylate ; Infant ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; drug therapy ; Male ; Middle Aged ; Piperazines ; therapeutic use ; Pregnancy ; Pregnancy Outcome ; Protein Kinase Inhibitors ; therapeutic use ; Protein-Tyrosine Kinases ; antagonists & inhibitors ; Pyrimidines ; therapeutic use ; Retrospective Studies ; Thiazoles ; therapeutic use ; Treatment Outcome

The isolate GN52 of Riemerrella anatipestifer was passaged on the Martin Medium successively according to the optimum condition. The experiments included Gram staining, biochemical test, drug sensitivity test and animal experiments were carried out on the bacteria of 3rd, 11th, 21st, 31st, 41st, 51st and 61st generations. It indicated that the bacterial morphs, biochemical character, drug resistance of the strain had no obvious change, but the virulence showed a trend of reduction.

Coronary Sinus ; abnormalities ; Humans ; Male ; Middle Aged ; Subclavian Vein ; Vena Cava, Superior

OBJECTIVESTo evaluate the efficacy and safety of imatinib mesylate (imatinib) for patients with Philadelphia chromosome-positive (Ph+ ) chronic myeloid leukemia (CML) in accelerated and blastic phase.

METHODSSeventy-five Ph+ CML patients in accelerated phase and 49 in blastic phase were treated with 400 mg or 600 mg of imatinib once daily.

RESULTSFor patients in accelerated phase, the cumulative hematological response (HR) rate was 93.3%, including complete HR (CHR) rate 85.3%, and returning to chronic phase (RCP) rate 8% in a median follow-up of 23.0 (1.0 -64.0 ) months. Cumulative major cytogenetic response (MCyR) rate was 33.0%, and complete cytogenetic response (CCyR) rate 28.0%. For patients with CCyR, the major molecular response (MMoR) rate was 47.6%. The estimated 4-year progression-free survival (PFS) rate and overall survival (OS) rate were 48.2% and 52.2% in patients with HR, respectively. Severe leukocytopenia, anemia and thrombocytopenia occurred in 37.3%, 34.6% and 45.3% of all patients, respectively. For patients in blastic phase, the cumulative HR rate was 63.3%, including CHR rate 44.9%, and RCP rate 18.4% in a median follow-up of 4.5 (0.3 -63.0) months. Cumulative MCyR rate and CCyR rate were both 12.2%. For patients with CCyR, the MMoR rate was 33.3%. For patients with HR, the estimated 1-year/2-year PFS and OS rates were 32.8%/15.8% and 46.0%/ 21.0% respectively. Severe leukocytopenia, anemia and thrombocytopenia occurred in 75.5%, 71.4% and 73.5% of all patients, respectively.

CONCLUSIONSThe efficiency of imatinib was decreasing, and severer hematological toxicities increasing with the disease progressing in patients with Ph+ CML. Imatinib improves progression-free survival significantly in most patients in accelerated phase, particularly in those with continuous CCyR or MMoR. The response duration in majority of blastic phase patients is short, and the relapse rate is high.

Adult ; Aged ; Antineoplastic Agents ; therapeutic use ; Benzamides ; Blast Crisis ; drug therapy ; Female ; Follow-Up Studies ; Humans ; Imatinib Mesylate ; Leukemia, Myeloid, Accelerated Phase ; drug therapy ; Male ; Middle Aged ; Piperazines ; therapeutic use ; Prognosis ; Pyrimidines ; therapeutic use ; Treatment Outcome

Objective: To investigate the characteristic and prognostic significance of leukemia stem cells associated antigens expressions including CD34, CD38, CD123, CD96 and TIM-3 in t (8;21) AML. Methods: Bone marrow samples of 47 t (8;21) AML patients were collected at diagnosis from October 2015 to April 2018 in Peking University Peoples' Hospital, then flow cytometry method was performed to detect the expression frequencies of CD34, CD38, CD123, CD96 and TIM-3 to analyze the relationship between leukemia stem cells associated antigens expressions and relapse. Results: Of 47 t (8;21) AML patients tested, the median percentages of CD34(+)CD38(-), CD34(+) CD38(-)CD123(+), CD34(+)CD38(-) CD96(+) and CD34(+) CD38(-) TIM-3(+) cells among nucleated cells were 2.37%, 0.24%, 0.27% and 0.06%, respectively. All the frequencies of CD34(+)CD38(-), CD34(+)CD38(-)CD123(+), CD34(+)CD38(-)CD96(+) and CD34(+) CD38(-)TIM-3(+) cells had no impact on the achievement of CR after the first course of induction. All higher frequencies of CD34(+)CD38(-), CD34(+)CD38(-)CD123(+), CD34(+)CD38(-)CD96(+) cells were related to higher 2-year CIR rate. Whereas, the frequency of CD34(+) CD38(-) TIM-3(+) cells had no impact on CIR rate. Both high frequency of CD34(+) CD38(-) cells and the high level of minimal residual diseases (patients with <3-log reduction in the RUNX1-RUNX1T1 transcript level after the second consolidation therapy) were independent poor prognostic factors of CIR[P=0.025, HR=6.9 (95%CI 1.3-37.4) ; P=0.031, HR=11.1 (95%CI 1.2-99.2) ]. Conclusion: Different leukemia stem cells associated antigens had distinct prognostic significance in t (8;21) AML. High frequencies of CD34(+) CD38(-), CD34(+) CD38(-) CD123(+) and CD34(+)CD38(-)CD96(+) cells at diagnosis predicted relapse in patients with t (8;21) AML.
ADP-ribosyl Cyclase 1 ; Antigens, CD ; Flow Cytometry ; Humans ; Interleukin-3 Receptor alpha Subunit ; Leukemia, Myeloid, Acute ; Neoplastic Stem Cells ; Prognosis ; Stem Cells

OBJECTIVETo characterize molecular and cytogenetic abnormalities in six 46, XX males, and to investigate the clinical manifestations and underlying mechanisms in such patients.

METHODSClinical data of six XX male patients were collected. Karyotyping, multiple polymerase chain reaction (PCR) and fluorescence in situ hybridization (FISH) were utilized to detect and locate the sex determining region (SRY) gene.

RESULTSPCR and FISH showed that all patients were SRY-positive XX males. All patients have their SRY gene located at the tip of derivative X chromosomes, which have resulted from translocation between short arms of X and Y chromosomes. High resolution karyotyping at 550-750 band level has revealed that the translocation breakpoints were at Xp22.33 and Yp11.2 in three patients. In the remaining patients, the breakpoints were either at Xp22.32 and Yp11.31 or Xp22.31 and Yp11.2. The breakpoints at Xp22.32, Xp22.31 and Yp11.31 were rarely reported. Genotype-phenotype correlation analysis indicated that the clinical manifestations were age-specific. Four adult patients have come to clinical attention due to infertility, with typical features including azoospermia and testis dysgenesis, whereas poorly developed secondary sexual characteristics and short stature were main complaints of adolescence patients, and short stature was the sole symptom in a child patient.

CONCLUSIONCombined karyotyping, PCR and FISH are important for the analysis of XX males. Particularly, high resolution karyotyping is valuable for the refinement of chromosome breakpoints and detailed analysis of genotype-phenotype correlation.

46, XX Disorders of Sex Development ; genetics ; Adolescent ; Adult ; Child, Preschool ; Chromosomes, Human, X ; Chromosomes, Human, Y ; Genetic Association Studies ; methods ; Humans ; Karyotyping ; methods ; Male ; Sex Chromosome Aberrations ; Translocation, Genetic ; Young Adult

In order to explored the change of PML/PML-RARalpha protein during tetraarsenic tetrasulfide (As4S4) treatment, acute promyelocytic leukemia (APL) cells from a group of newly diagnosed APL patients were examined by indirect immunofluorescence staining with anit-PML monoclonal antibody. The results showed that all samples typically presented many microspeckle signals throughout the nucleus before treatment. The redistribution occurred as early as on the second day after As4S4 treatment, which revealed loss of microspeckles with the presentation of a few large speckles. Anti-PML staining also emerged in the perinuclear cytoplasm. At last, microspeckles and large speckles all disappeared. When the therapy was combining all-trans-retinoic acid (ATRA) with As4S4, similar results were obtained. However, APL cells from patients treated with ATRA alone performed totally different appearance, presenting microspeckles and large speckles at the same time, followed with entirely large speckles. The conclusion is that As4S4 makes redistribution of PML/PML-RARalpha protein in leukemic cells from APL patients during the treatment, which is quite different from that during the treatment of ATRA.
Adolescent ; Adult ; Aged ; Antineoplastic Agents ; therapeutic use ; Arsenicals ; therapeutic use ; Female ; Fluorescent Antibody Technique, Indirect ; Humans ; In Situ Nick-End Labeling ; Leukemia, Promyelocytic, Acute ; drug therapy ; metabolism ; Male ; Middle Aged ; Neoplasm Proteins ; analysis ; Nuclear Proteins ; Oncogene Proteins, Fusion ; analysis ; Promyelocytic Leukemia Protein ; Transcription Factors ; analysis ; Tretinoin ; therapeutic use ; Tumor Suppressor Proteins

·AIM: To Evaluate the effects of different capsulotomy diameters during phacoemulsification on corneal and blood aqueous barrier. ·METHODS: Totally 78 cases (100 eyes) with cataract were treated by femtosecond laser assisted phacoemulsification. The patients were randomly divided into two groups. There were 36 cases (50 eyes) in experimental group, in which the capsulotomy diameter was 4.7mm,and 42 cases(50 eyes) in the control group, in which the capsulotomy diameter was 6. 0mm. Phacoemulsification power and time were recorded for each procedure. Follow-up exams were performed on 1d, 1wk and 2mo after surgery. Preoperative and postoperative best corrected visual acuity, central corneal thickness, aqueous flare, corneal endothelial cell count were assessed for the two groups. · RESULTS: No significant difference was found on preoperative best corrected visual acuity ( BCVA), hardness of the lens nucleus, centrel corneal thickness (CCT) and the effective phaco time and the average phaco power of the two groups(P>0.05). There was also no statistically significant difference on BCVA between the two groups after surgery(P>0.05). The change of central corneal thickness and the aqueous flare cells in the experimental group were less than those in the control group at 1d and 1wk postoperatively (P<0.05), while the difference was not obvious at 2mo after (P>0.05). The rate of lost corneal endothelial cell was significantly lower in the experimental group than the control group at 2mo postoperatively (P>0.05). · CONCLUSION: The phacoemulsification with small capsulotomy diameters decreases the injury to the corneal and blood aqueous barrier. The patients recovered more quickly.