Objectives To investigate the inlfuence of polymorphisms of SLC19A1 80G>A, MDR1 exon26C>T and MDR1 exon21G>T/A on curative effect and adverse reaction of high-dose methotrexate in patients with acute lymphoblastic leukemia. Methods MALDI-TOF-MS technique was used to detect the polymorphisms of SLC19A1 80G>A, MDR1 exon 26C>T and MDR1 exon21G>T/A in 108 patients with acute lymphoblastic leukemia (ALL). The relationship of genetic polymorphism, survival rate and toxicity was analyzed. Results The 36-month event-free survival was not related to any polymorphisms of MDR1 and SLC19A1. Patients with mutant types of MDR1 exon26C>T and MDR1 exon21G>T/A showed a much higher MTX plasma levels at 24 hours and higher incidence of hepatic injury (P<0.05). Conclusions The genetic polymorphism of MDR1 exon26>T, MDR1 exon21G>T/A has a large inlfuence on hepatic toxicity and plasma concentra-tions of MTX.

Objective:To systematically evaluate the efficacy of repetitive transcranial magnetic stimulation (rTMS) or transcranial direct current stimulation (tDCS) in dysphagia after stroke.Methods:Six Chinese or English databases, including PubMed, Web of Science, Embase, CNKI, Wanfang and VIP, were searched by computer for randomized controlled trials of dysphagia after stroke with rTMS or tDCS (experimental group) from database construction to May 2023; those received conventional treatment+sham stimulation or conventional treatment only were enrolled as control group. Effective data were screened and extracted after literature quality evaluation by Cochrane. The outcome indexes included scores of penetration-aspiration scale (PAS), fiberoptic endoscopic dysphagia severity scale (FEDSS) and functional oral intake scale (FOIS). Reviewer Manager 5.4 software was used for Meta analysis of the extracted data, and mean difference ( MD) or standardized mean difference ( SMD) were used as effect indexes. Results:Twelve articles were finally included in the research literature, involving 637 subjects. Meta-analysis indicated that compared with the control group, the experimental group had significantly decreased PAS scores ( MD=-0.740, 95% CI: -1.020--0.460, P<0.001); FOIS scores in the experimental group were significantly increased compared with those in the control group ( MD=0.680, 95% CI: 0.220-1.130, P=0.003); FEDSS scores in the experimental group were significantly decreased compared with those in the control group ( SMD=-0.890, 95% CI: -1.110--0.670, P<0.001). Conclusion:The rTMS or tDCS can effectively alleviate dysphagia symptoms after stroke.

Objective: To analyze the research hotspots of domestic narrative nursing and explore its related research trends which provide reference and guidance for its application and development in China. Methods: Wanfang, CNKI, VIP, CBM and other databases were retrieved from inception until October 2018. Word frequency analysis and graph cluster analysis were performed on the main information using Excel, Bicomb, Ucinet, Netdraw and gCLUTO software. Results: A total of 649 articles were included. The result of visual analysis showed that the annual amount of publications showed an upward trend. The articles distributed abroad in many different journals which educational journals account mostly. The study regions were distributed in 34 provinces except Taiwan of China, Hainan, Tibet, and Macao Special Administrative Regions where mainly concentrated on East China and North China. The cooperation among authors and institutions both were not close; A total of 25 high-frequency key words were intercepted,and three hotspots of narrative nursing research in China were obtained,which respectively were: (1) The application of narrative medicine and the cultivation of narrative ability; (2) The application research of narrative therapy in humanistic care; (3) The application of narrative nursing in nursing practice. Conclusions Narrative nursing has attracted the attention of domestic scholars, but the depth and breadth of research still need to be improved. It is necessary to strengthen cooperation between inter-regional institutions, individuals and scientific research groups and pay attention to research hotspots in this field. Also,there is a need to conduct more high quality studies to verify the significance of narrative nursing.