Chimeric antigen receptor T-cell (CAR-T) immunotherapy is a new type of immunotherapy,which has been developed rapidly in recent years.By using gene recombination and transfection techniques,CAR-modified effector T cells that specially recognize tumor-associated antigen was produced,which show better properties of targeting,killing activity and durability than conventional T cells.With the development of translational medicine research,CAR-T technology has experienced four generations of optimization and innovation,and presented a promising clinical efficacy in the treatment of various cancers,especially hematological malignancies.However,there are also potential risks with clinical use of this new technology,such as the off-target effect and cytokine storm.In this review,the progress,side effects,coping strategy,and development prospects of CAR-T in hematological malignancies immunotherapy were discussed.

Objective To compare the different effects of two rehabilitative therapies on cardiac rehabilitation of patients with acute myocardial infarction after interventional program.Methods Eighty AMI patients with no complications after interventional treatment were randomized equally into the observation group and the control group.The patients in the control group were given two-week cardiac rehabilitative training in line with the clinical nursing pathway.Besides the treatment in the control group,those in the observation group were given 10-day cardiac rehabilitative training by optimizing the nursing pathway.The two groups were compared in terms of left ventricular ejection fraction,self-care ability,heart function grading,incidence of complications,hospital stay and hospitalization cost.Results At discharge,The observation group was significantly better than the control group in terms of left ventricular ejection fraction,self-care ability and grading of cardiac function(all P<0.05).In regard to the incidence of complications,there was no statistically significant difference between the groups.Hospital stay in the observation group was obviously shorter than that in the control group and the hospitalization cost significantly less than that in the control group(P<0.01).Conclusion The 10-day cardiac rehabilitation program can promote patients’recovery,shorten the hospital stay and reduce the medical expense.

OBJECTIVE To search for the correlative factors among nurses with leukcopenia who occupationally contacted with chemotherapeutic agents,so as to increase their occupational protecting level.METHODS Totally 1232 nurses who occupationally contacted with chemotherapeutic agents from 24 hospitals were investigated by a stratified sampling method.The factors leading to leukopenia were surveyed and analyzed.RESULTS The leukopeuia was prominently correlated with five factors,namely nurses' protective knowledge,protective manipulation scoring,protective condition,exposure index and kinds of agents.CONCLUSIONS Low occupational protecting level can lead to leukopenia.A supporting system based on the occupational health and safety management must be established to insure the clinical nurses' health level.

Objective To construct evaluation standards for pediatric nursing responsibility. Methods With the method of expert enquiry for Delphi, coefficient of variation of each index through expert grading and Kendall W′s coordination coefficient were used to test the coordination degree in opinions among experts. After the coefficient of larger variation and lower weight were removed , the elements of nursing duty were ranked based on the weight by using hierarchy analysis method. Results The established practical pediatric nurses responsibility evaluation standard consisted of 3 modules, with 11 dimensions and 33 items. The Cr expert authority coefficient was between 0.77~0.90, with an average of 0.88. The variation coefficient of each index was low, ranging between 0.013 0.135 (<0.25). The Kendall W′s coordination coefficients of the primary, secondary and tertiary indicators were 0.482, 0.552 and 0.438, respectively, with significant differences in the coordination coefficient (P<0.001). Conclusion The experts are active and authoritative in participating in the standard establishment and they highly agreed on the standard , which indicates that the established the standard is reliable in a higher degree.

Objective To study the effects of task-oriented training combined with electromyographic biofeedback on wrist and finger extension after stroke.Methods Thirty-eight stroke patients were assigned randomly into either an experimental group (18 cases) or a control group (18 cases).Both groups received routine rehabilitation treatment and electromyographic biofeedback training.In addition,the experimental group was given task-oriented training in wrist and finger extension.Myoelectricity values,the active range of wrist dorsiflexion and the FuglMeyer upper extremity assessment (FMA) were assessed before and after 8 weeks of training.Results All of the patients showed significant improvements after 8 weeks of training,but compared with the controls,the patients in the experimental group improved significantly more in terms of all of the measures.Conclusion Task-oriented training with electromyographic biofeedback can improve upper extremity function,particularly wrist extension,among hemiplegic stroke survivors.

Objective:To investigate the changes and significances of serum cystatin C and transforming growth factor-β1 levels for the neonatal asphyxia.Methods:Forty-six asphyxia newborns were chosen as the asphyxia group,and thirty healthy newborns were selected as the control group.The TGF-β1,CysC,BUN,Scr,and GFR levels of both groups were detected on the 1st,3rd,7th day after hospitalization.According to the renal injury,the 46 newborns were divided into normal group and asphyxia group,and the serum indexes were detected and analyzed.Results:On the 1st,3rd,7th day after hospitalization,the TGF-β1,GFR of asphyxia group was obviously increased and was lower than those of the control group (P＜0.05);the level of CysC,BUN,Scr in both groups were decreased,and the change degree in asphyxia group were higher than that of the control group (P＜0.05);the CysC,BUN,Scr in renal injured group were higher than those of normal group,and TGF-β1,GFR were much lower (P＜0.05).Additionally,TGF-β1 level of renal injured group was negatively correlated to the BUN and Scr,and positively correlated with the GFR (P＜0.05).The level of serum CysC in renal injured group was positively correlated to BUN and Scr and negatively correlated to GFR (P＜0.05).Conclusion:The serum TGF-β1,CysC in asphyxia newborns had significant changes compared with the healthy newborns and was correlated to the renal injured indexes,which had clinical directive significance on the early diagnosis,condition judgment,and prognosis of neonatal asphyxia with renal injury.

Object This experiment was conducted to study the relationship between CFTR gene expression in the intestinal tissues and secretory diarrhea.Methods Twenty-four Kunming mice were selected, half male and half female, and were randomly divided into 3 groups ( n=8 in each group):control group with intraperitoneal injection of 0.2 mL nor-mal saline, and the experimental group of mice by intraperitoneal injection of lipopolysaccharide(LPS) (6 mg/kg· bw). The mental state and intestinal morphology of the mice at 1 h and 8 h after LPS injection were observed to assess whether the secretory diarrhea model was successfully established.The expression of CFTR gene segments of intestine tissue was de-tected by fluorescence quantitative PCR.Results LPS induced secretory diarrhea.CFTR gene was expressed in the mouse duodenum, jejunum, ileum and colon tissues with different expression abundance.It was highest in the colon, but the difference was not significant between intestinal segments.Compared with the control group, LPS up-regulated the tran-scription level of CFTR gene in the duodenum, jejunum and ileum, and down-regulated the transcription of CFTR gene in the colon.Conclusions The results of our study suggest that the changes of the transcriptional level of CFTR gene are closely related with the diarrhea induced by LPS and the effects in different intestinal segments on the diarrhea is different. The jejunum plays a crucial role and the colon plays a least role in the Cl-secretion.

Objective To investigate the effect of ReCell technique on diabetic foot and explore main nursing measures. Methods Forty patients with diabetic foot were divided into control group(n=20)and experiment group(n=20)according to admission time. With wound bed prepared, the control group received only free skin flap grafting and the observation group was managed with ReCell technique plus free skin flap grafting.The skin flap survival and treatment time in two groups were observed and compared. Result The skin flap survival in the experiment group was better than the control group and the treatment time was shorter. Conclusion ReCell technique is effective in raising the survival rate of skin flap in diabetic foot and shortening treatment time.The improvement of nursing measures is critical for the success of ReCell technique.

Objective To observe the different radiosensitivity induced by different doses of 137Csγ-ray irradiation between hematopoietic stem and progenitor cells. Methods Seventy-two C57BL/6 mice were randomly divided into control group and irradiated groups (2, 4 and 6 Csγ-ray irradiation, n=18 for each group). Mice of control group received sham irradiation, and the rest accepted 2, 4 and 6 Gy137Csγtotal body irradiation, respectively. After 14-day, 35-day and 56-day irradiation, the peripheral blood samples were collected by balls enucleation. The number of bone marrow nuclear cells, hematopoietic stem and progenitor cells were counted. Results The peripheral blood of irradiated mice showed significant changes in the number of white blood cells (WBC), red blood cells (RBC), platelets (PLT) and hemoglobin (HGB) in a dose-response relationship. Compared with the control group, the numbers of BMNCs and hematopoietic progenitor cells (HPCs) were significantly lower in irradiated group. At 35 d and 56 d after 6 Gy irradiation the numbers of BMNCs and HPCs were significantly lower than those of control group (P<0.05). There were no significant differences in numbers of BMNCs and HPCs between irradiated groups (2 and 4 Gy) and control group. The number of bone marrow hematopoietic stem cells (HSCs) was significantly lower in irradiated group than that in control group after 14-d and 56-d irradiation (P<0.05). Conclusion 137Csγ-ray irradiation has some damage in mouse hematopoietic system. The damage caused by radiation is persistent to hematopoietic stem cells.

Objective To investigate the level of self-concept on occupation among junior nurses.Methods One hundred and thirty-nine nurses with nursing experience of 1-5 years were involved in the survey by using the Nurses' Self-Concept Questionnaire (NSCQ).Comparisons were done between the groups of nurses with undergraduate education and those with three-year training courses in terms of self-concept and its dimensions.Results The total score of junior nurses on self concept was(5.33±0.77).The score of the nurses with undergraduate education was(5.16±0.88),significantly lower than the score of(5.44±0.71)of the nurses with three-year training courses(P<0.05).Conclusion The nursing administration should attach importance to the self-concept on occupation, instructing specially the nurses with undergraduate education so as to enhance their mental health and their self-identification of nursing as an occupation.