A 53-year-old female patient with stage Ⅳa colon cancer received 7 cycles of standard chemotherapy regimen. Due to the progression of the condition, she was treated with fruquintinib (5 mg once daily orally on day 1-21, 28 days as one cycle). After 20 days of treatments, the patient experienced sudden consciousness disorders, accompanied by limb convulsions. Her blood pressure was 200/150 mmHg, with urinary protein (+++). Enhanced MRI showed multiple cortical and subcortical abnormal signals in the bilateral frontal, temporal, parietal, and occipital lobes. Reversible posterior leukoencephalopathy syndrome caused by fruquintinib was considered. Then the drug was discontinued. After 2 days of symptomatic treatments such as oxygen therapy, blood pressure reduction, sedation, and antiepileptic therapy, the patient′s consciousness was improved, no limb convulsions occurred and her blood pressure was 130/80 mmHg. After 8 days of treatments, the patient′s condition stabilized and fruquintinib was given again after reducing the dosage. At an one month follow-up, MRI enhancement showed no significant abnormalities.

A 53-year-old female patient with stage Ⅳa colon cancer received 7 cycles of standard chemotherapy regimen. Due to the progression of the condition, she was treated with fruquintinib (5 mg once daily orally on day 1-21, 28 days as one cycle). After 20 days of treatments, the patient experienced sudden consciousness disorders, accompanied by limb convulsions. Her blood pressure was 200/150 mmHg, with urinary protein (+++). Enhanced MRI showed multiple cortical and subcortical abnormal signals in the bilateral frontal, temporal, parietal, and occipital lobes. Reversible posterior leukoencephalopathy syndrome caused by fruquintinib was considered. Then the drug was discontinued. After 2 days of symptomatic treatments such as oxygen therapy, blood pressure reduction, sedation, and antiepileptic therapy, the patient′s consciousness was improved, no limb convulsions occurred and her blood pressure was 130/80 mmHg. After 8 days of treatments, the patient′s condition stabilized and fruquintinib was given again after reducing the dosage. At an one month follow-up, MRI enhancement showed no significant abnormalities.

Objective To explore the relationship among psychological flexibility,coping style and job burnout of nurses.Methods A total of 694 nurses from one district level grade A tertiary general hospital in Yunnan were assessed using acceptance and action questionnaire 2nd edition (AAQ-Ⅱ),simplified coping style questionnaire (SCSQ) and nursing burnout scale (NBS).The relationship among psychological flexibility,coping style and job burnout of nurses was analyzed using structural equation model and Bootstrap test.Results (1) Correlation analysis showed that the total scores of AAQ-Ⅱ (21.81 ± 8.23),job burnout (22.71 ± 6.60) and its three dimensions including emotional exhaustion (8.93 ± 2.87),depersonalization (6.64±2.30)as well as reduced personal accomplishment(7.14±2.52) were positively correlated with negative coping dimension of coping style (10.86±4.99) (r=0.324-0.510,all P＜0.01),while negatively correlated with positive coping dimension(26.44±5.86) (r=-0.102--0.143,all P＜0.01).(2) Structural equation model analysis showed that positive and negative coping dimension had partial mediating effects on the relationship between psychological flexibility and job burnout (x2/df=2.30,GFI =0.91,AGFI =0.90,NFI=0.90,IFI=0.93,TLI=0.92,CFI=0.93,RMSEA=0.04).(3) Bootstrap test showed that the mediating effect sizes for positive and negative coping were 3.8％ and 8.9％ respectively and totally mediating effect size of coping style was 12.7％.Psychological flexibility had much larger effects on job burnout,and the direct effect size was 87.3％.Conclusion Coping style plays a mediating role in the relationship between psychological flexibility and job burnout,but its effect is less important.Psychological flexibility plays a major role and more directly influences on job burnout.

Ramie and kenaf were traditional fiber crops in China, but their stalk after decorticating has not been used effectively. The stalk contains a lot of cellulose, and can therefore be used for the production of bioethanol. We studied the effects of different chemical pretreatment on enzymatic digestibility of ramie stalk and kenaf stalk. Ramie and kenaf stalks pretreated with alkali were chosen to produce ethanol using quasi-simultaneous saccharification and fermentation (Q-SSF) process. The results show that for the stalks pretreated with 4% NaOH and 0.02% anthraquinone-2-sulfonic acid sodium salt (AQSS) as catalyzer at 170 degrees C for 1 h, the ethanol concentration could reach 51 g/L after fermentation for 168 h at 18% of solid substrate concentration. By fed-batch to 20% of solid substrate concentration, the ethanol concentration could reach 63 g/L, 77% and 79% of the cellulose conversion could get for ramie stalk and kenaf stalk, respectively. For kenaf stalk pretreated with 5.2% NaHSO3 and 0.2% H2SO4 at 170 degrees C for 1 h, the ethanol concentration and cellulose conversion could reach to 65 g/L and 72%, respectively.
Alkalies ; Biofuels ; Biotransformation ; Boehmeria ; Cellulose ; China ; Ethanol ; chemistry ; Fermentation ; Hibiscus ; Hydrolysis ; Plant Stems ; chemistry