Objective:To assess the efficacy and safety of azacitidine combined with lenalidomide in MDS patients and explore potential mechanisms of therapeutic response.Methods:Sixteen MDS patients with TP53 mutations received azacitidine plus lenalidomide at ZhongDa Hospital, Southeast University (January 2021–June 2025). Efficacy and safety were assessed, and TP53 mutation status was correlated with treatment response. Whole-transcriptome sequencing and bioinformatics were used to explore molecular biomarkers associated with therapeutic efficacy.Results:Sixteen patients (median age 69.5 years, range 52–82; 8 males, 8 females) were enrolled. According to the Molecular International Prognostic Scoring System (IPSS-M), 1, 2, and 13 patients were classified as median low, high, and very high risk, respectively. Among 16 TP53-mutated patients, 11 had biallelic mutations and 5 had monoallelic mutations. Overall response rate was 56.3% (9/16), composite complete remission rate (CRc) was 31.3% (5/16), and hematology improvement rate was 25% (4/16). Among TP53-mutated patients, the response rate was 56.3% (9/16), with variant allele frequency dropping from 65.6% to 16.5% in responders ( P=0.017). In patients with TP53 mutations and complex karyotype, response rate was 53.8% (7/13), with 57.1% (4/7) showing disappearance of CK post-treatment. The most common grade 3–4 nonhematologic adverse events were infections (9/16, 56.3% ), including pneumonia (4/16, 25.0% ), gastrointestinal infections (3/16, 18.8% ), perianal infections (1/16, 6.3% ) and sepsis (1/16, 6.3% ). High CBX8 expression may be linked to treatment response. Conclusion:Azacitidine plus lenalidomide is an effective and safe therapy for MDS, including patients with TP53 mutations and complex karyotypes. Treatment markedly reduces TP53 variant allele frequency in responders, and high CBX8 expression may predict therapeutic response.

Objective:To assess the efficacy and safety of azacitidine combined with lenalidomide in MDS patients and explore potential mechanisms of therapeutic response.Methods:Sixteen MDS patients with TP53 mutations received azacitidine plus lenalidomide at ZhongDa Hospital, Southeast University (January 2021–June 2025). Efficacy and safety were assessed, and TP53 mutation status was correlated with treatment response. Whole-transcriptome sequencing and bioinformatics were used to explore molecular biomarkers associated with therapeutic efficacy.Results:Sixteen patients (median age 69.5 years, range 52–82; 8 males, 8 females) were enrolled. According to the Molecular International Prognostic Scoring System (IPSS-M), 1, 2, and 13 patients were classified as median low, high, and very high risk, respectively. Among 16 TP53-mutated patients, 11 had biallelic mutations and 5 had monoallelic mutations. Overall response rate was 56.3% (9/16), composite complete remission rate (CRc) was 31.3% (5/16), and hematology improvement rate was 25% (4/16). Among TP53-mutated patients, the response rate was 56.3% (9/16), with variant allele frequency dropping from 65.6% to 16.5% in responders ( P=0.017). In patients with TP53 mutations and complex karyotype, response rate was 53.8% (7/13), with 57.1% (4/7) showing disappearance of CK post-treatment. The most common grade 3–4 nonhematologic adverse events were infections (9/16, 56.3% ), including pneumonia (4/16, 25.0% ), gastrointestinal infections (3/16, 18.8% ), perianal infections (1/16, 6.3% ) and sepsis (1/16, 6.3% ). High CBX8 expression may be linked to treatment response. Conclusion:Azacitidine plus lenalidomide is an effective and safe therapy for MDS, including patients with TP53 mutations and complex karyotypes. Treatment markedly reduces TP53 variant allele frequency in responders, and high CBX8 expression may predict therapeutic response.

Objective:To evaluate the quality of critical patient handover practice between emergency room and intensive care unit (ICU) nurses, and to provide a basis for structured handover process.Methods:From March to July 2023, a total of 223 pairs of nurses in emergency room and ICU (including EICU) of 5 Class 3 Grade A general hospitals in Suzhou were selected as the research objects by using cross-sectional survey method and convenience sampling method. Self-designed general information questionnaire and Patient Handover Practice Quality Scale were used to investigate the included 223 pairs of nurses in emergency room and ICU on the current situation of handover time and quality.Results:A total of 211 pairs of nurses were included, including 286 females (67.8%) and 136 males (32.2%). The average age of emergency department nurses was (27.31 ± 2.17) years old, and ICU nurses was (26.96 ± 3.04) years old. The total scores of the patient handover practice Quality Scale for nurses in the emergency room and ICU were (45.25 ± 6.26) and (43.55 ± 7.19) points respectively, and the scores of the information transmission dimension were (20.47 ± 5.43) and (17.66 ± 3.45) points. The scores of common understanding dimension were (7.59 ± 2.31) and (8.58 ± 2.46) points. The scores of work atmosphere dimension were (7.93 ± 2.11) and (8.39 ± 2.29) points. The scores of handover situation dimension were (5.33 ± 1.30) and (5.70 ± 1.53) points, and the differences were statistically significant ( t values were - 6.35-4.22, all P<0.05). There were statistically significant differences in the scores of handover practice quality between emergency room nurses and ICU nurses according to specialization, education background, working years and job category ( t values were - 4.91-2.56, all P<0.05). Conclusions:Emergency room nurses and ICU nurses have different requirements and expectations for handover procedures, so it is necessary to build a structured handover practice framework and carry out personalized handover practice training, in order to achieve the consistency of handover content and improve the quality of critical patients handover practice.

Brachytherapy ; Carcinoma, Hepatocellular/drug therapy* ; Chemoembolization, Therapeutic ; Combined Modality Therapy ; Humans ; Iodine Radioisotopes ; Liver Neoplasms/drug therapy* ; Portal Vein ; Retrospective Studies ; Sorafenib/therapeutic use* ; Thrombosis ; Treatment Outcome

Objective: To synthesize a folic acid (FA)-modified pH-sensitive nanomicelle containing sorafenib (SF) and superparamagnetic iron oxide (SPIO), and to access its visibility in MRI and anti-cancer efficacy on hepatocellular carcinoma (HCC) in vitro. Methods: The copolymer FA-PEG-Pasp (DBA/DIP) of FA, poly(ethylene glycol), N,N-dibutylethylenediamine and N,N-diisopropylethylenediamine grafted poly (L-aspartic acid) were prepared. SF and SPIO were encapsulated inside the copolymer to synthesize the targeting micelle FA-PEG-PAsp (DBA/DIP)-SPIO/SF (FPASS). The folate-free micelle[PEG-PAsp (DBA/DIP)-SPIO/SF (PASS)] was used as nontargeting micelle. The physicochemical properties and drug release behavior of the micelles were analyzed. MRI of HepG2 cells incubated with FPASS and PASS with different Fe concentrations and Prussian blue staining of cells treated with the micelles (Fe concentration of 20 μg/ml) was performed to assess the drug delivery capability and imaging function of the micelles. For the FA competitive inhibition assay in these experiments, HepG2 cells were pre-treated with an excess amount of free FA prior to the incubation with FPASS. Cell viability, cell apoptosis, cell cycle and tube formation assays were conducted for evaluating the anti-HCC effects of the micelles. Comparison between groups was analyzed by one-way ANOVA, and multiple comparisons correction was performed by LSD test. Results: The diameters of FPASS and PASS were (102.3±5.2) nm and (107.1±5.7) nm, respectively; the δ potentials of them were (29.7±1.6) mV and (31.5±1.4) mV, respectively. The T₂ relaxivity of both the micelles was (5.2±0.4) ml·μg^-1·s^-1, which was much higher than that of water soluble Fe₃O₄ nanoparticles [(2.3±0.1) ml·μg^-1·s^-1; F=76.45, P<0.01]. SF released from the micelles was much faster at pH5.0 than at pH7.4, which indicated that the micelles had a pH-triggered drug release behavior. MRI of HepG2 cell samples revealed the signal intensity on T₂WI images and the T₂ value on T₂-map images decreased with the increasing Fe concentrations in the micelles. At the same Fe concentration (5, 10, 20 and 40 μg/ml), the cells of FPASS group exhibited a more significant decrease in T₂ signal intensity and T₂ value compared with those of PASS group or FA competitive inhibition group (F=8.69, 14.03, 27.27, 32.25 and 19.80, 45.76, 113.20, 66.80; P<0.01). Prussian blue staining verified the existing of SPIO in the cytoplasm of cells. Compared with PASS, FPASS presented significantly higher anticancer effects on inducing apoptosis, causing G0/G1 phase arrest on HepG2 cells and inhibiting tube formation on human umbilical vein endothelial cells (t=7.905, 4.399 and 3.454, respectively; P<0.01). Conclusions The pH-sensitive nanomicelle FPASS was successfully constructed. This micelle possessed a hypersensitive MRI-visible function and a targeting SF delivery capability which may contribute to a significant anti-HCC effect.

Objective The study was to investigate the effect of psychological intervention on emotion and long-term effect of patients with nasopharyngeal cancer treated with radiotherapy. Methods A total of 100 patients with nasopharyngeal cancer were divided into the psychological intervention group and the control group with 50 cases in each. The patients in the psychological intervention group were given psychological intervention besides receiving radiotherapy and routine nursing which were similar to the control group. Anxiety score and depression score as well as survival rates before and after radiotherapy between two groups were compared. Results There was no difference in anxiety score and depression score between two groups before radiotherapy, but after radiotherapy, the anxiety score and depression score were more remarkably reduced in the psychological intervention group than in the control group. The 1, 3, 5-year overall survival rates were 100.0%, 94.0%, 85.9% respectively in the psychological intervention group, and were 96.0%, 85.6%, 70.7% respectively in the control group. Duration from the end of radiotherapy to relapse were (32.22±16.82) months in th psychological intervention group and (20.73±13.06) months in the control group. Conclusions Psychological intervention can improve anxiety and depression and shows a tendency to defer the occurrence of relapse and to improve the survival rate in patients with nasopharyngeal cancer treated with radiotherapy. The further research need to be done.