Objective:To explore the prognostic significance of preoperative carcinoembryonic antigen (CEA) in patients with stage Ⅳ colon cancer with simultaneous liver and/or lung metastasis, and establish a predictive model.Methods:Using the SEER database, 5 149 patients diagnosed with colon cancer from 2010 to 2015 were collected based on inclusion and exclusion criteria. They were divided into a CEA positive group and a CEA negative group based on their preoperative CEA status. Based on the different CEA status and metastatic sites, we plotted different survival curves and analyzed the differences using the Log rank method. We used the Cox proportional risk model to analyze the risk factors affecting the prognosis of patients with simultaneous liver and/or lung metastasis in colon cancer, and constructed a column chart based on the results. The area under the receiver operating characteristic (ROC) curve of different variable models was calculated and the model discrimination wasevaluated. By using x-tile software, the optimal cutoff value for individual total scores was selected and risk levels were classified to predict patient prognosis.Results:CEA positive colon cancer patients with liver and/or lung metastasis had a poor prognosis, with a 5-year survival rate of 13.4%. Cox proportional risk analysis showed that CEA positive patients had an increased risk of death compared to negative patients after adjusting for other factors ( HR=1.64). After incorporating the CEA+ X, X (independent risk factors other than CEA), and AJCC T+ N models, the areas under the ROC curve were 0.712, 0.706, and 0.59, respectively. According to the prediction score given in the column chart, the x-tilie selected for the best cutoff score was 262.5, which can be divided into high-risk and low-risk populations. The Log rank test was P<0.05. Conclusions:The preoperative CEA level has important predictive value for the prognosis of stage IV colon cancer patients with simultaneous liver and/or lung metastasis. The survival prediction model and column chart for colorectal cancer patients with liver and/or lung metastasis established based on the Cox proportional risk model are of great significance for patient prognosis evaluation and are conducive to the selection of personalized treatment plans.

Objective:To establish and apply an intelligent nursing system document management system to provide bedside guidance for clinical nurses and standardize clinical nursing services.Methods:The intelligent nursing system document management system was established and successfully applied in clinical practice. Its functions included upload management, intelligent retrieval, cross-specialty sharing, multi-terminal access, reading trace management, individualized document revision reminder and file validity management. The problem of time-consuming file management, file retrieval time, and problem occurrence rate in file management when collecting manual management paper system files and intelligent system management electronic system files was evaluated, and the application effect of the intelligent nursing system file management system was evaluated.Results:The average time taken by the file administrator to collect and recycle documents was (492.68±14.04) min and (195.43±8.12) min. After the system was established, the files could be updated and discarded directly on the computer, which saved the time of collection and collection. The time consumption of the document decreased from (82.72±7.47) s to (44.75±5.28) s, the difference was statistically significant ( t value was 34.242, P<0.01); the average incidence of dysfunction in the ward was 2.78%, and the average rate of inconsistent version was 5.56%. After that, the files were managed uniformly and synchronized, eliminating the lack of files and inconsistent versions; there was no need to print paper documents, which significantly reduced the cost of consumables. Conclusion:Through the establishment and application of the intelligent nursing system document management system, the document management process was rationally optimized, the accuracy and convenience of document use were effectively improved, the manpower and consumables cost of document management were reduced, and the efficiency and quality of document management were improved.

Objective: To explore clinical features and severity of chronic graft- versus- host disease (cGVHD) after chemotherapy plus donor lymphocyte infusion (Chemo-DLI) in a consecutive cohort of acute leukemia patients who were minimal residual disease (MRD) positive after allogeneic hematopoietic stem cell transplantation (allo-HSCT) . Methods: The global scoring system proposed by National Institutes of Health (NIH) Consensus Conference was used to identify the characteristics and severity of cGVHD in patients who MRD positive after Chemo-DLI. Results: 54 (59.3%) patients were diagnosed with cGVHD after Chemo-DLI, with the median time of onset of 70 (13-504) days. There were 6 cases (6.6%) of mild cGVHD, 21 cases (23.1%) of moderate cGVHD and 27 cases (29.7%) of severe cGVHD.The 5-year cumulative incidence of relapse after Chemo-DLI was 61.9% (95%CI 45.3%-78.5%) , 15.1% (95%CI 1.1%-29.1%) , and 26.6% (95%CI 9.2%-44.0%) (χ²=18.901, P<0.001) in non-cGVHD, mild to moderate cGVHD, and severe cGVHD groups, respectively. The 5-year cumulative incidence of relapse after Chemo-DLI was 61.9% (95%CI 45.3%-78.5%) , 19.9% (95%CI 8.1%-31.7%) , and 28.6% (95%CI 0.0%-65.0%) (χ²=18.307, P<0.001) in non-cGVHD, classical cGVHD, and overlap syndrome groups, respectively. cGVHD was not associated with non-relapse morality after Chemo-DLI. Probabilities of 5-year leukemia-free survival (LFS) after Chemo-DLI were 24.0% (95%CI 9.1%-38.9%) , 77.2% (95%CI 60.8%-93.6%) , and 64.9% (95%CI 45.7%-84.1%) (χ²=24.447, P<0.001) in non-cGVHD, mild to moderate cGVHD, and severe cGVHD groups, respectively. Probabilities of 5-year LFS after Chemo-DLI were 24.0% (95%CI 9.1%-38.9%) , 75.5% (95%CI 62.7%-88.3%) , and 42.9% (95%CI 1.8%-84.0%) (χ²=25.665, P<0.001) in non-cGVHD, classical cGVHD, and overlap syndrome groups, respectively. Probabilities of 5-year overall survival (OS) after Chemo-DLI were 50.0% (95%CI 31.1%-68.9%) , 87.9% (95%CI 74.7%-100.0%) , and 71.0% (95%CI 52.0%-90.0%) (χ²=9.517, P=0.009) in non-cGVHD, mild to moderate cGVHD, and severe cGVHD groups, respectively. Probabilities of 5-year OS after Chemo-DLI were 50.0% (95%CI 31.1%-68.9%) , 83.9% (95%CI 72.8%-95.0%) , and 51.4% (95%CI 6.2%-96.6%) (χ²=10.673, P=0.005) in non-cGVHD, classical cGVHD, and overlap syndrome groups, respectively. In multivariate analysis, patients receiving allo-HSCT in first complete remission stage and classical cGVHD after Chemo-DLI were associated with lower relapse risk and better survival. Conclusions These findings highlight the close relation between cGVHD and the graft-versus-leukemia effect in patients who were MRD positive and received Chemo-DLI after allo-HSCT. However, overlap syndrome could not improve the clinical outcomes of these patients.

This article reviews the related concepts of disaster nursing, the status of the development of disaster nursing education at home and abroad, the framework and Enlightenment of disaster nursing knowledge system both at home and abroad, and provides a reference for the formation of standard and unified, universal and professional knowledge system for disaster nursing.

Objective: To investigate the incidence and clinical features to probe the risk factors of hemorrhagic cystitis (HC) in children and adolescents with hematological diseases post haplo-hematopoietic stem cell transplantation (haplo-HSCT) . Methods: Medical records of 62 children and 27 adolescents with hematological diseases treated with haplo-HSCT between 2015 and 2016 were analyzed. Results: Of 89 cases (56 boys and 33 girls) , 44 patients were diagnosed with ALL, 33 AML, 3 AHL and 9 MDS. HC occurred in 32 of the 89 patients with an incidence of 36%, including 6 with grade Ⅰ, 16 with grade Ⅱ, 8 with grade Ⅲ, 2 with grade Ⅳ HC, respectively. The median time of HC onset was 25 days (range 2-55 days) after haplo-HSCT with the median duration as 19 days (range 3-95 days) , all of them were cured. The incidence of HC was lower in the group of children than that in the group of adolescents (27.4% vs 55.6%, χ²=6.466, P<0.05) , and the incidence of HC was higher in the group of patients who were ≥5 years old than that in the group of patients who were <5 years old (0 vs 34%, χ²=4.043, P<0.05) . Conclusion HC is one of common complications in children and adolescents with hematological diseases post haplo-HSCT, older age was associated with increased mortality.

ABSTRACTOBJECTIVE To study the growth suitability of Magnolia officinalis on the basis of investigation on the correla-tion between its growth and ecological factorsand to provide scientific basis for determining the suitable planting region of Magnolia officinalis in China.METHODS Based on the investigation of 43 sampling points of Magnolia officinalis the eco-logical factors affecting its growth was calculated by Maxent.The geographic information systemGIS was applied to assess the growth suitability rank dividing of Magnolia officinalis in China.RESULTS Precipitation of OctoberaltitudeSeptember precipitationprecipitation in July is the main ecological factors that influencing the growth of Magnolia officinalis .The habi-tat suitability values of Magnolia officinalis in Southwest of Hubei province and Eastern Chongqing is highest.CONCLUSION Hubei and Chongqing are the suitable planting areas of Magnoliae officinalis .

Objective To build a multi-system chain transitional care programme for postpartum pelvic floor training and test its effect.Methods By a prospective randomized controlled trial,the study group (n=60) received a multi-system chain transitional care programme which consisted of ward nurse,home visiting doctor,post-natal care clinic doctor,pelvic floor doctor and pelvic floor nurse.The control group(n=60) received routine care.The pelvic floor muscle strength,sexual function and patient satisfaction of baseline,on the 42th days,3rd months and 6th months were compared between two groups by short-term follow-up.Results There was no difference in baseline consisting of age,gestational weeks,birth weight and so on between groups.Participants in the study group had significantly better improvement and score in pelvic floor muscle strength,sexual thoughts,sexual arousal,sexual psychopathy and problems affecting sexual function.There was no difference in score of sexual pleasure and ejaculation time between two groups.Conclusions This study was an original effort to establish and evaluate a multi-system chain transitional care program for postpartum pelvic floor training.Results demonstrated that this transitional care was effective in improving pelvic floor function.

The process in the studies on physiological effects of rare earth elements in plants and their action mechanisms were summarized in the aspects of seed germination, photosynthesis, mineral metabolism and stress resistance. And the applications of rare earth elements in traditional Chinese medicine (TCM) in recent years were also overviewed, which will provide reference for further development and application of rare earth elements in TCM.
Medicine, Chinese Traditional ; Metals, Rare Earth ; analysis ; metabolism ; Photosynthesis ; Plants, Medicinal ; chemistry ; growth & development ; metabolism ; Soil ; analysis

Objective To analyse our series patients' data to assess its efficacy and safety of donor lymphocyte infusion (DLI) for Epstein-Barr virus (EBV) associated post-transplant lymphoproliferative disorders (PTLD) after allogeneic hematopoietic stem cell transplantation (HSCT). Methods Patients received HSCT from November 2006 to November 2009 and diagnosed as EBV associated PTLD by pathological or clinical methods were enrolled in this study. Lymphocyte was prepared by COBE collector.Related haplo-donors were the alternative if the original donors was unavailable. A range of mononuclear cell (MNC) dose of (0.5-1.0) × 108/kg was designed and the expected number of T lymphocyte included was at level of 107/kg. Cyclosporine (CsA) trough concentration was kept in a therapeutic level. Results Nine patients with PTLD received DLI 13 times, the median number of PBMC infused was 0.8 (0.16-1.03) ×108/kg, CD3+T cell number was 4.2 (1.6-5.7) × 107/kg. Seven patients received peripheral blood mononuclear cells (PBMC) from original haplo-identical donors, with 7 response and 6 complete remission.Defervescence occurred after 2 ( 1-5 ) d, and adenopathy began to recover in 6 ( 1-14 ) d after the initial infusion of leukocytes. Graft versus host diseases (GVHD) occurred in 6 recipients out of 7 evaluable patients, and all were controlled successfully. Three patients survived for 38, 23 and 3 months after PTLD.Conclusion In this small series cases, infusion of controlled dose of lymphocyte from primary donor is an effective and safe therapy for EBV associated PTLD after mismatched/haploidentical HSCT while the optimal regimen needs to be further studied.

Objective To investigate the influence of nursing intervention on perioperative psychological status and treatment compliance of patients undergoing breast augmentation. Methods 82 patients were investigated with self-rating anxiety scale (SAS), self-rating depression scale (SDS), self-designed mental activity questionnaire on patients with breast augmentation. And they were divided into the intervention group(42 patients) and the control group(40 patients) randomly. The control group was given routine treatment and nursing. The intervention group received systematic nursing intervention such as psychological needs,confidentiality, the relevant specialist knowledge and explanation and prevention o complications besides routine treatment and nursing care. The perioperative psychological status and treatment efficacy were compared between the two groups. Results The worrying degree about operation - related problems was lower in the intervention group compared with that of the control group, but SAS and SDS score showed no significant difference one day before operation between the two groups. SAS and SDS score of the intervention group were improved before discharge compared with those before operation and were also better than those of the control group. Conclusions Patients undergoing breast augmentation surgery subject to a variety of perioperative psychological barriers, systematic nursing intervention can significantly improve the psychological state and treatment compliance, make them to acquire the unification of perfect body shape and psychology with best physical and mental status during perioperative stage.