OBJECTIVE: To understand the biological characteristics of polycythemia vera (PV) patients with myeloid fibroplasia, and further analyze the risk factors affecting myeloid fibroplasia in PV patients, so as to provide ideas for predicting the occurrence of myeloid fibroplasia in PV patients. METHODS: Forty patients with PV in the Department of Hematology, Xiyuan Hospital of China Academy of Chinese Medical Sciences were collected and divided into two groups, with (hyperplasia group) and without (Non-proliferative group) hyperplasia of bone marrow fibers. The differences of basic clinical characteristics, blood routine, biochemistry, bone marrow cells, coagulation function and other indicators between the two groups were compared, and the independent risk factors affecting the proliferation of bone marrow fibrous tissue in PV patients were further analyzed by multivariate regression. RESULTS: Compared with Non-proliferative group, the JAK2 mutation rate (95% vs 70%，P=0.037), eosinophilic cell count (0.19 vs 0.11, P=0.047) and eosinophilic percentage (1.84 vs 1.27, P=0.001) in PV patients with hyperplasia were significantly increased, triglycerides (1.55 vs 1.91, P=0.038) and low-density lipoprotein (1.50 vs 3.08, P=0.000) were significantly reduced, bone marrow hematopoietic volume (0.85 vs 0.6, P=0.001), granulocyte/erythrocyte ratio (3.40 vs 1.89, P=0.033), lymphocyte/erythrocyte ratio (0.60 vs 0.42, P=0.033), and granulocyte+lymphocyte/erythrocyte ratio (3.72 vs 2.37, P=0.026) were significantly increased, thrombin time (18.84 vs 18.12, P=0.043) was significantly prolonged. Multivariate regression analysis results showed that peripheral blood eosinophil ≥2% and low-density lipoprotein ≤2 mmol/L were independent risk factors for bone marrow fibrous tissue hyperplasia in PV patients (P<0.05). CONCLUSION Increased proportion of peripheral blood eosinophils and decreased low density lipoprotein are risk factors for bone marrow fibrous tissue hyperplasia in PV patients.
Humans ; Bone Marrow/pathology* ; Polycythemia Vera ; Hyperplasia/pathology* ; Granulocytes/pathology* ; Janus Kinase 2/genetics* ; Risk Factors ; Lipoproteins, LDL ; Polycythemia/pathology*

Calreticulin/genetics* ; DNA Methylation ; Female ; Humans ; Janus Kinase 2/genetics* ; Mutation ; Myeloproliferative Disorders/genetics* ; Polycythemia Vera/genetics*

OBJECTIVE: To analysis the specific protein markers of essential thrombocythemia (ET) based on proteomics technology, to explore and verify the differential protein related to platelet activation. METHODS: Blood samples were obtained from ET patients and healthy people and a certain protein mass spectrometry was detected using label-free quantitative technology. The proteins relative abundance increased or down-regulated by 1.3 times in the disease group compared with the control group, and the protein abundance in the two groups t test P＜0.05 were defined as differential proteins. Bioinformatics analysis of the differential proteins was performed using GO and KEGG. The difference in the average protein abundance between the two groups was analyzed by t test and P＜0.05 was considered statistically significant. Differential proteins were selected for verification by parallel reaction monitoring (PRM) technology. RESULTS: A total of 140 differential proteins were found, of which 72 were up-regulated and 68 were down-regulated. KEGG enrichment showed that the differential protein expression was related to the platelet activation pathway. The differential proteins related to platelet activation were GPV, COL1A2, GP1bα, COL1A1 and GPVI. Among them, the expressions of GPV, GP1bα and GPVI were up-regulated, and the expressions of COL1A2 and COL1A1 were down-regulated. PRM verification of COL1A1, GP1bα, GPVI and GPV was consistent with LFP proteomics testing. CONCLUSION Differential proteins in ET patients are related to platelet activation pathway activation.Differential proteins such as GPV, GPVI, COL1A1 and GP1bα can be used as new targets related to ET platelet activation.
Blood Platelets/metabolism* ; Humans ; Platelet Activation ; Platelet Membrane Glycoproteins/metabolism* ; Technology ; Thrombocythemia, Essential

Objective    To explore the current situation of the readiness for hospital discharge and the quality of discharge teaching in lung cancer patients based on enhanced recovery after surgery, and to analyze their correlation. Methods    We conducted a cross-sectional study and 141 postoperative patients with lung cancer in our hospital from July to August 2018 were investigated by general information questionnaire, readiness for hospital discharge scale and quality of discharge teaching scale. There were 65 males and 76 females at age of 18-85 (55.35±12.15) years. Results    Totally 88.65% of postoperative patients with lung cancer reported that they were ready for discharge, and the total score of readiness for hospital discharge was 78.36±16.48, and the total score of quality of discharge teaching was 90.94±18.62. There was a positive correlation between the readiness for hospital discharge and the quality of discharge teaching in postoperative patients with lung cancer (r=0.57, P<0.01). Conclusion    The readiness for hospital discharge of postoperative patients with lung cancer keeps in medium level, while the quality of discharge teaching is good, and the readiness for hospital discharge is positively correlated with the quality of discharge teaching. Medical staff should pay more attention to the cognitive level of lung cancer patients' disease-related information and their physical function recovery, and enrich the discharge guidance content, in order to improve the readiness of postoperative patients with lung cancer.

Objective At present no deep investigation has been done on the relationship between handgrip strength and appendicular lean mass (ALM) in patients with chronic obstructive pulmonary disease (COPD). The study aimed to explore the present situation of handgrip strength in patients with stable COPD and relationship between handgrip strength and ALM.Methods A total of 93 patients with stable COPD who hospitalized in our department from August 2016 to July 2017 were selected for the study. All the patients underwent handgrip strength test, body composition analysis, as well as the analysis of the relationship between handgrip strength and ALM.Results Multivariate linear regression analysis showed age(X1), education(X2), smoking(X3), course of disease(X4) and lower limb lean mass(X5) could be taken as predictive factors for the variation degree of handgrip strength (R2=50.5%), and multiple linear regression equation was Y=9.959-4.315X1+1.397X2+2.679X3-1.526X4+1.538X5. The variation degree decreased to 48.1% when the course of disease was removed from the model, 28.3% when the limb lean mass was removed, 26.5% when two variables were removed. The correlation coefficients of ALM, upper limb, lower limb and torso lean mass (\[22.32±3.25\]kg, \[6.48±1.05\]kg, \[15.83±2.26\]kg, \[22.27±3.22\]kg) with handgrip strength (\[32.27±7.27\]kgf) were respectively 0.484, 0.436, 0.496 and 0.496 (P＜0.01).Conclusion The handgrip strength in patients with stable COPD is closely associated with ALM, and the course of disease and the lower limb lean mass greatly affect the handgrip strength. Clinical workers should pay extra attention to the relationship in order to give timely clinical intervention.

OBJECTIVETo evaluate the levels of coagulation indicators [thrombomodulin(TM)/ thrombin-antithrombin complexes(TAT)/ α-plasmin inhibitor-plasmin complexes(PIC)/ tissue plasminogen activator-inhibitor complexes(t-PAIC) /D-Dimer(D-D)/fibrin degradation products(FDP)] in the critical patients with thromboembolism, analyse their correlation with inflammatory factor (procalcitonin/C reactive protein/ interleukin-6), and explore the diagnostic significance of coagulation indicators for these patients.

METHODSThe serum levels of the coagulation indicators (TM/TAT/PIC/t-PAIC/D-D /FDP) and inflammatory factors (PCT/IL-6/CRP) were detected in the patient group with critical thromboembolism (n= 38) and critical patient group without thromboembolism as control (n= 81) . The correlation of coagulation indicators with inflammatory factors was analyzed.

RESULTSThe values of TM/TAT/PIC/D-D/FDP in thromboembolism group were statistically significantly higher than those in control group (P<0.05). However, the t-PAIC values were not significantly different (P>0.05), and 3 inflammatory factors (PCT/CRP/IL-6) in thromboembolism patients were significantly higher than those in control group (P<0.05). The correlation analysis suggested that the correlation coefficients of TM with PCT, CRP and IL-6 were 0.288, 0.249 and 0.270, respectively (P<0.05).

CONCLUSIONThe critical patients with thromboembolism show an obviously higher systemic inflammatory response, and accompany with coagulation dysfunction. There is a network relationship between inflammation and coagulation, the interaction of inflammatory factors with coagulation indicators promotes thromboembolism and inflammation.

Objective To investigate the effect of bowel preparation before colonoscopy and its influencing factors. Methods A total of 283 patients with colonoscopy were recruited by convenience sampling method. They were investigated with basic information questionnaire of bowel preparation and their intestinal cleanliness were assessed by the Ottawa Assessment Scale. The status of bowel preparation and it′s influenced factors were analyzed. Results The total score of Ottawa Assessment Scale was (5.37 ± 2.22) points, and the efficiency of intestinal cleaning was only 59%(167/283). Logistic regression analysis showed that age (OR=1.033, P=0.013); history of chronic constipation (OR=10.341, P=0.000);history of appendectomy (OR=5.349, P=0.007); walking time during medication (OR=0.350, P=0.000);incomplete intake of the preparation (OR=0.078, P=0.000), the time interval between the initiation of ingestion and the onset of bowel activity (OR=1.034, P=0.000), defecation frequency (OR =0.794, P=0.004);characteristics of last stool (OR=0.159, P=0.000) were influencing factors of intestinal cleanliness. Conclusions The intestinal cleanliness of patients with colonoscopy is still at a low level. In the future, medical personnel should identify patients with risk factors early, and give them specific bowel preparation, so as to improve the quality of bowel preparation effectively.

Objective To investigate the influence factors for quality of life in functional dyspepsia (FD) outpatients.Methods Based on purposive sampling,268 FD outpatients from a grade III class A hospital were selected from January to June 2014. The participants were assessed by using the functional dyspepsia-related quality of life (FDDQL) scale,FD self-efficacy scale,Zung self-rating anxiety scale (SAS),and depression self-rating scale (SDS).Results The total score for FDDQL was (57.78±7.45) in the participants. FDDQL was significantly different in people with different genders or SAS scores (P<0.05) but seemed less different in people with different BMI (P>0.05). FDDQL had a positive association with gender,self-efficacy,and BMI,but had a negative association with SAS,SDS,and symptom severity (P<0.05). Thus,the risk factors appeared to include anxiety,symptom severity,course of disease,self-efficacy,and depression in FD outpatients.Conclusions FD outpatients tend to have a low quality of life and need more concerns and management. During the nursing intervention,nurses should pay more attention to the mental status such as anxiety in patients with a short course of disease,severe symptom,and/or less self-efficacy. Patients should improve their ability of self-management to achieve a higher quality of life.

Objective To explore the influence of application of health management strategy on quality of life in outpatients with functional dyspepsia (FD). Methods A total of 140 FD patients were divided into the intervention group and the control group by random digits table method with 70 cases in each. The patients in the intervention group received the researchers on the implementation of health management strategy, and the patients in the control group were given routine outpatient health education and telephone follow- up. Before and after the intervention in one month or three, the FD patients Quality of Life Scale (FDDQL) was used to evaluate the quality condition of the patient's life. Results Eventually 65 cases in the intervention group and 61 cases in the control group completed the research. 1 months after intervention in the intervention group, total score of life quality and score of each dimension rose faster, in addition to the dimension of pressure, total score and daily activities, anxiety, diet, sleep, feeling unwell, health, disease control dimension scores were 73.84 ± 3.45, 81.22±4.55, 71.58±6.19, 73.05±5.14, 74.74± 5.58, 74.72±3.91, 79.26±5.85, 73.75±6.32, higher than 60.59 ±5.06, 76.04±6.06, 68.41±9.78, 69.52±6.68,66.63±9.87, 64.37±6.24, 54.50±7.96, 50.76±7.54, the difference was statistically significant (t =2.160-20.590, P < 0.01 or < 0.05). Three months after intervention, the intervention group the total score of life quality and score of daily activities, anxiety, diet, sleep, feeling unwell, health, disease control, pressure dimension scores were 76.35±3.74, 85.21±5.34, 80.15±5.86, 73.21±4.99, 75.49±6.81, 75.46±3.80, 79.35± 6.39, 74.06±6.74, 70.86±7.00, significantly higher than 58.60±5.22, 72.02±6.53, 59.26±7.81, 60.90±6.36, 61.19±9.08, 62.24±6.02, 54.15±8.25, 50.13±7.67, 60.02±5.67 in the control group, the difference of two groups was statistically significant (t = 5.726-19.946, P < 0.01). Conclusions Using health management strategy intervention for FD outpatients will improve FD patient′s quality of life.

Objective To explore life experience in chronic obstructive pulmonary disease (COPD) patients with the habit of exercise for more than 5 years,to enhance the confidence of participating in the rehabilitation in other patients, to help the medical staff pay more attention to guide the patients with COPD to take up the rehabilitation exercise. Methods The narrative research method in qualitative research was used to analyze the collected data. Results The study found that the coping approach of the contradiction between exercise and dyspnea, the ability to live together with the disease peacefully and the enthusiasm of persuing life were deserved to be learned. Conclusions Full of perseverance and persisted rehabilitation exercise may alleviate the symptoms, reduce the number of acute exacerbation of COPD and improve the quality of life for COPD patients. Medical staff should encourage COPD patients to participate in the rehabilitation in the right time with appropriate methods.