Objective:To investigate the carrier rate and clinical characteristics of epigenetic modification gene mutations (EMMs) among patients with acute myeloid leukemia (AML).Methods:One hundred seventy two patients who were initially diagnosed with AML at the First People′s Hospital of Lianyungang from May 2011 to February 2021 were selected as the study subjects. Next-generation sequencing was carried out to detect variants of 42 myeloid genes among these patients. Clinical and molecular characteristics of patients with EMMs and the effect of demethylation drugs (HMAs) on their survival were analyzed.Results:Among the 172 AML patients, 71 (41.28%) were found to harbor the EMMs, and carrier rates were TET2 (14.53%, 25/172), DNMT3A (11.63%, 20/172), ASXL1 (9.30%, 16/172), IDH2 (9.30%, 16/172), IDH1 (8.14%, 14/172), EZH2 (0.58%, 1/172). Patients with EMMs (+ ) had lower peripheral hemoglobin compared with those with EMMs (-) (72 g/L vs. 88 g/L, Z=-1.985, P<0.05). The proportion of EMMs(+ ) among elderly AML patients was significantly higher than that of young AML patients [71.11% (32/45) vs. 30.70% (39/127), χ2 = 22.38, P < 0.001]. EMMs (+ ) were significantly correlated with NPM1 gene variants ( r=0.413, P < 0.001), while negatively correlated with CEPBA double variants ( r=-0.219, P<0.05). Compared with conventional chemotherapy regimens, HMAs-containing chemotherapy regimens have improved the median progression-free survival (PFS) and median overall survival (OS) among intermediate-risk AML patients with EMMs (+ ) (PFS: 11.5 months vs. 25.5 months, P<0.05; 12.5 months vs. 27 months, P<0.05). Similarly, Compared with conventional chemotherapy regimens, chemotherapy with HMAs had increased median PFS and median OS in elderly AML patients with EMMs(+ ) (4 months vs. 18.5 months, P<0.05; 7 months vs. 23.5 months, P<0.05). Conclusion:Patients with AML have a high rate of EMMs carriage, and HMAs-containing chemotherapy regimens can prolong the survival of elderly patients with AML with poor prognosis, which may provide a reference for individualized treatment.

Objective To explore the effects of project management to reduce the rate of physical restraint for psychiatric inpatients.Methods From October 2014 to December 2015, 160 nurses was selected for the study in the hospital by whole group sampling method. Through the perfect system, processes and guide construction for physical restraint, as well as more training, implement and supervision, we observed the rate, duration and frequency of physical restraint, the achieved rate of physical restraint nursing quality and the adverse event incidences before (October to December in 2014) and after (October to December in 2015) project management.Results After the project management, the restraint rate was 53.42%, the duration of restraint (4.07±0.50)h, and the restraint's times for patients (2.35±1.25), which were all lower than that before the intervention (P<0.01). The qualified restraint rate increased from 83% to 93% (P<0.01); but the rate of adverse event had no statistical significance (P>0.05).Conclusions Project management not only provides advanced management methods for nurse administrators, but also reduces the rate of physical restraint for psychiatric inpatients, and improves the quality of physical restraint nursing.

Objective To explore the application effects of quality control circle (QCC)on reducing the peculiar smell in Psychiatry Ward for vagrant patients.Methods Quality control circle named “Improving the peculiar smell in Psychiatry Ward for vagrant patients”was established to investigate the current situation. The study investigated 35 patients who were hospitalized in April 201 4 and 20 nurses before the QCC.They also investigated 42 patients who were hospitalized in October 201 4 and 20 nurses after the QCC.The peculiar smell level and nurses′satisfaction were compared before and after the QCC,which included the analysis of the source of peculiar smell and the implementation of the related interventions.Results After the QCC,the feeling score of peculiar smell reduced from 6.78 to 1 .82 and the satisfaction level of nurses and patients were significantly improved (P <0.05 ).Conclusions The QCC can significantly reduce the peculiar smell of the Psychiatry Ward and improve the nursing quality and patients′satisfaction.