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Objective:To explore the application of understanding teaching mode combined with hierarchical training in the standardized training of nurses in gastrointestinal surgery department.Methods:Sixty-three nurses who had standardized training in gastrointestinal surgery department in West China Hospital, Sichuan University from January 2018 to January 2022 were selected as the study objects, among which, 32 nurses from January 2018 to July 2020 were set as the control group, taking regular training method, and 31 nurses from August 2020 to January 2022 were set as the observation group, taking the understanding teaching mode combined with hierarchical training method. The core competence scores of the two groups after training were compared, the scores of basic theory and practical skills of the two groups were compared, and the satisfaction degree of nurses during training was compared between the two groups. SPSS 22.0 was used to perform t-test. Results:After the training, the scores of core competence in the observation group were higher than that in the control group, and the difference was statistically significant ( P < 0.05). The scores of theoretical assessment (96.59±3.22) and practical skills (97.09±2.88) in the observation group were significantly higher than those in the control group (91.52±2.45)(91.14±2.85) ( P < 0.05). The total satisfaction scores of the observation group (93.48 ± 2.52) was higher than that of the control group (86.80 ± 2.22), and the difference was statistically significant ( P < 0.05). Conclusion:It is suggested that understanding teaching mode and joint hierarchical training can improve the core ability and assessment score of nurses in gastrointestinal surgery department, and improve the satisfaction of nurses.
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Objective:To explore the application effect of "connections, concepts, concrete practice and conclusions (4C)" teaching method combined with two-way evaluation method in nursing teaching of gastrointestinal surgery, so as to provide reference for personnel training and quality control of practice.Methods:A historical controlled study was conducted to prospectively include the nursing interns received by the Department of Gastrointestinal Surgery of the hospital from May 2020 to May 2022 as the subjects of this study. The interns were divided into the control group (64 interns from May 2020 to May 2021) and the research group (93 interns from June 2021 to May 2022) according to the order of admission of nursing interns. The control group was taught by traditional nursing teaching method, while the research group was taught by "4C" teaching method combined with two-way evaluation method. The scores of theoretical knowledge and operation of nursing students in the two groups were compared after 6 weeks of practice. The self-directed learning ability of nursing students in the two groups was compared before and after 6 weeks of practice [Chinese version of self-rating scale of self-directed learning (SRSSDL)]. The evaluation of teaching quality between two groups of nursing students were compared. SPSS 25.0 was used for t-test and Chi-square test. Results:One person in the control group voluntarily quit the internship, and two in the observation group voluntarily quit the internship. Finally, 63 people in the control group and 91 people in the research group entered the study. There was no statistical significant difference between the two groups in baseline data ( P>0.05). At 6 weeks of practice, the scores of theoretical knowledge (87.96±4.62) and operation (92.60±4.25) in the study group were higher than those in the control group [(86.02±4.53) and (88.27±4.31)] ( P<0.05). At 6 weeks of practice, the total scores of learning awareness, learning behavior, learning strategies, learning evaluation, interpersonal skills and self-directed learning ability of the two groups were higher than those before practice, and the study group was higher than the control group ( P<0.05). After 2 weeks, 4 weeks and 6 weeks of practice, the scores of the two groups of nursing students in evaluating the teaching quality of the teachers increased gradually compared with that of the first week of practice ( P<0.05). Conclusion:The "4C" teaching method combined with the two-way evaluation method in the nursing teaching of gastrointestinal surgery can improve the nursing students' theoretical knowledge, practical operation ability and self-directed learning ability, and is conducive to the improvement of teaching quality.
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Objective:To analyze the competence assessment examinations of registered dietitians in China during 2017-2021 to inform the training of dietetic professionals.Methods:A systematic review was conducted about the composition and changing trends of examination participants during 2017-2021. Participants were divided into subgroups based on gender, age, education, professional background and affiliations and the qualification rate was compared across different subgroups.Results:The number of examination participants showed an increasing trend overall, with the majority being females and aged 26-35 years. The ratio of participants with bachelor's: master's: doctor's degree was about 15: 9: 1. The proportion of participants majoring in nutrition science decreased from 32.1% to 20.3%, while that of participants majoring in other medical and food sciences increased. Among participants from healthcare institutions, a decreasing proportion of participants were with a major in nutrition science, while this proportion among participants from companies were stable at 38.8% to 50.2%. The average qualification rate was 35.7%, showing no significant differences among different gender and age groups. But the qualification rate varied significantly across subgroups with different education level, professional background, and affiliations ( P < 0.05). Subgroups with more advanced degrees showed higher qualification rate and the best rate was observed in the subgroups with professional background in nutrition science and from nutrition-related institutions. Conclusion:The training of dietetic professionals in China should be improved, lifelong learning should be promoted in nutrition practitioners, and the sustainable development of dietitians should be impelled.
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Objective:To investigate the value of robot-assisted laparoscopic indocyanine green sentinel lymph node (SLN) tracing in treating endometrial carcinoma.Methods:Thirty-two patients with early-staging endometrial carcinoma were operated with laparoscopic comprehensive staging laparotomy from January 2019 to December 2021. At the same time, the SLN detection was performed by near-infrared fluorescence imaging tracer technology, in which the tracer was indocyanine green. Sixteen cases were injected with indocyanine green before laparoscopic surgery, and 16 cases were injected with indocyanine green before robot-assisted laparoscopic surgery. The operation index, postoperative complications, prognosis, and lymph node dissection were compared between the two groups.Results:(1) The mean age of patients in the robot group was (54.7±8.1) years old, and was (54.9±8.8) years old in the laparoscopic group. There were no significant difference between the two groups ( t=0.06, P=0.951). (2) Intraoperative blood loss [(131±40) vs (169±57) ml], hemoglobin difference before and after surgery [(11.2±5.4) vs (15.5±5.7) g/L], the length of stay after operation [(6.2±1.3) vs (8.6±1.4) days] between the robot group and the laparoscopic group were compared, and the differences were statistically significant (all P<0.05). (3) SLNs were detected in all 16 patients in the robotic group, and a total of 41 SLNs were detected. SLNs were detected in 15 of the 16 patients in the laparoscopy group, and a total of 40 SLNs were detected. Compared with the laparoscopic group (15/16), the total detection rate of SLN in the robotic group (16/16), there were no statistical significance ( χ2=1.03, P=0.310). Compared with the laparoscopic group (7/15), the SLN bilateral detection rate in the robotic group (10/16), there were also no significant difference ( χ2=0.78, P=0.376). The number of lymph nodes detected in surgery group (16.6±4.1) were lower than those in the laparoscopy surgery group (21.0±7.1), while there were no statistically difference between the two groups ( χ2=2.01, P=0.054). There was no tumor metastasis in the resected lymph nodes and SLN between the two groups. The false negative rate of SLN in diagnosing endometrial cancer postoperative lymph node metastasis was 0, and the negative predictive value was 100%. (4) The pelvic and retroperitoneal lymph nodes were divided into five regions, which were the left pelvis, the right pelvis, the presacral region, the deep inguinal region, and the abdominal aorta. The numbers of SLN of unilateral detection and bilateral pelvic detection between two groups showed no significant differences (all P>0.05). The left pelvis had the most SLN imaging in both groups, followed by the right pelvis, para-aortic, and deep groin. (5) There was one patient in both robotic group and laparoscopic group with postoperative complications, which were urinary retention and pelvic lymph node cyst respectively. There were no significant differences in the incidence of complications between the two groups ( χ2=0.97, P=1.000). The median follow-up time after operation was 14 months (range 6-24 months). During the follow-up period, no local recurrence or distant metastasis was found between the two groups of endometrial cancer patients. Conclusions:Compared with the laparoscopic group, the robot group has less intraoperative blood loss and shorter postoperative hospital stay. The bilateral detection rate of SLN in the group was better than that of laparoscopy.
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Resistance to breast cancer (BCa) chemotherapy severely hampers the patient's prognosis. MicroRNAs provide a potential therapeutic prospect for BCa. In this study, the reversal function of microRNA34a (miR34a) on doxorubicin (Dox) resistance of BCa and the possible mechanism was investigated. We found that the relative level of miR34a was significantly decreased in Dox-resistant breast cancer cell MCF-7 (MCF-7/A) compared with Dox-sensitive MCF-7 cells. Transfection with miR34a significantly suppressed the invasion, migration, adhesion of MCF-7/A cells without inhibiting their growth obviously. The combination of miR34a and Dox could significantly inhibit the proliferation, migration, invasion and induce the apoptosis of MCF-7/A cells. The synergistic effect of this combination on resistant MCF-7/A cells has no obvious relation with the expressions of classical drug-resistant proteins P-GP, MRP and GST-
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This study aims to explore the pharmacodynamic differences of Puerariae Lobatae Radix(PLR), Puerariae Thomsonii Radix(PTR) and their different processed products and the influences of these medical materials on the diversity of intestinal flora. The Sennae Folium-induced diarrhea model, streptozotocin(STZ)-induced diabetes model and L-nitro-arginine methyl ester(L-NAME)-induced hypertension model were used to compare the pharmacodynamic differences in anti-diarrhea, blood glucose reduction and blood pressure lowering among raw, roasted and vinegar-processed PLR and PTR. The effects of raw and processed PLR and PTR on intestinal flora diversity of rats were evaluated by 16 S rDNA high-throughput sequencing. The roasted PLR and PTR performed better in anti-diarrhea, especially the former. PLR and its processed products all presented the efficacy of reducing blood glucose, and the vinegar-processed PLR was the most outstanding. The raw PTR was not that effective in reducing blood glucose, whereas its efficacy was improved after roasting and vinegar processing. Both PLR and PTR were capable of lowering blood pressure to a certain extent, and PLR is superior to PTR in this aspect. Further, the vinegar-processed PLR showed the best effect. The diversity of intestinal flora was different among rats to which different products of PLR and PTR were administered. The roasted PLR led to the highest abundance of Lactobacillus, which was closely related to its best antidiarrheal effect. The highest abilities of vinegar-processed PLR to lower blood glucose and blood pressure were associated with the high abundance of Blautia and Prevotella_9. This study lays a foundation for elucidating the processing mechanisms of PLR and PTR and provides a basis for their further development and application.
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Animals , Rats , Drugs, Chinese Herbal , Gastrointestinal Microbiome , Plant Roots , PuerariaABSTRACT
OBJECTIVE@#To analyze the clinical characteristics and factors affecting prognosis in children with severe aplastic anemia (SAA).@*METHODS@#Two hundred and five children with SAA treated in our department from January 2008 to April 2018 were selected, and the clinical characteristics and factors affecting prognosis were retrospectively analyzed.@*RESULTS@#Among 205 SAA children, the effective rate (CR+PR) at 3, 6 and 12 months after immunosuppressive therapy (IST) treatment was 50.9%, 59.0% and 73.9%, respectively, and 5-year overall survival rate was 93.1%±2.0%. Univariate analysis showed that 5-year overall survival rate of SAA children of spontaneous delivery was higher than that of cesarean section (P=0.039), while multivariate analysis showed that birth way had no significant influence on 5-year overall survival rate (P>0.05). The response rate at 3 months after IST of children with a recent history of decoration before SAA onset was higher than those without history of decoration (P<0.05).@*CONCLUSION@#Most of the SAA children can achieve high response rate and overall survival rate. Patients with recent history of home/school decoration may be the factor affecting hematological response after 3 months of IST, but have no influence on long-term overall survival.
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Child , Female , Humans , Pregnancy , Anemia, Aplastic , Cesarean Section , Immunosuppressive Agents , Prognosis , Retrospective Studies , Treatment OutcomeABSTRACT
OBJECTIVES@#Primary health workers are the first fine to identify postpartum depression, which is important for patients with this disease to get early specialist diagnosis and treatment. The smartphone-based virtual patient is economical, convenient and effective, and has been applied extensively to evaluate the competency to detect postpartum depression, but there is no relevant application in China. This study aims to use virtual patient to assess the current status on the competency of detecting postpartum depression among primary maternal and child health workers in Hunan Province, and to explore potential influencing factors.@*METHODS@#A total of 222 primary maternal and child health workers from 3 regions with low, medium, and high economic levels in Hunan Province were enrolled, and smartphone-based virtual patients with postpartum depression were used for the assessment from May to July in 2018, and a self-designed questionnaire was used to investigate their demographic characteristics. The competency to detect postpartum depression was measured by 2 indicators: diagnostic accuracy and treatment accuracy. Descriptive statistical methods were used to describe the competency to detect postpartum depression among them and their demographic characteristics. A logistic regression analysis was used to explore the possible influencing factors for the diagnostic accuracy and treatment accuracy.@*RESULTS@#The diagnostic accuracy rate was 64.0%. There was no significant difference between the demographic characteristics and diagnostic accuracy rate (@*CONCLUSIONS@#About half of the primary maternal and child health workers in Hunan Province, China have basic competency to detect postpartum depression, but the overall results are not satisfactory. The regional economic level is correlated with the competency of detecting postpartum depression, and the competency of detecting postpartum depression is stronger in more developed areas. Moreover, for the patients who have been identified as postpartum depression, the rate of correct treatment is low, which warrants particular attention in the follow-up training.
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Child , Female , Humans , China , Cross-Sectional Studies , Depression, Postpartum/diagnosis , Health Personnel , Surveys and QuestionnairesABSTRACT
China's limited community medical resources cannot meet the needs of chronic disease prevention and treatment due to the rapidly growing ageing population.The improvement and long-term maintenance of patient's self-management is essential for chronic disease management.In view of chronic disease management having a characteristic of being carried out in the family for a long time in recent years,it has been proposed that the key role of spouse in the management of chronic disease should not be underestimated.This article reviews the epidemiological evidence,theoretical foundations and interventional findings of elderly couples' collaborative management with chronic diseases,aiming to provide the evidence for efficiently conducting chronic disease management for community-dwelling older adults.
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China's limited community medical resources cannot meet the needs of chronic disease prevention and treatment due to the rapidly growing ageing population.The improvement and long-term maintenance of patient's self-management is essential for chronic disease management.In view of chronic disease management having a characteristic of being carried out in the family for a long time in recent years, it has been proposed that the key role of spouse in the management of chronic disease should not be underestimated.This article reviews the epidemiological evidence, theoretical foundations and interventional findings of elderly couples' collaborative management with chronic diseases, aiming to provide the evidence for efficiently conducting chronic disease management for community-dwelling older adults.
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Objective:To investigate the effect of PhysioTouch on upper limb lymphedema after breast cancer surgery. Methods:From September, 2017 to August, 2018, 42 patients with upper limb lymphedema after breast cancer operation were randomly divided into control group (n = 21) and experimental group (n = 21). Both groups accepted complex decongestion therapy, while the experimental group accepted PhysioTouch in addition, for four weeks. They were assessed with difference of upper limb volume, Disabilities of the Arm, Shoulder and Hand (DASH), and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire of Breast Cancer (EORTC QLQ‐BR23) before and after treatment. Results:All the indexes significantly improved in both groups after treatment (t > 17.925, P < 0.001), and improved more in the experimental group than in the control group (t > 2.407, P < 0.05). Conclusion:Combination of PhysioTouch can further relieve upper limb edema after breast cancer operation, and improve their shoulder-hand function and quality of life.
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Objective To investigate the influencing factors for the psychological burden of depressive patients' caregivers. Methods We enrolled the chief caregivers of depressive patients who were hospitalized in Sir Run Run Shaw Hospital as our subjects. We investigated them by Caregiver Burden Inventory, Social Support Revalued Scale (SSRS) , Hamilton Depression Scale (HAMD) and Suicide Risk Assessment Scale, and learned influencing factors for the psychological burden of these caregivers by multiple linear regression analysis. Results We totally enrolled 101 subjects and collected 96 questionnaires (95.04%) . The 96 respondents scored (24.88±12.94) points in the psychological burden and 54 of which scored more than 20 points, accounted for 56.25%. The positive rate of mental pressure was 65.63%, which was the lowest; the positive rate of social burden was 93.75%, which was the highest. Multiple linear regression analysis showed that the objective support (β=-1.856, P=0.002), subjective support (β=0.526, P=0.008) and high suicidal score of depressive patients (β=0.290, P=0.048) were the influencing factors for the psychological burden of depressive patients' caregivers. Conclusion More than half of the caregivers have psychological burden, which is associated with objective support, subjective support and high suicidal score of depressive patients.
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Juvenile myelomonocytic leukemia (JMML) is a rare chronic myeloid leukemia in children and has the features of both myelodysplastic syndrome and myeloproliferative neoplasm. It is highly malignant and has a poor treatment outcome. Children with JMML have a poor response to conventional chemotherapy. At present, hematopoietic stem cell transplantation is the only possible cure for this disease. In recent years, significant progress has been made in targeted therapy for mutant genes in the Ras signaling pathway and demethylation treatment of aberrant methylation of polygenic CpG islands. This article reviews the treatment and efficacy evaluation of JMML.
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Child , Humans , Hematopoietic Stem Cell Transplantation , Leukemia, Myelomonocytic, Juvenile , Methylation , Myelodysplastic Syndromes , Signal TransductionABSTRACT
Objective:To observe the effect of electroacupuncture (EA) on the expressions of acetylcholine (ACh) and mucin 5AC (MUC5AC) in the lungs of rats with chronic obstructive pulmonary disease (COPD),and explore the mechanism of EA in treating COPD.Methods:Thirty Sprague-Dawley (SD) rats were randomly divided into a control group,a COPD group,and an EA group,with 10 rats in each group.The control group was a group of normal rats.The COPD rat model was induced by cigarette smoke combined with lipopolysaccharide (LPS).The COPD rats were treated with EA at bilateral Feishu (BL 13) and Zusanli (ST 36) in the EA group,30 min each time,once a day,successively for 14 d.The lung function was tested.The contents of ACh and MUC5AC in lungs and bronchoalveolar lavage fluid (BALF) were detected by enzyme-linked immunosorbent assay (ELISA).Pearson method was used to analyze the correlation between pulmonary function and the content of MUC5AC in lungs.The mRNA and protein expressions of MUC5AC in lung tissues were detected by real-time polymerase chain reaction (RT-PCR) and Western blot (WB),respectively.The immune response of MUC5AC was observed by immunohistochemistry.Results:Eight rats were left in each group,and the other two died.Compared with the control group,the total airway resistance (Raw) increased significantly and dynamic compliance (Cdyn) decreased significantly in the COPD group (P＜0.01);compared with the COPD group,the Raw level declined significantly and Cdyn increased significantly in the EA group (P＜0.01).The contents of ACh and MUC5AC in the lungs and BALF were remarkably higher in the COPD group compared with those in the control group (P＜0.01,P＜0.001);compared with the COPD group,the contents of ACh and MUC5AC were significantly lower in the EA group (P＜0.05,P＜0.001).There was a negative correlation between MUC5AC content and lung function (P＜0.001).The mRNA and protein expressions of MUC5AC in the lungs were significantly higher in the COPD group than in the control group (P＜0.001);compared with the COPD group,the expressions were significantly lower in the EA group (P＜0.01).Compared with the control group,the immune response of MUC5AC in the airway epithelium significantly increased in the COPD group (P＜0.001);the immune response of MUC5AC was significantly lower in the EA group compared with that in the COPD group (P＜0.001).Conclusion:EA treatment can improve the lung function of COPD rats,which may be related to its effect in the down-regulation of ACh and MUC5AC contents in the lungs as well as the inhibition of mucus hypersecretion.
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Objective To investigate the effect of long-term high-fat diet on cognitive function and hippocampus neurons ultrastructure in obese rats.Methods Forty SD rats were randomly assigned to a high fat diet (HFD) group and a common diet (CD) group.Meanwhile,HFD-induced obese rat model were established.The spatial learning and memory were measured by the Morris water maze,and the neurons ultrastructural changes in rat hippocampus CA1 region at the corresponding period were observed by transmission electron microscopy.Results The average weight of rats was 25％,28％,and 22％ higher in the HFD group than in the CD group at the 12,16,and 20 weeks,respectively;the Lee's indexes were 6％,4％,and 8％ higher;the average swimming latency were 52％,44％,and 40％ longer;the average swimming distance were 85％,45％,and 51％ longer;the average swimming speed were 57％,34％,and 18％ higher;the duration of staying in the target quadrant were 32％,54％,and 63％ shorter;and the average times of crossing the plate form were 30％,34％,and 34％ shorter,respectively (all P ＜0.001).In comparison of ultrastructure in hippocampus CA1 region of rats at corresponding time points,the amounts of degenerated and necrosis neurons,of the deformed and vacuolar mitochondria,and of the less rough endoplasmic reticulum were significantly more at 12,16,and 20 weeks in the HFD group than in the CD group.Conclusions Long-term HFD-induced obesity damages the structure of neurons in the hippocampus,impairs spatial learning and memory function,and accelerates cognitive aging in rats.
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The effect of acupuncture cooperated with low-frequency repetitive transcranial magnetic stimulation (rTMS) on chronic insomnia was explored.Seventy-eight patients with chronic insomnia were randomly allocated into two groups:treatment group and control group.In the treatment group,the patients received acupuncture combined with rTMS treatment,and those in the control group were given acupuncture cooperated with sham rTMS treatment,3 days per week for 4 weeks.Before and after treatment,the primary outcomes including the scores on Insomnia Severity Index (ISI) and Pittsburgh Sleep Quality Index (PSQI) and the secondary outcomes including total sleep time (TST),sleep onset latency (SOL),wake after sleep onset (WASO),sleep efficiency (SE％) recorded by sleeping diary and actigraphy were observed in both groups.Seventy-five participants finished the study (38 in treatment group and 37 in control group respectively).After treatment,the scores in the two groups were improved significantly,more significantly in the treatment group than in the control group.It can be inferred that acupuncture cooperated with rTMS can effectively improve sleep quality,enhance the quality of life of patients and has less side effects.
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The effect of acupuncture cooperated with low-frequency repetitive transcranial magnetic stimulation (rTMS) on chronic insomnia was explored.Seventy-eight patients with chronic insomnia were randomly allocated into two groups:treatment group and control group.In the treatment group,the patients received acupuncture combined with rTMS treatment,and those in the control group were given acupuncture cooperated with sham rTMS treatment,3 days per week for 4 weeks.Before and after treatment,the primary outcomes including the scores on Insomnia Severity Index (ISI) and Pittsburgh Sleep Quality Index (PSQI) and the secondary outcomes including total sleep time (TST),sleep onset latency (SOL),wake after sleep onset (WASO),sleep efficiency (SE％) recorded by sleeping diary and actigraphy were observed in both groups.Seventy-five participants finished the study (38 in treatment group and 37 in control group respectively).After treatment,the scores in the two groups were improved significantly,more significantly in the treatment group than in the control group.It can be inferred that acupuncture cooperated with rTMS can effectively improve sleep quality,enhance the quality of life of patients and has less side effects.
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<p><b>OBJECTIVE</b>To assess the effect of long-term high-fat diet on the expressions of insulin receptor substrates in the hippocampus and spatial learning and memory ability of obese rats.</p><p><b>METHODS</b>A total of 100 4-week-old male SD rats were randomly divided into two groups and fed with common diet (CD group, n=40) or high-fat diet (HFD group, n=60) for 16 weeks. At 4, 8, 12, 16 and 20 weeks, 8 rats were randomly selected from each group for testing their spatial learning and memory function using Morris water maze. After the tests, the rats were sacrificed for measurement of the metabolic parameters and detection of the expressions of insulin receptor substrate-1 (IRS-1) and IRS-2 mRNAs in the CA1 region of the hippocampus.</p><p><b>RESULTS</b>Compared with those in CD group, the rats in HFD group showed a prolonged escape latency, longer swimming distance, faster average swimming speed, and shorter stay in the platformat 12 weeks. In HFD group, the serum levels of total cholesterol, triglyceride, low-density lipoprotein cholesterol, and fasting insulin were all significantly increased (P<0.05) and the level of high-density lipoprotein cholesterol decreased (P<0.01) in comparison with those in CD group at each of the time points. No significant difference was found in fast glucose levels between the two groups (P>0.05), but the expressions of IRS-1 and IRS-2 mRNAs were significantly decreased in HFD group at 12 weeks (P<0.05).</p><p><b>CONCLUSION</b>In obese rats, long-term feeding with high-fat diet leads to insulin resistance, which interferes with hippocampal expression of insulin receptor substrates and insulin metabolism to cause impairment of the cognitive function and accelerate cognitive deterioration.</p>
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<p><b>OBJECTIVE</b>To investigate the value of multiparameter flow cytometry (MFC) and flow cytometric scoring system (FCSS) in the diagnosis and prognostic evaluation of childhood myelodysplastic syndrome (MDS).</p><p><b>METHODS</b>A retrospective analysis was performed for the clinical data of 42 children who were diagnosed with MDS. MFC was performed to investigate the phenotype and proportion of each lineage of bone marrow cells. The correlations of FCSS score with MDS type, International Prognostic Scoring System (IPSS) score, and revised IPSS (IPSS-R) score were analyzed.</p><p><b>RESULTS</b>Of all the 42 children, 20 (48%) had an increase in abnormal marrow blasts, 19 (45%) had a lymphoid/myeloid ratio of >1, 14 (33%) had abnormal cross-lineage expression of lymphoid antigens in myeloid cells, 8 (19%) had abnormal CD13/CD16 differentiation antigens, 5 (12%) had abnormal expression of CD56, 3 (7%) had reduced or increased side scatter of granulocytes, 3 (7%) had reduced expression of CD36 in nucleated red blood cells, 2 (5%) had reduced expression of CD71 in nucleated red blood cells, 1 (2%) had absent expression of CD33 in myeloid cells, 1 (2%) had reduced or absent expression of CD11b in granulocytes, and 1 (2%) had absent expression of CD56 and CD14 in monocytes. There were significant differences in the median overall survival time and event-free survival time among the low-, medium-, and high-risk FCSS groups (P<0.05). Among the low-, medium-, and high-risk FCSS groups, the low-risk FCSS group had the highest 2-year overall survival rate, while there was no significant difference between the medium- and high-risk FCSS groups (P>0.05). The three groups had a 2-year event-free survival rate of 95%, 60%, and 46% respectively (P<0.05). FCSS score was positively correlated with MDS type, IPSS score, and IPSS-R score (P<0.05).</p><p><b>CONCLUSIONS</b>MFC and FCSS help with the diagnosis and prognostic evaluation of childhood MDS.</p>
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Objective: the importance of Oct4 and Sox2 in maintaining pluripotency and self-renewal is well-understood, but the functions of Klf4 and c-Myc has not been fully investigated. In the present study, we attempted to determine the roles of Klf4 and c-Myc on pluripotency maintenance of porcine induced pluripotent stem [piPS] cells
Materials and Methods: in this experimental study, we performed short hairpin RNA [shRNA] to knock down the Klf4 and c-Myc functions of piPS cells and examined pluripotency markers and teratoma formation to evaluate pips cell pluripotency. The shRNA-Klf4 and shRNA-c-Myc vectors containing a reporter gene, TagFP635, were transfected into piPS cells by lentivirus infection. The piPS cells fully expressing infrared fluorescence were selected to confirm gene knockdown of Klf4 and c-Myc reverse transcription-polymerase chain reaction [RT-PCR]. Next, for pluripotency evaluation, expression of pluripotency markers was detected by immunocytochemical staining, and capability of teratoma formation was investigated by piPS cell transplantation into nonobese diabetic-severe combined immunodeficiency [NOD-SCID] mice
Results: our findings indicated that Klf4 and c-Myc functions of piPS cells were knocked down by shRNA transfection, and knockdown of Klf4 and c-Myc functions impaired expression of pluripotency markers such as Oct4, AP, SSEA-3, SSEA-4, TRA-1-6, and TRA-1-81. Furthermore, piPS cells without Klf4 and c-Myc expression failed to form teratomas
Conclusion: the pluripotency of piPS cells are crucially dependent upon Klf4 and c-Myc expression. These findings, suggesting potential mechanisms of Klf4 and c-Myc contribution to piPS cell formation, have important implications for application, regulation, and tumorigenesis of piPS cells