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OBJECTIVE To explore the effects of 5，10-methylenetetetrahydrofolate reductase （MTHFR） gene polymorphism on the adverse reactions in patients with osteosarcoma after the first high-dose methotrexate （HD-MTX） treatment. METHODS A prospective study was conducted to include 53 patients with osteosarcoma treated with HD-MTX at the first admission in General Hospital of Eastern Theater Command. The dose of MTX was evaluated according to the polymorphism of rs1801133 in the METHFR gene and demographic factors， then whole pharmaceutical monitoring was conducted. The data on liver toxicity， renal toxicity， hematological toxicity， and gastrointestinal reaction were collected after the first chemotherapy cycle. Single factor analysis and binary Logistic regression analysis were used to analyze the correlation between MTX dose， 24 h blood drug concentration， and rs1801133 locus genotype with four adverse reactions. RESULTS The MTX dosage in patients with CC wild type was significantly higher than that in TT mutant type （7.97 g/m2 vs. 6.98 g/m2， P＝0.030）， but this difference did not affect the 0 h and 24 h blood drug concentrations of MTX. The above four adverse reactions were not related to the dose of MTX. The results of binary Logistic regression analysis showed that carrying one T allele increased the risk of developing hematological toxicity by 4.13 times（95% confidence interval：1.35-12.62，P＝0.013）. When 24 h plasma concentration threshold of MTX was set to 2.65 µmol/L， the sensitivity and specificity of predicting liver function damage were 53.33% and 86.96%， respectively； when the threshold was set to 7.28 μmol/L， the sensitivity and specificity of predicting renal damage were 100% and 81.63%. CONCLUSIONS The polymorphism of the rs1801133 in the MTHFR gene is associated with hematological toxicity of MTX. Patients who take HD-MTX for the first time and carry the T allele have a high risk of hematological toxicity. The 24 h plasma concentration of MTX is related to liver toxicity and renal toxicity. In addition， monitoring the 24 h blood drug concentration can predict liver and renal toxicity， and take early intervention.
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Objective:To explore the application of career planning combined with layered training mode in management of clinical research nurses(CRN)and its effect evaluation.Methods:100 CRNs from 8 tertiary hospitals in Shanxi province were randomly enrolled and divided into an intervention group and a control group. Both groups participated in training and meetings organized by drug research institutions. On this basis, the intervention group was added with a management method combining career planning guidance and layered training for 10 months. Before and after the intervention, career status questionnaire was used to evaluate the career status of the two groups of CRNs.Results:Before the intervention, the total scores of CRN career evaluation in the two groups were(66.64 ± 12.71)and(66.68 ± 12.88), respectively, and the difference was not statistically significant( P>0.05). The score of career evaluation in the intervention group was(79.94 ± 12.26)points after intervention, which was significantly higher than that before intervention(66.64 ± 12.71)points; the score of career evaluation in the intervention group was also higher than that in the control group after the intervention; the differences were statistically significant( P<0.05). After the intervention, the CRN career evaluation scores of the junior and senior seniority were higher than those of the middle seniority( P<0.05). Conclusions:Career planning combined with layered training mode can play a positive role in CRN management. Especially, it has a more significant impact on the career status of CRNs of junior and senior seniority.
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Marine-derived biopolymers are excellent raw materials for biomedical products due to their abundant resources, good biocompatibility, low cost and other unique functions. Marine-derived biomaterials become a major branch of biomedical industry and possess promising development prospects since the industry is in line with the trend of "green industry and low-carbon economy". Chitosan and alginates are the most commonly commercialized marine-derived biomaterials and have exhibited great potential in biomedical applications such as wound dressing, dental materials, antibacterial treatment, drug delivery and tissue engineering. This review focuses on the properties and applications of chitosan and alginates in biomedicine.
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Objective To investigate the association between serum sodium level and tricuspid annular plane systolic excursion (TAPSE) and estimated glomerular filtration rate (eGFR) in patients with decompensated heart failure.Methods Totally 116 in-patients with decompensated heart failure who had left ventricular ejection fraction (LVEF) ≤ 45％ confirmed by echocardiogram and belonged to Ⅲ-Ⅳ degree of NYHA were enrolled.We collected height,weight,systolic/diastolic blood pressure and other general information on the first day of hospitalization.The dates of serum electrolyte,urea,creatinine and N-terminal pro-brain natriuretic peptide (NT-proBNP) level were detected in the second day of hospitalization on an empty stomach.Then eGFR were obtained by the modified MDRD equation.Tricuspid annular plane systolic excursion (TAPSE),left ventricular end diameter(LVED),right ventricular end diameter(RVED),pulmonary arterial systolic pressure(PASP) and left ventricular ejection fraction(LVEF) all were measured by echocardiography within 48 hours of hospitalization.All the patients were divided into two groups,the hyponatremia group and non-hyponatremia group,according to the serum sodium level (serum sodium ≤ 135mmol/L was defined as hyponatremia,n =52;serum sodium ＞135mmol/L was defined as non-hyponatremia,n =64).The NT-proBNP,LVEF,TAPSE and eGFR were compared between the two groups.Besides,for the hyponatremia group,the relevance between serum sodium level and TAPSE,eGFR were respectively analyzed.And we also analyzed the relevance between TAPSE and eGFR.Results ①The level of NT-proBNP in hyponatremia group was higher than non-hyponatremia group with statistical significance (P =0.032),while TAPSE and eGFR were lower than non-hyponatremia group with statistical significance(P =0.015,P =0.004).②Logistic regression analysis results showed that serum sodium level was positively correlated with the decrease of both TAPSE and eGFR (r =0.785,r =0.702).Meanwhile the decrease of TAPSE was also positively correlated with the decrease of eGFR(r =0.630).Conclusion Hyponatremia was positively correlated with the decrease of both TAPSE and eGFR in patients with decompensated heart failure.And hyponatremia maybe was considered as an easy and practical predictor for identifying those patients who would experience worsening renal function in early state.
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Objective To explore the mechanism of Suzijiangqi decoction to passage recombination of asthma model by studying the effect of Suzijiangqi decoction on passage recombination and the relation between it and the content of TNF and ET of asthma model. Methods Asthma model was established by OVA atomized and inhaled, the effect of Suzijiangqi decoction on the lung histomorphometric and the content of TNF and ET in serum or plasma/BALF of asthma model were observed. Results Suzijiangqi decoction obviously improved the lung histomorphometric and significantly inhibited the content of TNF and ET. Conclusion Suzijiangqi decoction can obviously control passage recombination. It is relate to inhibiting the content of TNF and ET in serum or plasma/BALF of asthma model.