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Objective:To explore the mechanism of turnover intention of junior nurses after adverse events from three aspects: work pressure, leadership style and personal characteristics.Methods:This study was a cross-sectional survey, using the convenience sampling method, 289 nurses from Shanxi Bethune Hospital from December 2020 to March 2022 were selected as the research subjects, and the general data questionnaire, the Separation Tendency Scale, the Nurses′ Work Stressor Scale, the Service-oriented Leadership Style Scale, and the Prospective Personality Scale were used to survey them.Results:Structural equation model showed that nurses′ job stressor level positively predicted turnover intention, with a path coefficient of 0.74, P<0.01, while service-oriented leadership style and forward-looking personality negatively predicted turnover intention, with path coefficients of -0.60 and -0.37, respectively, both P<0.01. Hierarchical regression analysis showed that both service-oriented leadership style and forward-looking personality negatively moderated the promotion of job stressors on turnover intention, and the moderating effect regression coefficients were -0.146, -0.215, both P<0.01. Conclusions:Hospitals should improve the prospective personality traits of junior nurses and cultivate the service-oriented leadership style of nursing managers after adverse events, so as to reduce the turnover tendency of junior nurses as the second victim, promote the improvement of nursing quality, and stabilize nursing team development.
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Matrix metalloproteinase-9 (MMP-9) can promote the invasion and metastasis of breast cancer through various mechanisms.The expressions of MMP-9 in the patients with breast cancer are correlated with the prognosis.The higher expression of MMP-9 indicates poorer prognosis.It is suggested that the level change of MMP-9 pre and post treatment can be used as a reference standard for judging the prognosis and clinical effect.
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Aim To evaluate the reversal effect of 2-deoxy-D-glucose ( 2-DG ) on multidrug resistance ( MDR) by observing the uptake change of 99m Tc-MIBI in HNE-1/DDP cells, and to explore its mechanism. Methods The uptake of 99m Tc-MIBI in HNE-1/DDP cells under different concentrations of 2-DG was detec-ted by γ-counter, and the clearance rates of 99m Tc-MI-BI in HNE-1 cells and HNE-1/DDP cells after treated with 2-DG (10 mmol·L-1 ) were compared. The con-tent of ATP in HNE-1/DDP cells was detected after treated with 2-DG. P-glycoprotein ( P-gp ) and multi-drug resistance-associated proteins ( MRP ) expression were measured by Western blot. Apoptotic HNE-1/DDP cells treated with DDP alone or combined with 2-DG (10 mmol·L-1 ) were detected by propidium io-dide ( PI ) staining. Results The clearance rate of 99m Tc-MIBI in HNE-1/DDP cells was 54. 8%, which was significantly higher than that ( - 41. 3%) in HNE-1 cells (P<0. 01). The clearance rate of 99mTc-MIBI in HNE-1/DDP cells was -203. 7% after treat-ment with 2-DG ( 10 mmol · L-1 ) , which could be significantly reduced compared with the control group ( P<0. 01 ) . The level of ATP was 55 . 69% compared with the negative control group and the expression of P-gp and MRP protein decreased dramatically in HNE-1/DDP. With the combination of 2-DG and DDP, the ap-optotic rate of HNE-1/DDP cells reached 49 . 4%which was significantly higher than DDP treated group (22. 5%) . Conclusion Multidrug resistance and the reversal effect of 2-DG on multidrug resistance could be evaluated effectively by detecting the uptake change of 99m Tc-MIBI in HNE-1/DDP cells. The mechanism may be related with the inhibition of ATP level and the re-duced expression of P-gp and MRP protein in cancer cells.
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As the third-generation bisphosphonate,zoledronic acid (ZOL) has been widely used for the treatment of skeletal-related events in breast cancer.Previous studies have demonstrated that ZOL has antitumor activitie in breast cancer.ZOL can induce direct and indirect antitumor activities through inducing apoptosis,inhibiting the proliferation,adhesion and invasion formation of bone microenvironment which is conducive to tumor growth,besides inhibiting angiogensis and modulating immune response.Also evidences of synergistic antitumor effects are found when ZOL combines with radiotherapy and chemotherapy,endocrine,and targeted drugs.The observed improvement in antitumor effects by using combination therapy with ZOL in breast cancer is currently being verified through additional clinical trials.
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Objective: Non-small-cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR)-activating mutations have higher response rate and more prolonged survival following treatment with single-agent EGFR tyrosine kinase inhibitor (EGFR-TKI) compared with patients with wild-type EGFR. However, all patients treated with reversible inhibitors develop acquired re-sistance over time. The mechanisms of resistance are complicated. The lack of established therapeutic options for patients after a failed EGFR-TKI treatment poses a great challenge to physicians in managing this group of lung cancer patients. This study evaluates the in-fluence of EGFR-TKI retreatment following chemotherapy after failure of initial EGFR-TKI within at least six months on NSCLC pa-tients. Methods:The data of 27 patients who experienced treatment failure from their initial use of EGFR-TKI within at least 6 months were analyzed. After chemotherapy, the patients were retreated with EGFR-TKI (gefitinib 250 mg qd or erlotinib 150 mg qd), and the tumor progression was observed. The patients were assessed for adverse events and response to therapy. Targeted tumor lesions were as-sessed with CT scan. Results:Of the 27 patients who received EGFR–TKI retreatment, 1 (3.7%) patient was observed in complete re-sponse (CR), 8 (29.6%) patients in partial response (PR), 14 (51.9%) patients in stable disease (SD), and 4 (14.8%) patients in progres-sive disease (PD). The disease control rate (DCR) was 85.2%(95%CI=62%-94%). The median progression-free survival (mPFS) was 6 months (95%CI=1-29). Of the 13 patients who received the same EGFR-TKI, 1 patient in CR, 3 patients in PR, 8 patients in SD, and 2 patients in PD were observed. The DCR was 84.6%, and the mPFS was 5 months. Of the 14 patients who received another EG-FR-TKI, 0 patient in CR, 6 patients in PR, 6 patients in SD, and 2 patients in PD were observed. The DCR was 85.7%, and the mPFS was 9.5 months. Significant difference was found between the 2 groups in progression-free survival but not in response rate or disease control rate. Conclusion:Retreatment of EGFR-TKIs can be considered an option after failure of chemotherapy for patients who were previously controlled by EGFR-TKI treatment.
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Objective To improve the recognition and reduce the misdiagnosis of bipartite patella by analyzing and summarizing the imaging features.Methods X-ray,CT and MR images of 1 7 cases of bipartite patella were collected,imaging features were ana-lyzed and summarized.Results X-ray revealed the smooth interface of the main and accessory patella fragments with sclerotic mar-gins,the cleft was slightly wide but not sharp.CT showed the bone sclerosis of interface was mostly smooth,rough and vesicular interface could also be found in a few patients,low density soft tissue could be found in separation zone.MRI could detect the intact but thinned cartilage covering the main and accessory patella fragments,fibrous like tissues could be found in separation zone with MRI.Conclusion Imaging findings of bipartite patella are characteristic,these features are helpful in the diagnosis and differential di-agnosis of bipartite patella.