[Using Simulation Teaching to Improve the Communication Skills of Clinicians].

BACKGROUND & PROBLEM: Better communication skills improve the ability of nurses to reduce conflicts with patients. In our medical center, complaints related to poor communication skills during the indwelling of venous catheters number as many as 20-25 cases per month. In our survey, we found that over half (56.25%) of nursing personnel in our medical center self-reported as having "below average" communication skills. Our project team decided to make improvements using interviews and a field survey. After analysis, the team found that reasons for poor communications skills include: the design of educational training courses do not match clinical care needs; the lack of communicative experience while performing venous catheters indwelling; the low confidence of medical personnel; and the lack of communication-skills-related video teaching materials. PURPOSE: Establish suitable teaching project modes that improve the communication skills of nursing personnel in the pediatric department during venous catheters indwelling procedures. METHODS: The improvement methods proposed by the project team consisted of: modifying the pediatric-venous-catheter-indwelling training course, designing teaching courses to enhance communication skills, training seed teachers to teach communication skills, produce videos clips showing scenarios of communication, holding regular case report discussions, and compiling these discussions into an instruction manual. RESULTS: Nursing personnel utilized language or non-language methods to guide pediatric patients and to communicate with their parents during venous catheters indwelling. They understood what patients and their parents were expressing and responded to their questions and concerns logically. The mean score for overall communication skills increased from 27.25 to 35.94 (range: 8 to 40). CONCLUSIONS: Communication teaching modes that combine simulation teaching were established in this project. The communication skills of nurse personnel increased significantly during venous catheters indwelling. We expect to promote a better relationship between nurse personnel, pediatric patients, and their parents by sharing this project.

Efficacy and safety of domestic dasatinib as second-line treatment for chronic myeloid leukemia patients in the chronic phase / 中华血液学杂志

Objective: To investigate the efficiency and safety of domestic tyrosine kinase inhibitor (TKI) dasatinib (Yinishu) as second-line treatment for patients with chronic myeloid leukemia in chronic phase (CML-CP). Methods: A retrospective analysis of clinical data of CML-CP patients who received domestic dasatinib as second-line treatment in the CML collaborative group hospitals of Hubei province from March 2016 to July 2018 was performed. The optimal response rate, the cumulative complete cytogenetic response (CCyR), the cumulative major molecular responses (MMR), progression free survival (PFS), event free survival (EFS) and adverse effects (AEs) of the patients were assessed at 3, 6 and 12 months of treatment. Results: A total of 83 CML-CP patients were enrolled in this study. The median follow-up time was 23 months. The optimal response rates at 3, 6 and 12 months in 83 CML-CP patients treated with dasatinib were 77.5% (54/71), 72.6% (61/75) and 60.7% (51/69), respectively. By the end of follow-up, the cumulative CCyR and MMR rates were 65.5% (55/80) and 57.1% (48/73), respectively. The median time to achieving CCyR and MMR was 3 months. During follow-up time, the PFS rate was 94.0% (79/83) and the EFS rate was 77.4% (65/83). The most common non-hematological AEs of dasatinib were edema (32.5%), rash itching (18.1%) and fatigue (13.3%). The common hematological AEs of dasatinib were thrombocytopenia (31.3%), leukopenia (19.3%) and anemia (6.0%). Conclusion: Domestic dasatinib was effective and safe as the second-line treatment of CML-CP patients and it can be used as an option for CML-CP patients.

Expression and prognostic effect of DEPTOR in rectal carcinoma / 局解手术学杂志

Objective To clarify the expression of DEPTOR in rectal cancer,and to further explore the relationship between the expres-sion level of DEPTOR and histopathology and prognosis,in order to provide reference for the clinical diagnosis and treatment of rectal cancer. Methods The clinical data of 102 patients who underwent radical resection of rectal cancer in our hospital from January 2011 to January 2013 were analyzed retrospectively.The expression of DEPTOR in cancer tissues and adjacent tissues were evaluated by immunohistochemis-try and immunoblotting.The patients were divided into high expression group and low expression group by the median value of integrated opti-cal density(IOD);the relationship between the expression level of DEPTOR and clinical,histopathology and prognosis was analyzed. Results The results ofImmunohistochemistry and immunoblotting showed that the expression level of DEPTOR in cancer tissues was higher than that in adjacent tissues,the differences were significant(P<0.05). Univariate analysis showed that there was no significant differences in gender, age,and BMI(P>0.05),and there were significant differences in tumor diameter,T stage,N stage,and differentiation between the high-ex-pression and low-expression group (P<0.05).The independent influencing factors of DEPTOR expression was analyzed by the Logistic re-gression model,which showed that T stage and tumor diameter were independent influencing factors of high expression of DEPTOR.Compared with low expression group,the serum CEA level in patients with high expression group was higher,the differences was statistically significant ( P < 0.05 ). There was no significant difference in serum CA199 level between the expression group and the low expression group (P>0.05).Spearman correlation analysis showed that the expression level of DEPTOR was positively correlated with serum CEA level in rectal cancer patients (r=0.509,P<0.01).Compared with low expression group,the 5-year cumulative recurrence rate and the 5-year cumulative mortality rate in the high-expression group of DEPTOR were higher,the differences were statistically significant ( P <0.05). Conclusion DEPTOR is highly expressed and is associated with the degree of disease progression in rectal cancer,its elevation suggests a poor prognosis.