These findings suggest that higher psychological capital increases the self-reported job embeddedness and performance of these nurses.

Aerosol particle samples collected in spring 2002 in Beijing were analyzed to investigate the impact of transport pathways on chemical composition of Asian dust storms (DSs). The dust storms were divided into two episodes (i.e., DS I and DS II), which were transported along different pathways identified by back‐trajectory and PM10 concentrations. The transport pathway from the westerly direction could be seen as the “polluted” pathway and the north‐northwesterly direction as the relatively “less‐polluted” one. Dust storms not only delivered large amounts of mineral elements but also carried significant quantities of pollutants. The source regions and transport pathways were two vital factors affecting chemical composition of dust storms. Ca/Al could be used as elemental tracer to identify the sources of Asian dust storms owing to the difference in Ca content in different source regions. DS I of the “polluted” pathway carried more pollution elements than DS II of the “less‐polluted” one, and the pollution elements were either from dust soil (such as Zn), the mixing of dust soil with pollution aerosol on the pathway (such as As and Pb in DS I), the “pollution” dust resuspended on the pathway and Beijing local area (such as S in DS I, As and Pb in DS II), or the reactions on the surface of dust particles.

Background and purpose: Stroke is a leading cause of death and acquired disability in adults today. Inflammation plays an important role in the pathophysiology of stroke. The peripheral neutrophil-to-lymphocyte ratio (NLR) is an important global inflammatory indicator becoming more mainstream in stroke care. This meta-analysis aims to evaluate the relationship between the baseline NLR and acute ischemic and hemorrhagic stroke, as well as define the clinical significance of NLR in subtypes of ischemic stroke.Methods: This meta-analysis was registered in PROSPERO with the number CRD42018105305. We went through relevant articles from PubMed Central (PMC) and EMBASE. Prospective and retrospective studies were included if related to baseline NLR levels prior to treatment in patients with ischemic or hemorrhagic stroke. Studies were identified up until April 2019. The cutoff value for NLR and the sources of odds ratios (ORs)/risk ratios (RRs) were measured. Modified Rankin Scale (mRS) was used to investigate the outcomes during clinical follow-up. Predefined criteria were used to evaluate the risk of bias in eligible studies. P-values < 0.05 were considered statistically significant. STATA version 14.0 (STATA, College Station, TX) was used in all statistical analyses.Results: Thirty-seven studies with 43,979 individuals were included in the final analysis. Higher NLR levels were correlated with increased risk of ischemic stroke (ORs/RRs = 1.609; 95% CI = 1.283–2.019), unfavorable functional outcome at 3 months (ORs/RRs = 1.851; 95% CI = 1.325–2.584), and increased mortality in patients with ischemic stroke (ORs/RRs = 1.068; 95% CI = 1.027–1.111). While in terms of hemorrhagic stroke (including SAH and ICH), elevated NLR levels only had deleterious effects on mortality (ORs/RRs = 1.080; 95% CI = 1.018–1.146).Conclusions: Baseline NLR level is a promising predictor of the clinical outcomes in both ischemic and hemorrhagic stroke. In addition, elevated NLR is also associated with a high risk of ischemic stroke occurrence. However, future studies are needed to demonstrate the underlying mechanisms and further explain this association.

High-dose methotrexate (HDMTX) plays an important role in the treatment of acute lymphoblastic leukemia (ALL) although there is great inter-patient variability in the efficacy and toxicity of MTX. The relationship between polymorphisms in genes encoding MTX transporters and MTX response is controversial. In the present study, 322 Chinese children with standard- and intermediate-risk ALL were genotyped for 12 polymorphisms. SLCO1B1 rs10841753 showed a significant association with plasma MTX levels at 48 h (P = 0.017). Patients who had the ABCB1 rs1128503 C allele had longer duration of hospitalization than did those with the TT genotype (P = 0.006). No association was found between oral mucositis and any polymorphism. Long-term outcome was worse in patients with the SLCO1B1 rs4149056 CC genotype than in patients with TT or TC (5-year event-free survival [EFS] 33.3 ± 19.2% vs. 90.5 ± 1.7%, P < 0.001), and was worse in patients with the SCL19A1 rs2838958 AA genotype than in patients with AG or GG (5-year EFS 78.5 ± 4.6% vs. 92.2 ± 1.8%, P = 0.008). Multiple Cox regression analyses revealed associations of minimal residual disease (MRD) at day 33 (hazard ratio 3.458; P = 0.002), MRD at day 78 (hazard ratio 6.330; P = 0.001), SLCO1B1 rs4149056 (hazard ratio 12.242; P < 0.001), and SCL19A1 rs2838958 (hazard ratio 2.324; P = 0.019) with EFS. Our findings show that polymorphisms in genes encoding MTX transporters substantially influence the kinetics and response to HDMTX therapy in childhood ALL.

Acute lymphoblastic leukemia (ALL) with distinct fusion transcripts has unique clinical features. In this study, the incidence, clinical characteristics, early treatment response, and outcomes of 1,004 Chinese pediatric ALLs were analyzed. Patients with TEL‐AML1 and E2A‐PBX1 fusion genes or other B cell precursor ALLs (BCP‐ALL) had favorable clinical features, were sensitive to prednisone, had low minimal residual disease (MRD), and an excellent prognosis, with a 5‐year event‐free survival (EFS) of 84–92%. T‐ALL was associated with a high WBC, increased age, more central nervous system involvement, a poor prednisone response, and high MRD, with a 5‐year EFS of 68.4 ± 5.2%. Patients with BCR‐ABL and MLL rearrangements usually had adverse clinical presentations and treatment responses, and a dismal prognosis, with 5‐year EFS of 27.3 and 57.4%, respectively. We also showed that BCR‐ABL and MLL rearrangements, the prednisone response, and MRD were independent prognostic factors. Interestingly, the BCH‐2003 protocol resulted in a better outcome for E2A‐PBX1+ patients than the CCLG‐2008 protocol. Intermediate and late relapses were more common in TEL‐AML1+ patients and other BCP‐ALLs compared with other subgroups (P = 0.018). Therefore, this study suggests that a fusion gene‐specific chemotherapy regimen and/or targeted therapy should be developed to improve further the cure rate of pediatric ALL. Am. J. Hematol. 2012. © 2012 Wiley Periodicals, Inc.

This study aimed to investigate whether there was a correlation between the genotype or haplotype of the methylenetetrahydrofolate reductase gene (MTHFR) and toxicities during consolidation therapy or plasma methotrexate (MTX) levels at 48 h after the first dose of MTX infusion. We retrospectively genotyped 181 children with newly diagnosed acute lymphoblastic leukemia (ALL) who were treated with the Chinese Children's Leukemia Group protocol. In standard- and medium-risk treatment branches, the 677T carriers (CT + TT) had a higher risk of developing thrombocytopenia when compared with carriers of the CC genotype (odds ratio [OR] 5.21, 95% confidence interval [CI] 1.18-23.01, p = 0.017). The 1298AC/CC genotypes were associated with a decrease in skin toxicity, as compared with the common AA genotype (p = 0.037). An estimation of haplotype frequencies showed that there was no 677T-1298C haplotype in the population. A lower frequency of anemia (OR 0.44, 95% CI 0.21-0.90, p = 0.025) and lower MTX level (p = 0.044) were observed in patients with the 677C-1298C haplotype than in those without. High plasma MTX level was correlated with anemia (p = 0.011) and neutropenia (p = 0.044). In the high-risk group, the polymorphisms or plasma MTX levels were not correlated with any toxicity. Taken together, our data demonstrate that genotyping of MTHFR and measurement of plasma MTX levels might be useful to optimize MTX therapy.

Background: Red blood cell distribution width (RDW) may be a potential biomarker of inflammation in patients with stroke. Elevated RDW is associated with higher incidence of stroke, unfavorable functional outcome, and increased mortality, although results are inconsistent in the reported literature. This study aims to evaluate the predictive power of RDW regarding stroke occurrence and outcome.Methods: A thorough literature search was conducted utilizing the PubMed Central (PMC) and EMBASE databases to identify studies up to May 2019. Data from these studies were pooled, and combined odds ratios/risk ratios (ORs/RRs) were estimated for the risk of stroke, functional outcome, and mortality. A subgroup analysis was also performed to explore heterogeneity in terms of population status, demographic factors (age, gender distribution, and country), and vascular risk factors (hypertension, diabetes mellitus, and current smoking).Results: A total of 31 studies with 3,487,896 patients were included in the analysis. Elevated RDW was found to be a risk factor in ischemic stroke (OR/RR 1.528; 95% confidence interval [CI] = 1.372–1.703), whereas combined OR in subarachnoid hemorrhage (SAH) was not statistically significant (OR/RR 1.835; 95% CI = 0.888–3.792). Elevated RDW posed increased risk in populations with conventionally higher risk of stroke, such as atrial fibrillation (AF) (OR/RR 1.292; 95% CI = 1.107–1.508) and diabetes mellitus (OR/RR 2.101; 95% CI = 1.488–2.968), and in community cohorts (OR/RR 1.245; 95% CI = 1.216–1.275). In addition, higher RDW was associated with unfavorable functional outcome, either at discharge (OR/RR 1.220; 95% CI = 1.070–1.39) or at 90 days (OR/RR 1.277; 95% CI = 1.155–1.413). Higher mortality was found in patients with increased RDW (OR/RR 1.278; 95% CI = 1.221–1.337), independent of demographic factors (age, gender distribution, and country).Conclusions: Baseline RDW should be integrated into clinical practice as a predictor of ischemic stroke occurrence and outcome. Future studies should also explore the dynamic change of RDW in post-stroke patients to evaluate the clinical significance of RDW and its impact on the inflammatory state of ischemic stroke.

TSP and PM2.5 aerosol particles were synchronously sampled at six sites along the transport pathway of dust storms from desert regions to coastal areas in the spring of 2004 to investigate the regional characteristics of Asian dust and its impact on aerosol chemistry over northern China. Factor analysis of daily PM10 concentrations in 17 cities showed that northern China can be basically divided into five regions: (1) Northern Dust Region, (2) Northeastern Dust Region, (3) Western Dust Region, (4) Inland Passing Region, and (5) Coastal Region. Northern Dust Region was characterized by a high content of Ca. Northeastern Dust Region was a relatively clean area with a low concentration of pollutants and secondary ions in comparison to other regions. Inland Passing Region and Coastal Region showed high concentrations of anthropogenic pollutants. The impact of Asian dust on aerosol chemistry decreased in the order Yulin/Duolun > Beijing > Qingdao/Shanghai as transport distance increased. The ratio of Ca/Al, which showed significant differences in different regions over northern China, is suggested to be a tracer to identify the sources of dust storms. Asian dust either mixes pollutants on the pathway and carries them to the downwind regions or dilutes the pollutants over northern China, which affects the aerosol composition more in coarse particles in those areas near source regions and more in fine particles in downwind areas. The ratio of NO3−/SO42− during dust storms was significantly reduced and the lowest generally appeared after the peak of dust. Our results showed that Asian dust plays a critical role in buffering the acidity of aerosols over northern China by a potential increase of ∼1 unit pH for the aerosol particles in spring.