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Platinum anti-tumor drugs are currently the most widely used first-line chemotherapeutic drugs in clinical practice, and their curative effects are remarkable. However, the problems of platinum drug resistance in non-small cell lung cancer, breast cancer, ovarian cancer and others seriously limit effectiveness and clinical application of platinum drugs. The occurrence of platinum drug resistance is caused by many factors. At present, the resistance mechanism of platinum drugs mainly includes the following aspects: decreasing the accumulation of platinum in cells, increasing the inactivation of platinum in cells, repairing DNA damage and tumor cell apoptosis inactivation. This article reviews the drug resistance mechanism and coping strategy of platinum anti-tumor drugs, providing ideas for the development of platinum anti-tumor drugs and references for overcoming clinical platinum drug resistance.
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OBJECTIVE@#To assess the practical and health economical values of non-invasive prenatal test (NIPT) in Changsha Municipal Public Welfare Program.@*METHODS@#A retrospective analysis was carried out on 149 165 women undergoing NIPT test from April 9, 2018 to December 31, 2019. For pregnant women with high risks, invasive prenatal diagnosis and follow-up of pregnancy outcome were conducted. The cost-benefit of NIPT for Down syndrome was analyzed.@*RESULTS@#NIPT was carried out for 149 165 pregnant women and succeeded in 148 749 cases (99.72%), for which outcome were available in 148 538 (99.86%). 90% of pregnant women from the region accepted the screening with NIPT. 415 (0.27%) were diagnosed as high risk. Among these, 381 (91.81%) accepted amniocentesis, which led to the diagnosis of 212 cases of trisomy 21 (PPV=85.14%), 41 cases with trisomy 18 (PPV=48.81%) and 10 cases with trisomy 13 (PPV=20.83%). The sensitivity and specificity of NIPT for trisomy 21, trisomy 18 and trisomy 13 were (97.70%, 99.98%), (97.62%, 9.97%) and (100%, 99.97%), respectively. In addition, 213 and 30 cases were diagnosed with sex chromosomal aneuploidies (PPV=46.2%) and other autosomal anomalies (PPV=16.57%), respectively. For Down syndrome screening, the cost and benefit of the project was 120.79 million yuan and 1,056.95 million yuan, respectively. The cost-benefit ratio was 1: 8.75, and safety index was 0.0035.@*CONCLUSION@#NIPT is a highly accurate screening test for trisomy 21, which was followed by trisomy 18 and sex chromosomal aneuploidies, while it was less accurate for other autosomal aneuploidies. The application of NIPT screening has a high health economical value.
Subject(s)
Female , Humans , Pregnancy , Aneuploidy , Cost-Benefit Analysis , Noninvasive Prenatal Testing , Retrospective Studies , Trisomy 18 Syndrome/geneticsABSTRACT
Objective To understand the current status of aloneness and analyze the influencing factors,and to provide reference to improve the aloneness among middle?aged and elderly. Methods A total of 994 middle?aged and elderly in Donggang sampled by stratified random sampling method were investigated by UCLA scale. The influencing factors were assessed by t?test and one?way ANOVA. The data were analyzed by SPSS 16.0. Results The average score of UCLA scale among middle?aged and elderly was 41.54 ± 8.91. The results indicated whether living with their children,alcohol drinking,quality of sleep,history of trauma,psychological counseling,monthly income,chronic disease and physical training were the influencing factors of aloneness among middle?aged and elderly,and the differences were statistically significant(P<0.05). Conclusion The aloneness was obvious among middle?aged and elderly in China. Health interventions and effective social support should be provided to improve the physiological,psychological and economic levels that will lead to important influence on the improvement of aloneness among middle?aged and elder?ly in China.
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The national examination of doctors' qualification is the examination which assesses the medical students' knowledge and skills for doctors' work. This paper introduced autorities concerned, implementing agencies, examination forms and procedures, examination contents and keypoints, pass-ing criteria and matters needing attention of national examination of doctors's qualification be tween Canada and Australia expecting to provide references for the revolution of Chinese Examination of Doctors' Qualification.
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[Objective] To investigate the clinical effect of treatment of lumbar vertebral instability with posterior interbody fusion using autogenous bone and pedicle screw fixation.[Methods]Thirty-seven cases of lumbar instability were treated with posterior spinal canal,nerve root canal decompression,pedicle screw fixation and autogenous bone grafting,and results were evaluated.[Results]Postoperative follow up time was average 25 months(ranged,12-32 months).Excellent fusion was achieved in 29 cases and good fusion was achieved in 8 cases,with good-to-excellent rate of 100%.According to JOA standard efficacy evaluation,postoperative JOA score improved significantly than preoperative one(P