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Breast cancer has become the most common malignant tumor among women worldwide. Neoadjuvant chemotherapy (NAC) is a systemic cytotoxic drug therapy for breast cancer before local therapy, which can reduce the tumor staging, improve the pathological complete response rate and breast preservation rate. The therapeutic efficacy of NAC is affected by many factors. Imaging examination is of great clinical value to accurately evaluate the efficacy of patients undergoing NAC. This article reviews the progress of imaging methods such as X-ray, ultrasound, magnetic resonance imaging and PET in evaluating the efficacy of NAC in breast cancer.
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OBJECTIVE：To excavate the safety warning signals induced by azole antifungal agents ，including fluconazole ， ketoconazole，itraconazole and voriconazole after marketing ，and to provide references for rational drug use in the clinic. METHODS：Reporting odds ratio （ROR）data mining algorithm was used to investigate signals of adverse drug event （ADE）for fluconazole，ketoconazole，itraconazole and voriconazole from FDA Adverse Event Reporting System （FAERS）during January 1st，2004 to March 30th，2019. ROR data mining method was used to excavate the ADR signals of the drugs ，and main ADR involved in the safety information of azole antifungal agents instructions were analyzed. RESULTS ：A total of 27 831，5 712， 5 381 and 11 333 reports were picked out for fluconazole ，ketoconazole，itraconazole and voriconazole ，respectively. All of these drugs had exhibited high-risk signals detection by ROR ，including medical examination ，blood and lymphatic system disorders ， renal and urinary disorders ，endocrine diseases ，hepatobiliary disorders. The hepatotoxic-related ADR signals were mainly concentrated in fluconazole and voriconazole （fluconazole ROR ＝6.51，voriconazole ROR ＝14.65）；ADR detection results of Cushing’s-like syndrome （ROR＝24.86） and adrenal suppression （ROR＝44.06） by itraconazole showed high-risk signals ； ketoconazole and itraconazole had showed a strong ADR signal in adrenocortical dysfunction （ketoconazole ROR ＝15.64， itraconazole ROR ＝23.26），and the signal intensity of ketoconazole （ROR＝2.81）in skin and subcutaneous tissue disorders was significantly higher than that of other drugs . In addition ，hemorrhagic cystitis caused by fluconazole，itraconazole and voriconazole were not included in the drug instructions （fluconazole ROR ＝17.73，itraconazole ROR ＝31.43，voriconazole ROR ＝17.06）； netted green spot caused by fluconazole （ROR＝10.50）were not included in the drug instructions . CONCLUSIONS：Clinical staff should pay more attention to the differences in serious ADR related to fluconazole ，ketoconazole，itraconazole and voriconazole ； particularly some ADRs not mentioned in the drug instructions but have high incidence such as hemorrhagic cystitis caused by fluconazole，itraconazole，voriconazole and netted green spot caused by fluconazole ，as well as ADRs mentioned in the drug instructions but have abnormally high signal ，such as Cushing ’s-like syndrome and adrenal suppression caused by itraconazole .
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To analyze and research the number and size of public hospitals of our country at the present stage, and explore the regional health planning of public hospitals under the background of China's new medical reform, provide the scientific basis for our further layout of regional health planning for public hospitals of our country. Methods Mainly use the method of the document analysis, by collecting and analyzing the literature related to the regional health planning of public hospitals under the new health reform. And relevant data on China Health Statistics Yearbook 2011 were analyzed. Results The irrational regional health planning and layout design of public hospitals not only seriously affect the efficiency of health care resources, but also exacerbate the difficulty and high cost of people getting medical service. Conclusion Under the new health care reform, the definition of public hospitals and the positioning and functionality of public hospitals need to be re-examined. The following three aspects will solve the problem of regional health planning of public hospitals. First, to moderately reduce the number and size of public hospitals; second, to determine and adjust the number of public hospitals at all levels; Third, to reasonably lay out urban and rural public hospital.
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Objective To investigate the efficacy and safety of using stereotactic radiotherapy (SRT) technique for conducting re-therapy after thoracic tumor radiotherapy.Methods Thirty-eight patientswith SRT after receiving thoracic conventional radiotherapy (RT) in our hospital from July 2012 to November 2014 were selected.The treatment target area included the lung local primary lesion,recurrent lesions and lung metastasis tumor.Results Median dose of previous RT was 48 Gy (30-56 Gy).Median biologically equivalent effective dose (alpha/beta=10.0,BED10) of receiving SRT was 62 Gy (39-72 Gy).Median follow up time was 12.30 months;1-,2-year local progression-free survival (LPFS) was 76.32％ and 63.16 ％ respectively.Median recurrence-free (RFS) and overall survival (OS) were 13.20 months and 21.00 months respectively.Grade 2 and 3 pulmonary toxicity was 15.79 ％ and 7.89 ％ respectively.Other grade 2-4 toxicities adverse reactions included chest pain (15.79 ％),fatigue (18.42 ％) and skin lesion(2.63％).No grade 5 toxic injury occurred.Conclusion SRT can be safely and effectively used in the patients previously receiving thoracic RT.
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OBJECTIVE:To observe the anesthetic effect of dexmedetomidine in pelvic floor reconstructive surgery of elderly patients with pelvic organ prolapse(POP). METHODS:60 elderly patients with pelvic floor reconstructive surgery were randomly di-vided into observation group and control group. Observation group was treated with 0.5 μg/kg dexmedetomidine by pumping and control group was treated with 0.125 ml/kg 0.9% sodium chloride injection by pumping 15 min before anesthesia,and conventional intravenous induction was conducted after 15 min. MAP,HR and bispectral index(BIS)in entering the room(T0),5 min after ad-ministration(T1),immediate intubation(T2),1 min after intubation(T3),5 min after intubation(T4),surgical skin incision(T5), immediate extubation(T6)and 5 min after extubation(T7),restlessness score,sedation score,recovery time and incidence of ad-verse reactions in 2 groups were observed. RESULTS:MAP and HR in observation group in T1-7 were significantly lower than T0 and control group,MAP and HR in control group in T2-7 were significantly high than T0 except that T1 was significantly lower than T0,the differences were statistically significant(P0.05). Restlessness score in observation group was significantly lower than control group,sedation score was significantly higher than control group,the differ-ence was statistically significant(P0.05). There were no obvious adverse reactions in 2 groups during treatment. CONCLUSIONS:Dexmedetomidine can effectively reduce the stress response and maintain cycle stability in the treatment of elderly patients with pelvic floor reconstructive surgery,with good safety.
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OBJECTIVE:To study the characteristics of patent behaviors of Chinese pharmaceutical demonstration enterprises for intellectual property,and to provide reference for the improvement of patent behaviors in Chinese pharmaceutial enterprises. METHODS:After retrieving the applicants(patentees)from China Intellectual Property Right Net on the basis of taking 7 pharma-ceutical demonstration enterprises chosen through appraisal by State Intellectual Property Office of the P.R.C in 2013 as the study samples,empirical study was conducted on their patent behaviors during 1985 and 2013,including the number and type of the pat-ents for which applications were made,international patent classification and legal status. RESULTS:The number of patent applica-tions of the 7 pharmaceutical demonstration enterprises demonstrated a growing trend(an annual increase up to 79.0%). The appli-cations were dominated by the inventive patent(84.9%). Many patents were in an authorized legal status(46.7%). All of these en-terprises paid more attention to the maintenance of the authorized patent. The technology patent applications were mainly about chemical compound,composition,and preparation methods,including the technical proposal containing the active ingredients and properties of the pharmaceutical preparation (A61K),particularly the application of the technical proposal related to the treatment with the preparation (A61P). CONCLUSIONS:All the 7 pharmaceutical demonstration enterprises were aware of patent competi-tion and protection and characterized by a higher proportion of the application for the inventive patent,perfect patent information management institution and high-quality patent applications. Chinese pharmaceutical enterprises can enhance their competitiveness and creativity through adjusting patent behaviors and increasing their awareness of patent competition.
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Objective To investigate the effect of preemptive parecoxib on blood coagulation in patients undergoing abdominal hysterectomy. Methods This was a randomized, double-blind controlled study. Seventy ASA Ⅰ or Ⅱ patients aged 38-56 yr weighing 50-75 kg undergoing abdominal hysterectomy under combined spinal-epidural anesthesia were randomized to one of 2 groups (n=35 each): parecoxib group (group P) received intravenous parecoxib 40 mg/2 ml at 20 min before anesthesia and control group (group C) received normal saline 2 ml instead of parecoxib. Both groups received patient-controlled intravenous analgesia (PCIA) with butorphanol after surgery. The PCIA solution contained butorphanol 0.2 mg/kg and ondansetron 4 mg in normal saline 100 ml.The PCIA was set up with background infusion 2 ml/h, incremental dose 2 ml, and lockout interval 15 min. VAS score was used to assess the intensity of pain (O= no pain, 10 = worst pain). Venous blood samples were taken before and at 30 min and 2 h after parecoxib or normal saline administration for coagulation test and platelet count.The postoperative ambulation time and adverse response were recorded. Butorphanol consumption per hour during postoperative analgesia and total consumption of butorphanol within 24 h after operation were also recorded. Results Compared with those before parecoxib administration, prothrombin time and thrombin time in group C and thrombin time in group P were significantly prolonged and fibrinogen concentration was significantly lower in group C at 30 min after parecoxib administration (P＜ 0.05), but no significant difference was found in the other parameters of blood coagulation and platelet count at 30 min after parecoxib administration in group P ( P＞0.05).The fibrinogen concentration was significantly higher, the incidence of postoperative nausea and vomiting was significantly lower, the postoperative ambulation time was significantly shorter, and butorphanol consumption per hour during postoperative analgesia and total consumption of butorphanol within 24 h after operation were significantly lower in group P than in group C ( P＜0.05 ), but there was no significant difference in the other parameters of blood coagulation and platelet count between group P and group C ( P ＞ 0.05 ). Conclusion Preemptive parecoxib 40 mg can enhance blood coagulation in patients undergoing abdominal hysterectomy.
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As a noninvasive method, functional magnetic resonance imaging can provide metabolism and biochemical information in vivo. In recent years, it has been gradually applied to the diagnosis of breast diseases, and the diagnostic specificity of benign and malignant breast tumors has since become improved significantly. In this review, we introduce the functional magnetic resonance imaging of breast.
Subject(s)
Female , Humans , Breast Neoplasms , Diagnosis , Pathology , Diagnosis, Differential , Diffusion Magnetic Resonance Imaging , Methods , Magnetic Resonance Angiography , Methods , Magnetic Resonance Imaging , Methods , Magnetic Resonance Spectroscopy , MethodsABSTRACT
To analyze the adults' coronary artery anomalies revealed by 64-MDCT, we retrospectively analyzed 34 cases of coronary artery anomalies (26 males and 8 females, averagely aged 53. 4 years with a range from 30 to 72 years). Multi-plannar reconstruction (MPR), maximum intensity projection (MIP), surface shadow display (SSD) and volume rendering (VR) were used to demonstrate the anomalous coronary artery. We found 4 cases of RCA from the left coronary sinus, 8 cases with secondary RCA, 1 case with high locations of left main (LM) segments from left sinus of valves, 1 case with LAD originated from main pulmonary artery, 3 cases with separate origin of LAD and LCX. Ten cases with myocardial bridge were shown (9 cases in LAD, 1 case in LCX); coronary fistula was seen in 2 cases (one was RCA-RA fistula, another was LAD-RV fistula), coronary aneurysm was found in 2 cases. Three cases in RCA were short and small. In conclusion, 64-MDCT is a good choice for diagnosing the anomalous coronary artery.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Coronary Vessel Anomalies , Diagnostic Imaging , Retrospective Studies , Tomography, Spiral Computed , MethodsABSTRACT
Objective To observe the changes of image quality after adjusting the space location and the scan parameters of MRS.Methods 65 patients were scanned with magnetism resonance spectrum head examination.The location,size and other scan parameters of the region interested were changed intentionally.The quality of the images was preliminarily evaluated and the relationship between the parameters and the quality of MRS were probed.Results In the 65 cases,60 were with better shape of wave lines and metabolite peak positions,5 with aberrant lines and shifted peaks.Among the recorded data: the range of half high width value is 5~23,water suppression level 92~99.With the 60-case group,all those half high width values were within the given range of the system,on the contrast,within the 5-case group half high width values were 7,9,16 and 23,and water suppression levels were 95,96,97.Conclusion High-quality wave spectrum depends on high uniformity of magnetic field.The value of half high width is an important factor that reflects the uniformity of magnetic field.