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Under the background of "Medical Education Synergy", the clinical practice ability of postgraduates has been significantly improved, and the post competency has been enhanced. However, the "cultivation goal orientation" focuses on clinical practice, the education management department has weakened the cultivation of scientific research literacy, and the postgraduate tutors have not paid enough attention. As a result, the cultivation of scientific research literacy of professional degree postgraduates is seriously affected, and their scientific research ability is obviously weak. Taking gastroenterology as an example, by optimizing the course setting and rotation plan arrangement, attaching importance to the management of the graduate management department and the tutor responsibility system, and strengthening the application of interdisciplinary in the innovation and development of disciplines, we have explored an educational plan for cultivating professional degree postgraduates. The clinical practice and clinical research capabilities of postgraduates majoring in gastroenterology have been synergistically developed with remarkable results.
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Objective@#To understand the public health emergency response capacity in primary and secondary schools, and to explore the problems and challenges in the prevention and control of public health emergency in primary and secondary schools for specific strategies.@*Methods@#By using the stratified group sampling method, a questionnaire survey on general situation, knowledge, attitude and training, as well as public health emergencies response capacity among 2 988 teachers or leaders responsible for school emergency response in primary and secondary schools from Beijing, Chongqing and Yunnan.@*Results@#Participants varied on their positions, titles, educational background and knowledge accuracy. Higher knowledge accuracy was associated with higher educational background ( χ 2=50.73-203.36, P < 0.05 ). The implementation of regular public health emergency related programs was poorly conducted in high schools (50.0%). Urban schools (42.0%) had higher proportion of qualified health care professionals than rural schools (18.2%), and private schools (48.5%) was higher than public schools (24.7%). The primary challenges included the shortage of guidance from professionals and the lack of related testing equipment (84.91%, 74.03%).@*Conclusion@#Although the ability of emergency handling of public health emergencies in schools in the three regions is advancing with the times, there are still many deficiencies, some omissions in the mastery of knowledge. It is suggested to inerease pre service and special training of school health work CDC should strengthen technical guidance and work supervision of infectious disease management in schools.
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Non-small cell lung cancer (NSCLC) is the most common pathological type of lung cancer. The systemic antitumor therapy of advanced NSCLC has undergone renovations of chemotherapy, targeted therapy and immunotherapy, which results in greatly improved survival for patients with advanced NSCLC. Immune checkpoint inhibitors (ICIs), especially targeting programmed cell death protein 1 (PD-1)/programmed death-ligand 1 (PD-L1), has changed the treatment paradigm of NSCLC. ICIs have become the standard treatment for advanced NSCLC without epidermal growth factor receptor(EGFR) mutation or anaplastic lymphomakinase(ALK) translocation in the first- or second-line setting, and for locally advanced NSCLC following concurrent radiotherapy and chemotherapy. ICIs are also promising in adjuvant/neoadjuvant therapy. More and more ICIs have been approved domestically for the treatment of NSCLC. Led by the NSCLC expert committee of Chinese Society of Clinical Oncology (CSCO), this consensus was developed and updated based on thoroughly reviewing domestic and foreign literatures, clinical trial data, systematic reviews, experts' discussion and the consensus(2019 version). This consensus will aid domestic clinicians in the treatment of NSCLC with ICIs. .
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Immunotherapy plays a compelling role in cancer treatment and has already made remarkable progress. However, many patients receiving immune checkpoint inhibitors fail to achieve clinical benefits, and the response rates vary among tumor types. New approaches that promote anti-tumor immunity have recently been developed, such as small molecules, bispecific antibodies, chimeric antigen receptor T cell products, and cancer vaccines. Small molecule drugs include agonists and inhibitors that can reach the intracellular or extracellular targets of immune cells participating in innate or adaptive immune pathways. Bispecific antibodies, which bind two different antigens or one antigen with two different epitopes, are of great interest. Chimeric antigen receptor T cell products and cancer vaccines have also been investigated. This review explores the recent progress and challenges of different forms of immunotherapy agents and provides an insight into future immunotherapeutic strategies.
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Humans , Antibodies, Bispecific/therapeutic use , Cancer Vaccines , Immunotherapy , Neoplasms/therapy , Receptors, Chimeric Antigen , T-LymphocytesABSTRACT
Non-small cell lung cancer (NSCLC) is the most common pathological type of lung cancer, most NSCLC patients are at advanced stage at the time of diagnosis. For patients without sensitive driven-oncogene mutations, chemotherapy is still the main treatment at present, the overall prognosis is poor. Improving outcomes and obtaining long-term survival are the most urgent needs of patients with advanced NSCLC. In recent years, immunotherapy has developed rapidly. Immune checkpoint inhibitors (ICIs), especially targeting programmed death-1 (PD-1)/programmed death-ligand 1 (PD-L1), have made a breakthrough in the treatment of NSCLC, beneficial to patients' survival and changed the treatment pattern for NSCLC. It shows more and more important role in the treatment of NSCLC. Led by NSCLC expert committee of Chinese society of clinical oncology (CSCO), relevant experts in this field were organized. On the basis of referring to domestic and foreign literature, systematically evaluating the results of Chinese and foreign clinical trials, and combining the experiences of the experts, the experts group reached an agreement to develop this consensus. It will guide domestic counterparts for better application of ICIs to treat NSCLC.
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Objective To investigate the relationship between self-efficacy and positive degree in patients with cervical spondylosis.Method A questionnaire survey was conducted among 98 patients with cervical spondylosis.Results The self-efficacy score was 6.30±1.56,the score on the positive degree was 53.76 ±12.53.The self-efficacy and positive degrees were positively correlated (r=0.531,P＜0.001).Conclusions The patient's self-efficacy and positive degree are at medium level.Nursing staff should take corresponding measures to improve self-efficacy of cervical spondylosis patients,in order to improve its positive degree and achieve the purpose of effective self-management and health promotion.
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Objective To prepare a novel ultrasound contrast agent , targeted phase-shift lipid nanoparticles mediated by tumor homing and penetrating peptide tLyP-1 ,and to evaluate its characteristics . Methods The nanoparticles were prepared by filming-rehydration and acoustic-vibration methods .The morphology ,distribution ,particle size and zeta potential were detected . After heating and irradiating of low intensity focused ultrasound ( LIFU) ,the phase-shift characteristic and the enhancement effect in vitro were observed . The tumor homing and cell-penetrating properties of the nanoparticles were examined by confocal laser scanning microscopy and flow cytometry . The cytotoxicity of the nanoparticles was evaluated by CCK 8 assay . Results The size and distribution of nanoparticles were uniformed . The size and zeta potential of nanoparticles were ( 399 .50 ± 29 .98) nm and ( 3 .28 ± 1 .72) mV ,respectively . When the nanoparticles were heated to a temperature of 45 ℃ or after irradiated by LIFU ,nanoparticles generated phase-shift and enhanced ultrasound imaging in vitro ( P 0 .05 ) . Conclusions A novel ultrasound contrast agent , targeted phase-shift lipid nanoparticles mediated by tumor homing and penetrating peptide tLyP-1 ,is prepared successfully . It can target to MDA-MB-231 cell and penetrate into the cell in vitro ,and enhance ultrasound imaging in vitro after LIFU irradiation ,which expected to become a novel tumor targeted ultrasound contrast agent and achieve ultrasound molecular imaging at the level of tumor cell .
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Objective To explore the development requirements and tentative ideas on the standardized teaching wards in the internship course of undergraduate nursing students. Methods 134 nursing undergraduate students before the internship and 70 nursing teachers were recruited in this study. A self-made questionnaire was distributed to these students and teachers to explore their requirements and needs in the development of the standardized teaching wards. Results The majority of students and nursing teachers thought that it was necessary to design and develop the standardized teaching wards for the nursing students and the six items of this study were accepted by them. Conclusion The standardized teaching wards will be designed and developed according to the six items of this study.
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To investigate the effects of serum containing Yiqi Huayu Bushen Recipe, a compound Chinese herbal medicine, on expressions of aggrecan and type X collagen mRNAs of the degenerated intervertebral disc cells in patients with cervical spondylotic myelopathy.
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Objective:To investigate the relationship of-308bp polymorphism in tumor necrosis factor-α (TNFa)gene and+252bp in lymphotoxin-α(LTα)gene with the clinical course and outcome of non-Hodgkin's lymphoma(NHL).Methods:The single base change in TNFα gene and LTα gene was analyzed among 96 Chinese patients with NHL and 72 normal controls by using PCR-restrictive fragment length polymorphism (RFLP).The clinical data were collected and survival analysis was performed.Results:In NHL patients,no statistcally significant association was found between the presence of a given TNF/LT haplotype status and clinical variables such as age,seX,disease stage,and so on.The patients carrying low-risk haplotype achieved a more sensitive response to first-line therapy than that in patients with high-risk haplotype(70.4%v 45.2%:P=0.018).The estimated 1-year progression-free survival rates in the high-risk and low-risk groups were 66.67% and 87.5%,respectively(log-rank test,P=0.0231).Kaplan-Meier method showed that the estimated 2-year and 4-year overall survival rates were 39.95%and 8.32%in patents carrying high-risk haplotypes and 65.13%and 46.52%in patients carrying low-risk haplotypes,respectively(log-rank test,P=0.0012).In multivariate Cox regression models.the TNF/LT haplotype status was found to be a dsk factor for outcome of NHL (P=0.034).Conclusion:There is an association between TNF/LT haplotype status and response to therapy and outcomes of NHL in Canton area,China.Detecting TNF/LT haplotype may be a sensitive method to evaluate the outcome of NHL.
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<p><b>BACKGROUND AND OBJECTIVE</b>How to prolong progression free survival (PFS) and overall survival (OS) of patients with small cell lung cancer (SCLC) has been one of the hottest issues. We retrospectively reviewed our data to compare the survival of immediate with delayed topotecan after first-line therapy in SCLC.</p><p><b>METHODS</b>In our retrospective study, 53 patients with SCLC were divided into two groups as follow: patients receiving topotecan-containing regimen as maintenance/consolidation (maintenance/consolidation chemotherapy group) and salvage chemotherapy (salvage chemotherapy group). The Log-rank test was used to assess the difference in OS between two groups. Cox regression model was used for the multivariable analysis of independent prognostic factors.</p><p><b>RESULTS</b>Twenty-nine patients received topotecan as maintenance/consolidation treatment, whereas 24 patients salvage chemotherapy. The response rates were 51.7% and 41.7%, respectively. The median survival time were 20 months and 27 months respectively (P = 0.89). Multivariate Cox regression analyses identified sex and stage as independent prognostic factors.</p><p><b>CONCLUSION</b>Efficacy of first-line therapy was improved by topotecan maintenance/ consolidation treatment, which did not result in any significant survival benefits in SCLC.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Antineoplastic Agents , Therapeutic Uses , Lung Neoplasms , Drug Therapy , Mortality , Retrospective Studies , Small Cell Lung Carcinoma , Drug Therapy , Mortality , Topotecan , Therapeutic Uses , Treatment OutcomeABSTRACT
Objective To study the changes of insulin resistance due to severe short-term fluctuations of body mass in simple obese patients. Methods 94 women with simple obesity, were treated by low caloric and high protein diet for two months. A series of examinations were taken before and after the treatment. Results After two months, weight, body mass index (BMI), waist, hip, fasting serum insulin and HOMA-IR reduced significantly ( P <0. 01 or P < 0.05 ). But after 6 months follow-up,these data began to regain. After 12 months ,these data were not significantly different. Fasting serum insulin and HOMA-IR increased ( P < 0. 05). Conclusions The low caloric and high protein diet combined acupuncture or cupping could reduce weight. But 44% patients weight rebound, and HOMA-IR increased.
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<p><b>BACKGROUND</b>Gefitinib, a selective inhibitor of epidermal growth factor receptor (EGFR) tyrosine kinase, has been approved effective in local advanced or metastatic non-small cell lung cancer (NSCLC), with the equivalent response rate to that of chemotherapy in Asian patients. Asian ethnicity, gender, smoking history, adenocarcinoma histology were remarkably associated with gefitinib response and survival. However, predictive factors of gefitinib response and survival are still unclear in Asian population. In this study, we retrospectively reviewed the data of 153 Chinese NSCLC patients who received a single agent of gefitinib with the purpose of identifying the potential predictive factors of gefitinib response and survival.</p><p><b>METHODS</b>Tumor response, survival and the clinicopathologic factors of 153 NSCLC patients treated between November of 2003 and June of 2004 were collected retrospectively from the multicenter clinical trial in China. Pearson Chi-square test and Logistic regression test were performed respectively as univariate and multivariate analyses of gefitinib response. Overall survivals between groups with different predictive factors were compared by log-rank tests. Multivariate analysis was performed to identify factors that independently predict for survival.</p><p><b>RESULTS</b>A total of 153 patients were included in this analysis. Objective response rate was statistically significant higher in patients with younger age (≤65 years) and longer interval from diagnosis to gefitinib treatment (≥6 months) in multivariate analysis (P < 0.05). The median follow-up duration was 10.0 months (0.5-16.8). The median survival was 10.3 months (95% CI: 8.1-12.6) and 1-year survival was 44.1%. Significant independent predictive factors associated with longer survival in multivariate analysis were good performance status (score 0-1), controlled disease (CR+PR+SD) to most recent chemotherapy and controlled disease to gefitinib (P < 0.05).</p><p><b>CONCLUSIONS</b>Gefitinib is effective in local advanced or metastatic NSCLC patients who failed to chemotherapy in Chinese population. In Chinese NSCLC population, younger age (≤65 years) and longer interval from diagnosis to gefitinib treatment (≥6 months) were predictive factors in multivariate analysis for gefitinib response; good performance status (score 0-1), controlled disease to most recent chemotherapy and controlled disease to gefitinib were independent prognostic factors for survival.</p>
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AIM:To investigate effects of thrombopoietin(TPO) and TPOⅡ on human platelet activation in vitro. METHODS:Human platelets were incubated in the phosphate-buffered saline containing rhTPO or TPOⅡ at the concentration of 100 μg/L for five minutes. In order to determine the rate of platelet activation. The CD62P and CD41 expressions on platelets were analysed by flow cytometry using fluorescence labelled monoclonal antibody to CD62P and CD41. RESULTS:The results demonstrated that expression of CD62P on platelets which were incubated with rhTPO or TPOⅡ didn't increase compared with that of contrast group. CONCLUSION:Both rhTPO and TPOⅡdidn't cause the disorder of platelet activation.
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AIM: To investigate effects of thrombopoietin(TPO) and TPOⅡ on human platelet activation in vitro. METHODS:Human platelets were incubated in the phosphate-buffered saline containing rhTPO or TPOⅡ at the concentration of 100 ?g/L for five minutes. In order to determine the rate of platelet activation. The CD62P and CD41 expressions on platelets were analysed by flow cytometry using fluorescence labelled monoclonal antibody to CD62P and CD41. RESULTS: The results demonstrated that expression of CD62P on platelets which were incubated with rhTPO or TPOⅡ didn't increase compared with that of contrast group. CONCLUSION: Both rhTPO and TPOⅡdidn't cause the disorder of platelet activation.
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AIM: To investigate the biological activity of thrombopoietin Ⅱ(TPOⅡ) in vivo , which consists of two new kinds of ligand binding with thrombopoietin receptor. METHODS: Purified ligandⅠof TPOⅡ, artificial compound ligandⅡ of TPOⅡand rhTPO were injected into purebred Babl/c mice respectively in 7 days by intraperitoneal injection once for a day. Then the biological activity of TPOⅡ was analyzed by measuring peripheral platelet counts by the end of the seventh day. RESULTS: On the seventh day, the platelet counts of mice treated by ligandⅠof TPOⅡ were higher than that in the negative control group( P 0.05). On the fourteenth day, the platelet counts increased in two all experimental groups of TPOⅡcompared with negative control group( P 0.05). Moreover the platelet counts of mice in two experimental groups of TPOⅡ and the positive group showed increase with experimental days. CONCLUSION: The purified ligandⅠof TPOⅡ had obvious activity in increasing platelet production, which is not different from the effect of rhTPO.
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AIM: To investigate the effects of in situ transplantation of mobilized autologous bone marrow stem cells on infarction size and cardiac function in patients with acute myocardial infarction. METHODS:25 patients with first acute myocardial infarction were randomly divided into stem cells in situ transplantation group and control group, 12 patients in stem cells in situ transplantation group were injected subcutaneously with 300 ?g granulocyte colony-stimulating factor(G-CSF) daily for four days in addition to standard therapy. 13 patients in control group were treated with standard therapy alone. The conventional 12 leads electrocardiogram were recorded on 1, 28 days after admission and the cardiac function was scored by the QRS scoring system proposed by Wagner. Furthermore, the infarction size was assessed by radionuclide myocardial perfusion imaging 7, 28 days after admission. RESULTS:4 weeks after admission, the QRS scores decreased, the infarction size reduced significantly in the stem cells in situ transplantation group (from 36.0%?8.3% to 18.0%?5.8%, P