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Objective:To study the effects of different Epstein-Barr virus (EBV) DNA load, induction chemotherapy+ radiotherapy and concurrent radiochemotherapy on patients with stage Ⅲ nasopharyngeal carcinoma (NPC).Methods:A total of 178 patients with stage Ⅲ NPC were selected as the study subjects in the Department of Otorhinolaryngology of the First People′s Hospital of Xianning of Hubei Province from January 2012 to March 2019, including 44 patients received adjuvant chemotherapy. According to the pre-treatment EBV DNA load of 1 000 copies/ml, the patients were divided into high viral load group (EBV DNA≥1 000 copies/ml, n=53) and low viral load group (EBV DNA<1 000 copies/ml, n=125), and 14 patients in the high viral load group and 30 patients in the low viral load group received adjuvant chemotherapy. According to treatment method, the patients were divided into induction chemotherapy+ radiotherapy group ( n=105) and concurrent radiochemotherapy group ( n=73). The general clinical data, recurrence rate, 5-year overall survival (OS) rate, disease free survival (DFS) rate, local recurrence free survival (LRFS) rate and disease metastasis-free survival (DMFS) rate of each group were compared. Results:Among 178 patients with stage Ⅲ NPC, 34 cases recurred, accounting for 19.10%, and 29 cases died, accounting for 16.29%. There was a statistically significant difference in N staging between the induction chemotherapy+ radiotherapy group and the concurrent radiochemotherapy group ( χ2=6.40, P=0.01). The tumor recurrence rate in the high viral load group was 33.96% (18/53), and that in the low viral load group was 12.80% (16/125), and there was a statistically significant difference ( χ2=10.79, P<0.01). The recurrence rate of lymph nodes [(9.43% (5/53) vs. 1.60% (2/125), χ2=4.15, P=0.04], the distant metastasis rate [18.87% (10/53) vs. 5.60% (7/125), χ2=7.59, P=0.01] were significantly higher than those in the low viral load group, and there were statistically significant differences. The tumor recurrence rate of patients in the induction chemotherapy+ radiotherapy group was 17.14% (18/105), and that in the concurrent radiochemotherapy group was 21.91% (16/73), and there was no statistically significant difference ( χ2=0.63, P=0.43). The 5-year OS rate, DFS rate, LRFS rate and DMFS rate of 178 patients with stage Ⅲ NPC were 84.68%, 72.80%, 79.68% and 79.54%, respectively. The 5-year OS rate (79.25% vs. 92.80%, χ2=6.86, P<0.01), DFS rate (73.58% vs. 88.00%, χ2=5.67, P=0.01), LRFS rate (73.21% vs. 89.24%, χ2=8.32, P<0.01) and DMFS rate (65.24% vs. 78.00%, χ2=4.15, P=0.02) in the high viral load group were significantly lower than those in the low viral load group, and there were statistically significant differences. The 5-year OS rate (89.52% vs. 87.67%, χ2=0.15, P=0.70), DFS rate (84.76% vs. 82.19%, χ2=0.21, P=0.65), LRFS rate (80.38% vs. 79.84%, χ2=0.00, P=1.00) and DMFS rate (79.52% vs. 81.78%, χ2=0.05, P=0.83) in the induction chemotherapy+ radiotherapy group were not statistically significant compared with those in the concurrent radiochemotherapy group, and there were no statistically significant differences. The 5-year OS rate of 44 patients receiving adjuvant chemotherapy was significantly higher than that of patients who did not receive adjuvant chemotherapy (93.77% vs. 87.49%), and there was a statistically significant difference ( χ2=5.21, P=0.02). In the high viral load group, the 5-year OS rate of patients receiving adjuvant chemotherapy was significantly higher than that of patients who did not receive adjuvant chemotherapy (93.77% vs. 84.13%), and there was a statistically significant difference ( χ2=5.11, P=0.03). Conclusion:Induction chemotherapy+ radiotherapy can achieve the same therapeutic effect as concurrent radiochemotherapy. High viral load is associated with high recurrence rate and poor survival rate. For these patients with high viral load, treatment intensity needs to be strengthened.
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Objective The aim of this study was to compare hypophosphatemia between the sepsis patients and the non-sepsis patients,and between within the subgroups of sepsis patients.Methods We collected 312 sepsis cases and 300 non-sepsis cases by stratified random sampling method yearly.In the sepsis cases,the number infected by gram-negative bacteria was 170,and by gram-positive bacteria was 142,containing 4 different bacteria infected cases in each one.Serum phosphorus of cases in each group were collected.The data were statistically processed to compare the incidence rates of hypophosphatemia,mean serum phosphorus levels and relative risk among groups.Results There was a statistical difference between the sepsis cases and the non-sepsis cases in incidence rate of hypophosphatemia (P ＜ 0.05,and RR ＞ 1.2).There were statistical differences between the cases infected by gram-negative bacteria and the cases infected by the gram-positive bacteria,also among cases infected by 4 different gram-positive bacteria in both incidence rate of hypophosphatemia and average serum phosphorus level (all P ＜ 0.05),and both RR ＞ 1.2.There were no statistical differences among cases infected by 4 different gram-negative bacteria in both incidence rate of hypophosphatemia and average serum phosphorus level (both P ＞ 0.05),and RR ＜ 1.2.Conclusions The sepsis patients were susceptible to hypophosphatemia,especially the ones infected by the 4 gram-negative bacteria,staphylococcus aureus and enterococcus in this study.We should pay attention to the serum phosphorus level seriously and prevent the occurrence of serious complications.
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The report expounds the importancr of 'jiangxi treatment' by discussing the meaning,the researches in the past dynasties and the collation of variety methods of 'jiangxi treatment'. It thinks that the 'jiangxi treatment'in TCM includes the right way to decoct drugs,the rational way to take drugs and the variety ways to 'jiangxi 'after taking drugs. Thus,it should be used selectively in clinical. And the report suggests that the 'jiangxi treatment' is a effective way to increase the clinical eff icacy of drugs.
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This article expounds the formation,connotation and development of the etiology theory in TCM.By analyzing the deficiency of the existent etiology theory in TCM,we proposed that the essence of the etiology theory in TCM should be studied based on the concept of unification of human and nature.With the guidance of the concept of unification of human and nature,the etiology theory in TCM could be formed an integrated theory.The classification of etiology in TCM which includes basic etiology,secondum etiology and developing etiology was proposed,which makes the etiology theory system in TCM more scientific and logical.