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Purpose@#Combining targeted agents with adjuvant chemotherapy prolongs survival in human epidermal growth factor receptor 2 (HER2)-positive breast cancer patients, but also increases the risk of adverse effects. The updated results of 3 randomized controlled trials (RCTs) were reported in 2019. Given the lack of adequate head-to-head pairwise assessment for anti-HER2 agents, network meta-analysis facilitates obtaining more precise inference for evidence-based therapy. @*Methods@#RCTs comparing at least 2 anti-HER2 regimens in an adjuvant setting for HER2-positive early-stage breast cancer (EBC) were included. Hazard ratios for overall survival (OS) and disease free survival (DFS), with respective 95% confidence intervals were pooled for assessment of efficacy. A Bayesian statistical model was used, and odds ratios (ORs) for adverse events (AEs) were used to pool effect sizes. @*Results@#We demonstrated that 1-year trastuzumab plus chemotherapy had increased efficacy compared to shorter or longer treatment duration. The OR of cardiac events gradually increased from 6 months to 1 and 2-year trastuzumab arms, relative to chemotherapy only.Compared to trastuzumab plus chemotherapy, dual HER2-targeting therapies increased DFS, especially for hormone receptor negative patients. Dual anti-HER2 blockade regimens revealed an increased probability of gastrointestinal reactions. As a second agent, pertuzumab showed significantly higher DFS and OS. @*Conclusion@#We conclude that 1-year adjuvant trastuzumab should remain as the standard treatment for HER2-positive EBC patients, as it has greater efficacy and a manageable proportion of AEs. Clinical efficacy can be increased for hormone receptor-negative tumors by including a second HER2-targeted agent to the treatment regimen. For hormone receptorpositive cases with basal disease, it is acceptable to reduce the risk of cardiotoxicity by shortening the duration of trastuzumab.
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Objective@#To analyze the results of occupational physical examination for major occupational hazard exposed laborer in 2018 in Guangzhou, to provide scientific basis for occupational health supervise.@*Methods@#In January 2019, descriptive epidemiological methods were used as the data sources of the Occupational Disease and Occupational Health Information Surveillance System and the report data of Guangzhou Occupational Health Inspection Agency, collecting 2733 employers from 28 Occupational Health Inspection Organizations in 11 administrative regions of Guangzhou from January to December 2018, as well as the occupational health examination data of 97688 workers exposed to the occupational-disease-risk factors, to analyze the inspection of suspected occupational diseases and contraindications during the period of work of the workers who were monitored for the occupational hazard factors (silicon dust, welding fume, benzene, lead, Ethylene Dichloride, N-hexane, high temperature and hand-transmitted vibration) .@*Results@#Total 128 cases of suspected occupational disease were detected, including 3 suspected silicosis, 8 suspected welder＇s pneumoconiosis, 17 suspected other pneumoconiosis, 10 suspected benzene poisoning, 1 suspected lead poisoning and 89 suspected noise deafness. There were 2061 cases of occupational contraindication, among which 550 cases were contraindication of high temperature, 261 cases were benzene and 1089 cases were noise.@*Conclusion@#The Occupational Health Inspection Institution of this city should continuously monitor the occupational health status of the harmful workers during their work, do a good job of prevention, and strengthen the labor protection.
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Purpose@#Combining targeted agents with adjuvant chemotherapy prolongs survival in human epidermal growth factor receptor 2 (HER2)-positive breast cancer patients, but also increases the risk of adverse effects. The updated results of 3 randomized controlled trials (RCTs) were reported in 2019. Given the lack of adequate head-to-head pairwise assessment for anti-HER2 agents, network meta-analysis facilitates obtaining more precise inference for evidence-based therapy. @*Methods@#RCTs comparing at least 2 anti-HER2 regimens in an adjuvant setting for HER2-positive early-stage breast cancer (EBC) were included. Hazard ratios for overall survival (OS) and disease free survival (DFS), with respective 95% confidence intervals were pooled for assessment of efficacy. A Bayesian statistical model was used, and odds ratios (ORs) for adverse events (AEs) were used to pool effect sizes. @*Results@#We demonstrated that 1-year trastuzumab plus chemotherapy had increased efficacy compared to shorter or longer treatment duration. The OR of cardiac events gradually increased from 6 months to 1 and 2-year trastuzumab arms, relative to chemotherapy only.Compared to trastuzumab plus chemotherapy, dual HER2-targeting therapies increased DFS, especially for hormone receptor negative patients. Dual anti-HER2 blockade regimens revealed an increased probability of gastrointestinal reactions. As a second agent, pertuzumab showed significantly higher DFS and OS. @*Conclusion@#We conclude that 1-year adjuvant trastuzumab should remain as the standard treatment for HER2-positive EBC patients, as it has greater efficacy and a manageable proportion of AEs. Clinical efficacy can be increased for hormone receptor-negative tumors by including a second HER2-targeted agent to the treatment regimen. For hormone receptorpositive cases with basal disease, it is acceptable to reduce the risk of cardiotoxicity by shortening the duration of trastuzumab.
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Three female workers in a golf club production company in Guangzhou were diagnosed with occupational chronic mild benzene poisoning. Two of the female workers were assessed as Grade 7 disabilities. One female worker showed the symptoms of the decline of whole blood cells for unknown reasons in the later stages of the medical period. The final assessment was a Class 5 disability. The problems in this work ability appraisal include: the injury condition of the patient who has not been stable during the work ability appraisal, and the contradiction between the disability grade and the occupational disease diagnosis conclusion. In order to avoid similar situations, the following recommendations are recommended: after the worker's injury situation is relatively stable, the assessment will be conducted, the employer will actively exercise the right to review and appraisal, and the diagnosis of occupational diseases will be included in the evaluation criteria for disability grade.
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Subject(s)
Humans , Biomarkers , Breast Neoplasms , Breast , Drug Therapy , Neoadjuvant Therapy , Neoplasm, Residual , Pathology , Prognosis , United States Food and Drug AdministrationABSTRACT
Objective@#To investigate the situation and influential factors of the job burnout among the nurses in Guangzhou, China.@*Methods@#In April 2017, 166 nurses from 8 hospitals in Guangzhou were surveyed by applying the Maslach Burnout Inventory (MBI) to investigate their Emotion Exhaustion (EE) , Depersonalization (DP) and Personal Accomplishment (PA) , and applying Simplified Coping Style Questionnaire (SCSQ) to examine negative coping style and positive coping style based on group random sampling.@*Results@#The nurses exhibited moderate burnout on both EE and DP, as well as severe burnout on PA. Compared with the nurses in the general hospitals, the nurses in the occupational disease hospital had lower scores on both EE and DP (t=-7.305, -3.442, P<0.01) , and they had higher scores on PA (t=2.597, P<0.05) . The married nurses had higher scores on EE (t=2.988, P<0.01) . The nurses in the disinfection supply department had higher scores on EE and lower scores on PA than the nurses in other departments (t=3.788, -3.990, P<0.01) . There was a significant difference on EE between different working age groups (F=3.225, P<0.01) . 6-10 years and 21-25 years of working age had higher scores on EE. Positive coping was negatively correlated with DP (r=-0.190) , and it positively correlated with PA (r=0.323) . Negative coping was positively correlated with both EE and DP (r=0.389, 0.293) .Hospitals types, negative coping style and positive coping style both entered the regression equation for EE (R2=0.368, P<0.01) and the regression equation for DP (R2=0.199, P<0.01) . Positive coping style and department types entered the regression equation for PA (R2=0.201, P<0.01) .@*Conclusion@#Nurses in Guangzhou got moderate level on both EE and DP, lower level on PA. Hospitals types, department types, marital status, working ages and coping style are all the influential factors of job burnout.
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Objective:To determine the equilibrium solubility and the apparent oil/water partition coefficients of nicotinate-curcu-min ester,so as to provide basis for the new formula design. Methods:Nicotinate-curcumin ester was dissolved in buffer solution with pH of 1.2-7.8. HPLC was used to detect the equilibrium solubility of nicotinate-curcumin ester in various solutions. The apparent oil/water partition coefficients in octanol-water and octanol-buffer solution system were measured by a shaking-flask method. Results:The solubility of nicotinate-curcumin ester in pH 6.8 was the highest. The apparent oil-water partition coefficients of nicotinate-curcumin ester in pH 1.2,5.8,6.5 and 7.8 were lgPapvalues within the range(lgPap=1.69-1.98) beneficial to the absorption in vivo. But in pH 2,5 and 6.8,the lgPapvalues were greater than 2 with strong lipophilicity. Conclusion:The equilibrium solubility as well as ap-parent oil/water partition coefficients of nicotinate-curcumin ester is greatly influenced by the pH value of media. In the pH value with relatively high solubility,lipophilicity is stronger,suggesting it is difficult to be absorbed by the body and needs to be further studied on dosage forms.
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Objective@#To analyze the results of occupational physical examination for silica dust, benzene and noise-exposed laborer in 2016 in Guangzhou, to provide basis for occupational health supervise.@*Methods@#The data were derived from "occupational disease and health information surveillance system" and the summary data reported by all the occupational physical examination agencies, and analyzed by descriptive epidemiology method.@*Results@#77506 data from 21 agencies of 12 district were collected, and 63 suspected occupational disease were detected, which including 1 silicosis, 8 benzene poisoning, 54 noise deafness.@*Conclusion@#Noise exposure was distributed widely, noise deafness had to be focused on, occupational chronic benzene poisoning and silicosis should be monitored continuously. Small, foreign economy and manufacturing industry should be supervised firstly.
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Objective: To provide basis for the preparation process study by establishing an HPLC determination method for nicotinate-curcumin ester.Methods: A C18 column(250 mm×4.6 mm,5 μm) was used at 30℃ with the mobile phase of acetonitrile-0.5% acetic acid glacial(65∶35) at a flow rate of 1.0 ml·min-1.The UV detection wavelength was 280 nm.Results: The good linear relationship of nicotinate-curcumin ester was shown within the range of 5.200-104.000 μg · ml-1(r=0.9999 4), The average recovery of nicotinate-curcumin ester and its nanoparticles was 100.1% and 100.9%with RSD of 1.260% and 0.995 0%(n=6), respectively.Conclusion: The method is convenient, accurate and reproducible, and suitable for the determination of nicotinate-curcumin ester nanoparticles and the studies on the preparation technology.
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Tumor microenvironment (TME) plays a key role in the development and progression of tumors, such as pro?moting local drug resistance, immune escape, and distal metastasis. According to the TME of different individuals, accurate evaluation and selection of clinical medication can effectively control the malignant transformation of carcinoma in situ and metastatic cancer. At present, the main method to treat cancer is chemotherapy, TME can regulate the reaction of the tumor cells to the standard chemotherapy and target drug therapy, so the combination of the targeted TME therapy and chemothera?py will achieve better clinical efficacy. In this review, we summarized the mechanisms of TME in breast cancer, including ex?tracellular matrix, carcinoma-associated fibroblasts, carcinoma-associated macrophages, regulatory T cells and bone marrow mesenchymal stem cells, which providing a theoretical basis for the development of TME targeted therapy.