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Triple-negative breast cancer is a subtype of invasive breast cancer, accounting for about 15% of all breast cancers. Its clinical treatment is relatively difficult, prone to recurrence and metastasis, with a short median survival and poor prognosis. Sacituzumab govitecan is the first approved antigen-coupled drug targeting trophoblast surface antigen 2 in the world. It has significant clinical efficacy, high safety and less adverse reactions, which brings new hope to the treatment of triple-negative breast cancer.
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Objective@#To compare the treatment outcomes for locally advanced hypopharyngeal carcinoma between surgery plus radio(chemo) therapy(SRT) and non-surgery chemoradiotherapy(CRT).@*Methods@#A total of 119 patients diagnosed with advanced hypopharyngeal carcinoma without distant metastases between 2010 and 2014 were identified in the Chinese People′s Liberation Army General Hospital, and they were divided into 2 groups: 42 cases in SRT group and 77 cases in CRT group. Patients′ clinical information was collected. Survival rates and prognostic factors were analyzed by the Kaplan-Meier method with SPSS 23.0 software. The survival rates, laryngeal preservation rates and complication rates were compared between the two groups using the chi-square test.Among the 119 patients, 112 were males and 7 were females. Age ranged from 27 to 78 years, with an average age of 57 years.@*Results@#There were no significant difference between the SRT and CRT group for five-year disease-free survival (DFS, 53.9% vs. 45.1%, χ2=1.251, P=0.263) and overall survival (OS, 54.9% vs. 45.6%, χ2=1.749, P=0.186). Compared to SRT group, CRT group did not showed the significant increase of treatment complications (χ2=0.858, P=0.354), with a higher laryngeal preservation rate (50.0% vs. 71.4%, χ2=6.493, P=0.011).@*Conclusions@#Advanced hypopharyngeal carcinoma is of high malignancy and poor prognosis. Combined modality treatment is a main approach for advanced hypopharyngeal cancer. SRT offers disease-free survival and overall survival rates equivalent to CRT, but with a higher laryngeal preservation rate.
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Objective To design a medical banking system to realize self register,self settlement,self printing and etc so as to enhance the efficiency.Methods The system was composed of a outpatient self-service sub-system,a hospitalization self-service sub-system,an appointment register sub-system by network bank,a cellphone App for self service,a comprehensive supervision and management platform for self-service system and self-service terminals,which had the functions such as hospital outpatient service,hospitalization self service and background supervision and management.Results Fulfilled the requirements of the patient on self register and settlement,and decreased the workloads of medical staffs.Conclusion The satisfaction over hospital service is enhanced greatly,and the system is of great value for practical application.
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Objective To compare the two-dimensional (2D) and three-dimensional (3D) shear wave elastography (SWE) technology in the diagnosis of early stage breast cancer.Methods 84 patients (94 breast lesions) with breast disease confirmed by pathological examination were enrolled from December 2014 to December 2016.All patients underwent 2D and 3D color Doppler ultrasound and the relevant SWE examinations.The optimal maximum and mean elastic modulus of 2D and 3D SWE for diagnosing the benign and malignant breast lesions were obtained by the receiver operating characteristic curve (ROC).Based on the results of pathological examinations,the sensitivity,specificity and accuracy of 2D SWE and 3D SWE in benign and malignant breast lesions diagnosis were evaluated and compared.Results The optimal maximum and mean elastic modulus of 2D SWE for diagnosing the benign and malignant breast lesions were 98.82 kPa and 43.88 kPa respectively,while the corresponding modulus of 3D SWE were 102.54 kPa and 53.87 kPa.The sensitivity of 2D SWE and 3D SWE in breast cancer diagnosis was 89.5％ and 86.3％ respectively,and the difference was not statistically significant (P＞0.05).The specificity and the accuracy of 2D SWE in breast cancer diagnosis were 95.3％ and 92.7％ respectively,which was significant higher than 83.9％ and 85.1％ of 3D SWE,and the differences were statistically significant (all P＜O.05).Conclusions The efficiency of 2D SWE examination is significantly higher than the 3D SWE in benign and malignant breast lesions diagnosis,which can provide a reliable diagnostic basis and is worthy for clinical application.
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A method based on stable isotope dilution gas chromatography-mass spectrometry ( GC-MS ) was established to determine five kinds of organophosphate esters ( OPEs ) in different kinds of cosmetics. For cream and wax-based cosmetics, samples were extracted by appropriate solvent, and then purified by ENVI-Carb solid phase extracting column. For powder and aqueous samples, GC-MS test could be operated directly after solvent extraction and concentration. All of the samples were separated by DB-5MS (30 m×0. 25 mm× 0. 25 μm) chromatographic column, and detected by selected ion monitoring ( SIM ) mode. The target analytes were qualitatively confirmed by retention time and abundance ratio of characteristic ions, and quantified by stable isotope diluted internal standard method. Under the optimized conditions, the linear coefficients of the OPEs were larger than 0. 9995, the detection limits were 1. 0-30 μg/kg, the average recoveries ( n=6 ) ranged from 89 . 5% to 105%, and the RSDs were in the range of 2 . 9%-9 . 1%. The developed method, which was characteristic by satisfactory purification effect, favorable matrix effect elimination capacity, as well as high recovery, was suitable for the determination of OPEs in different kinds of cosmetic matrices.
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The questionnaire investigation showed that the clinicians in Sichuan Province have a rather good cognition of medical information with a strong desire for medical information.However, measures should be taken to alleviate the contradictions between their information need and access ability, and excellent medical information service should be provided for them at a low cost .
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ObjectiveTo evaluate the safety and efficacy of tirofiba in the treatment of patients with acute ST-elevation myocardial infarction (STEMI) undergoing emergency percutaneous coronary intervention (PCI). MethodsA total of 158 patients with acute STEMI were randomly divided into tirofiban group 1 (59 cases, received tirofiban before PCI), tirofiban group 2 (56 cases, received tirofiban when PCI) and control group(43 cases, only received PCI). The coronary reperfusion flow(TIMI grade) of infarct related artery (IRA) after PCI, the resolution of the sum of ST segment elevation(sum STR) at 90 min after the procedure, the changes of myocardial enzyme at 6 h and 12 h afterwards, the left ventricular ejection fraction (LVEF) 1 week later, the major adverse cardiac events(MACE) within 30 d, bleeding and thrombocytopenia complications were analyzed and compared among the three groups. ResultsTIMI reperfusion grades in tirofiban group 1[98.3％(58/59 )]and tirofiban group 2[92.9％(52/56)]were higher than those in control group[60.5％(26/43)](P ＜0.05). The resolution of sum STR at 90 min after PCI in tirofiban group 1 [(89.3 ± 6.9)％]and tirofiban group 2[(82.4 + 7.3)％]was higher than that in control group[(65.6 +8.1 )％](P＜ 0.01 ),and there was significant difference between tirofiban group I and tirofiban group 2 (P＜0.05 ). The occurrence of MACE within 30 d was lower in tirofiban group 1 and tirofiban group 2 than that in control group (P＜ 0.05). The level of CK-MB at 6 h and 12 h afterwards was lower in tirofiban group 1 than that in tirofiban group 2,and tirofiban group 2 was lower than control group (P＜ 0.05). LVEF 1 week later in tirofiban group 1[(56.2 + 6.4)％]was higher than that in tirofiban group 2[(51.1 + 4.9)％]and control group[(49.8 + 5.7)％](P ＜ 0.05),but there was no significant difference between tirofiban group 2 and control group (P ＞ 0.05). Although bleeding incidence in tirofiban group 1 and tirofiban group 2 was higher than that in control group, no severe bleeding and thrombocytopenia was observed. Conclusion Tirofiban can safely and effectively reduce the incidence of the ischemic events in the patients with acute STEM1 during preoperative of emergency PCI.
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Objective To analyse the mutation of low density lipeprotein receptor (LDLR) gene associated with familial hypercholesterolemia (FH) and make a discussion on the relationship between genotype and phenotype. Methods The blood fat, electrocardiogram, heart and great vessels color Doppler were examined in propositus and family member. The promoter and all eighteen exons of LDLR gene were investigated by polymerase chain reaction (PCR),degenerate high performance liquid chromatogram (DHPLC) and DNA sequence analysis. The results were compared with the normal sequences in GenBank and FH database (www.ucl.uk/fh) to find the mutation. In addition,the apolipoprotein B100(ApoB100) gene for the known mutations(Q3500R) that cause familial defective ApoB100(FDB) was detected by directed screening.Results Two novel heterozygous c.1864 G→A (Asp622Asn) and c.1959 C→T(Val 653Val) mutations in the exon 13 of LDLR in promoter were detected. And Asp622Asn mutation segregated with the disease. No mutation Q3500R of ApeB100 was observed. Conclusions The heterozygous c.1864 G→A (Asp622Asn)mutation of LDLR gene is firstly determined in China. The heterozygous c.1864 G→A (Asp622Asn)mutation of LDLR gene is probably responsible for FH. Perhaps it is a particular pathogenesis for Chinese people. PCB-DHPLC could be used for detecting the mutation.
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Objective To study Kaposi's sarcoma-associated herpesvirus(KSHV)infection in chronic hepatitis B(CHB)patients and its correlation with hepatitis B virus(HBV)replication and treatment-related factors.MethodsEnzyme-linked immunosorbent assay(ELISA)with recombination protein KSHV ORF65 was employed to detect the KSHV antibody and real-time polymerase chain reaction(PCR)was performed to detect KSHV DNA and HBV DNA in CHB patients.Age,HBV replication and licorice preparation treatment of patients were further analyzed.Comparison of rates was done using X~2 test.Results KSHV ORF65 antibody positive rates were 27.3% in 161 male CHB patients and 30.0% in 50 female patients(X~2=0.135,P＞0.05).The KSHV infection rates were increased with age,but this tendency was not obvious in patients older than 40 years old.The highest infection rate was in age group of 31-40 years old which was 37.1%.The positive rate of HBV DNA in CHB patients with KSHV infection was 73.5%,which was 56.3% in uninfected patients(X~2=3.969,P＜0.05).The average plasma level of KSHV DNA in patients treated with licorice preparations was 204.7 copy/mL and that in patients without licorice preparation treatment was 533.9 copy/mL.Eight patients were KSHV DNA positive(KSHV DNA＞ 100 copy/mL)in 16 patients treated with licorice preparations and 23 were positive in 33 patients without licorice preparation treatment.Conclusions The KSHV infection rates are increased with age of CHB patients.KSHV infection may interfere with HBV replication and licorice preparations may suppresss KSHV replication in vivo.
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@#Objective To observe the effect of the body weight support training (BWST) on walking ability of children with cerebral palsy (CP). Methods 50 children with CP were divided into the BWST group （n=30） and control group（n=20）. All cases were treated with physical therapy, but the BWST group were added with BWST. The scores of D and E dimensions of the Gross Motor Function Measure Scale (GMFM) were used to assess the walking ability before and after the treatment, respectively. Results The scores of D and E dimensions of GMFM improved in both groups after treatment (P<0.01), and that of the BWST group improved more than control group （P＜0.05）. Conclusion BWST can facilitate the recovery of the walking ability after cerebral palsy.
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s To compare the clinical effects of intravenously and orally administered aspirin in the treatment for acute coronary syndrome (ACS),and to evaluate the adverse effects of intravenous administration of aspirin.Methods One hundred and twenty-five patients with unstable angina pectoris or acute myocardial infarction were randomized into three groups:group 1 received intravenous aspirin (300mg/d,n =40),while groups 2 (n =42) and 3 (n =43) received orally administered aspirin (100mg/d and 300mg/ d,respectively).The control group included 30 patients with no heart disease or blood disease,and they had never taken aspirin and clopidogrel.Blood samples were taken at 2nd and 7th day of hospitalization.Platelet aggregation and the level ofplatelet activation marker CD62p were measured and compared among the groups.Patients were followed up for 6 months for the occurrence of major adverse cardiovascular events.Results There were no statistically significant differences in the decrease in adenosine diphosphate (ADP)-induced platelet aggregation rate (12.01±10.45%,6.76±14.62% and 9.73±16.72% for group 1,group2 and group 3,respectively),the decrease in arachidonic acid (AA)-induced platelet aggregation rate (6.73±11.34%,6.95±12.45% and 7.57±13.11%,respectively),and the decrease in CD62p level (10.89±18.62%,8.92±11.57% and 7.05±15.67%,respectively).At six months,there were 4 deaths (10%) in group 1,4 deaths (9.5%) in group 2 and 5 deaths (11.6%) in group 3 (P＞0.05).Conclusions Intravenous administration of aspirin provides a new approach as an anti-platelet treatment for ACS patients,especially those who can not tolerate oral administration of aspirin.(J Geriatr Cardiol 2008;5:212-216)