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Objective:To survey the cognition of general practice residency training and the willingness of teaching among specialists.Methods:A questionnaire survey was conducted among 221 specialists from 24 departments in Nantong First People's Hospital from May 2021 to June 2021 to investigate the their cognition of general practice residency training program and the teaching willingness.Results:Total 221 questionnaires were distributed and 185 valid ones were retrieved with a response rate of 83.70%. The results showed that 49 specialists (26.49%) well knew the national general practice training policy, 70 (37.84%) knew the most, 52 (28.11%) knew basically, 11 (5.95%) knew little, and 3 (1.62%) did not know at all. Meanwhile, 44 specialists (23.78%) well knew the hospital incentive policies about general practice education, 62 (33.51%) knew the most, 57 (30.81%) knew basically, 18 (9.73%) knew little, and 4 (2.16%) did not know at all. Whether they holding the teaching certificate of general practice was significantly associated with the cognition of national general practice training policy (χ2=14.28, P=0.003) and with their knowledge of residency training program (χ2=16.79, P=0.001), but not associated with knowing the hospital-level incentive policy (χ2=8.18, P=0.075). A total of 170 (91.89%) participants were willing to be clinical teachers of general practice. The reasons for the willingness of teaching were as following: learning more from the teaching in 161 participants (94.71%), expanding sources of patients from rural areas in 102 (60.00%), facilitating promotion in 77 (45.29%), and others in 30 (17.60%). Among 62 specialists holding teaching certificate, 60 (96.77%) were willing to teach general practice residents; while among 123 specialists without teaching certificate, 110 (89.43%) were willing to teach (χ2=4.92, P=0.027). In all hospital incentive policies, promotion of professional titles was most attractive one (82, 44.32%), followed by performance appraisal (63, 34.05%), priority for in-service training (25, 13.51%), and appraisal for excellence award (15, 8.11%). Conclusions:Strengthening trainings for general practice the faculty is helpful to improve their cognition of the general practice residency training programs. And rational hospital incentive policies can enhance the willingness of specialists to teach general practice residency.
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Objective To observe the efficacy and safety of apatinib combined with docetaxel in the third line and above treatment of advanced serum alpha-fetoprotein-positive gastric cancer(AFPGC). Methods A total of 41 patients with AFPGC from February 2015 to April 2018 in Suining Central Hospital of Sichuan Province were retrospectively analyzed. The patients were divided into experimental group and control group according to different treatment methods,15 patients in the experimental group received with apatinib combined with docetaxel,and 26 patients in the control group received chemotherapy alone or optimal nutritional support. The short-term efficacy,long-term efficacy and adverse reactions were evaluated by Response Evaluation Criteria in Solid Tumours(RECIST)version 1. 1,progression-free survival(PFS),overall survival(OS)and National Cancer Institute Common Terminology Criteria for Adverse Events(NCI CTCAE)version 4. 0. Results After 2 cycles of treatment,no complete remission( CR)was achieved in either group,4 partial remission (PR),7 stable disease(SD),4 progressive disease(PD)in the experimental group,and 2 PR,7 SD,17 PD in the control group. The objective response rate(ORR)was 26. 67％(4 / 15)and 7. 69％(2 / 26)respective-ly in the experimental group and the control group,with no significant difference(χ2 = 1. 433,P = 0. 231). The disease control rate(DCR)was 73. 33％(11 / 15)and 34. 62％(9 / 26)respectively in the two groups, with significant difference(χ2 = 5. 707,P = 0. 017). The median PFS of the experimental group and the control group were both 3. 0 months,and there was no significant difference between the two groups(χ2 = 4. 425,P =0. 350). The median OS were 6. 0 months and 4. 0 months respectively,and the difference was statistically sig-nificant(χ2 = 5. 727,P = 0. 017). The occurrence rates of leukopenia of the experimental group and the control group were 73. 33％(11 / 15)and 30. 77％(8 / 26),the occurrence rates of hypertension were 40. 00％(6 /15)and 0(0 / 26),the occurrence rates of proteinuria were 26. 67％(4 / 15)and 0(0 / 26),the occurrence rates of poor appetite were 80. 00％(12 / 15)and 38. 46％(10 / 26),and the occurrence rates of hemorrhage were 33. 33％(5 / 15)and 3. 85％(1 / 26). The occurrence rates of the above adverse reactions in the experi-mental group were significantly higher than those in the control group(χ2 = 6. 930,P = 0. 008;χ2 = 9. 191, P = 0. 002;χ2 = 4. 953,P = 0. 026;χ2 = 6. 600,P = 0. 010;χ2 = 4. 471,P = 0. 034),and the differences were statistically significant. There was no significant difference in the incidence of thrombocytopenia,anemia, nausea and vomiting,diarrhea,fatigue and hand-foot syndrome between the two groups( all P > 0. 05). Conclusion The DCR of apatinib combined with docetaxel in the third-line and above treatment of advanced AFPGC patients is higher. This scheme can prolong survival period,and the adverse reactions are more serious,but they are basically tolerable.
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Objective To explore the clinical efficacy and safety of intraoperative radiotherapy (IORT) for the patients with unresectable locally advanced pancreatic cancer. Methods Cochrane library, PubMed, EMbase, CBM, CNKI, VIP database and WANFANG database were used to retrieve, in addition to manual retrieval important literature references and conference papers. The randomised controlled trials, cohort study, controlled clinical trials of the IORT in unresectable locally advanced pancreatic cancer were searched. According to the inclusion criteria and exclusion criteria, after the extraction of literature and data, RevMan 5.3 software was used for meta-analysis. Results The total of 1 401 articles were retrieved, 7 met the inclusion criteria, including 1 for randomized controlled trials, 4 for cohort study, 2 for case-control study. 313 cases in the IORT group, 362 cases in the control group, and meta-analysis showed that IORT group was better than control group in overall survival (OS) (Z=4.15, P<0.000 1, RR=2, 95%CI 1.05-2.94). Because lack of complete data in local control rate, pain remission rate, complications, descriptive analysis was done, rather than meta-analysis. Conclusions IORT may improve the OS of patients with unresectable locally advanced pancreatic cancer and the local control rate, and effectively alleviate pain with favorale safety but it still needs high quality randomized controlled trials to confirm.
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Prognosis factors of Ⅲ A (N2) phase non-small cell lung cancer are various.The histological molecular markers are mainly about multi-resistant gene,growth factors,mucin 4,insulin-like growth factor-2,Ki-67,PTEN and so on.Different expressions of these genes may divide the N2 non-small-cell lung cancer into different molecular subtypes,which is more effective to guide clinical therapy.