Compliance analysis of adjuvant therapy in elderly patients with breast cancer under case-management model / 上海交通大学学报（医学版）

Objective: To investigate the current status of adjuvant therapy compliance in elderly breast cancer patients (≥65 years old) attended the case-management model and to analyze the impact of demographic characteristics and clinical features on adjuvant therapy compliance. Methods: This study enrolled 654 elderly early breast cancer patients who were treated in Ruijin Hospital and subsequently accepted case-management model between March 2013 and August 2016. Data on patients' compliance to adjuvant therapies which were designed by multidisciplinary treatment (MDT) were collected. The correlation of patients' adjuvant therapy compliance with demographic characteristics and clinical features were evaluated using χ2 test. The statistically significant variables were taken and the corresponding impact on adjuvant therapy compliance were further analyzed using multiple Logistic regression model. Results: In this study, 603 (92.20%) elderly breast cancer patients were treated with one or a combination of adjuvant therapies according to MDT discussion/recommendation. Overall patients' compliance to adjuvant therapy was 88.05%. 45.94% patients were required adjuvant chemotherapy, of which 91.34% patients complied in reality; 45.61% patients were required adjuvant radiotherapy, of which 88.73% patients complied in reality; 80.93% patients were required adjuvant endocrine therapy, of which 93.65% (median treatment duration 44.16 months) patients complied in reality; 12.94% patients were required adjuvant targeted therapy, of which 82.05% patients complied in reality. By number of adjuvant therapies that elderly early breast cancer patients were required, patients' compliance to one, two, three and four adjuvant therapies amounted to 94.30%, 83.68%, 87.20% and 60.00% respectively. The results from analysis of demographic characteristics and clinical features revealed that, age and number of adjuvant therapies had significant impact on adjuvant therapy compliance in elderly breast cancer patients (P<0.05). Furthermore, patients' education level showed strong correlation with patients' compliance to adjuvant chemotherapy and adjuvant radiotherapy (P<0.05). Additionally metastasis to lymph nodes impacted on patients' compliance to adjuvant chemotherapy (P<0.05). Conclusion: Case-management model is beneficial to improve adjuvant therapy compliance after surgery in elderly breast cancer patients. To further increase patients' compliance, more efforts should be invested to help patients older than 74 years old, with lower education level, negative lymph nodes and more types of comprehensive treatment.

A retrospective study on the relationship between LMR and preterm delivery in pregnant women / 中国实用妇科与产科杂志

OBJECTIVE: To study a potential relationship between preterm labor and lymphocyte to monocyte ratio(LMR).METHODS: This retrospective cohort study was conducted in Second Affiliated Hospital of Chongqing Medical University from August 2016 to November 2017. Totally 100 pregnant women who delivered between 28 th to 37 th gestational week were included as the study group,and 116 pregnant women who delivered after 37 th gestational week were as the control group. The data of routine blood test from 11 th to 13 th gestational week and 28 th to 30 th gestational week were observed and compared.RESULTS: The LMR value of preterm women was significantly higher than that of those who delivered at term(early pregnancy 4.90±1.40 vs. 4.31±1.30,P<0.01;middle and advanced stage of pregnancy 3.54±0.93 vs. 2.95±0.64,P<0.01). A negative correlation was observed between the level of LMR and the gestational weeks of termination of pregnancy(r=-0.350,P<0.01).CONCLUSION: The value of LMR in pregnancy is associated with the occurrence of preterm labor. Therefore,it is necessary to make further study.

Relationship between regulation effect of salvia miltiorrhiza on AQP2 in kidney and promoting blood circulation and diuresis / 中国中药杂志

Partial nature of "promoting blood circulation and dieresis" of Salvia Miltiorrhizain was initially demonstrated by investigating the regulation effect of AQP2 expression in kidney of trauma blood stasis model rats with the Salvia Miltiorrhizain so as to provide guidance for its clinical deployment of administration. Random allocation was taken to averagely divide 30 SD rats into two groups: 10 rats in normal group and 20 rats in blood stasis syndrome group. Trauma blood stasis rat model was established by quantitatively beating. Then the rat model group was divided into model group and salvia group. After 7 days of treatment, the rat kidney AQP2 expression was detected, the content of urine AQP2 was compared and the damaged local muscle and kidney pathological changes were observed by immunohistochemical method and western blot method. Compared with that of the normal group, rats in model group had inflammatory cells infiltration, blood stasis and edema of the injured local muscles and up-regulated AQP2 expression, decreasing urinary output, and kidney tissues blood stasis and edema (P < 0.05). On the other hand, compared with that of the model group, those parameters of rats in salvia group were all decreasing except urine output (P < 0.05). Such result indicated that Salvia Miltiorrhiza can reduce trauma blood stasis rat content of urine AQP2 and down-regulated AQP2 expression in kidney tissue, so as to reduce the reabsorption of water by renal tubular and increase urine output. The promoting blood circulation effect of Salvia Miltiorrhizain can alleviate the degree of the damaged tissue edema and encourage urine drainage. This therapy is closely related to the effect of regulating AQP2 in kidney by salvia, so the purpose of this study by verifying "promoting blood circulation and diuresis" as the mechanism for the regulation effect of the salvia on AQP2 expression.

Safety and immunogenicity on three lots of influenza split vaccines among adults / 中华流行病学杂志

Objective To evaluate the irnmunogenicity, safety and stability of the manufacture process regarding three consecutive lots of influenza split vaccines (Anflu ). Methods A double-blind, randomized and controlled clinical trial was conducted in healthy volunteers. A total of 566 subjects aged 18 to 60 years were recruited and stratified into four age groups before randomly assigned into four groups. Each group would receive one dose of influenza vaccine from either one of the three lots ofAnflu or one lot of the licensed control vaccine. Each dose of the vaccines contained 15 μg of each of the H1N1, H3N2 and B type antigen. Safety was assessed through 30-minute observation for immediate allergic reaction and three-day observation after vaccination. HI antibody titers were determined before vaccination and on day 21, after vaccination. Results Mild adverse reaction was reported and the overall incidence rates on fever of the four groups were from 1.4% to 2.8% but no significant difference was observed between groups. Seroconversion rates of the three viral strains in four groups were 80.3% and above with fold increase as≥11.1 and protection rate was≥93.4%. For the three lots of investigated vaccines, all of the indexes of the three viral strains in four groups exceeded the standards on EMEA and FDA for influenza vaccine. Conclusion The three consecutive lots of Anflu appeared to be good, with both consistent immunogenieity and safety, indicating the stability of manufacture process.