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OBJECTIVE To predict the development trends of licensed pharmacist staffing in retail pharmacies within the western China and provide reference for the formulation of policies related to licensed pharmacists. METHODS Based on the data of retail pharmacies and licensed pharmacists in the western China from 2016 to 2022， a grey model was constructed to analyze and predict the number development trends of retail pharmacies and licensed pharmacists in the western China from 2023 to 2026. RESULTS Currently， the 1∶1 staffing requirement for licensed pharmacists and retail pharmacies had been met in Shaanxi， Guangxi and Gansu. Based on current trends， Inner Mongolia， Chongqing， Yunnan， and Qinghai were expected to meet the 1∶1 staffing requirement for licensed pharmacists and retail pharmacies between 2023 and 2026. Sichuan and Xinjiang were also expected to meet this requirement in the future. However， there was still a significant gap in Guizhou， Xizang， and Ningxia towards achieving the above goals. CONCLUSIONS There is still a discrepancy between the deployment of licensed pharmacists and the national requirements in certain western provinces. Local authorities should formulate relevant policies according to local circumstances. Regions that have already met or will soon achieve the staffing requirement for licensed pharmacists should continue to enhance the quantity and quality of their licensed pharmacist workforce. In areas where meet this criterion in the short term is not feasible， it is necessary to strengthen the development of the licensed pharmacist workforce， and control the number of new retail pharmacies.
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Objective:To investigate the prognostic value of metabolic parameters of 18F-fluorodeoxyglucose ( 18F-FDG) positron emission computed tomography/computed tomography(PET/CT) in advanced non-small cell lung cancer(NSCLC) treated with first-line immune checkpoint inhibitor (ICI) combined with chemotherapy. Methods:A retrospective study was conducted to evaluate patients with advanced NSCLC who underwent baseline PET/CT before treatment at the Affiliated Cancer Hospital of Zhengzhou University from 2019 to 2021. Receiver operating characteristic (ROC) curve analysis was used to determine the cut-offs for metabolic parameters of PET/CT, including total metabolic tumor volume (TMTV), total lesion glycolysis (TLG), and maximum standard uptake value (SUV max). Kaplan-Meier method, Log-rank test, and Cox regression model were used to calculate the overall survival (OS) and the progression-free survival(PFS). Results:A total of 44 patients were enrolled. Univariate analysis showed that the factors influencing PFS were TMTV and the number of metastatic sites ( χ2=4.19, 11.28, P<0.05) and the factors influencing OS were TMTV and TLG ( χ2=14.96, 6.05, P<0.05). Multivariate analysis suggested that number of metastatic sites was an independent prognostic marker for PFS ( P=0.011) and TMTV was an independent prognostic marker for OS ( P=0.038). Conclusions:TMTV is a prognostic indicator of OS while the number of metastatic sites is a prognostic indicator of PFS in advanced NSCLC patients who received first-line ICI combined with chemotherapy, but further prospective studies are needed.
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Objective:To compare the effects of dexmedetomidine combined with propofol on anesthesia and thromboelastography in patients undergoing radical gastrectomy.Methods:From September 2017 to December 2019, 120 patients undergoing radical gastrectomy in Chaoyang Central Hospital were prospectively selected and divided into control group and observation group according to random number table method, with 60 cases in each group.The two groups used the same drugs before induction and the same way of anesthesia induction. During the maintenance of anesthesia, remifentanil and propofol were injected intravenously in the control group, and dexmedetomidine was injected in the observation group on the basis of the control group. The indexes of thromboelastography, preoperative and postoperative cellular immune function, postoperative analgesic effect [Visual Analogue Scale (VAS)], Ramsay sedation score, and postoperative adverse reactions were compared between the two groups at different times.Results:The reaction time of coagulation factor (R) and fibrinogen (K) in the two groups decreased 3 hours after operation, and those in the observation group were lower than those in the control group (all P<0.05); The maximum thrombus amplitude (MA) of the two groups increased 3 hours after operation, and MA in the observation group was higher than that in the control group (all P<0.05). Compared with that before operation, the VAS scores and Ramsay sedation scores in the control group and the observation group at 24 h and 48 h after operation were significantly lower (all P<0.05), and the VAS scores and Ramsay sedation scores in the observation group at 24 h and 48 h after operation were significantly lower than those in the control group (all P<0.05). Compared with that before operation, the CD4 +, CD8 +, CD4 + /CD8 + in the control group and the observation group were improved at 6 h and 48 h after operation (all P<0.05), and the improvement in the observation group was significantly better than that in the control group at 6 h and 48 h after operation (all P<0.05). The incidence of adverse reactions in the control group was 6.67%(4/60), which was slightly higher than that in the observation group of 5.00%(3/60), but the difference was not statistically significant ( P>0.05). Conclusions:Compared with propofol and remifentanil alone, combined application of dexmedetomidine can help patients undergoing radical gastrectomy for gastric cancer to achieve better analgesic effect, improve the blood coagulation state of patients, and play a better regulatory role on cellular immune function, which is worthy of further promotion in clinic.
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Objective:To investigate the effect of human umbilical cord mesenchymal stem cells (hUC-MSC) on the apoptosis of retinal ganglion cells (RGCs) in diabetic retinopathy (DR) model rats and on the regulation of p38 mitogen-activated protein kinase (p38MAPK) pathway.Methods:Forty-five SPF male 8-week old SD rats were selected.The DR rat model was established by intraperitoneal injection of streptozotocin (STZ) combined with a high-sugar and high-fat diet.The fasting blood glucose (FBG) and body weight of the rats were measured every week during the high-sugar and high-fat diet, and fundus angiography was used to observe the circulation and leakage of retinal blood vessels.Forty rats with successful modeling were randomly divided into model group and hUC-MSC injection group according to the random number table method, with 20 rats in each group.Another 20 normal rats fed routinely were served as control group, and intraperitoneally injected with the same amount of citric acid buffer.The hUC-MSC injection group was injected intravitreously with hUC-MSC, and the control group and model group were injected intravitreously with the same amount of phosphate buffer saline (PBS). Fluoro gold (FG) retrograde tracer labeling RGCs was used to observe the number of survived RGCs.Hematoxylin-eosin staining was used to observe the pathological changes of retina.TUNEL method was used to observe the apoptosis of RGCs.Western blot was used to detect B cell lymphoma /leukemia-2 (Bcl-2), Bcl-2 associated X protein (Bax), p38MAPK and phosphorylated (p-) p38MAPK protein expression in retinal tissues.The use and care of the rats complied with the ARVO statement.The study protocol was approved by an Animal Ethics Committee of Zhengzhou central Hospital Affiliated to Zhengzhou University (NO.2980316).Results:The FBG of control rats was maintained at a normal level, and the body weight gradually increased over time, and was gradually decreased as the course of disease prolonged.The retinal blood vessels ran normally without fluorescein leakage in the control group.In the modeling group, the FBG was maintained at a high level, and the body weight increased slowly and gradually decreased with the prolongation of the disease course since the second week after modeling.The distal retinal vessels were found twisted with large area of capillary fluorescein leakage in the modeling group.The density of RGCs in the control group, model group and hUC-MSC injection group were (2 136.10±215.17), (849.40±167.82), (1 549.20±183.26) cells/mm 2, with significant overall differences ( F=115.218, P<0.01). The density of RGCs in the model group and the hUC-MSC injection group were significantly lower than that of the control group, and the density of RGCs in the hUC-MSC injection group was significantly higher than that of the model group, and the differences were statistically significant (all at P<0.05). The retina in the control group was with clear structure, distinct layers, and a large number of complete RGCs.The number of RGCs in the model group was significantly reduced with nuclear pyknosis, thinned and atrophied RGC layer.The retinal structure was relatively complete, and there were more RGCs in the hUC-MSC injection group than the model group.The apoptosis rates of RGCs in the control group, model group and hUC-MSC injection group were (2.16±1.11)%, (43.47±2.26)%, (20.75±2.18)%, with significant overall difference ( F=445.159, P<0.01). The apoptosis rates of RGCs in the model group and hUC-MSC injection group were significantly higher than that of the control group, and the apoptosis rate of RGCs in the hUC-MSC injection group was lower than that of the model group, and the differences were statistically significant (all at P<0.05). There were statistically significant differences in the relative expression levels of Bax, Bcl-2 and p-p38MAPK proteins in the retina tissues among the three groups ( F=30.982, 12.526, 73.158, all at P<0.01). The relative expression of Bax and p-p38MAPK protein were significantly higher, and the relative expression of Bcl-2 protein was significantly lower in the hUC-MSC injection group and the hUC-MSC injection group than those of the control group, and the differences were statistically significant (all at P<0.05). The relative expression of Bax and p-p38MAPK protein was significantly lower, and the relative expression of Bcl-2 protein was significantly higher in the hUC-MSC injection group than those in the model group, and the differences were statistically significant (all at P<0.05). There was no significant difference in the relative expression of p38MAPK protein among the three groups ( F=1.182, P=0.322). Conclusions:Intravitreal injection of hUC-MSC can inhibit the apoptosis of RGCs in DR model rats and protect the retinal structure of rats, which may play an anti-apoptotic effect by inhibiting the p38MAPK signaling pathway.
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Objective:To analyze the characteristics of adverse events of active medical devices in Shandong province, as well as the impact of device use duration on the risk rate of adverse events, for reference in improving the monitoring system of active medical device adverse events in China and the level of hospital medical quality management.Methods:The data came from the adverse event reporting data of active medical devices collected by Shandong Adverse Drug Reaction Monitoring Center from January 2019 to October 2021. The R software was used to analyze the distribution, cause and severity of adverse events, and a linear regression model of adverse event risk rate(Y) and adverse event time point(X) was established.Results:A total of 35 254 adverse events of active devices were included, of which 3 059 were serious injuries. The province/municipality with the largest number of reported adverse events was Shanghai(8 006 cases), and the least was Hainan province(4 cases); The majority of adverse events were reported by hospitals, with 34 056(96.60%). The medical devices reporting a higher number of adverse events were ventilators(688 cases), monitors(4 623 cases), infusion pumps(1 079 cases), syringe infusion pumps(1 995 cases), medical electron accelerators(529 cases)and infant incubators(513 cases). In the linear regression model, the risk rate of adverse events increased with the useduration of the device when 0.00%≤ X<14.14%; the risk rate of adverse events decreased with the increase of service time when 14.14%≤ X<100.00%. Conclusions:The number of adverse events reported in each province is different, and hospitals are the main reporting units.The causes of adverse events of different medical devices indicate different correlation strengths with the product itself. The use duration of medical devices poses a great impact on the risk rate of adverse events.
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OBJECTIVE@#To compare the performance of the GE cyclotron MINItrace system before and after the upgrade.@*METHODS@#The upgrade of the MINItrace system included replacing the silver target with the Nb syetem and adopting the latest RF control and management system and lastest ion source system.The failrue rate and production efficiency were retrospectively analyzed before and after the upgrade.@*RESULTS@#After the upgrade, the cyclotron failure rate decreased by 86.2%, the average capacity increased by 45%.@*CONCLUSIONS@#After the upgrade of MINItrace cyclotron, the failure rate is sharply reduced, and the production efficiency is grately improved.
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Cyclotrons/standards , Equipment Failure , Retrospective StudiesABSTRACT
Objective@#To investigate the clinical efficacy of reduced port laparoscopic radical resection on colorectal cancer.@*Methods@#Clinical data of 46 patients with colorectal cancer undergoing reduced port laparoscopic radical resection were retrospectively analyzed.@*Results@#All of 46 patients underwent laparoscopic surgery, with an average operation time of 206 minutes, an average intraoperative bleeding of 56 ml, an average number of lymph nodes removement of 12/case (ranged from 6 to 21). One case had incision infection, 2 cases had anastomotic leakage, and they all recovered and discharged after treatment.@*Conclusions@#Reduced port laparoscopic radical resection of colorectal cancer is safe and feasible, reduces labor costs, and has a good clinical efficacy, which is worthy of clinical promotion.
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Objective To investigate the clinical efficacy of reduced port laparoscopic radical resection on colorectal cancer.Methods Clinical data of 46 patients with colorectal cancer undergoing reduced port laparoscopic radical resection were retrospectively analyzed.Results All of 46 patients underwent laparoscopic surgery,with an average operation time of 206 minutes,an average intraoperative bleeding of 56 ml,an average number of lymph nodes removement of 12/case (ranged from 6 to 21).One case had incision infection,2 cases had anastomotic leakage,and they all recovered and discharged after treatment.Conclusions Reduced port laparoscopic radical resection of colorectal cancer is safe and feasible,reduces labor costs,and has a good clinical efficacy,which is worthy of clinical promotion.
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Objective: To detect the methylation levels of homeobox protein Hox A7 (HOXA7) gene promoter in the plasma of non-small cell lung cancer (NSCLC) and to study the value of HOXA7 methylation and serum levels of the tumor markers carcinoembryonic antigen (CEA), carbohydrate antigen 199 (CA199), and cytokeratin 19 fragment (Cyfra21-1) in the auxiliary diagnosis of NSCLC. Methods: Plasma samples were collected from 80 patients with NSCLC and 50 healthy controls, which were enrolled in Henan Cancer Hospital from January 2012 to December 2016. The plasma HOXA7 methylation levels were detected by real-time quantitative methylation-specific PCR, and the plasma levels of CEA, CA199, and Cyfra21-1 were detected by electrochemical luminescence. The ROC curve was constructed to analyze the clinical value of each index in the differential diagnosis of NSCLC, and the relationship between HOXA7 methylation, clinical parameters, and tumor markers was analyzed. Results: The serum levels of HOXA7 methylation in NSCLC patients were significantly higher (χ2=36.972, P<0.000 1) than the healthy control group. The sensitivity and specificity of HOXA7 methylation in the diagnosis of NSCLC were 68.8% (55/80) and 86.0% (43/50), respectively. Plasma HOXA7 methylation was not related to gender, age, smoking history, or pathological type (all P>0.05), but was related to TNM stage (P<0.05). The plasma HOXA7 methylation level of stageⅣpatients (81.8%, 18/22) was the highest. Cyfra21-1 had the highest value in the diagnosis of NSCLC among tumor markers with a sensitivity of 70.00% and a specificity of 90.00%. The combination of HOXA7 methylation with all three tumor markers had the highest efficiency (AUC=0.893, sensitivity 73.75%, specificity 94%) in the diagnosis of NSCLC. The correlation coefficient between HOXA7 methylation and Cyfra21-1 was the highest (r=0.564, P<0.05). Conclusions: HOXA7 gene methylation is related to the degree of metastasis of NSCLC and proves as an efficient diagnostic marker for NSCLC when combined with tumor marker detection.
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OBJECTIVE:To observe clinical efficacy and safety of Tobramycin dexamethasone ointment in Nd∶YAG laser lac-rimal duct plasty. METHODS:Medical records of 1000 patients(1250 eyes)with obstructive lacrimal duct disease receiving To-bramycin dexamethasone ointment in Nd∶YAG laser lacrimal duct plasty were selected from our hospital during Jan. 2013-Jan. 2017. They were divided into chronic dacryocystitis group(380 eyes),small tears(total)tube obstruction group(360 eyes),naso-lacrimal duct obstruction group (342 eyes),punctal occlusion group (86 eyes) and traumatic canalicular laceration group (82 eyes)according to the lacrimal duct obstruction. In 5 groups,heated Tobramycin and dexamethasone ophthalmic ointment would be loaded in 1 mL syringe and injected into the lacrimal duct via probe,dropping the probe while pushing the ointment. They received lacrimal duct flushing regularly and were followed up for 3 months. Therapeutic efficacies and safty were compared among 5 groups. RESULTS:Cure rate and response rate of patients with chronic dacryocystitis were 85.00％ and 87.63％;those of patients with lacrimal small (total) obstruction were 87.78％ and 94.45％;those of patients with nasolacrimal duct obstruction were 89.18％ and 95.03％;those of patients with punctal occlusion were 84.88％ and 94.18％. All of above were significantly higher than 42.68％and 64.63％of patients with traumatic canalicular laceration,with statistical significance(P<0.05). There was no sta-tistical significance in the incidence of ADR among 5 groups(P>0.05). CONCLUSIONS:In the treatment of chronic dacryocysti-tis,small tears(total)tube obstruction,nasolacrimal duct obstruction and punctal occlusion,application of Tobramycin dexametha-sone eye ointment in Nd∶YAG laser lacrimal duct plasty shows good therapeutic efficacy and has less ADR.
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OBJECTIVE:To provide reference for further improving negotiation mechanism of drug medical insurance in Chi-na. METHODS:Questionnaire investigation was conducted among the medical insurance agency and pharmaceutical company staff who participated in drug medical insurance negotiation in Jiangsu province,Jiangxi province,Qingdao,Chengdu. Their business fa-miliarity and recognition of the negotiating mechanism were also investigated. The descriptive analysis,independent sample t test and other methods were adopted to analyze the data statistically. RESULTS:A total of 70 questionnaires were distributed and 68 val-id questionnaires were collected with effective recovery rate of 97.14%. Respondents included 21 staff members of medical insur-ance agencies and 47 of pharmaceutical companies. In terms of business familiarity,the average score of respondents in all aspects was greater than 3(4 points system),the lowest score wasmanagement of the implementation of drug negotiation projects. There were statistical significances in scores of 3 items between 2 parties in the negotiation(P4 except forpatients taking drugs is quick and easy. There was no statistical significance between 2 types of respondents in all aspects of overall effect of the negotiation mechanism, preparation of the negotiations and negotiation project's supervision and evaluation(P>0.05). But in the recognition of the substan-tive negotiation,there was statistically significance between 2 types of respondents innegotiations between the two sides in an equal,cooperative,harmonious atmosphere(P<0.05). Healthcare agencies'respondents had higher scores than pharmaceutical companies'ones. And in the recognition of the implementation of the negotiation agreement,there was statistical significance be-tween 2 types of respondents in theafter the agreement entered into force,the medical insurance agency will be strictly in accor-dance with the agreementandfund pay to pharmaceutical companies timely and reasonable(P≤0.05). Healthcare agencies're-spondents have higher scores for than pharmaceutical companies'ones. CONCLUSIONS:The current drug medical insurance nego-tiation mechanism shows good overall effect and runs smoothly. But there are still some shortages,such as collected information the preparation stage is not sufficient;the procedures of patients taking the drug is complicated;negotiating parties do not have equal status;the fund is not paid to the pharmaceutical enterprise timely;evaluation is not perfect.
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The aim of this study is to develop a physiologically based pharmacokinetic (PBPK) model in intraabdominal infected rats, and extrapolate it to human to predict moxifloxacin pharmacokinetics profiles in various tissues in intra-abdominal infected human. 12 male rats with intra- abdominal infections, induced by Escherichia coli, received a single dose of 40 mg/kg body weight of moxifloxacin. Blood plasma was collected at 5, 10, 20, 30, 60, 120, 240, 480, 1440 min after drug injection. A PBPK model was developed in rats and extrapolated to human using GastroPlus software. The predictions were assessed by comparing predictions and observations. In the plasma concentration versus time profile of moxifloxcinin rats, Cmax was 11.151 microg/mL at 5 min after the intravenous injection and t1/2 was 2.936 h. Plasma concentration and kinetics in human were predicted and compared with observed datas. Moxifloxacin penetrated and accumulated with high concentrations in redmarrow, lung, skin, heart, liver, kidney, spleen, muscle tissues in human with intra-abdominal infection. The predicted tissue to plasma concentration ratios in abdominal viscera were between 1.1 and 2.2. When rat plasma concentrations were known, extrapolation of a PBPK model was a method to predict drug pharmacokinetics and penetration in human. Moxifloxacin has a good penetration into liver, kidney, spleen, as well as other tissues in intra-abdominal infected human. Close monitoring are necessary when using moxifloxacin due to its high concentration distribution. This pathological model extrapolation may provide reference to the PK/PD study of antibacterial agents.
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Animals , Humans , Male , Rats , Anti-Bacterial Agents , Body Weight , Escherichia coli , Heart , Injections, Intravenous , Intraabdominal Infections , Kidney , Kinetics , Liver , Lung , Pharmacokinetics , Plasma , Skin , Spleen , VisceraABSTRACT
Objective In order to discuss the practicability and risk analysis of deep venous catheter in AIDS patients.Methods 112 patients who needed to keep the intravenous route between October in 2010 and February in 2012 in Yunnan AIDS care center were implemented deep venous catheter.Results Right Subclavian vein catheter 101 cases,right internal jugular vein catheter 10 cases,right femoral vein catheter in 1.Wound happened in 5 cases,catheter heterotopia 1 case.Conclusion Deep venous catheter in patients with HIV/AIDS clinical diagnosis and treatment work could not only relieve the patients' pain because of repeated puncture,reduce the nursing workload,ensure the smooth progress of the clinical diagnosis and treatment,but also the more important is to reduce the occupational exposure risk of medical staff.
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Objective To investigate the clinical value of PET-CT scans in lymphomatous patients in post-therapy evaluation. Methods 18F-FDG PET-CT imaging were performed in 40 lymphomatous patients whom had been received therapy. Successive PET-CT imaging were performed in 5 cases, and the treatment was evaluated with clinical evaluation. Results Successive PET-CT imaging were performed in 5 cases, in which the tumor was eradicated in 2 cases, improved in 2 cases, and relapsed in 1 case. In 35 patients PET-CT imaging was repeated after treatment, among them 30 cases with complete or partial remission, and PET-CT imaging was positive in 25 cases. PET-CT imaging was still positive in 8 cases with recurrent or remnant tumor. PET-CT imaging changed the therapeutic regime. Conclusion PET-CT imaging can detect the recurrent or remnant tumor sensitively and accurately. There is a significant value for the guidance of clinical therapeutic.
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Objective To compare the clinical value of 18F-FDG PET imaging and 99Tcm-MDP whole body bone imaging in detection of bone metastases. Methods 43 patients were undergone 18F-FDG PET and 99Tcm-MDP imaging within 2 weeks. 28 of them were with confirmed bone metastases by other examinations or follow-up and the remaining 15 were confirmed without bone metastases. The results of the 2 different modalities were analyzed. Results Among 28 patients with confirmed bone metastases, PET and MDP accurately diagnosed 26 and 27, respectively. The sensitivity of them were 92.9 %(26/28), 96.4 %(27/28), Among the remaining 19 cases without bone metastases, PET and MDP correctly gave 14 and 8 negative results, respectively. The specificity of them were 93.3 %(14/15), 53.3 %(8/15), and accuracy of them were 93.0 %(40/43), 81.4 %(35/43). The differences between specificities and accuracies of the two methods were significant, while no significant difference between the sensitivities of the two methods. Conclusion For the detection of bone metastases in patients with malignant tumors, 18F-FDG PET showed a similar sensitivity but better specificity and accuracy compared with 99Tcm-MDP bone scan. For patients with suspected bone metastases, negative finding or single hot spot in 99Tcm-MDP imaging, 18F-FDG PET imaging was recommend as a further and complementary assessment of bone metastases.
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Objective To study the clinical features and CT findings of pulmonary fungal infection(PFI) secondary to malignant tumor.Methods The clinical features and CT findings of PFI secondary to malignant tumor proved clinically and pathologically were analyzed retrospectively.Results In pulmonary fungal infection,pulmonary candidiasis was most common seen,which were found in 34 (68%) of 50 cases.CT findings of PFI usually consist of a mixture of patterns,ground-glass attenuation(n=31,62%)and air-space consolidation (n=29,58%) were most common CT findings. Other CT findings included nodule(n=20,40%), air cresceut sign (n=2,4%), thickening of bronchovascular bundles (n=7,14%), mass (n=1,2%),tree-in-bud appearance(n=5,10%),cavity(n=3,6%).Conclusion CT findings of PFI secondary to malignant tumor were nonspecific,which can’t distinguish from other pneumonia,to pay more attentions on it is necessary.
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Objective To study the normal microanatomy and HRCT findings in nasal bone part which is easy to be confused with the bone fracture, thus increasing the diagnostic accuracy of nasal bone fracture. Methods CT findings were compared between two groups 60 volunteers as normal group and 30 cases with nasal bone fracture as trauma group, which were all performed with HRCT in transverse and coronal scans to find the differences. Results Three experienced radiologists observed the films of the normal group in blind. 54 cases were diagnosed normal, 3 were suspected to have fracture, and 3 misdiagnosed as fracture. (1) There were some normal nasal structures which were susceptible to be confused with fracture, such as bone suture, internasal aperture, intersuture bone, and normal variations. (2) On transverse and coronal scan, nasal-maxillary suture demonstrated various characteristics, including 57 cases and 3 cases of inflated type, 39 and 5 of occluded type, 31 and 6 of intersuture bone, 16 and 34 of thin bony shapes, respectively. (3) Sometimes the extremity of outside was too depressed or flat which was related with the development, and it included 12 cases in left and 13 in right of inner alcula type, 4 in left and 4 in right of outer raised shape on coronal images, which were easily confused with fragment of fracture. But the conformation and structure were intact on transversal images, thus fracture could be excluded. Conclusion The understanding of morphological structure and characterized imaging findings can reduce the incidence of clinical misdiagnosis. Nasal bone fracture is not rare in facial trauma, and the following points should be paid attention to: 1.Normal nasal structures and variations of the nasal bone. 2.The scanning methods with HRCT. 3.Combination of the transversal and coronal scan can reinforce and testify with each other.
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Purpose: To evaluate the efficacy and toxicity of combination chemotherapy with paclitaxel and oxaliplatin (two new drugs) in patients with locally advanced and(or) metastatic gastric adenocarcinoma ( M/AGC). Methods: Between May 2001 and May 2002, 30 patients (22 male and 8 female) with a median age of 58 years (range35-80) were consecutively enrolled in this study. Oxaliplatin and paclitaxel were administered as a two-hour infusion every one or two weeks, respectively, and DDP or FUDR were infused in abdominal cavity every one week. Results: Thirty patients were evaluable for activity, with 2 complete and 17 partial responses, objective response rate( RR): 63% ( 95% CI: 46% -80%). Twenty-three of thirty patients (77%) experienced WHO grade Ⅰ-Ⅳ bone marrow suppression, which was the most common and serious toxicity. WHO Grade Ⅰ-Ⅲ side effect ( non-hematological toxicity) of gastrointestinal tract, liver, peripheral neuropathy, kidney , mucositis and heart occurred in 40%, 30%, 13%, 10%, 10% and 7% of patients, respectively. No patients withdrew because of treatment-related toxicity. Conclusions: Our data suggest that the combination of paclitaxel and oxaliplatin has promising therapeutic activity in patients with advanced gastric cancer. This regimen shows good efficacy and an acceptable safety profile in M/AGC patients, and may prove to be a suitable alternative regimen in this indication, especially for the patients with bad function of the heart , liver and kidney or old, physically weak patients.
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Objective To investigate the value of CT scans in differential diagnosis of thyroid neoplasm.Methods CT findings ofthyroid neoplasm in 29 cases including 8 cases thyroid adenoma,4 cases nodular goiter and 17 cases thyroid carcinoma identified by operation and pathology were analyzed retrospectively.Results The contour of thyroid adenoma was distinct,a completely enhanced ring in 5 cases and enhanced nodules in 3 cases were showed on contrast-enhanced scan.4 cases of nodular goiter showed homogenous cystic low density the lesions were localized and distinct in contour,the cystic wall could be seen.Thyroid carcinoma appeared unhomogenous density,the edges contour of lesion was not distinct and infiltration on adjacent tissue might be seen.Conclusion CT scan might play an important role in diagnosis and differential diagnosis of thyroid neoplasm.