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@#Esophageal cancer is the seventh most common cancer worldwide. On August 29, 2023, National Comprehensive Cancer Network (NCCN) released the NCCN esophageal and esophagogastric junction cancers clinical practice guidelines in oncology (version 3. 2023). This article aims to highlight the key updates in treatment and follow-up recommendations between the version 3 and the version 2 in 2023, providing the latest guidance for the management of esophageal cancer in our country.
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Objective:To explore the role of PDCA cycle in the standardized residency training in the department of hematology.Methods:Thirty residents trained in the department of hematology of Peking University Third Hospital from January 2019 to September 2019 were enrolled into experimental group, and 36 residents trained from January 2018 to December 2018 were enrolled into control group. Experimental group received the PDCA cycle teaching method and control group did the traditional one. At the end of the training, the results of theory examination and practical operation skills examination of the two groups were compared. The statistical significance was analyzed on the assessment scores and teaching satisfaction between the two groups. SPSS 20.0 was used for t test. Results:Compared with the control group, the examination scores and teaching satisfaction of the residents in the experimental group were higher than those in the control group ( P < 0.05). Conclusion:The teaching mode of PDCA cycle is conducive to improving the effect of standardized residency training in the department of hematology.
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To determine clinical and pathologic profiles for anaplastic large cell lymphoma (ALCL). Methods: The clinical data of 22 patients with ALCL were analyzed retrospectively. Therapentie effect of different treatment strategies on ALCL was evaluated. Results: The median age for these patients was 32(9-70) years old and the patients with positive ALK accounted for 68.2% (15/22). All patients underwent chemotherapy, including regiments of CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone), CHOPE (CHOP plus etoposide) or BEACOP (CHOP plus etoposide and bleomycin). Fourteen (63.6%) patients achieved initial complete remission (CR) and the CR rate for patients with ALK+ was significantly higher than that of patients with ALK- (P0.05). After a median follow-up of 41 (2-150) months, 12 patients were overall survival, the median progression free time was 22.5 (2-150) months, and the age, gender, stage, IPI index, ALK expression level, beta 2-MG level, LDH level, and B symptoms had no significant effect on the rate of overall survival (P>0.05). Conclusion: ALK-positive occurs mainly in ALCL patients. The chemotherapy is still the main treatment, and CHOPE regimen is a better initial treatment scheme because the most patients show good prognosis.
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Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Young Adult , Age Factors , Alkaline Phosphatase , Antineoplastic Combined Chemotherapy Protocols , Therapeutic Uses , Bleomycin , Cyclophosphamide , Doxorubicin , Etoposide , Lymphoma, Large-Cell, Anaplastic , Drug Therapy , Mortality , Prednisone , Prognosis , Retrospective Studies , Sex Factors , Treatment Outcome , VincristineABSTRACT
Objective To evaluate the efficiency of amifostine in protecting against oral and gastrointestinal mucositis in hematologic malignancies patients with high-dose total body irradiation following the hematopoietic stem cell transplantation,and assess the hematologic recovery as well as the potential side effect of amifostine.Methods Thirty-two hematologic malignancies patients underwent hematopoietic stem cell transplantation in our institution from 2012 to 2016 were retrospectively analyzed.All of them were treated with total body irradiation (700-1 200 cGy) and high-dose chemotherapy,in which 14 patients received 400 mg amifostine before radiotherapy.Prior institutional experience in 18 patients treated without amifostine was used as a historical comparison (no-amifostine group).Results Severe oral mucositis occurred in 14.3％ of patients in the amifostine group while 77.2％ in the no-amifostine group (x2 =10.62,P ＜0.05).Total parenteral nutrition was used in 21.4％ of amifostine group and 38.8％ in noamifostine group (P ＞ 0.05).The rates of grade 2 and 3 gastrointestinal mucositis were 35.7％ and 61.5％ in amifostine group,while in no-amifostine group the rates were 33.3％ and 66.7％,respectively (P ＞ 0.05).No significant difference was found in engraftnent times of granulocyte and platelet.No amifostine related side effects were observed.Conclusions The combination of amifostine and total body irradiation conditioning therapy during hematologic stem cell transplantation might reduce the severity of oral mucositis.The utilize of amifostine has no obvious effect on hematopoietic recovery and can be well tolerated.
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Objective To evaluate the fludarabine instead of cyclophosphamide in modified busulfancyclophosphamide (mBuCy) regimen as a new myeloablative conditioning regimen for the treatment of acute leukemia patients receiving allogeneic hematopoietic stem cell transplantation (HSCT).Methods The clinic data of 45 acute leukemia patients undergoing allogeneic HSCT were analyzed.Among them,23 patients received mBuCy as conditioning regimen and 22 patients received BuFlu regimen (fludarabine 40 mg·m-2·d-1 for 5 days,instead of cyclophosphamide in mBuCy).Hematopietic engraftment,regimen-related toxicity (RRT),graft-versus-host disease (GVHD),infection condition,non relapse mortality,and overall survival were compared between the two groups.Results All patients achieved hematopoietic reconstitution and complete donor chimerism except for one patient of mBuCy group died of cerebral hemorrhage during conditioning.The incidence of RRT was no significant differences (P ＞ 0.05).In BuFlu group,the incidence of virus infection was higher (P =0.009),and the incidence of Ⅲll-Ⅳ aGVHD were 26.l ％ (6/23) and 4.5 ％ (1/22) (P =0.046) in mBuCy and in BuFlu group respectively.With a median follow up of 41 months,the incidence of non relapse mortality in mBuCy group was 17.4 ％ (4/23) and in BuFlu group was 9.1％ (2/22) (P =0.665).In mBuCy group and in BuFlu group,the relapse rates were 30.3 ％ (7/23) and 40.9 ％ (9/22) (P =0.474),the 5-year overall survival rates were (55.1±11.9) ％ and (61.4±10.8) ％ (P =0.659),and disease-free survival rates were (44.5±12.1) ％ and (22.1±12.3) ％ (P =0.747),respectively.Conclusions Fludarabine instead of cyclophosphamide in mBuCy regimen as a new myeloablative conditioning regimen has well tolerance,lower incidence of sever GVHD,satisfied overall survival,but the risk of infection and replase should be considered.
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Objective To investigate the effect of paroxetine in the adjuvant treatment of maintenance hemodialysis(MHD)com-plicating depression.Methods 60 patients with MHD complicating depression were randomly divided into the control group and the observation group,30 cases in each group.The control group received the routine therapeutical scheme(hemodialysis,complication treatment and correcting the renal anemia,etc).On the basis of the routine therapy the observation group was given oral paroxetine 10 mg/d,once daily for continuous 8 weeks.The depression level was assessed by the Hamilton depression scale(HAMD).The clinical symptoms,levels of Hb,ALB,Kt/V,iPTH,SF and HAMD scores were statistically analyzed and compared between the two groups.Results The clinical symptoms,levels of Hb,ALB,Kt/V after 8-week treatment in the two groups were significantly im-proved compared with pretherapy(P<0.05);the level of iPTH,SF and the HAMD scores in the two groups were decreased com-pared with pretherapy(P<0.05).The effective rate of depression was 86.67% in the observation group and 23.33% in the control group,the difference between the two groups had statistical significance(P<0.05).Conclusion Paroxetine in the assisted treat-ment of MHD complicating depression symptom can improve the quality of life in MHD patients.
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Objective To investigate the effects of Maixuekang capsule on blood coagulation.Methods 50 patients with different diseases from cardiologic department of Chongqing First People's Hospital from 2011 May to 2011 September were selected.The changes of their blood coagulation function were observed after taking Maixuekang capsule.Results Activated partial thromboplastin time (APTT-sec) and activated partial thromboplastin ratio (APTT-ratio) in 84 ds [(35.64±3.07),(1.11±0.10)] after using the medicine showed no statistical difference compared with the value before taking the medicine [(35.29±3.32) before treatment),(1.10±0.10)] (P＞0.05); while coagulation zymogen activity (PT％),prothrombin normalized ratio (PT-INR),prothrombin ratio (PT-ratio),prothrombin time(PT-sec),fibrinogen (Fib),thrombin time (TT-sec),and thrombin ratio (TT-ratio) in 84 ds after using the medicine [(105.22 ± 11.69)％,(0.98 ±0.07),(1.00±0.05),(13.08±0.69),(3.37±0.74)g/L,(18.12±1.41),(1.07±0.08)] showed significant changes than before the treatment [(114.64±9.10) ％,(0.93±0.04),(0.94±0.03),(12.50±0.42),(3.66±0.59)g/L,(16.84±0.71),(0.99±0.04)] (P＜0.05).Conclusion Maixuekang capsule has anti-cogulant effect on patients.
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Objective To observe the effects of a motor relearning programme (MRP) combined with different early acupuncture interventions on muscle tension and motor function recovery after cerebral infarction.MethodsA total of 90 patients with cerebral infarction who met the inclusion criteria were divided into three groups at random:a YANGMING meridian acupuncture and MRP group ( group A),an anti-spasm acupuncture and MRP group ( group B),and an MRP group ( group C ).All of the patients in all three groups were treated with routine medication.The National Institute of Health stroke scale (NIHSS),the composite spasticity scale (CSS),Fugl-Meyer assessment (FMA),the Fugl-Meyer balance scale (FM-B) and the modified Barthel index (MBI) were used to measure performance before treatment and after 4 weeks of treatment.Another comparison was intra-group between before and after treatment. ResultsThere were significant differences in the assessment results in all of the groups after treatment compared with those before treatment.After treatment,group B was superior to group C only in terms of NIHSS scores.There was no significant NIHSS score difference between groups A and C.The FMA,CSS and MBI results revealed significant differences among all three groups,with the scores of group A consistently the highest.The average FMA score in group B was significantly higher than in group C but there was no statistically significant difference in FM-B scores among the three groups. ConclusionMRP therapy combined with early acupuncture intervention can improve motor function and muscular tension after cerebral infarction.Anti-spasm acupuncture can improve motor function and control muscular tension effectively at the same time,making it beneficial for MRP training.
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Objective To detect the mutagenicity of sulfur mustard in the tk gene of L5178Y3.7.2c tk +/- mouse lymphoma cells. Methods The plating efficiency and the mutant frequency were detected by the microtiter procedure. Results Sulfur mustard induced tk locus mutation with mutation frequency 2-15 times higher than that of spontaneous mutation frequency of L5178Y3.7.2c tk +/- cells. There were two different phenotypes of mutation colonies induced, which were large and small colonies, but most of them were small colonies. Conclusion Sulfur mustard is characterized by marked mutagenic activity and cytotoxicity. The compound may result in large range of DNA damage.
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Operation of radiological equipment affects not only the quality of clinical diagnosis & treatment,but also the health of the radiographer and subjects.The operation and safety protection of the aged radiological equipment in primary medical units has to be paid particular attention to.Based on the survey,some advices are put forward from the aspects of equipment management,personnel training and protection supervision.
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Objective To study the effects of sulfur mustard on chromosomal aberration in Chinese hamster fibroblast cell line (CHL cells) and the micronucleus (MN) frequency in the bone marrow cells of mice. Methods CHL cells (with and without S9) treated with different concentrations of sulfur mustard for 24 h were harvested for the preparation of chromosome. Subsequently, the frequency and the type of chromosomal aberration were examined. The KM mice were sacrificed at 24 h after subcutaneous injection of sulfur mustard. The number of micronuclei-containing polychromatic erythrocytes (PCEs) was counted by means of bone marrow smear and Giemsa staining. Results Sulfur mustard might increase the chromosomal aberration frequency of CHL cell in a dose-dependent manner. S9 had no effects on the classificaiton and the frequency of chromosomal aberration. The types of chromosomal aberration included gap, break, deletion, polyploid, and so on. Compared with that in the control group, the MN ratio in every group increased significantly (P
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Objective To investigate the effect of embryotrophic factors(ETF)from human oviductal cells on gene expression of mouse early developmental embryos and discuss the role of fallopian tube in early development of embryos.Methods ETF was isolated from conditioned medium of human oviductal cell line by sequential liquid chromatographic systems.Mouse embryos were treated by ETF in vitro.Using differential display RT-PCR,the gene expression of embryos treated by ETF was compared with embryos without ETF treatment.The differentially expressed genes were separated,re-amplified,cloned and sequenced.Results Gene expression profiles of embryos with ETF treatment was different from embryos without this treatment.Eight differentially expressed genes were cloned and sequenced.These genes functioned in RNA degradation,synthesis,splicing,protein trafficking,cellular differentiation and embryo development.Conclusion Embryotrophic factors from human oviductal cells affect gene expression of early developmental embryos.The human oviductal cells play wide roles in early developmental stages of embryos.