Roles of multidisciplinary team (MDT) in diagnosis and treatment of suspected cases of corona virus disease 2019 (COVID-19) / 浙江大学学报·医学版

OBJECTIVE@#To analyze the roles of multidisciplinary team (MDT) in the diagnosis and treatment of suspected cases of corona virus disease 2019 (COVID-19).@*METHODS@#The clinical data of 48 patients with suspected COVID-19 admitted in Jinhua Central Hospital from January 21, 2020 to March 20, 2020 were retrospectively analyzed.@*RESULTS@#Of the 48 suspected cases, 18 were diagnosed with COVID-19, and 30 were excluded. Each of the confirmed cases were discussed among MDT for 2 to 12 times with an average of (4.7±3.2) times; while for non-COVID-19 patients were discussed for 2 to 4 times with an average of (2.3±0.6) times per case. With the guidance of MDT, one COVID-19 patient was transferred to designated provincial hospital after effective treatment; one patient complicated with acute cholecystitis underwent gallbladder puncture and drainage; and COVID-19 was excluded in a highly suspected patient after alveolar lavage fluid examination. Except one transferred patient, all 17 confirmed COVID-19 patients were cured and discharged; there was no cross-infection occurred in suspected patients during the hospitalization; there were no deaths and no medical staff infections.@*CONCLUSIONS@#The efficiency of diagnosis and treatment for suspected COVID-19 patients can be improved under MDT mode, particularly for complicated and refractory cases.

Roles of multidisciplinary team in diagnosis and treatment of suspected cases of COVID-19 / 浙江大学学报·医学版

OBJECTIVE@#To analyze the roles of multidisciplinary team (MDT) in the diagnosis and treatment of suspected cases of coronavirus disease 2019 (COVID-19).@*METHODS@#The clinical data of 48 patients with suspected COVID-19 admitted in Jinhua Municipal Central Hospital from January 21, 2020 to March 20, 2020 were retrospectively analyzed.@*RESULTS@#In the 48 suspected cases, 18 were diagnosed with COVID-19, and 30 were excluded. Each of the confirmed cases were discussed among MDT for 2 to 12 times with an average of (4.7±3.2) times; while for non-COVID-19 patients were discussed for 2 to 4 times with an average of (2.3±0.6) times. With the guidance of MDT, one COVID-19 patient was transferred to designated provincial hospital after effective treatment; one patient complicated with acute cholecystitis underwent gallbladder puncture and drainage; and COVID-19 was excluded in a highly suspected patient after alveolar lavage fluid examination. Except one transferred patient, all 17 confirmed COVID-19 patients were cured and discharged. There was no cross-infection occurred in suspected patients during the hospitalization. There were no deaths and no medical staff infections.@*CONCLUSIONS@#The efficiency of diagnosis and treatment for suspected COVID-19 patients can be improved with MDT, particularly for complicated cases.

Effect of the HMGB1、CEA and SCC-Ag by paclitaxel combined with cisplatin chemotherapy in advanced esophageal cancer / 中国生化药物杂志

Objective To investigate the effect of the high mobility group protein 1 (HMGB1), cancer embryonic antigen (CEA) and squamous cell carcinoma antigen ( SCC-Ag) by paclitaxel combined with cisplatin chemotherapy in the treatment of advanced esophageal cancer patients .Methods 43 cases advanced esophageal cancer patients from our hospital were selected and randomly divided into the control group and the experiment group.19 cases in the control group were treated by surgery combined with postoperative chemotherapy , 24 cases in the experimental group were treated with surgery and chemotherapy.The clinical efficacy and high mobility group protein 1 ( HMGB1 ) , cancer embryonic antigen ( CEA ) and squamous cell carcinoma antigen ( SCC-Ag ) levels were compared between the two groups before and after treatment.Results The total effective rate of the experimental group was (91.7%) higher than that of the control group (57.9%), the difference was statistically significant (P <0.05).After treatment, the serum levels of SCC-Ag, CEA and HMGB1 were decreased in the two groups, compared with the control group, the experimental group SCC-Ag, CEA and HMGB1 levels were lower, the difference was statistically significant ( P <0.05 ) .There was no significant difference in adverse reactions between the two groups.Conclusion Paclitaxel combined with cisplatin in the treatment of advanced esophageal cancer patients with good results, presumably with the decrease of serum SCC-Ag, CEA and HMGB1 levels in patients with.

A randomized controlled trial comparing the efficacy and toxicities between neoadjuvant concomitant boost intensity-modulated radiotherapy (IMRT) and 3-dimensional conformal radiotherapy (3-DCRT) for locally advanced rectal cancer / 中华放射医学与防护杂志

Objective To compare the efficacy and toxicities between preoperative concomitant boost intensity-modulated radiotherapy (IMRT) and 3-dimensional conformal RT (3-DCRT) for locally advanced rectal cancer.Methods A prospective study from May 2010 to May 2015.A total of 130 patients with histologically confirmed,newly diagnosed,locally advanced rectal adenocarcinoma (cT3-T4 and/or cN +) located within 10 cm from the anal verge were included in this study.The patients were divided into IMRT and 3D-CRT groups by random number table method.Sixty-six patients were treated with IMRT,and the other sixty-four patients were treated with 3-DCRT.In the IMRT group,the prescription dose was 1.8 Gy/fraction to 45 Gy to the pelvis and 2.2 Gy/fraction to 55 Gy to the gross tumor volume simultaneously.The 3D-CRT prescription was 45 Gy in 25 fractions to the pelvis.Capecitabine (1 650 mg· m 2 · d-1) was given twice daily from days 1 to 14 and days 22 to 35 during RT in both arms.Total mesorectal excision (TME) was scheduled 6-8 weeks after the completion of chemoradiation.Results There were no significant differences in age,gender,tumor location,pathological differentiation degree and clinical stage between the two groups.Two patients withdrew from the study:one for grade 3 radiation dermatitis in IMRT group and the other for grade 3 fatigue in 3D-CRT.There was no significant difference in hematologic or nonhematologic toxicities between the two groups.No grade 4 or 5 toxicity was observed in either group.Compared with conformal radiotherapy,IMRT did not increase the difficulty of surgery.No significant difference was found in type of surgery or postoperative complications between the two groups.The rate of tumor regression grade (TRG) 4 (pathologic complete response,pCR) was 22.7％ for IMRT and 15.6％ for 3D-CRT,respectively(P ＞ 0.05).The rate of both TRG4 and 3 was 42.4％ for IMRT and 25.0％ for 3D-CRT,respectively (x2 =4.406,P=0.036).Conclusions Neoadjuvant concomitant boost IMRT is feasible and has a higher histopathological regression for patients with locally advanced rectal cancer.Trial registration Chinese clinical trial registry,ChiCTR-IN R-16008004.

Histopathological regression after preoperative chemoradiotherapy in locally advanced rectal carcinoma / 国际肿瘤学杂志

Neoadjuvant chemoradiotherapy (CRT) has become a standard treatment of locally advanced rectal carcinomas. There is a close correlation between histopathological regression after preoperative CRT and prognosis. To identify the markers for histopathological regression is significant for clinical treatment. Different strategies of chemoradiotherapy, application of targeted drugs in neoadjuvant chemothercepy and internal from neoodjuvant to operation are correlated with histopathological regression.