ABSTRACT
Objective:To compare the short-term clinical efficacy, adverse reactions and pharmacoeconomics of advanced mutation negative lung adenocarcinoma treated by albumin-bound paclitaxel or pemetrexed combined with cisplatin.Methods:From September 2019 to October 2020, 80 patients with advanced lung adenocarcinoma diagnosed in the First Affiliated Hospital of Bengbu Medical College were divided into observation group and the control group according to the randomized digital table, with 40 cases in each group. The observation group received albumin-bound paclitaxel combined with cisplatin, and the control group received pemetrexed combined with cisplatin. After 2 cycles of treatment, the short-term efficacy and the adverse reactions of the two groups were evaluated. The cost of chemotherapy drugs and the average length of hospital stay were compared between the two groups.Results:The objective response rates of the observation group and the control group were 30.0% (12/40) and 32.5% (13/40), the disease control rates were 77.5% (31/40) and 82.5% (33/40) respectively, and there were no significant differences ( χ2=0.058, P=0.809; χ2=0.313, P=0.576). The adverse reactions of the two groups were mainly grade Ⅰ-Ⅱ. The incidences of leucopenia, neutropenia, thrombocytopenia, hemoglobin decreased, gastrointestinal reaction, liver function damage and renal function damage in the observation group were 20.0% (8/40), 20.0% (8/40), 20.0% (8/40), 17.5% (7/40), 37.5% (15/40), 12.5% (5/40) and 7.5% (3/40) respectively, those in the control group were 25.0% (10/40), 20.0% (8/40), 17.5% (7/40), 15.0% (6/40), 32.5% (13/40), 17.5% (7/40) and 5.0% (2/40) respectively, and there were no statistically significant differences between the two groups ( χ2=0.287, P=0.592; χ2<0.001, P>0.999; χ2=0.082, P=0.775; χ2=0.092, P=0.762; χ2=0.220, P=0.639; χ2=0.392, P=0.531; χ2<0.001, P>0.999). The median cost of chemotherapy drugs and the median length of hospital stay in the observation group were 7 453 yuan and 6 days respectively, which were less than 8 956 yuan and 7 days in the control group, with statistically significant differences ( Z=-3.057, P=0.002; Z=-2.733, P=0.006). Conclusion:The short-term efficacy of albumin-bound paclitaxel combined with cisplatin is equal to pemetrexed combined with cisplatin in treatment of advanced mutation negative lung adenocarcinoma, and the adverse reactions are similar. However, the average cost of chemotherapy drugs of albumin-bound paclitaxel combined with cisplatin is less than pemetrexed combined with cisplatin, and the average length of hospital stay is shorter.
ABSTRACT
Through discussing the connotation of medical humanities spirit and the current situation of medical humanities education in our country, the authors put forward that in clinical practice, respiratory medicine interns medical ways for the cultivation of the humanistic spirit, which include: guide the trainee doctors in treating pa-tients alike, on the basis of understanding and respect for life and death;to cultivate the ability of effective commu-nication between patient and physician internship; interns cultivated the spirit of collaboration and leadership skills;the in-depth, on the basis of clinical practice, in practice the doctor to write a detailed records;construc-tion of a high level of teacher love team, set an example for the students.