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Objective:To evaluate the efficacy and safety of apatinib in combination with chemoradiotherapy for head and neck squamous cell carcinoma (HNSCC).Methods:37 patients orally received apatinib at 250 mg/d during concurrent chemoradiotherapy until completion of radiotherapy, complete remission assessed by imaging examination, the onset of unacceptable toxicity or death. Baseline characteristics, objective response rates (ORR) and adverse events were assessed in all enrolled patients with complete baseline and safety data. Progression-free survival (PFS) and overall survival (OS) were calculated by Kaplan-Meier method. Prognostic factors were statistically identified using Cox regression models.Results:The ORR was 85%(95% CI: 72%-98%). The median PFS was 17.9 months and the 2-year OS rate was 62%(95% CI: 48%-80%). Ineffective short-term efficacy ( HR=0.035, 995% CI: 0.02-0.652, P=0.025) was an independent risk factor for poor OS. In addition, ineffective short-term efficacy ( HR=0.104, 95% CI: 0.017-0.633, P=0.014) and lymphocytopenia ( HR=17.539, 95% CI: 2.040-150.779, P=0.009) were independent risk factors for poor PFS. Common adverse events (>60%) included lymphocytopenia (76%), leukopenia (68%) and irradiation-induced mucosal injury (65%). The most common treatment-associated grade 3 adverse event was lymphopenia (49%). Conclusions:Apatinib combined with chemoradiotherapy yield significant anti-tumor activity for HNSCC with controllable toxicity. For patients with advanced HNSCC, short-term efficacy and lymphocytopenia may be potential predictors for clinical efficacy of apatinib combined with chemoradiotherapy.
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OBJECTIVE:To investigate the influence of health education prescription on the reduction of intravenous dripping leakage in obstetrics and gynecology department of our hospital. METHODS:Totally 300 inpatients selected from obstetrics and gy-necology department of our hospital Jun.-Nov. 2015 were divided into observation group and control group according to random number table,with 150 cases in each group. Control group received health education of daily operation during intravenous dripping. In observation group,intravenous dripping treatment card came with a health education prescription of intravenous dripping,which facilitate the patients and families to consult;the nurses carried out health education for patients every day during dripping in accor-dance to the prescriptions;clinical pharmacists accompanied resident physicians to make patient round and conducted random health education inspection. Awareness rate of health education prescription content,satisfactory rate of treatment,dripping rate of Magne-sium sulfate injection and Cefazolin sodium for injection,the incidence of ADR were compared between 2 groups. The intravenous dripping leakage were observed in 2 groups. RESULTS:The awareness rate of health education prescription content and satisfactory rate of treatment were 94.0% and 96.0% in observation group,which was significantly higher than 70.35% and 85.75% of control group,with statistical significance (P<0.05). The dripping rate of Magnesium sulfate injection <40 drops/min accounted for 97.6% in observation group,which was significantly higher than 91.6% of control group;the incidence of ADR was 0.3% in ob-servation group,which was significantly lower than 1.3% of control group. The dripping rate of Cefazolin sodium for injection <60 drops/min accounted for 92.3%,which was significantly higher than 85.0% of control group;the incidence of ADR was 0.4%in observation group,which was significantly lower than 1.0% of control group,with statistical significance(P<0.05). The intra-venous dripping leakage rate was 5.5%in observation group,which was significantly lower than 9.5%of control group,with statis-tical significance(P<0.05). CONCLUSIONS:Health education prescription can significantly improve satisfactory degree of treat-ment and reduce ADR and leakage during intravenous dripping
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Objective To explore the diagnostic and clinical application value of combined detection of C-reactive protein (CRP),serum prealbumin (PA) and white blood cell (WBC) count in neonatal infectious diseases.Methods A total of 187 fullterm newborns were collected in this study,including 92 newborns of bacterial infection as the infection group and 95 newborns of non-infection diseases as non-infection group.The abnormal rates of CRP,PA and WBC in the two groups were measured;the sensitivity,specificity,false positive rate and false negative rate were compared between the single detection and combined detection of WBC,PA,CRP;the changes of the three indexes in the infection group were compared between before and after treatment.Results The abnormal rates of CRP,PA and WBC in the infection group were significantly higher than those in the non-bacterial infection diseases group (P＜0.05).The sensitivity and specificity of combined detection of CRP+ PA + WBC were higher than those of single detection of CRP,PA and WBC;after treatment,the level of CRP in the infection group was significantly decreased,the level of PA was significantly increased and the WBC count returned to normal(P＜0.05).Conclusion The combined detection of CRP,PA and WBC has an important clinical value in the early diagnosis of neonatal bacterial infection.
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Objectives To investigate the etiological factors,clinical features and treatment of pediatric primary spontaneous pneumothorax (PSP). Methods The clinical data of 84 PSP patients under the age of 18 from Departments of Emergency,Respiratory Diseases and Thoracic Surgery of our hospital from June 1999 to June 2009 were collected. There were 72 males (85.7%) and 12 females (15.3%) with a ratio of 6 to 1. Their age ranged from 14 to 18 (mean 17.06). Patients with pneumothorax following trauma,pneumonia,iatrogenic and other underlying causes were excluded. Therapeutic methods included oxygen therapy for 4.8% patients,closed drainage of pleural cavity for 57.1% patients,and surgery for 38.1% patients,But there were 31 patients receiving surgical treatment after closed drainage was failed. The period of follow-up ranged from 1 to 123 months (mean 25.73 months) through telephone or outpatient. Results Eighty-four patients were included,of whom 96.4% had chest pain,7.1% had chest tightness,66.7% had dyspnea,8.3% had shortness of breath and 14.3% had cough. There were 96.4% patients having decreased breathing sound and 3.6% having absent breathing sound. Bullae or blebs occurred mostly in apex and upper lobe. Twenty-one patients suffered from recurrent pneumothorax. Smokers (66.7%,n=9) had higher recurrent rate than non-smokers (22.0%,n=75). Conclusion PSP should be considered when symptoms such as chest pain and dyspnea appear in teenagers. Closed drainage of pleural cavity combined with surgical procedure is recommended for treatment. PSP patient with a history of smoking has higher recurrent rate of PSP.