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In recent years, basic scientific research and clinical studies on mesenchymal stem cell-derived exosome (MSC-Exo) have developed rapidly. MSC-Exo has shown good anti-tumor effects in preclinical and clinical studies. However, due to its diverse sources and functions, MSC-Exo therapy still faces many ethical issues in clinical conversion and application, including the unclear tumor types and mechanisms of action applicable to MSC-Exo, the risk/benefit issues in the process of clinical research, the lack of safety/effectiveness evaluation standards, lax access standards, and the incomplete regulatory systems. The technical guidelines and regulatory policies related to the clinical transformation and application of stem cell therapy are constantly improving. Therefore, to effectively avoid ethical risks, regulate the research and treatment related to the clinical transformation and application of MSC-Exo therapy, and improve the safety and efficacy of MSC-Exo therapy in tumor therapy, it is proposed to deepen clinical research on the relationship between MSC-Exo and tumor regulation, strengthen the risk/benefit analysis, supervise and improve the professional quality of researcher, deeply root in the principle of subjects not to be harmed, construct and perfect the relevant regulatory system, and improve the reviewing ability of the ethics committee, so as to promote the rapid clinical transformation of MSC-Exo and bring good news to cancer patients.
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【Objective】 To evaluate the detection and distribution characteristics of anti-P1 in tumor patients, so as to aid in blood screening and transfusion safety. 【Methods】 The clinical data of 112 658 tumor patients who underwent blood preparation and transfusion in our hospital from January 2014 to December 2021 were retrospectively analyzed, and column agglutination technique was used to perform transfusion compatibility test. 【Results】 A total of 1 079 (0.96%, 1 079/112 658) cases were detected with unexpected antibodies, of which 71 (6.58%, 71/1 079) were identified as anti-P1. In anti-P1 cases, 59.15% (42/71) were males; 60.56% had no pregnancy history (P<0.01); 29.58% (21/71), 52.11%(37/71), 12.68%(9/71) and 5.63%(4/71) of anti-P1 patients were with type A, B, O and AB, respectively. 57 cases of anti-P1 patients (80.28%) had difficulty in ABO blood group identification. The incidence of interfering in patients with type B was higher than that of other blood types (P<0.05), as the frequency of w+ in reverse blood typing was higher than other reactive patterns (P<0.05). The incidence of gastric tumor and brain space-occupying lesion in patients with anti-P1 was higher than that in patients with other alloantibodies, while the incidence of gynecological tumors was lower (P<0.05). 【Conclusion】 Anti-P1 affects the ABO blood group identification of tumor patients, and most of them had difficulty in ABO blood group identification. Compared with patients with other alloantibodies, patients with anti-P1 are more likely to be male and suffer from gastric and brain tumors, but less likely from gynecological tumors.
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【Objective】 To explore the effects of massive intraoperative RBC transfusion on multiple clinical test indicators and prognosis of patients, underwent tumor surgery in order to provide evidence for rational blood transfusion and effective intervention of complications caused by massive blood transfusion in tumor patients. 【Methods】 A total of 208 patients who underwent tumor resection in our hospital from January 2019 to December 2020 and received intraoperative RBC transfusion(>10 U) were selected as the study subjects. According to the amount of blood transfusion, they were divided into group A: 10~15 U, 144 patients; Group B: >15~25 U, 48 people; Group C: >25 U, 16 people. Data of liver function, coagulation, electrolyte, platelet count and short-term prognosis were collected and compared among 3 groups before and after surgery. 【Results】 No significant difference was noticed in patient pre-operation variables including ALT (U/L), AST (U/L) and TBIL (μmol/L) among three groups recieved massive blood transfusion (P>0.05), while AST was significantly lower than that after operation (P<0.05) : 105.33±238.18 vs 113.50±185.04 vs 291.25±457.33 (P<0.05). After operation, PT (s) (14.12±2.10, 14.79±2.67 and 16.10±4.06), INR(1.25±0.20, 1.31±0.26 and 1.44±0.38) and APTT (s) (30.52±5.63, 34.57±12.80 and 34.80±10.49) extended significantly than those before operation (P<0.05), while Plt (×109/L) decreased significantly (142.32±70.07, 100.04±57.50 and 85.40±41.10)(P<0.05). After operation, serum K+ and Ca2+ decreased significantly, Na+ and Cl- increased significantly, and pH value decreased (P < 0.05). Hospital stay of group C (d) was 33.73±34.62 vs 17.74±14.83 vs 20.92±17.69 (P<0.05). The mortality rate was 2.8%(4/44) vs 6.3%(3/48) vs 18.8%(3/16)(P<0.05), and mortality rate of group C was higher than the other two groups. 【Conclusion】 Postoperative dysfunction of liver and coagulation in tumor patients may be related to intraoperative RBC transfusions and consequent acid-base imbalance and electrolyte disturbance. The more the units of RBC transfused, the more abnormal the patients' clinical indicators, also the longer the hospital stay and the worse the short-term prognosis.
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OBJECTIVE：To explore the mode of pharmaceutical care for oral medication of tumor patients with dysphagia by clinical pharmacists ，so as to promote clinical rational and safe drug use. METHODS ：Based on typical cases ，the problems existing in the oral medication of tumor patients with dysphagia were analyzed ，and the medication guidance and pharmaceutical care given by clinical pharmacists were expounded. RESULTS ：Clinical pharmacists found that tumor patients with dysphagia had some problems during oral medication ，such as improper administration position ，tube feeding of slow-controlled release preparations after opening the capsule ，limited administration route ，biting cytotoxic drugs ，unknown solubility of targeted drugs ，interaction of multiple drugs. In view of the above problems ，clinical pharmacists assisted physicians and nursing staff to provide pharmaceutical care to patients in combination with the patient ’s disease characteristics ，pharmacy，pharmacokinetics，pharmacodynamics，drug solubility，drug interaction and other factors ，such as skillfully using appropriate drug delivery location and mode ，using local drug delivery mode ，selecting appropriate dosage form based on pharmaceutical knowledge （the characteristics of new dosage form ）， guiding patients to use drugs correctly by being familiar with the characteristics of cytotoxic drugs and targeted drugs ，paying attention to potential drug interactions and guiding nurses to use drugs correctly. The situation of improper medication was improved. CONCLUSIONS ：Clinical pharmacists should participate in clinical therapy actively ，and make appropriate interventions with professional knowledge of pharmacy so as to promote the correct use of oral medication for tumor patients with dysphagia.
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【Objective】 To analyze ABO subtype samples from tumor patients using both blood group serology and molecular biology technology. 【Methods】 32 samples of ABO subtype, identified by routine blood group serology in the Department of Transfusion, of solid tumor patients treated in Cancer Hospital of Chinese Academy of Medical Sciences from July 2014 to December 2019 were analyzed by sequence specific primer polymerase chain reaction (PCR-SSP) and gene sequencing (PCR-SBT). 5 samples were detected by PCR-SSP, 28 PCR-SBT, 1 both PCR-SSP and PCR-SBT. The serological and genotyping results were comparatively analyzed. 【Results】 66% (21/32) of the samples in this study were confirmed as ABO subtypes or harbored mutations by genotyping assays, including 7 cases of B(A).04, 2 of B(A).02, 1 of cis AB.01, 3 of BW.12, 4 of BEL.03, 1 of AEL.02, 1 of B 974G>C, 1 of A 797insT, and 1 of A 617C>G. Among the 21 subtype samples or harbored mutations, 15 had the same blood group serology and genotyping results, and 6 had no A or B antigen detected in the serological adsorption-elution test. An additional 34% (11/32) of the samples had no variants in the gene responsible for ABO subtype detected by molecular analysis. 【Conclusion】 Molecular biology techniques can assist in the identification of difficult ABO blood types caused by weakened antigens or antibodies, and subtypes in solid tumor patients, which is an important auxiliary method for accurate identification of difficult ABO blood group.
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【Objective】 To investigate the role of thromboelastography (TEG) in the diagnosis and treatment of PICC related venous thrombosis in tumor patients, and provide basis for predicting PIC related venous thrombosis. 【Methods】 148 tumor patients who underwent PICC catheterization in our hospital from January to July 2019 were enrolled. The patients were subjected to TEG examination and ultrasound examination of limb blood vessels on catheterization side regularly one day before catheterization and 4 successive weeks after catheterization(once a week), respectively. The patients with venous thrombosis were subjected to TEG examination and vascular ultrasound regularly for 3 successive weeks(once a week) after anticoagulant therapy. The relationship between the occurrence and time of venous thrombosis and the changes of TEG parameters was analyzed. 【Results】 The pre-/post-catheterization TEG parameter of 81 patients without venous thrombosis indicated that coagulation state was normal (R value F=0.198, K value F=0.047, α value F=0.442, MAvalue F=0.079, CIvalue F=0.026, P>0.05). The TEG parameter of 67 patients, who developed asymptomatic venous thrombosis 1 to 3 weeks after catheterization(38 cases in 1 week, 16 in 2 weeks and 13 in 3 weeks), indicated the blood was hypercoagulable and the TEG parameter was statistically different from the pre-catheterization value(P0.05). 【Conclusion】 TEG can reflect the status of PICC related venous thrombosis in tumor patients.Strengthening TEG monitor in tumor patients 1 to 3 weeks after PICC catheterization is conducive to early detection, diagnosis and treatment for PICCrelated thrombosis, thus reducing the harm of venous thrombosis to patients.
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Objective To explore the incidence and risk factors of common complications in PICC patients during chemotherapy in Xinjiang.Methods A prospective study was conducted.The patients with PICC were treated with PICC from April 2016 to April 2017 were followed up for 10 months. The incidence of PICC complication and the influencing factors were observed dynamically during chemotherapy.Results The incidence of PICC complication was 13.6%(42/208)during chemotherapy in Xinjiang patients.The incidence of PICC was higher in the third chemotherapy cycle and the incidences of the first and sixth chemotherapy cycles were lower. Age, valve type, number of punctures, maintenance time>7d, and living conditions were the influencing factors of PICC complications(P＜0.05). Conclusions The incidence of common complications of PICC in cancer patients during chemotherapy is high in Xinjiang region.The risk factors of complications include age＜18 years,number of open-end PICCs,increased number of punctures, maintenance time>7d and living conditions for rural areas. Clinical nurses should give personalized health guidance on the causes of complications in different patients to reduce the occurrence of complications of PICC,and improve the quality of PICC use.
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Objective To evaluate the clinical application of Fat Emulsion Injection in tumor patients and provide references for rational drug use.Methods A total of 1500 cases administered with Fat Emulsion Injection during January and December 2016 in Affiliated Cancer Hospital of Zhengzhou University were collected randomly and evaluated with the relevant standards.Results From the investigation of a total of 1 500 patients with cancer,fat Emulsion Injection was mainly used in the surgery department (68.2％).Of 1500 cases,unreasonable medical records accounted for 35.2 ％;inappropriate indication accounted for 16.1％,inappropriate selection of drugs accounted for 44.5％,incorrect dosage accounted for 50.6％,and incompatibility accounted for 18.3％.Conclusion Unreasonable use of Fat Emulsion Injection in the hospital is prevalent,therefore,measures should be taken to strengthen the standard use of this kind of drugs.
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Objective To investigate the effect of tourniquet modified strapping on venipuncture in tumor patients.Methods 120 tumor patients whose veins were exposed hard in radiotherapy department from October 2016 to March 2017, randomly divided into the control group and the observation group equally.The control group was treated with the traditional single strapping tourniquet to have venipuncture and the observation group with tourniquet modified strapping.Results The venous filling degree, the success rate of first puncture, and the satisfaction of the patients in the observation group were significantly higher than those in the control group (P<0.05).Conclusion The use of tourniquet modified strapping in tumor patients whose veins were exposed hard can significantly improve the venous filling degree, the success rate of puncture, the satisfaction of patients and the quality of nursing service, and thus it is worthy of clinical promotion.
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Objective To improve the rational use of human serum albumin(HSA)in cancer patients by the interventions of clinical pharmacists.Methods Literature search of HSA was performed by clinical pharmacists for clinical indications and appropriate usage.The HSA use protocol was implemented by clinical pharmacists and related clinical experts.The protocol adaptation was reinforced by clinical pharmacists.Results The rate of the rational use of HSA has been improved.Conclusion Clinical pharmacists play an important role in the clinical rational use of HSA based on evidence-based pharmacy.
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Objective:To investigate the application of leukogenic medicine in cancer patients and standardize the use of WBC increasing medicine in a hospital. Methods:A retrospective analysis of 579 patient records from January 2014 to December in a hospital diagnosed as malignant tumor and issued WBC increasing medicine . The kinds of drugs,timing of administration, dosage,frequency of administration,the use of medication,drug combination and the choice of solvent were analysed by collecting the patients’ essential information, chemotherapy, myelosuppression etc. Results: The l white blood drugs mainly oral preparations;There were 414 rational drug use medication orders,accounting for 71. 50 percent;irrational drug use medical record 165,accounting for 28. 50% . The dosage and duration of treatment in line with requirements,and unreasonable cases mainly suitable varieties and timing of administration based,42. 42% and 27. 88% ,respectively;followed by repeated dosing and combination therapy is not suitable,13. 33% 1and 2. 73,respectively;a lower incidence of solvent choice unsuitable,is 3. 64% . Conclusion:The use of WBC increasing medicine need to be standardized in cancer patients in the hospital. Clinicians need to strengthen studying the knowledge of the application of WBC increasing medicine and use WBC increasing medicine rationally.
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The PICC application in tumor chemotherapy patients has the advantages of simple operation, long time of implanting catheter, small pain and protect vein. They can ensure the chemotherapy smoothly, and further promotion in the clinical application, but when the patients took the tube back, the complications increased significantly. Health education is the mail channel for patient and family to get the major way to maintain PICC knowledge and skills. Through literature review of PICC health education at home and abroad, in our country, according to the present situation of PICC health education, the health education model, method and effect evaluation were summarized and looked for the problems in the present education of PICC health education. It can provide a basis for exploring new pattern of health education for improving the sevice life of the catheter and the patients’ life quality.
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OBJECTIVE:To explore the effects of entecavir combined with chemotherapy on positive HBV in tumor patients with normal liver function. METHODS:106 patients were selected and divided into observation group (44 cases) and control group (62 cases) according to therapy plan. Control group received routine chemotherapy according to tumor condition;observa-tion group was given Entecavir tablets orally 0.5 mg,qd,before 1 week of chemotherapy,for consecutive 1 week. HBV reactiva-tion rate,recurrence rate of severe hepatitis,mortality rate,serum level of ALT before and after treatment and the incidence of ADR were compared between 2 groups. RESULTS:4 patients of observation group and 2 of control group withdrew from the study. HBV reactivation rate,recurrence rate of severe hepatitis and mortality were 7.5%,0,0 in observation group and 56.7%, 50.0%,13.3% in control group,with statistical significance between 2 groups(P0.05);after chemotherapy,the serum levels of ALT in 2 groups were increased significantly,and the control group was significantly higher than the observation group,with statistical significance (P0.05). CONCLUSIONS:Entecavir can effectively prevent HBV reactivation and decrease the recurrence rate of severe hepatitis and mortality rate in tumor patients dur-ing chemotherapy, and doesn’t increase the risk of ADR.
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Objective To design and develop a treatment unit selecting system in aim of enhancing work efficiency and safety,adjusting treatment unit workload,improving quality of medical care.Methods Various treatment techniques,immobilization devices and setup verification devices were modeled in software.Workload of treatment units were extract from the Record and Verify System.These two types of information were then combined with the unit's workload capability to calculate the optimal radiotherapy apparatus for tumor patient.Results The system had finished selecting radiotherapy apparatusv for more than 5 000 patients since its taking place of the old patient selecting methods.Maximum variation of daily treatment duration between treatment units had decreased from 4-5 hours (mean 4.22 hours) to 1-2 hours (mean 1.84 hours) since the system have been put into operation.Workload and device configuration of various units could be controlled by easily editing of the system configuration file.Conclusions The system developed not only accomplish patient selecting in an optimal and safe way,but also provide a way of easily control the treatment unit workload.
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Objective To explore the effect of family constellation therapy on the spouses of female tumor patients . Methods Two hundred and two spouses of 202 female tumor patients were divided to the control group ( n = 43 ) and experiment group according to their wills(n=159):the former were intervened with health education and skills training and the latter trained in a workshop with family constellation by psychology training specialists in addition to health intervention and skill training intervention. After the intervention, the two groups were compared in terms of quality of life, family function and marriage status. Result The total scores of the experiment group on quality of life , social relationship and environment were all higher than those of the control group (all P<0.05) and the experiment group got higher score in trusting their spouses than the control group (P<0.05). Conclusion The family constellation can improve female tumor patients'quality of life and promote the trust in their spouses.
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Objective To explore the application of implantable venous access port(IVAP)in tumor patients.Methods Overall,246 tumor patients were enrolled.The clinical application and nursing of IVAPs were reviewed retrospectively.Results IVAPs were implanted successfully in all 246 patients.Complications included thrombosis in 10 patients,infection in 6,blockage in 1 and leakage in another.IVAPs were removed from 15 patients with complications.Conclusions The prevention and management of complications in IVAP are important for the patients embedded with IVAP.
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Objective To probe into the influencing factors of selecting the intravenous vascular access device for tumor patients undergoing intravenous therapy? Methods With convenience sampling,376 tumor patients in oncology department from 3 hospitals of class A hospitals in Guangzhou were selected for the survey including such 6 categories with 41 items as general data, patient’s willingness,punctured blood vessels,use of vascular access and clinical conditions? Results In 124 patients,peripheral venous catheter was used (33?0%)? Central venous catheter was used in 252 patients (67?0%),Multiple linear regression analysis showed that way for paying the expense,vascular conditions for venous punctuation,phased diagnosis,decision of the doctors,and prospected duration for detaining catheter significant influencing factors? Conclusions The state should raise their medical allowances for those with lower incomes? The administrative should enhance the training to doctors and nurses at grass levels,promote the communication between medical workers and patients and improve their recognition of transfusion devices so that they can make a right choice?
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OBJECTIVE To approach the flora distribution and drug-resistance status in deep fungal nosocomial infection in tumor patients and offer scientific evidence of prevention and controlling of it.METHODS Retrospective reviews were performed to analyze the 153 cases of deep fungal nosocomial infections in tumor department.Fungal cultivation,identification and susceptibility tests were performed strictly according to Rules of Operation in Clincal Laboratory of Nationwide.RESULTS The lower respiratory tract was the main site in deep fungal nosocomial infection in tumor patients,accounting for 61.4%.The digestive tract infection rated the second,accounting for 13.1%.Pathogenic bacteria mainly included Candida albicans(60.1%)and C.tropicalis(20.9%).The susceptibility test showed that the drug-resistance rate to amphotericin B and nystatin were all 0 and that to itraconazole and clotrimazole was 0-7.6%.The resistance rate(17.4-30.0%) to fluconazole showed upgrading tendency.CONCLUSIONS We should think highly of etiological detection and monitoring of drug-resistance in deep fungal nosocomial infections in tumor patients in order to control the infections effectively.
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90%),but they had low susceptibility rate to itraconazole(70.62%-50.45%).CONCLUSIONS The main species of fungi isolated from clinic is Can albicans which is susceptible to antifungal agents.It is important to give active treatment and choose antifungal agents reasonably for improving the prognosis and reduce drug-resistant strains.
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OBJECTIVE To study the frequency of fungal infection and its drug resistance in tumor patients, and to provide the reference for clinical treatment. METHODS From Aug 2006 to Jul 2008, the drug sensitivity test and pathogen distribution of 960 patients in our hospital were retrospectively analyzed. RESULTS A total of 308 fungal strains were detected from 960 patients (32.1%). Candida albicans infection rate reached 73.1%, and C. krusei and C. glabrata were 13.3% and 9.1%, respectively. Drug sensitivity showed that the drug resistance of C. albicans to ECC, KET and MIC was 43.9%, 34.2 and 27.1%, respectively, and that of the C. krusei to the ECC, KET and MIC were 53.3%, 42.2% and 48.8%, respectively, while their fungal infection was depressed by AMB, NYS and 5-FC. CONCLUSIONS C. albicans is the major fungus in patients of tumor hospital, and the infection rate of C. krusei and C. glabrata is also high. Clinical doctors should control the distribution and drug resistance of fungal infection in therapeutic process for a reasonable antibiotics usage.