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OBJECTIVE：To compare the eff icacy and safety of rivaroxaban versus enoxaparin in the treatment of malignant tumor complicated with venous thromboembolism （VTE），and to provide evidence-based reference to the clinic. METHODS ： Retrieved from PubMed ，Embase，Cochrane Library ，Clinical Trials ，CNKI，CBM and VIP ，clinical trials or observational studies about rivaroxaban versus enoxaparin were collected during the inception to Apr. 2020. After literature screening and data extraction ， the quality of included literatures were evaluated by Newcastle Ottawa scale ；Stata 15.0 software was used to conduct Meta-analysis，sensitivity analysis and publication bias analysis. RESULTS ：A total of 5 observational clinical cohort studies were retrieved，including 4 retrospective cohort studies and one prospective cohort study. Totally 997 patients were included ，among which 625 patients received enoxaparin and 372 patients received rivaroxaban. Results of Meta-analysis showed that there was no statistical significance in recurrence rate of VTE at 3 months follow-up [RR ＝0.91，95％CI（0.50，1.66），P＝0.760] and 6 months follow-up [RR ＝0.53，95％CI（0.24，1.15），P＝0.106] as well as the incidence of massive hemorrhage at 3 months follow-up [RR ＝ 1.22 ，95％CI（0.66，2.25），P＝0.530] and 6 months follow-up [RR ＝1.30，95％CI（0.73，2.33），P＝0.368]. The results of sensitivity analysis showed that the results of above Meta-analysis were stable ；the results of publication bias analysis showed that there was less possibility of publication bias in this study. CONCLUSIONS ：Rivaroxaban is as effective and safe as enoxaparin in the treatment of malignant tumor with VTE.
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@# Malignant cancer is a kind of fatal disease with severe threat to human health and social development, and seeking a scientific method for the proper diagnosis, treatment and assessment has become one of the most important public health problems in recent years. With the constant development in healthcare industry, traditional methods of tumor screening, prevention and prognosis assessment have made a rapid progress. However, owing to the characteristics of tumor heterogeneity and patient individuation, precision medicine mode in disease screening, diagnosis and treatment will become a general trend in future medical development. As an important part in precision medicine, gene variation detection in the field of tumors involves several aspects, including early screening, recurrence monitoring, guidance on use of targeted drugs and assessment of efficacy and prognosis etc; However, there are still many limitations in its clinical practice. Therefore, further research is needed to promote the development of tumor precision medicine. In this paper, the development history of gene variation detection and its application progress in precision medicine of malignant tumors are comprehensively discussed.
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Resumen Introducción: se determinó la asociación entre los hábitos alimentarios y la presencia de lesiones precursoras de malignidad gástrica (gastritis crónica atrófica, metaplasia intestinal y displasia leve), en hombres y mujeres entre los 30 y los 60 años de edad que acudieron a consulta de gastroenterología en el Centro de Investigación de Enfermedades Digestivas de la ciudad de Pasto (Nariño) durante el último trimestre del año 2015 y el primer semestre del año 2016. Metodología: estudio analítico transversal en el que se analizaron variables histológicas, sociales, demográficas, antropométricas y alimentarias. Se realizó un análisis descriptivo, bivariado y multivariado por medio de la odds ratio (oportunidad relativa) cruda y ajustada con un IC del 95%. Resultados: el 35,5% de los 231 pacientes encuestados fueron diagnosticados histológicamente con dichas lesiones; la edad promedio no superó los 46 años; predominó el sexo femenino con 57,1%; el 32,5% de los pacientes tenía una formación de nivel profesional y el 58% estaba afiliado al régimen subsidiado. Estas lesiones se asociaron con el consumo de cereales y grasas por encima de los 10 y 8,5 intercambios (OR 2,20; IC del 95%: 1,08-4,47 y OR 2,52; IC del 95%: 1,28-4,94), respectivamente. La incorporación de sal a las comidas servidas aumenta la probabilidad de presentar lesiones estomacales en 1,94 (IC del 95%: 1,03-3,66). El consumo regular de vegetales por encima de los 2 intercambios reduce la probabilidad de presentar lesiones estomacales (OR 0,53; IC del 95%: 0,27-0,99). Conclusión: con la investigación, se pretende aportar conocimientos acerca de diferentes factores que pueden participar en la iniciación, promoción y progresión del cáncer gástrico.
Abstract Introduction: Associations between dietary habits and precursor lesions of gastric malignancies including chronic atrophic gastritis, intestinal metaplasia and mild dysplasia were identified in men and women between the ages of 30 and 60 who came to the gastroenterology department of the Center for Research on Digestive Diseases of the city of Pasto, Nariño in the last quarter of 2015 and the first half of 2016. Methodology: This is a cross-sectional analytical study in which histological, social, demographic, anthropometric and dietary variables were analyzed. Descriptive, bivariate and multivariate analyzes were performed using crude and adjusted odds ratios with a 95% CI. Results: Of the 231 patients surveyed, 35.5% were diagnosed histologically with precursor lesions. The average age was 46 years old, and 57.1% of the cases were women, 32.5% were professionals, and 58% were affiliated with the subsidized health care scheme. These lesions were associated with cereal consumption of above 10 exchanges (OR 2.20, 95% CI: 1.08 - 4.47) and with and fat consumption above 8.5 exchanges (OR 2.52, 95% CI: 1.28-4.94). Adding salt to meals increased the likelihood of developing stomach lesions by 1.94 (95% CI: 1.03-3.66). Regular consumption of vegetables for more than two exchanges reduced the likelihood of stomach lesions (OR 0.53; 95% CI: 0.27-0.99). Conclusion: This study aims at contributing knowledge about factors that involved in initiation, promotion and progression of gastric cancer.
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Conducta Alimentaria , Neoplasias Gástricas , Heridas y LesionesRESUMEN
Objective To investigate the effects of the cognitive behavior therapy on anxiety for postoperative patients with oral and maxillofacial malignant cancer in surgery intensive care unit. Methods A total of 82 patients with oral and maxillofacial malignant tumor who accept surgery from January 2014 to September 2016 were chosen and averagely divided into intervention group with cognitive behavior therapy based on control group and control group taking routine nursing and general psychological care by random number table in SICU. The application of self-evaluation of anxiety scale (SAS) evaluation of anxiety level before and after the intervention in patients with and without improvement, and compare the two groups of stay in SICU patients satisfaction evaluation intervention is effective. Results Compared with control group, the cognitive behavioral therapy, after intervention group patients with SAS scoring[(50.56 ± 6.52) ]points SAS scores than the control group [(57.51 ± 6.11)] points decrease, the difference was statistically significant (P<0. 01);intervention group check in SICU satisfaction (97.6％,40/41) also better than the control group (90.2％, 37/41), the difference was statistically significant (χ2=7.527, P < 0.05). Conclusion cognitive behavioral therapy can effectively reduce the anxiety of postoperative patients with oral and maxillofacial malignant cancer in SICU, and effectively improve the comfort level and satisfaction in SICU.
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From the development of national clinical research base of traditional Chinese medicine ( TCM ) in Longhua Hospital, Shanghai University of Traditional Chinese Medicine, we made a success of construction, such as planning and foundation , curative effect , study protocol , standards , platform establishment . From the thinking to results , we made knowledge of the situation in order to provide references for the further building of clinical research base of TCM .
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Objective To investigate illness uncertainty state and explore its influencing factors in hospitalized children and adolescents with cancer.Methods A cross-sectional survey was performed in 112 children and adolescents with cancer aged 7～18 years old from two hospitals with the Chinese version of Uncertainty Scale for Kids-20 and the self-designed demographic questionnaire.Results The mean total scores of illness uncertainty was (45.16±6.67) points.The results of single-factor analysis showed that the factors influencing the uncertainty in illness of children and adolescents with cancer were as follows:age,personality characteristics,course of disease,the methods of treatment,current disease status,absence from school or not,the times of hospitalization,family monthly income,and the extent of parents' understanding about the disease-related knowledge.Multi-factor stepwise regression analysis showed that the main influencing factors of the uncertainty in illness were the current condition,family monthly income,absence from school or not and the extent of parents' understanding about the disease-related knowledge.Conclusions Illness uncertainty is common in children and adolescents with cancer.Nurses should attach importance to the impacts of illness uncertainty,and take effective interventions to decrease it,alleviate psychological pressure and improve quality of life in children and adolescents with cancer.
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Objective To analyze the effect of individualized care on prevention of postoperative urinary retention of malignancy patients undergoing hysterectomy and pelvic lymph node dissection.Methods 74 cases of patients with malignancies undergoing total hysterectomy and pelvic lymph node dissection in our hospital from June 2009 to December 2011 were chosen as the research object.They were divided into the control group and the observation group with 37 cases in each group.The control group was given traditional routine care,while the observation group was given individualized nursing assessment and intervention.The grasping level of knowledge about prevention of urinary retention,the cooperation degree with nursing,incidence of urinary retention,the residual urine volume and satisfaction degree of patients were analyzed and compared between two groups.Results The grasping level of knowledge about prevention of urinary retention,the cooperation degree with nursing,incidence of urinary retention,the residual urine volume and satisfaction degree of patients in the observation group were better than those of the control group,there were significant differences.Conclusions The effect of individualized care to prevent postoperative urinary retention of malignancies patients after hysterectomy and pelvic lymph node dissection is better.It plays an active role in improving mastering of knowledge about prevention of urinary retention and cooperative degree with nursing.
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Objective To know the situation of upper GI diseases among the residents in Dong tai city. Methods With three levels examination methods of Occult Blood Bead Detector,Gastroscope and pathological examination,residents aged over 30 yrs in Dongtai were screened during Aug 2005 to Sept 2006. Results 70 809 residents,about 6.13% of whole city population,were taken the screen with occult blood bead detector. There were about 28 392 people positive; the positive rate was 40.10%. Among the positive people,there were 8 121 people taking gastroscope inspection,and while 2 294 of them also took the pathological examination. The gastroscope results showed that 4 636 people suffered from chronic superficial gastritis,1 431 rotten gastritis,565 esophagus gastritis,339 chronic & atrophic gastritis,24 suspicious cancers,53 stomach cancer,44 esophagus cancer. Of these 97 cases with cancers diagnosed by gastroscope,87 cases were confirmed by pathological examination,the false positive rate of gastroscope examination was about 10.31%; Among 2 197 of the non-cancer subjects diagnosed by gastroscope,there were 25 cases with cancer diagnosed by pathological method,the false negative rate of gastroscope was 1.14%. For those 112 cancer cases diagnosed by pathology,there were 83 cases (74.11%) who were in the early or middle phase of cancer. Conclusion The prevalence of upper GI diseases in Dongtai City was higher. It should strengthen the education and the improvement of the health situation.
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Objective To evaluate therapeutic effect of zoledronic acid combined with chemotherapy in patients with cancer and bone metastases. Methods 60 patients with cancer and skeletal me-tastases were devided randomly into tow groups, 30 patients received zoledronic acid combined with chemotherapy, 30 patients only received chemotherapy. Cheotherapeutic program of tow groups were same. Results Response rate of bone pain relief was 83. 3% in zoledronic acid combined with chemotherapeutic group and 56.7% in chemotherapy alone group. Response rate of skeletal metastases was 53. 3% in zoledronic acid combined with chemotherapy group and 20. 0% in chemotherapy alone group. Response rate of movement capacity improvement was 73. 3% in zoledronic acid combined with chemotherapeutic group and 30. 0% in chemotherapy alone group. The therapeutic effect of zoledronic acid combined with chemotherapy group was better than that of chemotherapy alone group( P
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Serum ?-carotene contents of both the healthy adults and the patients with malignant tumour diagnosed by pathology were measured in Shenyang city. It was found that the levels of ?-carotene in the tumour group were obviously lower than those of the healthy adults (p