Clinical and pathological characteristics of small cell carcinoma of bladder and the efficacy of neoadjuvant therapy / 现代泌尿外科杂志

【Objective】 To investigate the clinical characteristics and prognostic factors of small cell carcinoma of bladder (SCCB), and to explore the efficacy of neoadjuvant therapy. 【Methods】 Clinical information of 47 SCCB patients were retrospectively collected, and the clinical and pathological features were compared with those of urothelial carcinoma (UBC). The prognostic factors and efficacy of neoadjuvant therapy were also investigated. 【Results】 SCCB had higher baseline tumor staging, and was more likely to invade the muscle (100%) and metastasize distantly (21.3%). The overall survival was poor (median: 13.1 months, 1-year survival rate: 53.7%, 5-year overall survival rate: 15.4%). Tumor T staging was a risk factor for SCCB, while neoadjuvant therapy was an independent protective factor that significantly reduced the risk of recurrence and metastasis (HR: 0.189, 95%CI: 0.051-0.697, P=0.012) and death (HR: 0.177, 95%CI: 0.045-0.698, P=0.013), and significantly improved disease-free survival and overall survival. In addition, compared with neoadjuvant chemotherapy alone, neoadjuvant chemotherapy combined with immunotherapy could improve the pathological complete response rate. 【Conclusion】 SCCB is highly malignant and prone to metastasis, and has a poor prognosis. Neoadjuvant therapy combined with radical cystectomy is recommended as the first-line treatment.

Information support practice for anti-COVID-19 consortium composed of multi-medical institutions’ staff / 西安交通大学学报(医学版)

In the emergency of the outbreak of COVID-19 in December 2019, Shaanxi Provincial Health Committee mobilized several medical teams from major hospitals in the province, and, by relying on Xi’an Chest Hospital, jointly established an anti COVID-19 consortium to control and eradicate the epidemic in a short time. Information support is an important guarantee for winning this battle. In order to realize the efficient cooperation among multiple medical teams, we have carried out some exploratory and innovative information support services on the basis of the original information system of the chest hospital. In this process, we have gone through some detours. Some compromises were made on some problems that could not be solved in the short term. Finally, in an environment full of uncertainty, a set of information support management system with basically smooth operation was built through rapid trial and error adjustment. The system mainly includes the following aspects: support of the organizational structure and operation process of the anti-epidemic consortium, support for medical collaboration related businesses of multiple medical teams, and support for statistical reports and online meetings. Information support has played a very important role in this action, and this practice has also accumulated experience for us to deal with similar situations in the future.

Construction of the emergency command system of public health emergency in COVID-19 epidemic prevention and control background / 西安交通大学学报(医学版)

Based on the current situation and task of fighting COVID-19, and combined with emergency management mode of public health emergencies and participation of multi-times emergency rescue practices along with the case analysis and literature review and brain-storming, we constructed a basic framework of the emergency command system of public health emergencies in COVID-19 epidemic prevention and control background. The framework contained four modules: the response mechanism, the organizational structure, the emergency capacity, and the supervisory mechanism and the advantages and key points in implementing this emergency command system was discussed.

Effects of Polyene Phosphatidylcholine on Hepatic Injury of Tumor?bearing Nude Mice Induced by Oxaliplatin and 5?fluorouracil Chemotherapy / 中国医科大学学报

Objective To study the protective effect of polyene phosphatidylcholine on hepatic injury induced by oxaliplatin and 5?fluorouracil. Methods A subcutaneous tumor model was established by transplanting colocarcinoma HCT116 cells into 30 nude mice,which were random?ized into three groups. The polyene phosphatidylcholine group was injected with polyene phosphatidylcholine(85 mg · kg-1 · d-1)and 5?fluorouracil (20 mg·kg-1·d-1)for 7 days,and then injected with oxaliplatin(6 mg·kg-1·d-1)for 1 day. The hepatic injury group was injected with 5?fluoroura?cil(20 mg·kg-1·d-1)for 7 days and oxaliplatin(6 mg·kg-1·d-1)for 1 day. The tumor?bearing blank group was injected with normal saline. Hepat?ic injury was observed with ultrathin pathological sections. Liver homogenates were prepared to detect superoxide dismutase(SOD)and catalase (CAT)activity. Results In the hepatic injury group,pathological sections revealed dissolved cellular cytoplasm,mitochondrial membrane dam?age,cell membrane edema,and fuzzy,sinusoidal cell expansion . There were no obvious hepatic injuries observed in the polyene phosphatidylcho?line group. The expression of SOD and CAT were lower in the hepatic injury and polyene phosphatidylcholine groups compared to the tumor?bear?ing blank group(P<0.05). The expression of SOD and CAT were higher in the polyene phosphatidylcholine group compared to the hepatic injury group(P<0.05). Conclusion Polyene phosphatidylcholine has a protective effect on hepatic injury induced by oxaliplatin and 5?fluorouracil, which may be related to its effect on membrane repair and inhibition of oxidative stress.

Analysis of 233 Cases of Severe Adverse Events in Drug Clinical Trials of Our Hospital / 中国药房

OBJECTIVE:To provide reference for performing quality control and protecting the subjects’rights and interests. METHODS:233 severe adverse events (SAE) cases reported by our hospital during Jan. 2012-Jun. 2015 were collected and ana-lyzed statistically in respects of subjects’gender and age,department,drug/equipment types,SAE types,relationship of SAE with drug/equipment,comorbidities,etc. RESULTS:The incidence of SAE in male was higher than female(71.2% vs. 28.8%);SAE mainly occurred in people over the age of 50(189 cases,81.1%);the incidence of SAE in cardiology department was the highest (137 cases,58.8%);main SAE type was hospitalization(183 cases,78.5%);most of SAE had nothing to do with studied drugs (164 cases,70.4%);more than half of the subjects suffered from other comorbidities(128 cases,54.9%). CONCLUSIONS:In order to ensure the quality of drug clinical trial data and safety of subjects,the investigator should strengthen the management of the elderly subjects and those suffering from comorbidities,to ensure that each SAE case is timely processed and accurately record-ed and reported.

Practice and Discussion on Ethical Review of Clinical Scientific Research-as the First Affiliated Hospital of Xi′an Jiaotong University an example / 中国医学伦理学

Combined with work experience, this paper described the project process of clinical research pro-jects and ethical review points, and pointed out that clinical research projects should be submitted to peer reviewers prior to ethical review. The ethics committee would review the projects in accordance with legality, scientificity, feasibility, ethics, and other points in detail. Accurately grasp of the balance between innovations and ethics ensure the standardized development of clinical research.