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Objective: Chemotherapy-induced peripheral neuropathy (CIPN) is a common and severe adverse reaction in taxane-based chemotherapy. This study aimed to analyze the risk factors of peripheral neuropathy in patients with breast cancer receiving paclitaxel chemotherapy to provide a reference for the early prevention of CIPN. Methods: We included 350 patients with breast cancer who received chemotherapy for the first time at the Tangshan People's Hospital between August 2022 and June 2023 and were followed for at least 3 months after the end of chemotherapy. The incidence of CIPN in patients with breast cancer was calculated, and risk factors for CIPN were analyzed using logistic regression analysis. Results: The incidence rate of CIPN was 79.1%. Multifactor logistic regression analysis indicated that age ≥45 years [odds ratio (OR)=5.119, 95% confidence interval (CI)=1.395-18.780] and ≥60 years (OR=9.366, 95% CI=1.228-71.421), history of hypertension (OR=3.475, 95% CI=1.073-11.250), cumulative dose of chemotherapy drugs >900 mg (OR=4.842, 95% CI=1.961-5.946), vitamin D deficiency (OR=6.214, 95% CI=2.308-16.729), abnormal alanine aminotransferase (OR=3.154, 95% CI=1.010-9.844), anemia before chemotherapy (OR=2.770, 95% CI=1.093-7.019), infusion duration of chemotherapy drugs >30 min (OR=3.673, 95% CI=1.414-9.539), body mass index ≥24 kg/m2 (OR=8.139, 95% CI=1.157-57.240), mild depression (OR=4.546, 95% CI=1.358-15.223), and major depression (OR=4.455, 95% CI=1.237-16.037) increased the risk of CIPN. Having a regular caregiver (OR=0.223, 95% CI=0.087-0.573), high levels of physical activity (OR=0.071, 95% CI=0.008-0.647), and strong social support (OR=0.048, 95% CI=0.003-0.682) were protective factors against CIPN. Conclusion: Clinical attention should be paid to patients with these risk factors, and active and effective preventive measures should be taken to reduce the occurrence of CIPN and improve the quality of life.
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ObjectiveClinicians in the emergency department (ED) face challenges in concurrently assessing patients with suspected COVID-19 infection, detecting bacterial co-infection, and determining illness severity since current practices require separate workflows. Here we explore the accuracy of the IMX-BVN-3/IMX-SEV-3 29 mRNA host response classifiers in simultaneously detecting SARS-CoV-2 infection, bacterial co-infections, and predicting clinical severity of COVID-19. Methods161 patients with PCR-confirmed COVID-19 (52.2% female, median age 50.0 years, 51% hospitalized, 5.6% deaths) were enrolled at the Stanford Hospital ED. RNA was extracted (2.5 mL whole blood in PAXgene Blood RNA) and 29 host mRNAs in response to the infection were quantified using Nanostring nCounter. ResultsThe IMX-BVN-3 classifier identified SARS-CoV-2 infection in 151 patients with a sensitivity of 93.8%. Six of 10 patients undetected by the classifier had positive COVID tests more than 9 days prior to enrolment and the remaining oscillated between positive and negative results in subsequent tests. The classifier also predicted that 6 (3.7%) patients had a bacterial co-infection. Clinical adjudication confirmed that 5/6 (83.3%) of the patients had bacterial infections, i.e. Clostridioides difficile colitis (n=1), urinary tract infection (n=1), and clinically diagnosed bacterial infections (n=3) for a specificity of 99.4%. 2/101 (2.8%) patients in the IMX-SEV-3 Low and 7/60 (11.7%) in the Moderate severity classifications died within thirty days of enrollment. ConclusionsIMX-BVN-3/IMX-SEV-3 classifiers accurately identified patients with COVID-19, bacterial co-infections, and predicted patients risk of death. A point-of-care version of these classifiers, under development, could improve ED patient management including more accurate treatment decisions and optimized resource utilization.
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Objective To compare the effects of different methods of blood pressure management in elderly hypertensive patients in the community,so as to explore the effective model for the management of chronic diseases.Methods 302 elderly hypertensive patients in Puhuangyu community health service center were divided into two groups by random number method:(1) receiving conventional antihypertensive drugs (control group,n=152);(2) receiving antihypertensive drugs combined with blood pressure self-measurements at least twice-weekly and real-time adjusting antihypertensive management (blood pressure self-measurements group,n =150).Medication adherence,levels of blood pressure control and blood pressure-targeting rate were compared between groups one year after intervention.Results Medication adherence rate was higher in self-measurements group than in the control group [94.7％ (142 cases) vs.75.7％ (115 cases),P＜ 0.05].After intervention,systolic pressure was decreased from (168.5±37.7) mmHg to (155.3±25.2) mmHg(1 mmHg=0.133 kPa) in the control group and from (168.0±38.1)mmHg to (141.7 ±22.9) mmHg in self-measurements group (all P＜0.05).Diastolic pressure level was similar in the two groups.There was a significant difference in the blood pressure-targeting rate between groups (P ＜0.05).Conclusions Blood pressure self-measurements are more effective in controlling blood pressure and can improve the self-management ability in elderly patients with chronic diseases in the community.
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Objective To find out the distribution of the subunit of Gs proteins (GNAS1) T393C polymorphism genetic in congestive heart failure patients and to investigate the effects of genetic polymorphisms on the therapeutic efficacy of carvedlol. Methods Genotype of 65 patients with congestive heart failure (heart function was ranked Ⅱ~Ⅳ level by NYHA) underwent PCR-RFLP for GNAS1 polymorphism genetic analysis, and then were treated with carvedlol. The initial dosage of carvedlol was 12.5 mg once daily in patients , and increased by 6.25 mg every 1 ~ 2 weeks for 12 months to a maximum dosage within 50 mg/d. Degree of LVEF changes and heart function improvement was adopted as measuring index , effect of Gs proteins α subunit T393C genetic polymorphism on carvedlol response in congestive heart failure patients was analyzed. Results After carvedlol treatment for 12 months , NYHA class distribution and LVEF in congestive heart failure patients improved significantly (P < 0.05). After carvedlol treatment for 6 months and 12 months mutation symptoms patients′ heart function improved significantly (P < 0.05) and LVEF increased significantly (P < 0.01). Conclusions GNAS1 T393C genetic polymorphism can influence the therapeutic efficacy of carvedlol in chronic congestive heart failure patients. 393 homozygous mutant and mutated symptoms patients′ heart improved more obviously and their LVEF improved more significantly.
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A novel type of carbon nanotube-coated Au nanoparticle and [bmim]BF4 composite modified glassy carbon electrode was fabricated by a layer-by-layer self-assembly technique. The electrochemical performance of acetaminophen (ACOP) on the modified electrode was investigated by cyclic voltammetry. The Nafion/GNPs/RTIL/MWNTs/GC electrode showed an excellent electrocatalytic activity for the oxidation of ACOP and accelerated electron transfer between the electrode and ACOP. For ACOP, the reversible electrochemical process was observed on the Nafion/GNPs/RTIL/MWNTs/GC electrode, while irreversible electrochemical process occurred on the GC electrode. For the Nafion/GNPs/RTIL/MWNTs/GC electrode, the anodic peak potential of ACOP was moved from 0.562 V to 0.413 V, with a potential drop of 149 mV. At the same time, the reduction peak potential was 0.384 V, and the potential difference was only 29 mV. It was shown that the modified electrode possessed higher electrocatalytic activity and more sensitive effect for the detection of ACOP than both MWNTs/GC electrode and GC electrode. The effects of the different experimental conditions on the electrochemical behaviors of ACOP were explored. Under the optimum conditions of preparation and experimental, the linear calibration curves of ACOP were obtained in a wide range of 2 x 10(-1) to 4.0 x 10(-4) mol x L(-1) with a correlation coefficient 0.999 2 and a detection limit of 2.6 x 10(-8) mol x L(-1) (the ratio of signal to noise, 3:1). The recovery rate was 97.9%-100.8%. This method can be used to determine ACOP in paracetamol tablets with satisfactory results.
