RESUMEN
Gastric cancer with bone marrow metastasis and disseminated intravascular coagulation constitutes a highly aggressive gastric cancer subtype which presents a peculiar biological behavior and very poor prognosis. Retrospective studies have shown chemotherapy could prolong survival, but a prospective trial is still unavailable. This study is the first prospective clinical trial to evaluate the safety and efficacy of chemotherapy for advanced gastric cancer patients with bone marrow metastasis.
Highly aggressive gastric cancer is a special subtype gastric cancer with highly aggressive biological behavior and very poor prognosis. This is a multicenter phase II clinical trial. Infusional fluorouracil of 200 mg/m2 on days 121 with docetaxel 25 mg/m2 on days 1, 8 and 15 will be administered as the first-line therapy to highly aggressive gastric cancer with platelet lower than 50 × 109/l, every 4 weeks. The primary end point is the hematological response rate, which is defined as the percentage of participants whose platelet count restores to normal range. The secondary end points are time to hematological response, 1-month mortality, overall survival, toxicity and quality of life. This study will provide high-level evidence to guide clinical practice for highly aggressive gastric cancer. Clinical Trial Registration: NCT04547153 (ClinicalTrials.gov).
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica , Neoplasias de la Médula Ósea , Coagulación Intravascular Diseminada , Neoplasias Gástricas , Humanos , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Neoplasias de la Médula Ósea/complicaciones , Neoplasias de la Médula Ósea/tratamiento farmacológico , Coagulación Intravascular Diseminada/complicaciones , Coagulación Intravascular Diseminada/tratamiento farmacológico , Docetaxel/uso terapéutico , Fluorouracilo/uso terapéutico , Estudios Prospectivos , Estudios Retrospectivos , Neoplasias Gástricas/complicaciones , Neoplasias Gástricas/tratamiento farmacológico , Resultado del Tratamiento , Ensayos Clínicos como AsuntoRESUMEN
Objective:To analyze the changes in the number and workload of pediatricians, for evidences in further optimizing the allocation of pediatrician resources and formulating relevant policies in China.Methods:According to data from the National Bureau of Statistics and the " China Health and Health Statistics Yearbook", descriptive analysis was made to investigate the changes in the number and workload of pediatricians in China from 2010 to 2019.Results:During 2010 and 2019, the number of pediatric practitioners(assistants) increased from 115 800 to 158 500, and the growth rate was faster than that of the children aged 0-14 years, but slower than that of overall medical practitioners(assistants). The number of pediatric practitioners(assistants) per thousand children in China had grown steadily from 0.52 to 0.67, compared with the burden and the workload of medical practitioners nationwide, the workload of pediatricians was still relatively heavy.Conclusions:The number of pediatricians had increased gradually between 2010 and 2019, and the effects of various policies began to work, while the workload was still heavy. It is recommended to further develop a salary system and supporting policies in line with the characteristics of pediatrics sector, and focus on such problems as unbalanced and inadequate distribution of pediatricians.
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Objective To get an understanding of the patient experience in public hospitals nationwide, and to evaluate the implementation of the Action Plan to Improve Health Care. Methods Supported by the mobile technology, from September 6, 2017 to December 15, 2018, the authors conducted an online survey that measured the satisfaction of both inpatients and outpatients at secondary and tertiary hospitals across the country. 15 questions from six dimensions including registration experience, patient-doctor communication, nurse-patient communication, the healthcare signage system, responsiveness of care providers and privacy protection were prepared for outpatients, while 20 questions from nine aspects such as nurse-patient communication, patient-doctor communication, pain management, medication communication, admission and discharge information, responsiveness of care-givers, food service, friendliness to patient family, and the healthcare signage system were directed at inpatients. Descriptive statistical analysis was used to describe the basic features of the data. Results 9.18 million valid responses from outpatients and another 5.38 million from inpatients were obtained. The overall satisfaction rate with outpatient services had reached a score of 90.45 points where nurse-patient communication stands out as the top-rated dimension and privacy protection gets the lowest rating. On the other hand, the inpatient satisfaction stands at a score of 93.01 with friendliness to patient family receiving the top score and patient-doctor communication the lowest. Conclusions Despite the positive feedback Chinese patients give on the outpatient care they receive, we should make efforts to improve the outpatient care environment, the wayfinding system, privacy protection, and responsiveness of care-givers.
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Medical service data center could play a pivotal role in the assessment and improvement of patient safety,assist of medical quality management,providing guidance for patients,promoting the development of biological bank,by collection,storage,maintenance and analysis of medical data.Even though the building of medical service data center in China is relatively late compared with developed countries,however,China has made some achievements in guiding medical service and medical service management.
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Objective To analyze the present situation of medical service prices in Beijing,and provide scientific basis in order to carry out the reform of medical service prices of the city.Methods Literature review method to collate the administration policy of medical service price in Beijing,and the method of statistical analysis to compare the Beijing medical service prices with 1 9 other provinces across the country.Results The number of medical service projects (4 613 )in Beijing is higher than the national average (4 507),but the average medical service prices (423 yuan)in Beijing is lower than the national average (609 yuan),and medical service price and the regional economic level has no statistical significance Conclusion Medical service prices of Beijing need to be adjusted,and a reform of medical service prices in Beijing should be implemented by the Development and Reform Commission,Health and Family Planning Commission.