Analysis of risk factors for hypokalemia caused by amphotericin B liposome / 中国药房

OBJECTIVE To investigate the risk factors for hypokalemia caused by amphotericin B liposome， and to provide reference for clinical use of drugs. METHODS A retrospective analysis was used to collect the information of patients who used amphotericin B liposome during the hospitalization in First Affiliated Hospital of Hainan Medical College from January 2012 to December 2021. The details of use information about amphotericin B liposome and the potassium supplementation were collected. The patients were divided into hypokalemia group and normal group according to the occurrence of hypokalemia. Univariate and multi-variate Logistic regression analyses were used to analyze the risk factors for hypokalemia induced by amphotericin B liposome. RESULTS Of the 121 patients included in this analysis， 60 patients were in hypokalemia group， 61 patients were in normal group. The following parameters of the hypokalemic group were significantly higher or longer than those of the normal group， such as the maintenance dose， cumulative dose and maximum daily dose （in patients with severe hypokalemia） of amphotericin B liposome， treatment days， the maintained days of hypokalemia， daily dose of potassium supplement （in patients with moderate or severe hypokalemia）， the duration of potassium supplement （in patients with moderate hypokalemia）. Results of single factor analysis showed that the cumulative dose of amphotericin B liposome ≥200 mg and the duration of treatment ≥5 days were independent risk factors of hypokalemia caused by this drug （P＜0.05）. Multi-variate analysis results showed that the presence of basic hypokalemia， body weight ＜50 kg， cumulative dose of amphotericin B liposome ≥200 mg and the duration of treatment ≥5 days were the independent risk factors for hypokalemia caused by amphotericin B liposome （P＜0.05）. CONCLUSIONS The incidence of hypokalemia caused by amphotericin B liposome is high， the independent risk factors for hypokalemia include cumulative dose ≥200 mg， treatment days ≥5 days， the presence of basic hypokalemia and body weight ＜ 50 kg. It is suggested that serum potassium should be elevated to normal level before amphotericin B liposome treatment， and the level of serum potassium should be monitored during medication to reduce the occurrence of hypokalemia.

Docetaxel and fluorouracil as first-line therapy for gastric cancer with bone marrow metastasis and disseminated intravascular coagulation.

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).

Study on occupational benefit and job satisfaction of nurses in Guangzhou nursing home / 中国实用护理杂志

Objective:To understand the present situation of occupational benefit and job satisfaction of nurses in Guangzhou medical and nursing institutions, and to analyze the influencing factors of occupational benefit, so as to provide reference for the managers of pension institutions to formulate measures.Methods:A total of 83 in-service nurses from four medical and nursing institutions in Guangzhou were selected by convenient sampling. The general data questionnaire, nurses′ occupational benefit scale, job satisfaction scale, organizational support scale and job input scale were used to adjust the questionnaire.Results:The total score of occupational benefit of nurses in Guangzhou medical and nursing institutions was 106.14±16.38, which was in the middle level. Among them, the score of good nurse-patient relationship (76.40%) was the highest, the score of positive occupational perception(69.20%) was the lowest, and the total score of job satisfaction was 95.25±14.06. Among them, the score of satisfaction with colleagues (76.87%) was the highest, and the score of welfare treatment and professional development opportunity (55.40%, 56.15%) was lower. The total scores of organizational support and work input were 40.18 ± 9.58 and 54.92 ± 9.58, respectively. The results of multiple linear regression showed that nurses′ age, job satisfaction, organizational support and job input were the important factors affecting nurses′ sense of professional benefit( t values were -3.518-6.668, P<0.01 or 0.05). Conclusions:The managers of pension institutions should take positive measures to improve the welfare treatment of nurses, increase their professional development opportunities, strengthen emotional support for nurses, improve nurses′ concentration and energy input to work, so as to improve nurses′ sense of professional benefit and job satisfaction.