Prenatal Substance Use and Perceptions of Parent and Partner Use Using the 4P’s Plus Screener

Maternal and Child Health Journal - Background Prenatal substance use screening is recommended. The 4 P’s Plus screener includes questions on perceived problematic substance use in parents...     

家长对小学生近视的知信行分析

目的 了解保定市小学生家长关于小学生近视知信行的相关现状及影响因素,制定有效干预措施,为预防儿童青少年近视提供有力依据。方法 运用分层整群随机抽样的方法,抽取保定市某小学一年级至六年级766名学生家长进行问卷调查。结果 小学生家长用眼卫生相关知识总正确率为64.90%。家长年龄越大、文化程度越高以及自身近视的家长掌握小学生近视的相关知识越多。家长年龄越大,督导孩子健康用眼的行为越易发生(P=0.027,OR=0.169)。结论 应多渠道对学生家长进行健康教育,为控制和预防小学生近视的发生与发展构建以家庭为主的第一道防线。     

Phase I study of lapatinib plus trametinib in patients with KRAS -mutant colorectal,non-small cell lung,and pancreatic cancer

KRAS oncogene mutations cause sustained signaling through the MAPK pathway. Concurrent inhibition of MEK, EGFR, and HER2 resulted in complete inhibition of tumor growth in KRAS-mutant (KRASm) and PIK3CA wild-type tumors, in vitro and in vivo. In this phase I study, patients with advanced KRASm and PIK3CA wild-type colorectal cancer (CRC), non-small cell lung cancer (NSCLC), and pancreatic cancer, were treated with combined lapatinib and trametinib to assess the recommended phase 2 regimen (RP2R). Patients received escalating doses of continuous or intermittent once daily (QD) orally administered lapatinib and trametinib, starting at 750 mg and 1 mg continuously, respectively. Thirty-four patients (16 CRC, 15 NSCLC, three pancreatic cancers) were enrolled across six dose levels and eight patients experienced dose-limiting toxicities, including grade 3 diarrhea (n = 2), rash (n = 2), nausea (n = 1), multiple grade 2 toxicities (n = 1), and aspartate aminotransferase elevation (n = 1), resulting in the inability to receive 75% of planned doses (n = 2) or treatment delay (n = 2). The RP2R with continuous dosing was 750 mg lapatinib QD plus 1 mg trametinib QD and with intermittent dosing 750 mg lapatinib QD and trametinib 1.5 mg QD 5 days on/2 days off. Regression of target lesions was seen in 6 of the 24 patients evaluable for response, with one confirmed partial response in NSCLC. Pharmacokinetic results were as expected. Lapatinib and trametinib could be combined in an intermittent dosing schedule in patients with manageable toxicity. Preliminary signs of anti-tumor activity in NSCLC have been observed and pharmacodynamic target engagement was demonstrated.     

他克莫司联合308nm准分子激光治疗面部白癜风

目的探讨他克莫司联合308nm准分子激光在面部白癜风治疗中的应用效果。方法选取2017年2月-2019年2月医院84例面部白癜风患者为研究对象,根据入院单双号将受试者进行分组,其中对照组42例患者接受308nm准分子激光治疗,研究组42例患者在对照组的基础上联合他克莫司软膏治疗,比较两组患者治疗后1个月、3个月时的治疗总有效率以及治疗前后白斑面积与皮损区IL-17水平变化。结果研究组患者在治疗后1个月、3个月时的治疗总有效率均显著高于对照组(P<0.05),与治疗前相比,治疗后两组患者白斑面积及皮损区IL-17水平均显著减少,且研究组显著少于对照组(P<0.05)。结论他克莫司联合308nm准分子激光可有效缩小白斑面积,降低皮损区IL-17水平,疗效确切。     

Comparing the efficacy of integrative body-mind-spirit intervention with cognitive behavioral therapy in patient-caregiver parallel groups for lung cancer patients using a randomized controlled trial

Abstract

Purposes/objectives: This paper reports the comparative efficacies of integrative body-mind-spirit intervention (I-BMS) and cognitive behavioral therapy (CBT) in patient-caregiver parallel groups for Chinese patients with lung cancer.

Design: Randomized controlled trial (RCT).

Methods: One hundred and fifty-seven patient-caregiver dyads with no marked functional impairment were randomized into one of the two interventions with eight weekly patient-caregiver parallel groups. Assessments were conducted at baseline, within one, eight- and sixteen-weeks post-intervention. Effects of treatment group across time were analyzed by multilevel modeling.

Findings: CBT led to greater reduction in emotional vulnerability than I-BMS. I-BMS resulted in greater increase in overall QoL and spiritual self-care, and more reduction in depression than CBT. Patients in both interventions experienced improvement in physical, emotional and spiritual, except social, domains of QoL.

Conclusion: I-BMS was more efficacious for diverse domains of QoL, and CBT was more effective for emotional well-being, despite the relatively small between-group effect sizes.

Implications for psychosocial providers/policy: (1) With the expanding repertoire of psychosocial interventions for families facing lung cancer, it has become imperative to investigate the comparative efficacies of empirically supported and culturally adapted interventions. (2) Our findings show that I-BMS was more effective for diverse domains of QoL, while CBT was more efficacious with emotional well-being, although both interventions led to significant improvements in physical, emotional and spiritual domains of patient QoL. (3) Patient-caregiver parallel groups have been shown to be effective for enhancing QoL of Chinese lung cancer patients. (4) Care professionals are encouraged to dispense interventions based on the idiosyncratic needs and preferences of the patients to maximize the treatment effects.     

35例新型冠状病毒肺炎患者中医临床特征分析

目的分析广东省新型冠状病毒肺炎患者临床资料及中医证候,为该病的防治提供科学依据。方法将2020年1月23日至2020年2月14日本院收治的35例新型冠状病毒肺炎患者纳为研究对象,收集患者的基本情况、流行病学史及疾病史,通过血液生化分析及胸部CT检查患者临床情况,由5名高级职称中医师对患者舌象进行诊断,并根据《广东省新型冠状病毒感染的肺炎中医药治疗方案(试行第一版)》进行辨证。结果新型冠状病毒肺炎患者年龄分布较广,平均年龄为(44.00±15.17)岁,以男性居多,57.14%的患者有武汉及周边地区旅居史,42.86%的患者有确诊患者接触史;50%以上的患者淋巴细胞绝对值降低,CD3、CD4和、CD8降低以及C反应蛋白增加;胸部CT显示,80%以上的患者出现肺部病变,其中双肺病变占60%,病变类型以斑块状阴影居多;多数患者伴有发热(85.71%)、咳嗽(80.00%)、肌肉酸痛(42.86%)、乏力(40.00%)等临床症状;患者的证型主要是湿邪郁肺(45.71%),其次为邪热壅肺(37.14%),病机特点以湿为主,其次为热;舌苔以腻苔为主,舌质以红和淡红为主。结论新型冠状病毒肺炎患者的中医证型以湿邪郁肺为主,致病特点以"湿"为主,可针对性地采取中医治疗。     

完全腹腔镜下与开腹胰十二指肠切除术治疗壶腹周围肿瘤近期疗效比较

目的探讨完全腹腔镜下胰十二指肠切除术(TLPD)与开腹胰十二指肠切除术(OPD)治疗壶腹周围肿瘤的近期疗效。方法回顾性分析山西医科大学第一医院2016年6月至2019年3月收治的50例壶腹周围肿瘤患者的临床资料,根据手术方式不同分为TLPD组(22例)及OPD组(28例),比较两组患者围术期及术后各项指标情况。结果两组患者均顺利完成手术,TLPD组手术时间[(665±213)min]长于OPD组[(447±215)min],差异有统计学意义(t=-0.356,P=0.001);TLPD组术中出血量[100 ml(50~325 ml)]少于OPD组[300 ml(100~500 ml)],差异有统计学意义(Z=-2.230,P=0.026)。TLPD组与OPD组术中输血者比例、淋巴结清扫数量、切除肿瘤长径、术后禁饮食时间、术后拔管时间、术后住院时间及术后并发症发生率比较,差异均无统计学意义(均P>0.05)。结论TLPD与OPD治疗壶腹周围肿瘤临床近期疗效相近,TLPD手术时间较OPD长,但可有效控制术中出血量。