基于龋风险评估的龋病治疗计划

随着对龋病病因及发病机制的深入认识,龋病的治疗不应局限于对现有龋损的修复治疗,而应以龋病风险评估和龋损活跃性评估为基础,以患者为中心,制定个性化的治疗方案,恢复口腔微生态平衡,进而控制龋病进展和恢复患牙的结构与功能。     

Comparaison entre Stump Cylinder et moule personnalisé, effet de la forme de l’applicateur sur la distribution de dose

PurposeThe purpose of this study was to compare the efficacy of two applicators used in high dose rate vaginal brachytherapy. The first is the Stump Cylinder used in the “brachycenter” department at the Middle East Institute of Health in Lebanon and the second is the custom mold used in the radiotherapy department at Tenon Hospital in France.Materials and methodA comparison of the clinical target volume and the doses received by the rectum and bladder was performed in order to determine the best method of treatment and to optimize the dose distribution. 95 patients were treated in both departments.ResultsThe average values of the D95% dose received by the CTV were respectively 89.43% for the Stump Cylinder and 110.16% for the custom mold. The conformity index was 0.84 for the Stump Cylinder while it was 0.97 for the custom mold, which ensures a better dose distribution. For the rectum, the maximum dose D2cc taken by volume was 71.23% for the Stump Cylinder and 79.51% for the custom mold. The bladder was better protected with Stump Cylinder with a D2cc value of 65.81% against 94.88% for the custom mold.ConclusionThe underdosing obtained using the Stump Cylinder was due to the shape of upper part of the cylinder which was not conform with the shape of the vaginal vault in women. A better protection of the organs at risk was observed with the Stump Cylinder since the dose taken by the rectum and bladder using a custom mold can reach the tolerance limits.     

氨基糖苷类等抗菌药物的个体化治疗应用

合理使用抗菌药物不仅能有力保护人类珍贵的药物资源，而且可促进感染病患者的规范诊治与健康。患者之间、病原菌之间、感染病之间及抗菌药物之间均存在明显差异，抗菌药物个体化治疗是合理用药的必由之路，关注感染病诊治中的人体、病原体、疾病与药物是个体化治疗的关键，值得临床高度重视。     

个性化护理措施对结核患者肺结核知晓率的影响

目的：针对结核患者的个性化护理措施探究肺结核知晓率的影响。方法选取该院于2012年8月—2014年8月期间收治的肺结核患者190例，随机进行分组，即实验组和对照组，每组95例，实验组在常规护理基础上加之行以护理干预，对照组则采用常规护理，观察两组患者对个性化护理措施产生的不同影响。结果对数据处理，得到实验组知晓率为86.32%，对照组知晓率为55.79%，两组相比，差异有统计学意义（P<0.05）。结论采用个性化护理能够提高患者肺结核知晓率，值得推广应用。     

Tumor Heterogeneity as a Predictor of Response to Neoadjuvant Chemotherapy in Locally Advanced Rectal Cancer

BackgroundNeoadjuvant chemoradiotherapy (nCRT) is the standard of care for locally advanced adenocarcinoma of the rectum, but it is currently unknown which patients have disease that will respond. This study tested the correlation between response to nCRT and intratumoral heterogeneity using next-generation sequencing assays.Patients and MethodsDNA was extracted from formalin-fixed, paraffin-embedded biopsy samples from a cohort of patients with locally advanced rectal adenocarcinoma (T3/4 or N1/2 disease) who received nCRT. High read-depth sequencing of > 400 cancer-relevant genes was performed. Tumor mutations and variant allele frequencies were used to calculate mutant-allele tumor heterogeneity (MATH) scores as measures of intratumoral heterogeneity. Response to nCRT was pathologically scored after surgical resection.ResultsBiopsy samples from 21 patient tumors were analyzed. Eight patients had disease noted to have complete response, 2 moderate, 4 minimal, and 7 poor. Higher MATH scores correlated with poorer response to treatment, demonstrating significantly increased tumor heterogeneity compared to complete response (P = .039).ConclusionThe application of MATH scores as a measure of tumor heterogeneity may provide a useful biomarker for treatment response in locally advanced rectal cancer.