Salvage Chemotherapy for Patients With Recurrent or Persistent Ovarian Clear Cell Carcinoma: A Retrospective Study of 164 Cases

The purpose of this study was to evaluate the effects of salvage chemotherapy on recurrent or persistent ovarian clear cell carcinoma (CCC) with the goal of identifying a more rational treatment regimen for this lethal disease.The medical records of patients with CCC were retrospectively reviewed to select patients that were subsequently treated for recurrent or persistent disease.Of the 164 women with recurrent or persistent CCC, 485 chemotherapy courses with 1766 cycles were administered. Overall, the clinical benefit rate (CBR) was 39.4%, and the mean progression-free survival (PFS) was 4.5 months. Grade 3/4 toxicities occurred in 94 courses (19.4%). The CBR for TC was 45.1%, with a PFS of 3.7 months. Compared to that of TC, the CBRs for PC and CC were significantly lower (P = 0.020 and 0.021, respectively). The CBRs and PFS for PAF-C were slightly higher (P = 0.518 and 0.077, respectively), but showed a significantly higher adverse event rate (AER, P = 0.039). The CBR for bevacizumab was 50% with an extraordinarily long PFS (49.8 months). Gemcitabine and oxaliplatin had similar values for CBRs (44.4% and 44.1%) and PFS (2.5 and 3.4 months), respectively. Docetaxel (weekly) exhibited a notably low AER of 2.7%, and topotecan was associated with a relatively long PFS (7.7 months).For cis/carboplatin-pretreated patients, the existing active agents, such as oxaliplatin, gemcitabine, topotecan, and especially bevacizumab, are promising. Docetaxel (weekly) is well tolerated and might offer a particularly viable option for heavily pretreated patients. However, additional research to identify for a continued search for the optimal combination of chemotherapeutics or novel agents is still warranted.     

Association of genetic variants at MYP10 and MYP15 with high myopia in a Han Chinese population

Background: Previous genome-wide association study (GWAS) has revealed the association between MYP10 at 8p23 and MYP15 at 10q21.1 and high myopia (HM) in a French population. This study is managed to discover the connection between some single nucleotide polymorphism (located at MYP10 and MYP15) and Han Chinese HM.

Methods and Results: This case-control association study contained 1673 samples, including 869 ophthalmic patients and 804 controls. Twelve tag SNPs have been selected from the MYP10 and MYP15 loci and genotyped by SNaPshot method. Among 12 SNPs, rs4840437 and rs6989782 in TNKS gene were found significant association with HM. Carriers of rs4840437G allele and rs4840437GG genotype created a low risk of high myopia (P = .036, OR = 0.81, 95%CI = 0.71–0.93; P = .016, OR = 0.73, 95%CI = 0.56–0.96; respectively). Carriers of rs6989782T allele and rs6989782TT+CT genotype also had a decreased risk of high myopia (P = .048, OR = 0.82, 95%CI = 0.71–0.94; P = .006, OR = 0.74, 95%CI = 0.59–0.92; respectively). Other 10 SNPs displaced nonsignificant association with HM. Additionally, the risk haplotype AC and the protective haplotype GT, generated by two SNPs in TNKS, were considerably more likely to be association with HM (for AC, P = .002 and OR = 1.26; for GT, P = .027 and OR = 0.84).

Conclusions: Our results demonstrated that some heritable variants in the TNKS gene are associated with HM in the Han population. The possible functions of TNKS in the development and pathogenesis of hereditary high myopia still require further researches to identify.     

基于对分课堂的护理本科安宁疗护教学改进

目的探讨护理本科安宁疗护教学内容与方法改进的效果。方法选取四年制护理本科生为研究对象,以2014级32人为对照组、2015级32人为观察组。对照组采取先讲授理论后实践的常规教学方法;观察组对分课堂,将理论教学内容整合为四大主题,案例教学贯穿其中。结果两组学生安宁疗护理论考试成绩比较,差异无统计学意义(P0.05);标准化病人考试成绩及教学满意度观察组显著高于对照组(P0.05,P0.01)。结论基于对分课堂的安宁疗护教学改进利于学生知识与技能的掌握,学生对教学满意度较高。     

湖北海棠总黄酮对卵巢早衰大鼠卵巢功能及骨代谢的影响

目的观察湖北海棠总黄酮对卵巢早衰大鼠卵巢功能及骨代谢的影响。方法将48只成年雌性大鼠随机分为空白组、模型组、戊酸雌二醇组及湖北海棠总黄酮高、中、低剂量组,每组8只。除空白组外,其余各组每天给予灌胃雷公藤多苷片(75 mg/kg),连续14 d,复制卵巢早衰模型。第15天起,戊酸雌二醇组给予灌胃戊酸雌二醇(1 mg/kg);湖北海棠总黄酮高、中、低剂量组分别给予灌胃湖北海棠总黄酮(160、80、40 mg/kg),每日1次,连续给药21 d。观察各组大鼠:动情周期;卵巢指数、子宫指数;血清中雌激素(E2)、孕激素(P)、卵泡刺激素(FSH)、黄体生成素(LH)水平变化;卵巢、子宫形态学变化;血清碱性磷酸酶(ALP)、骨碱性磷酸酶(BALP)活性、1,25(OH)_2D_3含量、超氧化物歧化酶(SOD)活力、丙二醛(MDA)含量,检测卵巢组织中ERα的表达。结果与空白组比较,模型组大鼠动情周期紊乱,卵巢指数、子宫指数降低,血清中E2、P水平降低,FSH水平升高(P0. 05,P0. 01)。与模型组比较,戊酸雌二醇组和湖北海棠总黄酮治疗组血清生殖激素水平得到明显改善(P0. 05),卵巢内生长卵泡数量增多,子宫内膜增厚,血清中ALP活力、BALP含量降低,1,25(OH)_2D_3含量升高(P0. 05,P0. 01);血清中SOD活力增强,MDA含量降低;卵巢组织中颗粒细胞、基质细胞ERα的表达增强。结论湖北海棠总黄酮对卵巢早衰大鼠卵巢及骨质疏松具有一定的治疗保护作用,其作用机制可能与体内抗氧化能力、增强颗粒细胞内雌激素受体的表达密切相关。     

药用植物蓝刺头的研究进展

摘 要 蓝刺头（Echinops latifolius Tausch）为菊科蓝刺头属植物,其干燥根作为中药禹州漏芦用,其干燥花絮作为蒙药蓝刺头用。本文对近几年来中药禹州漏芦和蒙药蓝刺头的研究成果进行了整理,并从化学成分、工艺研究、质量控制和药理作用四个方面对两种药材进行了比较和综述,以期为药用植物蓝刺头的进一步开发和利用提供科学依据。     

正交试验法优选更年安舒颗粒提取工艺

摘 要 目的： 优选更年安舒颗粒的提取工艺。方法: 采用正交试验设计法,以松果菊苷及特女贞苷含量为指标综合评价,考察加水量、提取时间、提取次数对提取工艺的影响。结果: 最佳提取工艺为加水煎煮2次,每次2 h,每次加8倍量的水。结论: 优选的工艺合理可行、重复性良好、提取效率高,适合于工业化生产。     

心理干预联合人文关怀在消化内镜诊疗患者的应用

目的探讨心理干预联合人文关怀在消化内镜诊疗患者的应用及对患者心理舒适度的影响。 方法选取2018年1月至2019年10月于徐州医科大学附属淮安医院行消化内镜诊疗患者80例，按照简单数字表法随机分成对照组(40例)和观察组(40例)。对照组患者予以实施常规护理，观察组患者则在予以常规护理的基础上予以心理干预以及人文关怀护理。分别比较两组患者的检查时的应激状态、舒适状况、心理状态以及治疗配合度。 结果观察组患者检查时期间的心率差值、收缩压差值均显著低于对照组患者(P<0.05)；观察组患者的舒适状况量表各维度评分显著高于对照组患者(P<0.05)；观察组的焦虑自评量表、汉密尔顿焦虑量表评分显著低于对照组(P<0.05)；观察组患者的治疗配合度(97.50%)明显优于对照组(82.50%)(P<0.05)。 结论在消化内镜诊疗中应用心理干预联合人文关怀对患者进行护理干预，能够有效缓解患者的诊疗应激状态，提高患者的治疗配合度及心理舒适度，取得良好的护理效果，值得广泛推广。     

马斯洛需要层次论理念的应用对消化内镜诊疗患者依从性及满意度的影响

目的探讨马斯洛需要层次论理念的应用对消化内镜诊疗患者治疗依从性及满意度的影响。 方法选取2018年1月至2019年5月徐州医科大学附属淮安医院行消化内镜诊疗患者96例，按照随机数字表法分成对照组(48例)和观察组(48例)。对照组患者予以实施常规护理干预，观察组患者则在予以常规护理的基础上结合应用马斯洛需要层次论理念实施护理干预。干预后比较两组患者的护理满意度、心理状态、治疗依从性及不良反应发生发生情况。 结果观察组患者的护理满意度(85.42%)显著高于对照组(62.50%)(P<0.05)；观察组患者的SAS、SDS评分显著高于对照组患者(P<0.05)；观察组患者的治疗依从性与积极性均明显优于对照组(P<0.05)；观察组患者的不良反应发生率(4.17%)显著低于对照组(18.75%)，差异有统计学意义(P<0.05)。 结论在消化内镜诊疗中应用马斯洛需要层次论理念对患者进行护理干预，能够显著提高患者的治疗依从性及护理满意度，减少不良反应的发生，在消化内镜诊疗患者的护理管理中具有显著优势，值得临床上广泛推广。     

长期服药精神病患者双肾下极脂肪囊的超声评价

目的探讨双肾下极脂肪囊(inferior pole area of perirenal fat,IPAPF)可否作为长期服抗精神病药患者心血管病的危险因素。方法纳入106例长期服药精神病患者作为研究组,112例体检人群作为对照组,比较两组一般资料、血脂及超声测量IPAPF。结果研究组HDL-C明显低于对照组,双肾下极脂肪囊面积明显高于对照组,差异有统计学意义(P<0.05)。两组间TC、TG、LDL-C、FBD差异没有统计学意义(P>0.05)。HDL-C、双肾下极脂肪囊呈负相关(r=-0.37,P<0.01)。结论双肾下极脂肪囊与反映冠心病风险的指标存在相关,因此超声测量双肾下极脂肪囊能反映长期服抗精神病药患者心血管病的风险。