Comparison of the safety and prognosis of sequential regorafenib after sorafenib and lenvatinib treatment failure in patients with unresectable hepatocellular carcinoma: a retrospective cohort study

BackgroundThere is lack of studies on sequential regorafenib after sorafenib and lenvatinib treatment failure in patients with unresectable hepatocellular carcinoma (HCC). This study was to explore the safety and prognosis of sequential regorafenib after sorafenib and lenvatinib failure in HCC patients.MethodsThis study was a retrospective, real-world study that included 50 HCC patients who received sequential regrafinib after sorafenib and lenvatinib failure. The safety and prognosis of two groups were compared.ResultsThe incidence of all grade and III/IV adverse events were 68% and 24%. According to Response Evaluation Criteria in Solid Tumours (RECIST) 1.1 and modified (m) RECIST standards, the objective response rates (ORRs) after receiving regorafenib were 14.0% and 22.0%, respectively. The disease control rates (DCRs) were 62.0% and 60.0%, respectively. Based on different first-line targeted drugs, 50 patients were divided into sorafenib (n=22) and lenvatinib group (n=28). There was no differences between two groups except age and bilirubin. And there was no differences in other treatments before or after regorafenib. The baseline between two groups was basically same and had good comparability. There was no difference in incidence of all grade and III/IV adverse events, ORR and DCR between two groups (P>0.05). On long-term prognosis, total overall survival (TOS) in sorafenib and lenvatinib group were 23.0 (95% CI: 15.1–30.9) vs. 29.7 (95% CI: 21.4–38.1) months. The difference was statistically significant (P=0.041). Besides, regorafenib overall survival (ROS) in sorafenib and lenvatinib group were 11.7 (95% CI: 7.1–16.3) vs. 15.9 (95% CI: 8.3–23.5) months. The difference was statistically significant ( P=0.045). The regorafenib progression-free survival (RPFS) was 5.6 (95% CI: 1.9–9.2) vs. 8.0 (95% CI: 5.1–10.9) months in sorafenib and lenvatinib group, respectively, and difference was not statistically significant (P=0.380).ConclusionsRegorafenib is an effective drug for second-line treatment of HCC, with fewer severe adverse events, ORR and DCR was 14–22% and 62–60%, respectively. Both TOS and ROS in lenvatinib group were better than those in sorafenib group. For HCC patients whose first-line targeted drug is lenvatinib, it is safe and effective to accept regorafenib after disease progresses.     

hs-CRP在急性脑梗死患者动态水平及预后的临床意义

目的：观察超敏C-反应蛋白（hs-CRP）在脑梗死患者的动态水平与其病情预示作用,了解hs-CRP同脑梗死患者病情关系。方法：收集126例脑梗死患者发病后72h内,第（4—7）d和第14d的血清进行超敏免疫比浊法测定hs-CRP。应用美国国立卫生研究院卒中量表（NIHSS）及Barthel指数（BI）记分法测定神经功能缺损评分。结果：脑梗死后72h血清hs-CRP浓度即开始升高,1周左右达高峰,至14d时接近对照组水平,并发多脏器功能衰竭者CRP水平最高。结论：hs—CRP是判断脑梗死病情轻重和预后的特异性指标,适时终止或减轻炎症反应损害,可以降低脑梗死的病死率及并发多脏器衰竭的危险。     

1200例次院内下呼吸道感染的病原菌及其药敏试验分析

目的：调查住院患者下呼吸道感染细菌菌群变迁及药敏试验情况，以指导临床应用抗生素。方法：对住院下呼吸道感染患者清晨多次漱口后咳深部痰或气管插管、气管切开患者用无菌吸痰管从气管内吸痰，于无菌管中进行培养并做药敏试验。结果：１２００例次下呼吸道感染痰培养共培养出细菌１３７８株，其中阴性杆菌与阳性球菌分别为８０．１９％和１９．８１％。其中不动杆菌感染率明显上升，居第２位（占１９．０１％）；药敏试验结果表明细菌耐药性明显增加。头孢三代、丁胺卡那霉素等抗生素为大多数细菌敏感，喹诺酮类抗生素在药敏试验中显示了很好的抗菌活性。结论：下呼吸道感染的致病菌以阴性杆菌为主，不动杆菌所占比例明显升高，今后可能成为下呼吸道感染首位致病菌；细菌耐药性明显增强，医生应严格控制抗生素的应用以降低细菌耐药性；喹诺酮类抗生素有可能成为控制呼吸道感染的首选抗生素     

红细胞生成素受体介导的白血病细胞5纱增殖信号传导的研究

目的 检测白血病细胞系红细胞生成素受体（ＥｐｏＲ）的表达并阐明ＥｐｏＲ介导的白血病细胞系ＫＯＣＬ－３３增殖信号传导途径。方法 用生物系酰基化Ｅｐｏ及流式细胞仪检测白血 纱ＫＯＣＬ－３３细胞中几种信号传导蛋白 酷氨酸磷酸化。结果 （１）除Ｔ淋巴细胞系外,其余细胞纱ＥｐｏＲ表达均为阳性,阳性率为１８％～９９％,均值５２％。不同类型的细胞系ＥｐｏＲ阳性率的差异没有统计学意义。（２）９株细胞中７株细胞因受     

音乐疗法联合理性情绪疗法对宫颈癌患者情绪 希望水平及自我护理能力的影响

目的探讨音乐疗法联合理性情绪疗法对宫颈癌患者情绪、希望水平及自我护理能力的影响。方法将120例宫颈癌患者按照随机数字表法分为研究组与对照组,各60例。两组均给予常规护理干预,研究组在此基础上给予音乐疗法联合理性情绪疗法干预。干预前后采用希望水平量表评定两组希望水平,自我护理能力量表评定两组自我护理能力,一般自我效能感量表评定两组自我效能感,癌症患者生活质量核心调查问卷评定两组生活质量,干预后比较两组干预满意度。结果干预后两组焦虑自评量表及抑郁自评量表评分均较干预前显著降低(P<0.01),研究组显著低于对照组(P<0.01)。干预后两组希望水平量表、自我护理能力量表、一般自我效能感量表、癌症患者生活质量核心调查问卷各维度评分均较干预前显著升高(P<0.01),研究组显著高于对照组(P<0.01),研究组干预总满意率显著高于对照组(P<0.05)。结论音乐疗法联合理性情绪疗法有利于提升宫颈癌患者的自我护理能力及希望水平,缓解负性情绪,改善自我效能,提高生活质量,干预满意度较高。     

山西营养与慢性病家庭队列人群体质指数与死亡率的关系

目的 分析山西营养与慢性病家庭队列人群BMI与总死亡率的关系。方法 以"2002年中国居民营养与健康状况调查"山西省调查人群为基线建立队列，于2015年12月至2016年3月对研究对象进行随访调查，对逝者进行死因回顾调查。2002年基线信息完整的≥ 18岁研究对象7 007人，随访到5 360人，随访率为76.5%。将研究对象按BMI分为8组，计算死亡率，以死亡率最低组作为参照，采用Cox比例风险回归模型估计全人群、分性别、年龄（≥ 60岁、<60岁）的各组死亡风险比（HR）及95% CI，模型调整基线年龄、性别、吸烟、饮酒、文化程度等因素，并进行敏感性分析。结果 共随访67 129人年，平均随访12.5年，死亡615人，队列总死亡率为916/10万人年。BMI为26.0~27.9 kg/m²组死亡率最低，以该组为参照组，多因素调整后，BMI<18.5、18.5~19.9、22.0~23.9和≥ 30.0 kg/m²组的死亡风险明显升高，调整HR值（95% CI）分别为1.90（1.26~2.86）、1.68（1.15~2.45）、1.49（1.08~2.06）和1.72（1.07~2.76）。对于≥ 60岁老年人，BMI<18.5 kg/m²组的死亡风险明显升高，调整HR值（95% CI）为1.94（1.20~3.15）。结论 BMI ≤ 19.9、22.0~23.9及≥ 30.0 kg/m²均会增加全因死亡风险。除关注肥胖外，低体重营养不良造成的老年人高死亡风险应特别引起重视。     

Effect of the Surface Morphology of Porous Coatings on Secondary Electron Yield of Metal Surface

Surface roughening is an important material surface treatment technique, and it is particularly useful for use in secondary electron yield (SEY) suppression on metal surfaces. Porous structures produced via roughening on coatings have been confirmed to reduce SEY, but the regulation strategy and the influence of process parameters both remain unclear in the practical fabrication of effective porous structures. In this paper, the effect of the surface morphology of porous coatings on the SEY of aluminum alloy substrates was studied. Surface characterization and SEY measurements were carried out for samples with a specific process technique on their surfaces. An exponential fitting model of the correlation between surface roughness and the peak values of SEY curves, δm, was summarized. Furthermore, an implementation strategy to enable low surface SEY was achieved from the analysis of the effect of process parameters on surface morphology formation. This work will aid our understanding of the effect of the irregular surface morphology of porous coatings on SEY, thereby revealing low-cost access to the realization of an easy-to-scale process that enables low SEY.     

跌倒风险管理及相关干预措施在老年人群中的作用价值

目的:研究跌倒风险管理及相关干预措施在老年人群中的作用价值。方法:回顾性分析从2014年1月至2016年1月该院收治的50例老年患者作为对照组,予以常规娱乐健身活动。另取2016年2月至2018年2月,该院收治的50例老年患者作为管理组,实施常规娱乐健身活动联合跌倒风险管理。分别比较干预前后两组跌倒风险情况以及护理质量...     

Thermo-Viscoelastic Response of 3D Braided Composites Based on a Novel FsMsFE Method

A homogenization-based five-step multi-scale finite element (FsMsFE) simulation framework is developed to describe the time-temperature-dependent viscoelastic behavior of 3D braided four-directional composites. The current analysis was performed via three-scale finite element models, the fiber/matrix (microscopic) representative unit cell (RUC) model, the yarn/matrix (mesoscopic) representative unit cell model, and the macroscopic solid model with homogeneous property. Coupling the time-temperature equivalence principle, multi-phase finite element approach, Laplace transformation and Prony series fitting technology, the character of the stress relaxation behaviors at three scales subject to variation in temperature is investigated, and the equivalent time-dependent thermal expansion coefficients (TTEC), the equivalent time-dependent thermal relaxation modulus (TTRM) under micro-scale and meso-scale were predicted. Furthermore, the impacts of temperature, structural parameters and relaxation time on the time-dependent thermo-viscoelastic properties of 3D braided four-directional composites were studied.