A phase II study of capecitabine plus oxaliplatin (XELOX): a new first-line option in metastatic colorectal cancer

Background: Capecitabine and oxaliplatin are both effective and well-tolerated monotherapies for the treatment of advanced colorectal cancer (CRC). Oxaliplatin has also been shown to be very effective when combined with 5-FU/LV in the first-line setting. Aim of the Study: Assess the efficacy and safety of capecitabine plus oxaliplatin (XELOX) in patients with previously untreated advanced CRC. Methods: Fifty-three patients with measurable disease received capecitabine 1,000 mg/m² twice daily on d 1–14 and oxaliplatin 130 mg/m² on d 1, every 3 wk. Of these, 52 were evaluable for safety and 49 for antitumor response. Results: There was a low rate of grade 1/2 adverse events; grade 3/4 events included leukopenia (10%), neutropenia (6%), thrombocytopenia (2%), nausea/vomiting (4%), and diarrhea (4%). The overall response rate was 39% (95% CI, 25–54%) and median time to disease progression was 7.8 mo. Conclusions: XELOX is an active and well-tolerated first-line treatment for advanced CRC. Randomized phase III studies are ongoing to compare XELOX with FOLFOX in view of the comparable efficacy and safety but superior convenience of XELOX therapy. Presented in part at the 39th American Society of Clinical Oncology Annual Meeting, Chicago, IL, May 31–June 3, 2003.     

国际肝病学会分委员会对急性和亚急性肝功能衰竭命名的建议

SKAcharya编者按：本期刊出国际肝病学会分委员会有关专家对急性肝功能衰竭（AHF）和亚急性肝功能衰竭（SHF）命名的建议。此命名将AHF和SHF视为两个独立的疾病,而不是一个综合征的两个亚型,与我国1995年“病毒性肝炎防治方案”中的重型肝炎分类有诸多差别：①病因方面：AHF和SHF由各种病因（病毒、药物和毒物等）所致,而重型肝炎仅以病毒性肝炎为病因;②病程和时间：AHF在症状出现后4周内、SHF在症状出现后1～6个月内发生,而急性或亚急性重型肝炎均在症状出现后10天内或以后（有的定为4～8周内）发生;③症状特征：AHF及…     

三维重建射频损伤区域观察猪舌根射频损伤体积与射频能量及时间的关系

目的：目前临床进行隧道法舌根射频治疗时,其作用参数的设置仍缺乏统一的标准,故通过计算机三维重建射频损伤区域,分析猪舌根射频损伤体积与射频能量、时间的关系,从中得出应用舌根隧道法射频治疗的最佳作用能级和作用时间。 方法：实验于2006-06/2007-05在上海交通大学耳鼻喉科研究所完成。将36只实验用猪以射频作用能级1,2,3,4,5,6随机分成6组,每组6头猪,各个猪舌的作用时间分别设置为2,5,10,15,20,25s。用Coblation射频发生仪及Reflex55刀头进行猪舌根射频操作。射频作用后的舌根组织行连续冰冻切片,苏木精-伊红染色后,进行序列组织切片的全貌二维图像采集,对拟重建的结构进行边界提取和图像分割。将提取分割图像导入Image-Pro Solution图像处理软件,利用3D Constructor插件进行三维重建,并根据设定参数进行体积计算。用SPSS10.0统计学软件对所测数据进行统计学分析。 结果：①作用能级固定时,舌根组织射频损伤体积随时间延长而增大,符合Logarithmic回归曲线。②作用时间固定时,舌根组织射频损伤体积随能级增大而增大,符合直线回归。③射频损伤体积随能量增大而增加亦符合Logarithmic回归曲线。④Coblation射频治疗系统在能级6时,在作用10s之前,损伤体积随作用时间增加而迅速增加,其后变化趋势平缓,超过20s后损伤体积无显著增加。 结论：①舌根区域射频治疗时,舌根组织射频损伤体积与时间或能量呈Logarithmic曲线相关,与能级呈直线相关。②Coblation射频治疗系统在能级6时,最佳作用时间范围为10-20s。     

早产儿三元整合式教育方案的构建与实施

目的 建立早产儿三元整合式教育方案,并探讨其培训效果。方法 组建三元整合教育团队,按照早产儿的发育发展特点构建教育课程,搭建教育平台,包括开办家长学校、开展家长微课堂、视频引导、家长床旁照护操作培训等。采用NICU家长满意度调查表调查并比较培训前后家长满意度。结果 培训后早产儿家长的满意度总分为（191.90±0.20）分,培训前满意度总分为（176.00±4.40）分,差异有统计学意义（t=-41.68,P<0.001）;培训前后家长的知识和信息维度、家长参与照护维度、医护人员专业态度维度得分的比较,差异有统计学意义（t₁=-20.83,P₁<0.001;t₂=-27.30,P₂<0.001;t₃=-27.10,P₃<0.001）。结论 早产儿三元整合式教育方案能提升家长的照护知识和参与照护能力,提高家长对医护人员专业态度的满意度。     

癌症患者同伴支持量表的汉化及信效度检验

目的 汉化癌症患者同伴支持量表,并检验其信效度。方法 通过正译、回译、文化调试和预调查对原量表进行汉化,形成中文版癌症患者同伴支持量表。于2021年3月—6月选取长沙市2所三级甲等医院的128例青年癌症患者进行问卷调查,分析量表的信效度;2021年7月—2022年3月选取该2所医院招募的241例患者进行问卷调查,用于验证性因子分析。结果 中文版癌症患者同伴支持量表包括3个维度、11个条目。量表水平的内容效度指数为0.948,条目水平的内容效度指数为0.714～1.000。探索性因子分析提取出3个公因子,各条目因子载荷为0.535～0.872,累计方差贡献率为69.64%,方程拟合良好。量表总的Cronbach’s α系数为0.923,折半信度为0.860。验证性因子分析结果 显示,模型拟合度良好。结论 中文版癌症患者同伴支持量表的信效度良好,适用于青年癌症患者同伴支持感的评估。     

亚太地区炎症性肠病处理共识意见(一)

虽然目前亚太地区尚无炎症性肠病（IBD）的大规模流行病学资料，但一系列研究显示其发病率和患病率呈上升趋势。与西方国家相比仍呈滞后现象。溃疡性结肠炎（UC）的发病率仍较克罗恩病（CD）高。除地域差异外。在一些多民族国家中，IBD尚可见种族差异。亚太地区IBD的遗传背景有异于西方国家。如据报道该地区CD患者未检出NOD2／CARDI5变异。一般而言，该地区IBD患者的临床过程似不如西方国家严重。 亚太地区IBD的诊断存在一些特殊问题。如缺乏IBD诊断金标准。存在多种小肠结肠炎，与IBD临床表现相似，使鉴别诊断特别困难。迄今为止，亚太地区IBD的诊断标准多采用西方国家的诊断标准。诊断必须逐步排除非IBD的小肠结肠炎。确诊应有典型的组织学表现。某些患者需借助随访和诊断性治疗才能确诊。进一步研究IBD发病机制将有助于开发更好的诊断标记物。 亚太地区IBD的治疗亦存在特殊问题。由于诊断困难。IBD患者常未能及时接受适当的药物治疗，但该地区仍广泛采用药物治疗方案。结合西方指南和本地经验可制定类似的处理原则。以利诱导缓解和维持缓解。提倡逐级使用基于病变范围、活动性和严重度的阶梯式治疗方案。对不同病例采用综合性、个体化的方法。随着对IBD发病机制和亚太地区IBD独特性的深入理解。合理、实用的药物治疗指南和应用生物制剂治疗将改善该地区IBD的治疗前景。     

Detection of canine echinococcosis by coproantigen ELISA

ObjectiveTo study the canine echinococcosis by coproantigen ELISA method.MethodsDuring the present investigation experimental infection was established using evaginated worms of Echinococcus granulosus (E. granulosus). To check cross reactivity two pups were infected with Taenia hydatigena (T. hydatigena). In order to detect the presence of antigen, hyperimmune sera were raised against excretory-secretory products of adult worms E. chinococcus granulosus. Faecal sample collected either from experimentally infected pups or from other sources were heated at 70 °C to detect heat stable soluble antigen.ResultsPups harbouring less than 104 worms showed negative results. Samples collected from 14 days onwards from experimentally infected animals harbouring more than 104 worms showed positive value. The maximum positive samples were detected in samples collected from in and around slaughter house and the least number of samples were detected positive maintained by dog squad.ConclusionsThe affinity purified IgG exhibited promising results for detection of canine echinococcosis by indirect ELISA.     

Management guidelines for uninvestigated and functional dyspepsia in the Asia-Pacific region: First Asian Pacific working party on functional dyspepsia

Dyspepsia is most optimally defined as pain or discomfort centred in the upper abdomen. The symptom complex may be caused by peptic ulcer disease, gastro-oesophageal reflux, or gastric cancer but is most often due to functional (or non-ulcer) dyspepsia. While upper endoscopy is the method of choice to determine the underlying cause of dyspepsia, it is expensive. A more pragmatic approach is needed in the Asia-Pacific region where health services are limited. A detailed treatment algorithm is given for managing patients presenting with new-onset dyspepsia and documented functional dyspepsia after endoscopy, and evidence to support this approach is reviewed. Prompt endoscopy is recommended for patients with alarm features. In patients without alarm features, treatment for 2–4 weeks with an empirical anti-secretory or prokinetic agent, followed by investigation using non-invasive Helicobacter pylori testing and treatment for patients who do not respond or relapse, is recommended. Trials of management strategies are now needed to establish the efficacy and cost-effectiveness of the approaches recommended.