Distribution of lymphoma subtypes in Ukraine according to the WHO 2016 classification

The Ukrainian Lymphoma Registry (ULR) was established in 2019 with the aim of monitoring the quality of diagnosis, staging, and treatment of lymphoma in Ukraine. Between September 2019 and October 2021, 546 patients with newly diagnosed lymphoma were prospectively registered. All cases were diagnosed according to the 2016 updated WHO lymphoma classification. The male-to-female ratio (M/F) for the whole population was 0.7, with a median age of 46 years (range 18–95). The adoption of the 2016 WHO classification resulted in the identification of 36 different lymphoma subtypes, with 132 cases (24.2%) classified differently compared to the 2008 WHO classification. Only 12 cases (2.8%) were true new entities, including seven cases of high-grade B-cell lymphoma NOS, three of anaplastic large B-cell lymphoma, ALK-negative, 1 case of HHV8+ DLBCL NOS, and 1 of high-grade B-cell lymphoma with C-MYC and BCL2/BCL6 rearrangement. Moreover, 55 (61.1%) entities, including 37 defined by WHO 2008 and 18 defined by WHO 2016, were not represented at all. The analysis of cases registered in the ULR provides a comprehensive breakdown of the subtypes, stage distribution, and treatment of malignant lymphomas (ML) in Ukraine, supporting the usefulness of prospective data collection and timely reporting. We believe that this study is the first step toward a better understanding of the real-life outcomes of patients with ML.     

蓝芩口服液佐治小儿手足口病普通病例疗效观察

目的:观察蓝芩口服液佐治小儿手足口病普通病例的临床疗效及不良反应。方法:将87例手足口病患儿随机分为治疗组47例和对照组40例。两组均给予常规治疗,治疗组在常规治疗基础上加用蓝芩口服液治疗,0～1岁,每次3.5 mL,每日3次;>1岁～3岁,每次5 mL,每日3次;>3岁～5岁,每次10 mL,每日2次;5岁以上,每次10 mL,每日3次,疗程为一周。结果:治疗组咽痛消失时间、口腔溃疡好转时间、手足皮疹消失时间均短于对照组(P<0.01);发热消失时间治疗组(1.92±0.65)d,优于对照组的(2.79±0.47)d,总病程治疗组(5.58±0.67)d,短于对照组的(7.07±0.71)d,两组比较差异均有统计学意义(P<0.01)。结论:蓝芩口服液佐治小儿手足口病在临床可取得较好疗效,值得临床推广应用。     

Cost-effectiveness of the MitraClip device in German heart failure patients with secondary mitral regurgitation

Aim

To evaluate the cost-effectiveness of the MitraClip device (MitraClip) in addition to optimal medical therapy (OMT) in patients with heart failure and secondary mitral regurgitation in Germany.

Methods and results

A model-based economic evaluation was performed to estimate the incremental cost per quality-adjusted life-years (QALYs) for patients with a moderate-to-severe or severe secondary mitral regurgitation receiving MitraClip plus OMT compared with OMT alone from the statutory health insurance (SHI) perspective. Transition probabilities, data on survival rates, and hospitalization rates were obtained from the COAPT trial, a randomized-controlled multicenter trial. Data on health utility and costs were taken from published evidence. To assess parameter uncertainty, several deterministic and probabilistic sensitivity analyses were performed. The incremental costs per QALY gained were € 59,728 (costs/incremental life years gained: € 42,360). The results were most sensitive to the transition probabilities and the hospitalization rates. The probabilistic sensitivity analysis showed that the MitraClip strategy was cost-effective with a probability of 80% at a willingness-to-pay threshold of € 67,000/QALY.

Conclusions

Depending on the willingness-to-pay threshold, for patients with heart failure and a moderate-to-severe or severe secondary mitral regurgitation the MitraClip can be cost-effective from the perspective of the German SHI.

Graphical abstract

     

放松训练对肺癌化疗患者疲乏症状及睡眠功能的影响

目的探讨放松训练对肺癌化疗患者疲乏症状及睡眠功能的改善效果。方法将肺癌化疗患者随机分为放松组和常规组,常规组(66例)采用常规的化疗护理,放松组(68例)在常规护理的基础上采用放松训练进行干预,分别在干预前及干预1、2、3周后应用修订版疲乏量表(RPFS)及匹兹堡睡眠质量指数(PSQI)进行评估。结果两组疲乏症状总分及各维度得分比较,组间效应、时间效应以及交互效应有统计学意义(P0.05,P0.01)。在睡眠质量方面,放松组干预1~3周后的主观睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、日间功能得分和总分均显著低于对照组,干预3周后的催眠药物得分显著高于对照组,差异有统计学意义(P0.05,P0.01)。结论放松训练能有效缓解肺癌化疗患者的疲乏症状,并提高其睡眠质量。