Efficacy and Safety of Niraparib as Maintenance Treatment in Patients With Extensive-Stage SCLC After First-Line Chemotherapy: A Randomized,Double-Blind,Phase 3 Study

IntroductionZL-2306-005 is a randomized, double-blind, multicenter phase 3 study evaluating the efficacy and safety of niraparib, a poly(adenosine diphosphate-ribose) polymerase inhibitor, as first-line maintenance therapy in Chinese patients with platinum-responsive, extensive-stage SCLC (ES-SCLC).MethodsPatients with complete response (CR) or partial response (PR) to standardized, platinum-based first-line chemotherapy were randomized 2:1 to receive niraparib or placebo (300 mg [baseline body weight ≥ 77 kg, platelet count ≥ 150,000/μL] or 200 mg) once daily until progression or unacceptable toxicity. Primary end points were progression-free survival (PFS) (blinded independent central review) and overall survival (sample size planned: 591 patients). Secondary end points included investigator-evaluated PFS and safety.ResultsZL-2306-005 was terminated early owing to ES-SCLC treatment landscape changes (data cutoff: March 20, 2020). During July 2018–February 2020, a total of 185 of 272 patients screened were randomized (niraparib: n = 125 [CR = 1, PR = 124]; placebo: n = 60 [CR = 1, PR = 59]). Median (95% confidence interval [CI]) PFS (blinded independent central review) was 1.54 months (1.41–2.69, niraparib) and 1.36 months (1.31–1.48, placebo); hazard ratio (HR) = 0.66 (95% CI: 0.46–0.95, p = 0.0242). Median overall survival was 9.92 months (9.33–13.54, niraparib) and 11.43 months (9.53–not estimable, placebo); HR = 1.03 (95% CI: 0.62–1.73, p = 0.9052). Median investigator-evaluated PFS was 1.48 months (1.41–2.56, niraparib) and 1.41 months (1.31–2.00, placebo); HR = 0.88 (95% CI: 0.61–1.26; p = 0.4653). Grade greater than or equal to 3 adverse events occurred in 34.4% (niraparib) and 25.0% (placebo) of patients.ConclusionsZL-2306-005 did not reach primary end points. Nevertheless, niraparib as maintenance therapy modestly improved PFS in patients with platinum-responsive ES-SCLC, with acceptable tolerability profile and no new safety signal.     

管理伦理学视角下医学高校教师量化考核的反思

从管理伦理学的角度对高校教师量化考核进行探讨,认为应进一步完善教师量化考核制度,尽可能减少其不利影响.教师量化考核制度应符合管理伦理学的基本原则,即以人为本的原则、义利统一的原则和公平与效率相结合的原则.同时,在高校教师量化考核制度的设计上,还应注重对员工健康的维护.     

Antitumor activity of a polysaccharide from longan seed on lung cancer cell line A549 in vitro and in vivo

In this study, a water-soluble longan seed polysaccharide (WLSP), with a molecular weight of 57 kDa, was isolated from longan seed. Gas chromatography (GC) analysis showed that WLSP was composed mainly of rhamnose (Rha), mannose (Man), arabinose (Ara), galactose (Gal), and glucose (Glc), with molar ratios of 2.4:1.5:2.3:5.6:6.5. The result in 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay showed that WLSP showed a dose-dependent antiproliferative effect on the proliferation of A549 human lung cancer cells, which is consistent with the amount of lactate dehydrogenase (LDH) release from A549 cells. Prompted by this antiproliferative effect, we further examined its antiproliferative mechanism and in vivo anticancer effect. Our results showed that WLSP had the ability to cause cell cycle arrest in G1 phase, activation of caspases 3 and 9, and cleavage of poly[ADP (ribose)] polymerase (PARP) in A549 cells. The result of this in vivo study showed that WLSP could suppress the growth of xenograft A549 tumors and induce apoptosis. Taken together, these results indicate that WLSP exert an anticancer effect in vitro and in vivo and may be useful for the prevention of lung tumorigenesis.     

应对方式与社会支持对糖耐量异常患者生活质量的影响

目的：探讨糖耐量异常患者的应对方式与社会支持分别作为内外两种调节方式对其生活质量的影响。方法：采用焦虑自评量表、抑郁自评量表、特质应对方式问卷、社会支持评定量表及生存质量量表等工具对全国不同地区6家三甲医院的283名糖耐量异常患者进行调查。结果：人口统计学变量不能预测糖耐量异常患者的生活质量：焦虑、抑郁、社会支持及应对方式对生活质量有显著影响。结论：情绪障碍、社会支持、应对方式对糖尿病患者生活质量的影响机制在糖耐量异常患者中同样存在。     

Expert consensus on emergency procedures for portal hypertension bleeding (2022)

Expert consensus proposes an emergency treatment protocol for portal hypertension bleeding. Herein, the emergency treatment procedures, which include first aid, medical, interventional, and surgical treatments, are described. In addition, the indications, contraindications, operating norms, precautions, and prevention of complications of portal hypertension are described to optimize the first aid process.     

实时超声弹性成像评估外周神经损伤

目的 探讨实时超声弹性成像（RTE）评估外周神经损伤的价值。方法 对52例疑诊外周神经损伤患者进行常规超声和RTE扫查,以5分制评价RTE弹性图像;将RTE评分、常规超声及联合应用两者诊断外周神经损伤的结果分别与手术结果进行对照。结果 RTE、常规超声及联合应用两者评估外周神经损伤的敏感度分别为72.09%（31/43）、69.77%（30/43）、95.35%（41/43）,特异度分别为33.33%（3/9）、44.44%（4/9）、66.67%（6/9）,准确率分别为65.38%（34/52）、65.38%（34/52）、90.38%（47/52）;联合应用二者诊断外周神经损伤的敏感度、准确率及阴性预测值均高于单独RTE评分及常规超声（P<0.05）。结论 联合应用RTE和常规超声可提高超声评估外周神经损伤的准确率,为临床治疗及术式选择提供参考依据。