辐射事故应急演习准备与实施的规范化

通过回顾2014年以来全国各省辐射事故应急演习工作的成果和经验,结合国际原子能机构(IAEA)、生态环境部关于辐射事故应急演习的相关指导文件,总结了综合性辐射事故应急演习的开展流程。此外,基于演习实战化的要求,详细介绍演习规划、准备、实施、评估等环节的技术要求和规范方法,为开展辐射事故应急演习提供参考和借鉴。     

瑞戈非尼联合XELOX化疗方案治疗结直肠癌的临床研究

目的 探究瑞戈非尼联合XELOX化疗方案治疗结直肠癌疗效及对血管新生指标、肿瘤免疫逃逸的影响。方法 选取2018年1月—2022年1月泸州市人民医院收治的80例结直肠癌患者,随机分为对照组和治疗组,每组各40例。对照组采用XELOX方案治疗,第1天静脉滴注注射用奥沙利铂130 mg/m²;第1～14天,口服卡培他滨片1 000 mg/m²,2次/d;21 d为1个周期。治疗组在对照组基础上口服瑞戈非尼片,160 mg/次,1次/d,用药21 d停用7 d,28 d为1个周期。病情进展或无法耐受停止用药。观察两组患者疾病控制率,比较治疗前后两组患者血清癌胚抗原(CEA)、大肠特异性抗原-2(CCSA-2)、糖类抗原19-9(CA19-9)、血管内皮生长因子(VEGF)、转化生长因子-β(TGF-β)、程序性死亡分子-1(PD-1)、程序性死亡分子配体-1(PD-L1)水平,及生存质量。结果 治疗后,治疗组疾病控制率(77.50%)较对照组(55.00%)明显升高(P<0.05)。治疗后,两组CA19-9、CCSA-2、CEA、TGF-β、...     

Effect of Jianpi Bushen formula for colon cancer patients who underwent adjuvant chemotherapy: Statistical analysis plan for a multicenter trialOA

Background: Patients with colon cancer who receive chemotherapy usually experience various gastrointestinal adverse reactions, including nausea, vomiting, and diarrhea, which make it challenging for them to adhere to treatment. As an effective traditional Chinese medicine, the Jianpi Bushen formula has been widely used to alleviate the side effects of chemotherapy.Objective: To evaluate the efficacy and safety of Jianpi Bushen formulae for patients who undergo chemotherapy. This statistical anal...     

优化新生脉散方治疗心力衰竭的网络药理学机制分析

[目的] 运用网络药理学方法分析优化新生脉散方治疗慢性心力衰竭（CHF）的作用机制。[方法] 基于中药系统药理数据库和分析平台（TCMSP）、BATMAN-TCM及UniProt数据库查询优化新生脉散方药物的主要活性成分与相应靶点,利用GeneCards数据库检索CHF相关靶点,通过OmicShare网站分析并结合Cytoscape-v3.6.0软件构建优化新生脉散方中药-化合物-靶点-疾病网络图,使用DAVID数据库对潜在靶点进行基因功能（GO）及京都基因和基因组百科全书（KEGG）通路富集分析。[结果] 根据类药性（DL）、口服吸收利用度（OB）、参数评分（Scorecutoff）筛选出与CHF相关的潜在化合物85种及靶点89个,其中,化合物有quercetin、luteolin、kaempferol等,靶点包括SCN5A、ADRB2、NOS2等。功能富集分析涉及生物过程、分子功能、细胞组分的GO条目共497个,主要参与调控细胞凋亡、增殖及缺氧、炎症反应等方面,KEGG通路富集得到139条,主要与缺氧诱导因子-1（HIF-1）、磷脂酰肌醇3激酶/蛋白激酶B（PI3K-Akt）、肿瘤坏死因子（TNF）信号通路等有关。[结论] 优化新生脉散方治疗CHF具有多成分、多靶点、多途径的作用,为进一步研究优化新生脉散方治疗CHF的潜在复杂机制提供参考方向。     

Psychiatric Advance Directives and their relevance to improving psychiatric care in Asian countries

People with mental illness may be unable to provide critical input about the care they wish to receive during a psychiatric crisis because of altered mental states. It is therefore imperative that clinicians seek to understand service users' wishes for care while they are well and able to provide meaningful input into the discussion. Achieving such an end may be done by discussing and completing a psychiatric advance directive. However, very few Asian countries have legislation that supports such advance directives. The present article seeks to give physicians more information about advance psychiatric directives and the potential role they could play to improve the healthcare provided in Asia to people at risk of losing capacity due to a mental illness. The degree to which mental health legislation supports psychiatric advance directives is documented for each country of South East Asia and Eastern Asia.     

Fear of cancer recurrence in lymphoma survivors: A descriptive study

Abstract

Objectives: Fear of cancer recurrence (FCR) is a common experience among cancer survivors and often persists after the termination of cancer treatments. The purpose of this paper was to evaluate FCR in survivors of Hodgkin’s and diffuse large B-cell lymphomas, given a high rate of survivorship in this patient population.

Research Approach: The parent study was a multi-site, cluster-randomized trial to assess a communication skills intervention: survivorship planning consultation (versus a time-attention control - wellness rehabilitation intervention) to promote transition to survivorship.

Participants & Methodological Approach: 199 patients enrolled in the study and completed a survivorship (or control) consultation one-month after receiving the news of their survivorship status; 141 of those patients (n?=?92 experimental arm, n?=?49 control arm) completed an interview at their 6-month follow-up consultation. In the interview, participants described frequency of FCR, causes of FCR, coping mechanisms, and specific things oncologists said to reduce FCR. Both qualitative and quantitative methods were utilized for analyzing participant responses.

Findings: The majority (88%) of participants reported experiencing FCR, with a higher number of participants in the experimental arm significantly more likely to endorse FCR compared to the control group participants. The main causes of FCR were having medical appointments and concerns about potential relapse and secondary cancers. Participants endorsed utilizing self-sufficient coping mechanisms. As well, participants reported that oncologists most frequently cited specific cure rates of lymphoma to reduce patients’ FCR.

Interpretation & Implications for Psychosocial Providers: Communication skills training programs should emphasize FCR in survivorship consultations.     

硼替佐米皮下注射方案治疗3例POEMS综合征并文献复习

目的:探讨含硼替佐米方案治疗POEMS综合征的有效性和安全性。方法:报道3例POEMS综合征经含硼替佐米方案治疗的过程及结果,并对相关文献进行复习。结果:3例病人经化疗后1例神经症状得到明显改善,1例腹胀症状消失,1例神经症状及胸闷、气短症状改善。结论:含硼替佐米方案治疗POEMS综合征患者取得了较好疗效,未出现神经毒副作用。     

超高CD34+采集的动员方案序贯二次自体造血干细胞移植治疗难治性 霍奇金淋巴瘤

目的:探讨超高CD34+采集的动员方案后序贯二次自体造血干细胞移植治疗难治性霍奇金淋巴瘤的疗效和安全性。方法:对1例经过多疗程一线、二线、新药、免疫等均难治的霍奇金淋巴瘤患者,予以IA+C方案化疗+G-CSF动员干细胞后采集出超高水平CD34+细胞,之后行自体造血干细胞移植,移植后获得完全缓解,再予序贯第二次自体造血干细胞移植进行巩固治疗。结果:总计输注单个核细胞数13.67×108/kg,CD34+细胞48.68×106/kg,第一次自体造血干细胞移植术后第7天造血功能恢复,复查全身PET-CT提示获得完全缓解,第二次自体造血干细胞移植术后第8天造血功能恢复,两次自体造血干细胞移植相关并发症均在可控范围内。结论:超高CD34+细胞采集的IA+C方案化疗+G-CSF动员可以让患者有机会进行多次自体造血干细胞移植,是临床动员的创新方案。对于难治性霍奇金淋巴瘤,序贯二次自体造血干细胞移植可达到更深层次缓解,且安全性较高,延长患者无疾病生存期及总生存期,为难治性霍奇金淋巴瘤治疗提供更多临床依据。     

路径式营养管理在食管癌患者围术期的应用研究

目的 探讨路径式营养管理在食管癌围术期患者中的应用效果。方法 选取2018年1月至2018年7月在四川省肿瘤医院胸外科接受食管癌根治手术治疗的患者156例,随机分为干预组（n=78）和对照组（n=78）,干预组采用路径式营养管理,对照组采用常规营养管理,比较两组患者在术后7d血红蛋白、前白蛋白、体质指数（BMI）、预后营养指数（PNI）等营养指标、术后并发症发生率及术后住院时间。结果 干预组患者术后7d血红蛋白（126.09±16.69）g/L、前白蛋白（208.74±38.51）mg/L、BMI（22.28±2.05）kg/m2、PNI（46.62±4.03）优于对照组,差异有统计学意义（P<0.05）;干预组患者胸腔积液发生率低于对照组,差异有统计学意义（t=4.02,P=0.04）;干预组患者住院时间短于对照组,差异有统计学意义（t=6.53,P=0.03）。结论 路径式营养管理能有效改善食管癌围术期患者营养状况、降低并发症发生率、缩短术后住院时间。