Observation versus radiotherapy with or without temozolomide in postoperative WHO grade II high-risk low-grade glioma: a retrospective cohort study

The optimal adjuvant treatment of high-risk low-grade glioma (LGG) is controversial. We performed this retrospective cohort study to compare three treatments including observation, radiotherapy (RT) alone, and radiotherapy combined with concomitant and adjuvant temozolomide (TMZ) chemotherapy (STUPP regimen) in patients with high-risk LGG. Patients with high-risk (age > 40 or undergoing subtotal resection or biopsy) LGG treated with observation or radiotherapy alone or STUPP regimen after operation were retrospectively analyzed. Survival rates were evaluated by the Kaplan-Meier method; the log-rank test was applied to compare differences between groups. A total of 250 patients met the inclusion criteria. Median follow-up for living people was 70 months. Overall, patients who received radiotherapy with or without temozolomide had better progression-free survival (PFS) and overall survival (OS) when compared with observation (median PFS: observation, 59 months; RT, 82 months; STUPP, not reached; median OS: observation, 96 months; RT, not reached; STUPP, not reached), whereas STUPP regimen did not further prolong PFS or OS than RT alone (PFS, P = 0.203; OS, P = 0.146). In oligodendroglioma (IDH mutant and 1p/19q codeleted) subtype, only STUPP regimen brought longer PFS when compared with observation (P = 0.008). The incidence of grade 3 or 4 neutropenia (P < 0.001) and nausea or vomiting (P = 0.004) was higher in the STUPP group than the figure for the RT alone group. PFS and OS were similarly improved in patients with high-risk LGG receiving RT alone or STUPP regimen. However, only STUPP regimen was able to bring better PFS for oligodendroglioma (IDH mutant and 1p/19q codeleted) subgroup. Longer follow-up time is needed to determine an association with treatment effect in different histological and molecular subgroups.

     

老年人慢性疼痛的治疗

随着我国医疗卫生事业的发展,我国人口的平均年龄有了明显的提高。目前上海市的老年人口已接近20％。老年人口的明显增加也使老年病人数相应增多。根据国外的有关统计,在老年人群中,各种疼痛的发生率明显高于青年人,约有25％～50％不等的老年人在不同的时期患有各种疼痛。其中最为常见的是慢性骨关节炎、腰腿痛、骨质疏松、头痛及带状疱疹的后遗痛等。     

源头与末端治理相结合处理半合成抗生素原料药生产废水

半合成抗生素原料药生产废水难降解,治理难度大。通过对半合成抗生素原料药生产过程污水排放节点分析,根据各类污水的性质采用不同的处理方法,回收了产品和溶剂,大幅降低了源头污水量和COD排放量。同时,结合原有污水处理工艺,采用Fenton氧化和膜生物反应器（MBR）处理技术,最终实现排放污水满足COD≤120mg／L的要求。