Реферат
Since the first operational definition of cognitive frailty was proposed by the expert consensus group of the International Academy of Nutrition and Aging and the International Association of Gerontology and Geriatrics in 2013, frailty and neurocognitive assessment has become the standard diagnostic tool.Since then, the reported prevalence in the literature for cognitive frailty in community-dwelling elderly people vary by dozens of times, as a result of different scales and diagnostic cut-off points, seriously affecting health decision-making.This article reviewed the current literature with a focus on the re-recognition of the clinical significance of cognitive frailty, the limitations of existing assessment tools for diagnosis, and possible solutions in the future.
Реферат
Objective:To perform adenovirus detection and genetic evolutionary analysis on specimens from a fever outbreak in Kunming city.Methods:Pharyngeal swabs from typical febrile patients were collected and tested for nucleic acids of 30 common respiratory pathogens using TaqMan Array Card technology. The full-length sequences of three important genes of adenovirus, Penton base, Hexon and Fiber, were amplified, sequenced and typed using Nanopore high-throughput sequencing. A phylogenetic tree was constructed. Molecular variations and genetic evolution of the three genes were analyzed.Results:Five specimens were collected and all of them tested positive for adenovirus and Haemophilus influenzae. The sequences of the full-length coding regions of the Penton base, Hexon and Fiber genes were obtained by Nanopore sequencing. The homology of the three gene sequences in the five specimens was 100.0%, 99.9%-100.0% and 100.0% in nucleotide sequences, and 100.0% in amino acid sequences. The three genes in the specimens had the highest homology with those of the reference strain of human adenovirus type 3 (HAdV3, accession number: AY599834) in nucleotide sequences, which was 98.6%, 98.7% and 98.9%, respectively. Results of the phylogenetic analysis of the three genes were basically consistent. These Kunming strains were clustered into an independent clade with the reference HAdV3 strain and had a distant relationship with the strains isolated in foreign countries and Taiwan, China in the early years. They were closely related to the domestic and foreign strains in recent years and highly homologous to the 2019 Japanese strain (accession: LC703523) and the Guangzhou strain (accession: MZ540961). Compared with the reference strain, these Kunming strains had five amino acid variations in Penton base, 10 in Hexon and 11 in Fiber. Conclusions:All of the adenovirus strains isolated in this outbreak belong to P3H3F3 type based on the full-length sequences of Penton base, Hexon and Fiber genes. They share high homology with the domestic and foreign HAdV3 strains, including the reference strain. Compared with the reference strain, several amino acid mutations are identified in these Kunming strains, and most of them are in the high variability region or functional regions. M7L in the Hexon protein is an unique amino acid mutation site of Kunming strains.
Реферат
Objective:To analyze the non-enterovirus A71 (non-EVA71) and non-coxsackievirus A16 (non-CVA16) enteroviruses causing hand, foot and mouth disease (HFMD) in Kunming and Qujing of Yunnan Province in 2021 by sequencing the VP4/VP2 and VP1 genes and to analyze the phylogenetic characteristics of the VP1 gene of CVA2, aiming to provide reference for the prevention and control of CVA2.Methods:The samples were made and extracted strictly according to the Laboratory Manual for Hand, Foot and Mouth Disease (China Center for Disease Control and Prevention, 2018 Edition). VP4/VP2 junction regions were firstly amplified and sequenced by MD91/OL68-1 primers. These sequences were firstly edited and then "blasted" on the GenBank to determine the virus serotype. To analyze the phylogenetic characteristics of CVA2, the entire VP1 gene sequences were amplified in two segments using enterovirus species A primers. Virus serotype was again confirmed online by "Enterovirus Genotyping Tool Version 0.1". The sequences of the reference virus genotypes/sub-genotypes were downloaded according to the reference. The phylogenetic trees were constructed by Mega5.2 software and the genetic characteristics were analyzed.Results:A total of 749 non-EVA71 and non-CVA16 enteroviruses were detected in the two areas in 2021. Group A enteroviruses were the main pathogens, with CVA16 as the predominant virus, and a small number of group B enteroviruses were reported. Only five strains of CVA2 were detected with a detection rate of 0.67% (5/749), indicating that CVA2 was a rare pathogen for HFMD in the two areas. The sequencing and serotyping results were consistent using the two genomic regions of VP4/VP2 junction region and VP1 region. Phylogenetic analysis showed that three Kunming strains belonged to genotype A, while two Qujing strains belonged to genotype D.Conclusions:The detection rate of CVA2 in Kunming and Qujing was 0.67% in 2021. CVA2 was a rare pathogen for HFMD in the two regions. Phylogenetic analysis showed genotypes A and D spread in Kunming and Qujing, respectively, but had not caused epidemics. To our knowledge, this was the first report of genotype A of CVA2 in China. Strengthening the laboratory surveillance especially molecular epidemiological surveillance is valuable for the monitor and analysis of transmission source for CVA2.
Реферат
Objective@#To understand the association between waist circumference with psychological sub health among middle school students in Xinjiang, and to provide evidence for the management of waist circumference and effective prevention of mental health problems.@*Methods@#By using the stratified cluster sampling, 6 191 middle school students aged 13-15 in Urumqi, Karamay, Yining, and Kashgar of Xinjiang were surveyed on demographic information, lifestyle, waist circumference, and psychological sub health symptoms. Chi square test, one way ANOVA, and Logistic regression analysis were used to analyze the association between waist circumference and mental sub health.@*Results@#The detection rate of psychological subhealth among secondary school students in Xinjiang was 21.4%. The detection rates of emotional problems, behavioral problems, and social adjustment difficulties were 28.4 %, 28.1%, and 17.7%, respectively. Significant differences in the detection rate of emotional problems, social adjustment difficulties, and psychological sub health scores were observed among students with different waist circumference levels ( F= 4.03 , 10.90 , 5.81, P <0.05). Logistic regression analysis showed that secondary school students with high waist circumference had a higher risk of social adjustment difficulties ( OR=1.45, 95%CI =1.20-1.75) and psychological sub health problems ( OR=1.46, 95%CI =1.22-1.74) compared to those with normal waist circumference ( P <0.01).@*Conclusion@#Psychological sub health problems of middle school students in Xinjiang are prominent, and the waist circumference is positively related to the psychological sub health problems. Schools should pay attention to the mental health education of middle school students, ensure reasonable diet, sleep and living habits, and promote their physical and mental health development.
Реферат
Objective·To describe the level of multiple symptom distress and physical activity in children and adolescents with cancer,analyze symptom distress profiles,and explicit the relationship between latent profiles and physical activity.Methods·From November 2021 to March 2023,the convenient sample method was used to recruit children and adolescents with cancer aged 10-18 years old,who had been treated for more than 1 month in the Departments of Hematology/Oncology,Shanghai Children's Medical Center and Xin Hua Hospital,Shanghai Jiao Tong University School of Medicine.The questionnaires,including General Information Questionnaire,Memorial Symptom Assessment Scale 10-18(MSAS 10-18)and Modified Chinese Version of Children's Leisure Time Activities Study Survey(CLASS-C),were used.Latent profile analysis was used to identify whether the level of multiple symptom distress in children and adolescents with cancer was population heterogeneity and its explicit characteristics.Whether there were differences in physical activity levels among different profiles of symptom distress was also analyzed.Results· A total of 165 valid questionnaires were collected,with an effective response rate of 91.7％.The symptom distress scores of the top five occurrence rates of symptoms in children and adolescents with cancer were lack of energy with a median of 1(1,2)point,nausea 1(1,2)point,lack of appetite 2(2,3)points,sweat 1(1,2)point,and pain 1(1,2)point.The physical activity level of the patients was mainly light,with a median of 2 530.00(1 577.50,3 721.00)min/week,and moderate to vigorous physical activity was relatively lower[70.00(10.00,197.50)min/week].The patients with cancer could be divided into two latent profiles:"high fatigue-high nausea-high hair loss-high sleepy"and"high fatigue-low nausea-low vomiting-low sleepy",which were named as high symptom distress(n=47,30.6％)and low symptom distress(n=l 18,69.4％)separately.Multivariate Logistic regression analysis showed that patients with acute lymphoblastic leukemia were more likely to be classified as high symptom distress group,and outpatients in the latest hospital visit were more likely to classified as low symptom distress group(both P＜0.05).In addition,patients with high symptom distress had a higher level of light physical activity(P＜0.05),and had a lower level of moderate to vigorous physical activity,but the difference was not statistically significant.Conclusion·There is population heterogeneity in the multiple symptom distress in children and adolescents with cancer.Disease type(acute leukemia)and the way of the latest hospital visit(through outpatient department)are the predictors of symptoms profiles of patients with cancer.Patients who experience high symptom distress have higher level of light physical activity,and perhaps lower level of moderate to vigorous physical activity.
Реферат
Objective:This study is to understand the hot spots and trends in the recruitment of clinical trial subjects in China over the past 20 years, explore the existing problems and countermeasures, and provide scientific ideas for domestic clinical trial institutions to effectively solve the problem of subject recruitment.Methods:Bibliometric analysis was used to study the relevant literature from three major domestic databases from 2001 to 2021, analyzing key indicators such as annual publication volume, journal distribution, institutional distribution, regional distribution, and high-frequency keyword co-occurrence.Results:A total of 162 articles were selected. The results showed that the overall publication volume in this field showed an upward trend, and the research institutions were diversified, with a concentration of medical and pharmaceutical institutions and universities. The current research hotspots in this field focused on quality and efficiency improvement of subject recruitment, with themes of subject protection, ethical review, regulation development, standardized management, etc.Conclusions:The research in this field has made significant progress, but the overall research level is still relatively weak. Therefore, it is suggested that the country should play a role in macro-regulation, on the one hand, starting with top-level design, promoting the construction of a standardized management system for subject recruitment, continuously strengthening subject protection, and enhancing the effectiveness of scientific recruitment. On the other hand, releasing the potential of grassroots institutions and giving full play to the volume advantage by promoting the sinking of advantageous resources. Meanwhile, great importance should be attached to the development of Phase I clinical trials, giving full play to the strong internal energy of traditional medicine and promoting the development of Chinese traditional medicine. These multi-measures should provide a theoretical basis for exploring the transformation of ′clinical research hospitals′, and promote the high-quality development of new drug research and development in China.
Реферат
@#As a structural barrier between the brain and the systemic circulation, the blood-brain barrier prevents macromolecules and most small-molecule drugs from entering the brain, which make it difficuct to treat central diseases.Various solute carriers such as glucose transporters and amino acid transporters which can transport various nutrients into the brain, are highly expressed on the blood-brain barrier.The ligand corresponding to the transporter is modified on the nano-drug carrier, and the drug is carried across the blood-brain barrier through transporter-mediated transport, which can achieve high-efficiency delivery of drugs to the brain and improve the diagnostic sensitivity and therapeutic effect of central diseases.In this paper, we review different types of solute carriers to mediate nanoformulations such as liposomes, metal nanoparticles, polymer micelles and dendrimers across the blood-brain barrier for the treatment of brain diseases and discuss the opportunities and challenges of this strategy in future applications.
Реферат
Strengthening clinical research is an inevitable requirement for expediting the development of the medical and healthcare services, as well as enhancing the capability of the hospitals in China. On the basis of sufficient argumentation of the significance and the internal and external environment of developing clinical research according to structure-conduct-performance analysis model, Henan Cancer Hospital set the aim of transforming from clinical hospital to clinical research hospital. By constructing a high-level phase Ⅰ clinical trials center, establishing the department of clinical research management, promoting the collaborative innovation and cooperation among medical institutions, research institutions, and enterprises, and developing the accessory clinical trial management system, Henan Cancer Hospital has turned abundant patient resources into advantages of clinical research. The quality and quantity of clinical trials have been elevated significantly, which could provide strong impetus for hospital′s discipline construction and high-quality development.
Реферат
OBJECTIVE To establish the HPLC fingerprint of Mongolian medicine Sanzisan ，and to evaluate its internal quality by chemical pattern recognition technique comprehensively. METHODS HPLC method was used. Using geniposide as reference，HPLC fingerprints of 15 batches of Sanzisan were drawn with Similarity Evaluation System of TCM Chromatogram Fingerprint（2012 edition）. Similarity evaluation and common peaks identification were conducted. Combined with cluster analysis （CA），principal component analysis （PCA），and orthogonal partial least squares-discriminant analysis （OPLS-DA），the quality of 15 batches of Sanzisan was evaluated ，and the differential markers that affected its quality were screened. RESULTS There were 29 common peaks in 15 batches of Sanzisan ，and the similarity was no less than 0.952，indicating that the chemical composition of the 15 batches of Sanzisan had good consistency. A total of 13 common peaks were identified ，which were chebulic acid ，gallic acid，punicalin，punicalagin A ，punicalagin B ，jasminoside B ，caffeic acid ，corilagin，geniposide，chebulagic acid ，1，2，3，4，6- O-galloylglucose，chebulinic acid ，ellagic acid. Both CA and PCA could divide 15 batches of Sanzisan into four categories ，and the classification results were consistent ，indicating that the quality of 15 batches of Sanzisan had certain differences. Fourteen differential markers （chebulic acid ，gallic acid ，ellagic acid ，etc）that lead to the quality difference between batches were screened out by OPLS-DA. CONCLUSIONS Established HPLC fingerprint analysis method is simple and stable. Combined with chemical pattern recognition analysis ，it can be used for the quality control of Sanzisan.
Реферат
Objective:To investigate the long-term efficacy of autologous hematopoietic stem cell transplantation (auto-HSCT) as the first-line consolidation therapy for high-risk diffuse large B-cell lymphoma (DLBCL) in the rituximab era.Methods:From January 2010 to June 2017, 113 DLBCL patients admitted to Henan Cancer Hospital who had complete remission (CR) after rituximab combined with chemotherapy were enrolled. Among 113 patients, 40 cases received auto-HSCT as the first-line consolidation treatment after chemotherapy (transplantation group) and 73 cases received chemotherapy only (non-transplantation group). The clinical data of 113 patients were retrospectively analyzed. The overall survival (OS) and progression-free survival (PFS) were analyzed by Kaplan-Meier method, and OS and PFS were compared between both groups.Results:The 2-, 3- and 5-year OS rates of transplantation group and non-transplantation group were 90.0% vs. 91.8%, 84.9% vs. 80.1%, 80.9% vs. 72.8%, respectively, and the difference in OS was statistically significant of both groups ( P = 0.457); the 2-, 3- and 5-year PFS rates were 85.0% vs. 85.0%, 82.2% vs. 61.8%, 82.2% vs. 60.0%, respectively, and the difference in PFS was statistically significant of both groups ( P = 0.046). None of the patients in the transplantation group experienced early transplantation-related death. Conclusions:In the era of rituximab treatment, the first-line auto-HSCT consolidation therapy could improve the PFS of high-risk DLBCL patients who are sensitive to chemotherapy, and it may improve the OS with a good safety.
Реферат
Objective:To investigate the potential risk factors for cryptogenic stroke (CS) in patients with patent foramen ovale (PFO).Methods:Patients underwent PFO closure in the Department of Cardiovascular Surgery, the Second Hospital of Hebei Medical University from June 2018 to December 2021 were enrolled retrospectively. Transesophageal echocardiography was used to evaluate the morphological characteristics of foramen ovale and right-to-left shunt (RLS). Multivariate logistic regression analysis was used to determine the independent risk factors for CS in patients with PFO. Results:A total of 203 patients with PFO were enrolled. Their age was 41.9±14.3, and 116 patients (57.1%) were male. There were 102 patients in CS group and 101 patients in non-stroke group. The age, body mass index, systolic blood pressure and diastolic blood pressure, and the constituent ratios of male, hypertension, diabetes, hyperlipidemia and smoking of the CS group were significant higher than those of the non-stroke group (all P<0.05). The PFO channel of the CS group was longer, wider and more combined with resting RLS (all P<0.05). Multivariate logistic regression analysis showed that systolic blood pressure (odds ratio [ OR] 1.065, 95% confidence interval [ CI] 1.022-1.111; P=0.003), PFO length ( OR 1.124, 95% CI 1.004-1.258; P=0.043) and resting RLS ( OR 5.449, 95% CI 2.283-13.004; P<0.001) were the independent risk factors for CS in patients with PFO. Conclusion:Systolic blood pressure, PFO length and the presence of resting RLS are the independent risk factors for CS in patients with PFO.
Реферат
Cryptogenic stroke (CS) is a type of stroke that can not find the exact cause after using the standard clinical examination procedure of stroke. In recent years, many studies have shown that patent foramen ovale (PFO) is closely associated with CS, and its main pathogenesis is paradoxical embolism. In clinical practice, ultrasound is often used for PFO screening. In the context of PFO, the secondary prevention of CS includes drug therapy and PFO closure, but the choice of treatment is still controversial. Screening and evaluation of possible PFO will help to develop secondary prevention strategies for patients with CS, especially those who can benefit from PFO closure.
Реферат
Objective To investigate the clinical efficacy and prognostic factors of autologous hematopoietic stem cell transplantation (ASCT) for Hodgkin's lymphoma (HL). Methods We retrospectively analyzed the data of 38 patients with HL who underwent ASCT. Kaplan-Meier and Cox methods were used to analyze the curative effect and prognostic factors after transplantation. Results All 38 transplanted patients obtained hematopoietic reconstitution. The CR rates before and after transplantation were 55.3% and 81.6%, respectively, and the 5-year PFS and OS were 76.1% and 79.0%, respectively. Univariate analysis showed that B symptoms, IPS score, pre-transplant remission status, extranodal invasion, and pretreatment regimen were the factors affecting the prognosis of ASCT in patients with HL. Multivariate analysis showed that B symptom was an independent risk factor affecting 5-year PFS. Conclusion ASCT is effective in the treatment of high-risk, relapsed, and refractory patients with HL. B symptom is an independent risk factor affecting the prognosis of transplantation.
Реферат
【Objective】 To study and analyze the characteristics of 56-60 years old apheresis platelet donors and the results of pre-donation blood testing in Tianjin, so as to provide reference for the management of blood stations and the maintenance and retention of blood donors. 【Methods】 The information of platelet donors were collected by Tianjin Blood Center from July 1, 2012 to June 30, 2021.The donors aged 56-60(the observation group) were compared with donors aged 18-55(the control). The number of blood donations, male to female ratio, donation frequency, proportion of two-therapeutic-amount donation, rate of deferred donation, incidence of adverse reactions to blood donation, etc of the two groups were studied. The pre-donation test results of the two groups were also compared through the analysis of the unqualified factors of blood routine. 【Results】 From 2012 to 2021, there were 2 837 platelet donors aged 56-60 in Tianjin, and the donation frequency and proportion of two-therapeutic-amount donation were significantly higher than those in the control. The blood routine indexes were significantly different between two groups, but all fluctuated within the normal range(P<0.05). More donors in the observation group than the control were deferred due to unqualified blood routine indexes, mainly caused by Hb deferral. 【Conclusion】 In the past 9 years, the number of apheresis platelet donors aged 56-60 in Tianjin has been stablely increasing. Elderly donors always meet the health requirements of donations according to the results of blood tests. Close monitor of the blood routine indexes, however, should be paid to such population to ensure the elderly donor health and donation safety.
Реферат
【Objective】 To compare and study the characteristics of blood donors with and without adverse reactions to apheresis platelet donation(ARAPD), and to study the influencing factors of blood donors participating in blood donation again, so as to provide basis for putting forward scientific and reasonable countermeasures and retaining blood donors to the greatest extent. 【Methods】 157 679 platelet donors from Tianjin Blood Center from December 26, 2015 to December 25, 2020 were selected and divided into ARAPD group(n=168) and non-ARAPD group (n=157 511). Such characteristics as sex, age, height, weight, blood type, educational background, first-time donation or not, platelet count, hematocrit, phlebotomy time, circulating blood volume and anticoagulant dosage of the two groups were analyzed. Chi-square test was used to identify the high-risk population with poor blood donation response. Multivariate binary logistic regression was used to study the influencing factors of blood donors returning. 【Results】 The age, height and weight of ARAPD group were lower than those of the non-ARAPD group, and the proportion of first-time blood donors, the proportion of women and phlebotomy time were higher than those of non-ARAPD group. There was little difference between the two groups in circulating blood volume, anticoagulant dosage, pre- and post-donation platelet count and hematocrit. Logistic regression analysis showed that the influencing factors of ARAPD were age, educational background, first-time donation or not and phlebotomy time, among which age and first-time donation or not were positively correlated, education and phlebotomy time were negatively correlated (P<0.05). 【Conclusion】 Female, low age, low height and weight, and less blood donation are the basic characteristics of high-risk people with ARAPD. Low age, high education, first-time blood donation and long phlebotomy time are the influencing factors that lead to donor lapsing. Therefore, countermeasures are put forward based on the above results.
Реферат
Objective:To summarize characteristics and rules of blood pressure variability (BPV) in children with H-type hypertension, in an attempt to explore some basis for further selection of the time points of treatment.Methods:A total of 117 children diagnosed as essential hypertension in Children′s Hospital Affiliated to Capital Institute of Pediatrics from March 2018 to September 2019 were selected as the research objective.According to the serum level of homocysteine (Hcy), those children were divided into the simple essential hypertension group (74 cases, Hcy≤13.9 μmol/L) and the H-type hypertension group (43 cases, Hcy>13.9 μmol/L). All children received 24 h ambulatory blood pressure monitoring (24 h ABPM), and BPV indexes were recorded and subject to group comparison.Meanwhile, the serum Hcy level was monitored.Besides, the demographic data and such blood biochemical indexes as blood glucose, blood fat and renal function were recorded or measured for an analysis of the correlation between BPV and each index.Results:There were no significant differences in gender, age, body mass index (BMI) and biochemical indexes between the simple essential hypertension group and the H-type hypertension group (all P>0.05). Compared with the simple essential hypertension group, the H-type hypertension group had a significantly higher 24 h systolic blood pressure standard deviation [24 h SSD, (11.21±3.23) mmHg vs.(9.64±2.73) mmHg, 1 mmHg=0.133 kPa, t=-2.806, P<0.05], nighttime systolic blood pressure standard deviation [nSSD, (10.79±3.89) mmHg vs.(9.26±3.23) mmHg, t=-2.292, P<0.05], and nighttime diastolic blood pressure standard deviation [nDSD, (10.23±3.53) mmHg vs.(8.73±2.93) mmHg, t=-2.617, P<0.05]. Pearson correlation analysis showed that the serum Hcy level was significantly positively correlated with 24 h, SSD, nSSD and nDSD ( r=0.194, 0.183, 0.182, all P<0.05). Conclusions:24 h SSD in children with H-type hypertension is significantly higher, with an obvious increase in both nSSD and nDSD, and the serum Hcy level was significantly positively correlated with BPV, which suggested that it was required to effectively control the serum Hcy level, reduce the range of blood pressure fluctuation and select the optimal time points of treatment, thus delaying the progress of hypertension.
Реферат
HYD-PEP06, an endostatin-modified polypeptide, has been shown to produce effective anti-colorectal carcinoma effects through inhibiting epithelial-mesenchymal transition (EMT). However, whether HYD-PEP06 has similar suppressive effect on hepatocellular carcinoma (HCC) remained unknown. In this study, HYD-PEP06 inhibited metastasis and EMT but not proliferation
Реферат
Objective:To evaluate risk factors and available treatments of extramedullary relapse (EMR) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with myeloid leukemia.Methods:A total of 280 patients were retrospectively analyzed from January 2008 to December 2018 in Affiliated Cancer Hospital of Zhengzhou University. Clinical data were collected including disease patterns, pre-transplantation status, chromosome karyotype, conditioning regimen, types of donor, extramedullary disease before transplantation and graft-versus-host disease (GVHD). The log-rank test and Cox proportional hazard model were uesd for univariate analysis and multivariate analysis, respectively.Results:Twenty patients developed EMR (7.14%). The median time of EMR was 7.5 (1-123) months after allo-HSCT. The mortality of EMR was 80% (16/20). Univariate analysis identified disease patterns, second complete remission (CR2) or progressive disease before transplantation, extramedullary disease, abnormal karyotype and conditioning regimen without total body radiation as significant factors correlated to EMR ( P<0.05). Multi-variable analysis revealed that CR2 or progressive disease ( RR=3.468,95% CI 2.189-7.786), abnormal karyotype ( RR=1.494,95% CI 1.020-2.189) and extramedullary disease before transplantation ( RR=8.627,95% CI 3.921-18.452) were independent risk factors of EMR. Conclusions:The clinical outcome of EMR after allo-HSCT is poor.It is crucial to comprehensively assess and identify EMR as early as possible.
Реферат
Objective:To investigate the risk factors, clinical features and prognosis of abnormal liver function after receiving oxaliplatin-containing chemotherapy regimen in patients with colorectal cancer, and to provide a relevant basis for clinical diagnosis and treatment.Methods:The clinical data of 108 colorectal cancer patients who received XELOX (oxaliplatin+capecitabine) or mFOLFOX6 (oxaliplatin+leucovorin+ 5-fluorouracil) chemotherapy regimen from October 2017 to May 2019 in the First Hospital of Shanxi Medical University were analyzed retrospectively. According to the liver function indexes after chemotherapy, the patients were divided into abnormal liver function group and normal liver function group. The observation indexes included alanine aminotransferase, aspartate aminotransferase, total bilirubin, direct bilirubin, alkaline phosphatase, γ-glutamyl transpeptidase. The clinical characteristics of liver dysfunction after oxaliplatin-containing chemotherapy were analyzed and the related factors that might lead to liver dysfunction were analyzed by using multivariate logistic regression analysis.Results:Among 108 patients receiving chemotherapy, there were 67 (62.0%) cases of abnormal liver function. The main grades of liver dysfunction were grade 1 and grade 2, including 49 cases of grade 1 (73.1%) and 16 cases of grade 2 (23.9%). After chemotherapy, the abnormal liver function usually began in 1-4 cycles, of which 22 cases were 1 cycle (32.8%), 17 cases were 2 cycles (25.4%), 20 cases were 3 cycles (29.8%), and 4 cases were 4 cycles (6.0%). Univariate analysis showed that the age <60 years old, chemotherapy cycle >6, the use of mFOLFOX6 regimen, unprotected hepatoprotective drugs were related to liver dysfunction ( χ2 values were 3.910,4.799, 12.861, 4.044; all P < 0.05). Multivariate logistic regression analysis showed that mFOLFOX6 regimen and unprotected hepatoprotective drugs were independent risk factors of abnormal liver function ( HR = 3.405, 95% CI 1.266-9.159, P = 0.015; HR = 2.348, 95% CI 1.012-5.477, P = 0.047). Conclusions:For patients with colorectal cancer who have a high risk of liver dysfunction after chemotherapy, it is recommended to prefer XELOX regimen among oxaliplatin-containing chemotherapy regimens and to take preventive liver protection treatment.
Реферат
【Objective】 To study and analyze the basic characteristics of blood donors under the COVID-19 epidemic in Tianjin area, so as to provide data support for improving the blood collection for emergency incidents. 【Methods】 The blood collection data of Tianjin Blood Center under the COVID-19 epidemic in 2020 were collected in terms of the number of blood donations, changes in blood donation units over time, group blood donation, donations given by regular blood donors and donations inside fixed blood donation sites, registered residence, gender, age, education, occupation, individual donation, group donation, and the annual daily blood collection and delivery data in Tianjin. 【Results】 The number of blood donations and donation units in Feb 2020 decreased by 56.96%(3 226/7 496-1)and 62.40%(5 382/14 314.5-1)compared with the same period in 2019, and decreased by 56.87%(3 226/7 480-1)and 60.70%(5 382/13 695.7-1)compared with the average value in the previous five years. The number of blood donations, donation units and rate of 400 mL donation in 2020 decreased by 13.25%(119 107/137 293-1), 17.7%(205 196.5/249 405-1)and 12.83%(66.0/75.8-1)respectively. Meanwhile the units of group donation increased by 22.59%(44 118.5/35 989.0-1)as compared with those in 2019. The proportion of regular blood donors raised up to 17.31%(20 623/119 107, which was the highest in recent 6 years. During the epidemic period, the number of blood donations of local registered residence, women, over 36 years old, with bachelor and above degree increased by varied extent compared with previous years. Workers, staff members and others were the main groups of voluntary blood donation, and civil servant, medical workers, farmers and teachers also played a certain role during the epidemic. 【Conclusion】 The clinical blood use in Tianjin was basically guaranteed during the COVID-19 epidemic. It is suggested to further optimize the structure of voluntary blood donors, establish a diversified and multi-level group blood donation team, and increase the number of regular blood donors.