Comparative Study on the Immunogenicity and Efficacy of Different Post-exposure Intramuscular Rabies Vaccination Regimens in China

Objective This study aimed to compare the current Essen rabies post-exposure immunization schedule(0-3-7-14-28)in China and the simple 4-dose schedule(0-3-7-14)newly recommended by the World Health Organization in terms of their safety,efficacy,and protection.Methods Mice were vaccinated according to different immunization schedules,and blood was collected for detection of rabies virus neutralizing antibodies(RVNAs)on days 14,21,28,35,and 120after the first immunization.Additionally,different groups of mice were injected with lethal doses of the CVS-11 virus on day 0,subjected to different rabies immunization schedules,and assessed for morbidity and death status.In a clinical trial,185 rabies-exposed individuals were selected for post-exposure vaccination according to the Essen schedule,and blood was collected for RVNAs detection on days 28and 42 after the first immunization.Results A statistically significant difference in RVNAs between mice in the Essen and 0-3-7-14 schedule groups was observed on the 35th day(P<0.05).The groups 0-3-7-14,0-3-7-21,and 0-3-7-28 showed no statistically significant difference(P>0.05)in RVNAs levels at any time point.The post-exposure immune protective test showed that the survival rate of mice in the control group was 20%,whereas that in the immunization groups was 40%.In the clinical trial,the RVNAs positive conversion rates on days 28(14 days after 4 doses)and 42(14 days after 5 doses)were both 100%,and no significant difference in RVNAs levels was observed(P>0.05).Conclusion The simple 4-dose schedule can produce sufficient RVNAs levels,with no significant effect of a delayed fourth vaccine dose(14–28 d)on the immunization potential.

Autologous hematopoietic stem cell transplantation conditioning regimens and chimeric antigen receptor T cell therapy in various diseases

Conditioning regimens employed in autologous stem cell transplantation have been proven useful in various hematological disorders and underlying malignancies;however,despite being efficacious in various instances,negative consequences have also been recorded.Multiple conditioning regimens were extracted from various literature searches from databases like PubMed,Google scholar,EMBASE,and Cochrane.Conditioning regimens for each disease were compared by using various end points such as overall survival(OS),progression free survival(PFS),and leukemia free survival(LFS).Variables were presented on graphs and analyzed to conclude a more efficacious conditioning regimen.In multiple myeloma,the most effective regimen was high dose melphalan(MEL)given at a dose of 200/mg/m2.The comparative results of acute myeloid leukemia were presented and the regimens that proved to be at an admirable position were busulfan(BU)+MEL regarding OS and BU+VP16 regarding LFS.In case of acute lymphoblastic leukemia(ALL),BU,fludarabine,and etoposide(BuFluVP)conferred good disease control not only with a paramount improvement in survival rate but also low risk of recurrence.However,for ALL,chimeric antigen receptor(CAR)T cell therapy was preferred in the context of better OS and LFS.With respect to Hodgkin’s lymphoma,mitoxantrone(MITO)/MEL overtook carmustine,VP16,cytarabine,and MEL in view of PFS and vice versa regarding OS.Non-Hodgkin’s lymphoma patients were administered MITO(60 mg/m2)and MEL(180 mg/m2)which showed promising results.Lastly,amyloidosis was considered,and the regimen that proved to be competent was MEL 200(200 mg/m2).This review article demonstrates a comparison between various conditioning regimens employed in different diseases.

SETD2 in cancer:functions,molecular mechanisms,and therapeutic regimens

In recent years,the histone methyltransferase SET domain containing 2(SETD2)has garnered significant attention for its involvement in carcinogenesis.Herein we aim to summarize the research advances regarding SETD2 in tumors,elucidate the role in global epigenetic regulation,highlight potential therapeutic regimens for patients with SETD2 deficiency,and outline future research directions.

复方苦参注射液联合EC-T方案治疗三阴性乳腺癌的临床疗效

目的探究复方苦参注射液联合EC-T方案治疗三阴性乳腺癌患者的临床效果。方法采用回顾性研究,将2021年1月—2022年12月北京丰台右安门医院收治的69例三阴性乳腺癌患者作为研究对象,依据不同的治疗手法分为观察组35例和对照组34例。对照组给予EC-T序贯化疗,观察组在化疗方案基础上加用复方苦参注射液,比较两组的临床疗效、免疫功能、生活质量以及不良反应的发生情况。结果治疗后,观察组客观缓解率为62.86%(22/35),显著高于对照组的26.47%(9/34),观察组疾病控制率为88.57%(31/35);对照组疾病控制率为52.94%(18/34)(均有P<0.05),由此可得出观察组临床疗效优于对照组。治疗后观察组患者IgG[(10.02±1.28)U/mL vs(13.51±1.09)U/mL]、IgM[(1.31±0.39)U/mL vs(1.61±0.32)U/mL]、IgA[(1.78±0.29)U/mL vs(1.96±0.27)U/mL]水平均比对照组低(均有P<0.05)。治疗后,观察组患者的生活质量总体改善情况[71.42%(25/35)]高于对照组[35.29%(12/34)](P=0.003)。两组患者在治疗期间的不良反应主要以胃肠道、周围神经系统、血小板、白细胞等,程度大多为Ⅰ~Ⅱ级,经对症治疗后均缓解;其中观察组的白细胞毒性反应[40%(14/35)vs 82.35%(28/34)]、血小板不良反应发生率[28.57%(10/35)vs 55.88%(19/34)]均低于对照组(均有P<0.05)。结论复方苦参注射液联合EC-T序贯化疗方案治疗三阴性乳腺癌比单纯化疗的临床疗效较好,可加强患者的免疫功能,改善患者的生活质量,降低不良反应,具有良好的临床应用价值。

Effect of cetuximab plus FOLFOX4 regimen on clinical outcomes in advanced gastric carcinoma patients receiving evidence-based care

BACKGROUND Although chemotherapy is effective for treating advanced gastric carcinoma(aGC),it may lead to an adverse prognosis.Establishing a highly effective and low-toxicity chemotherapy regimen is necessary for improving efficacy and outcomes in aGC patients.AIM To determine the efficacy and safety of cetuximab(CET)combined with the FOLFOX4 regimen(infusional fluorouracil,folinic acid,and oxaliplatin)as firstline therapy for patients with aGC,who received evidence-based care(EBC).METHODS A total of 117 aGC patients who received EBC from March 2019 to March 2022 were enrolled.Of these,60 in the research group(RG)received CET+FOLFOX4 as first-line therapy,whereas 57 in the control group(CG)received FOLFOX4.The efficacy[clinical response rate(RR)and disease control rate(DCR)],safety(liver and kidney dysfunction,leukopenia,thrombocytopenia,rash,and diarrhea),serum tumor marker expression[STMs;carbohydrate antigen(CA)19-9,CA72-4,and carcinoembryonic antigen(CEA)],inflammatory indicators[interleukin(IL)-2 and IL-10],and quality of life(QOL)of the two groups were compared.RESULTS A markedly higher RR and DCR were observed in the RG compared with the CG,with an equivalent safety profile between the two groups.RG exhibited notably reduced CA19-9,CA72-4,CEA,and IL-2 levels following treatment,which were lower than the pre-treatment levels and those in the CG.Post-treatment IL-10 was statistically increased in RG,higher than the pre-treatment level and the CG.Moreover,a significantly improved QOL was evident in the RG.CONCLUSION The CET+FOLFOX4 regimen is highly effective as first-line treatment for aGC patients receiving EBC.It facilitates the suppression of STMs,ameliorates the serum inflammatory microenvironment,and enhances QOL,without increased adverse drug effects.

Correlation between postoperative chemotherapy regimen and survival in patients with resectable gastric adenocarcinoma accompanied with vascular cancer thrombus

BACKGROUND Patients with resectable gastric adenocarcinoma accompanied by vascular cancer thrombus(RGAVCT)have a poor prognosis,with a 5-year survival rate ranging from 18.42%-53.57%.These patients need a reasonable postoperative treatment plan to improve their prognosis.AIM To determine the most effective postoperative chemotherapy regimen for patients with RGAVCT.METHODS We retrospectively collected the clinicopathological data of 530 patients who un-derwent radical resection for gastric cancer between January 2017 and January 2022 and who were pathologically diagnosed with gastric adenocarcinoma with a choroidal cancer embolus.Fur-thermore,we identified the high-risk variables that can influence the prognosis of patients with RGAVCT by asse-ssing the clinical and pathological features of the patients who met the inclusion criteria.We also assessed the significance of survival outcomes using Mantel-Cox univariate and multivariate analyses.The subgroups of pa-tients with stages Ⅰ,Ⅱ,and Ⅲ disease who received single-,dual-,or triple-drug regimens following surgery were analyzed using SPSS 25.0 and the ggplot2 package in R 4.3.0.RESULTS In all,530 eligible individuals with RGAVCT were enrolled in this study.The median overall survival(OS)of patients with RGAVCT was 24 months,and the survival rates were 80.2%,62.5%,and 42.3%at 12,24,and 59 months,respectively.Preoperative complications,tumor size,T stage,and postoperative chemotherapy were identified as independent factors that influenced OS in patients with RGAVCT according to the Cox multivariate analysis model.A Kaplan-Meier analysis revealed that chemotherapy had no effect on OS of patients with stage Ⅰ or Ⅱ RGAVCT;however,chemotherapy did have an effect on OS of stage Ⅲ patients.Stage Ⅲ patients who were treated with chemotherapy consisting of dual-or triple-agent regimens had better survival than those treated with single-agent regimens,and no significant difference was observed in the survival of patients treated with chemo-therapy consisting of dual-or triple-agent regimens.CONCLUSION For patients with stage Ⅲ RGAVCT,a dual-agent regimen of postoperative chemotherapy should be recom-mended rather than a triple-agent treatment,as the latter is associated with increased frequency of adverse events.

老年局部晚期乳腺癌患者根治术前实施重组人血管内皮抑制素联合EC-T序贯新辅助化疗的疗效及安全性分析

目的本研究通过分析老年局部晚期乳腺癌患者根治术前实施重组人血管内皮抑制素联合EC-T序贯新辅助化疗的疗效及安全性,以期为临床诊疗提供方法。方法回顾性选取2015年1月—2022年9月在广德市中医院接受治疗的老年LABC患者80例作为研究对象,依据不同的治疗方法将患者分为观察组(n=40例)和对照组(n=40)。对照组根治术前应用EC-T序贯新辅助化疗,观察组在与对照组患者相同治疗的基础上加用重组人血管内皮抑制素。比较2组临床疗效、血清肿瘤标志物水平和不良反应。结果治疗后,观察组患者治疗有效率、疾病控制率分别高于对照组(75.00%vs 52.50%、92.50%vs 75.00%,P<0.05);观察组和对照组患者血清CA125、CEA水平相比同组治疗前均降低,且观察组血清CA125、CEA水平均低于对照组,差异均有统计学意义(均P<0.05)。治疗后对患者随访12个月,观察组患者生存率高于对照组(92.50%vs 72.50%,P<0.05)。观察组和对照组患者肝功能损害、白细胞减少、心功能损害、血小板减少、皮肤反应和胃肠道反应发生差异均无统计学意义(均P>0.05)。结论老年局部晚期乳腺癌根治术前实施重组人血管内皮抑制素联合EC-T序贯新辅助化疗,可提高患者的临床疗效,降低患者血清肿瘤标志物水平,而未增加患者的不良反应。

Clinical Effects of the Follicular Phase Long Regimen and Luteal Phase Long Regimen on Ovulation Induction in IVF-ET Treatment: A Meta-Analysis

Objective:To systematically evaluate the clinical effects of the follicular phase long regimen and the luteal phase long regimen on ovulation induction in IVF-ET treatment.Methods:Databases including PubMed,Embase,Cochrane Library,CNKI,Chinese Biomedical Literature(CBM),VIP,Wanfang,and others were searched up to January 2021.Clinical studies on ovulation induction using the follicular phase long regimen and luteal phase long regimen in IVF-ET treatment were identified.Literature screening,data extraction,and quality evaluation were conducted based on inclusion and exclusion criteria.Meta-analysis was performed using RevMan 5.3 software.Results:After screening,a total of 11 studies were included,comprising 21,544 patients:9,974 in the follicular phase long regimen group and 11,570 in the luteal phase long regimen group.The meta-analysis results were as follows:(1)The number of Gn days and the total amount of Gn in the follicular phase long regimen were higher than those in the luteal phase long regimen(P<0.05);(2)The number of eggs obtained in the follicular phase long regimen was higher than that in the luteal phase long regimen(P<0.05).There were no significant differences in the rate of embryo optimization and cycle cancellation between the two groups(P>0.05);(3)The embryo implantation rate and clinical pregnancy rate in the follicular phase long regimen were higher than those in the luteal phase long regimen(P<0.05),while the abortion rate in the follicular phase long regimen was lower than that in the luteal phase long regimen(P<0.05).Conclusion:Compared to the luteal phase long regimen,the follicular phase long regimen involves more Gn days and a higher total amount of Gn.The optimal embryo rate and cycle cancellation rate were similar between the regimens,but the follicular phase long regimen resulted in more eggs,significantly improved the implantation and clinical pregnancy rates,and reduced the abortion rate.However,these conclusions require further validation through more multicenter,large-sample RCT studies.

TP与EC-T化疗方案在三阴性乳腺癌新辅助化疗中疗效与BRCA1突变关系

目的:探讨TP与EC-T化疗方案在三阴性乳腺癌新辅助化疗中的疗效,并探索铂类与BRCA1突变关系。方法:选取2016年5月-2020年5月在我院诊断三阴性乳腺癌需新辅助化疗的122例患者,均行BRCA检测,将BRCA1胚系突变患者及未突变患者随机分为两组,一组给予TP(62例)方案新辅助化疗,一组给予EC-T(60例)方案新辅助化疗;按照不同因素分析两组pCR差异。结果:TP组pCR率为56.5%,EC-T组pCR率36.7%,差异有统计学意义(P=0.029);对于ypT_(0/is)或ypN_(0)TP组对比EC-T组仍然具有明显优势(分别为64.5%vs 43.3%,P=0.019;69.4%vs 41.7%,P=0.002);对于BRCA1突变患者,TP组与EC-T组pCR率无统计学差异(50.0%vs 44.4%,P=0.343),对TP组内BRCA1突变与未突变人群pCR率无统计学差异(50.0%vs 57.7%,P=0.224),对EC-T组内BRCA1突变与未突变人群pCR率无统计学差异(44.4%vs 35.3%,P=0.248)。122例患者的不良反应以1-2级较常见。EC-T组和TP组患者1-2级恶心/呕吐的发生率分别为71.7%和38.7%(P=0.0003),3-4级恶心/呕吐的发生率分别为21.7%和3.2%(P=0.002);TP组和EC-T组患者1-2级血小板减少症的发生率分别为32.3%和8.3%(P=0.001),3-4级血小板减少症的发生率分别为9.7%和0%(P=0.008)。其他3-4级不良反应少见。结论:TP方案对比EC-T方案明显提高三阴性乳腺癌pCR率,BRCA1是否突变未发现影响铂类方案疗效,整体两组不良反应可以耐受,其中TP组血小板减少发生率较高。

EC-T序贯和ET方案新辅助化疗在ⅡB～ⅢC期乳腺癌患者中的临床效果对比及对毒副反应发生率的影响研究

目的探讨EC-T序贯和ET方案新辅助化疗在ⅡB～ⅢC期乳腺癌患者中的临床效果及毒副反应。方法选取本院2009年1月～2015年6月诊治的ⅡB～ⅢC期乳腺癌患者60例,采用随机数字表法分为两组,对照组患者30例实施ET方案新辅助化疗,观察组患者30例实施EC-T序贯新辅助化疗,比较两组患者的临床效果、整体功能生命质量、毒副反应、预后。结果两组患者治疗后整体功能生命质量评分(躯体功能、角色功能、情感功能、认知功能、社会功能、整体生命质量)较治疗前显著增加(P <0.05)。观察组患者治疗后整体功能生命质量评分(躯体功能、角色功能、情感功能、认知功能、社会功能、整体生命质量)高于对照组(P <0.05)。观察组患者手术时间短于对照组(P <0.05)。观察组患者术中出血量、淋巴结阳性数、淋巴切除数量少于对照组(P <0.05)。观察组患者肿瘤最大直径小于对照组(P <0.05)。观察组患者有效率、疾病控制率、病理完全缓解率高于对照组(P <0.05)。观察组患者毒副反应(中性粒细胞减少、恶心呕吐、发热、腹泻)发生率显著低于对照组(P <0.05)。两组患者毒副反应(白细胞下降、血小板下降、脱发、肝功能损害、心肌损害)、预后(1年生存率、2年生存率、3年生存率)比较,差异均无统计学意义(P> 0.05)。结论与ET方案相比,EC-T序贯新辅助化疗可提高ⅡB～ⅢC期乳腺癌患者的治疗效果,降低毒副反应发生率,并改善整体功能生命质量,值得临床推广使用。

丹参川芎嗪注射液联合EC-T方案对乳腺癌术后患者近期疗效、免疫功能及生活质量的影响

目的:探讨丹参川芎嗪注射液联合EC-T方案对乳腺癌术后患者近期疗效、免疫功能及生活质量的影响。方法:通过随机数字表法将2019年3月至2021年3月秦皇岛市第一医院收治的80例乳腺癌术后患者分为对照组与研究组(每组40例),对照组患者给予EC-T方案治疗,研究组患者在对照组的基础上加用丹参川芎嗪注射液治疗。比较两组患者中医症状评分、免疫功能(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)和自然杀伤细胞)和卡诺夫斯凯计分(KPS)变化情况,记录两组患者的近期疗效和不良反应发生情况。结果:与对照组(80.00%,32/40)相比,研究组患者的总有效率(95.00%,38/40)更高,差异有统计学意义(χ^(2)=4.114,P=0.043)。治疗后,两组患者各项中医症状评分均明显降低,且研究组患者失眠、乏力疲惫、乳房胀痛、出汗和口干评分明显低于对照组,差异均有统计学意义(P<0.05)。治疗后,两组患者CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)水平明显升高,CD8^(+)水平明显降低;且与对照组相比,研究组患者治疗后的CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)水平明显更高,CD8^(+)水平明显更低,差异均有统计学意义(P<0.05)。治疗后,两组患者的KPS评分均明显升高,且研究组患者治疗后的KPS评分明显高于对照组,差异有统计学意义(P<0.05)。研究组患者心脏毒性、血小板减少、脱发、恶心呕吐和白细胞减少的发生率明显低于对照组,差异均有统计学意义(P<0.05)。结论:针对乳腺癌术后患者,采用丹参川芎嗪注射液联合EC-T方案治疗能取得理想的疗效,不但可缓解临床症状,还能改善免疫功能,减少不良反应,提高生活质量。

复方苦参注射液联合EC-T化疗方案治疗乳腺癌术后患者的临床观察

目的:探讨复方苦参注射液联合EC-T化疗方案(即表柔比星联合环磷酰胺化疗后序贯多西他赛方案)对乳腺癌术后患者的肝肾功能、免疫功能及身体功能状态的影响,为临床提供新思路。方法:选取2018年1月~2022年12月的乳腺癌术后患者156例作为研究对象,采用随机数字表法分为对照组和观察组,每组78例。对照组给予EC-T化疗方案,观察组在对照组治疗基础上加用复方苦参注射液。比较治疗前后两组患者肝肾功能指标[丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、γ-谷氨酰转移酶(GGT)、血尿素氮(BUN)、肌酐(Cr)]、外周血T细胞亚群(CD3^(+)、CD4^(+)、CD8^(+)及CD4^(+)/CD8^(+))水平及身体功能状态[卡诺夫斯凯计分(KPS)]。结果:治疗后,两组患者ALT、AST、GGT、BUN、Cr比较均无统计学差异(P>0.05)。治疗后,观察组CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)升高,CD8^(+)降低(P<0.05);对照组CD3^(+)、CD4^(+)及CD4^(+)/CD8^(+)降低,CD8^(+)升高(P<0.05)。观察组KPS和身体功能状态改善率均优于对照组(P<0.05)。结论:与单用EC-T化疗方案相比,复方苦参注射液联合EC-T化疗方案可改善乳腺癌患者术后化疗期间的免疫功能和身体功能状态,值得临床推广。

乳腺癌患者接受TEC方案与EC-T方案治疗后白细胞水平的变化

目的研究乳腺癌患者接受TEC和EC-T化疗方案治疗后白细胞水平变化。方法选取106例乳腺癌患者作为研究对象,按照随机数字表法分为2组,对照组采用多西紫杉醇(T)、表阿霉素(E)、环磷酰胺(C)联合(TEC方案)化疗治疗6周期,观察组采用序贯(EC-T方案)化疗治疗4周期。对比化疗前后2种方案对患者的白细胞水平改变及白细胞下降率的影响。结果治疗7~14天患者白细胞水平降低最为明显,治疗的第7、14、21天2组白细胞水平均下降,但观察组略高于对照组(P<0.05);治疗的第7、14、21天观察组白细胞减少症发生率分别为18.52%、25.93%、37.03%,低于对照组的28.85%、44.23%、65.38%,差异有统计学意义,P<0.05;取4个治疗周期白细胞水平比较,观察组均略高于对照组,组间比较差异有统计学意义,P<0.05。结论 TEC治疗方案与EC-T方案相比,患者白细胞水平降低更严重,建议在病情允许的情况下选择EC-T方案化疗,以减少化疗引起的白细胞降低并发症,促进病情恢复。

EC-wP、EC-T和TEC新辅助化疗方案治疗乳腺癌的疗效比较

目的探讨表柔比星+环磷酰胺序贯紫杉醇(EC-wP)方案、表柔比星+环磷酰胺序贯多西他赛(EC-T)方案及多西他赛+表柔比星+环磷酰胺(TEC)方案治疗乳腺癌的疗效。方法将90例乳腺癌患者根据化疗方案不同分为EC-wP组、EC-T组、TEC组,每组30例。比较3组患者的治疗总有效率、预后、血清肿瘤标志物[癌胚抗原(CEA)、糖类抗原125(CA125)、糖类抗原153(CA153)、基质金属蛋白酶9(MMP9)]水平及不良反应发生情况。结果3组患者的治疗总有效率比较,差异无统计学意义(P>0.05)。EC-wP组患者3年无病生存率和总生存率均高于EC-T组和TEC组患者,差异均有统计学意义(P<0.05)。化疗后,3组患者各血清肿瘤标志物水平均较化疗前降低,EC-wP组和EC-T组患者各血清肿瘤标志物水平均低于TEC组,EC-wP组患者各血清肿瘤标志物水平均低于EC-T组,差异均有统计学意义(P<0.05)。EC-wP组和EC-T组患者中性粒细胞减少发生率均低于TEC组,EC-wP组患者中性粒细胞减少发生率低于EC-T组,差异均有统计学意义(P<0.05)。结论EC-wP、EC-T、TEC化疗方案在乳腺癌治疗中均具有良好的效果,但相较于EC-T、TEC化疗方案,EC-wP化疗方案的安全性较高,治疗效果较为显著,治疗后可有效抑制肿瘤的生长。

探究对乳腺癌采用EC-T序贯新辅助化疗方案的效果

目的探究对乳腺癌采用EC-T序贯新辅助化疗方案的效果。方法选取2015年1月—2020年1月该院收治的154例乳腺癌患者为研究对象进行回顾性分析,按照化疗方案分为两组,接受TEC化疗方案治疗的患者共77例为对照组,接受EC-T序贯新辅助化疗方案治疗的患者77例为观察组,比较两组化疗效果。结果观察组化疗1周期后、化疗2周期后、化疗3周期后白细胞计数均高于对照组,差异有统计学意义(t=4.809、7.817、6.985,P<0.05);观察组骨髓抑制、中性粒细胞减少症、闭经、肝功能损害发生率分别为6.49%、3.90%、3.90%、5.19%,均低于对照组的19.48%、14.29%、12.99%、16.88%,差异有统计学意义(χ^(2)=5.746、5.029、4.117、5.356,P<0.05);观察组化疗结束后肿瘤控制总有效率为77.92%,明显高于对照组肿瘤控制总有效率62.34%,差异有统计学意义(χ^(2)=4.464,P<0.05);观察组治疗结束后1年内的总生存率为90.91%,明显高于对照组总生存率79.22%,差异有统计学意义(χ^(2)=4.140,P<0.05);观察组随访期间的无进展生存时间为(9.27±2.46)个月,明显长于对照组(7.14±1.73)个月,差异有统计学意义(t=6.215,P<0.05)。结论乳腺癌采用EC-T序贯新辅助化疗方案能获得更好的肿瘤控制效果,能减轻毒副反应,增加患者生存获益,疗效及安全性均较满意,值得广泛推广。

The Adverse Effect of the 2-1-1 Regimen for Rabies PEP in Preschool Children

Post-exposure prophylaxis（PEP） has proved to be the most important measure for rabies prevention and control. There is little information regarding adverse reactions to the Essen and 2-1-1 regimens in preschool children（aged 0-6）. We reexamined the outcomes of 1,109 preschool children who were vaccinated using SPEEDA under the Essen regimen between January 2011 and December 2012 and 1,267 preschool children under the 2-1-1 regimen between January 2013 and December 2014. We find that, in preschool children, the febrile reaction after the first 2-dose injection in the 2-1-1 regimen was significantly higher than that induced by the first 1-dose in the Essen procedure. Thus, we recommend that the Essen regimen should still be used for rabies PEP in preschool children.

复方苦参注射液辅助EC-T方案治疗乳腺癌改良根治术后患者临床观察

目的:观察复方苦参注射液辅助EC-T方案治疗乳腺癌改良根治术后患者的临床疗效。方法:选取符合纳入标准的94例乳腺癌术后患者,随机分为两组各47例。对照组术后予EC-T方案进行化疗,治疗组在对照组基础上予复方苦参注射液治疗。观察两组临床疗效。结果:治疗组总有效率89.36%明显高于对照组的68.09%(P﹤0.05)。治疗后,两组患者的肿瘤标志物含量均较治疗前下降(P﹤0.05),且治疗组较对照组下降明显(P﹤0.05);两组患者免疫功能相关指标整体水平较均治疗前上升(P﹤0.05),且治疗组较对照组上升趋势更明显(P﹤0.05);治疗组WBC、HGB、PLT水平较对照组改善明显(P﹤0.05)。结论:复方苦参注射液辅助EC-T方案治疗乳腺癌改良根治术后患者,能增强疗效,降低不良反应发生率。

Comparison of two different treatment regimens’ efficacy in neovascular age-related macular degeneration in Turkish population—based on real life data-Bosphorus RWE Study Group

AIM: To compare two different anti-vascular endothelial growth factor(anti-VEGF) treatment regimens'-a priori pro re nata(PRN) and PRN regimen following^(th)e loading phaseanatomical and functional results in neovascular agerelated macular degeneration(n AMD) patients. METHODS: Totally 544 n AMD patients followed and treated with aflibercept(n=135) and ranibizumab(n=409)at 9 different centers between 2013 and 2015 were enrolled into^(th)is retrospective multicenter study. Patients with initial best corrected visual acuity(BCVA) interval of 1.3-0.3(log MAR) and a minimum follow-up of 12 mo were included. Patients under two different regimens-a priori pro re nata(1+PRN) or 3 consecutive intravitreal injections followed by a PRN regimen(3+PRN)-were compared in BCVA at 3^(th), 6^(th) and 12^(th) months, and in central macular^(th)ickness(CMT) at 6^(th) and 12^(th) months. The total study group, intravitreal ranibizumab(IVR) and intravitreal aflibercept(IVA) groups were evaluated separately. RESULTS: The mean CMT decreased in^(th)e 1+PRN(n=101) regimen from 407 to 358 and 340 μm and in^(th)e 3+PRN(n=443) group from 398 to 318 and finally to 310 μm at months 6 and 12, respectively. Anatomically,^(th)e CMT reduction at 6^(th) month(48.5 vs 76.4;P<0.05) was statistically significant in favor of 3+PRN group. BCVA changed in 1+PRN group from 0.77 to 0.78, 0.75 and 0.75;in 3+PRN group from 0.81 to 0.69, 0.72, and 0.76 at months 3, 6, and 12, respectively. Visual gain was statistically better in 3+PRN group at 3^(th) month(-0.01 vs 0.12;P<0.001). In IVR group, CMT reduction was in greater in 3+PRN at 6^(th)(44 vs 72) and 12^(th) month(61 vs 84), but statistically insignificant. The 3+PRN group revealed statistically better visual results at 3^(th) month(-0.02 vs 0.11, P<0.05). In IVA group, although statistically insignificant, CMT reduction(61 vs 89, 6^(th) month;85 vs 97, 12^(th) month) and visual gain(0.02 vs 0.16;0.02 vs 0.14;0.05 vs 0.11) was found in favor of 3+PRN group at all visits.CONCLUSION: The loading dose of anti-VEGF treatments in n AMD leads to significantly better anatomical and functional results, regardless of the agent, specially in early follow-up interval.

The Optimum Dosage Regimen of Intravenous Infusion for Drugs Obeying Parallel First-order and Michaelis-Menten Elimination Kinetics

For drugs obeying parallel first-order and Michaelis-Menten elimination kinetics,mathematical analysis concerning the optimum dosage regimen of intravenous infusion is conducted and following equations are derived:where Xo is the intravenous loading dose,Cb the plasma concentration level desired in clinical therapy,V the apparent distribution volume,k0 the rate constant of intravenouns infusion,K the first－order elimination rate constant,Vm the theoretical maximum rate of the Michaelis－Menten elimination process,Km the Michaelis constant.From this dosage regimen,plasma level maintains a constant Cb during the administration period.When K=0 the dosage regimen above is also suitable for drugs obeying Michaelis-Menten elimination kinetics.

Is a split-dose regimen of 2 L polyethylene glycol plus ascorbic acid tolerable for colonoscopy in an early morning visit to a comprehensive medical check-up?

To evaluate the effectiveness and tolerability of a split-dose 2 L polyethylene glycol (PEG)/ascorbic acid (AA) regimen for healthy examinees who visited for comprehensive medical check-up in the early morning.METHODSFrom February 2015 to March 2015, examinees of average risk who were scheduled for a colonoscopy in the morning were retrospectively enrolled.RESULTSThe 189 examinees were divided into split-dose and non-split-dose groups. The adequacy of bowel preparation for the split-dose group vs the non-split-dose group was 96.8% vs 85.2%, respectively, P < 0.001, and the compliance of the last meal restriction was 74.6% vs 58.2%, respectively, P < 0.001. The sleep disturbance (P < 0.001) was more prevalent in the split-dose group, however the willingness to repeat the same preparation method (P = 0.243) was not different in both groups. The split-dose regimen was the most important factor influencing adequate bowel preparation in multivariate analysis (HR = 10.89, 95%CI: 6.53-18.17, P < 0.001).CONCLUSIONA split-dose regimen of 2 L PEG/AA for an early morning colonoscopy was more effective and showed better compliance for diet restriction without any difference in satisfaction and discomfort. Introducing a split-dose regimen of 2 L PEG/AA to morning colonoscopy examinees is effective and tolerable in a comprehensive medical check-up setting.