BACKGROUND The advent of molecular targeted agents and immune checkpoint inhibitors has greatly improved the treatment of advanced renal cell carcinoma(RCC), thus significantly improving patient survival. The incidenc...BACKGROUND The advent of molecular targeted agents and immune checkpoint inhibitors has greatly improved the treatment of advanced renal cell carcinoma(RCC), thus significantly improving patient survival. The incidence of rare drug-related adverse events has gained increased attention.CASE SUMMARY We report a patient with advanced RCC treated with multiple lines of molecular targeted agents and immune checkpoint inhibitors, who developed a pulmonary infection after treatment with everolimus in combination with lenvatinib. Determining the pathogenic organism was difficult, but it was eventually identified as Pneumocystis jirovecii by next-generation sequencing(NGS) of bronchoscopic alveolar lavage fluid(BALF) and successfully treated with trimethoprim-sulfamethoxazole.CONCLUSION Rare pulmonary infections caused by molecular targeted agents are not uncommon in clinical practice, but their diagnosis is difficult. Evaluating BALF with NGS is a good method for rapid diagnosis of such infections.展开更多
背景慢性萎缩性胃炎为临床常见疾病,其病因及发病机制较为复杂,不仅与某些病理因素有关,个体对疾病的认知水平、心理状态、健康行为方式等也与之有关.从心理学角度来讲,适当的心理管理在疾病管理中的意义显著,尤其是在慢性疾病管理中的...背景慢性萎缩性胃炎为临床常见疾病,其病因及发病机制较为复杂,不仅与某些病理因素有关,个体对疾病的认知水平、心理状态、健康行为方式等也与之有关.从心理学角度来讲,适当的心理管理在疾病管理中的意义显著,尤其是在慢性疾病管理中的效果值得肯定.本研究以同伴支持教育为主要干预手段,分析其对慢性萎缩性胃炎患者健康行为及生活质量的影响.目的探讨同伴支持教育对慢性萎缩性胃炎(chronic atrophic gastritis,CAG)患者健康行为及生活质量的影响.方法选择2017-01/2017-12符合标准的CAG患者107例为研究对象,采用随机数字表法分为干预组55例、对照组52例.对照组给予包括疾病认知、健康行为、并发症预防等在内的常规健康教育,干预组联合应用同伴支持教育.随访6 mo,比较两组患者健康行为、生活质量、健康教育满意度等指标.结果干预组CAG患者合理膳食、运动锻炼、情绪控制、戒烟戒酒达标率明显高于对照组(87.27%vs 71.15%,89.09%vs 73.08%,85.45%vs 69.23%,89.09%vs 71.15%,χ2=4.252,4.510,4.044,5.4582,P<0.05);生理职能、总体健康、活力、社会功能、情感职能、精神健康评分明显高于对照组(76.62±8.21 vs 70.10±8.32,67.45±7.26 vs 61.24±7.32,70.12±8.23 vs 62.45±7.41,82.45±8.36 vs 76.45±8.45,73.12±8.42 v s 65.12±7.56,72.65±8.22 v s 64.78±8.34,t=4.079,4.405,5.056,3.691,5.161,4.915,P<0.05),健康教育满意度96.36%明显高于对照组84.62%(χ2=4.354,P<0.05).结论同伴支持教育更容易被CAG患者所接受,有助于促进患者健康行为方式的养成,进而改善患者生活质量.展开更多
文摘BACKGROUND The advent of molecular targeted agents and immune checkpoint inhibitors has greatly improved the treatment of advanced renal cell carcinoma(RCC), thus significantly improving patient survival. The incidence of rare drug-related adverse events has gained increased attention.CASE SUMMARY We report a patient with advanced RCC treated with multiple lines of molecular targeted agents and immune checkpoint inhibitors, who developed a pulmonary infection after treatment with everolimus in combination with lenvatinib. Determining the pathogenic organism was difficult, but it was eventually identified as Pneumocystis jirovecii by next-generation sequencing(NGS) of bronchoscopic alveolar lavage fluid(BALF) and successfully treated with trimethoprim-sulfamethoxazole.CONCLUSION Rare pulmonary infections caused by molecular targeted agents are not uncommon in clinical practice, but their diagnosis is difficult. Evaluating BALF with NGS is a good method for rapid diagnosis of such infections.
文摘背景慢性萎缩性胃炎为临床常见疾病,其病因及发病机制较为复杂,不仅与某些病理因素有关,个体对疾病的认知水平、心理状态、健康行为方式等也与之有关.从心理学角度来讲,适当的心理管理在疾病管理中的意义显著,尤其是在慢性疾病管理中的效果值得肯定.本研究以同伴支持教育为主要干预手段,分析其对慢性萎缩性胃炎患者健康行为及生活质量的影响.目的探讨同伴支持教育对慢性萎缩性胃炎(chronic atrophic gastritis,CAG)患者健康行为及生活质量的影响.方法选择2017-01/2017-12符合标准的CAG患者107例为研究对象,采用随机数字表法分为干预组55例、对照组52例.对照组给予包括疾病认知、健康行为、并发症预防等在内的常规健康教育,干预组联合应用同伴支持教育.随访6 mo,比较两组患者健康行为、生活质量、健康教育满意度等指标.结果干预组CAG患者合理膳食、运动锻炼、情绪控制、戒烟戒酒达标率明显高于对照组(87.27%vs 71.15%,89.09%vs 73.08%,85.45%vs 69.23%,89.09%vs 71.15%,χ2=4.252,4.510,4.044,5.4582,P<0.05);生理职能、总体健康、活力、社会功能、情感职能、精神健康评分明显高于对照组(76.62±8.21 vs 70.10±8.32,67.45±7.26 vs 61.24±7.32,70.12±8.23 vs 62.45±7.41,82.45±8.36 vs 76.45±8.45,73.12±8.42 v s 65.12±7.56,72.65±8.22 v s 64.78±8.34,t=4.079,4.405,5.056,3.691,5.161,4.915,P<0.05),健康教育满意度96.36%明显高于对照组84.62%(χ2=4.354,P<0.05).结论同伴支持教育更容易被CAG患者所接受,有助于促进患者健康行为方式的养成,进而改善患者生活质量.
