Like soldiers,frontline medical staff provide a first line of defense and have played a critical role in responses to the outbreak of coronavirus disease-2019 in December 2019.It is important to acknowledge the consid...Like soldiers,frontline medical staff provide a first line of defense and have played a critical role in responses to the outbreak of coronavirus disease-2019 in December 2019.It is important to acknowledge the considerable pressure placed on frontline medical staff in the face of a new type of coronavirus that is highly infectious and for which no specific treatment is available.Here,we review the various kinds of psychological problems afflicting frontline medical staff who are combatting the severe acute respiratory syndrome epidemic.These include anxiety,insomnia,depression,interpersonal difficulties,and post-traumatic stress disorder syndrome.We further present a summary of countermeasures for alleviating these problems based on our findings.These countermeasures include ensuring the provision of adequate protective gear for frontline medical staff,developing timely and clear guidelines,strengthening social support,and providing clear criteria and additional training,focusing on the choice of frontline medical staff.An understanding of the psychological impacts of an epidemic situation and of relevant countermeasures will contribute to reducing the psychological pressures on frontline medical staff.Consequently,they will be able to cope better with outbreaks of infectious diseases in the future,to reduce the psychological pressure of the front-line medical staff,and to improve the treatment level.展开更多
Background：Vascular endothelial growth factor-targeted agents are standard treatments in advanced clear-cell renal cell carcinoma （ccRCC）,but biomarkers of activity are lacking.The aim of this study was to investig...Background：Vascular endothelial growth factor-targeted agents are standard treatments in advanced clear-cell renal cell carcinoma （ccRCC）,but biomarkers of activity are lacking.The aim of this study was to investigate the association of Von Hippel-Lindau （VHL） gene status,vascular endothelial growth factor receptor （VEGFR） or stem cell factor receptor （KIT） expression,and their relationships with characteristics and clinical outcome of advanced ccRCC.Methods：A total of 59 patients who received targeted treatment with sunitinib or pazopanib were evaluated for determination at Cancer Hospital and Institute,Chinese Academy of Medical Sciences between January 2010 and November 2012.Paraffin-embedded tumor samples were collected and status of the VHL gene and expression of VEGFR and KIT were determined by VHL sequence analysis and immunohistochemistry.Clinical-pathological features were collected and efficacy such as response rate and Median progression-free survival （PFS） and ovcrall survival （OS） were calculated and then compared based on expression status.The Chi-square test,the KaplanMeier method,and the Lon-rank test were used for statistical analyses.Results：Of 59 patients,objective responses were observed in 28 patients （47.5%）.The median PFS was 13.8 months and median OS was 39.9 months.There was an improved PFS in patients with the following clinical features：Male gender,number of metastatic sites 2 or less,VEGFR-2 positive or KIT positive.Eleven patients （18.6%） had evidence of VHL mutation,with an objective response rate of 45.5%,which showed no difference with patients with no VHL mutation （47.9%）.VHL mutation status did not correlate with either overall response rate （P =0.938） or PFS （P =0.277）.The PFS was 17.6 months and 22.2 months in VEGFR-2 positive patients and KIT positive patients,respectively,which was significantly longer than that of VEGFR-2 or KIT negative patients （P =0.026 and P =0.043）.Conclusion：VHL mutation status could not predict the efficacy of sunitinib or pazopanib.Further investigation of VHL/VEGFR pathway components is needed.展开更多
基金Supported by the Jiangsu Maternal and Child Health Research Project,No.F201766the Lianyungang Medical Scientific Project,No.201722.
文摘Like soldiers,frontline medical staff provide a first line of defense and have played a critical role in responses to the outbreak of coronavirus disease-2019 in December 2019.It is important to acknowledge the considerable pressure placed on frontline medical staff in the face of a new type of coronavirus that is highly infectious and for which no specific treatment is available.Here,we review the various kinds of psychological problems afflicting frontline medical staff who are combatting the severe acute respiratory syndrome epidemic.These include anxiety,insomnia,depression,interpersonal difficulties,and post-traumatic stress disorder syndrome.We further present a summary of countermeasures for alleviating these problems based on our findings.These countermeasures include ensuring the provision of adequate protective gear for frontline medical staff,developing timely and clear guidelines,strengthening social support,and providing clear criteria and additional training,focusing on the choice of frontline medical staff.An understanding of the psychological impacts of an epidemic situation and of relevant countermeasures will contribute to reducing the psychological pressures on frontline medical staff.Consequently,they will be able to cope better with outbreaks of infectious diseases in the future,to reduce the psychological pressure of the front-line medical staff,and to improve the treatment level.
文摘Background：Vascular endothelial growth factor-targeted agents are standard treatments in advanced clear-cell renal cell carcinoma （ccRCC）,but biomarkers of activity are lacking.The aim of this study was to investigate the association of Von Hippel-Lindau （VHL） gene status,vascular endothelial growth factor receptor （VEGFR） or stem cell factor receptor （KIT） expression,and their relationships with characteristics and clinical outcome of advanced ccRCC.Methods：A total of 59 patients who received targeted treatment with sunitinib or pazopanib were evaluated for determination at Cancer Hospital and Institute,Chinese Academy of Medical Sciences between January 2010 and November 2012.Paraffin-embedded tumor samples were collected and status of the VHL gene and expression of VEGFR and KIT were determined by VHL sequence analysis and immunohistochemistry.Clinical-pathological features were collected and efficacy such as response rate and Median progression-free survival （PFS） and ovcrall survival （OS） were calculated and then compared based on expression status.The Chi-square test,the KaplanMeier method,and the Lon-rank test were used for statistical analyses.Results：Of 59 patients,objective responses were observed in 28 patients （47.5%）.The median PFS was 13.8 months and median OS was 39.9 months.There was an improved PFS in patients with the following clinical features：Male gender,number of metastatic sites 2 or less,VEGFR-2 positive or KIT positive.Eleven patients （18.6%） had evidence of VHL mutation,with an objective response rate of 45.5%,which showed no difference with patients with no VHL mutation （47.9%）.VHL mutation status did not correlate with either overall response rate （P =0.938） or PFS （P =0.277）.The PFS was 17.6 months and 22.2 months in VEGFR-2 positive patients and KIT positive patients,respectively,which was significantly longer than that of VEGFR-2 or KIT negative patients （P =0.026 and P =0.043）.Conclusion：VHL mutation status could not predict the efficacy of sunitinib or pazopanib.Further investigation of VHL/VEGFR pathway components is needed.
