Objective:We aimed to compare the quality-adjusted time without symptoms or toxicity(Q-TWiST)in acute myeloid leukemia(AML)patients who received haploidentical-related donor(HID)and identical sibling donor(ISD)hematop...Objective:We aimed to compare the quality-adjusted time without symptoms or toxicity(Q-TWiST)in acute myeloid leukemia(AML)patients who received haploidentical-related donor(HID)and identical sibling donor(ISD)hematopoietic stem cell transplantation(HSCT).Methods:Five clinical health states were defined:toxicity(TOX),acute graft-versus-host disease(GVHD),chronic GVHD(cGVHD),time without symptoms and toxicity(TWiST)and relapse(REL).The equation used in this study was as follows:Q-TWiST=UTOX×TOX+UTWiST×TWiST+UREL×REL+UaGVHD×aGVHD+UcGVHD×cGVHD.Results:A total of 239 AML patients were enrolled.We established a mathematical model,i.e.,Q-TWiST HID HSCT>Q-TWiST ISD HSCT,to explore the range of utility coefficients satisfying the inequality.Based on the raw data,the utility coefficient is equivalent to the following inequality:10.57067UTOX-46.27733UREL+105.9374+3.388078UaGVHD-210.8198UcGVHD>0.The model showed that when UTOX,UREL,and UaGVHD were within the range of 0-1,as well as when UcGVHD was within the range of 0-0.569,the inequality Q-TWiST HID HSCT>Q-TWiST ISD HSCT was valid.According to the results of the ChiCTR1800016972 study,the median coefficients of TOX,acute GVHD(aGVHD),and cGVHD were 0.56(0.41-0.76),0.56(0.47-0.72),and 0.54(0.37-0.79),respectively.We selected a series of specific examples of the coefficients,i.e.,UTOX=0.5,UREL=0.05,UaGVHD-0.5,and UcGVHD-0.5.The Q-TWiST values of ISD and HID HSCT were 896 and 900 d,respectively(P=0.470).Conclusions:We first observed that Q-TWiST was comparable between AML patients receiving HID HSCT and those receiving ISD HSCT.展开更多
The toxicity symptoms among 79migrant pesticide workers involved in open-field pesticide application in Oman were studied. Questionnaires addressing the workers＇ demographics, pesticide use and practices, use of prot...The toxicity symptoms among 79migrant pesticide workers involved in open-field pesticide application in Oman were studied. Questionnaires addressing the workers＇ demographics, pesticide use and practices, use of protective devices, disposal of empty containers, storage of pesticides and self-reported poisoning symptoms were administered face-to-face to the workers before commencement of work, during break or at home. A total of 28 toxicity symptoms were reported, skin rash being the symptom reported by a majority of the workers （78%）, followed by increased salivation （68%）. The gravity of toxicity symptoms was attributed principally to the non-use of protective devices during pesticide spraying. Other factors contributing to poisoning were the workers＇ poor post-application sanitation habits, improper disposal of empty pesticide containers and storage of partially used pesticides in bedrooms. In order to reduce the incidents of poisoning among the agropesticide workers, there is a need to educate them about the benefits of using PPE （personal protective equipment） and ensuring that they adopt good hygiene and sanitation habits at all stages of pesticide handling.展开更多
目的:探讨耐多药结核病(multidrug-resistant tuberculosis,MDR-TB)患者环丝氨酸相关性药物不良反应(adverse drug reactions,ADRs)的发生情况及其临床特点,为临床MDR-TB患者环丝氨酸的用药安全提供参考。方法:选取2018年1月1日—2021...目的:探讨耐多药结核病(multidrug-resistant tuberculosis,MDR-TB)患者环丝氨酸相关性药物不良反应(adverse drug reactions,ADRs)的发生情况及其临床特点,为临床MDR-TB患者环丝氨酸的用药安全提供参考。方法:选取2018年1月1日—2021年12月31日苏州市第五人民医院收治的182例MDR-TB患者作为研究对象,采集患者的年龄、性别、职业、结核病类型、治疗结局、环丝氨酸的使用情况及其相关ADRs的发生情况等信息,着重分析MDR-TB患者环丝氨酸相关性ADRs的发生情况和临床特点。结果:182例MDR-TB患者排除失访、死亡和未使用环丝氨酸的患者后仅剩167例,其中治疗成功的有134例,治疗成功率为80.24%;167例患者中,发生ADRs的有10例,发生率为5.99%;诺氏评估量表显示,10例ADRs与环丝氨酸的关联性评分均为5~8分,即关联性为“很可能”;10例ADRs的发生时间为用药后的4~361 d(中位数值为67.5 d),而其临床表现均为中枢神经毒性症状(如自杀倾向、精神错乱、重度失眠、焦虑、抑郁、嗜睡等);通过停用环丝氨酸或加大维生素B6用药量,10例患者的中枢神经毒性症状均缓解或消失。结论:含环丝氨酸抗结核治疗方案对MDR-TB患者的疗效较好,同时环丝氨酸相关性中枢神经毒性症状的发生率相对较低,但其症状表现较为严重,因此临床在对患者开展用药宣教时应交代明确,以保障患者的用药安全。展开更多
目的观察艾灸联合健胃止呕方穴位贴敷辅助治疗胃肠道恶性肿瘤患者化疗相关性恶心呕吐(CINV)的效果。方法采用随机数字表法将2021年9月至2024年6月接受化疗的92例胃肠道恶性肿瘤患者分为观察组46例(后脱落1例)和对照组46例。对照组化疗...目的观察艾灸联合健胃止呕方穴位贴敷辅助治疗胃肠道恶性肿瘤患者化疗相关性恶心呕吐(CINV)的效果。方法采用随机数字表法将2021年9月至2024年6月接受化疗的92例胃肠道恶性肿瘤患者分为观察组46例(后脱落1例)和对照组46例。对照组化疗前予阿扎司琼、倍他米松、甲氧氯普胺治疗,观察组在此基础上提前1 d加用艾灸及健胃止呕方穴位贴敷治疗。比较2组患者化疗前及化疗后24、48、72 h Karnofsky评分、中医症候积分、恶心呕吐指数评估量表(R-INVR)评分、简单厌食量表评分以及化疗不良反应发生情况。结果化疗24、48 h后,2组Karanofsky评分均较治疗前下降,对照组下降更明显(P<0.01);化疗72 h后对照组Karanofsky评分较化疗前下降,观察组无明显变化,且观察组高于对照组(P<0.01)。化疗24、48、72 h后2组中医症候积分总体均较化疗前升高,但观察组相对更低(P<0.01)。观察组化疗后24、48及72 h R-INVR评分低于对照组,简单厌食量表评分均高于对照组(P<0.01)。2组患者化疗后骨髓抑制、肝肾功能损伤发生率比较差异无统计学意义(P>0.05)。结论艾灸联合健胃止呕方穴位贴敷辅助治疗可有效缓解胃肠道恶性肿瘤患者CINV症状。展开更多
基金supported by the Key Program of the National Natural Science Foundation of China(No.81930004)the National Natural Science Foundation of China(No.82170208)+2 种基金Tongzhou District Distinguished Young Scholars(No.JCQN2023009)Plan Project of Tongzhou Municipal Science and Technology(No.KJ2024CX045)Beijing Natural Science Foundation(No.Z230016)。
文摘Objective:We aimed to compare the quality-adjusted time without symptoms or toxicity(Q-TWiST)in acute myeloid leukemia(AML)patients who received haploidentical-related donor(HID)and identical sibling donor(ISD)hematopoietic stem cell transplantation(HSCT).Methods:Five clinical health states were defined:toxicity(TOX),acute graft-versus-host disease(GVHD),chronic GVHD(cGVHD),time without symptoms and toxicity(TWiST)and relapse(REL).The equation used in this study was as follows:Q-TWiST=UTOX×TOX+UTWiST×TWiST+UREL×REL+UaGVHD×aGVHD+UcGVHD×cGVHD.Results:A total of 239 AML patients were enrolled.We established a mathematical model,i.e.,Q-TWiST HID HSCT>Q-TWiST ISD HSCT,to explore the range of utility coefficients satisfying the inequality.Based on the raw data,the utility coefficient is equivalent to the following inequality:10.57067UTOX-46.27733UREL+105.9374+3.388078UaGVHD-210.8198UcGVHD>0.The model showed that when UTOX,UREL,and UaGVHD were within the range of 0-1,as well as when UcGVHD was within the range of 0-0.569,the inequality Q-TWiST HID HSCT>Q-TWiST ISD HSCT was valid.According to the results of the ChiCTR1800016972 study,the median coefficients of TOX,acute GVHD(aGVHD),and cGVHD were 0.56(0.41-0.76),0.56(0.47-0.72),and 0.54(0.37-0.79),respectively.We selected a series of specific examples of the coefficients,i.e.,UTOX=0.5,UREL=0.05,UaGVHD-0.5,and UcGVHD-0.5.The Q-TWiST values of ISD and HID HSCT were 896 and 900 d,respectively(P=0.470).Conclusions:We first observed that Q-TWiST was comparable between AML patients receiving HID HSCT and those receiving ISD HSCT.
文摘The toxicity symptoms among 79migrant pesticide workers involved in open-field pesticide application in Oman were studied. Questionnaires addressing the workers＇ demographics, pesticide use and practices, use of protective devices, disposal of empty containers, storage of pesticides and self-reported poisoning symptoms were administered face-to-face to the workers before commencement of work, during break or at home. A total of 28 toxicity symptoms were reported, skin rash being the symptom reported by a majority of the workers （78%）, followed by increased salivation （68%）. The gravity of toxicity symptoms was attributed principally to the non-use of protective devices during pesticide spraying. Other factors contributing to poisoning were the workers＇ poor post-application sanitation habits, improper disposal of empty pesticide containers and storage of partially used pesticides in bedrooms. In order to reduce the incidents of poisoning among the agropesticide workers, there is a need to educate them about the benefits of using PPE （personal protective equipment） and ensuring that they adopt good hygiene and sanitation habits at all stages of pesticide handling.
文摘目的观察艾灸联合健胃止呕方穴位贴敷辅助治疗胃肠道恶性肿瘤患者化疗相关性恶心呕吐(CINV)的效果。方法采用随机数字表法将2021年9月至2024年6月接受化疗的92例胃肠道恶性肿瘤患者分为观察组46例(后脱落1例)和对照组46例。对照组化疗前予阿扎司琼、倍他米松、甲氧氯普胺治疗,观察组在此基础上提前1 d加用艾灸及健胃止呕方穴位贴敷治疗。比较2组患者化疗前及化疗后24、48、72 h Karnofsky评分、中医症候积分、恶心呕吐指数评估量表(R-INVR)评分、简单厌食量表评分以及化疗不良反应发生情况。结果化疗24、48 h后,2组Karanofsky评分均较治疗前下降,对照组下降更明显(P<0.01);化疗72 h后对照组Karanofsky评分较化疗前下降,观察组无明显变化,且观察组高于对照组(P<0.01)。化疗24、48、72 h后2组中医症候积分总体均较化疗前升高,但观察组相对更低(P<0.01)。观察组化疗后24、48及72 h R-INVR评分低于对照组,简单厌食量表评分均高于对照组(P<0.01)。2组患者化疗后骨髓抑制、肝肾功能损伤发生率比较差异无统计学意义(P>0.05)。结论艾灸联合健胃止呕方穴位贴敷辅助治疗可有效缓解胃肠道恶性肿瘤患者CINV症状。
