Objective：To explore the effect of Chinese drugs for supporting essence and strengthening Pi（脾, SESP） combining with chemotherapy on the quality of life（QOL） in the children with solid tumor.Methods：Using a dig...Objective：To explore the effect of Chinese drugs for supporting essence and strengthening Pi（脾, SESP） combining with chemotherapy on the quality of life（QOL） in the children with solid tumor.Methods：Using a digital table,146 children with solid tumor were randomized into two groups,77 in the control group and 69 in the treated group.They received conventional chemotherapy,but to the patients in the treated group,SESP were administered additionally.The patients＇ scores of QOL and adverse reaction occurred were compared. Results：The states in the treated group were superior to those in the control group.Statistical analysis showed that in the first year,the two groups were different in terms of somatic function,systemic symptoms,and general status（P〈0.05） and also in the occurrence of adverse reaction（P〈0.01）.In the second year,the difference was shown in aspects of somatic function and adverse reaction occurrence（P〈0.05）.Conclusion：Chinese drugs for SESP combining with chemotherapy could raise tumor patients＇ QOL by improving their somatic function and clinical symptoms.展开更多
Background： Cardiotoxicity is one of the most serious chronic complications ofanthracyclines therapy. Assessment of the left ventricular ejection fraction （LVEF） fails to detect subtle cardiac dysfunction of left v...Background： Cardiotoxicity is one of the most serious chronic complications ofanthracyclines therapy. Assessment of the left ventricular ejection fraction （LVEF） fails to detect subtle cardiac dysfunction of left ventricular （LV）. This study aimed to detect and evaluate new parameters of subclinical anthracyclines＇ cardiotoxicity in children with solid tumor. Methods： A detailed echocardiographic examination was performed in 36 children with hepatoblastoma or rhabdomyosarcoma after receiving anthracyclines＇ chemotherapy and 36 healthy controls from January 2015 to December 2016. The LVEF, ratio of early diastolic peak velocity of transmitral flow （E） and septal diastolic e＇ mitral annular peak velocity （e＇）, tricuspid annular plane systolic excursion （TAPSE）, and LV global longitudinal strain （GLS） were evaluated using M-mode, tissue Doppler imaging （TDI）, and two-dimensional speckle tracking echocardiography （2D-STE）, respectively. Echocardiographic parameters were compared between patient group and healthy controls. All patients were divided into two subgroups based on their anthracyclines＇ cumulative dosage （〈300 mg/m^2 subgroup and ≥300 mg/m^2 subgroup）. Results： All patients had no presentation of heart failure and LVEF within normal range （65.7 ± 5.1%）. Compared with healthy controls, the mean E/e＇ increased significantly （7.9 ±0.7 vs. 10.2 ± 3.5, t = 3.72, P 〈 0.01 ）, mean TAPSE decreased significantly （ 17.2 ± 1.3 mm vs. 14.2 ± 3.0 mm, t = -4.03, P 〈 0.01）, and mean LV GLS decreased significantly （-22.2% ± 1.9% vs. -17.9% ± 2.9%, t = -5.58, P 〈 0.01） in patient group. Compared with subgroup with anthracyclines＇ cumulative dosage 〈 300 mg/m^2, mean LV GLS decreased significantly （- 18.7 ＋ 2.7% vs. - 16.5 ~ 2. 1%, t = 2.15, P = 0.04）, the mean E/e＇ increased significantly （9.1 ±1.5 vs. 11.5 ± 4.9, t = -2.17, P = 0.04）, and mean TAPSE decreased significantly （14.2±2.1 mm vs. 12.5±2.2 mm, t = -2.82, P = 0.02） in subgroup with anthracyclines＇ cumulative dosage 〉300 mg/m^2. Conclusions： LV GLS is helpful in the early detection of subclinical LV dysfunction using 2D-STE. E/e＇ and TAPSE are other sensitive parameters in detecting subclinical cardiac dysfunction of both ventricles by TD1. These parameters show significant change with different anthracyclines＇ cumulative dosage, so cumulative dosage should be controlled in clinical treatment.展开更多
目的观察铂类药物在实体瘤儿童化疗过程中对听力的影响,考察铂类化疗药导致听力损伤的相关危险因素。方法回顾性分析于2014年1月至2015年4月在北京儿童医院血液肿瘤中心进行化疗的实体瘤儿童临床资料,所有患儿化疗过程中均使用铂类化疗...目的观察铂类药物在实体瘤儿童化疗过程中对听力的影响,考察铂类化疗药导致听力损伤的相关危险因素。方法回顾性分析于2014年1月至2015年4月在北京儿童医院血液肿瘤中心进行化疗的实体瘤儿童临床资料,所有患儿化疗过程中均使用铂类化疗药,分别在第1、3、6次化疗前进行规范听力学检查,包括纯音测听、畸变产物耳声发射和听性脑干反应。结果共纳入0.2-12.5岁实体瘤患儿47名,共计94耳,进行化疗的平均次数为5.4次(3-10次)。ABR检查中以任意一耳听阈大于30d B n HL为听力损伤,第6疗程听力异常发生率为6.4%(6/94),与基线水平对比,差异有统计学意义(p<0.05)。第3、6疗程ABR阈值与基线水平相比,ABR阈值明显升高,均有显著统计学差异(p<0.001);PTA检查中第6疗程6k Hz、8k Hz测听结果与基线水平相比均有统计学差异(p<0.05),相应阈值明显提高;DOPAE提示第6疗程6k Hz、8k Hz,通过率明显下降,与基线水平比较有显著统计学差异。Logistic回归模型中年龄是铂类药物耳毒性的危险因素,(p<0.05,OR值=0.912),提示年龄越小铂类药物的耳毒性越易显现。结论铂类药物用于儿童实体肿瘤化疗可引起听力损伤,在高频部分(6-8 k Hz)尤为显著。DOPAE、纯音测听及ABR可作为监测、评价铂类药物耳毒性的重要指标。儿童年龄越低则铂类药物引起听力损伤的危险越大,低龄儿童使用铂类药物时更需加强听力监测。展开更多
文摘Objective：To explore the effect of Chinese drugs for supporting essence and strengthening Pi（脾, SESP） combining with chemotherapy on the quality of life（QOL） in the children with solid tumor.Methods：Using a digital table,146 children with solid tumor were randomized into two groups,77 in the control group and 69 in the treated group.They received conventional chemotherapy,but to the patients in the treated group,SESP were administered additionally.The patients＇ scores of QOL and adverse reaction occurred were compared. Results：The states in the treated group were superior to those in the control group.Statistical analysis showed that in the first year,the two groups were different in terms of somatic function,systemic symptoms,and general status（P〈0.05） and also in the occurrence of adverse reaction（P〈0.01）.In the second year,the difference was shown in aspects of somatic function and adverse reaction occurrence（P〈0.05）.Conclusion：Chinese drugs for SESP combining with chemotherapy could raise tumor patients＇ QOL by improving their somatic function and clinical symptoms.
文摘Background： Cardiotoxicity is one of the most serious chronic complications ofanthracyclines therapy. Assessment of the left ventricular ejection fraction （LVEF） fails to detect subtle cardiac dysfunction of left ventricular （LV）. This study aimed to detect and evaluate new parameters of subclinical anthracyclines＇ cardiotoxicity in children with solid tumor. Methods： A detailed echocardiographic examination was performed in 36 children with hepatoblastoma or rhabdomyosarcoma after receiving anthracyclines＇ chemotherapy and 36 healthy controls from January 2015 to December 2016. The LVEF, ratio of early diastolic peak velocity of transmitral flow （E） and septal diastolic e＇ mitral annular peak velocity （e＇）, tricuspid annular plane systolic excursion （TAPSE）, and LV global longitudinal strain （GLS） were evaluated using M-mode, tissue Doppler imaging （TDI）, and two-dimensional speckle tracking echocardiography （2D-STE）, respectively. Echocardiographic parameters were compared between patient group and healthy controls. All patients were divided into two subgroups based on their anthracyclines＇ cumulative dosage （〈300 mg/m^2 subgroup and ≥300 mg/m^2 subgroup）. Results： All patients had no presentation of heart failure and LVEF within normal range （65.7 ± 5.1%）. Compared with healthy controls, the mean E/e＇ increased significantly （7.9 ±0.7 vs. 10.2 ± 3.5, t = 3.72, P 〈 0.01 ）, mean TAPSE decreased significantly （ 17.2 ± 1.3 mm vs. 14.2 ± 3.0 mm, t = -4.03, P 〈 0.01）, and mean LV GLS decreased significantly （-22.2% ± 1.9% vs. -17.9% ± 2.9%, t = -5.58, P 〈 0.01） in patient group. Compared with subgroup with anthracyclines＇ cumulative dosage 〈 300 mg/m^2, mean LV GLS decreased significantly （- 18.7 ＋ 2.7% vs. - 16.5 ~ 2. 1%, t = 2.15, P = 0.04）, the mean E/e＇ increased significantly （9.1 ±1.5 vs. 11.5 ± 4.9, t = -2.17, P = 0.04）, and mean TAPSE decreased significantly （14.2±2.1 mm vs. 12.5±2.2 mm, t = -2.82, P = 0.02） in subgroup with anthracyclines＇ cumulative dosage 〉300 mg/m^2. Conclusions： LV GLS is helpful in the early detection of subclinical LV dysfunction using 2D-STE. E/e＇ and TAPSE are other sensitive parameters in detecting subclinical cardiac dysfunction of both ventricles by TD1. These parameters show significant change with different anthracyclines＇ cumulative dosage, so cumulative dosage should be controlled in clinical treatment.
文摘目的观察铂类药物在实体瘤儿童化疗过程中对听力的影响,考察铂类化疗药导致听力损伤的相关危险因素。方法回顾性分析于2014年1月至2015年4月在北京儿童医院血液肿瘤中心进行化疗的实体瘤儿童临床资料,所有患儿化疗过程中均使用铂类化疗药,分别在第1、3、6次化疗前进行规范听力学检查,包括纯音测听、畸变产物耳声发射和听性脑干反应。结果共纳入0.2-12.5岁实体瘤患儿47名,共计94耳,进行化疗的平均次数为5.4次(3-10次)。ABR检查中以任意一耳听阈大于30d B n HL为听力损伤,第6疗程听力异常发生率为6.4%(6/94),与基线水平对比,差异有统计学意义(p<0.05)。第3、6疗程ABR阈值与基线水平相比,ABR阈值明显升高,均有显著统计学差异(p<0.001);PTA检查中第6疗程6k Hz、8k Hz测听结果与基线水平相比均有统计学差异(p<0.05),相应阈值明显提高;DOPAE提示第6疗程6k Hz、8k Hz,通过率明显下降,与基线水平比较有显著统计学差异。Logistic回归模型中年龄是铂类药物耳毒性的危险因素,(p<0.05,OR值=0.912),提示年龄越小铂类药物的耳毒性越易显现。结论铂类药物用于儿童实体肿瘤化疗可引起听力损伤,在高频部分(6-8 k Hz)尤为显著。DOPAE、纯音测听及ABR可作为监测、评价铂类药物耳毒性的重要指标。儿童年龄越低则铂类药物引起听力损伤的危险越大,低龄儿童使用铂类药物时更需加强听力监测。
