Treatment Free Intervals after Subsequent Chemotherapy Lines in Recurrent Ovarian Cancer

Aim: Despite recent advances in the treatment of ovarian cancer, recurrence of the disease is still frequent. This study evaluated whether multiple lines of chemotherapy have impact on overall survival (OS), progression free survival (PFS) or on treatment free intervals (TFIs) after serial chemotherapy lines in recurrent settings. Methods: A total of 189 patients with ovarian cancer (including fallopian tube and primary peritoneal cancer), who were treated in Kuopio University Hospital in Finland during 2009-2014, were enrolled. The medical files of these patients were retrospectively reviewed. Results: Median OS and PFS were significantly higher at the time of the first relapse compared to subsequent relapses (p < 0.001). TFIs shortened significantly after the first relapse (p < 0.001). The differences in TFIs were also seen when comparing platinum sensitive, semi-sensitive and platinum resistant patients. The total amount of TFI times during the whole follow-up time was significantly reduced in those patients that received at least one form of aggressive care at the end of life (p = 0.004). Conclusions: Ovarian cancer patients received often multiple lines of chemotherapy. TFIs after subsequent chemotherapy lines decreased during the disease course. More efforts should be taken to avoid unnecessary and ineffective treatments especially in recurrent phase of the disease.

Prevalence of Congenital Heart Disease at Extremely High Altitudes in Tibet and the Establishment of a New Free Treatment Model

Background: This study aimed to illustrate the prevalence of CHD by screening children in extremely high-altitudeareas (over 4000 m to even 5000 m above sea level) and explore an aid model for early diagnosis and treatmentfor the Tibetan population. Methods: A total of 2242 students from different schools in Ngamring County,Xigaze City, Tibet from September 2019 to September 2020 were selected for screening. The students were examinedthrough the inquiry of their current medical history and family history, cardiac auscultation and a physicalexamination, in order to screen out the suspected cases of CHD, and then the suspected cases were confirmed bycardiac color ultrasound examinations. After that, positive patients were be transferred to Shandong Province forfree treatment. Results: The prevalence of CHD among children in Ngamring County was 3.70% (83 cases),which is the highest incidence rate ever reported. The most common type of CHD was patent ductus arteriosus(PDA), accounting for 55.42% of the total number of cases screened, followed by atrial septal defect (ASD) andventricular septal defect (VSD), accounting for 28.92% and 12.05%, respectively. The prevalence of CHD in childrenat high altitude was significantly higher than that in children at low altitude. The children with CHD weretransferred to Shandong Province for surgery, the operations were successful and their recoveries went well.Conclusions: The results show that high altitude is closely related to the prevalence of CHD, and the incidencein Ngamring County is much higher than that in previous reports.

Chrome free surface treatments for galvanized steels—present and future

As the galvanized steels used for electrical and office appliances has achieved a complete chrome-free production worldwide,surface treatment technologies have entered a new phase of development.Grenter effort will be made in exploring new frontier for future surface treatment technologies.A greater contribution will be made for environmental protection,energy-saving and resource-saving,to prevent globalwarming.

复方红豆杉胶囊维持治疗气虚痰瘀证晚期非小细胞肺癌的多中心、大样本、前瞻性队列研究

目的:探讨复方红豆杉胶囊维持治疗气虚痰瘀证晚期非小细胞肺癌(non-small cell lung cancer,NSCLC)的临床疗效和安全性。方法:采用多中心、大样本、前瞻性队列研究方法,纳入一线化疗4~6周期后疗效评价疾病稳定以上进入维持治疗阶段患者,根据患者意愿分为治疗组160例,对照组109例。对照组根据鳞癌和非鳞癌分别给予吉西他滨和培美曲塞单药化疗维持治疗,治疗组给予复方红豆杉胶囊维持治疗。均以21天为1个疗程,两组干预至少2个疗程,每周期进行生活质量评价,每2疗程进行影像学疗效评价。比较两组疾病无进展生存时间(progression-free survival time,PFS)、生活质量,同时进行药物安全性评价。结果:269例入组患者中,246例患者出现PFS终点事件(91.45%),其中治疗组145例,中位PFS为106天,对照组101例,中位PFS为120天,两组PFS比较差异无统计学意义(P>0.05)。采用美国肺癌生存质量量表(FACT-L4.0版)和欧洲五维健康量表中视觉模拟量表(EQ-5D-VAS)对两组患者生活质量评分进行比较,两种生活质量评价量表均提示治疗组较对照组在提高生活质量方面存在优势(P<0.05)。治疗期间两组共有19例患者出现ADR,治疗组7例(占治疗组人数4.38%),对照组12例(占对照组人数11.01%),ADR发生率在治疗组中更低,尤其表现在骨髓抑制不良反应的发生率方面。结论:在延长PFS方面,复方红豆杉胶囊维持治疗气虚痰瘀证晚期NSCLC的疗效非劣于现代医学单药维持化疗,且在高生活质量、低不良反应方面,复方红豆杉胶囊更具有一定优势。

A comparative study between flattening filter-free beams and flattening filter beams in radiotherapy treatment

Flattening filter-free(FFF) beams generated by medical linear particle accelerators(linacs) have recently been used in radiotherapy clinical practice.FFF beams have fundamental physical parameter differences with respect to standard flattening filter(FF) beams,such that the generally used dosimetric parameters and definitions are not always viable.This study investigates dosimetric parameters for use in the quality assurance of FFF beams generated by medical linacs in radiotherapy.The main characteristics of the photon beams are analyzed using specific data generated by a Varian True Beam linac having both FFF and FF beams of 6 and 10 MV(megavolt) energy,respectively.Definitions for dose profile parameters are suggested,starting from the renormalization of the FFF with respect to the corresponding FF beam.From this point,the flatness concept is translated into one of "un-flatness",and other definitions are proposed,maintaining a strict parallelism between FFF and FF parameter concepts.The quality controls used in establishing a quality assurance program when introducing FFF beams into the clinical environment are given,maintaining similarity to those used for standard FF beams,and recommendations for the introduction of FFF beams into clinical radiotherapy application for breast cancer patients are provided as an example for comparison between FFF and FF for dose distribution and coverage for a target volume.Although there are many advantages of using a FFF beam,especially for advanced radiotherapy techniques,there are a few limitations(e.g.,using a relatively higher energy photon beam for stereotactic radiotherapy(SRT),limited speed of current multileaf collimators(MLCs),and off-axis distance-dependent modulation in intensitymodulated radiation therapy(IMRT)) as well as challenges(e.g.,criteria for beam quality evaluation and penumbra,establishment of dosimetry methods,and consequences of photon target burn-up) that need to be addressed for establishing the FFF beam as a viable alternative to the FF beam.

硫酸镁辅助镇痛效果及在无阿片类药物麻醉方案中的应用前景

在疼痛治疗过程中为了减少阿片药物的应用,已经尝试引入辅助镇痛剂。越来越多的数据表明N-甲基-D-天冬氨酸(NMDA)受体拮抗剂可能具有增强阿片样物质的镇痛作用,诸多研究显示硫酸镁的辅助镇痛作用在疼痛治疗和围手术期麻醉方面表现出很好的应用前景。硫酸镁应用于疼痛治疗的药理学机制主要是其具有NMDA偶联通道的生理电压依赖性阻断剂的作用,其抗伤害性作用与镁阻断钙内流,从而抑制中枢敏感化并降低先前存在的痛觉过敏有关。该文综述硫酸镁在围手术期应用的现状,主要介绍硫酸镁静脉给药、鞘内给药、局部给药的辅助镇痛效果和减少阿片类药物消耗作用,以及在无阿片类药物麻醉方案中的作用及应用前景。

基于医院信息系统重塑药物临床试验院内结算流程的实践

目的:基于医院信息系统(HIS)改造,实现药物临床试验项目费用院内自动结算。方法:在梳理HIS现有医嘱闭环管理的基础上,分析临床试验结算关键节点并改造优化,连通财务系统和HIS,实现临床试验医嘱执行时自动校验专项经费并即时结算。结果:该方案充分利用现有系统和流程,优化了临床试验组套维护工作,实现了临床试验医嘱权限精细化管理和药物临床试验数据全流程追溯,提高了临床试验经费管理效率。结论:基于HIS的药物临床试验院内结算流程改造,达到了受试者、研究者、管理者三方满意,具有良好的推广和应用价值。

随钻式含油钻屑无害化循环利用技术研究

废弃油基及合成基(气制油)钻井液钻屑资源回收价值高,再生循环利用技术处理含油钻屑,不仅具有经济价值,还具有明显的环境效益。针对含油岩屑特性,基于回收废水和回收基液性能、固体废渣检测和经济性评价,对撬装随钻式含油钻屑热降解循环利用装置进行评价。现场应用研究表明,使用撬装式多回程电磁加热解析技术处理含油钻屑,可以实现含油钻屑减量化、无害化和资源化,从而实现连续生产,解决了随钻含油钻屑处置及资源化利用技术难题。

INFLUENCES OF ACID POST-TREATMENT ON THE MORPHOLOGY OF SOAP-FREE P(MMA-EA-MAA)PARTICLES PREPARED BY SEEDED EMULSION POLYMERIZATION

Soap-free poly（methyl methacrylate-ethyl acrylate-methacrylic acid） latex particles with narrow size distribution were synthesized by seeded emulsion polymerization, and the porous particles were created by a stepwise alkali/acid treatment method. Effects of acid treatment conditions on the particle morphology were investigated. Results show that one to three pores were formed inside most of particles after post-treatment. At pH 7.0, when the treatment temperature was lower than 70℃, the size of particles and the volume of pores remained almost unchanged, and these two values increased significantly when the temperature was higher than 70℃. Both the particle size and the pore volume decreased with the increase of initial pH value and treatment time in the acid treatment. As the pH was below 4.0 and the treatment time was longer than 180 min, the particles shrunk in size.

食品用复合软包装设计教学方法研究

本课程进行了整体设计和课程思政融入设计,阐释在食品用复合软包装整个生命周期中的绿色环保举措,提升学生知识-能力-价值协同能力。通过该课程过程性评价可见该模式的教学成效显著,实现了既定目标。提升食品安全是重要的民生问题,更是包装人的使命,包装类课程以思政和使命为引领的系统设计和绿色理念的引入至关重要。

1例重度牙周炎患者牙周种植联合治疗5年观察

Ⅳ期C级牙周炎是临床上分期分级最严重的牙周炎类型,这类患者常伴有牙列缺损与软硬组织缺损,需要联合多学科针对病情设计个性化治疗方案。本文报道1例广泛型Ⅳ期C级牙周炎患者的序列治疗全过程,包括病情分析、治疗的个性化设计、多学科联合手术过程、支持治疗以及5年随访观察。

丙烯酸酯类无氟防污整理剂的合成及在羊毛织物上的应用

为提升羊毛织物的防污性能,首先采用酸性蛋白酶对织物进行预处理来增加粗糙度,然后以甲基丙烯酰氧丙基三(三甲基硅氧烷基)硅烷(M3T)与甲基丙烯酸十八烷酯(SMA)为功能单体,合成无氟防污整理剂MS,并将其应用于羊毛织物的防污整理。整理后织物的水接触角由118.6°提高为150.5°,花生油润湿时间由4 s提高至3 min,具有良好的防水性能与防油污性能,且整理后织物经20次洗涤后接触角仍有141.7°,经过3000次摩擦后接触角为139.7°,具有良好的耐洗性与耐摩擦性。

头颈癌治疗诱发的淋巴水肿:临床因素和预后分析

目的:探讨头颈部恶性肿瘤患者淋巴水肿的严重程度与其相关临床数据之间的关系。方法:对接受多模式治疗的79例头颈癌患者进行回顾性研究。基于术后6个月以上的磁共振成像结果进行淋巴水肿诊断和分级,通过查阅电子病历和电话随访获取相关信息。采用SPSS 26.0软件包对数据进行统计学分析。结果:随着TNM分期、颈淋巴清扫范围的增加,患者淋巴水肿重度率增加。术前接受药物诱导化疗的患者与未接受化疗的患者相比,淋巴水肿重度率更高。不同严重水肿程度患者无瘤生存期无统计学差异。结论:头颈部淋巴水肿的发生与肿瘤分期、淋巴清扫的程度以及综合治疗方式有一定相关性,仍需进一步关注和研究。

不同茶树品种γ-氨基丁酸(GABA)富集差异分析

以一芽二叶茶鲜叶为试材,采取厌氧/好氧间歇交替富集技术富集茶鲜叶,对富集前后谷氨酸(Glu)含量、谷氨酸脱羧酶(GAD)活性、γ-氨基丁酸(GABA)含量、游离氨基酸(FAA)总量和茶叶色泽、香气差异进行分析,以期为GABA高富集潜力茶树品种的筛选提供参考依据。结果表明:8 h厌氧/好氧间歇交替富集处理显著提高了茶鲜叶GABA含量和FAA总量;不同茶树品种GABA富集潜力、富集前后FAA总量及富集前鲜叶GAD活性和Glu含量均以‘白叶1号’显著最高,其次是‘福鼎大白茶’;茶鲜叶FAA总量、Glu含量和GAD活性可作为筛选GABA高富集潜力茶树品种的参考指标。

上尿路结石内镜治疗手术体位研究进展

在上尿路结石手术中采用正确的手术体位可提供良好的手术视野、缩短手术时间、减少并发症发生率,同时能够确保患者的气道安全和舒适度。腔内手术是肾结石和输尿管结石的首选手术治疗方式,术中采用传统体位复发率及严重并发症发生率较高,因此有更多体位逐渐被尝试应用。本文综述近年国内外不同手术体位在经皮肾镜取石术(PCNL)、逆行肾内输尿管软镜碎石术(RIRS)以及PCNL联合RIRS中的适用范围和治疗效果,并对其优缺点进行总结,以供临床参考。

3种免热处理压铸铝合金对模具钢的侵蚀性研究

通过将模具钢浸入熔融铝合金液中并进行动态旋转熔损试验,研究了3种大型一体压铸用免热处理铝合金材料对2种典型压铸模具钢的侵蚀作用。结果表明:经20 min旋转熔损试验后,1#铝合金液中的模具钢表面侵蚀面积最小、质量损失最小、对模具钢的侵蚀最轻,因此,3种免热处理压铸铝合金中,1#铝合金的粘模倾向最小。应用新型免热处理材料时,应选择与该免热处理材料粘模适配性好的模具材料,以获得最小的侵蚀质量损失,保证模具寿命。

《临证指南医案》以通为用论治风湿痹思想浅析

从风湿痹的定义、病因病机、治法方药等多个方面对《临证指南医案》中诊治风湿痹的医案进行总结分析,认为风湿痹的病因为风湿阻络或夹杂寒、热、瘀等因素,治法主要有通表利湿、散寒通脉、清热通下、祛瘀通经等,强调以通为用、启闭通痹。以通为用思想贯穿于《临证指南医案》的遣方用药之中。

低碳低合金无碳化物贝氏体钢热处理工艺及组织性能研究

开展了实验钢在Ms点以上及以下保温不同时间的等温淬火实验,结合高分辨膨胀仪、电子背散射衍射(EBSD)、X射线衍射(XRD)等其它实验手段,探究了引入一次马氏体对贝氏体相变动力学的影响,以及不同等温时间转变后微观组织和力学性能之间的关系。结果表明,在Ms点以下等温阶段引入的一次马氏体显著地加速了贝氏体相变动力学,并且提高了实验钢的屈服强度和伸长率。这是因为引入的一次马氏体为贝氏体提供了更多的形核界面,并且获得了由回火马氏体、二次马氏体、贝氏体和残余奥氏体组成的多相组织,其中较多数量的残余奥氏体因TRIP效应从而使实验钢的塑性提高。实验钢在300℃等温2 h后,其抗拉强度、屈服强度分别为1475、986 MPa,伸长率高达18.5%。

城市建筑废弃物绿色处理与循环利用的协同发展研究

通过研究城市建筑废弃物绿色处理与循环利用的协同发展策略,分析当前绿色处理技术的应用现状,探讨再生骨料和再生混凝土循环利用的途径与方法,并在此基础上强调了协同发展的必要性与可行性,提出了政策引导、市场机制、技术创新与产业融合等协同发展的策略与模式。通过具体案例与经验分析,展示了协同发展的实践成果。这对促进城市建筑废弃物资源化利用、推动可持续发展具有重要意义,为相关政策的制定和实践提供了理论支持和参考。

肉毒素注射在手足多汗症及腋臭治疗的应用新进展

手足多汗症及腋臭严重影响患者的生活及社交,甚至可导致焦虑、抑郁等。肉毒素是一种通过靶向突触传递治疗高胆碱能活性疾病的神经毒素,已广泛应用于局部多汗症及腋臭的治疗,为安全、有效的微创手段。本文旨在综述肉毒素的作用机制及多汗症、腋臭治疗现状,重点探讨肉毒素在手足多汗症中的新型“无针化”、“无痛”技术,以及在腋臭治疗中的最新研究进展。